Laboratory of Applied Microbiology, Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-903, Brazil.
Department of Biochemistry and Organic Chemistry, Institute of Chemistry, São Paulo State University (UNESP), Araraquara 14800-900, Brazil.
Int J Mol Sci. 2022 Mar 17;23(6):3226. doi: 10.3390/ijms23063226.
Considering the challenges related to antimicrobial resistance, other strategies for controlling infections have been suggested, such as antimicrobial photodynamic therapy (aPDT) and antimicrobial peptides (AMP). This study aims to perform a systematic review and meta-analysis to obtain evidence on the antimicrobial effectiveness of aPDT associated with AMP and establish in vitro knowledge on this topic for further study designs. The PubMed, Scopus, Web of Science, Science Direct, Scielo, and Cochrane Library databases were searched. Two independent and calibrated researchers (Kappa = 0.88) performed all the systematic steps according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The odds ratio (OR) was used as the effect measure. The Peto method was used to perform the meta-analysis due to the sparse data. Twenty studies were included in the present review. The result was significant (OR = 0.14/ = 0.0235/I-squared = 0%), showing better outcomes of aPDT associated with peptides than those of aPDT alone for controlling the microbial load. Only 20% of the studies included evaluated this approach in a biofilm culture. Combined treatment with aPDT and AMP highly increased the ability of microbial reduction of Gram-positive and Gram-negative bacteria. However, additional blind studies are required to evaluate the efficacy of this therapy on microbial biofilms.
考虑到与抗菌药物耐药性相关的挑战，已经提出了其他控制感染的策略，如抗菌光动力疗法（aPDT）和抗菌肽（AMP）。本研究旨在进行系统评价和荟萃分析，以获得有关 aPDT 联合 AMP 的抗菌效果的证据，并为进一步的研究设计建立该主题的体外知识。检索了 PubMed、Scopus、Web of Science、Science Direct、Scielo 和 Cochrane Library 数据库。两位独立且经过校准的研究人员（Kappa = 0.88）根据系统评价和荟萃分析的首选报告项目（PRISMA）进行了所有系统步骤。使用比值比（OR）作为效应量。由于数据稀疏，采用 Peto 方法进行荟萃分析。本综述共纳入 20 项研究。结果具有统计学意义（OR = 0.14/ = 0.0235/I-squared = 0%），表明 aPDT 联合肽比单独 aPDT 更能控制微生物负荷。只有 20%的研究在生物膜培养中评估了这种方法。联合治疗 aPDT 和 AMP 可显著提高减少革兰氏阳性和革兰氏阴性细菌的能力。然而，需要进一步的盲法研究来评估这种治疗方法对微生物生物膜的疗效。
