Regenerative rehabilitation with conductive biomaterials for spinal cord injury

The individual approaches of regenerative medicine efforts alone and rehabilitation efforts alone have not yet fully restored function after severe spinal cord injury (SCI). Regenerative rehabilitation may be leveraged to promote regeneration of the spinal cord tissue, and promote reorganization of the regenerated neural pathways and intact spinal circuits for better functional recovery for SCI. Conductive biomaterials may be a linchpin that empowers the synergy between regenerative medicine and rehabilitation approaches, as electrical stimulation applied to the spinal cord could facilitate neural reorganization. In this review, we discuss current regenerative medicine approaches in clinical trials and the rehabilitation, or neuromodulation, approaches for SCI, along with their respective translational limitations. Furthermore, we review the translational potential, in a surgical context, of conductive biomaterials (e.g., conductive polymers, carbon-based materials, metallic nanoparticle-based materials) as they pertain to SCI. While pre-formed scaffolds may be difficult to translate to human contusion SCIs, injectable composites that contain blended conductive components and can form within the injury may be more translational. However, given that there are currently no in vivo SCI studies that evaluated conductive materials combined with rehabilitation approaches, we discuss several limitations of conductive biomaterials, including demonstrating safety and efficacy, that will need to be addressed in the future for conductive biomaterials to become SCI therapeutics. Even so, the use of conductive biomaterials creates a synergistic opportunity to merge the fields of regenerative medicine and rehabilitation and redefine what regenerative rehabilitation means for the spinal cord. STATEMENT OF SIGNIFICANCE: For spinal cord injury (SCI), the individual approaches of regenerative medicine and rehabilitation are insufficient to fully restore functional recovery; however, the goal of regenerative rehabilitation is to combine these two disparate fields to maximize the functional outcomes. Concepts similar to regenerative rehabilitation for SCI have been discussed in several reviews, but for the first time, this review considers how conductive biomaterials may synergize the two approaches. We cover current regenerative medicine and rehabilitation approaches for SCI, and the translational advantages and disadvantages, in a surgical context, of conductive biomaterials used in biomedical applications that may be additionally applied to SCI. Furthermore, we identify the current limitations and translational challenges for conductive biomaterials before they may become therapeutics for SCI.

Carbon Nanotubes Interference with Luminescence-Based Assays

Carbon nanotubes (CNTs) are one of the most promising nanomaterials synthesized to date. Thanks to their unique mechanical, electronic, and optical properties, they have found a wide application in electronics in the production of biosensors and nanocomposites. The functionalization of multiwalled carbon nanotubes (MWCNTs) is aimed at making them biocompatible by adding hydrophilic groups on their surface, increasing their solubility and thus rendering them applicable in the regenerative medicine. So far, there is conflicting information about carbon nanotubes in biological systems. This paper investigates the effect of functionalized, oxidized, multiwalled carbon nanotubes (MWCNT-Ox) on the cytotoxicity of normal human articular chondrocytes (NHAC-kn cell line). Since absorbance-based and fluorescence-based assays were shown to interfere with carbon nanotubes, luminescence-based tests were carried out, as they work on a different method of detection and provide advantages over the mentioned ones. Cell viability and reactive oxygen species (ROS) tests were carried out. The cell viability assay showed that with the increasing MWCNTs concentration, the number of viable chondrocytes was significantly decreasing. Exposure to MWCNT-Ox indicated oxidative stress in the lowest investigated concentration with a decreased amount of ROS with higher concentrations. However, control experiments with adenosine triphosphate (ATP) and H₂O₂-molecules that are detected by the assays-showed that carbon nanotubes interfere directly with measurement, thus rendering the results unreliable. To understand the exact interference mechanisms, further studies must be taken. In conclusion, this study shows that luminescence-based tests yield erroneous results, confirming that in vitro experiments in the literature concerning carbon nanotubes should be analyzed with caution.

Colloidal systems toward 3D cell culture scaffolds

Three-dimensional porous scaffolds are essential for the development of tissue engineering and regeneration, as biomimetic supports to recreate the microenvironment present in natural tissues. To successfully achieve the growth and development of a specific kind of tissue, porous matrices should be able to influence cell behavior by promoting close cell-cell and cell-matrix interactions. To achieve this goal, the scaffold must fulfil a set of conditions, including ordered interconnected porosity to promote cell diffusion and vascularization, mechanical strength to support the tissue during continuous ingrowth, and biocompatibility to avoid toxicity. Among various building approaches to the construction of porous matrices, selected strategies afford hierarchical scaffolds with such defined properties. The control over porosity, microstructure or morphology, is crucial to the fabrication of high-end, reproducible scaffolds for the target application. In this review, we provide an insight into recent advances toward the colloidal fabrication of hierarchical scaffolds. After identifying the main requirements for scaffolds in biomedical applications, conceptual building processes are introduced. Examples of tissue regeneration applications are provided for different scaffold types, highlighting their versatility and biocompatibility. We finally provide a prospect about the current state of the art and limitations of porous scaffolds, along with challenges that are to be addressed, so these materials consolidate in the fields of tissue engineering and drug delivery.

Bioactive multiple-bent MWCNTs for sensitive and reliable electrochemical detection of picomolar-level C-reactive proteins

We present multiple-bent multi-walled carbon nanotubes (MWCNTs) that enable the picomolar detection of C-reactive protein (CRP), which is considered to be a promising biomarker for various diseases. The MWCNTs were grown via chemical vapor deposition repeating the asymmetric catalytic CNT growth on atypical carbon nanoparticles that were generated by carbon coating on a silicon substrate. The multiple-bent MWCNTs with the carbon film (CF) possessed abundant hydrophilic functional groups (-COOH and -OH) at their bending sites, resulting in enhanced bioadhesion to collagen and platelets, compared to MWCNTs grown without a CF layer. Interestingly, the bent MWCNTs enhanced the reliability and sensitivity of the electrochemical detection at low CRP concentrations, possibly due to molecular affinity at the bent site. The bioactive bent MWCNTs can play a significant role in ultrasensitive biosensors to improve their detection limit, thereby achieving early detection and monitoring of CRP-related diseases such as cardiovascular events and melanoma.

Freeze Casting: From Low-Dimensional Building Blocks to Aligned Porous Structures-A Review of Novel Materials, Methods, and Applications

Freeze casting, also known as ice templating, is a particularly versatile technique that has been applied extensively for the fabrication of well-controlled biomimetic porous materials based on ceramics, metals, polymers, biomacromolecules, and carbon nanomaterials, endowing them with novel properties and broadening their applicability. The principles of different directional freeze-casting processes are described and the relationships between processing and structure are examined. Recent progress in freeze-casting assisted assembly of low dimensional building blocks, including graphene and carbon nanotubes, into tailored micro- and macrostructures is then summarized. Emerging trends relating to novel materials as building blocks and novel freeze-cast geometries-beads, fibers, films, complex macrostructures, and nacre-mimetic composites-are presented. Thereafter, the means by which aligned porous structures and nacre mimetic materials obtainable through recently developed freeze-casting techniques and low-dimensional building blocks can facilitate material functionality across multiple fields of application, including energy storage and conversion, environmental remediation, thermal management, and smart materials, are discussed.

Looking into the Future: Toward Advanced 3D Biomaterials for Stem-Cell-Based Regenerative Medicine

Stem-cell-based therapies have the potential to provide novel solutions for the treatment of a variety of diseases, but the main obstacles to such therapies lie in the uncontrolled differentiation and functional engraftment of implanted tissues. The physicochemical microenvironment controls the self-renewal and differentiation of stem cells, and the key step in mimicking the stem cell microenvironment is to construct a more physiologically relevant 3D culture system. Material-based 3D assemblies of stem cells facilitate the cellular interactions that promote morphogenesis and tissue organization in a similar manner to that which occurs during embryogenesis. Both natural and artificial materials can be used to create 3D scaffolds, and synthetic organic and inorganic porous materials are the two main kinds of artificial materials. Nanotechnology provides new opportunities to design novel advanced materials with special physicochemical properties for 3D stem cell culture and transplantation. Herein, the advances and advantages of 3D scaffold materials, especially with respect to stem-cell-based therapies, are first outlined. Second, the stem cell biology in 3D scaffold materials is reviewed. Third, the progress and basic principles of developing 3D scaffold materials for clinical applications in tissue engineering and regenerative medicine are reviewed.

Ice as a Green-Structure-Directing Agent in the Synthesis of Macroporous MWCNTs and Chondroitin Sulphate Composites

The incorporation of multi-walled carbon nanotubes (MWCNTs) into chondroitin sulphate-based scaffolds and the effect on the structural, mechanical, conductive, and thermal properties of the resulting scaffolds is investigated. Three-dimensional hierarchical materials are prepared upon the application of the ice segregation-induced self-assembly (ISISA) process. The use of ice as structure-directing agents avoids chemicals typically used for this purpose (e.g., surfactants, block copolymers, etc.), hence, emphasising the green features of this soft-templating approach. We determine the critical parameters that control the morphology of the scaffolds formed upon ice-templating (i.e., MWCNTs type, freezing conditions, polymer and MWCNT concentration). MWCNTs are surface functionalized by acidic treatment. MWCNT functionalization is characterized by Raman, Fourier transfer infrared (FTIR) and X-ray Photoelectron (XPS) spectroscopies. Scanning electron microscopy (SEM) analysis and porosity studies reveal that MWCNT content modifies the morphology of the macroporous structure, which decreases by increasing MWCNT concentration. Differences in scaffold morphology should be translated into their conductivity and mechanical properties. As a general trend, the Young's modulus and the electrical conductivity of the scaffolds increase with the MWCNT content. Preliminary biocompatibility tests with human osteoblast-like cells also reveal the capability of these structures to support cell growth.

Porous three-dimensional carbon nanotube scaffolds for tissue engineering

Assembly of carbon nanomaterials into three-dimensional (3D) architectures is necessary to harness their unique physiochemical properties for tissue engineering and regenerative medicine applications. Herein, we report the fabrication and comprehensive cytocompatibility assessment of 3D chemically crosslinked macrosized (5-8 mm height and 4-6 mm diameter) porous carbon nanotube (CNT) scaffolds. Scaffolds prepared via radical initiated thermal crosslinking of single- or multiwalled CNTs (SWCNTs and MWCNTs) possess high porosity (>80%), and nano-, micro-, and macroscale interconnected pores. MC3T3 preosteoblast cells on MWCNT and SWCNT scaffolds showed good cell viability comparable to poly(lactic-co-glycolic) acid (PLGA) scaffolds after 5 days. Confocal live cell and immunofluorescence imaging showed that MC3T3 cells were metabolically active and could attach, proliferate, and infiltrate MWCNT and SWCNT scaffolds. SEM imaging corroborated cell attachment and spreading and suggested that cell morphology is governed by scaffold surface roughness. MC3T3 cells were elongated on scaffolds with high surface roughness (MWCNTs) and rounded on scaffolds with low surface roughness (SWCNTs). The surface roughness of scaffolds may be exploited to control cellular morphology and, in turn, govern cell fate. These results indicate that crosslinked MWCNTs and SWCNTs scaffolds are cytocompatible, and open avenues toward development of multifunctional all-carbon scaffolds for tissue engineering applications.

Electrically conductive polymers and composites for biomedical applications

This paper provides a review of the recent advances made in the field of electroactive polymers and composites for biomedical applications.

Preparation of chitosan nanocomposites with a macroporous structure by unidirectional freezing and subsequent freeze-drying

Chitosan is the N-deacetylated derivative of chitin, a naturally abundant mucopolysaccharide that consists of 2-acetamido-2-deoxy-β-d-glucose through a β (1→4) linkage and is found in nature as the supporting material of crustaceans, insects, etc. Chitosan has been strongly recommended as a suitable functional material because of its excellent biocompatibility, biodegradability, non-toxicity, and adsorption properties. Boosting all these excellent properties to obtain unprecedented performances requires the core competences of materials chemists to design and develop novel processing strategies that ultimately allow tailoring the structure and/or the composition of the resulting chitosan-based materials. For instance, the preparation of macroporous materials is challenging in catalysis, biocatalysis and biomedicine, because the resulting materials will offer a desirable combination of high internal reactive surface area and straightforward molecular transport through broad "highways" leading to such a surface. Moreover, chitosan-based composites made of two or more distinct components will produce structural or functional properties not present in materials composed of one single component. Our group has been working lately on cryogenic processes based on the unidirectional freezing of water slurries and/or hydrogels, the subsequent freeze-drying of which produce macroporous materials with a well-patterned structure. We have applied this process to different gels and colloidal suspensions of inorganic, organic, and hybrid materials. In this review, we will describe the application of the process to chitosan solutions and gels typically containing a second component (e.g., metal and ceramic nanoparticles, or carbon nanotubes) for the formation of chitosan nanocomposites with a macroporous structure. We will also discuss the role played by this tailored composition and structure in the ultimate performance of these materials.

Mechanical and biological properties of chitosan/carbon nanotube nanocomposite films

In this article, different concentrations of multiwalled carbon nanotube (MWCNT) were homogeneously dispersed throughout the chitosan (CS) matrix. A simple solvent-cast method was used to fabricate chitosan films with 0.1, 0.5, and 1% of MWCNT with the average diameter around 30 nm. The CS/MWCNT films were characterized for structural, viscous and mechanical properties with optical microscopy, wide-angle X-ray diffraction, Raman spectroscopy, tensile test machine, and microindentation testing machine. Murine osteoblasts were used to examine the cell viability and attachment of the nanocomposite films at two time points. In comparison to the pure chitosan film, the mechanical properties, including the tensile modulus and strength of the films, were greatly improved by increasing the percentage of MWCNT. Furthermore, adding MWCNT up to 1% increased the viscosity of the chitosan solution by 15%. However, adding MWCNT decreased the samples ductility and transparency. In biological point of view, no toxic effect on osteoblasts was observed in the presence of different percentages of MWCNT at day 3 and day 7. This investigation suggested MWCNT could be a promising candidate for improving chitosan mechanical properties without inducing remarkable cytotoxicity on bone cells.

Chondroitin sulphate-based 3D scaffolds containing MWCNTs for nervous tissue repair

Nervous tissue lesions are an important social concern due to their increasing prevalence and their high sanitary costs. Their treatment still remains a challenge because of the reduced ability of nervous tissue to regenerate, its intrinsic structural and functional complexity and the rapid formation of fibroglial scars inhibiting neural repair. Herein, we show that 3D porous scaffolds made of chondroitin sulphate (CS), a major regulatory component of the nervous tissue, and multi-walled carbon nanotubes (MWCNTs) are selective substrates for the formation of a viable and neuron-enriched network with a transitory low glial content. Scaffolds have been fabricated by using the ice segregation-induced self-assembly technique and cultured with embryonic neural progenitor cells. Cell adhesion, morphology, viability, neuron/glial differentiation, calcium signaling dynamics, and mitochondrial activity have been studied over time on the scaffolds and compared to appropriate 2D control substrates. Our results indicate the formation of viable cultures enriched in neuron cells for up to 20 days, with ability to display calcium transients and active mitochondria, even in the absence of poly-D-lysine coating. A synergistic neural-permissive signaling from both the scaffold structure and its components (i.e., MWCNTs and CS) is suggested as the major responsible factor for these findings. We anticipate that these scaffolds may serve nerve regeneration if implanted in the acute phase after injury, as it is during the first stages of graft implantation when the most critical sequence of phenomena takes place to drive either nervous regeneration or fibroglial scar formation. The temporary glial inhibition found may be, indeed, beneficial for promoting the formation of neuron-enriched circuits at early phases while guaranteeing posterior glial integration to support longer-term neuron survival and activity.