Medical Application of Microbial Biopolyesters Polyhydroxyalkanoates

PHB+aPHA Blends: From Polymer Bacterial Synthesis through Blend Preparation to Final Processing by Extrusion for Sustainable Materials Design

The inherent brittleness of polyhydroxybutyrate (PHB), a well-studied polyhydroxyalkanoate (PHA), limits its applicability in flexible and impact-resistant applications. This study explores the potential of blending PHB with a different PHA to overcome brittleness. The synthesis of PHA polymers, including PHB and an amorphous medium-chain-length PHA (aPHA) consisting of various monomers, was achieved in previous works through canola oil fermentation. Detailed characterization of aPHA revealed its amorphous nature, as well as good thermal stability and shear thinning behavior. The blending process was carried out at different mass ratios of aPHA and PHB, and the resulting blends were studied by differential scanning calorimetry (DSC), X-ray diffraction (XRD), scanning electron microscopy (SEM), and thermogravimetric analysis (TGA). The blends exhibited complex DSC curves, indicating the presence of multiple crystalline forms of PHB. SEM images revealed the morphology of the blends, with PHB particles dispersed within the aPHA matrix. TGA showed similar thermal degradation patterns for the blends, with the residue content decreasing as the PHB content increased. The crystallinity of the blends was influenced by the PHB content, with higher PHB ratios resulting in an increased degree of crystallinity. XRD confirmed the presence of both α and β crystals of PHB in the blends. Overall, the results demonstrate the potential of PHB+aPHA blends to enhance the mechanical properties of biopolymer materials, without com-promising the thermal stability, paving the way for sustainable material design and novel application areas.

PHA is not just a bioplastic!

Polyhydroxyalkanoates (PHA) have evolved into versatile biopolymers, transcending their origins as mere bioplastics. This extensive review delves into the multifaceted landscape of PHA applications, shedding light on the diverse industries that have harnessed their potential. PHA has proven to be an invaluable eco-conscious option for packaging materials, finding use in films foams, paper coatings and even straws. In the textile industry, PHA offers a sustainable alternative, while its application as a carbon source for denitrification in wastewater treatment showcases its versatility in environmental remediation. In addition, PHA has made notable contributions to the medical and consumer sectors, with various roles ranging from 3D printing, tissue engineering implants, and cell growth matrices to drug delivery carriers, and cosmetic products. Through metabolic engineering efforts, PHA can be fine-tuned to align with the specific requirements of each industry, enabling the customization of material properties such as ductility, elasticity, thermal conductivity, and transparency. To unleash PHA's full potential, bridging the gap between research and commercial viability is paramount. Successful PHA production scale-up hinges on establishing direct supply chains to specific application domains, including packaging, food and beverage materials, medical devices, and agriculture. This review underscores that PHA's future rests on ongoing exploration across these industries and more, paving the way for PHA to supplant conventional plastics and foster a circular economy.

Biodegradable Polymers in Veterinary Medicine-A Review

During the past two decades, tremendous progress has been made in the development of biodegradable polymeric materials for various industrial applications, including human and veterinary medicine. They are promising alternatives to commonly used non-degradable polymers to combat the global plastic waste crisis. Among biodegradable polymers used, or potentially applicable to, veterinary medicine are natural polysaccharides, such as chitin, chitosan, and cellulose as well as various polyesters, including poly(ε-caprolactone), polylactic acid, poly(lactic-co-glycolic acid), and polyhydroxyalkanoates produced by bacteria. They can be used as implants, drug carriers, or biomaterials in tissue engineering and wound management. Their use in veterinary practice depends on their biocompatibility, inertness to living tissue, mechanical resistance, and sorption characteristics. They must be designed specifically to fit their purpose, whether it be: (1) facilitating new tissue growth and allowing for controlled interactions with living cells or cell-growth factors, (2) having mechanical properties that address functionality when applied as implants, or (3) having controlled degradability to deliver drugs to their targeted location when applied as drug-delivery vehicles. This paper aims to present recent developments in the research on biodegradable polymers in veterinary medicine and highlight the challenges and future perspectives in this area.

Combination of stem cells and nerve guide conduit for the treatment of peripheral nerve injury: A meta-analysis

INTRODUCTION/AIMS

Many small-sized, single-center preclinical studies have investigated the benefits of introducing stem cells into the interior of nerve conduit. The aims of this meta-analysis are to review and contrast the effects of various types of stem cells in in vivo models used to reconstruct peripheral nerve injuries (PNIs) and to assess the reliability and stability of the available evidence.

METHODS

A systematic search was conducted using Cochrane Library, Embase, PubMed, and Web of Science to identify studies conducted from January 1, 2000, to September 21, 2022, and investigate stem cell therapy in peripheral nerve reconstruction animal models. Studies that met the relevant criteria were deemed eligible for this meta-analysis.

RESULTS

Fifty-five preclinical studies with a total of 1234 animals were incorporated. Stem cells demonstrated a positive impact on peripheral nerve regeneration at different follow-up times in the forest plots of five outcome indicators: compound muscle action potential (CMAP) amplitude, latency, muscle mass ratio, nerve conduction velocity, and sciatic functional index (SFI). In most comparisons, stem cell groups showed substantial differences compared with the control groups. The superior performance of adipose-derived stem cells (ADSCs) in terms of SFI, CMAP amplitude, and latency (p < .001) was identified.

DISCUSSION

The findings consistently demonstrated a favorable outcome in the reconstruction process when utilizing different groups of stem cells, as opposed to control groups where stem cells were not employed.

Strategies for Development of Synthetic Heart Valve Tissue Engineering Scaffolds

The current clinical solutions, including mechanical and bioprosthetic valves for valvular heart diseases, are plagued by coagulation, calcification, nondurability, and the inability to grow with patients. The tissue engineering approach attempts to resolve these shortcomings by producing heart valve scaffolds that may deliver patients a life-long solution. Heart valve scaffolds serve as a three-dimensional support structure made of biocompatible materials that provide adequate porosity for cell infiltration, and nutrient and waste transport, sponsor cell adhesion, proliferation, and differentiation, and allow for extracellular matrix production that together contributes to the generation of functional neotissue. The foundation of successful heart valve tissue engineering is replicating native heart valve architecture, mechanics, and cellular attributes through appropriate biomaterials and scaffold designs. This article reviews biomaterials, the fabrication of heart valve scaffolds, and their in-vitro and in-vivo evaluations applied for heart valve tissue engineering.

Statistical optimization of P(3HB-co-3HHx) copolymers production by Cupriavidus necator PHB-4/pBBR_CnPro-phaCRp and its properties characterization

Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) [P(3HB-co-3HHx)] is a bacterial copolymer in the polyhydroxyalkanoates (PHAs) family, a next-generation bioplastic. Our research team recently engineered a newly P(3HB-co-3HHx)-producing bacterial strain, Cupriavidus necator PHB^-4/pBBR_CnPro-phaC_Rp. This strain can produce P(3HB-co-2 mol% 3HHx) using crude palm kernel oil (CPKO) as a sole carbon substrate. However, the improvement of P(3HB-co-3HHx) copolymer production by this strain has not been studied so far. Thus, this study aims to enhance the production of P(3HB-co-3HHx) copolymers containing higher 3HHx monomer compositions using response surface methodology (RSM). Three significant factors for P(3HB-co-3HHx) copolymers production, i.e., CPKO concentration, sodium hexanoate concentration, and cultivation time, were studied in the flask scale. As a result, a maximum of 3.6 ± 0.4 g/L of P(3HB-co-3HHx) with 4 mol% 3HHx compositions was obtained using the RSM optimized condition. Likewise, the higher 3HHx monomer composition (5 mol%) was obtained when scaling up the fermentation in a 10L-stirrer bioreactor. Furthermore, the produced polymer's properties were similar to marketable P(3HB-co-3HHx), making this polymer suitable for a wide range of applications.

Biodegradable Electrospun Scaffolds as an Emerging Tool for Skin Wound Regeneration: A Comprehensive Review

Skin is designed to protect various tissues, and because it is the largest and first human bodily organ to sustain damage, it has an incredible ability to regenerate. On account of extreme injuries or extensive surface loss, the normal injury recuperating interaction might be inadequate or deficient, bringing about risky and disagreeable circumstances that request the utilization of fixed adjuvants and tissue substitutes. Due to their remarkable biocompatibility, biodegradability, and bioactive abilities, such as antibacterial, immunomodulatory, cell proliferative, and wound mending properties, biodegradable polymers, both synthetic and natural, are experiencing remarkable progress. Furthermore, the ability to convert these polymers into submicrometric filaments has further enhanced their potential (e.g., by means of electrospinning) to impersonate the stringy extracellular grid and permit neo-tissue creation, which is a basic component for delivering a mending milieu. Together with natural biomaterial, synthetic polymers are used to solve stability problems and make scaffolds that can dramatically improve wound healing. Biodegradable polymers, commonly referred to as biopolymers, are increasingly used in other industrial sectors to reduce the environmental impact of material and energy usage as they are fabricated using renewable biological sources. Electrospinning is one of the best ways to fabricate nanofibers and membranes that are very thin and one of the best ways to fabricate continuous nanomaterials with a wide range of biological, chemical, and physical properties. This review paper concludes with a summary of the electrospinning (applied electric field, needle-to-collector distance, and flow rate), solution (solvent, polymer concentration, viscosity, and solution conductivity), and environmental (humidity and temperature) factors that affect the production of nanofibers and the use of bio-based natural and synthetic electrospun scaffolds in wound healing.

Polymer/Layered Clay/Polyurethane Nanocomposites: P3HB Hybrid Nanobiocomposites-Preparation and Properties Evaluation

This paper presents an attempt to improve the properties of poly(3-hydroxybutyrate) (P3HB) using linear aliphatic polyurethane (PU400) and organomodified montmorillonite (MMT)-(Cloisite^®30B). The nanostructure of hybrid nanobiocomposites produced by extrusion was analyzed by X-ray diffraction and transmission electron microscopy, and the morphology was analyzed by scanning electron microscopy. In addition, selected mechanical properties and thermal properties were studied by thermogravimetric analysis, TGA, and differential scanning calorimetry, DSC. The interactions of the composite ingredients were indicated by FT IR spectroscopy. The effect of the amount of nanofiller on the properties of prepared hybrid nanobiocomposites was noted. Moreover, the non-equilibrium and equilibrium thermal parameters of nanobiocomposites were established based on their thermal history. Based on equilibrium parameters (i.e., the heat of fusion for the fully crystalline materials and the change in the heat capacity at the glass transition temperature for the fully amorphous nanobiocomposites), the degree of crystallinity and the mobile and rigid amorphous fractions were estimated. The addition of Cloisite^®30B and aliphatic polyurethane to the P3HB matrix caused a decrease in the degree of crystallinity in reference to the unfilled P3HB. Simultaneously, an increase in the amorphous phase contents was noted. A rigid amorphous fraction was also denoted. Thermogravimetric analysis of the nanocomposites was also carried out and showed that the thermal stability of all nanocomposites was higher than that of the unfilled P3HB. An additional 1% mass of nanofiller increased the degradation temperature of the nanocomposites by about 30 °C in reference to the unfilled P3HB. Moreover, it was found that obtained hybrid nanobiocomposites containing 10 wt.% of aliphatic polyurethane (PU400) and the smallest amount of nanofiller (1 wt.% of Cloisite^®30B) showed the best mechanical properties. We observed a desirable decrease in hardness of 15%, an increase in the relative strain at break of 60% and in the impact strength of 15% of the newly prepared nanobiocomposites with respect to the unfiled P3HB. The produced hybrid nanobiocomposites combined the best features induced by the plasticizing effect of polyurethane and the formation of P3HB-montmorillonite-polyurethane (P3HB-PU-MMT) adducts, which resulted in the improvement of the thermal and mechanical properties.

4D Biofabrication of Mechanically Stable Tubular Constructs Using Shape Morphing Porous Bilayers for Vascularization Application

This study reports the fabrication of highly porous electrospun self-folding bilayers, which fold into tubular structures with excellent mechanical stability, allowing them to be easily manipulated and handled. Two kinds of bilayers based on biocompatible and biodegradable soft (PCL, polycaprolactone) and hard (PHB, poly-hydroxybutyrate) thermoplastic polymers have been fabricated and compared. Multi-scroll structures with tunable diameter are obtained after the shape transformation of the bilayer in aqueous media, where PCL-based bilayer rolled longitudinally and PHB-based one rolled transversely with respect to the fiber direction. A combination of higher elastic modulus and transverse orientation of fibers with respect to rolling direction allowed precise temporal control of shape transformation of PHB-bilayer - stress produced by swollen methacrylated hyaluronic acid (HA-MA) do not relax with time and folding is not affected by the fact that bilayer is fixed in unfolded state in cell culture medium for more than 1 h. This property of PHB-bilayer allowed cell culturing without a negative effect on its shape transformation ability. Moreover, PHB-based tubular structure demonstrated superior mechanical stability compared to PCL-based ones and do not collapse during manipulations that happened to PCL-based one. Additionally, PHB/HA-MA bilayers showed superior biocompatibility, degradability, and long-term stability compared to PCL/HA-MA.

Sustainable applications of polyhydroxyalkanoates in various fields: A critical review

PHA is one of the most promising candidates in bio-polymer family which is biodegradable and environment-friendly in nature. In recent years, it has been applied as a biodegradable alternative for petroleum-based plastic across different domains. In literature, several research groups have scrutinised the biocompatibility and biodegradability of PHA in both in vivo settings as well as in in vitro conditions. Microbial yield polyhydroxyalkanoates (PHAs) are promoted at present as biodegradable plastics. On the other hand, only a limited number of products is being commercially manufactured out of PHAs (e.g., bottles). A succession of microbes (prokaryotes in addition to eukaryotes) has been identified as potential candidates that can disintegrate PHAs. These materials have been successfully employed in packaging industry, medical devices and implants, moulded goods, paper coatings, adhesives, performance additives, mulch films, non-woven fabrics, etc. The present paper reviews and focuses on the potential applications of PHA and its derivatives in different industries.

Electrically Conductive Biocomposites Based on Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) and Wood-Derived Carbon Fillers

In this paper, biobased carbons were used as fillers in poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV). The mechanical and electrical properties of these 100% biocomposites were analyzed. First, biocarbons were prepared from wood dust and cellulose fibers using carbonization temperatures ranging 900–2300 °C. XRD revealed significant improvements of the graphitic structure with increasing temperatures for both precursors, with slightly higher ordering in wood-dust-based carbons. An increase of the carbon content with continuous removal of other elements was observed with increasing temperature. The carbonized cellulose fiber showed an accumulation of Na and O on the fiber surface at a carbonization temperature of 1500 °C. Significant degradation of PHBV was observed when mixed with this specific filler, which can, most probably, be attributed to this exceptional surface chemistry. With any other fillers, the preparation of injection-molded PHBV composites was possible without any difficulties. Small improvements in the mechanical performance were observed, with carbonized fibers being slightly superior to the wood dust analogues. Improvements at higher filler content were observed. These effects were even more pronounced in the electrical conductivity. In the range of 15–20 vol.% carbonized fibers, the percolation threshold could be reached, resulting in an electrical conductivity of 0.7 S/cm. For comparison, polypropylene composites were prepared using cellulose fibers carbonized at 2000 °C. Due to longer fibers retained in the composites, percolation could be reached in the range of 5–10 vol.%. The electrical conductivity was even higher compared to that of composites using commercial carbon fibers, showing a great potential for carbonized cellulose fibers in electrical applications.

3D Disease Modelling of Hard and Soft Cancer Using PHA-Based Scaffolds

Simple Summary

Tumour progression in vivo was able to be well mimicked in 3D culture by utilizing biodegradable 10 mm × 10 mm × 8 mm P(3HO-co-3HD) and P(3HB)-based 3D scaffolds with a pore size of 30 to 300 µm. Both hard (MCF7 and MDA-MB-231) and soft (HCT116) tumour-related cells were successfully grown on the scaffolds, and their growth patterns were studied for 5 days. MDA-MB-231 tend to grow in clusters, and MCF7 cells form an evenly dispersed layer, which covered most of the 3D PHA scaffolds, while HCT116 formed large colonies within the pockets of the 3D PHA scaffold. Epithelial mesenchymal transition (EMT) marker genes, including Wnt-11, E-cadherin, Vim and Snail expression profiles, were like those seen in real tumour samples, which confirmed that the cancer models were exhibiting real tumour-like characteristics with high fidelity. These models are important in mimicking hypoxic tumours and in studying gene expression, cellular signalling, angiogenesis and drug response for translational research.

Abstract

Tumour cells are shown to change shape and lose polarity when they are cultured in 3D, a feature typically associated with tumour progression in vivo, thus making it significant to study cancer cells in an environment that mimics the in vivo milieu. In this study we established hard (MCF7 and MDA-MB-231, breast cancer) and soft (HCT116, colon cancer) 3D cancer tumour models utilizing a blend of P(3HO-co-3HD) and P(3HB). P(3HO-co-3HD) and P(3HB) belong to a group of natural biodegradable polyesters, PHAs, that are synthesised by microorganisms. The 3D PHA scaffolds produced, with a pore size of 30 to 300 µm, allow for nutrients to diffuse within the scaffold and provide the cells with the flexibility to distribute evenly within the scaffold and grow within the pores. Interestingly, by Day 5, MDA-MB-231 showed dispersed growth in clusters, and MCF7 cells formed an evenly dispersed dense layer, while HCT116 formed large colonies within the pockets of the 3D PHA scaffolds. Our results show Epithelial Mesenchymal Transition (EMT) marker gene expression profiles in the hard tumour cancer models. In the 3D-based PHA scaffolds, MDA-MB-231 cells expressed higher levels of Wnt-11 and mesenchymal markers, such as Snail and its downstream gene Vim mRNAs, while MCF7 cells exhibited no change in their expression. On the other hand, MCF7 cells exhibited a significantly increased E-Cadherin expression as compared to MDA-MB-231 cells. The expression levels of EMT markers were comparative to their expression reported in the tumour samples, making them good representative of cancer models. In future these models will be helpful in mimicking hypoxic tumours, in studying gene expression, cellular signalling, angiogenesis and drug response more accurately than 2D and perhaps other 3D models.

Electrospun piezoelectric scaffolds for cardiac tissue engineering

The use of smart materials in tissue engineering is becoming increasingly appealing to provide additional functionalities and control over cell fate. The stages of tissue development and regeneration often require various electrical and electromechanical cues supported by the extracellular matrix, which is often neglected in most tissue engineering approaches. Particularly, in cardiac cells, electrical signals modulate cell activity and are responsible for the maintenance of the excitation-contraction coupling. Addition of electroconductive and topographical cues improves the biomimicry of cardiac tissues and plays an important role in driving cells towards the desired phenotype. Current platforms used to apply electrical stimulation to cells in vitro often require large external equipment and wires and electrodes immersed in the culture media, limiting the scalability and applicability of this process. Piezoelectric materials represent a shift in paradigm in materials and methods aimed at providing electrical stimulation to cardiac cells since they can produce and deliver electrical signals to cells and tissues by mechanoelectrical transduction. Despite the ability of piezoelectric materials to mimic the mechanoelectrical transduction of the heart, the use of these materials is limited in cardiac tissue engineering and methods to characterise piezoelectricity are often built in-house, which poses an additional difficulty when comparing results from the literature. In this work, we aim at providing an overview of the main challenges in cardiac tissue engineering and how piezoelectric materials could offer a solution to them. A revision on the existing literature in electrospun piezoelectric materials applied to cardiac tissue engineering is performed for the first time, as electrospinning plays an important role in the manufacturing of scaffolds with enhanced piezoelectricity and extracellular matrix native-like morphology. Finally, an overview of the current techniques used to evaluate piezoelectricity and their limitations is provided.

Finding of novel polyhydroxybutyrate producer Loktanella sp. SM43 capable of balanced utilization of glucose and xylose from lignocellulosic biomass

Polyhydroxybutyrate (PHB) is a potential substitute for plastics derived from fossil fuels, owing to its biodegradable and biocompatible properties. Lignocellulosic biomass could be used to reduce PHB production costs; however, the co-utilization of sugars, such as glucose and xylose, without catabolite repression is a difficult problem to be solved. Here, we selected a novel Loktanella sp. SM43 from a marine environment and optimized the conditions for PHB production. Loktanella sp. SM43 showed high PHB production (66.5% content) from glucose. When glucose and xylose were used together, this strain showed high utilization of both substrates compared to other high PHB-producers such as Halomonas sp. and Cupriavidus necator, which showed glucose preference. Loktanella sp. SM43 showed high growth and PHB production with lignocellulosic hydrolysates. When pine tree hydrolysates were used, PHB production was the highest at 3.66 ± 0.01 g/L, followed by Miscanthus (3.46 ± 0.09 g/L) and barley straw hydrolysate (3.36 ± 0.36 g/L). Overall, these results reveal the potential of Loktanella sp. SM43 to produce PHB using various lignocellulosic hydrolysates as feedstock and the first systematic study for PHB production with Loktanella sp. The approach of screening novel strains is a strategy to overcome co-utilization of sugars without genetic engineering.

Biomedical Applications of Polyhydroxyalkanoate in Tissue Engineering

Tissue engineering technology aids in the regeneration of new tissue to replace damaged or wounded tissue. Three-dimensional biodegradable and porous scaffolds are often utilized in this area to mimic the structure and function of the extracellular matrix. Scaffold material and design are significant areas of biomaterial research and the most favorable material for seeding of in vitro and in vivo cells. Polyhydroxyalkanoates (PHAs) are biopolyesters (thermoplastic) that are appropriate for this application due to their biodegradability, thermo-processability, enhanced biocompatibility, mechanical properties, non-toxicity, and environmental origin. Additionally, they offer enormous potential for modification through biological, chemical and physical alteration, including blending with various other materials. PHAs are produced by bacterial fermentation under nutrient-limiting circumstances and have been reported to offer new perspectives for devices in biological applications. The present review discusses PHAs in the applications of conventional medical devices, especially for soft tissue (sutures, wound dressings, cardiac patches and blood vessels) and hard tissue (bone and cartilage scaffolds) regeneration applications. The paper also addresses a recent advance highlighting the usage of PHAs in implantable devices, such as heart valves, stents, nerve guidance conduits and nanoparticles, including drug delivery. This review summarizes the in vivo and in vitro biodegradability of PHAs and conducts an overview of current scientific research and achievements in the development of PHAs in the biomedical sector. In the future, PHAs may replace synthetic plastics as the material of choice for medical researchers and practitioners.

Biomedical polymers: synthesis, properties, and applications

Biomedical polymers have been extensively developed for promising applications in a lot of biomedical fields, such as therapeutic medicine delivery, disease detection and diagnosis, biosensing, regenerative medicine, and disease treatment. In this review, we summarize the most recent advances in the synthesis and application of biomedical polymers, and discuss the comprehensive understanding of their property-function relationship for corresponding biomedical applications. In particular, a few burgeoning bioactive polymers, such as peptide/biomembrane/microorganism/cell-based biomedical polymers, are also introduced and highlighted as the emerging biomaterials for cancer precision therapy. Furthermore, the foreseeable challenges and outlook of the development of more efficient, healthier and safer biomedical polymers are discussed. We wish this systemic and comprehensive review on highlighting frontier progress of biomedical polymers could inspire and promote new breakthrough in fundamental research and clinical translation.

Scaffolds the backbone of tissue engineering: Advancements in use of polyhydroxyalkanoates (PHA)

Our body is built to heal from inside out naturally but wide-ranging medical conditions necessitate the need for artificial assistance, and therefore, something that can assist the body to heal wounds and damaged tissues quickly and efficiently is of utmost importance. Tissue engineering technology helps to regenerate new tissue to replace the diseased or injured one. The technology uses biodegradable porous three-dimensional scaffolds for mimicking the structure and functions of the natural extracellular matrix. The material and design of scaffolds are critical areas of biomaterial research. Biomaterial-based three-dimensional structures have been the most promising material to serve as scaffolds for seeding cells, both in vivo and in vitro. One such material is polyhydroxyalkanoates (PHAs) which are thermoplastic biopolyesters that are highly suitable for this purpose due to their enhanced biocompatibility, biodegradability, thermo-processability, diverse mechanical properties, non-toxicity and natural origin. Moreover, they have tremendous possibilities of customization through biological physical and chemical modification as well as blending with other materials. They are being used for several tissue engineering applications such as bone graft substitute, cardiovascular patches, stents, for nerve repair and in implantology as valves and sutures. The present review overviews usage of a multitude of PHA-based biomaterials for a wide range of tissue engineering applications, based on their properties suitable for the specific applications.

Polyhydroxyalkanoates (PHAs) as Biomaterials in Tissue Engineering: Production, Isolation, Characterization

Polyhydroxyalkanoates (PHAs) are biodegradable and biocompatible biopolymers. These biomaterials have grown in importance in the fields of tissue engineering and tissue reconstruction for structural applications where tissue morphology is critical, such as bone, cartilage, blood vessels, and skin, among others. Furthermore, they can be used to accelerate the regeneration in combination with drugs, as drug delivery systems, thus reducing microbial infections. When cells are cultured under stress conditions, a wide variety of microorganisms produce them as a store of intracellular energy in the form of homo- and copolymers of [R]—hydroxyalkanoic acids, depending on the carbon source used for microorganism growth. This paper gives an overview of PHAs, their biosynthetic pathways, producing microorganisms, cultivation bioprocess, isolation, purification and characterization to obtain biomaterials with medical applications such as tissue engineering.

Current Advances towards 4-Hydroxybutyrate Containing Polyhydroxyalkanoates Production for Biomedical Applications

Polyhydroxyalkanoates (PHA) are polyesters having high promise in biomedical applications. Among different types of PHA, poly-4-hydroxybutyrate (P4HB) is the only polymer that has received FDA approval for medical applications. However, most PHA producing microorganisms lack the ability to synthesize P4HB or PHA comprising 4-hydroxybutyrate (4HB) monomer due to their absence of a 4HB monomer supplying pathway. Thus, most microorganisms require supplementation of 4HB precursors to synthesize 4HB polymers. However, usage of 4HB precursors incurs additional production cost. Therefore, researchers have adopted strategies to reduce the cost, such as utilizing low-cost substrate as well as constructing 4HB monomer supplying pathways in microorganisms. We herein summarize the biomedical applications of P4HB, the natural producers of 4HB polymer, and the various strategies that have been applied in producing 4HB polymers in non-4HB producing microorganisms. It is expected that the readers would gain a vivid idea on the different strategic developments in the field of 4HB polymer production.

Obtaining Active Polylactide (PLA) and Polyhydroxybutyrate (PHB) Blends Based Bionanocomposites Modified with Graphene Oxide and Supercritical Carbon Dioxide (scCO2)-Assisted Cinnamaldehyde: Effect on Thermal-Mechanical, Disintegration and Mass Transport Properties

Bionanocomposites based on Polylactide (PLA) and Polyhydroxybutyrate (PHB) blends were successfully obtained through a combined extrusion and impregnation process using supercritical CO₂ (scCO₂). Graphene oxide (GO) and cinnamaldehyde (Ci) were incorporated into the blends as nano-reinforcement and an active compound, respectively, separately, and simultaneously. From the results, cinnamaldehyde quantification values varied between 5.7% and 6.1% (w/w). When GO and Ci were incorporated, elongation percentage increased up to 16%, and, therefore, the mechanical properties were improved, with respect to neat PLA. The results indicated that the Ci diffusion through the blends and bionanocomposites was influenced by the nano-reinforcing incorporation. The disintegration capacity of the developed materials decreased with the incorporation of GO and PHB, up to 14 and 23 days of testing, respectively, without compromising the biodegradability characteristics of the final material.

Development and Advantages of Biodegradable PHA Polymers Based on Electrospun PHBV Fibers for Tissue Engineering and Other Biomedical Applications

Biodegradable polymeric biomaterials offer a significant advantage in disposable or fast-consuming products in medical applications. Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) is an example of a polyhydroxyalkanoate (PHA), i.e., one group of natural polyesters that are byproducts of reactions taking place in microorganisms in conditions with an excess carbon source. PHA polymers are a promising material for the production of everyday materials and biomedical applications. Due to the high number of monomers in the group, PHAs permit modifications enabling the production of copolymers of different compositions and with different proportions of individual monomers. In order to change and improve the properties of polymer fibers, PHAs are combined with either other natural and synthetic polymers or additives of inorganic phases. Importantly, electrospun PHBV fibers and mats showed an enormous potential in both the medical field (tissue engineering scaffolds, plasters, wound healing, drug delivery systems) and industrial applications (filter systems, food packaging). This Review summarizes the current state of the art in processing PHBV, especially by electrospinning, its degradation processes, and biocompatibility studies, starting from a general introduction to the PHA group of polymers.

Additive manufacturing of polyhydroxyalkanoates (PHAs) biopolymers: Materials, printing techniques, and applications

Additive manufacturing (AM) is recently imposing as a fast, reliable, and highly flexible solution to process various materials, that range from metals to polymers, to achieve a broad variety of customized end-goods without involving the injection molding process. The employment of biomaterials is of utmost relevance as the environmental footprint of the process and, consequently, of the end-goods is significantly decreased. Additive manufacturing can provide, in particular, an all-in-one platform to fabricate complex-shaped biobased items such as bone implants or biomedical devices, that would be, otherwise, extremely troublesome and costly to achieve. Polyhydroxyalkanoates (PHAs) is an emerging class of biobased and biodegradable polymeric materials achievable by fermentation from bacteria. There are some promising scientific and technical reports on the manufacturing of several commodities in PHAs by additive manufacturing. However, many challenges must still be faced in order to expand further the use of PHAs. In this framework, the present work reviews and classifies the relevant papers focused on the design and development of PHAs for different 3D printing techniques and overviews the most recent applications of this approach.

A Review of the Applications and Biodegradation of Polyhydroxyalkanoates and Poly(lactic acid) and Its Composites

Overconsumption of plastic goods and improper handling of petroleum-derived plastic waste have brought a plethora of negative impacts to the environment, ecosystem and human health due to its recalcitrance to degradation. These drawbacks become the main driving force behind finding biopolymers with the degradable properties. With the advancement in biopolymer research, polyhydroxyalkanoate (PHA) and poly(lacyic acid) (PLA) and its composites have been alluded to as a potential alternative to replace the petrochemical counterpart. This review highlights the current synthesis process and application of PHAs and PLA and its composites for food packaging materials and coatings. These biopolymers can be further ameliorated to enhance their applicability and are discussed by including the current commercially available packaging products. Factors influencing biodegradation are outlined in the latter part of this review. The main aim of this review article is to organize the scattered available information on various aspects of PHAs and PLA, and its composites for packaging application purposes. It is evident from a literature survey of about 140 recently published papers from the past 15 years that PLA and PHA show excellent physical properties as potential food packaging materials.

Biomedical applications of environmental friendly poly-hydroxyalkanoates

Biological polyesters of hydroxyacids are known as polyhydroxyalkanoates (PHA). They have proved to be an alternative, environmentally friendly and attractive candidate for the replacement of petroleum-based plastics in many applications. Many bacteria synthesize these compounds as an intracellular carbon and energy compound usually under unbalanced growth conditions. Biodegradability and biocompatibility of different PHA has been studied in cell culture systems or in an animal host during the last few decades. Such investigations have proposed that PHA can be used as biomaterials for applications in conventional medical devices such as sutures, patches, meshes, implants, and tissue engineering scaffolds as well. Moreover, findings related to encapsulation capability and degradation kinetics of some PHA polymers has paved their way for development of controlled drug delivery systems. The present review discusses about bio-plastics, their characteristics, examines the key findings and recent advances highlighting the usage of bio-plastics in different medical devices. The patents concerning to PHA application in biomedical field have been also enlisted that will provide a brief overview of the status of research in bio-plastic. This would help medical researchers and practitioners to replace the synthetic plastics aids that are currently being used. Simultaneously, it could also prove to be a strong step in reducing the plastic pollution that surged abruptly due to the COVID-19 medical waste.

Production and characterization of polyhydroxyalkanoates from industrial waste using soil bacterial isolates

Nowadays when conventional plastic is being looked as a menace, the possibility of it being replaced with polyhydroxyalkanoates (PHAs) which are biodegradable, environment friendly and biocompatible thermoplastics is not remote. PHAs are a fascinating group of biopolyesters stored within the cytoplasm of numerous bacterial cells as energy and carbon reserves. PHAs signify the best promising biological substitute to certain conventional petrochemical plastics which have wide range of applications in different industries such as biomedical sector, packaging, toners for printing, and adhesives for coating, etc. In the present study, PHAs producing bacterial strains were screened by Sudan black B staining and confirmed by Nile blue A staining. Out of forty bacterial strains showing positive results, six bacterial strains exhibited comparatively higher PHAs production. The highest PHAs producing bacterial strain was identified using 16s rRNA sequencing. Optimization of process parameters was performed by using one factor at a time (OFAT) approach. The isolated bacterium was able to synthesize PHAs when various agro-industrial wastes such as domestic kitchen waste, mixed fruit pulp, sugarcane molasses, and waste flour from bread factory were screened as a carbon substrate in the growth medium. The results showed accumulation of 44.5% PHAs of cell dry weight using domestic kitchen waste as carbon substrate. The characterization of biopolymers was performed using FTIR and XRD analysis. The commercial exploitation of results of this study may serve twin purposes of addressing the challenge of high production cost of PHAs being the major constraint in replacing petro-based plastics as well as address the problem of disposal of recurring domestic kitchen waste and other agro-industrial waste.

Processability and Mechanical Properties of Thermoplastic Polylactide/Polyhydroxybutyrate (PLA/PHB) Bioblends

This work considers the application of eco-friendly, biodegradable materials based on polylactide (PLA) and polyhydroxybutyrate (PHB), instead of conventional polymeric materials, in order to prevent further environmental endangerment by accumulation of synthetic petro-materials. This new approach to the topic is focused on analyzing the processing properties of blends without incorporating any additives that could have a harmful impact on human organisms, including the endocrine system. The main aim of the research was to find the best PLA/PHB ratio to obtain materials with desirable mechanical, processing and application properties. Therefore, two-component polymer blends were prepared by mixing different mass ratios of PLA and PHB (100/0, 50/10, 50/20, 40/30, 50/50, 30/40, 20/50, 10/50 and 0/100 mass ratio) using an extrusion process. The prepared blends were analyzed in terms of thermal and mechanical properties as well as miscibility and surface characteristics. Taking into account the test results, the PLA/PHB blend with a 50/10 ratio turned out to be most suitable in terms of mechanical and processing properties. This blend has the potential to become a bio-based and simultaneously biodegradable material safe for human health dedicated for the packaging industry.

Improved fermentation strategies in a bioreactor for enhancing poly(3-hydroxybutyrate) (PHB) production by wild type Cupriavidus necator from fructose

Poly(3-hydroxybutyrate) (PHB) belongs to the family of polyhydroxyalkanoates, biopolymers used for agricultural, industrial, or even medical applications. However, scaling up the production is still an issue due to the myriad of parameters involved in the fermentation processes. The present work seeks, firstly, to scale up poly(3-hydroxybutyrate) (PHB) production by wild type C. necator ATCC 17697 from shaken flasks to a stirred-tank bioreactor with the optimized media and fructose as carbon source. The second purpose is to improve the production of PHB by applying both the batch and fed-batch fermentation strategies in comparison with previous works of wild type C. necator with fructose. Furthermore, thinking of biomedical applications, physicochemical, and cytotoxicity analyses of the produced biopolymer, are presented.

Fed-batch fermentation with an exponential feeding strategy enabled us to achieve the highest values of PHB concentration and productivity, 25.7 g/l and 0.43 g/(l h), respectively. The PHB productivity was 3.3 and 7.2 times higher than the one in batch strategy and shaken flask cultures, respectively. DSC, FTIR, ¹H, and ¹³C NMR analysis led to determine that the biopolymer produced by C. necator ATCC 17697 has a molecular structure and characteristics in agreement with the commercial PHB. Additionally, the biopolymer does not induce cytotoxic effects on the NIH/3T3 cell culture.

Due to the improved fermentation strategies, PHB concentration resulted in 40 % higher of the already reported one for wild type C. necator using other fed-batch modes and fructose as a carbon source. Thus the produced PHB could be attractive for biomedical applications, which generate a rising interest in polyhydroxyalkanoates during recent years.

3D-printed porous tantalum: recent application in various drug delivery systems to repair hard tissue defects

INTRODUCTION

The treatment of hard tissue defects, especially those of bone and cartilage, induced by infections or tumors remains challenging. Traditional methods, including debridement with systematic chemotherapy, have shortcomings owing to their inability to eliminate infections and high systematic toxicity.

AREA COVERED

This review comprehensively summarizes and discusses the current applications of 3D-printed porous tantalum (3D-P-p-Ta), a novel drug delivery strategy, in drug delivery systems to repair hard tissue defects, as well as the limitations of existing data and potential future research directions.

EXPERT OPINION

Drug delivery systems have advanced medical treatments, with the advantages of high local drug concentration, long drug-release period, and minimal systematic toxicity. Due to its excellent biocompatibility, ideal mechanical property, and anti-corrosion ability, porous tantalum is one of the most preferable loading scaffolds. 3D printing allows for freedom of design and facilitates the production of regular porous implants with high repeatability. There are several reports on the application of 3D-P-p-Ta in drug delivery systems for the management of infection- or tumor-associated bone defects, yet, to the best of our knowledge, no reviews have summarized the current research progress.

A Deep Neural Network for Accurate and Robust Prediction of the Glass Transition Temperature of Polyhydroxyalkanoate Homo- and Copolymers

The purpose of this study was to develop a data-driven machine learning model to predict the performance properties of polyhydroxyalkanoates (PHAs), a group of biosourced polyesters featuring excellent performance, to guide future design and synthesis experiments. A deep neural network (DNN) machine learning model was built for predicting the glass transition temperature, T_g, of PHA homo- and copolymers. Molecular fingerprints were used to capture the structural and atomic information of PHA monomers. The other input variables included the molecular weight, the polydispersity index, and the percentage of each monomer in the homo- and copolymers. The results indicate that the DNN model achieves high accuracy in estimation of the glass transition temperature of PHAs. In addition, the symmetry of the DNN model is ensured by incorporating symmetry data in the training process. The DNN model achieved better performance than the support vector machine (SVD), a nonlinear ML model and least absolute shrinkage and selection operator (LASSO), a sparse linear regression model. The relative importance of factors affecting the DNN model prediction were analyzed. Sensitivity of the DNN model, including strategies to deal with missing data, were also investigated. Compared with commonly used machine learning models incorporating quantitative structure-property (QSPR) relationships, it does not require an explicit descriptor selection step but shows a comparable performance. The machine learning model framework can be readily extended to predict other properties.

Gamma radiation-induced grafting of n-hydroxyethyl acrylamide onto poly(3-hydroxybutyrate): A companion study on its polyurethane scaffolds meant for potential skin tissue engineering applications

This study aimed at investigating the synthesis, characterization, and search for a biotechnological application proposal for poly [(R)-3-hydroxybutyric acid] (PHB) grafted with the n-hydroxyethyl acrylamide (HEAA) monomer. The novel copolymer was prepared by ⁶⁰Co gamma radiation-induced-graft polymerization. The effect of different solvents in the graft polymerization; the degree of grafting, crystallinity, and hydrophilicity; the morphology and the thermal properties were evaluated. The polyurethane fabricated from the grafted PHB was suggested as a scaffold. The enzymatic degradation behavior and the spectroscopic, morphological, mechanical, and biological properties of the composites were assessed. According to the results, the successful grafting of HEAA onto PHB was verified. The grafting was significantly affected by the type of solvent employed. A decreased crystallinity and increased hydrophilicity of the graft copolymer, concerning the PHB, was found. An increased roughness was observed in the morphology of the polymer after grafting. The thermodynamic parameters, except for the glass transition temperature, also decreased for the synthetic biopolymer. The intended use of these scaffolds for skin tissue engineering was supported by a proper degradability and degree of porosity, improved mechanical properties, the optimal culture of human fibroblasts, and its transfection with a plasmid vector containing an enhanced green fluorescent protein.

Natural-Based Biomaterials for Peripheral Nerve Injury Repair

Peripheral nerve injury treatment is a relevant problem because of nerve lesion high incidence and because of unsatisfactory regeneration after severe injuries, thus resulting in a reduced patient's life quality. To repair severe nerve injuries characterized by substance loss and to improve the regeneration outcome at both motor and sensory level, different strategies have been investigated. Although autograft remains the gold standard technique, a growing number of research articles concerning nerve conduit use has been reported in the last years. Nerve conduits aim to overcome autograft disadvantages, but they must satisfy some requirements to be suitable for nerve repair. A universal ideal conduit does not exist, since conduit properties have to be evaluated case by case; nevertheless, because of their high biocompatibility and biodegradability, natural-based biomaterials have great potentiality to be used to produce nerve guides. Although they share many characteristics with synthetic biomaterials, natural-based biomaterials should also be preferable because of their extraction sources; indeed, these biomaterials are obtained from different renewable sources or food waste, thus reducing environmental impact and enhancing sustainability in comparison to synthetic ones. This review reports the strengths and weaknesses of natural-based biomaterials used for manufacturing peripheral nerve conduits, analyzing the interactions between natural-based biomaterials and biological environment. Particular attention was paid to the description of the preclinical outcome of nerve regeneration in injury repaired with the different natural-based conduits.

Bio-Based Electrospun Fibers for Wound Healing

Being designated to protect other tissues, skin is the first and largest human body organ to be injured and for this reason, it is accredited with a high capacity for self-repairing. However, in the case of profound lesions or large surface loss, the natural wound healing process may be ineffective or insufficient, leading to detrimental and painful conditions that require repair adjuvants and tissue substitutes. In addition to the conventional wound care options, biodegradable polymers, both synthetic and biologic origin, are gaining increased importance for their high biocompatibility, biodegradation, and bioactive properties, such as antimicrobial, immunomodulatory, cell proliferative, and angiogenic. To create a microenvironment suitable for the healing process, a key property is the ability of a polymer to be spun into submicrometric fibers (e.g., via electrospinning), since they mimic the fibrous extracellular matrix and can support neo- tissue growth. A number of biodegradable polymers used in the biomedical sector comply with the definition of bio-based polymers (known also as biopolymers), which are recently being used in other industrial sectors for reducing the material and energy impact on the environment, as they are derived from renewable biological resources. In this review, after a description of the fundamental concepts of wound healing, with emphasis on advanced wound dressings, the recent developments of bio-based natural and synthetic electrospun structures for efficient wound healing applications are highlighted and discussed. This review aims to improve awareness on the use of bio-based polymers in medical devices.

Outcomes of a new slowly resorbable biosynthetic mesh (Phasix™) in potentially contaminated incisional hernias: A prospective, multi-center, single-arm trial

BACKGROUND

Resorbable biomaterials have been developed to reduce the amount of foreign material remaining in the body after hernia repair over the long-term. However, on the short-term, these resorbable materials should render acceptable results with regard to complications, infections, and reoperations to be considered for repair. Additionally, the rate of resorption should not be any faster than collagen deposition and maturation; leading to early hernia recurrence. Therefore, the objective of this study was to collect data on the short-term performance of a new resorbable biosynthetic mesh (Phasix™) in patients requiring Ventral Hernia Working Group (VHWG) Grade 3 midline incisional hernia repair.

MATERIALS AND METHODS

A prospective, multi-center, single-arm trial was conducted at surgical departments in 15 hospitals across Europe. Patients aged ≥18, scheduled to undergo elective Ventral Hernia Working Group Grade 3 hernia repair of a hernia larger than 10 cm² were included. Hernia repair was performed with Phasix™ Mesh in sublay position when achievable. The primary outcome was the rate of surgical site occurrence (SSO), including infections, that required intervention until 3 months after repair.

RESULTS

In total, 84 patients were treated with Phasix™ Mesh. Twenty-two patients (26.2%) developed 32 surgical site occurrences. These included 11 surgical site infections, 9 wound dehiscences, 7 seromas, 2 hematomas, 2 skin necroses, and 1 fistula. No significant differences in surgical site occurrence development were found between groups repaired with or without component separation technique, and between clean-contaminated or contaminated wound sites. At three months, there were no hernia recurrences.

CONCLUSION

Phasix™ Mesh demonstrated acceptable postoperative surgical site occurrence rates in patients with a Ventral Hernia Working Group Grade 3 hernia. Longer follow-up is needed to evaluate the recurrence rate and the effects on quality of life. This study is ongoing through 24 months of follow-up.

Prevention of excessive scar formation using nanofibrous meshes made of biodegradable elastomer poly(3-hydroxybutyrate-co-3-hydroxyvalerate)

To reduce excessive scarring in wound healing, electrospun nanofibrous meshes, composed of haloarchaea-produced biodegradable elastomer poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV), are fabricated for use as a wound dressing. Three PHBV polymers with different 3HV content are used to prepare either solution-cast films or electrospun nanofibrous meshes. As 3HV content increases, the crystallinity decreases and the scaffolds become more elastic. The nanofibrous meshes exhibit greater elasticity and elongation at break than films. When used to culture human dermal fibroblasts in vitro, PHBV meshes give better cell attachment and proliferation, less differentiation to myofibroblasts, and less substrate contraction. In a full-thickness mouse wound model, treatment with films or meshes enables regeneration of pale thin tissues without scabs, dehydration, or tubercular scar formation. The epidermis of wounds treated with meshes develop small invaginations in the dermis within 2 weeks, indicating hair follicle and sweat gland regeneration. Consistent with the in vitro results, meshes reduce myofibroblast differentiation in vivo through downregulation of α-SMA and TGF-β1, and upregulation of TGF-β3. The regenerated wounds treated with meshes are softer and more elastic than those treated with films. These results demonstrate that electrospun nanofibrous PHBV meshes mitigate excessive scar formation by regulating myofibroblast formation, showing their promise for use as wound dressings.

Enzymatic Hydrolysis of Poly(3-Hydroxybutyrate-co-3-Hydroxyvalerate) Scaffolds

Polyhydroxyalkanoates (PHAs) are hydrolyzable bio-polyesters. The possibility of utilizing lignocellulosic waste by-products and grape pomace as carbon sources for PHA biosynthesis was investigated. PHAs were biosynthesized by employing Cupriavidus necator grown on fructose (PHBV-1) or grape sugar extract (PHBV-2). Fifty grams of lyophilized grape sugar extract contained 19.2 g of glucose, 19.1 g of fructose, 2.7 g of pectin, 0.52 g of polyphenols, 0.51 g of flavonoids and 7.97 g of non-identified rest compounds. The grape sugar extract supported the higher production of biomass and modified the composition of PHBV-2. The biosynthesized PHAs served as matrices for the preparation of the scaffolds. The PHBV-2 scaffolds had about 44.2% lower crystallinity compared to the PHBV-1 scaffolds. The degree of crystallinity markedly influenced the mechanical behavior and enzymatic hydrolysis of the PHA scaffolds in the synthetic gastric juice and phosphate buffer saline solution with the lipase for 81 days. The higher proportion of amorphous moieties in PHBV-2 accelerated enzymatic hydrolysis. After 81-days of lasting enzymatic hydrolysis, the morphological changes of the PHBV-1 scaffolds were negligible compared to the visible destruction of the PHBV-2 scaffolds. These results indicated that the presence of pectin and phenolic moieties in PHBV may markedly change the semi-crystalline character of PHBV, as well as its mechanical properties and the course of abiotic or enzymatic hydrolysis.

Poly(4-Hydroxybutyrate): Current State and Perspectives

By the end of 1980s, for the first time polyhydroxyalkanoate (PHA) copolymers with incorporated 4-hydroxybutyrate (4HB) units were produced in the bacterium Cupriavidus necator (formally Ralstonia eutropha) from structurally related carbon sources. After that, production of PHA copolymers composed of 3-hydroxybutyrate (3HB) and 4HB [P(3HB-co-4HB)] was demonstrated in diverse wild-type bacteria. The P4HB homopolymer, however, was hardly synthesized because existing bacterial metabolism on 4HB precursors also generate and incorporate 3HB. The resulting material assumes the properties of thermoplastics and elastomers depending on the 4HB fraction in the copolyester. Given the fact that P4HB is biodegradable and yield 4HB, which is a normal compound in the human body and proven to be biocompatible, P4HB has become a prospective material for medical applications, which is the only FDA approved PHA for medical applications since 2007. Different from other materials used in similar applications, high molecular weight P4HB cannot be produced via chemical synthesis. Thus, aiming at the commercial production of this type of PHA, genetic engineering was extensively applied resulting in various production strains, with the ability to convert unrelated carbon sources (e.g., sugars) to 4HB, and capable of producing homopolymeric P4HB. In 2001, Metabolix Inc. filed a patent concerning genetically modified and stable organisms, e.g., Escherichia coli, producing P4HB and copolymers from inexpensive carbon sources. The patent is currently hold by Tepha Inc., the only worldwide producer of commercial P4HB. To date, numerous patents on various applications of P4HB in the medical field have been filed. This review will comprehensively cover the historical evolution and the most recent publications on P4HB biosynthesis, material properties, and industrial and medical applications. Finally, perspectives for the research and commercialization of P4HB will be presented.

Increased Staphylococcus aureus Biofilm Formation on Biodegradable Poly(3-Hydroxybutyrate)-Implants Compared with Conventional Orthopedic Implants: An In Vitro Analysis

OBJECTIVE

To compare the biofilm formation on a biodegradable material, poly(3-hydroxybutyrate) (PHB), with that on conventional titanium (Ti) and steel (St) implant material.

METHODS

Pins made of the different materials were incubated in Müller-Hinton broth inoculated with 2 × 10 colony-forming units (CFU)·mL of Staphylococcus aureus for 2 and 7 days and then sonicated for the disruption of the biofilms. CFU were counted to quantify the number of bacteria in the biofilm, and the cell proliferation assay 2,3-Bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H- tetrazolium-5-carboxanilid salt was used to evaluate their metabolic activity. Scanning electron microscopy visualized the structure of the biofilm.

RESULTS

We found a significantly higher metabolic activity and CFU count in the biofilm of PHB pins compared with St and Ti pins (analysis of variance, P < 0.0001). Scanning electron microscopy revealed structured biofilms on PHB pins already after 2 days of incubation, which was not observed on the other tested implants.

CONCLUSION

PHB implants seem to provide an environment that advantages the formation of biofilms of S. aureus, a common pathogen in implant-related infections. The amount of biofilm is higher on PHB implant compared with conventionally used orthopedic titanium and steel implants. To overcome the potential risk of surgical site infections linked to the clinical use of PHB implants, possible modifications of the material, increasing its antibacterial properties, need to be further investigated.

Conjugating biomaterials with photosensitizers: advances and perspectives for photodynamic antimicrobial chemotherapy

Antimicrobial resistance is threatening to overshadow last century's medical advances. Previously eradicated infectious diseases are now resurgent as multi-drug resistant strains, leading to expensive, toxic and, in some cases, ineffective antimicrobial treatments. Given this outlook, researchers are willing to investigate novel antimicrobial treatments that may be able to deal with antimicrobial resistance, namely photodynamic therapy (PDT). PDT relies on the generation of toxic reactive oxygen species (ROS) in the presence of light and a photosensitizer (PS) molecule. PDT has been known for almost a century, but most of its applications have been directed towards the treatment of cancer and topical diseases. Unlike classical antimicrobial chemotherapy treatments, photodynamic antimicrobial chemotherapy (PACT) has a non-target specific mechanism of action, based on the generation of ROS, working against cellular membranes, walls, proteins, lipids and nucleic acids. This non-specific mechanism diminishes the chances of bacteria developing resistance. However, PSs usually are large molecules, prone to aggregation, diminishing their efficiency. This review will report the development of materials obtained from natural sources, as delivery systems for photosensitizing molecules against microorganisms. The present work emphasizes on the biological results rather than on the synthesis routes to prepare the conjugates. Also, it discusses the current state of the art, providing our perspective on the field.

Piezoelectric Scaffolds as Smart Materials for Neural Tissue Engineering

Injury to the central or peripheral nervous systems leads to the loss of cognitive and/or sensorimotor capabilities, which still lacks an effective treatment. Tissue engineering in the post-injury brain represents a promising option for cellular replacement and rescue, providing a cell scaffold for either transplanted or resident cells. Tissue engineering relies on scaffolds for supporting cell differentiation and growth with recent emphasis on stimuli responsive scaffolds, sometimes called smart scaffolds. One of the representatives of this material group is piezoelectric scaffolds, being able to generate electrical charges under mechanical stimulation, which creates a real prospect for using such scaffolds in non-invasive therapy of neural tissue. This paper summarizes the recent knowledge on piezoelectric materials used for tissue engineering, especially neural tissue engineering. The most used materials for tissue engineering strategies are reported together with the main achievements, challenges, and future needs for research and actual therapies. This review provides thus a compilation of the most relevant results and strategies and serves as a starting point for novel research pathways in the most relevant and challenging open questions.

Facile Preparation of Porous Microfiber from Poly-3-(R)-Hydroxybutyrate and Its Application

In this study, we described the development of a simplified wet spinning method of the production of a novel type of porous continuous fiber based on poly-3-(R)-hydroxybutyrate (PHB). The principle of this method is precipitation of PHB dissolved in chloroform solution into the ethanol precipitation bath. The influence of various PHB concentrations and feed rates on specific surface area (measured by nitrogen absorption method) was studied. Materials were also characterized by SEM. Surface areas of fibers achieved by wet spinning were in the range of tens of m².g^-1, and the biggest surface area value was 55 m².g^-1. The average diameter of fibers was in the range of 20-120 μm and was dependent on both PHB concentration and feed rate. Optimum conditions for reaching stable fibers of high surface area were 3-5 % w.t. of PHB and feed rate 0.5-3 ml.h^-1. Fibers were functionalized by adsorption of some natural plant extracts. The incorporation of active substances into fibers was confirmed by infrared spectroscopy. High antioxidant and antimicrobial effect of PHB-fibers with cloves extract was found, as well as excellent long-term stability and optimal dynamics of the release of active compounds. The newly produced material would be applicable in pharmacy, cosmetics, and wound healing.

Poly hydroxyalkanoates (PHA): Role in bone scaffolds

Polyhydroxyalkanoates (PHA) are prokaryotic macromolecules accumulated within the cytoplasm as granules. Due to their suitable mechanical properties, biocompatibility, degradation time, ability to be blended, surface modified, and form copolymers, it is widely used in medical devices and as scaffolds in bone tissue engineering. This review describes in brief the production and extraction sources, physico-chemical characteristic, mechanical properties, degradation rate and applications of various PHAs and its copolymers with special emphasis to its role as scaffolds in bone tissue engineering.

Antimicrobial PHAs coatings for solid and porous tantalum implants

Biomaterial-associated infections (BAI) are the major cause of failure of indwelling medical devices. The risk of BAI can end dramatically in the surgical removal of the affected device. Therefore, a major effort must be undertaken to guarantee the permanence of the implant. In this regard, we have developed antimicrobial coatings for tantalum (Ta) implants, using polyhydroxyalkanoates (PHAs) as matrices for carrying an active principle. The dip-coating technique was successfully used for covering solid Ta discs. An original PHA emulsion flow process was developed for the coating of porous Ta structures, specially for the inner surfaces. The complete characterization of the biopolymer coatings, their antibacterial properties, toxicity and biointegration were analyzed. Thus, non-toxic, well-biointegrated homogeneous biopolymer coatings were attained, which showed antibacterial properties. By using biodegradable PHAs, the resulting drug delivery system assured the protection of Ta against bacterial infections for a period of time.

PHBV/MWCNT Films: Hydrophobicity, Thermal and Mechanical Properties as a Function of MWCNT Concentration

The introduction of multi-walled carbon nanotubes (MWCNTs) into polymer matrixes has been an important tool to alter and improve some properties in polymer nanocomposites, including biodegradable polymers such as poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV). In this work, PHBV nanocomposites with 0.05, 0.50, 1.00, 1.50 and 2.00 wt % of MWCNTs were produced by solvent casting. MWCNT morphology and structure were characterized by Raman spectroscopy, and transmission electron microscopy (TEM). It was observed that MWCNTs have a considerable amount of amorphous carbon (AC) onto their surface and a wide distribution of the tube diameter. MWCNTs act as the nucleating agent in the PHBV matrix, as verified by differential scanning calorimetry (DSC). Thermogravimetric analysis (TGA) showed that thermal stability was not significantly affected. The nanofiller dispersion into the PHBV matrix was not effective for concentrations from 1 wt % according to the micrographs obtained in scanning electron microscopy (SEM). The contact angle was changed with the introduction of MWCNTs, turning the nanocomposites hydrophobic and improving the mechanical tensile properties of the PHBV matrix.

A post-market, prospective, multi-center, single-arm clinical investigation of Phasix™ mesh for VHWG grade 3 midline incisional hernia repair: a research protocol

Background

Incisional heia is a frequent complication of midline laparotomy. The use of mesh in hernia repair has been reported to lead to fewer recurrences compared to primary repair. However, in Ventral Hernia Working Group (VHWG) Grade 3 hernia patients, whose hernia is potentially contaminated, synthetic mesh is prone to infection. There is a strong preference for resorbable biological mesh in contaminated fields, since it is more able to resist infection, and because it is fully resorbed, the chance of a foreign body reaction is reduced. However, when not crosslinked, biological resorbable mesh products tend to degrade too quickly to facilitate native cellular ingrowth. Phasix™ Mesh is a biosynthetic mesh with both the biocompatibility and resorbability of a biological mesh and the mechanical strength of a synthetic mesh. This multi-center single-arm study aims to collect data on safety and performance of Phasix™ Mesh in Grade 3 hernia patients.

Methods

A total of 85 VHWG Grade 3 hernia patients will be treated with Phasix™ Mesh in 15 sites across Europe. The primary outcome is Surgical Site Occurrence (SSO) including hematoma, seroma, infection, dehiscence and fistula formation (requiring intervention) through 3 months. Secondary outcomes include recurrence, infection and quality of life related outcomes after 24 months. Follow-up visits will be at drain removal (if drains were not placed, then on discharge or staple removal instead) and in the 1st, 3rd, 6th, 12th, 18th and 24th month after surgery.

Conclusion

Based on evidence from this clinical study Depending on the results this clinical study will yield, Phasix™ Mesh may become a preferred treatment option in VHWG Grade 3 patients.

Trial registration

The trial was registered on March 25, 2016 on clinicaltrials.gov: NCT02720042.