title: Biosafety of the Novel Vancomycin-loaded Bone-like Hydroxyapatite/Poly-amino Acid Bony Scaffold.
abstract: BACKGROUND
  Recently, local sustained-release antibiotics systems have been developed because they can increase local foci of concentrated antibiotics without increasing the plasma concentration, and thereby effectively decrease any systemic toxicity and side effects. A vancomycin-loaded bone-like hydroxyapatite/poly-amino acid (V-BHA/PAA) bony scaffold was successfully fabricated with vancomycin-loaded poly lactic-co-glycolic acid microspheres and BHA/PAA, which was demonstrated to exhibit both porosity and perfect biodegradability. The aim of this study was to systematically evaluate the biosafety of this novel scaffold by conducting toxicity tests in vitro and in vivo.
  
  
  METHODS
  According to the ISO rules for medical implant biosafety, for in vitro tests, the scaffold was incubated with L929 fibroblasts or rabbit noncoagulant blood, with simultaneous creation of positive control and negative control groups. The growth condition of L929 cells and hemolytic ratio were respectively evaluated after various incubation periods. For in vivo tests, a chronic osteomyelitis model involving the right proximal tibia of New Zealand white rabbits was established. After bacterial identification, the drug-loaded scaffold, drug-unloaded BHA/PAA, and poly (methyl methacrylate) were implanted, and a blank control group was also set up. Subsequently, the in vivo blood drug concentrations were measured, and the kidney and liver functions were evaluated.
  
  
  RESULTS
  In the in vitro tests, the cytotoxicity grades of V-BHA/PAA and BHA/PAA-based on the relative growth rate were all below 1. The hemolysis ratios of V-BHA/PAA and BHA/PAA were 2.27% and 1.42%, respectively, both below 5%. In the in vivo tests, the blood concentration of vancomycin after implantation of V-BHA/PAA was measured at far below its toxic concentration (60 mg/L), and the function and histomorphology of the liver and kidney were all normal.
  
  
  CONCLUSIONS
  According to ISO standards, the V-BHA/PAA scaffold is considered to have sufficient safety for clinical utilization.
authors.forename: Zhi-Dong
authors.initials: ZD
authors.lastname: Cao
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
authors.forename: Dian-Ming
authors.initials: DM
authors.lastname: Jiang
authors.forename: Ling
authors.initials: L
authors.lastname: Yan
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
mesh_terms: D000596:Amino Acids / Q000737:chemistry*; D000818:Animals; D001842:Bone and Bones; D017886:Durapatite / Q000737:chemistry*; D008863:Microspheres; D011108:Polymers / Q000737:chemistry; D011817:Rabbits; D054457:Tissue Scaffolds / Q000737:chemistry; D014640:Vancomycin / Q000009:adverse effects*
chemical_list: D000596:Amino Acids; D011108:Polymers; D014640:Vancomycin; D017886:Durapatite
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