1
|
Haghpanah Z, Mondal D, Momenbeitollahi N, Mohsenkhani S, Zarshenas K, Jin Y, Watson M, Willett T, Gorbet M. In vitro evaluation of bone cell response to novel 3D-printable nanocomposite biomaterials for bone reconstruction. J Biomed Mater Res A 2024; 112:1725-1739. [PMID: 38619300 DOI: 10.1002/jbm.a.37719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/24/2024] [Accepted: 03/29/2024] [Indexed: 04/16/2024]
Abstract
Critically-sized segmental bone defects represent significant challenges requiring grafts for reconstruction. 3D-printed synthetic bone grafts are viable alternatives to structural allografts if engineered to provide appropriate mechanical performance and osteoblast/osteoclast cell responses. Novel 3D-printable nanocomposites containing acrylated epoxidized soybean oil (AESO) or methacrylated AESO (mAESO), polyethylene glycol diacrylate, and nanohydroxyapatite (nHA) were produced using masked stereolithography. The effects of volume fraction of nHA and methacrylation of AESO on interactions of differentiated MC3T3-E1 osteoblast (dMC3T3-OB) and differentiated RAW264.7 osteoclast cells with 3D-printed nanocomposites were evaluated in vitro and compared with a control biomaterial, hydroxyapatite (HA). Higher nHA content and methacrylation significantly improved the mechanical properties. All nanocomposites supported dMC3T3-OB cells' adhesion and proliferation. Higher amounts of nHA enhanced cell adhesion and proliferation. mAESO in the nanocomposites resulted in greater adhesion, proliferation, and activity at day 7 compared with AESO nanocomposites. Excellent osteoclast-like cells survival, defined actin rings, and large multinucleated cells were only observed on the high nHA fraction (30%) mAESO nanocomposite and the HA control. Thus, mAESO-based nanocomposites containing higher amounts of nHA have better interactions with osteoblast-like and osteoclast-like cells, comparable with HA controls, making them a potential future alternative graft material for bone defect repair.
Collapse
Affiliation(s)
- Zahra Haghpanah
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Dibakar Mondal
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Nikan Momenbeitollahi
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Sadaf Mohsenkhani
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Kiyoumars Zarshenas
- Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Yutong Jin
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Michael Watson
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Thomas Willett
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Maud Gorbet
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| |
Collapse
|
2
|
Civantos A, Mesa-Restrepo A, Torres Y, Shetty AR, Cheng MK, Jaramillo-Correa C, Aditya T, Allain JP. Nanotextured porous titanium scaffolds by argon ion irradiation: Toward conformal nanopatterning and improved implant osseointegration. J Biomed Mater Res A 2023; 111:1850-1865. [PMID: 37334879 DOI: 10.1002/jbm.a.37582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 04/29/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
Stress shielding and osseointegration are two main challenges in bone regeneration, which have been targeted successfully by chemical and physical surface modification methods. Direct irradiation synthesis (DIS) is an energetic ion irradiation method that generates self-organized nanopatterns conformal to the surface of materials with complex geometries (e.g., pores on a material surface). This work exposes porous titanium samples to energetic argon ions generating nanopatterning between and inside pores. The unique porous architected titanium (Ti) structure is achieved by mixing Ti powder with given amounts of spacer NaCl particles (vol % equal to 30%, 40%, 50%, 60%, and 70%), compacted and sintered, and combined with DIS to generate a porous Ti with bone-like mechanical properties and hierarchical topography to enhance Ti osseointegration. The porosity percentages range between 25% and 30% using 30 vol % NaCl space-holder (SH) volume percentages to porosity rates of 63%-68% with SH volume of 70 vol % NaCl. Stable and reproducible nanopatterning on the flat surface between pores, inside pits, and along the internal pore walls are achieved, for the first time on any porous biomaterial. Nanoscale features were observed in the form of nanowalls and nanopeaks of lengths between 100 and 500 nm, thicknesses of 35-nm and heights between 100 and 200 nm on average. Bulk mechanical properties that mimic bone-like structures were observed along with increased wettability (by reducing contact values). Nano features were cell biocompatible and enhanced in vitro pre-osteoblast differentiation and mineralization. Higher alkaline phosphatase levels and increased calcium deposits were observed on irradiated 50 vol % NaCl samples at 7 and 14 days. After 24 h, nanopatterned porous samples decreased the number of attached macrophages and the formation of foreign body giant cells, confirming nanoscale tunability of M1-M2 immuno-activation with enhanced osseointegration.
Collapse
Affiliation(s)
- Ana Civantos
- Department of Nuclear, Plasma and Radiological Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Nick Holonyak, Jr., Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Andrea Mesa-Restrepo
- Department of Biomedical Engineering, Pennsylvania State University, State College, Pennsylvania, USA
| | - Yadir Torres
- Department of Engineering and Materials Science and Transport, University of Seville, Seville, Spain
| | - Akshath R Shetty
- Department of Nuclear, Plasma and Radiological Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Ming Kit Cheng
- Department of Nuclear, Plasma and Radiological Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Camilo Jaramillo-Correa
- Department of Nuclear, Plasma and Radiological Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- The Ken and Mary Alice Lindquist Department of Nuclear Engineering, Pennsylvania State University, State College, Pennsylvania, USA
| | - Teresa Aditya
- The Ken and Mary Alice Lindquist Department of Nuclear Engineering, Pennsylvania State University, State College, Pennsylvania, USA
| | - Jean Paul Allain
- Department of Nuclear, Plasma and Radiological Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Nick Holonyak, Jr., Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Department of Biomedical Engineering, Pennsylvania State University, State College, Pennsylvania, USA
- The Ken and Mary Alice Lindquist Department of Nuclear Engineering, Pennsylvania State University, State College, Pennsylvania, USA
- Department of Materials Science and Engineering, Pennsylvania State University, State College, Pennsylvania, USA
| |
Collapse
|
3
|
Wang K, Frey N, Garcia A, Man K, Yang Y, Gualerzi A, Clemens ZJ, Bedoni M, LeDuc PR, Ambrosio F. Nanotopographical Cues Tune the Therapeutic Potential of Extracellular Vesicles for the Treatment of Aged Skeletal Muscle Injuries. ACS NANO 2023; 17:19640-19651. [PMID: 37797946 PMCID: PMC10603813 DOI: 10.1021/acsnano.3c02269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
Skeletal muscle regeneration relies on the tightly temporally regulated lineage progression of muscle stem/progenitor cells (MPCs) from activation to proliferation and, finally, differentiation. However, with aging, MPC lineage progression is disrupted and delayed, ultimately causing impaired muscle regeneration. Extracellular vesicles (EVs) have attracted broad attention as next-generation therapeutics for promoting tissue regeneration. As a next step toward clinical translation, strategies to manipulate EV effects on downstream cellular targets are needed. Here, we developed an engineering strategy to tune the therapeutic potential of EVs using nanotopographical cues. We found that EVs released by young MPCs cultured on flat substrates (fEVs) promoted the proliferation of aged MPCs while EVs released by MPCs cultured on nanogratings (nEVs) promoted myogenic differentiation. We then employed a bioengineered 3D muscle aging model to optimize the administration protocol and test the therapeutic potential of fEVs and nEVs in a high-throughput manner. We found that the sequential administration first of fEVs during the phase of MPC proliferative expansion (i.e., 1 day after injury) followed by nEV administration at the stage of MPC differentiation (i.e., 3 days after injury) enhanced aged muscle regeneration to a significantly greater extent than fEVs and nEVs delivered either in isolation or mixed. The beneficial effects of the sequential EV treatment strategy were further validated in vivo, as evidenced by increased myofiber size and improved functional recovery. Collectively, our study demonstrates the ability of topographical cues to tune EV therapeutic potential and highlights the importance of optimizing the EV administration strategy to accelerate aged skeletal muscle regeneration.
Collapse
Affiliation(s)
- Kai Wang
- Discovery
Center for Musculoskeletal Recovery, Schoen
Adams Research Institute at Spaulding, Charlestown, Massachusetts 02129, United States
- Department
of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts 02129, United States
- Department
of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
| | - Nolan Frey
- Department
of Biological Sciences, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
| | - Andres Garcia
- Department
of Mechanical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
| | - Kun Man
- Department
of Biomedical Engineering, University of
North Texas, Denton, Texas 76207, United States
| | - Yong Yang
- Department
of Biomedical Engineering, University of
North Texas, Denton, Texas 76207, United States
| | - Alice Gualerzi
- IRCCS
Fondazione Don Carlo Gnocchi ONLUS, Milan 20148, Italy
| | - Zachary J. Clemens
- Department
of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
| | - Marzia Bedoni
- IRCCS
Fondazione Don Carlo Gnocchi ONLUS, Milan 20148, Italy
| | - Philip R. LeDuc
- Department
of Biological Sciences, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
- Department
of Mechanical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
- Department
of Computational Biology, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
- Department
of Biomedical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
- Department
of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
| | - Fabrisia Ambrosio
- Discovery
Center for Musculoskeletal Recovery, Schoen
Adams Research Institute at Spaulding, Charlestown, Massachusetts 02129, United States
- Department
of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts 02129, United States
- Department
of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
| |
Collapse
|
4
|
Chaterjee O, Sur D. Artificially induced in situ macrophage polarization: An emerging cellular therapy for immuno-inflammatory diseases. Eur J Pharmacol 2023; 957:176006. [PMID: 37611840 DOI: 10.1016/j.ejphar.2023.176006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/10/2023] [Accepted: 08/18/2023] [Indexed: 08/25/2023]
Abstract
Macrophages are the mature form of monocytes that have high plasticity and can shift from one phenotype to another by the process of macrophage polarization. Macrophage has several vital pharmacological tasks like eliminating microorganism invasion, clearing dead cells, causing inflammation, repairing damaged tissues, etc. The function of macrophages is based on their phenotype. M1 macrophages are mostly responsible for the body's immune responses and M2 macrophages have healing properties. Inappropriate activation of any one of the phenotypes often leads to ROS-induced tissue damage and affects wound healing and angiogenesis. Therefore, maintaining tissue macrophage homeostasis is necessary. Studies are being done to find techniques for macrophage polarization. But, the process of macrophage polarization is very complex as it involves multiple signalling pathways involving innate immunity. Thus, identifying the right pathways for macrophage polarization is essential to apply the polarizing technique for the treatment of various inflammatory diseases where macrophage physiology influences the disease pathology. In this review, we highlighted the various techniques so far used to change macrophage plasticity. We believe that soon macrophage targeting therapeutics will hit the market for the management of inflammatory disease. Hence this review will help macrophage researchers choose suitable methods and materials/agents to polarize macrophages artificially in various disease models.
Collapse
Affiliation(s)
- Oishani Chaterjee
- Division of Pharmacology, Guru Nanak Institute of Pharmaceutical Science & Technology, Panihati, Kolkata, 700114, India
| | - Debjeet Sur
- Division of Pharmacology, Guru Nanak Institute of Pharmaceutical Science & Technology, Panihati, Kolkata, 700114, India.
| |
Collapse
|
5
|
Chen K, Henn D, Januszyk M, Barrera JA, Noishiki C, Bonham CA, Griffin M, Tevlin R, Carlomagno T, Shannon T, Fehlmann T, Trotsyuk AA, Padmanabhan J, Sivaraj D, Perrault DP, Zamaleeva AI, Mays CJ, Greco AH, Kwon SH, Leeolou MC, Huskins SL, Steele SR, Fischer KS, Kussie HC, Mittal S, Mermin-Bunnell AM, Diaz Deleon NM, Lavin C, Keller A, Longaker MT, Gurtner GC. Disrupting mechanotransduction decreases fibrosis and contracture in split-thickness skin grafting. Sci Transl Med 2022; 14:eabj9152. [PMID: 35584231 DOI: 10.1126/scitranslmed.abj9152] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Burns and other traumatic injuries represent a substantial biomedical burden. The current standard of care for deep injuries is autologous split-thickness skin grafting (STSG), which frequently results in contractures, abnormal pigmentation, and loss of biomechanical function. Currently, there are no effective therapies that can prevent fibrosis and contracture after STSG. Here, we have developed a clinically relevant porcine model of STSG and comprehensively characterized porcine cell populations involved in healing with single-cell resolution. We identified an up-regulation of proinflammatory and mechanotransduction signaling pathways in standard STSGs. Blocking mechanotransduction with a small-molecule focal adhesion kinase (FAK) inhibitor promoted healing, reduced contracture, mitigated scar formation, restored collagen architecture, and ultimately improved graft biomechanical properties. Acute mechanotransduction blockade up-regulated myeloid CXCL10-mediated anti-inflammation with decreased CXCL14-mediated myeloid and fibroblast recruitment. At later time points, mechanical signaling shifted fibroblasts toward profibrotic differentiation fates, and disruption of mechanotransduction modulated mesenchymal fibroblast differentiation states to block those responses, instead driving fibroblasts toward proregenerative, adipogenic states similar to unwounded skin. We then confirmed these two diverging fibroblast transcriptional trajectories in human skin, human scar, and a three-dimensional organotypic model of human skin. Together, pharmacological blockade of mechanotransduction markedly improved large animal healing after STSG by promoting both early, anti-inflammatory and late, regenerative transcriptional programs, resulting in healed tissue similar to unwounded skin. FAK inhibition could therefore supplement the current standard of care for traumatic and burn injuries.
Collapse
Affiliation(s)
- Kellen Chen
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.,Department of Surgery, University of Arizona College of Medicine, Tucson, AZ 85724, USA
| | - Dominic Henn
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Michael Januszyk
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Janos A Barrera
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Chikage Noishiki
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Clark A Bonham
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Michelle Griffin
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Ruth Tevlin
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Theresa Carlomagno
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Tara Shannon
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Tobias Fehlmann
- Chair for Clinical Bioinformatics, Saarland University, 66123 Saarbrücken, Germany
| | - Artem A Trotsyuk
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jagannath Padmanabhan
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Dharshan Sivaraj
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - David P Perrault
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alsu I Zamaleeva
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Chyna J Mays
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Autumn H Greco
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Sun Hyung Kwon
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Melissa C Leeolou
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Savana L Huskins
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Sydney R Steele
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Katharina S Fischer
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Hudson C Kussie
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Smiti Mittal
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alana M Mermin-Bunnell
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Nestor M Diaz Deleon
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Christopher Lavin
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Andreas Keller
- Chair for Clinical Bioinformatics, Saarland University, 66123 Saarbrücken, Germany.,Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94305, USA
| | - Michael T Longaker
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Geoffrey C Gurtner
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.,Department of Surgery, University of Arizona College of Medicine, Tucson, AZ 85724, USA
| |
Collapse
|
6
|
Implant Fibrosis and the Underappreciated Role of Myofibroblasts in the Foreign Body Reaction. Cells 2021; 10:cells10071794. [PMID: 34359963 PMCID: PMC8304203 DOI: 10.3390/cells10071794] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 02/06/2023] Open
Abstract
Body implants and implantable medical devices have dramatically improved and prolonged the life of countless patients. However, our body repair mechanisms have evolved to isolate, reject, or destroy any object that is recognized as foreign to the organism and inevitably mounts a foreign body reaction (FBR). Depending on its severity and chronicity, the FBR can impair implant performance or create severe clinical complications that will require surgical removal and/or replacement of the faulty device. The number of review articles discussing the FBR seems to be proportional to the number of different implant materials and clinical applications and one wonders, what else is there to tell? We will here take the position of a fibrosis researcher (which, coincidentally, we are) to elaborate similarities and differences between the FBR, normal wound healing, and chronic healing conditions that result in the development of peri-implant fibrosis. After giving credit to macrophages in the inflammatory phase of the FBR, we will mainly focus on the activation of fibroblastic cells into matrix-producing and highly contractile myofibroblasts. While fibrosis has been discussed to be a consequence of the disturbed and chronic inflammatory milieu in the FBR, direct activation of myofibroblasts at the implant surface is less commonly considered. Thus, we will provide a perspective how physical properties of the implant surface control myofibroblast actions and accumulation of stiff scar tissue. Because formation of scar tissue at the surface and around implant materials is a major reason for device failure and extraction surgeries, providing implant surfaces with myofibroblast-suppressing features is a first step to enhance implant acceptance and functional lifetime. Alternative therapeutic targets are elements of the myofibroblast mechanotransduction and contractile machinery and we will end with a brief overview on such targets that are considered for the treatment of other organ fibroses.
Collapse
|
7
|
Crawford L, Wyatt M, Bryers J, Ratner B. Biocompatibility Evolves: Phenomenology to Toxicology to Regeneration. Adv Healthc Mater 2021; 10:e2002153. [PMID: 33829678 PMCID: PMC8221530 DOI: 10.1002/adhm.202002153] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/26/2021] [Indexed: 12/20/2022]
Abstract
The word "biocompatibility," is inconsistent with the observations of healing for so-called biocompatible biomaterials. The vast majority of the millions of medical implants in humans today, presumably "biocompatible," are walled off by a dense, avascular, crosslinked collagen capsule, hardly suggestive of life or compatibility. In contrast, one is now seeing examples of implant biomaterials that lead to a vascularized reconstruction of localized tissue, a biological reaction different from traditional biocompatible materials that generate a foreign body capsule. Both the encapsulated biomaterials and the reconstructive biomaterials qualify as "biocompatible" by present day measurements of biocompatibility. Yet, this new generation of materials would seem to heal "compatibly" with the living organism, where older biomaterials are isolated from the living organism by the dense capsule. This review/perspective article will explore this biocompatibility etymological conundrum by reviewing the history of the concepts around biocompatibility, today's standard methods for assessing biocompatibility, a contemporary view of the foreign body reaction and finally, a compendium of new biomaterials that heal without the foreign body capsule. A new definition of biocompatibility is offered here to address advances in biomaterials design leading to biomaterials that heal into the body in a facile manner.
Collapse
Affiliation(s)
- Lars Crawford
- Department of Bioengineering, University of Washington, Seattle, WA, 98195, USA
| | - Meghan Wyatt
- Department of Bioengineering, University of Washington, Seattle, WA, 98195, USA
| | - James Bryers
- Department of Bioengineering, University of Washington, Seattle, WA, 98195, USA
| | - Buddy Ratner
- Department of Bioengineering, University of Washington, Seattle, WA, 98195, USA
| |
Collapse
|
8
|
Loye AM, Kwon HK, Dellal D, Ojeda R, Lee S, Davis R, Nagle N, Doukas PG, Schroers J, Lee FY, Kyriakides TR. Biocompatibility of platinum-based bulk metallic glass in orthopedic applications. Biomed Mater 2021; 16. [PMID: 33873168 DOI: 10.1088/1748-605x/abf981] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/19/2021] [Indexed: 01/19/2023]
Abstract
Bulk metallic glasses (BMGs) are a class of amorphous metals that exhibit high strength, ductility paired with wear and corrosion resistance. These properties suggest that they could serve as an alternative to conventional metallic implants that suffer wear and failure. In the present study, we investigated Platinum (Pt)-BMG biocompatibility in bone applications. Specifically, we investigated osteoclast formation on flat and nanopatterned Pt57.5Cu14.7Ni5.3P22.5(atomic percent) as well as titanium (control). Specifically, receptor activator of NF-κB (RANK) ligand-induced murine bone marrow derived mononuclear cell fusion was measured on multiple nanopatterns and was found to be reduced on nanorods (80 and 200 nm in diameter) and was associated with reduced tartrate-resistant acid phosphatase (TRAP) and matrix metalloproteinase (MMP9) expression. Evaluation of mesenchymal stem cell (MSC) to osteoblast differentiation on nanopatterned Pt-BMG showed significant reduction in comparison to flat, suggesting that further exploration of nanopatterns is required to have simultaneous induction of osteoblasts and inhibition of osteoclasts.Invivo studies were also pursued to evaluate the biocompatibility of Pt-BMG in comparison to titanium. Rods of each material were implanted in the femurs of mice and evaluated by x-ray, mechanical testing, micro-computed tomography (micro-CT), and histological analysis. Overall, Pt-BMG showed similar biocompatibility with titanium suggesting that it has the potential to improve outcomes by further processing at the nanoscale.
Collapse
Affiliation(s)
- Ayomiposi M Loye
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, United States of America
| | - Hyuk-Kwon Kwon
- Department of Orthopaedics and Rehabilitation, Yale University, New Haven, CT 06520, United States of America
| | - David Dellal
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, United States of America
| | - Rodrigo Ojeda
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT 06520, United States of America
| | - Sangmin Lee
- Department of Pathology, Yale University, P.O. Box 208089, New Haven, CT 06520, United States of America
| | - Rose Davis
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT 06520, United States of America
| | - Natalie Nagle
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, United States of America
| | - Panagiotis G Doukas
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, United States of America
| | - Jan Schroers
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT 06520, United States of America
| | - Francis Y Lee
- Department of Orthopaedics and Rehabilitation, Yale University, New Haven, CT 06520, United States of America
| | - Themis R Kyriakides
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, United States of America.,Department of Pathology, Yale University, P.O. Box 208089, New Haven, CT 06520, United States of America
| |
Collapse
|
9
|
Welch NG, Winkler DA, Thissen H. Antifibrotic strategies for medical devices. Adv Drug Deliv Rev 2020; 167:109-120. [PMID: 32553685 DOI: 10.1016/j.addr.2020.06.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 12/13/2022]
Abstract
A broad range of medical devices initiate an immune reaction known as the foreign body response (FBR) upon implantation. Here, collagen deposition at the surface of the implant occurs as a result of the FBR, ultimately leading to fibrous encapsulation and, in many cases, reduced function or failure of the device. Despite significant efforts, the prevention of fibrotic encapsulation has not been realized at this point in time. However, many next-generation medical technologies including cellular therapies, sensors and devices depend on the ability to modulate and control the FBR. For these technologies to become viable, significant advances must be made in understanding the underlying mechanism of this response as well as in the methods modulating this response. In this review, we highlight recent advances in the development of materials and coatings providing a reduced FBR and emphasize key characteristics of high-performing approaches. We also provide a detailed overview of the state-of-the-art in strategies relying on controlled drug release, the surface display of bioactive signals, materials-based approaches, and combinations of these approaches. Finally, we offer perspectives on future directions in this field.
Collapse
|
10
|
Lee RSB, Hamlet SM, Moon HJ, Ivanovski S. Re-establishment of macrophage homeostasis by titanium surface modification in type II diabetes promotes osseous healing. Biomaterials 2020; 267:120464. [PMID: 33130322 DOI: 10.1016/j.biomaterials.2020.120464] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/19/2020] [Accepted: 10/18/2020] [Indexed: 12/27/2022]
Abstract
Titanium surface mediated immunomodulation may address compromised post-implantation bone healing in diabetes mellitus. To assess in vitro phenotypic changes, M1 and M2 polarised Type 2 diabetic rat (Goto Kakizaki, GK) macrophages were cultured on micro-rough (SLA) or hydrophilic nanostructured SLA (modSLA) titanium. The in vivo effects of the SLA and modSLA surfaces on macrophage phenotype, wound-associated protein expression and bone formation were investigated using a critical-sized calvarial defect model. Compared to healthy macrophages, GK M2 macrophage function was compromised, secreting significantly lower levels of the anti-inflammatory cytokine IL-10. The modSLA surface attenuated the pro-inflammatory cellular environment, reducing pro-inflammatory cytokine production and promoting M2 macrophage phenotype differentiation. ModSLA also suppressed gene expression associated with macrophage multinucleation and giant cell formation and stimulated pro-osteogenic genes in co-cultured osteoblasts. In vivo, modSLA enhanced osteogenesis compared to SLA in GK rats. During early healing, proteomic analysis of both surface adherent and wound exudate material showed that modSLA promoted an immunomodulatory pro-reparative environment. The modSLA surface therefore successfully compensated for the compromised M2 macrophage function in Type 2 diabetes by attenuating the pro-inflammatory response and promoting M2 macrophage activity, thus restoring macrophage homeostasis and resulting in a cellular environment favourable for enhanced osseous healing.
Collapse
Affiliation(s)
- Ryan S B Lee
- The University of Queensland, School of Dentistry, Herston, Australia; School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Stephen M Hamlet
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Ho-Jin Moon
- Department of Dental Materials, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Saso Ivanovski
- The University of Queensland, School of Dentistry, Herston, Australia.
| |
Collapse
|
11
|
Rahmati M, Silva EA, Reseland JE, A Heyward C, Haugen HJ. Biological responses to physicochemical properties of biomaterial surface. Chem Soc Rev 2020; 49:5178-5224. [PMID: 32642749 DOI: 10.1039/d0cs00103a] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Biomedical scientists use chemistry-driven processes found in nature as an inspiration to design biomaterials as promising diagnostic tools, therapeutic solutions, or tissue substitutes. While substantial consideration is devoted to the design and validation of biomaterials, the nature of their interactions with the surrounding biological microenvironment is commonly neglected. This gap of knowledge could be owing to our poor understanding of biochemical signaling pathways, lack of reliable techniques for designing biomaterials with optimal physicochemical properties, and/or poor stability of biomaterial properties after implantation. The success of host responses to biomaterials, known as biocompatibility, depends on chemical principles as the root of both cell signaling pathways in the body and how the biomaterial surface is designed. Most of the current review papers have discussed chemical engineering and biological principles of designing biomaterials as separate topics, which has resulted in neglecting the main role of chemistry in this field. In this review, we discuss biocompatibility in the context of chemistry, what it is and how to assess it, while describing contributions from both biochemical cues and biomaterials as well as the means of harmonizing them. We address both biochemical signal-transduction pathways and engineering principles of designing a biomaterial with an emphasis on its surface physicochemistry. As we aim to show the role of chemistry in the crosstalk between the surface physicochemical properties and body responses, we concisely highlight the main biochemical signal-transduction pathways involved in the biocompatibility complex. Finally, we discuss the progress and challenges associated with the current strategies used for improving the chemical and physical interactions between cells and biomaterial surface.
Collapse
Affiliation(s)
- Maryam Rahmati
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317 Oslo, Norway. h.j.haugen.odont.uio.no
| | | | | | | | | |
Collapse
|
12
|
Fang JY, Yang Z, Han B. Switch of macrophage fusion competency by 3D matrices. Sci Rep 2020; 10:10348. [PMID: 32587271 PMCID: PMC7316750 DOI: 10.1038/s41598-020-67056-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/02/2020] [Indexed: 12/13/2022] Open
Abstract
Foreign body reaction reflects the integration between biomaterials and host cells. At the implantation microenvironment, macrophages usually fuse into multinuclear cells, also known as foreign body giant cells, to respond to the biomaterial implants. To understand the biomaterial-induced macrophage fusion, we examined whether biomaterial alone can initiate and control the fusion rate without exogenous cytokines and chemicals. We introduced a collagen-based 3D matrix to embed Raw264.7 cell line and primary rat bone marrow-derived macrophages. We found the biomaterial-stimuli interacted regional macrophages and altered the overall fusogenic protein expressions to regulate the macrophage fusion rate. The fusion rate could be altered by modulating the cell-matrix and cell-cell adhesions. The fused macrophage morphologies, the nuclei number in the fused macrophage, and the fusion rates were matrix dependent. The phenomena were also observed in the in vivo models. These results suggest that the biomaterial-derived stimuli exert similar functions as cytokines to alter the competency of macrophage fusion as well as their drug sensitivity in the biomaterial implanted tissue environment. Furthermore, this in vitro 3D-matrix model has the potential to serve as a toolbox to predict the host tissue response on implanted biomaterials.
Collapse
Affiliation(s)
- Josephine Y Fang
- Nimni-Cordoba Tissue Engineering and Drug Discovery Laboratory, Division of Plastic and Reconstructive Surgery, Departments of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
- Center of Craniofacial Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, United States
| | - Zhi Yang
- Nimni-Cordoba Tissue Engineering and Drug Discovery Laboratory, Division of Plastic and Reconstructive Surgery, Departments of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Bo Han
- Nimni-Cordoba Tissue Engineering and Drug Discovery Laboratory, Division of Plastic and Reconstructive Surgery, Departments of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States.
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Souther California, Los Angeles, California, United States.
| |
Collapse
|
13
|
Trout KL, Holian A. Macrophage fusion caused by particle instillation. Curr Res Toxicol 2020; 1:42-47. [PMID: 33336194 PMCID: PMC7740110 DOI: 10.1016/j.crtox.2020.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/25/2020] [Accepted: 04/30/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Multinucleated giant cells (MGC) are formed by fusion of macrophages in pathological conditions. These are often studied in the context of the foreign body response to biomaterial implants, but MGC formation is rarely assessed in response to inorganic particles in the lungs. Therefore, a major objective of this study was to quantitatively compare in vivo macrophage fusion resulting from exposure to a spectrum of micron- and nano-sized particles from both environmental and engineered origin, including crystalline silica, multiwalled carbon nanotubes, titanium nanobelts, and crocidolite asbestos. METHODS Groups of C57Bl/6 mice were instilled with inorganic particles or PBS control. Lung cells were collected by lavage after one week for cell differentials, quantification of macrophage fusion, and microscopic observation of particle uptake. RESULTS MGC were present in lungs of all mice exposed to particles; no MGC were found in control mice. Asbestos exposure resulted in significant macrophage fusion, which coincided with significantly increased total lavage cells and percent neutrophils. Microscopic observations show particle internalization in MGC and a unique case of potential heterotypic fusion of macrophages with neutrophils. CONCLUSION MGC can form in the lungs of mice within a relatively short one-week time period after particle exposure. The number of MGC was sufficient for quantification and statistical analysis, indicating that MGC formation was more than simply a rare chance occurrence. Observations of particles within MGC warrants further investigation of MGC involvement in inflammation and particle clearance.
Collapse
Affiliation(s)
- Kevin L. Trout
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, 32 Campus Dr, Missoula, MT 59812, United States
| | - Andrij Holian
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, 32 Campus Dr, Missoula, MT 59812, United States
| |
Collapse
|
14
|
Rumian Ł, Wolf-Brandstetter C, Rößler S, Reczyńska K, Tiainen H, Haugen HJ, Scharnweber D, Pamuła E. Sodium alendronate loaded poly(l-lactide- co-glycolide) microparticles immobilized on ceramic scaffolds for local treatment of bone defects. Regen Biomater 2020; 7:293-302. [PMID: 32523731 PMCID: PMC7266661 DOI: 10.1093/rb/rbaa012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/21/2020] [Accepted: 03/02/2020] [Indexed: 12/15/2022] Open
Abstract
Bone tissue regeneration in critical-size defects is possible after implantation of a 3D scaffold and can be additionally enhanced once the scaffold is enriched with drugs or other factors supporting bone remodelling and healing. Sodium alendronate (Aln), a widely used anti-osteoporosis drug, exhibits strong inhibitory effect on bone resorption performed by osteoclasts. Thus, we propose a new approach for the treatment of bone defects in craniofacial region combining biocompatible titanium dioxide scaffolds and poly(l-lactide-co-glycolide) microparticles (MPs) loaded with Aln. The MPs were effectively attached to the surface of the scaffolds’ pore walls by human recombinant collagen. Drug release from the scaffolds was characterized by initial burst (24 ± 6% of the drug released within first 24 h) followed by a sustained release phase (on average 5 µg of Aln released per day from Day 3 to Day 18). In vitro tests evidenced that Aln at concentrations of 5 and 2.5 µg/ml was not cytotoxic for MG-63 osteoblast-like cells (viability between 81 ± 6% and 98 ± 3% of control), but it prevented RANKL-induced formation of osteoclast-like cells from macrophages derived from peripheral blood mononuclear cells, as shown by reduced fusion capability and decreased tartrate-resistant acid phosphatase 5b activity (56 ± 5% reduction in comparison to control after 8 days of culture). Results show that it is feasible to design the scaffolds providing required doses of Aln inhibiting osteoclastogenesis, reducing osteoclast activity, but not affecting osteoblast functions, which may be beneficial in the treatment of critical-size bone tissue defects.
Collapse
Affiliation(s)
- Łucja Rumian
- Faculty of Materials Science and Ceramics, Department of Biomaterials and Composites, AGH University of Science and Technology, Al. A. Mickiewicza 30, Krakow 30-059, Poland
| | - Cornelia Wolf-Brandstetter
- Technische Universität Dresden, Institute of Materials Science, Max Bergmann Center of Biomaterials, Budapester Str. 27, Dresden 01-069, Germany
| | - Sina Rößler
- Technische Universität Dresden, Institute of Materials Science, Max Bergmann Center of Biomaterials, Budapester Str. 27, Dresden 01-069, Germany
| | - Katarzyna Reczyńska
- Faculty of Materials Science and Ceramics, Department of Biomaterials and Composites, AGH University of Science and Technology, Al. A. Mickiewicza 30, Krakow 30-059, Poland
| | - Hanna Tiainen
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, Geitmyrsveien 71, Blindern, P.O. Box 1109, Oslo NO-0317, Norway
| | - Håvard J Haugen
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, Geitmyrsveien 71, Blindern, P.O. Box 1109, Oslo NO-0317, Norway
| | - Dieter Scharnweber
- Technische Universität Dresden, Institute of Materials Science, Max Bergmann Center of Biomaterials, Budapester Str. 27, Dresden 01-069, Germany
| | - Elżbieta Pamuła
- Faculty of Materials Science and Ceramics, Department of Biomaterials and Composites, AGH University of Science and Technology, Al. A. Mickiewicza 30, Krakow 30-059, Poland
| |
Collapse
|
15
|
Padmanabhan J, Maan ZN, Kwon SH, Kosaraju R, Bonham CA, Gurtner GC. In Vivo Models for the Study of Fibrosis. Adv Wound Care (New Rochelle) 2019; 8:645-654. [PMID: 31827979 PMCID: PMC6904938 DOI: 10.1089/wound.2018.0909] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/28/2019] [Indexed: 02/04/2023] Open
Abstract
Significance: Fibrosis and scar formation pose a substantial physiological and psychological burden on patients and a significant public health burden on the economy, estimated to be up to $12 billion a year. Fibrosis research is heavily reliant on in vivo models, but variations in animal models and differences between animal and human fibrosis necessitates careful selection of animal models to study fibrosis. There is also an increased need for improved animal models that recapitulate human pathophysiology. Recent Advances: Several murine and porcine models, including xenograft, drug-induced fibrosis, and mechanical load-induced fibrosis, for different types of fibrotic disease have been described in the literature. Recent findings have underscored the importance of mechanical forces in the pathophysiology of scarring. Critical Issues: Differences in skin, properties of subcutaneous tissue, and modes of fibrotic healing in animal models and humans provide challenges toward investigating fibrosis with in vivo models. While porcine models are typically better suited to study cutaneous fibrosis, murine models are preferred because of the ease of handling and availability of transgenic strains. Future Directions: There is a critical need to develop novel murine models that recapitulate the mechanical cues influencing fibrosis in humans, significantly increasing the translational value of fibrosis research. We advocate a translational pipeline that begins in mouse models with modified biomechanical environments for foundational molecular and cellular research before validation in porcine models that closely mimic the human condition.
Collapse
Affiliation(s)
- Jagannath Padmanabhan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Zeshaan N. Maan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Sun Hyung Kwon
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Revanth Kosaraju
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Clark A. Bonham
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Geoffrey C. Gurtner
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| |
Collapse
|
16
|
Chen F, Wang M, Wang J, Chen X, Li X, Xiao Y, Zhang X. Effects of hydroxyapatite surface nano/micro-structure on osteoclast formation and activity. J Mater Chem B 2019; 7:7574-7587. [PMID: 31729515 DOI: 10.1039/c9tb01204d] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The surface structure of calcium phosphate (CaP) ceramic plays an important role in its osteoinductivity; however, little is known about its effects on osteoclastogenesis. In this study, an intramuscular implantation model suggested a potential relationship between hydroxyapatite (HA)-induced bone formation and osteoclast appearance in the non-osseous site, which might be modulated by scaffold surface structure. Then, three dense HA discs with different grain sizes from biomimetic nanoscale (∼100 nm) to submicron scale (∼500 nm) were fabricated via distinct sintering procedures, and their impacts on osteoclastic differentiation of RAW 264.7 macrophages under RANKL stimulation were further investigated. Our results showed that compared with the ones in the submicron-scale dimension, nano-structured HA discs markedly impaired osteoclastic formation and function, as evidenced by inhibited cell fusion, reduced osteoclast size, less-defined actin ring, increased osteoclast apoptosis, suppressed expression of osteoclast specific genes and proteins, decreased TRAP-positive cells, and hampered resorption activity. This demonstrated that the surface structure of CaP ceramics has a great influence on osteoclastogenesis, which might be further related to its osteoinductive capacity. These findings might not only help us gain insight into biomolecular events during CaP-involved osteoinduction, but also offer a principle for designing orthopaedic implants with an ability of regulating both osteogenesis and osteoclastogenesis to achieve the desired performance.
Collapse
Affiliation(s)
- Fuying Chen
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China.
| | - Menglu Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China.
| | - Jing Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China.
| | - Xuening Chen
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China.
| | - Xiangfeng Li
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China.
| | - Yumei Xiao
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China.
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China.
| |
Collapse
|
17
|
Datye A, Alexander Kube S, Verma D, Schroers J, Schwarz UD. Accelerated discovery and mechanical property characterization of bioresorbable amorphous alloys in the Mg-Zn-Ca and the Fe-Mg-Zn systems using high-throughput methods. J Mater Chem B 2019; 7:5392-5400. [PMID: 31411619 DOI: 10.1039/c9tb01302d] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Ternary amorphous alloys in the magnesium (Mg)-zinc (Zn)-calcium (Ca) and the iron (Fe)-Mg-Zn systems are promising candidates for use in bioresorbable implants and devices. The optimal alloy compositions for biomedical applications should be chosen from a large variety of available alloys with best combination of mechanical properties (modulus, strength, hardness) and biological response (in situ degradation rates, cell adhesion and proliferation). As a first step towards establishing a database designed to enable such targeted material selection, amorphous alloy composition libraries were fabricated employing a combinatorial magnetron sputtering approach where Mg, Zn, and Ca/Fe are co-deposited from separate sources onto a silicon wafer substrate. Composition analysis using energy dispersive X-ray spectroscopy documented a composition range of ∼15-85 at% Mg, ∼6-55 at% Zn, and ∼5-60 at% Ca for the Mg-Zn-Ca library and ∼26-84 at% Mg, ∼10-61 at% Zn, and ∼7-55 at% Fe for the Fe-Mg-Zn library. X-ray diffraction measurements established that amorphous alloys (i.e., glasses) form in almost the entire range of composition at the high cooling rates during sputtering for both alloy libraries. Finally, the effective material modulus, the Oliver-Pharr hardness, and the yield strength values obtained using nanoindentation reveal a wide range of mechanical properties within both systems.
Collapse
Affiliation(s)
- Amit Datye
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT 06511, USA.
| | - Sebastian Alexander Kube
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT 06511, USA.
| | - Devendra Verma
- Nanoscience Instruments, 10008 S. 51st Street, Ste 110, Phoenix, AZ 85044, USA
| | - Jan Schroers
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT 06511, USA.
| | - Udo D Schwarz
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT 06511, USA. and Department of Chemical Engineering, Yale University, New Haven, CT 06511, USA
| |
Collapse
|
18
|
Hamlet SM, Lee RS, Moon H, Alfarsi MA, Ivanovski S. Hydrophilic titanium surface‐induced macrophage modulation promotes pro‐osteogenic signalling. Clin Oral Implants Res 2019; 30:1085-1096. [DOI: 10.1111/clr.13522] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Stephen M. Hamlet
- Menzies Health Institute Queensland Griffith University Gold Coast Queensland Australia
- School of Dentistry and Oral Health Griffith University Gold Coast Queensland Australia
| | - Ryan S.B. Lee
- School of Dentistry and Oral Health Griffith University Gold Coast Queensland Australia
- School of Dentistry The University of Queensland Herston Queensland Australia
| | - Ho‐Jin Moon
- School of Dentistry and Oral Health Griffith University Gold Coast Queensland Australia
- Department of Dental Materials, School of Dentistry Kyung Hee University Seoul Republic of Korea Australia
| | | | - Sašo Ivanovski
- School of Dentistry The University of Queensland Herston Queensland Australia
| |
Collapse
|
19
|
Tumor Microenvironment and Cell Fusion. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5013592. [PMID: 31380426 PMCID: PMC6657644 DOI: 10.1155/2019/5013592] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 06/06/2019] [Accepted: 06/16/2019] [Indexed: 12/14/2022]
Abstract
Cell fusion is a highly regulated biological process that occurs under both physiological and pathological conditions. The cellular and extracellular environment is critical for the induction of the cell-cell fusion. Aberrant cell fusion is initiated during tumor progression. Tumor microenvironment is a complex dynamic system formed by the interaction between tumor cells and their surrounding cells. Cell-cell fusion mediates direct interaction between tumor cells and their surrounding cells and is associated with tumor initiation and progression. Various microenvironmental factors affect cell fusion in tumor microenvironment and generate hybrids that acquire genomes of both parental cells and exhibit novel characteristics, such as tumor stem cell-like properties, radioresistance, drug resistance, immune evasion, and enhanced migration and invasion abilities, which are closely related to the initiation, invasion, and metastasis of tumor. The phenotypic characteristics of hybrids are based on the phenotypes of parental cells, and the fusion of tumor cells with diverse types of microenvironmental fusogenic cells is concomitant with phenotypic heterogeneity. This review highlights the types of fusogenic cells in tumor microenvironment that can fuse with tumor cells and their specific significance and summarizes the various microenvironmental factors affecting tumor cell fusion. This review may be used as a reference to develop strategies for future research on tumor cell fusion and the exploration of cell fusion-based antitumor therapies.
Collapse
|
20
|
Shen MY, Yuran S, Aviv Y, Ayalew H, Luo CH, Tsai YH, Reches M, Yu HH, Shenhar R. Electrically Responsive, Nanopatterned Surfaces for Triggered Delivery of Biologically Active Molecules into Cells. ACS APPLIED MATERIALS & INTERFACES 2019; 11:1201-1208. [PMID: 30565453 DOI: 10.1021/acsami.8b15308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Polyelectrolyte multilayers (PEMs) assembled layer-by-layer have emerged as functional polymer films that are both stable and capable of containing drug molecules for controlled release applications. Most of these applications concentrate on sustained release, where the concentration of the released molecules remains rather constant with time. However, high-efficiency delivery requires obtaining high local concentrations at the vicinity of the cells, which is achieved by triggered release. Here, we show that a nanopatterned PEM platform demonstrates superior properties with respect to drug retention and triggered delivery. A chemically modified block copolymer film was used as a template for the selective deposition of poly(ethylene imine) and a charged derivative of the electroactive poly(3,4-ethylenedioxythiophene) together with a drug molecule. This nanopatterned PEM shows the following advantages: (1) high drug loading; (2) enhanced retention of the bioactive molecule; (3) release triggered by an electrochemical stimulus; (4) high efficacy of drug delivery to cells adsorbed on the surface compared to the delivery efficacy of a similar concentration of drug to cells suspended in a solution.
Collapse
Affiliation(s)
- Mo-Yuan Shen
- Institute of Chemistry , Academia Sinica , 128 Academia Road Sec. 2 , Nankang, Taipei 115 , Taiwan
| | - Sivan Yuran
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, Edmond J. Safra Campus , The Hebrew University of Jerusalem , Jerusalem 9190401 , Israel
| | - Yaron Aviv
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, Edmond J. Safra Campus , The Hebrew University of Jerusalem , Jerusalem 9190401 , Israel
| | - Hailemichael Ayalew
- Institute of Chemistry , Academia Sinica , 128 Academia Road Sec. 2 , Nankang, Taipei 115 , Taiwan
- Taiwan International Graduate Program (TIGP), Sustainable Chemical Science and Technology (SCST) , Academia Sinica , Taipei 115 , Taiwan
| | - Chun-Hao Luo
- Institute of Chemistry , Academia Sinica , 128 Academia Road Sec. 2 , Nankang, Taipei 115 , Taiwan
| | - Yu-Han Tsai
- Institute of Chemistry , Academia Sinica , 128 Academia Road Sec. 2 , Nankang, Taipei 115 , Taiwan
| | - Meital Reches
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, Edmond J. Safra Campus , The Hebrew University of Jerusalem , Jerusalem 9190401 , Israel
| | - Hsiao-Hua Yu
- Institute of Chemistry , Academia Sinica , 128 Academia Road Sec. 2 , Nankang, Taipei 115 , Taiwan
- Taiwan International Graduate Program (TIGP), Sustainable Chemical Science and Technology (SCST) , Academia Sinica , Taipei 115 , Taiwan
| | - Roy Shenhar
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, Edmond J. Safra Campus , The Hebrew University of Jerusalem , Jerusalem 9190401 , Israel
| |
Collapse
|
21
|
Shayan M, Padmanabhan J, Morris AH, Cheung B, Smith R, Schroers J, Kyriakides TR. Nanopatterned bulk metallic glass-based biomaterials modulate macrophage polarization. Acta Biomater 2018; 75:427-438. [PMID: 29859902 PMCID: PMC6119487 DOI: 10.1016/j.actbio.2018.05.051] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/16/2018] [Accepted: 05/30/2018] [Indexed: 12/16/2022]
Abstract
Polarization of macrophages by chemical, topographical and mechanical cues presents a robust strategy for designing immunomodulatory biomaterials. Here, we studied the ability of nanopatterned bulk metallic glasses (BMGs), a new class of metallic biomaterials, to modulate murine macrophage polarization. Cytokine/chemokine analysis of IL-4 or IFNγ/LPS-stimulated macrophages showed that the secretion of TNF-α, IL-1α, IL-12, CCL-2 and CXCL1 was significantly reduced after 24-hour culture on BMGs with 55 nm nanorod arrays (BMG-55). Additionally, under these conditions, macrophages increased phagocytic potential and exhibited decreased cell area with multiple actin protrusions. These in vitro findings suggest that nanopatterning can modulate biochemical cues such as IFNγ/LPS. In vivo evaluation of the subcutaneous host response at 2 weeks demonstrated that the ratio of Arg-1 to iNOS increased in macrophages adjacent to BMG-55 implants, suggesting modulation of polarization. In addition, macrophage fusion and fibrous capsule thickness decreased and the number and size of blood vessels increased, which is consistent with changes in macrophage responses. Our study demonstrates that nanopatterning of BMG implants is a promising technique to selectively polarize macrophages to modulate the immune response, and also presents an effective tool to study mechanisms of macrophage polarization and function. STATEMENT OF SIGNIFICANCE Implanted biomaterials elicit a complex series of tissue and cellular responses, termed the foreign body response (FBR), that can be influenced by the polarization state of macrophages. Surface topography can influence polarization, which is broadly characterized as either inflammatory or repair-like. The latter has been linked to improved outcomes of the FBR. However, the impact of topography on macrophage polarization is not fully understood, in part, due to a lack of high moduli biomaterials that can be reproducibly processed at the nanoscale. Here, we studied macrophage interactions with nanopatterned bulk metallic glasses (BMGs), a class of metallic alloys with amorphous microstructure and formability like polymers. We show that nanopatterned BMGs modulate macrophage polarization and transiently induce less fibrotic and more angiogenic responses. Overall, we demonstrate nanopatterning of BMG implants as a technique to polarize macrophages and modulate the FBR.
Collapse
Affiliation(s)
- Mahdis Shayan
- Department of Pathology, Yale University, New Haven, CT 06520, USA
| | | | - Aaron H Morris
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
| | - Bettina Cheung
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
| | - Ryan Smith
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
| | - Jan Schroers
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA; Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT 06520, USA
| | - Themis R Kyriakides
- Department of Pathology, Yale University, New Haven, CT 06520, USA; Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA.
| |
Collapse
|
22
|
Loye AM, Kinser ER, Bensouda S, Shayan M, Davis R, Wang R, Chen Z, Schwarz UD, Schroers J, Kyriakides TR. Regulation of Mesenchymal Stem Cell Differentiation by Nanopatterning of Bulk Metallic Glass. Sci Rep 2018; 8:8758. [PMID: 29884812 PMCID: PMC5993820 DOI: 10.1038/s41598-018-27098-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 05/24/2018] [Indexed: 01/08/2023] Open
Abstract
Mesenchymal stem cell (MSC) differentiation is regulated by surface modification including texturing, which is applied to materials to enhance tissue integration. Here, we used Pt57.5Cu14.7Ni5.3P22.5 bulk metallic glass (Pt-BMG) with nanopatterned surfaces achieved by thermoplastic forming to influence differentiation of human MSCs. Pt-BMGs are a unique class of amorphous metals with high strength, elasticity, corrosion resistance, and an unusual plastic-like processability. It was found that flat and nanopattened Pt-BMGs induced osteogenic and adipogenic differentiation, respectively. In addition, osteogenic differentiation on flat BMG exceeded that observed on medical grade titanium and was associated with increased formation of focal adhesions and YAP nuclear localization. In contrast, cells on nanopatterned BMGs exhibited rounded morphology, formed less focal adhesions and had mostly cytoplasmic YAP. These changes were preserved on nanopatterns made of nanorods with increased stiffness due to shorter aspect ratios, suggesting that MSC differentiation was primarily influenced by topography. These observations indicate that both elemental composition and nanotopography can modulate biochemical cues and influence MSCs. Moreover, the processability and highly tunable nature of Pt-BMGs enables the creation of a wide range of surface topographies that can be reproducibly and systematically studied, leading to the development of implants capable of engineering MSC functions.
Collapse
Affiliation(s)
- Ayomiposi M Loye
- Center for Research on Interface Structures and Phenomena, Yale University, New Haven, CT, 06520, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA
| | - Emily R Kinser
- Center for Research on Interface Structures and Phenomena, Yale University, New Haven, CT, 06520, USA
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT, 06520, USA
- IBM Thomas J, Watson Research Center, New York, NY, 10598, USA
| | - Sabrine Bensouda
- Center for Research on Interface Structures and Phenomena, Yale University, New Haven, CT, 06520, USA
| | - Mahdis Shayan
- Center for Research on Interface Structures and Phenomena, Yale University, New Haven, CT, 06520, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA
| | - Rose Davis
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, 06520, USA
| | - Rui Wang
- IBM Thomas J, Watson Research Center, New York, NY, 10598, USA
| | - Zheng Chen
- Center for Research on Interface Structures and Phenomena, Yale University, New Haven, CT, 06520, USA
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT, 06520, USA
| | - Udo D Schwarz
- Center for Research on Interface Structures and Phenomena, Yale University, New Haven, CT, 06520, USA
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT, 06520, USA
- Department of Chemical and Enviromental Engineering, Yale University, P.O. Box 208089, New Haven, CT, 06520, USA
| | - Jan Schroers
- Center for Research on Interface Structures and Phenomena, Yale University, New Haven, CT, 06520, USA
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT, 06520, USA
| | - Themis R Kyriakides
- Center for Research on Interface Structures and Phenomena, Yale University, New Haven, CT, 06520, USA.
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA.
- Department of Pathology, Yale University, P.O. Box 208089, New Haven, CT, 06520, USA.
| |
Collapse
|
23
|
Morris AH, Mahal RS, Udell J, Wu M, Kyriakides TR. Multicompartment Drug Release System for Dynamic Modulation of Tissue Responses. Adv Healthc Mater 2017. [PMID: 28636088 DOI: 10.1002/adhm.201700370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Pharmacological modulation of responses to injury is complicated by the need to deliver multiple drugs with spatiotemporal resolution. Here, a novel controlled delivery system containing three separate compartments with each releasing its contents over different timescales is fabricated. Core-shell electrospun fibers create two of the compartments in the system, while electrosprayed spheres create the third. Utility is demonstrated by targeting the foreign body response to implants because it is a dynamic process resulting in implant failure. Sequential delivery of a drug targeting nuclear factor-κB (NF-κB) and an antifibrotic is characterized in in vitro experiments. Specifically, macrophage fusion and p65 nuclear translocation in the presence of releasate or with macrophages cultured on the surfaces of the constructs are evaluated. In addition, releasate from pirfenidone scaffolds is shown to reduce transforming growth factor-β (TGF-β)-induced pSMAD3 nuclear localization in fibroblasts. In vivo, drug eluting constructs successfully mitigate macrophage fusion at one week and fibrotic encapsulation in a dose-dependent manner at four weeks, demonstrating effective release of both drugs over different timescales. Future studies can employ this system to improve and prolong implant lifetimes, or load it with other drugs to modulate other dynamic processes.
Collapse
Affiliation(s)
- Aaron H. Morris
- Department of Biomedical Engineering, Vascular Biology and Therapeutics Program Yale University New Haven CT 06519 USA
| | - Rajwant S. Mahal
- Department of Biomedical Engineering Yale University New Haven CT 06519 USA
| | - Jillian Udell
- Department of Biomedical Engineering Yale University New Haven CT 06519 USA
| | - Michelle Wu
- Department of Biomedical Engineering Yale University New Haven CT 06519 USA
| | - Themis R. Kyriakides
- Department of Biomedical Engineering Department of Pathology, Vascular Biology and Therapeutics Program Yale University New Haven CT 06519 USA
| |
Collapse
|
24
|
Sousa MP, Caridade SG, Mano JF. Control of Cell Alignment and Morphology by Redesigning ECM-Mimetic Nanotopography on Multilayer Membranes. Adv Healthc Mater 2017; 6:10.1002/adhm.201601462. [PMID: 28371516 PMCID: PMC6398568 DOI: 10.1002/adhm.201601462] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 02/11/2017] [Indexed: 01/08/2023]
Abstract
Inspired by native extracellular matrix (ECM) together with the multilevel architecture observed in nature, a material which topography recapitulates topographic features of the ECM and the internal architecture mimics the biological materials organization is engineered. The nanopatterned design along the XY plane is combined with a nanostructured organization along the Z axis on freestanding membranes prepared by layer-by-layer deposition of chitosan and chondroitin sulfate. Cellular behavior is monitored using two different mammalian cell lines, fibroblasts (L929) and myoblasts (C2C12), in order to perceive the response to topography. Viability, proliferation, and morphology of L929 are sensitively controlled by topography; also differentiation of C2C12 into myotubes is influenced by the presence of nanogrooves. This kind of nanopatterned structure has also been associated with strong cellular alignment. To the best of the knowledge, it is the first time that such a straightforward and inexpensive strategy is proposed to produce nanopatterned freestanding multilayer membranes. Controlling cellular alignment plays a critical role in many human tissues, such as muscles, nerves, or blood vessels, so these membranes can be potentially useful in specific tissue regeneration strategies.
Collapse
|
25
|
Development of fusogenic glass surfaces that impart spatiotemporal control over macrophage fusion: Direct visualization of multinucleated giant cell formation. Biomaterials 2017; 128:160-171. [PMID: 28340410 DOI: 10.1016/j.biomaterials.2017.02.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 02/21/2017] [Accepted: 02/26/2017] [Indexed: 01/07/2023]
Abstract
Implantation of synthetic material, including vascular grafts, pacemakers, etc. results in the foreign body reaction and the formation of multinucleated giant cells (MGCs) at the exterior surface of the implant. Despite the long-standing premise that fusion of mononucleated macrophages results in the formation of MGCs, to date, no published study has shown fusion in context with living specimens. This is due to the fact that optical-quality glass, which is required for the majority of live imaging techniques, does not promote macrophage fusion. Consequently, the morphological changes that macrophages undergo during fusion as well as the mechanisms that govern this process remain ill-defined. In this study, we serendipitously identified a highly fusogenic glass surface and discovered that the capacity to promote fusion was due to oleamide contamination. When adsorbed on glass, oleamide and other molecules that contain long-chain hydrocarbons promoted high levels of macrophage fusion. Adhesion, an essential step for macrophage fusion, was apparently mediated by Mac-1 integrin (CD11b/CD18, αMβ2) as determined by single cell force spectroscopy and adhesion assays. Micropatterned glass further increased fusion and enabled a remarkable degree of spatiotemporal control over MGC formation. Using these surfaces, we reveal the kinetics that govern MGC formation in vitro. We anticipate that the spatiotemporal control afforded by these surfaces will expedite studies designed to identify the mechanism(s) of macrophage fusion and MGC formation with implication for the design of novel biomaterials.
Collapse
|