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Yao X, Hu Y, Lin M, Peng K, Wang P, Gao Y, Gao X, Guo T, Zhang X, Zhou H. Self-assembling peptide RADA16: a promising scaffold for tissue engineering and regenerative medicine. Nanomedicine (Lond) 2023. [PMID: 37750388 DOI: 10.2217/nnm-2023-0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
RADA16 is a peptide-based biomaterial whose acidic aqueous solution spontaneously forms an extracellular matrix-like 3D structure within seconds upon contact with physiological pH body fluids. Meanwhile, its good biocompatibility, low immunogenicity, nontoxic degradation products and ease of modification make it an ideal scaffold for tissue engineering. RADA16 is a good delivery vehicle for cells, drugs and factors. Its shear thinning and thixotropic properties allow it to fill tissue voids by injection and not to swell. However, the weaker mechanical properties and poor hydrophilicity are troubling limitations of RADA16. To compensate for this limitation, various functional groups and polymers have been designed to modify RADA16, thus contributing to its scope and progress in the field of tissue engineering.
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Affiliation(s)
- Xin Yao
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China
- Key Laboratory of Bone & Joint Disease Research of Gansu Provincial, Lanzhou 730030, Gansu, China
| | - Yicun Hu
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China
- Key Laboratory of Bone & Joint Disease Research of Gansu Provincial, Lanzhou 730030, Gansu, China
| | - Maoqiang Lin
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China
- Key Laboratory of Bone & Joint Disease Research of Gansu Provincial, Lanzhou 730030, Gansu, China
| | - Kaichen Peng
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China
- Key Laboratory of Bone & Joint Disease Research of Gansu Provincial, Lanzhou 730030, Gansu, China
| | - Peng Wang
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China
- Key Laboratory of Bone & Joint Disease Research of Gansu Provincial, Lanzhou 730030, Gansu, China
| | - Yanbing Gao
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China
- Key Laboratory of Bone & Joint Disease Research of Gansu Provincial, Lanzhou 730030, Gansu, China
| | - Xidan Gao
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710000, Shaanxi, China
| | - Taowen Guo
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China
- Key Laboratory of Bone & Joint Disease Research of Gansu Provincial, Lanzhou 730030, Gansu, China
| | - Xiaobo Zhang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710000, Shaanxi, China
| | - Haiyu Zhou
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China
- Key Laboratory of Bone & Joint Disease Research of Gansu Provincial, Lanzhou 730030, Gansu, China
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2
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Ligorio C, Mata A. Synthetic extracellular matrices with function-encoding peptides. NATURE REVIEWS BIOENGINEERING 2023; 1:1-19. [PMID: 37359773 PMCID: PMC10127181 DOI: 10.1038/s44222-023-00055-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 06/28/2023]
Abstract
The communication of cells with their surroundings is mostly encoded in the epitopes of structural and signalling proteins present in the extracellular matrix (ECM). These peptide epitopes can be incorporated in biomaterials to serve as function-encoding molecules to modulate cell-cell and cell-ECM interactions. In this Review, we discuss natural and synthetic peptide epitopes as molecular tools to bioengineer bioactive hydrogel materials. We present a library of functional peptide sequences that selectively communicate with cells and the ECM to coordinate biological processes, including epitopes that directly signal to cells, that bind ECM components that subsequently signal to cells, and that regulate ECM turnover. We highlight how these epitopes can be incorporated in different biomaterials as individual or multiple signals, working synergistically or additively. This molecular toolbox can be applied in the design of biomaterials aimed at regulating or controlling cellular and tissue function, repair and regeneration.
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Affiliation(s)
- Cosimo Ligorio
- Biodiscovery Institute, University of Nottingham, Nottingham, UK
- Department of Chemical and Environmental Engineering, University of Nottingham, Nottingham, UK
| | - Alvaro Mata
- Biodiscovery Institute, University of Nottingham, Nottingham, UK
- Department of Chemical and Environmental Engineering, University of Nottingham, Nottingham, UK
- School of Pharmacy, University of Nottingham, Nottingham, UK
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Binaymotlagh R, Chronopoulou L, Palocci C. Peptide-Based Hydrogels: Template Materials for Tissue Engineering. J Funct Biomater 2023; 14:jfb14040233. [PMID: 37103323 PMCID: PMC10145623 DOI: 10.3390/jfb14040233] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023] Open
Abstract
Tissue and organ regeneration are challenging issues, yet they represent the frontier of current research in the biomedical field. Currently, a major problem is the lack of ideal scaffold materials' definition. As well known, peptide hydrogels have attracted increasing attention in recent years thanks to significant properties such as biocompatibility, biodegradability, good mechanical stability, and tissue-like elasticity. Such properties make them excellent candidates for 3D scaffold materials. In this review, the first aim is to describe the main features of a peptide hydrogel in order to be considered as a 3D scaffold, focusing in particular on mechanical properties, as well as on biodegradability and bioactivity. Then, some recent applications of peptide hydrogels in tissue engineering, including soft and hard tissues, will be discussed to analyze the most relevant research trends in this field.
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Affiliation(s)
- Roya Binaymotlagh
- Department of Chemistry, Sapienza University of Rome, P.le A. Moro 5, 00185 Rome, Italy
| | - Laura Chronopoulou
- Department of Chemistry, Sapienza University of Rome, P.le A. Moro 5, 00185 Rome, Italy
- Research Center for Applied Sciences to the Safeguard of Environment and Cultural Heritage (CIABC), Sapienza University of Rome, P.le A. Moro 5, 00185 Rome, Italy
| | - Cleofe Palocci
- Department of Chemistry, Sapienza University of Rome, P.le A. Moro 5, 00185 Rome, Italy
- Research Center for Applied Sciences to the Safeguard of Environment and Cultural Heritage (CIABC), Sapienza University of Rome, P.le A. Moro 5, 00185 Rome, Italy
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4
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Guo W, Ma Y, Hu L, Feng Y, Liu Y, Yi X, Zhang W, Tang F. Modification Strategies for Ionic Complementary Self-Assembling Peptides: Taking RADA16-I as an Example. Polymers (Basel) 2022; 14:polym14235221. [PMID: 36501615 PMCID: PMC9739689 DOI: 10.3390/polym14235221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/04/2022] Open
Abstract
Ion-complementary self-assembling peptides have been studied in many fields for their distinct advantages, mainly due to their self-assembly properties. However, their shortcomings, such as insufficient specific activity and poor mechanical properties, also limited their application. For the better and wider application of these promising biomaterials, ion-complementary self-assembling peptides can be modified with their self-assembly properties not being destroyed to the greatest extent. The modification strategies were reviewed by taking RADA16-I as an example. For insufficient specific activity, RADA16-I can be structurally modified with active motifs derived from the active domain of the extracellular matrix or other related active factors. For weak mechanical properties, materials with strong mechanical properties or that can undergo chemical crosslinking were used to mix with RADA16-I to enhance the mechanical properties of RADA16-I. To improve the performance of RADA16-I as drug carriers, appropriate adjustment of the RADA16-I sequence and/or modification of the RADA16-I-related delivery system with polymer materials or specific molecules can be considered to achieve sustained and controlled release of specific drugs or active factors. The modification strategies reviewed in this paper may provide some references for further basic research and clinical application of ion-complementary self-assembling peptides and their derivatives.
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Affiliation(s)
- Weiwei Guo
- Department of Clinical Pharmacy, Key Laboratory of Basic Pharmacology of Guizhou Province and School of Pharmacy, Zunyi Medical University, Zunyi 563006, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, China
- The Key Laboratory of Clinical Pharmacy of Zuni City, Zunyi Medical University, Zunyi 563006, China
| | - Yinping Ma
- Department of Clinical Pharmacy, Key Laboratory of Basic Pharmacology of Guizhou Province and School of Pharmacy, Zunyi Medical University, Zunyi 563006, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, China
- The Key Laboratory of Clinical Pharmacy of Zuni City, Zunyi Medical University, Zunyi 563006, China
| | - Lei Hu
- Department of Clinical Pharmacy, Key Laboratory of Basic Pharmacology of Guizhou Province and School of Pharmacy, Zunyi Medical University, Zunyi 563006, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, China
- The Key Laboratory of Clinical Pharmacy of Zuni City, Zunyi Medical University, Zunyi 563006, China
| | - Yujie Feng
- Department of Clinical Pharmacy, Key Laboratory of Basic Pharmacology of Guizhou Province and School of Pharmacy, Zunyi Medical University, Zunyi 563006, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, China
- The Key Laboratory of Clinical Pharmacy of Zuni City, Zunyi Medical University, Zunyi 563006, China
| | - Yanmiao Liu
- The Key Laboratory of Clinical Pharmacy of Zuni City, Zunyi Medical University, Zunyi 563006, China
- School of Preclinical Medicine, Zunyi Medical University, Zunyi 563006, China
| | - Xuedong Yi
- Department of Pharmacy, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Wenzhi Zhang
- Department of Pharmacy, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Fushan Tang
- Department of Clinical Pharmacy, Key Laboratory of Basic Pharmacology of Guizhou Province and School of Pharmacy, Zunyi Medical University, Zunyi 563006, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, China
- The Key Laboratory of Clinical Pharmacy of Zuni City, Zunyi Medical University, Zunyi 563006, China
- Correspondence: or ; Tel.: +86-851-28642337
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5
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Tang L, Xu C, Xuan A, Zhu Z, Ruan D. Functionalized self-assembling peptide RADKPS hydrogels promote regenerative repair of degenerated intervertebral discs. Biomater Sci 2022; 10:5134-5145. [PMID: 35820128 DOI: 10.1039/d2bm00634k] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective: the aim of this study was to investigate whether the functionalized self-assembling peptide hydrogel RADKPS is safe and effective for regenerative repair of degenerative intervertebral discs. Methods: an in vitro degenerative model of human nucleus pulposus cells was constructed by serum starvation culture, and their proliferation, apoptosis and viability were examined after three-dimensional culture with the RADKPS hydrogel. An in vivo degenerative model of the rabbit intervertebral disc was constructed by annulus fibrosus puncture, and the degeneration of the intervertebral disc was evaluated by imaging, histology, immunohistochemistry, and biomechanics after RADKPS hydrogel intervention. Results: through in vitro cell experiments it is shown that human degenerated nucleus pulposus cells after three-dimensional culture with the RADKPS hydrogel still exhibited better proliferation, viability, and low apoptosis rate. Through in vivo animal experiments we found that rabbit degenerated intervertebral discs intervened with the RADKPS hydrogel had higher water content, better histological morphology, more extracellular matrix synthesis, and better biomechanical properties. It is demonstrated that the RADKPS hydrogel may initiate the endogenous repair process through the sustained recruitment and enrichment of nucleus pulposus progenitor cells. Conclusion: it is verified from both in vitro cellular experiments and in vivo animal experiments that the regenerative repair effect of RADKPS, a functionalized self-assembling peptide hydrogel, on degenerated intervertebral discs is safe and effective. It is shown that it would be a new therapeutic approach for the regenerative repair action of intervertebral discs.
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Affiliation(s)
- Liang Tang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.,Department of Orthopedic Surgery, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China. .,Department of Orthopedic Surgery, Hengyang Central Hospital, Hunan, 421001, China
| | - Cheng Xu
- Department of Orthopedic Surgery, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China.
| | - Anwu Xuan
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Zhenbiao Zhu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Dike Ruan
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.,Department of Orthopedic Surgery, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China.
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Hao Z, Li H, Wang Y, Hu Y, Chen T, Zhang S, Guo X, Cai L, Li J. Supramolecular Peptide Nanofiber Hydrogels for Bone Tissue Engineering: From Multihierarchical Fabrications to Comprehensive Applications. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2103820. [PMID: 35128831 PMCID: PMC9008438 DOI: 10.1002/advs.202103820] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/02/2022] [Indexed: 05/03/2023]
Abstract
Bone tissue engineering is becoming an ideal strategy to replace autologous bone grafts for surgical bone repair, but the multihierarchical complexity of natural bone is still difficult to emulate due to the lack of suitable biomaterials. Supramolecular peptide nanofiber hydrogels (SPNHs) are emerging biomaterials because of their inherent biocompatibility, satisfied biodegradability, high purity, facile functionalization, and tunable mechanical properties. This review initially focuses on the multihierarchical fabrications by SPNHs to emulate natural bony extracellular matrix. Structurally, supramolecular peptides based on distinctive building blocks can assemble into nanofiber hydrogels, which can be used as nanomorphology-mimetic scaffolds for tissue engineering. Biochemically, bioactive motifs and bioactive factors can be covalently tethered or physically absorbed to SPNHs to endow various functions depending on physiological and pharmacological requirements. Mechanically, four strategies are summarized to optimize the biophysical microenvironment of SPNHs for bone regeneration. Furthermore, comprehensive applications about SPNHs for bone tissue engineering are reviewed. The biomaterials can be directly used in the form of injectable hydrogels or composite nanoscaffolds, or they can be used to construct engineered bone grafts by bioprinting or bioreactors. Finally, continuing challenges and outlook are discussed.
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Affiliation(s)
- Zhuowen Hao
- Department of OrthopedicsZhongnan Hospital of Wuhan UniversityDonghu Road 169Wuhan430071China
| | - Hanke Li
- Department of OrthopedicsZhongnan Hospital of Wuhan UniversityDonghu Road 169Wuhan430071China
| | - Yi Wang
- Department of OrthopedicsZhongnan Hospital of Wuhan UniversityDonghu Road 169Wuhan430071China
| | - Yingkun Hu
- Department of OrthopedicsZhongnan Hospital of Wuhan UniversityDonghu Road 169Wuhan430071China
| | - Tianhong Chen
- Department of OrthopedicsZhongnan Hospital of Wuhan UniversityDonghu Road 169Wuhan430071China
| | - Shuwei Zhang
- Department of OrthopedicsZhongnan Hospital of Wuhan UniversityDonghu Road 169Wuhan430071China
| | - Xiaodong Guo
- Department of OrthopedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyJiefang Road 1277Wuhan430022China
| | - Lin Cai
- Department of OrthopedicsZhongnan Hospital of Wuhan UniversityDonghu Road 169Wuhan430071China
| | - Jingfeng Li
- Department of OrthopedicsZhongnan Hospital of Wuhan UniversityDonghu Road 169Wuhan430071China
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7
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MA Z, ZHOU J, JIANG H, YU P, DAI F, LIU J. Yiqi Huoxue Recipe alleviates intervertebral disc degeneration by suppressing interleukin-17, nucleus pulposus cell apoptosis and promoting SOX9/β-catenin pathway. FOOD SCIENCE AND TECHNOLOGY 2021. [DOI: 10.1590/fst.86421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Zhijia MA
- Suzhou Hospital of Traditional Chinese Medicine, PR China
| | - Jingwen ZHOU
- Jiangsu Province Hospital of Traditional Chinese Medicine, P.R. China
| | - Hong JIANG
- Suzhou Hospital of Traditional Chinese Medicine, PR China
| | - Pengfei YU
- Suzhou Hospital of Traditional Chinese Medicine, PR China
| | - Feng DAI
- Suzhou Hospital of Traditional Chinese Medicine, PR China
| | - Jintao LIU
- Suzhou Hospital of Traditional Chinese Medicine, PR China
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8
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Liu ZM, Lu CC, Shen PC, Chou SH, Shih CL, Chen JC, Tien YC. Suramin attenuates intervertebral disc degeneration by inhibiting NF-κB signalling pathway. Bone Joint Res 2021; 10:498-513. [PMID: 34372688 PMCID: PMC8414441 DOI: 10.1302/2046-3758.108.bjr-2020-0041.r3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Aims Interleukin (IL)-1β is one of the major pathogenic regulators during the pathological development of intervertebral disc degeneration (IDD). However, effective treatment options for IDD are limited. Suramin is used to treat African sleeping sickness. This study aimed to investigate the pharmacological effects of suramin on mitigating IDD and to characterize the underlying mechanism. Methods Porcine nucleus pulposus (NP) cells were treated with vehicle, 10 ng/ml IL-1β, 10 μM suramin, or 10 μM suramin plus IL-1β. The expression levels of catabolic and anabolic proteins, proinflammatory cytokines, mitogen-activated protein kinase (MAPK), and nuclear factor (NF)-κB-related signalling molecules were assessed by Western blotting, quantitative real-time polymerase chain reaction (qRT-PCR), and immunofluorescence analysis. Flow cytometry was applied to detect apoptotic cells. The ex vivo effects of suramin were examined using IDD organ culture and differentiation was analyzed by Safranin O-Fast green and Alcian blue staining. Results Suramin inhibited IL-1β-induced apoptosis, downregulated matrix metalloproteinase (MMP)-3, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4, and ADAMTS-5, and upregulated collagen 2A (Col2a1) and aggrecan in IL-1β-treated NP cells. IL-1β-induced inflammation, assessed by IL-1β, IL-8, and tumour necrosis factor α (TNF-α) upregulation, was alleviated by suramin treatment. Suramin suppressed IL-1β-mediated proteoglycan depletion and the induction of MMP-3, ADAMTS-4, and pro-inflammatory gene expression in ex vivo experiments. Conclusion Suramin administration represents a novel and effectively therapeutic approach, which could potentially alleviate IDD by reducing extracellular matrix (ECM) deposition and inhibiting apoptosis and inflammatory responses in the NP cells. Cite this article: Bone Joint Res 2021;10(8):498–513.
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Affiliation(s)
- Zi-Miao Liu
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Chang Lu
- Department of Orthopedics, Faculty of Medical School, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Chih Shen
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Hsiang Chou
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Lung Shih
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jian-Chih Chen
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yin Chun Tien
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Orthopedics, Faculty of Medical School, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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9
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Dou Y, Sun X, Ma X, Zhao X, Yang Q. Intervertebral Disk Degeneration: The Microenvironment and Tissue Engineering Strategies. Front Bioeng Biotechnol 2021; 9:592118. [PMID: 34354983 PMCID: PMC8329559 DOI: 10.3389/fbioe.2021.592118] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 05/18/2021] [Indexed: 12/16/2022] Open
Abstract
Intervertebral disk degeneration (IVDD) is a leading cause of disability. The degeneration is inevitable, and the mechanisms are complex. Current therapeutic strategies mainly focus on the relief of symptoms, not the intrinsic regeneration of the intervertebral disk (IVD). Tissue engineering is a promising strategy for IVDD due to its ability to restore a healthy microenvironment and promote IVD regeneration. This review briefly summarizes the IVD anatomy and composition and then sets out elements of the microenvironment and the interactions. We rationalized different scaffolds based on tissue engineering strategies used recently. To fulfill the complete restoration of a healthy IVD microenvironment, we propose that various tissue engineering strategies should be combined and customized to create personalized therapeutic strategies for each individual.
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Affiliation(s)
- Yiming Dou
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Xun Sun
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Xinlong Ma
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Xin Zhao
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Qiang Yang
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, China
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10
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Distaffen HE, Jones CW, Abraham BL, Nilsson BL. Multivalent display of chemical signals on
self‐assembled
peptide scaffolds. Pept Sci (Hoboken) 2021. [DOI: 10.1002/pep2.24224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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11
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Ding X, Zhao H, Li Y, Lee AL, Li Z, Fu M, Li C, Yang YY, Yuan P. Synthetic peptide hydrogels as 3D scaffolds for tissue engineering. Adv Drug Deliv Rev 2020; 160:78-104. [PMID: 33091503 DOI: 10.1016/j.addr.2020.10.005] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/25/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022]
Abstract
The regeneration of tissues and organs poses an immense challenge due to the extreme complexity in the research work involved. Despite the tissue engineering approach being considered as a promising strategy for more than two decades, a key issue impeding its progress is the lack of ideal scaffold materials. Nature-inspired synthetic peptide hydrogels are inherently biocompatible, and its high resemblance to extracellular matrix makes peptide hydrogels suitable 3D scaffold materials. This review covers the important aspects of peptide hydrogels as 3D scaffolds, including mechanical properties, biodegradability and bioactivity, and the current approaches in creating matrices with optimized features. Many of these scaffolds contain peptide sequences that are widely reported for tissue repair and regeneration and these peptide sequences will also be discussed. Furthermore, 3D biofabrication strategies of synthetic peptide hydrogels and the recent advances of peptide hydrogels in tissue engineering will also be described to reflect the current trend in the field. In the final section, we will present the future outlook in the design and development of peptide-based hydrogels for translational tissue engineering applications.
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Affiliation(s)
- Xin Ding
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China.
| | - Huimin Zhao
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Yuzhen Li
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Ashlynn Lingzhi Lee
- Institute of Bioengineering and Nanotechnology, 31 Biopolis Way, The Nanos, Singapore 138669, Singapore
| | - Zongshao Li
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Mengjing Fu
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Chengnan Li
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Yi Yan Yang
- Institute of Bioengineering and Nanotechnology, 31 Biopolis Way, The Nanos, Singapore 138669, Singapore.
| | - Peiyan Yuan
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China.
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12
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Cheng S, Li X, Jia Z, Lin L, Ying J, Wen T, Zhao Y, Guo Z, Zhao X, Li D, Ji W, Wang D, Ruan D. The inflammatory cytokine TNF-α regulates the biological behavior of rat nucleus pulposus mesenchymal stem cells through the NF-κB signaling pathway in vitro. J Cell Biochem 2019; 120:13664-13679. [PMID: 30938863 DOI: 10.1002/jcb.28640] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 02/17/2019] [Accepted: 02/28/2019] [Indexed: 12/27/2022]
Abstract
Nucleus pulposus (NP) mesenchymal stem cells (NPMSCs) are a potential cell source for intervertebral disc (IVD) regeneration; however, little is known about their response to tumor necrosis factor-α (TNF-α), a critical inflammation factor contributing to accelerating IVD degeneration. Accordingly, the aim of this study was to investigate the regulatory effects of TNF-α at high and low concentrations on the biological behaviors of healthy rat NPMSCs, including proliferation, migration, and NP differentiation. In this study, NPMSCs were treated with different concentration of TNF-α (0-200 ng/mL). Then we used annexin V/propidium iodide flow cytometry analysis to detect the apoptosis rate of NPMSCs. Cell Counting Kit-8, Edu assay, and cell cycle test were used to examine the proliferation of NPMSCs. Migration ability of NPMSCs was detected by wound healing assay and transwell migration assay. Pellets method was used to induce NP differentiation of NPMSCs, and immunohistochemical staining, real-time polymerase chain reaction, and Western blot analysis were used to examine the NPC phenotypic genes and proteins. The cells were further treated with the nuclear factor-κB (NF-κB) pathway inhibitor Bay 11-7082 to determine the role of the NF-κB pathway in the mechanism underlying the differentiation process. Results showed that treatment with a high concentration of TNF-α (50-200 ng/mL) could induce apoptosis of NPMSCs, whereas a relatively low TNF-α concentration (0.1-10 ng/mL) promoted the proliferation and migration of NPMSCs, but inhibited their differentiation toward NP cells. Moreover, we identified that the NF-κB signaling pathway is activated during the TNF-α-inhibited differentiation of NPMSCs, and the NF-κB signal inhibitor Bay 11-7082 could partially eliminate the adverse effect of TNF-α on the differentiation of NPMSCs. Therefore, our findings provide important insight into the dynamic biological behavior reactivity of NPMSCs to TNF-α during IVD degeneration process, thus may help us understanding the underlying mechanism of IVD degeneration.
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Affiliation(s)
- Shi Cheng
- Department of Orthopedic Surgery, Navy General Hospital, Beijing, China.,The Second Clinical College, Southern Medical University, Guangzhou, China
| | - Xiaochuan Li
- Department of Orthopedic Surgery, The People's Hospital of Gaozhou, Guangdong, China
| | - Zhiwei Jia
- Department of Orthopedics, The 306th Hospital of People's Liberation Army, Beijing, China
| | - Linghan Lin
- Department of Orthopedic Surgery, Navy General Hospital, Beijing, China
| | - Jinwei Ying
- Department of Orthopedic Surgery, Navy General Hospital, Beijing, China
| | - Tianyong Wen
- Department of Orthopedic Surgery, Navy General Hospital, Beijing, China
| | - Yachao Zhao
- Department of Orthopedic Surgery, Navy General Hospital, Beijing, China
| | - Ziming Guo
- Department of Orthopedic Surgery, Navy General Hospital, Beijing, China
| | - Xiyan Zhao
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dandan Li
- The Second Clinical College, Southern Medical University, Guangzhou, China
| | - Wei Ji
- Department of Orthopedic Surgery, Navy General Hospital, Beijing, China
| | - Deli Wang
- Department of Orthopedic Surgery, Peking University Shenzhen Hospital, Guangdong, China
| | - Dike Ruan
- Department of Orthopedic Surgery, Navy General Hospital, Beijing, China
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13
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Zhang J, Wang X, Liu H, Li Z, Chen F, Wang H, Zheng Z, Wang J. TNF-α enhances apoptosis by promoting chop expression in nucleus pulposus cells: role of the MAPK and NF-κB pathways. J Orthop Res 2019; 37:697-705. [PMID: 30561076 DOI: 10.1002/jor.24204] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 11/28/2018] [Indexed: 02/04/2023]
Abstract
CHOP has been shown to be involved in AF cells apoptosis and disc degeneration in a rat model. The aim of this study was to investigate the regulatory effects of TNF-α on C/EBP homologous protein (CHOP) and the role of CHOP in nucleus pulposus (NP) cell apoptosis. The effects of TNF-α on chop were measured by qPCR, Western blot, and immunofluorescence. TNF receptor involvement was analyzed by small interfering RNA (siRNA), Western blotting, immunofluorescence, and qPCR. The effects of NF-κB and MAPK on TNF-α-mediated chop promoter activity were studied using siRNAs, Western blotting, immunofluorescence, and qPCR. The regulatory effects of TNF-α-induced CHOP on Bcl-2 and Bax were studied using siRNAs, Western blotting, immunofluorescence, and qPCR. Flow cytometric and TUNEL analyses were performed to investigate the effects of chop on NP cell apoptosis. Increased CHOP expression was observed in NP cells after TNF-α treatment. Treatment of cells with TNF receptor, NF-κB, and ERK/JNK-MAPK inhibitors or siRNAs abolished the effects of cytokines on CHOP expression. Pharmacological siRNA knockdown of chop promoted Bax, decreased Bcl-2, and attenuated TNF-α-mediated cell apoptosis. During intervertebral disc degeneration (IVDD), TNF-α binds to TNF receptors and controls the JNK/ERK-MAPK, and NF-κB signaling pathways in NP cells, increasing CHOP expression. This change up-regulates the pro-apoptotic protein Bax and down-regulates the anti-apoptosis protein Bcl-2, inducing cell apoptosis. This study suggests a potential therapeutic target for controlling the inflammatory-induced apoptosis associated with IVDD. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Affiliation(s)
- Jian Zhang
- Department of Spine Surgery, The 1st Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
- Department of Spine Surgery, Shenzhen Second People's Hospital, The 1st Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, PR China
| | - Xiaolin Wang
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The 6th Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Hui Liu
- Department of Spine Surgery, The 1st Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Zemin Li
- Department of Spine Surgery, The 1st Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Fan Chen
- Department of Spine Surgery, The 1st Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Hua Wang
- Department of Spine Surgery, The 1st Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Zhaomin Zheng
- Department of Spine Surgery, The 1st Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Jianru Wang
- Department of Spine Surgery, The 1st Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
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14
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Yang H, Hong N, Liu H, Wang J, Li Y, Wu S. Differentiated adipose-derived stem cell cocultures for bone regeneration in RADA16-I in vitro. J Cell Physiol 2018; 233:9458-9472. [PMID: 29995982 DOI: 10.1002/jcp.26838] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 05/10/2018] [Indexed: 02/06/2023]
Abstract
Craniofacial defects can cause morbidness. Adipose-derived stem cells (ADSCs) have shown great promise for osteogeneration and vascularization; therefore cocultures of differentiated ADSCs are explored to increase bone and vessel formation. In this study, ADSCs were induced into osteogenic ADSCs (os-ADSCs) and endothelial ADSCs (endo-ADSCs) cells, which were then cocultured in variable proportions (os-ADSCs/endo-ADSCs = 2:1, 1:1, 1:2). The os-ADSCs in a ratio of 1:1 expressed more ALP, RUNX2 and COL-I, whereas VEGF, vWF and CD31 were upregulated in the endo-ADSCs of this group. Next generation RNA sequencing (RNA-seq) was performed to evaluate the molecular mechanisms of cocultured ADSCs. The os-ADSCs and endo-ADSCs interacted with each other during osteogenic and angiogenic differentiation, especially at the ratio of 1:1, and were regulated by vascular-related genes, cell-mediated genes, bone-related genes and the transforming growth factor β signaling pathway (TGF-β), mitogen-activated protein kinase signaling pathway (MAPK) and wnt signaling pathway (Wnt). Angptl4, apoe, mmp3, bmp6, mmp13 and fgf18 were detected to be up-regulated, and cxcl12 and wnt5a were down-regulated. The results showed that the gene expression levels were consistent with that in RNA-seq. The cells were then seeded into self-assembling peptide RADA16-I scaffolds as cocultures (1:1) and monocultures (ADSCs, os-ADSCs, endo-ADSCs). The results showed that the cells of all groups grew and proliferated well on the scaffolds, and the cocultured group exhibited better osteogeneration and vascularization. In conclusion, cocultured os-ADSCs and endo-ADSCs at the ratio of 1:1 showed strong osteogenic and angiogenic differentiation. There is a great potential for osteogenesis and vascularization by 3D culturing cells in a 1:1 ratio in self-assembling peptide RADA16-I scaffolds, which requires evaluation for bone regeneration in vivo.
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Affiliation(s)
- Huifang Yang
- Department of Prosthodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Nanrui Hong
- Department of Prosthodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Hsiaowei Liu
- Department of Prosthodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Jieda Wang
- Department of Prosthodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yan Li
- Department of Prosthodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Shuyi Wu
- Department of Prosthodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
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15
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Chen Y, Hua Y, Zhang W, Tang C, Wang Y, Zhang Y, Qiu F. Amyloid-like staining property of RADA16-I nanofibers and its potential application in detecting and imaging the nanomaterial. Int J Nanomedicine 2018; 13:2477-2489. [PMID: 29719395 PMCID: PMC5922240 DOI: 10.2147/ijn.s159785] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Designer self-assembling peptide nanofibers (SAPNFs) as a novel kind of emerging nanomaterial have received more and more attention in the field of nanomedicine in recent years. However, a simple method to monitor and image SAPNFs is still currently absent. Methods RADA16-I, a well-studied ionic complementary peptide was used as a model to check potential amyloid-like staining properties of SAPNFs. Thioflavin-T (ThT) and Congo red (CR) as specific dyes for amyloid-like fibrils were used to stain RADA16-I nanofibers in solution, combined with drugs or cells, or injected in vivo as hydrogels. Fluorescent spectrometry and fluorescent microscopy were used to check ThT-binding property, and polarized light microscopy was used to check CR-staining property. Results ThT binding with the nanofibers showed enhanced and blue-shifted fluorescence, and specific apple-green birefringence could be observed after the nanofibers were stained with CR. Based on these properties we further showed that ThT-binding fluorescence intensity could be used to monitor the forming and changing of nanofibers in solution, while fluorescent microscopy and polarized light microscopy could be used to image the nanofibers as material for drug delivery, 3D cell culture, and tissue regeneration. Conclusion Our results may provide convenient and reliable tools for detecting SAPNFs, which would be helpful for understanding their self-assembling process and exploring their applications.
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Affiliation(s)
- Yongzhu Chen
- Periodical Press of West China Hospital, Sichuan University, Chengdu, China
| | - Yusi Hua
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Wensheng Zhang
- Laboratory of Anaesthesia and Critical Care Medicine, Translational Neuroscience Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Chengkang Tang
- Core Facility of West China Hospital, Sichuan University, Chengdu, China
| | - Yan Wang
- Core Facility of West China Hospital, Sichuan University, Chengdu, China
| | - Yujun Zhang
- Laboratory of Anaesthesia and Critical Care Medicine, Translational Neuroscience Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Feng Qiu
- Laboratory of Anaesthesia and Critical Care Medicine, Translational Neuroscience Centre, West China Hospital, Sichuan University, Chengdu, China
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16
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Jahanbazi Jahan-Abad A, Sahab Negah S, Hosseini Ravandi H, Ghasemi S, Borhani-Haghighi M, Stummer W, Gorji A, Khaleghi Ghadiri M. Human Neural Stem/Progenitor Cells Derived From Epileptic Human Brain in a Self-Assembling Peptide Nanoscaffold Improve Traumatic Brain Injury in Rats. Mol Neurobiol 2018; 55:9122-9138. [PMID: 29651746 DOI: 10.1007/s12035-018-1050-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 03/27/2018] [Indexed: 01/09/2023]
Abstract
Traumatic brain injury (TBI) is a disruption in the brain functions following a head trauma. Cell therapy may provide a promising treatment for TBI. Among different cell types, human neural stem cells cultured in self-assembling peptide scaffolds have been suggested as a potential novel method for cell replacement treatment after TBI. In the present study, we accessed the effects of human neural stem/progenitor cells (hNS/PCs) derived from epileptic human brain and human adipose-derived stromal/stem cells (hADSCs) seeded in PuraMatrix hydrogel (PM) on brain function after TBI in an animal model of brain injury. hNS/PCs were isolated from patients with medically intractable epilepsy undergone epilepsy surgery. hNS/PCs and hADSCs have the potential for proliferation and differentiation into both neuronal and glial lineages. Assessment of the growth characteristics of hNS/PCs and hADSCs revealed that the hNS/PCs doubling time was significantly longer and the growth rate was lower than hADSCs. Transplantation of hNS/PCs and hADSCs seeded in PM improved functional recovery, decreased lesion volume, inhibited neuroinflammation, and reduced the reactive gliosis at the injury site. The data suggest the transplantation of hNS/PCs or hADSCs cultured in PM as a promising treatment option for cell replacement therapy in TBI.
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Affiliation(s)
- Ali Jahanbazi Jahan-Abad
- Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran.,Department of Clinical Biochemistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sajad Sahab Negah
- Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran.,Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Sedigheh Ghasemi
- Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
| | | | - Walter Stummer
- Department of Neurosurgery, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Ali Gorji
- Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran. .,Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. .,Department of Neurosurgery, Westfälische Wilhelms-Universität Münster, Münster, Germany. .,Department of Neurology, Westfälische Wilhelms-Universität Münster, Münster, Germany. .,Epilepsy Research Center, Westfälische Wilhelms-Universität Münster, Robert-Koch-Strasse 45, 48149, Münster, Germany.
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17
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Ye D, Liang W, Dai L, Yao Y. Moderate Fluid Shear Stress Could Regulate the Cytoskeleton of Nucleus Pulposus and Surrounding Inflammatory Mediators by Activating the FAK-MEK5-ERK5-cFos-AP1 Signaling Pathway. DISEASE MARKERS 2018; 2018:9405738. [PMID: 30008976 PMCID: PMC6020454 DOI: 10.1155/2018/9405738] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/09/2018] [Indexed: 01/04/2023]
Abstract
We first applied moderate fluid shear stress to nucleus pulposus cells. The correlation of AP-1 with type II collagen, proteoglycan, Cytokeratin 8 protein, MAP-1, MAP-2, and MAP-4 and the correlation of AP-1 with IL-1β, TNF-α, IL-6, IL-8, MIP-1, MCP-1, and NO were detected. Our results document that moderate fluid shear stress could activate the FAK-MEK5-ERK5-cFos-AP1 signaling pathway. AP1 could downregulate the construct factors of cytoskeleton such as type II collagen, proteoglycan, Cytokeratin 8 protein, MAP-1, MAP-2, and MAP-4 in nucleus pulposus cell after the fluid shear stress was loaded. AP1 could upregulate the inflammatory factors such as IL-1β, TNF-α, IL-6, IL-8, MIP-1, MCP-1, and NO in nucleus pulposus cell after the fluid shear stress was loaded. Taken together, our data suggested that moderate fluid shear stress may play an important role in the cytoskeleton of nucleus pulposus and surrounding inflammatory mediators by activating the FAK-MEK5-ERK5-cFos-AP1 signaling pathway, thereby affecting cell degeneration.
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Affiliation(s)
- Dongping Ye
- Guangzhou City Red Cross Hospital, The Fourth Affiliated Hospital of Medical College, Jinan University, Guangzhou 510220, China
| | - Weiguo Liang
- Guangzhou City Red Cross Hospital, The Fourth Affiliated Hospital of Medical College, Jinan University, Guangzhou 510220, China
| | - Libing Dai
- Guangzhou City Red Cross Hospital, The Fourth Affiliated Hospital of Medical College, Jinan University, Guangzhou 510220, China
| | - Yicun Yao
- Guangzhou City Red Cross Hospital, The Fourth Affiliated Hospital of Medical College, Jinan University, Guangzhou 510220, China
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