Department of Surgery, Section of Colorectal Surgery, University of Arizona , Tucson, Arizona.
Surg Infect (Larchmt). 2018 Nov/Dec;19(8):831-835. doi: 10.1089/sur.2018.200. Epub 2018 Sep 25.
Conventional antibiotic agents are overused, leading to decreased efficacy because of a rising incidence in antimicrobial resistance. Further, conventional antibiotic agents result in widespread effects to human microbiota, which can lead directly to adverse events such as infection. This review provides a narrative summary of anti-sense therapies, an approach to managing bacterial infections by pursuing specific molecular targets that disrupt the flow of information from deoxyribonucleic acid to ribonucleic acid to protein, leading to the loss of bacterial functions. Included in this article is the rationale for this approach, the current data supporting its further investigation, and the challenges and future directions in this area of research. There is a compelling proof-of-concept against both gram-positive and gram-negative organisms to commend the use of modified anti-sense oligonucleotides as antimicrobial therapy. There are data demonstrating that anti-sense therapies are capable of killing bacteria, silencing antimicrobial resistance mechanisms to restore sensitivity to conventional antibiotic agents, and to target virulence pathways such as biofilm production. Further, these drugs have a significantly greater degree of organismal specificity, limiting antibiotic-associated diarrhea and lowering the risk of antibiotic-related infections such as infection. Anti-sense therapies show promise as a new class of antibiotic agents, providing molecular precision that leads to specific targeting of bacterial species and bacterial functions, including virulence mechanisms beyond the reach of current antibiotic agents. Further, changing the sequence of an anti-sense oligonucleotide provides a method of dealing with antimicrobial resistance that is more time- and cost-flexible than the available options with current conventional antibiotic agents.
传统抗生素的过度使用导致疗效下降,因为抗菌药物耐药性的发生率不断上升。此外,传统抗生素会对人类微生物群产生广泛影响,直接导致不良事件,如感染。
本文综述了反义疗法,这是一种通过针对特定分子靶点来管理细菌感染的方法,这些靶点可以破坏从脱氧核糖核酸到核糖核酸再到蛋白质的信息流,从而导致细菌功能丧失。本文包括这种方法的基本原理、支持进一步研究的现有数据,以及该研究领域的挑战和未来方向。
有令人信服的概念验证,既针对革兰氏阳性菌又针对革兰氏阴性菌,推荐使用修饰的反义寡核苷酸作为抗菌治疗。有数据表明,反义疗法能够杀死细菌,沉默抗菌耐药机制,恢复对传统抗生素的敏感性,并针对生物膜生成等毒力途径。此外,这些药物具有更高的生物体特异性,限制了抗生素相关性腹泻,并降低了抗生素相关感染(如感染)的风险。
反义疗法作为一类新的抗生素具有广阔的前景,提供了分子精度,可特异性靶向细菌种类和细菌功能,包括当前抗生素无法触及的毒力机制。此外,改变反义寡核苷酸的序列为解决抗菌药物耐药性提供了一种方法,比现有传统抗生素药物的选择更具时间和成本灵活性。