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1.
J Photochem Photobiol B ; 200: 111654, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31671373

RESUMO

The Enterococcus faecalis is a microorganism that causes multiple forms of resistance to a wide range of drugs used clinically. aPDT is a technique in which a visible light activates photosensitizer (PS), resulting in generation of reactive oxygen species that kill bacteria unselectively via an oxidative burst. aPDT is an alternative to antibiotics with the advantage of not causing resistance. The search for an alternative treatment of infections caused by E. faecalis, without using antibiotics, is off great clinical importance. The aim of present investigation was to assess the efficacy of using 3.32 ηg/mL of 1,9-dimethylmethylene blue (DMMB) as photosensitizer associated with the use of either Laser (λ660 nm) or LED (λ632 ±â€¯2 nm) using different energy densities (6, 12 and 18 J/cm2) to kill E. faecalis in vitro. Under different experimental conditions, 14 study groups, in triplicate, were used to compare the efficacy of the aPDT carried out with either the laser or LED lights using different energy densities associated to DMMB. The most probable number method (MPN) was used for quantitative analysis. Photodynamic antimicrobial effectiveness was directly proportional to the energy density used, reaching at 18 J/cm2, 99.999998% reduction of the counts of E. faecalis using both light sources. The results of this study showed that the use of 3.32 ηg/mL of DMMB associated with the use 18 J/cm2 of LED light (λ632 ±â€¯2 nm) reduced >7-log counts of planktonic culture of E. faecalis.


Assuntos
Enterococcus faecalis/efeitos dos fármacos , Luz , Azul de Metileno/análogos & derivados , Fármacos Fotossensibilizantes/farmacologia , Animais , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/veterinária , Macrófagos/citologia , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Azul de Metileno/química , Azul de Metileno/farmacologia , Azul de Metileno/uso terapêutico , Camundongos , Camundongos Endogâmicos BALB C , Fotoquimioterapia , Fármacos Fotossensibilizantes/química , Fármacos Fotossensibilizantes/uso terapêutico
2.
Medicine (Baltimore) ; 98(39): e16976, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574796

RESUMO

RATIONALE: Halitosis is an unpleasant odor that emanates from the mouth. Studies show halitosis returns in a week, after treatment with PDT. Probably, bacteria living in the periodontal sulcus could recolonize the dorsum of the tongue. Until nowadays, there are no study in adult population that associates halitosis and periodontal treatment with follow-up evaluation. The aim of this randomized, controlled, single-blinded clinical trial is to treat oral halitosis in healthy adults with photodynamic therapy (PDT), associated with periodontal treatment and follow them up for 3 months. PATIENT CONCERNS:: the concerns assessments will be done over the study using anamnesis interviews and specific questionnaire. DIAGNOSES:: halitosis will be evaluated by OralChroma. INTERVENTIONS: The participants (n = 40) with halitosis will be randomized into 2 groups: G1-treatment with PDT (n = 20) or G2-cleaning of the tongue with a tongue scraper (n = 20). OUTCOMES: Halitosis will be evaluated by measuring volatile sulfur compounds using gas chromatography. After the treatments, a second evaluation will be performed, along with a microbiological analysis (RT-PCR) for the identification of the bacteria T. denticola. The assessment of halitosis and the microbiological analysis will be repeated. After that, patients will receive periodontal treatment. The participants will return after 1 week and 3 months for an additional evaluation. Quality of life will be measured by Oral Health Impact Profile questionnaire (OHIP-14). LESSONS: This protocol will determine the effectiveness of phototherapy regarding the reduction of halitosis in adults. clinicaltrials.gov NCT03996915. ETHICS AND DISSEMINATION: This protocol received approval from the Human Research Ethics Committee of Universidade Nove de Julho (certificate number: 3.257.104). The data will be published in a peer-reviewed periodical.


Assuntos
Halitose/tratamento farmacológico , Doenças Periodontais/terapia , Fotoquimioterapia , Cromatografia Gasosa , Seguimentos , Halitose/etiologia , Halitose/microbiologia , Humanos , Pessoa de Meia-Idade , Higiene Bucal , Doenças Periodontais/complicações , Doenças Periodontais/microbiologia , Fármacos Fotossensibilizantes/uso terapêutico , Recidiva , Método Simples-Cego , Resultado do Tratamento , Treponema denticola/isolamento & purificação
3.
Middle East Afr J Ophthalmol ; 26(2): 95-100, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31543667

RESUMO

PURPOSE: The purpose of the study is to determine the safety and efficacy of corneal collagen cross-linking for keratoconus in pediatric patients with and without vernal keratoconjunctivitis (VKC). METHODS: This is a retrospective analysis of 89 eyes of 58 patients <18 years of age that underwent corneal collagen cross-linking for progressive keratoconus; inclusion criteria included a minimum of 2-year follow-up after cross-linking. The main outcomes measures included keratometry, pachymetry, vision, and complications following epithelial-off cross-linking with the Dresden protocol. RESULTS: VKC patients were more likely to be male; 81.6% of the non-VKC patients and 96.3% of VKC patients were male (P = 0.038). Comparing pretreatment to the 2-year follow-up, there was no statistically significant change in the mean steep or flat keratometry, corneal thickness, and uncorrected visual acuity or best spectacle-corrected visual acuity in either group. There were no statistically significant differences in the mean visual, keratometric, or adverse event outcomes between the two groups. The proportion exhibiting progression of ectasia at 2 years was 18.5% in the VKC group and 16.7% in the non-VKC group (P = 0.83). CONCLUSIONS: Cross-linking appears to be as safe and effective in pediatric patients with vernal keratoconjunctivits as in those without, with similar outcomes, adverse events, and progression of keratoconus after treatment. The proportion of patients exhibiting progression appears to be higher in pediatric patients than adults, and there is an association between male sex and diagnosis of VKC.


Assuntos
Conjuntivite Alérgica/tratamento farmacológico , Substância Própria/metabolismo , Reagentes para Ligações Cruzadas , Ceratocone/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Riboflavina/uso terapêutico , Adolescente , Criança , Colágeno/metabolismo , Conjuntivite Alérgica/metabolismo , Paquimetria Corneana , Topografia da Córnea , Dilatação Patológica , Progressão da Doença , Feminino , Seguimentos , Humanos , Ceratocone/metabolismo , Masculino , Fármacos Fotossensibilizantes/efeitos adversos , Exame Físico , Estudos Retrospectivos , Riboflavina/efeitos adversos , Raios Ultravioleta , Acuidade Visual
4.
Photochem Photobiol Sci ; 18(11): 2565-2612, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31397467

RESUMO

Photodynamic therapy (PDT) is a well-established treatment option in the treatment of certain cancerous and pre-cancerous lesions. Though best-known for its application in tumor therapy, historically the photodynamic effect was first demonstrated against bacteria at the beginning of the 20th century. Today, in light of spreading antibiotic resistance and the rise of new infections, this photodynamic inactivation (PDI) of microbes, such as bacteria, fungi, and viruses, is gaining considerable attention. This review focuses on the PDI of viruses as an alternative treatment in antiviral therapy, but also as a means of viral decontamination, covering mainly the literature of the last decade. The PDI of viruses shares the general action mechanism of photodynamic applications: the irradiation of a dye with light and the subsequent generation of reactive oxygen species (ROS) which are the effective phototoxic agents damaging virus targets by reacting with viral nucleic acids, lipids and proteins. Interestingly, a light-independent antiviral activity has also been found for some of these dyes. This review covers the compound classes employed in the PDI of viruses and their various areas of use. In the medical area, currently two fields stand out in which the PDI of viruses has found broader application: the purification of blood products and the treatment of human papilloma virus manifestations. However, the PDI of viruses has also found interest in such diverse areas as water and surface decontamination, and biosafety.


Assuntos
Luz , Fotoquimioterapia/tendências , Viroses/terapia , Vírus/efeitos da radiação , Humanos , Papillomaviridae/efeitos dos fármacos , Papillomaviridae/efeitos da radiação , Fármacos Fotossensibilizantes/química , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Espécies Reativas de Oxigênio/metabolismo , Viroses/tratamento farmacológico , Viroses/metabolismo , Vírus/efeitos dos fármacos , Vírus/metabolismo
5.
Photochem Photobiol Sci ; 18(10): 2381-2396, 2019 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-31432864

RESUMO

The synthesis, photophysics, and photobiological activities of a series of novel neutral heteroleptic cyclometalated iridium(iii) complexes incorporating boron dipyrromethene (BODIPY) substituted N-heterocyclic carbene (NHC) ligands (Ir1-Ir5) are reported. The effect of the substitution position of BODIPY on the NHC ligands, either on C4 of the phenyl ring (Ir1-Ir3) or C5 of the benzimidazole unit (Ir4 and Ir5), and its linker type (single or triple bond) on the photophysical properties was studied. Ir1-Ir5 exhibited BODIPY-localized intense 1IL (intraligand transition)/1MLCT (metal-to-ligand charge transfer) absorption at 530-543 nm and 1,3IL/1,3CT (charge transfer) emission at 582-610 nm. The nanosecond transient absorption results revealed that the lowest triplet excited states of these complexes were the BODIPY-localized 3π,π* states. Complexes Ir4 and Ir5 exhibited blue-shifted 1IL absorption and 1,3IL/1,3CT emission bands compared to the corresponding absorption and emission bands in complexes Ir1 and Ir3. However, replacing the methyl substituents on N3 of benzimidazole in complexes Ir1 and Ir4 with oligoether substituents in Ir3 and Ir5, respectively, did not impact the energies of the low-energy absorption and emission bands in the corresponding complexes. Water-soluble complexes Ir3 and Ir5 have been explored as photosensitizers for in vitro photodynamic therapy (PDT) effects toward human SKMEL28 melanoma cells. Ir3 showed no dark cytotoxicity (EC50 > 300 µM) but good photocytotoxic activity (9.66 ± 0.28 µM), whereas Ir5 exhibited a higher dark cytotoxicity (20.2 ± 1.26 µM) and excellent photocytotoxicity (0.15 ± 0.01 µM). The phototherapeutic indices with visible light (400-700 nm) activation were >31 for Ir3 and 135 for Ir5. Ir3 and Ir5 displayed 1O2 quantum yields of 38% and 22% in CH3CN, respectively, upon 450 nm excitation. Ir5 was more effective at generating reactive oxygen species (ROS) in vitro. Ir5 was also active against Staphylococcus aureus upon visible light activation, with a phototherapeutic index of >15 and EC50 value of 6.67 µM. These photobiological activities demonstrated that these neutral Ir(iii) complexes are promising in vitro PDT reagents, and substitution at C5 on the benzimidazole group of the NHC ligand was superior to C4 substitution on the phenyl ring.


Assuntos
Compostos de Boro/química , Complexos de Coordenação/química , Irídio/química , Metano/análogos & derivados , Fármacos Fotossensibilizantes/síntese química , Anti-Infecciosos/síntese química , Anti-Infecciosos/química , Anti-Infecciosos/farmacologia , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Complexos de Coordenação/farmacologia , Complexos de Coordenação/uso terapêutico , Humanos , Ligantes , Luz , Metano/química , Neoplasias/tratamento farmacológico , Neoplasias/patologia , Fotoquimioterapia , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Teoria Quântica , Espécies Reativas de Oxigênio/metabolismo , Staphylococcus aureus/efeitos dos fármacos , Nanomedicina Teranóstica
6.
J Photochem Photobiol B ; 198: 111564, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31382090

RESUMO

Light irradiation has been used in clinical therapy for several decades. In this context, photobiomodulation (PBM) modulates signaling pathways via ROS, ATP, Ca2+, while photodynamic therapy (PDT) generates reactive oxygen species by excitation of a photosensitizer. NO generation could be an important tool when combined with both kinds of light therapy. By using a metal-based compound, we found that PBM combined with PDT could be a beneficial cancer treatment option. We used two types of ruthenium compounds, ([Ru(Pc)], Pc = phthalocyanine) and trans-[Ru(NO)(NO2)(Pc)]. The UV-vis spectra of both complexes displayed a band in the 660 nm region. In the case of 0.5 µM trans-[Ru(NO)(NO2)(Pc)], light irradiation at the Q-band reduced the percentage of viable human melanoma (A375) cells to around 50% as compared to [Ru(Pc)]. We hypothesized that these results were due to a synergistic effect between singlet oxygen and nitric oxide. Similar experiments performed with PDT (660 nm) combined with PBM (850 nm) induced more photocytotoxicity using both [Ru(Pc)] and trans-[Ru(NO)(NO2)(Pc)]. This was interpreted as PBM increasing cell metabolism (ATP production) and the consequent higher uptake of the ruthenium phthalocyanine compounds and more efficient apoptosis. The use of metal-based photosensitizers combined with light therapy may represent an advance in the field of photodynamic therapy.


Assuntos
Trifosfato de Adenosina/metabolismo , Complexos de Coordenação/química , Óxido Nítrico/metabolismo , Compostos Organometálicos/química , Fármacos Fotossensibilizantes/química , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Complexos de Coordenação/farmacologia , Complexos de Coordenação/uso terapêutico , Humanos , Luz , Melanoma/tratamento farmacológico , Melanoma/metabolismo , Melanoma/patologia , Fotoquimioterapia , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Oxigênio Singlete/metabolismo
7.
Chemistry ; 25(59): 13472-13478, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31393035

RESUMO

A series of water-soluble cationic chalcogenoviologen-based photosensitizers for photodynamic antimicrobial therapy (PDAT) is reported. The Se-containing derivatives (SeMV2+ ) 5 b and 6 b showed good antimicrobial activities due to the presence of chalcogen atoms and a cationic scaffold. The former efficiently enhanced the generation of reactive oxygen species (ROS), and the latter facilitated the ROS delivery to bacteria, resulting in their death. Interestingly, alkyl-modified photosensitizers showed higher antimicrobial activities than commonly reported photosensitizers with quaternary ammonium (QA) groups. In particular, the SeMV2+ (6 b) with excellent antibacterial activities efficiently promoted the healing of infected wounds in mice. Simple yet novel, nontoxic and biocompatible chalcogenoviologens provided a promising strategy to develop new efficient photosensitizers for photodynamic antimicrobial therapy and skin regeneration.


Assuntos
Anti-Infecciosos/química , Cátions/química , Fármacos Fotossensibilizantes/uso terapêutico , Espécies Reativas de Oxigênio/química , Pele/fisiopatologia , Animais , Anti-Infecciosos/farmacologia , Anti-Infecciosos/uso terapêutico , Camundongos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/química , Regeneração
8.
Int J Nanomedicine ; 14: 5527-5540, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31413561

RESUMO

Background: Nonspecific tumor targeting, potential relapse and metastasis of tumor after treatment are the main barriers in clinical photodynamic therapy (PDT) for cancer, hence, inhibiting relapse and metastasis of tumor is significant issues in clinic. Purpose: In this work, chidamide as a histone deacetylases inhibitor (HADCi) was bound onto a pH-responsive block polymer folate polyethylene glycol-b-poly(aspartic acid) (PEG-b-PAsp) grafted folate (FA-PEG-b-PAsp) to obtain the block polymer folate polyethylene glycol-b-poly(asparaginyl-chidamide) (FA-PEG-b-PAsp-chidamide, FPPC) as multimodal tumor-targeting drug-delivery carrier to inhibiting tumor cell proliferation and tumor metastasis in mice. Methods: Model photosensitizer pyropheophorbide-a (Pha) was encapsulated by FPPC in PBS to form the polymer micelles Pha@FPPC [folate polyethylene glycol-b-poly(asparaginyl-chidamide) micelles encapsulating Pha]. Pha@FPPC was characterized by transmission electron microscope and dynamic light scattering; also, antitumor activity in vivo and in vitro were investigated by determination of cellular ROS level, detection of cell apoptosis and cell cycle arrest, PDT antitumor activity in vivo and histological analysis. Results: With favorable and stable sphere morphology under transmission electron microscope (TEM) (~93.0 nm), Pha@FPPC greatly enhanced the cellular uptake due to its folate-mediated effective endocytosis by mouse melanoma B16-F10 cells and the yield of ROS in tumor cells induced by PDT, and mainly caused necrocytosis and blocked cell growth cycle not only in G2 phase but also in G1/G0 phase after PDT. Pha@FPPC exhibited lower dark cytotoxicity in vitro and a better therapeutic index because of its higher dark cytotoxicity/photocytotoxicity ratio. Moreover, Pha@FPPC not only significantly inhibited the growth of implanted tumor and prolonged the survival time of melanoma-bearing mice due to both its folate-mediated tumor-targeting and selectively accumulation at tumor site by EPR (enhanced permeability and retention)effect as micelle nanoparticles but also remarkably prevented pulmonary metastasis of mice melanoma after PDT compared to free Pha, demonstrating its dual antitumor characteristics of PDT and HDACi. Conclusion: As a folate-mediated and acid-activated chidamide-grafted drug-delivery carrier, FPPC may have great potential to inhibit tumor metastasis in clinical photodynamic treatment for cancer because of its effective and multimodal tumor-targeting performance as photosensitizer vehicle.


Assuntos
Aminopiridinas/química , Benzamidas/química , Ácido Fólico/uso terapêutico , Micelas , Fotoquimioterapia , Fármacos Fotossensibilizantes/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Pontos de Checagem do Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Clorofila/análogos & derivados , Clorofila/farmacologia , Sistemas de Liberação de Medicamentos , Liberação Controlada de Fármacos , Endocitose/efeitos dos fármacos , Ácido Fólico/farmacologia , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Concentração de Íons de Hidrogênio , Melanoma Experimental/tratamento farmacológico , Melanoma Experimental/patologia , Camundongos Endogâmicos C57BL , Nanopartículas/química , Nanopartículas/ultraestrutura , Fármacos Fotossensibilizantes/farmacologia , Polietilenoglicóis/química , Espécies Reativas de Oxigênio/metabolismo
9.
Photochem Photobiol Sci ; 18(11): 2613-2656, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31460568

RESUMO

Photodynamic therapy (PDT), a shining beacon in the realm of photomedicine, is a non-invasive technique that utilizes dye-based photosensitizers (PSs) in conjunction with light and oxygen to produce reactive oxygen species to combat malignant tissues and infectious microorganisms. Yet, for PDT to become a common, routine therapy, it is still necessary to overcome limitations such as photosensitizer solubility, long-term side effects (e.g., photosensitivity) and to develop safe, biocompatible and target-specific formulations. Polymer based drug delivery platforms are an effective strategy for the delivery of PSs for PDT applications. Among them, hydrogels and 3D polymer scaffolds with the ability to swell in aqueous media have been deeply investigated. Particularly, hydrogel-based formulations present real potential to fulfill all requirements of an ideal PDT platform by overcoming the solubility issues, while improving the selectivity and targeting drawbacks of the PSs alone. In this perspective, we summarize the use of hydrogels as carrier systems of PSs to enhance the effectiveness of PDT against infections and cancer. Their potential in environmental and biomedical applications, such as tissue engineering photoremediation and photochemistry, is also discussed.


Assuntos
Portadores de Fármacos/química , Hidrogéis/química , Materiais Biomiméticos/química , Recuperação e Remediação Ambiental , Humanos , Nanopartículas/química , Neoplasias/tratamento farmacológico , Neoplasias/metabolismo , Fotoquimioterapia , Fármacos Fotossensibilizantes/química , Fármacos Fotossensibilizantes/uso terapêutico , Polímeros/química , Reologia , Engenharia Tecidual , Viscosidade
10.
J Photochem Photobiol B ; 197: 111554, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31326843

RESUMO

Bovine mastitis is an endemic disease of dairy cattle that is considered to be one of the most frequent and costly diseases in veterinary medicine. An increase in the incidence of disease results in the increased use of antibiotics, which in turn increases the potential of bacterial resistance. This study aimed to investigate the effectiveness of antimicrobial photodynamic therapy (aPDT) in the treatment of bovine mastitis, as an alternative to systemic antibiotics. To identify the key factors affecting photoinactivation efficacy, realistic experiments in view of the end-use were conducted in milk samples using two different photosensitizers: methylene blue (MB) and silicon (IV) phthalocyanine derivative (SiPc). We explored the effects of divalent ions and fat content on the aPDT outcome and determined influence of different proteins on aPDT efficacy. Levels of bacterial sensitivity to PSs varied depending on the type of bacteria (Gram-positive vs. Gram-negative) and light exposure time. Critical interrelated factors affecting aPDT in milk were identified and an efficient combination of treatment conditions that can lead to a full photodynamic inactivation of bacteria was determined.


Assuntos
Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Leite/microbiologia , Fármacos Fotossensibilizantes/farmacologia , Animais , Bovinos , Feminino , Indóis/química , Indóis/farmacologia , Indóis/uso terapêutico , Luz , Mastite Bovina/tratamento farmacológico , Mastite Bovina/microbiologia , Mastite Bovina/patologia , Azul de Metileno/farmacologia , Azul de Metileno/uso terapêutico , Proteínas do Leite/química , Fotoquimioterapia , Fármacos Fotossensibilizantes/uso terapêutico , Oxigênio Singlete/metabolismo
11.
J Photochem Photobiol B ; 197: 111544, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31295716

RESUMO

Photodynamic therapy (PDT) induced by protoporphyrin IX (PpIX) has been widely used in dermatological practices such as treatment of skin cancers. Clearance rate depends on different factors such as light irradiation, skin oxygenation and drug penetration. The poor penetration of 5-aminolevulinic acid (5-ALA) with topical application is limited and restrains the production of PpIX which could restrict PDT outcomes. This review will focus on techniques already used to enhance drug penetration in human skin, and will present their results, advantages, and drawbacks. Chemical and physical pretreatments will be discussed. Chemical pre-treatments comprise of drug formulation modification, use of agents that modify the heme cycle, enhance PpIX formation, and the combination of differentiation-promoting agent prior to PDT. On the other hand, physical pretreatments affect the skin barrier by creating holes in the skin or by removing stratum corneum. To promote drug penetration, iontophoresis and temperature modulation are interesting alternative methods. Cellular mechanisms enrolled during chemical or physical pretreatments have been investigated in order to understand how 5-ALA penetrates the skin, why it is preferentially metabolized in PpIX in tumour cells, and how it could be accumulated in deeper skin layers. The objective of this review is to compare clinical trials that use innovative technology to conventional PDT treatment. Most of these pretreatments present good or even better clinical outcomes than usual PDT.


Assuntos
Fármacos Fotossensibilizantes/metabolismo , Neoplasias Cutâneas/tratamento farmacológico , Ácido Aminolevulínico/química , Ácido Aminolevulínico/metabolismo , Ácido Aminolevulínico/uso terapêutico , Composição de Medicamentos , Humanos , Lipossomos/química , Micelas , Nanopartículas/química , Fotoquimioterapia , Fármacos Fotossensibilizantes/química , Fármacos Fotossensibilizantes/uso terapêutico , Protoporfirinas/química , Protoporfirinas/metabolismo , Protoporfirinas/uso terapêutico , Neoplasias Cutâneas/patologia
12.
Medicine (Baltimore) ; 98(27): e16275, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277154

RESUMO

BACKGROUND: Halitosis is the term used to define an unpleasant odor emanating from the mouth. However, no studies have evaluated the causes and treatment of halitosis in the population of older adults with denture. METHODS: A randomized, controlled trial is proposed. The patients will be divided into 2 groups: G1: older adults who wear complete dentures and will be treated with tongue scraper (n = 20); G2 older adults who wear complete dentures and will be treated with PDT (n = 20). If the halitosis persists, the participants will be submitted to hygiene procedures for the mucosa and dentures. The evaluation of halitosis will be made before and after treatments, with OralChroma. If the halitosis is solved, the participants will return after 1 week for an additional evaluation. Oral Health Impact Profile (OHIP-14) will be administered by a calibrated examiner on the day the patient history is taken (baseline) and 1 week after treatment for halitosis. DISCUSSION: This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of halitosis in older adults with complete denture. TRIAL REGISTRATION: This protocol was registered in ClinicalTrial.gov, under number NCT03960983. It was first posted and last updated in May 23, 2019. https://clinicaltrials.gov/ct2/show/NCT03960983.


Assuntos
Prótese Total/efeitos adversos , Halitose/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Idoso , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Método Simples-Cego , Fatores de Tempo
13.
Semin Ophthalmol ; 34(6): 436-441, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31309849

RESUMO

Purpose: To evaluate the efficacy and safety of oral eplerenone in cases of central serous chorioretinopathy (CSCR) refractory to photodynamic therapy (PDT). Methods: 19 patients with chronic CSCR and persistent subretinal fluid (SRF) were treated with oral eplerenone for 6 months, starting at a dose of 25 mg/day for 4 weeks and then 50 mg/day for 5 months. All patients underwent visual acuity measurement and optical coherence tomography (OCT), while fluorescein angiography was also performed at baseline, before treatment. Resolution of SRF, changes in retinal thickness and BCVA changes at month 6 and 12 post-treatment initiation were assessed. In addition, creatinine and electrolyte test was done on each patient every month for potential complications. Results: Two out of 19 cases were excluded, since one presented with hyperkaliemia 15 days after eplerenone intake and one with skin rash one day after the treatment initiation. At month 12, 88.2% of patients exhibited visual acuity improvement and 76.4% SRF resolution, while in 11.8% of patients SRF remained stable. Conclusions: This study has shown that eplerenone is safe and effective in cases of chronic CSCR, refractory to previous PDT.


Assuntos
Coriorretinopatia Serosa Central/tratamento farmacológico , Eplerenona/administração & dosagem , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Acuidade Visual/fisiologia , Administração Oral , Adulto , Coriorretinopatia Serosa Central/diagnóstico , Coriorretinopatia Serosa Central/fisiopatologia , Corioide/patologia , Doença Crônica , Relação Dose-Resposta a Droga , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas de Receptores de Mineralocorticoides/administração & dosagem , Estudos Prospectivos , Retina/patologia , Tomografia de Coerência Óptica , Resultado do Tratamento
14.
Carbohydr Polym ; 218: 289-298, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31221332

RESUMO

Bacterial infections are a growing global challenge for public health as antibiotic resistance could cause the failure of anti-infective treatment eventually. So, it is urgent to develop new potential antibacterial materials. Herein, a multifunctional chitosan (CS) functionalized magnetic Chlorin e6 (CS-MP-Ce6) was constructed to combat methicillin-resistant Staphylococcus aureus (MRSA) infection by integrating bacterial conjugation and enrichment, and near-infrared (NIR)-triggered photodynamic sterilization. CS-MP-Ce6 could efficiently capture bacteria due to positively charged property of CS, and Ce6 acted as an effective photodynamic killer to convert NIR light into local energy to enhance antibacterial activity. Specifically, after being trapped together with MRSA, CS-MP-Ce6 showed an excellent in vitro photodynamic sterilization ability. In vivo MRSA-induced abscess treatment studies showed faster healing when CS-MP-Ce6 was used as subcutaneous nano-localized energy sources with the assistance of external magnet to concentrate CS-MP-Ce6-bacteria conjugate. This work provides a promising framework for constructing a new system for efficiently combating MRSA.


Assuntos
Antibacterianos/uso terapêutico , Indóis/química , Nanopartículas de Magnetita/química , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Fármacos Fotossensibilizantes/uso terapêutico , Polímeros/química , Porfirinas/uso terapêutico , Animais , Antibacterianos/efeitos da radiação , Antibacterianos/toxicidade , Quitosana/química , Raios Infravermelhos , Camundongos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/efeitos da radiação , Fármacos Fotossensibilizantes/toxicidade , Porfirinas/efeitos da radiação , Porfirinas/toxicidade , Células RAW 264.7
15.
Rom J Ophthalmol ; 63(1): 68-74, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31198900

RESUMO

Objective. To determine the effect of corneal cross-linking (CXL) on the anterior and posterior corneal indices in terms of their repeatability and change as measured with Pentacam. Methods. Thirty eyes of 30 patients with progressive keratoconus undergoing CXL were enrolled. At each visit (pre-CXL, 6 and 12 months after CXL), imaging were done twice, one hour apart to determine the repeatability index (RI) and intra-class correlation coefficient (ICC). For same session measurements, we computed the intra-session repeatability. We also calculated 4 measures of change by subtracting baseline from 1-year results and determined the repeatability of measures of change. Results. There was no significant difference between the intra-session RI at baseline, 6 months, and 12 months for anterior Kmax-3mm (P=0.609), anterior Kmin-3mm (P=0.548), Kmax-8mm (P=0.860), posterior Kmax-3mm (P=0.717), posterior Kmin-3mm (P=0.548), Q-value-6mm (P=0.890), central corneal thickness (P=0.751), minimum corneal thickness (P=0.787), or anterior chamber depth (P=0.760). The ICCs for these indices were higher than 0.9. For keratoconus indices, there was no significant difference between the intra-session RI at baseline and follow-ups (P>0.05), and the ICC were higher than 0.9 except for baseline and 6-month index of height asymmetry (IHA). The ICC for all 1-year measures of change were more than 0.75 except for posterior corneal indices and IHA. Conclusion. Pentacam repeatability of different indices is not affected by CXL. However, the change of indices showed high variance, which should be taken into consideration, especially in systematic reviews because inter-study differences can be due to low repeatability of the measures of change.


Assuntos
Córnea/diagnóstico por imagem , Reagentes para Ligações Cruzadas/uso terapêutico , Ceratocone/tratamento farmacológico , Fotoquimioterapia/métodos , Riboflavina/uso terapêutico , Adolescente , Adulto , Córnea/efeitos dos fármacos , Paquimetria Corneana , Topografia da Córnea , Feminino , Seguimentos , Humanos , Ceratocone/diagnóstico , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Prospectivos , Acuidade Visual , Adulto Jovem
16.
J Photochem Photobiol B ; 197: 111533, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31254952

RESUMO

Melanoma is one of the most lethal tumors among the skin cancers, arising from complex genetic mutations in melanocyte. Melanoma microenvironment is very heterogeneous, showing complex vascular networks and immunogenicity, as well as induced acquired resistance to treatments by upregulation of multidrug resistance (MDR) mechanisms. Different studies have showed that Photodynamic Therapy (PDT) could be considered a new potential approach for melanoma treatment. PDT combines a light with a specific wavelength and a photosensitizer: when these two elements interact reactive oxygen species (ROS) are generated leading to tumor cell destruction. In this study verteporfin (Ver), a second-generation photosensitizer, has been conjugated with mesoporous silica nanoparticles (MSNs): the resulting Ver-MSNs are an efficient nanoplatforms used to enhance cargo capacity and cellular uptake. Our in vitro and in vivo studies investigated whether Ver-MSNs were able to reduce or inhibit melanoma growth. In vitro experiments performed using B16F10 mouse melanoma cells showed that Ver-MSNs stimulated by red light (693 nm) significantly decreased in vitro cells proliferation in a range of concentration between 0.1 µg/ml to 10 µg/ml. When Ver-MSNs (5 µg/ml in glycerol) were topically administrated to melanoma tumor mass developed in mice and stimulated by red light for four times in 16 days, they were able to reduce the tumor mass of 50.2 ±â€¯6,6% compared to the untreated (only glycerol) mice. In the light of this information, PDT performed using Ver-MSNs could be considered a new promising and potential approach to treat melanoma.


Assuntos
Melanoma Experimental/tratamento farmacológico , Nanopartículas Metálicas/química , Dióxido de Silício/química , Verteporfina/química , Animais , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Portadores de Fármacos/química , Feminino , Luz , Melanoma Experimental/patologia , Camundongos , Camundongos Endogâmicos C57BL , Microscopia de Fluorescência , Fotoquimioterapia , Fármacos Fotossensibilizantes/química , Fármacos Fotossensibilizantes/uso terapêutico , Porosidade , Espécies Reativas de Oxigênio/metabolismo , Verteporfina/uso terapêutico
17.
Adv Mater ; 31(33): e1901965, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31237375

RESUMO

Antibacterial photocatalytic therapy has been reported as a promising alternative water disinfection technology for combating antibiotic-resistant bacteria. Numerous inorganic nanosystems have been developed as antibiotic replacements for bacterial infection treatment, but these are limited due to the toxicity risk of heavy metal species. Organic semiconductor photocatalytic materials have attracted great attention due to their good biocompatibility, chemically tunable electronic structure, diverse structural flexibility, suitable band gap, low cost, and the abundance of the resources they require. An all-organic composite photocatalytic nanomaterial C3 N4 /perylene-3,4,9,10-tetracarboxylic diimide (PDINH) heterostructure is created through recrystallization of PDINH on the surface of C3 N4 in situ, resulting in enhanced photocatalytic efficiency due to the formation of a basal heterostructure. The absorption spectrum of this composite structure can be extended from ultraviolet to near-infrared light (750 nm), enhancing the photocatalytic effect to produce more reactive oxygen species, which have an excellent inactivation effect on both Gram-negative and positive bacteria, while demonstrating negligible toxicity to normal tissue cells. An efficient promotion of infectious wound regeneration in mice with Staphylococcus aureus infected dermal wounds is demonstrated. This all-organic heterostructure shows great promise for use in wound disinfection.


Assuntos
Antibacterianos/química , Imidas/química , Nitrilos/química , Perileno/análogos & derivados , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/química , Semicondutores , Animais , Antibacterianos/uso terapêutico , Antibacterianos/toxicidade , Catálise , Sobrevivência Celular , Escherichia coli/efeitos dos fármacos , Feminino , Luz , Camundongos , Camundongos Endogâmicos BALB C , Células NIH 3T3 , Nanoestruturas/química , Nitrilos/uso terapêutico , Nitrilos/toxicidade , Perileno/química , Fármacos Fotossensibilizantes/uso terapêutico , Fármacos Fotossensibilizantes/toxicidade , Porfirinas/uso terapêutico , Porfirinas/toxicidade , Espécies Reativas de Oxigênio/metabolismo , Staphylococcus aureus/efeitos dos fármacos , Cicatrização , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia
18.
Cornea ; 38(8): 986-991, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31180339

RESUMO

PURPOSE: To evaluate the changes in anterior corneal topography induced by short-time wear of scleral contact lenses (SLs) in keratoconic subjects with and without a history of corneal cross-linking (CXL). METHODS: Nine keratoconic patients (14 eyes) were fitted with 18.5 mm SLs for optical rehabilitation. Subjects were divided into 2 groups: 7 eyes without a history of CXL (Non-CXL group) and 7 with a history of CXL (CXL group). Corneal topography was performed at baseline and after 2 and 5 hours of lens wear. The differences for simulated flat (Kflat), steep (Ksteep) and maximal (Kmax) corneal curvatures, central corneal astigmatism (CCA), and central cornea thickness were evaluated. RESULTS: No statistically significant difference was detected between Non-CXL and CXL groups in any of these measures. Statistically significant flattening was detected in Ksteep Repeated measures analysis of variance ([RM-ANOVA), F (2,24) = 11.32, P < 0.0001], CCA [RM-ANOVA, F (2,24) = 15.34, P < 0.0001], and Kmax [RM-ANOVA, F (2,24) = 19.10, P < 0.0001). From baseline to 5 hours of SL wear, Ksteep decreased on average from 53.1 to 52.4 D, Kmax decreased from 56.7 to 55.8 D, and CCA decreased from 7.2 to 6.3 D. Kmax showed a trend toward more flattening in the Non-CXL group. Central cornea thickness showed significant thickening over time from baseline (451 µm) to 5 hours (458 µm) of SL wear [RM-ANOVA, F (1,12) = 319.3, P < 0.0001]. CONCLUSIONS: Short-term scleral lens wear in keratoconic patients may cause flattening of the anterior cornea. A history of CXL treatment does not guarantee corneal shape stability after scleral lens wear. Practitioners should be aware of these changes because scleral lens wear may mask the signs of keratoconus progression.


Assuntos
Lentes de Contato , Córnea/fisiopatologia , Topografia da Córnea , Reagentes para Ligações Cruzadas , Ceratocone/fisiopatologia , Ceratocone/terapia , Fotoquimioterapia/métodos , Adulto , Colágeno/metabolismo , Substância Própria/metabolismo , Feminino , Humanos , Ceratocone/tratamento farmacológico , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Riboflavina/uso terapêutico , Esclera , Acuidade Visual/fisiologia , Adulto Jovem
19.
Cornea ; 38(8): 1049-1057, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31169612

RESUMO

PURPOSE: To evaluate the safety, efficacy, and stability of topography-guided partial PRK combined with corneal cross-linking (CXL) (the Athens Protocol [AP]) in pediatric patients with keratoconus over a 4-year follow-up period. METHODS: This prospective study included 39 keratoconic eyes of 21 patients younger than 18 years with clinical and imaging evidence of keratoconus progression. Partial topography-guided excimer laser ablation in conjunction with high-fluence CXL was performed in all patients according to the AP. Uncorrected distance visual acuity, corrected distance visual acuity, refraction, keratometry, endothelial cell density, topography, and tomography using both Scheimpflug and optical coherence tomography (OCT) were evaluated for 4 years postoperatively. RESULTS: At 4 years postoperative, there was significant improvement in mean uncorrected distance visual acuity from 0.51 ± 0.31 (decimal) to 0.65 ± 0.26 (decimal; P < 0.05). Mean corrected distance visual acuity improved from 0.71 ± 0.22 (decimal) preoperatively to 0.81 ± 0.19 (decimal; P < 0.05), respectively. Mean flat keratometry (K1) and mean steep keratometry (K2) readings reduced from 44.95 ± 3.71 D and 49.32 ± 5.05 D, respectively, preoperatively to 43.14 ± 2.95 D and 46.28 ± 4.87 D, respectively, (P < 0.05) at 4 years. The mean anterior maximum keratometry (Kmax) reading reduced from 56.81 ± 2.94 D preoperatively to 48.11 ± 3.17 D at 48 months. The mean index of height decentration was 0.105 ± 0.054 µm preoperatively and 0.049 ± 0.024 (P < 0.05) at 4 years postoperative. Mean preoperative corneal thickness at the thinnest point was 436.7 ± 42.6 µm preoperatively, 392.50 ± 45.68 µm at 12 months postoperative, and 418.42 ± 17.01 µm at 4-year follow-up. Late-onset deep corneal haze, a potential intrinsic complication of this technique in pediatric patients, was encountered in 2 cases at least 1 year after the procedure. CONCLUSIONS: Long-term results of the AP seem to be safe and effective in pediatric patients, with marked improvement in visual function and keratometric symmetry indices.


Assuntos
Reagentes para Ligações Cruzadas , Ceratocone/terapia , Fotoquimioterapia/métodos , Ceratectomia Fotorrefrativa/métodos , Cirurgia Assistida por Computador/métodos , Adolescente , Criança , Protocolos Clínicos , Colágeno/metabolismo , Terapia Combinada , Substância Própria/metabolismo , Topografia da Córnea/métodos , Feminino , Humanos , Ceratocone/tratamento farmacológico , Ceratocone/metabolismo , Ceratocone/cirurgia , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Prospectivos , Refração Ocular/fisiologia , Riboflavina/uso terapêutico , Tomografia de Coerência Óptica , Raios Ultravioleta , Acuidade Visual/fisiologia
20.
Cornea ; 38(7): 864-867, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31170104

RESUMO

PURPOSE: To assess corneal thickness changes with isotonic riboflavin (RF) solution with hydroxylpropyl methylcellulose in patients undergoing accelerated corneal collagen crosslinking (CXL) with and without an eyelid speculum. METHODS: Fifty-two eyes of 48 patients with progressive keratoconus were enrolled in this study. The patients in this study were divided into 2 groups: in group 1 an eyelid speculum was removed during 20-minute RF (0.1%) + hydroxylpropyl methylcellulose (Mediocross M; Avedro Inc, Waltham, MA) instillation, and in group 2 the eyelid speculum was retained in place during the entire CXL procedure. All patients underwent accelerated CXL using continuous ultraviolet-A (UVA) light exposure at 9 mW/cm for 10 minutes; total energy dose was 5.4 J/cm. Intraoperative ultrasound pachymetry measurements were obtained before and after epithelial removal, after RF loading, and after UVA light exposure at 5 and 10 minutes. RESULTS: The preoperative pachymetric measurements decreased in both groups after the removal of epithelium [group 1 (n = 26): -25 µm, group 2 (n = 26): -31 µm, P = 0.234]. Although the thinnest pachymetry significantly increased after soaking in both group 1 (52.26 µm) and group 2 (27.88 µm, P < 0.001), closure of the eyelids during RF instillation further increased the pachymetry readings (P < 0.0001). The corneal thickness remained stable in both groups during UVA irradiation at 5 and 10 minutes (P > 0.05). CONCLUSIONS: Closure of the eyelids further induces corneal swelling that may offer an advantage to improve safety of the procedure particularly in thin corneas.


Assuntos
Colágeno/metabolismo , Córnea/efeitos dos fármacos , Derivados da Hipromelose/uso terapêutico , Ceratocone/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Riboflavina/uso terapêutico , Adolescente , Adulto , Criança , Reagentes para Ligações Cruzadas/uso terapêutico , Feminino , Humanos , Derivados da Hipromelose/farmacologia , Masculino , Fotoquimioterapia/instrumentação , Fármacos Fotossensibilizantes/farmacologia , Riboflavina/farmacologia , Instrumentos Cirúrgicos , Raios Ultravioleta , Adulto Jovem
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