Department of Infectious Diseases, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, 530021, China; Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Nanning, Guangxi, 530021, China.
Department of Otorhinolaryngology, Guangxi International Zhuang Medical Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, 530201, China.
Photodiagnosis Photodyn Ther. 2021 Jun;34:102310. doi: 10.1016/j.pdpdt.2021.102310. Epub 2021 Apr 24.
Antimicrobial photodynamic therapy (aPDT) using methylene blue (MB) plus potassium iodide (KI) has been shown to be effective in killing Candida albicans in many in vitro and in vivo studies, however, there are limited reports of clinical investigations. This study aimed to explore the clinical application of aPDT with MB plus KI for the treatment of oral infection caused by C. albicans in adult acquired immune deficiency syndrome (AIDS) patients.
A total of 21 adult AIDS patients with C. albicans oral candidiasis were divided into two groups according to MB concentration and received two consecutive aPDT treatments. Immediately before and after the aPDT treatments, C. albicans yeast isolates were recovered to measure the colony-forming units per mL (CFU/mL), biofilm formation, and to analyze the 25S rDNA genotype. Patients were assessed for the clinical recovery of oral lesions and improvement of symptoms.
The Log CFU/mL of C. albicans decreased significantly after the second aPDT but not the first aPDT. There was no significant difference between the two MB concentrations. Both aPDT protocols decreased the oral lesions and clinical symptoms with no significant difference after 2-fraction aPDT. The biofilm formation of C. albicans isolates did not change before and after aPDT. The killing efficiency of 2-fraction-aPDT was not associated with either biofilm formation or 25S rDNA genotype.
Two-fraction-aPDT with MB plus KI could reduce the number of viable C. albicans fungal cells and improve the clinical symptoms of oral candidiasis in adult AIDS patients, regardless of the biofilm formation or 25S rDNA genotype of infected C. albicans isolates.
使用亚甲蓝（MB）加碘化钾（KI）的抗菌光动力疗法（aPDT）已在许多体外和体内研究中显示出对杀死白色念珠菌的有效性，然而，临床研究的报道有限。本研究旨在探索 MB 加 KI 的 aPDT 治疗成人获得性免疫缺陷综合征（AIDS）患者口腔白色念珠菌感染的临床应用。
将 21 例成人 AIDS 患者的白色念珠菌口腔念珠菌病分为两组，根据 MB 浓度进行分组，并接受两次连续的 aPDT 治疗。在 aPDT 治疗前后，立即回收白色念珠菌酵母分离物以测量每毫升的菌落形成单位（CFU/mL）、生物膜形成，并分析 25S rDNA 基因型。对患者的口腔病变临床恢复和症状改善情况进行评估。
第二次 aPDT 后白色念珠菌的 Log CFU/mL 显著降低，但第一次 aPDT 后无明显降低。两种 MB 浓度之间无显著差异。两次 aPDT 方案均降低了口腔病变和临床症状，两次 aPDT 后无显著差异。白色念珠菌分离物的生物膜形成在 aPDT 前后没有变化。两次 aPDT 的杀伤效率与生物膜形成或 25S rDNA 基因型无关。
MB 加 KI 的两次 aPDT 可减少白色念珠菌真菌细胞的活菌数，并改善成人 AIDS 患者口腔念珠菌病的临床症状，与感染白色念珠菌分离物的生物膜形成或 25S rDNA 基因型无关。
