Comparative Antibacterial Efficacy of Photodynamic Therapy and Ultrasonic Irrigation Against Enterococcus faecalis In Vitro

Enterococcus faecalis poses a challenge to the efficacy of traditional root canal disinfection methods. This study was aimed to establish a synergistic root canal disinfection strategy combining ultrasonic irrigation with photodynamic therapy (PDT) together and to test its antibacterial efficacy against E. faecalis. Twenty‐seven bovine root canals infected with E. faecalis were randomly divided into three groups and treated with different disinfection methods as follows: ultrasonic irrigation with 2.5% NaOCl, methylene blue (MB)‐mediated PDT, or combined ultrasonic irrigation and PDT as described above. Quantification of E. faecalis was performed on the root canals before and immediately after the disinfection treatment. Residual bacteria were determined by counting colony‐forming units. Samples were randomly selected from the three groups, and the morphology of residual bacteria inside the dentinal tubules was studied by scanning electron microscopy. The number of surviving E. faecalis in the group treated with the combination method was significantly lower (P < 0.05) than those in the ultrasonic irrigation‐treated or PDT‐treated groups. Similar results were found in the morphological studies of the three groups. The results of our study highlighted the importance of combination of ultrasonic irrigation and PDT to produce significant antibacterial efficacy against E. faecalis during root canal disinfection.     

Minimizing Concentration of Sodium Hypochlorite in Root Canal Irrigation by Combination of Ultrasonic Irrigation with Photodynamic Treatment

Concentration of sodium hypochlorite (NaOCl) is positively correlated with its effectiveness in root canal disinfection but negatively correlated with its biocompatibility. The objective of this in vitro study was to compare the bactericidal effects among ultrasonic irrigation with different concentration of NaOCl alone or together with photodynamic treatment (PDT) against Enterococcus faecalis (E. faecalis) in infected root canals. One hundred and twenty bovine root canals contaminated with E. faecalis were randomly distributed into 12 groups treated with different disinfection methods: PDT, ultrasonic irrigation with NaOCl at different concentrations (0.5%, 1.0%, 2.0%, 2.5% and 5.25%), and ultrasonic irrigation with NaOCl at different concentrations plus PDT. Data of microorganism load were collected before and after disinfection and analyzed by one‐way ANOVA and LSD tests. Significantly enhanced antibacterial effects were noticed in groups treated by PDT plus 2.0% or 2.5% NaOCl irrigation (P < 0.05). No statistical differences existed in bactericidal efficacy among groups of PDT plus ultrasonic irrigation with 2.0%, 2.5% or 5.25% NaOCl, and ultrasonic irrigation with 5.25% NaOCl alone (P > 0.05). Our study confirmed the feasibility to reduce the concentration of NaOCl to a safer level while maintaining its antibacterial efficiency through synergistic effect of PDT with NaOCl ultrasonic irrigation.     

Liquid–liquid equilibria of aromatics removal from middle distillate using NMP

We investigated the removal of aromatics from a typical Kuwait middle distillate using liquid–liquid extraction. A multicomponent system; dodecane + hexadecane + 1,3,5-trimethyl benzene (mesitylene) + butylbenzene; was used to represent the middle distillate mixture. N-methyl-2-pyrrolidone (NMP) was used as a solvent. The liquid–liquid equilibria (LLE) of the mixture was studied over a temperature range of 293–323 K and at different solvent to feed ratios (1.35–1.97). The selectivity and distribution coefficient of the solvent were correlated successfully using the universal quasi-chemical (UNIQUAC) model for the pseudo-ternary system (paraffins (1) + aromatics (2) + NMP (3)) at the studied temperature range. The UNIQUAC model fit the experimental data with an average percentage root mean square deviation (rmds) of 0.2980%.     

Photodynamic Tumor Eradication With a Novel Targetable Photosensitizer: Strong Vascular Effects and Dependence on Treatment Repetition Versus Potentiation

A novel pyropheophorbide‐a (PPa) derivative, Ac‐sPPp, was developed in our lab for targeted photodynamic therapy (PDT) and combination therapies. Its versatile peptide moiety, high water‐solubility, amphiphilicity, and micellar aggregation allow efficient coupling to targeting moieties and convenient mixing with other therapeutics. Photosensitizer immunoconjugate (PIC) targeted PDT, using Ac‐sPPp conjugated to therapeutic anti‐epidermal growth factor receptor (EGFR) antibody cetuximab, and PDT + chemotherapy combination treatment, using Ac‐sPPp mixed with stealth liposomal doxorubicin (Doxil), were investigated as promising strategies for potentiating PDT and improving target specificity. Passively targeted PDT with Ac‐sPPp only or surfactant‐solubilized PPa was also investigated for comparison. The A‐431 human vulvar squamous cell carcinoma, xenografted in nude mice, was chosen as a tumor model because of its high EGFR expression and sensitivity to liposomal doxorubicin in vitro. Fluorescence imaging and PDT experiments showed that Ac‐sPPp formulations circulated far longer and provided superior tumor contrast and superior tumor control compared to PPa. Strong PDT vascular effects were observed by laser Doppler imaging regardless of whether Ac‐sPPp was passively or actively targeted. Passively targeted Ac‐sPPp PDT gave equivalent or better tumor control than PIC‐targeted PDT or PDT + Doxil combination therapy, and when treatments were repeated, it also yielded the highest cure rate.     

Luminol Chemiluminescence Reports Photodynamic Therapy‐Generated Neutrophil Activity In Vivo and Serves as a Biomarker of Therapeutic Efficacy

Inflammatory cells, most especially neutrophils, can be a necessary component of the antitumor activity occurring after administration of photodynamic therapy. Generation of neutrophil responses has been suggested to be particularly important in instances when the delivered photodynamic therapy (PDT) dose is insufficient. In these cases, the release of neutrophil granules and engagement of antitumor immunity may play an important role in eliminating residual disease. Herein, we utilize in vivo imaging of luminol chemiluminescence to noninvasively monitor neutrophil activation after PDT administration. Studies were performed in the AB12 murine model of mesothelioma, treated with Photofrin‐PDT. Luminol‐generated chemiluminescence increased transiently 1 h after PDT, followed by a subsequent decrease at 4 h after PDT. The production of luminol signal was not associated with the influx of Ly6G⁺ cells, but was related to oxidative burst, as an indicator of neutrophil function. Most importantly, greater levels of luminol chemiluminescence 1 h after PDT were prognostic of a complete response at 90 days after PDT. Taken together, this research supports an important role for early activity by Ly6G⁺ cells in the generation of long‐term PDT responses in mesothelioma, and it points to luminol chemiluminescence as a potentially useful approach for preclinical monitoring of neutrophil activation by PDT.     

Effects of Photobiomodulation on Root Resorption Induced by Orthodontic Tooth Movement and RANKL/OPG Expression in Rats

The aim of this study was to evaluate the effects of photobiomodulation on the repair of induced root resorption (RR) after orthodontic tooth movement. Twenty male rats were used in this study. Forty right and left upper first molars were evaluated and divided into four groups (n = 10): negative control group (NC), no tooth movement or irradiation; positive control group (PC), induced tooth movement and root resorption; conventional treatment group (CT), force was removed after 7 days; and photobiomodulation group (PBM) after force removal molars were irradiated every 48 h for 7 days using GaAlAs diode laser (810 nm). Energy per point was 1.5 J (100 mW, 15 s, 75 J cm^?2). NC and PC were euthanized on day 7; CT and PBM on day 14. Histomorphometric and immunohistochemsitry analyses showed increase in area of root resorption in all groups (P < 0.05) compared to NC. RR lacunae were larger in CT compared to PC and PBM at the compression side of the distal root. OPG was higher in PBM group (P < 0.05). PBM group showed low expression of RANKL compared to PC and CT on the tension side. PBM can potentially affect RR progression by increasing OPG expression in the compression area and decreasing number of clastic cells in the root surface.     

A Comparative Study of the Photosensitizer Penetration into Artificial Caries Lesions in Dentin Measured by the Confocal Raman Microscopy

This study utilized the confocal Raman microspectroscopy (CRM) technique for the first time to investigate the degree of the penetration of toluidine blue‐orto (TBO) in artificial caries lesions produced by two distinct caries‐inducing models. The dentin specimens (n = 10) were divided into three groups: control, in vitro and in situ. Thereafter, the lesion depth and the demineralization level were evaluated by cross‐sectional microhardness (CSMH). CRM mapping across the dentin surface was assessed after the dye application. The CSMH and CRM data were analyzed by t‐test and ANOVA, respectively (P < 0.05). The values of the lesion depth and the demineralization areas were higher for in situ samples (P < 0.05). The TBO penetration values (μm) for the control, in vitro and in situ groups were 44.8 ± 5.6, 46.1 ± 4.5 and 51.2 ± 8.5, respectively. There were no statistically significant differences among the groups (P > 0.05). The rate of TBO penetration was detected up to about <50 μm and the demineralization level did not influence the results. These results have showed promising parameters to develop new protocols for deep caries lesions management using photodynamic antimicrobial chemotherapy.     

Differential resin-dentin bonds created after caries removal with polymer burs

The objective of this article was to investigate the effect of carbide and polymer burs caries removal methods on the bond strength of different adhesives to dentin. Resin restorations were performed in sound and caries-affected dentin, after using polymer or carbide burs and bonding with four different adhesive (Single bond, SB; Clearfil SE bond, SEB; FL-Bond II, FLB; and Fuji II-LC, FUJI). Microtensile bond strength (MTBS) was measured. Data were analyzed with ANOVA and Student-Newman-Keuls tests. Debonded surfaces were observed by scanning electron microscopy. Bonded interfaces were examined using light microscopy (Masson's trichrome staining). In sound dentin, MTBS was similar for SEB and SB, and higher than that of FLB and FUJI. Bond strength to carbide bur prepared dentin was similar for SB, SEB, and FLB; FUJI presented the lowest. SB applied on polymer bur excavated dentin presented similar values to those of the carbide bur group; MTBS attained by SEB, FLB, and FUJI decreased when bonding to dentin treated with polymer burs; FUJI yielded pretesting failures in all specimens. Polymer burs created a thick smear layer that was not infiltrated by tested self-etching agents. The bonding effectiveness of self-etching and glass-ionomer-like adhesives to dentin decreased when polymer burs were used.     

Photodynamic Therapy Mediated by 5‐aminolevulinic Acid Promotes the Upregulation and Modifies the Intracellular Expression of Surveillance Proteins in Oral Squamous Cell Carcinoma

Expression of proteins related to cell surveillance has been described in tumors presenting resistance to photodynamic therapy (PDT). The aim of this study was to verify whether there was upregulation of proteins related to resistance in oral squamous cell carcinoma (OSCC) after PDT. OSCC was chemically induced in rats and treated after one cycle of PDT mediated by 5‐aminolevulinic acid (5‐ALA‐PDT). Immunolabeling of p‐NFκB, Bcl‐2, survivin, iNOS, p‐Akt, p‐mTOR and cyclin D1 was performed after the treatment. There was increased expression of Bcl‐2 (P = 0.008), iNOS (P = 0.020), p‐Akt (P = 0.020) and p‐mTOR (P = 0.010) by surviving neoplastic cells after PDT when compared to the control. In conclusion, after one cycle of 5‐ALA‐mediated PDT, Bcl‐2, p‐Akt, p‐mTOR and iNOS were upregulated in neoplastic cells of OSCC, suggesting an activation of antiapoptosis and cell proliferation pathways. This fact must be considered in the establishment of PDT protocols for OSCC treatment, mainly those in which PDT will be combined with chemotherapy drugs targeted at the studied proteins.     

Polydopamine-assisted co-deposition of polyacrylic acid inducing dentin biomimetic mineralization for tooth-like structure repair in vitro

The aging of the global population has caused dentin exposure and root caries to become significant patient-management issues in clinical dentistry. Biomimetic remineralization, as a non-invasive therapeutic method, is of great significance to solve the problem. Herein, a novel biomimetic-mineralizing strategy to induce the self-healing of dentin defects with similar tooth structure was developed through the easy one-step polydopamine (PDA)-assisted co-deposition of polyacrylic acid (PAA) (denoted as PDA@PAA) in vitro. Immersing demineralized dentin into PAA and dopamine (DA) mixed solutions. Hereafter, the modified demineralized dentin was immersed in the supersaturated solution of calcium and phosphate at 37 °C at designated time. Transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS) and attenuated total reflection fourier transform infrared (ATR-FTIR) were performed to analyze the interaction and co-deposition between PDA and PAA. The remineralization of demineralized dentin was characterized by field emission scanning electron microscope (FE-SEM), TEM, X-ray diffraction (XRD), friction and wear test, nanoindentation, acid resistance. And the cytocompatibility of PDA@PAA was evaluated by cell counting kit-8 (CCK-8) and cell morphology observation. The results that PAA inhibited further PDA polymerization and aggregation, PDA@PAA were co-deposited onto the surface of demineralized dentin matrix. SEM and TEM showed that the demineralized-dentin modified with PDA@PAA was completely remineralized at 12 h, not only the dentin tubules were occluded, but more importantly, the demineralized dentin collagen matrix was remineralized. Moreover, after mineralization for 24 h, a dense mineral layer similar to enamel structure was regenerated on the surface of dentin and closely combined with dentin. The results of mechanical properties and acid resistance suggested that the mechanical properties of the regenerated enamel-like structure are close to that of enamel, and its acid resistance is better than that of enamel. This study demonstrated that the PDA-assisted co-deposition of PAA can offer an inexpensive, rapid, and efficient strategy for the management of illnesses related to exposed and demineralized dentin.     

Photodynamic Inactivation of Conidia of the Fungi Metarhizium anisopliae and Aspergillus nidulans with Methylene Blue and Toluidine Blue

Antimicrobial photodynamic treatment (PDT) is a promising method that can be used to control localized mycoses or kill fungi in the environment. A major objective of the current study was to compare the conidial photosensitization of two fungal species (Metarhizium anisopliae and Aspergillus nidulans) with methylene blue (MB) and toluidine blue (TBO) under different incubation and light conditions. Parameters examined were media, photosensitizer (PS) concentration and light source. PDT with MB and TBO resulted in an incomplete inactivation of the conidia of both fungal species. Conidial inactivation reached up to 99.7%, but none of the treatments was sufficient to achieve a 100% fungicidal effect using either MB or TBO. PDT delayed the germination of the surviving conidia. Washing the conidia to remove unbound PS before light exposure drastically reduced the photosensitization of A. nidulans. The reduction was much smaller in M. anisopliae conidia, indicating that the conidia of the two species interact differently with MB and TBO. Conidia of green and yellow M. anisopliae mutants were less affected by PDT than mutants with white and violet conidia. In contrast to what occurred in PBS, photosensitization of M. anisopliae and A. nidulans conidia was not observed when PDT was performed in potato dextrose media.     

A Novel Prospective Study Assessing the Combination of Photodynamic Therapy and Proton Radiation Therapy: Safety and Outcomes When Treating Malignant Pleural Mesothelioma

Malignant pleural mesothelioma remains difficult to treat, with high failure rates despite optimal therapy. We present a novel prospective trial combining proton therapy (PT) and photodynamic therapy (PDT) and the largest‐ever mesothelioma PT experience (n = 10). PDT photosensitizers included porfimer sodium (2 mg·kg^?1; 24 h drug‐light interval) or 2‐[1‐hexyloxyethyl]‐2‐devinyl pyropheophorbide‐a (HPPH) (4 mg·m^?2;48 h) with wavelengths of 630 nm to 60J·cm^?2 and 665 nm to 15‐45J·cm^?2, respectively. With a median age of 69 years, patients were predominantly male (90%) with epithelioid histology (100%) and stage III‐IV disease (100%). PT was delivered to a median of 55.0 CGE/1.8‐2.0 CGE (range 50–75 CGE) adjuvantly (n = 8) or as salvage therapy (n = 2) following extended pleurectomy/decortication (ePD)/PDT. Two‐year local control was 90%, with distant and regional failure rates of 50% and 30%, respectively. All patients received chemotherapy, and four received immunotherapy. Surgical complications included atrial fibrillation (n = 3), pneumonia (n = 2), and deep vein thrombosis (n = 2). Median survival from PT completion was 19.5 months (30.3 months from diagnosis), and 1‐ and 2‐year survival rates were 58% and 29%. No patient experienced CTCAEv4 grade ≥2 acute or late toxicity. Our prolonged survival in very advanced‐stage patients compares favorably to survival for PT without PDT and photon therapy with PDT, suggesting possible spatial or systemic cooperativity and immune effect.     

Combination of surgical resection and photodynamic therapy of 9L gliosarcoma in the nude rat

The objective of the present study was to investigate the treatment of 9L gliosarcoma brain tumor in the rat with the combination of surgical resection and photodynamic therapy (PDT). Nude rats with intracranial 7-day-old 9L gliomas were randomly subjected to no treatment, PDT alone (Photofrin: 2 mg kg(-1), optical: 80 J cm(-2)), surgical resection alone or resection combined with 2 mg kg(-1) Photofrin-mediated PDT at an optical dose of 80 J cm(-2). All animals were sacrificed 14 days after tumor implantation. Hematoxylin-and-eosin and immunohistochemical stainings were performed to assess the tumor volume and the expression of vascular endothelial growth factor (VEGF) in the brain adjacent to the tumor (BAT) as well as the tumor cell apoptosis and proliferation. Our data show that both surgical resection alone and PDT alone significantly decreased tumor volume, but furthermore, surgical resection combined with PDT significantly reduced the tumor volume and reduced local tumor infiltration compared to either surgical resection or PDT treatment alone. PDT treatment with or without resection increased tumor apoptosis, but resection alone did not alter the tumor cell apoptosis compared with a nontreatment control group. Both surgical resection alone and PDT alone induced a significant increase in VEGF expression in the BAT; however intraoperative PDT did not further increase VEGF expression, compared with surgery alone or PDT alone. No significant differences were found in tumor cell proliferation as indicated by Ki67 immunoreactivity among the four groups. Our results suggest that PDT enhances the efficacy of surgical resection in the management of malignant gliomas without increasing VEGF expression in the BAT.     

Protoporphyrin IX–β‐Cyclodextrin Bimodal Conjugate: Nanosized Drug Transporter and Potent Phototoxin

Topical or systemic administration of 5‐aminolevulinic acid (ALA) and its esters results in increased production and accumulation of protoporphyrin IX (PpIX) in cancerous lesions allowing effective application of photodynamic therapy (PDT). The large concentrations of exogenous ALA practically required to bypass the negative feedback control exerted by heme on enzymatic ALA synthesis and the strong dimerization propensity of ALA are shortcomings of the otherwise attractive PpIX biosynthesis. To circumvent these limitations and possibly enhance the phototoxicity of PpIX by adjuvant chemotherapy, covalent bonding of PpIX with a drug carrier, β‐cyclodextrin (βCD) was implemented. The resulting PpIX + βCD product had both carboxylic termini of PpIX connected to the CD. PpIX + βCD was water soluble, was found to preferentially localize in mitochondria rather than in lysosomes both in MCF7 and DU145 cell lines while its phototoxiciy was comparable to that of PpIX. Moreover, PpIX + βCD effectively solubilized the breast cancer drug tamoxifen metabolite N‐desmethyltamoxifen (NDMTAM) in water. The PpIX + βCD/NDMTAM complex was readily internalized by both cell lines employed. Furthermore, the multimodal action of PpIX + βCD was demonstrated in MCF7 cells: while it retains the phototoxic profile of PpIX and its fluorescence for imaging purposes, PpIX + βCD can efficiently transport tamoxifen citrate intracellularly and confer cell death through a synergy of photo‐ and chemotoxicity.     

Atomic force microscopy of removal of dentin smear layers.

The regular periodontal practice of scaling and root planing produces a smear layer on the root surface that is detrimental to the readhesion of tissues during subsequent regeneration therapy. Although it has been demonstrated that gels containing the chelating agent ethylenediaminetetraacetic acid (EDTA) can assist in the removal of this contaminating layer, no quantitative method is yet available by which to evaluate the efficiency of the treatment. In this article, the power of atomic force microscopy (AFM) as a technique for monitoring and mapping the surfaces of dentinal roots is demonstrated. Roughness parameters of teeth that had been scaled and root planed were determined from AFM images acquired both before and after treatment with EDTA. The results confirmed that EDTA is an efficient cleaning agent and that dentinal samples free from a smear layer are significantly rougher than the same samples covered by a contaminating layer. AFM analysis is superior to alternative methods involving scanning electron microscopy because the same sample section can be analyzed many times, thus permitting it to be used as both the control and the treatment surface.     

Photodynamic therapy induces selective extravasation of macromolecules: Insights using intravital microscopy

Photodynamic therapy (PDT) with Visudyne^® acts by direct cellular phototoxicity and/or by an indirect vascular-mediated effect. Here, we demonstrate that the vessel integrity interruption by PDT can promote the extravasation of a macromolecular agent in normal tissue. To obtain extravasation in normal tissue PDT conditions were one order of magnitude more intensive than the ones in tissue containing neovessels reported in the literature.Fluorescein isothiocyanate dextran (FITC-D, 2000 kDa), a macromolecular agent, was intravenously injected 10 min before (LK0 group, n = 14) or 2 h (LK2 group, n = 16) after Visudyne^®-mediated PDT in nude mice bearing a dorsal skin fold chamber. Control animals had no PDT (CTRL group, n = 8). The extravasation of FITC-D from blood vessels in striated muscle tissue was observed in both groups in real-time for up to 2500 s after injection. We also monitored PDT-induced leukocyte rolling in vivo and assessed, by histology, the corresponding inflammatory reaction score in the dorsal skin fold chambers.In all animals, at the applied PDT conditions, FITC-D extravasation was significantly enhanced in the PDT-treated areas as compared to the surrounding non-treated areas (p < 0.0001). There was no FITC-D leakage in the control animals. Animals from the LK0 group had significantly less FITC-D extravasation than those from the LK2 group (p = 0.0002). In the LK0 group FITC-D leakage correlated significantly with the inflammation (p < 0.001).At the selected conditions, Visudyne^®-mediated PDT promotes vascular leakage and FITC-D extravasation into the interstitial space of normal tissue. The intensity of vascular leakage depends on the time interval between PDT and FITC-D injection. This concept could be used to locally modulate the delivery of macromolecules in vivo.     

Angiogenesis induced by photodynamic therapy in normal rat brains

Angiogenesis promotes tumor growth and invasiveness in brain. Because brain injury often induces expression of angiogenic-promoting molecules, we hypothesize that oxidative insult induced by photodynamic therapy (PDT) could lead to an endogenous angiogenic response, possibly diminishing the efficacy of PDT treatment of tumors. Therefore, we sought to establish whether PDT induced an angiogenic response within the nontumored brain. PDT using Photofrin as a sensitizer at an optical dose of 140 J/cm2 was performed on normal rat brain (n = 30). Animals were sacrificed at 24 h, and 1, 2, 3 and 6 weeks after PDT treatment. Fluorescein isothiocyanatedextran perfusion was performed, and brains were fixed for immunohistological study. Immunostaining revealed that vascular endothelial growth factor (VEGF) expression increased within the PDT-treated hemisphere 1 week after treatment and remained elevated for 6 weeks. Three-dimensional morphologic analysis of vasculature within PDT-treated and contralateral brain demonstrated PDT-induced angiogenesis, as indicated by a significant increase in vessel connectivity (P < 0.001) concomitant with decreased (P < 0.05) mean segment length compared with vessels within the contralateral hemisphere. Volumetric measurement of angiogenic regions indicate that neovascular expansion continued for 4 weeks after PDT. These data demonstrate that PDT induces VEGF expression and neovascularization within normal brain. Because angiogenesis promotes growth and invasiveness of tumor, antagonizing this endogenous angiogenic response to PDT may present a practical means to enhance the efficacy of PDT.     

Study of ion–solvent interactions of some tetraalkylammonium halides in THF + CCl4 mixtures by conductance measurements

Conductivities of some tetraalkylammonium halides, viz. tetrapentylammonium chloride (Pen₄NCl), tetrahexylammonium chloride (Hex₄NCl), tetraheptylammonium chloride (Hep₄NCl), and tetraoctylammonium chloride (Oct₄NCl) were measured at 298.15 K in THF + CCl₄ mixtures with 40, 60 and 80 mass% of THF. A minimum in the conductometric curves (molar conductance, Λ vs. square root of concentration, √c) was observed at concentrations which is dependent both on the salt and the solvent. The observed molar conductivities were explained by the formation of ion-pairs (M⁺ + X⁻ ↔ MX, K_P) and triple-ions (2M⁺ + X⁻ ↔ M₂X⁺; M⁺ + 2X⁻ ↔ MX₂⁻, K_T). A linear relationship between the triple-ion formation constants [log(K_T/K_P)] and the salt concentrations at the minimum conductivity (log C_min) was given for all salts in THF + CCl₄ mixtures. The formation of triple-ions might be attributed to the ion sizes in solutions in which coulombic interactions and covalent bonding forces act as the main forces between the ions (R₄N⁺X⁻).     

Linezolid and Vancomycin Decrease the Therapeutic Effect of Methylene Blue‐Photodynamic therapy in a Mouse Model of MRSA Bacterial Arthritis

We previously reported that photodynamic therapy (PDT) using intra‐articular methylene blue (MB) could be used to treat arthritis in mice caused by bioluminescent methicillin‐resistant Staphylococcus aureus (MRSA) either in a therapeutic or in a preventative mode. PDT accumulated neutrophils into the mouse knee via activation of chemoattractants such as inflammatory cytokines or chemokines. In this study, we asked whether PDT combined with antibiotics used for MRSA could provide added benefit in controlling the infection. We compared MB‐PDT alone, systemic administration of either linezolid (LZD) alone or vancomycin (VCM) alone or the combination of PDT with either LZD or VCM. Real‐time noninvasive imaging was used to serially follow the progress of the infection. PDT alone was the most effective, whereas LZD alone was ineffective and VCM alone showed some benefit. Surprisingly the addition of LZD or VCM reduced the therapeutic effect of PDT alone (P < 0.05). Considering that PDT in this mouse model stimulates neutrophils to be antibacterial rather than actively killing the bacteria, we propose that LZD and VCM might inhibit the activation of inflammatory cytokines without eradicating the bacteria, and thereby reduce the therapeutic effect of PDT.     

Molecular Electronic Tuning of Photosensitizers to Enhance Photodynamic Therapy: Synthetic Dicyanobacteriochlorins as a Case Study

Photophysical, photostability, electrochemical and molecular‐orbital characteristics are analyzed for a set of stable dicyanobacteriochlorins that are promising photosensitizers for photodynamic therapy (PDT). The bacteriochlorins are the parent compound (BC), dicyano derivative (NC)₂BC and corresponding zinc (NC)₂BC‐Zn and palladium chelate (NC)₂BC‐Pd. The order of PDT activity against HeLa human cancer cells in vitro is (NC)₂BC‐Pd > (NC)₂BC > (NC)₂BC‐Zn ≈ BC. The near‐infrared absorption feature of each dicyanobacteriochlorin is bathochromically shifted 35–50 nm (748–763 nm) from that for BC (713 nm). Intersystem crossing to the PDT‐active triplet excited state is essentially quantitative for (NC)₂BC‐Pd. Phosphorescence from (NC)₂BC‐Pd occurs at 1122 nm (1.1 eV). This value and the measured ground‐state redox potentials fix the triplet excited‐state redox properties, which underpin PDT activity via Type‐1 (electron transfer) pathways. A perhaps counterintuitive (but readily explicable) result is that of the three dicyanobacteriochlorins, the photosensitizer with the shortest triplet lifetime (7 μs), (NC)₂BC‐Pd has the highest activity. Photostabilities of the dicyanobacteriochlorins and other bacteriochlorins studied recently are investigated and discussed in terms of four phenomena: aggregation, reduction, oxidation and chemical reaction. Collectively, the results and analysis provide fundamental insights concerning the molecular design of PDT agents.