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Novel antibiotic-loaded orthopaedic bone cements: insights on drug release profiles and biocompatibility
Publication . Silva, Sofia Miguel dos Reis Pinto da; Bettencourt, Ana; Gonçalves, Lídia
Acrylic bone cement (BC) is widely used as an anchor of artificial joints. Bacterial infection due to biofilm formation and inflammation are common and difficult to treat problems associated with commercial available BC formulations. Research on novel BC compositions is urgently needed.
The main objective of this thesis was to develop a new biocompatible antibiotic-loaded BC with improved release profile. To achieve that aim several additives were incorporated, as an antibiotic (levofloxacin) to combat bacterial growth, an anti-inflammatory drug (diclofenac) to decrease the inflammatory process and two well-known and broadly used biopolymers, alginate and chitosan in order to increase matrix porosity, and in this way to intensify the amount of released drug.
Novel BC formulations were tested in order to find the most suitable one that had potential to proceed to clinical application. Numerous tests were conducted as: a) evaluation of drug release profiles in different biomimetic media, b) mechanical and surface studies, c) microbiological activity testing against Staphylococcus aureus and d) in vitro biocompatibility assays (fibroblasts and osteoblasts).
In general, the addition of biopolymers increased drug release, didn’t compromised BC mechanical properties and increased BC hydrophilicity. Microbiological testing revealed that Lev[BC]Chi was the only matrix that reduced significantly biofilm formation. On the contrary, alginate and diclofenac loading into BC seemed to increase biofilm growth. Biocompatibility studies showed some decrease in cell viability, in particularly on osteoblasts, mainly due to the high amounts of released drugs.
In conclusion, the present work has shown that the matrix with more potential to proceed in further investigations was Lev[BC]Chi. Other conditions (namely additives and drugs concentrations) should be evaluated with the other tested BC matrices before being discharged.
Antimicrobial effect of polymeric biomaterials for bone infection treatment
Publication . Ferreira, Magda Sofia Catroga; Bettencourt, Ana; Jordão, Luísa
Bone infection, mainly caused by Staphylococcus aureus, is a public health concern. Treatment is challenging due to multi-resistant strains, and S. aureus ability to adhere and form biofilm on bone and implant surfaces, as well as to invade and persist in osteoblast cells.
The present work consisted in the preparation and evaluation of novel acrylic polymeric systems that provide local and controlled antibiotic delivery for the treatment of bone infection, namely levofloxacin-loaded acrylic bone cement (BC), and vancomycin or daptomycin-loaded acrylic microparticles (MP).
Properties of both delivery systems with high impact on clinical performance were tested. Namely, contact angle and surface energy were determined in BC matrices and encapsulation efficiency in MP formulations. Release studies of levofloxacin-loaded BC matrices were also conducted. Also, the anti-biofilm activity of these systems was evaluated against S. aureus strains. Furthermore, BC and MP formulations were tested concerning the antibacterial intracellular activity using a human osteoblast infection model.
Overall, both BC formulations’ surface characteristics and MP encapsulation efficiency were in agreement with previously published data. The release studies of levofloxacin from BC matrices showed that the drug release is size- and incubation medium-dependent. All BC matrices loaded with levofloxacin concentrations of 1.5 % or higher exhibited anti-biofilm activity against all S. aureus tested strains. For BC matrices and Vancomycin-loaded MP, a decrease of viable intracellular bacteria was observed. For Daptomycin-loaded MP, no viable intracellular bacteria were detected.
In conclusion, this work has shown that the BC formulations with drug concentration of 1.5 % or 2.5 % and daptomycin-loaded MP show potential to be used in the context of bone infection treatment.
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Fundação para a Ciência e a Tecnologia
Programa de financiamento
3599-PPCDT
Número da atribuição
EXCL/CTM-NAN/0166/2012