Chemistry of biomaterials: future prospects

Multifunctional Biocomposites: Synthesis, Characterization, and Prospects for Regenerative Medicine and Controlled Drug Delivery

This article presents a new method for preparing multifunctional composite biomaterials with applications in advanced biomedical fields. The biomaterials consist of dicalcium phosphate (DCPD) and bioactive silicate glasses (SiO2/Na2O and SiO2/K2O), containing the antibiotic streptomycin sulfate. Materials were deeply characterized by X-ray diffraction and attenuated total reflectance Fourier transform infrared spectroscopy, and zeta potential analysis, UV-visible spectrophotometry, and ion-exchange measurement were applied in a simulating body fluid (SBF) solution. The main results include an in situ chemical transformation of dicalcium phosphate into an apatitic phase under the influence of silicate solutions and the incorporation of the antibiotic. The zeta potential showed a decrease in surface charge from ζ = -24.6 mV to ζ = -16.5 mV. In addition, a controlled and prolonged release of antibiotics was observed over a period of 37 days, with a released concentration of up to 755 ppm. Toxicity tests in mice demonstrated good tolerance of the biomaterials, with no significant adverse effects. Moreover, these biomaterials have shown potent antibacterial activity against various bacterial strains, including Listeria monocytogenes, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa, suggesting their potential use in tissue engineering, drug delivery, and orthopedic and dental implants. By integrating the antibiotic into the biomaterial composites, we achieved controlled release and prolonged antibacterial efficacy. This research contributes to advancing biomaterials by exploring innovative synthetic routes and showcasing their promise in regenerative medicine and controlled drug delivery.

Biomaterials barcoding: a high-throughput breakthrough

In the world of biomedical breakthroughs, Rice University bioengineer Omid Veiseh and his team are making waves with their recent publication in Nature Biomedical Engineering (2023) (Mukherjeeet al., Nat Biomed Eng. 7:867–886, 2023). This study is a pivotal step in our fight against fibrosis, an issue that has long hindered medical progress. Their pioneering research isn’t just a scientific milestone; it’s a game-changer in how we tackle tissue scarring. Veiseh and his team have introduced an innovative method that allows for rapid testing of various materials within living organisms. By employing cellular barcoding and cutting-edge sequencing techniques, they’ve accelerated the assessment of multiple hydrogels. As we delve deeper into the specifics of this groundbreaking study, we uncover not just scientific insights, but the potential to revolutionize how we conceptualize and utilize biomaterials. This discussion isn’t merely about research methods; it’s about the ray of hope and boundless opportunities this study illuminates across the spectrum of biomaterials science.

Octacalcium phosphate, a promising bone substitute material: a narrative review

Biomaterials have been used to supplement and restore function and structure by replacing or restoring parts of damaged tissues and organs. In ancient times, the medical use of biomaterials was limited owing to infection during surgery and poor surgical techniques. However, in modern times, the medical applications of biomaterials are diversifying owing to great developments in material science and medical technology. In this paper, we introduce biomaterials, focusing on calcium phosphate ceramics, including octacalcium phosphate, which has recently attracted attention as a bone graft material.

Incorporation of Controlled Release Systems Improves the Functionality of Biodegradable 3D Printed Cardiovascular Implants

New horizons in cardiovascular research are opened by using 3D printing for biodegradable implants. This additive manufacturing approach allows the design and fabrication of complex structures according to the patient's imaging data in an accurate, reproducible, cost-effective, and quick manner. Acellular cardiovascular implants produced from biodegradable materials have the potential to provide enough support for in situ tissue regeneration while gradually being replaced by neo-autologous tissue. Subsequently, they have the potential to prevent long-term complications. In this Review, we discuss the current status of 3D printing applications in the development of biodegradable cardiovascular implants with a focus on design, biomaterial selection, fabrication methods, and advantages of implantable controlled release systems. Moreover, we delve into the intricate challenges that accompany the clinical translation of these groundbreaking innovations, presenting a glimpse of potential solutions poised to enable the realization of these technologies in the realm of cardiovascular medicine.

In Vitro Degradation of Mg-Doped ZrO2 Bioceramics at the Interface with Xerostom® Saliva Substitute Gel

Zirconia-based bioceramics, one of the most important materials used for dental applications, have been intensively studied in recent years due to their excellent mechanical resistance and chemical inertness in the mouth. In this work, the structural, morphological and dissolution properties of the Zr_1-xMg_xO₂ (x = 0.05, 0.1, 0.15, 0.2, 0.25, and 0.3) system, prepared by the conventional ceramic method, were evaluated before and after immersion in saliva substitute gel (Xerostom^®, Biocosmetics Laboratories, Madrid, Spain), one of the most common topical dry mouth products used in dentistry. The X-ray powder diffraction (XRPD), Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDS) techniques were employed to investigate the phase transformations and morphology of the ceramics during the degradation process in Xerostom^®. In vitro analyses showed overall good stability in the Xerostom^® environment, except for the x = 0.05 composition, where significant t- to m-ZrO₂ transformation occurred. In addition, the strong interconnection of the grains was maintained after immersion, which could allow a high mechanical strength of the ceramics to be obtained.

An In Vivo Rat Study of Bioresorbable Mg-2Zn-2Ga Alloy Implants

In the present study, pins made from the novel Mg-2Zn-2Ga alloy were installed within the femoral bones of six Wistar rats. The level of bioresorption was assessed after 1, 3, and 6 months by radiography, histology, SEM, and EDX. Significant bioresorption was evident after 3 months, and complete dissolution of the pins occurred at 6 months after the installation. No pronounced gas cavities could be found at the pin installation sites throughout the postoperative period. The animals' blood parameters showed no signs of inflammation or toxication. These findings are sufficiently encouraging to motivate further research to broaden the experimental coverage to increase the number of observed animals and to conduct tests involving other, larger animals.

Osteogenic and anti-inflammatory effect of the multifunctional bionic hydrogel scaffold loaded with aspirin and nano-hydroxyapatite

Although tissue engineering offered new approaches to repair bone defects, it remains a great challenge to create a bone-friendly microenvironment and rebuild bone tissue rapidly by a scaffold with a bionic structure. In this study, a multifunctional structurally optimized hydrogel scaffold was designed by integrating polyvinyl alcohol (PVA), gelatin (Gel), and sodium alginate (SA) with aspirin (ASA) and nano-hydroxyapatite (nHAP). The fabrication procedure is through a dual-crosslinking process. The chemical constitution, crystal structure, microstructure, porosity, mechanical strength, swelling and degradation property, and drug-release behavior of the hydrogel scaffold were analyzed. Multi-hydrogen bonds, electrostatic interactions, and strong "egg-shell" structure contributed to the multi-network microstructure, bone tissue-matched properties, and desirable drug-release function of the hydrogel scaffold. The excellent performance in improving cell viability, promoting cell osteogenic differentiation, and regulating the inflammatory microenvironment of the prepared hydrogel scaffold was verified using mouse pre-osteoblasts (MC3T3-E1) cells. And the synergistic osteogenic and anti-inflammatory functions of aspirin and nano-hydroxyapatite were also verified. This study provided valuable insights into the design, fabrication, and biological potential of multifunctional bone tissue engineering materials with the premise of constructing a bone-friendly microenvironment.

Chitosans and Nanochitosans: Recent Advances in Skin Protection, Regeneration, and Repair

Chitosan displays a dual function, acting as both an active ingredient and/or carrier for pharmaceutical bioactive molecules and metal ions. Its hydroxyl- and amino-reactive groups and acetylation degree can be used to adjust this biopolymer's physicochemical and pharmacological properties in different forms, including scaffolds, nanoparticles, fibers, sponges, films, and hydrogels, among others. In terms of pharmacological purposes, chitosan association with different polymers and the immobilization or entrapment of bioactive agents are effective strategies to achieve desired biological responses. Chitosan biocompatibility, water entrapment within nanofibrils, antioxidant character, and antimicrobial and anti-inflammatory properties, whether enhanced by other active components or not, ensure skin moisturization, as well as protection against bacteria colonization and oxidative imbalance. Chitosan-based nanomaterials can maintain or reconstruct skin architecture through topical or systemic delivery of hydrophilic or hydrophobic pharmaceuticals at controlled rates to treat skin affections, such as acne, inflammatory manifestations, wounds, or even tumorigenesis, by coating chemotherapy drugs. Herein, chitosan obtention, physicochemical characteristics, chemical modifications, and interactions with bioactive agents are presented and discussed. Molecular mechanisms involved in chitosan skin protection and recovery are highlighted by overlapping the events orchestrated by the signaling molecules secreted by different cell types to reconstitute healthy skin tissue structures and components.

3D direct printing of composite bone scaffolds containing polylactic acid and spray dried mesoporous bioactive glass-ceramic microparticles

In this study, a three-dimensional composite scaffold is proposed consisting of polylactic acid and spray dried glass-ceramic microparticles (SGCMs). The compositional and structural characterization showed that the obtained spray dried powder formed as glass-ceramic (GC) with a completely interconnected porosity structure. Before direct printing of scaffolds, the rheological behavior of polylactic acid (PLA) and PLA-GC (PLA matrix containing SGCMs) inks were investigated. The PLA-GC composite ink represents sharper shear-thinning behavior and higher loss and storage modulus comparable to that of pure PLA. Microscopic observations and elemental mapping elements showed that 3D scaffolds had well-defined interconnected porosity and uniform distribution of the glass-ceramic particles. Mechanical tests indicated that compression strength is dependent on the scaffold porosity and the presence of SGCMs. Apatite formation evaluation besides ion release study showed better biomineralization capacity of PLA-GC scaffolds, as larger and denser sediments formed on the PLA-GC scaffolds after 7- and 14-day soaking. The preliminary cell response was studied with primary human mesenchymal stem cells (hMSCs) and revealed that SGCMs improved cell adhesion and viability and ALP activity. The appropriate combination of the biomaterials/methods to fabricate 3D porous constructs and their available bioactivity and biocompatibility, both being important characteristics for bone tissue engineering applications.

Facile Fabrication of 3D-Printed Porous Ti6Al4V Scaffolds with a Sr-CaP Coating for Bone Regeneration

To improve osseointegration caused by the stress-shielding effect and the inert nature of titanium-based alloys, in this work, we successfully constructed a strontium calcium phosphate (Sr-CaP) coating on three-dimensional (3D)-printed Ti6Al4V scaffolds to address this issue. The energy-dispersive X-ray spectroscopy (EDS) and X-ray diffraction (XRD) results indicated that the coatings with and without Sr doping mainly consisted of CaHPO₄. The bonding strength of Sr doping coating met the required ISO 13 779-4-2018 standard (≥15 MPa). The in vitro results suggested that the Sr-CaP-modified Ti6Al4V scaffolds were found to effectively promote mice bone-marrow stem cell (mBMSC) adhesion, spreading, and osteogenesis. The in vivo experiments also showed that the Sr-CaP-modified Ti6Al4V scaffolds could significantly improve bone regeneration and osseointegration. More importantly, Sr-doped CaP-coated Ti6Al4V scaffolds were found to accelerate bone healing in comparison to CaP-coated Ti6Al4V scaffolds. The Sr-CaP-modified Ti6Al4V scaffolds are considered a promising strategy to develop bioactive surfaces for enhancing the osseointegration between the implant and bone tissue.

Biodegradable Magnesium Biomaterials-Road to the Clinic

In recent decades, we have witnessed radical changes in the use of permanent biomaterials. The intrinsic ability of magnesium (Mg) and its alloys to degrade without releasing toxic degradation products has led to a vast range of applications in the biomedical field, including cardiovascular stents, musculoskeletal, and orthopedic applications. With the use of biodegradable Mg biomaterials, patients would not suffer second surgery and surgical pain anymore. Be that as it may, the main drawbacks of these biomaterials are the high corrosion rate and unexpected degradation in physiological environments. Since biodegradable Mg-based implants are expected to show controllable degradation and match the requirements of specific applications, various techniques, such as designing a magnesium alloy and modifying the surface characteristics, are employed to tailor the degradation rate. In this paper, some fundamentals and particular aspects of magnesium degradation in physiological environments are summarized, and approaches to control the degradation behavior of Mg-based biomaterials are presented.

Synthesis and Structural Characterization of CaO-P2O5-CaF:CuO Glasses with Antitumoral Effect on Skin Cancer Cells

Copper is one of the most used therapeutic metallic elements in biomedicine, ranging from antibacterial approaches to developing new complexes in cancer therapy. In the present investigation, we developed a novel xCuO∙(100 − x) [CaF₂∙3P₂O₅∙CaO] glass system with 0 ≤ x ≤ 16 mol% in order to determine the influence of doping on the composition structure of glasses. The samples were characterized by dissolution tests, pH measurements, Fourier-transform infrared spectroscopy (FT-IR), electron paramagnetic resonance (EPR), Scanning Electron Microscopy with energy dispersive spectroscopy (SEM-EDX) and afterward, their antitumor character was assessed. The glasses were mostly soluble in the aqueous medium, their dissolution rate being directly proportional to the increase in pH and the level of doping up to x = 8 mol%. FT-IR spectra of glass samples show the presence of all structural units characteristic to P₂O₅ in different rates and directly depending on the depolymerization process. SEM-EDX results revealed the presence of an amorphous glass structure composed of P, O, Ca, and Cu elements. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction assay showed strong cytotoxicity for tumoral cells A375 even in low concentrations for Cu-treatment. In contrast, the copper-free matrix (without Cu) determined a proliferative effect of over 70% viability for all concentrations used.

Bacterial Cellulose-A Remarkable Polymer as a Source for Biomaterials Tailoring

Nowadays, the development of new eco-friendly and biocompatible materials using ‘green’ technologies represents a significant challenge for the biomedical and pharmaceutical fields to reduce the destructive actions of scientific research on the human body and the environment. Thus, bacterial cellulose (BC) has a central place among these novel tailored biomaterials. BC is a non-pathogenic bacteria-produced polysaccharide with a 3D nanofibrous structure, chemically identical to plant cellulose, but exhibiting greater purity and crystallinity. Bacterial cellulose possesses excellent physicochemical and mechanical properties, adequate capacity to absorb a large quantity of water, non-toxicity, chemical inertness, biocompatibility, biodegradability, proper capacity to form films and to stabilize emulsions, high porosity, and a large surface area. Due to its suitable characteristics, this ecological material can combine with multiple polymers and diverse bioactive agents to develop new materials and composites. Bacterial cellulose alone, and with its mixtures, exhibits numerous applications, including in the food and electronic industries and in the biotechnological and biomedical areas (such as in wound dressing, tissue engineering, dental implants, drug delivery systems, and cell culture). This review presents an overview of the main properties and uses of bacterial cellulose and the latest promising future applications, such as in biological diagnosis, biosensors, personalized regenerative medicine, and nerve and ocular tissue engineering.

Three-dimensional-printed polycaprolactone/polypyrrole conducting scaffolds for differentiation of human olfactory ecto-mesenchymal stem cells into Schwann cell-like phenotypes and promotion of neurite outgrowth

Implantation of a suitable nerve guide conduit (NGC) seeded with sufficient Schwann cells (SCs) is required to improve peripheral nerve regeneration efficiently. Given the limitations of isolating and culturing SCs, using various sources of stem cells, including mesenchymal stem cells (MSCs) obtained from nasal olfactory mucosa, can be desirable. Olfactory ecto-MSCs (OE-MSCs) are a new population of neural crest-derived stem cells that can proliferate and differentiate into SCs and can be considered a promising autologous alternative to produce SCs. Regardless, a biomimetic physicochemical microenvironment in NGC such as electroconductive substrate can affect the fate of transplanted stem cells, including differentiation toward SCs and nerve regeneration. Therefore, in this study, the effect of 3D printed polycaprolactone (PCL)/polypyrrole (PPy) conductive scaffolds on differentiation of human OE-MSCS into functional SC-like phenotypes was investigated. Biological evaluation of 3D printed scaffolds was examined by in vitro culturing the OE-MSCs on samples surfaces, and conductivity showed no effect on increased cell attachment, proliferation rate, viability, and distribution. In contrast, immunocytochemical staining and real-time polymerase chain reaction analysis indicated that 3D structures coated with PPy could provide a favorable microenvironment for OE-MSCs differentiation. In addition, it was found that differentiated OE-MSCs within PCL/PPy could secrete the highest amounts of nerve growth factor and brain-derived neurotrophic factor neurotrophic factors compared to pure PCL and 2D culture. After co-culturing with PC12 cells, a significant increase in neurite outgrowth on PCL/PPy conductive scaffold seeded with differentiated OE-MSCs. These findings indicated that 3D printed PCL/PPy conductive scaffold could support differentiation of OE-MSCs into SC-like phenotypes to promote neurite outgrowth, suggesting their potential for neural tissue engineering applications.

A comprehensive review on metallic implant biomaterials and their subtractive manufacturing

There is a tremendous increase in the demand for converting biomaterials into high-quality industrially manufactured human body parts, also known as medical implants. Drug delivery systems, bone plates, screws, cranial, and dental devices are the popular examples of these implants - the potential alternatives for human life survival. However, the processing techniques of an engineered implant largely determine its preciseness, surface characteristics, and interactive ability with the adjacent tissue(s) in a particular biological environment. Moreover, the high cost-effective manufacturing of an implant under tight tolerances remains a challenge. In this regard, several subtractive or additive manufacturing techniques are employed to manufacture patient-specific implants, depending primarily on the required biocompatibility, bioactivity, surface integrity, and fatigue strength. The present paper reviews numerous non-degradable and degradable metallic implant biomaterials such as stainless steel (SS), titanium (Ti)-based, cobalt (Co)-based, nickel-titanium (NiTi), and magnesium (Mg)-based alloys, followed by their processing via traditional turning, drilling, and milling including the high-speed multi-axis CNC machining, and non-traditional  abrasive water jet machining (AWJM), laser beam machining (LBM), ultrasonic machining (USM), and electric discharge machining (EDM) types of subtractive manufacturing techniques. However, the review further funnels down its primary focus on Mg, NiTi, and Ti-based alloys on the basis of the increasing trend of their implant applications in the last decade due to some of their outstanding properties. In the recent years, the incorporation of cryogenic coolant-assisted traditional subtraction of biomaterials has gained researchers' attention due to its sustainability, environment-friendly nature, performance, and superior biocompatible and functional outcomes fitting for medical applications. However, some of the latest studies reported that the medical implant manufacturing requirements could be more remarkably met using the non-traditional subtractive manufacturing approaches. Altogether, cryogenic  machining among the traditional routes and EDM among the non-traditional means along with their variants, were identified as some of the most effective subtractive manufacturing techniques for achieving the dimensionally accurate and biocompatible metallic medical implants with significantly modified surfaces.

Simple Approach to Medical Grade Alumina and Zirconia Ceramics Surface Alteration via Acid Etching Treatment

In order for bioceramics to be further used in composites and their applications, it is important to change the surface so that the inert material is ready to interact with another material. Medical grade alumina and zirconia ceramic powders have been chemically etched with three selected acidic mixtures. Powder samples were taken for characterization, which was the key to evaluating a successful surface change. Changes in morphology, together with chemical composition, were studied using scanning electron microscopy, phase composition using X-ray diffraction methods, and nitrogen adsorption/desorption isotherms are used to evaluate specific surface area and porosity. The application of HF negatively affected the morphology of the material and caused agglomeration. The most effective modification of ceramic powders was the application of a piranha solution to obtain a new surface and a satisfactory degree of agglomeration. The prepared micro-roughness of the etched ceramic would provide an improved surface of the material either for its next step of incorporation into the selected matrix or to directly aid in the attachment and proliferation of osteoblast cells.

Isotropic and Anisotropic Scaffolds for Tissue Engineering: Collagen, Conventional, and Textile Fabrication Technologies and Properties

In this review article, tissue engineering and regenerative medicine are briefly explained and the importance of scaffolds is highlighted. Furthermore, the requirements of scaffolds and how they can be fulfilled by using specific biomaterials and fabrication methods are presented. Detailed insight is given into the two biopolymers chitosan and collagen. The fabrication methods are divided into two categories: isotropic and anisotropic scaffold fabrication methods. Processable biomaterials and achievable pore sizes are assigned to each method. In addition, fiber spinning methods and textile fabrication methods used to produce anisotropic scaffolds are described in detail and the advantages of anisotropic scaffolds for tissue engineering and regenerative medicine are highlighted.

Biodegradable magnesium-based biomaterials: An overview of challenges and opportunities

As promising biodegradable materials with nontoxic degradation products, magnesium (Mg) and its alloys have received more and more attention in the biomedical field very recently. Having excellent biocompatibility and unique mechanical properties, magnesium-based alloys currently cover a broad range of applications in the biomedical field. The use of Mg-based biomedical devices eliminates the need for biomaterial removal surgery after the healing process and reduces adverse effects induced by the implantation of permanent biomaterials. However, the high corrosion rate of Mg-based implants leads to unexpected degradation, structural failure, hydrogen evolution, alkalization, and cytotoxicity. To overcome these limitations, alloying Mg with suitable alloying elements and surface treatment come highly recommended. In this area, open questions remain on the behavior of Mg-based biomaterials in the human body and the effects of different factors that have resulted in these challenges. In addition to that, many techniques are yet to be verified to turn these challenges into opportunities. Accordingly, this article aims to review major challenges and opportunities for Mg-based biomaterials to minimize the challenges for the development of novel biomaterials made of Mg and its alloys.

Gum Tragacanth (GT): A Versatile Biocompatible Material beyond Borders

The use of naturally occurring materials in biomedicine has been increasingly attracting the researchers’ interest and, in this regard, gum tragacanth (GT) is recently showing great promise as a therapeutic substance in tissue engineering and regenerative medicine. As a polysaccharide, GT can be easily extracted from the stems and branches of various species of Astragalus. This anionic polymer is known to be a biodegradable, non-allergenic, non-toxic, and non-carcinogenic material. The stability against microbial, heat and acid degradation has made GT an attractive material not only in industrial settings (e.g., food packaging) but also in biomedical approaches (e.g., drug delivery). Over time, GT has been shown to be a useful reagent in the formation and stabilization of metal nanoparticles in the context of green chemistry. With the advent of tissue engineering, GT has also been utilized for the fabrication of three-dimensional (3D) scaffolds applied for both hard and soft tissue healing strategies. However, more research is needed for defining GT applicability in the future of biomedical engineering. On this object, the present review aims to provide a state-of-the-art overview of GT in biomedicine and tries to open new horizons in the field based on its inherent characteristics.

Platelet-rich plasma-hyaluronic acid/chondrotin sulfate/carboxymethyl chitosan hydrogel for cartilage regeneration

In this study, the chondrogenic potential of hyaluronic acid/chondrotin sulfate/carboxymethyl chitosan hydrogels with adipose-derived mesenchymal stem cells (ADMSCs) was evaluated. Here, hyaluronic acid, chondrotin sulfate, and carboxymethyl chitosan were used as the substrate for cartilage tissue engineering in which the hydrogel is formed due to electrostatic and hydrogen bonds through mixing the polymers. Because of the instability of this hydrogel in the biological environment, 1-ethyl-3-(3-dimethylaminopropyl-carbodiimide hydrochloride/N-hydroxy-succinimide was used as a crosslinker to increase the hydrogel stability. The hydrogels showed reasonable stability due to the combined effect of self-crosslinking and chemical crosslinking. The cells were treated with the prepared hydrogel samples for 14 and 21 days in nondifferentiation medium for evaluation of the cellular behavior of ADMSCs. Gene expression evaluation was performed, and expression of specific genes involved in differentiation was shown in the crosslinked hydrogel with platelet-rich plasma (PRP) (H-EN-P) had increased the gene expression levels. Quantification of immunofluorescence intensity indicated the high level of expression of SOX9 in H-EN-P hydrogel. Based on the results, we confirmed that the presence of PRP and the similarity of the hydrogel constituents to the cartilage extracellular matrix could have positive effects on the differentiation of the cells, which is favorable for cartilage tissue engineering approaches.

An overview of the use of biomaterials, nanotechnology, and stem cells for detection and treatment of COVID-19: towards a framework to address future global pandemics

A novel SARS-like coronavirus (severe acute respiratory syndrome-related coronavirus-2, SARS-CoV-2) outbreak has recently become a worldwide pandemic. Researchers from various disciplinary backgrounds (social to natural science, health and medicine, etc.) have studied different aspects of the pandemic. The current situation has revealed how the ongoing development of nanotechnology and nanomedicine can accelerate the fight against the novel viruses. A comprehensive solution to this and future pandemic outbreaks includes preventing the spread of the virus through anti-viral personal protective equipment (PPE) and anti-viral surfaces, plus efforts to encourage behavior to minimize risks. Studies of previously introduced anti-viral biomaterials and their optimization to fight against SARS-CoV-2 is the foundation of most of the recent progress. The identification of non-symptomatic patients and symptomatic patients is vital. Reviewing published research highlights the pivotal roles of nanotechnology and biomaterials in the development and efficiency of detection techniques, e.g., by applying nanotechnology and nanomedicine as part of the road map in the treatment of coronavirus disease 2019 (COVID-19) patients. In this review, we discuss efforts to deploy nanotechnology, biomaterials, and stem cells in each step of the fight against SARS-CoV-2, which may provide a framework for future efforts in combating global pandemics.

Copper-containing bioactive glasses and glass-ceramics: From tissue regeneration to cancer therapeutic strategies

Copper is one of the most used therapeutic metallic elements in biomedicine, ranging from antibacterial approaches to cancer theranostics. This element could be easily incorporated into different types of biomaterials; specifically, copper-doped bioactive glasses (BGs) provide great opportunities for biomedical engineers and clinicians as regards their excellent biocompatibility and regenerative potential. Although copper-incorporated BGs are mostly used in bone tissue engineering, accelerated soft tissue healing is achievable, too, with interesting potentials in wound treatment and skin repair. Copper can modulate the physico-chemical properties of BGs (e.g., reactivity with bio-fluids) and improve their therapeutic potential. Improving cell proliferation, promoting angiogenesis, reducing or even prohibiting bacterial growth are counted as prominent biological features of copper-doped BGs. Recent studies have also suggested the suitability of copper-doped BGs in cancer photothermal therapy (PTT). However, more research is needed to determine the extent to which copper-doped BGs are actually applicable for tissue engineering and regenerative medicine strategies in the clinic. Moreover, copper-doped BGs in combination with polymers may be considered in the future to produce relatively soft, pliable composites and printable inks for use in biofabrication.

Cerium Oxide Nanoparticles (Nanoceria): Hopes in Soft Tissue Engineering

Several biocompatible materials have been applied for managing soft tissue lesions; cerium oxide nanoparticles (CNPs, or nanoceria) are among the most promising candidates due to their outstanding properties, including antioxidant, anti-inflammatory, antibacterial, and angiogenic activities. Much attention should be paid to the physical properties of nanoceria, since most of its biological characteristics are directly determined by some of these relevant parameters, including the particle size and shape. Nanoceria, either in bare or functionalized forms, showed the excellent capability of accelerating the healing process of both acute and chronic wounds. The skin, heart, nervous system, and ophthalmic tissues are the main targets of nanoceria-based therapies, and the other soft tissues may also be evaluated in upcoming experimental studies. For the repair and regeneration of soft tissue damage and defects, nanoceria-incorporated film, hydrogel, and nanofibrous scaffolds have been proven to be highly suitable replacements with satisfactory outcomes. Still, some concerns have remained regarding the long-term effects of nanoceria administration for human tissues and organs, such as its clearance from the vital organs. Moreover, looking at the future, it seems necessary to design and develop three-dimensional (3D) printed scaffolds containing nanoceria for possible use in the concepts of personalized medicine.

"Hard" ceramics for "Soft" tissue engineering: Paradox or opportunity?

Tissue engineering provides great possibilities to manage tissue damages and injuries in modern medicine. The involvement of hard biocompatible materials in tissue engineering-based therapies for the healing of soft tissue defects has impressively increased over the last few years: in this regard, different types of bioceramics were developed, examined and applied either alone or in combination with polymers to produce composites. Bioactive glasses, carbon nanostructures, and hydroxyapatite nanoparticles are among the most widely-proposed hard materials for treating a broad range of soft tissue damages, from acute and chronic skin wounds to complex injuries of nervous and cardiopulmonary systems. Although being originally developed for use in contact with bone, these substances were also shown to offer excellent key features for repair and regeneration of wounds and "delicate" structures of the body, including improved cell proliferation and differentiation, enhanced angiogenesis, and antibacterial/anti-inflammatory activities. Furthermore, when embedded in a soft matrix, these hard materials can improve the mechanical properties of the implant. They could be applied in various forms and formulations such as fine powders, granules, and micro- or nanofibers. There are some pre-clinical trials in which bioceramics are being utilized for skin wounds; however, some crucial questions should still be addressed before the extensive and safe use of bioceramics in soft tissue healing. For example, defining optimal formulations, dosages, and administration routes remain to be fixed and summarized as standard guidelines in the clinic. This review paper aims at providing a comprehensive picture of the use and potential of bioceramics in treatment, reconstruction, and preservation of soft tissues (skin, cardiovascular and pulmonary systems, peripheral nervous system, gastrointestinal tract, skeletal muscles, and ophthalmic tissues) and critically discusses their pros and cons (e.g., the risk of calcification and ectopic bone formation as well as the local and systemic toxicity) in this regard. STATEMENT OF SIGNIFICANCE: Soft tissues form a big part of the human body and play vital roles in maintaining both structure and function of various organs; however, optimal repair and regeneration of injured soft tissues (e.g., skin, peripheral nerve) still remain a grand challenge in biomedicine. Although polymers were extensively applied to restore the lost or injured soft tissues, the use of bioceramics has the potential to provides new opportunities which are still partially unexplored or at the very beginning. This reviews summarizes the state of the art of bioceramics in this field, highlighting the latest evolutions and the new horizons that can be opened by their use in the context of soft tissue engineering. Existing results and future challenges are discussed in order to provide an up-to-date contribution that is useful to both experienced scientists and early-stage researchers of the biomaterials community.

Electrospun Nanofibers for Improved Angiogenesis: Promises for Tissue Engineering Applications

Angiogenesis (or the development of new blood vessels) is a key event in tissue engineering and regenerative medicine; thus, a number of biomaterials have been developed and combined with stem cells and/or bioactive molecules to produce three-dimensional (3D) pro-angiogenic constructs. Among the various biomaterials, electrospun nanofibrous scaffolds offer great opportunities for pro-angiogenic approaches in tissue repair and regeneration. Nanofibers made of natural and synthetic polymers are often used to incorporate bioactive components (e.g., bioactive glasses (BGs)) and load biomolecules (e.g., vascular endothelial growth factor (VEGF)) that exert pro-angiogenic activity. Furthermore, seeding of specific types of stem cells (e.g., endothelial progenitor cells) onto nanofibrous scaffolds is considered as a valuable alternative for inducing angiogenesis. The effectiveness of these strategies has been extensively examined both in vitro and in vivo and the outcomes have shown promise in the reconstruction of hard and soft tissues (mainly bone and skin, respectively). However, the translational of electrospun scaffolds with pro-angiogenic molecules or cells is only at its beginning, requiring more research to prove their usefulness in the repair and regeneration of other highly-vascularized vital tissues and organs. This review will cover the latest progress in designing and developing pro-angiogenic electrospun nanofibers and evaluate their usefulness in a tissue engineering and regenerative medicine setting.

Nanotechnology for angiogenesis: opportunities and challenges

Angiogenesis plays a critical role within the human body, from the early stages of life (i.e., embryonic development) to life-threatening diseases (e.g., cancer, heart attack, stroke, wound healing). Many pharmaceutical companies have expended huge efforts on both stimulation and inhibition of angiogenesis. During the last decade, the nanotechnology revolution has made a great impact in medicine, and regulatory approvals are starting to be achieved for nanomedicines to treat a wide range of diseases. Angiogenesis therapies involve the inhibition of angiogenesis in oncology and ophthalmology, and stimulation of angiogenesis in wound healing and tissue engineering. This review aims to summarize nanotechnology-based strategies that have been explored in the broad area of angiogenesis. Lipid-based, carbon-based and polymeric nanoparticles, and a wide range of inorganic and metallic nanoparticles are covered in detail. Theranostic and imaging approaches can be facilitated by nanoparticles. Many preparations have been reported to have a bimodal effect where they stimulate angiogenesis at low dose and inhibit it at higher doses.

Bioactive Glasses and Glass/Polymer Composites for Neuroregeneration: Should We Be Hopeful?

Bioactive glasses (BGs) have been identified as highly versatile materials in tissue engineering applications; apart from being used for bone repair for many years, they have recently shown promise for the regeneration of peripheral nerves as well. They can be formulated in different shapes and forms (micro-/nanoparticles, micro-/nanofibers, and tubes), thus potentially meeting the diverse requirements for neuroregeneration. Mechanical and biological improvements in three-dimensional (3D) polymeric scaffolds could be easily provided by adding BGs to their composition. Various types of silicate, borate, and phosphate BGs have been examined for use in neuroregeneration. In general, BGs show good compatibility with the nervous system compartments both in vitro and in vivo. Functionalization and surface modification plus doping with therapeutic ions make BGs even more effective in peripheral nerve regeneration. Moreover, the combination of BGs with conductive polymers is suggested to improve neural cell functions at injured sites. Taking advantage of BGs combined with novel technologies in tissue engineering, like 3D printing, can open new horizons in reconstructive approaches for the nervous system. Although there are great potential opportunities in BG-based therapies for peripheral nerve regeneration, more research should still be performed to carefully assess the pros and cons of BGs in neuroregeneration strategies.

Copper-enriched diamond-like carbon coatings promote regeneration at the bone-implant interface

There have been several attempts to design innovative biomaterials as surface coatings to enhance the biological performance of biomedical implants. The objective of this study was to design multifunctional Cu/a-C:H thin coating depositing on the Ti-6Al-4V alloy (TC4) via magnetron sputtering in the presence of Ar and CH4 for applications in bone implants. Moreover, the impact of Cu amount and sp2/sp3 ratio on the interior stress, corrosion behavior, mechanical properties, and tribological performance and biocompatibility of the resulting biomaterial was discussed. X-ray photoelectron spectroscopy (XPS) revealed that the sp2/sp3 portion of the coating was enhanced for samples having higher Cu contents. The intensity of the interior stress of the Cu/a-C:H thin bio-films decreased by increase of Cu content as well as the sp2/sp3 ratio. By contrast, the values of Young's modulus, the H3/E2 ratio, and hardness exhibited no significant difference with enhancing Cu content and sp2/sp3 ratio. However, there was an optimum Cu content (36.8 wt.%) and sp2/sp3 ratio (4.7) that it is feasible to get Cu/a-C:H coating with higher hardness and tribological properties. Electrochemical impedance spectroscopy test results depicted significant improvement of Ti-6Al-4V alloy corrosion resistance by deposition of Cu/a-C:H thin coating at an optimum Ar/CH4 ratio. Furthermore, Cu/a-C:H thin coating with higher Cu contents showed better antibacterial properties and higher angiogenesis and osteogenesis activities. The coated samples inhibited the growth of bacteria as compared to the uncoated sample (p < 0.05). In addition, such coating composition can stimulate angiogenesis, osteogenesis and control host response, thereby increasing the success rate of implants. Moreover, Cu/a-C:H thin films encouraged development of blood vessels on the surface of titanium alloy when the density of grown blood vessels was increased with enhancing the Cu amount of the films. It is speculated that such coating can be a promising candidate for enhancing the osseointegration features.

Strontium- and Cobalt-Doped Multicomponent Mesoporous Bioactive Glasses (MBGs) for Potential Use in Bone Tissue Engineering Applications

Mesoporous bioactive glasses (MBGs) offer suitable platforms for drug/ion delivery in tissue engineering strategies. The main goal of this study was to prepare strontium (Sr)- and cobalt (Co)-doped MBGs; strontium is currently used in the treatment of osteoporosis, and cobalt is known to exhibit pro-angiogenic effects. Sr- and Co-doped mesoporous glasses were synthesized for the first time in a multicomponent silicate system via the sol-gel method by using P123 as a structure-directing agent. The glassy state of the Sr- and Co-doped materials was confirmed by XRD before immersion in SBF, while an apatite-like layer was detected onto the surface of samples post-immersion. The textural characteristics of MBGs were confirmed by nitrogen adsorption/desorption measurements. In vitro experiments including MTT assay, Alizarin red staining, and cell attachment and migration showed the cytocompatibility of all the samples as well as their positive effects on osteoblast-like cell line MG-63. Early experiments with human umbilical vein endothelial cells also suggested the potential of these MBGs in the context of angiogenesis. In conclusion, the prepared materials were bioactive, showed the ability to improve osteoblast cell function in vitro and could be considered as valuable delivery vehicles for therapeutics, like Co2+ and Sr2+ ions.

Materials for Orthopedic Bioimplants: Modulating Degradation and Surface Modification Using Integrated Nanomaterials

Significant research and development in the field of biomedical implants has evoked the scope to treat a broad range of orthopedic ailments that include fracture fixation, total bone replacement, joint arthrodesis, dental screws, and others. Importantly, the success of a bioimplant depends not only upon its bulk properties, but also on its surface properties that influence its interaction with the host tissue. Various approaches of surface modification such as coating of nanomaterial have been employed to enhance antibacterial activities of a bioimplant. The modified surface facilitates directed modulation of the host cellular behavior and grafting of cell-binding peptides, extracellular matrix (ECM) proteins, and growth factors to further improve host acceptance of a bioimplant. These strategies showed promising results in orthopedics, e.g., improved bone repair and regeneration. However, the choice of materials, especially considering their degradation behavior and surface properties, plays a key role in long-term reliability and performance of bioimplants. Metallic biomaterials have evolved largely in terms of their bulk and surface properties including nano-structuring with nanomaterials to meet the requirements of new generation orthopedic bioimplants. In this review, we have discussed metals and metal alloys commonly used for manufacturing different orthopedic bioimplants and the biotic as well as abiotic factors affecting the failure and degradation of those bioimplants. The review also highlights the currently available nanomaterial-based surface modification technologies to augment the function and performance of these metallic bioimplants in a clinical setting.

Recent advances in metallopolymer-based drug delivery systems

Metallopolymers (MPs) or metal-containing polymers have shown great potential as new drug delivery systems (DDSs) due to their unique properties, including universal architectures, composition, properties and surface chemistry. Over the past few decades, the exponential growth of many new classes of MPs that deal with these issues has been demonstrated. This review presents and assesses the recent advances and challenges associated with using MPs as DDSs. Among the most widely used MPs for these purposes, metal complexes based on synthetic and natural polymers, coordination polymers, metal-organic frameworks, and metallodendrimers are distinguished. Particular attention is paid to the stimulus- and multistimuli-responsive metallopolymer-based DDSs. Of considerable interest is the use of MPs for combination therapy and multimodal systems. Finally, the problems and future prospects of using metallopolymer-based DDSs are outlined. The bibliography includes articles published over the past five years.