Integration of C-type natriuretic peptide gene-modified bone marrow mesenchymal stem cells with chitosan/silk fibroin scaffolds as a promising strategy for articular cartilage regeneration

Tissue engineering strategies hold promise for the repair of articular cartilage injury

Articular cartilage damage and wear can result in cartilage degeneration, ultimately culminating in osteoarthritis. Current surgical interventions offer limited capacity for cartilage tissue regeneration and offer only temporary alleviation of symptoms. Tissue engineering strategies are increasingly recognized as promising modalities for cartilage restoration. Currently, various biological scaffolds utilizing tissue engineering materials are extensively employed in both fundamental and clinical investigations of cartilage repair. In order to optimize the cartilage repair ability of tissue engineering scaffolds, researchers not only optimize the structure and properties of scaffolds from the perspective of materials science and manufacturing technology to enhance their histocompatibility, but also adopt strategies such as loading cells, cytokines, and drugs to promote cartilage formation. This review provides an overview of contemporary tissue engineering strategies employed in cartilage repair, as well as a synthesis of existing preclinical and clinical research. Furthermore, the obstacles faced in the translation of tissue engineering strategies to clinical practice are discussed, offering valuable guidance for researchers seeking to address these challenges.

Biomaterial-based scaffolds in promotion of cartilage regeneration: Recent advances and emerging applications

Osteoarthritis (OA) poses a significant burden for countless individuals, inflicting relentless pain and impairing their quality of life. Although traditional treatments for OA focus on pain management and surgical interventions, they often fall short of addressing the underlying cause of the disease. Fortunately, emerging biomaterial-based scaffolds offer hope for OA therapy, providing immense promise for cartilage regeneration in OA. These innovative scaffolds are ingeniously designed to provide support and mimic the intricate structure of the natural extracellular matrix, thus stimulating the regeneration of damaged cartilage. In this comprehensive review, we summarize and discuss current landscape of biomaterial-based scaffolds for cartilage regeneration in OA. Furthermore, we delve into the diverse range of biomaterials employed in their construction and explore the cutting-edge techniques utilized in their fabrication. By examining both preclinical and clinical studies, we aim to illuminate the remarkable versatility and untapped potential of biomaterial-based scaffolds in the context of OA.

Thetranslational potential of this article

By thoroughly examining the current state of research and clinical studies, this review provides valuable insights that bridge the gap between scientific knowledge and practical application. This knowledge is crucial for clinicians and researchers who strive to develop innovative treatments that go beyond symptom management and directly target the underlying cause of OA. Through the comprehensive analysis and multidisciplinary approach, the review paves the way for the translation of scientific knowledge into practical applications, ultimately improving the lives of individuals suffering from OA and shaping the future of orthopedic medicine.

Advances in Biomaterial-Mediated Gene Therapy for Articular Cartilage Repair

Articular cartilage defects caused by various reasons are relatively common in clinical practice, but the lack of efficient therapeutic methods remains a substantial challenge due to limitations in the chondrocytes’ repair abilities. In the search for scientific cartilage repair methods, gene therapy appears to be more effective and promising, especially with acellular biomaterial-assisted procedures. Biomaterial-mediated gene therapy has mainly been divided into non-viral vector and viral vector strategies, where the controlled delivery of gene vectors is contained using biocompatible materials. This review will introduce the common clinical methods of cartilage repair used, the strategies of gene therapy for cartilage injuries, and the latest progress.

Engineered cells along with smart scaffolds: critical factors for improving tissue engineering approaches

In this review, gene delivery and its applications are discussed in tissue engineering (TE); also, new techniques such as the CRISPR-Cas9 system, synthetics biology and molecular dynamics simulation to improve the efficiency of the scaffolds have been studied. CRISPR-Cas9 is expected to make significant advances in TE in the future. The fundamentals of synthetic biology have developed powerful and flexible methods for programming cells via artificial genetic circuits. The combination of regenerative medicine and artificial biology allows the engineering of cells and organisms for use in TE, biomaterials, bioprocessing and scaffold development. The dynamics of protein adsorption at the scaffold surface at the atomic level can provide valuable guidelines for the future design of TE scaffolds /implants.

Synergetic integrations of bone marrow stem cells and transforming growth factor-β1 loaded chitosan nanoparticles blended silk fibroin injectable hydrogel to enhance repair and regeneration potential in articular cartilage tissue

The cartilage repair and regeneration show inadequate self-healing capability and have some complications, which are inordinate challenges in clinical therapy. Biopolymeric injectable hydrogels, a prominent type of cell-carrier as well tissue engineering scaffolding materials, establish promising therapeutic potential of stem cell-based cartilage-regeneration treatment. In addition, injectable scaffolding biomaterial should have rapid gelation properties with adequate rheological and mechanical properties. In the present investigation, we developed and fabricated the macromolecular silk fibroin blended with polylysine modified chitosan polymer (SF/PCS) using thermal-sensitive glycerophosphate (GP), which contains effective gelation ability, morphology, porosity and also has enhanced mechanical properties to induce physical applicability, cell proliferation and nutrient exchange in the cell-based treatment. The developed and optimised injectable hydrogel group has good biocompatibility with human fibroblast (L929) cells and bone marrow-derived mesenchymal stem cells (BMSCs). Additionally, it was found that SF/PCS hydrogel group could sustainably release TGF-β1 and efficiently regulate cartilage-specific and inflammatory-related gene expressions. Finally, the cartilage-regeneration potential of the hydrogel groups embedded with and without BMSCs were evaluated in SD rat models under histopathological analysis, which showed promising cartilage repair. Overall, we conclude that the TGF-β1-SF/PCS injectable hydrogel demonstrates enhanced in vitro and in vivo tissue regeneration properties, which lead to efficacious therapeutic potential in cartilage regeneration.

Silk fibroin-based biomaterials for cartilage/osteochondral repair

Osteoarthritis (OA) is a common joint disease with a high disability rate. In addition, OA not only causes great physiological and psychological harm to patients, but also puts great pressure on the social healthcare system. Pathologically, the disintegration of cartilage and the lesions of subchondral bone are related to OA. Currently, tissue engineering, which is expected to overcome the defects of existing treatment methods, had a lot of research in the field of cartilage/osteochondral repair. Silk fibroin (SF), as a natural macromolecular material with good biocompatibility, unique mechanical properties, excellent processability and degradability, holds great potential in the field of tissue engineering. Nowadays, SF had been prepared into various materials to adapt to the demands of cartilage/osteochondral repair. SF-based biomaterials can also be functionally modified to enhance repair performance further. In this review, the preparation methods, types, structures, mechanical properties, and functional modifications of SF-based biomaterials used for cartilage/osteochondral repair are summarized and discussed. We hope that this review will provide a reference for the design and development of SF-based biomaterials in cartilage/osteochondral repair field.

Accelerating skin barrier repair using novel bioactive magnesium-doped nanofibers of non-mulberry silk fibroin during wound healing

Novel magnesium doped non-mulberry silk fibroin nanofibers with ability to enhance skin barrier function were successfully fabricated using electrospinning technique for wound healing applications. Magnesium nanoparticles incorporated in the electrospun nanofibers releases Mg2+ ions at the site of implementation. The effect of Mg2+ is of considerable concern in wound healing due to its skin barrier repair ability and its role in blood coagulation. The physicochemical characterization of the scaffold was investigated by determining the morphology and secondary structure confirmation. The effects of Mg2+ ions in silk fibroin microenvironment have been evaluated using SEM, XRD, and FTIR to confirm the incorporation of magnesium in the film. The aim of this study is to see the effect of doped Mg on the structural, physical, and biological properties of non-mulberry silk fibroin (NSF) film. The magnesium doped nanofibrous film exhibited enhanced mechanical property, satisfactory blood clotting ability, and good in vitro degradability. This silk fibroin-based film mimicking extracellular matrix for skin regeneration were constructed using electrospinning technique. The wound healing efficiency of prepared nanofibers were evaluated in full-thickness wound models of rat. The Mg doped silk fibroin film exhibited faster wound healing activity (14 days) among all experimental group. The study indicates the potential of magnesium-doped silk /PVA film as skin substitute film.

Marine origin materials on biomaterials and advanced therapies to cartilage tissue engineering and regenerative medicine

The body's self-repair capacity is limited, including injuries on articular cartilage zones. Over the past few decades, tissue engineering and regenerative medicine (TERM) has focused its studies on the development of natural biomaterials for clinical applications aiming to overcome this self-therapeutic bottleneck. This review focuses on the development of these biomaterials using compounds and materials from marine sources that are able to be produced in a sustainable way, as an alternative to mammal sources (e.g., collagens) and benefiting from their biological properties, such as biocompatibility, low antigenicity, biodegradability, among others. The structure and composition of the new biomaterials require mimicking the native extracellular matrix (ECM) of articular cartilage tissue. To design an ideal temporary tissue-scaffold, it needs to provide a suitable environment for cell growth (cell attachment, proliferation, and differentiation), towards the regeneration of the damaged tissues. Overall, the purpose of this review is to summarize various marine sources to be used in the development of different tissue-scaffolds with the capability to sustain cells envisaging cartilage tissue engineering, analysing the systems displaying more promising performance, while pointing out current limitations and steps to be given in the near future.

Bioactive Silk Fibroin-Based Hybrid Biomaterials for Musculoskeletal Engineering: Recent Progress and Perspectives

Musculoskeletal engineering has been considered as a promising approach to customize regenerated tissue (such as bone, cartilage, tendon, and ligament) via a self-healing performance. Recent advances have demonstrated the great potential of bioactive materials for regenerative medicine. Silk fibroin (SF), a natural polymer, is regarded as a remarkable bioactive material for musculoskeletal engineering thanks to its biocompatibility, biodegradability, and tunability. To improve tissue-engineering performance, silk fibroin is hybridized with other biomaterials to form silk-fibroin-based hybrid biomaterials, which achieve superior mechanical and biological performance. Herein, we summarize the recent development of silk-based hybrid biomaterials in musculoskeletal tissue with reasonable generalization and classification, mainly including silk fibroin-based inorganic and organic hybrid biomaterials. The applied inorganics are composed of calcium phosphate, graphene oxide, titanium dioxide, silica, and bioactive glass, while the polymers include polycaprolactone, collagen (or gelatin), chitosan, cellulose, and alginate. This article mainly focuses on the physical and biological performances both in vitro and in vivo study of several common silk-based hybrid biomaterials in musculoskeletal engineering. The timely summary and highlight of silk-fibroin-based hybrid biomaterials will provide a research perspective to promote the further improvement and development of silk fibroin hybrid biomaterials for improved musculoskeletal engineering.

Genetics in Cartilage Lesions: Basic Science and Therapy Approaches

Cartilage lesions have a multifactorial nature, and genetic factors are their strongest determinants. As biochemical and genetic studies have dramatically progressed over the past decade, the molecular basis of cartilage pathologies has become clearer. Several homeostasis abnormalities within cartilaginous tissue have been found, including various structural changes, differential gene expression patterns, as well as altered epigenetic regulation. However, the efficient treatment of cartilage pathologies represents a substantial challenge. Understanding the complex genetic background pertaining to cartilage pathologies is useful primarily in the context of seeking new pathways leading to disease progression as well as in developing new targeted therapies. A technology utilizing gene transfer to deliver therapeutic genes to the site of injury is quickly becoming an emerging approach in cartilage renewal. The goal of this work is to provide an overview of the genetic basis of chondral lesions and the different approaches of the most recent systems exploiting therapeutic gene transfer in cartilage repair. The integration of tissue engineering with viral gene vectors is a novel and active area of research. However, despite promising preclinical data, this therapeutic concept needs to be supported by the growing body of clinical trials.

Scaffold-Based Gene Therapeutics for Osteochondral Tissue Engineering

Significant progress in osteochondral tissue engineering has been made for biomaterials designed to deliver growth factors that promote tissue regeneration. However, due to diffusion characteristics of hydrogels, the accurate delivery of signaling molecules remains a challenge. In comparison to the direct delivery of growth factors, gene therapy can overcome these challenges by allowing the simultaneous delivery of growth factors and transcription factors, thereby enhancing the multifactorial processes of tissue formation. Scaffold-based gene therapy provides a promising approach for tissue engineering through transfecting cells to enhance the sustained expression of the protein of interest or through silencing target genes associated with bone and joint disease. Reports of the efficacy of gene therapy to regenerate bone/cartilage tissue regeneration are widespread, but reviews on osteochondral tissue engineering using scaffold-based gene therapy are sparse. Herein, we review the recent advances in gene therapy with a focus on tissue engineering scaffolds for osteochondral regeneration.

Biomechanical issues of tissue-engineered constructs for articular cartilage regeneration: in vitro and in vivo approaches

BACKGROUND

Given the limited regenerative capacity of injured articular cartilage, the absence of suitable therapeutic options has encouraged tissue-engineering approaches for its regeneration or replacement.

SOURCES OF DATA

Published articles in any language identified in PubMed and Scopus electronic databases up to August 2019 about the in vitro and in vivo properties of cartilage engineered constructs. A total of 64 articles were included following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

AREAS OF AGREEMENT

Regenerated cartilage lacks the biomechanical and biological properties of native articular cartilage.

AREAS OF CONTROVERSY

There are many different approaches about the development of the architecture and the composition of the scaffolds.

GROWING POINTS

Novel tissue engineering strategies focus on the development of cartilaginous biomimetic materials able to repair cartilage lesions in association to cell, trophic factors and gene therapies.

AREAS TIMELY FOR DEVELOPING RESEARCH

A multi-layer design and a zonal organization of the constructs may lead to achieve cartilage regeneration.