Sepsis is an acute inflammatory response that leads to life-threatening complications if not quickly and adequately treated. Cytolysin, hemolysin, and pneumolysin are toxins produced by gram-positive bacteria and are responsible for resistance to antimicrobial drugs, cause virulence and lead to sepsis. This work assessed the effects of Aloe-emodin (AE) and photodynamic therapy (PDT) on sepsis-associated gram-positive bacterial toxins. Standard and antibiotic-resistant Enterococcus faecalis, Staphylococcus aureus, and Streptococcus pneumonia bacterial strains were cultured in the dark with varying AE concentrations and later irradiated with 72 J/cm^-2 light. Colony and biofilm formation was determined. CCK-8, Griess reagent reaction, and ELISA assays were done on bacteria-infected RAW26.7 cells to determine the cell viability, NO, and IL-1β and IL-6 pro-inflammatory cytokines responses, respectively. Hemolysis and western blot assays were done to determine the effect of treatment on hemolysis activity and sepsis-associated toxins expressions. AE-mediated PDT reduced bacterial survival in a dose-dependent manner, with 32 µg/ml of AE almost eliminating their survival. Cell proliferation, NO, IL-1β, and IL-6 cytokines production were also significantly down-regulated. Further, the hemolytic activities and expressions of Cytolysin, hemolysin, and pneumolysin, were significantly reduced following AE-mediated PDT. In conclusion, combined use of AE and light (435 ± 10 nm) inactivates MRSA, S. aureus (ATCC 29213), S. pneumoniae (ATCC 49619), MDR-S pneumoniae, E. faecalis (ATCC 29212), and VRE (ATCC 51299) in AE-dose dependent manner. AE and light are also effective in reducing biofilm formations, suppressing pro-inflammatory cytokines, hemolytic activities, and inhibiting the expressions of toxins that cause sepsis.

中文翻译：

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芦荟大黄素介导的光动力疗法可在体外减弱选定革兰氏阳性细菌中与脓毒症相关的毒素。

脓毒症是一种急性炎症反应，如果不迅速和充分治疗，会导致危及生命的并发症。溶细胞素、溶血素和肺炎球菌溶血素是革兰氏阳性菌产生的毒素，导致抗菌药物产生耐药性，产生毒力并导致败血症。这项工作评估了芦荟大黄素 (AE) 和光动力疗法 (PDT) 对脓毒症相关革兰氏阳性细菌毒素的影响。标准的和抗生素耐药的粪肠球菌、金黄色葡萄球菌和肺炎链球菌菌株在黑暗中用不同的AE浓度培养，然后用72 J/cm ^-2光照射。测定菌落和生物膜的形成。对细菌感染的 RAW26.7 细胞进行 CCK-8、Griess 试剂反应和 ELISA 测定，分别测定细胞活力、NO、IL-1β 和 IL-6 促炎细胞因子反应。进行溶血和蛋白质印迹测定以确定治疗对溶血活性和脓毒症相关毒素表达的影响。AE 介导的 PDT 以剂量依赖性方式降低细菌存活率，32 µg/ml 的 AE 几乎消除了细菌的存活率。细胞增殖、NO、IL-1β 和 IL-6 细胞因子的产生也显着下调。此外，AE介导的PDT后溶血活性和溶细胞素、溶血素和肺炎球菌溶血素的表达显着降低。总之，结合使用 AE 和光 (435 ± 10 nm) 可灭活 MRSA、金黄色葡萄球菌(ATCC 29213)、肺炎链球菌 (ATCC 49619)、耐多药肺炎链球菌、粪肠球菌(ATCC 29212) 和 VRE（ ATCC 51299）以 AE 剂量依赖性方式。AE 和光还可以有效减少生物膜形成、抑制促炎细胞因子、溶血活性以及抑制引起败血症的毒素的表达。