Antimicrobial Photodynamic Therapy of the Respiratory Tract: From the Proof of Principles to Clinical Application

Abstract

Antimicrobial resistance (AMR) and its relevant health consequences have been explicitly framed as a shared global problem and are estimated to be one of the largest causes of death worldwide by 2050. Antimicrobial photodynamic therapy (aPDT) proposes an alternative treatment for localized infections in response to AMR’s ever-growing problem. This technique combines molecular oxygen, a non-toxic photoactivatable photosensitizer (PS), and light of appropriate wavelength, leading to the formation of cytotoxic reactive oxygen species. Besides the ability to inactivate resistant pathogens via a non-selective approach (multiple targets), a relevant advantage of aPDT resides in the fact that no evidence of microorganism resistance has ever been reported to it. In this chapter, we address some efforts to use this technology to kill bacteria in the respiratory tract, from in vitro to clinical applications. We put forward three focuses: pharyngotonsillitis, pneumonia, and preventing secondary infections during the use of a photosensitizer-functionalized endotracheal tube. The results here presented offer a foundation for what may become a much larger clinical approach to treat respiratory tract infections.