PL/Vancomycin/Nano-hydroxyapatite Sustained-release Material to Treat Infectious Bone Defect

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_biol-2020-0011_s_006_w2aab3b7c57b1b6b1aab1c15b1Aa"><jats:title>Objective</jats:title><jats:p>To evaluate the therapeutic effect of platelet lysate (PL)/vancomycin/nano-hydroxyapatite sustained-release material on treating staphylococcus aureus-induced infectious bone defects.</jats:p></jats:sec><jats:sec id="j_biol-2020-0011_s_007_w2aab3b7c57b1b6b1aab1c15b2Aa"><jats:title>Methods</jats:title><jats:p>40 New Zealand white rabbits were inoculated with staphylococcus aureus to construct the chronic tibial infectious bone defect model. After incision, debridement and washing, control group 1 was not given any filling, control group 2 was filled with PL/nano-hydroxyapatite sustained release material, control group 3 was filled with vancomycin/ nano-hydroxyapatite sustained release material, and the treatment group was filled with PL/vancomycin/nano-hydroxyapatite sustained-release material. Afterwards, the drug release profiles were determined in vitro and in vivo. Then, X-rays and bone specimens were used to evaluate the efficacy of the treatments.</jats:p></jats:sec><jats:sec id="j_biol-2020-0011_s_008_w2aab3b7c57b1b6b1aab1c15b3Aa"><jats:title>Results</jats:title><jats:p>TGF-β and PDGF were effectively released for 28 days in vitro. In addition, results of the inhibition zone experiment of the composite material proved that vancomycin had favorable antibacterial activity, which effectively suppressed bacteria for as long as 43 days, thus achieving the sustained-release antibacterial effect. The drug release profiles in vitro also demonstrated that the vancomycin concentration within the lesion region was the highest in composite material, and the infection in experimental rabbits was markedly alleviated. The original backbone deformity regained the normal shape, the normal bone marrow structure began to recover 6 weeks later, and the nano-hydroxyapatite transformed into the trabecula structure. By contrast, the inflammation in the control group still existed, with no obvious new bone formation.</jats:p></jats:sec><jats:sec id="j_biol-2020-0011_s_009_w2aab3b7c57b1b6b1aab1c15b4Aa"><jats:title>Conclusion</jats:title><jats:p>The PL/vancomycin/nano-hydroxyapatite sustained-release material effectively treats chronic infectious bone defects.</jats:p></jats:sec>

Local Antibiotic Delivery Ceramic Bone Substitutes for the Treatment of Infected Bone Cavities and Bone Regeneration: A Systematic Review on What We Have Learned from Animal Models

“…All bone defects were created in long bones. The proximal tibia metaphysis was the most used infection site (71.7%), as reported in 33 experiments [ 29 , 30 , 32 , 33 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 49 , 51 , 52 , 53 , 55 , 56 , 57 , 58 , 59 ]. The femoral metaphysis was used four times (8.7%): the proximal twice [ 50 ] and the distal twice [ 54 ].…”

“…Five hundred sixteen references were retrieved after a PubMed literature search. After applying the exclusion criteria, a total of 32 articles were included in this review [ 19 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. Two additional papers [ 58 , 59 ] were added to the final literature review after backward citation tracking, making a total of 34 papers.…”

“…The New Zealand White rabbit was the most used model in 69.6% of the experiments (32 out of 46) [ 19 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 44 , 45 , 47 , 49 , 50 , 52 , 53 , 57 , 58 ]. Sprague–Dawley rats were used seven times (15.2%) [ 28 , 43 , 46 , 55 , 56 ], Wistar rats were used four times (8.7%) [ 36 , 48 , 54 ], mongrel dogs were used twice (4.3%) [ 59 ], and Spanish goats were used once (2.2%) [ 51 ] ( Figure 3 ).…”

“…To induce bone cavity infection or to contaminate the bone defect, Staphylococcus aureus was used in all experiments. MRSA [ 29 , 30 , 31 , 33 , 37 , 38 , 39 , 41 , 42 , 43 , 44 , 48 , 49 , 52 ] and MSSA [ 27 , 29 , 30 , 35 , 40 , 45 , 50 , 51 , 53 , 54 , 57 ] were used in 18 (39.1%) and 17 (37.0%) of the experiments, respectively. In 11 series (23.9%), there was no reference to the methicillin resistance of strains [ 19 , 28 , 32 , 34 , 36 , 46 , 47 , 55 , 56 , 58 , 59 ], and this was more frequent in older works.…”

“…To facilitate the development of osteomyelitis, an adjuvant agent was used in 23.9% of the experiments: sodium morrhuate was used in nine [ 33 , 37 , 38 , 39 , 40 , 52 , 53 , 57 , 58 ] of the series, and arachidonic acid was used in two [ 35 ] of the series. In seven experiments (15.2%), the cavities were filled with foreign bodies: metal in five cases [ 42 , 43 , 46 , 55 ] (needle in three cases and titanium particles in two cases), PMMA in one case [ 45 ], and cotton balls in another case [ 53 ].…”