Enhancing wound healing in recalcitrant leg ulcers with aminolevulinic acid-mediated antimicrobial photodynamic therapy

Lin, Ming Hsien; Lee, Julia Yu Yun; Pan, Shiyan; Wong, Tak Wah

doi:10.1016/j.pdpdt.2020.102149

Cited by 17 publications

(33 citation statements)

References 7 publications

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“…Cucurmin is known to be a photosensitiser [ 150 , 151 , 152 , 153 , 154 ], and an encapsulated form of it in silica nanoparticles was used with APDT in an in vitro study on human fibroblast cultures, demonstrating its efficacy in reducing both the bacterial count of S. aureus and the production of biofilm, while also allowing improved human fibroblast activity [ 56 ].…”

Section: Resultsmentioning

confidence: 99%

“…In our review of the literature, many studies do not consider the histological evaluation of wound healing, preventing an assessment of their effect on the healing process and their direct correlation with the anti-biofilm action. However, many molecules have been referred with excellent potential against the staphylococcal biofilm and represent an important therapeutic possibility worthy of further studies, including applications on humans [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 ,…”

Section: Discussionmentioning

confidence: 99%

“…An important role in the treatment of wounds infected with biofilm-producing staphylococcal strains is played by APDT, which was proven, in association with RLP068/CI, [ 152 ] to be faster than teicoplanin in reducing bacterial load and more effective in wound healing on human fibroblast cultures. In vivo studies are needed to evaluate its efficacy in wound healing.…”

Section: Discussionmentioning

confidence: 99%

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New Perspectives on Old and New Therapies of Staphylococcal Skin Infections: The Role of Biofilm Targeting in Wound Healing

et al. 2021

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Among the most common complications of both chronic wound and surgical sites are staphylococcal skin infections, which slow down the wound healing process due to various virulence factors, including the ability to produce biofilms. Furthermore, staphylococcal skin infections are often caused by methicillin-resistant Staphylococcus aureus (MRSA) and become a therapeutic challenge. The aim of this narrative review is to collect the latest evidence on old and new anti-staphylococcal therapies, assessing their anti-biofilm properties and their effect on skin wound healing. We considered antibiotics, quorum sensing inhibitors, antimicrobial peptides, topical dressings, and antimicrobial photo-dynamic therapy. According to our review of the literature, targeting of biofilm is an important therapeutic choice in acute and chronic infected skin wounds both to overcome antibiotic resistance and to achieve better wound healing.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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New Perspectives on Old and New Therapies of Staphylococcal Skin Infections: The Role of Biofilm Targeting in Wound Healing

et al. 2021

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“…A-PDT seems to be an important alternative to antibiotics. A-PDT causes non-selective damage to different organelles in microbes and photodynamic-resistant bacterial strains have rarely been reported [17][18][19][20][21]. Due to the problem of antibiotic resistance, photodynamic therapy (PDT) is being developed as a novel antimicrobial treatment.…”

Section: Discussionmentioning

confidence: 99%

“…These ulcers healed after one to three sessions of A-PDT and there was no recurrence for more than 29 months. Lin stressed that A-PDT may be an effective treatment for patients with recalcitrant infected ulcers [17]. Cappugi described the treatment of 19 patients with refractory chronic venous ulcers using photodynamic therapy.…”

Section: Discussionmentioning

confidence: 99%

Photodynamic Therapy for the Treatment of Infected Leg Ulcers—A Pilot Study

et al. 2021

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Chronic and infected leg ulcers (LUs) are painful, debilitating, resistant to antibiotics, and immensely reduce a patient’s quality of life. The purpose of our study was to demonstrate the efficacy of photodynamic therapy (PDT) for the treatment of infected chronic LUs. Patients were randomized into two experimental groups: the first group received 5-aminolevulinic acid photodynamic therapy (ALA-PDT) (10 patients), and the second group of 10 patients received local octenidine dihydrochloride (Octenilin gel) exposed to a placebo light source with an inserted filter that mimiced red light. In the PDT group, we used 20% ALA topically applied for 4 hrs and irradiation from a Diomed laser source with a wavelength of 630 nm at a fluency of 80 J/cm2. ALA-PDT was performed 10 times during a 14-day hospitalization in 10 patients of both sexes aged 40–85 years with chronic leg ulcers. Treatments were carried out at 3-week intervals for 3–5 cycles. At 8-month follow-up with the PDT group, complete remission (CR) was obtained in four patients (40%), partial response (>50% reduction in ulcer diameter) in four patients (40%), and no response in two patients (20%) who additionally developed deterioration of the local condition with swelling, erythema, and inflammation. To assess the degree of pain during the trials, we used a numeric rating scale (NRS). From the preliminary results obtained, we concluded that PDT can be used to treat leg ulcers as a minimally invasive and effective method with no serious side effects, although further studies on a larger group of patients with LUs are warranted.

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Skin wound healing in diabetic rat model using low‐dose photodynamic therapy

Khorsandi,

Fekrazad

2024

Biotech and App Biochem

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Chronic wound is one of the major challenges in medicine and imposes a heavy financial burden on the healthcare of different countries. Diabetic foot ulcers as one of the important examples for chronic wounds can lead to lower limb amputation, disability, and death in diabetics. In this regard, novel technology with low side effects got attention in recent years. Low‐dose photodynamic therapy (LDPDT) is one of the noninvasive techniques that can be considered for wound healing in diabetic wounds. In this experiment, we aim to study the effect of LDPDT on diabetic rats’ wound healing and compare it to healthy rats. In this in vitro experimental study, 32 male rats were used. Rats in both normal and diabetic (streptozotocin injection) groups after being wounded (two wounds [0.8 × 0.8 cm]) on the back of each rat were randomly divided into four groups, including the control group (without treatment), radiation‐only (660 nm−1 J/cm2) group, 5‐ALA‐only (1 µg/mL) group, and LDPDT‐recipient group. The procedure has been done for 2 days, and at the end of Days 3, 7, 14, and 21, the wound sample was sent to the histopathology laboratory, and the wound size and tissue indices in these groups were evaluated by histology and microscopy techniques. The impact of low concentrations of 5‐ALA and low irradiation energy density in both normal and diabetic rats were positive, which accelerated the wound‐healing process as seen in the histology study. In diabetic rats treated with only radiation and LDPDT, the process of epithelial regeneration, collagen production, reduction of mast cells, and production of follicles was more as compared to the normal group. The results suggest that LDPDT can have a positive impact on the diabetic rat model wound healing.

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Enhancing wound healing in recalcitrant leg ulcers with aminolevulinic acid-mediated antimicrobial photodynamic therapy

Cited by 17 publications

References 7 publications

New Perspectives on Old and New Therapies of Staphylococcal Skin Infections: The Role of Biofilm Targeting in Wound Healing

New Perspectives on Old and New Therapies of Staphylococcal Skin Infections: The Role of Biofilm Targeting in Wound Healing

Photodynamic Therapy for the Treatment of Infected Leg Ulcers—A Pilot Study

Skin wound healing in diabetic rat model using low‐dose photodynamic therapy

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