Nkhani
Kafukufuku wa methylene blue yolimbana ndi tizilombo: mabakiteriya, bowa, ndi kuyambitsidwa ndi kuwala
Owerenga awiri akawona mawu akuti methylene blue yolimbana ndi tizilombo, amaganizira zinthu zosiyana. Wina amaganizira madzi abuluu amene amapha tizilombo akangokhudzana nazo. Wina amaganizira njira imene utoto pamodzi ndi kuwala kofiira zimawononga tizilomboto. Maganizo onsewa ali ndi mbali ina ya choonadi. Koma palibe limene limafotokoza zonse, ndipo kusokoneza ziwirizi ndi kumene zonena zambiri za pa intaneti zimalakwika.
Kusiyana kumeneku ndi nkhani ya ndemanga iyi. Methylene blue imakhala ndi mphamvu yochepa yowononga tizilombo mumdima ngati mulingo wake wakwanira. Ikakhala ndi kuwala kofiira, imakhala chinthu choyambitsa zochitika za mankhwala ikalandira kuwala, chotchedwa photosensitizer: imayamwa fotoni, imafika mu mkhalidwe wochitapo kanthu wa triplet, ndipo imayambitsa zochitika za oxidation zimene zimawononga zinthu zambiri nthawi imodzi. Njira yoyambitsidwa ndi kuwala imeneyi ili ndi dzina lake, chithandizo cha photodynamic cholimbana ndi tizilombo, komanso mikhalidwe yake yofunika. Mulingo wa utoto wokha si umene umaifotokoza. Utali wa mafunde a kuwala, mlingo wa kuwala, nthawi yosungira tizilombo ndi utoto, oxygen, ndi mtundu wa chamoyo ndi zimene zimasankha zotsatira.
Njira ziwiri zophera tizilombo
Ganizirani kaye njira ya mumdima. Methylene blue ndi utoto wa phenothiazinium wokhala ndi chaji yabwino. Umagwirizana ndi zigawo zakunja za tizilombo, umalowa m'maselo mosiyanasiyana, ndipo umachita zochitika za redox ndi zomangirirana ndi zinthu zina. Palibe mafotoni amene amatenga nawo mbali. Tizilombo timafa, koma pa milingo ya utoto imene imasiyana kwambiri malinga ndi chamoyo, ndipo njirayi siimangolunjika pa chinthu chimodzi chokha.
Njira ya photodynamic imawonjezera kuwala. Mafotoni ofiira a pafupifupi 630 mpaka 680 nm amagwirizana ndi gawo la mafunde amene utotowo umayamwa, ndipo monomer imayamwa kwambiri pafupi ndi 664 nm. Kuyamwa kumeneku kumayika utoto mu mkhalidwe wa singlet wokhalitsa kwa kanthawi kochepa, kenako mu mkhalidwe wa triplet wokhalitsa nthawi yaitali kuposawo. Kuchokera pamenepo, pamatsatira magulu awiri a zochitika. Mu zochitika za Type I, triplet imapereka electron ku chinthu china ndipo imayambitsa njira za ma radical zomwe zimaphatikizapo superoxide ndi hydroxyl. Mu zochitika za Type II, imapereka mphamvu mwachindunji ku oxygen yomwe ili mu mkhalidwe wake wamba ndipo imapanga singlet oxygen. Zonsezi zingachitike nthawi imodzi, ndipo kunena kuti utotowo umangopanga singlet oxygen yokha n'kufotokoza mosavuta kwambiri. Ndemanga ya kugwirizana kwa kapangidwe ndi ntchito ya ma photosensitizer a phenothiazinium ikusonyeza mfundoyi mwachindunji: pakati pa mitundu yogwirizana ya utoto, kuwononga mabakiteriya koyambitsidwa ndi kuwala sikunatsatire kuchuluka kwa singlet oxygen yokha, chifukwa kulowa kwa utoto, kumene unakhazikika, ndi kusanduka kwake mwa reduction kukhala leuco yosagwira ntchito zinali zofunika mofanana ndi mmene utotowo umachitira ndi kuwala. Zochitika za mankhwala zoyambitsidwa ndi kuwala zomwe zimafotokoza lamulo la utali wa mafunde zafotokozedwa mu ndemanga yogwirizana nayo ya utoto pamodzi ndi kuwala kofiira.
Singlet oxygen ndi yofunika pa khalidwe lina lothandiza. Imachita ndi mamolekyu ambiri a zamoyo nthawi imodzi, kotero kuwonongako kumakhudza zinthu zambiri m'malo molunjika pa enzyme imodzi kapena puloteni yomangirira. Kufotokoza koyambirira kwa kugwiritsa ntchito photodynamic polimbana ndi tizilombo kunasonyeza izi monga chifukwa chimene njira zomwe tizilombo timakanira mankhwala wamba zimakhala ndi mphamvu yochepa pano: puloteni yowonjezera yomangirira penicillin kapena topoisomerase yosinthika siziletsa kuchuluka kwadzidzidzi kwa mitundu ya oxygen yochitapo kanthu. Mfundo imeneyi inaoneka m'kuyesa pa Staphylococcus aureus yosamva methicillin ndi enterococci osamva vancomycin, monga tebulo ili pansipa likusonyezera. Sizitanthauza kuti kukana n'kosatheka, koma kuti kumagwira ntchito mosiyana. Mapampu otulutsa zinthu m'selo ndi njira zodzitetezera ku oxidation zingasinthebe mlingo wofunika, makamaka pa bowa.
Tebulo la zamoyo ndi njira za kafukufuku
Tebulo ili ndilo mbali yaikulu ya nkhaniyi. Chiwerengero chilichonse chikugwirizana ndi ndondomeko yake yeniyeni: utoto womwewo, koma mlingo wina wa kuwala kapena nthawi ina yosungira, zimapereka chiwerengero china. Musawerenge MBC, MLC, ndi MIC ngati kuti zikutanthauza chinthu chimodzi. MBC ndi MLC pano zikutanthauza kuti palibe tizilombo tomwe tapulumuka tikalimidwanso, pamene MIC ikutanthauza kulepheretsa kukula. Mikhalidwe ya kuwala yaperekedwa pa mzere uliwonse.
| Chamoyo ndi njira yoyesera | Zotsatira mumdima | Zotsatira pakuwala | Mikhalidwe |
|---|---|---|---|
| S. aureus NCTC 6571, maselo oyandama m'madzi | MBC 5 uM | MBC 5 uM | Tebulo la ndemanga, kuwala koyera 12 J per cm2 |
| S. aureus NCTC 6571, maselo oyandama m'madzi | MLC 2.5 uM | MLC 1 uM | Ndondomeko yoyambirira ya 1997, 1.7 mW per cm2 kwa ola 1, pafupifupi 6.3 J per cm2, tizilombo toyambirira pafupi ndi 10^6 CFU per mL, monga zinanenedwera mu kafukufuku woyambirira wa phenothiazinium yopha mabakiteriya ikalandira kuwala |
| MRSA EMRSA-15, maselo oyandama | MBC 80 uM | MBC 20 uM | Tebulo la ndemanga, pafupifupi 12 J per cm2, kukhudzidwa kunawonjezeka kanayi |
| MRSA EMRSA-16, maselo oyandama | MBC 40 uM | MBC 10 uM | Ndondomeko yomweyi ya pamwambapa |
| E. coli NCTC 9001, maselo oyandama | MBC 500 uM | MBC 100 uM | Ndondomeko yomweyi, kukhudzidwa kunawonjezeka kasanu |
| P. aeruginosa NCTC 10622, maselo oyandama | MBC 500 uM | MBC 25 uM | Ndondomeko yomweyi, kukhudzidwa kunawonjezeka ka makumi awiri |
| E. faecalis NCTC 775, maselo oyandama | MLC 100 uM | MLC 100 uM | Ndondomeko ya 1997 pa 6.3 J per cm2, palibe kusintha pa mtundu uwu ndi mlingo uwu |
| E. faecium yosamva vancomycin, maselo oyandama | MBC 400 uM | MBC 400 uM | Tebulo la ndemanga, palibe kusintha ndi utoto woyambirira, koma mitundu yochokera ku utotowo yokhala ndi magulu a methyl komanso yosagwirizana kwambiri ndi madzi inapereka kusintha, malinga ndi kafukufuku wa enterococcus yosamva vancomycin |
| Candida albicans, maselo oyandama | MIC yoposa 12.79 ug per mL | MIC 12.79, 6.39, ndi 1.59 ug per mL pa 5, 10, ndi 15 J per cm2 | Kusungira mumdima kwa mphindi 30 musanaunikire, LED yofiira ya 600 mpaka 650 nm yokhala ndi pachimake pa 635 nm, malinga ndi kafukufuku wa kusintha kwa zotsatira malinga ndi mlingo pa ntchito ya photodynamic ya methylene blue yolimbana ndi bowa |
| C. albicans YEM14 poyerekeza ndi mtundu wopanga mapampu otulutsa zinthu ochuluka, kupha koyezedwa ndi CFU | Sizikugwira ntchito pano | Kupha pafupifupi 5 log pa mtundu woyambirira, kupha pafupi ndi ziro pa mtundu wopanga CDR1/CDR2 ochuluka | Utoto wa 100 uM, kusungira kwa mphindi 30, 660 nm pa 60 J per cm2, malinga ndi kafukufuku wa mmene mapampu otulutsa zinthu amakhudzira kupha koyambitsidwa ndi kuwala kwa methylene blue |
| Ulusi wa Trichophyton rubrum poyerekeza ndi njere zake | Sizikugwira ntchito pano | MIC ya ulusi pafupifupi 6.3 ug per mL, ya njere pafupifupi 2.0 ug per mL; kulepheretsa CFU zonse kunafuna 5 ug per mL pamodzi ndi 100 J per cm2 pa ulusi poyerekeza ndi 1.25 ug per mL pamodzi ndi 40 J per cm2 pa njere | Ndondomeko ya photodynamic ya 635 nm, malinga ndi kafukufuku wa kukhudzidwa kwa dermatophyte pa magawo ake a kukula |
| Biofilm yokhwima ya pansi pa nkhama yokhala ndi mitundu 33, chipangizo cha Calgary, tsiku 6 | MB yokha inachepetsa chiwerengero chonse ndi zoposa 80 peresenti | MB pamodzi ndi LED ya 660 nm zinachepetsa ntchito ya kagayidwe ndi pafupifupi 55 peresenti, popanda kusintha kwakukulu kwa kapangidwe ka gulu la tizilombo | Utoto wa 0.01 peresenti (100 ug per mL), 660 nm pa pafupifupi 330 mW per cm2 kwa mphindi 5, kukula popanda oxygen, malinga ndi kafukufuku wa mu labotale wa biofilm ya m'kamwa yokhala ndi mitundu yambiri |
Pali zinthu zitatu zoonekera. Choyamba, staphylococci a Gram positive amafa pa milingo yotsika ya micromolar, pamene mabakiteriya ooneka ngati timitengo a Gram negative amafuna utoto wochuluka pafupifupi ka zana mumdima, chifukwa nembanemba yakunja ya Gram negative imalepheretsa kulowa. Kuwala kumachepetsa kusiyanako koma sikukumachotsa. Chachiwiri, ntchito ya methylene blue yolimbana ndi bowa ilipo, koma imadalira mikhalidwe: kupha Candida ndi methylene blue kumawonjezeka kwambiri ndi mlingo wa kuwala, ndipo kusintha kumodzi kwa khalidwe, monga kupanga mapampu otulutsa zinthu ochuluka, kungachotse kupha kwa 5 log pa mlingo womwewo. Chachitatu, biofilm yokhwima imachita mosiyana ndi maselo oyandama, ndipo mzere wa biofilm ya m'kamwa uyenera kumvedwa m'gulu limeneli.
Mabakiteriya: kumene kuwala kumathandiza kwambiri, ndi kumene sikuthandiza
Staphylococci ndi amene amakhudzidwa mosavuta. Ngakhale ziwerengero za tebulo la ndemanga za MRSA yofalikira pa mliri zimakhala zofanana kapena zotsika kuposa za vancomycin yomwe yagwiritsidwa ntchito poyerekezera, kuwala kukangogwiritsidwa ntchito. Ndipo mitundu yochokera ku utotowo yokhala ndi magulu awiri a methyl inachita bwino kwambiri, chifukwa kuwonjezera methyl kunawonjezera kugwirizana ndi mafuta ndi kupanga singlet oxygen, komanso kunalepheretsa kusanduka mwa reduction kukhala leuco. Mfundo ya mankhwala imeneyi ndi yofunika: ikusonyeza kuti kupha kumachokera ku kufika kwa utoto pamodzi ndi mmene umachitira ndi kuwala, osati mmene umachitira ndi kuwala kokha.
Zamoyo za Gram negative zimasonyeza kufunika kwa kufika kwa utoto. Pseudomonas inafuna 500 uM mumdima ndi 25 uM pakuwala, kusintha kwabwino ka makumi awiri, koma mlingo wa pakuwalawo udakali wapamwamba kwambiri kuposa wa staphylococci. Chaji yabwino imathandiza utoto kuyandikira nembanemba yakunja, koma kulowa kumakhalabe cholepheretsa. Kapangidwe ka zosakaniza, nthawi yosungira, ndi kusankha mtundu wochokera ku utotowo zimasintha ziwerengerozi kwambiri kuposa kungobwereza utoto womwewo pa mlingo wapamwamba.
Enterococci amapereka chenjezo. Mu ndondomeko zakale, E. faecalis sinasonyeze phindu lililonse la kuwala, ndipo E. faecium yosamva vancomycin inafuna molekyu ina m'malo mwa kuwala kochuluka. Aliyense amene akutchula MBC imodzi ya methylene blue ngati chiwerengero chosasintha cholimbana ndi mabakiteriya onse akuwerenga kafukufukuyu molakwika. Palibe chiwerengero chosasintha choterocho. Pali ziwerengero zokhazo zokhudzana ndi mtundu wa tizilombo, malo olimitsira, kuchuluka kwa tizilombo toyambirira, nthawi yosungira, utali wa mafunde, ndi mlingo wa mphamvu ya kuwala pa dera. Mmene mungawerengere ziwerengerozi popanda kudzinyenga mwafotokozedwa mu kalozera wa kumasulira magrafu a kupha tizilombo.
Bowa: amakhudzidwa, koma gawo la kukula ndi mapampu ndi amene amasankha
Makoma a bowa opangidwa ndi glucans, mannans, ndi chitin amapereka vuto lina la kulowa kwa utoto losiyana ndi la mabakiteriya, ndipo bowa ali ndi njira zina zodzitetezera zomwe zimagwira ntchito. Zotsatira za mapampu otulutsa zinthu za Candida zomwe zili pamwambapa ndi chitsanzo chomveka kwambiri: utoto womwewo, kuwala komweko, malo olimitsira omwewo, koma mtundu wopanga mapampu ochuluka unapulumuka pamene mtundu woyambirira unataya pafupifupi 99.999 peresenti ya mayunitsi opanga magulu a tizilombo. Pa dermatophytes, gawo la kukula limawonjezeranso kusiyana. Njere zimafa mosavuta kwambiri kuposa ulusi, kotero ndondomeko imene imachotsa njere ingasiyebe zidutswa za ulusi zamoyo pa mlingo womwewo.
N'chifukwa chake malipoti a methylene blue yolimbana ndi bowa amafunika kufotokoza kuwala mosamalitsa mofanana ndi a mabakiteriya. Kafukufuku wa photodynamic pa zikhadabo ndi khungu wa anthu unaphatikiza utoto wa 1 mpaka 2 peresenti ndi kuwala kofiira koyezedwa pa milingo yodziwika ya mphamvu pa dera komanso kutsatira zotsatira pambuyo pake, ndipo unasiyanitsa mmene malo oyesedwawo amaonekera ndi kutsimikizira kuchotsedwa kwa bowa. Mayeserowa afotokozedwa mu chidule cha umboni wa photodynamic pa bowa wa zikhadabo ndi khungu. Kupaka utoto wochepetsedwa pamalo okhudzidwa pakuwala kwa m'chipinda kumangobweretsa mtundu wake koma kumasiya njira yeniyeniyo.
Kuyesa pa biofilm: chitsanzo cha m'kamwa chokhala ndi mitundu 33
Kafukufuku wa 2024 wa biofilm ya m'kamwa yokhala ndi mitundu yambiri ndi woyenera kuganiziridwa chifukwa umayesa nkhani yovuta m'malo mwa yosavuta. Mitundu makumi atatu ndi itatu ya m'kamwa, kuphatikizapo Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, Fusobacterium, ndi streptococci a m'kamwa, inakula popanda oxygen n'kupanga biofilm yokhwima pa tsiku 6. Zomwe zinagwiritsidwa ntchito zinali utoto wa 0.01 peresenti pamodzi ndi LED ya 660 nm kwa mphindi 5 pa mphamvu yapamwamba ya kuwala pa dera. Utoto wokha ndi kuwala kokha zonse zinachepetsa kwambiri chiwerengero chonse, ndipo kuphatikiza ziwirizi kunachepetsa ntchito ya kagayidwe ndi pafupifupi theka, koma kapangidwe ka gulu la tizilombo sikunasinthe ndipo biofilm sinachotsedwe tizilombo tonse.
Izi ndi zotsatira zenizeni zokhala ndi malire ofotokozedwa moona mtima. Zimachirikiza chithandizo cha photodynamic ngati chowonjezera cha pamalo enaake m'thumba la nkhama lomwe layeretsedwa, osati ngati madzi otsukira m'kamwa amene paokha amachiza periodontitis yotsimikiziridwa. Izi zikutifikitsa ku kusiyana kwaikulu.
Chifukwa chake kupha mu labotale sikufanana ndi chithandizo
MBC ya maselo oyandama imayika maselo ofanana mu utoto wofanana ndi kuwala kofanana m'malo olimitsira okhala ndi oxygen. Malo okhudzidwa m'thupi sapereka chilichonse mwa zimenezi. Zinthu zozungulira maselo zimachedwetsa kulowa, maselo amene ali mu mikhalidwe yopirira amatha kupirira oxidation, magazi ndi madzi otuluka m'malo okhudzidwa zimayamwa kuwala, kapangidwe ka minofu kamasiya mithunzi, ndipo matumba okhala ndi oxygen yochepa amachepetsa zochitika za Type II chifukwa singlet oxygen imafuna oxygen ya mamolekyu mwa tanthauzo lake. Matenda osakanikirana amawonjezera mitundu yomwe imasiyana pa kulowetsa utoto ndi kukhudzidwa, kotero chiwerengero cha mtundu umodzi woyerekezera sichingaimire malo onsewo.
Chitsanzo cha m'kamwa chimapangitsa kusiyanaku kukhala komveka. Kuchepetsa Porphyromonas kapena streptococci m'mbale, kapena kuchepetsa biofilm yolimidwa ndi theka, sikutsimikizira kuti madzi abuluu otsukira m'kamwa amachiza periodontitis, amachiza matenda a m'kati mwa dzino, kapena amachotsa mabakiteriya m'magazi. Chisamaliro cha matenda a nkhama chimadalira kusokoneza ndi kuchotsa biofilm ndi zida, pamodzi ndi kusamalira kapangidwe ka thumba la nkhama, ndipo chithandizo cha kuwala chimafufuzidwa ngati chowonjezera cha pamalo enaake. Mulingo wa utoto umene umapha m'kabowo ka mbale yoyesera ulibe ubale wosasinthika ndi mulingo umene umafika ku mabakiteriya pansi pa m'mphepete mwa nkhama, ndipo kuwala kwa m'chipinda si mlingo wa 660 nm. Kusankha mlingo, chitetezo, ndi malire a kugwirizana ndi zinthu zina pa ntchito iliyonse ya m'kamwa ziyenera kusamalidwa ndi katswiri wa zaumoyo, monga zafotokozedwa mu chidziwitso cha chitetezo ndi kugwirizana ndi zinthu zina.
Zimene umboniwu sukutanthauza
Sikuti ndi zonena zakuti ndi mankhwala ophera tizilombo a m'nyumba. Matebulo a kupha mabakiteriya amagwiritsa ntchito mitundu yodziwika ya tizilombo, malo olimitsira, nthawi zokhudzana, mafunde a kuwala, ndi milingo ya mphamvu ya kuwala pa dera. Sakunena chilichonse za malo a m'khitchini, nthawi yokhudzana yofunika pamalo odetsedwa ndi zinthu zochokera ku zamoyo, kapena miyezo ya malamulo yopha tizilombo.
Komanso si cholowa m'malo mwa maantibayotiki amene amagwira ntchito m'thupi lonse. Ntchito wamba ya photodynamic imafuna utoto, kuwala koyamwidwa, ndi oxygen pamalo amodzi komanso nthawi imodzi. Kuwala sikufika kumalo akuya kapena ofalikira m'thupi mofanana ndi mmene mankhwala omezedwa amafikira m'magazi. Kafukufuku amaika njirayi pa matenda a pamalo opezekera mosavuta kapena ngati chowonjezera, monga momwe Wainwright anafotokozera kupha tizilombo pamalo enaake kuyambira pachiyambi.
Chidule cholondola chili ndi malire ochulukirapo koma chikadali chosangalatsa. Methylene blue ili ndi ntchito yochepa yolimbana ndi tizilombo mumdima, ndipo kuwala kofiira kumatsegula mphamvu yaikulu kwambiri ya photodynamic pa mabakiteriya ndi bowa ambiri. Pali kusiyana kwakukulu pakati pa kuwala ndi mdima, monga 500 mpaka 25 uM pa Pseudomonas ndi 80 mpaka 20 uM pa MRSA yofalikira pa mliri, pamodzi ndi kulephera kopereka phunziro pa enterococci ndi Candida yomwe ili ndi mapampu otulutsa zinthu ogwira ntchito. Kusintha zotsatira za labotale kukhala zothandiza m'chithandizo kumadalira kufika kwa utoto, mmene biofilm imagwirira ntchito, ndi oxygen mofanana ndi mulingo wotchulidwa wa utoto. Musabise mikhalidwe imeneyi, ndipo ziwerengerozo zimakhala ndi tanthauzo. Mukaichotsa, sizitanthauza kanthu.