Antiadhesive and antibiofilm activity of hyaluronic acid against bacteria responsible for respiratory tract infections

Abstract

To address the problem of limited efficacy of existing antibiotics in the treatment of bacterial biofilm, it is necessary to find alternative remedies. One candidate could be hyaluronic acid; this study therefore aimed to evaluate the in vitro antiadhesive and antibiofilm activity of hyaluronic acid toward bacterial species commonly isolated from respiratory infections. Interference exerted on bacterial adhesion was evaluated by using Hep‐2 cells, while the antibiofilm activity was assessed by means of spectrophotometry after incubation of biofilm with hyaluronic acid and staining with crystal violet. Our data suggest that hyaluronic acid is able to interfere with bacterial adhesion to a cellular substrate in a concentration‐dependent manner, being notably active when assessed as pure substance. Moreover, we found that Staphylococcus aureus biofilm was more sensitive to the action of hyaluronic acid than biofilm produced by Haemophilus influenzae and Moraxella catarrhalis. In conclusion, hyaluronic acid is characterized by notable antiadhesive properties, while it shows a moderate activity against bacterial biofilm. As bacterial adhesion to oral cells is the first step for colonization, these results further sustain the role of hyaluronic acid in prevention of respiratory infections.

Hyaluronic Acid and Its Composites as a Local Antimicrobial/Antiadhesive Barrier

“…More recently, the in vitro antiadhesive and antibiofilm activity of hyaluronic acid towards bacterial species commonly isolated from respiratory infections was investigated by Drago et al 33.…”

“…Among its various properties, several studies have recently shown the ability of HA to protect against various infectious agents 30, depending on HA concentration and molecular weight 31, 32, while more recently HA interference on bacterial adhesion and biofilm formation has been extensively investigated 33.…”

Topical administration of hyaluronic acid in children with recurrent or chronic middle ear inflammations

“…It can be speculated that the positive effect of HA on our patients was attributable to its homeostatic properties 12 and its anti-adhesive and anti-biofilm activity against the bacteria responsible for upper respiratory tract infection. 5 It has been shown that HA plays a role in regulating vasomotor tone and mucous gland secretion, modulating inflammatory airway processes 12 and improving mucociliary clearance of the upper respiratory tract. 6,8 Further studies would be welcome to assess the possible effect of HA on ciliar motility in children with recurrent or chronic middle ear disease.…”

“…1,4 We have recently evaluated the in vitro antiadhesive and anti-biofilm effects of hyaluronic acid (HA; an endogenous component of the extracellular matrix that is involved in airway healing and homeostasis) on the bacterial species frequently isolated from patients with upper respiratory tract infection. 5 The results showed that HA interferes with bacterial adhesion (the first step in biofilm formation) to Hep-2 cells in a concentration-dependent manner and also moderately inhibits the formation of biofilm itself. However, despite the positive preliminary results of clinical studies in patients with recurrent upper airway infections or allergic and non-allergic rhinitis, and those undergoing functional endoscopic sinus surgery, [6][7][8] there are no published data concerning the effectiveness of HA treatment in children with recurrent and chronic middle ear diseases.…”

A polycarboxylic/amino functionalized hyaluronic acid derivative for the production of pH sensible hydrogels in the prevention of bacterial adhesion on biomedical surfaces

“…Several studies have demonstrated the anti-biofilm and bacteriostatic properties of HA (Morra, 2005). The studies performed suggested that HA was unable to affect the lag phase of bacterial growth but it reduced the bacterial adhesion to cellular substrate, interfering with the formation of bacterial biofilm (Drago et al, 2014;Perrino et al, 2008). However, unmodified HA is poorly suitable for the coating of prostheses, due to its rapid dissolution and degradation by hyaluronidases.…”