Silk fibroin-based scaffolds for bone regeneration

Naturally Derived Luminescent Material in Engineered Silk and Its Application as a Fluorescent Dye with a Large Stokes Shift and Sensing Capability

Silkworms have provided valuable byproducts (spanning from high-quality textiles to health supplements) to humans for millennia. Despite their importance in sericultural economy and biotechnology, manifold possibilities inherent in the myriad natural or artificially generated silk varieties have been underestimated. In this paper, we report that the Yeonnokjam silk strain, which shows light-green color, contains quercetin fluorochrome (QueF) in sericin, and QueF can be used as a fluorescence dye with a large Stokes shift and high sensitivity to environmental temperature and pH, thus functioning as an environmental sensing material. A Stokes shift exceeding 180 nm, a quantum efficiency of 1.28%, and a rapid fluorescence decay of 0.67 ns are obtained, which are influenced by solvent polarities. Moreover, QueF can be used as a UV blocker as well, and its low cytotoxicity and biocompatibility further suggest promising prospects for diverse application in cosmetics and medical materials in the future.

Silk fibroin-based scaffolds for tissue engineering

Silk fibroin is an important natural fibrous protein with excellent prospects for tissue engineering applications. With profound studies in recent years, its potential in tissue repair has been developed. A growing body of literature has investigated various fabricating methods of silk fibroin and their application in tissue repair. The purpose of this paper is to trace the latest developments of SF-based scaffolds for tissue engineering. In this review, we first presented the primary and secondary structures of silk fibroin. The processing methods of SF scaffolds were then summarized. Lastly, we examined the contribution of new studies applying SF as scaffolds in tissue regeneration applications. Overall, this review showed the latest progress in the fabrication and utilization of silk fibroin-based scaffolds.

In vivo study of the immune response to bioengineered spider silk spheres

Bioengineered MS1 silk is derived from major ampullate spidroin 1 (MaSp1) from the spider Nephila clavipes. The MS1 silk was functionalized with the H2.1 peptide to target Her2-overexpressing cancer cells. The immunogenic potential of drug carriers made from MS1-type silks was investigated. The silk spheres were administered to healthy mice, and then (i) the phenotypes of the immune cells that infiltrated the Matrigel plugs containing spheres (implanted subcutaneously), (ii) the presence of silk-specific antibodies (after two intravenous injections of the spheres), (iii) the splenocyte phenotypes and their activity after restimulation ex vivo in terms of proliferation and cytokine secretion (after single intravenous injection of the spheres) were analyzed. Although the immunogenicity of MS1 particles was minor, the H2.1MS1 spheres attracted higher levels of B lymphocytes, induced a higher anti-silk antibody titer, and, after ex vivo restimulation, caused the activation of splenocytes to proliferate and express more IFN-γ and IL-10 compared with the PBS and MS1 groups. Although the H2.1MS1 spheres triggered a certain degree of an immunological response, multiple injections (up to six times) neither hampered the carrier-dependent specific drug delivery nor induced toxicity, as previously indicated in a mouse breast cancer model. Both findings indicate that a drug delivery system based on MS1-type silk has great potential for the treatment of cancer and other conditions.

Use of Bombyx mori silk fibroin in tissue engineering: From cocoons to medical devices, challenges, and future perspectives

Silk fibroin has become a prominent material in tissue engineering (TE) over the last 20 years with almost 10,000 published works spanning in all the TE applications, from skeleton to neuronal regeneration. Fibroin is an extremely versatile biopolymer that, due to its ease of processing, has enabled the development of an entire plethora of materials whose properties and architectures can be tailored to suit target applications. Although the research and development of fibroin TE materials and devices is mature, apart from sutures, only a few medical products made of fibroin are used in the clinical routines. <40 clinical trials of Bombyx mori silk-related products have been reported by the FDA and few of them resulted in a commercialized device. In this review, after explaining the structure and properties of silk fibroin, we provide an overview of both fibroin constructs existing in the literature and fibroin devices used in clinic. Through the comparison of these two categories, we identified the burning issues faced by fibroin products during their translation to the market. Two main aspects will be considered. The first is the standardization of production processes, which leads both to the standardization of the characteristics of the issued device and the correct assessment of its failure. The second is the FDA regulations, which allow new devices to be marketed through the 510(k) clearance by demonstrating their equivalence to a commercialized medical product. The history of some fibroin medical devices will be taken as a case study. Finally, we will outline a roadmap outlining what actions we believe are needed to bring fibroin products to the market.

Bioengineered Silkworm for Producing Cocoons with High Fibroin Content for Regenerated Fibroin Biomaterial-Based Applications

Silk fibroin exhibits high biocompatibility and biodegradability, making it a versatile biomaterial for medical applications. However, contaminated silkworm-derived substances in remnant sericin from the filature and degumming process can result in undesired immune reactions and silk allergy, limiting the widespread use of fibroin. Here, we established transgenic silkworms with modified middle silk glands, in which sericin expression was repressed by the ectopic expression of cabbage butterfly-derived cytotoxin pierisin-1A, to produce cocoons composed solely of fibroin. Intact, nondegraded fibroin can be prepared from the transgenic cocoons without the need for sericin removal by the filature and degumming steps that cause fibroin degradation. A wide-angle X-ray diffraction analysis revealed low crystallinity in the transgenic cocoons. However, nondegraded fibroin obtained from transgenic cocoons enabled the formation of fibroin sponges with varying densities by using 1–5% (v/v) alcohol. The effective chondrogenic differentiation of ATDC5 cells was induced following their cultivation on substrates coated with intact fibroin. Our results showed that intact, allergen-free fibroin can be obtained from transgenic cocoons without the need for sericin removal, providing a method to produce fibroin-based materials with high biocompatibility for biomedical uses.

Silk biomaterials for vascular tissue engineering applications

Vascular tissue engineering is a rapidly growing field of regenerative medicine, which strives to find innovative solutions for vascular reconstruction. Considering the limited success of synthetic grafts, research impetus in the field is now shifted towards finding biologically active vascular substitutes bestowing in situ growth potential. In this regard, silk biomaterials have shown remarkable potential owing to their favorable inherent biological and mechanical properties. This review provides a comprehensive overview of the progressive development of silk-based small diameter (<6 mm) tissue-engineered vascular grafts (TEVGs), emphasizing their pre-clinical implications. Herein, we first discuss the molecular structure of various mulberry and non-mulberry silkworm silk and identify their favorable properties at the onset of vascular regeneration. The emergence of various state-of-the-art fabrication methodologies for the advancement of silk TEVGs is rationally appraised in terms of their in vivo performance considering the following parameters: ease of handling, long-term patency, resistance to acute thrombosis, stenosis and aneurysm formation, immune reaction, neo-tissue formation, and overall remodeling. Finally, we provide an update on the pre-clinical status of silk-based TEVGs, followed by current challenges and future prospects. STATEMENT OF SIGNIFICANCE: Limited availability of healthy autologous blood vessels to replace their diseased counterpart is concerning and demands other artificial substitutes. Currently available synthetic grafts are not suitable for small diameter blood vessels owing to frequent blockage. Tissue-engineered biological grafts tend to integrate well with the native tissue via remodeling and have lately witnessed remarkable success. Silk fibroin is a natural biomaterial, which has long been used as medical sutures. This review aims to identify several favorable properties of silk enabling vascular regeneration. Furthermore, various methodologies to fabricate tubular grafts are discussed and highlight their performance in animal models. An overview of our understanding to rationally improve the biological activity fostering the clinical success of silk-based grafts is finally discussed.

Physical and biological performances of a semi-resorbable barrier membrane based on silk fibroin-glycerol-fish collagen material for guided bone regeneration

The fragility of silk fibroin film is a drawback to being used as a barrier membrane. Semi-resorbable barrier membranes maintain function longer than a resorbable membrane and no need to be removed. The study aimed to fabricate semi-resorbable membranes using silk fibroin with glycerol plasticizer (Group A), immobilized with fish collagen (Group B), and then characterized, in vitro biocompatibility tested, and compared with a commercial collagen membrane (Group C). Group B showed more roughness (0.2155 µm) than Group A (0.1424 µm). Group A was more hydrophilic (76.75° ± 3.07°) and more stiffness (28.93% ± 15.56%) than Group B (112.67° ± 1.94°, 42.10% ± 11.46%) and C (54.79% ± 13.44%) without significant difference. Group C had a significantly higher (p < 0.05) swelling degree and less degradation rate than others. Group A showed significantly highest (p < 0.05) cell proliferation. Group C showed more alkaline phosphatase activity than others but no significant difference in osteocalcin and Alizarin Red activity on day 21. The semi-resorbable membrane based on silk fibroin-glycerol possessed good physical and mechanical properties, and well-supported osteoblastic cell proliferation and differentiation.

Systematic Review of Silk Scaffolds in Musculoskeletal Tissue Engineering Applications in the Recent Decade

During the past decade, various novel tissue engineering (TE) strategies have been developed to maintain, repair, and restore the biomechanical functions of the musculoskeletal system. Silk fibroins are natural polymers with numerous advantageous properties such as good biocompatibility, high mechanical strength, and low degradation rate and are increasingly being recognized as a scaffolding material of choice in musculoskeletal TE applications. This current systematic review examines and summarizes the latest research on silk scaffolds in musculoskeletal TE applications within the past decade. Scientific databases searched include PubMed, Web of Science, Medline, Cochrane library, and Embase. The following keywords and search terms were used: musculoskeletal, tendon, ligament, intervertebral disc, muscle, cartilage, bone, silk, and tissue engineering. Our Review was limited to articles on musculoskeletal TE, which were published in English from 2010 to September 2019. The eligibility of the articles was assessed by two reviewers according to prespecified inclusion and exclusion criteria, after which an independent reviewer performed data extraction and a second independent reviewer validated the data obtained. A total of 1120 articles were reviewed from the databases. According to inclusion and exclusion criteria, 480 articles were considered as relevant for the purpose of this systematic review. Tissue engineering is an effective modality for repairing or replacing injured or damaged tissues and organs with artificial materials. This Review is intended to reveal the research status of silk-based scaffolds in the musculoskeletal system within the recent decade. In addition, a comprehensive translational research route for silk biomaterial from bench to bedside is described in this Review.

Preparation and Biocompatibility Characterization of Silk Fibroin 3D Scaffolds

In this paper, three different mass fractions of sodium carbonate were used for degumming to obtain different degrees of damaged silk fibroin fibers, which were then treated with formic acid to shrink and bond them into 3D scaffolds. The structure and performance of silk fibroin fibers and silk fibroin 3D scaffolds were characterized by scanning electron microscopy, infrared spectroscopy, X-ray diffraction, a differential thermal scanner, a universal materials testing machine, and laser confocal microscopy, and the degradation performance was tested by protease degradation. The results showed that an excessive mass fraction of sodium carbonate would cause partial hydrolysis of fibroin fibers, decrease the mechanical properties of fibroin fiber, increase the surface roughness of fibroin fibers, and make mouse embryonic fibroblasts easier to adhere and grow. Silk fibroin fibers were slightly dissolved, shrunk, and dispersed in formic acid. The mass fraction of sodium carbonate can adjust the enzymatic degradation rate of the silk fibroin 3D scaffolds. With the extension of the degradation time, minerals will be deposited on the surface of the scaffolds. The results show that the silk fibroin 3D scaffolds have biocompatibility, mechanical properties, and degradability, which provides a good material for a barrier biofilm in the future.

Effects of transgenic silk materials that incorporate FGF-7 protein microcrystals on the proliferation and differentiation of human keratinocytes

The silk glands of silkworms produce large quantities of fibroin, which is a protein that can be physically processed and used as a biodegradable carrier for cell growth factors in tissue engineering applications. Meanwhile, protein microcrystals known as polyhedra, which are derived from cypovirus 1, have been used as a vehicle to protect and release encapsulated cell growth factors. We report the generation of transgenic silkworms that express recombinant fibroblast growth factor-7 (FGF-7) fused with the polyhedron-encapsulating signal in polyhedra produced in the middle (MSG) and posterior (PSG) silk glands. Immunofluorescence showed that polyhedra from silk glands are associated with FGF-7. The MSG and PSG from transgenic silkworms were processed into fine powdery materials, from which FGF-7 activity was released to stimulate the proliferation of human keratinocyte epidermal cells. Powders from PSGs exhibited higher FGF-7 activity than those from MSGs. Moreover, PSG powder showed a gradual release of FGF-7 activity over a long period and induced keratinocyte proliferation and differentiation in 3D culture to promote the formation of stratified epidermis expressing positive differentiation marker proteins. Our results indicate that powdery materials incorporating the FGF-7-polyhedra microcrystals from silk glands are valuable for developing cell/tissue engineering applications in vivo and in vitro.

Engineering of sustainable biomaterial composites from cellulose and silk fibroin: Fundamentals and applications

This review addresses composites prepared from cellulose (Cel) and silk fibroin (SF) to generate multifunctional, biocompatible, biodegradable materials such as fibers, films and scaffolds for tissue engineering. First, we discuss briefly the molecular structures of Cel and SF. Their structural features explain why certain solvents, e.g., ionic liquids, inorganic electrolyte solutions dissolve both biopolymers. We discuss the mechanisms of Cel dissolution because in many cases they also apply to (much less studied) SF dissolution. Subsequently, we discuss the fabrication and characterization of Cel/SF composite biomaterials. We show how the composition of these materials beneficially affects their mechanical properties, compared to those of the precursor biopolymers. We also show that Cel/SF materials are excellent and versatile candidates for biomedical applications because of the inherent biocompatibility of their components.

Influence of the Casting Concentration on the Mechanical and Optical Properties of FA/CaCl2-Derived Silk Fibroin Membranes

In this study, we describe the manufacturing and characterization of silk fibroin membranes derived from the silkworm Bombyx mori. To date, the dissolution process used in this study has only been researched to a limited extent, although it entails various potential advantages, such as reduced expenses and the absence of toxic chemicals in comparison to other conventional techniques. Therefore, the aim of this study was to determine the influence of different fibroin concentrations on the process output and resulting membrane properties. Casted membranes were thus characterized with regard to their mechanical, structural and optical assets via tensile testing, SEM, light microscopy and spectrophotometry. Cytotoxicity was evaluated using BrdU, XTT, and LDH assays, followed by live-dead staining. The formic acid (FA) dissolution method was proven to be suitable for the manufacturing of transparent and mechanically stable membranes. The fibroin concentration affects both thickness and transparency of the membranes. The membranes did not exhibit any signs of cytotoxicity. When compared to other current scientific and technical benchmarks, the manufactured membranes displayed promising potential for various biomedical applications. Further research is nevertheless necessary to improve reproducible manufacturing, including a more uniform thickness, less impurity and physiological pH within the membranes.

Evaluation of a simple off-the-shelf bi-layered vascular scaffold based on poly(L-lactide-co-ε-caprolactone)/silk fibroin in vitro and in vivo

Purpose: In the field of small-caliber vascular scaffold research, excellent vascular remodeling is the key to ensuring anticoagulant function. We prepared an off-the-shelf bi-layered vascular scaffold with a dense inner layer and a loose outer layer and evaluated its remodeling capabilities by in vivo transplantation.

Materials and Methods: Based on poly(L-lactide-co-ε-caprolactone) (PLCL), silk fibroin(SF), and heparin (Hep), PLCL/SF/Hep bi-layered scaffolds and PLCL/Hep bi-layered scaffolds were prepared by electrospinning. The inner layer was a PLCL/SF/Hep or PLCL/Hep nanofiber membrane, and the outer layer was PLCL/SF nano yarn. The in vitro tests included a hydrophilicity test, mechanical properties test, and blood and cell compatibility evaluation. The in vivo evaluation was conducted via single rabbit carotid artery replacement and subsequent examinations, including ultrasound imaging, immunoglobulin assays, and tissue section staining.

Results: Compared to the PLCL/Hep nanofiber membrane, the hydrophilicity of the PLCL/SF/Hep nanofiber membrane was significantly improved. The mechanical strength met application requirements. Both the blood and cell compatibility were optimal. Most importantly, the PLCL/SF/Hep scaffolds maintained lumen patency for 3 months after carotid artery transplantation in live rabbits. At the same time, CD31 and α-SMA immunofluorescence staining confirmed bionic endothelial and smooth muscle layers remodeling.

Conclusion: Using this hybrid strategy, PLCL and SF were combined to manufacture bi-layered small-caliber vascular scaffolds; these PLCL/SF/Hep scaffolds showed satisfactory vascular remodeling.

Applications of Metals for Bone Regeneration

The regeneration of bone tissue is the main purpose of most therapies in dental medicine. For bone regeneration, calcium phosphate (CaP)-based substitute materials based on natural (allo- and xenografts) and synthetic origins (alloplastic materials) are applied for guiding the regeneration processes. The optimal bone substitute has to act as a substrate for bone ingrowth into a defect, as well as resorb in the time frame needed for complete regeneration up to the condition of restitution ad integrum. In this context, the modes of action of CaP-based substitute materials have been frequently investigated, where it has been shown that such materials strongly influence regenerative processes such as osteoblast growth or differentiation and also osteoclastic resorption due to different physicochemical properties of the materials. However, the material characteristics needed for the required ratio between new bone tissue formation and material degradation has not been found, until now. The addition of different substances such as collagen or growth factors and also of different cell types has already been tested but did not allow for sufficient or prompt application. Moreover, metals or metal ions are used differently as a basis or as supplement for different materials in the field of bone regeneration. Moreover, it has already been shown that different metal ions are integral components of bone tissue, playing functional roles in the physiological cellular environment as well as in the course of bone healing. The present review focuses on frequently used metals as integral parts of materials designed for bone regeneration, with the aim to provide an overview of currently existing knowledge about the effects of metals in the field of bone regeneration.

In vivo evaluation of modified silk fibroin scaffolds with a mimicked microenvironment of fibronectin/decellularized pulp tissue for maxillofacial surgery

This study aimed to carry out in vivo testing of the formation of new bone by modified silk fibroin scaffolds with a mimicked microenvironment of fibronectin/decellularized pulp in bone defects. Silk fibroin scaffolds were fabricated into three-dimensional scaffolds before being coated with fibronectin/decellularized pulp. The coated scaffolds were implanted into rabbits. Twenty-four bicortical calvarial defects in 12 rabbits were divided randomly into two groups: non-coated and coated silk fibroin scaffolds. The rabbits were sacrificed 2, 4 and 8 weeks after operation for evaluation of new bone formation. The morphology of the scaffolds, new bone formation and histology were evaluated by scanning electron microscopy, micro-CT and hematoxylin and eosin staining, respectively. The results showed that the coated silk fibroin scaffolds had a fibrillar network and crystal particles in the porous structure. The coated silk fibroin scaffolds demonstrated the ability to induce the formation of new bone with low inflammation and high vascularization. The results indicated that the modified silk fibroin scaffolds showed suitable biological performance and promise for bone regeneration in maxillofacial surgery.

Histological Reactions and the In Vivo Patency Rates of Small Silk Vascular Grafts in a Canine Model

Objective: To evaluate in vivo patency rates of silk fibroin (SF) vascular grafts and resulting histological reactions in a canine model. Methods: To generate 3.5-mm inner diameter vessels, a combination of plaited silk fibers were wound with cocoon filaments and subsequently coated with an SF solution. The resulting SF grafts (n=35) were implanted into the carotid arteries of male beagles (age, 1-2 years; body weight: 9.0-10.5 kg). Expanded polytetrafluoroethylene (4-mm inner diameter, ePTFE) grafts (n=5) were used as controls. Graft patency was monitored via ultrasonography with histological changes analyzed via microscopic examination. Results: Compared with animals that received the ePTFE grafts, animals that received SF grafts exhibited the same thickness of luminal layers and fibrin accumulation and collagen fiber replacement with endothelialization at 3 months post-implantation via histological examination. The patency rates of the SF and the ePTFE grafts at 6 months post-implantation were 7.8% and 0%, respectively. Conclusion: This canine model study demonstrated that SF grafts induce unique histological reactions but fail to achieve long-term patency.

13C NMR characterization of hydrated 13C labeled Bombyx mori silk fibroin sponges prepared using glycerin, poly(ethylene glycol diglycidyl ether) and poly(ethylene glycol) as porogens

There is a need to prepare softer and highly flexible Bombyx mori silk fibroin (SF) sponges for the development of biomaterials that are biodegradable and with stiffness that matches sponges and soft tissues. In this paper, we prepared SF sponges using glycerin (Glyc), poly(ethylene)glycol diglycidyl ether (PGDE) and poly(ethylene)glycol (PEG) as porogens. The detailed characterization of the hydrated SF sponges was done using three ¹³C solid state NMR techniques, viz.,¹³C refocused insensitive nuclei enhanced by polarization transfer (r-INEPT) NMR, ¹³C cross polarization/magic angle spinning (CP/MAS) NMR, and ¹³C dipolar decoupled-magic angle spinning (DD/MAS) NMR. These three NMR methods gave respective information on fast motion, slow motion, and both fast and slow motions for the local structure and dynamics of the hydrated SF sponges. There was no significant difference in the r-INEPT spectra of the three hydrated SF sponges. On the other hand, there were significant differences among the ¹³C CP/MAS NMR spectra of the three sponges. The fractions of two kinds of β-sheet structure, two kinds of random coil conformations with mobile and immobile motions, and the Silk I* (type II β-turn) conformation were determined for the Ser residues in the ¹³C DD/MAS NMR spectra. Similarly, the fractions of several conformations were also determined for Tyr, Ala and Gly residues in SF, which showed significant differences among the three hydrated sponges. The relationship between the local structure of these hydrated SF sponges and their mechanical properties was also briefly discussed.

Bioengineered Osteoinductive Broussonetia kazinoki/Silk Fibroin Composite Scaffolds for Bone Tissue Regeneration

In this article, Broussonetia kazinoki (BK) powdery extract is utilized to modify the silk fibroin (SF) scaffold and applied to the bone defect area. The BK/SF scaffold is an efficient cell carrier which promotes cell proliferation and osteogenic differentiation of rBMSCs (bone marrow derived mesenchymal stem cells). We confirmed biocompatibility and osteogenic differentiation capacity of BK/SF scaffolds compared to pristine SF scaffold in both in vitro and in vivo evaluation. Gene expression related to osteogenic differentiation and bone regeneration significantly upregulated in the BK/SF scaffold group. The implanted scaffolds were attached well to the surface of the bone defect region and integrated with surrounding tissues without significant inflammatory reaction. Furthermore, almost 45% of bone volume has been recovered at 8 weeks postsurgery, while the SF and control group showed 20% recovery. These results suggest that BK powdery extract incorporated with an SF scaffold might be a suitable substitute for an alternative bone graft for bone regeneration.

Effect of the surface morphology of silk fibroin scaffolds for bone regeneration

Existing scaffolds cannot adequately satisfy the simultaneous requirements for the regeneration of bone. The challenge remains of how to improve the integration of newly formed bone with the surrounding tissues. The purpose of this study was to investigate the effects of two silk fibroin scaffolds, a hexafluoro isopropanol-based silk fibroin (HFIP-F) and an aqueous-based silk fibroin (A-F), for their osteoinductive potentials in large critical size bone defects in vivo. β-tricalcium phosphate (β-TCP) was used as a positive control. After implantation into defects created in the knee joints of rabbits for 1 and 2 weeks, hematoxylin and eosin (H-E) and Azan staining revealed that the A-F scaffold as well as β-TCP had stronger osteoinductive ability than the HFIP-F scaffold. The A-F scaffold exhibited prominent areas of neo-tissue containing bone-like nodules. Furthermore, induced osteointegration was observed between native and neo-tissue within the osteo defects in the knee joints of rabbits. Immunohistochemical staining showed the highest expression of Runx2, BMP-2, BMP-7, Smad1/5/9 and Phospho-Smad in the A-F scaffold implants. Osteoinduction of the porous A-F scaffold might be influenced by the amount of BMP signaling present in the local microenvironment in the implants. This study opens a new avenue to use A-F silk fibroin scaffolds for the regeneration of bone defects.

Rapid endothelialization and thin luminal layers in vascular grafts using silk fibroin

The histological effects of silk fibroin in vascular grafts were clarified comprehensively on a large-animal model.

In vivo bioresponses to silk proteins

Silks are appealing materials for numerous biomedical applications involving drug delivery, tissue engineering, or implantable devices, because of their tunable mechanical properties and wide range of physical structures. In addition to the functionalities needed for specific clinical applications, a key factor necessary for clinical success for any implanted material is appropriate interactions with the body in vivo. This review summarizes our current understanding of the in vivo biological responses to silks, including degradation, the immune and inflammatory response, and tissue remodeling with particular attention to vascularization. While we focus in this review on silkworm silk fibroin protein due to the large quantity of in vivo data thanks to its widespread use in medical materials and consumer products, spider silk information is also included if available. Silk proteins are degraded in the body on a time course that is dependent on the method of silk fabrication and can range from hours to years. Silk protein typically induces a mild inflammatory response that decreases within a few weeks of implantation. The response involves recruitment and activation of macrophages and may include activation of a mild foreign body response with the formation of multinuclear giant cells, depending on the material format and location of implantation. The number of immune cells present decreases with time and granulation tissue, if formed, is replaced by endogenous, not fibrous, tissue. Importantly, silk materials have not been demonstrated to induce mineralization, except when used in calcified tissues. Due to its ability to be degraded, silk can be remodeled in the body allowing for vascularization and tissue ingrowth with eventual complete replacement by native tissue. The degree of remodeling, tissue ingrowth, or other specific cell behaviors can be modulated with addition of growth or other signaling factors. Silk can also be combined with numerous other materials including proteins, synthetic polymers, and ceramics to enhance its characteristics for a particular function. Overall, the diverse array of silk materials shows excellent bioresponses in vivo with low immunogenicity and the ability to be remodeled and replaced by native tissue making it suitable for numerous clinical applications.

Nonmulberry Silk Fibroin Scaffold Shows Superior Osteoconductivity Than Mulberry Silk Fibroin in Calvarial Bone Regeneration

Recent years have witnessed the advancement of silk biomaterials in bone tissue engineering, although clinical application of the same is still in its infancy. In this study, the potential of pure nonmulberry Antheraea mylitta (Am) fibroin scaffold, without preloading with bone precursor cells, to repair calvarial bone defect in a rat model is explored and compared with its mulberry counterpart Bombyx mori (Bm) silk fibroin. After 3 months of implantation, Am scaffold culminates in a completely ossified regeneration with a progressive increase in mineralization at the implanted site. On the other hand, the Bm scaffold fails to repair the damaged bone, presumably due to its low osteoconductivity and early degradation. The deposition of bone matrix on scaffolds is evaluated by scanning electron and atomic force microscopy. These results are corroborated by in vitro studies of enzymatic degradation, colony formation, and secondary conformational features of the scaffold materials. The greater biocompatibility and mineralization in pure nonmulberry fibroin scaffolds warrants the use of these scaffolds as an "ideal bone graft" biomaterial for effective repair of critical size defects.

Response of human mesenchymal stem cells to intrafibrillar nanohydroxyapatite content and extrafibrillar nanohydroxyapatite in biomimetic chitosan/silk fibroin/nanohydroxyapatite nanofibrous membrane scaffolds

Incorporation of nanohydroxyapatite (nHAP) within a chitosan (CS)/silk fibroin (SF) nanofibrous membrane scaffold (NMS) may provide a favorable microenvironment that more closely mimics the natural bone tissue physiology and facilitates enhanced osteogensis of the implanted cell population. In this study, we prepared pristine CS/SF NMS, composite CS/SF/nHAP NMS containing intrafibrillar nHAP by in situ blending of 10% or 30% nHAP before the electrospinning step, and composite CS/SF/nHAP NMS containing extrafibrillar nHAP by depositing 30% nHAP through alternative soaking surface mineralization. We investigated the effect of the incorporation of HAP nanoparticles on the physicochemical properties of pristine and composite NMS. We confirmed the presence of ~30 nm nHAP in the composite nanofibrous membranes by thermogravimetry analysis (TGA), X-ray diffraction (XRD), and scanning electron microscopy (SEM), either embedded in or exposed on the nanofiber. Nonetheless, the alternative soaking surface mineralization method drastically influenced the mechanical properties of the NMS with 88% and 94% drop in Young’s modulus and ultimate maximum stress. Using in vitro cell culture experiments, we investigated the effects of nHAP content and location on proliferation and osteogenic differentiation of human bone marrow mesenchymal stem cells (hMSCs). The proliferation of hMSCs showed no significant difference among pristine and composite NMS. However, the extent of osteogenic differentiation of hMSCs was found to be positively correlated with the content of nHAP in the NMS, while its location within the nanofiber played a less significant role. In vivo experiments were carried out with hMSCs seeded in CS/SF/30%nHAP NMS prepared by in situ blending and subcutaneous implantation in nude mice. Micro-computed tomography images as well as histological and immunohistochemical analysis of the retrieved hMSCs/NMS construct 1 and 2 months postimplantation indicated that NMS had the potential for bone regeneration and can be suggested as a promising scaffold for bone tissue engineering.

Scaffold-based regeneration of skeletal tissues to meet clinical challenges

The management and reconstruction of damaged or diseased skeletal tissues have remained a significant global healthcare challenge. The limited efficacy of conventional treatment strategies for large bone, cartilage and osteochondral defects has inspired the development of scaffold-based tissue engineering solutions, with the aim of achieving complete biological and functional restoration of the affected tissue in the presence of a supporting matrix. Nevertheless, significant regulatory hurdles have rendered the clinical translation of novel scaffold designs to be an inefficient process, mainly due to the difficulties of arriving at a simple, reproducible and effective solution that does not rely on the incorporation of cells and/or bioactive molecules. In the context of the current clinical situation and recent research advances, this review will discuss scaffold-based strategies for the regeneration of skeletal tissues, with focus on the contribution of bioactive ceramic scaffolds and silk fibroin, and combinations thereof, towards the development of clinically viable solutions.