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Jin XH, Fang JQ, Wang JG, Xu B, Wang X, Liu SH, Chen F, Liu JJ. PCL NGCs integrated with urolithin-A-loaded hydrogels for nerve regeneration. J Mater Chem B 2022; 10:8771-8784. [PMID: 36196763 DOI: 10.1039/d2tb01624a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Inflammation and oxidative stress are among the leading causes of poor prognosis after peripheral nerve injury (PNI). Urolithin-A (UA), an intermediate product produced by the catabolism of ellagitannins in the gastrointestinal tract, has anti-inflammatory, antioxidant, and immunomodulatory properties for inflammation, oxidative damage, and aging-related diseases. Hence, we prepared UA-loaded hydrogels and embedded them in the lumen of PCL nerve guide conduits (NGCs). The hydrogels continuously released appropriate doses of UA into the microenvironment. Based on in vitro studies, UA facilitates cell proliferation and reduces oxidative damage. Besides, the experimental evaluation revealed good biocompatibility of the materials involved. We implanted NGCs into rat models to bridge the sciatic nerve defects in an in vivo study. The sciatic functional index of the PCL/collagen/UA group was comparable to that of the autograft group. Additionally, the consequences of electrophysiological, gastrocnemius muscle and nerve histology assessment of the PCL/collagen/UA group were better than those in the PCL and PCL/collagen groups and close to those in the autograft group. In this study, UA sustained release via the PCL/collagen/UA NGC was found to be an effective alternative treatment for PNI, validating our hypothesis that UA could promote regeneration of nerve tissue.
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Affiliation(s)
- Xue-Han Jin
- Department of Orthopaedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Shanghai, 200072, P. R. China.
| | - Jia-Qi Fang
- Department of Orthopaedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Shanghai, 200072, P. R. China.
| | - Jian-Guang Wang
- Department of Orthopaedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Shanghai, 200072, P. R. China.
| | - Bo Xu
- Department of Orthopaedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Shanghai, 200072, P. R. China.
| | - Xu Wang
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Shu-Hao Liu
- Department of Orthopaedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Shanghai, 200072, P. R. China.
| | - Feng Chen
- Department of Orthopaedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Shanghai, 200072, P. R. China.
| | - Jun-Jian Liu
- Department of Orthopaedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Shanghai, 200072, P. R. China.
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Mohseni M, Ramazani Saadatabadi A. Highly conductive self-electrical stimuli core-shell conduit based on PVDF-chitosan–gelatin filled with in-situ gellan gum as a possible candidate for nerve regeneration: a rheological, electrical, and structural study. APPLIED NANOSCIENCE 2021. [DOI: 10.1007/s13204-021-02012-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Li Q, Li L, Yu M, Zheng M, Li Y, Yang J, Dai M, Zhong L, Sun L, Lu D. Elastomeric polyurethane porous film functionalized with gastrodin for peripheral nerve regeneration. J Biomed Mater Res A 2020; 108:1713-1725. [PMID: 32196902 DOI: 10.1002/jbm.a.36937] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Qing Li
- Science and Technology Achievement Incubation CenterKunming Medical University Kunming China
| | - Limei Li
- Science and Technology Achievement Incubation CenterKunming Medical University Kunming China
| | - Mali Yu
- Science and Technology Achievement Incubation CenterKunming Medical University Kunming China
| | - Meng Zheng
- Science and Technology Achievement Incubation CenterKunming Medical University Kunming China
| | - Yao Li
- Department of StomatologyThe First People's Hospital of Yunnan Provience Kunming China
| | - Jian Yang
- Department of Biomedical EngineeringMaterials Research Institute, The Huck Institutes of The Life Sciences, The Pennsylvania State University University Park Pennsylvania USA
| | - Min Dai
- Department of Second CardiologyThe Third People's Hospital of Kunming Kunming China
| | - Lianmei Zhong
- Department of NeurologyThe First Affiliated Hospital, Kunming Medical University Kunming China
| | - Lin Sun
- Department of CardiologyThe Second Affiliated Hospital, Kunming Medical University Kunming China
| | - Di Lu
- Science and Technology Achievement Incubation CenterKunming Medical University Kunming China
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Restoration of Neurological Function Following Peripheral Nerve Trauma. Int J Mol Sci 2020; 21:ijms21051808. [PMID: 32155716 PMCID: PMC7084579 DOI: 10.3390/ijms21051808] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/25/2020] [Accepted: 03/03/2020] [Indexed: 12/12/2022] Open
Abstract
Following peripheral nerve trauma that damages a length of the nerve, recovery of function is generally limited. This is because no material tested for bridging nerve gaps promotes good axon regeneration across the gap under conditions associated with common nerve traumas. While many materials have been tested, sensory nerve grafts remain the clinical “gold standard” technique. This is despite the significant limitations in the conditions under which they restore function. Thus, they induce reliable and good recovery only for patients < 25 years old, when gaps are <2 cm in length, and when repairs are performed <2–3 months post trauma. Repairs performed when these values are larger result in a precipitous decrease in neurological recovery. Further, when patients have more than one parameter larger than these values, there is normally no functional recovery. Clinically, there has been little progress in developing new techniques that increase the level of functional recovery following peripheral nerve injury. This paper examines the efficacies and limitations of sensory nerve grafts and various other techniques used to induce functional neurological recovery, and how these might be improved to induce more extensive functional recovery. It also discusses preliminary data from the clinical application of a novel technique that restores neurological function across long nerve gaps, when repairs are performed at long times post-trauma, and in older patients, even under all three of these conditions. Thus, it appears that function can be restored under conditions where sensory nerve grafts are not effective.
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Porzionato A, Barbon S, Stocco E, Dalzoppo D, Contran M, De Rose E, Parnigotto PP, Macchi V, Grandi C, De Caro R. Development of Oxidized Polyvinyl Alcohol-Based Nerve Conduits Coupled with the Ciliary Neurotrophic Factor. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E1996. [PMID: 31234386 PMCID: PMC6631399 DOI: 10.3390/ma12121996] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/09/2019] [Accepted: 06/19/2019] [Indexed: 12/14/2022]
Abstract
Functionalized synthetic conduits represent a promising strategy to enhance peripheral nerve regeneration by guiding axon growth while delivering therapeutic neurotrophic factors. In this work, hollow nerve conduits made of polyvinyl alcohol partially oxidized with bromine (OxPVA_Br2) and potassium permanganate (OxPVA_KMnO4) were investigated for their structural/biological properties and ability to absorb/release the ciliary neurotrophic factor (CNTF). Chemical oxidation enhanced water uptake capacity of the polymer, with maximum swelling index of 60.5% ± 2.5%, 71.3% ± 3.6% and 19.5% ± 4.0% for OxPVA_Br2, OxPVA_KMnO4 and PVA, respectively. Accordingly, hydrogel porosity increased from 15.27% ± 1.16% (PVA) to 62.71% ± 8.63% (OxPVA_Br2) or 77.50% ± 3.39% (OxPVA_KMnO4) after oxidation. Besides proving that oxidized PVA conduits exhibited mechanical resistance and a suture holding ability, they did not exert a cytotoxic effect on SH-SY5Y and Schwann cells and biodegraded over time when subjected to enzymatic digestion, functionalization with CNTF was performed. Interestingly, higher amounts of neurotrophic factor were detected in the lumen of OxPVA_Br2 (0.22 ± 0.029 µg) and OxPVA_KMnO4 (0.29 ± 0.033 µg) guides rather than PVA (0.11 ± 0.021 µg) tubular scaffolds. In conclusion, we defined a promising technology to obtain drug delivery conduits based on functionalizable oxidized PVA hydrogels.
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Affiliation(s)
- Andrea Porzionato
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Via N. Giustiniani 2, 35128 Padova, Italy.
| | - Silvia Barbon
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Via N. Giustiniani 2, 35128 Padova, Italy.
| | - Elena Stocco
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Via N. Giustiniani 2, 35128 Padova, Italy.
| | - Daniele Dalzoppo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Via F. Marzolo 5, 35128 Padova, Italy.
| | - Martina Contran
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
| | - Enrico De Rose
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
| | - Pier Paolo Parnigotto
- Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling (T.E.S.) Onlus, 35030 Padua, Italy.
| | - Veronica Macchi
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Via N. Giustiniani 2, 35128 Padova, Italy.
| | - Claudio Grandi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Via F. Marzolo 5, 35128 Padova, Italy.
| | - Raffaele De Caro
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Via N. Giustiniani 2, 35128 Padova, Italy.
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Liu Y, Yu S, Gu X, Cao R, Cui S. Tissue-engineered nerve grafts using a scaffold-independent and injectable drug delivery system: a novel design with translational advantages. J Neural Eng 2019; 16:036030. [PMID: 30965290 DOI: 10.1088/1741-2552/ab17a0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Currently commercially available nerve conduits have demonstrated suboptimal clinical efficacy in repairing peripheral nerve defects. Although tissue-engineered nerve grafts (TENGs) with sustained release of neurotrophic factors (NTFs) are experimentally proved to be more effective than these blank conduits, there remains a lack of clinical translation. NTFs are typically immobilized onto scaffold materials of the conduit via adsorption, specific binding or other incorporation techniques. These scaffold-based delivery strategies increase complexity and cost of conduit fabrication and lack flexibility in choosing different drugs. Therefore, to facilitate clinical translation and commercialization, we construct a TENG using a scaffold-independent drug delivery system (DDS). APPROACH This study adopted a scaffold-independent DDS based on methoxy-poly (ethylene glycol)-b-poly(γ-ethyl-L-glutamate) (mPEG-PELG) thermosensitive hydrogels that undergo sol-to-gel transition at body temperature. In addition, TENG, a chitosan scaffold filled with nerve growth factor (NGF)-loaded mPEG-PELG that gel in the lumen upon injection during surgery and function as a drug-releasing conduit-filler, was designed. Subsequently, the efficacy of DDS and therapeutic effects of TENG were assessed. MAIN RESULTS The results demonstrated that NGF-loaded mPEG-PELG controllably and sustainably released bioactive NGF for 28 d. When bridging a 10 mm rat sciatic nerve gap, the morphological, electrophysiological, and functional analyses revealed that NGF-releasing TENG (Scaffold + NGF/mPEG-PELG) achieved superior regenerative outcomes compared to plain scaffolds and those combined with systemic delivery of NGF (daily intramuscular injection (IM)), and its effects were relatively similar to autografts. SIGNIFICANCE This study has proposed a TENG using thermosensitive hydrogels as an injectable implant to controllably release NGF, which has promising therapeutic potential and translatability. Such TENGs obviate the need for conduit modification, complex preloading or binding mediators, therefore they allow the ease of drug switching in clinical practice and greatly simplify the manufacturing process due to the independent preparation of drug delivery system.
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Affiliation(s)
- Yanxi Liu
- Department of Hand Surgery, China-Japan Union Hospital, Jilin University, Changchun, People's Republic of China
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Xia B, Chen G, Zou Y, Yang L, Pan J, Lv Y. Low-intensity pulsed ultrasound combination with induced pluripotent stem cells-derived neural crest stem cells and growth differentiation factor 5 promotes sciatic nerve regeneration and functional recovery. J Tissue Eng Regen Med 2019; 13:625-636. [PMID: 30770650 DOI: 10.1002/term.2823] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 01/13/2019] [Accepted: 02/13/2019] [Indexed: 12/22/2022]
Abstract
The treatment of lengthy peripheral nerve defect is challenging in the field of nerve regeneration. Our previous studies have shown that low-intensity pulsed ultrasound (LIPUS) could promote the proliferation, cell viability, and neural differentiation of induced pluripotent stem cells-derived neural crest stem cells (iPSCs-NCSCs) and improve the regeneration of damaged peripheral nerve. In this study, the mechanical signal transduction pathway of LIPUS promoting iPSCs-NCSCs proliferation and differentiation was further explored, and the effects of LIPUS combined with iPSCs-NCSCs, perfluorotributylamine (PFTBA), and growth differentiation factor 5 (GDF5) on the repair of peripheral nerve injury were evaluated. Results showed LIPUS may regulate the proliferation and differentiation of iPSCs-NCSCs through FAK-ERK1/2 signal pathway. PFTBA could supply sufficient oxygen to promote the viability of iPSCs-NCSCs under 5% hypoxia culture condition and provide a favourable microenvironment for nerve regeneration. The addition of GDF5 could promote the neural differentiation of iPSCs-NCSCs in vitro. LIPUS treatment of allogeneic decellularized nerve conduit containing iPSCs-NCSCs, PFTBA, and GDF5 has very good effect on the repair of sciatic nerve injury. Taken together, these results provide functional evidence that LIPUS might be a useful tool to explore alternative approaches in the field of nerve regeneration.
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Affiliation(s)
- Bin Xia
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Bioengineering College, Chongqing University, Chongqing, China.,Mechanobiology and Regenerative Medicine Laboratory, Bioengineering College, Chongqing University, Chongqing, China
| | - Guobao Chen
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Bioengineering College, Chongqing University, Chongqing, China.,Mechanobiology and Regenerative Medicine Laboratory, Bioengineering College, Chongqing University, Chongqing, China
| | - Yang Zou
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Bioengineering College, Chongqing University, Chongqing, China.,Mechanobiology and Regenerative Medicine Laboratory, Bioengineering College, Chongqing University, Chongqing, China
| | - Li Yang
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Bioengineering College, Chongqing University, Chongqing, China.,Mechanobiology and Regenerative Medicine Laboratory, Bioengineering College, Chongqing University, Chongqing, China
| | - Jun Pan
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Bioengineering College, Chongqing University, Chongqing, China.,Mechanobiology and Regenerative Medicine Laboratory, Bioengineering College, Chongqing University, Chongqing, China
| | - Yonggang Lv
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Bioengineering College, Chongqing University, Chongqing, China.,Mechanobiology and Regenerative Medicine Laboratory, Bioengineering College, Chongqing University, Chongqing, China
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Li G, Chen S, Zeng M, Kong Y, Zhao F, Zhang L, Yang Y. Hierarchically aligned gradient collagen micropatterns for rapidly screening Schwann cells behavior. Colloids Surf B Biointerfaces 2019; 176:341-351. [PMID: 30654241 DOI: 10.1016/j.colsurfb.2019.01.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 12/25/2018] [Accepted: 01/07/2019] [Indexed: 12/13/2022]
Abstract
To penetrate the effect of protein gradient micropattern on peripheral nerve regeneration, the hierarchically aligned gradient collagen micropattern was prepared by micromoulding method and the influence on Schwann cells growth behavior was studied. The morphology, wettability, stability and component variation of the micropatterns were firstly characterized. Then, Schwann cells were cultured and the related mechanism was penetrated. The results showed that the gradient collagen micropattern could be well fabricated. The surface wettability varied with the change of collagen concentration, and the prepared gradient micropattern showed a good stability after PBS immersion for 15 days. The results of Schwann cells culture and morphological index analysis displayed that the prepared gradient collagen micropatten could well regulate the orientation growth of Schwann cells, while a much better cell alignment growth was obtained on the gradient micropattern with higher collagen concentration and wider pattern size. PCR and WB showed that the micropattern structure could effectively up-regulate the key specific genes for axon regeneration and myelination process. Overall, the study provides a systematic and facile method for understanding the effect of various sized micropatterns on cell behavior, which may have a great significance for the development of artificial implants for tissue engineering and regenerative medicine.
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Affiliation(s)
- Guicai Li
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China.
| | - Shiyu Chen
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China
| | - Ming Zeng
- School of Biology Science, Nantong University, 226019, Nantong, PR China
| | - Yan Kong
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China
| | - Fei Zhao
- School of Biology Science, Nantong University, 226019, Nantong, PR China
| | - Luzhong Zhang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China.
| | - Yumin Yang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China.
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Qian Y, Han Q, Zhao X, Song J, Cheng Y, Fang Z, Ouyang Y, Yuan WE, Fan C. 3D melatonin nerve scaffold reduces oxidative stress and inflammation and increases autophagy in peripheral nerve regeneration. J Pineal Res 2018; 65:e12516. [PMID: 29935084 DOI: 10.1111/jpi.12516] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 06/13/2018] [Accepted: 06/15/2018] [Indexed: 12/15/2022]
Abstract
Peripheral nerve defect is a common and severe kind of injury in traumatic accidents. Melatonin can improve peripheral nerve recovery by inhibiting oxidative stress and inflammation after traumatic insults. In addition, it triggers autophagy pathways to increase regenerated nerve proliferation and to reduce apoptosis. In this study, we fabricated a melatonin-controlled-release scaffold to cure long-range nerve defects for the first time. 3D manufacture of melatonin/polycaprolactone nerve guide conduit increased Schwann cell proliferation and neural expression in vitro and promoted functional, electrophysiological and morphological nerve regeneration in vivo. Melatonin nerve guide conduit ameliorated immune milieu by reducing oxidative stress, inflammation and mitochondrial dysfunction. In addition, it activated autophagy to restore ideal microenvironment, to provide energy for nerves and to reduce nerve cell apoptosis, thus facilitating nerve debris clearance and neural proliferation. This innovative scaffold will have huge significance in the nerve engineering.
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Affiliation(s)
- Yun Qian
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Qixin Han
- Center for Reproductive Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Xiaotian Zhao
- Engineering Research Center of Cell & Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Jialin Song
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yuan Cheng
- Engineering Research Center of Cell & Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiwei Fang
- Engineering Research Center of Cell & Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Yuanming Ouyang
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Wei-En Yuan
- Engineering Research Center of Cell & Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Cunyi Fan
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
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