Photodynamic therapy for localized infections--state of the art.
Photodynamic therapy for localized infections--state of the art.
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DOI：
10.1016/j.pdpdt.2009.10.008
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发表时间：
2009-09
影响因子：
3.3
通讯作者：
Hamblin, Michael R.
中科院分区：
文献类型：
--
作者：
Dai, Tianhong;Huang, Ying-Ying;Hamblin, Michael R.
光动力疗法（PDT）是在一百多年前通过观察当无害染料和可见光在体外结合时杀死微生物而发现的。从那时起，它主要被开发为癌症，眼科疾病和皮肤病的治疗。然而，近年来对PDT的抗微生物作用的兴趣已经恢复，并且已经提出将其作为多种局部感染的治疗。这种兴趣的复苏在很大程度上是由许多种类的病原体中抗药性的不可阻挡的增加所驱动的。PDT的优点包括与抗生素抗性无关的相等的杀伤效果，以及不诱导PDT抗性。缺点包括当光被关闭时，抗微生物效果停止，以及对微生物细胞的选择性低于宿主组织。本综述将涵盖使用PDT杀死或杀灭离体组织和生物材料（如血液）中的病原体。PDT已成功地用于杀灭病原体，甚至在几种局部感染的动物模型中挽救生命，例如表面伤口、烧伤、口腔部位、脓肿和中耳。PDT用于病毒性乳头状瘤病病变和痤疮的大量临床研究涉及其抗微生物作用，但尚不清楚这种微生物杀灭对整体治疗结果的重要性。牙周炎的PDT是一种快速增长的临床应用，其他牙科应用正在研究中。PDT正在临床研究用于其他皮肤病感染，如利什曼病和分枝杆菌。抗菌PDT在未来将变得更加重要，因为预计抗生素耐药性只会继续增加。
Photodynamic therapy (PDT) was discovered over one hundred years ago by observing the killing of microorganisms when harmless dyes and visible light were combined in vitro. Since then it has primarily been developed as a treatment for cancer, ophthalmologic disorders and in dermatology. However in recent years interest in the antimicrobial effects of PDT has revived and it has been proposed as a therapy for a large variety of localized infections. This revival of interest has largely been driven by the inexorable increase in drug resistance amongst many classes of pathogen. Advantages of PDT include equal killing effectiveness regardless of antibiotic resistance, and a lack of induction of PDT resistance. Disadvantages include the cessation of the antimicrobial effect when the light is turned off, and less than perfect selectivity for microbial cells over host tissue. This review will cover the use of PDT to kill or inactivate pathogens in ex vivo tissues and in biological materials such as blood. PDT has been successfully used to kill pathogens and even to save life in several animal models of localized infections such as surface wounds, burns, oral sites, abscesses and the middle ear. A large number of clinical studies of PDT for viral papillomatosis lesions and for acne refer to its anti-microbial effect, but it is unclear how important this microbial killing is to the overall therapeutic outcome. PDT for periodontitis is a rapidly growing clinical application and other dental applications are under investigation. PDT is being clinically studied for other dermatological infections such as leishmaniasis and mycobacteria. Antimicrobial PDT will become more important in the future as antibiotic resistance is only expected to continue to increase.
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