Efeitos Do Uso Tópico Do Sobrendante Livre De Células E Derivados De Lactobacillus Spp. Na Cicatrização E Fatores De Virulência Associados À Queimaduras De Segundo-Grau Induzidas Em Ratos Wistar Infectadas Por Pseudomonas Aeruginosa: Uma Revisão Sistemática De Estudos In Vitro E In Vivo

Abstract

Intact skin is an important primary physical barrier against pathogen invasion (Byrd; Belkaid; Segre, 2018). In this regard, the damage or complete destruction of this organ caused by severe burns represents a serious state of immunological

weakening and vulnerability to infections by Pseudomonas aeruginosa, a non- fermenting, gram-negative opportunistic bacillus endowed with an arsenal of

virulence factors and multidrug resistance (Sauvage; Hardouin, 2020). Due to the considerable positive effects of probiotics on health, beneficial microorganisms from the genera Lactobacillus, Saccharomyces, and Bifidobacterium have become the subject of study as an alternative topical treatment for dermatological conditions and infections in tissue lesions. Therefore, the objective of this review was to systematically analyze the in vivo effects, in a murine model, of the topical application

of the cell-free supernatant (CFS) and its variations—whole culture and colony- forming units (CFU)—derived from Lactobacillus spp. on the healing of second- degree burns infected by Pseudomonas aeruginosa. Furthermore, the in vitro

interaction of these derivatives with the growth of the bacterial agent and virulence determinants associated with this pathogen was also evaluated. The supernatants in their natural acidic form promoted faster elimination of multidrug-resistant P. aeruginosa present in the burns, and their use resulted in changes in the healing profile, highlighted by a decrease in the time required for tissue restoration. In

addition to the CFS, the whole culture also significantly inhibited biofilms, acyl- homoserine lactones, and elastase produced by standard and clinical strains of P.

aeruginosa in vitro, while the neutralized supernatant and washed CFU demonstrated less expressive bioactivity. The present study provides information supporting the possible interaction between P. aeruginosa, the host, and biological compounds—such as immunogenic structural molecules and bacteriocins—supplied by the CFU of Lactobacillus spp. and consequently concentrated in their supernatants. However, the restricted geographic distribution and the lack of important methodological data were contributing factors to the association with a high risk of bias in the presentation and interpretation of the results reported in the systematic synthesis. Despite these limitations, the evidence presented proved promising regarding the biotechnological application of probiotics and postbiotics, justifying the development of new studies with robust and higher-quality data, in order to support the propositions derived from this systematic analysis regarding the topical use of Lactobacillus spp. derivatives in the treatment of dermatological conditions and infections in tissue lesions.