Wiench Rafał, Fiegler-Rudol Jakub, Grzech-Leśniak Kinga, Skaba Dariusz, Arnabat-Dominguez Josep
Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
Laser Laboratory, Department of Integrated Dentistry, Faculty of Dentistry, Wroclaw Medical University, 50-425 Wroclaw, Poland.
Int J Mol Sci. 2025 Aug 20;26(16):8049. doi: 10.3390/ijms26168049.
Antimicrobial resistance is a critical global health issue exacerbated by biofilm-associated infections that often resist conventional therapies. Photodithazine-mediated antimicrobial photodynamic therapy (PDZ-aPDT) has emerged as a promising alternative, demonstrating a broad-spectrum antimicrobial efficacy against multidrug-resistant bacteria and fungi, including those in biofilms. This systematic review evaluates the efficacy, safety, and clinical applications of PDZ-aPDT by synthesizing evidence from preclinical and clinical studies. Databases including PubMed, Embase, Scopus, and Cochrane were systematically searched, resulting in the inclusion of 13 studies for qualitative analysis. PDZ-aPDT consistently reduced the microbial burden in various models, including oral candidiasis, denture stomatitis, acne, and infections related to medical devices. Synergistic combinations with conventional antimicrobials and adjunctive therapies (e.g., DNase I) further enhanced its effectiveness. However, the evidence base remains limited by methodological variability, small sample sizes, and short follow-up periods. Future research should focus on rigorous clinical trials with standardized protocols and extended follow-up to establish definitive efficacy and safety profiles, facilitating a broader clinical implementation in combating antimicrobial resistance.
抗菌耐药性是一个严峻的全球健康问题，生物膜相关感染使这一问题更加恶化，这类感染往往对传统疗法具有抗性。光二噻嗪介导的抗菌光动力疗法（PDZ-aPDT）已成为一种有前景的替代方法，对包括生物膜中的细菌和真菌在内的多重耐药菌展现出广谱抗菌功效。本系统评价通过综合临床前和临床研究的证据，评估PDZ-aPDT的疗效、安全性及临床应用。对包括PubMed、Embase、Scopus和Cochrane在内的数据库进行了系统检索，最终纳入13项研究进行定性分析。PDZ-aPDT在各种模型中均持续降低了微生物负荷，这些模型包括口腔念珠菌病、义齿性口炎、痤疮以及与医疗器械相关的感染。与传统抗菌药物和辅助疗法（如脱氧核糖核酸酶I）的协同联合进一步增强了其有效性。然而，证据基础仍受方法学变异性、样本量小和随访期短的限制。未来的研究应聚焦于采用标准化方案并延长随访期的严格临床试验，以确立确切的疗效和安全性概况，从而推动在对抗抗菌耐药性方面更广泛的临床应用。
