Management of biofilm-associated infections in diabetic wounds – from bench to bedside

Subhasri Bogadi; Pooja Rao; Vasudha KU; Gowthamarajan Kuppusamy; SubbaRao V. Madhunapantula; Vetriselvan Subramaniyan; Veera Venkata Satyanarayana Reddy Karri; Jamuna Bai Aswathanarayan

doi:10.1515/pac-2023-1117

Article

Management of biofilm-associated infections in diabetic wounds – from bench to bedside

Subhasri Bogadi , Pooja Rao , Vasudha KU , Gowthamarajan Kuppusamy , SubbaRao V. Madhunapantula , Vetriselvan Subramaniyan , Veera Venkata Satyanarayana Reddy Karri and Jamuna Bai Aswathanarayan

Published/Copyright: May 14, 2024

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From the journal Pure and Applied Chemistry Volume 96 Issue 10

Abstract

Biofilms are complex bacterial colonies embedded in an extracellular matrix. These pose a major obstacle to wound healing and are noticeable in chronic wounds. It protects the bacteria from the host’s immune system and conventional antibiotic treatments. The biofilm’s protective matrix prevents essential nutrients and oxygen from diffusing into the surrounding healthy tissue. In addition, microbes living in biofilms naturally have increased resistance to antibiotics, which reduces the effectiveness of traditional therapies. As such, biofilms serve as persistent reservoirs of infection, which further disrupts the normal course of wound healing. In this review, the current formulation strategies such as hydrogels, polymeric nanoparticles, and nanofibers that are used in wound healing to counteract biofilms have been comprehensively discussed. The formulations have been meticulously designed and developed to disturb the biofilm matrix, prevent the growth of microorganisms, and increase the potency of antimicrobials and antibiotics. The mechanism of action, advantages and limitations associated with the existing formulation strategies have been reviewed. The formulation strategies that have been translated into clinical applications and patented are also discussed in this paper.

Keywords: Advanced wound care; antibiofilm; biofilm; formulation strategies; VCCA-2023; wound healing

Corresponding authors: Veera Venkata Satyanarayana Reddy Karri, Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Tamil Nadu – 643001, India, e-mail: Narayana.reddy@jssuni.edu.in; and Jamuna Bai Aswathanarayan, Department of Microbiology, JSS Academy of Higher Education & Research, Mysuru, Karnataka – 570015, India, e-mail: jamunabhounsle@gmail.com

Article note: A collection of invited papers based on presentations at the Virtual Conference on Chemistry and its Applications 2023.

Funding source: University Grants Commission

Acknowledgments

The authors would like to thank the UGC BSR Start-up Research Grant, Department of Science and Technology – Fund for Improvement of Science and Technology Infrastructure (DST-FIST), Promotion of University Research and Scientific Excellence (DST-PURSE), SIG In Biofilms in Clinical Settings & their Control, JSS AHER for the facilities provided for conducting the research.

Research funding: The authors, Ms. Bogadi Subhasri, wish to express their gratitude to the Department of Science and Technology (DST-INSPIRE) Fellowship (ID IF200201) application reference no DST/INSPIRE/03/20 21/001920. New Delhi and technically approved by ICMR (Indian council of medical research) with Fellowship ID 2021–8531. The authors would like to acknowledge JSS AHER for the SIG grant – Biofilms in Clinical Settings & their Control and to UGC-BSR for Start-up Research Grant.

Abbreviations

PRRs: Pattern recognition receptors
PAMPs: Pathogen-associated molecular patterns
TLRs: Toll-like receptors
NLRs: NOD-like receptors
CLRs: C-type lectin receptors
ROS: Reactive oxygen species
ZnO: Zinc oxide
TiO₂: Titanium dioxide
MgO: Magnesium oxide
GO: Graphene oxide
Cu: Copper
Ag: Silver
Fe₃O₄: Magnetite as catalysts
Fe₂O₃: Hematite as catalysts
SPIONs: Supra-paramagnetic iron oxide nanoparticles
EPS: Extracellular polymeric substances
PDT: Photodynamic therapy
UV: Ultraviolet irradiation
NPWT: Negative Pressure Wound Therapy
LLLT: Low-level laser therapy
LEDs: Low-intensity laser or light-emitting diodes
ATP: Adenosine triphosphate
HPWT: High-pressure wound therapy
Nrf2: Nuclear factor erythroid 2-related factor 2
MAPK: Mitogen-activated protein kinase
SOD: Superoxide dismutase
GSTs: Glutathione S-transferases
NAD(P)H:: Quinone oxidoreductase 1
TNF-alpha: Necrosis factor-alpha
FGF: Fibroblast growth factor
VEGF: Vascular endothelial growth factor
PDGF: Platelet-derived growth factor
TGF: Transforming growth factor-beta
IL-1: Interleukin-1
IL-6: Interleukin-6
ECM: Extracellular matrix
MMPs: Matrix metalloproteinases
QSIs: Quorum sensing inhibitors
QS: Quorum sensing
EDTA: Ethylenediaminetetraacetic acid
PEGs: Polyethene glycols
SLS: Sodium lauryl sulfate
SDS: Sodium dodecyl sulfate
BAC: Benzalkonium chloride
CAPB: Cocamidopropyl betaine
COOH: Carboxyl group
MRSA: Methicillin-resistant Staphylococcus aureus
disodium EDTA: Disodium-ethylene-diamine tetraacetate
NO: Nitric oxide
GAGs: Glycosaminoglycans
NAC: N-acetylcysteine
HBT: Hyperbaric oxygen therapy
BNC: Bacterial nanocellulose

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Published Online: 2024-05-14

Published in Print: 2024-10-28

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Keywords for this article

Advanced wound care; antibiofilm; biofilm; formulation strategies; VCCA-2023; wound healing