Pechey Andrea, Elwood Chelsea N, Wignall Geoffrey R, Dalsin Jeffrey L, Lee Bruce P, Vanjecek Maaike, Welch Ian, Ko Raymond, Razvi Hassan, Cadieux Peter A
Lawson Health Research Institute, London, Ontario, Canada.
J Urol. 2009 Oct;182(4):1628-36. doi: 10.1016/j.juro.2009.06.008. Epub 2009 Aug 15.
A previous study showed decreased uropathogen adherence using a novel anti-fouling coating consisting of mussel adhesive protein mimics conjugated to poly(ethylene glycol). We assessed the ability of methoxy polyethylene glycol-dihydroxyphenylalanine (Nerites Corp. Ltd., Madison, Wisconsin) coated ureteral stents to resist bacterial adherence, infection development and encrustation in a rabbit model of uropathogenic Escherichia coli cystitis.
Sof-Flex stent curls that were uncoated and coated with 3 coatings, including Surphys 002, 008 and 009, respectively, and uncoated Percuflex Plus stents were inserted transurethrally into the bladder of 50 male New Zealand White rabbits (Charles River Laboratories, Montreal, Quebec, Canada), followed by instillation of uropathogenic E. coli strain GR12 (10(7) cfu). Urine was examined for bacteria on days 0, 1, 3 and 7, and for cytokine levels on day 7. On day 7 the animals were sacrificed. Stent curls and bladders were harvested for analysis. In a parallel experiment stents were challenged in vitro for 7 days with GR12 in human urine.
Surphys 009 coated devices showed decreased urine and stent bacterial counts compared to those in controls. Eight of 10 rabbits in the Surphys 009 group had sterile urine by day 3 vs 1 in each control group (p = 0.013), while stent adherent organisms were decreased by more than 75%. While no statistical differences were found in encrustation and bladder inflammation across the groups, immune scoring was lowest in the uncoated Sof-Flex control and Surphys 009 groups (p = 0.030).
Surphys 009 strongly resisted bacterial attachment, resulting in improved infection clearance over that of uncoated devices. However, this did not translate to decreased encrustation, which appeared to be independent of infection in this model.
先前的一项研究表明，使用一种由与聚乙二醇偶联的贻贝粘附蛋白模拟物组成的新型防污涂层，可降低尿路病原体的粘附。我们评估了甲氧基聚乙二醇 - 二羟基苯丙氨酸（Nerites公司，威斯康星州麦迪逊）涂层输尿管支架在致病性大肠杆菌膀胱炎兔模型中抵抗细菌粘附、感染发展和结垢的能力。
将未涂层以及分别涂有3种涂层（包括Surphys 002、008和009）的Sof - Flex支架卷曲物和未涂层的Percuflex Plus支架经尿道插入50只雄性新西兰白兔（加拿大魁北克省蒙特利尔市查尔斯河实验室）的膀胱中，随后注入致病性大肠杆菌菌株GR12（10⁷ cfu）。在第0、1、3和7天检测尿液中的细菌，并在第7天检测细胞因子水平。第7天处死动物。收集支架卷曲物和膀胱进行分析。在一项平行实验中，将支架在体外用人尿中的GR12攻击7天。
与对照组相比，涂有Surphys 009的装置尿液和支架细菌计数降低。Surphys 009组10只兔子中有8只在第3天尿液无菌，而每个对照组各有1只（p = 0.013），同时支架附着的微生物减少了75%以上。虽然各组在结垢和膀胱炎症方面未发现统计学差异，但未涂层的Sof - Flex对照组和Surphys 009组的免疫评分最低（p = 0.030）。
Surphys 009能强烈抵抗细菌附着，与未涂层装置相比，感染清除情况有所改善。然而，这并未转化为结垢减少，在该模型中结垢似乎与感染无关。
