Research and application of gas therapy in preventing biofilm associated infections

Yang, Pan1,2; Wang, Yadi1,2,*; Li, Xueling3; Lü, Junhong2,4,*

Author Information

1College of Pharmacy, Binzhou Medical University, Yantai, Shandong Province, China

2Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong Province, China

3College of Public Health, Shanghai University of Medicine & Health Sciences, Shanghai, China

4Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, School of Pharmacy, Yantai University, Yantai, Shandong Province, China

*Correspondence to: Junhong Lü, PhD, lvjunhong@jnl.ac.cn; Yadi Wang, PhD, wangydcas@163.com

Funding:This study was supported by Shanghai International Science & Technology Cooperation Program (No. 22490714400) and the Research Project of Jinan Microecological Biomedicine Shandong Laboratory (No. JNL-2025013C).

Abstract

Conventional antibiotic therapies often fail to eradicate biofilms, which can lead to persistent infections and significant clinical challenges. Gas therapy, which utilizes the unique properties of gas molecules such as nitric oxide, carbon monoxide, hydrogen, and hydrogen sulfide, is emerging as a promising and innovative strategy to address these challenges. This review first highlights gas signaling in bacterial biofilms. It then goes on to list four types of gas therapy in detail: photothermal-enhanced gas therapy, photodynamic-activated gas therapy, micro/nanobubble-mediated gas therapy, and gas-based synergistic therapy. Their potential applications and future directions are also fully discussed. Due to its unique bioactivity, low resistance, and synergy with existing treatments, gas therapy has demonstrated significant potential in the prevention and treatment of biofilm-associated infections. However, overcoming delivery challenges, validating efficacy in large-scale trials, and developing standardized protocols are essential for its clinical translation. Future efforts should prioritize the integration of nanotechnology and mechanistic studies to unlock broader therapeutic utility.

摘要

传统的抗生素疗法通常无法根除生物膜，这可能导致持续性感染并带来显著的临床挑战。气体疗法利用一氧化氮、一氧化碳、氢气和硫化氢等气体分子的独特性质，正成为一种有前景的创新策略来应对这些挑战。本综述首先强调了细菌生物膜中的气体信号作用。接着，详细列举了四种气体疗法：光热增强型气体疗法、光动力激活型气体疗法、微/纳米气泡介导的气体疗法以及基于气体的协同疗法。文章还充分讨论了它们的潜在应用和未来发展方向。由于其独特的生物活性、低耐药性以及与现有治疗的协同作用，气体疗法在预防和治疗生物膜相关感染方面展现出巨大潜力。然而，克服递送挑战、在大规模试验中验证疗效以及制定标准化方案对于其临床转化至关重要。未来的工作应优先考虑纳米技术的整合和机制研究，以解锁更广泛的治疗用途。