Prevention of Biomaterial Infection by Pre-Operative Incubation with Human Cells.

BACKGROUND: Cells of tissues and biofilm forming bacteria compete for the living space on the surface of an implant. We hypothesized the incubation of the implant (titanium, polydimethylsiloxane, and polystyrene surface) with human cells before implantation as a strategy to prevent bacterial adhesion and biofilm formation. METHODS: After 24 hours of incubation with human osteogenic sarcoma SaOS-2 cells (1 × 105 cells/mL), the materials were incubated for 4.5 hours or two days with Staphylococcus aureus in serial 1:10 dilutions of 108 colony-forming units/mL. The bacterial adherence and biofilm biomass on materials pre-incubated with SaOS-2 cells were compared with our previous results on materials incubated only with bacteria or in simultaneous co-culture of SaOS-2 cells and S. aureus. Fluorescent microscopy and crystal violet stain were used. The number of viable SaOS-2 and bacterial cells present was tested using colorimetric methods (MTT, LDH) and drop plate method, respectively. RESULTS: The pre-treatment with human cells was associated with a reduction of bacterial colonization of the biomaterial at 4.5 hours and 48 hours compared with the non-pre-treated materials. The presence of bacteria decreased the number of viable human cells on all materials. ( Supplementary Fig. 1 ; see online supplementary materials at www.liebertpub.com/sur ). CONCLUSIONS: These results suggest that the pre-operative incubation of prostheses with host cells could prevent infection of biomaterials.

Competitive colonization of prosthetic surfaces by staphylococcus aureus and human cells.

Implantation of a biomaterial provides an adhesion substratum both to host cell integration and to contaminating bacteria. We studied simultaneous competitive adhesion of Staphylococcus aureus in serial 1:10 dilutions of 108 colony forming units (CFU)/mL and human osteogenic sarcoma (SaOS-2) or primary osteoblast (hOB) cells, both 1x105 cells/mL, to the surfaces of titanium, polydimethylsiloxane and polystyrene. The bacterial adherence and human cell proliferation, cytotoxicity and production of reactive oxygen species (ROS) were studied using fluorometric (fluorescent microscopy and flow cytometry) and colorimetric methods (MTT, LDH and crystal violet). The bacterial cell viability was also evaluated using the drop plate method. The presence of bacteria resulted in reduced adherence of human cells to the surface of the biomaterials, increased production of ROS, and into increased apoptosis. On the other hand, the presence of either type of human cells was associated with a reduction of bacterial colonization of the biomaterial with Staphylococcus aureus. These results suggest that increasing colonization of the biomaterial surface in vitro by one negatively affects colonization by the other. Host cell integration to an implant surface reduces bacterial contamination, which opens novel opportunities for the design of infection-resistant biomaterials in current implantology and future regenerative medicine. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 62-72, 2017.

Dynamics of water confined in mesoporous magnesium carbonate.

We have measured the dynamics of water confined in a porous magnesium carbonate material, Upsalite®, using the high-resolution neutron backscattering spectrometer SPHERES. We found quasielastic scattering that does not flatten out up to 360 K, which means that the dynamics of water are much slower than in other matrix materials. Specifically, a single Lorentzian line could be fitted to the quasielastic part of the acquired spectra between 220 and 360 K. This, accompanied by an elastic line from dynamically frozen water present at all experimental temperatures, even above the melting point, signaled a significant amount of bound or slow water.

Crossover from localized to diffusive water dynamics in carbon nanohorns: A comprehensive quasielastic neutron-scattering analysis.

Incoherent neutron scattering by water confined in carbon nanohorns was measured with the backscattering spectrometer SPHERES and analyzed in exemplary breadth and depth. Quasielastic spectra admit δ-plus-Kohlrausch fits over a wide q and T range. From the q and T dependence of fitted amplitudes and relaxation times, however, it becomes clear that the fits do not represent a uniform physical process, but that there is a crossover from localized motion at low T to diffusive α relaxation at high T. The crossover temperature of about 210 to 230 K increases with decreasing wave number, which is incompatible with a thermodynamic strong-fragile transition. Extrapolated diffusion coefficients D(T) indicate that water motion is at room temperature about 2.5 times slower than in the bulk; in the supercooled state this factor becomes smaller. At even higher temperatures, where the α spectrum is essentially flat, a few percentages of the total scattering go into a Lorentzian with a width of about 1.6µeV, probably due to functional groups on the surface of the nanohorns.

Soluble biglycan: a potential mediator of cartilage degradation in osteoarthritis.

BACKGROUND: Soluble biglycan (sBGN) and soluble decorin (sDCN), are two closely related essential components of extracellular matrix which both have been shown to possess proinflammatory properties. We studied whether sBGN or sDCN were present in synovial fluid (SF) of osteoarthritis (OA) or rheumatoid arthritis (RA) patients and studied sBGN or sDCN potential role in the degradation of OA cartilage. METHODS: SF obtained from meniscus tear, OA, and RA patients were analysed for sBGN and sDCN using enzyme-linked immunosorbent assays. OA chondrocytes and cartilage explants were stimulated for 48 h with 5 µg/ml sBGN or 1 µg/ml lipopolysaccharide. Messenger RNA (mRNA) levels of Toll-like receptors (TLRs), proteinases and cartilage matrix molecules were determined using quantitative real-time polymerase chain reaction. Protein levels of matrix metalloproteinases (MMPs) and cytokines were measured using Luminex xMap technology. Production of nitric oxide (NO), release of proteoglycans and soluble collagen were measured from conditioned culture media using biochemical assays. OA cartilage explant proteoglycans were stained for Safranin O and quantified using image analysis. TLR4 activation by sBGN and sDCN was studied in engineered HEK-293 cells with TLR4 signalling genes inserted together with a reporter gene. RESULTS: sBGN was found in meniscus tear SF (14 ± 2 ng/ml), OA SF (582 ± 307 ng/ml) and RA SF (1191 ± 482 ng/ml). Low levels of sDCN could also be detected in SF of meniscus tear (51 ± 4) ng/ml, OA (52 ± 3 ng/ml), and RA (49 ± 4 ng/ml). Stimulation of chondrocytes with sBGN increased significantly the mRNA and protein expression of catabolic MMPs, including MMP1, MMP9 and MMP13, and of inflammatory cytokines interleukin (IL)-6 and IL-8, whereas the expression of anabolic markers aggrecan and collagen type II was decreased. sBGN induced release of proteoglycans, collagen and NO from chondrocytes and cartilage explants. The catabolic response in explants was dependent of OA cartilage degradation stage. The mechanism of action of sBGN was mainly mediated through the TLR4-nuclear factor-κB pathway. CONCLUSIONS: High levels of sBGN was found in advanced OA and RA SF. sBGN activates chondrocytes mainly via TLR4, which results in net loss of cartilage. Thus, sBGN can be a mediator of OA cartilage degradation and also a potential biomarker for arthritis.

Autoinflammation Around AES Total Ankle Replacement Implants.

BACKGROUND: Failure of total ankle replacement (TAR) can be characterized by early peri-implant osteolysis even in the presence of very modest numbers of wear particles. The hypothesis of the study was that this reaction is in part mediated by autoinflammatory responses mediated via damage-associated molecular patterns (DAMPs, danger signals) and pattern-recognizing danger signal receptors (PRRs). METHODS: Peri-implant tissue and control samples from 10 patients with AES implants were immunostained for hypoxia inducible factor-1α (HIF-1α), activated caspase-3, high-mobility group box 1 (HMGB1), receptor for advanced glycation end product (RAGE), and toll-like receptors TLR2 and TLR4. Results were evaluated on a 0 to 4 scale (from 0% to >50% stained area). RESULTS: Peri-implant tissue around failed TAR implants had a relatively high mean HIF-1α score of 3 on a scale, which however was similar in control samples. HMGB1 (a DAMP) was seen to be mobilized from nuclei to cellular cytoplasm, and the active caspase-3(+) cells were increased. All PRRs were increased in revision samples. CONCLUSIONS: Increased expression of HMGB1 and other danger signals together with increased PRR-dependent responsiveness could contribute to autoinflammatory peri-implantitis, multilocular cyst formation, and osteolysis in failed TAR implants. LEVEL OF EVIDENCE: Level IV, case series.

Sample processing, protocol, and statistical analysis of the time-of-flight secondary ion mass spectrometry (ToF-SIMS) of protein, cell, and tissue samples.

Time-of-flight secondary ion mass spectrometry (ToF-SIMS) is increasingly being used in analysis of biological samples. For example, it has been applied to distinguish healthy and osteoarthritic human cartilage. This chapter discusses ToF-SIMS principle and instrumentation including the three modes of analysis in ToF-SIMS. ToF-SIMS sets certain requirements for the samples to be analyzed; for example, the samples have to be vacuum compatible. Accordingly, sample processing steps for different biological samples, i.e., proteins, cells, frozen and paraffin-embedded tissues and extracellular matrix for the ToF-SIMS are presented. Multivariate analysis of the ToF-SIMS data and the necessary data preprocessing steps (peak selection, data normalization, mean-centering, and scaling and transformation) are discussed in this chapter.

Osteogenic differentiation on DLC-PDMS-h surface.

The hypothesis was that anti-fouling diamond-like carbon polydimethylsiloxane hybrid (DLC-PDMS-h) surface impairs early and late cellular adhesion and matrix-cell interactions. The effect of hybrid surface on cellular adhesion and cytoskeletal organization, important for osteogenesis of human mesenchymal stromal cells (hMSC), where therefore compared with plain DLC and titanium (Ti). hMSCs were induced to osteogenesis and followed over time using scanning electron microscopy (SEM), time-of-flight secondary ion mass spectrometry (ToF-SIMS), immunofluorescence staining, quantitative real-time polymerase chain reaction (qRT-PCR), and hydroxyapatite (HA) staining. SEM at 7.5 hours showed that initial adherence and spreading of hMSC was poor on DLC-PDMS-h. At 5 days some hMSC were undergoing condensation and apoptotic fragmentation, whereas cells on DLC and Ti grew well. DAPI-actin-vinculin triple staining disclosed dwarfed cells with poorly organized actin cytoskeleton-focal complex/adhesion-growth substrate attachments on hybrid coating, whereas spread cells, organized microfilament bundles, and focal adhesions were seen on DLC and in particular on Ti. Accordingly, at day one ToF-SIMS mass peaks showed poor protein adhesion to DLC-PDMS-h compared with DLC and Ti. COL1A1, ALP, OP mRNA levels at days 0, 7, 14, 21, and/or 28 and lack of HA deposition at day 28 demonstrated delayed or failed osteogenesis on DLC-PDMS-h. Anti-fouling DLC-PDMS-h is a poor cell adhesion substrate during the early protein adsorption-dependent phase and extracellular matrix-dependent late phase. Accordingly, some hMSCs underwent anoikis-type apoptosis and failed to complete osteogenesis, due to few focal adhesions and poor cell-to-ECM contacts. DLC-PDMS-h seems to be a suitable coating for non-integrating implants/devices designed for temporary use.

Back-side wear in HexLoc cups clinico-radiological, immunohistopathological, finite element, and retrieval analysis studies.

The HexLoc locking system was designed to prevent back-side wear of the polyethylene liner in the modular cementless metal-backed acetabular cup, but failed. Back-side wear was analyzed using clinico-radiological data, immunohistopathology, finite element modeling (FEM, and retrieval analysis. Screw holes allowed entry of titanium oxide and exit of polyethylene particles. Birefringent polyethylene wear particles were found behind the metal cup in macrophages containing pro-inflammatory tumor necrosis factor-α and interleukin-1ß, whereas fibroblast-like cells stained for osteoclastogenic receptor activator of nuclear factor kappa B ligand (RANKL). Computerized tomography revealed granulomas (83% versus 17 %) and cortical destruction (50% versus 5%) better than radiographs. In FEM, a change of the abduction angle from 45 to 60 deg, and liner thickness from 4.8 mm to 2.5 mm, increased the back-side wear by 90% and 120%, respectively. Screw holes were stress concentration areas; their removal decreased wear by 40%. Modeling results were validated in retrieved implants, which demonstrated extensive back-side wear damage of liners with a high abduction angle. Combined clinico-radiological, immunohistopathological, FEM, and retrieval analysis disclosed that back-side wear in the HexLoc design is sensitive to the abduction angle, liner thickness, and presence of screw holes.

Toll-like receptors in human chondrocytes and osteoarthritic cartilage.

BACKGROUND AND PURPOSE: Degenerating cartilage releases potential danger signals that react with Toll-like receptor (TLR) type danger receptors. We investigated the presence and regulation of TLR1, TLR2, and TLR9 in human chondrocytes. METHODS: We studied TLR1, TLR2, TLR4, and TLR9 mRNA (qRT-PCR) and receptor proteins (by immunostaining) in primary mature healthy chondrocytes, developing chondrocytes, and degenerated chondrocytes in osteoarthritis (OA) tissue sections of different OARSI grades. Effects of a danger signal and of a pro-inflammatory cytokine on TLRs were also studied. RESULTS: In primary 2D-chondrocytes, TLR1 and TLR2 were strongly expressed. Stimulation of 2D and 3D chondrocytes with a TLR1/2-specific danger signal increased expression of TLR1 mRNA 1.3- to 1.8-fold, TLR2 mRNA 2.6- to 2.8-fold, and TNF-α mRNA 4.5- to 9-fold. On the other hand, TNF-α increased TLR1 mRNA] expression 16-fold, TLR2 mRNA expression 143- to 201-fold, and TNF-α mRNA expression 131- to 265-fold. TLR4 and TLR9 mRNA expression was not upregulated. There was a correlation between worsening of OA and increased TLR immunostaining in the superficial and middle cartilage zones, while chondrocytes assumed a CD166(×) progenitor phenotype. Correspondingly, TLR expression was high soon after differentiation of mesenchymal stem cells to chondrocytes. With maturation, it declined (TLR2, TLR9). INTERPRETATION: Mature chondrocytes express TLR1 and TLR2 and may react to cartilage matrix/chondrocyte-derived danger signals or degradation products. This leads to synthesis of pro-inflammatory cytokines, which stimulate further TLR and cytokine expression, establishing a vicious circle. This suggests that OA can act as an autoinflammatory disease and links the old mechanical wear-and-tear concept with modern biochemical views of OA. These findings suggest that the chondrocyte itself is the earliest and most important inflammatory cell in OA.

Do changing toll-like receptor profiles in different layers and grades of osteoarthritis cartilage reflect disease severity?

OBJECTIVE: Cartilage degeneration in osteoarthritis (OA) leads to release of potential danger signals. The aim of our study was to profile OA cartilage for the Toll-like receptor (TLR) danger signal receptors. METHODS: Osteochondral cylinders from total knee replacements were graded using OA Research Society International score and stained for proteoglycans, collagenase-cleaved type II collagen, and TLR 1-10, which were analyzed histomorphometrically. RESULTS: Grade 1 OA lesions contained 22%-55% TLR 1-9-positive cells in the surface zone, depending on the TLR type. In Grade 2 TLR, immunoreactivity was 60%-100% (p < 0.01) and it was even higher in Grades 3 and 4 (p < 0.01 vs Grade 1). TLR-positive cells in Grade 1 middle zone were low, 0-19.9%, but were 5.1%-32.7% in Grade 2 (p < 0.01) and 34%-83% in Grades 3-4 samples (p < 0.001). TLR values in Grade 5 were low (14.3%-28.7%; p < 0.001). In Grades 3-4 OA, cartilage matrix stained strongly for TLR. In Grade 1, COL2-3/4M was restricted to chondrocytes, but was increasingly seen in matrix upon progress of OA to Grade 4, and then declined. CONCLUSION: Cells in the gliding surface zone are fully equipped with TLR in mild OA. Their proportion increases and extends to the middle or even the deep zone, reflecting OA progression. COL2A-3/4M staining suggests Endo180-mediated intake for intralysosomal degradation by cathepsins in Grade 1, but in higher grades this chondrocyte-mediated clearance fails and the matrix demonstrates extensive collagenase-induced damage. Detached and/or partially degraded matrix components can then act as endogenous danger signals (damage-associated molecular patterns or DAMP) and stimulate increasingly TLR-equipped chondrocytes to inflammation. At the peak inflammatory response, soluble TLR may exert negative feedback, explaining in part the low TLR levels in Grade 5 OA.

Cell adhesion and osteogenic differentiation on three-dimensional pillar surfaces.

We hypothesized that when compared with conventional two-dimensional (2D) cultures, substrates containing 3D micropillars would allow cells to grow at levels, activating their cytoskeleton to promote osteogenesis. Fibroblasts, osteoblast-like cells, and mesenchymal stem cells (MSCs) were studied. Planar substrates were compared with 200-nm-, 5-µm-, and 20-µm-high pillars of Ormocomp®, Si, diamond-like carbon, or TiO(2). Scanning electron microscopy and staining of actin cytoskeleton showed 7.5-h adhesion to pillar edges and 5-day stretching between adhesion contacts > 100-µm distances of fibroblast and MSC in 3D networks, whereas SaOS-2 cells adhered flatly and individually on horizontal and vertical surfaces. ERK and ROCK immunostaining at 14 and 21 days confirmed activation of the cytoskeleton. In contrast to expectations, success to induce osteogenesis was dominated by the cytocompatibility of the substrate over the 3D structure. This was shown using early alkaline phosphatase, intermediate osteopontin, and late mineralization markers, together with bone nodule formation, which were seen in planar substrates and low-profile TiO(2) pillars, but were poor in the 20-µm landscape. The lack of intercellular contacts seems to halt the osteogenesis-promoting effects of cytoskeletal organization and tension described earlier.

Formation and retention of staphylococcal biofilms on DLC and its hybrids compared to metals used as biomaterials.

Staphylococcus epidermidis and Staphylococcus aureus cause most of the implant-related infections. Antibiotic treatment often fails and cure requires surgical intervention. It was hypothesized that biomaterial coatings resistant to biofilms offer a preventive option. Physical vapour deposited diamond-like carbon (DLC) and its polytetrafluoroethylene (DLC-PTFE-h) and polydimethylsiloxane (DLC-PDMS-h) hybrids were compared to titanium (Ti), tantalum (Ta) and chromium (Cr) thin films on silicon wafers for their resistance against formation and/or retention of biofilms produced by S. epidermidis and S. aureus in vitro. Sample surfaces were characterized for surface topography, contact angle and zeta-potential, because such properties might affect the biofilm. Biofilm was stained using calcofluor white and analysed in fluorescence microscopy using morphometry. Sixteen hour incubation was selected in pilot tests; at this checkpoint Ti, Ta, Cr and DLC-PDMS-h were almost fully covered by biofilm, but DLC and DLC-PTFE-h were only partially biofilm coated by S. epidermidis (88±26%, p<0.001 and 56±39%, p<0.001, respectively) or S. aureus (81±24%, p<0.001 and 51±26%, p<0.001, respectively). DLC and its PTFE hybrid offer a potential biofilm hostile surface coating for implants and medical devices. This ability to resist biofilm formation and attachment could not be explained by only one factor, but it seems to be related to a combination of various properties, with electrokinetic streaming potential and protein coating being particularly important for its outcome.

In vitro adhesion of staphylococci to diamond-like carbon polymer hybrids under dynamic flow conditions.

This study compares the ability of selected materials to inhibit adhesion of two bacterial strains commonly implicated in implant-related infections. These two strains are Staphylococcus aureus (S-15981) and Staphylococcus epidermidis (ATCC 35984). In experiments we tested six different materials, three conventional implant metals: titanium, tantalum and chromium, and three diamond-like carbon (DLC) coatings: DLC, DLC-polydimethylsiloxane hybrid (DLC-PDMS-h) and DLC-polytetrafluoroethylene hybrid (DLC-PTFE-h) coatings. DLC coating represents extremely hard material whereas DLC hybrids represent novel nanocomposite coatings. The two DLC polymer hybrid films were chosen for testing due to their hardness, corrosion resistance and extremely good non-stick (hydrophobic and oleophobic) properties. Bacterial adhesion assay tests were performed under dynamic flow conditions by using parallel plate flow chambers (PPFC). The results show that adhesion of S. aureus to DLC-PTFE-h and to tantalum was significantly (P < 0.05) lower than to DLC-PDMS-h (0.671 ± 0.001 × 10(7)/cm(2) and 0.751 ± 0.002 × 10(7)/cm(2) vs. 1.055 ± 0.002 × 10(7)/cm(2), respectively). No significant differences were detected between other tested materials. Hence DLC-PTFE-h coating showed as low susceptibility to S. aureus adhesion as all the tested conventional implant metals. The adherence of S. epidermidis to biomaterials was not significantly (P < 0.05) different between the materials tested. This suggests that DLC-PTFE-h films could be used as a biomaterial coating without increasing the risk of implant-related infections.

Oblique self-assemblies and order-order transitions in polypeptide complexes with PEGylated triple-tail lipids.

We report on highly ordered oblique self-assemblies in ionic complexes of PEGylated triple-tail lipids and cationic polypeptides, as directed by side-chain crystallization, demonstrating also reversible oblique-to-hexagonal order-order transitions upon melting of the side chains. This is achieved in bulk by complexing cationic homopolypeptides, poly-l-lysine (PLys), poly-l-arginine (PArg), and poly-l-histidine (PHis), in stoichiometric amounts with anionic lipids incorporating two hydrophobic alkyl tails and one hydrophilic polyethylene glycol (PEG) tail in a star-shaped A(2)B geometry. Based on Fourier transform infrared spectroscopy (FTIR), the PLys and PArg complexes fold into α-helical conformation. Aiming to periodicities at different length scales, that is, hierarchies, the PEG tails were selected to control the separation of the polypeptide helices in one direction while the alkyl tails determine the distance between the hydrophilic polypeptide/PEG layers, resulting in an oblique arrangement of the helices. We expect that the high overall order, where the self-assembled domains are in 2D registry, is an outcome of a favorable interplay of plasticization due to the hydrophobic and hydrophilic lipid tails combined with the shape persistency of the peptide helices and the crystallization of the lipid alkyl chains. Upon heating the complexes over the melting temperature of the alkyl tails, an order-order transition from oblique to hexagonal columnar morphology was observed. This transition is reversible, that is, the oblique structure with 2D correlation of the helices is fully returned upon cooling, implying that the alkyl tail crystallization guides the structure formation. Also PHis complex forms an oblique self-assembly. However, instead of α-helices, FTIR suggests formation of helical structures lacking intramolecular hydrogen bonds, stabilized by steric crowding of the lipid. The current study exploits competition between the soft and harder domains, which teaches on concepts toward well-defined polypeptide-based materials.

Self-assembly and induced circular dichroism in dendritic supramolecules with cholesteric pendant groups.

We report on the solid-state structural features of self-assembled chiral supramolecules based on ionic complexation of chiral cholesteric pendant groups with achiral dendritic macromolecules and show that their optical activity exhibits a systematic change in the ultraviolet/visible light (UV-vis) absorption and enhancement in the circular dichroism (CD) signal, indicating the occurrence of supramolecular chirality, also referred to as induced circular dichroism (ICD). We construct a homologous series of complexes by varying systematically from 1 to 3 the generation of dendritic units contained in dendrons, dendrimers, and dendronized polymers. The structural properties of the complexes are investigated by means of small-angle X-ray scattering (SAXS) and transmission electron microscopy (TEM). Depending on the class of dendritic molecule and the generation, lamellar, columnar hexagonal, oblique columnar, and rectangular columnar phases can be found, with a direct correlation among the degrees of freedom of the dendritic macromolecules used and the level of order achieved in the self-assembled solid-state structures. The enhancement of the optical signals of these mesoscopic structures appears to be correlated with their order in the solid state. Complexes with the longest lattice correlation lengths also show the most enhanced CD signals. These results show the unique versatility of dendritic macromolecules as supramolecular templates capable of organizing low molecular weight chiral pendant units into a variety of solid-state structures with amplified optical properties.

Interactions of human bone cells with diamond-like carbon polymer hybrid coatings.

Diamond-like carbon (DLC) coatings produced using the plasma-accelerating filtered pulsed arc discharge (FPAD) method display excellent adherence to the substrate and improve its corrosion resistance. This article reports the interactions of human osteoblastic cells with DLC and two DLC polymer hybrid (DLC-p-h) coatings deposited on smooth, matt and rough silicon wafers by the FPAD method. The DLC-p-h materials were DLC-polytetrafluoroethylene hybrid (DLC-PTFE-h) and DLC-polydimethylsiloxane hybrid (DLC-PDMS-h) coatings. The biocompatibility of the coatings was assayed by using mesenchymal stem cells, primary osteoblasts and Saos-2 cells. Human mesenchymal stem cells proliferated when cultured on DLC and DLC-PTFE-h, but their numbers diminished on DLC-PDMS-h. In all three cell types studied, phalloidin-TRITC staining disclosed cell-type organization typical of an actin cytoskeleton on DLC and DLC-PTFE-h, but minimal and disorganized stress fibers on cells cultured on DLC-PDMS-h. The microtubular cytoskeleton was similarly disorganized on DLC-PDMS-h. Cells on DLC-PDMS-h developed a peculiar form of membrane damage, with nuclear staining by propidium iodide associated with granular calcein staining of the cytoplasm. Active caspase-3 labeling was only seen in cells cultured on DLC-PDMS-h, indicating that these cells undergo apoptosis induced by defective cell adhesion. Results suggest that DLC-PDMS-h coatings might be useful in orthopedic applications where an implant or implant-facet should be protected against bone overgrowth while DLC and DLC-PTFE-h coatings might improve osseointegration.

Bacterial adhesion to diamond-like carbon as compared to stainless steel.

Recent studies suggest that diamond-like carbon (DLC) coatings are suitable candidates for application on biomedical devices and implants, due to their high hardness, low friction, high wear and corrosion resistance, chemical inertness, smoothness, and tissue and blood compatibility. However, most studies have neglected the potential susceptibility of DLC coatings to bacterial adhesion, which is the first step in the development of implant-related infections. This study compares adhesion of seven bacterial strains, commonly implicated in implant-related infections, to tetrahedral amorphous carbon, with their adhesion to AISI 316L surgical steel. The results show that bacterial adhesion to DLC was similar to the adhesion to commonly used stainless steel. This suggests that DLC coating can be advantageously used on implants made of AISI 316L or other materials without increasing the risk to implant-related infections.

Load-bearing biomedical applications of diamond-like carbon coatings - current status.

The current status of diamond-like carbon (DLC) coatings for biomedical applications is reviewed with emphasis on load-bearing coatings. Although diamond-like carbon coating materials have been studied for decades, no indisputably successful commercial biomedical applications for high load situations exist today. High internal stress, leading to insufficient adhesion of thick coatings, is the evident reason behind this delay of the break-through of DLC coatings for applications. Excellent adhesion of thick DLC coatings is of utmost importance for load-bearing applications. According to this review superior candidate material for articulating implants is thick and adherent DLC on both sliding surfaces. With the filtered pulsed arc discharge method, all the necessary requirements for the deposition of thick and adherent DLC are fulfilled, provided that the substrate material is selected properly.

Adhesion of staphylococcal and Caco-2 cells on diamond-like carbon polymer hybrid coating.

Staphylococci cause the majority of the nosocomial implant-related infections initiated by adhesion of planktonic bacteria to the implant surface. It was hypothesized that plasma accelerating filtered pulsed arc discharge method enables combination of the advantageous properties of diamond with the antisoiling properties of polymers. Diamond-like carbon polytetrafluoroethylene hybrid (DLC-PTFE-h) coating was produced. The adhesion of S. aureus ATCC 25923 (10(8) colony-forming units/mL) to surfaces diminished from 2.32%, 2.35%, and 2.57% of high quality DLC, titanium, and oxidized silicon, respectively, to 1.93% of DLC-PTFE-h. For S. epidermidis ATCC 35984 the corresponding figures were 3.90%, 3.32%, 3.47%, and 2.57%. Differences in bacterial adhesion between recombinant DLC-PTFE-h and other materials were statistically significant (p < 0.05). In contrast, human Caco-2 cells adhered as well to DLC-PTFE-h as to DLC, titanium, or silicon, which were all in the MTT test found to be cytocompatible. DLC-PTFE-h coating can be used to modify the surface properties of any surgical implants and is an unfavorable substrate for staphylococcal cells, but compatible with human Caco-2 cells. DLC-PTFE-h coating may help in the combat against Staphylococcus-related implant infections which usually require both antibiotics and surgical removal of the implant for cure.