Arip Masita, Selvaraja Malarvili, R Mogana, Tan Lee Fang, Leong Mun Yee, Tan Puay Luan, Yap Vi Lien, Chinnapan Sasikala, Tat Ng Chin, Abdullah Maha, K Dharmendra, Jubair Najwan
Allergy and Immunology Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Setia Alam, Malaysia.
Department of Pharmaceutical Biology, Faculty of Pharmaceutical Sciences, UCSI University, Cheras, Malaysia.
Front Pharmacol. 2022 Sep 29;13:879495. doi: 10.3389/fphar.2022.879495. eCollection 2022.
Antimicrobial resistance (AMR) occurs when microbes no longer respond to any pharmacological agents, rendering the conventional antimicrobial agents ineffective. AMR has been classified as one of the top 10 life-threatening global health problems needed multilevel attention and global cooperation to attain the Sustainable Development Goals (SDGs) according to the World Health Organization (WHO), making the discovery of a new and effective antimicrobial agent a priority. The recommended treatments for drug-resistant microbes are available but limited. Furthermore, the transformation of microbes over time increases the risk of developing drug resistance. Hence, plant metabolites such as terpenes, phenolic compounds and alkaloids are widely studied due to their antibacterial, antiviral, antifungal and antiparasitic effects. Plant-derived antimicrobials are preferred due to their desirable efficacy and safety profile. Plant metabolites work by targeting microbial cell membranes, interfering with the synthesis of microbial DNA/RNA/enzymes and disrupting quorum sensing and efflux pump expression. They also work synergistically with conventional antibiotics to enhance antimicrobial effects. Accordingly, this review aims to identify currently available pharmacological therapies against microbes and AMR, as well as to discuss the importance of plant and secondary metabolites as a possible solution for AMR together with their mechanisms of action. All the information was obtained from government databases, WHO websites, PubMed, Springer, Google Scholar and Science Direct. Based on the information obtained, AMR is regarded as a significant warning to global healthcare. Plant derivatives such as secondary metabolites may be considered as potential therapeutic targets to mitigate the non-ending AMR.
当微生物不再对任何药物制剂产生反应，致使传统抗菌药物失效时，就会出现抗菌药物耐药性（AMR）。根据世界卫生组织（WHO）的说法，AMR已被列为全球十大危及生命的健康问题之一，需要多级关注和全球合作以实现可持续发展目标（SDGs），这使得发现新型有效抗菌药物成为当务之急。针对耐药微生物的推荐治疗方法虽有，但有限。此外，微生物随时间的演变增加了产生耐药性的风险。因此，植物代谢产物如萜类、酚类化合物和生物碱因其抗菌、抗病毒、抗真菌和抗寄生虫作用而受到广泛研究。植物源抗菌剂因其理想的疗效和安全性而更受青睐。植物代谢产物通过靶向微生物细胞膜、干扰微生物DNA/RNA/酶的合成以及破坏群体感应和外排泵表达来发挥作用。它们还与传统抗生素协同作用以增强抗菌效果。因此，本综述旨在确定目前可用的针对微生物和AMR的药物治疗方法，并讨论植物和次生代谢产物作为AMR可能解决方案的重要性及其作用机制。所有信息均来自政府数据库、WHO网站、PubMed、Springer、谷歌学术和科学Direct。根据所获得的信息，AMR被视为对全球医疗保健的重大警示。次生代谢产物等植物衍生物可被视为减轻无休止的AMR的潜在治疗靶点。
