Promising applications of D-amino acids in periprosthetic joint infection

Area of Science:

• Biomedical Engineering
• Infectious Diseases
• Orthopedic Surgery

Background:

• Aging populations are increasing demand for total joint arthroplasty (TJA), leading to a projected rise in periprosthetic joint infections (PJIs).
• Microbial biofilm formation presents a significant challenge in preventing and treating PJIs, despite advancements in surgical protocols.
• Dextrorotatory-isoforms of amino acids (D-AAs) are crucial for bacterial cell wall integrity and have demonstrated antimicrobial properties.

Purpose of the Study:

• To review the emerging role of D-AAs in the context of total joint arthroplasty (TJA).
• To explore the potential of D-AAs in preventing and treating periprosthetic joint infections (PJIs) by targeting biofilms.
• To highlight D-AAs as novel therapeutic targets for PJI management.

Main Methods:

• Literature review examining existing data on D-AAs and their effects on bacterial biofilms.
• Analysis of D-AA properties relevant to bacterial adhesion, biofilm formation, and disassembly.
• Exploration of D-AA's potential impact on host bone tissue response in the context of TJA.

Main Results:

• Exogenous administration of D-AAs has shown efficacy in preventing bacterial adhesion and biofilm formation on abiotic surfaces.
• D-AAs demonstrate substantial potential in promoting the disassembly of established microbial biofilms.
• The specific role of D-AAs in disrupting PJI biofilms and influencing host bone tissue response requires further investigation.

Conclusions:

• D-AAs represent a promising novel strategy for combating bacterial biofilms associated with periprosthetic joint infections (PJIs).
• D-AA bioengineering may offer a future therapeutic approach for the prevention and treatment of PJIs after total joint arthroplasty (TJA).
• Further research is warranted to fully elucidate the mechanisms and applications of D-AAs in PJI management.