Biomaterial-associated infection with Candida albicans in mice

In vitro corrosion behaviour and anti-Candida spp. activity of Zn coated with ZnO-nanostructured 'Anastacia' flowers

Rejection and colonization by microbes are two problematic issues that often require the surgical removal of medical implants with increased risks for patients. In this work it is shown that functionalization of Zn surfaces with ZnO-nanostructured 'Anastacia' flowers (NAF) resulted in improved biomaterials that can potentially overcome these important drawbacks, which can further boost the use of Zn in biomedical implants. The in vitro degradation of NAF-coated Zn under simulated physiological conditions resulted in the formation of a biomimetic corrosion layer rich in a hydroxyapatite analogue that, being an important bone component, may potentially decrease implant rejection. Colonization of the NAF-coated Zn surface by Candida parapsilosis and Candida albicans, two of the more relevant microbial species colonizing medical devices, was significantly reduced on the NAF-coated Zn surface. The mechanism by which this colonization inhibition occurred was distinct since for C. parapsilosis cells this was attributed to reduced cell viability, while for C. albicans the reduced colonization was related to impaired biofilm formation. This ZnO-derived coating is an expeditious strategy to improve the resilience of Zn-based resorbable biomaterials towards Candida spp. colonization, paving the way for the design of bioactive ZnO-derived coatings with potential for clinical applications on bone.

Effector function of leucocytes from susceptible and resistant mice against distinct isolates of Candida albicans

Neutrophils and macrophages were generated in vitro from mice that display either high or low tissue susceptibilities to Candida albicans infection and their ability to phagocytose and kill three isolates of the yeast with different virulence characteristics was evaluated. In the absence of opsonization, phagocytosis by BALB/c and CBA/CaH neutrophils was comparable, but the killing was very poor. Opsonization with normal serum slightly decreased phagocytosis, but it had markedly different effects on killing, either enhancing or inhibiting candidacidal activity, depending on the combination of yeast isolate and mouse strain. In contrast, BALB/c macrophages showed high levels of phagocytosis and killing of both unopsonized yeasts and opsonized yeasts; whereas killing of unopsonized yeasts by CBA/CaH macrophages was poor, it was markedly enhanced by opsonization.

In vitro effects of zirconia and alumina particles on human blood monocyte-derived macrophages: X-ray microanalysis and flow cytometric studies

The cytocompatibility of two particulate bioceramics, zirconia and alumina, was studied using human blood monocytes driven to differentiate into mature macrophages with granulocyte macrophage-colony-stimulating factor. Changes in individual cell elemental composition, particularly sodium and potassium content, were assessed by X-ray microanalysis of ultrathin freeze-dried sections. Phagocytosis and respiratory burst of macrophages exposed to biomaterial for 7 days were analyzed under flow cytometry using uptake of fluorescent latex beads and 2'7'-dichlorofluorescien diacetate oxidation, respectively. Zirconia and alumina particles were found to decrease the intracellular potassium/sodium ratio (an index of cell vitality) significantly (p<.01) in 7-day-cultured macrophages compared to control cells cultured out of material. Phagocytosis of both ceramic particles by macrophages was followed by a concomitant decrease in cell phagocytic ability (27%) and a marked altered oxidative metabolism (>2 times reduced by zirconia and >5 times reduced by alumina). The present study clearly demonstrates that reduction of the phagocytic capacity of macrophages associated with altered oxidative metabolism caused by biomaterial particles is characterized by changes in intracellular elemental content. Thus, investigation of cellular homeostasis by electron probe microanalysis together with analysis of functional changes may improve estimation of biomaterial cytocompatibility.

Specific immune response to staphylococcal antigens during long-lasting biomaterial implantation

Biomaterial-associated infections caused by staphylococci are one of the main therapeutic problems in modern medicine. There is no doubt that local disfunction of polymorphonuclear leukocytes and macrophages predisposes to such infections. However, it is not clear how implantation of a foreign body influences the antibacterial immune response. We analyzed some parameters of the specific immune response to staphylococcal antigens, in mice implanted for 3 months with heparinized polyethylene. Three weeks before the evaluation of the immune response, mice (implanted and non-implanted) were infected i.p. with 2 x 10(7) cells of Staphylococcus aureus Cowan 1. The proliferation of splenocytes was determined on the basis of [3H]thymidine incorporation in cultures stimulated with staphylococcal lipoteichoic acid, protein A, alpha-toxin, or phytohemagglutinin. Moreover, the level of specific antibodies to staphylococcal antigens was determined in serum samples (ELISA with the antigens lipoteichoic acid, protein A, and alpha-toxin). The data obtained indicate that long-lasting implantation caused evident changes in proliferative activity of lymphocytes and in humoral response to staphylococcal antigens. It enhanced spontaneous and lipoteichoic acid- or alpha-toxin-stimulated proliferation of splenocytes, in vitro. In contrast, heparinized polyethylene-implanted animals showed a significant decrease in the production of anti-protein A IgG2b and anti-alpha-toxin IgG2a and IgG2b.

The cells of monocyte-macrophage lineage in mice with the 2-month polyethylene implantation

End-point-attached heparinized polyethylene (H-PE) was implanted for 2 months into the peritoneum of C57B1/6 mice. The proliferation of bone marrow cells (BMCs) from implanted and non-implanted mice was investigated in M-CSF supplemented medium, in the presence or absence of macrophage-specific monoclonal antibodies (mAbs). The mAb HC 7.67.B, recognizing a surface determinant on immature monocytoid cells, inhibited the proliferation of BMCs from H-PE implanted mice without any influence on the proliferation of BMCs from non-implanted animals. The peritoneal macrophages from H-PE implanted mice demonstrated enhanced production of fibronectin (Fn) in comparison to the macrophages from non-implanted animals. Our results suggest changes in the differentiation of murine monocyte-macrophage lineage in the mice bearing H-PE implants for 2 months.

Effects of granulocyte-macrophage colony stimulating factor (GM-CSF) on biomaterial-associated staphylococcal infection in mice

Staphylococcal infections are a major complication in the usage of biomaterials. Different modifications of polymers have been made to reduce the incidence of such infections. We studied the effects of modifying heparinized polyethylene (H-PE) with mouse recombinant granulocyte-macrophage stimulating factor (rGM-CSF). The elimination of staphylococci (Staphylococcus aureus, S. epidermidis) from the peritoneum of mice implanted with rGM-CSF-coated H-PE was slightly more effective than the elimination of the bacteria from the peritoneum of animals implanted with uncoated H-PE. Most interestingly, the number of staphylococci present in the biofilms covering rGM-CSF-coated implants were significantly lower than the number of bacteria detected on the surface of H-PE not coated with rGM-CSF. In vitro, rGM-CSF restored the anti-bacterial potency of the phagocytes, which had been reduced by surface contact with H-PE. The results suggest that modification of biomaterials with rGM-CSF could be one way of preventing staphylococcal infections; especially in neutropenic disorders, which constitute the highest risk factor for foreign body-associated infections.