Host Reactions to Biomaterials and Their Evaluation

Guideline for Vascular Access Port Use and Maintenance in Large Animals for Biomedical Research

Purpose Vascular Access Ports (VAPs) consist of an indwelling catheter connected to an implanted port that provides direct access for sample collection or infusion. The use of VAPs in biomedical research reduces trauma on vessels from repeated venipuncture, decreases secondary infections, promotes social housing and animal welfare, and increases the accuracy and efficiency of study procedures. In addition to enabling comprehensive data collection, VAPs increase satisfaction, and well-being by minimizing interference with daily routines and fostering cooperation. The responsible use of VAPs includes approval by the institutional animal care and use committee (IACUC), verification of the surgeon′s skill and experience, and confirmation that research staff are trained on the proper maintenance and access techniques. This document aims to provide surgeons, researchers and research staff, veterinary staff, and IACUCs with guidelines for implanting, maintaining, accessing, and troubleshooting vascular access ports in large animal species. (Rabbit, Canine, Feline, Nonhuman Primate, Porcine).

Epithelial cell attachment and adhesion protein expression on novel in sol TiO2 coated zirconia and titanium alloy surfaces

An adequate mucosal attachment is important when it comes to preventing peri-implant inflammation. The aim of this study was to compare epithelial cell adhesion and adhesion protein expression on in sol TiO₂ -coated and non-coated zirconia and titanium alloy surfaces. Fifty-six zirconia and titanium discs were cut, and half of them were coated with bioactive TiO₂ -coating. To study the epithelial cell attachment, human gingival keratinocytes were cultivated on discs for 1, 3, 6, and 24 h. The cell proliferation was detected by cultivating cells for 1, 3, and 7 days. In addition, the levels of adhesion proteins laminin y2, integrin α6, β4, vinculin, and paxillin were detected with Western Blot method. Furthermore, high-resolution imaging of the actin cytoskeleton and focal adhesion proteins was established. Longer-term cell culture (1-7 days) revealed higher cell numbers on the coated zirconia and titanium discs compared to non-coated discs. The difference was statistically significant (p < .05) after 24 h on coated zirconia and after 3 and 7 days on coated titanium discs compared to non-coated discs. Clear induction in the protein levels of laminin y2 and integrin α6 were detected on both coated samples, meanwhile integrin β4 were clearly induced on coated titanium alloy. The microscope evaluation showed significantly increased cell spreading on the coated discs. According to this study, the in sol induced TiO₂ -coating increases keratinocyte attachment and the expression of adhesion proteins on coated zirconia and titanium in vitro. Consequently, the coating has potential to enhance the mucosal attachment on implant surfaces.

Association analysis of the common varieties of IL17A and IL17F genes with the risk of knee osteoarthritis

Osteoarthritis is mediated by various types of cytokines, growth factors, and inflammatory factors that the role of the interleukin-17 family in this disease is becoming increasingly apparent. The aim of this study is to determine the association between the common polymorphisms of IL17A (including rs2275913) and IL17F (including rs2397084 and rs763780) genes with the knee osteoarthritis risk which was followed by a bioinformatics approach. In a case-control study, 254 participants consisting of 127 healthy individuals and 127 subjects with knee osteoarthritis referring to Shahid Beheshti Hospital dependents on Kashan University of Medical Sciences (Kashan, Iran) were enrolled. After samples collection, the polymorphisms genotyping was determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Finally, some bioinformatics tools were used to analyze the molecular effects of the three studied polymorphisms. Data analysis showed a significant association between rs2275913-GA genotype and the decreased risk of knee osteoarthritis (OR = 0.57, 95% CI = 0.33-0.97, P = .040). However, rs763780-AG genotype (OR = 2.29, 95%CI = 1.11-4.69, P = .024) and rs763780-G allele (OR = 2.01, 95% CI = 1.09-3.72, P = .026) were associated with an increased risk of knee osteoarthritis. However, no significant associations were found between the rs2397084 polymorphism and knee osteoarthritis risk. Our structural analysis revealed that the rs2275913 polymorphism could create a new binding site for TFII-I at the promoter region of IL17A. Also, rs2397084 and rs763780 could significantly affect the function and structure of IL17A. Based on our findings, rs2275913 and rs763780 could be considered as protective and risk factors for knee osteoarthritis, respectively. Therefore, these polymorphisms can be considered as biomarkers for the screening of knee osteoarthritis susceptible persons.

Anti-inflammatory effects of octadecylamine-functionalized nanodiamond on primary human macrophages

Chronic inflammatory disorders such as rheumatoid arthritis are characterized by excessive pro-inflammatory or "M1" activation of macrophages, the primary cells of the innate immune system. Current treatments include delivery of glucocorticoids (e.g. dexamethasone - Dex), which reduce pro-inflammatory M1 behaviour in macrophages. However, these treatments have many off-target effects on cells other than macrophages, resulting in broad immunosuppression. To limit such side effects, drug-incorporated nano- and microparticles may be used to selectively target macrophages via phagocytosis, because of their roles as highly effective phagocytes in the body. In this study, surface-modified nanodiamond (ND) was explored as a platform for the delivery of dexamethasone to macrophages because of ND's rich surface chemistry, which contributes to ND's high potential as a versatile drug delivery platform. After finding that octadecylamine-functionalized nanodiamond (ND-ODA) enhanced adsorption of Dex compared to carboxylated ND, the effects of Dex, ND-ODA, and Dex-adsorbed ND-ODA on primary human macrophage gene expression were characterized. Surprisingly, even in the absence of Dex, ND-ODA had strong anti-inflammatory effects, as determined by multiplex gene expression via NanoString and by protein secretion analysis via ELISA. ND-ODA also inhibited expression of M2a markers yet increased the expression of M2c markers and phagocytic receptors. Interestingly, the adsorption of Dex to ND-ODA further increased some anti-inflammatory effects, but abrogated the effect on phagocytic receptors, compared to its individual components. Overall, the ability of ND-ODA to promote anti-inflammatory and pro-phagocytic behaviour in macrophages, even in the absence of loaded drugs, suggests its potential for use as an anti-inflammatory therapeutic to directly target macrophages through phagocytosis.

In Vitro Evaluation for Potential Calcification of Biomaterials Used for Staple Line Reinforcement in Lung Surgery

Bovine pericardium (BPC) and polytetrafluoroethylene (PTFE) have been widely used to reinforce staple lines in lung resection. Since limited Information regarding the calcification of these biomaterials is available, we undertook an In vitro study to evaluate their calcification potential. Commercially available BPC and PTFE biomaterials were evaluated and compared with custom-prepared BPC tissue. In vitro calcification was performed via submersion in supersaturated solution In a double-walled glass reactor at 37.0°C ± 0.1°C, pH 7.4 ± 0.1, mimicking most ion concentrations of human blood plasma. In processing of calcification, the pH decrease of the solution simulated the addition of consumed H+, Ca2+, and PO43– ions from titrant solutions, the concentrations of which were based on the stolchiometry of octacalcium phosphate. The molar ion addition with time was recorded, and the initial slope of the curve was computed for each experiment. The rate of calcification developed (molar calcium phosphate ion addition rate per time and total surface area) (R) was computed after that with respect to the relative supersaturation (σ) used in each experiment. R for custom-prepared BPC tissues was found to be in the range of 0.19 ± 0.08 to 0.52 ± 0.19 (n = 17) in σ range of 0.72 to 1.42. Commercial BPC was found to be 0.016 to 0.052 (n = 4), and PTFE was 0.005 to 0.05 (n = 8) in the same σ range. Both clinically applied biomaterials, BPC and PTFE, seemed to be calcified with rates of at least one order of magnitude lower than the custom-prepared BPC tissue. This data suggested that BPC and PTFE biomaterials showed a similar, relatively very low tendency for calcification compared with custom-prepared BPC tissue. Although further studies are necessary, staple line reinforcement by these two biomaterials should be considered safe from the calcification point of view.

Nanomaterials and synergistic low-intensity direct current (LIDC) stimulation technology for orthopedic implantable medical devices

Nanomaterials play a significant role in biomedical research and applications because of their unique biological, mechanical, and electrical properties. In recent years, they have been utilized to improve the functionality and reliability of a wide range of implantable medical devices ranging from well-established orthopedic residual hardware devices (e.g., hip implants) that can repair defects in skeletal systems to emerging tissue engineering scaffolds that can repair or replace organ functions. This review summarizes the applications and efficacies of these nanomaterials that include synthetic or naturally occurring metals, polymers, ceramics, and composites in orthopedic implants, the largest market segment of implantable medical devices. The importance of synergistic engineering techniques that can augment or enhance the performance of nanomaterial applications in orthopedic implants is also discussed, the focus being on a low-intensity direct electric current (LIDC) stimulation technology to promote the long-term antibacterial efficacy of oligodynamic metal-based surfaces by ionization, while potentially accelerating tissue growth and osseointegration. While many nanomaterials have clearly demonstrated their ability to provide more effective implantable medical surfaces, further decisive investigations are necessary before they can translate into medically safe and commercially viable clinical applications. The article concludes with a discussion about some of the critical impending issues with the application of nanomaterials-based technologies in implantable medical devices, and potential directions to address these.

Studies on the biocompatibility of bacterial cellulose

Bacterial cellulose was functionalized with a chimeric protein containing a cellulose-binding module and the adhesion peptide Arg-Gly-Asp. Small-diameter bacterial cellulose membranes were produced and subcutaneously implanted in sheep for 1–32 weeks. The implants triggered a biological response similar to other high surface-to-volume implants. There were no significant differences in the inflammation degree between the bacterial cellulose coated with the recombinant protein Arg-Gly-Asp–cellulose-binding module and the native bacterial cellulose. The implants were considered to be mildly irritating to the tissue compared to the negative control sample (expanded polytetrafluoroethylene). The analysis of the fluorescence microscopy revealed that, apart from increasing cell adhesion, the presence of Arg-Gly-Asp stimulated an even cell distribution, while the cells on the untreated bacterial cellulose seemed to form aggregates. Furthermore, the cells on the Arg-Gly-Asp–treated bacterial cellulose presented a more elongated morphology. Mechanical tests indicated that the small-diameter bacterial cellulose tubes were more elastic than the human arteries and veins.

Oxidative stress and antioxidant responses of liver and kidney tissue after implantation of titanium or titanium oxide coated plate in rat tibiae

Coating with titanium oxides is a promising method to improve the blood compatibility of materials to be used for medical implants. However, biodegradation of the coating can result in microparticles that subsequently cause oxidative stress. Therefore, the present study was carried out to throw some light on the mechanisms affecting the reaction of tissue surroundings Ti implants either in the form of titanium oxide or not in tibiae of rats. The serum collected twice from animals during the period of study and rats were sacrificed after two months of implantation. The complete blood picture, total proteins content and the activities of some serum enzymes were determined as liver biomarker. Kidney function was examined by measuring the levels of serum creatinine and uric acid. The level of lipid peroxidation and the activities of superoxide dismutase, catalase and glutathione S-transferase as well as glutathione content in liver and kidney tissue were evaluated. It has been indicated that the lipid peroxidation is one of the molecular mechanisms involved in Ti-plate induced cytotoxicity however; the TiO(2)-plate did not. The biodegradation of Ti-plate was very slow that could explain why the all enzymatic and non-enzymatic antioxidant not affected by implantation of Ti-plate. The total antioxidant level in serum was better in rats had TiO(2)/Ti-plate than those animals that had Ti-plate. The coating of titanium implants with titanium oxide leads to attaining of reduced the oxidative state in the cells, which enhance the healing process in comparison with the uncoated implants.

In Vivo Biostability of CVD Silicon Oxide and Silicon Nitride Films

Low pressure chemical vapor deposition (LPCVD) and plasma enhanced chemical vapor deposition (PECVD) silicon oxide and silicon nitride films were implanted subcutaneously in a rat model to study in vivo behavior of the films. Silicon chips coated with the films of interest were implanted for up to one year, and film thickness was evaluated by spectrophotometry and sectioning. Dissolution rates were estimated to be 0.33 nm/day for LPCVD silicon nitride, 2.0 nm/day for PECVD silicon nitride, and 3.5 nm/day for PECVD silicon oxide. A similar PECVD silicon oxide dissolution rate was observed on a silicon oxide / silicon nitride / silicon oxide stack that was sectioned by focused ion beam etching. These results provide a biostability reference for designing implantable microfabricated devices that feature exposed ceramic films.

Adhesion and proliferation of human fibroblasts on sol-gel coated titania

The objective of this study was to evaluate growth and attachment of human gingival fibroblasts on nonresorbable sol-gel-derived nanoporous titania (TiO2) coated discs and noncoated commercially pure titania (cpTi) discs in vitro. The strength of attachment was evaluated using serial trypsinization. The number of cells detached from TiO2-substrates was 30% +/- 3%, whereas those detached from the cpTi was 58% +/- 4% indicating a stronger cell attachment on the coated surfaces. In scanning electron microscopy (SEM) images fewer cells, with more rounded shape, were seen with cpTi than with TiO2 after the detachment assay. Fibroblasts grew more efficiently on TiO2 than on cpTi substrates, showing significantly higher cell activities at all times. In transmission electron microscopy (TEM), a continuous layer of two to three cells thick covered the coated and noncoated discs after 7 days of culture. The plasma membrane of cells in contact with the coating was in close opposition and the cytoplasm was ultrastructurally similar to the cells grown on noncoated discs with well-preserved organelles. In conclusion, we demonstrated that the sol-gel-derived TiO2 coatings can facilitate cell growth and attachment of human gingival fibroblasts on titanium in vitro. This in vitro study is in line with our previous in vivo observations of improved soft tissue attachment of TiO2 coatings in comparison with cpTi.

Increased osteoblast functions in the presence of BMP-7 short peptides for nanostructured biomaterial applications

To improve bone regeneration around orthopedic biomaterials, researchers have attempted to combine growth factors on and in implants. Equally as exciting, greater bone growth has been demonstrated around nanoscaled materials (like helical rosette nanotubes or nanocrystalline hydroxyapatite) that mimic the geometry of the natural components of bone. To combine these two approaches, in this in vitro study, the ability of three short peptides [labeled for convenience: a or SNVILKKYRN, b or KPSSAPTQLN, and c or KAISVLYFDDS chosen from the larger bone morphogenetic protein-7 (BMP-7)] to promote osteoblast (bone-forming cells) functions were determined. Shorter peptides of BMP-7 are required for growth factor incorporation into nanoscale biomaterials because their sizes are in the nanometer regime. Results showed that of all the peptides, peptide b and the peptide combination a,b, enhanced osteoblast density the most after 5 days when compared with the controls (no growth factors). Furthermore, osteoblasts cultured with peptide b had a larger and more spread morphology than did controls. In addition, peptide c and its combinations (a, c; b, c; and a, b, c) increased osteoblast calcium deposition after 14 and 21 days compared with the controls. Since these peptides are much smaller than BMP-7, the results of this study provided information that peptides can be easily chemically functionalized onto nanoscaled biomaterials to improve bone growth. Thus, the present study elucidated that shorter peptides in BMP-7 was found to be more appropriate for inclusion in and on nanomaterials to promote osteoblast proliferation (peptide b and the peptide combination a,b) and osteoblast deposition of calcium-containing mineral (peptide c and the peptide combinations a,c; b,c; and a, b, c).

Adsorption of human immunoglobulin to implantable alginate-poly-L-lysine microcapsules: effect of microcapsule composition

Alginate-poly-L-lysine-alginate (APA) microcapsules continue to be the most widely studied device for the immuno-protection of transplanted therapeutic cells. Producing APA microcapsules having a reproducible and high level of biocompatibility requires an understanding of the mechanisms of the immune response towards the implants. Here, we investigate the adsorption of immunoglobulins (IgG, IgM, and IgA) onto the surface of APA microcapsules in vitro after their exposure to human serum and peritoneal fluid. Immunoglobulins (Ig) are considered to be opsonizing proteins, thus they tend to mediate inflammation when adsorbed to foreign surfaces. Ig adsorption was monitored using direct immunofluorescence. The amount of Ig adsorbed to the microcapsule surface was not significantly influenced by the guluronic acid content nor the purity level of the alginate, although microcapsules of intermediate-G purified alginate corresponded with the lowest adsorption levels. Ig adsorption was negligible when the poly-L-lysine membrane was omitted, suggesting that positive charges at the microcapsule surface are responsible for binding Ig.

Peri-implant tissue response to TiO2 surface modified implants

OBJECTIVES

The objective of this study was to evaluate peri-implant soft tissue attachment and alveolar bone height on nanoporous TiO(2) thin film on commercial titanium dental implants compared with unmodified standard implants.

MATERIAL AND METHODS

In six adult beagle dogs, the mandibular premolars P2-P4 were extracted bilaterally. Sol-gel-derived nanoporous TiO(2) thin film was produced on smooth coronal part of standard ITI Straumann implants (4.1 mm x 8.0 mm) by dip coating method. After 3 months healing period of the extraction sockets modified (n=24) and unmodified (n=11) control implants were placed bilaterally. The animals were killed after 8 weeks and the samples were retrieved and processed for histologic/histomorfometric and TEM/SEM evaluations.

RESULTS

Histological examination showed mild or absent inflammatory reaction in peri-implant connective tissues around the surface modified implants. Further, junctional epithelium (JE)/connective tissue (CT) appeared to be in immediate contact with the experimental implants. Of the experimental implants, 22% were judged to be detached from the implant surface while 45% of the untreated control implants were detached. Dense plaques of hemidesmosomes were found in TEM evaluation of the JE cell membrane facing the surface-treated implants. In the histomorfometric analysis, the distance between the implant margin and alveolar bone crest was significantly shorter in surface-treated implants than in the control implants (P<0.02).

CONCLUSION

Nanoporous sol-gel-derived TiO(2) thin film on ITI Straumann dental implants improved soft tissue attachment in vivo.

Comparison between sol-gel-derived anatase- and rutile-structured TiO2 coatings in soft-tissue environment

The bioactivity of the surface reactive TiO(2) coatings for medical implants can be locally modified by CO(2) laser processing to match with the properties of surrounding tissues. The TiO(2) coatings heat-treated at 500 degrees C exhibit in vitro bioactivity. With further CO(2) laser treatment they exhibit enhanced in vitro bioactivity. The aim of this in vivo study was to compare the performance of heat-treated anatase-structured TiO(2) coatings with preheat-treated and CO(2) laser-treated rutile-structured coatings in terms of their ability to attach soft connective tissues. The coatings were characterized with TF-XRD and AFM. TiO(2)-coated discs were implanted in rats. The samples were analyzed with routine histology, SEM-EDS, and TEM. In both groups, already at 3 days, soft connective tissues were in immediate contact with the surface. No thick crystalline CaP layer was detected by SEM-EDS, but a thin amorphous CaP layer was detected by XPS. No gap between the cell membrane and the coating could be observed in TEM pictures. No differences were observed between the anatase- and rutile-structured coatings in terms of tissue responses. Further studies are needed to verify if the tissues are adherent to the surface of the implant.

Fabrication of nanostructured hydroxyapatite and analysis of human osteoblastic cellular response

Nano-sized hydroxyapatite (HA) powders were produced by a hydrothermal method and a precipitation method. Spark plasma sintering (SPS) was used to fabricate nanostructured HA (NHA) using nano-sized HA powders as a precursor. Conventional sintering was employed to produce microstructured HA (MHA). Characteristics of HA powders and HA bulk ceramics after sintering were investigated by XRD, FTIR, SEM, TEM, particle size distribution, and AFM. Dense compacts consisting of equiaxed grains with an average grain size of approximately 100 nm were obtained by SPS. Human osteoblasts were cultured on both NHA and MHA and cell attachment, proliferation, and mineralization were evaluated. After 90 min incubation, the cell density on NHA surface was significantly higher than that of MHA and glass control, whereas average cell area of a spread cell was significantly lower on NHA surface compared to MHA and glass control after 4 h incubation. Matrix mineralization was determined after 7 and 14 days incubation by using alizarin red assay combined with cetylpyridinium chloride extraction. NHA shows significant enhancement (p < 0.05) in mineralization compared to MHA. Results from this study suggest that NHA may be a much better candidate for clinical use in terms of bioactivity.

Osteoblast function on nanophase alumina materials: Influence of chemistry, phase, and topography

Alumina is a material that has been used in both dental and orthopedic applications. It is with these uses in mind that osteoblast (bone-forming cell) function on alumina of varying particulate size, chemistry, and phase was tested in order to determine what formulation might be the most beneficial for bone regeneration. Specifically, in vitro osteoblast adhesion, proliferation, intracellular alkaline phosphatase activity, and calcium deposition was observed on delta-phase nanospherical, alpha-phase conventional spherical, and boehmite nanofiber alumina. Results showed for the first time increased osteoblast functions on the nanofiber alumina. Specifically, a 16% increase in osteoblast adhesion over nanophase spherical alumina and a 97% increase over conventional spherical alumina were found for nanofiber alumina after 2 h. A 29% increase in cell number after 5 days and up to a 57% greater amount of calcium was found on the surface of the nanofiber alumina compared with other alumina surfaces. Some of the possible explanations for such enhanced osteoblast behavior on nanofiber alumina may be attributed to chemistry, crystalline phase, and topography. Increased osteoblast function on nanofiber alumina suggests that it may be an ideal material for use in orthopedic and dental applications.

Biocompatibility of chemoenzymatically derived dextran-acrylate hydrogels

The biocompatibility of chemoenzymatically generated dextran-acrylate hydrogels has been evaluated in vitro, using human foreskin fibroblasts, and in vivo, by subcutaneous and intramuscular implantation in Wistar rats for up to 40 days. In vitro tests show that hydrogel extracts only minimally reduced (<10%) the mitochondrial metabolic activity of fibroblasts. Direct contact of the hydrogels with cells induced a cellular proliferation inhibition index (CPII) of 50-80%, compared with a control, whereas through indirect contact, the CPII values were <16%, suggesting that the high CPII values achieved in the direct assay test were likely due to mechanical stress or limitations in oxygen diffusion. Hence, the hydrogels were noncytotoxic. Moreover, cell-material interaction studies show that these hydrogels were nonadhesive. Finally, histologic evaluation of tissue response to subcutaneous and intramuscular implants showed acceptable levels of biocompatibility, as characterized by a normal cellular response and the absence of necrosis of the surrounding tissues of the implant. In the first 10 days, the foreign-body reaction in the intramuscular implantation was more severe than in subcutaneous implantation, becoming identical after 30 days. In both cases, dextran hydrogels did not show signs of degradation 6 weeks postimplantation and were surrounded by a thin fibrous capsule and some macrophages and giant cells. This response is typical with a number of nondegradable biocompatible materials. These results indicate that dextran hydrogels are biocompatible, and may have suitable applications as implantable long-term peptide/protein delivery systems or scaffolds for tissue engineering.

Nanometer surface roughness increases select osteoblast adhesion on carbon nanofiber compacts

Carbon nanofibers have exceptional theoretical mechanical properties (such as low weight-to-strength ratios) that, along with possessing nanoscale fiber dimensions similar to crystalline hydroxyapatite found in bone, suggest strong possibilities for use as an orthopedic/dental implant material. To determine, for the first time, cytocompatibility properties pertinent for bone prosthetic applications, osteoblast (bone-forming cells), fibroblast (cells contributing to callus formation and fibrous encapsulation events that result in implant loosening), chondrocyte (cartilage-forming cells), and smooth muscle cell (for comparison purposes) adhesion were determined on carbon nanofibers in the present in vitro study. Results provided evidence that, compared to conventional carbon fibers, nanometer dimension carbon fibers promoted select osteoblast adhesion. Moreover, adhesion of other cells was not influenced by carbon fiber dimensions. In fact, smooth muscle cell, fibroblast, and chondrocyte adhesion decreased with an increase in either carbon nanofiber surface energy or simultaneous change in carbon nanofiber chemistry. To determine properties that selectively enhanced osteoblast adhesion, similar cell adhesion assays were performed on polymer (specifically, poly-lactic-co-glycolic; PLGA) casts of carbon fiber compacts previously tested. Compared to PLGA casts of conventional carbon fibers, results provided the first evidence of enhanced select osteoblast adhesion on PLGA casts of nanophase carbon fibers. The summation of these results demonstrate that due to a high degree of nanometer surface roughness, carbon fibers with nanometer dimensions may be optimal materials to selectively increase osteoblast adhesion necessary for successful orthopedic/dental implant applications.

Reactive oxygen species inhibited by titanium oxide coatings

Titanium is a successful biomaterial that possesses good biocompatibility. It is covered by a surface layer of titanium dioxide, and this oxide may play a critical role in inhibiting reactive oxygen species, such as peroxynitrite, produced during the inflammatory response. In the present study, titanium dioxide was coated onto silicone substrates by radio-frequency sputtering. Silicone coating with titanium dioxide enhanced the breakdown of peroxynitrite by 79%. At physiologic pH, the peroxynitrite donor 3-morpholinosydnonimine-N-ethylcarbamide (SIN-1) was used to nitrate 4-hydroxyphenylacetic acid (4-HPA) to form 4-hydroxy-3-nitrophenyl acetic acid (NHPA). Titanium dioxide-coated silicone inhibited the nitration of 4-HPA by 61% compared to aluminum oxide-coated silicone and 55% compared to uncoated silicone. J774A.1 mouse macrophages were plated on oxide-coated silicone and polystyrene and stimulated to produce superoxide and interleukin-6. Superoxide production was measured by the chemiluminescent reaction with 2-methyl-6-[p-methoxyphenyl]-3,7-dihydroimidazo[1,2-a]pyrazin-3-one (MCLA). Titanium dioxide-coated silicone exhibited a 55% decrease in superoxide compared to uncoated silicone and a 165% decrease in superoxide compared to uncoated polystyrene. Titanium dioxide-coated silicone inhibited IL-6 production by 77% compared to uncoated silicone. These results show that the anti-inflammatory properties of titanium dioxide can be transferred to the surfaces of silicone substrates.

Enhanced functions of osteoblasts on nanostructured surfaces of carbon and alumina

It is of the utmost importance to increase the activity of bone cells on the surface of materials used in the design of orthopaedic implants. Increased activity of such cells can promote either integration of these materials into surrounding bone or complete replacement with naturally produced bone if biodegradable materials are used. Osteoblasts are bone-producing cells and, for that reason, are the cells of interest in initial studies of new orthopaedic implants. If these cells are functioning normally, they lay down bone matrix onto both existing bone and prosthetic materials implanted into the body. It is generally accepted that a successful material should enhance osteoblast function, leading to more bone deposition and, consequently, increased strength of the interface between the material and juxtaposed bone. The present study provided the first evidence of greater osteoblast function on carbon and alumina formulations that mimic the nano-dimensional crystal geometry of hydroxyapatite found in bone.

Polymeric matrices based on graft copolymers of PCL onto acrylic backbones for releasing antitumoral drugs

Graft copolymers of poly(epsilon-caprolactone) (PCL) on poly(dimethylacrylamide) (PDMAm), poly(methylmethacrylate) (PMMA), or on copolymers of poly(DMAm-co-MMA) have been synthesized and characterized by (1)H NMR spectroscopy, differential scanning calorimetry (DSC), and size exclusion chromatography (SEC). These partially biodegradable copolymer matrices have been proposed as drug delivery systems for the release of low-molecular-weight glycosides. Octyl-N-acetyl-6-O-[2,2-bis(hydroxymethyl)-3-hydroxypropyl]-alpha-D-glucosamide, a synthetic carbohydrate able to inhibit the proliferation of human malignant glioma cells in culture and transplanted glioma in rats was selected as drug model. The in vitro aqueous behavior of four drug-loaded and unloaded graft copolymers of different MMA: DMAm and PCL ratios has been analyzed performing swelling, degradation, and drug release experiments. An intimate dependence of the aqueous behavior with the composition has been found. The higher was the DMAm content, the higher was the hydrophilicity of the synthesized systems as well as the swelling, degradation, and drug release rate. In vivo experiments in pigs demonstrated the very good tolerance of drug-loaded implanted polymeric discs, and that >95% of the charged drug is released after 2 months' implantation.

Hydrogels based on poly(ethylene oxide) and poly(tetramethylene oxide) or poly(dimethyl siloxane). III. In vivo biocompatibility and biostability

To investigate the effects of polymer chemistry and topology (linear or graft copolymer) on in vivo biocompatibility and biostability based on cage implant system, various hydrogels, composed of short hydrophilic [polyethylene oxide (PEO)] and hydrophobic block, were prepared by polycondensation reaction. Poly(tetramethylene oxide) (PTMO) or poly(dimethyl siloxane) (PDMS) was chosen as a hydrophobic block because of their wide utilization as a biomaterial. By using the specimens retrieved from rats killed after 1, 2, 3, 5, and 7 weeks' implantation, cellular and material responses were assessed. Most hydrogels showed a comparable value of macrophage density to Pellethane(R), control polymer, whereas they did significantly lower foreign body giant cell (FBGC) density and coverage because of the presence of PEO. However, PEO block length and polymer topology did not affect macrophage adhesion and FBGC formation in our polymer composition. The hydrogel based on PDMS alone showed significantly lower macrophage density and FBGC density than Pellethane(R), indicating that PDMS plays a role in inhibiting cellular adhesion. The results obtained from gel permeation chromatography curve and Fourier transform infrared spectra exhibited that all the polymers were susceptible to oxidative degradation in vivo. Although Pellethane(R) revealed surface degradation by 5 weeks in vivo, hydrogels showed rapid degradation in the bulk within 2 weeks because of the penetration of oxidative chemicals released from phagocytic cells into PEO domain of phase-separated hydrogels. The more significant degradation was observed in the hydrogels with longer PEO block and PTMO as a hydrophobic block instead of PDMS. It was evident that the minor degradation could be achieved by grafting PEO and adopting PDMS as a hydrophobic block in the hydrogel.

Synergistic induction of cyclooxygenase-II by bacterial lipopolysaccharide in combination with particles of medical device materials in a murine macrophage cell line J774A.1

Corrosion and wear of implanted medical devices may produce particulate debris, leading to acute and chronic inflammatory responses in the host. In the presence of biomaterial wear particles, host monocytes/macrophages are activated to synthesize or secrete mediators of inflammation. In order to understand the mechanisms underlying the host response to particulates and device-associated infections, we have focused on the effects of medical device particles on macrophage function, because these cells play a pivotal role in the body's response to foreign bodies and their interaction with other cellular components of the immune system. In order to evaluate the effects of particles of medical device materials on functional activities of macrophages, we developed a cyclooxygenase-II (COX-II) assay system using J774A.1 macrophages. Constitutive cyclooxygenase (COX-I) is present in cells under physiological conditions, whereas inducible COX-II is induced by some cytokines, mitogens, and endotoxin, presumably in pathological conditions such as inflammation. We have evaluated the inductive effects of implant materials, i.e., particles of polymethylmethacrylate (PMMA), hydroxyapatite (HA), titanium oxide, and silica, on the activity of COX-II using thin layer chromatography of prostaglandin D(2) (PGD(2)) formed from [1-(14)C]-labeled arachidonic acid (AA). Also, we have assessed the synergistic effects of these particles on lipopolysaccharide (LPS)-mediated macrophage activation. Addition of LPS to these particles increased PGD(2) production several-fold greater than the addition of any inducer alone. Our results indicated that device-associated infections could enhance inflammatory responses to the wear particles in subjects with medical implants or in whom particulate biomaterials are used for clinical purposes. The use of this model COX-II assay system may lead to the identification of inflammatory potentials for implant materials more specifically than present in vivo assays.

In vivo tissue engineering: Part I. Concept genesis and guidelines for its realization

A loss of function of an organ often represents a life-threatening situation. Transplantations are successful, but "replacement" availability, its compatibility with the host, and subsequent healing often pose serious questions. Tissue engineering, where a carefully prepared scaffold is populated, in vitro, by cells to form an artificial organ, addresses some of the problems mentioned above. Trauma associated with the implant introduction to the host often complicates the process. The novel concept of in vivo tissue engineering which is designed to mediate the healing and tissue regeneration process by providing an in vitro formed porous, microcellular scaffold is proposed. The scaffold (part or entire organ) is then populated by cells either spontaneously (the surrounding cells will spread and populate to inhabit the scaffold) or by cellular augmentation (encapsulated cells are delivered to this in statu nascendi scaffold). Minimally traumatic arthroscopic surgery combined with a unique polymer delivery system is envisioned for the introduction of this implant to a site to be repaired. Such an approach will require the formation of polymer in-situ, in a reasonable time. The scaffold-forming polymers will be, in principle, biodegradable. We propose to utilize biodegradable polyurethane systems for in vivo tissue engineering. Diversity of their structure/property relationships, relative "ease" of their preparation, and excellent biocompatibility predetermine polyurethanes to be the materials of choice. This paper describes the genesis of this concept and potentials for its realization. It is intended to initiate and stimulate discussion among the related scientific disciplines to form a basis for this field. The synthesis, application, and biodegradation of selected polyurethanes and variety of its medical utilization will be discussed in upcoming papers.

In vitro and in vivo degradation of poly(propylene fumarate-co-ethylene glycol) hydrogels

The degradation of poly(propylene fumarate-co-ethylene glycol) hydrogels was examined in vitro in phosphate-buffered saline at pH 7.4 and in vivo in a subcutaneous rat model. These hydrogels have potential application as biodegradable, injectable cardiovascular stents, and, as such, their mass loss, dimensional changes, mechanical properties, morphology, and biocompatibility over a 12-week time course were evaluated. Three formulations were fabricated: one base formulation consisting of 25% (w/w) PEG, molecular weight 4,600; one high weight percent PEG formulation with 50% (w/w) PEG; and one high molecular weight PEG formulation, molecular weight 10,500. All three formulations showed significant weight loss (between 40 and 60%) on the first day due to leaching of the uncrosslinked fraction. Further weight loss was observed only for the low weight percent PEG copolymers in the in vivo case, and a slight increase in volume was observed due to degradative swelling. The mechanical properties of the P(PF-co-EG) hydrogels decreased significantly in the first 3 weeks, showing the biphasic pattern typical of bulk degradation. In vitro, the hydrogels showed at least a 20% retention of their initial ultimate tensile stress after 3 weeks. The dynamic mechanical properties showed similar retention, with the in vivo mechanical properties differing from the in vitro properties only after 6 weeks of degradation. Differences in PEG molecular weight appeared to have little effect, but increasing the weight percent PEG decreased the rate of degradation both in vitro and in vivo. The morphology of the copolymer films, based on scanning electron microscopy observation, was not significantly different either among the three formulations or over the time course of the study, suggesting there were no macroscopic structural changes during this time period. The P(PF-co-EG) hydrogels demonstrated good initial biocompatibility, showing responses characteristic of biomaterial implants.

In vivo degradation of a poly(propylene fumarate)/beta-tricalcium phosphate injectable composite scaffold

This study was designed to investigate the in vivo biodegration and biocompatibility of a poly(propylene fumarate) (PPF)-based orthopedic biomaterial. The effects of varying the PPF to N-vinyl pyrrolidinone ratio and PPF to beta-tricalcium phosphate content were studied. The composite mechanical properties and local tissue interactions were analyzed over 12 weeks. An initial increase in both compressive modulus and strength was seen for composite formulations that incorporated beta-tricalcium phosphate. The samples incorporating a higher PPF to N-vinyl pyrrolidinone ratio reached a maximal compressive strength of 7.7 MPa and a maximal compressive modulus of 191.4 MPa at 3 weeks. The lower PPF to N-vinyl pyrrolidinone ratio samples gained a maximum compressive strength of 7.5 MPa initially and a compressive modulus of 134.0 MPa at 1 week. At 6 weeks, all samples for formulations incorporating beta-tricalcium phosphate crumbled upon removal and were not mechanically tested. Samples that did not incorporate beta-tricalcium phosphate were very weak and insufficient for bone replacement at the 4-day time point and beyond. Tissue interactions resulted in a mild inflammatory response at the initial time points and mature fibrous encapsulation by 12 weeks.