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Czy probiotyki są skuteczne w leczeniu biofilmu w ranach trudno gojących się?

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Probiotyki stosowane są przede wszystkim przy chorobach układu pokarmowego, aby odbudować mikroflorę jelitową. Badania pokazują, że mogą też znaleźć zastosowanie w leczeniu trudno gojących się ran z obecnością zakażenia i biofilmu.

Zakażenie rany wydłuża proces gojenia, ale też może stanowić zagrożenie dla zdrowia i życia pacjenta. Szczególnie niebezpieczne są zakażenia wywoływane przez bakterie tworzące biofilm. Jest to struktura bakteryjna zbudowana z wielu drobnoustrojów charakteryzująca się wzmożoną odpornością na antybiotyki i substancje o działaniu przeciwdrobnoustrojowym.

Odpowiada za to matryca biofilmu, która chroni drobnoustroje przed czynnikami zewnętrznymi, a w tym też przed lekami. Matryca zbudowana jest z warstw, przez które antybiotyki nie są w stanie przejść. Jednocześnie bakterie znajdujące się w biofilmie mają kontakt z antybiotykiem właśnie poprzez matrycę i uodparniają się na jego działanie. Oporność biofilmu na leczenie zmusza naukowców do opracowywania coraz to nowszych metod terapeutycznych, skutecznych w usuwaniu struktur tworzonych przez patogeny. W badaniu z 2019 roku opublikowanym w European Journal of Pharmaceutics and Biopharmaceutics wykazano skuteczność zastosowania bakterii probiotycznych i/lub ich metabolitów w leczeniu ran zakażonych biofilmem.

Wpływ probiotyków na biofilm

Szczepy bakterii probiotycznych różnią się między sobą sposobem oddziaływania na biofilm. Pierwszym z nich jest przemieszczenie, w którym bakterie probiotyczne przenikają do biofilmu, prowadząc do jego rozproszenia. Kolejny nazywany jest wykluczeniem. W tym przypadku probiotyki tworzą własny biofilm, który zapobiega tworzeniu biofilmu przez drobnoustroje chorobotwórcze. Ostatnim jest konkurencja. Polega on na współzawodnictwie pomiędzy bakteriami probiotycznymi i chorobotwórczymi o miejsce wiązania, co zapobiega kolonizacji przez patogeny.

W trakcie badań naukowcy wykorzystali nanocząsteczki (biosurfaktanty), które wyizolowano z bakterii probiotycznych Lactobacillus gasseri BC9. Cząsteczki umieszczono w liposomach, tworząc strukturę (BS-LP) zapobiegającą rozwojowi i eliminującą biofilmy tworzone przez bakterie MRSA. Badanie pokazało również, że struktura BS-LP jest skuteczniejsza niż wolne biosurfaktanty.

Wpływ probiotyków na bakterie gram-ujemne

Przeciwdrobnoustrojowe działanie probiotyków potwierdzają również badania opublikowane w Journal of Translational Medicine w 2019 roku. W czasie ich trwania wykonano specjalny model rany, symulujący prawdziwy uraz. Uwzględniono w nim czynniki odpornościowe oraz środowisko panujące w prawdziwej ranie.

W tym przypadku zbadano zależność pomiędzy aplikacją szczepu L. plantarum i/lub jego metabolitów a rozwojem biofilmu Pseudomonas aeruginosa. Po umieszczeniu probiotyków na powierzchni biofilmu oceniono ilościowo przeżycie bakterii po 4 i 24 godzinach inkubacji. Naukowcy zaobserwowali zahamowanie kolonizacji rany przez bakterie i tworzenia biofilmu.

Dalsze badania

Przedstawione wyniki badań pokazują, że probiotyki mogą mieć szerokie zastosowanie w procesie leczenia ran. Trzeba pamiętać, że skuteczność terapii z użyciem probiotyków zależy od tego, jakie szczepy bakterii probiotycznych zostaną użyte, a także od rodzajów drobnoustrojów tworzących biofilm. Naukowcy będą kontynuować badania, aby dokładnie zrozumieć mechanizmy stojące za dobroczynnym działaniem probiotyków.

Źródło: R. Dudek, Wicher, J. Paleczny, M. Bartoszewicz, „Potencjał antybiofilmowy szczepów probiotycznych”, „Forum Zakażeń” 2021;12(o6), str. 243-249

Więcej tematów związanych z zakażeniami będzie poruszanych na konferencji II Forum Zakażeń, która odbędzie się w dniach 12-14 maja w Jachrance. Serdecznie zapraszamy do rejestracji!

Przeczytaj bezpłatnie pokrewny artykuł w czasopiśmie „Forum Leczenia Ran”:  Charakterystyka, diagnoza i leczenie biofilmu. Przegląd piśmiennictwa

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