Does PGE₁ vasodilator prevent orthopaedic implant-related infection in diabetes? Preliminary results in a mouse model.
BACKGROUND
Implant-related infections are characterized by bacterial colonization and biofilm formation on the prosthesis. Diabetes represents one of the risk factors that increase the chances of prosthetic infections because of related severe peripheral vascular disease. Vasodilatation can be a therapeutic option to overcome diabetic vascular damages and increase the local blood supply. In this study, the effect of a PGE₁ vasodilator on the incidence of surgical infections in diabetic mice was investigated.


METHODS
A S. aureus implant-related infection was induced in femurs of diabetic mice, then differently treated with a third generation cephalosporin alone or associated with a PGE₁ vasodilator. Variations in mouse body weight were evaluated as index of animal welfare. The femurs were harvested after 28 days and underwent both qualitative and quantitative analysis as micro-CT, histological and microbiological analyses.


RESULTS
The analysis performed in this study demonstrated the increased host response to implant-related infection in diabetic mice treated with the combination of a PGE₁ and antibiotic. In this group, restrained signs of infections were identified by micro-CT and histological analysis. On the other hand, the diabetic mice treated with the antibiotic alone showed a severe infection and inability to successfully respond to the standard antimicrobial treatment.


CONCLUSIONS
The present study revealed interesting preliminary results in the use of a drug combination of antibiotic and vasodilator to prevent implant-related Staphylococcus aureus infections in a diabetic mouse model.
Cell and Tissue Engineering Laboratory, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
Arianna B
AB
Lovati
Dipartimento di Chirurgia Ricostruttiva e delle Infezioni Osteo-articolari, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
Carlo L
CL
Romanò
Dipartimento di Chirurgia Ricostruttiva e delle Infezioni Osteo-articolari, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
Lorenzo
L
Monti
Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
Christian
C
Vassena
Laboratory of Cancer Cachexia AIRC Start-Up, Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Sara
S
Previdi
Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy; Department of Biomedical Science for Health, University of Milan, Milan, Italy.
Lorenzo
L
Drago
D000527:Alprostadil / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D058491:Bacterial Load / Q000187:drug effects; D001835:Body Weight; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D003921:Diabetes Mellitus, Experimental / Q000097:blood / Q000150:complications*; D004195:Disease Models, Animal; D005260:Female; D007596:Joints / Q000473:pathology / Q000503:physiopathology; D016688:Mice, Inbred NOD; D009985:Orthopedics; D016459:Prosthesis-Related Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000502:physiology; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*; D055114:X-Ray Microtomography
D014665:Vasodilator Agents; D000527:Alprostadil