Recent Advances in Photodynamic Therapy against Fungal Keratitis
Fungal keratitis is a serious clinical infection on the cornea caused by fungi and is one of the leading causes of blindness in Asian countries. The treatment options are currently limited to a few antifungal agents. With the increasing incidence of drug-resistant infections, many patients fail to r...
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2021-11-01
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| author | Jia-Horung Hung Chaw-Ning Lee Huai-Wen Hsu I-Son Ng Chi-Jung Wu Chun-Keung Yu Nan-Yao Lee Yun Chang Tak-Wah Wong |
| author_facet | Jia-Horung Hung Chaw-Ning Lee Huai-Wen Hsu I-Son Ng Chi-Jung Wu Chun-Keung Yu Nan-Yao Lee Yun Chang Tak-Wah Wong |
| author_sort | Jia-Horung Hung |
| collection | DOAJ |
| description | Fungal keratitis is a serious clinical infection on the cornea caused by fungi and is one of the leading causes of blindness in Asian countries. The treatment options are currently limited to a few antifungal agents. With the increasing incidence of drug-resistant infections, many patients fail to respond to antibiotics. Riboflavin-mediated corneal crosslinking (similar to photodynamic therapy (PDT)) for corneal ectasia was approved in the US in the early 2000s. Current evidence suggests that PDT could have the potential to inhibit fungal biofilm formation and overcome drug resistance by using riboflavin and rose bengal as photosensitizers. However, only a few clinical trials have been initiated in anti-fungal keratitis PDT treatment. Moreover, the removal of the corneal epithelium and repeated application of riboflavin and rose bengal are required to improve drug penetration before and during PDT. Thus, an improvement in trans-corneal drug delivery is mandatory for a successful and efficient treatment. In this article, we review the studies published to date using PDT against fungal keratitis and aim to enhance the understanding and awareness of this research area. The potential of modifying photosensitizers using nanotechnology to improve the efficacy of PDT on fungal keratitis is also briefly reviewed. |
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| issn | 1999-4923 |
| language | English |
| last_indexed | 2024-03-10T03:20:45Z |
| publishDate | 2021-11-01 |
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| spelling | doaj.art-cd2eb44228484aa59ca3b3cb0cf017f92023-11-23T10:04:41ZengMDPI AGPharmaceutics1999-49232021-11-011312201110.3390/pharmaceutics13122011Recent Advances in Photodynamic Therapy against Fungal KeratitisJia-Horung Hung0Chaw-Ning Lee1Huai-Wen Hsu2I-Son Ng3Chi-Jung Wu4Chun-Keung Yu5Nan-Yao Lee6Yun Chang7Tak-Wah Wong8Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701, TaiwanDepartment of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, TaiwanSchool of Medicine, National Cheng Kung University, Tainan 701, TaiwanDepartment of Chemical Engineering, National Cheng Kung University, Tainan 701, TaiwanNational Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 704, TaiwanInstitute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 701, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, TaiwanSchool of Medicine, National Cheng Kung University, Tainan 701, TaiwanDepartment of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, TaiwanFungal keratitis is a serious clinical infection on the cornea caused by fungi and is one of the leading causes of blindness in Asian countries. The treatment options are currently limited to a few antifungal agents. With the increasing incidence of drug-resistant infections, many patients fail to respond to antibiotics. Riboflavin-mediated corneal crosslinking (similar to photodynamic therapy (PDT)) for corneal ectasia was approved in the US in the early 2000s. Current evidence suggests that PDT could have the potential to inhibit fungal biofilm formation and overcome drug resistance by using riboflavin and rose bengal as photosensitizers. However, only a few clinical trials have been initiated in anti-fungal keratitis PDT treatment. Moreover, the removal of the corneal epithelium and repeated application of riboflavin and rose bengal are required to improve drug penetration before and during PDT. Thus, an improvement in trans-corneal drug delivery is mandatory for a successful and efficient treatment. In this article, we review the studies published to date using PDT against fungal keratitis and aim to enhance the understanding and awareness of this research area. The potential of modifying photosensitizers using nanotechnology to improve the efficacy of PDT on fungal keratitis is also briefly reviewed.https://www.mdpi.com/1999-4923/13/12/2011candidacollagen cross-linkingdrug deliveryfungal infectionflavin mononucleotidekeratitis |
| spellingShingle | Jia-Horung Hung Chaw-Ning Lee Huai-Wen Hsu I-Son Ng Chi-Jung Wu Chun-Keung Yu Nan-Yao Lee Yun Chang Tak-Wah Wong Recent Advances in Photodynamic Therapy against Fungal Keratitis Pharmaceutics candida collagen cross-linking drug delivery fungal infection flavin mononucleotide keratitis |
| title | Recent Advances in Photodynamic Therapy against Fungal Keratitis |
| title_full | Recent Advances in Photodynamic Therapy against Fungal Keratitis |
| title_fullStr | Recent Advances in Photodynamic Therapy against Fungal Keratitis |
| title_full_unstemmed | Recent Advances in Photodynamic Therapy against Fungal Keratitis |
| title_short | Recent Advances in Photodynamic Therapy against Fungal Keratitis |
| title_sort | recent advances in photodynamic therapy against fungal keratitis |
| topic | candida collagen cross-linking drug delivery fungal infection flavin mononucleotide keratitis |
| url | https://www.mdpi.com/1999-4923/13/12/2011 |
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