{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T05:34:18Z","timestamp":1790487258690,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T00:00:00Z","timestamp":1605744000000},"content-version":"am","delay-in-days":366,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T00:00:00Z","timestamp":1574121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002602","name":"American Society for Laser Medicine and Surgery","doi-asserted-by":"publisher","award":["BS.F04.18."],"award-info":[{"award-number":["BS.F04.18."]}],"id":[{"id":"10.13039\/100002602","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI123312"],"award-info":[{"award-number":["R01AI123312"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["FA9550\u201017\u20101\u20100277"],"award-info":[{"award-number":["FA9550\u201017\u20101\u20100277"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Background and Objective<\/jats:title><jats:p><jats:italic>Candida albicans<\/jats:italic> is an opportunistic fungal pathogen of clinical importance and is the primary cause of fungal\u2010associated wound infections, sepsis, or pneumonia in immunocompromised individuals. With the rise in antimicrobial resistance, it is becoming increasingly difficult to successfully treat fungal infections using traditional antifungals, signifying that alternative non\u2010traditional approaches must be explored for their efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design\/Materials and Methods<\/jats:title><jats:p>We investigated the combination of antimicrobial blue light (aBL) and quinine hydrochloride (Q\u2010HCL) for improved inactivation of <jats:italic>C. albicans<\/jats:italic>, <jats:italic>in vitro<\/jats:italic> and <jats:italic>in vivo<\/jats:italic>, relative to either monotherapy. In addition, we evaluated the safety of this combination therapy <jats:italic>in vivo<\/jats:italic> using the TUNEL assay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The combination of aBL (108\u2009J\/cm<jats:sup>2<\/jats:sup>) with Q\u2010HCL (1\u2009mg\/mL) resulted in a significant improvement in the inactivation of <jats:italic>C. albicans<\/jats:italic> planktonic cells <jats:italic>in vitro<\/jats:italic>, where a 7.04 log<jats:sub>10<\/jats:sub> colony forming units (CFU) reduction was achieved, compared with aBL alone that only inactivated 3.06 log<jats:sub>10<\/jats:sub> CFU (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) or Q\u2010HCL alone which did not result in a loss of viability. aBL\u2009+\u2009Q\u2010HCL was also effective at inactivating 48\u2010hour biofilms, with an inactivation 1.73 log<jats:sub>10<\/jats:sub> CFU at the dose of 108\u2009J\/cm<jats:sup>2<\/jats:sup> aBL and 1\u2009mg\/mL Q\u2010HCL, compared with only a 0.73 or 0.66 log<jats:sub>10<\/jats:sub> CFU by aBL and Q\u2010HCL alone, respectively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Transmission electron microscopy revealed that aBL\u2009+\u2009Q\u2010HCL induced morphological and ultrastructural changes consistent with cell wall and cytoplasmic damage. In addition, aBL\u2009+\u2009Q\u2010HCL was effective at eliminating <jats:italic>C. albicans<\/jats:italic> within mouse abrasion wounds, with a 2.47 log<jats:sub>10<\/jats:sub> relative luminescence unit (RLU) reduction at the dose of 324\u2009J\/cm<jats:sup>2<\/jats:sup> aBL and 0.4\u2009mg\/cm<jats:sup>2<\/jats:sup> Q\u2010HCL, compared with a 1.44 log<jats:sub>10<\/jats:sub> RLU reduction by aBL alone. Q\u2010HCL or nystatin alone did not significantly reduce the RLU. The TUNEL assay revealed some apoptotic cells before and 24\u2009hours following treatment with aBL\u2009+\u2009Q\u2010HCL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of aBL\u2009+\u2009Q\u2010HCL was effective at eliminating <jats:italic>C. albicans<\/jats:italic> both <jats:italic>in vitro<\/jats:italic> and <jats:italic>in vivo<\/jats:italic>. A comprehensive assessment of toxicity (cytotoxicity and genotoxicity) is required to fully determine the safety of aBL\u2009+\u2009Q\u2010HCL therapy at different doses. In conclusion, the combination of aBL and Q\u2010HCL may be a viable option for the treatment of cutaneous candidiasis. Lasers Surg. Med. \u00a9 2019 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23180","type":"journal-article","created":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T05:15:48Z","timestamp":1574226948000},"page":"569-575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Quinine Improves the Fungicidal Effects of Antimicrobial Blue Light: Implications for the Treatment of Cutaneous Candidiasis"],"prefix":"10.1002","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6542-1776","authenticated-orcid":false,"given":"Leon G.","family":"Leanse","sequence":"first","affiliation":[{"name":"Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"},{"name":"Vaccine and Immunotherapy Center, Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueping Sharon","family":"Goh","sequence":"additional","affiliation":[{"name":"Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"},{"name":"Vaccine and Immunotherapy Center, Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianhong","family":"Dai","sequence":"additional","affiliation":[{"name":"Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"},{"name":"Vaccine and Immunotherapy Center, Massachusetts General Hospital, Harvard Medical School Boston 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