title: Stimuli-responsive polymers for antimicrobial therapy: drug targeting, contact-killing surfaces and competitive release.
abstract: Polymers can be designed to modify their features as a function of the level and nature of the surrounding microorganisms. Such responsive polymers can endow drug delivery systems and drug-medical device combination products with improved performance against intracellular infections and biofilms.
  
  
  
  Knowledge on microorganism growth environment outside and inside cells and formation of biofilm communities on biological and synthetic surfaces, together with advances in materials science and drug delivery are prompting strategies with improved efficacy and safety compared to traditional systemic administration of antimicrobial agents. This review deals with antimicrobial strategies that rely on: (i) polymers that disintegrate or undergo phase-transitions in response to changes in enzymes, pH and pO2 associated to microorganism growth; (ii) stimuli-responsive polymers that expose contact-killing groups when microorganisms try to adhere; and (iii) bioinspired polymers that recognize microorganisms for triggered (competitive/affinity-driven) drug release.
  
  
  
  Prophylaxis and treatment of infections may benefit from polymers that are responsive to the unique changes that microbial growth causes in the surrounding environment or that even recognize the microorganism itself or its quorum sensing signals. These polymers may offer novel tools for the design of macrophage-, bacteria- and/or biofilm-targeted nanocarriers as well as of medical devices with switchable antibiofouling properties.
authors.affiliation: a Departamento de Farmacia y Tecnología Farmacéutica , Universidade de Santiago de Compostela , Santiago de Compostela , Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Alvarez-Lorenzo
authors.affiliation: a Departamento de Farmacia y Tecnología Farmacéutica , Universidade de Santiago de Compostela , Santiago de Compostela , Spain.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Garcia-Gonzalez
authors.affiliation: b Departamento de Química de Radiaciones y Radioquímica , Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Circuito Exterior, Ciudad Universitaria , México DF , Mexico.
authors.forename: Emilio
authors.initials: E
authors.lastname: Bucio
authors.affiliation: a Departamento de Farmacia y Tecnología Farmacéutica , Universidade de Santiago de Compostela , Santiago de Compostela , Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Concheiro
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage*; D018441:Biofilms; D016503:Drug Delivery Systems; D006801:Humans; D011108:Polymers / Q000737:chemistry*
chemical_list: D000890:Anti-Infective Agents; D011108:Polymers
keywords: Antibiofilm; antimicrobial drug delivery; contact-killing surfaces; intracellular infections; medical device; microorganism-triggered release; nanocarrier