The cells of monocyte-macrophage lineage in mice with the 2-month polyethylene implantation

T cell subset distributions following primary and secondary implantation at subcutaneous biomaterial implant sites

Synthetic biomaterials are considered to be nonimmunogenic. Therefore, the role that adaptive immunity may play in the host response to implanted synthetic biomaterials has not been extensively studied. Cardinal features of adaptive immunity include specificity and T cell responses, which are greater and more effective with upregulation of activation receptors upon rechallenge. We compared the primary and secondary in vivo host response to three synthetic biomaterials: Elasthane 80A, silicone rubber, and polyethylene terephthalate using a cage implant model in Sprague Dawley rats. The synthetic biomedical polymers were subcutaneously implanted in cages for 14 days. Following explantation of the cages and a 2 week healing period, rats were implanted with cages containing the biomedical polymers for an additional 2 weeks. The cellular exudates within the cages were analyzed 4, 7, and 14 days post primary and secondary implantation by flow cytometry for the following cell types: T cells (inclusive of CD8(+), CD4(+), and CD4(+)/CD25(+) subsets), B cells, granulocytes, and macrophages. At day 14 following secondary implantation, there was an increase in T cells, granulocytes, and macrophages in the exudates when compared with primary implantation for all groups inclusive of the empty cage control. However, CD4(+)/CD8(+) ratios, the percentage of CD4(+)CD25(+) T cells, and the macrophage surface adhesion/fusion did not vary significantly upon secondary implantation. Despite a quantitative increase in T cells following secondary biomaterial exposure, T cell subset distribution did not change, indicating nonspecific recruitment rather than an adaptive immune response.

The production of nitric oxide and tumor necrosis factor by murine macrophages infected with mycobacterial strains differing by hemolytic activity

In this study, we compared the secretion of nitric oxide (NO) and tumor necrosis factor (TNF-alpha) by murine macrophages infected in vitro with hemolytic or unhemolytic mycobacteria isolates. We observed that unhemolytic mycobacteria induced more intensive NO production by macrophages and were more susceptible to bactericidal effect of mononuclear phagocytes than hemolytic mycobacterial strains. In contrast, the high-virulence hemolytic isolates induced significantly stronger TNF-alpha production by infected macrophages than the low-virulence unhemolytic bacilli.

Granulocyte-macrophage colony-stimulating factor (GM-CSF)-coated implants and their potential for reducing biomaterial-associated infection in neutropenic hosts

The incidence of infections associated with the use of medical biomaterials is high for skin-penetrating devices, when microbes of the normal skin flora like coagulase-positive and coagulase-negative staphylococci dominate as causative organisms. The most serious ones are infections in immunocompromised individuals. A mouse model of subcutaneous staphylococcal infection yielding abscesses in cyclophosphamide-induced neutropenic mice implanted with heparinized polyethylene (H-PE) was used. The present study addresses the question of the effects of implant modification with recombinant granulocyte-macrophage stimulating factor (rGM-CSF) on the course of infection. Our findings demonstrate that such modification reduces the proliferation of bacteria within the abscess and as a consequence limits the dissemination of bacteria from the local infection induced in the neutropenic host.

Cellular reaction to Mycobacterium avium complex (MAC) clinical isolates differing in hemolytic activity and virulence for C57BL/6 mice

In this study we showed that Mycobacterium avium complex (MAC) clinical isolates differed by the expression of hemolytic activity. Two hemolytic MAC strains were less susceptible to the mycobactericidal effect of murine macrophages than two unhemolytic MAC isolates. In vivo, hemolytic MAC bacilli survived in the spleens of infected mice for a longer time than unhemolytic MAC strains. This suggested a role of hemolysins in the virulence of MAC strains. There was no difference in the cytotoxicity of T cells from mice immunized with M. bovis BCG towards macrophages infected in vitro with MAC strains expressing or not expressing hemolytic activity.

Specific immune response to staphylococcal antigens during long-lasting biomaterial implantation

Biomaterial-associated infections caused by staphylococci are one of the main therapeutic problems in modern medicine. There is no doubt that local disfunction of polymorphonuclear leukocytes and macrophages predisposes to such infections. However, it is not clear how implantation of a foreign body influences the antibacterial immune response. We analyzed some parameters of the specific immune response to staphylococcal antigens, in mice implanted for 3 months with heparinized polyethylene. Three weeks before the evaluation of the immune response, mice (implanted and non-implanted) were infected i.p. with 2 x 10(7) cells of Staphylococcus aureus Cowan 1. The proliferation of splenocytes was determined on the basis of [3H]thymidine incorporation in cultures stimulated with staphylococcal lipoteichoic acid, protein A, alpha-toxin, or phytohemagglutinin. Moreover, the level of specific antibodies to staphylococcal antigens was determined in serum samples (ELISA with the antigens lipoteichoic acid, protein A, and alpha-toxin). The data obtained indicate that long-lasting implantation caused evident changes in proliferative activity of lymphocytes and in humoral response to staphylococcal antigens. It enhanced spontaneous and lipoteichoic acid- or alpha-toxin-stimulated proliferation of splenocytes, in vitro. In contrast, heparinized polyethylene-implanted animals showed a significant decrease in the production of anti-protein A IgG2b and anti-alpha-toxin IgG2a and IgG2b.

Effects of granulocyte-macrophage colony stimulating factor (GM-CSF) on biomaterial-associated staphylococcal infection in mice

Staphylococcal infections are a major complication in the usage of biomaterials. Different modifications of polymers have been made to reduce the incidence of such infections. We studied the effects of modifying heparinized polyethylene (H-PE) with mouse recombinant granulocyte-macrophage stimulating factor (rGM-CSF). The elimination of staphylococci (Staphylococcus aureus, S. epidermidis) from the peritoneum of mice implanted with rGM-CSF-coated H-PE was slightly more effective than the elimination of the bacteria from the peritoneum of animals implanted with uncoated H-PE. Most interestingly, the number of staphylococci present in the biofilms covering rGM-CSF-coated implants were significantly lower than the number of bacteria detected on the surface of H-PE not coated with rGM-CSF. In vitro, rGM-CSF restored the anti-bacterial potency of the phagocytes, which had been reduced by surface contact with H-PE. The results suggest that modification of biomaterials with rGM-CSF could be one way of preventing staphylococcal infections; especially in neutropenic disorders, which constitute the highest risk factor for foreign body-associated infections.