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Eltabeeb MA, Hamed RR, El-Nabarawi MA, Teaima MH, Hamed MIA, Darwish KM, Hassan M, Abdellatif MM. Nanocomposite alginate hydrogel loaded with propranolol hydrochloride kolliphor ® based cerosomes as a repurposed platform for Methicillin-Resistant Staphylococcus aureus-(MRSA)-induced skin infection; in-vitro, ex-vivo, in-silico, and in-vivo evaluation. Drug Deliv Transl Res 2024:10.1007/s13346-024-01611-z. [PMID: 38762697 DOI: 10.1007/s13346-024-01611-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/20/2024]
Abstract
Nanocomposite alginate hydrogel containing Propranolol hydrochloride (PNL) cerosomes (CERs) was prepared as a repurposed remedy for topical skin Methicillin-Resistant Staphylococcus aureus (MRSA) infection. CERs were formed via an ethanol injection technique using different ceramides, Kolliphores® as a surfactant, and Didodecyldimethylammonium bromide (DDAB) as a positive charge inducer. CERs were optimized utilizing 13. 22 mixed-factorial design employing Design-Expert® software, the assessed responses were entrapment efficiency (EE%), particle size (PS), and zeta potential (ZP). The optimum CER, composed of 5 mg DDAB, ceramide VI, and Kolliphor® RH40 showed tubular vesicles with EE% of 92.91 ± 0.98%, PS of 388.75 ± 18.99 nm, PDI of 0.363 ± 0.01, and ZP of 30.36 ± 0.69 mV. Also, it remained stable for 90 days and manifested great mucoadhesive aspects. The optimum CER was incorporated into calcium alginate to prepare nanocomposite hydrogel. The ex-vivo evaluation illustrated that PNL was permeated in a more prolonged pattern from PNL-loaded CERs nanocomposite related to PNL-composite, optimum CER, and PNL solution. Confocal laser scanning microscopy revealed a perfect accumulation of fluorescein-labeled CERs in the skin. The in-silico investigation illustrated that the PNL was stable when mixed with other ingredients in the CERs and confirmed that PNL is a promising candidate for curing MRSA. Moreover, the PNL-loaded CERs nanocomposite revealed superiority over the PNL solution in inhibiting biofilm formation and eradication. The PNL-loaded CERs nanocomposite showed superiority over the PNL-composite for treating MRSA infection in the in-vivo mice model. Histopathological studies revealed the safety of the tested formulations. In conclusion, PNL-loaded CERs nanocomposite provided a promising, safe cure for MRSA bacterial skin infection.
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Affiliation(s)
- Moaz A Eltabeeb
- Department of Industrial Pharmacy, College of Pharmaceutical Sciences and Drug Manufacturing, Misr University for Science and Technology, Giza, Egypt.
| | - Raghda Rabe Hamed
- Department of Industrial Pharmacy, College of Pharmaceutical Sciences and Drug Manufacturing, Misr University for Science and Technology, Giza, Egypt
| | - Mohamed A El-Nabarawi
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Mahmoud H Teaima
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Mohammed I A Hamed
- Organic and Medicinal Chemistry Department, Faculty of Pharmacy, Fayoum University, Faiyum, Egypt
| | - Khaled M Darwish
- Department of Medicinal Chemistry, Faculty of Pharmacy, Suez Canal University, Ismailia, 41522, Egypt
| | - Mariam Hassan
- Department of Microbiology and Immunology, Faculty of Pharmacy, Galala University, New Galala City, Suez, 43511, Egypt
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, 11562, Egypt
| | - Menna M Abdellatif
- Department of Industrial Pharmacy, College of Pharmaceutical Sciences and Drug Manufacturing, Misr University for Science and Technology, Giza, Egypt
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Mufty H, Van Den Eynde J, Meuris B, Metsemakers WJ, Van Wijngaerden E, Vandendriessche T, Steenackers HP, Fourneau I. Pre-clinical in vivo Models of Vascular Graft Coating in the Prevention of Vascular Graft Infection: A Systematic Review. Eur J Vasc Endovasc Surg 2021; 62:99-118. [PMID: 33840577 DOI: 10.1016/j.ejvs.2021.02.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 01/26/2021] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Vascular graft infection (VGI) remains an important complication with a high mortality and morbidity rate. Currently, studies focusing on the role of vascular graft coatings in the prevention of VGI are scarce. Therefore, the aims of this study were to survey and summarise key features of pre-clinical in vivo models that have been used to investigate coating strategies to prevent VGI and to set up an ideal model that can be used in future preclinical research. DATA SOURCES A systematic review was conducted in accordance with the Preferred reporting items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive search was performed in MEDLINE (PubMed), Embase, and Web of Science. REVIEW METHODS For each database, a specific search strategy was developed. Quality was assessed with the Toxicological data Reliability Assessment Tool (ToxRTool). The type of animal model, graft, coating, and pathogen were summarised. The outcome assessment in each study was evaluated. RESULTS In total, 4 667 studies were identified, of which 94 papers focusing on in vivo testing were included. Staphylococcus aureus was the organism most used (n = 65; 67.7%). Most of the graft types were polyester grafts. Rifampicin was the most frequently used antibiotic coating (n = 43, 48.3%). In the outcome assessment, most studies mentioned colony forming unit count (n = 88; 91.7%) and clinical outcome (n = 72; 75%). According to the ToxRTool, 21 (22.3%, n = 21/94) studies were considered to be not reliable. CONCLUSION Currently published in vivo models are very miscellaneous. More attention should be paid to the methodology of these pre-clinical reports when transferring novel graft coatings into clinical practice. Variables used in pre-clinical reports (bacterial strain, duration of activity coating) do not correspond well to current clinical studies. Based on the results of this review, a proposal for a complete and comprehensive set up for pre-clinical invivo testing of anti-infectious properties of vascular graft coatings was defined.
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Affiliation(s)
- Hozan Mufty
- Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Research Unit of Vascular Surgery, KU Leuven, Leuven, Belgium.
| | - Jef Van Den Eynde
- Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Research Unit of Vascular Surgery, KU Leuven, Leuven, Belgium
| | - Bart Meuris
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Research Unit of Vascular Surgery, KU Leuven, Leuven, Belgium
| | | | - Eric Van Wijngaerden
- Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Hans P Steenackers
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| | - Inge Fourneau
- Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Research Unit of Vascular Surgery, KU Leuven, Leuven, Belgium
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Wan M, Zhang J, Wang Q, Zhan S, Chen X, Mao C, Liu Y, Shen J. In Situ Growth of Mesoporous Silica with Drugs on Titanium Surface and Its Biomedical Applications. ACS APPLIED MATERIALS & INTERFACES 2017; 9:18609-18618. [PMID: 28513138 DOI: 10.1021/acsami.7b05163] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Mesoporous silica has been developed for the modification of titanium surfaces that are used as implant materials. Yet, the traditional modification methods failed to effectively construct mesoporous silica on the titanium surface evenly and firmly, in which the interaction between mesoporous silica and titanium was mainly physical. Here, in situ growth of mesoporous silica on a titanium surface was performed using a simple evaporation-induced self-assembly strategy. Meantime, in situ introduction of drugs (heparin and vancomycin) to mesoporous silica was also adopted to improve the drug-loading amount. Both the above-mentioned processes were completed at the same time. Transmission electron microscopy, N2 adsorption-desorption isotherms, Fourier transform infrared spectroscopy, scanning electron microscopy, and water contact angle measurements were used to characterize the structure of the mesoporous silica film. Results indicated that the mesoporous silica film that in situ grew on the titanium surface was smooth, thin, transparent, and stable. Cytotoxicity, proliferation performance of osteoblast cells, and in vitro and in vivo studies of the antibacterial activity of the coating were tested. This is the first study to modify the titanium surface by the in situ growth of a mesoporous silica coating with two kinds of drugs. The stability of the mesoporous silica coating can be attributed to the chemical bonding between dopamine and silicon hydroxyl of the mesoporous silica coating, and the smooth surface of mesoporous silica is a result of the method of in situ growth. The large amount of drug-loading also could be ascribed to the in situ introduction of drugs during the synthetic process. The strategy proposed in this work will bring more possibilities for the preparation of advanced functional materials based on the combination of mesoporous structure and metallic materials.
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Affiliation(s)
- Mimi Wan
- National and Local Joint Engineering Research Center of Biomedical Functional Materials, School of Chemistry and Materials Science, Nanjing Normal University , Nanjing 210046, China
| | - Jin Zhang
- National and Local Joint Engineering Research Center of Biomedical Functional Materials, School of Chemistry and Materials Science, Nanjing Normal University , Nanjing 210046, China
| | - Qi Wang
- National and Local Joint Engineering Research Center of Biomedical Functional Materials, School of Chemistry and Materials Science, Nanjing Normal University , Nanjing 210046, China
| | - Shuyue Zhan
- National and Local Joint Engineering Research Center of Biomedical Functional Materials, School of Chemistry and Materials Science, Nanjing Normal University , Nanjing 210046, China
| | - Xudong Chen
- National and Local Joint Engineering Research Center of Biomedical Functional Materials, School of Chemistry and Materials Science, Nanjing Normal University , Nanjing 210046, China
| | - Chun Mao
- National and Local Joint Engineering Research Center of Biomedical Functional Materials, School of Chemistry and Materials Science, Nanjing Normal University , Nanjing 210046, China
| | - Yuhong Liu
- National and Local Joint Engineering Research Center of Biomedical Functional Materials, School of Chemistry and Materials Science, Nanjing Normal University , Nanjing 210046, China
| | - Jian Shen
- National and Local Joint Engineering Research Center of Biomedical Functional Materials, School of Chemistry and Materials Science, Nanjing Normal University , Nanjing 210046, China
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The release kinetics, antimicrobial activity and cytocompatibility of differently prepared collagen/hydroxyapatite/vancomycin layers: Microstructure vs. nanostructure. Eur J Pharm Sci 2017; 100:219-229. [PMID: 28132822 DOI: 10.1016/j.ejps.2017.01.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/16/2017] [Accepted: 01/25/2017] [Indexed: 11/23/2022]
Abstract
The aim of this study was to develop an osteo-inductive resorbable layer allowing the controlled elution of antibiotics to be used as a bone/implant bioactive interface particularly in the case of prosthetic joint infections, or as a preventative procedure with respect to primary joint replacement at a potentially infected site. An evaluation was performed of the vancomycin release kinetics, antimicrobial efficiency and cytocompatibility of collagen/hydroxyapatite layers containing vancomycin prepared employing different hydroxyapatite concentrations. Collagen layers with various levels of porosity and structure were prepared using three different methods: by means of the lyophilisation and electrospinning of dispersions with 0, 5 and 15wt% of hydroxyapatite and 10wt% of vancomycin, and by means of the electrospinning of dispersions with 0, 5 and 15wt% of hydroxyapatite followed by impregnation with 10wt% of vancomycin. The maximum concentration of the released active form of vancomycin characterised by means of HPLC was achieved via the vancomycin impregnation of the electrospun layers, whereas the lowest concentration was determined for those layers electrospun directly from a collagen solution containing vancomycin. Agar diffusion testing revealed that the electrospun impregnated layers exhibited the highest level of activity. It was determined that modification using hydroxyapatite exerts no strong effect on vancomycin evolution. All the tested samples exhibited sufficient cytocompatibility with no indication of cytotoxic effects using human osteoblastic cells in direct contact with the layers or in 24-hour infusions thereof. The results herein suggest that nano-structured collagen-hydroxyapatite layers impregnated with vancomycin following cross-linking provide suitable candidates for use as local drug delivery carriers.
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Revest M, Jacqueline C, Boudjemaa R, Caillon J, Le Mabecque V, Breteche A, Steenkeste K, Tattevin P, Potel G, Michelet C, Fontaine-Aupart MP, Boutoille D. New in vitro and in vivo models to evaluate antibiotic efficacy in Staphylococcus aureus prosthetic vascular graft infection. J Antimicrob Chemother 2016; 71:1291-9. [PMID: 26851611 DOI: 10.1093/jac/dkv496] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/19/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Prosthetic vascular graft infection (PVGI) is an emerging disease, mostly caused by staphylococci, with limited data regarding efficacy of current antistaphylococcal agents. We aimed to assess the efficacy of different antibiotic regimens. METHODS Six different strains of MSSA and MRSA were used. We compared results of minimal biofilm inhibitory and eradicating concentrations (MBICs and MBECs) obtained with a Calgary Biofilm Pin Lid Device (CBPD) with those yielded by an original Dacron(®)-related minimal inhibitory and eradicating concentration measure model. We then used a murine model of Staphylococcus aureus vascular prosthetic material infection to evaluate efficacy of different antibiotic regimens: vancomycin and daptomycin combined or not with rifampicin for MRSA and the same groups with cloxacillin and cloxacillin combined with rifampicin for MSSA. RESULTS We demonstrated that classical measures of MBICs and MBECs obtained with a CPBD could overestimate the decrease in antibiotic susceptibility in material-related infections and that the nature of the support used might influence the measure of biofilm susceptibility, since results yielded by our Dacron(®)-related minimal eradicating assay were lower than those found with a plastic device. In our in vivo model, we showed that daptomycin was significantly more bactericidal than comparators for some strains of MRSA or MSSA but not for all. For the majority of strains, it was as efficient as comparators. The addition of rifampicin to daptomycin did not enhance daptomycin efficacy. CONCLUSIONS Despite the heterogeneity of results according to bacterial strains, these innovative models represent an option to better evaluate the in vitro efficacy of antibiotics on Dacron(®)-related biofilm S. aureus infections, and to screen different antibiotic regimens in a mouse model of PVGIs.
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Affiliation(s)
- M Revest
- Université Nantes, Faculté Médecine EA3826 Nantes, France CHU Rennes Infectious Diseases and Intensive Care Unit, Pontchaillou Hospital, 35033 Rennes Cedex, France CIC Inserm 1414, Rennes 1 University, Pontchaillou Hospital, 35033 Rennes Cedex, France
| | - C Jacqueline
- Université Nantes, Faculté Médecine EA3826 Nantes, France
| | - R Boudjemaa
- Institut des Sciences Moléculaires Orsay, CNRS, Université Paris-Sud, 91405 Orsay, France
| | - J Caillon
- Université Nantes, Faculté Médecine EA3826 Nantes, France
| | - V Le Mabecque
- Université Nantes, Faculté Médecine EA3826 Nantes, France
| | - A Breteche
- Université Nantes, Faculté Médecine EA3826 Nantes, France
| | - K Steenkeste
- Institut des Sciences Moléculaires Orsay, CNRS, Université Paris-Sud, 91405 Orsay, France
| | - P Tattevin
- CHU Rennes Infectious Diseases and Intensive Care Unit, Pontchaillou Hospital, 35033 Rennes Cedex, France CIC Inserm 1414, Rennes 1 University, Pontchaillou Hospital, 35033 Rennes Cedex, France
| | - G Potel
- Université Nantes, Faculté Médecine EA3826 Nantes, France
| | - C Michelet
- CHU Rennes Infectious Diseases and Intensive Care Unit, Pontchaillou Hospital, 35033 Rennes Cedex, France CIC Inserm 1414, Rennes 1 University, Pontchaillou Hospital, 35033 Rennes Cedex, France
| | - M P Fontaine-Aupart
- Institut des Sciences Moléculaires Orsay, CNRS, Université Paris-Sud, 91405 Orsay, France
| | - D Boutoille
- Université Nantes, Faculté Médecine EA3826 Nantes, France CHU Nantes, Infectious Diseases Unit, Hôtel Dieu, Nantes, France
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Waeiss RA, Negrini TC, Arthur RA, Bottino MC. Antimicrobial Effects of Drug-Containing Electrospun Matrices on Osteomyelitis-Associated Pathogens. J Oral Maxillofac Surg 2014; 72:1310-9. [DOI: 10.1016/j.joms.2014.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 01/06/2014] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
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Mohammed S, Pisimisis GT, Daram SP, Bechara CF, Barshes NR, Lin PH, Kougias P. Impact of intraoperative administration of local vancomycin on inguinal wound complications. J Vasc Surg 2013; 57:1079-83. [DOI: 10.1016/j.jvs.2012.09.073] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 09/25/2012] [Accepted: 09/26/2012] [Indexed: 11/16/2022]
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Aboshady I, Raad I, Shah AS, Vela D, Dvorak T, Safi HJ, Buja LM, Khalil KG. A pilot study of a triple antimicrobial-bonded Dacron graft for the prevention of aortic graft infection. J Vasc Surg 2012; 56:794-801. [PMID: 22579134 DOI: 10.1016/j.jvs.2012.02.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 02/02/2012] [Accepted: 02/05/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Perioperative infection of an aortic graft is one of the most devastating complications of vascular surgery, with a mortality rate of 10% to 30%. The rate of amputation of the lower limbs is generally >25%, depending on the graft material, the location of the graft and infection, and the bacterial virulence. In vitro studies suggest that an antibiotic-impregnated graft may help prevent perioperative graft infection. In a pilot animal study, we tested a locally developed technique of bonding Dacron aortic grafts with three antimicrobial agents to evaluate the ensuing synergistic preventive effect on direct perioperative bacterial contamination. METHODS We surgically implanted a 6-mm vascular knitted Dacron graft in the infrarenal abdominal aorta of six Sinclair miniature pigs. Two pigs received unbonded, uninoculated grafts; two received unbonded, inoculated grafts; and two received inoculated grafts that were bonded with chlorhexidine, rifampin, and minocycline. Before implantation, the two bonded grafts and the two unbonded grafts were immersed for 15 minutes in a 2-mL bacterial solution containing 1 to 2 × 10(7) colony-forming units (CFU)/mL of Staphylococcus aureus (ATCC 29213). Two weeks after graft implantation, the pigs were euthanized, and the grafts were surgically excised for clinical, microbiologic, and histopathologic study. RESULTS The two bonded grafts treated with S aureus showed no bacterial growth upon explant, whereas the two unbonded grafts treated with S aureus had high bacterial counts (6.25 × 10(6) and 1.38 × 10(7) CFU/graft). The two control grafts (unbonded and untreated) showed bacterial growth (1.8 × 10(3) and 7.27 × 10(3) CFU/graft) that presumably reflected direct, accidental perioperative bacterial contamination; S cohnii ssp urealyticus and S chromogenes, but not S aureus, were isolated. The histopathologic and clinical data confirmed the microbiologic findings. Only pigs that received unbonded grafts showed histopathologic evidence of a perigraft abscess. CONCLUSIONS Our results suggest that bonding aortic grafts with this triple antimicrobial combination is a promising method of reducing graft infection resulting from direct postoperative bacterial contamination for at least 2 weeks. Further studies are needed to explore the ability of this novel graft to combat one of the most feared complications in vascular surgery.
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Affiliation(s)
- Ibrahim Aboshady
- Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Tex 77030, USA.
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Nelson DM, Baraniak PR, Ma Z, Guan J, Mason NS, Wagner WR. Controlled release of IGF-1 and HGF from a biodegradable polyurethane scaffold. Pharm Res 2011; 28:1282-93. [PMID: 21347565 DOI: 10.1007/s11095-011-0391-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 02/03/2011] [Indexed: 12/13/2022]
Abstract
PURPOSE Biodegradable elastomers, which can possess favorable mechanical properties and degradation rates for soft tissue engineering applications, are more recently being explored as depots for biomolecule delivery. The objective of this study was to synthesize and process biodegradable, elastomeric poly(ester urethane)urea (PEUU) scaffolds and to characterize their ability to incorporate and release bioactive insulin-like growth factor-1 (IGF-1) and hepatocyte growth factor (HGF). METHODS Porous PEUU scaffolds made from either 5 or 8 wt% PEUU were prepared with direct growth-factor incorporation. Long-term in vitro IGF-1 release kinetics were investigated in saline or saline with 100 units/ml lipase to simulate in vivo degradation. Cellular assays were used to confirm released IGF-1 and HGF bioactivity. RESULTS IGF-1 release into saline occurred in a complex multi-phasic manner for up to 440 days. Scaffolds generated from 5 wt% PEUU delivered protein faster than 8 wt% scaffolds. Lipase-accelerated scaffold degradation led to delivery of >90% protein over 9 weeks for both polymer concentrations. IGF-1 and HGF bioactivity in the first 3 weeks was confirmed. CONCLUSIONS The capacity of a biodegradable elastomeric scaffold to provide long-term growth-factor delivery was demonstrated. Such a system might provide functional benefit in cardiovascular and other soft tissue engineering applications.
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Affiliation(s)
- Devin M Nelson
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Antibiotic-Releasing Mesh Coating to Reduce Prosthetic Sepsis: An In Vivo Study. J Surg Res 2010; 163:337-43. [DOI: 10.1016/j.jss.2010.03.065] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 03/23/2010] [Accepted: 03/29/2010] [Indexed: 11/17/2022]
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Morishima M, Marui A, Yanagi S, Nomura T, Nakajima N, Hyon SH, Ikeda T, Sakata R. Sustained release of vancomycin from a new biodegradable glue to prevent methicillin-resistant Staphylococcus aureus graft infection☆. Interact Cardiovasc Thorac Surg 2010; 11:52-5. [DOI: 10.1510/icvts.2010.232447] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Piterina AV, Cloonan AJ, Meaney CL, Davis LM, Callanan A, Walsh MT, McGloughlin TM. ECM-based materials in cardiovascular applications: Inherent healing potential and augmentation of native regenerative processes. Int J Mol Sci 2009; 10:4375-4417. [PMID: 20057951 PMCID: PMC2790114 DOI: 10.3390/ijms10104375] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 09/07/2009] [Accepted: 09/30/2009] [Indexed: 01/21/2023] Open
Abstract
The in vivo healing process of vascular grafts involves the interaction of many contributing factors. The ability of vascular grafts to provide an environment which allows successful accomplishment of this process is extremely difficult. Poor endothelisation, inflammation, infection, occlusion, thrombosis, hyperplasia and pseudoaneurysms are common issues with synthetic grafts in vivo. Advanced materials composed of decellularised extracellular matrices (ECM) have been shown to promote the healing process via modulation of the host immune response, resistance to bacterial infections, allowing re-innervation and reestablishing homeostasis in the healing region. The physiological balance within the newly developed vascular tissue is maintained via the recreation of correct biorheology and mechanotransduction factors including host immune response, infection control, homing and the attraction of progenitor cells and infiltration by host tissue. Here, we review the progress in this tissue engineering approach, the enhancement potential of ECM materials and future prospects to reach the clinical environment.
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Affiliation(s)
- Anna V. Piterina
- Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical & Aeronautical Engineering, and Materials and Surface Science Institute (MSSI), University of Limerick, Limerick, Ireland; E-Mails:
(A.V.P.);
(A.J.C.);
(C.L.M.);
(L.M.D.);
(A.C.);
(M.T.W.)
| | - Aidan J. Cloonan
- Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical & Aeronautical Engineering, and Materials and Surface Science Institute (MSSI), University of Limerick, Limerick, Ireland; E-Mails:
(A.V.P.);
(A.J.C.);
(C.L.M.);
(L.M.D.);
(A.C.);
(M.T.W.)
| | - Claire L. Meaney
- Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical & Aeronautical Engineering, and Materials and Surface Science Institute (MSSI), University of Limerick, Limerick, Ireland; E-Mails:
(A.V.P.);
(A.J.C.);
(C.L.M.);
(L.M.D.);
(A.C.);
(M.T.W.)
| | - Laura M. Davis
- Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical & Aeronautical Engineering, and Materials and Surface Science Institute (MSSI), University of Limerick, Limerick, Ireland; E-Mails:
(A.V.P.);
(A.J.C.);
(C.L.M.);
(L.M.D.);
(A.C.);
(M.T.W.)
| | - Anthony Callanan
- Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical & Aeronautical Engineering, and Materials and Surface Science Institute (MSSI), University of Limerick, Limerick, Ireland; E-Mails:
(A.V.P.);
(A.J.C.);
(C.L.M.);
(L.M.D.);
(A.C.);
(M.T.W.)
| | - Michael T. Walsh
- Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical & Aeronautical Engineering, and Materials and Surface Science Institute (MSSI), University of Limerick, Limerick, Ireland; E-Mails:
(A.V.P.);
(A.J.C.);
(C.L.M.);
(L.M.D.);
(A.C.);
(M.T.W.)
| | - Tim M. McGloughlin
- Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical & Aeronautical Engineering, and Materials and Surface Science Institute (MSSI), University of Limerick, Limerick, Ireland; E-Mails:
(A.V.P.);
(A.J.C.);
(C.L.M.);
(L.M.D.);
(A.C.);
(M.T.W.)
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Marui A, Hirose K, Sakaguchi H, Arai Y, Doi K, Tsukashita M, Shimamoto T, Ikeda T, Komeda M. A potential of autologous pericardium for a sustained-release carrier of vancomycin: A pilot study in vitro. J Thorac Cardiovasc Surg 2009; 137:783-4. [DOI: 10.1016/j.jtcvs.2008.02.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2007] [Revised: 01/18/2008] [Accepted: 02/04/2008] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Biodegradable elastomers have been used in many different manners for controlled drug delivery. The development of new biodegradable elastomers has recently increased, driven mainly by tissue engineering research. OBJECTIVE This review outlines the different uses of biodegradable elastomers in controlled release. METHODS This review was limited to those papers wherein the polymer chosen as the delivery vehicle was demonstrably elastomeric. CONCLUSION Biodegradable elastomers have an established role in controlled release and an expanding role in combination scaffolds providing controlled release and mechanical stimulation capability for tissue regeneration/engineering.
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Affiliation(s)
- Brian G Amsden
- Queen's University, Department of Chemical Engineering, Kingston, Ontario, Canada.
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Renvert S, Lindahl C, Renvert H, Persson GR. Clinical and microbiological analysis of subjects treated with Brånemark or AstraTech implants: a 7-year follow-up study. Clin Oral Implants Res 2008; 19:342-7. [DOI: 10.1111/j.1600-0501.2007.01476.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sakaguchi H, Marui A, Hirose K, Nomura T, Arai Y, Bir SC, Huang Y, Esaki J, Tabata Y, Ikeda T, Komeda M. Less-invasive and highly effective method for preventing methicillin-resistant Staphylococcus aureus graft infection by local sustained release of vancomycin. J Thorac Cardiovasc Surg 2008; 135:25-31. [PMID: 18179914 DOI: 10.1016/j.jtcvs.2007.06.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2007] [Revised: 05/12/2007] [Accepted: 06/20/2007] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Methicillin-resistant Staphylococcus aureus graft infection is one of the most serious complications of vascular surgery. Vancomycin is a potent antibiotic against methicillin-resistant S. aureus; however, systemic administration of vancomycin is not very effective against methicillin-resistant S. aureus graft infection. Therefore, we investigated whether a local sustained release of vancomycin prevents methicillin-resistant S. aureus graft infection. METHODS We have developed a poly-L-lactide-co-caprolactone sheet that enabled sustained release of vancomycin for 2 weeks. An expanded polytetrafluoroethylene vascular graft patch (1.5 mm2) was sutured at the anterior wall of the incised murine abdominal aorta. Methicillin-resistant S. aureus (1.0 x 10(3) colony-forming units) was inoculated onto the graft surface. Thereafter, the graft was treated as follows (n = 6 each): no treatment (control group), local injection of an aqueous solution of vancomycin (vancomycin solution group) and local implantation of poly-L-lactide-co-caprolactone containing vancomycin (vancomycin-PLCA group). After 7 days, the graft and blood were sampled and cultured. RESULTS The methicillin-resistant S. aureus counts in the grafts of the vancomycin-PLCA group were significantly lower than those of the other groups. Blood cultures of the vancomycin-PLCA group were all negative, whereas those of the other groups were all positive for infection. The survival rate in the vancomycin-PLCA group at 28 days was considerably higher than that in the control group (83.3% vs 16.7%). CONCLUSIONS A local sustained-release sheet containing vancomycin reduced methicillin-resistant S. aureus counts in the infected vascular grafts, prevented sepsis, and drastically improved survival rates. This can be used as a highly effective and less-invasive adjunctive treatment method for preventing prosthetic methicillin-resistant S. aureus graft infection.
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Affiliation(s)
- Hisashi Sakaguchi
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Lichtenfels E, Lucas ML, Webster R, d' Azevedo PA. Profilaxia antimicrobiana em cirurgia vascular periférica: cefalosporina ainda é o padrão-ouro? J Vasc Bras 2007. [DOI: 10.1590/s1677-54492007000400012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Nas cirurgias vasculares periféricas, as cefalosporinas têm seu uso consagrado como agente antimicrobiano profilático de escolha. Recentemente, observamos uma mudança nos padrões de colonização, prevalência de patógenos e suscetibilidade geral aos antimicrobianos. Os patógenos multirresistentes vêm se tornando cada vez mais freqüentes nas infecções de ferida cirúrgica vascular, demonstrando variações regionais e locais quanto à suscetibilidade aos antimicrobianos profiláticos utilizados na rotina cirúrgica. Os dados e a literatura disponível até o momento demonstram que não existe evidência suficiente para uma mudança na rotina profilática perioperatória. Entretanto, devemos levar em consideração os padrões regionais e institucionais de prevalência de patógenos resistentes e padrões de suscetibilidade aos antimicrobianos para estabelecer guias e orientações específicas para a utilização de antimicrobianos profiláticos alternativos.
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Affiliation(s)
- Eduardo Lichtenfels
- Hospital Moinhos de Vento; Fundação Faculdade Federal de Ciências Médicas de Porto Alegre
| | - Márcio L. Lucas
- Irmandade Santa Casa de Misericórdia de Porto Alegre; FFFCMPA
| | - Ronaldo Webster
- Fundação Faculdade Federal de Ciências Médicas de Porto Alegre; Irmandade Santa Casa de Misericórdia de Porto Alegre
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Javerliat I, Goëau-Brissonnière O, Sivadon-Tardy V, Coggia M, Gaillard JL. Prevention of Staphylococcus aureus graft infection by a new gelatin-sealed vascular graft prebonded with antibiotics. J Vasc Surg 2007; 46:1026-31. [PMID: 17905555 DOI: 10.1016/j.jvs.2007.06.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2007] [Accepted: 06/03/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy of a new gelatin-sealed graft prebonded with two antibiotics in resisting infection with Staphylococcus aureus (S aureus) A980142 after direct bacterial application in a dog model. METHODS Twelve 6.0-mm polyester grafts were implanted in dogs end-to-end into the infrarenal aorta. The dogs were divided into two groups. A test group (n = 6) received experimental antibiotic-bonded gelatin-sealed knitted polyester grafts, loaded with two antibiotics, rifampin and tobramycin. A control group (n = 6) received commercial gelatin-sealed knitted polyester grafts. At the end of graft implantation, 50 mul of a 1.8 x 10(4) CFU/mL S aureus solution were instilled directly over the graft. One week after implantation, grafts were harvested with sterile technique. Quantitative cultures were obtained from all the harvested grafts. The results were expressed as colony-forming units per cm(2) of surface of the graft. Bacteriological study was also performed on various tissue samples. The chi(2) test was used to compare the culture proven infection of control and antibiotics-bonded grafts. RESULTS Mean inoculum size was similar in the two groups of dogs. Five of the six control grafts grew S aureus A980142 at the time of graft removal, whereas none of the six antibiotic-bonded gelatin-sealed grafts were infected (P = .0192). None of the organ samples were infected in the group implanted with antibiotic-bonded grafts, whereas 15/34 samples grew S. aureus in the control group. CONCLUSION These results indicate that this gelatin sealed graft prebonded with two antibiotics resists infection caused by S aureus graft contamination in a dog model.
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Affiliation(s)
- Isabelle Javerliat
- Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France
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