Injectable thermosensitive PEG–PCL–PEG hydrogel/acellular bone matrix composite for bone regeneration in cranial defects

Injectable thermosensitive hydrogel systems based on functional PEG/PCL block polymer for local drug delivery

Injectable in situ thermosensitive hydrogels have potential applications in tissue engineering and drug delivery. The hydrogel formulations exist as aqueous solutions at room temperature but rapidly solidify into gels at 37 °C in situ, making them highly suitable for administering drugs in a minimally invasive manner to the target organ(s). The hydrogel formed with nanoparticles assembled with amphiphilic polymer blocks of polyethyleneglycol (PEG) and biodegradable polycaprolactone (PCL) have been tested as platforms for targeted and sustained drug delivery, and have shown encouraging results. In this review, we summarize the influence of the molecular weight, PEG/PCL ratio and functional structure of hydrophobic PCL blocks on the critical gelation temperature, gelling behavior and drug release kinetics of the hydrogels. The current studies on the biomedical applications of thermosensitive PEG/PCL hydrogels have also been discussed.

Recent advances in functional nanostructured materials for bone-related diseases

Bone-related diseases seriously threaten people's health and research studies have been dedicated towards searching for new and effective treatment methods. Nanotechnologies have opened up a new field in recent decades and nanostructured materials, which exist in a variety of forms, are considered to be promising materials in this field. This article reviews the most recent progress in the development of nanostructured materials for bone-related diseases, including osteoporosis, osteoarthritis, bone metastasis, osteomyelitis, myeloma, and bone defects. We highlight the advantages and functions of nanostructured materials, including sustained release, bone targeting, scaffolding in bone tissue engineering, etc., in bone-related diseases. We also include the remaining challenges of these emerging materials.

Bioactive hydrogels for bone regeneration

Bone self-healing is limited and generally requires external intervention to augment bone repair and regeneration. While traditional methods for repairing bone defects such as autografts, allografts, and xenografts have been widely used, they all have corresponding disadvantages, thus limiting their clinical use. Despite the development of a variety of biomaterials, including metal implants, calcium phosphate cements (CPC), hydroxyapatite, etc., the desired therapeutic effect is not fully achieved. Currently, polymeric scaffolds, particularly hydrogels, are of interest and their unique configurations and tunable physicochemical properties have been extensively studied. This review will focus on the applications of various cutting-edge bioactive hydrogels systems in bone regeneration, as well as their advantages and limitations. We will examine the composition and defects of the bone, discuss the current biomaterials for bone regeneration, and classify recently developed polymeric materials for hydrogel synthesis. We will also elaborate on the properties of desirable hydrogels as well as the fabrication techniques and different delivery strategies. Finally, the existing challenges, considerations, and the future prospective of hydrogels in bone regeneration will be outlined.

A high-strength mineralized collagen bone scaffold for large-sized cranial bone defect repair in sheep

Large-sized cranial bone defect repair presents a great challenge in the clinic. The ideal cranioplasty materials to realize the functional and cosmetic recovery of the defect must have sufficient mechanical support, excellent biocompatibility, good osseointegration and biodegradability as well. In this study, a high-strength mineralized collagen (MC) bone scaffold was developed with biomimetic composition, microstructure and mechanical properties for the repair of sheep large-sized cranial bone defects in comparison with two traditional cranioplasty materials, polymethyl methacrylate and titanium mesh. The compact MC scaffold showed no distinct pore structure and therefore possessed good mechanical properties. The strength and elastic modulus of the scaffold were much higher than those of natural cancellous bone and slightly lower than those of natural compact bone. In vitro cytocompatibility evaluation revealed that the human bone marrow mesenchymal stem cells (hBMSC) had good viability, attachment and proliferation on the compact MC scaffold indicating its excellent biocompatibility. An adult sheep cranial bone defect model was constructed to evaluate the performances of these cranioplasty materials in repairing the cranial bone defects. The results were investigated by gross observation, computed tomography scanning as well as histological assessments. The in vivo evaluations indicated that compact MC scaffold showed notable osteoconductivity and osseointegration with surrounding cranial bone tissues by promoting bone regeneration. Our results suggested that the compact MC scaffold has a promising potential for large-sized cranial bone defect repair.

Enzymatically cross-linked hydrogels based on a linear poly(ethylene glycol) analogue for controlled protein release and 3D cell culture

Injectable and enzyme-mediated cross-linked hydrogels are promising biomedical materials. However, although poly(ethylene glycol) (PEG) is a popular basic component of synthetic hydrogels, only a few PEG-based enzymatically cross-linked hydrogels have been developed based on branched PEG. Compared with branched PEG, linear PEGs with different molecular weights are readily available and low-cost, while the poor capacity for post-polymerization modifications of linear PEG limited its application on a greater scale. Herein, a linear PEG-based analogue functionalized with multiple phenolic hydroxyl moieties, PEGDA-DTT-HPA, was designed and synthesized via Michael-type polyaddition combined with Steglich esterification. Environmentally friendly hydrogels composed of PEGDA-DTT-HPA were facilely formed under the catalysis of horseradish peroxidase (HRP) in the presence of hydrogen peroxide (H₂O₂). The gelation time and mechanical strengths of hydrogels were found to be adjusted independently by altering the concentrations of HRP and H₂O₂, respectively. The hydrogels were further demonstrated as protein drug and cell carriers using bovine serum albumin (BSA) and lentivirus-mediated LifeAct-EGFP overexpressed human mesenchymal stem cells (hMSCs-LifeAct-EGFP), respectively. The BSA-loaded hydrogel systems exhibited a sustained drug release over 3 weeks; the encapsulated hMSCs showed good viability over all time points assessed. Consequently, the current study opens new avenues for the design of PEG-based injectable hydrogels and the PEGDA-DTT-HPA hydrogel has great potential for applications in drug delivery, 3D cell culture and tissue regeneration.

Toxicity Assessment of PEG-PCCL Nanoparticles and Preliminary Investigation on Its Anti-tumor Effect of Paclitaxel-Loading

The efficiency of single treatment of conventional chemotherapy drugs is unpleasantly reduced by the physiological barriers of tumors. In this regard, nanoparticles have become attractive for achieving such medical purpose of targeted cancer therapy by delivering anti-tumor agents to the needed area. A novel drug deliverer, poly (ethylene glycol) carboxyl-poly (ε-caprolactone) (PEG-PCCL), has been reported to be highly hydrophilic and stable, while little is known about its organic toxicity. This study focused on systemic toxicity assessments of PEG-PCCL. The pharmacokinetics of PTX-loaded PEG-PCCL (PEG-PCCL/PTX) and its anti-tumor effect were preliminarily investigated. In the present work, PEG-PCCL was characterized by laser particle size analyzer and transmission electron microscopy. The cytotoxicity was investigated by MTT test, LDH leakage assay, immunofluorescence, and transmission electron microscopy. Hemolysis, phlebitis, and organ toxicity tests were performed to demonstrate the biocompatibility and acute biotoxicity. H22 tumor-bearing mice were used to evaluate the pharmacokinetics of the micells of PEG-PCCL/PTX and its anti-tumor effect. The results showed that the size of PEG-PCCL nanospheres was 97 ± 2.6 nm. PEG-PCCL treatment showed little cytotoxicity and good biocompatibility, and did not exhibit organ toxicity. PTX-loading efficiency was 49.98%. The pharmacokinetic study on H22 tumor-bearing mice revealed that PEG-PCCL/PTX has higher stability and slower release than PTX alone. Together, these results suggest that PEG-PCCL nanosphere has little toxicity to organisms and is a potential candidate of biocompatible drug vehicle for hydrophobic drugs.

Nanoformulated ABT-199 to effectively target Bcl-2 at mitochondrial membrane alleviates airway inflammation by inducing apoptosis

Elimination of airway inflammatory cells is essential for asthma control. As Bcl-2 protein is highly expressed on the mitochondrial outer membrane in inflammatory cells, we chose a Bcl-2 inhibitor, ABT-199, which can inhibit airway inflammation and airway hyperresponsiveness by inducing inflammatory cell apoptosis. Herein, we synthesized a pH-sensitive nanoformulated Bcl-2 inhibitor (Nf-ABT-199) that could specifically deliver ABT-199 to the mitochondria of bronchial inflammatory cells. The proof-of-concept study of an inflammatory cell mitochondria-targeted therapy using Nf-ABT-199 was validated in a mouse model of allergic asthma. Nf-ABT-199 was proven to significantly alleviate airway inflammation by effectively inducing eosinophil apoptosis and inhibiting both inflammatory cell infiltration and mucus hypersecretion. In addition, the nanocarrier or Nf-ABT-199 showed no obvious influence on cell viability, airway epithelial barrier and liver function, implying excellent biocompatibility and with non-toxic effect. The nanoformulated Bcl-2 inhibitor Nf-ABT-199 accumulates in the mitochondria of inflammatory cells and efficiently alleviates allergic asthma.

Thermoresponsive Hydrogels and Their Biomedical Applications: Special Insight into Their Applications in Textile Based Transdermal Therapy

Various natural and synthetic polymers are capable of showing thermoresponsive properties and their hydrogels are finding a wide range of biomedical applications including drug delivery, tissue engineering and wound healing. Thermoresponsive hydrogels use temperature as external stimulus to show sol-gel transition and most of the thermoresponsive polymers can form hydrogels around body temperature. The availability of natural thermoresponsive polymers and multiple preparation methods of synthetic polymers, simple preparation method and high functionality of thermoresponsive hydrogels offer many advantages for developing drug delivery systems based on thermoresponsive hydrogels. In textile field applications of thermoresponsive hydrogels, textile based transdermal therapy is currently being applied using drug loaded thermoresponsive hydrogels. The current review focuses on the preparation, physico-chemical properties and various biomedical applications of thermoresponsive hydrogels based on natural and synthetic polymers and especially, their applications in developing functionalized textiles for transdermal therapies. Finally, future prospects of dual responsive (pH/temperature) hydrogels made by these polymers for textile based transdermal treatments are mentioned in this review.

Thermoresponsive Hydrogels and Their Biomedical Applications: Special Insight into Their Applications in Textile Based Transdermal Therapy

Various natural and synthetic polymers are capable of showing thermoresponsive properties and their hydrogels are finding a wide range of biomedical applications including drug delivery, tissue engineering and wound healing. Thermoresponsive hydrogels use temperature as external stimulus to show sol-gel transition and most of the thermoresponsive polymers can form hydrogels around body temperature. The availability of natural thermoresponsive polymers and multiple preparation methods of synthetic polymers, simple preparation method and high functionality of thermoresponsive hydrogels offer many advantages for developing drug delivery systems based on thermoresponsive hydrogels. In textile field applications of thermoresponsive hydrogels, textile based transdermal therapy is currently being applied using drug loaded thermoresponsive hydrogels. The current review focuses on the preparation, physico-chemical properties and various biomedical applications of thermoresponsive hydrogels based on natural and synthetic polymers and especially, their applications in developing functionalized textiles for transdermal therapies. Finally, future prospects of dual responsive (pH/temperature) hydrogels made by these polymers for textile based transdermal treatments are mentioned in this review.

Carboxylic Terminated Thermo-Responsive Copolymer Hydrogel and Improvement in Peptide Release Profile

To improve the release profile of peptide drugs, thermos-responsive triblock copolymer poly (ε-caprolactone-co-p-dioxanone)-b-poly (ethylene glycol)-b-poly (ε-caprolactone-co-p-dioxanone) (PECP) was prepared and end capped by succinic anhydride to give its carboxylic terminated derivative. Both PCEP block copolymer and its end group modified derivative showed temperature-dependent reversible sol-gel transition in water. The carboxylic end group could significantly decrease the sol-gel transition temperature by nearly 10 °C and strengthen the gel due to enhanced intermolecular force among triblock copolymer chains. Furthermore, compared with the original PECP triblock copolymer, HOOC-PECP-COOH copolymer displayed a retarded and sustained release profile for leuprorelin acetate over one month while effectively avoiding the initial burst. The controlled release was believed to be related to the formation of conjugated copolymer-peptide pair by ionic interaction and enhanced solubility of drug molecules into the hydrophobic domains of the hydrogel. Therefore, carboxyl terminated HOOC-PECP-COOH hydrogel was a promising and well-exhibited sustained release carrier for peptide drugs with the advantage of being able to develop injectable formulation by simple mixing.

Polymersome–hydrogel composites with combined quick and long-term antibacterial activities

Intrinsically antibacterial polymersomes loaded with antibiotics were incorporated into hydrogels, exhibiting quick and long-acting antibacterial activity.

Modifying collagen with alendronate sodium for bone regeneration applications

Phosphorylated materials are attractive candidates for bone regeneration because they may facilitate the construction of a phosphorylated bone extracellular matrix (ECM) to build a beneficial environment for bone formation. Here, we designed and synthesized a new phosphorylated material, collagen type I phosphorylated with alendronate sodium (Col-Aln), based on the biodegradable osteoconductive collagen backbone. Col-Aln can distinctly accelerate in vitro mineralization in simulated body fluid. Col-Aln showed good biocompatibility with bone marrow mesenchymal stem cells (BMSCs) and promoted their adhesion as well as the osteogenic differentiation of BMSCs more effectively than did pure collagen. Furthermore, collagen and Col-Aln scaffolds implanted into a critical-sized rat cranial defect for 4 and 8 weeks were shown to degrade in vivo and helped to facilitate bone growth in the defect, while the phosphate-containing Col-Aln scaffold significantly promoted new bone formation. Col-Aln provides a new strategy to integrate bioactive phosphate molecules via covalent grafting onto biopolymers and has promise for bone regeneration applications.

Efficient covalent bonding with phosphate-containing alendronate prompts the fast mineralization and osteoinduction of the collagen scaffold.

Thermosensitive hydrogels a versatile concept adapted to vaginal drug delivery

Vaginal drug delivery represents an attractive strategy for local and systemic delivery of drugs otherwise poorly absorbed after oral administration. The rather dense vascular network, mucus permeability and the physiological phenomenon of the uterine first-pass effect can all be exploited for therapeutic benefit. However, several physiological factors such as an acidic pH, constant secretion, and turnover of mucus as well as varying thickness of the vaginal epithelium can impact sustained drug delivery. In recent years, polymers have been designed to tackle challenges mentioned above. In particular, thermosensitive hydrogels hold great promise due to their stability, biocompatibility, adhesion properties and adjustable drug release kinetics. Here, we discuss the physiological and anatomical uniqueness of the vaginal environment and how it impacts the safe and efficient vaginal delivery and also reviewed several thermosensitive hydrogels deemed suitable for vaginal drug delivery by addressing specific characteristics, which are essential to engage the vaginal environment successfully.

Non-invasive monitoring of in vivo degradation of a radiopaque thermoreversible hydrogel and its efficacy in preventing post-operative adhesions

In vivo behavior of hydrogel-based biomaterials is very important for rational design of hydrogels for various biomedical applications. Herein, we developed a facile method for in situ fabrication of radiopaque hydrogel. An iodinated functional diblock copolymer of poly(ethylene glycol) and aliphatic polyester was first synthesized by coupling the hydroxyl end of the diblock copolymer with 2,3,5-triiodobenzoic acid (TIB) and then a radiopaque thermoreversible hydrogel was obtained by mixing it with the virgin diblock copolymer. A concentrated aqueous solution of the copolymer blend was injectable at room temperature and spontaneously turned into an in situ hydrogel at body temperature after injection. The introduction of TIB moieties affords the capacity of X-ray opacity, enabling in vivo visualization of the hydrogel using Micro-CT. A rat model with cecum and abdominal defects was utilized to evaluate the efficacy of the radiopaque hydrogel in the prevention of post-operative adhesions, and a significant reduction of the post-operative adhesion formation was confirmed. Meanwhile, the maintenance of the radiopaque hydrogel in the abdomen after administration was non-destructively detected via Micro-CT scanning. The reconstructed three-dimensional images showed that the radiopaque hydrogel with an irregular morphology was located on the injured abdominal wall. The time-dependent profile of the volume of the radiopaque hydrogel determined by Micro-CT imaging was well consistent with the trend obtained from the dissection observation. Therefore, the radiopaque thermoreversible hydrogel can serve as a potential visualized biomedical implant and this practical mixing approach is also useful for further extension into the in vivo monitoring of other biomaterials.

STATEMENT OF SIGNIFICANCE

While a variety of biomaterials have been extensively studied, it is rare to monitor in vivo degradation and medical efficacy of a material after being implanted deeply into the body. Herein, the radiopaque thermoreversible hydrogel developed by us not only holds desirable performance on the prevention of post-operative abdominal adhesions, but also allows non-invasive monitoring of its in vivo degradation with CT imaging in a real-time, quantitative and three-dimensional manner. The methodology based on CT imaging provides important insights into the in vivo fate of the hydrogel after being deeply implanted into mammals for different biomedical applications and significantly reduces the amount of animals sacrificed.

Sustained subconjunctival delivery of cyclosporine A using thermogelling polymers for glaucoma filtration surgery

We successfully developed a subconjunctival delivery system of CsA using an injectable thermogel to inhibit post-surgical scar formation after glaucoma filtration surgery.

Thermo-responsive polymers and their application as smart biomaterials

This review summarises smart thermo-responsive polymeric materials with reversible and ‘on–off’ remotely switchable properties for a wide range of biomedical and biomaterials applications.

Controlled release of liraglutide using thermogelling polymers in treatment of diabetes

In treatment of diabetes, it is much desired in clinics and challenging in pharmaceutics and material science to set up a long-acting drug delivery system. This study was aimed at constructing a new delivery system using thermogelling PEG/polyester copolymers. Liraglutide, a fatty acid-modified antidiabetic polypeptide, was selected as the model drug. The thermogelling polymers were presented by poly(ε-caprolactone-co-glycolic acid)-poly(ethylene glycol)-poly(ε-caprolactone-co-glycolic acid) (PCGA-PEG-PCGA) and poly(lactic acid-co-glycolic acid)-poly(ethylene glycol)-poly(lactic acid-co-glycolic acid) (PLGA-PEG-PLGA). Both the copolymers were soluble in water, and their concentrated solutions underwent temperature-induced sol-gel transitions. The drug-loaded polymer solutions were injectable at room temperature and gelled in situ at body temperature. Particularly, the liraglutide-loaded PCGA-PEG-PCGA thermogel formulation exhibited a sustained drug release manner over one week in both in vitro and in vivo tests. This feature was attributed to the combined effects of an appropriate drug/polymer interaction and a high chain mobility of the carrier polymer, which facilitated the sustained diffusion of drug out of the thermogel. Finally, a single subcutaneous injection of this formulation showed a remarkably improved glucose tolerance of mice for one week. Hence, the present study not only developed a promising long-acting antidiabetic formulation, but also put forward a combined strategy for controlled delivery of polypeptide.

Antibacterial modification of an injectable, biodegradable, non-cytotoxic block copolymer-based physical gel with body temperature-stimulated sol-gel transition and controlled drug release

Biomaterials are being extensively used in various biomedical fields; however, they are readily infected with microorganisms, thus posing a serious threat to the public health care. We herein presented a facile route to the antibacterial modification of an important A-B-A type biomaterial using poly (ethylene glycol) methyl ether (mPEG)- poly(ε-caprolactone) (PCL)-mPEG as a typical model. Inexpensive, commercial bis(2-hydroxyethyl) methylammonium chloride (DMA) was adopted as an antibacterial unit. The effective synthesis of the antibacterial copolymer mPEG-PCL-∼∼∼-PCL-mPEG (where ∼∼∼ denotes the segment with DMA units) was well confirmed by FTIR and (1)H NMR spectra. At an appropriate modification extent, the DMA unit could render the copolymer mPEG-PCL-∼∼∼-PCL-mPEG highly antibacterial, but did not largely alter its fascinating intrinsic properties including the thermosensitivity (e.g., the body temperature-induced sol-gel transition), non-cytotoxicity, and controlled drug release. A detailed study on the sol-gel-sol transition behavior of different copolymers showed that an appropriate extent of modification with DMA retained a sol-gel-sol transition, despite the fact that a too high extent caused a loss of sol-gel-sol transition. The hydrophilic and hydrophobic balance between mPEG and PCL was most likely broken upon a high extent of quaternization due to a large disturbance effect of DMA units at a large quantity (as evidenced by the heavily depressed PCL segment crystallinity), and thus the micelle aggregation mechanism for the gel formation could not work anymore, along with the loss of the thermosensitivity. The work presented here is highly expected to be generalized for synthesis of various block copolymers with immunity to microorganisms. Light may also be shed on understanding the phase transition behavior of various multiblock copolymers.

Hydrogel as a bioactive material to regulate stem cell fate

The encapsulation of stem cells in a hydrogel substrate provides a promising future in biomedical applications. However, communications between hydrogels and stem cells is complicated; various factors such as porosity, different polymer types, stiffness, compatibility and degradation will lead to stem cell survival or death. Hydrogels mimic the three-dimensional extracellular matrix to provide a friendly environment for stem cells. On the other hand, stem cells can sense the surroundings to make the next progression, stretching out, proliferating or just to remain. As such, understanding the correlation between stem cells and hydrogels is crucial. In this Review, we first discuss the varying types of the hydrogels and stem cells, which are most commonly used in the biomedical fields and further investigate how hydrogels interact with stem cells from the perspective of their biomedical application, while providing insights into the design and development of hydrogels for drug delivery, tissue engineering and regenerative medicine purpose. In addition, we compare the results such as stiffness, degradation time and pore size as well as peptide types of hydrogels from respected journals. We also discussed most recently magnificent materials and their effects to regulate stem cell fate.

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Hydrogels as Extracellular Matrix (ECM) mimics stem cells proliferation and differentiation.

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Discuss how hydrogels interact with stem cells from the perspective of their biomedical applications.

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Recent magnificent materials and their effects to regulate stem cells fate.

Injectable micellar supramolecular hydrogel for delivery of hydrophobic anticancer drugs

In this paper, an injectable micellar supramolecular hydrogel composed of α-cyclodextrin (α-CD) and monomethoxy poly(ethylene glycol)-b-poly(ε-caplactone) (MPEG5000-PCL5000) micelles was developed by a simple method for hydrophobic anticancer drug delivery. By mixing α-CD aqueous solution and MPEG5000-PCL5000 micelles, an injectable micellar supramolecular hydrogel could be formed under mild condition due to the inclusion complexation between α-CD and MPEG segment of MPEG5000-PCL5000 micelles. The resultant supramolecular hydrogel was thereafter characterized by X-ray diffraction (XRD) and Scanning electron microscopy (SEM). The effect of α-CD amount on the gelation time, mechanical strength and thixotropic property was studied by a rheometer. Payload of hydrophobic paclitaxel (PTX) to supramolecular hydrogel was achieved by encapsulation of PTX into MPEG5000-PCL5000 micelles prior mixing with α-CD aqueous solution. In vitro release study showed that the release behavior of PTX from hydrogel could be modulated by change the α-CD amount in hydrogel. Furthermore, such supramolecular hydrogel could enhance the biological activity of encapsulated PTX compared to free PTX, as indicated by in vitro cytotoxicity assay. All these results indicated that the developed micellar supramolecular hydrogel might be a promising injectable drug delivery system for anticancer therapy.

Stem cells, growth factors and scaffolds in craniofacial regenerative medicine

Current reconstructive approaches to large craniofacial skeletal defects are often complicated and challenging. Critical-sized defects are unable to heal via natural regenerative processes and require surgical intervention, traditionally involving autologous bone (mainly in the form of nonvascularized grafts) or alloplasts. Autologous bone grafts remain the gold standard of care in spite of the associated risk of donor site morbidity. Tissue engineering approaches represent a promising alternative that would serve to facilitate bone regeneration even in large craniofacial skeletal defects. This strategy has been tested in a myriad of iterations by utilizing a variety of osteoconductive scaffold materials, osteoblastic stem cells, as well as osteoinductive growth factors and small molecules. One of the major challenges facing tissue engineers is creating a scaffold fulfilling the properties necessary for controlled bone regeneration. These properties include osteoconduction, osetoinduction, biocompatibility, biodegradability, vascularization, and progenitor cell retention. This review will provide an overview of how optimization of the aforementioned scaffold parameters facilitates bone regenerative capabilities as well as a discussion of common osteoconductive scaffold materials.

Safe and Efficient Colonic Endoscopic Submucosal Dissection Using an Injectable Hydrogel

Endoscopic submucosal dissection (ESD) has not yet been widely adopted in the treatment of early colonic cancers due to the greater technical difficulty involved, longer procedure time, and the increased risk of perforation. Adequate mucosal elevation by submucosal injection is crucial for en bloc resection and prevention of perforation during colonic ESD. This study is aimed to evaluate the efficacy of an injectable thermoreversible hydrogel as the colonic submucosal agent for the first time. Triblock copolymer poly(lactic acid-co-glycolic acid)-poly(ethylene glycol)-poly(lactic acid-co-glycolic acid) (PLGA-PEG-PLGA) was synthesized, and its concentrated aqueous solution was injected into the colonic submucosa of living minipig and spontaneously transformed into an in situ hydrogel with adequate mucosal elevation at body temperature. Such a mucosal lifting lasted for a longer time than that created by the control group, glycerol fructose. Colonic ESD was then performed with the administration of hydrogels at various polymer concentrations or glycerol fructose. All colonic lesions were successfully resected en bloc after one single injection of the hydrogel, and repeated injections were not needed. No evidence of major hemorrhage, perforation and tissue damage were observed. Considering the injection pressure, duration of mucosal elevation and efficacy of "autodissection", the hydrogel containing 15 wt % polymer was the optimized system for colonic ESD. Consequently, the thermoreversible hydrogel is an ideal submucosal fluid that provides a durable mucosal lifting and makes colonic ESD accessible to a large extent. In particular, the efficacy of "autodissection" after one single injection of the hydrogel simplifies significantly the procedures while minimizing the complications.

Injectable in situ forming poly(l-glutamic acid) hydrogels for cartilage tissue engineering

Injectable, in situ forming hydrogels have exhibited many advantages in regenerative medicine. Herein, we present the novel design of poly(l-glutamic acid) injectable hydrogels via the self-crosslinking of adipic dihydrazide (ADH)-modified poly(l-glutamic acid) (PLGA-ADH) and aldehyde-modified poly(l-glutamic acid) (PLGA-CHO), and investigate their potential in cartilage tissue engineering. Both the hydrazide modification degree of PLGA-ADH and oxidation degree of PLGA-CHO can be adjusted by the amount of activators and sodium periodate, respectively. Experiments reveal that the solid content of the hydrogels, -NH₂/-CHO molar ratio, and oxidation degree of PLGA-CHO have a great effect on the gelation time, equilibrium swelling, mechanical properties, microscopic morphology, and in vitro degradation of the hydrogels. Encapsulation of rabbit chondrocytes within the hydrogels showed viability of the entrapped cells and cytocompatibility of the injectable hydrogels. A preliminary study exhibits injectability and rapid in vivo gel formation, as well as mechanical stability, cell ingrowth, and ectopic cartilage formation. These results suggest that the PLGA hydrogel has potential as an injectable cell delivery carrier for cartilage regeneration and could serve as a new biomaterial for tissue engineering.

Synthesis and characterization of a chitosan based nanocomposite injectable hydrogel

The aim of the current study was to enhance the mechanical property of chitosan/β-glycerophosphate disodium salt (CS/GP) injectable hydrogels. A novel nanocomposite injectable hydrogel was prepared by introducing attapulgite (ATP) nano particles into the CS/GP hydrogels. The mechanical properties of the composite hydrogels with two different water contents were characterized by tensile test, the results shown that the tensile strength and elongation at break of composite hydrogels both increased obviously with increasing of ATP content. And, in our testing range, the maximum values of tensile strength and elongation at break were both more than 5 times larger than that of neat CS/GP hydrogel. We discussed this enhancement effect in detail by Scanning electron microscope observations (SEM) and Fourier transform infrared spectroscopy testing (FT-IR). The SEM images of composite hydrogels shown quite different from the neat CS/GP hydrogel, where the pores were more tightly and with some uniform and smaller holes dispersed on the wall. FT-IR test results revealed that the introduction of ATP increased the cross-link density because of the hydrogen bonds formation between ATP nanoparticles and CS molecules. Also, we studied the impact of ATP introduction on gelation speed through tracking the dynamic process of the sol-gel transition by means of rheological measurement, and the results shown that the reaction rate increased significantly with the increase of ATP concentration.

Effects of bevacizumab loaded PEG-PCL-PEG hydrogel intracameral application on intraocular pressure after glaucoma filtration surgery

PEG-PCL-PEG (PECE) hydrogel for intracameral injection as a sustained delivery system can get a stable release of the medication and achieve an effective local concentration. The injectable PECE hydrogel is thermosensitive nano-material which is flowing sol at low temperature and can shift to nonflowing gel at body temperature. This study evaluated the intracameral injection of bevacizumab combined with a PECE hydrogel drug release system on postoperative scarring and bleb survival after experimental glaucoma filtration surgery. The best result was achieved in the bevacizumab loaded PECE hydrogels group, which presented the lowest IOP values after surgery. And the blebs were significantly more persistent in this group. Histology, Massion trichrome staining and immunohistochemistry further demonstrated that glaucoma filtration surgery in combination with bevacizumab loaded PECE hydrogel resulted in good bleb survival due to scar formation inhibition. In conclusions, this study demonstrated that bevacizumab-loaded PECE hydrogel for intracameral injection as a sustained delivery system provide a great opportunity to increase the therapeutic efficacy of glaucoma filtration surgery.

Biodegradable PEG-Based Amphiphilic Block Copolymers for Tissue Engineering Applications

Biodegradable tissue engineering scaffolds have great potential for delivering cells/therapeutics and supporting tissue formation. Polyesters, the most extensively investigated biodegradable synthetic polymers, are not ideally suited for diverse tissue engineering applications due to limitations associated with their hydrophobicity. This review discusses the design and applications of amphiphilic block copolymer scaffolds integrating hydrophilic poly(ethylene glycol) (PEG) blocks with hydrophobic polyesters. Specifically, we highlight how the addition of PEG results in striking changes to the physical properties (swelling, degradation, mechanical, handling) and biological performance (protein & cell adhesion) of the degradable synthetic scaffolds in vitro. We then perform a critical review of how these in vitro characteristics translate to the performance of biodegradable amphiphilic block copolymer-based scaffolds in the repair of a variety of tissues in vivo including bone, cartilage, skin, and spinal cord/nerve. We conclude the review with recommendations for future optimizations in amphiphilic block copolymer design and the need for better-controlled in vivo studies to reveal the true benefits of the amphiphilic synthetic tissue scaffolds.

Injectable Chitin-Poly(ε-caprolactone)/Nanohydroxyapatite Composite Microgels Prepared by Simple Regeneration Technique for Bone Tissue Engineering

Injectable gel systems, for the purpose of bone defect reconstruction, have many advantages, such as controlled flowability, adaptability to the defect site, and increased handling properties when compared to the conventionally used autologous graft, scaffolds, hydroxyapatite blocks, etc. In this work, nanohydroxyapatite (nHAp) incorporated chitin-poly(ε-caprolactone) (PCL) based injectable composite microgels has been developed by a simple regeneration technique for bone defect repair. The prepared microgel systems were characterized using scanning electron microscope (SEM), Fourier transformed infrared spectroscopy (FTIR), and X-ray diffraction (XRD). The composite microgel, with the incorporation of nHAp, showed an increased elastic modulus and thermal stability and had shear-thinning behavior proving the injectability of the system. The protein adsorption, cytocompatibility, and migration of rabbit adipose derived mesenchymal stem cells (rASCs) were also studied. Chitin-PCL-nHAp microgel elicited an early osteogenic differentiation compared to control gel. The immunofluorescence studies confirmed the elevated expression of osteogenic-specific markers such as alkaline phosphatase, osteopontin, and osteocalcin in chitin-PCL-nHAp microgels. Thus, chitin-PCL-nHAp microgel could be a promising injectable system for regeneration of bone defects which are, even in deeper planes, irregularly shaped and complex in nature.

Injectable and Biodegradable pH-Responsive Hydrogels for Localized and Sustained Treatment of Human Fibrosarcoma

Injectable hydrogels are an important class of biomaterials, and they have been widely used for controlled drug release. This study evaluated an injectable hydrogel formed in situ system by the reaction of a polyethylene glycol derivative with α,β-polyaspartylhydrazide for local cancer chemotherapy. This pH-responsive hydrogel was used to realize a sol-gel phase transition, where the gel remained a free-flowing fluid before injection but spontaneously changed into a semisolid hydrogel just after administration. As indicated by scanning electron microscopy images, the hydrogel exhibited a porous three-dimensional microstructure. The prepared hydrogel was biocompatible and biodegradable and could be utilized as a pH-responsive vector for drug delivery. The therapeutic effect of the hydrogel loaded with doxorubicin (DOX) after intratumoral administration in mice with human fibrosarcoma was evaluated. The inhibition of tumor growth was more obvious in the group treated by the DOX-loaded hydrogel, compared to that treated with the free DOX solution. Hence, this hydrogel with good syringeability and high biodegradability, which focuses on local chemotherapy, may enhance the therapeutic effect on human fibrosarcoma.

Biomimetic approaches in bone tissue engineering: Integrating biological and physicomechanical strategies

The development of responsive biomaterials capable of demonstrating modulated function in response to dynamic physiological and mechanical changes in vivo remains an important challenge in bone tissue engineering. To achieve long-term repair and good clinical outcomes, biologically responsive approaches that focus on repair and reconstitution of tissue structure and function through drug release, receptor recognition, environmental responsiveness and tuned biodegradability are required. Traditional orthopedic materials lack biomimicry, and mismatches in tissue morphology, or chemical and mechanical properties ultimately accelerate device failure. Multiple stimuli have been proposed as principal contributors or mediators of cell activity and bone tissue formation, including physical (substrate topography, stiffness, shear stress and electrical forces) and biochemical factors (growth factors, genes or proteins). However, optimal solutions to bone regeneration remain elusive. This review will focus on biological and physicomechanical considerations currently being explored in bone tissue engineering.

Development of Injectable Citrate-Based Bioadhesive Bone Implants

Injectable bone implants have been widely used in bone tissue repairs including the treatment of comminuted bone fractures (CBF). However, most injectable bone implants are not suitable for the treatment of CBF due to their weak tissue adhesion strengths and minimal osteoinduction. Citrate has been recently reported to promote bone formation through enhanced bioceramic integration and osteoinductivity. Herein, a novel injectable citrate-based mussel-inspired bioadhesive hydroxyapatite (iCMBA/HA) bone substitute was developed for CBF treatment. iCMBA/HA can be set within 2-4 minutes and the as-prepared (wet) iCMBA/HA possess low swelling ratios, compressive mechanical strengths of up to 3.2±0.27 MPa, complete degradation in 30 days, suitable biocompatibility, and osteoinductivity. This is also the first time to demonstrate that citrate supplementation in osteogenic medium and citrate released from iCMBA/HA degradation can promote the mineralization of osteoblastic committed human mesenchymal stem cells (hMSCs). In vivo evaluation of iCMBA/HA in a rabbit comminuted radial fracture model showed significantly increased bone formation with markedly enhanced three-point bending strength compared to the negative control. Neovascularization and bone ingrowth as well as highly organized bone formation were also observed showing the potential of iCMBA/HA in treating CBF.