Les peptides antimicrobiens dans la lutte contre la résistance aux antibiotiques : développement, limites et perspectives.

(2026)

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Abstract
Antibiotic resistance represents a major global health concern, prompting the investigation of alternative antimicrobial strategies such as antimicrobial peptides (AMPs). These molecules have attracted significant interest due to their broad-spectrum activity and mechanisms of action that differ from conventional antibiotics. However, AMP Activity is governed by complex structure-activity relationships, in which multiple interconnected physicochemical parameters play a critical role. This interdependence makes rational optimization challenging, as modifications intended to improve one property may adversely affect activity, selectivity, or safety. In addition, clinical translation of AMPs is hindered by several limitations, including host cell toxicity, proteolytic instability, poor bioavailability and manufacturing and formulation challenges. Although numerous optimization strategies have been explored, including chemical and structural modifications, peptidomimetics and drug delivery systems, none fully overcome these constraints. Consequently, AMPs are currently better positioned as complementary agents to existing antibiotics rather than as direct replacements. Future progress will depend on improved understanding of AMP structure-activity relationships, the integration of computational and AI-based design approaches and appropriate clinical evaluation strategies to more accurately assess their potential role in addressing antibiotic resistance.