title: Cytokine expression in human osteoblasts after antiseptic treatment: a comparative study between polyhexanide and chlorhexidine.
abstract: OBJECTIVE
  Chlorhexidine and polyhexanide are frequently used antiseptics in clinical practice and have a broad antimicrobial range. Both antiseptics are helpful medical agents for septic wound treatment with a high potential for defeating joint infections. Their effect on human osteoblasts has, so far, not been sufficiently evaluated. The aim of this study was to investigate the activating potential of polyhexanide and chlorhexidine on inflammatory cytokines/chemokines in human osteoblasts in vitro.
  
  
  METHODS
  Human osteoblasts were isolated and cultivated in vitro and then treated separately with 0.1% and 2% chlorhexidine and 0.04% polyhexanide as commonly applied concentrations in clinical practice. Detection of cell structure and cell morphology was performed by light microscopic inspection. Cytokine and chemokine secretion was determined by using a multiplex suspension array.
  
  
  RESULTS
  Cell shrinking, defective cell membrane, and the loss of cell adhesion indicated cell damage of human osteoblasts after treatment with both antiseptics was evaluated by using light microscopy. Polyhexanide, but not chlorhexidine, caused human osteoblasts to secrete various interleukins (1β, 6, and 7), interferon γ, tumor necrosis factor α, vascular endothelial growth factor, eotaxin, fibroblast growth factor basic, and granulocyte macrophage colony-stimulating factor as quantified by multiplex suspension array.
  
  
  CONCLUSIONS
  Both antiseptics induced morphological cell damage at an optimum exposure between 1 and 10 min. But only polyhexanide mediated a pronounced secretion of inflammatory cytokines and chemokines in human osteoblasts. Therefore, we recommend a preferred usage of chlorhexidine in septic surgery to avoid the induction of an inflammatory reaction.
authors.affiliation: 1Department of Orthopaedics, Rudolf-Elle-Hospital, Friedrich-Schiller-University of Jena, Eisenberg, Germany.
authors.forename: Eric
authors.initials: E
authors.lastname: Röhner
authors.forename: Paula
authors.initials: P
authors.lastname: Hoff
authors.forename: Timo
authors.initials: T
authors.lastname: Gaber
authors.forename: Annemarie
authors.initials: A
authors.lastname: Lang
authors.forename: Pauline
authors.initials: P
authors.lastname: Vörös
authors.forename: Frank
authors.initials: F
authors.lastname: Buttgereit
authors.forename: Carsten
authors.initials: C
authors.lastname: Perka
authors.forename: Christoph
authors.initials: C
authors.lastname: Windisch
authors.forename: Georg
authors.initials: G
authors.lastname: Matziolis
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000494:pharmacology* / Q000633:toxicity; D001645:Biguanides / Q000494:pharmacology* / Q000633:toxicity; D001853:Bone Marrow / Q000473:pathology; D002448:Cell Adhesion / Q000187:drug effects; D048430:Cell Shape / Q000187:drug effects; D002478:Cells, Cultured; D018925:Chemokines / Q000096:biosynthesis / Q000378:metabolism; D002710:Chlorhexidine / Q000494:pharmacology* / Q000633:toxicity; D016207:Cytokines / Q000096:biosynthesis* / Q000378:metabolism; D004353:Drug Evaluation, Preclinical; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000096:biosynthesis / Q000235:genetics; D020370:Osteoarthritis, Knee / Q000473:pathology; D010006:Osteoblasts / Q000187:drug effects* / Q000378:metabolism
chemical_list: D000891:Anti-Infective Agents, Local; D001645:Biguanides; D018925:Chemokines; D016207:Cytokines; D036341:Intercellular Signaling Peptides and Proteins; C031233:polihexanide; D002710:Chlorhexidine
keywords: chemokines; chlorhexidine; cytokines; human osteoblasts; polyhexanide