Bewersdorf Tim Niklas, Hofmann Jakob, Findeisen Sebastian, Schamberger Christian, Lingner Thomas, Sommer Ulrike, Schmidmaier Gerhard, Grossner Tobias
Clinic for Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, 69120 Heidelberg, Germany.
Genevention GmbH, Rudolf-Wissell-Str. 28A, 37079 Göttingen, Germany.
Antibiotics (Basel). 2024 Feb 15;13(2):186. doi: 10.3390/antibiotics13020186.
The treatment of fungal bone infections and infected non-unions is a huge challenge in modern trauma and orthopedics, which normally contain the local and systemic administration of anti-fungal drugs. Although frequently used, little is known about the impact of systemic and locally administered fungicides on the osteogenic regenerative capabilities of infected bone tissue, especially upon the osteogenesis of human bone marrow mesenchymal stem cells (BM-hMSCs). This study evaluates the effects of the three most common fungicides for the systemic treatment of bone infections, Voriconazole (VOR), liposomal Amphotericin B (LAMB), and Fluconazole (FLU), as well as the effects of VOR and LAMB-loaded Polymethylmethacrylate (PMMA) cement chips in different concentrations upon the osteogenic response of BM-hMSCs in vitro. Within this study, we compared the ability of BM-hMSC to differentiate into osteoblast-like cells and synthesize hydroxyapatite as assessed by radioactive Technetium-Hydroxydiphosphonate (Tc-HDP) labeling, cell proliferation, and analyses of supernatants upon various osteogenic parameters. Our results revealed that VOR added to the cell culture medium affects the osteogenic potential of BM-hMSC negatively, while there were no detectable effects of LAMB and FLU. Moreover, we showed dose-dependent negative effects of high- and extended-dose fungicide-loaded PMMA cement due to cytotoxicity, with a higher cytotoxic potential of VOR than LAMB, while low-dose fungicide-loaded PMMA had no significant effect on the osteogenic potential of BM-hMSC in vitro.
真菌性骨感染和感染性骨不连的治疗是现代创伤骨科领域的一项巨大挑战,通常包括抗真菌药物的局部和全身应用。尽管这些药物经常被使用,但关于全身和局部应用杀菌剂对感染骨组织成骨再生能力的影响,尤其是对人骨髓间充质干细胞(BM-hMSC)成骨作用的影响,人们了解甚少。本研究评估了三种最常用于骨感染全身治疗的杀菌剂,伏立康唑(VOR)、脂质体两性霉素B(LAMB)和氟康唑(FLU),以及不同浓度的负载VOR和LAMB的聚甲基丙烯酸甲酯(PMMA)骨水泥芯片对体外BM-hMSC成骨反应的影响。在本研究中,我们通过放射性锝-羟基二膦酸盐(Tc-HDP)标记、细胞增殖以及对各种成骨参数的上清液分析,比较了BM-hMSC分化为成骨样细胞并合成羟基磷灰石的能力。我们的结果显示,添加到细胞培养基中的VOR对BM-hMSC的成骨潜能有负面影响,而LAMB和FLU未检测到有影响。此外,我们发现高剂量和延长剂量的负载杀菌剂的PMMA骨水泥由于细胞毒性具有剂量依赖性负面影响,VOR的细胞毒性潜力高于LAMB,而低剂量负载杀菌剂的PMMA对体外BM-hMSC的成骨潜能没有显著影响。