Effects of metal ions on fibroblasts and spiral ganglion cells

Vapor-Phase-Deposited Ag/Ir and Ag/Au Film Heterostructures for Implant Materials: Cytotoxic, Antibacterial and Histological Studies

Using gas-phase deposition (Physical Vapor Deposition (PVD) and Metal Organic Chemical Vapor Deposition (MOCVD)) methods, modern implant samples (Ti alloy and CFR-PEEK polymer, 30% carbon fiber) were functionalized with film heterostructures consisting of an iridium or gold sublayer, on the surface of which an antibacterial component (silver) was deposited: Ag/Ir(Au)/Ti(CFR-PEEK). The biocidal effect of the heterostructures was investigated, the effect of the surface relief of the carrier and the metal sublayer on antibacterial activity was established, and the dynamics of silver dissolution was evaluated. It has been shown that the activity of Ag/Ir heterostructures was due to high Ag+ release rates, which led to rapid (2-4 h) inhibition of P. aeruginosa growth. In the case of Ag/Au type heterostructures, the inhibition of the growth of P. aeruginosa and S. aureus occurred more slowly (from 6 h), and the antibacterial activity appeared to be due to the contribution of two agents (Ag+ and Au+ ions). It was found, according to the in vitro cytotoxicity study, that heterostructures did not exhibit toxic effects (cell viability > 95-98%). An in vivo biocompatibility assessment based on the results of a morphohistological study showed that after implantation for a period of 30 days, the samples were characterized by the presence of a thin fibrous capsule without volume thickening and signs of inflammation.

The effect of surgically implanted metallic bullet fragments on the intervertebral disc using a canine model☆

PURPOSE

To characterize the gross, histologic, and systemic changes caused by implantation of metal fragments commonly used in commercial bullets into the intervertebral disc.

BACKGROUND CONTEXT

Long-term complications of retained bullet fragments in the spine have been documented in the literature; however, the impact of different metal projectiles on the intervertebral disc has not been described. This study was performed to assess the local effects of the metallic bullet fragments on the intervertebral disc and their systemic effects regarding metal ion concentrations in serum and solid organs.

STUDY DESIGN

Animal Model Study.

METHODS

Funding for this project was provided by the Cervical Spine Research Society in the amount of $10,000. Copper, lead, and aluminum alloys from commercially available bullets were surgically implanted into sequential intervertebral discs in the lumbar spine of six canines. Kirschner wire implantation and a sham operation were performed as controls. Radiographs were performed to confirm the location of the bullets. Animals were sacrificed at 4, 6, and 9 months postimplantation. Whole blood, plasma, cerebrospinal fluid, kidney tissue, and liver tissue samples were analyzed for copper and lead concentrations. Histologic and gross samples were examined at the time of sacrifice.

RESULTS

Significant tissue reactions were noted in the discs exposed to copper and lead. Copper resulted in significantly more severe disc degeneration than either the lead or aluminum alloy. In the short interval follow-up of this study, no statistically significant trend was observed in whole blood, plasma, cerebrospinal fluid, and tissue levels.

CONCLUSION

This study demonstrates that the canine intervertebral disc is differentially susceptible to metallic fragments depending on the composition. Trends were noted for increasing levels of lead and copper in liver tissue samples although statistical significance could not be reached due to short time interval and small sample size. The metallic composition of retained fragments can be a determining factor in deciding on surgical intervention.

Adaptive antibacterial biomaterial surfaces and their applications

Bacterial infections on the implant surface may eventually lead to biofilm formation ​and thus threaten the use of implants in body. Despite efficient host immune system, the implant surface can be rapidly occupied by bacteria, resulting in infection persistence, implant failure, and even death of the patients. It is difficult to cope with these problems because bacteria exhibit complex adhesion mechanisms to the implants that vary according to bacterial strains. Different biomaterial coatings have been produced to release antibiotics to kill bacteria. However, antibiotic resistance occurs very frequently. Stimuli-responsive biomaterials have gained much attention in recent years ​but are not effective enough in killing the pathogens because of the complex mechanisms in bacteria. This review is focused on the development of highly efficient and specifically targeted biomaterials that release the antimicrobial agents or respond to bacteria on demands in body. The mechanisms of bacterial adhesion, biofilm formation, and antibiotic resistance are discussed, and the released substances accounting for implant infection are described. Strategies that have been used in past for the eradication of bacterial infections are also discussed. Different types of stimuli can be triggered only upon the existence of bacteria, leading to the release of antibacterial molecules that in turn kill the bacteria. In particular, the toxin-triggered, pH-responsive, and dual stimulus-responsive adaptive antibacterial biomaterials are introduced. Finally, the state of the art in fabrication of dual responsive antibacterial biomaterials and tissue integration in medical implants is discussed.

Photochemical coating of Kapton® with hydrophilic polymers for the improvement of neural implants

The polyimide Kapton® was coated photochemically with hydrophilic polymers to prevent undesirable cell growth on the polyimide surface. The polymer coatings were generated using photochemically reactive polymers synthesized by a simple and modular strategy. Suitable polymers or previously synthesized copolymer precursors were functionalized with photoactive arylazide groups by a polymer analogous amide coupling reaction with 4-azidobenzoic acid. A photoactive chitosan derivative (chitosan-Az) and photochemically reactive copolymers containing DMAA, DEAA or MTA as primary monomers were synthesized using this method. The amount of arylazide groups in the polymers was adjusted to approximately 5%, 10% and 20%. As coating on Kapton® all polymers effect a significantly reduced water contact angle (WCA) and consequently a rise of the surface hydrophilicity compared to the untreated Kapton®. The presence of the polymer coatings was also proven by ATR-IR spectroscopy. Coatings with chitosan-Az and the DEAA copolymer cause a distinct inhibition of the growth of fibroblasts. In the case of the DMAA copolymer even a strong anti-adhesive behavior towards fibroblasts was verified. Biocompatibility of the polymer coatings was proven which enables their utilization in biomedical applications.

Validation of eGFP fluorescence intensity for testing in vitro cytotoxicity according to ISO 10993-5

ISO 10993-5 provides one of the accepted standards for testing the biotoxicity of new materials. All of the recommended test procedures rely upon the uptake or metabolism of dye by living cells. Results of direct contact tests can be potentially compromised by interaction or adsorption of the dye or its metabolic products. Therefore, the aim of the current study was to validate the use of the eGFP signal of transfected NIH-3T3 fibroblasts with the results of the MTT test in order to provide a test procedure that is very close to the ISO 10993-5 but has the advantage of not relying on the addition of dye. Our tests show that the MTT assay detects cytotoxicity in the eGFP NIH-3T3 cells at least as well as in the L929 cells. To facilitate the validation, we chose to integrate the fluorescence measurements into the MTT test procedure. To that end, an additional washing step was introduced. Additionally, medium without phenol red was used, resulting in a very high correlation of both measurements. Without these modifications, the fluorescence test was comparable to the MTT test in its ability to detect the cytotoxic potential of substances; however, it did result in slightly elevated IC50 concentrations. As the results of both tests correlated highly, measurement of the eGFP signal appears to present a reliable tool for detecting cytotoxicity of materials in line with the ISO 10993-5 norm with the advantage of avoiding the addition of dyes and the subsequent potential interaction with test materials. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 715-722, 2017.

Biocompatibility of silver containing silica films on Bioverit® II middle ear prostheses in rabbits

For several centuries silver is known for its antibacterial effects. The middle ear is an interesting new scope for silver application since chronic inflammations combined with bacterial infection cause complete destruction of the fragile ossicle chain and tympanic membrane. The resulting conductive deafness requires tympanoplasty for reconstruction. Strategies to prevent bacterial growth on middle ear prostheses are highly recommended. In this study, rabbits were implanted with Bioverit® II middle ear prostheses functionalized with silver containing dense and nanoporous silica films which were compared with pure silica coatings as well as silver sulfadiazine cream applied on nanoporous silica coating. The health status of animals was continuously monitored; blood was examined before and after implantation. After 21 days, the middle ears were inspected; implants and mucosal samples were processed for electron microscopy. Autopsies were performed and systemic spreading of silver was chemically analyzed exemplarily in liver and kidneys. For verification of direct cytotoxicity, NIH 3T3 cells were cultured on similar silver containing silica coatings on glass up to 3 days. In vitro a reduced viability of fibroblasts adhering directly on the samples was detected compared to cells growing on the surrounding plastic of the same culture dish. In transmission electron microscopy, phagocytosed silver silica fragments, silver sulfadiazine cream as well as silver nanoparticles were noticed inside endosomes. In vivo, clinical and post mortem examinations were inconspicuous. Chemical analyses showed no increased silver content compared to controls. Mucosal coverages on almost all prostheses were found. But reduction of granulation tissue was only obvious around silver-coated implants. Single necroses and apoptosis in the mucosa were correlated by intracellular accumulation of metallic silver. For confirming supportive healing effects of middle ear implants, silver ion aggregates need to be tested in the future to optimize biocompatibility while assuring bactericidal effects in the middle ear.

Surface biotechnology for refining cochlear implants

The advent of the cochlear implant is phenomenal because it is the first surgical prosthesis that is capable of restoring one of the senses. The subsequent rapid evolution of cochlear implants through increasing complexity and functionality has been synchronized with the recent advancements in biotechnology. Surface biotechnology has refined cochlear implants by directly influencing the implant–tissue interface. Emerging surface biotechnology strategies are exemplified by nanofibrous polymeric materials, topographical surface modification, conducting polymer coatings, and neurotrophin-eluting implants. Although these novel developments have received individual attention in the recent literature, the time has come to investigate their collective applications to cochlear implants to restore lost hearing.

Ciprofloxacin-collagen conjugate in the wound healing treatment

The synthesis of a novel functional biomaterial for wound healing treatment was carried out by adopting a free-radical grafting procedure in aqueous media. With this aim, ciprofloxacin (CFX) was covalently incorporated into collagen (T1C) chains employing an ascorbic acid/hydrogen peroxide redox pair as biocompatible initiator system. The covalent insertion of CFX in the polymeric chains was confirmed by FT-IR and UV analyses, while an antibacterial assay demonstrated the activity of the synthesized conjugate against Staphylococcusaureus and Escherichia coli, microorganisms that commonly infect wounds. A catechin blended conjugate was also tested in order to evaluate the ability to influence fibroblast cell growth. The observed antibacterial activity and stimulation of fibroblast growth support the applicability of CFX-T1C conjugate in wound treatment encouraging the healing process.

Titanium-copper-nitride coated spacers for two-stage revision of infected total hip endoprostheses

Within the first two years after total hip arthroplasty implant-associated infection has become the second most common reason for a revision surgery. Two-stage implant exchange is frequently conducted using temporary spacers made of antibiotic-loaded cement in order to prevent a bacterial colonization on the spacer. Avoiding several disadvantages of cement spacers, a conventional hemi-endoprosthesis was equipped with a copper-containing implant coating for inhibition of bacterial biofilms. In the present paper details of this novel treatment concept are presented including a case report.