A Novel Nanozyme-based Coordination Compound for Synergistic Periprosthetic Joint Infection Treatment and Bone Repair.

Abstract

Periprosthetic joint infection (PJI) represents a serious complication following joint arthroplasty, and it often results in implant failure, prolonged morbidity, and additional healthcare burdens. Current clinical strategies for PJI treatment face obstacles, including antibiotic resistance, high recurrence rate, and compromised bone repair. To address these challenges, a novel nanozyme-based coordination compound designated as W-GA-Van@Zn is developed. Gallic acid decorated tungsten nanozyme (W-GA) with dual photothermal and reactive oxygen species (ROS) scavenging ability is chosen as the core of W-GA-Van@Zn, and vancomycin as a bacterial targeting agent is decorated on W-GA surface using amide reaction. After that, zinc ions are introduced and formed a metal-phenolic coordination compound across by the polyphenolic groups on the nanozyme surface. W-GA-Van@Zn could achieve bacterial targeting ability through specific binding to D-Ala-D-Ala moieties on the bacterial surface, and realize synergistic PJI treatment combining mild photothermal therapy (PTT) and antibiotic therapy. Meanwhile, the nanozyme could simultaneously scavenge PTT-generated ROS, overcoming the side effect during PTT treatment. Besides, PTT-antibiotic combination therapy reduced antibiotic dosage and provided excellent bactericidal efficacy at low antibiotic concentrations. During the bone repair stage post-PJI treatment, the nanozyme sustained ROS scavenging to reduce inflammatory microenvironment, together with zinc ions for synergistic bone repairment.