Liu Yuan, Jia Yuqian, Yang Kangni, Wang Zhiqiang
College of Veterinary Medicine, Yangzhou University, Yangzhou, China.
Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, China.
Front Microbiol. 2020 Apr 23;11:563. doi: 10.3389/fmicb.2020.00563. eCollection 2020.
Antibiotic tolerance in bacterial pathogens that are genetically susceptible, but phenotypically tolerant to treatment, represents a growing crisis for public health. In particular, the intracellular bacteria-mediated antibiotic tolerance by acting as "Trojan horses" play a critical and underappreciated role in the disease burden of bacterial infections. Thus, more intense efforts are required to tackle this problem. In this review, we firstly provide a brief overview of modes of action of bacteria invasion and survival in macrophage or non-professional phagocytic cells. Furthermore, we summarize our current knowledge about promising strategies to eliminate these intracellular bacterial pathogens, including direct bactericidal agents, antibiotic delivery to infection sites by various carriers, and activation of host immune functions. Finally, we succinctly discuss the challenges faced by bringing them into clinical trials and our constructive perspectives.
在遗传上易感但表型上对治疗耐受的细菌病原体中的抗生素耐受性，对公共卫生而言是一场日益严重的危机。特别是，细胞内细菌通过充当“特洛伊木马”介导抗生素耐受性，在细菌感染的疾病负担中发挥着关键但未得到充分认识的作用。因此，需要付出更大努力来解决这个问题。在这篇综述中，我们首先简要概述细菌在巨噬细胞或非专职吞噬细胞中的侵袭和存活作用模式。此外，我们总结了目前关于消除这些细胞内细菌病原体的有前景策略的知识，包括直接杀菌药物、通过各种载体将抗生素递送至感染部位以及激活宿主免疫功能。最后，我们简要讨论将这些策略引入临床试验所面临的挑战以及我们的建设性观点。
