Strategies to Potentiate Antimicrobial Photoinactivation by Overcoming Resistant Phenotypes

Authors

  • Domingo Mariano Adolfo Vera,

    1. Department of Chemistry, Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
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  • Mark H. Haynes,

    1. Center for Molecular Discovery, University of New Mexico, Albuquerque, NM
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  • Anthony R. Ball,

    1. Toxikon Corp., Bedford, MA
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  • Tianhong Dai,

    1. Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA
    2. Department of Dermatology, Harvard Medical School, Boston, MA
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  • Christos Astrakas,

    1. Division of Internal Medicine, Democritus University of Thrace Medical School, Alexandroupolis, Greece
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  • Michael J. Kelso,

    1. School of Chemistry, University of Wollongong, NSW, Australia
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  • Michael R. Hamblin,

    1. Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA
    2. Department of Dermatology, Harvard Medical School, Boston, MA
    3. Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA
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  • George P. Tegos

    Corresponding author
    1. Center for Molecular Discovery, University of New Mexico, Albuquerque, NM
    2. Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA
    3. Department of Dermatology, Harvard Medical School, Boston, MA
    4. Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM
      Corresponding author email: gtegos@salud.unm.edu (George P. Tegos)
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  • This paper is part of the Symposium-in-Print on “Antimicrobial Photodynamic Therapy and Photoinactivation.”

Corresponding author email: gtegos@salud.unm.edu (George P. Tegos)

Abstract

Conventional antimicrobial strategies have become increasingly ineffective due to the emergence of multidrug resistance among pathogenic microorganisms. The need to overcome these deficiencies has triggered the exploration of alternative treatments and unconventional approaches towards controlling microbial infections. Photodynamic therapy (PDT) was originally established as an anticancer modality and is currently used in the treatment of age-related macular degeneration. The concept of photodynamic inactivation requires cell exposure to light energy, typically wavelengths in the visible region that causes the excitation of photosensitizer molecules either exogenous or endogenous, which results in the production of reactive oxygen species (ROS). ROS produce cell inactivation and death through modification of intracellular components. The versatile characteristics of PDT prompted its investigation as an anti-infective discovery platform. Advances in understanding of microbial physiology have shed light on a series of pathways, and phenotypes that serve as putative targets for antimicrobial drug discovery. Investigations of these phenotypic elements in concert with PDT have been reported focused on multidrug efflux systems, biofilms, virulence and pathogenesis determinants. In many instances the results are promising but only preliminary and require further investigation. This review discusses the different antimicrobial PDT strategies and highlights the need for highly informative and comprehensive discovery approaches.

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