title: Preferred use of polyhexanide in orthopedic surgery.
abstract: In orthopedic and trauma surgery, the most frequently used antiseptic is polyhexanide. Its favored application is based on prepossessing tissue compatibility in contrast to various antiseptics and a high antimicrobiological effect. Recent studies showed toxic effects of this antiseptic on human chondrocytes. The aim of this study was to further analyze the toxic and apoptotic effects of polyhexanide on primary human chondrocytes. The hypothesis of this study was that polyhexanide induces apoptosis on human chondrocytes. Primary human chondrocytes were isolated and cultured from human donors with osteoarthritis of the knee who underwent total arthroplasty and had no indication of infection. Polyhexanide at a standard concentration of 0.04% was added to the monolayer cultures. Early and late apoptotic cells were analyzed by flow cytometric detection of annexin V, active caspases, and 7AAD, and by fluorescence microscopy using annexin V and propidium iodide staining. Flow cytometric analysis demonstrated an increase of annexin V and active caspases expression of human chondrocytes after incubation with polyhexanide. Fluorescence microscopy demonstrated a high number of annexin V positive and propidium iodide negative early apoptotic cells. The data show that polyhexanide promotes apoptosis on primary human chondrocytes in vitro, which may indicate the use of polyhexanide in septic joint surgery.
authors.affiliation: Department of Traumatology and Orthopedics, Charité – Universitätsmedizin, Berlin, Germany. eric.roehner@charite.de
authors.forename: Eric
authors.initials: E
authors.lastname: Röhner
authors.forename: Jörn B
authors.initials: JB
authors.lastname: Seeger
authors.forename: Paula
authors.initials: P
authors.lastname: Hoff
authors.forename: Tilman
authors.initials: T
authors.lastname: Pfitzner
authors.forename: Bernd
authors.initials: B
authors.lastname: Preininger
authors.forename: Kristin
authors.initials: K
authors.lastname: Andreas
authors.forename: Frank
authors.initials: F
authors.lastname: Buttgereit
authors.forename: Carsten
authors.initials: C
authors.lastname: Perka
authors.forename: Georg
authors.initials: G
authors.lastname: Matziolis
mesh_terms: D017304:Annexin A5 / Q000378:metabolism; D000891:Anti-Infective Agents, Local / Q000633:toxicity*; D017209:Apoptosis / Q000187:drug effects; D001645:Biguanides / Q000633:toxicity*; D015415:Biomarkers / Q000378:metabolism; D020169:Caspases / Q000378:metabolism; D002478:Cells, Cultured; D019902:Chondrocytes / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D003609:Dactinomycin / Q000031:analogs & derivatives / Q000378:metabolism; D005434:Flow Cytometry; D006801:Humans; D008856:Microscopy, Fluorescence; D019637:Orthopedic Procedures / Q000379:methods*
chemical_list: D017304:Annexin A5; D000891:Anti-Infective Agents, Local; D001645:Biguanides; D015415:Biomarkers; D003609:Dactinomycin; C031233:polihexanide; C025942:7-aminoactinomycin D; D020169:Caspases