Citric Acid: A Nexus Between Cellular Mechanisms and Biomaterial Innovations

Citrate-based biodegradable polymers have emerged as a distinctive biomaterial platform with tremendous potential for diverse medical applications. By harnessing their versatile chemistry, these polymers exhibit a wide range of material and bioactive properties, enabling them to regulate cell metabolism and stem cell differentiation through energy metabolism, metabonegenesis, angiogenesis, and immunomodulation. Moreover, the recent US Food and Drug Administration (FDA) clearance of the biodegradable poly(octamethylene citrate) (POC)/hydroxyapatite-based orthopedic fixation devices represents a translational research milestone for biomaterial science. POC joins a short list of biodegradable synthetic polymers that have ever been authorized by the FDA for use in humans. The clinical success of POC has sparked enthusiasm and accelerated the development of next-generation citrate-based biomaterials. This review presents a comprehensive, forward-thinking discussion on the pivotal role of citrate chemistry and metabolism in various tissue regeneration and on the development of functional citrate-based metabotissugenic biomaterials for regenerative engineering applications.

Nanoclay Reinforced Integrated Scaffold for Dual-Lineage Regeneration of Cartilage and Subchondral Bone

Tissue engineering is theoretically considered a promising approach for repairing osteochondral defects. Nevertheless, the insufficient osseous support and integration of the cartilage layer and the subchondral bone frequently lead to the failure of osteochondral repair. Drawing from this, it was proposed that incorporating glycine-modified attapulgite (GATP) into poly(1,8-octanediol-co-citrate) (POC) scaffolds via the one-step chemical cross-linking is proposed to enhance cartilage and subchondral bone defect repair simultaneously. The effects of the GATP incorporation ratio on the physicochemical properties, chondrocyte and MC3T3-E1 behavior, and osteochondral defect repair of the POC scaffold were also evaluated. In vitro studies indicated that the POC/10% GATP scaffold improved cell proliferation and adhesion, maintained cell phenotype, and upregulated chondrogenesis and osteogenesis gene expression. Animal studies suggested that the POC/10% GATP scaffold has significant repair effects on both cartilage and subchondral bone defects. Therefore, the GATP-incorporated scaffold system with dual-lineage bioactivity showed potential application in osteochondral regeneration.

Tough and Water-Resistant Bioelastomers with Active-Controllable Degradation Rates

Biodegradable electronic devices have gained significant traction in modern medical applications. These devices are generally desired to have a long enough working lifetime for stable operation and allow for active control over their degradation rates after usage. However, current biodegradable materials used as encapsulations or substrates for these devices are challenging to meet the two requirements due to the constraints of inadequate water resistance, poor mechanical properties, and passive degradation characteristics. Herein, we develop a novel biodegradable elastomer named POC-SS-Res by introducing disulfide linkage and resveratrol (Res) into poly(1,8-octanediol-co-citrate) (POC). Compared to POC, POC-SS-Res exhibits good water resistance and excellent mechanical properties in PBS, providing effective protection for devices. At the same time, POC-SS-Res offers the unique advantage of an active-controllable degradation rate, and its degradation products express low biotoxicity. Good biocompatibility of POC-SS-Res is also demonstrated. Bioelectronic components encapsulated with POC-SS-Res have an obvious prolongation of working lifetime in PBS compared to that encapsulated with POC, and its degradation rate can be actively controlled by the addition of glutathione (GSH).

Enabling Proregenerative Medical Devices via Citrate-Based Biomaterials: Transitioning from Inert to Regenerative Biomaterials

Regenerative medicine aims to restore tissue and organ function without the use of prosthetics and permanent implants. However, achieving this goal has been elusive, and the field remains mostly an academic discipline with few products widely used in clinical practice. From a materials science perspective, barriers include the lack of proregenerative biomaterials, a complex regulatory process to demonstrate safety and efficacy, and user adoption challenges. Although biomaterials, particularly biodegradable polymers, can play a major role in regenerative medicine, their suboptimal mechanical and degradation properties often limit their use, and they do not support inherent biological processes that facilitate tissue regeneration. As of 2020, nine synthetic biodegradable polymers used in medical devices are cleared or approved for use in the United States of America. Despite the limitations in the design, production, and marketing of these devices, this small number of biodegradable polymers has dominated the resorbable medical device market for the past 50 years. This perspective will review the history and applications of biodegradable polymers used in medical devices, highlight the need and requirements for regenerative biomaterials, and discuss the path behind the recent successful introduction of citrate-based biomaterials for manufacturing innovative medical products aimed at improving the outcome of musculoskeletal surgeries.

Engineering multifunctional bioactive citrate-based biomaterials for tissue engineering

Developing bioactive biomaterials with highly controlled functions is crucial to enhancing their applications in regenerative medicine. Citrate-based polymers are the few bioactive polymer biomaterials used in biomedicine because of their facile synthesis, controllable structure, biocompatibility, biomimetic viscoelastic mechanical behavior, and functional groups available for modification. In recent years, various multifunctional designs and biomedical applications, including cardiovascular, orthopedic, muscle tissue, skin tissue, nerve and spinal cord, bioimaging, and drug or gene delivery based on citrate-based polymers, have been extensively studied, and many of them have good clinical application potential. In this review, we summarize recent progress in the multifunctional design and biomedical applications of citrate-based polymers. We also discuss the further development of multifunctional citrate-based polymers with tailored properties to meet the requirements of various biomedical applications.

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Multifunctional bioactive citrate-based biomaterials have broad applications in regenerative medicine.

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Recent advances in multifunctional design and biomedical applications of citate-based polymers are summarized.

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Future challenge of citrate-based polymers in various biomedical applications are discussed.

Synthesis of Silica-Based Solid-Acid Catalyst Material as a Potential Osteochondral Repair Model In Vitro

For osteochondral damage, the pH value change of the damaged site will influence the repair efficacy of the patient. For better understanding the mechanism of the acid-base effect, the construction of in vitro model is undoubtedly a simple and interesting work to evaluate the influence. Here, a novel porous silica-based solid-acid catalyst material was prepared by additive manufacturing technology, exhibiting improved eliminating effects of the residue. SEM, FTIR, and TGA were used to characterize the morphology, structure, and thermal stability of the synthesized 3D material. The reaction between 4-methoxybenzyl alcohol and 3, 4-dihydro-2H-pyran was used as a template reaction to evaluate the eliminating performance of the 3D porous material. Solvents were optimized, and three reaction groups in the presence of 3D SiO2, 3D SiO2-SO3H, and 3D SiO2-NH-SO3H, as well as one without catalyst, were compared. In addition, in consideration of the complicated situation of the physiological environment in vivo, universality of the synthesized 3D SiO2-NH-SO3H catalyst material was studied with different alcohols. The results showed that the sulfonic acid-grafted 3D material had excellent catalytic performance, achieving a yield over 95% in only 20 min. Besides, the catalyst material can be recycled at least 10 times, with yields still higher than 90%. Such a solid catalyst material is expected to have great potential in additive manufacturing because the catalyst material is easy-recyclable, renewable and biocompatible. The 3D material with connective channels may also be utilized as an in vitro model for environment evaluation of osteochondral repair in the future.

Pure polylysine-based foamy scaffolds and their interaction with MC3T3-E1 cells and osteogenesis

Polypeptide-derived copolymers have widely been exploited for drug/gene delivery due to their pendant functional groups and non-toxic degradation products. However, fabrication of polypeptide-based scaffolds for tissue engineering has seldom been reported. In this study, foamy poly(N _ε -benzyl formateoxycarbonyl-L-Lysine) (PZL) and poly(N _ε -benzyl formateoxycarbonyl-L-lysine-co-L-phenylalanine) (PZLP) scaffolds were successfully prepared by a combination of ring-opening polymerization of α-amino acid N-carboxyanhydride and negative porous NaCl templating approach. The physicochemical properties of these scaffolds including glass transition temperature, contact angle, compression modulus and degradation behavior were characterized. Both in vitro and in vivo biocompatibility of the scaffolds were evaluated by MC3T3-E1 cell culture and SD subcutaneous model, respectively. The results from live-dead staining, MTT and ALP activity assays indicated that PZL scaffolds were more conducive to the adhesion, proliferation and osteoblastic differentiation of MC3T3-E1 cells compared to PZLP scaffolds in the initial culture period due to their specific surface properties. While porous structure rather than surface properties of scaffolds played a decisive role in the later stage of cell culture. The results of in vivo studies including H&E, Masson's trichrome and CD34 staining further demonstrated that PZL scaffolds supported the ingrowth of microvessels than PZLP scaffolds due to their surface property difference. Collectively, PZL scaffolds displayed good biocompatibility and could be a promising candidate for tissue engineering application.

Hybrid polymer biomaterials for bone tissue regeneration

Native tissues possess unparalleled physiochemical and biological functions, which can be attributed to their hybrid polymer composition and intrinsic bioactivity. However, there are also various concerns or limitations over the use of natural materials derived from animals or cadavers, including the potential immunogenicity, pathogen transmission, batch to batch consistence and mismatch in properties for various applications. Therefore, there is an increasing interest in developing degradable hybrid polymer biomaterials with controlled properties for highly efficient biomedical applications. There have been efforts to mimic the extracellular protein structure such as nanofibrous and composite scaffolds, to functionalize scaffold surface for improved cellular interaction, to incorporate controlled biomolecule release capacity to impart biological signaling, and to vary physical properties of scaffolds to regulate cellular behavior. In this review, we highlight the design and synthesis of degradable hybrid polymer biomaterials and focus on recent developments in osteoconductive, elastomeric, photoluminescent and electroactive hybrid polymers. The review further exemplifies their applications for bone tissue regeneration.

Elastomeric biocomposite of silver-containing mesoporous bioactive glass and poly(1,8-octanediol citrate): Physiochemistry and in vitro antibacterial capacity in tissue engineering applications

A novel series of silver-doped mesoporous bioactive glass/poly(1,8-octanediol citrate) (AgMBG/POC) elastomeric biocomposite scaffolds were successfully constructed by a salt-leaching technique for the first time and the effect of inclusion of different AgMBG contents (5, 10, and 20 wt%) on physicochemical and biological properties of pure POC elastomer was evaluated. Results indicated that AgMBG particles were uniformly dispersed in the POC matrix and increasing the AgMBG concentration into POC matrix up to 20 wt% enhanced thermal behaviour, mechanical properties and water uptake ability of the composite scaffolds compared to those from POC. The 20%AgMBG/POC additionally showed higher degradation rate in Tris(hydroxymethyl)-aminomethane-HCl (Tris-HCl) compared with pure POC and lost about 26% of its initial weight after soaking for 28 days. The AgMBG phase incorporation also significantly endowed the resulting composite scaffolds with efficient antibacterial properties against Escherichia coli and Staphylococcus aureus bacteria while preserving their favorable biocompatibility with soft tissue cells (i.e., human dermal fibroblast cells). Taken together, our results suggest that the synergistic effect of both AgMBG and POC make these newly designed AgMBG/POC composite scaffold an attractive candidate for soft tissue engineering applications.

Biodegradable Multifunctional Bioactive Glass-Based Nanocomposite Elastomers with Controlled Biomineralization Activity, Real-Time Bioimaging Tracking, and Decreased Inflammatory Response

Controlled biomineralization activity of biomaterials is rather important in bone regeneration and osseointegration avoiding the formation of fibrous capsule. However, most of conventional biodegradable elastomeric biomaterials for bone regeneration do not possess biomineralization ability and inherent multifunctional properties. Herein, we report a multifunctional bioactive glass (BG)-based hybrid poly(citrate-siloxane) (PCS) elastomer with intrinsical biomineralization activity and photoluminescent properties for potential bone tissue regeneration. Monodispersed BG nanoparticles (BGNs) were used to control the elastomeric behavior, biomineralization activity, photoluminescent ability, and osteogenic cellular response of PCS elastomers. BGNs significantly enhanced the elastomeric modulus of PCS from 20 to 200 MPa (10 times improvement) and the hydrophilicity (from 82° to 28° in water contact angle). The photoluminescent properties of PCS elastomers were also tailored through the incorporation of BGNs. The in vivo degradation of PCS-BGN nanocomposites could be efficiently tracked through noninvasively monitoring their fluorescent change. PCS-BGN nanocomposites enhanced the proliferation and osteoblastic differentiation of osteoblasts (MC3T3-E1) and decreased the in vivo inflammatory response. This study provided a novel tactics for designing the bioactive elastomeric biomaterials with multifunctional properties for bone regeneration medicine.

Synthesis and characterization of a novel antibacterial material containing poly(sulfobetaine) using reverse atom transfer radical polymerization

A novel antibacterial agent was synthesized using 2-(dimethylamino)ethyl methacrylate (DM) and sodium 3-chloro-2-hydroxypropane sulfonate (CHPS). It was characterized by Fourier transform infrared spectroscopy (FTIR), NMR Spectroscopy (¹H NMR), and X-ray photoelectron spectroscopy (XPS). This new agent DMCHPS was then grafted onto a polyurethane (PU) substrate via surface-initiated reverse atom transfer radical polymerization (SI-RATRP). The modified PU was characterized by FTIR and XPS. The hydrophilic properties of the PU surface before and after the incorporation of DMCHPS were determined by static contact angle (SCA) measurements. The results showed that the hydrophilicity of the PU surface after the modification was remarkably improved. MIC tests and bacterial adhesion confirmed that modified PU has good antibacterial properties. Protein adsorption experiments show that the material has a certain ability to resist pollution. Furthermore, the high survival rate of HEK293 human embryonic kidney cells shows that the modified PU has a potential use as a medicinal material.

A novel antibacterial agent was synthesized using 2-(dimethylamino)ethyl methacrylate (DM) and sodium 3-chloro-2-hydroxypropane sulfonate (CHPS).

Development of strong, biodegradable and highly elastomeric polycitrate-gelatin hybrid polymer with enhanced cellular biocompatibility

Native human tissues possess incomparable biological performance due to their strong and viscoelastic mechanical properties, and biocompatible compositions. Herein, by a thermal polymerization and solvent hybridization method, we develop biomimetic polycitrate-gelatin hybrid polymers (PC-GT) with strong mechanical properties and tailored elastomeric behavior for tissue regeneration applications. The incorporation of gelatin significantly enhanced the mechanical properties and cellular biocompatibility of PC. PC-GT hybrids demonstrated the 135 times (from 7.5 to 1015MPa) and 11 times (from 4 to 46MPa) improvement for the elastomeric modulus and tensile strength respectively as compared with PC elastomers, while showing controlled stretchable and elastomeric behavior. In addition, PC-GT hybrids significantly improved the fibroblasts (L929) attachment and proliferation, suggesting their high biocompatibility. This study may provide a novel strategy to design biocompatible hybrid polymers with strong and elastomeric behavior for tissue regeneration and stretchable electronic devices applications.

Development of Biodegradable Poly(citrate)-Polyhedral Oligomeric Silsesquioxanes Hybrid Elastomers with High Mechanical Properties and Osteogenic Differentiation Activity

Biodegradable elastomeric biomaterials have attracted much attention in tissue engineering due to their biomimetic viscoelastic behavior and biocompatibility. However, the low mechanical stability at hydrated state, fast biodegradation in vivo, and poor osteogenic activity greatly limited bioelastomers applications in bone tissue regeneration. Herein, we develop a series of poly(octanediol citrate)-polyhedral oligomeric silsesquioxanes (POC-POSS) hybrids with highly tunable elastomeric behavior (hydrated state) and biodegradation and osteoblasts biocompatibility through a facile one-pot thermal polymerization strategy. POC-POSS hybrids show significantly improved stiffness and ductility in either dry or hydrated conditions, as well as good antibiodegradation ability (20-50% weight loss in 3 months). POC-POSS hybrids exhibit significantly enhanced osteogenic differentiation through upregulating alkaline phosphatase (ALP) activity, calcium deposition, and expression of osteogenic markers (ALPL, BGLAP, and Runx2). The high mechanical stability at hydrated state and enhanced osteogenic activity make POC-POSS hybrid elastomers promising as scaffolds and nanoscale vehicles for bone tissue regeneration and drug delivery. This study may also provide a new strategy (controlling the stiffness under hydrated condition) to design advanced hybrid biomaterials with high mechanical properties under physiological condition for tissue regeneration applications.