A review on antimicrobial strategies in mitigating biofilm-associated infections on medical implants

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.

Polysaccharides in contact lenses: From additives to bulk materials

As the number of applications has increased, so has the demand for contact lenses comfort. Adding polysaccharides to lenses is a popular way to enhance comfort for wearers. However, this may also compromise some lens properties. It is still unclear how to balance the variation of individual lens parameters in the design of contact lenses containing polysaccharides. This review provides a comprehensive overview of how polysaccharide addition impacts lens wear parameters, such as water content, oxygen permeability, surface wettability, protein deposition, and light transmittance. It also examines how various factors, such as polysaccharide type, molecular weight, amount, and mode of incorporation into lenses modulate these effects. Polysaccharide addition can improve some wear parameters while reducing others depending on the specific conditions. The optimal method, type, and amount of added polysaccharides depend on the trade-off between various lens parameters and wear requirements. Simultaneously, polysaccharide-based contact lenses may be a promising option for biodegradable contact lenses as concerns regarding environmental risks associated with contact lens degradation continue to increase. It is hoped that this review will shed light on the rational use of polysaccharides in contact lenses to make personalized lenses more accessible.

Polysaccharide-based antibacterial coating technologies

To tackle antimicrobial resistance, a global threat identified by the United Nations, is a common cause of healthcare-associated infections (HAI) and is responsible for significant costs on healthcare systems, a substantial amount of research has been devoted to developing polysaccharide-based strategies that prevent bacterial attachment and biofilm formation on surfaces. Polysaccharides are essential building blocks for life and an abundant renewable resource that have attracted much attention due to their intrinsic remarkable biological potential antibacterial activities. If converted into efficient antibacterial coatings that could be applied to a broad range of surfaces and applications, polysaccharide-based coatings could have a significant potential global impact. However, the ultimate success of polysaccharide-based antibacterial materials will be determined by their potential for use in manufacturing processes that are scalable, versatile, and affordable. Therefore, in this review we focus on recent advances in polysaccharide-based antibacterial coatings from the perspective of fabrication methods. We first provide an overview of strategies for designing polysaccharide-based antimicrobial formulations and methods to assess the antibacterial properties of coatings. Recent advances on manufacturing polysaccharide-based coatings using some of the most common polysaccharides and fabrication methods are then detailed, followed by a critical comparative overview of associated challenges and opportunities for future developments. STATEMENT OF SIGNIFICANCE: Our review presents a timely perspective by being the first review in the field to focus on advances on polysaccharide-based antibacterial coatings from the perspective of fabrication methods along with an overview of strategies for designing polysaccharide-based antimicrobial formulations, methods to assess the antibacterial properties of coatings as well as a critical comparative overview of associated challenges and opportunities for future developments. Meanwhile this work is specifically targeted at an audience focused on featuring critical information and guidelines for developing polysaccharide-based coatings. Including such a complementary work in the journal could lead to further developments on polysaccharide antibacterial applications.

Antimicrobial and Antiviral Properties of Triclosan-Containing Polymer Composite: Aging Effects of pH, UV, and Sunlight Exposure

The present study deals with the synthesis and characterization of a polymer composite based on an unsaturated ester loaded with 5 wt.% triclosan, produced by co-mixing on an automated hardware system. The polymer composite's non-porous structure and chemical composition make it an ideal material for surface disinfection and antimicrobial protection. According to the findings, the polymer composite effectively inhibited (100%) the growth of Staphylococcus aureus 6538-P under exposure to physicochemical factors, including pH, UV, and sunlight, over a 2-month period. In addition, the polymer composite demonstrated potent antiviral activity against human influenza virus strain A and the avian coronavirus infectious bronchitis virus (IBV), with infectious activities of 99.99% and 90%, respectively. Thus, the resulting triclosan-loaded polymer composite is revealed to have a high potential as a surface-coating non-porous material with antimicrobial properties.

"NIR-triggered ROS storage" photodynamic intraocular implant for high-efficient and safe posterior capsular opacification prevention

Posterior capsular opacification (PCO) is the leading cause of vision loss after cataract, mainly caused by the adhesion, proliferation and trans-differentiation of post-operative residual lens epithelial cells (LECs). Effective PCO prevention remains a huge challenge to ophthalmologists and researches for decades. Herein, we developed a "NIR-triggered ROS storage" intraocular implant (CTR-Py-PpIX) based on capsular tension ring (CTR), which is concurrently linked with photosensitizer protophorphyrin IX (PpIX) and energy storage 2-pyridone derivative (Py), to guarantee instantaneous and sustainable ROS generation for LECs killing, aiming to achieve more efficient and safer photodynamic therapy (PDT) to effectively prevent PCO. The silylated PpIX-Si and Py-Si were covalently conjugated to the plasma activated CTR surface to obtain CTR-Py-PpIX. Results demonstrated that CTR-Py-PpIX had dual functions of PDT and battery, in which PpIX could generate ROS extracellularly under irradiation, with one part directly inhibiting LECs by lipid peroxidation (LPO) induction of cell membranes. Meanwhile, the excess ROS stored in Py could be continuously released to amplify LPO levels after the irradiation was removed. Ultimately, the proliferation of LECs in capsular bag was completely inhibited under mild irradiation conditions, achieving a sustainable and controlled PDT effect for effective PCO prevention with good biocompatibility. This NIR-triggered ROS storage intraocular implant would provide a more efficient and safer approach for long-term PCO prevention.

Foldable Bulk Anti-adhesive Polyacrylic Intraocular Lens Material Design and Fabrication for Posterior Capsule Opacification Prevention

Posterior capsular opacification (PCO) is a primary complication after phacoemulsification combined with intraocular lens (IOL) implantation, which is attributed to adhesion, proliferation, and migration of residual lens epithelial cells on IOL. Although surface hydrophilic coating is considered to be a powerful way to inhibit PCO incidence after surgery, it requires complex post-production processes, thus limiting their applicability. In comparison, bulk modification is a stable, effective, and facile IOL synthesis method for PCO prevention. Herein, a new anti-adhesive IOL material was designed and successfully synthesized by radical copolymerization of ethylene glycol phenyl ether methacrylate (EGPEMA) and 2-(2-ethoxyethoxy) ethyl acrylate (EA). The physicochemical properties of P(EGPEMA-co-EA) copolymer materials, including chemical structure, mechanical, thermal, surface, and optical properties, were analyzed by using ¹H NMR spectroscopy, FT-IR spectroscopy, tensile test, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), water contact angle measurement, and UV-vis spectroscopy. The elongation at break and the modulus of elasticity of the copolymer were tunable through the change of the composition of monomers. Compared to other components, the tensile results showed that P(EGPEMA-co-EA) materials (70% EGPEMA in mass ratio, F7) are suitable for the preparation of foldable intraocular lens with lower elastic modulus and higher elongation at break. TGA and DSC showed that the material has high thermal stability, and the glass transition temperature of F7 material is 16.1 °C. The water contact angle measurement results showed that the introduction of EA improved the hydrophilicity of the material. The percentage of transmittance of all copolymers at 400-800 nm is above 85%. Then, the biocompatibility of the materials was evaluated by in vitro assay and subcutaneous implantation. Both in vitro results and subcutaneous implantation experiments showed that the designed IOL materials exhibited a good anti-adhesion effect and no cytotoxicity. Finally, phacoemulsification and IOL intraocular implantation were performed, and the in vivo results confirmed the good PCO prevention ability as well as the biocompatibility of the new IOL materials.

Surfaces with Antifouling-Antimicrobial Dual Function via Immobilization of Lysozyme on Zwitterionic Polymer Thin Films

Due to the emergence of wide-spread infectious diseases, there is a heightened need for antimicrobial and/or antifouling coatings that can be used to prevent infection and transmission in a variety...

Applications of Lysozyme, an Innate Immune Defense Factor, as an Alternative Antibiotic

Lysozyme is a ~14 kDa protein present in many mucosal secretions (tears, saliva, and mucus) and tissues of animals and plants, and plays an important role in the innate immunity, providing protection against bacteria, viruses, and fungi. Three main different types of lysozymes are known: the c-type (chicken or conventional type), the g-type (goose type), and the i-type (invertebrate type). It has long been the subject of several applications due to its antimicrobial properties. The problem of antibiotic resistance has stimulated the search for new molecules or new applications of known compounds. The use of lysozyme as an alternative antibiotic is the subject of this review, which covers the results published over the past two decades. This review is focused on the applications of lysozyme in medicine, (the treatment of infectious diseases, wound healing, and anti-biofilm), veterinary, feed, food preservation, and crop protection. It is available from a wide range of sources, in addition to the well-known chicken egg white, and its synergism with other compounds, endowed with antimicrobial activity, are also summarized. An overview of the modified lysozyme applications is provided in the form of tables.

A transparent hydrophilic anti-biofouling coating for intraocular lens materials prepared by "bridging" of the intermediate adhesive layer

The attachment of bio-foulants, including unwanted cells, proteins, and bacteria, to a medical device such as an intraocular lens can lead to implantation failure. Hydrophilic polymers are often used as surface modifiers in the fabrication of anti-biofouling coatings, but a hydrophilic coating can easily become swollen and peel off the substrate. In this study, we chose polymethyl methacrylate (PMMA) as the representative material of intraocular lenses because PMMA has better biocompatibility, a higher refractive index, better optical clarity, lighter weight, more stable performance, and lower cost than other intraocular lens materials. We fabricated polyvinyl alcohol (PVA) coatings with or without a "bridge", that is, an intermediate adhesive layer (AL), to increase the adhesion bonding effect between the anti-biofouling coating and the substrate. The results indicated that the prepared coatings were transparent and noncytotoxic. Moreover, the anti-adhesion properties of the cells and the resistance properties to nonspecific protein adsorption of PMMA modified by both AL and PVA coatings were better and more durable compared with the sample only modified with a physically dipped PVA coating. The coating prepared by AL "bridging" provides a new strategy for the preparation of a transparent hydrophilic anti-biofouling coating suitable for PMMA intraocular lens materials.

Foldable Glistening-Free Acrylic Intraocular Lens Biomaterials with Dual-Side Heterogeneous Surface Modification for Postoperative Endophthalmitis and Posterior Capsule Opacification Prophylaxis

Hydrophobic acrylic intraocular lenses (IOLs) are widely used in cataract treatment for posterior capsule opacification (PCO) prophylaxis. However, undesired glistening and postoperative endophthalmitis are two major potential risks. Hence, a series of poly(2-phenoxyethyl methacrylate-co-2-phenoxyethyl acrylate-co-2-ethylhexyl methacrylate) (PPPE) acrylic IOL materials were synthesized for "glistening-free" optimization. The selected PPPE with 2% 2-ethylhexyl methacrylate showed excellent optical, foldable, and thermomechanical properties. The anterior surface of PPPE was coated with polydopamine followed by gentamycin conjugation (PDA/GS). It inhibited bacterial adhesion by 74% and decreased the biofilm thickness by 87%. In inflammatory mimicking conditions, bacterial proliferation was restrained, with acidic-dependent GS release behavior. The surface of PPPE toward the posterior capsule remained hydrophobic. It was conducive to human lens epithelial cell adhesion, collagen IV and fibronectin adsorption, and the following "sealed sandwich structure" formation. In summary, the PPPE with a dual-side heterogeneous surface displayed good application prospects in postoperative endophthalmitis and PCO prevention.

A Critical Appraisal of New Developments in Intraocular Lens Modifications and Drug Delivery Systems for the Prevention of Cataract Surgery Complications

Cataract surgery is the commonest ophthalmic surgery worldwide. The replacement of the diseased lens with a synthetic one (intraocular lens-IOL) remains the treatment of choice, despite its potential complications that include infection, inflammation and posterior capsule opacification. The potential for drug delivery via the IOL has been researched extensively over a period of twenty-five years, yet there is very limited progress in transferring the findings from research to everyday practice. The objective of this review is to assess the progress made in the field of IOL lens modifications and drug delivery systems over the past five years. Thirty-six studies that were conducted during the past five years were identified and deemed suitable for inclusion. They were grouped in three broad categories, studies that described new methods for loading a drug onto the IOL, assessment of the effects of drugs that were loaded to the IOL and studies that assessed the effects of non-pharmaceutical modifications of IOLs. While considerable progress is continually being made with regard to methods and materials, there is still little capitalization upon these research studies, with no commercially available IOL-based drug delivery system being available. Close cooperation between researchers in basic sciences (chemistry, physics, materials science and pharmacy), clinical researchers, IOL manufacturers and the pharmaceutical industry is an important prerequisite for further development.

A scope at antifouling strategies to prevent catheter-associated infections

The use of invasive medical devices is becoming more common nowadays, with catheters representing one of the most used medical devices. However, there is a risk of infection associated with the use of these devices, since they are made of materials that are prone to bacterial adhesion with biofilm formation, often requiring catheter removal as the only therapeutic option. Catheter-related urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs) are among the most common causes of healthcare-associated infections (HAIs) worldwide while endotracheal intubation is responsible for ventilator-associated pneumonia (VAP). Therefore, to avoid the use of biocides due to the potential risk of bacterial resistance development, antifouling strategies aiming at the prevention of bacterial adherence and colonization of catheter surfaces represent important alternative measures. This review is focused on the main strategies that are able to modify the physical or chemical properties of biomaterials, leading to the creation of antiadhesive surfaces. The most promising approaches include coating the surfaces with hydrophilic polymers, such as poly(ethylene glycol) (PEG), poly(acrylamide) and poly(acrylates), betaine-based zwitterionic polymers and amphiphilic polymers or the use of bulk-modified poly(urethanes). Natural polysaccharides and its modifications with heparin, have also been used to improve hemocompatibility. Recently developed bioinspired techniques yielding very promising results in the prevention of bacterial adhesion and colonization of surfaces include slippery liquid-infused porous surfaces (SLIPS) based on the superhydrophilic rim of the pitcher plant and the Sharklet topography inspired by the shark skin, which are potential candidates as surface-modifying approaches for biomedical devices. Concerning the potential application of most of these strategies in catheters, more in vivo studies and clinical trials are needed to assure their efficacy and safety for possible future use.

Antibacterial Nanopillar Array for an Implantable Intraocular Lens

Postsurgical intraocular lens (IOL) infection caused by pathogenic bacteria can result in blindness and often requires a secondary operation to replace the contaminated lens. The incorporation of an antibacterial property onto the IOL surface can prevent bacterial infection and postoperative endophthalmitis. This study describes a polymeric nanopillar array (NPA) integrated onto an IOL, which captures and eradicates the bacteria by rupturing the bacterial membrane. This is accomplished by changing the behavior of the elastic nanopillars using bending, restoration, and antibacterial surface modification. The combination of the polymer coating and NPA dimensions can decrease the adhesivity of corneal endothelial cells and posterior capsule opacification without causing cytotoxicity. An ionic antibacterial polymer layer is introduced onto an NPA using an initiated chemical vapor deposition process. This improves bacterial membrane rupture efficiency by increasing the interactions between the bacteria and nanopillars and damages the bacterial membrane using quaternary ammonium compounds. The newly developed ionic polymer-coated NPA exceeds 99% antibacterial efficiency against Staphylococcus aureus, which is achieved through topological and physicochemical surface modification. Thus, this paper provides a novel, efficient strategy to prevent postoperative complications related to bacteria contamination of IOL after cataract surgery.

Multifunctional Tannic Acid (TA) and Lysozyme (Lys) Films Built Layer by Layer for Potential Application on Implant Coating

A multifunctional (TA/Lys)_n film, featuring good antioxidant property, fast cell attachment at the initial stage, enhanced osteogenesis, and broad-spectrum antibacterial property, was constructed by the layer-by-layer (LBL) method. The building process was monitored by quartz crystal microbalance with dissipation (QCM-D); the physical properties, such as topography, stiffness in dry and liquid state, and conformation of Lys in the film, were thoroughly characterized. These physical properties were modulated by varying the salt concentration at which the film was constructed. The film not only allows for favorable cell attachment and proliferation of preosteoblasts Mc3t3-E1 but also provides antibacterial property against Gram-positive bacteria, S. aureus and M. lysodeikticus, and Gram-negative bacteria, E. coli. It also displays good antioxidant property, which plays a critical role on fast cell attachment at the initial stage.

Bacterial infection microenvironment-responsive enzymatically degradable multilayer films for multifunctional antibacterial properties

The adhesion of bacteria is one of the most important stages in biofilm formation and bacterial infection. Once bacteria have adhered to a biomaterial surface, it is hard to eliminate them, and bacterial growth and infection are inevitable. In the current study, we have designed and constructed enzymatically degradable (hyaluronic acid/chitosan)n-(hyaluronic acid/polylysine)n ((HA/CHI)n-(HA/PLL)n) composite multilayer films via a layer-by-layer self-assembly method. Spectroscopic ellipsometry and scanning electron microscopy cross section measurements showed the exponential growth behavior of (HA/CHI)10-(HA/PLL)10 multilayer films (∼2 μm). The increased secretion of hyaluronidase and chymotrypsin in the bacterial infection microenvironment led to the fast degradation of the outer (PLL/HA)n multilayer films in the first 24 h. Enzymatic degradation of the multilayer films efficiently reduced the adhesion of both Staphylococcus aureus and Escherichia coli (>99%). Bacterial live/dead staining demonstrated the bactericidal action of the remaining bottom (CHI/HA)n multilayer films against the two kinds of bacteria. In vivo subcutaneous tests on New Zealand white rabbits, wound appearance and histopathology analysis showed that the implantation of composite multilayer film-modified PDMS promoted wound healing and the materials demonstrated a self-defense antibacterial effect. The material demonstrated both anti-adhesive and bactericidal properties and could be used to modify biomedical implants.

Biomimetic Hyaluronic Acid-Lysozyme Composite Coating on AZ31 Mg Alloy with Combined Antibacterial and Osteoinductive Activities

This study presents the covalent grafting of a hyaluronic acid-lysozyme (HA-LZ) composite onto corrosion-resistant silane-coated AZ31 Mg alloy via EDC-NHS coupling reactions. The HA-LZ composite coatings created a smooth and hydrophilic surface with the increased concentration of functional lysozyme complexed to the hyaluronic acid. This was confirmed by the measurement of AFM, water contact angle, and quantification of hyaluronic acid and lysozyme. The colonization of S.aureus on HA-LZ composite-coated substrates was significantly reduced as compared to the hyaluronic acid, lysozyme coated and uncoated AZ31 controls. Such activity is due to the enhanced antibacterial activity of lysozyme component as observed from the spread plate assay, propidium iodide staining, and scanning electron microscopy. Furthermore, morphology of the osteoblast cells, alkaline phosphatase activity and DNA quantification studies demonstrated the improved biocompatibility and osteoinductive properties of HA-LZ-coated substrates. This was verified by comparing with the lysozyme coated and uncoated AZ31 substrates in terms of cell adhesion, proliferation, and differentiation of osteoblastic cells. Therefore, such multifunctional composite coatings with antibacterial and osteoinductive properties are promising can be potentially used for the surface modifications of orthopedic implants.

A self-defensive antibacterial coating acting through the bacteria-triggered release of a hydrophobic antibiotic from layer-by-layer films

Drug delivery systems play important roles in the construction of antibacterial coatings on the surfaces of biomaterials. However, excessive release of antibiotics in the environment can lead to the generation of resistant bacteria. A methoxy poly(ethylene glycol)-poly(ε-caprolactone)-chitosan (MPEG-PCL-CS) block polymer was prepared through covalent grafting of CS onto MPEG-PCL. MPEG-PCL-CS micelles were prepared and showed a high load capacity for the hydrophobic antibiotic triclosan (TCA) (∼5 wt%). Multilayer films were constructed through self-assembling TCA/MPEG-PCL-CS cationic micelles with poly(acrylic acid) (PAA). Transmission and scanning electron microscopy analyses confirmed the presence of micelles on the surface (20-40 nm). As barriers for the antibiotic, the (TCA/MPEG-PCL-CS)/PAA multilayer films contained a high load of TCA (255 μg cm-2). Importantly, the multilayer films showed both bacteria-triggered and pH-responsive release properties and can be used as self-defensive antibacterial coatings. Bacterial adhesion caused a local acidic environment and altered the permeability of the multilayer films, promoting drug release. Both in vitro and in vivo antibacterial tests indicated a high bactericidal activity of drug-loaded multilayer films against both E. coli and S. aureus.

Antimicrobial efficiency of PAA/(PVP/CHI) erodible polysaccharide multilayer through loading and controlled release of antibiotics

The adhesion of bacteria and subsequent formation of biofilm on the surface of implants greatly affect the long-term use of the implants. The low molar mass gentamicin (GS) cations could hardly be directly incorporated into the multilayer films through alternately deposition with a polyanion. Herein, we have designed and constructed a (poly(acrylic acid)/(polyvinylpyrrolidone/chitosan))_n ((PAA/(PVP/CHI))_n) multilayer films through layer-by-layer self-assembly method. Through increasing the pH to destroy hydrogen bonding between PAA and PVP, PVP released into the solution and GS simultaneously combined with PAA through electrostatic interactions. The loading dosage of GS into the (PAA/(PVP/CHI))₁₀ multilayer film was up to 153.84±18.64μg/cm² and could be precisely tuned through changing the thickness of the films. The release behaviour of GS in phosphate buffer saline could also be regulated through thermal cross-linking of the films. The drug-loaded multilayer films displayed efficient against three kinds of Gram-positive and three kinds of Gram-negative bacteria and one kind of fungi, and good biocompatibility towards human lens epithelial cells. GS-loaded multilayer films-coated polydimethylsiloxane (PDMS) were compared with pristine PDMS in the rabbit subcutaneous S. aureus infection model. The antimicrobial-coated implants yielded a much lower degree of infections than pristine implants at day seven.

Hyaluronan as a promising excipient for ocular drug delivery

Hyaluronan (HA) is a naturally occurring polysaccharide and well known for its exceptional properties such as high biocompatibility and biodegradability, along with a low immunogenicity. Besides its use for various biomedical applications it recently came into focus as a favorable excipient for the formulation of various ocular therapeutics. This review article summarizes the ocular distribution of HA and its most heavily investigated binding protein "cluster of differentiation 44" (CD44) which is the rationale for the clinical use of HA, primarily as an additive in ocular applications ranging from eye drops to contact lenses. Moreover, examples will be given for using HA in various pre-clinical approaches to generate entirely new therapeutics, most notably in the field of nanotechnology.

Construction of a temperature-responsive terpolymer coating with recyclable bactericidal and self-cleaning antimicrobial properties

Once a biomedical implant is implanted into a human body, proteins and bacteria can easily colonize the implant, and subsequently, a biofilm can grow on the surface. A biofilm can protect the inhabiting bacteria against macrophages and neutrophil cell attack from the host immune system. The most important issue for artificial antibacterial surfaces is the accumulation of the bacteria corpse after they are killed by contact, which promotes further adhesion of bacteria and biofilm formation. Therefore, we constructed a novel multifunctional bactericidal and fouling release antibacterial surface through the combination of temperature-responsive N-vinylcaprolactam (VCL), hydrophilic 2-methacryloyloxyethyl phosphorylcholine (MPC) and a bactericidal quaternary ammonium salt (2-(dimethylamino)-ethyl methacrylate (DMAEMA+)). The terpolymer coating was prepared through surface-initiated reversible addition-fragmentation chain-transfer (RAFT) polymerization and characterized using water contact angle measurements, atomic force microscopy and spectroscopic ellipsometry. At a temperature above the lower critical solution temperature (LCST), the P(VCL-co-DMAEMA+-co-MPC) terpolymer coating was in a compressed and hydrophobic state with low moisture content, which displayed bactericidal efficiency against Gram-positive Staphylococcus aureus. The coating could be switched into a relatively hydrophilic surface at a temperature below the LCST, which showed self-cleaning properties against both bacteria and bovine serum albumin. The functionalized surface showed good biocompatibility against human lens epithelial cells as evaluated by morphology studies and activity measurements.

Copolymer Brushes with Temperature-Triggered, Reversibly Switchable Bactericidal and Antifouling Properties for Biomaterial Surfaces

The adherence of bacteria and the formation of biofilm on implants is a serious problem that often leads to implant failure. A series of antimicrobial coatings have been constructed to resist bacterial adherence or to kill bacteria through contact with or release of antibacterial agents. The accumulation of dead bacteria facilitates further bacterial contamination and biofilm development. Herein, we have designed and constructed a novel, reversibly switchable bactericidal and antifouling surface through surface-initiated reversible addition-fragmentation chain transfer (RAFT) polymerization to combine thermally responsive N-isopropylacrylamide (NIPAAm) and bactericidal quaternary ammonium salts (2-(dimethylamino)-ethyl methacrylate (DMAEMA⁺)). Measurements of spectroscopic ellipsometry and water contact angle and X-ray photoelectron spectroscopy were used to examine the process of the surface functionalization. The temperature-responsive P(DMAEMA⁺-co-NIPAAm) copolymer coating can switch by phase transition between a hydrophobic capturing surface at high temperatures and a relatively hydrophilic antifouling surface at lower temperatures. The quaternary ammonium salts of PDMAEMA⁺ displayed bactericidal efficiency against both Escherichia coli and Staphylococcus aureus. The functionalized surface could efficiently prevent bovine serum albumin adsorption and had good biocompatibility against human lens epithelial cells.

In vitro and in vivo evaluation of xanthan gum-succinic anhydride hydrogels for the ionic strength-sensitive release of antibacterial agents

In this work, we report a new approach to prepare high gel performance hydrogels which are used as ionic strength-sensitive drug release systems. Succinic anhydride (SA)-modified xanthan (XG-SA) derivatives were prepared and confirmed by Fourier transform-infrared spectroscopy and proton nuclear magnetic resonance spectroscopy. Rheological measurements showed that the storage moduli (G') and loss moduli (G'') of XG-SA were much higher than native XG suggesting a higher stability of the hydrogels. XG-SA could form stable hydrogels when the content of a dry gel was 1.4 wt%. Drug release studies showed the ionic strength-sensitive and sustained release of gentamicin (GS) for 9 days under aqueous physiological conditions. Biofilm inhibition assay revealed that the XG-SA/GS hydrogels were sufficient to inhibit biofilm formation. The Kirby-Bauer method showed that there was a zone of inhibition at around 8.2 mm indicating the excellent bactericidal function of the hydrogels. Cytocompatibility assessment against human lens epithelial cells revealed that the hydrogels supported cell adhesion, proliferation and migration when the loading dosage of GS was 1 mg g-1. XG-SA/GS hydrogels were compared to native XG-SA in the rabbit subcutaneous S. aureus infection model. XG-SA/GS hydrogels yielded a significantly lower degree of infection than XG-SA hydrogels at day 7. In this way, XG-SA hydrogels are promising drug delivery materials for antibacterial applications.

Polysaccharide-based antibiofilm surfaces

Surface treatment by natural or modified polysaccharide polymers is a promising means to fight against implant-associated biofilm infections. The present review focuses on polysaccharide-based coatings that have been proposed over the last ten years to impede biofilm formation on material surfaces exposed to bacterial contamination. Anti-adhesive and bactericidal coatings are considered. Besides classical hydrophilic coatings based on hyaluronic acid and heparin, the promising anti-adhesive properties of the algal polysaccharide ulvan are underlined. Surface functionalization by antimicrobial chitosan and derivatives is extensively surveyed, in particular chitosan association with other polysaccharides in layer-by-layer assemblies to form both anti-adhesive and bactericidal coatings.

STATEMENT OF SIGNIFICANCE

Bacterial contamination of surfaces, leading to biofilm formation, is a major problem in fields as diverse as medicine, first, but also food and cosmetics. Many prophylactic strategies have emerged to try to eliminate or reduce bacterial adhesion and biofilm formation on surfaces of materials exposed to bacterial contamination, in particular implant materials. Polysaccharides are widely distributed in nature. A number of these natural polymers display antibiofilm properties. Hence, surface treatment by natural or modified polysaccharides is a promising means to fight against implant-associated biofilm infections. The present manuscript is an in-depth look at polysaccharide-based antibiofilm surfaces that have been proposed over the last ten years. This review, which is a novelty compared to published literature, will bring well documented and updated information to readers of Acta Biomaterialia.

Bottom-Up Fabrication of PEG Brush on Poly(dimethylsiloxane) for Antifouling Surface Construction

Poly(dimethylsiloxane) silicones have found many applications in biomedical devices, whereas their surface hydrophobicity always brings about unexpected bioadhesion, causing complications of the implanted biomedical devices. In this work, surface-initiated reversible addition-fragmentation chain transfer (SI-RAFT) polymerization was utilized to generate PEG brushes on silicone surface, obtaining highly hydrophilic surface coatings. Such PEG brush coated silicone presents excellent antifouling to protein, cells, and bacteria, which may have great potential in implantable biomaterial surface modifications.

Nanotechnology for the Prevention and Treatment of Cataract

PURPOSE

The purpose of this article was to review recent advances in the applications of nanotechnology in cataract treatment and prevention strategies.

DESIGN

A literature review on the use of nanotechnology for the prevention and treatment of cataract was done.

METHODS

Research articles about nanotechnology-based treatments and prevention technologies for cataract were searched on Web of Science, and the most recent advances were reported.

RESULTS

Nonsteroid anti-inflammatory drugs, natural antioxidants, biologic and chemical chaperones, and chaperones such as molecules have found great application in preventing and treating cataracts. Current scientific research on new treatment strategies, which focuses on the biochemical basis of the disease, will likely result in new anticataract agents. However, none of the drug formulations will be approved for use unless efficient delivery is promised. Nanoparticle engineering together with biomimetic strategies enable the development of next-generation, more efficient, less complex, and personalized treatments.

CONCLUSIONS

The only currently available treatment for cataracts, surgical replacement of the opacified lens, is not an easily accessible option in developing countries. New treatment strategies based on topical drugs would enable treatment to reach massive populations facing the threat of blindness and more effectively deal with the postsurgical complications. Nanotechnology plays a key role in improving drug delivery systems with enhanced controlled release, targeted delivery, and bioavailability to overcome diffusion limitations in the eye.

Bio-inspired terpolymers containing dopamine, cations and MPC: a versatile platform to construct a recycle antibacterial and antifouling surface

A new kind of bio-inspired terpolymer was synthesized by a conventional free radical terpolymerization of dopamine methacrylamide (DMA), 2-(dimethylamino)-ethyl methacrylate (DMAEMA) and 2-methacryloyloxyethyl phosphorylcholine (MPC) with azobisisobutyronitrile (AIBN) as an initiator. DMA consists of a biomimetic adhesive side chain covalently linked to a polymerizable methacrylate monomer. 1H NMR and gel permeation chromatography confirmed the successful synthesis of P(DMA-co-MPC-co-DMAEMA). The terpolymer could self-assemble on the macroscopic planar substrates with DMA as an anchor. After being quaternized by 1-bromo-heptane, terpolymers of P(DMA-co-MPC-co-DMAEMA+) with bactericidal function were obtained. The self-assembly terpolymer on the substrate was confirmed by X-ray photoelectron spectroscopy, water contact angle, spectroscopic ellipsometry and atomic force microscopy. The hydrophilicity and antifouling properties of the self-assembly coating increased greatly against bacteria, protein and cells with the increase of MPC content. As the existence of bactericidal cations for electrostatic targeting of bacteria as well as membrane lysis, the terpolymer coating showed excellent bactericidal function against E. coli and S. aureus. Biofilm inhibition assay showed that terpolymer coating was very efficient to resist bacterial adhesion and biofilm formation in a nutrient environment. Bacteria could be continuously "captured" and killed by the terpolymer coating, and then bacteria corpse was released into the solution. Importantly, this work provides a versatile strategy for the fabrication of a recycle antibacterial and antifouling surface to modify biomaterials.

Biological and Clinical Implications of Lysozyme Deposition on Soft Contact Lenses

Within a few minutes of wear, contact lenses become rapidly coated with a variety of tear film components, including proteins, lipids, and mucins. Tears have a rich and complex composition, allowing a wide range of interactions and competitive processes, with the first event observed at the interface between a contact lens and tear fluid being protein adsorption. Protein adsorption on hydrogel contact lenses is a complex process involving a variety of factors relating to both the protein in question and the lens material. Among tear proteins, lysozyme is a major protein that has both antibacterial and anti-inflammatory functions. Contact lens materials that have high ionicity and high water content have an increased affinity to accumulate lysozyme during wear, when compared with other soft lens materials, notably silicone hydrogel lenses. This review provides an overview of tear film proteins, with a specific focus on lysozyme, and examines various factors that influence protein deposition on contact lenses. In addition, the impact of lysozyme deposition on various ocular physiological responses and bacterial adhesion to lenses and the interaction of lysozyme with other tear proteins are reviewed. This comprehensive review suggests that deposition of lysozyme on contact lens materials may provide a number of beneficial effects during contact lens wear.