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Devoy EJ, Jabari E, Kotsanos G, Choe RH, Fisher JP. An Exploration of the Role of Osteoclast Lineage Cells in Bone Tissue Engineering. TISSUE ENGINEERING. PART B, REVIEWS 2024. [PMID: 39041616 DOI: 10.1089/ten.teb.2024.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Bone defects because of age, trauma, and surgery, which are exacerbated by medication side effects and common diseases such as osteoporosis, diabetes, and rheumatoid arthritis, are a problem of epidemic scale. The present clinical standard for treating these defects includes autografts and allografts. Although both treatments can promote robust regenerative outcomes, they fail to strike a desirable balance of availability, side effect profile, consistent regenerative efficacy, and affordability. This difficulty has contributed to the rise of bone tissue engineering (BTE) as a potential avenue through which enhanced bone regeneration could be delivered. BTE is founded upon a paradigm of using biomaterials, bioactive factors, osteoblast lineage cells (ObLCs), and vascularization to cue deficient bone tissue into a state of regeneration. Despite promising preclinical results, BTE has had modest success in being translated into the clinical setting. One barrier has been the simplicity of its paradigm relative to the complexity of biological bone. Therefore, this paradigm must be critically examined and expanded to better account for this complexity. One potential avenue for this is a more detailed consideration of osteoclast lineage cells (OcLCs). Although these cells ostensibly oppose ObLCs and bone regeneration through their resorptive functions, a myriad of investigations have shed light on their potential to influence bone equilibrium in more complex ways through their interactions with both ObLCs and bone matrix. Most BTE research has not systematically evaluated their influence. Yet contrary to expectations associated with the paradigm, a selection of BTE investigations has demonstrated that this influence can enhance bone regeneration in certain contexts. In addition, much work has elucidated the role of many controllable scaffold parameters in both inhibiting and stimulating the activity of OcLCs in parallel to bone regeneration. Therefore, this review aims to detail and explore the implications of OcLCs in BTE and how they can be leveraged to improve upon the existing BTE paradigm.
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Affiliation(s)
- Eoin J Devoy
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
- Center for Engineering Complex Tissues, University of Maryland, College Park, Maryland, USA
| | - Erfan Jabari
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
- Center for Engineering Complex Tissues, University of Maryland, College Park, Maryland, USA
| | - George Kotsanos
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
- Center for Engineering Complex Tissues, University of Maryland, College Park, Maryland, USA
| | - Robert H Choe
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
- Center for Engineering Complex Tissues, University of Maryland, College Park, Maryland, USA
| | - John P Fisher
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
- Center for Engineering Complex Tissues, University of Maryland, College Park, Maryland, USA
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2
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Ali A, Polepalli L, Chowdhury S, Carr MA, Janorkar AV, Marquart ME, Griggs JA, Bumgardner JD, Roach MD. Silver-Doped Titanium Oxide Layers for Improved Photocatalytic Activity and Antibacterial Properties of Titanium Implants. J Funct Biomater 2024; 15:163. [PMID: 38921536 PMCID: PMC11204938 DOI: 10.3390/jfb15060163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/06/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
Titanium has a long history of clinical use, but the naturally forming oxide is not ideal for bacterial resistance. Anodization processes can modify the crystallinity, surface topography, and surface chemistry of titanium oxides. Anatase, rutile, and mixed phase oxides are known to exhibit photocatalytic activity (PCA)-driven bacterial resistance under UVA irradiation. Silver additions are reported to enhance PCA and reduce bacterial attachment. This study investigated the effects of silver-doping additions to three established anodization processes. Silver doping showed no significant influence on oxide crystallinity, surface topography, or surface wettability. Oxides from a sulfuric acid anodization process exhibited significantly enhanced PCA after silver doping, but silver-doped oxides produced from phosphoric-acid-containing electrolytes did not. Staphylococcus aureus attachment was also assessed under dark and UVA-irradiated conditions on each oxide. Each oxide exhibited a photocatalytic antimicrobial effect as indicated by significantly decreased bacterial attachment under UVA irradiation compared to dark conditions. However, only the phosphorus-doped mixed anatase and rutile phase oxide exhibited an additional significant reduction in bacteria attachment under UVA irradiation as a result of silver doping. The antimicrobial success of this oxide was attributed to the combination of the mixed phase oxide and higher silver-doping uptake levels.
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Affiliation(s)
- Aya Ali
- University of Mississippi Medical Center, Department of Biomedical Materials Science, Jackson, MS 39216, USA; (A.A.); (L.P.); (S.C.); (A.V.J.); (J.A.G.)
| | - Likhitha Polepalli
- University of Mississippi Medical Center, Department of Biomedical Materials Science, Jackson, MS 39216, USA; (A.A.); (L.P.); (S.C.); (A.V.J.); (J.A.G.)
| | - Sheetal Chowdhury
- University of Mississippi Medical Center, Department of Biomedical Materials Science, Jackson, MS 39216, USA; (A.A.); (L.P.); (S.C.); (A.V.J.); (J.A.G.)
| | - Mary A. Carr
- University of Mississippi Medical Center, Department of Cell and Molecular Biology, School of Medicine, Jackson, MS 39216, USA; (M.A.C.); (M.E.M.)
| | - Amol V. Janorkar
- University of Mississippi Medical Center, Department of Biomedical Materials Science, Jackson, MS 39216, USA; (A.A.); (L.P.); (S.C.); (A.V.J.); (J.A.G.)
| | - Mary E. Marquart
- University of Mississippi Medical Center, Department of Cell and Molecular Biology, School of Medicine, Jackson, MS 39216, USA; (M.A.C.); (M.E.M.)
| | - Jason A. Griggs
- University of Mississippi Medical Center, Department of Biomedical Materials Science, Jackson, MS 39216, USA; (A.A.); (L.P.); (S.C.); (A.V.J.); (J.A.G.)
| | - Joel D. Bumgardner
- Department of Biomedical Engineering, University of Memphis, Memphis, TN 38152, USA;
| | - Michael D. Roach
- University of Mississippi Medical Center, Department of Biomedical Materials Science, Jackson, MS 39216, USA; (A.A.); (L.P.); (S.C.); (A.V.J.); (J.A.G.)
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3
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Witzdam L, Garay-Sarmiento M, Gagliardi M, Meurer YL, Rutsch Y, Englert J, Philipsen S, Janem A, Alsheghri R, Jakob F, Molin DGM, Schwaneberg U, van den Akker NMS, Rodriguez-Emmenegger C. Brush-Like Coatings Provide a Cloak of Invisibility to Titanium Implants. Macromol Biosci 2024; 24:e2300434. [PMID: 37994518 DOI: 10.1002/mabi.202300434] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/19/2023] [Indexed: 11/24/2023]
Abstract
Orthopedic implants such as knee and hip implants are one of the most important types of medical devices. Currently, the surface of the most advanced implants consists of titanium or titanium-alloys with high porosity at the bone-contacting surface leading to superior mechanical properties, excellent biocompatibility, and the capability of inducing osseointegration. However, the increased surface area of porous titanium provides a nidus for bacteria colonization leading to implant-related infections, one of the main reasons for implant failure. Here, two readily applicable titanium-coatings based on hydrophilic carboxybetaine polymers that turn the surface stealth thereby preventing bacterial adhesion and colonization are developed. These coatings are biocompatible, do not affect cell functionality, exhibit great antifouling properties, and do not cause additional inflammation during the healing process. In this way, the coatings can prevent implant-related infections, while at the same time being completely innocuous to its biological environment. Thus, these coating strategies are a promising route to enhance the biocompatibility of orthopedic implants and have a high potential for clinical use, while being easy to implement in the implant manufacturing process.
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Affiliation(s)
- Lena Witzdam
- DWI - Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, 52074, Aachen, Germany
- Institute for Bioengineering of Catalonia (IBEC), Carrer de Baldiri Reixac, 10, 12, Barcelona, 08028, Spain
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, Worringerweg 2, 52074, Aachen, Germany
| | - Manuela Garay-Sarmiento
- DWI - Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, 52074, Aachen, Germany
- Institute for Bioengineering of Catalonia (IBEC), Carrer de Baldiri Reixac, 10, 12, Barcelona, 08028, Spain
- Chair of Biotechnology, RWTH Aachen University, Worringerweg 3, 52074, Aachen, Germany
| | - Mick Gagliardi
- Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Maastricht University, FHML, Universiteitssingel (UNS) 50, Maastricht, 6229ER, The Netherlands
| | - Yannick L Meurer
- DWI - Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, 52074, Aachen, Germany
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, Worringerweg 2, 52074, Aachen, Germany
| | - Yannik Rutsch
- DWI - Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, 52074, Aachen, Germany
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, Worringerweg 2, 52074, Aachen, Germany
| | - Jenny Englert
- DWI - Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, 52074, Aachen, Germany
- Chair of Biotechnology, RWTH Aachen University, Worringerweg 3, 52074, Aachen, Germany
| | - Sandra Philipsen
- Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Maastricht University, FHML, Universiteitssingel (UNS) 50, Maastricht, 6229ER, The Netherlands
| | - Anisa Janem
- Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Maastricht University, FHML, Universiteitssingel (UNS) 50, Maastricht, 6229ER, The Netherlands
| | - Rawan Alsheghri
- Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Maastricht University, FHML, Universiteitssingel (UNS) 50, Maastricht, 6229ER, The Netherlands
| | - Felix Jakob
- DWI - Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, 52074, Aachen, Germany
| | - Daniël G M Molin
- Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Maastricht University, FHML, Universiteitssingel (UNS) 50, Maastricht, 6229ER, The Netherlands
| | - Ulrich Schwaneberg
- DWI - Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, 52074, Aachen, Germany
- Chair of Biotechnology, RWTH Aachen University, Worringerweg 3, 52074, Aachen, Germany
| | - Nynke M S van den Akker
- Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Maastricht University, FHML, Universiteitssingel (UNS) 50, Maastricht, 6229ER, The Netherlands
| | - Cesar Rodriguez-Emmenegger
- DWI - Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, 52074, Aachen, Germany
- Institute for Bioengineering of Catalonia (IBEC), Carrer de Baldiri Reixac, 10, 12, Barcelona, 08028, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Passeig Lluís Companys 23, Barcelona, 08010, Spain
- Biomedical Research Networking, Center in Bioengineering, Biomaterials and Nanomedicine, The Institute of Health Carlos III, Madrid, 28029, Spain
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Kaspiris A, Vasiliadis E, Pantazaka E, Lianou I, Melissaridou D, Savvidis M, Panagopoulos F, Tsalimas G, Vavourakis M, Kolovos I, Savvidou OD, Pneumaticos SG. Current Progress and Future Perspectives in Contact and Releasing-Type Antimicrobial Coatings of Orthopaedic Implants: A Systematic Review Analysis Emanated from In Vitro and In Vivo Models. Infect Dis Rep 2024; 16:298-316. [PMID: 38667751 PMCID: PMC11050497 DOI: 10.3390/idr16020025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/05/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Despite the expanding use of orthopedic devices and the application of strict pre- and postoperative protocols, the elimination of postoperative implant-related infections remains a challenge. Objectives: To identify and assess the in vitro and in vivo properties of antimicrobial-, silver- and iodine-based implants, as well as to present novel approaches to surface modifications of orthopedic implants. Methods: A systematic computer-based review on the development of these implants, on PubMed and Web of Science databases, was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Overall, 31 in vitro and 40 in vivo entries were evaluated. Regarding the in vitro studies, antimicrobial-based coatings were assessed in 12 entries, silver-based coatings in 10, iodine-based in 1, and novel-applied coating technologies in 8 entries. Regarding the in vivo studies, antimicrobial coatings were evaluated in 23 entries, silver-coated implants in 12, and iodine-coated in 1 entry, respectively. The application of novel coatings was studied in the rest of the cases (4). Antimicrobial efficacy was examined using different bacterial strains, and osseointegration ability and biocompatibility were examined in eukaryotic cells and different animal models, including rats, rabbits, and sheep. Conclusions: Assessment of both in vivo and in vitro studies revealed a wide antimicrobial spectrum of the coated implants, related to reduced bacterial growth, inhibition of biofilm formation, and unaffected or enhanced osseointegration, emphasizing the importance of the application of surface modification techniques as an alternative for the treatment of orthopedic implant infections in the clinical settings.
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Affiliation(s)
- Angelos Kaspiris
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Elias Vasiliadis
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Evangelia Pantazaka
- Synthetic Organic Chemistry Laboratory, Department of Chemistry, University of Patras, 26504 Patras, Greece;
| | - Ioanna Lianou
- Department of Orthopedic Surgery, “Rion” University Hospital and Medical School, School of Health Sciences, University of Patras, 26504 Patras, Greece; (I.L.); (F.P.)
| | - Dimitra Melissaridou
- First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Rimini 1, 12462 Athens, Greece; (D.M.); (O.D.S.)
| | - Matthaios Savvidis
- Second Orthopedic Department, 424 General Military Hospital, 56429 Thessaloniki, Greece;
| | - Fotios Panagopoulos
- Department of Orthopedic Surgery, “Rion” University Hospital and Medical School, School of Health Sciences, University of Patras, 26504 Patras, Greece; (I.L.); (F.P.)
| | - Georgios Tsalimas
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Michail Vavourakis
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Ioannis Kolovos
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Olga D. Savvidou
- First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Rimini 1, 12462 Athens, Greece; (D.M.); (O.D.S.)
| | - Spiros G. Pneumaticos
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
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Mirzaali MJ, Zadpoor AA. Orthopedic meta-implants. APL Bioeng 2024; 8:010901. [PMID: 38250670 PMCID: PMC10799688 DOI: 10.1063/5.0179908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Meta-biomaterials, engineered materials with distinctive combinations of mechanical, physical, and biological properties stemming from their micro-architecture, have emerged as a promising domain within biomedical engineering. Correspondingly, meta-implants, which serve as the device counterparts of meta-biomaterials, offer exceptional functionalities, holding great potential for addressing complex skeletal diseases. This paper presents a comprehensive overview of the various types of meta-implants, including hybrid, shape-morphing, metallic clay, and deployable meta-implants, highlighting their unprecedented properties and recent achievement in the field. This paper also delves into the potential future developments of meta-implants, addressing the exploration of multi-functionalities in meta-biomaterials and their applications in diverse biomedical fields.
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Affiliation(s)
- Mohammad J. Mirzaali
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Delft 2628CD, The Netherlands
| | - Amir A. Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Delft 2628CD, The Netherlands
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6
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Wu Y, Li L, Ning Z, Li C, Yin Y, Chen K, Li L, Xu F, Gao J. Autophagy-modulating biomaterials: multifunctional weapons to promote tissue regeneration. Cell Commun Signal 2024; 22:124. [PMID: 38360732 PMCID: PMC10868121 DOI: 10.1186/s12964-023-01346-3] [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: 08/24/2023] [Accepted: 09/29/2023] [Indexed: 02/17/2024] Open
Abstract
Autophagy is a self-renewal mechanism that maintains homeostasis and can promote tissue regeneration by regulating inflammation, reducing oxidative stress and promoting cell differentiation. The interaction between biomaterials and tissue cells significantly affects biomaterial-tissue integration and tissue regeneration. In recent years, it has been found that biomaterials can affect various processes related to tissue regeneration by regulating autophagy. The utilization of biomaterials in a controlled environment has become a prominent approach for enhancing the tissue regeneration capabilities. This involves the regulation of autophagy in diverse cell types implicated in tissue regeneration, encompassing the modulation of inflammatory responses, oxidative stress, cell differentiation, proliferation, migration, apoptosis, and extracellular matrix formation. In addition, biomaterials possess the potential to serve as carriers for drug delivery, enabling the regulation of autophagy by either activating or inhibiting its processes. This review summarizes the relationship between autophagy and tissue regeneration and discusses the role of biomaterial-based autophagy in tissue regeneration. In addition, recent advanced technologies used to design autophagy-modulating biomaterials are summarized, and rational design of biomaterials for providing controlled autophagy regulation via modification of the chemistry and surface of biomaterials and incorporation of cells and molecules is discussed. A better understanding of biomaterial-based autophagy and tissue regeneration, as well as the underlying molecular mechanisms, may lead to new possibilities for promoting tissue regeneration. Video Abstract.
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Affiliation(s)
- Yan Wu
- Heilongjiang Key Laboratory of Tissue Damage and Repair, Mudanjiang Medical University, Mudanjiang, 157000, China
| | - Luxin Li
- Heilongjiang Key Laboratory of Tissue Damage and Repair, Mudanjiang Medical University, Mudanjiang, 157000, China
| | - Zuojun Ning
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Changrong Li
- Heilongjiang Key Laboratory of Tissue Damage and Repair, Mudanjiang Medical University, Mudanjiang, 157000, China
| | - Yongkui Yin
- Heilongjiang Key Laboratory of Tissue Damage and Repair, Mudanjiang Medical University, Mudanjiang, 157000, China
| | - Kaiyuan Chen
- Heilongjiang Key Laboratory of Tissue Damage and Repair, Mudanjiang Medical University, Mudanjiang, 157000, China
| | - Lu Li
- Department of plastic surgery, Naval Specialty Medical Center of PLA, Shanghai, 200052, China.
| | - Fei Xu
- Department of plastic surgery, Naval Specialty Medical Center of PLA, Shanghai, 200052, China.
| | - Jie Gao
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200433, China.
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7
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Zhao Q, Ni Y, Wei H, Duan Y, Chen J, Xiao Q, Gao J, Yu Y, Cui Y, Ouyang S, Miron RJ, Zhang Y, Wu C. Ion incorporation into bone grafting materials. Periodontol 2000 2024; 94:213-230. [PMID: 37823468 DOI: 10.1111/prd.12533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
The use of biomaterials in regenerative medicine has expanded to treat various disorders caused by trauma or disease in orthopedics and dentistry. However, the treatment of large and complex bone defects presents a challenge, leading to a pressing need for optimized biomaterials for bone repair. Recent advances in chemical sciences have enabled the incorporation of therapeutic ions into bone grafts to enhance their performance. These ions, such as strontium (for bone regeneration/osteoporosis), copper (for angiogenesis), boron (for bone growth), iron (for chemotaxis), cobalt (for B12 synthesis), lithium (for osteogenesis/cementogenesis), silver (for antibacterial resistance), and magnesium (for bone and cartilage regeneration), among others (e.g., zinc, sodium, and silica), have been studied extensively. This review aims to provide a comprehensive overview of current knowledge and recent developments in ion incorporation into biomaterials for bone and periodontal tissue repair. It also discusses recently developed biomaterials from a basic design and clinical application perspective. Additionally, the review highlights the importance of precise ion introduction into biomaterials to address existing limitations and challenges in combination therapies. Future prospects and opportunities for the development and optimization of biomaterials for bone tissue engineering are emphasized.
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Affiliation(s)
- Qin Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Yueqi Ni
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Hongjiang Wei
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Yiling Duan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Jingqiu Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Qi Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Jie Gao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Yiqian Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Yu Cui
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Simin Ouyang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Chengtie Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, China
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8
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Yu A, Zhu M, Chen C, Li Y, Cui H, Liu S, Zhao Q. Implantable Flexible Sensors for Health Monitoring. Adv Healthc Mater 2024; 13:e2302460. [PMID: 37816513 DOI: 10.1002/adhm.202302460] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/05/2023] [Indexed: 10/12/2023]
Abstract
Flexible sensors, as a significant component of flexible electronics, have attracted great interest the realms of human-computer interaction and health monitoring due to their high conformability, adjustable sensitivity, and excellent durability. In comparison to wearable sensor-based in vitro health monitoring, the use of implantable flexible sensors (IFSs) for in vivo health monitoring offers more accurate and reliable vital sign information due to their ability to adapt and directly integrate with human tissue. IFSs show tremendous promise in the field of health monitoring, with unique advantages such as robust signal reading capabilities, lightweight design, flexibility, and biocompatibility. Herein, a review of IFSs for vital signs monitoring is detailly provided, highlighting the essential conditions for in vivo applications. As the prerequisites of IFSs, the stretchability and wireless self-powered properties of the sensor are discussed, with a special attention paid to the sensing materials which can maintain prominent biosafety (i.e., biocompatibility, biodegradability, bioresorbability). Furthermore, the applications of IFSs monitoring various parts of the body are described in detail, with a summary in brain monitoring, eye monitoring, and blood monitoring. Finally, the challenges as well as opportunities in the development of next-generation IFSs are presented.
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Affiliation(s)
- Aoxi Yu
- College of Electronic and Optical Engineering, and College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, 9 Wenyuan, Nanjing, 210023, P. R. China
| | - Mingye Zhu
- State Key Laboratory of Organic Electronics and Information Displays, and Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Nanjing University of Posts and Telecommunications, 9 Wenyuan Road, Nanjing, 210023, P. R. China
| | - Congkai Chen
- State Key Laboratory of Organic Electronics and Information Displays, and Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Nanjing University of Posts and Telecommunications, 9 Wenyuan Road, Nanjing, 210023, P. R. China
| | - Yang Li
- College of Electronic and Optical Engineering, and College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, 9 Wenyuan, Nanjing, 210023, P. R. China
| | - Haixia Cui
- State Key Laboratory of Organic Electronics and Information Displays, and Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Nanjing University of Posts and Telecommunications, 9 Wenyuan Road, Nanjing, 210023, P. R. China
| | - Shujuan Liu
- State Key Laboratory of Organic Electronics and Information Displays, and Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Nanjing University of Posts and Telecommunications, 9 Wenyuan Road, Nanjing, 210023, P. R. China
| | - Qiang Zhao
- College of Electronic and Optical Engineering, and College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, 9 Wenyuan, Nanjing, 210023, P. R. China
- State Key Laboratory of Organic Electronics and Information Displays, and Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Nanjing University of Posts and Telecommunications, 9 Wenyuan Road, Nanjing, 210023, P. R. China
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9
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van Hengel IAJ, van Dijk B, Modaresifar K, Hooning van Duyvenbode JFF, Nurmohamed FRHA, Leeflang MA, Fluit AC, Fratila-Apachitei LE, Apachitei I, Weinans H, Zadpoor AA. In Vivo Prevention of Implant-Associated Infections Caused by Antibiotic-Resistant Bacteria through Biofunctionalization of Additively Manufactured Porous Titanium. J Funct Biomater 2023; 14:520. [PMID: 37888185 PMCID: PMC10607138 DOI: 10.3390/jfb14100520] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/09/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023] Open
Abstract
Additively manufactured (AM) porous titanium implants may have an increased risk of implant-associated infection (IAI) due to their huge internal surfaces. However, the same surface, when biofunctionalized, can be used to prevent IAI. Here, we used a rat implant infection model to evaluate the biocompatibility and infection prevention performance of AM porous titanium against bioluminescent methicillin-resistant Staphylococcus aureus (MRSA). The specimens were biofunctionalized with Ag nanoparticles (NPs) using plasma electrolytic oxidation (PEO). Infection was initiated using either intramedullary injection in vivo or with in vitro inoculation of the implant prior to implantation. Nontreated (NT) implants were compared with PEO-treated implants with Ag NPs (PT-Ag), without Ag NPs (PT) and infection without an implant. After 7 days, the bacterial load and bone morphological changes were evaluated. When infection was initiated through in vivo injection, the presence of the implant did not enhance the infection, indicating that this technique may not assess the prevention but rather the treatment of IAIs. Following in vitro inoculation, the bacterial load on the implant and in the peri-implant bony tissue was reduced by over 90% for the PT-Ag implants compared to the PT and NT implants. All infected groups had enhanced osteomyelitis scores compared to the noninfected controls.
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Affiliation(s)
- Ingmar Aeneas Jan van Hengel
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands (I.A.); (H.W.); (A.A.Z.)
| | - Bruce van Dijk
- Department of Orthopedics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Khashayar Modaresifar
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands (I.A.); (H.W.); (A.A.Z.)
| | | | | | - Marius Alexander Leeflang
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands (I.A.); (H.W.); (A.A.Z.)
| | - Adriaan Camille Fluit
- Department of Medical Microbiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Lidy Elena Fratila-Apachitei
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands (I.A.); (H.W.); (A.A.Z.)
| | - Iulian Apachitei
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands (I.A.); (H.W.); (A.A.Z.)
| | - Harrie Weinans
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands (I.A.); (H.W.); (A.A.Z.)
- Department of Orthopedics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Amir Abbas Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands (I.A.); (H.W.); (A.A.Z.)
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10
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Garmendia Urdalleta A, Van Poll M, Fahy N, Witte-Bouma J, Van Wamel W, Apachitei I, Zadpoor AA, Fratila-Apachitei LE, Farrell E. The response of human macrophages to 3D printed titanium antibacterial implants does not affect the osteogenic differentiation of hMSCs. Front Bioeng Biotechnol 2023; 11:1176534. [PMID: 37415788 PMCID: PMC10319998 DOI: 10.3389/fbioe.2023.1176534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
Macrophage responses following the implantation of orthopaedic implants are essential for successful implant integration in the body, partly through intimate crosstalk with human marrow stromal cells (hMSCs) in the process of new bone formation. Additive manufacturing (AM) and plasma electrolytic oxidation (PEO) in the presence of silver nanoparticles (AgNPs) are promising techniques to achieve multifunctional titanium implants. Their osteoimmunomodulatory properties are, however, not yet fully investigated. Here, we studied the effects of implants with AgNPs on human macrophages and the crosstalk between hMSCs and human macrophages when co-cultured in vitro with biofunctionalised AM Ti6Al4V implants. A concentration of 0.3 g/L AgNPs in the PEO electrolyte was found to be optimal for both macrophage viability and inhibition of bacteria growth. These specimens also caused a decrease of the macrophage tissue repair related factor C-C Motif Chemokine Ligand 18 (CCL18). Nevertheless, co-cultured hMSCs could osteogenically differentiate without any adverse effects caused by the presence of macrophages that were previously exposed to the PEO (±AgNPs) surfaces. Further evaluation of these promising implants in a bony in vivo environment with and without infection is highly recommended to prove their potential for clinical use.
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Affiliation(s)
- Amaia Garmendia Urdalleta
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, TU Delft, Delft, Netherlands
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Mathijs Van Poll
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, TU Delft, Delft, Netherlands
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Niamh Fahy
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Orthopaedics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Applied Science, Technological University of the Shannon: Midlands Midwest, Limerick, Ireland
| | - Janneke Witte-Bouma
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Willem Van Wamel
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Iulian Apachitei
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, TU Delft, Delft, Netherlands
| | - Amir A. Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, TU Delft, Delft, Netherlands
| | - Lidy E. Fratila-Apachitei
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, TU Delft, Delft, Netherlands
| | - Eric Farrell
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
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11
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Cecotto L, Stapels DAC, van Kessel KPM, Croes M, Lourens Z, Vogely HC, van der Wal BCH, van Strijp JAG, Weinans H, Amin Yavari S. Evaluation of silver bio-functionality in a multicellular in vitro model: towards reduced animal usage in implant-associated infection research. Front Cell Infect Microbiol 2023; 13:1186936. [PMID: 37342248 PMCID: PMC10277478 DOI: 10.3389/fcimb.2023.1186936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/16/2023] [Indexed: 06/22/2023] Open
Abstract
Background Despite the extensive use of silver ions or nanoparticles in research related to preventing implant-associated infections (IAI), their use in clinical practice has been debated. This is because the strong antibacterial properties of silver are counterbalanced by adverse effects on host cells. One of the reasons for this may be the lack of comprehensive in vitro models that are capable of analyzing host-bacteria and host-host interactions. Methods and results In this study, we tested silver efficacy through multicellular in vitro models involving macrophages (immune system), mesenchymal stem cells (MSCs, bone cells), and S. aureus (pathogen). Our model showed to be capable of identifying each element of culture as well as tracking the intracellular survival of bacteria. Furthermore, the model enabled to find a therapeutic window for silver ions (AgNO3) and silver nanoparticles (AgNPs) where the viability of host cells was not compromised, and the antibacterial properties of silver were maintained. While AgNO3 between 0.00017 and 0.017 µg/mL retained antibacterial properties, host cell viability was not affected. The multicellular model, however, demonstrated that those concentrations had no effect on the survival of S. aureus, inside or outside host cells. Similarly, treatment with 20 nm AgNPs did not influence the phagocytic and killing capacity of macrophages or prevent S. aureus from invading MSCs. Moreover, exposure to 100 nm AgNPs elicited an inflammatory response by host cells as detected by the increased production of TNF-α and IL-6. This was visible only when macrophages and MSCs were cultured together. Conclusions Multicellular in vitro models such as the one used here that simulate complex in vivo scenarios can be used to screen other therapeutic compounds or antibacterial biomaterials without the need to use animals.
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Affiliation(s)
- Leonardo Cecotto
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Daphne A. C. Stapels
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
- Infection Biology Group, Department of Biomolecular Health Sciences, Utrecht University, Utrecht, Netherlands
| | - Kok P. M. van Kessel
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Michiel Croes
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Zeldali Lourens
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - H. Charles Vogely
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Jos A. G. van Strijp
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Harrie Weinans
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| | - Saber Amin Yavari
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
- Regenerative Medicine Centre Utrecht, Utrecht University, Utrecht, Netherlands
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Chen H, Feng R, Xia T, Wen Z, Li Q, Qiu X, Huang B, Li Y. Progress in Surface Modification of Titanium Implants by Hydrogel Coatings. Gels 2023; 9:gels9050423. [PMID: 37233014 DOI: 10.3390/gels9050423] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
Although titanium and titanium alloys have become the preferred materials for various medical implants, surface modification technology still needs to be strengthened in order to adapt to the complex physiological environment of the human body. Compared with physical or chemical modification methods, biochemical modification, such as the introduction of functional hydrogel coating on implants, can fix biomolecules such as proteins, peptides, growth factors, polysaccharides, or nucleotides on the surface of the implants, so that they can directly participate in biological processes; regulate cell adhesion, proliferation, migration, and differentiation; and improve the biological activity on the surface of the implants. This review begins with a look at common substrate materials for hydrogel coatings on implant surfaces, including natural polymers such as collagen, gelatin, chitosan, and alginate, and synthetic materials such as polyvinyl alcohol, polyacrylamide, polyethylene glycol, and polyacrylic acid. Then, the common construction methods of hydrogel coating (electrochemical method, sol-gel method and layer-by-layer self-assembly method) are introduced. Finally, five aspects of the enhancement effect of hydrogel coating on the surface bioactivity of titanium and titanium alloy implants are described: osseointegration, angiogenesis, macrophage polarization, antibacterial effects, and drug delivery. In this paper, we also summarize the latest research progress and point out the future research direction. After searching, no previous relevant literature reporting this information was found.
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Affiliation(s)
- Huangqin Chen
- Department of Stomatology, School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China
| | - Rui Feng
- Department of Stomatology, School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China
| | - Tian Xia
- Department of Stomatology, School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China
| | - Zhehan Wen
- Department of Stomatology, School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China
| | - Qing Li
- Department of Stomatology, School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China
| | - Xin Qiu
- Department of Stomatology, School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China
| | - Bin Huang
- Department of Stomatology, School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China
| | - Yuesheng Li
- Hubei Key Laboratory of Radiation Chemistry and Functional Materials, Non-Power Nuclear Technology Collaborative Innovation Center, Hubei University of Science and Technology, Xianning 437100, China
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13
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Gao W, Han X, Sun D, Li Y, Liu X, Yang S, Zhou Z, Qi Y, Jiao J, Zhao J. Antibacterial properties of antimicrobial peptide HHC36 modified polyetheretherketone. Front Microbiol 2023; 14:1103956. [PMID: 36998411 PMCID: PMC10043374 DOI: 10.3389/fmicb.2023.1103956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/22/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionPolyetheretherketone (PEEK) is considered to be a new type of orthopedic implant material due to its mechanical properties and biocompatibility. It is becoming a replacement for titanium (Ti) due to its near-human-cortical transmission and modulus of elasticity. However, its clinical application is limited because of its biological inertia and susceptibility to bacterial infection during implantation. To solve this problem, there is an urgent need to improve the antibacterial properties of PEEK implants.MethodsIn this work, we fixed antimicrobial peptide HHC36 on the 3D porous structure of sulfonated PEEK (SPEEK) by a simple solvent evaporation method (HSPEEK), and carried out characterization tests. We evaluated the antibacterial properties and cytocompatibility of the samples in vitro. In addition, we evaluated the anti-infection property and biocompatibility of the samples in vivo by establishing a rat subcutaneous infection model.ResultsThe characterization test results showed that HHC36 was successfully fixed on the surface of SPEEK and released slowly for 10 days. The results of antibacterial experiments in vitro showed that HSPEEK could reduce the survival rate of free bacteria, inhibit the growth of bacteria around the sample, and inhibit the formation of biofilm on the sample surface. The cytocompatibility test in vitro showed that the sample had no significant effect on the proliferation and viability of L929 cells and had no hemolytic activity on rabbit erythrocytes. In vivo experiments, HSPEEK can significantly reduce the bacterial survival rate on the sample surface and the inflammatory reaction in the soft tissue around the sample.DiscussionWe successfully loaded HHC36 onto the surface of SPEEK through a simple solvent evaporation method. The sample has excellent antibacterial properties and good cell compatibility, which can significantly reduce the bacterial survival rate and inflammatory reaction in vivo. The above results indicated that we successfully improved the antibacterial property of PEEK by a simple modification strategy, making it a promising material for anti-infection orthopedic implants.
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Affiliation(s)
- Weijia Gao
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Xiao Han
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Duo Sun
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Yongli Li
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Xiaoli Liu
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Shihui Yang
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Department of Prostheses, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Zhe Zhou
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Yuanzheng Qi
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Junjie Jiao
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Jinghui Zhao
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
- *Correspondence: Jinghui Zhao,
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14
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Piñera-Avellaneda D, Buxadera-Palomero J, Ginebra MP, Calero JA, Manero JM, Rupérez E. Surface competition between osteoblasts and bacteria on silver-doped bioactive titanium implant. BIOMATERIALS ADVANCES 2023; 146:213311. [PMID: 36709627 DOI: 10.1016/j.bioadv.2023.213311] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
The rapid integration in the bone tissue and the prevention of bacterial infection are key for the success of the implant. In this regard, a silver (Ag)-doped thermochemical treatment that generate an Ag-doped calcium titanate layer on titanium (Ti) implants was previously developed by our group to improve the bone-bonding ability and provide antibacterial activity. In the present study, the biological and antibacterial potential of this coating has been further studied. In order to prove that the Ag-doped layer has an antibacterial effect with no detrimental effect on the bone cells, the behavior of osteoblast-like cells in terms of cell adhesion, morphology, proliferation and differentiation was evaluated, and the biofilm inhibition capacity was assessed. Moreover, the competition by the surface between cell and bacteria was carried out in two different co-culture methods. Finally, the treatment was applied to porous Ti implants to study in vivo osteointegration. The results show that the incorporation of Ag inhibits the biofilm formation and has no effect on the performance of osteoblast-like cells. Therefore, it can be concluded that the Ag-doped surface is capable of preventing bone bacterial infection and providing suitable osseointegration.
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Affiliation(s)
- David Piñera-Avellaneda
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019 Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034 Barcelona, Spain.
| | - Judit Buxadera-Palomero
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019 Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034 Barcelona, Spain
| | - María-Pau Ginebra
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019 Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034 Barcelona, Spain; Institute for Bioengineering of Catalonia (IBEC), 08028 Barcelona, Spain
| | - José A Calero
- AMES GROUP, 08980 Sant Feliu de Llobregat, Barcelona, Spain
| | - José María Manero
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019 Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034 Barcelona, Spain
| | - Elisa Rupérez
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019 Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034 Barcelona, Spain
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15
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Li H, Wang D, Zhang W, Xu G, Xu C, Liu W, Li J. Potential side effects of antibacterial coatings in orthopaedic implants: A systematic review of clinical studies. Front Bioeng Biotechnol 2023; 11:1111386. [PMID: 36845182 PMCID: PMC9947536 DOI: 10.3389/fbioe.2023.1111386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
Objective: The systematic review aimed to determine the potential side effects of antibacterial coatings in orthopaedic implants. Methods: Publications were searched in the databases of Embase, PubMed, Web of Science and Cochrane Library using predetermined keywords up to 31 October 2022. Clinical studies reporting side effects of the surface or coating materials were included. Results: A total of 23 studies (20 cohort studies and three case reports) reporting the concerns about the side effects of antibacterial coatings were identified. Three types of coating materials, silver, iodine and gentamicin were included. All of studies raised the concerns regarding safety of antibacterial coatings, and the occurrence of adverse events was observed in seven studies. The main side effect of silver coatings was the development of argyria. For iodine coatings, only one anaphylactic case was reported as an adverse event. No systemic or other general side effects were reported for gentamicin. Conclusion: Clinical studies on the side effects of antibacterial coatings were limited. Based on the available outcomes, the most reported side effects of antibacterial coatings in clinical use were argyria with silver coatings. However, researchers should always pay attention to the potential side effects of antibacterial materials, such as systematic or local toxicity and allergy.
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Affiliation(s)
- Hua Li
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China
| | - Daofeng Wang
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China
| | - Wupeng Zhang
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China,School of Medicine, Nankai University, Tianjin, China
| | - Gaoxiang Xu
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China
| | - Cheng Xu
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China,*Correspondence: Cheng Xu, ; Wanheng Liu, ; Jiantao Li,
| | - Wanheng Liu
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China,*Correspondence: Cheng Xu, ; Wanheng Liu, ; Jiantao Li,
| | - Jiantao Li
- Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China,*Correspondence: Cheng Xu, ; Wanheng Liu, ; Jiantao Li,
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16
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Recent Advancements in Metallic Drug-Eluting Implants. Pharmaceutics 2023; 15:pharmaceutics15010223. [PMID: 36678852 PMCID: PMC9862589 DOI: 10.3390/pharmaceutics15010223] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Over the past decade, metallic drug-eluting implants have gained significance in orthopedic and dental applications for controlled drug release, specifically for preventing infection associated with implants. Recent studies showed that metallic implants loaded with drugs were substituted for conventional bare metal implants to achieve sustained and controlled drug release, resulting in a desired local therapeutic concentration. A number of secondary features can be provided by the incorporated active molecules, including the promotion of osteoconduction and angiogenesis, the inhibition of bacterial invasion, and the modulation of host body reaction. This paper reviews recent trends in the development of the metallic drug-eluting implants with various drug delivery systems in the past three years. There are various types of drug-eluting implants that have been developed to meet this purpose, depending on the drug or agents that have been loaded on them. These include anti-inflammatory drugs, antibiotics agents, growth factors, and anti-resorptive drugs.
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Alipour S, Nour S, Attari SM, Mohajeri M, Kianersi S, Taromian F, Khalkhali M, Aninwene GE, Tayebi L. A review on in vitro/ in vivo response of additively manufactured Ti-6Al-4V alloy. J Mater Chem B 2022; 10:9479-9534. [PMID: 36305245 DOI: 10.1039/d2tb01616h] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Bone replacement using porous and solid metallic implants, such as Ti-alloy implants, is regarded as one of the most practical therapeutic approaches in biomedical engineering. The bone is a complex tissue with various mechanical properties based on the site of action. Patient-specific Ti-6Al-4V constructs may address the key needs in bone treatment for having customized implants that mimic the complex structure of the natural tissue and diminish the risk of implant failure. This review focuses on the most promising methods of fabricating such patient-specific Ti-6Al-4V implants using additive manufacturing (AM) with a specific emphasis on the popular subcategory, which is powder bed fusion (PBF). Characteristics of the ideal implant to promote optimized tissue-implant interactions, as well as physical, mechanical/chemical treatments and modifications will be discussed. Accordingly, such investigations will be classified into 3B-based approaches (Biofunctionality, Bioactivity, and Biostability), which mainly govern native body response and ultimately the success in implantation.
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Affiliation(s)
- Saeid Alipour
- Department of Materials Science and Engineering, Missouri University of Science and Technology, Rolla, MO 65409, USA
| | - Shirin Nour
- Tissue Engineering Group, Department of Biomedical Engineering, University of Melbourne, VIC 3010, Australia.,Polymer Science Group, Department of Chemical Engineering, University of Melbourne, VIC 3010, Australia
| | - Seyyed Morteza Attari
- Department of Material Science and Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Mohammad Mohajeri
- Department of Biomedical Engineering, College of Engineering, Texas A&M University, TX, USA
| | - Sogol Kianersi
- CÚRAM, SFI Centre for Research in Medical Devices, Biomedical Sciences, University of Galway, Galway, Ireland
| | - Farzaneh Taromian
- Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| | - Mohammadparsa Khalkhali
- Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| | - George E Aninwene
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences, University of California-Los Angeles, Los Angeles, California, USA.,Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, Los Angeles, California, USA.,California NanoSystems Institute (CNSI), University of California-Los Angeles, Los Angeles, California, USA
| | - Lobat Tayebi
- School of Dentistry, Marquette University, Milwaukee, Wisconsin, USA.
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18
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Li S, Cui Y, Liu H, Tian Y, Wang G, Fan Y, Wang J, Wu D, Wang Y. Application of bioactive metal ions in the treatment of bone defects. J Mater Chem B 2022; 10:9369-9388. [PMID: 36378123 DOI: 10.1039/d2tb01684b] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The treatment of bone defects is an important problem in clinical practice. The rapid development of bone tissue engineering (BTE) may provide a new method for bone defect treatment. Metal ions have been widely studied in BTE and demonstrated a significant effect in promoting bone tissue growth. Different metal ions can be used to treat bone defects according to specific conditions, including promoting osteogenic activity, inhibiting osteoclast activity, promoting vascular growth, and exerting certain antibacterial effects. Multiple studies have confirmed that metal ions-modified composite scaffolds can effectively promote bone defect healing. By studying current extensive research on metal ions in the treatment of bone defects, this paper reviews the mechanism of metal ions in promoting bone tissue growth, analyzes the loading mode of metal ions, and lists some specific applications of metal ions in different types of bone defects. Finally, this paper summarizes the advantages and disadvantages of metal ions and analyzes the future research trend of metal ions in BTE. This article can provide some new strategies and methods for future research and applications of metal ions in the treatment of bone defects.
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Affiliation(s)
- Shaorong Li
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China.
| | - Yutao Cui
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China.
| | - He Liu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China.
| | - Yuhang Tian
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China.
| | - Gan Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China.
| | - Yi Fan
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China.
| | - Jingwei Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China.
| | - Dankai Wu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China.
| | - Yanbing Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China.
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Chen X, Bi Y, Huang M, Cao H, Qin H. Why Is Tantalum Less Susceptible to Bacterial Infection? J Funct Biomater 2022; 13:jfb13040264. [PMID: 36547523 PMCID: PMC9781538 DOI: 10.3390/jfb13040264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/23/2022] Open
Abstract
Periprosthetic infection is one of the trickiest clinical problems, which often leads to disastrous consequences. The emergence of tantalum and its derivatives provides novel ideas and effective methods to solve this problem and has attracted great attention. However, tantalum was reported to have different anti-infective effects in vivo and in vitro, and the inherent antibacterial capability of tantalum is still controversial, which may restrict its development as an antibacterial material to some extent. In this study, the polished tantalum was selected as the experimental object, the implant-related tibia osteomyelitis model was first established to observe whether it has an anti-infective effect in vivo compared to titanium, and the early studies found that the tantalum had a lower infectious state in the implant-related tibia osteomyelitis model in vivo than titanium. However, further in vitro studies found that the polished tantalum was not superior to the titanium against bacterial adhesion and antibacterial efficacy. In addition, we focus on the state of interaction between cells, bacteria and materials to restore the internal environment as realistically as possible. We found that the adhesion of fibroblasts to tantalum was faster and better than that of titanium. Moreover, what is more, interesting is that, in the early period, bacteria were more likely to adhere to cells that had already attached to the surface of tantalum than to the bare surface of it, and over time, the cells eventually fell off the biomaterials and took away more bacteria in tantalum, making it possible for tantalum to reduce the probability of infection in the body through this mechanism. Moreover, these results also explained the phenomenon of the "race for the surface" from a completely different perspective. This study provides a new idea for further exploring the relationship between bacteria and host tissue cells on the implant surface and a meaningful clue for optimizing the preparation of antibacterial implants in the future.
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Affiliation(s)
- Xin Chen
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
- Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
| | - Yikang Bi
- Department of Orthopedics, The Eighth People’s Hospital, Jiang Su University, Shanghai 200235, China
- Department of Orthopedics, Xuhui Branch of Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200235, China
| | - Moran Huang
- Department of Orthopedic Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China
| | - Huiliang Cao
- Interfacial Electrochemistry and Biomaterials, Lab of Low-Dimensional Materials Chemistry, Key Laboratory for Ultrafine Materials of Ministry of Education, Shanghai Engineering Research Center of Hierarchical Nanomaterials, School of Materials Science and Engineering, East China University of Science & Technology, Shanghai 200237, China
- Correspondence: (H.C.); (H.Q.)
| | - Hui Qin
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
- Correspondence: (H.C.); (H.Q.)
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20
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Xie H, Liu Y, An H, Yi J, Li C, Wang X, Chai W. Recent advances in prevention, detection and treatment in prosthetic joint infections of bioactive materials. Front Bioeng Biotechnol 2022; 10:1053399. [PMID: 36440438 PMCID: PMC9685530 DOI: 10.3389/fbioe.2022.1053399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 10/31/2022] [Indexed: 11/07/2023] Open
Abstract
Prosthetic joint infection (PJI) is often considered as one of the most common but catastrophic complications after artificial joint replacement, which can lead to surgical failure, revision, amputation and even death. It has become a worldwide problem and brings great challenges to public health systems. A small amount of microbe attaches to the graft and forms a biofilm on its surface, which lead to the PJI. The current standard methods of treating PJI have limitations, but according to recent reports, bioactive materials have potential research value as a bioactive substance that can have a wide range of applications in the field of PJI. These include the addition of bioactive materials to bone cement, the use of antibacterial and anti-fouling materials for prosthetic coatings, the use of active materials such as bioactive glasses, protamine, hydrogels for prophylaxis and detection with PH sensors and fluorescent-labelled nanoparticles, and the use of antibiotic hydrogels and targeting delivery vehicles for therapeutic purposes. This review focus on prevention, detection and treatment in joint infections with bioactive materials and provide thoughts and ideas for their future applications.
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Affiliation(s)
- Hongbin Xie
- Senior Department of Orthopedics, Fourth Medical Center of People’s Liberation Army General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
- National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Yubo Liu
- Senior Department of Orthopedics, Fourth Medical Center of People’s Liberation Army General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
- National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Haoming An
- Senior Department of Orthopedics, Fourth Medical Center of People’s Liberation Army General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
- National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Jiafeng Yi
- Senior Department of Orthopedics, Fourth Medical Center of People’s Liberation Army General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
- National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Chao Li
- Senior Department of Orthopedics, Fourth Medical Center of People’s Liberation Army General Hospital, Beijing, China
- National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Xing Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Wei Chai
- Senior Department of Orthopedics, Fourth Medical Center of People’s Liberation Army General Hospital, Beijing, China
- National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
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21
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Putra NE, Leeflang MA, Ducret V, Patrulea V, Fratila-Apachitei LE, Perron K, Ye H, Zhou J, Apachitei I, Zadpoor AA. Preventing Antibiotic-Resistant Infections: Additively Manufactured Porous Ti6Al4V Biofunctionalized with Ag and Fe Nanoparticles. Int J Mol Sci 2022; 23:13239. [PMID: 36362029 PMCID: PMC9654018 DOI: 10.3390/ijms232113239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 08/20/2024] Open
Abstract
Implant-associated infections are highly challenging to treat, particularly with the emergence of multidrug-resistant microbials. Effective preventive action is desired to be at the implant site. Surface biofunctionalization of implants through Ag-doping has demonstrated potent antibacterial results. However, it may adversely affect bone regeneration at high doses. Benefiting from the potential synergistic effects, combining Ag with other antibacterial agents can substantially decrease the required Ag concentration. To date, no study has been performed on immobilizing both Ag and Fe nanoparticles (NPs) on the surface of additively manufactured porous titanium. We additively manufactured porous titanium and biofunctionalized its surface with plasma electrolytic oxidation using a Ca/P-based electrolyte containing Fe NPs, Ag NPs, and the combinations. The specimen's surface morphology featured porous TiO2 bearing Ag and Fe NPs. During immersion, Ag and Fe ions were released for up to 28 days. Antibacterial assays against methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa showed that the specimens containing Ag NPs and Ag/Fe NPs exhibit bactericidal activity. The Ag and Fe NPs worked synergistically, even when Ag was reduced by up to three times. The biofunctionalized scaffold reduced Ag and Fe NPs, improving preosteoblasts proliferation and Ca-sensing receptor activation. In conclusion, surface biofunctionalization of porous titanium with Ag and Fe NPs is a promising strategy to prevent implant-associated infections and allow bone regeneration and, therefore, should be developed for clinical application.
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Affiliation(s)
- Niko E. Putra
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Marius A. Leeflang
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Verena Ducret
- Microbiology Unit, Department of Botany and Plant Biology, University of Geneva, 30 Quai Ernest-Ansermet, 1211 Geneva, Switzerland
| | - Viorica Patrulea
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX3 7DQ, UK
| | - Lidy E. Fratila-Apachitei
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Karl Perron
- Microbiology Unit, Department of Botany and Plant Biology, University of Geneva, 30 Quai Ernest-Ansermet, 1211 Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
- Section of Pharmaceutical Sciences, University of Geneva, 1 Rue Michel Servet, 1211 Geneva, Switzerland
| | - Hua Ye
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX3 7DQ, UK
| | - Jie Zhou
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Iulian Apachitei
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Amir A. Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
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22
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Kim SK, Murugan SS, Dalavi PA, Gupta S, Anil S, Seong GH, Venkatesan J. Biomimetic chitosan with biocomposite nanomaterials for bone tissue repair and regeneration. BEILSTEIN JOURNAL OF NANOTECHNOLOGY 2022; 13:1051-1067. [PMID: 36247529 PMCID: PMC9531556 DOI: 10.3762/bjnano.13.92] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
Biomimetic materials for better bone graft substitutes are a thrust area of research among researchers and clinicians. Autografts, allografts, and synthetic grafts are often utilized to repair and regenerate bone defects. Autografts are still considered the gold-standard method/material to treat bone-related issues with satisfactory outcomes. It is important that the material used for bone tissue repair is simultaneously osteoconductive, osteoinductive, and osteogenic. To overcome this problem, researchers have tried several ways to develop different materials using chitosan-based nanocomposites of silver, copper, gold, zinc oxide, titanium oxide, carbon nanotubes, graphene oxide, and biosilica. The combination of materials helps in the expression of ideal bone formation genes of alkaline phosphatase, bone morphogenic protein, runt-related transcription factor-2, bone sialoprotein, and osteocalcin. In vitro and in vivo studies highlight the scientific findings of antibacterial activity, tissue integration, stiffness, mechanical strength, and degradation behaviour of composite materials for tissue engineering applications.
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Affiliation(s)
- Se-Kwon Kim
- Department of Marine Science and Convergence Engineering, College of Science and Technology, Hanyang University, Gyeonggi-do 11558, Korea
| | - Sesha Subramanian Murugan
- Biomaterials Research Laboratory, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, Karnataka 575018, India
| | - Pandurang Appana Dalavi
- Biomaterials Research Laboratory, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, Karnataka 575018, India
| | - Sebanti Gupta
- Biomaterials Research Laboratory, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, Karnataka 575018, India
| | - Sukumaran Anil
- Department of Dentistry, Oral Health Institute, Hamad Medical Corporation, College of Dental Medicine, Qatar University, Doha, Qatar
| | - Gi Hun Seong
- Department of Bionano Engineering, Center for Bionano Intelligence Education and Research, Hanyang University, Ansan 426-791, South Korea
| | - Jayachandran Venkatesan
- Biomaterials Research Laboratory, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, Karnataka 575018, India
- Department of Bionano Engineering, Center for Bionano Intelligence Education and Research, Hanyang University, Ansan 426-791, South Korea
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23
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Lu L, Zhang J, Guan K, Zhou J, Yuan F, Guan Y. Artificial neural network for cytocompatibility and antibacterial enhancement induced by femtosecond laser micro/nano structures. J Nanobiotechnology 2022; 20:365. [PMID: 35933376 PMCID: PMC9357338 DOI: 10.1186/s12951-022-01578-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/25/2022] [Indexed: 01/04/2023] Open
Abstract
The failure of orthopedic and dental implants is mainly caused by biomaterial-associated infections and poor osseointegration. Surface modification of biomedical materials plays a significant role in enhancing osseointegration and anti-bacterial infection. In this work, a non-linear relationship between the micro/nano surface structures and the femtosecond laser processing parameters was successfully established based on an artificial neural network. Then a controllable functional surface with silver nanoparticles (AgNPs) to was produced to improve the cytocompatibility and antibacterial properties of biomedical titanium alloy. The surface topography, wettability, and Ag+ release were carefully investigated. The effects of these characteristics on antibacterial activity and cytocompatibilty were also evaluated. Results show that the prepared surface is hydrophobic, which can prevent the burst release of Ag+ in the initial stage. The prepared surface also shows both good cytocompatibility toward the murine calvarial preosteoblasts MC3T3-E1 cells (derived from Mus musculus (mouse) calvaria) and good antibacterial effects against Gram-negative (E. coli) and Gram-positive (S. aureus) bacteria, which is caused by the combined effect of appropriate micro/nano-structured feature and reasonable Ag+ release rate. We do not only clarify the antibacterial mechanism but also demonstrate the possibility of balancing the antibacterial and osteointegration-promoting properties by micro/nano-structures. The reported method offers an effective strategy for the patterned surface modification of implants.
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Affiliation(s)
- Libin Lu
- Advanced Manufacturing Center, Ningbo Institute of Technology, Beihang University, Ningbo, 315100, China
| | - Jiaru Zhang
- School of Mechanical Engineering & Automation, Beihang University, Beijing, 100083, China
| | - Kai Guan
- Department of Radiotherapy, The Third Hospital of Zhangzhou City, Zhangzhou, 363005, Fujian, China
| | - Jin Zhou
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China.
| | - Fusong Yuan
- National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, 100081, China
| | - Yingchun Guan
- Advanced Manufacturing Center, Ningbo Institute of Technology, Beihang University, Ningbo, 315100, China. .,School of Mechanical Engineering & Automation, Beihang University, Beijing, 100083, China. .,National Engineering Laboratory of Additive Manufacturing for Large Metallic Components, Beihang University, 37 Xueyuan Road, Beijing, 100083, China.
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24
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Polymer–Metal Composite Healthcare Materials: From Nano to Device Scale. JOURNAL OF COMPOSITES SCIENCE 2022. [DOI: 10.3390/jcs6080218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Metals have been investigated as biomaterials for a wide range of medical applications. At nanoscale, some metals, such as gold nanoparticles, exhibit plasmonics, which have motivated researchers’ focus on biosensor development. At the device level, some metals, such as titanium, exhibit good physical properties, which could allow them to act as biomedical implants for physical support. Despite these attractive features, the non-specific delivery of metallic nanoparticles and poor tissue–device compatibility have greatly limited their performance. This review aims to illustrate the interplay between polymers and metals, and to highlight the pivotal role of polymer–metal composite/nanocomposite healthcare materials in different biomedical applications. Here, we revisit the recent plasmonic engineered platforms for biomolecules detection in cell-free samples and highlight updated nanocomposite design for (1) intracellular RNA detection, (2) photothermal therapy, and (3) nanomedicine for neurodegenerative diseases, as selected significant live cell–interactive biomedical applications. At the device scale, the rational design of polymer–metallic medical devices is of importance for dental and cardiovascular implantation to overcome the poor physical load transfer between tissues and devices, as well as implant compatibility under a dynamic fluidic environment, respectively. Finally, we conclude the treatment of these innovative polymer–metal biomedical composite designs and provide a future perspective on the aforementioned research areas.
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25
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Electrochemical and electrophoretic coatings of medical implants by nanomaterials. J Solid State Electrochem 2022. [DOI: 10.1007/s10008-022-05235-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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26
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Cao H, Qiao S, Qin H, Jandt KD. Antibacterial Designs for Implantable Medical Devices: Evolutions and Challenges. J Funct Biomater 2022; 13:jfb13030086. [PMID: 35893454 PMCID: PMC9326756 DOI: 10.3390/jfb13030086] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/12/2022] [Accepted: 06/17/2022] [Indexed: 11/25/2022] Open
Abstract
The uses of implantable medical devices are safer and more common since sterilization methods and techniques were established a century ago; however, device-associated infections (DAIs) are still frequent and becoming a leading complication as the number of medical device implantations keeps increasing. This urges the world to develop instructive prevention and treatment strategies for DAIs, boosting the studies on the design of antibacterial surfaces. Every year, studies associated with DAIs yield thousands of publications, which here are categorized into four groups, i.e., antibacterial surfaces with long-term efficacy, cell-selective capability, tailored responsiveness, and immune-instructive actions. These innovations are promising in advancing the solution to DAIs; whereas most of these are normally quite preliminary “proof of concept” studies lacking exact clinical scopes. To help identify the flaws of our current antibacterial designs, clinical features of DAIs are highlighted. These include unpredictable onset, site-specific incidence, and possibly involving multiple and resistant pathogenic strains. The key point we delivered is antibacterial designs should meet the specific requirements of the primary functions defined by the “intended use” of an implantable medical device. This review intends to help comprehend the complex relationship between the device, pathogens, and the host, and figure out future directions for improving the quality of antibacterial designs and promoting clinical translations.
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Affiliation(s)
- Huiliang Cao
- Interfacial Electrochemistry and Biomaterials, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai 200237, China
- Lab of Low-Dimensional Materials Chemistry, Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science & Technology, Shanghai 200237, China
- Chair of Materials Science, Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, 07743 Jena, Germany
- Correspondence: (H.C.); (S.Q.); (H.Q.); (K.D.J.)
| | - Shichong Qiao
- Department of Implant Dentistry, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
- Correspondence: (H.C.); (S.Q.); (H.Q.); (K.D.J.)
| | - Hui Qin
- Department of Orthopaedics, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
- Correspondence: (H.C.); (S.Q.); (H.Q.); (K.D.J.)
| | - Klaus D. Jandt
- Chair of Materials Science, Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, 07743 Jena, Germany
- Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, 07743 Jena, Germany
- Jena School for Microbial Communication (JSMC), Neugasse 23, 07743 Jena, Germany
- Correspondence: (H.C.); (S.Q.); (H.Q.); (K.D.J.)
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27
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Meng F, Yin Z, Ren X, Geng Z, Su J. Construction of Local Drug Delivery System on Titanium-Based Implants to Improve Osseointegration. Pharmaceutics 2022; 14:pharmaceutics14051069. [PMID: 35631656 PMCID: PMC9146791 DOI: 10.3390/pharmaceutics14051069] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/01/2022] [Accepted: 05/13/2022] [Indexed: 02/04/2023] Open
Abstract
Titanium and its alloys are the most widely applied orthopedic and dental implant materials due to their high biocompatibility, superior corrosion resistance, and outstanding mechanical properties. However, the lack of superior osseointegration remains the main obstacle to successful implantation. Previous traditional surface modification methods of titanium-based implants cannot fully meet the clinical needs of osseointegration. The construction of local drug delivery systems (e.g., antimicrobial drug delivery systems, anti-bone resorption drug delivery systems, etc.) on titanium-based implants has been proved to be an effective strategy to improve osseointegration. Meanwhile, these drug delivery systems can also be combined with traditional surface modification methods, such as anodic oxidation, acid etching, surface coating technology, etc., to achieve desirable and enhanced osseointegration. In this paper, we review the research progress of different local drug delivery systems using titanium-based implants and provide a theoretical basis for further research on drug delivery systems to promote bone–implant integration in the future.
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Affiliation(s)
- Fanying Meng
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, China;
- School of Medicine, Shanghai University, Shanghai 200444, China
- School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Zhifeng Yin
- Department of Orthopedics, Shanghai Zhongye Hospital, Shanghai 200941, China;
| | - Xiaoxiang Ren
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, China;
- Correspondence: (X.R.); (Z.G.); (J.S.)
| | - Zhen Geng
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, China;
- Correspondence: (X.R.); (Z.G.); (J.S.)
| | - Jiacan Su
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, China;
- Correspondence: (X.R.); (Z.G.); (J.S.)
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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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Berini F, Orlandi V, Gornati R, Bernardini G, Marinelli F. Nanoantibiotics to fight multidrug resistant infections by Gram-positive bacteria: hope or reality? Biotechnol Adv 2022; 57:107948. [PMID: 35337933 DOI: 10.1016/j.biotechadv.2022.107948] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/17/2022]
Abstract
The spread of antimicrobial resistance in Gram-positive pathogens represents a threat to human health. To counteract the current lack of novel antibiotics, alternative antibacterial treatments have been increasingly investigated. This review covers the last decade's developments in using nanoparticles as carriers for the two classes of frontline antibiotics active on multidrug-resistant Gram-positive pathogens, i.e., glycopeptide antibiotics and daptomycin. Most of the reviewed papers deal with vancomycin nanoformulations, being teicoplanin- and daptomycin-carrying nanosystems much less investigated. Special attention is addressed to nanoantibiotics used for contrasting biofilm-associated infections. The status of the art related to nanoantibiotic toxicity is critically reviewed.
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Affiliation(s)
- Francesca Berini
- Department of Biotechnology and Life Sciences, University of Insubria, via JH Dunant 3, 21100 Varese, Italy.
| | - Viviana Orlandi
- Department of Biotechnology and Life Sciences, University of Insubria, via JH Dunant 3, 21100 Varese, Italy.
| | - Rosalba Gornati
- Department of Biotechnology and Life Sciences, University of Insubria, via JH Dunant 3, 21100 Varese, Italy.
| | - Giovanni Bernardini
- Department of Biotechnology and Life Sciences, University of Insubria, via JH Dunant 3, 21100 Varese, Italy.
| | - Flavia Marinelli
- Department of Biotechnology and Life Sciences, University of Insubria, via JH Dunant 3, 21100 Varese, Italy.
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Sheng X, Wang A, Wang Z, Liu H, Wang J, Li C. Advanced Surface Modification for 3D-Printed Titanium Alloy Implant Interface Functionalization. Front Bioeng Biotechnol 2022; 10:850110. [PMID: 35299643 PMCID: PMC8921557 DOI: 10.3389/fbioe.2022.850110] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/28/2022] [Indexed: 12/20/2022] Open
Abstract
With the development of three-dimensional (3D) printed technology, 3D printed alloy implants, especially titanium alloy, play a critical role in biomedical fields such as orthopedics and dentistry. However, untreated titanium alloy implants always possess a bioinert surface that prevents the interface osseointegration, which is necessary to perform surface modification to enhance its biological functions. In this article, we discuss the principles and processes of chemical, physical, and biological surface modification technologies on 3D printed titanium alloy implants in detail. Furthermore, the challenges on antibacterial, osteogenesis, and mechanical properties of 3D-printed titanium alloy implants by surface modification are summarized. Future research studies, including the combination of multiple modification technologies or the coordination of the structure and composition of the composite coating are also present. This review provides leading-edge functionalization strategies of the 3D printed titanium alloy implants.
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Affiliation(s)
- Xiao Sheng
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Ao Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Chen Li
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
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Ye Z, Sang T, Li K, Fischer NG, Mutreja I, Echeverría C, Kumar D, Tang Z, Aparicio C. Hybrid nanocoatings of self-assembled organic-inorganic amphiphiles for prevention of implant infections. Acta Biomater 2022; 140:338-349. [PMID: 34896631 PMCID: PMC8828705 DOI: 10.1016/j.actbio.2021.12.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/08/2021] [Accepted: 12/06/2021] [Indexed: 12/14/2022]
Abstract
Antimicrobial coatings are one of the most promising strategies to prevent bacterial infections in orthopedic and dental implants. Combining antimicrobial agents with different antimicrobial mechanisms might have synergistic effects and be more potent. Others have shown that nanocomposites of silver nanoparticles (AgNPs) decorated with antimicrobial peptides (AMPs) show increased potency as free agents in solution. However, similar nanocomposites have not been explored to coat biomaterials through cooperative weak electrostatic attraction forces between AMP, AgNPs and substrates in need of protection against infection. In this work, we synthesized self-assembled antimicrobial amphiphiles of an AMP, GL13K. Then, we decorated the AMP nanostructures with AgNPs, which were finally used to coat etched Ti (eTi) surfaces. The strong hydrogen bonding between the AMP amphiphiles and the polar eTi yielded a robust and stable coating. When compared to single AgNP or single AMP coatings, our hybrid nanocoatings had notably higher in vitro antimicrobial potency against multiple bacteria strains related to implant infection. The hybrid coating also showed relevant antimicrobial activity in an in vivo subcutaneous infection model in rats. This work advances the application of AgNP/AMP nanocomposites as effective coatings for prevention of implant infections. STATEMENT OF SIGNIFICANCE: High morbidity, mortality and elevated costs are associated with orthopedic and dental implant infections. Conventional antibiotic treatment is ineffective due to barrier-like extracellular polymeric substances in biofilms and the increasing threat from antibiotic resistance. Antimicrobial coatings are one of the most promising strategies, but the performance is usually unsatisfactory, especially when tested in vivo. Here, we present a hybrid nanocoating with different modes of action to prevent implant infections using self-assembled antimicrobial peptide (AMP) amphiphiles decorated with silver nanoparticles (AgNPs). When compared to single AgNP or AMP coatings, our hybrid nanocoatings showed significant increases in antimicrobial potency against multiple implant infection-related bacterial strains in vitro and in an in vivo rat subcutaneous infection model.
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Affiliation(s)
- Zhou Ye
- MDRCBB, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN 55455, United States.
| | - Ting Sang
- The Affiliated Stomatological Hospital of Nanchang University & The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province 330006, China
| | - Kun Li
- The Affiliated Stomatological Hospital of Nanchang University & The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province 330006, China
| | - Nicholas G. Fischer
- MDRCBB, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Isha Mutreja
- MDRCBB, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Constanza Echeverría
- Cariology Unit, Department of Oral Rehabilitation, University of Talca, Talca 3460000, Chile
| | - Dhiraj Kumar
- MDRCBB, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Zhen Tang
- The Affiliated Stomatological Hospital of Nanchang University & The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province 330006, China.
| | - Conrado Aparicio
- MDRCBB, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN 55455, United States.
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Miranda A, Seyer D, Palomino-Durand C, Morakchi-Goudjil H, Massonie M, Agniel R, Rammal H, Pauthe E, Gand A. Poly-L-Lysine and Human Plasmatic Fibronectin Films as Proactive Coatings to Improve Implant Biointegration. Front Bioeng Biotechnol 2022; 9:807697. [PMID: 35111738 PMCID: PMC8801876 DOI: 10.3389/fbioe.2021.807697] [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: 11/02/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
The success of stable and long-term implant integration implies the promotion, control, and respect of the cell microenvironment at the site of implantation. The key is to enhance the implant–host tissue cross talk by developing interfacial strategies that guarantee an optimal and stable seal of soft tissue onto the implant, while preventing potential early and late infection. Indeed, implant rejection is often jeopardized by lack of stable tissue surrounding the biomaterial combined with infections which reduce the lifespan and increase the failure rate of implants and morbidity and account for high medical costs. Thin films formed by the layer-by-layer (LbL) assembly of oppositely charged polyelectrolytes are particularly versatile and attractive for applications involving cell–material contact. With the combination of the extracellular matrix protein fibronectin (Fn, purified from human plasma) and poly-L-lysine (PLL, exhibiting specific chain lengths), we proposed proactive and biomimetic coatings able to guarantee enhanced cell attachment and exhibiting antimicrobial properties. Fn, able to create a biomimetic interface that could enhance cell attachment and promote extracellular cell matrix remodeling, is incorporated as the anionic polymer during film construction by the LbL technic whereas PLL is used as the cationic polymer for its capacity to confer remarkable antibacterial properties.
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Affiliation(s)
- Anamar Miranda
- Equipe de Recherche sur les Relations Matrice Extracellulaire Cellules, Institut des Matériaux, CY Cergy-Paris Université, Cergy-Pontoise, France
| | - Damien Seyer
- Equipe de Recherche sur les Relations Matrice Extracellulaire Cellules, Institut des Matériaux, CY Cergy-Paris Université, Cergy-Pontoise, France
| | - Carla Palomino-Durand
- Equipe de Recherche sur les Relations Matrice Extracellulaire Cellules, Institut des Matériaux, CY Cergy-Paris Université, Cergy-Pontoise, France
| | - Houda Morakchi-Goudjil
- Equipe de Recherche sur les Relations Matrice Extracellulaire Cellules, Institut des Matériaux, CY Cergy-Paris Université, Cergy-Pontoise, France
| | - Mathilde Massonie
- Equipe de Recherche sur les Relations Matrice Extracellulaire Cellules, Institut des Matériaux, CY Cergy-Paris Université, Cergy-Pontoise, France
| | - Rémy Agniel
- Equipe de Recherche sur les Relations Matrice Extracellulaire Cellules, Institut des Matériaux, CY Cergy-Paris Université, Cergy-Pontoise, France
| | - Hassan Rammal
- Equipe de Recherche sur les Relations Matrice Extracellulaire Cellules, Institut des Matériaux, CY Cergy-Paris Université, Cergy-Pontoise, France
- EFOR Healthcare Paris, Biocompatibility Platform, Levallois-Perret, France
| | - Emmanuel Pauthe
- Equipe de Recherche sur les Relations Matrice Extracellulaire Cellules, Institut des Matériaux, CY Cergy-Paris Université, Cergy-Pontoise, France
- *Correspondence: Emmanuel Pauthe, ; Adeline Gand,
| | - Adeline Gand
- Equipe de Recherche sur les Relations Matrice Extracellulaire Cellules, Institut des Matériaux, CY Cergy-Paris Université, Cergy-Pontoise, France
- *Correspondence: Emmanuel Pauthe, ; Adeline Gand,
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Suwardi A, Wang F, Xue K, Han MY, Teo P, Wang P, Wang S, Liu Y, Ye E, Li Z, Loh XJ. Machine Learning-Driven Biomaterials Evolution. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2102703. [PMID: 34617632 DOI: 10.1002/adma.202102703] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/09/2021] [Indexed: 06/13/2023]
Abstract
Biomaterials is an exciting and dynamic field, which uses a collection of diverse materials to achieve desired biological responses. While there is constant evolution and innovation in materials with time, biomaterials research has been hampered by the relatively long development period required. In recent years, driven by the need to accelerate materials development, the applications of machine learning in materials science has progressed in leaps and bounds. The combination of machine learning with high-throughput theoretical predictions and high-throughput experiments (HTE) has shifted the traditional Edisonian (trial and error) paradigm to a data-driven paradigm. In this review, each type of biomaterial and their key properties and use cases are systematically discussed, followed by how machine learning can be applied in the development and design process. The discussions are classified according to various types of materials used including polymers, metals, ceramics, and nanomaterials, and implants using additive manufacturing. Last, the current gaps and potential of machine learning to further aid biomaterials discovery and application are also discussed.
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Affiliation(s)
- Ady Suwardi
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - FuKe Wang
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Kun Xue
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Ming-Yong Han
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Peili Teo
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Pei Wang
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Shijie Wang
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Ye Liu
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Enyi Ye
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Zibiao Li
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Xian Jun Loh
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
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Ma X, Gao Y, Zhao D, Zhang W, Zhao W, Wu M, Cui Y, Li Q, Zhang Z, Ma C. Titanium Implants and Local Drug Delivery Systems Become Mutual Promoters in Orthopedic Clinics. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 12:47. [PMID: 35009997 PMCID: PMC8746425 DOI: 10.3390/nano12010047] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Titanium implants have always been regarded as one of the gold standard treatments for orthopedic applications, but they still face challenges such as pain, bacterial infections, insufficient osseointegration, immune rejection, and difficulty in personalizing treatment in the clinic. These challenges may lead to the patients having to undergo a painful second operation, along with increased economic burden, but the use of drugs is actively solving these problems. The use of systemic drug delivery systems through oral, intravenous, and intramuscular injection of various drugs with different pharmacological properties has effectively reduced the levels of inflammation, lowered the risk of endophytic bacterial infection, and regulated the progress of bone tumor cells, processing and regulating the balance of bone metabolism around the titanium implants. However, due to the limitations of systemic drug delivery systems-such as pharmacokinetics, and the characteristics of bone tissue in the event of different forms of trauma or disease-sometimes the expected effect cannot be achieved. Meanwhile, titanium implants loaded with drugs for local administration have gradually attracted the attention of many researchers. This article reviews the latest developments in local drug delivery systems in recent years, detailing how various types of drugs cooperate with titanium implants to enhance antibacterial, antitumor, and osseointegration effects. Additionally, we summarize the improved technology of titanium implants for drug loading and the control of drug release, along with molecular mechanisms of bone regeneration and vascularization. Finally, we lay out some future prospects in this field.
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Zhang Q, Xiong Y, Cheng J, Tan Y, Liao X, Wang J. Synthesis and biological evaluation of ruthenium polypyridine complexes with 18β-glycyrrhetinic acid as antibacterial agents against Staphylococcus aureus. Dalton Trans 2021; 51:1099-1111. [PMID: 34935812 DOI: 10.1039/d1dt02692e] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Four new ruthenium(II) polypyridine complexes bearing 18β-glycyrrhetinic acid derivatives, [Ru(bpy)2L](PF6)2 (Ru1), [Ru(dmb)2L](PF6)2 (Ru2), [Ru(dtb)2L](PF6)2 (Ru3) and [Ru(phen)2L](PF6)2 (Ru4) (bpy = 2,2-bipyridine, dmb = 4,4'-dimethyl-2,2'-bipyridine, dtb = 4,4'-di-tert-butyl-2,2'-bipyridine, phen = 1,10-phenanthroline and L is the GA modified new ligand) were designed and synthesized. Their antimicrobial activities against Staphylococcus aureus (S. aureus) were evaluated and all complexes showed an obvious inhibitory effect, especially, the minimum inhibitory concentration (MIC) value of Ru2 was 3.9 μg mL-1. Moreover, Ru2 was found to significantly inhibit the formation of biofilms. The membrane-compromising action mode was suggested to be their potential antibactericidal mechanism. In hemolysis experiments, Ru2 hardly showed cytotoxicity to mammalian erythrocytes. Furthermore, the synergism between Ru2 and common antibiotics, such as ampicillin, chloramphenicol, tetracyclines and ofloxacin, against S. aureus was also detected using the checkerboard method. Finally, a mouse skin infection model was established to evaluate the antibacterial activity of Ru2in vivo, and the results showed that Ru2 could effectively promote wound healing in mice infected with S. aureus. Moreover, the results of histopathological research were consistent with the results of the hemolysis test, indicating that the Ru2 complex was almost non-toxic. Thus, it was demonstrated that the polypyridine ruthenium complexes modified with glycyrrhetinic acid (GA) are a promising strategy for developing interesting antibacterial agents.
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Affiliation(s)
- Qin Zhang
- Jiangxi Provincial Key Laboratory of Drug Design and Evaluation, School of Pharmacy, Jiangxi Science & Technology Normal University, Nanchang, 330013, People's Republic of China.
| | - Yanshi Xiong
- Jiangxi Provincial Key Laboratory of Drug Design and Evaluation, School of Pharmacy, Jiangxi Science & Technology Normal University, Nanchang, 330013, People's Republic of China.
| | - Jianxin Cheng
- Jiangxi Provincial Key Laboratory of Drug Design and Evaluation, School of Pharmacy, Jiangxi Science & Technology Normal University, Nanchang, 330013, People's Republic of China.
| | - Yanhui Tan
- State Key Laboratory for Chemistry and Molecular Engineering of Medicinal Resources, School of Chemistry and Pharmaceutical Sciences, Guangxi Normal University, Guilin, 541004, People's Republic of China
| | - Xiangwen Liao
- Jiangxi Provincial Key Laboratory of Drug Design and Evaluation, School of Pharmacy, Jiangxi Science & Technology Normal University, Nanchang, 330013, People's Republic of China.
| | - Jintao Wang
- Jiangxi Provincial Key Laboratory of Drug Design and Evaluation, School of Pharmacy, Jiangxi Science & Technology Normal University, Nanchang, 330013, People's Republic of China.
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Williams DF. Biocompatibility pathways and mechanisms for bioactive materials: The bioactivity zone. Bioact Mater 2021; 10:306-322. [PMID: 34901548 PMCID: PMC8636667 DOI: 10.1016/j.bioactmat.2021.08.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/07/2021] [Indexed: 12/14/2022] Open
Abstract
This essay analyzes the scientific evidence that forms the basis of bioactive materials, covering the fundamental understanding of bioactivity phenomena and correlation with the mechanisms of biocompatibility of biomaterials. This is a detailed assessment of performance in areas such as bone-induction, cell adhesion, immunomodulation, thrombogenicity and antimicrobial behavior. Bioactivity is the modulation of biological activity by characteristics of the interfacial region that incorporates the material surface and the immediate local host tissue. Although the term ‘bioactive material’ is widely used and has a well understood general meaning, it would be useful now to concentrate on this interfacial region, considered as ‘the bioactivity zone’. Bioactivity phenomena are either due to topographical/micromechanical characteristics, or to biologically active species that are presented in the bioactivity zone. Examples of topographical/micromechanical effects are the modulation of the osteoblast – osteoclast balance, nanotopographical regulation of cell adhesion, and bactericidal nanostructures. Regulation of bioactivity by biologically active species include their influence, especially of metal ions, on signaling pathways in bone formation, the role of cell adhesion molecules and bioactive peptides in cell attachment, macrophage polarization by immunoregulatory molecules and antimicrobial peptides. While much experimental data exists to demonstrate the potential of such phenomena, there are considerable barriers to their effective clinical translation. This essay shows that there is solid scientific evidence of the existence of bioactivity mechanisms that are associated with some types of biomaterials, especially when the material is modified in a manner designed to specifically induce that activity.
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Affiliation(s)
- David F Williams
- Wake Forest Institute of Regenerative Medicine, 391 Technology Way. Winston-Salem, North Carolina, 27101, USA
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Cyphert EL, Zhang N, Learn GD, Hernandez CJ, von Recum HA. Recent Advances in the Evaluation of Antimicrobial Materials for Resolution of Orthopedic Implant-Associated Infections In Vivo. ACS Infect Dis 2021; 7:3125-3160. [PMID: 34761915 DOI: 10.1021/acsinfecdis.1c00465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
While orthopedic implant-associated infections are rare, revision surgeries resulting from infections incur considerable healthcare costs and represent a substantial research area clinically, in academia, and in industry. In recent years, there have been numerous advances in the development of antimicrobial strategies for the prevention and treatment of orthopedic implant-associated infections which offer promise to improve the limitations of existing delivery systems through local and controlled release of antimicrobial agents. Prior to translation to in vivo orthopedic implant-associated infection models, the properties (e.g., degradation, antimicrobial activity, biocompatibility) of the antimicrobial materials can be evaluated in subcutaneous implant in vivo models. The antimicrobial materials are then incorporated into in vivo implant models to evaluate the efficacy of using the material to prevent or treat implant-associated infections. Recent technological advances such as 3D-printing, bacterial genomic sequencing, and real-time in vivo imaging of infection and inflammation have contributed to the development of preclinical implant-associated infection models that more effectively recapitulate the clinical presentation of infections and improve the evaluation of antimicrobial materials. This Review highlights the advantages and limitations of antimicrobial materials used in conjunction with orthopedic implants for the prevention and treatment of orthopedic implant-associated infections and discusses how these materials are evaluated in preclinical in vivo models. This analysis serves as a resource for biomaterial researchers in the selection of an appropriate orthopedic implant-associated infection preclinical model to evaluate novel antimicrobial materials.
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Affiliation(s)
- Erika L. Cyphert
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, United States
| | - Ningjing Zhang
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, United States
| | - Greg D. Learn
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, United States
| | - Christopher J. Hernandez
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York 14853, United States
- Hospital for Special Surgery, New York, New York 10021, United States
| | - Horst A. von Recum
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, United States
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Diez-Escudero A, Andersson B, Carlsson E, Recker B, Link H, Järhult JD, Hailer NP. 3D-printed porous Ti6Al4V alloys with silver coating combine osteocompatibility and antimicrobial properties. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 133:112629. [DOI: 10.1016/j.msec.2021.112629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/02/2021] [Accepted: 12/19/2021] [Indexed: 12/23/2022]
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Fitting pieces into the puzzle: The impact of titanium-based dental implant surface modifications on bacterial accumulation and polymicrobial infections. Adv Colloid Interface Sci 2021; 298:102551. [PMID: 34757285 DOI: 10.1016/j.cis.2021.102551] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/09/2021] [Accepted: 10/17/2021] [Indexed: 12/12/2022]
Abstract
Polymicrobial infection is the main cause of dental implant failure. Although numerous studies have reported the ability of titanium (Ti) surface modifications to inhibit microbial adhesion and biofilm accumulation, the majority of solutions for the utilization of Ti antibacterial surfaces have been testedin in vitro and animal models, with only a few developed surfaces progressing into clinical research. Motivated by this huge gap, we critically reviewed the scientific literature on the existing antibacterial Ti surfaces to help understand these surfaces' impact on the "puzzle" of undesirable dental implant-related infections. This manuscript comprises three main sections: (i) a narrative review on topics related to oral biofilm formation, bacterial-implant surface interactions, and on how implant-surface modifications can influence microbial accumulation; (ii) a critical evidence-based review to summarize pre-clinical and clinical studies in an attempt to "fit pieces into the puzzle" to unveil the best way to reduce microbial loads and control polymicrobial infection around dental implants showed by the current in vivo evidence; and (iii) discussion and recommendations for future research testing emerging antibacterial implant surfaces, connecting basic science and the requirements for future clinical translation. The findings of the present review suggest no consensus regarding the best available Ti surface to reduce bacterial colonization on dental implants. Smart release or on-demand activation surface coatings are a "new piece of the puzzle", which may be the most effective alternative for reducing microbial colonization on Ti surfaces, and future studies should focus on these technologies.
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He Y, Li K, Yang X, Leng J, Xu K, Yuan Z, Lin C, Tao B, Li X, Hu J, Dai L, Becker R, Huang TJ, Cai K. Calcium Peroxide Nanoparticles-Embedded Coatings on Anti-Inflammatory TiO 2 Nanotubes for Bacteria Elimination and Inflammatory Environment Amelioration. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2102907. [PMID: 34665526 DOI: 10.1002/smll.202102907] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/06/2021] [Indexed: 06/13/2023]
Abstract
Implant-associated bacterial infections significantly impair the integration between titanium and soft tissues. Traditional antibacterial modifications of titanium implants are able to eliminate bacteria, but the resulting pro-inflammatory reactions are usually ignored, which still poses potential risks to human bodies. Here, a dual drug-loading system on titanium has been developed via the adhesion of a catechol motif-modified methacrylated gelatin hydrogel onto TiO2 nanotubes. Then synthesized CaO2 nanoparticles (NPs) are embedded into the hydrogel, and interleukin-4 (IL-4) is loaded into the nanotubes to achieve both antibacterial and anti-inflammatory properties. The dual drug-loading system can eliminate Staphylococcus aureus (S. aureus) rapidly, attributed to the H2 O2 release from CaO2 NPs. The potential cytotoxicity of CaO2 NPs is also remarkably reduced after being embedded into the hydrogel. More importantly, with the gradual release of IL-4, the dual drug-loading system is capable of modulating pro-inflammatory reactions by inducing M2 phenotype polarization of macrophages. In a subcutaneous infection model, the S. aureus contamination is effectively resolved after 2 days, and the resulting pro-inflammatory reactions are also inhibited after 7 days. Finally, the damaged tissue is significantly recovered. Taken together, the dual drug-loading system exhibits great therapeutic potential in effectively killing pathogens and inhibiting the resulting pro-inflammatory reactions.
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Affiliation(s)
- Ye He
- Key Laboratory of Biorheological Science and Technology, Ministry of Education College of Bioengineering, Chongqing University, Chongqing, 400044, China
- Thomas Lord Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, 27708, USA
| | - Ke Li
- Key Laboratory of Biorheological Science and Technology, Ministry of Education College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Xin Yang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Jin Leng
- Key Laboratory of Biorheological Science and Technology, Ministry of Education College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Kun Xu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Zhang Yuan
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Chuanchuan Lin
- Key Laboratory of Biorheological Science and Technology, Ministry of Education College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Bailong Tao
- Key Laboratory of Biorheological Science and Technology, Ministry of Education College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Xuan Li
- Key Laboratory of Biorheological Science and Technology, Ministry of Education College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Jingwei Hu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Liangliang Dai
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Ryan Becker
- Department of Biomedical Engineering, Duke University, Durham, NC, 27708, USA
| | - Tony Jun Huang
- Thomas Lord Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, 27708, USA
| | - Kaiyong Cai
- Key Laboratory of Biorheological Science and Technology, Ministry of Education College of Bioengineering, Chongqing University, Chongqing, 400044, China
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Li Y, Wang S, Li S, Fei J. Clindamycin-loaded titanium prevents implant-related infection through blocking biofilm formation. J Biomater Appl 2021; 36:1231-1242. [PMID: 34723682 DOI: 10.1177/08853282211051183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Implant-related infection is a disastrous complication. Surface modification of titanium is considered as an important strategy to prevent implant-related infection. However, there is no recognized surface modification strategy that can be applied in clinic so far. We explored a new strategy of coating. The clindamycin-loaded titanium was constructed by layer-by-layer self-assembly. The release of clindamycin from titanium was detected through high performance liquid chromatography. Different titanium was co-cultured with Staphylococcus aureus for 24 h in vitro, then the effect of different titanium on bacterial colonization and biofilm formation was determined by spread plate method and scanning electron microscopy. Cytotoxicity and cytocompatibility of clindamycin-loaded titanium on MC3T3-E1 cells were measured by CCK8. The antibacterial ability of clindamycin-loaded titanium in vivo was also evaluated using a rat model of osteomyelitis. The number of osteoclasts in bone defect was observed by tartrate-resistant acid phosphatase staining. Bacterial burden of surrounding tissues around the site of infection was calculated by tissue homogenate and colony count. Clindamycin-loaded titanium could release clindamycin slowly within 160 h. It reduced bacterial colonization by three orders of magnitude compare to control (p < .05) and inhibits biofilm formation in vitro. Cells proliferation and adhesion were similar on three titanium surfaces (p > .05). In vivo, clindamycin-loaded titanium improved bone healing, reduced microbial burden, and decreased the number of osteoclasts compared control titanium in the rat model of osteomyelitis. This study demonstrated that clindamycin-loaded titanium exhibited good biocompatibility, and showed antibacterial activity both in vivo and in vitro. It is promising and might have potential for clinical application.
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Affiliation(s)
- Youbin Li
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China
| | - Shaochuan Wang
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China
| | - Shidan Li
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China
| | - Jun Fei
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China.,12525State Key Laboratory of Trauma, Burns and Combined Injury, Army Medical University, Chongqing, China
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Li W, Thian ES, Wang M, Wang Z, Ren L. Surface Design for Antibacterial Materials: From Fundamentals to Advanced Strategies. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:e2100368. [PMID: 34351704 PMCID: PMC8498904 DOI: 10.1002/advs.202100368] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/27/2021] [Indexed: 05/14/2023]
Abstract
Healthcare-acquired infections as well as increasing antimicrobial resistance have become an urgent global challenge, thus smart alternative solutions are needed to tackle bacterial infections. Antibacterial materials in biomedical applications and hospital hygiene have attracted great interest, in particular, the emergence of surface design strategies offer an effective alternative to antibiotics, thereby preventing the possible development of bacterial resistance. In this review, recent progress on advanced surface modifications to prevent bacterial infections are addressed comprehensively, starting with the key factors against bacterial adhesion, followed by varying strategies that can inhibit biofilm formation effectively. Furthermore, "super antibacterial systems" through pre-treatment defense and targeted bactericidal system, are proposed with increasing evidence of clinical potential. Finally, the advantages and future challenges of surface strategies to resist healthcare-associated infections are discussed, with promising prospects of developing novel antimicrobial materials.
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Affiliation(s)
- Wenlong Li
- Department of BiomaterialsState Key Lab of Physical Chemistry of Solid SurfaceCollege of MaterialsXiamen UniversityXiamen361005P. R. China
| | - Eng San Thian
- Department of Mechanical EngineeringNational University of SingaporeSingapore117576Singapore
| | - Miao Wang
- Department of BiomaterialsState Key Lab of Physical Chemistry of Solid SurfaceCollege of MaterialsXiamen UniversityXiamen361005P. R. China
| | - Zuyong Wang
- College of Materials Science and EngineeringHunan UniversityChangsha410082P. R. China
| | - Lei Ren
- Department of BiomaterialsState Key Lab of Physical Chemistry of Solid SurfaceCollege of MaterialsXiamen UniversityXiamen361005P. R. China
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Bhattacharjee B, Ghosh S, Patra D, Haldar J. Advancements in release-active antimicrobial biomaterials: A journey from release to relief. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2021; 14:e1745. [PMID: 34374498 DOI: 10.1002/wnan.1745] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/13/2021] [Accepted: 07/08/2021] [Indexed: 12/13/2022]
Abstract
Escalating medical expenses due to infectious diseases are causing huge socioeconomic pressure on mankind globally. The emergence of antibiotic resistance has further aggravated this problem. Drug-resistant pathogens are also capable of forming thick biofilms on biotic and abiotic surfaces to thrive in a harsh environment. To address these clinical problems, various strategies including antibacterial agent delivering matrices and bactericidal coatings strategies have been developed. In this review, we have discussed various types of polymeric vehicles such as hydrogels, sponges/cryogels, microgels, nanogels, and meshes, which are commonly used to deliver antibiotics, metal nanoparticles, and biocides. Compositions of these polymeric matrices have been elaborately depicted by elucidating their chemical interactions and potential activity have been discussed. On the other hand, various implant/device-surface coating strategies which exploit the release-active mechanism of bacterial killing are discussed in elaboration. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease.
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Affiliation(s)
- Brinta Bhattacharjee
- Antimicrobial Research Laboratory, New Chemistry, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru, Karnataka, India
| | - Sreyan Ghosh
- Antimicrobial Research Laboratory, New Chemistry, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru, Karnataka, India
| | - Dipanjana Patra
- Antimicrobial Research Laboratory, New Chemistry, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru, Karnataka, India
| | - Jayanta Haldar
- Antimicrobial Research Laboratory, New Chemistry, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru, Karnataka, India.,School of Advanced Materials, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru, Karnataka, India
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Jiao J, Zhang S, Qu X, Yue B. Recent Advances in Research on Antibacterial Metals and Alloys as Implant Materials. Front Cell Infect Microbiol 2021; 11:693939. [PMID: 34277473 PMCID: PMC8283567 DOI: 10.3389/fcimb.2021.693939] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Implants are widely used in orthopedic surgery and are gaining attention of late. However, their use is restricted by implant-associated infections (IAI), which represent one of the most serious and dangerous complications of implant surgeries. Various strategies have been developed to prevent and treat IAI, among which the closest to clinical translation is designing metal materials with antibacterial functions by alloying methods based on existing materials, including titanium, cobalt, tantalum, and biodegradable metals. This review first discusses the complex interaction between bacteria, host cells, and materials in IAI and the mechanisms underlying the antibacterial effects of biomedical metals and alloys. Then, their applications for the prevention and treatment of IAI are highlighted. Finally, new insights into their clinical translation are provided. This review also provides suggestions for further development of antibacterial metals and alloys.
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Affiliation(s)
- Juyang Jiao
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shutao Zhang
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xinhua Qu
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bing Yue
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Alipal J, Lee T, Koshy P, Abdullah H, Idris M. Evolution of anodised titanium for implant applications. Heliyon 2021; 7:e07408. [PMID: 34296002 PMCID: PMC8281482 DOI: 10.1016/j.heliyon.2021.e07408] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/15/2021] [Accepted: 06/23/2021] [Indexed: 12/26/2022] Open
Abstract
Anodised titanium has a long history as a coating structure for implants due to its bioactive and ossified surface, which promotes rapid bone integration. In response to the growing literature on anodised titanium, this article is the first to revisit the evolution of anodised titanium as an implant coating. The review reports the process and mechanisms for the engineering of distinctive anodised titanium structures, the significant factors influencing the mechanisms of its formation, bioactivity, as well as recent pre- and post-surface treatments proposed to improve the performance of anodised titanium. The review then broadens the discussion to include future functional trends of anodised titanium, ranging from the provision of higher surface energy interactions in the design of biocomposite coatings (template stencil interface for mechanical interlock) to techniques for measuring the bone-to-implant contact (BIC), each with their own challenges. Overall, this paper provides up-to-date information on the impacts of the structure and function of anodised titanium as an implant coating in vitro and in/ex vivo tests, as well as the four key future challenges that are important for its clinical translations, namely (i) techniques to enhance the mechanical stability and (ii) testing techniques to measure the mechanical stability of anodised titanium, (iii) real-time/in-situ detection methods for surface reactions, and (iv) cost-effectiveness for anodised titanium and its safety as a bone implant coating.
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Affiliation(s)
- J. Alipal
- Department of Chemical Engineering Technology, Faculty of Engineering Technology, Universiti Tun Hussein Onn Malaysia (UTHM), Pagoh Higher Education Hub, 84600 Muar, Johor, Malaysia
| | - T.C. Lee
- Department of Production and Operation Management, Faculty of Technology Management and Business, UTHM Parit Raja 86400, Batu Pahat, Johor, Malaysia
| | - P. Koshy
- School of Materials Science and Engineering, UNSW Sydney, Sydney, NSW 2052, Australia
| | - H.Z. Abdullah
- Department of Manufacturing Engineering, Faculty of Mechanical and Manufacturing Engineering, UTHM Parit Raja 86400, Batu Pahat, Johor, Malaysia
| | - M.I. Idris
- Department of Manufacturing Engineering, Faculty of Mechanical and Manufacturing Engineering, UTHM Parit Raja 86400, Batu Pahat, Johor, Malaysia
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Modaresifar K, Ganjian M, Angeloni L, Minneboo M, Ghatkesar MK, Hagedoorn PL, Fratila-Apachitei LE, Zadpoor AA. On the Use of Black Ti as a Bone Substituting Biomaterial: Behind the Scenes of Dual-Functionality. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2100706. [PMID: 33978318 DOI: 10.1002/smll.202100706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/24/2021] [Indexed: 06/12/2023]
Abstract
Despite the potential of small-scale pillars of black titanium (bTi) for killing the bacteria and directing the fate of stem cells, not much is known about the effects of the pillars' design parameters on their biological properties. Here, three distinct bTi surfaces are designed and fabricated through dry etching of the titanium, each featuring different pillar designs. The interactions of the surfaces with MC3T3-E1 preosteoblast cells and Staphylococcus aureus bacteria are then investigated. Pillars with different heights and spatial organizations differently influence the morphological characteristics of the cells, including their spreading area, aspect ratio, nucleus area, and cytoskeletal organization. The preferential formation of focal adhesions (FAs) and their size variations also depend on the type of topography. When the pillars are neither fully separated nor extremely tall, the colocalization of actin fibers and FAs as well as an enhanced matrix mineralization are observed. However, the killing efficiency of these pillars against the bacteria is not as high as that of fully separated and tall pillars. This study provides a new perspective on the dual-functionality of bTi surfaces and elucidates how the surface design and fabrication parameters can be used to achieve a surface topography with balanced bactericidal and osteogenic properties.
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Affiliation(s)
- Khashayar Modaresifar
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Mahya Ganjian
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Livia Angeloni
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
- Department of Precision and Microsystems Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Michelle Minneboo
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Murali K Ghatkesar
- Department of Precision and Microsystems Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Peter-Leon Hagedoorn
- Department of Biotechnology, Faculty of Applied Sciences, Delft University of Technology, Van der Maasweg 9, Delft, 2629 HZ, The Netherlands
| | - Lidy E Fratila-Apachitei
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
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Abstract
Implant-associated infections (IAIs) are among the most intractable and costly complications in implant surgery. They can lead to surgery failure, a high economic burden, and a decrease in patient quality of life. This manuscript is devoted to introducing current antimicrobial strategies for additively manufactured (AM) titanium (Ti) implants and fostering a better understanding in order to pave the way for potential modern high-throughput technologies. Most bactericidal strategies rely on implant structure design and surface modification. By means of rational structural design, the performance of AM Ti implants can be improved by maintaining a favorable balance between the mechanical, osteogenic, and antibacterial properties. This subject becomes even more important when working with complex geometries; therefore, it is necessary to select appropriate surface modification techniques, including both topological and chemical modification. Antibacterial active metal and antibiotic coatings are among the most commonly used chemical modifications in AM Ti implants. These surface modifications can successfully inhibit bacterial adhesion and biofilm formation, and bacterial apoptosis, leading to improved antibacterial properties. As a result of certain issues such as drug resistance and cytotoxicity, the development of novel and alternative antimicrobial strategies is urgently required. In this regard, the present review paper provides insights into the enhancement of bactericidal properties in AM Ti implants.
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48
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van Hengel IAJ, Tierolf MWAM, Fratila-Apachitei LE, Apachitei I, Zadpoor AA. Antibacterial Titanium Implants Biofunctionalized by Plasma Electrolytic Oxidation with Silver, Zinc, and Copper: A Systematic Review. Int J Mol Sci 2021; 22:3800. [PMID: 33917615 PMCID: PMC8038786 DOI: 10.3390/ijms22073800] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 02/06/2023] Open
Abstract
Patients receiving orthopedic implants are at risk of implant-associated infections (IAI). A growing number of antibiotic-resistant bacteria threaten to hamper the treatment of IAI. The focus has, therefore, shifted towards the development of implants with intrinsic antibacterial activity to prevent the occurrence of infection. The use of Ag, Cu, and Zn has gained momentum as these elements display strong antibacterial behavior and target a wide spectrum of bacteria. In order to incorporate these elements into the surface of titanium-based bone implants, plasma electrolytic oxidation (PEO) has been widely investigated as a single-step process that can biofunctionalize these (highly porous) implant surfaces. Here, we present a systematic review of the studies published between 2009 until 2020 on the biomaterial properties, antibacterial behavior, and biocompatibility of titanium implants biofunctionalized by PEO using Ag, Cu, and Zn. We observed that 100% of surfaces bearing Ag (Ag-surfaces), 93% of surfaces bearing Cu (Cu-surfaces), 73% of surfaces bearing Zn (Zn-surfaces), and 100% of surfaces combining Ag, Cu, and Zn resulted in a significant (i.e., >50%) reduction of bacterial load, while 13% of Ag-surfaces, 10% of Cu-surfaces, and none of Zn or combined Ag, Cu, and Zn surfaces reported cytotoxicity against osteoblasts, stem cells, and immune cells. A majority of the studies investigated the antibacterial activity against S. aureus. Important areas for future research include the biofunctionalization of additively manufactured porous implants and surfaces combining Ag, Cu, and Zn. Furthermore, the antibacterial activity of such implants should be determined in assays focused on prevention, rather than the treatment of IAIs. These implants should be tested using appropriate in vivo bone infection models capable of assessing whether titanium implants biofunctionalized by PEO with Ag, Cu, and Zn can contribute to protect patients against IAI.
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Affiliation(s)
- Ingmar A. J. van Hengel
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands; (M.W.A.M.T.); (L.E.F.-A.); (I.A.); (A.A.Z.)
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Bartmański M, Pawłowski Ł, Belcarz A, Przekora A, Ginalska G, Strugała G, Cieślik BM, Pałubicka A, Zieliński A. The Chemical and Biological Properties of Nanohydroxyapatite Coatings with Antibacterial Nanometals, Obtained in the Electrophoretic Process on the Ti13Zr13Nb Alloy. Int J Mol Sci 2021; 22:ijms22063172. [PMID: 33804677 PMCID: PMC8003631 DOI: 10.3390/ijms22063172] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 11/16/2022] Open
Abstract
The risk of an early inflammation after implantation surgery of titanium implants has caused the development of different antimicrobial measures. The present research is aimed at characterizing the effects of nanosilver and nanocopper dispersed in the nanohydroxyapatite coatings, deposited on the Ti13Zr13Nb alloy, and on the chemical and biological properties of the coatings. The one-stage deposition process was performed by the electrophoretic method at different contents of nanomaterials in suspension. The surface topography of the coatings was examined with scanning electron microscopy. The wettability was expressed as the water contact angle. The corrosion behavior was characterized by the potentiodynamic technique. The release rate of copper and silver into the simulated body fluid was investigated by atomic absorption spectrometry. The antibacterial efficiency was evaluated as the survivability and adhesion of the bacteria and the growth of the biofilm. The cytotoxicity was assessed for osteoblasts. The results demonstrate that silver and copper increase the corrosion resistance and hydrophilicity. Both elements together effectively kill bacteria and inhibit biofilm growth but appear to be toxic for osteoblasts. The obtained results show that the nanohydroxyapatite coatings doped with nanosilver and nanocopper in a one-stage electrophoretic process can be valuable for antibacterial coatings.
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Affiliation(s)
- Michał Bartmański
- Faculty of Mechanical Engineering and Ship Technology, Gdańsk University of Technology, 80-233 Gdansk, Poland; (Ł.P.); (G.S.); (A.Z.)
- Correspondence: ; Tel.: +48-500-034-220; Fax: +48-58-347-18-15
| | - Łukasz Pawłowski
- Faculty of Mechanical Engineering and Ship Technology, Gdańsk University of Technology, 80-233 Gdansk, Poland; (Ł.P.); (G.S.); (A.Z.)
| | - Anna Belcarz
- Department of Biochemistry and Biotechnology, Medical University of Lublin, 20-093 Lublin, Poland; (A.B.); (A.P.); (G.G.)
| | - Agata Przekora
- Department of Biochemistry and Biotechnology, Medical University of Lublin, 20-093 Lublin, Poland; (A.B.); (A.P.); (G.G.)
| | - Grazyna Ginalska
- Department of Biochemistry and Biotechnology, Medical University of Lublin, 20-093 Lublin, Poland; (A.B.); (A.P.); (G.G.)
| | - Gabriel Strugała
- Faculty of Mechanical Engineering and Ship Technology, Gdańsk University of Technology, 80-233 Gdansk, Poland; (Ł.P.); (G.S.); (A.Z.)
| | - Bartłomiej Michał Cieślik
- Department of Analytical Chemistry, Faculty of Chemistry, Gdańsk University of Technology, 80-233 Gdansk, Poland;
| | - Anna Pałubicka
- Department of Laboratory Diagnostics and Microbiology with Blood Bank, Specialist Hospital in Kościerzyna, 83-400 Kościerzyna, Poland;
- Department of Oncological Surgery, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Andrzej Zieliński
- Faculty of Mechanical Engineering and Ship Technology, Gdańsk University of Technology, 80-233 Gdansk, Poland; (Ł.P.); (G.S.); (A.Z.)
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50
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Abstract
Periprosthetic joint infection (PJI) is one of the most dreaded complications after arthroplasty surgery; thus numerous approaches have been undertaken to equip metal surfaces with antibacterial properties. Due to its antimicrobial effects, silver is a promising coating for metallic surfaces, and several types of silver-coated arthroplasty implants are in clinical use today. However, silver can also exert toxic effects on eukaryotic cells both in the immediate vicinity of the coated implants and systemically. In most clinically-used implants, silver coatings are applied on bulk components that are not in direct contact with bone, such as in partial or total long bone arthroplasties used in tumour or complex revision surgery. These implants differ considerably in the coating method, total silver content, and silver release rates. Safety issues, such as the occurrence of argyria, have been a cause for concern, and the efficacy of silver coatings in terms of preventing PJI is also controversial. The application of silver coatings is uncommon on parts of implants intended for cementless fixation in host bone, but this option might be highly desirable since the modification of implant surfaces in order to improve osteoconductivity can also increase bacterial adhesion. Therefore, an optimal silver content that inhibits bacterial colonization while maintaining osteoconductivity is crucial if silver were to be applied as a coating on parts intended for bone contact. This review summarizes the different methods used to apply silver coatings to arthroplasty components, with a focus on the amount and duration of silver release from the different coatings; the available experience with silver-coated implants that are in clinical use today; and future strategies to balance the effects of silver on bacteria and eukaryotic cells, and to develop silver-coated titanium components suitable for bone ingrowth. Cite this article: Bone Joint J 2021;103-B(3):423-429.
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Affiliation(s)
- Anna Diez-Escudero
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Nils P Hailer
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
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