{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T03:35:35Z","timestamp":1788838535965,"version":"build-2803163510"},"reference-count":35,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Key Research and Development Plan of Jining","award":["2024YXNS187"],"award-info":[{"award-number":["2024YXNS187"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["NM.82272358"],"award-info":[{"award-number":["NM.82272358"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["NM.82572596"],"award-info":[{"award-number":["NM.82572596"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,5,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Photodynamic therapy (PDT) has emerged as a potential strategy to combat drug-resistant fungal infections. This study aimed to evaluate the therapeutic efficacy of 5-aminolevulinic acid PDT (ALA-PDT) against drug-resistant\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      strains isolated from patients with candidiasis and to elucidate its underlying mechanisms. Drug-resistant strains were identified by their reduced antifungal susceptibility to azoles, micafungin, amphotericin B, and terbinafine. RNA sequencing (RNA-seq) was used to assess gene expression related to mycelial formation and fungal growth. Scanning electron microscopy (SEM) was employed to observe cell-wall morphology after ALA-PDT treatment. Biofilm formation and intracellular reactive oxygen species (ROS) levels were also measured to investigate the mechanism of ALA-PDT-mediated fungal killing.\n                      <jats:italic toggle=\"yes\">Candida albicans<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Candida tropicalis<\/jats:italic>\n                      accounted for over half, predominantly from male ICU patients aged over 40 years.\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      spp. strains exhibited resistance rates of approximately 69.38% to terbinafine, 40.8% to azole antifungals, and 16.3% to micafungin among 49 drug-resistant isolates. Treatment with 20% ALA-PDT effectively eradicated those azole-resistant\n                      <jats:italic toggle=\"yes\">C. albicans in vitro<\/jats:italic>\n                      , increased fungal killing, and significantly increased intracellular ROS levels. SEM analysis revealed varying degrees of cell-wall disruption, and RNA-seq demonstrated downregulation of mycelia-related genes following ALA-PDT. ALA-PDT effectively inhibits drug-resistant\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      spp. growth by inducing ROS-mediated cell damage and suppressing mycelial gene expression. These findings highlight ALA-PDT as a promising therapeutic approach for refractory candidiasis and provide mechanistic insights into its antifungal activity.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01645-25","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T15:53:15Z","timestamp":1776441195000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Drug-resistant clinical\n                    <i>Candida<\/i>\n                    responded to 5-aminolevulinic acid photodynamic therapy (ALA-PDT)\n                    <i>in vitro<\/i>\n                    via enhanced ROS release"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4003-630X","authenticated-orcid":false,"given":"Zhiya","family":"Yang","sequence":"first","affiliation":[{"name":"The Laboratory of Medical Mycology, Jining No. 1 People's Hospital","place":["Jining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghong","family":"Zhang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/011ashp19","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Dermatovenereology, West China Hospital, Sichuan University","place":["Chengdu, China"]},{"id":[{"id":"https:\/\/ror.org\/0523y5c19","id-type":"ROR","asserted-by":"publisher"}],"name":"Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3272-2513","authenticated-orcid":true,"given":"Dongmei","family":"Li","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00hjz7x27","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology and Immunology, Georgetown University Medical Center","place":["Washington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sisi","family":"Wang","sequence":"additional","affiliation":[{"name":"The Laboratory of Medical Mycology, Jining No. 1 People's Hospital","place":["Jining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoyu","family":"Shi","sequence":"additional","affiliation":[{"name":"The Laboratory of Medical Mycology, Jining No. 1 People's Hospital","place":["Jining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0886-4191","authenticated-orcid":true,"given":"Dongmei","family":"Shi","sequence":"additional","affiliation":[{"name":"The Laboratory of Medical Mycology, Jining No. 1 People's Hospital","place":["Jining, China"]},{"name":"Department of Dermatology, Jining No. 1 People\u2019s Hospital","place":["Jining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/femsre\/fuaa060"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(03)00801-6"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/cells12222655"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2022.102237"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.7499\/j.issn.1008-8830.2017.04.011"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S255843"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2018.02.028"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-022-00720-1"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1021\/acs.chemrev.0c00199"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2014.03.009"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2021.102271"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0781.2004.00095.x"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S387675"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2022.102839"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.7.5.704"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/7495218"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.4103\/0255-0857.124300"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1007076"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.4014\/jmb.2110.10014"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.21769\/BioProtoc.3803"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.0141-9854.2003.00549.x"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-6976.2011.00278.x"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2021.2019950"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/20002297.2017.1385372"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2008.00291.x"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2021.102525"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.micinf.2016.01.002"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2023.109809"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.micres.2007.08.001"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.redox.2025.103708"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2025.08.040"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-014-9828-3"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/dth.12149"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-018-0267-4"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.phymed.2023.154800"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.01645-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.01645-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T13:02:44Z","timestamp":1778072564000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/aac.01645-25"}},"subtitle":[],"editor":[{"given":"Andreas H.","family":"Groll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,6]]},"references-count":35,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,6]]}},"alternative-id":["10.1128\/aac.01645-25"],"URL":"https:\/\/doi.org\/10.1128\/aac.01645-25","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,6]]},"assertion":[{"value":"2025-11-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01645-25"}}