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Hulsart-Billström G, Stelzl C, Procter P, Pujari-Palmer M, Insley G, Engqvist H, Larsson S. In vivo safety assessment of a bio-inspired bone adhesive. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2020; 31:24. [PMID: 32036502 PMCID: PMC7007900 DOI: 10.1007/s10856-020-6362-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 01/08/2020] [Indexed: 05/14/2023]
Abstract
A new class of materials, bone adhesives, could revolutionise the treatment of highly fragmented fractures. We present the first biological safety investigation of a bio-inspired bone adhesive. The formulation was based upon a modified calcium phosphate cement that included the amino acid phosphoserine. This material has recently been described as substantially stronger than other bioresorbable calcium phosphate cements. Four adhesive groups with the active substance (phosphoserine) and two control groups without phosphoserine were selected for in vitro and in vivo biocompatibility testing. The test groups were subject for cell viability assay and subcutaneous implantation in rats that was followed by gene expression analysis and histology assessment after 6 and 12 weeks. All adhesive groups supported the same rate of cell proliferation compared to the α-TCP control and had viability between 45-64% when compared to cell control. There was no evidence of an increased immune response or ectopic bone formation in vivo. To conclude, this bio-inspired bone adhesive has been proven to be safe, in the present study, without any harmful effects on the surrounding soft tissue.
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Affiliation(s)
- Gry Hulsart-Billström
- Division of Orthopaedics, Department of Surgical Sciences, Uppsala University, Uppsala, 751 85, Sweden.
| | - Christina Stelzl
- Division of Orthopaedics, Department of Surgical Sciences, Uppsala University, Uppsala, 751 85, Sweden
| | - Philip Procter
- Division of Applied Material Science, Department of Engineering Sciences, Uppsala University, Uppsala, 751 21, Sweden
| | - Michael Pujari-Palmer
- Division of Applied Material Science, Department of Engineering Sciences, Uppsala University, Uppsala, 751 21, Sweden
| | - Gerard Insley
- GPBio Ltd, Unit 4D, Western Business Park, Shannnon, Co. Clare, Ireland
| | - Håkan Engqvist
- Division of Applied Material Science, Department of Engineering Sciences, Uppsala University, Uppsala, 751 21, Sweden
| | - Sune Larsson
- Division of Orthopaedics, Department of Surgical Sciences, Uppsala University, Uppsala, 751 85, Sweden
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Kolk A, Boskov M, Haidari S, Tischer T, van Griensven M, Bissinger O, Plank C. Comparative analysis of bone regeneration behavior using recombinant human BMP-2 versus plasmid DNA of BMP-2. J Biomed Mater Res A 2018; 107:163-173. [PMID: 30358084 DOI: 10.1002/jbm.a.36545] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/13/2018] [Accepted: 04/05/2018] [Indexed: 12/16/2022]
Abstract
Bone regeneration and the osteoinductive capacity of implants are challenging issues in clinical medicine. Currently, recombinant growth factors and nonviral gene transfer are the most frequently investigated methods for bone growth enhancement, although the more favorable method remains unclear. There is a lack of knowledge in literature about the in vivo comparison of these methods for bone regeneration. BMP-2, which is the most commonly used growth factor for osteogenesis, was applied at its most efficient dose as a recombinant growth factor (rhBMP-2) and as a growth-factor-encoding copolymer protected gene vector (pBMP-2) in a critical size bone defect (CSD) model to determine the most suitable method for bone regeneration. CSDs were induced bilaterally in 32 Sprague-Dawley rats. RhBMP-2 (62.5 μg) or pBMP-2 (2.5 μg) was embedded in poly(d,l-)lactide-coated titanium discs. Survival times were set at 14, 28, 56, and 112 days. After euthanasia, samples were analyzed via micro-computed tomography, polychrome sequential fluorescent labeling, and immunohistochemistry. Whereas defects in both groups were bridged with new bone after 56 days, rhBMP-2 initially induced ectopic new bone formation that was later remodeled in an unorganized hypodense manner. In contrast, pBMP-2 led to slower but steady bone regeneration with physiological tissue morphology, as confirmed by high osteoblast activity shown by osteocalcin staining. CD68 and TRAP staining verified high osteoclast activity for the rhBMP-2 group. pBMP-2 successfully induced locally controlled physiological bone regeneration, whereas rhBMP-2 triggered rapid and ectopic but insufficient bone formation. Thus, nonviral gene transfer appears to be more favorable for clinical applications. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 163-173, 2019.
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Affiliation(s)
- Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Institute of Molecular Immunology & Experimental Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Marko Boskov
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Selgai Haidari
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Tischer
- Department of Orthopaedics, Rostock University Medical Center, Munich, Germany
| | - Martijn van Griensven
- Experimental Trauma Surgery, Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Oliver Bissinger
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christian Plank
- Institute of Molecular Immunology & Experimental Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Todeschi MR, El Backly RM, Varghese OP, Hilborn J, Cancedda R, Mastrogiacomo M. Host cell recruitment patterns by bone morphogenetic protein-2 releasing hyaluronic acid hydrogels in a mouse subcutaneous environment. Regen Med 2017; 12:525-539. [DOI: 10.2217/rme-2017-0023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: This study aimed to identify host cell recruitment patterns in a mouse model in response to rhBMP-2 releasing hyaluronic acid hydrogels and influence of added nano-hydroxyapatite particles on rhBMP-2 release and pattern of bone formation. Materials & methods: Implanted gels were retrieved after implantation and cells were enzymatically dissociated for flow cytometric analysis. Percentages of macrophages, progenitor endothelial cells and putative mesenchymal stem cells were measured. Implants were evaluated for BMP-2 release by ELISA and by histology to monitor tissue formation. Results & conclusion: Hyaluronic acid+BMP-2 gels influenced the inflammatory response in the bone healing microenvironment. Host-derived putative mesenchymal stem cells were major contributors. Addition of hydroxyapatite nanoparticles modified the release pattern of rhBMP-2, resulting in enhanced bone formation.
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Affiliation(s)
- Maria R Todeschi
- Department of Experimental Medicine (DIMES), University of Genoa & IRCCS Policlinico San Martino, Genoa, Italy
| | - Rania M El Backly
- Department of Experimental Medicine (DIMES), University of Genoa & IRCCS Policlinico San Martino, Genoa, Italy
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Oommen P Varghese
- Department of Chemistry, Angstrom Laboratory, Uppsala University, Uppsala, Sweden
| | - Jöns Hilborn
- Department of Chemistry, Angstrom Laboratory, Uppsala University, Uppsala, Sweden
| | - Ranieri Cancedda
- Department of Experimental Medicine (DIMES), University of Genoa & IRCCS Policlinico San Martino, Genoa, Italy
| | - Maddalena Mastrogiacomo
- Department of Experimental Medicine (DIMES), University of Genoa & IRCCS Policlinico San Martino, Genoa, Italy
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An in vivo cross-linkable hyaluronan gel with inherent anti-inflammatory properties reduces OA cartilage destruction in female mice subjected to cruciate ligament transection. Osteoarthritis Cartilage 2017; 25:157-165. [PMID: 27587077 DOI: 10.1016/j.joca.2016.08.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/17/2016] [Accepted: 08/22/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To explore the possibility of cartilage protection in osteoarthritis (OA) by intraarticular injection of a chemically modified hyaluronan (HA) gel and investigate whether the chemical modifications provide intrinsic anti-inflammatory activity. METHOD OA was induced in C57BL/6 mice by anterior cruciate ligament transection (ACLT) and HA gel or carbazate-modified component was injected intra-articularly. Assessment of cartilage rescue was performed by histology, immunohistochemistry and TUNEL analysis. Serum levels of proinflammatory cytokines were evaluated with cytometric bead array, measuring IL-1β, TNF, IFN-γ, KC/CXCL1 and MCP-1. RESULTS Intraarticular injection of the HA gel showed significantly reduced cartilage destruction and decreased osteophyte formation. Besides the biological and biomechanical effects of HA, we investigated lipid peroxidation products as an alternative inflammatory and potential mechanism contributing to OA. To address this, injection of the carbazate-modified component alone was performed, which also demonstrated a cartilage-saving effect. Besides the cartilage amelioration effects, decreased apoptosis, 4-hydroxynonenal (4-HNE) and MHC class II staining was recorded. No changes in serum levels of proinflammatory cytokines were detected. CONCLUSION We have shown that the HA gel has an anti-destructive effect on articular cartilage (AC). Our results demonstrated that the carbazate-modified component could suppress apoptotic events, potentially by quenching of ROS/LPO products such as 4-HNE in OA joints. Modification of the HA molecule offers opportunities to introduce (covalent) coupling of additional molecules to the gel, with controlled retention and subsequent release in the joint.
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Zhao N, Wang X, Qin L, Zhai M, Yuan J, Chen J, Li D. Effect of hyaluronic acid in bone formation and its applications in dentistry. J Biomed Mater Res A 2016; 104:1560-9. [PMID: 27007721 DOI: 10.1002/jbm.a.35681] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 01/20/2023]
Affiliation(s)
- Ningbo Zhao
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Xin Wang
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Lei Qin
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Min Zhai
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Jing Yuan
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Ji Chen
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Dehua Li
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
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Agrawal V, Sinha M. A review on carrier systems for bone morphogenetic protein-2. J Biomed Mater Res B Appl Biomater 2016; 105:904-925. [PMID: 26728994 DOI: 10.1002/jbm.b.33599] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 12/01/2015] [Accepted: 12/03/2015] [Indexed: 01/26/2023]
Abstract
Bone morphogenetic protein-2 (BMP-2) has unique bone regeneration property. The powerful osteoinductive nature makes it considered as second line of therapy in nonunion bone defect. A large number of carriers and delivery systems made up of different materials have been investigated for controlled and sustained release of BMP-2. The delivery systems are in the form of hydrogel, microsphere, nanoparticles, and fibers. The carriers used for the delivery are made up of metals, ceramics, polymers, and composites. Implantation of these protein-loaded carrier leads to cell adhesion, degradation which eventually releases the drug/protein at site specific. But, problems like ectopic growth, lesser protein delivery, inactivation of the protein are reported in the available carrier systems. Therefore, it is need of an hour to modify the available carrier systems as well as explore other biomaterials with desired properties. In this review, all the reported carrier systems made of metals, ceramics, polymers, composites are evaluated in terms of their processing conditions, loading capacity and release pattern of BMP-2. Along with these biomaterials, the attempts of protein modification by adding some functional group to BMP-2 or extracting functional peptides from the protein to achieve the desired effect, is also evaluated. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 904-925, 2017.
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Affiliation(s)
- Vishal Agrawal
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research-Ahmedabad, Ahmedabad-, 380054, India
| | - Mukty Sinha
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research-Ahmedabad, Ahmedabad-, 380054, India
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In Vitro and In Vivo Response to Low-Modulus PMMA-Based Bone Cement. BIOMED RESEARCH INTERNATIONAL 2015; 2015:594284. [PMID: 26366415 PMCID: PMC4558433 DOI: 10.1155/2015/594284] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/10/2015] [Indexed: 11/28/2022]
Abstract
The high stiffness of acrylic bone cements has been hypothesized to contribute to the increased number of fractures encountered after vertebroplasty, which has led to the development of low-modulus cements. However, there is no data available on the in vivo biocompatibility of any low-modulus cement. In this study, the in vitro cytotoxicity and in vivo biocompatibility of two types of low-modulus acrylic cements, one modified with castor oil and one with linoleic acid, were evaluated using human osteoblast-like cells and a rodent model, respectively. While the in vitro cytotoxicity appeared somewhat affected by the castor oil and linoleic acid additions, no difference could be found in the in vivo response to these cements in comparison to the base, commercially available cement, in terms of histology and flow cytometry analysis of the presence of immune cells. Furthermore, the in vivo radiopacity of the cements appeared unaltered. While these results are promising, the mechanical behavior of these cements in vivo remains to be investigated.
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Characterization and Properties of Hydrogels Made from Neutral Soluble Chitosans. Polymers (Basel) 2015. [DOI: 10.3390/polym7030373] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Skeletal tissue regeneration: where can hydrogels play a role? INTERNATIONAL ORTHOPAEDICS 2014; 38:1861-76. [PMID: 24968789 DOI: 10.1007/s00264-014-2402-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 05/29/2014] [Indexed: 02/07/2023]
Abstract
The emerging field of tissue engineering reveals promising approaches for the repair and regeneration of skeletal tissues including the articular cartilage, bone, and the entire joint. Amongst the myriad of biomaterials available to support this strategy, hydrogels are highly tissue mimicking substitutes and thus of great potential for the regeneration of functional tissues. This review comprises an overview of the novel and most promising hydrogels for articular cartilage, osteochondral and bone defect repair. Chondro- and osteo-conductive and -instructive hydrogels are presented, highlighting successful combinations with inductive signals and cell sources. Moreover, advantages, drawbacks, and future perspectives of the role of hydrogels in skeletal regeneration are addressed, pointing out the current state of this rising approach.
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Stenfelt S, Hulsart-Billström G, Gedda L, Bergman K, Hilborn J, Larsson S, Bowden T. Pre-incubation of chemically crosslinked hyaluronan-based hydrogels, loaded with BMP-2 and hydroxyapatite, and its effect on ectopic bone formation. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2014; 25:1013-1023. [PMID: 24477873 DOI: 10.1007/s10856-014-5147-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 01/10/2014] [Indexed: 06/03/2023]
Abstract
The effects of pre-incubation of hyaluronan hydrogels, for different lengths of time after the initiation of chemical crosslinking and prior to injection, were explored both by investigating the in vitro BMP-2 release kinetics from the hydrogel and by studying the ectopic bone formation in rats. From the curing profile, obtained from rheological analysis, appropriate pre-incubation times (1 min, 5 h and 3 days) were selected, to prepare slightly, moderately and fully cured hydrogels. Comparable release profiles were observed for all three test groups in vitro. Furthermore, radiography, pQCT and histology of the explanted grafts showed cancellous bone formation in all groups after 5 weeks in vivo. However, longer pre-incubation times gave rise to an increase in bone volume, but a decrease in bone density. Moreover, the 5 h and the 3 days grafts appeared to be more ordered and resistant to deformation from the surrounding tissue than the 1 min grafts. The observed variations in mechanical and biological properties could potentially be used to adapt the treatment for a specific indication.
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Affiliation(s)
- Sonya Stenfelt
- Department of Chemistry - Ångström Laboratory, Uppsala University, Box 538, 751 21, Uppsala, Sweden
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Hulsart-Billström G, Yuen PK, Marsell R, Hilborn J, Larsson S, Ossipov D. Bisphosphonate-Linked Hyaluronic Acid Hydrogel Sequesters and Enzymatically Releases Active Bone Morphogenetic Protein-2 for Induction of Osteogenic Differentiation. Biomacromolecules 2013; 14:3055-63. [DOI: 10.1021/bm400639e] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Gry Hulsart-Billström
- Department
of Surgical Sciences, Orthopedics, Uppsala University Hospital, Uppsala, SE 751 85, Sweden
| | - Pik Kwan Yuen
- Department
of Surgical Sciences, Orthopedics, Uppsala University Hospital, Uppsala, SE 751 85, Sweden
| | - Richard Marsell
- Department
of Surgical Sciences, Orthopedics, Uppsala University Hospital, Uppsala, SE 751 85, Sweden
| | - Jöns Hilborn
- Science
for Life
Laboratory, Division of Polymer Chemistry, Department
of Chemistry-Ångström, Uppsala University, Uppsala, SE 751 21, Sweden
| | - Sune Larsson
- Department
of Surgical Sciences, Orthopedics, Uppsala University Hospital, Uppsala, SE 751 85, Sweden
| | - Dmitri Ossipov
- Science
for Life
Laboratory, Division of Polymer Chemistry, Department
of Chemistry-Ångström, Uppsala University, Uppsala, SE 751 21, Sweden
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