Immunotoxicity of stainless-steel nanoparticles obtained after 3D printing

This study aims to investigate the in vitro effects of nanoparticles (NPs) produced during the selective laser melting (SLM) of 316 L stainless steel metal powder on the immune response in a human blood model. Experimental data did not reveal effect on viability of 316 L NPs for the tested doses. Functional immune assays showed a significant immunosuppressive effect of NPs. There was moderate stimulation (117%) of monocyte phagocytic activity without significant changes in phagocytic activity and respiratory burst of granulocytes. A significant dose-dependent increase in the levels of the pro-inflammatory cytokine TNF-a was found in blood cultures treated with NPs. On the contrary, IL-8 chemokine levels were significantly suppressed. The levels of the pro-inflammatory cytokine IL-6 were reduced by only a single concentration of NPs. These new findings can minimise potential health risks and indicate the need for more research in this area.

Elimination of detached Listeria monocytogenes from the biofilm on stainless steel surfaces during milk and cheese processing using natural plant extracts

Bacterial cells can form biofilm on food contact surfaces, becoming a source of food contamination with profound health implications. The current study aimed to determine some Egyptian medicinal plants antibacterial and antibiofilm effects against foodborne bacterial strains in milk plants. Results indicated that four ethanolic plant extracts, Cinnamon (Cinnamomum verum), Chamomile (Matricaria chamomilla), Marigold (Calendula officinalis), and Sage (Salvia officinalis), had antibacterial (12.0-26.5 mm of inhibition zone diameter) and antibiofilm (10-99%) activities against Staphylococcus aureus, Bacillus cereus, Listeria monocytogenes and Salmonella Typhimurium. The tested extracts had minimum inhibitory concentration values between 0.14 and 2.50 mg/ml and minimum bactericidal concentration values between 0.14 and 12.50 mg/ml. L. monocytogenes was more sensitive for all tested ethanolic extracts; Sage and Cinnamon showed a bacteriocidal effect, while Chamomile and Marigold were bacteriostatic. The ethanolic extracts mixture from Chamomile, Sage, and Cinnamon was chosen for its antibiofilm activity against L. monocytogenes using L-optimal mixture design. Gas chromatography and mass spectrometry analysis showed that this mixture contained 12 chemical compounds, where 2-Propenal,3-phenyl- had the maximum area % (34.82%). At concentrations up to 500 µg/ml, it had no cytotoxicity in the normal Vero cell line, and the IC50 value was 671.76 ± 9.03 µg/ml. Also, this mixture showed the most significant antibacterial effect against detached L. monocytogenes cells from formed biofilm in stainless steel milk tanks. At the same time, white soft cheese fortified with this mixture was significantly accepted overall for the panelist (92.2 ± 2.7) than other cheese samples, including the control group.

Antibacterial properties and abrasion-stability: Development of a novel silver-compound material for orthodontic bracket application

PURPOSE

Bacteria-induced white spot lesions are a common side effect of modern orthodontic treatment. Therefore, there is a need for novel orthodontic bracket materials with antibacterial properties that also resist long-term abrasion. The aim of this study was to investigate the abrasion-stable antibacterial properties of a newly developed, thoroughly silver-infiltrated material for orthodontic bracket application in an in situ experiment.

METHODS

To generate the novel material, silver was vacuum-infiltrated into a sintered porous tungsten matrix. A tooth brushing simulation machine was used to perform abrasion equal to 2 years of tooth brushing. The material was characterized by energy dispersive X‑ray (EDX) analysis and roughness measurement. To test for antibacterial properties in situ, individual occlusal splints equipped with specimens were worn intraorally by 12 periodontal healthy patients for 48 h. After fluorescence staining, the quantitative biofilm volume and live/dead distribution of the initial biofilm formation were analyzed by confocal laser scanning microscopy (CLSM).

RESULTS

Silver was infiltrated homogeneously throughout the tungsten matrix. Toothbrush abrasion only slightly reduced the material's thickness similar to conventional stainless steel bracket material and did not alter surface roughness. The new silver-modified material showed significantly reduced biofilm accumulation in situ. The effect was maintained even after abrasion.

CONCLUSION

A promising, novel silver-infiltrated abrasion-stable material for use as orthodontic brackets, which also exhibit strong antibacterial properties on in situ grown oral biofilms, was developed. The strong antibacterial properties were maintained even after surface abrasion simulated with long-term toothbrushing.

Bactericidal Effect of Ultrasound-Responsive Microbubbles and Sub-inhibitory Gentamicin against Pseudomonas aeruginosa Biofilms on Substrates With Differing Acoustic Impedance

The aim of this research was to explore the interaction between ultrasound-activated microbubbles (MBs) and Pseudomonas aeruginosa biofilms, specifically the effects of MB concentration, ultrasound exposure and substrate properties on bactericidal efficacy. Biofilms were grown using a Centre for Disease Control (CDC) bioreactor on polypropylene or stainless-steel coupons as acoustic analogues for soft and hard tissue, respectively. Biofilms were treated with different concentrations of phospholipid-shelled MBs (10⁷-10⁸ MB/mL), a sub-inhibitory concentration of gentamicin (4 µg/mL) and 1-MHz ultrasound with a continuous or pulsed (100-kHz pulse repetition frequency, 25% duty cycle, 0.5-MPa peak-to-peak pressure) wave. The effect of repeated ultrasound exposure with intervals of either 15- or 60-min was also investigated. With polypropylene coupons, the greatest bactericidal effect was achieved with 2 × 5 min of pulsed ultrasound separated by 60 min and a microbubble concentration of 5 × 10⁷ MBs/mL. A 0.76 log (83%) additional reduction in the number of bacteria was achieved compared with the use of an antibiotic alone. With stainless-steel coupons, a 67% (0.46 log) reduction was obtained under the same exposure conditions, possibly due to enhancement of a standing wave field which inhibited MB penetration in the biofilm. These findings demonstrate the importance of treatment parameter selection in antimicrobial applications of MBs and ultrasound in different tissue environments.

Evaluation of surface disinfection methods to inactivate the beta coronavirus Murine Hepatitis Virus

The list of EPA-approved disinfectants for coronavirus features many products for use on hard, non-porous materials. There are significantly fewer products registered for use on porous materials. Further, many common, high-touch surfaces fall in between non-porous materials such as glass and porous materials such as soft fabrics. The objective of this study was to assess the efficacy of selected commercially available disinfectant products against coronaviruses on common, high-touch surfaces. Four disinfectants (Clorox Total 360, Bleach solution, Vital Oxide, and Peroxide Multi-Surface Cleaner) were evaluated against Murine Hepatitis Virus A59 (MHV) as a surrogate coronavirus for SARS-CoV-2. MHV in cell culture medium was inoculated onto four materials: stainless steel, latex-painted drywall tape, Styrene Butadiene rubber (rubber), and bus seat fabric. Immediately (T0) or 2-hr (T2) post-inoculation, disinfectants were applied by trigger-pull or electrostatic sprayer and either held for recommended contact times (Spray only) or immediately wiped (Spray and Wipe). Recovered infectious MHV was quantified by median tissue culture infectious dose assay. Bleach solution, Clorox Total 360, and Vital Oxide were all effective (>3-log₁₀ reduction or complete kill of infectious virus) with both the Spray Only and Spray and Wipe methods on stainless steel, rubber, and painted drywall tape when used at recommended contact times at both T0 and T2 hr. Multi-Surface Cleaner unexpectedly showed limited efficacy against MHV on stainless steel within the recommended contact time; however, it showed increased (2.3 times greater efficacy) when used in the Spray and Wipe method compared to Spray Only. The only products to achieve a 3-log₁₀ reduction on fabric were Vital Oxide and Clorox Total 360; however, the efficacy of Vital Oxide against MHV on fabric was reduced to below 3-log₁₀ when applied by an electrostatic sprayer compared to a trigger-pull sprayer. This study highlights the importance of considering the material, product, and application method when developing a disinfection strategy for coronaviruses on high-touch surfaces.

Using engineered water nanostructures (EWNS) for wound disinfection: Case study of Acinetobacter baumannii inactivation on skin and the inhibition of biofilm formation

Engineered water nanostructures (EWNS) were utilized to deliver a cocktail of nature derived antimicrobials, to assess their efficacy as a solution to the problem of wound infections. The wound related microorganism Acinetobacter baumannii was inoculated on stainless steel and porcine skin and treated with EWNS. EWNS were able to reduce A. baumannii on stainless steel by 4.79 logs in 15 min, and 2 logs in 30 min on porcine skin. The EWNS were able to reduce the strength of A. baumannii biofilm on stainless steel by 87.31% as measured with the XTT assay (P < .001) and 86.27% in cellular counts (P < .001), after two EWNS interventions of 30 min each. Total antimicrobial dose delivered to the surface was 1.42 ng. SEM of biofilms after EWNS treatment showed reduced biomass. These results indicate that the EWNS technology has potential for application in field of wound disinfection and healing.

Evaluation of the Pathogenic-Mixed Biofilm Formation of Pseudomonas aeruginosa/Staphylococcus aureus and Treatment with Limonene on Three Different Materials by a Dynamic Model

Background: Biofilms have been found growing on implantable medical devices. This can lead to persistent clinical infections. The highly antibiotic-resistant property of biofilms necessitates the search for both potent antimicrobial agents and novel antibiofilm strategies. Natural product-based anti-biofilm agents were found to be as efficient as chemically synthesized counterparts with fewer side effects. In the present study, the effects of limonene as an antibiofilm agent were evaluated on Pseudomonas aeruginosa and Staphylococcus aureus biofilm formed on different surfaces using the CDC model system in continuous flow. The flgK gene and the pilA gene expression in P. aeruginosa, and the icaA gene and eno gene in S. aureus, which could be considered as efficient resistance markers, were studied. Methods: Mono- and dual-species biofilms were grown on polycarbonate, polypropylene, and stainless-steel coupons in a CDC biofilm reactor (Biosurface Technologies, Bozeman, MT, USA). To evaluate the ability of limonene to inhibit and eradicate biofilm, a sub-MIC concentration (10 mL/L) was tested. The gene expression of P. aeruginosa and S. aureus was detected by SYBR Green quantitative Real-Time PCR assay (Meridiana Bioline, Brisbane, Australia). Results: The limonene added during the formation of biofilms at sub-MIC concentrations works very well in inhibiting biofilms on all three materials, reducing their growth by about 2 logs. Of the same order of magnitude is the ability of limonene to eradicate both mono- and polymicrobial mature biofilms on all three materials. Greater efficacy was observed in the polymicrobial biofilm on steel coupons. The expression of some genes related to the virulence of the two microorganisms was differently detected in mono- and polymicrobial biofilm. Conclusions: These data showed that the limonene treatment expressed different levels of biofilm-forming genes, especially when both types of strains alone and together grew on different surfaces. Our findings showed that limonene treatment is also very efficient when biofilm has been grown under shear stress causing significant and irreversible damage to the biofilm structure. The effectiveness of the sanitation procedures can be optimized by applying antimicrobial combinations with natural compounds (e.g., limonene).

Brain-Derived Neurotrophic Factor Potentiates Entorhinal-Dentate but not Hippocampus CA1 Pathway in Adult Male Rats: A Mechanism of Taurine-Modulated BDNF on Learning and Memory

Taurine plays an important role in neural growth and function from early to adult life, particularly in learning and memory via BDNF action. This study tested the hypothesis that BDNF differentially potentiates entorhinal-hippocampal synaptic transmission in vivo in adult rats. In anesthetized male Sprague-Dawley rats, a stainless steel recording electrode with an attached microinjector was placed into CA1 and the dentate gyrus to record fEPSP, and a paired stainless steel electrode was inserted into entorhinal cortex for continuous paired-pulse stimulation of that brain region. In the dentate gyrus, microinjection of BDNF resulted in a gradual increase in the peak slope of the fEPSP. Following the infusion, the peak fEPSP began to rise in about 8 min, reached a maximum of 120 ± 2% (from baseline) by about 20 min, and remained near peak elevation (~115%) for more than 30 min. In contrast, the same dose of BDNF when injected into CA1 had no consistent effect on fEPSP slopes in the CA1. Further, an equimolar cytochrome C (horse heart) infusion had no significant effect on fEPSP slopes in either the dentate gyrus or CA1. The potentiation effect of BDNF in the dentate gyrus is consistent with a significant increase in power spectral density of dentate gyrus field potentials at 70-200 Hz, but not at frequencies below 70 Hz. In addition, the CA1 power spectral density was not affected by BDNF (compared to cytochrome C). These data indicate that in vivo BDNF potentiates entorhinal-hippocampal synaptic transmission in dentate gyrus, but not in CA1.

In vivo biocompatibility of diamond-like carbon films containing TiO2 nanoparticles for biomedical applications

Hybrid diamond-like carbon (DLC) with incorporated titanium dioxide (TiO₂) nanoparticle coatings have low friction coefficient, high wear resistance, high hardness, biocompatibility, and high chemical stability. They could be employed to modify biomedical alloys surfaces for numerous applications in biomedical engineering. Here we investigate for the first time the in vivo inflammatory process of DLC coatings with incorporated TiO₂ nanoparticles. TiO₂-DLC films were grown on AISI 316 stainless-steel substrates using plasma-enhanced chemical vapor deposition. The coated substrates were implanted in CF1 mice peritoneum. The in vivo cytotoxicity and biocompatibility of the samples were analyzed from macrophage lavage. Analysis in the first weeks after implantation could be helpful to evaluate the acute cytotoxicity generated after a possible inflammatory process. The in vivo results showed no inflammatory process. A significant increase in nitric oxide production on the uncoated substrates was confirmed through cytometry, and the coated substrates demonstrated biocompatibility. The presence of TiO₂ nanoparticles enhanced the wound healing activity, due to their astringent and antimicrobial properties. DLC and TiO₂-DLC coatings were considered biocompatible, and the presence of TiO₂ nanoparticles reduced the inflammatory reactions, increasing DLC biocompatibility.

Anticorrosive and Microbial Inhibition Performance of a Coating Loaded with Andrographis paniculata on Stainless Steel in Seawater

With the trend for green technology, the study focused on utilizing a forgotten herb to produce an eco-friendly coating. Andrographis paniculata or the kalmegh leaves extract (KLE) has been investigated for its abilities in retarding the corrosion process due to its excellent anti-oxidative and antimicrobial properties. Here, KLE was employed as a novel additive in coatings and formulations were made by varying its wt%: 0, 3, 6, 9, and 12. These were applied to stainless steel 316L immersed in seawater for up to 50 days. The samples were characterized and analyzed to measure effectiveness of inhibition of corrosion and microbial growth. The best concentration was revealed to be 6 wt% KLE; it exhibited the highest performance in improving the ionic resistance of the coating and reducing the growth of bacteria.

Surface Roughness of Cu-Bearing Stainless Steel Affects Its Contact-Killing Efficiency by Mediating the Interfacial Interaction with Bacteria

Numerous studies have found that the surface topography affects the material antibacterial properties by reducing the attachment of bacteria on the surfaces without influencing the viability of the adhered cells. For Cu-bearing alloys with excellent contact-killing properties, bacterial adhesion on the surface is also accompanied by short-range interactions which regulate the toxic effects of the material surface against bacterial cells. Thus, the surface topography of Cu-bearing alloys, as an important factor dominating the exposure level of bacteria on the surfaces, should affect the subsequent contact-killing efficiency. In this work, our major focus was on the regulation mechanism of the surface features on the material-bacterial interactions. We correlated the surface properties including different surface roughnesses of Cu-bearing stainless steel (SS) with the bacterial damage pattern and attempted to clarify the role of surface roughness in mediating the contact-killing behavior of Cu-bearing SS. The results of both atomic force microscopy and scanning electron microscopy investigations showed that E. coli cells experienced the most rapid physical and mechanical damages after incubating with the diamond-polished Cu-bearing SS surface. The bacterial cells noticeably stiffened and the adhesion force significantly increased, as evidenced by force-distance curve measurements. Because of the enhanced hydrophobicity and higher surface potential of the diamond-polished surface, which strengthened the Lewis acid-base attractive forces and weakened the electrostatic barrier between the bacteria and the surface, a higher exposure surface for bacteria was generated. Furthermore, the contact-induced charge transfer, manifested by Cu ion burst release, and reactive oxygen species overexpression contribute to an efficient contact-killing process.

Nosocomial pathogen biofilms on biomaterials: Different growth medium conditions and components of biofilms produced in vitro

BACKGROUND/PURPOSE (S)

Nosocomial pathogens can develop biofilms on hospital surfaces and medical devices; however, few studies have focused on the evaluation of mono-and dual-species biofilms developed by nosocomial pathogens under different growth conditions.

METHODS

This study investigated biofilm development by nosocomial pathogens (Acinetobacter baumannii, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa) on biomaterials in different culture media and their components of the extracellular matrix biofilm.

RESULTS

The mono-species biofilms showed cell densities from 7.50 to 9.27 Log₁₀ CFU/cm² on natural rubber latex type I (NLTI) and from 7.58 to 8.79 Log₁₀ CFU/cm² on stainless steel (SS). Dual-species biofilms consisted of S. aureus + P. aeruginosa (7.87-8.27 Log₁₀ CFU/cm² in TSBP and TSBME onto SS; p < 0.05), E. coli + P. aeruginosa (8.32-8.86 Log₁₀ CFU/cm² in TSBME onto SS and TSBP onto NLTI; p < 0.05), and S. aureus + E. coli (7.82 Log₁₀ CFU/cm² in TSBME onto SS; p < 0.05). Furthermore, biofilm detachment after proteinase K treatment was 5.54-32.81% compared to 7.95-24.15% after DNase I treatment in the mono-dual species biofilm matrix. Epifluorescence microscopy and scanning electron microscopy (SEM) enabled visualizing the bacteria and extracellular polymeric substances of biofilms on SS and NLTI.

CONCLUSION

Nosocomial pathogens can develop biofilms on biomaterials. Mono-species biofilms of Gram-negative bacteria showed lower densities than dual-species biofilms in TSBME and TSBP. Additionally, dual-species biofilms showed a higher concentration of proteins and eDNA in the extracellular matrix.

Stability and bioactivity of pepCD47 attachment on stainless steel surfaces

In-stent restenosis (ISR) and late stent thrombosis are the major complications associated with the use of metal stents and drug eluting stents respectively. Our lab previously investigated the use of peptide CD47 in improving biocompatibility of bare metal stents in a rat carotid stent model and our results demonstrated a significant reduction in platelet deposition and ISR. However, this study did not characterize the stability of the pepCD47 on metal surfaces post storage, sterilization and deployment. Thus, the objective of the present study was 1) to test the stability of the peptide post - storage, sterilization, exposure to shear and mechanical stress and 2) to begin to expand our current knowledge of pepCD47 coated metal surfaces into the preclinical large animal rabbit model. Our results show that the maximum immobilization density of pepCD47 on metal surfaces is approximately 350 ng/cm². 100% of the pepCD47 was retained on the metal surface post 24 weeks of storage at 4 °C, exposure to physiological shear stress, and mechanical stress of stent expansion. The bioactivity of the pepCD47 was found to be intact post 24 weeks of storage and ethylene oxide sterilization. Finally our ex vivo studies demonstrated that compared to bare metal the rabbit pepCD47 coated surfaces showed - 45% reduced platelet adhesion, a 10-fold decrease in platelet activation, and 93% endothelial cell retention. Thus, our data suggests that pepCD47 coating on metal surfaces is stable and rabbit pepCD47 shows promising preliminary results in preventing thrombosis and not inhibiting the growth of endothelial cells. STATEMENT OF SIGNIFICANCE: Biocompatibility of bare metal stents is a major challenge owing to the significantly high rates of in-stent restenosis. Previously we demonstrated that peptide CD47 functionalization improves the biocompatibility of bare metal stents in rat model. A similar trend was observed in our ex vivo studies where rabbit blood was perfused over the rabbit pepCD47 functionalized surfaces. These results provide valuable proof of concept data for future in vivo rabbit model studies. In addition, we investigated stability of the pepCD47 on metal surface and observed that pepCD47 coating is stable over time and resistant to industrially relevant pragmatic challenges.

Tailoring Surface Hydrophilicity Property for Biomedical 316L and 304 Stainless Steels: A Special Perspective on Studying Osteoconductivity and Biocompatibility

Stainless steels used as metal implants in the medical field have been attracting intensive attention due to their advantages in mechanical properties, anticorrosion properties, and cost effectiveness. Good osteoconductivity, low toxicity, and low inflammatory reactions are essential to stainless steel implant in vivo. However, there are few cases about the surface modification performed for enhancing the corrosion resistance, and there are few researches on the relationship between the surface properties of stainless steel and osteoconductivity when used as implants. This study employed 316L and 304 stainless steel for surface modification including hydrothermal treatment after acid immersion and anodizing treatment, while the as-polished stainless steel was used as a control group. Anticorrosion properties, protein adsorption properties, osteoconductivity, and anti-inflammation property of these specimens were intensively investigated in vitro and in vivo. It was found that specimen subjected to hydrothermal treatment at 230 °C after immersion in 18 M H₂SO₄ had the lowest metal ions release, while the anodized specimen had the highest release of Fe and Cr due to corrosion. The protein adsorption amount of the specimens was positively related to the osteoconductivity, suggesting protein adsorption is the prerequisite for good osteoconductivity. The osteoconductivity decreased first and then increased with the increase in water contact angle (WCA) value. The specimen with the surface modified by hydrothermal treatment after acid immersion had the highest protein adsorption amount and the best osteoconductivity due to its superhydrophilicity property. The protein adsorption capacity and osteoconductivity for stainless steel tended to be the same as Ti alloys studied before, indicating the surface hydrophilicity property of the implanted metals was the dominant factor affecting the osteoconductivity. From an anti-inflammation perspective, the specimen with the surface modified by hydrothermal treatment after acid immersion also exhibited the lowest thickness of the fibrous capsule membrane from the in vivo tests, suggesting its advantageous biocompatibility. Thus, this research can provide new insight into the application of austenitic stainless steel for implanted material purposes.

Reduction of Escherichia Coli Using Metal Plates with the Influenced of Applied Low Current and Physical Barrier of Filter Layers

Although metal contact is known to reduce bacterial growth, the effects of physical barriers and electricity need further investigation. This study examined the bacteria-reducing properties of copper and stainless-steel metal plates with an added electrical current and up to three filter layers on the growth of Escherichia coli (bacteria) and MS2 bacteriophages (virus). When used with a stainless-steel plate, electricity increased bacteria reduction by 39.5 ± 2.30% in comparison with no electricity added, whereas a three-layer physical barrier decreased its efficiency. Copper also reduced the growth of bacteria, by 58.2 ± 8.23%, and the addition of electricity reduced it further (79.5 ± 2.34%). Bacteriophages were also affected by the metal contact. Further experiments showed that MS2 was also reduced by copper, to 82.9 ± 4.5% after 24 h at 37 °C.

P2000 - A high-nitrogen austenitic steel for application in bone surgery

Optimal treatment of bone fractures with minimal complications requires implant alloys that combine high strength with high ductility. Today, TiAl6V4 titanium and 316L steel are the most applied alloys in bone surgery, whereas both share advantages and disadvantages. The nickel-free, high-nitrogen austenitic steel X13CrMnMoN18-14-3 (1.4452, brand name: P2000) exhibits high strength in combination with superior ductility. In order to compare suitable alloys for bone implants, we investigated titanium, 316L steel, CoCrMo and P2000 for their biocompatibility and hemocompatibility (according to DIN ISO 10993-5 and 10993-4), cell metabolism, mineralization of osteoblasts, electrochemical and mechanical properties. P2000 exhibited good biocompatibility of fibroblasts and osteoblasts without impairment in vitality or changing of cell morphology. Furthermore, investigation of the osteoblasts function by ALP activity and protein levels of the key transcription factor RUNX2 revealed 2x increased ALP activity and more than 4x increased RUNX2 protein levels for P2000 compared to titanium or 316 steel, respectively. Additionally, analyses of osteoblast biomineralization by Alizarin Red S staining exhibited more than 6x increased significant mineralization of osteoblasts grown on P2000 as compared to titanium. Further, P2000 showed no hemolytic effect and no significant influence on hemocompatibility. Nanoindentation hardness tests of Titanium and 316L specimens exposed an indentation hardness (HIT) of about 4 GPa, whereas CoCrMo and P2000 revealed HIT of 7.5 and 5.6 GPa, respectively. Moreover, an improved corrosion resistance of P2000 compared to 316L steel was observed. In summary, we could demonstrate that the nickel-free high-nitrogen steel P2000 appears to be a promising alternative candidate for applications in bone surgery. As to nearly all aspects like biocompatibility and hemocompatibility, cell metabolism, mineralization of osteoblasts and mechanical properties, P2000 was similar to or revealed advantages against titanium, 316L or CoCrMo.

Antibacterial durability and biocompatibility of antibacterial-passivated 316L stainless steel in simulated physiological environment

Stainless steel (SS) has been widely applied as one of the most efficient implant metal materials, although corrosion and infection in body environment are still challenging. Herein, an antibacterial passivation method was employed to enhance the antibacterial performance and corrosion resistance of the medical 316L SS. The result proved that the antibacterial-passivated 316L SS exhibited stable antibacterial activity and effectively inhibited the formation of bacterial biofilm. Electrochemical measurements combined with X-ray photoelectron spectroscopy technique were used to study the corrosion resistance and semiconductor behavior of passivated 316L SS immersed in simulated physiological environment. The results indicated that the 316L SS after antibacterial passivation treatment for 1 h, soaking in the medium for 10 days, showed satisfactory corrosion resistance attributing to proper Cu deposition in the passive film. The anodic stripping voltammetry measurement further confirmed that the Cu-bearing passive film could continuously release Cu ions into medium. The zebrafish test demonstrated an excellent in vivo biocompatibility for the 316L SS with antibacterial passivation for 0.5 and 1 h, respectively. In addition, changes of surface roughness, contact angle and chemical composition after antibacterial passivation played an important role in explaining the antibacterial mechanism, which could be clearly divided into contact killing and ionic release killing. Hence, the antibacterial passivation treatment was preliminarily proved as a potential way for enhancing the persistent antibacterial activity and corrosion resistance of 316L SS.

Pure and Oxidized Copper Materials as Potential Antimicrobial Surfaces for Spaceflight Activities

Microbial biofilms can lead to persistent infections and degrade a variety of materials, and they are notorious for their persistence and resistance to eradication. During long-duration space missions, microbial biofilms present a danger to crew health and spacecraft integrity. The use of antimicrobial surfaces provides an alternative strategy for inhibiting microbial growth and biofilm formation to conventional cleaning procedures and the use of disinfectants. Antimicrobial surfaces contain organic or inorganic compounds, such as antimicrobial peptides or copper and silver, that inhibit microbial growth. The efficacy of wetted oxidized copper layers and pure copper surfaces as antimicrobial agents was tested by applying cultures of Escherichia coli and Staphylococcus cohnii to these metallic surfaces. Stainless steel surfaces were used as non-inhibitory control surfaces. The production of reactive oxygen species and membrane damage increased rapidly within 1 h of exposure on pure copper surfaces, but the effect on cell survival was negligible even after 2 h of exposure. However, longer exposure times of up to 4 h led to a rapid decrease in cell survival, whereby the survival of cells was additionally dependent on the exposed cell density. Finally, the release of metal ions was determined to identify a possible correlation between copper ions in suspension and cell survival. These measurements indicated a steady increase of free copper ions, which were released indirectly by cells presumably through excreted complexing agents. These data indicate that the application of antimicrobial surfaces in spaceflight facilities could improve crew health and mitigate material damage caused by microbial contamination and biofilm formation. Furthermore, the results of this study indicate that cuprous oxide layers were superior to pure copper surfaces related to the antimicrobial effect and that cell density is a significant factor that influences the time dependence of antimicrobial activity. Key Words: Contact killing-E. coli-S. cohnii-Antimicrobial copper surfaces-Copper oxide layers-Human health-Planetary protection. Astrobiology 17, 1183-1191.

Peptide-functionalized poly[oligo(ethylene glycol) methacrylate] brushes on dopamine-coated stainless steel for controlled cell adhesion

The modification of the surface of surgical implants with cell adhesion ligands has emerged as a promising approach to improve biomaterial-host interactions. However, these approaches are limited by the non-specific adsorption of biomolecules and uncontrolled presentation of desired bioactive ligands on implant surfaces. This leads to sub-optimal integration with host tissue and delayed healing. Here we present a strategy to grow non-fouling polymer brushes of oligo(ethylene glycol) methacrylate by atom transfer radical polymerization from dopamine-functionalized clinical grade 316 stainless steel. These brushes prevent non-specific adsorption of proteins and attachment of cells. Subsequently, the brushes can be modified with covalently tethered adhesive peptides that provide controlled cell adhesion. This approach may therefore have broad application to promote bone growth and improvements in osseointegration.

STATEMENT OF SIGNIFICANCE

Stainless steel (SS) implants are widely used clinically for orthopaedic, spinal, dental and cardiovascular applications. However, non-specific adsorption of biomolecules onto implant surfaces results in sub-optimal integration with host tissue. To allow controlled cell-SS interactions, we have developed a strategy to grow non-fouling polymer brushes that prevent protein adsorption and cell adhesion and can be subsequently functionalized with adhesive peptides to direct cell adhesion and signaling. This approach has broad application to improve osseointegration onto stainless steel implants in bone repair.

Surface modification of esophageal stent materials by a polyethylenimine layer aiming at anti-cancer function

Esophageal cancer is difficult to cure globally and possesses high mortality rate, and it is generally accepted that palliative care such as stent implantation is the main therapy method for esophageal cancer in later period. However, the restenosis caused by tumor cells and inflammatory cells seriously interferes the stent clinical application and limits its long-term services. To solve this problem, series of drug delivery stents were developed and proven rather effective in the early stage of implantation, but more serious restenosis occurred after the drug delivery was over, which endangered the patients' life. Therefore, endowing the esophageal stent continuous anti-cancer function become an ideal strategy for inhibiting the restenosis. In this contribution, the functional layer composed of polydopamine (PDA) and Poly-ethylenimine (PEI) with series of molecular weights (MW, 1.8 × 10³, 1 × 10⁴, 2.5 × 10⁴ and 7 × 10⁴ Da) were fabricated onto the esophageal stent material 317L stainless steel (317L SS) surface. The surface characterization including amine quantitative, atomic force microscopy (AFM) and water contact angle measurement indicated successful preparation of the PDA/PEI layer. The Eca109 cells culture results proved that the PDA/PEI layers significantly improve Eca109 cells apoptosis and necrosis, suggesting excellent anti-cancer function. In addition, we also found that the anti-cancer function of the PDA/PEI layers was positively correlated to the immobilized PEIs' MW. All the results demonstrated the potential application of the PDA/PEI layers on the surface modification of esophageal stent for continuous anti-cancer function. It is generally accepted that the restenosis caused by tumor cells seriously interferes the esophageal stent clinical application. Thus, endowing the esophageal stent continuous anti-cancer function is the ideal strategy for inhibiting the restenosis. In this work, we fabricated functional layers composed of polydopamine (PDA) and Poly-ethylenimine (PEI) with series of molecular weights (MW, 1.8 × 10³, 1 × 10⁴, 2.5 × 10⁴ and 7 × 10⁴ Da) onto the esophageal stent material 317L stainless steel (317L SS) surface to inhibit the tumor cells growth, and this function was related to the PEIs' molecular weights. The functional PDA/PEI layers were expected potentially applied for surface modification of esophageal stent materials.

Variations in biofilm formation, desiccation resistance and Benzalkonium chloride susceptibility among Listeria monocytogenes strains isolated in Canada

Listeria monocytogenes is a pathogenic foodborne microorganism noted for its ability to survive in the environment and food processing facilities. Survival may be related to the phenotype of individual strains including the ability to form biofilms and resist desiccation and/or sanitizer exposure. The objectives of this research were to compare 14 L. monocytogenes strains isolated from blood (3), food (6) and water (5) with respect to their benzalkonium chloride (BAC) sensitivity, desiccation resistance, and ability to form biofilm. Correlations were tested between those responses, and the presence of the SSI-1 (Stress Survival Islet) and LGI1/CC8 (Listeria Genomic Island 1 in a clonal complex 8 background) genetic markers. Genetic sequences from four strains representing different phenotypes were also probed for predicted amino acid differences in biofilm, desiccation, and membrane related genes. The water isolates were among the most desiccation susceptible strains, while strains exhibiting desiccation resistance harboured SSI-1 or both the SSI-1 and LGI1/CC8 markers. BAC resistance was greatest in planktonic LGI1/CC8 cells (relative to non-LGI1/CC8 cells), and higher BAC concentrations were also needed to inhibit the formation of biofilm by LGI1/CC8 strains during incubation for 48h and 6days compared to other strains. Formation of biofilm on stainless steel was not significantly (p>0.05) different among the strains. Analysis of genetic sequence data from desiccation and BAC sensitive (CP4 5-1, CP5 2-3, both from water), intermediate (Lm568, food) and desiccation and BAC resistant (08 5578, blood, human outbreak) strains led to the finding of amino acid differences in predicted functional protein domains in several biofilm, desiccation and peptidoglycan related genes (e.g., lmo0263, lmo0433, lmo0434, lmo0771, lmo0973, lmo1080, lmo1224, lmo1370, lmo1744, and lmo2558). Notably, the LGI1/CC8 strain 08-5578 had a frameshift mutation in lmo1370, a gene previously associated with desiccation resistance. In conclusion, the more desiccation and BAC resistant LGI1/CC8 isolates may pose a challenge for sanitation efforts.

Mg-Doped Hydroxyapatite/Chitosan Composite Coated 316L Stainless Steel Implants for Biomedical Applications

In this investigation, ultrasonication process was used for the synthesis of magnesium doped nano-hydroxyapatite (MH) (0, 1, 2, and 3 mol% of Mg concentration) particles with controlled size and surface morphology. The size of the prepared MH particles was in the range of 20-100 nm with narrow distribution. Increase in the concentration of Mg reduced the particle size distribution from 60 to 40 nm. On incorporation of Mg in HAp lattice, an increase of 20-66 nm in specific surface area was observed in microporous HAp particles. XRF and XRD patterns reveal that the particles possess stoichiometric composition with reduced crystallinity with respect to the Mg concentration. Surface morphology of MH/chitosan (CTS) coated implant was found to be uniform without any defects. The corrosion rate of the implant decreased with increase in Mg concentration. The in vitro formation of bonelike apatite layer on the surface of the MH/CTS coated implant was observed from simulated body fluid studies. The antimicrobial activity of the MH/CTS composites against gram-positive and gram-negative bacterial strains indicated that increasing Mg concentration enhanced antimicrobial properties. Nanoindentation analysis of apatite coated implant surface reveals that the mechanical property depends on the concentration of magnesium in HAp. From the cytotoxicity analysis against NIH 3T3 fibroblast, it was observed that the Mg incorporated HAp/CTS composite was less toxic than the MHO/CTS composite. From this result, it was concluded that the MH/CTS nanocomposites coated implant is the excellent material for implants.

Enhancing the mechanical and biological performance of a metallic biomaterial for orthopedic applications through changes in the surface oxide layer by nanocrystalline surface modification

Nanostructured metals are a promising class of biomaterials for application in orthopedics to improve the mechanical performance and biological response for increasing the life of biomedical implants. Surface mechanical attrition treatment (SMAT) is an efficient way of engineering nanocrystalline surfaces on metal substrates. In this work, 316L stainless steel (SS), a widely used orthopedic biomaterial, was subjected to SMAT to generate a nanocrystalline surface. Surface nanocrystallization modified the nature of the oxide layer present on the surface. It increased the corrosion-fatigue strength in saline by 50%. This increase in strength is attributed to a thicker oxide layer, residual compressive stresses, high strength of the surface layer, and lower propensity for intergranular corrosion in the nanocrystalline layer. Nanocrystallization also enhanced osteoblast attachment and proliferation. Intriguingly, wettability and surface roughness, the key parameters widely acknowledged for controlling the cellular response remained unchanged after nanocrystallization. The observed cellular behavior is explained in terms of the changes in electronic properties of the semiconducting passive oxide film present on the surface of 316L SS. Nanocrystallization increased the charge carrier density of the n-type oxide film likely preventing denaturation of the adsorbed cell-adhesive proteins such as fibronectin. In addition, a net positive charge developed on the otherwise neutral oxide layer, which is known to facilitate cellular adhesion. The role of changes in the electronic properties of the oxide films on metal substrates is thus highlighted in this work. This study demonstrates the advantages of nanocrystalline surface modification by SMAT for processing metallic biomaterials used in orthopedic implants.

Inactivation of foodborne microorganisms using engineered water nanostructures (EWNS)

Foodborne diseases caused by the consumption of food contaminated with pathogenic microorganisms or their toxins have very serious economic and public health consequences. Here, we explored the effectiveness of a recently developed intervention method for inactivation of microorganisms on fresh produce, and food production surfaces. This method utilizes Engineered Water Nanostructures (EWNS) produced by electrospraying of water vapor. EWNS possess unique properties; they are 25 nm in diameter, remain airborne in indoor conditions for hours, contain Reactive Oxygen Species (ROS) and have very strong surface charge (on average 10 e/structure). Here, their efficacy in inactivating representative foodborne bacteria such as Escherichia coli, Salmonella enterica, and Listeria innocua, on stainless steel surfaces and on organic tomatoes, was assessed. The inactivation was facilitated using two different exposure approaches in order to optimize the delivery of EWNS to bacteria: (1) EWNS were delivered on the surfaces by diffusion and (2) a "draw through" Electrostatic Precipitator Exposure System (EPES) was developed and characterized for EWNS delivery to surfaces. Using the diffusion approach and an EWNS concentration of 24,000 #/cm3, the bacterial concentrations on the surfaces were reduced, depending on the bacterium and the surface type, by values ranging between 0.7 to 1.8 logs. Using the EPES approach and for an aerosol concentration of 50,000 #/cm3 at 90 min of exposure, results show a 1.4 log reduction for E. coli on organic tomato surfaces, as compared to the control (same conditions in regards to temperature and Relative Humidity). Furthermore, for L. innocua, the dose-response relationship was demonstrated and found to be a 0.7 and 1.2 logs removal at 12,000 and 23,000 #/cm3, respectively. The results presented here indicate that this novel, chemical-free, and environmentally friendly intervention method holds potential for development and application in the food industry, as a "green" alternative to existing disinfection methods.

[The biocompatibility testing of various types of nonorganic implants]

Impact of living organism on nonorganic materials, which are applied for the implants manufacturing, was studied. There was established, that organism of a recipient patient actively effects on exogenic material, destroying its superficial layer and forming the connective tissue capsule around the implant. The implant surface may start to dissolve selectively as a result of aseptic inflammation, keeping around, in such a situation it become necessary to remove the prostheses, which have lost their function. Impact of organism on surface of different implants of nonorganic origin and the ways of it prophylaxis were investigated. Instrumental method of the preoperative compatibility testing between a recipient organism and the implant material, using the atomic-power microscope, was proposed.

Enhanced performance of sulfate reducing bacteria based biocathode using stainless steel mesh on activated carbon fabric electrode

An anoxic biocathode was developed using sulfate-reducing bacteria (SRB) consortium on activated carbon fabric (ACF) and the effect of stainless steel (SS) mesh as additional current collector was investigated. Improved performance of biocathode was observed with SS mesh leading to nearly five folds increase in power density (from 4.79 to 23.11 mW/m(2)) and threefolds increase in current density (from 75 to 250 mA/m(2)). Enhanced redox currents and lower Tafel slopes observed from cyclic voltammograms of ACF with SS mesh indicated the positive role of uniform electron collecting points. Differential pulse voltammetry technique was employed as an additional tool to assess the redox carriers involved in bioelectrochemical reactions. SRB biocathode was also tested for reduction of volatile fatty acids (VFA) present in the fermentation effluent stream and the results indicated the possibility of integration of this system with anaerobic fermentation for efficient product recovery.

Process of prototyping coronary stents from biodegradable Fe-Mn alloys

Biodegradable stents are considered to be a recent innovation, and their feasibility and applicability have been proven in recent years. Research in this area has focused on materials development and biological studies, rather than on how to transform the developed biodegradable materials into the stent itself. Currently available stent technology, the laser cutting-based process, might be adapted to fabricate biodegradable stents. In this work, the fabrication, characterization and testing of biodegradable Fe-Mn stents are described. A standard process for fabricating and testing stainless steel 316L stents was referred to. The influence of process parameters on the physical, metallurgical and mechanical properties of the stents, and the quality of the produced stents, were investigated. It was found that some steps of the standard process such as laser cutting can be directly applied, but changes to parameters are needed for annealing, and alternatives are needed to replace electropolishing.

Pulsed electric field mediated in vitro cellular response of fibroblast and osteoblast-like cells on conducting austenitic stainless steel substrate

This article reports the intermittent pulse electric field stimulus mediated in vitro cellular response of L929 mouse fibroblast/SaOS2 osteoblast-like cells on austenitic steel substrates in reference to the field strength dependent behavior. The cellular density and morphometric analyses revealed that the optimal electric (E) fields for the maximum cell density of adhered L929 (~270 % to that of untreated sample) and SaOS2 (~280 % to that of untreated sample) cells are 1 V (0.33 V/cm) and 2 V (0.67 V/cm), respectively. The trend in aspect ratio of elongated SaOS2 cells did not indicate any significant difference among the untreated and treated (up to 3.33 V/cm) cells. The average cell and nucleus areas (for SaOS2 cells) were increased with an increase in the applied voltage up to 8 V (2.67 V/cm) and reduced thereafter. However, the ratio of nucleus to total cell area was increased significantly on the application of higher voltages (2-10 V), indicating the possible influence of E-field on cell growth. Further, the cell density results were compared with earlier results obtained with sintered Hydroxyapatite (HA) and HA-BaTiO3 composites and such comparison revealed that the enhanced cell density on steel sample occurs upon application of much lower field strength and stimulation time. This indicates the possible role of substrate conductivity towards cell growth in pulsed E-field mediated culture conditions.

Reduction of in-stent restenosis risk on nickel-free stainless steel by regulating cell apoptosis and cell cycle

High nitrogen nickel-free austenitic stainless steel (HNNF SS) is one of the biomaterials developed recently for circumventing the in-stent restenosis (ISR) in coronary stent applications. To understand the ISR-resistance mechanism, we have conducted a comparative study of cellular and molecular responses of human umbilical vein endothelial cells (HUVECs) to HNNF SS and 316L SS (nickel-containing austenitic 316L stainless steel) which is the stent material used currently. CCK-8 analysis and flow cytometric analysis were used to assess the cellular responses (proliferation, apoptosis, and cell cycle), and quantitative real-time PCR (qRT-PCR) was used to analyze the gene expression profile of HUVECs exposed to HNNF SS and 316L SS, respectively. Flow cytometry analysis revealed that 316L SS could activate the cellular apoptosis more efficiently and initiate an earlier entry into the S-phase of cell cycle than HNNF SS. At the molecular level, qRT-PCR results showed that the genes regulating cell apoptosis and autophagy were overexpressed on 316L SS. Further examination indicated that nickel released from 316L SS triggered the cell apoptosis via Fas-Caspase8-Caspase3 exogenous pathway. These molecular mechanisms of HUVECs present a good model for elucidating the observed cellular responses. The findings in this study furnish valuable information for understanding the mechanism of ISR-resistance on the cellular and molecular basis as well as for developing new biomedical materials for stent applications.

[In vitro evaluation of antibacterial activity and cytocompatibility of antibacterial stainless steel containing copper]

To study the in vitro antibacterial activity and biocompatibility of 317L stainless steel containing 4.5% copper alloy (317L-Cu), we produced 317L-Cu stainless steel with epsilon-Cu phase. The cell proliferation of osteoblasts on material surface was detected in vitro. Escherichia coli was cultured with 317L-Cu for evaluating the antibacterial activity. We found that the 317L-Cu could effectively kill the Escherichia coli on material surface. The cell proliferation of osteoblasts on material surface was not different significantly, compared with titanium material. Our study clearly demonstrated that the 317L-Cu alloys had a significant antimicrobial activity and was biocompatible in vitro, so it would be suitable to be used as a new medical material with antibacterial activity.

Antibacterial effect of 317L stainless steel contained copper in prevention of implant-related infection in vitro and in vivo

Bone and intramedullary bacterial infections are one of the most serious complications of the surgical repair of fractures. To reduce the incidence of implant-related infections, several biomaterial surface treatments with integrated antibiotics, antiseptics, or metal ions have been developed for implants. In this study, we evaluated the antibacterial activity and biocompatibility of 317L stainless steel containing 4.5% copper alloy (317L-Cu) in vitro and in vivo using an animal model. Common pathogens of implant-related infections are Staphylococcus aureus and Escherichia coli, which were injected into implant materials to study their antimicrobial potential. We compared antimicrobial potential of 317L-Cu with 317L stainless steel (317L) and titanium (Ti-6Al-4V) alloys as controls. Compared with controls, 317L-Cu materials inhibited colonization by both bacteria in vitro and in vivo. Compared with 317L and Ti-6Al-4V controls, 317L-Cu showed no significant difference in colony formation of osteoblast-like cells on metal surfaces after 72 h of incubation in vitro. Metal screws containing these materials were also made for our vivo study in a rabbit model. Tissue-implants were analyzed for infection and inflammatory changes by hematoxylin-eosin staining of implants in bone. The screw tract inflammation and infection of 317L-Cu was minimal, although some inflammatory cells gathered at acutely infected sites. In addition, after materials had been implanted for 14 days in vivo, the expression of insulin-like growth factor-1 (IGF-1) in osteoblasts around 317L-Cu screws tracts had increased compared with 317L and Ti-6Al-4V controls. Overall, 317L-Cu demonstrated strong antimicrobial activity and biocompatibility in vitro and in vivo and may be used as a biomaterial to reduce implant-related infections.

Effect of food residues on norovirus survival on stainless steel surfaces

Background

In households and food processing plants, minute food residues left behind from improper cleaning may influence the survivability of human norovirus on surfaces. In this study, the survivability of norovirus on desiccated food residue-attached stainless steel coupons was investigated.

Methodology/Principal Findings

Using murine norovirus-1 (MNV-1) as a surrogate of human norovirus, the survivability of norovirus was investigated on lettuce, cabbage, or ground pork-attached stainless steel coupons. A 6.2 log MPN/ml of MNV-1 infectivity was completely lost at day 30 in residue-free coupons, whereas only a 1.4 log MPN/ml reduction was observed in coupons with residues. Moreover, the disinfective effect of sodium hypochlorite was reduced when residues were present on the coupons.

Conclusions/Significance

This study revealed that the food residues increased the survivability and the resistance to chemicals of norovirus, indicating the need of thorough cleaning in food processing plants and household settings.

Lysozyme-coupled poly(poly(ethylene glycol) methacrylate)-stainless steel hybrids and their antifouling and antibacterial surfaces

An environmentally benign approach to impart stainless steel (SS) surfaces with antifouling and antibacterial functionalities was described. Surface-initiated atom transfer radical polymerization (ATRP) of poly(ethylene glycol) monomethacrylate) (PEGMA) from the SS surface-coupled catecholic L-3,4-dihydroxyphenylalanine (DOPA) with terminal alkyl halide initiator was first carried out, followed by the immobilization of lysozyme at the chain ends of poly(ethylene glycol) branches of the grafted PEGMA polymer brushes. The functionalized SS surfaces were shown to be effective in preventing bovine serum albumin (BSA) adsorption and in reducing bacterial adhesion and biofilm formation. The surfaces also exhibited good bactericidal effects against Escherichia coli and Staphylococcus aureus. The concomitant incorporation of antifouling hydrophilic brushes and antibacterial enzymes or peptides onto metal surfaces via catecholic anchors should be readily adaptable to other metal substrates, and is potentially useful for biomedical and biomaterial applications.

The Otto Aufranc Award: enhanced biocompatibility of stainless steel implants by titanium coating and microarc oxidation

BACKGROUND

Stainless steel is one of the most widely used biomaterials for internal fixation devices, but is not used in cementless arthroplasty implants because a stable oxide layer essential for biocompatibility cannot be formed on the surface. We applied a Ti electron beam coating, to form oxide layer on the stainless steel surface. To form a thicker oxide layer, we used a microarc oxidation process on the surface of Ti coated stainless steel. Modification of the surface using Ti electron beam coating and microarc oxidation could improve the ability of stainless steel implants to osseointegrate.

QUESTIONS/PURPOSES

The ability of cells to adhere to grit-blasted, titanium-coated, microarc-oxidated stainless steel in vitro was compared with that of two different types of surface modifications, machined and titanium-coated, and microarc-oxidated.

METHODS

We performed energy-dispersive x-ray spectroscopy and scanning electron microscopy investigations to assess the chemical composition and structure of the stainless steel surfaces and cell morphology. The biologic responses of an osteoblastlike cell line (SaOS-2) were examined by measuring proliferation (cell proliferation assay), differentiation (alkaline phosphatase activity), and attraction ability (cell migration assay).

RESULTS

Cell proliferation, alkaline phosphatase activity, migration, and adhesion were increased in the grit-blasted, titanium-coated, microarc-oxidated group compared to the two other groups. Osteoblastlike cells on the grit-blasted, titanium-coated, microarc-oxidated surface were strongly adhered, and proliferated well compared to those on the other surfaces.

CONCLUSIONS

The surface modifications we used (grit blasting, titanium coating, microarc oxidation) enhanced the biocompatibility (proliferation and migration of osteoblastlike cells) of stainless steel.

CLINICAL RELEVANCE

This process is not unique to stainless steel; it can be applied to many metals to improve their biocompatibility, thus allowing a broad range of materials to be used for cementless implants.

Surface immobilized zoledronate improves screw fixation in rat bone: a new method for the coating of metal implants

Previous studies show that surface immobilized bisphosphonates improve the fixation of stainless steel screws in rat tibia after 2-8 weeks of implantation. We report here about the immobilization of a potent bisphosphonate, zoledronate, to crosslinked fibrinogen by the use of another technique, i.e. ethyl-dimethyl-aminopropylcarbodiimide (EDC)/imidazole immobilization. Bone fixation of zoledronate-coated screws was compared to screws coated with crosslinked fibrinogen only and ditto with EDC/N-hydroxy-succinimide immobilized pamidronate. Fixation in rat tibia was evaluated by a pull-out test at either 2 or 6 weeks after implantation. Both bisphosphonate coatings increased the pull-out force at both time points, and zoledronate showed a significantly higher pull-out force than pamidronate. To further evaluate the new coating technique we also performed a morphometric study, focusing on the area surrounding the implant. The zoledronate coating resulted in an increased bone density around the screws compared to controls. No pronounced increase was seen around the pamidronate coated screws. Together, the results demonstrate the possibility of obtaining a significant local therapeutic effect with minute amounts of surface immobilized zoledronate.

Antibacterial inorganic-organic hybrid coatings on stainless steel via consecutive surface-initiated atom transfer radical polymerization for biocorrosion prevention

To enhance the corrosion resistance of stainless steel (SS) and to impart its surface with antibacterial functionality for inhibiting biofilm formation and biocorrosion, well-defined inorganic-organic hybrid coatings, consisting of a polysilsesquioxane inner layer and quaternized poly(2-(dimethyamino)ethyl methacrylate) (P(DMAEMA)) outer blocks, were prepared via successive surface-initiated atom transfer radical polymerization (ATRP) of 3-(trimethoxysilyl)propyl methacrylate (TMSPMA) and 2-(dimethylamino)ethyl methacrylate (DMAEMA). The cross-linked P(TMASPMA), or polysilsesquioxane, inner layer provided a durable and resistant coating to electrolytes. The pendant tertiary amino groups of the P(DMAEMA) outer block were quaternized with alkyl halide to produce a high concentration of quaternary ammonium groups with biocidal functionality. The so-synthesized inorganic-organic hybrid coatings on the SS substrates exhibited good anticorrosion and antibacterial effects and inhibited biocorrosion induced by sulfate-reducing bacteria (SRB) in seawater media, as revealed by antibacterial assay and electrochemical analyses, and they are potentially useful to steel-based equipment under harsh industrial and marine environments.

Using enzymes to remove biofilms of bacterial isolates sampled in the food-industry

The aim of this study was to analyze the cleaning efficiency of polysaccharidases and proteolytic enzymes against biofilms of bacterial species found in food industry processing lines and to study enzyme effects on the composition of extracellular polymeric substances (EPS) and biofilm removal in a Clean-in-Place (CIP) procedure. The screening of 7 proteases and polysaccharidases for removal of biofilms of 16 bacterial species was first evaluated using a microtiter plate assay. The alkaline pH buffer removed more biofilm biomass as well as affecting a larger range of bacterial species. The two serine proteases and alpha-amylase were the most efficient enzymes. Proteolytic enzymes promoted biofilm removal of a larger range of bacterial species than polysaccharidases. Using three isolates derived from two bacterial species widely found in food processing lines (Pseudomonas fluorescens and the Bacillus cereus group), biofilms were developed on stainless steel slides and enzymatic solutions were used to remove the biofilms using CIP procedure. Serine proteases were more efficient in removing cells of Bacillus biofilms than polysaccharidases. However, polysaccharidases were more efficient in removing P. fluorescens biofilms than serine proteases. Solubilization of enzymes with a buffer containing surfactants, and dispersing and chelating agents enhanced the efficiency of polysaccharidases and proteases respectively in removing biofilms of Bacillus and P. fluorescens. A combination of enzymes targeting several components of EPS, surfactants, dispersing and chelating agents would be an efficient alternative to chemical cleaning agents.

Influence of dynamic load on friction behavior of human articular cartilage, stainless steel and polyvinyl alcohol hydrogel as artificial cartilage

Many biomaterials are being developed to be used for cartilage substitution and hemiarthroplasty implants. The lubrication property is a key feature of the artificial cartilage. The frictional behavior of human articular cartilage, stainless steel and polyvinyl alcohol (PVA) hydrogel were investigated under cartilage-on-PVA hydrogel contact, cartilage-on-cartilage contact and cartilage-on-stainless steel contact using pin-on-plate method. Tests under static load, cyclic load and 1 min load change were used to evaluate friction variations in reciprocating motion. The results showed that the lubrication property of cartilage-on-PVA hydrogel contact and cartilage-on-stainless steel contact were restored in both 1 min load change and cyclic load tests. The friction coefficient of PVA hydrogel decreased from 0.178 to 0.076 in 60 min, which was almost one-third of the value under static load in continuous sliding tests. In each test, the friction coefficient of cartilage-on-cartilage contact maintained far lower value than other contacts. It is indicated that a key feature of artificial cartilage is the biphasic lubrication properties.

Load sensing surgical instruments

Force and pressure sensing technology applied to smart surgical instruments as well as implants allow to give a direct feedback of loads to the surgeon lead to better reliability and success of surgical operations. A common technology used for sensors is low-cost piezoresistive thick-film technology. However, the standard thick-film firing conditions degrade the properties of medical alloys. In order to avoid this problem, the solution is to decrease the firing temperature of thick films. This work presents the development and characterisation of low-firing thick-film systems (dielectrics, resistors and conductors), formulated to achieve chemical and thermal expansion compatibility with an austenitic stainless steel medical alloy. Adherence tests and results on electrical properties of these systems: resistance, temperature coefficient of resistance (TCR) are presented. It was found that the main issue in these systems lies in mastering the materials interactions during firing, especially at the silver-based resistor terminations. The interaction of silver, resistor and dielectric tends to give rise to highly resistive zones at the terminations, affecting reliability. This can be circumvented by post-firing the resistor terminations at a moderate temperature.

Human aortic endothelial cell response to 316L stainless steel material microstructure

The role of metal microstructure (e.g. grain sizes) in modulating cell adherence behavior is not well understood. This study investigates the effect of varying grain sizes of 316L stainless steel (SS) on the attachment and spreading of human aortic endothelial cells (HAECs). Four different grain size samples; from 16 to 66 microm (ASTM 9.0-4.9) were sectioned from sheets. Grain structure was revealed by polishing and etching with glycergia. Contact angle measurement was done to assess the hydrophilicity of the specimens. Atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS) were used to characterize the roughness and surface chemistry of the specimens. Cells were seeded on mechanically polished and chemically etched specimens followed by identification of activated focal adhesion sites using fluorescently tagged anti-pFAK (phosphorylated focal adhesion kinase). The 16 microm grain size etched specimens had significantly (P < 0.01) higher number of cells attached per cm(2) than other specimens, which may be attributed to the greater grain boundary area and associated higher surface free energy. This study shows that the underlying material microstructure may influence the HAEC behavior and may have important implications in endothelialization.

An Investigation into the Effect of Surface Roughness of Stainless Steel on Human Umbilical Vein Endothelial Cell Gene Expression

The surface properties of vascular devices dictate the initial postimplantation reactions that occur and thus the efficacy of the implantation procedure. Over the last number of years, a number of different stent designs have emerged and stents are generally polished to a mirror finish during the manufacturing procedure. This study sought to investigate the effect of stainless steel surface roughness on endothelial cell gene expression using an appropriate cell culture in vitro assay system. Stainless steel discs were roughened by shot blasting or polished by mechanical polishing. The surface roughness of the treated and untreated discs was determined by atomic force microscopy (AFM). Cells were seeded on collagen type 1 gels and left to attach for 24 h. Stainless steel discs of varying roughness were then placed in contact with the cells and incubated for 24 h. RNA extractions and quantitative real-time reverse transcriptase-polymerase chain reaction (RT-PCR) was then performed to determine the expression levels of candidate genes in the treated cells compared to suitable control cells. E-selectin and vascular cellular adhesion molecule (VCAM-1) were found to be significantly up-regulated in cells incubated with polished and roughened samples, indicating endothelial cell activation and inflammation. This study indicates that the surface roughness of stainless steel is an important surface property in the development of vascular stents.

[An experimental study on the cytokine expression of macrophage influenced by biomaterials]

This experiment was designed to investigate the influence of two biomaterials, titanium oxide (Ti-O) and stainless steel (SS), on the cytokine expression of macrophage, and further, to evaluate their biocompatibility. After being co-cultured with Ti-O and SS for 72 h, the cell number and morphology of macrophages attached on materials were detected by fluorescent microscope and SEM. Nitride oxide (NO) and monocyte chemoattractant protein 1 (MCP-1) released by the macrophages co-cultured with different materials were also examined and compared. We found that the cell number of macrophages attached to Ti-O was smaller than that attached to SS. The levels of NO and MCP-1 released by the macrophages co-cultured with Ti-O were lower when compared with those released by macrophages co-cultured with SS. These results demonstrate that Ti-O has better biocompatibility than does SS.

Human osteoblast cell spreading and vinculin expression upon biomaterial surfaces

Any biomaterial implanted within the human body is influenced by the interactions that take place between its surface and the surrounding biological milieu. These interactions are known to influence the tissue interface dynamic, and thus act to emphasize the need to study cell-surface interactions as part of any biomaterial design process. The work described here investigates the relationship between human osteoblast attachment, spreading and focal contact formation on selected surfaces using immunostaining and digital image processing for vinculin, a key focal adhesion component. Our observations show that a relationship exists between levels of cell attachment, the degree of vinculin-associated plaque formation and biocompatibility. It also suggests that cell adhesion is not indicative of how supportive a substrate is to cell spreading, and that cell spreading does not correlate with focal contact formation.

Bactericidal Activity of Copper and Niobium–Alloyed Austenitic Stainless Steel

Biofouling and microbiologically influenced corrosion are processes of material deterioration that originate from the attachment of microorganisms as quickly as the material is immersed in a nonsterile environment. Stainless steels, despite their wide use in different industries and as appliances and implant materials, do not possess inherent antimicrobial properties. Changes in hygiene legislation and increased public awareness of product quality makes it necessary to devise control methods that inhibit biofilm formation or to act at an early stage of the biofouling process and provide the release of antimicrobial compounds on a sustainable basis and at effective level. These antibacterial stainless steels may find a wide range of applications in fields, such as kitchen appliances, medical equipment, home electronics, and tools and hardware. The purpose of this study was to obtain antibacterial stainless steel and thus mitigate the microbial colonization and bacterial infection. Copper is known as an antibacterial agent; in contrast, niobium has been demonstrated to improve the antimicrobial effect of copper by stimulating the formation of precipitated copper particles and its distribution in the matrix of the stainless steel. Thus, we obtained slides of 3.8% copper and 0.1% niobium alloyed stainless steel; subjected them to three different heat treatment protocols (550 degrees C, 700 degrees C, and 800 degrees C for 100, 200, 300, and 400 hours); and determined their antimicrobial activities by using different initial bacterial cell densities and suspending solutions to apply the bacteria to the stainless steels. The bacterial strain used in these experiments was Escherichia coli CCM 4517. The best antimicrobial effects were observed in the slides of stainless steel treated at 700 degrees C and 800 degrees C using an initial cell density of approximately 10(5) cells ml(-1) and phosphate-buffered saline as the solution in which the bacteria came into contact with copper and niobium-containing steel.

Potential use of copper surfaces to reduce survival of epidemic meticillin-resistant Staphylococcus aureus in the healthcare environment

Epidemic meticillin-resistant Staphylococcus aureus (EMRSA) emerged in the early 1980s with EMRSA-15 and -16 being the most prevalent strains within the UK. MRSA transmission between patients is largely via the hands of healthcare workers, and contamination of the hospital environment may occur. The objective of this study was to evaluate the effectiveness of copper and brass to reduce the viability of air-dried deposits of three MRSA strains [MRSA (NCTC 10442), EMRSA-1 (NCTC 11939) and EMRSA-16 (NCTC 13143)] compared with stainless steel. MRSA and EMRSA [10(7)colony-forming units (CFU)] were inoculated on to coupons (1 cm x 1 cm) of copper, brass or stainless steel and incubated at either 22 degrees C or 4 degrees C for various time periods. Viability was determined by resuspending removed CFUs and plating out on tryptone soy agar plates in addition to staining with the respiratory indicator fluorochrome 5-cyano-2,3-ditolyl tetrazolium. On pure copper surfaces, 10(7) MRSA, EMRSA-1 and EMRSA-16 were completely killed after 45, 60 and 90 min, respectively, at 22 degrees C. In contrast, viable organisms for all three strains were detected on stainless steel (grade 304) after 72 h at 22 degrees C. At 4 degrees C, complete kill was achieved on copper for all three strains within 6 h. The results demonstrate an antimicrobial effect of copper on MRSA, EMRSA-1 and -16 in contrast to stainless steel. Consequently, the contemporary application of stainless steel in hospital environments for work surfaces and door furniture is not recommended.

In vitro antibacterial and cytotoxicity assay of multilayered polyelectrolyte-functionalized stainless steel

Infection of implanted materials by bacteria constitutes one of the most serious complications following prosthetic and implant surgery. In the present study, a new strategy for confering stainless steel with antibacterial property via the alternate deposition of quaternized polyethylenimine (PEI) or quaternized polyethylenimine-silver complex and poly(acrylic acid) (PAA) was investigated. The success of the deposition of the polyelectrolyte multilayers (PEM) and its chemical nature was investigated by static water contact angle and X-ray photoelectron spectroscopy (XPS), respectively. The antibacterial activity was assessed using Escherichia coli (E. coli, a gram-negative bacterium) and Staphylococcus aureus (S. aureus, a gram-positive bacterium). The inhibition of E. coli and S aureus growth on the surface of functionalized films was clearly shown using the LIVE/DEAD Baclight bacterial viability kits and fluorescence microscopy. The cytotoxicity of the PEM to mammalian cells, evaluated by the MTT assay, was shown to be minimal and long-term antibacterial efficacy can be maintained. These results indicate new possibilities for the use of such easily built and functionalized architectures for the functionalization of surfaces of implanted medical devices.

BIOCOMPATIBILITY OF NITINOL AND STAINLESS STEEL IN THE BLADDER: AN EXPERIMENTAL STUDY

PURPOSE

We tested the biocompatibility of nitinol, a nickel titanium alloy, and stainless steel (SS) as bladder implant materials.

MATERIALS AND METHODS

Rats received a nitinol implant, an SS implant or were sham controls. Two, 3, 6 and 8 weeks following implantation 24-hour voiding behavior studies were performed to investigate bladder irritation. All animals were sacrificed 8 weeks after implantation and a sample of urine was aspirated for culture. The bladders were examined by light microscopy and scanning electron microscopy (SEM).

RESULTS

No visible encrustations or infections were noted in urine. Voiding frequency in the light period 6 weeks after implantation was significantly decreased in the 2 implant groups compared with sham controls. There were no other significant differences in frequency or mean volume per void in the light or dark periods at any time point. Light microscopy demonstrated similar implant tissue effects in all groups with little or no inflammation or fibrosis. Under SEM all implants showed a brittle, amorphous coating devoid of cells. The transition between the urothelium mucosa and the rod was smoother for SS than for nitinol, suggesting an affinity of SS for mucosa. In all nitinol rods discontinuity was present between the mucosa and rod.

CONCLUSIONS

Nitinol and SS do not cause more irritation than the effects of surgery alone and the 2 materials seem to be biocompatible in the bladder. Nitinol may be more inert than SS based on SEM results.

Carbon dioxide laser-assisted nerve repair: effect of solder and suture material on nerve regeneration in rat sciatic nerve

In order to further improve and explore the role of lasers for nerve reconstruction, this study was designed to investigate regeneration of sharply transected peripheral nerves repaired with a CO(2) milliwatt laser in combination with three different suture materials and a bovine albumin protein solder as an adjunct to the welding process. Unilateral sciatic nerve repair was performed in 44 rats. In the laser group, nerves were gently apposed, and two stay sutures (10-0 nylon, 10-0 polyglycolic acid, or 25 microm stainless steel) were placed epi/perineurially. Thereafter, the repair site was fused at 100 mW with pulses of 1.0 s. In the subgroup of laser-assisted nerve repair (LANR), albumen was used as a soldering agent to further reinforce the repair site. The control group consisted of nerves repaired by conventional microsurgical suture repair (CMSR), using 4-6 10-0 nylon sutures. Evaluation was performed at 1 and 6 weeks after surgery, and included qualitative and semiquantitative light microscopy. LANR performed with a protein solder results in a good early peripheral nerve regeneration, with an optimal alignment of nerve fibers and minimal connective tissue proliferation at the repair site. All three suture materials produced a foreign body reaction; the least severe was with polyglycolic acid sutures. CMSR resulted in more pronounced foreign-body granulomas at the repair site, with more connective-tissue proliferation and axonal misalignment. Furthermore, axonal regeneration in the distal nerve segment was better in the laser groups. Based on these results, CO(2) laser-assisted nerve repair with soldering in combination with absorbable sutures has the potential of allowing healing to occur with the least foreign-body reaction at the repair site. Further experiments using this combination are in progress.

Impact of a nickel-reduced stainless steel implant on striated muscle microcirculation: a comparative in vivo study

The impairment of skeletal muscle microcirculation by a biomaterial may have profound consequences. With moderately good physical and corrosion characteristics, implant-quality stainless steel is particularly popular in orthopedic surgery. However, due to the presence of a considerable amount of nickel in the alloy, concern has been voiced in respect to local tissue responses. More recently a stainless steel alloy with a significant reduction of nickel has become commercially available. We, therefore, studied in vivo nutritive perfusion and leukocytic response of striated muscle to this nickel-reduced alloy, and compared these results with those of the materials conventional stainless steel and titanium. Using the hamster dorsal skinfold chamber preparation and intravital microscopy, we could demonstrate that reduction of the nickel quantity in a stainless steel implant has a positive effect on local microvascular parameters. Although the implantation of a conventional stainless steel sample led to a distinct and persistent activation of leukocytes combined with disruption of the microvascular endothelial integrity, marked leukocyte extravasation, and considerable venular dilation, animals with a nickel-reduced stainless steel implant showed only a moderate increase of these parameters, with a clear tendency of recuperation. Titanium implants merely caused a transient increase of leukocyte-endothelial cell interaction within the first 120 min, and no significant change in macromolecular leakage, leukocyte extravasation, or venular diameter. Pending biomechanical and corrosion testing, nickel-reduced stainless steel may be a viable alternative to conventional implant-quality stainless steel for biomedical applications. Concerning tolerance by the local vascular system, titanium currently remains unsurpassed.

Effect of nickel-titanium shape memory metal alloy on bone formation

The aim of this study was to determine the biocompatibility of NiTi alloy on bone formation in vivo. For this purpose we used ectopic bone formation assay which goes through all the events of bone formation and calcification. Comparisons were made between Nitinol (NiTi), stainless steel (Stst) and titanium-aluminium (6%)-vanadium (4%) alloy (Ti-6Al-4V), which were implanted for 8 weeks under the fascia of the latissimus dorsi muscle in 3-month-old rats. A light-microscopic examination showed no chronic inflammatory or other pathological findings in the induced ossicle or its capsule. New bone replaced part of the decalcified matrix with mineralized new cartilage and bone. The mineral density was measured with peripheral quantitative computed tomography (pQCT). The total bone mineral density (BMD) values were nearly equal between the control and the NiTi samples, the Stst samples and the Ti-6Al-4V samples had lower BMDs. Digital image analysis was used to measure the combined area of new fibrotic tissue and original implanted bone matrix powder around the implants. There were no significant differences between the implanted materials, although Ti-6Al-4V showed the largest matrix powder areas. The same method was used for measurements of proportional cartilage and new bone areas in the ossicles. NiTi showed the largest cartilage area (p < or = 0.05). Between implant groups the new bone area was largest in NiTi. We conclude that NiTi has good biocompatibility, as its effects on ectopic bone formation are similar to those of Stst, and that the ectopic bone formation assay developed here can be used for biocompatibility studies.