title: Prevention of Biomaterial Infection by Pre-Operative Incubation with Human Cells.
abstract: BACKGROUND
  Cells of tissues and biofilm forming bacteria compete for the living space on the surface of an implant. We hypothesized the incubation of the implant (titanium, polydimethylsiloxane, and polystyrene surface) with human cells before implantation as a strategy to prevent bacterial adhesion and biofilm formation.
  
  
  METHODS
  After 24 hours of incubation with human osteogenic sarcoma SaOS-2 cells (1 × 105cells/mL), the materials were incubated for 4.5 hours or two days with Staphylococcus aureus in serial 1:10 dilutions of 108colony-forming units/mL. The bacterial adherence and biofilm biomass on materials pre-incubated with SaOS-2 cells were compared with our previous results on materials incubated only with bacteria or in simultaneous co-culture of SaOS-2 cells and S. aureus. Fluorescent microscopy and crystal violet stain were used. The number of viable SaOS-2 and bacterial cells present was tested using colorimetric methods (MTT, LDH) and drop plate method, respectively.
  
  
  RESULTS
  The pre-treatment with human cells was associated with a reduction of bacterial colonization of the biomaterial at 4.5 hours and 48 hours compared with the non-pre-treated materials. The presence of bacteria decreased the number of viable human cells on all materials. ( Supplementary Fig. 1 ; see online supplementary materials at www.liebertpub.com/sur ).
  
  
  CONCLUSIONS
  These results suggest that the pre-operative incubation of prostheses with host cells could prevent infection of biomaterials.
authors.affiliation: 1 Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki , Helsinki, Finland .
authors.forename: Ramón
authors.initials: R
authors.lastname: Pérez-Tanoira
authors.affiliation: 1 Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki , Helsinki, Finland .
authors.forename: Antti A
authors.initials: AA
authors.lastname: Aarnisalo
authors.affiliation: 2 Clinicum, University of Helsinki , Helsinki, Finland .|5 Department of Rheumatology, Helsinki University Hospital and University of Helsinki , Helsinki, Finland .
authors.forename: Kari K
authors.initials: KK
authors.lastname: Eklund
authors.affiliation: 2 Clinicum, University of Helsinki , Helsinki, Finland .
authors.forename: Xia
authors.initials: X
authors.lastname: Han
authors.affiliation: 3 ORTON Research Institute , Helsinki, Finland .|4 ORTON Orthopedic Hospital , Helsinki, Finland .
authors.forename: Antti
authors.initials: A
authors.lastname: Soininen
authors.affiliation: 3 ORTON Research Institute , Helsinki, Finland .|4 ORTON Orthopedic Hospital , Helsinki, Finland .
authors.forename: Veli-Matti
authors.initials: VM
authors.lastname: Tiainen
authors.affiliation: 6 Clinical Microbiology , IIS-Fundación Jiménez Díaz, Madrid, Spain .
authors.forename: Jaime
authors.initials: J
authors.lastname: Esteban
authors.affiliation: 1 Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki , Helsinki, Finland .
authors.forename: Teemu J
authors.initials: TJ
authors.lastname: Kinnari
mesh_terms: D001422:Bacterial Adhesion; D058491:Bacterial Load; D001672:Biocompatible Materials; D018441:Biofilms / Q000254:growth & development*; D002448:Cell Adhesion; D002460:Cell Line; D002468:Cell Physiological Phenomena; D002470:Cell Survival; D003124:Colorimetry; D006801:Humans; D019736:Prostheses and Implants / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000502:physiology*
chemical_list: D001672:Biocompatible Materials
keywords: bacterial adherence; biofilm; biomaterial; pre-operative incubation; race for the surface