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Li Y, Mei Z, Deng P, Zhou S, Qian A, Zhang X, Li J. Unraveling the mechanism in l-Caldesmon regulating the osteogenic differentiation of PDLSCs: An innovative perspective. Cell Signal 2024; 118:111147. [PMID: 38513808 DOI: 10.1016/j.cellsig.2024.111147] [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: 12/15/2023] [Revised: 02/27/2024] [Accepted: 03/17/2024] [Indexed: 03/23/2024]
Abstract
Maxillofacial bone defect is one of the common symptoms in maxillofacial, which affects the function and aesthetics of maxillofacial region. Periodontal ligament stem cells (PDLSCs) are extensively used in bone tissue engineering. The mechanism that regulates the osteogenic differentiation of PDLSCs remains not fully elucidated. Previous studies demonstrated that l-Caldesmon (l-CALD, or CALD1) might be involved in the osteogenic differentiation of PDLSCs. Here, the mechanism by which CALD1 regulates the osteogenic differentiation of PDLSCs is investigated. The osteogenic differentiation of PDLSCs is enhanced with Cald1 knockdown. Whole transcriptome sequencing (RNA-seq) analysis shows that bone morphogenetic proteins (BMP) signaling pathway and Wingless type (Wnt) pathway have significant change with Cald1 knockdown, and the expressions of Wnt-induced secreted protein 1 (WISP1), BMP2, Smad1/5/9, and p-Smad1/5/9 are significantly upregulated, while Glycogen synthase kinase 3β (GSK3β) and p-GSK3β are downregulated. In addition, subcutaneous implantation in nude mice shows that knockdown of Cald1 enhances the osteogenic differentiation of PDLSCs in vivo. Taken together, this study demonstrates that knockdown of Cald1 enhances the osteogenic differentiation of PDLSCs by BMP and Wnt signaling pathways, and provides a novel approach for subsequent clinical treatment.
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Affiliation(s)
- Yuejia Li
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases, Chongqing Medical University, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
| | - Ziyi Mei
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases, Chongqing Medical University, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
| | - Pingmeng Deng
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases, Chongqing Medical University, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
| | - Sha Zhou
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases, Chongqing Medical University, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
| | - Aizhuo Qian
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases, Chongqing Medical University, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
| | - Xiya Zhang
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases, Chongqing Medical University, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
| | - Jie Li
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases, Chongqing Medical University, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China..
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Al Maruf DSA, Cheng K, Xin H, Cheung VKY, Foley M, Wise IK, Lewin W, Froggatt C, Wykes J, Parthasarathi K, Leinkram D, Howes D, Suchowerska N, McKenzie DR, Gupta R, Crook JM, Clark JR. A Comparison of In Vivo Bone Tissue Generation Using Calcium Phosphate Bone Substitutes in a Novel 3D Printed Four-Chamber Periosteal Bioreactor. Bioengineering (Basel) 2023; 10:1233. [PMID: 37892963 PMCID: PMC10604717 DOI: 10.3390/bioengineering10101233] [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: 07/06/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Autologous bone replacement remains the preferred treatment for segmental defects of the mandible; however, it cannot replicate complex facial geometry and causes donor site morbidity. Bone tissue engineering has the potential to overcome these limitations. Various commercially available calcium phosphate-based bone substitutes (Novabone®, BioOss®, and Zengro®) are commonly used in dentistry for small bone defects around teeth and implants. However, their role in ectopic bone formation, which can later be applied as vascularized graft in a bone defect, is yet to be explored. Here, we compare the above-mentioned bone substitutes with autologous bone with the aim of selecting one for future studies of segmental mandibular repair. Six female sheep, aged 7-8 years, were implanted with 40 mm long four-chambered polyether ether ketone (PEEK) bioreactors prepared using additive manufacturing followed by plasma immersion ion implantation (PIII) to improve hydrophilicity and bioactivity. Each bioreactor was wrapped with vascularized scapular periosteum and the chambers were filled with autologous bone graft, Novabone®, BioOss®, and Zengro®, respectively. The bioreactors were implanted within a subscapular muscle pocket for either 8 weeks (two sheep), 10 weeks (two sheep), or 12 weeks (two sheep), after which they were removed and assessed by microCT and routine histology. Moderate bone formation was observed in autologous bone grafts, while low bone formation was observed in the BioOss® and Zengro® chambers. No bone formation was observed in the Novabone® chambers. Although the BioOss® and Zengro® chambers contained relatively small amounts of bone, endochondral ossification and retained hydroxyapatite suggest their potential in new bone formation in an ectopic site if a consistent supply of progenitor cells and/or growth factors can be ensured over a longer duration.
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Affiliation(s)
- D. S. Abdullah Al Maruf
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Kai Cheng
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia;
| | - Hai Xin
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Veronica K. Y. Cheung
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; (V.K.Y.C.); (R.G.)
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Matthew Foley
- Sydney Microscopy & Microanalysis, The University of Sydney, Camperdown, NSW 2006, Australia;
| | - Innes K. Wise
- Laboratory Animal Services, The University of Sydney, Camperdown, NSW 2050, Australia;
| | - Will Lewin
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (W.L.); (D.R.M.); (J.M.C.)
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Catriona Froggatt
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
| | - James Wykes
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
| | - Krishnan Parthasarathi
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
| | - David Leinkram
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia;
| | - Dale Howes
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
| | - Natalka Suchowerska
- School of Physics, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia;
| | - David R. McKenzie
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (W.L.); (D.R.M.); (J.M.C.)
- School of Physics, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia;
| | - Ruta Gupta
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; (V.K.Y.C.); (R.G.)
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Jeremy M. Crook
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (W.L.); (D.R.M.); (J.M.C.)
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Intelligent Polymer Research Institute, AIIM Facility, The University of Wollongong, Wollongong, NSW 2522, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Jonathan R. Clark
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia;
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Xin H, Tomaskovic-Crook E, Al Maruf DSA, Cheng K, Wykes J, Manzie TGH, Wise SG, Crook JM, Clark JR. From Free Tissue Transfer to Hydrogels: A Brief Review of the Application of the Periosteum in Bone Regeneration. Gels 2023; 9:768. [PMID: 37754449 PMCID: PMC10530949 DOI: 10.3390/gels9090768] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023] Open
Abstract
The periosteum is a thin layer of connective tissue covering bone. It is an essential component for bone development and fracture healing. There has been considerable research exploring the application of the periosteum in bone regeneration since the 19th century. An increasing number of studies are focusing on periosteal progenitor cells found within the periosteum and the use of hydrogels as scaffold materials for periosteum engineering and guided bone development. Here, we provide an overview of the research investigating the use of the periosteum for bone repair, with consideration given to the anatomy and function of the periosteum, the importance of the cambium layer, the culture of periosteal progenitor cells, periosteum-induced ossification, periosteal perfusion, periosteum engineering, scaffold vascularization, and hydrogel-based synthetic periostea.
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Affiliation(s)
- Hai Xin
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (K.C.); (J.W.); (T.G.H.M.); (J.R.C.)
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Eva Tomaskovic-Crook
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (E.T.-C.); (J.M.C.)
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia;
- Intelligent Polymer Research Institute, AIIM Facility, Innovation Campus, University of Wollongong, North Wollongong, NSW 2500, Australia
| | - D S Abdullah Al Maruf
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (K.C.); (J.W.); (T.G.H.M.); (J.R.C.)
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Kai Cheng
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (K.C.); (J.W.); (T.G.H.M.); (J.R.C.)
- Royal Prince Alfred Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - James Wykes
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (K.C.); (J.W.); (T.G.H.M.); (J.R.C.)
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Timothy G. H. Manzie
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (K.C.); (J.W.); (T.G.H.M.); (J.R.C.)
| | - Steven G. Wise
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia;
| | - Jeremy M. Crook
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (E.T.-C.); (J.M.C.)
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia;
- Intelligent Polymer Research Institute, AIIM Facility, Innovation Campus, University of Wollongong, North Wollongong, NSW 2500, Australia
| | - Jonathan R. Clark
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (K.C.); (J.W.); (T.G.H.M.); (J.R.C.)
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW 2050, Australia
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Xin H, Romanazzo S, Tomaskovic-Crook E, Mitchell TC, Hung JC, Wise SG, Cheng K, Al Maruf DSA, Stokan MJ, Manzie TGH, Parthasarathi K, Cheung VKY, Gupta R, Ly M, Pulitano C, Wise IK, Crook JM, Clark JR. Ex Vivo Preservation of Ovine Periosteum Using a Perfusion Bioreactor System. Cells 2023; 12:1724. [PMID: 37443758 PMCID: PMC10340137 DOI: 10.3390/cells12131724] [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: 05/11/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Periosteum is a highly vascularized membrane lining the surface of bones. It plays essential roles in bone repair following injury and reconstruction following invasive surgeries. To broaden the use of periosteum, including for augmenting in vitro bone engineering and/or in vivo bone repair, we have developed an ex vivo perfusion bioreactor system to maintain the cellular viability and metabolism of surgically resected periosteal flaps. Each specimen was placed in a 3D printed bioreactor connected to a peristaltic pump designed for the optimal flow rates of tissue perfusate. Nutrients and oxygen were perfused via the periosteal arteries to mimic physiological conditions. Biochemical assays and histological staining indicate component cell viability after perfusion for almost 4 weeks. Our work provides the proof-of-concept of ex vivo periosteum perfusion for long-term tissue preservation, paving the way for innovative bone engineering approaches that use autotransplanted periosteum to enhance in vivo bone repair.
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Affiliation(s)
- Hai Xin
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Sara Romanazzo
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Eva Tomaskovic-Crook
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Intelligent Polymer Research Institute, University of Wollongong, Innovation Campus, Squires Way, North Wollongong, NSW 2500, Australia
| | - Timothy C. Mitchell
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Jui Chien Hung
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Steven G. Wise
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Kai Cheng
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - D S Abdullah Al Maruf
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Murray J. Stokan
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Timothy G. H. Manzie
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Krishnan Parthasarathi
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Veronica K. Y. Cheung
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- The Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Ruta Gupta
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- The Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Mark Ly
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- RPA Translational Center for Organ Assessment, Repair, and Optimization, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Carlo Pulitano
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- RPA Translational Center for Organ Assessment, Repair, and Optimization, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Innes K. Wise
- Laboratory Animal Services, Charles Perkins Center, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Jeremy M. Crook
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Intelligent Polymer Research Institute, University of Wollongong, Innovation Campus, Squires Way, North Wollongong, NSW 2500, Australia
| | - Jonathan R. Clark
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW 2050, Australia
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Repair of complex ovine segmental mandibulectomy utilizing customized tissue engineered bony flaps. PLoS One 2023; 18:e0280481. [PMID: 36827358 PMCID: PMC9955661 DOI: 10.1371/journal.pone.0280481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 01/03/2023] [Indexed: 02/26/2023] Open
Abstract
Craniofacial defects require a treatment approach that provides both robust tissues to withstand the forces of mastication and high geometric fidelity that allows restoration of facial architecture. When the surrounding soft tissue is compromised either through lack of quantity (insufficient soft tissue to enclose a graft) or quality (insufficient vascularity or inducible cells), a vascularized construct is needed for reconstruction. Tissue engineering using customized 3D printed bioreactors enables the generation of mechanically robust, vascularized bony tissues of the desired geometry. While this approach has been shown to be effective when utilized for reconstruction of non-load bearing ovine angular defects and partial segmental defects, the two-stage approach to mandibular reconstruction requires testing in a large, load-bearing defect. In this study, 5 sheep underwent bioreactor implantation and the creation of a load-bearing mandibular defect. Two bioreactor geometries were tested: a larger complex bioreactor with a central groove, and a smaller rectangular bioreactor that were filled with a mix of xenograft and autograft (initial bone volume/total volume BV/TV of 31.8 ± 1.6%). At transfer, the tissues generated within large and small bioreactors were composed of a mix of lamellar and woven bone and had BV/TV of 55.3 ± 2.6% and 59.2 ± 6.3%, respectively. After transfer of the large bioreactors to the mandibular defect, the bioreactor tissues continued to remodel, reaching a final BV/TV of 64.5 ± 6.2%. Despite recalcitrant infections, viable osteoblasts were seen within the transferred tissues to the mandibular site at the end of the study, suggesting that a vascularized customized bony flap is a potentially effective reconstructive strategy when combined with an optimal stabilization strategy and local antibiotic delivery prior to development of a deep-seated infection.
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Rothweiler R, Kuhn S, Stark T, Heinemann S, Hoess A, Fuessinger MA, Brandenburg LS, Roelz R, Metzger MC, Hubbe U. Development of a new critical size defect model in the paranasal sinus and first approach for defect reconstruction-An in vivo maxillary bone defect study in sheep. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:76. [PMID: 36264396 PMCID: PMC9584845 DOI: 10.1007/s10856-022-06698-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Fractures of the paranasal sinuses often require surgical intervention. Persisting bone defects lead to permanent visible deformities of the facial contours. Bone substitutes for reconstruction of defects with simultaneous induction of new bone formation are not commercially available for the paranasal sinus. New materials are urgently needed and have to be tested in their future area of application. For this purpose critical size defect models for the paranasal sinus have to be developed. A ≥2.4 cm large bilateral circular defect was created in the anterior wall of the maxillary sinus in six sheep via an extraoral approach. The defect was filled with two types of an osteoconductive titanium scaffold (empty scaffold vs. scaffold filled with a calcium phosphate bone cement paste) or covered with a titanium mesh either. Sheep were euthanized after four months. All animals performed well, no postoperative complications occured. Meshes and scaffolds were safely covered with soft tissue at the end of the study. The initial defect size of ≥2.4 cm only shrunk minimally during the investigation period confirming a critical size defect. No ingrowth of bone into any of the scaffolds was observed. The anterior wall of the maxillary sinus is a region with low complication rate for performing critical size defect experiments in sheep. We recommend this region for experiments with future scaffold materials whose intended use is not only limited to the paranasal sinus, as the defect is challenging even for bone graft substitutes with proven osteoconductivity. Graphical abstract.
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Affiliation(s)
- R Rothweiler
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - S Kuhn
- Stryker Leibinger GmbH & Co. KG, Bötzinger Straße 41, 79111, Freiburg, Germany
| | - T Stark
- Stryker Leibinger GmbH & Co. KG, Bötzinger Straße 41, 79111, Freiburg, Germany
| | - S Heinemann
- INNOTERE GmbH, Meissner Str. 191, 01445, Radebeul, Germany
| | - A Hoess
- INNOTERE GmbH, Meissner Str. 191, 01445, Radebeul, Germany
| | - M A Fuessinger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - L S Brandenburg
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - R Roelz
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - M C Metzger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - U Hubbe
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany.
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Rothweiler RM, Zankovic S, Brandenburg LS, Fuessinger MA, Gross C, Voss PJ, Metzger MC. Feasibility of Implant Strain Measurement for Assessing Mandible Bone Regeneration. MICROMACHINES 2022; 13:1602. [PMID: 36295956 PMCID: PMC9610677 DOI: 10.3390/mi13101602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
Nonunion is one of the most dreaded complications after operative treatment of mandible fractures or after mandible reconstruction using vascularized and non-vascularized bone grafts. Often diagnosis is made at advanced stage of disease when pain or complications occur. Devices that monitor fracture healing and bone regeneration continuously are therefore urgently needed in the craniomaxillofacial area. One promising approach is the strain measurement of plates. An advanced prototype of an implantable strain measurement device was tested after fixation to a locking mandible reconstruction plate in multiple compression experiments to investigate the potential functionality of strain measurement in the mandibular region. Compression experiments show that strain measurement devices work well under experimental conditions in the mandibular angle and detect plate deformation in a reliable way. For monitoring in the mandibular body, the device used in its current configuration was not suitable. Implant strain measurement of reconstruction plates is a promising methodical approach for permanent monitoring of bone regeneration and fracture healing in the mandible. The method helps to avoid or detect complications at an early point in time after operative treatment.
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Affiliation(s)
- René Marcel Rothweiler
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Sergej Zankovic
- G.E.R.N. Center for Tissue Replacement, Regeneration & Neogenesis, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, 79108 Freiburg, Germany
| | - Leonard Simon Brandenburg
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Marc-Anton Fuessinger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Christian Gross
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Pit Jacob Voss
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Marc-Christian Metzger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
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8
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Tsiklin IL, Shabunin AV, Kolsanov AV, Volova LT. In Vivo Bone Tissue Engineering Strategies: Advances and Prospects. Polymers (Basel) 2022; 14:polym14153222. [PMID: 35956735 PMCID: PMC9370883 DOI: 10.3390/polym14153222] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/25/2022] [Accepted: 08/04/2022] [Indexed: 12/12/2022] Open
Abstract
Reconstruction of critical-sized bone defects remains a tremendous challenge for surgeons worldwide. Despite the variety of surgical techniques, current clinical strategies for bone defect repair demonstrate significant limitations and drawbacks, including donor-site morbidity, poor anatomical match, insufficient bone volume, bone graft resorption, and rejection. Bone tissue engineering (BTE) has emerged as a novel approach to guided bone tissue regeneration. BTE focuses on in vitro manipulations with seed cells, growth factors and bioactive scaffolds using bioreactors. The successful clinical translation of BTE requires overcoming a number of significant challenges. Currently, insufficient vascularization is the critical limitation for viability of the bone tissue-engineered construct. Furthermore, efficacy and safety of the scaffolds cell-seeding and exogenous growth factors administration are still controversial. The in vivo bioreactor principle (IVB) is an exceptionally promising concept for the in vivo bone tissue regeneration in a predictable patient-specific manner. This concept is based on the self-regenerative capacity of the human body, and combines flap prefabrication and axial vascularization strategies. Multiple experimental studies on in vivo BTE strategies presented in this review demonstrate the efficacy of this approach. Routine clinical application of the in vivo bioreactor principle is the future direction of BTE; however, it requires further investigation for overcoming some significant limitations.
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Affiliation(s)
- Ilya L. Tsiklin
- Biotechnology Center “Biotech”, Samara State Medical University, 443079 Samara, Russia
- City Clinical Hospital Botkin, Moscow Healthcare Department, 125284 Moscow, Russia
- Correspondence: ; Tel.: +7-903-621-81-88
| | - Aleksey V. Shabunin
- City Clinical Hospital Botkin, Moscow Healthcare Department, 125284 Moscow, Russia
| | - Alexandr V. Kolsanov
- Biotechnology Center “Biotech”, Samara State Medical University, 443079 Samara, Russia
| | - Larisa T. Volova
- Biotechnology Center “Biotech”, Samara State Medical University, 443079 Samara, Russia
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9
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Wickramasinghe ML, Dias GJ, Premadasa KMGP. A novel classification of bone graft materials. J Biomed Mater Res B Appl Biomater 2022; 110:1724-1749. [DOI: 10.1002/jbm.b.35029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 12/19/2022]
Affiliation(s)
- Maduni L. Wickramasinghe
- Department of Biomedical Engineering General Sir John Kotelawala Defense University Ratmalana Sri Lanka
| | - George J. Dias
- Department of Anatomy, School of Medical Sciences University of Otago Dunedin New Zealand
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10
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Jing T, Yi Liu, Xu L, Chen C, Liu F. The incorporation of β-tricalcium phosphate nanoparticles within silk fibroin composite scaffolds for enhanced bone regeneration: An in vitro and in vivo study. J Biomater Appl 2022; 36:1567-1578. [PMID: 35135370 DOI: 10.1177/08853282211065621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To investigate the osteogenesis of β-tricalcium phosphate nanoparticles-incorporated silk fibroin (SF/β-TCP) composite scaffolds, SF-based scaffolds with different β-TCP proportion (2/1, 1/1, and 1/2) were fabricated by freeze-drying technology in the present study. Structural and physicochemical properties of SF-based scaffolds were evaluated by using scanning electron microscope, X-ray diffraction, Fourier transformed infrared spectroscopy (ATR-FTIR) and transmission electron microscope. Biocompatibility and osteogenesis of SF/β-TCP scaffolds were investigated by using bone marrow mesenchymal stem cells (BMSCs). Eight New Zealand rabbits were selected, while four 8-mm-diameter calvarial defects were created in each rabbit to place SF/β-TCP scaffolds. The harvested specimens at 4 and 12 weeks were used to evaluate the bone forming ability by micro-CT and histological examination. The results suggested incorporation of β-TCP displayed flake-like pore morphology with proper pore sizes. With the increasing proportion of β-TCP, composite scaffolds exhibited higher compressive strength, lower swelling ratio and degradation rate, as well as enhanced biomineralization capacity. Alkaline phosphatase activity and collagen type I expression levels of BMSCs were significantly increased in the presence of β-TCP nanoparticles. All composite scaffolds with different β-TCP proportion had good bone formation ability at 12 weeks. Among them, SF/β-TCP (1/2) scaffold exhibited the favorable osteogenesis capability which had great potential for applications in bone regeneration.
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Affiliation(s)
- Tienan Jing
- Department of Oral Mucosa Disease, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Yi Liu
- Department of Orthodontics, School and Hospital of Stomatology, 162778China Medical University, Shenyang, China
| | - Li Xu
- Department of Laboratory Medicine, First Hospital of China Medical University, Shenyang, China
| | - Cen Chen
- College of Life College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou China
| | - Fan Liu
- Department of Orthodontics, School and Hospital of Stomatology, 162778China Medical University, Shenyang, China
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11
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Farris AL, Lambrechts D, Zhou Y, Zhang NY, Sarkar N, Moorer MC, Rindone AN, Nyberg EL, Perdomo-Pantoja A, Burris SJ, Free K, Witham TF, Riddle RC, Grayson WL. 3D-printed oxygen-releasing scaffolds improve bone regeneration in mice. Biomaterials 2022; 280:121318. [PMID: 34922272 PMCID: PMC8918039 DOI: 10.1016/j.biomaterials.2021.121318] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/06/2021] [Accepted: 12/08/2021] [Indexed: 01/03/2023]
Abstract
Low oxygen (O2) diffusion into large tissue engineered scaffolds hinders the therapeutic efficacy of transplanted cells. To overcome this, we previously studied hollow, hyperbarically-loaded microtanks (μtanks) to serve as O2 reservoirs. To adapt these for bone regeneration, we fabricated biodegradable μtanks from polyvinyl alcohol and poly (lactic-co-glycolic acid) and embedded them to form 3D-printed, porous poly-ε-caprolactone (PCL)-μtank scaffolds. PCL-μtank scaffolds were loaded with pure O2 at 300-500 psi. When placed at atmospheric pressures, the scaffolds released O2 over a period of up to 8 h. We confirmed the inhibitory effects of hypoxia on the osteogenic differentiation of human adipose-derived stem cells (hASCs and we validated that μtank-mediated transient hyperoxia had no toxic impacts on hASCs, possibly due to upregulation of endogenous antioxidant regulator genes. We assessed bone regeneration in vivo by implanting O2-loaded, hASC-seeded, PCL-μtank scaffolds into murine calvarial defects (4 mm diameters × 0.6 mm height) and subcutaneously (4 mm diameter × 8 mm height). In both cases we observed increased deposition of extracellular matrix in the O2 delivery group along with greater osteopontin coverages and higher mineral deposition. This study provides evidence that even short-term O2 delivery from PCL-μtank scaffolds may enhance hASC-mediated bone tissue regeneration.
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Affiliation(s)
- Ashley L. Farris
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dennis Lambrechts
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yuxiao Zhou
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicholas Y. Zhang
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Naboneeta Sarkar
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Megan C. Moorer
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD,Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Alexandra N. Rindone
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ethan L. Nyberg
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - S. J. Burris
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kendall Free
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Timothy F. Witham
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ryan C. Riddle
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD,Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Warren L. Grayson
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA,Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA,Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD,Corresponding author:
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12
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Mueller ML, Ottensmeyer MP, Thamm JR, Schmelzeisen R, Troulis MJ, Guastaldi FPS. Increased Osteogenic Activity of Dynamic Cultured Composite Bone Scaffolds: Characterization and In Vitro Study. J Oral Maxillofac Surg 2021; 80:303-312. [PMID: 34822754 DOI: 10.1016/j.joms.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to develop and characterize beta-tricalcium phosphate (β-TCP)/polycaprolactone (PCL) scaffolds, with 2 different ratios (50/50% and 65/35%), using 3-dimensionally (3D) printed dissolvable molds, and to evaluate cellular growth and osteogenic differentiation of both groups seeded with porcine bone marrow stem cells (pBMSCs) under dynamic culture in vitro. MATERIALS AND METHODS Two different groups of scaffolds were produced: group 1 (n = 40) with a ratio (wt%) of 50/50% and group 2 (n = 40) with 65/35% of β-TCP/PCL. Physicochemical, morphological, and mechanical characterization of the scaffolds were performed. Scaffolds were seeded with pBMSCs and differentiated osteogenically in dynamic culture. Cell density, distribution, and viability were assessed. Osteogenic differentiation was examined through alkaline phosphatase (ALP) staining, immunofluorescence, and photospectrometry. RESULTS Osteogenic differentiated constructs showed homogenous and viable cell distribution. Cell density was significantly higher (P < .05) for 65/35% scaffolds at 10 days postseeding, whereas at 6 weeks, cell number equalized for both groups. ALP activity increased over time and was significantly higher (P < .05) for 65/35% scaffolds at 14 days postseeding. CONCLUSIONS The mechanical properties of the developed 65/35% scaffolds were within the range of natural trabecular bone. Moreover, the 65/35% scaffolds showed biological advantages, such as higher cell growth and higher ALP activity.
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Affiliation(s)
- Max-Laurin Mueller
- Research Fellow, Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA
| | - Mark P Ottensmeyer
- Senior Engineer, Medical Device & Simulation Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Janis R Thamm
- Research Fellow, Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA
| | - Rainer Schmelzeisen
- Medical Director, Department of Oral and Maxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - Maria J Troulis
- Walter C. Guralnick Distinguished Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA
| | - Fernando P S Guastaldi
- Instructor of Oral and Maxillofacial Surgery, Director, Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA.
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13
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Defining the Dimensions of Periosteal Free Tissue Transfer Harvest Sites. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3846. [PMID: 34616645 PMCID: PMC8489887 DOI: 10.1097/gox.0000000000003846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/02/2021] [Indexed: 11/26/2022]
Abstract
Supplemental Digital Content is available in the text. Information about the use and donor site morbidity of periosteal free flaps in head and neck reconstruction is limited. The aim of this study was to examine potential periosteal free flap donor sites with respect to their dimensions, tissue and pedicle characteristics, and predicted donor site morbidity in a cadaveric model. The following cadaveric periosteal specimens with a vascular pedicle were harvested using standard surgical approaches: skull, chest wall, sternum, scapula, iliac crest, femur, and humerus. Data relating to the periosteum size and quality, vascular pedicle, surgical factors, feasibility of use, and the potential donor-site morbidity were recorded. One female (age: 78 years, height: 152 cm) and one male (age: 65 years, height: 186 cm) cadaver were used for flap harvest. The skull, chest wall, scapula, and femur were suitable in terms of the size of the periosteum harvested. The procedure to remove the periosteum from the scalp, chest wall, and scapula had the least predicted donor-site morbidity. The pedicle length and vessel caliber from the periosteal flaps were most favorable from the skull, scapula, and iliac crest. Considering all factors, the periosteum harvested from the skull and scapula were the most promising.
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14
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Wang J, Wang X, Zhen P, Fan B. [Research progress of in vivo bioreactor for bone tissue engineering]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2021; 35:627-635. [PMID: 33998218 DOI: 10.7507/1002-1892.202012083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To review the research progress of in vivo bioreactor (IVB) for bone tissue engineering in order to provide reference for its future research direction. Methods The literature related to IVB used in bone tissue engineering in recent years was reviewed, and the principles of IVB construction, tissue types, sites, and methods of IVB construction, as well as the advantages of IVB used in bone tissue engineering were summarized. Results IVB takes advantage of the body's ability to regenerate itself, using the body as a bioreactor to regenerate new tissues or organs at injured sites or at ectopic sites that can support the regeneration of new tissues. IVB can be constructed by tissue flap (subcutaneous pocket, muscle flap/pocket, fascia flap, periosteum flap, omentum flap/abdominal cavity) and axial vascular pedicle (axial vascular bundle, arteriovenous loop) alone or jointly. IVB is used to prefabricate vascularized tissue engineered bone that matched the shape and size of the defect. The prefabricated vascularized tissue engineered bone can be used as bone graft, pedicled bone flap, or free bone flap to repair bone defect. IVB solves the problem of insufficient vascularization in traditional bone tissue engineering to a certain extent. Conclusion IVB is a promising method for vascularized tissue engineered bone prefabrication and subsequent bone defect reconstruction, with unique advantages in the repair of large complex bone defects. However, the complexity of IVB construction and surgical complications hinder the clinical application of IVB. Researchers should aim to develop a simple, safe, and efficient IVB.
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Affiliation(s)
- Jian Wang
- First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou Gansu, 730000, P.R.China.,Orthopaedic Center, the 940th Hospital of PLA Joint Logistics Support Force, Lanzhou Gansu, 730000, P.R.China
| | - Xiao Wang
- School of Design and Art, Lanzhou University of Technology, Lanzhou Gansu, 730000, P.R.China
| | - Ping Zhen
- Orthopaedic Center, the 940th Hospital of PLA Joint Logistics Support Force, Lanzhou Gansu, 730000, P.R.China
| | - Bo Fan
- Orthopaedic Center, the 940th Hospital of PLA Joint Logistics Support Force, Lanzhou Gansu, 730000, P.R.China
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15
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Liu W, Jing X, Xu Z, Teng C. PEGDA/HA mineralized hydrogel loaded with Exendin4 promotes bone regeneration in rat models with bone defects by inducing osteogenesis. J Biomater Appl 2021; 35:1337-1346. [PMID: 33467965 DOI: 10.1177/0885328220987046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Scaffolds with osteogenic differentiation function play an important role in the healing process of bone defects. Here, we designed a high strength Poly(ethyleneglycol) diacrylate/Hydroxyapatite (PEGDA/HA) mineralized hydrogel loaded with Exendin4 for inducing osteogenic differentiation. In this study, PEGDA hydrogel was prepared by photo initiating method. PEGDA/HA mineralized hydrogel was prepared by in-situ precipitation method, and Exendin4 was loaded by gel adsorption. The effects of different calcium and phosphorus concentrations on the strength and Exendin4 release of PEGDA/HA hydrogels were investigated. Rat models of bone defect were made and randomly divided into 5 groups. The experimental group was implanted with PEGDA hydrogel, Exendin4-PEGDA hydrogel, PEGDA/HA mineralized hydrogel, Exendin4-PEGDA/HA mineralized hydrogel, and no materials were implanted in the blank control group. Computed tomography (CT) and histology were observed 4 and 8 weeks after operation. Our results revealed that the PEGDA/HA mineralized hydrogel had porous structure, high mechanical strength and good biocompatibility. In vitro release test showed that the mineralized hydrogel exhibited good sustained release profile within 20 d. The animal experiments showed that the mineralized hydrogel accelerated the formation of new bone after 4 and 8 weeks, and formed a seamless union on the defected bone area after 8 weeks. In conclusions, The Exendin4-PEGDA/HA mineralized hydrogel can effectively repair bone defects in rats, and it is expected to be used as a biomaterial for human bone tissue repair.
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Affiliation(s)
- Wei Liu
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Xiaowei Jing
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Zhiwen Xu
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Chong Teng
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
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16
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Taguchi T, Lopez MJ. An overview of de novo bone generation in animal models. J Orthop Res 2021; 39:7-21. [PMID: 32910496 PMCID: PMC7820991 DOI: 10.1002/jor.24852] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 02/04/2023]
Abstract
Some of the earliest success in de novo tissue generation was in bone tissue, and advances, facilitated by the use of endogenous and exogenous progenitor cells, continue unabated. The concept of one health promotes shared discoveries among medical disciplines to overcome health challenges that afflict numerous species. Carefully selected animal models are vital to development and translation of targeted therapies that improve the health and well-being of humans and animals alike. While inherent differences among species limit direct translation of scientific knowledge between them, rapid progress in ex vivo and in vivo de novo tissue generation is propelling revolutionary innovation to reality among all musculoskeletal specialties. This review contains a comparison of bone deposition among species and descriptions of animal models of bone restoration designed to replicate a multitude of bone injuries and pathology, including impaired osteogenic capacity.
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Affiliation(s)
- Takashi Taguchi
- Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary MedicineLouisiana State UniversityBaton RougeLouisianaUSA
| | - Mandi J. Lopez
- Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary MedicineLouisiana State UniversityBaton RougeLouisianaUSA
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17
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Chen J, Hendriks M, Chatzis A, Ramasamy SK, Kusumbe AP. Bone Vasculature and Bone Marrow Vascular Niches in Health and Disease. J Bone Miner Res 2020; 35:2103-2120. [PMID: 32845550 DOI: 10.1002/jbmr.4171] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/21/2020] [Accepted: 08/05/2020] [Indexed: 12/20/2022]
Abstract
Bone vasculature and bone marrow vascular niches supply oxygen, nutrients, and secrete angiocrine factors required for the survival, maintenance, and self-renewal of stem and progenitor cells. In the skeletal system, vasculature creates nurturing niches for bone and blood-forming stem cells. Blood vessels regulate hematopoiesis and drive bone formation during development, repair, and regeneration. Dysfunctional vascular niches induce skeletal aging, bone diseases, and hematological disorders. Recent cellular and molecular characterization of the bone marrow microenvironment has provided unprecedented insights into the complexity, heterogeneity, and functions of the bone vasculature and vascular niches. The bone vasculature is composed of distinct vessel subtypes that differentially regulate osteogenesis, hematopoiesis, and disease conditions in bones. Further, bone marrow vascular niches supporting stem cells are often complex microenvironments involving multiple different cell populations and vessel subtypes. This review provides an overview of the emerging vascular cell heterogeneity in bone and the new roles of the bone vasculature and associated vascular niches in health and disease. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Junyu Chen
- Tissue and Tumor Microenvironments Group, The Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Michelle Hendriks
- Institute of Clinical Sciences, Imperial College London, London, UK
- MRC London Institute of Medical Sciences, Imperial College London, London, UK
| | - Alexandros Chatzis
- Tissue and Tumor Microenvironments Group, The Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Saravana K Ramasamy
- Institute of Clinical Sciences, Imperial College London, London, UK
- MRC London Institute of Medical Sciences, Imperial College London, London, UK
| | - Anjali P Kusumbe
- Tissue and Tumor Microenvironments Group, The Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
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Watson E, Smith BT, Smoak MM, Tatara AM, Shah SR, Pearce HA, Hogan KJ, Shum J, Melville JC, Hanna IA, Demian N, Wenke JC, Bennett GN, van den Beucken JJJP, Jansen JA, Wong ME, Mikos AG. Localized mandibular infection affects remote in vivo bioreactor bone generation. Biomaterials 2020; 256:120185. [PMID: 32599360 PMCID: PMC7423761 DOI: 10.1016/j.biomaterials.2020.120185] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/05/2020] [Accepted: 06/07/2020] [Indexed: 12/30/2022]
Abstract
Mandibular reconstruction requires functional and aesthetic repair and is further complicated by contamination from oral and skin flora. Antibiotic-releasing porous space maintainers have been developed for the local release of vancomycin and to promote soft tissue attachment. In this study, mandibular defects in six sheep were inoculated with 106 colony forming units of Staphylococcus aureus; three sheep were implanted with unloaded porous space maintainers and three sheep were implanted with vancomycin-loaded space maintainers within the defect site. During the same surgery, 3D-printed in vivo bioreactors containing autograft or xenograft were implanted adjacent to rib periosteum. After 9 weeks, animals were euthanized, and tissues were analyzed. Antibiotic-loaded space maintainers were able to prevent dehiscence of soft tissue overlying the space maintainer, reduce local inflammatory cells, eliminate the persistence of pathogens, and prevent the increase in mandibular size compared to unloaded space maintainers in this sheep model. Animals with an untreated mandibular infection formed bony tissues with greater density and maturity within the distal bioreactors. Additionally, tissues grown in autograft-filled bioreactors had higher compressive moduli and higher maximum screw pull-out forces than xenograft-filled bioreactors. In summary, we demonstrated that antibiotic-releasing space maintainers are an innovative approach to preserve a robust soft tissue pocket while clearing infection, and that local infections can increase local and remote bone growth.
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Affiliation(s)
- Emma Watson
- Department of Bioengineering, Rice University, Houston, TX, USA; Medical Scientist Training Program, Baylor College of Medicine, Houston, TX, USA
| | - Brandon T Smith
- Department of Bioengineering, Rice University, Houston, TX, USA; Medical Scientist Training Program, Baylor College of Medicine, Houston, TX, USA
| | - Mollie M Smoak
- Department of Bioengineering, Rice University, Houston, TX, USA
| | - Alexander M Tatara
- Department of Bioengineering, Rice University, Houston, TX, USA; Medical Scientist Training Program, Baylor College of Medicine, Houston, TX, USA
| | - Sarita R Shah
- Department of Bioengineering, Rice University, Houston, TX, USA; Medical Scientist Training Program, Baylor College of Medicine, Houston, TX, USA
| | - Hannah A Pearce
- Department of Bioengineering, Rice University, Houston, TX, USA
| | - Katie J Hogan
- Department of Bioengineering, Rice University, Houston, TX, USA; Medical Scientist Training Program, Baylor College of Medicine, Houston, TX, USA
| | - Jonathan Shum
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - James C Melville
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Issa A Hanna
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nagi Demian
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Joseph C Wenke
- Extremity Trauma & Regenerative Medicine, U.S. Army Institute of Surgical Research, San Antonio, TX, USA
| | | | | | - John A Jansen
- Department of Biomaterials, Radboudumc, Nijmegen, the Netherlands
| | - Mark E Wong
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Antonios G Mikos
- Department of Bioengineering, Rice University, Houston, TX, USA.
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19
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Niermeyer WL, Rodman C, Li MM, Chiang T. Tissue engineering applications in otolaryngology-The state of translation. Laryngoscope Investig Otolaryngol 2020; 5:630-648. [PMID: 32864434 PMCID: PMC7444782 DOI: 10.1002/lio2.416] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/06/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022] Open
Abstract
While tissue engineering holds significant potential to address current limitations in reconstructive surgery of the head and neck, few constructs have made their way into routine clinical use. In this review, we aim to appraise the state of head and neck tissue engineering over the past five years, with a specific focus on otologic, nasal, craniofacial bone, and laryngotracheal applications. A comprehensive scoping search of the PubMed database was performed and over 2000 article hits were returned with 290 articles included in the final review. These publications have addressed the hallmark characteristics of tissue engineering (cellular source, scaffold, and growth signaling) for head and neck anatomical sites. While there have been promising reports of effective tissue engineered interventions in small groups of human patients, the majority of research remains constrained to in vitro and in vivo studies aimed at furthering the understanding of the biological processes involved in tissue engineering. Further, differences in functional and cosmetic properties of the ear, nose, airway, and craniofacial bone affect the emphasis of investigation at each site. While otolaryngologists currently play a role in tissue engineering translational research, continued multidisciplinary efforts will likely be required to push the state of translation towards tissue-engineered constructs available for routine clinical use. LEVEL OF EVIDENCE NA.
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Affiliation(s)
| | - Cole Rodman
- The Ohio State University College of MedicineColumbusOhioUSA
| | - Michael M. Li
- Department of Otolaryngology—Head and Neck SurgeryThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Tendy Chiang
- Department of OtolaryngologyNationwide Children's HospitalColumbusOhioUSA
- Department of Otolaryngology—Head and Neck SurgeryThe Ohio State University Wexner Medical CenterColumbusOhioUSA
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20
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Watson E, Tatara AM, van den Beucken JJJP, Jansen JA, Wong ME, Mikos AG. An Ovine Model of In Vivo Bioreactor-Based Bone Generation. Tissue Eng Part C Methods 2020; 26:384-396. [PMID: 32536266 DOI: 10.1089/ten.tec.2020.0125] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The generation of vascularized mineralized tissues of complex geometry without the use of extrinsic growth factors or exogenous cells requires a large animal model to recapitulate the challenges seen in the clinic. The proposed versatile ovine model can be utilized to investigate the use of a customized bioreactor to generate mineralized tissue, matching the size and shape of a defect before transfer to and integration within another site. The protocol results in bioreactors that can be harvested for investigation of the effects of different biomaterials for the generation of bone or to generate tissues appropriate for repair of bony defects; this protocol focuses on reconstruction of the mandible but could be modified for orthopedic applications. The bioreactor packing material can be altered, allowing for the study of various commercially available or novel graft materials. The surgical procedure requires ∼1.5 h to implant four bioreactors adjacent to rib periosteum. After 9 weeks, the harvest of the bioreactor tissue takes approximately 1 h. If creating a craniofacial defect, an additional 2 h should be taken for mandibular defect creation and 2 to 3 h for the reconstruction. Sheep that have undergone reconstruction are typically euthanized after 12 weeks to allow for evaluation of transferred tissues. In this protocol, we discuss the necessary steps to ensure the reproducibility and analytical techniques to assess bone regeneration such as microcomputed tomography, mechanical analysis, and histology. Impact statement Bone grafting is a frequent procedure in the fields of orthopedics, otolaryngology, and oral and maxillofacial surgery. Generating customized, vascularized, and mechanically robust bony tissues while eliminating common complications such as donor site morbidity with autograft harvest or lack of suitable mechanical properties with commercially available synthetic graft would greatly improve the lives of patients. A large animal model is necessary to generate tissues of clinically relevant geometries. In this article, a reproducible ovine model of in vivo bioreactor technology toward customized bone generation is presented with broad application to tissue engineering and regenerative medicine.
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Affiliation(s)
- Emma Watson
- Department of Bioengineering, Rice University, Houston, Texas, USA.,Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, USA
| | - Alexander M Tatara
- Department of Bioengineering, Rice University, Houston, Texas, USA.,Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, USA
| | | | - John A Jansen
- Department of Dentistry-Biomaterials, Radboudumc, Nijmegen, The Netherlands
| | - Mark E Wong
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Antonios G Mikos
- Department of Bioengineering, Rice University, Houston, Texas, USA
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21
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Zeng X, Wang Y, Dong Q, Ma MX, Liu XD. DLX2 activates Wnt1 transcription and mediates Wnt/β-catenin signal to promote osteogenic differentiation of hBMSCs. Gene 2020; 744:144564. [DOI: 10.1016/j.gene.2020.144564] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/08/2020] [Indexed: 12/19/2022]
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22
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Shi L, Tee BC, Emam H, Prokes R, Larsen P, Sun Z. Enhancement of bone marrow aspirate concentrate with local self-healing corticotomies. Tissue Cell 2020; 66:101383. [PMID: 32933706 DOI: 10.1016/j.tice.2020.101383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 01/08/2023]
Abstract
Bone marrow aspirate concentrate (BMAC) is a potentially useful biological product for bone regeneration. This study investigated whether BMAC can be enriched by local minor corticotomies. Five 4-month-old domestic pigs were used with each pig undergoing two minor corticotomies at one randomly-selected tibia. Two weeks after the operation, bone marrow was aspirated from both tibiae and processed into BMAC samples. The amount of mesenchymal stem cells (MSCs) and the concentration of several regenerative growth factors contained in BMAC, as well as the proliferative and osteogenic differentiation capacity of MSCs, were compared between the corticotomy and the control sides. Another four weeks later, healing of the corticotomies was evaluated by radiographic and histological methods. The results demonstrated that BMAC from the corticotomy side contained significantly more MSCs than the control side. MSCs from the corticotomy side also proliferated significantly faster and tended to have stronger osteogenic differentiation than those from the control side. In contrast, the protein concentration of TGF-β, BMP-2 and PDGF contained in BMAC was only minimally changed by the corticotomies. The corticotomies in all pigs healed uneventfully, showing complete obliteration of the corticotomy gaps on CT images. Comparison between the two sides showed that the corticotomy side had thicker and denser cortical bone and more abundant osteogenic cell differentiation than the control side. These findings suggest that the quantity and proliferative/osteogenic differentiation capacity of MSCs contained in local BMAC can be enhanced by minor corticotomies, and spontaneous healing of the corticotomy can be completed within 6 weeks of the operation.
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Affiliation(s)
- Lei Shi
- Department of Pediatric Dentistry, Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200011, China; Division of Orthodontics, College of Dentistry, The Ohio State University, Rm 4088 Postle Hall, 305 W 12th Ave, 43210 Columbus, OH, USA
| | - Boon Ching Tee
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Hany Emam
- Division of Oral and Maxillofacial Surgery, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Rachael Prokes
- Division of Oral and Maxillofacial Surgery, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Peter Larsen
- Division of Oral and Maxillofacial Surgery, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Zongyang Sun
- Division of Orthodontics, College of Dentistry, The Ohio State University, Rm 4088 Postle Hall, 305 W 12th Ave, 43210 Columbus, OH, USA.
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23
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Synergistic Effects on Incorporation of β-Tricalcium Phosphate and Graphene Oxide Nanoparticles to Silk Fibroin/Soy Protein Isolate Scaffolds for Bone Tissue Engineering. Polymers (Basel) 2020; 12:polym12010069. [PMID: 31906498 PMCID: PMC7023539 DOI: 10.3390/polym12010069] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/16/2019] [Accepted: 12/16/2019] [Indexed: 02/07/2023] Open
Abstract
In bone tissue engineering, an ideal scaffold is required to have favorable physical, chemical (or physicochemical), and biological (or biochemical) properties to promote osteogenesis. Although silk fibroin (SF) and/or soy protein isolate (SPI) scaffolds have been widely used as an alternative to autologous and heterologous bone grafts, the poor mechanical property and insufficient osteoinductive capability has become an obstacle for their in vivo applications. Herein, β-tricalcium phosphate (β-TCP) and graphene oxide (GO) nanoparticles are incorporated into SF/SPI scaffolds simultaneously or individually. Physical and chemical properties of these composite scaffolds are evaluated using field emission scanning electron microscope (FESEM), X-ray diffraction (XRD) and attenuated total reflectance Fourier transformed infrared spectroscopy (ATR-FTIR). Biocompatibility and osteogenesis of the composite scaffolds are evaluated using bone marrow mesenchymal stem cells (BMSCs). All the composite scaffolds have a complex porous structure with proper pore sizes and porosities. Physicochemical properties of the scaffolds can be significantly increased through the incorporation of β-TCP and GO nanoparticles. Alkaline phosphatase activity (ALP) and osteogenesis-related gene expression of the BMSCs are significantly enhanced in the presence of β-TCP and GO nanoparticles. Especially, β-TCP and GO nanoparticles have a synergistic effect on promoting osteogenesis. These results suggest that the β-TCP and GO enhanced SF/SPI scaffolds are promising candidates for bone tissue regeneration.
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24
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Paré A, Bossard A, Laure B, Weiss P, Gauthier O, Corre P. Reconstruction of segmental mandibular defects: Current procedures and perspectives. Laryngoscope Investig Otolaryngol 2019; 4:587-596. [PMID: 31890875 PMCID: PMC6929581 DOI: 10.1002/lio2.325] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/02/2019] [Accepted: 10/21/2019] [Indexed: 11/11/2022] Open
Abstract
Background The reconstruction of segmental mandibular defects remains a challenge for the reconstructive surgeon, from both a functional and an esthetic point of view. Methods This clinical review examines the different techniques currently in use for mandibular reconstruction as related to a range of etiologies, including the different bone donor sites, the alternatives to free flaps (FFs), as well as the contribution of computer‐assisted surgery. Recent progress and the perspectives in bone tissue engineering (BTE) are also discussed. Results Osseous FF allows reliable and satisfying outcomes. However, locoregional flap, distraction osteogenesis, or even induced membrane techniques are other potential options in less favorable cases. Obtaining an engineered bone with satisfactory mechanical properties and sufficient vascular supply requires further investigations. Conclusions Osseous FF procedure remains the gold standard for segmental mandible reconstruction. BTE strategies offer promising alternatives.
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Affiliation(s)
- Arnaud Paré
- Service de Chirurgie Maxillo Faciale Plastique et Brulés, Hôpital Trousseau, CHU de Tours Tours France.,Laboratoire Regenerative Medicine and Skeleton RMeS, France INSERM, U 1229 Nantes France.,UFR Médecine Université de Tours Tours France.,UFR Odontologie Université́ de Nantes Nantes France
| | - Adeline Bossard
- ONIRIS Nantes-Atlantic College of Veterinary Medicine Centre de Rechecherche et D'investigation Préclinique (CRIP) Nantes France
| | - Boris Laure
- Service de Chirurgie Maxillo Faciale Plastique et Brulés, Hôpital Trousseau, CHU de Tours Tours France
| | - Pierre Weiss
- Laboratoire Regenerative Medicine and Skeleton RMeS, France INSERM, U 1229 Nantes France.,UFR Odontologie Université́ de Nantes Nantes France
| | - Olivier Gauthier
- Laboratoire Regenerative Medicine and Skeleton RMeS, France INSERM, U 1229 Nantes France.,ONIRIS Nantes-Atlantic College of Veterinary Medicine Centre de Rechecherche et D'investigation Préclinique (CRIP) Nantes France
| | - Pierre Corre
- Laboratoire Regenerative Medicine and Skeleton RMeS, France INSERM, U 1229 Nantes France.,UFR Odontologie Université́ de Nantes Nantes France.,Service de Chirurgie Maxillo-Faciale et Stomatologie CHU de Nantes Nantes France
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25
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Yin S, Zhang W, Zhang Z, Jiang X. Recent Advances in Scaffold Design and Material for Vascularized Tissue-Engineered Bone Regeneration. Adv Healthc Mater 2019; 8:e1801433. [PMID: 30938094 DOI: 10.1002/adhm.201801433] [Citation(s) in RCA: 145] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/24/2019] [Indexed: 12/21/2022]
Abstract
Bone tissue is a highly vascularized tissue and concomitant development of the vascular system and mineralized matrix requires a synergistic interaction between osteogenesis and angioblasts. Several strategies have been applied to achieve vascularized tissue-engineered bone, including the addition of cytokines as well as pre-vascularization strategies and co-culture systems. However, the scaffold is another extremely important component to consider, and development of vascularized bone scaffolds remains one of the greatest challenges for engineering clinically relevant bone substitutes. Here, this review highlights the biomaterial selection, preparation of pre-vascularized scaffolds, composition modification of the scaffold, structural design, and the comprehensive use of the above synergistic modifications of scaffold materials for vascular scaffolds in bone tissue engineering. Moreover, a strategy is proposed for the design of future scaffold structures, in which promoting the regeneration of vascularized bone by regulating the microenvironment should be the main focus. This overview can help illuminate progress in this field and identify the most recently developed scaffolds that show the greatest potential for achieving clinically vascularized bone.
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Affiliation(s)
- Shi Yin
- Department of ProsthodonticsShanghai Ninth People's HospitalCollege of StomatologyShanghai Jiao Tong University School of Medicine No. 639, Manufacturing Bureau Road Huangpu District Shanghai China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology No. 639, Manufacturing Bureau Road Huangpu District Shanghai China
- Shanghai Engineering Research Center of Advanced Dental Technology and MaterialsNational Clinical Research Center of Stomatology Shanghai 200011 China
| | - Wenjie Zhang
- Department of ProsthodonticsShanghai Ninth People's HospitalCollege of StomatologyShanghai Jiao Tong University School of Medicine No. 639, Manufacturing Bureau Road Huangpu District Shanghai China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology No. 639, Manufacturing Bureau Road Huangpu District Shanghai China
- Shanghai Engineering Research Center of Advanced Dental Technology and MaterialsNational Clinical Research Center of Stomatology Shanghai 200011 China
| | - Zhiyuan Zhang
- Shanghai Engineering Research Center of Advanced Dental Technology and MaterialsNational Clinical Research Center of Stomatology Shanghai 200011 China
| | - Xinquan Jiang
- Department of ProsthodonticsShanghai Ninth People's HospitalCollege of StomatologyShanghai Jiao Tong University School of Medicine No. 639, Manufacturing Bureau Road Huangpu District Shanghai China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology No. 639, Manufacturing Bureau Road Huangpu District Shanghai China
- Shanghai Engineering Research Center of Advanced Dental Technology and MaterialsNational Clinical Research Center of Stomatology Shanghai 200011 China
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26
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Tatara AM, Koons GL, Watson E, Piepergerdes TC, Shah SR, Smith BT, Shum J, Melville JC, Hanna IA, Demian N, Ho T, Ratcliffe A, van den Beucken JJJP, Jansen JA, Wong ME, Mikos AG. Biomaterials-aided mandibular reconstruction using in vivo bioreactors. Proc Natl Acad Sci U S A 2019; 116:6954-6963. [PMID: 30886100 PMCID: PMC6452741 DOI: 10.1073/pnas.1819246116] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Large mandibular defects are clinically challenging to reconstruct due to the complex anatomy of the jaw and the limited availability of appropriate tissue for repair. We envision leveraging current advances in fabrication and biomaterials to create implantable devices that generate bone within the patients themselves suitable for their own specific anatomical pathology. The in vivo bioreactor strategy facilitates the generation of large autologous vascularized bony tissue of customized geometry without the addition of exogenous growth factors or cells. To translate this technology, we investigated its success in reconstructing a mandibular defect of physiologically relevant size in sheep. We fabricated and implanted 3D-printed in vivo bioreactors against rib periosteum and utilized biomaterial-based space maintenance to preserve the native anatomical mandibular structure in the defect site before reconstruction. Nine weeks after bioreactor implantation, the ovine mandibles were repaired with the autologous bony tissue generated from the in vivo bioreactors. We evaluated tissues generated in bioreactors by radiographic, histological, mechanical, and biomolecular assays and repaired mandibles by radiographic and histological assays. Biomaterial-aided mandibular reconstruction was successful in a large superior marginal defect in five of six (83%) sheep. Given that these studies utilized clinically available biomaterials, such as bone cement and ceramic particles, this strategy is designed for rapid human translation to improve outcomes in patients with large mandibular defects.
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Affiliation(s)
- Alexander M Tatara
- Department of Bioengineering, Rice University, Houston, TX 77030
- Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030
| | - Gerry L Koons
- Department of Bioengineering, Rice University, Houston, TX 77030
- Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030
| | - Emma Watson
- Department of Bioengineering, Rice University, Houston, TX 77030
- Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030
| | | | - Sarita R Shah
- Department of Bioengineering, Rice University, Houston, TX 77030
- Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030
| | - Brandon T Smith
- Department of Bioengineering, Rice University, Houston, TX 77030
- Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030
| | - Jonathan Shum
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - James C Melville
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Issa A Hanna
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Nagi Demian
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Tang Ho
- Department of Otorhinolaryngology, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | | | | | - John A Jansen
- Department of Biomaterials, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands
| | - Mark E Wong
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Antonios G Mikos
- Department of Bioengineering, Rice University, Houston, TX 77030;
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27
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Liu F, Liu Y, Li X, Wang X, Li D, Chung S, Chen C, Lee IS. Osteogenesis of 3D printed macro-pore size biphasic calcium phosphate scaffold in rabbit calvaria. J Biomater Appl 2019; 33:1168-1177. [PMID: 30665312 DOI: 10.1177/0885328218825177] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
To investigate the osteogenesis of macro-pore sized bone scaffolds, biphasic calcium phosphate scaffolds with accurately controlled macro-pore size (0.8, 1.2, and 1.6 mm) and identical porosity of 70% were fabricated by the 3D printing technology. Eight New Zealand rabbits were selected in the present study, while four 8-mm-diameter calvarial defects were created in each rabbit to place BCP scaffolds with different macro-pore size. The harvested specimens of four and eight weeks were used to evaluate the bone forming ability by micro CT and histological examination. All 3D-printed BCP scaffolds exhibited excellent mechanical properties and had better bone-forming ability than the control at both four and eight weeks. Among them, scaffold with 0.8 mm pore size was superior for initial bone formation and maturation, resulting in the highest value of total bone formation.
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Affiliation(s)
- Fan Liu
- 1 Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, China.,3 Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Yi Liu
- 1 Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Xinyu Li
- 2 Department of Tissue Engineering, School of Fundamental Sciences, China Medical University, Shenyang, China
| | - Xiaohong Wang
- 1 Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Danni Li
- 4 Department of Medical Oncology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - SungMin Chung
- 5 Biomaterials R&D Center, GENOSS Co., Ltd., Suwon, Republic of Korea
| | - Cen Chen
- 6 College of Life Sciences, Zhejiang Sci-Tech University, Hangzhou, China
| | - In-Seop Lee
- 7 College of Materials and Textiles, Zhejiang Sci-Tech University, Hangzhou, China.,8 Institute of Natural Sciences, Yonsei University, Seoul, Republic of Korea
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28
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Akar B, Tatara AM, Sutradhar A, Hsiao HY, Miller M, Cheng MH, Mikos AG, Brey EM. Large Animal Models of an In Vivo Bioreactor for Engineering Vascularized Bone. TISSUE ENGINEERING. PART B, REVIEWS 2018; 24:317-325. [PMID: 29471732 PMCID: PMC6080121 DOI: 10.1089/ten.teb.2018.0005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 02/06/2018] [Indexed: 12/23/2022]
Abstract
Reconstruction of large skeletal defects is challenging due to the requirement for large volumes of donor tissue and the often complex surgical procedures. Tissue engineering has the potential to serve as a new source of tissue for bone reconstruction, but current techniques are often limited in regards to the size and complexity of tissue that can be formed. Building tissue using an in vivo bioreactor approach may enable the production of appropriate amounts of specialized tissue, while reducing issues of donor site morbidity and infection. Large animals are required to screen and optimize new strategies for growing clinically appropriate volumes of tissues in vivo. In this article, we review both ovine and porcine models that serve as models of the technique proposed for clinical engineering of bone tissue in vivo. Recent findings are discussed with these systems, as well as description of next steps required for using these models, to develop clinically applicable tissue engineering applications.
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Affiliation(s)
- Banu Akar
- Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois
- Research Service, Hines Veterans Administration Hospital, Hines, Illinois
| | - Alexander M. Tatara
- Department of Bioengineering, Rice University, Houston, Texas
- Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas
| | - Alok Sutradhar
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio
| | - Hui-Yi Hsiao
- Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Michael Miller
- Department of Plastic Surgery, The Ohio State University, Columbus, Ohio
| | - Ming-Huei Cheng
- Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | | | - Eric M. Brey
- Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois
- Research Service, Hines Veterans Administration Hospital, Hines, Illinois
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, Texas
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29
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Moroni L, Burdick JA, Highley C, Lee SJ, Morimoto Y, Takeuchi S, Yoo JJ. Biofabrication strategies for 3D in vitro models and regenerative medicine. NATURE REVIEWS. MATERIALS 2018; 3:21-37. [PMID: 31223488 PMCID: PMC6586020 DOI: 10.1038/s41578-018-0006-y] [Citation(s) in RCA: 370] [Impact Index Per Article: 61.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Organs are complex systems composed of different cells, proteins and signalling molecules that are arranged in a highly ordered structure to orchestrate a myriad of functions in our body. Biofabrication strategies can be applied to engineer 3D tissue models in vitro by mimicking the structure and function of native tissue through the precise deposition and assembly of materials and cells. This approach allows the spatiotemporal control over cell-cell and cell-extracellular matrix communication and thus the recreation of tissue-like structures. In this Review, we examine biofabrication strategies for the construction of functional tissue replacements and organ models, focusing on the development of biomaterials, such as supramolecular and photosensitive materials, that can be processed using biofabrication techniques. We highlight bioprinted and bioassembled tissue models and survey biofabrication techniques for their potential to recreate complex tissue properties, such as shape, vasculature and specific functionalities. Finally, we discuss challenges, such as scalability and the foreign body response, and opportunities in the field and provide an outlook to the future of biofabrication in regenerative medicine.
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Affiliation(s)
- Lorenzo Moroni
- MERLN Institute for Technology-Inspired Regenerative Medicine, Department of Complex Tissue Regeneration, Maastricht University, Maastricht, Netherlands
| | - Jason A. Burdick
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Highley
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Sang Jin Lee
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Yuya Morimoto
- Institute of Industrial Science, University of Tokyo, Tokyo, Japan
| | - Shoji Takeuchi
- Institute of Industrial Science, University of Tokyo, Tokyo, Japan
| | - James J. Yoo
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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30
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Abstract
Bioreactors have become indispensable tools in the cell-based therapy industry. Various forms of bioreactors are used to maintain well-controlled microenvironments to regulate cell growth, differentiation, and tissue development. They are essential for providing standardized, reproducible cell-based products for regenerative medicine applications or to establish physiologically relevant
in vitro models for testing of pharmacologic agents. In this review, we discuss three main classes of bioreactors: cell expansion bioreactors, tissue engineering bioreactors, and lab-on-a-chip systems. We briefly examine the factors driving concerted research endeavors in each of these areas and describe the major advancements that have been reported in the last three years. Emerging issues that impact the commercialization and clinical use of bioreactors include (i) the need to scale up to greater cell quantities and larger graft sizes, (ii) simplification of
in vivo systems to function without exogenous stem cells or growth factors or both, and (iii) increased control in the manufacture and monitoring of miniaturized systems to better capture complex tissue and organ physiology.
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Affiliation(s)
- Makeda Stephenson
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Warren Grayson
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, Maryland, USA.,Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, Maryland, USA
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31
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Prefabrication of a functional bone graft with a pedicled periosteal flap as an in vivo bioreactor. Sci Rep 2017; 7:18038. [PMID: 29269864 PMCID: PMC5740121 DOI: 10.1038/s41598-017-17452-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 11/26/2017] [Indexed: 01/07/2023] Open
Abstract
The in vivo bioreactor principle, which focuses on using the body as a living bioreactor to cultivate stem cells, bioscaffolds, and growth factors and leveraging the body’s self-regenerative capacity to regenerate new tissue, has been considered a potential approach for bone defect reconstruction. The histological characteristics of the periosteum allow it to possess a remarkable capacity to induce bone growth and remodeling, making it suitable as an in vivo bioreactor strategy for bone graft prefabrication. The present study was designed to prefabricate vascularized bone grafts using pedicled periosteal flaps and decellularized bone matrix (DBM) scaffolds in a rabbit model. The muscular pouches created in the femoral muscle were acted as a control. Our histological results revealed that both the periosteal flap group and muscular pouch group induced bone tissue formation on the DBM surface at both 8 and 16 weeks postoperatively. However, micro-computed tomography (microCT) scanning, biomechanical, and histomorphometric findings indicated that bone grafts from the periosteal flap group showed larger bone mass, faster bone formation rates, higher vascular density, and stronger biomechanical properties than in the muscular pouch group. We suggest that using the pedicled periosteal flap as an in vivo bioreactor is a promising approach for functional bone graft prefabrication.
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Bioreactor as a New Resource of Autologous Bone Graft to Overcome Bone Defect In Vivo. Clin Rev Bone Miner Metab 2017. [DOI: 10.1007/s12018-017-9237-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zhang X, Xu B, Gao F, Zheng P, Liu W. Repair of volumetric bone defects with a high strength BMP-loaded-mineralized hydrogel tubular scaffold. J Mater Chem B 2017. [DOI: 10.1039/c7tb01279a] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A high strength and BMP-2-loaded tubular scaffold was engineered by in situ mineralization of a supramolecular hydrogel. This tubular scaffold could lead to an efficient volumetric bone repair.
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Affiliation(s)
- Xuran Zhang
- School of Materials Science and Engineering
- Tianjin Key Laboratory of Composite and Functional Materials
- Tianjin University
- Tianjin 300352
- China
| | - Bing Xu
- School of Materials Science and Engineering
- Tianjin Key Laboratory of Composite and Functional Materials
- Tianjin University
- Tianjin 300352
- China
| | - Fei Gao
- School of Materials Science and Engineering
- Tianjin Key Laboratory of Composite and Functional Materials
- Tianjin University
- Tianjin 300352
- China
| | - Pengbin Zheng
- Tianjin First Center Hospital
- Tianjin 300192
- P. R. China
| | - Wenguang Liu
- School of Materials Science and Engineering
- Tianjin Key Laboratory of Composite and Functional Materials
- Tianjin University
- Tianjin 300352
- China
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