Laboratory of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307 Gdansk, Poland.
Department of Pharmaceutical Microbiology, The Faculty of Pharmacy, Medical University of Gdansk, Hallera 107, 80-416 Gdansk, Poland.
Int J Mol Sci. 2021 Feb 23;22(4):2224. doi: 10.3390/ijms22042224.
Due to rapidly growing antimicrobial resistance, there is an urgent need to develop alternative, non-antibiotic strategies. Recently, numerous light-based approaches, demonstrating killing efficacy regardless of microbial drug resistance, have gained wide attention and are considered some of the most promising antimicrobial modalities. These light-based therapies include five treatments for which high bactericidal activity was demonstrated using numerous in vitro and in vivo studies: antimicrobial blue light (aBL), antimicrobial photodynamic inactivation (aPDI), pulsed light (PL), cold atmospheric plasma (CAP), and ultraviolet (UV) light. Based on their multitarget activity leading to deleterious effects to numerous cell structures-i.e., cell envelopes, proteins, lipids, and genetic material-light-based treatments are considered to have a low risk for the development of tolerance and/or resistance. Nevertheless, the most recent studies indicate that repetitive sublethal phototreatment may provoke tolerance development, but there is no standard methodology for the proper evaluation of this phenomenon. The statement concerning the lack of development of resistance to these modalities seem to be justified; however, the most significant motivation for this review paper was to critically discuss existing dogma concerning the lack of tolerance development, indicating that its assessment is more complex and requires better terminology and methodology.
由于抗菌药物耐药性的迅速发展，迫切需要开发替代的非抗生素策略。最近，许多基于光的方法已经引起了广泛的关注，这些方法显示出无论微生物对抗菌药物的耐药性如何都具有杀菌效果，被认为是最有前途的抗菌方式之一。这些基于光的疗法包括五种治疗方法，许多体外和体内研究都证明了它们具有很高的杀菌活性：抗菌蓝光（aBL）、抗菌光动力灭活（aPDI）、脉冲光（PL）、冷等离体等离子体（CAP）和紫外线（UV）光。基于其多靶向活性，对许多细胞结构（即细胞包膜、蛋白质、脂质和遗传物质）造成有害影响，基于光的治疗方法被认为发生耐药性和/或耐受性发展的风险较低。然而，最近的研究表明，重复的亚致死光处理可能会引发耐受性的发展，但目前还没有用于正确评估这种现象的标准方法。关于这些方法不会产生耐药性的说法似乎是合理的；然而，撰写这篇评论文章的主要动机是批判性地讨论关于不会产生耐受性发展的现有教条，表明其评估更为复杂，需要更好的术语和方法。
