Notwithstanding ceaseless endeavors toward developing effective
antibiofilm chemotherapeutics, biofilm-associated infections continue to
be one of the most perplexing challenges confronting medicine today.
Endogenous host defense peptides, such as the human cathelicidin LL-37,
are being propounded as promising options for treating such infectious
diseases. Over the past decennium, LL-37 has duly received tremendous
research attention by virtue of its broad-spectrum antimicrobial
activity and immunomodulatory properties. No attempt has hitherto been
made, as far as we are aware, to comprehensively review the antibiofilm
effects of LL-37. Accordingly, the intent in this paper is to provide a
fairly all-embracing review of the literature available on the subject.
Accumulating evidence suggests that LL-37 is able to prevent biofilm
establishment by different bacterial pathogens such as Acinetobacter
baumannii, Aggregatibacter actinomycetemcomitans, Bacteroides fragilis,
Burkholderia thailandensis, Cutibacterium acnes, Escherichia coli,
Francisella tularensis, Helicobacter pylori, Klebsiella pneumoniae,
Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus
pyogenes. Inhibition of bacterial adhesion, downregulation of
biofilm-associated genes, suppression of quorum-sensing pathways,
degradation of biofilm matrix, and eradication of biofilm-residing cells
are the major mechanisms responsible for antibiofilm properties of
LL-37. In terms of its efficacy and safety in vivo, there are still many
questions to be answered. Undoubtedly, LL-37 can open up new windows of
opportunity to prevent and treat obstinate biofilm-mediated infections.