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. 2020 Mar;7(2):213-220.
doi: 10.1093/rb/rbz052. Epub 2020 Jan 25.

Candida albicans aspects of binary titanium alloys for biomedical applications

Shuyang Chen  1   2 , James K H Tsoi  1 , Peter C S Tsang  3 , Yeong-Joon Park  4 , Ho-Jun Song  4 , Jukka P Matinlinna  1
Affiliations

Candida albicans aspects of binary titanium alloys for biomedical applications

Shuyang Chen et al. Regen Biomater. 2020 Mar.

Abstract

Titanium and its alloys are widely used in biomedical devices, e.g. implants, due to its biocompatibility and osseointegration ability. In fact, fungal (Candida spp.) infection has been identified as one of the key reasons causing the failure of the device that is inevitable and impactful to the society. Thus, this study evaluated the surface morphology, surface chemical composition and Candida albicans adhesion on specimens of 16 binary Ti-alloys (∼5 wt% of any one of the alloy elements: Ag, Al, Au, Co, Cr, Cu, Fe, In, Mn, Mo, Nb, Pd, Pt, Sn, V and Zr) compared with cp-Ti, targeting to seek for the binary Ti-alloys which has the lowest C. albicans infection. Candida albicans cultures were grown on the specimens for 48 h, and colony forming units (CFUs) and real-time polymerase chain reaction (RT-PCR) were used to evaluate the biofilm formation ability. Scanning electron microscopy and confocal laser scanning microscopy confirmed the formation of C. albicans biofilm on all specimens' surfaces, such that CFU results showed Ti-Mo, Ti-Zr, Ti-Al and Ti-V have less C. albicans formed on the surfaces than cp-Ti. RT-PCR showed Ti-Zr and Ti-Cu have significantly higher C. albicans DNA concentrations than Ti-Al and Ti-V (P < 0.05), whereas Ti-Cu has even showed a statistically higher concentration than Ti-Au, Ti-Co, Ti-In and Ti-Pt (P < 0.05). This study confirmed that Ti-Mo, Ti-Zr, Ti-Al and Ti-V have lower the occurrence of C. albicans which might be clinically advantageous for medical devices, but Ti-Cu should be used in caution.

Keywords: C. albicans; binary titanium alloy; fungal infection; medical devices; titanium.

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Figures

Figure 1
Figure 1
SEM micrographs of the polished Ti-alloys and cp-Ti at 500× magnification. (a) Ti-5Ag, (b) Ti-5Al, (c) Ti-5Au, (d) Ti-5Co, (e) Ti-5Cr, (f) Ti-5Cu, (g) Ti-5Fe, (h) Ti-5In, (i) Ti-5Mn, (j) Ti-5Mo, (k) Ti-5Nb, (l) Ti-5Pd, (m) Ti-5Pt, (n) Ti-5Sn, (o) Ti-5V, (p) Ti-5Zr and (q) cp-Ti. Red arrows indicate the flaws and blue arrows indicate the microcracks
Figure 2
Figure 2
SEM micrographs (2000×) magnification and CLSM of the stained candida on the specimen (a) Ti-5Ag, (b) Ti-5Al, (c) Ti-5Au, (d) Ti-5Co, (e) Ti-5Cr, (f) Ti-5Cu, (g) Ti-5Fe, (h) Ti-5In, (i) Ti-5Mn, (j) Ti-5Mo, (k) Ti-5Nb, (l) Ti-5Pd, (m) Ti-5Pt, (n) Ti-5Sn, (o) Ti-5V, (p) Ti-5Zr and (q) cp-Ti. Alive cell was stained in green, and dead cell was stained in red
Figure 3
Figure 3
Box-plot (min–max, box: Q1–Q3) of the CFU/ml per unit area in this study. Red line indicates the cp-Ti value for easier comparison
Figure 4
Figure 4
Box-plot (min–max, box: Q1–Q3) of the C. albicans DNA concentration per unit area in this study. Red line indicates the cp-Ti value for easier comparison
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