Guo Pengbo, Xue Hui-Yi, Wong Ho-Lun
Department of Pharmaceutical Sciences, Temple University School of Pharmacy, 3307 North Broad Street, Philadelphia, PA 19140, United States.
Curr Drug Deliv. 2018;15(7):941-952. doi: 10.2174/1567201815666180228162949.
Despite extended, aggressive use of conventional antibiotics, drug treatment of bone infections frequently fails as a combined result of the widespread of drug-resistant bacteria, poor accessibility of many antimicrobials to the deeper portion of the bones, the ease of biofilm formation on the bone surface, and high risk of drug toxicity. Emerging therapeutic nanotechnology offers potential solutions to these issues. In recent years, a number of nanoantimicrobials, i.e. nanoscale devices with intrinsic antibacterial activities or capacity for delivering antibiotics, have been developed for the treatment and prevention of bone infections. These nanoantimicrobials can be designed to have controlled and sustained drug release kinetics, surface-modifications for bone or bacteria targeting, and increased affinity for biofilms. Given the potential value of nanoantimicrobials, clinical application of nanoantimicrobials for bone infection treatment remains scant when compared with the number of ongoing research. It is, therefore, a good time to carefully examine this promising yet relatively uncharted area. This review will extensively discuss the development and state of the art of different classes of nanoantimicrobials for bone infections with emphasis on the treatment aspect and identify the factors that prevent the clinical translation of nanoantimicrobial therapy from bench to bedside.
尽管广泛且积极地使用传统抗生素，但由于耐药菌的广泛传播、许多抗菌药物难以到达骨骼深部、骨表面易于形成生物膜以及药物毒性风险高，骨感染的药物治疗常常失败。新兴的治疗性纳米技术为这些问题提供了潜在的解决方案。近年来，已经开发出多种纳米抗菌剂，即具有内在抗菌活性或能够递送抗生素的纳米级装置，用于治疗和预防骨感染。这些纳米抗菌剂可以设计成具有可控和持续的药物释放动力学、针对骨骼或细菌的表面修饰以及对生物膜的亲和力增加。鉴于纳米抗菌剂的潜在价值，与正在进行的研究数量相比，纳米抗菌剂在骨感染治疗中的临床应用仍然很少。因此，现在是仔细研究这个有前景但相对未知领域的好时机。本综述将广泛讨论用于骨感染的不同类纳米抗菌剂的发展和现状，重点是治疗方面，并确定阻碍纳米抗菌治疗从实验室到临床转化的因素。
