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Bobzin L, Roberts RR, Chen HJ, Crump JG, Merrill AE. Development and maintenance of tendons and ligaments. Development 2021; 148:239823. [PMID: 33913478 DOI: 10.1242/dev.186916] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Tendons and ligaments are fibrous connective tissues vital to the transmission of force and stabilization of the musculoskeletal system. Arising in precise regions of the embryo, tendons and ligaments share many properties and little is known about the molecular differences that differentiate them. Recent studies have revealed heterogeneity and plasticity within tendon and ligament cells, raising questions regarding the developmental mechanisms regulating tendon and ligament identity. Here, we discuss recent findings that contribute to our understanding of the mechanisms that establish and maintain tendon progenitors and their differentiated progeny in the head, trunk and limb. We also review the extent to which these findings are specific to certain anatomical regions and model organisms, and indicate which findings similarly apply to ligaments. Finally, we address current research regarding the cellular lineages that contribute to tendon and ligament repair, and to what extent their regulation is conserved within tendon and ligament development.
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Affiliation(s)
- Lauren Bobzin
- Division of Biomedical Sciences, Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA.,Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Ryan R Roberts
- Division of Biomedical Sciences, Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA.,Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.,Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Hung-Jhen Chen
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - J Gage Crump
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Amy E Merrill
- Division of Biomedical Sciences, Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA.,Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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102
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Chen H, Wang Z, Zhou L, Wu B, Lu H, Zhang C, Zhang T. Recombinant human bone morphogenetic protein-4 enhances tendon-to-bone attachment healing in a murine model of rotator cuff tear. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:565. [PMID: 33987263 DOI: 10.21037/atm-20-6761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Injuries of tendon-to-bone attachments (TBA) are common clinical challenges. Bone morphogenetic protein-4 (BMP-4) is potent in chondrogenesis. However, studies focusing on the influence of BMP-4 on the healing of TBA are scarce. Thus, this study's objective was to explore the effect of BMP-4 on the healing of TBA in a murine model of rotator cuff tear. Methods An injury model of the supraspinatus tendon (SST) insertion was established on a total of 120 mature C57 black (BL)/6 mice (12 weeks old), who were then randomly allocated into 3 groups: BMP-4, noggin (an inhibitor of all BMP activities), and control, At weeks 2 and 4 after surgery, the supraspinatus tendon-humerus complexes (SSTHC) were harvested for microradiographic, histologic, immunofluorescent, and biomechanical evaluations. Results Radiographic data showed that BMP-4 was able to improve the quality of subchondral bone, manifested as higher bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), and lower trabecular spacing (Tb.Sp). Histologically, the BMP-4 group at week-2 and -4 showed a better TBA healing interface, characterized by better organizational integration and remodeling, thicker fibrocartilage layer, and more fibrocartilage cells. Immunofluorescence evaluation demonstrated that the number of SOX 9 positive cells in the BMP-4 group was significantly more than that in the control or noggin groups at postoperative weeks 2 and 4 (P<0.05 for all). Mechanical testing results at postoperative weeks 4 demonstrated the failure load, and stiffness in the BMP-4 group were significantly higher (P<0.05 for both), while in the noggin group were significantly lower (P<0.05 for both), compared to the control group. Conclusions The BMP-4 might enhance TBA healing by promoting the regeneration of fibrocartilaginous enthesis and mineralization, while this process was inhibited by noggin. Thus, BMP-4 may be a potential therapy to augment TBA healing and finally lead to more rapid rehabilitation and reduce recurrent injury risk.
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Affiliation(s)
- Huabin Chen
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Zhanwen Wang
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Li Zhou
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Department of Orthopedic Center, Kunshan Hospital of Traditional Chinese Medicine, Suzhou, China
| | - Bing Wu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Hongbin Lu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Ciliu Zhang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Tao Zhang
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
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103
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Wang D, Zhang X, Huang S, Liu Y, Fu BSC, Mak KKL, Blocki AM, Yung PSH, Tuan RS, Ker DFE. Engineering multi-tissue units for regenerative Medicine: Bone-tendon-muscle units of the rotator cuff. Biomaterials 2021; 272:120789. [PMID: 33845368 DOI: 10.1016/j.biomaterials.2021.120789] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022]
Abstract
Our body systems are comprised of numerous multi-tissue units. For the musculoskeletal system, one of the predominant functional units is comprised of bone, tendon/ligament, and muscle tissues working in tandem to facilitate locomotion. To successfully treat musculoskeletal injuries and diseases, critical consideration and thoughtful integration of clinical, biological, and engineering aspects are necessary to achieve translational bench-to-bedside research. In particular, identifying ideal biomaterial design specifications, understanding prior and recent tissue engineering advances, and judicious application of biomaterial and fabrication technologies will be crucial for addressing current clinical challenges in engineering multi-tissue units. Using rotator cuff tears as an example, insights relevant for engineering a bone-tendon-muscle multi-tissue unit are presented. This review highlights the tissue engineering strategies for musculoskeletal repair and regeneration with implications for other bone-tendon-muscle units, their derivatives, and analogous non-musculoskeletal tissue structures.
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Affiliation(s)
- Dan Wang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Ministry of Education Key Laboratory for Regenerative Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Xu Zhang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR
| | - Shuting Huang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR
| | - Yang Liu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Bruma Sai-Chuen Fu
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Anna Maria Blocki
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Patrick Shu-Hang Yung
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Rocky S Tuan
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR
| | - Dai Fei Elmer Ker
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Ministry of Education Key Laboratory for Regenerative Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR.
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Tsai SL, Noedl MT, Galloway JL. Bringing tendon biology to heel: Leveraging mechanisms of tendon development, healing, and regeneration to advance therapeutic strategies. Dev Dyn 2021; 250:393-413. [PMID: 33169466 PMCID: PMC8486356 DOI: 10.1002/dvdy.269] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/29/2020] [Accepted: 11/03/2020] [Indexed: 12/11/2022] Open
Abstract
Tendons are specialized matrix-rich connective tissues that transmit forces from muscle to bone and are essential for movement. As tissues that frequently transfer large mechanical loads, tendons are commonly injured in patients of all ages. Following injury, mammalian tendons heal poorly through a slow process that forms disorganized fibrotic scar tissue with inferior biomechanical function. Current treatments are limited and patients can be left with a weaker tendon that is likely to rerupture and an increased chance of developing degenerative conditions. More effective, alternative treatments are needed. However, our current understanding of tendon biology remains limited. Here, we emphasize why expanding our knowledge of tendon development, healing, and regeneration is imperative for advancing tendon regenerative medicine. We provide a comprehensive review of the current mechanisms governing tendon development and healing and further highlight recent work in regenerative tendon models including the neonatal mouse and zebrafish. Importantly, we discuss how present and future discoveries can be applied to both augment current treatments and design novel strategies to treat tendon injuries.
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Affiliation(s)
- Stephanie L. Tsai
- Center for Regenerative Medicine, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
- Harvard Stem Cell Institute, Cambridge, MA 02138
| | - Marie-Therese Noedl
- Center for Regenerative Medicine, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
- Harvard Stem Cell Institute, Cambridge, MA 02138
| | - Jenna L. Galloway
- Center for Regenerative Medicine, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
- Harvard Stem Cell Institute, Cambridge, MA 02138
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105
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Gauthier R, Jeannin C, Attik N, Trunfio-Sfarghiu AM, Gritsch K, Grosgogeat B. Tissue Engineering for Periodontal Ligament Regeneration: Biomechanical Specifications. J Biomech Eng 2021; 143:030801. [PMID: 33067629 DOI: 10.1115/1.4048810] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Indexed: 11/08/2022]
Abstract
The periodontal biomechanical environment is very difficult to investigate. By the complex geometry and composition of the periodontal ligament (PDL), its mechanical behavior is very dependent on the type of loading (compressive versus tensile loading; static versus cyclic loading; uniaxial versus multiaxial) and the location around the root (cervical, middle, or apical). These different aspects of the PDL make it difficult to develop a functional biomaterial to treat periodontal attachment due to periodontal diseases. This review aims to describe the structural and biomechanical properties of the PDL. Particular importance is placed in the close interrelationship that exists between structure and biomechanics: the PDL structural organization is specific to its biomechanical environment, and its biomechanical properties are specific to its structural arrangement. This balance between structure and biomechanics can be explained by a mechanosensitive periodontal cellular activity. These specifications have to be considered in the further tissue engineering strategies for the development of an efficient biomaterial for periodontal tissues regeneration.
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Affiliation(s)
- R Gauthier
- Univ Lyon - Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, Villeurbanne F-69622, France; Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon 69008, France
| | - Christophe Jeannin
- Univ Lyon - Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, Villeurbanne F-69622, France; Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon 69008, France; Hospices Civils de Lyon, Service d'Odontologie, Lyon 69007, France
| | - N Attik
- Univ Lyon - Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, Villeurbanne F-69622, France; Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon 69008, France
| | | | - K Gritsch
- Univ Lyon - Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, Villeurbanne F-69622, France; Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon 69008, France; Hospices Civils de Lyon, Service d'Odontologie, Lyon 69007, France
| | - B Grosgogeat
- Univ Lyon - Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, Villeurbanne F-69622, France; Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon 69008, France; Hospices Civils de Lyon, Service d'Odontologie, Lyon 69007, France
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106
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Shi Q, Chen C, Li M, Chen Y, Xu Y, Hu J, Liu J, Lu H. Characterization of the distributions of collagen and PGs content in the decellularized book-shaped enthesis scaffolds by SR-FTIR. BMC Musculoskelet Disord 2021; 22:235. [PMID: 33648475 PMCID: PMC7923620 DOI: 10.1186/s12891-021-04106-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
Background Bone-tendon interface (enthesis) plays a pivotal role in relaxing load transfer between otherwise structurally and functionally distinct tissue types. Currently, decellularized extracellular matrix (DEM) from enthesis provide a natural three-dimensional scaffold with tissue-specific orientations of extracellular matrix molecules for enthesis regeneration, however, the distributions of collagen and PGs content in the decellularized book-shaped enthesis scaffolds from rabbit rotator cuff by SR-FTIR have not been reported. Methods Native enthesis tissues (NET) harvested from rabbit rotator cuff were sectioned into cuboid (about 30 mm × 1.2 mm × 10 mm) for decalcification. The decellularized book-shaped enthesis scaffolds and intrinsic ultrastructure were evaluated by histological staining and scanning electron microscopy (SEM), respectively. The distributions of collagen and PGs content in the decellularized book-shaped enthesis scaffolds from rabbit rotator cuff were also measured innovatively by SR-FTIR. Results The decellularized book-shaped enthesis scaffolds from rabbit rotator cuff were successfully obtained. Histomorphology and SEM evaluated the effect of decellularization and the structure of extracellular matrix during decellularization. After mechanical testing, the failure load in the NET group showed significantly higher than that in the DEM group (P < 0.05). Meanwhile, the stiffness of the DEM group was significantly lower than the NET group. Furthermore, the distributions of collagen and PGs content in the decellularized book-shaped enthesis scaffolds were decreased obviously after decellularization by SR-FTIR quantitative analysis. Conclusion SR-FTIR was applied innovatively to characterize the histological morphology of native enthesis tissues from rabbit rotator cuff. Moreover, this technology can be applied for quantitative mapping of the distribution of collagen and PGs content in the decellularized book-shaped enthesis scaffolds.
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Affiliation(s)
- Qiang Shi
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, Hunan, China.,Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, Hunan, China
| | - Can Chen
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, Hunan, China.,Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, Hunan, China.,Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Muzhi Li
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, Hunan, China.,Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, Hunan, China
| | - Yang Chen
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, Hunan, China.,Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, Hunan, China
| | - Yan Xu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, Hunan, China.,Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, Hunan, China
| | - Jianzhong Hu
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, Hunan, China.,Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, Hunan, China.,Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Jun Liu
- Department of limbs (foot and hand) microsurgery, Affiliated Chenzhou No.1 People's Hospital, Southern Medical University, Chenzhou, 423000, Hunan, China.
| | - Hongbin Lu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, Hunan, China.,Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, Hunan, China
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107
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Beisbayeva Z, Zhanbassynova A, Kulzhanova G, Mukasheva F, Erisken C. Change in Collagen Fibril Diameter Distribution of Bovine Anterior Cruciate Ligament upon Injury Can Be Mimicked in a Nanostructured Scaffold. Molecules 2021; 26:molecules26051204. [PMID: 33668154 PMCID: PMC7956598 DOI: 10.3390/molecules26051204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 11/24/2022] Open
Abstract
More than 200,000 people are suffering from Anterior Cruciate Ligament (ACL) related injuries each year in the US. There is an unmet clinical demand for improving biological attachment between grafts and the host tissue in addition to providing mechanical support. For biological graft integration, it is important to provide a physiologically feasible environment for the host cells to enable them to perform their duties. However, behavior of cells during ACL healing and the mechanism of ACL healing is not fully understood partly due to the absence of appropriate environment to test cell behavior both in vitro and in vivo. This study aims at (i) investigating the change in fibril diameter of bovine ACL tissue upon injury and (ii) fabricating nanofiber-based scaffolds to represent the morphology and structure of healthy and injured ACL tissues. We hypothesized that distribution and mean diameter of ACL fibrils will be altered upon injury. Findings revealed that the collagen fibril diameter distribution of bovine ACL changed from bimodal to unimodal upon injury with subsequent decrease in mean diameter. Polycaprolactone (PCL) scaffold fiber diameter distribution exhibited similar bimodal and unimodal distribution behavior to qualitatively represent the cases of healthy and injured ACL, respectively. The native ACL tissue demonstrated comparable modulus values only with the aligned bimodal PCL scaffolds. There was significant difference between mechanical properties of aligned bimodal and unaligned unimodal PCL scaffolds. We believe that the results obtained from measurements of diameter of collagen fibrils of native bovine ACL tissue can serve as a benchmark for scaffold design.
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Affiliation(s)
- Zhuldyz Beisbayeva
- Department of Chemical and Materials Engineering, School of Engineering & Digital Sciences, Nazarbayev University, 53 Kabanbay Batyr, Nur-Sultan 010000, Kazakhstan; (Z.B.); (A.Z.); (F.M.)
| | - Ainur Zhanbassynova
- Department of Chemical and Materials Engineering, School of Engineering & Digital Sciences, Nazarbayev University, 53 Kabanbay Batyr, Nur-Sultan 010000, Kazakhstan; (Z.B.); (A.Z.); (F.M.)
| | - Gulzada Kulzhanova
- Department of Biological Sciences, Nazarbayev University, 53 Kabanbay Batyr, Nur-Sultan 010000, Kazakhstan;
| | - Fariza Mukasheva
- Department of Chemical and Materials Engineering, School of Engineering & Digital Sciences, Nazarbayev University, 53 Kabanbay Batyr, Nur-Sultan 010000, Kazakhstan; (Z.B.); (A.Z.); (F.M.)
| | - Cevat Erisken
- Department of Chemical and Materials Engineering, School of Engineering & Digital Sciences, Nazarbayev University, 53 Kabanbay Batyr, Nur-Sultan 010000, Kazakhstan; (Z.B.); (A.Z.); (F.M.)
- Correspondence:
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108
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Lei T, Zhang T, Ju W, Chen X, Heng BC, Shen W, Yin Z. Biomimetic strategies for tendon/ligament-to-bone interface regeneration. Bioact Mater 2021; 6:2491-2510. [PMID: 33665493 PMCID: PMC7889437 DOI: 10.1016/j.bioactmat.2021.01.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/04/2021] [Accepted: 01/20/2021] [Indexed: 12/19/2022] Open
Abstract
Tendon/ligament-to-bone healing poses a formidable clinical challenge due to the complex structure, composition, cell population and mechanics of the interface. With rapid advances in tissue engineering, a variety of strategies including advanced biomaterials, bioactive growth factors and multiple stem cell lineages have been developed to facilitate the healing of this tissue interface. Given the important role of structure-function relationship, the review begins with a brief description of enthesis structure and composition. Next, the biomimetic biomaterials including decellularized extracellular matrix scaffolds and synthetic-/natural-origin scaffolds are critically examined. Then, the key roles of the combination, concentration and location of various growth factors in biomimetic application are emphasized. After that, the various stem cell sources and culture systems are described. At last, we discuss unmet needs and existing challenges in the ideal strategies for tendon/ligament-to-bone regeneration and highlight emerging strategies in the field.
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Affiliation(s)
- Tingyun Lei
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine and Department of Orthopedic Surgery of Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310058, China.,Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Tao Zhang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine and Department of Orthopedic Surgery of Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310058, China.,Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Wei Ju
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine and Department of Orthopedic Surgery of Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310058, China.,Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Xiao Chen
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, 310058, China.,Department of Orthopedic Surgery of The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310052, China.,Department of Sports Medicine, School of Medicine, Zhejiang University, Hangzhou, 310058, China.,China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310058, China
| | | | - Weiliang Shen
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, 310058, China.,Department of Orthopedic Surgery of The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310052, China.,Department of Sports Medicine, School of Medicine, Zhejiang University, Hangzhou, 310058, China.,China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310058, China
| | - Zi Yin
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine and Department of Orthopedic Surgery of Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310058, China.,Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, 310058, China.,Department of Sports Medicine, School of Medicine, Zhejiang University, Hangzhou, 310058, China.,China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310058, China
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109
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Lim TK, Dorthé E, Williams A, D'Lima DD. Nanofiber Scaffolds by Electrospinning for Rotator Cuff Tissue Engineering. Chonnam Med J 2021; 57:13-26. [PMID: 33537215 PMCID: PMC7840345 DOI: 10.4068/cmj.2021.57.1.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022] Open
Abstract
Rotator cuff tears continue to be at risk of retear or failure to heal after surgical repair, despite the use of various surgical techniques, which stimulate development of novel scaffolding strategies. They should be able to address the known causes of failure after the conventional rotator cuff repair: (1) failure to reproduce the normal tendon healing process, (2) resultant failure to reproduce four zones of the enthesis, and (3) failure to attain sufficient mechanical strength after repair. Nanofiber scaffolds are suited for this application because they can be engineered to mimic the ultrastructure and properties of the native rotator cuff tendon. Among various methods for tissue-engineered nanofibers, electrospinning has recently been highlighted in the rotator cuff field. Electrospinning can create fibrous and porous structures that resemble natural tendon's extracellular matrix. Other advantages include the ability to create relatively large surface-to-volume ratios, the ability to control fiber size from the micro to the nano scale, and the flexibility of material choices. In this review, we will discuss the anatomical and mechanical features of the rotator cuff tendon, their potential impacts on improper healing after repair, and the current knowledge of the use of electrospinning for rotator cuff tissue engineering.
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Affiliation(s)
- Tae Kang Lim
- Department of Orthopaedic Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.,Shiley Center for Orthopedic Research & Education at Scripps Clinic, CA, USA.,Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
| | - Erik Dorthé
- Shiley Center for Orthopedic Research & Education at Scripps Clinic, CA, USA.,Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
| | - Austin Williams
- Shiley Center for Orthopedic Research & Education at Scripps Clinic, CA, USA.,Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
| | - Darryl D D'Lima
- Shiley Center for Orthopedic Research & Education at Scripps Clinic, CA, USA.,Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
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110
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Kult S, Olender T, Osterwalder M, Markman S, Leshkowitz D, Krief S, Blecher-Gonen R, Ben-Moshe S, Farack L, Keren-Shaul H, Salame TM, Capellini TD, Itzkovitz S, Amit I, Visel A, Zelzer E. Bi-fated tendon-to-bone attachment cells are regulated by shared enhancers and KLF transcription factors. eLife 2021; 10:55361. [PMID: 33448926 PMCID: PMC7810463 DOI: 10.7554/elife.55361] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 11/30/2020] [Indexed: 12/17/2022] Open
Abstract
The mechanical challenge of attaching elastic tendons to stiff bones is solved by the formation of a unique transitional tissue. Here, we show that murine tendon-to-bone attachment cells are bi-fated, activating a mixture of chondrocyte and tenocyte transcriptomes, under regulation of shared regulatory elements and Krüppel-like factors (KLFs) transcription factors. High-throughput bulk and single-cell RNA sequencing of humeral attachment cells revealed expression of hundreds of chondrogenic and tenogenic genes, which was validated by in situ hybridization and single-molecule ISH. ATAC sequencing showed that attachment cells share accessible intergenic chromatin areas with either tenocytes or chondrocytes. Epigenomic analysis revealed enhancer signatures for most of these regions. Transgenic mouse enhancer reporter assays verified the shared activity of some of these enhancers. Finally, integrative chromatin and motif analyses and transcriptomic data implicated KLFs as regulators of attachment cells. Indeed, blocking expression of both Klf2 and Klf4 in developing limb mesenchyme impaired their differentiation.
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Affiliation(s)
- Shiri Kult
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Tsviya Olender
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Marco Osterwalder
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National, Berkeley, United States.,Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Svetalana Markman
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Dena Leshkowitz
- Life Sciences Core Facilities, Weizmann Institute of Science, Rehovot, Israel
| | - Sharon Krief
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | | | - Shani Ben-Moshe
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Lydia Farack
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Hadas Keren-Shaul
- Life Sciences Core Facilities, Weizmann Institute of Science, Rehovot, Israel
| | - Tomer-Meir Salame
- Life Sciences Core Facilities, Weizmann Institute of Science, Rehovot, Israel
| | - Terence D Capellini
- Department of Human Evolutionary Biology, Harvard University, Department of Human Evolutionary Biology, United States; Broad Institute of Harvard and MIT, Cambridge, United States
| | - Shalev Itzkovitz
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Ido Amit
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Axel Visel
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National, Berkeley, United States.,U.S. Department of Energy Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, United States.,School of Natural Sciences, University of California, Merced, Merced, United States
| | - Elazar Zelzer
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
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111
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Chae S, Sun Y, Choi YJ, Ha DH, Jeon IH, Cho DW. 3D cell-printing of tendon-bone interface using tissue-derived extracellular matrix bioinks for chronic rotator cuff repair. Biofabrication 2020; 13. [PMID: 33285539 DOI: 10.1088/1758-5090/abd159] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/07/2020] [Indexed: 01/01/2023]
Abstract
The tendon-bone interface (TBI) in rotator cuffs exhibits a structural and compositional gradient integrated through the fibrocartilaginous transition. Owing to restricted healing capacity, functional regeneration of the TBI is considered a great clinical challenge. Here, we establish a novel therapeutic platform based on 3D cell-printing and tissue-specific bioinks to achieve spatially-graded physiology for functional TBI regeneration. The 3D cell-printed TBI patch constructs are created via a spatial arrangement of cell-laden tendon and bone-specific bioinks in a graded manner, approximating a multi-tissue fibrocartilaginous interface. This TBI patch offers a cell favorable microenvironment, including high cell viability, proliferative capacity, and zonal-specific differentiation of encapsulated stem cells for TBI formation in vitro. Furthermore, in vivo application of spatially-graded TBI patches with stem cells demonstrates their regenerative potential, indicating that repair with 3D cell-printed TBI patch significantly accelerates and promotes TBI healing in a rat chronic tear model. Therefore, our findings propose a new therapeutic strategy for functional TBI regeneration using 3D cell-printing and tissue-specific decellularized extracellular matrix (dECM) bioink-based approach.
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Affiliation(s)
- Suhun Chae
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-ro, Nam-gu, Pohang, Gyeongsangbuk-do, 37673, Korea (the Republic of)
| | - Yucheng Sun
- Department of Hand Surgery, Affiliated Hospital of Nantong University, College of Medicine, Nantong University, No 20, West Temple Road, Nantong, 226000, CHINA
| | - Yeong-Jin Choi
- Department of Advanced Biomaterials Research, Korea Institute of Materials Science, 797, Changwon-daero, Seongsan-gu, Gyeongsangnam-do, Changwon, 51508, Korea (the Republic of)
| | - Dong-Heon Ha
- EDmicBio Inc., 117-3, Hoegi-ro, Dongdaemun-gu, Seoul, 02445, Korea (the Republic of)
| | - In-Ho Jeon
- Orthopaedic Surgery, University of Ulsan, Asan Medical Center, 88, OLYMPIC-RO 43-GIL, SONGPA-GU, Seoul, 05505, Korea (the Republic of)
| | - Dong-Woo Cho
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-ro, Nam-gu, Pohang, Gyeongsangbuk-do, 37673, Korea (the Republic of)
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112
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Xing SG, Zhou YL, Yang QQ, Ju F, Zhang L, Tang JB. Effects of nanoparticle-mediated growth factor gene transfer to the injured microenvironment on the tendon-to-bone healing strength. Biomater Sci 2020; 8:6611-6624. [PMID: 33231577 DOI: 10.1039/d0bm01222j] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The tendon-to-bone healing after trauma is usually slow and weak, and the repair site is easily disrupted during early mobilization exercise. bFGF and VEGFA gene therapy may hold promise in augmenting the tendon-to-bone healing process through enhancing cell proliferation and angiogenesis. This study is conducted to determine the effects of nanoparticle-mediated co-delivery of bFGF and VEGFA genes to the tendon-to-bone repair interface on the healing strength and biological responses in a chicken model. The PLGA nanoparticle/pEGFP-bFGF + pEGFP-VEGFA plasmid complexes were prepared and were characterized in vitro and in vivo. The nanoparticle/plasmid complexes can effectively transfer bFGF and VEGFA genes to the tendon-to-bone interface. Nanoparticle-mediated co-delivery of bFGF and VEGFA genes significantly improved the tendon-to-bone healing in terms of healing strengths and histology in a chicken flexor tendon repair model. Our results suggest a new biological approach to accelerate the tendon-to-bone healing.
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Affiliation(s)
- Shu Guo Xing
- The Nanomedicine Research Laboratory, Research for Frontier Medicine and Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China.
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113
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Barajaa MA, Nair LS, Laurencin CT. Bioinspired Scaffold Designs for Regenerating Musculoskeletal Tissue Interfaces. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2020; 6:451-483. [PMID: 33344758 PMCID: PMC7747886 DOI: 10.1007/s40883-019-00132-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/14/2019] [Accepted: 09/13/2019] [Indexed: 12/17/2022]
Abstract
The musculoskeletal system works at a very advanced level of synchrony, where all the physiological movements of the body are systematically performed through well-organized actions of bone in conjunction with all the other musculoskeletal soft tissues, such as ligaments, tendons, muscles, and cartilage through tissue-tissue interfaces. Interfaces are structurally and compositionally complex, consisting of gradients of extracellular matrix components, cell phenotypes as well as biochemical compositions and are important in mediating load transfer between the distinct orthopedic tissues during body movement. When an injury occurs at interface, it must be re-established to restore its function and stability. Due to the structural and compositional complexity found in interfaces, it is anticipated that they presuppose a concomitant increase in the complexity of the associated regenerative engineering approaches and scaffold designs to achieve successful interface regeneration and seamless integration of the engineered orthopedic tissues. Herein, we discuss the various bioinspired scaffold designs utilized to regenerate orthopedic tissue interfaces. First, we start with discussing the structure-function relationship at the interface. We then discuss the current understanding of the mechanism underlying interface regeneration, followed by discussing the current treatment available in the clinic to treat interface injuries. Lastly, we comprehensively discuss the state-of-the-art scaffold designs utilized to regenerate orthopedic tissue interfaces.
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Affiliation(s)
- Mohammed A Barajaa
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, 06269, USA
| | - Lakshmi S Nair
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Raymond & Beverly Sackler Center for Biomedical, Biological, Physical & Engineering Sciences, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Orthopedic Surgery, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Materials Science & Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Institute of Materials Science, University of Connecticut, Storrs, CT, USA
- Department of Chemical & Bimolecular Engineering, University of Connecticut, Storrs, CT, 06269, USA
| | - Cato T Laurencin
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Raymond & Beverly Sackler Center for Biomedical, Biological, Physical & Engineering Sciences, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Orthopedic Surgery, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Materials Science & Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Institute of Materials Science, University of Connecticut, Storrs, CT, USA
- Department of Chemical & Bimolecular Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT, 06030, USA
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114
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Shi Q, Chen Y, Li M, Zhang T, Ding S, Xu Y, Hu J, Chen C, Lu H. Designing a novel vacuum aspiration system to decellularize large-size enthesis with preservation of physicochemical and biological properties. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1364. [PMID: 33313109 PMCID: PMC7723548 DOI: 10.21037/atm-20-3661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Functional and rapid enthesis regeneration remains a challenge after arthroscopic rotator cuff (RC) repair. Tissue-engineering a large-size biomimetic scaffold may be an adjuvant strategy to improve this clinical dilemma. Herein, we developed an optimized protocol to decellularize large-size enthesis as scaffolds for augmenting RC tear. Methods A novel vacuum aspiration system (VAS) was set up, which can provide a negative pressure to suck out cellular substances from tissue blocks without using chemical detergents. Large-size enthesis tissue specimens were harvested from canine infraspinatus tendon (IT) insertion, and then decellularized with an optimized protocol [freeze-thaw processing followed by nuclease digestion and phosphate buffer saline (PBS) rinsing in the custom-designed VAS], or a conventional protocol (freeze-thaw processing followed by nuclease digestion and PBS rinsing), thus fabricating two kinds of acellular enthesis matrix (AEM), namely C-AEM and O-AEM. After that, the C-AEM and O-AEM were comparatively evaluated from the aspect of their physicochemical and biological properties. Results Physiochemically, the O-AEM preserved the morphologies, ingredients, and tensile properties much better than the C-AEM. Biologically, in vitro studies demonstrated that both C-AEM and O-AEM show no cytotoxicity and low immunogenicity, which could promote stem cells attachment and proliferation. Interestingly, O-AEM showed better region-specific inducibility on the interacted stem cell down osteogenic, chondrogenic and tenogenic lineages compared with C-AEM. Additionally, using a canine IT repair model, the injured enthesis patched with O-AEM showed a significant improvement compared with the injured enthesis patched with C-AEM or direct suture histologically. Conclusions The proposed VAS may help us fabricate large-size AEM with good physicochemical and biological properties, and this AEM may have potential clinical applications in patching large/massive RC tear.
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Affiliation(s)
- Qiang Shi
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Yang Chen
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Muzhi Li
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Tao Zhang
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Shulin Ding
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Xu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Jianzhong Hu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Can Chen
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
| | - Hongbin Lu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
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115
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Aghaei A, Bochud N, Rosi G, Naili S. Assessing the effective elastic properties of the tendon-to-bone insertion: a multiscale modeling approach. Biomech Model Mechanobiol 2020; 20:433-448. [PMID: 33057842 DOI: 10.1007/s10237-020-01392-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/20/2020] [Indexed: 11/25/2022]
Abstract
The interphase joining tendon to bone plays the crucial role of integrating soft to hard tissues, by effectively transferring stresses across two tissues displaying a mismatch in mechanical properties of nearly two orders of magnitude. The outstanding mechanical properties of this interphase are attributed to its complex hierarchical structure, especially by means of competing gradients in mineral content and collagen fibers organization at different length scales. The goal of this study is to develop a multiscale model to describe how the tendon-to-bone insertion derives its overall mechanical behavior. To this end, the effective anisotropic stiffness tensor of the interphase is predicted by modeling its elastic response at different scales, spanning from the nanostructural to the mesostructural levels, using continuum micromechanics methods. The results obtained at a lower scale serve as inputs for the modeling at a higher scale. The obtained predictions are in good agreement with stochastic finite element simulations and experimental trends reported in literature. Such model has implication for the design of bioinspired bi-materials that display the functionally graded properties of the tendon-to-bone insertion.
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Affiliation(s)
- A Aghaei
- Univ Paris Est Creteil, CNRS, MSME, F-94010, Creteil, France
- Univ Gustave Eiffel, MSME, F-77454, Marne-la-Vallée, France
| | - N Bochud
- Univ Paris Est Creteil, CNRS, MSME, F-94010, Creteil, France.
- Univ Gustave Eiffel, MSME, F-77454, Marne-la-Vallée, France.
| | - G Rosi
- Univ Paris Est Creteil, CNRS, MSME, F-94010, Creteil, France
- Univ Gustave Eiffel, MSME, F-77454, Marne-la-Vallée, France
| | - S Naili
- Univ Paris Est Creteil, CNRS, MSME, F-94010, Creteil, France
- Univ Gustave Eiffel, MSME, F-77454, Marne-la-Vallée, France
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116
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Zhang Y, Pon N, Awaji A, Rowan SJ. Squid Beak Inspired Cross-Linked Cellulose Nanocrystal Composites. Biomacromolecules 2020; 22:201-212. [PMID: 32969223 DOI: 10.1021/acs.biomac.0c01051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Bioinspired cross-linked polymer nanocomposites that mimic the water-enhanced mechanical gradient properties of the squid beak have been prepared by embedding either carboxylic acid- or allyl-functionalized cellulose nanocrystals (CNC) into an alkene-containing polymer matrix (poly(vinyl acetate-co-vinyl pentenoate), P(VAc-co-VP)). Cross-linking is achieved by imbibing the composite with a tetrathiol cross-linker and carrying out a photoinduced thiol-ene reaction. Central to this study was an investigation on how the placement of cross-links (i.e., within matrix only or between the matrix and filler) impacts the wet mechanical properties of these materials. Through cross-linking both the CNCs and matrix, it is possible to access larger wet mechanical contrasts (E'stiff/E'soft = ca. 20) than can be obtained by just cross-linking the matrix alone (where contrast E'stiff/E'soft of up 11 are observed). For example, in nanocomposites fabricated with 15 wt % of allyl-functionalized tunicate CNCs and P(VAc-co-VP) with about 30 mol % of the alkene-containing VP units, an increase in the modulus of the wet composite from about 14 MPa to about 289 MPa at physiological temperature (37 °C) can be observed after UV irradiation. The water swelling of the nanocomposites is greatly reduced in the cross-linked materials as a result of the thiol-ene cross-linking network, which also contributes to the wet modulus increase. Given the mechanical turnability and the relatively simple approach that also allows photopatterning the material properties, these water-activated bioinspired nanocomposites have potential uses in a broad range of biomedical applications, such as mechanically compliant intracortical microelectrodes.
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Affiliation(s)
- Yefei Zhang
- Pritzker School of Molecular Engineering, University of Chicago, 5640 S Ellis Avenue, Chicago, Illinois 60637, United States
| | - Nanetta Pon
- Department of Chemistry, University of Chicago, 5735 S Ellis Avenue, Chicago, Illinois 60637, United States
| | - Ahmed Awaji
- Department of Macromolecular Science and Engineering, Case Western Reserve University, 2100 Adelbert Road, Cleveland, Ohio 44106, United States
| | - Stuart J Rowan
- Pritzker School of Molecular Engineering, University of Chicago, 5640 S Ellis Avenue, Chicago, Illinois 60637, United States.,Department of Chemistry, University of Chicago, 5735 S Ellis Avenue, Chicago, Illinois 60637, United States.,Chemical and Engineering Sciences, Argonne National Laboratory, 9700 Cass Avenue, Lemont, Illinois 60439, United States
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117
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Wang Z, Long Z, Amadio PC, Gingery A, Moran SL, Steinmann SP, Zhao C. Biomechanical Comparison of Augmentation of Engineered Tendon-Fibrocartilage-Bone Composite With Acellular Dermal Graft Using Double Rip-Stop Technique for Canine Rotator Cuff Repair. Orthop J Sports Med 2020; 8:2325967120939001. [PMID: 32953920 PMCID: PMC7476351 DOI: 10.1177/2325967120939001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 03/09/2020] [Indexed: 01/08/2023] Open
Abstract
Background The retear rate after rotator cuff repair remains unacceptably high. Various biological engineered scaffolds have been proposed to reduce the retear rate. We have developed a double rip-stop repair with medial row knot (DRSK) technique to enhance suture-tendon strength and a novel engineered tendon-fibrocartilage-bone composite (TFBC) for rotator cuff repair. Hypothesis DRSK rotator cuff repair augmented with TFBC will have better biomechanical properties than that of DRSK repair with an acellular dermal graft (DG). Study Design Controlled laboratory study. Methods Fresh-frozen canine shoulders (n = 30) and knees (n = 10) were used. TFBCs were harvested from the patellar tendon-tibia complex and prepared for rotator cuff repair. The infraspinatus tendon was sharply detached from its bony attachment and randomly assigned to the (1) control group: DRSK repair alone, (2) TFBC group: DRSK repair with TFBC, and (3) DG group: DRSK repair with DG. All specimens were tested to failure, and videos were recorded. The footprint area, tendon thickness, load to create 3-mm gap formation, failure load, failure modes, and stiffness were recorded and compared. Data were recorded as mean ± SD. Results The mean load to create a 3-mm gap in both the control group (206.8 ± 55.7 N) and TFBC group (208.9 ± 39.1 N) was significantly higher than that in the DG group (157.7 ± 52.3 N) (P < .05 for all). The failure load of the control group (275.7 ± 75.0 N) and TFBC group (275.2 ± 52.5 N) was significantly higher compared with the DG group (201.5 ± 49.7 N) (P < .05 for both comparisons). The stiffness of the control group (26.4 ± 4.7 N/mm) was significantly higher than of the TFBC group (20.4 ± 4.4 N/mm) and the DG group (21.1 ± 4.8 N/mm) (P < .05 for both comparisons). Conclusion TFBC augmentation showed superior biomechanical performance to DG augmentation in rotator cuff tears repaired using the DRSK technique, while there was no difference between the TFBC and control groups. Clinical Relevance TFBC may help to reduce retear or gap formation after rotator cuff repair using the DRSK technique.
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Affiliation(s)
- Zhanwen Wang
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, PR China
| | - Zeling Long
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Peter C Amadio
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Anne Gingery
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Steven L Moran
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Scott P Steinmann
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Chunfeng Zhao
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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118
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Sun Han Chang RA, Shanley JF, Kersh ME, Harley BAC. Tough and tunable scaffold-hydrogel composite biomaterial for soft-to-hard musculoskeletal tissue interfaces. SCIENCE ADVANCES 2020; 6:eabb6763. [PMID: 32875114 PMCID: PMC7438087 DOI: 10.1126/sciadv.abb6763] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
Tendon inserts into bone via a fibrocartilaginous interface (enthesis) that reduces mechanical strain and tissue failure. Despite this toughening mechanism, tears occur because of acute (overload) or degradative (aging) processes. Surgically fixating torn tendon into bone results in the formation of a scar tissue interface with inferior biomechanical properties. Progress toward enthesis regeneration requires biomaterial approaches to protect cells from high levels of interfacial strain. We report an innovative tissue reinforcement strategy: a stratified scaffold containing osseous and tendinous tissue compartments attached through a continuous polyethylene glycol (PEG) hydrogel interface. Tuning the gelation kinetics of the hydrogel modulates integration with the flanking compartments and yields biomechanical performance advantages. Notably, the hydrogel interface reduces formation of strain concentrations between tissue compartments in conventional stratified biomaterials that can have deleterious biological effects. This design of mechanically robust stratified composite biomaterials may be appropriate for a broad range of tendon and ligament-to-bone insertions.
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Affiliation(s)
- Raul A Sun Han Chang
- Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - John F Shanley
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Mariana E Kersh
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Brendan A C Harley
- Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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119
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Shen H, Schwartz AG, Civitelli R, Thomopoulos S. Connexin 43 Is Necessary for Murine Tendon Enthesis Formation and Response to Loading. J Bone Miner Res 2020; 35:1494-1503. [PMID: 32227614 PMCID: PMC7725385 DOI: 10.1002/jbmr.4018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/08/2020] [Accepted: 03/21/2020] [Indexed: 12/28/2022]
Abstract
The enthesis is a mineralized fibrocartilage transition that attaches tendon to bone and is vital for musculoskeletal function. Despite recent studies demonstrating the necessity of muscle loading for enthesis formation, the mechanisms that regulate enthesis formation and mechanoresponsiveness remain unclear. Therefore, the current study investigated the role of the gap junction protein connexin 43 in these processes by deleting Gja1 (the Cx43 gene) in the tendon and enthesis. Compared with their wild-type (WT) counterparts, mice lacking Cx43 showed disrupted entheseal cell alignment, reduced mineralized fibrocartilage, and impaired biomechanical properties of the supraspinatus tendon entheses during postnatal development. Cx43-deficient mice also exhibited reduced ability to complete a treadmill running protocol but no apparent deficits in daily activity, metabolic indexes, shoulder muscle size, grip strength, and major trabecular bone properties of the adjacent humeral head. To examine enthesis mechanoresponsiveness, young adult mice were subjected to modest treadmill exercise. Gja1 deficiency in the tendon and enthesis reduced entheseal anabolic responses to treadmill exercise: WT mice had increased expression of Sox9, Ihh, and Gli1 and increased Brdu incorporation, whereas Cx43-deficient mice showed no changes or decreased levels with exercise. Collectively, the results demonstrated an essential role for Cx43 in postnatal tendon enthesis formation, function, and response to loading; results further provided evidence implicating a link between Cx43 function and the hedgehog signaling pathway. © 2020 American Society for Bone and Mineral Research.
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Affiliation(s)
- Hua Shen
- Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA
| | - Andrea G Schwartz
- Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA
| | - Roberto Civitelli
- Department of Internal Medicine, Division of Bone and Mineral Disease, Washington University, St. Louis, MO, USA
| | - Stavros Thomopoulos
- Department of Orthopedic Surgery, Columbia University, New York, NY, USA.,Department of Biomedical Engineering, Columbia University, New York, NY, USA
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120
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Yao Z, Xue T, Cai C, Li J, Lu M, Liu X, Jin T, Wu F, Liu S, Fan C. Parathyroid Hormone‐Loaded Microneedle Promotes Tendon Healing Through Activation of mTOR. ADVANCED THERAPEUTICS 2020. [DOI: 10.1002/adtp.202000025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Zhixiao Yao
- Department of OrthopaedicsShanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China
| | - Tong Xue
- School of PharmacyShanghai Jiao Tong University 800 Dongchuan Road Shanghai 200240 China
| | - Chuandong Cai
- Department of OrthopaedicsShanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China
| | - Juehong Li
- Department of OrthopaedicsShanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China
| | - Mingkuan Lu
- Department of OrthopaedicsShanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China
| | - Xudong Liu
- Department of OrthopaedicsShanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China
| | - Tuo Jin
- School of PharmacyShanghai Jiao Tong University 800 Dongchuan Road Shanghai 200240 China
| | - Fei Wu
- School of PharmacyShanghai Jiao Tong University 800 Dongchuan Road Shanghai 200240 China
| | - Shen Liu
- Department of OrthopaedicsShanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China
| | - Cunyi Fan
- Department of OrthopaedicsShanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China
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Friese N, Gierschner MB, Schadzek P, Roger Y, Hoffmann A. Regeneration of Damaged Tendon-Bone Junctions (Entheses)-TAK1 as a Potential Node Factor. Int J Mol Sci 2020; 21:E5177. [PMID: 32707785 PMCID: PMC7432881 DOI: 10.3390/ijms21155177] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 12/20/2022] Open
Abstract
Musculoskeletal dysfunctions are highly prevalent due to increasing life expectancy. Consequently, novel solutions to optimize treatment of patients are required. The current major research focus is to develop innovative concepts for single tissues. However, interest is also emerging to generate applications for tissue transitions where highly divergent properties need to work together, as in bone-cartilage or bone-tendon transitions. Finding medical solutions for dysfunctions of such tissue transitions presents an added challenge, both in research and in clinics. This review aims to provide an overview of the anatomical structure of healthy adult entheses and their development during embryogenesis. Subsequently, important scientific progress in restoration of damaged entheses is presented. With respect to enthesis dysfunction, the review further focuses on inflammation. Although molecular, cellular and tissue mechanisms during inflammation are well understood, tissue regeneration in context of inflammation still presents an unmet clinical need and goes along with unresolved biological questions. Furthermore, this review gives particular attention to the potential role of a signaling mediator protein, transforming growth factor beta-activated kinase-1 (TAK1), which is at the node of regenerative and inflammatory signaling and is one example for a less regarded aspect and potential important link between tissue regeneration and inflammation.
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Affiliation(s)
- Nina Friese
- Department of Orthopedic Surgery, Graded Implants and Regenerative Strategies, OE 8893, Laboratory for Biomechanics and Biomaterials, Hannover Medical School (MHH), 30625 Hannover, Germany; (N.F.); (M.B.G.); (P.S.); (Y.R.)
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), 30625 Hannover, Germany
| | - Mattis Benno Gierschner
- Department of Orthopedic Surgery, Graded Implants and Regenerative Strategies, OE 8893, Laboratory for Biomechanics and Biomaterials, Hannover Medical School (MHH), 30625 Hannover, Germany; (N.F.); (M.B.G.); (P.S.); (Y.R.)
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), 30625 Hannover, Germany
| | - Patrik Schadzek
- Department of Orthopedic Surgery, Graded Implants and Regenerative Strategies, OE 8893, Laboratory for Biomechanics and Biomaterials, Hannover Medical School (MHH), 30625 Hannover, Germany; (N.F.); (M.B.G.); (P.S.); (Y.R.)
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), 30625 Hannover, Germany
| | - Yvonne Roger
- Department of Orthopedic Surgery, Graded Implants and Regenerative Strategies, OE 8893, Laboratory for Biomechanics and Biomaterials, Hannover Medical School (MHH), 30625 Hannover, Germany; (N.F.); (M.B.G.); (P.S.); (Y.R.)
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), 30625 Hannover, Germany
| | - Andrea Hoffmann
- Department of Orthopedic Surgery, Graded Implants and Regenerative Strategies, OE 8893, Laboratory for Biomechanics and Biomaterials, Hannover Medical School (MHH), 30625 Hannover, Germany; (N.F.); (M.B.G.); (P.S.); (Y.R.)
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), 30625 Hannover, Germany
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Chen P, Li L, Dong L, Wang S, Huang Z, Qian Y, Wang C, Liu W, Yang L. Gradient Biomineralized Silk Fibroin Nanofibrous Scaffold with Osteochondral Inductivity for Integration of Tendon to Bone. ACS Biomater Sci Eng 2020; 7:841-851. [PMID: 33715375 DOI: 10.1021/acsbiomaterials.9b01683] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Enthesis injury repair remains a huge challenge because of the unique biomolecular composition, microstructure, and mechanics in the interfacial region. Surgical reconstruction often creates new bone-scaffold interfaces with mismatched properties, resulting in poor osseointegration. To mimic the natural interface tissue structures and properties, we fabricated a nanofibrous scaffold with gradient mineral coating based on 10 × simulated body fluid (SBF) and silk fibroin (SF). We then characterized the physicochemical properties of the scaffold and evaluated its biological functions both in vitro and in vivo. The results showed that different areas of SF nanofibrous scaffold had varying levels of mineralization with disparate mechanical properties and had different effects on bone marrow mesenchymal stem cell growth and differentiation. Furthermore, the gradient scaffolds exhibited an enhancement of integration in the tendon-to-bone interface with a higher ultimate load and more fibrocartilage-like tissue formation. These findings demonstrate that the silk-based nanofibrous scaffold with gradient mineral coating can regulate the formation of interfacial tissue and has the potential to be applied in interface tissue engineering.
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Affiliation(s)
- Peixing Chen
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, Bioengineering College, Chongqing University, Chongqing 400044, P. R. China
| | - Linhao Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, P. R. China
| | - Lili Dong
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, Bioengineering College, Chongqing University, Chongqing 400044, P. R. China
| | - Sixiang Wang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, Bioengineering College, Chongqing University, Chongqing 400044, P. R. China
| | - Zhi Huang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, Bioengineering College, Chongqing University, Chongqing 400044, P. R. China
| | - Yuna Qian
- Wenzhou Institute of Biomaterials & Engineering, University of Chinese Academy of Sciences, Wenzhou 325001, P. R. China
| | - Chunli Wang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, Bioengineering College, Chongqing University, Chongqing 400044, P. R. China
| | - Wanqian Liu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, Bioengineering College, Chongqing University, Chongqing 400044, P. R. China
| | - Li Yang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, Bioengineering College, Chongqing University, Chongqing 400044, P. R. China.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, P. R. China
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123
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林 奕, 蔡 武, 黄 锡, 李 箭, 李 棋. [The killer turn in the posterior cruciate ligament reconstruction: mechanism and improvement]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2020; 34:787-792. [PMID: 32538573 PMCID: PMC8171534 DOI: 10.7507/1002-1892.201907066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 01/20/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To summarize the research progress of killer turn in posterior cruciate ligament (PCL) reconstruction. METHODS The literature related to the killer turn in PCL reconstruction in recent years was searched and summarized. RESULTS The recent studies show that the killer turn is considered to be the most critical cause of graft relaxation after PCL reconstruction. In clinic, this effect can be reduced by changing the fixation mode of bone tunnel, changing the orientation of bone tunnel, squeezing screw fixation, retaining the remnant, and grinding the bone at the exit of bone tunnel. But there is still a lack of long-term follow-up. CONCLUSION There are still a lot of controversies on the improved strategies of the killer turn. More detailed basic researches focusing on biomechanics to further explore the mechanism of the reconstructed graft abrasion are needed.
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Affiliation(s)
- 奕鹏 林
- 四川大学华西医院骨科(成都 610041)Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - 武峰 蔡
- 四川大学华西医院骨科(成都 610041)Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - 锡豪 黄
- 四川大学华西医院骨科(成都 610041)Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - 箭 李
- 四川大学华西医院骨科(成都 610041)Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - 棋 李
- 四川大学华西医院骨科(成都 610041)Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
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Jiang N, He J, Zhang W, Li D, Lv Y. Directed differentiation of BMSCs on structural/compositional gradient nanofibrous scaffolds for ligament-bone osteointegration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 110:110711. [DOI: 10.1016/j.msec.2020.110711] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 01/26/2020] [Accepted: 01/30/2020] [Indexed: 12/11/2022]
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Chen C, Chen Y, Li M, Xiao H, Shi Q, Zhang T, Li X, Zhao C, Hu J, Lu H. Functional decellularized fibrocartilaginous matrix graft for rotator cuff enthesis regeneration: A novel technique to avoid in-vitro loading of cells. Biomaterials 2020; 250:119996. [PMID: 32334201 DOI: 10.1016/j.biomaterials.2020.119996] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/09/2020] [Accepted: 03/20/2020] [Indexed: 02/07/2023]
Abstract
Rapid and functional enthesis regeneration after rotator cuff tear (RCT) remains a challenge in clinic. Current tissue-engineering strategies for solving this challenge are focused on developing grafts with the mode of in-vitro loading cells on a scaffold. However, this mode is complicated and time-inefficient, moreover the preservation of this graft outside a cell incubator is highly inconvenient, thus limiting their clinical application. Developing a cell-free graft with chemotaxis to recruit postoperative injected cells may be a promising approach to solve these problems. Herein, we prepared a recombinant SDF-1α (termed as C-SDF-1α) capable of binding collagen and chemotaxis, which were then tethered on the collagen fibers of book-shaped decellularized fibrocartilage matrix (BDFM) to fabricate this cell-free graft (C-SDF-1α/BDFM). This C-SDF-1α/BDFM is noncytotoxicity and low-immunogenicity, allows synovium-derived mesenchymal stem cells (SMSCs) attachment and proliferation, and shows superior chondrogenic inducibility. More importantly, C-SDF-1α/BDFM released the tethered SDF-1α with a sustained release profile in-vitro and in-vivo, thus steadily recruiting chemokine (C-X-C motif) receptor 4 positive (CXCR4+) cells. Rats with RCT were repaired acutely with C-SDF-1α/BDFM together with postoperative CXCR4+SMSCs injection (C-SDF-1α/BDFM + CXCR4+SMSCs), BDFM in-vitro pre-loaded CXCR4+SMSCs (BDFM/CXCR4+SMSCs), or direct suture only (CTL). At postoperative 14-day, compared with BDFM/CXCR4+SMSCs, C-SDF-1α/BDFM + CXCR4+SMSCs showed a little more CXCR4+SMSCs at the healing site. At postoperative week 4 or 8, rats treated with C-SDF-1α/BDFM + CXCR4+SMSCs presented a similar RC healing quality as BDFM/CXCR4+SMSCs, both of which were significantly better than the CTL. Collectively, compared with conventional BDFM/CXCR4+SMSCs, C-SDF-1α/BDFM, as a cell-free graft with chemotaxis, could recruit postoperative injected CXCR4+cells into the healing site to participating RC healing, thus avoiding the complex process of in-vitro loading cells on a scaffold and necessitating immense care for the graft outside cell incubator, making it very convenient for clinical application.
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Affiliation(s)
- Can Chen
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China; Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China; Xiangya Hospital-International Chinese Musculeskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China; Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Yang Chen
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China; Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China; Xiangya Hospital-International Chinese Musculeskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Muzh Li
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China; Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China; Xiangya Hospital-International Chinese Musculeskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Han Xiao
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China; Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China; Xiangya Hospital-International Chinese Musculeskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Qiang Shi
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China; Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China; Xiangya Hospital-International Chinese Musculeskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Tao Zhang
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China; Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China; Xiangya Hospital-International Chinese Musculeskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Xing Li
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China; Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Chunfeng Zhao
- Division of Orthopedic Research and Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, United States
| | - Jianzhong Hu
- Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China; Xiangya Hospital-International Chinese Musculeskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China; Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
| | - Hongbin Lu
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China; Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China; Xiangya Hospital-International Chinese Musculeskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China.
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Xu G, Ding Z, Lu Q, Zhang X, Zhou X, Xiao L, Lu G, Kaplan DL. Electric field-driven building blocks for introducing multiple gradients to hydrogels. Protein Cell 2020; 11:267-285. [PMID: 32048173 PMCID: PMC7093350 DOI: 10.1007/s13238-020-00692-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 01/14/2020] [Indexed: 01/25/2023] Open
Abstract
Gradient biomaterials are considered as preferable matrices for tissue engineering due to better simulation of native tissues. The introduction of gradient cues usually needs special equipment and complex process but is only effective to limited biomaterials. Incorporation of multiple gradients in the hydrogels remains challenges. Here, beta-sheet rich silk nanofibers (BSNF) were used as building blocks to introduce multiple gradients into different hydrogel systems through the joint action of crosslinking and electric field. The blocks migrated to the anode along the electric field and gradually stagnated due to the solution-hydrogel transition of the systems, finally achieving gradient distribution of the blocks in the formed hydrogels. The gradient distribution of the blocks could be tuned easily through changing different factors such as solution viscosity, which resulted in highly tunable gradient of mechanical cues. The blocks were also aligned under the electric field, endowing orientation gradient simultaneously. Different cargos could be loaded on the blocks and form gradient cues through the same crosslinking-electric field strategy. The building blocks could be introduced to various hydrogels such as Gelatin and NIPAM, indicating the universality. Complex niches with multiple gradient cues could be achieved through the strategy. Silk-based hydrogels with suitable mechanical gradients were fabricated to control the osteogenesis and chondrogenesis. Chondrogenic-osteogenic gradient transition was obtained, which stimulated the ectopic osteochondral tissue regeneration in vivo. The versatility and highly controllability of the strategy as well as multifunction of the building blocks reveal the applicability in complex tissue engineering and various interfacial tissues.
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Affiliation(s)
- Gang Xu
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, China
- Department of Orthopedics, Affiliated Hospital of Xuzhou Medical University, Lianyungang, 222061, China
| | - Zhaozhao Ding
- Department of Burns and Plastic Surgery, Engineering Research Center of the Ministry of Education for Wound Repair Technology, The Affiliated Hospital of Jiangnan University, Wuxi, 214041, China
| | - Qiang Lu
- Department of Burns and Plastic Surgery, Engineering Research Center of the Ministry of Education for Wound Repair Technology, The Affiliated Hospital of Jiangnan University, Wuxi, 214041, China.
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou, 215123, China.
| | - Xiaoyi Zhang
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou, 215123, China
| | - Xiaozhong Zhou
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, China.
| | - Liying Xiao
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou, 215123, China
| | - Guozhong Lu
- Department of Burns and Plastic Surgery, Engineering Research Center of the Ministry of Education for Wound Repair Technology, The Affiliated Hospital of Jiangnan University, Wuxi, 214041, China.
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, MA, 02155, USA
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Kasahara M, Matsunaga S, Someya T, Kitamura K, Odaka K, Ishimoto T, Nakano T, Abe S, Hattori M. Micro- and nano-bone analyses of the human mandible coronoid process and tendon-bone entheses. J Biomed Mater Res B Appl Biomater 2020; 108:2799-2806. [PMID: 32190994 DOI: 10.1002/jbm.b.34609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 03/03/2020] [Accepted: 03/08/2020] [Indexed: 11/07/2022]
Abstract
The coronoid process provides attachment to temporalis and masseter muscles, and thus plays an important role in mastication. Tendons connect muscles and bones, mediating the transmission of functional loads to bones. Thus, tendon-bone entheses govern mechanical stress in bones. The preferential orientation of biological apatite (BAp) crystallites, the main mineral component in bones, is an important index for bone quality and function, and is largely influenced by locally applied stress. In this study, we analyzed BAp orientation, Young's modulus, and bone mineral density (BMD) at different sites in the human coronoid process. No differences in BMD were found among the analyzed sites, but BAp crystal orientation was observed to differ. BAp crystallites showed a uni-directional orientation in the mesiodistal direction at the coronoid process apex, but were oriented in the direction vertical to the occlusal plane at other sites. Young's modulus tended to vary according to the BAp orientation. At the apex, a tendon form with characteristics different from those at other sites, including the presence of a fibrocartilaginous layer that may act as a stretching brake to control stress concentration, was observed. These findings suggest that the functional pressure of the temporalis muscle affects bone quality and strength.
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Affiliation(s)
- Masaaki Kasahara
- Department of Dental Materials Science, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Satoru Matsunaga
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.,Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | - Tomoko Someya
- Department of Dental Materials Science, Tokyo Dental College, Tokyo, Japan
| | - Kei Kitamura
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.,Department of Histology and Developmental Biology, Tokyo, Japan
| | - Kento Odaka
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.,Department of Oral and Maxillofacial Radiology, Tokyo Dental College, Tokyo, Japan
| | - Takuya Ishimoto
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Osaka, Japan
| | - Takayoshi Nakano
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Osaka, Japan
| | - Shinichi Abe
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | - Masayuki Hattori
- Department of Dental Materials Science, Tokyo Dental College, Tokyo, Japan
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Li M, Tang Y, Chen C, Zhou J, Zheng C, Chen H, Lu H, Qu J. Comparison of bone surface and trough fixation on bone-tendon healing in a rabbit patella-patellar tendon injury model. J Orthop Translat 2020; 21:49-56. [PMID: 32099804 PMCID: PMC7029051 DOI: 10.1016/j.jot.2019.12.007] [Citation(s) in RCA: 3] [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] [Received: 05/14/2019] [Revised: 12/09/2019] [Accepted: 12/13/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Many orthopedic surgical procedures involve reattachment between tendon and bone. Whether bone-tendon healing is better facilitated by tendon fixation on a bone surface or within a tunnel is unknown. The purpose of this study was to comparatively evaluate the effects of bone surface versus bone trough fixation on bone-tendon healing in a rabbit patella-patellar tendon (PPT) injury model. METHODS The rabbits underwent partial patellectomy with patellar-tendon fixation on the osteotomy surface (bone surface fixation, BSF group) (n = 28) or within a bone trough (bone trough fixation, BTF group) (n = 28). The PPT interface was evaluated by macroscopic observation, micro-computed tomography scanning, histological analysis, and biomechanical testing at postoperative week 8 or week 16. RESULTS Macroscopically, no signs of infection or osteoarthritis were observed, and the regenerated tissue bridging the residual patella and patellar tendon showed no obvious difference between the two groups. There were significantly higher bone mineral density and trabecular thickness in BSF group compared with BTF group at week 8 (p < 0.05 for both). However, the bone volume fraction (BVF), bone mineral density and trabecular thickness in BSF group were significantly lower than those in BTF group (p < 0.05 for all) at week 16. Histological analysis demonstrated that new bone was formed at the proximal patella and reattached to the residual patellar tendon through a regenerated fibrocartilage-like tissue in both groups. There was more formation and better remodelling of fibrocartilage-like tissue in BTF group than BSF group at week 8 and week 16 (p < 0.05 for both). Biomechanical testing revealed that there was higher failure load and stiffness at the PPT interface in BTF group than BSF group at week 16 (p < 0.05 for both). CONCLUSIONS These results suggested that raptured tendon fixation in a bone trough resulted in superior bone-tendon healing in comparison with tendon fixation on bone surface in a rabbit PPT injury model. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE Although the structural and functional difference of knee joint between human and rabbit limit the results to be directly used in clinical, our research does offer a valuable reference for the improvement of reattachment between bone and tendon.
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Affiliation(s)
- Muzhi Li
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
- Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Central South University, Changsha, China
| | - Yifu Tang
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
- Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Central South University, Changsha, China
| | - Can Chen
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
- Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Central South University, Changsha, China
| | - Jiefu Zhou
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
- Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Central South University, Changsha, China
| | - Cheng Zheng
- Department of Orthopaedics, Hospital of Wuhan Sports University, Wuhan Sports University, Wuhan, China
| | - Huabin Chen
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
- Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Central South University, Changsha, China
| | - Hongbin Lu
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
- Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Central South University, Changsha, China
| | - Jin Qu
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
- Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Central South University, Changsha, China
- Corresponding author. No 87, Xiangya Road, Xiangya Hospital, Central South University, Changsha, 410008, China.
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Tendon and ligament mechanical loading in the pathogenesis of inflammatory arthritis. Nat Rev Rheumatol 2020; 16:193-207. [PMID: 32080619 DOI: 10.1038/s41584-019-0364-x] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2019] [Indexed: 12/18/2022]
Abstract
Mechanical loading is an important factor in musculoskeletal health and disease. Tendons and ligaments require physiological levels of mechanical loading to develop and maintain their tissue architecture, a process that is achieved at the cellular level through mechanotransduction-mediated fine tuning of the extracellular matrix by tendon and ligament stromal cells. Pathological levels of force represent a biological (mechanical) stress that elicits an immune system-mediated tissue repair pathway in tendons and ligaments. The biomechanics and mechanobiology of tendons and ligaments form the basis for understanding how such tissues sense and respond to mechanical force, and the anatomical extent of several mechanical stress-related disorders in tendons and ligaments overlaps with that of chronic inflammatory arthritis in joints. The role of mechanical stress in 'overuse' injuries, such as tendinopathy, has long been known, but mechanical stress is now also emerging as a possible trigger for some forms of chronic inflammatory arthritis, including spondyloarthritis and rheumatoid arthritis. Thus, seemingly diverse diseases of the musculoskeletal system might have similar mechanisms of immunopathogenesis owing to conserved responses to mechanical stress.
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Tang Y, Chen C, Liu F, Xie S, Qu J, Li M, Li Z, Li X, Shi Q, Li S, Li X, Hu J, Lu H. Structure and ingredient-based biomimetic scaffolds combining with autologous bone marrow-derived mesenchymal stem cell sheets for bone-tendon healing. Biomaterials 2020; 241:119837. [PMID: 32109704 DOI: 10.1016/j.biomaterials.2020.119837] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/10/2020] [Accepted: 01/30/2020] [Indexed: 12/21/2022]
Abstract
Tendon attaches to bone across a robust fibrocartilaginous tissue termed the bone-tendon interface (BTI), commonly injured in the field of sports medicine and orthopedics with poor prognosis. So far, there is still a lack of effective clinical interventions to achieve functional healing post BTI injury. However, tissue-engineering may be a promising treatment strategy. In this study, a gradient book-type triphasic (bone-fibrocartilage-tendon) scaffold is fabricated based on the heterogeneous structure and ingredient of BTI. After decellularization, the scaffold exhibits no residual cells, while the characteristic extracellular matrix of the original bone, fibrocartilage and tendon is well preserved. Meanwhile, the bone, fibrocartilage and tendon regions of the acellular scaffold are superior in osteogenic, chondrogenic and tenogenic inducibility, respectively. Furthermore, autologous bone marrow mesenchymal stem cell (BMSC) sheets (CS) combined with the acellular scaffolds is transplanted into the lesion site of a rabbit BTI injury model to investigate the therapeutic effects. Our results show that the CS modified scaffold not only successfully achieves triple biomimetic of BTI in structure, ingredient and cell distribution, but also effectively accelerates bone-tendon (B-T) healing. In general, this work demonstrates book-type acellular triphasic scaffold combined with autologous BMSCs sheets is a promising graft for repairing BTI injury.
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Affiliation(s)
- Yifu Tang
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, People's Republic of China
| | - Can Chen
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China
| | - Fei Liu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, People's Republic of China
| | - Shanshan Xie
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, People's Republic of China; Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, People's Republic of China
| | - Jin Qu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China
| | - Muzhi Li
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, People's Republic of China
| | - Zan Li
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, People's Republic of China
| | - Xiaoning Li
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China
| | - Qiang Shi
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, People's Republic of China
| | - Shengcan Li
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, People's Republic of China
| | - Xing Li
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, People's Republic of China
| | - Jianzhong Hu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, People's Republic of China; Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China.
| | - Hongbin Lu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, People's Republic of China; Xiangya Hospital-International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, People's Republic of China.
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Zhang J, Liu Z, Tang J, Li Y, You Q, Yang J, Jin Y, Zou G, Ge Z, Zhu X, Yang Q, Liu Y. Fibroblast growth factor 2-induced human amniotic mesenchymal stem cells combined with autologous platelet rich plasma augmented tendon-to-bone healing. J Orthop Translat 2020; 24:155-165. [PMID: 33101966 PMCID: PMC7548348 DOI: 10.1016/j.jot.2020.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 01/07/2020] [Accepted: 01/13/2020] [Indexed: 01/09/2023] Open
Abstract
Objective The purpose of this study was to explore the effect of fibroblast growth factor 2 (FGF-2) on collagenous fibre formation and the osteogenic differentiation of human amniotic mesenchymal stem cells (hAMSCs) in vitro, as well as the effect of FGF-2–induced hAMSCs combined with autologous platelet-rich plasma (PRP) on tendon-to-bone healing in vivo. Methods In vitro, hAMSCs were induced by various concentrations of FGF-2 (0, 10, 20, and 40 ng/ml) for 14 days, and the outcomes of ligamentous differentiation and osteogenic differentiation were detected by quantitative real-time reverse transcription PCR, Western blot, immunofluorescence, and picrosirius red staining. In addition, a lentivirus carrying the FGF-2 gene was used to transfect hAMSCs, and transfection efficiency was detected by quantitative real time reverse transcription PCR (qRT-PCR) and Western blot. In vivo, the effect of hAMSCs transfected with the FGF-2 gene combined with autologous PRP on tendon-to-bone healing was detected via histological examination, as well as biomechanical analysis and radiographic analysis. Results In vitro, different concentrations of FGF-2 (10, 20, and 40 ng/ml) all promoted the ligamentous differentiation and osteogenic differentiation of hAMSCs, and the low concentration of FGF-2 (10 ng/ml) had a good effect on differentiation. In addition, the lentivirus carrying the FGF-2 gene was successfully transfected into hAMSCs with an optimal multiplicity of infection (MOI) (50), and autologous PRP was prepared successfully. In vivo, the hAMSCs transfected with the FGF-2 gene combined with autologous PRP had a better effect on tendon-to-bone healing than the other groups (p < 0.05), as evidenced by histological examination, biomechanical analysis, and radiographic analysis. Conclusion hAMSCs transfected with the FGF-2 gene combined with autologous PRP could augment tendon-to-bone healing in a rabbit extra-articular model. The translational potential of this article hAMSCs transfected with the FGF-2 gene combined with autologous PRP may be a good clinical treatment for tendon-to-bone healing, especially for acute sports-related tendon–ligament injuries.
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Affiliation(s)
- Jun Zhang
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, China
| | - Ziming Liu
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, China
| | - Jingfeng Tang
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, China
| | - Yuwan Li
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Qi You
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, China
| | - Jibin Yang
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, China
| | - Ying Jin
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, China
| | - Gang Zou
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, China
| | - Zhen Ge
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, China
| | - Xizhong Zhu
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, China
| | - Qifan Yang
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, China
| | - Yi Liu
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, China
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Cao Y, Yang S, Zhao D, Li Y, Cheong SS, Han D, Li Q. Three-dimensional printed multiphasic scaffolds with stratified cell-laden gelatin methacrylate hydrogels for biomimetic tendon-to-bone interface engineering. J Orthop Translat 2020; 23:89-100. [PMID: 32514393 PMCID: PMC7267011 DOI: 10.1016/j.jot.2020.01.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/18/2019] [Accepted: 01/13/2020] [Indexed: 12/18/2022] Open
Abstract
Background The anatomical properties of the enthesis of the rotator cuff are hardly regained during the process of healing. The tendon-to-bone interface is normally replaced by fibrovascular tissue instead of interposition fibrocartilage, which impairs biomechanics in the shoulder and causes dysfunction. Tissue engineering offers a promising strategy to regenerate a biomimetic interface. Here, we report heterogeneous tendon-to-bone interface engineering based on a 3D-printed multiphasic scaffold. Methods A multiphasic poly(ε-caprolactone) (PCL)–PCL/tricalcium phosphate (TCP)–PCL/TCP porous scaffold was manufactured using 3D printing technology. The three phases of the scaffold were designed to mimic the graded tissue regions in the tendon-to-bone interface—tendon, fibrocartilage, and bone. Fibroblasts, bone marrow–derived mesenchymal stem cells, and osteoblasts were separately encapsulated in gelatin methacrylate (GelMA) and loaded seriatim on the relevant phases of the scaffold, by which a cells/GelMA-multiphasic scaffold (C/G-MS) construct, replicating the native interface, was fabricated. Cell proliferation, viability, and chondrogenic differentiation were evaluated in vitro. The C/G-MS constructs were further examined to determine the potential of regenerating a continuous interface with gradual transition of teno-, fibrocartilage- and osteo-like tissues in vivo. Results In vitro tests confirmed the good cytocompatibility of the constructs. After seven days in culture, cellular microfilament staining indicated that not only could cells well proliferate in GelMA hydrogels but also efficiently attach to and grow on scaffold fibres. Moreover, by immunolocalizing collagen type II, chondrogenesis was identified in the intermediate phase of the C/G-MS construct that had been treated with transforming growth factor β3 for 21 days. After subcutaneous implantation in mice, the C/G-MS construct exhibited a heterogeneous and graded structure up to eight weeks, with distinguished matrix distribution observed at one week. Overall, gene expression of tenogenic, chondrogenic, and osteogenic markers showed increasing patterns for eight weeks. Among them, expression of collagen type X gene was found drastically increasing during eight weeks, indicating progressive formation of calcifying cartilage within the constructs. Conclusion Our findings demonstrate that the stratified manner of fabrication based on the 3D-printed multiphasic scaffold is an effective strategy for tendon-to-bone interface engineering in terms of efficient cell seeding, chondrogenic potential, and distinct matrix deposition in varying phases. The translational potential of this article We fabricated a biomimetic tendon-to-bone interface by using a 3D-printed multiphasic scaffold and adopting a stratified cell-seeding manner with GelMA. The biomimetic interface might have applications in tendon-to-bone repair in the rotator cuff. It can not only be an alternative to a biological fixation device but also offer an ex vivo living graft to replace the damaged enthesis.
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Affiliation(s)
- Yi Cao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengbing Yang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danyang Zhao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sou San Cheong
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Han
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Corresponding author. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 17/F, No. 1 Building, 639 Zhi Zao Ju Road, Shanghai, 200011, PR China.
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Corresponding author. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 19/F, No. 1 Building, 639 Zhi Zao Ju Road, Shanghai, 200011, PR China.
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Li H, Wu T, Xue J, Ke Q, Xia Y. Transforming Nanofiber Mats into Hierarchical Scaffolds with Graded Changes in Porosity and/or Nanofiber Alignment. Macromol Rapid Commun 2020; 41:e1900579. [PMID: 31867797 PMCID: PMC7772797 DOI: 10.1002/marc.201900579] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/02/2019] [Indexed: 12/30/2022]
Abstract
A method for generating hierarchical scaffolds with graded changes in porosity and/or fiber alignment through solution-masked, vapor-induced welding of electrospun poly(lactic-co-glycolic acid) (PLGA) nanofibers is reported. The success of this method relies on the fact that the PLGA nanofibers are swollen and welded more slowly by ethanol when immersed in its aqueous solution relative to direct exposure to its vapor. For a mat composed of random nanofibers, the treatment generates a gradation in porosity (both surface and bulk), with the over-welded region evolving from a highly porous mat into a dense film. If uniaxially aligned nanofibers are involved, however, graded changes are observed in both surface porosity and fiber alignment. When bone marrow stem cells are cultured on such a scaffold, they exhibit highly organized and random morphologies on the regions of uniaxially aligned nanofibers and dense film, respectively, with gradual changes in between. Such a scaffold shows promise in mimicking the connective tissue, such as the tendon-to-bone insertion, that relies on a graded transition in cell morphology from uniaxially aligned to random.
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Affiliation(s)
- Haoxuan Li
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
- Key Laboratory of Textile Science and Technology, College of Textiles, Donghua University, Shanghai, 201620, P. R. China
| | - Tong Wu
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
| | - Jiajia Xue
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
| | - Qinfei Ke
- Key Laboratory of Textile Science and Technology, College of Textiles, Donghua University, Shanghai, 201620, P. R. China
| | - Younan Xia
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
- School of Chemistry and Biochemistry, School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
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Mechanism of muscle–tendon–bone complex development in the head. Anat Sci Int 2020; 95:165-173. [DOI: 10.1007/s12565-019-00523-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 12/24/2019] [Indexed: 12/11/2022]
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FGF-2-Induced Human Amniotic Mesenchymal Stem Cells Seeded on a Human Acellular Amniotic Membrane Scaffold Accelerated Tendon-to-Bone Healing in a Rabbit Extra-Articular Model. Stem Cells Int 2020; 2020:4701476. [PMID: 32399042 PMCID: PMC7199597 DOI: 10.1155/2020/4701476] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/02/2019] [Accepted: 12/14/2019] [Indexed: 01/26/2023] Open
Abstract
Background FGF-2 (basic fibroblast growth factor) has a positive effect on the proliferation and differentiation of many kinds of MSCs. Therefore, it represents an ideal molecule to facilitate tendon-to-bone healing. Nonetheless, no studies have investigated the application of FGF-2-induced human amniotic mesenchymal stem cells (hAMSCs) to accelerate tendon-to-bone healing in vivo. Objective The purpose of this study was to explore the effect of FGF-2 on chondrogenic differentiation of hAMSCs in vitro and the effect of FGF-2-induced hAMSCs combined with a human acellular amniotic membrane (HAAM) scaffold on tendon-to-bone healing in vivo. Methods In vitro, hAMSCs were transfected with a lentivirus carrying the FGF-2 gene, and the potential for chondrogenic differentiation of hAMSCs induced by the FGF-2 gene was assessed using immunofluorescence and toluidine blue (TB) staining. HAAM scaffold was prepared, and hematoxylin and eosin (HE) staining and scanning electron microscopy (SEM) were used to observe the microstructure of the HAAM scaffold. hAMSCs transfected with and without FGF-2 were seeded on the HAAM scaffold at a density of 3 × 105 cells/well. Immunofluorescence staining of vimentin and phalloidin staining were used to confirm cell adherence and growth on the HAAM scaffold. In vivo, the rabbit extra-articular tendon-to-bone healing model was created using the right hind limb of 40 New Zealand White rabbits. Grafts mimicking tendon-to-bone interface (TBI) injury were created and subjected to treatment with the HAAM scaffold loaded with FGF-2-induced hAMSCs, HAAM scaffold loaded with hAMSCs only, HAAM scaffold, and no special treatment. Macroscopic observation, imageological analysis, histological assessment, and biomechanical analysis were conducted to evaluate tendon-to-bone healing after 3 months. Results In vitro, cartilage-specific marker staining was positive for the FGF-2 overexpression group. The HAAM scaffold displayed a netted structure and mass extracellular matrix structure. hAMSCs or hAMSCs transfected with FGF-2 survived on the HAAM scaffold and grew well. In vivo, the group treated with HAAM scaffold loaded with FGF-2-induced hAMSCs had the narrowest bone tunnel after three months as compared with other groups. In addition, macroscopic and histological scores were higher for this group than for the other groups, along with the best mechanical strength. Conclusion hAMSCs transfected with FGF-2 combined with the HAAM scaffold could accelerate tendon-to-bone healing in a rabbit extra-articular model.
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Abstract
With the rapidly development of clinical treatments, precision medicine has come to people eyes with the requirement according to different people and different disease situation. So precision medicine is called personalized medicine which is a new frontier of healthcare. Bone tissue engineering developed from traditional bone graft to precise medicine era. So scientists seek approaches to harness stem cells, scaffolds, growth factors, and extracellular matrix to promise enhanced and more reliable bone formation. This review provides an overview of novel developments on precision medicine in tissue engineering of bone hoping it can open new perspectives of strategies on bone treatment.
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Affiliation(s)
| | | | - Rong Zhou
- Department of Stomatology, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Haixia Liu
- Department of Stomatology, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shengcai Qi
- Department of Stomatology, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Raorao Wang
- Department of Stomatology, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China.
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Kamalitdinov TB, Fujino K, Shetye SS, Jiang X, Ye Y, Rodriguez AB, Kuntz AF, Zgonis MH, Dyment NA. Amplifying Bone Marrow Progenitors Expressing α-Smooth Muscle Actin Produce Zonal Insertion Sites During Tendon-to-Bone Repair. J Orthop Res 2020; 38:105-116. [PMID: 31228280 PMCID: PMC6917878 DOI: 10.1002/jor.24395] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/06/2019] [Indexed: 02/04/2023]
Abstract
Traditional tendon-to-bone repair where the tendon is reattached to bone via suture anchors often results in disorganized scar production rather than the formation of a zonal insertion. In contrast, ligament reconstructions where tendon grafts are passed through bone tunnels can yield zonal tendon-to-bone attachments between the graft and adjacent bone. Therefore, ligament reconstructions can be used to study mechanisms that regulate zonal tendon-to-bone repair in the adult. Anterior cruciate ligament (ACL) reconstructions are one of the most common reconstruction procedures and while we know that cells from outside the graft produce the attachments, we have not yet established specific cell populations that give rise to this tissue. To address this knowledge gap, we performed ACL reconstructions in lineage tracing mice where α-smooth muscle actin (αSMACreERT2) was used to label αSMA-expressing progenitors within the bone marrow that produced zonal attachments. Expression of αSMA was increased during early stages of the repair process such that the contribution of SMA-labeled cells to the tunnel integration was highest when tamoxifen was delivered in the first week post-surgery. The zonal attachments shared features with normal entheses, including tidemarks oriented perpendicularly to collagen fibers, Col1a1-expressing cells, alkaline phosphatase activity, and proteoglycan-rich staining. Finally, the integration strength increased with time, requiring 112% greater force to remove the graft from the tunnel at 28 days compared with 14 days post-surgery. Future studies will target these progenitor cells to define the pathways that regulate zonal tendon-to-bone repair in the adult. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:105-116, 2020.
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Affiliation(s)
- Timur B. Kamalitdinov
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Keitaro Fujino
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA,Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Snehal S. Shetye
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Xi Jiang
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Yaping Ye
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Ashley B. Rodriguez
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew F. Kuntz
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Miltiadis H. Zgonis
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Nathaniel A. Dyment
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
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Improved cellular bioactivity by heparin immobilization on polycarbonate film via an aminolysis modification for potential tendon repair. Int J Biol Macromol 2020; 142:835-845. [DOI: 10.1016/j.ijbiomac.2019.09.136] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/23/2019] [Accepted: 09/30/2019] [Indexed: 12/19/2022]
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Claudel M, Jouzeau JY, Cailotto F. Secreted Frizzled-related proteins (sFRPs) in osteo-articular diseases: much more than simple antagonists of Wnt signaling? FEBS J 2019; 286:4832-4851. [PMID: 31677330 DOI: 10.1111/febs.15119] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/10/2019] [Accepted: 10/31/2019] [Indexed: 12/30/2022]
Abstract
Osteo-articular diseases are characterized by a dysregulation of joint and/or bone homeostasis. These include diseases affecting the joints originally, such as osteoarthritis and rheumatoid arthritis, or the bone, such as osteoporosis. Inflammation and the involvement of Wingless-related integration site (Wnt) signaling pathways are key pathophysiological features of these diseases resulting in tissue degradation by matrix-degrading enzymes, namely matrix metalloproteinases (MMPs) and a disintegrin and metalloproteinases with thrombospondin motifs (ADAMTs), secreted by the joint resident cells and/or by infiltrating immune cells. Activation of Wnt signaling pathways is modulated by different families of proteins, including Dickkopfs and the secreted Frizzled-related proteins (sFRPs). The sFRP family is composed of five secreted glycoproteins in mammals that regulate Wnt signaling in the extracellular compartment. Indeed, sFRPs are able to bind both to the soluble Wnt ligands and to their cell membrane receptors, the Frizzled proteins. Their expression profile is altered in osteo-articular diseases, suggesting that they could account for the abnormal activation of Wnt pathways. In the present article, we review how sFRPs are more than simple antagonists of the Wnt signaling pathways and discuss their pathophysiological relevance in the context of osteo-articular diseases. We detail their Wnt-dependent and their Wnt-independent roles, with a particular emphasis on their ability to modulate the inflammatory response and extracellular matrix (ECM) remodeling. We also discuss their potential therapeutic use with a focus on bone remodeling, osteo-articular cancers, and tissue engineering.
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Affiliation(s)
- Marion Claudel
- UMR 7365 CNRS-UL IMoPA, Biopôle de l'Université de Lorraine, Vandoeuvre-Les-Nancy, France
| | - Jean-Yves Jouzeau
- UMR 7365 CNRS-UL IMoPA, Biopôle de l'Université de Lorraine, Vandoeuvre-Les-Nancy, France
| | - Frédéric Cailotto
- UMR 7365 CNRS-UL IMoPA, Biopôle de l'Université de Lorraine, Vandoeuvre-Les-Nancy, France
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Han F, Zhang P, Chen T, Lin C, Wen X, Zhao P. A LbL-Assembled Bioactive Coating Modified Nanofibrous Membrane for Rapid Tendon-Bone Healing in ACL Reconstruction. Int J Nanomedicine 2019; 14:9159-9172. [PMID: 31819424 PMCID: PMC6883935 DOI: 10.2147/ijn.s214359] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 10/21/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction In anterior cruciate ligament (ACL) reconstruction, hamstring tendon autograft is a well-accepted surgical choice as an alternative ACL graft. But the main disadvantage of autograft is its inefficient healing with host bone-tunnel which will leading to surgery failure. Methods A biomimetic nanofibrous membrane for tendon-bone integration is fabricated in this work, which is composed of polycaprolactone (PCL) electrospinning membrane and chitosan/hyaluronic acid (CS/HA) multilayers film. Results By using layer-by-layer (LbL) self-assembly this functional CS/HA multilayer films are deposited on the surface of PCL nanofiber to enable the local delivery of stromal cell-derived factor-1 α (SDF-1α) and bone morphogenetic protein-2 (BMP-2) in tendon-bone interface. This membrane can promote cell proliferation and recruitment, as well as inducing the osteogenic differentiation and recruitment of BMSCs. Conclusion Further in vivo studies demonstrate that to wrap the tendon autograft using the membrane may afford superior tendon-bone integration and inhibit scar tissue formation in a rabbit ACL reconstruction model. More importantly, the biomechanical properties of the tendon-bone interface have been improved. This study shows that this biomimetic nanofibrous membrane is effective for improving tendon-bone healing after ACL reconstruction surgery.
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Affiliation(s)
- Fei Han
- Institute for Translational Medicine, Institute for Biomedical Engineering and Nanoscience, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200092, People's Republic of China
| | - Peng Zhang
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, People's Republic of China
| | - Tianwu Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, People's Republic of China
| | - Chao Lin
- Institute for Translational Medicine, Institute for Biomedical Engineering and Nanoscience, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200092, People's Republic of China
| | - Xuejun Wen
- Institute for Translational Medicine, Institute for Biomedical Engineering and Nanoscience, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200092, People's Republic of China
| | - Peng Zhao
- Institute for Translational Medicine, Institute for Biomedical Engineering and Nanoscience, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200092, People's Republic of China
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141
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Kwon DR, Park GY, Lee SC. Regenerative effects of mesenchymal stem cells by dosage in a chronic rotator cuff tendon tear in a rabbit model. Regen Med 2019; 14:1001-1012. [PMID: 31726959 DOI: 10.2217/rme-2018-0125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim: We investigated the therapeutic effects and optimal dose of human umbilical cord blood (UCB)-derived mesenchymal stem cell (MSC) injection in a chronic full-thickness rotator cuff tendon tear. Methods: Rabbits (n = 30) were allocated into three groups (normal saline, G1-Sal; 1 × 106 cells UCB-MSC, G2-Low; 2 × 106 cells UCB-MSC, G3-High). Injections were done into the chronic full-thickness rotator cuff tendon tear 6 weeks after a full-thickness tendon tear of the subscapularis was created. Gross & histologic evaluation and motion analysis was done at pre and 4 weeks post-injection. Results: There were no significant differences in tear size and motion analysis parameters 4 weeks after injection between G2-Low and G3-High. Conclusion: The benefits of UCB-MSCs are not dose-dependent in a rabbit model.
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Affiliation(s)
- Dong Rak Kwon
- Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Gi-Young Park
- Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Sang Chul Lee
- Department & Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
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142
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Grier WK, Sun Han Chang RA, Ramsey MD, Harley BA. The influence of cyclic tensile strain on multi-compartment collagen-GAG scaffolds for tendon-bone junction repair. Connect Tissue Res 2019; 60:530-543. [PMID: 31007094 PMCID: PMC6706312 DOI: 10.1080/03008207.2019.1601183] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background: Orthopedic injuries often occur at the interface between soft tissues and bone. The tendon-bone junction (TBJ) is a classic example of such an interface. Current clinical strategies for TBJ injuries prioritize mechanical reattachment over regeneration of the native interface, resulting in poor outcomes. The need to promote regenerative healing of spatially-graded tissues inspires our effort to develop new tissue engineering technologies that replicate features of the spatially-graded extracellular matrix and strain profiles across the native TBJ. Materials and Methods: We recently described a biphasic collagen-glycosaminoglycan (CG) scaffold containing distinct compartment with divergent mineral content and structural alignment (isotropic vs. anisotropic) linked by a continuous interface zone to mimic structural and compositional features of the native TBJ. Results: Here, we report application of cyclic tensile strain (CTS) to the scaffold via a bioreactor leads to non-uniform strain profiles across the spatially-graded scaffold. Further, combinations of CTS and matrix structural features promote rapid, spatially-distinct differentiation profiles of human bone marrow-derived mesenchymal stem cells (MSCs) down multiple osteotendinous lineages. CTS preferentially upregulates MSC activity and tenogenic differentiation in the anisotropic region of the scaffold. This work demonstrates a tissue engineering approach that couples instructive biomaterials with cyclic tensile stimuli to promote regenerative healing of orthopedic interfaces.
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Affiliation(s)
- William K. Grier
- Dept. Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Raul A. Sun Han Chang
- Dept. Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Matthew D. Ramsey
- Dept. Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Brendan A.C. Harley
- Dept. Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801,Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801
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143
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Song W, Ma Z, Wang C, Li H, He Y. Pro-chondrogenic and immunomodulatory melatonin-loaded electrospun membranes for tendon-to-bone healing. J Mater Chem B 2019; 7:6564-6575. [PMID: 31588948 DOI: 10.1039/c9tb01516g] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Reconstructing the native structure of the tendon-to-bone insertion site (enthesis) in rotator cuff repair has always been a great challenge for orthopedic surgeons. Difficulty arises mainly due to the limited enthesis regenerative capability and severe inflammatory cell infiltration, which result in fibrovascular scar formation instead of native cartilage-like enthesis. Therefore, tissue engineering scaffolds with pro-chondrogenic and immunomodulatory capabilities may offer a new strategy for native enthesis regeneration. In this study, melatonin-loaded aligned polycaprolactone (PCL) electrospun fibrous membranes were fabricated. The sustained release of melatonin from this membrane significantly promoted the chondrogenic differentiation of human bone marrow-derived mesenchymal stem cells (hBMSCs) in a long-term chondroid pellet model. After the membranes were implanted in a rat acute rotator cuff tear model, melatonin-loaded PCL membranes inhibited macrophage infiltration in the tendon-to-bone interface at the early healing phase, increasing chondroid zone formation, promoting collagen maturation, decreasing fibrovascular tissue formation and eventually improving the biomechanical strength of the regenerated enthesis. Taken together, melatonin-loaded PCL membranes possess great clinical application potential for tendon-to-bone healing.
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Affiliation(s)
- Wei Song
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
| | - Zhijie Ma
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China and School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China.
| | - Chongyang Wang
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
| | - Haiyan Li
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China and School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China.
| | - Yaohua He
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China. and Department of Orthopedics, Shanghai Sixth People's Hospital, Jinshan Branch, 147 Jiankang Road, Shanghai 201599, China
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144
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Jung O, Porchetta D, Schroeder ML, Klein M, Wegner N, Walther F, Feyerabend F, Barbeck M, Kopp A. In Vivo Simulation of Magnesium Degradability Using a New Fluid Dynamic Bench Testing Approach. Int J Mol Sci 2019; 20:ijms20194859. [PMID: 31574947 PMCID: PMC6801401 DOI: 10.3390/ijms20194859] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/21/2019] [Accepted: 09/23/2019] [Indexed: 12/12/2022] Open
Abstract
The degradation rate of magnesium (Mg) alloys is a key parameter to develop Mg-based biomaterials and ensure in vivo-mechanical stability as well as to minimize hydrogen gas production, which otherwise can lead to adverse effects in clinical applications. However, in vitro and in vivo results of the same material often differ largely. In the present study, a dynamic test bench with several single bioreactor cells was constructed to measure the volume of hydrogen gas which evolves during magnesium degradation to indicate the degradation rate in vivo. Degradation medium comparable with human blood plasma was used to simulate body fluids. The media was pumped through the different bioreactor cells under a constant flow rate and 37 °C to simulate physiological conditions. A total of three different Mg groups were successively tested: Mg WE43, and two different WE43 plasma electrolytically oxidized (PEO) variants. The results were compared with other methods to detect magnesium degradation (pH, potentiodynamic polarization (PDP), cytocompatibility, SEM (scanning electron microscopy)). The non-ceramized specimens showed the highest degradation rates and vast standard deviations. In contrast, the two PEO samples demonstrated reduced degradation rates with diminished standard deviation. The pH values showed above-average constant levels between 7.4–7.7, likely due to the constant exchange of the fluids. SEM revealed severe cracks on the surface of WE43 after degradation, whereas the ceramized surfaces showed significantly decreased signs of corrosion. PDP results confirmed the improved corrosion resistance of both PEO samples. While WE43 showed slight toxicity in vitro, satisfactory cytocompatibility was achieved for the PEO test samples. In summary, the dynamic test bench constructed in this study enables reliable and simple measurement of Mg degradation to simulate the in vivo environment. Furthermore, PEO treatment of magnesium is a promising method to adjust magnesium degradation.
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Affiliation(s)
- Ole Jung
- Department of Oral Maxillofacial Surgery, University Medical Center, 20246 Hamburg-Eppendorf, Germany.
| | - Dario Porchetta
- Department of Materials Test Engineering (WPT), TU Dortmund University, 44227 Dortmund, Germany.
- Meotec GmbH, 52068 Aachen, Germany.
| | - Marie-Luise Schroeder
- Department of Oral Maxillofacial Surgery, University Medical Center, 20246 Hamburg-Eppendorf, Germany.
| | - Martin Klein
- Department of Materials Test Engineering (WPT), TU Dortmund University, 44227 Dortmund, Germany.
| | - Nils Wegner
- Department of Materials Test Engineering (WPT), TU Dortmund University, 44227 Dortmund, Germany.
| | - Frank Walther
- Department of Materials Test Engineering (WPT), TU Dortmund University, 44227 Dortmund, Germany.
| | - Frank Feyerabend
- Institute of Materials Research, Division Metallic Biomaterials, Helmholtz-Zentrum Geesthacht, 21502 Geesthacht, Germany.
| | - Mike Barbeck
- Department of Oral Maxillofacial Surgery, University Medical Center, 20246 Hamburg-Eppendorf, Germany.
- BerlinAnalytix GmbH, 12109 Berlin, Germany.
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145
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Blaudez F, Ivanovski S, Hamlet S, Vaquette C. An overview of decellularisation techniques of native tissues and tissue engineered products for bone, ligament and tendon regeneration. Methods 2019; 171:28-40. [PMID: 31394166 DOI: 10.1016/j.ymeth.2019.08.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 12/14/2022] Open
Abstract
Decellularised tissues and organs have been successfully used in a variety of tissue engineering/regenerative medicine applications. Because of the complexity of each tissue (size, porosity, extracellular matrix (ECM) composition etc.), there is no standardised protocol and the decellularisation methods vary widely, thus leading to heterogeneous outcomes. Physical, chemical, and enzymatic methods have been developed and optimised for each specific application and this review describes the most common strategies utilised to achieve decellularisation of soft and hard tissues. While removal of the DNA is the primary goal of decellularisation, it is generally achieved at the expense of ECM preservation due to the harsh chemical or enzymatic processing conditions. As denaturation of the native ECM has been associated with undesired host responses, decellularisation conditions aimed at effectively achieving simultaneous DNA removal and minimal ECM damage will be highlighted. Additionally, the utilisation of decellularised matrices in regenerative medicine is explored, as are the most recent strategies implemented to circumvent challenges in this field. In summary, this review focusses on the latest advancements and future perspectives in the utilisation of natural ECM for the decoration of synthetic porous scaffolds.
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Affiliation(s)
- F Blaudez
- Griffith University, School of Dentistry, Gold Coast, Australia
| | - S Ivanovski
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia
| | - S Hamlet
- Griffith University, School of Dentistry, Gold Coast, Australia
| | - C Vaquette
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia.
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146
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Roberts RR, Bobzin L, Teng CS, Pal D, Tuzon CT, Schweitzer R, Merrill AE. FGF signaling patterns cell fate at the interface between tendon and bone. Development 2019; 146:dev.170241. [PMID: 31320326 DOI: 10.1242/dev.170241] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 06/21/2019] [Indexed: 12/17/2022]
Abstract
Tendon and bone are attached by a transitional connective tissue that is morphologically graded from tendinous to osseous and develops from bipotent progenitors that co-express scleraxis (Scx) and Sox9 (Scx+/Sox9+). Scx+/Sox9+ progenitors have the potential to differentiate into either tenocytes or chondrocytes, yet the developmental mechanism that spatially resolves their bipotency at the tendon-bone interface during embryogenesis remains unknown. Here, we demonstrate that development of Scx+/Sox9+ progenitors within the mammalian lower jaw requires FGF signaling. We find that loss of Fgfr2 in the mouse tendon-bone interface reduces Scx expression in Scx+/Sox9+ progenitors and induces their biased differentiation into Sox9+ chondrocytes. This expansion of Sox9+ chondrocytes, which is concomitant with decreased Notch2-Dll1 signaling, prevents formation of a mixed population of chondrocytes and tenocytes, and instead results in ectopic endochondral bone at tendon-bone attachment units. Our work shows that FGF signaling directs zonal patterning at the boundary between tendon and bone by regulating cell fate decisions through a mechanism that employs Notch signaling.
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Affiliation(s)
- Ryan R Roberts
- Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA.,Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Lauren Bobzin
- Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA.,Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Camilla S Teng
- Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.,Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, CA 90033, USA
| | - Deepanwita Pal
- Research Division, Shriners Hospital for Children, Oregon Health & Science University, Portland, OR 97239, USA
| | - Creighton T Tuzon
- Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA.,Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Ronen Schweitzer
- Research Division, Shriners Hospital for Children, Oregon Health & Science University, Portland, OR 97239, USA
| | - Amy E Merrill
- Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA .,Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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147
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Calejo I, Costa-Almeida R, Reis RL, Gomes ME. Enthesis Tissue Engineering: Biological Requirements Meet at the Interface. TISSUE ENGINEERING PART B-REVIEWS 2019; 25:330-356. [DOI: 10.1089/ten.teb.2018.0383] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Isabel Calejo
- 3B's Research Group, I3Bs—Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Raquel Costa-Almeida
- 3B's Research Group, I3Bs—Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rui L. Reis
- 3B's Research Group, I3Bs—Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
- The Discoveries Center for Regenerative and Precision Medicine, Headquarters at University of Minho, Guimarães, Portugal
| | - Manuela E. Gomes
- 3B's Research Group, I3Bs—Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
- The Discoveries Center for Regenerative and Precision Medicine, Headquarters at University of Minho, Guimarães, Portugal
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148
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Lu H, Tang Y, Liu F, Xie S, Qu J, Chen C. Comparative Evaluation of the Book-Type Acellular Bone Scaffold and Fibrocartilage Scaffold for Bone-Tendon Healing. J Orthop Res 2019; 37:1709-1722. [PMID: 30977542 DOI: 10.1002/jor.24301] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/16/2019] [Accepted: 03/25/2019] [Indexed: 02/04/2023]
Abstract
Bone-tendon (B-T) healing is a clinical challenge due to its limited regeneration capability. Fibrocartilage regeneration and bone formation at the healing site are two critical factors for B-T healing. Promoting fibrocartilage regeneration and bone formation by tissue-engineering may be a promising treatment strategy. In this study, we innovatively fabricated two kinds of acellular scaffolds from bone or fibrocartilage tissues, namely the book-type the acellular bone scaffold (BABS) and the book-type acellular fibrocartilage scaffold (BAFS). Histologically, the two scaffolds well preserved the native extracellular matrix (ECM) structure without cellular components. In vitro studies showed BABS is superior in osteogenic inducibility, while BAFS has good chondrogenic inducibility. To comparatively investigate the efficacy on B-T healing, the BABS or BAFS were, respectively, implanted into a rabbit partial patellectomy model. Macroscopically, a regenerated bone-tendon insertion (BTI) was bridging the residual patella and patellar-tendon with no signs of infection and osteoarthritis. Radiologically, more new bone was formed at the healing interface in the BABS group as compared with the BAFS or control (CTL) groups (p < 0.05). Histologically, at postoperative week 16, histological scores were significantly better for regenerated fibrocartilage in the BAFS group or BABS group compared with the CTL group, but the BAFS group showed a significantly larger score than the BABS groups (p < 0.05). Biomechanical evaluation indicated a higher failure load and stiffness were shown in the BAFS group than those in the BABS or CTL groups at week 16 (p < 0.05). This study indicated that the BAFS is a more promising scaffold for B-T healing in comparison with the BABS. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1709-1722, 2019.
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Affiliation(s)
- Hongbin Lu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China
- Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Xiangya Hospital, International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China
| | - Yifu Tang
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China
- Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Xiangya Hospital, International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China
| | - Fei Liu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Shanshan Xie
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China
- Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Xiangya Hospital, International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China
| | - Jin Qu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China
- Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Xiangya Hospital, International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China
| | - Can Chen
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China
- Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Xiangya Hospital, International Chinese Musculoskeletal Research Society Sports Medicine Research Centre, Changsha, 410008, China
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149
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Walters M, Crew M, Fyfe G. Bone Surface Micro‐Topography at Craniofacial Entheses: Insights on Osteogenic Adaptation at Muscle Insertions. Anat Rec (Hoboken) 2019; 302:2140-2155. [DOI: 10.1002/ar.24215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 02/04/2019] [Accepted: 03/06/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Mark Walters
- School of Human SciencesThe University of Western Australia Crawley Perth Western Australia
- Department of Plastic and Reconstructive SurgeryPerth Children's Hospital Nedlands Perth Western Australia
| | - Michael Crew
- Health Department of Western Australia and Faculty of Health SciencesCurtin University Western Australia
| | - Georgina Fyfe
- Faculty of Health SciencesCurtin University Perth Western Australia
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150
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Zheng C, Lu H, Tang Y, Wang Z, Ma H, Li H, Chen H, Chen Y, Chen C. Autologous Freeze-Dried, Platelet-Rich Plasma Carrying Icariin Enhances Bone-Tendon Healing in a Rabbit Model. Am J Sports Med 2019; 47:1964-1974. [PMID: 31150275 DOI: 10.1177/0363546519849657] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Tendon-bone interface (TBI) injuries are common in sports activities. Owing to the limited regenerative ability of the TBI, its functional healing remains a difficulty in clinical practice. Icariin (ICA) provides strong stimulation for osteogenesis. Platelet-rich plasma (PRP) can be used as a carrier for bioactive molecules, although its ability to provide sustained release for such molecules needs improvement. HYPOTHESIS Freeze-dried PRP (FD-PRP) as a carrier for ICA can provide sustained release of ICA into the tendon-bone (T-B) healing site, thus accelerating T-B healing. STUDY DESIGN Controlled laboratory study. METHODS A total of 84 New Zealand rabbits with partial patellectomy in the hindlimb were randomly allocated into 3 different treatments: ICA incorporated with FD-PRP (ICA/FD-PRP), FD-PRP alone (FD-PRP), or saline control (CTL). The rabbit patella-patellar tendon (PP) interfaces were postoperatively harvested at postoperative week 8 or 16 for gross, radiological, histological, and mechanical evaluations. RESULTS Our results showed that FD-PRP can act as a carrier for sustained release of ICA into the T-B healing site. Macroscopically, no signs of infection or osteoarthritis were shown in the regenerated PP interfaces, and the area of cartilaginous metaplasia in the FD-PRP and ICA/FD-PRP groups at postoperative week 16 was significantly larger than that of the CTL group (P < .05 for all). Radiologically, micro-computed tomography showed that new bone which formed at the healing site in the ICA/FD-PRP group was significantly increased, remodeled, and mineralized in comparison with the CTL group (P < .05 for all). Histologically, the ICA/FD-PRP group exhibited a significant native PP interface, as shown by the enlargement and remodeling of new bone, well-organized collagen fibers, and robust production of proteoglycans in the regenerated fibrocartilage. The mechanical strength of the regenerated PP interface was significantly improved in the ICA/FD-PRP group. Significantly higher failure load and stiffness were shown in the ICA/FD-PRP group compared with the CTL and FD-PRP groups, respectively (P < .05 for all). CONCLUSION FD-PRP is a suitable sustained-release carrier for ICA, and ICA/FD-PRP can provide sustained release of ICA into the T-B healing site, thus effectively accelerating T-B healing. CLINICAL RELEVANCE Findings of this study demonstrate the feasibility of using FD-PRP as a carrier for ICA to improve T-B healing and provide a foundation for future clinical application.
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Affiliation(s)
- Cheng Zheng
- Department of Orthopedics, Affiliated Hospital of Wuhan Sports University, Wuhan, Hubei, China
| | - Hongbin Lu
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Yifu Tang
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Zhanwen Wang
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Haozhe Ma
- College of International Education, Wuhan Sports University, Hubei Wuhan, China
| | - Haixia Li
- Graduate School, Wuhan Sports University, Hubei Wuhan, China
| | - Huabin Chen
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Yang Chen
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Can Chen
- Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
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