对骨科手术的需求不断增加,包括关节置换,是由人口老龄化和关节疾病诊断的改善所驱动的。骨科手术有感染的风险,尤其是有合并症的患者。抗生素耐药性的上升加剧了这个问题,需要替代品,如体外生物工程抗菌肽(AMP),提供广谱活动和多种作用机制。这篇综述旨在评估重组AMP家族中抗菌潜力的流行程度和纯化后的产量。使用针对涉及临床感染的最常见细菌的最小抑制浓度(MIC)值评估抗微生物潜力。这项系统审查遵循了PRISMA指南,专注于重组AMPs的体外研究。搜索策略是在PubMed上运行的,Scopus和Embase至2023年3月30日。人口,使用暴露和结果模型从研究和ToxRTool中提取数据进行偏倚风险分析。这篇综述包括提供肽产量数据和针对病原菌的MIC值的研究。非英语文本,reviews,会议摘要,书籍,只专注于化学合成的研究,那些报告不完整数据集的人,使用非标准的MIC评估方法,或将MIC值表示为范围而不是精确的浓度,被排除在外。从370种出版物中,分析了34项关于AMP的研究。这些涵盖了18个家庭的46个AMP,最常见的是防御素和肝素。产量从0.5到2,700mg/L不等。对23个细菌属的AMP进行了测试,MIC值范围为0.125至>1,152μg/mL。Arenicins显示出最高的抗菌活性,特别是针对常见的骨科感染病原体。然而,AMP的产量各不相同,某些AMP对某些细菌菌株的有效性有限。本系统综述强调了生物工程AMP在应对感染和抗生素耐药性方面的关键作用。它精心评估重组AMP,专注于它们的抗菌功效和产量。审查强调,尽管AMP产量和有效性存在差异,Arenicins和Defensins是未来研究和临床应用中治疗抗生素耐药性骨科感染的有希望的候选者。这项研究大大有助于理解医疗保健中的AMP,强调它们在应对日益增长的抗生素耐药性挑战方面的潜力。系统审查注册:https://osf.io/2uq4c/。
The increasing demand for orthopedic surgeries, including joint replacements, is driven by an aging population and improved diagnosis of joint conditions. Orthopedic surgeries carry a risk of infection, especially in patients with comorbidities. The rise of antibiotic resistance exacerbates this issue, necessitating alternatives like in vitro bioengineered antimicrobial peptides (AMPs), offering broad-spectrum activity and multiple action mechanisms. This review aimed to assess the prevalence of antimicrobial potential and the yield after purification among recombinant AMP families. The antimicrobial potential was evaluated using the Minimum Inhibitory Concentration (MIC) values against the most common bacteria involved in clinical infections. This systematic review adhered to PRISMA guidelines, focusing on in vitro studies of recombinant AMPs. The search strategy was run on PubMed, Scopus and Embase up to 30th March 2023. The Population, Exposure and Outcome model was used to extract the data from studies and ToxRTool for the risk of bias analysis. This review included studies providing peptide production yield data and MIC values against pathogenic bacteria. Non-English texts, reviews, conference abstracts, books, studies focusing solely on chemical synthesis, those reporting incomplete data sets, using non-standard MIC assessment methods, or presenting MIC values as ranges rather than precise concentrations, were excluded. From 370 publications, 34 studies on AMPs were analyzed. These covered 46 AMPs across 18 families, with Defensins and Hepcidins being most common. Yields varied from 0.5 to 2,700 mg/L. AMPs were tested against 23 bacterial genera, with MIC values ranging from 0.125 to >1,152 μg/mL. Arenicins showed the highest antimicrobial activity, particularly against common orthopedic infection pathogens. However, AMP production yields varied and some AMPs demonstrated limited effectiveness against certain bacterial strains. This systematic review emphasizes the critical role of bioengineered AMPs to cope infections and antibiotic resistance. It meticulously evaluates recombinant AMPs, focusing on their antimicrobial efficacy and production yields. The review highlights that, despite the variability in AMP yields and effectiveness, Arenicins and Defensins are promising candidates for future research and clinical applications in treating antibiotic-resistant orthopedic infections. This study contributes significantly to the understanding of AMPs in healthcare, underscoring their potential in addressing the growing challenge of antibiotic resistance. Systematic review registration:https://osf.io/2uq4c/.