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Arciola CR, Ravaioli S, Mirzaei R, Dolzani P, Montanaro L, Daglia M, Campoccia D. Biofilms in Periprosthetic Orthopedic Infections Seen through the Eyes of Neutrophils: How Can We Help Neutrophils? Int J Mol Sci 2023; 24:16669. [PMID: 38068991 PMCID: PMC10706149 DOI: 10.3390/ijms242316669] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Despite advancements in our knowledge of neutrophil responses to planktonic bacteria during acute inflammation, much remains to be elucidated on how neutrophils deal with bacterial biofilms in implant infections. Further complexity transpires from the emerging findings on the role that biomaterials play in conditioning bacterial adhesion, the variety of biofilm matrices, and the insidious measures that biofilm bacteria devise against neutrophils. Thus, grasping the entirety of neutrophil-biofilm interactions occurring in periprosthetic tissues is a difficult goal. The bactericidal weapons of neutrophils consist of the following: ready-to-use antibacterial proteins and enzymes stored in granules; NADPH oxidase-derived reactive oxygen species (ROS); and net-like structures of DNA, histones, and granule proteins, which neutrophils extrude to extracellularly trap pathogens (the so-called NETs: an allusive acronym for "neutrophil extracellular traps"). Neutrophils are bactericidal (and therefore defensive) cells endowed with a rich offensive armamentarium through which, if frustrated in their attempts to engulf and phagocytose biofilms, they can trigger the destruction of periprosthetic bone. This study speculates on how neutrophils interact with biofilms in the dramatic scenario of implant infections, also considering the implications of this interaction in view of the design of new therapeutic strategies and functionalized biomaterials, to help neutrophils in their arduous task of managing biofilms.
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Affiliation(s)
- Carla Renata Arciola
- Laboratory of Immunorheumatology and Tissue Regeneration, Laboratory of Pathology of Implant Infections, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy
| | - Stefano Ravaioli
- Laboratorio di Patologia delle Infezioni Associate all’Impianto, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy; (S.R.); (D.C.)
| | - Rasoul Mirzaei
- Venom and Biotherapeutics Molecules Laboratory, Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran 1316943551, Iran;
| | - Paolo Dolzani
- Laboratorio di Immunoreumatologia e Rigenerazione Tissutale, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
| | - Lucio Montanaro
- Laboratory of Immunorheumatology and Tissue Regeneration, Laboratory of Pathology of Implant Infections, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy
| | - Maria Daglia
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Naples, Italy;
| | - Davide Campoccia
- Laboratorio di Patologia delle Infezioni Associate all’Impianto, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy; (S.R.); (D.C.)
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Maduka CV, Habeeb OM, Kuhnert MM, Hakun M, Goodman SB, Contag CH. Glycolytic reprogramming underlies immune cell activation by polyethylene wear particles. BIOMATERIALS ADVANCES 2023; 152:213495. [PMID: 37301057 DOI: 10.1016/j.bioadv.2023.213495] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 04/20/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
Primary total joint arthroplasties (TJAs) are widely and successfully applied reconstructive procedures to treat end-stage arthritis. Nearly 50 % of TJAs are now performed in young patients, posing a new challenge: performing TJAs which last a lifetime. The urgency is justified because subsequent TJAs are costlier and fraught with higher complication rates, not to mention the toll taken on patients and their families. Polyethylene particles, generated by wear at joint articulations, drive aseptic loosening by inciting insidious inflammation associated with surrounding bone loss. Down modulating polyethylene particle-induced inflammation enhances integration of implants to bone (osseointegration), preventing loosening. A promising immunomodulation strategy could leverage immune cell metabolism, however, the role of immunometabolism in polyethylene particle-induced inflammation is unknown. Our findings reveal that immune cells exposed to sterile or contaminated polyethylene particles show fundamentally altered metabolism, resulting in glycolytic reprogramming. Inhibiting glycolysis controlled inflammation, inducing a pro-regenerative phenotype that could enhance osseointegration.
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Affiliation(s)
- Chima V Maduka
- Comparative Medicine & Integrative Biology, Michigan State University, East Lansing, MI 48824, USA; Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA; Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Oluwatosin M Habeeb
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA; Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Maxwell M Kuhnert
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA; Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Maxwell Hakun
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA; Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Stuart B Goodman
- Department of Orthopedic Surgery, Stanford University, CA 94063, USA; Department of Bioengineering, Stanford University, CA 94305, USA
| | - Christopher H Contag
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA; Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA; Department of Microbiology & Molecular Genetics, Michigan State University, East Lansing, MI 48864, USA.
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Wood J, Hayles A, Bright R, Palms D, Vasilev K, Hasan J. Nanomechanical tribological characterisation of nanostructured titanium alloy surfaces using AFM: A friction vs velocity study. Colloids Surf B Biointerfaces 2022; 217:112600. [PMID: 35665641 DOI: 10.1016/j.colsurfb.2022.112600] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/06/2022] [Accepted: 05/24/2022] [Indexed: 01/23/2023]
Abstract
Medical-grade titanium alloys used for orthopaedic implants are at risk from infections and complications such as wear and tear. We have recently shown that hydrothermally etched (HTE) nanostructures (NS) formed on the Ti6AlV4 alloy surfaces impart enhanced anti-bacterial activity which results in inhibited formation of bacterial biofilm. Although these titanium alloy nanostructures may resist bacterial colonisation, their frictional properties are yet to be understood. Orthopaedic devices are encapsulated by bone and muscle tissue. Contact friction between orthopaedic implant surfaces and these host tissues may trigger inflammation, osteolysis and wear. To address these challenges, we performed simulation of the contact behaviour between a smooth control Ti6Al4V alloy and HTE surfaces against a hardwearing SiO2 sphere using Atomic Force Microscopy (AFM) in Lateral Force Microscopy mode. The friction study was evaluated in both air and liquid environments at high (5 Hz) and low (0.5 Hz) scan velocities. Lower scan velocities demonstrated opposing friction force changes between the two mediums, with friction stabilising at higher velocities. The friction measured on the NS alloy surfaces was reduced by ~20% in air and ~80% in phosphate buffered saline, in comparison to the smooth control surface, displaying a non-linear behaviour of the force applied by the AFM tip. Changes in friction values and cantilever scan velocities on different substrates are discussed with respect to the Stribeck curve. Reduced friction on nanostructured surfaces may improve wear resistance and aid osseointegration.
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Affiliation(s)
- Jonathan Wood
- Academic Unit of STEM, University of South Australia, Mawson Lakes, Adelaide 5095, South Australia, Australia
| | - Andrew Hayles
- Academic Unit of STEM, University of South Australia, Mawson Lakes, Adelaide 5095, South Australia, Australia
| | - Richard Bright
- Academic Unit of STEM, University of South Australia, Mawson Lakes, Adelaide 5095, South Australia, Australia
| | - Dennis Palms
- Academic Unit of STEM, University of South Australia, Mawson Lakes, Adelaide 5095, South Australia, Australia
| | - Krasimir Vasilev
- Academic Unit of STEM, University of South Australia, Mawson Lakes, Adelaide 5095, South Australia, Australia
| | - Jafar Hasan
- Academic Unit of STEM, University of South Australia, Mawson Lakes, Adelaide 5095, South Australia, Australia.
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Siverino C, Freitag L, Arens D, Styger U, Richards RG, Moriarty TF, Stadelmann VA, Thompson K. Titanium Wear Particles Exacerbate S. epidermidis-Induced Implant-Related Osteolysis and Decrease Efficacy of Antibiotic Therapy. Microorganisms 2021; 9:microorganisms9091945. [PMID: 34576840 PMCID: PMC8468325 DOI: 10.3390/microorganisms9091945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/04/2021] [Accepted: 09/08/2021] [Indexed: 12/28/2022] Open
Abstract
Total joint arthroplasty (TJA) surgeries are common orthopedic procedures, but bacterial infection remains a concern. The aim of this study was to assess interactions between wear particles (WPs) and immune cells in vitro and to investigate if WPs affect the severity, or response to antibiotic therapy, of a Staphylococcus epidermidis orthopedic device-related infection (ODRI) in a rodent model. Biofilms grown on WPs were challenged with rifampin and cefazolin (100 µg/mL) to determine antibiotic efficacy. Neutrophils or peripheral blood mononuclear cells (PBMCs) were incubated with or without S. epidermidis and WPs, and myeloperoxidase (MPO) and cytokine release were analyzed, respectively. In the ODRI rodent model, rats (n = 36) had a sterile or S. epidermidis-inoculated screw implanted in the presence or absence of WPs, and a subgroup was treated with antibiotics. Bone changes were monitored using microCT scanning. The presence of WPs decreased antibiotic efficacy against biofilm-resident bacteria and promoted MPO and pro-inflammatory cytokine production in vitro. WPs exacerbated osteolytic responses to S. epidermidis infection and markedly reduced antibiotic efficacy in vivo. Overall, this work shows that the presence of titanium WPs reduces antibiotic efficacy in vitro and in vivo, induces proinflammatory cytokine release, and exacerbates S. epidermidis-induced osteolysis.
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Affiliation(s)
- Claudia Siverino
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - Linda Freitag
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - Daniel Arens
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - Ursula Styger
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - R. Geoff Richards
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - T. Fintan Moriarty
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - Vincent A. Stadelmann
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
- Department of Teaching, Research and Development, Schulthess Clinic, 8008 Zürich, Switzerland
| | - Keith Thompson
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
- Correspondence: ; Tel.: +41-81-414-2325
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