PS for photodynamic inactivation of the bacteria. Those authors observed more PDTresistantMRSA strains compared with the MSSA strains, as observed in the presentstudy. Tsai et al. [22] also found that the PDT susceptibility of MRSA strains waslower than the other antibiotic-susceptible strains. This greater resistance of MRSAstrains to PDT has been related to the capsular polysacchari<strong>de</strong> structure on thebacterial cell surface, which would limit the penetration of the PS into the MRSAcells, reducing the toxic effects of the ROS generated during photodynamicinactivation [23]. The need for higher light fluences and drug concentration forresistant strains have been also observed for yeasts, showing that fluconazole-resistantC. albicans and C. glabrata strains had reduced sensitivity to PDT [12]. It is acceptedthat PDT is a non-specific and effective treatment against both susceptible andresistant pathogen [22]. Until now, the studies reported that PDT effect is strain andisolate-<strong>de</strong>pen<strong>de</strong>nt. In our study, the ATTC evaluated strains presented the behavior ofsusceptible bacteria being more sensitive to PDT treatment than the resistant bacteria.However, Grinholc et al. [14] reported on MRSA isolates highly sensitive to PDT,whereas there are some other MRSA isolates resistant to its effects [14,22]. Therefore,it is relevant to evaluate the susceptibility of resistant microorganisms to PDT in or<strong>de</strong>rto <strong>de</strong>termine whether it can be used in the treatment of infections in which theprevalence of these microorganisms has increased at alarming rates.In the same way, it is important to investigate the potential toxic effects ofPDT to the host’s cells, which are also susceptible to the action of ROS. In the presentstudy, the metabolism of cultured fibroblast cells <strong>de</strong>creased by 68.1, 75.1 and 80% inresponse to exposure to curcumin at 5, 10 and 20 µM concentrations, respectively, incombination with blue LED light illumination. Similarly, in a previous study,porphyrin-mediated photodynamic therapy reduced the viability of human <strong>de</strong>rmalfibroblasts by 66.5% and caused photodynamic inactivation of 99.9% of MRSA [14].Even consi<strong>de</strong>ring that the reduction of cell metabolism was accentuated in our study,it was not sufficient to cause complete inhibition of the SDH enzyme, suggesting thatboth MSSA and MRSA strains were more susceptible to PDT than the L929fibroblasts. Dovigo et al. [24] obtained similar results when the same parameters usedfor fungal cells were applied for macrophage cell culture. While a completephotokilling was achieved for C. albicans planktonic cells, the macrophagesmetabolism was not completely reduced. Despite the significant reduction of cellmetabolism, the in vitro experiments cannot reproduce all in vivo conditions. In a
living organism, in response to the oxidative stress generated by the presence of ROS,the <strong>de</strong>fense the system releases several endogenous antioxidant agents, such asperoxidases and catalases, which promotes an enzymatic <strong>de</strong>gradation of those highlyreactive and unstable molecules to avoid excessive tissue damage [25].The interaction of curcumin with biomolecules and cells has beeninvestigated. Results of recent studies have indicated that curcumin bindspreferentially to lipid membrane and some cell proteins [18]. Bruzell et al. [26]observed that PDT using curcumin at 13.5 µM in combination with halogen lightillumination (6 J/cm 2 ) resulted in around 80% of necrotic cell <strong>de</strong>ath and less the 20%of apoptotic cell <strong>de</strong>ath. In the present study, the SEM analysis revealed that thefibroblast cell cultures subjected to PDT exhibited a significant <strong>de</strong>crease in thenumber of cells adhered to the glass substrate. In addition, several cytoplasmic restsremained adhered to the glass coverslip, indicating rupture of the cytoplasmicmembrane and suggesting necrotic cell <strong>de</strong>ath.Another factor to be consi<strong>de</strong>red for the use of curcumin as a PS is the vehicleused to <strong>de</strong>liver this compound. As curcumin is relatively insoluble in water, variousdiluents like acetone, DMSO and ethanol as well as other preparations such asmicelles, cyclo<strong>de</strong>xtrine, liposomes and hydrophilic polymers have been proposed asvehicles for curcumin [26]. DMSO is the most commonly used vehicle to evaluate thephototoxic effects of PDT in in vitro studies and it has become a control to evaluateseveral types of drug vehicles because of its excellent solvent propriety [15,20]. In thepresent study, dilution of curcumin in DMSO increased its solubility in aqueoussolutions, improving its bioavailability and promoting bacterial photokilling [27].Bruzell et al. [26] reported that the use of curcumin at 13.5 µM diluted in DMSO wassufficient to reduce by 80% the viability of rat submandibular salivary gland acinarcells. However, preparation of the same curcumin concentration in cyclo<strong>de</strong>xtrine orliposome did not cause reduction of enzymatic activity. It is known that DMSO is notan optimal vehicle for in vivo applications because it increases membranepermeability to the drugs and may cause tissue damage and systemic effects [20].Therefore, further studies should evaluate different vehicles as efficient as DMSO forcurcumin to exert photokilling against bacterial strains.Both essential components of PDT - the PS and the visible light - can alter cellfunctions. However, in the present study, no significant differences were observedbetween the groups exposed only to curcumin (C+L-) or blue LED light (C-L+) when
- Page 1: UNESP - UNIVERSIDADE ESTADUAL PAULI
- Page 4 and 5: Dados CurricularesAna Paula Dias Ri
- Page 6 and 7: Dedico este trabalho...Aos meus pai
- Page 8 and 9: Dedico este trabalho... Ao meu amor
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- Page 12 and 13: À Lívia, Juliana, Fernanda Alves,
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control (p˂0.05); the other contro
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ClAlPc or diluted in DMSO. On the o
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In addition to the photodynamic eff
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Authors Contribution:All authors ha
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Lambert PA (2002) Cellular impermea
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FiguresFigure 1. Line graphic repre
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Figure 5. Box-plot graphic represen
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4 DiscussãoA Terapia Fotodinâmica
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antibioticoterapia 80 . Entretanto,
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Sabe-se que o DMSO não representa
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como a membrana nuclear 19 . Dessa
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esultando em comportamento semelhan
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A investigação do efeito antimicr
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5 Conclusão
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as maiores doses de luz avaliadas.
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6 Referências ∗1. Allison RR, Mo
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22. Dovigo LN, Pavarina AC, Mima EG
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41. Kussovski V, Mantareva V, Angel
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59. Primo FL, Bentley MV, Tedesco A
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80. Tsai T, Yang YT, Wang TH, Chien
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7 ApêndiceNesta seção estão apr
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Tabela A1- Valores originais de ufc
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Tabela A7- Medidas de resumo, em lo
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B- Avaliação de diferentes concen
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Tabela A15- Sumário da Análise de
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Tabela A19- Sumário da Análise de
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Tabela A21- Valores originais de lo
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Tabela A24- Valores originais de ab
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Tabela A27- Valores originais obtid
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Tabela A28- Resultado das comparaç
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Testes foram realizados para verifi
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Tabela A33- Valores originais de lo
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Tabela A36- Resultado do teste de c
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Tabela A39- Valores originais de ab
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Tabela A43- Resultado do teste de c
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Tabela A46- Medidas de resumo de ab
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