Abstract

Regenerative medicine has become an extremely valuable tool offering an alternative to conventional therapies for the repair and regeneration of tissues. The re-establishment of tissue and organ functions can be carried out by tissue engineering strategies or by using medical devices such as implants. However, with any material being implanted inside the human body, one of the conundrums that remains is the ease with which these materials can get contaminated by bacteria. Bacterial adhesion leads to the formation of mature, alive and complex three-dimensional biofilm structures, further infection of surrounding tissues and consequent development of complicated chronic infections. Hence, novel tissue engineering strategies delivering biofilm-targeted therapies, while at the same time allowing tissue formation are highly relevant. In this study our aim was to develop surface modified polyhydroxyalkanoate-based fiber meshes with enhanced bacterial anti-adhesive and juvenile biofilm disrupting properties for tissue regeneration purposes. Using reactive and amphiphilic star-shaped macromolecules as an additive to a polyhydroxyalkanoate spinning solution, a synthetic antimicrobial peptide, Amhelin, with strong bactericidal and anti-biofilm properties, and Dispersin B, an enzyme promoting the disruption of exopolysaccharides found in the biofilm matrix, were covalently conjugated to the fibers by addition to the solution before the spinning process. Staphylococcus epidermidis is one of the most problematic pathogens responsible for tissue-related infections. The initial antibacterial screening showed that Amhelin proved to be strongly bactericidal at 12 μg/ml and caused >50% reductions of biofilm formation at 6 μg/ml, while Dispersin B was found to disperse >70% of pre-formed biofilms at 3 μg/ml. Regarding the cytotoxicity of the agents toward L929 murine fibroblasts, a CC50 of 140 and 115 μg/ml was measured for Amhelin and Dispersin B, respectively. Optimization of the electrospinning process resulted in aligned fibers. Surface activated fibers with Amhelin and Dispersin B resulted in 83% reduction of adhered bacteria on the surface of the fibers. Additionally, the materials developed were found to be cytocompatible toward L929 murine fibroblasts. The strategy reported in this preliminary study suggests an alternative approach to prevent bacterial adhesion and, in turn biofilm formation, in materials used in regenerative medicine applications such as tissue engineering.

Highlights

  • Within regenerative medicine applications, the failure of implantable in situ tissue engineering scaffolds, that should replace missing or damaged tissue and recruit cells from the surrounding tissues of the host, bears generally the probability of bacterial adhesion to its external and internal surface and subsequent biofilm formation at the time point of implantation or even later by hematogenous spread

  • The antibacterial properties of Amhelin were tested against S. epidermidis (ATCC R 35984TM) by determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), respectively

  • The peptide concentration that completely inhibited visible bacterial growth was determined as the MIC, while the peptide concentration that resulted in a reduction of 99.9% of CFUs relative to that in the initial inoculum was determined as the MBC

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Summary

Introduction

The failure of implantable in situ tissue engineering scaffolds, that should replace missing or damaged tissue and recruit cells from the surrounding tissues of the host, bears generally the probability of bacterial adhesion to its external and internal surface and subsequent biofilm formation at the time point of implantation or even later by hematogenous spread. The complexity of the biofilm structure, decreased growth rates, secretion of enzymes capable of degrading antibiotics, horizontal gene transfer and communication via quorum sensing systems are just few of the main factors involved in the resistance of biofilms against antibiotics (Donlan and Costerton, 2002; Wi and Patel, 2018) This leads to many therapeutic difficulties and most of the times the solution involves surgical removal of all foreign material (e.g., medical device, implant or scaffold) and comprehensive debridement of the infected tissue (Zimmerli and Moser, 2012). This, along with the lack of treatment options against biofilms, emphasizes the need to develop new locally acting antibacterial, anti-adhesive and anti-biofilm materials in the regenerative medicine field

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