北京生物醫(yī)學(xué)工程

抗菌肽在骨感染治療中的研究進(jìn)展

Research progress of antimicrobial peptides in the treatment of bone infection

單位：吉林大學(xué)第二醫(yī)院 （長(zhǎng)春130041） 通信作者：彭傳剛。E-mail: [email protected]

關(guān)鍵詞：抗菌肽；骨感染；抗菌機(jī)制；藥物載體；治療應(yīng)用

分類號(hào)：R318

出版年·卷·期（頁(yè)碼）：2022·41·2（208-214）

摘要：

創(chuàng)傷后骨髓炎是骨組織感染的嚴(yán)重并發(fā)癥，使患者長(zhǎng)期臥床，生活質(zhì)量下降，最終殘疾甚至危及生命。目前臨床控制骨感染的首選療法是徹底清創(chuàng)外加全身和局部使用抗生素。但細(xì)菌在局部感染部位的繁殖可形成生物膜，從而使細(xì)菌難以被清除，成為控制感染的難點(diǎn)。此外，長(zhǎng)期使用抗生素還會(huì)引起各種全身不良反應(yīng)并增加細(xì)菌耐藥性。抗菌肽（antimicrobial peptides, AMPs）是種類豐富的新興抗菌物質(zhì)，能通過(guò)破壞細(xì)菌細(xì)胞膜或細(xì)胞壁的抗菌機(jī)制對(duì)抗耐藥菌，引起研究者的青睞。考慮到抗菌肽局部給藥療效更好，近年來(lái)研究者對(duì)AMPs與局部藥物遞送相結(jié)合治療骨感染進(jìn)行了研究。如骨水泥、鈦合金假體、水凝膠以及發(fā)展較快的納米粒子可將抗菌肽穩(wěn)定釋放而不影響抗菌肽的生物活性。根據(jù)AMPs的特點(diǎn)、結(jié)構(gòu)分類及抗菌機(jī)制選取合適的藥物載體搭載AMPs或與抗生素共同整合從而制作出具有較強(qiáng)抗菌功能的材料是治療骨組織感染的一種有效且有前景的方法。本文介紹了AMPs的抗菌機(jī)制及將其運(yùn)送至局部靶向部位的一些載體，總結(jié)討論AMPs對(duì)抗耐藥病原體的優(yōu)勢(shì)，并分析了AMPs在現(xiàn)有的研究環(huán)境下所要處理的優(yōu)先事項(xiàng)和應(yīng)用前瞻。

Post-traumatic osteomyelitis is a serious complication of bone tissue infection, which leads to long-term bedridden patients, decreased quality of life, and eventually disability or even life-threatening. At present, the preferred treatment for clinical control of bone infection is complete debridement plus systemic and local antibiotic use. However, the reproduction of bacteria in the locally infected parts can form biofilms, which makes it difficult to remove the bacteria and becomes the difficulty in infection control. In addition, long-term use of antibiotics can cause a variety of systemic adverse reactions and increase bacterial resistance. Antimicrobial peptides are a variety of emerging antimicrobial substances, which can fight against drug-resistant bacteria by destroying the antimicrobial mechanism of bacterial cell membrane or cell wall. Considering that local administration of antimicrobial peptides has better efficacy, researchers have studied the combination of antimicrobial peptides and local drug delivery in the treatment of bone infection in recent years. Such as bone cement, titanium alloy prostheses ,hydrogels, and nanoparticles which have developed rapidly in recent years can release antimicrobial peptides stably without affecting their biological activity. It is an effective and promising method for the treatment of bone tissue infection to select appropriate drug carriers to carry antimicrobial peptides or to integrate antimicrobial peptides with antibiotics according to the characteristics, structural classification and antimicrobial mechanism. In this review, we introduce the antimicrobial mechanism of AMPs and the vectors that deliver them to locally targeted sites, summarize and discuss the advantages of antimicrobial peptides against drug-resistant pathogens, and analyze the priorities and application prospects of AMPs in the current research environment.

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