Postbiotics as microbial-derived therapeutics for wound healing disorders: from molecular mechanisms to future application

Skin microbiota emerged as an important factor in modulating all aspects of the wound healing process, with the potential utilization of residing microbes as biological therapeutics. Commensal or probiotic bacteria represent a first layer of the cutaneous barrier protection, inhibiting detrimental effects of pathogens and modulating cutaneous immune response. In this review, we highlight the latest findings on pro-healing ability of a new subclass of probiotic-derived products named postbiotics, defined as preparations of inanimate microorganisms and/or their components that confer a health benefit on the host. By mimicking the beneficial effect of live probiotics, postbiotics have the ability to restore healthy skin microbiome through inhibition of pathogen colonization and biofilm formation. Postbiotics also regulate skin epithelial barrier function and cutaneous immune response to suppress intracellular pathogen invasion. In order to effectively restore barrier breach, postbiotics stimulate multiple cellular components of the cutaneous wound healing process. This review describes molecular and cellular aspects of host-postbiotics interactions during cutaneous wound healing and provides a current viewpoint of therapeutic potential and advantages of postbiotics application for treatment of cutaneous wound healing disorders. In the era of rising antimicrobial resistance and epidemic proportions of wound healing disorders, probiotic-based therapeutics offer safe, effective and yet underutilized solutions for unmet clinical need.