Antimicrobial Photodynamic Therapy: A New Approach for Oral Candidiasis?

The effectiveness of antimicrobial photodynamic therapy (aPDT) in the treatment of oral yeast infections was examined many times in recent years. The authors of this review tried to address the question: “Should TBO (toluidine blue ortho)-mediated aPDT be considered a possible alternative treatment for oral candidiasis?”. PubMed/Medline and the Cochrane Central Register of Controlled Trials (CEN-TRAL) databases were searched from 1997 up to the 27th of October 2020 using a combination of the following keywords: (Candida OR Candidiasis oral OR Candidosis oral OR denture stomatitis) AND (toluidine blue OR photodynamic therapy OR aPDT OR photodynamic antimicrobial chemotherapy OR PACT OR photodynamic inactivation OR PDI). Animal studies or in vitro studies involving Candida albicans (C. albicans) and/or nonalbicans stain, randomized clinical trials (RCT) involving patients with oral candidiasis or denture stomatitis published solely in English language were included. Candida elimination method in animal, in vitro studies and RCT used was TBO-mediated aPDT. Exactly 393 studies were taken into consideration. Then, after analyzing titles and abstracts of said studies, 361 were excluded. Only 32 studies ended up being selected for in-depth screening, after which 21 of them were included in this study. All studies reported the antifungal effectiveness of aPDT with TBO against C. albicans and non-albicans Candida. In studies conducted with planktonic cells, only one study showed eradication of C. albicans. All others showed partial elimination and only one of them was not statistically significant. Experiments on yeast biofilms, in all cases, showed partial, statistically significant cell growth inhibition and weight reduction (a reduction in the number of cells—mainly hyphae) and the mass of extracellular polymeric substance (EPS). In vivo aPDT mediated by TBO exhibits antifungal effects against oral Candida spp.; however, its clinical effectiveness as a potent therapeutic strategy for oral yeast infections requires further investigation.

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Antimicrobial photodynamic therapy as a new approach for the treatment of vulvovaginal candidiasis: preliminary results

Lasers in Medical Science ◽

10.1007/s10103-018-2557-y ◽

2018 ◽

Vol 33 (9) ◽

pp. 1925-1931 ◽

Cited By ~ 2

Author(s):

Maria Eugênia Simões Onofre de Santi ◽

Renato Araujo Prates ◽

Cristiane Miranda França ◽

Rúbia Garcia Lopes ◽

Aline Silva Sousa ◽

...

Keyword(s):

Photodynamic Therapy ◽

Vulvovaginal Candidiasis ◽

Antimicrobial Photodynamic Therapy ◽

New Approach ◽

Preliminary Results

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Antimicrobial Photodynamic Therapy in Combination with Nystatin in the Treatment of Experimental Oral Candidiasis Induced by Candida albicans Resistant to Fluconazole

Pharmaceuticals ◽

10.3390/ph12030140 ◽

2019 ◽

Vol 12 (3) ◽

pp. 140 ◽

Cited By ~ 1

Author(s):

Karem Janeth Rimachi Hidalgo ◽

Juliana Cabrini Carmello ◽

Cláudia Carolina Jordão ◽

Paula Aboud Barbugli ◽

Carlos Alberto de Sousa Costa ◽

...

Keyword(s):

Candida Albicans ◽

Photodynamic Therapy ◽

Combined Therapy ◽

Oral Candidiasis ◽

Confocal Scanning Laser Microscopy ◽

Antimicrobial Photodynamic Therapy ◽

Promising Alternative ◽

Confocal Scanning ◽

Confocal Scanning Laser

Background: It has been demonstrated that azole-resistant strains of Candida albicans have a greater resistance to antimicrobial photodynamic therapy (aPDT) when compared to their more susceptible counterparts. For this reason, the present study evaluated the efficacy of aPDT, together with nystatin (NYS), in the treatment of oral candidiasis in vivo. Methods: Mice were infected with fluconazole-resistant C. albicans (ATCC 96901). To perform the combined therapy, aPDT, mediated by Photodithazine (PDZ) and LED light, was used together with NYS. The efficacy of the treatments was evaluated by microbiological, macroscopic, histopathological and Confocal Scanning Laser Microscopy analyses of the lesions. The expression of p21 and p53, proteins associated with cell death, from the tongues of mice, was also performed. Results: The combined therapy reduced the fungal viability by around 2.6 log10 and decreased the oral lesions and the inflammatory reaction. Additionally, it stimulated the production of p53 and p21. Conclusions: The combined therapy is a promising alternative treatment for oral candidiasis induced by C. albicans resistant to fluconazole.

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Antimicrobial Photodynamic Therapy in the Treatment of Oral Candidiasis in HIV-Infected Patients

Photomedicine and Laser Surgery ◽

10.1089/pho.2012.3225 ◽

2012 ◽

Vol 30 (8) ◽

pp. 429-432 ◽

Cited By ~ 40

Author(s):

Agnes Roberta Scwingel ◽

Ana Rita Pinheiro Barcessat ◽

Silvia Cristina Núñez ◽

Martha Simões Ribeiro

Keyword(s):

Photodynamic Therapy ◽

Oral Candidiasis ◽

Antimicrobial Photodynamic Therapy

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Phase IIa randomized, placebo-controlled study of antimicrobial photodynamic therapy in bacterially colonized, chronic leg ulcers and diabetic foot ulcers: a new approach to antimicrobial therapy

British Journal of Dermatology ◽

10.1111/bjd.12098 ◽

2013 ◽

Vol 168 (3) ◽

pp. 617-624 ◽

Cited By ~ 70

Author(s):

S. Morley ◽

J. Griffiths ◽

G. Philips ◽

H. Moseley ◽

C. O’Grady ◽

...

Keyword(s):

Photodynamic Therapy ◽

Antimicrobial Therapy ◽

Diabetic Foot ◽

Controlled Study ◽

Foot Ulcers ◽

Antimicrobial Photodynamic Therapy ◽

Leg Ulcers ◽

Diabetic Foot Ulcers ◽

New Approach ◽

Chronic Leg Ulcers

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Antimicrobial photodynamic therapy to oral candidiasis not responsive to micafungin in a patient undergoing hematopoietic cell transplantation

Photodiagnosis and Photodynamic Therapy ◽

10.1016/j.pdpdt.2021.102296 ◽

2021 ◽

Vol 34 ◽

pp. 102296

Author(s):

Luana Campos ◽

Sandra Bastos Rezende ◽

Luiz Felipe Palma ◽

Andressa Matucci Hotsumi ◽

Ricardo Yudi Tateno ◽

...

Keyword(s):

Photodynamic Therapy ◽

Cell Transplantation ◽

Hematopoietic Cell Transplantation ◽

Oral Candidiasis ◽

Hematopoietic Cell ◽

Antimicrobial Photodynamic Therapy

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Antimicrobial photodynamic therapy reduces adhesion capacity and biofilm formation of Candida albicans from induced oral candidiasis in mice

Photodiagnosis and Photodynamic Therapy ◽

10.1016/j.pdpdt.2019.06.010 ◽

2019 ◽

Vol 27 ◽

pp. 402-407 ◽

Cited By ~ 10

Author(s):

Juliana Cabrini Carmello ◽

Fernanda Alves ◽

Fernanda G. Basso ◽

Carlos Alberto de Souza Costa ◽

Antônio Cláudio Tedesco ◽

...

Keyword(s):

Candida Albicans ◽

Photodynamic Therapy ◽

Biofilm Formation ◽

Oral Candidiasis ◽

Antimicrobial Photodynamic Therapy

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Antimicrobial Photodynamic Therapy Mediated by Curcumin-Loaded Polymeric Nanoparticles in a Murine Model of Oral Candidiasis

Molecules ◽

10.3390/molecules23082075 ◽

2018 ◽

Vol 23 (8) ◽

pp. 2075 ◽

Cited By ~ 10

Author(s):

Vinicius Sakima ◽

Paula Barbugli ◽

Paulo Cerri ◽

Marlus Chorilli ◽

Juliana Carmello ◽

...

Keyword(s):

Dna Damage ◽

Photodynamic Therapy ◽

Murine Model ◽

Water Solubility ◽

Polymeric Nanoparticles ◽

Oral Candidiasis ◽

Positive Control ◽

Poly Lactic Acid ◽

Antimicrobial Photodynamic Therapy ◽

Antifungal Effect

Antimicrobial photodynamic therapy (aPDT) has been proposed as an alternative method for oral candidiasis (OC), while nanocarriers have been used to improve the water solubility of curcumin (CUR). The aim of this study is to encapsulate CUR in polymeric nanoparticles (NPs) and to evaluate its photodynamic effects on a murine model of OC. Anionic and cationic CUR-NP is synthesized using poly-lactic acid and dextran sulfate and then characterized. Female mice are immunosuppressed and inoculated with Candida albicans (Ca) to induce OC. aPDT is performed by applying CUR-NP or free CUR on the dorsum of the tongue, followed by blue light irradiation for five consecutive days. Nystatin is used as positive control. Afterward, Ca are recovered and cultivated. Animals are euthanized for histological, immunohistochemical, and DNA damage evaluation. Encapsulation in NP improves the water solubility of CUR. Nystatin shows the highest reduction of Ca, followed by aPDT mediated by free CUR, which results in immunolabelling of cytokeratins closer to those observed for healthy animals. Anionic CUR-NP does not show antifungal effect, and cationic CUR-NP reduces Ca even in the absence of light. DNA damage is associated with Ca infection. Consecutive aPDT application is a safe treatment for OC.

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