Near-infrared light II - assisted rapid biofilm elimination platform for bone implants at mild temperature

Light-triggered therapy is a prospective method to combat implant-associated infection but near-infrared I (NIR-I) light has insufficient penetrating ability in tissues and local hyperthermia induced by the photothermal treatment may destroy surrounding healthy tissues. Herein, a near-infrared II (NIR-II) phototherapy system composed of upconversion elements doped titanium dioxide nanorods (TiO₂ NRs)/curcumin (Cur)/hyaluronic acid (HA)/bone morphogenetic protein-2 (BMP-2) is designed for biomedical titanium and demonstrated to overcome the above hurdles simultaneously. Incorporation of F, Yb, and Ho not only improves the photocatalytic ability, but also renders the implants with the upconversion capability, so that the NRs can generate enough reactive oxygen species (ROS) when irradiated by the NIR-II laser. Furthermore, the combined actions of quorum sensing inhibitors, ROS, and physical puncture by NRs eliminate Staphylococcus aureus biofilms on titanium rapidly at a mild temperature of 45 °C by only requiring irradiation with the 1060 nm laser for only 15 min in vitro and in vivo. The presence of Cur mitigates the immune response and BMP-2 improves osteogenic differentiation, thus accelerating new bone formation. This low-temperature NIR-II light-triggered antibacterial platform has large potential in combating deep-tissue infection in clinical applications.