Histological changes of implanted collagen material during bone induction

Local application of an ibandronate/collagen sponge improves femoral fracture healing in ovariectomized rats

Non-union is a major clinical problem in the healing of fractures, especially in patients with osteoporosis. The systemic administration of drugs is time consuming and large doses are demanding and act slowly, whereas local release acts rapidly, increases the quality and quantity of the bone tissue. We hypothesize that local delivery demonstrates better therapeutic effects on an osteoporotic fracture. The aim of this paper is to investigate the effect of the local application of ibandronate loaded with a collagen sponge on regulating bone formation and remodeling in an osteoporotic rat model of fracture healing. We found that the local delivery of ibandronate exhibited excellent effects on improving the bone microarchitecture and suppressed effects on bone remodeling. At 4 weeks, more callus formation and improvement of mechanical character and microstructure were observed in a local delivery via μCT, mechanical test, histological research and serum analysis. The suppression of bone remodeling was compared with a systemic treatment at 12 weeks, and the structural mechanical properties and microarchitecture were also improved with local delivery. This research identifies an earlier, safer and integrated approach for local delivery of ibandronate with collagen and provides a better strategy for the treatment of osteoporotic fracture in rats.

Novel synthesis and characterization of a collagen-based biopolymer initiated by hydroxyapatite nanoparticles

In this study, we developed a novel synthesis method to create a complex collagen-based biopolymer that promises to possess the necessary material properties for a bone graft substitute. The synthesis was carried out in several steps. In the first step, a ring-opening polymerization reaction initiated by hydroxyapatite nanoparticles was used to polymerize d,l-lactide and glycolide monomers to form poly(lactide-co-glycolide) co-polymer. In the second step, the polymerization product was coupled with succinic anhydride, and subsequently was reacted with N-hydroxysuccinimide in the presence of dicyclohexylcarbodiimide as the cross-linking agent, in order to activate the co-polymer for collagen attachment. In the third and final step, the activated co-polymer was attached to calf skin collagen type I, in hydrochloric acid/phosphate buffer solution and the precipitated co-polymer with attached collagen was isolated. The synthesis was monitored by proton nuclear magnetic resonance, infrared and Raman spectroscopies, and the products after each step were characterized by thermal and mechanical analysis. Calculations of the relative amounts of the various components, coupled with initial dynamic mechanical analysis testing of the resulting biopolymer, afforded a preliminary assessment of the structure of the complex biomaterial formed by this novel polymerization process.

Autologous bone marrow derived mononuclear cells combined with β-tricalcium phosphate and absorbable atelocollagen for a treatment of aneurysmal bone cyst of the humerus in child

Aneurysmal bone cyst is a benign, locally destructive lesion of bone. Based on progressive cortical thinning pathological fractures are common, and are often the presenting feature. Despite the long experience of orthopaedists, radiologists and pathologists with aneurysmal bone cyst there is limited knowledge regarding the cause of the lesion and optimal treatment. Common methods of treatment vary considerably in the literature, particularly in children. A large variety of bone substitutes have been used to fill the cystic lesions. To date there has been no graft material which can be regarded as completely satisfactory. Our experience with freshly isolated autologous bone marrow derived mononuclear cells combined with β-tricalcium phosphate and absorbable atelocollagen for bone formation is presented. The concept of this treatment is based on stimulation of natural events continuously present in living bone appear to be a reasonable and beneficial alternative to promote healing of bone cysts and offering both osteoinduction and osteoconductive features.

Pharmacokinetics and bone formation by BMP-2 entrapped in polyethylenimine-coated albumin nanoparticles

The osteoinductive growth factor, bone morphogenetic protein-2 (BMP-2), is capable of inducing de novo bone formation after implantation. A nanoparticulate (NP) system was developed for BMP-2 delivery based on NPs fabricated from bovine serum albumin (BSA) and stabilized by polyethylenimine (PEI) coating. In this study, the pharmacokinetics and osteoinductivity of BMP-2 delivered with different BSA NP formulations were determined by subcutaneous implantation in rats. A 7-day pharmacokinetics study showed that PEI coating on NPs effectively reduced the initial burst release of BMP-2 and prolonged the BMP-2 retention at implantation site. However, the uncoated BMP-2 NPs (BMP-2 loading of 1.44% w/w) were able to induce a robust ectopic bone formation, while no bone formation was found by the BMP-2 NPs coated with PEI. The toxicity of the PEI used for NP coating was determined to be the reason for lack of osteoinduction. Increasing BMP-2 loading (up to 5.76% w/w) was then employed to formulate NPs with lower PEI content; the higher BMP-2 loading was found to better promote induction of de novo bone. Our findings indicated that PEI coating on BSA NPs was effective for controlling BMP-2 release from NPs, but the toxicity of cationic PEI was a concern for the osteoinductive activity, which should be alleviated by further optimization of NP formulations.

The effect on osteogenesis of type I collagen applied to experimental bone defects

The purpose of the present investigation was to evaluate the effects of type I collagen sponge on the healing of bone defects. In this study, six adult male rabbits were used. After the induction of general anesthesia with intraperitoneal kethamine, the anterior surfaces of tibias of the rabbits were surgically exposed, and two holes with 4 mm in diameter were prepared on each tibia for the investigation. Only one hole in each tibia was filled with type I collagen, the other unfilled hole was used as control. During the study, radiopacity changes in the radiographs of the tibias of the rabbits were evaluated. The animals were killed on the 28th day, and histologic sections of the tibias were prepared. On the 28th day, it was histopathologically observed that collagen cavities were filled with new bone. In addition, it was determined that there was an increase in radiopacity of the defect areas from 14 to 28 days in both groups, and there were statistically a significant difference between control and collagen groups (P = 0.0001). In this study, consequently, it was determined that type I collagen sponge in the experimental cavities provides a more rapid regeneration of bone defects compared with non-filled cavities.

A composite graft material containing bone particles and collagen in osteoinduction in mouse

Demineralized allogenic bone matrices (DABM) and demineralized freeze-dried bone allograft (DFDBA) have been successfully used as bone-graft materials in the treatment of acquired and congenital cranio-maxillofacial defects and in some orthopedic surgery. However, these bone-graft "powders" have many shortcomings. For example, placement of particulate graft material in a hemorrhaging site can result in inadequacies or inaccurate attachment as well as loss of the graft materials. To minimize the inadequacies of powderlike graft materials, xenogenic collagen isolated from human tendon, skin, or bone was added to the bone-graft particles to form a composite spongelike implant. This material is commercially available and consists of 60% collagen and 40% DFDBA (DynaGraft, GenSci Co., Irvine, CA). The goal of this study was to evaluate the characteristics of composite graft implants in the mineralization process in an animal model in comparison with DFDBA powder and pure collagen. Seventy-two Swiss Webster mice were divided into three groups: an experimental group implanted with DynaGraft, two comparison groups implanted with either DFDBA or collagen only. All the graft materials were surgically implanted and inserted into the left thigh muscle. Mice were humanely killed at 1, 2, 3, 4, 6, 8, and 12 weeks. Then the muscle tissues in the vicinity of the implants were excised and processed for histology. Paraffin sections were stained with hematoxylin and eosin (H&E), the Von Kossa method, and Masson's trichrome. Some selected specimens were processed for transmission electron microscopic observation. After 1 week of implantation, the DynaGraft group showed calcium deposition on the collagen material and on the periphery of the DFDBA particles. Increased calcification and bone-forming cells were observed at 4-6 weeks. After 8 weeks, the implant formed a calcified nodule and only heavily mineralized connective tissue was observed at the implanted site. The group implanted with DFDBA powder showed calcification around the particulates. The collagen-sponge control group revealed no calcification or bone formation during the period of implantation. The light microscopic findings were confirmed by electron microscopy. Quantitative radiographic density DynaGraft and DFDBA graft followed sequentially over a period 120 days. It was concluded that a higher rate of calcification and bone formation was produced in the composite graft implant compared to the DFDBA implant. The composite graft material (DynaGraft), which contains both collagen and DFDBA, proved to be more effective for bone formation than particle components alone.

Evaluation of the effect of heterologous type I collagen on healing of bone defects

PURPOSE

The purpose of this investigation was to evaluate the effect of type I collagen on the healing of bone defects both experimentally and clinically.

MATERIALS AND METHODS

In the experimental study, 16 adult male rabbits were divided into 2 groups: a collagen group and a control group. After the induction of general anesthesia with intraperitoneal ketamine, the anterior surfaces of tibias of the rabbits were surgically exposed, and a hole 4 mm in diameter was made in each tibia. In the collagen group, the defects were filled with type I collagen. The unfilled defects of the other animals were used as controls. During the study, the serum alkaline phosphatase activity of the rabbits, and radiopacity changes in the radiographs of the tibias of the rabbits were evaluated. The rabbits were killed on the 35th day, and histologic sections of the tibias were prepared. The clinical study was carried out on periapical defects in a total of 15 patients who underwent apicoectomy. After the surgical procedure, the osseous defects in periapical regions of 7 patients were filled with type I collagen. The unfilled cavities of the other patients were used for control purposes. The patients were evaluated clinically and radiographically in the postoperative period. The data were analyzed by Student's t-test and Mann-Whitney U test.

RESULTS

In the experimental study, there was an increase in radiopacity corresponding with the serum alkaline phosphatase activity, and there were statistically significant differences between the control and collagen groups both radiologically and biochemically on the 14th and 28th days of the study. In the clinical study, the control cavities filled with a tissue of normal bone density in about 5 months, but the collagen cavities filled in 3 months.

CONCLUSIONS

It was determined that heterologous type I collagen provides a more rapid regeneration of bone defects.

Osteogenic evaluation of glutaraldehyde crosslinked gelatin composite with fetal rat calvarial culture model

The cytotoxicity of the synthetic bone substitute composed of tricalcium phosphate and glutaraldehyde crosslinked gelatin (GTG) were evaluated by osteoblast cell culture. In a previous study, the GTG composites were soaked in distilled water for 1, 2, 4, 7, 14, 28, and 42 days, and then the solutions (or extracts) were cocultured with osteoblasts to evaluate the cytotoxicity of GTG composites by alive cell counting. In this study, the extracts were cocultured with the osteoblasts; thereafter, the concentration of transforming growth factor-beta (TGF-beta1) and prostaglandin E2 (PGE2) in the medium was analyzed to strictly reflect the biological effects of GTG composites on the growth of osteoblasts. In order to investigate the osteoconductive potential of the GTG composites on new bone formation in a relative short term, a model of neonatal rat calvarial organ culture was designed prior to animal experiments. Three experimental materials of 4, 8, and 12% GTG composites were evaluated by fetal rat calvarial organ culture for their ability for bone regeneration. Deproteinized bovine and porcine cancellous bone matrixes were used as the controlled materials. All the organ culture units were maintained in cultured medium for 5 weeks. Following the culture period, the morphology of tissue was observed under an optical microscope, and the quantitative evaluation of the new generation bone was determined by using a semiautomatic histomorphometeric method. Except in the initial 4 days, the concentration of TGF-beta1 of 4% and 8% GTG composites was higher than that of the blank group for all the other experimental time periods. The PGE2 concentration for 4% and 8% GTG composites was lower than that of the blank group. It revealed that the 4% and 8% GTG composites would not lead to inflammation and would promote osteoblast growth. The morphology and activity of the osteoblasts were not transformed or changed by the 2 GTG composites. For the 12% GTG composite, the performance of the in vitro condition was inferior to the blank group and the other 2 GTG composites. Although the concentration of TGF-beta1 and PGE2 was gradually back to normal after 14 days, the morphology of the osteoblasts was abnormal with features such as contracted cytoplast structures. The osteoblast was damaged perhaps in the initial stage. We suggested that the 4% and 8% GTG composites should be soaked in distilled water at least for 4 days before medical applications. The 12% GTG composite and the composites with a concentration of glutaraldehyde solution higher than 12% were not recommended as a medical prostheses in any condition. The fetal rat calvaria culture also showed the same results with the analysis of TGF-beta1 and PGE2. From the study, we could predict the results of animal experiments in the future.

Morphologic analysis of BMP-9 gene therapy-induced osteogenesis

The present study was performed to determine the histological, ultrastructural, and radiographic changes that occur over time at intramuscular BMP-9 gene therapy treatment sites. Several members of the bone morphogenetic protein (BMP) family have the potential to induce osteochondrogenesis when the protein is delivered to rodents, canines, rabbits, and nonhuman primates. Previous studies have also demonstrated that BMP gene therapy utilizing adenoviral vectors can also stimulate orthotopic and heterotopic bone formation in rodents and rabbits. Athymic nude and Sprague-Dawley rats were injected with Ad-BMP-9 or Ad-beta-Gal (3.75 x 10(9) particles) in their thigh musculature and light microscopic, electron microscopic, and computerized tomography analysis was performed 3, 6, 9, 12, 15, 18, 21, and 100 days later. To assess early mesenchymal cell proliferation, a bromodeoxyuridine (BrdU) immunohistochemical analysis was also performed 48, 60, and 72 hr postinjection in athymic nude rats. All animals demonstrated extensive endochondral bone formation at the Ad-BMP-9 treatment sites within 3 weeks. The Sprague-Dawley rats also exhibited a massive, acute inflammatory infiltrate during the first week. Proliferating mesenchymal stem cells were clearly evident as early as 2 days after treatment, which differentiated into small or hypertrophied chondrocytes during the next week. During the third week, the cartilaginous matrix mineralized and formed woven bone, which converted to lamellar bone by 3 months. No evidence of bone formation was demonstrated at the Ad-beta-Gal injection sites in the athymic nude or Sprague-Dawley rats. In addition, no cellular proliferation was seen at the Ad-beta-Gal treatment sites in the athymic nude animals as assessed by light microscopy and BrdU immunohistochemistry. The extensive bone formation induced by Ad-BMP-9 suggests that BMP gene therapy may have potential utility in the treatment of degenerative, rheumatic, or traumatic bone pathology.

Platelet derived growth factor releasing chitosan sponge for periodontal bone regeneration

With an aim of improving bone regeneration, chitosan sponge containing platelet-derived growth factor-BB (PDGF-BB) were developed. For fabrication of chitosan sponge, chitosan solution was freeze-dried, crosslinked and freeze-dried again. PDGF-BB was incorporated into the chitosan sponge by soaking chitosan sponge into the PDGF-BB solution. Release kinetics of PDGF-BB, cell attachment, proliferation capacity and bony regenerative potentials of PDGF-BB-loaded chitosan sponge were investigated. Prepared chitosan sponge retained porous structure with 100 microm pore diameter that was suitable for cellular migration and growth. Release rate of PDGF-BB could be controlled by varying initial loading content of PDGF-BB to obtain optimal therapeutic efficacy. PDGF-BB-loaded chitosan sponge induced significantly high cell attachment and proliferation level, which indicated good cellular adaptability. PDGF-BB-loaded chitosan sponge demonstrated marked increase in new bone formation and rapid calcification. Degradation of the chitosan sponge was proceeded at defect site and subsequently replaced with new bone. Histomorphometric analysis confirmed that PDGF-BB-loaded chitosan sponge significantly induced new bone formation. These results suggested that chitosan sponge and PDGF-BB-loaded chitosan sponge may be beneficial to enhance periodontal bone regeneration.

Collagen--biomaterial for drug delivery

The use of collagen as a biomaterial is currently undergoing a renaissance in the tissue engineering field. The biotechnological applications focus on the aspects of cellular growth or delivery of proteins capable of stimulating cellular response. However, basic knowledge about collagen biochemistry and the processing technology in combination with understanding of the physico-chemical properties is necessary for an adequate application of collagen for carrier systems. The purpose of this review article is to summarize information available on collagen dosage forms for drug delivery as well as to impart an overview of the chemical structures and the galenical properties including detailed description of the processing steps - extraction, purification, chemical crosslinking and sterilization. The most successful and stimulating applications are shields in ophthalmology, injectable dispersions for local tumor treatment, sponges carrying antibiotics and minipellets loaded with protein drugs. However, the scientific information about manipulating release properties or mechanistic studies is not as abundant as for some synthetic polymers.

Bone formation by cells from femurs cultured among three-dimensionally arranged hydroxyapatite granules

In vitro bone formation by cells derived from adult rabbit femurs was investigated on or in several substrates with small porous hydroxyapatite granules (HAGs). When the bone fragments were cultured in HAG-packed glass tubes, which were inclined (5 degrees -30 degrees ) and rotated 90 degrees per day after one week of culture, thin lamellar tissues were newly formed in narrow spaces among the HAGs. By 11 days of culture, these tissues had been mineralized except for their periphery and had well developed collagen bundles and several monolayer cells. Some cells resided in bone lacuna-like spaces. By contrast, mineralization was negligible in 6-week cultures on two-dimensional glass and polystyrene plates with or without two-dimensionally arranged HAGs on their surfaces and in three-dimensional collagen gels with or without HAGs in spite of active cell proliferation. These results suggest that osteogenesis is accelerated in a specific three-dimensional constitution of extracellular matrix and/or under the effects of mechanical forces for the new tissue and that bioactive HAGs offer favorable three-dimensional spaces for osteogenic tissue formation.

Protein delivery from biodegradable microspheres

The key components to the successful development of a biodegradable microsphere formulation for the delivery of proteins are polymer chemistry, engineering, and protein stability. These areas are intricately related and require a thorough investigation prior to embarking on the encapsulation of proteins. While each of these components is important for the development of a biodegradable microsphere formulation for protein delivery, other critical issues should also be considered. In particular, preclinical studies in the appropriate animal model are usually necessary to assess the potential feasibility of a continuous-release dosage form. These studies should be performed at the earliest possible stage of development to validate the feasibility of a controlled release formulation. After the utility of a controlled release formulation has been demonstrated, the polymer matrix should be chosen and bench-scale production of microspheres initiated. The only polymers presently approved for human use for controlled delivery are the polylactides [poly(lactic acid), poly(glycolic acid), and poly(lactic-coglycolic) acid]. These polymers require multiphase processes involving several steps to produce microspheres containing the desired protein. A thorough review of previous work on encapsulation with these polymers should provide some insight into conditions to be assessed in developing a process. Once a process is chosen, it must be optimized to provide the highest possible yield of microspheres with the desired characteristics (e.g., loading, release, size, etc.). Finally, the final aseptic process should be validated and methods generated to assess the final product. The clinical studies should then start upon approval of the IND application. In the future, the biotechnology industry, and the pharmaceutical industry in general, will be seeking new methods to improve the delivery of therapeutic agents such as proteins and peptides. Formulations like biodegradable microspheres significantly reduce health-care costs since fewer administrations are needed, and they provide a competitive advantage in markets with several competing products (e.g., LHRH agonist market). Further, many new indications such as neurological diseases may require a long-term delivery system. The future success of biodegradable microsphere formulations will primarily depend on the commitment of the pharmaceutical and biotechnology industries to the development of this technology.

Morphological features of bone healing under the effect of collagen-graft-glycosaminoglycan copolymer supplemented with the tripeptide Gly-His-Lys

The authors prepared 7.5% and 12.5% collagen gel, and supplemented it with the tripeptide Gly-His-Lys (GHK), perfloxacine and hypersulphated glycosaminoglycan (HSGAG). By means of 125l marking, its absorption was followed from small polyurethane sponges placed under the skin of rats. The absorption of gel without HSGAG was found to be faster. Antibodies against collagen (type I, II and III) or collagen gel were generated either in rabbits or in minipigs, in which collagen gel was tested. Microbiological tests proved the sterility of the collagen gel. The collagen gel supplemented with GHK, pefloxacine and HSGAG was named Colladel, and was used in a model experiment in guinea-pigs for filling artificially created bone defects in diaphyses of femurs, and with cementless endoprostheses. The healing process was followed by means of RTG and NMR, and histologically. The slowest healing process was found in unfilled bone defects. Defects filled with Colladel without GHK healed substantially more quickly, and the most accelerated healing was connected with complete Colladel application. When Colladel was used with cementless endoprostheses, vivid osteogenic activity at the interface of trabecular bone and metal stem was detectable in the course of the experiment.