Hu Yanling, Li Shengke, Dong Heng, Weng Lixing, Yuwen Lihui, Xie Yannan, Yang Jun, Shao Jinjun, Song Xuejiao, Yang Dongliang, Wang Lianhui
State Key Laboratory of Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Nanjing University of Posts & Telecommunications, Nanjing, 210023, P. R. China.
Nanjing Polytechnic Institute, Nanjing, 210048, P. R. China.
Adv Healthc Mater. 2023 Oct;12(26):e2300985. doi: 10.1002/adhm.202300985. Epub 2023 Jun 15.
The application of medical implants has greatly improved the survival rate and life quality of patients. Nevertheless, in recent years, there are increasing cases of implant dysfunction or failure because of bacterial infections. Despite significant improvements in biomedicine, there are still serious challenges in the treatment of implant-related infections. With the formation of bacterial biofilms and the development of bacterial resistance, these limitations lead to a low efficacy of conventional antibiotics. To address these challenges, it is urgent to exploit innovative treatment strategies for implant-related infections. Based on these ideas, environment-responsive therapeutic platforms with high selectivity, low drug resistance, and minor dose-limiting toxicity have attracted widespread attention. By using exogenous/endogenous stimuli, the antibacterial activity of therapeutics can be activated on demand and exhibit remarkable therapeutic effects. Exogenous stimuli include photo, magnetism, microwave, and ultrasound. Endogenous stimuli mainly include the pathological characteristics of bacterial infections such as acidic pH, anomalous temperature, and abnormal enzymatic activities. In this review, the recent progress of environment-responsive therapeutic platforms with spatiotemporally controlled drug release/activation is systematically summarized. Afterward, the limitations and opportunities of these emerging platforms are highlighted. Finally, it is hoped that this review will offer novel ideas and techniques to combat implant-related infections.
医用植入物的应用极大地提高了患者的存活率和生活质量。然而，近年来，由于细菌感染导致植入物功能障碍或失效的病例越来越多。尽管生物医学取得了显著进步，但在治疗与植入物相关的感染方面仍面临严峻挑战。随着细菌生物膜的形成和细菌耐药性的发展，这些局限性导致传统抗生素疗效低下。为应对这些挑战，迫切需要开发针对与植入物相关感染的创新治疗策略。基于这些理念，具有高选择性、低耐药性和轻微剂量限制毒性的环境响应治疗平台受到了广泛关注。通过利用外源性/内源性刺激，可以按需激活治疗剂的抗菌活性并展现出显著的治疗效果。外源性刺激包括光、磁、微波和超声。内源性刺激主要包括细菌感染的病理特征，如酸性pH值、异常温度和异常酶活性。在本综述中，系统总结了具有时空控制药物释放/激活功能的环境响应治疗平台的最新进展。随后，强调了这些新兴平台的局限性和机遇。最后，希望本综述能为对抗与植入物相关的感染提供新思路和新技术。
