On-Demand
The Academy gathers experts from around the world to present and discuss the most current and cutting-edge technology in implant dentistry.
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Edward Schwarz, PhD
Director, Center for Musculoskeletal Research University of Rochester Medical Center
Implant-associated osteomyelitis is the bane of elective orthopaedic surgeries (i.e. total joint replacement). Staphylococcus aureus is the primary pathogen, and 50% of cases involve MRSA. I will present experimental evidence with clinical correlates demonstrating four distinct pathogenic mechanisms: intracellular infection, biofilm on implants and necrotic tissue, staphylococcus abscess communities and colonization of osteocyte lacuno-canalicular network (OLCN). I will also present pre-clinical and clinical data on the immune proteome against S. aureus, and that both protective antibodies and pathogenic antibodies exist. Protective antibodies (e.g. anti-glucosaminidase) neutralize critical S. aureus proteins, while pathogenic antibodies (e.g. anti-IsdB) facilitate Trojan horse leukocyte formation, bacteria dissemination from surgical site infection, and septic death.
Based on these basic science discoveries I will present pre-clinical research on bone targeting antibiotics, which overcome the pharmacokinetic and biodistribution limits of standard of care antibiotics, and have potential to kill bacteria within the OLCN of cortical bone. I will also present pre-clinical data on a passive immunization for MRSA. As there are many parallels between orthopaedic implant-associated osteomyelitis and peri-implantitis, I will conclude with thoughts on how this new information might be used to prevent and manage oral infections.
Upon completion of this presentation, participants should be able to:
1) recognize the four distinct S . aureus biofilms that exist in chronic bone infections;
2) explain why standard of care antibiotics including high-dose antibiotic loaded bone cement cannot irradiate bacteria within osteocyte lacuno-canalicular networks (OLCN); and
3) discuss the immune proteome against S . aureus and how it affects infection severity and clinical outcomes
Biography
Dr. Edward M. Schwarz is the Burton Professor of Orthopaedics and Director of the Center for Musculoskeletal Research at the University of Rochester Medical Center in Rochester, New York. He serves as Director of NIH P50 CORT “Translating the Osteoimmunology of Bone Infection”, Director of NIH P30 “The University of Rochester Resource-Based Center for Musculoskeletal Biology and Medicine”, and Co-Director of NIH CTSA-fund Pilot Studies in the University of Rochester Clinical & Translational Sciences Institute. Dr. Schwarz is also the Editor-in-Chief of the Journal of Orthopaedic Research, Chief Science Officer of Telephus Biomedical, LLC, and Chief Product Officer of BioVinc, LLC. He is an Osteoimmunologist whose research is focused on inflammatory bone loss in osteomyelitis and rheumatoid arthritis. His lab developed novel bone targeted antibiotics and a passive immunization for S. aureus infections.