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Akay S, Yaghmur A. Recent Advances in Antibacterial Coatings to Combat Orthopedic Implant-Associated Infections. Molecules 2024; 29:1172. [PMID: 38474684 DOI: 10.3390/molecules29051172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/02/2024] [Accepted: 03/03/2024] [Indexed: 03/14/2024] Open
Abstract
Implant-associated infections (IAIs) represent a major health burden due to the complex structural features of biofilms and their inherent tolerance to antimicrobial agents and the immune system. Thus, the viable options to eradicate biofilms embedded on medical implants are surgical operations and long-term and repeated antibiotic courses. Recent years have witnessed a growing interest in the development of robust and reliable strategies for prevention and treatment of IAIs. In particular, it seems promising to develop materials with anti-biofouling and antibacterial properties for combating IAIs on implants. In this contribution, we exclusively focus on recent advances in the development of modified and functionalized implant surfaces for inhibiting bacterial attachment and eventually biofilm formation on orthopedic implants. Further, we highlight recent progress in the development of antibacterial coatings (including self-assembled nanocoatings) for preventing biofilm formation on orthopedic implants. Among the recently introduced approaches for development of efficient and durable antibacterial coatings, we focus on the use of safe and biocompatible materials with excellent antibacterial activities for local delivery of combinatorial antimicrobial agents for preventing and treating IAIs and overcoming antimicrobial resistance.
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Affiliation(s)
- Seref Akay
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Anan Yaghmur
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
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2
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Bredikhin M, Sawant S, Gross C, Antonio ELS, Borodinov N, Luzinov I, Vertegel A. Highly Adhesive Antimicrobial Coatings for External Fixation Devices. Gels 2023; 9:639. [PMID: 37623093 PMCID: PMC10453896 DOI: 10.3390/gels9080639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/26/2023] Open
Abstract
Pin site infections arise from the use of percutaneous pinning techniques (as seen in skeletal traction, percutaneous fracture pinning, and external fixation for fracture stabilization or complex deformity reconstruction). These sites are niduses for infection because the skin barrier is disrupted, allowing for bacteria to enter a previously privileged area. After external fixation, the rate of pin site infections can reach up to 100%. Following pin site infection, the pin may loosen, causing increased pain (increasing narcotic usage) and decreasing the fixation of the fracture or deformity correction construct. More serious complications include osteomyelitis and deep tissue infections. Due to the morbidity and costs associated with its sequelae, strategies to reduce pin site infections are vital. Current strategies for preventing implant-associated infections include coatings with antibiotics, antimicrobial polymers and peptides, silver, and other antiseptics like chlorhexidine and silver-sulfadiazine. Problems facing the development of antimicrobial coatings on orthopedic implants and, specifically, on pins known as Kirschner wires (or K-wires) include poor adhesion of the drug-eluting layer, which is easily removed by shear forces during the implantation. Development of highly adhesive drug-eluting coatings could therefore lead to improved antimicrobial efficacy of these devices and ultimately reduce the burden of pin site infections. In response to this need, we developed two types of gel coatings: synthetic poly-glycidyl methacrylate-based and natural-chitosan-based. Upon drying, these gel coatings showed strong adhesion to pins and remained undamaged after the application of strong shear forces. We also demonstrated that antibiotics can be incorporated into these gels, and a K-wire with such a coating retained antimicrobial efficacy after drilling into and removal from a bone. Such a coating could be invaluable for K-wires and other orthopedic implants that experience strong shear forces during their implantation.
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Affiliation(s)
- Mikhail Bredikhin
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA; (M.B.); (S.S.)
| | - Sushant Sawant
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA; (M.B.); (S.S.)
| | - Christopher Gross
- Department of Orthopedic Surgery, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Erik L. S. Antonio
- Department of Materials Science and Enfineering, Clemson University, Clemson, SC 29634, USA; (E.L.S.A.); (N.B.); (I.L.)
| | - Nikolay Borodinov
- Department of Materials Science and Enfineering, Clemson University, Clemson, SC 29634, USA; (E.L.S.A.); (N.B.); (I.L.)
| | - Igor Luzinov
- Department of Materials Science and Enfineering, Clemson University, Clemson, SC 29634, USA; (E.L.S.A.); (N.B.); (I.L.)
| | - Alexey Vertegel
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA; (M.B.); (S.S.)
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Abdelhamid AG, Yousef AE. Combating Bacterial Biofilms: Current and Emerging Antibiofilm Strategies for Treating Persistent Infections. Antibiotics (Basel) 2023; 12:1005. [PMID: 37370324 DOI: 10.3390/antibiotics12061005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Biofilms are intricate multicellular structures created by microorganisms on living (biotic) or nonliving (abiotic) surfaces. Medically, biofilms often lead to persistent infections, increased antibiotic resistance, and recurrence of infections. In this review, we highlighted the clinical problem associated with biofilm infections and focused on current and emerging antibiofilm strategies. These strategies are often directed at disrupting quorum sensing, which is crucial for biofilm formation, preventing bacterial adhesion to surfaces, impeding bacterial aggregation in viscous mucus layers, degrading the extracellular polymeric matrix, and developing nanoparticle-based antimicrobial drug complexes which target persistent cells within the biofilm core. It is important to acknowledge, however, that the use of antibiofilm agents faces obstacles, such as limited effectiveness in vivo, potential cytotoxicity to host cells, and propensity to elicit resistance in targeted biofilm-forming microbes. Emerging next generation antibiofilm strategies, which rely on multipronged approaches, were highlighted, and these benefit from current advances in nanotechnology, synthetic biology, and antimicrobial drug discovery. The assessment of current antibiofilm mitigation approaches, as presented here, could guide future initiatives toward innovative antibiofilm therapeutic strategies. Enhancing the efficacy and specificity of some emerging antibiofilm strategies via careful investigations, under conditions that closely mimic biofilm characteristics within the human body, could bridge the gap between laboratory research and practical application.
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Affiliation(s)
- Ahmed G Abdelhamid
- Department of Food Science and Technology, The Ohio State University, 2015 Fyffe Court, Columbus, OH 43210, USA
- Botany and Microbiology Department, Faculty of Science, Benha University, Benha 13518, Egypt
| | - Ahmed E Yousef
- Department of Food Science and Technology, The Ohio State University, 2015 Fyffe Court, Columbus, OH 43210, USA
- Department of Microbiology, The Ohio State University, 105 Biological Sciences Building, 484 West 12th Avenue, Columbus, OH 43210, USA
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Talebian S, Mendes B, Conniot J, Farajikhah S, Dehghani F, Li Z, Bitoque D, Silva G, Naficy S, Conde J, Wallace GG. Biopolymeric Coatings for Local Release of Therapeutics from Biomedical Implants. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2207603. [PMID: 36782094 PMCID: PMC10131825 DOI: 10.1002/advs.202207603] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Indexed: 06/18/2023]
Abstract
The deployment of structures that enable localized release of bioactive molecules can result in more efficacious treatment of disease and better integration of implantable bionic devices. The strategic design of a biopolymeric coating can be used to engineer the optimal release profile depending on the task at hand. As illustrative examples, here advances in delivery of drugs from bone, brain, ocular, and cardiovascular implants are reviewed. These areas are focused to highlight that both hard and soft tissue implants can benefit from controlled localized delivery. The composition of biopolymers used to achieve appropriate delivery to the selected tissue types, and their corresponding outcomes are brought to the fore. To conclude, key factors in designing drug-loaded biopolymeric coatings for biomedical implants are highlighted.
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Affiliation(s)
- Sepehr Talebian
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
- Nano Institute (Sydney Nano)The University of SydneySydneyNSW2006Australia
| | - Bárbara Mendes
- ToxOmicsNOVA Medical School|Faculdade de Ciências MédicasNMS|FCMUniversidade Nova de LisboaLisboa1169‐056Portugal
| | - João Conniot
- ToxOmicsNOVA Medical School|Faculdade de Ciências MédicasNMS|FCMUniversidade Nova de LisboaLisboa1169‐056Portugal
| | - Syamak Farajikhah
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
- Nano Institute (Sydney Nano)The University of SydneySydneyNSW2006Australia
| | - Fariba Dehghani
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
- Nano Institute (Sydney Nano)The University of SydneySydneyNSW2006Australia
| | - Zhongyan Li
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
| | - Diogo Bitoque
- ToxOmicsNOVA Medical School|Faculdade de Ciências MédicasNMS|FCMUniversidade Nova de LisboaLisboa1169‐056Portugal
| | - Gabriela Silva
- ToxOmicsNOVA Medical School|Faculdade de Ciências MédicasNMS|FCMUniversidade Nova de LisboaLisboa1169‐056Portugal
| | - Sina Naficy
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
- Nano Institute (Sydney Nano)The University of SydneySydneyNSW2006Australia
| | - João Conde
- ToxOmicsNOVA Medical School|Faculdade de Ciências MédicasNMS|FCMUniversidade Nova de LisboaLisboa1169‐056Portugal
| | - Gordon G. Wallace
- Intelligent Polymer Research InstituteARC Centre of Excellence for Electromaterials ScienceAIIM FacilityUniversity of WollongongSydneyNSW2522Australia
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Sun T, Huang J, Zhang W, Zheng X, Wang H, Liu J, Leng H, Yuan W, Song C. Simvastatin-hydroxyapatite coatings prevent biofilm formation and improve bone formation in implant-associated infections. Bioact Mater 2023; 21:44-56. [PMID: 36017072 PMCID: PMC9395756 DOI: 10.1016/j.bioactmat.2022.07.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022] Open
Abstract
Implant-associated infections (IAIs) caused by biofilm formation are the most devastating complications of orthopedic surgery. Statins have been commonly and safely used drugs for hypercholesterolemia for many years. Here, we report that simvastatin-hydroxyapatite-coated titanium alloy prevents biofilm-associated infections. The antibacterial properties of simvastatin against Staphylococcus aureus and Staphylococcus epidermidis biofilms in vitro was confirmed by crystal violet staining and live-dead bacterial staining. We developed a simvastatin-and hydroxyapatite (Sim-HA)-coated titanium alloy via electrochemical deposition. Sim-HA coatings inhibited Staphylococcus aureus biofilm formation and improved the biocompatibility of the titanium alloy. Sim-HA coatings effectively prevented Staphylococcus aureus IAI in rat femurs, as confirmed by radiological assessment and histological examination. The antibacterial effects of the Sim-HA coatings were attributed to their inhibitory effects on biofilm formation, as verified by scanning electron microscopic observations and bacterial spread plate analysis. In addition, the Sim-HA coatings enhanced osteogenesis and osteointegration, as verified by micro-CT, histological evaluation, and biomechanical pull-out tests. In summary, Sim-HA coatings are promising implant materials for protection against biofilm-associated infections. Simvastatin-hydroxyapatite coatings were prepared on Ti6Al4V by electrochemical deposition process. The Simvastatin-hydroxyapatite coatings inhibited S. aureus biofilm formation and improved biocompatibility in vitro. The coatings exhibited antibacterial effects and improved bone formation in a rat femur IAI model. Simvastatin coatings are promising for application in orthopedic implants.
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Mishra S, Gupta A, Upadhye V, Singh SC, Sinha RP, Häder DP. Therapeutic Strategies against Biofilm Infections. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010172. [PMID: 36676121 PMCID: PMC9866932 DOI: 10.3390/life13010172] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
A biofilm is an aggregation of surface-associated microbial cells that is confined in an extracellular polymeric substance (EPS) matrix. Infections caused by microbes that form biofilms are linked to a variety of animals, including insects and humans. Antibiotics and other antimicrobials can be used to remove or eradicate biofilms in order to treat infections. However, due to biofilm resistance to antibiotics and antimicrobials, clinical observations and experimental research clearly demonstrates that antibiotic and antimicrobial therapies alone are frequently insufficient to completely eradicate biofilm infections. Therefore, it becomes crucial and urgent for clinicians to properly treat biofilm infections with currently available antimicrobials and analyze the results. Numerous biofilm-fighting strategies have been developed as a result of advancements in nanoparticle synthesis with an emphasis on metal oxide np. This review focuses on several therapeutic strategies that are currently being used and also those that could be developed in the future. These strategies aim to address important structural and functional aspects of microbial biofilms as well as biofilms' mechanisms for drug resistance, including the EPS matrix, quorum sensing (QS), and dormant cell targeting. The NPs have demonstrated significant efficacy against bacterial biofilms in a variety of bacterial species. To overcome resistance, treatments such as nanotechnology, quorum sensing, and photodynamic therapy could be used.
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Affiliation(s)
- Sonal Mishra
- Laboratory of Photobiology and Molecular Microbiology, Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Amit Gupta
- Laboratory of Photobiology and Molecular Microbiology, Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Vijay Upadhye
- Department of Microbiology, Parul Institute of Applied Science (PIAS), Center of Research for Development (CR4D), Parul University, Vadodara 391760, Gujarat, India
| | - Suresh C. Singh
- Pathkits Healthcare Pvt. Ltd., Gurugram 122001, Haryana, India
| | - Rajeshwar P. Sinha
- Laboratory of Photobiology and Molecular Microbiology, Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Donat-P. Häder
- Department of Botany, Emeritus from Friedrich-Alexander University, 91096 Möhrendorf, Germany
- Correspondence: ; Tel.: +49-913-148-730
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Lopes Gama e Silva G, Sato de Souza de Bustamante Monteiro M, Lopes Dias M, Machado Costa A, Malta Rossi A, Paula dos Santos Matos A, Santos-Oliveira R, Ricci-Júnior E. Antibiotics-loaded nanofibers fabricated by electrospinning for the treatment of bone infections: An integrative review of in vitro and in vivo studies. ARAB J CHEM 2022. [DOI: 10.1016/j.arabjc.2022.104392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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8
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Li J, Cheung WH, Chow SK, Ip M, Leung SYS, Wong RMY. Current therapeutic interventions combating biofilm-related infections in orthopaedics : a systematic review of in vivo animal studies. Bone Joint Res 2022; 11:700-714. [PMID: 36214177 PMCID: PMC9582863 DOI: 10.1302/2046-3758.1110.bjr-2021-0495.r3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aims Biofilm-related infection is a major complication that occurs in orthopaedic surgery. Various treatments are available but efficacy to eradicate infections varies significantly. A systematic review was performed to evaluate therapeutic interventions combating biofilm-related infections on in vivo animal models. Methods Literature research was performed on PubMed and Embase databases. Keywords used for search criteria were “bone AND biofilm”. Information on the species of the animal model, bacterial strain, evaluation of biofilm and bone infection, complications, key findings on observations, prevention, and treatment of biofilm were extracted. Results A total of 43 studies were included. Animal models used included fracture-related infections (ten studies), periprosthetic joint infections (five studies), spinal infections (three studies), other implant-associated infections, and osteomyelitis. The most common bacteria were Staphylococcus species. Biofilm was most often observed with scanning electron microscopy. The natural history of biofilm revealed that the process of bacteria attachment, proliferation, maturation, and dispersal would take 14 days. For systemic mono-antibiotic therapy, only two of six studies using vancomycin reported significant biofilm reduction, and none reported eradication. Ten studies showed that combined systemic and topical antibiotics are needed to achieve higher biofilm reduction or eradication, and the effect is decreased with delayed treatment. Overall, 13 studies showed promising therapeutic potential with surface coating and antibiotic loading techniques. Conclusion Combined topical and systemic application of antimicrobial agents effectively reduces biofilm at early stages. Future studies with sustained release of antimicrobial and biofilm-dispersing agents tailored to specific pathogens are warranted to achieve biofilm eradication. Cite this article: Bone Joint Res 2022;11(10):700–714.
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Affiliation(s)
- Jie Li
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Simon K. Chow
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Margaret Ip
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Sharon Y. S. Leung
- School of Pharmacy, The Chinese University of Hong Kong, Hong Kong, China
| | - Ronald M. Y. Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China, Ronald Man Yeung Wong. E-mail:
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Shariati A, Chegini Z, Ghaznavi-Rad E, Zare EN, Hosseini SM. PLGA-Based Nanoplatforms in Drug Delivery for Inhibition and Destruction of Microbial Biofilm. Front Cell Infect Microbiol 2022; 12:926363. [PMID: 35800390 PMCID: PMC9253276 DOI: 10.3389/fcimb.2022.926363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/23/2022] [Indexed: 12/12/2022] Open
Abstract
The biofilm community of microorganisms has been identified as the dominant mode of microbial growth in nature and a common characteristic of different microorganisms such as Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis. The biofilm structure helps in the protection from environmental threats including host immune system and antimicrobial agents. Thus, the biofilm community has led to a higher prevalence of multidrug-resistant (MDR) strains in recent years. In this regard, the use of a new class of antibiotics, natural compounds, and anti-biofilm enzymes has been considered for the destruction of the microbial biofilm. However, different drawbacks such as low penetration, high susceptibility to degradation, instability, and poor solubility in aqueous solutions limit the use of anti-biofilm agents (ABAs) in a clinical setting. As such, recent studies have been using poly lactic-co-glycolic acid (PLGA)-based nanoplatforms (PLGA NPFs) for delivery of ABAs that have reported promising results. These particles, due to proper drug loading and release kinetics, could suppress microbial attachment, colonization, and biofilm formation for a long time. Additionally, PLGA NPFs, because of the high drug-loading efficiencies, hydrophilic surface, negative charge, and electrostatic interaction, lead to effective penetration of antibiotics to the deeper layer of the biofilm, thereby eliminating the microbial biofilm. Thus, PLGA NPFs could be considered as a potential candidate for coating catheters and other medical material surfaces for inhibition and destruction of the microbial biofilm. However, the exact interaction of PLGA NPFs and the microbial biofilm should be evaluated in animal studies. Additionally, a future goal will be to develop PLGA formulations as systems that can be used for the treatment of the MDR microbial biofilm, since the exact interactions of PLGA NPFs and these biofilm structures are not elucidated. In the present review article, we have discussed various aspects of PLGA usage for inhibition and destruction of the microbial biofilm along with different methods and procedures that have been used for improving PLGA NPF efficacy against the microbial biofilm.
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Affiliation(s)
- Aref Shariati
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran
| | - Zahra Chegini
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ehsanollah Ghaznavi-Rad
- Department of Microbiology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | | | - Seyed Mostafa Hosseini
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- *Correspondence: Seyed Mostafa Hosseini,
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Amoxicillin-loaded multilayer pullulan-based nanofibers maintain long-term antibacterial properties with tunable release profile for topical skin delivery applications. Int J Biol Macromol 2022; 215:413-423. [PMID: 35700845 DOI: 10.1016/j.ijbiomac.2022.06.054] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/22/2022]
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Wei H, Song X, Liu P, Liu X, Yan X, Yu L. Antimicrobial coating strategy to prevent orthopaedic device-related infections: recent advances and future perspectives. BIOMATERIALS ADVANCES 2022; 135:212739. [PMID: 35929213 DOI: 10.1016/j.bioadv.2022.212739] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 06/15/2023]
Abstract
The rapid development of multidrug-resistant (MDR) bacteria and biofilm-related infections (BRIs) has urgently called for new strategies to combat severe orthopaedic device-related infections (ODRIs). Antimicrobial coating has emerged as a promising strategy in halting the incidence of ODRIs and treating ODRIs in long term. With the advancement of material science and biotechnology, numerous antimicrobial coatings have been reported in literature, showing superior antimicrobial and osteogenic functions. This review has specifically discussed the currently developed antimicrobial coatings in the perspective of drug release from the coating system, focusing on their realization of controlled and on demand antimicrobial agents release, as well as multi-functionality. Acknowledging the multidisciplinary nature of antimicrobial coating, the conceptual design, the deposition method and the therapeutic effect of the antimicrobial coatings have been described in detail and discussed critically. Particularly, the challenges and opportunities on the way toward the clinical translation of antimicrobial coatings have been highlighted.
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Affiliation(s)
- Huichao Wei
- Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education College of Chemistry and Chemical Engineering, Ocean University of China, Qingdao 266100, China
| | - Xinyu Song
- Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education College of Chemistry and Chemical Engineering, Ocean University of China, Qingdao 266100, China.
| | - Pengyan Liu
- Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education College of Chemistry and Chemical Engineering, Ocean University of China, Qingdao 266100, China
| | - Xiaohu Liu
- Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education College of Chemistry and Chemical Engineering, Ocean University of China, Qingdao 266100, China
| | - Xuefeng Yan
- Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education College of Chemistry and Chemical Engineering, Ocean University of China, Qingdao 266100, China
| | - Liangmin Yu
- Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education College of Chemistry and Chemical Engineering, Ocean University of China, Qingdao 266100, China.
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12
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Ndukwe ARN, Wiedbrauk S, Boase NRB, Fairfull-Smith KE. Strategies to improve the potency of oxazolidinones towards bacterial biofilms. Chem Asian J 2022; 17:e202200201. [PMID: 35352479 PMCID: PMC9321984 DOI: 10.1002/asia.202200201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/28/2022] [Indexed: 11/29/2022]
Abstract
Biofilms are part of the natural lifecycle of bacteria and are known to cause chronic infections that are difficult to treat. Most antibiotics are developed and tested against bacteria in the planktonic state and are ineffective against bacterial biofilms. The oxazolidinones, including the last resort drug linezolid, are one of the main classes of synthetic antibiotics progressed to clinical use in the last 50 years. They have a unique mechanism of action and only develop low levels of resistance in the clinical setting. With the aim of providing insight into strategies to design more potent antibiotic compounds with activity against bacterial biofilms, we review the biofilm activity of clinically approved oxazolidinones and report on structural modifications to oxazolidinones and their delivery systems which lead to enhanced anti‐biofilm activity.
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Affiliation(s)
- Audrey R N Ndukwe
- Queensland University of Technology - QUT: Queensland University of Technology, Faculty of Science, AUSTRALIA
| | - Sandra Wiedbrauk
- Queensland University of Technology - QUT: Queensland University of Technology, Faculty of Science, AUSTRALIA
| | - Nathan R B Boase
- Queensland University of Technology - QUT: Queensland University of Technology, Faculty of Science, AUSTRALIA
| | - Kathryn E Fairfull-Smith
- Queensland University of Technology Faculty of Science, Centre for Materials Science, 2 George St, 4001, Brisbane, AUSTRALIA
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Hu J, Chen S, Yang Y, Li L, Cheng X, Cheng Y, Huang Q. A Smart Hydrogel with Anti-Biofilm and Anti-Virulence Activities to Treat Pseudomonas aeruginosa Infections. Adv Healthc Mater 2022; 11:e2200299. [PMID: 35306745 DOI: 10.1002/adhm.202200299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/26/2022] [Indexed: 01/04/2023]
Abstract
Biofilm is the main culprit of refractory infections and seriously threaten to the human health. Here, a smart hydrogel consisted of norspermidine, aminoglycosides, and oxidized polysaccharide is prepared via the formation of acid-labile imine linkage to treat Pseudomonas aeruginosa biofilm infections in several animal models. The increased acidity caused by bacterial infection triggers the release of norspermidine and aminoglycosides covalently bound with the polymer scaffold. The released norspermidine inhibits biofilm formation and virulence production by regulating the quorum sensing of P. aeruginosa, while the aminoglycoside antibiotics effectively kill the released bacteria. The gel thoroughly inhibits biofilm formation on various medical devices and decreases bacteria pathogenicity. It efficiently inhibits implantation-associated biofilm infections and chronic wound infections, and shows great promise to prevent and treat biofilm-induced refractory infection in clinics.
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Affiliation(s)
- Jingjing Hu
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, 200241, China
| | - Sijia Chen
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, 200241, China
| | - Yongxin Yang
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, 200241, China
| | - Lin Li
- Department of Orthopedics Oncology, Changzheng Hospital, Navy Medical University, Shanghai, 200003, China
| | - Xuejing Cheng
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, 200241, China
| | - Yiyun Cheng
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, 200241, China
| | - Quan Huang
- Department of Orthopedics Oncology, Changzheng Hospital, Navy Medical University, Shanghai, 200003, China
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Elsadek NE, Nagah A, Ibrahim TM, Chopra H, Ghonaim GA, Emam SE, Cavalu S, Attia MS. Electrospun Nanofibers Revisited: An Update on the Emerging Applications in Nanomedicine. MATERIALS 2022; 15:ma15051934. [PMID: 35269165 PMCID: PMC8911671 DOI: 10.3390/ma15051934] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 02/06/2023]
Abstract
Electrospinning (ES) has become a straightforward and customizable drug delivery technique for fabricating drug-loaded nanofibers (NFs) using various biodegradable and non-biodegradable polymers. One of NF's pros is to provide a controlled drug release through managing the NF structure by changing the spinneret type and nature of the used polymer. Electrospun NFs are employed as implants in several applications including, cancer therapy, microbial infections, and regenerative medicine. These implants facilitate a unique local delivery of chemotherapy because of their high loading capability, wide surface area, and cost-effectiveness. Multi-drug combination, magnetic, thermal, and gene therapies are promising strategies for improving chemotherapeutic efficiency. In addition, implants are recognized as an effective antimicrobial drug delivery system overriding drawbacks of traditional antibiotic administration routes such as their bioavailability and dosage levels. Recently, a sophisticated strategy has emerged for wound healing by producing biomimetic nanofibrous materials with clinically relevant properties and desirable loading capability with regenerative agents. Electrospun NFs have proposed unique solutions, including pelvic organ prolapse treatment, viable alternatives to surgical operations, and dental tissue regeneration. Conventional ES setups include difficult-assembled mega-sized equipment producing bulky matrices with inadequate stability and storage. Lately, there has become an increasing need for portable ES devices using completely available off-shelf materials to yield highly-efficient NFs for dressing wounds and rapid hemostasis. This review covers recent updates on electrospun NFs in nanomedicine applications. ES of biopolymers and drugs is discussed regarding their current scope and future outlook.
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Affiliation(s)
- Nehal E. Elsadek
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1 Sho-machi, Tokushima 770-8505, Japan;
| | - Abdalrazeq Nagah
- Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt; (A.N.); (G.A.G.)
| | - Tarek M. Ibrahim
- Department of Pharmaceutics, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt; (T.M.I.); (S.E.E.)
| | - Hitesh Chopra
- Chitkara College of Pharmacy, Chitkara University, Punjab 140401, India;
| | - Ghada A. Ghonaim
- Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt; (A.N.); (G.A.G.)
| | - Sherif E. Emam
- Department of Pharmaceutics, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt; (T.M.I.); (S.E.E.)
| | - Simona Cavalu
- Faculty of Medicine and Pharmacy, University of Oradea, P-ta 1 Decembrie 10, 410087 Oradea, Romania
- Correspondence: (S.C.); (M.S.A.)
| | - Mohamed S. Attia
- Department of Pharmaceutics, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt; (T.M.I.); (S.E.E.)
- Correspondence: (S.C.); (M.S.A.)
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15
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Wang Y, Dikeman D, Zhang J, Ackerman N, Kim S, Alphonse MP, Ortines RV, Liu H, Joyce DP, Dillen CA, Thompson JM, Thomas AA, Plaut RD, Miller LS, Archer NK. CCR2 contributes to host defense against Staphylococcus aureus orthopedic implant-associated infections in mice. J Orthop Res 2022; 40:409-419. [PMID: 33713394 PMCID: PMC8435538 DOI: 10.1002/jor.25027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/19/2021] [Accepted: 03/10/2021] [Indexed: 02/04/2023]
Abstract
C-C motif chemokine receptor 2 (CCR2) is an important mediator of myeloid cell chemotaxis during inflammation and infection. Myeloid cells such as monocytes, macrophages, and neutrophils contribute to host defense during orthopedic implant-associated infections (OIAI), but whether CCR2-mediated chemotaxis is involved remains unclear. Therefore, a Staphylococcus aureus OIAI model was performed by surgically placing an orthopedic-grade titanium implant and inoculating a bioluminescent S. aureus strain in knee joints of wildtype (wt) and CCR2-deficient mice. In vivo bioluminescent signals significantly increased in CCR2-deficient mice compared with wt mice at later time points (Days 14-28), which was confirmed with ex vivo colony-forming unit enumeration. S. aureus γ-hemolysin utilizes CCR2 to induce host cell lysis. However, there were no differences in bacterial burden when the OIAI model was performed with a parental versus a mutant γ-hemolysin-deficient S. aureus strain, indicating that the protection was mediated by the host cell function of CCR2 rather than γ-hemolysin virulence. Although CCR2-deficient and wt mice had similar cellular infiltrates in the infected joint tissue, CCR2-deficient mice had reduced myeloid cells and γδ T cells in the draining lymph nodes. Taken together, CCR2 contributed to host defense at later time points during an OIAI by increasing immune cell infiltrates in the draining lymph nodes, which likely contained the infection and prevented invasive spread.
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Affiliation(s)
- Yu Wang
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| | - Dustin Dikeman
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| | - Jeffrey Zhang
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| | - Nicole Ackerman
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| | - Sophia Kim
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| | - Martin P. Alphonse
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| | - Roger V. Ortines
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| | - Haiyun Liu
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| | - Daniel P. Joyce
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| | - Carly A. Dillen
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| | - John M. Thompson
- Department of Orthopaedic Surgery, Johns Hopkins University
School of Medicine, Baltimore, Maryland, USA
| | - Abigail A. Thomas
- Division of Bacterial Parasitic, and Allergenic Products,
Center for Biologics Evaluation and Research, Food and Drug Administration, Silver
Spring, Maryland, USA
| | - Roger D. Plaut
- Division of Bacterial Parasitic, and Allergenic Products,
Center for Biologics Evaluation and Research, Food and Drug Administration, Silver
Spring, Maryland, USA
| | - Lloyd S. Miller
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA,Department of Immunology, Janssen Research and Development,
Spring House, Pennsylvania, USA
| | - Nathan K. Archer
- Department of Dermatology, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
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16
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Nadar S, Khan T, Patching SG, Omri A. Development of Antibiofilm Therapeutics Strategies to Overcome Antimicrobial Drug Resistance. Microorganisms 2022; 10:microorganisms10020303. [PMID: 35208758 PMCID: PMC8879831 DOI: 10.3390/microorganisms10020303] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 02/04/2023] Open
Abstract
A biofilm is a community of stable microorganisms encapsulated in an extracellular matrix produced by themselves. Many types of microorganisms that are found on living hosts or in the environment can form biofilms. These include pathogenic bacteria that can serve as a reservoir for persistent infections, and are culpable for leading to a broad spectrum of chronic illnesses and emergence of antibiotic resistance making them difficult to be treated. The absence of biofilm-targeting antibiotics in the drug discovery pipeline indicates an unmet opportunity for designing new biofilm inhibitors as antimicrobial agents using various strategies and targeting distinct stages of biofilm formation. The strategies available to control biofilm formation include targeting the enzymes and proteins specific to the microorganism and those involved in the adhesion pathways leading to formation of resistant biofilms. This review primarily focuses on the recent strategies and advances responsible for identifying a myriad of antibiofilm agents and their mechanism of biofilm inhibition, including extracellular polymeric substance synthesis inhibitors, adhesion inhibitors, quorum sensing inhibitors, efflux pump inhibitors, and cyclic diguanylate inhibitors. Furthermore, we present the structure–activity relationships (SAR) of these agents, including recently discovered biofilm inhibitors, nature-derived bioactive scaffolds, synthetic small molecules, antimicrobial peptides, bioactive compounds isolated from fungi, non-proteinogenic amino acids and antibiotics. We hope to fuel interest and focus research efforts on the development of agents targeting the uniquely complex, physical and chemical heterogeneous biofilms through a multipronged approach and combinatorial therapeutics for a more effective control and management of biofilms across diseases.
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Affiliation(s)
- Sahaya Nadar
- Department of Pharmaceutical Chemistry, St. John Institute of Pharmacy and Research, Mumbai 400056, India;
| | - Tabassum Khan
- Department of Pharmaceutical Chemistry & Quality Assurance, SVKM’s Dr. Bhanuben Nanavati College of Pharmacy, Mumbai 400056, India;
| | - Simon G. Patching
- School of Biomedical Sciences and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds LS2 9JT, UK
- Correspondence: or (S.G.P.); (A.O.)
| | - Abdelwahab Omri
- The Novel Drug & Vaccine Delivery Systems Facility, Department of Chemistry and Biochemistry, Laurentian University, Sudbury, ON P3E 2C6, Canada
- Correspondence: or (S.G.P.); (A.O.)
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17
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Gama e Silva GL, Sato de Souza Bustamante Monteiro M, dos Santos Matos AP, Santos-Oliveira R, Kenechukwu FC, Ricci-Júnior E. Nanofibers in the treatment of osteomyelitis and bone regeneration. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2021.102999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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18
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Zhao T, Zhang J, Gao X, Yuan D, Gu Z, Xu Y. Electrospun Nanofibers for Bone Regeneration: From Biomimetic Composition, Structure to Function. J Mater Chem B 2022; 10:6078-6106. [DOI: 10.1039/d2tb01182d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In recent years, a variety of novel materials and processing technologies have been developed to prepare tissue engineering scaffolds for bone defect repair. Among them, nanofibers fabricated via electrospinning technology...
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19
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Xi W, Hegde V, Zoller SD, Park HY, Hart CM, Kondo T, Hamad CD, Hu Y, Loftin AH, Johansen DO, Burke Z, Clarkson S, Ishmael C, Hori K, Mamouei Z, Okawa H, Nishimura I, Bernthal NM, Segura T. Point-of-care antimicrobial coating protects orthopaedic implants from bacterial challenge. Nat Commun 2021; 12:5473. [PMID: 34531396 PMCID: PMC8445967 DOI: 10.1038/s41467-021-25383-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
Implant related infections are the most common cause of joint arthroplasty failure, requiring revision surgeries and a new implant, resulting in a cost of $8.6 billion annually. To address this problem, we created a class of coating technology that is applied in the operating room, in a procedure that takes less than 10 min, and can incorporate any desired antibiotic. Our coating technology uses an in situ coupling reaction of branched poly(ethylene glycol) and poly(allyl mercaptan) (PEG-PAM) polymers to generate an amphiphilic polymeric coating. We show in vivo efficacy in preventing implant infection in both post-arthroplasty infection and post-spinal surgery infection mouse models. Our technology displays efficacy with or without systemic antibiotics, the standard of care. Our coating technology is applied in a clinically relevant time frame, does not require modification of implant manufacturing process, and does not change the implant shelf life.
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Affiliation(s)
- Weixian Xi
- Department of Chemical and Biomolecular Engineering, University of California Los Angeles, Los Angeles, CA, United States
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Vishal Hegde
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Stephen D Zoller
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Howard Y Park
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Christopher M Hart
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Takeru Kondo
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, University of California Los Angeles School of Dentistry, Los Angeles, CA, United States
| | - Christopher D Hamad
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Yan Hu
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Amanda H Loftin
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Daniel O Johansen
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Zachary Burke
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Samuel Clarkson
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Chad Ishmael
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Kellyn Hori
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Zeinab Mamouei
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Hiroko Okawa
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, University of California Los Angeles School of Dentistry, Los Angeles, CA, United States
| | - Ichiro Nishimura
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, University of California Los Angeles School of Dentistry, Los Angeles, CA, United States
| | - Nicholas M Bernthal
- Department of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
| | - Tatiana Segura
- Department of Chemical and Biomolecular Engineering, University of California Los Angeles, Los Angeles, CA, United States.
- Department of Biomedical Engineering, Neurology, Dermatology, Duke University, Durham, NC, United States.
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20
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Thompson JM, Ashbaugh AG, Wang Y, Miller RJ, Pickett JE, Thorek DLJ, Sterling RS, Miller LS. Predilection for developing a hematogenous orthopaedic implant-associated infection in older versus younger mice. J Orthop Surg Res 2021; 16:556. [PMID: 34521424 PMCID: PMC8439019 DOI: 10.1186/s13018-021-02594-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/28/2021] [Indexed: 11/17/2022] Open
Abstract
Background The pathogenesis of hematogenous orthopaedic implant-associated infections (HOIAI) remains largely unknown, with little understanding of the influence of the physis on bacterial seeding. Since the growth velocity in the physis of long bones decreases during aging, we sought to evaluate the role of the physis on influencing the development of Staphylococcus aureus HOIAI in a mouse model comparing younger versus older mice. Methods In a mouse model of HOIAI, a sterile Kirschner wire was inserted retrograde into the distal femur of younger (5–8-week-old) and older (14–21-week-old) mice. After a 3-week convalescent period, a bioluminescent Staphylococcus aureus strain was inoculated intravenously. Bacterial dissemination to operative and non-operative legs was monitored longitudinally in vivo for 4 weeks, followed by ex vivo bacterial enumeration and X-ray analysis. Results In vivo bioluminescence imaging and ex vivo CFU enumeration of the bone/joint tissue demonstrated that older mice had a strong predilection for developing a hematogenous infection in the operative legs but not the non-operative legs. In contrast, this predilection was less apparent in younger mice as the infection occurred at a similar rate in both the operative and non-operative legs. X-ray imaging revealed that the operative legs of younger mice had decreased femoral length, likely due to the surgical and/or infectious insult to the more active physis, which was not observed in older mice. Both age groups demonstrated substantial reactive bone changes in the operative leg due to infection. Conclusions The presence of an implant was an important determinant for developing a hematogenous orthopaedic infection in older but not younger mice, whereas younger mice had a similar predilection for developing periarticular infection whether or not an implant was present. On a clinical scale, diagnosing HOIAI may be difficult particularly in at-risk patients with limited examination or other data points. Understanding the influence of age on developing HOIAI may guide clinical surveillance and decision-making in at-risk patients.
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Affiliation(s)
- John M Thompson
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - Alyssa G Ashbaugh
- School of Medicine, University of California Irvine, Irvine, CA, 92697, USA
| | - Yu Wang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Robert J Miller
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Julie E Pickett
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Daniel L J Thorek
- Division of Radiological Chemistry and Imaging Laboratory, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Robert S Sterling
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Lloyd S Miller
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.,Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.,Immunology, Janssen Research and Development, 1400 McKean Road, Spring House, PA, 19477, USA
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21
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Josyula A, Parikh KS, Pitha I, Ensign LM. Engineering biomaterials to prevent post-operative infection and fibrosis. Drug Deliv Transl Res 2021; 11:1675-1688. [PMID: 33710589 PMCID: PMC8238864 DOI: 10.1007/s13346-021-00955-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 12/19/2022]
Abstract
Implantable biomaterials are essential surgical devices, extending and improving the quality of life of millions of people globally. Advances in materials science, manufacturing, and in our understanding of the biological response to medical device implantation over several decades have resulted in improved safety and functionality of biomaterials. However, post-operative infection and immune responses remain significant challenges that interfere with biomaterial functionality and host healing processes. The objectives of this review is to provide an overview of the biology of post-operative infection and the physiological response to implanted biomaterials and to discuss emerging strategies utilizing local drug delivery and surface modification to improve the long-term safety and efficacy of biomaterials.
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Affiliation(s)
- Aditya Josyula
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Kunal S Parikh
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
- Center for Bioengineering Innovation and Design, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Ian Pitha
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Laura M Ensign
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA.
- Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, 21287, USA.
- Departments Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
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22
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Cahill SV, Kwon HK, Back J, Lee I, Lee S, Alder KD, Hao Z, Yu KE, Dussik CM, Kyriakides TR, Lee FY. Locally delivered adjuvant biofilm-penetrating antibiotics rescue impaired endochondral fracture healing caused by MRSA infection. J Orthop Res 2021; 39:402-414. [PMID: 33336805 DOI: 10.1002/jor.24965] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 02/04/2023]
Abstract
Infection is a devastating complication following an open fracture. We investigated whether local rifampin-loaded hydrogel can combat infection and improve healing in a murine model of methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis. A transverse fracture was made at the tibia midshaft of C57BL/6J mice aged 10-12 weeks and stabilized with an intramedullary pin. A total of 1 × 106 colony-forming units (CFU) of MRSA was inoculated. A collagen-based hydrogel containing low-dose (60 μg) and high-dose (300 μg) rifampin was applied before closure. Postoperative treatment response was assessed through bacterial CFU counts from tissue and hardware, tibial radiographs and microcomputed tomography (μCT), immunohistochemistry, and histological analyses. All untreated MRSA-infected fractures progressed to nonunion by 28 days with profuse MRSA colonization. Infected fractures demonstrated decreased soft callus formation on safranin O stain compared to controls. Areas of dense interleukin-1β stain were associated with poor callus formation. High-dose rifampin hydrogels reduced the average MRSA load in tissue (p < 0.0001) and implants (p = 0.041). Low-dose rifampin hydrogels reduced tissue bacterial load by 50% (p = 0.021). Among sterile models, 88% achieved union compared to 0% of those infected. Mean radiographic union scale in tibia scores improved from 6 to 8.7 with high-dose rifampin hydrogel (p = 0.024) and to 10 with combination local/systemic rifampin therapy (p < 0.0001). μCT demonstrated reactive bone formation in MRSA infection. Histology demonstrated restored fracture healing with bacterial elimination. Rifampin-loaded hydrogels suppressed osteomyelitis, prevented implant colonization, and improved healing. Systemic rifampin was more effective at eliminating infection and improving fracture healing. Further investigation into rifampin-loaded hydrogels is required to correlate these findings with clinical efficacy.
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Affiliation(s)
- Sean V Cahill
- Department of Orthopedic Surgery, Washington University in St. Louis, St. Louis, Missouri, USA
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Hyuk-Kwon Kwon
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jungho Back
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Inkyu Lee
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Life Science, Chung-Ang University, Seoul, Republic of Korea
| | - Saelim Lee
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
- College of Medicine, Dankook University, Yongin, Gyeonggi-do, Republic of Korea
| | - Kareme D Alder
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Zichen Hao
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Emergency and Trauma, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Kristin E Yu
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Christopher M Dussik
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Themis R Kyriakides
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Francis Y Lee
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
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23
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Topcu B, Gultekinoglu M, Timur SS, Eroglu I, Ulubayram K, Eroglu H. Current approaches and future prospects of nanofibers: a special focus on antimicrobial drug delivery. J Drug Target 2021; 29:563-575. [PMID: 33345641 DOI: 10.1080/1061186x.2020.1867991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Antibacterial nanofibers have a great potential for effective treatment of infections. They act as drug reservoir systems that release higher quantities of antibacterial agents/drug in a controlled manner at infection sites and prevent drug resistance, while concomitantly decreasing the systemic toxicity. With this drug delivery system, it is also possible to achieve multiple drug entrapment and also simultaneous or sequential release kinetics at the site of action. Therefore, advances in antibacterial nanofibers as drug delivery systems were overviewed within this article. Recently published data on antibacterial drug delivery was also summarised to provide a view of the current state of art in this field. Although antibacterial use seems to be limited and one can ask that 'what is left to be discovered?'; recent update literatures in this field highlighted the use of nanofibers from very different perspectives. We believe that readers will be benefiting this review for enlightening of novel ideas.
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Affiliation(s)
- Betul Topcu
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Merve Gultekinoglu
- Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Selin Seda Timur
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Ipek Eroglu
- Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Kezban Ulubayram
- Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey.,Department of Nanotechnology and Nanomedicine, Institute of Graduate Studies in Science and Engineering, Ankara, Turkey.,Department of Bioengineering, Institute of Graduate Studies in Science and Engineering, Hacettepe University, Ankara, Turkey
| | - Hakan Eroglu
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
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Thamer BM, Esmail GA, Al-Dhabi NA, Moydeen A. M, Arasu MV, Al-Enizi AM, El-Newehy MH. Fabrication of biohybrid electrospun nanofibers for the eradication of wound infection and drug-resistant pathogens. Colloids Surf A Physicochem Eng Asp 2021. [DOI: 10.1016/j.colsurfa.2020.125691] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Quarterman JC, Geary SM, Salem AK. Evolution of drug-eluting biomedical implants for sustained drug delivery. Eur J Pharm Biopharm 2020; 159:21-35. [PMID: 33338604 DOI: 10.1016/j.ejpb.2020.12.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/19/2020] [Accepted: 12/08/2020] [Indexed: 02/06/2023]
Abstract
In the field of drug delivery, the most commonly used treatments have traditionally been systemically delivered using oral or intravenous administration. The problems associated with this type of delivery is that the drug concentration is controlled by first pass metabolism, and therefore may not always remain within the therapeutic window. Implantable drug delivery systems (IDDSs) are an excellent alternative to traditional delivery because they offer the ability to precisely control the drug release, deliver drugs locally to the target tissue, and avoid the toxic side effects often experienced with systemic administration. Since the creation of the first FDA-approved IDDS in 1990, there has been a surge in research devoted to fabricating and testing novel IDDS formulations. The versatility of these systems is evident when looking at the various biomedical applications that utilize IDDSs. This review provides an overview of the history of IDDSs, with examples of the different types of IDDS formulations, as well as looking at current and future biomedical applications for such systems. Though there are still obstacles that need to be overcome, ever-emerging new technologies are making the manufacturing of IDDSs a rewarding therapeutic endeavor with potential for further improvements.
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Affiliation(s)
- Juliana C Quarterman
- University of Iowa College of Pharmacy, Department of Pharmaceutical Sciences and Experimental Therapeutics, 180 S. Grand Avenue, Iowa City, IA 52242, United States
| | - Sean M Geary
- University of Iowa College of Pharmacy, Department of Pharmaceutical Sciences and Experimental Therapeutics, 180 S. Grand Avenue, Iowa City, IA 52242, United States
| | - Aliasger K Salem
- University of Iowa College of Pharmacy, Department of Pharmaceutical Sciences and Experimental Therapeutics, 180 S. Grand Avenue, Iowa City, IA 52242, United States.
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Wulf K, Arbeiter D, Matschegewski C, Teske M, Huling J, Schmitz KP, Grabow N, Kohse S. Smart releasing electrospun nanofibers—poly: L.lactide fibers as dual drug delivery system for biomedical application. Biomed Mater 2020; 16:015022. [DOI: 10.1088/1748-605x/abbec8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Ashoka AH, Kong SH, Seeliger B, Andreiuk B, Soares RV, Barberio M, Diana M, Klymchenko AS. Near-infrared fluorescent coatings of medical devices for image-guided surgery. Biomaterials 2020; 261:120306. [DOI: 10.1016/j.biomaterials.2020.120306] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/31/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022]
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Gahane AY, Singh V, Kumar A, Kumar Thakur A. Development of mechanism-based antibacterial synergy between Fmoc-phenylalanine hydrogel and aztreonam. Biomater Sci 2020; 8:1996-2006. [PMID: 32073033 DOI: 10.1039/c9bm01978b] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Recently, fluorenylmethyloxycarbonyl (Fmoc) conjugated amino acids (Fmoc-AA), especially Fmoc-phenylalanine (Fmoc-F), have been discovered to have antimicrobial properties specific to Gram-positive bacteria including MRSA. Their weak antibacterial activity against Gram-negative bacteria is due to their inability to cross the bacterial membrane. Here in order to increase the antibacterial spectrum of Fmoc-F, we prepared a formulation of Fmoc-F with the Gram-negative specific antibiotic aztreonam (AZT). This formulation displayed antibacterial activity against both Gram-positive and Gram-negative bacteria and significantly reduced the bacterial load in a mouse wound infection model. The combination produced a synergistic effect and higher efficacy against P. aeruginosa due to the increased Fmoc-F permeability by AZT through the bacterial membrane. This combinatorial approach could be an effective strategy for other Fmoc-AA having a Gram-positive specific antibacterial effect for the better management of bacterial wound infections.
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Affiliation(s)
- Avinash Yashwant Gahane
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur 208016, India.
| | - Virender Singh
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur 208016, India.
| | - Ashok Kumar
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur 208016, India.
| | - Ashwani Kumar Thakur
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur 208016, India.
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Amiri N, Ajami S, Shahroodi A, Jannatabadi N, Amiri Darban S, Fazly Bazzaz BS, Pishavar E, Kalalinia F, Movaffagh J. Teicoplanin-loaded chitosan-PEO nanofibers for local antibiotic delivery and wound healing. Int J Biol Macromol 2020; 162:645-656. [DOI: 10.1016/j.ijbiomac.2020.06.195] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 02/01/2023]
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Bianchera A, Buttini F, Bettini R. Micro/nanosystems and biomaterials for controlled delivery of antimicrobial and anti-biofilm agents. Expert Opin Ther Pat 2020; 30:983-1000. [PMID: 33078643 DOI: 10.1080/13543776.2020.1839415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Microbial resistance is a severe problem for clinical practice due to misuse of antibiotics that promotes the development of surviving strategies by bacteria and fungi. Microbial cells surrounded by a self-produced polymer matrix, defined as biofilms, are inherently more difficult to eradicate. Biofilms endow bacteria with a unique resistance against antibiotics and other anti-microbial agents and play a crucial role in chronic infection. AREAS COVERED Biofilm-associated antimicrobial resistance in the lung and wounds. Existing inhaled therapies for treatment of biofilm-associated lung infections. Role of pharmaceutical nanotechnologies to fight resistant microbes and biofilms. EXPERT OPINION The effectiveness of antibiotics has gradually decreased due to the onset of resistance phenomena. The formation of biofilms represents one of the most important steps in the development of resistance to antimicrobial treatment. The most obvious solution for overcoming this criticality would be the discovery of new antibiotics. However, the number of new molecules with antimicrobial activity brought into clinical development has considerably decreased. In the last decades the development of innovative drug delivery systems, in particular those based on nanotechnological platforms, has represented the most effective and economically affordable approach to optimize the use of available antibiotics, improving their effectiveness profile. Abbreviations AZT: Aztreonam; BAT: Biofilm antibiotic tolerance; CF: Cystic Fibrosis; CIP: Ciprofloxacin; CRS: Chronic Rhinosinusitis; DPPG: 1,2-dipalmytoyl-sn-glycero-3-phosphoglycerol; DSPC: 1,2-distearoyl-sn-glycero-phosphocholine sodium salt; EPS: extracellular polymeric substance; FEV1: Forced Expiratory Volume in the first second; GSNO: S-nitroso-glutathione; LAE: lauroyl arginate ethyl; MIC: Minimum inhibitory Concentration; NCFB: Non-Cystic Fibrosis Bronchiectasis; NTM: Non-Tuberculous Mycobacteria; NTM-LD: Non-tuberculous mycobacteria Lung Disease PA: Pseudomonas aeruginosa; pDMAEMA: poly(dimethylaminoethyl methacrylate);pDMAEMA-co-PAA-co-BMA: poly(dimethylaminoethyl methacrylate)-co-propylacrylic acid-co-butyl methacrylate; PEG: polyethylene glycol; PEGDMA: polyethylene glycol dimethacrylate;PCL: Poly-ε-caprolactone; PLA: poly-lactic acid; PLGA: poly-lactic-co-glycolic acid; PVA: poli-vinyl alcohol; SA: Staphylococcus aureus; TIP: Tobramycin Inhalation Powder; TIS: Tobramycin Inhalation Solution; TPP: Tripolyphosphate.
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Affiliation(s)
| | | | - Ruggero Bettini
- Food and Drug Department, University of Parma , Parma, Italy
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Nikam SP, Nettleton K, Everitt JI, Barton HA, Becker ML. Antibiotic eluting poly(ester urea) films for control of a model cardiac implantable electronic device infection. Acta Biomater 2020; 111:65-79. [PMID: 32447067 DOI: 10.1016/j.actbio.2020.04.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/05/2020] [Accepted: 04/13/2020] [Indexed: 02/07/2023]
Abstract
Cardiac implantable electronic device (CIED) infections acquired during or after surgical procedures are a major complication that are challenging to treat therapeutically, resulting in chronic and sometimes fatal infections. Localized delivery of antibiotics at the surgical site could be used to supplement traditional systemic administration as a preventative measure. Herein, we investigate a cefazolin-eluting l-valine poly(ester urea) (PEU) films as a model system for localized antibiotic delivery for CIEDs. Poly(1-VAL-8) PEU was used to fabricate a series of antibiotic-loaded films with varied loading concentrations (2%, 5%, 10% wt/wt) and thicknesses (40 µm, 80 µm, 140 µm). In vitro release measurements show thickness and loading concentration influence the amount and rate of cefazolin release. Group 10%-140 µm (load-thickness) showed 22.5% release of active pharmaceutical ingredient (API) in the first 24 h and 81.2% of cumulative percent release through day 14 and was found most effective in bacterial clearance in vitro. This group was also effective in clearing a bacterial infection in a model in vivo rat study while eliciting a limited inflammatory response. Our results suggest the feasibility of cefazolin-loaded PEU films as an effective sustained release matrix for localized delivery of antibiotics. SIGNIFICANCE STATEMENT: Implant-associated infections acquired during surgical procedures are a major complication that have proven a challenge to treat clinically, resulting in chronic and sometimes fatal infections. In this manuscript, we investigate an antibiotic-eluting L-valine poly(ester urea) (PEU) films as a model system for localized delivery of cefazolin. Significantly, we demonstrate a wide variation in temporal delivery and dosing within this family of PEUs and show that the delivery can be extended by varying the film thickness. The in vivo results show efficacy in an infected wound model and suggest antibiotic loaded PEU films function as an effective sustained release matrix for localized delivery of antibiotics across a number of clinical indications.
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Chiesa E, Dorati R, Pisani S, Bruni G, Rizzi LG, Conti B, Modena T, Genta I. Graphene Nanoplatelets for the Development of Reinforced PLA-PCL Electrospun Fibers as the Next-Generation of Biomedical Mats. Polymers (Basel) 2020; 12:polym12061390. [PMID: 32575840 PMCID: PMC7362196 DOI: 10.3390/polym12061390] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 12/24/2022] Open
Abstract
Electrospun scaffolds made of nano- and micro-fibrous non-woven mats from biodegradable polymers have been intensely investigated in recent years. In this field, polymer-based materials are broadly used for biomedical applications since they can be managed in high scale, easily shaped, and chemically changed to tailor their specific biologic properties. Nonetheless polymeric materials can be reinforced with inorganic materials to produce a next-generation composite with improved properties. Herein, the role of graphene nanoplatelets (GNPs) on electrospun poly-l-lactide-co-poly-ε-caprolactone (PLA-PCL, 70:30 molar ratio) fibers was investigated. Microfibers of neat PLA-PCL and with different amounts of GNPs were produced by electrospinning and they were characterized for their physicochemical and biologic properties. Results showed that GNPs concentration notably affected the fibers morphology and diameters distribution, influenced PLA-PCL chain mobility in the crystallization process and tuned the mechanical and thermal properties of the electrospun matrices. GNPs were also liable of slowing down copolymer degradation rate in simulated physiological environment. However, no toxic impurities and degradation products were pointed out up to 60 d incubation. Furthermore, preliminary biologic tests proved the ability of the matrices to enhance fibroblast cells attachment and proliferation probably due to their unique 3D-interconnected structure.
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Affiliation(s)
- Enrica Chiesa
- Department of Drug Sciences, University of Pavia, V.le Taramelli 12—27100 Pavia, Italy; (E.C.); (R.D.); (B.C.); (T.M.)
| | - Rossella Dorati
- Department of Drug Sciences, University of Pavia, V.le Taramelli 12—27100 Pavia, Italy; (E.C.); (R.D.); (B.C.); (T.M.)
- Polymerix srl, V.le Taramelli 24—27100 Pavia, Italy
| | - Silvia Pisani
- Immunology and Transplantation Laboratory, Pedriatric Hematology Oncology Unit, Department of Maternal and Children’s Health, Fondazione IRCCS Policlinico S. Matteo—27100 Pavia, Italy;
| | - Giovanna Bruni
- Department of Chemistry, Physical Chemistry Section, University of Pavia, Via Taramelli 12/14, 27100 Pavia, PV, Italy;
| | - Laura G. Rizzi
- Directa Plus S.p.a., COMO NexT, Via Cavour, 2—22074 Lomazzo (CO), Italy;
| | - Bice Conti
- Department of Drug Sciences, University of Pavia, V.le Taramelli 12—27100 Pavia, Italy; (E.C.); (R.D.); (B.C.); (T.M.)
- Polymerix srl, V.le Taramelli 24—27100 Pavia, Italy
| | - Tiziana Modena
- Department of Drug Sciences, University of Pavia, V.le Taramelli 12—27100 Pavia, Italy; (E.C.); (R.D.); (B.C.); (T.M.)
- Polymerix srl, V.le Taramelli 24—27100 Pavia, Italy
| | - Ida Genta
- Department of Drug Sciences, University of Pavia, V.le Taramelli 12—27100 Pavia, Italy; (E.C.); (R.D.); (B.C.); (T.M.)
- Polymerix srl, V.le Taramelli 24—27100 Pavia, Italy
- Correspondence: ; Tel.: +39-0382987371
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Khan F, Pham DTN, Oloketuyi SF, Kim YM. Antibiotics Application Strategies to Control Biofilm Formation in Pathogenic Bacteria. Curr Pharm Biotechnol 2020; 21:270-286. [PMID: 31721708 DOI: 10.2174/1389201020666191112155905] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/09/2019] [Accepted: 10/31/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The establishment of a biofilm by most pathogenic bacteria has been known as one of the resistance mechanisms against antibiotics. A biofilm is a structural component where the bacterial community adheres to the biotic or abiotic surfaces by the help of Extracellular Polymeric Substances (EPS) produced by bacterial cells. The biofilm matrix possesses the ability to resist several adverse environmental factors, including the effect of antibiotics. Therefore, the resistance of bacterial biofilm-forming cells could be increased up to 1000 times than the planktonic cells, hence requiring a significantly high concentration of antibiotics for treatment. METHODS Up to the present, several methodologies employing antibiotics as an anti-biofilm, antivirulence or quorum quenching agent have been developed for biofilm inhibition and eradication of a pre-formed mature biofilm. RESULTS Among the anti-biofilm strategies being tested, the sub-minimal inhibitory concentration of several antibiotics either alone or in combination has been shown to inhibit biofilm formation and down-regulate the production of virulence factors. The combinatorial strategies include (1) combination of multiple antibiotics, (2) combination of antibiotics with non-antibiotic agents and (3) loading of antibiotics onto a carrier. CONCLUSION The present review paper describes the role of several antibiotics as biofilm inhibitors and also the alternative strategies adopted for applications in eradicating and inhibiting the formation of biofilm by pathogenic bacteria.
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Affiliation(s)
- Fazlurrahman Khan
- Marine-Integrated Bionics Research Center, Pukyong National University, Busan 48513, Korea.,Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida 201306, U.P., India
| | - Dung T N Pham
- Department of Food Science and Technology, Pukyong National University, Busan 48513, Korea
| | - Sandra F Oloketuyi
- Laboratory for Environmental and Life Sciences, University of Nova Gorica 5000, Nova Gorica, Slovenia
| | - Young-Mog Kim
- Marine-Integrated Bionics Research Center, Pukyong National University, Busan 48513, Korea.,Department of Food Science and Technology, Pukyong National University, Busan 48513, Korea
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Recent advances in the implant-based drug delivery in otorhinolaryngology. Acta Biomater 2020; 108:46-55. [PMID: 32289495 DOI: 10.1016/j.actbio.2020.04.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/31/2020] [Accepted: 04/03/2020] [Indexed: 12/13/2022]
Abstract
The surgical implant is an interdisciplinary therapeutic modality that offers unique advantages in the daily practice of otorhinolaryngology. Some well-known examples include cochlear implants, bone-anchored hearing aids, sinus stents, and tracheostomy tubes. Neuroprotective, osteogenic, anti-inflammatory, and antimicrobial effects are among their established or pursued functions. Implant-based drug delivery affords an efficient and potent approach to enhancing these therapeutic functions. Recent innovations have infiltrated all four elements of a drug-eluting implant. The purpose of this pre-clinical, biotechnology-oriented review is to discuss these developments in terms of the implant biomaterial, loaded medication, delivery pattern, and system fabrication. Cell-mediated neurotrophin release, fabrication of a hydroxyapatite-supported system, biodegradable polymer-based implants, and multiclass and multidrug delivery are some representative advancements. The ultimate goal here is to bridge the gap between biotechnology advances and clinical needs. The review is concluded with a perspective regarding the future opportunities and challenges in this popular and rapidly developing subject of research. STATEMENT OF SIGNIFICANCE: Surgical implants and local drug delivery are representative modern modalities of surgical treatment and medical treatment, respectively. Their synergy offers unique therapeutic advantages, such as minimal systemic side effects, proximity-related high efficiency, and potential absorbability. The applications of implant-based drug delivery have infiltrated otorhinolaryngology and head & neck surgery, which is well known for its related tissue diversity and surgical complexity. Examples discussed here include cochlear implants, bone-anchored hearing aids, sinus stents, and airway tubes. This timely review focuses primarily on the four fundamental components of an implant-based drug delivery system, namely implant biomaterial, loaded medication, delivery pattern, and system fabrication. A particular emphasis is placed upon the in vitro cellular and in vivo animal studies that demonstrate pre-clinical potentials.
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Kumar A, Al-Jumaili A, Bazaka K, Mulvey P, Warner J, Jacob MV. In-Situ Surface Modification of Terpinen-4-ol Plasma Polymers for Increased Antibacterial Activity. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E586. [PMID: 32012768 PMCID: PMC7040605 DOI: 10.3390/ma13030586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 01/07/2020] [Accepted: 01/14/2020] [Indexed: 11/16/2022]
Abstract
Surface modification of thin films is often performed to enhance their properties. In this work, in situ modification of Terpinen-4-ol (T4) plasma polymer is carried out via simultaneous surface functionalization and nanoparticle immobilization. Terpinen-4-ol plasma polymers surface were decorated with a layer of ZnO nanoparticles in an oxygen plasma environment immediately after polymer deposition. A combination of hydrophilic modification and ZnO nanoparticle functionalization of the T4 polymer surface led to an enhancement in antibacterial properties by factor of 3 (from 0.75 to 0.25 CFU.mm-2). In addition, ZnO nanoparticle-modified coatings demonstrated improved UV absorbing characteristics in the region of 300-400 nm by 60% relative to unmodified coatings. The ZnO modified coatings were transparent in the visible region of 400-700 nm. The finding points towards the potential use of ZnO nanoparticle-modified T4 plasma polymers as optically transparent UV absorbing coatings.
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Affiliation(s)
- Avishek Kumar
- Electronics Materials Lab, College of Science and Engineering, James Cook University, Townsville 4811, Australia; (A.K.); (A.A.-J.); (K.B.)
| | - Ahmed Al-Jumaili
- Electronics Materials Lab, College of Science and Engineering, James Cook University, Townsville 4811, Australia; (A.K.); (A.A.-J.); (K.B.)
| | - Kateryna Bazaka
- Electronics Materials Lab, College of Science and Engineering, James Cook University, Townsville 4811, Australia; (A.K.); (A.A.-J.); (K.B.)
- Institute for Future Environments, Queensland University of Technology, Brisbane 4000, Australia
- Research School of Electrical, Energy and Materials Engineering, The Australian National University, Canberra 2601, Australia
| | - Peter Mulvey
- AITHM, Immunology & Infectious Disease, Australian Institute of Tropical Health & Medicine, James Cook University, Townsville 4811, Australia;
| | - Jeffrey Warner
- Discipline of Biomedicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia;
| | - Mohan V. Jacob
- Electronics Materials Lab, College of Science and Engineering, James Cook University, Townsville 4811, Australia; (A.K.); (A.A.-J.); (K.B.)
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Archer NK, Wang Y, Ortines RV, Liu H, Nolan SJ, Liu Q, Alphonse MP, Dikeman DA, Mazhar M, Miller RJ, Anderson LS, Francis KP, Simon SI, Miller LS. Preclinical Models and Methodologies for Monitoring Staphylococcus aureus Infections Using Noninvasive Optical Imaging. Methods Mol Biol 2020; 2069:197-228. [PMID: 31523776 PMCID: PMC7745539 DOI: 10.1007/978-1-4939-9849-4_15] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In vivo whole-animal optical (bioluminescence and fluorescence) imaging of Staphylococcus aureus infections has provided the opportunity to noninvasively and longitudinally monitor the dynamics of the bacterial burden and ensuing host immune responses in live anesthetized animals. Herein, we describe several different mouse models of S. aureus skin infection, skin inflammation, incisional/excisional wound infections, as well as mouse and rabbit models of orthopedic implant infection, which utilized this imaging technology. These animal models and imaging methodologies provide insights into the pathogenesis of these infections and innate and adaptive immune responses, as well as the preclinical evaluation of diagnostic and treatment modalities. Noninvasive approaches to investigate host-pathogen interactions are extremely important as virulent community-acquired methicillin-resistant S. aureus strains (CA-MRSA) are spreading through the normal human population, becoming more antibiotic resistant and creating a serious threat to public health.
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Affiliation(s)
- Nathan K Archer
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yu Wang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Roger V Ortines
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Haiyun Liu
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sabrina J Nolan
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Qi Liu
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Martin P Alphonse
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dustin A Dikeman
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Momina Mazhar
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert J Miller
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Leif S Anderson
- Department of Biomedical Engineering, University of California, Davis, Davis, CA, USA
| | | | - Scott I Simon
- Department of Biomedical Engineering, University of California, Davis, Davis, CA, USA
| | - Lloyd S Miller
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA.
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Chang C, Ginn B, Livingston NK, Yao Z, Slavin B, King MW, Chung S, Mao HQ. Medical Fibers and Biotextiles. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00038-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Leung CM, Dhand C, Mayandi V, Ramalingam R, Lim FP, Barathi VA, Dwivedi N, Orive G, Beuerman RW, Ramakrishna S, Toh YC, Loh XJ, Verma NK, Chua AWC, Lakshminarayanan R. Wound healing properties of magnesium mineralized antimicrobial nanofibre dressings containing chondroitin sulphate – a comparison between blend and core–shell nanofibres. Biomater Sci 2020; 8:3454-3471. [DOI: 10.1039/d0bm00530d] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Effect of chondroitin sulphate incorporated PCL/gelatin as blends or core–shell composite nanofibres are compared in terms of their biocompatibility for skin cells and wound healing in porcine model of partial thickness burns.
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Thompson JM, Miller LS. Preclinical Optical Imaging to Study Pathogenesis, Novel Therapeutics and Diagnostics Against Orthopaedic Infection. J Orthop Res 2019; 37:2269-2277. [PMID: 31342546 DOI: 10.1002/jor.24428] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/15/2019] [Indexed: 02/04/2023]
Abstract
Preclinical in vivo optical imaging includes bioluminescence imaging (BLI) and fluorescence imaging (FLI), which provide noninvasive and longitudinal monitoring of biological processes in an in vivo context. In vivo BLI involves the detection of photons of light from bioluminescent bacteria engineered to naturally emit light in preclinical animal models of infection. Meanwhile, in vivo FLI involves the detection of photons of a longer emission wavelength of light after exposure of a fluorophore to a shorter excitation wavelength of light. In vivo FLI has been used in preclinical animal models to detect fluorescent-labeled host proteins or cells (often in engineered fluorescent reporter mice) to understand host-related processes, or to detect injectable near-infrared fluorescent probes as a novel approach for diagnosing infection. This review describes the use of in vivo optical imaging in preclinical models of orthopaedic implant-associated infection (OIAI), including (i) pathogenesis of the infectious course, (ii) monitoring efficacy of antimicrobial prophylaxis and therapy and (iii) evaluating novel near-infrared fluorescent probes for diagnosing infection. Finally, we describe optoacoustic imaging and fluorescence image-guided surgery, which are recent technologies that have the potential to translate to diagnosing and treating OIAI in humans. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2269-2277, 2019.
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Affiliation(s)
- John M Thompson
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21287
| | - Lloyd S Miller
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21287
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21231
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21287
- Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, Maryland, 21218
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Tschon M, Sartori M, Contartese D, Giavaresi G, Aldini NN, Fini M. Use of Antibiotic Loaded Biomaterials for the Management of Bone Prosthesis Infections: Rationale and Limits. Curr Med Chem 2019; 26:3150-3174. [PMID: 29189125 DOI: 10.2174/0929867325666171129220031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/25/2017] [Accepted: 11/24/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Periprosthetic joint infection still represents a challenging issue for the orthopedic community. In the United States approximately a million joint arthroplasties are performed each year, with infection rates ranging from 1 to 2%: revisions has significant implications on health care costs and appropriate resource management. The use of locally applied antibiotics as a prophylaxis measure or as a component of the therapeutic approach in primary or revision surgery is finalized at eliminating any microorganism and strengthening the effectiveness of systemic therapy. OBJECTIVE The present review of clinical and preclinical in vivo studies tried to identify advantages and limitations of the materials used in the clinical orthopedic practice and discuss developed biomaterials, innovative therapeutic approaches or strategies to release antibiotics in the infected environment. METHODS A systematic search was carried out by two independent observers in two databases (www.pubmed.com and www.scopus.com) in order to identify pre-clinical and clinical reports in the last 10 years. RESULTS 71 papers were recognized eligible: 15 articles were clinical studies and 56 in vivo studies. CONCLUSION Polymethylmethacrylate was the pioneer biomaterial used to manage infections after total joint replacement. Despite its widespread use, several issues still remain debated: the methods to combine materials and antibiotics, the choice of antibiotics, releasing kinetics and antibiotics efficacy. In the last years, the interest was directed towards the selection of different antibiotics, loaded in association with more than only one class and biomaterials with special focus on delivery systems as implant surface coatings, hydrogels, ceramics, micro-carriers, microspheres or nanoparticles.
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Affiliation(s)
- M Tschon
- Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136, Bologna, Italy
| | - M Sartori
- Laboratory of Biocompatibility, Technological Innovations and Advanced Therapies, Istituto Ortopedico Rizzoli - RIT Department, via di Barbiano 1/10, 40136, Bologna, Italy
| | - D Contartese
- Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136, Bologna, Italy
| | - G Giavaresi
- Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136, Bologna, Italy
| | - N Nicoli Aldini
- Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136, Bologna, Italy
| | - M Fini
- Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136, Bologna, Italy
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Zhang B, Braun BM, Skelly JD, Ayers DC, Song J. Significant Suppression of Staphylococcus aureus Colonization on Intramedullary Ti6Al4V Implants Surface-Grafted with Vancomycin-Bearing Polymer Brushes. ACS APPLIED MATERIALS & INTERFACES 2019; 11:28641-28647. [PMID: 31313901 PMCID: PMC8086729 DOI: 10.1021/acsami.9b07648] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Orthopedic implant-associated bacterial infection presents a major health threat due to tendency for periprosthetic bacterial colonization/biofilm formation that protects bacteria from host immune response and conventional antibiotic treatment. Using surface-initiated atom transfer radical polymerization and copper-catalyzed azide-alkyne cycloaddition (CuAAC), alkynylated vancomycin is conjugated to azido-functionalized side chains of polymethacrylates grafted from Ti6Al4V. High-efficiency CuAAC across the substrate is confirmed by complete surface conversion of azides by X-ray photoelectron spectroscopy (XPS) and elemental mapping of changing characteristic elements. The vancomycin-modified surface (Ti-pVAN) significantly reduces in vitro adhesion and colonization of Staphylococcus aureus (S. aureus), a main bacterial pathogen responsible for periprosthetic infection and osteomyelitis, compared to untreated Ti6Al4V, supporting retained antibacterial properties of the covalently conjugated antibiotics. When the surface-modified intramedullary Ti-pVAN pins are inserted into mouse femoral canals infected by bioluminescent Xen29 S. aureus, significantly reduced local bioluminescence along with mitigated blood markers for infection are detected compared to untreated Ti6Al4V pins over 21 days. Ti-pVAN pins retrieved after 21 days are confirmed with ∼20-fold reduction in adherent bacteria counts compared to untreated control, supporting the ability of surface-conjugated vancomycin in inhibiting periprosthetic S. aureus adhesion and colonization.
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Cattò C, Cappitelli F. Testing Anti-Biofilm Polymeric Surfaces: Where to Start? Int J Mol Sci 2019; 20:E3794. [PMID: 31382580 PMCID: PMC6696330 DOI: 10.3390/ijms20153794] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 08/02/2019] [Indexed: 12/11/2022] Open
Abstract
Present day awareness of biofilm colonization on polymeric surfaces has prompted the scientific community to develop an ever-increasing number of new materials with anti-biofilm features. However, compared to the large amount of work put into discovering potent biofilm inhibitors, only a small number of papers deal with their validation, a critical step in the translation of research into practical applications. This is due to the lack of standardized testing methods and/or of well-controlled in vivo studies that show biofilm prevention on polymeric surfaces; furthermore, there has been little correlation with the reduced incidence of material deterioration. Here an overview of the most common methods for studying biofilms and for testing the anti-biofilm properties of new surfaces is provided.
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Affiliation(s)
- Cristina Cattò
- Department of Food Environmental and Nutritional Sciences, Università degli Studi di Milano, via Celoria 2, 20133 Milano, Italy
| | - Francesca Cappitelli
- Department of Food Environmental and Nutritional Sciences, Università degli Studi di Milano, via Celoria 2, 20133 Milano, Italy.
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Zhang S, Xing M, Li B. Recent advances in musculoskeletal local drug delivery. Acta Biomater 2019; 93:135-151. [PMID: 30685475 PMCID: PMC6615977 DOI: 10.1016/j.actbio.2019.01.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/18/2018] [Accepted: 01/22/2019] [Indexed: 12/17/2022]
Abstract
Musculoskeletal disorders are a significant burden on the global economy and public health. Advanced drug delivery plays a key role in the musculoskeletal field and holds the promise of enhancing the repair of degenerated and injured musculoskeletal tissues. Ideally, drug delivery should have the ability to directly deliver therapeutic agents to the diseased/injured sites with a desirable drug level over a period of time. Here, we present a mini-review of the current state-of-the-art research associated with local drug delivery and its use for the treatment of musculoskeletal disorders. First, an overview of drug delivery strategies, with a focus on issues related to musculoskeletal pathology, potential therapeutic strategies, conventional and non-conventional drugs, and various delivery systems, is introduced. Then, we highlight recent advances in the emerging fields of musculoskeletal local drug delivery, involving therapeutic drugs (e.g., genes, small molecule therapeutics, and stem cells), novel delivery vehicles (e.g., 3D printing and tissue engineering techniques), and innovative delivery approaches (e.g., multi-drug delivery and smart stimuli-responsive delivery). The review concludes with future perspectives and associated challenges for developing local drug delivery for musculoskeletal applications. STATEMENT OF SIGNIFICANCE: Three important aspects are highlighted in this manuscript: 1) The advanced musculoskeletal drug delivery is introduced from the aspects ranging from musculoskeletal disorders, potential therapeutic solutions, and various drug delivery systems. 2) The recent advances in the emerging fields of musculoskeletal local drug delivery, involving therapeutic drugs (e.g., genes, small molecule therapeutics, and stem cells), novel delivery vehicles (e.g., 3D printing and tissue engineering technique), and innovative delivery approaches (e.g., multi-drug delivery and smart stimuli-responsive delivery), are highlighted. 3) The challenges and perspectives of future research directions in the development of musculoskeletal local drug delivery are presented.
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Affiliation(s)
- Shichao Zhang
- Department of Orthopaedics, School of Medicine, West Virginia University, Morgantown, WV 26506-9196, United States
| | - Malcolm Xing
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Bingyun Li
- Department of Orthopaedics, School of Medicine, West Virginia University, Morgantown, WV 26506-9196, United States.
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Li Y, Liao C, Tjong SC. Electrospun Polyvinylidene Fluoride-Based Fibrous Scaffolds with Piezoelectric Characteristics for Bone and Neural Tissue Engineering. NANOMATERIALS (BASEL, SWITZERLAND) 2019; 9:E952. [PMID: 31261995 PMCID: PMC6669491 DOI: 10.3390/nano9070952] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/14/2019] [Accepted: 06/15/2019] [Indexed: 02/07/2023]
Abstract
Polyvinylidene fluoride (PVDF) and polyvinylidene fluoride-trifluoroethylene (P(VDF-TrFE) with excellent piezoelectricity and good biocompatibility are attractive materials for making functional scaffolds for bone and neural tissue engineering applications. Electrospun PVDF and P(VDF-TrFE) scaffolds can produce electrical charges during mechanical deformation, which can provide necessary stimulation for repairing bone defects and damaged nerve cells. As such, these fibrous mats promote the adhesion, proliferation and differentiation of bone and neural cells on their surfaces. Furthermore, aligned PVDF and P(VDF-TrFE) fibrous mats can enhance neurite growth along the fiber orientation direction. These beneficial effects derive from the formation of electroactive, polar β-phase having piezoelectric properties. Polar β-phase can be induced in the PVDF fibers as a result of the polymer jet stretching and electrical poling during electrospinning. Moreover, the incorporation of TrFE monomer into PVDF can stabilize the β-phase without mechanical stretching or electrical poling. The main drawbacks of electrospinning process for making piezoelectric PVDF-based scaffolds are their small pore sizes and the use of highly toxic organic solvents. The small pore sizes prevent the infiltration of bone and neuronal cells into the scaffolds, leading to the formation of a single cell layer on the scaffold surfaces. Accordingly, modified electrospinning methods such as melt-electrospinning and near-field electrospinning have been explored by the researchers to tackle this issue. This article reviews recent development strategies, achievements and major challenges of electrospun PVDF and P(VDF-TrFE) scaffolds for tissue engineering applications.
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Affiliation(s)
- Yuchao Li
- Department of Materials Science and Engineering, Liaocheng University, Liaocheng 252000, China.
| | - Chengzhu Liao
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Sie Chin Tjong
- Department of Physics, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China.
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Electrospun essential oil-polycaprolactone nanofibers as antibiofilm surfaces against clinical Candida tropicalis isolates. Biotechnol Lett 2019; 41:511-522. [PMID: 30879154 DOI: 10.1007/s10529-019-02660-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 03/06/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE As an approach to prevent biofilm infections caused by Candida tropicalis on various surfaces, determination of effect of biodegradable polycaprolactone nanofibers (PCLNFs) with different concentrations of two different essential oils were tested in this study. RESULTS Both of the tested essential oils exhibited antifungal effect (minimal inhibitory concentration; 0.25-0.49 µL/mL, minimal fungicidal concentration; 0.25-0.49 µL/mL, depending on the C. tropicalis strain) (Zone of inhibition caused by 500 μL/mL concentration of oils; 28-56 mm). 0, 2, 4% clove oil PCLNFs and 0, 2, 4% red thyme oil-PCLNFs were free from bead formation and uniform in diameter. Diameters of all essential oil containing PCLNFs were ranged from 760 to 1100 nm and were significantly different from 0% essential oil-PCLNF (P < 0.05). 0, 2, 4% clove oil-PCLNFs were significantly more hydrophobic compared to 8% clove oil-PCLNF (P < 0.01), whereas 0% and 2% red thyme oil-PCLNFs were significantly more hydrophobic compared to 4% and 8% red thyme oil PCLNFs (P < 0.01). Highest amount of biofilm inhibition was observed by 4% clove oil-PCLNF and by 4% red thyme oil-PCLNF. CONCLUSIONS Clove and red thyme oils may be used not only as antifungals but also as biofilm inhibitive agents on surfaces of biomaterials that are frequently contaminated by C. tropicalis, when they are incorporated into PCLNFs.
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Miller RJ, Thompson JM, Zheng J, Marchitto MC, Archer NK, Pinsker BL, Ortines RV, Jiang X, Martin RA, Brown ID, Wang Y, Sterling RS, Mao HQ, Miller LS. In Vivo Bioluminescence Imaging in a Rabbit Model of Orthopaedic Implant-Associated Infection to Monitor Efficacy of an Antibiotic-Releasing Coating. J Bone Joint Surg Am 2019; 101:e12. [PMID: 30801375 PMCID: PMC6738548 DOI: 10.2106/jbjs.18.00425] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND In vivo bioluminescence imaging (BLI) provides noninvasive monitoring of bacterial burden in animal models of orthopaedic implant-associated infection (OIAI). However, technical limitations have limited its use to mouse and rat models of OIAI. The goal of this study was to develop a larger, rabbit model of OIAI using in vivo BLI to evaluate the efficacy of an antibiotic-releasing implant coating. METHODS A nanofiber coating loaded with or without linezolid-rifampin was electrospun onto a surgical-grade locking peg. To model OIAI in rabbits, a medial parapatellar arthrotomy was performed to ream the femoral canal, and a bright bioluminescent methicillin-resistant Staphylococcus aureus (MRSA) strain was inoculated into the canal, followed by retrograde insertion of the coated implant flush with the articular surface. In vivo BLI signals were confirmed by ex vivo colony-forming units (CFUs) from tissue, bone, and implant specimens. RESULTS In this rabbit model of OIAI (n = 6 rabbits per group), implants coated without antibiotics were associated with significantly increased knee width and in vivo BLI signals compared with implants coated with linezolid-rifampin (p < 0.001 and p < 0.05, respectively). On day 7, the implants without antibiotics were associated with significantly increased CFUs from tissue (mean [and standard error of the mean], 1.4 × 10 ± 2.1 × 10 CFUs; p < 0.001), bone (6.9 × 10 ± 3.1 × 10 CFUs; p < 0.05), and implant (5.1 × 10 ± 2.2 × 10 CFUs; p < 0.05) specimens compared with implants with linezolid-rifampin, which demonstrated no detectable CFUs from any source. CONCLUSIONS By combining a bright bioluminescent MRSA strain with modified techniques, in vivo BLI in a rabbit model of OIAI demonstrated the efficacy of an antibiotic-releasing coating. CLINICAL RELEVANCE The new capability of in vivo BLI for noninvasive monitoring of bacterial burden in larger-animal models of OIAI may have important preclinical relevance.
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Affiliation(s)
- Robert J. Miller
- Departments of Dermatology (R.J.M., M.C.M., N.K.A., B.L.P., R.V.O., I.D.B., Y.W., and L.S.M.) and Orthopaedic Surgery (J.M.T., R.S.S., and L.S.M.) and Division of Infectious Diseases, Department of Medicine (L.S.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - John M. Thompson
- Departments of Dermatology (R.J.M., M.C.M., N.K.A., B.L.P., R.V.O., I.D.B., Y.W., and L.S.M.) and Orthopaedic Surgery (J.M.T., R.S.S., and L.S.M.) and Division of Infectious Diseases, Department of Medicine (L.S.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jesse Zheng
- Departments of Biomedical Engineering (J.Z.) and Materials Science and Engineering (X.J., R.A.M., H.-Q.M., and L.S.M.), Translational Tissue Engineering Center (X.J., R.A.M., H.-Q.M., and L.S.M.), Institute for NanoBioTechnology (X.J., R.A.M., and H.-Q.M.), and Whitaker Biomedical Engineering Institute (H.-Q.M.), Johns Hopkins University, Baltimore, Maryland
| | - Mark C. Marchitto
- Departments of Dermatology (R.J.M., M.C.M., N.K.A., B.L.P., R.V.O., I.D.B., Y.W., and L.S.M.) and Orthopaedic Surgery (J.M.T., R.S.S., and L.S.M.) and Division of Infectious Diseases, Department of Medicine (L.S.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nathan K. Archer
- Departments of Dermatology (R.J.M., M.C.M., N.K.A., B.L.P., R.V.O., I.D.B., Y.W., and L.S.M.) and Orthopaedic Surgery (J.M.T., R.S.S., and L.S.M.) and Division of Infectious Diseases, Department of Medicine (L.S.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bret L. Pinsker
- Departments of Dermatology (R.J.M., M.C.M., N.K.A., B.L.P., R.V.O., I.D.B., Y.W., and L.S.M.) and Orthopaedic Surgery (J.M.T., R.S.S., and L.S.M.) and Division of Infectious Diseases, Department of Medicine (L.S.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Roger V. Ortines
- Departments of Dermatology (R.J.M., M.C.M., N.K.A., B.L.P., R.V.O., I.D.B., Y.W., and L.S.M.) and Orthopaedic Surgery (J.M.T., R.S.S., and L.S.M.) and Division of Infectious Diseases, Department of Medicine (L.S.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Xuesong Jiang
- Departments of Biomedical Engineering (J.Z.) and Materials Science and Engineering (X.J., R.A.M., H.-Q.M., and L.S.M.), Translational Tissue Engineering Center (X.J., R.A.M., H.-Q.M., and L.S.M.), Institute for NanoBioTechnology (X.J., R.A.M., and H.-Q.M.), and Whitaker Biomedical Engineering Institute (H.-Q.M.), Johns Hopkins University, Baltimore, Maryland
| | - Russell A. Martin
- Departments of Biomedical Engineering (J.Z.) and Materials Science and Engineering (X.J., R.A.M., H.-Q.M., and L.S.M.), Translational Tissue Engineering Center (X.J., R.A.M., H.-Q.M., and L.S.M.), Institute for NanoBioTechnology (X.J., R.A.M., and H.-Q.M.), and Whitaker Biomedical Engineering Institute (H.-Q.M.), Johns Hopkins University, Baltimore, Maryland
| | - Isabelle D. Brown
- Departments of Dermatology (R.J.M., M.C.M., N.K.A., B.L.P., R.V.O., I.D.B., Y.W., and L.S.M.) and Orthopaedic Surgery (J.M.T., R.S.S., and L.S.M.) and Division of Infectious Diseases, Department of Medicine (L.S.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Yu Wang
- Departments of Dermatology (R.J.M., M.C.M., N.K.A., B.L.P., R.V.O., I.D.B., Y.W., and L.S.M.) and Orthopaedic Surgery (J.M.T., R.S.S., and L.S.M.) and Division of Infectious Diseases, Department of Medicine (L.S.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert S. Sterling
- Departments of Dermatology (R.J.M., M.C.M., N.K.A., B.L.P., R.V.O., I.D.B., Y.W., and L.S.M.) and Orthopaedic Surgery (J.M.T., R.S.S., and L.S.M.) and Division of Infectious Diseases, Department of Medicine (L.S.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hai-Quan Mao
- Departments of Biomedical Engineering (J.Z.) and Materials Science and Engineering (X.J., R.A.M., H.-Q.M., and L.S.M.), Translational Tissue Engineering Center (X.J., R.A.M., H.-Q.M., and L.S.M.), Institute for NanoBioTechnology (X.J., R.A.M., and H.-Q.M.), and Whitaker Biomedical Engineering Institute (H.-Q.M.), Johns Hopkins University, Baltimore, Maryland
| | - Lloyd S. Miller
- Departments of Dermatology (R.J.M., M.C.M., N.K.A., B.L.P., R.V.O., I.D.B., Y.W., and L.S.M.) and Orthopaedic Surgery (J.M.T., R.S.S., and L.S.M.) and Division of Infectious Diseases, Department of Medicine (L.S.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland,Departments of Biomedical Engineering (J.Z.) and Materials Science and Engineering (X.J., R.A.M., H.-Q.M., and L.S.M.), Translational Tissue Engineering Center (X.J., R.A.M., H.-Q.M., and L.S.M.), Institute for NanoBioTechnology (X.J., R.A.M., and H.-Q.M.), and Whitaker Biomedical Engineering Institute (H.-Q.M.), Johns Hopkins University, Baltimore, Maryland
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Barik A, Chakravorty N. Targeted Drug Delivery from Titanium Implants: A Review of Challenges and Approaches. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1251:1-17. [PMID: 31768968 DOI: 10.1007/5584_2019_447] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Titanium implants are considered the gold standard of treatment for dental and orthopedic applications. Biocompatibility, low elasticity, and corrosion resistance are some of the key properties of these metallic implants. Nonetheless, a long-term clinical failure of implants may occur due to inadequate osseointegration. Poor osseointegration induces mobility, inflammation, increased bone resorption, and osteolysis; hence, it may result in painful revision surgeries. Topographical modifications, improvement in hydrophilicity, and the development of controlled-release drug-loading systems have shown to improve cellular adhesion, proliferation, and differentiation. Surface modifications, along with drug coating, undoubtedly demonstrate better osseointegration, especially in challenged degenerative conditions, such as osteoporosis, osteoarthritis, and osteogenesis imperfecta. Anabolic bone-acting drugs, such as parathyroid hormone peptides, simvastatin, prostaglandin-EP4-receptor antagonist, vitamin D, strontium ranelate, and anti-catabolic bone-acting drugs, such as calcitonin, bisphosphonates, and selective estrogen receptor modulators, expedite the process of osseointegration. In addition, various proteins, peptides, and growth factors may accessorize the idea of localized therapy. Loading these substances on modified titanium surfaces is achieved commonly by mechanisms such as direct coating, adsorption, and incorporating in biodegradable polymers. The primary approach toward the optimum drug loading is a critical trade-off between factors preventing release of a drug immediately and those allowing slow and sustained release. Recent advances broaden the understanding of the efficacy of adsorption, hydrogel coating, and electrospinning layer-by-layer coating facilitated by differential charge on metallic surface. This review discusses the existing approaches and challenges for the development of stable and sustained drug delivery systems on titanium implants, which would promote faster and superior osseointegration.
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Affiliation(s)
- Anwesha Barik
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, Paschim Medinipur, West Bengal, India
| | - Nishant Chakravorty
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, Paschim Medinipur, West Bengal, India.
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Rozenbaum RT, Su L, Umerska A, Eveillard M, Håkansson J, Mahlapuu M, Huang F, Liu J, Zhang Z, Shi L, van der Mei HC, Busscher HJ, Sharma PK. Antimicrobial synergy of monolaurin lipid nanocapsules with adsorbed antimicrobial peptides against Staphylococcus aureus biofilms in vitro is absent in vivo. J Control Release 2018; 293:73-83. [PMID: 30465823 DOI: 10.1016/j.jconrel.2018.11.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 11/16/2018] [Indexed: 12/22/2022]
Abstract
Bacterial infections are mostly due to bacteria in their biofilm-mode of growth, while penetrability of antimicrobials into infectious biofilms and increasing antibiotic resistance hamper infection treatment. In-vitro, monolaurin lipid nanocapsules (ML-LNCs) carrying adsorbed antimicrobial peptides (AMPs) displayed synergistic efficacy against planktonic Staphylococcus aureus, but it has not been demonstrated, neither in-vitro nor in-vivo, that such ML-LNCs penetrate into infectious S. aureus biofilms and maintain synergy with AMPs. This study investigates the release mechanism of AMPs from ML-LNCs and possible antimicrobial synergy of ML-LNCs with the AMPs DPK-060 and LL-37 against S. aureus biofilms in-vitro and in a therapeutic, murine, infected wound-healing model. Zeta potentials demonstrated that AMP release from ML-LNCs was controlled by the AMP concentration in suspension. Both AMPs demonstrated no antimicrobial efficacy against four staphylococcal strains in a planktonic mode, while a checkerboard assay showed synergistic antimicrobial efficacy when ML-LNCs and DPK-060 were combined, but not for combinations of ML-LNCs and LL-37. Similar effects were seen for growth reduction of staphylococcal biofilms, with antimicrobial synergy persisting only for ML-LNCs at the highest level of DPK-060 or LL-37 adsorption. Healing of wounds infected with bioluminescent S. aureus Xen36, treated with ML-LNCs alone, was faster when treated with PBS, while AMPs alone did not yield faster wound-healing than PBS. Faster, synergistic wound-healing due to ML-LNCs with adsorbed DPK-060, was absent in-vivo. Summarizing, antimicrobial synergy of ML-LNCs with adsorbed antimicrobial peptides as seen in-vitro, is absent in in-vivo healing of infected wounds, likely because host AMPs adapted the synergistic role of the AMPs added. Thus, conclusions regarding synergistic antimicrobial efficacy, should not be drawn from planktonic data, while even in-vitro biofilm data bear little relevance for the in-vivo situation.
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Affiliation(s)
- René T Rozenbaum
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, P.O Box 196, 9700 AD Groningen, the Netherlands
| | - Linzhu Su
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, P.O Box 196, 9700 AD Groningen, the Netherlands; State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Functional Polymer Materials, Ministry of Education, Institute of Polymer Chemistry, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Nankai University, Tianjin 300071, PR China
| | - Anita Umerska
- MINT, UNIV Angers, INSERM U1066, CNRS 6021, Université Bretagne Loire, Angers, Cedex, France
| | - Matthieu Eveillard
- Equipe ATIP AVENIR, CRCINA, Inserm, Université de Nantes, Université d'Angers, Angers, France
| | - Joakim Håkansson
- Research Institutes of Sweden, Division Biosciences and Materials, Section for Medical Technology, Box 857, 50115 Borås, Sweden
| | - Margit Mahlapuu
- Promore Pharma, Karolinska Institutet Science Park, Fogdevreten 2, SE-171 65, Solna, Sweden
| | - Fan Huang
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Science, Peking Union Medical College, Tianjin 300192, PR China
| | - Jianfeng Liu
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Science, Peking Union Medical College, Tianjin 300192, PR China.
| | - Zhenkun Zhang
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Functional Polymer Materials, Ministry of Education, Institute of Polymer Chemistry, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Nankai University, Tianjin 300071, PR China
| | - Linqi Shi
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Functional Polymer Materials, Ministry of Education, Institute of Polymer Chemistry, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Nankai University, Tianjin 300071, PR China
| | - Henny C van der Mei
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, P.O Box 196, 9700 AD Groningen, the Netherlands
| | - Henk J Busscher
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, P.O Box 196, 9700 AD Groningen, the Netherlands
| | - Prashant K Sharma
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, P.O Box 196, 9700 AD Groningen, the Netherlands.
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Xu T, Zhang J, Zhu Y, Zhao W, Pan C, Ma H, Zhang L. A poly(hydroxyethyl methacrylate)-Ag nanoparticle porous hydrogel for simultaneous in vivo prevention of the foreign-body reaction and bacterial infection. NANOTECHNOLOGY 2018; 29:395101. [PMID: 29989569 DOI: 10.1088/1361-6528/aad257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The use of implants or indwelling medical devices has greatly enhanced the quality and efficacy of health care. However, foreign-body reactions (FBRs) and infections can lead to potential failure or removal of the devices, or increased morbidity and mortality of patients. Herein, we develop a silver nanoparticle (AgNP) loaded poly(hydroxyethyl methacrylate) hydrogel with spherical, interconnected 40 μm pores. The resulting hydrogels displayed good antibacterial properties regarding both gram positive bacteria (Staphylococcus aureus) and gram negative bacteria (Escherichia coli (E. coli)) in vitro and were highly efficient at inhibiting bacterial cell growth. Moreover, they exhibited an in vivo resistance to FBRs by reducing the immune responses, and completely prevented the formation of collagen capsules. Finally, in vivo studies of the E. coli infected mouse model demonstrated that the AgNP loaded porous hydrogels were highly efficient at resisting the bacterial FBRs and infections, while they promoted cell mitigation and infiltration. Findings from this work suggest that AgNP loaded porous hydrogels hold promise in various biomedical applications including in the new generation of implantable biomedical devices and tissue engineering scaffolds.
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Affiliation(s)
- Tong Xu
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300072, People's Republic of China. Key Laboratory of Systems Bioengineering (Ministry of Education), Tianjin University, Tianjin 300072, People's Republic of China. Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Tianjin University, Tianjin, 300072, People's Republic of China
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50
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Dhand C, Balakrishnan Y, Ong ST, Dwivedi N, Venugopal JR, Harini S, Leung CM, Low KZW, Loh XJ, Beuerman RW, Ramakrishna S, Verma NK, Lakshminarayanan R. Antimicrobial quaternary ammonium organosilane cross-linked nanofibrous collagen scaffolds for tissue engineering. Int J Nanomedicine 2018; 13:4473-4492. [PMID: 30122921 PMCID: PMC6080871 DOI: 10.2147/ijn.s159770] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction In search for cross-linkers with multifunctional characteristics, the present work investigated the utility of quaternary ammonium organosilane (QOS) as a potential cross-linker for electrospun collagen nanofibers. We hypothesized that the quaternary ammonium ions improve the electrospinnability by reducing the surface tension and confer antimicrobial properties, while the formation of siloxane after alkaline hydrolysis could cross-link collagen and stimulate cell proliferation. Materials and methods QOS collagen nanofibers were electrospun by incorporating various concentrations of QOS (0.1%–10% w/w) and were cross-linked in situ after exposure to ammonium carbonate. The QOS cross-linked scaffolds were characterized and their biological properties were evaluated in terms of their biocompatibility, cellular adhesion and metabolic activity for primary human dermal fibroblasts and human fetal osteoblasts. Results and discussion The study revealed that 1) QOS cross-linking increased the flexibility of otherwise rigid collagen nanofibers and improved the thermal stability; 2) QOS cross-linked mats displayed potent antibacterial activity and 3) the biocompatibility of the composite mats depended on the amount of QOS present in dope solution – at low QOS concentrations (0.1% w/w), the mats promoted mammalian cell proliferation and growth, whereas at higher QOS concentrations, cytotoxic effect was observed. Conclusion This study demonstrates that QOS cross-linked mats possess anti-infective properties and confer niches for cellular growth and proliferation, thus offering a useful approach, which is important for hard and soft tissue engineering and regenerative medicine.
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Affiliation(s)
- Chetna Dhand
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Discovery Tower, Singapore, , .,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore,
| | | | - Seow Theng Ong
- Dermatology and Skin Biology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore,
| | - Neeraj Dwivedi
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
| | - Jayarama R Venugopal
- Faculty of Industrial Sciences & Technology, Universiti Malaysia Pahang, Gambang, Malaysia
| | - Sriram Harini
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Discovery Tower, Singapore, ,
| | - Chak Ming Leung
- Department of Bioengineering, National University of Singapore, Singapore
| | - Kenny Zhi Wei Low
- Department of Mechanical Engineering, Faculty of Engineering, Center for Nanofibers and Nanotechnology, National University of Singapore, Singapore
| | - Xian Jun Loh
- Department of Mechanical Engineering, Faculty of Engineering, Center for Nanofibers and Nanotechnology, National University of Singapore, Singapore
| | - Roger W Beuerman
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Discovery Tower, Singapore, , .,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore,
| | - Seeram Ramakrishna
- Soft Materials Department, Institute of Materials Research and Engineering, ASTAR (Agency for Science, Technology and Research, Singapore
| | - Navin Kumar Verma
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Discovery Tower, Singapore, , .,Dermatology and Skin Biology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore,
| | - Rajamani Lakshminarayanan
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Discovery Tower, Singapore, , .,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore,
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