Histocompatibility of photocrosslinked polyanhydrides: a novel in situ forming orthopaedic biomaterial

Synthetic and Bone tissue engineering graft substitutes: What is the future?

The management of large segmental bone defects caused by trauma or disease remains clinically challenging within orthopaedics. The major impediment to bone healing with current treatment options is insufficient vascularization and incorporation of graft material. Lack of rapid adequate vascularization leads to cellular necrosis within the inner regions of the implanted material and a failure of bone regeneration. Current treatment options for critical size bone defects include the continued "gold standard" autograft, allograft, synthetic bone graft substitutes, vascularized fibular graft, induced membrane technique, and distraction osteogenesis. Bone tissue engineering (BTE) remains an exciting prospect for the treatment of large segmental bone defects; however, current clinical integration of engineered scaffolds remains low. We believe that the barrier to clinical application of bone tissue engineering constructs lies in the lack of concomitant vascularization of these scaffolds. This mini-review outlines the progress made and the significant limitations remaining in successful clinical incorporation of engineered synthetic bone substitutes for segmental defects.

Systematic Studies on Surface Erosion of Photocrosslinked Polyanhydride Tablets and Data Correlation with Release Kinetic Models

Photocrosslinkable polyanhydrides that undergo surface erosion are suitable materials for controlled-release drug delivery systems. Investigating the impact of different parameters on their erosion behavior is essential before use in drug delivery systems. Although their synthesis is well-established, parameters that may substantially affect the erosion of thiol-ene polyanhydrides including temperature and pH of the media, the geometry of the polymers, and the media shaking rate (the convective force for the polymer erosion), have not yet been studied. This study explores the effects of different environmental and geometric parameters on mass loss (erosion) profiles of polyanhydrides synthesized by thiol-ene photopolymerization. A comparative study on several release kinetic models fitting is also described for a better understanding of the polymer erosion behavior. The results demonstrated that although the temperature was the only parameter that affected the induction period substantially, the mass-loss rate was influenced by the polymer composition, tablet geometry, temperature, pH, and mass transfer (shaking) rate. With regard to geometrical parameters, polymers with the same surface area to volume ratios showed similar mass loss trends despite their various volumes and surface areas. The mass loss of polyanhydride tablets with more complicated geometries than a simple slab was shown to be non-linear, and the kinetic model study indicated the dominant surface erosion mechanism. The results of this study allow for designing and manufacturing efficient delivery systems with a high-predictable drug release required in precision medicine using surface-erodible polyanhydrides.

Novel Injectable and In situ Curable Glycolide/Lactide Based Biodegradable Polymer Resins and Composites

Novel in situ polymerizable liquid three-arm biodegradable oligomeric polyesters based upon glycolic acid (GA), L-lactic acid (LLA), and their copolymers are synthesized and characterized. Injectable and in situ curable polymer neat resins and their composites formulated with bioabsorbable beta-tricalcium phosphate are prepared at room temperature using photo- and redox-initiation systems, respectively. The cured neat resins show the initial compressive yield strength (YCS, MPa), modulus (M, MPa), ultimate compressive strength (UCS, MPa), and toughness (T, kN mm), ranging from 4.0 to 20.1, 201.5 to 730.2, 82.7 to 310.5, and 1.02 to 3.93. The cured composites show the initial YCS, M, UCS and T, ranging from 27.7 to 56.4, 1440 to 4870, 81.6 to 158.9, and 0.94 to 1.97. Increasing GA/LLA ratio increases all the initial compressive strengths of both neat resins and composites. Increasing filler content increases YCS and M but decreases UCS and T. A diametral tensile strength test shows the same trend as a compressive strength test. There seems to be an optimal flexural strength for the composite at the filler content around 43%. An increasing molar ratio increases curing time but decreases the degree of conversion (DC). An increasing filler content increases curing time but decreases exotherm and DC. During the course of degradation, all the materials show a burst degradation behavior within 24 h, followed by an increase in CS. The poly(glycolic acid) neat resin completely loses its strength at around Day 45. The composites completely lose their strengths at different time intervals, depending on their molar ratio and filler content. The degradation rate is found to be molar ratio and filler-content dependent.

Vascularization in bone tissue engineering constructs

Vascularization of large bone grafts is one of the main challenges of bone tissue engineering (BTE), and has held back the clinical translation of engineered bone constructs for two decades so far. The ultimate goal of vascularized BTE constructs is to provide a bone environment rich in functional vascular networks to achieve efficient osseointegration and accelerate restoration of function after implantation. To attain both structural and vascular integration of the grafts, a large number of biomaterials, cells, and biological cues have been evaluated. This review will present biological considerations for bone function restoration, contemporary approaches for clinical salvage of large bone defects and their limitations, state-of-the-art research on the development of vascularized bone constructs, and perspectives on evaluating and implementing novel BTE grafts in clinical practice. Success will depend on achieving full graft integration at multiple hierarchical levels, both between the individual graft components as well as between the implanted constructs and their surrounding host tissues. The paradigm of vascularized tissue constructs could not only revolutionize the progress of BTE, but could also be readily applied to other fields in regenerative medicine for the development of new innovative vascularized tissue designs.

Physical properties and erosion behavior of poly(trimethylene carbonate-co-ε-caprolactone) networks

Form-stable resorbable networks are prepared by gamma irradiating trimethylene carbonate (TMC)- and ε-caprolactone (CL)-based (co)polymer films. To evaluate their suitability for biomedical applications, their physical properties and erosion behavior are investigated. Homopolymer and copolymer networks that are amorphous at room temperature are flexible and rubbery with elastic moduli ranging from 1.8 ± 0.3 to 5.2 ± 0.4 MPa and permanent set values as low as 0.9% strain. The elastic moduli of the semicrystalline networks are higher and range from 61 ± 3 to 484 ± 34 MPa. The erosion behavior of (co)polymer networks is investigated in vitro using macrophage cultures, and in vivo by subcutaneous implantation in rats. In macrophage cultures, as well as upon implantation, a surface erosion process is observed for the amorphous (co)polymer networks, while an abrupt decrease in the rate and a change in the nature of the erosion process are observed with increasing crystallinity. These resorbable and form-stable networks with tuneable properties may find application in a broad range of biomedical applications.

In vitro comparative study of white and dark polycaprolactone trifumarate in situ cross-linkable scaffolds seeded with rat bone marrow stromal cells

OBJECTIVE

Dark poly(caprolactone) trifumarate is a successful candidate for use as a bone tissue engineering scaffold. Recently, a white polymeric scaffold was developed that shows a shorter synthesis time and is more convenient for tissue-staining work. This is an in vitro comparative study of both the white and dark scaffolds.

METHODS

Both white and dark poly(caprolactone) trifumarate macromers were characterized via Fourier transform infrared spectroscopy before being chemically cross-linked and molded into disc-shaped scaffolds. Biodegradability was assessed by percentage weight loss on days 7, 14, 28, 42 and 56 (n = 5) after immersion in 10% serum-supplemented medium or distilled water. Static cell seeding was employed in which isolated and characterized rat bone marrow stromal cells were seeded directly onto the scaffold surface. Seeded scaffolds were subjected to a series of biochemical assays and scanning electron microscopy at specified time intervals for up to 28 days of incubation.

RESULTS

The degradation of the white scaffold was significantly lower compared with the dark scaffold but was within the acceptable time range for bone-healing processes. The deoxyribonucleic acid and collagen contents increased up to day 28 with no significant difference between the two scaffolds, but the glycosaminoglycan content was slightly higher in the white scaffold throughout 14 days of incubation. Scanning electron microscopy at day 1 [corrected] revealed cellular growth and attachment.

CONCLUSIONS

There was no cell growth advantage between the two forms, but the white scaffold had a slower biodegradability rate, suggesting that the newly synthesized poly(caprolactone) trifumarate is more suitable for use as a bone tissue engineering scaffold.

Effect of β-sheet crystalline content on mass transfer in silk films

The material properties of silk are favorable for drug delivery due to the ability to control material structure and morphology under ambient, aqueous processing conditions. Mass transport of compounds with varying physical-chemical characteristics was studied in silk fibroin films with control of β-sheet crystalline content. Two compounds, vitamin B12 and fluorescein isothiocynate (FITC) labeled lysozyme were studied in a diffusion apparatus to determine transport through silk films. The films exhibited size exclusion phenomenon with permeability coefficients with contrasting trends with increases in β-sheet crystallinity. The size exclusion phenomenon observed with the two model compounds was characterized by contrasting trends in permeability coefficients of the films as a function of β-sheet crystallinity. The diffusivity of the compounds was examined in the context of free volume theory. Apart from the β-sheet crystallinity, size of the compound and its interactions with silk influenced mass transfer. Diffusivity of vitamin B12 was modeled to define a power law relationship with β-sheet crystallinity. The results of the study demonstrate that diffusion of therapeutic agents though silk fibroin films can be directed to match a desired rate by modulating secondary structure of the silk proteins.

Polyanhydride microparticles enhance dendritic cell antigen presentation and activation

The present study was designed to evaluate the adjuvant activity of polyanhydride microparticles prepared in the absence of additional stabilizers, excipients or immune modulators. Microparticles composed of varying ratios of either 1,6-bis(p-carboxyphenoxy)hexane (CPH) and sebacic acid or 1,8-bis(p-carboxyphenoxy)-3,6-dioxaoctane and CPH were added to in vitro cultures of bone marrow-derived dendritic cells (DCs). Microparticles were efficiently and rapidly phagocytosed by DCs in the absence of opsonization and without centrifugation or agitation. Within 2h, internalized particles were rapidly localized to an acidic, phagolysosomal compartment. By 48 h, only a minor reduction in microparticle size was observed in the phagolysosomal compartment, indicating minimal particle erosion consistent with being localized within an intracellular microenvironment favoring particle stability. Polyanhydride microparticles increased DC surface expression of major histocompatability complex class II, the co-stimulatory molecules CD86 and CD40, and the C-type lectin CIRE (murine DC-SIGN; CD209). In addition, microparticle stimulation of DCs also enhanced secretion of the cytokines IL-12p40 and IL-6, a phenomenon found to be dependent on polymer chemistry. DCs cultured with polyanhydride microparticles and ovalbumin induced polymer chemistry-dependent antigen-specific proliferation of both CD4(+) OT-II and CD8(+) OT-I T cells. These data indicate that polyanhydride particles can be tailored to take advantage of the potential plasticity of the immune response, resulting in the ability to induce immune protection against many types of pathogens.

In vivo behavior of trimethylene carbonate and ε-caprolactone-based (co)polymer networks: degradation and tissue response

The in vivo erosion behavior of crosslinked (co)polymers based on trimethylene carbonate (TMC) and ε-caprolactone (CL) was investigated. High molecular weight poly(trimethylene carbonate) (PTMC) homopolymer- and copolymer films were crosslinked by gamma irradiation. To adjust the in vivo erosion rate of the (co)polymer films, both the irradiation dose (25, 50, or 100 kGy) for PTMC and composition (100-70 mol % TMC) at a constant irradiation dose of 25 kGy were varied. After subcutaneous implantation of irradiated films in rats, their in vivo behavior was evaluated qualitatively and quantitatively. When the irradiation dose for PTMC was increased from 25 to 100 kGy, the erosion rate of nonextracted PTMC films (determined at day 5) decreased from 39.7 ± 16.0 μm day(-1) to 15.1 ± 2.5 μm day(-1), and the number of lymphocytes in the tissue surrounding the films decreased from 235 ± 114 cells mm(-2) to 64 ± 33 cells mm(-2). The number of macrophages and giant cells at the tissue-polymer interface also decreased with increasing irradiation dose. All (co)polymer films eroded completely within 28 days of implantation. Variation of the TMC content of gamma irradiated (co)polymer films did not affect the tissue response to the gamma irradiated (co)polymer films and their in vivo erosion behavior much.

Biomechanical analysis of a synthetic, biodegradable impaction graft substitute

Impaction bone grafting in revision arthroplasty is a common and successful procedure to restore primary bone stock. Reducing the amount of bone needed to fill large grafts has been a driving force for the use of synthetic materials that can act as extenders or substitutes. To this end, we evaluated the mechanical properties of a new class of biodegradable polymer beads with and without donor bone to determine its suitability for use in impaction grafting. Biodegradable methacrylated anhydride beads were synthesized using thermal polymerization techniques. The mechanical properties of the beads were then tested in an impaction grafting test chamber and compared with morsellised porcine allograft. The beads, porcine allograft and a 50/50 combination all had similar mechanical properties, both in compression and relaxation. Pure polymer beads compacted significantly less than pure allograft and retained macroporosity after impaction. Our results suggest that the biodegradable beads have sufficient mechanical properties to be considered as an impaction grafting substitute or extender. Their ability to fill space whilst retaining macroporosity may be advantageous for tissue ingrowth and remodeling.

From natural bone grafts to tissue engineering therapeutics: Brainstorming on pharmaceutical formulative requirements and challenges

Tissue engineering is an emerging multidisciplinary field of investigation focused on the regeneration of diseased or injured tissues through the delivery of appropriate molecular and mechanical signals. Therefore, bone tissue engineering covers all the attempts to reestablish a normal physiology or to speed up healing of bone in all musculoskeletal disorders and injuries that are lashing modern societies. This article attempts to give a pharmaceutical perspective on the production of engineered man-made bone grafts that are described as implantable tissue engineering therapeutics, and to highlight the importance of understanding bone composition and structure, as well as osteogenesis and bone healing processes, to improve the design and development of such implants. In addition, special emphasis is given to pharmaceutical aspects that are frequently minimized, but that, instead, may be useful for formulation developments and in vitro/in vivo correlations.

Biodegradable injectable polyurethanes: synthesis and evaluation for orthopaedic applications

Biodegradable polyurethanes offer advantages in the design of injectable or preformed scaffolds for tissue engineering and other medical implant applications. We have developed two-part injectable prepolymer systems (prepolymer A and B) consisting of lactic acid and glycolic acid based polyester star polyols, pentaerythritol (PE) and ethyl lysine diisocyanate (ELDI). This study reports on the formulation and properties of a series of cross linked polyurethanes specifically developed for orthopaedic applications. Prepolymer A was based on PE and ELDI. Polyester polyols (prepolymer B) were based on PE and dl-lactic acid (PEDLLA) or PE and glycolic acid (PEGA) with molecular weights 456 and 453, respectively. Several cross linked porous and non-porous polyurethanes were prepared by mixing and curing prepolymers A and B and their mechanical and thermal properties, in vitro (PBS/37 degrees C/pH 7.4) and in vivo (sheep bi-lateral) degradation evaluated. The effect of incorporating beta-tricalcium phosphate (beta-TCP, 5 microns, 10 wt.%) was also investigated. The cured polymers exhibited high compressive strength (100-190 MPa) and modulus (1600-2300 MPa). beta-TCP improved mechanical properties in PEDLLA based polyurethanes and retarded the onset of in vitro and in vivo degradation. Sheep study results demonstrated that the polymers in both injectable and precured forms did not cause any surgical difficulties or any adverse tissue response. Evidence of new bone growth and the gradual degradation of the polymers were observed with increased implant time up to 6 months.

In vivo Degradation and histocompatibility of a novel class of fluorescent copolyanhydrides, poly{[di(p-carboxyphenyl) succinate]-co-(sebacic anhydride)}

In this work, the in vivo degradation and tissue compatibility of a novel class of inherently fluorescent copolyanhydrides, P(dCPS:SA), were investigated. It was found that the degradation of the copolyanhydrides increased with the increase of SA content in the copolymers. The in vivo degradation rate of the copolymers was slower than that studied in vitro. A surface erosion characteristic of the copolyanhydrides was revealed by SEM and fluorescent microscopy. Mild inflammatory reactions were observed on days 6 and 10 after implantation for all the studied copolymers. By the end of 30 d, there were almost no inflammation reactions taking place.

Review: Photopolymerizable and Degradable Biomaterials for Tissue Engineering Applications

Photopolymerizable and degradable biomaterials are finding widespread application in the field of tissue engineering for the engineering of tissues such as bone, cartilage, and liver. The spatial and temporal control afforded by photoinitiated polymerizations has allowed for the development of injectable materials that can deliver cells and growth factors, as well as for the fabrication of scaffolding with complex structures. The materials developed for these applications range from entirely synthetic polymers (e.g., poly(ethylene glycol)) to purely natural polymers (e.g., hyaluronic acid) that are modified with photoreactive groups, with degradation based on the hydrolytic or enzymatic degradation of bonds in the polymer backbone or crosslinks. The degradation behavior also ranges from purely bulk to entirely surface degrading, based on the nature of the backbone chemistry and type of degradable units. The mechanical properties of these polymers are primarily based on factors such as the network crosslinking density and polymer concentration. As we better understand biological features necessary to control cellular behavior, smarter materials are being developed that can incorporate and mimic many of these factors.

Effects of neighboring sulfides and pH on ester hydrolysis in thiol-acrylate photopolymers

Networks synthesized through thiol-acrylate photopolymerization or Michael-type addition step growth reactions contain esters with neighboring sulfide groups. Previous work has demonstrated that these esters are readily hydrolyzable at physiological pH. Here, the influence of the distance between the sulfide and ester, as well as the water concentration, on ester hydrolysis was characterized. These preliminary results indicate that reducing the number of carbons between the sulfide and the ester from 2 to 1 increased the rate of ester hydrolysis from 0.022+/-0.001 to 0.08+/-0.015days(-1). Increases in ester hydrolysis rates were also observed as hydrophilicity increased for oligomers prepared from a trithiol, tetrathiol and dithiol monomer (0.012+/-0.003, 0.032+/-0.004, and 0.091+/-0.003days(-1), respectively). Additionally, in bulk-eroding polymeric biomaterials, variations in pH impacted the ester hydrolysis rate. This work confirms that small variations in buffer pH predictably alter the mass loss profile of a thiol-acrylate photopolymer. More specifically, as buffer pH was changed from 7.4 to 8.0, the rate of ester hydrolysis increased from 0.074+/-0.003 to 0.28+/-0.005days(-1). The magnitude of this observed change in ester hydrolysis rate was correlated to the increase in hydroxide ion concentration that accompanied this pH change.

Development and Characterization of Degradable Thiol-Allyl Ether Photopolymers

Degradable thiol-ene photopolymer networks were formed through radically mediated step growth reactions. Variations in the network structure were used to alter the initial and temporal moduli, mass loss profiles, and equilibrium swelling ratios. Mass loss rates varied with changes in the solvent concentration, monomer molecular weight, average monomer functionality, and concentration of degradable linkages. The time required for the networks to degrade completely ranged from 1.20 ± 0.01 to 24.5 ± 0.1 days, which corresponded to hydrolysis rates of 0.18 ± 0.01 and 0.021 ± 0.0003 days(-1). Initial moduli also varied considerably as a function of network structure, ranging from 150 ± 35 to nearly 5000 ± 100 kPa, and initial equilibrium swelling ratios ranged from 2.5 ± 0.01 to 18.7 ± 2. Collectively, these results demonstrate how the material properties and the mass loss behavior of thiol-ene networks can be independently tuned for specific applications.

Synthesis of two-component injectable polyurethanes for bone tissue engineering

The advent of injectable polymer technologies has increased the prospect of developing novel, minimally invasive arthroscopic techniques to treat a wide variety of ailments. In this study, we have synthesised and evaluated a novel polyurethane-based injectable, in situ curable, polymer platform to determine its potential uses as a tissue engineered implant. Films of the polymers were prepared by reacting two pentaerythritol-based prepolymers, and characterised for mechanical and surface properties, and cytocompatibility. This polymer platform displayed mechanical strength and elasticity superior to many injectable bone cements and grafts. Cytotoxicity tests using primary human osteoblasts, revealed positive cell viability and increased proliferation over a period of 7 days in culture. This favourable cell environment was attributed to the hydrophilic nature of the films, as assessed by dynamic contact angle (DCA) analysis of the sample surfaces. The incorporation of beta-TCP was shown to improve mechanical properties, surface wettability, and cell viability and proliferation, compared to the other sample types. SEM/EDX analysis of these surfaces also revealed physicochemical surface heterogeneity in the presence of beta-TCP. Based on preliminary mechanical analysis and cytotoxicity results, these injectable polymers may have a number or potential orthopaedic applications; ranging from bone glues to scaffolds for bone regeneration.

Gel Permeation Chromatography Characterization of the Chain Length Distributions in Thiol-Acrylate Photopolymer Networks

Crosslinked, degradable networks formed from the photopolymerization of thiol and acrylate monomers are explored as potential biomaterials. The degradation behavior and material properties of these networks are influenced by the molecular weight of the nondegradable thiol-polyacrylate backbone chains that form during photopolymerization. Here, gel permeation chromatography was used to characterize the thiol-polyacrylate backbone chain lengths in degraded thiol-acrylate networks. Increasing thiol functionality from 1 to 4 increased the backbone molecular weight (M̄(w) = 2.3 ± 0.07 × 10(4) Da for monothiol and 3.6 ± 0.1 × 10(4) Da for tetrathiol networks). Decreasing thiol functional group concentration from 30 to 10 mol% also increased the backbone lengths (M̄(w) = 7.3 ± 1.1 × 10(4) Da for the networks containing 10 mol% thiol groups as compared to 3.6 ± 0.1 × 10(4) Da for 30 mol% thiol). Finally, the backbone chain lengths were probed at various stages of degradation and an increase in backbone molecular weight was observed as mass loss progressed from 10 to 70%.

Synthesis, material properties, and biocompatibility of a novel self-cross-linkable poly(caprolactone fumarate) as an injectable tissue engineering scaffold

A novel self-cross-linkable and biodegradable macromer, poly(caprolactone fumarate) (PCLF), has been developed for guided bone regeneration. This macromer is a copolymer of fumaryl chloride, which contains double bonds for in-situ cross-linking, and poly(epsilon-caprolactone), which has a flexible chain to facilitate self-cross-linkability. PCLF was characterized with Fourier transform infrared spectroscopy, 1H and 13C nuclear magnetic resonance spectroscopy, and gel permeation chromatography. Porous scaffolds were fabricated with sodium chloride particles as the porogen and a chemical initiation system. The PCLF scaffolds were characterized with scanning electron microscopy and micro-computed-tomography. The cytotoxicity and in vivo biocompatibility of PCLF were also assessed. Our results suggest that this novel copolymer, PCLF, is an injectable, self-cross-linkable, and biocompatible macromer that may be potentially used as a scaffold for tissue engineering applications.

AnIn Vivo Study of the Host Response to Starch-Based Polymers and Composites Subcutaneously Implanted in Rats

Implant failure is one of the major concerns in the biomaterials field. Several factors have been related to the fail but in general these biomaterials do not exhibit comparable physical, chemical or biological properties to natural tissues and ultimately, these devices can lead to chronic inflammation and foreign-body reactions. Starch-based biodegradable materials and composites have shown promising properties for a wide range of biomedical applications as well as a reduced capacity to elicit a strong reaction from immune system cells in vitro. In this work, blends of corn starch with ethylene vinyl alcohol (SEVA-C), cellulose acetate (SCA) and polycaprolactone (SPCL), as well as hydroxyapatite (HA) reinforced starch-based composites, were investigated in vivo. The aim of the work was to assess the host response evoked for starch-based biomaterials, identifying the presence of key cell types. The tissues surrounding the implant were harvested together with the material and processed histologically for evaluation using immunohistochemistry. At implant retrieval there was no cellular exudate around the implants and no macroscopic signs of an inflammatory reaction in any of the animals. The histological analysis of the sectioned interface tissue after immunohistochemical staining using ED1, ED2, CD54, MHC class II and alpha/beta antibodies showed positively stained cells for all antibodies, except for alpha/beta for all the implantation periods, where it was different for the various polymers and for the period of implantation. SPCL and SCA composites were the materials that stimulated the greatest cellular tissue responses, but generally biodegradable starch-based materials did not induce a severe reaction for the studied implantation times, which contrasts with other types of degradable polymeric biomaterials.