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Fuglsang-Madsen AJ, Henriksen NL, Chávez ES, Kvich LA, Birch JKM, Hartmann KT, Eriksen T, Bjarnsholt T, Gottlieb H, Andresen TL, Jensen LK, Henriksen JR, Hansen AE. Eradication of Staphylococcus aureus in Implant-Associated Osteomyelitis by an Injectable In Situ-Forming Depot Antibiotics Delivery System. J Infect Dis 2024; 230:614-623. [PMID: 38537273 DOI: 10.1093/infdis/jiae139] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND Bone infections with Staphylococcus aureus are notoriously difficult to treat and have high recurrence rates. Local antibiotic delivery systems hold the potential to achieve high in situ antibiotic concentrations, which are otherwise challenging to achieve via systemic administration. Existing solutions have been shown to confer suboptimal drug release and distribution. Here we present and evaluate an injectable in situ-forming depot system termed CarboCell. The CarboCell technology provides sustained and tuneable release of local high-dose antibiotics. METHODS CarboCell formulations of levofloxacin or clindamycin with or without antimicrobial adjuvants cis-2-decenoic acid or cis-11-methyl-2-dodecenoic acid were tested in experimental rodent and porcine implant-associated osteomyelitis models. In the porcine models, debridement and treatment with CarboCell-formulated antibiotics was carried out without systemic antibiotic administration. The bacterial burden was determined by quantitative bacteriology. RESULTS CarboCell formulations eliminated S. aureus in infected implant rat models. In the translational implant-associated pig model, surgical debridement and injection of clindamycin-releasing CarboCell formulations resulted in pathogen-free bone tissues and implants in 9 of 12 and full eradication in 5 of 12 pigs. CONCLUSIONS Sustained release of antimicrobial agents mediated by the CarboCell technology demonstrated promising therapeutic efficacy in challenging translational models and may be beneficial in combination with the current standard of care.
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Affiliation(s)
| | - Nicole Lind Henriksen
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | | | - Lasse Andersson Kvich
- Costerton Biofilm Centre, Institute of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | | | - Katrine Top Hartmann
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Thomas Eriksen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Thomas Bjarnsholt
- Costerton Biofilm Centre, Institute of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Hans Gottlieb
- Department of Orthopedic Surgery, Herlev Hospital, Herlev, Denmark
| | - Thomas Lars Andresen
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Louise Kruse Jensen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | | | - Anders Elias Hansen
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
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2
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Top Hartmann K, Lund Nielsen R, Mikkelsen FC, Aalbæk B, Lichtenberg M, Holm Jakobsen T, Bjarnsholt T, Kvich L, Ingmer H, Odgaard A, Elvang Jensen H, Kruse Jensen L. Bacterial micro-aggregates as inoculum in animal models of implant-associated infections. Biofilm 2024; 7:100200. [PMID: 38803605 PMCID: PMC11128829 DOI: 10.1016/j.bioflm.2024.100200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
Is it time to rethink the inoculum of animal models of implant-associated infections (IAI)? Traditionally, animal models of IAI are based on inoculation with metabolically active overnight cultures of planktonic bacteria or pre-grown surface-attached biofilms. However, such inoculums do not mimic the clinical initiation of IAI. Therefore, the present study aimed to develop a clinically relevant inoculum of low metabolic micro-aggregated bacteria. The porcine Staphylococcus aureus strain S54F9 was cultured in Tryptone Soya Broth (TSB) for seven days to facilitate the formation of low metabolic micro-aggregates. Subsequently, the aggregated culture underwent filtration using cell strainers of different pore sizes to separate micro-aggregates. Light microscopy was used to evaluate the aggregate formation and size in the different fractions, while isothermal microcalorimetry was used to disclose a low metabolic activity. The micro-aggregate fraction obtained with filter size 5-15 μm (actual measured mean size 32 μm) was used as inoculum in a porcine implant-associated osteomyelitis (IAO) model and compared to a standard overnight planktonic inoculum and a sham inoculum of 0.9 % saline. The micro-aggregate and planktonic inoculums caused IAO with the re-isolation of S. aureus from soft tissues, bones, and implants. However, compared to their planktonic counterpart, neither of the micro-aggregate inoculated animals showed signs of osteomyelitis, i.e., sequester, osteolysis, and pus at gross inspection. Furthermore, inoculation with low metabolic micro-aggregates resulted in a strong healing response with pronounced osteoid formation, comparable to sham animals. In conclusion, the formation and separation of low metabolic bacterial micro-aggregates into various size fractions is possible, however, planktonic bacteria were still seen in all size fractions. Inoculation with micro-aggregates caused a less-aggressive osteomyelitis i.e. combination of infected tissue and strong healing response. Therefore, the use of low metabolic micro-aggregates could be a relevant inoculum for animal models of less-aggressive and thereby slower developing IAI and add in to our understanding of the host-implant-bacteria interactions in slow-onset low-grade infections.
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Affiliation(s)
- Katrine Top Hartmann
- Department of Veterinary- and Animal Sciences, University of Copenhagen, Grønnegårdsvej 7, 1870, Frederiksberg C, Denmark
| | - Regitze Lund Nielsen
- Costerton Biofilm Center, Department of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Freja Cecilie Mikkelsen
- Department of Veterinary- and Animal Sciences, University of Copenhagen, Grønnegårdsvej 7, 1870, Frederiksberg C, Denmark
| | - Bent Aalbæk
- Department of Veterinary- and Animal Sciences, University of Copenhagen, Grønnegårdsvej 7, 1870, Frederiksberg C, Denmark
| | - Mads Lichtenberg
- Costerton Biofilm Center, Department of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Tim Holm Jakobsen
- Costerton Biofilm Center, Department of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Thomas Bjarnsholt
- Costerton Biofilm Center, Department of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Lasse Kvich
- Costerton Biofilm Center, Department of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Hanne Ingmer
- Department of Veterinary- and Animal Sciences, University of Copenhagen, Grønnegårdsvej 7, 1870, Frederiksberg C, Denmark
| | - Anders Odgaard
- Department of Orthopedic Surgery, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns vej 6, 2100, Copenhagen, Denmark
| | - Henrik Elvang Jensen
- Department of Veterinary- and Animal Sciences, University of Copenhagen, Grønnegårdsvej 7, 1870, Frederiksberg C, Denmark
| | - Louise Kruse Jensen
- Department of Veterinary- and Animal Sciences, University of Copenhagen, Grønnegårdsvej 7, 1870, Frederiksberg C, Denmark
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3
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Iglesias MJ, Soengas R, López-Ortiz F, Biondi N, Tredici MR, Gutiérrez-Del-Río I, López-Ibáñez S, Villar CJ, Lombó F, López Y, Gabasa Y, Soto S. Effect of culture conditions at lab-scale on metabolite composition and antibacterial and antibiofilm activities of Dunaliella tertiolecta. JOURNAL OF PHYCOLOGY 2023; 59:356-369. [PMID: 36690599 DOI: 10.1111/jpy.13316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/02/2022] [Accepted: 12/19/2022] [Indexed: 05/28/2023]
Abstract
Dunaliella tertiolecta RCC6 was cultivated indoors in glass bubble column photobioreactors operated under batch and semi-continuous regimens and using two different conditions of light and temperature. Biomass was harvested by centrifugation, frozen, and then lyophilized. The soluble material was obtained by sequential extraction of the lyophilized biomass with solvents with a gradient of polarity (hexane, ethyl acetate, and methanol) and its metabolic composition was investigated through nuclear magnetic resonance (NMR) spectroscopy. The effect of light on chlorophyll biosynthesis was clearly shown through the relative intensities of the 1 H NMR signals due to pheophytins. The highest signal intensity was observed for the biomasses obtained at lower light intensity, resulting in a lower light availability per cell. Under high temperature and light conditions, the 1 H NMR spectra of the hexane extracts showed an incipient accumulation of triacylglycerols. In these conditions and under semi-continuous regimen, an enhancement of β-carotene and sterols production was observed. The antibacterial and antibiofilm activities of the extracts were also tested. Antibacterial activity was not detected, regardless of culture conditions. In contrast, the minimal biofilm inhibitory concentrations (MBICs) against Escherichia coli for the hexane extract obtained under semi-continuous regimen using high temperature and irradiance conditions was promising.
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Affiliation(s)
- María José Iglesias
- Área de Química Orgánica, Research Centre CIAIMBITAL, Universidad de Almería, Almería, Spain
| | - Raquel Soengas
- Área de Química Orgánica, Research Centre CIAIMBITAL, Universidad de Almería, Almería, Spain
| | - Fernando López-Ortiz
- Área de Química Orgánica, Research Centre CIAIMBITAL, Universidad de Almería, Almería, Spain
| | - Natascia Biondi
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Florence, Italy
| | - Mario R Tredici
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Florence, Italy
| | - Ignacio Gutiérrez-Del-Río
- Área de Microbiología, Research Group BIONUC, Universidad de Oviedo, IUOPA (Instituto Universitario de Oncología del Principado de Asturias), ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Oviedo, Spain
| | - Sara López-Ibáñez
- Área de Microbiología, Research Group BIONUC, Universidad de Oviedo, IUOPA (Instituto Universitario de Oncología del Principado de Asturias), ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Oviedo, Spain
| | - Claudio J Villar
- Área de Microbiología, Research Group BIONUC, Universidad de Oviedo, IUOPA (Instituto Universitario de Oncología del Principado de Asturias), ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Oviedo, Spain
| | - Felipe Lombó
- Área de Microbiología, Research Group BIONUC, Universidad de Oviedo, IUOPA (Instituto Universitario de Oncología del Principado de Asturias), ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Oviedo, Spain
| | - Yuly López
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Yaiza Gabasa
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Sara Soto
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
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4
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Jensen N, Jensen HE, Aalbaek B, Blirup-Plum SA, Soto SM, Cepas V, López Y, Gabasa Y, Gutiérrez-del-Río I, Villar CJ, Lombó F, Iglesias MJ, Soengas R, López Ortiz F, Jensen LK. Synthesis of the cyanobacterial halometabolite Chlorosphaerolactylate B and demonstration of its antimicrobial effect in vitro and in vivo. Front Microbiol 2022; 13:950855. [PMID: 36246241 PMCID: PMC9557163 DOI: 10.3389/fmicb.2022.950855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/18/2022] [Indexed: 12/02/2022] Open
Abstract
Chlorosphaerolactylate B, a newly discovered antimicrobial halometabolite from the cyanobacterium Sphaerospermopsis sp. LEGE 00249 has been synthesized in three steps by using 12-bromododecanoic acid as starting material. A total of 0.5 g was produced for in vitro and in vivo antimicrobial efficacy testing. In vitro, the minimal inhibitory concentration (MIC) was estimated to be 256 mg/L for Staphylococcus aureus, while the minimal biofilm inhibitory concentration (MBIC) was estimated to be 74 mg/L. The in vivo study utilized a porcine model of implant-associated osteomyelitis. In total, 12 female pigs were allocated into 3 groups based on inoculum (n = 4 in each group). An implant cavity (IC) was drilled in the right tibia and followed by inoculation and insertion of a steel implant. All pigs were inoculated with 10 μL containing either: 11.79 mg synthetic Chlorosphaerolactylate B + 104 CFU of S. aureus (Group A), 104 CFU of S. aureus (Group B), or pure saline (Group C), respectively. Pigs were euthanized five days after inoculation. All Group B animals showed macroscopic and microscopic signs of bone infection and both tissue and implant harbored S. aureus bacteria (mean CFU on implants = 1.9 × 105). In contrast, S. aureus could not be isolated from animals inoculated with saline. In Group A, two animals had a low number of S. aureus (CFU = 6.7 × 101 and 3.8 × 101, respectively) on the implants, otherwise all Group A animals were similar to Group C animals. In conclusion, synthetic Chlorosphaerolactylate B holds potential to be a novel antimicrobial and antibiofilm compound.
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Affiliation(s)
- Nikoline Jensen
- Section for Pathobiological Sciences, Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Elvang Jensen
- Section for Pathobiological Sciences, Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - Bent Aalbaek
- Section for Pathobiological Sciences, Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - Sophie Amalie Blirup-Plum
- Section for Pathobiological Sciences, Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - Sara M. Soto
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- CIBER Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Virginio Cepas
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Yuly López
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Yaiza Gabasa
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Ignacio Gutiérrez-del-Río
- Biotechnology in Nutraceuticals and Bioactive Compounds-BIONUC, Department of Functional Biology, University of Oviedo, Oviedo, Spain
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Claudio J. Villar
- Biotechnology in Nutraceuticals and Bioactive Compounds-BIONUC, Department of Functional Biology, University of Oviedo, Oviedo, Spain
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Felipe Lombó
- Biotechnology in Nutraceuticals and Bioactive Compounds-BIONUC, Department of Functional Biology, University of Oviedo, Oviedo, Spain
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - María José Iglesias
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Raquel Soengas
- Área de Química Orgánica, Centro de Investigación CIAIMBITAL, Universidad de Almería, Almería, Spain
| | - Fernando López Ortiz
- Área de Química Orgánica, Centro de Investigación CIAIMBITAL, Universidad de Almería, Almería, Spain
- *Correspondence: Fernando López Ortiz,
| | - Louise Kruse Jensen
- Section for Pathobiological Sciences, Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
- Louise Kruse Jensen,
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5
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Afzelius P, Morsing MK, Nielsen OL, Alstrup AKO, Jensen SB, Jødal L. Lymph Nodes Draining Infections Investigated by PET and Immunohistochemistry in a Juvenile Porcine Model. Molecules 2022; 27:molecules27092792. [PMID: 35566137 PMCID: PMC9104488 DOI: 10.3390/molecules27092792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND [18F]FDG and [11C]methionine accumulate in lymph nodes draining S. aureus -infected foci. The lymph nodes were characterized by weight, [11C]methionine- and [18F]FDG-positron emissions tomography (PET)/computed tomography (CT), and immunohistochemical (IHC)-staining. METHODS 20 pigs inoculated with S. aureus into the right femoral artery were PET/CT-scanned with [18F]FDG, and nine of the pigs were additionally scanned with [11C]methionine. Mammary, medial iliac, and popliteal lymph nodes from the left and right hind limbs were weighed. IHC-staining for calculations of area fractions of Ki-67, L1, and IL-8 positive cells was done in mammary and popliteal lymph nodes from the nine pigs. RESULTS The pigs developed one to six osteomyelitis foci. Some pigs developed contiguous infections of peri-osseous tissue and inoculation-site abscesses. Weights of mammary and medial iliac lymph nodes and their [18F]FDG maximum Standardized Uptake Values (SUVFDGmax) showed a significant increase in the inoculated limb compared to the left limb. Popliteal lymph node weight and their FDG uptake did not differ significantly between hind limbs. Area fractions of Ki-67 and IL-8 in the right mammary lymph nodes and SUVMetmax in the right popliteal lymph nodes were significantly increased compared with the left side. CONCLUSION The PET-tracers [18F]FDG and [11C]methionine, and the IHC- markers Ki-67 and IL-8, but not L1, showed increased values in lymph nodes draining soft tissues infected with S. aureus. The increase in [11C]methionine may indicate a more acute lymph node response, whereas an increase in [18F]FDG may indicate a more chronic response.
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Affiliation(s)
- Pia Afzelius
- Department of Clinical Physiology and Nuclear Medicine Zealand Koege, University Hospital of Copenhagen, 4600 Copenhagen, Denmark
- Department of Nuclear Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark; (S.B.J.); (L.J.)
- Correspondence:
| | - Malene Kjelin Morsing
- Department of Veterinary and Animal Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark; (M.K.M.); (O.L.N.)
| | - Ole Lerberg Nielsen
- Department of Veterinary and Animal Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark; (M.K.M.); (O.L.N.)
| | - Aage Kristian Olsen Alstrup
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Skejby, 8200 Aarhus, Denmark;
- Department of Clinical Medicine, Aarhus University, Skejby, 8200 Aarhus, Denmark
| | - Svend Borup Jensen
- Department of Nuclear Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark; (S.B.J.); (L.J.)
- Department of Chemistry and Biosciences, Aalborg University, 9220 Aalborg, Denmark
| | - Lars Jødal
- Department of Nuclear Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark; (S.B.J.); (L.J.)
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Cepas V, Gutiérrez-Del-Río I, López Y, Redondo-Blanco S, Gabasa Y, Iglesias MJ, Soengas R, Fernández-Lorenzo A, López-Ibáñez S, Villar CJ, Martins CB, Ferreira JD, Assunção MFG, Santos LMA, Morais J, Castelo-Branco R, Reis MA, Vasconcelos V, López-Ortiz F, Lombó F, Soto SM. Microalgae and Cyanobacteria Strains as Producers of Lipids with Antibacterial and Antibiofilm Activity. Mar Drugs 2021; 19:md19120675. [PMID: 34940674 PMCID: PMC8709229 DOI: 10.3390/md19120675] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/19/2021] [Accepted: 11/25/2021] [Indexed: 12/16/2022] Open
Abstract
Lipids are one of the primary metabolites of microalgae and cyanobacteria, which enrich their utility in the pharmaceutical, feed, cosmetic, and chemistry sectors. This work describes the isolation, structural elucidation, and the antibiotic and antibiofilm activities of diverse lipids produced by different microalgae and cyanobacteria strains from two European collections (ACOI and LEGE-CC). Three microalgae strains and one cyanobacteria strain were selected for their antibacterial and/or antibiofilm activity after the screening of about 600 strains carried out under the NoMorFilm European project. The total organic extracts were firstly fractionated using solid phase extraction methods, and the minimum inhibitory concentration and minimal biofilm inhibitory concentration against an array of human pathogens were determined. The isolation was carried out by bioassay-guided HPLC-DAD purification, and the structure of the isolated molecules responsible for the observed activities was determined by HPLC-HRESIMS and NMR methods. Sulfoquinovosyldiacylglycerol, monogalactosylmonoacylglycerol, sulfoquinovosylmonoacylglycerol, α-linolenic acid, hexadeca-4,7,10,13-tetraenoic acid (HDTA), palmitoleic acid, and lysophosphatidylcholine were found among the different active sub-fractions selected. In conclusion, cyanobacteria and microalgae produce a great variety of lipids with antibiotic and antibiofilm activity against the most important pathogens causing severe infections in humans. The use of these lipids in clinical treatments alone or in combination with antibiotics may provide an alternative to the current treatments.
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Affiliation(s)
- Virginio Cepas
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (V.C.); (Y.L.); (Y.G.)
| | - Ignacio Gutiérrez-Del-Río
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, 33006 Oviedo, Spain; (I.G.-D.-R.); (S.R.-B.); (A.F.-L.); (S.L.-I.); (C.J.V.); (F.L.)
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Principality of Asturias, 33006 Oviedo, Spain
- ISPA (Instituto de Investigaciones Sanitarias del Principado de Asturias), Principality of Asturias, 33011 Oviedo, Spain
| | - Yuly López
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (V.C.); (Y.L.); (Y.G.)
| | - Saúl Redondo-Blanco
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, 33006 Oviedo, Spain; (I.G.-D.-R.); (S.R.-B.); (A.F.-L.); (S.L.-I.); (C.J.V.); (F.L.)
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Principality of Asturias, 33006 Oviedo, Spain
- ISPA (Instituto de Investigaciones Sanitarias del Principado de Asturias), Principality of Asturias, 33011 Oviedo, Spain
| | - Yaiza Gabasa
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (V.C.); (Y.L.); (Y.G.)
| | - María José Iglesias
- Área de Química Orgánica, Centro de Investigación CIAIMBITAL, Universidad de Almería, 04120 Almería, Spain; (M.J.I.); (R.S.); (F.L.-O.)
| | - Raquel Soengas
- Área de Química Orgánica, Centro de Investigación CIAIMBITAL, Universidad de Almería, 04120 Almería, Spain; (M.J.I.); (R.S.); (F.L.-O.)
| | - Andrés Fernández-Lorenzo
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, 33006 Oviedo, Spain; (I.G.-D.-R.); (S.R.-B.); (A.F.-L.); (S.L.-I.); (C.J.V.); (F.L.)
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Principality of Asturias, 33006 Oviedo, Spain
- ISPA (Instituto de Investigaciones Sanitarias del Principado de Asturias), Principality of Asturias, 33011 Oviedo, Spain
| | - Sara López-Ibáñez
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, 33006 Oviedo, Spain; (I.G.-D.-R.); (S.R.-B.); (A.F.-L.); (S.L.-I.); (C.J.V.); (F.L.)
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Principality of Asturias, 33006 Oviedo, Spain
- ISPA (Instituto de Investigaciones Sanitarias del Principado de Asturias), Principality of Asturias, 33011 Oviedo, Spain
| | - Claudio J. Villar
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, 33006 Oviedo, Spain; (I.G.-D.-R.); (S.R.-B.); (A.F.-L.); (S.L.-I.); (C.J.V.); (F.L.)
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Principality of Asturias, 33006 Oviedo, Spain
- ISPA (Instituto de Investigaciones Sanitarias del Principado de Asturias), Principality of Asturias, 33011 Oviedo, Spain
| | - Clara B. Martins
- Coimbra Collection of Algae (ACOI), Department of Life Sciences, Calçada Martim de Freitas, University of Coimbra, 3000-456 Coimbra, Portugal; (C.B.M.); (J.D.F.); (M.F.G.A.); (L.M.A.S.)
- “Molecular Physical-Chemistry” R&D Unit, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal
| | - Joana D. Ferreira
- Coimbra Collection of Algae (ACOI), Department of Life Sciences, Calçada Martim de Freitas, University of Coimbra, 3000-456 Coimbra, Portugal; (C.B.M.); (J.D.F.); (M.F.G.A.); (L.M.A.S.)
| | - Mariana F. G. Assunção
- Coimbra Collection of Algae (ACOI), Department of Life Sciences, Calçada Martim de Freitas, University of Coimbra, 3000-456 Coimbra, Portugal; (C.B.M.); (J.D.F.); (M.F.G.A.); (L.M.A.S.)
| | - Lília M. A. Santos
- Coimbra Collection of Algae (ACOI), Department of Life Sciences, Calçada Martim de Freitas, University of Coimbra, 3000-456 Coimbra, Portugal; (C.B.M.); (J.D.F.); (M.F.G.A.); (L.M.A.S.)
| | - João Morais
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, University of Porto, 4450-208 Matosinhos, Portugal; (J.M.); (R.C.-B.); (M.A.R.); (V.V.)
| | - Raquel Castelo-Branco
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, University of Porto, 4450-208 Matosinhos, Portugal; (J.M.); (R.C.-B.); (M.A.R.); (V.V.)
| | - Mariana A. Reis
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, University of Porto, 4450-208 Matosinhos, Portugal; (J.M.); (R.C.-B.); (M.A.R.); (V.V.)
| | - Vitor Vasconcelos
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, University of Porto, 4450-208 Matosinhos, Portugal; (J.M.); (R.C.-B.); (M.A.R.); (V.V.)
- Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, Edifício FC4, 4169-007 Porto, Portugal
| | - Fernando López-Ortiz
- Área de Química Orgánica, Centro de Investigación CIAIMBITAL, Universidad de Almería, 04120 Almería, Spain; (M.J.I.); (R.S.); (F.L.-O.)
| | - Felipe Lombó
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, 33006 Oviedo, Spain; (I.G.-D.-R.); (S.R.-B.); (A.F.-L.); (S.L.-I.); (C.J.V.); (F.L.)
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Principality of Asturias, 33006 Oviedo, Spain
- ISPA (Instituto de Investigaciones Sanitarias del Principado de Asturias), Principality of Asturias, 33011 Oviedo, Spain
| | - Sara M. Soto
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (V.C.); (Y.L.); (Y.G.)
- Correspondence: ; Tel.: +34-932275400
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7
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Nielsen OL, Mellergaard M, Frees D, Larsen MN, Skov S, Olsen LH, Reimann MJ. A porcine model of subcutaneous Staphylococcus aureus infection: a pilot study. APMIS 2021; 130:359-370. [PMID: 33644910 DOI: 10.1111/apm.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022]
Abstract
In this descriptive pilot study, we aim to establish a porcine Staphylococcus aureus skin infection model by subcutaneous injection (s.c.) of the porcine S54F9 S. aureus strain in the groin area. Six pigs were used in the study: Five pigs were injected with S. aureus, inocula ranging from 7 × 103 to 5 × 107 colony-forming units per kg bodyweight; one pig was injected with saline exclusively. Lesions were recorded up to 6 days postinoculation using clinical evaluation, ultrasound evaluation, microbiology, flow cytometry, and pathology. Inoculation gave rise to lesions ranging from localized skin infection, that is, minute histological changes, intracellular infection, and macroscopic abscess formation with sequestration of soft tissue, to generalized infection and development of disseminated intravascular coagulation necessitating euthanasia only 10 h after inoculation. Ultrasound assessment of maximum width and characteristics was not able to disclose the progress of the local infection. Flow cytometry and immunohistochemistry revealed the participation of γδT cells in the immune response. In conclusion, we did see a graded inflammatory response associated with the dose of s.c. inoculated bacteria, which may be useful for studying, in particular, the interaction of bacteria and inflammatory mononuclear cell populations. It needs to be investigated if the model is discriminatory and robust.
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Affiliation(s)
- Ole Lerberg Nielsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Maiken Mellergaard
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Dorte Frees
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Maria Nygaard Larsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Søren Skov
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Lisbeth Høier Olsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Maria Josefine Reimann
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
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8
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Lüthje FL, Skovgaard K, Jensen HE, Blirup-Plum SA, Henriksen NL, Aalbæk B, Jensen LK. Receptor Activator of Nuclear Factor kappa-B Ligand is Not Regulated During Chronic Osteomyelitis in Pigs. J Comp Pathol 2020; 179:7-24. [PMID: 32958151 DOI: 10.1016/j.jcpa.2020.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/30/2020] [Accepted: 06/17/2020] [Indexed: 01/12/2023]
Abstract
Bone loss is a major complication of osteomyelitis and from numerous in-vitro studies, it has been concluded that the bone lysis is caused by elevated expression of the receptor activator of nuclear factor κB ligand (RANKL), leading to increased osteoclast activity. However, we failed to find any relationship between bone loss and osseous RANKL expression in a porcine model of acute and chronic implant-associated osteomyelitis (IAO) due to Staphylococcus aureus or in chronic osteomyelitis lesions in slaughter pigs. Surprisingly, we found that the expression of RANKL was reduced during chronic bone infections. This is in line with the few studies conducted on human samples. A significant bone loss was observed in IAO lesions and in lesions from slaughter pigs, but with no indication of osteoclast involvement using histochemistry, immunohistochemistry for RANKL, receptor activator of nuclear factor kappa-B, osteoprotegerin and cathepsin K, and high-throughput quantitative real-time polymerase chain reaction on bone tissue from osteomyelitic lesions. A strong inflammatory response was seen in the infected animals and, therefore, we propose proteolytic enzymes induced by inflammation to be a major component of the bone loss. Furthermore, we found a significant upregulation of the IL26 gene in infected animals, which can inhibit RANKL-induced osteoclastogenesis, but has no homologue in mice. This finding emphasises that neither murine models nor in-vitro studies can mirror human disease development completely. The present study emphasises that the interactions between microorganisms, the immune system and bone cells in osteomyelitis are too complex to be accurately represented by an in-vitro model.
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Affiliation(s)
- F L Lüthje
- Department of Veterinary and Animal Science, University of Copenhagen, Frederiksberg C, Denmark; Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - K Skovgaard
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - H E Jensen
- Department of Veterinary and Animal Science, University of Copenhagen, Frederiksberg C, Denmark
| | - S A Blirup-Plum
- Department of Veterinary and Animal Science, University of Copenhagen, Frederiksberg C, Denmark
| | - N L Henriksen
- Department of Veterinary and Animal Science, University of Copenhagen, Frederiksberg C, Denmark
| | - B Aalbæk
- Department of Veterinary and Animal Science, University of Copenhagen, Frederiksberg C, Denmark
| | - L K Jensen
- Department of Veterinary and Animal Science, University of Copenhagen, Frederiksberg C, Denmark.
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9
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Blirup-Plum SA, Bjarnsholt T, Jensen HE, Kragh KN, Aalbæk B, Gottlieb H, Bue M, Jensen LK. Pathological and microbiological impact of a gentamicin-loaded biocomposite following limited or extensive debridement in a porcine model of osteomyelitis. Bone Joint Res 2020; 9:394-401. [PMID: 32793334 PMCID: PMC7393185 DOI: 10.1302/2046-3758.97.bjr-2020-0007.r1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aims CERAMENT|G is an absorbable gentamicin-loaded biocomposite used as an on-site vehicle of antimicrobials for the treatment of chronic osteomyelitis. The purpose of the present study was to investigate the sole effect of CERAMENT|G, i.e. without additional systemic antimicrobial therapy, in relation to a limited or extensive debridement of osteomyelitis lesions in a porcine model. Methods Osteomyelitis was induced in nine pigs by inoculation of 104 colony-forming units (CFUs) of Staphylococcus aureus into a drill hole in the right tibia. After one week, the pigs were allocated into three groups. Group A (n = 3) received no treatment during the study period (19 days). Groups B (n = 3) and C (n = 3) received limited or extensive debridement seven days postinoculation, respectively, followed by injection of CERAMENT|G into the bone voids. The pigs were euthanized ten (Group C) and 12 (Group B) days after the intervention. Results All animals presented confirmatory signs of bone infection post-mortem. The estimated amount of inflammation was substantially greater in Groups A and B compared to Group C. In both Groups B and C, peptide nucleic acid fluorescence in situ hybridization (PNA FISH) of CERAMENT|G and surrounding bone tissue revealed bacteria embedded in an opaque matrix, i.e. within biofilm. In addition, in Group C, the maximal measured post-mortem gentamicin concentrations in CERAMENT|G and surrounding bone tissue samples were 16.6 μg/ml and 6.2 μg/ml, respectively. Conclusion The present study demonstrates that CERAMENT|G cannot be used as a standalone alternative to extensive debridement or be used without the addition of systemic antimicrobials. Cite this article: Bone Joint Res 2020;9(7):394–401.
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Affiliation(s)
- Sophie A Blirup-Plum
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Bjarnsholt
- Costerton Biofilm Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henrik E Jensen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kasper N Kragh
- Costerton Biofilm Center, Department of Immunology and Microbiology, Copenhagen, Copenhagen, Denmark
| | - Bent Aalbæk
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hans Gottlieb
- Department of Orthopedic Surgery, Herlev Hospital, Herlev, Denmark
| | - Mats Bue
- Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Louise K Jensen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
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10
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Bue M, Bergholt NL, Jensen LK, Jensen HE, Søballe K, Stilling M, Hanberg P. Inflammatory proteins in infected bone tissue - An explorative porcine study. Bone Rep 2020; 13:100292. [PMID: 32637468 PMCID: PMC7330156 DOI: 10.1016/j.bonr.2020.100292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/02/2020] [Accepted: 06/22/2020] [Indexed: 12/01/2022] Open
Abstract
Objective To explore the in situ inflammatory proteins in the local extracellular fluid of infected bone tissue. Material and methods Seven pigs went through a two-step surgery performing a traumatically implant-associated Staphylococcus aureus osteomyelitis in the proximal tibia. Five days later, microdialysis catheters (membrane cut off: 20 kDa) were placed in the implant cavity, infected and healthy cancellous bone, and infected and healthy subcutaneous tissue. Plasma samples were collected simultaneously. We employed an antibody-based proximity extension assay (Olink Inflammatory panel) for the measurement of inflammatory molecules within plasma and extracellular fluid of the investigated tissue compartments. Results A higher normalized protein expression in the infected bone tissue in comparison to healthy bone tissue was identified for proteins associated with angiogenesis and bone remodeling: OPG, TGFα, MCP-1, VEGFA, and uPA. Moreover, a parallel detectability of the systemic range of cytokines and chemokines as from the investigated local tissue compartments was demonstrated, indicating the same occurrence of proteins in the local environment as within plasma. Conclusion An angiogenic and osteogenic inflammatory protein composition within the extracellular fluid of infected bone tissue was described. The findings support the current histopathological knowledge and, therefore, microdialysis may represent a valid method for sampling of material for protein investigation of the in vivo inflammatory composition within the extracellular environment in infected bone tissue.
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Affiliation(s)
- Mats Bue
- Aarhus Microdialysis Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.,Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Natasja Leth Bergholt
- Aarhus Microdialysis Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Louise Kruse Jensen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Denmark
| | | | - Kjeld Søballe
- Aarhus Microdialysis Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.,Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Maiken Stilling
- Aarhus Microdialysis Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.,Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Pelle Hanberg
- Aarhus Microdialysis Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.,Department of Orthopaedic Surgery, Horsens Regional Hospital, Horsens, Denmark
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11
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Gutiérrez-Del-Río I, Brugerolle de Fraissinette N, Castelo-Branco R, Oliveira F, Morais J, Redondo-Blanco S, Villar CJ, Iglesias MJ, Soengas R, Cepas V, Cubillos YL, Sampietro G, Rodolfi L, Lombó F, González SMS, López Ortiz F, Vasconcelos V, Reis MA. Chlorosphaerolactylates A-D: Natural Lactylates of Chlorinated Fatty Acids Isolated from the Cyanobacterium Sphaerospermopsis sp. LEGE 00249. JOURNAL OF NATURAL PRODUCTS 2020; 83:1885-1890. [PMID: 32479093 DOI: 10.1021/acs.jnatprod.0c00072] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Four natural lactylates of chlorinated fatty acids, chlorosphaerolactylates A-D (1-4), were isolated from the methanolic extract of the cyanobacterium Sphaerospermopsis sp. LEGE 00249 through a combination of bioassay-guided and MS-guided approaches. Compounds 1-4 are esters of (mono-, di-, or tri)chlorinated lauric acid and lactic acid, whose structures were assigned on the basis of spectrometric and spectroscopic methods inclusive of 1D and 2D NMR experiments. High-resolution mass-spectrometry data sets also demonstrated the existence of other minor components that were identified as chlorosphaero(bis)lactylate analogues. The chlorosphaerolactylates were tested for potential antibacterial, antifungal, and antibiofilm properties using bacterial and fungal clinical isolates. Compounds 1-4 showed a weak inhibitory effect on the growth of Staphylococcus aureus S54F9 and Candida parapsilosis SMI416, as well as on the biofilm formation of coagulase-negative Staphylococcus hominis FI31.
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Affiliation(s)
- Ignacio Gutiérrez-Del-Río
- Departamento de Biología Funcional), IUOPA (Instituto Universitario de Oncología del Principado de Asturias), IISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Research Unit "Biotechnology in Nutraceuticals and Bioactive Compounds-BIONUC", Universidad de Oviedo (Área de Microbiología, 3, Oviedo, Spain
| | - Nelly Brugerolle de Fraissinette
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, University of Porto, 4450-208 Matosinhos, Portugal
| | - Raquel Castelo-Branco
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, University of Porto, 4450-208 Matosinhos, Portugal
| | - Flavio Oliveira
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, University of Porto, 4450-208 Matosinhos, Portugal
| | - João Morais
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, University of Porto, 4450-208 Matosinhos, Portugal
| | - Saúl Redondo-Blanco
- Departamento de Biología Funcional), IUOPA (Instituto Universitario de Oncología del Principado de Asturias), IISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Research Unit "Biotechnology in Nutraceuticals and Bioactive Compounds-BIONUC", Universidad de Oviedo (Área de Microbiología, 3, Oviedo, Spain
| | - Claudio J Villar
- Departamento de Biología Funcional), IUOPA (Instituto Universitario de Oncología del Principado de Asturias), IISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Research Unit "Biotechnology in Nutraceuticals and Bioactive Compounds-BIONUC", Universidad de Oviedo (Área de Microbiología, 3, Oviedo, Spain
| | - María José Iglesias
- Área de Química Orgánica, Research Centre CIAIMBITAL, Universidad de Almería, Ctra. Sacramento s/n, 04120, Almería, Spain
| | - Raquel Soengas
- Área de Química Orgánica, Research Centre CIAIMBITAL, Universidad de Almería, Ctra. Sacramento s/n, 04120, Almería, Spain
| | - Virginio Cepas
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain
| | - Yuly López Cubillos
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain
| | - Giacomo Sampietro
- Fotosintetica & Microbiologica S.r.l., Via dei Della Robbia 54, 50132 Firenze, Italy
| | - Liliana Rodolfi
- Fotosintetica & Microbiologica S.r.l., Via dei Della Robbia 54, 50132 Firenze, Italy
| | - Felipe Lombó
- Departamento de Biología Funcional), IUOPA (Instituto Universitario de Oncología del Principado de Asturias), IISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Research Unit "Biotechnology in Nutraceuticals and Bioactive Compounds-BIONUC", Universidad de Oviedo (Área de Microbiología, 3, Oviedo, Spain
| | | | - Fernando López Ortiz
- Área de Química Orgánica, Research Centre CIAIMBITAL, Universidad de Almería, Ctra. Sacramento s/n, 04120, Almería, Spain
| | - Vitor Vasconcelos
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, University of Porto, 4450-208 Matosinhos, Portugal
- Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, Edifício FC4, 4169-007 Porto, Portugal
| | - Mariana A Reis
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, University of Porto, 4450-208 Matosinhos, Portugal
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12
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Afzelius P, Heegaard PMH, Jensen SB, Alstrup AKO, Schønheyder HC, Eek A, Boerman O, Nielsen OL. [ 99mTc]-labelled interleukin-8 as a diagnostic tool compared to [ 18F]FDG and CT in an experimental porcine osteomyelitis model. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2020; 10:32-46. [PMID: 32211217 PMCID: PMC7076304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
Osteomyelitis (OM) is an important cause of morbidity and sometimes mortality in children and adults. Long-term complications can be reduced when treatment is initiated in an early phase. The diagnostic gold standard is microbial examination of a biopsy and current non-invasive imaging methods are not always optimal. [111In]-leukocyte scintigraphy is recommended for peripheral OM, but is time-consuming and not recommended in children. [18F]FDG PET/CT is recommended for vertebral OM in adults, but has the disadvantage of false positive findings and a relatively high radiation exposure; the latter is a problem in children. [99mTc]-based tracers are consequently preferred in children. We, therefore, aimed to find a [99mTc]-marked tracer with high specificity and sensitivity for early detection of OM. Suppurating inflammatory lesions like OM caused by Staphylococcus aureus (S. aureus) will attract large numbers of neutrophils and macrophages. A preliminary study has shown that [99m Tc]-labelled IL8 may be a possible candidate for imaging of peripheral OM. We investigated [99mTc]IL8 scintigraphy in a juvenile pig model of peripheral OM and compared it with [18F]FDG PET/CT. The pigs were experimentally inoculated with S. aureus to induce OM and scanned one week later. We also examined leukocyte count, serum CRP and IL8, as well as performed histopathological and microbiological investigations. [ 99m Tc]IL8 was easily and relatively quickly prepared and was shown to be suitable for visualization of OM lesions in peripheral bones detecting 70% compared to a 100% sensitivity of [18F]FDG PET/CT. [ 99m Tc]IL8 is a promising candidate for detection of OM in peripheral bones in children.
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Affiliation(s)
- Pia Afzelius
- Department of Nuclear Medicine, Aalborg University HospitalAalborg, Denmark
- North Zealand Hospital, Hillerød, University Hospital of CopenhagenDenmark
| | | | - Svend Borup Jensen
- Department of Nuclear Medicine, Aalborg University HospitalAalborg, Denmark
- Department of Chemistry and Biochemistry, Aalborg UniversityAalborg, Denmark
| | | | - Henrik Carl Schønheyder
- Department of Clinical Microbiology, Aalborg University HospitalAalborg
- Department of Clinical Medicine, Aalborg UniversityAalborg
| | - Annemarie Eek
- Department of Radiology and Nuclear Medicine, Raboud UMCNijmegen, The Netherlands
| | - Otto Boerman
- Department of Radiology and Nuclear Medicine, Raboud UMCNijmegen, The Netherlands
| | - Ole Lerberg Nielsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of CopenhagenCopenhagen, Denmark
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13
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Alstrup AK, Afzelius PM, Jensen SB, Leifsson PS, Wegener KM, Nielsen OL. Effects of Long-term Anesthesia, Blood Sampling, Transportation, and Infection Status on Hearts and Brains in Pigs Inoculated with Staphylococcus aureus and Used for Imaging Studies. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE 2019; 59:74-84. [PMID: 31847929 DOI: 10.30802/aalas-jaalas-19-000062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Laboratory animals are widely used in imaging studies, including infection, heart, and brain research. Compared with rodents, pigs are especially useful because of their large organ sizes, ability to tolerate long-term anesthesia, and substantial blood volume, which allows repeated blood sampling. These factors are particularly important in positron emission tomography studies of potential new radioactive tracers, because the scans often are prolonged; in addition, kinetic studies involving repeated blood sampling may be performed to establish the optimal scan time. However, protracted studies may affect the cardiovascular system, brain, and other organs. This raises the question of how to monitor and counteract the effects of longterm anesthesia in pigs in a typical experimental setting yet prevent introducing bias into the experiment. To address this question, we investigated the effects of long-term anesthesia (maximum, 18 h), repeated blood sampling (maximum of 20 mL blood per kilogram body weight), and road transportation (as long as 1.5 h between 2 imaging centers) on key variables of lung, heart, and brain function in the context of a well-established pig model of Staphylococcus aureus infection. Pulse rate, oxygen saturation, body temperature, arterial pressure of CO₂, and urine production were stable during anesthesia for at least 16 h, whereas blood glucose slowly decreased. Hct and leukocyte count decreased due to repeated blood sampling. During road transportation, blood lactate levels increased 5 fold and arterial pressure of O₂ decreased by 50%. Repeated CT scans, necropsy results, and histopathology findings documented progressive lung changes and acute cardiac necrosis. No lesions indicative of hypoxia were found in brain. The study data show that the typical monitoring parameters do not fully depict the cardiovascular state of pigs during prolonged anesthesia. We recommend streamlining experimental protocols for imaging studies in pigs to avoid organ pathology.
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14
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Jødal L, Roivainen A, Oikonen V, Jalkanen S, Hansen SB, Afzelius P, Alstrup AKO, Nielsen OL, Jensen SB. Kinetic Modelling of [ 68Ga]Ga-DOTA-Siglec-9 in Porcine Osteomyelitis and Soft Tissue Infections. Molecules 2019; 24:molecules24224094. [PMID: 31766140 PMCID: PMC6891593 DOI: 10.3390/molecules24224094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/07/2019] [Accepted: 11/10/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND [68Ga]Ga-DOTA-Siglec-9 is a positron emission tomography (PET) radioligand for vascular adhesion protein 1 (VAP-1), a protein involved in leukocyte trafficking. The tracer facilitates the imaging of inflammation and infection. Here, we studied the pharmacokinetic modelling of [68Ga]Ga-DOTA-Siglec-9 in osteomyelitis and soft tissue infections in pigs. METHODS Eight pigs with osteomyelitis and soft tissue infections in the right hind limb were dynamically PET scanned for 60 min along with arterial blood sampling. The fraction of radioactivity in the blood accounted for by the parent tracer was evaluated with radio-high-performance liquid chromatography. One- and two-tissue compartment models were used for pharmacokinetic evaluation. Post-mortem soft tissue samples from one pig were analysed with anti-VAP-1 immunofluorescence. In each analysis, the animal's non-infected left hind limb was used as a control. RESULTS Tracer uptake was elevated in soft tissue infections but remained low in osteomyelitis. The kinetics of [68Ga]Ga-DOTA-Siglec-9 followed a reversible 2-tissue compartment model. The tracer metabolized quickly; however, taking this into account, produced more ambiguous results. Infected soft tissue samples showed endothelial cell surface expression of the Siglec-9 receptor VAP-1. CONCLUSION The kinetics of [68Ga]Ga-DOTA-Siglec-9 uptake in porcine soft tissue infections are best described by the 2-tissue compartment model.
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Affiliation(s)
- Lars Jødal
- Department of Nuclear Medicine, Aalborg University Hospital, DK-9000 Aalborg, Denmark;
- Correspondence: ; Tel.: +45-9766-5500
| | - Anne Roivainen
- Turku PET Centre, Turku University Hospital, FI-20520 Turku, Finland; (A.R.); (V.O.)
- Turku PET Centre, University of Turku, FI-20520 Turku, Finland
| | - Vesa Oikonen
- Turku PET Centre, Turku University Hospital, FI-20520 Turku, Finland; (A.R.); (V.O.)
- Turku PET Centre, University of Turku, FI-20520 Turku, Finland
| | - Sirpa Jalkanen
- MediCity Research Laboratory and Institute of Biomedicine, University of Turku, FI-20520 Turku, Finland;
| | - Søren B. Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus, Denmark; (S.B.H.); (A.K.O.A.)
| | - Pia Afzelius
- North Zealand Hospital, Hillerød, Copenhagen University Hospital, DK-3400 Hillerød, Denmark;
| | - Aage K. O. Alstrup
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus, Denmark; (S.B.H.); (A.K.O.A.)
| | - Ole L. Nielsen
- Department of Veterinary and Animal Sciences, University of Copenhagen, DK-1870 Copenhagen, Denmark;
| | - Svend B. Jensen
- Department of Nuclear Medicine, Aalborg University Hospital, DK-9000 Aalborg, Denmark;
- Department of Chemistry and Biosciences, Aalborg University, DK-9100 Aalborg, Denmark
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15
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Jensen LK, Henriksen NL, Blirup SA, Jensen HE. Guideline for Preclinical Studies of Bone Infections in Large Animals Based on a Systematic Review of 316 Non-Rodent Models. J Bone Joint Surg Am 2019; 101:1894-1903. [PMID: 31567666 DOI: 10.2106/jbjs.18.01369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND In recent years, animal models of bone infections have been used with increased frequency in order to evaluate novel diagnostic and anti-infective technologies, like antibacterial coating of bone implants or local antibiotic carrier products. Therefore, it is highly relevant to evaluate the scientific quality of existing bone infection models. METHODS We conducted a systematic review of 316 studies of large non-rodent animal models of bone infection (254 rabbit, 16 pig, 23 dog, 11 goat, and 12 sheep) and extracted data on study design, methodological quality, and postmortem evaluation of infection with respect to reporting and quantification of pathology and microbiology. RESULTS The review demonstrated a substantial lack of study-design information, which hampers reproducibility and continuation of the established work. Furthermore, the methodological study quality was found to be low, as the definition of infection, randomization, power analysis, and blinding were only seldomly reported. The use of histology increased in recent years, but a semi-quantitative scoring of the lesions was often missing, i.e. no objective quantification of outcome. Most of the studies focused on whether the inoculated bacteria were present within the bone tissue post mortem or not. However, very often the bacterial burden was not quantified. In many of the models, different antimicrobial interventions were examined and, although antimicrobial effects were commonly described, a lack of complete sterile outcome was observed in many models. On the basis of the systematic review, we established a study template providing a guideline for the standard reporting of animal models of bone infections, including details related to the animal, pathogen, infected animal, and postmortem analysis that are of crucial importance for validation of results and reproducibility. CONCLUSIONS As the aim of many bone infection models is to examine the effect of an intervention, the guideline emphasizes the importance of objective quantification of outcome, e.g., blinded quantitative scoring of histological findings and quantification of bacterial burden within tissue and on inserted implants. Less than 5% of the analyzed studies adhered completely to the ideal form presented in the study template. CLINICAL RELEVANCE Anti-infective interventions must be tested in preclinical animal models before implementation in human patients, and optimal design and validation is essential for a high translational value.
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Affiliation(s)
- L K Jensen
- Section for Pathobiological Sciences, Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - N L Henriksen
- Section for Pathobiological Sciences, Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - S A Blirup
- Section for Pathobiological Sciences, Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - H E Jensen
- Section for Pathobiological Sciences, Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
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16
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Afzelius P, Nielsen OL, Schønheyder HC, Alstrup A, Hansen SB. An untapped potential for imaging of peripheral osteomyelitis in paediatrics using [ 18F]FDG PET/CT -the inference from a juvenile porcine model. EJNMMI Res 2019; 9:29. [PMID: 30903403 PMCID: PMC6430261 DOI: 10.1186/s13550-019-0498-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 03/11/2019] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To examine parameters affecting the detection of osteomyelitis (OM) by [18F]FDG PET/CT and to reduce tracer activity in a pig model. BACKGROUND [18F]FDG PET/CT is recommended for the diagnosis of OM in the axial skeleton of adults. In children, OM has a tendency to become chronic or recurrent, especially in low-income countries. Early diagnosis and initiation of therapy are therefore essential. We have previously demonstrated that [18F]FDG PET/CT is promising in juvenile Staphylococcus aureus (S. aureus) OM of peripheral bones in a pig model, not failing even small lesions. When using imaging in children, radiation exposure should be balanced against fast diagnostics in the individual case. METHODS Twenty juvenile pigs were inoculated with S. aureus. One week after inoculation, the pigs were [18F]FDG PET/CT scanned. PET list-mode acquired data of a subgroup were retrospectively processed in order to simulate and examine the image quality obtainable with an injected activity of 132 MBq, 44 MBq, 13.2 MBq, and 4.4 MBq, respectively. RESULTS All lesions were detected by [18F]FDG PET and CT. Some lesions were very small (0.01 cm3), and others were larger (4.18 cm3). SUVmax was higher when sequesters (p = 0.023) and fistulas were formed (p < 0.0001). The simulated data demonstrated that it was possible to reduce the activity to 4.4 MBq without compromising image quality in pigs. CONCLUSIONS [18F]FDG PET/CT localized even small OM lesions in peripheral bones. It was possible to reduce the injected activity considerably without compromising image quality, impacting the applicability of PET/CT in peripheral OM in children.
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Affiliation(s)
- P. Afzelius
- Department of Diagnostic Imaging, Section of Clinical Physiology and Nuclear Medicine, North Zealand Hospital, Dyrehavevej 29, 3400 Hillerod, Denmark
- Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - O. L. Nielsen
- Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - H. C. Schønheyder
- Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - A.K.O. Alstrup
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark
| | - S. B. Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark
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17
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In Vivo Gentamicin Susceptibility Test for Prevention of Bacterial Biofilms in Bone Tissue and on Implants. Antimicrob Agents Chemother 2019; 63:AAC.01889-18. [PMID: 30455228 DOI: 10.1128/aac.01889-18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/12/2018] [Indexed: 12/22/2022] Open
Abstract
The objective of this study was to set up an in vivo gentamicin susceptibility test for biofilm prevention in bone tissue and on implants. Twenty-five pigs were allocated to six groups. Pigs in group A (n = 6) were inoculated with saline. Pigs in groups B (n = 6), C (n = 3), D (n = 3), E (n = 3), and F (n = 4) were inoculated with 10 μl saline containing 104 CFU of Staphylococcus aureus Different concentrations based on the MIC of gentamicin for the specific strain were added to the 10-μl inoculum for groups C (160× MIC), D (1,600× MIC), E (16,000× MIC), and F (160,000× MIC). The inocula were injected into a predrilled tibial implant cavity, followed by insertion of a steel implant (2 by 15 mm). The pigs were euthanized after 5 days. In vitro, all the doses used were found to be bactericidal after up to 6 h. All implant cavities of pigs inoculated with bacteria and bacteria plus 160× MIC or 1,600× MIC of gentamicin were positive for S. aureus In animals in each of groups E (16,000× MIC) and F (160,000× MIC), 2/3 and 1/4 of the implant cavities were S. aureus positive, respectively. By grouping groups C and D (<10,000× MIC) and groups E and F (>10,000× MIC), a significant decrease in the number of implant-attached bacteria was seen only between the high-MIC-value group and group B. Histologically, it was demonstrated that 1,600×, 16,000×, and 160,000× MIC resulted in a peri-implant tissue reaction comparable to that in saline-inoculated animals. In vivo, the antimicrobial tolerance of the inoculated planktonic bacteria was increased by in vivo-specific factors of acute inflammation. This resulted in bacterial aggregation and biofilm formation, which further increased the gentamicin tolerance. Thus, susceptibility patterns in vitro might not reflect the actual in vivo susceptibility locally within a developing infectious area.
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18
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Jensen LK, Henriksen NL, Bjarnsholt T, Kragh KN, Jensen HE. Combined Staining Techniques for Demonstration of Staphylococcus aureus Biofilm in Routine Histopathology. J Bone Jt Infect 2018; 3:27-36. [PMID: 29545993 PMCID: PMC5852845 DOI: 10.7150/jbji.22799] [Citation(s) in RCA: 9] [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] [Received: 09/12/2017] [Accepted: 01/19/2018] [Indexed: 11/24/2022] Open
Abstract
Aim: Visualization of Staphylococcus aureus biofilm using histochemical staining and combined histochemistry (HC) and immunohistochemistry (IHC). Methods: The ability of S. aureus S54F9 to form biofilm was tested in vitro. Hereafter, infected bone tissue was collected from two different porcine models of osteomyelitis inoculated with S. aureus strain S54F9. The infection time was five and fifteen days, respectively. Twenty-five different histochemical staining protocols were tested in order to find the stains that could identify extracellular biofilm matrix. Protocols with an optimal visualization of biofilm extracellular matrix were combined with an immunohistochemical protocol based on a specific antibody against S. aureus. The combined protocols were applied to the tissue from the porcine models and to infected bone tissue from a child suffering from chronic staphylococcal osteomyelitis for more than a year. Results:S. aureus S54F9 showed an ability to form biofilm in vitro. Visualization of biofilm, i.e. bacterial cells and extracellular matrix in different colours, was seen when the immunohistochemical protocol was combined with Alcian Blue pH3, Luna and Methyl-pyronin green. The bacterial cells were red to light brown and the extracellular matrix either light blue, blue or orange depending on the histochemical stain. In the porcine models and the human case 10 and 90 percent, respectively, of the bacterial aggregates in a 100x magnification field displayed both the extracellular matrix and the bacterial cells simultaneously in two different colours. Conclusions: A combination of HC and IHC can be used to diagnose and characterise biofilm infections on a routine basis.
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Affiliation(s)
- Louise Kruse Jensen
- Department of Veterinary Clinical and Animal Sciences, Ridebanevej 3, 1870 Frederiksberg C, University of Copenhagen, Denmark
| | - Nicole Lind Henriksen
- Department of Veterinary Clinical and Animal Sciences, Ridebanevej 3, 1870 Frederiksberg C, University of Copenhagen, Denmark
| | - Thomas Bjarnsholt
- Costerton Biofilm Center, Department of Immunology and Microbiology, Blegdamsvej 3B, 2200 Copenhagen N, University of Copenhagen, Denmark.,Department of Clinical Microbiology, Juliane Maries Vej 22, 2100 Copenhagen Ø, Copenhagen University Hospital, Denmark
| | - Kasper Nørskov Kragh
- Costerton Biofilm Center, Department of Immunology and Microbiology, Blegdamsvej 3B, 2200 Copenhagen N, University of Copenhagen, Denmark
| | - Henrik Elvang Jensen
- Department of Veterinary Clinical and Animal Sciences, Ridebanevej 3, 1870 Frederiksberg C, University of Copenhagen, Denmark
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19
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Jensen LK, Koch J, Dich-Jorgensen K, Aalbaek B, Petersen A, Fuursted K, Bjarnsholt T, Kragh KN, Tøtterup M, Bue M, Hanberg P, Søballe K, Heegaard PMH, Jensen HE. Novel porcine model of implant-associated osteomyelitis: A comprehensive analysis of local, regional, and systemic response. J Orthop Res 2017; 35:2211-2221. [PMID: 27958656 DOI: 10.1002/jor.23505] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 12/05/2016] [Indexed: 02/04/2023]
Abstract
UNLABELLED Pigs are favorable experimental animals for infectious diseases in humans. However, implant-associated osteomyelitis (IAO) models in pigs have only been evaluated using high-inoculum infection (>108 CFU) models in 1975 and 1993. Therefore, the aim of this paper was to present a new low inoculum porcine model of human IAO based on 42 experimental pigs. The model was created by drilling an implant cavity in the tibial bone followed by insertion of a small steel implant and simultaneous inoculation of Staphylococcus aureus bacteria (n = 32) or saline (n = 10). The infected pigs were either inoculated with 104 CFU (n = 26) or 102 and 103 CFU (n = 6). All animals were euthanized 5 days after insertion of implants. Pigs receiving the high-inoculum infections showed a significantly higher volume of bone lesion, number of neutrophils around the implant, concentrations of acute phase proteins in serum, and enlargement of regional lymph nodes. A positive correlation was present between a high number of surrounding neutrophils and high values of all other parameters. Furthermore, a threshold of 40 neutrophils per 10 high power fields for the histopathological diagnosis of high grade IAO was defined. IN CONCLUSION This paper describes a novel low-inoculum S. aureus porcine model of IAO which was demonstrated to be reliable, reproducible and discriminative to human IAO, and represents a requested and valuable tool in orthopedic research. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2211-2221, 2017.
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Affiliation(s)
- Louise Kruse Jensen
- Department of Veterinary Disease Biology, University of Copenhagen, Ridebanevej 3, 1870, Frederiksberg C, Denmark
| | - Janne Koch
- Department of Experimental Medicine, University of Copenhagen, Blegdamsvej 2, 2200, Copenhagen N, Denmark
| | - Kirstine Dich-Jorgensen
- Department of Veterinary Disease Biology, University of Copenhagen, Ridebanevej 3, 1870, Frederiksberg C, Denmark
| | - Bent Aalbaek
- Department of Veterinary Disease Biology, University of Copenhagen, Ridebanevej 3, 1870, Frederiksberg C, Denmark
| | - Andreas Petersen
- Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
| | - Kurt Fuursted
- Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
| | - Thomas Bjarnsholt
- Costerton Biofilm Center, Institute of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital, Juliane Maries Vej 22, 2100, Copenhagen Ø, Denmark
| | - Kasper Nørskov Kragh
- Costerton Biofilm Center, Institute of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Mikkel Tøtterup
- Orthopedic Research Unit, Aarhus University Hospital, Building 1A, Nørrebrogade 44, 8000, Aarhus, Denmark.,Department of Orthopedic Surgery, Randers Regional Hospital, Skovlyvej 15, 8930, Randers NØ, Denmark
| | - Mats Bue
- Orthopedic Research Unit, Aarhus University Hospital, Building 1A, Nørrebrogade 44, 8000, Aarhus, Denmark.,Department of Orthopedic Surgery, Horsens Regional Hospital, Sundvej 30, 8700, Horsens, Denmark
| | - Pelle Hanberg
- Orthopedic Research Unit, Aarhus University Hospital, Building 1A, Nørrebrogade 44, 8000, Aarhus, Denmark
| | - Kjeld Søballe
- Orthopedic Research Unit, Aarhus University Hospital, Building 1A, Nørrebrogade 44, 8000, Aarhus, Denmark
| | - Peter M H Heegaard
- Innate Immunology Group, National Veterinary Institute, Technical University of Denmark, Bülowsvej 27, 1870, Frederiksberg C, Denmark
| | - Henrik Elvang Jensen
- Department of Veterinary Disease Biology, University of Copenhagen, Ridebanevej 3, 1870, Frederiksberg C, Denmark
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20
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Post Mortem Leukocyte Scintigraphy in Juvenile Pigs with Experimentally Induced Osteomyelitis. CONTRAST MEDIA & MOLECULAR IMAGING 2017; 2017:3603929. [PMID: 29097917 PMCID: PMC5612606 DOI: 10.1155/2017/3603929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 07/27/2017] [Accepted: 08/07/2017] [Indexed: 12/03/2022]
Abstract
We have previously demonstrated that 111In-labeled autologous leukocyte scintigraphy is able to detect osteomyelitis in living juvenile pigs. In animal research studies, it may well be an advantage if the animals could be scanned after euthanasia. Applying traditional scanning of living animals to euthanized animals will render anaesthesia unnecessary and be ideal for obtaining good and reliable scans for the correct interpretation of imaging afterwards, since the animals do not move. The autologous leukocytes of the pigs were collected, marked with 111In, and reinjected into the pigs and allowed for homing to the site of infections as usual while the pigs were alive. In this study, we demonstrate that it is possible to perform SPECT/CT with 111In-labelled autologous leukocytes almost 24 hrs after euthanasia with the same detectability of osteomyelitic lesions as in living pigs (78% versus 79%). The pigs in this study had exactly the same experimental conditions as the living pigs and were examined in parallel with the living pigs except for euthanasia prior to the leukocyte scan and that no PET/CT scans were performed.
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21
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Jensen LK, Koch J, Aalbaek B, Moodley A, Bjarnsholt T, Kragh KN, Petersen A, Jensen HE. Early implant-associated osteomyelitis results in a peri-implanted bacterial reservoir. APMIS 2016; 125:38-45. [PMID: 27704604 PMCID: PMC5298028 DOI: 10.1111/apm.12597] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/31/2016] [Indexed: 01/18/2023]
Abstract
Implant-associated osteomyelitis (IAO) is a common complication in orthopedic surgery. The aim of this study was to elucidate how deep IAO can go into the peri-implanted bone tissue within a week. The study was performed in a porcine model of IAO. A small steel implant and either 104 CFU/kg body weight of Staphylococcus aureus or saline was inserted into the right tibial bone of 12 pigs. The animals were consecutively killed on day 2, 4 and 6 following implantation. Bone tissue around the implant was histologically evaluated. Identification of S. aureus was performed immunohistochemically on tissue section and with scanning electron microscopy and peptide nucleic acid in situ hybridization on implants. The distance of the peri-implanted pathological bone area (PIBA), measured perpendicular to the implant, was significantly larger in infected animals compared to controls (p = 0.0014). The largest differences were seen after 4 and 6 days of inoculation, where PIBA measurements of up to 6 mm were observed. Positive S. aureus bacteria were identified on implants and from 25 μm to 6 mm into PIBA. This is important knowledge for optimizing outcomes of surgical debridement in osteomyelitis.
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Affiliation(s)
- Louise Kruse Jensen
- Department of Veterinary Disease Biology, University of Copenhagen, Frederiksberg, Denmark
| | - Janne Koch
- Department of Experimental Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bent Aalbaek
- Department of Veterinary Disease Biology, University of Copenhagen, Frederiksberg, Denmark
| | - Arshnee Moodley
- Department of Veterinary Disease Biology, University of Copenhagen, Frederiksberg, Denmark
| | - Thomas Bjarnsholt
- Costerton Biofilm Center, Institute of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kasper Nørskov Kragh
- Costerton Biofilm Center, Institute of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Henrik Elvang Jensen
- Department of Veterinary Disease Biology, University of Copenhagen, Frederiksberg, Denmark
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22
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Olsen HG, Kjelgaard-Hansen M, Tveden-Nyborg P, Birck MM, Hammelev KP, Vegge A, Aalbæk B, Leifsson PS, Jensen HE, Iburg T, Heegaard PMH, Nielsen OL. Modelling severe Staphylococcus aureus sepsis in conscious pigs: are implications for animal welfare justified? BMC Res Notes 2016; 9:99. [PMID: 26879530 PMCID: PMC4755015 DOI: 10.1186/s13104-016-1888-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 01/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A porcine model of haematogenous Staphylococcus aureus sepsis has previously been established in our research group. In these studies, pigs developed severe sepsis including liver dysfunction during a 48 h study period. As pigs were awake during the study, animal welfare was challenged by the severity of induced disease, which in some cases necessitated humane euthanasia. A pilot study was therefore performed in order to establish the sufficient inoculum concentration and application protocol needed to produce signs of liver dysfunction within limits of our pre-defined humane endpoints. METHODS Four pigs received 1 × 10(8) cfu/kg BW of S. aureus, and two controls were sham inoculated with saline. A fixed infusion rate of 3 mL/min was used, while the inoculum concentration, i.e., the dose volume, was changed between the pigs. The following dose volumes were used: 10 mL (n = 1), 20 mL (n = 2), and 30 mL (n = 1), corresponding to infusion durations of 3.33, 6.66, and 10 min at dose rates of 3 × 10(7), 1.5 × 10(7), and 1 × 10(7) cfu/min/kg BW, respectively. Blood samples were drawn for complete blood count, clinical chemistry, and inflammatory markers before and every 6 h after inoculation. Prior to euthanasia, a galactose elimination capacity test was performed to assess liver function. Pigs were euthanised 48 h post inoculation for necropsy and histopathological evaluation. RESULTS While infusion times of 6.66 min, and higher, did not induce liver dysfunction (n = 3), the infusion time of 3.33 min (n = 1) caused alterations in parameters similar to what had been seen in our previous studies, i.e., increasing bilirubin and aspartate aminotransferase, as well as histopathological occurrence of intravascular fibrin split products in the liver. This pig was however euthanised after 30 h, according to humane endpoints. CONCLUSIONS A usable balance between scientific purpose and animal welfare could not be achieved, and we therefore find it hard to justify further use of this conscious porcine sepsis model. In order to make a model of translational relevance for human sepsis, we suggest that future model versions should use long-term anaesthesia.
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Affiliation(s)
- Helle G Olsen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
| | - Mads Kjelgaard-Hansen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark. .,Novo Nordisk, Måløv, Denmark.
| | - Pernille Tveden-Nyborg
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
| | - Malene M Birck
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
| | - Karsten P Hammelev
- Department of Experimental Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
| | - Andreas Vegge
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark. .,Novo Nordisk, Måløv, Denmark.
| | - Bent Aalbæk
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
| | - Páll S Leifsson
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
| | - Henrik E Jensen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
| | - Tine Iburg
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark. .,National Veterinary Institute, Technical University of Denmark, Frederiksberg, Denmark.
| | - Peter M H Heegaard
- National Veterinary Institute, Technical University of Denmark, Frederiksberg, Denmark.
| | - Ole L Nielsen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
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