Background: Antioxidants are multifaceted molecules playing a crucial role in several cellular functions. There is by now a well-established knowledge about their involvement in numerous processes associated with aging, including vascular damage, neurodegenerative diseases and cancer. An emerging area of application has been lately identified for these compounds in relation to the recent findings indicating their ability to affect biofilm formation by some microbial pathogens, including Staphylococcus aureus, Streptococcus mutans, and Pseudomonas aeruginosa.
Methods: A structured search of bibliographic databases for peer-reviewed research literature was performed using a focused review question. The quality of retrieved papers was appraised using standard tools.
Results: One hundred sixty five papers extracted from pubmed database and published in the last fifteen years were included in this review focused on the assessment of the antimicrobial and anti-biofilm activity of antioxidant compounds, including vitamins, flavonoids, non-flavonoid polyphenols, and antioxidant polymers. Mechanisms of action of some important antioxidant compounds, especially for vitamin C and phenolic acids, were identified.
Conclusions: The findings of this review confirm the potential benefits of the use of natural antioxidants as antimicrobial/antibiofilm compounds. Generally, gram-positive bacteria were found to be more sensitive to antioxidants than gram-negatives. Antioxidant polymeric systems have been also developed mainly derived from functionalization of polysaccharides with antioxidant molecules. The application of such systems in clinics may permit to overcome some issues related to the systemic delivery of antioxidants, such as poor absorption, loss of bioactivity, and limited half-life. However, investigations focused on the study of antibiofilm activity of antioxidant polymers are still very limited in number and therefore they are strongly encouraged in order to lay the foundations for application of antioxidant polymers in treatment of biofilm-based infections.