Investigation of The Cellular Response to Bone Fractures: Evidence for Flexoelectricity

Efferocytosis and Bone Dynamics

PURPOSE OF REVIEW

This review summarizes the recently published scientific evidence regarding the role of efferocytosis in bone dynamics and skeletal health.

RECENT FINDINGS

Several types of efferocytes have been identified within the skeleton, with macrophages being the most extensively studied. Efferocytosis is not merely a 'clean-up' process vital for maintaining skeletal homeostasis; it also plays a crucial role in promoting resolution pathways and orchestrating bone dynamics, such as osteoblast-osteoclast coupling during bone remodeling. Impaired efferocytosis has been associated with aging-related bone loss and various skeletal pathologies, including osteoporosis, osteoarthritis, rheumatoid arthritis, and metastatic bone diseases. Accordingly, emerging evidence suggests that targeting efferocytic mechanisms has the potential to alleviate these conditions. While efferocytosis remains underexplored in the skeleton, recent discoveries have shed light on its pivotal role in bone dynamics, with important implications for skeletal health and pathology. However, there are several knowledge gaps and persisting technical limitations that must be addressed to fully unveil the contributions of efferocytosis in bone.

Local E-rhBMP-2/β-TCP Application Rescues Osteocyte Dendritic Integrity and Reduces Microstructural Damage in Alveolar Bone Post-Extraction in MRONJ-like Mouse Model

The pathology of medication-related osteonecrosis of the jaw (MRONJ), often associated with antiresorptive therapy, is still not fully understood. Osteocyte networks are known to play a critical role in maintaining bone homeostasis and repair, but the exact condition of these networks in MRONJ is unknown. On the other hand, the local application of E-coli-derived Recombinant Human Bone Morphogenetic Protein 2/β-Tricalcium phosphate (E-rhBMP-2/β-TCP) has been shown to promote bone regeneration and mitigate osteonecrosis in MRONJ-like mouse models, indicating its potential therapeutic application for the treatment of MRONJ. However, the detailed effect of BMP-2 treatment on restoring bone integrity, including its osteocyte network, in an MRONJ condition remains unclear. Therefore, in the present study, by applying a scanning electron microscope (SEM) analysis and a 3D osteocyte network reconstruction workflow on the alveolar bone surrounding the tooth extraction socket of an MRONJ-like mouse model, we examined the effectiveness of BMP-2/β-TCP therapy on the alleviation of MRONJ-related bone necrosis with a particular focus on the osteocyte network and alveolar bone microstructure (microcrack accumulation). The 3D osteocyte dendritic analysis showed a significant decrease in osteocyte dendritic parameters along with a delay in bone remodeling in the MRONJ group compared to the healthy counterpart. The SEM analysis also revealed a notable increase in the number of microcracks in the alveolar bone surface in the MRONJ group compared to the healthy group. In contrast, all of those parameters were restored in the E-rhBMP-2/β-TCP-treated group to levels that were almost similar to those in the healthy group. In summary, our study reveals that MRONJ induces osteocyte network degradation and microcrack accumulation, while application of E-rhBMP-2/β-TCP can restore a compromised osteocyte network and abrogate microcrack accumulation in MRONJ.

Nanotechnology's Applications and Potential in Various Fields

Since ancient times, several sorts of nanoparticles have been employed in the quickly expanding field of nanotechnology. These features include size, shape, and chemical as well as physical properties. Because of their small size and huge surface area, carbon-based nanoparticles, including fullerenes, carbon nanotubes, graphene, graphene oxide, and carbon-based quantum dots, have attracted a lot of attention in a variety of sectors, including biomedical applications. Lipid bilayers form the spherical vesicles known as liposomes. Magnetic resonance imaging (MRI) contrast agents are iron oxide nanoparticles. These materials are perfect for drug and delivery of genes, bioimaging, and bone repair because of their remarkable mechanical, electrical, visual, and chemical properties. However, concerns about potential asbestos-related diseases have arisen due to their length-to-width aspect ratio. Ceramic nanoparticles, on the other hand, are a common material in daily life and play a crucial role in bone repair, multiscale hybridisation, and aerospace structures. These nanoparticles can enhance osseointegration and bone development by mimicking the nanocomposition and nanoscale characteristics of bone tissue and enhance osteoconductive and osteoinductive capacities. Ceramic nanoparticles, however, have the potential to generate oxidative stress, which can result in irritation of the reticuloendothelial system, cytotoxicity to the heart, liver, and lungs, as well as toxicity to the cells that are attached. Additionally, oxidative stress, cell damage, and genotoxicity might result from the generation of free radicals by ceramic nanoparticles. Metal nanoparticles exhibit linear optical properties similar to molecular systems but arise from a different physical process. Semiconductor nanocrystals (NCs) are made from various compounds, such as silicon and germanium. Polyandry nanoparticles are particles approximately 10 and 10000 nanometers (nm) in size that can contain active substances. They have applications in vaccine delivery, gene therapy, and polymer nanoparticles (nanomedicine) for therapeutic applications.

Piezoelectric Amyloid Fibril for Energy Harvesting, Reactive Oxygen Species Generation, and Wireless Cell Therapy

Biomolecular piezoelectric materials are envisioned for advanced biomedical applications for their robust piezoelectricity, biocompatibility, and flexibility. Here, we report the piezoelectric property of amyloid fibrils derived from three distinct proteins: lysozyme, insulin, and amyloid-β. We found that piezoelectric properties are dependent on the extent of the β-sheet structure and the extent of fibril anisotropy. We have observed the piezoelectric constant value in the range of 24-42 pm/V for fibrils made of lysozyme/insulin/amyloid-β, and for the sheet/bundle-like structure of lysozyme aggregates, the value becomes 62 pm/V. These piezoelectric constant values are 4-10 times higher than the native lysozyme/insulin/amyloid proteins. Computational studies show that extension of the β-sheet structure produces an asymmetric arrangement of charges (in creating dipole moment) and mechanical stress induces an aligned orientation of these dipoles that results in a piezoelectric effect. It is shown that these piezoelectric fibrils can harvest mechanical as well as ultrasound-based energy to produce a voltage of up to 1 V and a current of up to 13 nA. These fibrils are employed for reactive oxygen species (ROS) generation under ultrasound exposure and utilized for ultrasonic degradation of organic pollutants or killing of cancer cells via intracellular ROS generation under ultrasound exposure. Our findings demonstrate that the piezoelectric property of protein fibrils has potential for wireless therapeutic applications and may have physiological roles that are yet to be explored.

Landscape of Well-Coordinated Fracture Healing in a Mouse Model Using Molecular and Cellular Analysis

The success of fracture healing relies on overlapping but coordinated cellular and molecular events. Characterizing an outline of differential gene regulation throughout successful healing is essential for identifying crucial phase-specific markers and may serve as the basis for engineering these in challenging healing situations. This study analyzed the healing progression of a standard closed femoral fracture model in C57BL/6N (age = 8 weeks) wild-type male mice. The fracture callus was assessed across various days post fracture (D = days 0, 3, 7, 10, 14, 21, and 28) by microarray, with D0 serving as a control. Histological analyses were carried out on samples from D7 until D28 to support the molecular findings. Microarray analysis revealed a differential regulation of immune response, angiogenesis, ossification, extracellular matrix regulation, mitochondrial and ribosomal genes during healing. In-depth analysis showed differential regulation of mitochondrial and ribosomal genes during the initial phase of healing. Furthermore, the differential gene expression showed an essential role of Serpin Family F Member 1 over the well-known Vascular Endothelial Growth Factor in angiogenesis, especially during the inflammatory phase. The significant upregulation of matrix metalloproteinase 13 and bone sialoprotein from D3 until D21 asserts their importance in bone mineralization. The study also shows type I collagen around osteocytes located in the ossified region at the periosteal surface during the first week of healing. Histological analysis of matrix extracellular phosphoglycoprotein and extracellular signal-regulated kinase stressed their roles in bone homeostasis and the physiological bone-healing process. This study reveals previously unknown and novel candidates, that could serve as a target for specific time points in healing and to remedy cases of impaired healing.

Directly Observing the Evolution of Flexoelectricity at the Tip of Nanocracks

As an electromechanical coupling between strain gradients and polarization, flexoelectricity is largely enhanced at the nanoscale. However, directly observing the evolution of flexoelectric fields at the nanoscale usually suffers from the difficulty of producing strain gradients and probing electrical responses simultaneously. Here, we introduce nanocracks in SrTiO₃, Ba_0.67Sr_0.33TiO₃, and TiO₂ samples and apply continuously varying mechanical loading to them, and as a result, huge strain gradients appear at the crack tip and result in a significant flexoelectric effect. Then, using atomic force microscopy, we successfully measure the evolution of flexoelectricity around the crack tips. For the case of SrTiO₃, the maximum induced electric field reaches 11 kV/m due to the tensile load increasing. The proposed method provides a reliable way to identify the significance of the flexoelectric effect. It may also open a new avenue for the study of flexoelectricity involving multiple physics phenomena including flexoelectronics, the flexo-photovoltaic effect, and others.

Mechanical writing of electrical polarization in poly (L-lactic) acid

Stimuli responsive materials are found in a broad range of applications, from energy harvesters to biomolecular sensors. Here, we report the production of poly (L-lactic acid) (PLLA) thin films that exhibit a mechanical stress responsive behaviour. By simply applying a mechanical stress through an AFM tip, a local electrical polarization was generated and measured by Kelvin Probe Force Microscopy. We showed that the magnitude of the stress generated electrical polarization can be manipulated by varying the thickness or crystallization state of the PLLA thin films. Besides exhibiting a mechanical stress-response behaviour with potential for energy harvesting and sensor applications, we show by AFM that these platforms react to mechanical forces with physiological relevance: interaction forces as low as a cell sheet migrating over a substrate or larger ones as the fluid induced stresses in bone tissue. In living tissues, as most mechanical stimuli are transduced as strain gradients for the anatomical structures, these mechanically responsive substrates can be used as ex vivo platforms to study the protein and cells response over a large range of electrical stimuli amplitude. As a proof of concept, selective adsorption of a human fibronectin was demonstrated by local patterning of the stimuli responsive PLLA films. STATEMENT OF SIGNIFICANCE: Bioelectricity is inherent to the formation and repair of living tissues and electrical stimulation has been recognized for promoting regeneration. Given the proven beneficial effects of electric fields and the absence of a suitable method of stimulation, there is a clinical need for smart substrates, which can generate a polarization (charges) to promote tissue regeneration without the need of external devices. In this work, we report the fabrication of poly(L-lactic) acid platforms that exhibit a mechanical stress responsive behaviour when subjected to physiologically relevant forces. This behaviour can be tailored by varying the thickness or crystallization state of the PLLA films. We further demonstrate the biofunctionality of such platforms by exploiting the mechanically-induced charge for adhesion protein adsorption.

BEM evaluation of surface octahedral strains and internal strain gradients in 3D-printed scaffolds used for bone tissue regeneration

Most of the mechnoregulatory computational models appearing so far in tissue engineering for bone healing predictions, utilize as regulators for cell differentiation mainly the octahedral volume strains and the interstitial fluid velocity calculated at any point of the fractured bone area and controlled by empirical constants concerning these two parameters. Other stimuli like the electrical and chemical signaling of bone constituents are covered by those two regulatory fields. It is apparent that the application of the same mechnoregulatory computational models for bone healing predictions in scaffold-aided regeneration is questionable since the material of a scaffold disturbs the signaling pathways developed in the environment of bone fracture. Thus, the goal of the present work is to evaluate numerically two fields developed in the body of two different compressed scaffolds, which seem to be proper for facilitating cell sensing and improving cell viability and cell seeding efficiency. These two fields concern the surface octahedral strains that the cells attached to the scaffold can experience and the internal strain gradients that create electrical pathways due to flexoelectric phenomenon. Both fields are evaluated with the aid of the Boundary Element Method (BEM), which is ideal for evaluating with high accuracy surface strains and stresses as well as strain gradients appearing throughout the analyzed elastic domain.

Silk-Based Materials for Hard Tissue Engineering

Hard tissues, e.g., bone, are mechanically stiff and, most typically, mineralized. To design scaffolds for hard tissue regeneration, mechanical, physico-chemical and biological cues must align with those found in the natural tissue. Combining these aspects poses challenges for material and construct design. Silk-based materials are promising for bone tissue regeneration as they fulfill several of such necessary requirements, and they are non-toxic and biodegradable. They can be processed into a variety of morphologies such as hydrogels, particles and fibers and can be mineralized. Therefore, silk-based materials are versatile candidates for biomedical applications in the field of hard tissue engineering. This review summarizes silk-based approaches for mineralized tissue replacements, and how to find the balance between sufficient material stiffness upon mineralization and cell survival upon attachment as well as nutrient supply.

Smart Porous Multi-Stimulus Polysaccharide-Based Biomaterials for Tissue Engineering

Recently, tissue engineering and regenerative medicine studies have evaluated smart biomaterials as implantable scaffolds and their interaction with cells for biomedical applications. Porous materials have been used in tissue engineering as synthetic extracellular matrices, promoting the attachment and migration of host cells to induce the in vitro regeneration of different tissues. Biomimetic 3D scaffold systems allow control over biophysical and biochemical cues, modulating the extracellular environment through mechanical, electrical, and biochemical stimulation of cells, driving their molecular reprogramming. In this review, first we outline the main advantages of using polysaccharides as raw materials for porous scaffolds, as well as the most common processing pathways to obtain the adequate textural properties, allowing the integration and attachment of cells. The second approach focuses on the tunable characteristics of the synthetic matrix, emphasizing the effect of their mechanical properties and the modification with conducting polymers in the cell response. The use and influence of polysaccharide-based porous materials as drug delivery systems for biochemical stimulation of cells is also described. Overall, engineered biomaterials are proposed as an effective strategy to improve in vitro tissue regeneration and future research directions of modified polysaccharide-based materials in the biomedical field are suggested.