Antimicrobial Peptides in the Battle against Orthopedic Implant-Related Infections: A Review

Prevention of orthopedic implant-related infections is a major medical challenge, particularly due to the involvement of biofilm-encased and multidrug-resistant bacteria. Current therapies, based on antibiotic administration, have proven to be insufficient, and infection prevalence may rise due to t...

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Bibliographic Details
Published in:Pharmaceutics 2021-11, Vol.13 (11), p.1918
Main Authors: Costa, Bruna, Martínez-de-Tejada, Guillermo, Gomes, Paula A C, L Martins, M Cristina, Costa, Fabíola
Format: Article
Language:English
Subjects:
Antibiotics
antimicrobial
Antimicrobial agents
antimicrobial-peptides (AMPs)
Bacteria
Bacterial infections
Bioavailability
Biofilms
Biomedical materials
Bone surgery
Calcium phosphates
Drug resistance
Immune system
orthopedic implant-related infections
Orthopedics
peptide immobilization
peptide release
Peptides
Review
Staphylococcus infections
surface functionalization
Transplants & implants
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Summary:Prevention of orthopedic implant-related infections is a major medical challenge, particularly due to the involvement of biofilm-encased and multidrug-resistant bacteria. Current therapies, based on antibiotic administration, have proven to be insufficient, and infection prevalence may rise due to the dissemination of antibiotic resistance. Antimicrobial peptides (AMPs) have attracted attention as promising substitutes of conventional antibiotics, owing to their broad-spectrum of activity, high efficacy at very low concentrations, and, importantly, low propensity for inducing resistance. The aim of this review is to offer an updated perspective of the development of AMPs-based preventive strategies for orthopedic and dental implant-related infections. In this regard, two major research strategies are herein addressed, namely (i) AMP-releasing systems from titanium-modified surfaces and from bone cements or beads; and (ii) AMP immobilization strategies used to graft AMPs onto titanium or other model surfaces with potential translation as coatings. In overview, releasing strategies have evolved to guarantee higher loadings, prolonged and targeted delivery periods upon infection. In addition, avant-garde self-assembling strategies or polymer brushes allowed higher immobilized peptide surface densities, overcoming bioavailability issues. Future research efforts should focus on the regulatory demands for pre-clinical and clinical validation towards clinical translation.
ISSN:1999-4923
1999-4923
DOI:10.3390/pharmaceutics13111918