Effect of polymerizable quaternary ammonium monomer MEIM-x's alkyl chain length and content on bone cement's antibacterial activity and physicochemical properties

Cetyltrimethylammonium-chloride assisted in situ metabolic incorporation of nano-sized ROS-generating cascade-reaction containers in Gram-positive and Gram-negative peptidoglycan layers for the control of bacterially-induced sepsis

Cascade-reaction containers generating reactive oxygen species (ROS) as an alternative for antibiotic-based strategies for bacterial infection control, require endogenous oxygen-sources and ROS-generation close to or preferably inside target bacteria. Here, this is achieved by cetyltrimethylammonium-chloride (CTAC) assisted in situ metabolic labeling and incorporation of mesoporous SiO2-nanoparticles, dual-loaded with glucose-oxidase and Fe3O4-nanoparticles as cascade-reaction containers, inside bacterial cell walls. First, azide-functionalized d-alanine (D-Ala-N3) was inserted in cell wall peptidoglycan layers of growing Gram-positive pathogens. In Gram-negatives, this could only be achieved after outer lipid-membrane permeabilization, using a low concentration of CTAC. Low concentrations of CTAC had no adverse effect on in vitro blood clotting or hemolysis nor on the health of mice when blood-injected. Next, dibenzocyclooctyne-polyethylene-glycol modified, SiO2-nanoparticles were in situ click-reacted with d-Ala-N3 in bacterial cell wall peptidoglycan layers. Herewith, a two-step cascade-reaction is facilitated inside bacteria, in which glucose-oxidase generates H2O2 at endogenously-available glucose concentrations, while subsequently Fe3O4-nanoparticles catalyze generation of •OH from the H2O2 generated. Generation of •OH inside bacterial cell walls by dual-loaded mesoporous SiO2-nanoparticles yielded more effective in vitro killing of both planktonic Gram-positive and Gram-negative bacteria suspended in 10 % plasma than SiO2-nanoparticles solely loaded with glucose-oxidase. Gram-positive or Gram-negative bacterially induced sepsis in mice could be effectively treated by in situ pre-treatment with tail-vein injected CTAC and d-Ala-N3, followed by injection of dual-loaded cascade-reaction containers without using antibiotics. This makes in situ metabolic incorporation of cascade-reaction containers as described attractive for further investigation with respect to the control of other types of infections comprising planktonic bacteria. STATEMENT OF SIGNIFICANCE: In situ metabolic-incorporation of cascade-reaction-containers loaded with glucose-oxidase and Fe3O4 nanoparticles into bacterial cell-wall peptidoglycan is described, yielding ROS-generation from endogenous glucose, non-antibiotically killing bacteria before ROS inactivates. Hitherto, only Gram-positives could be metabolically-labeled, because Gram-negatives possess two lipid-membranes. The outer membrane impedes direct access to the peptidoglycan. This problem was solved by outer-membrane permeabilization using a quaternary-ammonium compound. Several studies on metabolic-labeling perform crucial labeling steps during bacterial-culturing that in real-life should be part of a treatment. In situ metabolic-incorporation as described, can be applied in well-plates during in vitro experiments or in the body as during in vivo animal experiments. Surprisingly, metabolic-incorporation proceeded unhampered in blood and a murine, bacterially-induced sepsis could be well treated.

Preparation and characterizations of antibacterial poly(methyl methacrylate) bone cement via copolymerization with a quaternary ammonium monomer of dimethylaminotriclosan methacrylate

Poly (methyl methacrylate) (PMMA) bone cement relies on the loaded antibiotic to realize the antibacterial purpose. But the exothermic behavior during setting often makes temperature-sensitive antibiotics inactivated. It is necessary to develop new material candidates to replace antibiotics. In this study, a new quaternary ammonium methacrylate (QAM) monomer called dimethylaminetriclosan methacrylate (DMATCM) was designed by the quaternization between 2-(Dimethylamino)ethyl methacrylate and triclosan, then employed as the modifier to explore the feasibility of equipping bone cement with antibacterial activity, and to investigate the variations on the physical and biological performances brought by the substitution ratio of DMATCM to MMA. Results showed that DMATCM opened its C=C bonding to participate in the MMA polymerization, and the quaternary ammonium group helped it to perform broad-spectrum antibacterial property against both Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. With an increased substitution ratio of DMATCM to MMA, the glass transition temperatures, the maximum exothermic temperatures, and the contact angles of bone cements declined, but the residual monomer contents, the fluid uptakes, and the setting times under Vical indentation increased. Long-term soaking made almost no changes to the weight loss and the mechanical properties of DMATCM-modified cements with lower substitution ratios of 0∼20%, and the activation rather enhanced the strengths of uncured AMBC-4 and AMBC-5 samples. Owing to more DMATCM exposed on the cement surface, the inhibition ring diameter produced by modified cement was improved to a maximum of 28.09 mm, and MC3T3-E1 cells performed the cell viabilities all beyond 70% and healthy adhesion after 72 h co-culturing. Taking all measured properties and ISO standards into account, the antibacterial bone cement under the ratio of 10% performed better, besides its good bactericidal effect, the other properties satisfied the requirements for clinical application.

Preparation of new bio-based antibacterial acrylic bone cement via modification with a biofunctional monomer of nitrofurfuryl methacrylate

The new bio-based antibacterial p(NFMA-co-MMA) bone cement exhibits excellent antibacterial performance in the treatment of osteoporotic vertebral compression fracture.

Preparation of antibacterial acrylic bone cement with methacrylate derived from benzothiazole

Methacrylate derived from benzothiazole (BTTMA) was incorporated into acrylic bone cement with a series of mass ratio (5 wt%, 10 wt%, and 15 wt%) with the aim to endow antibacterial activity. Properties such as dough time (t_dough), setting time (t_set), maximum temperature (T_peak), fluid uptake, water solubility, mechanical properties, and biocompatibility of BTTMA containing bone cements were all investigated. Bone cement without BTTMA was used as control and named as plain cement. The results showed that, after incorporating BTTMA, t_dough, flexural modulus, compressive strength of bone cements could be increased, while t_set, T_peak, fluid uptake, water solubility, and flexural strength would be reduced. All of BTTMA containing bone cements did not show hemolytic activity and cell toxicity, but only bone cement with 15 wt% of BTTMA showed antibacterial activity against Staphylococcus aureus (S. aureus).

Preparation, characterization, and antibacterial property of carboxymethyl cellulose derivatives bearing tetrabutylammonium salt

Carboxymethyl cellulose derivatives bearing tetrabutylammonium moieties (CMC-TBA) were synthesized by the acidification of carboxymethyl cellulose (CMC) followed by acid-base neutralization with tetrabutylammonium hydroxide. The products were identified by Fourier transform infrared (FT-IR), ¹H nuclear magnetic resonance (NMR) spectroscopy and the degrees of substitution (DS) values were also quantified according to the integral area values in ¹H NMR spectra. It was revealed that DS values had a positive relationship with the molar ratios of TBAOH to CMC. The antibacterial behaviors against gram-positive bacteria S. aureus and gram-negative bacteria E. coli were investigated using serial two-fold dilution method (MIC and MBC) and the disc diffusion method (inhibition zone). The results showed that comparison with CMC, all new CMC-TBA derivatives exhibited high antibacterial activity that depends on bacteria type and their degrees of cationization. The antibacterial action was more effective against S. aureus than E. coli, which could be attributed to the fact that the latter has a complicated bilayer structure of cell wall. Besides, an apparent tendency that the antibacterial activity of CMC-TBA derivatives enhanced with an increase in the degrees of cationization was found. This work suggests that these new derivatives can be introduced as efficient antibacterial biomaterials for biomedical purposes.

Progress of antibiotic-loaded bone cement in joint arthroplasty

Bone cement, consisting of polymethyl methacrylate, is a bioinert material used for prothesis fixation in joint arthroplasty. To treat orthopedic infections, such as periprosthetic joint infection, antibiotic-loaded bone cement (ALBC) was introduced into clinical practice. Recent studies have revealed the limitations of the antibacterial effect of ALBC. Moreover, with the increase in high infection risk patients and highly resistant microbes, more researches and modification of ALBC are required. This paper reviewed latest findings about ALBC for most popular and destructive pathogens, summarized the influence of antibiotic kind, drug dosage, application method, and environment towards characteristic of ALBC. Subsequently, new cement additives and clinical applications of ALBC in joint arthroplasty were also discussed.

Synthesis of antibacterial dimethacrylate derived from niacin and its application in preparing antibacterial dental resin system

In this research, a bio-based monomer 1,3-bis(methacryloyloxy)propyl-carbonyl- hexylpyridinium bromide (QANMA) that derived from niacin was synthesized and incorporated into Bisphenol A glycidyl methacrylate (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA) (50 wt/50 wt) with a series of mass fraction as antibacterial agent. The double bond conversion (DC), volumetric shrinkage (VS), mechanical properties, water sorption (WS) and solubility (SL) were investigated among groups with different QANMA concentrations. Antibacterial activity against S. mutans were conducted by bacteria colony counting and bacteria LIVE/DEAD staining. The results showed that QANMA had no influence on DC of dental resin (p > 0.05), but would lead to lower volumetric shrinkage (p < 0.05). Only dental resin with 10 wt% and 20 wt% of QANMA showed obviously antibacterial activity. Mechanical properties, WS and SL of dental resin could be impaired by incorporation QANMA, flexural strength and modulus were decreased with the increasing of QANMA concentration (p < 0.05), while WS and SL were increased with the increasing of QANMA concentration (p < 0.05). Dental resin with 10 wt% of QANMA seemed to be the optimal resin system in this research, for it showed significant antibacterial activity and its flexural strength was still met the requirement of ISO standard. This work suggested that bio-based monomer QANMA could be used as antibacterial agent in dental materials, but further optimization experiment and biocompatibility evaluation should be taken in future.