Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK.
Clinical Engineering, Salford Royal Foundation Trust, Salford, UK.
Photochem Photobiol Sci. 2022 Mar;21(3):385-395. doi: 10.1007/s43630-021-00169-w. Epub 2022 Feb 7.
Antimicrobial photodynamic therapy has become an important component in the treatment of human infection. This review considers historical guidelines, and the scientific literature to envisage what future clinical guidelines for treating skin infection might include. Antibiotic resistance, vertical and horizontal infection control strategies and a range of technologies effective in eradicating microbes without building up new resistance are described. The mechanism of action of these treatments and examples of their clinical use are also included. The research recommendations of NICE Guidelines on the dermatological manifestations of microbial infection were also reviewed to identify potential applications for PDT. The resistance of some microbes to antibiotics can be halted, or even reversed through the use of supplementary drugs, and so they are likely to persist as a treatment of infection. Conventional PDT will undoubtedly continue to be used for a range of skin conditions given existing healthcare infrastructure and a large evidence base. Daylight PDT may find broader antimicrobial applications than just Acne and Cutaneous Leishmaniasis, and Ambulatory PDT devices could become popular in regions where resources are limited or daylight exposure is not possible or inappropriate. Nanotheranostics were found to be highly relevant, and often include PDT, however, new treatments and novel applications and combinations of existing treatments will be subject to Clinical Trials.
抗菌光动力疗法已成为治疗人类感染的重要组成部分。本综述考虑了历史指南和科学文献，以设想未来治疗皮肤感染的临床指南可能包括哪些内容。描述了抗生素耐药性、垂直和水平感染控制策略以及一系列可有效消除微生物而不产生新耐药性的技术。还包括这些治疗方法的作用机制及其临床应用实例。还审查了 NICE 指南关于微生物感染的皮肤病表现的研究建议，以确定 PDT 的潜在应用。一些微生物对抗生素的耐药性可以通过使用辅助药物来阻止，甚至逆转，因此它们可能仍然是一种抗感染治疗方法。鉴于现有的医疗保健基础设施和大量的证据基础，传统 PDT 将无疑继续用于一系列皮肤疾病。日光 PDT 可能会在抗生素的应用范围比单纯痤疮和皮肤利什曼病更广，并且日间 PDT 设备可能在资源有限或日光照射不可能或不适当的地区流行。纳米治疗学被发现具有高度相关性，并且通常包括 PDT，然而，新的治疗方法以及现有治疗方法的新应用和组合将需要进行临床试验。
