5-aminolevulinic acid photodynamic therapy for chronic wound infection in rats with diabetes

Ning Guo; Jingyu Chen; Feiyan Kong; Yuying Gao; Jiayue Bian; Tianjun Liu; Ge Hong; Zhanjuan Zhao

Biomedicine & Pharmacotherapy (Sep 2024)

5-aminolevulinic acid photodynamic therapy for chronic wound infection in rats with diabetes

Ning Guo,
Jingyu Chen,
Feiyan Kong,
Yuying Gao,
Jiayue Bian,
Tianjun Liu,
Ge Hong,
Zhanjuan Zhao

Affiliations

Ning Guo: School of Basic Medical Sciences, Hebei University, China; Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China
Jingyu Chen: Tianjin University of Traditional Chinese Medicine, China
Feiyan Kong: School of Basic Medical Sciences, Hebei University, China
Yuying Gao: Hebei University, China
Jiayue Bian: Hebei University, China
Tianjun Liu: Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China
Ge Hong: Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China; Correspondence to: Academy of Basic Medical Sciences, Hebei University, Hebei, China. Tianjin Key Laboratory of Biomedical materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China.
Zhanjuan Zhao: School of Basic Medical Sciences, Hebei University, China; Correspondence to: Academy of Basic Medical Sciences, Hebei University, Hebei, China. Tianjin Key Laboratory of Biomedical materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China.

Journal volume & issue: Vol. 178
p. 117132

Abstract

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Recent research indicated that ulcers and peripheral vascular disease resulting from drug-resistant bacterial infections are the main causes of delayed healing in chronic diabetic wounds. 5-Aminolevulinic acid (ALA) is a second-generation endogenous photosensitizer. The therapeutic effect and mechanism of ALA-mediated photodynamic therapy (ALA-PDT) on methicillin-resistant Staphylococcus aureus (MRSA)-infected wounds in diabetic rats were investigated in this study. The results revealed the promising antibacterial effects of ALA-PDT MRSA in vitro, with a minimum inhibitory concentration and minimum bactericidal concentration of 250 and 500 μM, respectively. ALA-PDT also changed the permeability and structural integrity of bacterial cell membranes by producing reactive oxygen species. Meanwhile, ALA-PDT accelerated wound healing in MRSA-infected diabetic rats, with 5 % ALA-PDT achieving complete sterilization in 14 days and wound closure in 21 days. Treatment with 5 % ALA-PDT additionally improved the histopathological appearance of skin tissue, as well as fibrosis, inflammatory cytokine release, and angiogenesis-related protein expression. These findings indicated that ALA-PDT significantly promoted the healing of MRSA-infected wounds in diabetic rats by eliminating bacteria, inhibiting inflammation, generating granulation tissues, promoting neovascularization, and restoring damaged nerves. In addition, the healing mechanism was related to the activation of inflammatory and angiogenesis pathways through the regulation of tumor necrosis factor-alpha and interleukin-6 expression and upregulation of CD206, CD31, and VEGF. These findings underscored the potential role of ALA-PDT in promoting the healing of chronic diabetic wounds.

Published in Biomedicine & Pharmacotherapy

ISSN: 0753-3322 (Print); 1950-6007 (Online)
Publisher: Elsevier
Country of publisher: France
LCC subjects: Medicine: Therapeutics. Pharmacology
Website: https://www.journals.elsevier.com/biomedicine-and-pharmacotherapy

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