Nanosensor-Enabled Detection and Identification of Intracellular Bacterial Infections in Macrophages.

Opportunistic bacterial pathogens can evade the immune response by residing and reproducing within host immune cells, including macrophages. These intracellular infections provide reservoirs for pathogens that enhance the progression of infections and inhibit therapeutic strategies. Current sensing strategies for intracellular infections generally use immunosensing of specific biomarkers on the cell surface or polymerase chain reaction (PCR) of the corresponding nucleic acids, making detection difficult, time-consuming, and challenging to generalize. Intracellular infections can induce changes in macrophage glycosylation, providing a potential strategy for signature-based detection of intracellular infections. We report here the detection of bacterial infection in macrophages using a boronic acid (BA)-based pH-responsive polymer sensor array engineered to distinguish mammalian cell phenotypes by their cell surface glycosylation signatures. The sensor was able to discriminate between different infecting bacteria in minutes, providing a promising tool for diagnostic and screening applications.

Evaluation of the metabolic activity of the torn rotator cuff muscles by 18 F-2-deoxy- d -glucose PET-computed tomography scan.

OBJECTIVES: Fatty atrophy and fatty infiltration have been considered as limiting factors for rotator cuff repair. The metabolic activity of the muscle can be measured noninvasively by PET. In our study, we aim to compare the metabolic activity between the shoulders with rotator cuff tears and normal shoulders. METHODS: All the patients with unilateral full-thickness rotator cuff tears were included. The patients were divided into two groups based on fatty atrophy and the metabolic activities of the rotator cuff muscles, trapezius, and deltoid were calculated using an 18 F-2-deoxy- d -glucose PET-computed tomography scan for comparison. RESULTS: A total of 17 patients were included. The standardized uptake values were compared between the affected shoulder and the normal shoulders. There was a significant increase in uptake in the insertion sites and musculotendinous junctions in the rotator cuff torn group. The standardized uptake values showed no significant difference between the low-grade and high-grade groups. CONCLUSION: Our first hypothesis was also proven wrong; when we found that there was no statistically significant difference in the metabolic activity in muscle bellies of normal shoulders and those with rotator cuff tears. Our second hypothesis was proven wrong when found that there was no statistically significant difference in the metabolic activities of rotator cuff muscles between high-grade and low-grade fatty atrophy groups. The metabolic activities of the middle deltoid and trapezius are inversely related. Based on the findings of our study, fatty atrophy or fatty infiltration alone cannot be considered a limiting factor for rotator cuff repair.

Antimicrobial-loaded biodegradable nanoemulsions for efficient clearance of intracellular pathogens in bacterial peritonitis.

Intracellular pathogenic bacteria use immune cells as hosts for bacterial replication and reinfection, leading to challenging systemic infections including peritonitis. The spread of multidrug-resistant (MDR) bacteria and the added barrier presented by host cell internalization limit the efficacy of standard antibiotic therapies for treating intracellular infections. We present a non-antibiotic strategy to treat intracellular infections. Antimicrobial phytochemicals were stabilized and delivered by polymer-stabilized biodegradable nanoemulsions (BNEs). BNEs were fabricated using different phytochemicals, with eugenol-loaded BNEs (E-BNEs) affording the best combination of antimicrobial efficacy, macrophage accumulation, and biocompatibility. The positively-charged polymer groups of the E-BNEs bind to the cell surface of macrophages, facilitating the entry of eugenol that then kills the intracellular bacteria without harming the host cells. Confocal imaging and flow cytometry confirmed that this entry occurred mainly via cholesterol-dependent membrane fusion. As eugenol co-localized and interacted with intracellular bacteria, antibacterial efficacy was maintained. E-BNEs reversed the immunosuppressive effects of MRSA on macrophages. Notably, E-BNEs did not elicit resistance selection after multiple exposures of MRSA to sub-therapeutic doses. The E-BNEs were highly effective against a murine model of MRSA-induced peritonitis with better bacterial clearance (99 % bacteria reduction) compared to clinically-employed treatment with vancomycin. Overall, these findings demonstrate the potential of E-BNEs in treating peritonitis and other refractory intracellular infections.

Antimicrobial polymer-loaded hydrogels for the topical treatment of multidrug-resistant wound biofilm infections.

Integration of antimicrobial polymeric nanoparticles into hydrogel materials presents a promising strategy to address multidrug-resistant biofilm infections. Here we report an injectable hydrogel loaded with engineered cationic antimicrobial polymeric nanoparticles (PNPs) for the effective topical treatment of severe wound biofilm infections. The PNPs demonstrated biofilm penetration and disruption, resulting in the eradication of resistant and persister cells that reside within the biofilm. Significantly, PNPs did not elicit resistance development even after multiple exposures to sub-therapeutic doses. In vitro studies showed PNPs significantly reduced prolonged inflammation due to infection and promoted fibroblast migration. These PNPs were then incorporated into Poloxamer 407 (P407) hydrogels and utilized as an inert carrier for PNPs to provide a controlled and sustained topical release of the antimicrobial nanoparticles at the wound area. In vivo studies using a mature (4-day) wound biofilm infection in a murine model mimicking severe human wound infections demonstrated provided 99% bacterial biofilm clearance and significantly enhanced wound healing. Overall, this work demonstrated the efficacy and selectivity of the antimicrobial polymer-loaded hydrogel platform as a topical treatment for difficult-to-treat wound biofilm infections.

Sensor Array-Enabled Identification of Drugs for Repolarization of Macrophages to Anti-Inflammatory Phenotypes.

Macrophages are key components of the innate immune system that have essential functions in physiological processes and diseases. The phenotypic plasticity of macrophages allows cells to be polarized into a multidimensional spectrum of phenotypes, broadly classed as pro-inflammatory (M1) and anti-inflammatory (M2) states. Repolarization of M1 to M2 phenotypes alters the immune response to ameliorate autoimmune and inflammation-associated diseases. Detection of this repolarization, however, is challenging to execute in high-throughput applications. In this work, we demonstrate the ability of a single polymer fabricated to provide a six-channel sensor array that can determine macrophage polarization phenotypes. This sensing platform provides a sensitive and high-throughput tool for detecting drug-induced M1-to-M2 repolarization, allowing the identification of new therapeutic leads for inflammatory diseases. The ability of this sensor array to discriminate different M2 subtypes induced by drugs can also improve the efficacy evaluation of anti-inflammatory drugs and avoid adverse effects.

Biodegradable nanoemulsion-based bioorthogonal nanocatalysts for intracellular generation of anticancer therapeutics.

Bioorthogonal catalysis mediated by transition metal catalysts (TMCs) provides controlled in situ activation of prodrugs through chemical reactions that do not interfere with cellular bioprocesses. The direct use of 'naked' TMCs in biological environments can have issues of solubility, deactivation, and toxicity. Here, we demonstrate the design and application of a biodegradable nanoemulsion-based scaffold stabilized by a cationic polymer that encapsulates a palladium-based TMC, generating bioorthogonal nanocatalyst "polyzymes". These nanocatalysts enhance the stability and catalytic activity of the TMCs while maintaining excellent mammalian cell biocompatibility. The therapeutic potential of these nanocatalysts was demonstrated through efficient activation of a non-toxic prodrug into an active chemotherapeutic drug, leading to efficient killing of cancer cells.

Synergistic Treatment of Multidrug-Resistant Bacterial Biofilms Using Silver Nanoclusters Incorporated into Biodegradable Nanoemulsions.

Multidrug resistance (MDR) in bacteria is a critical global health challenge that is exacerbated by the ability of bacteria to form biofilms. We report a combination therapy for biofilm infections that integrates silver nanoclusters (AgNCs) into polymeric biodegradable nanoemulsions (BNEs) incorporating eugenol. These Ag-BNEs demonstrated synergistic antimicrobial activity between the AgNCs and the BNEs. Microscopy studies demonstrated that Ag-BNEs penetrated the dense biofilm matrix and effectively disrupted the bacterial membrane. The Ag-BNE vehicle also resulted in more effective silver delivery into the biofilm than AgNCs alone. This combinacional system featured disruptionof biofilms by BNEs and enhanced delivery of AgNCs for synergy to provide highly efficient killing of MDR biofilms.

Identification of Proteins Using Supramolecular Gold Nanoparticle-Dye Sensor Arrays.

The rapid detection of proteins is very important in the early diagnosis of diseases. Gold nanoparticles (AuNPs) can be engineered to bind biomolecules efficiently and differentially. Cross-reactive sensor arrays have high sensitivity for sensing proteins using differential interactions between sensor elements and bioanalytes. A new sensor array was fabricated using surface-charged AuNPs with dyes supramolecularly encapsulated into the AuNP monolayer. The fluorescence of dyes is partially quenched by the AuNPs and can be restored or further quenched due to the differential interactions between AuNPs with proteins. This sensing system enables the discrimination of proteins in both buffer and human serum, providing a potential tool for real-world disease diagnostics.

Fungal Infection Post Arthroscopic Meniscal Repair: A Rare Complication.

Infections after arthroscopic procedures are rare. Infection due to fungal organisms is rarer and difficult to diagnose due to its insidious nature and chronic presentation but when neglected has devastating consequences. We present a 23-year-old immunocompetent adult post-arthroscopic meniscal repair with fungal surgical site infection. The patient underwent open debridement and was started on antifungals. His surgical wound healed and with physiotherapy he regained his full range of movement.

A Minimally Invasive Surgical Technique for Hallux Valgus Deformity Correction Using an Ultrasonic Bone Scalpel (All India Institute of Medical Sciences Technique).

Hallux valgus is a common forefoot deformity characterized by medial deviation of the first metatarsal and lateral deviation of the hallux. More than 150 procedures have been described for the hallux valgus deformity with no proven superiority of one over the other. The initial osteotomies are open, and with the advent of power and micro instruments, the osteotomies were manageable via mini incisions and percutaneous procedures. The minimally invasive procedures have been divided into three generations. The first-generation osteotomies involve wedge correction. The second and third-generation osteotomies are translational. The second generation is a simple osteotomy, and the third is a chevron-type osteotomy. In our technique, we have used a hybrid procedure of second and third-generation procedures. The technique uses an ultrasonic bone scalpel to create a transverse sub-capital osteotomy which is then fixed with screws for a stable construct.

Direct discrimination of cell surface glycosylation signatures using a single pH-responsive boronic acid-functionalized polymer.

Cell surface glycans serve fundamental roles in many biological processes, including cell-cell interaction, pathogen infection, and cancer metastasis. Cancer cell surface have alternative glycosylation to healthy cells, making these changes useful hallmarks of cancer. However, the diversity of glycan structures makes glycosylation profiling very challenging, with glycan 'fingerprints' providing an important tool for assessing cell state. In this work, we utilized the pH-responsive differential binding of boronic acid (BA) moieties with cell surface glycans to generate a high-content six-channel BA-based sensor array that uses a single polymer to distinguish mammalian cell types. This sensing platform provided efficient discrimination of cancer cells and readily discriminated between Chinese hamster ovary (CHO) glycomutants, providing evidence that discrimination is glycan-driven. The BA-functionalized polymer sensor array is readily scalable, providing access to new diagnostic and therapeutic strategies for cell surface glycosylation-associated diseases.

Identification of a TNF-TNFR-like system in malaria vectors (Anopheles stephensi) likely to influence Plasmodium resistance.

Identification of Plasmodium-resistance genes in malaria vectors remains an elusive goal despite the recent availability of high-quality genomes of several mosquito vectors. Anopheles stephensi, with its three distinctly-identifiable forms at the egg stage, correlating with varying vector competence, offers an ideal species to discover functional mosquito genes implicated in Plasmodium resistance. Recently, the genomes of several strains of An. stephensi of the type-form, known to display high vectorial capacity, were reported. Here, we report a chromosomal-level assembly of an intermediate-form of An. stephensi strain (IndInt), shown to have reduced vectorial capacity relative to a strain of type-form (IndCh). The contig level assembly with a L50 of 4 was scaffolded into chromosomes by using the genome of IndCh as the reference. The final assembly shows a heterozygous paracentric inversion, 3Li, involving 8 Mbp, which is syntenic to the extensively-studied 2La inversion implicated in Plasmodium resistance in An. gambiae involving 21 Mbp. Deep annotation of genes within the 3Li region in the IndInt assembly using the state-of-the-art protein-fold prediction and other annotation tools reveals the presence of a tumor necrosis factor-alpha (TNF-alpha) like gene, which is the homolog of the Eiger gene in Drosophila. Subsequent chromosome-wide searches revealed homologs of Wengen (Wgn) and Grindelwald (Grnd) genes, which are known to be the receptors for Eiger in Drosophila. We have identified all the genes in IndInt required for Eiger-mediated signaling by analogy to the TNF-alpha system, suggesting the presence of a functionally-active Eiger signaling pathway in IndInt. Comparative genomics of the three type-forms with that of IndInt, reveals structurally disruptive mutations in Eiger gene in all three strains of the type-form, suggesting compromised innate immunity in the type-form as the likely cause of high vectorial capacity in these strains. This is the first report of the presence of a homolog of Eiger in malaria vectors, known to be involved in cell death in Drosophila, within an inversion region in IndInt syntenic to an inversion associated with Plasmodium resistance in An. gambiae.

Ultrasound-Enhanced Antibacterial Activity of Polymeric Nanoparticles for Eradicating Bacterial Biofilms.

Bacterial biofilms are a major healthcare concern resulting in refractory conditions such as chronic wounds, implant infections and failure, and multidrug-resistant infections. Aggressive and invasive strategies are employed to cure biofilm infections but are prone to long and expensive treatments, adverse side-effects, and low patient compliance. Recent strategies such as ultrasound-based therapies and antimicrobial nanomaterials have shown some promise in the effective eradication of biofilms. However, maximizing therapeutic effect while minimizing healthy tissue damage is a key challenge that needs to be addressed. Here a combination treatment involving ultrasound and antimicrobial polymeric nanoparticles (PNPs) that synergistically eradicate bacterial biofilms is reported. Ultrasound treatment rapidly disrupts biofilms and increases penetration of antimicrobial PNPs thereby enhancing their antimicrobial activity. This results in superior biofilm toxicity, while allowing for a two- to sixfold reduction in both the concentration of PNPs as well as the duration of ultrasound. Furthermore, that this reduction minimizes cytotoxicity toward fibroblast cells, while resulting in a 100- to 1000-fold reduction in bacterial concentration, is demonstrated.

Dual antimicrobial-loaded biodegradable nanoemulsions for synergistic treatment of wound biofilms.

Wound biofilm infections caused by multidrug-resistant (MDR) bacteria constitute a major threat to public health; acquired resistance combined with resistance associated with the biofilm phenotype makes combatting these infections challenging. Biodegradable polymeric nanoemulsions that encapsulate two hydrophobic antimicrobial agents (eugenol and triclosan) (TE-BNEs) as a strategy to combat chronic wound infections are reported here. The cationic nanoemulsions efficiently penetrate and accumulate in biofilms, synergistically eradicating MDR bacterial biofilms, including persister cells. Notably, the nanoemulsion platform displays excellent biocompatibility and delays emergence of resistance to triclosan. The TE-BNEs are active in an in vivo murine model of mature MDR wound biofilm infections, with 99% bacterial elimination. The efficacy of this system coupled with prevention of emergence of bacterial resistance highlight the potential of this combination platform to treat MDR wound biofilm infections.

A Polymer-Based Multichannel Sensor for Rapid Cell-Based Screening of Antibiotic Mechanisms and Resistance Development.

Antibiotic resistance presents a critical threat to public health, necessitating the rapid development of novel antibiotics and an appropriate choice of therapeutics to combat refractory bacterial infections. Here, we report a high-throughput polymer-based sensor platform that rapidly (30 min) profiles mechanisms of antibiotic activity. The sensor array features three fluorophore-conjugated polymers that can detect subtle antibiotic-induced phenotypic changes on bacterial surfaces, generating distinct mechanism-based fluorescence patterns. Notably, discrimination of different generations of antibiotic resistance was achieved with high efficiency. This sensor platform combines trainability, simplicity, and rapid screening into a readily translatable platform.

Cell-Based Chemical Safety Assessment and Therapeutic Discovery Using Array-Based Sensors.

Synthetic chemicals are widely used in food, agriculture, and medicine, making chemical safety assessments necessary for environmental exposure. In addition, the rapid determination of chemical drug efficacy and safety is a key step in therapeutic discoveries. Cell-based screening methods are non-invasive as compared with animal studies. Cellular phenotypic changes can also provide more sensitive indicators of chemical effects than conventional cell viability. Array-based cell sensors can be engineered to maximize sensitivity to changes in cell phenotypes, lowering the threshold for detecting cellular responses under external stimuli. Overall, array-based sensing can provide a robust strategy for both cell-based chemical risk assessments and therapeutics discovery.

An array-based nanosensor for detecting cellular responses in macrophages induced by femtomolar levels of pesticides.

Environmental agents can induce cellular responses at concentrations far below the limits of detection for current viability and biomarker-based cell sensing platforms. Hypothesis-free cell sensor platforms can be engineered to maximize sensitivity to phenotypic changes, providing a tool for lowering the threshold for detecting cellular changes. Pesticides are one of the most prevalent sources of chemical exposure due to their use in food and agriculture fields. We report here a FRET-based nanosensor array engineered to maximize responses to changes at cell surfaces after pesticide exposure. This sensor array robustly detected macrophage responses to femtomolar concentrations of common pesticides-orders of magnitude lower concentrations than traditional toxicological and biomarker-based strategies. Significantly, this platform was able to classify these responses by pesticide class, demonstrating the ability to distinguish between changes induced by these different agents. Taken together, hypothesis-free cell surface sensing is a promising tool for detecting the effects of ultra-trace environmental chemicals on human health, as well as detecting threshold responses for use in drug discovery and diagnostics.

Polymeric Nanoparticles Active against Dual-Species Bacterial Biofilms.

Biofilm infections are a global public health threat, necessitating new treatment strategies. Biofilm formation also contributes to the development and spread of multidrug-resistant (MDR) bacterial strains. Biofilm-associated chronic infections typically involve colonization by more than one bacterial species. The co-existence of multiple species of bacteria in biofilms exacerbates therapeutic challenges and can render traditional antibiotics ineffective. Polymeric nanoparticles offer alternative antimicrobial approaches to antibiotics, owing to their tunable physico-chemical properties. Here, we report the efficacy of poly(oxanorborneneimide) (PONI)-based antimicrobial polymeric nanoparticles (PNPs) against multi-species bacterial biofilms. PNPs showed good dual-species biofilm penetration profiles as confirmed by confocal laser scanning microscopy. Broad-spectrum antimicrobial activity was observed, with reduction in both bacterial viability and overall biofilm mass. Further, PNPs displayed minimal fibroblast toxicity and high antimicrobial activity in an in vitro co-culture model comprising fibroblast cells and dual-species biofilms of Escherichia coli and Pseudomonas aeruginosa. This study highlights a potential clinical application of the presented polymeric platform.

Activity of Biodegradable Polymeric Nanosponges against Dual-Species Bacterial Biofilms.

Infections caused by multidrug-resistant (MDR) bacteria present an emerging global health crisis, and the threat is intensified by the involvement of biofilms. Some biofilm infections involve more than one species; this can further challenge treatment using traditional antibiotics. Nanomaterials are being developed as alternative therapeutics to traditional antibiotics; here we report biodegradable polymer-stabilized oil-in-water nanosponges (BNS) and show their activity against dual-species bacterial biofilms. The described engineered nanosponges demonstrated broad-spectrum antimicrobial activity through prevention of dual-species biofilm formation as well as eradication of preformed biofilms. The BNS showed no toxicity against mammalian cells. Together, these data highlight the therapeutic potential of this platform.

Nano Assessing Nano: Nanosensor-Enabled Detection of Cell Phenotypic Changes Identifies Nanoparticle Toxicological Effects at Ultra-Low Exposure Levels.

Industrial use of nanomaterials is rapidly increasing, making the effects of these materials on the environment and human health of critical concern. Standard nanotoxicity evaluation methods rely on detecting cell death or major dysfunction and will miss early signs of toxicity. In this work, the use of rapid and sensitive nanosensors that can efficiently detect subtle phenotypic changes on the cell surface following nanomaterial exposure is reported. Importantly, the method reveals significant phenotypic changes at dosages where other conventional methods show normal cellular activity. This approach holds promise in toxicological and pharmacological evaluations to ensure safer and better use of nanomaterials.