Background:

Endotracheal tubes, used for mechanical ventilation assistance for bedridden patients, are conducive to developing microbial biofilms due to the accumulation of body fluids. These systems are closely linked to hospital pneumonia by dispersing these cells from microbial biofilm from endotracheal tube to the lung.

Objective:

Describe endotracheal tubes' functionalization with photosensitizers such as curcumin, the progress, and perspectives of this research.

Methods:

An antimicrobial endotracheal tube was developed through the functionalization of its surface with a photosensitizer activated by light for the generation of reactive oxygen species, which inactivate microorganisms. Therefore, the prevention of pneumonia associated with mechanical ventilation was the object of a study to reach a future phase of clinical research tests.

Results:

The mechanisms involved in a complete airway system (upper and lower), including microbial biofilm formation and its elimination, are being studied to prove the transition to clinical applications.

Conclusion:

In this context, the main factors related to the development and use of functionalized endotracheal tube with photosensitizer to prevent hospital pneumonia will be described in this mini review.

Introduction:

Pathogenic microorganisms, including mainly multiresistant bacteria to known antimicrobials and untreated respiratory viruses, have been causing emerging diseases of worldwide importance and endotracheal intubation allows ventilatory assistance in these patients [1]. Hospital pneumonia are characterized by the inflammatory response resulting from penetration and microbial multiplication in the lower respiratory tract after 48 hours from endotracheal intubation [2]. The microorganisms that cause this pneumonia can originate from the patient's endogenous flora or even from nasal cavities with the non-filtration of the inhaled air in these conditions [3]. These microorganisms form biofilms in these materials through initial adhesion on the endotracheal tube (ETT) surface, which use body fluids such as saliva and mucus as a source of nutrients in their development, forming an extracellular polysaccharide. resulting from the irreversible adhesion of the microorganisms to the tube [4]. The biofilm consists of microbial cells from one or more species and from 75 to 90% formed by the extracellular polysaccharide, which guarantees their dispersion as planktonic cells can reach the lung [4]. Aiming to address this issue, an photo-antimicrobial ETT was developed thought functionalization of ETT surface with Curcumin (a natural photosensitizer (PS)) and characterized by spectroscopy, microscopy, and mechanical traction methods [5]. This Curcumin functionalized ETT can be activated by light producing a photodynamic action that is able to VentilatorAssociated Pneumonia (VAP). The photo-antimicrobial action is based on formation of oxygen-reactive species (ROS) by Curcumin in the medium and the restructuring of the bacterial biofilm due to the electrostatic repulsions between the photosensitizer molecules and the biofilm polysaccharides .

Regards

Adina

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