TY - JOUR T1 - Bioactive Coating of Titanium Surfaces with Recombinant Human ß-Defensin-2 (rHußD2) May Prevent Bacterial Colonization in Orthopaedic Surgery AU - Pfeufer, Nadine Y. AU - Hofmann-Peiker, Karsten AU - Mühle, Mike AU - Warnke, Patrick H. AU - Weigel, Martin C. AU - Kleine, Michael Y1 - 2011/05/04 N1 - 10.2106/JBJS.I.01738 JO - The Journal of Bone & Joint Surgery SP - 840 EP - 846 VL - 93 IS - 9 N2 - Background:  A promising strategy to prevent infections around orthopaedic titanium implants is to use naturally occurring cationic antimicrobial peptides (CAMPs) such as the human ß-defensin-2 as antibacterial coatings. Human antimicrobial peptides represent a part of the innate immune system and have a broad antimicrobial spectrum against bacteria, fungi, and viruses.Methods:  In the present study, titanium surfaces were functionalized by four different self-assembled monolayers (SAMs) forming methoxy silanes: (1) hexadecyltrimethoxysilane, (2) dimethoxymethyloctylsilane, (3) allyltrimethylsilane, and (4) 3-aminopropyltrimethoxysilane. In addition, calf skin type-I collagen was cross-linked to the SAM surface 3-aminopropyltrimethoxysilane by means of two different treatments: (1) N-hydroxysuccinimide and (2) glutaraldehyde. The functionalized titanium surfaces were coated with recombinant human ß-defensin-2 (rHußD2), an antimicrobial peptide, and were tested for antibacterial activity against Escherichia coli. The release of rHußD2 was quantified by means of enzyme-linked immunosorbent assay (ELISA).Results:  The coating of functionalized titanium surfaces with rHußD2 was successful. Recombinant HußD2 was eluted from the titanium surfaces continuously, yielding antimicrobial activity up to several hours. Antimicrobial activity with a killing rate of 100% was observed for all functionalized titanium surfaces after two hours of incubation. The dimethoxymethyloctylsilane-functionalized titanium surface delivered 0.65 µg of rHußD2 after six hours with a 60% bacterial killing rate. The silane-functionalized surfaces exhibited a faster release of antimicrobially active rHußD2 compared with collagen modifications.Conclusions:  Natural antibiotics such as rHußD2 integrated into the metal surface of titanium implants may be a promising tool to prevent and control infections around orthopaedic implants.Clinical Relevance:  This kind of titanium surface modification may provide an alternative treatment of serious, life-threatening infections related to prosthetic implant surgery. SN - 0021-9355 M3 - doi: 10.2106/JBJS.I.01738 UR - http://dx.doi.org/10.2106/JBJS.I.01738 ER -