1
|
Pivonka P, Calvo-Gallego JL, Schmidt S, Martínez-Reina J. Advances in mechanobiological pharmacokinetic-pharmacodynamic models of osteoporosis treatment - Pathways to optimise and exploit existing therapies. Bone 2024; 186:117140. [PMID: 38838799 DOI: 10.1016/j.bone.2024.117140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/17/2024] [Accepted: 05/29/2024] [Indexed: 06/07/2024]
Abstract
Osteoporosis (OP) is a chronic progressive bone disease which is characterized by reduction of bone matrix volume and changes in the bone matrix properties which can ultimately lead to bone fracture. The two major forms of OP are related to aging and/or menopause. With the worldwide increase of the elderly population, particularly age-related OP poses a serious health issue which puts large pressure on health care systems. A major challenge for development of new drug treatments for OP and comparison of drug efficacy with existing treatments is due to current regulatory requirements which demand testing of drugs based on bone mineral density (BMD) in phase 2 trials and fracture risk in phase 3 trials. This requires large clinical trials to be conducted and to be run for long time periods, which is very costly. This, together with the fact that there are already many drugs available for treatment of OP, makes the development of new drugs inhibitive. Furthermore, an increased trend of the use of different sequential drug therapies has been observed in OP management, such as sequential anabolic-anticatabolic drug treatment or switching from one anticatabolic drug to another. Running clinical trials for concurrent and sequential therapies is neither feasible nor practical due to large number of combinatorial possibilities. In silico mechanobiological pharmacokinetic-pharmacodynamic (PK-PD) models of OP treatments allow predictions beyond BMD, i.e. bone microdamage and degree of mineralisation can also be monitored. This will help to inform clinical drug usage and development by identifying the most promising scenarios to be tested clinically (confirmatory trials rather than exploratory only trials), optimise trial design and identify subgroups of the population that show benefit-risk profiles (both good and bad) that are different from the average patient. In this review, we provide examples of the predictive capabilities of mechanobiological PK-PD models. These include simulation results of PMO treatment with denosumab, implications of denosumab drug holidays and coupling of bone remodelling models with calcium and phosphate systems models that allows to investigate the effects of co-morbidities such as hyperparathyroidism and chronic kidney disease together with calcium and vitamin D status on drug efficacy.
Collapse
Affiliation(s)
- Peter Pivonka
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, QLD 4000, Australia.
| | - José Luis Calvo-Gallego
- Departmento de Ingeniería Mecánica y Fabricación, Universidad de Sevilla, Seville 41092, Spain
| | - Stephan Schmidt
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL 32827, USA
| | - Javier Martínez-Reina
- Departmento de Ingeniería Mecánica y Fabricación, Universidad de Sevilla, Seville 41092, Spain
| |
Collapse
|
2
|
Al-Qudsy L, Hu YW, Xu H, Yang PF. Mineralized Collagen Fibrils: An Essential Component in Determining the Mechanical Behavior of Cortical Bone. ACS Biomater Sci Eng 2023; 9:2203-2219. [PMID: 37075172 DOI: 10.1021/acsbiomaterials.2c01377] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Bone comprises mechanically different materials in a specific hierarchical structure. Mineralized collagen fibrils (MCFs), represented by tropocollagen molecules and hydroxyapatite nanocrystals, are the fundamental unit of bone. The mechanical characterization of MCFs provides the unique adaptive mechanical competence to bone to withstand mechanical load. The structural and mechanical role of MCFs is critical in the deformation mechanisms of bone and the marvelous strength and toughness possessed by bone. However, the role of MCFs in the mechanical behavior of bone across multiple length scales is not fully understood. In the present study, we shed light upon the latest progress regarding bone deformation at multiple hierarchical levels and emphasize the role of MCFs during bone deformation. We propose the concept of hierarchical deformation of bone to describe the interconnected deformation process across multiple length scales of bone under mechanical loading. Furthermore, how the deterioration of bone caused by aging and diseases impairs the hierarchical deformation process of the cortical bone is discussed. The present work expects to provide insights on the characterization of MCFs in the mechanical properties of bone and lays the framework for the understanding of the multiscale deformation mechanics of bone.
Collapse
Affiliation(s)
- Luban Al-Qudsy
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
- Department of Medical Instrumentation Engineering Techniques, Electrical Engineering Technical College, Middle Technical University, 8998+QHJ Baghdad, Iraq
| | - Yi-Wei Hu
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Huiyun Xu
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Peng-Fei Yang
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| |
Collapse
|
3
|
Ilan Y. Order Through Disorder: The Characteristic Variability of Systems. Front Cell Dev Biol 2020; 8:186. [PMID: 32266266 PMCID: PMC7098948 DOI: 10.3389/fcell.2020.00186] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 03/05/2020] [Indexed: 12/17/2022] Open
Abstract
Randomness characterizes many processes in nature, and therefore its importance cannot be overstated. In the present study, we investigate examples of randomness found in various fields, to underlie its fundamental processes. The fields we address include physics, chemistry, biology (biological systems from genes to whole organs), medicine, and environmental science. Through the chosen examples, we explore the seemingly paradoxical nature of life and demonstrate that randomness is preferred under specific conditions. Furthermore, under certain conditions, promoting or making use of variability-associated parameters may be necessary for improving the function of processes and systems.
Collapse
Affiliation(s)
- Yaron Ilan
- Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| |
Collapse
|
4
|
Yang T, Xie P, Wu Z, Liao Y, Chen W, Hao Z, Wang Y, Zhu Z, Teng W. The Injectable Woven Bone-Like Hydrogel to Perform Alveolar Ridge Preservation With Adapted Remodeling Performance After Tooth Extraction. Front Bioeng Biotechnol 2020; 8:119. [PMID: 32154241 PMCID: PMC7047753 DOI: 10.3389/fbioe.2020.00119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 02/06/2020] [Indexed: 02/05/2023] Open
Abstract
Grafting bone substitute is paramount to prevent the alveolar ridge resorption after tooth extraction and facilitate the subsequent implant treatment. An ideal bone substitute should acquire the excellent osteogenic property, more importantly, possess the suitable remodeling rate in balance with bone formation and desirable clinical manageability. However, none of bone substitute is simultaneously characterized by these features, and currently, the limited remodeling property leads to the excessive waiting time before implantation. Enlightened by woven bone, the transitional tissue that is able to induce osteogenesis during bone healing could be easily remodeled within a short period and depend on the favorable injectability of hydrogel, an injectable woven bone-like hydrogel (IWBLH) was constructed in this study to address the above problems. To mimic the component and hierarchical structure of woven bone, amorphous calcium phosphate (ACP) and mineralized collagen fibril were synthesized and compounded with alginate to form IWBLHs with various ratio. Screened by physiochemical characterization and in vitro biological assays, an optimal IWBLH was selected and further explored in rat model of tooth extraction. Compared with the most widely used bone substitute, we showed that IWBLH could be easily handled to fully fill the tooth socket, perform a comparable function to prevent the alveolar bone resorption, and completely remodeled within 4 weeks. This IWBLH stands as a promising candidate for alveolar ridge preservation (ARP) in future.
Collapse
Affiliation(s)
- Tao Yang
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Peng Xie
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhenzhen Wu
- Department of Periodontology and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Yunmao Liao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenchuan Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhichao Hao
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yushu Wang
- Department of Biomedical Engineering, Tufts University, Medford, MA, United States
| | - Zhimin Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Teng
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
5
|
Bartold M, Gronthos S, Haynes D, Ivanovski S. Mesenchymal stem cells and biologic factors leading to bone formation. J Clin Periodontol 2019; 46 Suppl 21:12-32. [PMID: 30624807 DOI: 10.1111/jcpe.13053] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/23/2018] [Accepted: 10/26/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Physiological bone formation and bone regeneration occurring during bone repair can be considered distinct but similar processes. Mesenchymal stem cells (MSC) and associated biologic factors are crucial to both bone formation and bone regeneration. AIM To perform a narrative review of the current literature regarding the role of MSC and biologic factors in bone formation with the aim of discussing the clinical relevance of in vitro and in vivo animal studies. METHODS The literature was searched for studies on MSC and biologic factors associated with the formation of bone in the mandible and maxilla. The search specifically targeted studies on key aspects of how stem cells and biologic factors are important in bone formation and how this might be relevant to bone regeneration. The results are summarized in a narrative review format. RESULTS Different types of MSC and many biologic factors are associated with bone formation in the maxilla and mandible. CONCLUSION Bone formation and regeneration involve very complex and highly regulated cellular and molecular processes. By studying these processes, new clinical opportunities will arise for therapeutic bone regenerative treatments.
Collapse
Affiliation(s)
- Mark Bartold
- School of Dentistry, University of Adelaide, Adelaide, SA, Australia
| | - Stan Gronthos
- Mesenchymal Stem Cell Laboratory, Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - David Haynes
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Saso Ivanovski
- School of Dentistry, University of Queensland, Brisbane, Qld, Australia
| |
Collapse
|
6
|
Speed A, Groetsch A, Schwiedrzik JJ, Wolfram U. Extrafibrillar matrix yield stress and failure envelopes for mineralised collagen fibril arrays. J Mech Behav Biomed Mater 2019; 105:103563. [PMID: 32279843 DOI: 10.1016/j.jmbbm.2019.103563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/20/2019] [Accepted: 11/26/2019] [Indexed: 11/16/2022]
Abstract
Bone metabolic diseases such as osteoporosis constitute a major socio-economic challenge. A detailed understanding of the structure-property relationships of bone's underlying hierarchical levels has the potential to improve diagnosis and the ability to treat those diseases, especially with regards to the onset of failure. Therefore, elastic and yield properties of mineralised turkey leg tendon (MTLT), a mineralised tissue that is similar to bone but has a simpler multiscale structure, were investigated. Elastic properties were identified using a multiscale micromechanical model. The input parameters include constituent mechanical properties, volume fractions and inclusion aspect ratios and these were obtained from a wide variety of literature sources. The determined elastic properties were used to formulate micromechanically informed yield surfaces and to identify yield properties of MTLT at the nanometre length scale where failure is first reported to occur. This was done in conjunction with experimental results from the compression of micropillars extracted from individual mineralised collagen fibres. This data was then used to identify micromechanically informed failure envelopes. The shear yield stress of the extrafibrillar matrix, associated with interfibrillar sliding, was identified as 137.65 MPa. The ratio between tensile and compressive yield stress in the Drucker-Prager yield criterion was 0.65. For both criteria apparent yield stress of the mineralised collagen fibril decreased to 25.3-31.4% when varying fibril orientation from 0° to 90°. This study identified yield properties of extrafibrillar matrix using an aligned mineralised tissue. The ability to obtain yield stress data and unloading stiffness from micropillar compression tests of MTLT at the level of the mineralised collagen fibril array and downscaling these into the EM mitigates against possible errors associated with macroscopic stiffness predictions and proved to be an invaluable advantage compared to similar modelling approaches. Results may help to improve computational models that may then be used in pre-clinical testing or development of personalised treatment strategies.
Collapse
Affiliation(s)
- Allan Speed
- School of Engineering and Physical Sciences, Institute of Mechanical, Process and Energy Engineering, Heriot-Watt University, United Kingdom
| | - Alexander Groetsch
- School of Engineering and Physical Sciences, Institute of Mechanical, Process and Energy Engineering, Heriot-Watt University, United Kingdom
| | - J Jakob Schwiedrzik
- Laboratory for Mechanics of Materials and Nanostructures, Empa Swiss Federal Laboratories for Material Science and Technology, Thun, Switzerland
| | - Uwe Wolfram
- School of Engineering and Physical Sciences, Institute of Mechanical, Process and Energy Engineering, Heriot-Watt University, United Kingdom.
| |
Collapse
|
7
|
Martínez-Reina J, García-Rodríguez J, Mora-Macías J, Domínguez J, Reina-Romo E. Comparison of the volumetric composition of lamellar bone and the woven bone of calluses. Proc Inst Mech Eng H 2018; 232:682-689. [PMID: 29962326 DOI: 10.1177/0954411918784085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Woven tissue is mainly present in the bone callus, formed very rapidly either after a fracture or in distraction processes. This high formation speed is probably responsible for its disorganized microstructure and this, in turn, for its low stiffness. Nonetheless, the singular volumetric composition of this tissue may also play a key role in its mechanical properties. The volumetric composition of woven tissue extracted from the bone transport callus of sheep was investigated and compared with that of the lamellar tissue extracted from the cortical shell of the same bone. Significant differences were found in the mineral and water contents, but they can be due to the different ages of both tissues, which affects the mineral/water ratio. However, the content in organic phase remains more or less constant throughout the mineralization process and has proven to be a good variable to measure the different composition of both tissues, being that content significantly higher in woven tissue. This may be linked to the abnormally high concentration of osteocytes in this tissue, which is likely a consequence of the more abundant presence of osteoblasts secreting osteoid and burying other osteoblasts, which then differentiate into osteocytes. This would explain the high formation rate of woven tissue, useful to recover the short-term stability of the bone. Nonetheless, the more abundant presence of organic phase prevents the woven tissue from reaching a stiffness similar to that of lamellar tissue in the long term, when it is fully mineralized.
Collapse
Affiliation(s)
- Javier Martínez-Reina
- 1 Departamento de Ingeniería Mecánica y Fabricación, Escuela Técnica Superior de Ingeniería, Universidad de Sevilla, Seville, Spain
| | - Javier García-Rodríguez
- 1 Departamento de Ingeniería Mecánica y Fabricación, Escuela Técnica Superior de Ingeniería, Universidad de Sevilla, Seville, Spain
| | - Juan Mora-Macías
- 2 Departamento de Ingeniería Minera, Mecánica, Energética y de la Construcción, Universidad de Huelva, Huelva, Spain
| | - Jaime Domínguez
- 1 Departamento de Ingeniería Mecánica y Fabricación, Escuela Técnica Superior de Ingeniería, Universidad de Sevilla, Seville, Spain
| | - Esther Reina-Romo
- 1 Departamento de Ingeniería Mecánica y Fabricación, Escuela Técnica Superior de Ingeniería, Universidad de Sevilla, Seville, Spain
| |
Collapse
|
8
|
Parwani R, Curto M, Kao AP, Rowley PJ, Pani M, Tozzi G, Barber AH. Morphological and Mechanical Biomimetic Bone Structures. ACS Biomater Sci Eng 2017; 3:2761-2767. [DOI: 10.1021/acsbiomaterials.6b00652] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. Parwani
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| | - M. Curto
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| | - A. P. Kao
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| | - P. J. Rowley
- School
of Earth and Environmental Sciences, Burnaby Building, Burnaby Road, University of Portsmouth, Portsmouth PO1 3QL, United Kingdom
| | - M. Pani
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| | - G. Tozzi
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| | - A. H. Barber
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| |
Collapse
|