北京生物医学工程

抗菌肽在骨感染治疗中的研究进展

Research progress of antimicrobial peptides in the treatment of bone infection

单位：吉林大学第二医院 （长春130041） 通信作者：彭传刚。E-mail: pengcg@jlu.edu.cn

分类号：R318

出版年·卷·期（页码）：2022·41·2（208-214）

摘要：

创伤后骨髓炎是骨组织感染的严重并发症，使患者长期卧床，生活质量下降，最终残疾甚至危及生命。目前临床控制骨感染的首选疗法是彻底清创外加全身和局部使用抗生素。但细菌在局部感染部位的繁殖可形成生物膜，从而使细菌难以被清除，成为控制感染的难点。此外，长期使用抗生素还会引起各种全身不良反应并增加细菌耐药性。抗菌肽（antimicrobial peptides, AMPs）是种类丰富的新兴抗菌物质，能通过破坏细菌细胞膜或细胞壁的抗菌机制对抗耐药菌，引起研究者的青睐。考虑到抗菌肽局部给药疗效更好，近年来研究者对AMPs与局部药物递送相结合治疗骨感染进行了研究。如骨水泥、钛合金假体、水凝胶以及发展较快的纳米粒子可将抗菌肽稳定释放而不影响抗菌肽的生物活性。根据AMPs的特点、结构分类及抗菌机制选取合适的药物载体搭载AMPs或与抗生素共同整合从而制作出具有较强抗菌功能的材料是治疗骨组织感染的一种有效且有前景的方法。本文介绍了AMPs的抗菌机制及将其运送至局部靶向部位的一些载体，总结讨论AMPs对抗耐药病原体的优势，并分析了AMPs在现有的研究环境下所要处理的优先事项和应用前瞻。

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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