Biocompatibility of poly (DL-lactic acid/glycine) copolymers

Implication of Mesenchymal Stem Cells and Their Derivates for Osteochondral Regeneration

Healing of articular cartilage defects presents a challenging issue, due to its regenerative shortcomings. Lacking vascularity and innervation of cartilage and low proliferative potential of chondrocytes are the main reasons for the limited healing potential of articular cartilage. Traditional reparative approaches are limited in their efficiency, hence there is a demand for novel reparative treatments. Mesenchymal stromal cells, preferred for clinical uses, can be readily derived from various sources and have been proven to have a therapeutic effect on cartilage and subchondral bone. Therefore, mesenchymal stromal cells, their derivates, and scaffolds have been utilized in research targeting osteochondral regeneration. The present review aims to comprehensively outline and discuss literature considering this topic published within last 5 years.

Implantable Microfluidic Device: An Epoch of Technology

Implantable microfluidic devices are milestones in developing devices that can either measure parameters like ocular pressure and blood glucose level or deliver various components for therapeutic needs or behavioral modification. Researchers are currently focusing on the miniaturization of almost all its tools for a better healthcare platform. Implantable microfluidic devices are a combination of various systems including, but not limited to, microfluidic platforms, reservoirs, sensors, and actuators, implanted inside the body of a living entity (in vivo) with the purpose of directly or indirectly helping the entity. It is a multidisciplinary approach with immense potential in the area of the biomedical field. Significant resources are utilizing on for the research and development of these devices for various applications. The induction of an implantable microfluidic device into an animal would enable us to measure the responses without any repeated invasive procedures. Such data would help in the development of a better drug delivery profile. Implantable microfluidic devices with reservoirs deliver specific chemical or biological products to treat situations like cancers and diabetes. They can also deliver fluorophores for specific imaging inside the body. Implantable microfluidic devices help provide a microenvironment for various cell differentiation procedure. These devices know no boundaries, and this article reviews these devices based on their design and applications.

Made in Germany: A Quality Indicator Not Only in the Automobile Industry But Also When It Comes to Skin Replacement: How an Automobile Textile Research Institute Developed a New Skin Substitute

Successful research and development cooperation between a textile research institute, the German Federal Ministry of Education and Research via the Center for Biomaterials and Organ Substitutes, the University of Tübingen, and the Burn Center of Marienhospital, Stuttgart, Germany, led to the development of a fully synthetic resorbable temporary epidermal skin substitute for the treatment of burns, burn-like syndromes, donor areas, and chronic wounds. This article describes the demands of the product and the steps that were taken to meet these requirements. The material choice was based on the degradation and full resorption of polylactides to lactic acid and its salts. The structure and morphology of the physical, biological, and degradation properties were selected to increase the angiogenetic abilities, fibroblasts, and extracellular matrix generation. Water vapor permeability and plasticity were adapted for clinical use. The available scientific literature was screened for the use of this product. A clinical application demonstrated pain relief paired with a reduced workload, fast wound healing with a low infection rate, and good cosmetic results. A better understanding of the product's degradation process explained the reduction in systemic oxidative stress shown in clinical investigations compared to other dressings, positively affecting wound healing time and reducing the total area requiring skin grafts. Today, the product is in clinical use in 37 countries. This article describes its development, the indications for product growth over time, and the scientific foundation of treatments.

Connecting primitive phase separation to biotechnology, synthetic biology, and engineering

One aspect of the study of the origins of life focuses on how primitive chemistries assembled into the first cells on Earth and how these primitive cells evolved into modern cells. Membraneless droplets generated from liquid-liquid phase separation (LLPS) are one potential primitive cell-like compartment; current research in origins of life includes study of the structure, function, and evolution of such systems. However, the goal of primitive LLPS research is not simply curiosity or striving to understand one of life's biggest unanswered questions, but also the possibility to discover functions or structures useful for application in the modern day. Many applicational fields, including biotechnology, synthetic biology, and engineering, utilize similar phaseseparated structures to accomplish specific functions afforded by LLPS. Here, we briefly review LLPS applied to primitive compartment research and then present some examples of LLPS applied to biomolecule purification, drug delivery, artificial cell construction, waste and pollution management, and flavor encapsulation. Due to a significant focus on similar functions and structures, there appears to be much for origins of life researchers to learn from those working on LLPS in applicational fields, and vice versa, and we hope that such researchers can start meaningful cross-disciplinary collaborations in the future.

Nonclinical Immunotoxicity Testing in the Pharmaceutical World: The Past, Present, and Future

An examination for potential direct or indirect adverse effects on the immune system (immunotoxicity) is an established component of nonclinical testing to support safe use of new drugs. Testing recommendations occur in various regulatory guidance documents, especially ICH S8, and these will be presented. Key evaluation usually occurs in toxicology studies with further investigative work a consideration if a positive signal is seen. Expectations around whether findings may occur are related to the type of compound being developed, including a chemically synthesized small molecule, a small molecule oncology drug, a biopharmaceutical, an oligonucleotide, a gene therapy/stem cell product, a vaccine, or reformulation of drugs in liposomes or depots. Examples of immunotoxicity/immunogenicity findings will be discussed for all of these types of compound. Overall, it can be concluded that our main tool for evaluation of potential immunotoxicity/immunogenicity for a new drug still remains standard toxicology study testing with key assessment for effects on clinical pathology and lymphoid organs/tissues (weights and cellularity). Additional evaluation from studies using a T cell-dependent antibody response (TDAR) and lymphocyte phenotyping is also valuable, if needed. Thus, using the tools from the past, it is the role of toxicologists to work with clinical teams now and in the future, to interpret findings from nonclinical testing to possible adverse findings in humans.

Osteochondral Regeneration with a Scaffold-Free Three-Dimensional Construct of Adipose Tissue-Derived Mesenchymal Stromal Cells in Pigs

Osteochondral lesion is a major joint disease in humans. Therefore, this study was designed to investigate the regeneration of articular cartilage and subchondral bone, using three-dimensional constructs of autologous adipose tissue-derived mesenchymal stromal cells without any biocompatible scaffolds. Mesenchymal stromal cells were harvested by liposuction from seven pigs, isolated enzymatically, and expanded until construct creation. The pig models had two osteochondral defects (cylindrical defects with a diameter of 5.2 mm and a depth of 5 mm) in one of their patello-femoral grooves. A columnar structure consisting of approximately 770 spheroids of 5 × 10⁴ autologous mesenchymal stromal cells were implanted into one of the defects (implanted defect), while the other defect was not implanted (control). The defects were evaluated pathologically at 6 months (in three pigs) and 12 months (in five pigs) after implantation. At 6 months after surgery, histopathology revealed active endochondral ossification underneath the plump fibrocartilage in the implanted defects, but a deficiency of fibrocartilaginous coverage in the controls. At 12 months after surgery, the fibrocartilage was transforming into hyaline cartilage as thick as the surrounding normal cartilage and the subchondral bone was thickening in the implanted defects. The histological averages of the implanted sites were significantly higher than those in the control sites at both 6 and 12 months after surgery. The implantation of a scaffold-free three-dimensional construct of autologous mesenchymal stromal cells into an osteochondral defect can induce regeneration of hyaline cartilage and subchondral bone structures over a period of 12 months.

Transplantation of Scaffold-Free Cartilage-Like Cell-Sheets Made from Human Bone Marrow Mesenchymal Stem Cells for Cartilage Repair: A Preclinical Study

OBJECTIVE

The object of this study was to determine culture conditions that create stable scaffold-free cartilage-like cell-sheets from human bone marrow-derived mesenchymal stem cells (hBMSCs) and to assess their effects after transplantation into osteochondral defects in nude rats.

DESIGN

(Experiment 1) The hBMSCs were harvested from 3 males, the proliferative and chondrogenic capacities were assessed at passage 1, and the cells were expanded in 3 different culture conditions: (1) 5% fetal bovine serum (FBS), (2) 10% FBS, and (3) 5% FBS with fibroblast growth factor 2 (FGF-2). The cells were harvested and made chondrogenic pellet culture. The cell proliferation rate, glycosaminoglycan/DNA ratio, and safranin-O staining intensity of pellets cultured condition 3 were higher than those of conditions 1 and 2. (Experiment 2) The hBMSCs were expanded and passaged 3 times under culture condition 3, and fabricate the cell-sheets in chondrogenic medium either with or without FBS. The cell-sheets fabricated with FBS maintained their size with flat edges. (Experiment 3) The cell-sheets were transplanted into osteochondral defects in nude rats. Histological analysis was performed at 2, 4, and 12 weeks after surgery.

RESULTS

The osteochondral repair was better after sheet transplantation than in the control group and significantly improved Wakitani score. Immunostaining with human-specific vimentin antibody showed that the transplanted cells became fewer and disappeared at 12 weeks.

CONCLUSIONS

These results indicate that culture with FGF-2 may help to quickly generate sufficient numbers of cells to create stable and reliable scaffold-free cartilage-like cell-sheets, which contribute to the regeneration of osteochondral defects.

Polymeric Biodegradable Stent Insertion in the Esophagus

Esophageal stent insertion has been used as a well-accepted and effective alternative to manage and improve the quality of life for patients diagnosed with esophageal diseases and disorders. Current stents are either permanent or temporary and are fabricated from either metal or plastic. The partially covered self-expanding metal stent (SEMS) has a firm anchoring effect and prevent stent migration, however, the hyperplastic tissue reaction cause stent restenosis and make it difficult to remove. A fully covered SEMS and self-expanding plastic stent (SEPS) reduced reactive hyperplasia but has a high migration rate. The main advantage that polymeric biodegradable stents (BDSs) have over metal or plastic stents is that removal is not require and reduce the need for repeated stent insertion. But the slightly lower radial force of BDS may be its main shortcoming and a post-implant problem. Thus, strengthening support of BDS is a content of the research in the future. BDSs are often temporarily effective in esophageal stricture to relieve dysphagia. In the future, it can be expect that biodegradable drug-eluting stents (DES) will be available to treat benign esophageal stricture, perforations or leaks with additional use as palliative modalities for treating malignant esophageal stricture, as the bridge to surgery or to maintain luminal patency during neoadjuvant chemoradiation.

Binary gene vectors based on hyperbranched poly(l-lactide-co-polyglycerol) and polyethylenimine for prolonged transgene expression via co-assembly with DNA into fiber core-shell triplexes

Hyper-branched PG6-PLA polymers based on hydrophilic hyperbranched polyglycerol (PG6) and the ester chain poly(l-lactide) (PLA) were synthesized and facilitated to develop a novel biocompatible release-controlled gene vector. The hyper-branched structure of PG6-PLA was verified by NMR, FT-IR and SEC-MALLS analysis. The co-assembly of PG6-PLA with high molecular weight polyethylenimine (PEI) of 25 kDa was discussed. The results of TEM, fluorescence tracking and size/zeta-potential analysis revealed that the PG6-PLA/PEI25k/DNA could co-assemble to generate a novel fiber core-shell conformation. In vitro cell experiment demonstrated that PG6-PLA significantly enhanced the ability of PEI25k to remain within cells and mediate luciferase and EGFP expression in the human embryonic kidney cell line 293T and human cervical carcinoma cell line HeLa, which was accompanied by improved cell biocompatibility and an extended period of transgene expression. Importantly, the binary vector PG6-PLA/PEI25k exhibited specific affinity to some tumour cell lines including HeLa and the HepG2 human hepatoma cell line. These results suggested that the novel gene delivery system based on fiber core-shell PG6-PLA/PEI25k/DNA can serve as a gene delivery system to mediate more efficient transgene expression.

Xeno-free and shrinkage-free preparation of scaffold-free cartilage-like disc-shaped cell sheet using human bone marrow mesenchymal stem cells

Aiming for the clinical application of cartilage regeneration, the xeno-free cultivation method to obtain a scaffold-free cartilage-like disc-shaped cell sheet using mesenchymal stem cells (MSCs) derived from human bone marrow without the shrinkage of the sheet was investigated. MSCs were inoculated into Cell Culture Insert (0.3 cm(2), pore size; 0.4 μm, pore density; 1.0 × 10(8)/cm(2)) using serum-free chondrogenic differentiation medium containing TGF-β3, IGF-1 and dexamethasone or other modified media, and cultured at 37 °C in 5% CO2 for 3 weeks. Sheet thickness, cartilage specific genes expression, ECM accumulation were determined, and the sections of sheets were stained with alcian blue. A novel mixed medium consisting of a growth medium (10% FCS) with a serum-free chondrogenic differentiation medium could prevent the shrinkage of the sheet and produced a disc-shaped cell sheet. The depth of the sheet was approximately 0.7 mm and the gene expression levels were higher than those in cells in normal human cartilage. The use of human serum instead of FCS did not cause shrinkage and did not decrease the accumulation levels of sGAG and type 2 collagen in the sheet. The cultivation of MSCs grown with completely xeno-free materials using the mixed medium containing human serum in a cell culture insert showed a sheet depth of 1.0 mm and gene expression levels higher than those in normal cartilage. The scaffold-free and xeno-free cartilage-like cell sheet was successfully formed without shrinkage using human bone marrow MSCs and the chondrogenic differentiation medium containing human serum.

In Vitro Biofabrication of Tissues and Organs

In vitro fabrication of tissues and the regeneration of internal organs are no longer regarded as science fiction but as potential remedies for individuals suffering from chronic degenerative diseases. Tissue engineering has generated much interest from researchers in many fields, including cell and molecular biology, biomedical engineering, transplant medicine, and organic chemistry. Attempts to build tissues or organs in vitro have utilized both scaffold and scaffold-free approaches. Despite considerable progress, fabrication of three-dimensional tissue constructs in vitro remains a challenge. In this chapter, we introduce and discus current concepts of tissue engineering with particular focus on future clinical application.

Endoscopic submucosal dissection combined with the placement of biodegradable stents for recurrent esophageal cancer after chemoradiotherapy

We report a case of a patient with esophageal squamous cell carcinoma who presented with obstruction of the esophagus. On endoscopy, a central ulcerating lesion was found spreading to the anterior wall of the middle esophagus. Four courses of chemoradiation therapy successfully produced a complete response for 3 years. A recurrence occurred which consisted of a morphologically flat lesion that occupied the entire circumference of the esophagus. Endoscopic submucosal dissection removed all lesions en bloc. To prevent a post-procedure mucosal defect of the circumference of the esophagus, biodegradable poly-l-lactic acid monofilaments esophageal stents were placed on the same day. One month later, the patient reported a feeling of obstruction. An endoscopic examination revealed food stuck in the stents, this was removed, and balloon dilatation provided good passage which has been maintained for 7 months.

Modeling of polyethylene, poly(l-lactide), and CNT composites: a dissipative particle dynamics study

Dissipative particle dynamics (DPD), a mesoscopic simulation approach, is used to investigate the effect of volume fraction of polyethylene (PE) and poly(l-lactide) (PLLA) on the structural property of the immiscible PE/PLLA/carbon nanotube in a system. In this work, the interaction parameter in DPD simulation, related to the Flory-Huggins interaction parameter χ, is estimated by the calculation of mixing energy for each pair of components in molecular dynamics simulation. Volume fraction and mixing methods clearly affect the equilibrated structure. Even if the volume fraction is different, micro-structures are similar when the equilibrated structures are different. Unlike the blend system, where no relationship exists between the micro-structure and the equilibrated structure, in the di-block copolymer system, the micro-structure and equilibrated structure have specific relationships.

Shrinkage-free preparation of scaffold-free cartilage-like disk-shaped cell sheet using human bone marrow mesenchymal stem cells

Aiming for the clinical application of cartilage regeneration, a culture method for mesenchymal stem cells (MSCs) derived from human bone marrow to obtain scaffold-free cartilage-like disk-shaped sheet of uniform sizes without the shrinkage was investigated. A disk-shaped cell sheet having the same diameter as that of the membrane without the shrinkage was formed after the cultivation of MSCs (18.6 × 10(5)cells/well) for 3 weeks in a cell culture insert (CCI) containing a flat membrane whose porosity was 12%, while 6.2 and 31.0 × 10(5)MSCs/well, respectively, resulted in the shrinkage of the aggregate and the hole formation in the center part of the sheet. Cell aggregates shrunk also in a 96-well plate and CCIs having lower porosity. The disk-shaped cell sheet showed the comparable thickness (1.2mm) and sulfated glycosaminoglycan (sGAG) density to those of the pellet formed in a pellet culture. The gene expression levels of aggrecan and type II collagen in the disk-shaped cell sheet were not lower than those in the pellet. In conclusion, the usage of CCI having 12% porosity and 18.6 × 10(5)MSCs/well could avoid the shrinkage from the formation of the scaffold-free cartilage-like disk-shaped cell sheet.

Coating of indomethacin-loaded embolic microspheres for a successful embolization therapy

Indomethacin-loaded dietheylaminoethyl trisacryl microspheres (DEAE-MS), originally designed for therapeutic embolization, were encapsulated using two methods: coacervation and solvent evaporation/extraction. This encapsulation was achieved using a biocompatible polymer, the PLGA 50 : 50, and aimed to control the release of the anti-inflammatory non-steroidal drug (AINSD) in the occluded vessel. PLGA degradation study showed that it had an erosion half-life of approximately 35 days. Scanning electron microscopy (SEM) photographs showed that microcapsules (MC) prepared by coacervation had a wrinkled surface while those prepared using solvent-removal process showed non-porous, smooth surface, those of originally DEAE-MS showed a macro-porous, rough surface. The mean diameters were 61 microm for naked DEAE-MS vs. 71 microm and 65 microm for MC prepared by coacervation and solvent evaporation/extraction method, respectively. In vitro release study of indomethacin adsorbed onto MS indicated that drug release from MC was controlled by a diffusion process. Indomethacin diffusivity from MC was much lower than its free diffusivity from MS (mean 14.5 and 10.5 times lower for formulations prepared by coacervation and solvent evaporation/extraction method, respectively). This indicates that efficient indomethacin concentrations could be maintained over much longer time-periods in the embolized region, which is assumed to be beneficial in inhibiting normally occurring inflammatory reaction and the subsequent revascularization; responsible for treatment failure when definitive occlusion is required.

Novel biodegradable stents for benign esophageal strictures following endoscopic submucosal dissection

The application of metallic stents for benign stenosis is limited due to long-term complications. We report here the results of the implantation of a novel biodegradable poly-L-lactic acid (PLLA) esophageal stent in two patients with benign esophageal stenosis after endoscopic submucosal dissection (ESD). Case 1 was a 64-year-old man who received ESD for an early squamous esophageal cancer in the middle esophagus. The mucosal defect was seven-eighths of the circumference, and the distal margin of the resection scar formed the stenosis. After balloon dilatation, the PLLA esophageal stent was endoscopically placed; for 6 months, he has not experienced any symptoms of re-stenosis. Case 2 consisted of a 62-year-old man who developed an early squamous esophageal cancer in the middle esophagus. The lesion was resected by ESD, and the mucosal defect was seven-eighths of the circumference. The resection scar formed the stenosis, and the PLLA esophageal stent was endoscopically placed. He also has not experienced any symptoms of re-stenosis for 6 months. In conclusion, the PLLA esophageal stent provides a new possibility for the management of benign esophageal strictures after ESD. Due to the biodegradable features of this stent, longer term studies are necessary to investigate the relationship between the expected disappearance of the stent and the patency of the stricture.

Modeling of polyethylene and poly (L-lactide) polymer blends and diblock copolymer: Chain length and volume fraction effects on structural arrangement

Dissipative particle dynamics (DPD), a mesoscopic simulation approach, has been used to investigate the chain length effect on the structural property of the immiscible polyethylene (PE)/poly(L-lactide) (PLLA) polymer in a polymer blend and in a system with their diblock copolymer. In this work, the interaction parameter in DPD simulation, related to the Flory-Huggins interaction parameter chi, is estimated by the calculation of mixing energy for each pair of components in molecular dynamics simulation. The immiscibility property of PE and PLLA polymers induces the phase separation and exhibits different architectures at different volume fractions. In order to observe the structural property, the radius of gyration is used to observe the detailed arrangement of the polymer chains. It shows that the structure arrangement of a polymer chain is dependent on the phase structure and has a significantly different structural arrangement character for the very short chains in the homopolymer and copolymers. The chain length effect on the degree of stretching or extension of polymers has also been observed. As the chain length increases, the chain exhibits more stretching behavior at lamellae, perforated lamellae, and cylindrical configurations, whereas the chain exhibits a similar degree of stretching or extension at the cluster configuration.

Usefulness of biodegradable stents constructed of poly-l-lactic acid monofilaments in patients with benign esophageal stenosis

AIM: To report 13 patients with benign esophageal stenosis treated with the biodegradable stent.

METHODS: We developed a Ultraflex-type stent by knitting poly-l-lactic acid monofilaments.

RESULTS: Two cases were esophageal stenosis caused by drinking of caustic liquid, 4 cases were due to surgical resection of esophageal cancers, and 7 cases were patients with esophageal cancer who received the preventive placement of biodegradable stents for post-endoscopic mucosal dissection (ESD) stenosis. The preventive placement was performed within 2 to 3 d after ESD. In 10 of the 13 cases, spontaneous migration of the stents occurred between 10 to 21 d after placement. In these cases, the migrated stents were excreted with the feces, and no obstructive complications were experienced. In 3 cases, the stents remained at the proper location on d 21 after placement. No symptoms of re-stenosis were observed within the follow-up period of 7 mo to 2 years. Further treatment with balloon dilatation or replacement of the biodegradable stent was not required.

CONCLUSION: Biodegradable stents were useful for the treatment of benign esophageal stenosis, particularly for the prevention of post-ESD stenosis.

Biocompatibility and integrin-mediated adhesion of human osteoblasts to poly(DL-lactide-co-glycolide) copolymers

The biocompatibility of polylactic acid (PLA) and polyglycolic acid (PGA) copolymers, employed in manufacturing bone-graft substitutes, is affected by their chemical composition, molecular weight and cell environment, and by the methods of polymerization and processing. Their in vitro bioactivity on human osteoblasts has been investigated very little. We first evaluated the behavior of primary human osteoblasts cultured in close contact with 75:25 and 50:50 PLA-PGA copolymers for 14 days adopting a cell culture system that allowed us to evaluate the influence of direct contact, and of factors released from polymers. The copolymers had no negative influence on cell morphology, cell viability and proliferation. Alkaline phosphatase (ALP) activity and osteocalcin production were also not affected. The initial adhesion of osteoblasts on implant surfaces requires the contribution of integrins, acting as a primary mechanism regulating cell-extracellular matrix (ECM) interactions. We observed that adhesion of osteoblasts to PLA-PGA copolymers, 2h after plating, was reduced by approximately 70% by antibodies capable to block integrin beta(1) and alpha(5)beta(1) complex and only by approximately 30% by an anti-integrin alpha(v) antibody. Therefore, beta(1) integrins may represent a predominant adhesion receptor subfamily utilized by osteoblasts to adhere to PLA-PGA copolymers. These materials do not show any negative influence on cell proliferation and differentiation.

Preliminary report on the biocompatibility of a moldable, resorbable, composite bone graft consisting of calcium phosphate cement and poly(lactide-co-glycolide) microspheres

We have assessed the biocompatibility of a new composite bone graft consisting of calcium phosphate cement (CPC) and poly(lactide-co-glycolide) (PLGA) microspheres (approximate diameter of 0.18-0.36 mm) using cell culture techniques. CPC powder is mixed with PLGA microspheres and water to yield a workable paste that could be sculpted to fit the contours of a wound. The cement then hardens into a matrix of hydroxyapatite microcrystals containing PLGA microspheres. The rationale for this design is that the microspheres will initially stabilize the graft but can then degrade to leave behind macropores for colonization by osteoblasts. The CPC matrix could then be resorbed and replaced with new bone. In the present study, osteoblast-like cells (MC3T3-E1 cells) were seeded onto graft specimens and evaluated with fluorescence microscopy, environmental scanning electron microscopy and the Wst-1 assay (an enzymatic assay for mitochondrial dehydrogenase activity). Cells were able to adhere, attain a normal morphology, proliferate and remain viable when cultured on the new composite graft (CPC-PLGA) or on a control graft (CPC alone). These results suggest that our new cement consisting of CPC and PLGA microspheres is biocompatible. This is the first time that a 'polymer-in-mineral' (PLGA microspheres dispersed in a CPC matrix) cement has been formulated that is moldable, resorbable and that can form macropores after the cement has set.

Cytotoxicity of poly(96L/4D-lactide): the influence of degradation and sterilization

The cytotoxicity of poly(96L/4D-lactide) (PLA96), and of its accumulated degradation products, was investigated following different sterilization methods and pre-determined heat-accelerated degradation intervals. PLA96 samples sterilized by either steam, ethylene oxide, or gamma irradiation were left untreated (S0 samples), or were degraded for 30 h or 60 h (S30 and S60 samples) at 90 degrees C in water. Extracts of the samples and of the remaining degradation fluids (F30 and F60) were prepared. The toxicity of both unfiltered and filtered extracts was analyzed in a cell growth inhibition (CGI) assay and a lactate dehydrogenase (LDH) leakage assay. Physical analysis of the extracted samples and of the degradation fluids also was performed. The S0 extracts demonstrated no significant CGI. The CGI of the S30 extracts ranged from 37 to 78%, whereas the CGI of the S60 extracts ranged from 6 to 33%. The CGI of the F30 extracts ranged from 19 to 38% and the CGI of the F60 extracts was 98 to 123%. The LDH leakage assay only showed a high response to the unfiltered F60 extracts. Neither sterilization nor filtration appeared to influence the cytotoxicity of the extracts. Particle accumulation, however, might affect cell membrane permeability resulting in LDH leakage. The results of this study suggest that the cytotoxicity of PLA96 is related to the pH and possibly the osmolarity of the tested extracts. The pH and osmolarity, in turn, may depend on variations in the amounts of solubilized lactic acid and oligomers. These variations appear to result from degradation stage-dependent differences in crystallinity, molecular weight and molecular weight distribution of the PLA96 samples.

The future of biodegradable osteosyntheses

In the last 3 decades, much progress has been made in the development of biodegradable osteosyntheses. Despite this progress, these materials are still only used in small numbers, and the scope of their application has been limited. The limitations of biodegradable osteosyntheses mainly are related to problems with their mechanical properties and, in particular, biocompatibility. These problems need to be solved so that biodegradable osteosyntheses can perform up to their full potential and thus, eventually, make their general clinical application routine. This paper presents a historical perspective on the development of biodegradable osteosyntheses, discusses the successful developmental achievements and the still-existing problems, and gives a perspective on their future development.

Effect of heat treatment of poly(L-lactide) on the response of osteoblast-like MC3T3-E1 cells

Poly(L-lactide) (PLLA) products are molded by heat extrusion. These treatments may change chemical properties and biological response of the PLLA to cells. In this study, the effect of heat treatment of PLLA on osteoblast proliferation and differentiation was examined in vitro. Osteoblast-like MC3T3-E1 cells were cultured for 2 weeks on the PLLA subjected to various heating temperature and time combinations. The protein, DNA, and hydroxyproline (HYP) contents and alkaline phosphatase (ALP) activity of cells cultured on the untreated (non-heated) PLLA with a weight average molecular weight (Mw) of 1,000,000 (high Mw PLLA) were not significantly different from those of cells cultured on glass. The activation of osteoblast differentiation by the high Mw PLLA was weak. In contrast, increases in ALP activity and HYP content were found for cells cultured on the PLLA heated at a high temperature of 200 or 250 degrees C. Heat treatment of high Mw PLLA increased differentiation of MC3T3-E1 cells cultured upon it. Significant degradation of PLLA (decrease in molecular weight and increase in molecular weight distribution) were observed following heat treatment. The Mw of PLLA decreased from 1,000,000 to below 20,000, and 14.4 microg of L-lactic acid was released from 10 mg of PLLA by heating at 250 degrees C. Therefore, the effect of low Mw chemicals, which were expected to be the degradation products of high Mw PLLA after heat treatment, on MC3T3-E1 cell activities was examined. Increases in the protein, DNA and HYP amounts and ALP activity for cells cultured with L-lactide or L-lactic acid were observed at 100 microg/ml, but not at 10 microg/ml. When the cells were cultured on the low Mw PLLA (Mw 20,000), their biological parameters also increased. Twelve micrograms of L-lactic acid released from 10 mg of the low Mw PLLA during 2 weeks incubation. The concentration of L-lactic acid in the incubation solution of low Mw PLLA or heat-treated PLLA was too small to cause cell activation. These results suggested that increases in osteoblast differentiation on the heat-treated PLLA was not to due to soluble degradation chemicals, such as L-lactic acid, rather than the remaining low Mw PLLA.

Six bioabsorbable polymers: in vitro acute toxicity of accumulated degradation products

Bioabsorbable polymer implants may provide a viable alternative to metal implants for internal fracture fixation. One of the potential difficulties with absorbable implants is the possible toxicity of the polymeric degradation products especially if they accumulate and become concentrated. Accordingly, material evaluation must involve dose-response toxicity data as well as mechanical properties and degradation rates. In this study the toxicity and rates of degradation for six polymers were determined, along with the toxicity of their degradation product components. The polymers studied were poly(glycolic acid) (PGA), two samples of poly(L-lactic acid) (PLA) having different molecular weights, poly(ortho ester) (POE), poly(epsilon-caprolactone) (PCL), and poly(hydroxy butyrate valerate) (5% valerate) (PHBV). Polymeric specimens were incubated at 37 degrees C in 0.05 M Tris buffer (pH 7.4 at 37 degrees C) and sterile deionized water. The solutions were not changed during the incubation intervals, providing a worst-case model of the effects of accumulation of degradation products. The pH and acute toxicity of the incubation solutions and the mass loss and logarithmic viscosity number of the polymer samples were measured at 10 days, 4, 8, 12, and 16 weeks. Toxicity was measured using a bioluminescent bacteria, acute toxicity assay system. The acute toxicity of pure PGA, PLA, POE, and PCL degradation product components was also determined. Degradation products for PHBV were not tested. PGA incubation solutions were toxic at 10 days and at all following intervals. The lower molecular weight PLA incubation solutions were not toxic in buffer but were toxic by 4 weeks in water.(ABSTRACT TRUNCATED AT 250 WORDS)

New technique to extend the useful life of a biodegradable cartilage implant

Biodegradable implants made of alpha-hydroxypolyesters, such as polylactic acid, polyglycolic acid, or their copolymers, undergo bulk degradation with a concomitant mass loss. Although biocompatibility or toxicity problems, which have occasionally been reported in response to these materials' in vivo behavior, have not been conclusively linked to rapid mass loss, we hypothesized that such implants should degrade and lose mass in a more uniform rate. To this end, we designed a new implant, intended to be used in articular cartilage repair, consisting of a blend of three copolymers of 50:50 poly(d,l)-lactide coglycolide with inherent viscosities of 0.23, 0.58, and 1.37 dL/g. The objective of the blend implant design was to achieve a slower rate of degradation and mass loss in comparison to a previous design, which used a single copolymer of inherent viscosity of 0.58 dL/g. The blend's in vitro degradation characteristics were obtained and compared to those of the control design in terms of mass, molecular weight, pH, mechanical properties, gross morphology, and porosity. Another objective of our study was to design and employ a novel test for assessing the permeability of porous scaffolds, using a custom apparatus under direct permeation conditions. Significant differences in the temporal behavior of the two groups were found. The blend implants maintained their overall structural integrity longer than control specimens (6 weeks versus 3 weeks). This was a surprising finding in light of the fact that losses in molecular weight were similar in the two groups. Extension of structural usefulness to 6 weeks, achieved by the method described in the study, can be expected to enhance the viability of this scaffold in an in vivo application such as cartilage repair. Thus, the blended copolymer implants may be more suitable in orthopedic applications, where a decreased degradation rate would be preferable.

Bovine serum albumin loaded poly(lactide-co-glycolide) microspheres: the influence of polymer purity on particle characteristics

To study the influence of polymer purity on microsphere characteristics, bovine serum albumin (BSA) loaded biodegradable microspheres were prepared by spray drying using two samples of poly(lactide-co-glycolide), PLG, (50:50, mwt = 35 and 69 kDa). Polymer properties were varied by DL-lactide and glycolide addition or by ultrafiltration. While the effective drug loading was not affected by polymer purity, Tg was decreased with increasing monomer and oligomer content. The removal of these low molecular weight substances by ultrafiltration led to a narrower molecular weight distribution compared to the untreated PLG. Concerning the polymer with the higher molecular weight, microsphere morphology was also strongly affected by polymer composition. In contrast to the non-modified PLG, monomer addition yielded particles with a much smoother surface structure. Moreover, in vitro cytotoxicity of the microspheres prepared from the polymer pretreated by ultrafiltration was significantly reduced, whereas monomer addition caused a dramatic decrease of cells surviving contact with the microsphere extract. The in vivo degradation rate of the ultrafiltered microspheres was decreased and as a result, protein release at later times was slowed down. Furthermore, depending on the effective drug loading level, monomer addition resulted in a decrease in the initial protein burst. It can be concluded that the effect of low molecular weight impurities in a polymer on microsphere characteristics and on cytotoxicity cannot be ignored. Their elimination is possible by ultrafiltration.

In vitro biocompatibility of bioresorbable polymers: poly(L, DL-lactide) and poly(L-lactide-co-glycolide)

The acute toxicity of two degradable polymers, a 70:30 poly (L-D, L-lactide) (PLDLA) and a 90:10 poly(L-lactide-co-glycolide) (PLGA), was evaluated by the agar diffusion test and the filter test with L929 mouse fibroblasts. Extracts of the materials prepared in phosphate-buffered saline at 37 and 70 degrees C were assessed for mitochondrial succinate dehydrogenase activity by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT assay) and the incorporation of 5-bromo-2'-deoxyuridine (BrdU) into DNA of BALB 3T3 cells. Both materials revealed no signs of cytotoxicity during the agar diffusions and filter tests. In the MTT and BrdU assays PLDLA and PLGA showed similar results. Cells treated with extracts prepared at 37 degrees C caused slight stimulation of mitochondrial activity. In contrast, cells incubated with the 70 degrees C media revealed a concentration-dependent decrease of mitochondrial activity. DNA synthesis was significantly decreased by the 37 degrees C extracts. As in the MTT assay, the effect of the extracts prepared at 70 degrees C was significantly greater. From these in vitro results it is suggested that PLDLA and PLGA have satisfactory biocompatibility. High concentrations of the degradation products, however, had a toxic influence on the cell culture systems used.

Biocompatibility of a biodegradable matrix used as a skin substitute: an in vivo evaluation

Synthetic biodegradable polymeric matrices, with a dense top layer and porous under-layer, made of a (poly)ether/(poly)ester (PEO:PBT) copolymer called Polyactive, and also of poly-L-lactide (PLLA), are under investigation as part of a cell-seeded skin substitute for third-degree, large-scale skin defects. The biocompatibility of subcutaneously implanted matrices representing large body surface areas, were studied at 2, 4, 13, 26, and 52 weeks in rats. To investigate local or systemic effects, the weight development of the complete animal and of their hearts, kidneys, lungs, livers, and spleens, as well as the macroscopic and histologic appearance of the implants and organs, were monitored. Early inflammatory response was associated with surgical implantation trauma. All matrices showed neovascular and fibrous tissue ingrowth into the porous underlayer within 2-4 weeks after implantation. Copolymeric and PLLA matrices increasingly fragmented and liquified. After 1 year, small polymeric fragments embedded in fibrous, vascularized tissue could be retrieved at the implantation site. No systemic effects of the implants on the organs or on the animal as a whole were observed. These results and earlier studies on (skin) cell substrate properties and physicochemical characteristics of the matrices indicate the suitability of the matrices as part of a cell-seeded skin substitute.

Cell-seeding and in vitro biocompatibility evaluation of polymeric matrices of PEO/PBT copolymers and PLLA

A bilayered matrix has been evaluated in vitro as a carrier for autografts of cultured epidermal keratinocytes and dermal fibroblasts, to be used as a skin substitute in deep dermal skin defects. A poly-L-lactide (PLLA) and an elastomeric and biodegradable poly(ethyleneoxide)-poly(butyleneterephthalate)(PEO-PBT++ +)copolymer, called Polyactive, were chosen as the constituents of the matrix. The substrate properties of the bilayers for human and rat epidermal keratinocytes and dermal fibroblasts were assessed. Keratinocytes attached and expanded into confluent sheets on both the routine cell culture plastic (TCPS) and the experimental substrates. Morphology of the cells cultured on the biomaterials was found to be comparable with the morphology of those grown on TCPS. In contrast to dense films, porous PEO:PBT copolymer and PLLA appeared poor substrates for fibroblasts. Long-term (in vivo) degradation of the biomaterials was mimicked in vitro to screen the biomaterials for any release of toxic substances. Culturing keratinocytes and fibroblasts in media based on the artificially aged biomaterials did not result in any negative effects on proliferative activity or morphological appearance of the cells.