Abstract

Bacteriocins, a class of antimicrobial peptide produced by bacteria, may offer a potential alternative to traditional antibiotics, an important step towards mitigating the ever-increasing antimicrobial resistance crisis. They are active against a range of clinically relevant Gram-positive and Gram-negative bacteria. Bacteriocins have been discussed in the literature for over a century. Although they are used as preservatives in food, no medicine based on their antimicrobial activity exists on the market today. In order to formulate them into clinical antibiotics, pre-formulation studies on their biophysical and physicochemical properties that will influence their activity in vivo and their stability during manufacture must be elucidated. Thermal, pH and enzymatic stability of bacteriocins are commonly studied and regularly reported in the literature. Solubility, permeability and aggregation properties on the other hand are less frequently reported for many bacteriocins, which may contribute to their poor clinical progression. Promising cytotoxicity studies report that bacteriocins exhibit few cytotoxic effects on a variety of mammalian cell lines, at active concentrations. This review highlights the lack of quantitative data and in many cases even qualitative data, on bacteriocins’ solubility, stability, aggregation, permeability and cytotoxicity. The formulation strategies that have been explored to date, proposed routes of administration, trends in in vitro/in vivo behaviour and efforts in clinical development are discussed. The future promise of bacteriocins as a new generation of antibiotics may require tailored local delivery strategies to fulfil their potential as a force to combat antimicrobial-resistant bacterial infections.

Highlights

  • Antimicrobial resistance (AMR) is a major contributing factor to mortality and morbidity across the world with major public health and societal implications [1,2]

  • Strategies that have been suggested to date for the formulation of bacteriocins are discussed and essential parameters that are currently lacking for their development into medicines for antimicrobial-resistant infections are identified

  • There exists a large panel of bacteriocins that exhibit a wide range of activities against clinically relevant bacteria

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Summary

Introduction

Antimicrobial resistance (AMR) is a major contributing factor to mortality and morbidity across the world with major public health and societal implications [1,2]. The World Health Organisation (WHO) has attempted to focus research towards novel therapeutics as the number of antimicrobial agents in the clinical pipeline is not sufficient to mitigate this problem and the rate of development of novel antimicrobials is not fast enough They are steering research towards systems to effec­ tively monitor the rising levels of AMR [5,6]. Several bacteriocins have been identified with activity against clin­ ically relevant Gram-negative and Gram-positive bacteria These include bacterial strains that show resistance to commonly used antibiotics, such as C. difficile, methicillin-resistant S. aureus (MRSA), S. pneumonia and vancomycin-resistant enterococci (VRE) [9,32,33,34]. Strategies that have been suggested to date for the formulation of bacteriocins are discussed and essential parameters that are currently lacking for their development into medicines for antimicrobial-resistant infections are identified

Bacteriocins
Physicochemical properties of bacteriocins
Physical stability
Chemical stability
The cytotoxicity of bacteriocins
Drug delivery strategies for bacteriocins
Routes of administration and bioavailability
Formulation approaches for Bacteriocins
Semisynthetic bacteriocins
Clinical development of bacteriocins
Findings
Conclusion and future perspectives

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