Recent research on antibiotic-free therapies has demonstrated remarkable effectiveness in preventing and controlling multi-drug-resistant (MDR) bacterial infection. Antimicrobial sonodynamic therapy (aSDT) developed from photodynamic therapy (PDT) is of particular interest to researchers and clinicians as it is a promising noninvasive treatment of less accessible infections. However, several aSDT-related challenges need to be addressed. These involve companion imaging and diagnosis of aSDT in vivo, insufficient efficacy of aSDT due to the limited oxygen level in the site of infection, infection in the immunocompromised host, and the synergetic approaches for enhanced ROS-mediated antimicrobial activity. This Spotlight on Applications presents the recent approaches in the development of sonoactivated nanoantimicrobials. These developed strategies including bacterial enzyme-responsive sonotheranostics, the ultrasound-switchable nanoenzyme-augmented aSDT, sono-immunomodulating therapy, and sonoactivated chemodynamic therapy (CDT) have shown positive outcomes in the treatment of MDR infections. However, despite the promising results of these approaches, a deeper understanding of the nanoantimicrobial SDT mechanisms in the more precise preclinical model is essential for future optimization regarding efficacy and safety.

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声波活化纳米抗菌剂：后抗生素时代的有力武器

最近对无抗生素疗法的研究表明，在预防和控制多重耐药性 (MDR) 细菌感染方面具有显着效果。从光动力疗法 (PDT) 发展而来的抗菌声动力疗法 (aSDT) 是研究人员和临床医生特别感兴趣的，因为它是一种有前途的非侵入性治疗较难感染的方法。然而，需要解决几个与 aSDT 相关的挑战。这些涉及体内aSDT的伴随成像和诊断，由于感染部位的氧气水平有限、免疫功能低下的宿主感染以及增强 ROS 介导的抗菌活性的协同方法，aSDT 的功效不足。本次应用聚焦介绍了声活化纳米抗菌剂开发的最新方法。这些开发的策略包括细菌酶反应性超声治疗、超声可切换纳米酶增强的 aSDT、声免疫调节疗法和声波激活化学动力学疗法 (CDT) 在 MDR 感染的治疗中显示出积极的结果。然而，尽管这些方法取得了可喜的成果，但在更精确的临床前模型中更深入地了解纳米抗菌 SDT 机制对于未来优化疗效和安全性至关重要。