Antibakterieller Effekt hochenergetischer extrakorporaler Stoßwellen: Ein in vitro Nachweis

Gollwitzer, Hans; Horn, Carsten; Eiff, Christof von; Henne, Mark; Gerdesmeyer, Ludger

doi:10.1055/s-2004-822825

Cited by 18 publications

(4 citation statements)

References 16 publications

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“…Finally, according to our findings, we suggest that combinations of biofilm-validated antibiotics with shock wave therapy should be further investigated against C. acnes biofilms, as recent in vitro studies have suggested that such treatment combinations are highly effective against biofilms produced by clinically relevant aerobic bacteria [12,52,53].…”

Section: Study Limitations and Implications For Future Researchsupporting

confidence: 66%

“…Based on the results of prior in vitro laboratory studies, extracorporeal shock wave therapy (ESWT) presents a promising track record of properties against biofilms produced by clinically relevant aerobic microorganisms [11,12]. While the exact mechanism of the bactericidal action of shock waves still remains unclear [13], it has been postulated that shock wave antibacterial activity occurs at a cell wall level through an increase in permeabilization of bacterial cells [14].…”

Section: Introductionmentioning

confidence: 99%

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Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial

et al. 2020

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Background: Antibiotic management of low-virulent implant-associated infections induced by Cutibacterium acnes may be compromised by multi-drug resistance development, side effects, and increased cost. Therefore, we sought to assess the effects of shock wave therapy against the above pathogen using an in vitro model of infection. Methods: We used a total of 120 roughened titanium alloy disks, simulating orthopedic biomaterials, to assess the results of radial extracorporeal shock wave therapy (rESWT) against C. acnes (ATCC 11827) biofilms relative to untreated control. In particular, we considered 1.6 to 2.5 Bar with a frequency ranging from 8–11 Hz and 95 to 143 impulses per disk to investigate the antibacterial effect of rESWT against C. acnes planktonic (free-floating) and biofilm forms. Results: Planktonic bacteria load diminished by 54% compared to untreated control after a 1.8-bar setting with a frequency of 8 Hz and 95 impulses was applied (median absorbance (MA) for intervention vs. control groups was 0.9245 (IQR= 0.888 to 0.104) vs. 0.7705 (IQR = 0.712 to 0.864), respectively, p = 0.001). Likewise, a statistically significant reduction in the amount of biofilm relative to untreated control was documented when the above setting was considered (MA for treatment vs biofilm control groups was 0.244 (IQR= 0.215–0.282) and 0.298 (IQR = 0.247–0.307), respectively, p = 0.033). Conclusion: A 50% biofilm eradication was documented following application of low-pressure and low-frequency radial shock waves, so rESWT could be investigated as an adjuvant treatment to antibiotics, but it cannot be recommended as a standalone treatment against device-associated infections induced by C. ances.

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Section: Study Limitations and Implications For Future Researchsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial

et al. 2020

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“…Therefore, on-demand activation could be an additional modality in addressing implant-related infections. Previous studies have demonstrated a reduction in biofilm presence both in vitro and in vivo when exposed to shock wave treatment [ 39 , 40 , 41 , 42 , 43 ]. The concrete effects of the shock waves have not yet been fully understood.…”

Section: Discussionmentioning

confidence: 99%

Shock Wave-Activated Silver-Loaded Biopolymer Implant Coating Eliminates Staphylococcus epidermidis on the Surface and in the Surrounding of Implants

Schulze,

Nonhoff,

Hasselmann

et al. 2023

Pharmaceutics

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Bacterial biofilms on foreign surfaces are considered a primary cause of implant-related infections, which are challenging to treat. A new implant coating was developed, containing anti-infective silver within a biocompatible polymer carrier substance. In addition to its passive effect on the implant surface, highly concentrated anti-infective silver can be released as needed via the application of high-energy shock waves. This intervention could be applied transcutaneously in a clinical setting without the need for additional surgery. We investigated the inhibition of biofilm formation and the effectiveness of eradication after activation of the coating via shock waves in an in vitro biofilm model using Staphylococcus epidermidis RP62A. This was performed via scanning electron microscopy and quantitative microbiology. Additionally, we examined the cytotoxicity of the new coating on normal human fibroblasts and Saos-2 osteoblast-like cells, depending on the silver concentration. All studies were compared to uncoated titanium surfaces Ti6Al4V and a conventional electroplated silver coating. Cytotoxicity toward normal human fibroblasts and Saos-2 osteoblast-like cells increased with higher silver content but remained tolerable at 6%. Compared to uncoated Ti6Al4V and the electroplated silver coating, the new coating with a silver content of 4% and 6% exhibited a significant reduction in adherent bacteria by a factor of approximately 1000. This was also evident via microscopic examination of the surface morphology of the biofilms. Furthermore, following shock wave activation, no bacteria were detectable on either the implant or in the surrounding fluid after a 24 h period.

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“… susp Johannes et al 1994 [ 10 ] em cgel,mem,water tube PP susp Oosterhof et al 1989 [ 41 ] em cgel,mem,water tube PE susp Kusnierczak et al 2000 [ 16 ] em cgel,mem,water tube ? adh Gollwitzer et al 2004 [ 52 ] em cgel,mem,water pipette PE susp Suhr et al 2013 [ 73 ] em cgel,mem,med plate/dish ? adh SW shockwave technology, eh electrohydraulic, em electromagnetic, p piezoelectric, cgel coupling gel, mem membrane, med cell culture medium, custom custom made, PP polypropylene, PE polyethylene, PS polystyrene, PVC polyvinyl chloride, susp suspension, adh adherent, pel pellet/sediment, gel embedded in gel, organ organ or tissue sample The material of the cell container because the sound field inside it can be modified by reflection, diffraction, refraction, and absorption.…”

Section: Methodsmentioning

confidence: 99%

In-vitro cell treatment with focused shockwaves—influence of the experimental setup on the sound field and biological reaction

et al. 2016

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BackgroundTo improve understanding of shockwave therapy mechanisms, in vitro experiments are conducted and the correlation between cell reaction and shockwave parameters like the maximum pressure or energy density is studied. If the shockwave is not measured in the experimental setup used, it is usually assumed that the device’s shockwave parameters (=manufacturer’s free field measurements) are valid. But this applies only for in vitro setups which do not modify the shockwave, e.g., by reflection or refraction. We hypothesize that most setups used for in vitro shockwave experiments described in the literature influence the sound field significantly so that correlations between the physical parameters and the biological reaction are not valid.MethodsTo reveal the components of common shockwave in vitro setups which mainly influence the sound field, 32 publications with 37 setups used for focused shockwave experiments were reviewed and evaluated regarding cavitation, cell container material, focal sound field size relative to cell model size, and distance between treated cells and air. For further evaluation of the severity of those influences, experiments and calculations were conducted.ResultsIn 37 setups, 17 different combinations of coupling, cell container, and cell model are described. The setup used mainly is a transducer coupled via water to a tube filled with a cell suspension. As changes of the shockwaves’ maximum pressure of 11 % can already induce changes of the biological reaction, the sound field and biological reactions are mainly disturbed by use of standard cell containers, use of coupling gel, air within the 5 MPa focal zone, and cell model sizes which are bigger than half the −6 dB focal dimensions.ConclusionsUntil now, correct and sufficient information about the shockwave influencing cells in vitro is only provided in 1 of 32 publications. Based on these findings, guidelines for improved in vitro setups are proposed which help minimize the influence of the setup on the sound field.Electronic supplementary materialThe online version of this article (doi:10.1186/s40349-016-0053-z) contains supplementary material, which is available to authorized users.

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Antibakterieller Effekt hochenergetischer extrakorporaler Stoßwellen: Ein in vitro Nachweis

Cited by 18 publications

References 16 publications

Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial

Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial

Shock Wave-Activated Silver-Loaded Biopolymer Implant Coating Eliminates Staphylococcus epidermidis on the Surface and in the Surrounding of Implants

In-vitro cell treatment with focused shockwaves—influence of the experimental setup on the sound field and biological reaction

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