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Review
. 2021 Nov;20(11):1497-1545.
doi: 10.1007/s43630-021-00102-1. Epub 2021 Oct 27.

Photodynamic disinfection and its role in controlling infectious diseases

Rafael T Aroso  1 , Fábio A Schaberle  1 , Luís G Arnaut  2 , Mariette M Pereira  3
Affiliations
Review

Photodynamic disinfection and its role in controlling infectious diseases

Rafael T Aroso et al. Photochem Photobiol Sci. 2021 Nov.

Abstract

Photodynamic therapy is witnessing a revival of its origins as a response to the rise of multi-drug resistant infections and the shortage of new classes of antibiotics. Photodynamic disinfection (PDDI) of microorganisms is making progresses in preclinical models and in clinical cases, and the perception of its role in the clinical armamentarium for the management of infectious diseases is changing. We review the positioning of PDDI from the perspective of its ability to respond to clinical needs. Emphasis is placed on the pipeline of photosensitizers that proved effective to inactivate biofilms, showed efficacy in animal models of infectious diseases or reached clinical trials. Novel opportunities resulting from the COVID-19 pandemic are briefly discussed. The molecular features of promising photosensitizers are emphasized and contrasted with those of photosensitizers used in the treatment of solid tumors. The development of photosensitizers has been accompanied by the fabrication of a variety of affordable and customizable light sources. We critically discuss the combination between photosensitizer and light source properties that may leverage PDDI and expand its applications to wider markets. The success of PDDI in the management of infectious diseases will ultimately depend on the efficacy of photosensitizers, affordability of the light sources, simplicity of the procedures, and availability of fast and efficient treatments.

Keywords: Bacteria; Biofilm; Fungi; Inactivation; Photodynamic disinfection; Virus.

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Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Schematic representation of the biological membrane in animal cells [89]
Fig. 2
Fig. 2
Schematic representation of the biological membranes in bacteria: a Gram-positive bacteria; b Gram-negative bacteria [115]
Fig. 3
Fig. 3
Schematic representation of bacterial biofilm [124]
Fig. 4
Fig. 4
Fungal cell wall (illustrated for Candida albicans) [210]
Fig. 5
Fig. 5
Coronavirus with its lipid envelope containing hemagglutinin-esterase, spike, envelop and membrane proteins, surrounding its positive-sense, single-stranded RNA, embedded in a helical nucleocapsid. Adapted from Graham et al. [267].
Fig. 6
Fig. 6
Normalized absorption and emission spectra of Rose Bengal (black) and a fluorescent lamp (red). The overlap resulting in the LDC factor of 0.22 is shown in blue
See this image and copyright information in PMC

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