Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA; Department of Dermatology, Harvard Medical School, Boston, MA, USA; Department of Dermatology, Southwest Hospital, Third Military Medical University, Chongqing, China.
Curr Opin Pharmacol. 2013 Oct;13(5):731-62. doi: 10.1016/j.coph.2013.08.009. Epub 2013 Sep 20.
Owing to the worldwide increase in antibiotic resistance, researchers are investigating alternative anti-infective strategies to which it is supposed microorganisms will be unable to develop resistance. Prominent among these strategies, is a group of approaches which rely on light to deliver the killing blow. As is well known, ultraviolet light, particularly UVC (200-280 nm), is germicidal, but it has not been much developed as an anti-infective approach until recently, when it was realized that the possible adverse effects to host tissue were relatively minor compared to its high activity in killing pathogens. Photodynamic therapy is the combination of non-toxic photosensitizing dyes with harmless visible light that together produce abundant destructive reactive oxygen species (ROS). Certain cationic dyes or photosensitizers have good specificity for binding to microbial cells while sparing host mammalian cells and can be used for treating many localized infections, both superficial and even deep-seated by using fiber optic delivered light. Many microbial cells are highly sensitive to killing by blue light (400-470 nm) due to accumulation of naturally occurring photosensitizers such as porphyrins and flavins. Near infrared light has also been shown to have antimicrobial effects against certain species. Clinical applications of these technologies include skin, dental, wound, stomach, nasal, toenail and other infections which are amenable to effective light delivery.
由于抗生素耐药性在全球范围内的增加，研究人员正在研究替代抗感染策略，预计微生物将无法对此产生耐药性。在这些策略中，有一组方法依赖于光来发挥杀伤作用。众所周知，紫外线，特别是 UVC（200-280nm），具有杀菌作用，但直到最近才将其作为一种抗感染方法进行大量开发，当时人们意识到与宿主组织的可能不利影响相比，其在杀死病原体方面的高活性相对较小。光动力疗法是将无毒的光敏染料与无害的可见光结合在一起，共同产生大量破坏性的活性氧物质（ROS）。某些阳离子染料或光敏剂对结合微生物细胞具有很好的特异性，同时对宿主哺乳动物细胞具有保护作用，可用于治疗许多局部感染，包括通过光纤输送光治疗浅表和深部感染。许多微生物细胞由于积累了天然存在的光敏剂，如卟啉和黄素，对蓝光（400-470nm）的杀伤非常敏感。近红外光也已被证明对某些物种具有抗菌作用。这些技术的临床应用包括皮肤、牙齿、伤口、胃、鼻腔、脚趾甲和其他可有效进行光输送的感染。
