Photodynamic therapy of microbial infections: State of the art and perspectives
Photodynamic therapy of microbial infections: State of the art and perspectives
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DOI：
10.1615/jenvironpatholtoxicoloncol.v25.i1-2.320
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发表时间：
2006-01-01
影响因子：
2.4
通讯作者：
Jori, G
中科院分区：
文献类型：
--
作者：
Jori, G
光动力疗法（PDT）作为一种有效的替代治疗微生物感染的方法正在成熟，这一问题目前因抗生素耐药微生物菌株的日益广泛扩散而加剧。特别是，使用红光吸收光敏剂作为光动力抗菌剂具有各种有利的特点，包括：(a)选定的吩噻嗪类、卟啉类和酞菁类具有广谱的抗菌作用，通过使用一种光疗方案和温和的照射条件，促进革兰氏（+）和革兰氏（-）细菌、真菌、支原体和寄生虫的光敏失活；(b)在光化学活性剂量下，卟啉/酞菁在黑暗中没有明显的毒性；(c)微生物细胞死亡主要是由典型的多靶点过程造成的膜光损伤造成的，这可以最大限度地减少发生诱变过程和选择抗光细胞的风险；(d)这种光敏剂对野生菌株和耐抗生素菌株的作用效率基本相同，而未观察到光抗性微生物病原体的选择；(e)抗生素和光动力疗法的结合是可能的。提供了一个典型的酞菁致敏光灭活耐甲氧西林金黄色葡萄球菌（MRSA）的例子。目前，抗菌PDT似乎特别方便治疗局部感染，如口腔念珠菌病、牙周炎或慢性伤口。
Photodynamic therapy (PDT) is coming of age as an efficient alternative treatment for microbial infections, a problem which is presently aggravated by the increasingly widespread diffusion of antibiotic-resistant microbial strains. In particular, the use of red light-absorbing photosensitizers as photodynamic antimicrobial agents is characterized by various favorable features, including: (a) the broad spectrum of antimicrobial action of selected phenothiazines, porphyrins, and phthalo-cyanines, which promote the photosensitized inactivation of Gram(+) and Gram(-) bacteria, fungi, mycoplasma, and parasites by using one phototherapeutic protocol and mild irradiation conditions; (b) porphyrins/phthalocyanines display no appreciable toxicity in the dark at photochemically active doses; (c) microbial cell death is primarily a consequence of membrane photodamage through a typically multi-target process, which minimizes the risk of both the onset of mutagenic processes and the selection of photoresistant cells; (d) such photosensitizers act with essentially identical efficiency against both wild and antibiotic-resistant strains, whereas no selection of photoresistant microbial pathogens has been observed; (e) a combination between antibiotic-based and photodynamic therapy is possible. A typical example of phthalocyanine-sensitized photoinactivation of methicillin-resistant Staphylococcus aureus (MRSA) is provided. At present, antimicrobial PDT appears to be especially convenient for the treatment of localized infections, such as oral candidosis, periodontitis or chronic wounds.