Journal of Clinical PracticeJournal of Clinical PracticeКлиническая практика2220-30952618-8627Eco-Vector69852810.17816/clinpract698528CPWCCCReviewsНаучные обзорыReview ArticleTherapeutic effects of probiotics in topical treatment of infected woundsМеханизмы терапевтического действия живых пробиотиков в местном лечении инфицированных ранhttps://orcid.org/0000-0003-0260-69229021-7370IshchenkoRoman V.ИщенкоРоман Викторович
Russian Federation

MD, PhD, Professor

д-р мед. наук, профессор

ishenkorv@rambler.ruhttps://orcid.org/0000-0002-0174-57983953-2954GolubitskiyKirill O.ГолубицкийКирилл Олегович
Russian Federation

MD, PhD

канд. мед. наук

kirill.golubitskiy@mail.ruhttps://orcid.org/0000-0001-7053-44283147-0739SolopovMaksim V.СолоповМаксим Витальевич
Russian Federation
mxsolopov@yandex.ruhttps://orcid.org/0009-0006-6404-29301781-3235KisilenkoIrina A.КисиленкоИрина Александровна
Russian Federation
irinka.dn.15@gmail.comhttps://orcid.org/0009-0004-3019-144X7737-6730BelotserkovskayaMargarita A.БелоцерковскаяМаргарита Андреевна
Russian Federation
margarita-amb@mail.ruhttps://orcid.org/0000-0002-6461-49043675-2361TurchynViktor V.ТурчинВиктор Васильевич
Russian Federation
turchin.dn@mail.ruhttps://orcid.org/0000-0002-4542-68601491-8262FilimonovDmitry A.ФилимоновДмитрий Алексеевич
Russian Federation

MD, PhD

д-р мед. наук

neuro.dnmu@gmail.comhttps://orcid.org/0000-0001-9755-1869PopandopuloAndrey G.ПопандопулоАндрей Геннадьевич
Russian Federation

MD, PhD, Professor

д-р мед. наук, профессор

pag.lctc@mail.ruhttps://orcid.org/0000-0001-6311-08388212-9821GasanovVagif A.ГасановВагиф Али оглы
Russian Federation

MD, PhD

канд. мед. наук

gasanovvagif@gmail.comV.K. Gusak Institute of Urgent and Recovery SurgeryИнститут неотложной и восстановительной хирургии имени В.К. ГусакаV.K. Gusak Institute of Urgent and Recovery SurgeryИнститут неотложной и восстановительной хирургии имени В.К. ГусакаKoltzov Institute of Developmental Biology Russian Academy of ScienceИнститут биологии развития имени Н.К. Кольцова110420260105202617186951212202524022026Copyright ©; 2026, Eco-VectorCopyright ©; 2026, Эко-Вектор2026Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://clinpractice.ru/clinpractice/article/view/698528

Wound infections, exacerbated by antibiotic resistance and biofilm formation, necessitate alternative therapeutic options. One promising approach is topical bacteriotherapy with live probiotics. The work aimed to summarize existing research on the multifaceted effects of live probiotics in infected wound healing. The review examines how probiotics directly influence pathogenic wound microflora by competing for adhesion sites and nutrients, secreting antagonistic compounds, altering the wound environment, and promoting co-aggregation. Probiotics’ antibiofilm activity is highlighted, including inhibition of quorum sensing systems and disruption of the extracellular biofilm matrix. Moreover, the review discusses the findings of in vitro and in vivo studies on the effects of live probiotics on macroorganisms. Probiotics have been shown to activate signaling pathways that regulate macrophage shift from a pro-inflammatory (M1) phenotype to a pro-repair (M2) phenotype, cytokine synthesis, keratinocyte and fibroblast migration and proliferation, angiogenesis, and collagen matrix formation. Thus, the multifaceted effects of probiotics cannot be replicated by metabolites or inactivated cells alone, highlighting the need for effective delivery systems for live probiotic cultures in infected wound management.

Раневые инфекции, усугубляемые антибиотикорезистентностью и образованием биоплёнок, требуют поиска альтернативных методов лечения, среди которых перспективной является местная бактериотерапия с использованием живых пробиотиков. Целью данного обзора является систематизация современных данных о комплексных механизмах действия живых пробиотиков на заживление инфицированных ран. В работе описаны пути прямого влияния пробиотиков на патогенную микрофлору раны, которые реализуются через конкуренцию за места адгезии и питательные вещества, секрецию антагонистических соединений, изменение раневой среды и совместную агрегацию. Отдельное внимание уделено антибиоплёночной активности пробиотиков, включая подавление систем кворум-чувствительности и разрушение внеклеточного матрикса биоплёнок. Представлен анализ результатов in vitro и in vivo исследований, посвящённых влиянию живых пробиотиков на макроорганизм. Показано, что пробиотики активируют сигнальные пути, регулирующие переключение макрофагов с провоспалительного фенотипа M1 на репаративный фенотип M2, синтез цитокинов, миграцию и пролиферацию кератиноцитов и фибробластов, ангиогенез и формирование коллагенового матрикса. Таким образом, многофакторное действие пробиотиков не может быть воспроизведено лишь метаболитами или инактивированными клетками, что подчёркивает необходимость разработки эффективных форм доставки живых пробиотических культур для лечения инфицированных ран.

probioticsinfected woundwound treatmentpathogenic microflorabacteriocinssignaling pathwaysпробиотикиинфицированная раналечение ранпатогенная микрофлорабактериоцинысигнальные путиRussian Science FoundationРоссийский научный фонд25-15-20602The study was carried out within the framework of a grant from the Russian Science Foundation (grant number 25-15-20602). The Russian Science Foundation did not participate in the organization, planning, or conduct of the study; in the collection, storage, analysis, or interpretation of the data; in the preparation of the manuscript or the decision to publish it; nor in the oversight of the study. The Russian Science Foundation imposed no restrictions on data use or dissemination of the study results.Исследование выполнено в рамках гранта Российского научного фонда (регистрационный номер 25-15-20602). 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