β-FeOOH/Fe-TiO2 heterojunctions on Ti for bacteria inactivation under light irradiation and biosealing

Porous Titanium Scaffolds with Mechanoelectrical Conversion and Photothermal Function: A Win-Win Strategy for Bone Reconstruction of Tumor-Resected Defects

Bone metastases severely threaten the lives of patients. Although surgical treatment combined with adjuvant chemotherapy significantly improves the survival rate of patients, tumor recurrence, or metastasis after surgical resection and bone defects caused by surgical treatment remain major challenges for clinicians. Given the abovementioned clinical requirements, barium titanate-containing iron-coated porous titanium alloy scaffolds have been proposed to promote bone defect repair and inhibit tumor recurrence. Fortunately, in vitro and in vivo experimental research confirms that barium titanate containing iron-coated porous titanium alloy scaffolds promote osteogenesis and bone reconstruction in defect repair via mechanoelectric conversion and inhibit tumor recurrence via photothermal effects. Furthermore, the underlying and intricate mechanisms of bone defect repair and tumor recurrence prevention of barium titanate-containing iron-coated porous titanium alloy scaffolds are explored. A win-win strategy for mechanoelectrical conversion and photothermal functionalization provides promising insights into bone reconstruction of tumor-resected defects.

Surface-Confined Piezocatalysis Inspired by ROS Generation of Mitochondria Respiratory Chain for Ultrasound-Driven Noninvasive Elimination of Implant Infection

Implant-associated infections (IAI) are great challenges to medical healthcare and human wellness, yet current clinical treatments are limited to the use of antibiotics and physical removal of infected tissue or the implant. Inspired by the protein/membrane complex structure and its generation of reactive oxygen species in the mitochondria respiration process of immune cells during bacteria invasion, we herein propose a metal/piezoelectric nanostructure embedded on the polymer implant surface to achieve efficient piezocatalysis for combating IAI. The piezoelectricity-enabled local electron discharge and the induced oxidative stress generated at the implant-bacteria interface can efficiently inhibit the activity of the attachedStaphylococcus aureusby cell membrane disruption and sugar energy exhaustion, possess high biocompatibility, and eliminate the subcutaneous infection by simply applying the ultrasound stimulation. For further demonstration, the treatment of root canal reinfection with simplified procedures has been achieved by using piezoelectric gutta-percha implanted in ex vivo human teeth. This surface-confined piezocatalysis antibacterial strategy, which takes advantage of the limited infection interspace, easiness of polymer processing, and noninvasiveness of sonodynamic therapy, has potential applications in IAI treatment.

Alkaline "Nanoswords" Coordinate Ferroptosis-like Bacterial Death for Antibiosis and Osseointegration

Ferroptosis is an iron-dependent cell death and is associated with cancer therapy. Can it play a role in resistance of postoperative infection of implants, especially with an extracellular supplement of Fe ions in a non-cytotoxic dose? To answer this, "nanoswords" of Fe-doped titanite are fabricated on a Ti implant surface to resist bacterial invasion by a synergistic action of ferroptosis-like bacteria killing, proton disturbance, and physical puncture. The related antibiosis mechanism is explored by atomic force microscopy and genome sequencing. The nanoswords induce an increased local pH value, which not only weakens the proton motive force, reducing adenosine triphosphate synthesis of Staphylococcus aureus, but also decreases the membrane modulus, making the nanoswords distort and even puncture a bacterial membrane easily. Simultaneously, more Fe ions are taken by bacteria due to increased bacterial membrane permeability, resulting in ferroptosis-like death of bacteria, and this is demonstrated by intracellular iron enrichment, lipid peroxidation, and glutathione depletion. Interestingly, a microenvironment constructed by these nanoswords improves osteoblast behavior in vitro and bone regeneration in vivo. Overall, the nanoswords can induce ferroptosis-like bacterial death without cytotoxicity and have great promise in applications with clinical implants for outstanding antibiosis and biointegration performance.

Building biointegration of Fe2O3-FeOOH coated titanium implant by regulating NIR irradiation in an infected model

Killing bacteria, eliminating biofilm and building soft tissue integration are very important for percutaneous implants which service in a complicated environment. In order to endow Ti implants with above abilities, multifunctional coatings consisted of Fe₂O₃–FeOOH nanograins as an outer layer and Zn doped microporous TiO₂ as an inner layer were fabricated by micro-arc oxidation, hydrothermal treatment and annealing treatment. The microstructures, physicochemical properties and photothermal response of the coatings were observed; their antibacterial efficiencies and cell response in vitro as well as biofilm elimination and soft tissue integration in vivo were evaluated. The results show that with the increased annealing temperature, coating morphologies didn't change obviously, but lattices of β-FeOOH gradually disorganized into amorphous state and rearranged to form Fe₂O_3. The coating annealed at 450 °C (MA450) had nanocrystallized Fe₂O₃ and β-FeOOH. With a proper NIR irradiation strategy, MA450 killed adhered bacteria efficiently and increased fibroblast behaviors via up-regulating fibrogenic-related genes in vitro; in an infected model, MA450 eliminated biofilm, reduced inflammatory response and improved biointegration with soft tissue. The good performance of MA450 was due to a synergic effect of photothermal response and released ions (Zn²⁺ and Fe³⁺).

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Nanocrystallized Fe₂O₃–FeOOH layer endows Ti with good photothermal response.

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With NIR irradiation, Fe₂O₃–FeOOH layer improves biointegration in an infected model.

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Photothermal response combined with released ions gives implants good performance.