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Kadirvelu L, Sivaramalingam SS, Jothivel D, Chithiraiselvan DD, Karaiyagowder Govindarajan D, Kandaswamy K. A review on antimicrobial strategies in mitigating biofilm-associated infections on medical implants. CURRENT RESEARCH IN MICROBIAL SCIENCES 2024; 6:100231. [PMID: 38510214 PMCID: PMC10951465 DOI: 10.1016/j.crmicr.2024.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Biomedical implants are crucial in providing support and functionality to patients with missing or defective body parts. However, implants carry an inherent risk of bacterial infections that are biofilm-associated and lead to significant complications. These infections often result in implant failure, requiring replacement by surgical restoration. Given these complications, it is crucial to study the biofilm formation mechanism on various biomedical implants that will help prevent implant failures. Therefore, this comprehensive review explores various types of implants (e.g., dental implant, orthopedic implant, tracheal stent, breast implant, central venous catheter, cochlear implant, urinary catheter, intraocular lens, and heart valve) and medical devices (hemodialyzer and pacemaker) in use. In addition, the mechanism of biofilm formation on those implants, and their pathogenesis were discussed. Furthermore, this article critically reviews various approaches in combating implant-associated infections, with a special emphasis on novel non-antibiotic alternatives to mitigate biofilm infections.
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Affiliation(s)
- Lohita Kadirvelu
- Research Center for Excellence in Microscopy, Department of Biotechnology, Kumaraguru College of Technology, Coimbatore, 641049, Tamil Nadu, India
| | - Sowmiya Sri Sivaramalingam
- Research Center for Excellence in Microscopy, Department of Biotechnology, Kumaraguru College of Technology, Coimbatore, 641049, Tamil Nadu, India
| | - Deepsikha Jothivel
- Research Center for Excellence in Microscopy, Department of Biotechnology, Kumaraguru College of Technology, Coimbatore, 641049, Tamil Nadu, India
| | - Dhivia Dharshika Chithiraiselvan
- Research Center for Excellence in Microscopy, Department of Biotechnology, Kumaraguru College of Technology, Coimbatore, 641049, Tamil Nadu, India
| | | | - Kumaravel Kandaswamy
- Research Center for Excellence in Microscopy, Department of Biotechnology, Kumaraguru College of Technology, Coimbatore, 641049, Tamil Nadu, India
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Jiang H, Li L, Li Z, Chu X. Metal-based nanoparticles in antibacterial application in biomedical field: Current development and potential mechanisms. Biomed Microdevices 2024; 26:12. [PMID: 38261085 PMCID: PMC10806003 DOI: 10.1007/s10544-023-00686-8] [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] [Accepted: 11/27/2023] [Indexed: 01/24/2024]
Abstract
The rise in drug resistance in pathogenic bacteria greatly endangers public health in the post-antibiotic era, and drug-resistant bacteria currently pose a great challenge not only to the community but also to clinical procedures, including surgery, stent implantation, organ transplantation, and other medical procedures involving any open wound and compromised human immunity. Biofilm-associated drug failure, as well as rapid resistance to last-resort antibiotics, necessitates the search for novel treatments against bacterial infection. In recent years, the flourishing development of nanotechnology has provided new insights for exploiting promising alternative therapeutics for drug-resistant bacteria. Metallic agents have been applied in antibacterial usage for several centuries, and the functional modification of metal-based biomaterials using nanotechnology has now attracted great interest in the antibacterial field, not only for their intrinsic antibacterial nature but also for their ready on-demand functionalization and enhanced interaction with bacteria, rendering them with good potential in further translation. However, the possible toxicity of MNPs to the host cells and tissue still hinders its application, and current knowledge on their interaction with cellular pathways is not enough. This review will focus on recent advances in developing metallic nanoparticles (MNPs), including silver, gold, copper, and other metallic nanoparticles, for antibacterial applications, and their potential mechanisms of interaction with pathogenic bacteria as well as hosts.
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Affiliation(s)
- Hao Jiang
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Lingzhi Li
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Zhong Li
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Xiang Chu
- State Key Laboratory of Trauma, Burn and Combined Injury, Department of Emergency, Daping Hospital, Army Medical University, Chongqing, 400042, China
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Sathishkumar S, Paulraj J, Chakraborti P, Muthuraj M. Comprehensive Review on Biomaterials and Their Inherent Behaviors for Hip Repair Applications. ACS APPLIED BIO MATERIALS 2023; 6:4439-4464. [PMID: 37871169 DOI: 10.1021/acsabm.3c00327] [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] [Indexed: 10/25/2023]
Abstract
Developing biomaterials for hip prostheses is challenging and requires dedicated attention from researchers. Hip replacement is an inevitable and remarkable orthopedic therapy for enhancing the quality of patient life for those who have arthritis as well as trauma. Generally, five types of hip replacement procedures are successfully performed in the current medical market: total hip replacements, hip resurfacing, hemiarthroplasty, bipolar, and dual mobility systems. The average life span of artificial hip joints is about 15 years, and several studies have been conducted over the last 60 years to improve the performance and thereby increase the lifespan of artificial hip joints. Present-day prosthetic hip joints are linked to the wide availability of biomaterials. Metals, ceramics, and polymers are some of the most promising types of biomaterials; nevertheless, each biomaterial has advantages and disadvantages. Metals and ceramics fail in most applications owing to stress shielding and the emission of wear debris; ongoing research is being carried out to find a remedy to these unfavorable responses. Recent research found that polymers and composites based on polymers are significant alternative materials for artificial joints. With growing research and several biomaterials, recent reviews lag in effectively addressing hip implant materials' individual mechanical, tribological, and physiological behaviors. This Review comprehensively investigates the historical evolution of artificial hip replacement procedures and related biomaterials' mechanical, tribological, and biological characteristics. In addition, the most recent advances are also discussed to stimulate and guide future researchers as they seek more effective methods and synthesis of innovative biomaterials for hip arthroplasty application.
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Liu X, Li X, Huo S, Lu L, Zhou C, Li Z. Magnesium bioactive glass hybrid functionalized polyetheretherketone with immunomodulatory function to guide cell fate and bone regeneration. Colloids Surf B Biointerfaces 2023; 230:113523. [PMID: 37634286 DOI: 10.1016/j.colsurfb.2023.113523] [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: 07/01/2023] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
Polyetheretherketone (PEEK) is being increasingly recognized as a highly promising polymer implant in orthopaedics due to its advantageous biocompatibility, favorable processability, and radiation resistance. Nonetheless, the long-term application of PEEK implants in vivo faces challenges due to unfavorable post-implantation inflammatory and immune reactions, which result in suboptimal osseointegration rates. Hence, biofunctionalizing the surface of PEEK implants emerges as a viable strategy to enhance osseointegration and increase the success rate. In this study, we developed a multifunctional PEEK implant through the in-situ incorporation of chitosan-coated bioactive glass nanoparticles (BGNs). This approach can impart immunomodulatory properties and enhance the potential for osseointegration. The resulting biofunctionalized PEEK material exhibited multiple beneficial effects. For instance, it facilitated M2 phenotypic polarization of macrophages, diminished the expression of inflammatory factors, and enhanced the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in vitro. Moreover, it exhibited an improved capacity for osseointegration when tested in vivo. The findings of the experiment highlighted the pivotal and complex role of the biofunctionalized PEEK implant in maintaining typical bone immunity and metabolism. The study proposes that the application of chitosan-BGNs presents a straightforward approach to developing multifunctional implants with the ability to promote biomineralization and immunomodulation, specifically tailored for orthopaedic applications.
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Affiliation(s)
- Xuesong Liu
- Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, China
| | - Xinyu Li
- Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, China
| | - Shicheng Huo
- Department of Orthopedic Surgery, Spine Center, Changzheng Hospital, Navy Medical University, China
| | - Liangjing Lu
- Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, China
| | - Chun Zhou
- Orthpaedic Trauma, Department of Orthopedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, China.
| | - Zhanyu Li
- Orthpaedic Trauma, Department of Orthopedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, China.
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Ma H, Han H, Zhao X, Ma J, Qu X, Lou X, Suonan A, Lei B, Zhang Y. Engineering Multifunctional Polyether Ether Ketone Implant: Mechanics-Adaptability, Biominerialization, Immunoregulation, Anti-Infection, Osteointegration, and Osteogenesis. Adv Healthc Mater 2023; 12:e2202799. [PMID: 36808883 DOI: 10.1002/adhm.202202799] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/23/2022] [Indexed: 02/19/2023]
Abstract
Polyether ether ketone (PEEK) has become one of the most promising polymer implants in bone orthopedics, due to the biocompatibility, good processability, and radiation resistance. However, the poor mechanics-adaptability/osteointegration/osteogenesis/antiinfection limits the long-term in vivo applications of PEEK implants. Herein, a multifunctional PEEK implant (PEEK-PDA-BGNs) is constructed through in situ surface deposition of polydopamine-bioactive glass nanoparticles (PDA-BGNs). PEEK-PDA-BGNs exhibit good performance on osteointegration and osteogenesis in vitro and in vivo, due to their multifunctional properties including mechanics-adaptability, biominerialization, immunoregulation, anti-infection, and osteoinductive activity. PEEK-PDA-BGNs can show the bone tissue-adaptable mechanic surface and induce the rapid biomineralization (apatite formation) under a simulated body solution. Additionally, PEEK-PDA-BGNs can induce the M2 phenotype polarization of macrophages, reduce the expression of inflammatory factors, promote the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), and improve the osseointegration and osteogenesis ability of the PEEK implant. PEEK-PDA-BGNs also show good photothermal antibacterial activity and can kill 99% of Escherichia coli (E. coli) and Methicillin-resistant Staphylococcus aureus (MRSA), suggesting their potential antiinfection ability. This work suggests that PDA-BGNs coating is probably a facile strategy to construct multifunctional (biomineralization, antibacterial, immunoregulation) implants for bone tissue replacement.
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Affiliation(s)
- Hongyun Ma
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P. R. China.,Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710000, P. R. China.,Department of Orthopedics, Qinghai Provincial People's Hospital, Qinghai, 810007, P. R. China
| | - Hao Han
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P. R. China.,Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710000, P. R. China
| | - Xiaoming Zhao
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P. R. China.,Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710000, P. R. China
| | - Junping Ma
- Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710000, P. R. China
| | - Xiaoyan Qu
- Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710000, P. R. China
| | - Xiaoxiao Lou
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P. R. China
| | - Angxiu Suonan
- Department of Orthopedics, Qinghai Provincial People's Hospital, Qinghai, 810007, P. R. China
| | - Bo Lei
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P. R. China.,Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710000, P. R. China
| | - Yingang Zhang
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P. R. China
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Imani A, Clifford AM, Raman RKS, Asselin E. Insight into synergetic effects of serum albumin and glucose on the biodegradation behavior of WE43 alloy in simulated body fluid. Biomed Mater 2022; 18. [PMID: 36395511 DOI: 10.1088/1748-605x/aca3e8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/17/2022] [Indexed: 11/18/2022]
Abstract
The biodegradation rate of Mg alloy medical devices, such as screws and plates for temporary bone fracture fixation or coronary angioplasty stents, is an increasingly important area of study.In vitromodels of the corrosion behavior of these devices use revised simulated body fluid (m-SBF) based on a healthy individual's blood chemistry. Therefore, model outputs have limited application to patients with altered blood plasma glucose or protein concentrations. This work studies the biodegradation behavior of Mg alloy WE43 in m-SBF modified with varying concentrations of glucose and bovine serum albumin (BSA) to (1) mimic a range of disease states and (2) determine the contributions of each biomolecule to corrosion. Measurements include the Mg ion release rate, electrolyte pH, the extent of hydrogen evolution (as a proxy for corrosion rate), surface morphology, and corrosion product composition and effects. BSA (0.1 g l-1) suppresses the rate of hydrogen evolution (about 30%) after 24 h and-to a lesser degree-Mg2+release in both the presence and absence of glucose. This effect gets more pronounced with time, possibly due to BSA adsorption on the Mg surface. Electrochemical studies confirm that adding glucose (2 g l-1) to the solution containing BSA (0.1 g l-1) caused a decrease in corrosion resistance (by around 40%), and concomitant increase in the hydrogen evolution rate (from 10.32 to 11.04 mg cm-2d-1) to levels far beyond the tolerance limits of live tissues.
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Affiliation(s)
- Amin Imani
- Department of Materials Engineering, Faculty of Applied Science, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada.,Department of Mechanical and Aerospace Engineering, Monash University, Clayton, VIC 3800, Australia
| | - Amanda M Clifford
- Department of Materials Engineering, Faculty of Applied Science, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - R K Singh Raman
- Department of Mechanical and Aerospace Engineering, Monash University, Clayton, VIC 3800, Australia.,Department of Chemical and Biological Engineering, Monash University, Clayton, VIC 3800, Australia
| | - Edouard Asselin
- Department of Materials Engineering, Faculty of Applied Science, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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