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Koh RH, Kim J, Kim JU, Kim SL, Rajendran AK, Lee SS, Lee H, Kim JH, Jeong JH, Hwang Y, Bae JW, Hwang NS. Bioceramic-mediated chondrocyte hypertrophy promotes calcified cartilage formation for rabbit osteochondral defect repair. Bioact Mater 2024; 40:306-317. [PMID: 38978806 PMCID: PMC11228467 DOI: 10.1016/j.bioactmat.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/24/2024] [Accepted: 06/10/2024] [Indexed: 07/10/2024] Open
Abstract
Osteochondral tissue is a highly specialized and complex tissue composed of articular cartilage and subchondral bone that are separated by a calcified cartilage interface. Multilayered or gradient scaffolds, often in conjunction with stem cells and growth factors, have been developed to mimic the respective layers for osteochondral defect repair. In this study, we designed a hyaline cartilage-hypertrophic cartilage bilayer graft (RGD/RGDW) with chondrocytes. Previously, we demonstrated that RGD peptide-modified chondroitin sulfate cryogel (RGD group) is chondro-conductive and capable of hyaline cartilage formation. Here, we incorporated whitlockite (WH), a Mg2+-containing calcium phosphate, into RGD cryogel (RGDW group) to induce chondrocyte hypertrophy and form collagen X-rich hypertrophic cartilage. This is the first study to use WH to produce hypertrophic cartilage. Chondrocytes-laden RGDW cryogel exhibited significantly upregulated expression of hypertrophy markers in vitro and formed ectopic hypertrophic cartilage in vivo, which mineralized into calcified cartilage in bone microenvironment. Subsequently, RGD cryogel and RGDW cryogel were combined into bilayer (RGD/RGDW group) and implanted into rabbit osteochondral defect, where RGD layer supports hyaline cartilage regeneration and bioceramic-containing RGDW layer promotes calcified cartilage formation. While the RGD group (monolayer) formed hyaline-like neotissue that extends into the subchondral bone, the RGD/RGDW group (bilayer) regenerated hyaline cartilage tissue confined to its respective layer and promoted osseointegration for integrative defect repair.
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Affiliation(s)
- Rachel H Koh
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul, 08826, South Korea
| | - Junhee Kim
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul, 08826, South Korea
| | - Jeong-Uk Kim
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul, 08826, South Korea
| | - Seunghyun L Kim
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, 08826, South Korea
| | - Arun Kumar Rajendran
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul, 08826, South Korea
| | - Seunghun S Lee
- Department of Biomedical Engineering, Dongguk University, Seoul, 10326, South Korea
| | - Heesoo Lee
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul, 08826, South Korea
| | - Joo Hyun Kim
- Soonchunhyang Institute of Medi-bio Science (SIMS), Soonchunhyang University, Cheonan, 31151, South Korea
- Department of Integrated Biomedical Science, Soonchunhyang University, Asan, 31538, South Korea
| | - Ji Hoon Jeong
- Soonchunhyang Institute of Medi-bio Science (SIMS), Soonchunhyang University, Cheonan, 31151, South Korea
- Department of Integrated Biomedical Science, Soonchunhyang University, Asan, 31538, South Korea
| | - Yongsung Hwang
- Soonchunhyang Institute of Medi-bio Science (SIMS), Soonchunhyang University, Cheonan, 31151, South Korea
- Department of Integrated Biomedical Science, Soonchunhyang University, Asan, 31538, South Korea
| | - Jong Woo Bae
- Department of Orthopaedic Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, 27376, South Korea
| | - Nathaniel S Hwang
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul, 08826, South Korea
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, 08826, South Korea
- BioMAX Institute, Seoul National University, Seoul, 08826, South Korea
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2
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Ajisafe VA, Raichur AM. Snail Mucus-Enhanced Adhesion of Human Chondrocytes on 3D Porous Agarose Scaffolds. ACS APPLIED MATERIALS & INTERFACES 2024; 16:11324-11335. [PMID: 38406881 DOI: 10.1021/acsami.3c19557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
This study reports the preparation of a novel porous 3D scaffold from agarose-snail mucus (AGSMu) for cartilage tissue repair applications. AG is reported for its unique thermal and mechanical properties, biocompatibility, and biodegradability, making it suitable for biomedical applications. Still, it lacks the cell adhesion properties required for tissue engineering applications. SMu is a complex substance identified to contain glycosaminoglycans (GAGs) and other bioactive molecules that promote wound healing and reduce cartilage deterioration and inflammation. Hence, porous 3D blend scaffolds containing AG and SMu were prepared by the freeze-drying method, characterized, and investigated for bioactive effects on human chondrocyte (C28/I2) cells. The scaffolds had a microporous structure with an average pore size of 245 μm. FTIR spectroscopy showed that SMu was successfully incorporated into the scaffolds. The SMu increased the mechanical strength of the composite scaffolds by more than 80% compared to the pristine AG scaffold. The scaffolds were found to be biocompatible with tunable degradation. The human chondrocyte cells attached and proliferated well on the 3D scaffolds in a few days, demonstrating a marked improvement in adhesion due to the presence of SMu. Enhanced cell adhesion and mechanical properties of 3D porous AG scaffolds could make them suitable for articular cartilage repair and regeneration.
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Affiliation(s)
- Victor A Ajisafe
- Department of Materials Engineering, Indian Institute of Science, Bengaluru, Karnataka 560012, India
| | - Ashok M Raichur
- Department of Materials Engineering, Indian Institute of Science, Bengaluru, Karnataka 560012, India
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Chen Y, Zhang Y, Chen X, Huang J, Zhou B, Zhang T, Yin W, Fang C, Yin Z, Pan H, Li X, Shen W, Chen X. Biomimetic Intrafibrillar Mineralization of Native Tendon for Soft-Hard Interface Integration by Infiltration of Amorphous Calcium Phosphate Precursors. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2304216. [PMID: 37870172 DOI: 10.1002/advs.202304216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/21/2023] [Indexed: 10/24/2023]
Abstract
Soft and hard tissues possess distinct biological properties. Integrating the soft-hard interface is difficult due to the inherent non-osteogenesis of soft tissue, especially of anterior cruciate ligament and rotator cuff reconstruction. This property makes it difficult for tendons to be mineralized and integrated with bone in vivo. To overcome this challenge, a biomimetic mineralization strategy is employed to engineer mineralized tendons. The strategy involved infiltrating amorphous calcium phosphate precursors into collagen fibrils, resulting in hydroxyapatite deposition along the c-axis. The mineralized tendon presented characteristics similar to bone tissue and induced osteogenic differentiation of mesenchymal stem cells. Additionally, the interface between the newly formed bone and tendon is serrated, suggesting a superb integration between the two tissues. This strategy allows for biomineralization of tendon collagen and replicating the hallmarks of the bone matrix and extracellular niche, including nanostructure and inherent osteoinductive properties, ultimately facilitating the integration of soft and hard tissues.
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Affiliation(s)
- Yangwu Chen
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, P. R. China
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University, Hangzhou, 310058, P. R. China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310000, P. R. China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310000, P. R. China
| | - Yuxiang Zhang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, P. R. China
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, P. R. China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310000, P. R. China
| | - Xiaoyi Chen
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, P. R. China
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University, Hangzhou, 310058, P. R. China
| | - Jiayun Huang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, P. R. China
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University, Hangzhou, 310058, P. R. China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310000, P. R. China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310000, P. R. China
| | - Bo Zhou
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, P. R. China
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University, Hangzhou, 310058, P. R. China
| | - Tao Zhang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, P. R. China
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University, Hangzhou, 310058, P. R. China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310000, P. R. China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310000, P. R. China
| | - Wei Yin
- Core Facilities, Zhejiang University School of Medicine, Hangzhou, 310000, P. R. China
| | - Cailian Fang
- Rehabilitation Department, Lishui People's Hospital, Lishui, 323000, P. R. China
| | - Zi Yin
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University, Hangzhou, 310058, P. R. China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310000, P. R. China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310000, P. R. China
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, P. R. China
| | - Haihua Pan
- Qiushi Academy for Advanced Studies, Zhejiang University, Hangzhou, 310058, P. R. China
| | - Xiongfeng Li
- Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, 313000, P. R. China
| | - Weiliang Shen
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, P. R. China
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University, Hangzhou, 310058, P. R. China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310000, P. R. China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310000, P. R. China
| | - Xiao Chen
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine and Department of Orthopedic Surgery of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, P. R. China
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University, Hangzhou, 310058, P. R. China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310000, P. R. China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310000, P. R. China
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4
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Niu X, Li N, Du Z, Li X. Integrated gradient tissue-engineered osteochondral scaffolds: Challenges, current efforts and future perspectives. Bioact Mater 2023; 20:574-597. [PMID: 35846846 PMCID: PMC9254262 DOI: 10.1016/j.bioactmat.2022.06.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/30/2022] [Accepted: 06/15/2022] [Indexed: 02/07/2023] Open
Abstract
The osteochondral defect repair has been most extensively studied due to the rising demand for new therapies to diseases such as osteoarthritis. Tissue engineering has been proposed as a promising strategy to meet the demand of simultaneous regeneration of both cartilage and subchondral bone by constructing integrated gradient tissue-engineered osteochondral scaffold (IGTEOS). This review brought forward the main challenges of establishing a satisfactory IGTEOS from the perspectives of the complexity of physiology and microenvironment of osteochondral tissue, and the limitations of obtaining the desired and required scaffold. Then, we comprehensively discussed and summarized the current tissue-engineered efforts to resolve the above challenges, including architecture strategies, fabrication techniques and in vitro/in vivo evaluation methods of the IGTEOS. Especially, we highlighted the advantages and limitations of various fabrication techniques of IGTEOS, and common cases of IGTEOS application. Finally, based on the above challenges and current research progress, we analyzed in details the future perspectives of tissue-engineered osteochondral construct, so as to achieve the perfect reconstruction of the cartilaginous and osseous layers of osteochondral tissue simultaneously. This comprehensive and instructive review could provide deep insights into our current understanding of IGTEOS. Providing main challenges to establish integrated gradient osteochondral scaffold. Discussing the current tissue-engineered efforts to resolve the above challenges. Highlighting construct techniques, and evaluation index and methods of IGTEOS. Discussing the future perspectives to achieve perfect osteochondral reconstruction.
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Affiliation(s)
- Xiaolian Niu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China
| | - Ning Li
- Department of Orthopedics, The Fourth Central Hospital of Baoding City, Baoding, 072350, China
| | - Zhipo Du
- Department of Orthopedics, The Fourth Central Hospital of Baoding City, Baoding, 072350, China
- Corresponding author.
| | - Xiaoming Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China
- Corresponding author.
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5
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Wu J, Wang S, Zheng Z, Li J. Fabrication of Biologically Inspired Electrospun Collagen/Silk fibroin/bioactive glass composited nanofibrous scaffold to accelerate the treatment efficiency of bone repair. Regen Ther 2022; 21:122-138. [PMID: 35844293 PMCID: PMC9253997 DOI: 10.1016/j.reth.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 04/15/2022] [Accepted: 05/15/2022] [Indexed: 12/03/2022] Open
Abstract
Bone disease and disorder treatment might be difficult because of its complicated nature. Millions of patients each year need bone substitutes that may help them recover quickly from a variety of illnesses. Synthetic bone replacements that mirror the structural, chemical, and biological features of bone matrix structure will be very helpful and in high demand. In this research, the inorganic bioactive glass nanoparticles matrixed with organic collagen and silk fibroin structure (COL/SF/CaO-SiO2) were used to create multifunctional bone-like fibers in this study, which we describe here. The fiber structure is organized in a layered fashion comparable to the sequence in which apatite and neo tissue are formed. The amino groups in COL and SF combined with CaO-SiO2 to stabilize the resulting composite nanofiber. Morphological and functional studies confirmed that crystalline CaO-SiO2 nanoparticles with average sizes of 20 ± 5 nm are anchored on a 115 ± 10 nm COL/SF nanofiber matrix. X-ray photoelectron spectroscopic (XPS) results confirmed the presence of C, N, O, Ca, and Si in the composite fiber with an atomic percentage of 59.46, 3.30, 20.25, 3.38 and 13.61%. respectively. The biocompatibility examination with osteoblast cells (Saos-2) revealed that the CAL/SF/CaO-SiO2 composite nanofiber had enhanced osteogenic activity. Finally, when the CAL/SF/CaO-SiO2 composite nanofiber scaffolds were used to treat an osteoporotic bone defect in a rat model, the composite nanofiber scaffolds significantly promoted bone regeneration and vascularization. This novel fibrous scaffold class represents a potential breakthrough in the design of advanced materials for complicated bone regeneration.
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Affiliation(s)
- Jianjun Wu
- Department of Spine Surgery, The Third Clinical Medical College, Fujian Medical University
- Department of Spine Surgery, Fuzhou Second Hospital, PR China
- Corresponding author. No. 47, Shangteng Road, Cangshan District, Fuzhou 350007, Fujian Province, China.
| | - Shengxuan Wang
- Department of Spine Surgery, The Third Clinical Medical College, Fujian Medical University
- Department of Spine Surgery, Fuzhou Second Hospital, PR China
| | - Zhong Zheng
- Department of Spine Surgery, The Third Clinical Medical College, Fujian Medical University
- Department of Spine Surgery, Fuzhou Second Hospital, PR China
| | - Jianbao Li
- Department of Spine Surgery, The Third Clinical Medical College, Fujian Medical University
- Department of Spine Surgery, Fuzhou Second Hospital, PR China
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6
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Guimarães CF, Marques AP, Reis RL. Pushing the Natural Frontier: Progress on the Integration of Biomaterial Cues toward Combinatorial Biofabrication and Tissue Engineering. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2105645. [PMID: 35419887 DOI: 10.1002/adma.202105645] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 03/14/2022] [Indexed: 06/14/2023]
Abstract
The engineering of fully functional, biological-like tissues requires biomaterials to direct cellular events to a near-native, 3D niche extent. Natural biomaterials are generally seen as a safe option for cell support, but their biocompatibility and biodegradability can be just as limited as their bioactive/biomimetic performance. Furthermore, integrating different biomaterial cues and their final impact on cellular behavior is a complex equation where the outcome might be very different from the sum of individual parts. This review critically analyses recent progress on biomaterial-induced cellular responses, from simple adhesion to more complex stem cell differentiation, looking at the ever-growing possibilities of natural materials modification. Starting with a discussion on native material formulation and the inclusion of cell-instructive cues, the roles of shape and mechanical stimuli, the susceptibility to cellular remodeling, and the often-overlooked impact of cellular density and cell-cell interactions within constructs, are delved into. Along the way, synergistic and antagonistic combinations reported in vitro and in vivo are singled out, identifying needs and current lessons on the development of natural biomaterial libraries to solve the cell-material puzzle efficiently. This review brings together knowledge from different fields envisioning next-generation, combinatorial biomaterial development toward complex tissue engineering.
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Affiliation(s)
- Carlos F Guimarães
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, Guimarães, 4805-017, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Alexandra P Marques
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, Guimarães, 4805-017, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rui L Reis
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, Guimarães, 4805-017, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
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7
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Liu M, Ke X, Yao Y, Wu F, Ye S, Zhang L, Yang G, Shen M, Li Y, Yang X, Zhong C, Gao C, Gou Z. Artificial osteochondral interface of bioactive fibrous membranes mediating calcified cartilage reconstruction. J Mater Chem B 2021; 9:7782-7792. [PMID: 34586140 DOI: 10.1039/d1tb01238j] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Calcified cartilage is a mineralized osteochondral interface region between the hyaline cartilage and subchondral bone. There are few reported artificial biomaterials that could offer bioactivities for substantial reconstruction of calcified cartilage. Herein we developed new poly(L-lactide-co-caprolactone) (PLCL)-based trilayered fibrous membranes as a functional interface for calcified cartilage reconstruction and superficial cartilage restoration. The trilayered membranes were prepared by the electrospinning technique, and the fibrous morphology was maintained when the chondroitin sulfate (CS) or bioactive glass (BG) particles were introduced in the upper or bottom layer, respectively. Although 30% BG in the bottom layer led to a significant decrease in tensile resistance, the inorganic ion release was remarkably higher than that in the counterpart with 10% BG. The in vivo studies showed that the fibrous membranes as osteochondral interfaces exhibited different biological performances on superficial cartilage restoration and calcified cartilage reconstruction. All of the implanted host hyaline cartilage enabled a self-healing process and an increase in the BG content in the membranes was desirable for promoting the repair of the calcified cartilage with time. The histological staining confirmed the osteochondral interface in the 30% BG bottom membrane maintained appreciable calcified cartilage repair after 12 weeks. These findings demonstrated that such an integrated artificial osteochondral interface containing appropriate bioactive ions are potentially applicable for osteochondral interface tissue engineering.
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Affiliation(s)
- Mengtao Liu
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China.
| | - Xiurong Ke
- Department of Orthopaedic Surgery of The third Hospital Affiliated to Wenzhou Medical University, Rui'an 325200, China
| | - Yuejun Yao
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Fanghui Wu
- Department of Orthopaedic Surgery of The third Hospital Affiliated to Wenzhou Medical University, Rui'an 325200, China
| | - Shuo Ye
- Department of Orthopaedic Surgery of The third Hospital Affiliated to Wenzhou Medical University, Rui'an 325200, China
| | - Lei Zhang
- Department of Orthopaedic Surgery of The third Hospital Affiliated to Wenzhou Medical University, Rui'an 325200, China
| | - Guojing Yang
- Department of Orthopaedic Surgery of The third Hospital Affiliated to Wenzhou Medical University, Rui'an 325200, China
| | - Miaoda Shen
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China.
| | - Yifan Li
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China.
| | - Xianyan Yang
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China.
| | - Cheng Zhong
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China.
| | - Changyou Gao
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China. .,MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Zhongru Gou
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China.
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8
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Su Y, Toftdal MS, Le Friec A, Dong M, Han X, Chen M. 3D Electrospun Synthetic Extracellular Matrix for Tissue Regeneration. SMALL SCIENCE 2021. [DOI: 10.1002/smsc.202100003] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Yingchun Su
- State Key Laboratory of Urban Water Resource and Environment School of Chemistry and Chemical Engineering Harbin Institute of Technology Harbin 150001 China
- Department of Biological and Chemical Engineering Aarhus University DK-8000 Aarhus C Denmark
- Interdisciplinary Nanoscience Center (iNANO) Aarhus University DK-8000 Aarhus C Denmark
| | - Mette Steen Toftdal
- Department of Biological and Chemical Engineering Aarhus University DK-8000 Aarhus C Denmark
- Stem Cell Delivery and Pharmacology Novo Nordisk A/S DK-2760 Måløv Denmark
| | - Alice Le Friec
- Department of Biological and Chemical Engineering Aarhus University DK-8000 Aarhus C Denmark
| | - Mingdong Dong
- Interdisciplinary Nanoscience Center (iNANO) Aarhus University DK-8000 Aarhus C Denmark
| | - Xiaojun Han
- State Key Laboratory of Urban Water Resource and Environment School of Chemistry and Chemical Engineering Harbin Institute of Technology Harbin 150001 China
| | - Menglin Chen
- Department of Biological and Chemical Engineering Aarhus University DK-8000 Aarhus C Denmark
- Interdisciplinary Nanoscience Center (iNANO) Aarhus University DK-8000 Aarhus C Denmark
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9
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Lowen JM, Leach JK. Functionally graded biomaterials for use as model systems and replacement tissues. ADVANCED FUNCTIONAL MATERIALS 2020; 30:1909089. [PMID: 33456431 PMCID: PMC7810245 DOI: 10.1002/adfm.201909089] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Indexed: 05/03/2023]
Abstract
The heterogeneity of native tissues requires complex materials to provide suitable substitutes for model systems and replacement tissues. Functionally graded materials have the potential to address this challenge by mimicking the gradients in heterogeneous tissues such as porosity, mineralization, and fiber alignment to influence strength, ductility, and cell signaling. Advancements in microfluidics, electrospinning, and 3D printing enable the creation of increasingly complex gradient materials that further our understanding of physiological gradients. The combination of these methods enables rapid prototyping of constructs with high spatial resolution. However, successful translation of these gradients requires both spatial and temporal presentation of cues to model the complexity of native tissues that few materials have demonstrated. This review highlights recent strategies to engineer functionally graded materials for the modeling and repair of heterogeneous tissues, together with a description of how cells interact with various gradients.
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Affiliation(s)
- Jeremy M. Lowen
- Department of Biomedical Engineering, University of California, Davis, CA, 95616
| | - J. Kent Leach
- Department of Biomedical Engineering, University of California, Davis, CA, 95616
- Department of Orthopaedic Surgery, UC Davis Health, Sacramento, CA 95817
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10
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Zhao Y, Li Z, Jiang Y, Liu H, Feng Y, Wang Z, Liu H, Wang J, Yang B, Lin Q. Bioinspired mineral hydrogels as nanocomposite scaffolds for the promotion of osteogenic marker expression and the induction of bone regeneration in osteoporosis. Acta Biomater 2020; 113:614-626. [PMID: 32565370 DOI: 10.1016/j.actbio.2020.06.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/09/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022]
Abstract
Osteoporosis is one of the most prevalent age-related diseases worldwide and is characterized by a systemic deterioration of bone strength (bone mineral density and bone quality) with a resulting increase in fragility fractures. Due to the complex osteoporotic pathological environment, it is a huge challenge to induce bone regeneration under osteoporosis conditions. In this study, we successfully nanoengineer a bioinspired mineralized hydrogel from the supramolecular assembly of nano-hydroxyapatite, sodium carbonate, and polyacrylic acid, termed as CHAp-PAA. The resultant nanocomposite hydrogels can maintain their initial morphology and mechanical properties under physiological conditions, while exhibiting good primary stability, biocompatibility, bioactivity, and osteoconductivity. We demonstrate that this optimized hydrogel scaffold has shown superior performance for bone marrow stem cells (BMSCs) proliferation, differentiation, and extracellular matrix production in vitro. Remarkably, the mineralized CHAp-PAA hydrogels could be used as scaffolds for the critical-sized bone defect (6.0 mm diameter and 10.0 mm depth) in the osteoporotic rabbit model. Without the delivery of additional therapeutic agents or stem cells, these CHAp-PAA hydrogel scaffolds can improve bone ingrowth and accelerate new bone formation even in complex osteoporotic pathological environments. Therefore, this work presents a type of bioinspired multifunctional mineral hydrogel that offers an alternative strategy to manage osteoporosis. STATEMENT OF SIGNIFICANCE.
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Liu Z, Ramakrishna S, Liu X. Electrospinning and emerging healthcare and medicine possibilities. APL Bioeng 2020; 4:030901. [PMID: 32695956 PMCID: PMC7365682 DOI: 10.1063/5.0012309] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/01/2020] [Indexed: 01/06/2023] Open
Abstract
Electrospinning forms fibers from either an electrically charged polymer solution or polymer melt. Over the past decades, it has become a simple and versatile method for nanofiber production. Hence, it has been explored in many different applications. Commonly used electrospinning assembles fibers from polymer solutions in various solvents, known as solution electrospinning, while melt and near-field electrospinning techniques enhance the versatility of electrospinning. Adaption of additive manufacturing strategy to electrospinning permits precise fiber deposition and predefining pattern construction. This manuscript critically presents the potential of electrospun nanofibers in healthcare applications. Research community drew impetus from the similarity of electrospun nanofibers to the morphology and mechanical properties of fibrous extracellular matrices (ECM) of natural human tissues. Electrospun nanofibrous scaffolds act as ECM analogs for specific tissue cells, stem cells, and tumor cells to realize tissue regeneration, stem cell differentiation, and in vitro tumor model construction. The large surface-to-volume ratio of electrospun nanofibers offers a considerable number of bioactive agents binding sites, which makes it a promising candidate for a number of biomedical applications. The applications of electrospinning in regenerative medicine, tissue engineering, controlled drug delivery, biosensors, and cancer diagnosis are elaborated. Electrospun nanofiber incorporations in medical device coating, in vitro 3D cancer model, and filtration membrane are also discussed.
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Affiliation(s)
- Ziqian Liu
- Department of Mechanical, Materials and Manufacturing, The University of Nottingham Ningbo China, Ningbo 315100, China
| | - Seeram Ramakrishna
- Center for Nanofibers and Nanotechnology, Department of Mechanical Engineering, National University of Singapore, Singapore 117581, Singapore
| | - Xiaoling Liu
- Department of Mechanical, Materials and Manufacturing, The University of Nottingham Ningbo China, Ningbo 315100, China
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Zhao W, Du Z, Fang J, Fu L, Zhang X, Cai Q, Yang X. Synthetic/natural blended polymer fibrous meshes composed of polylactide, gelatin and glycosaminoglycan for cartilage repair. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2020; 31:1437-1456. [DOI: 10.1080/09205063.2020.1760701] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Wenwen Zhao
- State Key Laboratory of Organic-Inorganic Composites; Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, P.R. China
| | - Zhiyun Du
- State Key Laboratory of Organic-Inorganic Composites; Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, P.R. China
| | - Jiajin Fang
- State Key Laboratory of Organic-Inorganic Composites; Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, P.R. China
| | - Lei Fu
- State Key Laboratory of Organic-Inorganic Composites; Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, P.R. China
| | - Xin Zhang
- Beijing Key Laboratory of Sports Injuries, Institute of Sports Medicine, Peking University Third Hospital, Beijing, P.R. China
| | - Qing Cai
- State Key Laboratory of Organic-Inorganic Composites; Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, P.R. China
| | - Xiaoping Yang
- State Key Laboratory of Organic-Inorganic Composites; Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing, P.R. China
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Jin L, Zhao W, Ren B, Li L, Hu X, Zhang X, Cai Q, Ao Y, Yang X. Osteochondral tissue regenerated via a strategy by stacking pre-differentiated BMSC sheet on fibrous mesh in a gradient. ACTA ACUST UNITED AC 2019; 14:065017. [PMID: 31574486 DOI: 10.1088/1748-605x/ab49e2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The reconstruction of osteochondral tissue remains a challenging task in clinical therapy because of its heterogeneous structure. The best way to face the challenge is to develop a biomimetic construct to mimic the multilayered gradient from cartilage, to calcified cartilage and subchondral bone. In this study, bone marrow mesenchymal stromal cells (BMSCs) were cultured on electrospun fibrous meshes and cell sheets were incubated. The fibrous meshes were composed of 50% poly(L-lactide) and 50% gelatin, displaying excellent biocompatibility, cell affinity and degradability. Differentiation of BMSC sheets on fibrous meshes was induced chondrogenically or osteogenically. In particular, the BMSC sheets were able to be efficiently induced differentiating towards calcified cartilage by using a 1:1 (v/v) mixed medium of chondrogenic and osteogenic inductive media. Thus, a gradient 3D construct was built by stacking the differently pre-differentiated cell/mesh complexes layer by layer from top to bottom to mimic the cartilage-to-bone transition. With this gradient construct being implanted in the rabbit knee osteochondral defect, it was confirmed that it could promote the tissue regeneration with intact cartilage layer formation in comparison with the multilayered construct without a gradient. The strategy of using properly pre-differentiated BMSC sheet on fibrous mesh to build the osteochondral interface was thus suggested as being feasible and effective in mimicking its hierarchical complexity, and favored the repairing of injured joint cartilage.
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Affiliation(s)
- Le Jin
- State Key Laboratory of Organic-Inorganic Composites; Beijing Laboratory of Biomedical Materials; Beijing University of Chemical Technology, Beijing 100029, People's Republic of China
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Abstract
Electrospinning is a versatile and viable technique for generating ultrathin fibers. Remarkable progress has been made with regard to the development of electrospinning methods and engineering of electrospun nanofibers to suit or enable various applications. We aim to provide a comprehensive overview of electrospinning, including the principle, methods, materials, and applications. We begin with a brief introduction to the early history of electrospinning, followed by discussion of its principle and typical apparatus. We then discuss its renaissance over the past two decades as a powerful technology for the production of nanofibers with diversified compositions, structures, and properties. Afterward, we discuss the applications of electrospun nanofibers, including their use as "smart" mats, filtration membranes, catalytic supports, energy harvesting/conversion/storage components, and photonic and electronic devices, as well as biomedical scaffolds. We highlight the most relevant and recent advances related to the applications of electrospun nanofibers by focusing on the most representative examples. We also offer perspectives on the challenges, opportunities, and new directions for future development. At the end, we discuss approaches to the scale-up production of electrospun nanofibers and briefly discuss various types of commercial products based on electrospun nanofibers that have found widespread use in our everyday life.
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Affiliation(s)
- Jiajia Xue
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332, United States
| | - Tong Wu
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332, United States
| | - Yunqian Dai
- School of Chemistry and Chemical Engineering, Southeast University, Nanjing, Jiangsu 211189, People’s Republic of China
| | - Younan Xia
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332, United States
- School of Chemistry and Biochemistry, School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332, United States
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Aguiar AE, de O. Silva M, Rodas AC, Bertran CA. Mineralized layered films of xanthan and chitosan stabilized by polysaccharide interactions: A promising material for bone tissue repair. Carbohydr Polym 2019; 207:480-491. [DOI: 10.1016/j.carbpol.2018.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 11/22/2018] [Accepted: 12/04/2018] [Indexed: 11/25/2022]
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Zhou Y, Chyu J, Zumwalt M. Recent Progress of Fabrication of Cell Scaffold by Electrospinning Technique for Articular Cartilage Tissue Engineering. Int J Biomater 2018; 2018:1953636. [PMID: 29765405 PMCID: PMC5889894 DOI: 10.1155/2018/1953636] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 02/05/2018] [Accepted: 02/19/2018] [Indexed: 01/08/2023] Open
Abstract
As a versatile nanofiber manufacturing technique, electrospinning has been widely employed for the fabrication of tissue engineering scaffolds. Since the structure of natural extracellular matrices varies substantially in different tissues, there has been growing awareness of the fact that the hierarchical 3D structure of scaffolds may affect intercellular interactions, material transportation, fluid flow, environmental stimulation, and so forth. Physical blending of the synthetic and natural polymers to form composite materials better mimics the composition and mechanical properties of natural tissues. Scaffolds with element gradient, such as growth factor gradient, have demonstrated good potentials to promote heterogeneous cell growth and differentiation. Compared to 2D scaffolds with limited thicknesses, 3D scaffolds have superior cell differentiation and development rate. The objective of this review paper is to review and discuss the recent trends of electrospinning strategies for cartilage tissue engineering, particularly the biomimetic, gradient, and 3D scaffolds, along with future prospects of potential clinical applications.
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Affiliation(s)
- Yingge Zhou
- Department of Industrial, Manufacturing, and System Engineering, Texas Tech University, Lubbock, TX, USA
| | - Joanna Chyu
- Department of Orthopedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Mimi Zumwalt
- Department of Orthopedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Bracaglia LG, Smith BT, Watson E, Arumugasaamy N, Mikos AG, Fisher JP. 3D printing for the design and fabrication of polymer-based gradient scaffolds. Acta Biomater 2017; 56:3-13. [PMID: 28342878 PMCID: PMC5544968 DOI: 10.1016/j.actbio.2017.03.030] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 02/24/2017] [Accepted: 03/21/2017] [Indexed: 12/27/2022]
Abstract
To accurately mimic the native tissue environment, tissue engineered scaffolds often need to have a highly controlled and varied display of three-dimensional (3D) architecture and geometrical cues. Additive manufacturing in tissue engineering has made possible the development of complex scaffolds that mimic the native tissue architectures. As such, architectural details that were previously unattainable or irreproducible can now be incorporated in an ordered and organized approach, further advancing the structural and chemical cues delivered to cells interacting with the scaffold. This control over the environment has given engineers the ability to unlock cellular machinery that is highly dependent upon the intricate heterogeneous environment of native tissue. Recent research into the incorporation of physical and chemical gradients within scaffolds indicates that integrating these features improves the function of a tissue engineered construct. This review covers recent advances on techniques to incorporate gradients into polymer scaffolds through additive manufacturing and evaluate the success of these techniques. As covered here, to best replicate different tissue types, one must be cognizant of the vastly different types of manufacturing techniques available to create these gradient scaffolds. We review the various types of additive manufacturing techniques that can be leveraged to fabricate scaffolds with heterogeneous properties and discuss methods to successfully characterize them. STATEMENT OF SIGNIFICANCE Additive manufacturing techniques have given tissue engineers the ability to precisely recapitulate the native architecture present within tissue. In addition, these techniques can be leveraged to create scaffolds with both physical and chemical gradients. This work offers insight into several techniques that can be used to generate graded scaffolds, depending on the desired gradient. Furthermore, it outlines methods to determine if the designed gradient was achieved. This review will help to condense the abundance of information that has been published on the creation and characterization of gradient scaffolds and to provide a single review discussing both methods for manufacturing gradient scaffolds and evaluating the establishment of a gradient.
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Affiliation(s)
- Laura G Bracaglia
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, USA
| | - Brandon T Smith
- Department of Bioengineering, Rice University, 6500 Main Street, Houston, TX 77030, USA
| | - Emma Watson
- Department of Bioengineering, Rice University, 6500 Main Street, Houston, TX 77030, USA
| | - Navein Arumugasaamy
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, USA; Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, D.C. 20010, USA
| | - Antonios G Mikos
- Department of Bioengineering, Rice University, 6500 Main Street, Houston, TX 77030, USA.
| | - John P Fisher
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, USA.
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Griffin MF, Szarko M, Seifailan A, Butler PE. Nanoscale Surface Modifications of Medical Implants for Cartilage Tissue Repair and Regeneration. Open Orthop J 2016; 10:824-835. [PMID: 28217208 PMCID: PMC5299577 DOI: 10.2174/1874325001610010824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/12/2016] [Accepted: 05/31/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Natural cartilage regeneration is limited after trauma or degenerative processes. Due to the clinical challenge of reconstruction of articular cartilage, research into developing biomaterials to support cartilage regeneration have evolved. The structural architecture of composition of the cartilage extracellular matrix (ECM) is vital in guiding cell adhesion, migration and formation of cartilage. Current technologies have tried to mimic the cell's nanoscale microenvironment to improve implants to improve cartilage tissue repair. METHODS This review evaluates nanoscale techniques used to modify the implant surface for cartilage regeneration. RESULTS The surface of biomaterial is a vital parameter to guide cell adhesion and consequently allow for the formation of ECM and allow for tissue repair. By providing nanosized cues on the surface in the form of a nanotopography or nanosized molecules, allows for better control of cell behaviour and regeneration of cartilage. Chemical, physical and lithography techniques have all been explored for modifying the nanoscale surface of implants to promote chondrocyte adhesion and ECM formation. CONCLUSION Future studies are needed to further establish the optimal nanoscale modification of implants for cartilage tissue regeneration.
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Affiliation(s)
- MF Griffin
- University College London Centre for Nanotechnology & Regenerative Medicine, UCL Division of Surgery & Interventional Science, London, UK
| | - M Szarko
- Anatomy Department, St Georges Hospital, London, UK
| | - A Seifailan
- University College London Centre for Nanotechnology & Regenerative Medicine, UCL Division of Surgery & Interventional Science, London, UK
| | - PE Butler
- University College London Centre for Nanotechnology & Regenerative Medicine, UCL Division of Surgery & Interventional Science, London, UK
- Department of Plastic and Reconstructive Surgery, Royal Free Hampstead NHS Trust Hospital, London, UK
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Vaikkath D, Anitha R, Sumathy B, Nair PD. A simple and effective method for making multipotent/multilineage scaffolds with hydrophilic nature without any postmodification/treatment. Colloids Surf B Biointerfaces 2016; 141:112-119. [DOI: 10.1016/j.colsurfb.2015.12.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/18/2015] [Accepted: 12/19/2015] [Indexed: 10/22/2022]
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