Self-Oxygenating Surfaces Enhance Neutrophil Function and Combat Implant-Associated Infections

In this study, we investigated the ability of self-oxygenation surface modulation to promote bactericidal activity and apoptosis of neutrophils under hypoxic conditions using a rat model and in vitro tests with human neutrophils. It is important to note that there are significant differences in the structure, composition, and biochemistry between rat and human neutrophils (57). Therefore, further research is necessary to understand the applicability of this strategy in controlling implant-associated infections. Additionally, this study focused on the role of neutrophils as the primary defense against infection in the early stages and did not assess the contribution of macrophages in pathogen killing and their functions under various oxygen partial pressures (14, 58). Furthermore, the local concentration of oxygen in bone tissues is spatially heterogeneous, and there is currently no accurate measurement method available (59). Consequently, determining the oxygen requirements for neutrophil bactericidal activity and neutrophil apoptosis poses a challenge. Nonetheless, our study clearly demonstrates the efficacy of the oxygen self-supporting interface modulation strategy in enhancing frustrated neutrophil functions. In conclusion, this study not only presents a promising coating for preventing implant-associated bone infections but also showcases how neutrophil functions can be manipulated to promote implant-bone integration.