Tissue responses to natural aragonite (Margaritifera shell) implants in vivo

On the physicochemical properties, setting chemical reaction, and in vitro bioactivity of aragonite–chitosan composite cement as a bone substitute

A chitosan gel additive modulates the initial vaterite dissolution–recrystallisation in injectable aragonite-based composite cement and promotes its in vitro bioactivity.

A global synthesis of ecosystem services provided and disrupted by freshwater bivalve molluscs

Identification of ecosystem services, i.e. the contributions that ecosystems make to human well-being, has proven instrumental in galvanising public and political support for safeguarding biodiversity and its benefits to people. Here we synthesise the global evidence on ecosystem services provided and disrupted by freshwater bivalves, a heterogenous group of >1200 species, including some of the most threatened (in Unionida) and invasive (e.g. Dreissena polymorpha) taxa globally. Our systematic literature review resulted in a data set of 904 records from 69 countries relating to 24 classes of provisioning (N = 189), cultural (N = 491) and regulating (N = 224) services following the Common International Classification of Ecosystem Services (CICES). Prominent ecosystem services included (i) the provisioning of food, materials and medicinal products, (ii) knowledge acquisition (e.g. on water quality, past environments and historical societies), ornamental and other cultural contributions, and (iii) the filtration, sequestration, storage and/or transformation of biological and physico-chemical water properties. About 9% of records provided evidence for the disruption rather than provision of ecosystem services. Synergies and trade-offs of ecosystem services were observed. For instance, water filtration by freshwater bivalves can be beneficial for the cultural service 'biomonitoring', while negatively or positively affecting food consumption or human recreation. Our evidence base spanned a total of 91 genera and 191 species, dominated by Unionida (55% of records, 76% of species), Veneroida (21 and 9%, respectively; mainly Corbicula spp.) and Myoida (20 and 4%, respectively; mainly Dreissena spp.). About one third of records, predominantly from Europe and the Americas, related to species that were non-native to the country of study. The majority of records originated from Asia (35%), with available evidence for 23 CICES classes, as well as Europe (29%) and North America (23%), where research was largely focused on 'biomonitoring'. Whilst the earliest record (from 1949) originated from North America, since 2000, annual output of records has increased rapidly in Asia and Europe. Future research should focus on filling gaps in knowledge in lesser-studied regions, including Africa and South America, and should look to provide a quantitative valuation of the socio-economic costs and benefits of ecosystem services shaped by freshwater bivalves.

Preclinical safety study of nacre powder in an intraosseous sheep model

Objectives

The purpose of this preclinical study was to evaluate the safety, the local tissue effects and bone healing performance (osteoconduction, osseointegration) of nacre powder in a sheep intraosseous implantation model. This represents the first preclinical study to assess nacre safety and efficacy in supporting new bone formation in accordance with the ISO 10993 standard for biomedical devices.

Methods

The local tissue effects and the material performance were evaluated 8 weeks after implantation by qualitative macroscopic observation and qualitative as well as semiquantitative microscopic analyses of the bone sites. Histopathological characterisations were run to assess local tissue effects. In addition, microarchitectural, histomorphometric and histological characterisations were used to evaluate the effects of the implanted material.

Results

Nacre powder was shown to cause a moderate inflammatory response in the site where it was implanted compared with the sites left empty. The biomaterial implanted within the generated defects was almost entirely degraded over the investigated time span and resulted in the formation of new bone with a seamless connection with the surrounding tissue. On the contrary, in the empty defects, the formation of a thick compact band of sclerotic bone was observed by both microarchitectural and histological characterisation.

Conclusions

Nacre powder was confirmed to be a safe biomaterial for bone regeneration applications in vivo, while supporting bone formation.

Induction of Osseointegration by Nacre in Pigs

Nacre is a biomaterial that has shown osteoinductive and osteoconductive properties in vitro and in vivo. These properties make nacre a material of interest for inducing bone regeneration. However, information is very limited regarding the introduction of nacre to dental implant surgery for promoting osteogenesis. This study investigated the potential of nacre powder for peri-implant bone regeneration in a porcine model. Ninety-six dental implants were placed into the tibia of twelve male domestic pigs. The dental implants were coated with nacre powder from the giant oyster before implantation. Implantations without nacre powder were used as control groups. Euthanization took place at 2, 4 and 6 weeks after implantation, after which we measured bone-to-implant contact (BIC) and bone volume density (BVD) of the implanted bone samples using micro-computed tomography (micro-CT), and examined the histology of the surrounding bone using histological sections stained with Stevenel’s blue and Alizarin red S. The micro-CT analyses showed that the BIC of dental implantations with nacre powder were significantly higher than those without nacre powder, by 7.60%. BVD of implantations with nacre powder were significantly higher than those without nacre powder, by 12.48% to 13.66% in cortical bone, and by 3.37% to 6.11% in spongy bone. Histological study revealed more peri-implant bone regeneration toward the surface of the dental implants after implantation with nacre powder. This was consistent with the micro-CT results. This study demonstrates the feasibility of using nacre to promote peri-implant bone regeneration in dental implantation.

Green efficient ultrasonic-assisted extraction of abalone nacre water-soluble organic matrix for bioinspired enamel remineralization

Reconstructing enamel-like hydroxyapatite structures on damaged teeth remains a great challenge in the materials science and dentistry due to its highly ordered hierarchical microstructure. Inspired by the mineralization of mollusk nacre in nature, abalone nacre water-soluble organic matrix (WSM) was isolated successfully though an ultrasonic-assisted water extraction (UWE) strategy with nondestructive activity and high-quality extraction for simulating the process of tooth hard tissue mineralization. Results showed that the UWE strategy significantly increased the protein yield from 7.60% to 9.60% and improved the polysaccharide yield from 2.59% to 3.34%, respectively, indicating its excellent extraction efficiency of WSM. Noteworthily, the smallest averaged particle size (~155 nm) of WSM were obtained at an ultrasound time of 6 h, whereas the highest absolute values (~ -32 mV) of zeta potential was produced. Moreover, it was proved that WSM could induce the growth of enamel-like hydroxyapatite crystals to further facilitate biomimetic remineralization of the demineralized enamel and restore its continuous and smooth surface structure in vitro. Besides, the hardness (4.37 ± 0.07 GPa) and modulus of elasticity (84.80 ± 1.49 GPa) of the WSM-repaired enamel was similar to that of native enamel, indicating superior mechanical properties after repair. Herein, it provides a promising green, efficient strategy for the remineralization of damaged enamel and high value utilization of waste abalone shells.

Natural Biomaterials from Biodiversity for Healthcare Applications

Natural biomaterials originating during the growth cycles of all living organisms have been used for many applications. They span from bioinert to bioactive materials including bioinspired ones. As they exhibit an increasing degree of sophistication, natural biomaterials have proven suitable to address the needs of the healthcare sector. Here the different natural healthcare biomaterials, their biodiversity sources, properties, and promising healthcare applications are reviewed. The variability of their properties as a result of considered species and their habitat is also discussed. Finally, some limitations of natural biomaterials are discussed and possible future developments are provided as more natural biomaterials are yet to be discovered and studied.

Piezoelectric hybrid scaffolds mineralized with calcium carbonate for tissue engineering: Analysis of local enzyme and small-molecule drug delivery, cell response and antibacterial performance

As the next generation of materials for bone reconstruction, we propose a multifunctional bioactive platform based on biodegradable piezoelectric polyhydroxybutyrate (PHB) fibrous scaffolds for tissue engineering with drug delivery capabilities. To use the entire surface area for local drug delivery, the scaffold surface was uniformly biomineralized with biocompatible calcium carbonate (CaCO₃) microparticles in a vaterite-calcite polymorph mixture. CaCO₃-coated PHB scaffolds demonstrated a similar elastic modulus compared to that of pristine one. However, reduced tensile strength and failure strain of 31% and 67% were observed, respectively. The biomimetic immobilization of enzyme alkaline phosphatase (ALP) and glycopeptide antibiotic vancomycin (VCM) preserved the CaCO₃-mineralized PHB scaffold morphology and resulted in partial recrystallization of vaterite to calcite. In comparison to pristine scaffolds, the loading efficiency of CaCO₃-mineralized PHB scaffolds was 4.6 and 3.5 times higher for VCM and ALP, respectively. Despite the increased number of cells incubated with ALP-immobilized scaffolds (up to 61% for non-mineralized and up to 36% for mineralized), the CaCO₃-mineralized PHB scaffolds showed cell adhesion; those containing both VCM and ALP molecules had the highest cell density. Importantly, no toxicity for pre-osteoblastic cells was detected, even in the VCM-immobilized scaffolds. In contrast with antibiotic-free scaffolds, the VCM-immobilized ones had a pronounced antibacterial effect against gram-positive bacteria Staphylococcus aureus. Thus, piezoelectric hybrid PHB scaffolds modified with CaCO₃ layers and immobilized VCM/ALP are promising materials in bone tissue engineering.

Biodegradable calcium carbonate/mesoporous silica/poly(lactic-glycolic acid) microspheres scaffolds with osteogenesis ability for bone regeneration

Sintered microsphere-based scaffolds provide a porous structure and high-resolution spatial organization control, show great potential for bone regeneration, mainly from biodegradable biomaterials including poly(lactic-glycolic acid) (PLGA). However, acidic monomer regeneration, mainly from biodegradable biomaterials including poly(lactic-glycolic acid) (PLGA). However, acidic monomers generated by PLGA degradation tend to cause tissue inflammation, which is the central issue of PLGA-based bone regeneration scaffolds development. In this work, calcium carbonate (CC)/hexagonal mesoporous silica (HMS)/PLGA sintered microsphere-based scaffolds were developed. The scaffolds possessed a three-dimensional (3D) network structure and 30–40% porosity. The degradation results indicated that CC/HMS/PLGA scaffolds could compensate for pH increased caused by PLGA acidic byproducts effectively. Degradation results showed that CC/HMS/PLGA scaffold could effectively compensate for the pH increase caused by PLGA acidic by-products. Composite CC additives can induce the increase of adhesive proteins in the environment, which is conducive to the adhesion of cells to scaffolds. Mesenchymal stem cells (MSCs) proliferation and osteogenic differentiation were evaluated by CCK-8 assay, alkaline phosphatase (ALP) activity, ALP staining, and Alizarin Red staining. The results showed that compared with HMS/PLGA scaffolds, the proliferation of MSCs cultured with CC/HMS/PLGA scaffolds was enhanced. When cultured on the CC/HMS/PLGA scaffolds, MSCs also showed significantly enhanced ALP activity and higher calcium secretion compared with the HMS/PLGA scaffolds. CC/HMS/PLGA sintered microsphere-based scaffolds provides an attractive strategy for bone repair and regeneration with better performance.

Sintered microsphere-based scaffolds provide a porous structure and high-resolution spatial organization control, show great potential for bone regeneration, mainly from biodegradable biomaterials including poly(lactic-glycolic acid) (PLGA).

In vivo osseointegration and erosion of nacre screws in an animal model

The use of resorbable devices for osteosynthesis has become a subject of interest. Nacre has been proposed as a resorbable and osteoconductive material favoring bone apposition without triggering an inflammatory reaction. We compared the in vivo osseointegration and erosion of nacre screws in an animal model with titanium screws. Implantation of similar nacre and titanium screws was performed in the femoral condyles of adult rats. Animals (n = 41) were randomized in four groups sacrificed at day one, 1, 6, and 12 months. Microcomputed tomography (microCT) allowed 3D morphometry of erosion of nacre. Osseointegration was measured as the volume of trabecular bone bone volume/tissue volume (BV/TV) in a standardized volume of interest around each screw. Undecalcified bone histology was also done. Gross examination revealed a similar clinical osseointegration for titanium and nacre screws. A progressive erosion of nacre screws, but no erosion of titanium screws, was observed in microCT. The volume of nacre screws progressively decreased over time whereas no modification occurred for titanium. For titanium screws, BV/TV remained stable throughout the study. For nacre screws, the BV/TV decrease was not statistically different. A significant difference was found between nacre and titanium screws at 6 months but not at 12 months. The screw heads, outside the bone shaft, were not eroded even after 12 months. Erosion of nacre occurred during the entire study period, only within the bone shaft in direct contact with bone marrow. Bone apposition was observed on nacre surfaces without signs of erosion. Nacre is a promising biomaterial in maxillofacial surgery.

The osteoinductive effect of nano-nacre particles on MC-3T3 E1 preosteoblast through controlled release of water soluble matrix and calciumions

Prostheses and implants have been widely utilized in the orthopedic and dental fields. Nowadays, significant advances have been made in the structural and functional connection between living bone and prostheses, especially in the presence of compromised bone quantity/quality. Despite improvement in the treatment outcomes after augmentation, there are still challenges to meet the clinical demands due to limited materials available. In the current study, we investigated the effects of nano-nacre particles as an alternative material on stimulating bone cell differentiation and formation. Mouse osteoblastic cells (MC3T3-E1) were cultured on nano-nacre/type I collagen composite scaffold (NN-ICS) and type I collagen scaffold (ICS). Generated nano-nacre particles showed controlled release of protein and calcium for a period of 36 days. NN-ICS significantly contributed to the proliferation and differentiation of preosteoblasts compared to ICS controls. Our data showed that nano-nacre particles could serve as a candidate of bone substitution material, which potentially contributed to treatment outcomes in cases with compromised bone quality and/or quality.

Giant cells and osteoclasts present in bone grafted with nacre differ by nuclear cytometry evaluated by texture analysis

Nacre (mother of pearl) is a natural biomaterial used to prepare orthopedic devices. We have implanted screws and plates made with nacre in five sheeps. Bone were harvested after two months and embedded in poly(methyl methacrylate). Blocks were saws and the thick slabs were grinded, polished and surface stained. Sections were photographed at an ×1000 magnification. Giant cells were found in contact with nacre in eroded areas and true osteoclasts were found at distance in the neighboring bone in Howship lacunae. A texture analysis of the nuclei of giant cells and osteoclasts was done using the run-length method of the MaZda freeware. The size of the nuclei was reduced in osteoclast and their mean gray level appeared reduced. Texture analysis revealed that chromatin had a completely different pattern in giant cells when compared to osteoclasts. Giant cells had a fine repartition of the chromatin with large clear areas around prominent nucleoli. On the contrary, osteoclast nuclei had chromatin blocks evenly dispersed in the nuclei. This reflects the different origin of these cells expressing different functions.

Phase-specific bioactivity and altered Ostwald ripening pathways of calcium carbonate polymorphs in simulated body fluid

Calcium carbonate is an abundant biomineral, and already archeological records demonstrate its bioactivity and applicability for osseo-integrative implants. Its solubility, which is generally higher than those of calcium phosphates, depends on its polymorph turning calcium carbonate into a promising biomaterial with tunable bioresorption rate. However, the phase-dependent bioactivity of calcium carbonate, i.e., its osteoconductivity, is still insufficiently characterized. In this study, we address this issue by monitoring the behavior of the four most important calcium carbonate phases, i.e., calcite, aragonite, vaterite, and amorphous calcium carbonate, in simulated body fluid solution at 37 °C. Our results demonstrate that the thermodynamically stable calcite phase is essentially inert. In contrast, the metastable phases aragonite and vaterite are bioactive, thus promoting the formation of calcium phosphate. Amorphous calcium carbonate (ACC) shows prominent bioactivity accompanied by pronounced redissolution processes. Mg-stabilized ACC was additionally tested since its increased stability eases formulation and handling in future applications. It is highly bioactive and, moreover, the additional release of Mg promotes cell viability. Overall, our results demonstrate that bioactivity of calcium carbonate is phase-dependent, allowing tailored response and bioactivity of future calcareous biomaterials. Our results also reveal that phosphate ions strongly interfere with Ostwald-Lussac step ripening of calcium carbonate, kinetically stabilizing metastable polymorphs such as vaterite and aragonite; this is a distinctive feature of the calcium carbonate mineral system which clearly has to be considered in future applications of calcium carbonate as a bioceramic.

Piezoelectric 3-D Fibrous Poly(3-hydroxybutyrate)-Based Scaffolds Ultrasound-Mineralized with Calcium Carbonate for Bone Tissue Engineering: Inorganic Phase Formation, Osteoblast Cell Adhesion, and Proliferation

Elaboration of novel biocomposites providing simultaneously both biodegradability and stimulated bone tissue repair is essential for regenerative medicine. In particular, piezoelectric biocomposites are attractive because of a possibility to electrically stimulate cell response. In the present study, novel CaCO₃-mineralized piezoelectric biodegradable scaffolds based on two polymers, poly[( R)3-hydroxybutyrate] (PHB) and poly[3-hydroxybutyrate- co-3-hydroxyvalerate] (PHBV), are presented. Mineralization of the scaffold surface is carried out by the in situ synthesis of CaCO₃ in the vaterite and calcite polymorphs using ultrasound (U/S). Comparative characterization of PHB and PHBV scaffolds demonstrated an impact of the porosity and surface charge on the mineralization in a dynamic mechanical system, as no essential distinction was observed in wettability, structure, and surface chemical compositions. A significantly higher (4.3 times) piezoelectric charge and a higher porosity (∼15%) lead to a more homogenous CaCO₃ growth in 3-D fibrous structures and result in a two times higher relative mass increase for PHB scaffolds compared to that for PHBV. This also increases the local ion concentration incurred upon mineralization under U/S-generated dynamic mechanical conditions. The modification of the wettability for PHB and PHBV scaffolds from hydrophobic (nonmineralized fibers) to superhydrophilic (mineralized fibers) led to a pronounced apatite-forming behavior of scaffolds in a simulated body fluid. In turn, this results in the formation of a dense monolayer of well-distributed and proliferated osteoblast cells along the fibers. CaCO₃-mineralized PHBV surfaces had a higher osteoblast cell adhesion and proliferation assigned to a higher amount of CaCO₃ on the surface compared to that on PHB scaffolds, as incurred from micro-computed tomography (μCT). Importantly, a cell viability study confirmed biocompatibility of all the scaffolds. Thus, hybrid biocomposites based on the piezoelectric PHB polymers represent an effective scaffold platform functionalized by an inorganic phase and stimulating the growth of the bone tissue.

50 years of scanning electron microscopy of bone-a comprehensive overview of the important discoveries made and insights gained into bone material properties in health, disease, and taphonomy

Bone is an architecturally complex system that constantly undergoes structural and functional optimisation through renewal and repair. The scanning electron microscope (SEM) is among the most frequently used instruments for examining bone. It offers the key advantage of very high spatial resolution coupled with a large depth of field and wide field of view. Interactions between incident electrons and atoms on the sample surface generate backscattered electrons, secondary electrons, and various other signals including X-rays that relay compositional and topographical information. Through selective removal or preservation of specific tissue components (organic, inorganic, cellular, vascular), their individual contribution(s) to the overall functional competence can be elucidated. With few restrictions on sample geometry and a variety of applicable sample-processing routes, a given sample may be conveniently adapted for multiple analytical methods. While a conventional SEM operates at high vacuum conditions that demand clean, dry, and electrically conductive samples, non-conductive materials (e.g., bone) can be imaged without significant modification from the natural state using an environmental scanning electron microscope. This review highlights important insights gained into bone microstructure and pathophysiology, bone response to implanted biomaterials, elemental analysis, SEM in paleoarchaeology, 3D imaging using focused ion beam techniques, correlative microscopy and in situ experiments. The capacity to image seamlessly across multiple length scales within the meso-micro-nano-continuum, the SEM lends itself to many unique and diverse applications, which attest to the versatility and user-friendly nature of this instrument for studying bone. Significant technological developments are anticipated for analysing bone using the SEM.

Polarized mapping Raman spectroscopy: identification of particle orientation in biominerals

The identification of the texture of biominerals and the particle orientation in the bivalve shells of Anodonta cygnea was performed using polarized Raman spectroscopy mapping measurements. A single crystal of aragonite served as a reference to disclose orientational information on the mesoscopic scale. The relative intensities of different Raman modes combined with the determination of depolarization ratio of the Ag Raman mode at 1087 cm−1 of an aragonite single crystal was used to indicate the angular variation of aragonite crystallites in biominerals. The imaging technique shows that the a- and b-axis of aragonite crystallites in both, nacreous and prismatic layers do not only have one orientation but they are organized in a domain-type arrangement. The angular divergence in the prismatic layer of the shells is larger and hence, the crystallites in the nacreous layer have a higher degree of co-orientation. Results provide relevant textural information about aragonitic shells and indicate a sensitive technique to evaluate the crystal orientation in biominerals.

PFMG1 promotes osteoblast differentiation and prevents osteoporotic bone loss

Nacre is a widely used mineral medicine that has been reported to have beneficial effects in bone remodeling without an increase in inflammation. Water-soluble nacre matrix has been demonstrated to be responsible for the effect, yet core active ingredients are unknown. Pinctada fucata mantle gene 1 (PFMG1) was first discovered in the mantle tissue of Pinctada fucata. The protein has 2 EF-hands, a calcium-binding domain. PFMG1 protein can affect the growth of calcium carbonate crystals in vitro. Here, we demonstrate that PFMG1 affects cell-cycle distribution and promotes preosteoblast proliferation. PFMG1 accelerates preosteoblast differentiation and extracellular matrix mineralization. During the differentiation process, PFMG1 increases the expression level of osteoblastic marker genes and activates the Erk signaling pathway. PFMG1 also accelerates calcium crystal aggregation in culture medium and suppresses osteoclast formation. Moreover, PFMG1 prevents bone loss caused by ovariectomy. RNA sequencing analysis demonstrated that PFMG1 stimulates genes that are associated with tissue development and ossification, which indicated new genes that function in bone remodeling. Our findings demonstrate the therapeutic potential of PFMG1 from nacre as a novel medicine for osteoporosis.-Li, L., Wang, P., Hu, K., Wang, X., Cai, W., Ai, C., Liu, S., Wang, Z. PFMG1 promotes osteoblast differentiation and prevents osteoporotic bone loss.

Ovarian Aging and Osteoporosis

Osteoporosis is the most common bone metabolic disease with a very high morbidity, and women usually got a higher risk of osteoporosis than men. The high incidence rate of osteoporosis in women was mainly caused by (1) women having fewer skeletons and bone mass, (2) pregnancy consuming a large amount of calcium and other nutrients, and most importantly (3) the cease of estrogen secretion by ovaries after menopause. Along with ovarian aging, the follicle pool gradually declines and the oocyte quality reduced, accompanied with decline in serum estrogen. Estrogen deficiency plays an important role in the pathogenesis of postmenopausal osteoporosis; it is mainly a result of the recognition that estrogen regulates bone remodeling by modulating the production of cytokines and growth factors from bone marrow and bone cells. This review will summarize current knowledge concerning ovarian aging and postmenopause osteoporosis and also discuss clinical treatment and new ideas of drug development for osteoporosis.

Design strategies and applications of nacre-based biomaterials

The field of tissue engineering and regenerative medicine relies heavily on materials capable of implantation without significant foreign body reactions and with the ability to promote tissue differentiation and regeneration. The field of bone tissue engineering in particular requires materials capable of providing enhanced mechanical properties and promoting osteogenic cell lineage commitment. While bone repair has long relied almost exclusively on inorganic, calcium phosphate ceramics such as hydroxyapatite and their composites or on non-degradable metals, the organically derived shell and pearl nacre generated by mollusks has emerged as a promising alternative. Nacre is a naturally occurring composite material composed of inorganic, calcium carbonate plates connected by a framework of organic molecules. Similar to mammalian bone, the highly organized microstructure of nacre endows the composite with superior mechanical properties while the organic phase contributes to significant bioactivity. Studies, both in vitro and in vivo, have demonstrated nacre's biocompatibility, biodegradability, and osteogenic potential, which are superior to pure inorganic minerals such as hydroxyapatite or non-degradable metals. Nacre can be used directly as a bulk implant or as part of a composite material when combined with polymers or other ceramics. While nacre has demonstrated its effectiveness in multiple cell culture and animal models, it remains a relatively underexplored biomaterial. This review introduces the formation, structure, and characteristics of nacre, and discusses the present and future uses of this biologically-derived material as a novel biomaterial for orthopedic and other tissue engineering applications.

STATEMENT OF SIGNIFICANCE

Mussel derived nacre, a biological composite composed of mineralized calcium carbonate platelets and interplatelet protein components, has recently gained interest as a potential alternative ceramic material in orthopedic biomaterials, combining the integration and mechanical capabilities of calcium phosphates with increased bioactivity derived from proteins and biomolecules; however, there is limited awareness of this material's potential. Herein, we present, to our knowledge, the first comprehensive review of nacre as a biomaterial. Nacre is a highly promising yet overlooked biomaterial for orthopedic tissue engineering with great potential in a wide variety of material systems. It is our hope that publication of this article will lead to increased community awareness of the potential of nacre as a versatile, bioactive ceramic capable of improving bone tissue regeneration and will elicit increased research effort and innovation utilizing nacre.

Nacre, a natural, multi-use, and timely biomaterial for bone graft substitution

During the past two decades, with a huge and rapidly increasing clinical need for bone regeneration and repair, bone substitutes are more and more seen as a potential solution. Major innovation efforts are being made to develop such substitutes, some having advanced even to clinical practice. It is now time to turn to natural biomaterials. Nacre, or mother-of-pearl, is an organic matrix-calcium carbonate coupled shell structure produced by molluscs. In vivo and in vitro studies have revealed that nacre is osteoinductive, osteoconductive, biocompatible, and biodegradable. With many other outstanding qualities, nacre represents a natural and multi-use biomaterial as a bone graft substitute. This review aims at summarising the current needs in orthopaedic clinics and the challenges for the development of bone substitutes; most of all, we systematically review the physiological characteristics and biological evidence of nacre's effects centred on osteogenesis, and finally we put forward the potential use of nacre as a bone graft substitute. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 662-671, 2017.

In vivo erosion of orthopedic screws prepared from nacre (mother of pearl)

BACKGROUND

Biodegradable biomaterials have been proposed to prepare orthopedic devices. Nacre is a natural aragonitic material made of calcium carbonate and is bioerodible.

WORKING HYPOTHESIS

We postulated that nacre is biodegradable without provoking bone erosion and favors bone apposition.

MATERIAL AND METHODS

We prepared orthopedic screws from nacre of the giant oyster Pinctada maxima. Threaded screws (3.5mm diameter) were implanted in 6 ewes in the upper tibial metaphysis (3 to 4 screws per animal). Their trajectory was transcortical and intramedullary to the opposite cortex. Animals were kept for 3months (n=2) and 6 months (n=4). They did not develop local inflammation. Before euthanasia, they received a double calcein labeling. Bone samples were analyzed by X-ray nanotomography and histology after embedding in poly(methyl methacrylate). The fractal dimension of the screw profiles (measured by the box-counting method) was used to quantify surface erosion.

RESULTS

3D nanotomography showed a gradual erosion of the threads, which was confirmed by a decreased fractal dimension. Histologically, multinucleated cells (non-osteoclastic appearance) were visible at the surface of the screws. No ruffled border was seen in these cells but they had extensions creeping in the organic matter between the aragonite tablets. Bone apposition was noted in the transcortical path of the screws with limited osteoconduction at the endosteum. Mineralization rate was increased in these zones composed of woven bone in contact with the nacre.

DISCUSSION AND CONCLUSION

Screws prepared from nacre have the advantage of an in vivo resorbability by macrophage-derived cells and an osteoconductive apposition in contact with the material without triggering a local inflammatory reaction.

Mesoscale twinning in shells of Pinctada martensii

Biominerals have attracted multidiscipline interest (e.g. in material, medical and bio-geosciences) due to their unique organic–inorganic microtexture. In this work, electron backscatter diffraction (EBSD) and topological analysis of pole figures show that aragonite nacreous layers of Pinctada martensii (marine bivalve) shells have a mesocrystalline organization, which consists of at least a two-level domain structure. Primary domains are related by twin laws. The twinning between the primary domains is described as “mesotwinning.” Each domain is twinned by (110) planes. Secondary domains inside the primary domains are submicrometre units, ranging from several to hundreds of microns in dimension. The secondary domains are separated by low-angle grain boundaries. Angles between primary domains are ca. 63.5° or 52.5°; angles between secondary domains range from 5° to 12°. The twin relationship is quantified and twin boundary patterns are discussed.

DFT Calculations with van der Waals Interactions of Hydrated Calcium Carbonate Crystals CaCO3·(H2O, 6H2O): Structural, Electronic, Optical, and Vibrational Properties

The role of hydration on the structural, electronic, optical, and vibrational properties of monohydrated (CaCO3·H2O, hexagonal, P31, Z = 9) and hexahydrated (CaCO3·6H2O, monoclinic, C2/c, Z = 4) calcite crystals is assessed with the help of published experimental and theoretical data applying density functional theory within the generalized gradient approximation and a dispersion correction scheme. We show that the presence of water increases the main band gap of monohydrocalcite by 0.4 eV relative to the anhydrous structure, although practically not changing the hexahydrocalcite band gap. The gap type, however, is modified from indirect to direct as one switches from the monohydrated to the hexahydrated crystal. A good agreement was obtained between the simulated vibrational infrared and Raman spectra and the experimental data, with an infrared signature of hexahydrocalcite relative to monohydrocalcite being observed at 837 cm(-1). Other important vibrational signatures of the lattice, water molecules, and CO3(2-) were identified as well. Analysis of the phonon dispersion curves shows that, as the hydration level of calcite increases, the longitudinal optical-transverse optical phonon splitting becomes smaller. The thermodynamics properties of hexahydrocalcite as a function of temperature resemble closely those of calcite, while monohydrocalcite exhibits a very distinct behavior.

Osteoblasts growth behaviour on bio-based calcium carbonate aragonite nanocrystal

Calcium carbonate (CaCO3) nanocrystals derived from cockle shells emerge to present a good concert in bone tissue engineering because of their potential to mimic the composition, structure, and properties of native bone. The aim of this study was to evaluate the biological response of CaCO3 nanocrystals on hFOB 1.19 and MC3T3 E-1 osteoblast cells in vitro. Cell viability and proliferation were assessed by MTT and BrdU assays, and LDH was measured to determine the effect of CaCO3 nanocrystals on cell membrane integrity. Cellular morphology was examined by SEM and fluorescence microscopy. The results showed that CaCO3 nanocrystals had no toxic effects to some extent. Cell proliferation, alkaline phosphatase activity, and protein synthesis were enhanced by the nanocrystals when compared to the control. Cellular interactions were improved, as indicated by SEM and fluorescent microscopy. The production of VEGF and TGF-1 was also affected by the CaCO3 nanocrystals. Therefore, bio-based CaCO3 nanocrystals were shown to stimulate osteoblast differentiation and improve the osteointegration process.

Early stage biomineralization in the periostracum of the 'living fossil' bivalve Neotrigonia

A detailed investigation of the shell formation of the palaeoheterodont ‘living fossil’ Neotrigonia concentrated on the timing and manufacture of the calcified ‘bosses’ which stud the outside of all trigonioid bivalves (extant and fossil) has been conducted. Electron microscopy and optical microscopy revealed that Neotrigonia spp. have a spiral-shaped periostracal groove. The periostracum itself is secreted by the basal cell, as a thin dark pellicle, becoming progressively transformed into a thin dark layer by additions of secretions from the internal outer mantle fold. Later, intense secretion of the internal surface of the outer mantle fold forms a translucent layer, which becomes transformed by tanning into a dark layer. The initiation of calcified bosses occurred at a very early stage of periostracum formation, deep within the periostracal groove immediately below the initialmost dark layer. At this stage, they consist of a series of polycyclically twinned crystals. The bosses grow as the periostracum traverse through the periostracal groove, in coordination with the thickening of the dark periostracal layer and until, upon reaching the mantle edge, they impinge upon each other and become transformed into large prisms separated by dark periostracal walls. In conclusion, the initial bosses and the external part of the prismatic layer are fully intraperiostracal. With later growth, the prisms transform into fibrous aggregates, although the details of the process are unknown. This reinforces the relationships with other groups that have the ability to form intraperiostracal calcifications, for example the unionoids with which the trigonioids form the clade Paleoheterodonta. The presence of similar structures in anomalodesmatans and other euheterodonts raises the question of whether this indicates a relationship or represents a convergence. The identification of very early calcification within an organic sheet has interesting implications for our understanding of how shells may have evolved.

Synthesis of nano-textured biocompatible scaffolds from chicken eggshells

Cell adhesion, morphology and growth are influenced by surface topography at nano and micrometer scales. Nano-textured surfaces are prepared using photolithography, plasma etching and long polymer chemical etching which are cost prohibitive and require specialized equipment. This article demonstrates a simple approach to synthesize nano-textured scaffolds from chicken eggshells. Varieties of pattern are made on the eggshells like micro-needle forests and nanopores, giving very uniform nano-textures to the surfaces. The surfaces are characterized for chemical composition and crystal phase. The novel patterns are transferred to PDMS surfaces and the nano-textured PDMS surfaces are used to study the effect of texturing on human fibroblast cell growth and attachment. The effects of surface topographies, along with laminin coating on cell cultures, are also studied. We find an exciting phenomenon that the initial seeding density of the fibroblast cells affects the influence of the nano-texturing on cell growth. These nano-textured surfaces give 16 times more fibroblast growth when compared to flat PDMS surfaces. The novel nano-textured patterns also double the laminin adsorption on PDMS.

Alveolar bone regeneration by implantation of nacre and B-tricalcium phosphate in guinea pig

PURPOSE

To investigate alveolar bone regeneration after nacre implantation in comparison to β-tricalcium phosphate (β-TCP) for the potential application to bone grafting.

MATERIAL AND METHODS

The rod-shaped, 2 × 2 mm in diameter and length, implanted materials were prepared from nacre particles of the giant oyster (Pinctada maxima), and β-TCP (Chronos; Synthes, Switzerland) particles. Bilateral drilling procedures were performed in 10 male guinea pigs in the mandible. Eight animals were implanted with nacre and β-TCP rods on each side of the mandibles. Two animals were sham operated. The animals were sacrificed after 30 and 60 days during the healing period. Decalcified histological sections of the mandibles were stained with azan stain.

RESULTS

Alveolar bone regeneration in surgically created defects was more effective in material-implanted groups than in the sham-operated group. The nacre-implanted group exhibited the highest new bone formation, followed by the β-TCP-implanted group and the sham-operated group, respectively. Large space filling with some fibrous tissue in central region of the defected site in β-TCP-implanted and sham-operated mandibles was noted.

CONCLUSION

The results demonstrate the feasibility of using nacre as an alternative bone graft material.

The role of nacreous factors in preventing osteoporotic bone loss through both osteoblast activation and osteoclast inactivation

Excessive bone resorption by osteoclasts relative to bone formation by osteoblasts results in the development of osteoporosis. Anti-osteoporotic agents that are able both to inhibit bone resorption and to stimulate bone formation are not available. We now show that water-soluble nacreous factors prepared from the pearl oyster Pteria martensii prevent osteoporotic bone loss associated with estrogen deficiency in mice mainly through osteoclast inactivation. Nacreous factors stimulated osteoblast biomineralization in vitro in association with activation of signaling by c-Jun NH(2)-terminal kinase (JNK) and Fos-related antigen-1 (Fra-1). They also suppressed both osteoclast formation by blocking up-regulation of nuclear factor of activated T cells cytoplasmic 1 (NFATc1) as well as bone pit formation mediated by mature osteoclasts, likely by disrupting the actin ring of these cells. Our findings thus show that the components of a natural material have beneficial effects on bone remodeling that are mediated through regulation of both osteoblast and osteoclast function. They may thus provide a basis for the development of biomimetic bone material as well as anti-osteoporotic agents.

Cellular attachment and osteoblast differentiation of mesenchymal stem cells on natural cuttlefish bone

The purpose of this study was to describe an approach that aims to provide fundamental information for the application of natural cuttlefish bone. Before applying cuttlefish bone as a bone defect filling material, we evaluated proliferation, adhesion, and cell viability of human mesenchymal stem cells (hMSCs) cultured on cuttlefish bone. Cuttlefish bone was separated into two parts (dorsal shield and lamellar region) and each part was used. Cell proliferation and viability were assessed using the MTS assay and live/dead fluorescence staining method. The morphology was observed using scanning electron microscopy (SEM). hMSCs were stimulated with osteogenic medium and osteoblast differentiation was evaluated. The fluorescence images showed that the seeded cells grew well and that cell distribution was in accordance with the surface morphology of the cuttlefish bone. Compared with the dorsal shield, cells penetrated deeper into the three-dimensional inner space of the lamellar part. Furthermore, under osteogenic differentiation conditions, alkaline phosphatase activity increased and the mRNA expression of ALP, runt-related transcription factor 2, and collagen type I α1 was increased in hMSCs cultured on both the dorsal shield and lamellar block. These results indicate the potential of cuttlefish bone as an ideal scaffold for bone regenerative materials. © 2012 Wiley Periodicals, Inc. J Biomed Mater Res Part A, 2012.

Potential induction of bone regeneration by nacre: an in vitro study

PURPOSE

Because of limitations of autogenous grafts, alternative bone substitute material was investigated for its capacity in promoting bone formation. This study compared the osteogenic effects of nacre (mother of pearl) and beta-tricalcium phosphate (β-TCP).

MATERIALS AND METHODS

Human bone cells (HBCs) were obtained from the culture of bone tissues after orthognathic surgery. The HBCs were cocultured with nacre chips of the giant oyster Pinctada maxima and with β-TCP particles for 1, 2, 3, and 4 weeks. Cells of each week specimens were used to study alkaline phosphatase (ALP), bone sialoprotein (BSP), and osteocalcin (OC) gene expression by noncompetitive reverse-transcriptase polymerase chain reaction and to study BSP synthesis by means of an immunocytochemical technique in conjunction with fluorescent microscopy.

RESULTS

Reverse-transcriptase polymerase chain reaction demonstrated stronger expression levels of ALP mRNA in HBCs cocultured with the nacre chips than those with β-TCP at weeks 2 and 4. BSP gene expression levels in HBCs with nacre were more intense compared with β-TCP at weeks 3 and 4. Although the OC gene expression level in HBCs with β-TCP was higher than those with nacre at week 2, the expression was not different at weeks 3 to 4. Immunocytochemical study revealed that BSP synthesis were presented in the nacre and β-TCP from week 2 and decreased toward week 4.

CONCLUSION

This study indicated that nacre promotes ALP, BSP, and OC gene expression.

Nacre-driven water-soluble factors promote wound healing of the deep burn porcine skin by recovering angiogenesis and fibroblast function

To assess the recovery effect of water-soluble components of nacre on wound healing of burns, water-soluble nacre (WSN) was obtained from powdered nacre. Alterations to WSN-mediated wound healing characteristics were examined in porcine skin with deep second-degree burns; porcine skin was used as a proxy for human. When WSN was applied to a burned area, the burn-induced granulation sites were rapidly filled with collagen, and the damaged dermis and epidermis were restored to the appearance of normal skin. WSN enhanced wound healing recovery properties for burn-induced apoptotic and necrotic cellular damage and spurred angiogenesis. Additionally, WSN-treated murine fibroblast NIH3T3 cells showed increased proliferation and collagen synthesis. Collectively, the findings indicate that WSN improves the process of wound healing in burns by expeditiously restoring angiogenesis and fibroblast activity. WSN may be useful as a therapeutic agent, with superior biocompatibility to powdered nacre, and evoking less discomfort when applied to a wounded area.

Synthesis of three-dimensional calcium carbonate nanofibrous structure from eggshell using femtosecond laser ablation

BACKGROUND

Natural biomaterials from bone-like minerals derived from avian eggshells have been considered as promising bone substitutes owing to their biodegradability, abundance, and lower price in comparison with synthetic biomaterials. However, cell adhesion to bulk biomaterials is poor and surface modifications are required to improve biomaterial-cell interaction. Three-dimensional (3D) nanostructures are preferred to act as growth support platforms for bone and stem cells. Although there have been several studies on generating nanoparticles from eggshells, no research has been reported on synthesizing 3D nanofibrous structures.

RESULTS

In this study, we propose a novel technique to synthesize 3D calcium carbonate interwoven nanofibrous platforms from eggshells using high repetition femtosecond laser irradiation. The eggshell waste is value engineered to calcium carbonate nanofibrous layer in a single step under ambient conditions. Our striking results demonstrate that by controlling the laser pulse repetition, nanostructures with different nanofiber density can be achieved. This approach presents an important step towards synthesizing 3D interwoven nanofibrous platforms from natural biomaterials.

CONCLUSION

The synthesized 3D nanofibrous structures can promote biomaterial interfacial properties to improve cell-platform surface interaction and develop new functional biomaterials for a variety of biomedical applications.

Pinctada fucata mantle gene 3 (PFMG3) promotes differentiation in mouse osteoblasts (MC3T3-E1)

Nacre is secreted from the mantle of pearl oysters. In vivo and in vitro experiments have demonstrated that water-soluble extracts of nacre stimulate osteoblast differentiation and matrix mineralization, but the component responsible for this activity is unclear. It was reported that Pinctada fucata mantle gene 3 (PFMG3) with an N-terminal signal peptide could be secreted into the nacre of P. fucata. Here we report that PFMG3 is specifically expressed at the outer fold of the mantle and could promote calcium carbonate crystal formation in vitro. Consistent with this observation, we found that matrix mineralization of MC3T3-E1 cells, a murine osteoblast cell line, is accelerated upon treatment with PFMG3. Intriguingly, we observed that alkaline phosphatase activity and cell viability are increased after treating MC3T3-E1 cell with PFMG3. mRNA levels of osteoblast-specific marker genes osteocalcin and osteopontin are also increased. We conclude that PFMG3 from the mantle of P. fucata promotes MC3T3-E1 osteoblast cell differentiation, matrix mineralization, and calcium carbonate deposition in vitro. Our findings provide new evidence that PFMG3 may be used as a potential therapeutic molecule for the treatment of osteoporosis.