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Bal Z, Kushioka J, Kodama J, Kaito T, Yoshikawa H, Korkusuz P, Korkusuz F. BMP and TGFβ use and release in bone regeneration. Turk J Med Sci 2020; 50:1707-1722. [PMID: 32336073 PMCID: PMC7672355 DOI: 10.3906/sag-2003-127] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/24/2020] [Indexed: 12/17/2022] Open
Abstract
A fracture that does not unite in nine months is defined as nonunion. Nonunion is common in fragmented fractures and large bone defects where vascularization is impaired. The distal third of the tibia, the scaphoid bone or the talus fractures are furthermore prone to nonunion. Open fractures and spinal fusion cases also need special monitoring for healing. Bone tissue regeneration can be attained by autografts, allografts, xenografts and synthetic materials, however their limited availability and the increased surgical time as well as the donor site morbidity of autograft use, and lower probability of success, increased costs and disease transmission and immunological reaction probability of allografts oblige us to find better solutions and new grafts to overcome the cons. A proper biomaterial for regeneration should be osteoinductive, osteoconductive, biocompatible and mechanically suitable. Cytokine therapy, where growth factors are introduced either exogenously or triggered endogenously, is one of the commonly used method in bone tissue engineering. Transforming growth factor β (TGFβ) superfamily, which can be divided structurally into two groups as bone morphogenetic proteins (BMPs), growth differentiation factors (GDFs) and TGFβ, activin, Nodal branch, Mullerian hormone, are known to be produced by osteoblasts and other bone cells and present already in bone matrix abundantly, to take roles in bone homeostasis. BMP family, as the biggest subfamily of TGFβ superfamily, is also reported to be the most effective growth factors in bone and development, which makes them one of the most popular cytokines used in bone regeneration. Complications depending on the excess use of growth factors, and pleiotropic functions of BMPs are however the main reasons of why they should be approached with care. In this review, the Smad dependent signaling pathways of TGFβ and BMP families and their relations and the applications in preclinical and clinical studies will be briefly summarized.
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Affiliation(s)
- Zeynep Bal
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Junichi Kushioka
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Joe Kodama
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Petek Korkusuz
- Department of Histology and Embryology, Medical Faculty, Hacettepe University, Ankara, Turkey
| | - Feza Korkusuz
- Department of Sports Medicine, Medical Faculty, Hacettepe University, Ankara, Turkey
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2
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Park SA, Lee HJ, Kim SY, Kim KS, Jo DW, Park SY. Three-dimensionally printed polycaprolactone/beta-tricalcium phosphate scaffold was more effective as an rhBMP-2 carrier for new bone formation than polycaprolactone alone. J Biomed Mater Res A 2020; 109:840-848. [PMID: 32776655 PMCID: PMC8048475 DOI: 10.1002/jbm.a.37075] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 07/17/2020] [Accepted: 07/26/2020] [Indexed: 01/10/2023]
Abstract
Recombinant human bone morphogenetic protein 2 (rhBMP‐2) has been widely used in bone tissue engineering to enhance bone regeneration because of its osteogenic inductivity. However, clinical outcomes can vary depending on the scaffold materials used to deliver rhBMP‐2. In this study, 3D‐printed scaffolds with a ratio of 1:1 polycaprolactone and beta‐tricalcium phosphate (PCL/T50) were applied as carriers for rhBMP‐2 in mandibular bone defect models in dog models. Before in vivo application, in vitro experiments were conducted. Preosteoblast proliferation was not significantly different between scaffolds made of PCL/T50 and polycaprolactone alone (PCL/T0) regardless of rhBMP‐2 delivery. However, PCL/T50 showed an increased level of the alkaline phosphatase activity and mineralization assay when rhBMP‐2 was delivered. In in vivo, the newly formed bone volume of the PCL/T50 group was significantly increased compared with that of the PCL/T0 scaffolds regardless of rhBMP‐2 delivery. Histological examination showed that PCL/T50 with rhBMP‐2 produced significantly greater amounts of newly bone formation than PCL/T0 with rhBMP‐2. The quantities of scaffold remaining were lower in the PCL/T50 group than in the PCL/T0 group, although it was not significantly different. In conclusion, PCL/T50 scaffolds were advantageous for rhBMP‐2 delivery as well as for maintaining space for bone formation in mandibular bone defects.
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Affiliation(s)
- Su A Park
- Department of Nature-Inspired Nanoconvergence Systems, Nanoconvergence and Manufacturing Systems Research Division, Korea Institute of Machinery and Materials (KIMM), Daejeon, South Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si, South Korea
| | - Sung-Yeol Kim
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si, South Korea
| | - Keun-Suh Kim
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si, South Korea
| | - Deuk-Won Jo
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si, South Korea
| | - Shin-Young Park
- Program in Dental Clinical Education and Dental Research Institute, Seoul National University School of Dentistry, Seoul, South Korea
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Cheng X, Wan Q, Pei X. Graphene Family Materials in Bone Tissue Regeneration: Perspectives and Challenges. NANOSCALE RESEARCH LETTERS 2018; 13:289. [PMID: 30229504 PMCID: PMC6143492 DOI: 10.1186/s11671-018-2694-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 08/28/2018] [Indexed: 02/05/2023]
Abstract
We have witnessed abundant breakthroughs in research on the bio-applications of graphene family materials in current years. Owing to their nanoscale size, large specific surface area, photoluminescence properties, and antibacterial activity, graphene family materials possess huge potential for bone tissue engineering, drug/gene delivery, and biological sensing/imaging applications. In this review, we retrospect recent progress and achievements in graphene research, as well as critically analyze and discuss the bio-safety and feasibility of various biomedical applications of graphene family materials for bone tissue regeneration.
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Affiliation(s)
- Xinting Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Peoples Road, Chengdu, 610041 China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Peoples Road, Chengdu, 610041 China
| | - Qianbing Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Peoples Road, Chengdu, 610041 China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Peoples Road, Chengdu, 610041 China
| | - Xibo Pei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Peoples Road, Chengdu, 610041 China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Peoples Road, Chengdu, 610041 China
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4
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Decambron A, Fournet A, Bensidhoum M, Manassero M, Sailhan F, Petite H, Logeart-Avramoglou D, Viateau V. Low-dose BMP-2 and MSC dual delivery onto coral scaffold for critical-size bone defect regeneration in sheep. J Orthop Res 2017; 35:2637-2645. [PMID: 28401593 DOI: 10.1002/jor.23577] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 04/06/2017] [Indexed: 02/04/2023]
Abstract
Tissue-engineered constructs (TECs) combining resorbable calcium-based scaffolds and mesenchymal stem cells (MSCs) have the capability to regenerate large bone defects. Inconsistent results have, however, been observed, with a lack of osteoinductivity as a possible cause of failure. This study aimed to evaluate the impact of the addition of low-dose bone morphogenetic protein-2 (BMP-2) to MSC-coral-TECs on the healing of clinically relevant segmental bone defects in sheep. Coral granules were either seeded with autologous MSCs (bone marrow-derived) or loaded with BMP-2. A 25-mm-long metatarsal bone defect was created and stabilized with a plate in 18 sheep. Defects were filled with one of the following TECs: (i) BMP (n = 5); (ii) MSC (n = 7); or (iii) MSC-BMP (n = 6). Radiographic follow-up was performed until animal sacrifice at 4 months. Bone formation and scaffold resorption were assessed by micro-CT and histological analysis. Bone union with nearly complete scaffold resorption was observed in 1/5, 2/7, and 3/6 animals, when BMP-, MSC-, and MSC-BMP-TECs were implanted, respectively. The amount of newly formed bone was not statistically different between groups: 1074 mm3 [970-2478 mm3 ], 1155 mm3 [970-2595 mm3 ], and 2343 mm3 [931-3276 mm3 ] for BMP-, MSC-, and MSC-BMP-TECs, respectively. Increased scaffold resorption rate using BMP-TECs was the only potential side effect observed. In conclusion, although the dual delivery of MSCs and BMP-2 onto a coral scaffold further increased bone formation and bone union when compared to single treatment, results were non-significant. Only 50% of the defects healed, demonstrating the need for further refinement of this strategy before clinical use. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2637-2645, 2017.
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Affiliation(s)
- Adeline Decambron
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France.,Ecole Nationale Vétérinaire d'Alfort (Université Paris-Est), 7 avenue du général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - Alexandre Fournet
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France.,Ecole Nationale Vétérinaire d'Alfort (Université Paris-Est), 7 avenue du général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - Morad Bensidhoum
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France
| | - Mathieu Manassero
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France.,Ecole Nationale Vétérinaire d'Alfort (Université Paris-Est), 7 avenue du général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - Frédéric Sailhan
- Hopital Cochin, Service d'orthopédie et chirurgie du rachis, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.,Clinique Arago, 187 Rue Raymond Losserand, 75014, Paris, France
| | - Hervé Petite
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France
| | - Delphine Logeart-Avramoglou
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France
| | - Véronique Viateau
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France.,Ecole Nationale Vétérinaire d'Alfort (Université Paris-Est), 7 avenue du général de Gaulle, 94704, Maisons-Alfort Cedex, France
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Hermenean A, Codreanu A, Herman H, Balta C, Rosu M, Mihali CV, Ivan A, Dinescu S, Ionita M, Costache M. Chitosan-Graphene Oxide 3D scaffolds as Promising Tools for Bone Regeneration in Critical-Size Mouse Calvarial Defects. Sci Rep 2017; 7:16641. [PMID: 29192253 PMCID: PMC5709492 DOI: 10.1038/s41598-017-16599-5] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 11/15/2017] [Indexed: 12/12/2022] Open
Abstract
Limited self-regenerating capacity of human skeleton makes the reconstruction of critical size bone defect a significant challenge for clinical practice. Aimed for regenerating bone tissues, this study was designed to investigate osteogenic differentiation, along with bone repair capacity of 3D chitosan (CHT) scaffolds enriched with graphene oxide (GO) in critical-sized mouse calvarial defect. Histopathological/histomorphometry and scanning electron microscopy(SEM) analysis of the implants revealed larger amount of new bone in the CHT/GO-filled defects compared with CHT alone (p < 0.001). When combined with GO, CHT scaffolds synergistically promoted the increase of alkaline phosphatase activity both in vitro and in vivo experiments. This enhanced osteogenesis was corroborated with increased expression of bone morphogenetic protein (BMP) and Runx-2 up to week 4 post-implantation, which showed that GO facilitates the differentiation of osteoprogenitor cells. Meanwhile, osteogenesis was promoted by GO at the late stage as well, as indicated by the up-regulation of osteopontin and osteocalcin at week 8 and overexpressed at week 18, for both markers. Our data suggest that CHT/GO biomaterial could represent a promising tool for the reconstruction of large bone defects, without using exogenous living cells or growth factors.
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Affiliation(s)
- Anca Hermenean
- Department of Histology, Faculty of Medicine, Vasile Goldis Western University of Arad, 86 Rebreanu, 310414, Arad, Romania.
- Department of Experimental and Applied Biology, Institute of Life Sciences, Vasile Goldis Western University of Arad, 86 Rebreanu, 310414, Arad, Romania.
| | - Ada Codreanu
- Department of Histology, Faculty of Medicine, Vasile Goldis Western University of Arad, 86 Rebreanu, 310414, Arad, Romania
| | - Hildegard Herman
- Department of Experimental and Applied Biology, Institute of Life Sciences, Vasile Goldis Western University of Arad, 86 Rebreanu, 310414, Arad, Romania
| | - Cornel Balta
- Department of Experimental and Applied Biology, Institute of Life Sciences, Vasile Goldis Western University of Arad, 86 Rebreanu, 310414, Arad, Romania
| | - Marcel Rosu
- Department of Experimental and Applied Biology, Institute of Life Sciences, Vasile Goldis Western University of Arad, 86 Rebreanu, 310414, Arad, Romania
| | - Ciprian Valentin Mihali
- Department of Experimental and Applied Biology, Institute of Life Sciences, Vasile Goldis Western University of Arad, 86 Rebreanu, 310414, Arad, Romania
| | - Alexandra Ivan
- Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy, 300041, Timisoara, Romania
| | - Sorina Dinescu
- Department of Biochemistry and Molecular Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095, Bucharest, Romania
| | - Mariana Ionita
- Advanced Polymer Materials Group, University Politehnica of Bucharest, CaleaVictoriei 147, Bucharest, 010737, Romania
| | - Marieta Costache
- Department of Biochemistry and Molecular Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095, Bucharest, Romania
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6
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Chen H, Ji XR, Zhang Q, Tian XZ, Zhang BX, Tang PF. Effects of Calcium Sulfate Combined with Platelet-rich Plasma on Restoration of Long Bone Defect in Rabbits. Chin Med J (Engl) 2017; 129:557-61. [PMID: 26904990 PMCID: PMC4804437 DOI: 10.4103/0366-6999.176981] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The treatment for long bone defects has been a hot topic in the field of regenerative medicine. This study aimed to evaluate the therapeutic effects of calcium sulfate (CS) combined with platelet-rich plasma (PRP) on long bone defect restoration. METHODS A radial bone defect model was constructed through an osteotomy using New Zealand rabbits. The rabbits were randomly divided into four groups (n = 10 in each group): a CS combined with PRP (CS-PRP) group, a CS group, a PRP group, and a positive (recombinant human bone morphogenetic protein-2) control group. PRP was prepared from autologous blood using a two-step centrifugation process. CS-PRP was obtained by mixing hemihydrate CS with PRP. Radiographs and histologic micrographs were generated. The percentage of bone regenerated bone area in each rabbit was calculated at 10 weeks. One-way analysis of variance was performed in this study. RESULTS The radiographs and histologic micrographs showed bone restoration in the CS-PRP and positive control groups, while nonunion was observed in the CS and PRP groups. The percentages of bone regenerated bone area in the CS-PRP (84.60 ± 2.87%) and positive control (52.21 ± 4.53%) groups were significantly greater than those in the CS group (12.34 ± 2.17%) and PRP group (16.52 ± 4.22%) (P < 0.001). In addition, the bone strength of CS-PRP group (43.10 ± 4.10%) was significantly greater than that of the CS group (20.10 ± 3.70%) or PRP group (25.10 ± 2.10%) (P < 0.001). CONCLUSION CS-PRP functions as an effective treatment for long bone defects through stimulating bone regeneration and enhancing new bone strength.
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Affiliation(s)
| | | | | | | | | | - Pei-Fu Tang
- Department of Orthopaedics, Chinese People's Liberation Army General Hospital, Beijing 100038, China
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Santo VE, Ratanavaraporn J, Sato K, Gomes ME, Mano JF, Reis RL, Tabata Y. Cell engineering by the internalization of bioinstructive micelles for enhanced bone regeneration. Nanomedicine (Lond) 2015; 10:1707-21. [DOI: 10.2217/nnm.15.11] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To direct precursor cells toward the osteoblastic lineage, by using an intracellular nanocarrier releasing dexamethasone. Materials & methods: Biodegradable gelatin-based micelles entrapped dexamethasone (dex-micelles). Internalization efficiency and biocompatibility of dex-micelles and their potency for in vitro osteogenic differentiation and in vivo bone regeneration were assessed. Results: Dex-micelles were internalized by rat bone marrow mesenchymal stem cells and demonstrated a pH-responsive release profile and an enhancement of 2D and 3D in vitro osteogenic differentiation. In vivo implantation of gelatin scaffolds seeded with rat bone marrow mesenchymal stem cells precultured for 24 h with dex-micelles promoted a significant enhancement of de novo bone formation in a rat ulna defect, in a dose-dependent manner. Conclusion: The proposed intracellular delivery system is a powerful tool to promote bone regeneration.
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Affiliation(s)
- Vítor E Santo
- Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Sakyo Ku, Kyoto 6068507, Japan
- 3B's Research Group – Biomaterials, Biodegradables & Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering & Regenerative Medicine, AvePark, 4806–909 Taipas, Guimarães, Portugal
- ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Juthamas Ratanavaraporn
- Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Sakyo Ku, Kyoto 6068507, Japan
| | - Keisuke Sato
- Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Sakyo Ku, Kyoto 6068507, Japan
| | - Manuela E Gomes
- 3B's Research Group – Biomaterials, Biodegradables & Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering & Regenerative Medicine, AvePark, 4806–909 Taipas, Guimarães, Portugal
- ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - João F Mano
- 3B's Research Group – Biomaterials, Biodegradables & Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering & Regenerative Medicine, AvePark, 4806–909 Taipas, Guimarães, Portugal
- ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rui L Reis
- 3B's Research Group – Biomaterials, Biodegradables & Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering & Regenerative Medicine, AvePark, 4806–909 Taipas, Guimarães, Portugal
- ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Yasuhiko Tabata
- Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Sakyo Ku, Kyoto 6068507, Japan
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Hoshi S, Akizuki T, Matsuura T, Ikawa T, Kinoshita A, Oda S, Tabata Y, Matsui M, Izumi Y. Ridge augmentation using recombinant human fibroblast growth factor-2 with biodegradable gelatin sponges incorporating β-tricalcium phosphate: a preclinical study in dogs. J Periodontal Res 2015; 51:77-85. [PMID: 26031712 DOI: 10.1111/jre.12285] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Fibroblast growth factor-2 (FGF-2) regulates the proliferation and differentiation of osteogenic cells, resulting in the promotion of bone formation. Biodegradable gelatin sponges incorporating β-tricalcium phosphate (β-TCP) have been reported as a scaffold, which has the ability to control growth factor release, offering sufficient mechanical strength and efficient migration of mesenchymal cells. In this study, we evaluated the effects of the combined use of recombinant human FGF-2 (rhFGF-2) and gelatin/β-TCP sponge on ridge augmentation in dogs. MATERIAL AND METHODS Six male beagle dogs were used in this study. Twelve wk after tooth extraction, bilateral 10 × 5 mm (width × depth) saddle-type defects were created 3 mm apart from the mesial side of the maxillary canine. At the experimental sites, the defects were filled with gelatin/β-TCP sponge infiltrated with 0.3% rhFGF-2, whereas gelatin/β-TCP sponge infiltrated with saline was applied to the control sites. Eight wk after surgery, qualitative and quantitative analyses were performed. RESULTS There were no signs of clinical inflammation at 8 wk after surgery. Histometric measurements revealed that new bone height at the experimental sites (2.98 ± 0.65 mm) was significantly greater than that at the control sites (1.56 ± 0.66 mm; p = 0.004). The total tissue height was greater at the experimental sites (6.62 ± 0.66 mm) than that at the control sites (5.95 ± 0.74 mm), although there was no statistical significant difference (p = 0.051). Cast model measurements revealed that the residual defect height at the experimental sites (2.31 ± 0.50 mm) was significantly smaller than that at the control sites (3.51 ± 0.78 mm; p = 0.012). CONCLUSION The combined use of rhFGF-2 and gelatin/β-TCP sponge promotes ridge augmentation in canine saddle-type bone defects.
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Affiliation(s)
- S Hoshi
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - T Akizuki
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.,Division of Periodontology, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Kanagawa, Japan
| | - T Matsuura
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - T Ikawa
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - A Kinoshita
- Department of Educational Media Development, Institute for Library and Media Information Technology, Tokyo Medical and Dental University, Tokyo, Japan
| | - S Oda
- Oral Diagnosis and General Dentistry, University Hospital of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Y Tabata
- Department of Biomaterials, Kyoto University, Kyoto, Japan
| | - M Matsui
- Department of Biomaterials, Kyoto University, Kyoto, Japan
| | - Y Izumi
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
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Effect of Biodegradable Gelatin β-Tri Calcium Phosphate Sponges Containing Mesenchymal Stem Cells and Bone Morphogenetic Protein-2 on Equine Bone Defect. J Equine Vet Sci 2014. [DOI: 10.1016/j.jevs.2014.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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10
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Rustamov IR, Dyatlov VA, Grebeneva TA, Dyatlov AV, Zaitsev VV, Maleev VI. Polycyanoacrylate porous material for bone tissue substitution. J Mater Chem B 2014; 2:4310-4317. [PMID: 32261569 DOI: 10.1039/c4tb00554f] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A proof of concept study has been conducted for the design of a porous biodegradable material containing nanocapsules and two actives with independent release-bimodal drug-eluting implants. Completely safe synthetic material free from risk of prion and virus contamination was tested in vivo, and a method for controlling the rate of biodegradation of poly-2-cyanoacrylic polymer was developed. Novel perfluorinated 2-cyanoacrylic esters have been applied for the chemical modification of polyethyl-2-cyanoacrlylate copolymers. Internal imide-cycle formation has been used to retard the rate of enzymatic hydrolysis of the 2-cyanoacrylic copolymer main chain.
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Affiliation(s)
- I R Rustamov
- D. Mendeleev University of Chemical Technology of Russia, Russia
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11
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Huang CL, Lee WL, Loo JS. Drug-eluting scaffolds for bone and cartilage regeneration. Drug Discov Today 2014; 19:714-24. [DOI: 10.1016/j.drudis.2013.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 10/16/2013] [Accepted: 11/06/2013] [Indexed: 12/19/2022]
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12
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Horch RE, Beier JP, Kneser U, Arkudas A. Successful human long-term application of in situ bone tissue engineering. J Cell Mol Med 2014; 18:1478-85. [PMID: 24801710 PMCID: PMC4124030 DOI: 10.1111/jcmm.12296] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 03/12/2014] [Indexed: 12/21/2022] Open
Abstract
Tissue Engineering (TE) and Regenerative Medicine (RM) have gained much popularity because of the tremendous prospects for the care of patients with tissue and organ defects. To overcome the common problem of donor-site morbidity of standard autologous bone grafts, we successfully combined tissue engineering techniques for the first time with the arteriovenous loop model to generate vascularized large bone grafts. We present two cases of large bone defects after debridement of an osteomyelitis. One of the defects was localized in the radius and one in the tibia. For osseus reconstruction, arteriovenous loops were created as vascular axis, which were placed in the bony defects. In case 1, the bone generation was achieved using cancellous bone from the iliac crest and fibrin glue and in case 2 using a clinically approved β-tricalciumphosphate/hydroxyapatite (HA), fibrin glue and directly auto-transplanted bone marrow aspirate from the iliac crest. The following post-operative courses were uneventful. The final examinations took place after 36 and 72 months after the initial operations. Computer tomogrphy (CT), membrane resonance imaging (MRI) and doppler ultrasound revealed patent arterio-venous (AV) loops in the bone grafts as well as completely healed bone defects. The patients were pain-free with normal ranges of motion. This is the first study demonstrating successfully axially vascularized in situ tissue engineered bone generation in large bone defects in a clinical scenario using the arteriovenous loop model without creation of a significant donor-site defect utilizing TE and RM techniques in human patients with long-term stability.
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Affiliation(s)
- Raymund E Horch
- Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg, Erlangen, Germany
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Osteoinductivity of gelatin/β-tricalcium phosphate sponges loaded with different concentrations of mesenchymal stem cells and bone morphogenetic protein-2 in an equine bone defect model. Vet Res Commun 2014; 38:73-80. [DOI: 10.1007/s11259-013-9587-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2013] [Indexed: 10/25/2022]
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Zhang Q, Tan K, Zhang Y, Ye Z, Tan WS, Lang M. In situ controlled release of rhBMP-2 in gelatin-coated 3D porous poly(ε-caprolactone) scaffolds for homogeneous bone tissue formation. Biomacromolecules 2013; 15:84-94. [PMID: 24266740 DOI: 10.1021/bm401309u] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In tissue engineering, incorporation of bone morphogenetic protein-2 (BMP-2) into biomaterial scaffolds is an attractive strategy to stimulate bone repair. However, suboptimal release of BMP-2 remains a great concern, which may cause unfavorable bone formation as well as severe inflammation. In this study, genipin-cross-linked gelatin entrapped with recombinant human BMP-2 (rhBMP-2) was exploited to decorate the interior surface of three-dimensional porous poly(ε-caprolactone) (PCL) scaffolds. With gelatin-coating, PCL scaffolds demonstrated enhanced water uptake and improved compressive moduli. Intriguingly, a unique release profile of rhBMP-2 composed of a transient burst release followed by a sustained release was achieved in coated scaffolds. These coated scaffolds well supported growth and osteogenesis of human mesenchymal stem cells (hMSCs) in vitro, indicating the retaining of rhBMP-2 bioactivity. When hMSCs-seeded scaffolds were implanted subcutaneously in nude mice for 4 weeks, better bone formation was observed in gelatin/rhBMP-2-coated scaffolds. Specifically, the spatial distribution of newly formed bone was more uniform in gelatin-coated scaffolds than in uncoated scaffolds, which displayed preferential bone formation at the periphery. These results collectively demonstrated that gelatin-coating of porous PCL scaffolds is a promising approach for delivering rhBMP-2 to stimulate improved bone regeneration.
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Affiliation(s)
- Qingchun Zhang
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering and ‡State Key Laboratory of Bioreactor Engineering, School of Bioengineering, East China University of Science and Technology , Shanghai 200237, China
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15
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Jung SY, Ko YJ, Jang HS, Kang SW, Park JH. The effect of carrier for BMP-2 delivery on histological aspects of tissue-engineered bone. Tissue Eng Regen Med 2013. [DOI: 10.1007/s13770-013-1102-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Effects of bilayer gelatin/β-tricalcium phosphate sponges loaded with mesenchymal stem cells, chondrocytes, bone morphogenetic protein-2, and platelet rich plasma on osteochondral defects of the talus in horses. Res Vet Sci 2013; 95:1210-6. [PMID: 24054973 DOI: 10.1016/j.rvsc.2013.08.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 07/22/2013] [Accepted: 08/24/2013] [Indexed: 12/17/2022]
Abstract
Osteochondrosis (OC) is a common and clinically important joint disorder in horses. However, repair of the OC region is difficult because of the avascular nature of cartilage. This study aimed to evaluate the efficacy of bilayer gelatin/β-tricalcium phosphate (GT) sponges loaded with mesenchymal stem cells (MSCs), chondrocytes, bone morphogenetic protein-2 (BMP-2), and platelet rich plasma (PRP) for the repair of osteochondral defects of the talus in horses. Full-thickness osteochondral defects were created on both the lateral trochlear ridges of the talus (n = 6). In the test group, a basic GT sponge loaded with MSCs and BMP-2 (MSC/BMP2/GT) was inserted into the lower part of the defect, and an acidic GT sponge loaded with chondrocyte, MSCs, and PRP (Ch/MSC/PRP/GT) was inserted into the upper part of the defect. In the control group, the defect was treated only with bilayer GT sponges. Repair of osteochondral defects was assessed by radiography, quantitative computed tomography (QCT), and macroscopic and histological evaluation. The test group showed significantly higher radiographic, QCT, macroscopic, and histological scores than the control group. This study demonstrated that the bilayer scaffolds consisting of Ch/MSC/PRP/GT for the chondrogenic layer and MSC/BMP2/GT for the osteogenic layer promoted osteochondral regeneration in an equine model. The bilayer scaffolds described here may be useful for treating horses with OC.
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Rodríguez-Évora M, Delgado A, Reyes R, Hernández-Daranas A, Soriano I, San Román J, Evora C. Osteogenic effect of local, long versus short term BMP-2 delivery from a novel SPU-PLGA-βTCP concentric system in a critical size defect in rats. Eur J Pharm Sci 2013; 49:873-84. [PMID: 23797057 DOI: 10.1016/j.ejps.2013.06.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 06/04/2013] [Accepted: 06/06/2013] [Indexed: 10/26/2022]
Abstract
A concentric delivery system, composed of the three biomaterials SPU, PLGA, and βTCP (segmented polyurethane, poly[lactic-co-glycolic acid], and β-tricalcium phosphate) was fabricated as an external, porous ring of βTCP with a pasty core of a new SPU, mixed with PLGA microspheres. The regenerative effects of two distinct doses of either immediately available or continuously released rhBMP-2 were evaluated in an 8mm, critical calvaria defect in rats. Protein dose and release kinetics affected material resorption rates and the progression of the regeneration process. Groups treated with the empty system alone or in conjunction with free rhBMP-2 did not respond. By contrast, after 12 weeks, approximately 20% and 60% of the defects implanted with systems loaded with 1.6 μg and 6.5 μg rhBMP-2, respectively were healed, with all the growth factor being released in the course of 6 weeks. The NMR, FTIR, GPC, DSC, and histological analyses showed that PLGA microsphere degradation occurred independently of the regenerative process. However, the resorption rate of the SPU and βTCP did depend on the regeneration process, which was governed by dose and release rate of rhBMP-2. Furthermore, the biocompatibility and high capacity of adaptation to the defect convert the herein proposed, new SPU polymer into a potential material for applications in tissue engineering and regenerative medicine.
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Affiliation(s)
- M Rodríguez-Évora
- Department of Chemical Engineering and Pharmaceutical Technology, University of La Laguna, 38200 La Laguna, Spain
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Waselau M, Patrikoski M, Juntunen M, Kujala K, Kääriäinen M, Kuokkanen H, Sándor GK, Vapaavuori O, Suuronen R, Mannerström B, von Rechenberg B, Miettinen S. Effects of bioactive glass S53P4 or beta-tricalcium phosphate and bone morphogenetic protein-2 and bone morphogenetic protein-7 on osteogenic differentiation of human adipose stem cells. J Tissue Eng 2012; 3:2041731412467789. [PMID: 23316275 PMCID: PMC3540822 DOI: 10.1177/2041731412467789] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The effects of bioactive glass S53P4 or beta-tricalcium phosphate; and bone morphogenetic proteins bone morphogenetic protein-2, bone morphogenetic protein-7, or bone morphogenetic protein-2 + 7 on osteogenic differentiation of human adipose stem cells were compared in control medium, osteogenic medium, and bone morphogenetic protein-supplemented osteogenic medium to assess suitability for bone tissue engineering. Cell amount was evaluated with qDNA measurements; osteogenic differentiation using marker gene expression, alkaline phosphate activity, and angiogenic potential was measured by vascular endothelial growth factor expression. As compared to beta-tricalcium phosphate, cell amount was significantly greater for bioactive glass in control medium after 7 days and in osteogenic medium after 14 days, and alkaline phosphate activity was always significantly greater for bioactive glass in control medium. However, alkaline phosphate activity increased for beta-tricalcium phosphate and decreased for bioactive glass granules in osteogenic medium. For both biomaterials, bone morphogenetic protein supplementation decreased cell amount and osteogenic differentiation of human adipose stem cells, and vascular endothelial growth factor expressions correlated with cell amounts. Effects of culture medium on human adipose stem cells are biomaterial dependent; bioactive glass in control medium enhanced osteogenic differentiation most effectively.
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Affiliation(s)
- Martin Waselau
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland ; Adult Stem Cell Group, Institute of Biomedical Technology, University of Tampere, Tampere, Finland
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Ulrich D, Edwards SL, White JF, Supit T, Ramshaw JAM, Lo C, Rosamilia A, Werkmeister JA, Gargett CE. A preclinical evaluation of alternative synthetic biomaterials for fascial defect repair using a rat abdominal hernia model. PLoS One 2012. [PMID: 23185528 PMCID: PMC3502256 DOI: 10.1371/journal.pone.0050044] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Fascial defects are a common problem in the abdominal wall and in the vagina leading to hernia or pelvic organ prolapse that requires mesh enhancement to reduce operation failure. However, the long-term outcome of synthetic mesh surgery may be unsatisfactory due to post-surgical complications. We hypothesized that mesh fabricated from alternative synthetic polymers may evoke a different tissue response, and provide more appropriate mechanical properties for hernia repair. Our aim was to compare the in vivo biocompatibility of new synthetic meshes with a commercial mesh. METHODS We have fabricated 3 new warp-knitted synthetic meshes from different polymers with different tensile properties polyetheretherketone (PEEK), polyamide (PA) and a composite, gelatin coated PA (PA+G). The rat abdominal hernia model was used to implant the meshes (25 × 35 mm, n = 24/ group). After 7, 30, 60, 90 days tissues were explanted for immunohistochemical assessment of foreign body reaction and tissue integration, using CD31, CD45, CD68, alpha-SMA antibodies. The images were analysed using an image analysis software program. Biomechanical properties were uniaxially evaluated using an Instron Tensile® Tester. RESULTS This study showed that the new meshes induced complex differences in the type of foreign body reaction over the time course of implantation. The PA, and particularly the composite PA+G meshes, evoked a milder early inflammatory response, and macrophages were apparent throughout the time course. Our meshes led to better tissue integration and new collagen deposition, particularly with the PA+G meshes, as well as greater and sustained neovascularisation compared with the PP meshes. CONCLUSION PA, PA+G and PEEK appear to be well tolerated and are biocompatible, evoking an overlapping and different host tissue response with time that might convey mechanical variations in the healing tissue. These new meshes comprising different polymers may provide an alternative option for future treatment of fascial defects.
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Affiliation(s)
- Daniela Ulrich
- Monash Institute of Medical Research, Clayton, Victoria, Australia
- Medical University Graz, Graz, Austria
- Department of Obstetrics and Gynaecology and Monash Micro Imaging, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
| | - Sharon L. Edwards
- CSIRO Materials Science and Engineering, Clayton, Victoria, Australia
| | - Jacinta F. White
- CSIRO Materials Science and Engineering, Clayton, Victoria, Australia
| | - Tommy Supit
- Monash Institute of Medical Research, Clayton, Victoria, Australia
| | | | - Camden Lo
- Monash Institute of Medical Research, Clayton, Victoria, Australia
| | - Anna Rosamilia
- Department of Obstetrics and Gynaecology and Monash Micro Imaging, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
| | | | - Caroline E. Gargett
- Monash Institute of Medical Research, Clayton, Victoria, Australia
- Department of Obstetrics and Gynaecology and Monash Micro Imaging, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
- * E-mail:
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Xishan Z, Baoxin H, Xinna Z, Jun R. Comparison of the effects of human adipose and bone marrow mesenchymal stem cells on T lymphocytes. Cell Biol Int 2012; 37:11-8. [PMID: 23319317 DOI: 10.1002/cbin.10002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 09/05/2012] [Indexed: 12/29/2022]
Abstract
Mesenchymal stem cells (MSCs) are multipotent cells that can be derived either from the bone marrow (bMSCs) or adipose tissue (aMSCs). We have compared the immune regulatory properties of cells derived from bone marrow and adipose tissue to provide a theoretical basis for the choice of stem cell source for transplantation. The phenotypes of bMSCs and aMSCs are similar, differing only in the expression of CD106. aMSCs proliferate faster than bMSCs, but aMSCs suppressed T-lymphocyte proliferation and activation more poorly than bMSCs. Thus cell origin and abundance are important factors in determining the suitability of MSCs for transplantation. Adipose tissue offers a more promising source of cells for such an application.
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Affiliation(s)
- Zhu Xishan
- Institute of Medical Oncology, Beijing Shijitan Hospital, Capitial Medical University, Beijing 100038, PR China
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Yonenaga K, Nishizawa S, Fujihara Y, Asawa Y, Kanazawa S, Nagata S, Takato T, Hoshi K. Application of floating cells for improved harvest in human chondrocyte culture. Biomed Res 2012; 33:281-9. [PMID: 23124248 DOI: 10.2220/biomedres.33.281] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cell culture medium, which must be discarded during medium change, may contain many cells that do not attach to culture plates. In the present study, we focused on these floating cells and attempted to determine their usefulness for cartilage regeneration. We counted the number of floating cells discarded during medium change and compared the proliferation and differentiation between floating cells and their adherent counterparts. Chondrocyte monolayer culture at a density of 5 × 103 cells/cm(2) produced viable floating cells at a rate of 2.7-3.2 × 10(3) cells/cm(2) per primary culture. When only the floating cells from one dish were harvested and replated in another dish, the number of cells was 2.8 × 10(4) cells/cm(2) (approximately half confluency) on culture day 7. The number of cells was half of that obtained by culturing only adherent cells (5 × 10(4) cells/cm(2)). The floating and adherent cells showed similar proliferation and differentiation properties. The recovery of floating cells from the culture medium could provide an approximately 1.5-fold increase in cell number over conventional monolayer culture. Thus, the collection of floating cells may be regarded as a simple, easy, and reliable method to increase the cell harvest for chondrocytes.
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Affiliation(s)
- Kazumichi Yonenaga
- Department of 1 Cartilage & Bone Regeneration (Fujisoft), The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
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Renth AN, Detamore MS. Leveraging "raw materials" as building blocks and bioactive signals in regenerative medicine. TISSUE ENGINEERING. PART B, REVIEWS 2012; 18:341-62. [PMID: 22462759 PMCID: PMC3458620 DOI: 10.1089/ten.teb.2012.0080] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 03/28/2012] [Indexed: 01/15/2023]
Abstract
Components found within the extracellular matrix (ECM) have emerged as an essential subset of biomaterials for tissue engineering scaffolds. Collagen, glycosaminoglycans, bioceramics, and ECM-based matrices are the main categories of "raw materials" used in a wide variety of tissue engineering strategies. The advantages of raw materials include their inherent ability to create a microenvironment that contains physical, chemical, and mechanical cues similar to native tissue, which prove unmatched by synthetic biomaterials alone. Moreover, these raw materials provide a head start in the regeneration of tissues by providing building blocks to be bioresorbed and incorporated into the tissue as opposed to being biodegraded into waste products and removed. This article reviews the strategies and applications of employing raw materials as components of tissue engineering constructs. Utilizing raw materials holds the potential to provide both a scaffold and a signal, perhaps even without the addition of exogenous growth factors or cytokines. Raw materials contain endogenous proteins that may also help to improve the translational success of tissue engineering solutions to progress from laboratory bench to clinical therapies. Traditionally, the tissue engineering triad has included cells, signals, and materials. Whether raw materials represent their own new paradigm or are categorized as a bridge between signals and materials, it is clear that they have emerged as a leading strategy in regenerative medicine. The common use of raw materials in commercial products as well as their growing presence in the research community speak to their potential. However, there has heretofore not been a coordinated or organized effort to classify these approaches, and as such we recommend that the use of raw materials be introduced into the collective consciousness of our field as a recognized classification of regenerative medicine strategies.
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Affiliation(s)
- Amanda N. Renth
- Bioengineering Program, University of Kansas, Lawrence, Kansas
| | - Michael S. Detamore
- Bioengineering Program, University of Kansas, Lawrence, Kansas
- Department of Chemical and Petroleum Engineering, University of Kansas, Lawrence, Kansas
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