Biodegradable hydrophilic polyurethane PEGU25 loading antimicrobial peptide Bmap-28: a sustained-release membrane able to inhibit bacterial biofilm formation in vitro

Medical Device-Associated Biofilm Infections and Multidrug-Resistant Pathogens

Medical devices such as venous catheters (VCs) and urinary catheters (UCs) are widely used in the hospital setting. However, the implantation of these devices is often accompanied by complications. About 60 to 70% of nosocomial infections (NIs) are linked to biofilms. The main complication is the ability of microorganisms to adhere to surfaces and form biofilms which protect them and help them to persist in the host. Indeed, by crossing the skin barrier, the insertion of VC inevitably allows skin flora or accidental environmental contaminants to access the underlying tissues and cause fatal complications like bloodstream infections (BSIs). In fact, 80,000 central venous catheters-BSIs (CVC-BSIs)-mainly occur in intensive care units (ICUs) with a death rate of 12 to 25%. Similarly, catheter-associated urinary tract infections (CA-UTIs) are the most commonlyhospital-acquired infections (HAIs) worldwide.These infections represent up to 40% of NIs.In this review, we present a summary of biofilm formation steps. We provide an overview of two main and important infections in clinical settings linked to medical devices, namely the catheter-asociated bloodstream infections (CA-BSIs) and catheter-associated urinary tract infections (CA-UTIs), and highlight also the most multidrug resistant bacteria implicated in these infections. Furthermore, we draw attention toseveral useful prevention strategies, and advanced antimicrobial and antifouling approaches developed to reduce bacterial colonization on catheter surfaces and the incidence of the catheter-related infections.

Functional and toxicological evaluation of the MAA-41: a novel rationally designed antimicrobial peptide using hybridization and modification methods from LL-37 and BMAP-28

Background:

Managing bacterial infections caused by multidrug-resistant (MDR) and biofilm-forming bacteria is a global health concern. Therefore, enormous efforts were directed toward finding potential alternative antimicrobial agents such as antimicrobial peptides (AMPs).

Aim:

We aimed to synthesize a novel modified hybrid peptide designed from natural parents’ peptides with enhanced activity and reduced toxicity profile.

Method:

Rational design was used to hybridize the two antimicrobial peptides, in which the alpha-helical parts of BMAP-28 and LL-37 were combined. Then, several amino acid modifications were applied to generate a modified hybrid peptide named MAA-41. The physicochemical properties were checked using in silico methods. The MAA-41 was evaluated for its antimicrobial and anti-biofilm activities. Synergistic studies were performed with five conventional antibiotics. Finally, the cytotoxicity on mammalian cells and the hemolytic activity were assessed.

Results:

The MAA-41 revealed a broad-spectrum activity against both Gram-positive and Gram-negative bacteria including standard and MDR bacterial strains. The concentration against planktonic cells ranged between 10 and 20 μM with higher potency against Gram-negative bacteria. Additionally, the MAA-41 displayed potent activity in eradicating biofilm-forming cells, and the reported MBECs were equal to the MIC values reported for planktonic cells. This new peptide exhibited reduced toxicity profiles against erythrocyte cells but not against Vero cells. Combining MAA-41 peptides with conventional antibiotics improved the antimicrobial activity of the combined agents. Either synergistic or additive effects were shown as a significant decrease in MIC to 0.25 μM.

Conclusion:

This study proposes the validity of a novel peptide (MAA-41) with enhanced antimicrobial activity and reduced toxicity, especially when used as conventional antibiotic combinations.

Peptide profiling in cow urine reveals molecular signature of physiology-driven pathways and in-silico predicted bioactive properties

Peptidomics allows the identification of peptides that are derived from proteins. Urinary peptidomics has revolutionized the field of diagnostics as the samples represent complete systemic changes happening in the body. Moreover, it can be collected in a non-invasive manner. We profiled the peptides in urine collected from different physiological states (heifer, pregnancy, and lactation) of Sahiwal cows. Endogenous peptides were extracted from 30 individual cows belonging to three groups, each group comprising of ten animals (biological replicates n = 10). Nano Liquid chromatography Mass spectrometry (nLC-MS/MS) experiments revealed 5239, 4774, and 5466 peptides in the heifer, pregnant and lactating animals respectively. Urinary peptides of <10 kDa size were considered for the study. Peptides were extracted by 10 kDa MWCO filter. Sequences were identified by scanning the MS spectra ranging from 200 to 2200 m/z. The peptides exhibited diversity in sequences across different physiological states and in-silico experiments were conducted to classify the bioactive peptides into anti-microbial, anti-inflammatory, anti-hypertensive, and anti-cancerous groups. We have validated the antimicrobial effect of urinary peptides on Staphylococcus aureus and Escherichia coli under an in-vitro experimental set up. The origin of these peptides was traced back to certain proteases viz. MMPs, KLKs, CASPs, ADAMs etc. which were found responsible for the physiology-specific peptide signature of urine. Proteins involved in extracellular matrix structural constituent (GO:0005201) were found significant during pregnancy and lactation in which tissue remodeling is extensive. Collagen trimers were prominent molecules under cellular component category during lactation. Homophilic cell adhesion was found to be an important biological process involved in embryo attachment during pregnancy. The in-silico study also highlighted the enrichment of progenitor proteins on specific chromosomes and their relative expression in context to specific physiology. The urinary peptides, precursor proteins, and proteases identified in the study offers a base line information in healthy cows which can be utilized in biomarker discovery research for several pathophysiological studies.

A new urinary catheter design reduces in-vitro biofilm formation by influencing hydrodynamics

AIM

To evaluate the performance of a new catheter design based on different hydrodynamics aiming to reduce the development of biofilm, and compare it with a conventional Foley catheter (FC).

METHODS

The new proposed design (NPD) catheter is a modification of the FC, based on asymmetric positioning of the balloon and additional drainage holes allowing continuous urine drainage and complete voiding of the bladder. A first experiment was undertaken to assess drainage capability, and a second experiment was performed using a bioreactor with a set-up simulating the bladder and using the test catheter as a flow-through system. The biofilm formation of five bacterial species associated with catheter-associated urinary tract infection (CAUTI) was determined after 24 h of incubation using an MTT assay. Morphological evaluation was performed using scanning electron microscopy. In-vitro determination of residual fluid, and quantitative and morphological data on biofilm formation on the intravesical and intraluminal parts of the tested catheters were assessed.

RESULTS

Residual fluid was significantly higher in the FC (5.60 ± 0.43 mL) compared with the NPD catheter (0.2 ± 0.03 mL). The NPD catheter showed significantly less biofilm formation (P<0.0001) than the FC. Catheter design had a variable effect on biofilm formation depending on the bacterial strain tested. There was significantly less intraluminal biomass compared with intravesical biomass in both catheters (P<0.0001). Multi-layered biofilms that covered the FC surfaces completely were seen for all tested strains, while the NPD catheter surfaces showed reduced biofilm formation.

CONCLUSIONS

Modifications of the hydrodynamic characteristics of a catheter can significantly reduce bacterial colonization. Integrated design approaches combining chemical, mechanical and topographical elements can help to reduce the occurrence of CAUTI.

Antimicrobial Peptides in Farm Animals: An Updated Review on Its Diversity, Function, Modes of Action and Therapeutic Prospects

Antimicrobial peptides (AMPs) are the arsenals of the innate host defense system, exhibiting evolutionarily conserved characteristics that are present in practically all forms of life. Recent years have witnessed the emergence of antibiotic-resistant bacteria compounded with a slow discovery rate for new antibiotics that have necessitated scientific efforts to search for alternatives to antibiotics. Research on the identification of AMPs has generated very encouraging evidence that they curb infectious pathologies and are also useful as novel biologics to function as immunotherapeutic agents. Being innate, they exhibit the least cytotoxicity to the host and exerts a wide spectrum of biological activity including low resistance among microbes and increased wound healing actions. Notably, in veterinary science, the constant practice of massive doses of antibiotics with inappropriate withdrawal programs led to a high risk of livestock-associated antimicrobial resistance. Therefore, the world faces tremendous pressure for designing and devising strategies to mitigate the use of antibiotics in animals and keep it safe for posterity. In this review, we illustrate the diversity of farm animal-specific AMPs, and their biochemical foundations, mode of action, and prospective application in clinics. Subsequently, we present the data for their systematic classification under the major and minor groups, antipathogenic action, and allied bioactivities in the host. Finally, we address the limitations of their clinical implementation and envision areas for further advancement.

Functional-modified polyurethanes for rendering surfaces antimicrobial: An overview

Antimicrobial surfaces and coatings are rapidly emerging as primary components in functional modification of materials and play an important role in addressing the problems associated with biofouling and microbial infection. Polyurethane (PU) consisting of alternating soft and hard segments has been one of the most important coating materials that have been widely applied in many fields due to its versatile properties. This review attempts to provide insight into the recent advances in antimicrobial polyurethane coatings or surfaces. According to different classes of antimicrobial components along with their antimicrobial mechanism, the synthesis pathways are presented systematically herein to afford polyurethane with antimicrobial properties. Also, the challenges and opportunities of antimicrobial PU coatings and surfaces are also discussed. This review will be beneficial to the exploitation and the further studies of antimicrobial polyurethane materials for a variety of applications.

Implantable Medical Devices and Tissue Engineering: An Overview of Manufacturing Processes and the Use of Polymeric Matrices for Manufacturing and Coating their Surfaces

Medical devices are important diagnosis and therapy tools for several diseases which include a wide range of products. Technological advances in this area have been proposed to reduce adverse complication incidences. New technologies and manufacturing processes, as well as the development of new materials or medical devices with modified surface and the use of biodegradable polymeric devices such as a substrate for cell culture in the field of tissue engineering, have attracted considerable attention in recent years by the scientific community intended to produce medical devices with superior properties and morphology. This review article focused on implantable devices, addresses the major advances in the biomedical field related to the devices manufacture processes such as 3D printing and hot melting extrusion, and the use of polymer matrices composed of copolymers, blends, nanocomposites or grafted with antiproliferative drugs for manufacturing and/or coating the devices surface.

Biodegradable ciprofloxacin-incorporated waterborne polyurethane polymers prevent bacterial biofilm formation in vitro

The aim of the present study was to explore whether ciprofloxacin-incorporated waterborne polyurethane (WBPU) polymers have the capacity to inhibit bacterial biofilm formation in vitro. WBPU polymers were incorporated with ciprofloxacin and were cultured with Escherichia coli (E. coli) or Staphylococcus aureus (S. aureus) in media for 2, 4 or 7 days. In another experiment, the WBPU membranes were cultured with Proteus mirabilis (P. mirabilis) in artificial urine for 2, 4 or 7 days. Colony counting, scanning electron microscopy and fluorescence confocal microscopy were utilized to examine bacterial biofilms on the surfaces of membranes. The membranes were further co-cultured with P. mirabilis in a simple model of an artificial catheterized bladder in order to evaluate their ability to control encrustation. The WBPU films with ciprofloxacin effectively inhibited bacterial biofilm formation in the culture medium and in artificial urine. In addition, in artificial urine, the films with ciprofloxacin reduced catheter obstruction. In conclusion, ciprofloxacin-incorporated WBPU polymers are able to effectively inhibit bacterial biofilm formation in vitro.

On-demand release of ciprofloxacin from a smart nanofiber depot with acoustic stimulus

Herein, an antibiotic-loaded electrospun scaffold with improved drug delivery via acoustic stimulation has been developed. Ultrasound stimulus with an intensity of 15 W/cm², duty-cycle of 50% and duration of 10 min was repeatedly applied to ciprofloxacin loaded alginate fibers. Ultrasonication with the aforesaid conditions increased drug release from scaffold probably due to disturbance of ionic crosslinks of alginate network. Scaffolds exposed to acoustic stimulus revealed higher antibacterial activity compared to those with no stimulus. Interestingly, antibiotic release radically increased and antibacterial function improved as ultrasound perturbed scaffold framework, but scaffold integrity was regained once the ultrasound probe was retracted.

Evaluation of a ureteral catheter coating by means of a BioEncrustation in vitro model

Biomaterials for applications in the urinary tract are challenged with both biofilm formation and encrustation, two highly interconnected processes. While great effort has been achieved developing promising materials there is only a limited choice of sophisticated in vitro models that are available to analyse the performance of biomaterials prior to performing delicate and expensive in vivo studies. In this study we present a complex BioEncrustation model that imitates both the processes of multi-species biofilm formation and encrustation in vitro. The resulting crystalline biofilms are compared to the deposits found on explanted ureteral stent surfaces (in vivo situation) and to deposits formed in an experimental set up that does not contain bacteria (Encrustator®). Further focus of this study is dedicated to employing the developed BioEncrustation model to evaluate the effect multifunctional coatings impose on the processes of biofilm formation and encrustation under in vitro conditions. The investigated TANP coating combines unspecific and broad band specific antibacterial properties with a degrading polymer matrix that is intended to inhibit crystal formation. The coating was prepared on both polyurethane and silicone tubes and the subsequent results of the in vitro BioEncrustation analyses reveal a promising potential for employing the coating to render ureteral stent surfaces more biocompatible.

Mechanistic and structural basis of bioengineered bovine Cathelicidin-5 with optimized therapeutic activity

Peptide-drug discovery using host-defense peptides becomes promising against antibiotic-resistant pathogens and cancer cells. Here, we customized the therapeutic activity of bovine cathelicidin-5 targeting to bacteria, protozoa, and tumor cells. The membrane dependent conformational adaptability and plasticity of cathelicidin-5 is revealed by biophysical analysis and atomistic simulations over 200 μs in thymocytes, leukemia, and E. coli cell-membranes. Our understanding of energy-dependent cathelicidin-5 intrusion in heterogeneous membranes aided in designing novel loss/gain-of-function analogues. In vitro findings identified leucine-zipper to phenylalanine substitution in cathelicidin-5 (1-18) significantly enhance the antimicrobial and anticancer activity with trivial hemolytic activity. Targeted mutants of cathelicidin-5 at kink region and N-terminal truncation revealed loss-of-function. We ensured the existence of a bimodal mechanism of peptide action (membranolytic and non-membranolytic) in vitro. The melanoma mouse model in vivo study further supports the in vitro findings. This is the first structural report on cathelicidin-5 and our findings revealed potent therapeutic application of designed cathelicidin-5 analogues.

Release of bioactive peptides from polyurethane films in vitro and in vivo: Effect of polymer composition

Thermoplastic polyurethanes (TPUs) are widely used in biomedical applications due to their excellent biocompatibility. Their role as matrices for the delivery of small molecule therapeutics has been widely reported. However, very little is known about the release of bioactive peptides from this class of polymers. Here, we report the release of linear and cyclic peptides from TPUs with different hard and soft segments. Solvent casting of the TPU at room temperature mixed with the different peptides resulted in reproducible efflux profiles with no evidence of drug degradation. Peptide release was dependent on the size as well as the composition of the TPU. Tecoflex 80A (T80A) showed more extensive release than ElastEon 5-325, which correlated with a degree of hydration. It was also shown that the composition of the medium influenced the rate and extent of peptide efflux. Blending the different TPUs allowed for better control of peptide efflux, especially the initial burst effect. Peptide-loaded TPU prolonged the plasma levels of the anti-inflammatory cyclic peptide PMX53, which normally has a plasma half-life of less than 30min. Using a blend of T80A and E5-325, therapeutic plasma levels of PMX53 were observed up to 9days following a single intraperitoneal implantation of the drug-loaded film. PMX53 released from the blended TPUs significantly inhibited B16-F10 melanoma tumor growth in mice demonstrating its bioactivity in vivo. This study provides important findings for TPU-based therapeutic peptide delivery that could improve the pharmacological utility of peptides as therapeutics.

STATEMENT OF SIGNIFICANCE

Therapeutic peptides can be highly specific and potent pharmacological agents, but are poorly absorbed and rapidly degraded in the body. This can be overcome by using a matrix that protects the peptide in vivo and promotes its slow release so that a therapeutic effect can be achieved over days or weeks. Thermoplastic polyurethanes are a versatile family of polymers that are biocompatible and used for medical implants. Here, the release of several peptides from a range of polyurethanes was shown to depend on the type of polymer used in the polyurethane. This is the first study to examine polyurethane blends for peptide delivery and shows that the rate and extent of peptide release can be fine-tuned using different hard and soft segment mixtures in the polymer.

A Novel Surface Structure Consisting of Contact-active Antibacterial Upper-layer and Antifouling Sub-layer Derived from Gemini Quaternary Ammonium Salt Polyurethanes

Contact-active antibacterial surfaces play a vital role in preventing bacterial contamination of artificial surfaces. In the past, numerous researches have been focused on antibacterial surfaces comprising of antifouling upper-layer and antibacterial sub-layer. In this work, we demonstrate a reversed surface structure which integrate antibacterial upper-layer and antifouling sub-layer. These surfaces are prepared by simply casting gemini quaternary ammonium salt waterborne polyurethanes (GWPU) and their blends. Due to the high interfacial energy of gemini quaternary ammonium salt (GQAS), chain segments containing GQAS can accumulate at polymer/air interface to form an antibacterial upper-layer spontaneously during the film formation. Meanwhile, the soft segments composed of polyethylene glycol (PEG) formed the antifouling sub-layer. Our findings indicate that the combination of antibacterial upper-layer and antifouling sub-layer endow these surfaces strong, long-lasting antifouling and contact-active antibacterial properties, with a more than 99.99% killing efficiency against both gram-positive and gram-negative bacteria attached to them.

A novel non-releasing antibacterial poly(styrene-acrylate)/waterborne polyurethane composite containing gemini quaternary ammonium salt

Novel non-releasing antibacterial poly(styrene-acrylate)/waterborne polyurethane composites containing gemini quaternary ammonium salt were designed and preparedviaa facile blending strategy.