Gristina A G, Rovere G D, Shoji H, Nicastro J F
J Biomed Mater Res. 1976 Mar;10(2):273-81. doi: 10.1002/jbm.820100208.
The clinical use of inert materials for internal fixation and joint replacement devices is increasing rapidly; studies on the effect of these materials on bacteria and host resistance to infection have not kept apace. Any substance placed within the body may interfere with host-parasite interaction, either by its physical presence or by physiochemical activity at its interface with the surrounding tissue. Either mechanism, by altering the normal host defense mechanism, may promote or retard bacterial growth. Bacterial growth may also be altered if a trace element essential to or inhibitory to the bacteria or an element that antagonizes or potentiates humoral antibacterial systems is leached from the substance. We have tested bacterial growth and inhibition in vitro in the presence of substances used as implant materials: surgical silver, iron, zinc-coated galvanized iron, aluminum alloy, stainless steel, Vitallium, and methyl methacrylate. Our results showed: 1) metals that have low grades of tissue reactivity and little bacteriotoxic effect provided a framework along which bacterial growth and propagation occurred; 2) metals that have higher levels of cellular reactivity, specifically aluminum and galvanized wire, caused selective bacterial toxicity. The in vitro response of bacteria to methyl methacrylate was similar to that of Vitallium and other inert substances, i.e., growth and propagation were abundant adjacent to methyl methacrylate. These studies led us to speculate that, if similar phenomena occur in vivo, bacterial growth and dissemination might be increased when an inert implant material was used and decreased when the implant material was more reactive.
惰性材料在内部固定和关节置换装置中的临床应用正在迅速增加；而关于这些材料对细菌以及宿主抗感染能力影响的研究却未能跟上步伐。体内植入的任何物质都可能干扰宿主与寄生虫的相互作用，这或是由于其物理存在，或是由于其与周围组织界面处的物理化学活性。这两种机制中的任何一种，通过改变正常的宿主防御机制，都可能促进或抑制细菌生长。如果对细菌必不可少或具有抑制作用的微量元素，或者对体液抗菌系统具有拮抗或增强作用的元素从该物质中沥出，细菌生长也可能会发生改变。我们在用作植入材料的物质存在的情况下进行了体外细菌生长和抑制测试，这些物质包括外科用银、铁、镀锌铁、铝合金、不锈钢、维他灵以及甲基丙烯酸甲酯。我们的结果表明：1）组织反应性低且几乎没有细菌毒性作用的金属为细菌生长和繁殖提供了一个框架；2）细胞反应性较高的金属，特别是铝和镀锌丝，会引起选择性细菌毒性。细菌对甲基丙烯酸甲酯的体外反应与维他灵及其他惰性物质相似，即甲基丙烯酸甲酯附近细菌生长和繁殖旺盛。这些研究使我们推测，如果体内发生类似现象，使用惰性植入材料时细菌生长和扩散可能会增加，而使用反应性更强的植入材料时则会减少。
