3D printed chitosan-gelatine hydrogel coating on titanium alloy surface as biological fixation interface of artificial joint prosthesis

Optimization of chitosan-gelatin-based 3D-printed scaffolds for tissue engineering and drug delivery applications

The combination of biocompatible materials and advanced three-dimensional (3D) additive manufacturing technologies holds great potential in the development of finely tuned complex scaffolds with reproducible macro- and micro-structural characteristics for biomedical applications, such as tissue engineering and drug delivery. In this study, biocompatible printable inks based on chitosan, collagen and gelatin were developed and 3D-printed with a pneumatic-based extrusion printer. The printability of various chitosan-gelatin (CS-Gel) hydrogel inks was assessed by evaluating the quality of the printed constructs. The inks required an extrusion pressure of 150 ± 40 MPa with G22 and G25 nozzles for optimal printing. Inks with low chitosan concentrations (<4% w/v) exhibited poor printability, while inks with 4 % w/v chitosan and 1 % w/v gelatin (CG) demonstrated satisfactory extrusion and printing quality. The addition of collagen (0.1 % w/v) to the optimized ink (CGC) did not compromise printability. Post-printing stabilization using KOH produced self-supporting scaffolds with consistent morphological integrity, while weaker bases like NaOH/EtOH and ammonia vapors resulted in lower pore sizes and reduced structural stability. Water evaporation studies showed that neutralized samples had slower evaporation rates due to the strong intermolecular interactions formed during the neutralization process, contributing to a stable crosslinked network. FTIR spectra confirmed the formation of polyelectrolyte complexes in the CS-Gel and CS-Gel-Collagen blends, further enhancing structural stability. Swelling tests indicated that neutralized constructs maintained stability in different pH environments, with KOH-treated samples exhibiting the lowest swelling ratios and the highest structural stability. After optimizing the ink composition, 10 wt% Levofloxacin was loaded in the constructs as a model antibiotic and it's in vitro release rate was quantified. Drug loading was approximately 4 % for both ink compositions GC and CGC. CG Levo released over 80 % of levofloxacin within the first hour, reaching full release in 24 h, indicating inadequate control, while CGK Levo exhibited slower initial release (55 % in 15 min) followed by stabilized release after 4 h, likely due to controlled diffusion from expanded constructs. These findings demonstrate that the developed hydrogel inks and optimized printing parameters can produce scaffolds suitable for tissue engineering applications. Finally, the cell compatibility of the 3D-printed constructs was confirmed with MTT assay on fibroblasts and the antimicrobial activity of the drug-loaded constructs was tested against E. coli and S. aureus, showing an increase of the bacteria free zone from 8 ± 0.4 mm of the control against E. coli up to 16.4 ± 0.37 mm in the presence of the KOH-treated CG Levo printed construct.

Recent advance for animal-derived polysaccharides in nanomaterials

Inspired by the structure characteristics of natural products, the size and morphology of particles are carefully controlled using a bottom-up approach to construct nanomaterials with specific spatial unit distribution. Animal polysaccharide nanomaterials, such as chitosan and chondroitin sulfate nanomaterials, exhibit excellent biocompatibility, degradability, customizable surface properties, and novel physical and chemical properties. These nanomaterials hold great potential for development in achieving a sustainable bio-economy. This paper provides a summary of the latest research results on the preparation of nanomaterials from animal polysaccharides. The mechanism for preparing nanomaterials through the bottom-up method from different sources of animal polysaccharides is introduced. Furthermore, this paper discusses the potential hazards posed by industrial applications to the environment and human health, as well as the challenges and future prospects associated with using animal polysaccharides in nanomaterials.

Optimization of mechanical properties of small diameter artificial blood vessels based on alginate/chitosan/gelatin

Due to the rise in cardiovascular disease and the problem of autologous transplant limitation, the emergence of 3D bioprinted blood vessels using natural polymer materials as ink is becoming increasingly important in the field of small-diameter artificial blood vessels (φ ≤ 6 mm). In this paper, gelatin was firstly adopted to explore alginate/chitosan composite hydrogel properties and solve the current issues of poor mechanical performance and suboptimal printability of small-diameter blood vessels, which indicated that the modification caused a 17.7 % increase in compressive strength and a 63.2 % enhancement in tensile properties. The material microstructure evaluation showed that the samples with gelatin(4 %) presented the excellent water absorption rate(>90 %) significantly increasing their porosities. A self-developed 3D bioprinter was utilized to clarify the controllable mechanism of small-diameter artificial blood vessel, which has superior performance and excellent printability. This study provides a new reference solution to the current challenges in the bio-ink performance and printability of small-diameter artificial blood vessels.

Progress in Designing Therapeutic Antimicrobial Hydrogels Targeting Implant-associated Infections: Paving the Way for a Sustainable Platform Applied to Biomedical Devices

Implantable biomedical devices have found widespread use in restoring lost functions or structures within the human body, but they face a significant challenge from microbial-related infections, which often lead to implant failure. In this context, antimicrobial hydrogels emerge as a promising strategy for treating implant-associated infections owing to their tunable physicochemical properties. However, the literature lacks a comprehensive analysis of antimicrobial hydrogels, encompassing their development, mechanisms, and effect on implant-associated infections, mainly in light of existing in vitro, in vivo, and clinical evidence. Thus, this review addresses the strategies employed by existing studies to tailor hydrogel properties to meet the specific needs of each application. Furthermore, this comprehensive review critically appraises the development of antimicrobial hydrogels, with a particular focus on solving infections related to metallic orthopedic or dental implants. Then, preclinical and clinical studies centering on providing quantitative microbiological results associated with the application of antimicrobial hydrogels are systematically summarized. Overall, antimicrobial hydrogels benefit from the tunable properties of polymers and hold promise as an effective strategy for the local treatment of implant-associated infections. However, future clinical investigations, grounded on robust evidence from in vitro and preclinical studies, are required to explore and validate new antimicrobial hydrogels for clinical use.

Silver Nanoparticles in 3D Printing: A New Frontier in Wound Healing

This review examines the convergence of silver nanoparticles (AgNPs), three-dimensional (3D) printing, and wound healing, focusing on significant advancements in these fields. We explore the unique properties of AgNPs, notably their strong antibacterial efficacy and their potential applications in enhancing wound recovery. Furthermore, the review delves into 3D printing technology, discussing its core principles, various materials employed, and recent innovations. The integration of AgNPs into 3D-printed structures for regenerative medicine is analyzed, emphasizing the benefits of this combined approach and identifying the challenges that must be addressed. This comprehensive overview aims to elucidate the current state of the field and to direct future research toward developing more effective solutions for wound healing.

Hydrogel Coatings of Implants for Pathological Bone Repair

Hydrogels are well-suited for biomedical applications due to their numerous advantages, such as excellent bioactivity, versatile physical and chemical properties, and effective drug delivery capabilities. Recently, hydrogel coatings have developed to functionalize bone implants which are biologically inert and cannot withstand the complex bone tissue repair microenvironment. These coatings have shown promise in addressing unique and pressing medical needs. This review begins with the major functionalized performance and interfacial bonding strategy of hydrogel coatings, with a focus on the novel external field response properties of the hydrogel. Recent advances in the fabrication strategies of hydrogel coatings and their use in the treatment of pathologic bone regeneration are highlighted. Finally, challenges and emerging trends in the evolution and application of physiological environment-responsive and external electric field-responsive hydrogel coatings for bone implants are discussed.

Research on the osteogenic properties of 3D-printed porous titanium alloy scaffolds loaded with Gelma/PAAM-ZOL composite hydrogels

Although titanium alloy is the most widely used endoplant material in orthopedics, the material is bioinert and good bone integration is difficult to achieve. Zoledronic acid (ZOL) has been shown to locally inhibit osteoclast formation and prevent osteoporosis, but excessive concentrations of ZOL exert an inhibitory effect on osteoblasts; therefore, stable and controlled local release of ZOL may reshape bone balance and promote bone regeneration. To promote the adhesion of osteoblasts to many polar groups, researchers have applied gelatine methacryloyl (Gelma) combined with polyacrylamide hydrogel (PAAM), which significantly increased the hydrogen bonding force between the samples and improved the stability of the coating and drug release. A series of experiments demonstrated that the Gelma/PAAM-ZOL bioactive coating on the surface of the titanium alloy was successfully prepared. The coating can induce osteoclast apoptosis, promote osteoblast proliferation and differentiation, achieve dual regulation of bone regeneration, successfully disrupt the balance of bone remodelling and promote bone tissue regeneration. Additionally, the coating improves the metal biological inertness on the surface of titanium alloys and improves the bone integration of the scaffold, offering a new strategy for bone tissue engineering to promote bone technology.

Techniques, applications and prospects of polysaccharide and protein based biopolymer coatings: A review

The growing relevance of sustainable materials has recently led to the exploration of naturally derived biopolymeric hydrogels as coating materials due to their biodegradability, biocompatibility, ease of fabrication and modification. Although many review articles exist on biopolymeric coatings, they mainly focus on a specific polysaccharide, protein biopolymer, or a particular application- biomedical engineering or food preservation. The current review first summarizes the commonly used polysaccharide and protein-based biopolymers like chitosan, alginate, carrageenan, pectin, cellulose, starch, pullulan, agarose and silk fibroin, gelatin, respectively, with a systematic description of the techniques widely used for physical coating on substrates. Then, broad applications of these biopolymeric coatings on various substrates in biomedical engineering- 3D scaffolds, biomedical implants, and nanoparticles are described in detail. It also entails the application of biopolymeric coatings for food preservation in the form of food packaging and edible coatings. A brief discussion on the newly discovered interest in exploring biopolymers for anticorrosive coating applications is also included. Finally, concluding remarks on the role of biopolymer microstructures in forming homogeneous coatings, prospective alternatives to the currently used biopolymers as coating material and the advent of computer-aided technologies to expedite experimental findings are presented.

Recent Advances in Antibacterial Coatings to Combat Orthopedic Implant-Associated Infections

Implant-associated infections (IAIs) represent a major health burden due to the complex structural features of biofilms and their inherent tolerance to antimicrobial agents and the immune system. Thus, the viable options to eradicate biofilms embedded on medical implants are surgical operations and long-term and repeated antibiotic courses. Recent years have witnessed a growing interest in the development of robust and reliable strategies for prevention and treatment of IAIs. In particular, it seems promising to develop materials with anti-biofouling and antibacterial properties for combating IAIs on implants. In this contribution, we exclusively focus on recent advances in the development of modified and functionalized implant surfaces for inhibiting bacterial attachment and eventually biofilm formation on orthopedic implants. Further, we highlight recent progress in the development of antibacterial coatings (including self-assembled nanocoatings) for preventing biofilm formation on orthopedic implants. Among the recently introduced approaches for development of efficient and durable antibacterial coatings, we focus on the use of safe and biocompatible materials with excellent antibacterial activities for local delivery of combinatorial antimicrobial agents for preventing and treating IAIs and overcoming antimicrobial resistance.

Growth of Double-Network Tough Hydrogel Coatings by Surface-Initiated Polymerization

Hydrogel coatings exhibit versatile applications in biomedicine, flexible electronics, and environmental science. However, current coating methods encounter challenges in simultaneously achieving strong interfacial bonding, robust hydrogel coatings, and the ability to coat substrates with controlled thickness. This paper introduces a novel approach to grow a double-network (DN) tough hydrogel coating on various substrates. The process involves initial substrate modification using a silane coupling agent, followed by the deposition of an initiator layer on its surface. Subsequently, the substrate is immersed in a DN hydrogel precursor, where the coating grows under ultraviolet (UV) illumination. Precise control over the coating thickness is achieved by adjusting the UV illumination duration and the initiator quantity. The experimental measurement of adhesion reveals strong bonding between the DN hydrogel coating and diverse substrates, reaching up to 1012.9 J/m2 between the DN hydrogel coating and a glass substrate. The lubricity performance of the DN hydrogel coating is experimentally characterized, which is dependent on the coating thickness, applied pressure, and sliding velocity. The incorporation of 3D printing technology into the current coating method enables the creation of intricate hydrogel coating patterns on a flat substrate. Moreover, the hydrogel coating's versatility is demonstrated through its effective applications in oil-water separation and antifogging glasses, underscoring its wide-ranging potential. The robust DN hydrogel coating method presented here holds promise for advancing hydrogel applications across diverse fields.

Mechanical and Biological Properties of Titanium and Its Alloys for Oral Implant with Preparation Techniques: A Review

Dental implants have revolutionised restorative dentistry, offering patients a natural-looking and durable solution to replace missing or severely damaged teeth. Titanium and its alloys have emerged as the gold standard among the various materials available due to their exceptional properties. One of the critical advantages of titanium and its alloys is their remarkable biocompatibility which ensures minimal adverse reactions within the human body. Furthermore, they exhibit outstanding corrosion resistance ensuring the longevity of the implant. Their mechanical properties, including hardness, tensile strength, yield strength, and fatigue strength, align perfectly with the demanding requirements of dental implants, guaranteeing the restoration's functionality and durability. This narrative review aims to provide a comprehensive understanding of the manufacturing techniques employed for titanium and its alloy dental implants while shedding light on their intrinsic properties. It also presents crucial proof-of-concept examples, offering tangible evidence of these materials' effectiveness in clinical applications. However, despite their numerous advantages, certain limitations still exist necessitating ongoing research and development efforts. This review will briefly touch upon these restrictions and explore the evolving trends likely to shape the future of titanium and its alloy dental implants.

Strong and Ultra-tough Ionic Hydrogel Based on Hyperbranched Macro-Cross-linker: Influence of Topological Structure on Properties

The application of hydrogels often suffers from their inherent limitation of poor mechanical properties. Here, a carboxyl-functionalized and acryloyl-terminated hyperbranched polycaprolactone (PCL) was synthesized and used as a macro-cross-linker to fabricate a super strong and ultra-tough ionic hydrogel. The terminal acryloyl groups of hyperbranched PCL are chemically incorporated into the network to form covalent cross-links, which contribute to robust networks. Meanwhile, the hydrophobic domains formed by the spontaneous aggregation of PCL chains and coordination bonds between Fe3+ and COO- groups serve as dynamic non-covalent cross-links, which enhance the energy dissipation ability. Especially, the influence of the hyperbranched topological structure of PCL on hydrogel properties has been well investigated, exhibiting superior strengthening and toughening effects compared to the linear one. Moreover, the hyperbranched PCL cross-linker also endowed the ionic hydrogel with higher sensitivity than the linear one when used as a strain sensor. As a result, this well-designed ionic hydrogel possesses high mechanical strength, superior toughness, and well ionic conductivity, exhibiting potential applications in the field of flexible strain sensors.

Osteoblast and bacterial cell response on RGD peptide-functionalized chitosan coatings electrophoretically deposited from different suspensions on Ti13Nb13Zr alloy

Metallic materials for long-term load-bearing implants still do not provide high antimicrobial activity while maintaining strong compatibility with bone cells. This study aimed to modify the surface of Ti13Nb13Zr alloy by electrophoretic deposition of a chitosan coating with a covalently attached Arg-Gly-Asp (RGD) peptide. The suspensions for coating deposition were prepared in two different ways either using hydroxyacetic acid or a carbon dioxide saturation process. The coatings were deposited using a voltage of 10 V for 1 min. The prepared coatings were examined using SEM, EDS, FTIR, and XPS techniques. In addition, the wettability of these surfaces, corrosion resistance, adhesion of the coatings to the metallic substrate, and their antimicrobial activity (E. coli, S. aureus) and cytocompatibility properties using the MTT and LDH assays were studied. The coatings produced tightly covered the metallic substrate. Spectroscopic studies confirmed that the peptide did not detach from the chitosan chain during electrophoretic deposition. All tested samples showed high corrosion resistance (corrosion current density measured in nA/cm2 ). The deposited coatings contributed to a significant increase in the antimicrobial activity of the samples against Gram-positive and Gram-negative bacteria (reduction in bacterial counts from 99% to, for CS-RGD-Acid and the S. aureus strain, total killing capacity). MTT and LDH results showed high compatibility with bone cells of the modified surfaces compared to the bare substrate (survival rates above 75% under indirect contact conditions and above 100% under direct contact conditions). However, the adhesion of the coatings was considered weak.

New Insights into the Applications of 3D-Printed Biomaterial in Wound Healing and Prosthesis

Recently three-dimensional bioprinting (3D-bioP) has emerged as a revolutionary technique for numerous biomedical applications. 3D-bioP has facilitated the printing of advanced and complex human organs resulting in satisfactory therapeutic practice. One of the important biomedical applications of 3D-bioP is in tissue engineering, wound healing, and prosthetics. 3D-bioP is basically aimed to restore the natural extracellular matrix of human's damage due to wounds. The relevant search was explored using various scientific database, viz., PubMed, Web of Science, Scopus, and ScienceDirect. The objective of this review is to emphasize interpretations from the pre-executed studies and to assess the worth of employing 3D-bioP in wound healing as well as prosthetics in terms of patient compliance, clinical outcomes, and economic viability. Furthermore, the benefits of applying 3D-bioP in wound healing over traditional methods have been covered along with the biocompatible biomaterials employed as bioinks has been discussion. Additionally, the review expands about the clinical trials in 3D-bioP field, showing promise of biomedical applicability of this technique with growing advancement in recent years.

Polysaccharide-based antibacterial coating technologies

To tackle antimicrobial resistance, a global threat identified by the United Nations, is a common cause of healthcare-associated infections (HAI) and is responsible for significant costs on healthcare systems, a substantial amount of research has been devoted to developing polysaccharide-based strategies that prevent bacterial attachment and biofilm formation on surfaces. Polysaccharides are essential building blocks for life and an abundant renewable resource that have attracted much attention due to their intrinsic remarkable biological potential antibacterial activities. If converted into efficient antibacterial coatings that could be applied to a broad range of surfaces and applications, polysaccharide-based coatings could have a significant potential global impact. However, the ultimate success of polysaccharide-based antibacterial materials will be determined by their potential for use in manufacturing processes that are scalable, versatile, and affordable. Therefore, in this review we focus on recent advances in polysaccharide-based antibacterial coatings from the perspective of fabrication methods. We first provide an overview of strategies for designing polysaccharide-based antimicrobial formulations and methods to assess the antibacterial properties of coatings. Recent advances on manufacturing polysaccharide-based coatings using some of the most common polysaccharides and fabrication methods are then detailed, followed by a critical comparative overview of associated challenges and opportunities for future developments. STATEMENT OF SIGNIFICANCE: Our review presents a timely perspective by being the first review in the field to focus on advances on polysaccharide-based antibacterial coatings from the perspective of fabrication methods along with an overview of strategies for designing polysaccharide-based antimicrobial formulations, methods to assess the antibacterial properties of coatings as well as a critical comparative overview of associated challenges and opportunities for future developments. Meanwhile this work is specifically targeted at an audience focused on featuring critical information and guidelines for developing polysaccharide-based coatings. Including such a complementary work in the journal could lead to further developments on polysaccharide antibacterial applications.

A Novel Multifunctional Crosslinking PVA/CMCS Hydrogel Containing Cyclic Peptide Actinomycin X2 and PA@Fe with Excellent Antibacterial and Commendable Mechanical Properties

Bacterial infected environments and resulting bacterial infections have been threatening the human health globally. Due to increased bacterial resistance caused by improper and excessive use of antibiotics, antibacterial biomaterials are being developed as alternatives to antibiotics in some cases. Herein, an advanced multifunctional hydrogel with excellent antibacterial properties, enhanced mechanical properties, biocompatibility and self-healing performance, was designed through freezing-thawing method. This hydrogel network is composed of polyvinyl alcohol (PVA), carboxymethyl chitosan (CMCS), protocatechualdehyde (PA), ferric iron (Fe) and an antimicrobial cyclic peptide actinomycin X2 (Ac.X2). The double dynamic bonds among protocatechualdehyde (PA), ferric iron (Fe) and carboxymethyl chitosan containing coordinate bond (catechol-Fe) as well as dynamic Schiff base bonds and hydrogen bonds endowed the hydrogel with enhanced mechanical properties. Successful formation of hydrogel was confirmed through ATR-IR and XRD, and structural evaluation through SEM analysis, whereas mechanical properties were tested with electromechanical universal testing machine. The resulting PVA/CMCS/Ac.X2/PA@Fe (PCXPA) hydrogel has favorable biocompatibility and excellent broad-spectrum antimicrobial activity against both S. aureus (95.3 %) and E. coli (90.2 %) compared with free-soluble Ac.X2, which exhibited subpar performance against E. coli reported in our previous studies. This work provides a new insight on preparing multifunctional hydrogels containing antimicrobial peptides as antibacterial material.

Engineering 3D-Printed Advanced Healthcare Materials for Periprosthetic Joint Infections

The use of additive manufacturing or 3D printing in biomedicine has experienced fast growth in the last few years, becoming a promising tool in pharmaceutical development and manufacturing, especially in parenteral formulations and implantable drug delivery systems (IDDSs). Periprosthetic joint infections (PJIs) are a common complication in arthroplasties, with a prevalence of over 4%. There is still no treatment that fully covers the need for preventing and treating biofilm formation. However, 3D printing plays a major role in the development of novel therapies for PJIs. This review will provide a deep understanding of the different approaches based on 3D-printing techniques for the current management and prophylaxis of PJIs. The two main strategies are focused on IDDSs that are loaded or coated with antimicrobials, commonly in combination with bone regeneration agents and 3D-printed orthopedic implants with modified surfaces and antimicrobial properties. The wide variety of printing methods and materials have allowed for the manufacture of IDDSs that are perfectly adjusted to patients' physiognomy, with different drug release profiles, geometries, and inner and outer architectures, and are fully individualized, targeting specific pathogens. Although these novel treatments are demonstrating promising results, in vivo studies and clinical trials are required for their translation from the bench to the market.

Preparation and Properties of Physical Gel on Medical Titanium Alloy Surface

Medical titanium alloy Ti-6Al-4V (TC4) has been widely used in the medical field, especially in human tissue repair. However, TC4 has some shortcomings, which may cause problems with biocompatibility and mechanical compatibility in direct contact with the human body. To solve this problem, physical gels are formed on the surface of TC4, and the storage modulus of the formed physical gel matches that of the human soft tissue. 2-bromoisobutyryl bromide (BIBB) and dopamine (DA) were used to form initiators on the surface of hydroxylated medical titanium alloy. Different initiators were formed by changing the ratio of BIBB and DA, and the optimal one was selected for subsequent reactions. Under the action of the catalyst, L-lactide and D-lactide were ring-opened polymerized with hydroxyethyl methacrylate (HEMA), respectively, to form macromolecular monomers HEMA-PLLA₂₉ and HEMA-PDLA₂₉ with a polymerization degree of 29. The two macromolecular monomers were stereo-complexed by ultrasound to form HEMA-stereocomplex polylactic acid (HEMA-scPLA₂₉). Based on two monomers, 2-(2-methoxyethoxy) ethyl methacrylate (MEO₂MA) and oligo (ethylene oxide) methacrylate (OEGMA), and the physical crosslinking agent HEMA-scPLA_29, physical gels are formed on the surface of TC4 attached to the initiator via Atom Transfer Radical Addition Reaction (ATRP) technology. The hydrogels on the surface of titanium alloy were characterized and analyzed by a series of instruments. The results showed that the storage modulus of physical glue was within the range of the energy storage modulus of human soft tissue, which was conducive to improving the mechanical compatibility of titanium alloy and human soft tissue.

Feather keratin-montmorillonite nanocomposite hydrogel promotes bone regeneration by stimulating the osteogenic differentiation of endogenous stem cells

Bone defects caused by bone trauma, infection, surgery, or other systemic diseases remain a severe challenge for the medical field. To address this clinical problem, different hydrogels were exploited to promote bone tissue regrowth and regeneration. Keratins are natural fibrous proteins found in wool, hair, horns, nails, and feather. Due to their unique characteristics of outstanding biocompatibility, great biodegradability, and hydrophilic, keratins have been widely applicated in different fields. In our study, the feather keratin-montmorillonite nanocomposite hydrogels that consist of keratin hydrogels serving as the scaffold support to accommodate endogenous stem cells and montmorillonite is synthesized. The introduction of montmorillonite greatly improves the osteogenic effect of the keratin hydrogels via bone morphogenetic protein 2 (BMP-2)/phosphorylated small mothers against decapentaplegic homolog 1/5/8 (p-SMAD 1/5/8)/runt-related transcription factor 2 (RUNX2) expression. Moreover, the incorporation of montmorillonite into hydrogels can improve the mechanical properties and bioactivity of the hydrogels. The morphology of feather keratin-montmorillonite nanocomposite hydrogels was shown by scanning electron microscopy (SEM) to have an interconnected porous structure. The incorporation of montmorillonite into the keratin hydrogels was confirmed by the energy dispersive spectrum (EDS). We prove that the feather keratin-montmorillonite nanocomposite hydrogels enhance the osteogenic differentiation of BMSCs. Furthermore, micro-CT and histological analysis of rat cranial bone defect demonstrated that feather keratin-montmorillonite nanocomposite hydrogels dramatically stimulated bone regeneration in vivo. Collectively, feather keratin-montmorillonite nanocomposite hydrogels can regulate BMP/SMAD signaling pathway to stimulate osteogenic differentiation of endogenous stem cells and promote bone defect healing, indicating their promising candidate in bone tissue engineering.

Chitosan Hydrogel as Tissue Engineering Scaffolds for Vascular Regeneration Applications

Chitosan hydrogels have a wide range of applications in tissue engineering scaffolds, mainly due to the advantages of their chemical and physical properties. This review focuses on the application of chitosan hydrogels in tissue engineering scaffolds for vascular regeneration. We have mainly introduced these following aspects: advantages and progress of chitosan hydrogels in vascular regeneration hydrogels and the modification of chitosan hydrogels to improve the application in vascular regeneration. Finally, this paper discusses the prospects of chitosan hydrogels for vascular regeneration.

Antibacterial-Based Hydrogel Coatings and Their Application in the Biomedical Field-A Review

Hydrogels exhibit excellent moldability, biodegradability, biocompatibility, and extracellular matrix-like properties, which make them widely used in biomedical fields. Because of their unique three-dimensional crosslinked hydrophilic networks, hydrogels can encapsulate various materials, such as small molecules, polymers, and particles; this has become a hot research topic in the antibacterial field. The surface modification of biomaterials by using antibacterial hydrogels as coatings contributes to the biomaterial activity and offers wide prospects for development. A variety of surface chemical strategies have been developed to bind hydrogels to the substrate surface stably. We first introduce the preparation method for antibacterial coatings in this review, which includes surface-initiated graft crosslinking polymerization, anchoring the hydrogel coating to the substrate surface, and the LbL self-assembly technique to coat crosslinked hydrogels. Then, we summarize the applications of hydrogel coating in the biomedical antibacterial field. Hydrogel itself has certain antibacterial properties, but the antibacterial effect is not sufficient. In recent research, in order to optimize its antibacterial performance, the following three antibacterial strategies are mainly adopted: bacterial repellent and inhibition, contact surface killing of bacteria, and release of antibacterial agents. We systematically introduce the antibacterial mechanism of each strategy. The review aims to provide reference for the further development and application of hydrogel coatings.

Phosphoserine-loaded chitosan membranes promote bone regeneration by activating endogenous stem cells

Bone defects that result from trauma, infection, surgery, or congenital malformation can severely affect the quality of life. To address this clinical problem, a phosphoserine-loaded chitosan membrane that consists of chitosan membranes serving as the scaffold support to accommodate endogenous stem cells and phosphoserine is synthesized. The introduction of phosphoserine greatly improves the osteogenic effect of the chitosan membranes via mutual crosslinking using a crosslinker (EDC, 1-ethyl-3-(3-dimethyl aminopropyl)-carbodiimide). The morphology of PS-CS membranes was shown by scanning electron microscopy (SEM) to have an interconnected porous structure. The incorporation of phosphoserine into chitosan membranes was confirmed by energy dispersive spectrum (EDS), Fourier Transforms Infrared (FTIR), and X-ray diffraction (XRD) spectrum. The CCK8 assay and Live/Dead staining, Hemolysis analysis, and cell adhesion assay demonstrated that PS-CS membranes had good biocompatibility. The osteogenesis-related gene expression of BMSCs was higher in PS-CS membranes than in CS membranes, which was verified by alkaline phosphatase (ALP) activity, immunofluorescence staining, and real-time quantitative PCR (RT-qPCR). Furthermore, micro-CT and histological analysis of rat cranial bone defect demonstrated that PS-CS membranes dramatically stimulated bone regeneration in vivo. Moreover, H&E staining of the main organs (heart, liver, spleen, lung, or kidney) showed no obvious histological abnormalities, revealing that PS-CS membranes were no additional systemic toxicity in vivo. Collectively, PS-CS membranes may be a promising candidate for bone tissue engineering.

PCL/Collagen/UA Composite Biomedical Dressing with Ordered Microfiberous Structure Fabricated by a 3D Near-Field Electrospinning Process

In this work, a functionalized polycaprolactone (PCL) composite fiber combining calf-type I collagen (CO) and natural drug usnic acid (UA) was prepared, in which UA was used as an antibacterial agent. Through 3D near-field electrospinning, the mixed solution was prepared into PCL/CO/UA composite fibers (PCUCF), which has a well-defined perfect arrangement structure. The influence of electrospinning process parameters on fiber diameter was investigated, the optimal electrospinning parameters were determined, and the electric field simulation was conducted to verify the optimal parameters. The addition of 20% collagen made the composite fiber have good hydrophilicity and water absorption property. In the presence of PCUCF, 1% UA content significantly inhibited the growth rate of Gram-positive and negative bacteria in the plate culture. The AC-PCUCF (after crosslinking PCUCF) prepared by crosslinking collagen with genipin showed stronger mechanical properties, water absorption property, thermal stability, and drug release performance. Cell proliferation experiments showed that PCUCF and AC-PCUCF had no cytotoxicity and could promote cell proliferation and adhesion. The results show that PCL/CO/UA composite fiber has potential application prospects in biomedical dressing.

Strong adhesive and drug-loaded hydrogels for enhancing bone-implant interface fixation and anti-infection properties

The bonding strength of the bone-titanium (Ti) implant interface is critical for patients undergoing joint replacement. However, current bone adhesives used in clinic have shortcomings, such as biological inertness, cytotoxicity, and lack of osteogenic ability. In this study, a simple and low-cost hydrogel-based bone adhesive was prepared to improve the osseointegration ability and anti-infection ability of the bone-implant interface. A multifunctional hydrogel was prepared by incorporating nano-hydroxyapatite (HA) on polyethyleneimine (PEI) and polyacrylic acid (PAA) (PEI/PAA-HA). It was shown that PEI/PAA-HA hydrogel exhibited good self-healing and strong adhesive ability. The adhesive strengths of bone-Ti and Ti-Ti were measured as 2.30 ± 0.15 MPa and 1.07 ± 0.07 MPa, respectively. Vancomycin (VAN) was loaded into the PEI/PAA-HA hydrogel (PEI/PAA-HA-VAN) via a simple immersion method. The PEI/PAA-HA-VAN showed excellent antibacterial effect by sustained release of VAN. In addition, the PEI/PAA-HA-VAN hydrogel exhibited excellent cytocompatibility promoting the expression of osteogenic genes and the deposition of mineralized matrix. Collectively, this strong adhesive hydrogel showed great potential in enhancing bone-implant interface fixation.

3D Bioprinted Chitosan-Based Hydrogel Scaffolds in Tissue Engineering and Localised Drug Delivery

Bioprinting is an emerging technology with various applications in developing functional tissue constructs for the replacement of harmed or damaged tissues and simultaneously controlled drug delivery systems (DDSs) for the administration of several active substances, such as growth factors, proteins, and drug molecules. It is a novel approach that provides high reproducibility and precise control over the fabricated constructs in an automated way. An ideal bioink should possess proper mechanical, rheological, and biological properties essential to ensure proper function. Chitosan is a promising natural-derived polysaccharide to be used as ink because of its attractive properties, such as biodegradability, biocompatibility, low cost, and non-immunogenicity. This review focuses on 3D bioprinting technology for the preparation of chitosan-based hydrogel scaffolds for the regeneration of tissues delivering either cells or active substances to promote restoration.

Chitosan-based high-strength supramolecular hydrogels for 3D bioprinting

The loss of tissues and organs is a major challenge for biomedicine, and the emerging 3D bioprinting technology has brought the dawn for the development of tissue engineering and regenerative medicine. Chitosan-based supramolecular hydrogels, as novel biomaterials, are considered as ideal materials for 3D bioprinting due to their unique dynamic reversibility and fantastic biological properties. Although chitosan-based supramolecular hydrogels have wonderful biological properties, the mechanical properties are still under early exploration. This paper aims to provide some inspirations for researchers to further explore. In this review, common 3D bioprinting techniques and the properties required for bioink for 3D bioprinting are firstly described. Then, several strategies to enhance the mechanical properties of chitosan hydrogels are introduced from the perspectives of both materials and supramolecular binding motifs. Finally, current challenges and future opportunities in this field are discussed. The combination of chitosan-based supramolecular hydrogels and 3D bioprinting will hold promise for developing novel biomedical implants.

Establishing a novel 3D printing bioinks system with recombinant human collagen

Bioinks are one of the key elements in realizing three-dimensional (3D) bioprinting. However, bioinks prepared from conventional collagen are hindered to their further applications due to concerns of collagen purity, unstable mechanical properties, and low solubility under neutralized conditions. This study aimed to develop a reliable UV-curable bioink system from a novel water-soluble recombinant human collagen (RHC). RHC was modified by methacrylic anhydride (MAA) and later crosslinked by 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC)/N-hydroxysuccinimide (NHS) to obtain Pro-RHCMA. ¹H nuclear magnetic resonance (¹H NMR) confirmed the methacryloyl grafts, Fourier transform-infrared spectroscopy (FT-IR) illustrated the chemical crosslinking in producing the Pro-RHCMA. Internal morphology, mechanical properties and degradation of UV cured boinks were MAA and EDC/NHS modification-dependent. Photorheological properties and printability of the bioinks were determined. Cellular bioactivities were sustained within the printed bioinks, validating the bioinks biocompatibility in vitro. Finally, qRT-PCR revealed that the Pro-RHCMA bioinks provided a cell-friendly microenvironment for human umbilical vein endothelial cells (HUVECs) and human foreskin fibroblasts (HFFs), by supporting the expression of extracellular matrix (ECM) and angiogenesis-associated proteins, respectively. Taken together, this novel RHC-based bioink system shows great potential in tissue engineering and regenerative medicine.

Personalized Artificial Tibia Bone Structure Design and Processing Based on Laser Powder Bed Fusion

Bone defects caused by bone diseases and bone trauma need to be implanted or replaced by surgery. Therefore, it is of great significance to design and prepare a tibial implant with good biocompatibility and excellent comprehensive mechanical properties. In this paper, with 316L stainless steel powder as the main material, a personalized artificial tibia design and processing method based on laser powder bed fusion is proposed. Firstly, the personalized model of the damaged part of the patient is reconstructed. Then, the porous structure of human tibia is manufactured by selective laser melting technology. To research the factors affecting the quality of selective laser melting porous structure, a laser heat source model, heat transfer model and molten pool model of laser powder bed fusion process were constructed; then, by changing the laser process parameters (laser power, laser beam diameter, scanning speed, powder layer thickness, etc.) to conduct multiple sets of simulation experiments, it is obtained that when the “laser power is 180 W, the laser scanning speed is 1000 mm/s, the laser beam diameter is 80 μm, the powder layer thickness is 50 μm”, the porous stainless steel parts with better quality can be obtained. Finally, the porous structure was fabricated by selective laser processing, and its properties were tested and analyzed. The experimental results show that the cell side length of cube is 1.2 mm, the elastic modulus of octahedral porous structure with pillar diameter of 0.35 mm is about 17.88 GPa, which match well with tibial bone tissue.

Bioactive Coatings on Titanium: A Review on Hydroxylation, Self-Assembled Monolayers (SAMs) and Surface Modification Strategies

Titanium (Ti) and its alloys have been demonstrated over the last decades to play an important role as inert materials in the field of orthopedic and dental implants. Nevertheless, with the widespread use of Ti, implant-associated rejection issues have arisen. To overcome these problems, antibacterial properties, fast and adequate osseointegration and long-term stability are essential features. Indeed, surface modification is currently presented as a versatile strategy for developing Ti coatings with all these challenging requirements and achieve a successful performance of the implant. Numerous approaches have been investigated to obtain stable and well-organized Ti coatings that promote the tailoring of surface chemical functionalization regardless of the geometry and shape of the implant. However, among all the approaches available in the literature to functionalize the Ti surface, a promising strategy is the combination of surface pre-activation treatments typically followed by the development of intermediate anchoring layers (self-assembled monolayers, SAMs) that serve as the supporting linkage of a final active layer. Therefore, this paper aims to review the latest approaches in the biomedical area to obtain bioactive coatings onto Ti surfaces with a special focus on (i) the most employed methods for Ti surface hydroxylation, (ii) SAMs-mediated active coatings development, and (iii) the latest advances in active agent immobilization and polymeric coatings for controlled release on Ti surfaces.

An extremely tough and ionic conductive natural-polymer-based double network hydrogel

Hydrogels are widely used in fields such as drug delivery, tissue regeneration, soft robotics and flexible smart electronic devices, yet their application is often limited by unsatisfactory mechanical behaviors. Among the various improvement strategies, double network (DN) hydrogels from synthetic polymers demonstrated impressive mechanical properties, while those from natural polymers were usually inferior. Here, a novel DN hydrogel composed fully of natural polymers exhibiting remarkable mechanical properties and conductivity is prepared by simply soaking a virgin gellan gum/gelatin composite hydrogel in a mixed solution of Na₂SO₄ and (NH₄)₂SO₄. This hydrogel exhibits a tunable Young's modulus (0.08 to 42.6 MPa), good fracture stress (0.05 to 7.5 MPa), good fracture stretch (1.4 to 7.1), high fracture toughness (up to 27.7 kJ m^-2), and high ionic conductivity (up to 11.4 S m^-1 at f = 1 kHz). The improvement in the mechanical properties of the DN gel is attributed to the chain-entanglement crosslinking points introduced by SO₄^2- in the gelatin network and the electrostatic interaction crosslinking points introduced by Na⁺ in the gellan gum network. The high ionic conductivity of the DN gel is attributed to the infiltration of the DN gel in a salt solution of high concentration. The developed gellan gum/gelatin DN hydrogel has shown a new pathway towards strengthening natural-polymer-based DN hydrogels and towards potential applications in biomedical engineering and flexible electronic devices.

Advanced Metallic and Polymeric Coatings for Neural Interfacing: Structures, Properties and Tissue Responses

Neural electrodes are essential for nerve signal recording, neurostimulation, neuroprosthetics and neuroregeneration, which are critical for the advancement of brain science and the establishment of the next-generation brain-electronic interface, central nerve system therapeutics and artificial intelligence. However, the existing neural electrodes suffer from drawbacks such as foreign body responses, low sensitivity and limited functionalities. In order to overcome the drawbacks, efforts have been made to create new constructions and configurations of neural electrodes from soft materials, but it is also more practical and economic to improve the functionalities of the existing neural electrodes via surface coatings. In this article, recently reported surface coatings for neural electrodes are carefully categorized and analyzed. The coatings are classified into different categories based on their chemical compositions, i.e., metals, metal oxides, carbons, conducting polymers and hydrogels. The characteristic microstructures, electrochemical properties and fabrication methods of the coatings are comprehensively presented, and their structure-property correlations are discussed. Special focus is given to the biocompatibilities of the coatings, including their foreign-body response, cell affinity, and long-term stability during implantation. This review article can provide useful and sophisticated insights into the functional design, material selection and structural configuration for the next-generation multifunctional coatings of neural electrodes.

Development of an anti-infective coating on the surface of intraosseous implants responsive to enzymes and bacteria

Background

Bacterial proliferation on the endosseous implants surface presents a new threat to the using of the bone implants. Unfortunately, there is no effective constructed antibacterial coating which is bacterial anti-adhesion substrate-independent or have long-term biofilm inhibition functions.

Methods

Drug release effect was tested in Chymotrypsin (CMS) solution and S. aureus. We used bacterial inhibition rate assays and protein leakage experiment to analyze the in vitro antibacterial effect of (Montmorillonite/Poly-l-lysine-Chlorhexidine)₁₀ [(MMT/PLL-CHX)₁₀] multilayer film. We used the CCK-8 assay to analyze the effect of (MMT/PLL-CHX)₁₀ multilayer films on the growth and proliferation of rat osteoblasts. Rat orthopaedic implant-related infections model was constructed to test the antimicrobial activity effect of (MMT/PLL-CHX)₁₀ multilayer films in vivo.

Results

In this study, the (MMT/PLL-CHX)₁₀ multilayer films structure were progressively degraded and showed well concentration-dependent degradation characteristics following incubation with Staphylococcus aureus and CMS solution. Bacterial inhibition rate assays and protein leakage experiment showed high levels of bactericidal activity. While the CCK-8 analysis proved that the (MMT/PLL-CHX)₁₀ multilayer films possess perfect biocompatibility. It is somewhat encouraging that in the in vivo antibacterial tests, the K-wires coated with (MMT/PLL-CHX)₁₀ multilayer films showed lower infections incidence and inflammation than the unmodified group, and all parameters are close to SHAM group.

Conclusion

(MMT/PLL-CHX)₁₀ multilayer films provides a potential therapeutic method for orthopaedic implant-related infections.

Current achievements in 3D bioprinting technology of chitosan and its hybrids

Chitosan and its hybrids, as an appropriate bioink in 3D printing technology, for the fabrication of engineered constructions.