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锂皂石插层仿生多层涂层可防止糖皮质激素诱导的骨科植入物失效。

Laponite intercalated biomimetic multilayer coating prevents glucocorticoids induced orthopedic implant failure.

作者信息

Liu Zhe, Tang Qian, Liu Ruo-Tao, Yu Ming-Zhao, Peng Hao, Zhang Chang-Qing, Zhu Zhen-Zhong, Wei Xiao-Juan

机构信息

Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China.

Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China.

出版信息

Bioact Mater. 2022 Sep 26;22:60-73. doi: 10.1016/j.bioactmat.2022.09.013. eCollection 2023 Apr.

Abstract

Implant failure, which is commonly associated with failure of osseointegration and peri-implant infection, is a severe complication of orthopedic surgery. In particular, the survival rate of implants is significantly decreased in patients using long-term glucocorticoids (GCs). However, the exact molecular mechanism underlying GCs-induced implant loosening, as well as preventive strategies for these patients, is unclear. To address this problem, we performed RNA-sequencing and found that WNT16 was correlated with GCs-induced osteopenia (LogFC = -5.17, p < 0.01). Inspired by the concept of "organic-inorganic" hybrid, we theorized to introduce a bioactive two-dimensional nanosheet into a layer-by-layer (LbL) self-assembly coating to construct a customized implant that targets WNT16. After screening commercially available nanosheets, laponite (LAP) was identified as a cost-effective rescuer for GCs-induced WNT16 inhibition, which was then intercalated into LbL deposition system consisting of quaternized chitosan (QCS) and hyaluronic acid (HA). The hybrid coating (QCS/HA/LAP) showed micrometer thickness and improved hydrophilicity and interface roughness. Furthermore, QCS/HA/LAP coated polyetheretherketone (PEEK) implant enhanced cell viability, adhesion, and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), and promoted osteointegration of PEEK in GCs-treated rats by targeting the WNT16/β-catenin axis. The assembled QCS has proven antibacterial properties, and the hybrid coating exerted potent detrimental effects against methicillin-resistant (MRSA) and (), both and . Taken together, these results suggest that QCS/HA/LAP coating has great potential for use in implants customization, and has synergistic pro-osteogenic and antibacterial effects that help prevent implant failure in GCs-treated patients.

摘要

种植体失败通常与骨整合失败和种植体周围感染相关,是骨科手术的严重并发症。特别是,长期使用糖皮质激素(GCs)的患者中种植体的存活率显著降低。然而,GCs诱导种植体松动的具体分子机制以及针对这些患者的预防策略尚不清楚。为了解决这个问题,我们进行了RNA测序,发现WNT16与GCs诱导的骨质减少相关(LogFC = -5.17,p < 0.01)。受“有机-无机”杂化概念的启发,我们设想将生物活性二维纳米片引入逐层(LbL)自组装涂层中,以构建靶向WNT16的定制种植体。在筛选市售纳米片后,锂皂石(LAP)被确定为GCs诱导的WNT16抑制的经济有效解救剂,然后将其插入由季铵化壳聚糖(QCS)和透明质酸(HA)组成的LbL沉积系统中。杂化涂层(QCS/HA/LAP)显示出微米级厚度,并改善了亲水性和界面粗糙度。此外,QCS/HA/LAP涂层的聚醚醚酮(PEEK)种植体增强了骨髓间充质干细胞(BMSCs)的细胞活力、粘附力和成骨分化,并通过靶向WNT16/β-连环蛋白轴促进了PEEK在GCs处理大鼠中的骨整合。组装好的QCS已被证明具有抗菌性能,并且杂化涂层对耐甲氧西林金黄色葡萄球菌(MRSA)和()均产生了强大的有害作用,两者均如此。综上所述,这些结果表明QCS/HA/LAP涂层在种植体定制方面具有巨大潜力,并且具有协同的促骨生成和抗菌作用,有助于预防GCs处理患者的种植体失败。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ae9/9519439/9cb32c0d8b8d/ga1.jpg

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