Comparing the bulking effect of calcium hydroxyapatite and Deflux injection into the bladder neck for improvement of urinary incontinence in bladder exstrophy–epispadias complex

Eftekharzadeh, Sahar; Sabetkish, Nastaran; Sabetkish, Shabnam; Kajbafzadeh, Abdol‐Mohammad

doi:10.1007/s11255-016-1464-z

Cited by 12 publications

(2 citation statements)

References 32 publications

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“…A testimony to this protean nature comes from the fact that HAp, the most abundant phosphate mineral on Earth, is ubiquitous in igneous, sedimentary and metamorphic rocks and is also used in a number of different fields, including geology, petrology, agronomy, pharmacy, dentistry, medicine, ecology, and gastronomy [22]. Among countless industrial applications, HAp has been used as a filter for environmental remediation [23], a sorbent in chromatographic columns [24], a catalyst for fuel production [25], a fertilizer [26], a leavening agent [27] and a bulking agent [28], while its uses in medicine, dentistry and pharmacy have been no less numerous [29]. Despite this breadth of industrial and medical applications, CP is a material that has recently fallen out of favor in the dental and orthopedic clinics as an option for hard tissue substitution, in spite of its aforementioned reputation as the most traditional of all biomaterials [30].…”

Section: Introductionmentioning

confidence: 99%

Calcium phosphate nanoparticles as intrinsic inorganic antimicrobials: mechanism of action

Tang

Uskoković

2020

Biomed. Mater.

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This is the final report of the study aimed at assessing the antimicrobial activity of calcium phosphate (CP) nanoparticles delivered in the form of hydroxyapatite (HAp) or amorphous CP (ACP) and understanding the fundamental principles behind their mechanisms of action. Not responding to propidium iodide and causing no gross morphological changes except moderate stress-induced filamentation in Escherichia coli (E. coli), CP nanoparticles were shown to be bacteriostatic, not bactericidal. Also, the lack of expression of genes involved in DNA repair indicated no genotoxic activity. In contrast, the softening of amide infrared bands and the partial dissociation of lipopolysaccharide structures comprising the membrane of Gram-negative Pseudomonas aeruginosa (P. aeruginosa) was detected in a vibrational spectroscopic analysis of the nanoparticle/bacterium interaction. Similarly, the inhibition of the growth of Staphylococcus aureus (S. aureus) was paralleled by a reduced integrated intensity and the softening of the C = O ester carbonyl stretch in lipoteichoic acid, a major component of the Gram-positive cell membrane. Electron microscopy analyses confirmed that changes to the cell membrane are a major mode of action of CP nanoparticles. While HAp got internalized by E. coli significantly more than ACP, the membrane damage was more pronounced in ACP-treated bacteria, which was explained by the higher surface reactivity of ACP. HAp nanoparticles decreased the activity of overexpressed efflux pumps in methicillin-resistant S. aureus, suggesting that they may hijack these pumps and use them to enter the cell without producing any visible damage to the membrane, thus acting on the cell from the inside out, as opposed to ACP, whose action is mostly external in mechanism. This may explain why HAp, unlike ACP, suppresses the mechanisms of resistance in methicillin- and multidrug-resistant S. aureus and P. aeruginosa, respectively. The findings of this study will be essential in the optimization of these nanoparticles for becoming an alternative to less biocompatible inorganics and small molecule antibiotics in the global effort to curb the rising resistance of bacterial pathogens to the existing therapies.

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Section: Introductionmentioning

confidence: 99%

Calcium phosphate nanoparticles as intrinsic inorganic antimicrobials: mechanism of action

Tang

Uskoković

2020

Biomed. Mater.

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“…In one study in 2019, patients underwent endoscopic correction of primary VUR by sub-ureteric injection of PPC or Dx/HA, the result of which confirmed PPC as a more effective material (28). The results of another study showed that calcium hydroxyapatite may be also applied as an effective bulking agent in the treatment of urinary incontinence in patients with bladder exstrophy-epispadias complex after injection into the bladder neck, with no significant difference in terms of bladder capacity as compared with Deflux (29).…”

Section: Discussionmentioning

confidence: 99%

Local tissue reaction and histopathological characteristics of three different bulking agents: a rabbit model

et al. 2021

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Purpose: We assessed the efficacy and safety of a single injection of three bulking agents over the short-and long-term follow-ups in rabbits. Dermal and preputial matrices were compared with Deflux (DxHA) injection. Material and methods: Twenty-four rabbits were divided into three groups. Group I (n=8) underwent the injection of a lyophilized dermal matrix (LDM) beneath the seromuscular layer of the bladder wall. Rabbits in group II (n=8) were injected with lyophilized preputial matrix (LPM). Rabbits of group III (n=8) were injected with DxHA as the control group. They were followed up for 1 and 6 months after the injection. Subcutaneous injection of all bulking agents was also performed in nude mice. Biopsies were stained with LCA (leukocyte common antibody), CD68, CD31, and CD34. Scanning electron microscopy (SEM) and MTT assay were also performed. Results: Immunohistochemistry staining with CD68 and LCA revealed higher inflammation grade in LDM as compared with LPM and DxHA. Fibrosis grade was also higher in LDM both in short-and long-term follow-ups. However, no significant difference was detected in CD31 and CD34 staining between control and experimental groups. SEM analysis showed that the particle size of LPM was more similar to DxHA. MTT assay revealed that cell proliferation was similar in DxHA, LDM, and LPM. In-vivo assay in nude mice model showed more promising results in LPM as compared with LDM. Conclusion: The long-term results demonstrated that LPM was more similar to Deflux with the least local tissue reaction, inflammation, and fibrosis grade.

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The Bladder Exstrophy-Epispadias Complex (BEEC)

et al. 2019

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Comparing the bulking effect of calcium hydroxyapatite and Deflux injection into the bladder neck for improvement of urinary incontinence in bladder exstrophy–epispadias complex

Abstract: The preliminary results of this study revealed that CaHA may be applied as an affordable bulking agent in treatment of urinary incontinence in BEEC.

Cited by 12 publications

References 32 publications

Calcium phosphate nanoparticles as intrinsic inorganic antimicrobials: mechanism of action

Calcium phosphate nanoparticles as intrinsic inorganic antimicrobials: mechanism of action

Local tissue reaction and histopathological characteristics of three different bulking agents: a rabbit model

The Bladder Exstrophy-Epispadias Complex (BEEC)

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