Effects of PACT using phenothiazine-derived drugs and red light on the macrophage x S. aureus interface

The aim of this study was to evaluate the lethal potential of macrophages infected with Staphylococcus aureus after PACT (Photochemical Antimicrobial Chemotherapy) using phenothiazine derivatives (a solution containing 1:1 methylene blue and O toluidine blue) and laser (660 nm, 40 mW, 60 s, 12 J/cm²) or LED (632 ± 2 nm, 145 mW, 40 s, 12 J/cm²). Six experimental groups were evaluated: Control Group (untreated); Photosensitizer group (phenothiazines - 12.5 μg/mL); Laser Group; LED Group; Laser PACT Group; and LED PACT Group. The pre-irradiation time used in this study was 5 min. Macrophages and bacteria were cultured in specific culture media and/or allowed interaction between the cell types. Subsequently, tests were carried out to evaluate microbial proliferation, ROS production by macrophages and survival capacity of S. aureus after phagocytosis. Fluorescence microscopy assays were performed with the H₂DCFDA probe, after PACT, at the initial time (0 h), 4-h and 12-h. The tests were performed in triplicate and the statistical test used was ANOVA with Tukey post-test. After PACT, a statistically significant difference (p > 0.0001) was observed between the microbial growth of the control group and the PACTs groups. Laser PACT and LED PACT groups presented, respectively, reductions of 84.2% and 81.5% when compared to control and 53.3% and 46% when compared to the photosensitizer group. It is concluded that the therapeutic protocols presented in this study increased the phagocytic capacity, the response rate of the phagocytes and the consequent reduction of the numbers of S. aureus for both PACT protocols, however the increase in ROS production was only observed in the group irradiated with Laser light.