Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA.
Curr Pharm Des. 2011;17(13):1303-19. doi: 10.2174/138161211795703735.
Antimicrobial photodynamic therapy (aPDT) is an emerging alternative to antibiotics motivated by growing problems with multi-drug resistant pathogens. aPDT uses non-toxic dyes or photosensitizers (PS) in combination with harmless visible of the correct wavelength to be absorbed by the PS. The excited state PS can form a long-lived triplet state that can interact with molecular oxygen to produce reactive oxygen species such as singlet oxygen and hydroxyl radical that kill the microbial cells. To obtain effective PS for treatment of infections it is necessary to use cationic PS with positive charges that are able to bind to and penetrate different classes of microbial cells. Other drug design criteria require PS with high absorption coefficients in the red/near infra-red regions of the spectrum where light penetration into tissue is maximum, high photostability to minimize photobleaching, and devising compounds that will selectively bind to microbial cells rather than host mammalian cells. Several molecular classes fulfill many of these requirements including phenothiazinium dyes, cationic tetrapyrroles such as porphyrins, phthalocyanines and bacteriochlorins, cationic fullerenes and cationic derivatives of other known PS. Larger structures such as conjugates between PS and cationic polymers, cationic nanoparticles and cationic liposomes that contain PS are also effective. In order to demonstrate in vivo efficacy it is necessary to use animal models of localized infections in which both PS and light can be effectively delivered into the infected area. This review will cover a range of mouse models we have developed using bioluminescent pathogens and a sensitive low light imaging system to non-invasively monitor the progress of the infection in real time. Effective aPDT has been demonstrated in acute lethal infections and chronic biofilm infections; in infections caused by Gram-positive, Gram-negative bacteria and fungi; in infections in wounds, third degree burns, skin abrasions and soft-tissue abscesses. This range of animal models also represents a powerful aid in antimicrobial drug discovery.
抗菌光动力疗法(aPDT)是一种新兴的抗生素替代疗法,其动机是多药耐药病原体日益严重的问题。aPDT 使用无毒染料或光敏剂(PS)与无害的正确波长的可见光结合使用,该 PS 可以被吸收。激发态 PS 可以形成长寿命的三重态,与分子氧相互作用产生活性氧物质,如单线态氧和羟基自由基,从而杀死微生物细胞。为了获得有效的 PS 来治疗感染,有必要使用带正电荷的阳离子 PS,该 PS 能够与不同种类的微生物细胞结合并穿透它们。其他药物设计标准要求 PS 在光谱的红光/近红外区域具有高吸收系数,该区域的光穿透组织的能力最强,具有高的光稳定性以最小化光漂白,并且设计出的化合物将选择性地与微生物细胞结合而不是与宿主哺乳动物细胞结合。包括吩噻嗪染料、阳离子四吡咯如卟啉、酞菁和细菌叶绿素、阳离子富勒烯和其他已知 PS 的阳离子衍生物在内的几种分子类别满足了许多这些要求。较大的结构,如 PS 和阳离子聚合物、阳离子纳米粒子和含有 PS 的阳离子脂质体之间的缀合物,也具有很好的效果。为了证明体内疗效,有必要使用局部感染的动物模型,其中 PS 和光都可以有效地输送到感染区域。本综述将涵盖我们使用生物发光病原体和灵敏的低光成像系统开发的一系列小鼠模型,以非侵入性地实时监测感染的进展。在急性致死性感染和慢性生物膜感染、革兰氏阳性菌、革兰氏阴性菌和真菌引起的感染、伤口、三度烧伤、皮肤擦伤和软组织脓肿感染中,都证明了有效的 aPDT。这种范围广泛的动物模型也为抗菌药物的发现提供了有力的帮助。