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Kruse HV, Chakraborty S, Chen R, Kumar N, Yasir M, Lewin WT, Suchowerska N, Willcox MDP, McKenzie DR. Protecting Orthopaedic Implants from Infection: Antimicrobial Peptide Mel4 Is Non-Toxic to Bone Cells and Reduces Bacterial Colonisation When Bound to Plasma Ion-Implanted 3D-Printed PAEK Polymers. Cells 2024; 13:656. [PMID: 38667271 PMCID: PMC11049013 DOI: 10.3390/cells13080656] [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: 01/11/2024] [Revised: 03/21/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Even with the best infection control protocols in place, the risk of a hospital-acquired infection of the surface of an implanted device remains significant. A bacterial biofilm can form and has the potential to escape the host immune system and develop resistance to conventional antibiotics, ultimately causing the implant to fail, seriously impacting patient well-being. Here, we demonstrate a 4 log reduction in the infection rate by the common pathogen S. aureus of 3D-printed polyaryl ether ketone (PAEK) polymeric surfaces by covalently binding the antimicrobial peptide Mel4 to the surface using plasma immersion ion implantation (PIII) treatment. The surfaces with added texture created by 3D-printed processes such as fused deposition-modelled polyether ether ketone (PEEK) and selective laser-sintered polyether ketone (PEK) can be equally well protected as conventionally manufactured materials. Unbound Mel4 in solution at relevant concentrations is non-cytotoxic to osteoblastic cell line Saos-2. Mel4 in combination with PIII aids Saos-2 cells to attach to the surface, increasing the adhesion by 88% compared to untreated materials without Mel4. A reduction in mineralisation on the Mel4-containing surfaces relative to surfaces without peptide was found, attributed to the acellular portion of mineral deposition.
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Affiliation(s)
- Hedi Verena Kruse
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Missenden Road, Camperdown, Sydney, NSW 2050, Australia;
- School of Physics, The University of Sydney, Sydney, NSW 2006, Australia;
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Missenden Road, Camperdown, Sydney, NSW 2050, Australia
| | - Sudip Chakraborty
- School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia (R.C.); (N.K.)
| | - Renxun Chen
- School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia (R.C.); (N.K.)
| | - Naresh Kumar
- School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia (R.C.); (N.K.)
| | - Muhammad Yasir
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2052, Australia; (M.Y.); (M.D.P.W.)
| | - William T. Lewin
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Missenden Road, Camperdown, Sydney, NSW 2050, Australia;
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Missenden Road, Camperdown, Sydney, NSW 2050, Australia
- School of Medical Sciences, The University of Sydney, Sydney, NSW 2006, Australia
| | | | - Mark D. P. Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2052, Australia; (M.Y.); (M.D.P.W.)
| | - David R. McKenzie
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Missenden Road, Camperdown, Sydney, NSW 2050, Australia;
- School of Physics, The University of Sydney, Sydney, NSW 2006, Australia;
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Missenden Road, Camperdown, Sydney, NSW 2050, Australia
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Karthik C, Sarngadharan SC, Thomas V. Low-Temperature Plasma Techniques in Biomedical Applications and Therapeutics: An Overview. Int J Mol Sci 2023; 25:524. [PMID: 38203693 PMCID: PMC10779006 DOI: 10.3390/ijms25010524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/04/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Plasma, the fourth fundamental state of matter, comprises charged species and electrons, and it is a fascinating medium that is spread over the entire visible universe. In addition to that, plasma can be generated artificially under appropriate laboratory techniques. Artificially generated thermal or hot plasma has applications in heavy and electronic industries; however, the non-thermal (cold atmospheric or low temperature) plasma finds its applications mainly in biomedicals and therapeutics. One of the important characteristics of LTP is that the constituent particles in the plasma stream can often maintain an overall temperature of nearly room temperature, even though the thermal parameters of the free electrons go up to 1 to 10 keV. The presence of reactive chemical species at ambient temperature and atmospheric pressure makes LTP a bio-tolerant tool in biomedical applications with many advantages over conventional techniques. This review presents some of the important biomedical applications of cold-atmospheric plasma (CAP) or low-temperature plasma (LTP) in modern medicine, showcasing its effect in antimicrobial therapy, cancer treatment, drug/gene delivery, tissue engineering, implant modifications, interaction with biomolecules, etc., and overviews some present challenges in the field of plasma medicine.
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Affiliation(s)
- Chandrima Karthik
- Department of Materials & Mechanical Engineering, University of Alabama at Birmingham, 1150 10th Avenue South, Birmingham, AL 35205, USA;
| | | | - Vinoy Thomas
- Department of Materials & Mechanical Engineering, University of Alabama at Birmingham, 1150 10th Avenue South, Birmingham, AL 35205, USA;
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Khallaf RM, Emam AN, Mostafa AA, Nassif MS, Hussein TS. Strength and bioactivity of PEEK composites containing multiwalled carbon nanotubes and bioactive glass. J Mech Behav Biomed Mater 2023; 144:105964. [PMID: 37336042 DOI: 10.1016/j.jmbbm.2023.105964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/04/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
Polyetheretherketone (PEEK) polymer is a widely accepted implantable biomaterial in the biomedical field. However, PEEK has a low elastic modulus (E-modulus) as well as a bio-inert nature which is not conductive to rapid bone cell attachment, hence, producing delayed or weak bone-implant integration. Multiwalled carbon nanotubes (MWCNTs) represent one of the strongest known materials that could be added to a polymer to improve its mechanical properties. Bioactive glasses (BGs) can form hydroxyapatite deposits on their surfaces and form a tight bond with the bone, thus, their incorporation into the PEEK matrix may improve its bioactivity. METHODS Eight groups were formulated according to the type and percentage of modification of PEEK by MWCNTs and BGs. Group 1: Pure PEEK (P), Group 2: P + 3% MWCNTs (PC3), Group 3: P + 5% MWCNTs (PC5), Group 4: P + 5% BGs (PG5), Group 5: P + 10% BGs (PG10), Group 6: P + 3% MWCNTs + 5% BGs (PC3G5), Group 7: P + 3% MWCNTs + 10% BGs (PC3G10), and Group 8: P + 5% MWCNTs + 5% BGs (PC5G5). Characterization of the vacuum-pressed PEEK and PEEK composite specimens was done using FE-SEM, EDS, FT-IR and TF-XRD. Three-point load test was done to obtain the flexural strength (F.S) and the E-modulus of the specimens. Wettability was determined by measuring the contact angle with distilled water. In-vitro bioactivity was determined after immersion of specimens in simulated body fluid (SBF). Moreover, the effect of the specimens on osteoblastic cell viability was evaluated. RESULTS Three-point load test results have shown an improvement in both F.S. and E-modulus for groups PC5, PC3G5 and PC5G5. The lowest contact angle was obtained for group PC5G5 followed by the PC3G10 group. All specimens containing BGs showed the formation of hydroxyapatite-like deposits after their immersion in SBF, as well as an improvement in osteoblastic cell viability compared to PEEK. CONCLUSION PC3G10, PC3G5 and PG10, groups are promising for the fabrication of patient-specific implants that can be used in low-stress-bearing areas.
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Affiliation(s)
- Reem Magdy Khallaf
- Ain-Shams University, Department of Dental Biomaterials, 11566, Cairo, Egypt.
| | - Ahmed N Emam
- Refractories, Ceramics & Building Materials, Advanced Materials Technology and Mineral Resources Research Institute, National Research Centre (NRC), 12622, Dokki, Cairo, Egypt; Nanomedicine & Tissue Engineering Research Lab., MRCE, National Research Centre (NRC), 12622, Dokki, Cairo, Egypt
| | - Amany A Mostafa
- Refractories, Ceramics & Building Materials, Advanced Materials Technology and Mineral Resources Research Institute, National Research Centre (NRC), 12622, Dokki, Cairo, Egypt; Nanomedicine & Tissue Engineering Research Lab., MRCE, National Research Centre (NRC), 12622, Dokki, Cairo, Egypt.
| | | | - Tarek Salah Hussein
- Ain-Shams University, Department of Dental Biomaterials, 11566, Cairo, Egypt
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Surface Treatments of PEEK for Osseointegration to Bone. Biomolecules 2023; 13:biom13030464. [PMID: 36979399 PMCID: PMC10046336 DOI: 10.3390/biom13030464] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Polymers, in general, and Poly (Ether-Ether-Ketone) (PEEK) have emerged as potential alternatives to conventional osseous implant biomaterials. Due to its distinct advantages over metallic implants, PEEK has been gaining increasing attention as a prime candidate for orthopaedic and dental implants. However, PEEK has a highly hydrophobic and bioinert surface that attenuates the differentiation and proliferation of osteoblasts and leads to implant failure. Several improvements have been made to the osseointegration potential of PEEK, which can be classified into three main categories: (1) surface functionalization with bioactive agents by physical or chemical means; (2) incorporation of bioactive materials either as surface coatings or as composites; and (3) construction of three-dimensionally porous structures on its surfaces. The physical treatments, such as plasma treatments of various elements, accelerated neutron beams, or conventional techniques like sandblasting and laser or ultraviolet radiation, change the micro-geometry of the implant surface. The chemical treatments change the surface composition of PEEK and should be titrated at the time of exposure. The implant surface can be incorporated with a bioactive material that should be selected following the desired use, loading condition, and antimicrobial load around the implant. For optimal results, a combination of the methods above is utilized to compensate for the limitations of individual methods. This review summarizes these methods and their combinations for optimizing the surface of PEEK for utilization as an implanted biomaterial.
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Poly (Ether-Ether-Ketone) for Biomedical Applications: From Enhancing Bioactivity to Reinforced-Bioactive Composites-An Overview. Polymers (Basel) 2023; 15:polym15020373. [PMID: 36679253 PMCID: PMC9861117 DOI: 10.3390/polym15020373] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/21/2022] [Accepted: 12/24/2022] [Indexed: 01/13/2023] Open
Abstract
The global orthopedic market is forecasted to reach US$79.5 billion by the end of this decade. Factors driving the increase in this market are population aging, sports injury, road traffic accidents, and overweight, which justify a growing demand for orthopedic implants. Therefore, it is of utmost importance to develop bone implants with superior mechanical and biological properties to face the demand and improve patients' quality of life. Today, metallic implants still hold a dominant position in the global orthopedic implant market, mainly due to their superior mechanical resistance. However, their performance might be jeopardized due to the possible release of metallic debris, leading to cytotoxic effects and inflammatory responses in the body. Poly (ether-ether-ketone) (PEEK) is a biocompatible, high-performance polymer and one of the most prominent candidates to be used in manufacturing bone implants due to its similarity to the mechanical properties of bone. Unfortunately, the bioinert nature of PEEK culminates in its diminished osseointegration. Notwithstanding, PEEK's bioactivity can be improved through surface modification techniques and by the development of bioactive composites. This paper overviews the advantages of using PEEK for manufacturing implants and addresses the most common strategies to improve the bioactivity of PEEK in order to promote enhanced biomechanical performance.
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Rendas P, Figueiredo L, Machado C, Mourão A, Vidal C, Soares B. Mechanical performance and bioactivation of 3D-printed PEEK for high-performance implant manufacture: a review. Prog Biomater 2022; 12:89-111. [PMID: 36496542 PMCID: PMC10154446 DOI: 10.1007/s40204-022-00214-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/03/2022] [Indexed: 12/14/2022] Open
Abstract
Polyetheretherketone (PEEK) has stood out as the leading high-performance thermoplastic for the replacement of metals in orthopaedic, trauma and spinal implant applications due to its high biocompatibility and mechanical properties. Despite its potential for custom-made medical devices, 3D-printed PEEK's mechanical performance depends on processing parameters and its bioinertness may hinder bone opposition to the implant. Concerning these challenges, this review focuses on the available literature addressing the improvement of the mechanical performance of PEEK processed through "fused filament fabrication" (FFF) along with literature on bioactivation of PEEK for improved osseointegration. The reviewed research suggests that improvements can be achieved in mechanical performance of 3D-printed PEEK with adequate FFF parametrization while different bioactivation techniques can be used to improve the bioperformance of 3D-printed PEEK. The adequate approaches towards these procedures can increase PEEK's potential for the manufacture of high-performance custom-made implantable devices that display improved bone-implant integration and prevent stress shielding of the treated bone.
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Al Maruf DSA, Ghosh YA, Xin H, Cheng K, Mukherjee P, Crook JM, Wallace GG, Klein TJ, Clark JR. Hydrogel: A Potential Material for Bone Tissue Engineering Repairing the Segmental Mandibular Defect. Polymers (Basel) 2022; 14:polym14194186. [PMID: 36236133 PMCID: PMC9571534 DOI: 10.3390/polym14194186] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Free flap surgery is currently the only successful method used by surgeons to reconstruct critical-sized defects of the jaw, and is commonly used in patients who have had bony lesions excised due to oral cancer, trauma, infection or necrosis. However, donor site morbidity remains a significant flaw of this strategy. Various biomaterials have been under investigation in search of a suitable alternative for segmental mandibular defect reconstruction. Hydrogels are group of biomaterials that have shown their potential in various tissue engineering applications, including bone regeneration, both through in vitro and in vivo pre-clinical animal trials. This review discusses different types of hydrogels, their fabrication techniques, 3D printing, their potential for bone regeneration, outcomes, and the limitations of various hydrogels in preclinical models for bone tissue engineering. This review also proposes a modified technique utilizing the potential of hydrogels combined with scaffolds and cells for efficient reconstruction of mandibular segmental defects.
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Affiliation(s)
- D S Abdullah Al Maruf
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
- Correspondence:
| | - Yohaann Ali Ghosh
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
| | - Hai Xin
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
| | - Kai Cheng
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local, Camperdown 2050, Australia
| | - Payal Mukherjee
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local, Camperdown 2050, Australia
| | - Jeremy Micah Crook
- Biomedical Innovation, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- ARC Centre of Excellence for Electromaterials Science, The University of Wollongong, Wollongong 2522, Australia
- Intelligent Polymer Research Institute, AIIM Facility, The University of Wollongong, Wollongong 2522, Australia
- Illawarra Health and Medical Research Institute, The University of Wollongong, Wollongong 2522, Australia
| | - Gordon George Wallace
- ARC Centre of Excellence for Electromaterials Science, The University of Wollongong, Wollongong 2522, Australia
- Intelligent Polymer Research Institute, AIIM Facility, The University of Wollongong, Wollongong 2522, Australia
| | - Travis Jacob Klein
- Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove 4059, Australia
| | - Jonathan Robert Clark
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local, Camperdown 2050, Australia
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Application of biomolecules modification strategies on PEEK and its composites for osteogenesis and antibacterial properties. Colloids Surf B Biointerfaces 2022; 215:112492. [PMID: 35430485 DOI: 10.1016/j.colsurfb.2022.112492] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/24/2022] [Accepted: 04/04/2022] [Indexed: 12/24/2022]
Abstract
As orthopedic and dental implants, polyetheretherketone (PEEK) is expected to be a common substitute material of titanium (Ti) and its alloys due to its good biocompatibility, chemical stability, and elastic modulus close to that of bone tissue. It could avoid metal allergy and bone resorption caused by the stress shielding effect of Ti implants, widely studied in the medical field. However, the lack of biological activity is not conducive to the clinical application of PEEK implants. Therefore, the surface modification of PEEK has increasingly become one of the research hotspots. Researchers have explored various biomolecules modification methods to effectively enhance the osteogenic and antibacterial activities of PEEK and its composites. Therefore, this review mainly summarizes the recent research of PEEK modified by biomolecules and discusses the further research directions to promote the clinical transformation of PEEK implants.
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Han X, Sharma N, Spintzyk S, Zhou Y, Xu Z, Thieringer FM, Rupp F. Tailoring the biologic responses of 3D printed PEEK medical implants by plasma functionalization. Dent Mater 2022; 38:1083-1098. [PMID: 35562293 DOI: 10.1016/j.dental.2022.04.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The objective of this study was to determine the effect of two plasma surface treatments on the biologic responses of PEEK medical implants manufactured by fused filament fabrication (FFF) 3D printing technology. METHODS This study created standard PEEK samples using an FFF 3D printer. After fabrication, half of the samples were polished to simulate a smooth PEEK surface. Then, argon (Ar) or oxygen (O2) plasma was used to modify the bioactivity of FFF 3D printed and polished PEEK samples. Scanning electron microscopy (SEM) and a profilometer were used to determine the microstructure and roughness of the sample surfaces. The wettability of the sample surface was assessed using a drop shape analyzer (DSA) after plasma treatment and at various time points following storage in a closed environment. Cell adhesion, metabolic activity, proliferation, and osteogenic differentiation of SAOS-2 osteoblasts were evaluated to determine the in vitro osteogenic activity. RESULTS SEM analysis revealed that several spherical nanoscale particles and humps appeared on sample surfaces following plasma treatment. The wettability measurement demonstrated that plasma surface treatment significantly increased the surface hydrophilicity of PEEK samples, with only a slight aging effect found after 21 days. Cell adhesion, spreading, proliferation, and differentiation of SAOS-2 osteoblasts were also up-regulated after plasma treatment. Additionally, PEEK samples treated with O2 plasma demonstrated a higher degree of bioactivation than those treated with Ar. SIGNIFICANCE Plasma-modified PEEK based on FFF 3D printing technology was a feasible and prospective bone grafting material for bone/dental implants.
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Affiliation(s)
- Xingting Han
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Technology of Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing 100081, PR China; University Hospital Tübingen, Section Medical Materials Science and Technology, Osianderstr. 2-8, Tübingen D-72076, Germany.
| | - Neha Sharma
- Medical Additive Manufacturing Research Group, Hightech Research Center, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland; Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.
| | - Sebastian Spintzyk
- University Hospital Tübingen, Section Medical Materials Science and Technology, Osianderstr. 2-8, Tübingen D-72076, Germany; ADMiRE Lab - Additive Manufacturing, intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, Villach, Austria.
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Technology of Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing 100081, PR China.
| | - Zeqian Xu
- University Hospital Tübingen, Section Medical Materials Science and Technology, Osianderstr. 2-8, Tübingen D-72076, Germany; Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, PR China.
| | - Florian M Thieringer
- Medical Additive Manufacturing Research Group, Hightech Research Center, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland; Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.
| | - Frank Rupp
- University Hospital Tübingen, Section Medical Materials Science and Technology, Osianderstr. 2-8, Tübingen D-72076, Germany.
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Chen J, Cao G, Li L, Cai Q, Dunne N, Li X. Modification of polyether ether ketone for the repairing of bone defects. Biomed Mater 2022; 17. [PMID: 35395651 DOI: 10.1088/1748-605x/ac65cd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/08/2022] [Indexed: 11/12/2022]
Abstract
Bone damage as a consequence of disease or trauma is a common global occurrence. For bone damage treatment - bone implant materials are necessary across three classifications of surgical intervention (i.e. fixation, repair, and replacement). Many types of bone implant materials have been developed to meet the requirements of bone repair. Among them, polyether ether ketone (PEEK) has been considered as one of the next generation of bone implant materials, owing to its advantages related to good biocompatibility, chemical stability, X-ray permeability, elastic modulus comparable to natural bone, as well as the ease of processing and modification. However, as PEEK is a naturally bioinert material, some modification is needed to improve its integration with adjacent bones after implantation. Therefore, it has become a very hot topic of biomaterials research and various strategies for the modification of PEEK including blending, 3D printing, coating, chemical modification and the introduction of bioactive and/or antibacterial substances have been proposed. In this systematic review, the recent advances in modification of PEEK and its application prospect as bone implants are summarized, and the remaining challenges are also discussed.
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Affiliation(s)
- Junfeng Chen
- Beihang University, 37 Xueyuan Rd, Haidian District, Beijing, Beijing, 100083, CHINA
| | - Guangxiu Cao
- Beihang University, 37 Xueyuan Rd, Haidian District, Beijing, Beijing, 100083, CHINA
| | - Linhao Li
- Beihang University, 37 Xueyuan Rd, Haidian District, Beijing, 100083, CHINA
| | - Qiang Cai
- Tsinghua University Department of Materials Science and Engineering, 30 shuangqing Rd, Haidian District, Beijing, Beijing, 100084, CHINA
| | - Nicholas Dunne
- School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin 9, Dublin, D09, IRELAND
| | - Xiaoming Li
- Biological Science and Medical Engineering, Beihang University, 37 Xueyuan Rd, Haidian District, Beijing, Beijing, 100083, CHINA
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Al Maruf DSA, Parthasarathi K, Cheng K, Mukherjee P, McKenzie DR, Crook JM, Wallace GG, Clark JR. Current and future perspectives on biomaterials for segmental mandibular defect repair. INT J POLYM MATER PO 2022. [DOI: 10.1080/00914037.2022.2052729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- D S Abdullah Al Maruf
- Craniomaxillofacial Prosthetic and Advanced Reconstructive Translational Surgery, Chris O’Brien Lifehouse, Camperdown, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Krishnan Parthasarathi
- Craniomaxillofacial Prosthetic and Advanced Reconstructive Translational Surgery, Chris O’Brien Lifehouse, Camperdown, Australia
| | - Kai Cheng
- Craniomaxillofacial Prosthetic and Advanced Reconstructive Translational Surgery, Chris O’Brien Lifehouse, Camperdown, Australia
- The Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, Australia
| | - Payal Mukherjee
- Craniomaxillofacial Prosthetic and Advanced Reconstructive Translational Surgery, Chris O’Brien Lifehouse, Camperdown, Australia
- The Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, Australia
| | - David R. McKenzie
- Biomedical Innovation, Chris O’Brien Lifehouse, Camperdown, Australia
- School of Physics, Faculty of Science, The University of Sydney, Camperdown, Australia
| | - Jeremy M. Crook
- Biomedical Innovation, Chris O’Brien Lifehouse, Camperdown, Australia
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Camperdown, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, The University of Wollongong, Wollongong, Australia
- Illawarrah Health and Medical Research Institute, The University of Wollongong, Wollongong, Australia
| | - Gordon G. Wallace
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, The University of Wollongong, Wollongong, Australia
| | - Jonathan R. Clark
- Craniomaxillofacial Prosthetic and Advanced Reconstructive Translational Surgery, Chris O’Brien Lifehouse, Camperdown, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
- The Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, Australia
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Roohani I, Yeo GC, Mithieux SM, Weiss AS. Emerging concepts in bone repair and the premise of soft materials. Curr Opin Biotechnol 2021; 74:220-229. [PMID: 34974211 DOI: 10.1016/j.copbio.2021.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 02/07/2023]
Abstract
Human bone has a strong regenerative capacity that allows for restoration of its function and structure after damage. For degenerative bone diseases or large defects, bone regeneration requirements exceed the natural potential for self-healing, so bone grafts or bone substitute materials are required to support the regeneration of bone tissue. Compared to the plethora of endogenous bioactive molecules and cells in native bone grafts, the regenerative capacity of tissue-engineered materials is limited. The modest clinical impact of tissue-engineered strategies in this domain can be attributed to a failure to fully recognize key physical and biological events during bone healing, and to recapitulate the structure and composition of the target tissue to generate truly biomimetic grafts. This limitation has motivated the emergence of new strategies such as immunomodulation, endochondral ossification routes, engineered microtissues and hematoma regulation, and the development of advanced biomaterials including gene-activated matrices, soft microgels and hierarchically designed materials.
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Affiliation(s)
- Iman Roohani
- School of Life and Environmental Sciences, University of Sydney, NSW 2006, Australia; Charles Perkins Centre D17, University of Sydney, NSW 2006, Australia; Sydney Nano Institute, University of Sydney, NSW 2006, Australia
| | - Giselle C Yeo
- School of Life and Environmental Sciences, University of Sydney, NSW 2006, Australia; Charles Perkins Centre D17, University of Sydney, NSW 2006, Australia
| | - Suzanne M Mithieux
- School of Life and Environmental Sciences, University of Sydney, NSW 2006, Australia; Charles Perkins Centre D17, University of Sydney, NSW 2006, Australia
| | - Anthony S Weiss
- School of Life and Environmental Sciences, University of Sydney, NSW 2006, Australia; Charles Perkins Centre D17, University of Sydney, NSW 2006, Australia; Sydney Nano Institute, University of Sydney, NSW 2006, Australia.
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Chandrasekar K, Farrugia BL, Johnson L, Marks D, Irving D, Elgundi Z, Lau K, Kim HN, Rnjak‐Kovacina J, Bilek MM, Whitelock JM, Lord MS. Effect of Recombinant Human Perlecan Domain V Tethering Method on Protein Orientation and Blood Contacting Activity on Polyvinyl Chloride. Adv Healthc Mater 2021; 10:e2100388. [PMID: 33890424 DOI: 10.1002/adhm.202100388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/06/2021] [Indexed: 12/23/2022]
Abstract
Surface modification of biomaterials is a promising approach to control biofunctionality while retaining the bulk biomaterial properties. Perlecan is the major proteoglycan in the vascular basement membrane that supports low levels of platelet adhesion but not activation. Thus, perlecan is a promising bioactive for blood-contacting applications. This study furthers the mechanistic understanding of platelet interactions with perlecan by establishing that platelets utilize domains III and V of the core protein for adhesion. Polyvinyl chloride (PVC) is functionalized with recombinant human perlecan domain V (rDV) to explore the effect of the tethering method on proteoglycan orientation and bioactivity. Tethering of rDV to PVC is achieved via either physisorption or covalent attachment via plasma immersion ion implantation (PIII) treatment. Both methods of rDV tethering reduce platelet adhesion and activation compared to the pristine PVC, however, the mechanisms are unique for each tethering method. Physisorption of rDV on PVC orientates the molecule to hinder access to the integrin-binding region, which inhibits platelet adhesion. In contrast, PIII treatment orientates rDV to allow access to the integrin-binding region, which is rendered antiadhesive to platelets via the glycosaminoglycan (GAG) chain. These effects demonstrate the potential of rDV biofunctionalization to modulate platelet interactions for blood contacting applications.
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Affiliation(s)
| | - Brooke L. Farrugia
- Department of Biomedical Engineering Melbourne School of Engineering The University of Melbourne Melbourne VIC 3010 Australia
| | - Lacey Johnson
- Australian Red Cross Lifeblood Alexandria NSW 2015 Australia
| | - Denese Marks
- Australian Red Cross Lifeblood Alexandria NSW 2015 Australia
| | - David Irving
- Australian Red Cross Lifeblood Alexandria NSW 2015 Australia
| | - Zehra Elgundi
- Graduate School of Biomedical Engineering UNSW Sydney Sydney NSW 2052 Australia
| | - Kieran Lau
- Graduate School of Biomedical Engineering UNSW Sydney Sydney NSW 2052 Australia
| | - Ha Na Kim
- Graduate School of Biomedical Engineering UNSW Sydney Sydney NSW 2052 Australia
| | | | - Marcela M. Bilek
- The Charles Perkins Centre University of Sydney Sydney NSW 2006 Australia
- The University of Sydney Nano Institute University of Sydney Sydney NSW 2006 Australia
- School of Physics University of Sydney Sydney NSW 2006 Australia
- School of Biomedical Engineering University of Sydney Sydney NSW 2006 Australia
| | - John M. Whitelock
- Graduate School of Biomedical Engineering UNSW Sydney Sydney NSW 2052 Australia
| | - Megan S. Lord
- Graduate School of Biomedical Engineering UNSW Sydney Sydney NSW 2052 Australia
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14
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Salva ML, Rocca M, Niemeyer CM, Delamarche E. Methods for immobilizing receptors in microfluidic devices: A review. MICRO AND NANO ENGINEERING 2021. [DOI: 10.1016/j.mne.2021.100085] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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15
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Gu X, Sun X, Sun Y, Wang J, Liu Y, Yu K, Wang Y, Zhou Y. Bioinspired Modifications of PEEK Implants for Bone Tissue Engineering. Front Bioeng Biotechnol 2021; 8:631616. [PMID: 33511108 PMCID: PMC7835420 DOI: 10.3389/fbioe.2020.631616] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/10/2020] [Indexed: 12/15/2022] Open
Abstract
In recent years, polyetheretherketone (PEEK) has been increasingly employed as an implant material in clinical applications. Although PEEK is biocompatible, chemically stable, and radiolucent and has an elastic modulus similar to that of natural bone, it suffers from poor integration with surrounding bone tissue after implantation. To improve the bioactivity of PEEK, numerous strategies for functionalizing the PEEK surface and changing the PEEK structure have been proposed. Inspired by the components, structure, and function of bone tissue, this review discusses strategies to enhance the biocompatibility of PEEK implants and provides direction for fabricating multifunctional implants in the future.
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Affiliation(s)
| | | | | | | | | | | | | | - Yanmin Zhou
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, Changchun, China
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16
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Tan RP, Hallahan N, Kosobrodova E, Michael PL, Wei F, Santos M, Lam YT, Chan AHP, Xiao Y, Bilek MMM, Thorn P, Wise SG. Bioactivation of Encapsulation Membranes Reduces Fibrosis and Enhances Cell Survival. ACS APPLIED MATERIALS & INTERFACES 2020; 12:56908-56923. [PMID: 33314916 DOI: 10.1021/acsami.0c20096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Encapsulation devices are an emerging barrier technology designed to prevent the immunorejection of replacement cells in regenerative therapies for intractable diseases. However, traditional polymers used in current devices are poor substrates for cell attachment and induce fibrosis upon implantation, impacting long-term therapeutic cell viability. Bioactivation of polymer surfaces improves local host responses to materials, and here we make the first step toward demonstrating the utility of this approach to improve cell survival within encapsulation implants. Using therapeutic islet cells as an exemplar cell therapy, we show that internal surface coatings improve islet cell attachment and viability, while distinct external coatings modulate local foreign body responses. Using plasma surface functionalization (plasma immersion ion implantation (PIII)), we employ hollow fiber semiporous poly(ether sulfone) (PES) encapsulation membranes and coat the internal surfaces with the extracellular matrix protein fibronectin (FN) to enhance islet cell attachment. Separately, the external fiber surface is coated with the anti-inflammatory cytokine interleukin-4 (IL-4) to polarize local macrophages to an M2 (anti-inflammatory) phenotype, muting the fibrotic response. To demonstrate the power of our approach, bioluminescent murine islet cells were loaded into dual FN/IL-4-coated fibers and evaluated in a mouse back model for 14 days. Dual FN/IL-4 fibers showed striking reductions in immune cell accumulation and elevated levels of the M2 macrophage phenotype, consistent with the suppression of fibrotic encapsulation and enhanced angiogenesis. These changes led to markedly enhanced islet cell survival and importantly to functional integration of the implant with the host vasculature. Dual FN/IL-4 surface coatings drive multifaceted improvements in islet cell survival and function, with significant implications for improving clinical translation of therapeutic cell-containing macroencapsulation implants.
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Affiliation(s)
- Richard P Tan
- Department of Physiology, School of Medical Sciences, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, John Hopkins Drive, Camperdown, NSW 2006, Australia
| | - Nicole Hallahan
- Department of Physiology, School of Medical Sciences, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, John Hopkins Drive, Camperdown, NSW 2006, Australia
| | - Elena Kosobrodova
- Applied Plasma and Physics, A28, School of Physics, University of Sydney, Physics Road, Camperdown, NSW 2006, Australia
| | - Praveesuda L Michael
- Department of Physiology, School of Medical Sciences, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, John Hopkins Drive, Camperdown, NSW 2006, Australia
| | - Fei Wei
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4000, Australia
| | - Miguel Santos
- Department of Physiology, School of Medical Sciences, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, John Hopkins Drive, Camperdown, NSW 2006, Australia
| | - Yuen Ting Lam
- Department of Physiology, School of Medical Sciences, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, John Hopkins Drive, Camperdown, NSW 2006, Australia
| | - Alex H P Chan
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA 94305, United States
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4000, Australia
| | - Marcela M M Bilek
- Applied Plasma and Physics, A28, School of Physics, University of Sydney, Physics Road, Camperdown, NSW 2006, Australia
| | - Peter Thorn
- Department of Physiology, School of Medical Sciences, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, John Hopkins Drive, Camperdown, NSW 2006, Australia
| | - Steven G Wise
- Department of Physiology, School of Medical Sciences, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, John Hopkins Drive, Camperdown, NSW 2006, Australia
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Rahmati M, Silva EA, Reseland JE, A Heyward C, Haugen HJ. Biological responses to physicochemical properties of biomaterial surface. Chem Soc Rev 2020; 49:5178-5224. [PMID: 32642749 DOI: 10.1039/d0cs00103a] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Biomedical scientists use chemistry-driven processes found in nature as an inspiration to design biomaterials as promising diagnostic tools, therapeutic solutions, or tissue substitutes. While substantial consideration is devoted to the design and validation of biomaterials, the nature of their interactions with the surrounding biological microenvironment is commonly neglected. This gap of knowledge could be owing to our poor understanding of biochemical signaling pathways, lack of reliable techniques for designing biomaterials with optimal physicochemical properties, and/or poor stability of biomaterial properties after implantation. The success of host responses to biomaterials, known as biocompatibility, depends on chemical principles as the root of both cell signaling pathways in the body and how the biomaterial surface is designed. Most of the current review papers have discussed chemical engineering and biological principles of designing biomaterials as separate topics, which has resulted in neglecting the main role of chemistry in this field. In this review, we discuss biocompatibility in the context of chemistry, what it is and how to assess it, while describing contributions from both biochemical cues and biomaterials as well as the means of harmonizing them. We address both biochemical signal-transduction pathways and engineering principles of designing a biomaterial with an emphasis on its surface physicochemistry. As we aim to show the role of chemistry in the crosstalk between the surface physicochemical properties and body responses, we concisely highlight the main biochemical signal-transduction pathways involved in the biocompatibility complex. Finally, we discuss the progress and challenges associated with the current strategies used for improving the chemical and physical interactions between cells and biomaterial surface.
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Affiliation(s)
- Maryam Rahmati
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317 Oslo, Norway. h.j.haugen.odont.uio.no
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Buck E, Li H, Cerruti M. Surface Modification Strategies to Improve the Osseointegration of Poly(etheretherketone) and Its Composites. Macromol Biosci 2019; 20:e1900271. [DOI: 10.1002/mabi.201900271] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/18/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Emily Buck
- Department of Mining and Materials EngineeringMcGill University 3610 University Street Montreal QC H3A 0C5 Canada
| | - Hao Li
- Department of Mining and Materials EngineeringMcGill University 3610 University Street Montreal QC H3A 0C5 Canada
| | - Marta Cerruti
- Department of Mining and Materials EngineeringMcGill University 3610 University Street Montreal QC H3A 0C5 Canada
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19
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Abstract
Human bones have unique structures and characteristics, and replacing a natural bone in the case of bone fracture or bone diseases is a very complicated problem. The main goal of this paper was to summarize the recent research on polymer materials as bone substitutes and for bone repair. Bone treatment methods, bone substitute materials as well as their advantages and drawbacks, and manufacturing methods were reviewed. Biopolymers are the most promising materials in the field of artificial bones and using biopolymers with the shape memory effect can improve the integration of an artificial bone into the human body by better mimicking the structure and properties of natural bones, decreasing the invasiveness of surgical procedures by producing deployable implants. It has been shown that the application of the rapid prototyping technology for artificial bones allows the customization of bone substitutes for a patient and the creation of artificial bones with a complex structure.
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Affiliation(s)
- Anastasiia Kashirina
- Department of Astronautical Science and Mechanics, Harbin Institute of Technology, PO Box 301, No. 92 West Dazhi Street, Harbin 150001, China
| | - Yongtao Yao
- National Key Laboratory of Science and Technology on Advanced Composites in Special Environments, Harbin Institute of Technology, No. 2 YiKuang Street, Harbin 150080, China.
| | - Yanju Liu
- Department of Astronautical Science and Mechanics, Harbin Institute of Technology, PO Box 301, No. 92 West Dazhi Street, Harbin 150001, China
| | - Jinsong Leng
- National Key Laboratory of Science and Technology on Advanced Composites in Special Environments, Harbin Institute of Technology, No. 2 YiKuang Street, Harbin 150080, China.
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Enhanced biocompatibility of polyurethane-type shape memory polymers modified by plasma immersion ion implantation treatment and collagen coating: An in vivo study. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 99:863-874. [PMID: 30889761 DOI: 10.1016/j.msec.2019.02.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/06/2019] [Accepted: 02/10/2019] [Indexed: 01/23/2023]
Abstract
As one of the promising smart materials, polyurethane-type shape memory polymers (SMPU) have been extensively investigated as potential biomedical implant materials. However, the hydrophobicity and bio-inertness of SMPU are major problems for biomedical applications. We applied plasma immersion ion implantation (PIII) to increase surface wettability and enable one-step covalent, functionalisation of SMPU with biological molecules to create a tuneable, biocompatible surface. The changes of surface properties due to PIII treatment in nitrogen plasma were determined by measurements of morphology, contact angle, surface energy, and nanoindentation. Collagen attachment on SMPU with and without PIII treatment was measured by Attenuated total reflectance-Fourier transform infrared (ATR-FTIR). To investigate in vivo biocompatibility, SMPU with/without PIII and with/without collagen were subcutaneously implanted in mice. SMPU implants with surrounding tissue were collected at days 1, 3, 7, 14 and 28 to study acute/subacute inflammatory responses at histopathological and immunohistochemical levels. The results show that PIII treatment improves wettability and releases residual stress in the SMPU surfaces substantially. Covalent attachment of collagen on PIII treated SMPU in a single step incubation was demonstrated by its resistance to removal by rigorous Sodium Dodecyl Sulfonate (SDS) washing. The in-vivo results showed significantly lower acute/subacute inflammation in response to SMPU with PIII treatment + collagen coating compared to untreated SMPU, collagen coated untreated SMPU, and PIII treated SMPU, characterised by lower total cell numbers, macrophages, neovascularisation, cellular proliferation, cytokine production, and matrix metalloproteinase production. This comprehensive in vivo study of PIII treatment with protein coating demonstrates that the combination of PIII treatment and collagen coating is a promising approach to enhance the biocompatibility of SMPU, facilitating its application as an implantable biomaterial.
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