Lan Jiaming, Zou Jingyu, Xin He, Sun Jin, Han Tao, Sun Mengchi, Niu Meng
Department of Interventional Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China.
Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China.
J Control Release. 2025 May 10;381:113589. doi: 10.1016/j.jconrel.2025.113589. Epub 2025 Mar 1.
The problem of antimicrobial resistance (AMR) has caused global concern due to its great threat to human health. Evidences are emerging for a critical role of biofilms, one of the natural protective mechanisms developed by bacteria during growth, in resisting commonly used clinical antibiotics. Advances in nanomedicines with tunable physicochemical properties and unique anti-biofilm mechanisms provide opportunities for solving AMR risks more effectively. In this review, we summarize the five "A" stages (adhesion, amplification, alienation, aging and allocation) of biofilm formation and mechanisms through which they protect the internal bacteria. Aimed at the characteristics of biofilms, we emphasize the design "THAT" principles (targeting, hacking, adhering and transport) of nanomedicines in their interactions with biofilms and internal bacteria. Furthermore, recent progresses in multimodal antibacterial nanomedicines, including biofilms disruption and bactericidal activity, and the types of currently available antibiofilm nanomedicines contained organic and inorganic nanomedicines are outlined and highlighted their potential applications in the development of preclinical research. Last but not least, we offer a perspective for the effectiveness of nanomedicines designed to address AMR and challenges associated with their clinical translation.
抗菌耐药性（AMR）问题因其对人类健康构成巨大威胁而引起全球关注。越来越多的证据表明，生物膜作为细菌生长过程中形成的一种天然保护机制，在抵抗常用临床抗生素方面发挥着关键作用。具有可调节物理化学性质和独特抗生物膜机制的纳米药物的进展为更有效地解决AMR风险提供了机会。在这篇综述中，我们总结了生物膜形成的五个“A”阶段（粘附、扩增、异化、老化和分布）及其保护内部细菌的机制。针对生物膜的特性，我们强调了纳米药物与生物膜及内部细菌相互作用时的设计“THAT”原则（靶向、破解、粘附和运输）。此外，概述了多模态抗菌纳米药物（包括生物膜破坏和杀菌活性）的最新进展，以及目前可用的抗生物膜纳米药物的类型（包括有机和无机纳米药物），并强调了它们在临床前研究开发中的潜在应用。最后但同样重要的是，我们对旨在解决AMR的纳米药物的有效性及其临床转化相关挑战提出了展望。
