1
|
Sarkar K. Research progress on biodegradable magnesium phosphate ceramics in orthopaedic applications. J Mater Chem B 2024. [PMID: 39140212 DOI: 10.1039/d4tb01123f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
To overcome critical size bone defects, calcium phosphate (CaP)-based ceramics have been widely explored. The compositional similarity with bone matrix and degradability are the main reasons for their selection in orthopaedic biomaterials. However, the low solubility rate under in vivo conditions raises concerns about these CaP groups, particularly hydroxyapatite (HA) and tricalcium phosphate (TCP) ceramics. Therefore, reliable and suitable degradable ceramics for bone defect repair are always an important research direction for researchers. The magnesium phosphate (MgP) group of bioceramics has been studied for orthopaedic applications and is comparatively new compared to traditional CaP ceramics. The role of magnesium in different biochemical processes, such as DNA stabilization, bone density maintenance, regulating Ca and Na ion channels, and cell proliferation and differentiation enhancement, is a key parameter for the development of MgP bioceramics. This article aims to give a comprehensive review of MgP ceramics in bone tissue engineering. Here, we have highlighted several preparation techniques, the existence of porosity, and the impact of metal ion doping on MgP bioceramics. Finally, in vitro and in vivo responses of MgP bioceramics in bone formation are discussed.
Collapse
Affiliation(s)
- Kaushik Sarkar
- Department of Ceramic Engineering, Indian Institute of Technology (BHU), Varanasi 221005, India.
| |
Collapse
|
2
|
Willbold E, Kalla K, Janning C, Bartsch I, Bobe K, Brauneis M, Haupt M, Reebmann M, Schwarze M, Remennik S, Shechtman D, Nellesen J, Tillmann W, Witte F. Dissolving magnesium hydroxide implants enhance mainly cancellous bone formation whereas degrading RS66 implants lead to prominent periosteal bone formation in rabbits. Acta Biomater 2024:S1742-7061(24)00407-0. [PMID: 39053818 DOI: 10.1016/j.actbio.2024.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/20/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024]
Abstract
Bone fractures often require internal fixation using plates or screws. Normally, these devices are made of permanent metals like titanium providing necessary strength and biocompatibility. However, they can also cause long-term complications and may require removal. An interesting alternative are biocompatible degradable devices, which provide sufficient initial strength and then degrade gradually. Among other materials, biodegradable magnesium alloys have been developed for craniofacial and orthopaedic applications. Previously, we tested implants made of magnesium hydroxide and RS66, a strong and ductile ZK60-based alloy, with respect to biocompatibility and degradation behaviour. Here, we compare the effects of dissolving magnesium hydroxide and RS66 cylinders on bone regeneration and bone growth in rabbit condyles using microtomographical and histological analysis. Both magnesium hydroxide and RS66 induced a considerable osteoblastic activity leading to distinct but different spatio-temporal patterns of cancellous and periosteal bone growth. Dissolving RS66 implants induced a prominent periosteal bone formation on the medial surface of the original condyle whereas dissolving magnesium hydroxide implants enhance mainly cancellous bone formation. Especially periosteal bone formation was completed after 6 and 8 weeks, respectively. The observed bone promoting functions are in line with previous reports of magnesium stimulating cancellous and periosteal bone growth and possible underlying signalling mechanisms are discussed. STATEMENT OF SIGNIFICANCE: Biodegradable magnesium based implants are promising candidates for use in orthopedic and traumatic surgery. Although these implants are in the scientific focus for a long time, comparatively little is known about the interactions between degrading magnesium and the biological environment. In this work, we investigated the effects of two degrading cylindrical magnesium implants (MgOH2 and RS66) both on bone regeneration and on bone growth. Both MgOH2 and RS66 induce remarkable osteoblastic activities, however with different spatio-temporal patterns regarding cancellous and periosteal bone growth. We hypothesize that degradation products do not diffuse directionless away, but are transported by the restored blood flow in specific spatial patterns which is also dependent on the used surgical technique.
Collapse
Affiliation(s)
- Elmar Willbold
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany.
| | - Katharina Kalla
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany
| | - Carla Janning
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany
| | - Ivonne Bartsch
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany
| | - Katharina Bobe
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany
| | - Maria Brauneis
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany
| | - Maike Haupt
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany
| | - Mattias Reebmann
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany
| | - Michael Schwarze
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany
| | - Sergei Remennik
- The Center for Nanoscience and Nanotechnology, The Hebrew University of Jerusalem, Jerusalem 9190401, Israel
| | - Dan Shechtman
- Department of Materials Engineering, Technion-Israel Institute of Technology, Haifa 32000, Israel
| | - Jens Nellesen
- Institute of Materials Engineering, Technische Universität Dortmund, Leonhard-Euler-Straße 2, 44227 Dortmund, Germany
| | - Wolfgang Tillmann
- Institute of Materials Engineering, Technische Universität Dortmund, Leonhard-Euler-Straße 2, 44227 Dortmund, Germany
| | - Frank Witte
- Charité - Universitätsmedizin Berlin, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| |
Collapse
|
3
|
Hassan N, Krieg T, Kopp A, Bach AD, Kröger N. Challenges and Pitfalls of Research Designs Involving Magnesium-Based Biomaterials: An Overview. Int J Mol Sci 2024; 25:6242. [PMID: 38892430 PMCID: PMC11172609 DOI: 10.3390/ijms25116242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/21/2024] Open
Abstract
Magnesium-based biomaterials hold remarkable promise for various clinical applications, offering advantages such as reduced stress-shielding and enhanced bone strengthening and vascular remodeling compared to traditional materials. However, ensuring the quality of preclinical research is crucial for the development of these implants. To achieve implant success, an understanding of the cellular responses post-implantation, proper model selection, and good study design are crucial. There are several challenges to reaching a safe and effective translation of laboratory findings into clinical practice. The utilization of Mg-based biomedical devices eliminates the need for biomaterial removal surgery post-healing and mitigates adverse effects associated with permanent biomaterial implantation. However, the high corrosion rate of Mg-based implants poses challenges such as unexpected degradation, structural failure, hydrogen evolution, alkalization, and cytotoxicity. The biocompatibility and degradability of materials based on magnesium have been studied by many researchers in vitro; however, evaluations addressing the impact of the material in vivo still need to be improved. Several animal models, including rats, rabbits, dogs, and pigs, have been explored to assess the potential of magnesium-based materials. Moreover, strategies such as alloying and coating have been identified to enhance the degradation rate of magnesium-based materials in vivo to transform these challenges into opportunities. This review aims to explore the utilization of Mg implants across various biomedical applications within cellular (in vitro) and animal (in vivo) models.
Collapse
Affiliation(s)
- Nourhan Hassan
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Cologne, 50937 Cologne, Germany
- Institute for Laboratory Animal Science and Experimental Surgery, University of Aachen Medical Center, Faculty of Medicine, RWTH-Aachen University, 52074 Aachen, Germany
- Biotechnology Department, Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Thomas Krieg
- Translational Matrix Biology, Medical Faculty, University of Cologne, 50937 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50937 Cologne, Germany
- Center for Molecular Medicine (CMMC), University of Cologne, 50937 Cologne, Germany
| | | | - Alexander D. Bach
- Department of Plastic, Aesthetic and Hand Surgery, St. Antonius Hospital Eschweiler, 52249 Eschweiler, Germany
| | - Nadja Kröger
- Institute for Laboratory Animal Science and Experimental Surgery, University of Aachen Medical Center, Faculty of Medicine, RWTH-Aachen University, 52074 Aachen, Germany
- Department of Plastic, Aesthetic and Hand Surgery, St. Antonius Hospital Eschweiler, 52249 Eschweiler, Germany
| |
Collapse
|
4
|
Jeong H, Byun H, Lee J, Han Y, Huh SJ, Shin H. Enhancement of Bone Tissue Regeneration with Multi-Functional Nanoparticles by Coordination of Immune, Osteogenic, and Angiogenic Responses. Adv Healthc Mater 2024:e2400232. [PMID: 38696729 DOI: 10.1002/adhm.202400232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/15/2024] [Indexed: 05/04/2024]
Abstract
Inorganic nanoparticles are promising materials for bone tissue engineering due to their chemical resemblance to the native bone structure. However, most studies are unable to capture the entirety of the defective environment, providing limited bone regenerative abilities. Hence, this study aims to develop a multifunctional nanoparticle to collectively control the defective bone niche, including immune, angiogenic, and osteogenic systems. The nanoparticles, self-assembled by biomimetic mineralization and tannic acid (TA)-mediated metal-polyphenol network (MPN), are released sustainably after the incorporation within a gelatin cryogel. The released nanoparticles display a reduction in M1 macrophages by means of reactive oxygen species (ROS) elimination. Consequently, osteoclast maturation is also reduced, which is observed by the minimal formation of multinucleated cells (0.4%). Furthermore, the proportion of M2 macrophages, osteogenic differentiation, and angiogenic potential are consistently increased by the effects of magnesium from the nanoparticles. This orchestrated control of multiple systems influences the in vivo vascularized bone regeneration in which 80% of the critical-sized bone defect is regenerated with new bones with mature lamellar structure and arteriole-scale micro-vessels. Altogether, this study emphasizes the importance of the coordinated modulation of immune, osteogenic, and angiogenic systems at the bone defect site for robust bone regeneration.
Collapse
Affiliation(s)
- Hyewoo Jeong
- Department of Bioengineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
- BK21 FOUR, Education and Research Group for Biopharmaceutical Innovation Leader, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Hayeon Byun
- Department of Bioengineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Jinkyu Lee
- Department of Bioengineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Yujin Han
- Department of Bioengineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
- BK21 FOUR, Education and Research Group for Biopharmaceutical Innovation Leader, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Seung Jae Huh
- Department of Bioengineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
- BK21 FOUR, Education and Research Group for Biopharmaceutical Innovation Leader, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Heungsoo Shin
- Department of Bioengineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
- BK21 FOUR, Education and Research Group for Biopharmaceutical Innovation Leader, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
- Institute of Nano Science and Technology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| |
Collapse
|
5
|
Shi W, Jiang Y, Wu T, Zhang Y, Li T. Advancements in drug-loaded hydrogel systems for bone defect repair. Regen Ther 2024; 25:174-185. [PMID: 38230308 PMCID: PMC10789937 DOI: 10.1016/j.reth.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/18/2024] Open
Abstract
Bone defects are primarily the result of high-energy trauma, pathological fractures, bone tumor resection, or infection debridement. The treatment of bone defects remains a huge clinical challenge. The current treatment options for bone defects include bone traction, autologous/allogeneic bone transplantation, gene therapy, and bone tissue engineering amongst others. With recent developments in the field, composite scaffolds prepared using tissue engineering techniques to repair bone defects are used more often. Among the various composite scaffolds, hydrogel exhibits the advantages of good biocompatibility, high water content, and degradability. Its three-dimensional structure is similar to that of the extracellular matrix, and as such it is possible to load stem cells, growth factors, metal ions, and small molecule drugs upon these scaffolds. Therefore, the hydrogel-loaded drug system has great potential in bone defect repair. This review summarizes the various natural and synthetic materials used in the preparation of hydrogels, in addition to the latest research status of hydrogel-loaded drug systems.
Collapse
Affiliation(s)
- Weipeng Shi
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yaping Jiang
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Tingyu Wu
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yingze Zhang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tao Li
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| |
Collapse
|
6
|
Gong C, Yang J, Zhang X, Wei Z, Wang X, Huang X, Yu L, Guo W. Functionalized Magnesium Phosphate Cement Induces In Situ Vascularized Bone Regeneration via Surface Lyophilization of Chondroitin Sulfate. Biomedicines 2023; 12:74. [PMID: 38255182 PMCID: PMC10812989 DOI: 10.3390/biomedicines12010074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/15/2023] [Accepted: 12/24/2023] [Indexed: 01/24/2024] Open
Abstract
Bone defect repair poses significant challenges in orthopedics, thereby increasing the demand for bone substitutes. Magnesium phosphate cements (MPCs) are widely used for bone defect repair because of their excellent mechanical properties and biodegradability. However, high crystallinity and uncontrolled magnesium ion (Mg2+) release limit the surface bioactivity of MPCs in bone regeneration. Here, we fabricate chondroitin sulfate (CS) as a surface coating via the lyophilization method, namely CMPC. We find that the CS coating is uniformly distributed and improves the mechanical properties of MPC through anionic electrostatic adsorption, while mediating degradation-related controlled ion release of Mg2+. Using a combination of in vitro and in vivo analyses, we show that the CS coating maintained cytocompatibility while increasing the cell adhesion area of MC3T3-E1s. Furthermore, we display accelerated osteogenesis and angiogenesis of CMPC, which are related to appropriate ion concentration of Mg2+. Our findings reveal that the preparation of a lyophilized CS coating is an effective method to promote surface bioactivity and mediate Mg2+ concentration dependent osteogenesis and angiogenesis, which have great potential in bone regeneration.
Collapse
Affiliation(s)
- Changtian Gong
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, China; (C.G.); (J.Y.); (X.Z.); (Z.W.); (X.W.); (X.H.); (L.Y.)
- Center of Regenerative Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jian Yang
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, China; (C.G.); (J.Y.); (X.Z.); (Z.W.); (X.W.); (X.H.); (L.Y.)
| | - Xiping Zhang
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, China; (C.G.); (J.Y.); (X.Z.); (Z.W.); (X.W.); (X.H.); (L.Y.)
| | - Zhun Wei
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, China; (C.G.); (J.Y.); (X.Z.); (Z.W.); (X.W.); (X.H.); (L.Y.)
| | - Xingyu Wang
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, China; (C.G.); (J.Y.); (X.Z.); (Z.W.); (X.W.); (X.H.); (L.Y.)
| | - Xinghan Huang
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, China; (C.G.); (J.Y.); (X.Z.); (Z.W.); (X.W.); (X.H.); (L.Y.)
| | - Ling Yu
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, China; (C.G.); (J.Y.); (X.Z.); (Z.W.); (X.W.); (X.H.); (L.Y.)
| | - Weichun Guo
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, China; (C.G.); (J.Y.); (X.Z.); (Z.W.); (X.W.); (X.H.); (L.Y.)
| |
Collapse
|
7
|
Luo Y, Liu H, Zhang Y, Liu Y, Liu S, Liu X, Luo E. Metal ions: the unfading stars of bone regeneration-from bone metabolism regulation to biomaterial applications. Biomater Sci 2023; 11:7268-7295. [PMID: 37800407 DOI: 10.1039/d3bm01146a] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
In recent years, bone regeneration has emerged as a remarkable field that offers promising guidance for treating bone-related diseases, such as bone defects, bone infections, and osteosarcoma. Among various bone regeneration approaches, the metal ion-based strategy has surfaced as a prospective candidate approach owing to the extensive regulatory role of metal ions in bone metabolism and the diversity of corresponding delivery strategies. Various metal ions can promote bone regeneration through three primary strategies: balancing the effects of osteoblasts and osteoclasts, regulating the immune microenvironment, and promoting bone angiogenesis. In the meantime, the complex molecular mechanisms behind these strategies are being consistently explored. Moreover, the accelerated development of biomaterials broadens the prospect of metal ions applied to bone regeneration. This review highlights the potential of metal ions for bone regeneration and their underlying mechanisms. We propose that future investigations focus on refining the clinical utilization of metal ions using both mechanistic inquiry and materials engineering to bolster the clinical effectiveness of metal ion-based approaches for bone regeneration.
Collapse
Affiliation(s)
- Yankun Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Hanghang Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
- Department of Emergency, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin Nanlu, Chengdu, Sichuan, 610041, People's Republic of China
| | - Yaowen Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yao Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
- Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Shibo Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
- Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Xian Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
- Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - En Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
- Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| |
Collapse
|
8
|
Gupta T, Ghosh SB, Bandyopadhyay-Ghosh S, Sain M. Is it possible to 3D bioprint load-bearing bone implants? A critical review. Biofabrication 2023; 15:042003. [PMID: 37669643 DOI: 10.1088/1758-5090/acf6e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 09/05/2023] [Indexed: 09/07/2023]
Abstract
Rehabilitative capabilities of any tissue engineered scaffold rely primarily on the triad of (i) biomechanical properties such as mechanical properties and architecture, (ii) chemical behavior such as regulation of cytokine expression, and (iii) cellular response modulation (including their recruitment and differentiation). The closer the implant can mimic the native tissue, the better it can rehabilitate the damage therein. Among the available fabrication techniques, only 3D bioprinting (3DBP) can satisfactorily replicate the inherent heterogeneity of the host tissue. However, 3DBP scaffolds typically suffer from poor mechanical properties, thereby, driving the increased research interest in development of load-bearing 3DBP orthopedic scaffolds in recent years. Typically, these scaffolds involve multi-material 3D printing, comprising of at-least one bioink and a load-bearing ink; such that mechanical and biological requirements of the biomaterials are decoupled. Ensuring high cellular survivability and good mechanical properties are of key concerns in all these studies. 3DBP of such scaffolds is in early developmental stages, and research data from only a handful of preliminary animal studies are available, owing to limitations in print-capabilities and restrictive materials library. This article presents a topically focused review of the state-of-the-art, while highlighting aspects like available 3DBP techniques; biomaterials' printability; mechanical and degradation behavior; and their overall bone-tissue rehabilitative efficacy. This collection amalgamates and critically analyses the research aimed at 3DBP of load-bearing scaffolds for fulfilling demands of personalized-medicine. We highlight the recent-advances in 3DBP techniques employing thermoplastics and phosphate-cements for load-bearing applications. Finally, we provide an outlook for possible future perspectives of 3DBP for load-bearing orthopedic applications. Overall, the article creates ample foundation for future research, as it gathers the latest and ongoing research that scientists could utilize.
Collapse
Affiliation(s)
- Tanmay Gupta
- Engineered Biomedical Materials Research and Innovation Centre (EnBioMatRIC), Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan, India
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
| | - Subrata Bandhu Ghosh
- Engineered Biomedical Materials Research and Innovation Centre (EnBioMatRIC), Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan, India
| | - Sanchita Bandyopadhyay-Ghosh
- Engineered Biomedical Materials Research and Innovation Centre (EnBioMatRIC), Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan, India
| | - Mohini Sain
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
9
|
Gelli R, Ridi F. An Overview of Magnesium-Phosphate-Based Cements as Bone Repair Materials. J Funct Biomater 2023; 14:424. [PMID: 37623668 PMCID: PMC10455751 DOI: 10.3390/jfb14080424] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023] Open
Abstract
In the search for effective biomaterials for bone repair, magnesium phosphate cements (MPCs) are nowadays gaining importance as bone void fillers thanks to their many attractive features that overcome some of the limitations of the well-investigated calcium-phosphate-based cements. The goal of this review was to highlight the main properties and applications of MPCs in the orthopedic field, focusing on the different types of formulations that have been described in the literature, their main features, and the in vivo and in vitro response towards them. The presented results will be useful to showcase the potential of MPCs in the orthopedic field and will suggest novel strategies to further boost their clinical application.
Collapse
Affiliation(s)
| | - Francesca Ridi
- Department of Chemistry “Ugo Schiff” and CSGI Consortium, University of Florence, Via della Lastruccia 3, 50019 Sesto Fiorentino, Italy;
| |
Collapse
|
10
|
Skalny AV, Aschner M, Silina EV, Stupin VA, Zaitsev ON, Sotnikova TI, Tazina SI, Zhang F, Guo X, Tinkov AA. The Role of Trace Elements and Minerals in Osteoporosis: A Review of Epidemiological and Laboratory Findings. Biomolecules 2023; 13:1006. [PMID: 37371586 DOI: 10.3390/biom13061006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
The objective of the present study was to review recent epidemiological and clinical data on the association between selected minerals and trace elements and osteoporosis, as well as to discuss the molecular mechanisms underlying these associations. We have performed a search in the PubMed-Medline and Google Scholar databases using the MeSH terms "osteoporosis", "osteogenesis", "osteoblast", "osteoclast", and "osteocyte" in association with the names of particular trace elements and minerals through 21 March 2023. The data demonstrate that physiological and nutritional levels of trace elements and minerals promote osteogenic differentiation through the up-regulation of BMP-2 and Wnt/β-catenin signaling, as well as other pathways. miRNA and epigenetic effects were also involved in the regulation of the osteogenic effects of trace minerals. The antiresorptive effect of trace elements and minerals was associated with the inhibition of osteoclastogenesis. At the same time, the effect of trace elements and minerals on bone health appeared to be dose-dependent with low doses promoting an osteogenic effect, whereas high doses exerted opposite effects which promoted bone resorption and impaired bone formation. Concomitant with the results of the laboratory studies, several clinical trials and epidemiological studies demonstrated that supplementation with Zn, Mg, F, and Sr may improve bone quality, thus inducing antiosteoporotic effects.
Collapse
Affiliation(s)
- Anatoly V Skalny
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, 150003 Yaroslavl, Russia
- Center of Bioelementology and Human Ecology, Institute of Biodesign and Modeling of Complex Systems, Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Ekaterina V Silina
- Center of Bioelementology and Human Ecology, Institute of Biodesign and Modeling of Complex Systems, Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia
| | - Victor A Stupin
- Department of Hospital Surgery No. 1, Pirogov Russian National Research Medical University, 117997 Moscow, Russia
| | - Oleg N Zaitsev
- Department of Physical Education, Yaroslavl State Technical University, 150023 Yaroslavl, Russia
| | - Tatiana I Sotnikova
- Center of Bioelementology and Human Ecology, Institute of Biodesign and Modeling of Complex Systems, Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia
- City Clinical Hospital n. a. S.P. Botkin of the Moscow City Health Department, 125284 Moscow, Russia
| | - Serafima Ia Tazina
- Center of Bioelementology and Human Ecology, Institute of Biodesign and Modeling of Complex Systems, Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an 710061, China
| | - Xiong Guo
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an 710061, China
| | - Alexey A Tinkov
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, 150003 Yaroslavl, Russia
- Center of Bioelementology and Human Ecology, Institute of Biodesign and Modeling of Complex Systems, Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia
| |
Collapse
|
11
|
Lukina Y, Safronova T, Smolentsev D, Toshev O. Calcium Phosphate Cements as Carriers of Functional Substances for the Treatment of Bone Tissue. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4017. [PMID: 37297151 PMCID: PMC10254876 DOI: 10.3390/ma16114017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/14/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
Interest in calcium phosphate cements as materials for the restoration and treatment of bone tissue defects is still high. Despite commercialization and use in the clinic, the calcium phosphate cements have great potential for development. Existing approaches to the production of calcium phosphate cements as drugs are analyzed. A description of the pathogenesis of the main diseases of bone tissue (trauma, osteomyelitis, osteoporosis and tumor) and effective common treatment strategies are presented in the review. An analysis of the modern understanding of the complex action of the cement matrix and the additives and drugs distributed in it in relation to the successful treatment of bone defects is given. The mechanisms of biological action of functional substances determine the effectiveness of use in certain clinical cases. An important direction of using calcium phosphate cements as a carrier of functional substances is the volumetric incorporation of anti-inflammatory, antitumor, antiresorptive and osteogenic functional substances. The main functionalization requirement for carrier materials is prolonged elution. Various release factors related to the matrix, functional substances and elution conditions are considered in the work. It is shown that cements are a complex system. Changing one of the many initial parameters in a wide range changes the final characteristics of the matrix and, accordingly, the kinetics. The main approaches to the effective functionalization of calcium phosphate cements are considered in the review.
Collapse
Affiliation(s)
- Yulia Lukina
- National Medical Research Center for Traumatology and Orthopedics Named after N.N. Priorov, Ministry of Health of the Russian Federation, Priorova 10, 127299 Moscow, Russia;
- Faculty of Digital Technologies and Chemical Engineering, Mendeleev University of Chemical Technology of Russia, Miusskaya pl. 9, 125047 Moscow, Russia
| | - Tatiana Safronova
- Department of Chemistry, Lomonosov Moscow State University, Building 3, Leninskie Gory 1, 119991 Moscow, Russia;
- Department of Materials Science, Lomonosov Moscow State University, Building 73, Leninskie Gory 1, 119991 Moscow, Russia;
| | - Dmitriiy Smolentsev
- National Medical Research Center for Traumatology and Orthopedics Named after N.N. Priorov, Ministry of Health of the Russian Federation, Priorova 10, 127299 Moscow, Russia;
| | - Otabek Toshev
- Department of Materials Science, Lomonosov Moscow State University, Building 73, Leninskie Gory 1, 119991 Moscow, Russia;
| |
Collapse
|
12
|
Dominguez LJ, Veronese N, Ciriminna S, Pérez-Albela JL, Vásquez-López VF, Rodas-Regalado S, Di Bella G, Parisi A, Tagliaferri F, Barbagallo M. Association between Serum Magnesium and Fractures: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2023; 15:nu15061304. [PMID: 36986033 PMCID: PMC10053795 DOI: 10.3390/nu15061304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
Magnesium, an essential cation for numerous cellular processes, is a major component of bone. However, its relationship with the risk of fractures is still uncertain. The present systematic review and meta-analysis aim to investigate the impact of serum Mg on the risk of incident fractures. A systematic search was conducted using several databases including PubMed/Medline and Scopus from inception to 24 May 2022, including observational studies investigating serum Mg and the incidence of fractures considered as outcomes. Abstract and full-text screenings, data extractions, and risk of bias assessments were conducted by two investigators independently. Any inconsistencies were resolved by consensus with a third author. The Newcastle–Ottawa Scale was used to assess the study quality/risk of bias. Among 1332 records initially screened, 16 were retrieved as full-texts; of them, four papers were included in the systematic review with a total of 119,755 participants. We found that lower serum Mg concentrations were associated with a significantly higher risk of incident fractures (RR = 1.579; 95%CI: 1.216–2.051; p = 0.001; I2 = 46.9%). Our systematic review with meta-analysis suggests a strong association of serum Mg concentrations with incident fractures. Further research is needed to confirm our results among other populations and to assess whether serum Mg is potentially relevant in the prevention of fractures, which continue to increase and represent a significant health burden due to the associated disability.
Collapse
Affiliation(s)
- Ligia J. Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
- Faculty of Medicine and Surgery, Kore University of Enna, 94100 Enna, Italy
- Correspondence: or
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Stefano Ciriminna
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | | | | | | | - Giovanna Di Bella
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Angela Parisi
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Federica Tagliaferri
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| |
Collapse
|
13
|
Eugen G, Claus M, Anna-Maria S, Niklas D, Philipp S, Andrea E, Andrea ML, Elke V. Degradation of 3D-printed magnesium phosphate ceramics in vitro and a prognosis on their bone regeneration potential. Bioact Mater 2023; 19:376-391. [PMID: 35574054 PMCID: PMC9062425 DOI: 10.1016/j.bioactmat.2022.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/30/2022] [Accepted: 04/17/2022] [Indexed: 12/13/2022] Open
Abstract
Regenerative bone implants promote new bone formation and ideally degrade simultaneously to osteogenesis. Although clinically established calcium phosphate bone grafts provide excellent osseointegration and osteoconductive efficacy, they are limited in terms of bioresorption. Magnesium phosphate (MP) based ceramics are a promising alternative, because they are biocompatible, mechanically extremely stable, and degrade much faster than calcium phosphates under physiological conditions. Bioresorption of an implant material can include both chemical dissolution as well as cellular resorption. We investigated the bioresorption of 3D powder printed struvite and newberyite based MP ceramics in vitro by a direct human osteoclast culture approach. The osteoclast response and cellular resorption was evaluated by means of fluorescence and TRAP staining, determination of osteoclast activities (CA II and TRAP), SEM imaging as well as by quantification of the ion release during cell culture. Furthermore, the bioactivity of the materials was investigated via SBF immersion, whereas hydroxyapatite precipitates were analyzed by SEM and EDX measurements. This bioactive coating was resorbed by osteoclasts. In contrast, only chemical dissolution contributed to bioresorption of MP, while no cellular resorption of the materials was observed. Based on our results, we expect an increased bone regeneration effect of MP compared to calcium phosphate based bone grafts and complete chemical degradation within a maximum of 1.5-3.1 years.
Collapse
Affiliation(s)
- Gefel Eugen
- Institute and Department for Functional Materials in Medicine and Dentistry, University Clinic Wuerzburg, Wuerzburg, Germany
| | - Moseke Claus
- Institute for Biomedical Engineering (IBMT), University of Applied Sciences Mittelhessen (THM), Wiesenstraße 14, Gießen, Germany
| | - Schmitt Anna-Maria
- Institute and Department for Functional Materials in Medicine and Dentistry, University Clinic Wuerzburg, Wuerzburg, Germany
| | - Dümmler Niklas
- Institute and Department for Functional Materials in Medicine and Dentistry, University Clinic Wuerzburg, Wuerzburg, Germany
| | - Stahlhut Philipp
- Institute and Department for Functional Materials in Medicine and Dentistry, University Clinic Wuerzburg, Wuerzburg, Germany
| | - Ewald Andrea
- Institute and Department for Functional Materials in Medicine and Dentistry, University Clinic Wuerzburg, Wuerzburg, Germany
| | - Meyer-Lindenberg Andrea
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-Universität, Munich, Germany
| | - Vorndran Elke
- Institute and Department for Functional Materials in Medicine and Dentistry, University Clinic Wuerzburg, Wuerzburg, Germany
| |
Collapse
|
14
|
Yuan Z, Wan Z, Gao C, Wang Y, Huang J, Cai Q. Controlled magnesium ion delivery system for in situ bone tissue engineering. J Control Release 2022; 350:360-376. [PMID: 36002052 DOI: 10.1016/j.jconrel.2022.08.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 10/15/2022]
Abstract
Magnesium cation (Mg2+) has been an emerging therapeutic agent for inducing vascularized bone regeneration. However, the therapeutic effects of current magnesium (Mg) -containing biomaterials are controversial due to the concentration- and stage-dependent behavior of Mg2+. Here, we first provide an overview of biochemical mechanism of Mg2+ in various concentrations and suggest that 2-10 mM Mg2+in vitro may be optimized. This review systematically summarizes and discusses several types of controlled Mg2+ delivery systems based on polymer-Mg composite scaffolds and Mg-containing hydrogels, as well as their design philosophy and several parameters that regulate Mg2+ release. Given that the continuous supply of Mg2+ may prevent biomineral deposition in the later stage of bone regeneration and maturation, we highlight the controlled delivery of Mg2+ based dual- or multi-ions system, especially for the hierarchical therapeutic ion release system, which shows enhanced biomineralization. Finally, the remaining challenges and perspectives of Mg-containing biomaterials for future in situ bone tissue engineering are discussed as well.
Collapse
Affiliation(s)
- Zuoying Yuan
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China
| | - Zhuo Wan
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China; Beijing Innovation Centre for Engineering Science and Advanced Technology, Peking University, Beijing 100871, China
| | - Chenyuan Gao
- State Key Laboratory of Organic-Inorganic Composites, Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China
| | - Yue Wang
- State Key Laboratory of Organic-Inorganic Composites, Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China
| | - Jianyong Huang
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China; Beijing Innovation Centre for Engineering Science and Advanced Technology, Peking University, Beijing 100871, China.
| | - Qing Cai
- State Key Laboratory of Organic-Inorganic Composites, Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China..
| |
Collapse
|
15
|
Tran NT, Kim YK, Kim SY, Lee MH, Lee KB. Comparative Osteogenesis and Degradation Behavior of Magnesium Implant in Epiphysis and Diaphysis of the Long Bone in the Rat Model. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15165630. [PMID: 36013766 PMCID: PMC9416751 DOI: 10.3390/ma15165630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 06/01/2023]
Abstract
Magnesium (Mg), as a biodegradable material, is a promising candidate for orthopedic surgery. Long-bone fractures usually occur in cancellous-bone-rich epiphysis at each end or the cortical-rich diaphysis in the center, with different bone healing processes. Little is known about the differences in results between the two regions when applying Mg implants. Therefore, this study aimed to compare the biodegradation and osteogenesis of Mg implants in a rat model's epiphysis and diaphysis of the long bone. Twelve male Sprague Dawley rats underwent Mg rod implantation in the distal femoral epiphyses and tibial diaphyses. Every three weeks for up to twelve weeks, degradation behavior, gas evolution, and new bone formation were measured by micro CT. Histomorphology was analyzed by Hematoxylin and Eosin, Villanueva bone staining, and TRAP staining for osteoclastogenesis evaluations. Micro-CT analysis showed statistically significant higher new bone formation in the epiphysis group than in the diaphysis group, which correlated with a lower gas volume. Histological analysis showed higher osseointegration of Mg implants in the epiphyseal region than in the diaphyseal region. The magnesium implant's osteoclastogenesis-inhibiting properties were shown in the surrounding areas in both the cortical bone of the diaphysis and the cancellous bone of the epiphysis. Our findings show the differences in the magnesium implant's osteogenesis and biodegradation in the epiphysis and the diaphysis. These dissimilarities indicate a better response of the epiphyseal region to the Mg implants, a promising biomaterial for orthopedic surgery applications.
Collapse
Affiliation(s)
- Nhat Tien Tran
- Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju 54896, Korea
- Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue 530000, Vietnam
| | - Yu-Kyoung Kim
- Department of Dental Biomaterials, Institute of Biodegradable Materials and Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju 54896, Korea
| | - Seo-Young Kim
- Department of Dental Biomaterials, Institute of Biodegradable Materials and Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju 54896, Korea
| | - Min-Ho Lee
- Department of Dental Biomaterials, Institute of Biodegradable Materials and Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju 54896, Korea
| | - Kwang-Bok Lee
- Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju 54896, Korea
| |
Collapse
|
16
|
Bohner M, Maazouz Y, Ginebra MP, Habibovic P, Schoenecker JG, Seeherman H, van den Beucken JJ, Witte F. Sustained local ionic homeostatic imbalance caused by calcification modulates inflammation to trigger heterotopic ossification. Acta Biomater 2022; 145:1-24. [PMID: 35398267 DOI: 10.1016/j.actbio.2022.03.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 12/15/2022]
Abstract
Heterotopic ossification (HO) is a condition triggered by an injury leading to the formation of mature lamellar bone in extraskeletal soft tissues. Despite being a frequent complication of orthopedic and trauma surgery, brain and spinal injury, the etiology of HO is poorly understood. The aim of this study is to evaluate the hypothesis that a sustained local ionic homeostatic imbalance (SLIHI) created by mineral formation during tissue calcification modulates inflammation to trigger HO. This evaluation also considers the role SLIHI could play for the design of cell-free, drug-free osteoinductive bone graft substitutes. The evaluation contains five main sections. The first section defines relevant concepts in the context of HO and provides a summary of proposed causes of HO. The second section starts with a detailed analysis of the occurrence and involvement of calcification in HO. It is followed by an explanation of the causes of calcification and its consequences. This allows to speculate on the potential chemical modulators of inflammation and triggers of HO. The end of this second section is devoted to in vitro mineralization tests used to predict the ectopic potential of materials. The third section reviews the biological cascade of events occurring during pathological and material-induced HO, and attempts to propose a quantitative timeline of HO formation. The fourth section looks at potential ways to control HO formation, either acting on SLIHI or on inflammation. Chemical, physical, and drug-based approaches are considered. Finally, the evaluation finishes with a critical assessment of the definition of osteoinduction. STATEMENT OF SIGNIFICANCE: The ability to regenerate bone in a spatially controlled and reproducible manner is an essential prerequisite for the treatment of large bone defects. As such, understanding the mechanism leading to heterotopic ossification (HO), a condition triggered by an injury leading to the formation of mature lamellar bone in extraskeletal soft tissues, would be very useful. Unfortunately, the mechanism(s) behind HO is(are) poorly understood. The present study reviews the literature on HO and based on it, proposes that HO can be caused by a combination of inflammation and calcification. This mechanism helps to better understand current strategies to prevent and treat HO. It also shows new opportunities to improve the treatment of bone defects in orthopedic and dental procedures.
Collapse
|
17
|
Wu T, Li B, Huang W, Zeng X, Shi Y, Lin Z, Lin C, Xu W, Xia H, Zhang T. Developing a novel calcium magnesium silicate/graphene oxide incorporated silk fibroin porous scaffold with enhanced osteogenesis, angiogenesis and inhibited osteoclastogenesis. Biomed Mater 2022; 17. [PMID: 35395653 DOI: 10.1088/1748-605x/ac65cc] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/08/2022] [Indexed: 11/11/2022]
Abstract
Recently, biofunctional ions (Mg2+, Si4+, etc.) and graphene derivatives are proved to be promising in stimulating bone formation. In this study, a novel inorganic/organic composite porous scaffold based on silk fibroin (SF), graphene oxide (GO), and calcium magnesium silicate (CMS) was developed for bone repair. The porous scaffolds obtained by lyophilization showed a little difference in pore structure while GO and CMS displayed a good interaction with SF matrix. The addition of CMS with good mineralization potential and sustainedly release ability of biofunctional ions (Ca2+, Mg2+ and Si4+) increased the strength of SF scaffolds a little and facilitated the osteogenic differentiation of bone mesenchymal stem cells (BMSCs) by upregulating bone formation-related genes (ALP, COL1, OC and Runx2). The further incorporation of GO in SF scaffolds enhanced the compressive strength and water retention, and also remarkably promoted the osteogenic differentiation of BMSCs. Besides, the angiogenesis of human umbilical vein endothelial cells was significantly promoted by CMS/GO/SF scaffold extract through the upregulation of angiogenesis genes (eNOs and bFGF). Moreover, the osteoclastic formation ability of RAW264.7 cells was suppressed by the released ions from CMS/GO/SF scaffold through the down-regulation of CAK, MMP9 and TRAP. The promoted osteogenesis, angiogenesis and inhibited osteoclastogenesis functions of CMS/GO/SF composite scaffold may enable it as a novel therapy for bone repair and regeneration.
Collapse
Affiliation(s)
- Tingting Wu
- Guangdong Key Lab of Medical Electronic Instruments and Polymer Material Products, Institute of Medicine and Health, Guangdong Academy of Sciences, No. 1307, Guangzhou Avenue Middle, Guangzhou, Guangdong, 510500, CHINA
| | - Binglin Li
- PLA General Hospital of Southern Theatre Command, No.111, Liuhua Road, Guangzhou, Guangdong, 510010, CHINA
| | - Wenhan Huang
- Department of Orthopaedics, Guangdong Academy of Medical Sciences, No.06, Zhongshan 2nd Road, Guangzhou, 510080, CHINA
| | - Xianli Zeng
- Southern Medical University, No.1023-1063, Shatai South Road, Baiyun District, Guangzhou, 510515, CHINA
| | - YiWan Shi
- Jinan University, 613 Huangpu Avenue West, Guangzhou, Guangdong, 510630, CHINA
| | - Zefeng Lin
- Department of Orthopedics,, PLA General Hospital of Southern Theatre Command, No.111, Liuhua road, Guangzhou, Guangdong, 510010, CHINA
| | - Chengxiong Lin
- Guangdong Academy of Sciences, No. 1307, Guangzhou Avenue Middle, Guangzhou, Guangdong, 510500, CHINA
| | - Weikang Xu
- Guangdong Academy of Sciences, No. 1307, Guangzhou Avenue Middle, Guangzhou, Guangdong, 510500, CHINA
| | - Hong Xia
- PLA General Hospital of Southern Theatre Command, No.111, Liuhua Road, Guangzhou, Guangdong, 510010, CHINA
| | - Tao Zhang
- PLA General Hospital of Southern Theatre Command, No.111, Liuhua Road, Guangzhou, 510010, CHINA
| |
Collapse
|
18
|
Stulajterova R, Medvecky L, Giretova M, Sopcak T, Luptakova L, Bures R, Szekiova E. Characterization of Tetracalcium Phosphate/Monetite Biocement Modified by Magnesium Pyrophosphate. MATERIALS 2022; 15:ma15072586. [PMID: 35407918 PMCID: PMC9000233 DOI: 10.3390/ma15072586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/24/2022]
Abstract
Magnesium pyrophosphate modified tetracalcium phosphate/monetite cement mixtures (MgTTCPM) were prepared by simple mechanical homogenization of compounds in a ball mill. The MgP2O7 was chosen due to the suitable setting properties of the final cements, in contrast to cements with the addition of amorphous (Ca, Mg) CO3 or newberite, which significantly extended the setting time even in small amounts (corresponding ~to 1 wt% of Mg in final cements). The results showed the gradual dissolution of the same amount of Mg2P2O7 phase, regardless of its content in the cement mixtures, and the refinement of formed HAP nanoparticles, which were joined into weakly and mutually bound spherical agglomerates. The compressive strength of composite cements was reduced to 14 MPa and the setting time was 5–10 min depending on the composition. Cytotoxicity of cements or their extracts was not detected and increased proliferative activity of mesenchymal stem cells with upregulation of osteopontin and osteonectin genes was verified in cells cultured for 7 and 15 days in cement extracts. The above facts, including insignificant changes in the pH of simulated body fluid solution and mechanical strength close to cancellous bone, indicate that MgTTCPM cement mixtures could be suitable biomaterials for use in the treatment of bone defects.
Collapse
Affiliation(s)
- Radoslava Stulajterova
- Division of Functional and Hybrid Systems, Institute of Materials Research of SAS, Watsonova 47, 040 01 Kosice, Slovakia; (R.S.); (M.G.); (T.S.); (R.B.)
| | - Lubomir Medvecky
- Division of Functional and Hybrid Systems, Institute of Materials Research of SAS, Watsonova 47, 040 01 Kosice, Slovakia; (R.S.); (M.G.); (T.S.); (R.B.)
- Correspondence:
| | - Maria Giretova
- Division of Functional and Hybrid Systems, Institute of Materials Research of SAS, Watsonova 47, 040 01 Kosice, Slovakia; (R.S.); (M.G.); (T.S.); (R.B.)
| | - Tibor Sopcak
- Division of Functional and Hybrid Systems, Institute of Materials Research of SAS, Watsonova 47, 040 01 Kosice, Slovakia; (R.S.); (M.G.); (T.S.); (R.B.)
| | - Lenka Luptakova
- Department of Biology and Physiology, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia;
| | - Radovan Bures
- Division of Functional and Hybrid Systems, Institute of Materials Research of SAS, Watsonova 47, 040 01 Kosice, Slovakia; (R.S.); (M.G.); (T.S.); (R.B.)
| | - Eva Szekiova
- Institute of Neurobiology of Biomedical Research Center of SAS, Soltesovej 4–6, 040 01 Kosice, Slovakia;
| |
Collapse
|
19
|
Impact of degradable magnesium implants on osteocytes in single and triple cultures. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2022; 134:112692. [DOI: 10.1016/j.msec.2022.112692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/12/2022] [Accepted: 01/29/2022] [Indexed: 11/21/2022]
|
20
|
Wu H, Yang S, Xiao J, Ouyang Z, Yang M, Zhang M, Zhao D, Huang Q. Facile synthesis of multi-functional nano-composites by precise loading of Cu 2+ onto MgO nano-particles for enhanced osteoblast differentiation, inhibited osteoclast formation and effective bacterial killing. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 130:112442. [PMID: 34702527 DOI: 10.1016/j.msec.2021.112442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/31/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
Biomaterials with multi-functions including enhancing osteogenesis, inhibiting osteoclastogenesis and effectively removing bacteria are urgently needed in the treatment of osteoporotic bone defects. In this study, MgO nano-particles were employed as a platform for precise Cu2+ loading. By immersing MgO into CuSO4 solution with a pre-defined concentration (0.1, 1 or 10 mM), 1 mg MgO adsorbed 3.25, 32.5 or 325 μg Cu2+ from the solution. As-synthesized nano-composites were referred as MgO-0.1Cu, MgO-1Cu or MgO-10Cu depending on the concentration of employed CuSO4 solution. The results revealed that MgO-xCu (x = 0.1, 1 and 10) nano-composites were lamella-shaped and composed of amorphous Cu(OH)2, crystalline Mg(OH)2 and minor MgO. The extracellular release of Cu2+ was rather limited due the capture of Cu2+ by Mg(OH)2. In vitro results revealed that MgO-xCu (x = 0.1, 1 and 10) nano-composites modulated osteoblast, osteoclast and bacterium response in a Cu2+ loading amount-dependent manner. MgO-0.1Cu nano-composite exhibited stimulatory function on osteoblast proliferation without influencing osteoblast maturation, osteoclast formation and bacterial survival. MgO-1Cu nano-composite enhanced osteoblast proliferation and differentiation, inhibited osteoclast formation and effectively killed bacteria. When larger amount of Cu2+ was loaded, MgO-10Cu nano-composite exhibited stronger stimulatory effect on osteoblast maturation, enhanced inhibitory function on osteoclast formation and promoted bactericidal performance, although it showed a certain degree of initial cyto-toxicity. Together, the results suggest that MgO nano-particles could be employed as potential platform for precise Cu2+ loading and intracellular Cu2+ delivery. MgO-xCu (x = 1 and 10) nano-composites are promising to be employed as multi-functional fillers in bone tissue engineering scaffolds for osteoporotic bone regeneration.
Collapse
Affiliation(s)
- Hong Wu
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha 410083, China
| | - Si Yang
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha 410083, China
| | - Jian Xiao
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhengxiao Ouyang
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Minghua Yang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Mingming Zhang
- Department of Neurosurgery, The Second Xiangya Hospital, Central South University. Changsha 410013, China
| | - Dapeng Zhao
- College of Biology, Hunan University, Changsha 410082, China
| | - Qianli Huang
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha 410083, China; Foshan (Southern China) Institute for New Materials, Foshan 528200, China.
| |
Collapse
|
21
|
Rendenbach C, Fischer H, Kopp A, Schmidt-Bleek K, Kreiker H, Stumpp S, Thiele M, Duda G, Hanken H, Beck-Broichsitter B, Jung O, Kröger N, Smeets R, Heiland M. Improved in vivo osseointegration and degradation behavior of PEO surface-modified WE43 magnesium plates and screws after 6 and 12 months. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 129:112380. [PMID: 34579899 DOI: 10.1016/j.msec.2021.112380] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/30/2021] [Accepted: 08/15/2021] [Indexed: 11/26/2022]
Abstract
Magnesium is a highly promising candidate with respect to its future use as a material for resorbable implants. When magnesium degrades, hydrogen gas is released. High doses of gas emergence are reported to impair osseointegration and may therefore lead to fixation failure. The successful delay and reduction of the degradation rate by applying plasma electrolytic oxidation (PEO) as a post processing surface modification method for magnesium alloy has recently been demonstrated. The aim of this study was thus to compare the degradation behavior of a WE43-based plate system with and without respective PEO surface modification and to further investigate osseointegration, as well as the resulting effects on the surrounding bony tissue of both variants in a miniature pig model. WE43 magnesium screws and plates without (WE43) and with PEO surface modification (WE43-PEO) were implanted in long bones of Göttingen Miniature Pigs. At six and twelve months after surgery, micro-CT and histomorphometric analysis was performed. Residual screw volume (SV/TV; WE43: 28.8 ± 21.1%; WE43-PEO: 62.9 ± 31.0%; p = 0.027) and bone implant contact area (BIC; WE43: 18.1 ± 21.7%; WE43-PEO: 51.6 ± 27.7%; p = 0.015) were increased after six months among the PEO-modified implants. Also, surrounding bone density within the cortical bone was not affected by surface modification (BVTV; WE43: 76.7 ± 13.1%; WE43-PEO: 73.1 ± 16.2%; p = 0.732). Intramedullar (BV/TV; WE43: 33.2 ± 16.7%; WE43-PEO 18.4 ± 9.0%; p = 0.047) and subperiosteal (bone area; WE43: 2.6 ± 3.4 mm2; WE43-PEO: 6,9 ± 5.2 mm2; p = 0.049) new bone formation was found for both, surface-modified and non-surface-modified groups. After twelve months, no significant differences of SV/TV and BV/TV were found between the two groups. PEO surface modification of WE43 plate systems improved osseointegration and significantly reduced the degradation rate within the first six months in vivo. Osteoconductive and osteogenic stimulation by WE43 magnesium implants led to overall increased bone growth, when prior PEO surface modification was conducted.
Collapse
Affiliation(s)
- Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Heilwig Fischer
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany; Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | | | - Katharina Schmidt-Bleek
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Henri Kreiker
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Sabine Stumpp
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Mario Thiele
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Georg Duda
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Henning Hanken
- Department of Oral and Maxillofacial Surgery, Asklepios Hospital North, Faculty of Medicine, Semmelweis University Campus Hamburg, Langenhorner Chaussee 560, 22419 Hamburg, Germany
| | - Benedicta Beck-Broichsitter
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Nadja Kröger
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Cologne, Kerpener Str. 62, 50 937 Köln, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| |
Collapse
|
22
|
Kazakova G, Safronova T, Golubchikov D, Shevtsova O, Rau JV. Resorbable Mg 2+-Containing Phosphates for Bone Tissue Repair. MATERIALS (BASEL, SWITZERLAND) 2021; 14:4857. [PMID: 34500951 PMCID: PMC8432688 DOI: 10.3390/ma14174857] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/24/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023]
Abstract
Materials based on Mg2+-containing phosphates are gaining great relevance in the field of bone tissue repair via regenerative medicine methods. Magnesium ions, together with condensed phosphate ions, play substantial roles in the process of bone remodeling, affecting the early stage of bone regeneration through active participation in the process of osteosynthesis. In this paper we provide a comprehensive overview of the usage of biomaterials based on magnesium phosphate and magnesium calcium phosphate in bone reconstruction. We consider the role of magnesium ions in angiogenesis, which is an important process associated with osteogenesis. Finally, we summarize the biological properties of calcium magnesium phosphates for regeneration of bone.
Collapse
Affiliation(s)
- Gilyana Kazakova
- Department of Materials Science, Lomonosov Moscow State University, Laboratory Building B, 1-73 Leninskiye Gory, Moscow 119991, Russia;
- Department of Chemistry, Lomonosov Moscow State University, GSP-1, 1-3 Leninskiye Gory, Moscow 119991, Russia;
| | - Tatiana Safronova
- Department of Materials Science, Lomonosov Moscow State University, Laboratory Building B, 1-73 Leninskiye Gory, Moscow 119991, Russia;
- Department of Chemistry, Lomonosov Moscow State University, GSP-1, 1-3 Leninskiye Gory, Moscow 119991, Russia;
| | - Daniil Golubchikov
- Department of Materials Science, Lomonosov Moscow State University, Laboratory Building B, 1-73 Leninskiye Gory, Moscow 119991, Russia;
| | - Olga Shevtsova
- Department of Chemistry, Lomonosov Moscow State University, GSP-1, 1-3 Leninskiye Gory, Moscow 119991, Russia;
| | - Julietta V. Rau
- Istituto di Struttura della Materia (ISM-CNR), Via del Fosso del Cavaliere 100, 00133 Roma, Italy;
- Department of Analytical, Physical and Colloid Chemistry, Institute of Pharmacy, Sechenov First Moscow State Medical University, Trubetskaya 8, Build. 2, Moscow 119991, Russia
| |
Collapse
|
23
|
Rosehip Extract-Functionalized Magnesium Hydroxide Nanoparticles and Its Effect on Osteoblastic and Osteoclastic Cells. MATERIALS 2021; 14:ma14154172. [PMID: 34361365 PMCID: PMC8348532 DOI: 10.3390/ma14154172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/19/2021] [Accepted: 07/24/2021] [Indexed: 01/21/2023]
Abstract
Considering the role of magnesium in bone metabolism and the increasing relevance of plant-mediated green-synthesis, this work compares the bone cytocompatibility of magnesium hydroxide nanoparticles (NPs) produced by using pure water, Mg(OH)2, or a rosehip (RH) aqueous extract, Mg(OH)2RH. The NPs were evaluated for dose- and time-dependent effects on human osteoblastic and osteoclastic response, due to the direct involvement of the two cell types in bone metabolism. Mg(OH)2 NPs presented nanoplatelet-like morphology (mean diameter ~90 nm) and a crystalline structure (XRD analysis); the RH-mediated synthesis yielded smaller rounded particles (mean diameter <10 nm) with decreased crystallinity. On the ATR-FTIR spectra, both NPs presented the characteristic Mg-OH peaks; Mg(OH)2RH exhibited additional vibration bands associated with the presence of phytochemicals. On osteoblastic cells, NPs did not affect cell growth and morphology but significantly increased alkaline phosphatase (ALP) activity; on osteoclastic cells, particles had little effect in protein content, tartrate-resistant acid phosphatase (TRAP) activity, percentage of multinucleated cells, and cell area. However, compared with Mg(OH)2, Mg(OH)2RH increased osteoblastic differentiation by inducing ALP activity and promoting the expression of Runx2, SP7, Col1a1, and ALP, and had a negative effect on the expression of the osteoclastic genes NFATC1, CA2, and CTSK. These observations suggest the potential usefulness of Mg(OH)2RH NPs in bone regeneration.
Collapse
|
24
|
Díez-Tercero L, Delgado LM, Bosch-Rué E, Perez RA. Evaluation of the immunomodulatory effects of cobalt, copper and magnesium ions in a pro inflammatory environment. Sci Rep 2021; 11:11707. [PMID: 34083604 PMCID: PMC8175577 DOI: 10.1038/s41598-021-91070-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
Biomaterials and scaffolds for Tissue Engineering are widely used for an effective healing and regeneration. However, the implantation of these scaffolds causes an innate immune response in which the macrophage polarization from M1 (pro-inflammatory) to M2 (anti-inflammatory) phenotype is crucial to avoid chronic inflammation. Recent studies have showed that the use of bioactive ions such as cobalt (Co2+), copper (Cu2+) and magnesium (Mg2+) could improve tissue regeneration, although there is limited evidence on their effect on the macrophage response. Therefore, we investigated the immunomodulatory potential of Co2+, Cu2+ and Mg2+ in macrophage polarization. Our results indicate that Mg2+ and concentrations of Cu2+ lower than 10 μM promoted the expression of M2 related genes. However, higher concentrations of Cu2+ and Co2+ (100 μM) stimulated pro-inflammatory marker expression, indicating a concentration dependent effect of these ions. Furthermore, Mg2+ were able to decrease M1 marker expression in presence of a mild pro-inflammatory stimulus, showing that Mg2+ can be used to modulate the inflammatory response, even though their application can be limited in a strong pro-inflammatory environment.
Collapse
Affiliation(s)
- Leire Díez-Tercero
- grid.410675.10000 0001 2325 3084Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona Spain
| | - Luis M. Delgado
- grid.410675.10000 0001 2325 3084Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona Spain
| | - Elia Bosch-Rué
- grid.410675.10000 0001 2325 3084Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona Spain
| | - Roman A. Perez
- grid.410675.10000 0001 2325 3084Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona Spain
| |
Collapse
|
25
|
Wang J, Kural MH, Wu J, Leiby KL, Mishra V, Lysyy T, Li G, Luo J, Greaney A, Tellides G, Qyang Y, Huang N, Niklason LE. An ex vivo physiologic and hyperplastic vessel culture model to study intra-arterial stent therapies. Biomaterials 2021; 275:120911. [PMID: 34087584 DOI: 10.1016/j.biomaterials.2021.120911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 11/19/2022]
Abstract
Conventional in vitro methods for biological evaluation of intra-arterial devices such as stents fail to accurately predict cytotoxicity and remodeling events. An ex vivo flow-tunable vascular bioreactor system (VesselBRx), comprising intra- and extra-luminal monitoring capabilities, addresses these limitations. VesselBRx mimics the in vivo physiological, hyperplastic, and cytocompatibility events of absorbable magnesium (Mg)-based stents in ex vivo stent-treated porcine and human coronary arteries, with in-situ and real-time monitoring of local stent degradation effects. Unlike conventional, static cell culture, the VesselBRx perfusion system eliminates unphysiologically high intracellular Mg2+ concentrations and localized O2 consumption resulting from stent degradation. Whereas static stented arteries exhibited only 20.1% cell viability and upregulated apoptosis, necrosis, metallic ion, and hypoxia-related gene signatures, stented arteries in VesselBRx showed almost identical cell viability to in vivo rabbit models (~94.0%). Hyperplastic intimal remodeling developed in unstented arteries subjected to low shear stress, but was inhibited by Mg-based stents in VesselBRx, similarly to in vivo. VesselBRx represents a critical advance from the current static culture standard of testing absorbable vascular implants.
Collapse
Affiliation(s)
- Juan Wang
- Department of Anesthesiology, School of Medicine, Yale University, New Haven, CT, 06519, USA
| | - Mehmet H Kural
- Department of Anesthesiology, School of Medicine, Yale University, New Haven, CT, 06519, USA
| | - Jonathan Wu
- Department of Biomedical Engineering, School of Medicine, Yale University, New Haven, CT, 06519, USA
| | - Katherine L Leiby
- Department of Biomedical Engineering, School of Medicine, Yale University, New Haven, CT, 06519, USA
| | - Vinayak Mishra
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, 06269, USA
| | - Taras Lysyy
- Department of Surgery, School of Medicine, Yale University, New Haven, CT, 06519, USA
| | - Guangxin Li
- Department of Surgery, School of Medicine, Yale University, New Haven, CT, 06519, USA
| | - Jiesi Luo
- Yale Cardiovascular Research Center, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT06519, USA
| | - Allison Greaney
- Department of Biomedical Engineering, School of Medicine, Yale University, New Haven, CT, 06519, USA
| | - George Tellides
- Department of Surgery, School of Medicine, Yale University, New Haven, CT, 06519, USA
| | - Yibing Qyang
- Yale Cardiovascular Research Center, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT06519, USA
| | - Nan Huang
- School of Material Science and Engineering, Southwest Jiaotong University, Chengdu, Sichuan, 610031, China
| | - Laura E Niklason
- Department of Anesthesiology, School of Medicine, Yale University, New Haven, CT, 06519, USA; Department of Biomedical Engineering, School of Medicine, Yale University, New Haven, CT, 06519, USA.
| |
Collapse
|
26
|
Hori M, Yasuda K, Takahashi H, Yamazaki C, Morozumi K, Maruyama S. Impact of serum magnesium and bone mineral density on systemic fractures in chronic hemodialysis patients. PLoS One 2021; 16:e0251912. [PMID: 34014999 PMCID: PMC8136656 DOI: 10.1371/journal.pone.0251912] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/06/2021] [Indexed: 01/13/2023] Open
Abstract
Introduction Bone mineral density (BMD) measured with dual-energy X-ray absorptiometry (DXA) can be used to predict fractures, but its clinical utility has not been fully established in chronic kidney disease (CKD) patients. Magnesium is an essential trace element. Although magnesium is associated with the risk of fractures in non-CKD populations, the relationship is unknown in CKD patients. Methods BMD and serum magnesium levels were measured in 358 stable outpatients undergoing maintenance hemodialysis therapy. The primary outcome was fragility fracture. Patients were divided into groups according to the median level of magnesium and the normal threshold value of lumbar spine BMD. Results During the median follow-up period of 36 months, 36 (10.0%) fractures occurred. The cumulative incidence rates of fractures were 17.6% and 5.2% [adjusted hazard ratio (aHR) 2.31, 95% confidence interval (CI) 1.03–5.17, P = 0.030] in the lower (<2.6 mg/dL) and higher (≥2.6 mg/dL) magnesium (Mg) groups, respectively, and 21.2% and 7.3% (aHR 2.59, 95% CI 1.09–6.16, P = 0.027) in the low- and high-BMD groups, respectively. The lower-Mg and low-BMD group had a 9.21-fold higher risk of fractures (95% CI; 2.35–47.00; P = 0.0010) than the higher-Mg and high-BMD group. Furthermore, adding both magnesium levels and lumbar spine BMD levels to the established risk factors significantly improved the prediction of fractures (C-index: 0.784 to 0.830, p = 0.041). Discussion/Conclusions The combination of serum magnesium and lumbar spine BMD can be used for fracture risk stratification and synergistically improves the prediction of fractures in CKD patients.
Collapse
Affiliation(s)
- Mayuko Hori
- Department of Nephrology, Masuko Memorial Hospital, Nakamura-ku, Nagoya, Aichi, Japan
- * E-mail:
| | - Kaoru Yasuda
- Department of Nephrology, Masuko Memorial Hospital, Nakamura-ku, Nagoya, Aichi, Japan
| | - Hiroshi Takahashi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | | | - Kunio Morozumi
- Department of Nephrology, Masuko Memorial Hospital, Nakamura-ku, Nagoya, Aichi, Japan
| | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| |
Collapse
|
27
|
Liu Y, Wu J, Zhang H, Wu Y, Tang C. Covalent immobilization of the phytic acid-magnesium layer on titanium improves the osteogenic and antibacterial properties. Colloids Surf B Biointerfaces 2021; 203:111768. [PMID: 33872830 DOI: 10.1016/j.colsurfb.2021.111768] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/03/2021] [Accepted: 04/12/2021] [Indexed: 11/15/2022]
Abstract
In order to improve early osseointegration and long-term survival rate of implants, a multifunctional titanium surface that promotes osteogenesis and antibacterial properties is expected. Incorporation of bioactive trace elements such as magnesium ions was proved a promising method to improve osseointegration of titanium. Phytic acid has strong chelating ability with multivalent cations, which has been used in surface modification. Moreover, phytic acid was proved antibacterial potential. Herein, to improve the osteogenic and antibacterial properties, a phytic acid-magnesium (PA-Mg) layer was introduced on titanium using phytic acid as a cross-linker molecule. No obvious changes of the surface characterization were observed by scanning electron microscopy and atomic force microscopy. X-ray photoelectron spectroscopy confirmed that the PA-Mg layer covalently bond to the Ti surface, and the thickness of the PA-Mg layer was about 150 nm. Besides, improved hydrophilic and more protein adsorption were observed on Ti-PA-Mg. Notably, a relatively controlled magnesium release was also observed on Ti-PA-Mg. Human bone mesenchymal stem cells showed better adhesion, proliferation, and osteogenic differentiation on Ti-PA-Mg samples, indicating improved biocompatibility and osteoinductivity. Moreover, Ti-PA-Mg had better antibacterial properties against porphyromonas gingivalis than Ti. Overall, the PA-Mg layer on Ti surface improved the osteogenic and antibacterial properties, which may have promise for use in dental implantation.
Collapse
Affiliation(s)
- Yajing Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China; Department of Dental Implantology, Affiliated Stomatological Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China
| | - Jin Wu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China; Department of Dental Implantology, Affiliated Stomatological Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China
| | - Hao Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China; Department of Dental Implantology, Affiliated Stomatological Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China; Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yizhen Wu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China; Department of Dental Implantology, Affiliated Stomatological Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China
| | - Chunbo Tang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China; Department of Dental Implantology, Affiliated Stomatological Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China.
| |
Collapse
|
28
|
In vivo degradation and bone formation behaviors of hydroxyapatite-coated Mg alloys in rat femur. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 122:111942. [PMID: 33641928 DOI: 10.1016/j.msec.2021.111942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/17/2020] [Accepted: 01/31/2021] [Indexed: 01/01/2023]
Abstract
Various coatings have been developed for biodegradable Mg alloys to control the degradation speed and to improve the bone conductivity. In this study, hydroxyapatite (HAp) coatings were formed on pure Mg, Mg-0.8mass% Ca (MgCa), Mg-4mass% Y-3mass% rare earth (RE) (WE43), Mg-3mass% RE-1mass% Y (EW31) and Mg-4mass% RE (RE4) alloy rods with a chemical solution deposition method. The HAp-coated and uncoated Mg/Mg alloy rods were implanted in the femurs of rats for 3-6 months, and the corrosion suppression and bone formation abilities of the HAp coating were examined using a scanning electron microscope. The corrosion rate of WE43 was suppressed by 1/3 with the HAp coating for 6 months, and the corrosion product showed very slow dissolution. The effect of the HAp coating for pure Mg and MgCa disappeared in 1-2 months with the thinning of the rods accompanying with the obvious dissolution of the corrosion products. The effect of the HAp coating for EW31 and RE4 was not stable due to the expansion and collapse of the corrosion products. The bone formation was enhanced on the HAp layers. Eventually, the HAp coating basically suppressed the corrosion initiation and corrosion progress of Mg substrates. The magnitude of the suppression effect depended mainly on the chemical and physical stability of the corrosion products.
Collapse
|
29
|
Arkin V, Narendrakumar U, Madhyastha H, Manjubala I. Characterization and In Vitro Evaluations of Injectable Calcium Phosphate Cement Doped with Magnesium and Strontium. ACS OMEGA 2021; 6:2477-2486. [PMID: 33553866 PMCID: PMC7859950 DOI: 10.1021/acsomega.0c03927] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/04/2021] [Indexed: 05/17/2023]
Abstract
Injectable calcium phosphate cement is a promising biomaterial for hard tissue repair due to its osteoinductivity, biocompatibility properties, and its use to correct defect areas involving narrow cavities with limited accessibility by the minimally invasive technique. Microwave-synthesized hydroxyapatite (HA) was used for the preparation of cement. In recent years, both magnesium and strontium calcium phosphate cements have exhibited rapid setting, improved mechanical strength, and a good resorption rate. A big step still remains to develop injectable magnesium and strontium phosphate cements with ideal self-setting properties, adequate mechanical strength, and good biocompatibility for clinical applications. In this study, both magnesium and strontium were doped with synthesized semiamorphous and crystalline hydroxyapatite (HA). The powder mixture was mixed with Na2HPO4, NaH2PO4, and a carboxymethyl cellulose (CMC) solution to develop the novel magnesium and strontium calcium phosphate cement. The setting time, physiochemical properties of hardened cement, microstructure, mechanical strength, and injectability of the prepared cement were studied. The toxicity evaluation and cell adhesion, which are necessary to identify the suitability of the material for different applications, were quantified and investigated using fibroblast cells. The setting time of cement was reduced substantially for magnesium- or strontium-doped cement by 2 min. The phase composition of the hardened cement expresses the semiamorphous or crystalline phase of HA with additives. Smooth and complete injection of cement paste was observed in semiamorphous HA-based cement. The intercellular reactive oxygen stress (ROS) of the Sr2+-doped cement sample showed varied degrees of toxicity to cells in terms of different concentrations. The Mg2+-doped cement showed significant attachment of cells after treatment at varying incubation times.
Collapse
Affiliation(s)
- Vetharaj
HephzibahRajam Arkin
- Department
of Biosciences, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Uttamchand Narendrakumar
- Department
of Manufacturing Engineering, School of Mechanical Engineering, Vellore Institute of Technology, Vellore 632014, India
| | - Harishkumar Madhyastha
- Department
of Applied Physiology, Faculty of Medicine, University of Miyazaki, Miyazaki 8891692, Japan
| | - Inderchand Manjubala
- Department
of Biosciences, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore 632014, India
| |
Collapse
|
30
|
Negrescu AM, Necula MG, Gebaur A, Golgovici F, Nica C, Curti F, Iovu H, Costache M, Cimpean A. In Vitro Macrophage Immunomodulation by Poly(ε-caprolactone) Based-Coated AZ31 Mg Alloy. Int J Mol Sci 2021; 22:ijms22020909. [PMID: 33477539 PMCID: PMC7831122 DOI: 10.3390/ijms22020909] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 12/12/2022] Open
Abstract
Due to its excellent bone-like mechanical properties and non-toxicity, magnesium (Mg) and its alloys have attracted great interest as biomaterials for orthopaedic applications. However, their fast degradation rate in physiological environments leads to an acute inflammatory response, restricting their use as biodegradable metallic implants. Endowing Mg-based biomaterials with immunomodulatory properties can help trigger a desired immune response capable of supporting a favorable healing process. In this study, electrospun poly(ε-caprolactone) (PCL) fibers loaded with coumarin (CM) and/or zinc oxide nanoparticles (ZnO) were used to coat the commercial AZ31 Mg alloy as single and combined formulas, and their effects on the macrophage inflammatory response and osteoclastogenic process were investigated by indirect contact studies. Likewise, the capacity of the analyzed samples to generate reactive oxygen species (ROS) has been investigated. The data obtained by attenuated total reflection Fourier-transform infrared (FTIR-ATR) and X-ray photoelectron spectroscopy (XPS) analyses indicate that AZ31 alloy was perfectly coated with the PCL fibers loaded with CM and ZnO, which had an important influence on tuning the release of the active ingredient. Furthermore, in terms of degradation in phosphate-buffered saline (PBS) solution, the PCL-ZnO- and secondary PCL-CM-ZnO-coated samples exhibited the best corrosion behaviour. The in vitro results showed the PCL-CM-ZnO and, to a lower extent, PCL-ZnO coated sample exhibited the best behaviour in terms of inflammatory response and receptor activator of nuclear factor kappa-B ligand (RANKL)-mediated differentiation of RAW 264.7 macrophages into osteoclasts. Altogether, the results obtained suggest that the coating of Mg alloys with fibrous PCL containing CM and/or ZnO can constitute a feasible strategy for biomedical applications.
Collapse
Affiliation(s)
- Andreea-Mariana Negrescu
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania; (A.-M.N.); (M.-G.N.); (C.N.); (M.C.)
| | - Madalina-Georgiana Necula
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania; (A.-M.N.); (M.-G.N.); (C.N.); (M.C.)
| | - Adi Gebaur
- Advance Polymer Materials Group, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Gh. Polizu 17, 011061 Bucharest, Romania; (A.G.); (F.C.); (H.I.)
| | - Florentina Golgovici
- Department of General Chemistry, Faculty of Applied Chemistry and Material Science, University Politehnica of Bucharest, Gh. Polizu 1-7, 011061 Bucharest, Romania;
| | - Cristina Nica
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania; (A.-M.N.); (M.-G.N.); (C.N.); (M.C.)
| | - Filis Curti
- Advance Polymer Materials Group, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Gh. Polizu 17, 011061 Bucharest, Romania; (A.G.); (F.C.); (H.I.)
| | - Horia Iovu
- Advance Polymer Materials Group, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, Gh. Polizu 17, 011061 Bucharest, Romania; (A.G.); (F.C.); (H.I.)
| | - Marieta Costache
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania; (A.-M.N.); (M.-G.N.); (C.N.); (M.C.)
| | - Anisoara Cimpean
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania; (A.-M.N.); (M.-G.N.); (C.N.); (M.C.)
- Correspondence: ; Tel.: +40-21-318-1575 (ext. 106)
| |
Collapse
|
31
|
Severin AV, Rudin VN, Paul’ ME. Characteristic Features of Mg2+ Behavior and Mg2+ Effect on the Structure and Morphology of Nanohydroxyapatite in the Adsorption Method for the Fabrication of the HA-Mg Composite. RUSS J INORG CHEM+ 2020. [DOI: 10.1134/s003602362009017x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
|
32
|
He W, Zhang H, Qiu J. Osteogenic effects of bioabsorbable magnesium implant in rat mandibles and in vitro. J Periodontol 2020; 92:1181-1191. [PMID: 32846010 DOI: 10.1002/jper.20-0162] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/03/2020] [Accepted: 07/30/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Bone augmentation or grafting is often required for placement of dental implants or surgical reconstruction of bony defects. Bioabsorbable magnesium implant was shown to promote osteogenesis in long bones. The objectives of this study were to determine osteogenic effects of pure magnesium (Mg) in rat mandible and underlying mechanisms. METHODS Pure Mg was implanted in sockets after rat mandibular incisors were extracted. Titanium (Ti) was used as control. Systemic effects were determined by serum Mg level and histologic analyses of liver and kidney. Local Mg concentration was measured by microscopy-energy-dispersive spectroscopy (SEM-EDS). Alveolar bone was analyzed by micro-computed tomography (micro-CT) and histology. Osteogenic effects of 0.8 to 20 mM magnesium chloride (MgCl2 ) on periosteum-derived cells (PDCs) were evaluated by proliferation, alizarin red staining and quantitative RT-PCR assays. RESULTS Systemic effects were similar in Mg and Ti groups. Higher local Mg concentration was detected in Mg group (P < 0.05). Micro-CT showed higher alveolar bone volume (2- and 6-weeks post-operation) and denser cancellous bone (2 weeks post-operation) in Mg group, with significant amount of new subperiosteal bone formation on lateral alveolar bone surfaces by H&E staining. In PDC culture, proliferation rates, osteogenic gene expression for runt related transcription factor 2 (Runx2), bone sialoprotein (Bsp) and osteocalcin (Ocn), as well as calcium nodule formation rose significantly in 5, 10, and 20 mM MgCl2 groups. CONCLUSIONS Rapid osteogenesis (especially subperiosteal) is induced by pure Mg in rat mandibular alveolar bone. Osteogenic capacity of PDCs is enhanced by higher Mg ion concentrations in vitro.
Collapse
Affiliation(s)
- Wei He
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hai Zhang
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Jiaxuan Qiu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| |
Collapse
|
33
|
Shen J, Chen B, Zhai X, Qiao W, Wu S, Liu X, Zhao Y, Ruan C, Pan H, Chu PK, Cheung KM, Yeung KW. Stepwise 3D-spatio-temporal magnesium cationic niche: Nanocomposite scaffold mediated microenvironment for modulating intramembranous ossification. Bioact Mater 2020; 6:503-519. [PMID: 32995676 PMCID: PMC7492774 DOI: 10.1016/j.bioactmat.2020.08.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 12/15/2022] Open
Abstract
The fate of cells and subsequent bone regeneration is highly correlated with temporospatial coordination of chemical, biological, or physical cues within a local tissue microenvironment. Deeper understanding of how mammalian cells react to local tissue microenvironment is paramount important when designing next generation of biomaterials for tissue engineering. This study aims to investigate that the regulation of magnesium cationic (Mg2+) tissue microenvironment is able to convince early-stage bone regeneration and its mechanism undergoes intramembranous ossification. It was discovered that moderate Mg2+ content niche (~4.11 mM) led to superior bone regeneration, while Mg2+-free and strong Mg2+ content (~16.44 mM) discouraged cell adhesion, proliferation and osteogenic differentiation, thereby bone formation was rarely found. When magnesium ions diffused into free Mg zone from concentrated zone in late time point, new bone formation on free Mg zone became significant through intramembranous ossification. This study successfully demonstrates that magnesium cationic microenvironment serves as an effective biochemical cue and is able to modulate the process of bony tissue regeneration. The knowledge of how a Mg2+ cationic microenvironment intertwines with cells and subsequent bone formation gained from this study may provide a new insight to develop the next generation of tissue-repairing biomaterials. Regulation of Mg2+ concertation in tissue microenvironment can convince early-stage bone regeneration. Samples without and with strong Mg2+ microenvironments (16.44 mM) suppressed the osteogenic differentiation. When Mg2+ diffused into free Mg zone from concentrated zone over time, bone formation over free Mg zone becomes significant. Bone defect repair through intramembranous ossification was promoted by 3D-scaffold-created moderate Mg2+ microenvironment.
Collapse
Affiliation(s)
- Jie Shen
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, the University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Bo Chen
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
- Shanghai Institute of Traumatology and Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xinyun Zhai
- School of Materials Science and Engineering, Nankai University, Tianjin, China
| | - Wei Qiao
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, the University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Shuilin Wu
- School of Materials Science & Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Tianjin, China
- Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, School of Materials Science & Engineering, Hubei University, Wuhan, China
| | - Xuanyong Liu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, China
- Cixi Center of Biomaterials Surface Engineering, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Ningbo, China
| | - Ying Zhao
- Center for Human Tissues and Organs Degeneration, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Changshun Ruan
- Center for Human Tissues and Organs Degeneration, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Haobo Pan
- Center for Human Tissues and Organs Degeneration, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Paul K. Chu
- Department of Physics, Department of Materials Science & Engineering, and Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Kenneth M.C. Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, the University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Kelvin W.K. Yeung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, the University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Corresponding author. Department of Orthopaedics and Traumatology, the University of Hong Kong, Hong Kong, China
| |
Collapse
|
34
|
Li LY, Han ZZ, Zeng RC, Qi WC, Zhai XF, Yang Y, Lou YT, Gu T, Xu D, Duan JZ. Microbial ingress and in vitro degradation enhanced by glucose on bioabsorbable Mg-Li-Ca alloy. Bioact Mater 2020; 5:902-916. [PMID: 32637753 PMCID: PMC7329939 DOI: 10.1016/j.bioactmat.2020.06.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 01/10/2023] Open
Abstract
Biodegradable magnesium alloys are challenging to be implanted in patients with hyperglycemia and diabetes. A hypothesis is suggested that glucose accelerates microbial ingress and in vitro degradation of Mg-Li-Ca implants. Corrosion resistance and mechanical properties was demonstrated using electrochemical, hydrogen evolution and tensile tests. The bacteria from Hank's solution were isolated via 16S rRNA gene analysis. The results revealed that Mg-1Li-1Ca alloy exhibited different responses to Hank's solution with and without glucose. The solution acidity was ascribed to Microbacterium hominis and Enterobacter xiangfangensis, indicating that glucose promoted microbial activity and degradation and deterioration in mechanical property of Mg-1Li-1Ca alloy.
Collapse
Affiliation(s)
- Ling-Yu Li
- Corrosion Laboratory for Light Metals, College of Material Science and Engineering, Shandong University of Science and Technology, Qingdao, 266590, China
| | - Zhuang-Zhuang Han
- Corrosion Laboratory for Light Metals, College of Material Science and Engineering, Shandong University of Science and Technology, Qingdao, 266590, China
| | - Rong-Chang Zeng
- Corrosion Laboratory for Light Metals, College of Material Science and Engineering, Shandong University of Science and Technology, Qingdao, 266590, China.,School of Materials Science and Engineering, Zhengzhou University, Zhengzhou, 450002, China
| | - Wei-Chen Qi
- Corrosion Laboratory for Light Metals, College of Material Science and Engineering, Shandong University of Science and Technology, Qingdao, 266590, China
| | - Xiao-Fan Zhai
- Institute of Oceanology, Chinese Academy of Sciences, Qingdao, 266590, China
| | - Yi Yang
- Shenyang National Laboratory for Materials Science, Northeastern University, Shenyang, 110819, China
| | - Yun-Tian Lou
- Shenyang National Laboratory for Materials Science, Northeastern University, Shenyang, 110819, China
| | - Tingyue Gu
- Department of Chemical & Biomolecular Engineering, Russ College of Engineering and Technology, Ohio University, Athens, OH, 45701-2979, USA
| | - Dake Xu
- Shenyang National Laboratory for Materials Science, Northeastern University, Shenyang, 110819, China
| | - Ji-Zhou Duan
- Institute of Oceanology, Chinese Academy of Sciences, Qingdao, 266590, China
| |
Collapse
|
35
|
Zhai D, Chen L, Chen Y, Zhu Y, Xiao Y, Wu C. Lithium silicate-based bioceramics promoting chondrocyte maturation by immunomodulating M2 macrophage polarization. Biomater Sci 2020; 8:4521-4534. [DOI: 10.1039/d0bm00450b] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
LCS scaffolds promoted chondrocyte maturation by inducing M2 macrophage polarization.
Collapse
Affiliation(s)
- Dong Zhai
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics
- Chinese Academy of Sciences
- Shanghai 200050
- PR China
| | - Lei Chen
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics
- Chinese Academy of Sciences
- Shanghai 200050
- PR China
| | - Yu Chen
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics
- Chinese Academy of Sciences
- Shanghai 200050
- PR China
| | - Yufang Zhu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics
- Chinese Academy of Sciences
- Shanghai 200050
- PR China
| | - Yin Xiao
- The Institute of Health and Biomedical Innovation
- Queensland University of Technology
- Queensland 4059
- Australia
| | - Chengtie Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics
- Chinese Academy of Sciences
- Shanghai 200050
- PR China
| |
Collapse
|
36
|
Yang Y, Liu L, Luo H, Zhang D, Lei S, Zhou K. Dual-Purpose Magnesium-Incorporated Titanium Nanotubes for Combating Bacterial Infection and Ameliorating Osteolysis to Realize Better Osseointegration. ACS Biomater Sci Eng 2019; 5:5368-5383. [PMID: 33464078 DOI: 10.1021/acsbiomaterials.9b00938] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Ying Yang
- State Key Laboratory of Powder Metallurgy, Research Institute of Powder Metallurgy, Central South University, Changsha 410083, China
- Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Lihong Liu
- State Key Laboratory of Powder Metallurgy, Research Institute of Powder Metallurgy, Central South University, Changsha 410083, China
- Department of Orthopedic Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Hang Luo
- State Key Laboratory of Powder Metallurgy, Research Institute of Powder Metallurgy, Central South University, Changsha 410083, China
| | - Dou Zhang
- State Key Laboratory of Powder Metallurgy, Research Institute of Powder Metallurgy, Central South University, Changsha 410083, China
| | - Shaorong Lei
- Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Kechao Zhou
- State Key Laboratory of Powder Metallurgy, Research Institute of Powder Metallurgy, Central South University, Changsha 410083, China
| |
Collapse
|
37
|
Li Y, Gao J, Yang L, Shen J, Jiang Q, Wu C, Zhu D, Zhang Y. Biodegradable and Bioactive Orthopedic Magnesium Implants with Multilayered Protective Coating. ACS APPLIED BIO MATERIALS 2019; 2:3290-3299. [DOI: 10.1021/acsabm.9b00313] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yixuan Li
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210093, China
| | - Jing Gao
- Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, China
| | - Liyun Yang
- Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, China
| | - Jian Shen
- Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, China
| | - Qing Jiang
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210093, China
| | - Chi Wu
- Department of Chemistry, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Dan Zhu
- Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, China
| | - Yifeng Zhang
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210093, China
| |
Collapse
|
38
|
Yue J, Jin S, Gu S, Sun R, Liang Q. High concentration magnesium inhibits extracellular matrix calcification and protects articular cartilage via Erk/autophagy pathway. J Cell Physiol 2019; 234:23190-23201. [PMID: 31161622 DOI: 10.1002/jcp.28885] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/14/2019] [Accepted: 05/01/2019] [Indexed: 01/05/2023]
Abstract
The significant cytopathological changes of osteoarthritis are chondrocyte hypertrophy, proteoglycan loss, extracellular matrix (ECM) calcification, and terminally, the replacement of cartilage by bone. Meanwhile, magnesium ion (Mg2+ ), as the second most abundant divalent cation in the human body, has been proved to inhibit the ECM calcification of hBMSCs (human bone marrow stromal cells), hVSMCs (Human vascular smooth muscle cells), and TDSCs (tendon-derived stem cells) in vitro studies. The ATDC5 cell line, which holds chondrocyte characteristics, was used in this study as an in vitro subject. We found that Mg2+ can efficiently suppress the ECM calcification and downregulate both hypertrophy and matrix metalloproteinase-related genes. Meanwhile, Mg2+ inhibits the formation of autophagy by inhibiting Erk phosphorylation signaling and lowers the expression of LC3, and eventually effectively reduces the formation of ECM calcification in vitro. In this study, we also used destabilization of the medial meniscus (DMM)-induced osteoarthritis (OA) animal model to further confirm the protective effect of Mg2+ on articular cartilage. Compared with the control group (saline-injected), continuous intra-articular magnesium chloride (MgCl2 ) injection can significantly alleviate the severity of cartilage calcification in OA animal model. Immunofluorescence staining also revealed that saline-injected DMM group had a higher positive rate of LC3 expression in cartilage chondrocytes, compared with MgCl2 -injected DMM group. In general, Mg2+ can significantly downregulate the hypertrophic gene Runx2, MMP13, and Col10α1, upregulate the chondrogenic genes Sox9 and Col1α1, inhibit the Erk phosphorylation signaling, reduce the expression of autophagy protein LC3, and effectively inhibit the ECM calcification of ATDC5. In vivo study also proved that intra-articular injection of Mg2+ protected knee cartilage by inhibiting the autophagy formation.
Collapse
Affiliation(s)
- Jiaji Yue
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Shanzi Jin
- Department of Critical Care Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Shizhong Gu
- Department of Sports Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Rui Sun
- Department of Sports Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Qingwei Liang
- Department of Sports Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| |
Collapse
|
39
|
Bai L, Liu Y, Zhang X, Huang X, Yao X, Hang R, Tang B, Xiao Y. Favorable manipulation of macrophage/endothelial cell functionality and their cross-talk on silicon-doped titania nanotube arrays. NANOSCALE 2019; 11:5920-5931. [PMID: 30693919 DOI: 10.1039/c8nr08381a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Inflammatory reactions and the functionality of endothelial cells (ECs) on the surfaces of coronary stents are critical in the prevention of in-stent restenosis and subsequent neoatherosclerosis. However, the interactions between immune cells and ECs on modified coronary stent surfaces have long been underestimated. In the present study, silicon (Si)-doped titania nanotube arrays (TNA-Sis) were obtained via the facile anodization of magnetron-sputtered Ti-Si coatings. The synergetic effects of titania nanotube arrays (TNAs) and chemical cues (Si) on the functionality of macrophages (MΦs)/ECs and their cross-talk were investigated. The results indicated that TNA-Sis specimens, in comparison with TNAs alone, not only promoted the initial vitality of ECs, enhanced the expression of vascular endothelial growth factor (VEGF) and nitric oxide (NO), and activated multiple cell signaling pathways (vWF, PECAM, eNOS), but also induced a favorable immune response through the polarization of MΦs to a pro-healing M2 phenotype via the activation of cell autophagy, resulting in the downregulation of inflammatory reactions. This beneficial immune response further facilitated cross-talk between ECs and MΦs, resulting in profoundly increased functionality of ECs on TNA-Sis surfaces. This study demonstrated that using TNA-Sis surface coatings for coronary stents may be a promising strategy to prevent in-stent restenosis.
Collapse
Affiliation(s)
- Long Bai
- Research Institute of Surface Engineering, College of Materials Science and Engineering, Taiyuan University of Technology, Taiyuan, China.
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Du Z, Yu X, Nie B, Zhu Z, Ibrahim M, Yang K, Tan L, Wang Y. Effects of magnesium coating on bone-implant interfaces with and without polyether-ether-ketone particle interference: A rabbit model based on porous Ti6Al4V implants. J Biomed Mater Res B Appl Biomater 2019; 107:2388-2396. [PMID: 30684307 DOI: 10.1002/jbm.b.34332] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 12/25/2018] [Accepted: 01/13/2019] [Indexed: 11/06/2022]
Abstract
We investigated the effects of magnesium (Mg) on osteogenesis and bone resorption at a porous structure interface. A three-dimensional (3D)-printed porous Ti6Al4V implant coated with Mg was introduced, and polyether-ether-ketone wear particles were added to generate an animal model of implant loosening. We also examined the effects of Mg leach liquor on osteoblast/osteoclast gene expression, alkaline phosphatase activity, collagen secretion, tartrate-resistant acid phosphatase activity, and bone resorption in vitro. Mg inhibited the early stage of osteoclast differentiation and inhibited bone resorption in vitro and in vivo. However, Mg did not enhance osteogenesis in vitro or in vivo in the porous structures or in peripheral areas around the implants. For implants with porous structures, the Mg coating did not improve the osteogenic ability by itself, but could restrain peri-implant osteolysis, which may make it favorable for use in patients with osteoporosis. Further studies are needed to examine the precise mechanism of Mg-induced anti-osteolysis and the long-term effects of Mg-coated implants in humans. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2388-2396, 2019.
Collapse
Affiliation(s)
- Zhe Du
- Trauma Center, Peking University People's Hospital, Beijing, China.,Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiaoming Yu
- Institute of Metal Research, Chinese Academy of Science, Shenyang, China
| | - Binen Nie
- Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Zhonglin Zhu
- Jiangsu OKANI Medical Technology Co., Ltd, Soochow, China
| | - Muhammad Ibrahim
- Institute of Metal Research, Chinese Academy of Science, Shenyang, China.,School of Materials Science and Engineering, University of Science and Technology of China, Shenyang, China
| | - Ke Yang
- Institute of Metal Research, Chinese Academy of Science, Shenyang, China
| | - Lili Tan
- Institute of Metal Research, Chinese Academy of Science, Shenyang, China
| | - You Wang
- Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| |
Collapse
|
41
|
Magnesium Is a Key Regulator of the Balance between Osteoclast and Osteoblast Differentiation in the Presence of Vitamin D₃. Int J Mol Sci 2019; 20:ijms20020385. [PMID: 30658432 PMCID: PMC6358963 DOI: 10.3390/ijms20020385] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/21/2018] [Accepted: 01/12/2019] [Indexed: 01/28/2023] Open
Abstract
Magnesium (Mg) is crucial for bone health. Low concentrations of Mg inhibit the activity of osteoblasts while promoting that of osteoclasts, with the final result of inducing osteopenia. Conversely, little is known about the effects of high concentrations of extracellular Mg on osteoclasts and osteoblasts. Since the differentiation and activation of these cells is coordinated by vitamin D₃ (VD3), we investigated the effects of high extracellular Mg, as well as its impact on VD3 activity, in these cells. U937 cells were induced to osteoclastic differentiation by VD3 in the presence of supra-physiological concentrations (>1 mM) of extracellular Mg. The effect of high Mg concentrations was also studied in human bone-marrow-derived mesenchymal stem cells (bMSCs) induced to differentiate into osteoblasts by VD3. We demonstrate that high extra-cellular Mg levels potentiate VD3-induced osteoclastic differentiation, while decreasing osteoblastogenesis. We hypothesize that Mg might reprogram VD3 activity on bone remodeling, causing an unbalanced activation of osteoclasts and osteoblasts.
Collapse
|
42
|
Zhang N, Liu N, Sun C, Zhu J, Wang D, Dai Y, Wu Y, Wang Y, Li J, Zhao D, Yan J. [ In vivo study of a novel micro-arc oxidation coated magnesium-zinc-calcium alloy scaffold/autologous bone particles repairing critical size bone defect in rabbit]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2018; 32:298-305. [PMID: 29806278 DOI: 10.7507/1002-1892.201710003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To evaluate the effect of a novel micro-arc oxidation (MAO) coated magnesium-zinc-calcium (Mg-Zn-Ca) alloy scaffold/autologous bone particles to repair critical size bone defect (CSD) in rabbit and explore the novel scaffold in vivo corrosion resistance and biocompatibility. Methods Seventy-two New Zealand white rabbits were randomly divided into 3 groups ( n=24), group A was uncoated Mg-Zn-Ca alloy scaffold group, group B was 10 μm MAO coated Mg-Zn-Ca alloy scaffold group, and group C was control group with only autologous bone graft. The animals were operated to obtain bilateral ulnar CSD (15 mm in length) models. The bone fragment was removed and minced into small particles and were filled into the scaffolds of groups A and B. Then, the scaffolds or autologous bone particles were replanted into the defects. The animals were sacrificed at 2, 4, 8, and 12 weeks after surgery (6 rabbits each group). The local subcutaneous pneumatosis was observed and recorded. The ulna defect healing was evaluated by X-ray image and Van Gieson staining. The X-ray images were assessed and scored by Lane-Sandhu criteria. The percentage of the lost volume of the scaffold (ΔV) and corrosion rate (CR) were calculated by the Micro-CT. The Mg 2+ and Ca 2+ concentrations were monitored during experiment and the rabbit liver, brain, kidney, and spleen were obtained to process HE staining at 12 weeks after surgery. Results The local subcutaneous pneumatosis in group B was less than that in group A at 2, 4, and 8 weeks after surgery, showing significant differences between 2 groups at 2 and 4 weeks after surgery ( P<0.05); and the local subcutaneous pneumatosis was significantly higher in group B than that in group A at 12 weeks after surgery ( P<0.05). The X-ray result showed that the score of group C was significantly higher than those of groups A and B at 4 and 8 weeks after surgery ( P<0.05), and the score of group B was significantly higher than that of group A at 8 weeks ( P<0.05). At 12 weeks after surgery, the scores of groups B and C were significantly higher than that of group A ( P<0.05). Meanwhile, the renew bone moulding of group B was better than that in group A at 12 weeks after surgery. Micro-CT showed that ΔV and CR in group B were significantly lower than those in group A ( P<0.05). Van Gieson staining showed that group B had better biocompatibility and osteanagenesis than group A. The Mg 2+ and Ca 2+ concentrations in serum showed no significant difference between groups during experiments ( P>0.05). And there was no obvious pathological changes in the liver, brain, kidney, and spleen of the 3 groups with HE staining at 12 weeks. Conclusion The MAO coated Mg-Zn-Ca alloy scaffold/autologous bone particles could be used to repair CSD effectively. At the same time, 10 μm MAO coating can effectively improve the osteanagenesis, corrosion resistance, and biocompatibility of Mg-Zn-Ca alloy scaffold.
Collapse
Affiliation(s)
- Nan Zhang
- Department of Orthopedics, Second Affiliated Hospital of Qiqihar Medical College, Qiqihar Heilongjiang, 161000, P.R.China;Department of Orthopedics, Second Affiliated Hospital of Harbin Medical University, Harbin Heilongjiang, 150086,
| | - Na Liu
- Department of Orthopedics, Second Affiliated Hospital of Qiqihar Medical College, Qiqihar Heilongjiang, 161000, P.R.China
| | - Chu Sun
- Department of Orthopedics, Second Affiliated Hospital of Qiqihar Medical College, Qiqihar Heilongjiang, 161000, P.R.China
| | - Jianfeng Zhu
- Department of Orthopedics, Second Affiliated Hospital of Qiqihar Medical College, Qiqihar Heilongjiang, 161000, P.R.China
| | - Dongxu Wang
- Department of Orthopedics, Second Affiliated Hospital of Qiqihar Medical College, Qiqihar Heilongjiang, 161000, P.R.China
| | - Yunfeng Dai
- Department of Orthopedics, Second Affiliated Hospital of Qiqihar Medical College, Qiqihar Heilongjiang, 161000, P.R.China
| | - Yunfeng Wu
- Institute for Advanced Ceramics, Harbin Institute of Technology, Harbin Heilongjiang, 150001, P.R.China
| | - Yaming Wang
- Institute for Advanced Ceramics, Harbin Institute of Technology, Harbin Heilongjiang, 150001, P.R.China
| | - Junlei Li
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian Liaoning, 116001, P.R.China
| | - Dewei Zhao
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian Liaoning, 116001, P.R.China
| | - Jinglong Yan
- Department of Orthopedics, Second Affiliated Hospital of Harbin Medical University, Harbin Heilongjiang, 150086, P.R.China
| |
Collapse
|
43
|
Tripathi G, Sugiura Y, Tsuru K, Ishikawa K. In vivo stability evaluation of Mg substituted low crystallinity ß-tricalcium phosphate granules fabricated through dissolution-precipitation reaction for bone regeneration. ACTA ACUST UNITED AC 2018; 13:065002. [PMID: 30010092 DOI: 10.1088/1748-605x/aad385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Although β-tricalcium phosphate (β-TCP) is widely used in clinical applications as a bone substitute owing to its positive tissue response and its ability to be replaced by new bone through a bone-remodeling process, it has the limitation of rapid resorption in vivo, which might become a reason for tissue atrophy and high crystallinity, which decrease biocompatibility. A reduction in the crystallinity might increase the biocompatibility of the bone substitute. To overcome the drawbacks of β-TCP, decrease in crystallinity and solubility, both are required. Therefore, in this study, the feasibility of fabricating Mg substituted low crystalline β-TCP (Mg-LC-β-TCP) granules formed in aqueous solution was evaluated in vivo focusing long-term adsorption and bone formation in bone defects formed in the rabbit femur using sintered β-TCP granules as a control. With Mg-LC-β-TCP, the resorption of the substitute was suppressed, and no tissue atrophy was observed even at 24 weeks post-implantation, whereas a few granules with surrounding tissue atrophy were observed at 12 weeks post-implantation. Tartrate-resistant acid phosphatase-staining indicated that the density of osteoclasts type cells with Mg-LC-β-TCP was significantly lower than that with β-TCP, and also the numbers of osteoblasts type cells with Mg-LC-β-TCP were significantly higher than that with β-TCP. It is suggested that Mg substitution to form low crystallinity β-TCP is a valuable way to overcome the limitations of β-TCP as a bone substitute.
Collapse
Affiliation(s)
- Garima Tripathi
- Department of Biomaterials, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi, Fukuoka 812-8532, Japan
| | | | | | | |
Collapse
|
44
|
Maradze D, Musson D, Zheng Y, Cornish J, Lewis M, Liu Y. High Magnesium Corrosion Rate has an Effect on Osteoclast and Mesenchymal Stem Cell Role During Bone Remodelling. Sci Rep 2018; 8:10003. [PMID: 29968794 PMCID: PMC6030161 DOI: 10.1038/s41598-018-28476-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 06/19/2018] [Indexed: 01/12/2023] Open
Abstract
The aim of this study was to gain an understanding on the collective cellular effects of magnesium (Mg) corrosion products on the behaviour of cells responsible for bone formation and remodelling. The response of mesenchymal stem cells (MSCs) and osteoclast cells to both soluble (Mg ions) and insoluble (granule) corrosion products were recapitulated in vitro by controlling the concentration of the corrosion products. Clearance of corrosion granules by MSCs was also inspected by TEM analysis at sub-cellular level. The effect of Mg corrosion products varied depending on the state of differentiation of cells, concentration and length of exposure. The presence of the corrosion products significantly altered the cells' metabolic and proliferative activities, which further affected cell fusion/differentiation. While cells tolerated higher than physiological range of Mg concentration (16 mM), concentrations below 10 mM were beneficial for cell growth. Furthermore, MSCs were shown to contribute to the clearance of intercellular corrosion granules, whilst high concentrations of corrosion products negatively impacted on osteoclast progenitor cell number and mature osteoclast cell function.
Collapse
Affiliation(s)
- Diana Maradze
- Centre of Biological Engineering, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - David Musson
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Yufeng Zheng
- College of Engineering, Peking University, Beijing, 100871, China
| | - Jillian Cornish
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Mark Lewis
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - Yang Liu
- Centre of Biological Engineering, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
| |
Collapse
|
45
|
Agha NA, Liu Z, Feyerabend F, Willumeit-Römer R, Gasharova B, Heidrich S, Mihailova B. The effect of osteoblasts on the surface oxidation processes of biodegradable Mg and Mg-Ag alloys studied by synchrotron IR microspectroscopy. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 91:659-668. [PMID: 30033300 DOI: 10.1016/j.msec.2018.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 04/26/2018] [Accepted: 06/05/2018] [Indexed: 11/16/2022]
Abstract
High-resolution analytical methods, including synchrotron infrared microspectroscopy combined with wavelength-dispersive X-ray emission spectroscopy were applied to study the structure and chemical composition of the oxidized layer of pure and Ag-alloyed Mg exposed to cell culture media without and with osteoblasts. Comparative analysis has been done on pure Mg immersed in two different cell culture media: Dulbecco's Modified Eagle's Medium (DMEM) and Roswell Park Memorial Institute medium (RPMI), whereas Mg-xAg binary alloys (x = 2, 4, 6, 8 wt%) were studied after immersion in DMEM. It is shown that the physicochemical formation of degradation products as well as the activity of the biological component is influenced by the addition of silver. It could be demonstrated that the presence of Ag in the Mg alloy enhances the chemical reaction between Mg and C to form amorphous and/or crystalline MgCO3 on account of CaCO3. As a consequence, the further available P and Ca react easily to form Mg-poor amorphous calcium phosphate phases. Osteoblasts actively adjusted these phases towards hydroxyapatite-like phases.
Collapse
Affiliation(s)
- Nezha Ahmad Agha
- Institute of Material Research, Helmholtz-Zentrum Geesthacht, Max-Planck-Str. 1, 21502 Geesthacht, Germany
| | - Zhidan Liu
- Institute of Material Research, Helmholtz-Zentrum Geesthacht, Max-Planck-Str. 1, 21502 Geesthacht, Germany
| | - Frank Feyerabend
- Institute of Material Research, Helmholtz-Zentrum Geesthacht, Max-Planck-Str. 1, 21502 Geesthacht, Germany.
| | - Regine Willumeit-Römer
- Institute of Material Research, Helmholtz-Zentrum Geesthacht, Max-Planck-Str. 1, 21502 Geesthacht, Germany
| | - Billiana Gasharova
- Institut für Beschleunigerphysik und Technologie, Karlsruher Institut für Technologie, P.O. Box 3640, Karlsruhe 76021, Germany
| | - Stefanie Heidrich
- Department Earth Sciences, University of Hamburg, Grindelallee 48, 20146 Hamburg, Germany
| | - Boriana Mihailova
- Department Earth Sciences, University of Hamburg, Grindelallee 48, 20146 Hamburg, Germany
| |
Collapse
|
46
|
Ma C, Gerhard E, Lu D, Yang J. Citrate chemistry and biology for biomaterials design. Biomaterials 2018; 178:383-400. [PMID: 29759730 DOI: 10.1016/j.biomaterials.2018.05.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/17/2018] [Accepted: 05/03/2018] [Indexed: 12/18/2022]
Abstract
Leveraging the multifunctional nature of citrate in chemistry and inspired by its important role in biological tissues, a class of highly versatile and functional citrate-based materials (CBBs) has been developed via facile and cost-effective polycondensation. CBBs exhibiting tunable mechanical properties and degradation rates, together with excellent biocompatibility and processability, have been successfully applied in vitro and in vivo for applications ranging from soft to hard tissue regeneration, as well as for nanomedicine designs. We summarize in the review, chemistry considerations for CBBs design to tune polymer properties and to introduce functionality with a focus on the most recent advances, biological functions of citrate in native tissues with the new notion of degradation products as cell modulator highlighted, and the applications of CBBs in wound healing, nanomedicine, orthopedic, cardiovascular, nerve and bladder tissue engineering. Given the expansive evidence for citrate's potential in biology and biomaterial science outlined in this review, it is expected that citrate based materials will continue to play an important role in regenerative engineering.
Collapse
Affiliation(s)
- Chuying Ma
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, 16801, PA, USA
| | - Ethan Gerhard
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, 16801, PA, USA
| | - Di Lu
- Rehabilitation Engineering Research Laboratory, Biomedicine Engineering Research Centre Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Jian Yang
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, 16801, PA, USA.
| |
Collapse
|
47
|
Wang J, Wu Y, Li H, Liu Y, Bai X, Chau W, Zheng Y, Qin L. Magnesium alloy based interference screw developed for ACL reconstruction attenuates peri-tunnel bone loss in rabbits. Biomaterials 2018; 157:86-97. [DOI: 10.1016/j.biomaterials.2017.12.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 12/05/2017] [Accepted: 12/10/2017] [Indexed: 01/03/2023]
|
48
|
Huang Y, Wu C, Zhang X, Chang J, Dai K. Regulation of immune response by bioactive ions released from silicate bioceramics for bone regeneration. Acta Biomater 2018; 66:81-92. [PMID: 28864248 DOI: 10.1016/j.actbio.2017.08.044] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/29/2017] [Accepted: 08/28/2017] [Indexed: 12/12/2022]
Abstract
Silicate bioceramics have been considered to possess a wide prospect of clinical application for orthopedic tissue regeneration due to their excellent osteogenesis and angiogenesis. However, the mechanism for silicate bioceramics stimulating bone formation is not fully understood. The host immune defense to implants is proved to greatly influence the osteogenesis and new bone formation, but up to now, few studies are focused on the silicate bioceramics modulated host immune responses. In our present study, two representative silicate bioceramics, akermanite (AKT) and nagelschmidtite (NAGEL) were used as model materials to investigate the inflammation responses in vitro and in vivo, and β-tricalcium phosphate (β-TCP) bioceramics were used as a control. It was found that the mouse macrophage cell RAW264.7 that cultured on AKT and NAGEL bioceramics displayed not only less viability and proliferation, but also a significant less inflammatory cytokine secretion than those on β-TCP in vitro. The formation of foreign body giant cells and fibrous capsules, the invasion of macrophages, as well as the detected inflammatory cytokines around the implanted materials were much lower in both AKT and NAGEL bioceramic groups as compared with those in the β-TCP controls in vivo. Furthermore, it was found that not just the certain concentration of extracellular Si-containing ionic products released from the silicate bioceramics, but also the separate Si, Mg and Ca ions revealed the activity to inhibit the macrophage inflammatory responses by the way of suppressing the activated inflammatory MAPK and NF-κB signaling pathway and promoting the caspase-dependent apoptosis of macrophages. In general, our study suggests that the silicate bioceramics could regulate immune responses by altering the ionic microenvironment between the implants and hosts, which may offer new insight about the mechanism of the bioactivity of silicate bioceramics in bone regeneration and provide profitable guidance for designing new biomaterials for bone tissue engineering. STATEMENT OF SIGNIFICANCE Silicate bioceramics have been widely used for orthopedic tissue regeneration because of their excellent characteristics in bone formation. However, there are few studies concerning their interrelationships with the host immune defense that has been proved to greatly influence osteogenesis. In our present study, the akermanite and nagelschmidtite were used as two representative silicate bioceramics to investigate the inflammation responses in vitro and in vivo; and for the first time, the bioactive ions released from the silicate bioceramics were discovered to regulate the macrophage immune responses through both inhibiting the inflammatory signaling and activating apoptosis of macrophages. Our findings in this study may not only increase the understanding in osteogenic activity of silicate bioceramics, but also provide profitable guidance for designing and manufacturing new biomaterials for bone tissue engineering.
Collapse
|
49
|
Magnesium-based bioceramics in orthopedic applications. Acta Biomater 2018; 66:23-43. [PMID: 29197578 DOI: 10.1016/j.actbio.2017.11.033] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/17/2017] [Accepted: 11/20/2017] [Indexed: 11/22/2022]
Abstract
Magnesium ions are directly involved in numerous biological mechanisms; for example, they play an important part in the regulation of ion channels, DNA stabilization, enzyme activation and stimulation of cell growth and proliferation. This alkaline earth metal has gained great popularity in orthopedic applications in recent years. Magnesium-based bioceramics include a large group of magnesium containing compounds such as oxides, phosphates and silicates, that are involved in orthopedic applications like bone cements, bone scaffolds or implant coatings. This article aims to give a comprehensive review on different magnesium-based bioceramics, e.g. magnesium phosphates (MgO-P2O5), calcium magnesium phosphates (CaO-MgO-P2O5), and magnesium glasses (SiO2-MgO) with a strong focus on the chemistry and properties of magnesium phosphate containing cements as the main application form. In addition, the processing of magnesium phosphate minerals into macroporous scaffolds for tissue engineering applications by either using traditional porogens or by additive manufacturing approaches are reflected. Finally, the biological in vitro and in vivo properties of magnesium phosphates for bone regeneration are summarized, which show promising results regarding the application as bone replacement material, but still lack in terms of testing in large animal models, load-bearing application sites and clinical data. STATEMENT OF SIGNIFICANCE Though bone substitutes from calcium phosphates have been investigated for a long time, a new trend is visible in the biomaterials sector: magnesium based bioceramics from magnesium phosphates and silicates due to the special biological significance of magnesium ions in enzymatic activation, cell growth and proliferation, etc. In contrast to pure magnesium implants, such formulations do not release hydrogen during degradation. As with calcium based bioceramics, magnesium based bioceramics are used for the development of diverse applications such as cements, macroporous scaffolds and coatings. From this perspective, we present a systematic overview on diverse kinds of magnesium based bioceramics, their processing regimes for different clinical purposes and their behavior both in vitro and in vivo.
Collapse
|
50
|
Wu L, Luthringer BJC, Feyerabend F, Zhang Z, Machens HG, Maeda M, Taipaleenmäki H, Hesse E, Willumeit-Römer R, Schilling AF. Increased levels of sodium chloride directly increase osteoclastic differentiation and resorption in mice and men. Osteoporos Int 2017; 28:3215-3228. [PMID: 28849275 PMCID: PMC5635092 DOI: 10.1007/s00198-017-4163-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 07/13/2017] [Indexed: 01/30/2023]
Abstract
UNLABELLED To better understand the association between high salt intake and osteoporosis, we investigated the effect of sodium chloride (NaCl) on mice and human osteoclastogenesis. The results suggest a direct, activating role of NaCl supplementation on bone resorption. INTRODUCTION High NaCl intake is associated with increased urinary calcium elimination and parathyroid hormone (PTH) secretion which in turn stimulates the release of calcium from the bone, resulting in increased bone resorption. However, while calciuria after NaCl loading could be shown repeatedly, several studies failed to reveal a significant increase in PTH in response to a high-sodium diet. Another possible explanation that we investigated here could be a direct effect of high-sodium concentration on bone resorption. METHODS Mouse bone marrow macrophage and human peripheral blood mononuclear cells (PBMC) driven towards an osteoclastogenesis pathway were cultivated under culture conditions mimicking hypernatremia environments. RESULTS In this study, a direct effect of increased NaCl concentrations on mouse osteoclast differentiation and function was observed. Surprisingly, in a human osteoclast culture system, significant increases in the number of tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts, calcitonin receptor (CTR)-positive osteoclasts, nuclear factor-activated T cells c1 (NFATc1) gene expression, and areal and volumetric resorptions were observed for increasing concentrations of NaCl. This suggests a direct, activating, cell-mediated effect of increased concentrations of NaCl on osteoclasts. CONCLUSIONS The reported that enhanced bone resorption after high-sodium diets may not only be secondary to the urinary calcium loss but may also be a direct, cell-mediated effect on osteoclastic resorption. These findings allow us to suggest an explanation for the clinical findings independent of a PTH-mediated regulation.
Collapse
Affiliation(s)
- L Wu
- Department of Biological Characterisation, Institute for Materials Research, Helmholtz-Zentrum Geesthacht, Geesthacht, Germany
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - B J C Luthringer
- Department of Biological Characterisation, Institute for Materials Research, Helmholtz-Zentrum Geesthacht, Geesthacht, Germany
| | - F Feyerabend
- Department of Biological Characterisation, Institute for Materials Research, Helmholtz-Zentrum Geesthacht, Geesthacht, Germany
| | - Z Zhang
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
- Department of Orthopedics, Hand Surgery Division, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - H G Machens
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - M Maeda
- Heisenberg Group for Molecular Skeletal Biology, Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Taipaleenmäki
- Heisenberg Group for Molecular Skeletal Biology, Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Hesse
- Heisenberg Group for Molecular Skeletal Biology, Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Willumeit-Römer
- Department of Biological Characterisation, Institute for Materials Research, Helmholtz-Zentrum Geesthacht, Geesthacht, Germany
| | - A F Schilling
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
- Clinic for Trauma Surgery, Orthopedic Surgery, and Plastic Surgery, University Medical Center Göttingen, Göttingen, Germany.
| |
Collapse
|