Engineered nanoparticle for controlled superoxide flux potentiates antibiotics in MDR clinical isolates.

Reactive oxygen species (ROS) represent a broad range of chemical species including superoxide, hydroxyl, singlet oxygen, and hydrogen peroxide. Each species behaves differently in the cellular environment. Some can play specific roles as intracellular signaling molecules, while others act primarily as indiscriminate oxidants. Several recent reports have promoted the use of exogenous ROS as therapeutic agents with applications from cancer therapies to novel antimicrobials. However, therapeutics, specifically antibiotics, should either kill or inhibit the growth of harmful cells (bacteria here) without harming the host cells, and hence selectivity of action is of vital importance. Here, we show that among different ROS, only superoxide was found to be bactericidal, killing a range of multidrug-resistant (MDR) pathogens without affecting the viability or growth of mammalian cells. Superoxide has a high thermodynamic capacity to be a strong oxidant. However, its lack of reactivity with cellular components at a physiological pH, except for the inactivation of biosynthetic enzymes containing labile iron−sulfur clusters, is key to its selectivity. The role of iron in bacterial pathogenesis also makes superoxide a strong candidate for antimicrobial therapy. Additionally, using a series of selective scavengers, we show that the superoxide radical is therapeutically effective and selective compared to other ROS like hydroxyl radicals, confirming previous results that used Escherichia coli gene knockouts to show that superoxide selectively deactivates some enzymes rather than causing indiscriminate damage of cellular components. In our in vitro studies, intracellular superoxide generation using light-activated quantum dots yielded highly selective and effective antimicrobial action. We screened 45 clinical MDR bacterial isolates and observed inhibition/therapeutic action in all strains, highlighting the applicability of such nanoparticle superoxide therapy. These results can pave the way for rational design of nanoscale therapies as precision medicine.

The rapid emergence of superbugs, or multi-drug resistant (MDR) organisms, has prompted a search for novel antibiotics, beyond traditional small-molecule therapies. Nanotherapeutics are being investigated as alternatives, and recently superoxide-generating quantum dots (QDs) have been shown as important candidates for selective light-activated therapy, while also potentiating existing antibiotics against MDR superbugs. Their therapeutic action is selective, can be tailored by simply changing their quantum-confined conduction-valence band (CB-VB) positions and alignment with different redox half-reactions—and hence their ability to generate specific radical species in biological media. Here, we show the design of superoxide-generating QDs using optimal QD material and size well-matched to superoxide redox potential, charged ligands to modulate their uptake in cells and selective redox interventions, and core/shell structures to improve their stability for therapeutic action. We show that cadmium telluride (CdTe) QDs with conduction band (CB) position at −0.5 V with respect to Normal Hydrogen Electron (NHE) and visible 2.4 eV bandgap generate a large flux of selective superoxide radicals, thereby demonstrating the effective light-activated therapy. Although the positively charged QDs demonstrate large cellular uptake, they bind indiscriminately to cell surfaces and cause non-selective cell death, while negatively charged and zwitterionic QD ligands reduce the uptake and allow selective therapeutic action via interaction with redox species. The stability of designed QDs in biologically-relevant media increases with the formation of core-shell QD structures, but an appropriate design of core-shell structures is needed to minimize any reduction in charge injection efficiency to adsorbed oxygen molecules (to form superoxide) and maintain similar quantitative generation of tailored redox species, as measured using electron paramagnetic resonance (EPR) spectroscopy and electrochemical impedance spectroscopy (EIS). Using these findings, we demonstrate the rational design of QDs as selective therapeutic to kill more than 99% of a priority class I pathogen, thus providing an effective therapy against MDR superbugs.

Traditional therapeutics and vaccines represent the bedrock of modern medicine, where isolated biochemical molecules or designed proteins have led to success in treating and preventing diseases. However, several adaptive pathogens, such as multidrug-resistant (MDR) superbugs, and rapidly evolving diseases, such as cancer, can evade such molecules very effectively. This poses an important problem since the rapid emergence of multidrug-resistance among microbes is one of the most pressing public health crises of our time—one that could claim more than 10 million lives and 100 trillion dollars annually by 2050. Several non-traditional antibiotics are now being developed that can survive in the face of adaptive drug resistance. One such versatile strategy is redox perturbation using quantum dot (QD) therapeutics. While redox molecules are nominally used by cells for intracellular signaling and other functions, specific generation of such species exogenously, using an electromagnetic stimulus (light, sound, magnetic field), can specifically kill the cells most vulnerable to such species. For example, recently QD therapeutics have shown tremendous promise by specifically generating superoxide intracellularly (using light as a trigger) to selectively eliminate a wide range of MDR pathogens. While the efficacy of such QD therapeutics was shown using in vitro studies, several apparent contradictions exist regarding QD safety and potential for clinical applications. In this review, we outline the design rules for creating specific QD therapies for redox perturbation; summarize the parameters for choosing appropriate materials, size, and capping ligands to ensure their facile clearance; and highlight a potential path forward towards developing this new class of radical QD therapeutics.

The emergence of multidrug‐resistant (MDR) pathogens represents one of the most urgent global public health crises. Light‐activated quantum dots (QDs) are alternative antimicrobials, with efficient transport, low cost, and therapeutic efficacy, and they can act as antibiotic potentiators, with a mechanism of action orthogonal to small‐molecule drugs. Furthermore, light‐activation enhances control over the spatiotemporal release and dose of the therapeutic superoxide radicals from QDs. However, the limited deep‐tissue penetration of visible light needed for QD activation, and concern over trace heavy metals, have prevented further translation. Herein, we report two indium phosphide (InP) QDs that operate in the near‐infrared and deep‐red light window, enabling deeper tissue penetration. These heavy‐metal‐free QDs eliminate MDR pathogenic bacteria, while remaining non‐toxic to host human cells. This work provides a pathway for advancing QD nanotherapeutics to combat MDR superbugs.