In vitro and in vivo studies to evaluate the feasibility of Zn-0.1Li and Zn-0.8Mg application in the uterine cavity microenvironment compared to pure zinc

Zinc based biodegradable metals for bone repair and regeneration: Bioactivity and molecular mechanisms

Bone fractures and critical-size bone defects are significant public health issues, and clinical treatment outcomes are closely related to the intrinsic properties of the utilized implant materials. Zinc (Zn)-based biodegradable metals (BMs) have emerged as promising bioactive materials because of their exceptional biocompatibility, appropriate mechanical properties, and controllable biodegradation. This review summarizes the state of the art in terms of Zn-based metals for bone repair and regeneration, focusing on bridging the gap between biological mechanism and required bioactivity. The molecular mechanism underlying the release of Zn ions from Zn-based BMs in the improvement of bone repair and regeneration is elucidated. By integrating clinical considerations and the specific bioactivity required for implant materials, this review summarizes the current research status of Zn-based internal fixation materials for promoting fracture healing, Zn-based scaffolds for regenerating critical-size bone defects, and Zn-based barrier membranes for reconstituting alveolar bone defects. Considering the significant progress made in the research on Zn-based BMs for potential clinical applications, the challenges and promising research directions are proposed and discussed.

Recent advances in Fe-based bioresorbable stents: Materials design and biosafety

Fe-based materials have received more and more interests in recent years as candidates to fabricate bioresorbable stents due to their appropriate mechanical properties and biocompatibility. However, the low degradation rate of Fe is a serious limitation for such application. To overcome this critical issue, many efforts have been devoted to accelerate the corrosion rate of Fe-based stents, through the structural and surface modification of Fe matrix. As stents are implantable devices, the released corrosion products (Fe2+ ions) in vessels may alter the metabolism, by generating reactive oxygen species (ROS), which might in turn impact the biosafety of Fe-based stents. These considerations emphasize the importance of combining knowledge in both materials and biological science for the development of efficient and safe Fe-based stents, although there are still only limited numbers of reviews regarding this interdisciplinary field. This review aims to provide a concise overview of the main strategies developed so far to design Fe-based stents with accelerated degradation, highlighting the fundamental mechanisms of corrosion and the methods to study them as well as the reported approaches to accelerate the corrosion rates. These approaches will be divided into four main sections, focusing on (i) increased active surface areas, (ii) tailored microstructures, (iii) creation of galvanic reactions (by alloying, ion implantation or surface coating of noble metals) and (iv) decreased local pH induced by degradable surface organic layers. Recent advances in the evaluation of the in vitro biocompatibility of the final materials and ongoing in vivo tests are also provided.

Solid implantable devices for sustained drug delivery

Implantable drug delivery systems (IDDS) are an attractive alternative to conventional drug administration routes. Oral and injectable drug administration are the most common routes for drug delivery providing peaks of drug concentrations in blood after administration followed by concentration decay after a few hours. Therefore, constant drug administration is required to keep drug levels within the therapeutic window of the drug. Moreover, oral drug delivery presents alternative challenges due to drug degradation within the gastrointestinal tract or first pass metabolism. IDDS can be used to provide sustained drug delivery for prolonged periods of time. The use of this type of systems is especially interesting for the treatment of chronic conditions where patient adherence to conventional treatments can be challenging. These systems are normally used for systemic drug delivery. However, IDDS can be used for localised administration to maximise the amount of drug delivered within the active site while reducing systemic exposure. This review will cover current applications of IDDS focusing on the materials used to prepare this type of systems and the main therapeutic areas of application.

A Comprehensive Review of the Current Research Status of Biodegradable Zinc Alloys and Composites for Biomedical Applications

Zinc (Zn)-based biodegradable materials show moderate degradation rates in comparison with other biodegradable materials (Fe and Mg). Biocompatibility and non-toxicity also make them a viable option for implant applications. Furthermore, Pure Zn has poor mechanical behavior, with a tensile strength of around 100-150 MPa and an elongation of 0.3-2%, which is far from reaching the strength required as an orthopedic implant material (tensile strength is more than 300 MPa, elongation more than 15%). Alloy and composite fabrication have proven to be excellent ways to improve the mechanical performance of Zn. Therefore, their alloys and composites have emerged as an innovative category of biodegradable materials. This paper summarizes the most important recent research results on the mechanical and biological characteristics of biodegradable Zn-based implants for orthopedic applications and the most commonly added components in Zn alloys and composites.

A novel method combining VAT photopolymerization and casting for the fabrication of biodegradable Zn-1Mg scaffolds with triply periodic minimal surface

Zinc alloy porous scaffolds are expected to be the next generation of degradable orthopedic implants attributed to their suitable degradation rate. However, a few studies have thoroughly investigated its applicable preparation method and functionality as an orthopedic implant. This study fabricated Zn-1Mg porous scaffolds with triply periodic minimal surface (TPMS) structure by a novel method combining VAT photopolymerization and casting. As-built porous scaffolds displayed fully connected pore structures with controllable topology. The manufacturability, mechanical properties, corrosion behaviors, biocompatibility, and antimicrobial performance of the bioscaffolds with pore sizes of 650 μm, 800 μm, and 1040 μm were investigated, and then compared and discussed with each other. In simulations, the mechanical behaviors of porous scaffolds exhibited the same tendency as the experiments. In addition, the mechanical properties of porous scaffolds as a function of degradation time were studied through a 90-day immersion experiment, which can provide a new option for analyzing the mechanical properties of porous scaffolds implanted in vivo. The G06 scaffold with lower pore size presented better mechanical properties before and after degradation compared with G10. The G06 scaffold with the pore size of 650 μm revealed good biocompatibility and antibacterial properties, which makes it possible to be one of the candidates for orthopedic implants.

Gallium-Strontium Phosphate Conversion Coatings for Promoting Infection Prevention and Biocompatibility of Magnesium for Orthopedic Applications

Device-associated infections remain a clinical challenge. The common strategies to prevent bacterial infection are either toxic to healthy mammalian cells and tissue or involve high doses of antibiotics that can prompt long-term negative consequences. An antibiotic-free coating strategy to suppress bacterial growth is presented herein, which concurrently promotes bone cell growth and moderates the dissolution kinetics of resorbable magnesium (Mg) biomaterials. Pure Mg as a model biodegradable material was coated with gallium-doped strontium-phosphate through a chemical conversion process. Gallium was distributed in a gradual manner throughout the strontium-phosphate coating, with a compact structure and a gallium-rich surface. It was demonstrated that the coating protected the underlying Mg parts from significant degradation in minimal essential media at physiological conditions over 9 days. In terms of bacteria culture, the liberated gallium ions from the coatings upon Mg specimens, even though in minute quantities, inhibited the growth of Gram-positiveStaphylococcus aureus, Gram-negative Escherichia coli, andPseudomonas aeruginosa ─ key pathogens causing infection and early failure of the surgical implantations in orthopedics and trauma. More importantly, the gallium dopants displayed minimal interferences with the strontium-phosphate-based coating which boosted osteoblasts and undermined osteoclasts in in vitro co-cultures. This work provides a new strategy to prevent bacterial infection and control the degradation behavior of Mg-based orthopedic implants, while preserving osteogenic features of the devices.

Feasibility evaluation of a Zn-Cu alloy for intrauterine devices: In vitro and in vivo studies

The comprehensively adopted copper-containing intrauterine devices (Cu-IUDs) present typical adverse effects such as bleeding and pain at the initial stage of post-implantation. The replacement of Cu material is demanded. Zinc and its alloys, the emerging biodegradable materials, exhibited contraceptive effects since 1969. In this work, we evaluated the feasibility of bulk Zn alloys as IUD active material. Using pure Cu and pure Zn as control groups, we investigated the contraceptive performance of Zn-0.5Cu and Zn-1Cu alloys via in vitro and in vivo tests. The results showed that the main corrosion product of Zn-Cu alloys is ZnO from both in vitro and in vivo studies. CaZn₂(PO₄)₂·2H₂O is formed atop after long-term immersion in simulated uterine fluid, whereas CaCO₃ is generally formed atop after implantation in the rat uterine environment. The cytocompatibility of the Zn-1Cu alloy was significantly higher than that of the pure Zn and pure Cu to the human endometrial epithelial cell lines. Furthermore, the in vivo results showed that the Zn-1Cu alloy presented much improved histocompatibility, least damage and the fastest recovery on endometrium structure in comparison to pure Zn, Zn-0.5Cu and pure Cu. The systematic and comparing studies suggest that Zn-1Cu alloy can be considered as a possible candidate for IUD with great biochemical and biocompatible properties as well as high contraceptive effectiveness. STATEMENT OF SIGNIFICANCE: The existing adverse effects with the intrinsic properties of copper materials for copper-containing intrauterine devices (Cu-IUD) are of concerns in their employment. Such as burst release of cupric ions (Cu²⁺) at the initial stage of the Cu-IUD. Zinc and its alloys which have been emerging as a potential biodegradable material exhibited contraceptive effects since 1969. In this study, Zn-1Cu alloys displayed significantly improved biocompatibility with human uterus cells and a decreased inflammatory response within the uterus. Therefore, high antifertility efficacy of the Zn-1Cu alloy was well maintained, while the adverse effects are significantly eased, suggesting that the Zn-1Cu alloy is promising for IUD.

Facile fabrication of biodegradable endothelium-mimicking coatings on bioabsorbable zinc-alloy stents by one-step electrophoretic deposition

The zinc-alloy stent is one of the best potential candidates for bioabsorbable metal stents because of its appropriate corrosion rate aligned to the duration of the healing process of the surrounding vessel tissues. However, excessive release of zinc ions, causing cytotoxicity of endothelial cells, and insufficient surface bio-functions of Zn-alloy stents lead to considerable challenge in their application. Herein, one-step electrophoretic deposition was employed to apply a hybrid coating of polycarbonate, tannic acid, and copper ions with tailored functions on Zn-alloy stents to enhance their corrosion resistance and provide an endothelium-mimicking surface. Specifically, the synthesized amino-functionalized aliphatic polycarbonates endowed the hybrid coating with specific surface-erosion properties, resulting in superior corrosion resistance and long-term stability in degradation tests both in vitro and in vivo. The immobilized copper ions enabled the catalytic generation of nitric oxide and promoted the adhesion and proliferation of endothelial cells on zinc alloy. The added tannic acid firmly chelated the copper ions and formed durable phenolic-copper-amine crosslinked networks by electrostatic interaction, resulting in long-term stability of the hybrid coating during the 21 day dynamic immersion test. Tannic acid exerted a synergistic antibacterial effect with copper ions as well as a reduction in the inflammatory response to the zinc substrate. In addition, the hybrid coating improved the in vitro hemocompatibility of zinc alloys. By adjusting the amount of chelated copper in the coating system, the biological function of the corresponding coatings can be controlled, providing a facile surface treatment strategy to promote the progress of zinc-alloy stents in clinical applications.

Preliminary Investigation on Degradation Behavior and Cytocompatibility of Ca-P-Sr Coated Pure Zinc

Zinc and its alloys show a good application prospect as a new biodegradable material. However, one of the drawbacks is that Zn and its alloys would induce the release of more Zn ions, which are reported to be cytotoxic to cells. In this study, a Ca-P-Sr bioactive coating was prepared on the surface of pure zinc by the hydrothermal method to address this issue. The morphology, thickness, and composition were characterized, and the effects of the coating on the degradation, cell viability, and ALP staining were investigated. The results demonstrated that the degradation rate of pure zinc was reduced, while the cytocompatibility was significantly improved after pure zinc was treated with Ca-P-Sr coating. It is considered that the Ca-P-Sr bioactive coating prepared by the hydrothermal method has promising application in the clinic.