Non-mulberry silk fibroin influence osteogenesis and osteoblast-macrophage cross talk on titanium based surface

A Comprehensive Review on Silk Fibroin as a Persuasive Biomaterial for Bone Tissue Engineering

Bone tissue engineering (BTE) utilizes a special mix of scaffolds, cells, and bioactive factors to regulate the microenvironment of bone regeneration and form a three-dimensional bone simulation structure to regenerate bone tissue. Silk fibroin (SF) is perhaps the most encouraging material for BTE given its tunable mechanical properties, controllable biodegradability, and excellent biocompatibility. Numerous studies have confirmed the significance of SF for stimulating bone formation. In this review, we start by introducing the structure and characteristics of SF. After that, the immunological mechanism of SF for osteogenesis is summarized, and various forms of SF biomaterials and the latest development prospects of SF in BTE are emphatically introduced. Biomaterials based on SF have great potential in bone tissue engineering, and this review will serve as a resource for future design and research.

Natural Coatings and Surface Modifications on Magnesium Alloys for Biomedical Applications

Magnesium (Mg) alloys have great potential in biomedical applications due to their incomparable properties regarding other metals, such as stainless steels, Co-Cr alloys, and titanium (Ti) alloys. However, when Mg engages with body fluids, its degradation rate increases, inhibiting the complete healing of bone tissue. For this reason, it has been necessary to implement protective coatings to control the rate of degradation. This review focuses on natural biopolymer coatings used on Mg alloys for resorbable biomedical applications, as well as some modification techniques implemented before applying natural polymer coatings to improve their performance. Issues such as improving the corrosion resistance, cell adhesion, proliferation, and biodegradability of natural biopolymers are discussed through their basic comparison with inorganic-type coatings. Emphasis is placed on the expected biological behavior of each natural polymer described, to provide basic information as a reference on this topic.

Advancement in "Garbage In Biomaterials Out (GIBO)" concept to develop biomaterials from agricultural waste for tissue engineering and biomedical applications

Presently on a global scale, one of the major concerns is to find effective strategies to manage the agricultural waste to protect the environment. One strategy that has been drawing attention among the researchers is the development of biocompatible materials from agricultural waste. This strategy implies successful conversion of agricultural waste products (e.g.: cellulose, eggshell etc.) into building blocks for biomaterial development. Some of these wastes contain even bioactive compounds having biomedical applications. The replacement and augmentation of human tissue with biomaterials as alternative to traditional method not only bypasses immune-rejection, donor scarcity, and maintenance; but also provides long term solution to damaged or malfunctioning organs. Biomaterials development as one of the key challenges in tissue engineering approach, resourced from natural origin imparts better biocompatibility due to closely mimicking composition with cellular microenvironment. The "Garbage In, Biomaterials Out (GIBO)" concept, not only recycles the agricultural wastes, but also adds to biomaterial raw products for further product development in tissue regeneration. This paper reviews the conversion of garbage agricultural by-products to the biocompatible materials for various biomedical applications.

GRAPHICAL ABSTRACT

The agro-waste biomass processed, purified, modified, and further utilized for the fabrication of biomaterials-based support system for tissue engineering applications to grow living body parts in vitro or in vivo.

Nonmulberry silk fibroin-based biomaterials: Impact on cell behavior regulation and tissue regeneration

Silk fibroin (SF) is a promising biomaterial due to its good biocompatibility, easy availability, and high mechanical properties. Compared with mulberry silk fibroin (MSF), nonmulberry silk fibroin (NSF) isolated from typical nonmulberry silkworm silk exhibits unique arginine-glycine-aspartic acid (RGD) sequences with favorable cell adhesion enhancing effect. This inherent property probably makes the NSF more suitable for cell culture and tissue regeneration-related applications. Accordingly, various types of NSF-based biomaterials, such as particles, films, fiber mats, and 3D scaffolds, are constructed and their application potential in different biomedical fields is extensively investigated. Based on these promising NSF biomaterials, this review firstly makes a systematical comparison between the molecular structure and properties of MSF and typical NSF and highlights the unique properties of NSF. In addition, we summarize the effective fabrication strategies from degummed nonmulberry silk fibers to regenerated NSF-based biomaterials with controllable formats and their recent application progresses in cell behavior regulation and tissue regeneration. Finally, current challenges and future perspectives for the fabrication and application of NSF-based biomaterials are discussed. Related research and perspectives may provide valuable references for designing and modifying effective NSF-based and other natural biomaterials. STATEMENT OF SIGNIFICANCE: There exist many reviews about mulberry silk fibroin (MSF) biomaterials and their biomedical applications, while that about nonmulberry silk fibroin (NSF) biomaterials is scarce. Compared with MSF, NSF exhibits unique arginine-glycine-aspartic acid sequences with promising cell adhesion enhancing effect, which makes NSF more suitable for cell culture and tissue regeneration related applications. Focusing on these advanced NSF biomaterials, this review has systematically compared the structure and properties of MSF and NSF, and emphasized the unique properties of NSF. Following that, the effective construction strategies for NSF-based biomaterials are summarized, and their recent applications in cell behavior regulations and tissue regenerations are highlighted. Furthermore, current challenges and future perspectives for the fabrication and application of NSF-based biomaterials were discussed.

Osteoimmunomodulatory potential of 3D printed submicron patterns assessed in a direct co-culture model

Modulation of the immune response following the implantation of biomaterials can have beneficial effects on bone regeneration. This involves complex interactions between the inflammatory and osteogenic cells. Therefore, the study of cell-cell interactions using direct co-culture models integrated with biomaterials is of great interest. This research aimed to study the viability, morphology, and osteogenic activity of preosteoblasts (OBs) co-cultured with pro-inflammatory macrophages (M1s) on the 3D printed (non)patterned surfaces. OBs and M1s remained alive and proliferated actively for 14 days in the mixture of Dulbecco's Modified Eagle's Medium (DMEM) and alpha Minimum Essential Medium (α-MEM) (1:1), regardless of the cell ratio in the co-cultures. The spatial organization of the two types of cells changed with the time of culture from an initially uniform cell distribution to the formation of a thick layer of OBs covered by clusters of M1s. On day 7, the expression of PGE2 and TNF-α were upregulated in the co-culture relative to the mono-culture of OBs and M1s. The inflammation decreased differentiation and matrix mineralization of OBs after 28 days of culture. Interestingly, the incorporation of 3D printed submicron pillars into the direct co-culture model enhanced the differentiation of preosteoblasts, as shown by relatively higher RUNX2 expression, thereby revealing the osteoimmunomodulatory potential of such surface patterns.

Silk Fibroin/Hydroxyapatite Coating Improved Osseointegration of Porous Titanium Implants under Diabetic Conditions via Activation of the PI3K/Akt Signaling Pathway

The application of three-dimensional printed porous titanium implants (TIs) is compromised in patients suffering from diabetes mellitus (DM), which disturbs the normal process of implant osseointegration, resulting in fixation failure. It was possibly because of reactive oxygen species (ROS) overproduction at the bone-implant interface. A silk fibroin-based hydroxyapatite (SF/HA) hybrid material emerged as a novel biological material for accelerating new bone formation. We proposed that the SF/HA hybrid coated titanium implant (SHT) could mitigate DM-mediated impaired osseointegration, which had never been reported previously. To test this assumption and further elucidate the mechanisms, primary rabbit osteoblasts were seeded on TIs or SHTs and cultured with normal serum, diabetic serum (DS), DS + N-acetyl-L-cysteine (NAC) (a potent ROS inhibitor), and DS + LY294002 (a specific PI3K/Akt inhibitor) for osteoblast behavior examinations. An animal study was performed on diabetic rabbits implanted with the two kinds of implants for osseointegration tests. DM-mediated ROS overproduction caused osteoblastic biological dysfunctions and apoptotic injury, associated with suppression of PI3K/Akt signaling in osteoblasts cultured on a TI substrate. Of note, the SHT substrate significantly suppressed ROS overproduction under diabetic conditions, improved osteoblast functional recovery including ameliorative osteoblast adhesion and morphology, improved cellular proliferation and differentiation, and abrogated apoptosis, which exhibited the same effect as NAC administration on the TI. The in vitro results were further corroborated in vivo by enhanced osteogenesis and osseointegration of SHTs in diabetic rabbits. Moreover, the aforesaid promotive effects afforded by the SF/HA coating were totally abolished with administration of LY294002 for blocking PI3K/Akt signaling. The above results collectively demonstrated that the SF/HA hybrid coating significantly ameliorated DM-mediated impaired osseointegration of the TI via reactivation of the ROS-mediated PI3K/Akt signaling pathway. The hybrid coating elicited a novel surface biofunctionalization strategy to attain favorable clinical performance of TI in diabetics.

Superior processability of Antheraea mylitta silk with cryo-milling: Performance in bone tissue regeneration

Non-mulberry silk polymers have a promising future in biomedical applications. However, the dissolution of non-mulberry silk fiber is a still challenge and this poor processability has limited the use of this material. Here, we report a unique protocol to process the Antheraea mylitta (AM) silk fiber. We have shown that the cryo-milling of silk fiber reduces the beta sheet content by more than 10% and results in an SF powder that completely dissolves in routine solvents like trifluoroacetic acid (TFA) within few hours to form highly concentrated solutions (~20 wt%). Further, these solutions can be processed using conventional processing techniques such as electrospinning to form 3D scaffolds. Bombyx mori (BM) silk was used as a control sample in the study. In-vitro studies were also performed to monitor cell adhesion and proliferation and hMSCs differentiation into osteogenic lineage. Finally, the osteogenic potential of the scaffolds was also evaluated by a 4-week implantation study in rat calvarial model. The in-vitro and in-vivo results show that the processing techniques do not affect the biocompatibility of the material and the AM scaffolds support bone regeneration. Our results, thus, show that cryo-milling facilitates enhanced processability of non-mulberry silk and therefore expands its potential in biomedical applications.

Nonmulberry silk proteins: multipurpose ingredient in bio-functional assembly

The emerging field of tissue engineering and regenerative medicines utilising artificial polymers is facing many problems. Despite having mechanical stability, non-toxicity and biodegradability, most of them lack cytocompatibility and biocompatibility. Natural polymers (such as collagen, hyaluronic acid, fibrin, fibroin, and others), including blends, are introduced to the field to solve some of the relevant issues. Another natural biopolymer: silkworm silk gained special attention primarily due to its specific biophysical, biochemical, and material properties, worldwide availability, and cost-effectiveness. Silk proteins, namely fibroin and sericin extracted from domesticated mulberry silkwormBombyx mori, are studied extensively in the last few decades for tissue engineering. Wild nonmulberry silkworm species, originated from India and other parts of the world, also produce silk proteins with variations in their nature and properties. Among the nonmulberry silkworm species,Antheraea mylitta(Indian Tropical Tasar),A. assamensis/A. assama(Indian Muga), andSamia ricini/Philosamia ricini(Indian Eri), along withA. pernyi(Chinese temperate Oak Tasar/Tussah) andA. yamamai(Japanese Oak Tasar) exhibit inherent tripeptide motifs of arginyl glycyl aspartic acid in their fibroin amino acid sequences, which support their candidacy as the potential biomaterials. Similarly, sericin isolated from such wild species delivers unique properties and is used as anti-apoptotic and growth-inducing factors in regenerative medicines. Other characteristics such as biodegradability, biocompatibility, and non-inflammatory nature make it suitable for tissue engineering and regenerative medicine based applications. A diverse range of matrices, including but not limited to nano-micro scale structures, nanofibres, thin films, hydrogels, and porous scaffolds, are prepared from the silk proteins (fibroins and sericins) for biomedical and tissue engineering research. This review aims to represent the progress made in medical and non-medical applications in the last couple of years and depict the present status of the investigations on Indian nonmulberry silk-based matrices as a particular reference due to its remarkable potentiality of regeneration of different types of tissues. It also discusses the future perspective in tissue engineering and regenerative medicines in the context of developing cutting-edge techniques such as 3D printing/bioprinting, microfluidics, organ-on-a-chip, and other electronics, optical and thermal property-based applications.

Peptide-Enriched Silk Fibroin Sponge and Trabecular Titanium Composites to Enhance Bone Ingrowth of Prosthetic Implants in an Ovine Model of Bone Gaps

Osteoarthritis frequently requires arthroplasty. Cementless implants are widely used in clinics to replace damaged cartilage or missing bone tissue. In cementless arthroplasty, the risk of aseptic loosening strictly depends on implant stability and bone–implant interface, which are fundamental to guarantee the long-term success of the implant. Ameliorating the features of prosthetic materials, including their porosity and/or geometry, and identifying osteoconductive and/or osteoinductive coatings of implant surfaces are the main strategies to enhance the bone-implant contact surface area. Herein, the development of a novel composite consisting in the association of macro-porous trabecular titanium with silk fibroin (SF) sponges enriched with anionic fibroin-derived polypeptides is described. This composite is applied to improve early bone ingrowth into the implant mesh in a sheep model of bone defects. The composite enables to nucleate carbonated hydroxyapatite and accelerates the osteoblastic differentiation of resident cells, inducing an outward bone growth, a feature that can be particularly relevant when applying these implants in the case of poor osseointegration. Moreover, the osteoconductive properties of peptide-enriched SF sponges support an inward bone deposition from the native bone towards the implants. This technology can be exploited to improve the biological functionality of various prosthetic materials in terms of early bone fixation and prevention of aseptic loosening in prosthetic surgery.

The Effects of Biomaterial Implant Wear Debris on Osteoblasts

Aseptic loosening subsequent to periprosthetic osteolysis is the leading cause for the revision of arthroplasty failure. The biological response of macrophages to wear debris has been well established, however, the equilibrium of bone remodeling is not only dictated by osteoclastic bone resorption but also by osteoblast-mediated bone formation. Increasing evidence shows that wear debris significantly impair osteoblastic physiology and subsequent bone formation. In the present review, we update the current state of knowledge regarding the effect of biomaterial implant wear debris on osteoblasts. The interaction of osteoblasts with osteoclasts and macrophages under wear debris challenge, and potential treatment options targeting osteoblasts are also presented.

Fabrication and characterization of silk fibroin coating on APTES pretreated Mg-Zn-Ca alloy

To delay the degradation of magnesium alloys, silk fibroin as a natural organic polymer coating was fabricated on a 3-amino-propyltriethoxysilane (APTES) pretreated Mg-Zn-Ca alloy. APTES pretreatment coated the surface of magnesium alloys with amino groups, which can bond with functional groups in silk fibroin to form a compact coating/substrate interface. The influences of the APTES concentration and drying temperature on the coating adhesion and interface were investigated to explore the optimal parameters in the fabrication process. The nanoporous silk fibroin films completely covered the APTES pretreated Mg-Zn-Ca surface, which reached a thickness of ~7 μm. The chemical states for the coated Mg-Zn-Ca alloy were compared to those of the bare Mg-Zn-Ca alloy and the APTES pretreated Mg-Zn-Ca alloy to illustrate the coating mechanism. During in vitro degradation and electrochemical measurements in simulated body fluid (SBF), the samples with the silk fibroin coating showed remarkably improved corrosion resistance and a slower degradation rate compared to those of the bare samples, suggesting that the silk fibroin coating was an effective protection coating for the substrates and can delay the degradation of magnesium alloys. Moreover, a model for the in vitro degradation was proposed. In vitro cell experiments confirmed the excellent biocompatibility of silk fibroin coated Mg-Zn-Ca structure.

Recent trends in the application of widely used natural and synthetic polymer nanocomposites in bone tissue regeneration

The goal of a biomaterial is to support the bone tissue regeneration process at the defect site and eventually degrade in situ and get replaced with the newly generated bone tissue. Nanocomposite biomaterials are a relatively new class of materials that incorporate a biopolymeric and biodegradable matrix structure with bioactive and easily resorbable fillers which are nano-sized. This article is a review of a few polymeric nanocomposite biomaterials which are potential candidates for bone tissue regeneration. These nanocomposites have been broadly classified into two groups viz. natural and synthetic polymer based. Natural polymer-based nanocomposites include materials fabricated through reinforcement of nanoparticles and/or nanofibers in a natural polymer matrix. Several widely used natural biopolymers, such as chitosan (CS), collagen (Col), cellulose, silk fibroin (SF), alginate, and fucoidan, have been reviewed regarding their present investigation on the incorporation of nanomaterial, biocompatibility, and tissue regeneration. Synthetic polymer-based nanocomposites that have been covered in this review include polycaprolactone (PCL), poly (lactic-co-glycolic) acid (PLGA), polyethylene glycol (PEG), poly (lactic acid) (PLA), and polyurethane (PU) based nanocomposites. An array of nanofillers, such as nano hydroxyapatite (nHA), nano zirconia (nZr), nano silica (nSi), silver nano particles (AgNPs), nano titanium dioxide (nTiO₂), graphene oxide (GO), that is used widely across the bone tissue regeneration research platform are included in this review with respect to their incorporation into a natural and/or synthetic polymer matrix. The influence of nanofillers on cell viability, both in vitro and in vivo, along with cytocompatibility and new tissue generation has been encompassed in this review. Moreover, nanocomposite material characterization using some commonly used analytical techniques, such as electron microscopy, spectroscopy, diffraction patterns etc., has been highlighted in this review. Biomaterial physical properties, such as pore size, porosity, particle size, and mechanical strength which strongly influences cell attachment, proliferation, and subsequent tissue growth has been covered in this review. This review has been sculptured around a case by case basis of current research that is being undertaken in the field of bone regeneration engineering. The nanofillers induced into the polymeric matrix render important properties, such as large surface area, improved mechanical strength as well as stability, improved cell adhesion, proliferation, and cell differentiation. The selection of nanocomposites is thus crucial in the analysis of viable treatment strategies for bone tissue regeneration for specific bone defects such as craniofacial defects. The effects of growth factor incorporation on the nanocomposite for controlling new bone generation are also important during the biomaterial design phase.

Emergence of Three Dimensional Printed Cardiac Tissue: Opportunities and Challenges in Cardiovascular Diseases

Three-dimensional (3D) printing, also known as additive manufacturing, was developed originally for engineering applications. Since its early advancements, there has been a relentless de-velopment in enthusiasm for this innovation in biomedical research. It allows for the fabrication of structures with both complex geometries and heterogeneous material properties. Tissue engineering using 3D bio-printers can overcome the limitations of traditional tissue engineering methods. It can match the complexity and cellular microenvironment of human organs and tissues, which drives much of the interest in this technique. However, most of the preliminary evaluations of 3D-printed tissues and organ engineering, including cardiac tissue, relies extensively on the lessons learned from tradi-tional tissue engineering. In many early examples, the final printed structures were found to be no bet-ter than tissues developed using traditional tissue engineering methods. This highlights the fact that 3D bio-printing of human tissue is still very much in its infancy and more work needs to be done to realise its full potential. This can be achieved through interdisciplinary collaboration between engi-neers, biomaterial scientists and molecular cell biologists. This review highlights current advance-ments and future prospects for 3D bio-printing in engineering ex vivo cardiac tissue and associated vasculature, such as coronary arteries. In this context, the role of biomaterials for hydrogel matrices and choice of cells are discussed. 3D bio-printing has the potential to advance current research signif-icantly and support the development of novel therapeutics which can improve the therapeutic out-comes of patients suffering fatal cardiovascular pathologies.

Silk fibroin film-coated MgZnCa alloy with enhanced in vitro and in vivo performance prepared using surface activation

Magnesium and its alloys have generated considerable interest as one of the most promising biodegradable metals for biomedical bone implants. However, the enormous challenges are to improve their rapid corrosion excessively as well as to endow them with biocompatibility and biosafety. Herein, we introduce a natural silk fibroin protein coating to control the corrosion resistance and enhance the biocompatibility of MgZnCa alloy. To obtain a robust and reliable coated structure, different surface-activation processes are employed to increase the available functional groups on MgZnCa surfaces before coating. Compared to oxygen plasma activation, our unique vacuum ultraviolet-ozone (VUV/O₃) activation method is effective in realizing uniform silk fibroin films as a protective barrier on MgZnCa alloy surfaces, and the nanoscratch test verified the superior adhesion strength of the silk fibroin-coated magnesium alloy structure. Long-term immersion results combined with electrochemical tests showed the preferable in vitro anticorrosion behavior and a low degradation rate of coated Mg alloy (1/8 times that of uncoated Mg alloy). Cell adhesion and cytotoxicity tests demonstrated that silk fibroin-coated MgZnCa presented improved biocompatibility with bone marrow mesenchymal stem cells. An animal study involving silk fibroin-coated MgZnCa implanted on one side of a rabbit spine for 180 days showed remarkably improved in vivo corrosion resistance, with 1/18 times the degradation rate of uncoated MgZnCa. These results not only comprehensively confirmed the validity of the VUV/O₃-activation method as a coating strategy but also implied the tremendous potential of the modified Mg alloy for application as a degradable biomedical implant material. STATEMENT OF SIGNIFICANCE: MgZnCa alloy is a promising material in clinical implantation. Silk fibroin (SF) is a natural organic material with biocompatibility and biodegradability. To date, the combination of SF and MgZnCa alloy has exhibited considerable prospects for orthopedic applications. The realization of a direct coating is an enormous challenge because strong chemical bonds cannot be easily formed between organic and inorganic materials. To solve this bottleneck, we proposed a unique vacuum ultraviolet-ozone (VUV/O₃) surface-activation method for the first time to modify the Mg alloy surface before SF coating, which significantly enhanced both in vitro and in vivo performance, such as superior biocompatibility and remarkably improved corrosion resistance of magnesium alloys (∼1/18 the in vivo degradation rate of uncoated MgZnCa).

Bioactive Silk-Based Nerve Guidance Conduits for Augmenting Peripheral Nerve Repair

Repair of peripheral nerve injuries depends upon complex biology stemming from the manifold and challenging injury-healing processes of the peripheral nervous system. While surgical treatment options are available, they tend to be characterized by poor clinical outcomes for the injured patients. This is particularly apparent in the clinical management of a nerve gap whereby nerve autograft remains the best clinical option despite numerous limitations; in addition, effective repair becomes progressively more difficult with larger gaps. Nerve conduit strategies based on tissue engineering approaches and the use of silk as scaffolding material have attracted much attention in recent years to overcome these limitations and meet the clinical demand of large gap nerve repair. This review examines the scientific advances made with silk-based conduits for peripheral nerve repair. The focus is on enhancing bioactivity of the conduits in terms of physical guidance cues, inner wall and lumen modification, and imbuing novel conductive functionalities.

Biomaterials for the Delivery of Growth Factors and Other Therapeutic Agents in Tissue Engineering Approaches to Bone Regeneration

Bone fracture followed by delayed or non-union typically requires bone graft intervention. Autologous bone grafts remain the clinical "gold standard". Recently, synthetic bone grafts such as Medtronic's Infuse Bone Graft have opened the possibility to pharmacological and tissue engineering strategies to bone repair following fracture. This clinically-available strategy uses an absorbable collagen sponge as a carrier material for recombinant human bone morphogenetic protein 2 (rhBMP-2) and a similar strategy has been employed by Stryker with BMP-7, also known as osteogenic protein-1 (OP-1). A key advantage to this approach is its "off-the-shelf" nature, but there are clear drawbacks to these products such as edema, inflammation, and ectopic bone growth. While there are clinical challenges associated with a lack of controlled release of rhBMP-2 and OP-1, these are among the first clinical examples to wed understanding of biological principles with biochemical production of proteins and pharmacological principles to promote tissue regeneration (known as regenerative pharmacology). After considering the clinical challenges with such synthetic bone grafts, this review considers the various biomaterial carriers under investigation to promote bone regeneration. This is followed by a survey of the literature where various pharmacological approaches and molecular targets are considered as future strategies to promote more rapid and mature bone regeneration. From the review, it should be clear that pharmacological understanding is a key aspect to developing these strategies.

Silk scaffolds in bone tissue engineering: An overview

Bone tissue plays multiple roles in our day-to-day functionality. The frequency of accidental bone damage and disorder is increasing worldwide. Moreover, as the world population continues to grow, the percentage of the elderly population continues to grow, which results in an increased number of bone degenerative diseases. This increased elderly population pushes the need for artificial bone implants that specifically employ biocompatible materials. A vast body of literature is available on the use of silk in bone tissue engineering. The current work presents an overview of this literature from materials and fabrication perspective. As silk is an easy-to-process biopolymer; this allows silk-based biomaterials to be molded into diverse forms and architectures, which further affects the degradability. This makes silk-based scaffolds suitable for treating a variety of bone reconstruction and regeneration objectives. Silk surfaces offer active sites that aid the mineralization and/or bonding of bioactive molecules that facilitate bone regeneration. Silk has also been blended with a variety of polymers and minerals to enhance its advantageous properties or introduce new ones. Several successful works, both in vitro and in vivo, have been reported using silk-based scaffolds to regenerate bone tissues or other parts of the skeletal system such as cartilage and ligament. A growing trend is observed toward the use of mineralized and nanofibrous scaffolds along with the development of technology that allows to control scaffold architecture, its biodegradability and the sustained releasing property of scaffolds. Further development of silk-based scaffolds for bone tissue engineering, taking them up to and beyond the stage of human trials, is hoped to be achieved in the near future through a cross-disciplinary coalition of tissue engineers, material scientists and manufacturing engineers.

STATEMENT OF SIGNIFICANCE

The state-of-art of silk biomaterials in bone tissue engineering, covering their wide applications as cell scaffolding matrices to micro-nano carriers for delivering bone growth factors and therapeutic molecules to diseased or damaged sites to facilitate bone regeneration, is emphasized here. The review rationalizes that the choice of silk protein as a biomaterial is not only because of its natural polymeric nature, mechanical robustness, flexibility and wide range of cell compatibility but also because of its ability to template the growth of hydroxyapatite, the chief inorganic component of bone mineral matrix, resulting in improved osteointegration. The discussion extends to the role of inorganic ions such as Si and Ca as matrix components in combination with silk to influence bone regrowth. The effect of ions or growth factor-loaded vehicle incorporation into regenerative matrix, nanotopography is also considered.

Optical Spectroscopic and Morphological Characterizations of Curcuminized Silk Biomaterials: A Perspective from Drug Stabilization

Silk protein fibroins have gained remarkable attention in recent years as a potential drug carrier in the developing medicinal field of research. In this work, the stability of anticancer agent curcumin in the presence of two different silk protein fibroins from nonmulberry Antheraea mylitta (Am) and mulberry Bombyx mori (Bm) has been examined, and the possible mechanism of stabilization in a physiologically relevant medium has also been explored. In solution phase, upon treatment with curcumin, the predominated β-sheet structure of Am is marginally altered, whereas in the case of Bm, a substantial structural changeover has been observed (from coil to β-sheet) to accommodate the hydrophobic drug. Also, the morphological assessments suggest that curcumin is nicely housed in the nanoscaffold of silk fibroin (SF). Consequently, the extent of degradation of curcumin is remarkably suppressed upon encapsulation with the SF. The dissimilarity in the binding patterns of curcumin with these silk proteins could be responsible for the observed difference in the stability orders. Curcumin binds the surface of Bm, whereas in Am, the drug is incorporated in the hydrophobic cavity, and as a consequence, the drug is effectively sequestered out of the aqueous medium. The increase in the fluorescence quantum yield upon interaction with the protein greatly modulates the excited-state intermolecular hydrogen atom transfer (ESIPT) process, which is in tune with a substantial increase in the lifetime of the excited-state of curcumin. The ESIPT is known to play a crucial role in the degradation of curcumin under physiological pH conditions, which perhaps implies its potential therapeutic activity in the presence of silk. The in-depth spectroscopic analyses of curcumin-SF complexes in aqueous medium can provide useful insights for further applicative developments in bioengineering.

The potential of Antheraea pernyi silk for spinal cord repair

One of the most challenging applications for tissue regeneration is spinal cord damage. There is no cure for this, partly because cavities and scar tissue formed after injury present formidable barriers that must be crossed by axons to restore function. Natural silks are considered increasingly for medical applications because they are biocompatible, biodegradable and in selected cases promote tissue growth. Filaments from wild Antheraea pernyi silkworms can support axon regeneration in peripheral nerve injury. Here we presented evidence that degummed A. pernyi filaments (DAPF) support excellent outgrowth of CNS neurons in vitro by cell attachment to the high density of arginine-glycine-aspartic acid tripeptide present in DAPF. Importantly, DAPF showed stiffness properties that are well suited to spinal cord repair by supporting cell growth mechano-biology. Furthermore, we demonstrated that DAPF induced no activation of microglia, the CNS resident immune cells, either in vitro when exposed to DAPF or in vivo when DAPF were implanted in the cord. In vitro DAPF degraded gradually with a corresponding decrease in tensile properties. We conclude that A. pernyi silk meets the major biochemical and biomaterial criteria for spinal repair, and may have potential as a key component in combinatorial strategies for spinal repair.

Electrophoretic Deposition of Gentamicin-Loaded Silk Fibroin Coatings on 3D-Printed Porous Cobalt-Chromium-Molybdenum Bone Substitutes to Prevent Orthopedic Implant Infections

In addition to customizing shapes of metal bone substitutes for patients, the 3D printing technique can reduce the modulus of the substitutes through the design and manufacture of interconnected porous structures, achieving the modulus match between substitute and surrounding bone to improve implant longevity. However, the porous bone substitutes take more risks of postoperative infection due to its much larger surface area compared with the traditional casting solid bone substitute. Here, we prepared of gentamicin-loaded silk fibroin coatings on 3D-printed porous cobalt-chromium-molybdenum (CoCrMo) bone substitutes via electrophoretic deposition technique. Through optimization, relatively intact, continuous, homogeneous, and conformal coatings with a thickness of 2.30 ± 0.58 μm were deposited around the struts with few pore blocked. The porous metal structures exhibited no loss in mechanical properties after the anode galvanic corrosion in EPD process. The initial osteoblastic response on coatings was better than that on metal surface, including cell spreading, proliferation and cytotoxicity. Antibacterial efficacy experiments showed that the coatings had an antibacterial effect on both adherent and planktonic bacteria within 1 week. These results suggested that the beneficial properties of anode electrophoretic deposited silk fibroin coatings could be exploited to improve the biological functionality of porous structures made of medical metals.

Biological responses to M13 bacteriophage modified titanium surfaces in vitro

Phage-based materials have showed great potential in tissue engineering application. However, it is unknown what inflammation response will happen to this kind of materials. This work is to explore the biological responses to M13 bacteriophage (phage) modified titanium surfaces in vitro from the aspects of their interaction with macrophages, osteoblasts and mineralization behavior. Pretreated Ti surface, Ti surfaces with noncrosslinked phage film (APP) and crosslinked phage film (APPG) were compared. Phage films could limit the macrophage adhesion and activity due to inducing adherent-cell apoptosis. The initial inflammatory activity (24h) caused by phage films was relatively high with more production of TNF-α, but in the later stage (7-10days) inflammatory response was reduced with lower TNF-α, IL-6 and higher IL-10. In addition, phage films improved osteoblast adhesion, differentiation, and hydroapatite (HA)-forming via a combination of topographical and biochemcial cues. The noncrosslinked phage film displayed the best immunomodulatory property, osteogenic activity and HA mineralization ability. This work provides better understanding of inflammatory and osteogenetic activity of phage-based materials and contributes to their future application in tissue engineering.

STATEMENT OF SIGNIFICANCE

In vivo, the bone and immune cells share a common microenvironment, and are being affected by similar cytokines, signaling molecules, transcription factors and membrane receptors. Ideal implants should cause positive biological response, including adequate and appropriate inflammatory reaction, well-balanced bone formation and absorption. Phage-based materials have showed great potential in tissue engineering application. However, at present it is unknown what inflammation response will happen to this kind of materials. A good understanding of the immune response possibly induced by phage-based materials is needed. This work studied the osteoimmunomodulation property of phage films on titanium surface, involving inflammatory response, osteogenic activity and biomineralization ability. It provides more understanding of the phage-based materials and contributes to their future application in tissue engineering.

Methods for Implant Acceptance and Wound Healing: Material Selection and Implant Location Modulate Macrophage and Fibroblast Phenotypes

This review focuses on materials and methods used to induce phenotypic changes in macrophages and fibroblasts. Herein, we give a brief overview on how changes in macrophages and fibroblasts phenotypes are critical biomarkers for identification of implant acceptance, wound healing effectiveness, and are also essential for evaluating the regenerative capabilities of some hybrid strategies that involve the combination of natural and synthetic materials. The different types of cells present during the host response have been extensively studied for evaluating the reaction to different materials and there are varied material approaches towards fabrication of biocompatible substrates. We discuss how natural and synthetic materials have been used to engineer desirable outcomes in lung, heart, liver, skin, and musculoskeletal implants, and how certain properties such as rigidity, surface shape, and porosity play key roles in the progression of the host response. Several fabrication strategies are discussed to control the phenotype of infiltrating macrophages and fibroblasts: decellularization of scaffolds, surface coatings, implant shape, and pore size apart from biochemical signaling pathways that can inhibit or accelerate unfavorable host responses. It is essential to factor all the different design principles and material fabrication criteria for evaluating the choice of implant materials or regenerative therapeutic strategies.

The influence of calcitonin gene-related peptide on markers of bone metabolism in MG-63 osteoblast-like cells co-cultured with THP-1 macrophage-like cells under virtually osteolytic conditions

Background

The neuropeptide calcitonin gene-related peptide (CGRP) has been described to have an inhibitory effect on endotoxin- and wear particle-induced inflammation in the early stages of periprosthetic osteolysis. In the present study, the crosstalk between immune cells and osteoblasts in osteolytic conditions treated with CGRP has been analyzed to evaluate whether the anti-inflammatory properties of the peptide also have a beneficial, i.e. an anti-resorptive and osteo-anabolic impact on bone metabolism.

Methods

MG-63 osteoblast-like cells were co-cultured with THP-1 macrophage-like cells stimulated with either ultra-high molecular weight polyethylene (UHMWPE) particles or different concentrations of bacterial lipopolysaccharides (LPS) and simultaneously treated with CGRP. Inflammation was monitored in terms of measuring the levels of tumor necrosis factor (TNF)-α secretion. Furthermore, the production of the osteoblast markers osteoprotegerin (OPG), receptor activator of nuclear factor κB ligand (RANKL), alkaline phosphatase (ALP) and osteopontin (OPN) was quantified. Also, ALP enzymatic activity was measured.

Results

Stimulation of co-cultured THP-1 macrophages with either high levels of LPS or UHMWPE induced the secretion of TNF-α which could be inhibited by CGRP to a great extent. However, no remarkable changes in the OPG/RANKL ratio or bone ALP activity were observed. Interestingly, OPN was exclusively produced by THP-1 cells, thus acting as a marker of inflammation. In addition, TNF-α production in THP-1 single cell cultures was found to be considerably higher than in co-cultured cells.

Conclusions

In the co-culture system used in the present study, no obvious relation between inflammation, its mitigation by CGRP, and the modulation of bone metabolism became evident. Nonetheless, the results suggest that during the onset of periprosthetic osteolysis the focus might lie on the modulation of inflammatory reactions. Possibly, implant-related inflammation might merely have an impact on osteoclast differentiation rather than on the regulation of osteoblast activity.

Electronic supplementary material

The online version of this article (doi:10.1186/s12891-016-1044-5) contains supplementary material, which is available to authorized users.

Non-mulberry silk fibroin grafted poly (Є-caprolactone)/nano hydroxyapatite nanofibrous scaffold for dual growth factor delivery to promote bone regeneration

HYPOTHESIS

This study aims at developing biodegradable, mineralized, nanofibrous scaffolds for use in bone regeneration. Scaffolds are loaded with combinations of bone morphogenic protein-2 (rhBMP-2) and transforming growth factor beta (TGF-β) and evaluated in vitro for enhancement in osteoinductivity.

EXPERIMENTS

Poly(Є-caprolactone) (PCL) doped with different portions of nano-hydroxyapatite is electrospun into nanofibrous scaffolds. Non-mulberry silk fibroin (NSF) obtained from Antheraea mylitta is grafted by aminolysis onto them. Scaffolds prepared have three concentrations of nano-hydroxyapatite: 0% (NSF-PCL), 25% (NSF-PCL/n25), and 50% (NSF-PCL/n50). Growth factor loading is carried out in three different combinations, solely rhBMP-2 (BN25), solely TGF-β (TN25) and rhBMP-2+TGF-β (T/B N25) via carbodiimide coupling.

FINDINGS

NSF-PCL/n25 showed the best results in examination of mechanical properties, bioactivity, and cell viability. Hence only NSF-PCL/n25 is selected for loading growth factors and subsequent detailed in vitro experiments using MG-63 cell-line. Both growth factors show sustain release kinetics from the matrix. The T/B N25 scaffolds support cellular activity, proliferation, and triggering of bone-associated genes' expression better and promote earlier cell differentiation. Dual growth factor loaded NSF grafted electrospun PCL/nHAp scaffolds show promise for further development into a suitable scaffold for bone tissue engineering.

Ti nanorod arrays with a medium density significantly promote osteogenesis and osteointegration

Ti implants are good candidates in bone repair. However, how to promote bone formation on their surface and their consequent perfect integration with the surrounding tissue is still a challenge. To overcome such challenge, we propose to form Ti nanorods on their surface to promote the new bone formation around the implants. Here Ti nanorod arrays (TNrs) with different densities were produced on pure Ti surfaces using an anodizing method. The influence of TNr density on the protein adsorption as well as on the adhesion, proliferation, and osteogenic differentiation of MC3T3-E1 pre-osteoblastic cells were assessed. The TNrs were also implanted into the bone defects in rabbits to test their application in promoting bone formation and osteointegration at the implant-bone interface. TNrs with the medium density were found to show the best capability in promoting the protein adsorption from surrounding medium, which in turn efficiently enhanced osteogenic differentiation in vitro and osteointegration in vivo. Our work suggests that growing TNrs with a medium density on the surface of traditional Ti implants is an efficient and facile method for promoting bone formation and osteointegration in bone repair.

Silk fibroin nanoparticles support in vitro sustained antibiotic release and osteogenesis on titanium surface

Increasing amounts of metal-based implants are used for orthopedic or dental surgeries throughout the world. Still several implant-related problems such as inflammation, loosening and bacterial infection are prevalent. These problems stem from the immediate microbial contamination and failure of initial osteoblast adhesion. Additionally, bacterial infections can cause serious and life-threatening conditions such as osteomyelitis. Here, antibiotic (gentamicin)-loaded silk protein fibroin (non-mulberry silkworm, Antheraea mylitta) nanoparticles are fabricated and deposited over the titanium surface to achieve sustained drug release in vitro and to alter the surface nano-roughness. Based on the altered surface topography, chemistry and antibacterial activity, we conclude that the nanoparticle-deposited surfaces are superior for osteoblast adhesion, proliferation and differentiation in comparison to bare Ti. This method can be utilized as a cost-effective approach in implant modification.

FROM THE CLINICAL EDITOR

Titanium-based implants are commonly used in the field of orthopedics or dentistry. Surface modification of an implant is vital to ensure osseointegration. In this article, the author investigated the use of silk protein fibroins for metal surface modification and also for drug delivery against bacteria. The encouraging data should provide a new method in terms of nanotechnology in the respective clinical fields.

Tailoring biomaterial surface properties to modulate host-implant interactions: implication in cardiovascular and bone therapy

Host body response to a foreign medical device plays a critical role in defining its fate post implantation. It is thus important to control host-material interactions by designing innovative implant surfaces. In the recent years, biochemical and topographical features have been explored as main target to produce this new type of bioinert or bioresponsive implants. The review discusses specific biofunctional materials and strategies to achieve a precise control over implant surface properties and presents possible solutions to develop next generation of implants, particularly in the fields of bone and cardiovascular therapy.