Effects of adding resorbable chitosan microspheres to calcium phosphate cements for bone regeneration

Hybrid Bone Substitute Containing Tricalcium Phosphate and Silver Modified Hydroxyapatite-Methylcellulose Granules

Despite years of extensive research, achieving the optimal properties for calcium phosphate-based biomaterials remains an ongoing challenge. Recently, 'biomicroconcretes' systems consisting of setting-phase-forming bone cement matrix and aggregates (granules/microspheres) have been developed and studied. However, further investigations are necessary to clarify the complex interplay between the synthesis, structure, and properties of these materials. This article focusses on the development and potential applications of hybrid biomaterials based on alpha-tricalcium phosphate (αTCP), hydroxyapatite (HA) and methylcellulose (MC) modified with silver (0.1 wt.% or 1.0 wt.%). The study presents the synthesis and characterization of silver-modified hybrid granules and seeks to determine the possibility and efficiency of incorporating these hybrid granules into αTCP-based biomicroconcretes. The αTCP and hydroxyapatite provide structural integrity and osteoconductivity, the presence of silver imparts antimicrobial properties, and MC allows for the self-assembling of granules. This combination creates an ideal environment for bone regeneration, while it potentially may prevent bacterial colonization and infection. The material's chemical and phase composition, setting times, compressive strength, microstructure, chemical stability, and bioactive potential in simulated body fluid are systematically investigated. The results of the setting time measurements showed that both the size and the composition of granules (especially the hybrid nature) have an impact on the setting process of biomicroconcretes. The addition of silver resulted in prolonged setting times compared to the unmodified materials. Developed biomicroconcretes, despite exhibiting lower compressive strength compared to traditional calcium phosphate cements, fall within the range of human cancellous bone and demonstrate chemical stability and bioactive potential, indicating their suitability for bone substitution and regeneration. Further in vitro studies and in vivo assessments are needed to check the potential of these biomaterials in clinical applications.

Chitosan composite with mesenchymal stem cells: Properties, mechanism, and its application in bone regeneration

Bone defects resulting from trauma, illness or congenital abnormalities represent a significant challenge to global health. Conventional treatments such as autographs and allografts have limitations, leading to the exploration of bone tissue engineering (BTE) as an alternative approach. This review aims to provide a comprehensive analysis of bone regeneration mechanisms with a focus on the role of chitosan-based biomaterials and mesenchymal stem cells (MSCs) in BTE. In addition, the physiochemical and biological properties of chitosan, its potential for bone regeneration when combined with other materials and the mechanisms through which MSCs facilitate bone regeneration were investigated. In addition, different methods of scaffold development and the incorporation of MSCs into chitosan-based scaffolds were examined. Chitosan has remarkable biocompatibility, biodegradability and osteoconductivity, making it an attractive choice for BTE. Interactions between transcription factors such as Runx2 and Osterix and signaling pathways such as the BMP and Wnt pathways regulate the differentiation of MSCs and bone regeneration. Various forms of scaffolding, including porous and fibrous injections, have shown promise in BTE. The synergistic combination of chitosan and MSCs in BTE has significant potential for addressing bone defects and promoting bone regeneration, highlighting the promising future of clinical challenges posed by bone defects.

Highly bioactive bone cement microspheres based on α-tricalcium phosphate microparticles/mesoporous bioactive glass nanoparticles: Formulation, physico-chemical characterization and in vivo bone regeneration

Calcium phosphate cement (CPC) is a self-setting, biocompatible and osteoconductive bone cement, however its use as a bone substitute is still limited owing to its low bioactivity (i.e. its slow in vivo resorption and slow new bone formation rate) which is a challenging issue to be addressed. Herein, we report for the first time highly bioactive bone cement microspheres formulated from a cement paste containing α-tricalcium phosphate microparticles (α-TCP) and mesoporous calcium silicate bioactive glass nanoparticles (mesoporous BGn) using a water-in-oil emulsion method. Indeed, bioactive microspheres possess high potential as bone defect fillers for bone regeneration. The α-TCP microparticles were prepared by a solid state synthesis at 1400 ºC while mesoporous BGn were synthesized by template-assissted ultrasound-mediated sol-gel method. The particle size distribution of as-prepared cement microspheres was in the range of 200 - 450 µm with a sphericity index in the range of 0.92 - 0.94. The surface morphology of α-TCP microspheres revealed α-TCP micoparticles with smooth surfaces whereas α-TCP/BGn microspheres unveiled nano-roughened α-TCP microparticles. The as-prepared α-TCP/BGn cement microspheres exhibited larger specific surface area ca 18.6 m²/g, sustained release of soluble silicate (SiO₄^4-) ions (118 ppm within a week) and high protein adsorption capacity (252 mg/g). Notably, the α-TCP/BGn cement microspheres showed excellent in vitro surface bioactivity via formation of massive amounts of bone-like hydroxyapatite spherules and aggregates on their surfaces after soaking in simulated body fluid. Importantly, the in vivo implantation of as-prepared α-TCP/BGn cement microspheres in rat calvarial critical size bone defects for 6 weeks unveiled high in vivo bioactivity in terms of substantial new bone ingrowth and significant new bone formation within the bone defect as evidenced by histological analyses, X-ray radiography and micro-computed tomography evaluations.

Chitosan-Based Biomaterial Scaffolds for the Repair of Infected Bone Defects

The treatment of infected bone defects includes infection control and repair of the bone defect. The development of biomaterials with anti-infection and osteogenic ability provides a promising strategy for the repair of infected bone defects. Owing to its antibacterial properties, chitosan (an emerging natural polymer) has been widely studied in bone tissue engineering. Moreover, it has been shown that chitosan promotes the adhesion and proliferation of osteoblast-related cells, and can serve as an ideal carrier for bone-promoting substances. In this review, the specific molecular mechanisms underlying the antibacterial effects of chitosan and its ability to promote bone repair are discussed. Furthermore, the properties of several kinds of functionalized chitosan are analyzed and compared with those of pure chitosan. The latest research on the combination of chitosan with different types of functionalized materials and biomolecules for the treatment of infected bone defects is also summarized. Finally, the current shortcomings of chitosan-based biomaterials for the treatment of infected bone defects and future research directions are discussed. This review provides a theoretical basis and advanced design strategies for the use of chitosan-based biomaterials in the treatment of infected bone defects.

Bioactive Chitosan-Based Organometallic Scaffolds for Tissue Engineering and Regeneration

Captivating achievements in developing advanced hybrid biostructures through integrating natural biopolymers with inorganic materials (e.g., metals and metalloids) have paved the way towards the application of bioactive organometallic scaffolds (OMSs) in tissue engineering and regenerative medicine (TERM). Of various biopolymers, chitosan (CS) has been used widely for the development of bioactive OMSs, in large part due to its unique characteristics (e.g., biocompatibility, biodegradability, surface chemistry, and functionalization potential). In integration with inorganic elements, CS has been used to engineer advanced biomimetic matrices to accommodate both embedded cells and drug molecules and serve as scaffolds in TERM. The use of the CS-based OMSs is envisioned to provide a new pragmatic potential in TERM and even in precision medicine. In this review, we aim to elaborate on recent achievements in a variety of CS/metal, CS/metalloid hybrid scaffolds, and discuss their applications in TERM. We also provide comprehensive insights into the formulation, surface modification, characterization, biocompatibility, and cytotoxicity of different types of CS-based OMSs.

Mesenchymal stem cell-based nanoparticles and scaffolds in regenerative medicine

Mesenchymal stem cells (MSCs) are adult stem cells owing to their regenerative potential and multilineage potency. MSCs have wide-scale applications either in their native cellular form or in conjugation with specific biomaterials as nanocomposites. Majorly, these natural or synthetic biomaterials are being used in the form of metallic and non-metallic nanoparticles (NPs) to encapsulate MSCs within hydrogels like alginate or chitosan or drug cargo loading into MSCs. In contrast, nanofibers of polymer scaffolds such as polycaprolactone (PCL), poly-lactic-co-glycolic acid (PLGA), poly-L-lactic acid (PLLA), silk fibroin, collagen, chitosan, alginate, hyaluronic acid (HA), and cellulose are used to support or grow MSCs directly on it. These MSCs based nanotherapies have application in multiple domains of biomedicine including wound healing, bone and cartilage engineering, cardiac disorders, and neurological disorders. This study focused on current approaches of MSCs-based therapies and has been divided into two major sections. The first section elaborates on MSC-based nano-therapies and their plausible applications including exosome engineering and NPs encapsulation. The following section focuses on the various MSC-based scaffold approaches in tissue engineering. Conclusively, this review mainly focused on MSC-based nanocomposite's current approaches and compared their advantages and limitations for building effective regenerative medicines.

Urine-derived stem cells loaded onto a chitosan-optimized biphasic calcium-phosphate scaffold for repairing large segmental bone defects in rabbits

The treatment of large segmental bone defects can be challenging for orthopedic surgeons. The development of bone tissue engineering technology, including the selection of seeding cells and the construction of scaffolds, provides a promising solution. In this study, we investigated osteogenic differentiation of human urine-derived stem cells (hUSCs, a newly identified class of stem cells), and developed a novel porous hybrid scaffold using biphasic calcium phosphate (BCP) bioceramic ornamented with chitosan sponges (CS). We combined hUSCs with a CS/BCP hybrid scaffold to construct tissue-engineered bone and evaluated whether the combination promotes bone regeneration in large segmental bone defects in rabbits. The study showed that hUSCs can differentiate into osteoblasts, and the hUSCs adhered, proliferated, and differentiated on CS/BCP hybrid scaffolds. Micro-computed tomography measurements, biomechanical detection, and histological analyses revealed that the combination of hUSCs and the CS/BCP hybrid scaffold enhanced bone regeneration more effectively compared with conventional pure BCP scaffolds, indicating that hUSCs can be used as a cell source for bone tissue engineering and that cell-scaffold-based biomimetic bone may be a promising approach to the repair of bone defects.

Preparation and Characterization of Sustained-Release Naringin Coating on Magnesium Surface

Given the three-dimensional multi-level structure of natural bone and the multi-factor time-shifting effect in the healing process after bone trauma, there are plans to introduce drug-controlled release systems into the treatment of orthopedic diseases. To achieve multi-level loading and controlled release of biologically active substances, it is necessary to create synergistic behavior between biological factors, thereby improving the bone regeneration ability of artificial bone replacement materials. A naringin-loaded (NG) coating was prepared, compared with ultrasonic micro-arc oxidation (UMAO). The coating was characterized by X-ray diffraction, infrared spectroscopy, and scanning electron microscopy. The corrosion resistance of the coating was studied through the wetting angle and polarization curve. The high-performance liquid chromatography method was used to test the release of the drug. It can be seen from the experimental results that the NG coating has a larger wetting angle and better corrosion resistance. In addition, the NG coating produces more apatite substances and has good biological activity. The NG coatings can stimulate the natural bone regeneration and repair process by releasing drugs during the process, which can effectively promote bone regeneration and repair after implantation in the body.

The preparation and application of calcium phosphate biomedical composites in filling of weight-bearing bone defects

Nowadays, artificial bone materials have been widely applied in the filling of non-weight bearing bone defects, but scarcely ever in weight-bearing bone defects. This study aims to develop an artificial bone with excellent mechanical properties and good osteogenic capability. Firstly, the collagen-thermosensitive hydrogel-calcium phosphate (CTC) composites were prepared as follows: dissolving thermosensitive hydrogel at 4 °C, then mixing with type I collagen as well as tricalcium phosphate (CaP) powder, and moulding the composites at 37 °C. Next, the CTC composites were subjected to evaluate for their chemical composition, micro morphology, pore size, Shore durometer, porosity and water absorption ability. Following this, the CTC composites were implanted into the muscle of mice while the 70% hydroxyapatite/30% β-tricalcium phosphate (HA/TCP) biomaterials were set as the control group; 8 weeks later, the osteoinductive abilities of biomaterials were detected by histological staining. Finally, the CTC and HA/TCP biomaterials were used to fill the large segments of tibia defects in mice. The bone repairing and load-bearing abilities of materials were evaluated by histological staining, X-ray and micro-CT at week 8. Both the CTC and HA/TCP biomaterials could induce ectopic bone formation in mice; however, the CTC composites tended to produce larger areas of bone and bone marrow tissues than HA/TCP. Simultaneously, bone-repairing experiments showed that HA/TCP biomaterials were easily crushed or pushed out by new bone growth as the material has a poor hardness. In comparison, the CTC composites could be replaced gradually by newly formed bone and repair larger segments of bone defects. The CTC composites trialled in this study have better mechanical properties, osteoinductivity and weight-bearing capacity than HA/TCP. The CTC composites provide an experimental foundation for the synthesis of artificial bone and a new option for orthopedic patients.

Synthesis and Characterization of Melatonin-Loaded Chitosan Microparticles Promote Differentiation and Mineralization in Preosteoblastic Cells

In terms of a novel scaffold with well good osteoinductive and osteoconductive capacity, melatonin (Mel) possesses positive effects on chemical linkage in scaffold structures, which may allow osteogenic differentiation. The aim of this study is to fabricate Mel-loaded chitosan (CS) microparticles (MPs) as a novel bone substitute through generating a Mel sustained release system from Mel-loaded CS MPs and evaluating its effect on the osteogenic capacity of MC3T3-E1 in vitro. The physical-chemical characteristics of the prepared CS MPs were examined by both Fourier transform infrared spectroscopy and scanning electron microscopy. The released profile and kinetics of Mel from MPs were quantified, and the bioactivity of the released Mel on preosteoblastic MC3T3-E1 cells was characterized in vitro. An in vitro drug release assay has shown high encapsulation efficiency and sustained release of Mel over the investigation period. In an osteogenesis assay, Mel-loaded CS MPs have significantly enhanced alkaline phosphatase (ALP) mRNA expression and ALP activity compared with the control group. Meanwhile, the osteoblast-specific differentiation genes, including runt related transcription factor 2 (Runx2), bone morphogentic protein-2 (Bmp2), collagen I (Col I), and osteocalcin (Ocn), were also significantly upregulated. Furthermore, quantificational alizarin red-based assay demonstrated that Mel-loaded CS MPs notably enhanced the calcium deposit of MC3T3-E1 compared with controls. In essence, Mel-loaded CS MPs can control the release of Mel for a period of time to accelerate osteogenic differentiation of preosteoblast cells in vitro.

Optimization by Central Composite Experimental Design of the Synthesis of Physically Crosslinked Chitosan Spheres

Chitosan (CS) has special properties such as biocompatibility, biodegradability, antibacterial, and biological activity which make this material is currently studied in various applications, including tissue engineering. There are different methods to modify the morphology of CS. Most use chemical crosslinking agents, however, those methods have disadvantages such as low polymer degradability and unwanted side effects. The objective of this research was to obtain CS spheres through the physical crosslinking of commercial CS without using crosslinking agents through a simple coacervation method. A central composite experimental design was used to optimize the synthesis of the CS spheres and by the response surface methodology it was possible to obtain CS spheres with the smallest diameter and the most regular morphology. With the optimal formulation (CS solution 1.8% (w/v), acetic acid (AAC) solution 1% (w/v), sodium hydroxide (NaOH) solution 13% (w/v), relative humidity of (10%) and needle diameter of 0.6 mm), a final sphere diameter of 1 mm was obtained. Spheres were characterized by physical, chemical, thermal, and biological properties in simulated body fluid (SBF). The results obtained allowed us to understand the effect of the studied variables on the spheres' diameter. An optimized condition facilitated the change in the morphology of the CS while maintaining its desirable properties for use in tissue engineering.

Influence of the chitosan morphology on the properties of acrylic cements and their biocompatibility

Acrylic bone cements (ABC) are materials widely used in orthopedics and biomedical applications. Several active compounds have been introduced to ABC formulations to improve their mechanical properties and bifunctionality. In this research, we studied the effect of the addition of chitosan (CS) microspheres and chitosan sheets on ABC formulations. For mechanical performance optimization, the compression strength was taken as a response variable using an extreme vertices mixing design with fraction by weight of CS and poly(methyl methacrylate) (PMMA) as the variable factors. According to the statistical analysis, the control samples (without CS), samples with 7% (wt.) of CS sheets, and samples with 17% (wt.) of CS spheres presented the best compression properties: 90.6 MPa and 95.6 MPa, respectively. The study of these formulations confirmed that CS spheres allow a higher amount of loading on the formulation, maintaining comparable compression strength. By ¹H-NMR, it was observed that the residual monomer was similar in all wording. The hydrolytic degradation assay in simulated body fluid (SBF) determined that the sphere incorporation increased by 50% and 35% for the water uptake and weight loss values, respectively, when compared with the reported values with CS sheets. By morphological analysis via SEM, it was observed that the porosity increased considerably in the presence of CS spheres throughout the immersion time in SBF. The subdermal implant results demonstrated excellent compatibility between the cement studied and the biological environment.

Acrylic bone cements (ABC) are materials widely used in orthopedics and biomedical applications.

Chitosan/calcium phosphate flower-like microparticles as carriers for drug delivery platform

A special flower-like chitosan (CS)/calcium phosphate (CaP) microparticle was fabricated as a novel pH-sensitive carrier for sustained release drug system via a rapid one-pot approach. The CS-tripolyphosphate (TPP) nanocomplexes were firstly prepared through ionotropic gelation. Then, the CS nanocomplexes network acted as the template and inducer for adsorbing the mineralized CaP nanosheets and directing its assembly into the flower-like microparticles. The preparation condition optimized by Box-Behnken design-response surface methodology was achieved with 3.16 mg/ml of CS, 127.22 mg/ml of TPP, and 89.50 mM of CaCl₂. The morphologies of the system were observed by scanning electron microscopy (SEM) and transmission electron microscope (TEM), and it showed that the flower-like microparticles with a diameter of 5-7 μm are composed of sheet-like petals with about 40 nm in thickness. And the TEM results showed that the petals consist by nanosheets with the thickness of 2-5 nm. The X-ray diffraction (XRD) results showed that the P/Ca ratio of CS/CaP microparticles is 1.29/1. The in vitro release studies demonstrated well sustained-release properties and pH-sensitive releasing characteristic of CS/CaP microparticles. The drug release mechanism was fitted by Korsmeyer-Peppas model at a pH of 5.8 and 7.4, respectively. The in vitro cell viability research demonstrated the microparticles have no obvious cytotoxicity at the dosages below 500 μg/ml. This work supplied a versatile platform as a novel drug delivery system with excellent pH-sensitive and sustained release performances.

Cystine dimethyl ester cross-linked PEG-poly(urethane-urea)/nano-hydroxyapatite composited biomimetic scaffold for bone defect repair

Polyurethane (PU) and polyurea (PUA) materials have shown significant potential for application in tissue repair. Herein, we design a glycerol ethoxylate (PEG)-based poly(urethane-urea) for bone tissue repair. The polymer precursor was prepared from the reaction of PEG and isophorone diisocyanate (IPDI). The cystine dimethyl ester was used as a cross-linker for the preparation of poly(urethane-urea) elastomers. The material was further strengthened by physical blending of nano-hydroxyapatite (nHA). The physical and biological properties of final material were evaluated by mechanical testing, scanning electron microscopy characterization, degradation tests, cell proliferation and cell differentiation assays. The obtained scaffolds showed good mechanical strength, excellent biocompatibility and osteogenic capability. All the evidences demonstrated that this type of materials has good prospects for bone tissue repair application.

Controlled-release curcumin attenuates progression of tendon ectopic calcification by regulating the differentiation of tendon stem/progenitor cells

Tendon calcification is a common but intractable problem leading to pain and activity limitation when injury or tendinopathy progresses into the late stage. This is because tendon stem/progenitor cells (TSPCs) can undergo aberrant osteogenic differentiation under inflammatory conditions. This study aims to investigate the effect of curcumin, a natural anti-inflammatory agent, on regulating the differentiation of TSPCs in tendon calcification. With inflammatory stimulation, TSPCs showed higher alkaline phosphatase activity and more frequent formation of mineralized nodules which were verified in the culture system; however, curcumin significantly alleviated these pathological changes. In in vivo function analysis, chitosan microsphere-encapsulated curcumin was delivered to injured sites of rat tendon ectopic calcification model. The inflammation in the tendon tissues of the curcumin group was significantly relieved. Controlled-release curcumin partially rescued tendon calcification and enhanced tendon regeneration in animal model. This study demonstrates that controlled-release curcumin can manipulate the fate decision of TSPCs, and that it promotes the tenogenesis and inhibits the osteogenesis of TSPCs in a pathological microenvironment, which provides a possible new therapeutic strategy for tendon disease.

In vitro and in vivo analysis of the biocompatibility of two novel and injectable calcium phosphate cements

Calcium phosphate cements (CPCs) have been widely used as bone graft substitutes for many years. The aim of this study was to evaluate the biocompatibility of two novel injectable, bioactive cements: β-tricalcium phosphate (β-TCP)/CPC and chitosan microsphere/CPC in vitro and in vivo. This was accomplished by culturing mouse pre-osteoblastic cells (MC3T3-E1) on discs and pastes of CPCs. Cell growth, adhesion, proliferation and differentiation were assessed by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide and alkaline phosphatase assays as well as by scanning electron microscopy and fluorescence. The effect of CPC paste curing was also evaluated. Implantation of two materials into the muscle tissue of rabbits was also studied and evaluated by histological analysis. Cell analysis indicated good biocompatibility in vitro. The fluorescence assay suggested that the cured material discs had no obvious effect on cell growth, while the curing process did. Histological examination showed no inflammatory cell infiltration into soft tissue. These data suggest that β-TCP/CPC and chitosan microsphere/CPC composites may be promising injectable material for bone tissue engineering.

MBG scaffolds containing chitosan microspheres for binary delivery of IL-8 and BMP-2 for bone regeneration

Biomimetic delivery of chemokines and growth factors based on stem cell recruitment and endochondral ossification, as the key steps in natural regenerative process, has been an area of intense research in recent years. An inflammatory chemokine, interleukin-8 (IL-8), was recently reported with high recruitment efficiency of bone marrow stem cells, chondrogenic inductivity and immune regulatory functions. In this study, the effect of IL-8 action duration on bone morphogenetic protein-2 (BMP-2)-induced bone regeneration was studied to achieve an optimal synergism of these two proteins. Herein, a mesoporous bioactive glass (MBG)-based scaffold with BMP-2 entrapment and IL-8-loaded chitosan microspheres (CMs) was developed. The MBG scaffold with size-matched mesopores was adopted for the long-term sustained delivery of BMP-2; and CMs with different sizes, prepared using a modified ionotropic gelation method, were customized to match the optimal action time of IL-8. The results indicated that CMs of 100 μm diameter and medium crosslinking density exhibited an 85% release of IL-8 in 7 days and the MBG substrate exhibited a long-term sustained release of BMP-2. Furthermore, the binary delivery system exhibited excellent biocompatibility and synergistically enhanced osteoinductivity. In an in situ bone regeneration model of a rabbit radius large segmental defect, the system efficiently accelerated the whole regenerative process, with the highest bone formation amount from an early stage and the highest degree of regenerative completion. Since delivery systems for multiple cytokines have been in great demand due to the requirement of complicated biological processes, we believe that this new binary delivery system could be customized to design other dual delivery systems for improving bone-repairing biomaterials with higher regenerative efficiency.

Nanocements produced from mesoporous bioactive glass nanoparticles

Biomedical cements are considered promising injectable materials for bone repair and regeneration. Calcium phosphate composition sized with tens of micrometers is currently one of the major powder forms. Here we report a unique cement form made from mesoporous bioactive glass nanoparticles (BGn). The nanopowder could harden in reaction with aqueous solution at powder-to-liquid ratios as low as 0.4-0.5 (vs. 2.0-3.0 for conventional calcium phosphate cement CPC). The cementation mechanism investigated from TEM, XRD, FT-IR, XPS, and NMR analyses was demonstrated to be the ionic (Si and Ca) dissolution and then reprecipitation to form Si-Ca-(P) based amorphous nano-islands that could network the particles. The nanopowder-derived nanocement exhibited high surface area (78.7 m²/g); approximately 9 times higher than conventional CPC. The immersion of nanocement in simulated body fluid produced apatite nanocrystallites with ultrafine size of 10 nm (vs. 55 nm in CPC). The ultrafine nanocement adsorbed protein molecules (particularly positive charged proteins) at substantial levels; approximately 160 times higher than CPC. The nanocement released Si and Ca ions continuously over the test period of 2 weeks; the Si release was unique in nanocement whereas the Ca release was in a similar range to that observed in CPC. The release of ions significantly stimulated the responses of cells studied (rMSCs and HUVECs). The viability and osteogenesis of rMSCs were significantly enhanced by the nanocement ionic extracts. Furthermore, the in vitro tubular networking of HUVECs was improved by the nanocement ionic extracts. The in vivo neo-blood vessel formation in CAM model was significantly higher by the nanocement implant when compared with the CPC counterpart, implying the Si ion release might play a significant role in pro-angiogenesis. Furthermore, the early bone forming response of the nanocement, based on the implantation in a rat calvarial bone defect, demonstrated a sign of osteoinductivity along with excellent osteocondution and bone matrix formation. Although more studies remain to confirm the potential of nanocement, some of the intriguing physico-chemical properties and the biological responses reported herein support the promise of the new 'nanopowder-based nanocement' for hard tissue repair and regeneration.

Extraordinary biological properties of a new calcium hydroxyapatite/poly(lactide-co-glycolide)-based scaffold confirmed by in vivo investigation

This study examined the potential of a new porous calcium hydroxyapatite scaffold covered with poly (lactide-co-glycolide) (PLGA) as a bone substitute, identifying its advantages over Geistlich Bio-Oss®, considered the gold standard, in in vivo biofunctionality investigations. Structural and morphological properties of the new scaffold were analyzed by scanning electron and atomic force microscopy. The biofunctionality assays were performed on New Zealand white rabbits using new scaffold for filling full-thickness defects of critical size. The evaluated parameters were: the presence of macrophages, giant cells, monoocytes, plasma cells, granulocytes, neoangiogenesis, fibroplasia, and the percentage of mineralization. Parallel biofunctionality assays were performed using Geistlich Bio-Oss®. The appearance of bone defects 12 weeks after the new scaffold implantation showed the presence of a small number of typical immune response cells. Furthermore, significantly reduced number of capillary buds, low intensity of fibroplasia and high degree of mineralization in a lamellar pattern indicated that the inflammation process has been almost completely overcome and that the new bone formed was in the final phase of remodeling. All biofunctionality assays proved the new scaffold's suitability as a bone substitute for applications in maxillofacial surgery. It showed numerous biological advantages over Geistlich Bio-Oss® which was reflected mainly as a lower number of giant cells surrounding implanted material and higher degree of mineralization in new formed bone.

Enhanced biological fixation of ligaments to bone tissues utilizing chitin fabrics

In ligament reconstruction involving anterior cruciate ligament surgery, biological fixation between the transferred ligament and bone tissue is critical for achieving successful outcomes. Here, we administered chitin fabrics into the bone tunnels and evaluated their efficacy in promoting biological fixation. An animal model on the rat's patellar ligament was employed. First, bone tunnels were created in the lateral condyle of the femur. The ligament was then separated from the tibial tuberosity, and half was inserted into the tunnel and fixed with the use of end button. Animals in the experimental group were treated with microfiber nonwoven chitin fabric, whereas control animals received no treatment. Specimens were collected at 2, 4, and 6 weeks after surgery, and the fixation strength was measured by mechanical tests. Histological sections were prepared from samples prepared 4 weeks after surgery, and the diameter of bone tunnel and the width ratio of collagenous tissue in the bone tunnel were measured. Administration of chitin significantly increased the mean fixation strength at 4 and 6 weeks after surgery. Furthermore, chitin also promoted bone formation in the bone tunnel and increased the density of collagen fibers. Thus, microfiber nonwoven chitin fabric enhanced the biological fixation of the ligament to the bone tissue. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2355-2360, 2018.

Comparative study of porous hydroxyapatite/chitosan and whitlockite/chitosan scaffolds for bone regeneration in calvarial defects

Hydroxyapatite (HAP; Ca10(PO4)6(OH)2) and whitlockite (WH; Ca18Mg2(HPO4)2(PO4)12) are widely utilized in bone repair because they are the main components of hard tissues such as bones and teeth. In this paper, we synthesized HAP and WH hollow microspheres by using creatine phosphate disodium salt as an organic phosphorus source in aqueous solution through microwave-assisted hydrothermal method. Then, we prepared HAP/chitosan and WH/chitosan composite membranes to evaluate their biocompatibility in vitro and prepared porous HAP/chitosan and WH/chitosan scaffolds by freeze drying to compare their effects on bone regeneration in calvarial defects in a rat model. The experimental results indicated that the WH/chitosan composite membrane had a better biocompatibility, enhancing proliferation and osteogenic differentiation ability of human mesenchymal stem cells than HAP/chitosan. Moreover, the porous WH/chitosan scaffold can significantly promote bone regeneration in calvarial defects, and thus it is more promising for applications in tissue engineering such as calvarial repair compared to porous HAP/chitosan scaffold.

An update on the Application of Nanotechnology in Bone Tissue Engineering

Background:

Natural bone is a complex and hierarchical structure. Bone possesses an extracellular matrix that has a precise nano-sized environment to encourage osteoblasts to lay down bone by directing them through physical and chemical cues. For bone tissue regeneration, it is crucial for the scaffolds to mimic the native bone structure. Nanomaterials, with features on the nanoscale have shown the ability to provide the appropriate matrix environment to guide cell adhesion, migration and differentiation.

Methods:

This review summarises the new developments in bone tissue engineering using nanobiomaterials. The design and selection of fabrication methods and biomaterial types for bone tissue engineering will be reviewed. The interactions of cells with different nanostructured scaffolds will be discussed including nanocomposites, nanofibres and nanoparticles.

Results:

Several composite nanomaterials have been able to mimic the architecture of natural bone. Bioceramics biomaterials have shown to be very useful biomaterials for bone tissue engineering as they have osteoconductive and osteoinductive properties. Nanofibrous scaffolds have the ability to provide the appropriate matrix environment as they can mimic the extracellular matrix structure of bone. Nanoparticles have been used to deliver bioactive molecules and label and track stem cells.

Conclusion:

Future studies to improve the application of nanomaterials for bone tissue engineering are needed.

Immobilization of salvianolic acid B-loaded chitosan microspheres distributed three-dimensionally and homogeneously on the porous surface of hydroxyapatite scaffolds

Porous hydroxyapatite (HA) scaffolds combined with a drug delivery system have attracted much attention for bone tissue engineering. In this study, an easy and highly efficient method was developed to immobilize salvianolic acid B (Sal B)-loaded chitosan (CS) microspheres three dimensionally and homogeneously on the surface of HA scaffolds pre-coated with alginate. Porous HA scaffolds were prepared via a template-leaching process and CS microspheres (used as drug carriers) were fabricated by an emulsion method. To improve adhesion between the microspheres and HA scaffolds, alginate was used to pre-coat the porous surface of the HA scaffolds. Various concentrations of alginate were used to optimize the adhesion of Sal B-loaded CS microspheres to the scaffold surface. During the adherence process, coated HA scaffolds were immersed in an aqueous solution containing Sal B-loaded CS microspheres, followed by standing or shaking at 37 °C for a certain time. The results showed that the microspheres were solidly and homogeneously distributed on the porous surface of the alginate pre-coated HA scaffolds via electrostatic interactions. Few microspheres detached from the porous surface, even after the HA scaffolds with microspheres were treated by shaking in distilled water for as long as 7 d. Compared with the static condition, the distribution of Sal B-loaded CS microspheres on the porous surface of pre-coated HA scaffolds in the shaken condition was more homogeneous and almost unaggregated. Additionally, the compressive strength of the scaffolds coated with alginate was obviously improved. The optimal alginate coating concentration was 1% (i.e. the microstructure of the porous surfaces of the HA scaffolds was almost unchanged). The release profile of Sal B over a 30 d immersion found an initial burst release followed by a sustained release. The result of cell culture in vitro was that 1% alginate-coated scaffolds with Sal B-loaded CS microspheres obviously promoted cell proliferation after cell culture for 3 and 7 d, and cells were attached and uniformly distributed on the porous surface of the scaffolds. The strategy of incorporating drug-loaded microspheres with porous HA scaffolds could provide an excellent bone substitute for repair of bone tissue defects.

Production and characterization of hyaluronic acid microparticles for the controlled delivery of growth factors using a spray/dehydration method

Hyaluronic acid is the main polysaccharide present in the connective tissue. Besides its structural function as backbone of the extracellular matrix, hyaluronic acid plays staple roles in several biological processes including the modulation of inflammation and wound healing processes. The application of hyaluronic acid in regenerative medicine, either as cells and/or drug/growth factors delivery vehicles, relies on its ability to be cross-linked using a plethora of reactions, producing stable hydrogels. In this work, we propose a novel method for the production of hyaluronic acid microparticles that presents several advantages over others that have been used. Basically, droplets of hyaluronic acid solution produced with a nozzle are collected in an isopropanol dehydration bath, and stabilized after crosslinking with adipic acid dihydrazide, using a cabodiimide-based chemistry. The size and morphology of the hyaluronic acid microparticles produced by this method varied with the molecular weight and concentration of the hyaluronic acid solution, the nozzle chamber pressure, the distance between the nozzle and the crosslinking solution, and the number of crosslinking steps. The degree of crosslinking of the hyaluronic acid microparticles produced was tunable and allowed to control the rate of the degradation promoted by hyaluronidase. Moreover, the particles were loaded with platelet lysate, a hemoderivative rich in cytokines with interest for regenerative medicine applications. The hyaluronic acid microparticles showed potential to bind selectively to positively charged molecules, as the factors present in the platelet lysate. It is envisioned that these can be further released in a sustained manner by ion exchange or by the degradation of the hyaluronic acid microparticles matrix promoted by extracellular matrix remodeling.

Efficacy of the biomaterials 3wt%-nanostrontium-hydroxyapatite-enhanced calcium phosphate cement (nanoSr-CPC) and nanoSr-CPC-incorporated simvastatin-loaded poly(lactic-co-glycolic-acid) microspheres in osteogenesis improvement: An explorative multi-phase experimental in vitro/vivo study

AIMS

The purpose of this multi-phase explorative in vivo animal/surgical and in vitro multi-test experimental study was to (1) create a 3wt%-nanostrontium hydroxyapatite-enhanced calcium phosphate cement (Sr-HA/CPC) for increasing bone formation and (2) creating a simvastatin-loaded poly(lactic-co-glycolic acid) (SIM-loaded PLGA) microspheres plus CPC composite (SIM-loaded PLGA+nanostrontium-CPC). The third goal was the extensive assessment of multiple in vitro and in vivo characteristics of the above experimental explorative products in vitro and in vivo (animal and surgical studies).

METHODS AND RESULTS PERTAINING TO SR-HA/CPC

Physical and chemical properties of the prepared Sr-HA/CPC were evaluated. MTT assay and alkaline phosphatase activities, and radiological and histological examinations of Sr-HA/CPC, CPC and negative control were compared. X-ray diffraction (XRD) indicated that crystallinity of the prepared cement increased by increasing the powder-to-liquid ratio. Incorporation of Sr-HA into CPC increased MTT assay (biocompatibility) and ALP activity (P<0.05). Histomorphometry showed greater bone formation after 4weeks, after implantation of Sr-HA/CPC in 10 rats compared to implantations of CPC or empty defects in the same rats (n=30, ANOVA P<0.05). METHODS AND RESULTS PERTAINING TO SIM-LOADED PLGA MICROSPHERES+NANOSTRONTIUM-CPC COMPOSITE: After SEM assessment, the produced composite of microspheres and enhanced CPC were implanted for 8weeks in 10 rabbits, along with positive and negative controls, enhanced CPC, and enhanced CPC plus SIM (n=50). In the control group, only a small amount of bone had been regenerated (localized at the boundary of the defect); whereas, other groups showed new bone formation within and around the materials. A significant difference was found in the osteogenesis induced by the groups sham control (16.96±1.01), bone materials (32.28±4.03), nanostrontium-CPC (24.84±2.6), nanostrontium-CPC-simvastatin (40.12±3.29), and SIM-loaded PLGA+nanostrontium-CPC (44.8±6.45) (ANOVA P<0.001). All the pairwise comparisons were significant (Tukey P<0.01), except that of nanostrontium-CPC-simvastatin and SIM-loaded PLGA+nanostrontium-CPC. This confirmed the efficacy of the SIM-loaded PLGA+nanostrontium-CPC composite, and its superiority over all materials except SIM-containing nanostrontium-CPC.

Chitosan and Its Potential Use as a Scaffold for Tissue Engineering in Regenerative Medicine

Tissue engineering is an important therapeutic strategy to be used in regenerative medicine in the present and in the future. Functional biomaterials research is focused on the development and improvement of scaffolding, which can be used to repair or regenerate an organ or tissue. Scaffolds are one of the crucial factors for tissue engineering. Scaffolds consisting of natural polymers have recently been developed more quickly and have gained more popularity. These include chitosan, a copolymer derived from the alkaline deacetylation of chitin. Expectations for use of these scaffolds are increasing as the knowledge regarding their chemical and biological properties expands, and new biomedical applications are investigated. Due to their different biological properties such as being biocompatible, biodegradable, and bioactive, they have given the pattern for use in tissue engineering for repair and/or regeneration of different tissues including skin, bone, cartilage, nerves, liver, and muscle. In this review, we focus on the intrinsic properties offered by chitosan and its use in tissue engineering, considering it as a promising alternative for regenerative medicine as a bioactive polymer.

Role of Counterions in Controlling the Properties of Ultrasonically Generated Chitosan-Stabilized Oil-in-Water Emulsions

An oil-in-water emulsion was ultrasonically prepared in aqueous chitosan solutions containing different counterions. Tetradecane was used as the oil phase in order to mimic nonpolar substances used in food processes. Various acids were used to dissolve chitosan, and we found that conjugate bases of the acids used, which act as counterions to neutralize the positive charges of ammonium ions present in the chitosan backbone, played a significant role in controlling the size, size distribution, and stability of chitosan-encapsulated tedradecane emulsion droplets (microspheres). The counterion effect is also found to be strongly dependent upon tetradecane (TD)/chitosan (CS) ratio and ultrasonic power. Key observations are: (i) for a given TD/CS ratio, the size and size distribution decrease when the acid is varied from nitric acid to benzenesulfonic acid at high TD/CS ratio, and the effect becomes less significant at low TD/CS ratio; (ii) for a given acid, the size and size distribution increase with an increase in TD/CS ratio; and (iii) at low TD/CS ratio the size and size distribution are significantly influenced by the viscosity of the system. A possible mechanism for the observed counterion effect is proposed. The role of counterions, solution viscosity, and ultrasonic power in controlling the physical and functional properties of ultrasonically generated chitosan-stabilized tetradecane microspheres is discussed in detail. The key new finding of this study is that it is possible to form stable emulsions without the addition of external emulsifiers and stabilizers, but only using chitosan with different acids to dissolve chitosan. This strategy could be used in the generation of stable food emulsions.