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Lasers in Medical Science

, Volume 33, Issue 9, pp 1925–1931 | Cite as

Antimicrobial photodynamic therapy as a new approach for the treatment of vulvovaginal candidiasis: preliminary results

  • Maria Eugênia Simões Onofre de Santi
  • Renato Araujo Prates
  • Cristiane Miranda França
  • Rúbia Garcia Lopes
  • Aline Silva Sousa
  • Luis Rodolfo Ferreira
  • Sandra Kalil Bussadori
  • Adjaci Uchoa Fernandes
  • Alessandro Melo DeanaEmail author
Original Article

Abstract

In this work, we present the efficacy of photodynamic therapy against yeast cells in an animal model. We tested two photosensitizers, methylene blue and protoporphyrin IX. Thirty-seven female BALB-c mice with a body mass of 20–25 g were used. To achieve persistent vaginitis, estrus was induced by subcutaneous injection of 0.1 mg/mL estradiol valerate applied weekly. Three days after pseudo-estrus, intravaginal inoculation with Candida albicans was performed. Mice were anesthetized with ketamine (80 mg/kg) and xylazine (10 mg/kg) by intraperitoneal injection before inoculation, and antimicrobial photodynamic therapy (aPDT) was performed 5 days after fungal inoculation. Two photosensitizers were tested, methylene blue (MB; 100 μM) and protoporphyrin IX (PpNetNI; 10 μM). Two custom-made LEDs emitting light at 660 and 630 nm at approximately 800 mW each were used for irradiation. The aPDT treatment reduced the fungal colony-forming units (CFUs) by one order of magnitude for the MB (p = 0.020) and PpNetNI (p = 0.018) photosensitizers. Seven days after the treatment, there were significantly fewer CFUs compared to the control group (p = 0.041 and p = 0.035 for MB and PpNetNI, respectively), but this was not increased compared to the initial number immediately after aPDT. Using aPDT as a therapeutic option to decrease fungal infection in a vaginal candidiasis model resulted in a significant reduction in the C. albicans population. Both photosensitizers were effective for preventing reinfection within 7 days. The aPDT also had no effect on the vaginal mucosa at the ultrastructural level. In addition to the fungicide effect, we observed reduced swelling and lack of the formation of abscesses, microabscesses coating the cornified epithelial layer, and the accumulation of neutrophils in the submucosa.

Keywords

Laser Photobiomodulation Antimicrobial photodynamic therapy Candida Vulvovaginal candidiasis Candidiasis treatment 

Notes

Funding

The work was partially funded by the São Paulo Research Foundation (FAPESP) grant 08/57721-3.

Compliance with ethical standards

The Ethics Committee of Universidade Nove de Julho (protocol number 00025/2013) approved this work.

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The Ethics Committee of Universidade Nove de Julho (protocol number 00025/2013) approved this study.

Informed consent

This work involved an animal study; therefore, obtaining informed consent was not necessary.

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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  • Maria Eugênia Simões Onofre de Santi
    • 1
  • Renato Araujo Prates
    • 1
  • Cristiane Miranda França
    • 1
  • Rúbia Garcia Lopes
    • 1
  • Aline Silva Sousa
    • 1
  • Luis Rodolfo Ferreira
    • 1
  • Sandra Kalil Bussadori
    • 1
  • Adjaci Uchoa Fernandes
    • 2
  • Alessandro Melo Deana
    • 1
    Email author return OK on get
  1. 1.Biophotonics Applied to Health SciencesUniversidade Nove de Julho (UNINOVE)LiberdadeBrazil
  2. 2.Universidade Anhembi MorumbiSão PauloBrazil

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