Shariati Aref, Vesal Soheil, Khoshbayan Amin, Goudarzi Parnian, Darban-Sarokhalil Davood, Razavi Shabnam, Didehdar Mojtaba, Chegini Zahra
Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran.
Department of Molecular Genetics, Faculty of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran.
J Appl Microbiol. 2022 Apr;132(4):2531-2546. doi: 10.1111/jam.15398. Epub 2021 Dec 14.
An important role has been recently reported for bacterial biofilm in the pathophysiology of chronic diseases, such as chronic rhinosinusitis (CRS). CRS, affecting sinonasal mucosa, is a persistent inflammatory condition with a high prevalence around the world. Although the exact pathological mechanism of this disease has not been elicited yet, biofilm formation is known to lead to a more significant symptom burden and major objective clinical indicators. The high prevalence of multidrug-resistant bacteria has severely restricted the application of antibiotics in recent years. Furthermore, systemic antibiotic therapy, on top of its insufficient concentration to eradicate bacteria in the sinonasal biofilm, often causes toxicity, antibiotic resistance, and an effect on the natural microbiota, in patients. Thus, coming up with alternative therapeutic options instead of systemic antibiotic therapy is emphasized in the treatment of bacterial biofilm in CRS patients. The use of topical antibiotic therapy and antibiotic eluting sinus stents that induce higher antibiotic concentration, and decrease side effects could be helpful. Besides, recent research recognized that various natural products, nitric oxide, and bacteriophage therapy, in addition to the hindered biofilm formation, could degrade the established bacterial biofilm. However, despite these improvements, new antibacterial agents and CRS biofilm interactions are complicated and need extensive research. Finally, most studies were performed in vitro, and more preclinical animal models and human studies are required to confirm the collected data. The present review is specifically discussing potential therapeutic strategies for the treatment of bacterial biofilm in CRS patients.
最近有报道称细菌生物膜在慢性疾病如慢性鼻-鼻窦炎（CRS）的病理生理学中发挥重要作用。CRS影响鼻窦黏膜，是一种持续性炎症疾病，在全球范围内患病率很高。尽管该疾病的确切病理机制尚未明确，但已知生物膜形成会导致更严重的症状负担和主要客观临床指标。近年来，多重耐药菌的高患病率严重限制了抗生素的应用。此外，全身抗生素治疗除了在鼻窦生物膜中根除细菌的浓度不足外，还常常导致患者出现毒性、抗生素耐药性以及对天然微生物群的影响。因此，在CRS患者细菌生物膜的治疗中，强调提出替代全身抗生素治疗的其他治疗选择。使用局部抗生素治疗以及能诱导更高抗生素浓度并减少副作用的抗生素洗脱鼻窦支架可能会有所帮助。此外，最近的研究认识到，除了阻碍生物膜形成外，各种天然产物、一氧化氮和噬菌体疗法还可以降解已形成的细菌生物膜。然而，尽管有这些进展，但新型抗菌剂与CRS生物膜之间的相互作用很复杂，需要广泛研究。最后，大多数研究是在体外进行的，需要更多的临床前动物模型和人体研究来证实所收集的数据。本综述专门讨论CRS患者细菌生物膜治疗的潜在治疗策略。
