Biomaterials: where we have been and where we are going

Hyperspectral infrared laser polarimetry for single-shot phase-amplitude imaging of thin films

We recently presented a novel laser-based infrared (IR) spectroscopic phase-amplitude polarimeter for sub-decisecond and sub-mm² measurements of organic thin films [Opt. Lett.44, 4387 (2019)OPLEDP0146-959210.1364/OL.44.004387]. Here we report on the hyperspectral-imaging capabilities of this device. The single-shot polarimeter employs a broadly tunable mid-IR (1318-1765  cm^-1) quantum cascade laser (QCL) and a four-channel beam-division design for simultaneous phase and amplitude measurements. Fast QCL tuning speeds of up to 1500  cm^-1/s enable hyperspectral mapping of large sample areas (50×50  mm²) within several tens of minutes, achieving 120 μm spatial and <0.5  cm^-1 spectral resolution. We apply the instrument for imaging both the heterogeneous chemical and structural properties of sub-100 nm thin polymer and fatty-acid films. Our polarimeter opens up new applications regarding laterally resolved IR analyses of complex thin films.

Zwitterionic PMCP-Modified Polycaprolactone Surface for Tissue Engineering: Antifouling, Cell Adhesion Promotion, and Osteogenic Differentiation Properties

Biodegradable polycaprolactone (PCL) has been widely applied as a scaffold material in tissue engineering. However, the PCL surface is hydrophobic and adsorbs nonspecific proteins. Some traditional antifouling modifications using hydrophilic moieties have been successful but inhibit cell adhesion, which is not ideal for tissue engineering. The PCL surface is modified with bioinspired zwitterionic poly[2-(methacryloyloxy)ethyl choline phosphate] (PMCP) via surface-initiated atom transfer radical polymerization to improve cell adhesion through the unique interaction between choline phosphate (CP, on PMCP) and phosphate choline (PC, on cell membranes). The hydrophilicity of the PCL surface is significantly enhanced after surface modification. The PCL-PMCP surface reduces nonspecific protein adsorption (e.g., up to 91.7% for bovine serum albumin) due to the zwitterionic property of PMCP. The adhesion and proliferation of bone marrow mesenchymal stem cells on the modified surface is remarkably improved, and osteogenic differentiation signs are detected, even without adding any osteogenesis-inducing supplements. Moreover, the PCL-PMCP films are more stable at the early stage of degradation. Therefore, the PMCP-functionalized PCL surface promotes cell adhesion and osteogenic differentiation, with an antifouling background, and exhibits great potential in tissue engineering.

Effect of Thermomechanical Treatments on the Phases, Microstructure, Microhardness and Young's Modulus of Ti-25Ta-Zr Alloys

Titanium and its alloys currently are used as implants, possessing excellent mechanical properties (more suited than stainless steel and Co-Cr alloys), good corrosion resistance and good biocompatibility. The titanium alloy used for most biomedical applications is Ti-6Al-4V, however, studies showed that vanadium and aluminum cause allergic reactions in human tissues and neurological disorders. New titanium alloys without the presence of these elements are being studied. The objective of this study was to analyze the influence of thermomechanical treatments, such as hot-rolling, annealing and solution treatment in the structure, microstructure and mechanical properties of the Ti-25Ta-Zr ternary alloy system. The structural and microstructural analyses were performed using X-ray diffraction, as well as optical, scanning and transmission electron microscopy. The mechanical properties were analyzed using microhardness and Young's modulus measurements. The results showed that the structure of the materials and the mechanical properties are influenced by the different thermal treatments: rapid cooling treatments (hot-rolling and solubilization) induced the formation of α" and β phases, while the treatments with slow cooling (annealing) induced the formation of martensite phases. Alloys in the hot-rolled and solubilized conditions have better mechanical properties results, such as low elastic modulus, due to retention of the β phase in these alloys.

Gelatin-polytrimethylene carbonate blend based electrospun tubular construct as a potential vascular biomaterial

The present work details the fabrication of electrospun tubular scaffolds based on the biocompatible and unexploited blend of gelatin and polytrimethylene carbonate (PTMC) as a media (middle layer of blood vessel) equivalent for blood vessel regeneration. An attempt to resemble the media stimulated the selection of gelatin as a matrix (substitution for collagen) with the inclusion of the biodegradable elastomer PTMC (substitution for elastin). -The work highlights the variation of electrospinning parameters and its assiduous selection based on fiber diameter distribution and pore size distribution to obtain smooth microfibers and micropores which is reported for the first time for this blend. Electrospun conduits of gelatin-PTMC blend had fibers sized 6-8 μm and pores sized ~100-150 μm. Young's modulus of 0.40 ± 0.045 MPa was observed, resembling the tunica media of the native artery (~0.5 MPa). An evaluation of the surface properties, topography, and mechanical properties validated its physical requirements for inclusion in a vascular graft. Preliminary biological tests confirmed its minimal in-vitro toxicity and in-vivo biocompatibility. MTT assay (indirect) elucidated cell viability above 70% with scaffold extract, considered to be non-toxic according to the EN ISO-10993-5/12 protocol. The in-vivo subcutaneous implantation in rat showed a marked reduction in macrophages within 15 days revealing its biocompatibility and its possibility for host integration. This comprehensive study presents for the first time the potential of microporous electrospun gelatin and PTMC blend based tubular construct as a potential biomaterial for vascular tissue engineering. The proposed media equivalent included in a bilayer or trilayer polymeric construct can be a promising off-shelf vascular graft.

(PVA/Chitosan/Fucoidan)-Ampicillin: A Bioartificial Polymeric Material with Combined Properties in Cell Regeneration and Potential Antibacterial Features

Chitosan, fucoidan, and polyvinyl alcohol are categorized as polymers with biomedical applications. Ampicillin, on the other hand, is considered as an important antibiotic that has shown effectivity in both gram-positive and gram-negative micro-organisms. The aforementioned polymers possess unique properties that are considered desirable for cell regeneration although they exhibit drawbacks that can affect their final application. Therefore, films of these biomaterials were prepared and they were characterized using FTIR, SEM, XRD, degree of swelling and solubility, and MTT assay. The statistical significance of the experiments was determined using a two-way analysis of variance (ANOVA) with p < 0.05. The characterization techniques demonstrated that the obtained material exhibits properties suitable for cell regeneration, and that a higher concentration of natural polymers promotes cells proliferation to a greater extent. The presence of PVA, on the other hand, is responsible for matrix stability and dictates the degree of swelling and solubility. The SEM images demonstrated that neither aggregations nor clusters were formed, which is favorable for the biological properties without detrimental to the morphological and physical features. Cell viability was comparatively similar in samples with and without antibiotic, and the physical and biological properties were not negatively affected. Indeed, the inherent bactericidal effect of chitosan was reinforced by the presence of ampicillin. The new material is an outstanding candidate for cell regeneration as a consequence of the synergic effect that each component provides to the blend.

Bijel-templated implantable biomaterials for enhancing tissue integration and vascularization

Mitigation of the foreign body response (FBR) and successful tissue integration are essential to ensuring the longevity of implanted devices and biomaterials. The use of porous materials and coatings has been shown to have an impact, as the textured surfaces can mediate macrophage interactions with the implant and influence the FBR, and the pores can provide space for vascularization and tissue integration. In this study, we use a new class of implantable porous biomaterials templated from bicontinuous interfacially jammed emulsion gels (bijels), which offer a fully percolating, non-constricting porous network with a uniform pore diameter on the order of tens of micrometers, and surfaces with consistent curvature. We demonstrate that these unique morphological features, inherent to bijel-templated materials (BTMs), can enhance tissue integration and vascularization, and reduce the FBR. Cylindrical polyethylene glycol diacrylate (PEGDA) BTMs, along with PEGDA particle-templated materials (PTMs), and non-templated materials (NTMs), were implanted into the subcutaneous space of athymic nude mice. After 28 days, implants were retrieved and analyzed via histological techniques. Within BTMs, blood vessels of increased size and depth, changes in collagen deposition, and increased presence of pro-healing macrophages were observed compared to that of PTM and NTM implants. Bijel templating offers a new route to biomaterials that can improve the function and longevity of implantable devices. STATEMENT OF SIGNIFICANCE: All implanted biomaterials are subject to the foreign body response (FBR) which can have a detrimental effect on their efficacy. Altering the surface chemistry can decrease the FBR by limiting the amount of proteins adsorbed to the implant. This effect can be enhanced by including pores in the biomaterial to allow new tissue growth as the implant becomes integrated in the body. Here, we introduce a new class of self-assembled biomaterials comprising a fully penetrating, non-constricting pore phase with hyperbolic (saddle) surfaces for enhanced tissue integration. These unique morphological characteristics result in dense blood vessel formation and favorable tissue response properties demonstrated in a four-week implantation study.

Rational Design and Development of Anisotropic and Mechanically Strong Gelatin-Based Stress Relaxing Hydrogels for Osteogenic/Chondrogenic Differentiation

Rational design and development of tailorable simple synthesis process remains a centerpiece of investigational efforts toward engineering advanced hydrogels. In this study, a green and scalable synthesis approach is developed to formulate a set of gelatin-based macroporous hybrid hydrogels. This approach consists of four sequential steps starting from liquid-phase pre-crosslinking/grafting, unidirectional freezing, freeze-drying, and finally post-curing process. The chemical crosslinking mainly involves between epoxy groups of functionalized polyethylene glycol and functional groups of gelatin both in liquid and solid state. Importantly, this approach allows to accommodate different polymers, chitosan or hydroxyethyl cellulose, under identical benign condition. Structural and mechanical anisotropy can be tuned by the selection of polymer constituents. Overall, all hydrogels show suitable structural stability, good swellability, high porosity and pore interconnectivity, and maintenance of mechanical integrity during 3-week-long hydrolytic degradation. Under compression, hydrogels exhibit robust mechanical properties with nonlinear elasticity and stress-relaxation behavior and show no sign of mechanical failure under repeated compression at 50% deformation. Biological experiment with human bone marrow mesenchymal stromal cells (hMSCs) reveals that hydrogels are biocompatible, and their physicomechanical properties are suitable to support cells growth, and osteogenic/chondrogenic differentiation, demonstrating their potential application for bone and cartilage regenerative medicine toward clinically relevant endpoints.

Interaction of fibroblasts and induced pluripotent stem cells with poly(vinyl alcohol)-based hydrogel substrates

Induced pluripotent stem cells (iPSCs) provide a promising means of creating custom-tailored cell lines for cellular therapies. Their application in regenerative medicine, however, depends on the possibility that the maintenance and differentiation of cells and organs occur under defined conditions. One major component of stem cell culture systems is the substrate, where the cells must attach and proliferate. The present study aimed to investigate the putative cytotoxic effects of poly(vinyl alcohol) (PVA)-based matrices on the in vitro culture of mouse fetal fibroblasts. In addition, the PVA-based hydrogels were used to determine the capacity of bovine induced pluripotent stem cells (biPSCs) to adhere and proliferate on synthetic substrates. Our results show that both cell types interacted with the substrate and presented proliferation during culture. The biPSCs formed new colonies when cell suspensions were placed onto the hydrogel surface for culture. These results may represent a new characterized xeno-free clinical grade culture system to be widely applied in cell-based therapies.

A self-cleaning, mechanically robust membrane for minimizing the foreign body reaction: towards extending the lifetime of sub-Q glucose biosensors

Long-term, subcutaneously implanted continuous glucose biosensors have the potential to improve diabetes management and reduce associated complications. However, the innate foreign body reaction (FBR) both alters the local glucose concentrations in the surrounding tissues and compromises glucose diffusion to the biosensor due to the recruitment of high-metabolizing inflammatory cells and the formation of a dense, collagenous fibrous capsule. Minimizing the FBR has mainly focused on "passively antifouling" materials that reduce initial cellular attachment, including poly(ethylene glycol) (PEG). Instead, the membrane reported herein utilizes an "actively antifouling" or "self-cleaning" mechanism to inhibit cellular attachment through continuous, cyclic deswelling/reswelling in response to normal temperature fluctuations of the subcutaneous tissue. This thermoresponsive double network (DN) membrane is based on N-isopropylacrylamide (NIPAAm) and 2-acrylamido-2-methylpropane sulfonic acid (AMPS) (75:25 and 100:0 NIPAAm:AMPS in the 1st and 2nd networks, respectively; "DN-25%"). The extent of the FBR reaction of a subcutaneously implanted DN-25% cylindrical membrane was evaluated in rodents in parallel with a PEG-diacrylate (PEG-DA) hydrogel as an established benchmark biocompatible control. Notably, the DN-25% implants were more than 25× stronger and tougher than the PEG-DA implants while maintaining a modulus near that of subcutaneous tissue. From examining the FBR at 7, 30 and 90 days after implantation, the thermoresponsive DN-25% implants demonstrated a rapid healing response and a minimal fibrous capsule (~20-25 µm), similar to the PEG-DA implants. Thus, the dynamic self-cleaning mechanism of the DN-25% membranes represents a new approach to limit the FBR while achieving the durability necessary for long-term implantable glucose biosensors.

Thermodynamic Principles for the Design of Polymers for Drug Formulations

Polymers play an essential role in drug formulation and production of medical devices, implants, and diagnostics. Following drug discovery, an appropriate formulation is selected to enable drug delivery. This task can be exceedingly challenging owing to the large number of potential delivery methods and formulation and process variables that can interact in complex ways. This evolving solubility challenge has inspired an increasing emphasis on the developability of drug candidates in early discovery as well as various advanced drug solubilization strategies. Among the latter, formulation approaches that lead to prolonged drug supersaturation to maximize the driving force for sustained intestinal absorption of an oral product, or to allow sufficient time for injection after reconstitution of a parenteral lyophile formulation, have attracted increasing interest. Although several kinetic and thermodynamic components are involved in stabilizing amorphous dispersions, it is generally assumed that maximum physical stability, defined in terms of inhibition of drug crystallization, requires that the drug and excipient remain intimately mixed. Phase separation of the drug from its excipient may be the first step that ultimately leads to crystallization. We discuss the role of advanced thermodynamics using two examples: ASD and vitamin E-stabilized ultrahigh-molecular weight polyethylene implants.

Biomaterials: Been There, Done That, and Evolving into the Future

Biomaterials as we know them today had their origins in the late 1940s with off-the-shelf commercial polymers and metals. The evolution of materials for medical applications from these simple origins has been rapid and impactful. This review relates some of the early history; addresses concerns after two decades of development in the twenty-first century; and discusses how advanced technologies in both materials science and biology will address concerns, advance materials used at the biointerface, and improve outcomes for patients.

Effect of crystalline phases of titania nanotube arrays on adipose derived stem cell adhesion and proliferation

The aim of this work was to evaluate the cellular response to titanium nanotube arrays with variable crystalline structure. Cytotoxicity, viability and the ability of the titania nanotube arrays to stimulate adhesion and proliferation of adipose derived stem cells (ADSCs) was evaluated. Titania nanotube arrays were fabricated by electrochemical anodization of titanium in diethyleneglycol/hydrofluoric acid electrolyte at 60 V for 6 h, then annealed at 300, 530 and 630 °C for 5 h. The nanotube arrays were characterized using scanning electron microscopy (SEM), contact angle goniometry, x-ray diffraction (XRD) and protein adsorption. ADSCs were cultured on titania nanotube arrays at a density of 1 × 10⁴ cells/ml. The cells were allowed to adhere and to proliferate for 1, 4 and 7 days. Cell viability was characterized by the CellTiter-Blue® Cell Viability Assay; and cell morphology was characterized by SEM. Cell adhesion, proliferation and morphology were characterized using fluorescence microscopy by staining the cells with DAPI and rhodamine/phalloidin. The results from this study showed that the annealing at 300 and 530 °C formed anatase phase, and annealing at 630 °C formed anatase/rutile phase. The results indicated that the modification of the crystalline structure (i.e. anatase/rutile phase) of titania nanotube arrays influenced the ADSC adhesion and proliferation. Future studies are now directed towards evaluating differentiation of this cellular model in osteoblasts.

Polyhydroxyalkanoate (PHBV) fibers obtained by a wet spinning method: Good in vitro cytocompatibility but absence of in vivo biocompatibility when used as a bone graft

Polyhydroxyalkanoates (PHAs) are biomaterials widely investigated for tissue-engineering applications. In this regard, we describe a method to prepare fibers of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) by a wet-spinning technique. Polymer fibers were used to test the cytocompatibility of the material in vitro. We have investigated their behavior in vitro in presence of the osteoblast-like (SaOs2) and macrophage (J774.2) cell lines. The PHBV fibers used were 100-200μm in diameter and offered a large surface for cell adhesion, similar to that they encounter when apposed onto a bone trabeculae. The fiber surface possessed a suitable roughness, a factor known to favor the adherence of cells, particularly osteoblasts. PHBV fibers were degraded in vitro by J774.2 cells as erosion pits were observable by transmission electron microscopy. The fibers were also colonisable by SaOs2 cells, which can spread and develop onto their surface. However, despite this good cytocompatibility observed in vitro, implantation in a bone defect drilled in rabbit femoral condyles showed that the material was only biotolerated without any sign of osteoconduction or degradation in vivo. We can conclude that PHBV is cytocompatible but is not suitable to be used as a bone graft as it does not favor osteoconduction and is not resorbed by bone marrow macrophages.

P4VP Modified Zwitterionic Polymer for the Preparation of Antifouling Functionalized Surfaces

Zwitterionic polymers are suitable for replacing poly(ethylene glycol) (PEG) polymers because of their better antifouling properties, but zwitterionic polymers have poor mechanical properties, strong water absorption, and their homopolymers should not be used directly. To solve these problems, a reversible-addition fragmentation chain transfer (RAFT) polymerization process was used to prepare copolymers comprised of zwitterionic side chains that were attached to an ITO glass substrate using spin-casting. The presence of 4-vinylpyridine (4VP) and zwitterion chains on these polymer-coated ITO surfaces was confirmed using 1H NMR, FTIR, and GPC analyses, with successful surface functionalization confirmed using water contact angle, X-ray photoelectron spectroscopy (XPS), and atomic force microscopy (AFM) studies. Changes in water contact angles and C/O ratios (XPS) analysis demonstrated that the functionalization of these polymers with β-propiolactone resulted in hydrophilic mixed 4VP/zwitterionic polymers. Protein adsorption and cell attachment assays were used to optimize the ratio of the zwitterionic component to maximize the antifouling properties of the polymer brush surface. This work demonstrated that the antifouling surface coatings could be readily prepared using a "P4VP-modified" method, that is, the functionality of P4VP to modify the prepared zwitterionic polymer. We believe these materials are likely to be useful for the preparation of biomaterials for biosensing and diagnostic applications.

Advances in immunotherapy delivery from implantable and injectable biomaterials

Macroscale biomaterials, such as preformed implantable scaffolds and injectable soft materials, possess powerful synergies with anti-cancer immunotherapies. Immunotherapies on their own typically have poor delivery properties, and often require repeated high-dose injections that result in serious off-tumor effects and/or limited efficacy. Rationally designed biomaterials allow for discrete localization and controlled release of immunotherapeutic agents, and have been shown in a large number of applications to improve outcomes in the treatment of cancers via immunotherapy. Among various strategies, macroscale biomaterial delivery systems can take the form of robust tablet-like scaffolds that are surgically implanted into a tumor resection site, releasing programmed immune cells or immunoregulatory agents. Alternatively they can be developed as soft gel-like materials that are injected into solid tumors or sites of resection to stimulate a potent anti-tumor immune response. Biomaterials synthesized from diverse components such as polymers and peptides can be combined with any immunotherapy in the modern toolbox, from checkpoint inhibitors and stimulatory adjuvants, to cancer antigens and adoptive T cells, resulting in unique synergies and improved therapeutic efficacy. The field is growing rapidly in size as publications continue to appear in the literature, and biomaterial-based immunotherapies are entering clinical trials and human patients. It is unarguably an exciting time for cancer immunotherapy and biomaterial researchers, and further work seeks to understand the most critical design considerations in the development of the next-generation of immunotherapeutic biomaterials. This review will discuss recent advances in the delivery of immunotherapies from localized biomaterials, focusing on macroscale implantable and injectable systems. STATEMENT OF SIGNIFICANCE: Anti-cancer immunotherapies have shown exciting clinical results in the past few decades, yet they suffer from a few distinct limitations, such as poor delivery kinetics, narrow patient response profiles, and systemic side effects. Biomaterial systems are now being developed that can overcome many of these problems, allowing for localized adjuvant delivery, focused dose concentrations, and extended therapy presentation. The field of biocompatible carrier materials is uniquely suited to be combined with immunotherapy, promising to yield significant improvements in treatment outcomes and clinical care. In this review, the first pioneering efforts and most recent advances in biomaterials for immunotherapeutic applications are explored, with a specific focus on implantable and injectable biomaterials such as porous scaffolds, cryogels, and hydrogels.

Permanent Hydrophilization and Generic Bioactivation of Melt Electrowritten Scaffolds

Melt electrowriting (MEW) is an emerging additive manufacturing technology that direct-writes low-micron diameter fibers into 3D scaffolds with high porosities. Often, the polymers currently used for MEW are hydrophobic thermoplastics that induce unspecific protein adsorption and subsequent uncontrolled cell adhesion. Here are developed a coating strategy for MEW scaffolds based on six-arm star-shaped NCO-poly(ethylene oxide-stat-propylene oxide) (sP(EO-stat-PO)). This permanently hydrophilizes the PCL through the formation of a hydrogel coating and minimizes unspecific interactions with proteins and cells. It also provides the option of simultaneous covalent attachment of bioactive molecules through reaction with isocyanates before these are hydrolyzed. Furthermore, a photoactivatable chemical functionalization is introduced that is not dependent on the time-limited window of isocyanate chemistry. For this, photo-leucine is covalently immobilized into the sP(EO-stat-PO) layer, resulting in a photoactivatable scaffold that enables the binding of sterically demanding molecules at any timepoint after scaffold preparation and coating and is decoupled from the isocyanate chemistry. A successful biofunctionalization of MEW scaffolds via this strategy is demonstrated with streptavidin and collagen as examples. This hydrogel coating system is a generic one that introduces flexible specific and multiple surface functionalization, potentially for a spectrum of polymers made from different manufacturing processes.

Terminal chemical functions of polyamidoamine dendrimer surfaces and its impact on bone cell growth

Besides their use for drug and gene delivery, dendrimer molecules are also favorable for the design of new surface coatings for orthopedic and dental implants due to the wide variety of functional terminal groups and their multivalent character. The purpose of this work was to observe how covalently immobilized polyamidoamine (PAMAM) dendrimer molecules with different terminal chemical groups influenced serum protein adsorption and osteoblast behavior. To this end, fifth-generation PAMAM dendrimers were immobilized on silicon surfaces with an anhydride-containing silane coupling agent which results in positively charged terminal NH₂-groups. Coatings with a net negative charge were generated by introduction of terminal CO₂H- or CH₃-groups. Surface characterization was performed by static and dynamic contact angle and zeta potential. The in vitro studies with human MG-63 osteoblastic cells focused on cell adhesion, morphology, cell cycle, apoptosis and actin formation within 24 h. This work demonstrated that cell growth was dependent on surface chemistry and correlated strongly with the surface free energy and charge of the material. The positively charged NH₂ surface induced tight cell attachment with well-organized actin stress fibers and a well spread morphology. In contrast, CO₂H- and CH₃-functional groups provoked a decrease in cell adhesion and spreading and indicated higher apoptotic potential, although both were hydrophilic. The knowledge about the cell-material dialogue is of relevance for the development of bioactive implants in regenerative medicine.

Lipid bilayer disruption induced by amphiphilic Janus nanoparticles: the non-monotonic effect of charged lipids

In this study, we report the complex effects of charged lipids on the interaction between amphiphilic Janus nanoparticles and lipid bilayers. Janus nanoparticles are cationic on one hemisphere and hydrophobic on the other. We show that the nanoparticles, beyond threshold concentrations, induce holes in both cationic and anionic lipid bilayers mainly driven by hydrophobic interactions. However, the formation of these defects is non-monotonically dependent on ionic lipid composition. The electrostatic attraction between the particles and anionic lipid bilayers enhances particle adsorption and lowers the particle concentration threshold for defect initiation, but leads to more localized membrane disruption. Electrostatic repulsion leads to reduced particle adsorption on cationic bilayers and extensive defect formation that peaks at intermediate contents of cationic lipids. This study elucidates the significant role lipid composition plays in influencing how amphiphilic Janus nanoparticles interact with and perturb lipid membranes.

Designing Novel Interfaces via Surface Functionalization of Short-Chain-Length Polyhydroxyalkanoates

Polyhydroxyalkanoates (PHA), a microbial plastic has emerged as promising biomaterial owing to the broad range of mechanical properties. However, some studies revealed that PHA is hydrophobic and has no recognition site for cell attachment and this is often a limitation in tissue engineering aspects. Owing to this, the polymer is tailored accordingly in order to enhance the biocompatibilityin vivoas well as to suit the intended application. Thus far, these surface modifications have led to PHA being widely used in various biomedical and pharmaceutical applications such as cardiac patches, wound management, nerve, bone, and cartilage repair. This review addresses the surface modification on biomedical applications focusing on short-chain-length PHA such as poly(3-hydroxybutyrate) [P(3HB)], poly(3-hydroxybutyrate-co-4-hydroxybutyrate) [P(3HB-co-4HB)] and poly(3-hydroxybutyrate-co-3-hydroxyvalerate) [P(3HB-co-3HV)].

Devising micro/nano-architectures in multi-channel nerve conduits towards a pro-regenerative matrix for the repair of spinal cord injury

Multi-channel nerve conduits have shown significant advantages in guidance of axonal growth and functional restoration after spinal cord injury (SCI). It was realized that the micro/nano-architectures of these implanted conduits can effectively tune the lesion-induced biological responses, including inflammation and scar formation. In this work, two PLLA multi-channel conduits were fabricated with ladder-like porous channel wall (labelled as LNCs) and nano-fibrous channel wall (labelled as NNCs), respectively, and transferred into complete spinal cord transected injury model in rats. The implantation of such two scaffolds significantly alleviated the infiltration of macrophages/microglia and accumulation of astrocyte and collagen scar, especially in the NNCs group. Meanwhile, recruitment of endogenous stem cells and axonal growth was observed in both of the multi-channel conduits. Compared to the LNCs, the extracellular matrix (ECM) - mimicry nanostructures in the NNCs promoted directional nerve fiber growth within the channels. Moreover, a relatively denser nano-architecture in the channel wall confined the nerve fiber extension within the channels. These results from in vivo evaluations suggested that the NNCs implants possess a great potential in future application for SCI treatment and nerve regeneration. STATEMENTS OF SIGNIFICANCE: The implantation of biocompatible and degradable polymeric scaffolds holds great potential in clinical treatment and tissue regeneration after spinal cord injury (SCI). In this work, the ladder-like nerve conduits (LNCs) and nano-fibrous nerve conduits (NNCs) were fabricated and implanted into completely spinal cord transected rats, respectively. In vivo characteristics showed significant reduction in post-injury inflammation and scar formation, with elevated nerve stem cells (NSCs) recruitment and nerve fiber growth, hence both conduits resulted in significant functional restoration after implantation. Remarkably, we noticed that not only the multi-channels in the conduits can guide nerve fiber regeneration, their micro-/nano-structured walls also played a critical role in modulating the post-implantation biological responses.

Using Artificial Skin Devices as Skin Replacements: Insights into Superficial Treatment

Artificial skin devices are able to mimic the flexibility and sensory perception abilities of the skin. They have thus garnered attention in the biomedical field as potential skin replacements. This Review delves into issues pertaining to these skin-deep devices. It first elaborates on the roles that these devices have to fulfill as skin replacements, and identify strategies that are used to achieve such functionality. Following which, a comparison is done between the current state of these skin-deep devices and that of natural skin. Finally, an outlook on artificial skin devices is presented, which discusses how complementary technologies can create skin enhancements, and what challenges face such devices.

Ultralow Fouling and Functionalizable Surface Chemistry Based on Zwitterionic Carboxybetaine Random Copolymers

Here, we report a simple yet effective surface-modification approach to imparting hydrophobic surfaces with superhydrophilicity using ultralow fouling/functionalizable carboxybetaine (CB) copolymers via a dip-coating technique. A new series of CB random copolymers with varying amphiphilicities were synthesized and coated on hydrophobic polypropylene (PP) and polystyrene (PS) surfaces. The nonfouling capability of each coating was screened by an enzyme-linked immunosorbent assay (ELISA) and further comprehensively assessed against 100% human serum by a Micro BCA protein assay kit. The random copolymer containing ∼30 mol % CB units showed superhydrophilicity with the highest air contact angle of more than 165° in DI water and the best nonfouling capability against 100% human blood serum. Surfaces of a 96-well plate coated with the optimal CB random copolymer had a significantly better nonfouling capability than those of a commercial 96-well plate with an ultralow attachment surface. The adhesion of mouse embryonic fibroblast cells (NIH3T3) was completely inhibited on surfaces coated with CB random copolymers. Furthermore, the optimal nonfouling CB copolymer surface was functionalized with an antigen via covalent bonding where its specific interactions with its antibody were verified. Thus, this CB random copolymer is capable of imparting both ultralow fouling and functionalizable capabilities to hydrophobic surfaces for blood-contacting devices.

Biomaterials: Foreign Bodies or Tuners for the Immune Response?

The perspectives of regenerative medicine are still severely hampered by the host response to biomaterial implantation, despite the robustness of technologies that hold the promise to recover the functionality of damaged organs and tissues. In this scenario, the cellular and molecular events that decide on implant success and tissue regeneration are played at the interface between the foreign body and the host inflammation, determined by innate and adaptive immune responses. To avoid adverse events, rather than the use of inert scaffolds, current state of the art points to the use of immunomodulatory biomaterials and their knowledge-based use to reduce neutrophil activation, and optimize M1 to M2 macrophage polarization, Th1 to Th2 lymphocyte switch, and Treg induction. Despite the fact that the field is still evolving and much remains to be accomplished, recent research breakthroughs have provided a broader insight on the correct choice of biomaterial physicochemical modifications to tune the reaction of the host immune system to implanted biomaterial and to favor integration and healing.

ROS-triggered degradation of selenide-containing polymers based on selenoxide elimination

A degradable ROS responsive selenide-containing block polymer would undergo an oxidation-related elimination and degradation process.

Applications of self-assembling ultrashort peptides in bionanotechnology

Peptides are intriguing building blocks for a variety of applications in bionanotechnology. Peptides can self-assemble into well-ordered nanostructures. Among the various nanomorphology forms, peptide nanofibers and nanotubes are relevant in biomedical applications. In this review, their applications as tissue engineering scaffolds, drug delivery vehicles, three-dimensional printing bioinks and bioimaging nanoprobes will be illustrated. This review article describes di-, tri-, tetra-peptides because they are cost-effective, simple to prepare, and amenable to production on a large scale.

Ultrashort peptide applications in bionanotechnology.

Alginate Nanoparticles for Drug Delivery and Targeting

Nanotechnology refers to the control, manipulation, study and manufacture of structures and devices at the nanometer size range. The small size, customized surface, improved solubility and multi-functionality of nanoparticles will continue to create new biomedical applications, as nanoparticles allow to dominate stability, solubility and bioavailability, as well controlled release of drugs. The type of a nanoparticle, and its related chemical, physical and morphological properties influence its interaction with living cells, as well as determine the route of clearance and possible toxic effects. This field requires cross-disciplinary research and gives opportunities to design and develop multifunctional devices, which allow the diagnosis and treatment of devastating diseases. Over the past few decades, biodegradable polymers have been studied for the fabrication of drug delivery systems. There was extensive development of biodegradable polymeric nanoparticles for drug delivery and tissue engineering, in view of their applications in controlling the release of drugs, stabilizing labile molecules from degradation and site-specific drug targeting. The primary aim is to reduce dosing frequency and prolong the therapeutic outcomes. For this purpose, inert excipients should be selected, being biopolymers, e.g. sodium alginate, commonly used in controlled drug delivery. Nanoparticles composed of alginate (known as anionic polysaccharide widely distributed in the cell walls of brown algae which, when in contact with water, forms a viscous gum) have emerged as one of the most extensively characterized biomaterials used for drug delivery and targeting a set of administration routes. Their advantages include not only the versatile physicochemical properties, which allow chemical modifications for site-specific targeting but also their biocompatibility and biodegradation profiles, as well as mucoadhesiveness. Furthermore, mechanical strength, gelation, and cell affinity can be modulated by combining alginate nanoparticles with other polymers, surface tailoring using specific targeting moieties and by chemical or physical cross-linking. However, for every physicochemical modification in the macromolecule/ nanoparticles, a new toxicological profile may be obtained. In this paper, the different aspects related to the use of alginate nanoparticles for drug delivery and targeting have been revised, as well as how their toxicological profile will determine the therapeutic outcome of the drug delivery system.

Photo-crosslinked coatings based on 2-hydroxypropyl acrylamide for the prevention of biofouling

We have developed a simple and versatile polymer coating method that provides excellent non-biofouling properties.

Apoptotic Cell-Mimetic Polymers for Anti-Inflammatory Therapy

The field of biomaterials has seen a strong rejuvenation due to the new potential to modulate immune system in our body. This special class of materials is called "immunomodulatory biomaterials". Generally, three fundamental strategies are followed in the design of immunomodulatory biomaterials: (1) immuno-inert biomaterials, (2) immuno-activating biomaterials, and (3) immuno-tolerant biomaterials. While many applications of immuno-inert biomaterials such as biocompatible medical implants have been already proposed in the past decades, the ability to engineer biological activity into synthetic materials greatly increases the number of their potential uses and improves their performance in more traditional applications. The major focus of researchers is now set on developing immuno-tolerant biomaterials for anti-inflammatory therapies. In this review, we therefore introduce recent developments of immuno-tolerant biomaterials. Especially we introduce an apoptotic cell membrane-inspired polymer and its post-inflammatory effects on immune cells in this article.

The inflammasome in host response to biomaterials: Bridging inflammation and tissue regeneration

The development of new biomaterials to be used in tissue engineering applications is creating new solutions for a range of healthcare problems. The trend in biomaterials research has shifted from biocompatible "immune-evasive" biomaterials to "immune-interactive" materials that modulate the inflammatory response supporting implant integration as well as improving healing and tissue regeneration. Inflammasomes are large intracellular multiprotein complexes that are key players in host defence during innate immune responses and assemble after recognition of pathogens or danger signals. The process of biomaterial implantation causes injury to tissues that will consequently release danger signals that could be sensed by the inflammasome. There are increasing evidences that the inflammasome has a role in several inflammatory processes, from pathogen clearance to chronic inflammation or tissue repair. Thus, modulation of the inflammasome activity appears as an important target in the development of effective approaches in regenerative medicine. In this review, we discuss the main points of the current understanding on the host response to implanted biomaterials and how the paradigm of "immune-evasive" biomaterials has shifted over the last years; the significance of the inflammasome in the inflammatory response to biomaterials; and the growing idea that the immune system is of key importance in an effective tissue repair and regeneration. STATEMENT OF SIGNIFICANCE: We herein discuss the main points of the current understanding on the host response to implanted biomaterials and how the paradigm of "immune-evasive" biomaterials has shifted to "immune-interactive" over the last years; the significance of the inflammasome in the inflammatory response to biomaterials; and the growing idea that the immune system is of key importance in an effective tissue repair and regeneration, supporting the emerging concept of Regenerative Immunology. The inflammasome is a recent and central concept in immunology research. Since the beginning of this century the inflammasome is viewed as key platform of the innate immune response. We believe that, successful modulation of the inflammasome activity will become a milestone in the fields of tissue engineering and regenerative medicine.

Present and future of tissue engineering scaffolds for dentin-pulp complex regeneration

More than two thirds of the global population suffers from tooth decay, which results in cavities with various levels of lesion severity. Clinical interventions to treat tooth decay range from simple coronal fillings to invasive root canal treatment. Pulp capping is the only available clinical option to maintain the pulp vitality in deep lesions, but irreversible pulp inflammation and reinfection are frequent outcomes for this treatment. When affected pulp involvement is beyond repair, the dentist has to perform endodontic therapy leaving the tooth non-vital and brittle. On-going research strategies have failed to overcome the limitations of existing pulp capping materials so that healthy and progressive regeneration of the injured tissues is attained. Preserving pulp vitality is crucial for tooth homeostasis and durability, and thus, there is a critical need for clinical interventions that enable regeneration of the dentin-pulp complex to rescue millions of teeth annually. The identification and development of appropriate biomaterials for dentin-pulp scaffolds are necessary to optimize clinical approaches to regenerate these hybrid dental tissues. Likewise, a deep understanding of the interactions between the micro-environment, growth factors, and progenitor cells will provide design basis for the most fitting scaffolds for this purpose. In this review, we first introduce the long-lasting clinical dental problem of rescuing diseased tooth vitality, the limitations of current clinical therapies and interventions to restore the damaged tissues, and the need for new strategies to fully revitalize the tooth. Then, we comprehensively report on the characteristics of the main materials of naturally-derived and synthetically-engineered polymers, ceramics, and composite scaffolds as well as their use in dentin-pulp complex regeneration strategies. Finally, we present a series of innovative smart polymeric biomaterials with potential to overcome dentin-pulp complex regeneration challenges.

Nanostructured endodontic materials mixed with different radiocontrast agents-biocompatibility study

The aim of this study was to investigate the biocompatibility of nanostructured materials based on highly active calcium silicates mixed with different radiocontrast agents in comparison to MTA⁺ using in vitro and in vivo model. Morphology of materials' samples was analyzed using SEM while the phase compositions were identified by XRD. pH values of materials' suspensions were conducted by pH-meter. The cytotoxicity of materials' solutions was tested by MTT test (100, 50, 25 and 12.5 mg/ml). LDH and ³H-thymidine assay were utilized for biocompatibility investigations of materials' eluates (24 h, 7 day and 21 day). Eighteen Guinea pigs were used for intramuscular implantation, as teflon tubes with freshly prepared materials were placed into intramuscular pockets. All samples were composed of round and needle-like particles equally distributed with Ca/Si ratio ~2.7 at%, with the presence of hydrated calcium silicate phases. The pH values of ALBO-MPCA₁ and ALBO-MPCA₂ were high alkaline, while in case of MTA⁺ they were lower and continuously declined (p < 0.05). Investigated materials didn't exhibit dose-dependent effect on metabolic activity of L929 cells (p > 0.05). Significant differences in the percentage of cytotoxicity between diluted and undiluted extracts between all tested materials after 24 h and 7 day were noticed (p < 0.05). Increase in L929 cells proliferation was noticed in case of undiluted eluates of ALBO-MPCA₁ and ALBO-MPCA₂ after 7 day (p < 0.05). There were no statistically significant differences in the intensity of inflammatory response between investigated materials and control group after 60 day (p > 0.05). Evaluation of biocompatibility of both ALBO-MPCA₁ and ALBO-MPCA₂ indicate their potential clinical use.

Predoctoral and Postdoctoral Training Pipeline in Translational Biomaterials Research and Regenerative Medicine

The translation of biomaterial based and regenerative therapies from the laboratory to patients involves multiple challenges. One of the most pressing challenges is the educational one: to train a cohort of scientists and engineers capable of translating their discoveries from bench to market to clinic. To meet this need, translational training programs are being implemented globally at universities and as partnerships between universities and corporations. In this perspective, we describe two translational NIH T32 graduate and postgraduate training programs that augment the traditional approach to training early stage scientists and engineers. At the graduate level, Boston University developed and implemented the Translational Research in Biomaterials (TRB) predoctoral training program. At the postgraduate level, Rutgers, The State University of New Jersey, developed and implemented the Translational Research in Regenerative Medicine (TRRM) program for postdoctoral training. These programs are motivated by the need for training in translational research in the biomedical field, by young scientists' requests for such training, and by the fundamental challenges facing future discovery and clinical implementation of biomaterial-based technologies. The TRB program immerses trainees in the concept of translating an idea from the research laboratory to the clinic, introduces them to the challenges of such an endeavor, provides discussions with relevant faculty (for example, with businesses, patient care, or clinical trial experience), and educates them in the critical areas required for their future careers. Similarly, the TRRM program emphasizes translational research and the concept of "training without borders," which enables collaborations across several geographically dispersed institutions so as to make regional experts accessible regardless of where they are located physically. Both programs promote interdisciplinary research, expose young scientists and engineers to challenges outside of their specialty, and build interpersonal skills for cross-disciplinary communication. The TRB program focuses on quantitative science and engineering courses, together with translation-based courses in clinical trials and business. The TRRM program focuses on broadening the horizon of its trainees through exposure to a wider network of mentors than traditional postdoctoral programs, and by encouraging trainees to engage in collaborative research across at least two different laboratories. Both programs meet significant public health needs: the skills that trainees acquire are essential in future biomedical careers as they join teams that combine diverse backgrounds to meet a common goal in research, development, and ultimately commercialization.

Tuning Bulk Hydrogel Degradation by Simultaneous Control of Proteolytic Cleavage Kinetics and Hydrogel Network Architecture

Degradation of three-dimensional hydrogels is known to regulate many cellular behaviors. Accordingly, several elegant approaches have been used to render hydrogels degradable by cell-secreted proteases. However, existing hydrogel systems are limited in their ability to simultaneously and quantitatively tune two aspects of hydrogel degradability: cleavage rate (the rate at which individual chemical bonds are cleaved) and degraded hydrogel architecture (the network structure during degradation). Using standard peptide engineering approaches, we alter the proteolytic kinetics of the polymer cleavage rate to tune gel degradation time from less than 12 h to greater than 9 days. Independently, we vary the cross-linker functionality to achieve network architectures that initially have identical molecular weight between cross-links but upon degradation are designed to release between 5% and 100% of the polymer. Confirming the biological relevance of both parameters, formation of vascular-like structures by endothelial cells is regulated both by bond cleavage rate and by degraded hydrogel architecture. This strategy to fine-tune different aspects of hydrogel degradability has applications in cell culture, regenerative medicine, and drug delivery.

The Role of Colloidal Stability and Charge in Functionalization of Aqueous Quantum Dots

Semiconductor quantum dots (QDs), also known as nanocrystals, have unique photophysical properties that have allowed them to find utility in many applications, including television and display technologies. They also have significant potential as imaging agents in the biomedical field. To gain the most value from the use of QDs as health-related fluorescent probes, they must be biologically targetable and sensitive to metabolic analytes such as pH and O₂, and the resulting signal must be quantifiable. To achieve these goals, QDs need to be conjugated to vectors such as antibodies or environmentally sensitive chromophores. Until recently, the functionalization of these nanomaterials required a complex fully "bottom-up" approach beginning with the synthesis of the QDs and subsequent manipulations. To simplify this process, our group set out to develop straightforward methods to prepare functionalized nanomaterials for biological imaging and sensing using low-cost, commercially available aqueous QD dispersions. In this Account, we review the common problems and likely solutions related to functionalization of QDs in water with chemical and biological vectors. Early in our investigations, we found that established protocols using a commercially available activating reagent resulted in either low reaction yields or QD precipitation. This was a consequence of the perturbation of the QDs' surface charges by the activating reagent and the conjugation substrate. These surface charges are derived from the anionic surfactants that are commonly employed for encapsulating water-soluble nanomaterials. Thus, cancellation of the surface charges by reagents or substrates results in colloidal instability. To address this problem, we devised conjugation methods that do not alter the overall charge balance of the system. Incorporating reactive moieties directly into the QD's water-solubilizing polymer encapsulants negates the need for destabilizing activators, allowing for functionalization of aqueous samples without precipitation. The most successful approach was realized using neutral activating reagents, such as poly(ethylene glycol) carbodiimide (PEG-CD). PEG-CD binds to the carboxylic acid coating of water-soluble QDs, which primes them for amide bond formation with amine-functionalized substrates. Most importantly, this method can be applied to commercially available aqueous QDs. Using this method, we achieved reaction yields as high as 95%, allowing us to demonstrate a wide-range of QD functionalities and applications for chemical and biological sensing. Conjugation of environmentally sensitive dyes to water-soluble QDs results in reversible and ratiometrically reporting fluorescent probes for metabolic analytes such as pH, bisulfide, and O₂. QDs can also be functionalized with proteins for passive cell delivery or coated with poly(ethylene glycol) to enhance biocompatibility for in vivo studies. In the future, these capabilities may be combined to realize the full potential of quantum dot nanotechnology for biological discovery.

Toll-like Receptor 2-Dependent NF-κB/AP-1 Activation by Damage-Associated Molecular Patterns Adsorbed on Polymeric Surfaces

The foreign body reaction is a chronic inflammatory response to an implanted biomaterial that ultimately leads to fibrous encapsulation of the implant. It is widely accepted that the host response to implanted biomaterials is largely dependent on the species and conformations of proteins adsorbed onto the material surface due to the adsorbate's role in mediating cellular interactions with the implanted material. While the cellular response to adsorbed serum-derived proteins has been studied extensively, the presence of endogenous, matrix- and cell-derived mediators of inflammation within the adsorbed protein layer and their impact on cell-material interactions is not well-understood. Damage associated molecular patterns (DAMPs) are endogenous ligands released by stressed or damaged tissues to stimulate sterile inflammatory responses via Toll-like receptors (TLRs) and other pattern recognition receptors. The present study investigated the potential role of tissue-derived, pro-inflammatory stimuli in macrophage responses to biomaterials using cell lysate as a complex source of cell-derived DAMPs and poly(methyl methacrylate) (PMMA) and polydimethylsiloxane (PDMS) films as model biomaterials. We show that lysate-adsorbed PMMA and PDMS surfaces strongly induced NF-κB/AP-1 transcription factor activity and pro-inflammatory cytokine secretion in the RAW-Blue macrophage cell line compared to serum-adsorbed surfaces. Lysate-dependent NF-κB/AP-1 activation and cytokine expression were strongly attenuated by TLR2 neutralizing antibodies, while TLR4 inhibition resulted in a modest reduction. These data suggest that DAMPs, in their adsorbed conformations on material surfaces, may play a significant role in macrophage activation through TLR signaling, and that TLR pathways, particularly TLR2, merit further investigation as potential therapeutic targets to modulate host responses to implanted biomaterials.

Fouling-Release Properties of Dendritic Polyglycerols against Marine Diatoms

Dendritic polyglycerols (PGs) were grafted onto surfaces using a ring-opening polymerization reaction, and the fouling-release properties against marine organisms were determined. The coatings were characterized by spectroscopic ellipsometry, contact angle goniometry, ATR-FTIR, and stability tests in different aqueous media. A high resistance toward the attachment of different proteins was found. The PG coatings with three different thicknesses were tested in a laboratory assay against the diatom Navicula incerta and in a field assay using a rotating disk. Under static conditions, the PG coatings did not inhibit the initial attachment of diatoms, but up to 94% of attached diatoms could be removed from the coatings after exposure to a shear stress of 19 Pa. Fouling release was found to be enhanced if the coatings were sufficiently thick. The excellent fouling-release properties were supported in dynamic field-immersion experiments in which the samples were continually exposed to a shear stress of 0.18 Pa.

Foreign Body Reaction to a Subcutaneously Implanted Self-Cleaning, Thermoresponsive Hydrogel Membrane for Glucose Biosensors

Towards achieveing a subcutaneously implanted glucose biosensor with long-term functionality, a thermoresponsive membrane previously shown to have potential to house a glucose sensing assay was evaluated herein for its ability to minimize the foriegn body reaction (FBR) and the resulting fibrous capsule. The severity of the FBR proportionally reduces diffusion of glucose to the sensor and hence sensor lifetime. However, efforts to reduce the FBR have largedly focused on anti-fouling materials that passively inhibit cellular attachment, particularly poly(ethylene glycol) (PEG). Herein, the extent of the FBR of a subcutaneously implanted "self-cleaning" cylindrical membrane was analyzed in rodents. This membrane represents an "actively anti-fouling" approach to reduce cellular adhesion. It is a thermoresponsive double network nanocomposite hydrogel (DNNC) comprised of poly(N-isopropylacrylamide) (PNIPAAm) and embedded polysiloxane nanoparticles. The membrane's cyclical deswelling/reswelling response to local body temperature fluctuations was anticipated to limit cellular accumulation. Indeed, after 30 days, the self-cleaning membrane exhibited a notably thin fibrous capsule (~30 µm) and increased microvascular density within 1 mm of the implant surface in comparison to a non-thermoresponsive, benchmark biocompatible control (PEG diacrylate, PEG-DA).

In vivo regeneration functionalities of experimental organo-biomaterials containing water-soluble nacre extract

Background

Novel multifunctional biomaterials were recently designed to allow for an optimized tissue regeneration process.

Purpose

To comprehensively assess (photographic, radiographic and histological) the in vivo functionality of demineralized bovine bone matrix (DBM) associated with an experimental marine organic extract (MOE) from nacre in a sheep ectopic grafting model.

Materials and methods

Synthesis of MOE was based on mixing powdered nacre (0.05 g, particles average size <0.1 mm) with acetic acid (5 mL, pH 7) under constant stirring for 72 hours (25 °C). Polyethylene tubes (3/animal, n = 4, diameter: 5.0 mm × length: 10.0 mm) from the control (empty) or experimental groups (DBM or DBM + MOE) were then intramuscularly implanted into the lumbar regions of sheep (n = 8, 2-years old, ≈45 kg). Animals were euthanized at 3 and 6 months to allow for the collection of tissue samples. Tissue samples were fixed in formalin 10% (buffered, 7 days) in preparation for photographic, radiographic and histological assessments. Acquired images were then analyzed using digital image analysis software to quantify the amount of neoformed tissues, whereas radiographic and histological analyses were performed to determine radiopacity and classification of tissues deposited inside of the tubes.

Results

Photographic and radiographic analyses have shown that both pure (unaltered) and MOE-modified DBM were capable of depositing neoformed tissues (at 3 and 6 months), where higher levels of deposition and radiopacity were observed on groups treated with experimental materials. Histological results, however, demonstrated that tissues formed from both unaltered and MOE-modified DBM were only fibrous connective in origin.

Conclusions

As an ectopic grafting in sheep, the experimental organo-biomaterial association applied did not reveal any osteoinductive property but led to a fibrous tissue repair only.