Politecnico di Torino, Department of Mechanical and Aerospace Engineering, Torino 10129, Italy.
Politecnico di Torino, Polito BIOmed Lab, Torino 10129, Italy.
Biomater Sci. 2024 Oct 22;12(21):5433-5449. doi: 10.1039/d4bm00936c.
Bacterial colonization and biofilm formation on medical devices represent one of the most urgent and critical challenges in modern healthcare. These issues not only pose serious threats to patient health by increasing the risk of infections but also exert a considerable economic burden on national healthcare systems due to prolonged hospital stays and additional treatments. To address this challenge, there is a need for smart, customized biomaterials for medical device fabrication, particularly through the development of surface modification strategies that prevent bacterial adhesion and the growth of mature biofilms. This review explores three bioinspired approaches through which antibacterial and antiadhesive coatings can be engineered to exhibit smart, stimuli-responsive features. This responsiveness is greatly valuable as it provides the coatings with a controlled, on-demand antibacterial response that is activated only in the presence of bacteria, functioning as self-defensive coatings. Such coatings can be designed to release antibacterial agents or change their surface properties/conformation in response to specific stimuli, like changes in pH, temperature, or the presence of bacterial enzymes. This targeted approach minimizes the risk of developing antibiotic resistance and reduces the need for continuous, high-dose antibacterial treatments, thereby preserving the natural microbiome and further reducing healthcare costs. The final part of the review reports a critical analysis highlighting the potential improvements and future evolutions regarding antimicrobial self-defensive coatings and their validation.
细菌在医疗器械上的定植和生物膜形成是现代医疗保健领域最紧迫和最关键的挑战之一。这些问题不仅通过增加感染风险对患者健康构成严重威胁，而且由于住院时间延长和额外治疗，给国家医疗保健系统带来了相当大的经济负担。为了应对这一挑战，需要为医疗器械制造开发智能、定制化的生物材料，特别是通过开发防止细菌附着和成熟生物膜生长的表面改性策略。这篇综述探讨了三种仿生方法，通过这些方法可以设计出具有智能、响应性特征的抗菌和抗黏附涂层。这种响应性非常有价值，因为它为涂层提供了一种受控的按需抗菌响应，只有在存在细菌的情况下才会被激活，从而起到自我防御的作用。这些涂层可以设计为响应特定的刺激（如 pH 值、温度或细菌酶的变化）释放抗菌剂或改变其表面性质/构象。这种靶向方法最大限度地降低了产生抗生素耐药性的风险，并减少了对持续、高剂量抗菌治疗的需求，从而保护了自然微生物组并进一步降低了医疗保健成本。综述的最后一部分报告了一项批判性分析，强调了抗菌自我防御涂层及其验证方面的潜在改进和未来发展。
