Salamanna Francesca, De Luca Angela, Vandenbulcke Filippo, Di Matteo Berardo, Kon Elizaveta, Grassi Alberto, Ballardini Alberto, Morozzi Giacomo, Raimondi Lavinia, Bellavia Daniele, Costa Viviana, Zaffagnini Stefano, Fini Milena, Giavaresi Gianluca
Surgical Science and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Front Bioeng Biotechnol. 2024 Jul 9;12:1412584. doi: 10.3389/fbioe.2024.1412584. eCollection 2024.
The development of reliable treatments for infected or potentially infected bone loss resulting from open fractures and non-unions is extremely urgent, especially to reduce the prolonged courses of antimicrobial therapy to which affected patients are subjected. Numerous bone graft substitutes have been used over the years, but there are currently no effective solutions to treat critical bone loss, especially in the presence of infection. The present study evaluated the use of the biomorphic calcium phosphate bone scaffold b. Bone™, based on a next-generation resorbable biomimetic biomaterial, in bone reconstruction surgery in cases of infection. Using an " 3D bone fracture model" to predict the behavior of this drug delivery system during critical bone loss at an infected (or potentially infected) site, the effects of scaffolds loaded with gentamicin or vancomycin on the viability and differentiation capacity of human mesenchymal stem cells (hMSCs) were evaluated. This scaffold, when loaded with gentamicin or vancomycin, exhibits a typical drug release curve that determines the inhibitory effects on the growth of , and , as well as relative biofilm formation. The study demonstrates that b.bone scaffolds can effectively address key challenges in orthopedic surgery and patient care by inhibiting bacterial growth and biofilm formation through rapid, potent antibiotic release, reducing the risk of treatment failure due to resistance, and providing a promising solution for bone infections and improved patient outcomes. Future studies could explore the combination of different antibiotics on these scaffolds for more tailored and effective treatments against post-traumatic osteomyelitis pathogens.
开发针对开放性骨折和骨不连所致感染性或潜在感染性骨质流失的可靠治疗方法迫在眉睫，尤其是要减少受影响患者所需的长期抗菌治疗疗程。多年来已使用了多种骨移植替代物，但目前尚无有效方法治疗严重骨质流失，尤其是在存在感染的情况下。本研究评估了基于下一代可吸收仿生生物材料的生物形态磷酸钙骨支架b.Bone™在感染病例的骨重建手术中的应用。使用“3D骨折模型”预测该药物递送系统在感染（或潜在感染）部位严重骨质流失期间的行为，评估了负载庆大霉素或万古霉素的支架对人间充质干细胞（hMSCs）活力和分化能力的影响。这种支架在负载庆大霉素或万古霉素时，呈现出典型的药物释放曲线，该曲线决定了对金黄色葡萄球菌和大肠杆菌生长的抑制作用以及相关生物膜形成。该研究表明，b.Bone支架可通过快速、强效释放抗生素抑制细菌生长和生物膜形成，有效应对骨科手术和患者护理中的关键挑战，降低因耐药导致治疗失败的风险，并为骨感染和改善患者预后提供有前景的解决方案。未来的研究可以探索在这些支架上联合使用不同抗生素，以针对创伤后骨髓炎病原体进行更具针对性和有效的治疗。
