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史林启课题组 | BIOMATERIALS

发布人:    发布时间:2024/08/26   浏览次数:

Beyond surface modification strategies to control infections associated with implanted biomaterials and devices - Addressing the opportunities offered by nanotechnology


By

Wang, DY (Wang, Da-Yuan) [1] , [2] , [3] ; Su, LZ (Su, Linzhu) [4] ; Poelstra, K (Poelstra, Kees) [5] ; Grainger, DW (Grainger, David W.) [6] ; van der Mei, HC (van der Mei, Henny C.) [1] , [2] ; Shi, LQ (Shi, Linqi) [3] ; Busscher, HJ (Busscher, Henk J.) [1] , [2]
(provided by Clarivate)

Source

BIOMATERIALS

Volume

308

DOI

10.1016/j.biomaterials.2024.122576

Article Number

122576

Published

JUL 2024

Indexed

2024-08-20

Document Type

Article

Abstract

Biomaterial-associated infection (BAI) is considered a unique infection due to the presence of a biomaterial yielding frustrated immune-cells, ineffective in clearing local micro-organisms. The involvement of surfaceadherent/surface-adapted micro-organisms in BAI, logically points to biomaterial surface-modifications for BAI-control. Biomaterial surface-modification is most suitable for prevention before adhering bacteria have grown into a mature biofilm, while BAI-treatment is virtually impossible through surface-modification. Hundreds of different surface-modifications have been proposed for BAI-control but few have passed clinical trials due to the statistical near-impossibility of benefit-demonstration. Yet, no biomaterial surface-modification forwarded, is clinically embraced. Collectively, this leads us to conclude that surface-modification is a dead-end road. Accepting that BAI is, like most human infections, due to surface-adherent biofilms (though not always to a foreign material), and regarding BAI as a common infection, opens a more-generally-applicable and therewith easier-to-validate road. Pre-clinical models have shown that stimuli-responsive nano-antimicrobials and antibiotic-loaded nanocarriers exhibit prolonged blood-circulation times and can respond to a biofilm's micro- environment to penetrate and accumulate within biofilms, prompt ROS-generation and synergistic killing with antibiotics of antibiotic-resistant pathogens without inducing further antimicrobial-resistance. Moreover, they can boost frustrated immune-cells around a biomaterial reducing the importance of this unique BAI-feature. Time to start exploring the nano-road for BAI-control.