Nanocomposite systems based on metal nanoparticles and polysaccharides for biomedical applications

2008/2009Questo lavoro riguarda lo sviluppo di materiali nanocompositi per applicazioni biomediche e si configura all’ interno del progetto europeo “Newbone” (EU-FP6); in particolare, lo scopo principale della tesi era realizzare un rivestimento biocompatibile e dotato di proprietà antibatteriche per protesi ortopediche. Sono stati preparati sistemi nanocompositi basati su un polisaccaride derivato dal chitosano (Chitlac) che permette di ottenere soluzioni colloidali di nanoparticelle (argento e oro) con proprietà antibatteriche. Parallelamente, è stato studiato un particolare meccanismo chimico di riduzione degli ioni argento ad opera dei residui di lattitolo del Chitlac; le proprietà ottiche delle nanoparticelle ottenute attraverso questo meccanismo sono state valutate attraverso spettroscopia Raman, evidenziando la possibilità di avere un incremento del segnale grazie al verificarsi dell’ effetto SERS. Essendo state riscontrate migliori proprietà biologiche del sistema a base di argento (Chitlac-nAg) rispetto a quello a base di oro in termini di efficacia antimicrobica e biocompatibilità, Chitlac-nAg è stato scelto per i successivi studi di realizzazione del rivestimento per la protesi. Test sul meccanismo antimicrobico della soluzione ChitlacnAg hanno dimostrato l’interazione tra le nanoparticelle e la membrana batterica. Allo stesso tempo, poiché la mancanza di barriere fisiche può favorire la diffusione delle nanoparticelle all’ interno delle cellule eucariote con rischio di effetti citotossici causati dalla loro internalizzazione, si è voluto realizzare delle strutture tridimensionali a base di Chitlac in grado di intrappolare le nanoparticelle. A questo scopo, sono state sfruttate le proprietà di gelificazione del polisaccaride alginato in modo da ottenere un sistema semi-solido in miscela con Chitlac-nAg; il materiale ottenuto possiede marcate proprietà antibatteriche senza però risultare tossico per le cellule eucariote, come dimostrato da test in vitro e in vivo. Questo risultato è particolarmente importante in relazione allo stato dell’ arte sull’ argomento. Poiché la parte portante della protesi è costituita da un polimero metacrilico, al fine di rivestire questo materiale di substrato è stata messa a punto una tecnica basata sull’ attivazione della superficie e successiva deposizione del rivestimento a base di Chitlac. Questa tecnica permette di ottenere un rivestimento nanocomposito costituito da nanoparticelle di argento incorporate nella matrice di Chitlac. Grazie a questo strato bioattivo la superficie della protesi acquisisce un’ efficace attività antibatterica che si manifesta quando i batteri entrano in diretto contatto con il materiale. Inoltre, test in vitro hanno dimostrato che le cellule eucariote aderiscono e proliferano sul rivestimento nanocomposito, suggerendo quindi una buona integrazione del materiale nei tessuti attorno all’ impianto. La combinazione di tali proprietà ha determinato la scelta di questo rivestimento per il test in vivo su “minipig” a conclusione del progetto europeo: questo test è al momento in via di svolgimento e da esso ci si può attendere una conferma degli incoraggianti risultati ottenuti dagli studi in vitro.The present work is focused on the development of nanocomposite systems for biomedical applications and has been carried out in the framework of the European Project called “Newbone” (EU-FP6); in particular, the main goal of the thesis was to realize biocompatible coatings for orthopedic prosthesis endowed with antimicrobial properties. Nanocomposite systems based on a chitosan-derived polysaccharide (Chitlac) that stabilizes metal nanoparticles (silver and gold) have been prepared in colloidal solutions which possess broad spectrum antibacterial properties. As a complementary work, it was studied and defined a particular chemical mechanism of silver ions reduction carried out by the lactose moieties of Chitlac; the optical properties of the metallic nanoparticles obtained through this mechanism were tested by means of Raman spectroscopy, thus detecting considerable enhancements of the signal due to the SERS effect (Surface Enhanced Raman Scattering). Given the better biological properties of silver-based systems (Chitlac-nAg) with respect to gold in terms of antimicrobial efficacy and biocompatibility, only the former metal was chosen in the following steps towards the preparation of the nanocomposite coating for the prosthesis. Studies on the biocidal mechanism of the Chitlac-nAg solution ascribed the activity to the interaction metal-bacteria membrane. On the other hand, since the lack of physical barriers to nanoparticle diffusion into eukaryotic cells determines the risk of a massive uptake with cytotoxic outcomes, we focused our attention toward the preparation of Chitlac-based threedimensional structures entrapping silver nanoparticles. To this end, the gel forming properties of the polysaccharide alginate were exploited allowing the production of a semi-solid system in a mixture with Chitlac-nAg: this material displays potent antibacterial properties without showing cytotoxic effects towards eukaryotic cells, as verified by in vitro and in vivo tests. Such result was particularly important in relation to the state of the art in this research field. Since the core material of the prosthesis is made of methacrylic thermosets, in order to coat this substrate material we have devised a technique based on surface activation followed by deposition of the Chitlac-based layer. Such technique allows obtaining a nanocomposite coating where silver nanoparticles are entrapped within the Chitlac matrix. This bioactive layer endows the thermoset surface with considerable antimicrobial properties, as bacteria are rapidly killed upon direct contact with the material. At the same time, in vitro tests proved that eukaryotic cells adhere and proliferate on the nanocomposite coating, which indicates the possibility to have good integration of the material in the tissues surrounding the implant. The combination of these properties determined the choice of our coating for the final in vivo test in a minipig model as a conclusion of the European project; this test is in progress at the moment and it will hopefully confirm the encouraging studies in vitro.XXII Ciclo198

Alginate membranes loaded with hyaluronic acid and silver nanoparticles to foster tissue healing and to control bacterial contamination of non-healing wounds

Chronic non-healing wounds are a clinically important problem in terms of number of patients and costs. Wound dressings such as hydrogels, hydrocolloids, polyurethane films and foams are commonly used to manage these wounds since they tend to maintain a moist environment which is shown to accelerate re-epithelialization. The use of antibacterial compounds is important in the management of wound infections. A novel wound-dressing material based on a blended matrix of the polysaccharides alginate, hyaluronic acid and Chitlac-silver nanoparticles is here proposed and its application for wound healing is examined. The manufacturing approach to obtain membranes is based on gelling, foaming and freeze-casting of alginate, hyaluronic acid and Chitlac-silver nanoparticles mixtures using calcium ions as the cross-linking agent. Comprehensive evaluations of the morphology, swelling kinetics, permeability, mechanical characteristics, cytotoxicity, capability to inhibit metalloproteinases and of antibacterial property were conducted. Biological in vitro studies demonstrated that hyaluronic acid released by the membrane is able to stimulate the wound healing meanwhile the metal silver exploits an efficient antibacterial activity against both planktonic bacteria and biofilms. Overall, the experimental data evidence that the studied material could be used as antibacterial wound dressing for wound healing promotion

Silver-containing antimicrobial membrane based on chitosan-TPP hydrogel for the treatment of wounds

Treatment of non-healing wounds represents hitherto a severe dilemma because of their failure to heal caused by repeated tissue insults, bacteria contamination and altered physiological condition. This leads to face huge costs for the healthcare worldwide. To this end, the development of innovative biomaterials capable of preventing bacterial infection, of draining exudates and of favoring wound healing is very challenging. In this study, we exploit a novel technique based on the slow diffusion of tripolyphosphate for the preparation of macroscopic chitosan hydrogels to obtain soft pliable membranes which include antimicrobial silver nanoparticles (AgNPs) stabilized by a lactose-modified chitosan (Chitlac). UV-Vis and TEM analyses demonstrated the time stability and the uniform distribution of AgNPs in the gelling mixture, while swelling studies indicated the hydrophilic behavior of membrane. A thorough investigation on bactericidal properties of the material pointed out the synergistic activity of chitosan and AgNPs to reduce the growth of S. aureus, E. coli, S. epidermidis, P. aeruginosa strains and to break apart mature biofilms. Finally, biocompatibility assays on keratinocytes and fibroblasts did not prove any harmful effects on the viability of cells. This novel technique enables the production of bioactive membranes with great potential for the treatment of non-healing wounds

Hyaluronan delivery by polymer demixing in polysaccharide-based hydrogels and membranes for biomedical applications

Alginate-based membranes containing hyaluronic acid (HA) were manufactured by freeze-drying calcium-reticulated hydrogels. The study of the distribution of the two macromolecules within the hydrogel enabled to highlight a polymer demixing mechanism that tends to segregate HA in the external parts of the constructs. Resistance and pliability of the membranes were tuned, while release and degradation studies enabled to quantify the diffusion of both polysaccharides in physiological solution and to measure the viable lifetime of the membranes. Biological studies in vitro proved that the liquid extracts from the HA-containing membranes stimulate wound healing and that fibroblasts are able to colonize the membranes. Overall, such novel alginate-HA membranes represent a promising solution for several medical needs, in particular for wound treatment, giving the possibility to provide an in situ administration of HA from a resorbable device

Innovative thermal and acoustic insulation foam from recycled waste glass powder

An innovative powder-foaming process able to produce thermal and acoustic insulating foams obtained by sol-gel and a subsequent freeze-drying process was developed. Gel containing glass powder was formed using alginate, a polysaccharide composed of 1-4linked \u3b1-L-guluronic acid and \u3b2-D-mannuronic acid, capable to form stable gels in presence of calcium cations. In order to obtain a porous foam, gels were frozen and then freeze-dried. Foam properties strongly depend on production parameters, particle dimension and different binder concentrations, their influence was investigated. The resulting glass foams were characterized in order to evaluate structure, density, mechanical and acoustic properties. The results pointed out an improved acoustic insulating performance respect to rock wool. Foams were also subjected to a thermal process to better fix powders into the final glass structure

Antibacterial-Nanocomposite Bone Filler Based on Silver Nanoparticles and Polysaccharides

Injectable bone fillers represent an attractive strategy for the treatment of bone defects. These injectable materials should be biocompatible, capable of supporting cell growth and possibly able to exert antibacterial effects. In this work, nanocomposite microbeads based on alginate, chitlac, hydroxyapatite and silver nanoparticles were prepared and characterized. The dried microbeads displayed a rapid swelling in contact with simulated body fluid and maintained their integrity for more than 30\ua0days. The evaluation of silver leakage from the microbeads showed that the antibacterial metal is slowly released in saline solution, with less than 6% of silver released after 1\ua0week. Antibacterial tests proved that the microbeads displayed bactericidal effects toward S. aureus, P. aeruginosa and S. epidermidis and were also able to damage pre-formed bacterial biofilms. On the other hand, the microbeads did not exert any cytotoxic effect towards osteoblast-like cells. After characterization of the bioactive microbeads, a possible means to embed them in a fluid medium was explored in order to obtain an injectable paste. Upon suspension of the particles in alginate solution or alginate/hyaluronic acid mixtures, a homogenous and time-stable paste was obtained. Mechanical tests enabled to quantify the extrusion forces from surgical syringes, pointing out the proper injectability of the material. This novel antibacterial bone-filler appears as a promising material for the treatment of bone defects, in particular when possible infections could compromise the bone-healing process

Nucleation, reorganization and disassembly of an active network from lactose-modified chitosan mimicking biological matrices

Developing synthetic materials able to mimic micro- and macrorheological properties of natural networks opens up to novel applications and concepts in materials science. The present contribution describes an active network based on a semi-synthetic polymer, a lactitol-bearing chitosan derivative (Chitlac), and a transient inorganic cross-linker, boric acid. Due to the many and diverse anchoring points for boric acid on the flanking groups of Chitlac, the cross-links constantly break and reform in a highly dynamic fashion. The consequence is a network with unusual non-equilibrium and mechanical properties closely resembling the rheological behavior of natural three-dimensional arrangements and of cytoskeleton. Concepts like network nucleation, reorganization and disassembly are declined in terms of amount of the cross-linker, which acts as a putative motor for remodeling of the network upon application of energy. The out-of-equilibrium and non-linear behavior render the semi-synthetic system of great interest for tissue engineering and for developing in-vitro mimics of natural active matrices

Long-term Clinical Outcomes and Cost-Effectiveness of Full-Arch Implant-Supported Zirconia-Based and Metal-Acrylic Fixed Dental Prostheses: A Retrospective Analysis

Purpose: To provide a long-term comparison of metal-acrylic and zirconia implant-supported fixed complete dental prostheses. Materials and methods: Patients treated with a metal-acrylic or zirconia fixed implant prosthesis with a minimum 5-year follow-up were included. All complications were registered, along with events such as peri-implantitis and implant failure. Survival and all costs associated with the prostheses were assessed to provide an overall evaluation of each type of fixed implant prosthesis protocol. Results: Seventy-four rehabilitated arches (43 metal-acrylic, 31 zirconia, mean follow-up: 8.7 ± 3.37 years) were included. Delayed complications accompanied the metal-acrylic prostheses more frequently. In both groups, single tooth chipping/fracture was the most prominent minor complication, and incidence of multiple teeth and framework fracture was the most frequent major complication. Zirconia fixed implant prostheses demonstrated higher prosthetic survival rates than the metal-acrylic prostheses (93.7% ± 5.5% at 5 years vs 83.0% ± 11.1%). No difference was observed for peri-implantitis or implant failure. The initial cost for zirconia prosthesis fabrication was significantly higher than metal-acrylic hybrids (an estimated difference of $7,829 [P < .001]); however, due to reduced complication rates for the zirconia fixed implant prosthesis, maintenance and treatment for complications did not greatly differ between groups. Conclusion: Within the limitations, zirconia fixed implant prostheses presented higher initial costs than metal-acrylic hybrids, however, with satisfactory outcomes, reduction of overall complications, and superior survival rates.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/169152/1/Barootchi et al. 2020 - Long-term clinical outcomes and cost-effectiveness of full-arch.pdfDescription of Barootchi et al. 2020 - Long-term clinical outcomes and cost-effectiveness of full-arch.pdf : Full text of published articleSEL

Effects of a new nanocomposite system on Human Gingival Fibroblasts/Streptococcus mitis co-culture

In the broad field of biomaterials, Bisphenol A glycidylmethacrylate (BisGMA)/triethyleneglycol dimethacrylate (TEGDMA) thermosets are frequently used for dental restoration (Lehtinen et al 2008), but infections due to bacterial adhesion remain the main reason of dental devices failure. In order to avoid biofilm formation on the components used for restoration and to reduce cytotoxicity against eukaryotic cells, a new material with antimicrobial properties was developed. Indeed, silver nanoparticles (n-Ag), which have well-known antimicrobial properties, were stabilized with a polyelectrolyte solution-Chitlac (lactose-modified chitosan) and was used to coating methacrylic thermosets (Travan et al, 2011). This study was aimed at evaluating the in vitro biological response of human gingival fibroblasts (HGFs)/Streptococcus mitis co-colture to this nanocomposite system. HGFs were obtained from fragments of healthy marginal gingival tissue, co-cultured with the clinical strain of S. mitis and treated for 24 -48 h with thermosets (uncoated or coated with Chitlac or Chitlac n-Ag). Cytotoxicity was evaluated by LDH assay; cell morphology and adhesion were verified by means of SEM and optical microscopy; cell migration was studied by a modified Boyden chamber and finally IL-6 and PGE2 secretion were detected by ELISA assays. In vitro results showed that in our co-culture model, which mimics the microenvironment of the oral cavity, the nanocomposite material does not exert cytotoxic effect towards HGFs that are able to adhere and migrate. The secretion of IL-6 is significant, but PGE2 production is minimal suggesting that IL-6 production is not related to an inflammatory response. Basing on its good biocompatibility we suggest this new tool useful for the realization of dental devices

Effect of Chitlac-nAg on Streptococcus mitis internalization into human gingival fibroblasts

The surfaces of the oral cavity are always exposed to a broad variety of microor- ganisms able to form biofilms (Filoche et al, 2010) characterized by microbial com- munities that are organized as a network of cell-to-cell interactions. Streptococci are the predominant bacterial population of the oral environment and S.mitis in particular is the first colonizer of the oral biofilm (Di Giulio et al, 2013). Silver-based medical products have been proven to be effective in retarding and preventing bacterial growth. In order to prevent silver nanoparticles aggregation, a lactose-modified chitosan has been set up and resulted effective in stabilizing colloidal solution of nanoparticles (Chitlac-nAg) (Travan et al, 2009). Since many bacteria are able to internalize into eukaryotic cells, in our study we have investigated both the intracellular signaling governing S. mitis internalization into HGFs and the biological effect of ChitlacnAg on eukaryotic and prokaryotic cells in a co-culture model system. The internalization of S. mitis into HGFs is due to F-actin cytoskeleton reorganization and reduced expression within the cell. Immunofluorescence shows actin polymerization at invasion sites along with vinculin increased expression and spot organization. Vinculin is an adaptor protein that regulates the adhesion of integrin receptors to actin cytoskeleton. In presence of S. mitis an increment of integrin β1 and FAK expression, responsible for the entrance of the microorganism in HGFs is consistent, as revealed by electron microscopy analysis. This adhesion and uptake proteins profile is the same in the presence of saliva as well as bacteria uptake. When Chitlac-nAg is administred to cell culture the expression of all four proteins decreases and Ag nano- particles are recognized within the cells. Further, in presence of Ag nanoparticles the low amount of FAK is almost localized at nuclear level. In presence of Ag and S.mitis, the expression of all four proteins is increased, with respect to control, and F-actin cytoskeleton rearranged, while a raised number of bacteria is shown. This effect is mit- igated by the presence of saliva in cell culture, which probably prevents bacteria entry into the cell. These results let us hypothesize that Chitlac-nAg, developing its bacteri- cidal action could represent a good component of tooth paste and mouthwash