1. Interaction of Bacteria, Immune Cells, and Surface Topography in Periprosthetic Joint Infections
- Author
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Cristina Belgiovine, Luca Pellegrino, Alberto Bulgarelli, Francesca Cecilia Lauta, Alessia Di Claudio, Roberta Ciceri, Assunta Cancellara, Francesca Calcaterra, Domenico Mavilio, Guido Grappiolo, Katia Chiappetta, Mattia Loppini, and Roberto Rusconi
- Subjects
Inorganic Chemistry ,Organic Chemistry ,periprosthetic joint infection (PJI) ,immune response ,surface topography ,staphylococcal biofilms ,General Medicine ,Physical and Theoretical Chemistry ,Molecular Biology ,Spectroscopy ,Catalysis ,Computer Science Applications - Abstract
The incidence of periprosthetic joint infections (PJIs) is ~2% of total procedures and it is expected to rise due to an ageing population. Despite the large burden PJI has on both the individual and society, the immune response to the most commonly isolated pathogens, i.e., Staphylococcus aureus and Staphylococcus epidermidis, remains incompletely understood. In this work, we integrate the analysis of synovial fluids from patients undergoing hip and knee replacement surgery with in-vitro experimental data obtained using a newly developed platform, mimicking the environment of periprosthetic implants. We found that the presence of an implant, even in patients undergoing aseptic revisions, is sufficient to induce an immune response, which is significantly different between septic and aseptic revisions. This difference is confirmed by the presence of pro- and anti-inflammatory cytokines in synovial fluids. Moreover, we discovered that the immune response is also dependent on the type of bacteria and the topography of the implant surface. While S. epidermidis seems to be able to hide better from the attack of the immune system when cultured on rough surfaces (indicative of uncemented prostheses), S. aureus reacts differently depending on the contact surface it is exposed to. The experiments we performed in-vitro also showed a higher biofilm formation on rough surfaces compared to flat ones for both species, suggesting that the topography of the implant could influence both biofilm formation and the consequent immune response.
- Published
- 2023
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