Aspirin alleviates orthopedic implant‑associated infection

Abstract

Implant-associated infection (IAI), a common condition marked by progressive inflammation and bone destruction, is mentally and financially devastating to those it affects, causing severe morbidity, prolonged hospital admissions, significant hospital costs and, in certain cases, mortality. Aspirin, a popular synthetic compound with a history of >100 years, is antipyretic, anti-inflammatory and analgesic. It is the most active component of non-steroidal anti-inflammatory drugs. However, the effects of aspirin on IAI remain unknown. In the present study, an IAI animal model was used, in which a stainless steel pin coated with Staphylococcus aureus was implanted through the left shaft of the tibia in mice. The animals were then randomized into five groups and subjected respectively to IAI, IAI + 15 mg aspirin treatment, IAI + 30 mg aspirin treatment, IAI + 60 mg aspirin treatment and IAI + 120 mg aspirin treatment groups. Aspirin was injected intraperitoneally twice daily for 11 days. Micro-CT and histological assays were performed to assess the effects of aspirin on IAI. It was found that aspirin reduced osteolysis and periosteal reaction, inhibited the activation of osteoclasts, promoted the activation of osteoblasts and facilitated healing of the infected fracture.

The non-steroidal anti-inflammatory drug carprofen negatively impacts new bone formation and antibiotic efficacy in a rat model of orthopaedic-device-related infection

“…In a paper aiming at investigating anti-virulence properties of diflunisal (a COX-1 selective NSAID) on S. aureus, Hendrix et al (2016) demonstrated that diflunisal protected from osteolysis in a rodent model of S. aureus-induced osteomyelitis. Similar protective effects were also observed with aspirin (also a COX-1 selective NSAID) in a murine model of ODRI (Jiang et al, 2019), thereby suggesting that COX inhibition may prevent infection-induced bone destruction. However, clinical evidence on the effect of NSAID use on fracture healing is limited, with relatively few high-quality studies available.…”

Asprin‐loaded strontium‐containing α‐calcium sulphate hemihydrate/nano‐hydroxyapatite composite promotes regeneration of critical bone defects

“…It has a certain impact on bone metabolism and bone health, promoting osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), inhibiting adipogenic differentiation of BMSCs, activating osteoblasts and inhibiting osteoclasts. [18][19][20][21][22] It has been found to promote bone formation by inhibiting the expression of inflammatory factors such as IFN-γ and TNF-α. [23][24][25] It may also improve bone marrow microenvironment and enhance immune regulation of BMSCs.…”

Aspirin and Infection: A Narrative Review

“…In 2019, using a mouse model of orthopedic implant-associated infections ( S. aureus ), researchers demonstrated that treatment with moderate doses of ASA resulted in decreased periosteal reactive bone, osteolysis and osteoclast activation but increased osteoblast activation in implant-associated infections mice, whereas a high dose of ASA aggravated rather than alleviated implant-associated infections [ 80 ].…”