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Review
. 2021 Nov 24;13(12):1995.
doi: 10.3390/pharmaceutics13121995.

Antimicrobial Photodynamic Therapy: Latest Developments with a Focus on Combinatory Strategies

Raphaëlle Youf  1 , Max Müller  2 , Ali Balasini  3 , Franck Thétiot  4 , Mareike Müller  2 , Alizé Hascoët  1 , Ulrich Jonas  3 , Holger Schönherr  2 , Gilles Lemercier  5 , Tristan Montier  1   6 , Tony Le Gall  1
Affiliations
Review

Antimicrobial Photodynamic Therapy: Latest Developments with a Focus on Combinatory Strategies

Raphaëlle Youf et al. Pharmaceutics. .

Abstract

Antimicrobial photodynamic therapy (aPDT) has become a fundamental tool in modern therapeutics, notably due to the expanding versatility of photosensitizers (PSs) and the numerous possibilities to combine aPDT with other antimicrobial treatments to combat localized infections. After revisiting the basic principles of aPDT, this review first highlights the current state of the art of curative or preventive aPDT applications with relevant clinical trials. In addition, the most recent developments in photochemistry and photophysics as well as advanced carrier systems in the context of aPDT are provided, with a focus on the latest generations of efficient and versatile PSs and the progress towards hybrid-multicomponent systems. In particular, deeper insight into combinatory aPDT approaches is afforded, involving non-radiative or other light-based modalities. Selected aPDT perspectives are outlined, pointing out new strategies to target and treat microorganisms. Finally, the review works out the evolution of the conceptually simple PDT methodology towards a much more sophisticated, integrated, and innovative technology as an important element of potent antimicrobial strategies.

Keywords: ROS; antimicrobials; combinatory strategies; multidrug resistance; nanoparticles; photodynamic therapy; photosensitizers.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
(A) Modified Jablonski diagram describing the photochemical and photophysical mechanisms leading to ROS production during PDT. (B) Overview of aPDT already applied to the critical category of pathogens, as defined by the NIAID (https://www.niaid.nih.gov/research/emerging-infectious-diseases-pathogens, accessed date: 1 September 2021). For each category, the chart specifies the number and the proportion (percent of pathogens already assayed in at least one aPDT study either before or after 2015).
Figure 2
Figure 2
Representative compounds in various classes of PSs used in aPDT. (A) Examples of some organic PSs and their derivatives. (B) Examples of metallic-based PSs. (C) Different types of polymer-based PS carriers, which can be functionalized with ligands for specific target delivery (Adapted from [94], published by MDPI, 2020).
See this image and copyright information in PMC

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