---
title: "ALA photodynamic therapy plus ceftazidime for MDR Pseudomonas aeruginosa in diabetic wound infecti"
id: "pubmed-42127741"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42127741"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42127741/"
doi: "10.1016/j.bioorg.2026.109955"
published_at: "2026-08-15T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# ALA photodynamic therapy plus ceftazidime for MDR Pseudomonas aeruginosa in diabetic wound infecti
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42127741
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42127741/)
- **DOI:** [10.1016/j.bioorg.2026.109955](https://doi.org/10.1016%2Fj.bioorg.2026.109955)
- **Published At:** 2026-08-15T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This study evaluated combination therapy of **5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT)** with the antibiotic **ceftazidime** against multidrug-resistant **Pseudomonas aeruginosa** in the context of chronic diabetic wounds. - The combination showed **synergistic inhibition** of bacterial growth compared with either treatment alone. - Combined treatment prevented **biofilm formation**, delayed development of antibiotic resistance, inactivated the virulence pigment **pyocyanin**, and produced a prolonged post-antibiotic effect. - Mechanistic data indicated that ALA-PDT generated **reactive oxygen species (ROS)**, caused bacterial cell structural damage, increased membrane permeability, and promoted bacterial uptake of ceftazidime. - In a full-thickness skin defect infection model in diabetic rats, the combination produced the highest bactericidal effect and the greatest wound closure rates among groups tested. - Transcriptomic analysis of wound tissue comparing combination therapy with untreated model wounds found differentially expressed genes enriched in **IL-17**, **AKT-STAT**, and **VEGF** signaling pathways. - Molecular assays suggested the combination therapy may regulate **IL-17**, activate the **JAK-STAT** axis (increasing p-JAK2 and p-STAT3, decreasing SOCS3), and upregulate Ki-67, CD31, and VEGF, correlating with enhanced angiogenesis, collagen deposition, and tissue regeneration. - The authors conclude that combining **PDT** with an antibiotic offers an efficient approach to treat infections in diabetic wounds. - Specific experimental details (doses, light parameters, sample sizes, quantitative outcomes, statistical measures) were not reported in the abstract and therefore are not summarized here.
## Clinical Analysis & Structured Key Points
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Epub 2026 May 9. # Photodynamic and antibiotic combination therapy against multidrug-resistant Pseudomonas aeruginosa wound infections in diabetic rats [Feiyan Kong](https://pubmed.ncbi.nlm.nih.gov/?term=Kong+F&cauthor_id=42127741)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#full-view-affiliation-1 "School of Basic Medical Sciences, Hebei University, Baoding, China; Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China."), [Ting Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+T&cauthor_id=42127741)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#full-view-affiliation-2 "School of Basic Medical Sciences, Hebei University, Baoding, China."), [Yuetong Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+Y&cauthor_id=42127741)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#full-view-affiliation-3 "The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China."), [Yutong Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+Y&cauthor_id=42127741)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#full-view-affiliation-4 "School of Clinical Medicine, Hebei University, Baoding, China."), [Xiaotong Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+X&cauthor_id=42127741)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#full-view-affiliation-2 "School of Basic Medical Sciences, Hebei University, Baoding, China."), [Chuanpeng Bai](https://pubmed.ncbi.nlm.nih.gov/?term=Bai+C&cauthor_id=42127741)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#full-view-affiliation-2 "School of Basic Medical Sciences, Hebei University, Baoding, China."), [Tianyu Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+T&cauthor_id=42127741)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#full-view-affiliation-4 "School of Clinical Medicine, Hebei University, Baoding, China."), [Zhanjuan Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+Z&cauthor_id=42127741)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#full-view-affiliation-5 "School of Basic Medical Sciences, Hebei University, Baoding, China. Electronic address: zhaozhanjuanv@163.con."), [Ge Hong](https://pubmed.ncbi.nlm.nih.gov/?term=Hong+G&cauthor_id=42127741)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#full-view-affiliation-6 "Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China. Electronic address: hongge@bme.pumc.edu.cn.") Affiliations Expand ### Affiliations * 1 School of Basic Medical Sciences, Hebei University, Baoding, China; Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China. * 2 School of Basic Medical Sciences, Hebei University, Baoding, China. * 3 The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China. * 4 School of Clinical Medicine, Hebei University, Baoding, China. * 5 School of Basic Medical Sciences, Hebei University, Baoding, China. Electronic address: zhaozhanjuanv@163.con. * 6 Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China. Electronic address: hongge@bme.pumc.edu.cn. * PMID: **42127741** * DOI: [ 10.1016/j.bioorg.2026.109955 ](https://doi.org/10.1016/j.bioorg.2026.109955) Item in Clipboard # Photodynamic and antibiotic combination therapy against multidrug-resistant Pseudomonas aeruginosa wound infections in diabetic rats Feiyan Kong et al. Bioorg Chem. 2026. Show details Display options Display options Format Abstract PubMed PMID Bioorg Chem Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Bioorg+Chem%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Bioorg+Chem%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42127741/) . 2026 Aug 15:178:109955. doi: 10.1016/j.bioorg.2026.109955. Epub 2026 May 9. ### Authors [Feiyan Kong](https://pubmed.ncbi.nlm.nih.gov/?term=Kong+F&cauthor_id=42127741)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#short-view-affiliation-1 "School of Basic Medical Sciences, Hebei University, Baoding, China; Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China."), [Ting Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+T&cauthor_id=42127741)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#short-view-affiliation-2 "School of Basic Medical Sciences, Hebei University, Baoding, China."), [Yuetong Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+Y&cauthor_id=42127741)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#short-view-affiliation-3 "The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China."), [Yutong Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+Y&cauthor_id=42127741)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#short-view-affiliation-4 "School of Clinical Medicine, Hebei University, Baoding, China."), [Xiaotong Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+X&cauthor_id=42127741)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#short-view-affiliation-2 "School of Basic Medical Sciences, Hebei University, Baoding, China."), [Chuanpeng Bai](https://pubmed.ncbi.nlm.nih.gov/?term=Bai+C&cauthor_id=42127741)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#short-view-affiliation-2 "School of Basic Medical Sciences, Hebei University, Baoding, China."), [Tianyu Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+T&cauthor_id=42127741)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#short-view-affiliation-4 "School of Clinical Medicine, Hebei University, Baoding, China."), [Zhanjuan Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+Z&cauthor_id=42127741)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#short-view-affiliation-5 "School of Basic Medical Sciences, Hebei University, Baoding, China. Electronic address: zhaozhanjuanv@163.con."), [Ge Hong](https://pubmed.ncbi.nlm.nih.gov/?term=Hong+G&cauthor_id=42127741)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42127741/#short-view-affiliation-6 "Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China. Electronic address: hongge@bme.pumc.edu.cn.") ### Affiliations * 1 School of Basic Medical Sciences, Hebei University, Baoding, China; Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China. * 2 School of Basic Medical Sciences, Hebei University, Baoding, China. * 3 The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China. * 4 School of Clinical Medicine, Hebei University, Baoding, China. * 5 School of Basic Medical Sciences, Hebei University, Baoding, China. Electronic address: zhaozhanjuanv@163.con. * 6 Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China. Electronic address: hongge@bme.pumc.edu.cn. * PMID: **42127741** * DOI: [ 10.1016/j.bioorg.2026.109955 ](https://doi.org/10.1016/j.bioorg.2026.109955) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract In our previous study, 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) promoted chronic diabetic wound healing by reducing the microbial burden. However, the anti-bacterial efficacy of ALA-PDT is often compromised by limited light penetration into tissues. To increase the efficacy of ALA-PDT, this study assessed its combined use with the antibiotic ceftazidime in treating chronic diabetic wounds and examined the potential mechanism of action. The results indicated that the combination of ALA-PDT and ceftazidime synergistically inhibited the growth of multidrug-resistant Pseudomonas aeruginosa. The treatment also prevented the formation of bacterial biofilm, delayed the development of antibiotic resistance, inactivated pyocyanin, and exerted a prolonged post-antibiotic effect. The mechanism supporting the synergistic antibacterial effect might involve ALA-PDT-mediated reactive oxygen species generation, leading to bacterial cell structure destruction, increased membrane permeability, and cellular ceftazidime uptake. In a full-thickness skin defect infection model in rats with diabetes, the bactericidal and wound closure rates were highest in the combination therapy group. Transcriptomics analysis of wound tissues revealed that the differentially expressed genes between the combination therapy and model groups were mainly enriched in the IL-17, AKT-STAT, and VEGF signaling pathways. Molecular biology experiments illustrated that the combination therapy might regulate the expression of IL-17, activate the JAK-STAT axis, increase p-JAK2 and p-STAT3 expression, and decrease SOCS3 expression, ultimately leading to Ki-67, CD31, and VEGF upregulation and exerting beneficial effects on angiogenesis, collagen deposition, and tissue regeneration. Overall, PDT and antibiotic combination therapy offers an efficient approach to treat infections in diabetic wounds. **Keywords:** 5-aminolevulinic acid; Ceftazidime; Diabetes wound; Photodynamic therapy. Copyright © 2026 Elsevier Inc. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ A novel ROS switcher potentiates the type-I photodynamic effect of sodium zinc chlorophyllin against Pseudomonas aeruginosa in diabetic wounds. ](https://pubmed.ncbi.nlm.nih.gov/41576608/) Wang G, Chen H, Wu L, Yuan C, Huang M.Wang G, et al.Biomater Adv. 2026 May;182:214721. doi: 10.1016/j.bioadv.2026.214721. Epub 2026 Jan 19.Biomater Adv. 2026.PMID: 41576608 * [ Efficacy of the therapy of 5-aminolevulinic acid photodynamic therapy combined with human umbilical cord mesenchymal stem cells on methicillin-resistant Staphylococcus aureus-infected wound in a diabetic mouse model. ](https://pubmed.ncbi.nlm.nih.gov/34375775/) Huang J, Wu S, Wu M, Zeng Q, Wang X, Wang H.Huang J, et al.Photodiagnosis Photodyn Ther. 2021 Dec;36:102480. doi: 10.1016/j.pdpdt.2021.102480. Epub 2021 Aug 8.Photodiagnosis Photodyn Ther. 2021.PMID: 34375775 * [ Antimicrobial activity and mechanistic insights of AMP-17 against drug-resistant _Pseudomonas aeruginosa_ and its efficacy in wound infection management. ](https://pubmed.ncbi.nlm.nih.gov/40861483/) Tao R, Tian C, Su T, Cai R, Song D, Zhao N, Lei Y, Jiao Z, Guo G.Tao R, et al.Front Cell Infect Microbiol. 2025 Aug 8;15:1634825. doi: 10.3389/fcimb.2025.1634825. eCollection 2025.Front Cell Infect Microbiol. 2025.PMID: 40861483Free PMC article. * [ DHTPY-Cu@ZOL-Enhanced Photodynamic Therapy: A Strategic Platform for Advanced Treatment of Drug-Resistant Bacterial Wound Infections. ](https://pubmed.ncbi.nlm.nih.gov/38919773/) Hou B, Li B, Deng W, Li B, Ren B, Hu C, Zhang G, Yang F, Xiao M, Xie S, Xie D.Hou B, et al.Int J Nanomedicine. 2024 Jun 21;19:6319-6336. doi: 10.2147/IJN.S458520. eCollection 2024.Int J Nanomedicine. 2024.PMID: 38919773Free PMC article. * [ Functionalized hyaluronic acid microneedles integrated with gallium-tannic acid nanocomplex for synergistic therapy of diabetic wound infections. ](https://pubmed.ncbi.nlm.nih.gov/41932470/) Wang N, Sun X, Zhang S, Ouyang XK.Wang N, et al.Int J Biol Macromol. 2026 Apr;358:151784. doi: 10.1016/j.ijbiomac.2026.151784. Epub 2026 Apr 1.Int J Biol Macromol. 2026.PMID: 41932470Review. 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