Gallo J, Hradilová Š, Joska L, Večeřová R, Galandáková A, Cvrček L, Kriegová E
Ortopedická klinika Lékařské fakulty Univerzity Palackého v Olomouci a Fakultní nemocnice Olomouc.
Acta Chir Orthop Traumatol Cech. 2019;86(2):110-117.
PURPOSE OF THE STUDY Nano-structuring and nano-silver have been extensively studied for improving the antibacterial ability of implants due to their powerful antibacterial activity; however, there is no clinical application as yet. The aim of the study was to determine the antibacterial, antiadhesive and cytotoxic features of Ti6Al4V modified with nano-texturing and silver nano-particles. MATERIAL AND METHODS The nanoparticles were applied on polished and nano-textured Ti6Al4V using sonoreduction. The surface topography, roughness, friction coefficients, hardness and elastic modulus values for prepared top layers were established. The materials were tested for antibacterial and antiadhesion activity using reference bacterial strains (Staphylococcus epidermidis CCM 7221, Staphylococcus aureus MRSA 4591, Enterococcus faecalis CCM 4224, Escherichia coli CCM 3954) and their cytocompatibility. RESULTS A strong antibacterial activity of samples treated with nano-texture and/or silver nanoparticles compared to all the tested bacterial strains at 24 hours was proven. This antibacterial activity was diminishing in relation to Staphylococcus aureusand Enterococcus faecalisat 48 and 72 hours but remained very effective against Staphylococcus epidermidisand Escherichia coli. We also demonstrated antibiofilm activity for samples treated with silver nanoparticles and nano-tubes in experiments lasting 24 and 72 hours. DISCUSSION Our main findings are in agreement with those reported in recent literature. The implant surfaces treated with nano-texture in combination with silver nanoparticles exhibit strong antibacterial and antibiofilm characteristics. Despite there is conclusive evidence of strong antibacterial functioning, why these implant modifications have not been widely applied in clinical practice remains a question. While many obstacles including legislative procedures required for clinical implementation are more or less known, it should be clearly demonstrated that this surface modification does neither harm the patient nor interfere with the long-term survivorship of the implants before their wide-range clinical application. CONCLUSIONS Surface modification of Ti6Al4V with nano-texturing and silver nanoparticles resulted in strong antibacterial and modest antibiofilm effects. Thus, our results confirmed the technological potential of nano-texturing and silver nanoparticles for the improvement of antibacterial properties of implants. Key words:prosthetic joint infection, anti-infective biomaterials, titanium alloy, silver nanoparticles, nanotubes, prevention of infection.
研究目的 由于纳米结构和纳米银具有强大的抗菌活性，已被广泛研究用于提高植入物的抗菌能力；然而，目前尚无临床应用。本研究的目的是确定经纳米纹理化和银纳米颗粒改性的Ti6Al4V的抗菌、抗粘附和细胞毒性特性。材料与方法 使用声还原法将纳米颗粒应用于抛光和纳米纹理化的Ti6Al4V上。确定了制备的顶层的表面形貌、粗糙度、摩擦系数、硬度和弹性模量值。使用参考细菌菌株（表皮葡萄球菌CCM 7221、金黄色葡萄球菌MRSA 4591、粪肠球菌CCM 4224、大肠杆菌CCM 3954）对材料进行抗菌和抗粘附活性测试以及细胞相容性测试。结果 与所有测试细菌菌株相比，经纳米纹理化和/或银纳米颗粒处理的样品在24小时时具有很强的抗菌活性。这种抗菌活性在48小时和72小时时相对于金黄色葡萄球菌和粪肠球菌有所减弱，但对表皮葡萄球菌和大肠杆菌仍然非常有效。在持续24小时和72小时的实验中，我们还证明了经银纳米颗粒和纳米管处理的样品具有抗生物膜活性。讨论 我们的主要发现与最近文献报道的结果一致。经纳米纹理化与银纳米颗粒结合处理的植入物表面表现出很强的抗菌和抗生物膜特性。尽管有确凿证据表明其具有强大的抗菌功能，但为什么这些植入物改性尚未在临床实践中广泛应用仍是一个问题。虽然包括临床实施所需的立法程序在内的许多障碍或多或少是已知的，但在其广泛临床应用之前，应明确证明这种表面改性既不会伤害患者，也不会干扰植入物的长期存活率。结论 用纳米纹理化和银纳米颗粒对Ti6Al4V进行表面改性产生了很强的抗菌作用和适度的抗生物膜作用。因此，我们的结果证实了纳米纹理化和银纳米颗粒在改善植入物抗菌性能方面的技术潜力。关键词：人工关节感染；抗感染生物材料；钛合金；银纳米颗粒；纳米管；感染预防
