Electrospun scaffolds for bone tissue engineering

Additively manufactured porous scaffolds by design for treatment of bone defects

There has been increasing attention to produce porous scaffolds that mimic human bone properties for enhancement of tissue ingrowth, regeneration, and integration. Additive manufacturing (AM) technologies, i.e., three dimensional (3D) printing, have played a substantial role in engineering porous scaffolds for clinical applications owing to their high level of design and fabrication flexibility. To this end, this review article attempts to provide a detailed overview on the main design considerations of porous scaffolds such as permeability, adhesion, vascularisation, and interfacial features and their interplay to affect bone regeneration and osseointegration. Physiology of bone regeneration was initially explained that was followed by analysing the impacts of porosity, pore size, permeability and surface chemistry of porous scaffolds on bone regeneration in defects. Importantly, major 3D printing methods employed for fabrication of porous bone substitutes were also discussed. Advancements of MA technologies have allowed for the production of bone scaffolds with complex geometries in polymers, composites and metals with well-tailored architectural, mechanical, and mass transport features. In this way, a particular attention was devoted to reviewing 3D printed scaffolds with triply periodic minimal surface (TPMS) geometries that mimic the hierarchical structure of human bones. In overall, this review enlighten a design pathway to produce patient-specific 3D-printed bone substitutions with high regeneration and osseointegration capacity for repairing large bone defects.

Electrospun Biomimetic Nanofibrous Scaffolds: A Promising Prospect for Bone Tissue Engineering and Regenerative Medicine

Skeletal-related disorders such as arthritis, bone cancer, osteosarcoma, and osteoarthritis are among the most common reasons for mortality in humans at present. Nanostructured scaffolds have been discovered to be more efficient for bone regeneration than macro/micro-sized scaffolds because they sufficiently permit cell adhesion, proliferation, and chemical transformation. Nanofibrous scaffolds mimicking artificial extracellular matrices provide a natural environment for tissue regeneration owing to their large surface area, high porosity, and appreciable drug loading capacity. Here, we review recent progress and possible future prospective electrospun nanofibrous scaffolds for bone tissue engineering. Electrospun nanofibrous scaffolds have demonstrated promising potential in bone tissue regeneration using a variety of nanomaterials. This review focused on the crucial role of electrospun nanofibrous scaffolds in biological applications, including drug/growth factor delivery to bone tissue regeneration. Natural and synthetic polymeric nanofibrous scaffolds are extensively inspected to regenerate bone tissue. We focused mainly on the significant impact of nanofibrous composite scaffolds on cell adhesion and function, and different composites of organic/inorganic nanoparticles with nanofiber scaffolds. This analysis provides an overview of nanofibrous scaffold-based bone regeneration strategies; however, the same concepts can be applied to other organ and tissue regeneration tactics.

Impact of the solvent composition on the structural and mechanical properties of customizable electrospun poly(vinylpyrrolidone) fiber mats

The performance of fibrous membrane composites fabricated via electrospinning is strongly influenced by the solution's properties, process variables and ambient conditions, although a precise mechanism for controlling the properties of the resulting composite has remained elusive. In this work, we focus on the fabrication of electrospun poly(vinylpyrrolidone) (PVP) fibers, by varying both the polymer concentration and the mixture of ethanol (EtOH) and dimethylformamide (DMF) used as solvent. The impact of the solvent composition on the structural properties is assessed by a combined experimental and theoretical approach, employing scanning electron microscopy (SEM), differential scanning calorimetry (DSC), rheology, Fourier-transform infrared spectroscopy (FTIR) and stress-strain curves obtained from tensile tests to characterize the fibrous membranes produced, and density functional theory (DFT) calculations to explain the solvent's affect on PVP crystallization. We establish a morphological phase diagram, and propose a possible mechanism based on the measured fiber diameter distribution, the viscoelastic properties of the precursor solution, the correlation between the functional groups and the mechanical properties, the thermal transitions and the degree of crystallinity. We also employ DFT calculations to model the polymer coverage at equilibrium of a PVP polymer chain in the presence of EtOH/DMF solvent mixtures to corroborate the crucial role their O or -OH groups play in achieving high PVP coverages and promoting the stability of the resulting fiber. These findings will be valuable to researchers interested in predicting, modulating, and controlling both a fiber's morphology and its concomitant physico-chemical properties.

Functionalization of Electrospun Polycaprolactone Scaffolds with Matrix-Binding Osteocyte-Derived Extracellular Vesicles Promotes Osteoblastic Differentiation and Mineralization

Synthetic polymeric materials have demonstrated great promise for bone tissue engineering based on their compatibility with a wide array of scaffold-manufacturing techniques, but are limited in terms of the bioactivity when compared to naturally occurring materials. To enhance the regenerative properties of these materials, they are commonly functionalised with bioactive factors to guide growth within the developing tissue. Extracellular matrix vesicles (EVs) play an important role in facilitating endochondral ossification during long bone development and have recently emerged as important mediators of cell-cell communication coordinating bone regeneration, and thus represent an ideal target to enhance the regenerative properties of synthetic scaffolds. Therefore, in this paper we developed tools and protocols to enable the attachment of MLO-Y4 osteocyte-derived EVs onto electrospun polycaprolactone (PCL) scaffolds for bone repair. Initially, we optimize a method for the functionalization of PCL materials with collagen type-1 and fibronectin, inspired by the behaviour of matrix vesicles during endochondral ossification, and demonstrate that this is an effective method for the adhesion of EVs to the material surface. We then used this functionalization process to attach osteogenic EVs, collected from mechanically stimulated MLO-Y4 osteocytes, to collagen-coated electrospun PCL scaffolds. The EV-functionalized scaffold promoted osteogenic differentiation (measured by increased ALP activity) and mineralization of the matrix. In particular, EV-functionalised scaffolds exhibited significant increases in matrix mineralization particularly at earlier time points compared to uncoated and collagen-coated controls. This approach to matrix-based adhesion of EVs provides a mechanism for incorporating vesicle signalling into polyester scaffolds and demonstrates the potential of osteocyte derived EVs to enhance the rate of bone tissue regeneration.

Biomineralization of Collagen-Based Materials for Hard Tissue Repair

Hydroxyapatite (HA) reinforced collagen fibrils serve as the basic building blocks of natural bone and dentin. Mineralization of collagen fibrils play an essential role in ensuring the structural and mechanical functionalities of hard tissues such as bone and dentin. Biomineralization of collagen can be divided into intrafibrillar and extrafibrillar mineralization in terms of HA distribution relative to collagen fibrils. Intrafibrillar mineralization is termed when HA minerals are incorporated within the gap zone of collagen fibrils, while extrafibrillar mineralization refers to the minerals that are formed on the surface of collagen fibrils. However, the mechanisms resulting in these two types of mineralization still remain debatable. In this review, the evolution of both classical and non-classical biomineralization theories is summarized. Different intrafibrillar mineralization mechanisms, including polymer induced liquid precursor (PILP), capillary action, electrostatic attraction, size exclusion, Gibbs-Donnan equilibrium, and interfacial energy guided theories, are discussed. Exemplary strategies to induce biomimetic intrafibrillar mineralization using non-collagenous proteins (NCPs), polymer analogs, small molecules, and fluidic shear stress are discussed, and recent applications of mineralized collagen fibers for bone regeneration and dentin repair are included. Finally, conclusions are drawn on these proposed mechanisms, and the future trend of collagen-based materials for bone regeneration and tooth repair is speculated.

β-mercaptoethanol promotes osteogenesis of human mesenchymal stem cells via sirt1-ERK pathway

Human umbilical cord-derived mesenchymal stem cells (hUMSCs) hold strong self-renewal capacity and low immunogenicity, which have attracted attention as potential candidates for bone repair and regeneration. However, insufficient osteogenic differentiation markedly hinders the clinical applications of hUMSCs. In the present study, the effect of β-mercaptoethanol (BME), a small molecule antioxidant which has been identified to regulate cell proliferation and differentiation, on osteogenic differentiation of hUMSCs and underlying signaling mechanism were investigated. The results indicated that under osteogenic induction conditions, BME treatment increased the alkaline phosphatase (ALP) activity and promoted calcium mineralization in hUMSCs. The gene and protein expression of osteogenesis-related markers such as ALP, osteopontin (OPN), osteocalcin (OCN) and collagen type I (COLI) were also significantly up-regulated. Besides, BME promoted the protein expression of silent information regulator type 1 (sirt1) and stimulated the activation of extracellular signal-related kinase (ERK), contributing to increased Runx2 expression. Furthermore, blocking the expression of sirt1 attenuated BME-enhanced ERK phosphorylation and osteogenic differentiation of hUMSCs. These results indicated that BME accelerated osteogenic differentiation of hUMSCs by activating the sirt1-ERK signaling pathway, thereby providing insights into the development of MSCs-based bone regeneration strategies.

Polyaniline-coated titanium oxide nanoparticles and simvastatin-loaded poly(ε-caprolactone) composite nanofibers scaffold for bone tissue regeneration application

Poly(ε-caprolactone) (PCL) nanofibers loaded with polyaniline coated titanium oxide nanoparticles (TiO2/PANI) and simvastatin (SIM) drug were produced by the electrospinning method. As-prepared samples were investigated in terms of morphology characterization, mechanical properties, physiochemical properties, drug release, biomimetic mineralization, and biocompatibility. in vitro drug release studies were conducted in the phosphate buffer saline (PBS) at pH 7.4. The results suggest that varying the concentrations of TiO2/PANI nanoparticles could change the rate of drug release. The release mechanism was studied using several kinetic models, including the Higuchi model, the Hixson-Crowell model, and the Korsmeyer-Peppas model, to clarify the mechanism of SIM release from the composite nanofibers. The assessment of in vitro mineralization of the composite nanofibers for the growth of hydroxyapatite was performed in simulated body fluid (SBF). Field scanning electron microscopy (FE-SEM) imagery and energy-dispersive X-ray spectroscopy (EDS) analyses indicated that after soaking in SBF, a hydroxyapatite layer was formed on the surface of the nanofibrous webs. These novel composite nanofibers release simvastatin in a controlled manner with profound cell proliferation and attachment compared to that in pure PCL nanofiber, which indicates their potential for bone regeneration applications.

3D Hierarchical, Nanostructured Chitosan/PLA/HA Scaffolds Doped with TiO2/Au/Pt NPs with Tunable Properties for Guided Bone Tissue Engineering

Bone tissue is the second tissue to be replaced. Annually, over four million surgical treatments are performed. Tissue engineering constitutes an alternative to autologous grafts. Its application requires three-dimensional scaffolds, which mimic human body environment. Bone tissue has a highly organized structure and contains mostly inorganic components. The scaffolds of the latest generation should not only be biocompatible but also promote osteoconduction. Poly (lactic acid) nanofibers are commonly used for this purpose; however, they lack bioactivity and do not provide good cell adhesion. Chitosan is a commonly used biopolymer which positively affects osteoblasts' behavior. The aim of this article was to prepare novel hybrid 3D scaffolds containing nanohydroxyapatite capable of cell-response stimulation. The matrixes were successfully obtained by PLA electrospinning and microwave-assisted chitosan crosslinking, followed by doping with three types of metallic nanoparticles (Au, Pt, and TiO2). The products and semi-components were characterized over their physicochemical properties, such as chemical structure, crystallinity, and swelling degree. Nanoparticles' and ready biomaterials' morphologies were investigated by SEM and TEM methods. Finally, the scaffolds were studied over bioactivity on MG-63 and effect on current-stimulated biomineralization. Obtained results confirmed preparation of tunable biomimicking matrixes which may be used as a promising tool for bone-tissue engineering.

Emerging Trends in Information-Driven Engineering of Complex Biological Systems

Synthetic biological systems are used for a myriad of applications, including tissue engineered constructs for in vivo use and microengineered devices for in vitro testing. Recent advances in engineering complex biological systems have been fueled by opportunities arising from the combination of bioinspired materials with biological and computational tools. Driven by the availability of large datasets in the "omics" era of biology, the design of the next generation of tissue equivalents will have to integrate information from single-cell behavior to whole organ architecture. Herein, recent trends in combining multiscale processes to enable the design of the next generation of biomaterials are discussed. Any successful microprocessing pipeline must be able to integrate hierarchical sets of information to capture key aspects of functional tissue equivalents. Micro- and biofabrication techniques that facilitate hierarchical control as well as emerging polymer candidates used in these technologies are also reviewed.

Osteogenic induction of human mesenchymal stem cells in multilayered electrospun scaffolds at different flow rates and configurations in a perfusion bioreactor

Electrospun scaffolds are potentially interesting in bone tissue engineering due to a strong structural similarity to the natural bone matrix. To investigate the osteogenic behavior of cells on the scaffolds, dynamic culture of cells is essential to simulate the biological environment. In the present study, human mesenchymal stem cells (hMSCs) were cultured on multilayer nanohydroxyapatite-polycaprolactone electrospun scaffolds at different configurations (horizontal with or without pressure and parallel with the medium flow) and flow rates in a perfusion bioreactor. Alkaline phosphatase (ALP) activity, cell viability, Ca deposition and RUNX2 expression were determined in three different dynamic states, and compared with static culture after 1, 3, 7, and 14 days. Among dynamic groups, RUNX2 gene expression upregulated more in a horizontal state at a low flow rate without mechanical pressure (LF) and parallel flow (PF), than static group on day 7. At a high flow rate with mechanical pressure, Ca deposition and ALP activity increased 2.34 and 1.7 folds more than in static culture over 7 days, respectively. Furthermore, ALP activity, Ca deposition and RUNX2 gene expression increased in PF samples. PF provided longer culture time with higher cell differentiation. Therefore, high flow rate with mechanical pressure and PF are suggested for producing differentiated cell structure for bone tissue engineering.

3D-printed poly(lactic acid) scaffolds for trabecular bone repair and regeneration: scaffold and native bone characterization

PURPOSE

Study objectives were set to (i) fabricate 3D-printed scaffolds/grafts with varying pore sizes, (ii) characterize surface and mechanical properties of scaffolds, (iii) characterize biomechanical properties of bovine trabecular bone, and (iv) evaluate attachment and proliferation of human bone marrow mesenchymal stem cells on 3D-printed scaffolds.

MATERIALS AND METHODS

Poly(lactic acid) scaffolds were fabricated using 3D-printing technology, and characterized in terms of their surface as well as compressive mechanical properties. Trabecular bone specimens were obtained from bovine and characterized biomechanically under compression. Human bone marrow mesenchymal stem cells were seeded on the scaffolds, and their attachment capacity and proliferation were evaluated.

RESULTS

Contact angles and compressive moduli of scaffolds decreased with increasing pore dimensions of 0.5 mm, 1.0 mm, and 1.25 mm. Biomechanical characterization of trabecular bone yielded higher modulus values as compared to scaffolds with all pore sizes studied. Human bone marrow mesenchymal stem cells attached to the surfaces of all scaffolds yet proliferated more on scaffolds with 1.25 mm pore size.

CONCLUSIONS

Collectively, given the similarity between 3D-printed scaffolds and native bone in terms of pore size, porosity, and appropriate mechanical properties of scaffolds, the 3D-printed poly(lactic acid) (PLA) scaffolds of this study appear as candidate substitutes for bone repair and regeneration.

The multiple functions of melatonin in regenerative medicine

Melatonin research has been experiencing hyper growth in the last two decades; this relates to its numerous physiological functions including anti-inflammation, oncostasis, circadian and endocrine rhythm regulation, and its potent antioxidant activity. Recently, a large number of studies have focused on the role of melatonin in the regeneration of cells or tissues after their partial loss. In this review, we discuss the recent findings on the molecular involvement of melatonin in the regeneration of various tissues including the nervous system, liver, bone, kidney, bladder, skin, and muscle, among others.

Electrospun Polyhydroxybutyrate/Poly(ε-caprolactone)/Sol-Gel-Derived Silica Hybrid Scaffolds with Drug Releasing Function for Bone Tissue Engineering Applications

Electrospun hybrid scaffolds are an effective platform to deliver drugs site specifically for the prevention and treatment of diseases in addition to promote tissue regeneration because of the flexibility to load drugs therein. In the present study, electrospun hybrid scaffolds containing antibiotics were developed to support cellular activities and eliminate potential postoperative inflammation and infection. As a model drug, levofloxacin (LFX) was successfully incorporated into pure polyhydroxybutyrate/poly(ε-caprolactone) (PHB/PCL) scaffolds and PHB/PCL/sol-gel-derived silica (SGS) scaffolds. The influence of LFX on the morphology, mechanical performance, chemical structure, drug release profile, and antibacterial effect of the scaffolds was thoroughly and comparatively investigated. MG-63 osteoblast-like cell cultivation on both scaffolds certified that LFX inclusion did not impair the biocompatibility. In addition to the favorable cellular proliferation and differentiation, scaffolds containing both LFX and SGS displayed highly increased mineralization content. Therefore, the present multifunctional hybrid scaffolds are promising in tissue engineering applications.

Hybrid polycaprolactone/polyethylene oxide scaffolds with tunable fiber surface morphology, improved hydrophilicity and biodegradability for bone tissue engineering applications

In the present study, we attempt to modify Polycaprolactone (PCL) by blending it with a water soluble polymer Polyethyleneoxide (PEO) having two different molecular weights (Mv ~1,00,000 and 6,00,000) using electrospinning technique. The effect of PEO molecular weight and blend ratio on fiber morphology, porosity, surface wettability, static and dynamic mechanical properties of PCL was investigated. In vitro degradation studies in phosphate buffer saline (PBS) at 37 °C demonstrated formation of pores on fiber surface especially in blend scaffolds with 50:50 ratios. In vitro studies using human osteoblast sarcoma (hOS) cell lines on blend scaffolds showed improved cellular response with good cell adhesion, viability and proliferation. The study revealed that incorporation of PEO on PCL scaffolds complemented the properties of PCL and facilitated fabrication of scaffolds with improved hydrophilicity, mechanical property and tunable degradation profile with better cell viability which makes it an ideal candidate for bone tissue engineering applications.

Electrospun and Electrosprayed Scaffolds for Tissue Engineering

Electrospinning and electrospraying technologies provide an accessible and universal synthesis method for the continuous preparation of nanostructured materials. This chapter introduces recent uses of electrospun and electrosprayed scaffolds for tissue regeneration applications. More recent in vitro and in vivo of electrospun fibers are also discussed in relation to soft and hard tissue engineering applications. The focus is made on the bone, vascular, skin, neural and soft tissue regeneration. An introduction is presented regarding the production of biomaterials made by synthetic and natural polymers and inorganic and metallic materials for use in the production of scaffolds for regenerative medicine. For this proposal, the following techniques are discussed: electrospraying, co-axial and emulsion electrospinning and bio-electrospraying. Tissue engineering is an exciting and rapidly developing field for the understanding of how to regenerate the human body.

Silk scaffolds in bone tissue engineering: An overview

Bone tissue plays multiple roles in our day-to-day functionality. The frequency of accidental bone damage and disorder is increasing worldwide. Moreover, as the world population continues to grow, the percentage of the elderly population continues to grow, which results in an increased number of bone degenerative diseases. This increased elderly population pushes the need for artificial bone implants that specifically employ biocompatible materials. A vast body of literature is available on the use of silk in bone tissue engineering. The current work presents an overview of this literature from materials and fabrication perspective. As silk is an easy-to-process biopolymer; this allows silk-based biomaterials to be molded into diverse forms and architectures, which further affects the degradability. This makes silk-based scaffolds suitable for treating a variety of bone reconstruction and regeneration objectives. Silk surfaces offer active sites that aid the mineralization and/or bonding of bioactive molecules that facilitate bone regeneration. Silk has also been blended with a variety of polymers and minerals to enhance its advantageous properties or introduce new ones. Several successful works, both in vitro and in vivo, have been reported using silk-based scaffolds to regenerate bone tissues or other parts of the skeletal system such as cartilage and ligament. A growing trend is observed toward the use of mineralized and nanofibrous scaffolds along with the development of technology that allows to control scaffold architecture, its biodegradability and the sustained releasing property of scaffolds. Further development of silk-based scaffolds for bone tissue engineering, taking them up to and beyond the stage of human trials, is hoped to be achieved in the near future through a cross-disciplinary coalition of tissue engineers, material scientists and manufacturing engineers.

STATEMENT OF SIGNIFICANCE

The state-of-art of silk biomaterials in bone tissue engineering, covering their wide applications as cell scaffolding matrices to micro-nano carriers for delivering bone growth factors and therapeutic molecules to diseased or damaged sites to facilitate bone regeneration, is emphasized here. The review rationalizes that the choice of silk protein as a biomaterial is not only because of its natural polymeric nature, mechanical robustness, flexibility and wide range of cell compatibility but also because of its ability to template the growth of hydroxyapatite, the chief inorganic component of bone mineral matrix, resulting in improved osteointegration. The discussion extends to the role of inorganic ions such as Si and Ca as matrix components in combination with silk to influence bone regrowth. The effect of ions or growth factor-loaded vehicle incorporation into regenerative matrix, nanotopography is also considered.

An update on the Application of Nanotechnology in Bone Tissue Engineering

Background:

Natural bone is a complex and hierarchical structure. Bone possesses an extracellular matrix that has a precise nano-sized environment to encourage osteoblasts to lay down bone by directing them through physical and chemical cues. For bone tissue regeneration, it is crucial for the scaffolds to mimic the native bone structure. Nanomaterials, with features on the nanoscale have shown the ability to provide the appropriate matrix environment to guide cell adhesion, migration and differentiation.

Methods:

This review summarises the new developments in bone tissue engineering using nanobiomaterials. The design and selection of fabrication methods and biomaterial types for bone tissue engineering will be reviewed. The interactions of cells with different nanostructured scaffolds will be discussed including nanocomposites, nanofibres and nanoparticles.

Results:

Several composite nanomaterials have been able to mimic the architecture of natural bone. Bioceramics biomaterials have shown to be very useful biomaterials for bone tissue engineering as they have osteoconductive and osteoinductive properties. Nanofibrous scaffolds have the ability to provide the appropriate matrix environment as they can mimic the extracellular matrix structure of bone. Nanoparticles have been used to deliver bioactive molecules and label and track stem cells.

Conclusion:

Future studies to improve the application of nanomaterials for bone tissue engineering are needed.

Composite poly(l-lactic-acid)/silk fibroin scaffold prepared by electrospinning promotes chondrogenesis for cartilage tissue engineering

Nanofibrous materials produced by electrospinning have attracted considerable attention from researchers in regenerative medicine. A combination of nanofibrous scaffold and chondrocytes is considered promising for repair of cartilage defect or damage. In the present study, we fabricated a poly(l-lactic-acid) (PLLA)/silk fibroin (SF) nanofibrous scaffold by electrospinning and evaluated its chondrogenic potential. The PLLA/SF nanofibers were characterized for diameter, surface wettability, swelling ratio, and tensile strength. Throughin vitroexperiments, PLLA/SF scaffold-chondrocyte interactions were investigated relative to the unmodified PLLA scaffold with regard to cellular adhesion, spreading, and proliferation by scanning electron microscopy and confocal laser scanning microscopy, and through analyses of DNA, sulfated glycosaminoglycan, and collagen. In addition, hematoxylin-eosin and Alcian blue-nuclear fast red staining were used to observe growth of chondrocytes, and secretion and distribution of cartilage-specific extracellular matrices in the scaffolds. Expressions of cartilage-related genes (collagen II, aggrecan, sox9, collagen I, and collagen X) were detected by real-time quantitative PCR. The PLLA/SF scaffold had better hydrophilicity, and could support chondrocytes adhesion and spreading more effectively than the unmodified PLLA scaffold. Chondrocytes secreted more cartilage-specific extracellular matrices and maintained their phenotype on the PLLA/SF scaffold. So it is concluded that the PLLA/SF scaffold is more conducive toin vitroformation of cartilage-like new tissues than the unmodified PLLA scaffold, and may be a promising material in cartilage tissue engineering.

Bioactivity assessment of PLLA/PCL/HAP electrospun nanofibrous scaffolds for bone tissue engineering

AIMS

The purpose of this paper was to fabricate PLLA/PCL nanofibrous scaffolds containing HAP to mimic the native bone extracellular matrix for potential applications as bone tissue engineering scaffolds materials and ultimately to help the repairing of bone defects.

MATERIALS AND METHODS

PLLA (MW 200kDa), PCL (MW 80kDa), HAP, dichloromethane, N,N-dimethylformamide; α-MEM, FBS, trypsin-EDTA, penicillin G, streptomycin, β-sodium glycerophosphate, l-ascorbic acid, dexamethasone; CCK-8, Alkaline Phosphatase Assay Kit, Mouse Osteocalcin ELISA Kit, MC3T3-E1 cells. PLLA, PCL and HAP were dissolved in the solution of DCM and DMF to fabricate nanofibrous scaffolds through electrospinning. The morphology of the scaffolds was investigated with SEM, while the diameter of the fibers, pore size and water uptake of the scaffolds were tested, respectively. TGA was carried out to verify the percentage of HAP in the composite scaffolds fabricated with different HAP concentrations. Cell count kit-8 assay, alkaline phosphatase (ALP) assay, and osteocalcin assay were applied to observe the MC3T3-E1 cells proliferation, differentiation on the composite scaffolds.

KEY FINDINGS

MC3T3-E1 cells were found to grow actively on the composite scaffolds based on the results of CCK-8 assay. The level of MC3T3-E1 differentiation was evaluated through the ALP activity and osteocalcin concentration, which showed higher value with HAP containing (PLLA/PCL/HAP) than that ones without (PLLA/PCL).

SIGNIFICANCE

The results demonstrated that the biocomposite PLLA/PCL/HAP nanofibrous scaffold should be a promising candidate for proliferation, differentiation and mineralization of osteoblasts, and potentially can be used for bone tissue regeneration.

Emerging chitin and chitosan nanofibrous materials for biomedical applications

Over the past several decades, we have witnessed significant progress in chitosan and chitin based nanostructured materials. The nanofibers from chitin and chitosan with appealing physical and biological features have attracted intense attention due to their excellent biological properties related to biodegradability, biocompatibility, antibacterial activity, low immunogenicity and wound healing capacity. Various methods, such as electrospinning, self-assembly, phase separation, mechanical treatment, printing, ultrasonication and chemical treatment were employed to prepare chitin and chitosan nanofibers. These nanofibrous materials have tremendous potential to be used as drug delivery systems, tissue engineering scaffolds, wound dressing materials, antimicrobial agents, and biosensors. This review article discusses the most recent progress in the preparation and application of chitin and chitosan based nanofibrous materials in biomedical fields.

Bone regenerative medicine: classic options, novel strategies, and future directions

This review analyzes the literature of bone grafts and introduces tissue engineering as a strategy in this field of orthopedic surgery. We evaluated articles concerning bone grafts; analyzed characteristics, advantages, and limitations of the grafts; and provided explanations about bone-tissue engineering technologies. Many bone grafting materials are available to enhance bone healing and regeneration, from bone autografts to graft substitutes; they can be used alone or in combination. Autografts are the gold standard for this purpose, since they provide osteogenic cells, osteoinductive growth factors, and an osteoconductive scaffold, all essential for new bone growth. Autografts carry the limitations of morbidity at the harvesting site and limited availability. Allografts and xenografts carry the risk of disease transmission and rejection. Tissue engineering is a new and developing option that had been introduced to reduce limitations of bone grafts and improve the healing processes of the bone fractures and defects. The combined use of scaffolds, healing promoting factors, together with gene therapy, and, more recently, three-dimensional printing of tissue-engineered constructs may open new insights in the near future.

Bone regenerative medicine: classic options, novel strategies, and future directions

This review analyzes the literature of bone grafts and introduces tissue engineering as a strategy in this field of orthopedic surgery. We evaluated articles concerning bone grafts; analyzed characteristics, advantages, and limitations of the grafts; and provided explanations about bone-tissue engineering technologies. Many bone grafting materials are available to enhance bone healing and regeneration, from bone autografts to graft substitutes; they can be used alone or in combination. Autografts are the gold standard for this purpose, since they provide osteogenic cells, osteoinductive growth factors, and an osteoconductive scaffold, all essential for new bone growth. Autografts carry the limitations of morbidity at the harvesting site and limited availability. Allografts and xenografts carry the risk of disease transmission and rejection. Tissue engineering is a new and developing option that had been introduced to reduce limitations of bone grafts and improve the healing processes of the bone fractures and defects. The combined use of scaffolds, healing promoting factors, together with gene therapy, and, more recently, three-dimensional printing of tissue-engineered constructs may open new insights in the near future.

Mineralization and Characterization of Composite Lyophilized Gelatin Sponges Intended for Early Bone Regeneration

The application of freeze-dried gelatin sponges as alternative bone grafting substitutes has many advantages, including the ability to swell, high porosity, tailorable degradation, and versatility to incorporate multiple components such as growth factors and nanofillers. The purpose of this study was to mineralize (M) and further characterize 1-Ethyl-3-[3-dimethylaminopropyl]carbodiimide hydrochloride (EDC) cross-linked gelatin sponges enhanced with preparations rich in growth factors, hydroxyapatite, and chitin whiskers (PHCE). Sponges were characterized for their swelling and in vitro mineralization potential, surface characteristics, protein release, mechanical properties, and MG-63 cell attachment and infiltration. All sponges swelled up to 50% of their original volume upon hydration. Scanning electron microscopy showed sparse mineral deposition for gelatin-M scaffolds while PHCE-M scaffolds exhibited more uniform mineral nucleation. Over 21 days, PHCE-M scaffolds cumulatively released significantly more (30%) of its initial protein content than all other scaffolds. PHCE-M scaffolds reported lower modulus values (1.3-1.6 MPa) when compared to gelatin control scaffolds (1.6-3.2 MPa). Increased cell attachment and infiltration was noticed on PHCE and PHCE-M scaffolds. The results of the study demonstrate the enhanced performance of PHCE and PHCE-M scaffolds to serve as bone healing scaffolds. Their potential to release incorporated factors, comparable composition/mechanical properties to tissues developed in the early stages of bone healing, and enhanced initial cellular response make them suitable for further studies evaluating more complex cellular interactions.

Advancements in electrospinning of polymeric nanofibrous scaffolds for tissue engineering

Polymeric nanofibers have potential as tissue engineering scaffolds, as they mimic the nanoscale properties and structural characteristics of native extracellular matrix (ECM). Nanofibers composed of natural and synthetic polymers, biomimetic composites, ceramics, and metals have been fabricated by electrospinning for various tissue engineering applications. The inherent advantages of electrospinning nanofibers include the generation of substrata with high surface area-to-volume ratios, the capacity to precisely control material and mechanical properties, and a tendency for cellular in-growth due to interconnectivity within the pores. Furthermore, the electrospinning process affords the opportunity to engineer scaffolds with micro- to nanoscale topography similar to the natural ECM. This review describes the fundamental aspects of the electrospinning process when applied to spinnable natural and synthetic polymers; particularly, those parameters that influence fiber geometry, morphology, mesh porosity, and scaffold mechanical properties. We describe cellular responses to fiber morphology achieved by varying processing parameters and highlight successful applications of electrospun nanofibrous scaffolds when used to tissue engineer bone, skin, and vascular grafts.

The transpedicular approach for the study of intervertebral disc regeneration strategies: in vivo characterization

PURPOSE

To characterize in vivo the transpedicular approach (TA) as an alternative route to study intervertebral disc (IVD) regeneration strategies in a sheep model.

METHODS

48 IVD of 12 sheep were used. TA was performed under fluoroscopy, followed by nucleotomy (2-mm shaver resector). A polyurethane scaffold was used to repair the end-plate. X-ray and MRI images were acquired pre-, intra- and post-operatively (1, 3, 6 months). Complications were recorded.

RESULTS

TA was feasible in all animals; nucleus pulposus (NP) from L1 to L5 was accessible. Nucleotomy followed by end-plate repair was achieved. Loss of NP signal intensity was shown in MRI images of the nucleotomy group.

CONCLUSIONS

TA is feasible in vivo, repeatable after only a short learning period and safely performed without significant morbidity. This animal model allows the study of IVD degeneration physiopathology and investigation of IVD regeneration techniques in vivo.

Recent developments of functional scaffolds for craniomaxillofacial bone tissue engineering applications

Autogenous bone grafting remains a gold standard for the reconstruction critical-sized bone defects in the craniomaxillofacial region. Nevertheless, this graft procedure has several disadvantages such as restricted availability, donor-site morbidity, and limitations in regard to fully restoring the complicated three-dimensional structures in the craniomaxillofacial bone. The ultimate goal of craniomaxillofacial bone reconstruction is the regeneration of the physiological bone that simultaneously fulfills both morphological and functional restorations. Developments of tissue engineering in the last two decades have brought such a goal closer to reality. In bone tissue engineering, the scaffolds are fundamental, elemental and mesenchymal stem cells/osteoprogenitor cells and bioactive factors. A variety of scaffolds have been developed and used as spacemakers, biodegradable bone substitutes for transplanting to the new bone, matrices of drug delivery system, or supporting structures enhancing adhesion, proliferation, and matrix production of seeded cells according to the circumstances of the bone defects. However, scaffolds to be clinically completely satisfied have not been developed yet. Development of more functional scaffolds is required to be applied widely to cranio-maxillofacial bone defects. This paper reviews recent trends of scaffolds for crania-maxillofacial bone tissue engineering, including our studies.

Electrospun fibers as a scaffolding platform for bone tissue repair

The purpose of the study is to investigate the effects of electrospun fiber diameter and orientation on differentiation and ECM organization of bone marrow stromal cells (BMSCs), in attempt to provide rationale for fabrication of a periosteum mimetic for bone defect repair. Cellular growth, differentiation, and ECM organization were analyzed on PLGA-based random and aligned fibers using fluorescent microscopy, gene analyses, electron scanning microscopy (SEM), and multiphoton laser scanning microscopy (MPLSM). BMSCs on aligned fibers had a reduced number of ALP+ colony at Day 10 as compared to the random fibers of the same size. However, the ALP+ area in the aligned fibers increased to a similar level as the random fibers at Day 21 following stimulation with osteogenic media. Compared with the random fibers, BMSCs on the aligned fibers showed a higher expression of OSX and RUNX2. Analyses of ECM on decellularized spun fibers showed highly organized ECM arranged according to the orientation of the spun fibers, with a broad size distribution of collagen fibers in a range of 40-2.4 μm. Taken together, our data support the use of submicron-sized electrospun fibers for engineering of oriented fibrous tissue mimetic, such as periosteum, for guided bone repair and reconstruction.

One-step arthroscopic technique for the treatment of osteochondral lesions of the knee with bone-marrow-derived cells: three years results

Osteochondral lesions of the knee (OLK) are a common cause of knee pain and associated diseases. A new bone-marrow-derived mesenchymal stem cells technique has been developed for the treatment of OLK. 30 patients with OLK underwent arthroscopic one-step procedure. The bone marrow was harvested from the patients' posterior iliac crest and arthroscopically implanted with a scaffold into the lesion site. Clinical inspection and MRI were performed. Mean International Knee Documentation Committee (IKDC) score before surgery was 29.9 ± 13.2 and 85.4 ± 4.2 at 29 ± 4.1 months (p < 0.0005), while Knee injury and Osteoarthritis Outcome Score (KOOS) before surgery was 35.1 ± 11.9 and 87.3 ± 7.3 at 29 ± 4.1 months (p < 0.0005). Control MRI and bioptic samples showed an osteochondral regeneration of the lesion site. The one-step technique appears to be a good and reliable option for treatment of OLK at three years of follow-up. Level of evidence Case series, Level IV.

A novel porous scaffold fabrication technique for epithelial and endothelial tissue engineering

Porous scaffolds have the ability to minimize transport barriers for both two- (2D) and three-dimensional tissue engineering. However, current porous scaffolds may be non-ideal for 2D tissues such as epithelium due to inherent fabrication-based characteristics. While 2D tissues require porosity to support molecular transport, pores must be small enough to prevent cell migration into the scaffold in order to avoid non-epithelial tissue architecture and compromised function. Though electrospun meshes are the most popular porous scaffolds used today, their heterogeneous pore size and intense topography may be poorly-suited for epithelium. Porous scaffolds produced using other methods have similar unavoidable limitations, frequently involving insufficient pore resolution and control, which make them incompatible with 2D tissues. In addition, many of these techniques require an entirely new round of process development in order to change material or pore size. Herein we describe "pore casting," a fabrication method that produces flat scaffolds with deterministic pore shape, size, and location that can be easily altered to accommodate new materials or pore dimensions. As proof-of-concept, pore-cast poly(ε-caprolactone) (PCL) scaffolds were fabricated and compared to electrospun PCL in vitro using canine kidney epithelium, human colon epithelium, and human umbilical vein endothelium. All cell types demonstrated improved morphology and function on pore-cast scaffolds, likely due to reduced topography and universally small pore size. These results suggest that pore casting is an attractive option for creating 2D tissue engineering scaffolds, especially when the application may benefit from well-controlled pore size or architecture.

Electrospinning of PCL/PVP blends for tissue engineering scaffolds

Currently, one of the main drawbacks of using poly(ε-caprolactone) in the biomedical and pharmaceutical fields is represented by its low biodegradation rate. To overcome this limitation, electrospinning of PCL blended with a water-soluble poly(N-vinyl-2-pyrrolidone) was used to fabricate scaffolds with tunable fiber surface morphology and controllable degradation rates. Electrospun scaffolds revealed a highly immiscible blend state. The incorporated PVP phase was dispersed as inclusions within the electrospun fibers, and then easily extracted by immersing them in cell culture medium, exhibiting nanoporosity on the fiber surface. As a striking result, nanoporosity facilitated not only fiber biodegradation rates, but also improved cell attachment and spreading on the blend electrospun scaffolds. The present findings demonstrate that simultaneous electrospinning technique for PCL with water-soluble PVP provides important insights for successful tuning biodegradation rate for the PCL electrospun scaffolds but not limited to expand other high valuable biocompatible polymers for the future biomedical applications, ranging from tissue regeneration to controlled drug delivery.

Craniofacial bone tissue engineering

There are numerous conditions, such as trauma, cancer, congenital malformations, and progressive deforming skeletal diseases, that can compromise the function and architectonics of bones of craniofacial region. The need to develop new approaches for treatment of these disorders arises from the fact that conventional therapeutic strategies face many obstacles and limitations. The use of tissue engineering in regeneration of craniofacial bone structures is a very promising possibility and a great challenge for researchers and practitioners. Developments in stem cell biology and engineering have led to the discovery of different stem cell populations and biodegradable materials with suitable properties. This review summarizes the current achievements in tissue engineering of craniofacial bone, temporomandibular joint, and periodontal ligament.

Delivery of platelet-derived growth factor as a chemotactic factor for mesenchymal stem cells by bone-mimetic electrospun scaffolds

The recruitment of mesenchymal stem cells (MSCs) is a vital step in the bone healing process, and hence the functionalization of osteogenic biomaterials with chemotactic factors constitutes an important effort in the tissue engineering field. Previously we determined that bone-mimetic electrospun scaffolds composed of polycaprolactone, collagen I and nanohydroxyapatite (PCL/col/HA) supported greater MSC adhesion, proliferation and activation of integrin-related signaling cascades than scaffolds composed of PCL or collagen I alone. In the current study we investigated the capacity of bone-mimetic scaffolds to serve as carriers for delivery of an MSC chemotactic factor. In initial studies, we compared MSC chemotaxis toward a variety of molecules including PDGF-AB, PDGF-BB, BMP2, and a mixture of the chemokines SDF-1α, CXCL16, MIP-1α, MIP-1β, and RANTES. Transwell migration assays indicated that, of these factors, PDGF-BB was the most effective in stimulating MSC migration. We next evaluated the capacity of PCL/col/HA scaffolds, compared with PCL scaffolds, to adsorb and release PDGF-BB. We found that significantly more PDGF- BB was adsorbed to, and subsequently released from, PCL/col/HA scaffolds, with sustained release extending over an 8-week interval. The PDGF-BB released was chemotactically active in transwell migration assays, indicating that bioactivity was not diminished by adsorption to the biomaterial. Complementing these studies, we developed a new type of migration assay in which the PDGF-BB-coated bone-mimetic substrates were placed 1.5 cm away from the cell migration front. These experiments confirmed the ability of PDGF-BB-coated PCL/col/HA scaffolds to induce significant MSC chemotaxis under more stringent conditions than standard types of migration assays. Our collective results substantiate the efficacy of PDGF-BB in stimulating MSC recruitment, and further show that the incorporation of native bone molecules, collagen I and nanoHA, into electrospun scaffolds not only enhances MSC adhesion and proliferation, but also increases the amount of PDGF-BB that can be delivered from scaffolds.

New approach to bone tissue engineering: simultaneous application of hydroxyapatite and bioactive glass coated on a poly(L-lactic acid) scaffold

A combination of bioceramics and polymeric nanofibers holds promising potential for bone tissue engineering applications. In the present study, hydroxyapatite (HA), bioactive glass (BG), and tricalcium phosphate (TCP) particles were coated on the surface of electrospun poly(L-lactic acid) (PLLA) nanofibers, and the capacity of the PLLA, BG-PLLA, HA-PLLA, HA-BG-PLLA, and TCP-PLLA scaffolds for bone regeneration was investigated in rat critical-size defects using digital mammography, multislice spiral-computed tomography (MSCT) imaging, and histological analysis. Electrospun scaffolds exhibited a nanofibrous structure with a homogeneous distribution of bioceramics along the surface of PLLA nanofibers. A total of 8 weeks after implantation, no sign of complication or inflammation was observed at the site of the calvarial bone defect. On the basis of imaging analysis, a higher level of bone reconstruction was observed in the animals receiving HA-, BG-, and TCP-coated scaffolds compared to an untreated control group. In addition, simultaneous coating of HA and BG induced the highest regeneration among all groups. Histological staining confirmed these findings and also showed an efficient osseointegration in HA-BG-coated nanofibers. On the whole, it was demonstrated that nanofibrous structures could serve as an appropriate support to guide the healing process, and coating their surface with bioceramics enhanced bone reconstruction. These bioceramic-coated scaffolds can be used as new bone-graft substitutes capable of efficiently inducing osteoconduction and osseointegration in orthopedic fractures and defects.