A comprehensive review of the pathogenic mechanisms of Pseudomonas aeruginosa: synergistic effects of virulence factors, quorum sensing, and biofilm formation

作者：Xindan Zhang, Duo Zhang, Di Zhou, Shuai Zheng, Shuang Li, Qinlong Hou, Gen Li, Huiming Han · 发表于：Frontiers in Microbiology · 年份：2025 · DOI：10.3389/fmicb.2025.1619626 · 被引用次数：49 · 研究领域：Bacterial biofilms and quorum sensing、Vibrio bacteria research studies、Inhalation and Respiratory Drug Delivery

Pseudomonas aeruginosa ( P. aeruginosa ) is a ubiquitous opportunistic pathogen and a major cause of nosocomial infections worldwide. It can provoke a spectrum of clinical manifestations-ranging from postoperative wound infections, pressure ulcers, abscesses, and otitis media to life-threatening bacteremia and sepsis, especially in burn patients. Over the past decade, extensive research has elucidated its complex virulence repertoire, including exotoxins, proteases, and siderophores; the hierarchical Quorum Sensing (QS) networks; and its robust capacity for biofilm formation. In this review, we consolidate significant studies published since 2015 to develop a comprehensive framework elucidating the virulence mechanisms of P. aeruginosa . Beyond cataloging individual factors, we highlight how QS regulators coordinate toxin production and biofilm maturation, and how these processes converge to facilitate immune evasion. We further examine cross-talk between QS circuits (Las, Rhl, and Pqs), their response to environmental cues, and the modulatory role of host signals. Despite these advances, significant gaps remain: the spatiotemporal interplay among different virulence modules; the precise molecular triggers of biofilm dispersal; and the dynamics of bacterial–host immune interactions in vivo . Notably, targeting QS with small-molecule inhibitors has shown promise in attenuating pathogenicity, yet translating these findings into clinical therapies requires more nuanced understan...