The British Journal of Rheumatology, Vol 36, 957-963, Copyright © 1997 by British Society for Rheumatology
S Meghji, SJ Crean, S Nair, M Wilson, S Poole, M Harris and B Henderson
Staphylococcus epidermidis is the most commonly isolated coagulase-
negative staphylococcus from the skin, gut and upper respiratory tract.
Although it is less virulent than Staphylococcus aureus, it has emerged in
recent years as an important causative agent of infections associated with
metal implants, prosthetic devices and i.v. lines. We have previously
demonstrated that a saline wash of S. aureus contained proteins which had
potent bone-resorbing activity in vitro. The purpose of this study was to
determine whether gently washing S. epidermidis in saline also released
osteolytically active proteins. The so-called surface-associated material
(SAM) eluted from S. epidermidis in saline was able to induce osteolysis,
and activity was heat and trypsin sensitive, suggesting that the active
component was proteinaceous. Fractionation studies have suggested that
activity is due to a small number of cationic proteins. This SAM-induced
bone resorption was not inhibited by the cyclo-oxygenase inhibitor,
indomethacin, or the 5- lipoxygenase inhibitors BWA70C and MK886. However,
it was partially inhibited by high concentrations of interleukin-1 receptor
antagonist and was completely blocked by a neutralizing antibody to tumour
necrosis factor-alpha. Thus, the SAM from this organism is a potent
osteolytic agent which differs from that of S. aureus SAM in not being
inhibited by cyclo-oxygenase inhibitors. As adjunctive therapy is becoming
necessary in infectious diseases, either as a result of the side-effects of
antibiotics or their lack of efficacy, consideration should be given to the
future treatment of bone infections with staphylococci in the light of the
different mechanisms of action of the surface proteins produced by these
bacteria.
ORIGINAL PAPERS
Staphylococcus epidermidis produces a cell-associated proteinaceous fraction which causes bone resorption by a prostanoid-independent mechanism: relevance to the treatment of infected orthopaedic implants
Maxillofacial Surgery Research Unit, Eastman Dental Institute, University College London.
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