Silver-substituted hydroxyapatite inhibits Pseudomonas aeruginosa outer membrane protein F: A potential antibacterial mechanism

Bone fractures are one of the most common injuries, and they have a big effect on population health worldwide. Traumatic bone injuries can be partially treated with implanting bone-graft substitutes, for example, hydroxyapatite (HA), a bioceramic that is similar materially to natural bones with good bioactivity and osteoconductivity. It could, however, be vulnerable to infections because of the way an HA-based bone graft is put in, which could be a weakness in the host's defense. This study incorporated silver (Ag) into hydroxyapatite (Ag-HA) and silicon-containing hydroxyapatite (AgSi-HA) discs to combat this implant-triggered infection. Further, we investigated the antibacterial activities and potential underlying mechanism against a gram-negative bacterium, Pseudomonas aeruginosa. We noticed that the rich calcium (Ca2+) content in HA discs could trigger the change in P. aeruginosa physiology that leads to the enhanced bacterial growth on non‑silver incorporated HA discs. But the released Ag+ from Ag-HA and AgSi-HA discs caused significant damage to bacterial cells at a low concentration of 0.3 ppm. We also observed dramatic morphological changes of Ag-HA and AgSi-HA surface-attached bacteria cells. Finally, we identified a potential action mechanism – the surface-bound Ag+ from Ag-HA and AgSi-HA potently inhibited the outer membrane protein F (OprF) expression of P. aeruginosa. Collectively, our results indicate that incorporating silver ions into HA could contribute viably to excellent antibacterial activities against P. aeruginosa to prevent HA-based bone graft infection.