Implant Biofilm Mediated Immune Response

项目摘要 这是早期研究者提出的解决宿主生物膜的机制基础的建议 手术植入物相关并发症背景下的相互作用。据估计， 全球范围内，包括300万美国人植入了隆胸手术。超过700万美国人生活在髋关节/膝关节植入物中。在美国，每年有近300，000名妇女进行乳房植入手术，原因包括乳房切除术后乳房重建（乳腺癌和预防性乳房切除术）、先前乳房植入体的修改、乳房植入体的植入和乳房植入体的植入。 隆乳/再造、美容隆乳和性别确认。超过100万个全髋关节和总 在美国，每年都进行膝关节置换手术。随着人口老龄化， 改善流动性和生活质量。关节置换手术的数量预计将增加 在未来相当大的。全关节置换手术预计将继续成为最常见的手术之一。 在未来几十年里，选择性外科手术。 已经有越来越多的识别患者经历的一系列症状相关的， 植入物.所描述的症状包括肌痛、慢性疲劳、结缔组织疾病和一系列 其他表现往往与自身免疫性疾病。在隆胸手术中，这些星座 乳房植入体疾病（Breast Implant Illness，BII）。在受试者中报告了类似的症状 矫形植入物。用于关节成形术的金属/塑料植入物和用于乳房的硅胶植入物由以下材料制成： 不同的材料。因此，这些情况的根本原因可能与以下因素有关： 植入材料。细菌生物膜是外科植入物失败、感染和并发症的主要原因之一。 翻修手术尽管努力在手术期间保持无菌性，但可植入医疗装置可能变得不安全。 被来自宿主微生物群落的机会性细菌污染，其中许多可以形成生物膜。 该提案旨在研究细菌生物膜在植入物相关疾病中的作用。寄主生物膜 相互作用是由生物膜所在的宿主的局部微环境生态位引导的。乳房和臀部 关节置换物具有富含包含脂质的脂肪组织的宿主微环境。这项建议旨在 研究在生物膜-宿主相互作用期间形成的脂质代谢物。我们假设，由于脂质代谢产物的形成， 称为（E）-10-羟基-8-十八碳烯酸（10-HOME）的生物膜可以刺激CD 4 + T细胞， 自身免疫样综合征代谢产物10- HOME是生物膜作用于宿主形成的氧脂素的一员 油酸氧化脂质是由脂肪酸通过涉及双氧依赖性的反应形成的氧化脂质。 氧化据报道，氧化脂质有助于炎症反应。所涉提议主要是 来自患者样本的初步数据，使用体外和体内动物模型进行了广泛研究， 了解在存在氧脂素的情况下，由于以下原因导致的CD 4 + Th 1亚型活化的机制途径： 宿主-生物膜相互作用

PROJECT SUMMARY This is a proposal from early-stage investigator to address the mechanistic underpinnings of host-biofilm interaction in the context of surgical implant-associated complications. It is estimated 10 million women worldwide, including 3 million Americans have breast implants. Over 7 million Americans are living with hip/knee implants. Nearly 300,000 women annually have breast implant surgery in the United States, for reasons including post-mastectomy breast reconstruction (breast cancer and prophylactic mastectomy), revision of prior augmentation/ reconstruction, cosmetic augmentation, and gender affirmation. Over 1 million total hip and total knee replacement surgeries are performed each year in the US. With an aging population, there is a demand for improved mobility and quality of life. The number of joint replacement surgeries are projected to increase considerably in the future. Total joint replacement surgery is expected to continue to be one of the most common elective surgical procedures in the coming decades. There has been increased identification of patients experiencing a constellation of symptoms related to their implants. The symptoms described include myalgias, chronic fatigue, connective-tissue disorders, and a host of other manifestations often associated with autoimmune illnesses. In case of breast implants, these constellations of immune symptoms are named Breast Implant Illness (BII). Similar symptoms have been reported in subjects with orthopedic implants. Metal/plastic implants for arthroplasty and silicone implants for breasts are made of different materials. Thus, the underlying cause of these conditions may be associated with factors other than the implant material. Bacterial biofilms are one of the leading causes of surgical implant failures, infection and revision surgeries. Despite efforts to maintain sterility during surgery, implantable medical devices can become contaminated with the opportunistic bacteria from the host microflora many of which can form biofilm. This proposal aims to investigate the role of bacterial biofilms in the implant-associated illness. Host-biofilm interactions are guided by the local micro-environmental niche of host in which the biofilm reside. Breast and hip joint replacements have a host-microenvironment rich in adipose tissue comprising lipids. The proposal aims to study lipid metabolites formed during biofilm-host interaction. We hypothesize that a lipid metabolite formed due to biofilm called (E)-10-hydroxy-8-octadecenoic acid (10-HOME) can stimulate CD4+ T cell leading to autoimmune-like syndromes. The metabolite 10- HOME is a member of oxylipin formed by biofilm acting on host oleic acid. Oxylipins are oxidized lipids formed from fatty acids by reactions involving dioxygen-dependent oxidation. Oxilipins have been reported to contribute to inflammatory response. The proposal is based on preliminary data derived from patient samples, studied extensively using in vitro and in vivo animal models to understand the mechanistic pathway of CD4+ Th1 subtype activation in presence of oxylipins derived due to host-biofilm interaction.