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Li X, Liu Y, Li L, Huo R, Ghezelbash F, Ma Z, Bao G, Liu S, Yang Z, Weber MH, Li-Jessen NYK, Haglund L, Li J. Tissue-mimetic hybrid bioadhesives for intervertebral disc repair. MATERIALS HORIZONS 2023; 10:1705-1718. [PMID: 36857679 DOI: 10.1039/d2mh01242a] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Intervertebral disc (IVD) degeneration and herniation often necessitate surgical interventions including a discectomy with or without a nucleotomy, which results in a loss of the normal nucleus pulposus (NP) and a defect in the annulus fibrosus (AF). Due to the limited regenerative capacity of the IVD tissue, the annular tear may remain a persistent defect and result in recurrent herniation post-surgery. Bioadhesives are promising alternatives but show limited adhesion performance, low regenerative capacity, and inability to prevent re-herniation. Here, we report hybrid bioadhesives that combine an injectable glue and a tough sealant to simultaneously repair and regenerate IVD post-nucleotomy. The glue fills the NP cavity while the sealant seals the AF defect. Strong adhesion occurs with the IVD tissues and survives extreme disc loading. Furthermore, the glue can match native NP mechanically, and support the viability and matrix deposition of encapsulated cells, serving as a suitable cell delivery vehicle to promote NP regeneration. Besides, biomechanical tests with bovine IVD motion segments demonstrate the capacity of the hybrid bioadhesives to restore the biomechanics of bovine discs under cyclic loading and to prevent permanent herniation under extreme loading. This work highlights the synergy of bioadhesive and tissue-engineering approaches. Future works are expected to further improve the tissue specificity of bioadhesives and prove their efficacy for tissue repair and regeneration.
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Affiliation(s)
- Xuan Li
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada.
| | - Yin Liu
- Department of Biomedical Engineering, McGill University, 3775 rue University, Montreal, Quebec H3A 2B4, Canada
| | - Li Li
- Department of Surgery, McGill University, 1650 Cedar Avenue, Room C10.148.2, Montreal, QC, H3G 1A4, Canada.
| | - Ran Huo
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada.
| | - Farshid Ghezelbash
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada.
- Department of Mechanical Engineering, Polytechnique Montreal, Montreal, Quebec H3C 3A7, Canada
| | - Zhenwei Ma
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada.
| | - Guangyu Bao
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada.
| | - Shiyu Liu
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada.
| | - Zhen Yang
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada.
| | - Michael H Weber
- Department of Surgery, McGill University, 1650 Cedar Avenue, Room C10.148.2, Montreal, QC, H3G 1A4, Canada.
| | - Nicole Y K Li-Jessen
- Department of Biomedical Engineering, McGill University, 3775 rue University, Montreal, Quebec H3A 2B4, Canada
- School of Communication Sciences and Disorders, McGill University, Montreal, Quebec H3A 1G1, Canada
- Department of Otolaryngology-Head & Neck Surgery, McGill University, Montreal, Quebec H3A 1G1, Canada
| | - Lisbet Haglund
- Department of Surgery, McGill University, 1650 Cedar Avenue, Room C10.148.2, Montreal, QC, H3G 1A4, Canada.
| | - Jianyu Li
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada.
- Department of Biomedical Engineering, McGill University, 3775 rue University, Montreal, Quebec H3A 2B4, Canada
- Department of Surgery, McGill University, 1650 Cedar Avenue, Room C10.148.2, Montreal, QC, H3G 1A4, Canada.
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Jarrah RM, Potes MDA, Vitija X, Durrani S, Ghaith AK, Mualem W, Zamanian C, Bhandarkar AR, Bydon M. Alginate hydrogels: A potential tissue engineering intervention for intervertebral disc degeneration. J Clin Neurosci 2023; 113:32-37. [PMID: 37159956 DOI: 10.1016/j.jocn.2023.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 05/11/2023]
Abstract
Intervertebral disc (IVD) degeneration is a major cause of low back pain and disability, affecting millions of people worldwide. Current treatments for IVD degeneration are limited to invasive surgery or pain management. Recently, there has been increasing interest in the use of biomaterials, such as alginate hydrogels, for the treatment of IVD degeneration. Alginate hydrogels are an example of such a biomaterial that is biocompatible and can be tailored to mimic the native extracellular matrix of the IVD. Derived from alginate, a naturally derived polysaccharide from brown seaweed that can be transformed into a gelatinous solution, alginate hydrogels are emerging in the field of tissue engineering. They can be used to deliver therapeutic agents, such as growth factors or cells, to the site of injury, providing a localized and sustained release that may enhance treatment outcomes. This paper provides an overview on the use of alginate hydrogels for the treatment of IVD degeneration. We discuss the properties of alginate hydrogels and their potential applications for IVD regeneration, including the mechanism against IVD degeneration. We also highlight the research outcomes to date along with the challenges and limitations of using alginate hydrogels for IVD regeneration, including their mechanical properties, biocompatibility, and surgical compatibility. Overall, this review paper aims to provide a comprehensive overview of the current research on alginate hydrogels for IVD degeneration and to identify future directions for research in this area.
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Affiliation(s)
- Ryan M Jarrah
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA; Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Maria D Astudillo Potes
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA; Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Xheneta Vitija
- Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA; College of Engineering, Michigan State University, East Lansing, MI, USA
| | - Sulaman Durrani
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA; Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Abdul Karim Ghaith
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA; Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
| | - William Mualem
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA; Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Cameron Zamanian
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA; Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Archis R Bhandarkar
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA; Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Mohamad Bydon
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA; Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA.
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Yamada K, Iwasaki N, Sudo H. Biomaterials and Cell-Based Regenerative Therapies for Intervertebral Disc Degeneration with a Focus on Biological and Biomechanical Functional Repair: Targeting Treatments for Disc Herniation. Cells 2022; 11:602. [PMID: 35203253 PMCID: PMC8870062 DOI: 10.3390/cells11040602] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/22/2022] [Accepted: 02/07/2022] [Indexed: 12/11/2022] Open
Abstract
Intervertebral disc (IVD) degeneration is a common cause of low back pain and most spinal disorders. As IVD degeneration is a major obstacle to the healthy life of so many individuals, it is a major issue that needs to be overcome. Currently, there is no clinical treatment for the regeneration of degenerated IVDs. However, recent advances in regenerative medicine and tissue engineering suggest the potential of cell-based and/or biomaterial-based IVD regeneration therapies. These treatments may be indicated for patients with IVDs in the intermediate degenerative stage, a point where the number of viable cells decreases, and the structural integrity of the disc begins to collapse. However, there are many biological, biomechanical, and clinical challenges that must be overcome before the clinical application of these IVD regeneration therapies can be realized. This review summarizes the basic research and clinical trials literature on cell-based and biomaterial-based IVD regenerative therapies and outlines the important role of these strategies in regenerative treatment for IVD degenerative diseases, especially disc herniation.
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Affiliation(s)
- Katsuhisa Yamada
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (K.Y.); (N.I.)
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (K.Y.); (N.I.)
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
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Architecture-Promoted Biomechanical Performance-Tuning of Tissue-Engineered Constructs for Biological Intervertebral Disc Replacement. MATERIALS 2021; 14:ma14102692. [PMID: 34065565 PMCID: PMC8160686 DOI: 10.3390/ma14102692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 12/26/2022]
Abstract
Background: Biological approaches to intervertebral disc (IVD) restoration and/or regeneration have become of increasing interest. However, the IVD comprises a viscoelastic system whose biological replacement remains challenging. The present study sought to design load-sharing two-component model systems of circular, nested, concentric elements reflecting the nucleus pulposus and annulus fibrosus. Specifically, we wanted to investigate the effect of architectural design variations on (1) model system failure loads when testing the individual materials either separately or homogeneously mixed, and (2) also evaluate the potential of modulating other mechanical properties of the model systems. Methods: Two sets of softer and harder biomaterials, 0.5% and 5% agarose vs. 0.5% agarose and gelatin, were used for fabrication. Architectural design variations were realized by varying ring geometries and amounts while keeping the material composition across designs comparable. Results: Variations in the architectural design, such as lamellar width, number, and order, combined with choosing specific biomaterial properties, strongly influenced the biomechanical performance of IVD constructs. Biomechanical characterization revealed that the single most important parameter, in which the model systems vastly exceeded those of the individual materials, was failure load. The model system failure loads were 32.21- and 84.11-fold higher than those of the agarose materials and 55.03- and 2.14-fold higher than those of the agarose and gelatin materials used for system fabrication. The compressive strength, dynamic stiffness, and viscoelasticity of the model systems were always in the range of the individual materials. Conclusions: Relevant architecture-promoted biomechanical performance-tuning of tissue-engineered constructs for biological IVD replacement can be realized by slight modifications in the design of constructs while preserving the materials’ compositions. Minimal variations in the architectural design can be used to precisely control structure–function relations for IVD constructs rather than choosing different materials. These fundamental findings have important implications for efficient tissue-engineering of IVDs and other load-bearing tissues, as potential implants need to withstand high in situ loads.
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Guerrero J, Häckel S, Croft AS, Albers CE, Gantenbein B. The effects of 3D culture on the expansion and maintenance of nucleus pulposus progenitor cell multipotency. JOR Spine 2021; 4:e1131. [PMID: 33778405 PMCID: PMC7984018 DOI: 10.1002/jsp2.1131] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/29/2020] [Accepted: 11/04/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Low back pain (LBP) is a global health concern. Increasing evidence implicates intervertebral disk (IVD) degeneration as a major contributor. In this respect, tissue-specific progenitors may play a crucial role in tissue regeneration, as these cells are perfectly adapted to their niche. Recently, a novel progenitor cell population was described in the nucleus pulposus (NP) that is positive for Tie2 marker. These cells have self-renewal capacity and in vitro multipotency potential. However, extremely low numbers of the NP progenitors limit the feasibility of cell therapy strategies. OBJECTIVE Here, we studied the influence of the culture method and of the microenvironment on the proliferation rate and the differentiation potential of human NP progenitors in vitro. METHOD Cells were obtained from human NP tissue from trauma patients. Briefly, the NP tissue cells were cultured in two-dimensional (2D) (monolayer) or three-dimensional (3D) (alginate beads) conditions. After 1 week, cells from 2D or 3D culture were expanded on fibronectin-coated flasks. Subsequently, expanded NP cells were then characterized by cytometry and tri-lineage differentiation, which was analyzed by qPCR and histology. Moreover, experiments using Tie2+ and Tie2- NP cells were also performed. RESULTS The present study aims to demonstrate that 3D expansion of NP cells better preserves the Tie2+ cell populations and increases the chondrogenic and osteogenic differentiation potential compared to 2D expansion. Moreover, the cell sorting experiments reveal that only Tie2+ cells were able to maintain the pluripotent gene expression if cultured in 3D within alginate beads. Therefore, our results highly suggest that the maintenance of the cell's multipotency is mainly, but not exclusively, due to the higher presence of Tie2+ cells due to 3D culture. CONCLUSION This project not only might have a scientific impact by evaluating the influence of a two-step expansion protocol on the functionality of NP progenitors, but it could also lead to an innovative clinical approach.
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Affiliation(s)
- Julien Guerrero
- Tissue Engineering for Orthopaedics & Mechanobiology, Department for BioMedical Research (DBMR) of the Faculty of Medicine of the University of BernUniversity of BernSwitzerland
| | - Sonja Häckel
- Department of Orthopaedic Surgery & Traumatology, InselspitalBern University HospitalBernSwitzerland
| | - Andreas S. Croft
- Tissue Engineering for Orthopaedics & Mechanobiology, Department for BioMedical Research (DBMR) of the Faculty of Medicine of the University of BernUniversity of BernSwitzerland
| | - Christoph E. Albers
- Department of Orthopaedic Surgery & Traumatology, InselspitalBern University HospitalBernSwitzerland
| | - Benjamin Gantenbein
- Tissue Engineering for Orthopaedics & Mechanobiology, Department for BioMedical Research (DBMR) of the Faculty of Medicine of the University of BernUniversity of BernSwitzerland
- Department of Orthopaedic Surgery & Traumatology, InselspitalBern University HospitalBernSwitzerland
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Schmitz TC, Salzer E, Crispim JF, Fabra GT, LeVisage C, Pandit A, Tryfonidou M, Maitre CL, Ito K. Characterization of biomaterials intended for use in the nucleus pulposus of degenerated intervertebral discs. Acta Biomater 2020; 114:1-15. [PMID: 32771592 DOI: 10.1016/j.actbio.2020.08.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/06/2020] [Accepted: 08/03/2020] [Indexed: 12/19/2022]
Abstract
Biomaterials for regeneration of the intervertebral disc must meet complex requirements conforming to biological, mechanical and clinical demands. Currently no consensus on their characterization exists. It is crucial to identify parameters and their method of characterization for accurate assessment of their potential efficacy, keeping in mind the translation towards clinical application. This review systematically analyses the characterization techniques of biomaterial systems that have been used for nucleus pulposus (NP) restoration and regeneration. Substantial differences in the approach towards assessment became evident, hindering comparisons between different materials with respect to their suitability for NP restoration and regeneration. We have analysed the current approaches and identified parameters necessary for adequate biomaterial characterization, with the clinical goal of functional restoration and biological regeneration of the NP in mind. Further, we provide guidelines and goals for their measurement. STATEMENT OF SIGNIFICANCE: Biomaterials intended for restoration of regeneration of the nucleus pulposus within the intervertebral disc must meet biological, biomechanical and clinical demands. Many materials have been investigated, but a lack of consensus on which parameters to evaluate leads to difficulties in comparing materials as well as mostly partial characterization of the materials in question. A gap between current methodology and clinically relevant and meaningful characterization is prevalent. In this article, we identify necessary methods and their implementation for complete biomaterial characterization in the context of clinical applicability. This will allow for a more unified approach to NP-biomaterials research within the field as a whole and enable comparative analysis of novel materials yet to be developed.
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Affiliation(s)
- Tara C Schmitz
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, Netherlands.
| | - Elias Salzer
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, Netherlands.
| | - João F Crispim
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, Netherlands.
| | - Georgina Targa Fabra
- Centre for Research in Medical Devices (CÚRAM), National University of Ireland Galway, 7WQJ+8F Galway, Ireland.
| | - Catherine LeVisage
- Université de Nantes, INSERM UMR 1229, Regenerative Medicine and Skeleton, RMeS School of Dental Surgery, University of Nantes, 1 Place Ricordeau, 44300 Nantes, France.
| | - Abhay Pandit
- Centre for Research in Medical Devices (CÚRAM), National University of Ireland Galway, 7WQJ+8F Galway, Ireland.
| | - Marianna Tryfonidou
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, Netherlands.
| | - Christine Le Maitre
- Biomolecular Sciences Research Centre Sheffield Hallam University, City Campus, Howard Street, S1 1WB Sheffield, United Kingdom.
| | - Keita Ito
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, Netherlands.
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Tang G, Zhou B, Li F, Wang W, Liu Y, Wang X, Liu C, Ye X. Advances of Naturally Derived and Synthetic Hydrogels for Intervertebral Disk Regeneration. Front Bioeng Biotechnol 2020; 8:745. [PMID: 32714917 PMCID: PMC7344321 DOI: 10.3389/fbioe.2020.00745] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/10/2020] [Indexed: 12/15/2022] Open
Abstract
Intervertebral disk (IVD) degeneration is associated with most cases of cervical and lumbar spine pathologies, amongst which chronic low back pain has become the primary cause for loss of quality-adjusted life years. Biomaterials science and tissue engineering have made significant progress in the replacement, repair and regeneration of IVD tissue, wherein hydrogel has been recognized as an ideal biomaterial to promote IVD regeneration in recent years. Aspects such as ease of use, mechanical properties, regenerative capacity, and their applicability as carriers for regenerative and anti-degenerative factors determine their suitability for IVD regeneration. This current review provides an overview of naturally derived and synthetic hydrogels that are related to their clinical applications for IVD regeneration. Although each type has its own unique advantages, it rarely becomes a standard product in truly clinical practice, and a more rational design is proposed for future use of biomaterials for IVD regeneration. This review aims to provide a starting point and inspiration for future research work on development of novel biomaterials and biotechnology.
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Affiliation(s)
- Guoke Tang
- Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
- Department of Spine Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medical CSU, Zhuzhou, China
| | - Bingyan Zhou
- Department of Spine Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medical CSU, Zhuzhou, China
| | - Feng Li
- Department of Spine Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medical CSU, Zhuzhou, China
| | - Weiheng Wang
- Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yi Liu
- Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xing Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Chao Liu
- Department of Spine Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medical CSU, Zhuzhou, China
| | - Xiaojian Ye
- Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Growney EA, Linder HR, Garg K, Bledsoe JG, Sell SA. Bio-conjugation of platelet-rich plasma and alginate through carbodiimide chemistry for injectable hydrogel therapies. J Biomed Mater Res B Appl Biomater 2019; 108:1972-1984. [PMID: 31846217 DOI: 10.1002/jbm.b.34538] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/04/2019] [Accepted: 11/29/2019] [Indexed: 01/19/2023]
Abstract
Alginate is a highly tailorable, biocompatible polymer whose properties can be tuned to mimic the properties of native nucleus pulposus (NP) tissue. Platelet-rich plasma (PRP) is a highly accessible, inexpensive, and readily available mix of pro-regenerative factors. By functionalizing alginate with PRP, a mechanically optimized, bioactive alginate NP analogue may stimulate NP cells to proliferate and accumulate matrix over a longer period of time than if the PRP were solely encapsulated within the hydrogel. In this study, PRP was chemically bound to alginate using carbodiimide chemistry and mechanically, physically, and cytologically compared to plain alginate as well as alginate containing free-floating lyophilized PRP. The alginates were mechanically and physically characterized; PRP-conjugated alginate had similar mechanical properties to controls and had the benefit of retained PRP proteins within the hydrogel. Human nucleus pulposus cells (hNPCs) were seeded within the modified alginates and cultured for 14 days. Quantification data of glycosaminoglycans suggests that PRP-incorporated alginate has the potential to increase ECM production within the characterized alginate constructs, and that PRP-functionalized alginate can retain protein within the hydrogel over time. This is the first study to functionalize the milieu of PRP proteins onto alginate and characterize the mechanical and physical properties of the modified alginates. This study also incorporates hNPCs into the characterized PRP-modified alginates to observe phenotypic maintenance when encapsulated within the in situ gelling constructs.
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Affiliation(s)
- Emily A Growney
- Centre for Research in Medical Devices (CÙRAM), National University of Ireland Galway, Galway, Ireland.,Department of Biomedical Engineering, Parks College of Engineering, Aviation & Technology, Saint Louis University, St. Louis, Missouri
| | - Houston R Linder
- Department of Biomedical Engineering, Parks College of Engineering, Aviation & Technology, Saint Louis University, St. Louis, Missouri
| | - Koyal Garg
- Department of Biomedical Engineering, Parks College of Engineering, Aviation & Technology, Saint Louis University, St. Louis, Missouri
| | - J Gary Bledsoe
- Department of Biomedical Engineering, Parks College of Engineering, Aviation & Technology, Saint Louis University, St. Louis, Missouri
| | - Scott A Sell
- Department of Biomedical Engineering, Parks College of Engineering, Aviation & Technology, Saint Louis University, St. Louis, Missouri
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Giz AS, Aydelik-Ayazoglu S, Catalgil-Giz H, Bayraktar H, Alaca BE. Stress relaxation and humidity dependence in sodium alginate-glycerol films. J Mech Behav Biomed Mater 2019; 100:103374. [DOI: 10.1016/j.jmbbm.2019.103374] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/12/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
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Mantha S, Pillai S, Khayambashi P, Upadhyay A, Zhang Y, Tao O, Pham HM, Tran SD. Smart Hydrogels in Tissue Engineering and Regenerative Medicine. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E3323. [PMID: 31614735 PMCID: PMC6829293 DOI: 10.3390/ma12203323] [Citation(s) in RCA: 353] [Impact Index Per Article: 70.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 01/01/2023]
Abstract
The field of regenerative medicine has tremendous potential for improved treatment outcomes and has been stimulated by advances made in bioengineering over the last few decades. The strategies of engineering tissues and assembling functional constructs that are capable of restoring, retaining, and revitalizing lost tissues and organs have impacted the whole spectrum of medicine and health care. Techniques to combine biomimetic materials, cells, and bioactive molecules play a decisive role in promoting the regeneration of damaged tissues or as therapeutic systems. Hydrogels have been used as one of the most common tissue engineering scaffolds over the past two decades due to their ability to maintain a distinct 3D structure, to provide mechanical support for the cells in the engineered tissues, and to simulate the native extracellular matrix. The high water content of hydrogels can provide an ideal environment for cell survival, and structure which mimics the native tissues. Hydrogel systems have been serving as a supportive matrix for cell immobilization and growth factor delivery. This review outlines a brief description of the properties, structure, synthesis and fabrication methods, applications, and future perspectives of smart hydrogels in tissue engineering.
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Affiliation(s)
- Somasundar Mantha
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada.
| | - Sangeeth Pillai
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada.
| | - Parisa Khayambashi
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada.
| | - Akshaya Upadhyay
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada.
| | - Yuli Zhang
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada.
| | - Owen Tao
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada.
| | - Hieu M Pham
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada.
| | - Simon D Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada.
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12
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Krouwels A, Melchels FPW, van Rijen MHP, Öner FC, Dhert WJA, Tryfonidou MA, Creemers LB. Comparing Hydrogels for Human Nucleus Pulposus Regeneration: Role of Osmolarity During Expansion. Tissue Eng Part C Methods 2018; 24:222-232. [PMID: 29457534 DOI: 10.1089/ten.tec.2017.0226] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Hydrogels can facilitate nucleus pulposus (NP) regeneration, either for clinical application or research into mechanisms of regeneration. However, many different hydrogels and culture conditions for human degenerated NP have been employed, making literature data difficult to compare. Therefore, we compared six different hydrogels of natural polymers and investigated the role of serum in the medium and of osmolarity during expansion or redifferentiation in an attempt to provide comparators for future studies. Human NP cells of Thompson grade III discs were cultured in alginate, agarose, fibrin, type II collagen, gelatin methacryloyl (gelMA), and hyaluronic acid-poly(ethylene glycol) hydrogels. Medium containing fetal bovine serum and a serum-free (SF) medium were compared in agarose, gelMA, and type II collagen hydrogels. Isolation and expansion of NP cells in low compared to high osmolarity medium were performed before culture in agarose and type II collagen hydrogels in media of varying osmolarity. NP cells in agarose produced the highest amounts of proteoglycans, followed by cells in type II collagen hydrogels. The absence of serum reduced the total amount of proteoglycans produced by the cells, although incorporation efficiency was higher in type II collagen hydrogels in the absence than in the presence of serum. Isolation and expansion of NP cells in high osmolarity medium improved proteoglycan production during culture in hydrogels, but variation in osmolarity during redifferentiation did not have any effect. Agarose hydrogels seem to be the best option for in vitro culture of human NP cells, but for clinical application, type II collagen hydrogels may be better because, as opposed to agarose, it degrades in time. Although culture in SF medium reduces the amount of proteoglycans produced during redifferentiation culture, isolating and expanding the cells in high osmolarity medium can largely compensate for this loss.
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Affiliation(s)
- Anita Krouwels
- 1 Department of Orthopedics, University Medical Center Utrecht , Utrecht, The Netherlands
| | - Ferry P W Melchels
- 2 Institute of Biological Chemistry, Department of Biophysics and Bioengineering, School of Engineering and Physical Sciences, Heriot-Watt University , Edinburgh, United Kingdom
| | - Mattie H P van Rijen
- 1 Department of Orthopedics, University Medical Center Utrecht , Utrecht, The Netherlands
| | - F Cumhur Öner
- 1 Department of Orthopedics, University Medical Center Utrecht , Utrecht, The Netherlands
| | - Wouter J A Dhert
- 3 Faculty of Veterinary Medicine, Utrecht University , Utrecht, The Netherlands
| | - Marianna A Tryfonidou
- 4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University , Utrecht, The Netherlands
| | - Laura B Creemers
- 1 Department of Orthopedics, University Medical Center Utrecht , Utrecht, The Netherlands
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13
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Focal adhesion signaling affects regeneration by human nucleus pulposus cells in collagen- but not carbohydrate-based hydrogels. Acta Biomater 2018; 66:238-247. [PMID: 29174589 DOI: 10.1016/j.actbio.2017.11.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 10/26/2017] [Accepted: 11/17/2017] [Indexed: 01/07/2023]
Abstract
Hydrogel-based 3D cell cultures are an emerging strategy for the regeneration of cartilage. In an attempt to regenerate dysfunctional intervertebral discs, nucleus pulposus (NP) cells can be cultured in hydrogels of various kinds and physical properties. Stiffness sensing through focal adhesions is believed to direct chondrogenesis, but the mechanisms by which this works are largely unknown. In this study we compared focal adhesion formation and glycosaminoglycan (GAG) deposition by NP cells in a range of hydrogels. Using a focal adhesion kinase (FAK) inhibitor, we demonstrated that focal adhesion signaling is involved in the response of NP cells in hydrogels that contain integrin binding sites (i.e. methacrylated gelatin (gelMA) and type II collagen), but not in hydrogels deplete from integrin binding sites such as alginate and agarose, or CD44-binding hydrogels based on hyaluronic acid. As a result of FAK inhibition we observedenhanced proteoglycan production in gelMA, but decreased production in type II collagen hydrogels, which could be explained by alteration in cell fate as supported by the increase in the adipogenic marker peroxisome proliferator-activated receptor gamma (PPARy). Furthermore, GAG deposition was inversely proportional to polymer concentration in integrin-binding gelMA, while no direct relationship was found for the non-integrin binding gels alginate and agarose. This corroborates our finding that focal adhesion formation plays an important role in NP cell response to its surrounding matrix. STATEMENT OF SIGNIFICANCE Biomaterials are increasingly being investigated for regenerative medicine applications, including regeneration of the nucleus pulposus. Cells interact with their environment and are influenced by extracellular matrix or polymer properties. Insight in these interactions can improve regeneration and helps to understand degeneration processes. The role of focal adhesion formation in the regenerative response of nucleus pulposus cells is largely unknown. Therefore, the relation between materials, stiffness and focal adhesion formation is studied here.
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14
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van Uden S, Silva-Correia J, Oliveira JM, Reis RL. Current strategies for treatment of intervertebral disc degeneration: substitution and regeneration possibilities. Biomater Res 2017; 21:22. [PMID: 29085662 PMCID: PMC5651638 DOI: 10.1186/s40824-017-0106-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 10/05/2017] [Indexed: 02/06/2023] Open
Abstract
Background Intervertebral disc degeneration has an annual worldwide socioeconomic impact masked as low back pain of over 70 billion euros. This disease has a high prevalence over the working age class, which raises the socioeconomic impact over the years. Acute physical trauma or prolonged intervertebral disc mistreatment triggers a biochemical negative tendency of catabolic-anabolic balance that progress to a chronic degeneration disease. Current biomedical treatments are not only ineffective in the long-run, but can also cause degeneration to spread to adjacent intervertebral discs. Regenerative strategies are desperately needed in the clinics, such as: minimal invasive nucleus pulposus or annulus fibrosus treatments, total disc replacement, and cartilaginous endplates decalcification. Main body Herein, it is reviewed the state-of-the-art of intervertebral disc regeneration strategies from the perspective of cells, scaffolds, or constructs, including both popular and unique tissue engineering approaches. The premises for cell type and origin selection or even absence of cells is being explored. Choice of several raw materials and scaffold fabrication methods are evaluated. Extensive studies have been developed for fully regeneration of the annulus fibrosus and nucleus pulposus, together or separately, with a long set of different rationales already reported. Recent works show promising biomaterials and processing methods applied to intervertebral disc substitutive or regenerative strategies. Facing the abundance of studies presented in the literature aiming intervertebral disc regeneration it is interesting to observe how cartilaginous endplates have been extensively neglected, being this a major source of nutrients and water supply for the whole disc. Conclusion Several innovative avenues for tackling intervertebral disc degeneration are being reported – from acellular to cellular approaches, but the cartilaginous endplates regeneration strategies remain unaddressed. Interestingly, patient-specific approaches show great promise in respecting patient anatomy and thus allow quicker translation to the clinics in the near future.
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Affiliation(s)
- Sebastião van Uden
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR Gandra, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga Portugal.,Present Address: Bioengineering Laboratories Srl, Viale Brianza 8, Meda, Italy.,Present Address: Politecnico di Milano, Piazza Leonardo da Vinci, 32 Milan, Italy
| | - Joana Silva-Correia
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR Gandra, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga Portugal
| | - Joaquim Miguel Oliveira
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR Gandra, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga Portugal.,The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, 4805-017 Barco Guimarães, Portugal
| | - Rui Luís Reis
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR Gandra, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga Portugal.,The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, 4805-017 Barco Guimarães, Portugal
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15
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Growney Kalaf EA, Pendyala M, Bledsoe JG, Sell SA. Characterization and restoration of degenerated IVD function with an injectable, in situ gelling alginate hydrogel: An in vitro and ex vivo study. J Mech Behav Biomed Mater 2017; 72:229-240. [DOI: 10.1016/j.jmbbm.2017.05.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 03/20/2017] [Accepted: 05/06/2017] [Indexed: 12/30/2022]
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16
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Vedicherla S, Buckley CT. In vitro extracellular matrix accumulation of nasal and articular chondrocytes for intervertebral disc repair. Tissue Cell 2017; 49:503-513. [PMID: 28515001 DOI: 10.1016/j.tice.2017.05.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 04/26/2017] [Accepted: 05/05/2017] [Indexed: 12/26/2022]
Abstract
Chondrocyte based regenerative therapies for intervertebral disc repair such as Autologous Disc Cell Transplantation (ADCT, CODON) and allogeneic juvenile chondrocyte implantation (NuQu®, ISTO Technologies) have demonstrated good outcomes in clinical trials. However concerns remain with the supply demand reconciliation and issues surrounding immunoreactivity which exist for allogeneic-type technologies. The use of stem cells is challenging due to high growth factor requirements, regulatory barriers and differentiation towards a stable phenotype. Therefore, there is a need to identify alternative non-disc cell sources for the development and clinical translation of next generation therapies for IVD regeneration. In this study, we compared Nasal Chondrocytes (NC) as a non-disc alternative chondrocyte source with Articular Chondrocytes (AC) in terms of cell yield, morphology, proliferation kinetics and ability to produce key extracellular matrix components under 5% and 20% oxygen conditions, with and without exogenous TGF-β supplementation. Results indicated that NC maintained proliferative capacity with high amounts of sGAG and lower collagen accumulation in the absence of TGF-β supplementation under 5% oxygen conditions. Importantly, osteogenesis and calcification was inhibited for NC when cultured in IVD-like microenvironmental conditions. The present study provides a rationale for the exploration of nasal chondrocytes as a promising, potent and clinically feasible autologous cell source for putative IVD repair strategies.
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Affiliation(s)
- S Vedicherla
- Trinity Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Ireland; School of Medicine, Trinity College Dublin, Ireland
| | - C T Buckley
- Trinity Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Ireland; School of Medicine, Trinity College Dublin, Ireland; Department of Mechanical and Manufacturing Engineering, School of Engineering, Trinity College Dublin, Ireland; Advanced Materials and Bioengineering Research (AMBER) Centre, Royal College of Surgeons in Ireland & Trinity College Dublin, Ireland.
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17
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de la Portilla F, Pereira S, Molero M, De Marco F, Perez-Puyana V, Guerrero A, Romero A. Microstructural, mechanical, and histological evaluation of modified alginate-based scaffolds. J Biomed Mater Res A 2016; 104:3107-3114. [PMID: 27506966 DOI: 10.1002/jbm.a.35857] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/01/2016] [Accepted: 08/05/2016] [Indexed: 12/16/2022]
Abstract
Scaffolds are three-dimensional structures used for tissue regeneration being the base in tissue engineering. These scaffolds are obtained from natural and/or synthetic polymers and they should satisfy some specific requirements such as biocompatibility, suitable mechanical, and microstructural properties to favor cellular adhesion and neovascularization. This work shows a preclinic study about the production of low and medium molecular weight alginate through the use of calcium salts (calcium glutamate). The results showed prove that better structures, distribution, and pore sizes as well as better mechanical properties correspond to medium molecular weight alginate and higher calcium salts concentration. This type of scaffold, after muscular cells cultivation, has been proved as an excellent material for muscle growth. The histopathological analysis shows a low inflammatory response, without a foreign body reaction, suitable neovascularization and good fibroblasts incorporation. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 3107-3114, 2016.
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Affiliation(s)
- F de la Portilla
- Department of General and Digestive Surgery, Unit Colorrectal Surgery, "Virgen del Rocío" University Hospital/IBiS/CSIC/University of Seville, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD o Ciberehd), Instituto de Salud Carlos III, Spain
| | - S Pereira
- Institute of Biomedicine of Seville (IBiS), "Virgen del Rocío" University Hospital/IBiS/CSIC/University of Seville, Seville, Spain
| | - M Molero
- Department of Physical Chemistry, Faculty of Chemistry, University of Seville, Sevilla, Spain
| | - F De Marco
- Institute of Biomedicine of Seville (IBiS), "Virgen del Rocío" University Hospital/IBiS/CSIC/University of Seville, Seville, Spain
| | - V Perez-Puyana
- Department of Chemical Engineering, Faculty of Chemistry, University of Seville, Sevilla, Spain
| | - A Guerrero
- Department of Chemical Engineering, Faculty of Chemistry, University of Seville, Sevilla, Spain
| | - A Romero
- Department of Chemical Engineering, Faculty of Chemistry, University of Seville, Sevilla, Spain.
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18
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Kook YM, Kang YM, Moon SH, Koh WG. Bi-compartmental 3D scaffolds for the co-culture of intervertebral disk cells and mesenchymal stem cells. J IND ENG CHEM 2016. [DOI: 10.1016/j.jiec.2016.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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19
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Zukas BG, Gupta NR. Improved Water Barrier Properties of Calcium Alginate Capsules Modified by Silicone Oil. Gels 2016; 2:gels2020014. [PMID: 30674146 PMCID: PMC6318625 DOI: 10.3390/gels2020014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/28/2016] [Accepted: 04/01/2016] [Indexed: 12/21/2022] Open
Abstract
Calcium alginate films generally offer poor diffusion resistance to water. In this study, we present a technique for encapsulating aqueous drops in a modified calcium alginate membrane made from an emulsion of silicone oil and aqueous alginate solution and explore its effect on the loss of water from the capsule cores. The capsule membrane storage modulus increases as the initial concentration of oil in the emulsion is increased. The water barrier properties of the fabricated capsules were determined by observing the mass loss of capsules in a controlled environment. It was found that capsules made with emulsions containing 50 wt% silicone oil were robust while taking at least twice the time to dry completely as compared to capsules made from only an aqueous alginate solution. The size of the oil droplets in the emulsion also has an effect on the water barrier properties of the fabricated capsules. This study demonstrates a facile method of producing aqueous core alginate capsules with a modified membrane that improves the diffusion resistance to water and can have a wide range of applications.
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Affiliation(s)
- Brian G Zukas
- Department of Chemical Engineering, University of New Hampshire, Durham, NH 03824, USA.
| | - Nivedita R Gupta
- Department of Chemical Engineering, University of New Hampshire, Durham, NH 03824, USA.
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20
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Growney Kalaf EA, Flores R, Bledsoe JG, Sell SA. Characterization of slow-gelling alginate hydrogels for intervertebral disc tissue-engineering applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 63:198-210. [PMID: 27040212 DOI: 10.1016/j.msec.2016.02.067] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/27/2016] [Accepted: 02/22/2016] [Indexed: 11/25/2022]
Abstract
Reversal of intervertebral disc degeneration can have a potentially monumental effect on spinal health. As such, the goal of this research is to create an injectable, cellularized alginate-based nucleus pulposus that will restore disc function; with the primary goal of creating an alginate gel with tailorable rates of gelation to improve functionality over standard CaCl2 crosslinking techniques. Gelation characteristics of 1% sodium alginate were analyzed over various molar concentrations of a 1:2 ratio of CaCO3:glucono-δ-lactone (GDL), with 10% CaCl2 as the control crosslinker. Alginate construct characterization for all concentrations was performed via ultimate and cyclic compressive testing over a 28day degradation period in PBS. Dehydration, swell testing, and albumin release kinetics were determined, and cytotoxicity and cell homogeneity tests showed promise for cellularization strategies. Overall, the 30 and 60mM GDL alginate concentrations presented the most viable option for use in further studies, with a gelation time between 10 and 30min, low hysteresis over control, low percent change in thickness and weight under both PBS degradation and swelling conditions, and stable mechanical properties over 28days in vitro.
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Affiliation(s)
- Emily A Growney Kalaf
- Parks College of Engineering, Aviation & Technology, Department of Biomedical Engineering, Saint Louis University, 3507 Lindell Boulevard, St. Louis, MO 63103, USA
| | - Reynaldo Flores
- Parks College of Engineering, Aviation & Technology, Department of Biomedical Engineering, Saint Louis University, 3507 Lindell Boulevard, St. Louis, MO 63103, USA
| | - J Gary Bledsoe
- Parks College of Engineering, Aviation & Technology, Department of Biomedical Engineering, Saint Louis University, 3507 Lindell Boulevard, St. Louis, MO 63103, USA
| | - Scott A Sell
- Parks College of Engineering, Aviation & Technology, Department of Biomedical Engineering, Saint Louis University, 3507 Lindell Boulevard, St. Louis, MO 63103, USA.
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21
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Morelli A, Betti M, Puppi D, Bartoli C, Gazzarri M, Chiellini F. Enzymatically Crosslinked Ulvan Hydrogels as Injectable Systems for Cell Delivery. MACROMOL CHEM PHYS 2015. [DOI: 10.1002/macp.201500353] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Andrea Morelli
- BIOLab Research Group; Department of Chemistry and Industrial Chemistry; University of Pisa; UdR-INSTM PISA via Moruzzi 13 56124 Pisa Italy
| | - Margherita Betti
- BIOLab Research Group; Department of Chemistry and Industrial Chemistry; University of Pisa; UdR-INSTM PISA via Moruzzi 13 56124 Pisa Italy
| | - Dario Puppi
- BIOLab Research Group; Department of Chemistry and Industrial Chemistry; University of Pisa; UdR-INSTM PISA via Moruzzi 13 56124 Pisa Italy
| | - Cristina Bartoli
- BIOLab Research Group; Department of Chemistry and Industrial Chemistry; University of Pisa; UdR-INSTM PISA via Moruzzi 13 56124 Pisa Italy
| | - Matteo Gazzarri
- BIOLab Research Group; Department of Chemistry and Industrial Chemistry; University of Pisa; UdR-INSTM PISA via Moruzzi 13 56124 Pisa Italy
| | - Federica Chiellini
- BIOLab Research Group; Department of Chemistry and Industrial Chemistry; University of Pisa; UdR-INSTM PISA via Moruzzi 13 56124 Pisa Italy
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22
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Lee JTY, Cheung KMC, Leung VYL. Systematic study of cell isolation from bovine nucleus pulposus: Improving cell yield and experiment reliability. J Orthop Res 2015; 33:1743-55. [PMID: 26036782 DOI: 10.1002/jor.22942] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 05/08/2015] [Indexed: 02/04/2023]
Abstract
Differences in matrix compositions in human nucleus pulposus (NP) clinical samples demand different cell isolation protocols for optimal results but there is no clear guide about this to date. Sub-optimal protocols may result in low cell yield, limited reliability of results or even failure of experiments. Cell yield, viability and attachment of cells isolated from bovine NP tissue with different protocols were estimated by cell counting, Trypan blue staining and cell culturing respectively. RNA was extracted from isolated cells and quantified by Nanodrop spectrometry and RT-qPCR. Higher collagenase concentration, longer digestion duration and pronase pre-treatment increased the cell yield. Cell viability remained high (<5% dead cells) even after 0.2% collagenase treatment for overnight. NP cells remained to have high ACAN, COL2A1, CDH2, KRT18, and KRT19 expression compared to muscle cells for different cell isolation conditions tested. Digestion by collagenase alone without the use of pronase could isolate cells from human degenerated NP tissue but clusters of cells were observed. We suggest the use of the disappearance of tissue as an indirect measure of cells released. This study provides a guide for researchers to decide the parameters involved in NP cell isolation for optimal outcome.
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Affiliation(s)
- Juliana T Y Lee
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Kenneth M C Cheung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Victor Y L Leung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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23
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Detiger SEL, de Bakker JY, Emanuel KS, Schmitz M, Vergroesen PPA, van der Veen AJ, Mazel C, Smit TH. Translational challenges for the development of a novel nucleus pulposus substitute: Experimental results from biomechanical and in vivo studies. J Biomater Appl 2015; 30:983-94. [PMID: 26494611 DOI: 10.1177/0885328215611946] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Nucleus pulposus replacement therapy could offer a less invasive alternative to restore the function of moderately degenerated intervertebral discs than current potentially destructive surgical procedures. Numerous nucleus pulposus substitutes have already been investigated, to assess their applicability for intradiscal use. Still, the current choice of testing methods often does not lead to efficient translation into clinical application. In this paper, we present the evaluation of a novel nucleus pulposus substitute, consisting of a hydromed core and an electrospun envelope. We performed three mechanical evaluations and an in vivo pilot experiment. Initially, the swelling pressure of the implant was assessed in confined compression. Next, we incorporated the implant into mechanically damaged caprine lumbar intervertebral discs to determine biomechanical segment behaviour in bending and torsion. Subsequently, segments were serially tested in native, damaged and repaired conditions under dynamic axial compressive loading regimes in a loaded disc culture system. Finally, nucleus pulposus substitutes were implanted in a live goat spine using a transpedicular approach. In confined compression, nucleus pulposus samples as well as implants showed some load-bearing capacity, but the implant exhibited a much lower absolute pressure. In bending and torsion, we found that the nucleus pulposus substitute could partly restore the mechanical response of the disc. During dynamic axial compression in the loaded disc culture system, on the other hand, the implant was not able to recover axial compressive behaviour towards the healthy situation. Moreover, the nucleus pulposus substitutes did not remain in place in the in vivo situation but migrated out of the disc area. From these results, we conclude that implants may mimic native disc behaviour in simple mechanical tests, yet fail in other, more realistic set-ups. Therefore, we recommend that biomaterials for nucleus pulposus replacement be tested in testing modalities of increasing complexity and in their relevant anatomical surroundings, for a more reliable prediction of clinical potential.
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Affiliation(s)
- S E L Detiger
- Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands Center for Translational Regenerative Medicine (CTRM) and MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - J Y de Bakker
- Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands Center for Translational Regenerative Medicine (CTRM) and MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - K S Emanuel
- Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands Center for Translational Regenerative Medicine (CTRM) and MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M Schmitz
- Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands Center for Translational Regenerative Medicine (CTRM) and MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - P P A Vergroesen
- Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands Center for Translational Regenerative Medicine (CTRM) and MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - A J van der Veen
- Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - C Mazel
- Department of Orthopaedic and Spine Surgery, Institute Mutualiste Montsouris, Paris, France
| | - T H Smit
- Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands Center for Translational Regenerative Medicine (CTRM) and MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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24
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Yang HY, van Ee RJ, Timmer K, Craenmehr EG, Huang JH, Öner FC, Dhert WJ, Kragten AH, Willems N, Grinwis GC, Tryfonidou MA, Papen-Botterhuis NE, Creemers LB. A novel injectable thermoresponsive and cytocompatible gel of poly(N-isopropylacrylamide) with layered double hydroxides facilitates siRNA delivery into chondrocytes in 3D culture. Acta Biomater 2015; 23:214-228. [PMID: 26022968 DOI: 10.1016/j.actbio.2015.05.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 05/14/2015] [Accepted: 05/18/2015] [Indexed: 01/12/2023]
Abstract
Hybrid hydrogels composed of poly(N-isopropylacrylamide) (pNIPAAM) and layered double hydroxides (LDHs) are presented in this study as novel injectable and thermoresponsive materials for siRNA delivery, which could specifically target several negative regulators of tissue homeostasis in cartilaginous tissues. Effectiveness of siRNA transfection using pNIPAAM formulated with either MgAl-LDH or MgFe-LDH platelets was investigated using osteoarthritic chondrocytes. Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was used as an endogenous model gene to evaluate the extent of silencing. No significant adverse effects of pNIPAAM/LDH hydrogels on cell viability were noticed. Cellular uptake of fluorescently labeled siRNA was greatly enhanced (>75%) in pNIPAAM/LDH hydrogel constructs compared to alginate, hyaluronan and fibrin gels, and was absent in pNIPAAM hydrogel without LDH platelets. When using siRNA against GAPDH, 82-98% reduction of gene expression was found in both types of pNIPAAM/LDH hydrogel constructs after 6 days of culturing. In the pNIPAAM/MgAl-LDH hybrid hydrogel, 80-95% of GAPDH enzyme activity was reduced in parallel with gene. Our findings show that the combination of a cytocompatible hydrogel and therapeutic RNA oligonucleotides is feasible. Thus it might hold promise in treating degeneration of cartilaginous tissues by providing supporting scaffolds for cells and interference with locally produced degenerative factors.
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25
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Cuadros TR, Erices AA, Aguilera JM. Porous matrix of calcium alginate/gelatin with enhanced properties as scaffold for cell culture. J Mech Behav Biomed Mater 2015; 46:331-42. [DOI: 10.1016/j.jmbbm.2014.08.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 08/20/2014] [Accepted: 08/27/2014] [Indexed: 10/24/2022]
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26
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Zeng Y, Chen C, Liu W, Fu Q, Han Z, Li Y, Feng S, Li X, Qi C, Wu J, Wang D, Corbett C, Chan BP, Ruan D, Du Y. Injectable microcryogels reinforced alginate encapsulation of mesenchymal stromal cells for leak-proof delivery and alleviation of canine disc degeneration. Biomaterials 2015; 59:53-65. [PMID: 25956851 DOI: 10.1016/j.biomaterials.2015.04.029] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 04/12/2015] [Accepted: 04/14/2015] [Indexed: 01/07/2023]
Abstract
In situ crosslinked thermo-responsive hydrogel applied for minimally invasive treatment of intervertebral disc degeneration (IVDD) may not prevent extrusion of cell suspension from injection site due to high internal pressure of intervertebral disc (IVD), causing treatment failure or osteophyte formation. In this study, mesenchymal stromal cells (MSCs) were encapsulated in alginate precursor and loaded into previously developed macroporous PGEDA-derived microcryogels (PMs) to form three-dimensional (3D) microscale cellular niches, enabling non-thermo-responsive alginate hydrogel to be injectable. The PMs reinforced alginate hydrogel showed superior elasticity compared to alginate hydrogel alone and could well protect encapsulated cells through injection. Chondrogenic committed MSCs in the injectable microniches expressed higher level of nucleus pulposus (NP) cell markers compared to 2D cultured cells. In an ex vivo organ culture model, injection of MSCs-laden PMs into NP tissue prevented cell leakage, improved cell retention and survival compared to free cell injection. In canine IVDD models, alleviated degeneration was observed in MSCs-laden PMs treated group after six months which was superior to other treated groups. Our results provide in-depth demonstration of injectable alginate hydrogel reinforced by PMs as a leak-proof cell delivery system for augmented regenerative therapy of IVDD in canine models.
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Affiliation(s)
- Yang Zeng
- Department of Biomedical Engineering, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Tsinghua University, Beijing 100084, China
| | - Chun Chen
- Department of Orthopaedics, Navy General Hospital, Beijing 100048, China; Department of Orthopedic Surgery, First Affiliated Hospital, Wenzhou Medical University, Wenzhou 325000, China
| | - Wei Liu
- Department of Biomedical Engineering, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Tsinghua University, Beijing 100084, China
| | - Qinyouen Fu
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Zhihua Han
- Department of Orthopaedics, Navy General Hospital, Beijing 100048, China
| | - Yaqian Li
- Department of Biomedical Engineering, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Tsinghua University, Beijing 100084, China
| | - Siyu Feng
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Xiaokang Li
- Department of Biomedical Engineering, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Tsinghua University, Beijing 100084, China
| | - Chunxiao Qi
- Department of Biomedical Engineering, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Tsinghua University, Beijing 100084, China
| | - Jianhong Wu
- Department of Orthopaedics, Navy General Hospital, Beijing 100048, China
| | - Deli Wang
- Department of Orthopaedics, Navy General Hospital, Beijing 100048, China
| | - Christopher Corbett
- Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD 21231, USA
| | - Barbara P Chan
- Tissue Engineering Laboratory, Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Rd, Hong Kong Special Administrative Region, China
| | - Dike Ruan
- Department of Orthopaedics, Navy General Hospital, Beijing 100048, China.
| | - Yanan Du
- Department of Biomedical Engineering, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Tsinghua University, Beijing 100084, China.
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Thermogelling bioadhesive scaffolds for intervertebral disk tissue engineering: preliminary in vitro comparison of aldehyde-based versus alginate microparticle-mediated adhesion. Acta Biomater 2015; 16:71-80. [PMID: 25641647 DOI: 10.1016/j.actbio.2015.01.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 01/10/2015] [Accepted: 01/20/2015] [Indexed: 01/08/2023]
Abstract
Tissue engineering of certain load-bearing parts of the body can be dependent on scaffold adhesion or integration with the surrounding tissue to prevent dislocation. One such area is the regeneration of the intervertebral disc (IVD). In this work, poly(N-isopropylacrylamide) (PNIPAAm) was grafted with chondroitin sulfate (CS) (PNIPAAm-g-CS) and blended with aldehyde-modified CS to generate an injectable polymer that can form covalent bonds with tissue upon contact. However, the presence of the reactive aldehyde groups can compromise the viability of encapsulated cells. Thus, liposomes were encapsulated in the blend, designed to deliver the ECM derivative, gelatin, after the polymer has adhered to tissue and reached physiological temperature. This work is based on the hypothesis that the discharge of gelatin will enhance the biocompatibility of the material by covalently reacting with, or "end-capping", the aldehyde functionalities within the gel that did not participate in bonding with tissue upon contact. As a comparison, formulations were also created without CS aldehyde and with an alternative adhesion mediator, mucoadhesive calcium alginate particles. Gels formed from blends of PNIPAAm-g-CS and CS aldehyde exhibited increased adhesive strength compared to PNIPAAm-g-CS alone (p<0.05). However, the addition of gelatin-loaded liposomes to the blend significantly decreased the adhesive strength (p<0.05). The encapsulation of alginate microparticles within PNIPAAm-g-CS gels caused the tensile strength to increase twofold over that of PNIPAAm-g-CS blends with CS aldehyde (p<0.05). Cytocompatibility studies indicate that formulations containing alginate particles exhibit reduced cytotoxicity over those containing CS aldehyde. Overall, the results indicated that the adhesives composed of alginate microparticles encapsulated in PNIPAAm-g-CS have the potential to serve as a scaffold for IVD regeneration.
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Shape-memory porous alginate scaffolds for regeneration of the annulus fibrosus: effect of TGF-β3 supplementation and oxygen culture conditions. Acta Biomater 2014; 10:1985-95. [PMID: 24380722 DOI: 10.1016/j.actbio.2013.12.037] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 12/16/2013] [Accepted: 12/19/2013] [Indexed: 12/28/2022]
Abstract
Disc herniation as a result of degenerative or traumatic injury is believed to be the primary instigator of low back pain. At present there is a lack of viable treatment options to repair damaged annulus fibrosus (AF) tissue. Developing alternative strategies to fill and repair ruptured AF tissue is a key challenge. In this work we developed a porous alginate scaffold with shape-memory properties which can be delivered using minimally invasive approaches and recover its original geometry once hydrated. Covalently cross-linked alginate hydrogels were created using carbodiimide chemistry, followed by a freeze-drying step to impart porosity and create porous scaffolds. Results showed that porous alginate scaffolds exhibited shape-memory recovery and mechanical behaviour that could be modulated depending on the cross-linker concentrations. The scaffold can be repeatedly compressed and expanded, which provides the potential to deliver the biomaterial directly to the damaged area of the AF tissue. In vitro experiments demonstrated that scaffolds were cytocompatible and supported cell seeding, penetration and proliferation under intervertebral-disc-like microenvironmental conditions (low glucose media and low oxygen concentration). Extracellular matrix (ECM) was secreted by AF cells with TGF-β3 stimulation and after 21days had filled the porous scaffold network. This biological matrix was rich in sulfated glycosaminoglycan and collagen type I, which are the main compounds of native AF tissue. Successful ECM deposition was also confirmed by the increase in the peak stress of the scaffold. However, the immaturity of the matrix network after only 21days of in vitro culture was not sufficient to attain native AF tissue mechanical properties. The ability to deliver porous scaffolds using minimal invasive approaches that can potentially promote the regeneration of AF defects provides an exciting new avenue for disc repair.
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29
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Bidarra SJ, Barrias CC, Granja PL. Injectable alginate hydrogels for cell delivery in tissue engineering. Acta Biomater 2014; 10:1646-62. [PMID: 24334143 DOI: 10.1016/j.actbio.2013.12.006] [Citation(s) in RCA: 339] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 11/28/2013] [Accepted: 12/05/2013] [Indexed: 12/16/2022]
Abstract
Alginate hydrogels are extremely versatile and adaptable biomaterials, with great potential for use in biomedical applications. Their extracellular matrix-like features have been key factors for their choice as vehicles for cell delivery strategies aimed at tissue regeneration. A variety of strategies to decorate them with biofunctional moieties and to modulate their biophysical properties have been developed recently, which further allow their tailoring to the desired application. Additionally, their potential use as injectable materials offers several advantages over preformed scaffold-based approaches, namely: easy incorporation of therapeutic agents, such as cells, under mild conditions; minimally invasive local delivery; and high contourability, which is essential for filling in irregular defects. Alginate hydrogels have already been explored as cell delivery systems to enhance regeneration in different tissues and organs. Here, the in vitro and in vivo potential of injectable alginate hydrogels to deliver cells in a targeted fashion is reviewed. In each example, the selected crosslinking approach, the cell type, the target tissue and the main findings of the study are highlighted.
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Affiliation(s)
- Sílvia J Bidarra
- INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal.
| | - Cristina C Barrias
- INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal.
| | - Pedro L Granja
- INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; FEUP - Faculdade de Engenharia da Universidade do Porto, Departamento de Engenharia Metalúrgica e de Materiais, Rua Dr. Roberto Frias, s/n, 4200-465 Porto, Portugal; ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
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30
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Foss BL, Maxwell TW, Deng Y. Chondroprotective supplementation promotes the mechanical properties of injectable scaffold for human nucleus pulposus tissue engineering. J Mech Behav Biomed Mater 2014; 29:56-67. [DOI: 10.1016/j.jmbbm.2013.08.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 08/08/2013] [Accepted: 08/13/2013] [Indexed: 12/27/2022]
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31
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Hunt JA, Chen R, van Veen T, Bryan N. Hydrogels for tissue engineering and regenerative medicine. J Mater Chem B 2014; 2:5319-5338. [DOI: 10.1039/c4tb00775a] [Citation(s) in RCA: 242] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Injectable hydrogels have become an incredibly prolific area of research in the field of tissue engineering and regenerative medicine, because of their high water content, mechanical similarity to natural tissues, and ease of surgical implantation, hydrogels are at the forefront of biomedical scaffold and drug carrier design.
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Affiliation(s)
- John A. Hunt
- Clinical Engineering
- Institute of Ageing and Chronic Disease
- University of Liverpool
- Liverpool, UK
| | - Rui Chen
- Clinical Engineering
- Institute of Ageing and Chronic Disease
- University of Liverpool
- Liverpool, UK
| | - Theun van Veen
- Clinical Engineering
- Institute of Ageing and Chronic Disease
- University of Liverpool
- Liverpool, UK
| | - Nicholas Bryan
- Clinical Engineering
- Institute of Ageing and Chronic Disease
- University of Liverpool
- Liverpool, UK
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32
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The application of fiber-reinforced materials in disc repair. BIOMED RESEARCH INTERNATIONAL 2013; 2013:714103. [PMID: 24383057 PMCID: PMC3870616 DOI: 10.1155/2013/714103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 11/18/2013] [Indexed: 01/08/2023]
Abstract
The intervertebral disc degeneration and injury are the most common spinal diseases with tremendous financial and social implications. Regenerative therapies for disc repair are promising treatments. Fiber-reinforced materials (FRMs) are a kind of composites by embedding the fibers into the matrix materials. FRMs can maintain the original properties of the matrix and enhance the mechanical properties. By now, there are still some problems for disc repair such as the unsatisfied static strength and dynamic properties for disc implants. The application of FRMs may resolve these problems to some extent. In this review, six parts such as background of FRMs in tissue repair, the comparison of mechanical properties between natural disc and some typical FRMs, the repair standard and FRMs applications in disc repair, and the possible research directions for FRMs' in the future are stated.
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33
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Silva-Correia J, Correia SI, Oliveira JM, Reis RL. Tissue engineering strategies applied in the regeneration of the human intervertebral disk. Biotechnol Adv 2013; 31:1514-31. [DOI: 10.1016/j.biotechadv.2013.07.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 07/12/2013] [Accepted: 07/26/2013] [Indexed: 01/03/2023]
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34
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Hudson KD, Alimi M, Grunert P, Härtl R, Bonassar LJ. Recent advances in biological therapies for disc degeneration: tissue engineering of the annulus fibrosus, nucleus pulposus and whole intervertebral discs. Curr Opin Biotechnol 2013; 24:872-9. [PMID: 23773764 DOI: 10.1016/j.copbio.2013.04.012] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/18/2013] [Accepted: 04/23/2013] [Indexed: 01/04/2023]
Abstract
Advanced intervertebral disc (IVD) degeneration, a major cause of back pain in the United States, is treated using invasive surgical intervention which may cause further degeneration is the future. Because of the limitations of traditional solutions, tissue engineering therapies have become increasingly popular. IVDs have two distinct regions, the inner nucleus pulposus (NP) which is jelly-like and rich in glycosaminoglycans (GAGs) and the outer annulus fibrosus (AF) which is organized into highly collagenous lamellae. Tissue engineered scaffolds, as well as whole organ culture systems have been developed. These culture systems may help elucidate the initial causes of disc degeneration. To create an effective tissue engineered therapy, researchers have focused on designing materials that mimic the properties of these two regions to be used independently or in concert. The few in vivo studies show promise in retaining disc height and MRI T2 signal intensity, the gold standard in determining disc health.
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Affiliation(s)
- Katherine D Hudson
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, United States
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35
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Detiger SEL, Hoogendoorn RJW, van der Veen AJ, van Royen BJ, Helder MN, Koenderink GH, Smit TH. Biomechanical and rheological characterization of mild intervertebral disc degeneration in a large animal model. J Orthop Res 2013; 31:703-9. [PMID: 23255234 DOI: 10.1002/jor.22296] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 11/26/2012] [Indexed: 02/04/2023]
Abstract
Biomechanical properties of healthy and degenerated nucleus pulposus (NP) are thought to be important for future regenerative strategies for intervertebral disc (IVD) repair. However, which properties are pivotal as design criteria when developing NP replacement materials is ill understood. Therefore, we determined and compared segmental biomechanics and NP viscoelastic properties in normal and mildly degenerated discs. In eight goats, three lumbar IVDs were chemically degenerated using chondroitinase ABC (CABC), confirmed with radiography and MRI after euthanasia 12 weeks post-operative. Neutral zone (NZ) stiffness and range of motion (ROM) were determined sagitally, laterally, and rotationally for each spinal motion segment (SMS) using a mechanical testing device. NPs were isolated for oscillatory shear experiments; elastic and viscous shear moduli followed from the ratio between shear stress and strain. Water content was quantified by weighing before and after freeze-drying. Disc height on radiographs and signal intensity on MRI decreased (6% and 22%, respectively, p < 0.01) after CABC treatment, confirming that chemical degeneration provides a good model of disc degeneration. Furthermore, CABC-injected IVDs had significantly lower NZ stiffness and larger ROM in lateral bending (LB) and axial rotation (AR) than controls. Rheometry consistently revealed significantly lower (10-12%) viscoelastic moduli after mild degeneration within goats, though the inter-animal differences were relatively large (complex modulus ∼12 to 41 kPa). Relative water content in the NP was unaffected by CABC, remaining at ∼75%. These observations suggest that viscoelastic properties have a marginal influence on mechanical behavior of the whole SMS. Therefore, when developing replacement materials the focus should be on other design criteria, such as biochemical cues and swelling pressure.
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Affiliation(s)
- Suzanne E L Detiger
- Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands
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36
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Silva-Correia J, Gloria A, Oliveira MB, Mano JF, Oliveira JM, Ambrosio L, Reis RL. Rheological and mechanical properties of acellular and cell-laden methacrylated gellan gum hydrogels. J Biomed Mater Res A 2013; 101:3438-46. [DOI: 10.1002/jbm.a.34650] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 01/30/2013] [Accepted: 02/04/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Joana Silva-Correia
- 3B's Research Group-Biomaterials; Biodegradables and Biomimetics; Department of Polymer Engineering; University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; AvePark S. Cláudio de Barco Caldas das Taipas Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga/Guimarães Portugal
| | - Antonio Gloria
- Institute of Composite and Biomedical Materials; National Research Council of Italy; P.le Tecchio 80 80125 Naples Italy
| | - Mariana B. Oliveira
- 3B's Research Group-Biomaterials; Biodegradables and Biomimetics; Department of Polymer Engineering; University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; AvePark S. Cláudio de Barco Caldas das Taipas Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga/Guimarães Portugal
| | - João F. Mano
- 3B's Research Group-Biomaterials; Biodegradables and Biomimetics; Department of Polymer Engineering; University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; AvePark S. Cláudio de Barco Caldas das Taipas Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga/Guimarães Portugal
| | - Joaquim M. Oliveira
- 3B's Research Group-Biomaterials; Biodegradables and Biomimetics; Department of Polymer Engineering; University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; AvePark S. Cláudio de Barco Caldas das Taipas Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga/Guimarães Portugal
| | - Luigi Ambrosio
- Institute of Composite and Biomedical Materials; National Research Council of Italy; P.le Tecchio 80 80125 Naples Italy
| | - Rui L. Reis
- 3B's Research Group-Biomaterials; Biodegradables and Biomimetics; Department of Polymer Engineering; University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; AvePark S. Cláudio de Barco Caldas das Taipas Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga/Guimarães Portugal
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37
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Silva-Correia J, Zavan B, Vindigni V, Silva TH, Oliveira JM, Abatangelo G, Reis RL. Biocompatibility evaluation of ionic- and photo-crosslinked methacrylated gellan gum hydrogels: in vitro and in vivo study. Adv Healthc Mater 2013. [PMID: 23184642 DOI: 10.1002/adhm.201200256] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In this study, the stability and biocompatibility of methacrylated gellan gum hydrogels, obtained either by ionic- (iGG-MA) or photo-crosslinking (phGG-MA), were evaluated in vitro and in vivo. Size exclusion chromatography analysis of the methacrylated gellan gum (GG-MA) powder revealed that molecular weight is lower as compared to the non-modified material, i.e., low acyl gellan gum. The water uptake and swelling of iGG-MA and phGG-MA hydrogels were investigated in phosphate-buffered saline solution (pH 7.4). The biocompatibility of the hydrogels was firstly evaluated by producing cell-laden hydrogels. The in vitro cells encapsulation study showed that lung fibroblast cells (L929 cells) and human intervertebral disc (hIVD) cells are viable when cultured within both hydrogels, up to 21 days of culturing. The iGG-MA and phGG-MA hydrogels were also subcutaneously implanted in Lewis rats for 10 and 18 days. Tissue response to the hydrogels implantation was determined by histological analysis (haematoxylin-eosin staining). A thin fibrous capsule was observed around the implanted hydrogels. No necrosis, calcification, and acute inflammatory reaction were observed. The results presented in this study demonstrate that iGG-MA and phGG-MA hydrogels are stable in vitro and in vivo, support L929 and hIVD cells' encapsulation and viability, and were found to be well-tolerated and non-toxic in vivo.
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38
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Guterl CC, See EY, Blanquer SB, Pandit A, Ferguson SJ, Benneker LM, Grijpma DW, Sakai D, Eglin D, Alini M, Iatridis JC, Grad S. Challenges and strategies in the repair of ruptured annulus fibrosus. Eur Cell Mater 2013; 25:1-21. [PMID: 23283636 PMCID: PMC3655691 DOI: 10.22203/ecm.v025a01] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Lumbar discectomy is the surgical procedure most frequently performed for patients suffering from low back pain and sciatica. Disc herniation as a consequence of degenerative or traumatic processes is commonly encountered as the underlying cause for the painful condition. While discectomy provides favourable outcome in a majority of cases, there are conditions where unmet requirements exist in terms of treatment, such as large disc protrusions with minimal disc degeneration; in these cases, the high rate of recurrent disc herniation after discectomy is a prevalent problem. An effective biological annular repair could improve the surgical outcome in patients with contained disc herniations but otherwise minor degenerative changes. An attractive approach is a tissue-engineered implant that will enable/stimulate the repair of the ruptured annulus. The strategy is to develop three-dimensional scaffolds and activate them by seeding cells or by incorporating molecular signals that enable new matrix synthesis at the defect site, while the biomaterial provides immediate closure of the defect and maintains the mechanical properties of the disc. This review is structured into (1) introduction, (2) clinical problems, current treatment options and needs, (3) biomechanical demands, (4) cellular and extracellular components, (5) biomaterials for delivery, scaffolding and support, (6) pre-clinical models for evaluation of newly developed cell- and material-based therapies, and (7) conclusions. This article highlights that an interdisciplinary approach is necessary for successful development of new clinical methods for annulus fibrosus repair. This will benefit from a close collaboration between research groups with expertise in all areas addressed in this review.
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Affiliation(s)
- Clare C. Guterl
- Department of Orthopaedics, Mount Sinai Medical Centre, New York, NY, USA,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - Eugene Y. See
- Network of Excellence for Functional Biomaterials, National University of Ireland, Galway, Ireland,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - Sebastien B.G. Blanquer
- Department of Biomaterials Science and Technology, University of Twente, Enschede, The Netherlands,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - Abhay Pandit
- Network of Excellence for Functional Biomaterials, National University of Ireland, Galway, Ireland,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - Stephen J. Ferguson
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - Lorin M. Benneker
- Department of Orthopaedic Surgery, University of Bern, Bern, Switzerland,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - Dirk W. Grijpma
- Department of Biomaterials Science and Technology, University of Twente, Enschede, The Netherlands,Department of Biomedical Engineering, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - Daisuke Sakai
- Department of Orthopaedic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - David Eglin
- AO Research Institute Davos, Davos, Switzerland,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - Mauro Alini
- AO Research Institute Davos, Davos, Switzerland,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - James C. Iatridis
- Department of Orthopaedics, Mount Sinai Medical Centre, New York, NY, USA,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - Sibylle Grad
- AO Research Institute Davos, Davos, Switzerland,Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland,Address for correspondence: Sibylle Grad, PhD, AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, Switzerland, Telephone Number: +41 81 414 2480, FAX Number: +41 81 414 2288,
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40
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He X, Dziak R, Mao K, Genco R, Swihart M, Swithart M, Li C, Yang S. Integration of a novel injectable nano calcium sulfate/alginate scaffold and BMP2 gene-modified mesenchymal stem cells for bone regeneration. Tissue Eng Part A 2012; 19:508-18. [PMID: 22994418 DOI: 10.1089/ten.tea.2012.0244] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The repair of craniofacial bone defects is surgically challenging due to the complex anatomical structure of the craniofacial skeleton. Current strategies for bone tissue engineering using a preformed scaffold have not resulted in the expected clinical regeneration due to difficulty in seeding cells into the deep internal space of scaffold, and the inability to inject them in minimally invasive surgeries. In this study, we used the osteoconductive and mechanical properties of nano-scale calcium sulfate (nCS) and the biocompatibility of alginate to develop the injectable nCS/alginate (nCS/A) paste, and characterized the effect of this nCS/A paste loaded with bone morphogenetic protein 2 (BMP2) gene-modified rat mesenchymal stem cells (MSCs) on bone and blood vessel growth. Our results showed that the nCS/A paste was injectable under small injection forces. The mechanical properties of the nCS/A paste were increased with an increased proportion of alginate. MSCs maintained their viability after the injection, and MSCs and BMP2 gene-modified MSCs in the injectable pastes remained viable, osteodifferentiated, and yielded high alkaline phosphatase activity. By testing the ability of this injectable paste and BMP2-gene-modified MSCs for the repair of critical-sized calvarial bone defects in a rat model, we found that BMP2-gene-modified MSCs in nCS/A (nCS/A+M/B2) showed robust osteogenic activity, which resulted in consistent bone bridging of the bone defects. The vessel density in nCS/A+M/B2 was significantly higher than that in the groups of blank control, nCS/A alone, and nCS/A mixed with MSCs (nCS/A+M). These results indicate that BMP2 promotes MSCs-mediated bone formation and vascularization in nCS/A paste. Overall, the results demonstrated that the combination of injectable nCS/A paste and BMP2-gene-modified MSCs is a new and effective strategy for the repair of bone defects.
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Affiliation(s)
- Xiaoning He
- Department of Oral Biology, The State University of New York at Buffalo, Buffalo, New York 14214, USA
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Milani AH, Freemont AJ, Hoyland JA, Adlam DJ, Saunders BR. Injectable Doubly Cross-Linked Microgels for Improving the Mechanical Properties of Degenerated Intervertebral Discs. Biomacromolecules 2012; 13:2793-801. [DOI: 10.1021/bm3007727] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Amir H. Milani
- Biomaterials Research Group,
Manchester Materials Science Centre, School of Materials, University of Manchester, Grosvenor Street, Manchester,
M13 9PL United Kingdom
| | - Anthony J. Freemont
- Regenerative Medicine, Developmental
Biomedicine Research Group, School of Medicine, Stopford Building, University of Manchester, Oxford Road, Manchester,
M13 9PT United Kingdom
| | - Judith A. Hoyland
- Regenerative Medicine, Developmental
Biomedicine Research Group, School of Medicine, Stopford Building, University of Manchester, Oxford Road, Manchester,
M13 9PT United Kingdom
| | - Daman J. Adlam
- Regenerative Medicine, Developmental
Biomedicine Research Group, School of Medicine, Stopford Building, University of Manchester, Oxford Road, Manchester,
M13 9PT United Kingdom
| | - Brian R. Saunders
- Biomaterials Research Group,
Manchester Materials Science Centre, School of Materials, University of Manchester, Grosvenor Street, Manchester,
M13 9PL United Kingdom
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Park SU, Lee BK, Kim MS, Park KK, Sung WJ, Kim HY, Han DG, Shim JS, Lee YJ, Kim SH, Kim IH, Park DH. The possibility of microbial cellulose for dressing and scaffold materials. Int Wound J 2012; 11:35-43. [PMID: 22762434 DOI: 10.1111/j.1742-481x.2012.01035.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
In recent years, natural polymers such as cellulose, alginate and chitosan have been used worldwide as biomedical materials and devices, as they offer more advantages over synthetic polymers. The aim of this study was to clarify the usefulness of microbial cellulose (MC) for use as a dressing and scaffold material. For evaluating the biodegradability and toxicity of MC, we divided the rats (n = 12) into two groups (the implanted group and the non-implanted group). In the implanted group, we implanted the film type of MC in the backs of six rats. In the non-implanted group, however, we did not implant the film type of MC in the backs of the six rats. Four weeks later, we compared two groups by the gross, histological and biochemical characteristics by using blood and tissue samples. To evaluate the wound healing effects of MC, three full-thickness skin defects were made on the backs of each rat (n = 20). Three wounds on the backs of the same rats were treated with other dressing materials, namely, Vaseline gauze (group Con), Algisite M(®) (group Alg) and MC (group MC). We analysed the gross, histological and biochemical characteristics by western blotting. MC was found to be biodegradable and non-toxic. On day 3, the MC film was visible under the subcutaneous tissue; however, after 4 weeks, no remnants of the film were visible under the subcutaneous tissue. Furthermore, there was no evidence of MC-induced toxicity. Moreover, group MC showed more rapid wound healing compared with group Con. On day 14 after skin excision, group MC showed greater decrease in wound size compared with group Con (33% versus 7·2%). The wound healing effects were also substantiated by the histological findings (greater reduction in inflammation and rapid collagen deposition as well as neovascularisation) and western blotting (decreased expression of vascular endothelial growth factor and transforming growth factor-β1 in group MC on day 14 after skin excision, unlike group Con). This study showed that, in addition to having wound healing effects, MC is biodegradable and non-toxic and can, therefore, be used as a dressing and scaffold material.
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Affiliation(s)
- Sang Uk Park
- Department of Plastic and Reconstructive Surgery, Daegu Catholic University, Daegu, KoreaDepartment of Pathology, College of Medicine, Daegu Catholic University, Daegu, KoreaDepartment of Food Science and Engineering, Daegu University, Daegu, Korea
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Silva-Correia J, Miranda-Gonçalves V, Salgado AJ, Sousa N, Oliveira JM, Reis RM, Reis RL. Angiogenic Potential of Gellan-Gum-Based Hydrogels for Application in Nucleus Pulposus Regeneration: In Vivo Study. Tissue Eng Part A 2012; 18:1203-12. [DOI: 10.1089/ten.tea.2011.0632] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Joana Silva-Correia
- Department of Polymer Engineering, 3B's Research Group—Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Vera Miranda-Gonçalves
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Life and Health Science Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - António J. Salgado
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Life and Health Science Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Nuno Sousa
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Life and Health Science Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Joaquim M. Oliveira
- Department of Polymer Engineering, 3B's Research Group—Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rui M. Reis
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Life and Health Science Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Rui L. Reis
- Department of Polymer Engineering, 3B's Research Group—Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
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