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亚甲蓝和碘化钾介导的光动力抗菌疗法治疗雌性大鼠尿路感染模型。

Antimicrobial photodynamic therapy mediated by methylene blue and potassium iodide to treat urinary tract infection in a female rat model.

机构信息

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA.

Department of Dermatology, Harvard Medical School, Boston, MA, 02115, USA.

出版信息

Sci Rep. 2018 May 8;8(1):7257. doi: 10.1038/s41598-018-25365-0.

Abstract

Drug-resistant urinary tract infections (UTIs) are difficult and sometimes impossible to treat. Many UTIs are caused by uropathogenic Escherichia coli (UPEC). We developed an intact rat model of UTI, by catheterizing female rats and introducing a bioluminescent UPEC strain into the female rat bladder which lasted for up to six days. We recently showed that antimicrobial photodynamic inactivation (aPDI) of a bacterial infection mediated by the well-known phenothiazinium salt, methylene blue (MB) could be strongly potentiated by addition of the non-toxic salt potassium iodide (KI). In the intact rat model we introduced MB into the bladder by catheter, followed by KI solution and delivered intravesicular illumination with a diffusing fiber connected to a 1 W 660 nm laser. Bioluminescent imaging of the bacterial burden was carried out during the procedure and for 6 days afterwards. Light-dose dependent loss of bioluminescence was observed with the combination of MB followed by KI, but recurrence of infection was seen the next day in some cases. aPDT with MB + KI gave a significantly shorter duration of infection compared to untreated controls. aPDT with MB alone was the least effective. No signs of aPDT damage to the bladder lining were detected. This procedure to treat urinary tract infections without antibiotics by using already approved pharmaceutical substances (MB and KI) may have clinical applicability, either initially as a stand-alone therapy, or as an adjunct to antibiotic therapy by a rapid and substantial reduction of the bacterial burden.

摘要

耐药性尿路感染 (UTI) 难以治疗,有时甚至无法治疗。许多 UTI 是由尿路致病性大肠杆菌 (UPEC) 引起的。我们通过给雌性大鼠导尿并将生物发光 UPEC 菌株引入雌性大鼠膀胱,建立了完整的 UTI 大鼠模型,该模型可持续长达六天。我们最近表明,由著名的吩噻嗪盐亚甲蓝 (MB) 介导的抗菌光动力失活 (aPDI) 可以通过添加无毒盐碘化钾 (KI) 得到强烈增强。在完整的大鼠模型中,我们通过导尿管将 MB 引入膀胱,然后是 KI 溶液,并通过连接到 1 W 660nm 激光的漫射光纤进行膀胱内照射。在该过程中以及之后的 6 天内,进行细菌负荷的生物发光成像。用 MB 加 KI 观察到光剂量依赖性生物发光损失,但在某些情况下,第二天会出现感染复发。与未治疗的对照组相比,MB+KI 的 aPDT 使感染持续时间明显缩短。单独使用 MB 的 aPDT 效果最差。未发现膀胱衬里的 aPDT 损伤迹象。这种使用已批准的药物(MB 和 KI)治疗尿路感染而不使用抗生素的方法可能具有临床适用性,无论是最初作为单一疗法,还是作为抗生素治疗的辅助手段,通过迅速和实质性地降低细菌负荷来增强抗生素治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa05/5940872/9779747b56ec/41598_2018_25365_Fig1_HTML.jpg

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