Microbial infections present a major global healthcare challenge, in large part because of the development of microbial resistance to the currently approved antimicrobial drugs. This demands the development of new antimicrobial agents. Metal oxide nanoparticles (MONPs) are a class of materials that have been widely explored for diagnostic and therapeutic purposes. They are reported to have wide-ranging antimicrobial activities and to be potent against bacteria, viruses, and protozoans. The use of MONPs reduces the possibility of resistance developing because they have multiple mechanisms of action (including via reactive oxygen species generation), simultaneously attacking many sites in the microorganism. However, despite this there are to date no MONPs clinically approved for antimicrobial therapy. This review explores the recent literature in this area, discusses the mechanisms of MONP action against microorganisms, and considers the barriers faced to the use of MONPs in humans. These include biological challenges, of which the potential for an immune response and off-target toxicity are key. We explore in detail the possible benefits/disbenefits of an immune response being initiated, and consider the effect of production method (chemical vs. green synthesis) on cytotoxicity. There are also a number of technical and manufacturing challenges hindering MONP translation to the clinic which are additionally discussed in depth. In the short term, there are potentially some "quick wins" from the repurposing of already-approved nanoparticle-based medicines for anti-infective applications, but a number of hurdles, both technical and biological, lie in the path to long-term clinical translation of new MONP-based formulations. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease Therapeutic Approaches and Drug Discovery > Emerging Technologies Toxicology and Regulatory Issues in Nanomedicine > Toxicology of Nanomaterials.

中文翻译：

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金属氧化物纳米颗粒的潜在抗感染应用：系统综述。

微生物感染对全球医疗保健构成了重大挑战，很大程度上是由于对目前批准的抗菌药物产生了耐药性。这就要求开发新的抗菌剂。金属氧化物纳米颗粒（MONP）是一类已广泛用于诊断和治疗目的的材料。据报道它们具有广泛的抗菌活性，并且对细菌，病毒和原生动物具有有效的作用。MONP的使用降低了耐药性发展的可能性，因为它们具有多种作用机制（包括通过活性氧的产生），同时会攻击微生物中的许多位点。然而，尽管如此，迄今为止尚无临床上批准用于抗菌治疗的MONP。这篇综述探索了该领域的最新文献，讨论了MONP对抗微生物的作用机制，并考虑了在人类中使用MONP所面临的障碍。其中包括生物学挑战，其中免疫应答和脱靶毒性的潜力至关重要。我们详细探讨了引发免疫应答的可能的好处/缺点，并考虑了生产方法（化学合成与绿色合成）对细胞毒性的影响。还存在许多技术和制造难题，这些难题阻碍了MONP到临床的翻译，对此进行了深入讨论。在短期内，将已经批准的基于纳米颗粒的药物用于抗感染应用可能会带来“快速获胜”，但存在许多障碍，无论是技术上的还是生物学上的，都在基于MONP的新配方的长期临床翻译中。本文归类于：治疗方法和药物发现>传染病的纳米药物治疗方法和药物发现>纳米技术中的新兴技术毒理学和法规问题>纳米材料的毒理学。