Use of Photodynamic Therapy Associated with Antimicrobial Peptides for Bacterial Control: A Systematic Review and Meta-Analysis

Abstract

Considering the challenges related to antimicrobial resistance, other strategies for controlling infections have been suggested, such as antimicrobial photodynamic therapy (aPDT) and antimicrobial peptides (AMP). This study aims to perform a systematic review and meta-analysis to obtain evidence on the antimicrobial effectiveness of aPDT associated with AMP and establish in vitro knowledge on this topic for further study designs. The PubMed, Scopus, Web of Science, Science Direct, Scielo, and Cochrane Library databases were searched. Two independent and calibrated researchers (Kappa = 0.88) performed all the systematic steps according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The odds ratio (OR) was used as the effect measure. The Peto method was used to perform the meta-analysis due to the sparse data. Twenty studies were included in the present review. The result was significant (OR = 0.14/p = 0.0235/I-squared = 0%), showing better outcomes of aPDT associated with peptides than those of aPDT alone for controlling the microbial load. Only 20% of the studies included evaluated this approach in a biofilm culture. Combined treatment with aPDT and AMP highly increased the ability of microbial reduction of Gram-positive and Gram-negative bacteria. However, additional blind studies are required to evaluate the efficacy of this therapy on microbial biofilms.

Zwitterionic Core-Sheath Nanofibers in Antibacterial Photodynamic Therapy

“…Antibacterial photodynamic therapy (aPDT) is considered as an alternative strategy to effectively kill pathogenic bacteria but has low tendency to induce the appearance of undesirable drug-resistant strains. − The mechanism of aPDT relies on a photosensitizer (PS) in the presence of oxygen and light of appropriate wavelength to generate highly damaging reactive oxygen species (ROS) (e.g., superoxide, hydroxyl radicals, etc.) or singlet oxygen species ( 1 O 2 ) via the type I or type II processes, respectively. , The generated ROS or 1 O 2 produces toxic effects on pathogenic bacteria, including oxidizing the cell membrane of pathogens that cause damage and increase its permeability, inactivating enzymes and proteins, damaging DNA, etc. , Several photosensitizers have been demonstrated to effectively inactivate microorganisms without causing tissue damage to the host .…”

In Vitro Evaluation of Photodynamic Activity of Plant Extracts from Senna Species against Microorganisms of Medical and Dental Interest

“…In addition, nanoparticles improve the bioavailable, solubility, selectivity and can be used to overtake the cytotoxicity effect related to possible new drugs and PS [ 40 , 41 , 42 , 43 ]. Besides that, antimicrobial peptides can be also utilized in combination with aPDT [ 45 ] to overcome these microbial challenge citated above.…”

Histological and Histomorphometric Evaluation of Implanted Photodynamic Active Biomaterials for Periodontal Bone Regeneration in an Animal Study

“…Both biomaterials, also contained the photosensitizer mTHPC that enables a strong antibacterial surface effect upon illumination with light at 652 nm. As shown by various authors, antimicrobial photodynamic therapy (aPDT) is efficient in suppressing different oral pathogenic bacterial species to significant high extents [ 33 , 34 , 60 , 61 , 62 , 63 ]. aPDT is also considered an alternative to the systemic treatment of biofilm-related infectious diseases with antibiotics [ 64 , 65 , 66 ].…”