Tissue response and in vivo degradation of selected polyhydroxyacids: polylactides (PLA), poly(3-hydroxybutyrate) (PHB), and poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHB/VA)

The efficacy of powdered polydioxanone in terms of collagen production compared with poly-L-lactic acid in a murine model

BACKGROUND

There are many collagen-stimulating fillers, including calcium hydroxyapatite, polycaprolactone (PCL), and poly-L-lactic acid (PLLA), and other materials have been tested. Polydioxanone (PDO) has recently been used as absorbable thread-lifting material due to its collagen-forming effects. PDO in powdered form is expected to be a good material for collagen-producing fillers.

OBJECTIVES

To evaluate the collagen-producing effects of powdered PDO injection compared with PLLA injection in a murine model.

MATERIALS AND METHODS

Powdered PDO mixed with sodium carboxymethyl cellulose, PLLA, and phosphate-buffered saline was injected on dorsal skin of 8-week-old rat. Tissue samples were obtained 1, 2, and 12 weeks after the procedures for histopathologic review and for real-time PCR to quantify collagen and tissue growth factors.

RESULTS

Both PLLA and powdered PDO injections induced granulomatous reactions. Collagen type 1, collagen type 3, TGF-β1, TGF-β2, and TGF-β3 showed increases 2 weeks after injection but decreased 12 weeks after injection for both powdered PDO and PLLA.

CONCLUSION

Our results suggested that powdered PDO injection induces collagen formation more effectively than PLLA injection. Therefore, PDO can be a good option for forming collagen.

Antifungal activity of P3HB microparticles containing tebuconazole

In this study, tebuconazole (TEB)-loaded poly-3-hydroxybutyrate (P3HB)-based microparticles were developed and comprehensively characterized. TEB-loaded microparticles with the initial loading amounts of the fungicide of 10, 25, and 50% of the polymer mass (TEB 10, TEB 25, and TEB 50%) were prepared using emulsion technique. Encapsulation efficiency of TEB varied from 59 to 86%. As the loading amount was increased, the average diameter of microparticles increased too, from 41.3 to 71.7 µm, while zeta potential was not influenced by TEB loading, varying between -32.6 and -35.7 mV. TEB was gradually released from the microparticles to the model medium, and after 60 d, from 25 to 43% of TEB was released depending on the content of the encapsulated fungicide. The data obtained from in vitro TEB release were fitted to different mathematical models. It was shown that the release profiles of TEB could be best explained by the Zero-order, Higuchi, and Hixson-Crowell models. The antifungal activity of the P3HB/TEB microparticles against phytopathogenic fungi Fusarium moniliforme and Fusarium solani was demonstrated by in vitro tests conducted in Petri dishes. Thus, hydrophobic agrochemicals (TEB) can be effectively encapsulated into P3HB microparticles to construct slow-release formulations.

The comparison of biocompatibility and osteoinductivity between multi-walled and single-walled carbon nanotube/PHBV composites

The applications of poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) in tissue engineering have been widely studied. This study aimed to compare the biocompatibility and osteoinductivity of single-walled carbon nanotubes (SWCNTs)/PHBV composites with multi-walled CNTs (MWCNTs)/PHBV composites. CNTs were dispersed in PHBV by ultrasonication and composites were created using thermal injection moulding. In order to test their biocompatibility and osteoinductivity. Rat osteoblasts (rOBs) were then cultured and seeded on the composites. The composites were implanted in rat femoral bone defects. Our results showed that lower weight percentages of SWCNTs and MWCNTs (2-4%) improved both their mechanical and thermal decomposition properties. However, further reduction of rOBs cell death was observed in MWCNTs/PHBV. SWCNTs were shown to upregulate the expression of Runx-2 and Bmp-2 in early stage significantly, while MWCNTs showed a stronger long-term effect on Opn and Ocn. The in vivo result was that MWCNTs/PHBV composites induced intact rounding new bone, increased integration with new bone, and earlier completed bone remodeling when compared with SWCNTs. Immunohistochemistry also detected higher expression of RUNX-2 around MWCNTs/PHBV composites. In conclusion, there were no differences observed between SWCNTs and MWCNTs in the reinforcement of PHBV, while MWCNTs/PHBV composites showed better biocompatibility and osteoinductivity both in vitro and in vivo.

The Aging Face

The aging face is a popular topic in modern medicine. To understand and treat unwanted signs of aging, it is imperative to understand the biological and physical causes and contributing factors to facial aging, preventative measures to avoid advanced facial aging, and current treatment options. Changes to the human face are progressive with time; however, there are many methods, both surgical and nonsurgical, to reduce the stigmata of aging and provide patients with the appearance they desire. The process of aging is discussed in this article, as well as the multiple treatment options, both surgical and nonsurgical.

In vitro degradation of a unique porous PHBV scaffold manufactured using selective laser sintering

Biodegradable poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) scaffolds have shown great promise for bone tissue engineering applications. The investigation of their hydrolytic degradation is thus essential to understand the effect of hydrolysis on the complex biodegradation behavior of PHBV scaffolds. In this study, we investigated the degradation behavior of high molecular weight PHBV scaffolds manufactured using selective laser sintering (SLS) without using predesigned porous architectures. The manufactured scaffolds have high specific surface areas with great water-uptake abilities. After an incubation of 6 weeks in phosphate-buffered saline solution, the structural integrity of the scaffolds was unaffected. However, a significant decrease in molecular weight ranging from 39% to 46% was found. The measured weight loss was negligible, but their compressive modulus and strength both decreased, likely due to water plasticization. These findings suggest that hydrolytic degradation of PHBV by means of bulk degradation was the predominant mechanism, attributed to their excellent water absorptivity. Overall, the PHBV scaffolds manufactured using SLS exhibited adequate mechanical properties and satisfactory structural integrity after incubation. As a result, the scaffolds have great potential as candidates for bone repair in clinical practice. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 154-162, 2019.

Injectable Biomaterials in Plastic and Reconstructive Surgery: A Review of the Current Status

BACKGROUND

Injectable biomaterials have attracted increasing attention for volume restoration and tissue regeneration. The main aim of this review is to discuss the current status of the injectable biomaterials for correction of tissue defects in plastic and reconstructive surgery.

METHODS

Requirements of injectable biomaterials, mechanism of in situ gelation, characteristics, and the combinational usage of adipose-derived stem cells (ADSCs) and growth factors were reviewed.

RESULTS

The ideal injectable biomaterials should be biocompatible, non-toxic, easy to use, and cost-effective. Additionally, it should possess adequate mechanical properties and stability. In situ gelation method includes physical, chemical, enzymatic and photo-initiated methods. Natural and synthetic biomaterials carry their pros and cons due to their inherent properties. The combined use of ADSCs and growth factors provides enhanced potential for adipose tissue regeneration.

CONCLUSIONS

The usage of injectable biomaterials has been increasing for the tissue restoration and regeneration. The future of incorporating ADSCs and growth factors into the injectable biomaterials is promising.

Filling Procedures for Lip and Perioral Rejuvenation: A Systematic Review

The ideal perioral and lip rejuvenation technique provides the longest period of efficacy, lowest complication rate, and best esthetic results. Genetics, intrinsic aging, sun exposure, and repetitive muscle twitching of the orbicularis oris produce angular, radial, and vertical lines of the perioral lines and, for this reason, the needs of patients in the treatment of this anatomical area can range from simple lip enhancement to a broader and more comprehensive treatment with simultaneous correction of perioral wrinkles. A myriad of materials have been described for rejuvenation of this area. At present, the most popular and commonly used lip enhancers are dermal fillers, but there is still no agreement on what the best material for filling soft tissue of the face and in particular of the perioral region is. This systematic review will focus on the various dermal fillers, of different materials approved by the US Food and Drug Administration (FDA) namely poly-L-lactic acid, calcium hydroxylapatite, and hyaluronic acid and also different grafts, for perioral rejuvenation, with the goal of determining the optimal approach. A systematic search for English studies involving perioral rejuvenation was performed using these databases: PubMed, Google Scholar, and Ovid, using a combined keyword search or medical subject headings. At the end of our study selection process, 17 relevant publications were included. For each study, year of publication, type of material used for filling, number of patients, subject of study assessment, and efficacy of the filler procedure for lip rejuvenation were analyzed.

Transcutaneously refillable, 3D-printed biopolymeric encapsulation system for the transplantation of endocrine cells

Autologous cell transplantation holds enormous promise to restore organ and tissue functions in the treatment of various pathologies including endocrine, cardiovascular, and neurological diseases among others. Even though immune rejection is circumvented with autologous transplantation, clinical adoption remains limited due to poor cell retention and survival. Cell transplant success requires homing to vascularized environment, cell engraftment and importantly, maintenance of inherent cell function. To address this need, we developed a three dimensional (3D) printed cell encapsulation device created with polylactic acid (PLA), termed neovascularized implantable cell homing and encapsulation (NICHE). In this paper, we present the development and systematic evaluation of the NICHE in vitro, and the in vivo validation with encapsulated testosterone-secreting Leydig cells in Rag1-/- castrated mice. Enhanced subcutaneous vascularization of NICHE via platelet-rich plasma (PRP) hydrogel coating and filling was demonstrated in vivo via a chorioallantoic membrane (CAM) assay as well as in mice. After establishment of a pre-vascularized bed within the NICHE, transcutaneously transplanted Leydig cells, maintained viability and robust testosterone secretion for the duration of the study. Immunohistochemical analysis revealed extensive Leydig cell colonization in the NICHE. Furthermore, transplanted cells achieved physiologic testosterone levels in castrated mice. The promising results provide a proof of concept for the NICHE as a viable platform technology for autologous cell transplantation for the treatment of a variety of diseases.

Evaluation of absorbable PLA nasal implants in an ovine model

Objective

To examine biocompatibility and absorption profile of a poly (L‐lactide‐co‐D,L‐lactide) 70:30 nasal implant.

Methods

In an ovine model, 66 rod‐shaped absorbable implants were placed in 11 nasal dorsa. The sheep were sacrificed at 1.5 (N = 3), 6 (N = 3), 12 (N = 3), 18 (N = 1), and 24 months (N = 1). The nasal dorsum was harvested from each animal. Gross and histopathological examinations were performed.

Results

There were no postoperative complications, signs of infection, or tissue rejection throughout follow‐up time points. Upon sacrifice, no abnormalities were identified during gross pathological examinations. The histology of the implant sites at all time points showed the implants were fully encapsulated through 12 months. The inflammatory reaction to the implants was minimal to mild at 1.5, 6, and 12 months. At 18 months the implant material was in the mass loss phase, being actively absorbed. During this phase, the inflammatory reaction within the fibrous connective tissue capsule reached expected moderate levels. By 24 months, the inflammatory reaction had diminished in most implantation sites and complete absorption of the rod implants was noted at some sites with nodular bundles of mature collagenized fibrous tissue replacing the implant, devoid of an inflammatory infiltrate.

Conclusion

Biocompatibility of the poly (L‐lactide‐co‐D,L‐lactide) 70:30 material was demonstrated when used as a nasal implant in the nasal dorsum ovine model. Absorption of the implant occurred approximately 18 to 24 months postoperatively, and the implant site was replaced with collagenized fibrous tissue.

Level of Evidence

NA.

Physiochemical Characteristics of Poly-L-Lactic Acid (PLLA)

Poly-L-lactic acid (PLLA) is a synthetic, biocompatible, biodegradable polymer. For soft-tissue augmentation, the size and chemical attributes of the PLLA microparticles are central to this agent's ability to promote a subclinical inflammatory response that stimulates deposition of collagen in the extracellular matrix. The resultant restoration of facial volume occurs in a controlled, predictable manner and is long lasting. The unique physiochemical and biostimulatory properties of PLLA differentiate it from other available treatments and are the foundation of the unique treatment methodology required for optimal results.

A novel surgical technique for a rat subcutaneous implantation of a tissue engineered scaffold

Objectives

Subcutaneous implantations in small animal models are currently required for preclinical studies of acellular tissue to evaluate biocompatibility, including host recellularization and immunogenic reactivity.

Methods

Three rat subcutaneous implantation methods were evaluated in six Sprague Dawley rats. An acellular xenograft made from porcine pericardium was used as the tissue-scaffold. Three implantation methods were performed; 1) Suture method is where a tissue-scaffold was implanted by suturing its border to the external oblique muscle, 2) Control method is where a tissue-scaffold was implanted without any suturing or support, 3) Frame method is where a tissue-scaffold was attached to a circular frame composed of polycaprolactone (PCL) biomaterial and placed subcutaneously. After 1 and 4 weeks, tissue-scaffolds were explanted and evaluated by hematoxylin and eosin (H&E), Masson’s trichrome, Picrosirius Red, transmission electron microscopy (TEM), immunohistochemistry, and mechanical testing.

Results

Macroscopically, tissue-scaffold degradation with the suture method and tissue-scaffold folding with the control method were observed after 4 weeks. In comparison, the frame method demonstrated intact tissue scaffolds after 4 weeks. H&E staining showed progressive cell repopulation over the course of the experiment in all groups with acute and chronic inflammation observed in suture and control methods throughout the duration of the study. Immunohistochemistry quantification of CD3, CD 31, CD 34, CD 163, and αSMA showed a statistically significant differences between the suture, control and frame methods (P < 0.05) at both time points. The average tensile strength was 4.03 ± 0.49, 7.45 ± 0.49 and 5.72 ± 1.34 (MPa) after 1 week and 0.55 ± 0.26, 0.12 ± 0.03 and 0.41 ± 0.32 (MPa) after 4 weeks in the suture, control, and frame methods; respectively. TEM analysis showed an increase in inflammatory cells in both suture and control methods following implantation.

Conclusion

Rat subcutaneous implantation with the frame method was performed with success and ease. The surgical approach used for the frame technique was found to be the best methodology for in vivo evaluation of tissue engineered acellular scaffolds, where the frame method did not compromise mechanical strength, but it reduced inflammation significantly.

Improving mandibular contour: A pilot study for indication of PPLA traction thread use

Background: The request for less-aggressive procedures to improve mandibular contour is increasing. Several kinds of threads have been used for this purpose. Nevertheless, PLLA (poly-L-Lactic acid) traction thread procedure has not been previously described. Aim: To investigate the role of PLLA traction threads in improving mandibular contour. Methods: Twenty women were enrolled in the study. They were differentially classified for skin laxity. Patients were treated in a single session with two PLLA traction threads per side. Specific post-procedure instructions were given to patients, and complications occurred after the procedures were estimated. A Fisher's t-test was performed to identify criteria related to longevity of results. Results: We found longevity of results to be associated with younger age (p = 0.001), absence of severe skin laxity of jawline and neck (p = 0.001), and aesthetic satisfaction (p = 0.024). Edema, swelling, and temporary skin contour irregularities were found in most cases (N = 16; 80%), whereas paresthesia resolving without sequelae in 2-4 weeks was found in two cases (10%). Conclusions: Our results show that selected patients, younger than 51 and showing a mild-moderate degree of skin laxity of jawline and neck angle represent ideal candidates for PLLA traction thread treatment. Further studies will be performed to confirm our results.

Natural and Synthetic Polyesters for Musculoskeletal Tissue Repair: Experimental in Vitro and in Vivo Evaluations

Two natural Biopol™ polyesters, containing 8% (D400G) and 12% (D600G) of hydroxyvalerate component, and a synthetic polyester based on 1,4 cyclohexanediol [Poly(cyclohexyl-sebacate) - PCS] were studied to investigate their in vitro and in vivo behavior for application in musculoskeletal tissue repair. The polyesters were placed in direct contact with L929 fibroblasts and cell proliferation (WST-1), cytotoxic effect (LDH), synthetic activity (total proteins) and cytokine production (IL-1β, IL-6, TNFα) were assessed after an incubation period of 72 hours and 7 days. Then, 12 Sprague-Dawley rats underwent dorsal subcutaneous implants of tested polyesters under general anesthesia. After 1 and 4 weeks from surgery, the animals were pharmacologically euthanized and the implants retrieved with surrounding tissue for histologic and histomorphometric investigations. In vitro results showed that D600G behaved a little worse in comparison to other tested polyesters in terms of cell proliferation and TNFα at 7 days. PCS presented the lowest total protein value at 7 days. In vivo results indicated that PCS implants produced a higher (p < 0.01) extent of inflammatory tissue in comparison to D600G at 1 week and to D400G at 4 weeks, and the lowest vascular densities at both experimental times. D400G seems to be the most suitable material for biomedical application when tested in fibroblast cultures and in the subcutaneous tissue of rats.

Comparison of Resorbable Mesh (Poly L-Lactide/Glycolic Acid) and Porous Polyethylene in Orbital Floor Fractures in an Experimental Model

BACKGROUND

Resorbable mesh and porous polyethylene are frequently used alloplastic materials for the treatment of the orbital blowout fractures. The literature lacks reports comparing their long-term effects on experimental models.

OBJECTIVE

Our aim was to radiologically and histologically evaluate the effectiveness and safety of porous polyethylene and resorbable mesh in a rabbit orbital blowout fracture model.

METHODS

Twelve New Zealand white rabbits (24 orbits) were randomized to 4 groups. In group 1, only orbital floor dissection was done. In group 2, following orbital floor dissection, a 10-mm defect was created without any extra procedure. In group 3, following a 10-mm defect creation, a 12-mm-round cut porous polyethylene was placed on the defect. In group 4, following a 10-mm defect creation, a 12-mm-round cut resorbable mesh was placed on the defect. Computed tomographic analysis was performed during follow-up period. Orbital floors were evaluated histologically at month 6.

RESULTS

No clinical complications were observed during follow-up period. In radiological evaluation, there was no statistically significant difference between groups regarding bone formation. In histological evaluation, the connective tissue was denser, and organized and better bone formation was observed in group 3 and 4 when compared with other groups.

CONCLUSION

Although no significant radiological changes were present, porous polyethylene and resorbable mesh performed better histologically. They were effective and well tolerated for reconstruction of the isolated orbital floor defects.

Exploring the in vitro and in vivo compatibility of PLA, PLA/GNP and PLA/CNT-COOH biodegradable nanocomposites: Prospects for tendon and ligament applications

Anterior cruciate ligament (ACL) reconstructive surgeries are the most frequent orthopedic procedures in the knee. Currently, existing strategies fail in completely restoring tissue functionality and have a high failure rate associated, presenting a compelling argument towards the development of novel materials envisioning ACL reinforcement. Tendons and ligaments, in general, have a strong demand in terms of biomechanical features of developed constructs. We have previously developed polylactic acid (PLA)-based biodegradable films reinforced either with graphene nanoplatelets (PLA/GNP) or with carboxyl-functionalized carbon nanotubes (PLA/CNT-COOH). In the present study, we comparatively assessed the biological performance of PLA, PLA/GNP, and PLA/CNT-COOH by seeding human dermal fibroblasts (HFF-1) and studying cell viability and proliferation. In vivo tests were also performed by subcutaneous implantation in 6-week-old C57Bl/6 mice. Results showed that all formulations studied herein did not elicit cytotoxic responses in seeded HFF-1, supporting cell proliferation up to 3 days in culture. Moreover, animal studies indicated no physiological signs of severe inflammatory response after 1 and 2 weeks after implantation. Taken together, our results present a preliminary assessment on the compatibility of PLA reinforced with GNP and CNT-COOH nanofillers, highlighting the potential use of these carbon-based nanofillers for the fabrication of reinforced synthetic polymer-based structures for ACL reinforcement. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2182-2190, 2017.

Surface functionalized electrospun fibrous poly(3-hydroxybutyrate) membranes and sleeves: a novel approach for fixation in anterior cruciate ligament reconstruction

Effective osteointegration for fixation of the tendon to bone junction is the most important issue in anterior cruciate ligament (ACL) reconstruction. In this study, functionalized electrospun poly(3-hydroxybutyrate) (PHB) membranes and sleeves were prepared and evaluated for the fixation of the tendon to bone junction. The electrospun fibrous PHB membranes were modified with hydrogen peroxide, dopamine (DA), chitosan (CS), glutaraldehyde (GA), and then immobilized with growth factors (GFs) from platelet rich plasma (PRP). The water-contact angle measurement showed enhanced wettability in the membranes after the sequential surface functionalization. Successful graftings of DA, CS and GFs from PRP on the membrane surface were demonstrated using X-ray photoelectron spectroscopy (XPS). The ninhydrin assay revealed the amount of immobilized TGF-β1 and PDFG-AB. The modified membranes showed good biocompatibility in an in vitro rabbit tenocyte cultivation study, as the cells showed good attachment and proliferation activity. Significant increases in extracellular matrix and gene expression of type I collagen were observed when the membrane surface was treated with the GFs from PRP. In a rabbit model, the tendon to bone junction was filled with newly formed fibrocartilage and osteointegration behavior was observed. This suggests that the use of functionalized PHB sleeves can enhance tendon to bone healing and the tendon sleeves might provide a novel method for ACL reconstruction.

Injectable formulations of poly(lactic acid) and its copolymers in clinical use

Poly(lactic acid) and its copolymers have revolutionized the field of drug delivery due to their excellent biocompatibility and tunable physico-chemical properties. These copolymers have served the healthcare sector by contributing many products to combat various diseases and for biomedical applications. This article provides a comprehensive overview of clinically used products of poly(lactic acid) and its copolymers. Multi-dimension information covering product approval, formulation aspects and clinical status is described to provide a panoramic overview of each product. Moreover, leading patented technologies and various clinical trials on these products for different applications are included. This review focuses on marketed injectable formulations of PLA and its copolymers.

Biocompatibility and safety of PLA and its copolymers

PLA and its copolymers are commonly used for a wide variety of applications. While they are considered to be biocompatible, side effects resulting from their implantation have been reported. The implantation of biomaterials always results in a foreign body reaction. Such a reaction has also been reported following PLA and its copolymers. This article reviews the process of inflammatory reaction that is to be expected following implantation of PLA, and it highlights specific cases in which the inflammatory reaction can result in safety concerns. The authors also review selected cases from different medical fields to demonstrate possible clinical side effects resulting from its use.

PDLLA scaffolds with Cu- and Zn-doped bioactive glasses having multifunctional properties for bone regeneration

Novel multifunctional scaffolds for bone regeneration can be developed by incorporation of bioactive glasses (BG) doped with therapeutic and antibacterial metal ions, such as copper (Cu) and zinc (Zn), into a biodegradable polymer. In this context, porous composite materials of biodegradable poly(d, l-lactide) (PDLLA) mixed with sol-gel BG of chemical composition 60SiO₂ ; 25CaO; 11Na₂ O; and 4P₂ O₅ (mol %) doped with either 1 mol % of CuO or ZnO, and with both metals, were prepared. The cytocompatibility of the scaffolds on bone marrow stromal cells (ST-2) depended on both, the amount of glass filler and the concentration of metal ion, as evaluated by lactate dehydrogenase (LDH) activity, cell viability (water-soluble tetrazolium salt [WST-8]), and by cell morphology (scanning electron microscopy [SEM]) tests. In particular, scaffolds having a filler content of 10 wt % showed the highest cytocompatibility. In addition, compared to the neat polymer, the scaffolds containing Cu promoted the angiogenesis marker (Vascular endothelial growth factor concentration) to a larger extent while scaffolds containing Zn increased the osteogenesis marker (specific alkaline phosphatase-activity). Noteworthy, the scaffolds with both metal ions showed a combined effect on both properties. Cu- and Zn-doped glasses also provided higher antibacterial capacity to PDLLA-based scaffolds against methicillin-resistant S. aureus bacteria than undoped glass. In combination, our results showed that by a proper addition of Cu- and Zn-doped BG to a PDLLA matrix, multifunctional composite scaffolds with enhanced biological activity can be designed for bone tissue regeneration. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 746-756, 2017.

ELABORATION AND EVALUATION OF A COMPOSITE BONE SUBSTITUTE BASED ON β-TCP/DCPD AND PHBV, PRELIMINARY RESULTS

Objective: In the present study, we investigate the biological performance of a calcium phosphate ceramics (CPC) bone substitute combined with poly-hydroxybutyrate-co-hydroxyvalerate (PHBV). Materials and Methods: A particulate CPC [45% beta-tricalcium phosphate ([Formula: see text]-TCP) and 55% of dihydrated dicalcium phosphate (DCPD)] was incorporated into a biodegradable copolymer PHBV. Two series of the composite, 1 and 2, with CPC–PHBV weight ratios of (40%–60% and 60%–40%), respectively, were prepared using chloroform for dissolving the polymer and a pressure molding process for shaping the composite samples. After particle size analysis, the two composites were characterized by scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS). In a second step, a 10[Formula: see text]mm bony segmental defect created in the tibias of 20 New Zealand White Rabbits was filled randomly with either composite 1 for group 1 or composite 2 for group 2. There were 10 animals in each group. Clinical, radiological and histological assessments were then carried out to evaluate the biological properties of developed CPC–PHBV composites. Results: For both variants of the developed CPC–PHBV biocomposite, there was evidence of osseous consolidation within three months. An in vivo investigation revealed the biological properties of the biocomposite, namely, biocompatibility, bioactivity, biodegradability and osteoconductivity. The morphological characteristics, granule size and chemical composition, were indeed found to be favorable for osseous cell development. This study likewise showed lower mortality for the variant with weight ratio (40%CPC–60%PHBV). Conclusion: An in vivo investigation revealed that the new biomaterial composed of CPC and PHBV exhibits manifest osteoconductivity and bioactivity with better degradation kinetics than the CPC. Moreover, the variant with 40%CPC/60%PHBV appeared more resistant to infection than the 60%CPC/40%PHBV which is an indicator of biocompatibility.

Preparation and characterization of biodegradable polyhydroxybutyrate-co-hydroxyvalerate/polyethylene glycol-based microspheres

The in vivo effectiveness of biomolecules may be limited by their rapid diffusion in the body and short half-life time. Encapsulation of these biomolecules allows protecting them against degradation and ensuring a controlled release over time. In this work, the production of polyhydroxybutyrate-co-hydroxyvalerate/polyethylene glycol-based microspheres loaded with heparin by double emulsion-solvent evaporation is investigated. Significant improvements are achieved after blending PHB-HV microspheres with PEG. First of all, an important decrease of the initial burst effect is ensured. Moreover, lower degradation of the microspheres is observed after 30days in the release medium. Finally, the release rate could be controlled using different PEG molecular weights and concentrations. A toxic effect of PHB-HV 30% PEG 1100gmol^-1 microspheres is observed whereas PHB-HV and PHB-HV 30% PEG 10,000gmol^-1 microspheres are not toxic. These microspheres seem to be most suited for further tissue engineering applications. The effectiveness of direct PEG blending to PHB-HV is proved, limiting the use of chemical reagents for PHB-HV/PEG copolymer synthesis and steps for chemical reagents removal from the copolymer.

Investigation of the Impact of Poly(Ethylene Glycol)-Modulation of Poly(B-Hydroxybutyrate) Syntheses on Cell Interactions of the Resulting Polymers

Poly(-hydroxybutyrate), PHB is a bacterial polyester known for its excellent bone compatibility, however, the material lacks blood and tissue compatibility. Poly(ethylene glycol), PEG,-modulated fermentation of Alcaligenes latus and Azotobacter vinelandii UWD was employed to yield copolymers consisting of PHB and PEG that exhibit diminished cell-adhesion surface properties. PEGs with molecular weights of 3400, 2000, and 400 as well as diethylene glycol, DEG, and pentaerythritol ethoxylate, PEE, were used in a concentration of 2% (w/v) for amending the fermentation broths. This modulation of the fermentation conditions did not influence polymer yields. However, the resulting copolymers had drastically reduced molecular weights, 82% less for the DEG-amended fermentation of A. latus. The reduction in molecular weight was attributed to an end-capping reaction of the nascent PHB-chain with PEG and/or early chain termination by water facilitated by the presence of the highly hydrophilic PEG-molecules. The formation of a covalent linkage was proven unambiguously by H-NMR-spectroscopic methods only for the copolymers obtained in the DEG-modified fermentations of both strains. Cell growth experiments using SK-MEL 28 and MDA-MB 231 cells were used for the evaluation of polymer-cell interaction. Copolymer films obtained from PEG-modulated syntheses showed significantly less cell adhesion with reductions in cell adhesions; up to 74% less in the two-day experiments (MDA-MB 231 on the copolymer obtained in DEG-modified fermentation of A. latus) and 48% less in the seven-day experiments (SK-MEL 28 on the copolymer obtained in PEG 400-modified fermentation of A. vinelandii UWD). In the two-day experiments, no differences in the cellinteraction was observed between the polymers obtained from two different bacterial sources, the polymers differed in their long-term, seven-day, cell interaction with copolymers obtained from A. vinelandii UWD maintaining more effective cell repulsion.

Third generation poly(hydroxyacid) composite scaffolds for tissue engineering

Bone tissue engineering based on scaffolds is quite a complex process as a whole gamut of criteria needs to be satisfied to promote cellular attachment, proliferation and differentiation: biocompatibility, right surface properties, adequate mechanical performance, controlled bioresorbability, osteoconductivity, angiogenic cues, and vascularization. Third generation scaffolds are more of composite types to maximize biological-mechanical-chemical properties. In the present review, our focus is on the performance of micro-organism-derived polyhydroxyalkanoates (PHAs)-polyhydroxybutyrate (PHB) and polyhydroxybutyrate-co-valerate (PHBV)-composite scaffolds with ceramics and natural polymers for tissue engineering applications with emphasis on bone tissue. We particularly emphasize on how material properties of the composites affect scaffold performance. PHA-based composites have demonstrated their biocompatibility with a range of tissues and their capacity to induce osteogenesis due to their piezoelectric properties. Electrospun PHB/PHBV fiber mesh in combination with human adipose tissue-derived stem cells (hASCs) were shown to improve vascularization in engineered bone tissues. For nerve and skin tissue engineering applications, natural polymers such as collagen and chitosan remain the gold standard but there is scope for development of scaffolds combining PHAs with other natural polymers which can address some of the limitations such as brittleness, lack of bioactivity and slow degradation rate presented by the latter. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1667-1684, 2017.

Nanofibrous poly(3-hydroxybutyrate)/poly(3-hydroxyoctanoate) scaffolds provide a functional microenvironment for cartilage repair

Articular cartilage defects, when repaired ineffectively, often lead to further deterioration of the tissue, secondary osteoarthritis and, ultimately, joint replacement. Unfortunately, current surgical procedures are unable to restore normal cartilage function. Tissue engineering of cartilage provides promising strategies for the regeneration of damaged articular cartilage. As yet, there are still significant challenges that need to be overcome to match the long-term mechanical stability and durability of native cartilage. Using electrospinning of different blends of biodegradable poly(3-hydroxybutyrate)/poly(3-hydroxyoctanoate), we produced polymer scaffolds and optimised their structure, stiffness, degradation rates and biocompatibility. Scaffolds with a poly(3-hydroxybutyrate)/poly(3-hydroxyoctanoate) ratio of 1:0.25 exhibit randomly oriented fibres that closely mimic the collagen fibrillar meshwork of native cartilage and match the stiffness of native articular cartilage. Degradation of the scaffolds into products that could be easily removed from the body was indicated by changes in fibre structure, loss of molecular weight and a decrease in scaffold stiffness after one and four months. Histological and immunohistochemical analysis after three weeks of culture with human articular chondrocytes revealed a hyaline-like cartilage matrix. The ability to fine tune the ultrastructure and mechanical properties using different blends of poly(3-hydroxybutyrate)/poly(3-hydroxyoctanoate) allows to produce a cartilage repair kit for clinical use to reduce the risk of developing secondary osteoarthritis. We further suggest the development of a toolbox with tailor-made scaffolds for the repair of other tissues that require a ‘guiding’ structure to support the body’s self-healing process.

Comparative evaluation of in vivo biocompatibility and biodegradability of regenerated silk scaffolds reinforced with/without natural silk fibers

Nowadays, exceptional advantages of silk fibroin over synthetic and natural polymers have impelled the scientists to application of this biomaterial for tissue engineering purposes. Recently, we showed that embedding natural degummed silk fibers in regenerated Bombyx mori silk-based scaffold significantly increases the mechanical stiffness, while the porosity of the scaffolds remains the same. In the present study, we evaluated degradation rate, biocompatibility and regenerative properties of the regenerated 2% and 4% wt silk-based composite scaffolds with or without embedded natural degummed silk fibers within 90 days in both athymic nude and wild-type C57BL/6 mice through subcutaneous implantation. In all scaffolds, a suitable interconnected porous structure for cell penetration was seen under scanning electron microscopy. Compressive tests revealed a functional relationship between fiber reinforcement and compressive modulus. In addition, the fiber/fibroin composite scaffolds support cell attachment and proliferation. On days 30 to 90 after subcutaneous implantation, the retrieved tissues were examined via gross morphology, histopathology, immunofluorescence staining and reverse transcription-polymerase chain reaction as shown in Figure 1 . Results showed that embedding the silk fibers within the matrix enhances the biodegradability of the matrix resulting in replacement of the composite scaffolds with the fresh connective tissue. Fortification of the composites with degummed fibers not only regulates the degradation profile but also increases the mechanical performance of the scaffolds. This report also confirmed that pore size and structure play an important role in the degradation rate. In conclusion, the findings of the present study narrate key role of additional surface area in improving in vitro and in vivo biological properties of the scaffolds and suggest the potential ability of these fabricated composite scaffolds for connective tissue regeneration. [Figure: see text]

A Canadian study of the use of poly-L-lactic acid dermal implant for the treatment of hill and valley acne scarring

BACKGROUND

Hill and valley scarring is 1 of 3 atrophic scar types that occur as a result of acne, becoming more apparent with facial skin aging. Treatment includes resurfacing techniques and the use of injectable fillers. Poly-L-lactic acid is an injectable collagen builder that has been used for the treatment of HIV-associated lipodystrophy and cosmetic enhancement.

OBJECTIVE

To determine the degree of correction attainable with poly-L-lactic acid and safety findings for the treatment of hill and valley acne scarring.

MATERIALS AND METHODS

Poly-L-lactic acid was injected over 3 to 4 serial treatments at 4-week intervals in 22 subjects in this single-arm, unblinded, open-label Phase II study. Efficacy was determined by physician, blinded evaluator, and subject assessment of scar improvement using Likert scales, comparing photographs taken by 3 camera systems at treatment visits 2 to 4 and follow-up to baseline. Subjects also assessed treatment satisfaction.

RESULTS

Percentage of patients with much to excellent improvement using the most sensitive camera system (VISIA-CR) ranged from 45.5% to 68.2%. Subject treatment satisfaction scores increased by 44%. One patient experienced a palpable nonvisible nodule. No subjects discontinued treatment.

CONCLUSION

Injectable poly-L-lactic acid facilitated improvement in hill and valley acne scarring and was well tolerated.

A Uniform Ultra-Small Microsphere/SAIB Hybrid Depot with Low Burst Release for Long-Term Continuous Drug Release

PURPOSE

In the present study, a uniform ultra-small microsphere/sucrose acetate isobutyrate (SAIB) hybrid depot (m-SAIB depot) was designed to provide a long-term sustained release drug delivery system which not only reduced the burst release of an SAIB depot, but also eliminated the lag-time of PLGA microspheres.

METHODS

Risperidone loaded m-SAIB depot (Ris-m-SAIB depot) was characterized by in vitro drug release, pharmacokinetics, in vivo degradation and biocompatibility, in comparison with risperidone loaded SAIB depot (Ris-SAIB depot).

RESULTS

Ris-m-SAIB depot showed a low burst release (0.64%) and a reduced in vitro drug release rate due to the encapsulation of most drug in microspheres. After intramuscular administration, the in vivo burst release of Ris-m-SAIB was significantly decreased, as reflected by the low Cmax/Cs(4-td) (approximately 30-fold reduction), in comparison with Ris-SAIB depot. From 4 to 78 days, Ris-m-SAIB depot showed a higher plasma drug level (1.55 ~ 16.30 ng/ml) with a steadier drug release profile compared with Ris-SAIB depot. Ris-m-SAIB depot degraded gradually with a degradation t1/2 of 54.6 days and exhibited good biocompatibility in vivo.

CONCLUSION

These results demonstrate the potential application of a uniform ultra-small microsphere/SAIB hybrid depot for continuously delivering small drug molecules for long periods of time without burst release.

Extended culture of macrophages from different sources and maturation results in a common M2 phenotype

Inflammatory responses to biomaterials heavily influence the environment surrounding implanted devices, often producing foreign-body reactions. The macrophage is a key immunomodulatory cell type consistently associated with implanted biomaterials and routinely used in short-term in vitro cell studies of biomaterials aiming to reproduce host responses. Inconsistencies within these studies, including differently sourced cells, different durations of culture, and assessment of different activation markers, lead to many conflicting results in vitro that confound consistency and conclusions. We hypothesize that different experimentally popular monocyte-macrophage cell types have intrinsic in vitro culture-specific differences that yield conflicting results. Recent studies demonstrate changes in cultured macrophage cytokine expression over time, leading to the hypothesis that changes in macrophage phenotype also occur in response to extended culture. Here, macrophage cells of different transformed and primary-derived origins were cultured for 21 days on model polymer biomaterials. Cell type-based differences in morphology and cytokine/chemokine expression as well as changes in cell surface biomarkers associated with differentiation stage, activation state, and adhesion were compared. Results reflect consistent macrophage development toward an M2 phenotype via up-regulation of the macrophage mannose receptor for all cell types following 21-day extended culture. Significantly, implanted biomaterials experiencing the foreign-body response and encapsulation in vivo often elicit a shift toward an analogous M2 macrophage phenotype. In vitro "default" of macrophage cultures, regardless of lineage, to this M2 state in the presence of biomaterials at long culture periods is not recognized, but has important implications to in vitro modeling of in vivo host response.