Enhancement of photodynamic inactivation against Pseudomonas aeruginosa by a nano-carrier approach.

As pathogens steadily develop resistance to widely used antibiotics, new methodologies for their efficient inactivation must be developed. Photodynamic therapy is an upcoming technique that provides an alternative option for treating pathogenic infections. The efficiency of photodynamic therapy has been limited by the use of aqueous mediums for dispersing photosensitising agents. Toluidine Blue O (TBO) was chosen for this study as a cationic photosensitiser to inhibit Gram-negative bacterium Pseudomonas aeruginosa. Enhanced delivery of the photosensitiser was ensured by utilising an essential oil-based microemulsion. The efficiency of photodynamic therapy was further improved by the use of a chemical penetration enhancer to improve permeability of the bacterial outer membrane. TBO accumulation patterns in neonate pig skin were studied using confocal laser scanning microscopy. The physicochemical properties of the TBO loaded microemulsion, including UV-vis absorbance, size distribution and zeta potential, were analysed to understand the enhanced antimicrobial activity. Confocal laser scanning microscopy confirmed the formation of a TBO reservoir in the skin by the TBO-loaded microemulsions. TBO (5 µg/mL) in the vehicles significantly inhibited the growth of P. aeruginosa. All these efforts resulted in inhibition obtained at a drug concentration and light intensity much lower than what is reported by the works of previous investigators.

Epidermal expression of an Elovl4 transgene rescues neonatal lethality of homozygous Stargardt disease-3 mice.

Elongase of very long chain fatty acids-4 (ELOVL4) is the only mammalian enzyme known to synthesize C28-C36 fatty acids. In humans, ELOVL4 mutations cause Stargardt disease-3 (STGD3), a juvenile dominant macular degeneration. Heterozygous Stgd3 mice that carry a pathogenic mutation in the mouse Elovl4 gene demonstrate reduced levels of retinal C28-C36 acyl phosphatidylcholines (PC) and epidermal C28-C36 acylceramides. Homozygous Stgd3 mice die shortly after birth with signs of disrupted skin barrier function. In this study, we report generation of transgenic (Tg) mice with targeted Elovl4 expression driven by an epidermal-specific involucrin promoter. In homozygous Stgd3 mice, this transgene reinstates both epidermal Elovl4 expression and synthesis of two missing epidermal lipid groups: C28-C36 acylceramides and (O-linoleoyl)-omega-hydroxy C28-C36 fatty acids. Transgene expression also restores skin barrier function and rescues the neonatal lethality of homozygous Stgd3 mice. These studies establish the critical requirement for epidermal C28-C36 fatty acid synthesis for animal viability. In addition to the skin, Elovl4 is also expressed in other tissues, including the retina, brain, and testes. Thus, these mice will facilitate future studies to define the roles of C28-C36 fatty acids in the Elovl4-expressing tissues.

Potential of photodynamic therapy in treatment of fungal infections of the mouth. Design and characterisation of a mucoadhesive patch containing toluidine blue O.

Mucocutaneous oropharyngeal candidiasis is predominately caused by Candida albicans. The overall incidence of oral candidiasis in young adults has increased dramatically with the spread of HIV/AIDS. Conventional treatments have been shown to have a fungistatic rather than a fungicidal effect, resulting in an inadequate treatment outcome for patients. In addition, increasing resistance of C. albicans to antifungal agents has made effective treatment more difficult. Accordingly, interest has arisen in development of new prophylaxis/treatment regimens. One such alternative treatment is photodynamic antimicrobial chemotherapy (PACT), in which a combination of a photosensitising drug and visible light cause selective destruction of microbial cells. Due to the highly coloured nature of photosensitisers and the potential for staining of teeth, lips and buccal mucosa, administration of photosensitisers to humans as a liquid mouthwash is undesirable. Targeted delivery of the photosensitiser directly to the site of infection should be the aim. The current study, therefore, reports on a mucoadhesive patch containing toluidine blue O (TBO), as a potential delivery system for use in PACT of oropharyngeal candidiasis. Patches prepared from aqueous blends of poly(methyl vinyl ether/maleic anhydride) and tripropyleneglycol methyl ether possessed suitable properties for use as mucoadhesive drug delivery systems and were capable of resisting dissolution when immersed in artificial saliva. When releasing directly into an aqueous sink, patches containing 50 and 100mg TBO cm(-2) both generated receiver compartment concentrations exceeding the concentration (2.0-5.0 mg ml(-1)) required to produce high levels of kill (>90%) of both planktonic and biofilm-grown C. albicans upon illumination. However, the concentrations of TBO in the receiver compartments separated from patches by membranes intended to mimic biofilm structures were an order of magnitude below those inducing high levels of kill, even after 6h release. Therefore, short application times of TBO-containing mucoadhesive patches should allow treatment of recently-acquired oropharyngeal candidiasis, caused solely by planktonic cells. Longer patch application times may be required for persistent disease where biofilms are implicated.

Toluidine blue uptake in potentially malignant oral lesions in vivo: clinical and histological assessment.

To assess the histological features of in vivo toluidine blue (TB) uptake in potentially malignant oral lesions (PML) and to determine whether any were related to clinical Dark versus Pale Royal Blue stain and/or to the malignant/dysplastic nature of the lesions. Frozen sections were used to evaluate TB extra- and intra-epithelial distribution, depth of penetration and nuclear or extra-nuclear uptake. Eighteen lesions were studied. The clinical appearance of a Dark Royal Blue stain was significantly related to the nuclear uptake of the dye. Conversely Pale Royal Blue staining was unrelated to any histological feature. Dark Royal Blue-malignant lesions had more nuclear uptake than benign lesions. The results suggest that Dark Royal Blue staining is the true positive outcome of a TB test and showed that Dark Royal Blue-malignant and Dark Royal Blue-benign lesions have a different histological pattern of uptake.

In vivo killing of Porphyromonas gingivalis by toluidine blue-mediated photosensitization in an animal model.

Porphyromonas gingivalis is one of the major causative organisms of periodontitis and has been shown to be susceptible to toluidine blue-mediated photosensitization in vitro. The aims of the present study were to determine whether this technique could be used to kill the organism in the oral cavities of rats and whether this would result in a reduction in the alveolar bone loss characteristic of periodontitis. The maxillary molars of rats were inoculated with P. gingivalis and exposed to up to 48 J of 630-nm laser light in the presence of toluidine blue. The number of surviving bacteria was then determined, and the periodontal structures were examined for evidence of any damage. When toluidine blue was used together with laser light there was a significant reduction in the number of viable P. gingivalis organisms. No viable bacteria could be detected when 1 mg of toluidine blue per ml was used in conjunction with all light doses used. On histological examination, no adverse effect of photosensitization on the adjacent tissues was observed. In a further group of animals, after time was allowed for the disease to develop in controls, the rats were killed and the level of maxillary molar alveolar bone was assessed. The bone loss in the animals treated with light and toluidine blue was found to be significantly less than that in the control groups. The results of this study show that toluidine blue-mediated lethal photosensitization of P. gingivalis is possible in vivo and that this results in decreased bone loss. These findings suggest that photodynamic therapy may be useful as an alternative approach for the antimicrobial treatment of periodontitis.

Fluorescence biodistribution and photosensitising activity of toluidine blue o on rat buccal mucosa.

The antimicrobial activity of toluidine blue O (TBO) in the presence of red light has been demonstrated for a wide range of microorganisms. The response of tissues to TBO-induced photosensitisation is an important factor in assessing the clinical usefulness of this technique for the treatment of infectious diseases. The aims of this study were to determine the effect of TBO-mediated photosensitisation on rat buccal mucosa and the biodistribution of the photosensitiser in this tissue. An aqueous solution of TBO was applied to one side of the buccal mucosa of the animals. A 6 mm diameter area was then exposed to light (633 nm) from a copper vapour pumped-dye laser. The opposite, untreated, side of the buccal mucosa served as a control. TBO concentrations of 25, 50 and 200 microg/ml, laser light doses of 110, 170 and 340 J/cm(2) were assessed. Control groups of animals were subjected to 340 J/cm(2) laser light alone or to 200 microg/ml TBO alone. Serial sacrifices were performed after 72 h to obtain mucosal tissue samples for histological examination. For the determination of TBO biodistribution, additional groups received the same TBO doses and were sacrificed after 1 min or 10 min. Specimens were removed and frozen immediately for digital fluorescence imaging. No necrotic or inflammatory changes were found in the buccal mucosa of the animals with any of the treatments (using up to 200 microg/ml TBO and 340 J/cm(2) laser light). A high TBO fluorescence in the epithelium, particularly in the keratinised layer, with almost no fluorescence in the underlying connective tissue was demonstrated by the digital imaging. The results of this study suggest that TBO-mediated PDT (within the concentrations and light doses tested) could be a safe antimicrobial approach for the oral infections without damaging the adjacent normal tissue.

Photodynamic therapy with toluidine blue in Jurkat cells: cytotoxicity, subcellular localization and apoptosis induction.

Toluidine blue (TBO) is a cationic thiazine dye with an affinity for neoplastic tissues in vivo. The objective of this study was to explore the in vitro photosensitizing potential of TBO and its capacity to induce apoptosis in human leukaemic T cells. Jurkat cells were incubated with TBO for one hour followed by exposure to 11 J cm(-2) of visible light from a slide projector. Cytotoxicity was assessed at 24 hours using a MTT assay. DNA fragmentation was examined at different intervals after photodynamic treatment using a DNA elution-filtration assay with [14C]-thymidine labelled cells. Caspase-3 like activation induced by photodynamic treatment was studied by measuring AC-DEVD-AMC peptide hydrolysis. The MTT assay showed a 97% decrease in optical density 24 hours following photodynamic therapy with 0.15 microg ml(-1) of TBO. Dark toxicity was absent under these conditions. DNA fragmentation was detected as early as 2 hours after photodynamic therapy and reached 68% at 6 hours. At higher TBO concentrations less DNA fragmentation and more dark toxicity was observed. An increase in caspase-3 like activity was also induced by photodynamic therapy with TBO. At the time of light exposure TBO was present in the endoplasmic reticulum and Golgi regions. In conclusion, TBO-based photodynamic therapy has a potent phototoxic effect and induces apoptosis in Jurkat cells.

Pulmonary reduction of an intravascular redox polymer.

Pulmonary endothelial cells in culture reduce external electron acceptors via transplasma membrane electron transport (TPMET). In studying endothelial TPMET in intact lungs, it is difficult to exclude intracellular reduction and reducing agents released by the lung. Therefore, we evaluated the role of endothelial TPMET in the reduction of a cell-impermeant redox polymer, toluidine blue O polyacrylamide (TBOP(+)), in intact rat lungs. When added to the perfusate recirculating through the lungs, the venous effluent TBOP(+) concentration decreased to an equilibrium level reflecting TBOP(+) reduction and autooxidation of its reduced (TBOPH) form. Adding superoxide dismutase (SOD) to the perfusate increased the equilibrium TBOP(+) concentration. Kinetic analysis indicated that the SOD effect could be attributed to elimination of the superoxide product of TBOPH autooxidation rather than of superoxide released by the lungs, and experiments with lung-conditioned perfusate excluded release of other TBOP(+) reductants in sufficient quantities to cause significant TBOP(+) reduction. Thus the results indicate that TBOP(+) reduction is via TPMET and support the utility of TBOP(+) and the kinetic model for investigating TPMET mechanisms and their adaptations to physiological and pathophysiological stresses in the intact lung.

Protein synthesis inhibition in neocortical grafts evaluated by systemic amino acid uptake autoradiography.

The temporal pattern of protein synthesis inhibition was examined in grafted neocortical neurons using [(3)H]valine in vivo autoradiography. Neuronal uptake levels of systemically administered (3)H-labeled amino acids which cross the blood-brain barrier (BBB) via endothelial cell neutral carriers have long been a hallmark in studies of experimental ischemic pathology; there is likely a strong correlation between persistent protein synthesis inhibition and the progression of cell damage. Because the grafting procedure involves the loss of blood flow and the subsequent reperfusion of the donor tissue there are, mechanistically, important similarities to reversible ischemia models. The effects of ischemic injury on grafted CNS neurons are not fully understood. Quantitative analysis of grain distribution in individual graft or control (adjacent host cortex) neurons indicated an initial breakdown of the amino acid barrier system, subsequent recovery, and progressive reduction of amino acid uptake by 1 year. Up to 3 weeks after surgery grafts were flooded with the [(3)H]valine tracer but individual neurons contained relatively few silver grains. After this time, the tracer was normally distributed within graft neurons but at significantly lower levels than in controls. Grain density gradually decreased over time such that 12-month grafted neurons had approximately half that compared to control and only 58% of that in 2-month grafts; the 12-month levels were comparable to those observed at early (10 days) postoperative times. Autoradiography of immunostained sections for MAP-2, SMI 311 (neurofilament marker), and neuron-specific enolase showed reduced expression of these proteins in neurons coupled with weak amino acid tracer uptake. The results further suggest that grafted neurons bear intriguing similarities to neurons placed at ischemic risk, particularly "penumbral" neurons, which are affected by reduced blood flow and are metabolically weakened. The loss of BBB properties in early grafts may also extend to the endothelial cell amino acid carrier system, and the delayed revascularization process could affect neuronal uptake mechanisms.

Toluidine blue O and methylene blue as endothelial redox probes in the intact lung.

There is increasing evidence that the redox activities of the pulmonary endothelial surface may have important implications for the function of both lungs and blood. Because of the inherent complexity of intact organs, it can be difficult to study these activities in situ. Given the availability of appropriate indicator probes, the multiple-indicator dilution (MID) method is one approach for dealing with some aspects of this complexity. Therefore, the objectives of the present study were to 1) evaluate the potential utility of two thiazine redox indicators, methylene blue (MB) and toluidine blue O (TBO), as MID electron acceptor probes for in situ pulmonary endothelium and 2) develop a mathematical model of the pulmonary disposition of these indicators as a tool for quantifying their reduction on passage through the lungs. Experiments were carried out using isolated rabbit lungs perfused with physiological salt solution with or without plasma albumin over a range of flow rates. A large fraction of the injected TBO disappeared from the perfusate on passage through the lungs. The reduction of its oxidized, strongly polar, relatively hydrophilic blue form to its colorless, highly lipophilic reduced form was revealed by the presence of the reduced form in the venous effluent when plasma albumin was included in the perfusate. MB was also lost from the perfusate, but the fraction was considerably smaller than for TBO. A distributed-in-space-and-time model was developed to estimate the reduction rate parameter, which was approximately 29 and 1.0 ml/s for TBO and MB, respectively, and almost flow rate independent for both indicators. The results suggest the utility particularly of TBO as an electron acceptor probe for MID studies of in situ pulmonary endothelium and of the model for quantitative evaluation of the data.

Transport and reaction at endothelial plasmalemma: distinguishing intra- from extracellular events.

The pulmonary endothelium is a chemical reactor that modifies blood composition in several ways, including reduction of the oxidized forms of certain redox active substances in the blood. The physiological functions of the transplasma membrane electron transport systems involved in the latter are not fully understood, but an argument is made that they are involved in antioxidant defense. In addition, the experimental approaches used to characterize the process, including studies at whole organ, cell culture, and subcellular levels, along with the use of mathematical modeling, may be representative of the physiome concept wherein a goal is the integration of information obtained at all levels of biological organization. In this article, separation of intra- and extracellular events involved in the disposition of redox active probes within the lungs is the particular example.

A study of the uptake of toluidine blue O by Porphyromonas gingivalis and the mechanism of lethal photosensitization.

The purpose of the study was to determine the distribution of the photosensitizer toluidine blue O (TBO) within Porphyromonas gingivalis and the possible mechanism(s) involved in the lethal photosensitization of this organism. The distribution of TBO was determined by incubating P. gingivalis with tritiated TBO (3H-TBO) and fractionating the cells into outer membrane (OM), plasma membrane (PM), cytoplasmic proteins, other cytoplasmic constituents and DNA. The percentage of TBO in each of the fractions was found to be, 86.7, 5.4, 1.9, 5.7 and 0.3%, respectively. The involvement of cytotoxic species in the lethal photosensitization induced by light from a heliumneon (HeNe) laser and TBO was investigated by using deuterium oxide (D2O), which prolongs the lifetime of singlet oxygen, and the free radical and signlet oxygen scavenger L-tryptophan. There were 9.0 log10 and 2 log10 reductions in the presence of D2O and H2O (saline solutions), respectively, at a light dose of 0.44 J (energy density = 0.22 J/cm2), suggesting the involvement of singlet oxygen. Decreased kills were attained in the presence of increasing concentrations of L-tryptophan. The effect of lethal photosensitization on whole cell proteins was determined by measuring tryptophan fluorescence, which decreased by 30% using 4.3 J (energy density = 4.3 J/cm2) of light. Effects on the OM and PM proteins were determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis. There was evidence of change in the molecular masses of several PM proteins and OM proteins compared to controls. There was evidence of damage to the DNA obtained from irradiated cells. Scanning electron microscopic studies showed that there was coaggregation of P. gingivalis cells when sensitized and then exposed to laser light. These results suggest that lethal photosensitization of P. gingivalis may involve changes in OM and/or PM proteins and DNA damage mediated by singlet oxygen.

Kinetics of plasma membrane electron transport in a pulmonary endothelial cell-column.

Thiazine dyes such as toluidine blue O (TBO) are reduced at the luminal endothelial surface. The purpose of this study was to determine the rate of this reaction in endothelial cells in culture. A multiple indicator dilution method was used to measure the reaction kinetics during transient passage of a TBO-containing bolus through a chromatographic column filled with bovine pulmonary arterial endothelial cells grown on microcarrier beads (cell-column). A bolus containing TBO and an inert extracellular reference indicator (FITC-Dextran) was injected upstream of the cell-column, and the indicator concentrations were measured downstream using on-line photodetection. The effects of column flow rate, PO2, and TBO concentration were studied. The fraction of TBO reduced upon passage through the cell-column decreased with increasing flow indicating that the reaction rate rather than TBO delivery controlled TBO reduction. The fraction of TBO reduced did not change with PO2 or dose in the ranges studied. TBO reduction was about 10 times that for steady state TBO sequestration by these cells which, along with the lack of a PO2 effect indicates that the rapid rate of reduction is not the rate-limiting step in steady state sequestration.

Pharmacokinetics and toxicity of tolonium chloride in sheep.

The pharmacokinetic disposition, urinary excretion and toxicity of tolonium chloride were determined after i.v. administration to sheep. Pretreatment with sodium nitrite significantly decreased the volume of the central compartment, apparent volume of distribution, area under the concentration-time curve, and total body clearance of tolonium chloride. Urinary excretion of tolonium chloride and its metabolite, leucotolonium chloride, together accounted for less than 15% of the administered dose in sheep receiving sodium nitrite and less than 10% of the administered dose in control sheep. The LD50 of tolonium chloride was 10 mg/kg with a 95% confidence interval of 7.35-13.60 mg/kg. Comparison with previously published data describing the pharmacokinetics and toxicity of a related compound, methylene blue, indicated that tolonium chloride has a higher volume of distribution and a narrower therapeutic index.

Uptake of ³H-labelled commercial toluidine blue and subfractions (thionine, toluidine blue, and azur A) in the parathyroids of rabbits.

Chromatographic separation of ³H-labelled commercial toluidine blue demonstrated four dye fractions. Following i.v. injection into rabbits, the uptakes of the dye mixture and of three separated dye fractions were determined by radioactivity assays of parathyroids, thyroid, and muscle. Mean uptake ratio per g parathyroid/thyroid of the dye mixture was 2.6 and of the different fractions varied from 2.2 to 2.7. During continuous infusion of labelled dye mixture, the concentration in the parathyroids was, on an average, 1.6 times that in the thyroids. It follows that as a means for external scintigraphy of the parathyroids, derivatives of dye fraction will probably not prove better than derivatives of the commercial dye mixture. Because of its high toxicity, thionine should be eliminated from commercial toluidine blue when given to patients in amounts necessary to stain the parathyroids.