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多糖基制剂在皮肤相关伤口感染治疗中的应用:来自动物模型和临床试验的经验教训。

Polysaccharide-Based Formulations for Healing of Skin-Related Wound Infections: Lessons from Animal Models and Clinical Trials.

机构信息

Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075-120, Brazil.

Departamento de Medicina, Universidade de Pernambuco, Garanhuns, Pernambuco 55294902, Brazil.

出版信息

Biomolecules. 2019 Dec 30;10(1):63. doi: 10.3390/biom10010063.

Abstract

Skin injuries constitute a gateway for pathogenic bacteria that can be either part of tissue microbiota or acquired from the environmental. These microorganisms (such as and ) produce virulence factors that impair tissue integrity and sustain the inflammatory phase leading for establishment of chronic wounds. The high levels of antimicrobial resistance have limited the therapeutic arsenal for combatting skin infections. Thus, the treatment of non-healing chronic wounds is a huge challenge for health services worldwide, imposing great socio-economic damage to the affected individuals. This scenario has encouraged the use of natural polymers, such as polysaccharide, in order to develop new formulations (membranes, nanoparticles, hydrogels, scaffolds) to be applied in the treatment of skin infections. In this non-exhaustive review, we discuss the applications of polysaccharide-based formulations in the healing of infected wounds in animal models and clinical trials. The formulations discussed in this review were prepared using alginate, cellulose, chitosan, and hyaluronic acid. In addition to have healing actions , these polysaccharide formulations can act as transdermal drug delivery systems, controlling the release of active ingredients (such as antimicrobial and healing agents). The papers show that these polysaccharides-based formulations are efficient in controlling infection and improve the healing, even in chronic infected wounds. These data should positively impact the design of new dressings to treat skin infections.

摘要

皮肤损伤构成了病原菌的门户,这些病原菌既可以是组织微生物群的一部分,也可以从环境中获得。这些微生物(如 和 )产生毒力因子,破坏组织完整性并维持炎症阶段,导致慢性伤口的形成。高水平的抗生素耐药性限制了治疗皮肤感染的治疗手段。因此,非愈合性慢性伤口的治疗对全球卫生服务构成了巨大挑战,给受影响的个人带来了巨大的社会经济损失。这种情况促使人们使用天然聚合物,如多糖,开发新的制剂(膜、纳米粒子、水凝胶、支架)来治疗皮肤感染。在本次非详尽的综述中,我们讨论了基于多糖的制剂在动物模型和临床试验中治疗感染性伤口的应用。本综述中讨论的制剂是使用藻酸盐、纤维素、壳聚糖和透明质酸制备的。除了具有愈合作用外,这些多糖制剂还可以作为透皮药物输送系统,控制活性成分(如抗菌和愈合剂)的释放。这些论文表明,这些基于多糖的制剂在控制感染和促进愈合方面非常有效,即使在慢性感染性伤口中也是如此。这些数据应该会对设计治疗皮肤感染的新型敷料产生积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/431f/7022374/3ae034a2001d/biomolecules-10-00063-g001.jpg

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