In the context of reducing resistance, the development of alternative anti-infective drugs against BAI is particularly important. Natural product monomers, with their advantages of being green, low-toxicity, and less likely to develop resistance, are considered to be promising candidate drugs for combating BAI[7]. Paeonol, also known as moutan phenol or paeony alcohol, with the chemical formula C9H10O, is a phenolic compound extracted from the dried root bark of the peony or the whole herb vincetoxicum pycnostelma kitag[8]. It has a wide range of biological activities, such as antimicrobial, anti-inflammatory, analgesic, antipyretic, and antiallergic effects[9]. Studies have shown that paeonol can inhibit the formation of biofilms in bacteria, such as Pseudomonas aeruginosa and Klebsiella pneumoniae[10, 11]. This study used crystal violet staining and CLSM techniques to find that paeonol has a significant effect in eradicating E.coli biofilms, and this effect exhibits a typical dose-dependent pattern. Under the CLSM observation, a dense biofilm was clearly observed in the control group. In contrast, the fluorescence intensity was significantly reduced in the paeonol treatment group, with only a small amount of biofilm remaining. Quantitative analysis of the CLSM images by Biofilm Q software, with the methods of analyzing fluorescence intensity per unit area and per unit volume, can better reflect the survival status of bacteria within the biofilm[12]. This study found that paeonol reduced the Ec032 mature biofilm, and the main mechanism was by decreasing the biofilm volume.
With the result that genes related to the bacterial QS system, such as luxS, lsrK, qseB, and qseC, have undergone significant changes. Among them, luxS and lsrK encode LuxS, which is involved in the synthesis of AI-2, and LsrK, which is responsible for phosphorylating AI-2, respectively. AI-2 serves as an important signaling molecule in the QS system and participates in the regulation of biofilm formation and various biological processes. After the intervention of paeonol, the expression of both luxS and lsrK genes were significantly downregulated, indicating that paeonol can inhibit the production of bacterial AI-2, thereby suppressing the formation of bacterial biofilms. The AI-2 can also activate the QS regulator MqsR, which influences the formation and structure of bacterial biofilms[13]. MqsR can also positively regulate the transcription of the qseBC and motAB genes, and negatively regulate the transcription of the main biofilm formation control factor CsgD[14, 15]. In the differentially expressed proteins, the expression of qseBC, flhDC, motAB, and ycgR were downregulated, suggesting that paeonol may inhibit the flagellar motility of biofilm-forming bacteria. Furthermore, paeonol seems to disrupt the regulatory process of MqsR on qseBC and motAB, leading to the upregulation of MqsR. While the transcription level of the multi-level cascaded CsgD decreased, indicating that paeonol did not affect the regulatory role of MqsR on CsgD. Studies have shown that decreased CsgD expression can affect the reattachment process of biofilm-forming bacteria[16]. Combining the omics results, it is speculated that paeonol indirectly affects the adhesion ability of bacteria by influencing the regulatory function of MqsR, thereby inhibiting biofilm formation. The adhesins and extracellular polysaccharides as polysaccharide components of EPS in E. coli can stabilize the three-dimensional structure of the biofilm[17]. The study found that the expression of BcsA, the cellulose synthase encoded by bcsA, was downregulated, suggesting that paeonol may lead to decreased cellulose production and inhibit curli fimbriae synthesis in biofilm-forming bacteria. The transcription levels of waz and papG were also downregulated, resulting in reduced production of colanic acid and other polysaccharide components, leading to a more loosened structure of the mature biofilm. In summary, paeonol may reduce the EPS matrix of the biofilm, leading to decreased flagellar motility and aggregation ability of biofilm-forming bacteria, thereby disrupting the mature biofilm structure.
The proteomic results suggest that paeonol may act on the QS system of E.coli, leading to reduced biofilm formation. The QS signal transduction protein TqsA can inhibit or promote the transport of AI-2[18]. TqsA is also related to antibiotic resistance, and deletion of the tqsA gene affects AI-2 transport, inducing the expression of the efflux pump genes acrEF[19]. Among the differentially expressed proteins, AcrE and AcrF were upregulated, perhaps due to the inductive effect of TqsA. After treatment with paeonol, the proteins responsible for regulating AI-2 transport and phosphorylation in the biofilm-forming bacteria were downregulated, consistent with the qRT-PCR results. However, the TqsA protein, which is responsible for AI-2 transport, was significantly upregulated. Paeonol may upregulate the expression of TqsA, leading to increased export of AI-2 from the cells, thus increasing the extracellular AI-2 concentration. At the same time, paeonol also reduced the expression of the AI-2 uptake proteins LsrA and LsrD, decreasing the amount of AI-2 entering the cells. Due to the insufficient phospho-AI-2 inside the cells, it was unable to effectively relieve the repression of the lsrR and lsr operons by LsrR[20]. As a result, the bacteria was unable to obtain enough AI-2 signals to trigger the normal cell processes related to biofilm formation, as the proteins involved in AI-2 uptake and utilization were reduced, and the threshold for activating the massive AI-2 uptake process could not be reached[21, 22]. In addition, the biosensor strain CV026 does not produce AHL signaling molecules, but it can utilize exogenous autoinducer signals in the environment to produce the purple pigment violacein, displaying a purple color reaction. Therefore, it can be used to detect whether a drug is a QS Inhibitor (QSI)[23]. Similarly, there are reports that the crude extract of Paeonia suffruticosa has anti-QS activity, and the active QSI component in Paeonia suffruticosa has been identified as paeonol[24]. The current study found that paeonol can inhibit the production of violacein in CV026, further confirming that paeonol is a QSI. From this, we can see that paeonol can reduce biofilm formation by affecting the AI-2 transport and utilization pathways in the bacterial QS system.
In this investigation, the proteins responsible for flagellar assembly (FliC, FliG, FliM, FliN, FlgE, FlgF, FlgH, FlgL, FliD, FliF, FliH, FliI) and YcgR were all downregulated. Combined with the bacterial motility results, this indicates that paeonol can inhibit the flagellar assembly process in the biofilm-forming bacteria, thereby weakening the bacterial motility. This suggests that paeonol affects the assembly of flagellar components, impairing the normal function of the flagella and reducing the swimming motility. This in turn decreases the supportive role of the EPS matrix components in the biofilm structure, leading to reduced biofilm formation. The BarA-UvrY TCS consists of the transmembrane sensor kinase protein BarA and the cytoplasmic response regulator protein UvrY, where UvrY can also stimulate the transcription of barA[25, 26]. Among the differentially expressed biofilm-associated proteins, the expression of UvrY was decreased, suggesting that paeonol may interfere with the expression of type I fimbriae, affecting the adhesion of bacteria. Among the differentially expressed biofilm proteins, RcsD was upregulated, while the expression of RcsC and RcsB showed no statistical significance. Paeonol appears to enhance the phosphorylation and transfer process, affecting the expression of csgD and flhD by the RcsCDB system, indirectly regulating the production of EPS structural components and controlling the re-adhesion process of bacteria. All in all, paeonol can affect the assembly of flagella and the synthesis of curli fimbriae in the EPS structural components, thereby weakening the supporting role of EPS in the biofilm structure and making the biofilm structure unstable. It may also affect the initial adhesion process of bacteria, reducing the formation of biofilms. Furthermore, the study found that the expression of RpoS and CsgD were downregulated, indicating that paeonol may also affect the biofilm reattachment process, resulting in decreased bacterial adhesion to the surface.
The MarA protein is encoded by the marRAB operon and is a regulator of biofilm formation[27]. The multidrug resistance repressor protein MarR is a negative regulator of the marRAB operon, which can be induced and bound by plant phenolic compounds[28]. The paeonol studied in this paper is a phenolic compound extracted from plants, and the expression of both MarA and MarR was upregulated after paeonol intervention, indicating that paeonol can bind to MarR and weaken its inhibitory effect on the marRAB operon, leading to increased expression of MarA. This indirectly reduces the EPS polysaccharide component of the biofilm, thereby diminishing the volume of the mature biofilm[29]. There are reports that paeonol can reduce the content of extracellular polysaccharides in Klebsiella pneumoniae, and the expression of GcfE, a protein involved in the production/export of extracellular polysaccharides, is downregulated[30]. Combined with the experimental results, this further confirms that paeonol has the ability to reduce extracellular polysaccharides. Therefore, it is speculated that paeonol reduces the content of EPS polysaccharide components, which may be more due to its impact on the colanic acid content, leading to a loose biofilm structure, reduced volume of mature biofilms, and ultimately achieving the goal of eradicating biofilms.
BsmA is a biofilm peroxide resistance protein, belonging to the BhsA/McbA family, encoded by the bsmABC gene cluster, and is involved in protecting the biofilm from stress responses[31]. The most notable feature of bsmA deletion is the loss of microcolony formation and a significant increase in flagellar motility[32]. In this analysis, the expression of stress response-related proteins BsmA and BhsA, as well as multiple antibiotic resistance and efflux pump proteins (AcrA, MdtD, MdtQ, etc.) were upregulated. The addition of paeonol may have triggered a stress response in E. coli, stimulating an increase in the resistance of BsmA and BhsA proteins, protecting the biofilm from drug damage and forcing the expulsion of paeonol.
The research results of this paper show that the expression of OmpX is upregulated, indicating that paeonol can inhibit flagellar motility, thereby reducing the formation of biofilms. The outer membrane protein regulator OmpR, as a member of the TCS, plays a role in the regulation of various genes, including the specific regulation of the master regulator flhDC of flagella in E.coli, the main control factor CsgD for biofilm formation, and the alteration of virulence characteristics of pathogens[33–35]. The results found that OmpR protein expression was upregulated, while CsgD expression was downregulated, and biofilm formation was reduced. OmpR may act as a bacterial compensatory mechanism to maintain low-level expression of curli fimbriae[36]. The proteomic results show that the expression of FimH and CsgD were downregulated. Paeonol may upregulate the expression of OmpR and promote its phosphorylation, thereby weakening the bacterial adhesion ability and inhibiting the re-formation of biofilms. Combined with the results of molecular docking, this study speculates that OmpR is a key target of the action of paeonol.