51
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Tan AR, Hung CT. Concise Review: Mesenchymal Stem Cells for Functional Cartilage Tissue Engineering: Taking Cues from Chondrocyte-Based Constructs. Stem Cells Transl Med 2017; 6:1295-1303. [PMID: 28177194 PMCID: PMC5442836 DOI: 10.1002/sctm.16-0271] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 12/21/2016] [Indexed: 01/01/2023] Open
Abstract
Osteoarthritis, the most prevalent form of joint disease, afflicts 9% of the U.S. population over the age of 30 and costs the economy nearly $100 billion annually in healthcare and socioeconomic costs. It is characterized by joint pain and dysfunction, though the pathophysiology remains largely unknown. Due to its avascular nature and limited cellularity, articular cartilage exhibits a poor intrinsic healing response following injury. As such, significant research efforts are aimed at producing engineered cartilage as a cell-based approach for articular cartilage repair. However, the knee joint is mechanically demanding, and during injury, also a milieu of harsh inflammatory agents. The unforgiving mechano-chemical environment requires tissue replacements that are capable of bearing such burdens. The use of mesenchymal stem cells (MSCs) for cartilage tissue engineering has emerged as a promising cell source due to their ease of isolation, capacity to readily expand in culture, and ability to undergo lineage-specific differentiation into chondrocytes. However, to date, very few studies utilizing MSCs have successfully recapitulated the structural and functional properties of native cartilage, exposing the difficult process of uniformly differentiating stem cells into desired cell fates and maintaining the phenotype during in vitro culture and after in vivo implantation. To address these shortcomings, here, we present a concise review on modulating stem cell behavior, tissue development and function using well-developed techniques from chondrocyte-based cartilage tissue engineering. Stem Cells Translational Medicine 2017;6:1295-1303.
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52
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Frasca S, Norol F, Le Visage C, Collombet JM, Letourneur D, Holy X, Sari Ali E. Calcium-phosphate ceramics and polysaccharide-based hydrogel scaffolds combined with mesenchymal stem cell differently support bone repair in rats. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:35. [PMID: 28110459 PMCID: PMC5253158 DOI: 10.1007/s10856-016-5839-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 12/29/2016] [Indexed: 06/05/2023]
Abstract
Research in bone tissue engineering is focused on the development of alternatives to autologous bone grafts for bone reconstruction. Although multiple stem cell-based products and biomaterials are currently being investigated, comparative studies are rarely achieved to evaluate the most appropriate approach in this context. Here, we aimed to compare different clinically relevant bone tissue engineering methods and evaluated the kinetic repair and the bone healing efficiency supported by mesenchymal stem cells and two different biomaterials, a new hydrogel scaffold and a commercial hydroxyapatite/tricalcium phosphate ceramic, alone or in combination.Syngeneic mesenchymal stem cells (5 × 105) and macroporous biphasic calcium phosphate ceramic granules (Calciresorb C35®, Ceraver) or porous pullulan/dextran-based hydrogel scaffold were implanted alone or combined in a drilled-hole bone defect in rats. Using quantitative microtomography measurements and qualitative histological examinations, their osteogenic properties were evaluated 7, 30, and 90 days after implantation. Three months after surgery, only minimal repair was evidenced in control rats while newly mineralized bone was massively observed in animals treated with either hydrogels (bone volume/tissue volume = 20%) or ceramics (bone volume/tissue volume = 26%). Repair mechanism and resorption kinetics were strikingly different: rapidly-resorbed hydrogels induced a dense bone mineralization from the edges of the defect while ceramics triggered newly woven bone formation in close contact with the ceramic surface that remained unresorbed. Delivery of mesenchymal stem cells in combination with these biomaterials enhanced both bone healing (>20%) and neovascularization after 1 month, mainly in hydrogel.Osteogenic and angiogenic properties combined with rapid resorption make hydrogels a promising alternative to ceramics for bone repair by cell therapy.
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Affiliation(s)
- Sophie Frasca
- Département Soutien Médico-Chirurgical des Forces, Institut de Recherche Biomédicale des Armées (IRBA), BP 73, 91223, Brétigny-sur-Orge cedex, France.
| | - Françoise Norol
- AP-HP, Service de Biothérapie, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Catherine Le Visage
- INSERM U791, Centre for Osteoarticular and Dental Tissue Engineering, Nantes, France
| | - Jean-Marc Collombet
- Département Soutien Médico-Chirurgical des Forces, Institut de Recherche Biomédicale des Armées (IRBA), BP 73, 91223, Brétigny-sur-Orge cedex, France
| | - Didier Letourneur
- INSERM U1148, LVTS, Université Paris 13, Hôpital X. Bichat, Université Paris Diderot, Paris, France
| | - Xavier Holy
- Département Soutien Médico-Chirurgical des Forces, Institut de Recherche Biomédicale des Armées (IRBA), BP 73, 91223, Brétigny-sur-Orge cedex, France
| | - Elhadi Sari Ali
- AP-HP, Département de Chirurgie Orthopédique et Traumatologie, Hôpital de la Pitié Salpêtrière, Paris, France
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53
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Chuah YJ, Peck Y, Lau JEJ, Hee HT, Wang DA. Hydrogel based cartilaginous tissue regeneration: recent insights and technologies. Biomater Sci 2017; 5:613-631. [DOI: 10.1039/c6bm00863a] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Hydrogel based technologies has been extensively employed in both exploratory research and clinical applications to address numerous existing challenges in the regeneration of articular cartilage and intervertebral disc.
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Affiliation(s)
- Yon Jin Chuah
- School of Chemical and Biomedical Engineering
- Nanyang Technological University
- Singapore 637459
- Singapore
| | - Yvonne Peck
- School of Chemical and Biomedical Engineering
- Nanyang Technological University
- Singapore 637459
- Singapore
| | - Jia En Josias Lau
- School of Chemical & Life Sciences
- Singapore Polytechnic
- Singapore 139651
- Singapore
| | - Hwan Tak Hee
- Lee Kong Chian School of Medicine
- Nanyang Technological University
- Singapore 636921
- Singapore
- Pinnacle Spine & Scoliosis Centre
| | - Dong-An Wang
- School of Chemical and Biomedical Engineering
- Nanyang Technological University
- Singapore 637459
- Singapore
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54
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Khader A, Sherman LS, Rameshwar P, Arinzeh TL. Sodium Tungstate for Promoting Mesenchymal Stem Cell Chondrogenesis. Stem Cells Dev 2016; 25:1909-1918. [PMID: 27615276 PMCID: PMC5165671 DOI: 10.1089/scd.2016.0158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 09/09/2016] [Indexed: 02/07/2023] Open
Abstract
Articular cartilage has a limited ability to heal. Mesenchymal stem cells (MSCs) derived from the bone marrow have shown promise as a cell type for cartilage regeneration strategies. In this study, sodium tungstate (Na2WO4), which is an insulin mimetic, was evaluated for the first time as an inductive factor to enhance human MSC chondrogenesis. MSCs were seeded onto three-dimensional electrospun scaffolds in growth medium (GM), complete chondrogenic induction medium (CCM) containing insulin, and CCM without insulin. Na2WO4 was added to the media leading to final concentrations of 0, 0.01, 0.1, and 1 mM. Chondrogenic differentiation was assessed by biochemical analyses, immunostaining, and gene expression. Cytotoxicity using human peripheral blood mononuclear cells (PBMCS) was also investigated. The chondrogenic differentiation of MSCs was enhanced in the presence of low concentrations of Na2WO4 compared to control, without Na2WO4. In the induction medium containing insulin, cells in 0.01 mM Na2WO4 produced significantly higher sulfated glycosaminoglycans, collagen type II, and chondrogenic gene expression than all other groups at day 28. Cells in 0.1 mM Na2WO4 had significantly higher collagen II production and significantly higher sox-9 and aggrecan gene expression compared to control at day 28. Cells in GM and induction medium without insulin containing low concentrations of Na2WO4 also expressed chondrogenic markers. Na2WO4 did not stimulate PBMC proliferation or apoptosis. The results demonstrate that Na2WO4 enhances chondrogenic differentiation of MSCs, does not have a toxic effect, and may be useful for MSC-based approaches for cartilage repair.
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Affiliation(s)
- Ateka Khader
- 1 Department of Biomedical Engineering, New Jersey Institute of Technology , Newark, New Jersey
| | - Lauren S Sherman
- 2 Department of Medicine-Hematology/Oncology, Rutgers-New Jersey Medical School , Newark, New Jersey
| | - Pranela Rameshwar
- 2 Department of Medicine-Hematology/Oncology, Rutgers-New Jersey Medical School , Newark, New Jersey
| | - Treena L Arinzeh
- 1 Department of Biomedical Engineering, New Jersey Institute of Technology , Newark, New Jersey
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55
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Radhakrishnan J, Subramanian A, Krishnan UM, Sethuraman S. Injectable and 3D Bioprinted Polysaccharide Hydrogels: From Cartilage to Osteochondral Tissue Engineering. Biomacromolecules 2016; 18:1-26. [PMID: 27966916 DOI: 10.1021/acs.biomac.6b01619] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Biomechanical performance of functional cartilage is executed by the exclusive anisotropic composition and spatially varying intricate architecture in articulating ends of diarthrodial joint. Osteochondral tissue constituting the articulating ends comprise superfical soft cartilage over hard subchondral bone sandwiching interfacial soft-hard tissue. The shock-absorbent, lubricating property of cartilage and mechanical stability of subchondral bone regions are rendered by extended chemical structure of glycosaminoglycans and mineral deposition, respectively. Extracellular matrix glycosaminoglycans analogous polysaccharides are major class of hydrogels investigated for restoration of functional cartilage. Recently, injectable hydrogels have gained momentum as it offers patient compliance, tunable mechanical properties, cell deliverability, and facile administration at physiological condition with long-term functionality and hyaline cartilage construction. Interestingly, facile modifiable functional groups in carbohydrate polymers impart tailorability of desired physicochemical properties and versatile injectable chemistry for the development of highly potent biomimetic in situ forming scaffold. The scaffold design strategies have also evolved from single component to bi- or multilayered and graded constructs with osteogenic properties for deep subchondral regeneration. This review highlights the significance of polysaccharide structure-based functions in engineering cartilage tissue, injectable chemistries, strategies for combining analogous matrices with cells/stem cells and biomolecules and multicomponent approaches for osteochondral mimetic constructs. Further, the rheology and precise spatiotemporal positioning of cells in hydrogel bioink for rapid prototyping of complex three-dimensional anisotropic cartilage have also been discussed.
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Affiliation(s)
- Janani Radhakrishnan
- Centre for Nanotechnology and Advanced Biomaterials, School of Chemical and Biotechnology, SASTRA University , Thanjavur-613401, India
| | - Anuradha Subramanian
- Centre for Nanotechnology and Advanced Biomaterials, School of Chemical and Biotechnology, SASTRA University , Thanjavur-613401, India
| | - Uma Maheswari Krishnan
- Centre for Nanotechnology and Advanced Biomaterials, School of Chemical and Biotechnology, SASTRA University , Thanjavur-613401, India
| | - Swaminathan Sethuraman
- Centre for Nanotechnology and Advanced Biomaterials, School of Chemical and Biotechnology, SASTRA University , Thanjavur-613401, India
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56
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Cross LM, Thakur A, Jalili NA, Detamore M, Gaharwar AK. Nanoengineered biomaterials for repair and regeneration of orthopedic tissue interfaces. Acta Biomater 2016; 42:2-17. [PMID: 27326917 DOI: 10.1016/j.actbio.2016.06.023] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 06/07/2016] [Accepted: 06/16/2016] [Indexed: 12/21/2022]
Abstract
UNLABELLED Orthopedic interface tissue engineering aims to mimic the structure and function of soft-to-hard tissue junctions, particularly bone-ligament, bone-tendon, and bone-cartilage interfaces. A range of engineering approaches has been proposed to mimic the gradient architecture, physical properties and chemical characteristics of interface tissues using conventional polymeric biomaterials. Recent developments in nanomaterials and nanofabrication technologies introduce a range of synthesis and fabrication tools to effectively engineer the structure and function of native tissue interfaces. In this review, we will focus on nanoengineered strategies used to replicate the structural and functional aspects of native biological tissues for engineering bone-cartilage, bone-ligament, and bone-tendon interfaces. This review will also highlight some of the emerging applications and future potential of nanomaterials and fabrication technologies in engineering tissue interfaces. STATEMENT OF SIGNIFICANCE A major challenge in engineering interfaces is to control the physical and structural characteristics of an artificial environment. The use of nanomaterials and nanoengineered strategies allow for greater control over the changes in structure and function at molecular and nanometer length scale. This review focuses on advanced nanomaterials and nanofabrication approaches developed to emulate bone-cartilage, bone-ligament, and bone-tendon interface regions. Some of the emerging nanoengineered biomaterials proposed to mimic tissue interfaces are also highlighted.
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Affiliation(s)
- Lauren M Cross
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77841, USA
| | - Ashish Thakur
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77841, USA
| | - Nima A Jalili
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77841, USA
| | - Michael Detamore
- Department of Chemical and Petroleum Engineering, University of Kansas, Lawrence, KS 66045, USA
| | - Akhilesh K Gaharwar
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77841, USA; Department of Materials Science and Engineering, Texas A&M University, College Station, TX 77841, USA; Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA.
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57
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Sun AX, Numpaisal PO, Gottardi R, Shen H, Yang G, Tuan RS. Cell and Biomimetic Scaffold-Based Approaches for Cartilage Regeneration. ACTA ACUST UNITED AC 2016. [DOI: 10.1053/j.oto.2016.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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58
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Singh YP, Bhardwaj N, Mandal BB. Potential of Agarose/Silk Fibroin Blended Hydrogel for in Vitro Cartilage Tissue Engineering. ACS APPLIED MATERIALS & INTERFACES 2016; 8:21236-21249. [PMID: 27459679 DOI: 10.1021/acsami.6b08285] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
An osteoarthritis pandemic has accelerated exploration of various biomaterials for cartilage reconstruction with a special emphasis on silk fibroin from mulberry (Bombyx mori) and non-mulberry (Antheraea assamensis) silk worms. Retention of positive attributes of the agarose standard and nullification of its negatives are central to the current agarose/silk fibroin hydrogel design. In this study, hydrogels of mulberry and non-mulberry silk fibroin blended with agarose were fabricated and evaluated in vitro for two weeks for cartilaginous tissue formation. The fabricated hydrogels were physicochemically characterized and analyzed for cell viability, proliferation, and extra cellular matrix deposition. The amalgamation of silk fibroin with agarose impacted the pore size, as illustrated by field emission scanning electron microscopy studies, swelling behavior, and in vitro degradation of the hydrogels. Fourier transform infrared spectroscopy results indicated the blend formation and confirmed the presence of both components in the fabricated hydrogels. Rheological studies demonstrated enhanced elasticity of blended hydrogels with G' > G″. Biochemical analysis revealed significantly higher levels of sulfated glycosaminoglycans (sGAGs) and collagen (p ≤ 0.01) in blended hydrogels. More specifically, the non-mulberry silk fibroin blend showed sGAG and collagen content (∼1.5-fold) higher than that of the mulberry blend (p ≤ 0.05). Histological and immunohistochemical analyses further validated the enhanced deposition of sGAG and collagen, indicating maintenance of chondrogenic phenotype within constructs after two weeks of culture. Real-time PCR analysis further confirmed up-regulation of cartilage-specific aggrecan, sox-9 (∼1.5-fold) and collagen type II (∼2-fold) marker genes (p ≤ 0.01) in blended hydrogels. The hydrogels demonstrated immunocompatibility, which was evidenced by minimal in vitro secretion of tumor necrosis factor-α (TNF-α) by murine macrophages. Taken together, the results suggest promising attributes of blended hydrogels and particularly the non-mulberry silk fibroin/agarose blends as alternative biomaterial for cartilage tissue engineering.
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Affiliation(s)
- Yogendra Pratap Singh
- Biomaterial and Tissue Engineering Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati , Guwahati 781039, Assam, India
| | - Nandana Bhardwaj
- Biological and Chemical Sciences Section, Life Sciences Division, Institute of Advanced Study in Science and Technology (IASST) , Guwahati 781035, Assam, India
| | - Biman B Mandal
- Biomaterial and Tissue Engineering Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati , Guwahati 781039, Assam, India
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59
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Park H, Kim D, Lee KY. Interaction-tailored cell aggregates in alginate hydrogels for enhanced chondrogenic differentiation. J Biomed Mater Res A 2016; 105:42-50. [PMID: 27529335 DOI: 10.1002/jbm.a.35865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/14/2016] [Accepted: 08/10/2016] [Indexed: 12/12/2022]
Abstract
Controlling cell-matrix interactions is critical when transferring cells into the body using a scaffold, which can be elaborately tailored to successfully engineer the desired tissue. In this study, ATDC5 cells were encapsulated within alginate hydrogels and their chondrogenic differentiation was investigated in vitro. Cell-matrix interactions were introduced using RGD peptides, which improved the viability of encapsulated cells and enhanced the formation of condensed structures similar to a chondrogenic nodule. When N-cadherin of ATDC5 cells was blocked, the encapsulated cells did not form an aggregate, and chondrogenic differentiation could not be induced. Preformed cell aggregates with defined cell numbers in RGD-modified alginate gels retained adequate N-cadherin-mediated cell-cell interactions and increased chondrogenic marker gene expression, compared with the homogeneously dispersed cells in the gels. This approach may be useful to promote chondrogenesis with relatively few cells if they are encapsulated into a scaffold as a form of aggregates. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 42-50, 2017.
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Affiliation(s)
- Honghyun Park
- Department of Bioengineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - Doyun Kim
- Department of Bioengineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - Kuen Yong Lee
- Department of Bioengineering, Hanyang University, Seoul, 04763, Republic of Korea.,Institute of Nano Science and Technology, Hanyang University, Seoul, 04763, Republic of Korea
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60
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Parmar PA, St-Pierre JP, Chow LW, Puetzer JL, Stoichevska V, Peng YY, Werkmeister JA, Ramshaw JAM, Stevens MM. Harnessing the Versatility of Bacterial Collagen to Improve the Chondrogenic Potential of Porous Collagen Scaffolds. Adv Healthc Mater 2016; 5:1656-66. [PMID: 27219220 PMCID: PMC5405340 DOI: 10.1002/adhm.201600136] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/09/2016] [Indexed: 12/21/2022]
Abstract
Collagen I foams are used in the clinic as scaffolds to promote articular cartilage repair as they provide a bioactive environment for cells with chondrogenic potential. However, collagen I as a base material does not allow for precise control over bioactivity. Alternatively, recombinant bacterial collagens can be used as "blank slate" collagen molecules to offer a versatile platform for incorporation of selected bioactive sequences and fabrication into 3D scaffolds. Here, we show the potential of Streptococcal collagen-like 2 (Scl2) protein foams modified with peptides designed to specifically and noncovalently bind hyaluronic acid and chondroitin sulfate to improve chondrogenesis of human mesenchymal stem cells (hMSCs) compared to collagen I foams. Specific compositions of functionalized Scl2 foams lead to improved chondrogenesis compared to both nonfunctionalized Scl2 and collagen I foams, as indicated by gene expression, extracellular matrix accumulation, and compression moduli. hMSCs cultured in functionalized Scl2 foams exhibit decreased collagens I and X gene and protein expression, suggesting an advantage over collagen I foams in promoting a chondrocytic phenotype. These highly modular foams can be further modified to improve specific aspects chondrogenesis. As such, these scaffolds also have the potential to be tailored for other regenerative medicine applications.
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Affiliation(s)
- Paresh A. Parmar
- Department of Materials, Department of Bioengineering, Institute of Biomedical Engineering, Imperial College London SW7 2AZ, UK; The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Bayview Avenue, Clayton, Victoria 3169, Australia
| | - Jean-Philippe St-Pierre
- Department of Bioengineering Institute of Biomedical Engineering Imperial College London, SW7 2AZ, UK
| | - Lesley W. Chow
- Department of Bioengineering Institute of Biomedical Engineering Imperial College London, SW7 2AZ, UK
| | - Jennifer L. Puetzer
- Department of Bioengineering Institute of Biomedical Engineering Imperial College London, SW7 2AZ, UK
| | - Violet Stoichevska
- The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Bayview Avenue, Clayton, Victoria 3169, Australia
| | - Yong Y. Peng
- The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Bayview Avenue, Clayton, Victoria 3169, Australia
| | - Jerome A. Werkmeister
- The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Bayview Avenue, Clayton, Victoria 3169, Australia
| | - John A. M. Ramshaw
- The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Bayview Avenue, Clayton, Victoria 3169, Australia
| | - Molly M. Stevens
- Department of Bioengineering Institute of Biomedical Engineering Imperial College London, SW7 2AZ, UK
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61
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Popa EG, Reis RL, Gomes ME. Seaweed polysaccharide-based hydrogels used for the regeneration of articular cartilage. Crit Rev Biotechnol 2016; 35:410-24. [PMID: 24646368 DOI: 10.3109/07388551.2014.889079] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This manuscript provides an overview of the in vitro and in vivo studies reported in the literature focusing on seaweed polysaccharides based hydrogels that have been proposed for applications in regenerative medicine, particularly, in the field of cartilage tissue engineering. For a better understanding of the main requisites for these specific applications, the main aspects of the native cartilage structure, as well as recognized diseases that affect this tissue are briefly described. Current available treatments are also presented to emphasize the need for alternative techniques. The following part of this review is centered on the description of the general characteristics of algae polysaccharides, as well as relevant properties required for designing hydrogels for cartilage tissue engineering purposes. An in-depth overview of the most well known seaweed polysaccharide, namely agarose, alginate, carrageenan and ulvan biopolymeric gels, that have been proposed for engineering cartilage is also provided. Finally, this review describes and summarizes the translational aspect for the clinical application of alternative systems emphasizing the importance of cryopreservation and the commercial products currently available for cartilage treatment.
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Affiliation(s)
- Elena Geta Popa
- a 3B's Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine , AvePark , Guimarães , Portugal and
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62
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Jeuken RM, Roth AK, Peters RJRW, Van Donkelaar CC, Thies JC, Van Rhijn LW, Emans PJ. Polymers in Cartilage Defect Repair of the Knee: Current Status and Future Prospects. Polymers (Basel) 2016; 8:E219. [PMID: 30979313 PMCID: PMC6432241 DOI: 10.3390/polym8060219] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/26/2016] [Accepted: 05/31/2016] [Indexed: 02/06/2023] Open
Abstract
Cartilage defects in the knee are often seen in young and active patients. There is a need for effective joint preserving treatments in patients suffering from cartilage defects, as untreated defects often lead to osteoarthritis. Within the last two decades, tissue engineering based techniques using a wide variety of polymers, cell sources, and signaling molecules have been evaluated. We start this review with basic background information on cartilage structure, its intrinsic repair, and an overview of the cartilage repair treatments from a historical perspective. Next, we thoroughly discuss polymer construct components and their current use in commercially available constructs. Finally, we provide an in-depth discussion about construct considerations such as degradation rates, cell sources, mechanical properties, joint homeostasis, and non-degradable/hybrid resurfacing techniques. As future prospects in cartilage repair, we foresee developments in three areas: first, further optimization of degradable scaffolds towards more biomimetic grafts and improved joint environment. Second, we predict that patient-specific non-degradable resurfacing implants will become increasingly applied and will provide a feasible treatment for older patients or failed regenerative treatments. Third, we foresee an increase of interest in hybrid construct, which combines degradable with non-degradable materials.
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Affiliation(s)
- Ralph M Jeuken
- Department of Orthopaedic Surgery, Maastricht University Medical Center, P. Debyelaan 25, Maastricht 6229 HX, The Netherlands.
| | - Alex K Roth
- Department of Orthopaedic Surgery, Maastricht University Medical Center, P. Debyelaan 25, Maastricht 6229 HX, The Netherlands.
| | | | - Corrinus C Van Donkelaar
- Department of Biomedical Engineering, Eindhoven University of Technology, P.O. Box 513, Eindhoven 5600 MB, The Netherlands.
| | - Jens C Thies
- DSM Biomedical, Koestraat 1, Geleen 6167 RA, The Netherlands.
| | - Lodewijk W Van Rhijn
- Department of Orthopaedic Surgery, Maastricht University Medical Center, P. Debyelaan 25, Maastricht 6229 HX, The Netherlands.
| | - Pieter J Emans
- Department of Orthopaedic Surgery, Maastricht University Medical Center, P. Debyelaan 25, Maastricht 6229 HX, The Netherlands.
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63
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Abstract
Treatment of osteochondral defects (OCLs) of the talus is a challenging orthopedic surgery. Treatment of talar OCLs has evolved through the 3 "R" paradigm: reconstruction, repair, and replacement. This article highlights current state-of-the-art techniques and reviews recent advances in the literature about articular cartilage repair using various novel tissue engineering approaches, including various scaffolds, growth factors, and cell niches; which include chondrocytes and culture-expanded bone marrow-derived mesenchymal stem cells.
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Affiliation(s)
- Amgad M Haleem
- Department of Orthopedic Surgery, Oklahoma University College of Medicine Health Sciences Center, Oklahoma City, OK, USA; Department of Orthopedic Surgery, Kasr Al-Ainy Hospital, Cairo University School of Medicine, Saray El-Manial Street, El-Manial, Cairo 12411, Egypt.
| | - Mostafa M AbouSayed
- Department of Orthopedic Surgery, Kasr Al-Ainy Hospital, Cairo University School of Medicine, Saray El-Manial Street, El-Manial, Cairo 12411, Egypt; Department of Orthopedic Surgery, Albany Medical College, 1367 Washington Avenue, Albany, NY 12206, USA
| | - Mohammed Gomaa
- Department of Orthopedic Surgery, Kasr Al-Ainy Hospital, Cairo University School of Medicine, Saray El-Manial Street, El-Manial, Cairo 12411, Egypt
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64
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DiBartola AC, Everhart JS, Magnussen RA, Carey JL, Brophy RH, Schmitt LC, Flanigan DC. Correlation between histological outcome and surgical cartilage repair technique in the knee: A meta-analysis. Knee 2016; 23:344-9. [PMID: 26898766 DOI: 10.1016/j.knee.2016.01.017] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 11/03/2015] [Accepted: 01/17/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Compare histological outcomes after microfracture (MF), autologous chondrocyte implantation (ACI), and osteochondral autograft transfer (OATS). METHODS Literature review using PubMed MEDLINE, SCOPUS, Cumulative Index for Nursing and Allied Health Literature (CINAHL), and Cochrane Collaboration Library. Inclusion criteria limited to English language studies International Cartilage Repair Society (ICRS) grading criteria for cartilage analysis after ACI (autologous chondrocyte implantation), MF (microfracture), or OATS (osteochondral autografting) repair techniques. RESULTS Thirty-three studies investigating 1511 patients were identified. Thirty evaluated ACI or one of its subtypes, six evaluated MF, and seven evaluated OATS. There was no evidence of publication bias (Begg's p=0.48). No statistically significant correlation was found between percent change in clinical outcome and percent biopsies showing ICRS Excellent scores (R(2)=0.05, p=0.38). Percent change in clinical outcome and percent of biopsies showing only hyaline cartilage were significantly associated (R(2)=0.24, p=0.024). Mean lesion size and histological outcome were not correlated based either on percent ICRS Excellent (R(2)=0.03, p=0.50) or percent hyaline cartilage only (R(2)=0.01, p=0.67). Most common lesion location and histological outcome were not correlated based either on percent ICRS Excellent (R(2)=0.03, p=0.50) or percent hyaline cartilage only (R(2)=0.01, p=0.67). CONCLUSIONS Microfracture has poorer histologic outcomes than other cartilage repair techniques. OATS repairs primarily are comprised of hyaline cartilage, followed closely by cell-based techniques, but no significant difference was found cartilage quality using ICRS grading criteria among OATS, ACI-C, MACI, and ACI-P. LEVEL OF EVIDENCE IV, meta-analysis.
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Affiliation(s)
- Alex C DiBartola
- Ohio State University College of Medicine, Columbus, OH, United States
| | - Joshua S Everhart
- Department of Orthopaedics, Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Robert A Magnussen
- Department of Orthopaedics, Ohio State University Wexner Medical Center, Columbus, OH, United States; Sports Medicine, Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - James L Carey
- Penn Center for Advanced Cartilage Repair and Osteochondritis Dissecans Treatment; Perelman School of Medicine, University of Pennsylvania, United States
| | - Robert H Brophy
- Department of Orthopaedic Surgery, Washington University in St. Louis, United States
| | - Laura C Schmitt
- Sports Medicine, Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - David C Flanigan
- Department of Orthopaedics, Ohio State University Wexner Medical Center, Columbus, OH, United States; Sports Medicine, Ohio State University Wexner Medical Center, Columbus, OH, United States; Cartilage Restoration Program, United States.
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Abstract
One of the most important issues facing cartilage tissue engineering is the inability to move technologies into the clinic. Despite the multitude of current research in the field, it is known that 90% of new drugs that advance past animal studies fail clinical trials. The objective of this review is to provide readers with an understanding of the scientific details of tissue engineered cartilage products that have demonstrated a certain level of efficacy in humans, so that newer technologies may be developed upon this foundation. Compared to existing treatments, such as microfracture or autologous chondrocyte implantation, a tissue engineered product can potentially provide more consistent clinical results in forming hyaline repair tissue and in filling the entirety of the defect. The various tissue engineering strategies (e.g., cell expansion, scaffold material, media formulations, biomimetic stimuli, etc.) used in forming these products, as collected from published literature, company websites, and relevant patents, are critically discussed. The authors note that many details about these products remain proprietary, not all information is made public, and that advancements to the products are continuously made. Nevertheless, by understanding the design and production processes of these emerging technologies, one can gain tremendous insight into how to best use them and also how to design the next generation of tissue engineered cartilage products.
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66
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Huang BJ, Hu JC, Athanasiou KA. Cell-based tissue engineering strategies used in the clinical repair of articular cartilage. Biomaterials 2016; 98:1-22. [PMID: 27177218 DOI: 10.1016/j.biomaterials.2016.04.018] [Citation(s) in RCA: 260] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 04/15/2016] [Accepted: 04/20/2016] [Indexed: 12/12/2022]
Abstract
One of the most important issues facing cartilage tissue engineering is the inability to move technologies into the clinic. Despite the multitude of current research in the field, it is known that 90% of new drugs that advance past animal studies fail clinical trials. The objective of this review is to provide readers with an understanding of the scientific details of tissue engineered cartilage products that have demonstrated a certain level of efficacy in humans, so that newer technologies may be developed upon this foundation. Compared to existing treatments, such as microfracture or autologous chondrocyte implantation, a tissue engineered product can potentially provide more consistent clinical results in forming hyaline repair tissue and in filling the entirety of the defect. The various tissue engineering strategies (e.g., cell expansion, scaffold material, media formulations, biomimetic stimuli, etc.) used in forming these products, as collected from published literature, company websites, and relevant patents, are critically discussed. The authors note that many details about these products remain proprietary, not all information is made public, and that advancements to the products are continuously made. Nevertheless, by understanding the design and production processes of these emerging technologies, one can gain tremendous insight into how to best use them and also how to design the next generation of tissue engineered cartilage products.
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Affiliation(s)
- Brian J Huang
- Department of Biomedical Engineering, University of California Davis, USA.
| | - Jerry C Hu
- Department of Biomedical Engineering, University of California Davis, USA.
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California Davis, USA; Department of Orthopedic Surgery, University of California Davis, USA.
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67
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Clavé A, Potel JF, Servien E, Neyret P, Dubrana F, Stindel E. Third-generation autologous chondrocyte implantation versus mosaicplasty for knee cartilage injury: 2-year randomized trial. J Orthop Res 2016; 34:658-65. [PMID: 26742454 DOI: 10.1002/jor.23152] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 12/29/2015] [Indexed: 02/04/2023]
Abstract
Numerous surgical techniques have been developed to treat osteochondral defects of the knee. A study reported encouraging outcomes of third-generation autologous chondrocyte implantation achieved using the solid agarose-alginate scaffold Cartipatch®. Whether this scaffold is better than conventional techniques remains unclear. This multicenter randomized controlled trial compared 2-year functional outcomes (IKDC score) after Cartipatch® versus mosaicplasty in patients with isolated symptomatic femoral chondral defects (ICRS III and IV) measuring 2.5-7.5 cm(2) . In addition, a histological evaluation based on the O'Driscoll score was performed after 2 years. We needed 76 patients to demonstrate an at least 10-point subjective IKDC score difference with α = 5% and 90% power. During the enrolment period, we were able to include 55 patients, 30 of them were allocated at random to Cartipatch® and 25 to mosaicplasty. After 2 years, eight patients had been lost to follow-up, six in the Cartipatch® group, and two in the mosaicplasty group. The baseline characteristics of the two groups were not significantly different. The mean IKDC score and score improvement after 2 years were respectively 73.7 ± 20.1 and 31.8 ± 20.8 with Cartipatch® and 81.5 ± 16.4 and 44.4 ± 15.2 with mosaicplasty. The 12.6-point absolute difference in favor of mosaicplasty is statistically significant. Twelve adverse events were recorded in the Cartipatch® group against six in the mosaicplasty group. After 2 years, functional outcomes were significantly worse after Cartipatch® treatment compared to mosaicplasty for isolated focal osteochondral defects of the femur.
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Affiliation(s)
- Arnaud Clavé
- Université de Bretagne Occidentale, Faculté de Médecine, 22 avenue Camille Desmoulins, 29200, Brest, France.,Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, bd Tanguy Prigent, 29200, Brest, France.,LaTIM, INSERM UMR 1101, 2 av Foch, 29609, Brest Cedex, France
| | | | - Elvire Servien
- Centre Albert Trillat, service de chirurgie orthopédique, Hôpital de la Croix-Rousse, Hospices civils de Lyon, 103 grande rue de la Croix-Rousse, 69004, Lyon, France
| | - Philippe Neyret
- Centre Albert Trillat, service de chirurgie orthopédique, Hôpital de la Croix-Rousse, Hospices civils de Lyon, 103 grande rue de la Croix-Rousse, 69004, Lyon, France
| | - Frédéric Dubrana
- Université de Bretagne Occidentale, Faculté de Médecine, 22 avenue Camille Desmoulins, 29200, Brest, France.,Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, bd Tanguy Prigent, 29200, Brest, France
| | - Eric Stindel
- Université de Bretagne Occidentale, Faculté de Médecine, 22 avenue Camille Desmoulins, 29200, Brest, France.,Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, bd Tanguy Prigent, 29200, Brest, France.,LaTIM, INSERM UMR 1101, 2 av Foch, 29609, Brest Cedex, France
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68
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Tiruvannamalai Annamalai R, Mertz DR, Daley ELH, Stegemann JP. Collagen Type II enhances chondrogenic differentiation in agarose-based modular microtissues. Cytotherapy 2016; 18:263-77. [PMID: 26794716 PMCID: PMC4724061 DOI: 10.1016/j.jcyt.2015.10.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 10/04/2015] [Accepted: 10/13/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND AIMS Cell-based therapies have made an impact on the treatment of osteoarthritis; however, the repair and regeneration of thick cartilage defects is an important and growing clinical problem. Next-generation therapies that combine cells with biomaterials may provide improved outcomes. We have developed modular microenvironments that mimic the composition of articular cartilage as a delivery system for consistently differentiated cells. METHODS Human bone marrow-derived mesenchymal stem cells (MSC) were embedded in modular microbeads consisting of agarose (AG) supplemented with 0%, 10% and 20% collagen Type II (COL-II) using a water-in-oil emulsion technique. AG and AG/COL-II microbeads were characterized in terms of their structural integrity, size distribution and protein content. The viability of embedded MSC and their ability to differentiate into osteogenic, adipogenic and chondrogenic lineages over 3 weeks in culture were also assessed. RESULTS Microbeads made with <20% COL-II were robust, generally spheroidal in shape and 80 ± 10 µm in diameter. MSC viability in microbeads was consistently high over a week in culture, whereas viability in corresponding bulk hydrogels decreased with increasing COL-II content. Osteogenic differentiation of MSC was modestly supported in both AG and AG/COL-II microbeads, whereas adipogenic differentiation was strongly inhibited in COL-II containing microbeads. Chondrogenic differentiation of MSC was clearly promoted in microbeads containing COL-II, compared with pure AG matrices. CONCLUSIONS Inclusion of collagen Type II in agarose matrices in microbead format can potentiate chondrogenic differentiation of human MSC. Such compositionally tailored microtissues may find utility for cell delivery in next-generation cartilage repair therapies.
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Affiliation(s)
| | - David R Mertz
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Ethan L H Daley
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Jan P Stegemann
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA.
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69
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Li Y, Fang M, Zhang J, Wang J, Song Y, Shi J, Li W, Wu G, Ren J, Wang Z, Zou W, Wang L. Hydrogel dual delivered celecoxib and anti-PD-1 synergistically improve antitumor immunity. Oncoimmunology 2016; 5:e1074374. [PMID: 27057439 PMCID: PMC4801446 DOI: 10.1080/2162402x.2015.1074374] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 07/14/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022] Open
Abstract
Two major challenges facing cancer immunotherapy are the relatively low therapeutic efficacy and the potential side effects. New drug delivery system and efficient drug combination are required to overcome these challenges. We utilize an alginate hydrogel system to locally deliver 2 FDA-approved drugs, celecoxib and programmed death 1 (PD-1) monoclonal antibody (mAb), to treat tumor-bearing mice. In two cancer models, B16-F10 melanoma and 4T1 metastatic breast cancer, the alginate hydrogel delivery system significantly improves the antitumor activities of celecoxib (CXB), PD-1 mAb, or both combined. These effects are associated with the sustained high concentrations of the drugs in peripheral circulation and within tumor regions. Strikingly, the simultaneous dual local delivery of celecoxib and PD-1 from this hydrogel system synergistically enhanced the presence of CD4+inteferon (IFN)-γ+ and CD8+IFN-γ+ T cells within the tumor as well as in the immune system. These effects are accompanied with reduced CD4+FoxP3+ regulatory T cells (Tregs) and myeloid derived suppressor cells (MDSCs) in the tumor, reflecting a weakened immuosuppressive response. Furthermore, this combinatorial therapy increases the expression of two anti-angiogenic chemokines C-X-C motif ligand (CXCL) 9 and CXCL10, and suppresses the intratumoral production of interleukin (IL)-1, IL-6, and cycloxygenase-2 (COX2), suggesting a dampened pro-tumor angiogenic and inflammatory microenvironment. This alginate-hydrogel-mediated, combinatorial therapy of celecoxib and PD-1 mAb provides a potential valuable regimen for treating human cancer.
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Affiliation(s)
- Yongkui Li
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Min Fang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jian Zhang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jian Wang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yu Song
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jie Shi
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Li
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Department of Surgery, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Gang Wu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jinghua Ren
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zheng Wang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Department of Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weiping Zou
- Department of Surgery, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Lin Wang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Medical Research Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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70
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Díaz-Rodríguez P, Rey-Rico A, Madry H, Landin M, Cucchiarini M. Effective genetic modification and differentiation of hMSCs upon controlled release of rAAV vectors using alginate/poloxamer composite systems. Int J Pharm 2015; 496:614-26. [PMID: 26556623 DOI: 10.1016/j.ijpharm.2015.11.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 02/02/2023]
Abstract
Viral vectors are common tools in gene therapy to deliver foreign therapeutic sequences in a specific target population via their natural cellular entry mechanisms. Incorporating such vectors in implantable systems may provide strong alternatives to conventional gene transfer procedures. The goal of the present study was to generate different hydrogel structures based on alginate (AlgPH155) and poloxamer PF127 as new systems to encapsulate and release recombinant adeno-associated viral (rAAV) vectors. Inclusion of rAAV in such polymeric capsules revealed an influence of the hydrogel composition and crosslinking temperature upon the vector release profiles, with alginate (AlgPH155) structures showing the fastest release profiles early on while over time vector release was more effective from AlgPH155+PF127 [H] capsules crosslinked at a high temperature (50°C). Systems prepared at room temperature (AlgPH155+PF127 [C]) allowed instead to achieve a more controlled release profile. When tested for their ability to target human mesenchymal stem cells, the different systems led to high transduction efficiencies over time and to gene expression levels in the range of those achieved upon direct vector application, especially when using AlgPH155+PF127 [H]. No detrimental effects were reported on either cell viability or on the potential for chondrogenic differentiation. Inclusion of PF127 in the capsules was also capable of delaying undesirable hypertrophic cell differentiation. These findings are of promising value for the further development of viral vector controlled release strategies.
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Affiliation(s)
- P Díaz-Rodríguez
- Center of Experimental Orthopaedics, Saarland University Medical Center, Homburg/Saar, Germany; Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, Spain
| | - A Rey-Rico
- Center of Experimental Orthopaedics, Saarland University Medical Center, Homburg/Saar, Germany
| | - H Madry
- Center of Experimental Orthopaedics, Saarland University Medical Center, Homburg/Saar, Germany; Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg/Saar, Germany
| | - M Landin
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, Spain
| | - M Cucchiarini
- Center of Experimental Orthopaedics, Saarland University Medical Center, Homburg/Saar, Germany.
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71
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An In Vitro Chondrocyte Electrical Stimulation Framework: A Methodology to Calculate Electric Fields and Modulate Proliferation, Cell Death and Glycosaminoglycan Synthesis. Cell Mol Bioeng 2015. [DOI: 10.1007/s12195-015-0419-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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72
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Keller L, Wagner Q, Schwinté P, Benkirane-Jessel N. Double compartmented and hybrid implant outfitted with well-organized 3D stem cells for osteochondral regenerative nanomedicine. Nanomedicine (Lond) 2015; 10:2833-45. [PMID: 26377156 DOI: 10.2217/nnm.15.113] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
AIM Articular cartilage repair remains challenging, because most clinical failures are due to the lack of subchondral bone regeneration. We report an innovative approach improving cartilage repair by regenerating a robust subchondral bone, supporting articular cartilage. MATERIALS & METHODS We developed a compartmented living implant containing triple-3D structure: stem cells as microtissues for embryonic endochondral development mimic, nanofibrous collagen to enhance mineralization for subchondral bone and alginate hydrogel for cartilage regeneration. RESULTS & CONCLUSION This system mimics the natural gradient of the osteochondral unit, using only one kind of stem cell, targeting their ability to express specific bone or cartilage proteins. Mineralization gradient of articular cartilage and the natural 'glue' between subchondral bone and cartilage were reproduced in vitro.
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Affiliation(s)
- Laetitia Keller
- INSERM UMR1109, Osteoarticular & Dental Regenerative Nanomedicine, Faculté de Médecine, FMTS, F-67085 Strasbourg, France.,Université de Strasbourg, Faculté de Chirurgie Dentaire, 1 place de l'Hôpital, F-67000 Strasbourg, France
| | - Quentin Wagner
- INSERM UMR1109, Osteoarticular & Dental Regenerative Nanomedicine, Faculté de Médecine, FMTS, F-67085 Strasbourg, France.,Université de Strasbourg, Faculté de Chirurgie Dentaire, 1 place de l'Hôpital, F-67000 Strasbourg, France
| | - Pascale Schwinté
- INSERM UMR1109, Osteoarticular & Dental Regenerative Nanomedicine, Faculté de Médecine, FMTS, F-67085 Strasbourg, France
| | - Nadia Benkirane-Jessel
- INSERM UMR1109, Osteoarticular & Dental Regenerative Nanomedicine, Faculté de Médecine, FMTS, F-67085 Strasbourg, France.,Université de Strasbourg, Faculté de Chirurgie Dentaire, 1 place de l'Hôpital, F-67000 Strasbourg, France
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73
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The Addition of Platelet-Rich Plasma to Scaffolds Used for Cartilage Repair: A Review of Human and Animal Studies. Arthroscopy 2015; 31:1607-25. [PMID: 25823672 DOI: 10.1016/j.arthro.2015.01.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/15/2015] [Accepted: 01/22/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To review the available literature on studies focusing on platelet-rich plasma (PRP)-enhanced scaffolds for cartilage lesion repair in animals and to analyze the clinical outcomes of similar biologically augmented cartilage regeneration techniques in humans. METHODS We conducted a literature search and subsequent review investigating the potential of PRP to enhance articular cartilage repair using scaffolds or bioengineered implants. RESULTS Of the 14 animal model studies reviewed, 10 reported positive effects with PRP whereas only 2 showed negative overall effects. The remaining 2 studies reported no significant differences, or neutral results, with the use of PRP. With the addition of PRP, the gross appearance and histologic analysis of repair cartilage were improved or no difference was seen compared with control (11 of 12 studies that looked at this). Human studies of the knee or talar dome showed improvements in clinical assessment scores as soon as 6 months after surgery. There was great variability in the method of PRP preparation, choice of scaffold, and cell source between studies. CONCLUSIONS PRP-augmented scaffolds have been shown to be beneficial in the articular cartilage repair process in animals and humans based on macroscopic, histologic, and biochemical analysis and based on clinical outcome scores, respectively. Comparison between studies is difficult because there is great variability in PRP preparation and administration. LEVEL OF EVIDENCE Level IV, systematic review of Level III and IV studies.
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74
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Fensky F, Reichert JC, Traube A, Rackwitz L, Siebenlist S, Nöth U. Chondrogenic predifferentiation of human mesenchymal stem cells in collagen type I hydrogels. ACTA ACUST UNITED AC 2015; 59:375-83. [PMID: 24803605 DOI: 10.1515/bmt-2013-0076] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 04/02/2014] [Indexed: 11/15/2022]
Abstract
Hyaline cartilage displays a limited regenerative potential. Consequently, therapeutic approaches have been developed to treat focal cartilage lesions. Larger-sized lesions are commonly treated by osteochondral grafting/mosaicplasty, autologous chondrocyte implantation (ACI) or matrix-induced chondrocyte implantation (MACI). As an alternative cell source to chondrocytes, multipotent mesenchymal stem cells (MSCs) are regarded a promising option. We therefore investigated the feasibility of pre-differentiating human MSCs incorporated in hydrogels clinically applied for MACI (CaReS®). MSC-laden hydrogels were cast and cultured over 10 days in a defined chondrogenic differentiation medium supplemented with TGF-β1. This was followed by an 11-day culture in TGF-β1 free media. After 21 days, considerable contraction of the hydrogels was observed. Histochemistry showed cells of a chondrocyte-like morphology embedded in a proteoglycan-rich extracellular matrix. Real-time polymerase chain reaction (RT-PCR) analysis showed the expression of chondrogenic marker genes, such as collagen type II and aggrecan. In summary, we demonstrate that chondrogenic differentiation of human mesenchymal stem cells embedded in collagen type I hydrogels can be induced under the influence of TGF-β1 over a period of 10 days.
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75
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Madry H, Cucchiarini M. Tissue-engineering strategies to repair joint tissue in osteoarthritis: nonviral gene-transfer approaches. Curr Rheumatol Rep 2015; 16:450. [PMID: 25182678 DOI: 10.1007/s11926-014-0450-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Loss of articular cartilage is a common clinical consequence of osteoarthritis (OA). In the past decade, substantial progress in tissue engineering, nonviral gene transfer, and cell transplantation have provided the scientific foundation for generating cartilaginous constructs from genetically modified cells. Combining tissue engineering with overexpression of therapeutic genes enables immediate filling of a cartilage defect with an engineered construct that actively supports chondrogenesis. Several pioneering studies have proved that spatially defined nonviral overexpression of growth-factor genes in constructs of solid biomaterials or hydrogels is advantageous compared with gene transfer or scaffold alone, both in vitro and in vivo. Notably, these investigations were performed in models of focal cartilage defects, because advanced cartilage-repair strategies based on the principles of tissue engineering have not advanced sufficiently to enable resurfacing of extensively degraded cartilage as therapy for OA. These studies serve as prototypes for future technological developments, because they raise the possibility that cartilage constructs engineered from genetically modified chondrocytes providing autocrine and paracrine stimuli could similarly compensate for the loss of articular cartilage in OA. Because cartilage-tissue-engineering strategies are already used in the clinic, combining tissue engineering and nonviral gene transfer could prove a powerful approach to treat OA.
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Affiliation(s)
- Henning Madry
- Center of Experimental Orthopaedics and Department of Orthopaedic Surgery, Saarland University, 66421, Homburg, Germany,
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76
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Youngstrom DW, Cakstina I, Jakobsons E. Cartilage-derived extracellular matrix extract promotes chondrocytic phenotype in three-dimensional tissue culture. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2015; 44:1040-7. [PMID: 25707441 DOI: 10.3109/21691401.2015.1014091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cell transplantation is a promising regenerative therapy for cartilage degeneration. However, obtaining sufficient numbers of cells for this purpose is a challenge, due a lack of autologous donor tissue and the difficulty of culturing chondrocytes in vitro. Tissue engineering strategies that induce or maintain chondrocytic phenotype may solve these problems by (1) broadening the range of available donor tissue, and (2) facilitating the expansion of these cells while controlling phenotypic drift. In this study, bone marrow-derived mesenchymal stem cells (MSCs) and cartilage-derived cells (CDCs) were cultured on composite hydrogels containing agarose and homogenized cartilage extracellular matrix (ECM). MSCs cultured on agarose-ECM scaffolds did not show significant signs of chondrogenic differentiation in the absence of additional cues. However, CDCs cultured on agarose-ECM scaffolds proliferated more rapidly than their ECM-free counterparts and MSCs, while retaining chondrocytic morphology. These results were corroborated via expression of cartilage marker genes: in autologous constructs, SOX 9 expression was upregulated by 12.6 ± 5.3-fold, and COL II was upregulated by 2.0 ± 0.3-fold. Agarose-ECM composite hydrogels are therefore useful for expanding partially differentiated CDCs for applications in regenerative medicine.
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Affiliation(s)
- Daniel W Youngstrom
- a Program in Biomedical and Veterinary Sciences, Marion duPont Scott Equine Medical Center, Virginia Tech , Old Waterford Road, Leesburg , Virginia , USA
| | - Inese Cakstina
- b Cell Transplantation Centre, Pauls Stradins Clinical University Hospital , Riga , Latvia
| | - Eriks Jakobsons
- b Cell Transplantation Centre, Pauls Stradins Clinical University Hospital , Riga , Latvia
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Brudno Y, Desai RM, Kwee BJ, Joshi NS, Aizenberg M, Mooney DJ. In Vivo Targeting through Click Chemistry. ChemMedChem 2015; 10:617-20. [DOI: 10.1002/cmdc.201402527] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/28/2015] [Indexed: 01/08/2023]
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78
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O'Connell GD, Tan AR, Cui V, Bulinski JC, Cook JL, Attur M, Abramson SB, Ateshian GA, Hung CT. Human chondrocyte migration behaviour to guide the development of engineered cartilage. J Tissue Eng Regen Med 2015; 11:877-886. [PMID: 25627968 DOI: 10.1002/term.1988] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 10/24/2014] [Accepted: 12/09/2014] [Indexed: 01/01/2023]
Abstract
Tissue-engineering techniques have been successful in developing cartilage-like tissues in vitro using cells from animal sources. The successful translation of these strategies to the clinic will likely require cell expansion to achieve sufficient cell numbers. Using a two-dimensional (2D) cell migration assay to first identify the passage at which chondrocytes exhibited their greatest chondrogenic potential, the objective of this study was to determine a more optimal culture medium for developing three-dimensional (3D) cartilage-like tissues using human cells. We evaluated combinations of commonly used growth factors that have been shown to promote chondrogenic growth and development. Human articular chondrocytes (AC) from osteoarthritic (OA) joints were cultured in 3D environments, either in pellets or encapsulated in agarose. The effect of growth factor supplementation was dependent on the environment, such that matrix deposition differed between the two culture systems. ACs in pellet culture were more responsive to bone morphogenetic protein (BMP2) alone or combinations containing BMP2 (i.e. BMP2 with PDGF or FGF). However, engineered cartilage development within agarose was better for constructs cultured with TGFβ3. These results with agarose and pellet culture studies set the stage for the development of conditions appropriate for culturing 3D functional engineered cartilage for eventual use in human therapies. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Grace D O'Connell
- Department of Mechanical Engineering, University of California, Berkeley, CA, USA
| | - Andrea R Tan
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Victoria Cui
- Department of Biological Sciences, Columbia University, New York, NY, USA
| | - J Chloe Bulinski
- Department of Biological Sciences, Columbia University, New York, NY, USA
| | - James L Cook
- Missouri Orthopedic Institute, University of Missouri, Columbia, MO, USA
| | - Mukundan Attur
- Department of Medicine, New York University School of Medicine, and NYU Langone Medical Center, New York, NY, USA
| | - Steven B Abramson
- Department of Medicine, New York University School of Medicine, and NYU Langone Medical Center, New York, NY, USA
| | - Gerard A Ateshian
- Department of Biomedical Engineering, Columbia University, New York, NY, USA.,Department of Mechanical Engineering, Columbia University, New York, NY, USA
| | - Clark T Hung
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
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79
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Chen AX, Hoffman MD, Chen CS, Shubin AD, Reynolds DS, Benoit DSW. Disruption of cell-cell contact-mediated notch signaling via hydrogel encapsulation reduces mesenchymal stem cell chondrogenic potential: winner of the Society for Biomaterials Student Award in the Undergraduate Category, Charlotte, NC, April 15 to 18, 2015. J Biomed Mater Res A 2014; 103:1291-302. [PMID: 25504509 DOI: 10.1002/jbm.a.35383] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/17/2014] [Accepted: 12/04/2014] [Indexed: 12/20/2022]
Abstract
Cell-cell contact-mediated Notch signaling is essential for mesenchymal stem cell (MSC) chondrogenesis during development. However, subsequent deactivation of Notch signaling is also required to allow for stem cell chondrogenic progression. Recent literature has shown that Notch signaling can also influence Wnt/β-catenin signaling, critical for MSC differentiation, through perturbations in cell-cell contacts. Traditionally, abundant cell-cell contacts, consistent with development, are emulated in vitro using pellet cultures for chondrogenesis. However, cells are often encapsulated within biomaterials-based scaffolds, such as hydrogels, to improve therapeutic cell localization in vivo. To explore the role of Notch and Wnt/β-catenin signaling in the context of hydrogel-encapsulated MSC chondrogenesis, we compared signaling and differentiation capacity of MSCs in both hydrogels and traditional pellet cultures. We demonstrate that encapsulation within poly(ethylene glycol) hydrogels reduces cell-cell contacts, and both Notch (7.5-fold) and Wnt/β-catenin (84.7-fold) pathway activation. Finally, we demonstrate that following establishment of cell-cell contacts and transient Notch signaling in pellet cultures, followed by Notch signaling deactivation, resulted in a 1.5-fold increase in MSC chondrogenesis. Taken together, these findings support that cellular condensation, and establishment of initial cell-cell contacts is critical for MSC chondrogenesis, and this process is inhibited by hydrogel encapsulation.
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Affiliation(s)
- Amanda X Chen
- Department of Biomedical Engineering, University of Rochester, 207 Robert B. Goergen Hall, Box 270168, Rochester, New York, 14627-0168
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80
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Bhardwaj N, Devi D, Mandal BB. Tissue-engineered cartilage: the crossroads of biomaterials, cells and stimulating factors. Macromol Biosci 2014; 15:153-82. [PMID: 25283763 DOI: 10.1002/mabi.201400335] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 08/25/2014] [Indexed: 02/06/2023]
Abstract
Damage to cartilage represents one of the most challenging tasks of musculoskeletal therapeutics due to its limited propensity for healing and regenerative capabilities. Lack of current treatments to restore cartilage tissue function has prompted research in this rapidly emerging field of tissue regeneration of functional cartilage tissue substitutes. The development of cartilaginous tissue largely depends on the combination of appropriate biomaterials, cell source, and stimulating factors. Over the years, various biomaterials have been utilized for cartilage repair, but outcomes are far from achieving native cartilage architecture and function. This highlights the need for exploration of suitable biomaterials and stimulating factors for cartilage regeneration. With these perspectives, we aim to present an overview of cartilage tissue engineering with recent progress, development, and major steps taken toward the generation of functional cartilage tissue. In this review, we have discussed the advances and problems in tissue engineering of cartilage with strong emphasis on the utilization of natural polymeric biomaterials, various cell sources, and stimulating factors such as biophysical stimuli, mechanical stimuli, dynamic culture, and growth factors used so far in cartilage regeneration. Finally, we have focused on clinical trials, recent innovations, and future prospects related to cartilage engineering.
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Affiliation(s)
- Nandana Bhardwaj
- Seri-Biotechnology Unit, Life Science Division, Institute of Advanced Study in Science and Technology, Guwahati, 781035, India
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81
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82
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Park IK, Cho CS. Stem Cell-assisted Approaches for Cartilage Tissue Engineering. Int J Stem Cells 2014; 3:96-102. [PMID: 24855547 DOI: 10.15283/ijsc.2010.3.2.96] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2010] [Indexed: 12/31/2022] Open
Abstract
The regeneration of damaged articular cartilage remains challenging due to its poor intrinsic capacity for repair. Tissue engineering of articular cartilage is believed to overcome the current limitations of surgical treatment by offering functional regeneration in the defect region. Selection of proper cell sources and ECM-based scaffolds, and incorporation of growth factors or mechanical stimuli are of primary importance to successfully produce artificial cartilage for tissue repair. When designing materials for cartilage tissue engineering, biodegradability and biocompatibility are the key factors in selecting material candidates, for either synthetic or natural polymers. The unique environment of cartilage makes it suitable to use a hydrogel with high water content in the cross-linked or thermosensitive (injectable) form. Moreover, design of composite scaffolds from two polymers with complementary physicochemical and biological properties has been explored to provide residing chondrocytes with a combination of the merits that each component contributes.
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Affiliation(s)
- In-Kyu Park
- Department of Biomedical Sciences, Chonnam National University Medical School, The Research Institute of Medical Science, Chonnam National University, Gwangju
| | - Chong-Su Cho
- Department of Agricultural Biotechnology, Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Korea
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83
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O’Connell G, Nims R, Green J, Cigan A, Ateshian G, Hung C. Time and dose-dependent effects of chondroitinase ABC on growth of engineered cartilage. Eur Cell Mater 2014; 27:312-20. [PMID: 24760578 PMCID: PMC4096549 DOI: 10.22203/ecm.v027a22] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Tissue engineering techniques have been effective in developing cartilage-like tissues in vitro. However, many scaffold-based approaches to cultivating engineered cartilage have been limited by low collagen production, an impediment for attaining native functional load-bearing tensile mechanical properties. Enzymatic digestion of glycosaminoglycans (GAG) with chondroitinase ABC (chABC) temporarily suppresses the construct's GAG content and compressive modulus and increases collagen content. Based on the promising results of these early studies, the aim of this study was to further promote collagen deposition through more frequent chABC treatments. Weekly dosing of chABC at a concentration of 0.15 U/mL resulted in a significant cell death, which impacted the ability of the engineered cartilage to fully recover GAG and compressive mechanical properties. In light of these findings, the influence of lower chABC dosage on engineered tissue (0.004 and 0.015 U/mL) over a longer duration (one week) was investigated. Treatment with 0.004 U/mL reduced cell death, decreased the recovery time needed to achieve native compressive mechanical properties and GAG content, and resulted in a collagen content that was 65 % greater than the control. In conclusion, the results of this study demonstrate that longer chABC treatment (one week) at low concentrations can be used to improve collagen content in developing engineered cartilage more expediently than standard chABC treatments of higher chABC doses administered over brief durations.
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Affiliation(s)
- G.D. O’Connell
- Department of Mechanical Engineering, University of California, Berkeley, CA, USA
| | - R.J. Nims
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - J. Green
- Department of Orthopaedic Surgery, St Luke’s Roosevelt Hospital Center, New York, NY, USA
| | - A.D. Cigan
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - G.A. Ateshian
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - C.T. Hung
- Department of Biomedical Engineering, Columbia University, New York, NY, USA,Address for correspondence: Clark T. Hung, Ph.D. Columbia University, Biomedical Engineering Department, 351 Engineering Terrace, New York, NY 10027, USA, Telephone Number: 212-854-6542, FAX Number: 212-854-8725,
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84
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Lin H, Cheng AWM, Alexander PG, Beck AM, Tuan RS. Cartilage tissue engineering application of injectable gelatin hydrogel with in situ visible-light-activated gelation capability in both air and aqueous solution. Tissue Eng Part A 2014; 20:2402-11. [PMID: 24575844 DOI: 10.1089/ten.tea.2013.0642] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Chondroprogenitor cells encapsulated in a chondrogenically supportive, three-dimensional hydrogel scaffold represents a promising, regenerative approach to articular cartilage repair. In this study, we have developed an injectable, biodegradable methacrylated gelatin (mGL)-based hydrogel capable of rapid gelation via visible light (VL)-activated crosslinking in air or aqueous solution. The mild photocrosslinking conditions permitted the incorporation of cells during the gelation process. Encapsulated human-bone-marrow-derived mesenchymal stem cells (hBMSCs) showed high, long-term viability (up to 90 days) throughout the scaffold. To assess the applicability of the mGL hydrogel for cartilage tissue engineering, we have evaluated the efficacy of chondrogenesis of the encapsulated hBMSCs, using hBMSCs seeded in agarose as control. The ability of hBMSC-laden mGL constructs to integrate with host tissues after implantation was further investigated utilizing an in vitro cartilage repair model. The results showed that the mGL hydrogel, which could be photopolymerized in air and aqueous solution, supports hBMSC growth and TGF-β3-induced chondrogenesis. Compared with agarose, mGL constructs laden with hBMSCs are mechanically stronger with time, and integrate well with native cartilage tissue upon implantation based on push-out mechanical testing. VL-photocrosslinked mGL scaffold thus represents a promising scaffold for cell-based repair and resurfacing of articular cartilage defects.
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Affiliation(s)
- Hang Lin
- 1 Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
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85
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Patient-oriented and performance-based outcomes after knee autologous chondrocyte implantation: a timeline for the first year of recovery. J Sport Rehabil 2014; 23:223-34. [PMID: 24589660 DOI: 10.1123/jsr.2013-0094] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CONTEXT It is well established that autologous chondrocyte implantation (ACI) can require extended recovery postoperatively; however, little information exists to provide clinicians and patients with a timeline for anticipated function during the first year after ACI. OBJECTIVE To document the recovery of functional performance of activities of daily living after ACI. PATIENTS ACI patients (n = 48, 29 male; 35.1 ± 8.0 y). INTERVENTION All patients completed functional tests (weight-bearing squat, walk-across, sit-to-stand, step-up/over, and forward lunge) using the NeuroCom long force plate (Clackamas, OR) and completed patient-reported outcome measures (International Knee Documentation Committee Subjective Knee Evaluation Form, Lysholm, Western Ontario and McMaster Osteoarthritis Index [WOMAC], and 36-Item Short-Form Health Survey) preoperatively and 3, 6, and 12 mo postoperatively. MAIN OUTCOME MEASURES A covariance pattern model was used to compare performance and self-reported outcome across time and provide a timeline for functional recovery after ACI. RESULTS Participants demonstrated significant improvement in walk-across stride length from baseline (42.0% ± 8.9% height) at 6 (46.8% ± 8.1%) and 12 mo (46.6% ± 7.6%). Weight bearing on the involved limb during squatting at 30°, 60°, and 90° was significantly less at 3 mo than presurgery. Step-up/over time was significantly slower at 3 mo (1.67 ± 0.69 s) than at baseline (1.49 ± 0.33 s), 6 mo (1.51 ± 0.36 s), and 12 mo (1.40 ± 0.26 s). Step-up/over lift-up index was increased from baseline (41.0% ± 11.3% body weight [BW]) at 3 (45.0% ± 11.7% BW), 6 (47.0% ± 11.3% BW), and 12 mo (47.3% ± 11.6% BW). Forward-lunge time was decreased at 3 mo (1.51 ± 0.44 s) compared with baseline (1.39 ± 0.43 s), 6 mo (1.32 ± 0.05 s), and 12 mo (1.27 ± 0.06). Similarly, forward-lunge impact force was decreased at 3 mo (22.2% ± 1.4% BW) compared with baseline (25.4% ± 1.5% BW). The WOMAC demonstrated significant improvements at 3 mo. All patient-reported outcomes were improved from baseline at 6 and 12 mo postsurgery. CONCLUSIONS Patients' perceptions of improvements may outpace physical changes in function. Decreased function for at least the first 3 mo after ACI should be anticipated, and improvement in performance of tasks requiring weight-bearing knee flexion, such as squatting, going down stairs, or lunging, may not occur for a year or more after surgery.
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86
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Abstract
The central objective in the treatment of any osteochondritis dissecans lesion is to preserve the native articular cartilage and bone. Unfortunately, there are those cases that either fail to heal despite appropriate treatment or present in such a deteriorated state that primary fixation is not possible. This situation is generally determined by the condition of the progeny fragment. Primary fixation may not be the most viable option. In the case of an unsalvageable fragment, the surgeon is faced with several options, which are discussed in this article.
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Affiliation(s)
- John D Polousky
- The Rocky Mountain Youth Sports Medicine Institute, 14000 East Arapahoe Road, Centennial, CO 80111, USA.
| | - Jay Albright
- Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO 80045, USA
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87
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Popa EG, Carvalho PP, Dias AF, Santos TC, Santo VE, Marques AP, Viegas CA, Dias IR, Gomes ME, Reis RL. Evaluation of the in vitro and in vivo biocompatibility of carrageenan-based hydrogels. J Biomed Mater Res A 2014; 102:4087-97. [PMID: 24443370 DOI: 10.1002/jbm.a.35081] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 12/09/2013] [Accepted: 01/13/2014] [Indexed: 02/02/2023]
Abstract
Carrageenans are highly sulphated galactans, well-known for their thermogelation properties which have been extensively exploited in food and cosmetics industry but poorly explored in the biomedicine field. In this study, we have assessed the in vitro and in vivo biocompatibility of κ-carrageenan hydrogels that have been explored for regenerative medicine and tissue engineering applications. The in vitro cytotoxicity of the materials using a L929 mouse fibroblast cell line was evaluated, and the effect of κ-carrageenan hydrogels on the activation of human polymorphonuclear neutrophils cells (hPMNs) was also evaluated by the quantification of reactive oxygen species by chemiluminescence. Subsequently, the inflammatory/immune reaction to κ-carrageenan hydrogels on subcutaneous implantation was studied in rats. Explants were retrieved after 1 and 2 weeks of implantation for histological and RT-PCR analysis. The cytotoxicity screening revealed that κ-carrageenan hydrogels did not significantly affect L929 metabolic activity. Moreover, hPMNs contact with κ-carrageenan resulted in a reduced and a neglectable signal regarding the detection of superoxide and hydroxyl anions, respectively. The results from the in vivo experiments indicated that κ-carrageenan induce a low inflammatory response. Overall, the data obtained suggest that κ-carrageenan hydrogels are biocompatible and thus can be further studied for their use in target biomedical applications.
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Affiliation(s)
- Elena G Popa
- 3B's Research Group-Biomaterials Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, 4806-909, Taipas, Guimarães, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
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88
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Madry H, Rey-Rico A, Venkatesan JK, Johnstone B, Cucchiarini M. Transforming growth factor Beta-releasing scaffolds for cartilage tissue engineering. TISSUE ENGINEERING PART B-REVIEWS 2013; 20:106-25. [PMID: 23815376 DOI: 10.1089/ten.teb.2013.0271] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The maintenance of a critical threshold concentration of transforming growth factor beta (TGF-β) for a given period of time is crucial for the onset and maintenance of chondrogenesis. Thus, the development of scaffolds that provide temporal and/or spatial control of TGF-β bioavailability has appeal as a mechanism to induce the chondrogenesis of stem cells in vitro and in vivo for articular cartilage repair. In the past decade, many types of scaffolds have been designed to advance this goal: hydrogels based on polysaccharides, hyaluronic acid, and alginate; protein-based hydrogels such as fibrin, gelatin, and collagens; biopolymeric gels and synthetic polymers; and solid and hybrid composite (hydrogel/solid) scaffolds. In this study, we review the progress in developing strategies to deliver TGF-β from scaffolds with the aim of enhancing chondrogenesis. In the future, such scaffolds could prove critical for tissue engineering cartilage, both in vitro and in vivo.
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Affiliation(s)
- Henning Madry
- 1 Center of Experimental Orthopaedics, Saarland University , Homburg, Germany
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89
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Forget A, Christensen J, Lüdeke S, Kohler E, Tobias S, Matloubi M, Thomann R, Shastri VP. Polysaccharide hydrogels with tunable stiffness and provasculogenic properties via α-helix to β-sheet switch in secondary structure. Proc Natl Acad Sci U S A 2013; 110:12887-92. [PMID: 23886665 PMCID: PMC3740890 DOI: 10.1073/pnas.1222880110] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Mechanical aspects of the cellular environment can influence cell function, and in this context hydrogels can serve as an instructive matrix. Here we report that physicochemical properties of hydrogels derived from polysaccharides (agarose, κ-carrageenan) having an α-helical backbone can be tailored by inducing a switch in the secondary structure from α-helix to β-sheet through carboxylation. This enables the gel modulus to be tuned over four orders of magnitude (G' 6 Pa-3.6 × 10(4) Pa) independently of polymer concentration and molecular weight. Using carboxylated agarose gels as a screening platform, we demonstrate that soft-carboxylated agarose provides a unique environment for the polarization of endothelial cells in the presence of soluble and bound signals, which notably does not occur in fibrin and collagen gels. Furthermore, endothelial cells organize into freestanding lumens over 100 μm in length. The finding that a biomaterial can modulate soluble and bound signals provides impetus for exploring mechanobiology paradigms in regenerative therapies.
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Affiliation(s)
- Aurelien Forget
- Institute for Macromolecular Chemistry
- BIOSS–Centre for Biological Signaling Studies, and
| | - Jon Christensen
- Institute for Macromolecular Chemistry
- BIOSS–Centre for Biological Signaling Studies, and
| | - Steffen Lüdeke
- Institute for Pharmaceutical Sciences, University of Freiburg, 79104 Freiburg, Germany
| | - Esther Kohler
- Institute for Macromolecular Chemistry
- BIOSS–Centre for Biological Signaling Studies, and
| | | | | | | | - V. Prasad Shastri
- Institute for Macromolecular Chemistry
- BIOSS–Centre for Biological Signaling Studies, and
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90
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Buda R, Vannini F, Cavallo M, Baldassarri M, Luciani D, Mazzotti A, Pungetti C, Olivieri A, Giannini S. One-step arthroscopic technique for the treatment of osteochondral lesions of the knee with bone-marrow-derived cells: three years results. Musculoskelet Surg 2013; 97:145-151. [PMID: 23420394 DOI: 10.1007/s12306-013-0242-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 01/11/2013] [Indexed: 06/01/2023]
Abstract
Osteochondral lesions of the knee (OLK) are a common cause of knee pain and associated diseases. A new bone-marrow-derived mesenchymal stem cells technique has been developed for the treatment of OLK. 30 patients with OLK underwent arthroscopic one-step procedure. The bone marrow was harvested from the patients' posterior iliac crest and arthroscopically implanted with a scaffold into the lesion site. Clinical inspection and MRI were performed. Mean International Knee Documentation Committee (IKDC) score before surgery was 29.9 ± 13.2 and 85.4 ± 4.2 at 29 ± 4.1 months (p < 0.0005), while Knee injury and Osteoarthritis Outcome Score (KOOS) before surgery was 35.1 ± 11.9 and 87.3 ± 7.3 at 29 ± 4.1 months (p < 0.0005). Control MRI and bioptic samples showed an osteochondral regeneration of the lesion site. The one-step technique appears to be a good and reliable option for treatment of OLK at three years of follow-up. Level of evidence Case series, Level IV.
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Affiliation(s)
- Roberto Buda
- Clinical Orthopaedic and Traumatology Unit I, Rizzoli Orthopaedic Institute, via G.C. Pupilli n.1, Bologna, Italy
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91
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Consideration of religious sentiments while selecting a biological product for knee arthroscopy. Knee Surg Sports Traumatol Arthrosc 2013; 21:1577-86. [PMID: 23143388 DOI: 10.1007/s00167-012-2292-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 10/29/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE There is an increasing use of various synthetic and biological products in orthopaedics. The use of a biological product can be a major area of concern for patients of various cultures/religions. The purpose of this work is to study various restrictions in different faiths and their compatibility with available products focused on cartilage repair. METHODS A systematic search in several databases, CINAHL, EMBASE, Global health, PubMed, MEDLINE and the Cochrane collaboration, was performed to find out various religious beliefs of some major religions regarding the use of animal products. Hindu, Muslim, Christian, Jewish and Buddhist faiths were studied to find out whether animal-derived surgical implants are permitted. Major religious scholars were asked about their opinions, and guidelines related to human/religious ethics were evaluated. A market survey was carried out to find out biological contents of various products and their compatibility. RESULTS Jews and Muslims have religious restrictions for porcine products, while Hindus reject bovine products. Vegetarian Hindus reject usage of any animal product. Most Christians do not have any restrictions except those who follow vegetarian dietary regulations. Though there is no prohibition for the use of animal products in Buddhism, a code of non-violence to animals is being followed. However, difference of opinion exists about interpretation of these dietary guidelines for surgical usage amongst various scholars. CONCLUSION Products of biological origin have a definite restriction for various religions, with few exceptions. Surgeons should know the source of the product and should be aware of the basic requirements of the patient's faith. Patient should be informed about the source of the product and alternative if available, and an informed consent may be considered. LEVEL OF EVIDENCE Type of study, Level V.
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92
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Gadjanski I, Yodmuang S, Spiller K, Bhumiratana S, Vunjak-Novakovic G. Supplementation of exogenous adenosine 5'-triphosphate enhances mechanical properties of 3D cell-agarose constructs for cartilage tissue engineering. Tissue Eng Part A 2013; 19:2188-200. [PMID: 23651296 DOI: 10.1089/ten.tea.2012.0352] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Formation of tissue-engineered cartilage is greatly enhanced by mechanical stimulation. However, direct mechanical stimulation is not always a suitable method, and the utilization of mechanisms underlying mechanotransduction might allow for a highly effective and less aggressive alternate means of stimulation. In particular, the purinergic, adenosine 5'-triphosphate (ATP)-mediated signaling pathway is strongly implicated in mechanotransduction within the articular cartilage. We investigated the effects of transient and continuous exogenous ATP supplementation on mechanical properties of cartilaginous constructs engineered using bovine chondrocytes and human mesenchymal stem cells (hMSCs) encapsulated in an agarose hydrogel. For both cell types, we have observed significant increases in equilibrium and dynamic compressive moduli after transient ATP treatment applied in the fourth week of cultivation. Continuous ATP treatment over 4 weeks of culture only slightly improved the mechanical properties of the constructs, without major changes in the total glycosaminoglycan (GAG) and collagen content. Structure-function analyses showed that transiently ATP-treated constructs, and in particular those based on hMSCs, had the highest level of correlation between compositional and mechanical properties. Transiently treated groups showed intense staining of the territorial matrix for GAGs and collagen type II. These results indicate that transient ATP treatment can improve functional mechanical properties of cartilaginous constructs based on chondrogenic cells and agarose hydrogels, possibly by improving the structural organization of the bulk phase and territorial extracellular matrix (ECM), that is, by increasing correlation slopes between the content of the ECM components (GAG, collagen) and mechanical properties of the construct.
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Affiliation(s)
- Ivana Gadjanski
- Department of Biomedical Engineering, Columbia University, 622 West 168th Street, New York, NY 10032, USA
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93
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Irion VH, Flanigan DC. New and Emerging Techniques in Cartilage Repair: Other Scaffold-Based Cartilage Treatment Options. OPER TECHN SPORT MED 2013. [DOI: 10.1053/j.otsm.2013.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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94
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Cigan AD, Nims RJ, Albro MB, Esau JD, Dreyer MP, Vunjak-Novakovic G, Hung CT, Ateshian GA. Insulin, ascorbate, and glucose have a much greater influence than transferrin and selenous acid on the in vitro growth of engineered cartilage in chondrogenic media. Tissue Eng Part A 2013; 19:1941-8. [PMID: 23544890 DOI: 10.1089/ten.tea.2012.0596] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The primary goal of this study was to characterize the response of chondrocyte-seeded agarose constructs to varying concentrations of several key nutrients in a chondrogenic medium, within the overall context of optimizing the key nutrients and the placement of nutrient channels for successful growth of cartilage tissue constructs large enough to be clinically relevant in the treatment of osteoarthritis (OA). To this end, chondrocyte-agarose constructs (ø4×2.34 mm, 30×10(6) cells/mL) were subjected to varying supplementation levels of insulin (0× to 30× relative to standard supplementation), transferrin (0× to 30×), selenous acid (0× to 10×), ascorbate (0× to 30×), and glucose (0× to 3×). The quality of resulting engineered tissue constructs was evaluated by their compressive modulus (E(-Y)), tensile modulus (E(+Y)), hydraulic permeability (k), and content of sulfated glycosaminoglycans (sGAG) and collagen (COL); DNA content was also quantified. Three control groups from two separate castings of constructs (1× concentrations of all medium constituents) were used. After 42 days of culture, values in each of these controls were, respectively, E(-Y)=518±78, 401±113, 236±67 kPa; E(+Y)=1420±430, 1140±490, 1240±280 kPa; k=2.3±0.8×10(-3), 5.4±7.0×10(-3), 3.3±1.3×10(-3) mm(4)/N·s; sGAG=7.8±0.3, 6.3±0.4, 4.1±0.5%/ww; COL=1.3±0.2, 1.1±0.3, 1.4±0.4%/ww; and DNA=11.5±2.2, 12.1±0.6, 5.2±2.8 μg/disk. The presence of insulin and ascorbate was essential, but their concentrations may drop as low as 0.3× without detrimental effects on any of the measured properties; excessive supplementation of ascorbate (up to 30×) was detrimental to E(-Y), and 30× insulin was detrimental to both E(+Y) and E(-Y). The presence of glucose was similarly essential, and matrix elaboration was significantly dependent on its concentration (p<10(-6)), with loss of functional properties, composition, and cellularity observed at ≤0.3×; excessive glucose supplementation (up to 3×) showed no detrimental effects. In contrast, transferrin and selenous acid had no influence on matrix elaboration. These findings suggest that adequate distributions of insulin, ascorbate, and glucose, but not necessarily of transferrin and selenous acid, must be ensured within large engineered cartilage constructs to produce a viable substitute for joint tissue lost due to OA.
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Affiliation(s)
- Alexander D Cigan
- Department of Mechanical Engineering, Columbia University, New York, New York 10027, USA
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95
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Ye K, Felimban R, Moulton SE, Wallace GG, Bella CD, Traianedes K, Choong PFM, Myers DE. Bioengineering of articular cartilage: past, present and future. Regen Med 2013; 8:333-49. [DOI: 10.2217/rme.13.28] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The treatment of cartilage defects poses a clinical challenge owing to the lack of intrinsic regenerative capacity of cartilage. The use of tissue engineering techniques to bioengineer articular cartilage is promising and may hold the key to the successful regeneration of cartilage tissue. Natural and synthetic biomaterials have been used to recreate the microarchitecture of articular cartilage through multilayered biomimetic scaffolds. Acellular scaffolds preserve the microarchitecture of articular cartilage through a process of decellularization of biological tissue. Although promising, this technique often results in poor biomechanical strength of the graft. However, biomechanical strength could be improved if biomaterials could be incorporated back into the decellularized tissue to overcome this limitation.
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Affiliation(s)
- Ken Ye
- Department of Orthopaedics, St Vincent’s Hospital, Fitzroy, Victoria 3065, Australia
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Fitzroy, Victoria 3065, Australia.
| | - Raed Felimban
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Fitzroy, Victoria 3065, Australia
- Department of Orthopaedics, St Vincent’s Hospital, Fitzroy, Victoria 3065, Australia
| | - Simon E Moulton
- Intelligent Polymer Research Institute, University of Wollongong, ARC Centre of Excellence for Electromaterials Science (ACES), Squires Way, North Wollongong, New South Wales 2552, Australia
| | - Gordon G Wallace
- Intelligent Polymer Research Institute, University of Wollongong, ARC Centre of Excellence for Electromaterials Science (ACES), Squires Way, North Wollongong, New South Wales 2552, Australia
| | - Claudia Di Bella
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Fitzroy, Victoria 3065, Australia
- Department of Orthopaedics, St Vincent’s Hospital, Fitzroy, Victoria 3065, Australia
| | - Kathy Traianedes
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Fitzroy, Victoria 3065, Australia
| | - Peter FM Choong
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Fitzroy, Victoria 3065, Australia
- Department of Orthopaedics, St Vincent’s Hospital, Fitzroy, Victoria 3065, Australia
| | - Damian E Myers
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Fitzroy, Victoria 3065, Australia
- Department of Orthopaedics, St Vincent’s Hospital, Fitzroy, Victoria 3065, Australia
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96
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Perrier-Groult E, Pasdeloup M, Malbouyres M, Galéra P, Mallein-Gerin F. Control of collagen production in mouse chondrocytes by using a combination of bone morphogenetic protein-2 and small interfering RNA targeting Col1a1 for hydrogel-based tissue-engineered cartilage. Tissue Eng Part C Methods 2013; 19:652-64. [PMID: 23311625 DOI: 10.1089/ten.tec.2012.0396] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Because articular cartilage does not self-repair, tissue-engineering strategies should be considered to regenerate this tissue. Autologous chondrocyte implantation is already used for treatment of focal damage of articular cartilage. Unfortunately, this technique includes a step of cell amplification, which results in dedifferentiation of chondrocytes, with expression of type I collagen, a protein characteristic of fibrotic tissues. Therefore, the risk of producing a fibrocartilage exists. The aim of this study was to propose a new strategy for authorizing the recovery of the differentiated status of the chondrocytes after their amplification on plastic. Because the bone morphogenetic protein (BMP)-2 and the transforming growth factor (TGF)-β1 are cytokines both proposed as stimulants for cartilage repair, we undertook a detailed comparative analysis of their biological effects on chondrocytes. As a cellular model, we used mouse chondrocytes after their expansion on plastic and we tested the capability of BMP-2 or TGF-β1 to drive their redifferentiation, with special attention given to the nature of the proteins synthesized by the cells. To prevent any fibrotic character of the newly synthesized extracellular matrix, we silenced type I collagen by transfecting small interfering RNA (siRNA) into the chondrocytes, before their exposure to BMP-2 or TGF-β1. Our results showed that addition of siRNA targeting the mRNA encoded by the Col1a1 gene (Col1a1 siRNA) and BMP-2 represents the most efficient combination to control the production of cartilage-characteristic collagen proteins. To go one step further toward scaffold-based cartilage engineering, Col1a1 siRNA-transfected chondrocytes were encapsulated in agarose hydrogel and cultured in vitro for 1 week. The analysis of the chondrocyte-agarose constructs by using real-time polymerase chain reaction, Western-blotting, immunohistochemistry, and electron microscopy techniques demonstrated that the BMP-2/Col1a1 siRNA combination is effective in reinitializing correct production and assembly of the cartilage-characteristic matrix in agarose hydrogel, without production of type I collagen. Because agarose is known to favor long-term expression of the chondrocyte phenotype and agarose-based hydrogels are approved for clinical trials, this strategy appears very promising to repair hyaline cartilage.
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97
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Kock LM, Geraedts J, Ito K, van Donkelaar CC. Low agarose concentration and TGF-β3 distribute extracellular matrix in tissue-engineered cartilage. Tissue Eng Part A 2013; 19:1621-31. [PMID: 23469833 DOI: 10.1089/ten.tea.2012.0541] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The mechanical properties of articular cartilage are dominated by the interterritorial matrix, as the matrix in this region is stiffer, greater in volume, and more interconnected compared to that in the pericellular and territorial region. Hence, tissue-engineered constructs in which a newly synthesized matrix accumulates in the pericellular and territorial regions may be of a lower mechanical quality compared to constructs in which the interterritorial region contains abundant matrix. OBJECTIVE In this study, we explored the extent to which matrix distribution may be modulated by altering the agarose concentration and the presence of the transforming growth factor-β (TGF-β) and how this affects the mechanical properties of cultured cartilage constructs. METHODS Cartilage development in constructs with agarose concentrations varying from 1%, 2%, and 3% (study 1) and in constructs with no or very low agarose concentrations of 0.25%, 0.5%, and 1% (study 2) were compared. In both studies, the effect of TGF-β3 was compared to fetal bovine serum. After 21 and 42 days of culture, the matrix content and distribution were analyzed and mechanical properties were assessed at day 42. RESULTS Culture in lower agarose concentrations did not significantly influence the matrix content per wet weight, but did result in a more homogeneous distribution. Constructs cultured with less agarose also showed a higher equilibrium modulus. The presence of TGF-β3 resulted in an increased extracellular matrix (ECM) deposition, a more homogeneous matrix distribution, and an equilibrium modulus. CONCLUSIONS Culturing with no or low agarose concentrations and TGF-β3 is favorable for cartilage tissue-engineering studies, because both stimulate the formation of a more homogeneous ECM and consequently result in improved mechanical properties.
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Affiliation(s)
- Linda M Kock
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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98
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Howard JS, Lattermann C, Hoch JM, Mattacola CG, Medina McKeon JM. Comparing Responsiveness of Six Common Patient-Reported Outcomes to Changes Following Autologous Chondrocyte Implantation: A Systematic Review and Meta-Analysis of Prospective Studies. Cartilage 2013; 4:97-110. [PMID: 26069653 PMCID: PMC4297098 DOI: 10.1177/1947603512470684] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To compare the responsiveness of six common patient-reported outcomes (PROs) following autologous chondrocyte implantation (ACI). DESIGN A systematic search was conducted to identify reports of PROs following ACI. Study quality was evaluated using the modified Coleman Methodology Score (mCMS). For each outcome score, pre- to postoperative paired Hedge's g effect sizes were calculated with 95% confidence intervals (CIs). Random effects meta-analyses were performed to provide a summary response for each PRO at time points (TP) I (<1 year), II (1 year to <2 years), III (2 years to <4 years), IV (≥4 years), and overall. RESULTS The mean mCMS for the 42 articles included was 50.9 ± 9.2. For all evaluated instruments, none of the mean effect size CIs encompassed zero. The International Knee Documentation Committee Subjective Knee Form (IKDC) had increasing responsiveness over time with TP-IV, demonstrating greater mean effect size [confidence interval] (1.78 [1.33, 2.24]) than TP-I (0.88 [0.69, 1.07]). The Knee Injury and Osteoarthritis Outcome Score-Sports and recreation subscale (KOOS-Sports) was more responsive at TP-III (1.76 [0.87, 2.64]) and TP-IV (0.98 [0.81, 1.15]) than TP-I (0.61 [0.44, 0.78]). Overall, the Medical Outcomes Study 36-Item Short Form Health Survey Physical Component Scale (0.60 [0.46, 0.74]) was least responsive. Both the Lysholm Scale (1.42 [1.14, 1.72]) and the IKDC (1.37 [1.13, 1.62]) appear more responsive than the KOOS-Sports (0.90 [0.73, 1.07]). All other KOOS subscales had overall effect sizes ranging from 0.90 (0.74, 1.22) (Symptoms) to 1.15 (0.76, 1.54) (Quality of Life). CONCLUSIONS All instruments were responsive to improvements in function following ACI. The Lysholm and IKDC were the most responsive instruments across time. IKDC and KOOS-Sports may be more responsive to long-term outcomes, especially among active individuals.
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Affiliation(s)
- Jennifer S. Howard
- Division of Athletic Training, Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA,Center for Cartilage Repair and Restoration, Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA
| | - Christian Lattermann
- Center for Cartilage Repair and Restoration, Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA
| | - Johanna M. Hoch
- School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA, USA
| | - Carl G. Mattacola
- Division of Athletic Training, Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA
| | - Jennifer M. Medina McKeon
- Division of Athletic Training, Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA
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99
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Matsiko A, Levingstone TJ, O'Brien FJ. Advanced Strategies for Articular Cartilage Defect Repair. MATERIALS (BASEL, SWITZERLAND) 2013; 6:637-668. [PMID: 28809332 PMCID: PMC5452095 DOI: 10.3390/ma6020637] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 02/06/2013] [Accepted: 02/16/2013] [Indexed: 02/07/2023]
Abstract
Articular cartilage is a unique tissue owing to its ability to withstand repetitive compressive stress throughout an individual's lifetime. However, its major limitation is the inability to heal even the most minor injuries. There still remains an inherent lack of strategies that stimulate hyaline-like articular cartilage growth with appropriate functional properties. Recent scientific advances in tissue engineering have made significant steps towards development of constructs for articular cartilage repair. In particular, research has shown the potential of biomaterial physico-chemical properties significantly influencing the proliferation, differentiation and matrix deposition by progenitor cells. Accordingly, this highlights the potential of using such properties to direct the lineage towards which such cells follow. Moreover, the use of soluble growth factors to enhance the bioactivity and regenerative capacity of biomaterials has recently been adopted by researchers in the field of tissue engineering. In addition, gene therapy is a growing area that has found noteworthy use in tissue engineering partly due to the potential to overcome some drawbacks associated with current growth factor delivery systems. In this context, such advanced strategies in biomaterial science, cell-based and growth factor-based therapies that have been employed in the restoration and repair of damaged articular cartilage will be the focus of this review article.
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Affiliation(s)
- Amos Matsiko
- Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.
- Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland.
| | - Tanya J Levingstone
- Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.
- Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland.
| | - Fergal J O'Brien
- Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.
- Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland.
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100
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Kon E, Filardo G, Di Matteo B, Perdisa F, Marcacci M. Matrix assisted autologous chondrocyte transplantation for cartilage treatment: A systematic review. Bone Joint Res 2013; 2:18-25. [PMID: 23610698 PMCID: PMC3626217 DOI: 10.1302/2046-3758.22.2000092] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 11/21/2012] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Matrix-assisted autologous chondrocyte transplantation (MACT) has been developed and applied in the clinical practice in the last decade to overcome most of the disadvantages of the first generation procedures. The purpose of this systematic review is to document and analyse the available literature on the results of MACT in the treatment of chondral and osteochondral lesions of the knee. METHODS ALL STUDIES PUBLISHED IN ENGLISH ADDRESSING MACT PROCEDURES WERE IDENTIFIED, INCLUDING THOSE THAT FULFILLED THE FOLLOWING CRITERIA: 1) level I-IV evidence, 2) measures of functional or clinical outcome, 3) outcome related to cartilage lesions of the knee cartilage. RESULTS The literature analysis showed a progressively increasing number of articles per year. A total of 51 articles were selected: three randomised studies, ten comparative studies, 33 case series and five case reports. Several scaffolds have been developed and studied, with good results reported at short to medium follow-up. CONCLUSIONS MACT procedures are a therapeutic option for the treatment of chondral lesions that can offer a positive outcome over time for specific patient categories, but high-level studies are lacking. Systematic long-term evaluation of these techniques and randomised controlled trials are necessary to confirm the potential of this treatment approach, especially when comparing against less ambitious traditional treatments.
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Affiliation(s)
- E. Kon
- Rizzoli Orthopaedic Institute, Biomechanics
Laboratory and II Orthopaedic Clinic, Via di Barbiano
n. 1/10, Bologna 40136, Italy
| | - G. Filardo
- Rizzoli Orthopaedic Institute, Biomechanics
Laboratory and II Orthopaedic Clinic, Via di Barbiano
n. 1/10, Bologna 40136, Italy
| | - B. Di Matteo
- Rizzoli Orthopaedic Institute, Biomechanics
Laboratory and II Orthopaedic Clinic, Via di Barbiano
n. 1/10, Bologna 40136, Italy
| | - F. Perdisa
- Rizzoli Orthopaedic Institute, Biomechanics
Laboratory and II Orthopaedic Clinic, Via di Barbiano
n. 1/10, Bologna 40136, Italy
| | - M. Marcacci
- Rizzoli Orthopaedic Institute, Biomechanics
Laboratory and II Orthopaedic Clinic, Via di Barbiano
n. 1/10, Bologna 40136, Italy
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