Szabályozott hatóanyag-felszabadulású antibiotikumokat tartalmazó biológiai hordozók alkalmazása csonthiányok pótlására = Application of biological carrier systems containing antibiotics with controlled drug delivery in bone grafting

A kutatás gyógyszerészeti alapkutatásból, gyógyszerészeti technológiai részből, mikrobiológiai értékmérésből, majd állatkísérletekből állt. A gyógyszerészeti munka eredményeként olyan gyógyszerhordozó rendszert lehetett létrehozni, ami in vitro körülmények között alkalmas volt antibiotikum kiáramlás biztosítására kontrollált körülmények között, megfelelően hosszú ideig, MIC (minimális gátlási koncentráció) feletti koncentrációban. A hatóanyag leadási görbék megfeleltek az előzetes hypothesisben felállított normáknak. A mikrobiológiai értékméréssel igazolni lehetett a rendszer antimikróbás hatását. Állatkísérletekben bizonyítást nyert, hogy a gyógyszer hordozó rendszer alkalmas arra, hogy csontörleményhez kevere antimikróbás hatást fejtsen ki, és ne gátolja a csont beépülését a gazda szervezetbe. Az antibiotikumot kibocsátó gyógyszerhordozó rendszer és a csontőrlemény antibiotikummal való impregnálás módszere szabadalmi oltalom alá kerül a projekt keretén belül. | The project consists of basic pharmaceutical research, pharmaceutical technology, microbiologic investigations and animal experiments. The result of the research was a drug carrier system, which was suitable for antibiotic drug release with a controlled release rate over a longer period of time, above the MIC (minimally inhibitory concentration) value. The release curves revealed characteristics of the previously determined hypothesis. The microbiologic examinations proved the in vitro results in terms of antimicrobial effect of the drug delivery system. In a rabbit osteomyelitis model we could show the antimicrobial effect and the osteointegration without any limit with the novel developed drug delivery system. Intellectual property of the developed antibiotic carrier system was subject of copyright

Csípőízületi tbc = Tuberculosis of the hip

Hazánkban az elmúlt években évente átlagosan 2000–2500 új tbc-s beteget regisztráltak. A betegség gyakorisága az utóbbi 10 évben folyamatosan csökkent: incidenciája 2000-ben 36/100 000 volt, 2005-ben mindössze 20, 2006-ban 18,8 megbetegedés jutott 100 000 lakosra. Az extrapulmonalis esetek rendkívül alacsony gyakorisága, a lassan induló, szegényes tünettan miatt a specifikus ízületi gyulladás diagnosztikája nem képezi a mozgásszervi betegekkel foglalkozó szakrendeléseken a mindennapi rutin részét. A pontos diagnózis felállításához és a sikeres kezeléshez számos szakma – esetünkben ortopéd sebész, radiológus, infektológus, pulmonológus, mikrobiológus, urológus – együttműködésére van szükség. A szerzők cikkükben bemutatják egy 19 éves férfi beteg két éve fennálló csípőízületi panaszai hátterében talált tuberkulózis diagnosztikai és kezelési lépéseit. | In Hungary about 1900–2500 new patients suffering from tuberculosis have been registered yearly in the last few years. In 2000 the incidence was 36/100,000, which decreased to 18.8/100,000 by the year 2006. Extrapulmonar, skeletal forms are uncommon and develop in a slow way, therefore the specific diagnostic steps are not part of the daily routine orthopedic examination. To provide appropriate diagnosis and successful treatment, the cooperative work of many faculties is essential. Authors report a case of a 19-year-old male patient with hip complaints in the last two years. X-ray, CT and MRI examinations proved a progressive pattern of destruction of the hip joint. Diagnostic steps and failures, also the surgical therapeutic solution of active hip tuberculosis, have been presented

In vitro efficiency of vancomycin containing experimental drug delivery systems

Biofilm-forming Staphylococcus epidermidis strains are common cause of the periprosthetic infection. The treatment of the periprosthetic infection is very problematic, so the prevention of these infections by an antibiotic containing prothesis could be an option for prevention.The purpose of the present study was to examine the in vitro effects of drug delivery systems (DDSs), namely Wax 1 and Wax 2 with different vancomycin content: 0.5, 1, 2 and 4 mg. In order to control the antibacterial activity of DDSs killing curve study was performed and in order to determine the antibiotic release and the antibiotic peak concentration from the DDSs biological assay was carried out.The time kill curve studies showed, that both DDSs with all vancomycin concentration decreased significantly the bacterial counts, however, Wax 2 with 4 mg vancomycin significantly decreased the bacterial count than all the other groups.The vancomycin release was the best with the highest peak concentration from DDSs with 4 mg vancomycin contain; it was significantly better than in the other groups, however, no significant difference was observed between Wax 1 and Wax 2 in this respect.These findings suggest that Wax 2 with 4 mg vancomycin content could be a potential agent for clinical use

Activated Polymorphonuclear Derived Extracellular Vesicles are Potential Biomarkers of Periprosthetic Joint Infection

BACKGROUND: Extracellular vesicles (EVs) are considered as crucial players in a wide variety of biological processes. Although their importance in joint diseases or infections has been shown by numerous studies, much less is known about their function in periprosthetic joint infection (PJI). Our aim was to investigate activated polymorphonuclear (PMN)-derived synovial EVs in patients with PJI. QUESTIONS/PURPOSES: (1) Is there a difference in the number and size of extracellular vesicles between periprosthetic joint aspirates of patients with PJI and aseptic loosening? (2) Are these vesicles morphologically different in the two groups? (3) Are there activated PMN-derived EVs in septic samples evaluated by flow cytometry after CD177 labelling? (4) Is there a difference in the protein composition carried by septic and aseptic vesicles? METHODS: Thirty-four patients (n = 34) were enrolled into our investigation, 17 with PJI and 17 with aseptic prosthesis loosening. Periprosthetic joint fluid was aspirated and EVs were separated. Samples were analysed by nanoparticle tracking analysis (NTA) and transmission electron microscopy (TEM) and flow cytometry (after Annexin V and CD177 labelling). The protein content of the EVs was studied by mass spectrometry (MS). RESULTS: NTA showed particle size distribution in both groups between 150 nm and 450 nm. The concentration of EVs was significantly higher in the septic samples (p = 0.0105) and showed a different size pattern as compared to the aseptic ones. The vesicular nature of the particles was confirmed by TEM and differential detergent lysis. In the septic group, FC analysis showed a significantly increased event number both after single and double labelling with fluorochrome conjugated Annexin V (p = 0.046) and Annexin V and anti-CD177 (p = 0.0105), respectively. MS detected a significant difference in the abundance of lactotransferrin (p = 0.00646), myeloperoxidase (p = 0.01061), lysozyme C (p = 0.04687), annexin A6 (p = 0.03921) and alpha-2-HS-glycoprotein (p = 0.03146) between the studied groups. CONCLUSIONS: An increased number of activated PMN derived EVs were detected in the synovial fluid of PJI patients with a characteristic size distribution and a specific protein composition. The activated PMNs-derived extracellular vesicles can be potential biomarkers of PJI