In vivo biocompatibility of collagen-poly(hydroxyethyl methacrylate) hydrogels

Influence of High Strain Dynamic Loading on HEMA-DMAEMA Hydrogel Storage Modulus and Time Dependence

Hydrogels have been extensively studied for biomedical applications such as drug delivery, tissue-engineered scaffolds, and biosensors. There is a gap in the literature pertaining to the mechanical properties of hydrogel materials subjected to high-strain dynamic-loading conditions even though empirical data of this type are needed to advance the design of innovative biomedical designs and inform numerical models. For this work, HEMA-DMAEMA hydrogels are fabricated using a photopolymerization approach. Hydrogels are subjected to high-compression oscillatory dynamic mechanical loading at strain rates equal to 50%, 60%, and 70%, and storage and loss moduli are observed over time, e.g., 72 h and 5, 10, and 15 days. As expected, the increased strains resulted in lower storage and loss moduli, which could be attributed to a breakdown in the hydrogel network attributed to several mechanisms, e.g., increased network disruption, chain scission or slippage, and partial plastic deformation. This study helps to advance our understanding of hydrogels subjected to high strain rates to understand their viscoelastic behavior, i.e., strain rate sensitivity, energy dissipation mechanisms, and deformation kinetics, which are needed for the accurate modeling and prediction of hydrogel behavior in real-world applications.

Mevacor/Poly(vinyl acetate/2-hydroxyethyl methacrylate) as Solid Solution: Preparation, Solubility Enhancement and Drug Delivery

Mevacor/Poly(vinyl acetate-co-2-hydroxyethyl methacrylate) drug carrier systems (MVR/VAC-HEMA) containing different Mevacor (MVR) contents were prepared in one pot by free radical copolymerization of vinyl acetate with 2-hydroxyethyl methacrylate using an LED lamp light in the presence of camphorquinone as a photoinitiator and Mevacor as a drug filler. The prepared material was characterized by FTIR, 1H NMR, DSC, SEM and XRD methods. Different parameters influencing the efficiency in the Mecvacor-water solubility and the drug delivery of this system, such as the swelling capacity of the carrier, the amount of Mevacor loaded and the pH medium have been widely investigated. The results obtained revealed that the Mevacor particles were uniformly dispersed in their molecular state in the copolymer matrix forming a solid solution; the cell toxicity of the virgin poly(vinyl acetate-co-2-hydroxy ethyl methacrylate) (VAC-HEMA) and MVR/VAC-HEMA drug carrier system exhibited no significant effect on their viability when between 0.25 and 2.00 wt% was loaded in these materials; the average swelling capacity of VAC-HEMA material in water was found to be 45.16 wt%, which was practically unaffected by the pH medium and the solubility of MVR deduced from the release process reached more than 22 and 37 times that of the powder dissolved directly in pH 1 and 7 media, respectively. The in vitro MVR release kinetic study revealed that the MVR/VAC-HEMA system containing 0.5 wt% MVR exhibited the best performance in the short gastrointestinal transit (GITT), while that containing 2.0 wt% is for the long transit as they were able to considerably reduce the minimum release of this drug in the stomach (pH1).

No association found between late-onset inflammatory adverse events after soft tissue filler injections and the adaptive immune system

BACKGROUND

To date, it is unknown why some individuals develop late-onset inflammatory adverse events after treatment with fillers. These events may result from various factors, including an immunological response of the adaptive immune system.

OBJECTIVE

In a pilot study, we looked for evidence that is there a relation between late-onset inflammatory adverse events and the presence of immune cells surrounding the injected filler.

METHODS AND MATERIALS

We included 47 patients, of whom 20 experienced late-onset inflammatory adverse events to different fillers (inflammatory group) and 27 who did not (reference group). A biopsy was taken from the area of the adverse event. Hematoxylin-eosin staining and immunohistochemistry analysis with CD3 (T-cells) and CD68 (macrophages) on paraffin tissue sections was used to assess the biopsies.

RESULTS

Immune cells were found in biopsies obtained from 18 of 47 patients: Nine biopsies from the inflammation group and nine from the reference group. All these 18 cases showed CD68-positive immune cells. Virtually no CD3-positive immune cells were found.

CONCLUSION

Our results indicate that there is no T-cell activity in biopsies from areas with late-onset adverse events after filler injections. The macrophages found in the biopsies are probably not responsible for the inflammatory response.

Adjustable biodegradability of low-swelling hydrogels prepared from recombinant peptides based on human collagen type 1

An ideal hydrogel for tissue engineering and regenerative therapy is cytocompatible, biocompatible, and has low-swelling characteristics. Recently, a novel low-swelling hydrogel with a homogenous structure was developed by crosslinking a recombinant peptide, modeled on human collagen type 1 (RCPhC1), with a four-arm polyethylene glycol (tetra-PEG). Here, we hypothesized that the biodegradability of the RCPhC1 hydrogel was adjustable by altering its initial polymer concentration. Three types of RCPhC1 hydrogels were prepared using the initial polymer at different concentrations, and their morphology, swelling ratio, collagenase degradability, cytocompatibility, biocompatibility, and biodegradability were compared. The results revealed a low swelling ratio. The higher the concentration of the initial polymer, the longer it took for it to be degraded by collagenase. The average cell viability ratio was over 92% when using the direct contact method, which suggests that the hydrogels have excellent cytocompatibility. No death, tumorigenesis, exposure of the implants, or skin necrosis associated with the subcutaneous implantation of the hydrogels was found in mice in vivo. Moreover, histological evaluation revealed the formation of a thin fibrous capsule, which suggests an acceptable biocompatibility. Furthermore, as hypothesized, it was confirmed that the biodegradability can be adjusted by changing the initial polymer concentration. Collectively, the ability to fine-tune the biodegradability of RCPhC1 hydrogels demonstrates their potential for use in various clinical applications.

NANOCOMPOSITES BASED ON SINGLECOMPONENT AND MULTICOMPONENT POLYMER MATRICES FOR BIOMEDICAL APPLICATIONS

The review is devoted to analysis of the publications in the area of polymers of biomedical applications. Different types of the polymer matrices for drug delivery are analyzed, including polyurethanes, hydroxyacrylates, and multicomponent polymer matrices, which created by method of interpenetrating polymer networks. Particular attention is paid to description of synthesized and investigated nanocomposites based on polyurethane / poly (2-hydroxyethyl methacrylate) polymer matrix and nanooxides modified by biologically active compounds.

Polyethylene terephthalate textile heart valve: How poly(ethylene glycol) grafting limits fibrosis

Transcatheter aortic valve replacement (TAVR) is an alternative technique to surgical valve replacement for over 300,000 patients worldwide. The valve material used in the TAVR is made of biological tissues, whose durability remains unknown. The success of the TAVR favors the research toward synthetic valve leaflet materials as an alternative to biological tissues. In particular, polyethylene terephthalate (PET) textile valves have recently proven durability over a 6-month period in animal sheep models. Excessive fibrotic tissue formation remains, however, a critical issue to be addressed. The aim of this work was therefore to investigate the potential of PET textiles covalently conjugated with polyethylene glycol (PEG), known for its antifouling properties, to modulate the fibrosis formation both in vitro and in vivo. For this purpose, the surfaces of heart valves made of PET textiles were functionalized with an atmospheric pressure plasma, leading to the formation of carboxylic acid (COOH) groups, further used for PEG-NH₂ conjugation. Surface modification efficiency was assessed by X-ray photoelectron spectroscopy and water contact angle measurements. The biological behavior of the as-modified surfaces was evaluated by in vitro assays, using rat cardiac fibroblast cells. The results show that PEG treated substrates restrained the fibroblasts adhesion and proliferation. The PEG treated valve, implanted in a juvenile sheep model, showed a significant fibrosis reduction. The explant also revealed calcification issues that need to be addressed.

Phenylalanine-Tethered pH-Responsive Poly(2-Hydroxyethyl Methacrylate)

A series of pH-responsive random copolymers comprised of 2-hydroxyethyl methacrylate (HEMA) and tert-butyl carbamate (Boc)-protected phenylalanine methacryloyloxyethyl ester (Boc-Phe-EMA) were synthesized via reversible addition-fragmentation chain transfer (RAFT) polymerization in N,N'-dimethylformamide (DMF) at 70 °C. The synthesized copolymers were comprehensively characterized using a combination of techniques, including ¹ H NMR, FT-IR spectroscopy and size exclusion chromatography (SEC). Reactivity of each monomers towards controlled radical polymerization was evaluated by determining the reactivity ratios by virtue of extended Kelen-Tüdös method at high conversions revealed the higher reactivity of non-modified HEMA (r_HEMA =1.03) in contrast to Boc-Phe-EMA (r_Boc-Phe-EMA =0.48). Furthermore, the expulsion of the Boc-groups resulted copolymers with ionizable pendant primary ammonium and hydroxyl groups. To understand the glass transition behaviours of homo- and co-polymers, differential scanning calorimetric (DSC) measurements were carried out. The effect of HEMA content on the pH-sensitivity of the copolymers in aqueous medium was investigated through turbidity measurements. Finally, the counteranion exchange from trifluoroacetate to chloride provided copolymers with enhanced water solubility and unaltered phase transition pH.

Polymer microcapsules and microbeads as cell carriers for in vivo biomedical applications

Polymer microcarriers are being extensively explored as cell delivery vehicles in cell-based therapies and hybrid tissue and organ engineering. Spherical microcarriers are of particular interest due to easy fabrication and injectability. They include microbeads, composed of a porous matrix, and microcapsules, where matrix core is additionally covered with a semipermeable membrane. Microcarriers provide cell containment at implantation site and protect the cells from host immunoresponse, degradation and shear stress. Immobilized cells may be genetically altered to release a specific therapeutic product directly at the target site, eliminating side effects of systemic therapies. Cell microcarriers need to fulfil a number of extremely high standards regarding their biocompatibility, cytocompatibility, immunoisolating capacity, transport, mechanical and chemical properties. To obtain cell microcarriers of specified parameters, a wide variety of polymers, both natural and synthetic, and immobilization methods can be applied. Yet so far, only a few approaches based on cell-laden microcarriers have reached clinical trials. The main issue that still impedes progress of these systems towards clinical application is limited cell survival in vivo. Herein, we review polymer biomaterials and methods used for fabrication of cell microcarriers for in vivo biomedical applications. We describe their key limitations and modifications aiming at improvement of microcarrier in vivo performance. We also present the main applications of polymer cell microcarriers in regenerative medicine, pancreatic islet and hepatocyte transplantation and in the treatment of cancer. Lastly, we outline the main challenges in cell microimmobilization for biomedical purposes, the strategies to overcome these issues and potential future improvements in this area.

Effect of bFGF and fibroblasts combined with hyaluronic acid-based hydrogels on soft tissue augmentation: an experimental study in rats

Background

Hyaluronic acid (HA) has been applied as a primary biomaterial for temporary soft tissue augmentation and as a carrier for cells and the delivery of growth factors to promote tissue regeneration. Although HA derivatives are the most versatile soft tissue fillers on the market, they are resorbed early, within 3 to 12 months. To overcome their short duration, they can be combined with cells or growth factors. The purpose of this study was to investigate the stimulating effects of human fibroblasts and basic fibroblast growth factors (bFGF) on collagen synthesis during soft tissue augmentation by HA hydrogels and to compare these with the effects of a commercial HA derivative (Restylane®).

Methods

The hydrogel group included four conditions. The first condition consisted of hydrogel (H) alone as a negative control, and the other three conditions were bFGF-containing hydrogel (HB), human fibroblast-containing hydrogel (HF), and human fibroblast/bFGF-containing hydrogel (HBF). In the Restylane® group (HGF), the hydrogel was replaced with Restylane® (R, RB, RF, RBF). The gels were implanted subdermally into the back of each nude mouse at four separate sites. Twelve nude mice were used for the hydrogel (n = 6) and Restylane® groups (n = 6). The specimens were harvested 8 weeks after implantation and assessed histomorphometrically, and collagen synthesis was evaluated by RT-PCR.

Results

The hydrogel group showed good biocompatibility with the surrounding tissues and stimulated the formation of a fibrous matrix. HBF and HF showed significantly higher soft tissue synthesis compared to H (p < 0.05), and human collagen type I was well expressed in HB, HF, and HBF; HBF showed the strongest expression. The Restylane® filler was surrounded by a fibrous capsule without any soft tissue infiltration from the neighboring tissue, and collagen synthesis within the Restylane® filler could not be observed, even though no inflammatory reactions were observed.

Conclusion

This study revealed that HA-based hydrogel alone or hydrogel combined with fibroblasts and/or bFGF can be effectively used for soft tissue augmentation.

Therapeutic Contact Lenses with Polymeric Vehicles for Ocular Drug Delivery: A Review

The eye has many barriers with specific anatomies that make it difficult to deliver drugs to targeted ocular tissues, and topical administration using eye drops or ointments usually needs multiple instillations to maintain the drugs’ therapeutic concentration because of their low bioavailability. A drug-eluting contact lens is one of the more promising platforms for controllable ocular drug delivery, and, among various manufacturing methods for drug-eluting contact lenses, incorporation of novel polymeric vehicles with versatile features makes it possible to deliver the drugs in a sustained and extended manner. Using the diverse physicochemical properties of polymers for nanoparticles or implants that are selected according to the characteristics of drugs, enhancement of encapsulation efficiency and prolonged drug release are possible. Even though therapeutic contact lenses with polymeric vehicles allow us to achieve sustained ocular drug delivery, drug leaching during storage and distribution and the possibility of problems related to surface roughness due to the incorporated vehicles still need to be discussed before application in a real clinic. This review highlights the overall trends in methodology to develop therapeutic contact lenses with polymeric vehicles and discusses the limitations including comparison to cosmetically tinted soft contact lenses.

Photochemical control of microphase structure in biocompatible polyester membranes generated by ultraviolet irradiation

The morphologies of PEMA-RB/PHEMA semi-interpenetrating polymeric network (semi-IPN) blended membranes prepared via ultraviolet (UV) promoted in situ photopolymerization were investigated using laser scanning confocal fluorescence microscopy (LSCFM). The results show that the semi-IPN morphology generated through UV light irradiation-induced microphase separation is considerably dependent on the relative rates of the photochemical reaction and microphase separation in the reactive precursor mixtures, which are determined by reactive dynamic factors. Changing the dynamic conditions, such as the UV light intensity, content of cross-linker and concentration of HEMA photopolymerization monomer resulted in a corresponding alteration of the morphological structure in the semi-IPN membranes. The hierarchical morphology appearing in the PEMA-RB/PHEMA semi-IPN should be related to the inhomogeneous photoreaction dynamics of the mixed system. Desired morphologies of the semi-IPN blend membranes can be obtained by controlling the corresponding dynamic conditions of both the photochemical reaction and microphase separation.

Investigation of the Lag Phase of Collagen Fibrillogenesis Using Fluorescence Anisotropy

The lag phase of collagen fibrillogenesis (1.0 mg/mL collagen solution) with an L-glutamine-L-arginine mixture (Glu-Arg) was monitored by the fluorescence anisotropy of tyrosine residues in real time. A suitable concentration of Glu-Arg (40 mmol/L) could control the aggregate ingredients in a collagen solution effectively before fibrillogenesis, and the mechanism was found to be similar to that with the monovalent ions. Fluorescence anisotropy analysis in the lag phase for a 1.0 mg/mL collagen solution confirmed the formation of collagen nuclei in multiple steps during the lag phase when the initial state of the collagen molecules was monomeric. A comparison of the fibrillogenesis lag phase for collagen solutions of 0.25, 0.50, and 1.0 mg/mL with 40 mmol/L Glu-Arg suggested that the length of the lag phase is inversely proportional to the increase in collagen concentration. Atomic force microscopy was used to investigate the effect of collagen aggregates on the fiber size. Based on the fluorescence anisotropy and atomic force microscopy results, it was proposed that an equilibrium exists between collagen aggregates and monomers accompanied by a nucleation of collagen monomers. A kinetic analysis for 0.25 and 1.0 mg/mL collagen with 40 mmol/L Glu-Arg at 18-38 °C indicated that collagen nucleation in the lag phase was favored by increasing temperature, and a corresponding activation energy of 76 and 97 kJ/mol was obtained for a collagen fibrillogenesis lag phase of 0.25 and 1.0 mg/mL, respectively.

Polymers in cell encapsulation from an enveloped cell perspective

In the past two decades, many polymers have been proposed for producing immunoprotective capsules. Examples include the natural polymers alginate, agarose, chitosan, cellulose, collagen, and xanthan and synthetic polymers poly(ethylene glycol), polyvinyl alcohol, polyurethane, poly(ether-sulfone), polypropylene, sodium polystyrene sulfate, and polyacrylate poly(acrylonitrile-sodium methallylsulfonate). The biocompatibility of these polymers is discussed in terms of tissue responses in both the host and matrix to accommodate the functional survival of the cells. Cells should grow and function in the polymer network as adequately as in their natural environment. This is critical when therapeutic cells from scarce cadaveric donors are considered, such as pancreatic islets. Additionally, the cell mass in capsules is discussed from the perspective of emerging new insights into the release of so-called danger-associated molecular pattern molecules by clumps of necrotic therapeutic cells. We conclude that despite two decades of intensive research, drawing conclusions about which polymer is most adequate for clinical application is still difficult. This is because of the lack of documentation on critical information, such as the composition of the polymer, the presence or absence of confounding factors that induce immune responses, toxicity to enveloped cells, and the permeability of the polymer network. Only alginate has been studied extensively and currently qualifies for application. This review also discusses critical issues that are not directly related to polymers and are not discussed in the other reviews in this issue, such as the functional performance of encapsulated cells in vivo. Physiological endocrine responses may indeed not be expected because of the many barriers that the metabolites encounter when traveling from the blood stream to the enveloped cells and back to circulation. However, despite these diffusion barriers, many studies have shown optimal regulation, allowing us to conclude that encapsulated grafts do not always follow nature's course but are still a possible solution for many endocrine disorders for which the minute-to-minute regulation of metabolites is mandatory.

Osteogenic potential of BMP-2-releasing self-assembled membranes

We report here the use of novel self-assembling collagen-hyaluronic acid (HyA) membranes to deliver bone morphogenetic protein-2 (BMP-2) for orthopedic applications. Prior work has demonstrated that collagen-HyA membranes are formed initially through electrostatic interactions between the oppositely charged collagen and HyA molecules, and that membrane growth is driven by osmotic pressure imbalances between the collagen and HyA solutions. The purpose of this study was to investigate the potential of incorporating charged growth factors such as BMP-2 within the membrane for regenerative medicine applications. Membrane material properties, protein mass loss, and release kinetics of BMP-2, as well as biocompatibility and osteogenic potential in vitro and in vivo using a subcutaneous mouse model were assessed. Scanning electron microscopy and mechanical testing confirmed no loss of structural or mechanical integrity upon BMP-2 incorporation into the membranes. Slow and steady release of the growth factor was demonstrated with 17% of total loaded BMP-2 released over the course of 49 days. To test biocompatibility and osteogenic potential in vitro, human mesenchymal stem cells were cultured on collagen-HyA membranes and showed greater proliferation rates (for up to 28 days) on membranes without BMP-2, but a greater alkaline phosphatase activity and osteocalcin production on membranes releasing BMP-2. In vivo subcutaneous implantation of the membranes showed a minimal immune response with osteoblasts and mineral deposits present in the ectopic site for BMP-2-releasing membranes, further demonstrating the potential of the BMP-2-releasing membranes to induce osteogenic differentiation. This study presents a novel strategy to create self-assembled membranes using two biocompatible molecules that can deliver bioactive agents in a sustained manner to induce a local regenerative response.

Biocompatibility evaluation of ionic- and photo-crosslinked methacrylated gellan gum hydrogels: in vitro and in vivo study

In this study, the stability and biocompatibility of methacrylated gellan gum hydrogels, obtained either by ionic- (iGG-MA) or photo-crosslinking (phGG-MA), were evaluated in vitro and in vivo. Size exclusion chromatography analysis of the methacrylated gellan gum (GG-MA) powder revealed that molecular weight is lower as compared to the non-modified material, i.e., low acyl gellan gum. The water uptake and swelling of iGG-MA and phGG-MA hydrogels were investigated in phosphate-buffered saline solution (pH 7.4). The biocompatibility of the hydrogels was firstly evaluated by producing cell-laden hydrogels. The in vitro cells encapsulation study showed that lung fibroblast cells (L929 cells) and human intervertebral disc (hIVD) cells are viable when cultured within both hydrogels, up to 21 days of culturing. The iGG-MA and phGG-MA hydrogels were also subcutaneously implanted in Lewis rats for 10 and 18 days. Tissue response to the hydrogels implantation was determined by histological analysis (haematoxylin-eosin staining). A thin fibrous capsule was observed around the implanted hydrogels. No necrosis, calcification, and acute inflammatory reaction were observed. The results presented in this study demonstrate that iGG-MA and phGG-MA hydrogels are stable in vitro and in vivo, support L929 and hIVD cells' encapsulation and viability, and were found to be well-tolerated and non-toxic in vivo.

The aggregation behavior of native collagen in dilute solution studied by intrinsic fluorescence and external probing

The aggregation behavior of type I collagen in acid solutions with the concentrations covering a range of 0.06-1.50mg/mL was studied utilizing both of the fluorescence resonance energy transfer (FRET) between the phenylalanine and tyrosine residues and the external probing of 1,8-anilinonaphthalene sulfonate (ANS). FRET at 0.30 mg/mL showed the distance among collagen monomers was within 10nm without the obvious aggregates formed. The predominance of tyrosine fluorescence in FRET in the range of 0.45-0.75 mg/mL identified the existence of collagen aggregates companied with the formation of hydrophobic microdomains revealed by the change of the fluorescence of ANS. The blue-shift of tyrosine fluorescence from 303 to 293 nm for 0.90-1.50mg/mL dedicated the formation of high order aggregates. The results from the two-phase diagrams of the intrinsic fluorescence for the guanidine hydrochloride-induced unfolding of collagen confirmed these conclusions. By the two-dimensional correlation analysis for the intrinsic fluorescence of collagen solutions of 0.45, 0.75 and 1.05 mg/mL, the probable characteristic fluorescence peaks for the interactions of proline-aromatic (CH∼π) among the collagen molecules were found at 298 and 316 nm.

An in vivo model system for evaluation of the host response to biomaterials

We describe an in vivo model system designed to evaluate the host response to implanted biomaterials: The partial thickness rat abdominal wall defect model. The model allows for determination of the temporal and spatial distribution of the cellular and vascular response, the remodeling of the implanted material and surrounding host soft tissue, and the function of the remodeled tissue over time.

Plasma-enhanced copolymerization of amino acid and synthetic monomers

In this paper we report the use of plasma-enhanced chemical vapor deposition (PECVD) for the simultaneous deposition and copolymerization of an amino acid with other organic and inorganic monomers. We investigate the fundamental effects of plasma-enhanced copolymerization on different material chemistries in stable ultrathin coatings of mixed composition with an amino acid component. This study serves to determine the feasibility of a direct, facile method for integrating biocompatible/active materials into robust polymerized coatings with the ability to plasma copolymerize a biological molecule (L-tyrosine) with different synthetic materials in a dry, one-step process to form ultrathin coatings of mixed composition. This process may lead to a method of interfacing biologic systems with synthetic materials as a way to enhance the biomaterial-tissue interface and preserve biological activity within composite films.

Biocompatibility issues with modern implants in bone - a review for clinical orthopedics

Skeletal defects may result from traumatic, infectious, congenital or neoplastic processes and are considered to be a challenge for reconstructive surgery. Although the autologous bone graft is still the “gold standard”, there is continuing demand for bone substitutes because of associated disadvantages, such as limited supply and potential donor side morbidity [1]. This is not only true for indications in orthopedic and craniomaxillofacial surgeries, but also in repairing endodontic defects and in dental implantology.

Before clinical use all new bone substitute materials have to be validated for their osseoconductive and - depending on the composition of the material also –inductive ability, as well as for their long-term biocompatibility in bone. Serving this purpose various bone healing models to test osteocompatibility and inflammatory potential of a novel material on one hand and, on the other hand, non-healing osseous defects to assess the healing potential of a bone substitute material have been developed. Sometimes the use of more than one implantation site can be helpful to provide a wide range of information about a new material [2].

Important markers for biocompatibility and inflammatory responses are the cell types appearing after the implantation of foreign material. There, especially the role of foreign body giant cells (FBGC) is discussed controversial in the pertinent literature, such that it is not clear whether their presence marks an incompatibility of the biomaterial, or whether it belongs to a normal degradation behavior of modern, resorbable biomaterials.

This publication is highlighting the different views currently existing about the function of FBGC that appear in response to biomaterials at the implantation sites. A short overview of the general classes of biomaterials, where FBGC may appear as cellular response, is added for clarity, but may not be complete.

Biocompatibility of Agarose Gel as a Dermal Filler: Histologic Evaluation of Subcutaneous Implants

BACKGROUND

The search for safe and effective tissue fillers has been an ongoing effort in plastic and cosmetic surgery over recent decades. Biocompatibility is a prerequisite for any substance to be used as an implant material, and potential biomaterials need to be characterized by histologic evaluation of tissue responses. Collagen is a well-known tissue filler. Agarose gel is widely used in bioengineering. Both products are considered biocompatible. The purpose of this study was to evaluate the bioactivity of agarose gel as a dermal filler compared with collagen.

METHODS

Tissue responses to agarose gel and collagen were evaluated in a rat in vivo model (n = 96). Four groups were evaluated: group 1 (n = 24), rats with agarose gel implants; group 2 (n = 24), rats with collagen implants; group 3, a placebo group (n = 24); and group 4, a control group (n = 24). Responses and biocompatibility were assessed by histopathologic and histomorphometric evaluation at 1 week to 8 months after implantation.

RESULTS

Agarose gel showed marked bioactivity and biodegradation, although the implants integrated well into tissues: newly formed collagen bands were observed inside the implants and no granulomas were detected. Collagen implants showed low cell infiltration and a significant loss of product over time.

CONCLUSIONS

Agarose gel is a biocompatible product that can be considered for use as a tissue filler. Further investigation is required to assess its long-term efficacy and safety.

Biocompatibility of Two Novel Dermal Fillers: Histological Evaluation of Implants of a Hyaluronic Acid Filler and a Polyacrylamide Filler

BACKGROUND

Several biomaterials are currently available for soft-tissue augmentation. Biocompatibility is an indispensable condition for any such product. Appropriate histologic evaluation is a prerequisite for understanding the responses of tissues to implant materials. Recently, hyaluronic acid and polyacrylamide gel products have been introduced as dermal fillers. Both types of product are widely considered to be biocompatible.

METHODS

The present study compared tissue responses in a rat in vivo model (n = 80) to a hyaluronic acid filler (Restylane Perlane; Q-Med AB, Uppsala, Sweden) and a polyacrylamide gel filler (Aquamid; Contura SA, Montreux, Switzerland). Four groups were evaluated: group 1 (n = 20) received the Restylane Perlane implant, group 2 received the Aquamid implant (n = 20), group 3 comprised a placebo group (n = 20), group 4 was the control group (n = 20). Responses and biocompatibility were assessed by histopathologic and histomorphometric evaluations between 1 week and 8 months after implantation.

RESULTS

The two products induced very different tissue responses. The polyacrylamide gel filler was highly bioactive, undergoing cell infiltration and integration into tissues. The hyaluronic acid filler underwent minimal cell infiltration, and the product remained surrounded by a uniformly thin capsule.

CONCLUSIONS

This study reveals that two soft-tissue fillers considered to be biocompatible induce very different tissue reactions. This indicates that their behavior in clinical practice is likely to be different.

Collagen/Poloxamine Hydrogels: Cytocompatibility of Embedded HepG2 Cells and Surface-Attached Endothelial Cells

The effects of cross-linked poloxamine hydrogels on the cellular function of embedded HepG2 cells and surface-attached endothelial cells were assessed. HepG2 cells embedded within collagen/poloxamine-methacrylate gel survived photo-cross-linking (MTT viability, 78%). There was a gradual increase in cell number during the first week. The cumulative secretion of alpha1-antitrypsin by HepG2 cells showed an almost linear profile. However, lower levels for the collagen/poloxamine-methacrylate matrix were observed when compared with collagen. Endothelial cells attached poorly to poloxamine gels without collagen (alamarBlue reduction ranged from 36 to 63%) and did not spread well. The addition of collagen led to spread cells and alamarBlue reduction levels of 75-93% (24 h after seeding). On day 5, some detachment was noted through analysis of vascular endothelial cadherin staining. Finally, the collagen-containing matrix was used to prepare cylindrical modules containing HepG2 cells to show the utility of this material in modular tissue constructs. A fluorescent cytoplasmic tracer, Vybrant CFDA SE, showed that embedded cells remained viable for more than 2 months, confirming the good cytocompatibility of collagen/poloxamine-methacrylate in the form of modules. The suitability of these modules for preparing uniform, scaleable, and vascularized constructs remains to be demonstrated.

Long-term in vivo biomechanical properties and biocompatibility of poly(2-hydroxyethyl methacrylate-co-methyl methacrylate) nerve conduits

Artificial grafts are promising alternatives to nerve grafts for peripheral nerve repair because they obviate the complications and disadvantages associated with autografting such as donor site morbidity and limited tissue availability. We have synthesized poly(2-hydroxyethyl methacrylate-co-methyl methacrylate) (PHEMA-MMA) porous tubes and studied their efficacy in vivo. Specifically, we studied the short- and long-term stability and biocompatibility of 12 mm long tubes for the repair of surgically created 10 mm nerve gaps in rat sciatic nerves. Prior to implantation, tubes were analyzed in vitro using a micro-mechanical tester to measure displacement achieved with load applied. These results served as a calibration curve, y = 6.8105 x -0.0073 (R2 = 0.9750, n = 28), for in vivo morphometric tube compression measurements. In vivo, most of the PHEMA-MMA conduits maintained their structural integrity up to 8 weeks, but 29% (4/14) of them collapsed by 16 weeks. Interestingly, the tube wall area of collapsed 16-week tubes was significantly lower than those of patent tubes. Tubes were largely biocompatible; however, a small subset of 16-week tubes displayed signs of chronic inflammation characterized by "finger-like" tissue extensions invading the inner tube aspect, inflammatory cells (some of which were ED1+macrophages) and giant cells. Tubes also demonstrated signs of calcification, which increased from 8 to 16 weeks. To overcome these issues, future nerve conduits will be re-designed to be more robust and biocompatible.

Microwave-treated gelatin microspheres as drug delivery system

The crosslinking process of natural macromolecules with microwave energy should have the potentiality to overcome the problems due to the toxicity of the residuals of chemical crosslinking agents and moreover of the "in vivo" biodegradation products of the chemical crosslinked macromolecule. To evaluate the effective crosslinking of the gelatin forming the microspheres, the water-soluble fraction at 37 degrees C, the water absorption capability, the free amino and free carboxylic acid groups of the gelatin were determined. The structural change in the gelatin microspheres has been detected by the porosity studies. Moreover, both the "in vitro" biodegradability and the biocompatibility of the gelatin microspheres microwave-treated after a subcutaneous injection into female albino guinea pigs were tested. As the results suggest only the gelatin microspheres microwave-treated for 10 min at an inlet temperature of 250 degrees C could have been modified by the crosslink formation among the macromolecular chains. The gelatin microspheres treated with the microwave energy were very well biodegraded as indicated both by the "in vitro" enzymatic degradation studies and mainly by the histopathological examination. This latter study has also demonstrated the biocompatibility of the gelatin microspheres crosslinked with the microwave energy. In order to evaluate the feasibility of the microwave crosslinking process for pharmaceutical applications, both the drug loading and the drug release processes were evaluated using diclofenac as drug model, either as acidic form or as sodium salt. The microspheres were swollen in aqueous solution of diclofenac sodium salt, followed by a washing procedure with cool water to maintain the sodium salt into the microspheres or with pH 1.5 HCl to induce the diclofenac precipitation. To increase the amount of diclofenac acid form in the microspheres, the procedure was repeated three times washing with pH 1.5 HCl after each swelling process. Both the X-ray diffractometry and thermal analysis investigations showed a different physical state of the two drug forms in the microspheres, i.e. the amorphous state of the sodium salt and the crystalline state of the acidic form. According to the experimental results, the drug is released from gelatin microspheres according to the drug loading and the drug solubility.

Growth factor enhancement of peripheral nerve regeneration through a novel synthetic hydrogel tube

OBJECT

The authors' long-term goal is repair of peripheral nerve injuries by using synthetic nerve guidance devices that improve both regeneration and functional outcome relative to an autograft. They report the in vitro processing and in vivo application of synthetic hydrogel tubes that are filled with collagen gel impregnated with growth factors.

METHODS

Poly(2-hydroxyethyl methacrylate-co-methyl methacrylate) (PHEMA-MMA) porous 12-mm-long tubes with an inner diameter of 1.3 mm and an outer diameter of 1.8 mm were used to repair surgically created 10-mm gaps in the rat sciatic nerve. The inner lumen of the tubes was filled with collagen matrix alone or matrix supplemented with either neurotropin-3 at 1 microg/ml, brain-derived neurotrophic factor at 1 microg/ml, or acidic fibroblast growth factor (FGF-1) at 1 or 10 microg/ml. Nerve regeneration through the growth factor-enhanced tubes was assessed at 8 weeks after repair by histomorphometric analysis at the midgraft level and in the nerve distal to the tube repair. The tubes were biostable and biocompatible, and supported nerve regeneration in more than 90% of cases. Nerve regeneration was improved in tubes in which growth factors were added, compared with empty tubes and those containing collagen gel alone (negative controls). Tubes filled with 10 microg/ml of FGF-1 dispersed in collagen demonstrated regeneration comparable to autografts (positive controls) and showed significantly better regeneration than the other groups.

CONCLUSIONS

The PHEMA-MMA tubes augmented with FGF-1 in their lumens appear to be a promising alternative to autografts for repair of nerve injuries. Studies are in progress to assess the long-term biocompatibility of these implants and to enhance regeneration further.

Synthesis and hydration properties of pH-sensitive p(HEMA)-based hydrogels containing 3-(trimethoxysilyl)propyl methacrylate

An amphiphilic hydrogel network was synthesized from a cross-linked poly(2-hydroxyethyl methacrylate) backbone copolymerized with the monomers 3-(trimethoxysilyl)propyl methacrylate (PMA) and dimethylaminoethyl methacrylate (DMAEMA) using tetraethylene glycol diacrylate (TEGDA) as cross-linker and using the radical initiator system comprising N,N,N',N'-tetramethylethylenediamine and ammonium peroxydisulfate. The degree of hydration of hydrogel slabs was investigated as functions of varying monomer compositions and cross-link density and as a function of pH and ionic strength of the bathing medium. As much as a 45% increase in hydration was observed for hydrogels containing 15 mol % DMAEMA upon reducing the pH of the bathing medium from 8.0 to 2.0. This confirms the pH-modulated swelling of amine-containing hydrogels. Increasing the concentration of TEGDA cross-linker from 3 to 12 mol % in a 10 mol % DMAEMA-containing hydrogel resulted in only a 10% reduction in the degree of hydration of the gel. There was, however, a 40-50% reduction in the degree of hydration of a 15 mol % DMAEMA hydrogel upon increasing the molar composition of PMA from 0 up to 20 mol %. The presence of PMA confers hydrophobic character that reduces hydration and introduces additional cross-links that reduce network mesh size. The water content of the hydrogel was consistently higher in buffers of lower ionic strength. The reversible pH-dependent swelling observed in these studies, along with the control of cross-link density afforded by the PMA component, endows these biocompatible materials with potential for use in pH-controlled drug delivery of more hydrophobic drugs and present new compositions for in vitro and in vivo biocompatibility studies.

NMR imaging of water sorption into poly(hydroxyethyl methacrylate-co-tetrahydrofurfuryl methacrylate)

The diffusion of water into a series of hydroxyethyl methacrylate, HEMA, copolymers with tetrahydrofurfuryl methacrylate, THFMA, has been studied over a range of copolymer compositions using NMR imaging analyses. For polyHEMA the diffusion was found to be consistent with a Fickian model. The mass diffusion coefficient of water in polyHEMA at 37 degrees C was determined from the profiles of the diffusion front to be 1.5 x 10(-11) m(2) s(-1), which is less than the value based upon mass uptake, 2.0 x 10(-11) m(2) s(-1). The profiles of the water diffusion front obtained from the NMR images showed that stress was induced at the interface between the rubbery and glassy regions which led to formation of small cracks in this region of the glassy matrix of polyHEMA and its copolymers with mole fractions of HEMA greater than 0.6. Water was shown to be able to enter these cracks forming water "pools". For copolymers of HEMA and THFMA with mole fractions of HEMA less than 0.6 the absence of cracks was attributed to the ability of the THFMA sequences to undergo stress relaxation by creep.