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Steadman W, Chapman PR, Schuetz M, Schmutz B, Trampuz A, Tetsworth K. Local Antibiotic Delivery Options in Prosthetic Joint Infection. Antibiotics (Basel) 2023; 12:752. [PMID: 37107114 PMCID: PMC10134995 DOI: 10.3390/antibiotics12040752] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Prosthetic Joint Infection (PJI) causes significant morbidity and mortality for patients globally. Delivery of antibiotics to the site of infection has potential to improve the treatment outcomes and enhance biofilm eradication. These antibiotics can be delivered using an intra-articular catheter or combined with a carrier substance to enhance pharmacokinetic properties. Carrier options include non-resorbable polymethylmethacrylate (PMMA) bone cement and resorbable calcium sulphate, hydroxyapatite, bioactive glass, and hydrogels. PMMA allows for creation of structural spacers used in multi-stage revision procedures, however it requires subsequent removal and antibiotic compatibility and the levels delivered are variable. Calcium sulphate is the most researched resorbable carrier in PJI, but is associated with wound leakage and hypercalcaemia, and clinical evidence for its effectiveness remains at the early stage. Hydrogels provide a versatile combability with antibiotics and adjustable elution profiles, but clinical usage is currently limited. Novel anti-biofilm therapies include bacteriophages which have been used successfully in small case series.
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Affiliation(s)
- William Steadman
- Jamieson Trauma Institute, Royal Brisbane and Women’s Hospital, Herston, Brisbane 4029, Australia
- Department of Orthopaedics, Royal Brisbane and Women’s Hospital, Herston, Brisbane 4029, Australia
- Faculty of Health, Queensland University of Technology, Brisbane 4059, Australia
| | - Paul R. Chapman
- Jamieson Trauma Institute, Royal Brisbane and Women’s Hospital, Herston, Brisbane 4029, Australia
- Herston Infectious Disease Institute, Royal Brisbane and Women’s Hospital, Herston, Brisbane 4029, Australia
- Department of Infectious Diseases, Royal Brisbane and Women’s Hospital, Herston, Brisbane 4029, Australia
| | - Michael Schuetz
- Jamieson Trauma Institute, Royal Brisbane and Women’s Hospital, Herston, Brisbane 4029, Australia
- Department of Orthopaedics, Royal Brisbane and Women’s Hospital, Herston, Brisbane 4029, Australia
- Faculty of Health, Queensland University of Technology, Brisbane 4059, Australia
| | - Beat Schmutz
- Jamieson Trauma Institute, Royal Brisbane and Women’s Hospital, Herston, Brisbane 4029, Australia
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane 4000, Australia
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane 4059, Australia
- Australian Research Council Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane 4059, Australia
| | - Andrej Trampuz
- Center for Musculoskeletal Surgery, Septic Unit Charité-Universitätsmedizin, 10117 Berlin, Germany
| | - Kevin Tetsworth
- Department of Orthopaedics, Royal Brisbane and Women’s Hospital, Herston, Brisbane 4029, Australia
- School of Medicine, University of Queensland, Brisbane 4029, Australia
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Heffernan JM, McLaren AC, Glass CM, Overstreet DJ. Extended Release of Bupivacaine from Temperature-responsive Hydrogels Provides Multi-day Analgesia for Postoperative Pain. PAIN MEDICINE 2023; 24:113-121. [PMID: 35944219 DOI: 10.1093/pm/pnac119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE A local anesthetic that provides analgesia lasting at least three days could significantly improve postoperative pain management. This study evaluated the analgesic efficacy and safety of an extended-release formulation of bupivacaine based on the injectable hydrogel carrier poly(N-isopropylacrylamide-co-dimethylbutyrolactone acrylamide-co-Jeffamine M-1000 acrylamide) (PNDJ). METHODS The efficacy of PNDJ containing 4% bupivacaine (SBG004) given by peri-incisional subcutaneous injection (SBG004 SC) or wound filling instillation (SBG004 WF) was evaluated compared to saline, liposomal bupivacaine, bupivacaine collagen sponge, bupivacaine-meloxicam polyorthoester, and bupivacaine HCl in a porcine skin and muscle incision model. Mechanical allodynia was assessed by withdrawal from application of von Frey filaments, and local tolerance was evaluated by histology. Bupivacaine pharmacokinetics for SBG004 SC were measured in rabbits (16.5 mg bupivacaine/kg). RESULTS Animals demonstrated less mechanical allodynia at incisions receiving SBG004 SC for up to 96 hours postoperatively. Incisions treated with SBG004 SC tolerated more force without a withdrawal indicative of pain compared to saline for 96 hours, and compared to SBG004 WF and all active controls at 24, 48, and 72 hours except bupivacaine-meloxicam polyorthoester at 72 hours. By 49 days, SBG004 was histologically absent and was replaced with granulation tissue infiltrated with immune cells in some areas. In rabbits, Cmax was 41.6 ± 9.7 ng/mL with t1/2 82.0 ± 35.8 hours (mean ± SD). CONCLUSIONS Peri-incisional SBG004 SC provided extended release of bupivacaine sufficient to reduce sensation of incisional pain for 96 hours, in vivo bupivacaine delivery for at least 7 days, and a favorable local and systemic toxicity profile.
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Affiliation(s)
| | - Alex C McLaren
- Sonoran Biosciences, Tempe, Arizona, USA.,Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Christopher M Glass
- School of Biological & Health Systems Engineering, Arizona State University, Tempe, Arizona, USA
| | - Derek J Overstreet
- Sonoran Biosciences, Tempe, Arizona, USA.,School of Biological & Health Systems Engineering, Arizona State University, Tempe, Arizona, USA
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3
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Sousa A, Phung AN, Škalko-Basnet N, Obuobi S. Smart delivery systems for microbial biofilm therapy: Dissecting design, drug release and toxicological features. J Control Release 2023; 354:394-416. [PMID: 36638844 DOI: 10.1016/j.jconrel.2023.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/14/2022] [Accepted: 01/02/2023] [Indexed: 01/15/2023]
Abstract
Bacterial biofilms are highly protected surface attached communities of bacteria that typically cause chronic infections. To address their recalcitrance to antibiotics and minimise side effects of current therapies, smart drug carriers are being explored as promising platforms for antimicrobials. Herein, we briefly summarize recent efforts and considerations that have been applied in the design of these smart carriers. We guide readers on a journey on how they can leverage the inherent biofilm microenvironment, external stimuli, or combine both types of stimuli in a predictable manner. The specific carrier features that are responsible for their 'on-demand' properties are detailed and their impact on antibiofilm property are further discussed. Moreover, an analysis on the impact of such features on drug release profiles is provided. Since nanotechnology represents a significant slice of the drug delivery pie, some insights on the potential toxicity are also depicted. We hope that this review inspires researchers to use their knowledge and creativity to design responsive systems that can eradicate biofilm infections.
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Affiliation(s)
- A Sousa
- Drug Transport and Delivery Research Group, Department of Pharmacy, UIT The Arctic University of Norway, Tromsø, Norway
| | - A Ngoc Phung
- Drug Transport and Delivery Research Group, Department of Pharmacy, UIT The Arctic University of Norway, Tromsø, Norway
| | - N Škalko-Basnet
- Drug Transport and Delivery Research Group, Department of Pharmacy, UIT The Arctic University of Norway, Tromsø, Norway
| | - S Obuobi
- Drug Transport and Delivery Research Group, Department of Pharmacy, UIT The Arctic University of Norway, Tromsø, Norway.
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4
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Qi D, Wang N, Cheng Y, Zhao Y, Meng L, Yue X, She P, Gao H. Application of Porous Polyetheretherketone Scaffold/ Vancomycin-Loaded Thermosensitive Hydrogel Composites for Antibacterial Therapy in Bone Repair. Macromol Biosci 2022; 22:e2200114. [PMID: 35850169 DOI: 10.1002/mabi.202200114] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/04/2022] [Indexed: 11/09/2022]
Abstract
Polyetheretherketone (PEEK) has been widely used in bone repair, but it often fails due to bacterial infection. Herein, a high-strength porous polyetheretherketone scaffold (ps-PK) loaded with antibacterial drug-loaded hydrogel strategy is proposed. The prepared ps-PK possesses high porosity (30.8%-64.7%) and the compression modulus is between 0.4-0.98 GPa. The interconnected pore-type structure endows it with a drug loading capacity. Poly(D,L -lactic acid-co-glycolic acid)-b-Poly(ethylene glycol)-b-Poly(D,L -lactic acid-co-glycolic acid) (PLGA-PEG-PLGA) thermoresponsive hydrogels loaded with vancomycin are used as the drug sustained-release system. The vancomycin-loaded hydrogels in the solution state at a low temperature were filled into a porous polyetheretherketone scaffold (ps-PK-VGel) and formed a gel state after implantation in vivo. The antibacterial rate of ps-PK-VGel against methicillin-resistant staphylococcus aureus (MRSA) in vitro was 99.7% and histological observation in vivo demonstrates that the ps-PK-VGel shows obvious antibacterial activity. Given its excellent antibacterial ability and mechanical properties, the porous PEEK scaffold composite drug-loaded thermosensitive hydrogel has great potential in bone repair surgery applications. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Desheng Qi
- Engineering Research Center of Special Engineering Plastics, Ministry of Education, College of Chemistry, Jilin University, Changchun, 130021, China
| | - Ningning Wang
- Department of Prosthetic Dentistry, Hospital of Stomatology, Jilin University, Changchun, 130021, China
| | - Yuanqiang Cheng
- Department of Bone and Joint Surgery, No1 Hospital of Jilin University, Changchun, 130021, China
| | - Yao Zhao
- Department of Bone and Joint Surgery, No1 Hospital of Jilin University, Changchun, 130021, China
| | - Lingcheng Meng
- Engineering Research Center of Special Engineering Plastics, Ministry of Education, College of Chemistry, Jilin University, Changchun, 130021, China
| | - Xigui Yue
- Engineering Research Center of Special Engineering Plastics, Ministry of Education, College of Chemistry, Jilin University, Changchun, 130021, China
| | - Peng She
- Department of orthopedics, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 528406, China
| | - Hang Gao
- Department of Bone and Joint Surgery, No1 Hospital of Jilin University, Changchun, 130021, China
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5
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Heffernan JM, McLaren AC, Overstreet DJ. Local antimicrobial delivery from temperature-responsive hydrogels reduces incidence of intra-abdominal infection in rats. Comp Immunol Microbiol Infect Dis 2022; 86:101823. [PMID: 35636372 PMCID: PMC9430827 DOI: 10.1016/j.cimid.2022.101823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
The objective of this study was to evaluate local antimicrobial delivery from temperature-responsive hydrogels for preventing infection in a rat model of intra-abdominal infection (IAI), and to determine whether delivery of tobramycin and vancomycin in combination is effective against IAI pathogens. Rats received intraperitoneal inoculation of E. coli, rat cecal contents, or cecal contents supplemented with E. coli, and received either no treatment, subcutaneous cefoxitin, or local delivery from hydrogels containing vancomycin, tobramycin, or both antimicrobials. Only the hydrogel with tobramycin and vancomycin significantly increased the infection free-rate compared to no treatment for all inocula (E. coli: 13/17, p < 0.0001; cecal contents: 11/17, p = 0.0013; cecal contents + E. coli: 15/19, p < 0.0001). Additionally, tobramycin and vancomycin displayed no synergy or antagonism against clinical isolates in vitro. Local delivery of tobramycin and vancomycin from temperature-responsive hydrogels provides broad coverage and high antimicrobial concentrations for several hours that may be effective for preventing IAIs.
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Affiliation(s)
| | - Alex C McLaren
- Sonoran Biosciences, 1048 E Knight Ln, Tempe, AZ, USA; University of Arizona College of Medicine, 475N 5th St, Phoenix, AZ, USA.
| | - Derek J Overstreet
- Sonoran Biosciences, 1048 E Knight Ln, Tempe, AZ, USA; Arizona State University, PO Box 879709, Tempe, AZ, USA.
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6
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WPI Hydrogels with a Prolonged Drug-Release Profile for Antimicrobial Therapy. Pharmaceutics 2022; 14:pharmaceutics14061199. [PMID: 35745772 PMCID: PMC9231275 DOI: 10.3390/pharmaceutics14061199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 12/10/2022] Open
Abstract
Infectious sequelae caused by surgery are a significant problem in modern medicine due to their reduction of therapeutic effectiveness and the patients’ quality of life.Recently, new methods of local antimicrobial prophylaxis of postoperative sequelae have been actively developed. They allow high local concentrations of drugs to be achieved, increasing the antibiotic therapy’s effectiveness while reducing its side effects. We have developed and characterized antimicrobial hydrogels based on an inexpensive and biocompatible natural substance from the dairy industry—whey protein isolate—as matrices for drug delivery. The release of cefazolin from the pores of hydrogel structures directly depends on the amount of the loaded drug and occurs in a prolonged manner for three days. Simultaneously with the antibiotic release, hydrogel swelling and partial degradation occurs. The WPI hydrogels absorb solvent, doubling in size in three days and retaining cefazolin throughout the duration of the experiment. The antimicrobial activity of cefazolin-loaded WPI hydrogels against Staphylococcus aureus growth is prolonged in comparison to that of the free cefazolin. The overall cytotoxic effect of cefazolin-containing WPI hydrogels is lower than that of free antibiotics. Thus, our work shows that antimicrobial WPI hydrogels are suitable candidates for local antibiotic therapy of infectious surgical sequelae.
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7
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Xin W, Gao Y, Yue B. Recent Advances in Multifunctional Hydrogels for the Treatment of Osteomyelitis. Front Bioeng Biotechnol 2022; 10:865250. [PMID: 35547176 PMCID: PMC9081433 DOI: 10.3389/fbioe.2022.865250] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Osteomyelitis (OM), a devastating disease caused by microbial infection of bones, remains a major challenge for orthopedic surgeons. Conventional approaches for prevention and treatment of OM are unsatisfactory. Various alternative strategies have been proposed, among which, hydrogel-based strategies have demonstrated potential due to their unique properties, including loadable, implantable, injectable, printable, degradable, and responsive to stimuli. Several protocols, including different hydrogel designs, selection of antimicrobial agent, co-administration of bone morphogenetic protein 2 (BMP 2), and nanoparticles, have been shown to improve the biological properties, including antimicrobial effects, osteo-induction, and controlled drug delivery. In this review, we describe the current and future directions for designing hydrogels and their applications to improve the biological response to OM in vivo.
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Heffernan JM, Overstreet DJ, Vernon BL, McLemore RY, Nagy T, Moore RC, Badha VS, Childers EP, Nguyen MB, Gentry DD, Calara FM, Saunders WB, Feltis T, McLaren AC. In vivo evaluation of temperature-responsive antimicrobial-loaded PNIPAAm hydrogels for prevention of surgical site infection. J Biomed Mater Res B Appl Biomater 2022; 110:103-114. [PMID: 34128323 PMCID: PMC8608705 DOI: 10.1002/jbm.b.34894] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/07/2021] [Accepted: 06/07/2021] [Indexed: 01/03/2023]
Abstract
Surgical site infections (SSIs) are a persistent clinical challenge. Local antimicrobial delivery may reduce the risk of SSI by increasing drug concentrations and distribution in vulnerable surgical sites compared to what is achieved using systemic antimicrobial prophylaxis alone. In this work, we describe a comprehensive in vivo evaluation of the safety and efficacy of poly(N-isopropylacrylamide-co-dimethylbutyrolactone acrylamide-co-Jeffamine M-1000 acrylamide) [PNDJ], an injectable temperature-responsive hydrogel carrier for antimicrobial delivery in surgical sites. Biodistribution data indicate that PNDJ is primarily cleared via the liver and kidneys following drug delivery. Antimicrobial-loaded PNDJ was generally well-tolerated locally and systemically when applied in bone, muscle, articulating joints, and intraperitoneal space, although mild renal toxicity consistent with the released antimicrobials was identified at high doses in rats. Dosing of PNDJ at bone-implant interfaces did not affect normal tissue healing and function of orthopedic implants in a transcortical plug model in rabbits and in canine total hip arthroplasty. Finally, PNDJ was effective at preventing recurrence of implant-associated MSSA and MRSA osteomyelitis in rabbits, showing a trend toward outperforming commercially available antimicrobial-loaded bone cement and systemic antimicrobial administration. These studies indicate that antimicrobial-loaded PNDJ hydrogels are well-tolerated and could reduce incidence of SSI in a variety of surgical procedures.
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Affiliation(s)
| | - Derek J Overstreet
- Sonoran Biosciences, Tempe, AZ,School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ
| | - Brent L Vernon
- Sonoran Biosciences, Tempe, AZ,School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ
| | - Ryan Y McLemore
- Sonoran Biosciences, Tempe, AZ,University of Arizona College of Medicine, Phoenix, AZ,Systems Planning and Analysis, Inc. Alexandria, VA
| | - Tamas Nagy
- College of Veterinary Medicine, University of Georgia, Athens, GA
| | - Rex C Moore
- Sonoran Biosciences, Tempe, AZ,School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ
| | - Vajra S Badha
- Sonoran Biosciences, Tempe, AZ,School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ
| | | | - Michael B Nguyen
- Sonoran Biosciences, Tempe, AZ,School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ
| | - Daniel D Gentry
- Sonoran Biosciences, Tempe, AZ,School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ
| | | | - W Brian Saunders
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX
| | | | - Alex C McLaren
- Sonoran Biosciences, Tempe, AZ,School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ,University of Arizona College of Medicine, Phoenix, AZ
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9
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Harrison ZL, Pace LR, Brown MN, Beenken KE, Smeltzer MS, Bumgardner JD, Haggard WO, Jennings JA. Staphylococcal infection prevention using antibiotic-loaded mannitol-chitosan paste in a rabbit model of implant-associated osteomyelitis. J Orthop Res 2021; 39:2455-2464. [PMID: 33470467 PMCID: PMC8289950 DOI: 10.1002/jor.24986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/08/2020] [Accepted: 01/11/2021] [Indexed: 02/04/2023]
Abstract
Antibiotic-loaded chitosan pastes have shown advantages in the treatment and coverage of complex musculoskeletal defects. We added mannitol, previously shown to increase antibiotic susceptibility of biofilm, to an injectable chitosan/polyethylene glycol paste for delivery of antibiotics. Ground sponges (0.85% acetic acid solution, 1% chitosan, 0% or 2% mannitol, 1% polyethylene glycol) were hydrated using phosphate-buffered saline with 10 mg/ml amikacin and 10 mg/ml vancomycin added to form pastes. We inoculated rabbit radial defects with 105 colony-forming units of Staphylococcus aureus (UAMS-1) and inserted titanium pins into the cortical bone. Groups compared included mannitol blend pastes, non-mannitol blends, antibiotic-loaded bone cement, vancomycin powder, and no treatment controls. We harvested tissue samples and retrieved the pins retrieved at 3 weeks. All antibiotic-loaded groups lowered bacterial growth and colony-forming unit counts in soft and bone tissue and on titanium pins in in vivo studies. The results indicate this biomaterial is capable of eluting active antibiotics at concentrations that reduce bacterial growth on biomaterials and tissue, which, in turn, may prevent biofilm formation. Blends of chitosan and mannitol may be useful in prevention and treatment of osteomyelitis and implant-associated infections.
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Affiliation(s)
- Zoe L. Harrison
- Department of Biomedical Engineering, University of Memphis, Memphis, TN, USA
| | - Leslie R. Pace
- Department of Biomedical Engineering, University of Memphis, Memphis, TN, USA
| | - Madison N. Brown
- Department of Biomedical Engineering, University of Memphis, Memphis, TN, USA
| | - Karen E. Beenken
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Mark S. Smeltzer
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Joel D. Bumgardner
- Department of Biomedical Engineering, University of Memphis, Memphis, TN, USA
| | - Warren O. Haggard
- Department of Biomedical Engineering, University of Memphis, Memphis, TN, USA
| | - J. Amber Jennings
- Department of Biomedical Engineering, University of Memphis, Memphis, TN, USA
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10
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Jamaledin R, Yiu CKY, Zare EN, Niu LN, Vecchione R, Chen G, Gu Z, Tay FR, Makvandi P. Advances in Antimicrobial Microneedle Patches for Combating Infections. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2020; 32:e2002129. [PMID: 32602146 DOI: 10.1002/adma.202002129] [Citation(s) in RCA: 210] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/16/2020] [Indexed: 05/22/2023]
Abstract
Skin infections caused by bacteria, viruses and fungi are difficult to treat by conventional topical administration because of poor drug penetration across the stratum corneum. This results in low bioavailability of drugs to the infection site, as well as the lack of prolonged release. Emerging antimicrobial transdermal and ocular microneedle patches have become promising medical devices for the delivery of various antibacterial, antifungal, and antiviral therapeutics. In the present review, skin anatomy and its barriers along with skin infection are discussed. Potential strategies for designing antimicrobial microneedles and their targeted therapy are outlined. Finally, biosensing microneedle patches associated with personalized drug therapy and selective toxicity toward specific microbial species are discussed.
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Affiliation(s)
- Rezvan Jamaledin
- Center for Advanced Biomaterials for Health Care (iit@CRIB), Istituto Italiano di Tecnologia, Naples, 80125, Italy
| | - Cynthia K Y Yiu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, P. R. China
| | - Ehsan N Zare
- School of Chemistry, Damghan University, Damghan, 36716-41167, Iran
| | - Li-Na Niu
- State Key Laboratory of Military Stomatology National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710000, P. R. China
| | - Raffaele Vecchione
- Center for Advanced Biomaterials for Health Care (iit@CRIB), Istituto Italiano di Tecnologia, Naples, 80125, Italy
| | - Guojun Chen
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, CA, 90095, USA
| | - Zhen Gu
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, CA, 90095, USA
| | - Franklin R Tay
- The Graduate School, Augusta University, Augusta, GA, 30912, USA
| | - Pooyan Makvandi
- Institute for Polymers, Composites, and Biomaterials (IPCB), National Research Council (CNR), Naples, 80125, Italy
- Chemistry Department, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, 61537-53843, Iran
- Department of Medical Nanotechnology, Faculty of Advanced, Technologies in Medicine, Iran University of Medical Sciences, Tehran, 14496-14535, Iran
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11
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Abstract
Cardiovascular diseases (CVDs) pose a serious threat to human health, which are characterized by high disability and mortality rate globally such as myocardial infarction (MI), atherosclerosis, and heart failure. Although stem cells transplantation and growth factors therapy are promising, their low survival rate and loss at the site of injury are major obstacles to this therapy. Recently, the development of hydrogel scaffold materials provides a new way to solve this problem, which have shown the potential to treat CVD. Among these scaffold materials, environmentally responsive hydrogels have great prospects in repairing the microenvironment of cardiovascular tissues and vascular regeneration. They provide a new method for the treatment of cardiovascular tissue repair and space-time control for the release of various therapeutic drugs, including small-molecule drugs, growth factors, and stem cells. Herein, this article reviews the occurrence and current treatment of CVD, as well as the repair of cardiovascular injury by several environmental responsive hydrogels systems currently used, mainly focusing on the delivery of growth factors or the application of cell therapy to revascularization. In addition, we will also discuss the enormous potential and personal perspectives of environmentally responsive hydrogels in cardiovascular repair.
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