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Pecorini G, Braccini S, Simoni S, Corti A, Parrini G, Puppi D. Additive Manufacturing of Wet-Spun Poly(3-hydroxybutyrate-co-3-hydroxyvalerate)-Based Scaffolds Loaded with Hydroxyapatite. Macromol Biosci 2024; 24:e2300538. [PMID: 38534197 DOI: 10.1002/mabi.202300538] [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: 11/21/2023] [Revised: 03/20/2024] [Indexed: 03/28/2024]
Abstract
Tissue engineering represents an advanced therapeutic approach for the treatment of bone tissue defects. Polyhydroxyalkanoates are a promising class of natural polymers in this context thanks to their biocompatibility, processing versatility, and mechanical properties. The aim of this study is the development by computer-aided wet-spinning of novel poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV)-based composite scaffolds for bone engineering. In particular, PHBV scaffolds are loaded with hydroxyapatite (HA), an osteoinductive ceramic, in order to tailor their biological activity and mechanical properties. PHBV blending with poly(lactide-co-glycolide) (PLGA) is also explored to increase the processing properties of the polymeric mixture used for composite scaffold fabrication. Different HA percentages, up to 15% wt., can be loaded into the PHBV or PHBV/PLGA scaffolds without compromising their interconnected porous architecture, as well as the polymer morphological and thermal properties, as demonstrated by scanning electron microscopy, thermogravimetric analysis, and differential scanning calorimetry. In addition, HA loading results in increased scaffold compressive stiffness to levels comparable to those of trabecular bone tissue, as well as in higher in vitro MC3T3-E1 cell viability and production of mineralized extracellular matrix, in comparison to what observed for unloaded scaffolds. The observed mechanical and biological properties suggest the suitability of the developed scaffolds for bone engineering.
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Affiliation(s)
- Gianni Pecorini
- BIOLab Research Group, Department of Chemistry and Industrial Chemistry, University of Pisa, UdR INSTM Pisa, Via Moruzzi 13, Pisa, 56124, Italy
| | - Simona Braccini
- BIOLab Research Group, Department of Chemistry and Industrial Chemistry, University of Pisa, UdR INSTM Pisa, Via Moruzzi 13, Pisa, 56124, Italy
| | - Stefano Simoni
- BIOLab Research Group, Department of Chemistry and Industrial Chemistry, University of Pisa, UdR INSTM Pisa, Via Moruzzi 13, Pisa, 56124, Italy
| | - Andrea Corti
- BIOLab Research Group, Department of Chemistry and Industrial Chemistry, University of Pisa, UdR INSTM Pisa, Via Moruzzi 13, Pisa, 56124, Italy
| | | | - Dario Puppi
- BIOLab Research Group, Department of Chemistry and Industrial Chemistry, University of Pisa, UdR INSTM Pisa, Via Moruzzi 13, Pisa, 56124, Italy
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2
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Mazzoni E, Iaquinta MR, Mosaico M, De Pace R, D'Agostino A, Tognon M, Martini F. Human Mesenchymal Stem Cells and Innovative Scaffolds for Bone Tissue Engineering Applications. TISSUE ENGINEERING. PART B, REVIEWS 2023; 29:514-531. [PMID: 37212264 DOI: 10.1089/ten.teb.2022.0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Stem cell-based therapy is a significant topic in regenerative medicine, with a predominant role being played by human mesenchymal stem cells (hMSCs). The hMSCs have been shown to be suitable in regenerative medicine for the treatment of bone tissue. In the last few years, the average lifespan of our population has gradually increased. The need of biocompatible materials, which exhibit high performances, such as efficiency in bone regeneration, has been highlighted by aging. Current studies emphasize the benefit of using biomimetic biomaterials, also known as scaffolds, for bone grafts to speed up bone repair at the fracture site. For the healing of injured bone and bone regeneration, regenerative medicine techniques utilizing a combination of these biomaterials, together with cells and bioactive substances, have drawn a great interest. Cell therapy, based on the use of hMSCs, alongside materials for the healing of damaged bone, has obtained promising results. In this work, several aspects of cell biology, tissue engineering, and biomaterials applied to bone healing/regrowth will be considered. In addition, the role of hMSCs in these fields and recent progress in clinical applications are discussed. Impact Statement The restoration of large bone defects is both a challenging clinical issue and a socioeconomic problem on a global scale. Different therapeutic approaches have been proposed for human mesenchymal stem cells (hMSCs), considering their paracrine effect and potential differentiation into osteoblasts. However, different limitations are still to be overcome in using hMSCs as a therapeutic opportunity in bone fracture repair, including hMSC administration methods. To identify a suitable hMSC delivery system, new strategies have been proposed using innovative biomaterials. This review provides an update of the literature on hMSC/scaffold clinical applications for the management of bone fractures.
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Affiliation(s)
- Elisa Mazzoni
- Department of Chemical, Pharmaceutical and Agricultural Sciences, and University of Ferrara, Ferrara, Italy
| | - Maria Rosa Iaquinta
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Maria Mosaico
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Raffaella De Pace
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Antonio D'Agostino
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Mauro Tognon
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fernanda Martini
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Laboratory for Technologies of Advanced Therapies, University of Ferrara, Ferrara, Italy
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3
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Prabhath A, Vernekar VN, Esdaille CJ, Eisenberg E, Lebaschi A, Badon M, Seyedsalehi A, Dzidotor G, Tang X, Dyment N, Thomopoulos S, Kumbar SG, Deymier A, Weber E, Laurencin CT. Pegylated insulin-like growth factor-1 biotherapeutic delivery promotes rotator cuff regeneration in a rat model. J Biomed Mater Res A 2022; 110:1356-1371. [PMID: 35253991 DOI: 10.1002/jbm.a.37378] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/17/2022] [Accepted: 02/25/2022] [Indexed: 12/27/2022]
Abstract
Tears in the rotator cuff are challenging to repair because of the complex, hypocellular, hypovascular, and movement-active nature of the tendon and its enthesis. Insulin-like Growth Factor-1 (IGF-1) is a promising therapeutic for this repair. However, its unstable nature, short half-life, and ability to disrupt homeostasis has limited its clinical translation. Pegylation has been shown to improve the stability and sustain IGF-1 levels in the systemic circulation without disrupting homeostasis. To provide localized delivery of IGF-1 in the repaired tendons, we encapsulated pegylated IGF-1 mimic and its controls (unpegylated IGF-1 mimic and recombinant human IGF-1) in polycaprolactone-based matrices and evaluated them in a pre-clinical rodent model of rotator cuff repair. Pegylated-IGF-1 mimic delivery reestablished the characteristic tendon-to-bone enthesis structure and improved tendon tensile properties within 8 weeks of repair compared to controls, signifying the importance of pegylation in this complex tissue regeneration. These results demonstrate a simple and scalable biologic delivery technology alternative to tissue-derived grafts for soft tissue repair.
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Affiliation(s)
- Anupama Prabhath
- Connecticut Convergence Institute for Translation in Regenerative Engineering, Farmington, Connecticut, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA.,Department of Biomedical Engineering, UConn Health, Farmington, Connecticut, USA
| | - Varadraj N Vernekar
- Connecticut Convergence Institute for Translation in Regenerative Engineering, Farmington, Connecticut, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA
| | - Caldon J Esdaille
- Connecticut Convergence Institute for Translation in Regenerative Engineering, Farmington, Connecticut, USA
| | - Ellen Eisenberg
- Department of Pathology and Laboratory Medicine, UConn Health, Farmington, Connecticut, USA
| | - Amir Lebaschi
- Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA
| | - Mary Badon
- Connecticut Convergence Institute for Translation in Regenerative Engineering, Farmington, Connecticut, USA
| | - Amir Seyedsalehi
- Connecticut Convergence Institute for Translation in Regenerative Engineering, Farmington, Connecticut, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA.,Department of Biomedical Engineering, UConn Health, Farmington, Connecticut, USA
| | - Godwin Dzidotor
- Connecticut Convergence Institute for Translation in Regenerative Engineering, Farmington, Connecticut, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA.,Department of Chemical Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Xiaoyan Tang
- Connecticut Convergence Institute for Translation in Regenerative Engineering, Farmington, Connecticut, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA.,Department of Material Science and Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Nathaniel Dyment
- McKay Orthopaedic Research Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stavros Thomopoulos
- Department of Orthopedic Surgery, Columbia University, New York, New York, USA.,Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Sangamesh G Kumbar
- Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA.,Department of Biomedical Engineering, UConn Health, Farmington, Connecticut, USA.,Department of Material Science and Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Alix Deymier
- Department of Biomedical Engineering, UConn Health, Farmington, Connecticut, USA
| | - Eckhard Weber
- Novartis Institutes for BioMedical Research (NIBR), Basel, Switzerland
| | - Cato T Laurencin
- Connecticut Convergence Institute for Translation in Regenerative Engineering, Farmington, Connecticut, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA.,Department of Biomedical Engineering, UConn Health, Farmington, Connecticut, USA.,Department of Chemical Engineering, University of Connecticut, Storrs, Connecticut, USA.,Department of Material Science and Engineering, University of Connecticut, Storrs, Connecticut, USA
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4
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Prabhath A, Vernekar VN, Vasu V, Badon M, Avochinou JE, Asandei AD, Kumbar SG, Weber E, Laurencin CT. Kinetic degradation and biocompatibility evaluation of polycaprolactone-based biologics delivery matrices for regenerative engineering of the rotator cuff. J Biomed Mater Res A 2021; 109:2137-2153. [PMID: 33974735 PMCID: PMC8440380 DOI: 10.1002/jbm.a.37200] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/26/2021] [Accepted: 04/07/2021] [Indexed: 11/06/2022]
Abstract
Whereas synthetic biodegradable polymers have been successfully applied for the delivery of biologics in other tissues, the anatomical complexity, poor blood supply, and reduced clearance of degradation byproducts in the rotator cuff create unique design challenges for implantable biomaterials. Here, we investigated lower molecular weight poly-lactic acid co-epsilon-caprolactone (PLA-CL) formulations with varying molecular weight and film casting concentrations as potential matrices for the therapeutic delivery of biologics in the rotator cuff. Matrices were fabricated with target footprint dimensions to facilitate controlled and protected release of model biologic (Bovine Serum Albumin), and anatomically-unhindered implantation under the acromion in a rodent model of acute rotator cuff repair. The matrix obtained from the highest polymeric-film casting concentration showed a controlled release of model biologics payload. The tested matrices rapidly degraded during the initial 4 weeks due to preferential hydrolysis of the lactide-rich regions within the polymer, and subsequently maintained a stable molecular weight due to the emergence of highly-crystalline caprolactone-rich regions. pH evaluation in the interior of the matrix showed minimal change signifying lesser accumulation of acidic degradation byproducts than seen in other bulk-degrading polymers, and maintenance of conformational stability of the model biologic payload. The context-dependent biocompatibility evaluation in a rodent model of acute rotator cuff repair showed matrix remodeling without eliciting excessive inflammatory reaction and is anticipated to completely degrade within 6 months. The engineered PLA-CL matrices offer unique advantages in controlled and protected biologic delivery, non-toxic biodegradation, and biocompatibility overcoming several limitations of commonly-used biodegradable polyesters.
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Affiliation(s)
- Anupama Prabhath
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut, USA
- Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA
- Department of Biomedical Engineering, UConn Health, Farmington, Connecticut, USA
| | - Varadraj N Vernekar
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut, USA
- Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA
| | - Vignesh Vasu
- Department of Material Science and Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Mary Badon
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut, USA
| | - Jean-Emmanuel Avochinou
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut, USA
| | - Alexandru D Asandei
- Department of Material Science and Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Sangamesh G Kumbar
- Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA
- Department of Biomedical Engineering, UConn Health, Farmington, Connecticut, USA
- Department of Material Science and Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Eckhard Weber
- Musculoskeletal Division, Novartis Institutes for BioMedical Research (NIBR), Basel, Switzerland
| | - Cato T Laurencin
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut, USA
- Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, USA
- Department of Biomedical Engineering, UConn Health, Farmington, Connecticut, USA
- Department of Material Science and Engineering, University of Connecticut, Storrs, Connecticut, USA
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5
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Ghorbani M, Mahmoodzadeh F, Yavari Maroufi L, Nezhad-Mokhtari P. Electrospun tetracycline hydrochloride loaded zein/gum tragacanth/poly lactic acid nanofibers for biomedical application. Int J Biol Macromol 2020; 165:1312-1322. [DOI: 10.1016/j.ijbiomac.2020.09.225] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/12/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023]
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6
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Lanier OL, Ficarrotta JM, Adjei I, Wable D, Lewis C, Nacea C, Sharma B, Dobson J, McFetridge P. Magnetically Responsive Polymeric Microparticles for the Triggered Delivery of a Complex Mixture of Human Placental Proteins. Macromol Biosci 2020; 21:e2000249. [PMID: 33015960 DOI: 10.1002/mabi.202000249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/09/2020] [Indexed: 12/21/2022]
Abstract
Bone loss through traumatic injury is a significant clinical issue. Researchers have created many scaffold types to mimic an extracellular matrix to provide structural support for the formation of new bone, however functional regeneration of larger scaffolds has not been fully achieved. Newer scaffolds aim to deliver bioactive molecules to improve tissue regeneration. To achieve a more comprehensive regenerative response, a magnetically triggerable polymeric microparticle platform is developed for the on-demand release of a complex mixture of isolated human placental proteins. This system is composed of polycaprolactone (PCL) microparticles, encapsulating magnetic nanoparticles (MNPs), and placental proteins. When subjected to an alternating magnetic field (AMF), the MNPs heat and melt the PCL, enhancing the diffusion of proteins from microparticles. When the field is off, the PCL re-solidifies. This potentially allows for cyclic drug delivery. Here the design, synthesis, and proof-of-concept experiments for this system are reported. In addition, it is shown that the proteins retain function after being magnetically released. The ability to trigger the release of complex protein mixtures on-demand may provide a significant advantage with wounds where stagnation of healing processes can occur (e.g., large segmented bone defects).
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Affiliation(s)
- Olivia L Lanier
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Joseph M Ficarrotta
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Isaac Adjei
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Dayita Wable
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Camryn Lewis
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Christopher Nacea
- Department of Materials Science and Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Blanka Sharma
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Jon Dobson
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Peter McFetridge
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
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7
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Paudwal G, Rawat N, Gupta R, Baldi A, Singh G, Gupta PN. Recent Advances in Solid Dispersion Technology for Efficient Delivery of Poorly Water-Soluble Drugs. Curr Pharm Des 2019; 25:1524-1535. [DOI: 10.2174/1381612825666190618121553] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/11/2019] [Indexed: 11/22/2022]
Abstract
Drug discovery is generally considered as a costly affair and it takes approximately 15 years to reach a
new chemical entity into the market. Among the recent potent drug molecules with most effective pharmacological
properties, very few reached for Phase I clinical trial in humans. Unfortunately, the historical average reveals
an almost 90% overall attrition rate in clinical trials. The solubility and permeability of a drug are the critical
factors influencing the success of a drug. Oral drug delivery systems still continue to exist as the most favored,
simplest and easiest administration route. A huge number of potential clinical candidates won’t make it to the
market or accomplish their maximum capacity except if their solubility and oral bioavailability are enhanced by
formulation. The solubility of drugs will continue to exist as important aspects of formulation development. With
the emergence of synthetic methods for new molecule synthesis in chemistry and better screening methods, the
number of poorly water soluble compounds has dramatically expanded in the last few years. Solid dispersion is
one of the most important techniques as it can be prepared by several methods. It is mostly prepared with a drug
having poor water solubility and it explores hydrophilic polymers either individually or in combination for the
enhancement of solubility. In comparison to the conventional formulations such as tablets or capsules, there are
different methods with which solid dispersions can be prepared and also have many benefits over conventional
drug delivery approaches. Solid dispersion systems are potential for increasing the solubility, oral absorption and
bioavailability of drugs and the significance of the solid dispersion technology is constantly increasing. The main
focus of this review is to present recent advancements in the area of solid dispersion. This review also includes an
account of recent patents on solid dispersion and clinical status of solid dispersion based formulations.
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Affiliation(s)
- Gourav Paudwal
- PK-PD Toxicology & Formulation Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - Neha Rawat
- Department of Pharmacy, Maharaja Ranjit Singh Punjab Technical University, Bathinda, India
| | - Rahul Gupta
- PK-PD Toxicology & Formulation Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - Ashish Baldi
- Department of Pharmacy, Maharaja Ranjit Singh Punjab Technical University, Bathinda, India
| | - Gurdarshan Singh
- PK-PD Toxicology & Formulation Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - Prem N. Gupta
- PK-PD Toxicology & Formulation Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
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8
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Bellucci D, Braccini S, Chiellini F, Balasubramanian P, Boccaccini AR, Cannillo V. Bioactive glasses and glass‐ceramics versus hydroxyapatite: Comparison of angiogenic potential and biological responsiveness. J Biomed Mater Res A 2019; 107:2601-2609. [DOI: 10.1002/jbm.a.36766] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/31/2019] [Indexed: 01/02/2023]
Affiliation(s)
- Devis Bellucci
- Dipartimento di Ingegneria Enzo FerrariUniversità degli Studi di Modena e Reggio Emilia Modena Italy
| | - Simona Braccini
- Dipartimento di Chimica e Chimica IndustrialeUniversità di Pisa Pisa Italy
| | - Federica Chiellini
- Dipartimento di Chimica e Chimica IndustrialeUniversità di Pisa Pisa Italy
| | | | - Aldo R. Boccaccini
- Institute of BiomaterialsUniversity of Erlangen‐Nuremberg Erlangen Germany
| | - Valeria Cannillo
- Dipartimento di Ingegneria Enzo FerrariUniversità degli Studi di Modena e Reggio Emilia Modena Italy
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9
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Christiani TR, Baroncini E, Stanzione J, Vernengo AJ. In vitro evaluation of 3D printed polycaprolactone scaffolds with angle-ply architecture for annulus fibrosus tissue engineering. Regen Biomater 2019; 6:175-184. [PMID: 31198585 PMCID: PMC6547313 DOI: 10.1093/rb/rbz011] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 01/28/2019] [Accepted: 02/21/2019] [Indexed: 12/20/2022] Open
Abstract
Tissue engineering of the annulus fibrosus (AF) is currently being investigated as a treatment for intervertebral disc degeneration, a condition frequently associated with low back pain. The objective of this work was to use 3D printing to generate a novel scaffold for AF repair that mimics the structural and biomechanical properties of the native tissue. Multi-layer scaffolds were fabricated by depositing polycaprolactone struts in opposing angular orientations, replicating the angle-ply arrangement of the native AF tissue. Scaffolds were printed with varied strut diameter and spacing. The constructs were characterized morphologically and by static and dynamic mechanical analyses. Scaffold surfaces were etched with unidirectional grooves and the influence on bovine AF cell metabolic activity, alignment, morphology and protein expression was studied in vitro. Overall, the axial compressive and circumferential tensile properties of the scaffolds were found to be in a similar range to the native AF tissue. Confocal microscopy images indicated that cells were able to attach and spread on the smooth polycaprolactone scaffolds, but the surface texture induced cellular alignment and proliferation. Furthermore, immunofluorescence analysis demonstrated the aligned deposition of collagen type I, aggrecan and the AF-specific protein marker tenomodulin on the etched scaffolds. Overall, results demonstrated the potential for using the scaffolds as a template for AF regeneration.
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Affiliation(s)
- T R Christiani
- Department of Biomedical Engineering, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, USA
| | - E Baroncini
- Department of Chemical Engineering, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, USA
| | - J Stanzione
- Department of Chemical Engineering, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, USA
| | - A J Vernengo
- Department of Biomedical Engineering, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, USA
- Department of Chemical Engineering, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, USA
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10
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Kumar A, Zhang Y, Terracciano A, Zhao X, Su TL, Kalyon DM, Katebifar S, Kumbar SG, Yu X. Load-bearing biodegradable polycaprolactone-poly (lactic-co-glycolic acid)- beta tri-calcium phosphate scaffolds for bone tissue regeneration. POLYM ADVAN TECHNOL 2019; 30:1189-1197. [PMID: 31728108 PMCID: PMC6855254 DOI: 10.1002/pat.4551] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 12/27/2018] [Indexed: 12/17/2022]
Abstract
A biodegradable scaffold with tissue ingrowth and load-bearing capabilities is required to accelerate the healing of bone defects. However, it is difficult to maintain the mechanical properties as well as biodegradability and porosity (necessary for bone ingrowth) at the same time. Therefore, in the present study, polycaprolactone (PCL) and poly(lactic-co-glycolic acid) (PLGA5050) were mixed in varying ratio and incorporated with 20 wt.% βTCP. The mixture was shaped under pressure into originally non-porous cylindrical constructs. It is envisioned that the fabricated constructs will develop porosity with the time-dependent biodegradation of the polymer blend. The mechanical properties will be sustained since the decrease in mechanical properties associated with the dissolution of the PLGA and the formation of the porous structure will be compensated with the new bone formation and ingrowth. To prove the hypothesis, we have systematically studied the effects of samples composition on the time-dependent dissolution behavior, pore formation, and mechanical properties of the engineered samples, in vitro. The highest initial (of as-prepared samples) values of the yield strength (0.021±0.002 GPa) and the Young's modulus (0.829±0.096 GPa) were exhibited by the samples containing 75 wt.% of PLGA. Increase of the PLGA concentration from 25 wt.% to 75 wt.% increased the rate of biodegradation by a factor of 3 upon 2 weeks in phosphate buffered saline (1× PBS). The overall porosity and the pore sizes increased with the dissolution time indicating that the formation of in-situ pores can indeed enable the migration of cells followed by vascularization and bone growth.
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Affiliation(s)
| | - Yiren Zhang
- Department of Chemical Engineering and Materials Science
| | - Amalia Terracciano
- Center for Environmental Systems Stevens Institute of Technology, Hoboken, NJ, USA
| | - Xiao Zhao
- Department of Chemical Engineering and Materials Science
| | - Tsan-Liang Su
- Center for Environmental Systems Stevens Institute of Technology, Hoboken, NJ, USA
| | | | - Sara Katebifar
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Sangamesh G. Kumbar
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, USA
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11
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Niza E, Castro-Osma JA, Posadas I, Alonso-Moreno C, Bravo I, Garzón A, Canales-Vázquez J, Ceña V, Lara-Sánchez A, Albaladejo J, Otero A. Assessment of doxorubicin delivery devices based on tailored bare polycaprolactone against glioblastoma. Int J Pharm 2019; 558:110-119. [PMID: 30639216 DOI: 10.1016/j.ijpharm.2018.12.079] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 12/22/2018] [Accepted: 12/24/2018] [Indexed: 12/27/2022]
Abstract
Bare polycaprolactones with controlled molar mass and dispersity were employed to manufacture biodegradable devices, which were applied for doxorubicin delivery in glioblastoma. Micro- and nanoscale devices were prepared by emulsion formation or by a combination of precipitation and hydrolysis. The carriers were characterized by scanning electron microscopy, dynamic light scattering techniques, thermogravimetric analysis and differential scanning calorimetry. The encapsulation parameters and drug-release profiles are discussed in order to evaluate the influence of different fundamental parameters, such as molar mass and dispersity value, pH, morphology or crystallinity, on the efficiency of the doxorubicin delivery systems. The ability of doxorubicin-loaded micro- and nanoscale devices to induce cellular toxicity in glioblastoma cells was also explored. A cell viability assay against C6 cells of doxorubicin-loaded nanocarriers showed higher cytotoxicity than doxorubicin-loaded microcarriers. In addition, doxorubicin-loaded nanocarriers also showed good antitumor profile in human tumoral cells and improved the security profile in relation to free doxorubicin in non-tumoral cells. Consistent with the assessment study described in this manuscript, the results provide a proof of concept for the suitability of the approach, based on bare polycaprolactone, to local controlled-sustained release of doxorubicin for the treatment of glioblastoma.
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Affiliation(s)
- Enrique Niza
- Universidad de Castilla-La Mancha, Dpto. de Química Inorgánica, Orgánica y Bioquímica, Facultad de Farmacia, 02071 Albacete, Spain
| | - José A Castro-Osma
- Universidad de Castilla-La Mancha, Dpto. de Química Inorgánica, Orgánica y Bioquímica, Facultad de Farmacia, 02071 Albacete, Spain
| | - Inmaculada Posadas
- Unidad Asociada Neurodeath CSIC-UCLM, Dpto. de Ciencias Médicas, Facultad de Farmacia, Universidad de Castilla-La Mancha, Campus Universitario de Albacete, 02071 Albacete, Spain
| | - Carlos Alonso-Moreno
- Universidad de Castilla-La Mancha, Dpto. de Química Inorgánica, Orgánica y Bioquímica, Facultad de Farmacia, 02071 Albacete, Spain.
| | - Iván Bravo
- Universidad de Castilla-La Mancha, Dpto. de Química Física, Facultad de Farmacia, 02071 Albacete, Spain.
| | - Andrés Garzón
- Universidad de Castilla-La Mancha, Dpto. de Química Física, Facultad de Farmacia, 02071 Albacete, Spain
| | | | - Valentín Ceña
- Unidad Asociada Neurodeath CSIC-UCLM, Dpto. de Ciencias Médicas, Facultad de Farmacia, Universidad de Castilla-La Mancha, Campus Universitario de Albacete, 02071 Albacete, Spain
| | - Agustín Lara-Sánchez
- Universidad de Castilla-La Mancha, Dpto. de Química Inorgánica, Orgánica y Bioquímica, Facultad de Farmacia, 02071 Albacete, Spain
| | - José Albaladejo
- Universidad de Castilla-La Mancha, Dpto. de Química Física, Facultad de Farmacia, 02071 Albacete, Spain
| | - Antonio Otero
- Universidad de Castilla-La Mancha, Dpto. de Química Inorgánica, Orgánica y Bioquímica, Facultad de Farmacia, 02071 Albacete, Spain
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12
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Chung R, Kalyon DM, Yu X, Valdevit A. Segmental bone replacement via patient-specific, three-dimensional printed bioresorbable graft substitutes and their use as templates for the culture of mesenchymal stem cells under mechanical stimulation at various frequencies. Biotechnol Bioeng 2018; 115:2365-2376. [PMID: 29940090 DOI: 10.1002/bit.26780] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/25/2018] [Accepted: 06/18/2018] [Indexed: 12/15/2022]
Abstract
The treatment of large segmental bone defects remains a challenge as infection, delayed union, and nonunion are common postoperative complications. A three-dimensional printed bioresorbable and physiologically load-sustaining graft substitute was developed to mimic native bone tissue for segmental bone repair. Fabricated from polylactic acid, this graft substitute is novel as it is readily customizable to accommodate the particular size and location of the segmental bone of the patient to be replaced. Inspired by the structure of the native bone tissue, the graft substitute exhibits a gradient in porosity and pore size in the radial direction and exhibit mechanical properties similar to those of the native bone tissue. The graft substitute can serve as a template for tissue constructs via seeding with stem cells. The biocompatibility of such templates was tested under in vitro conditions using a dynamic culture of human mesenchymal stem cells. The effects of the mechanical loading of cell-seeded templates under in vitro conditions were assessed via subjecting the tissue constructs to 28 days of daily mechanical stimulation. The frequency of loading was found to have a significant effect on the rate of mineralization, as the alkaline phosphatase activity and calcium deposition were determined to be particularly high at the typical walking frequency of 2 Hz, suggesting that mechanical stimulation plays a significant role in facilitating the healing process of bone defects. Utilization of such patient-specific and biocompatible graft substitutes, coupled with patient's bone marrow cells seeded and exposed to mechanical stimulation of 2 Hz have the potential of reducing significant volumes of cadaveric tissue required, improving long-term graft stability and incorporation, and alleviating financial burdens associated with delayed or failed fusions of long bone defects.
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Affiliation(s)
- Rebecca Chung
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
| | - Dilhan M Kalyon
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey.,Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey
| | - Xiaojun Yu
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
| | - Antonio Valdevit
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
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13
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Fereshteh Z, Fathi M, Bagri A, Boccaccini AR. Preparation and characterization of aligned porous PCL/zein scaffolds as drug delivery systems via improved unidirectional freeze-drying method. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 68:613-622. [DOI: 10.1016/j.msec.2016.06.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/17/2016] [Accepted: 06/03/2016] [Indexed: 01/15/2023]
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14
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Iyer Ganapathi J, Fisher FT, Kalyon DM. Distributive mixing of carbon nanotubes in poly(caprolactone) via solution and melt processing: Viscoelasticity and crystallization behavior versus mixing indices. ACTA ACUST UNITED AC 2016. [DOI: 10.1002/polb.24137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Frank T. Fisher
- Department of Mechanical EngineeringStevens Institute of TechnologyHoboken New Jersey07030
| | - Dilhan M. Kalyon
- Department of Chemical Engineering and Materials ScienceStevens Institute of TechnologyHoboken New Jersey07030
- Department of Biomedical EngineeringChemistry and Biological Sciences, Stevens Institute of TechnologyHoboken New Jersey07030
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15
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Koupaei N, Karkhaneh A. Porous crosslinked polycaprolactone hydroxyapatite networks for bone tissue engineering. Tissue Eng Regen Med 2016; 13:251-260. [PMID: 30603406 DOI: 10.1007/s13770-016-9061-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/01/2015] [Accepted: 09/08/2015] [Indexed: 11/29/2022] Open
Abstract
In this study, porous scaffolds were produced by a thermal crosslinking of polycaprolactone diacrylate in the presence of hydroxyapatite (HA) and particulate leaching technique with sodium chloride as the water soluble porogen for bone tissue engineering applications. The prepared scaffolds were characterized using techniques such as Field Emission Scanning Electron Microscopy, Differential Scanning Calorimetry, and Attenuated Total Reflectance-Fourier Transform Infrared Spectroscopy. Moreover, dynamic mechanical properties were investigated using Dynamic Mechanical Thermal Analysis. The obtained scaffolds present a porous structure with interconnected pores and porosity around 73%. It was found that the incorporation of HA particles to polycaprolactone (PCL) matrix resulted in an increased crystallinity. Moreover, both the storage modulus (E') and glass transition temperature (Tg) increased, while the loss factor (tan δ) decreased due to the hindrance of the HA particles to the mobility of polymer segments. Cytocompatability of the scaffolds was assessed by MTT assay and cell attachment studies. Osteoconductivity of the scaffolds was investigated with cells alkaline phosphatase extraction. The levels of alkaline phosphatase activity were found to be higher for PCL/HA network scaffold than for PCL network scaffold. In addition, cytocompatibility of the PCL/HA network scaffold indicated no toxicity, and cells were attached and spread to the scaffold walls.
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Affiliation(s)
- Narjes Koupaei
- 1Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Akbar Karkhaneh
- 2Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, 15875-4413 Iran
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16
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Mauro N, Chiellini F, Bartoli C, Gazzarri M, Laus M, Antonioli D, Griffiths P, Manfredi A, Ranucci E, Ferruti P. RGD-mimic polyamidoamine-montmorillonite composites with tunable stiffness as scaffolds for bone tissue-engineering applications. J Tissue Eng Regen Med 2016; 11:2164-2175. [DOI: 10.1002/term.2115] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/17/2015] [Accepted: 11/18/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Nicolò Mauro
- Dipartimento di Chimica; Università degli Studi di Milano; Italy
- Dipartimento di Scienze e Tecnologie Biologiche Chimiche e Farmaceutiche, Laboratory of Biocompatible Polymers; Università Degli Studi di Palermo; Via Archirafi 32 90123 Palermo Italy
| | | | | | | | - Michele Laus
- Dipartimento di Scienze ed Innovazione Tecnologica; Università del Piemonte Orientale 'A. Avogadro'; Alessandria Italy
| | - Diego Antonioli
- Dipartimento di Scienze ed Innovazione Tecnologica; Università del Piemonte Orientale 'A. Avogadro'; Alessandria Italy
| | - Peter Griffiths
- Department of Pharmaceutical, Chemical and Environmental Sciences, Faculty of Engineering and Science; University of Greenwich, Medway Campus; Kent UK
| | - Amedea Manfredi
- Dipartimento di Chimica; Università degli Studi di Milano; Italy
| | | | - Paolo Ferruti
- Dipartimento di Chimica; Università degli Studi di Milano; Italy
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Yilgör E, Isik M, Söz CK, Yilgör I. Synthesis and structure-property behavior of polycaprolactone-polydimethylsiloxane-polycaprolactone triblock copolymers. POLYMER 2016. [DOI: 10.1016/j.polymer.2015.12.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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18
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Castro NJ, O'Brien J, Zhang LG. Integrating biologically inspired nanomaterials and table-top stereolithography for 3D printed biomimetic osteochondral scaffolds. NANOSCALE 2015; 7:14010-22. [PMID: 26234364 PMCID: PMC4537413 DOI: 10.1039/c5nr03425f] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The osteochondral interface of an arthritic joint is notoriously difficult to regenerate due to its extremely poor regenerative capacity and complex stratified architecture. Native osteochondral tissue extracellular matrix is composed of numerous nanoscale organic and inorganic constituents. Although various tissue engineering strategies exist in addressing osteochondral defects, limitations persist with regards to tissue scaffolding which exhibit biomimetic cues at the nano to micro scale. In an effort to address this, the current work focused on 3D printing biomimetic nanocomposite scaffolds for improved osteochondral tissue regeneration. For this purpose, two biologically-inspired nanomaterials have been synthesized consisting of (1) osteoconductive nanocrystalline hydroxyapatite (nHA) (primary inorganic component of bone) and (2) core-shell poly(lactic-co-glycolic) acid (PLGA) nanospheres encapsulated with chondrogenic transforming growth-factor β1 (TGF-β1) for sustained delivery. Then, a novel table-top stereolithography 3D printer and the nano-ink (i.e., nHA + nanosphere + hydrogel) were employed to fabricate a porous and highly interconnected osteochondral scaffold with hierarchical nano-to-micro structure and spatiotemporal bioactive factor gradients. Our results showed that human bone marrow-derived mesenchymal stem cell adhesion, proliferation, and osteochondral differentiation were greatly improved in the biomimetic graded 3D printed osteochondral construct in vitro. The current work served to illustrate the efficacy of the nano-ink and current 3D printing technology for efficient fabrication of a novel nanocomposite hydrogel scaffold. In addition, tissue-specific growth factors illustrated a synergistic effect leading to increased cell adhesion and directed stem cell differentiation.
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Affiliation(s)
- Nathan J Castro
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC 20052, USA.
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19
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Ninan N, Muthiah M, Park IK, Wong TW, Thomas S, Grohens Y. Natural Polymer/Inorganic Material Based Hybrid Scaffolds for Skin Wound Healing. POLYM REV 2015. [DOI: 10.1080/15583724.2015.1019135] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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20
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Vakilian S, Mashayekhan S, Shabani I, Khorashadizadeh M, Fallah A, Soleimani M. Structural stability and sustained release of protein from a multilayer nanofiber/nanoparticle composite. Int J Biol Macromol 2015; 75:248-57. [DOI: 10.1016/j.ijbiomac.2015.01.051] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 01/14/2015] [Accepted: 01/16/2015] [Indexed: 02/08/2023]
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21
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Stanković M, Frijlink HW, Hinrichs WLJ. Polymeric formulations for drug release prepared by hot melt extrusion: application and characterization. Drug Discov Today 2015; 20:812-23. [PMID: 25660507 DOI: 10.1016/j.drudis.2015.01.012] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 01/08/2015] [Accepted: 01/27/2015] [Indexed: 12/15/2022]
Abstract
Over the past few decades hot melt extrusion (HME) has emerged as a powerful processing technology for the production of pharmaceutical solid dosage forms in which an active pharmaceutical ingredient (API) is dispersed into polymer matrices. It has been shown that formulations using HME can provide time-controlled, sustained and targeted drug delivery, and improved bioavailability of poorly soluble drugs. In this review, the basic principles of the HME process are described together with an overview of some of the most common biodegradable and nonbiodegradable polymers used for the preparation of different formulations using this method. Further, the applications of HME in drug delivery and analytical techniques employed to characterize HME products are addressed.
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Affiliation(s)
- Milica Stanković
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands; Research Center Pharmaceutical Engineering GmbH, Inffeldgasse 13, A-8010, Graz, Austria.
| | - Henderik W Frijlink
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Wouter L J Hinrichs
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
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22
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Ramburrun P, Kumar P, Choonara YE, Bijukumar D, du Toit LC, Pillay V. A review of bioactive release from nerve conduits as a neurotherapeutic strategy for neuronal growth in peripheral nerve injury. BIOMED RESEARCH INTERNATIONAL 2014; 2014:132350. [PMID: 25143934 PMCID: PMC4131113 DOI: 10.1155/2014/132350] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 05/04/2014] [Indexed: 02/07/2023]
Abstract
Peripheral nerve regeneration strategies employ the use of polymeric engineered nerve conduits encompassed with components of a delivery system. This allows for the controlled and sustained release of neurotrophic growth factors for the enhancement of the innate regenerative capacity of the injured nerves. This review article focuses on the delivery of neurotrophic factors (NTFs) and the importance of the parameters that control release kinetics in the delivery of optimal quantities of NTFs for improved therapeutic effect and prevention of dose dumping. Studies utilizing various controlled-release strategies, in attempt to obtain ideal release kinetics, have been reviewed in this paper. Release strategies discussed include affinity-based models, crosslinking techniques, and layer-by-layer technologies. Currently available synthetic hollow nerve conduits, an alternative to the nerve autografts, have proven to be successful in the bridging and regeneration of primarily the short transected nerve gaps in several patient cases. However, current research emphasizes on the development of more advanced nerve conduits able to simulate the effectiveness of the autograft which includes, in particular, the ability to deliver growth factors.
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Affiliation(s)
- Poornima Ramburrun
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Pradeep Kumar
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Yahya E. Choonara
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Divya Bijukumar
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Lisa C. du Toit
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Viness Pillay
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
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23
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Killion JA, Geever LM, Devine DM, Farrell H, Higginbotham CL. Compressive Strength and Bioactivity Properties of Photopolymerizable Hybrid Composite Hydrogels for Bone Tissue Engineering. INT J POLYM MATER PO 2014. [DOI: 10.1080/00914037.2013.854238] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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24
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Zhang X, Chang W, Lee P, Wang Y, Yang M, Li J, Kumbar SG, Yu X. Polymer-ceramic spiral structured scaffolds for bone tissue engineering: effect of hydroxyapatite composition on human fetal osteoblasts. PLoS One 2014; 9:e85871. [PMID: 24475056 PMCID: PMC3903490 DOI: 10.1371/journal.pone.0085871] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 12/06/2013] [Indexed: 12/28/2022] Open
Abstract
For successful bone tissue engineering, a scaffold needs to be osteoconductive, porous, and biodegradable, thus able to support attachment and proliferation of bone cells and guide bone formation. Recently, hydroxyapatites (HA), a major inorganic component of natural bone, and biodegrade polymers have drawn much attention as bone scaffolds. The present study was designed to investigate whether the bone regenerative properties of nano-HA/polycaprolactone (PCL) spiral scaffolds are augmented in an HA dose dependent manner, thereby establishing a suitable composition as a bone formation material. Nano-HA/PCL spiral scaffolds were prepared with different weight ratios of HA and PCL, while porosity was introduced by a modified salt leaching technique. Human fetal osteoblasts (hFOBs) were cultured on the nano-HA/PCL spiral scaffolds up to 14 days. Cellular responses in terms of cell adhesion, viability, proliferation, differentiation, and the expression of bone-related genes were investigated. These scaffolds supported hFOBs adhesion, viability and proliferation. Cell proliferation trend was quite similar on polymer-ceramic and neat polymer spiral scaffolds on days 1, 7, and 14. However, the significantly increased amount of alkaline phosphatase (ALP) activity and mineralized matrix synthesis was evident on the nano-HA/PCL spiral scaffolds. The HA composition in the scaffolds showed a significant effect on ALP and mineralization. Bone phenotypic markers such as bone sialoprotein (BSP), osteonectin (ON), osteocalcin (OC), and type I collagen (Col-1) were semi-quantitatively estimated by reverse transcriptase polymerase chain reaction analysis. All of these results suggested the osteoconductive characteristics of HA/PCL nanocomposite and cell maturation were HA dose dependent. For instance, HA∶PCL = 1∶4 group showed significantly higher ALP mineralization and elevated levels of BSP, ON, OC and Col-I expression as compared other lower or higher ceramic ratios. Amongst the different nano-HA/PCL spiral scaffolds, the 1∶4 weight ratio of HA and PCL is shown to be the most optimal composition for bone tissue regeneration.
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Affiliation(s)
- Xiaojun Zhang
- Department of Chemistry, Chemical Biology, and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, United States of America
- Department of Physics and Mathematics, School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Wei Chang
- Department of Chemistry, Chemical Biology, and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, United States of America
| | - Paul Lee
- Department of Chemistry, Chemical Biology, and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, United States of America
| | - Yuhao Wang
- Department of Chemistry, Chemical Biology, and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, United States of America
| | - Min Yang
- Department of Chemistry, Chemical Biology, and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, United States of America
| | - Jun Li
- Department of Chemistry, Chemical Biology, and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, United States of America
| | - Sangamesh G. Kumbar
- Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, Connecticut, United States of America
| | - Xiaojun Yu
- Department of Chemistry, Chemical Biology, and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, United States of America
- * E-mail:
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25
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Shell-core bi-layered scaffolds for engineering of vascularized osteon-like structures. Biomaterials 2013; 34:8203-12. [DOI: 10.1016/j.biomaterials.2013.07.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 07/09/2013] [Indexed: 12/16/2022]
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26
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Junka R, Valmikinathan CM, Kalyon DM, Yu X. Laminin Functionalized Biomimetic Nanofibers For Nerve Tissue Engineering. J BIOMATER TISS ENG 2013; 3:494-502. [PMID: 24083073 DOI: 10.1166/jbt.2013.1110] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Large-gap peripheral nerve injuries present a significant challenge for nerve regeneration due to lack of suitable grafts, insufficient cell penetration, and repair. Biomimetic nanofibrous scaffolds, functionalized on the surface with extracellular matrix proteins, can lead to novel therapies for repair and regeneration of damaged peripheral nerves. Here, nanofibrous scaffolds electrospun from blends of poly(caprolactone) (PCL) and chitosan were fabricated. Taking advantage of the amine groups on the chitosan, the surface of the scaffolds were functionalized with laminin by carbodiimide based crosslinking. Crosslinking allowed laminin to be attached to the surfaces of the PCL-chitosan nanofibers at relatively high concentrations that were not possible using conventional adsorption methods. The nanofibrous meshes were tested for wettability, mechanical properties and cell attachment and proliferation. Blending of chitosan with PCL provided more favorable surfaces for attachment of Schwann cells due to the reduction of the contact angle in comparison to neat PCL. Proliferation rates of Schwann cells grown on PCL-chitosan scaffolds with crosslinked laminin were significantly higher than the rates for PCL-chitosan nanofibrous matrices with adsorbed laminin. PCL-chitosan scaffolds with modified surfaces via crosslinking of laminin could potentially serves as versatile substrates with excellent mechanical and surface properties for in vivo cell delivery for nerve tissue engineering applications.
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Affiliation(s)
- Radoslaw Junka
- Department of Chemistry, Chemical Biology and Biomedical Engineering Stevens Institute of Technology, Hoboken, NJ, 07030
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27
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Sethuraman V, Makornkaewkeyoon K, Khalf A, Madihally SV. Influence of scaffold forming techniques on stress relaxation behavior of polycaprolactone scaffolds. J Appl Polym Sci 2013. [DOI: 10.1002/app.39599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Vijayalakshmi Sethuraman
- School of Chemical Engineering; Oklahoma State University; 423 Engineering North; Stillwater; OK; 74078
| | - Kornkarn Makornkaewkeyoon
- School of Chemical Engineering; Oklahoma State University; 423 Engineering North; Stillwater; OK; 74078
| | - Abdurizzagh Khalf
- School of Chemical Engineering; Oklahoma State University; 423 Engineering North; Stillwater; OK; 74078
| | - Sundararajan V. Madihally
- School of Chemical Engineering; Oklahoma State University; 423 Engineering North; Stillwater; OK; 74078
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28
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Ergun A, Yu X, Valdevit A, Ritter A, Kalyon DM. Radially and axially graded multizonal bone graft substitutes targeting critical-sized bone defects from polycaprolactone/hydroxyapatite/tricalcium phosphate. Tissue Eng Part A 2012; 18:2426-36. [PMID: 22764839 PMCID: PMC3501112 DOI: 10.1089/ten.tea.2011.0625] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 06/18/2012] [Indexed: 01/16/2023] Open
Abstract
Repair and regeneration of critical sized defects via the utilization of polymeric bone graft substitutes are challenges. Here, we introduce radially and axially graded multizonal bone graft substitutes fabricated from polycaprolactone (PCL), and PCL biocomposites with osteoconductive particles, that is, hydroxyapatite (HA), and β-tricalcium phosphate (TCP). The novel bone graft substitutes should provide a greater degree of freedom to the orthopedic surgeon especially for repair of critically sized bone defects. The modulus of the graft substitute could be tailored in the axial direction upon the systematic variation of the HA/TCP concentration, while in the radial direction the bone graft substitute consisted of an outer layer with high stiffness, encapsulating a softer core with greater porosity. The biocompatibility of the bone graft substitutes was investigated using in vitro culturing of human bone marrow-derived stromal cells followed by the analysis of cell proliferation and differentiation rates. The characterization of the tissue constructs included the enzymatic alkaline phosphates (ALP) activity, microcomputed tomography imaging, and polymerase chain reaction analysis involving the expressions of bone markers, that is, Runx2, ALP, collagen type I, osteopontin, and osteocalcin, overall demonstrating the differentiation of bone marrow derived stem cells (BMSCs) via osteogenic lineage and formation of mineralized bone tissue.
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Affiliation(s)
- Asli Ergun
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey
| | - Xiaojun Yu
- Department of Chemistry, Chemical Biology and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
| | - Antonio Valdevit
- Department of Chemistry, Chemical Biology and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
| | - Arthur Ritter
- Department of Chemistry, Chemical Biology and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
| | - Dilhan M. Kalyon
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey
- Department of Chemistry, Chemical Biology and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
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Abstract
Melt extrusion (ME) over recent years has found widespread application as a viable drug delivery option in the drug development process. ME applications include taste masking, solid-state stability enhancement, sustained drug release and solubility enhancement. While ME can result in amorphous or crystalline solid dispersions depending upon several factors, solubility enhancement applications are centered around generating amorphous dispersions, primarily because of the free energy benefits they offer. In line with the purview of the current issue, this review assesses the utility of ME as a means of enhancing solubility of poorly soluble drugs/chemicals. The review describes major processing aspects of ME technology, definition and understanding of the amorphous state, manufacturability, analytical characterization and biopharmaceutical performance testing to better understand the strength and weakness of this formulation strategy for poorly soluble drugs. In addition, this paper highlights the potential advantages of employing a fusion of techniques, including pharmaceutical co-crystals and spray drying/solvent evaporation, facilitating the design of formulations of API exhibiting specific physico-chemical characteristics. Finally, the review presents some successful case studies of commercialized ME based products.
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Affiliation(s)
- Sejal Shah
- Department of Pharmaceutics, Pii Center for Pharmaceutical Technology, School of Pharmacy, The University of Mississippi, University, MS 38677-1848, United States
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Cui Z, Nelson B, Peng Y, Li K, Pilla S, Li WJ, Turng LS, Shen C. Fabrication and characterization of injection molded poly (ε-caprolactone) and poly (ε-caprolactone)/hydroxyapatite scaffolds for tissue engineering. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2012; 32:1674-81. [DOI: 10.1016/j.msec.2012.04.064] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 01/20/2012] [Accepted: 04/24/2012] [Indexed: 10/28/2022]
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Puppi D, Mota C, Gazzarri M, Dinucci D, Gloria A, Myrzabekova M, Ambrosio L, Chiellini F. Additive manufacturing of wet-spun polymeric scaffolds for bone tissue engineering. Biomed Microdevices 2012; 14:1115-27. [DOI: 10.1007/s10544-012-9677-0] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Muehlenfeld C, Thommes M. Miniaturization in pharmaceutical extrusion technology: feeding as a challenge of downscaling. AAPS PharmSciTech 2012; 13:94-100. [PMID: 22160884 DOI: 10.1208/s12249-011-9726-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 11/04/2011] [Indexed: 11/30/2022] Open
Abstract
In recent years, extrusion technology has shifted the focus of pharmaceutical research due to versatile applications like pelletization, bioavailability improvement or manipulation of solid-state properties of drugs, continuous granulation, and the development of novel solid dosage forms. Meanwhile, a major effort has been devoted to the miniaturization of equipment in pharmaceutical extrusion technology, particularly with regard to the requirements of the development of new chemical entities and formulations. In the present study, a lab-scale twin-screw extruder was investigated in order to determine the limitations imposed by the feeding systems. The wet extrusion process was considered as challenging because both a powder and a liquid feeder have to be considered. Initially, the accuracy and uniformity of the powder and liquid feeder were tested independently of the extrusion process. After modification of the powder feeder, both feeders were investigated in conjunction with extrusion. Based on this, an optimization of the liquid feeder was required and completed. Both feeder modifications reduced the variability of the moisture content in the extrudates 10-fold. This led to a reliable small-scale extrusion process.
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Appel WPJ, Meijer EW, Dankers PYW. Enzymatic Activity at the Surface of Biomaterials via Supramolecular Anchoring of Peptides: The Effect of Material Processing. Macromol Biosci 2011; 11:1706-12. [DOI: 10.1002/mabi.201100225] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 07/25/2011] [Indexed: 12/15/2022]
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Erisken C, Kalyon DM, Wang H, Örnek-Ballanco C, Xu J. Osteochondral Tissue Formation Through Adipose-Derived Stromal Cell Differentiation on Biomimetic Polycaprolactone Nanofibrous Scaffolds with Graded Insulin and Beta-Glycerophosphate Concentrations. Tissue Eng Part A 2011; 17:1239-52. [DOI: 10.1089/ten.tea.2009.0693] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Cevat Erisken
- Department of Chemical Engineering and Material Science, Stevens Institute of Technology, Hoboken, New Jersey
| | - Dilhan M. Kalyon
- Department of Chemical Engineering and Material Science, Stevens Institute of Technology, Hoboken, New Jersey
- Department of Chemistry, Chemical Biology and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
| | - Hongjun Wang
- Department of Chemistry, Chemical Biology and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
| | - Ceren Örnek-Ballanco
- Department of Chemistry, Chemical Biology and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
| | - Jiahua Xu
- Department of Chemistry, Chemical Biology and Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey
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Hong JK, Madihally SV. Next generation of electrosprayed fibers for tissue regeneration. TISSUE ENGINEERING. PART B, REVIEWS 2011; 17:125-42. [PMID: 21210761 PMCID: PMC3062468 DOI: 10.1089/ten.teb.2010.0552] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 01/06/2011] [Indexed: 11/12/2022]
Abstract
Electrospinning is a widely established polymer-processing technology that allows generation of fibers (in nanometer to micrometer size) that can be collected to form nonwoven structures. By choosing suitable process parameters and appropriate solvent systems, fiber size can be controlled. Since the technology allows the possibility of tailoring the mechanical properties and biological properties, there has been a significant effort to adapt the technology in tissue regeneration and drug delivery. This review focuses on recent developments in adapting this technology for tissue regeneration applications. In particular, different configurations of nozzles and collector plates are summarized from the view of cell seeding and distribution. Further developments in obtaining thick layers of tissues and thin layered membranes are discussed. Recent advances in porous structure spatial architecture parameters such as pore size, fiber size, fiber stiffness, and matrix turnover are summarized. In addition, possibility of developing simple three-dimensional models using electrosprayed fibers that can be utilized in routine cell culture studies is described.
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Affiliation(s)
- Jong Kyu Hong
- School of Chemical Engineering, Oklahoma State University, Stillwater, Oklahoma, USA
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Valmikinathan CM, Hoffman J, Yu X. Impact of Scaffold Micro and Macro Architecture on Schwann Cell Proliferation under Dynamic Conditions in a Rotating Wall Vessel Bioreactor. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2011; 31:22-29. [PMID: 21552367 DOI: 10.1016/j.msec.2010.04.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Over the last decade tissue engineering has emerged as a powerful alternative to regenerate lost tissues owing to trauma or tumor. Evidence shows that Schwann cell containing scaffolds have improved performance in vivo as compared to scaffolds that depend on cellularization post implantation. However, owing to limited supply of cells from the patients themselves, several approaches have been taken to enhance cell proliferation rates to produce complete and uniform cellularization of scaffolds. The most common approach is the application of a bioreactor to enhance cell proliferation rate and therefore reduce the time needed to obtain sufficiently significant number of glial cells, prior to implantation.In this study, we show the application of a rotating wall bioreactor system for studying Schwann cell proliferation on nanofibrous spiral shaped scaffolds, prepared by solvent casting and salt leaching techniques. The scaffolds were fabricated from polycaprolactone (PCL), which has ideal mechanical properties and upon degradation does not produce acidic byproducts. The spiral scaffolds were coated with aligned or random nanofibers, produced by electrospinning, to provide a substrate that mimics the native extracellular matrix and the essential contact guidance cues.At the 4 day time point, an enhanced rate of cell proliferation was observed on the open structured nanofibrous spiral scaffolds in a rotating wall bioreactor, as compared to static culture conditions. However, the cell proliferation rate on the other contemporary scaffolds architectures such as the tubular and cylindrical scaffolds show reduced cell proliferation in the bioreactor as compared to static conditions, at the same time point. Moreover, the rotating wall bioreactor does not alter the orientation or the phenotype of the Schwann cells on the aligned nanofiber containing scaffolds, wherein, the cells remain aligned along the length of the scaffolds. Therefore, these open structured spiral scaffolds pre-cultured with Schwann cells, in bioreactors could potentially shorten the time needed for grafts for peripheral nerve regeneration.
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Affiliation(s)
- Chandra M Valmikinathan
- Department of Chemistry, Chemical Biology and Biomedical Engineering Stevens Institute of Technology, Hoboken, NJ, 07030
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Wang J, Yu X. Preparation, characterization and in vitro analysis of novel structured nanofibrous scaffolds for bone tissue engineering. Acta Biomater 2010; 6:3004-12. [PMID: 20144749 DOI: 10.1016/j.actbio.2010.01.045] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Revised: 12/13/2009] [Accepted: 01/28/2010] [Indexed: 10/19/2022]
Abstract
In a previous study, a three-dimensional nanofibrous spiral scaffold for bone tissue engineering was developed, which showed enhanced human osteoblast cell attachment, proliferation and differentiation compared with traditional cylinder scaffolds, owing to the incorporation of spiral structures and nanofiber. However, the application of these scaffolds to bone tissue engineering was limited by their weak mechanical strength. This limitation triggered the design for novel structured scaffolds with reinforced physical characteristics. In this study, spiral polycaprolactone (PCL) nanofibrous scaffolds were inserted into poly(lactide-co-glycolide) (PLGA) microsphere sintered tubular scaffolds to form integrated scaffolds to provide mechanical properties and bioactivity appropriate for bone tissue engineering. Four experiment groups were designed: PLGA cylinder scaffold; PLGA tubular scaffold; PLGA tubular scaffold with PCL spiral structured inner core; PLGA tubular scaffold with PCL nanofiber containing spiral structured inner core. The morphology, porosity and mechanical properties of the scaffolds were characterized. Furthermore, human osteoblastic cells were seeded on these scaffolds, and the cell attachment, proliferation, differentiation and mineralized matrix deposition on the scaffolds were evaluated. The integrated scaffolds had Young's modulus 250-300 MPa, and compressive strength 8-11 MPa under uniaxial compression. With the addition of an inner highly porous insert to the tubular shell, human osteoblast cells seeded on the integrated scaffolds showed slightly higher cell proliferation, 20-25% more alkaline phosphatase expression and twofold higher calcium deposition than those on the cylinder and tubular scaffolds. Furthermore, compared with sintered PLGA cylinder scaffolds, the integrated scaffolds allowed better cellular infiltration Therefore, this design demonstrates great potential for integrated scaffolds in bone tissue engineering applications.
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Ghosh A, Ali MA, Selvanesan L, Dias GJ. Structure–function characteristics of the biomaterials based on milk-derived proteins. Int J Biol Macromol 2010; 46:404-11. [DOI: 10.1016/j.ijbiomac.2010.02.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 01/23/2010] [Accepted: 02/23/2010] [Indexed: 10/19/2022]
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