Development of organic photosensitizers for antimicrobial photodynamic therapy

Bacterial infection poses a significant threat to human health, and the emergence of antibiotic-resistant strains has exacerbated the situation. Antimicrobial photodynamic therapy (aPDT) has emerged as a promising antibiotic-free treatment option that employs reactive oxygen species (ROS) to cause oxidative damage to bacteria and surrounding biomolecules for treating microbial infections. This review summarizes the recent progress in the development of organic photosensitizers, including porphyrins, chlorophyll, phenothiazines, xanthenes and aggregation-induced emission photosensitizers, for aPDT. A detailed description of innovative therapeutic strategies that rely on the infection microenvironment or the unique structural properties of bacteria to amplify the therapeutic effects is provided. Moreover, the combination of aPDT with other therapy strategies such as antimicrobial peptide therapy, photothermal therapy (PTT) or gas therapy, is described. Finally, the current challenges and perspectives of organic photosensitizers for clinical antibacterial applications are discussed.