Potential of photodynamic therapy in modulating the inflammatory response and microbial virulence factors: evaluation in a model of three-dimensional co-cultures of gingival fibroblasts, Candida albicans and Staphylococcus aureus

Abstract

Increased resistance to antibiotics is one of the most urgent challenges for Medicine worldwide and requires the search for innovative and more efficient medical strategies. The treatment of ulcerated oral lesions represents a great challenge, because in addition to the important symptoms, oral ulcers are susceptible to colonization by microorganisms, and these lesions may be more painful, more extensive, and may have a prolonged duration or worsening of the condition clinical when the oral microflora is unbalanced and harmful bacteria are in increasing proliferation, which can penetrate the tissue and cause the emergence of systemic infectious conditions. Photodynamic therapy (PDT) presents itself as a promising alternative for the treatment of inflammatory and infectious skin processes. However, few studies have evaluated the effectiveness of PDT in ulcerated lesions of the oral cavity, and no study has evaluated its action on microorganisms related to these oral lesions. Thus, the present study is divided into three studies and aims to: 1) carry out a systematic review of the literature followed by a meta-analysis in order to assess the effectiveness of PDT under tissue disinfection of ulcerated lesions; 2) to evaluate the dose-response relationship of the concentration of photosensitizing agents (Photodithazine® and Senna reticulata plant extract), and of the light dose, using cell cultures in gingival fibroblast monolayer and 3) to evaluate the in vitro potential of mediated PDT by these photosensitizing agents to be used as a new therapeutic modality for the treatment and prevention of infectious processes present in oral ulcerated lesions. For this, a three-dimensional cell model of coc-culture of gingival fibroblasts, Candida albicans and Staphylococcus aureus will be made and the evaluation of microbial virulence factors and tissue inflammatory modulation will be performed using the qRT-PCR technique. (AU)