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The negatively charged microbial cell surface is a fundamental structural target for cationic antimicrobial agents, including polymyxins and antimicrobial peptides (AMPs). This negative charge is primarily generated by lipopolysaccharides (LPS) in Gram-negative bacteria and teichoic acids in Gram-positive bacteria, which create an electrostatic gradient that attracts positively charged molecules [1, 4]. Unlike mammalian cell membranes, which are largely zwitterionic and contain cholesterol, microbial surfaces provide a selective docking site for these cationic drugs [2]. Upon binding, the drugs displace stabilizing divalent cations and insert into the lipid bilayer, leading to membrane permeabilization and cell death [1, 3]. This target is highly significant in treating multi-drug resistant infections because it relies on broad physicochemical properties rather than a single protein binding site [2, 5]. However, pathogens can develop resistance by modifying their surface charge to reduce drug affinity [5].
Cationic antimicrobial agents target the negatively charged microbial cell surface through initial electrostatic recruitment to anionic components like lipopolysaccharides or teichoic acids. This interaction leads to the displacement of membrane-stabilizing magnesium and calcium ions, followed by the hydrophobic insertion of the drug into the membrane. This process disrupts the lipid bilayer integrity via mechanisms such as the barrel-stave, toroidal pore, or carpet models, ultimately causing cytoplasmic leakage and rapid microbial lysis [1, 2, 4].
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