University College London (UCL) School of Pharmacy, Department of Pharmaceutics, University College London, London, United Kingdom.
Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom.
Front Cell Infect Microbiol. 2022 Aug 4;12:956808. doi: 10.3389/fcimb.2022.956808. eCollection 2022.
Bacterial biofilms are a major and ongoing concern for public health, featuring both inherited genetic resistance traits and a conferred innate tolerance to traditional antibiotic therapies. Consequently, there is a growing need for novel methods of drug delivery, to increase the efficacy of antimicrobial agents. This research evaluated the anti-biofilm and bactericidal effects of ultrasound responsive gas-microbubbles (MBs) of either air or nitric oxide, using an biofilm model grown in artificial wound medium. The four lipid-based MB formulations evaluated were room-air MBs (RAMBs) and nitric oxide MBs (NOMBs) with no electrical charge, as well as cationic (+) RAMBs and NOMBs. Two principal treatment conditions were used: i) ultrasound stimulated MBs only, and ii) ultrasound stimulated MBs with a sub-inhibitory concentration (4 µg/mL) of the antibiotic gentamicin. The total treatment time was divided into a 60 second passive MB interaction period prior to 40 second ultrasound exposure; each MB formulation was tested in triplicate. Ultrasound stimulated RAMBs and NOMBs without antibiotic achieved reductions in biofilm biomass of 93.3% and 94.0%, respectively. Their bactericidal efficacy however was limited, with a reduction in culturable cells of 26.9% and 65.3%, respectively. NOMBs with sub-inhibitory antibiotic produced the most significant reduction in biofilm biomass, corresponding to a 99.9% (SD ± 5.21%); and a 99.9% (SD ± 0.07%) (3-log) reduction in culturable bacterial cells. Cationic MBs were initially manufactured to promote binding of MBs to negatively charged biofilms, but these formulations also demonstrated intrinsic bactericidal properties. In the absence of antibiotic, the bactericidal efficacy of RAMB and NOMB was greater that of uncharged counterparts, reducing culturable cells by 84.7% and 86.1% respectively; increasing to 99.8% when combined with antibiotic. This study thus demonstrates the anti-biofilm and bactericidal utility of ultrasound stimulated MBs, and specifically is the first to demonstrate the efficacy of a NOMB for the dispersal and potentiation of antibiotics against bacterial biofilms Importantly the biofilm system and complex growth-medium were selected to recapitulate key morphological features of biofilms. The results us offer new insight for the development of new clinical treatments, for example, in chronic wounds.
细菌生物膜是公共卫生领域的一个主要且持续存在的问题,其具有遗传抗性和对传统抗生素治疗的固有耐受性。因此,需要开发新的药物输送方法来提高抗菌剂的疗效。本研究使用人工伤口培养基中生长的生物膜模型,评估了超声响应气体微泡(MBs)的抗生物膜和杀菌作用。评估的四种基于脂质的 MB 制剂为空气 MB(RAMB)和一氧化氮 MB(NOMB),它们不带电荷,以及带正电荷的(+)RAMB 和 NOMB。使用了两种主要的处理条件:i)仅超声刺激 MB,ii)超声刺激 MB 并加入亚抑制浓度(4μg/mL)的抗生素庆大霉素。总处理时间分为 60 秒的被动 MB 相互作用期,然后进行 40 秒的超声暴露;每种 MB 制剂均进行了三次重复测试。没有抗生素的超声刺激 RAMB 和 NOMB 分别使生物膜生物量减少了 93.3%和 94.0%。然而,它们的杀菌效果有限,可培养细胞的减少分别为 26.9%和 65.3%。含有亚抑制抗生素的 NOMB 产生了最大程度的生物膜生物量减少,对应于 99.9%(SD ± 5.21%);以及可培养细菌细胞减少 99.9%(SD ± 0.07%)(3-log)。阳离子 MB 最初是为了促进 MB 与带负电荷的生物膜结合而制造的,但这些制剂也表现出内在的杀菌特性。在没有抗生素的情况下,RAMB 和 NOMB 的杀菌效果优于不带电荷的对应物,可培养细胞分别减少 84.7%和 86.1%;当与抗生素结合时,增加到 99.8%。因此,本研究证明了超声刺激 MB 的抗生物膜和杀菌作用,特别是首次证明了 NOMB 在分散和增强抗生素对细菌生物膜的作用方面的功效。重要的是,选择生物膜系统和复杂的生长培养基来重现生物膜的关键形态特征。这些结果为新的临床治疗方法的开发提供了新的见解,例如在慢性伤口中。
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