Dual-functional porous and cisplatin-loaded polymethylmethacrylate cement for reconstruction of load-bearing bone defect kills bone tumor cells

Modelling bone metastasis in spheroids to study cancer progression and screen cisplatin efficacy

Most bone metastases are caused by primary breast or prostate cancer cells settling in the bone microenvironment, affecting normal bone physiology and function and reducing 5-year survival rates to 10% and 6%, respectively. To expedite clinical availability of novel and effective bone metastases treatments, reliable and predictive in vitro models are urgently required to screen for novel therapies as current in vitro 2D planar mono-culture models do not accurately predict the clinical efficacy. We herein engineered a novel human in vitro 3D co-culture model based on spheroids to study dynamic cellular quantities of (breast or prostate) cancer cells and human bone marrow stromal cells and screen chemotherapeutic efficacy and specificity of the common anticancer drug cisplatin. Bone metastatic spheroids (BMSs) were formed rapidly within 24 h, while the morphology of breast versus prostate cancer BMS differed in terms of size and circularity upon prolonged culture periods. Prestaining cell types prior to BMS formation enabled confocal imaging and quantitative image analysis of in-spheroid cellular dynamics for up to 7 days of BMS culture. We found that cancer cells in BMS proliferated faster and were less susceptible to cisplatin treatment compared to 2D control cultures. Based on these findings and the versatility of our methodology, BMS represent a feasible 3D in vitro model for screening of new bone cancer metastases therapies.

Study on the poly(methyl methacrylate-acrylic acid)/calcium phosphate cement composite bound by chelation with enhanced water absorption and biomechanical properties

Polymethylmethacrylate (PMMA) bone cement has been widely used as a critical material for fixing prostheses and filling bone defects. The shrinkage of PMMA bone cement was addressed by the additives, however, the uneven integral water absorption and expansion performance as well as the deteriorated mechanical properties of the modified bone cement after immersion in phosphate buffered saline (PBS) and simulation body fluid (SBF) affected the long-term stability after implantation. Calcium phosphate cement (CPC) is a biomaterial with promising applications in orthopedics, whose hydration reaction provides an important driving force for the transfer of water. Besides, the mechanical properties of CPC can be enhanced with the curing process. In this study, CPC was utilized to modify the poly(methyl methacrylate-acrylic acid) [P(MMA-AA)] bone cement. The results demonstrated the successful construction of interconnected CPC water delivery networks in the P(MMA-AA)/CPC composite, the water absorption ratio and expansion ratio of the composite were up to 131.18 ± 9.14% and 168.19 ± 5.44%, respectively. Meanwhile, the transformation of CPC water delivery networks into rigid mechanical support networks as well as the chelation interaction between organic-inorganic enhanced the mechanical properties of the composite after immersion, the compressive strength after immersion reached 62.97 ± 0.97 MPa, which was 27.65% higher than that before immersion. The degradation ratio of the composite was up to 13.76 ± 0.23% after 9 days of immersion, which was 16.4% higher than that of CPC. Furthermore, composites exhibited superior biocompatibility as the release of Ca2+. Therefore, P(MMA-AA)/CPC composite serves as a promising medical filling material for clinical use.

Comprehensive evaluation and advanced modification of polymethylmethacrylate cement in bone tumor treatment

Bone tumors are invasive diseases with a tendency toward recurrence, disability, and high mortality rates due to their grievous complications. As a commercial polymeric biomaterial, polymethylmethacrylate (PMMA) cement possesses remarkable mechanical properties, injectability, and plasticity and is, therefore, frequently applied in bone tissue engineering. Numerous positive effects in bone tumor treatment have been demonstrated, including biomechanical stabilization, analgesic effects, and tumor recurrence prevention. However, to our knowledge, a comprehensive evaluation of the application of the PMMA cement in bone tumor treatment has not yet been reported. This review comprehensively evaluates the efficiency and complications of the PMMA cement in bone tumor treatment, for the first time, and introduces advanced modification strategies, providing an objective and reliable reference for the application of the PMMA cement in treating bone tumors. We have also summarized the current research on modifications to enhance the anti-tumor efficacy of the PMMA cement, such as drug carriers and magnetic hyperthermia.

Engineered biomaterial delivery strategies are used to reduce cardiotoxicity in osteosarcoma

Osteosarcoma (OS) is the most common malignant bone tumor in children and adolescents. Chemotherapy drugs play an integral role in OS treatment. Preoperative neoadjuvant chemotherapy and postoperative conventional adjuvant chemotherapy improve survival in patients with OS. However, the toxic side effects of chemotherapy drugs are unavoidable. Cardiotoxicity is one of the common side effects of chemotherapy drugs that cannot be ignored. Chemotherapy drugs affect the destruction of mitochondrial autophagy and mitochondria-associated proteins to cause a decrease in cardiac ejection fraction and cardiomyocyte necrosis, which in turn causes heart failure and irreversible cardiomyopathy. Biomaterials play an important role in nanomedicine. Biomaterials act as carriers to deliver chemotherapy drugs precisely around tumor cells and continuously release carriers around the tumor. It not only promotes anti-tumor effects but also reduces the cardiotoxicity of chemotherapy drugs. In this paper, we first introduce the mechanism by which chemotherapy drugs commonly used in OS cause cardiotoxicity. Subsequently, we introduce biomaterials for reducing cardiotoxicity in OS chemotherapy. Finally, we prospect biomaterial delivery strategies to reduce cardiotoxicity in OS.

Injectable nanofiber-reinforced bone cement with controlled biodegradability for minimally-invasive bone regeneration

Injectable materials show their special merits in regeneration of damaged/degenerated bones in minimally-invasive approach. Injectable calcium phosphate bone cement (CPC) has attracted broad attention for its bioactivity, as compared to non-degradable polymethyl methacrylate cement. However, its brittleness, poor anti-washout property and uncontrollable biodegradability are the main challenges to limit its further clinical application mainly because of its stone-like dense structure and fragile inorganic-salt weakness. Herein, we developed a kind of injectable CPC bone cement with porous structure and improved robustness by incorporating poly(lactide-co-glycolic acid) (PLGA) nanofiber into CPC, with carboxymethyl cellulose (CMC) to offer good injectability as well as anti-wash-out capacity. Furthermore, the introduction of PLGA and CMC also enabled a formation of initial porous structure in the cements, where PLGA nanofiber endowed the cement with a dynamically controllable biodegradability which provided room for cell movement and bone ingrowth. Interestingly, the reinforced biodegradable cement afforded a sustainable provision of Ca²⁺ bioactive components, together with its porous structure, to improve synergistically new bone formation and osteo-integration in vivo by using a rat model of femur condyle defect. Further study on regenerative mechanisms indicated that the good minimally-invasive bone regeneration may come from the synergistic enhanced osteogenic effect of calcium ion enrichment and the improved revascularization capacity contributed from the porosity as well as the lactic acid released from PLGA nanofiber. These results indicate the injectable bone cement with high strength, anti-washout property and controllable biodegradability is a promising candidate for bone regeneration in a minimally-invasive approach.

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Poly (lactide-co-glycolide) nanofiber incorporation reinforces the brittle CPC bone cement.

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The introduction of carboxymethyl cellulose offers good injectability and anti-washout resistance.

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PLGA nanofiber controllable biodegradability dynamically creates potential pores for bone formation and ingrowth.

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The cement continuously releases Ca²⁺ and lactic acid to improve bone regeneration and revascularization efficacy.

Fabrication and characterization of cellulose nano crystal and soya modified injectable brushite bone cement for enhanced bone regeneration

An inventive, cellulose nano crystal (CNC) and isolated soya flour (SPI) laden brushite-based injectable bone substitute (IBS) material has been developed in the present research. The purpose of the study was to discover the physical, mechanical, in-vitro biological, and in-vivo bone forming ability of the prepared IBS. The incomparable abilities of CNC together with SPI resulted in enhanced biocompatibility, mechanical strength, and biodegradability, which together with its exclusive properties, sort it ideal for bone restoration. The CNC/SPI laden composites showed suitable mechanical strength of ~10.5 MPa for BM23 composite. The in- vitro cytocompatibility of the prepared samples were evaluated by osteoblast type MC3T3-E1 cells via MTT assay. Protein absorption and mineralization behavior of BRCNC2.0 was around (1.7 and 2.3)-fold higher than that of BR, respectively. In vivo performance was also found appreciable with ~(31.33 ± 2.04) % BV/TV. Incorporation of SPI resulted in enhanced bone formation at the central zone of the defect, while unmodified samples resulted in bone formation only at the peripheral zone. The findings of the current study proposed that CNC/SPI laden, brushite based injectable bone substitute might be proficient for bone regeneration ability.