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Yuan Y, Zou M, Wu S, Liu C, Hao L. Recent advances in nanomaterials for the treatment of femoral head necrosis. Hum Cell 2024; 37:1290-1305. [PMID: 38995503 DOI: 10.1007/s13577-024-01102-w] [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: 02/12/2024] [Accepted: 07/05/2024] [Indexed: 07/13/2024]
Abstract
Osteonecrosis of the femoral head (ONFH) is a condition that causes considerable pain and discomfort for patients, and its pathogenic mechanisms are not yet fully understood. While there have been many studies that suggest multiple factors may contribute to its development, current treatments involve both surgical and nonsurgical options. However, there is still much room for improvement in these treatment methods, particularly when it comes to preventing postoperative complications and optimizing surgical procedures. Nanomaterials, as a type of small molecule material, have shown great promise in treating bone tissue diseases, including ONFH. In fact, several nanocomposite materials have demonstrated specific effects in preventing ONFH, promoting bone tissue repair and growth, and optimizing surgical treatment. This article provides a comprehensive overview of current treatments for ONFH, including their advantages and limitations, and reviews the latest advances in nanomaterials for treating this condition. Additionally, this article explores the therapeutic mechanisms involved in using nanomaterials to treat ONFH and to identify new methods and ideas for improving outcomes for patients.
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Affiliation(s)
- Yalin Yuan
- Department of Orthopedics, Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- The Second Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Mi Zou
- Department of Orthopedics, Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- The Second Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Shuqin Wu
- Department of Orthopedics, Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- The Second Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Congcong Liu
- Department of Orthopedics, Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- The Second Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Liang Hao
- Department of Orthopedics, Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
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Fendi F, Abdullah B, Suryani S, Usman AN, Tahir D. Development and application of hydroxyapatite-based scaffolds for bone tissue regeneration: A systematic literature review. Bone 2024; 183:117075. [PMID: 38508371 DOI: 10.1016/j.bone.2024.117075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024]
Abstract
Hydroxyapatite [HA, Ca10(PO4)6(OH)2], with its robust biocompatibility and bioactivity, has found extensive utility in bone grafting, replacement therapies, and supplemental medical materials. HA is highly regarded for its osteoconductive properties because it boasts hydrophilicity, nontoxicity, non-allergenicity, and non-mutagenicity. Nevertheless, HA's intrinsic mechanical weakness has spurred efforts to enhance its properties. This enhancement is achieved through ion incorporation, with elements such as magnesium, zinc, lithium, strontium, boron, and others being integrated into the HA structure. In the domain of orthopedics, HA-based scaffolds have emerged as a solution for addressing prevalent issues like bone deformities and defects stemming from congenital anomalies, injuries, trauma, infections, or tumors. The fabrication of three-dimensional scaffolds (3D scaffolds) has enabled advancements in bone regeneration and replacement, with a focus on practical applications such as repairing calvarial, skull, and femoral defects. In vitro and in vivo assessments have substantiated the effectiveness of 3D scaffolds for bone defect repair, regeneration, and tissue engineering. Beyond bone-related applications, scaffolds demonstrate versatility in enhancing cartilage healing and serving as bioimplants. The wide array of scaffold applications underscores their ongoing potential for further development in the realm of medical science.
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Affiliation(s)
- Fendi Fendi
- Department of Physics, Hasanuddin University, Makassar 90245, Indonesia
| | - Bualkar Abdullah
- Department of Physics, Hasanuddin University, Makassar 90245, Indonesia
| | - Sri Suryani
- Department of Physics, Hasanuddin University, Makassar 90245, Indonesia
| | | | - Dahlang Tahir
- Department of Physics, Hasanuddin University, Makassar 90245, Indonesia.
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Wang Q, Yang Z, Li Q, Zhang W, Kang P. Lithium prevents glucocorticoid-induced osteonecrosis of the femoral head by regulating autophagy. J Cell Mol Med 2024; 28:e18385. [PMID: 38801405 PMCID: PMC11129728 DOI: 10.1111/jcmm.18385] [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: 10/19/2023] [Revised: 04/17/2024] [Accepted: 04/27/2024] [Indexed: 05/29/2024] Open
Abstract
Autophagy may play an important role in the occurrence and development of glucocorticoid-induced osteonecrosis of the femoral head (GC-ONFH). Lithium is a classical autophagy regulator, and lithium can also activate osteogenic pathways, making it a highly promising therapeutic agent for GC-ONFH. We aimed to evaluate the potential therapeutic effect of lithium on GC-ONFH. For in vitro experiments, primary osteoblasts of rats were used for investigating the underlying mechanism of lithium's protective effect on GC-induced autophagy levels and osteogenic activity dysfunction. For in vivo experiments, a rat model of GC-ONFH was used for evaluating the therapeutic effect of oral lithium on GC-ONFH and underlying mechanism. Findings demonstrated that GC over-activated the autophagy of osteoblasts and reduced their osteogenic activity. Lithium reduced the over-activated autophagy of GC-treated osteoblasts through PI3K/AKT/mTOR signalling pathway and increased their osteogenic activity. Oral lithium reduced the osteonecrosis rates in a rat model of GC-ONFH, and restrained the increased expression of autophagy related proteins in bone tissues through PI3K/AKT/mTOR signalling pathway. In conclusion, lithium can restrain over-activated autophagy by activating PI3K/AKT/mTOR signalling pathway and up-regulate the expression of genes for bone formation both in GC induced osteoblasts and in a rat model of GC-ONFH. Lithium may be a promising therapeutic agent for GC-ONFH. However, the role of autophagy in the pathogenesis of GC-ONFH remains controversial. Studies are still needed to further explore the role of autophagy in the pathogenesis of GC-ONFH, and the efficacy of lithium in the treatment of GC-ONFH and its underlying mechanisms.
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Affiliation(s)
- Qiuru Wang
- Department of Orthopedic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Zhouyuan Yang
- Department of Orthopedic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Qianhao Li
- Department of Orthopedic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Wanli Zhang
- Public Laboratory Technology Center, West China HospitalSichuan UniversityChengduChina
| | - Pengde Kang
- Department of Orthopedic Surgery, West China HospitalSichuan UniversityChengduChina
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Tsubosaka M, Maruyama M, Lui E, Kushioka J, Toya M, Gao Q, Shen H, Li X, Chow SKH, Zhang N, Yang YP, Goodman SB. Preclinical models for studying corticosteroid-induced osteonecrosis of the femoral head. J Biomed Mater Res B Appl Biomater 2024; 112:e35360. [PMID: 38247252 DOI: 10.1002/jbm.b.35360] [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: 02/23/2023] [Revised: 11/02/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024]
Abstract
Nontraumatic osteonecrosis of the femoral head (ONFH) is a refractory condition that commonly results in femoral head collapse and degenerative arthritis of the hip. In the early stages, surgical procedures for hip preservation, including core decompression (CD), have been developed to prevent progressive collapse of the femoral head. Optimization of bone regeneration and biological augmentation may further enhance the therapeutic efficacy of CD for ONFH. Thus, combining CD with cell-based therapy has recently been proposed. In fact, patients treated with cell-based therapy using autologous bone marrow concentrate demonstrate improved survivorship of the femoral head, compared with conventional CD alone. Preclinical research studies to investigate adjunctive therapies for CD often utilize the rabbit model of corticosteroid-induced ONFH. Mesenchymal stem cells (MSCs) are known to promote osteogenesis and angiogenesis, and decrease inflammation in bone. Local drug delivery systems have the potential to achieve targeted therapeutic effects by precisely controlling the drug release rate. Scaffolds can provide an osteoconductive structural framework to facilitate the repair of osteonecrotic bone tissue. We focused on the combination of both cell-based and scaffold-based therapies for bone tissue regeneration in ONFH. We hypothesized that combining CD and osteoconductive scaffolds would provide mechanical strength and structural cell guidance; and that combining CD and genetically modified (GM) MSCs to express relevant cytokines, chemokines, and growth factors would promote bone tissue repair. We developed GM MSCs that overexpress the anti-inflammatory, pro-reconstructive cytokines platelet-derived growth factor-BB to provide MSCs with additional benefits and investigated the efficacy of combinations of these GM MSCs and scaffolds for treatment of ONFH in skeletally mature male New Zealand white rabbits. In the future, the long-term safety, efficacy, durability, and cost-effectiveness of these and other biological and mechanical treatments must be demonstrated for the patients affected by ONFH.
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Affiliation(s)
- Masanori Tsubosaka
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Masahiro Maruyama
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Elaine Lui
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
- Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA
| | - Junichi Kushioka
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Masakazu Toya
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Qi Gao
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Huaishuang Shen
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Xueping Li
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Simon Kwoon-Ho Chow
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Ning Zhang
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Yunzhi Peter Yang
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
- Department of Material Science and Engineering, Stanford University School of Medicine, Stanford, California, USA
- Department of Bioengineering, Stanford University School of Medicine, Stanford, California, USA
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
- Department of Bioengineering, Stanford University School of Medicine, Stanford, California, USA
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Cai T, Chen S, Wu C, Lou C, Wang W, Lin C, Jiang H, Xu X. Erythropoietin suppresses osteoblast apoptosis and ameliorates steroid-induced necrosis of the femoral head in rats by inhibition of STAT1-caspase 3 signaling pathway. BMC Musculoskelet Disord 2023; 24:894. [PMID: 37978375 PMCID: PMC10655348 DOI: 10.1186/s12891-023-07028-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Steroid-induced avascular necrosis of the femoral head (SANFH) is characterized by osteoblast apoptosis, leading to a loss of bone structure and impaired hip joint function. It has been demonstrated that erythropoietin (EPO) performs a number of biological roles. OBJECTIVE We examined the effects of EPO on SANFH and its regulation of the STAT1-caspase 3 signaling pathway. METHOD In vitro, osteoblasts were treated with dexamethasone (Dex) or EPO. We identified the cytotoxicity of EPO by CCK-8, the protein expression of P-STAT1, cleaved-caspase9, cleaved-caspase3, Bcl-2, BAX, and cytochrome c by Western blotting, and evaluated the apoptosis of osteoblasts by flow cytometry. In vivo, we analyzed the protective effect of EPO against SANFH by hematoxylin and eosin (H&E), Immunohistochemical staining, and Micro-computed tomography (CT). RESULTS In vitro, EPO had no apparent toxic effect on osteoblasts. In Dex-stimulated cells, EPO therapy lowered the protein expression of BAX, cytochrome c, p-STAT1, cleaved-caspase9, and cleaved-caspase3 while increasing the expression of Bcl-2. EPO can alleviate the apoptosis induced by Dex. In vivo, EPO can lower the percentage of empty bone lacunae in SANFH rats. CONCLUSION The present study shows that EPO conferred beneficial effects in rats with SANFH by inhibiting STAT1-caspase 3 signaling, suggesting that EPO may be developed as a treatment for SANFH.
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Affiliation(s)
- Tingwen Cai
- Department of Orthopedics, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, Zhejiang Province, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Siyuan Chen
- Department of Orthopedics, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, Zhejiang Province, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Chenghu Wu
- School of Biomedical Engineering, School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Chao Lou
- Department of Orthopedics, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, Zhejiang Province, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Weidan Wang
- Department of Orthopedics, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, Zhejiang Province, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Chihao Lin
- Department of Orthopedics, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, Zhejiang Province, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Hongyi Jiang
- Department of Orthopedics, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, Zhejiang Province, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xinxian Xu
- Department of Orthopedics, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
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Hjazi A, Sukmana BI, Ali SS, Alsaab HO, Gupta J, Ullah MI, Romero-Parra RM, Alawadi AHR, Alazbjee AAA, Mustafa YF. Functional role of circRNAs in osteogenesis: A review. Int Immunopharmacol 2023; 121:110455. [PMID: 37290324 DOI: 10.1016/j.intimp.2023.110455] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/20/2023] [Accepted: 06/02/2023] [Indexed: 06/10/2023]
Abstract
The extracellular matrixes (ECM), as well as the microenvironmental signals, play an essential role in osteogenesis by regulating intercellular pathways. Recently, it has been demonstrated that a newly identified RNA, circular RNA, contributes to the osteogenesis process. Circular RNA (circRNA), the most recently identified RNA, is involved in the regulation of gene expression at transcription to translation levels. The dysregulation of circRNAs has been observed in several tumors and diseases. Also, various studies have shown that circRNAs expression is changed during osteogenic differentiation of progenitor cells. Therefore, understanding the role of circRNAs in osteogenesis might help the diagnosis as well as treatment of bone diseases such as bone defects and osteoporosis. In this review, circRNA functions and the related pathways in osteogenesis have been discussed.
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Affiliation(s)
- Ahmed Hjazi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Bayu Indra Sukmana
- Department of Oral Biology, Faculty of Dentistry, Lambung Mangkurat University, Banjarmasin, Indonesia
| | - Sally Saad Ali
- College of Dentistry, Al-Bayan University, Baghdad, Iraq
| | - Hashem O Alsaab
- Pharmaceutics and Pharmaceutical Technology, Taif University, Taif, Saudi Arabia
| | - Jitendra Gupta
- Institute of Pharmaceutical Research, GLA University, Mathura, Pin Code 281406 U.P., India
| | - Muhammad Ikram Ullah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 75471, Aljouf, Saudi Arabia
| | | | - Ahmed H R Alawadi
- Medical Analysis Department, College of Medical Technology, The Islamic University, Najaf, Iraq
| | | | - Yasser Fakri Mustafa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul-41001, Iraq
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Quan H, Ren C, He Y, Wang F, Dong S, Jiang H. Application of Biomaterials in Treating Early Osteonecrosis of the Femoral Head: Research Progress and Future Perspectives. Acta Biomater 2023; 164:15-73. [PMID: 37080444 DOI: 10.1016/j.actbio.2023.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/24/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
Osteonecrosis of the femoral head (ONFH), a progressive pathological process of femoral head ischemia and osteocyte necrosis, is a refractory orthopedic disease caused by multiple etiologies and there is no complete cure at present. With the extension of ONFH duration, osteocyte apoptosis and trabecular bone loss can decrease the load-bearing capacity of the femoral head, which leads to the collapse of the articular cartilage and subchondral bone. Therefore, an urgent clinical need exists to develop effective treatment strategies of early-stage ONFH for maintaining the hip joint function and preventing femoral head collapse. In recent years, extensive attention has been paid to the application of diverse biomaterials in treating early ONFH for sustaining the normal morphology and function of the autologous femoral head, and slowing disease progression. Herein, we review the research progress of bone grafts, metallic materials, bioceramics, bioglasses and polymer materials for early ONFH treatment, and discuss the biological mechanisms of bone repair and regeneration in the femoral-head necrotic area. We propose suggestions for future research directions, from a special perspective of improving the local microenvironment in femoral head by facilitating vessel-associated osteoclasts (VAOs) generation and coupling of bone-specific angiogenesis and osteogenesis, as well as inhibiting bone-associated osteoclasts (BAOs) and BAO-mediated bone resorption. This review can provide ideas for the research, development, and clinical application of biomaterials for treating early ONFH. STATEMENT OF SIGNIFICANCE: We believe that at least three aspects of this manuscript make it interesting to readers of the Acta Biomaterialia. First, we briefly summarize the incidence, pathogenesis, risk factors, classification criteria and treatment of early osteonecrosis of the femoral head (ONFH). Second, we review the research progress in biomaterials for early ONFH treatment and the biological mechanisms of bone repair and regeneration in femoral-head necrotic area. Third, we propose future research progress on improving the local microenvironment in femoral head by facilitating vessel-associated osteoclasts generation and coupling of bone-specific angiogenesis and osteogenesis, as well as inhibiting bone-associated osteoclasts and bone resorption. We hope this review can provide ideas for the research, development, and clinical application of biomaterials for treating early ONFH.
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Affiliation(s)
- Hongyu Quan
- Department of Biomedical Materials Science, School of Biomedical Engineering, Third Military Medical University, Chongqing, 400038, China; College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Chencan Ren
- Department of Biomedical Materials Science, School of Biomedical Engineering, Third Military Medical University, Chongqing, 400038, China; College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Yuwei He
- Department of Biomedical Materials Science, School of Biomedical Engineering, Third Military Medical University, Chongqing, 400038, China
| | - Fuyou Wang
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.
| | - Shiwu Dong
- Department of Biomedical Materials Science, School of Biomedical Engineering, Third Military Medical University, Chongqing, 400038, China; State Key Laboratory of Trauma, Burns and Combined Injury, Third Military Medical University, Chongqing 400038, China.
| | - Hong Jiang
- Department of Biomedical Materials Science, School of Biomedical Engineering, Third Military Medical University, Chongqing, 400038, China.
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Bian Y, Hu T, Lv Z, Xu Y, Wang Y, Wang H, Zhu W, Feng B, Liang R, Tan C, Weng X. Bone tissue engineering for treating osteonecrosis of the femoral head. EXPLORATION (BEIJING, CHINA) 2023; 3:20210105. [PMID: 37324030 PMCID: PMC10190954 DOI: 10.1002/exp.20210105] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/12/2022] [Indexed: 06/16/2023]
Abstract
Osteonecrosis of the femoral head (ONFH) is a devastating and complicated disease with an unclear etiology. Femoral head-preserving surgeries have been devoted to delaying and hindering the collapse of the femoral head since their introduction in the last century. However, the isolated femoral head-preserving surgeries cannot prevent the natural progression of ONFH, and the combination of autogenous or allogeneic bone grafting often leads to many undesired complications. To tackle this dilemma, bone tissue engineering has been widely developed to compensate for the deficiencies of these surgeries. During the last decades, great progress has been made in ingenious bone tissue engineering for ONFH treatment. Herein, we comprehensively summarize the state-of-the-art progress made in bone tissue engineering for ONFH treatment. The definition, classification, etiology, diagnosis, and current treatments of ONFH are first described. Then, the recent progress in the development of various bone-repairing biomaterials, including bioceramics, natural polymers, synthetic polymers, and metals, for treating ONFH is presented. Thereafter, regenerative therapies for ONFH treatment are also discussed. Finally, we give some personal insights on the current challenges of these therapeutic strategies in the clinic and the future development of bone tissue engineering for ONFH treatment.
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Affiliation(s)
- Yixin Bian
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Tingting Hu
- State Key Laboratory of Chemical Resource EngineeringBeijing Advanced Innovation Center for Soft Matter Science and EngineeringBeijing University of Chemical TechnologyBeijingChina
| | - Zehui Lv
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Yiming Xu
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Yingjie Wang
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Han Wang
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Wei Zhu
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Bin Feng
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Ruizheng Liang
- State Key Laboratory of Chemical Resource EngineeringBeijing Advanced Innovation Center for Soft Matter Science and EngineeringBeijing University of Chemical TechnologyBeijingChina
| | - Chaoliang Tan
- Department of ChemistryCity University of Hong KongKowloonHong Kong SARChina
| | - Xisheng Weng
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
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9
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Zheng K, Bai J, Yang H, Xu Y, Pan G, Wang H, Geng D. Nanomaterial-assisted theranosis of bone diseases. Bioact Mater 2022; 24:263-312. [PMID: 36632509 PMCID: PMC9813540 DOI: 10.1016/j.bioactmat.2022.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 12/27/2022] Open
Abstract
Bone-related diseases refer to a group of skeletal disorders that are characterized by bone and cartilage destruction. Conventional approaches can regulate bone homeostasis to a certain extent. However, these therapies are still associated with some undesirable problems. Fortunately, recent advances in nanomaterials have provided unprecedented opportunities for diagnosis and therapy of bone-related diseases. This review provides a comprehensive and up-to-date overview of current advanced theranostic nanomaterials in bone-related diseases. First, the potential utility of nanomaterials for biological imaging and biomarker detection is illustrated. Second, nanomaterials serve as therapeutic delivery platforms with special functions for bone homeostasis regulation and cellular modulation are highlighted. Finally, perspectives in this field are offered, including current key bottlenecks and future directions, which may be helpful for exploiting nanomaterials with novel properties and unique functions. This review will provide scientific guidance to enhance the development of advanced nanomaterials for the diagnosis and therapy of bone-related diseases.
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Affiliation(s)
- Kai Zheng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215006, Jiangsu, China
| | - Jiaxiang Bai
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215006, Jiangsu, China,Corresponding author.Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
| | - Huilin Yang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215006, Jiangsu, China
| | - Yaozeng Xu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215006, Jiangsu, China
| | - Guoqing Pan
- Institute for Advanced Materials, School of Materials Science and Engineering, Jiangsu University, Zhenjiang, 212013, Jiangsu, China
| | - Huaiyu Wang
- Center for Human Tissues and Organs Degeneration, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China,Corresponding author.
| | - Dechun Geng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215006, Jiangsu, China,Corresponding author. Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
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10
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Chai H, Wang W, Yuan X, Zhu C. Bio-Activated PEEK: Promising Platforms for Improving Osteogenesis through Modulating Macrophage Polarization. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9120747. [PMID: 36550953 PMCID: PMC9774947 DOI: 10.3390/bioengineering9120747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 10/30/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
The attention on orthopedic biomaterials has shifted from their direct osteogenic properties to their osteoimmunomodulation, especially the modulation of macrophage polarization. Presently, advanced technologies endow polyetheretherketone (PEEK) with good osteoimmunomodulation by modifying PEEK surface characteristics or incorporating bioactive substances with regulating macrophage polarization. Recent studies have demonstrated that the fabrication of a hydrophilic surface and the incorporation of bioactive substances into PEEK (e.g., zinc, calcium, and phosphate) are good strategies to promote osteogenesis by enhancing the polarization of M2 macrophages. Furthermore, the modification by other osteoimmunomodulatory composites (e.g., lncRNA-MM2P, IL-4, IL-10, and chitosan) and their controlled and desired release may make PEEK an optimal bio-activated implant for regulating and balancing the osteogenic system and immune system. The purpose of this review is to comprehensively evaluate the potential of bio-activated PEEK in polarizing macrophages into M2 phenotype to improve osteogenesis. For this objective, we retrieved and discussed different kinds of bio-activated PEEK regarding improving osteogenesis through modulating macrophage polarization. Meanwhile, the relevant challenges and outlook were presented. We hope that this review can shed light on the development of bio-activated PEEK with more favorable osteoimmunomodulation.
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Affiliation(s)
- Haobu Chai
- Department of Orthopaedics, The First Affiliated Hospital of University of Science and Technology of China, University of Science and Technology of China, Hefei 230001, China
| | - Wenzhi Wang
- Department of Orthopaedics, The First Affiliated Hospital of University of Science and Technology of China, University of Science and Technology of China, Hefei 230001, China
| | - Xiangwei Yuan
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
- Correspondence: (X.Y.); (C.Z.)
| | - Chen Zhu
- Department of Orthopaedics, The First Affiliated Hospital of University of Science and Technology of China, University of Science and Technology of China, Hefei 230001, China
- Correspondence: (X.Y.); (C.Z.)
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11
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Application of Hydrogels as Sustained-Release Drug Carriers in Bone Defect Repair. Polymers (Basel) 2022; 14:polym14224906. [PMID: 36433033 PMCID: PMC9695274 DOI: 10.3390/polym14224906] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Large bone defects resulting from trauma, infection and tumors are usually difficult for the body's repair mechanisms to heal spontaneously. Generally, various types of bones and orthopedic implants are adopted to enhance bone repair and regeneration in the clinic. Due to the limitations of traditional treatments, bone defect repair is still a compelling challenge for orthopedic surgeons. In recent years, bone tissue engineering has become a potential option for bone repair and regeneration. Amidst the various scaffolds for bone tissue engineering applications, hydrogels are considered a new type of non-toxic, non-irritating and biocompatible materials, which are widely used in the biomedicine field currently. Some studies have demonstrated that hydrogels can provide a three-dimensional network structure similar to a natural extracellular matrix for tissue regeneration and can be used to transport cells, biofactors, nutrients and drugs. Therefore, hydrogels may have the potential to be multifunctional sustained-release drug carriers in the treatment of bone defects. The recent applications of different types of hydrogels in bone defect repair were briefly reviewed in this paper.
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Farmani AR, Salmeh MA, Golkar Z, Moeinzadeh A, Ghiasi FF, Amirabad SZ, Shoormeij MH, Mahdavinezhad F, Momeni S, Moradbeygi F, Ai J, Hardy JG, Mostafaei A. Li-Doped Bioactive Ceramics: Promising Biomaterials for Tissue Engineering and Regenerative Medicine. J Funct Biomater 2022; 13:162. [PMID: 36278631 PMCID: PMC9589997 DOI: 10.3390/jfb13040162] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Lithium (Li) is a metal with critical therapeutic properties ranging from the treatment of bipolar depression to antibacterial, anticancer, antiviral and pro-regenerative effects. This element can be incorporated into the structure of various biomaterials through the inclusion of Li chloride/carbonate into polymeric matrices or being doped in bioceramics. The biocompatibility and multifunctionality of Li-doped bioceramics present many opportunities for biomedical researchers and clinicians. Li-doped bioceramics (capable of immunomodulation) have been used extensively for bone and tooth regeneration, and they have great potential for cartilage/nerve regeneration, osteochondral repair, and wound healing. The synergistic effect of Li in combination with other anticancer drugs as well as the anticancer properties of Li underline the rationale that bioceramics doped with Li may be impactful in cancer treatments. The role of Li in autophagy may explain its impact in regenerative, antiviral, and anticancer research. The combination of Li-doped bioceramics with polymers can provide new biomaterials with suitable flexibility, especially as bio-ink used in 3D printing for clinical applications of tissue engineering. Such Li-doped biomaterials have significant clinical potential in the foreseeable future.
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Affiliation(s)
- Ahmad Reza Farmani
- Tissue Engineering and Applied Cell Sciences Department, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran 14166-34793, Iran
- Tissue Engineering Department, School of Advanced Technologies in Medicine, Fasa University of Medical Sciences, Fasa 74615-168, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran 14166-34793, Iran
| | - Mohammad Ali Salmeh
- Department of Biotechnology, School of Chemical Engineering, College of Engineering, University of Tehran, Tehran 14155-6619, Iran
| | - Zahra Golkar
- Department of Midwifery, Firoozabad Branch, Islamic Azad University, Firoozabad 74715-117, Iran
| | - Alaa Moeinzadeh
- Department of Tissue Engineering and Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran 14496-14535, Iran
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran 14496-14535, Iran
| | - Farzaneh Farid Ghiasi
- Department of Tissue Engineering and Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran 14496-14535, Iran
| | - Sara Zamani Amirabad
- Department of Chemical Engineering, Faculty of Engineering, Yasouj University, Yasouj 75918-74934, Iran
| | - Mohammad Hasan Shoormeij
- Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran 14166-34793, Iran
| | - Forough Mahdavinezhad
- Anatomy Department, School of Medicine, Tehran University of Medical Sciences, Tehran 14166-34793, Iran
- Department of Infertility, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin 34199-15315, Iran
| | - Simin Momeni
- Chemistry Department, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz 83151-61355, Iran
| | - Fatemeh Moradbeygi
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Jafar Ai
- Tissue Engineering and Applied Cell Sciences Department, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran 14166-34793, Iran
| | - John G. Hardy
- Department of Chemistry, Faraday Building, Lancaster University, Lancaster LA1 4YB, UK
- Materials Science Institute, Lancaster University, Lancaster LA1 4YW, UK
| | - Amir Mostafaei
- Department of Mechanical, Materials, and Aerospace Engineering, Illinois Institute of Technology, 10 W 32nd Street, Chicago, IL 60616, USA
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Bioinformatic Data Mining for Candidate Drugs Affecting Risk of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) in Cancer Patients. DISEASE MARKERS 2022; 2022:3348480. [PMID: 36157219 PMCID: PMC9492334 DOI: 10.1155/2022/3348480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022]
Abstract
Background. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) leads to significant morbidity. Other coadministered drugs may modulate the risk for BRONJ. The present study aimed to leverage bioinformatic data mining to identify drugs that potentially modulate the risk of BRONJ in cancer. Methods. A GEO gene expression dataset of peripheral blood mononuclear cells related to BRONJ in multiple myeloma patients was downloaded, and differentially expressed genes (DEGs) in patients with BRONJ versus those without BRONJ were identified. A protein-protein interaction network of the DEGs was constructed using experimentally validated interactions in the STRING database. Overrepresented Gene Ontology (GO) molecular function terms and KEGG pathways in the network were analysed. Network topology was determined, and ‘hub genes’ with degree ≥2 in the network were identified. Known drug targets of the hub genes were mined from the ‘drug gene interaction database’ (DGIdb) and labelled as candidate drugs affecting the risk of BRONJ. Results. 751 annotated DEGs (
,
) were obtained from the microarray gene expression dataset GSE7116. A PPI network with 633 nodes and 168 edges was constructed. Data mining for drugs interacting with 49 gene nodes was performed. 37 drug interactions were found for 9 of the hub genes including TBP, TAF1, PPP2CA, PRPF31, CASP8, UQCRB, ACTR2, CFLAR, and FAS. Interactions were found for several established and novel anticancer chemotherapeutic, kinase inhibitor, caspase inhibitor, antiangiogenic, and immunomodulatory agents. Aspirin, metformin, atrovastatin, thrombin, androgen and antiandrogen drugs, progesterone, Vitamin D, and Ginsengoside 20(S)-Protopanaxadiol were also documented. Conclusions. A bioinformatic data mining strategy identified several anticancer, immunomodulator, and other candidate drugs that may affect the risk of BRONJ in cancer patients.
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Luo X, Xiao D, Zhang C, Wang G. The Roles of Exosomes upon Metallic Ions Stimulation in Bone Regeneration. J Funct Biomater 2022; 13:jfb13030126. [PMID: 36135561 PMCID: PMC9506099 DOI: 10.3390/jfb13030126] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Metallic ions have been widely investigated and incorporated into bone substitutes for bone regeneration owing to their superior capacity to induce angiogenesis and osteogenesis. Exosomes are key paracrine mediators that play a crucial role in cell-to-cell communication. However, the role of exosomes in metallic ion-induced bone formation and their underlying mechanisms remain unclear. Thus, this review systematically analyzes the effects of metallic ions and metallic ion-incorporated biomaterials on exosome secretion from mesenchymal stem cells (MSCs) and macrophages, as well as the effects of secreted exosomes on inflammation, angiogenesis, and osteogenesis. In addition, possible signaling pathways involved in metallic ion-mediated exosomes, followed by bone regeneration, are discussed. Despite limited investigation, metallic ions have been confirmed to regulate exosome production and function, affecting immune response, angiogenesis, and osteogenesis. Although the underlying mechanism is not yet clear, these insights enrich our understanding of the mechanisms of the metallic ion-induced microenvironment for bone regeneration, benefiting the design of metallic ion-incorporated implants.
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Affiliation(s)
- Xuwei Luo
- Orthopedic Research Institute, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China
- Research Institute of Tissue Engineering and Stem Cells, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong 637000, China
| | - Dongqin Xiao
- Research Institute of Tissue Engineering and Stem Cells, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong 637000, China
- Correspondence: (D.X.); (G.W.)
| | - Chengdong Zhang
- Research Institute of Tissue Engineering and Stem Cells, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong 637000, China
| | - Guanglin Wang
- Orthopedic Research Institute, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence: (D.X.); (G.W.)
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15
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Zheng LW, Lan CN, Kong Y, Liu LH, Fan YM, Zhang CJ. Exosomal miR-150 derived from BMSCs inhibits TNF-α-mediated osteoblast apoptosis in osteonecrosis of the femoral head by GREM1/NF-κB signaling. Regen Med 2022; 17:739-753. [PMID: 35938412 DOI: 10.2217/rme-2021-0169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Aim: The purpose of this study was to investigate the functions of exosomal miR-150 derived from bone marrow mesenchymal stem cells in osteonecrosis of the femoral head (ONFH). Materials & methods: Cell viability and apoptosis were detected using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and flow cytometry. Alizarin red staining was performed to detect calcium deposits. A rat model was established to assess the effects of exosomal miR-150 on ONFH in vivo. Results: Exosomes or exosomal miR-150 derived from bone marrow mesenchymal stem cells inhibited TNF-α-induced osteoblast apoptosis and promoted osteogenic differentiation and autophagy. Exosomal miR-150 suppressed apoptosis and induced autophagy in TNF-α-treated osteoblasts by regulating the GREM1/NF-κB axis. Exosomal miR-150 also improved the pathological features of ONFH in vivo. Conclusion: Exosomal miR-150 alleviates ONFH by mediating the GREM1/NF-κB axis. This study provides a potential therapeutic strategy for ONFH.
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Affiliation(s)
- Li-Wen Zheng
- Department of Rehabilitation, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Chun-Na Lan
- Department of Rehabilitation, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Ying Kong
- Department of Rehabilitation, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Li-Hong Liu
- Department of Rehabilitation, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yong-Mei Fan
- Department of Rehabilitation, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Chang-Jie Zhang
- Department of Rehabilitation, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
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16
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Dong Z, Fan C, Deng W, Sun P. Porous gelatin microsphere-based scaffolds containing MC3T3-E1 cells and calcitriol for the repair of skull defect. BIOMATERIALS ADVANCES 2022; 138:212964. [PMID: 35913236 DOI: 10.1016/j.bioadv.2022.212964] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/30/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
There is an increasing demand for biomaterials with skull regeneration for clinical application. However, most of the current skull repair materials still have limitations, such as inadequate sources, poor cell adherence, differentiation, tissue infiltration, and foreign body sensation. Therefore, this study developed porous microsphere-based scaffolds containing mouse embryonic osteoblast precursor cells (MC3T3-E1 cells) and calcitriol (Cal) using gelatin and gelatin/hydroxyapatite through green freeze-crosslinking and freeze-drying. Gelatin was employed to prepare porous microspheres with a particle size of 100-300 μm, containing open pores of 2-70 μm and interconnected paths. Furthermore, the addition of Cal to porous gelatin microsphere-based scaffolds containing MC3T3-E1 cells (PGMSs-MC) and porous gelatin/hydroxyapatite composite microspheres containing MC3T3-E1 cells (HPGMSs-MC) improved their osteoinductivity and cell proliferation and promoted the formation of mature and well-organized bone. The developed Cal-HPGMSs-MC and Cal-PGMSs-MC displayed a good porous structure and cytocompatibility, histocompatibility, osteoconductivity, and osteoinduction. Thus, the designed scaffolds provide a promising prospect for tissue-engineered constructs with skull growth and integration, laying a foundation for further research on the reconstruction of skull defects.
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Affiliation(s)
- Zuoxiang Dong
- Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao 266000, China; Institute for Translational Medicine, College of Medicine, Qingdao University, Qingdao 266000, China
| | - Changjiang Fan
- Institute for Translational Medicine, College of Medicine, Qingdao University, Qingdao 266000, China.
| | - Wenshuai Deng
- Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Peng Sun
- Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao 266000, China.
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17
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Li Q, Yang Z, Wei Z, Li D, Luo Y, Kang P. Copper-Lithium-Doped Nanohydroxyapatite Modulates Mesenchymal Stem Cells Homing to Treat Glucocorticoids-Related Osteonecrosis of the Femoral Head. Front Bioeng Biotechnol 2022; 10:916562. [PMID: 35721865 PMCID: PMC9201282 DOI: 10.3389/fbioe.2022.916562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/18/2022] [Indexed: 12/13/2022] Open
Abstract
In situ tissue regeneration has been demonstrated to promote bone repair. To identify a better approach for treating osteonecrosis of the femoral head (ONFH), we prepared scaffolds using copper-lithium-doped nanohydroxyapatite (Cu-Li-nHA), which has the potential to modulate mesenchymal stem cells (MSCs) homing. The scaffold was fabricated using the gas foaming method and the migration, angiogenesis, and osteogenesis activities of MSCs were detected using Transwell assays, tube formation assays, alkaline phosphatase and alizarin red S staining, respectively. We then implanted the Cu-Li-nHA scaffold into the femoral heads of ONFH rabbits, and CFSE labeled exogenous MSCs were injected intravenously to verify cell homing. The repair effect was subsequently examined using micro-CT and histological analysis in vivo. The results showed that Cu-Li-nHA significantly promoted MSCs migration and homing by upregulating the HIF-1α/SDF-1 pathway. The Cu-Li-nHA group showed optimal osteogenesis and angiogenesis and greater improvements in new bone formation in ONFH rabbits. To summarize, Cu-Li-nHA promoted homing and induced the osteogenic differentiation of MSCs, thereby enhancing bone regeneration during ONFH repair. Thus, Cu-Li-nHA implantation may serve as a potential therapeutic strategy for ONFH in the future.
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18
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Zhang Y, Feng Y, Sun X. Recombinant human erythropoietin accelerated the proliferation of non-small cell lung cancer cell lines and reduced the expression of VEGF, HIF-1α, and PD-L1 under a simulated hypoxic environment in vitro. Chronic Dis Transl Med 2022; 8:124-133. [PMID: 35774428 PMCID: PMC9215718 DOI: 10.1002/cdt3.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/09/2021] [Indexed: 11/11/2022] Open
Abstract
Background As erythropoietin (EPO) has been used to treat anemia in cancer patients, negative controversy has continued. Unfortunately, its effects on non-small-cell lung carcinoma (NSCLC) cell lines are uncertain and the phenomenon of inducing immune escape of tumor cells remains to be explored. This study aimed to provide an important basis for the application of exogenous EPO in the treatment of tumor-associated anemia. Methods Cells were cultured in 1% O2, 5% CO2, and 94% N2 to simulate a hypoxic environment of the tumor. A549 cell line (lower expression EPOR) and NCI-H838 cell line (higher expression EPOR) were treated with 2 and 8 U/ml recombinant human EPO (rhEPO). CCK-8 method was used to determine the logarithmic growth phase of the cells and to detect cell proliferation. The expression levels of VEGF, HIF-1α, and PD-L1 were determined by western blot. One-way ANOVA was used for statistical analysis between groups, with p < 0.05 indicating a significant difference. Results Hypoxia itself could decrease the survival rate of NSCLC cells. Under the hypoxic condition, rhEPO induced tumor cells proliferation, especially in the NCI-H838 cell line, where 2 U/ml rhEPO increased the total number of surviving cells (Hypoxia + rhEPO 2 U/ml vs. Hypoxia, p < 0.05). Western blot analysis showed that hypoxia upregulated the expression of VEGF, HIF-1α, and PD-L1 in NSCLC cell lines (Normoxia vs. Hypoxia, p < 0.05), but may not be dependent on the expression levels of EPOR. RhEPO decreased the expression levels of VEGF and HIF-1α. In the A549 cell line, it depended on the concentration of rhEPO and was particularly obvious in HIF-1α (Hypoxia vs. Hypoxia + rhEPO 2 U/ml vs. Hypoxia + rhEPO 8 U/ml, p < 0.05). A low concentration of rhEPO may not reduce VEGF expression. In the NCI-H838 cell line, the effect of rhEPO on VEGF was more obvious, but it may be independent of rhEPO concentrations. The downregulation of PD-L1 expression by rhEPO was only presented in the A549 cell line and required higher rhEPO concentrations (Hypoxia + rhEPO 8 U/ml vs. Hypoxia&Hypoxia + rhEPO 2 U/ml, p < 0.05). Conclusion The effect of prolonged high concentrations of rhEPO under hypoxic conditions resulted in accelerated cells proliferation of non-small-cell lung cancer and was independent of EPOR expression levels on the cell lines surface. Hypoxia resulted in increased expression of VEGF, HIF-1α, and PD-L1 on the NSCLC cell lines. Under normoxic conditions, rhEPO did not affect the expression of VEGF, HIF-1α, and PD-L1; but under hypoxic conditions, the application of rhEPO reduced the expression of VEGF, HIF-1α, and PD-L1, producing an impact on the biological behavior of tumor cells.
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Affiliation(s)
- Yajing Zhang
- Department of LaboratoryAffiliated Cancer Hospital of Xinjiang Medical UniversityUrumqiXinjiang830011China
| | - Yangchun Feng
- Department of LaboratoryAffiliated Cancer Hospital of Xinjiang Medical UniversityUrumqiXinjiang830011China
| | - Xiaojie Sun
- Department of Blood TransfusionAffiliated Cancer Hospital of Xinjiang Medical UniversityUrumqiXinjiang830011China
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Ma J, Sun Y, Zhou H, Li X, Bai Y, Liang C, Jia X, Zhang P, Yang L. Animal Models of Femur Head Necrosis for Tissue Engineering and Biomaterials Research. Tissue Eng Part C Methods 2022; 28:214-227. [PMID: 35442092 DOI: 10.1089/ten.tec.2022.0043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Femur head necrosis, also known as osteonecrosis of the femoral head (ONFH), is a widespread disabling pathology mostly affecting young and middle-aged population and one of the major causes of total hip arthroplasty in the elderly. Currently, there are limited number of different clinical or medication options for the treatment or the reversal of progressive ONFH, but their clinical outcomes are neither satisfactory nor consistent. In pursuit of more reliable therapeutic strategies for ONFH, including recently emerged tissue engineering and biomaterials approaches, in vivo animal models are extremely important for therapeutic efficacy evaluation and mechanistic exploration. Based on the better understanding of pathogenesis of ONFH, animal modeling method has evolved into three major routes, including steroid-, alcohol-, and injury/trauma-induced osteonecrosis, respectively. There is no consensus yet on a standardized ONFH animal model for tissue engineering and biomaterial research; therefore, appropriate animal modeling method should be carefully selected depending on research purposes and scientific hypotheses. In this work, mainstream types of ONFH animal model and their modeling techniques are summarized, showing both merits and demerits for each. In addition, current studies and experimental techniques of evaluating therapeutic efficacy on the treatment of ONFH using animal models are also summarized, along with discussions on future directions related to tissue engineering and biomaterial research. Impact statement Exploration of tissue engineering and biomaterial-based therapeutic strategy for the treatment of femur head necrosis is important since there are limited options available with satisfactory clinical outcomes. To promote the translation of these technologies from benchwork to bedside, animal model should be carefully selected to provide reliable results and clinical outcome prediction. Therefore, osteonecrosis of the femoral head animal modeling methods as well as associated tissue engineering and biomaterial research are overviewed and discussed in this work, as an attempt to provide guidance for model selection and optimization in tissue engineering and biomaterial translational studies.
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Affiliation(s)
- Jiali Ma
- School of Materials Science and Engineering, Hebei University of Technology, Tianjin, People's Republic of China
| | - Yuting Sun
- Department of Anatomy and Histology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, People's Republic of China
| | - Huan Zhou
- School of Materials Science and Engineering, Hebei University of Technology, Tianjin, People's Republic of China.,Center for Health Sciences and Engineering, School of Health Sciences and Biomedical Engineering, Hebei University of Technology, Tianjin, People's Republic of China
| | - Xinle Li
- Department of Anatomy and Histology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, People's Republic of China
| | - Yanjie Bai
- School of Chemical Engineering, Hebei University of Technology, Tianjin, People's Republic of China
| | - Chunyong Liang
- School of Materials Science and Engineering, Hebei University of Technology, Tianjin, People's Republic of China.,Changzhou Blon Minimally Invasive Medical Device Technology Co. Ltd., Jiangsu, People's Republic of China
| | - Xiaowei Jia
- School of Materials Science and Engineering, Hebei University of Technology, Tianjin, People's Republic of China
| | - Ping Zhang
- Department of Anatomy and Histology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, People's Republic of China
| | - Lei Yang
- School of Materials Science and Engineering, Hebei University of Technology, Tianjin, People's Republic of China.,Center for Health Sciences and Engineering, School of Health Sciences and Biomedical Engineering, Hebei University of Technology, Tianjin, People's Republic of China
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Yao T, Wang L, Ding ZF, Yin ZS. hsa_circ_0058122 knockdown prevents steroid-induced osteonecrosis of the femoral head by inhibiting human umbilical vein endothelial cells apoptosis via the miR-7974/IGFBP5 axis. J Clin Lab Anal 2022; 36:e24134. [PMID: 35274778 PMCID: PMC8993663 DOI: 10.1002/jcla.24134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Steroid-induced osteonecrosis of femoral head (SONFH) is a serious complication of glucocorticoid overused. Recent evidence has demonstrated that circRNAs exert key pathophysiological roles in a variety of disease processes. However, the role of circRNA in SONFH remains largely unknown. The current study sought to evaluate how hsa_circ_0058122 affects SONFH in dexamethasone (DEX) treated human umbilical vein endothelial cells (HUVECs) model. METHODS RT-PCR was used to demonstrate the hsa_circ_0058122 expression level in Dex-treated HUVECs cells. The effects of hsa_circ_0058122 on HUVECs apoptosis were evaluated via overexpression plasmid and siRNA. Using dual-luciferase and fluorescence in situ hybridization assays, we demonstrated that hsa_circ_0058122 binds to miR-7974 thereby facilitating HUVECs apoptosis. Bioinformatics analysis and western blot were performed to confirm target genes of hsa-miR-7974. RESULTS In our previous work, we revealed the top 20 elevated circRNAs in SONFH patients were hsa_circ_0010027, hsa_circ_0058115, hsa_circ_0010026, hsa_circ_0058839, hsa_circ_0056886, hsa_circ_0056885, hsa_circ_0058146, hsa_circ_0058105, hsa_circ_0058112, hsa_circ_0058143, hsa_circ_0058102, hsa_circ_0058090, hsa_circ_0075353, hsa_circ_0058126, hsa_circ_0058130, hsa_circ_0058140, hsa_circ_0058122, hsa_circ_0058123, hsa_circ_0058103, and hsa_circ_0058121. Among these, hsa_circ_0058122 was finally selected for further investigation. We found hsa_circ_0058122 expression was markedly elevated in Dex-treated HUVECs cells, and the Dex-mediated HUVEC apoptosis was impaired in hsa_circ_0058122-silenced cells and increased in hsa_circ_0058122-overexpressing cells. hsa_circ_0058122 competitively binds to hsa-miR-7974, which in turn interacts with insulin-like growth factor binding protein 5 (IGFBP5). CONCLUSIONS hsa_circ_0058122/miR-7974/IGFBP5 was proposed to be a key regulatory pathway for SONFH. DEX treatment upregulated hsa_circ_0058122 expression in HUVECs, which sponged miR-7974, thereby increasing IGFBP5 expression, the hsa_circ_0058122/miR-7974/IGFBP5 axis contributed to the Dex-mediated apoptosis. These findings may identify novel targets for SONFH molecular therapy.
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Affiliation(s)
- Tao Yao
- Department of Orthopaedics, The Third Affiliated Hospital of Anhui Medical University, The First People's Hospital of Hefei, Hefei, China
| | - Lei Wang
- Department of Orthopaedics, The Third Affiliated Hospital of Anhui Medical University, The First People's Hospital of Hefei, Hefei, China
| | - Zhen-Fei Ding
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zong-Sheng Yin
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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21
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Screening of Potential Biomarkers in the Peripheral Serum for Steroid-Induced Osteonecrosis of the Femoral Head Based on WGCNA and Machine Learning Algorithms. DISEASE MARKERS 2022; 2022:2639470. [PMID: 35154510 PMCID: PMC8832155 DOI: 10.1155/2022/2639470] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/27/2021] [Indexed: 12/24/2022]
Abstract
Background. Steroid-induced osteonecrosis of the femoral head (SONFH) has produced a substantial burden of medical and social experience. However, the current diagnosis is still limited. Thus, this study is aimed at identifying potential biomarkers in the peripheral serum of patients with SONFH. Methods. The expression profile data of SONFH (number: GSE123568) was acquired from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) in SONFH were identified and used for weighted gene coexpression network analysis (WGCNA). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to investigate the biological functions. The protein-protein interaction (PPI) network and machine learning algorithms were employed to screen for potential biomarkers. Gene set enrichment analysis (GSEA), transcription factor (TF) enrichment analysis, and competing endogenous RNA (ceRNA) network were used to determine the biological functions and regulatory mechanisms of the potential biomarkers. Results. A total of 562 DEGs, including 318 upregulated and 244 downregulated genes, were identified between SONFH and control samples, and 94 target genes were screened based on WGCNA. Moreover, biological function analysis suggested that target genes were mainly involved in erythrocyte differentiation, homeostasis and development, and myeloid cell homeostasis and development. Furthermore, GYPA, TMCC2, and BPGM were identified as potential biomarkers in the peripheral serum of patients with SONFH based on machine learning algorithms and showed good diagnostic values. GSEA revealed that GYPA, TMCC2, and BPGM were mainly involved in immune-related biological processes (BPs) and signaling pathways. Finally, we found that GYPA might be regulated by hsa-miR-3137 and that BPGM might be regulated by hsa-miR-340-3p. Conclusion. GYPA, TMCC2, and BPGM are potential biomarkers in the peripheral serum of patients with SONFH and might affect SONFH by regulating erythrocytes and immunity.
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22
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Wang Y, Wang P, Wu Q, Qin Z, Xiang Z, Chu Y, Li J. Loading of erythropoietin on biphasic calcium phosphate bioceramics promotes osteogenesis and angiogenesis by regulating EphB4/EphrinB2 molecules. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:19. [PMID: 35072831 PMCID: PMC8786765 DOI: 10.1007/s10856-022-06644-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
Improving osteogenesis and angiogenesis using different cells and drugs is critical in the field of bone tissue engineering. Recent research has found that erythropoietin (EPO) plays an important role in both osteogenesis and angiogenesis. In this study, we grafted polydopamine and EPO onto the surface of biphasic calcium phosphate. The characterization and release property of the modified bioceramics were assessed. Cell proliferation, expression of osteoblastic and endothelial markers, and EphB4/EphrinB2 molecules were investigated while employing co-cultures of two different cells [rat vein endothelial cells (VECs) and rat bone marrow mesenchymal stromal cells (BMSCs)]. The modified bioceramics were finally implanted into the SD rats' femurs and followed by investigating the bone defect repair efficacy and the expression of EphB4/EphrinB2 molecules in vivo. The results indicated that the modified bioceramics could control the release of EPO continuously. The osteogenesis and angiogenesis were improved along with the increased expression of EphB4/EphrinB2 molecules. The expression of EphB4/EphrinB2 molecules was also significantly increased in vivo and the bone defect was repaired effectively. Overall, our findings demonstrated that EPO loading on biphasic calcium phosphate bioceramics could promote both osteogenesis and angiogenesis. The results suggest that EphB4/EphrinB2 may be crucial in the process. Graphical abstract.
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Affiliation(s)
- Yu Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Peng Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Qionghui Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Zhifan Qin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Zichao Xiang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Yuxian Chu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Jihua Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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23
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Li D, Yang Z, Luo Y, Zhao X, Tian M, Kang P. Delivery of MiR335-5p-Pendant Tetrahedron DNA Nanostructures Using an Injectable Heparin Lithium Hydrogel for Challenging Bone Defects in Steroid-Associated Osteonecrosis. Adv Healthc Mater 2022; 11:e2101412. [PMID: 34694067 DOI: 10.1002/adhm.202101412] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/01/2021] [Indexed: 02/05/2023]
Abstract
Corticosteroids-induced Dickkopf-1 (DKK1) upregulation and Wnt signaling inhibition result in bone metabolism disorder and steroid-associated osteonecrosis (SAON). Implanting biomaterials to regulate the Wnt pathway is a promising method to repair challenging bone defects associated with SAON. Here, tetrahedral DNA nanostructures (TDNs) are fabricated as gene carriers to deliver MiR335-5p, which targets DKK1 translation. Heparin lithium hydrogel (Li-hep-gel) is synthesized to act as a lithium and MiR@TDNs delivery agent. Finally, the repair effects on challenging bone defect in SAON using a MiR@TDNs/Li-hep-gel composite are assessed in vivo. The results reveal that MiR@TDNs are absorbed by bone mesenchymal stem cells (BMSCs) and increase cell viability and reduce apoptosis. Moreover, MiR@TDNs promote alkaline phosphatase expression and calcium nodular deposition, decrease lipid droplet expression of BMSCs, and improve vascular endothelial growth factor secretion and vascular-like structure formation in vitro. After MiR@TDNs/Li-hep-gel is implanted into the SAON model, the internal bone defect of osteonecrosis is repaired with a large area of new bone accompanied with neovascularization and reduced empty lacunae. In conclusion, MiR@TDNs/Li-hep-gel can provide dual delivery of lithium and MiR@TDNs, which synergistically upregulate the Wnt signaling pathway, enhancing bone regeneration in challenging bone defects, and can be potentially used in SAON repair.
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Affiliation(s)
- Donghai Li
- Orthopedic Research Institution Department of Orthopaedics West China Hospital Sichuan University 37# Wuhou Guoxue Road Chengdu 610041 P. R. China
| | - Zhouyuan Yang
- Orthopedic Research Institution Department of Orthopaedics West China Hospital Sichuan University 37# Wuhou Guoxue Road Chengdu 610041 P. R. China
| | - Yue Luo
- Orthopedic Research Institution Department of Orthopaedics West China Hospital Sichuan University 37# Wuhou Guoxue Road Chengdu 610041 P. R. China
| | - Xin Zhao
- Orthopedic Research Institution Department of Orthopaedics West China Hospital Sichuan University 37# Wuhou Guoxue Road Chengdu 610041 P. R. China
| | - Meng Tian
- Neurosurgery Research Laboratory West China Hospital Sichuan University Chengdu Sichuan 610041 P. R. China
| | - Pengde Kang
- Orthopedic Research Institution Department of Orthopaedics West China Hospital Sichuan University 37# Wuhou Guoxue Road Chengdu 610041 P. R. China
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24
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Wu XY, Zhu YM, Qi Y, Xu WW, Jing-Zhai. Erythropoietin, as a biological macromolecule in modification of tissue engineered constructs: A review. Int J Biol Macromol 2021; 193:2332-2342. [PMID: 34793816 DOI: 10.1016/j.ijbiomac.2021.11.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/08/2021] [Accepted: 11/10/2021] [Indexed: 12/14/2022]
Abstract
In recent years, tissue engineering has emerged as a promising approach to address limitations of organ transplantation. The ultimate goal of tissue engineering is to provide scaffolds that closely mimic the physicochemical and biological cues of native tissues' extracellular matrix. In this endeavor, new generation of scaffolds have been designed that utilize the incorporation of signaling molecules in order to improve cell recruitment, enhance angiogenesis, exert healing activities, and increase the engraftment of the scaffolds. Among different signaling molecules, the role of erythropoietin (EPO) in regenerative medicine is increasingly being appreciated. It is a biological macromolecule which can prevent programed cell death, modulate inflammation, induce cell proliferation, and provide tissue protection in different disease models. In this review, we have outlined and critically analyzed different techniques of scaffolds' modification with EPO or EPO-loaded nanoparticles. We have also explored different strategies for the incorporation of EPO into scaffolds. Non-hematopoietic functions of EPO have also been discussed. Finalizing with detailed discussion surrounding the applications, challenges, and future perspectives of EPO-modified scaffolds in regenerative medicine.
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Affiliation(s)
- Xiao-Yu Wu
- Department of Surgical Oncology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China
| | - Yi-Miao Zhu
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210046, China
| | - Yang Qi
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210046, China
| | - Wen-Wen Xu
- Department of Gynaecology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China.
| | - Jing-Zhai
- Department of Surgical Oncology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China.
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25
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Murab S, Hawk T, Snyder A, Herold S, Totapally M, Whitlock PW. Tissue Engineering Strategies for Treating Avascular Necrosis of the Femoral Head. Bioengineering (Basel) 2021; 8:200. [PMID: 34940353 PMCID: PMC8699035 DOI: 10.3390/bioengineering8120200] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 12/30/2022] Open
Abstract
Avascular necrosis (AVN) of the femoral head commonly leads to symptomatic osteoarthritis of the hip. In older patients, hip replacement is a viable option that restores the hip biomechanics and improves pain but in pediatric, adolescent, and young adult patients hip replacements impose significant activity limitations and the need for multiple revision surgeries with increasing risk of complication. Early detection of AVN requires a high level of suspicion as diagnostic techniques such as X-rays are not sensitive in the early stages of the disease. There are multiple etiologies that can lead to this disease. In the pediatric and adolescent population, trauma is a commonly recognized cause of AVN. The understanding of the pathophysiology of the disease is limited, adding to the challenge of devising a clinically effective treatment strategy. Surgical techniques to prevent progression of the disease and avoid total hip replacement include core decompression, vascular grafts, and use of bone-marrow derived stem cells with or without adjuncts, such as bisphosphonates and bone morphogenetic protein (BMP), all of which are partially effective only in the very early stages of the disease. Further, these strategies often only improve pain and range of motion in the short-term in some patients and do not predictably prevent progression of the disease. Tissue engineering strategies with the combined use of biomaterials, stem cells and growth factors offer a potential strategy to avoid metallic implants and surgery. Structural, bioactive biomaterial platforms could help in stabilizing the femoral head while inducing osteogenic differentiation to regenerate bone and provide angiogenic cues to concomitantly recover vasculature in the femoral head. Moreover, injectable systems that can be delivered using a minimal invasive procedure and provide mechanical support the collapsing femoral head could potentially alleviate the need for surgical interventions in the future. The present review describes the limitations of existing surgical methods and the recent advances in tissue engineering that are leading in the direction of a clinically effective, translational solution for AVN in future.
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Affiliation(s)
- Sumit Murab
- Division of Pediatric Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (T.H.); (A.S.); (S.H.); (M.T.)
- Department of Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Teresa Hawk
- Division of Pediatric Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (T.H.); (A.S.); (S.H.); (M.T.)
| | - Alexander Snyder
- Division of Pediatric Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (T.H.); (A.S.); (S.H.); (M.T.)
| | - Sydney Herold
- Division of Pediatric Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (T.H.); (A.S.); (S.H.); (M.T.)
| | - Meghana Totapally
- Division of Pediatric Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (T.H.); (A.S.); (S.H.); (M.T.)
| | - Patrick W. Whitlock
- Division of Pediatric Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (T.H.); (A.S.); (S.H.); (M.T.)
- Department of Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45219, USA
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26
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Dong H, Zhu T, Zhang M, Wang D, Wang X, Huang G, Wang S, Zhang M. Polymer Scaffolds-Enhanced Bone Regeneration in Osteonecrosis Therapy. Front Bioeng Biotechnol 2021; 9:761302. [PMID: 34631688 PMCID: PMC8498195 DOI: 10.3389/fbioe.2021.761302] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/09/2021] [Indexed: 12/12/2022] Open
Abstract
Osteonecrosis without effective early treatment eventually leads to the collapse of the articular surface and causes arthritis. For the early stages of osteonecrosis, core decompression combined with bone grafting, is a procedure worthy of attention and clinical trial. And the study of bone graft substitutes has become a hot topic in the area of osteonecrosis research. In recent years, polymers have received more attention than other materials due to their excellent performance. However, because of the harsh microenvironment in osteonecrosis, pure polymers may not meet the stringent requirements of osteonecrosis research. The combined application of polymers and various other substances makes up for the shortcomings of polymers, and to meet a broad range of requirements for application in osteonecrosis therapy. This review focuses on various applying polymers in osteonecrosis therapy, then discusses the development of biofunctionalized composite polymers based on the polymers combined with different bioactive substances. At the end, we discuss their prospects for translation to clinical practice.
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Affiliation(s)
- Hengliang Dong
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Tongtong Zhu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Mingran Zhang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Dapeng Wang
- Department of Orthopedics, Siping Central Hospital, Siping, China
| | - Xukai Wang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Guanning Huang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Shuaishuai Wang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Minglei Zhang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
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27
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Li B, Lei Y, Hu Q, Li D, Zhao H, Kang P. Porous copper- and lithium-doped nano-hydroxyapatite composite scaffold promotes angiogenesis and bone regeneration in the repair of glucocorticoids-induced osteonecrosis of the femoral head. Biomed Mater 2021; 16. [PMID: 34492640 DOI: 10.1088/1748-605x/ac246e] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/07/2021] [Indexed: 02/08/2023]
Abstract
Glucocorticoids-induced osteonecrosis of the femoral head (GIONFH) is a common refractory disease. In the present study, we aimed to synthesize the nano-hydroxyapatite-copper-lithium (Cu-Li-nHA) composite porous scaffold to promote osteogenesis and angiogenesis functions to repair GIONFH by regulating the Wnt/β-catenin and HIF-1α/VEGF pathways. The physicochemical property of the scaffold was characterized and their osteogenic and angiogenic effects were tested through a serial of experimentsin vitroandin vivo. Results showed that 0.25% Cu-Li-nHA scaffolds possessed the highest mechanical and biocompatibilityin vitro. Then the 0.25% Cu-Li-nHA scaffolds significantly enhanced the new bone formation on defects in GIONFH rabbitsin vivo. Moreover, the scaffold could increase the expression of osteogenic and angiogenic factors along with the activation of factors in Wnt/β-catenin and HIF-1α/VEGF pathwaysin vitroandin vivo. In conclusion, the 0.25% Cu-Li-nHA scaffold could improve the osteogenesis and angiogenesis by upregulating the Wnt/β-catenin and HIF-1α/VEGF pathways which benefited to repair the GIONFH in rabbit models.
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Affiliation(s)
- Bohua Li
- Department of Orthopedics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People's Republic of China
| | - Yan Lei
- Arts College of Sichuan University, Chengdu 610041, People's Republic of China
| | - Qinsheng Hu
- Orthopedics Research Institute, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Donghai Li
- Department of Orthopedics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People's Republic of China
| | - Haiyan Zhao
- Department of Orthopedics, The First Hospital of Lanzhou University, 1# West Donggang Road, Lanzhou 730000, People's Republic of China
| | - Pengde Kang
- Department of Orthopedics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People's Republic of China
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28
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Lithium chloride prevents glucocorticoid-induced osteonecrosis of femoral heads and strengthens mesenchymal stem cell activity in rats. Chin Med J (Engl) 2021; 134:2214-2222. [PMID: 34224402 PMCID: PMC8478381 DOI: 10.1097/cm9.0000000000001530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Accumulating evidence suggests that lithium influences mesenchymal stem cell (MSC) proliferation and osteogenic differentiation. As decreased bone formation in femoral heads is induced by glucocorticoids (GCs), we hypothesized that lithium has a protective effect on GC-induced osteonecrosis of femoral heads (ONFH). Methods: A rat ONFH model was induced by methylprednisolone (MP) and the effect of lithium chloride on the models was evaluated. Micro-computed tomography (CT)-based angiography and bone scanning were performed to analyze the vessels and bone structure in the femoral heads. Hematoxylin and eosin and immunohistochemical staining were performed to evaluate the trabecular structure and osteocalcin (OCN) expression, respectively. Bone marrow-derived MSCs were isolated from the models, and their proliferative and osteogenic ability was evaluated. Western blotting and quantitative real-time polymerase chain reaction were performed to detect osteogenic-related proteins including Runx2, alkaline phosphatase, and Collagen I. Results: Micro-CT analysis showed a high degree of osteonecrotic changes in the rats that received only MP injection. Treatment with lithium reduced this significantly in rats that received lithium (MP + Li group); while 18/20 of the femoral heads in the MP showed severe osteonecrosis, only 5/20 in the MP + Li showed mild osteonecrotic changes. The MP + Li group also displayed a higher vessel volume than the MP group (0.2193 mm3vs. 0.0811 mm3, P < 0.05), shown by micro-CT-based angiography. Furthermore, histological analysis showed better trabecular structures and more OCN expression in the femoral heads of the MP + Li group compared with the MP group. The ex vivo investigation indicated higher proliferative and osteogenic ability and upregulated osteogenic-related proteins in MSCs extracted from rats in the MP + Li group than that in the MP group. Conclusions: We concluded that lithium chloride has a significant protective effect on GC-induced ONFH in rats and that lithium also enhances MSC proliferation and osteogenic differentiation in rats after GC administration.
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29
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Huang Z, Zhao Z, Lang J, Wang W, Fu Y, Wang W. Therapeutic Study of Thermosensitive Hydrogel Loaded with Super-Activated Platelet Lysate Combined with Core Decompression Technology for the Treatment of Femoral Head Necrosis. Stem Cells Int 2021; 2021:7951616. [PMID: 34257669 PMCID: PMC8257358 DOI: 10.1155/2021/7951616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/01/2021] [Indexed: 11/24/2022] Open
Abstract
Super activated platelet lysate (sPL) is a derivative of platelet-rich plasma (PRP) that contains high levels of several growth factors. In this study, we synthesized a temperature-sensitive hydrogel that contained temperature-sensitive Poly(DL-lactide-glycolide-glycolide acid) (PLGA), SrCl2, and HA, and loaded it with different concentrations of sPL. The hydrogel showed satisfactory encapsulation efficiency and release of the growth factors in a sustained manner, indicating its suitability as a drug carrier. The sPL-loaded hydrogel was inserted into the necrotic femoral head of a rat model and core decompression was applied and resulted in significantly accelerated bone repair and regeneration. Therefore, encapsulation of sPL in a hydrogel scaffolding may be an effective strategy for treating femoral head necrosis.
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Affiliation(s)
- Zhipeng Huang
- The First Affiliated Hospital of Harbin Medical University, 23 You Zheng Street, Harbin 150001, China
| | - Zhe Zhao
- Southern University of Science and Technology Hospital, 6019 Liuxian Avenue, Xili, Nanshan District, Shenzhen 518000, China
| | - Jun Lang
- The First Affiliated Hospital of Harbin Medical University, 23 You Zheng Street, Harbin 150001, China
| | - Wantao Wang
- The First Affiliated Hospital of Harbin Medical University, 23 You Zheng Street, Harbin 150001, China
| | - Yinsheng Fu
- Tianqing Stem Cell Co., Ltd., Jubao Second Road, Science and Technology Innovation City, Songbei District, Harbin 150000, China
| | - Wenbo Wang
- The First Affiliated Hospital of Harbin Medical University, 23 You Zheng Street, Harbin 150001, China
- Southern University of Science and Technology Hospital, 6019 Liuxian Avenue, Xili, Nanshan District, Shenzhen 518000, China
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30
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Girón J, Kerstner E, Medeiros T, Oliveira L, Machado GM, Malfatti CF, Pranke P. Biomaterials for bone regeneration: an orthopedic and dentistry overview. Braz J Med Biol Res 2021; 54:e11055. [PMID: 34133539 PMCID: PMC8208772 DOI: 10.1590/1414-431x2021e11055] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/23/2021] [Indexed: 12/14/2022] Open
Abstract
Because bone-associated diseases are increasing, a variety of tissue engineering approaches with bone regeneration purposes have been proposed over the last years. Bone tissue provides a number of important physiological and structural functions in the human body, being essential for hematopoietic maintenance and for providing support and protection of vital organs. Therefore, efforts to develop the ideal scaffold which is able to guide the bone regeneration processes is a relevant target for tissue engineering researchers. Several techniques have been used for scaffolding approaches, such as diverse types of biomaterials. On the other hand, metallic biomaterials are widely used as support devices in dentistry and orthopedics, constituting an important complement for the scaffolds. Hence, the aim of this review is to provide an overview of the degradable biomaterials and metal biomaterials proposed for bone regeneration in the orthopedic and dentistry fields in the last years.
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Affiliation(s)
- J Girón
- Laboratório de Hematologia e Células Tronco, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Programa de Pós-graduação em Fisiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - E Kerstner
- Programa de Pós-graduação em Engenharia de Minas, Metalúrgica e de Materiais, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - T Medeiros
- Laboratório de Hematologia e Células Tronco, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Programa de Pós-graduação em Fisiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - L Oliveira
- Laboratório de Hematologia e Células Tronco, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - G M Machado
- Programa de Gradução em Odontologia, Universidade Luterana do Brasil, Canoas, RS, Brasil
| | - C F Malfatti
- Programa de Pós-graduação em Engenharia de Minas, Metalúrgica e de Materiais, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - P Pranke
- Laboratório de Hematologia e Células Tronco, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Programa de Pós-graduação em Fisiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Instituto de Pesquisa com Células Tronco, Porto Alegre, RS, Brasil
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31
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The preconditioning of lithium promotes mesenchymal stem cell-based therapy for the degenerated intervertebral disc via upregulating cellular ROS. Stem Cell Res Ther 2021; 12:239. [PMID: 33853670 PMCID: PMC8048279 DOI: 10.1186/s13287-021-02306-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/22/2021] [Indexed: 02/07/2023] Open
Abstract
Abstract Adipose-derived stem cell (ADSC) is one of the most widely used candidate cell for intervertebral disc (IVD) degeneration-related disease. However, the poor survival and low differentiation efficacy in stressed host microenvironment limit the therapeutic effects of ADSC-based therapy. The preconditioning has been found effective to boost the proliferation and the functioning of stem cells in varying pathological condition. Lithium is a common anti-depression drug and has been proved effective to enhance stem cell functioning. In this study, the effects of preconditioning using LiCl on the cellular behavior of ADSC was investigated, and specially in a degenerative IVD-like condition. Method The cellular toxicity on rat ADSC was assessed by detecting lactate dehydrogenase (LDH) production after treatment with a varying concentration of lithium chloride (LiCl). The proliferative capacity of ADSC was determined by detecting Ki67 expression and the relative cell number of ADSC. Then, the preconditioned ADSC was challenged by a degenerative IVD-like condition. And the cell viability as well as the nucleus pulpous (NP) cell differentiation efficacy of preconditioned ADSC was evaluated by detecting the major marker expression and extracellular matrix (ECM) deposit. The therapeutic effects of preconditioned ADSC were evaluated using an IVD degeneration rat model, and the NP morphology and ECM content were assessed. Results A concentration range of 1–10 mmol/L of LiCl was applied in the following study, since a higher concentration of LiCl causes a major cell death (about 40%). The relative cell number was similar between preconditioned groups and the control group after preconditioning. The Ki67 expression was elevated after preconditioning. Consistently, the preconditioned ADSC showed stronger proliferation capacity. Besides, the preconditioned groups exhibit higher expression of NP markers than the control group after NP cell induction. Moreover, the preconditioning of LiCl reduced the cell death and promoted ECM deposits, when challenged with a degenerative IVD-like culture. Mechanically, the preconditioning of LiCl induced an increased cellular reactive oxidative species (ROS) level and activation of ERK1/2, which was found closely related to the enhanced cell survival and ECM deposits after preconditioning. The treatment with preconditioned ADSC showed better therapeutic effects than control ADSC transplantation, with better NP preservation and ECM deposits. Conclusion These results suggest that the preconditioning with a medium level of LiCl boosts the cell proliferation and differentiation efficacy under a normal or hostile culture condition via the activation of cellular ROS/ERK axis. It is a promising pre-treatment of ADSC to promote the cell functioning and the following regenerative capacity, with superior therapeutic effects than untreated ADSC transplantation.
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Li D, Yang Z, Zhao X, Luo Y, Ou Y, Kang P, Tian M. A bone regeneration strategy via dual delivery of demineralized bone matrix powder and hypoxia-pretreated bone marrow stromal cells using an injectable self-healing hydrogel. J Mater Chem B 2021; 9:479-493. [PMID: 33289774 DOI: 10.1039/d0tb01924k] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Demineralized bone matrix (DBM) powder is a potential alternative bone grafting material due to its bone regeneration capacity when the supply of autogenous bone is insufficient. However, the use of DBM powder alone remains challenging in many aspects in the clinic, such as its unstable osteoinductivity due to inactivation of growth factors during the preparation process, lack of bone regeneration cells, and difficulty in handling. Herein, we report a strategy that adopts a dual delivery of DBM powder and hypoxia-pretreated bone marrow stromal cells (BMSCs) using an injectable self-healing hydrogel to enhance bone regeneration and repair a cranial bone defect in a rabbit model. The injectable self-healing hydrogel was prepared based on a double crosslinking architecture, which comprised a dynamically cross-linked Schiff-base network as a self-healing component and a borax ion cross-linked physical network that strengthened its mechanical properties. The handling of the DBM powder was improved by mixing with the hydrogel, and, more importantly, the expression of osteocalcin (OCN) and vascular endothelial growth factor (VEGF) of the encapsulated BMSCs in the hydrogel was significantly up-regulated after hypoxia-pretreatment. The in vivo study demonstrated that the use of the hydrogel alone cannot heal the cranial bone defect, while the hydrogel/BMSC composite could increase the bone formation but was inferior to the hydrogel/DBM composite. Finally, the hydrogel/DBM/BMSC composite exhibited the best bone defect repairing effects among all groups. Overall, our results demonstrate that this dual delivery approach is a promising strategy to enhance bone regeneration for bone defect repair.
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Affiliation(s)
- Donghai Li
- Department of Orthopaedics Surgery, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu 610041, P. R. China.
| | - Zhouyuan Yang
- Department of Orthopaedics Surgery, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu 610041, P. R. China.
| | - Xin Zhao
- Department of Orthopaedics Surgery, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu 610041, P. R. China.
| | - Yue Luo
- Department of Orthopaedics Surgery, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu 610041, P. R. China.
| | - Yi Ou
- Neurosurgery Research Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China.
| | - Pengde Kang
- Department of Orthopaedics Surgery, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu 610041, P. R. China.
| | - Meng Tian
- Neurosurgery Research Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China.
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Zhao H, Yeersheng R, Xia Y, Kang P, Wang W. Hypoxia Enhanced Bone Regeneration Through the HIF-1α/β-Catenin Pathway in Femoral Head Osteonecrosis. Am J Med Sci 2021; 362:78-91. [PMID: 33727018 DOI: 10.1016/j.amjms.2021.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/12/2020] [Accepted: 03/11/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Osteonecrosis of the femoral head (ONFH) is a common disease. Transplantation of bone marrow stem cells (BMSCs) is a promising method to treat ONFH but is impeded by the low survival rate and deficiency of cell bioactivity. METHODS We performed hypoxic preprocessing to treat BMSCs and assessed cell viability, apoptosis, differentiation, and growth factor expression in vitro. Subsequently, we constructed the ONFH model and delivered hypoxia-pretreated BMSCs to the rabbit femoral head after core decompression surgery, evaluating its effects on bone regeneration and ONFH repair. Six weeks later, micro-computed tomography (CT) and histopathology were performed to evaluate ONFH repair. RESULTS Our findings demonstrated that hypoxic preprocessing promoted the viability of BMSCs, increased the expression of hypoxia-inducible factor-1 alpha (HIF-1α), vascular endothelial growth factor (VEGF), alkaline phosphatase (ALP), calcium deposition, and enhanced the formation of vessels-shaped structures. In an in vivo study, micro-CT observations demonstrated that the bone volume was increased in the hypoxia BMSCs group. Histological examination revealed reduced cellular apoptosis, lower empty lacunae rate, enhanced bone formation, and stronger trabecular bone in the hypoxia BMSCs group when compared with those transplanted with normoxia treated BMSCs. Additionally, immunological assessment of the hypoxia BMSCs group demonstrated increased expression of HIF-1α and β-catenin, as well as increased VEGF, ALP, osteocalcin (OCN), and collagen type I (Col-1). CONCLUSIONS Collectively, our findings indicated that hypoxia stimulated angiogenesis and bone regeneration via the HIF-1/β-catenin pathway in BMSCs and that the delivery of hypoxia-pretreated BMSCs contributed to the treatment of early ONFH.
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Affiliation(s)
- HaiYan Zhao
- Department of Orthopedics, The First Hospital of Lanzhou University, Lanzhou, China
| | - Releken Yeersheng
- Department of Orthopedics, The First Hospital of Lanzhou University, Lanzhou, China
| | - YaYi Xia
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, China
| | - PengDe Kang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - WenJi Wang
- Department of Orthopedics, The First Hospital of Lanzhou University, Lanzhou, China.
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Wang C, Xu H, Liu C, Peng Z, Min R, Zhang Z, Li J, Jin Y, Wang Y, Li Z, Guo J, Zhu L. CaO 2/gelatin oxygen slow-releasing microspheres facilitate tissue engineering efficiency for the osteonecrosis of femoral head by enhancing the angiogenesis and survival of grafted bone marrow mesenchymal stem cells. Biomater Sci 2021; 9:3005-3018. [PMID: 33651043 DOI: 10.1039/d0bm02071k] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The osteonecrosis of femoral head (ONFH), a common refractory disease, is still not fully understood today. Hypoxia caused by ischemia is not only an important pathogenic factor but also a critical challenge for the survival of seed cells in the tissue engineering therapy of ONFH. To explore an efficient strategy to treat ONFH by targeting hypoxia, newly designed CaO2/gelatin microspheres were composited with 3D printed polycaprolactone/nano-hydroxyapatite (PCL/nHA) porous scaffold, sodium alginate/gelatin hydrogel, and bone marrow mesenchymal stem cells (BMSCs) to develop a novel tissue engineering scaffold and then transplanted into the core depression area of the ONFH rabbit model. The current data demonstrated that CaO2/gelatin microspheres can constantly release oxygen for 19 days. In vitro assays with BMSCs illustrated that scaffolds have high biocompatibility and are favorable for cell proliferation in extreme hypoxia (1% O2). The in vivo study demonstrated that the transplanted scaffold with oxygen-generating microspheres significantly enhanced the osteogenic and angiogenic effects compared to the scaffold without microspheres. Further assessments revealed that microspheres in the scaffold can reduce the local cell apoptosis and enhance the survival of grafted cells in the host. Collectively, the present study developed a novel oxygen slow-releasing composite scaffold, which can facilitate tissue engineering efficiency for treating the osteonecrosis of the femoral head by enhancing the angiogenesis and survival of grafted stem cells.
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Affiliation(s)
- Chengqiang Wang
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
| | - Haixia Xu
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
| | - Chun Liu
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
| | - Ziyue Peng
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
| | - Ruoxing Min
- Department of Ultrasound Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Zhiming Zhang
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China. and Department of Orthopedics, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Jianjun Li
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
| | - Yanglei Jin
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
| | - Yihan Wang
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
| | - Zhihao Li
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
| | - Jiasong Guo
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China. and Department of Histology and Embryology, Southern Medical University, Guangzhou 510515, China and Key Laboratory of Tissue Construction and Detection of Guangdong Province, Guangzhou 510515, China and Institute of Bone Biology, Academy of Orthopedics, Guangzhou 510665, Guangdong Province, China and Key Laboratory of Mental Health of the Ministry of Education; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong Province Key Laboratory of Psychiatric Disorders, Guangzhou 510515, China and Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510530, China
| | - Lixin Zhu
- Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
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Repair of segmental bone defect using tissue engineered heterogeneous deproteinized bone doped with lithium. Sci Rep 2021; 11:4819. [PMID: 33649409 PMCID: PMC7921440 DOI: 10.1038/s41598-021-84526-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/17/2021] [Indexed: 02/05/2023] Open
Abstract
Lithium have been shown to play an important role in improving the osteogenic properties of biomaterials. This study aims to explore the osteogenic improvement effect of tissue engineered heterogeneous deproteinized bone (HDPB) doped with lithium, and evaluate their effectiveness in the healing of bone defects. Bone marrow mesenchymal stem cells (BMSCs) were co-cultured with different concentration of lithium chloride. Cell proliferation in each group was analyzed by 3-(4, 5-dimetyl-2-thiazoly-2, 5-diphenyl-2-H-tetrazolium bromide (MTT) assay. BMSCs were then co-cultured in osteogenic induction medium with different concentration of lithium chloride, and the expression of related mRNA was detected. The role of lithium in promoting BMSCs osteogenic differentiation and inhibiting BMSCs lipogenic differentiation was also investigated. Biomechanical properties of the tibia were evaluated at 8 weeks after operation. The tibial specimens of each group were collected at 4 and 8 weeks after surgery for histological examination and histological analysis. Micro-computed tomography (CT) scanning and 3D reconstruction were performed at 8 weeks. The results demonstrate that lithium can induce the osteogenic differentiation inhibit of adipogenic differentiation of BMSCs by regulating the Wnt signaling pathway. The histological evaluation further certified that average bone formation area in the group of tissue engineered HDPB doped with lithium was also significantly better than that of HDPB alone group. Based on the above evaluation, tissue engineered HDPB doped with lithium can effectively promote the regeneration of segmental bone defect, which can be used as a tissue engineering scaffold for clinical trials.
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Combined Pharmacotherapy with Alendronate and Desferoxamine Regulate the Bone Resorption and Bone Regeneration for Preventing Glucocorticoids-Induced Osteonecrosis of the Femoral Head. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3120458. [PMID: 33029500 PMCID: PMC7532397 DOI: 10.1155/2020/3120458] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/04/2020] [Accepted: 09/15/2020] [Indexed: 12/01/2022]
Abstract
Background Osteonecrosis of the femoral head (ONFH) is a challenge for surgeons and is still without effective treatment method. This study is aimed at evaluating the combined pharmacotherapy with alendronate and desferoxamine for preventing glucocorticoid-induced osteonecrosis of the femoral head (GIOFH) and evaluating the efficacy of the combined medicine in regulating the bone resorption and bone regeneration. Materials and Methods Thirty-six rats were randomly assigned to three groups: group A received alendronate and desferoxamine (n = 12), group B received alendronate only (n = 12), and group C acted as the control group received placebo (n = 12). All rats induced the GIOFH using methylprednisolone combined with lipopolysaccharide. Eight weeks later, all rats were killed and their tissues were subjected to radiographic and histological analyses. Results According to the results, alendronate administration improved the trabecular thickness and separation in micro-CT analysis but had no significant evidence in increasing the bone area and decreasing the ratio of osteocyte lacunae in histological analysis when compared with the control group. Meanwhile, the alendronate group had more OCs, but less OCN and VEGF levels along with decreased p-AKT, HIF-1α, RANKL, and NFATc1 expressions than the control group. For comparison, alendronate combined with DFO further improved the bone volume, trabecular number, trabecular separation, and trabecular thickness with lower ratio of osteocyte lacunae and OC number, higher expression of OCN and VEGF and upregulated signal factors of HIF-1α and β-catenin, and decreased RANKL and NFATc1. Conclusion Combined pharmacotherapy with alendronate and desferoxamine provide significant effects in regulating the bone resorption and bone regeneration for preventing GIOFN.
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Liang T, Wu J, Li F, Huang Z, Pi Y, Miao G, Ren W, Liu T, Jiang Q, Guo L. Drug-loading three-dimensional scaffolds based on hydroxyapatite-sodium alginate for bone regeneration. J Biomed Mater Res A 2020; 109:219-231. [PMID: 32490561 DOI: 10.1002/jbm.a.37018] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/03/2020] [Accepted: 04/19/2020] [Indexed: 12/29/2022]
Abstract
Bone tissue engineering is a promising approach for tackling clinical challenges. Osteoprogenitor cells, osteogenic factors, and osteoinductive/osteoconductive scaffolds are employed in bone tissue engineering. However, scaffold materials remain limited due to their source, low biocompatibility, and so on. In this study, a composite hydrogel scaffold composed of hydroxyapatite (HA) and sodium alginate (SA) was manufactured using three-dimensional printing. Naringin (NG) and calcitonin-gene-related peptide (CGRP) were used as osteogenic factors in the fabrication of drug-loaded scaffolds. Investigation using animal experiments, as well as scanning electron microscopy, cell counting kit-8 testing, alkaline phosphatase staining, and alizarin red-D staining of bone marrow mesenchymal stem cell culture showed that the three scaffolds displayed similar physicochemical properties and that the HA/SA/NG and HA/SA/CGRP scaffolds displayed better osteogenesis than that of the HA/SA scaffold. Thus, the HA/SA scaffold could be a biocompatible material with potential applications in bone regeneration. Meanwhile, NG and CGRP doping could result in better and more positive proliferation and differentiation.
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Affiliation(s)
- Tingting Liang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jingwen Wu
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Fuyao Li
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhu Huang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yixing Pi
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Guohou Miao
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wen Ren
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tiantao Liu
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qianzhou Jiang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lvhua Guo
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
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Zhu T, Cui Y, Zhang M, Zhao D, Liu G, Ding J. Engineered three-dimensional scaffolds for enhanced bone regeneration in osteonecrosis. Bioact Mater 2020; 5:584-601. [PMID: 32405574 PMCID: PMC7210379 DOI: 10.1016/j.bioactmat.2020.04.008] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/11/2020] [Accepted: 04/11/2020] [Indexed: 12/15/2022] Open
Abstract
Osteonecrosis, which is typically induced by trauma, glucocorticoid abuse, or alcoholism, is one of the most severe diseases in clinical orthopedics. Osteonecrosis often leads to joint destruction, and arthroplasty is eventually required. Enhancement of bone regeneration is a critical management strategy employed in osteonecrosis therapy. Bone tissue engineering based on engineered three-dimensional (3D) scaffolds with appropriate architecture and osteoconductive activity, alone or functionalized with bioactive factors, have been developed to enhance bone regeneration in osteonecrosis. In this review, we elaborate on the ideal properties of 3D scaffolds for enhanced bone regeneration in osteonecrosis, including biocompatibility, degradability, porosity, and mechanical performance. In addition, we summarize the development of 3D scaffolds alone or functionalized with bioactive factors for accelerating bone regeneration in osteonecrosis and discuss their prospects for translation to clinical practice. Engineered three-dimensional scaffolds boost bone regeneration in osteonecrosis. The ideal properties of three-dimensional scaffolds for osteonecrosis treatment are discussed. Bioactive factors-functionalized three-dimensional scaffolds are promising bone regeneration devices for osteonecrosis management. The challenges and opportunities of engineered three-dimensional scaffolds for osteonecrosis therapy are predicted.
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Affiliation(s)
- Tongtong Zhu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033, PR China
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
| | - Yutao Cui
- Department of Orthopedics, The Second Hospital of Jilin University, 218 Ziqiang Road, Changchun, 130041, PR China
| | - Mingran Zhang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033, PR China
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
| | - Duoyi Zhao
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
| | - Guangyao Liu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033, PR China
- Corresponding author.
| | - Jianxun Ding
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
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Wong SK, Chin KY, Ima-Nirwana S. The Skeletal-Protecting Action and Mechanisms of Action for Mood-Stabilizing Drug Lithium Chloride: Current Evidence and Future Potential Research Areas. Front Pharmacol 2020; 11:430. [PMID: 32317977 PMCID: PMC7154099 DOI: 10.3389/fphar.2020.00430] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 03/20/2020] [Indexed: 12/21/2022] Open
Abstract
Lithium, the lightest natural-occurring alkali metal with an atomic number of three, stabilizes the mood to prevent episodes of acute manic and depression. Multiple lines of evidence point to lithium as an anti-suicidal, anti-viral, anti-cancer, immunomodulatory, neuroprotective and osteoprotective agent. This review article provides a comprehensive review of studies investigating the bone-enhancing effects of lithium and its possible underlying molecular mechanisms. Most of the animal experimental studies reported the beneficial effects of lithium in defective bones but not in healthy bones. In humans, the effects of lithium on bones remain heterogeneous. Mechanistically, lithium promotes osteoblastic activities by activating canonical Wingless (Wnt)/beta (β)-catenin, phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) and bone morphogenetic protein-2 (BMP-2) transduction pathways but suppresses osteoclastic activities by inhibiting the receptor activator of nuclear factor-kappa B (RANK)/receptor activator of nuclear factor-kappa B ligand (RANKL)/osteoprotegerin (OPG) system, nuclear factor-kappa B (NF-κB), mitogen-activated protein kinase (MAPK), and calcium signaling cascades. In conclusion, lithium confers protection to the skeleton but its clinical utility awaits further validation from human clinical trials.
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Affiliation(s)
- Sok Kuan Wong
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Liu W, Zhang G, Wu J, Zhang Y, Liu J, Luo H, Shao L. Insights into the angiogenic effects of nanomaterials: mechanisms involved and potential applications. J Nanobiotechnology 2020; 18:9. [PMID: 31918719 PMCID: PMC6950937 DOI: 10.1186/s12951-019-0570-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/31/2019] [Indexed: 12/18/2022] Open
Abstract
The vascular system, which transports oxygen and nutrients, plays an important role in wound healing, cardiovascular disease treatment and bone tissue engineering. Angiogenesis is a complex and delicate regulatory process. Vascular cells, the extracellular matrix (ECM) and angiogenic factors are indispensable in the promotion of lumen formation and vascular maturation to support blood flow. However, the addition of growth factors or proteins involved in proangiogenic effects is not effective for regulating angiogenesis in different microenvironments. The construction of biomaterial scaffolds to achieve optimal growth conditions and earlier vascularization is undoubtedly one of the most important considerations and major challenges among engineering strategies. Nanomaterials have attracted much attention in biomedical applications due to their structure and unique photoelectric and catalytic properties. Nanomaterials not only serve as carriers that effectively deliver factors such as angiogenesis-related proteins and mRNA but also simulate the nano-topological structure of the primary ECM of blood vessels and stimulate the gene expression of angiogenic effects facilitating angiogenesis. Therefore, the introduction of nanomaterials to promote angiogenesis is a great helpful to the success of tissue regeneration and some ischaemic diseases. This review focuses on the angiogenic effects of nanoscaffolds in different types of tissue regeneration and discusses the influencing factors as well as possible related mechanisms of nanomaterials in endothelial neovascularization. It contributes novel insights into the design and development of novel nanomaterials for vascularization and therapeutic applications.
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Affiliation(s)
- Wenjing Liu
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Guilan Zhang
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Junrong Wu
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Yanli Zhang
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Jia Liu
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Haiyun Luo
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Longquan Shao
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China.
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Guangzhou, 510515, China.
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Yin Y, Ding L, Hou Y, Jiang H, Zhang J, Dai Z, Zhang G. Upregulating MicroRNA-410 or Downregulating Wnt-11 Increases Osteoblasts and Reduces Osteoclasts to Alleviate Osteonecrosis of the Femoral Head. NANOSCALE RESEARCH LETTERS 2019; 14:383. [PMID: 31853663 PMCID: PMC6920280 DOI: 10.1186/s11671-019-3221-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Little is known regarding the functional role of microRNA-410 (miR-410) in osteonecrosis of the femoral head (ONFH); hence, the aim of the present study was to investigate miR-410 targeting Wnt-11 to modulate the osteogenic and osteoclastic mechanism in the prevention of ONFH. METHODS Fifteen ONFH samples and 15 normal samples were gathered. The pathological changes of the femoral head, osteoblasts, and osteoclasts in the clinical samples were observed. The rat model of ONFH was injected with agomir-miR-410, Wnt-11-siRNA, or oe-Wnt-11. MiR-410; Wnt-11; osteoblast-related factors alkaline phosphatase (ALP), bone gamma-carboxyglutamate protein (BGLAP), and Collα1 expression; and osteoclast-related factors acid phosphatase 5 (ACP5), cathepsin K (CTSK), and MMP9, as well as Bcl-2 and Bax expression, were tested by RT-qPCR and western blot analysis. The osteogenic function index ALP and OCN together with osteoclast function index NTX-1 and CTX-1 in serum was tested by ELISA. RESULTS MiR-410, ALP, BGLAP, and Collα1 degraded as well as Wnt-11, ACP5, CTSK, and MMP9 enhanced in ONFH tissues of the clinical samples. Upregulated miR-410 and downregulated Wnt-11 enhanced bone mineral density (BMD) and BV/TV of rats, heightened the BMD level of the femoral shaft, femoral head, and spinal column, and also raised the serum calcium and phosphorus levels of rats, while restrained apoptosis of osteocytes, elevated OCN, ALP, BGLAP, and Collα1 expression and declined ACP5, CTSK, NTX-1, CTX-1, and MMP9 expression in rats. CONCLUSION This study suggested that upregulating miR-410 or downregulating Wnt-11 increases osteoblasts and reduces osteoclasts to alleviate the occurrence of ONFH. Thus, miR-410 may serve as a potential target for the treatment of ONFH.
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Affiliation(s)
- Yukun Yin
- Department of Traditional Chinese Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Lixiang Ding
- Department of Spine, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China.
| | - Yu Hou
- Department of Spine, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China
| | - Haoran Jiang
- Department of Spine, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China
| | - Ji Zhang
- Department of Spine, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China
| | - Zhong Dai
- Department of General medicine, Huanxing Cancer Hospital, Chaoyang District, Beijing, 100005, People's Republic of China
| | - Genai Zhang
- Department of Spine, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China.
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Ma Y, Li Y, Hao J, Ma B, Di T, Dong H. Evaluation of the degradation, biocompatibility and osteogenesis behavior of lithium-doped calcium polyphosphate for bone tissue engineering. Biomed Mater Eng 2019; 30:23-36. [PMID: 30530956 DOI: 10.3233/bme-181030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Calcium polyphosphate (CPP) is a commonly used biomaterial in bone tissue engineering, but CPP is insufficient in osteoinduction. This study aimed to fabricate lithium doped CPP (LiCPP) scaffolds and assess their characterization, degradation, biocompatibility and osteogenesis behavior for bone tissue engineering. METHODS The novel scaffold was characterized by XRD, FTIR and SEM. The porosity, cell mediated degradation behavior and mechanical properties were also investigated. Meanwhile, cell proliferation activity and adhesion in vitro was exploited. Finally, osteogenesis the LiCPP scaffolds in vitro and in vivo was researched. RESULTS The outcomes revealed that low-content Li doping had no significant influence on the structure of CPP. The results of cells mediated degradation experiments from the weight loss and the release of ions indicated that Li doped CPP improved biological degradation. The compressive strength of CPP with 66% porosity was improved to 7 MPa. Cells proliferation experiment and adhesion experiment demonstrated 2.0%LiCPP scaffold was most beneficial to cell growth and attachment. Furthermore, Li doped CPP up-regulated Wnt signal pathway when co-cultured with MG63 and increased osteogenic marker ALP expression and calcium phosphate deposition in vitro. At the same time, new bone formation in vivo was also enhanced by using LiCPP scaffolds and the 2.0%LiCPP scaffolds obtained best osteogenesis outcomes. CONCLUSION The results obtained in our study suggest that 2.0%LiCPP scaffold could benefit from improving the osteogenesis behavior and is a promising biomaterial for bone repairing applications.
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Affiliation(s)
- Yanchao Ma
- Department of Orthopaedics Surgery, Second Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
| | - Yanhong Li
- Department of Orthopaedics Surgery, Second Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
| | - Junlong Hao
- Department of Orthopaedics Surgery, Second Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
| | - Bin Ma
- Department of Orthopaedics Surgery, Second Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
| | - Tianning Di
- Department of Orthopaedics Surgery, Second Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
| | - Haitao Dong
- Department of Orthopaedics Surgery, Second Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
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Albulescu R, Popa AC, Enciu AM, Albulescu L, Dudau M, Popescu ID, Mihai S, Codrici E, Pop S, Lupu AR, Stan GE, Manda G, Tanase C. Comprehensive In Vitro Testing of Calcium Phosphate-Based Bioceramics with Orthopedic and Dentistry Applications. MATERIALS 2019; 12:ma12223704. [PMID: 31717621 PMCID: PMC6888321 DOI: 10.3390/ma12223704] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/29/2019] [Accepted: 11/05/2019] [Indexed: 02/07/2023]
Abstract
Recently, a large spectrum of biomaterials emerged, with emphasis on various pure, blended, or doped calcium phosphates (CaPs). Although basic cytocompatibility testing protocols are referred by International Organization for Standardization (ISO) 10993 (parts 1-22), rigorous in vitro testing using cutting-edge technologies should be carried out in order to fully understand the behavior of various biomaterials (whether in bulk or low-dimensional object form) and to better gauge their outcome when implanted. In this review, current molecular techniques are assessed for the in-depth characterization of angiogenic potential, osteogenic capability, and the modulation of oxidative stress and inflammation properties of CaPs and their cation- and/or anion-substituted derivatives. Using such techniques, mechanisms of action of these compounds can be deciphered, highlighting the signaling pathway activation, cross-talk, and modulation by microRNA expression, which in turn can safely pave the road toward a better filtering of the truly functional, application-ready innovative therapeutic bioceramic-based solutions.
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Affiliation(s)
- Radu Albulescu
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
- Department Pharmaceutical Biotechnology, National Institute for Chemical-Pharmaceutical R&D, 031299, Bucharest, Romania
| | - Adrian-Claudiu Popa
- National Institute of Materials Physics, 077125 Magurele, Romania (G.E.S.)
- Army Centre for Medical Research, 010195 Bucharest, Romania
| | - Ana-Maria Enciu
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
- Department of Cellular and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050047 Bucharest, Romania
| | - Lucian Albulescu
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Maria Dudau
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
- Department of Cellular and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050047 Bucharest, Romania
| | - Ionela Daniela Popescu
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Simona Mihai
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Elena Codrici
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Sevinci Pop
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Andreea-Roxana Lupu
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
- Cantacuzino National Medico-Military Institute for Research and Development, 050096 Bucharest, Romania
| | - George E. Stan
- National Institute of Materials Physics, 077125 Magurele, Romania (G.E.S.)
| | - Gina Manda
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Cristiana Tanase
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
- Cajal Institute, Titu Maiorescu University, 004051 Bucharest, Romania
- Correspondence:
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Mohiuddin OA, Campbell B, Poche JN, Ma M, Rogers E, Gaupp D, Harrison MAA, Bunnell BA, Hayes DJ, Gimble JM. Decellularized Adipose Tissue Hydrogel Promotes Bone Regeneration in Critical-Sized Mouse Femoral Defect Model. Front Bioeng Biotechnol 2019; 7:211. [PMID: 31552237 PMCID: PMC6743019 DOI: 10.3389/fbioe.2019.00211] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 08/19/2019] [Indexed: 12/18/2022] Open
Abstract
Critical-sized bone defects fail to heal and often cause non-union. Standard treatments employ autologous bone grafting, which can cause donor tissue loss/pain. Although several scaffold types can enhance bone regeneration, multiple factors limit their level of success. To address this issue, this study evaluated a novel decellularized human adipose tissue (DAT) hydrogel as an alternative. In this study, DAT hydrogel alone, or in combination with adipose-derived stromal/stem cells (ASC), osteo-induced ASCs (OIASC), and hydroxyapatite were tested for their ability to mediate repair of a critical-sized (3 mm) femoral defect created in C57BL/6 mice. Micro-computed tomography results showed that all DAT hydrogel treated groups significantly enhanced bone regeneration, with OIASC + hydroxyapatite treated group displaying the most robust bone regeneration. Histological analyses revealed that all treatments resulted in significantly higher tissue areas with the relative mineralized tissue area significantly increased at 12 weeks; however, cartilaginous content was lowest among treatment groups with OIASC. Immunohistochemical analyses showed that DAT hydrogel enhanced collagen I and osteopontin expression, while the addition of OIASCs to the hydrogel reduced collagen II levels. Thus, DAT hydrogel promotes bone regeneration in a critical-sized femoral defect model that is further enhanced in the presence of OIASCs and hydroxyapatite.
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Affiliation(s)
- Omair A Mohiuddin
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, United States
| | - Brett Campbell
- School of Medicine, Tulane University, New Orleans, LA, United States
| | - J Nick Poche
- School of Medicine, Louisiana State University, New Orleans, LA, United States
| | - Michelle Ma
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, United States.,Obatala Sciences, New Orleans, LA, United States
| | - Emma Rogers
- Department of Biomedical Engineering, Tulane University, New Orleans, LA, United States
| | - Dina Gaupp
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, United States
| | - Mark A A Harrison
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, United States
| | - Bruce A Bunnell
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, United States
| | - Daniel J Hayes
- Department of Biomedical Engineering, Pennsylvania State University, State College, PA, United States
| | - Jeffrey M Gimble
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, United States.,LaCell LLC, New Orleans, LA, United States
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Maruyama M, Lin T, Pan CC, Moeinzadeh S, Takagi M, Yang YP, Goodman SB. Cell-Based and Scaffold-Based Therapies for Joint Preservation in Early-Stage Osteonecrosis of the Femoral Head. JBJS Rev 2019; 7:e5. [DOI: 10.2106/jbjs.rvw.18.00202] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Filho GC, de Sousa A, Viana R, Rocha H, de Medeiros SB, Moreira S. Osteogenic activity of non-genotoxic sulfated polysaccharides from the green seaweed Caulerpa sertularioides. ALGAL RES 2019. [DOI: 10.1016/j.algal.2019.101546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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48
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Wang L, Xu L, Peng C, Teng G, Wang Y, Xie X, Wu D. The effect of bone marrow mesenchymal stem cell and nano-hydroxyapatite/collagen I/poly-L-lactic acid scaffold implantation on the treatment of avascular necrosis of the femoral head in rabbits. Exp Ther Med 2019; 18:2021-2028. [PMID: 31452701 PMCID: PMC6704490 DOI: 10.3892/etm.2019.7800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 06/20/2019] [Indexed: 11/06/2022] Open
Abstract
For avascular necrosis of the femoral head (ANFH), repair and regeneration are difficult because of the edema and high pressure caused by continuous ischemia and hypoxia. Core decompression (CD) is a classic method for treating early ANFH before the collapse of the femoral head; however, its effect is still controversial. To improve the therapeutic effect of CD on ANFH, a novel tissue-engineered bone (TEB) was constructed by combining bone marrow mesenchymal stem cells (BMSCs) with nano-hydroxyapatite/collagen I/poly-L-lactic acid (nHAC/PLA) scaffolds and implanting the TEB into the bone tunnel of CD. Cell attachment was observed by scanning electron microscopy and hematoxylin and eosin staining. The authors' previous studies confirmed that nHAC/PLA is an excellent scaffold material with favorable biocompatibility and no cytotoxicity. A total of 24 New Zealand rabbits with ANFH were randomly divided into three groups, as follows: Group A (n=8), pure CD; group B (n=8), CD+nHAC/PLA; and group C (n=8), CD+BMSCs-nHAC/PLA. The favorable effect of BMSCs-nHAC/PLA on angiogenesis and bone formation in necrotic areas was further evaluated via radiographic and histological analyses. Computerized tomography (CT) scanning and H&E staining showed more capillaries and new osteoid tissue in group C compared with in groups B and A. Micro-CT showed that the new bone coverage rate and implanted material degradation degree were each increased in group C compared with in group B. These results indicate that BMSCs-nHAC/PLA scaffolds may improve the curative effect of CD and provide a strategy for treating ANFH.
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Affiliation(s)
- Le Wang
- Department of Spinal Surgery, Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China
| | - Leixin Xu
- Department of Orthopedics, The Fourth People's Hospital, Heze, Shandong 274100, P.R. China
| | - Changliang Peng
- Department of Spinal Surgery, Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China
| | - Guoxin Teng
- Department of Pathology, Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China
| | - Yu Wang
- Department of Radiology, Affiliated Hospital of Shandong Traditional Chinese Medicine University, Jinan, Shandong 250012, P.R. China
| | - Xiaoshuai Xie
- Department of Kidney Transplantation, Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China
| | - Dongjin Wu
- Department of Spinal Surgery, Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China
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Wang L, Zhang K, Hao Y, Liu M, Wu W. Osteoblast/bone-tissue responses to porous surface of polyetheretherketone-nanoporous lithium-doped magnesium silicate blends' integration with polyetheretherketone. Int J Nanomedicine 2019; 14:4975-4989. [PMID: 31371942 PMCID: PMC6626899 DOI: 10.2147/ijn.s197179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/14/2019] [Indexed: 01/12/2023] Open
Abstract
The porous surface of a polyetheretherketone (PK)-nanoporous lithium-doped magnesium silicate (NLS) blend (PKNLS) was fabricated on a PK surface by layer-by-layer pressuring, sintering, and salt-leaching. As controls, porous surfaces of a PK/lithium-doped magnesium silicate blend (PKLS) and PK were fabricated using the same method. The results revealed that porosity, water absorption, and protein absorption of the porous surface of PKNLS containing macropores and nanopores were obviously enhanced compared to PKLS and PK containing macropores without nanopores. In addition, PKNLS, with both macroporostiy and nanoporosity, displayed the highest ability of apatite mineralization in simulated body liquid, indicating excellent bioactivity. In vitro responses (including adhesion, proliferation, and differentiation) of MC3T3E1 cells to PKNLS were significantly enhanced compared to PKLS and PK. In vivo implantation results showed that new bone grew into the macroporous surface of PKNLS, and the amount of new bone for PKNLS was the highest. In short, PKNLS integration with PK significantly promoted cells/bone-tissue responses and exhibited excellent osteogenesis in vivo, which might have great potential for bone repair.
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Affiliation(s)
- Lei Wang
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai200011, People’s Republic of China
| | - Kai Zhang
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai200011, People’s Republic of China
| | - Yongqiang Hao
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai200011, People’s Republic of China
| | - Ming Liu
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai200011, People’s Republic of China
| | - Wen Wu
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai200011, People’s Republic of China
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Huang TB, Li YZ, Yu K, Yu Z, Wang Y, Jiang ZW, Wang HM, Yang GL. Effect of the Wnt signal-RANKL/OPG axis on the enhanced osteogenic integration of a lithium incorporated surface. Biomater Sci 2019; 7:1101-1116. [PMID: 30633253 DOI: 10.1039/c8bm01411f] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Bone remolding involves the formation of new bone by osteoblasts and the absorption of old bones by osteoclasts. Due to the vital role of osteoblasts and osteoclasts during bone regeneration, it might be feasible to promote osseointegration around the titanium implants by stimulating osteoblasts and inhibiting osteoclasts by modifying the surfaces of the implants. Lithium is used in the treatment of psychiatric patients, and it may be associated with osteogenesis. In this study, lithium was incorporated with sandblasted, large-grit and acid-etched titanium implants via a hydrothermal treatment. In vitro, the nano-scale surface enhanced the adhesion and proliferation of bone marrow mesenchymal stem cells (BMSCs). Moreover, the SLA-Li surface displayed a negative effect on the process of osteoclastogenesis. Further mechanism analysis indicated that the canonical Wnt/β-catenin signaling pathway was activated according to the results of RT-PCR and western blotting. More importantly, the RANKL/OPG signaling axis was also involved in these effects on the SLA-Li surface. The experiments in vivo proved that the SLA-Li surface could induce the bone formation and osseointegration during the early osseointegration after the dental implant surgery. These results suggested that bone homeostasis could be manipulated by an SLA-Li surface, which implied that this new surface might serve as a promising material for clinical application in the future.
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Affiliation(s)
- Ting-Ben Huang
- Department of Implantology, Stomatology Hospital, School of Medicine, Zhejiang University, Yan'an Road, Hangzhou, P. R. China.
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