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Combination strategies to enhance the efficacy of antimicrobial peptides against bacterial biofilms

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Abstract
The great clinical significance of biofilm-associated infections and their inherent recalcitrance to antibiotic treatment urgently demand the development of novel antibiofilm strategies. In this regard, antimicrobial peptides (AMPs) are increasingly recognized as a promising template for the development of antibiofilm drugs. Indeed, owing to their main mechanism of action, which relies on the permeabilization of bacterial membranes, AMPs exhibit a strong antimicrobial activity also against multidrugresistant bacteria and slow-growing or dormant biofilm-forming cells and are less prone to induce resistance compared to current antibiotics. Furthermore, the antimicrobial potency of AMPs can be highly increased by combining them with conventional (antibiotics) as well as unconventional bioactive molecules. Combination treatments appear particularly attractive in the case of biofilms since the heterogeneous nature of these microbial communities requires to target cells in different metabolic states (e.g., actively growing cells, dormant cells) and environmental conditions (e.g., acidic pH, lack of oxygen or nutrients). Therefore, the combination of different bioactive molecules acting against distinct biofilm components has the potential to facilitate biofilm control and/ or eradication. The aim of this review is to highlight the most promising combination strategies developed so far to enhance the therapeutic potential of AMPs against bacterial biofilms. The rationale behind and beneficial outcomes of using AMPs in combination with conventional antibiotics, compounds capable of disaggregating the extracellular matrix, inhibitors of signaling pathways involved in biofilm formation (i.e., quorum sensing), and other peptide-based molecules will be presented and discussed.
Keywords
antimicrobial peptides, bacterial biofilms, combination therapies, antibiofilm strategies, synergistic interactions, MULTIDRUG-RESISTANT STRAINS, QUORUM-SENSING INHIBITORS, PSEUDOMONAS-AERUGINOSA, IN-VITRO, STAPHYLOCOCCUS-AUREUS, ANTIBIOTICS, INFECTIONS, ANTIBIOFILM, SUSCEPTIBILITY, ANTIBACTERIAL

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MLA
Grassi, Lucia, et al. “Combination Strategies to Enhance the Efficacy of Antimicrobial Peptides against Bacterial Biofilms.” FRONTIERS IN MICROBIOLOGY, vol. 8, Frontiers Media Sa, 2017, doi:10.3389/fmicb.2017.02409.
APA
Grassi, L., Maisetta, G., Esin, S., & Batoni, G. (2017). Combination strategies to enhance the efficacy of antimicrobial peptides against bacterial biofilms. FRONTIERS IN MICROBIOLOGY, 8. https://doi.org/10.3389/fmicb.2017.02409
Chicago author-date
Grassi, Lucia, Giuseppantonio Maisetta, Semih Esin, and Giovanna Batoni. 2017. “Combination Strategies to Enhance the Efficacy of Antimicrobial Peptides against Bacterial Biofilms.” FRONTIERS IN MICROBIOLOGY 8. https://doi.org/10.3389/fmicb.2017.02409.
Chicago author-date (all authors)
Grassi, Lucia, Giuseppantonio Maisetta, Semih Esin, and Giovanna Batoni. 2017. “Combination Strategies to Enhance the Efficacy of Antimicrobial Peptides against Bacterial Biofilms.” FRONTIERS IN MICROBIOLOGY 8. doi:10.3389/fmicb.2017.02409.
Vancouver
1.
Grassi L, Maisetta G, Esin S, Batoni G. Combination strategies to enhance the efficacy of antimicrobial peptides against bacterial biofilms. FRONTIERS IN MICROBIOLOGY. 2017;8.
IEEE
[1]
L. Grassi, G. Maisetta, S. Esin, and G. Batoni, “Combination strategies to enhance the efficacy of antimicrobial peptides against bacterial biofilms,” FRONTIERS IN MICROBIOLOGY, vol. 8, 2017.
@article{8663115,
  abstract     = {{The great clinical significance of biofilm-associated infections and their inherent recalcitrance to antibiotic treatment urgently demand the development of novel antibiofilm strategies. In this regard, antimicrobial peptides (AMPs) are increasingly recognized as a promising template for the development of antibiofilm drugs. Indeed, owing to their main mechanism of action, which relies on the permeabilization of bacterial membranes, AMPs exhibit a strong antimicrobial activity also against multidrugresistant bacteria and slow-growing or dormant biofilm-forming cells and are less prone to induce resistance compared to current antibiotics. Furthermore, the antimicrobial potency of AMPs can be highly increased by combining them with conventional (antibiotics) as well as unconventional bioactive molecules. Combination treatments appear particularly attractive in the case of biofilms since the heterogeneous nature of these microbial communities requires to target cells in different metabolic states (e.g., actively growing cells, dormant cells) and environmental conditions (e.g., acidic pH, lack of oxygen or nutrients). Therefore, the combination of different bioactive molecules acting against distinct biofilm components has the potential to facilitate biofilm control and/ or eradication. The aim of this review is to highlight the most promising combination strategies developed so far to enhance the therapeutic potential of AMPs against bacterial biofilms. The rationale behind and beneficial outcomes of using AMPs in combination with conventional antibiotics, compounds capable of disaggregating the extracellular matrix, inhibitors of signaling pathways involved in biofilm formation (i.e., quorum sensing), and other peptide-based molecules will be presented and discussed.}},
  articleno    = {{2409}},
  author       = {{Grassi, Lucia and Maisetta, Giuseppantonio and Esin, Semih and Batoni, Giovanna}},
  issn         = {{1664-302X}},
  journal      = {{FRONTIERS IN MICROBIOLOGY}},
  keywords     = {{antimicrobial peptides,bacterial biofilms,combination therapies,antibiofilm strategies,synergistic interactions,MULTIDRUG-RESISTANT STRAINS,QUORUM-SENSING INHIBITORS,PSEUDOMONAS-AERUGINOSA,IN-VITRO,STAPHYLOCOCCUS-AUREUS,ANTIBIOTICS,INFECTIONS,ANTIBIOFILM,SUSCEPTIBILITY,ANTIBACTERIAL}},
  language     = {{eng}},
  pages        = {{8}},
  publisher    = {{Frontiers Media Sa}},
  title        = {{Combination strategies to enhance the efficacy of antimicrobial peptides against bacterial biofilms}},
  url          = {{http://doi.org/10.3389/fmicb.2017.02409}},
  volume       = {{8}},
  year         = {{2017}},
}

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