Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL.
Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, AL.
Int Forum Allergy Rhinol. 2018 Apr;8(4):482-489. doi: 10.1002/alr.22081. Epub 2018 Jan 15.
The ciprofloxacin-coated sinus stent (CSS) has unique therapeutic potential to deliver antibiotics to the sinuses. The objective of this study is to evaluate the efficacy of the CSS stent in eliminating Pseudomonas aeruginosa infection in a rabbit model of sinusitis.
A ciprofloxacin-eluting sinus stent was created by coating ciprofloxacin/Eudragit RS100 on biodegradable poly-D/L-lactic acid (2 mg). After analyzing in-vitro inhibition of P aeruginosa (PAO-1 strain) biofilm formation, a total of 8 stents (4 shams, 4 CSSs) were placed unilaterally in rabbit maxillary sinuses via dorsal sinusotomy after inducing infection for 1 week with PAO-1. Animals were assessed 2 weeks after stent insertion with nasal endoscopy, sinus culture, computed tomography (CT) scan, histopathology, and scanning electron microscopy (SEM).
PAO-1 biofilm formation was significantly reduced in vitro with exposure to the CSS (p < 0.0001). Insertion of the stent in PAO-1-infected rabbits for 2 weeks resulted in significant improvement in sinusitis according to endoscopy scoring (p < 0.0001) and CT scoring (p < 0.002). Histology and SEM revealed marked improvement in the structure of the mucosa and submucosa with no detection of biofilm structures in the CSS cohort.
Although this study had a small sample size, we identified robust therapeutic efficacy of the CSS by reducing bacterial load and biofilm formation of P aeruginosa in a preclinical model of sinusitis after placement for 2 weeks.
环丙沙星涂层鼻窦支架（CSS）具有将抗生素递送到鼻窦的独特治疗潜力。本研究的目的是评估 CSS 支架在消除兔鼻窦炎模型中铜绿假单胞菌感染的疗效。
通过将环丙沙星/ Eudragit RS100 涂覆在可生物降解的聚-D/L-乳酸（2mg）上，创建了一种环丙沙星洗脱鼻窦支架。在分析体外抑制铜绿假单胞菌（PAO-1 株）生物膜形成后，在感染 PAO-1 1 周后通过背窦切开术将总共 8 个支架（4 个假手术，4 个 CSS）单侧放置在兔上颌窦中。支架插入后 2 周，通过鼻内窥镜、鼻窦培养、计算机断层扫描（CT）扫描、组织病理学和扫描电子显微镜（SEM）评估动物。
PAO-1 生物膜形成在体外接触 CSS 时显著减少（p <0.0001）。在 PAO-1 感染的兔子中插入支架 2 周后，根据内窥镜评分（p <0.0001）和 CT 评分（p <0.002），鼻窦炎显著改善。组织学和 SEM 显示，黏膜和黏膜下层的结构明显改善，CSS 组未检测到生物膜结构。
尽管本研究样本量较小，但我们发现 CSS 通过减少铜绿假单胞菌的细菌负荷和生物膜形成，在鼻窦炎的临床前模型中放置 2 周后具有强大的治疗效果。
