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Waidi YO, Debnath S, Datta S, Chatterjee K. 3D-Printed Silk Proteins for Bone Tissue Regeneration and Associated Immunomodulation. Biomacromolecules 2024; 25:5512-5540. [PMID: 39133748 DOI: 10.1021/acs.biomac.4c00540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
Current bone repair methods have limitations, prompting the exploration of innovative approaches. Tissue engineering emerges as a promising solution, leveraging biomaterials to craft scaffolds replicating the natural bone environment, facilitating cell growth and differentiation. Among fabrication techniques, three-dimensional (3D) printing stands out for its ability to tailor intricate scaffolds. Silk proteins (SPs), known for their mechanical strength and biocompatibility, are an excellent choice for engineering 3D-printed bone tissue engineering (BTE) scaffolds. This article comprehensively reviews bone biology, 3D printing, and the unique attributes of SPs, specifically detailing criteria for scaffold fabrication such as composition, structure, mechanics, and cellular responses. It examines the structural, mechanical, and biological attributes of SPs, emphasizing their suitability for BTE. Recent studies on diverse 3D printing approaches using SPs-based for BTE are highlighted, alongside advancements in their 3D and four-dimensional (4D) printing and their role in osteo-immunomodulation. Future directions in the use of SPs for 3D printing in BTE are outlined.
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Affiliation(s)
- Yusuf Olatunji Waidi
- Department of Materials Engineering, Indian Institute of Science, C. V. Raman Avenue, Bangalore 560012, India
| | - Souvik Debnath
- Department of Materials Engineering, Indian Institute of Science, C. V. Raman Avenue, Bangalore 560012, India
| | - Sudipto Datta
- Department of Materials Engineering, Indian Institute of Science, C. V. Raman Avenue, Bangalore 560012, India
| | - Kaushik Chatterjee
- Department of Bioengineering, Indian Institute of Science, C. V. Raman Avenue, Bangalore 560012, India
- Department of Materials Engineering, Indian Institute of Science, C. V. Raman Avenue, Bangalore 560012, India
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Niziołek K, Słota D, Sobczak-Kupiec A. Polysaccharide-Based Composite Systems in Bone Tissue Engineering: A Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:4220. [PMID: 39274610 DOI: 10.3390/ma17174220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 08/13/2024] [Accepted: 08/18/2024] [Indexed: 09/16/2024]
Abstract
In recent years, a growing demand for biomaterials has been observed, particularly for applications in bone regenerative medicine. Bone tissue engineering (BTE) aims to develop innovative materials and strategies for repairing and regenerating bone defects and injuries. Polysaccharides, due to their biocompatibility, biodegradability as well as bioactivity, have emerged as promising candidates for scaffolds or composite systems in BTE. Polymers combined with bioactive ceramics can support osteointegration. Calcium phosphate (CaP) ceramics can be a broad choice as an inorganic phase that stimulates the formation of new apatite layers. This review provides a comprehensive analysis of composite systems based on selected polysaccharides used in bone tissue engineering, highlighting their synthesis, properties and applications. Moreover, the applicability of the produced biocomposites has been analyzed, as well as new trends in modifying biomaterials and endowing them with new functionalizations. The effects of these composites on the mechanical properties, biocompatibility and osteoconductivity were critically analyzed. This article summarizes the latest manufacturing methods as well as new developments in polysaccharide-based biomaterials for bone and cartilage regeneration applications.
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Affiliation(s)
- Karina Niziołek
- Cracow University of Technology, CUT Doctoral School, Faculty of Materials Engineering and Physics, Department of Materials Science, 37 Jana Pawła II Av., 31-864 Krakow, Poland
| | - Dagmara Słota
- Cracow University of Technology, CUT Doctoral School, Faculty of Materials Engineering and Physics, Department of Materials Science, 37 Jana Pawła II Av., 31-864 Krakow, Poland
| | - Agnieszka Sobczak-Kupiec
- Cracow University of Technology, Faculty of Materials Engineering and Physics, Department of Materials Science, 37 Jana Pawła II Av., 31-864 Krakow, Poland
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Zhang X, Xia Y, Xu J, Kang J, Li X, Li Y, Yan W, Tian F, Zhao B, Li B, Wang C, Wang L. Cell-free chitosan/silk fibroin/bioactive glass scaffolds with radial pore for in situ inductive regeneration of critical-size bone defects. Carbohydr Polym 2024; 332:121945. [PMID: 38431423 DOI: 10.1016/j.carbpol.2024.121945] [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: 11/01/2023] [Revised: 01/27/2024] [Accepted: 02/10/2024] [Indexed: 03/05/2024]
Abstract
Tissue-engineered is an effective method for repairing critical-size bone defects. The application of bioactive scaffold provides artificial matrix and suitable microenvironment for cell recruitment and extracellular matrix deposition, which can effectively accelerate the process of tissue regeneration. Among various scaffold properties, appropriate pore structure and distribution have been proven to play a crucial role in inducing cell infiltration differentiation and in-situ tissue regeneration. In this study, a chitosan (CS) /silk fibroin (SF) /bioactive glass (BG) composite scaffold with distinctive radially oriented pore structure was constructed. The composite scaffolds had stable physical and chemical properties, a unique pore structure of radial arrangement from the center to the periphery and excellent mechanical properties. In vitro biological studies indicated that the CS/SF/BG scaffold could promote osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and the expression of related genes due to the wide range of connected pore structures and released active elements. Furthermore, in vivo study showed CS/SF/BG scaffold with radial pores was more conducive to the repair of skull defects in rats with accelerated healing speed during the bone tissue remodeling process. These results demonstrated the developed CS/SF/BG scaffold would be a promising therapeutic strategy for the repair of bone defects regeneration.
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Affiliation(s)
- Xinsong Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Yijing Xia
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Jie Xu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Jie Kang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Xiujuan Li
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Yuanjiao Li
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Wenpeng Yan
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Feng Tian
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Bin Zhao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Bing Li
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China.
| | - ChunFang Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China.
| | - Lu Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China.
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Xiao M, Yao J, Shao Z, Chen X. Silk-Based 3D Porous Scaffolds for Tissue Engineering. ACS Biomater Sci Eng 2024; 10:2827-2840. [PMID: 38690985 DOI: 10.1021/acsbiomaterials.4c00373] [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] [Indexed: 05/03/2024]
Abstract
Silk fibroin, extracted from the silk of the Bombyx mori silkworm, stands out as a biomaterial due to its nontoxic nature, excellent biocompatibility, and adjustable biodegradability. Porous scaffolds, a type of biomaterial, are crucial for creating an optimal microenvironment that supports cell adhesion and proliferation, thereby playing an essential role in tissue remodeling and repair. Therefore, this review focuses on 3D porous silk fibroin-based scaffolds, first summarizing their preparation methods and then detailing their regenerative effects on bone, cartilage, tendon, vascular, neural, skin, hepatic, and tracheal epithelial tissue engineering in recent years.
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Affiliation(s)
- Menglin Xiao
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Shanghai Stomatological Hospital & School of Stomatology, Laboratory of Advanced Materials, Fudan University, Shanghai, 200433, People's Republic of China
| | - Jinrong Yao
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Shanghai Stomatological Hospital & School of Stomatology, Laboratory of Advanced Materials, Fudan University, Shanghai, 200433, People's Republic of China
| | - Zhengzhong Shao
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Shanghai Stomatological Hospital & School of Stomatology, Laboratory of Advanced Materials, Fudan University, Shanghai, 200433, People's Republic of China
| | - Xin Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Shanghai Stomatological Hospital & School of Stomatology, Laboratory of Advanced Materials, Fudan University, Shanghai, 200433, People's Republic of China
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Wang J, Zhang L, Wang K. Bioactive ceramic-based materials: beneficial properties and potential applications in dental repair and regeneration. Regen Med 2024; 19:257-278. [PMID: 39118532 PMCID: PMC11321270 DOI: 10.1080/17460751.2024.2343555] [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: 12/04/2023] [Accepted: 04/12/2024] [Indexed: 08/10/2024] Open
Abstract
Bioactive ceramics, primarily consisting of bioactive glasses, glass-ceramics, calcium orthophosphate ceramics, calcium silicate ceramics and calcium carbonate ceramics, have received great attention in the past decades given their biocompatible nature and excellent bioactivity in stimulating cell proliferation, differentiation and tissue regeneration. Recent studies have tried to combine bioactive ceramics with bioactive ions, polymers, bioactive proteins and other chemicals to improve their mechanical and biological properties, thus rendering them more valid in tissue engineering scaffolds. This review presents the beneficial properties and potential applications of bioactive ceramic-based materials in dentistry, particularly in the repair and regeneration of dental hard tissue, pulp-dentin complex, periodontal tissue and bone tissue. Moreover, greater insights into the mechanisms of bioactive ceramics and the development of ceramic-based materials are provided.
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Affiliation(s)
- Jiale Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No.14, Section 3rd of Renmin South Road, Chengdu, 610041, China
| | - Linglin Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No.14, Section 3rd of Renmin South Road, Chengdu, 610041, China
| | - Kun Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No.14, Section 3rd of Renmin South Road, Chengdu, 610041, China
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Li Y, Huang X, Fu W, Zhang Z, Xiao K, Lv H. Preparation of PDA-GO/CS composite scaffold and its effects on the biological properties of human dental pulp stem cells. BMC Oral Health 2024; 24:157. [PMID: 38297260 PMCID: PMC10832331 DOI: 10.1186/s12903-023-03849-4] [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: 09/14/2023] [Accepted: 12/31/2023] [Indexed: 02/02/2024] Open
Abstract
Reduced graphene oxide (rGO) is an graphene oxide (GO) derivative of graphene, which has a large specific surface area and exhibited satisfactory physicochemical characteristics. In this experiment, GO was reduced by PDA to generate PDA-GO complex, and then PDA-GO was combined with Chitosan (CS) to synthesize PDA-GO/CS composite scaffold. PDA-GO was added to CS to improve the degradation rate of CS, and it was hoped that PDA-GO/CS composite scaffolds could be used in bone tissue engineering. Physicochemical and antimicrobial properties of the different composite scaffolds were examined to find the optimal mass fraction. Besides, we examined the scaffold's biocompatibility by Phalloidin staining and Live and Dead fluorescent staining.Finally, we applied ALP staining, RT-qPCR, and Alizarin red S staining to detect the effect of PDA-GO/CS on the osteogenic differentiation of human dental pulp stem cells (hDPSCs). The results showed that PDA-GO composite was successfully prepared and PDA-GO/CS composite scaffold was synthesized by combining PDA-GO with CS. Among them, 0.3%PDA-GO/CS scaffolds improves the antibacterial activity and hydrophilicity of CS, while reducing the degradation rate. In vitro, PDA-GO/CS has superior biocompatibility and enhances the early proliferation, migration and osteogenic differentiation of hDPSCs. In conclusion, PDA-GO/CS is a new scaffold materialsuitable for cell culture and has promising application prospect as scaffold for bone tissue engineering.
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Affiliation(s)
- Yaoyao Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Xinhui Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Weihao Fu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Zonghao Zhang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Kuancheng Xiao
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Hongbing Lv
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
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Wang Z, Xu Z, Yang X, Li M, Yip RCS, Li Y, Chen H. Current application and modification strategy of marine polysaccharides in tissue regeneration: A review. BIOMATERIALS ADVANCES 2023; 154:213580. [PMID: 37634336 DOI: 10.1016/j.bioadv.2023.213580] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/24/2023] [Accepted: 08/04/2023] [Indexed: 08/29/2023]
Abstract
Marine polysaccharides (MPs) are exceptional bioactive materials that possess unique biochemical mechanisms and pharmacological stability, making them ideal for various tissue engineering applications. Certain MPs, including agarose, alginate, carrageenan, chitosan, and glucan have been successfully employed as biological scaffolds in animal studies. As carriers of signaling molecules, scaffolds can enhance the adhesion, growth, and differentiation of somatic cells, thereby significantly improving the tissue regeneration process. However, the biological benefits of pure MPs composite scaffold are limited. Therefore, physical, chemical, enzyme modification and other methods are employed to expand its efficacy. Chemically, the structural properties of MPs scaffolds can be altered through modifications to functional groups or molecular weight reduction, thereby enhancing their biological activities. Physically, MPs hydrogels and sponges emulate the natural extracellular matrix, creating a more conducive environment for tissue repair. The porosity and high permeability of MPs membranes and nanomaterials expedite wound healing. This review explores the distinctive properties and applications of select MPs in tissue regeneration, highlighting their structural versatility and biological applicability. Additionally, we provide a brief overview of common modification strategies employed for MP scaffolds. In conclusion, MPs have significant potential and are expected to be a novel regenerative material for tissue engineering.
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Affiliation(s)
- Zhaokun Wang
- Marine College, Shandong University, NO. 180 Wenhua West Road, Gao Strict, Weihai 264209, China.
| | - Zhiwen Xu
- Marine College, Shandong University, NO. 180 Wenhua West Road, Gao Strict, Weihai 264209, China.
| | - Xuan Yang
- Marine College, Shandong University, NO. 180 Wenhua West Road, Gao Strict, Weihai 264209, China.
| | - Man Li
- Marine College, Shandong University, NO. 180 Wenhua West Road, Gao Strict, Weihai 264209, China.
| | - Ryan Chak Sang Yip
- Center for Nanomedicine, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Yuanyuan Li
- Department of Food Science, Cornell University, Stocking Hall, Ithaca, NY 14853, USA.
| | - Hao Chen
- Marine College, Shandong University, NO. 180 Wenhua West Road, Gao Strict, Weihai 264209, China; The Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, Jiangnan University, NO. 1800 Lihu Road, Wuxi 214122, China.
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Silva SS, Rodrigues LC, Fernandes EM, Soares da Costa D, Villalva DG, Loh W, Reis RL. Chitosan/Virgin-Coconut-Oil-Based System Enriched with Cubosomes: A 3D Drug-Delivery Approach. Mar Drugs 2023; 21:394. [PMID: 37504925 PMCID: PMC10381190 DOI: 10.3390/md21070394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/29/2023] Open
Abstract
Emulsion-based systems that combine natural polymers with vegetable oils have been identified as a promising research avenue for developing structures with potential for biomedical applications. Herein, chitosan (CHT), a natural polymer, and virgin coconut oil (VCO), a resource obtained from coconut kernels, were combined to create an emulsion system. Phytantriol-based cubosomes encapsulating sodium diclofenac, an anti-inflammatory drug, were further dispersed into CHT/VCO- based emulsion. Then, the emulsions were frozen and freeze-dried to produce scaffolds. The scaffolds had a porous structure ranging from 20.4 to 73.4 µm, a high swelling ability (up to 900%) in PBS, and adequate stiffness, notably in the presence of cubosomes. Moreover, a well-sustained release of the entrapped diclofenac in the cubosomes into the CHT/VCO-based system, with an accumulated release of 45 ± 2%, was confirmed in PBS, compared to free diclofenac dispersed (80 ± 4%) into CHT/VCO-based structures. Overall, the present approach opens up new avenues for designing porous biomaterials for drug delivery through a sustainable pathway.
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Affiliation(s)
- Simone S Silva
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Luísa C Rodrigues
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Emanuel M Fernandes
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Diana Soares da Costa
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Denise G Villalva
- Institute of Chemistry, University of Campinas (UNICAMP), Campinas 13083-970, Brazil
| | - Watson Loh
- Institute of Chemistry, University of Campinas (UNICAMP), Campinas 13083-970, Brazil
| | - Rui L Reis
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Zona Industrial da Gandra, 4805-017 Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
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Application Progress of Modified Chitosan and Its Composite Biomaterials for Bone Tissue Engineering. Int J Mol Sci 2022; 23:ijms23126574. [PMID: 35743019 PMCID: PMC9224397 DOI: 10.3390/ijms23126574] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 12/28/2022] Open
Abstract
In recent years, bone tissue engineering (BTE), as a multidisciplinary field, has shown considerable promise in replacing traditional treatment modalities (i.e., autografts, allografts, and xenografts). Since bone is such a complex and dynamic structure, the construction of bone tissue composite materials has become an attractive strategy to guide bone growth and regeneration. Chitosan and its derivatives have been promising vehicles for BTE owing to their unique physical and chemical properties. With intrinsic physicochemical characteristics and closeness to the extracellular matrix of bones, chitosan-based composite scaffolds have been proved to be a promising candidate for providing successful bone regeneration and defect repair capacity. Advances in chitosan-based scaffolds for BTE have produced efficient and efficacious bio-properties via material structural design and different modifications. Efforts have been put into the modification of chitosan to overcome its limitations, including insolubility in water, faster depolymerization in the body, and blood incompatibility. Herein, we discuss the various modification methods of chitosan that expand its fields of application, which would pave the way for future applied research in biomedical innovation and regenerative medicine.
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