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Premnath P, Lun T, Siddiqui H, Stahl AR, Ardebili AA, Olsen A, Krawetz R. Absence of E2f1 Negates Pro-osteogenic Impacts of p21 Absence. Calcif Tissue Int 2024; 114:625-637. [PMID: 38643416 DOI: 10.1007/s00223-024-01210-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/03/2024] [Indexed: 04/22/2024]
Abstract
Loss of p21 leads to increased bone formation post-injury; however, the mechanism(s) by which this occurs remains undetermined. E2f1 is downstream of p21 and as a transcription factor can act directly on gene expression; yet it is unknown if E2f1 plays a role in the osteogenic effects observed when p21 is differentially regulated. In this study we aimed to investigate the interplay between p21 and E2f1 and determine if the pro-regenerative osteogenic effects observed with the loss of p21 are E2f1 dependent. To accomplish this, we employed knockout p21 and E2f1 mice and additionally generated a p21/E2f1 double knockout. These mice underwent burr-hole injuries to their proximal tibiae and healing was assessed over 7 days via microCT imaging. We found that p21 and E2f1 play distinct roles in bone regeneration where the loss of p21 increased trabecular bone formation and loss of E2f1 increased cortical bone formation, yet loss of E2f1 led to poorer bone repair overall. Furthermore, when E2f1 was absent, either individually or simultaneously with p21, there was a dramatic decrease of the number of osteoblasts, osteoclasts, and chondrocytes at the site of injury compared to p21-/- and C57BL/6 mice. Together, these results suggest that E2f1 regulates the cell populations required for bone repair and has a distinct role in bone formation/repair compared to p21-/-E2f1-/-. These results highlight the possibility of cell cycle and/or p21/E2f1 being potential druggable targets that could be leveraged in clinical therapies to improve bone healing in pathologies such as osteoporosis.
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Affiliation(s)
- Priyatha Premnath
- Department of Biomedical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Theodore Lun
- Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - Humza Siddiqui
- Department of Biological Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Alana Ruth Stahl
- Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - Aria Ahadzadeh Ardebili
- Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
- Department of Biomedical Engineering, University of Calgary, Calgary, AB, Canada
| | - Alexandra Olsen
- Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
- Department of Biomedical Engineering, University of Calgary, Calgary, AB, Canada
| | - Roman Krawetz
- Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
- Department of Cell Biology and Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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2
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Liang W, Zhou C, Zhang H, Bai J, Long H, Jiang B, Liu L, Xia L, Jiang C, Zhang H, Zhao J. Pioneering nanomedicine in orthopedic treatment care: a review of current research and practices. Front Bioeng Biotechnol 2024; 12:1389071. [PMID: 38860139 PMCID: PMC11163052 DOI: 10.3389/fbioe.2024.1389071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/08/2024] [Indexed: 06/12/2024] Open
Abstract
A developing use of nanotechnology in medicine involves using nanoparticles to administer drugs, genes, biologicals, or other materials to targeted cell types, such as cancer cells. In healthcare, nanotechnology has brought about revolutionary changes in the treatment of various medical and surgical conditions, including in orthopedic. Its clinical applications in surgery range from developing surgical instruments and suture materials to enhancing imaging techniques, targeted drug delivery, visualization methods, and wound healing procedures. Notably, nanotechnology plays a significant role in preventing, diagnosing, and treating orthopedic disorders, which is crucial for patients' functional rehabilitation. The integration of nanotechnology improves standards of patient care, fuels research endeavors, facilitates clinical trials, and eventually improves the patient's quality of life. Looking ahead, nanotechnology holds promise for achieving sustained success in numerous surgical disciplines, including orthopedic surgery, in the years to come. This review aims to focus on the application of nanotechnology in orthopedic surgery, highlighting the recent development and future perspective to bridge the bridge for clinical translation.
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Affiliation(s)
- Wenqing Liang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Chao Zhou
- Department of Orthopedics, Zhoushan Guanghua Hospital, Zhoushan, Zhejiang, China
| | - Hongwei Zhang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Juqin Bai
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Hengguo Long
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Bo Jiang
- Rehabilitation Department, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Lu Liu
- Medical Research Center, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Linying Xia
- Medical Research Center, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Chanyi Jiang
- Department of Pharmacy, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, Zhejiang, China
| | - Hengjian Zhang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Jiayi Zhao
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
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Tateiwa D, Iwamoto M, Kodama J, Ukon Y, Hirai H, Ikuta M, Kitahara T, Furuichi T, Bun M, Otsuru S, Okada S, Kaito T. A synthetic retinoic acid receptor γ antagonist (7C)-loaded nanoparticle enhances bone morphogenetic protein-induced bone regeneration in a rat spinal fusion model. Spine J 2024; 24:899-908. [PMID: 38092193 DOI: 10.1016/j.spinee.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/19/2023] [Accepted: 11/27/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND CONTEXT Bone morphogenetic proteins (BMPs) have potent osteoinductivity and have been applied clinically for challenging musculoskeletal conditions. However, the supraphysiological doses of BMPs used in clinical settings cause various side effects that prevent widespread use, and therefore the BMP dosage needs to be reduced. PURPOSE To address this problem, we synthesized 7C, a retinoic acid receptor γ antagonist-loaded nanoparticle (NP), and investigated its potential application in BMP-based bone regeneration therapy using a rat spinal fusion model. STUDY DESIGN An experimental animal study. METHODS Fifty-three male 8-week-old Sprague-Dawley rats underwent posterolateral spinal fusion and were divided into the following five treatment groups: (1) no recombinant human (rh)BMP-2 and blank-NP (Control), (2) no rhBMP-2 and 1 μg 7C-NP (7C group), (3) low-dose rhBMP-2 (0.5 μg) and 1 μg blank-NP (L-BMP group), (4) low-dose rhBMP-2 (0.5 μg) and 1 μg 7C-NP (L-BMP + 7C group), and (5) high-dose rhBMP-2 (5.0 μg) and 1 μg blank-NP (H-BMP group). Micro-computed tomography and histologic analysis were performed 2 and 6 weeks after the surgery. RESULTS The spinal fusion rates of the Control and 7C groups were both 0%, and those of the L-BMP, L-BMP + 7C, and H-BMP groups were 55.6%, 94.4%, and 100%, respectively. The L-BMP + 7C group markedly promoted cartilaginous tissue formation during BMP-induced endochondral bone formation that resulted in a significantly better spinal fusion rate and bone formation than in the L-BMP group. Although spinal fusion was slower in the L-BMP + 7C group, the L-BMP + 7C group formed a spinal fusion mass with better bone quality than the spinal fusion mass in the H-BMP group. CONCLUSIONS The combined use of 7C-NP with rhBMP-2 in a rat posterolateral lumbar fusion model increased spinal fusion rate and new bone volume without deteriorating the quality of newly formed bone. CLINICAL SIGNIFICANCE 7C-NP potentiates BMP-2-induced bone regeneration and has the potential for efficient bone regeneration with low-dose BMP-2, which can reduce the dose-dependent side effects of BMP-2 in clinical settings.
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Affiliation(s)
- Daisuke Tateiwa
- Department of Orthopaedic Surgery, Osaka General Medical Center, 3-1-56, Mandaihigashi, Sumiyoshi, Osaka, Japan
| | - Masahiro Iwamoto
- Department of Orthopaedic, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, USA
| | - Joe Kodama
- Department of Orthopaedic, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, USA
| | - Yuichiro Ukon
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hiromasa Hirai
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Masato Ikuta
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takayuki Kitahara
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takuya Furuichi
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Masayuki Bun
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Satoru Otsuru
- Department of Orthopaedic, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, USA
| | - Seiji Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
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Zuvairiya U, R P, Palati S. Evaluation of Cardiospermum halicacabum on Bone Morphogenetic Protein-2 (BMP2) mRNA Expression in Osteoblast Cells. Cureus 2024; 16:e60292. [PMID: 38872645 PMCID: PMC11170541 DOI: 10.7759/cureus.60292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction Maintaining bone health is crucial for overall well-being, with osteoblasts playing a vital role in bone formation. Bone morphogenetic protein-2 (BMP2) is a key regulator, stimulating bone matrix synthesis and osteoblast differentiation. Recognizing BMP2's significance, there's growing interest in natural compounds, such as Cardiospermum halicacabum. This study explores Cardiospermum halicacabum's potential influence on BMP2 mRNA expression in osteoblast cells for insights into bone health modulation. Materials and methods This research utilized Cardiospermum halicacabum to explore its impact on MG-63 cells, a human osteoblast cell line. Osteoblast cells were cultured in Dulbecco's modified Eagle's medium (DMEM), supplemented with 10% heat-inactivated fetal bovine serum, and maintained at 37°C in a 5% CO2 and 95% air environment. Cell viability was evaluated by seeding osteoblast cells into 96-well plates and exposing them to different concentrations of Cardiospermum halicacabum (2.0 μg/ml and 20 μg/ml). The study observed both the promotion of osteoblast cell growth in MG-63 and morphological changes in the cells under an inverted light microscope at 10x magnification. Results were presented using one-way analysis of variance (ANOVA) conducted with IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). Result The reverse transcription-polymerase chain (RT-PCR) results revealed an increased expression of BMP-2 mRNA fold change in comparison to the control group. A clear positive correlation was observed between the BMP-2 mRNA fold change and the notable increase in the concentration of Cardiospermum halicacabum. This investigation revealed a direct association of BMP-2 mRNA expression with the proliferation of osteoblast cells. Specifically, the BMP-2 mRNA fold change was recorded at 2.26±1.05 in Cardiospermum halicacabum at 2.0 μg/ml and 2.0 ± 0.84 at 20 μg/ml, with corresponding significances of 0.00, respectively. Conclusion Potential effects of Cardiospermum halicacabum on BMP-2 mRNA expression in osteoblast cells and its role in bone health modulation revealed that Cardiospermum halicacabum may upregulate BMP-2 mRNA expression, suggesting its potential as a natural compound for enhancing bone formation. The observed positive correlation between Cardiospermum halicacabum concentration and BMP-2 mRNA fold change showed the significance of this botanical agent in promoting osteoblast cell proliferation. These results highlight the importance of further research to explore the applications of Cardiospermum halicacabum in managing bone disorders and improving overall bone health.
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Affiliation(s)
- Ummu Zuvairiya
- Department of General Pathology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Priyadharshini R
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Sinduja Palati
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Sun L, Niu H, Wu Y, Dong S, Li X, Kim BY, Liu C, Ma Y, Jiang W, Yuan Y. Bio-integrated scaffold facilitates large bone regeneration dominated by endochondral ossification. Bioact Mater 2024; 35:208-227. [PMID: 38327823 PMCID: PMC10847751 DOI: 10.1016/j.bioactmat.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/23/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
Repair of large bone defects caused by severe trauma, non-union fractures, or tumor resection remains challenging because of limited regenerative ability. Typically, these defects heal through mixed routines, including intramembranous ossification (IMO) and endochondral ossification (ECO), with ECO considered more efficient. Current strategies to promote large bone healing via ECO are unstable and require high-dose growth factors or complex cell therapy that cause side effects and raise expense while providing only limited benefit. Herein, we report a bio-integrated scaffold capable of initiating an early hypoxia microenvironment with controllable release of low-dose recombinant bone morphogenetic protein-2 (rhBMP-2), aiming to induce ECO-dominated repair. Specifically, we apply a mesoporous structure to accelerate iron chelation, this promoting early chondrogenesis via deferoxamine (DFO)-induced hypoxia-inducible factor-1α (HIF-1α). Through the delicate segmentation of click-crosslinked PEGylated Poly (glycerol sebacate) (PEGS) layers, we achieve programmed release of low-dose rhBMP-2, which can facilitate cartilage-to-bone transformation while reducing side effect risks. We demonstrate this system can strengthen the ECO healing and convert mixed or mixed or IMO-guided routes to ECO-dominated approach in large-size models with clinical relevance. Collectively, these findings demonstrate a biomaterial-based strategy for driving ECO-dominated healing, paving a promising pave towards its clinical use in addressing large bone defects.
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Affiliation(s)
- Lili Sun
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai, 200237, PR China
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Haoyi Niu
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai, 200237, PR China
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yuqiong Wu
- Department of Prosthodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Shiyan Dong
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Xuefeng Li
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Betty Y.S. Kim
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Changsheng Liu
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai, 200237, PR China
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Yifan Ma
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai, 200237, PR China
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Wen Jiang
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Yuan Yuan
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai, 200237, PR China
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
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Brown M, Cush G, Adams SB. Use of 3D-Printed Implants in Complex Foot and Ankle Reconstruction. J Orthop Trauma 2024; 38:S17-S22. [PMID: 38502599 DOI: 10.1097/bot.0000000000002763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 03/21/2024]
Abstract
SUMMARY Treatment of traumatic critical-sized bone defects remains a challenge for orthopaedic surgeons. Autograft remains the gold standard to address bone loss, but for larger defects, different strategies must be used. The use of 3D-printed implants to address lower extremity trauma and bone loss is discussed with current techniques including bone transport, Masquelet, osteomyocutaneous flaps, and massive allografts. Considerations and future directions of implant design, augmentation, and optimization of the peri-implant environment to maximize patient outcome are reviewed.
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Affiliation(s)
- Matthew Brown
- Department of Orthopaedic Surgery, Duke University, Durham, NC; and
| | - Gerard Cush
- SUN Orthopaedics of Evangelical, Lewisburg, PA
| | - Samuel B Adams
- Department of Orthopaedic Surgery, Duke University, Durham, NC; and
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7
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Wang W, Gong Z, Wang K, Tian M, Zhang Y, Li X, You X, Wu J. Activation of the BMP2-SMAD1-CGRP pathway in dorsal root ganglia contributes to bone cancer pain in a rat model. Heliyon 2024; 10:e27350. [PMID: 38496903 PMCID: PMC10944225 DOI: 10.1016/j.heliyon.2024.e27350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024] Open
Abstract
Peripheral nerve remodeling and sensitization are involved in cancer-related bone pain. As a member of the transforming growth factor-β class, bone morphogenetic protein 2 (BMP2) is recognized to have a role in the development of the neurological and skeletal systems. Our previous work showed that BMP2 is critical for bone cancer pain (BCP) sensitization. However, the mechanism remains unknown. In the current study, we demonstrated a substantial increase in BMP2 expression in the dorsal root ganglia (DRG) in a rat model of BCP. Knockdown of BMP2 expression ameliorated BCP in rats. Furthermore, the DRG neurons of rats with BCP expressed higher levels of calcitonin gene-related peptide (CGRP), and BCP was successfully suppressed by intrathecal injection of a CGRP receptor blocker (CGRP8-37). Downregulation of BMP2 expression reduced the expression of CGRP in the DRG of rats with BCP and relieved pain behavior. Moreover, we revealed that upregulation of CGRP expression in the DRG may be induced by activation of the BMPR/Smad1 signaling pathway. These findings suggest that BMP2 contributes to BCP by upregulating CGRP in DRG neurons via activating BMPR/Smad1 signaling pathway and that therapeutic targeting of the BMP2-Smad1-CGRP pathway may ameliorate BCP in the context of advanced cancer.
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Affiliation(s)
- Wei Wang
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200030, China
| | - Zhihao Gong
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200030, China
| | - Kai Wang
- Central Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200030, China
| | - Mi Tian
- Department of Intensive Care Medicine, HuaShan Hospital, Fudan University, Shanghai 200040, China
| | - Yuxin Zhang
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200030, China
| | - Xin Li
- School of Medicine, Shanghai University, Shanghai 200444, China
| | - Xingji You
- School of Medicine, Shanghai University, Shanghai 200444, China
| | - Jingxiang Wu
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200030, China
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8
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Xia Y, Zhang Z, Zhou K, Lin Z, Shu R, Xu Y, Zeng Z, Chang J, Xie Y. Cuprorivaite/hardystonite/alginate composite hydrogel with thermionic effect for the treatment of peri-implant lesion. Regen Biomater 2024; 11:rbae028. [PMID: 38605852 PMCID: PMC11007117 DOI: 10.1093/rb/rbae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/24/2024] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
Peri-implant lesion is a grave condition afflicting numerous indi-viduals with dental implants. It results from persistent periodontal bacteria accumulation causing inflammation around the implant site, which can primarily lead to implant loosening and ultimately the implant loss. Early-stage peri-implant lesions exhibit symptoms akin to gum disease, including swelling, redness and bleeding of the gums surrounding the implant. These signs indicate infection and inflammation of the peri-implant tissues, which may result in bone loss and implant failure. To address this problem, a thermionic strategy was applied by designing a cuprorivaite-hardystonite bioceramic/alginate composite hydrogel with photothermal and Cu/Zn/Si multiple ions releasing property. This innovative approach creates a thermionic effect by the release of bioactive ions (Cu2+ and Zn2+ and SiO 3 2 - ) from the composite hydrogel and the mild heat environment though the photothermal effect of the composite hydrogel induced by near-infrared light irradiation. The most distinctive advantage of this thermionic effect is to substantially eliminate periodontal pathogenic bacteria and inhibit inflammation, while simultaneously enhance peri-implant osseointegration. This unique attribute renders the use of this composite hydrogel highly effective in significantly improving the survival rate of implants after intervention in peri-implant lesions, which is a clinical challenge in periodontics. This study reveals application potential of a new biomaterial-based approach for peri-implant lesion, as it not only eliminates the infection and inflammation, but also enhances the osteointegration of the dental implant, which provides theoretical insights and practical guidance to prevent and manage early-stage peri-implant lesion using bioactive functional materials.
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Affiliation(s)
- Yiru Xia
- Department of Periodontology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhaowenbin Zhang
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325000, China
- State Key Laboratory of High-Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, China
| | - Kecong Zhou
- Department of Periodontology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhikai Lin
- Department of Periodontology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Rong Shu
- Department of Periodontology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yuze Xu
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325000, China
- State Key Laboratory of High-Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, China
| | - Zhen Zeng
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325000, China
- State Key Laboratory of High-Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Jiang Chang
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325000, China
- State Key Laboratory of High-Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, China
| | - Yufeng Xie
- Department of Periodontology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Department of Periodontology, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
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9
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Gantenbein B, Oswald KAC, Erbach GF, Croft AS, Bermudez-Lekerika P, Strunz F, Bigdon SF, Albers CE. The bone morphogenetic protein 2 analogue L51P enhances spinal fusion in combination with BMP2 in an in vivo rat tail model. Acta Biomater 2024; 177:148-156. [PMID: 38325708 DOI: 10.1016/j.actbio.2024.01.039] [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: 07/27/2023] [Revised: 12/31/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
Bone morphogenic protein 2 (BMP2) is known to induce osteogenesis and is applied clinically to enhance spinal fusion despite adverse effects. BMP2 needs to be used in high doses to be effective due to the presence of BMP2 inhibitors. L51P is a BMP2 analogue that acts by inhibition of BMP2 inhibitors. Here, we hypothesized that mixtures of BMP2 and L51P could achieve better spinal fusion outcomes regarding ossification. To test whether mixtures of both cytokines are sufficient to improve ossification, 45 elderly Wistar rats (of which 21 were males) were assigned to seven experimental groups, all which received spinal fusion surgery, including discectomy at the caudal 4-5 level using an external fixator and a porous β-tricalcium phosphate (βTCP) carrier. These βTCP carriers were coated with varying concentrations of BMP2 and L51P. X-rays were taken immediately after surgery and again six and twelve weeks post-operatively. Histological sections and µCT were analyzed after twelve weeks. Spinal fusion was assessed using X-ray, µCT and histology according to the Bridwell scale by voxel-based quantification and a semi-quantitative histological score, respectively. The results were congruent across modalities and revealed high ossification for high-dose BMP2 (10 µg), while PBS induced no ossification. Low-dose BMP2 (1 µg) or 10 µg L51P alone did not induce relevant bone formation. However, all combinations of low-dose BMP2 with L51P (1 µg + 1/5/10 µg) were able to induce similar ossificationas high-dose BMP2. These results are of high clinical relevance, as they indicate L51P is sufficient to increase the efficacy of BMP2 and thus lower the required dose for spinal fusion. STATEMENT OF SIGNIFICANCE: Spinal fusion surgery is frequently applied to treat spinal pathologies. Bone Morphogenic Protein-2 (BMP2) has been approved by the U .S. Food and Drug Administration (FDA-) and by the "Conformité Européenne" (CE)-label. However, its application is expensive and high concentrations cause side-effects. This research targets the improvement of the efficacy of BMP2 in spinal fusion surgery.
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Affiliation(s)
- Benjamin Gantenbein
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Medical Faculty, University of Bern, Bern, Switzerland; Tissue Engineering for Orthopaedics & Mechanobiology, Bone & Joint Program, Department for BioMedical Research (DBMR), Medical Faculty, University of Bern, Bern, Switzerland.
| | - Katharina A C Oswald
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Medical Faculty, University of Bern, Bern, Switzerland
| | - Georg F Erbach
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Medical Faculty, University of Bern, Bern, Switzerland
| | - Andreas S Croft
- Tissue Engineering for Orthopaedics & Mechanobiology, Bone & Joint Program, Department for BioMedical Research (DBMR), Medical Faculty, University of Bern, Bern, Switzerland; Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, Bern, Switzerland
| | - Paola Bermudez-Lekerika
- Tissue Engineering for Orthopaedics & Mechanobiology, Bone & Joint Program, Department for BioMedical Research (DBMR), Medical Faculty, University of Bern, Bern, Switzerland; Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, Bern, Switzerland
| | - Franziska Strunz
- Tissue Engineering for Orthopaedics & Mechanobiology, Bone & Joint Program, Department for BioMedical Research (DBMR), Medical Faculty, University of Bern, Bern, Switzerland; Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, Bern, Switzerland
| | - Sebastian F Bigdon
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Medical Faculty, University of Bern, Bern, Switzerland
| | - Christoph E Albers
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Medical Faculty, University of Bern, Bern, Switzerland
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Harrer JA, Fulton TM, Sangadala S, Kaiser J, Devereaux EJ, Oliver C, Presciutti SM, Boden SD, Willett NJ. Local FK506 delivery induces osteogenesis in in vivo rat bone defect and rabbit spine fusion models. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.08.584163. [PMID: 38559240 PMCID: PMC10979893 DOI: 10.1101/2024.03.08.584163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Bone grafting procedures are commonly used for the repair, regeneration, and fusion of bones in in a wide range of orthopaedic surgeries, including large bone defects and spine fusion procedures. Autografts are the clinical gold standard, though recombinant human bone morphogenetic proteins (rhBMPs) are often used, particularly in difficult clinical situations. However, treatment with rhBMPs can have off-target effects and significantly increase surgical costs, adding to patients' already high economic and mental burden. Recent studies have identified that FDA-approved immunosuppressant drug, FK506 (Tacrolimus), can also activate the BMP pathway by binding to its inhibitors. This study tested the hypothesis that FK506, as a standalone treatment, could induce osteogenic differentiation of human mesenchymal stromal cells (hMSCs), as well as functional bone formation in a rat segmental bone defect model and rabbit spinal fusion model. FK506 potentiated the effect of low dose BMP-2 to enhance osteogenic differentiation and mineralization of hMSCs in vitro. Standalone treatment with FK506 delivered on a collagen sponge, produced consistent bone bridging of a rat critically-sized femoral defect with functional mechanical properties comparable to naïve bone. In a rabbit single level posterolateral spine fusion model, treatment with FK506 delivered on a collagen sponge successfully fused the L5-L6 vertebrae at rates comparable to rhBMP-2 treatment. These data demonstrate the ability of FK506 to induce bone formation in human cells and two challenging in vivo models, and indicate FK506 can be utilized either as a standalone treatment or in conjunction with rhBMP to treat a variety of spine disorders.
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Affiliation(s)
- Julia Andraca Harrer
- Atlanta VA Medical Center, Decatur, GA 30033, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30322, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA
- Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, OR 97403, USA
| | - Travis M. Fulton
- Atlanta VA Medical Center, Decatur, GA 30033, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Sreedhara Sangadala
- Atlanta VA Medical Center, Decatur, GA 30033, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Jarred Kaiser
- Atlanta VA Medical Center, Decatur, GA 30033, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Emily J. Devereaux
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | | | - Steven M. Presciutti
- Atlanta VA Medical Center, Decatur, GA 30033, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Scott D. Boden
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nick J. Willett
- Atlanta VA Medical Center, Decatur, GA 30033, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30322, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA
- Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, OR 97403, USA
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11
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Siverino C, Tirkkonen-Rajasalo L, Freitag L, Günther C, Thompson K, Styger U, Zeiter S, Eglin D, Stadelmann VA. Restoring implant fixation strength in osteoporotic bone with a hydrogel locally delivering zoledronic acid and bone morphogenetic protein 2. A longitudinal in vivo microCT study in rats. Bone 2024; 180:117011. [PMID: 38176642 DOI: 10.1016/j.bone.2023.117011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/06/2024]
Abstract
Osteoporosis poses a major public health challenge, and it is characterized by low bone mass, deterioration of the microarchitecture of bone tissue, causing a consequent increase in bone fragility and susceptibility to fractures and complicating bone fixation, particularly screw implantation. In the present study, our aim was to improve implant stability in osteoporotic bone using a thermoresponsive hyaluronan hydrogel (HA-pNIPAM) to locally deliver the bisphosphonate zoledronic acid (ZOL) to prevent bone resorption and bone morphogenetic protein 2 (BMP2) to induce bone formation. Adult female Wistar rats (n = 36) were divided into 2 treatment groups: one group of SHAM-operated animals and another group that received an ovariectomy (OVX) to induce an osteoporotic state. All animals received a polyetheretherketone (PEEK) screw in the proximal tibia. In addition, subgroups of SHAM or OVX animals received either the HA-pNIPAM hydrogel without or with ZOL/BMP2, placed into the defect site prior to screw implantation. Periprosthetic bone and implant fixation were monitored using longitudinal in vivo microCT scanning post-operatively and at 3, 6, 9, 14, 20 and 28 days. Histological assessment was performed post-mortem. Our data showed that pure hydrogel has no impact of implant fixation The ZOL/BMP2-hydrogel significantly increased bone-implant contact and peri-implant bone fraction, primarily through reduced resorption. STATEMENT OF CLINICAL SIGNIFICANCE: Local delivery of ZOL and BMP2 using a biocompatible hydrogel improved implant stability in osteoporotic bone. This approach could constitute a potent alternative to systemic drug administration and may be useful in avoiding implant loosening in clinical settings.
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Affiliation(s)
| | | | | | | | | | | | | | - David Eglin
- AO Research Institute Davos, Davos, Switzerland; Mines Saint-Étienne, Univ Jean Monnet, INSERM, U1059 Sainbiose, Saint-Étienne, France.
| | - Vincent A Stadelmann
- AO Research Institute Davos, Davos, Switzerland; Schulthess Klinik, Department of Research and Development, Zürich, Switzerland.
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12
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Hamouda WO, Veranis S, Krol O, Sagoo NS, Passias PG, Buser Z, Meisel HJ, Yoon T. Dosing Strategy for Osteobiologics Used in ACDF Surgery: Influence on Fusion Rates and Associated Complications. A Systematic Literature Review. Global Spine J 2024; 14:129S-140S. [PMID: 38421331 PMCID: PMC10913908 DOI: 10.1177/21925682231195766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
STUDY DESIGN Systematic review. OBJECTIVE To assess the available evidence related to dose-dependent effectiveness (i.e., bone fusion) and morbidity of osteobiologics used in anterior cervical discectomy and fusion (ACDF). METHODS Studies with more than 9 adult patients with degenerated/herniated cervical discs operated for one-to four-levels ACDF reporting used osteobiologics doses, fusion rates at six months or later, and related comorbidities were included. PubMed, EMBASE, ClinicalTrials, and Cochrane were searched through September 2021. Data extracted in spread sheet and risk of bias assessed using MINORS and Rob-2. RESULTS Sixteen studies were selected and sub-grouped into BMP and non-BMP osteobiologics. For the 10 BMP studies, doses varied from 0.26 to 2.1 mg in 649 patients with fusion rates of 95.3 to 100% at 12 months. For other osteobiologics, each of six studies reported one type of osteobiologic in certain dose/concentration/volume in a total of 580 patients with fusion rates of 6.8 to 96.9% at 12 months. Risk of bias was low in three of the 13 non-randomized (18.75%) and in all the three randomized studies (100%). CONCLUSIONS Taking into account the inconsistent reporting within available literature, for BMP usage in ACDF, doses lower than 0.7 mg per level can achieve equal successful fusion rates as higher doses, and there is no complication-free dose proved yet. It seems that the lower the dose the lower the incidence of serious complications. As for non-BMP osteobiologics the studies are very limited for each osteobiologic and thus conclusions must be drawn individually and with caution.
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Affiliation(s)
- Waeel O Hamouda
- Department of Neurosurgery, Kasr Alainy Faculty of Medicine, Research, and Teaching Hospitals, Cairo University, Cairo, Egypt
- Neurological & Spinal surgery service, Security Forces Hospital, Dammam, Saudi Arabia
| | | | - Oscar Krol
- Spine Research Institute, Department of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NY Spine Institute, New York, NY, USA
| | | | - Peter G Passias
- Division of Spinal Surgery/ Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY, USA
| | - Zorica Buser
- Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, NY, USA
- Director of Regenerative Medicine (Spine Restoration), Gerling Institute Formerly SpineCare, New York, NY, USA
| | - Hans Jörg Meisel
- Department of Neurosurgery, BG Klinikum Bergmannstrost Halle, Halle, Germany
| | - Tim Yoon
- Department of Orthopaedics, Emory University, Atlanta, GA, USA
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13
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Bergin SM, Crutcher CL, Keeler C, Rocos B, Haglund MM, Michael Guo H, Gottfried ON, Richardson WJ, Than KD. Osteoimmunology: Interactions With the Immune System in Spinal Fusion. Int J Spine Surg 2023; 17:S9-S17. [PMID: 38050073 PMCID: PMC10753333 DOI: 10.14444/8556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
Spinal fusion is important for the clinical success of patients undergoing surgery, and the immune system plays an increasingly recognized role. Osteoimmunology is the study of the interactions between the immune system and bone. Inflammation impacts the osteogenic, osteoconductive, and osteoinductive properties of bone grafts and substitutes and ultimately influences the success of spinal fusion. Macrophages have emerged as important cells for coordinating the immune response following spinal fusion surgery, and macrophage-derived cytokines impact each phase of bone graft healing. This review explores the cellular and molecular immune processes that regulate bone homeostasis and healing during spinal fusion.
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Affiliation(s)
- Stephen M Bergin
- Department of Neurosurgery, Division of Spine, Duke University, Durham, NC, USA
| | - Clifford L Crutcher
- Department of Neurosurgery, Division of Spine, Duke University, Durham, NC, USA
| | - Carolyn Keeler
- Department of Neurosurgery, Division of Spine, Duke University, Durham, NC, USA
| | - Brett Rocos
- Department of Orthopedic Surgery, Division of Spine, Duke University, Durham, NC, USA
| | - Michael M Haglund
- Department of Neurosurgery, Division of Spine, Duke University, Durham, NC, USA
| | - H Michael Guo
- Department of Orthopedic Surgery, Division of Spine, Duke University, Durham, NC, USA
| | - Oren N Gottfried
- Department of Neurosurgery, Division of Spine, Duke University, Durham, NC, USA
| | - William J Richardson
- Department of Orthopedic Surgery, Division of Spine, Duke University, Durham, NC, USA
| | - Khoi D Than
- Department of Neurosurgery, Division of Spine, Duke University, Durham, NC, USA
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14
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Hong YR, Kim TH, Lee K, Lim JO, Oh CW. Bioactive Bone Substitute in a Rabbit Ulna Model: Preclinical Study. Tissue Eng Regen Med 2023; 20:1205-1217. [PMID: 37815697 PMCID: PMC10645865 DOI: 10.1007/s13770-023-00591-4] [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: 07/04/2023] [Revised: 08/09/2023] [Accepted: 08/13/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Current therapies to effectively treat long-bone defects and extensive bone tissue loss remains limited. In this study, we created a new bone substitute by integrating advanced technologies such as structure patterning, controlled release of a bone growth factor and conjugation system for clinically effective bone regeneration. This novel bioactive bone substitute was evaluated for its safety and efficacy using a rabbit ulna model. METHODS A three dimensional bone patterned cylindrical structure with 1.5 cm in length and 5 mm in diameter was printed using poly(L-lactic acid)(PLLA) as a weight-bearing support and space-filling scaffold. And a bone morphogenetic protein 2 (BMP2) was employed to enhance bone regeneration, and coated to a 3D PLLA using alginate catechol and collagen to prolong the release kinetics. This novel bone substitute (BS)was evaluated for its physico-chemical and biological properties in vitro, and histological analysis and radiographical analysis such as X-ray, CT and micro-CT image analysis were performed to evaluate new bone formation in vivo. RESULTS The BS possesses an ideal shape and mechanically suitable proeperties for clinical use, with an easy-to-grab and break-resistant design at both ends, 80 ± 10 MPa of compression strength, and BMP2 release for two months. Histological analysis demonstrated the biocompability of BS with minimal inflammation and immune response, and X-ray, CT and micro-CT demonstrated effective new bone formation in rabbit ulna defect model. CONCLUSION The preclinical study of a novel bioactive bone substitute has shown its safe and effective properties in an animal model suggesting its clinical potential.
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Affiliation(s)
- Yu Ri Hong
- Bio-Medical Research Institute, Kyungpook National University Hospital, Daegu, 41940, Republic of Korea
- Joint Institute for Regenerative Medicine, Kyungpook National University, Daegu, 41940, Republic of Korea
| | - Tae-Ho Kim
- Bio-Medical Research Institute, Kyungpook National University Hospital, Daegu, 41940, Republic of Korea
- Joint Institute for Regenerative Medicine, Kyungpook National University, Daegu, 41940, Republic of Korea
| | - Kyueui Lee
- Department of Chemistry and Green-Nano Materials Research Center, Kyungpook National University, Daegu, 41566, Republic of Korea
| | - Jeong Ok Lim
- Bio-Medical Research Institute, Kyungpook National University Hospital, Daegu, 41940, Republic of Korea.
- School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea.
- Joint Institute for Regenerative Medicine, Kyungpook National University, Daegu, 41940, Republic of Korea.
| | - Chang-Wug Oh
- School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea.
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, 41944, Republic of Korea.
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15
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Luo Y, Liu H, Zhang Y, Liu Y, Liu S, Liu X, Luo E. Metal ions: the unfading stars of bone regeneration-from bone metabolism regulation to biomaterial applications. Biomater Sci 2023; 11:7268-7295. [PMID: 37800407 DOI: 10.1039/d3bm01146a] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
In recent years, bone regeneration has emerged as a remarkable field that offers promising guidance for treating bone-related diseases, such as bone defects, bone infections, and osteosarcoma. Among various bone regeneration approaches, the metal ion-based strategy has surfaced as a prospective candidate approach owing to the extensive regulatory role of metal ions in bone metabolism and the diversity of corresponding delivery strategies. Various metal ions can promote bone regeneration through three primary strategies: balancing the effects of osteoblasts and osteoclasts, regulating the immune microenvironment, and promoting bone angiogenesis. In the meantime, the complex molecular mechanisms behind these strategies are being consistently explored. Moreover, the accelerated development of biomaterials broadens the prospect of metal ions applied to bone regeneration. This review highlights the potential of metal ions for bone regeneration and their underlying mechanisms. We propose that future investigations focus on refining the clinical utilization of metal ions using both mechanistic inquiry and materials engineering to bolster the clinical effectiveness of metal ion-based approaches for bone regeneration.
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Affiliation(s)
- Yankun Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Hanghang Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
- Department of Emergency, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin Nanlu, Chengdu, Sichuan, 610041, People's Republic of China
| | - Yaowen Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yao Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
- Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Shibo Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
- Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Xian Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
- Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - En Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
- Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
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16
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Ma Y, Sun L, Zhang J, Chiang C, Pan J, Wang X, Kwak KJ, Li H, Zhao R, Rima XY, Zhang C, Zhang A, Liu Y, He Z, Hansford D, Reategui E, Liu C, Lee AS, Yuan Y, Lee LJ. Exosomal mRNAs for Angiogenic-Osteogenic Coupled Bone Repair. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2302622. [PMID: 37847907 PMCID: PMC10667797 DOI: 10.1002/advs.202302622] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/25/2023] [Indexed: 10/19/2023]
Abstract
Regenerative medicine in tissue engineering often relies on stem cells and specific growth factors at a supraphysiological dose. These approaches are costly and may cause severe side effects. Herein, therapeutic small extracellular vesicles (t-sEVs) endogenously loaded with a cocktail of human vascular endothelial growth factor A (VEGF-A) and human bone morphogenetic protein 2 (BMP-2) mRNAs within a customized injectable PEGylated poly (glycerol sebacate) acrylate (PEGS-A) hydrogel for bone regeneration in rats with challenging femur critical-size defects are introduced. Abundant t-sEVs are produced by a facile cellular nanoelectroporation system based on a commercially available track-etched membrane (TM-nanoEP) to deliver plasmid DNAs to human adipose-derived mesenchymal stem cells (hAdMSCs). Upregulated microRNAs associated with the therapeutic mRNAs are enriched in t-sEVs for enhanced angiogenic-osteogenic regeneration. Localized and controlled release of t-sEVs within the PEGS-A hydrogel leads to the retention of therapeutics in the defect site for highly efficient bone regeneration with minimal low accumulation in other organs.
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Affiliation(s)
- Yifan Ma
- Department of Biomedical EngineeringThe Ohio State UniversityColumbusOH43210USA
- William G. Lowrie Department of Chemical and Biomolecular EngineeringThe Ohio State UniversityColumbusOH43210USA
| | - Lili Sun
- Key Laboratory for Ultrafine Materials of Ministry of Education and Frontiers Science Center for Materiobiology and Dynamic ChemistryEast China University of Science and Technology200237ShanghaiP. R. China
| | - Jingjing Zhang
- William G. Lowrie Department of Chemical and Biomolecular EngineeringThe Ohio State UniversityColumbusOH43210USA
| | - Chi‐ling Chiang
- William G. Lowrie Department of Chemical and Biomolecular EngineeringThe Ohio State UniversityColumbusOH43210USA
| | - Junjie Pan
- William G. Lowrie Department of Chemical and Biomolecular EngineeringThe Ohio State UniversityColumbusOH43210USA
| | - Xinyu Wang
- William G. Lowrie Department of Chemical and Biomolecular EngineeringThe Ohio State UniversityColumbusOH43210USA
| | | | - Hong Li
- William G. Lowrie Department of Chemical and Biomolecular EngineeringThe Ohio State UniversityColumbusOH43210USA
| | - Renliang Zhao
- Department of Orthopedic Surgery and Shanghai Institute of Microsurgery on ExtremitiesShanghai Jiao Tong University Affiliated Sixth People's Hospital200233ShanghaiChina
| | - Xilal Y. Rima
- William G. Lowrie Department of Chemical and Biomolecular EngineeringThe Ohio State UniversityColumbusOH43210USA
| | - Chi Zhang
- College of PharmacyThe Ohio State UniversityColumbusOH43210USA
| | - Anan Zhang
- Key Laboratory for Ultrafine Materials of Ministry of Education and Frontiers Science Center for Materiobiology and Dynamic ChemistryEast China University of Science and Technology200237ShanghaiP. R. China
| | - Yutong Liu
- Key Laboratory for Ultrafine Materials of Ministry of Education and Frontiers Science Center for Materiobiology and Dynamic ChemistryEast China University of Science and Technology200237ShanghaiP. R. China
| | - Zirui He
- Key Laboratory for Ultrafine Materials of Ministry of Education and Frontiers Science Center for Materiobiology and Dynamic ChemistryEast China University of Science and Technology200237ShanghaiP. R. China
| | - Derek Hansford
- Department of Biomedical EngineeringThe Ohio State UniversityColumbusOH43210USA
| | - Eduardo Reategui
- William G. Lowrie Department of Chemical and Biomolecular EngineeringThe Ohio State UniversityColumbusOH43210USA
| | - Changsheng Liu
- Key Laboratory for Ultrafine Materials of Ministry of Education and Frontiers Science Center for Materiobiology and Dynamic ChemistryEast China University of Science and Technology200237ShanghaiP. R. China
| | - Andrew S. Lee
- School of Chemical Biology and BiotechnologyPeking University Shenzhen Graduate School518055ShenzhenChina
- Institute for Cancer ResearchShenzhen Bay Laboratory518055ShenzhenChina
| | - Yuan Yuan
- William G. Lowrie Department of Chemical and Biomolecular EngineeringThe Ohio State UniversityColumbusOH43210USA
- Key Laboratory for Ultrafine Materials of Ministry of Education and Frontiers Science Center for Materiobiology and Dynamic ChemistryEast China University of Science and Technology200237ShanghaiP. R. China
| | - Ly James Lee
- Department of Biomedical EngineeringThe Ohio State UniversityColumbusOH43210USA
- William G. Lowrie Department of Chemical and Biomolecular EngineeringThe Ohio State UniversityColumbusOH43210USA
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17
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Jeong CH, Lim SY, Um JE, Lim HW, Hwang KH, Park KM, Yun JS, Kim D, Huh JK, Kim HS, Yook JI, Kim NH, Kwak YH. Micellized protein transduction domain-bone morphogenetic protein-2 accelerates bone healing in a rat tibial distraction osteogenesis model. Acta Biomater 2023; 170:360-375. [PMID: 37611691 DOI: 10.1016/j.actbio.2023.08.031] [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: 03/07/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023]
Abstract
The clinical application of growth factors such as recombinant human bone morphogenetic protein-2 (rh-BMP-2), for functional bone regeneration remains challenging due to limited in vivo efficacy and adverse effects of previous modalities. To overcome the instability and short half-life of rh-BMP-2 in vivo, we developed a novel osteogenic supplement by fusing a protein transduction domain (PTD) with BMP-2, effectively creating a prodrug of BMP-2. In this study, we first created an improved PTD-BMP-2 formulation using lipid nanoparticle (LNP) micellization, resulting in downsizing from micrometer to nanometer scale and achieving a more even distribution. The micellized PTD-BMP-2 (mPTD-BMP-2) demonstrated improved distribution and aggregation profiles. As a prodrug of BMP-2, mPTD-BMP-2 successfully activated Smad1/5/8 and induced mineralization with osteogenic gene induction in vitro. In vivo pharmacokinetic analysis revealed that mPTD-BMP-2 had a much more stable pharmacokinetic profile than rh-BMP-2, with a 7.5-fold longer half-life. The in vivo BMP-responsive element (BRE) reporter system was also successfully activated by mPTD-BMP-2. In the in vivo rat tibia distraction osteogenesis (DO) model, micro-computed tomography (micro-CT) scan findings indicated that mPTD-BMP-2 significantly increased bone volume, bone surface, axis moment of inertia (MOI), and polar MOI. Furthermore, it increased the expression of osteogenesis-related genes, and induced bone maturation histologically. Based on these findings, mPTD-BMP-2 could be a promising candidate for the next-generation osteogenesis drug to promote new bone formation in DO surgery. STATEMENT OF SIGNIFICANCE: This study introduces micellized bone morphogenetic protein-2 (mPTD-BMP-2), a next-generation osteogenic supplement that combines protein transduction domain (PTD) and nano-sized micelle formulation technique to improve transduction efficiency and stability. The use of PTD represents a novel approach, and our results demonstrate the superiority of mPTD-BMP-2 over rh-BMP-2 in terms of in vivo pharmacokinetic profile and osteogenic potential, particularly in a rat tibial model of distraction osteogenesis. These findings have significant scientific impact and potential clinical applications in the treatment of bone defects that require distraction osteogenesis. By advancing the field of osteogenic supplements, our study has the potential to contribute to the development of more effective treatments for musculoskeletal disorders.
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Affiliation(s)
- Cheol Hee Jeong
- Department of Oral Pathology, Yonsei University College of Dentistry, Seoul, 03722, Korea; Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Song-Yi Lim
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea
| | - Jo Eun Um
- MET Life Science, Seoul, 03722, Korea
| | - Hyo Won Lim
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea
| | | | - Kyeong-Mee Park
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Jun Seop Yun
- Department of Oral Pathology, Yonsei University College of Dentistry, Seoul, 03722, Korea; Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Dohun Kim
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, 06273, Korea
| | - Hyun Sil Kim
- Department of Oral Pathology, Yonsei University College of Dentistry, Seoul, 03722, Korea; Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, 03722, Korea; MET Life Science, Seoul, 03722, Korea
| | - Jong In Yook
- Department of Oral Pathology, Yonsei University College of Dentistry, Seoul, 03722, Korea; Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, 03722, Korea; MET Life Science, Seoul, 03722, Korea
| | - Nam Hee Kim
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, 03722, Korea; MET Life Science, Seoul, 03722, Korea.
| | - Yoon Hae Kwak
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea.
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Romero-Torrecilla JA, Lamo-Espinosa JM, Ripalda-Cemboráin P, López-Martínez T, Abizanda G, Riera-Álvarez L, de Galarreta-Moriones SR, López-Barberena A, Rodríguez-Flórez N, Elizalde R, Jayawarna V, Valdés-Fernández J, de Anleo MEG, Childs P, de Juan-Pardo E, Salmeron-Sanchez M, Prósper F, Muiños-López E, Granero-Moltó F. An engineered periosteum for efficient delivery of rhBMP-2 and mesenchymal progenitor cells during bone regeneration. NPJ Regen Med 2023; 8:54. [PMID: 37773177 PMCID: PMC10541910 DOI: 10.1038/s41536-023-00330-2] [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: 02/14/2023] [Accepted: 09/14/2023] [Indexed: 10/01/2023] Open
Abstract
During bone regeneration, the periosteum acts as a carrier for key regenerative cues, delivering osteochondroprogenitor cells and crucial growth factors to the injured bone. We developed a biocompatible, 3D polycaprolactone (PCL) melt electro-written membrane to act as a mimetic periosteum. Poly (ethyl acrylate) coating of the PCL membrane allowed functionalization, mediated by fibronectin and low dose recombinant human BMP-2 (rhBMP-2) (10-25 μg/ml), resulting in efficient, sustained osteoinduction in vitro. In vivo, rhBMP-2 functionalized mimetic periosteum demonstrated regenerative potential in the treatment of rat critical-size femoral defects with highly efficient healing and functional recovery (80%-93%). Mimetic periosteum has also proven to be efficient for cell delivery, as observed through the migration of transplanted periosteum-derived mesenchymal cells to the bone defect and their survival. Ultimately, mimetic periosteum demonstrated its ability to deliver key stem cells and morphogens to an injured site, exposing a therapeutic and translational potential in vivo when combined with unprecedentedly low rhBMP-2 doses.
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Affiliation(s)
- Juan Antonio Romero-Torrecilla
- Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Spain
- Biomedical Engineering Program, Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain
| | - José María Lamo-Espinosa
- Department of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Pamplona, Spain
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA), Pamplona, Spain
| | - Purificación Ripalda-Cemboráin
- Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Spain
- Biomedical Engineering Program, Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain
- Department of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Pamplona, Spain
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA), Pamplona, Spain
| | - Tania López-Martínez
- Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Spain
- Biomedical Engineering Program, Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA), Pamplona, Spain
| | - Gloria Abizanda
- Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Spain
- Biomedical Engineering Program, Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain
| | - Luis Riera-Álvarez
- Department of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Pamplona, Spain
| | | | | | - Naiara Rodríguez-Flórez
- Tecnun-School of Engineering, Universidad de Navarra, San Sebastian, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Reyes Elizalde
- Tecnun-School of Engineering, Universidad de Navarra, San Sebastian, Spain
| | - Vineetha Jayawarna
- Center for the Cellular Microenvironment, James Watt School of Engineering, University of Glasgow, Glasgow, United Kingdom
| | - José Valdés-Fernández
- Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Spain
- Biomedical Engineering Program, Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain
| | - Miguel Echanove-González de Anleo
- Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Spain
- Biomedical Engineering Program, Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain
| | - Peter Childs
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Elena de Juan-Pardo
- T3mPLATE, Harry Perkins Institute of Medical Research, Queen Elizabeth II Medical Centre and the UWA Centre for Medical Research, The University of Western Australia, Perth, Australia
| | - Manuel Salmeron-Sanchez
- Center for the Cellular Microenvironment, James Watt School of Engineering, University of Glasgow, Glasgow, United Kingdom
| | - Felipe Prósper
- Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Spain
- Biomedical Engineering Program, Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA), Pamplona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Pamplona, Spain
- Department of Hematology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Emma Muiños-López
- Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Spain.
- Biomedical Engineering Program, Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain.
- Department of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Pamplona, Spain.
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA), Pamplona, Spain.
| | - Froilán Granero-Moltó
- Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Spain.
- Biomedical Engineering Program, Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain.
- Department of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Pamplona, Spain.
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA), Pamplona, Spain.
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Liau Zi Qiang G, Liu Jiani S, Lam WMR, Weng J, Hua LHK, Kok L, Husain SF, Liu L, Khanna S, Wong HK. Systemic Diclofenac Sodium Reduces Postoperative rhBMP-2 Induced Neuroinflammation: A Rodent Model Study. Spine (Phila Pa 1976) 2023; 48:1326-1334. [PMID: 37326447 DOI: 10.1097/brs.0000000000004749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 05/31/2023] [Indexed: 06/17/2023]
Abstract
STUDY DESIGN This is a basic science, animal research study. OBJECTIVE This study aims to explore, in rodent models, the effectiveness of systemic nonsteroidal anti-inflammatory drugs in reducing recombinant human bone morphogenetic protein-2 (rhBMP-2) induced neuroinflammation. SUMMARY OF BACKGROUND DATA rhBMP-2 is increasingly used to augment fusion in lumbar interbody fusion surgeries, although it can cause complications including postoperative radiculitis. MATERIALS AND METHODS Eighteen 8-week-old Sprague-Dawley rats underwent Hargreaves testing to measure the baseline thermal withdrawal threshold before undergoing surgical intervention. The L5 nerve root was exposed and wrapped with an Absorbable Collagen Sponge containing rhBMP-2. Rats were randomized into 3 groups: (1) Low dose (LD), (2) high dose (HD) diclofenac sodium, and (3) saline, receiving daily injection treatment. Hargreaves testing was performed postoperatively on days 5 and 7. Seroma volumes were measured by aspiration and the nerve root was then harvested for hematoxylin and eosin, immunohistochemistry, Luxol Fast Blue staining, and real-time quantitative polymerase chain reaction. The Student t test was used to evaluate the statistical significance among groups. RESULTS The intervention groups showed reduced seroma volume, and a general reduction of inflammatory markers (MMP12, MAPK6, GFAP, CD68, and IL18) compared with controls, with the reduction in MMP12 being statistically significant ( P = 0.02). Hematoxylin and eosin and immunohistochemistry of the nerve roots showed the highest macrophage density in the saline controls and the lowest in the HD group. Luxol Fast Blue staining showed the greatest extent of demyelination in the LD and saline groups. Lastly, Hargreaves testing, a functional measure of neuroinflammation, of the HD group demonstrated a minimal change in thermal withdrawal latency. In contrast, the thermal withdrawal latency of the LD and saline groups showed a statistically significant decrease of 35.2% and 28.0%, respectively ( P < 0.05). CONCLUSION This is the first proof-of-concept study indicating that diclofenac sodium is effective in alleviating rhBMP-2-induced neuroinflammation. This can potentially impact the clinical management of rhBMP-2-induced radiculitis. It also presents a viable rodent model for evaluating the effectiveness of analgesics in reducing rhBMP-2-induced inflammation.
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Affiliation(s)
- Glen Liau Zi Qiang
- University Spine Centre, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital System, Singapore, Singapore
| | - Sherry Liu Jiani
- University Spine Centre, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital System, Singapore, Singapore
| | - Wing Moon Raymond Lam
- Department of Orthopedic Surgery, National University of Health System, Singapore, Singapore
| | - Jiayi Weng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lucius Ho Kang Hua
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Louise Kok
- University Spine Centre, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital System, Singapore, Singapore
| | - Syeda Fabeha Husain
- Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Ling Liu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sanjay Khanna
- Centre for Life Sciences (CeLS), National University of Singapore, Singapore, Singapore
| | - Hee Kit Wong
- University Spine Centre, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital System, Singapore, Singapore
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20
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Seong CH, Chiba N, Fredy M, Kusuyama J, Ishihata K, Kibe T, Amir MS, Tada R, Ohnishi T, Nakamura N, Matsuguchi T. Early induction of Hes1 by bone morphogenetic protein 9 plays a regulatory role in osteoblastic differentiation of a mesenchymal stem cell line. J Cell Biochem 2023; 124:1366-1378. [PMID: 37565579 DOI: 10.1002/jcb.30452] [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: 12/10/2022] [Revised: 07/08/2023] [Accepted: 07/19/2023] [Indexed: 08/12/2023]
Abstract
Bone morphogenic protein 9 (BMP9) is one of the most potent inducers of osteogenic differentiation among the 14 BMP members, but its mechanism of action has not been fully demonstrated. Hes1 is a transcriptional regulator with basic helix-loop-helix (bHLH) domain and is a well-known Notch effector. In this study, we investigated the functional roles of early induction of Hes1 by BMP9 in a mouse mesenchymal stem cell line, ST2. Hes1 mRNA was transiently and periodically induced by BMP9 in ST2, which was inhibited by BMP signal inhibitors but not by Notch inhibitor. Interestingly, Hes1 knockdown in ST2 by siRNA increased the expression of osteogenic differentiation markers such as Sp7 and Ibsp and matrix mineralization in comparison with control siRNA transfected ST2. In contrast, forced expression of Hes1 by using the Tet-On system suppressed the expression of osteogenic markers and matrix mineralization by BMP9. We also found that the early induction of Hes1 by BMP9 suppressed the expression of Alk1, an essential receptor for BMP9. In conclusion, BMP9 rapidly induces the expression of Hes1 via the SMAD pathway in ST2 cells, which plays a negative regulatory role in osteogenic differentiation of mesenchymal stem cells induced by BMP9.
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Affiliation(s)
- Chang-Hwan Seong
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Department of Oral Biochemistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Norika Chiba
- Department of Oral Biochemistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Mardiyantoro Fredy
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Department of Oral Biochemistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Airlangga University, Surabaya, Indonesia
| | - Joji Kusuyama
- Department of Oral Biochemistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Brawijaya University, Malang, Indonesia
| | - Kiyohide Ishihata
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Toshiro Kibe
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Muhammad Subhan Amir
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Department of Oral Biochemistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Department of Biosignals and Inheritance, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Ryohei Tada
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Department of Oral Biochemistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tomokazu Ohnishi
- Department of Oral Biochemistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Norifumi Nakamura
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tetsuya Matsuguchi
- Department of Oral Biochemistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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21
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Panos JA, Coenen MJ, Nagelli CV, McGlinch EB, Atasoy-Zeybek A, De Padilla CL, De la Vega RE, Evans CH. Segmental defect healing in the presence or absence of recombinant human BMP2: Novel insights from a rat model. J Orthop Res 2023; 41:1934-1944. [PMID: 36850029 PMCID: PMC10440238 DOI: 10.1002/jor.25530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/16/2023] [Accepted: 02/08/2023] [Indexed: 03/01/2023]
Abstract
This study defined and compared the course of native, impaired and growth factor-stimulated bone regeneration in a rat femoral defect model. A mid-diaphyseal defect with rigid internal fixation was surgically created in the right femur of male Fischer rats and serially analyzed over 36 weeks. Native bone regeneration was modeled using a sub-critical, 1 mm size defect, which healed uneventfully. Critical size defects of 5 mm were used to analyze impaired bone regeneration. In a third group, the 5 mm defects were filled with 11 µg of recombinant human bone morphogenetic protein 2 (rhBMP2) impregnated onto an absorbable collagen sponge, modeling its clinical use. Native bone regeneration was characterized by endochondral ossification with progressive remodeling to ultimately resemble intact femora. An endochondral response was also observed under conditions of impaired bone regeneration, but by week 8 medullary capping occurred with fibrofatty consolidation of the tissue within the defect, resembling an atrophic non-union. rhBMP2 treatment was associated with prolonged inflammatory cytokine expression and rapid intramembranous bone formation occurring with reduced expression of cartilage-associated collagens. Between weeks 4 and 36, rhBMP2-treated bones demonstrated decreased trabecular number and increased trabecular separation, which resulted in inferior mechanical properties compared with bones that healed naturally. Clinical Significance: Recombinant human bone morphogenetic protein 2 (rhBMP2) is used clinically to promote healing of long bones. Our data suggest that it drives intramembraneous ossification producing an inferior regenerate that deteriorates with time. Clinical outcomes would be improved by technologies favoring endochondral regenerative ossification.
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Affiliation(s)
- Joseph A. Panos
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
- Graduate School of Biomedical Sciences, Mayo Clinic; Rochester, Minnesota, USA
- Medical Scientist Training Program, Mayo Clinic; Rochester, Minnesota, USA
| | - Michael J. Coenen
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
| | - Christopher V. Nagelli
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
| | - Erin B. McGlinch
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
- Graduate School of Biomedical Sciences, Mayo Clinic; Rochester, Minnesota, USA
- Virology and Gene Therapy Graduate Program, Mayo Clinic; Rochester, Minnesota, USA
| | - Aysegul Atasoy-Zeybek
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
| | - Consuelo Lopez De Padilla
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
| | - Rodolfo E. De la Vega
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute; Maastricht, The Netherlands
| | - Christopher H. Evans
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
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Munim MA, Berlinberg E, Federico VP, Nolte MT, Prabhu M, Pawlowski H, Patel KS, Colman MW. Usage Trends and Safety Profile of Recombinant Human Bone Morphogenetic Protein-2 for Spinal Column Tumor Surgery: A National Matched Cohort Analysis. Global Spine J 2023:21925682231194248. [PMID: 37542521 DOI: 10.1177/21925682231194248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
STUDY DESIGN Retrospective Cohort Analysis. OBJECTIVE The purpose of this study is to investigate national rates of rhBMP-2 utilization in spinal tumor surgery and examine its association with postoperative complications, revisions, and carcinogenicity. METHODS All patients diagnosed with primary or metastatic spinal tumors with subsequent surgical intervention involving a spinal fusion procedure were identified in PearlDiver. Patients were 1:1 matched into 2 cohorts according to rhBMP-2 usage. Postoperative complications and revisions were examined at 1 month, 3 months, 6 months, and 1 year after fusion. New cancer incidence following spinal tumor surgery was assessed until 5 years postoperatively. RESULTS A total of 11,198 patients underwent fusion surgery after resection of spinal tumors between 2005 and 2020, with 909 cases reporting the use of rhBMP-2 (8.1%). An annualized analysis revealed that the proportion of spine tumor fusion procedures utilizing rhBMP-2 has been significantly decreasing (R2 = .859, P < .001), with the most recent annual utilization rate at 1.1%. At least 3 months after surgery, significantly increased incidences of surgical site (11.4% vs 3.3%, P = .03) and systemic infections (8.1% vs 1.6%, P = .02) were observed in patients who underwent fusion with rhBMP-2. Across all time points, no significant differences were observed in survival, implant removal, revision rates, or new cancer diagnoses. CONCLUSION This analysis demonstrated significantly declining national utilization rates. Spinal tumor cases utilizing rhBMP-2 sustained greater rates of surgical site and systemic infections. rhBMP-2 usage did not significantly reduce the risk of mortality, implant failure, or reoperation.
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Affiliation(s)
- Mohammed A Munim
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Elyse Berlinberg
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Vincent P Federico
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Michael T Nolte
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Michael Prabhu
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Hanna Pawlowski
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Karan S Patel
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Matthew W Colman
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
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23
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Wei J, Xia X, Xiao S, Jin S, Zou Q, Zuo Y, Li Y, Li J. Sequential Dual-Biofactor Release from the Scaffold of Mesoporous HA Microspheres and PLGA Matrix for Boosting Endogenous Bone Regeneration. Adv Healthc Mater 2023; 12:e2300624. [PMID: 36938866 DOI: 10.1002/adhm.202300624] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Indexed: 03/21/2023]
Abstract
The combined design of scaffold structure and multi-biological factors is a prominent strategy to promote bone regeneration. Herein, a composite scaffold of mesoporous hydroxyapatite (HA) microspheres loaded with the bone morphogenetic protein-2 (BMP-2) and a poly(DL-lactic-co-glycolic acid) (PLGA) matrix is constructed by 3D printing. Furthermore, the chemokine stromal cell-derived factor-1α (SDF-1α) is adsorbed on a scaffold surface to achieve the sequential release of the dual-biofactors. The results indicate that the rapid release of SDF-1α chemokine on the scaffold surface effectively recruits bone marrow-derived mesenchymal stem cells (BMSCs) to the target defect area, whereas the long-term sustained release of BMP-2 from the HA microspheres in the degradable PLGA matrix successfully triggers the osteogenic differentiation in the recruited BMSCs, significantly promoting bone regeneration and reconstruction. In addition, these structures/biofactors specially combining scaffold exhibit significantly better biological performance than that of other combined scaffolds, including the bare HA/PLGA scaffold, the scaffold loaded with SDF-1α or BMP-2 biofactor alone, and the scaffold with surface SDF-1α and BMP-2 dual-biofactors. The utilization of mesoporous HA, the assembly method, and sequential release of the two biofactors in the 3D printed composite scaffold present a new method for future design of high-performance bone repairing scaffolds.
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Affiliation(s)
- Jiawei Wei
- Research Center for Nano-Biomaterials, Analytical and Testing Center, Sichuan University, Chengdu, 610064, P. R. China
| | - Xue Xia
- Research Center for Nano-Biomaterials, Analytical and Testing Center, Sichuan University, Chengdu, 610064, P. R. China
| | - Shiqi Xiao
- Research Center for Nano-Biomaterials, Analytical and Testing Center, Sichuan University, Chengdu, 610064, P. R. China
| | - Shue Jin
- Research Center for Nano-Biomaterials, Analytical and Testing Center, Sichuan University, Chengdu, 610064, P. R. China
| | - Qin Zou
- Research Center for Nano-Biomaterials, Analytical and Testing Center, Sichuan University, Chengdu, 610064, P. R. China
| | - Yi Zuo
- Research Center for Nano-Biomaterials, Analytical and Testing Center, Sichuan University, Chengdu, 610064, P. R. China
| | - Yubao Li
- Research Center for Nano-Biomaterials, Analytical and Testing Center, Sichuan University, Chengdu, 610064, P. R. China
| | - Jidong Li
- Research Center for Nano-Biomaterials, Analytical and Testing Center, Sichuan University, Chengdu, 610064, P. R. China
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Awad K, Ahuja N, Yacoub AS, Brotto L, Young S, Mikos A, Aswath P, Varanasi V. Revolutionizing bone regeneration: advanced biomaterials for healing compromised bone defects. FRONTIERS IN AGING 2023; 4:1217054. [PMID: 37520216 PMCID: PMC10376722 DOI: 10.3389/fragi.2023.1217054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/06/2023] [Indexed: 08/01/2023]
Abstract
In this review, we explore the application of novel biomaterial-based therapies specifically targeted towards craniofacial bone defects. The repair and regeneration of critical sized bone defects in the craniofacial region requires the use of bioactive materials to stabilize and expedite the healing process. However, the existing clinical approaches face challenges in effectively treating complex craniofacial bone defects, including issues such as oxidative stress, inflammation, and soft tissue loss. Given that a significant portion of individuals affected by traumatic bone defects in the craniofacial area belong to the aging population, there is an urgent need for innovative biomaterials to address the declining rate of new bone formation associated with age-related changes in the skeletal system. This article emphasizes the importance of semiconductor industry-derived materials as a potential solution to combat oxidative stress and address the challenges associated with aging bone. Furthermore, we discuss various material and autologous treatment approaches, as well as in vitro and in vivo models used to investigate new therapeutic strategies in the context of craniofacial bone repair. By focusing on these aspects, we aim to shed light on the potential of advanced biomaterials to overcome the limitations of current treatments and pave the way for more effective and efficient therapeutic interventions for craniofacial bone defects.
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Affiliation(s)
- Kamal Awad
- Bone Muscle Research Center, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, TX, United States
- Department of Materials Science and Engineering, College of Engineering, The University of Texas at Arlington, Arlington, TX, United States
| | - Neelam Ahuja
- Bone Muscle Research Center, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, TX, United States
| | - Ahmed S. Yacoub
- Bone Muscle Research Center, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, TX, United States
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt
| | - Leticia Brotto
- Bone Muscle Research Center, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, TX, United States
| | - Simon Young
- Katz Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Antonios Mikos
- Center for Engineering Complex Tissues, Center for Excellence in Tissue Engineering, J.W. Cox Laboratory for Biomedical Engineering, Rice University, Houston, TX, United States
| | - Pranesh Aswath
- Department of Materials Science and Engineering, College of Engineering, The University of Texas at Arlington, Arlington, TX, United States
| | - Venu Varanasi
- Bone Muscle Research Center, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, TX, United States
- Department of Materials Science and Engineering, College of Engineering, The University of Texas at Arlington, Arlington, TX, United States
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Cottrill E, Pennington Z, Wolf MT, Dirckx N, Ehresman J, Perdomo-Pantoja A, Rajkovic C, Lin J, Maestas DR, Mageau A, Lambrechts D, Stewart V, Sciubba DM, Theodore N, Elisseeff JH, Witham T. Creation and preclinical evaluation of a novel mussel-inspired, biomimetic, bioactive bone graft scaffold: direct comparison with Infuse bone graft using a rat model of spinal fusion. J Neurosurg Spine 2023; 39:113-121. [PMID: 37021767 PMCID: PMC10758288 DOI: 10.3171/2023.2.spine22936] [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: 08/18/2022] [Accepted: 02/20/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE Infuse bone graft is a widely used osteoinductive adjuvant; however, the simple collagen sponge scaffold used in the implant has minimal inherent osteoinductive properties and poorly controls the delivery of the adsorbed recombinant human bone morphogenetic protein-2 (rhBMP-2). In this study, the authors sought to create a novel bone graft substitute material that overcomes the limitations of Infuse and compare the ability of this material with that of Infuse to facilitate union following spine surgery in a clinically translatable rat model of spinal fusion. METHODS The authors created a polydopamine (PDA)-infused, porous, homogeneously dispersed solid mixture of extracellular matrix and calcium phosphates (BioMim-PDA) and then compared the efficacy of this material directly with Infuse in the setting of different concentrations of rhBMP-2 using a rat model of spinal fusion. Sixty male Sprague Dawley rats were randomly assigned to each of six equal groups: 1) collagen + 0.2 µg rhBMP-2/side, 2) BioMim-PDA + 0.2 µg rhBMP-2/side, 3) collagen + 2.0 µg rhBMP-2/side, 4) BioMim-PDA + 2.0 μg rhBMP-2/side, 5) collagen + 20 µg rhBMP-2/side, and 6) BioMim-PDA + 20 µg rhBMP-2/side. All animals underwent posterolateral intertransverse process fusion at L4-5 using the assigned bone graft. Animals were euthanized 8 weeks postoperatively, and their lumbar spines were analyzed via microcomputed tomography (µCT) and histology. Spinal fusion was defined as continuous bridging bone bilaterally across the fusion site evaluated via µCT. RESULTS The fusion rate was 100% in all groups except group 1 (70%) and group 4 (90%). Use of BioMim-PDA with 0.2 µg rhBMP-2 led to significantly greater results for bone volume (BV), percentage BV, and trabecular number, as well as significantly smaller trabecular separation, compared with the use of the collagen sponge with 2.0 µg rhBMP-2. The same results were observed when the use of BioMim-PDA with 2.0 µg rhBMP-2 was compared with the use of the collagen sponge with 20 µg rhBMP-2. CONCLUSIONS Implantation of rhBMP-2-adsorbed BioMim-PDA scaffolds resulted in BV and bone quality superior to that afforded by treatment with rhBMP-2 concentrations 10-fold higher implanted on a conventional collagen sponge. Using BioMim-PDA (vs a collagen sponge) for rhBMP-2 delivery could significantly lower the amount of rhBMP-2 required for successful bone grafting clinically, improving device safety and decreasing costs.
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Affiliation(s)
- Ethan Cottrill
- Department of Neurosurgery, University School of Medicine, Baltimore, Maryland
- Department of Biomedical Engineering, University School of Medicine, Baltimore, Maryland
- Department of Orthopaedic Surgery, Duke University Health System, Durham, North Carolina
| | - Zach Pennington
- Department of Neurosurgery, University School of Medicine, Baltimore, Maryland
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Matthew T. Wolf
- Department of Biomedical Engineering, University School of Medicine, Baltimore, Maryland
- Laboratory of Cancer Immunometabolism, Center for Cancer Research, National Cancer Institute, Frederick, Maryland
| | - Naomi Dirckx
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jeff Ehresman
- Department of Neurosurgery, University School of Medicine, Baltimore, Maryland
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona
| | | | - Christian Rajkovic
- Department of Neurosurgery, University School of Medicine, Baltimore, Maryland
| | - Jessica Lin
- Department of Neurosurgery, University School of Medicine, Baltimore, Maryland
| | - David R. Maestas
- Department of Biomedical Engineering, University School of Medicine, Baltimore, Maryland
| | - Ashlie Mageau
- Department of Biomedical Engineering, University School of Medicine, Baltimore, Maryland
| | - Dennis Lambrechts
- Department of Biomedical Engineering, University School of Medicine, Baltimore, Maryland
| | - Veronica Stewart
- Department of Chemistry, University, Baltimore, Maryland
- Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Daniel M. Sciubba
- Department of Neurosurgery, University School of Medicine, Baltimore, Maryland
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, New York
| | - Nicholas Theodore
- Department of Neurosurgery, University School of Medicine, Baltimore, Maryland
| | - Jennifer H. Elisseeff
- Department of Biomedical Engineering, University School of Medicine, Baltimore, Maryland
| | - Timothy Witham
- Department of Neurosurgery, University School of Medicine, Baltimore, Maryland
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26
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Bi Z, Shi X, Liao S, Li X, Sun C, Liu J. Strategies of immobilizing BMP-2 with 3D-printed scaffolds to improve osteogenesis. Regen Med 2023; 18:425-441. [PMID: 37125508 DOI: 10.2217/rme-2022-0222] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
The management and definitive treatment of critical-size bone defects in severe trauma, tumor resection and congenital malformation are troublesome for orthopedic surgeons and patients worldwide without recognized good treatment strategies. Researchers and clinicians are working to develop new strategies to treat these problems. This review aims to summarize the techniques used by additive manufacturing scaffolds loaded with BMP-2 to promote osteogenesis and to analyze the current status and trends in relevant clinical translation. Optimize composite scaffold design to enhance bone regeneration through printing technology, material selection, structure design and loading methods of BMP-2 to advance the clinical therapeutic bone repair field.
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Affiliation(s)
- Zhiguo Bi
- Department of Orthopaedics, The First Hospital of Jilin University, Changchun, Jilin Province, 130021, China
| | - Xiaotong Shi
- Department of Orthopaedics, The First Hospital of Jilin University, Changchun, Jilin Province, 130021, China
| | - Shiyu Liao
- Department of Orthopaedics, The First Hospital of Jilin University, Changchun, Jilin Province, 130021, China
| | - Xiao Li
- Department of Orthopaedics, The First Hospital of Jilin University, Changchun, Jilin Province, 130021, China
| | - Chao Sun
- Department of Orthopaedics, The First Hospital of Jilin University, Changchun, Jilin Province, 130021, China
| | - Jianguo Liu
- Department of Orthopaedics, The First Hospital of Jilin University, Changchun, Jilin Province, 130021, China
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Lee D, Lee J, Koo KT, Seol YJ, Lee YM. The impact of polydeoxyribonucleotide on early bone formation in lateral-window sinus floor elevation with simultaneous implant placement. J Periodontal Implant Sci 2023; 53:157-169. [PMID: 36468479 PMCID: PMC10133820 DOI: 10.5051/jpis.2202760138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/13/2022] [Accepted: 08/09/2022] [Indexed: 04/26/2023] Open
Abstract
PURPOSE The aim of this study was to evaluate the impact of polydeoxyribonucleotide (PDRN) on histologic outcomes when implant placement and lateral sinus floor elevation are performed simultaneously. METHODS Three bimaxillary premolars (P2, P3, and P4) were extracted from 4 beagle dogs 2 months before lateral sinus floor elevation. After lateral elevation of the sinus membrane, each sinus was allocated to either the test or control group. Sinuses underwent either 1) collagenated synthetic bone graft with PDRN following lateral sinus floor elevation (test group) or 2) collagenated synthetic bone graft without PDRN after lateral sinus floor elevation (control group). Eight weeks after the surgical procedure, all animals were euthanised for a histologic and histomorphometric assessment. Augmented height (AH), protruding height (PH), and bone-to-implant contact in pristine (BICp) and augmented (BICa) bone were measured. The composition of the augmented area, which was divided into 3 areas of interest located in coronal, middle and apical areas (AOI_C, AOI_M, and AOI_A), was calculated with 3 parameters: the area percentage of new bone (pNB), residual bone graft particle (pRBP), and fibrovascular connective tissue (pFVT). RESULTS AH, PH, BICp, BICa total, BICa coronal, and BICa middle values were not significantly different between sinuses in the control and test groups (all P>0.05). The BICa apical of sinuses in the test group (76.7%±9.3%) showed statistically higher values than those of sinuses in the control group (55.6%±22.1%) (P=0.038). pNB, pRBP, and pFVT showed statistically significant differences between the 2 groups in AOI_A (P=0.038, P=0.028, and P=0.007, respectively). pNB, pRBP, and pFVT in AOI_C and AOI_M were not significantly different between samples in the control and test groups (all P>0.05). CONCLUSIONS The histologic findings revealed that lateral sinus floor elevation with PDRN might improve early new bone formation and enable higher bone-to-implant contact.
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Affiliation(s)
- Dongseob Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea
| | - Jungwon Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Korea.
| | - Ki-Tae Koo
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea
| | - Yang-Jo Seol
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea.
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Woloszyk A, Aguilar L, Perez L, Salinas EL, Glatt V. Biomimetic hematoma delivers an ultra-low dose of rhBMP-2 to successfully regenerate large femoral bone defects in rats. BIOMATERIALS ADVANCES 2023; 148:213366. [PMID: 36905826 DOI: 10.1016/j.bioadv.2023.213366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/10/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
Successful repair of large bone defects remains a clinical challenge. Following fractures, a bridging hematoma immediately forms as a crucial step that initiates bone healing. In larger bone defects the micro-architecture and biological properties of this hematoma are compromised, and spontaneous union cannot occur. To address this need, we developed an ex vivo Biomimetic Hematoma that resembles naturally healing fracture hematoma, using whole blood and the natural coagulants calcium and thrombin, as an autologous delivery vehicle for a very reduced dose of rhBMP-2. When implanted into a rat femoral large defect model, complete and consistent bone regeneration with superior bone quality was achieved with 10-20× less rhBMP-2 compared to that required with the collagen sponges currently used. Moreover, calcium and rhBMP-2 demonstrated a synergistic effect enhancing osteogenic differentiation, and fully restored mechanical strength 8 weeks after surgery. Collectively, these findings suggest the Biomimetic Hematoma provides a natural reservoir for rhBMP-2, and that retention of the protein within the scaffold rather than its sustained release might be responsible for more robust and rapid bone healing. Clinically, this new implant, using FDA-approved components, would not only reduce the risk of adverse events associated with BMPs, but also decrease treatment costs and nonunion rates.
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Affiliation(s)
- Anna Woloszyk
- Department of Orthopaedics, University of Texas Health Science Center, San Antonio 78229, TX, USA
| | - Leonardo Aguilar
- Department of Orthopaedics, University of Texas Health Science Center, San Antonio 78229, TX, USA
| | - Louis Perez
- Department of Orthopaedics, University of Texas Health Science Center, San Antonio 78229, TX, USA
| | - Emily L Salinas
- Department of Orthopaedics, University of Texas Health Science Center, San Antonio 78229, TX, USA
| | - Vaida Glatt
- Department of Orthopaedics, University of Texas Health Science Center, San Antonio 78229, TX, USA; Sam and Ann Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center, San Antonio 78229, TX, USA.
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29
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Su N, Villicana C, Barati D, Freeman P, Luo Y, Yang F. Stem Cell Membrane-Coated Microribbon Scaffolds Induce Regenerative Innate and Adaptive Immune Responses in a Critical-Size Cranial Bone Defect Model. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2208781. [PMID: 36560890 PMCID: PMC10057912 DOI: 10.1002/adma.202208781] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/09/2022] [Indexed: 05/31/2023]
Abstract
Naturally-derived cell membranes have shown great promise in functionalizing nanoparticles to enhance biointerfacing functions for drug delivery applications. However, its potential for functionalizing macroporous scaffolds to enhance tissue regeneration in vivo remains unexplored. Engineering scaffolds with immunomodulatory functions represents an exciting strategy for tissue regeneration but is largely limited to soft tissues. Critical-sized bone defects cannot heal on their own, and the role of adaptive immune cells in scaffold-mediated healing of cranial bone defects remains largely unknown. Here, mensenchymal stem cell membrane (MSCM)-coated microribbon (µRB) scaffolds for treating critical size cranial bone defects via targeting immunomodulation are reported. Confocal imaging and proteomic analyses are used to confirm successful coating and characterize the compositions of cell membrane coating. It is demonstrated that MSCM coating promotes macrophage (Mφ) polarization toward regenerative phenotype, induces CD8+ T cell apoptosis, and enhances regulatory T cell differentiation in vitro and in vivo. When combined with a low dosage of BMP-2, MSCM coating further accelerates bone regeneration and suppresses inflammation. These results establish cell membrane-coated microribbon scaffolds as a promising strategy for treating critical size bone defects via immunomodulation. The platform may be broadly used with different cell membranes and scaffolds to enhance regeneration of multiple tissue types.
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Affiliation(s)
- Ni Su
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Cassandra Villicana
- Department of Bioengineering, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Danial Barati
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Peyton Freeman
- Department of Bioengineering, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Ying Luo
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts, USA 02155
| | - Fan Yang
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Department of Bioengineering, Stanford University School of Medicine, Stanford, CA, 94305, USA
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30
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Lee AE, Choi JG, Shi SH, He P, Zhang QZ, Le AD. DPSC-Derived Extracellular Vesicles Promote Rat Jawbone Regeneration. J Dent Res 2023; 102:313-321. [PMID: 36348514 DOI: 10.1177/00220345221133716] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Repair and functional reconstruction of large jawbone defects remain one of the challenges in the field of head and neck surgery. The recent progress in tissue engineering technologies and stem cell biology has significantly promoted the development of regenerative reconstruction of jawbone defects. The multiple trophic activities of extracellular vesicles (EVs) produced by mesenchymal stem cells (MSCs) may play a critical role in their therapeutic effects. Accumulating evidence has shown the promise of dental pulp stem cells (DPSCs) in bone regeneration, but less is known about the regenerative effects of DPSC-EVs on jawbone defects. The purpose of this study is to explore the osteogenic effects of DPSC-EVs on jawbone marrow-derived MSCs (JB-MSCs) in vitro and their osteoinductive effects in a mandibular bone defect model in rats. Our results showed that JB-MSCs could efficiently uptake DPSC-EVs, which in turn significantly promoted the expression of osteogenic genes, such as runt-related transcription factor 2 (RUNX2), alkaline phosphatase (ALP), and osteocalcin (OCN), as well as the osteogenic differentiation capability of JB-MSCs. Meanwhile, we found that the pro-osteogenic effect in vitro induced by DPSC-EVs was comparable to that induced by BMP-2 (bone morphogenetic protein 2), currently the only Food and Drug Administration-approved osteoinductive growth factor. In vivo, animals that were locally treated with DPSC-EVs laden with a commercially available collagen membrane exhibited a relatively fast wound closure and increased new bone density at the mandible defects. Our results provide evidence for the osteogenic and osteoinductive effects of DPSC-EVs on jawbone regeneration. Due to the accessibility, rapid proliferation, and osteogenic propensity of DPSCs, DPSC-EVs may represent a safe cell-free therapeutic approach for craniofacial bone regeneration.
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Affiliation(s)
- A E Lee
- Department of Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J G Choi
- Department of Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Oral and Maxillofacial Surgery, NYU Langone Hospitals, New York, NY, USA
| | - S H Shi
- Department of Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - P He
- Department of Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Oral and Maxillofacial Surgery, Perelman Center for Advanced Medicine, Penn Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Q Z Zhang
- Department of Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - A D Le
- Department of Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Oral and Maxillofacial Surgery, Perelman Center for Advanced Medicine, Penn Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Liu Y, Puthia M, Sheehy EJ, Ambite I, Petrlova J, Prithviraj S, Oxborg MW, Sebastian S, Vater C, Zwingenberger S, Struglics A, Bourgine PE, O'Brien FJ, Raina DB. Sustained delivery of a heterodimer bone morphogenetic protein-2/7 via a collagen hydroxyapatite scaffold accelerates and improves critical femoral defect healing. Acta Biomater 2023; 162:164-181. [PMID: 36967054 DOI: 10.1016/j.actbio.2023.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 04/07/2023]
Abstract
Despite the glimmer of hope provided by the discovery and commercialization of bone morphogenetic protein-2 (BMP-2) as a bone graft substitute, side effects related to the use of supraphysiological doses have hindered its clinical usage. In this study, we compared the osteoinductive potential of BMP-2 homodimer with a heterodimer of BMP-2/7, both delivered via a collagen-hydroxyapatite (CHA) scaffold delivery system, with the aim to reduce the overall therapeutic BMP doses and the associated side-effects. We first show that the incorporation of hydroxyapatite in collagen-based BMP delivery systems is pivotal for achieving efficient BMP sequestration and controlled release. Using an ectopic implantation model, we then showed that the CHA+BMP-2/7 was more osteoinductive than CHA+BMP-2. Further evaluation of the molecular mechanisms responsible for this increased osteoinductivity at an early stage in the regeneration process indicated that the CHA+BMP-2/7 enhanced progenitor cell homing at the implantation site, upregulated the key transcriptomic determinants of bone formation, and increased the production of bone extracellular matrix components. Using fluorescently labelled BMP-2/7 and BMP-2, we demonstrated that the CHA scaffold provided a long-term delivery of both molecules for at least 20 days. Finally, using a rat femoral defect model, we showed that an ultra-low dose (0.5 µg) of BMP-2/7 accelerated fracture healing and performed at a level comparable to 20-times higher BMP-2 dose. Our results indicate that the sustained delivery of BMP-2/7 via a CHA scaffold could bring us a step closer in the quest for the use of physiological growth factor doses in fracture healing. STATEMENT OF SIGNIFICANCE: • Incorporation of hydroxyapatite (HA) in a collagen scaffold dramatically improves bone morphogenic protein (BMP) sequestration via biophysical interactions with BMP, thereby providing more controlled BMP release compared with pristine collagen. • We then investigate the molecular mechanisms responsible for increased osteoinductive potential of a heterodimer BMP-2/7 with is clinically used counterpart, the BMP-2 homodimer. • The superior osteoinductive properties of BMP-2/7 are a consequence of its direct positive effect on progenitor cell homing at the implantation site, which consequently leads to upregulation of cartilage and bone related genes and biochemical markers. • An ultra-low dose of BMP-2/7 delivered via a collagen-HA (CHA) scaffold leads to accelerated healing of a critical femoral defect in rats while a 20-times higher BMP-2 dose was required to achieve comparable results.
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32
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Abel F, Tan ET, Sneag DB, Lebl DR, Chazen JL. Postoperative Lumbar Fusion Bone Morphogenic Protein-Related Epidural Cyst Formation. AJNR Am J Neuroradiol 2023; 44:351-355. [PMID: 36797032 PMCID: PMC10187819 DOI: 10.3174/ajnr.a7799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/27/2023] [Indexed: 02/18/2023]
Abstract
Bone morphogenetic protein is broadly used in spinal surgery to enhance fusion rates. Several complications have been associated with the use of bone morphogenetic protein, including postoperative radiculitis and pronounced bone resorption/osteolysis. Bone morphogenetic protein-related epidural cyst formation may represent another complication that has not been described aside from limited case reports. In this case series, we retrospectively reviewed imaging and clinical findings of 16 patients with epidural cysts on postoperative MR imaging following lumbar fusion. In 8 patients, mass effect on the thecal sac or lumbar nerve roots was noted. Of these, 6 patients developed new postoperative lumbosacral radiculopathy. During the study period, most patients were managed conservatively, and 1 patient required revision surgery with cyst resection. Concurrent imaging findings included reactive endplate edema and vertebral bone resorption/osteolysis. Epidural cysts had characteristic findings on MR imaging in this case series and may represent an important postoperative complication in patients following bone morphogenetic protein-augmented lumbar fusion.
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Affiliation(s)
- F Abel
- From the Departments of Radiology and Imaging (F.A., E.T.T., D.B.S., J.L.C.)
- Spine Surgery (F.A., D.R.L.), Hospital for Special Surgery, New York, New York
| | - E T Tan
- From the Departments of Radiology and Imaging (F.A., E.T.T., D.B.S., J.L.C.)
| | - D B Sneag
- From the Departments of Radiology and Imaging (F.A., E.T.T., D.B.S., J.L.C.)
| | - D R Lebl
- Spine Surgery (F.A., D.R.L.), Hospital for Special Surgery, New York, New York
| | - J L Chazen
- From the Departments of Radiology and Imaging (F.A., E.T.T., D.B.S., J.L.C.)
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Bozorgi A, Khazaei M, Bozorgi M, Jamalpoor Z. Fabrication and characterization of apigenin-loaded chitosan/gelatin membranes for bone tissue engineering applications. J BIOACT COMPAT POL 2023. [DOI: 10.1177/08839115221149725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Fabricating degradable polymer-based membranes has attracted much attention for guided bone regeneration. Chitosan/gelatin (Cs/Gel) composites are among the most known scaffolds with structural similarity to bone matrix and a high potential to support cell attachment and proliferation. Recently, plant-derived phenolic compound apigenin has been identified to direct the osteogenic differentiation of mesenchymal stem cells and retain osteoblast metabolic functions. We incorporated apigenin into Cs/Gel membranes to improve apigenin bioavailability and get proper concentrations for efficient biological activities. Apigenin-loaded Cs/Gel membranes were prepared using a solution casting method with various apigenin contents (0, 10, 25, 50, and 100 µM). Chemical composition, morphological characteristics, swelling behavior, degradation rate, and apigenin release from membranes were evaluated. Saos-2 osteoblasts were cultured on membranes to investigate cell-membrane interaction, proliferation, viability, and mineralization under the osteogenic culture condition. The results showed that membranes had homogeneous and moderate rough surfaces, facilitating osteoblast attachment and expansion. Swelling ratios exceeded 200%, reaching a stable rate in 24 h. Apigenin-loaded membranes degraded slower in vitro. Membranes containing lower apigenin concentrations exhibited a higher cargo release profile over 21 days. Apigenin improved osteoblast proliferation and viability, but the mineralization depended on apigenin dose, with optimized values at low concentrations. These data suggested that Cs/Gel membranes loaded with low apigenin contents improved osteoblast survival, proliferation, and mineralization.
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Affiliation(s)
- Azam Bozorgi
- Department of Tissue Engineering, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozafar Khazaei
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Bozorgi
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Jamalpoor
- Trauma Research Center, AJA University of Medical Sciences, Tehran, Iran
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Bone Sialoprotein Immobilized in Collagen Type I Enhances Angiogenesis In Vitro and In Ovo. Polymers (Basel) 2023; 15:polym15041007. [PMID: 36850289 PMCID: PMC9968013 DOI: 10.3390/polym15041007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/24/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
Bone fracture healing is a multistep process, including early immunological reactions, osteogenesis, and as a key factor, angiogenesis. Molecules inducing osteogenesis as well as angiogenesis are rare, but hold promise to be employed in bone tissue engineering. It has been demonstrated that the bone sialoprotein (BSP) can induce bone formation when immobilized in collagen type I, but its effect on angiogenesis still has to be characterized in detail. Therefore, the aim of this study was to analyse the effects of BSP immobilized in a collagen type I gel on angiogenesis. First, in vitro analyses with endothelial cells (HUVECs) were performed detecting enhancing effects of BSP on proliferation and gene expression of endothelial markers. A spheroid model was employed confirming these results. Finally, the inducing impact of BSP-collagen on vascular density was proved in a yolk sac membrane assay. Our results demonstrate that BSP is capable of inducing angiogenesis and confirm that collagen type I is the optimal carrier for this protein. Taking into account former results, and literature showing that BSP also induces osteogenesis, one can hypothesize that BSP couples angiogenesis and osteogenesis, making it a promising molecule to be used in bone tissue regeneration.
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Xu J, Fahmy-Garcia S, Wesdorp MA, Kops N, Forte L, De Luca C, Misciagna MM, Dolcini L, Filardo G, Labberté M, Vancíková K, Kok J, van Rietbergen B, Nickel J, Farrell E, Brama PAJ, van Osch GJVM. Effectiveness of BMP-2 and PDGF-BB Adsorption onto a Collagen/Collagen-Magnesium-Hydroxyapatite Scaffold in Weight-Bearing and Non-Weight-Bearing Osteochondral Defect Bone Repair: In Vitro, Ex Vivo and In Vivo Evaluation. J Funct Biomater 2023; 14:jfb14020111. [PMID: 36826910 PMCID: PMC9961206 DOI: 10.3390/jfb14020111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Despite promising clinical results in osteochondral defect repair, a recently developed bi-layered collagen/collagen-magnesium-hydroxyapatite scaffold has demonstrated less optimal subchondral bone repair. This study aimed to improve the bone repair potential of this scaffold by adsorbing bone morphogenetic protein 2 (BMP-2) and/or platelet-derived growth factor-BB (PDGF-BB) onto said scaffold. The in vitro release kinetics of BMP-2/PDGF-BB demonstrated that PDGF-BB was burst released from the collagen-only layer, whereas BMP-2 was largely retained in both layers. Cell ingrowth was enhanced by BMP-2/PDFG-BB in a bovine osteochondral defect ex vivo model. In an in vivo semi-orthotopic athymic mouse model, adding BMP-2 or PDGF-BB increased tissue repair after four weeks. After eight weeks, most defects were filled with bone tissue. To further investigate the promising effect of BMP-2, a caprine bilateral stifle osteochondral defect model was used where defects were created in weight-bearing femoral condyle and non-weight-bearing trochlear groove locations. After six months, the adsorption of BMP-2 resulted in significantly less bone repair compared with scaffold-only in the femoral condyle defects and a trend to more bone repair in the trochlear groove. Overall, the adsorption of BMP-2 onto a Col/Col-Mg-HAp scaffold reduced bone formation in weight-bearing osteochondral defects, but not in non-weight-bearing osteochondral defects.
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Affiliation(s)
- Jietao Xu
- Department of Orthopedics and Sports Medicine, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Shorouk Fahmy-Garcia
- Department of Orthopedics and Sports Medicine, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Marinus A. Wesdorp
- Department of Orthopedics and Sports Medicine, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Nicole Kops
- Department of Orthopedics and Sports Medicine, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Lucia Forte
- Fin-Ceramica Faenza S.p.A, 48018 Faenza, Italy
| | | | | | | | - Giuseppe Filardo
- Applied and Translational Research Center, IRCCS Rizzoli Orthopaedic Institute, 40136 Bologna, Italy
| | - Margot Labberté
- School of Veterinary Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Karin Vancíková
- School of Veterinary Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Joeri Kok
- Department of Biomedical Engineering, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands
| | - Bert van Rietbergen
- Department of Biomedical Engineering, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands
| | - Joachim Nickel
- Department Tissue Engineering and Regenerative Medicine, University Hospital Würzburg, 97070 Würzburg, Germany
| | - Eric Farrell
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Pieter A. J. Brama
- School of Veterinary Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Gerjo J. V. M. van Osch
- Department of Orthopedics and Sports Medicine, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Otorhinolaryngology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
- Correspondence: ; Tel.: +31-107043661
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Evaluation of Topology Optimization Using 3D Printing for Bioresorbable Fusion Cages: A Biomechanical Study in a Porcine Model. Spine (Phila Pa 1976) 2023; 48:E46-E53. [PMID: 36130044 PMCID: PMC9855756 DOI: 10.1097/brs.0000000000004491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/31/2022] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Preclinical biomechanical study of topology optimization versus standard ring design for bioresorbable poly-ε-caprolactone (PCL) cervical spine fusion cages delivering bone morphogenetic protein-2 (BMP-2) using a porcine model. OBJECTIVE The aim was to evaluate range of motion (ROM) and bone fusion, as a function of topology optimization and BMP-2 delivery method. SUMMARY OF BACKGROUND DATA 3D printing technology enables fabrication of topology-optimized cages using bioresorbable materials, offering several advantages including customization, and lower stiffness. Delivery of BMP-2 using topology optimization may enhance the quality of fusion. METHODS Twenty-two 6-month-old pigs underwent anterior cervical discectomy fusion at one level using 3D printed PCL cages. Experimental groups (N=6 each) included: Group 1: ring design with surface adsorbed BMP-2, Group 2: topology-optimized rectangular design with surface adsorbed BMP-2, and Group 3: ring design with BMP-2 delivery via collagen sponge. Additional specimens, two of each design, were implanted without BMP-2, as controls. Complete cervical segments were harvested six months postoperatively. Nanocomputed tomography was performed to assess complete bony bridging. Pure moment biomechanical testing was conducted in all three planes, separately. Continuous 3D motions were recorded and analyzed. RESULTS Three subjects suffered early surgical complications and were not evaluated. Overall, ROM for experimental specimens, regardless of design or BMP-2 delivery method, was comparable, with no clinically significant differences among groups. Among experimental specimens at the level of the fusion, ROM was <1.0° in flexion and extension, indicative of fusion, based on clinically applied criteria for fusion of <2 to 4°. Despite the measured biomechanical stability, using computed tomography evaluation, complete bony bridging was observed in 40% of the specimens in Group 1, 50% of Group 2, 100% of Group 3, and none of the control specimens. CONCLUSION A topology-optimized PCL cage with BMP-2 is capable of resulting in an intervertebral fusion, similar to a conventional ring-based design of the same bioresorbable material.
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Hao D, Liu R, Fernandez TG, Pivetti C, Jackson JE, Kulubya ES, Jiang HJ, Ju HY, Liu WL, Panitch A, Lam KS, Leach JK, Farmer DL, Wang A. A bioactive material with dual integrin-targeting ligands regulates specific endogenous cell adhesion and promotes vascularized bone regeneration in adult and fetal bone defects. Bioact Mater 2023; 20:179-193. [PMID: 35663336 PMCID: PMC9160290 DOI: 10.1016/j.bioactmat.2022.05.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 12/18/2022] Open
Abstract
Significant progress has been made in designing bone materials capable of directing endogenous cells to promote vascularized bone regeneration. However, current strategies lack regulation of the specific endogenous cell populations for vascularized bone regeneration, thus leading to adverse tissue formation and decreased regenerative efficiency. Here, we engineered a biomaterial to regulate endogenous cell adhesion and promote vascularized bone regeneration. The biomaterial works by presenting two synthetic ligands, LLP2A and LXW7, explicitly targeting integrins α4β1 and αvβ3, respectively, expressed on the surfaces of the cells related to bone formation and vascularization, such as mesenchymal stem cells (MSCs), osteoblasts, endothelial progenitor cells (EPCs), and endothelial cells (ECs). In vitro, the LLP2A/LXW7 modified biomaterial improved the adhesion of MSCs, osteoblasts, EPCs, and ECs via integrin α4β1 and αvβ3, respectively. In an adult rat calvarial bone defect model, the LLP2A/LXW7 modified biomaterial enhanced bone formation and vascularization by synergistically regulating endogenous cells with osteogenic and angiogenic potentials, such as DLX5+ cells, osteocalcin+ cells, CD34+/CD45- cells and CD31+ cells. In a fetal sheep spinal bone defect model, the LLP2A/LXW7 modified biomaterial augmented bone formation and vascularization without any adverse effects. This innovative biomaterial offers an off-the-shelf, easy-to-use, and biologically safe product suitable for vascularized bone regeneration in both fetal and adult disease environments. Two integrin-binding ligands for constructing vascularized bone biomaterial. Extracellular matrix (ECM)-mimicking collagen-based biomaterial with specific integrin binding sites for cell adhesion. Biomaterial regulates adhesion of endogenous stem cells with osteogenic and angiogenic potentials. Biomaterial promotes vascularized bone formation in adult and fetal bone defects without safety issues. An easy-to-make and off-the-shelf biomaterial for treatment of clinical bone diseases.
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Affiliation(s)
- Dake Hao
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA, 95817, United States
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, 95817, United States
| | - Ruiwu Liu
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, CA, 95817, United States
| | - Tomas Gonzalez Fernandez
- Department of Biomedical Engineering, University of California Davis, Davis, CA, 95616, United States
| | - Christopher Pivetti
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA, 95817, United States
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, 95817, United States
| | - Jordan Elizabeth Jackson
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA, 95817, United States
| | - Edwin Samuel Kulubya
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA, 95817, United States
| | - Hong-Jiang Jiang
- Wendeng Orthopaedic Hospital, No. 1 Fengshan Road, Wendeng, 264400, Shandong, China
| | - Hai-Yang Ju
- Wendeng Orthopaedic Hospital, No. 1 Fengshan Road, Wendeng, 264400, Shandong, China
| | - Wen-Liang Liu
- Wendeng Orthopaedic Hospital, No. 1 Fengshan Road, Wendeng, 264400, Shandong, China
| | - Alyssa Panitch
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA, 95817, United States
- Department of Biomedical Engineering, University of California Davis, Davis, CA, 95616, United States
| | - Kit S. Lam
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, CA, 95817, United States
| | - J. Kent Leach
- Department of Orthopaedic Surgery, School of Medicine, University of California Davis, Sacramento, CA, 95817, United States
| | - Diana L. Farmer
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA, 95817, United States
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, 95817, United States
| | - Aijun Wang
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA, 95817, United States
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, 95817, United States
- Department of Biomedical Engineering, University of California Davis, Davis, CA, 95616, United States
- Corresponding author. Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California, Davis, 4625 2nd Ave., Research II, Suite 3005, Sacramento, CA, 95817, USA.
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Combined application of BMP-2 and naturally occurring bioactive factor mixtures for the optimized therapy of segmental bone defects. Acta Biomater 2023; 157:162-174. [PMID: 36481501 DOI: 10.1016/j.actbio.2022.11.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/27/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Critical bone defects are the result of traumatic, infection- or tumor-induced segmental bone loss and represent a therapeutic problem that has not been solved by current reconstructive or regenerative strategies yet. Scaffolds functionalized with naturally occurring bioactive factor mixtures show a promising chemotactic and angiogenic potential in vitro and therefore might stimulate bone regeneration in vivo. To assess this prospect, the study targets at heparin-modified mineralized collagen scaffolds functionalized with naturally occurring bioactive factor mixtures and/or rhBMP-2. These scaffolds were implanted into a 2-mm segmental femoral defect in mice and analyzed in respect to newly formed bone volume (BV) and bone mineral density (BMD) by micro-computed tomography scans after an observation period of 6 weeks. To rate the degree of defect healing, the number of vessels, and the activity of osteoclasts and osteoblasts were analyzed histologically. The sole application of bioactive factor mixtures is inferior to the use of the recombinant growth factor rhBMP-2 regarding BV and degree of defect healing. A higher rhBMP-2 concentration or the combination with bioactive factor mixtures does not lead to a further enhancement in defect healing. Possibly, a synergistic effect can be achieved by further concentration or a prolonged release of bioactive factor mixtures. STATEMENT OF SIGNIFICANCE: The successful therapy of extended bone defects is still a major challenge in clinical routine. In this study we investigated the bone regenerative potential of naturally occuring bioactive factor mixtures derived from platelet concentrates, adipose tissue and cell secretomes as a cheap and promising alternative to recombinant growth factors in a murine segmental bone defect model. The mixtures alone were not able to induce complete bridging of the bone defect, but in combination with bone morphogenetic protein 2 bone healing seemed to be more physiological. The results show that naturally occuring bioactive factor mixtures are a promising add-on in a clinical setting.
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Panos JA, Coenen MJ, Nagelli CV, McGlinch EB, Atasoy-Zeybek A, De Padilla CL, Coghlan RF, Johnstone B, Ferreira E, Porter RM, De la Vega RE, Evans CH. IL-1Ra gene transfer potentiates BMP2-mediated bone healing by redirecting osteogenesis toward endochondral ossification. Mol Ther 2023; 31:420-434. [PMID: 36245128 PMCID: PMC9931547 DOI: 10.1016/j.ymthe.2022.10.007] [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: 05/23/2022] [Revised: 09/14/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022] Open
Abstract
An estimated 100,000 patients each year in the United States suffer severe disability from bone defects that fail to heal, a condition where bone-regenerative therapies could provide substantial clinical benefits. Although recombinant human bone morphogenetic protein-2 (rhBMP2) is an osteogenic growth factor that is clinically approved for this purpose, it is only effective when used at exceedingly high doses that incur substantial costs, induce severe inflammation, produce adverse side effects, and form morphologically abnormal bone. Using a validated rat femoral segmental defect model, we show that bone formed in response to clinically relevant doses of rhBMP2 is accompanied by elevated expression of interleukin-1 (IL-1). Local delivery of cDNA encoding the IL-1 receptor antagonist (IL-1Ra) achieved bridging of segmental, critical size defects in bone with a 90% lower dose of rhBMP2. Unlike use of high-dose rhBMP2, bone formation in the presence of IL-1Ra occurred via the native process of endochondral ossification, resulting in improved quality without sacrificing the mechanical properties of the regenerated bone. Our results demonstrate that local immunomodulation may permit effective use of growth factors at lower doses to recapitulate more precisely the native biology of healing, leading to higher-quality tissue regeneration.
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Affiliation(s)
- Joseph A Panos
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA; Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, USA; Medical Scientist Training Program, Mayo Clinic, Rochester, MN, USA
| | - Michael J Coenen
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Christopher V Nagelli
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Erin B McGlinch
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA; Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, USA; Virology and Gene Therapy Graduate Program, Mayo Clinic, Rochester, MN, USA
| | - Aysegul Atasoy-Zeybek
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Consuelo Lopez De Padilla
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Ryan F Coghlan
- Research Center, Shriners Hospitals for Children, Portland, OR, USA
| | - Brian Johnstone
- Research Center, Shriners Hospitals for Children, Portland, OR, USA; Department of Orthopedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
| | - Elisabeth Ferreira
- Center for Musculoskeletal Disease Research, Departments of Internal Medicine and Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ryan M Porter
- Center for Musculoskeletal Disease Research, Departments of Internal Medicine and Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Rodolfo E De la Vega
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA; Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute, Maastricht, the Netherlands
| | - Christopher H Evans
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA.
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Xu X, Skelly JD, Song J. Chemically Crosslinked Amphiphilic Degradable Shape Memory Polymer Nanocomposites with Readily Tuned Physical, Mechanical, and Biological Properties. ACS APPLIED MATERIALS & INTERFACES 2023; 15:2693-2704. [PMID: 36607181 DOI: 10.1021/acsami.2c19441] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Facile surgical delivery and stable fixation of synthetic scaffolds play roles just as critically as degradability and bioactivity in ensuring successful scaffold-guided tissue regeneration. Properly engineered shape memory polymers (SMPs) may meet these challenges. Polyhedral oligomeric silsesquioxanes (POSSs) can be covalently integrated with urethane-crosslinked polylactide (PLA) to give high-strength, degradable SMPs around physiological temperatures. To explore their potential for guided bone regeneration, here we tune their hydrophilicity, degradability, cytocompatibility, and osteoconductivity/osteoinductivity by crosslinking star-branched POSS-PLA with hydrophilic polyethylene glycol diisocyanates of different lengths and up to 60 wt % hydroxyapatite (HA). The composites exhibit high compliance, toughness, up to gigapascal storage moduli, and excellent shape recovery (>95%) at safe triggering temperatures. Water swelling ratios and hydrolytic degradation rates positively correlated with the hydrophilic crosslinker lengths, while the negative impact of degradation on the proliferation and osteogenesis of bone marrow stromal cells was mitigated with HA incorporation. Macroporous composites tailored for a rat femoral segmental defect were fabricated, and their ability to stably retain and sustainedly release recombinant osteogenic bone morphogenetic protein-2 and support cell attachment and osteogenesis was demonstrated. These properties combined make these amphiphilic osteoconductive degradable SMPs promising candidates as next-generation synthetic bone grafts.
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Affiliation(s)
- Xiaowen Xu
- Department of Orthopedics and Physical Rehabilitation, Department of Biochemistry and Molecular Biotechnology, UMass Chan Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, United States
| | - Jordan D Skelly
- Department of Orthopedics and Physical Rehabilitation, Department of Biochemistry and Molecular Biotechnology, UMass Chan Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, United States
| | - Jie Song
- Department of Orthopedics and Physical Rehabilitation, Department of Biochemistry and Molecular Biotechnology, UMass Chan Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, United States
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Liu F, Sun T, An Y, Ming L, Li Y, Zhou Z, Shang F. The potential therapeutic role of extracellular vesicles in critical-size bone defects: Spring of cell-free regenerative medicine is coming. Front Bioeng Biotechnol 2023; 11:1050916. [PMID: 36733961 PMCID: PMC9887316 DOI: 10.3389/fbioe.2023.1050916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023] Open
Abstract
In recent years, the incidence of critical-size bone defects has significantly increased. Critical-size bone defects seriously affect patients' motor functions and quality of life and increase the need for additional clinical treatments. Bone tissue engineering (BTE) has made great progress in repairing critical-size bone defects. As one of the main components of bone tissue engineering, stem cell-based therapy is considered a potential effective strategy to regenerate bone tissues. However, there are some disadvantages including phenotypic changes, immune rejection, potential tumorigenicity, low homing efficiency and cell survival rate that restrict its wider clinical applications. Evidence has shown that the positive biological effects of stem cells on tissue repair are largely mediated through paracrine action by nanostructured extracellular vesicles (EVs), which may overcome the limitations of traditional stem cell-based treatments. In addition to stem cell-derived extracellular vesicles, the potential therapeutic roles of nonstem cell-derived extracellular vesicles in critical-size bone defect repair have also attracted attention from scholars in recent years. Currently, the development of extracellular vesicles-mediated cell-free regenerative medicine is still in the preliminary stage, and the specific mechanisms remain elusive. Herein, the authors first review the research progress and possible mechanisms of extracellular vesicles combined with bone tissue engineering scaffolds to promote bone regeneration via bioactive molecules. Engineering modified extracellular vesicles is an emerging component of bone tissue engineering and its main progression and clinical applications will be discussed. Finally, future perspectives and challenges of developing extracellular vesicle-based regenerative medicine will be given. This review may provide a theoretical basis for the future development of extracellular vesicle-based biomedicine and provide clinical references for promoting the repair of critical-size bone defects.
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Affiliation(s)
- Fen Liu
- Department of Periodontology, Shenzhen Stomatological Hospital (Pingshan), Southern Medical University, Shenzhen, Guangdong, China
| | - Tianyu Sun
- Department of Periodontology, Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Ying An
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture and Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Leiguo Ming
- Department of Research and Development, Shaanxi Zhonghong Institute of Regenerative Medicine, Xi’an, Shaanxi, China
| | - Yinghui Li
- Department of Orthodontics, Stomatological Hospital, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhifei Zhou
- Department of Stomatology, General Hospital of Tibetan Military Command, Lhasa, Tibet, China,*Correspondence: Fengqing Shang, ; Zhifei Zhou,
| | - Fengqing Shang
- Department of Stomatology, Air Force Medical Center, Fourth Military Medical University, Beijing, China,*Correspondence: Fengqing Shang, ; Zhifei Zhou,
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Long-Term Changes in Adipose Tissue in the Newly Formed Bone Induced by Recombinant Human BMP-2 In Vivo. Biomimetics (Basel) 2023; 8:biomimetics8010033. [PMID: 36648819 PMCID: PMC9844441 DOI: 10.3390/biomimetics8010033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
Recombinant human bone morphogenetic protein-2 (rhBMP-2) induces osteogenesis and adipogenesis in bone scaffolds. We evaluated rhBMP-2-induced long-term changes in adipose tissue in the newly formed bone in different scaffolds forms. Bovine bone particles and blocks were grafted along with rhBMP-2 in the subperiosteal space of a rat calvarial bone, and the formation of new bone and adipose tissue were evaluated at 6 and 16 weeks after the surgery. The bone mineral density (BMD) and trabecular thickness (TbTh) of the 16w particle group were significantly higher than those of the 6w particle group (p = 0.018 and 0.012, respectively). The BMD and TbTh gradually increased in the particle group from weeks 6 to 16. The average adipose tissue volume (ATV) of the 6w particle group was higher than that of the 16w particle group, although the difference was not significant (p > 0.05), and it decreased gradually. There were no significant changes in the bone volume (BV) and BMD between the 6w and 16w block groups. Histological analysis revealed favorable new bone regeneration in all groups. Adipose tissue was formed between the bone particles and at the center in the particle and block groups, respectively. The adipose tissue space decreased, and the proportion of new bone increased in the 16w particle group compared to that in the 6w group. To summarize, in the particle group, the adipose tissue decreased in a time-dependent manner, BMD and TbTh increased, and new bone formation increased from 6 to 16 weeks. These results suggest that rhBMP-2 effectively induces new bone formation in the long term in particle bone scaffolds.
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Lee JH, Kweon H, Oh JH, Kim SG. The optimal scaffold for silk sericin-based bone graft: collagen versus gelatin. Maxillofac Plast Reconstr Surg 2023; 45:2. [PMID: 36617599 PMCID: PMC9826769 DOI: 10.1186/s40902-022-00368-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/23/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Silk sericin is an active ingredient in bone grafts. However, the optimal scaffold for silk sericin has yet to be identified. METHOD A critical-sized bone defect model in rat calvaria was used to evaluate bone regeneration. Silk sericin from Yeonnokjam, Bombyx mori, was incorporated into gelatin (group G, n = 6) and collagen (group C, n = 6). Bone regeneration was evaluated using micro-computed tomography (mCT) and histology. RESULTS Group C showed a larger bone volume than group G in the mCT analysis (P = 0.001). Histological analysis showed a larger area of bony defects in group G than in group C. The bone regeneration area in group C was significantly larger than that in group G (P = 0.003). CONCLUSION Compared with gelatin, collagen shows better bone regeneration in silk sericin-based bone grafts.
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Affiliation(s)
- Ji Hae Lee
- grid.420186.90000 0004 0636 2782Sericultural and Apicultural Division, National Institute of Agricultural Science, RDA, Wanju, 55365 Republic of Korea
| | - HaeYong Kweon
- grid.420186.90000 0004 0636 2782Sericultural and Apicultural Division, National Institute of Agricultural Science, RDA, Wanju, 55365 Republic of Korea
| | - Ji-Hyeon Oh
- grid.411733.30000 0004 0532 811XDepartment of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
| | - Seong-Gon Kim
- grid.411733.30000 0004 0532 811XDepartment of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
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Concentration-Dependent Efficacy of Recombinant Human Bone Morphogenetic Protein-2 Using a HA/β-TCP Hydrogel Carrier in a Mini-Pig Vertebral Oblique Lateral Interbody Fusion Model. Int J Mol Sci 2023; 24:ijms24010892. [PMID: 36614335 PMCID: PMC9821164 DOI: 10.3390/ijms24010892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
Bone morphogenetic protein-2 (BMP-2) is used in the treatment of degenerative spinal disease and vertebral fractures, spine fusion, dental surgery, and facial surgery. However, high doses are associated with side effects such as inflammation and osteophytes. In this study, we performed spinal fusion surgery on mini-pigs using BMP-2 and a HA/β-TCP hydrogel carrier, and evaluated the degree of fusion and osteophyte growth according to time and dosage. Increasing the dose of BMP-2 led to a significantly higher fusion rate than was observed in the control group, and there was no significant difference between the 8-week and 16-week samples. We also found that the HA + β-TCP hydrogel combination helped maintain the rate of BMP-2 release. In conclusion, the BMP-2-loaded HA/β-TCP hydrogel carrier used in this study overcame the drawback of potentially causing side effects when used at high concentrations by enabling the sustained release of BMP-2. This method is also highly efficient, since it provides mineral matter to accelerate the fusion rate of the spine and improve bone quality.
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Priddy LB, Krishnan L, Hettiaratchi MH, Karthikeyakannan S, Gupte N, Guldberg RE. Amniotic membrane attenuates heterotopic ossification following high-dose bone morphogenetic protein-2 treatment of segmental bone defects. J Orthop Res 2023; 41:130-140. [PMID: 35340049 PMCID: PMC9512937 DOI: 10.1002/jor.25324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/31/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023]
Abstract
Treatment of large bone defects with supraphysiological doses of bone morphogenetic protein-2 (BMP-2) has been associated with complications including heterotopic ossification (HO), inflammation, and pain, presumably due to poor spatiotemporal control of BMP-2. We have previously recapitulated extensive HO in our rat femoral segmental defect model by treatment with high-dose BMP-2 (30 μg). Using this model and BMP-2 dose, our objective was to evaluate the utility of a clinically available human amniotic membrane (AM) around the defect space for guided bone regeneration and reduction of HO. We hypothesized that AM surrounding collagen sponge would attenuate heterotopic ossification compared with collagen sponge alone. In vitro, AM retained more BMP-2 than a synthetic poly(ε-caprolactone) membrane through 21 days. In vivo, as hypothesized, the collagen + AM resulted in significantly less heterotopic ossification and correspondingly, lower total bone volume (BV), compared with collagen sponge alone. Although bone formation within the defect was delayed with AM around the defect, by 12 weeks, defect BVs were equivalent. Torsional stiffness was significantly reduced with AM but was equivalent to that of intact bone. Collagen + AM resulted in the formation of dense fibrous tissue and mineralized tissue, while the collagen group contained primarily mineralized tissue surrounded by marrow-like structures. Especially in conjunction with high doses of growth factor delivered via collagen sponge, these findings suggest AM may be effective as an overlay adjacent to bone healing sites to spatially direct bone regeneration and minimize heterotopic ossification.
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Affiliation(s)
- Lauren B. Priddy
- Parker H. Petit Institute for Bioengineering & Bioscience, Georgia Institute of Technology, 315 Ferst Drive NW, Atlanta, GA 30332, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive NW, Atlanta, GA 30332, USA
- Current affiliation: Department of Agricultural and Biological Engineering, Mississippi State University, 130 Creelman Street, Mississippi State, MS 39762, USA
| | - Laxminarayanan Krishnan
- Parker H. Petit Institute for Bioengineering & Bioscience, Georgia Institute of Technology, 315 Ferst Drive NW, Atlanta, GA 30332, USA
| | - Marian H. Hettiaratchi
- Parker H. Petit Institute for Bioengineering & Bioscience, Georgia Institute of Technology, 315 Ferst Drive NW, Atlanta, GA 30332, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive NW, Atlanta, GA 30332, USA
- Current affiliation: Phil and Penny Knight Campus for Accelerating Scientific Impact, University of Oregon, 6231 University of Oregon, Eugene, OR 97403, USA
| | - Sukhita Karthikeyakannan
- Parker H. Petit Institute for Bioengineering & Bioscience, Georgia Institute of Technology, 315 Ferst Drive NW, Atlanta, GA 30332, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive NW, Atlanta, GA 30332, USA
| | - Nikhil Gupte
- Parker H. Petit Institute for Bioengineering & Bioscience, Georgia Institute of Technology, 315 Ferst Drive NW, Atlanta, GA 30332, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive NW, Atlanta, GA 30332, USA
| | - Robert E. Guldberg
- Parker H. Petit Institute for Bioengineering & Bioscience, Georgia Institute of Technology, 315 Ferst Drive NW, Atlanta, GA 30332, USA
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, 801 Ferst Drive NW, Atlanta, GA 30332, USA
- Current affiliation: Phil and Penny Knight Campus for Accelerating Scientific Impact, University of Oregon, 6231 University of Oregon, Eugene, OR 97403, USA
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46
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Suh JW, Lee KM, Ko EA, Yoon DS, Park KH, Kim HS, Yook JI, Kim NH, Lee JW. Promoting angiogenesis and diabetic wound healing through delivery of protein transduction domain-BMP2 formulated nanoparticles with hydrogel. J Tissue Eng 2023; 14:20417314231190641. [PMID: 37601810 PMCID: PMC10434183 DOI: 10.1177/20417314231190641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
Decreased angiogenesis contributes to delayed wound healing in diabetic patients. Recombinant human bone morphogenetic protein-2 (rhBMP2) has also been demonstrated to promote angiogenesis. However, the short half-lives of soluble growth factors, including rhBMP2, limit their use in wound-healing applications. To address this limitation, we propose a novel delivery model using a protein transduction domain (PTD) formulated in a lipid nanoparticle (LNP). We aimed to determine whether a gelatin hydrogel dressing loaded with LNP-formulated PTD-BMP2 (LNP-PTD-BMP2) could enhance the angiogenic function of BMP2 and improve diabetic wound healing. In vitro, compared to the control and rhBMP2, LNP-PTD-BMP2 induced greater tube formation in human umbilical vein endothelial cells and increased the cell recruitment capacity of HaCaT cells. We inflicted large, full-thickness back skin wounds on streptozotocin-induced diabetic mice and applied gelatin hydrogel (GH) cross-linked by microbial transglutaminase containing rhBMP2, LNP-PTD-BMP2, or a control to these wounds. Wounds treated with LNP-PTD-BMP2-loaded GH exhibited enhanced wound closure, increased re-epithelialization rates, and higher collagen deposition than those with other treatments. Moreover, LNP-PTD-BMP2-loaded GH treatment resulted in more CD31- and α-SMA-positive cells, indicating greater neovascularization capacity than rhBMP2-loaded GH or GH treatments alone. Furthermore, in vivo near-infrared fluorescence revealed that LNP-PTD-BMP2 has a longer half-life than rhBMP2 and that BMP2 localizes around wounds. In conclusion, LNP-PTD-BMP2-loaded GH is a viable treatment option for diabetic wounds.
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Affiliation(s)
- Jae Wan Suh
- Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, South Korea
| | - Kyoung-Mi Lee
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Ae Ko
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Suk Yoon
- Department of Biomedical Science, Hwasung Medi-Science University, Hwaseong-Si, Gyeonggi-Do, South Korea
| | - Kwang Hwan Park
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyun Sil Kim
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jong In Yook
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, South Korea
| | - Nam Hee Kim
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jin Woo Lee
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, South Korea
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
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Advances in bone regeneration with growth factors for spinal fusion: A literature review. NORTH AMERICAN SPINE SOCIETY JOURNAL 2022; 13:100193. [PMID: 36605107 PMCID: PMC9807829 DOI: 10.1016/j.xnsj.2022.100193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Bone tissue is regenerated via the spatiotemporal involvement of various cytokines. Among them, the bone morphogenetic protein (BMP), which plays a vital role in the bone regeneration process, has been applied clinically for the treatment of refractory orthopedic conditions. Although BMP therapy using a collagen carrier has shown efficiency in bone regeneration over the last two decades, a major challenge-considerable side effects associated with the acute release of high doses of BMPs-has also been revealed. To improve BMP efficiency, the development of new carriers and biologics that can be used in conjunction with BMPs is currently underway. In this review, we describe the current status and future prospects of bone regeneration therapy, with a focus on BMPs. Furthermore, we outline the characteristics and molecular signaling pathways involving BMPs, clinical applications of BMPs in orthopedics, clinical results of BMP use in human spinal surgeries, drugs combined with BMPs to provide synergistic effects, and novel BMP carriers.
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48
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Hu J, Wang Z, Miszuk JM, Zeng E, Sun H. High Molecular Weight Poly(glutamic acid) to Improve BMP2-Induced Osteogenic Differentiation. Mol Pharm 2022; 19:4565-4575. [PMID: 35675584 PMCID: PMC9729371 DOI: 10.1021/acs.molpharmaceut.2c00141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
FDA-approved bone morphogenetic protein 2 (BMP2) has serious side effects due to the super high dose requirement. Heparin is one of the most well-studied sulfated polymers to stabilize BMP2 and improve its functionality. However, the clinical use of heparin is questionable because of its undesired anticoagulant activity. Recent studies suggest that poly(glutamic acid) (pGlu) has the potential to improve BMP2 bioactivity with less safety concerns; however, the knowledge on pGlu's contribution remains largely unknown. Therefore, we aimed to study the role of pGlu in BMP2-induced osteogenesis and its potential application in bone tissue engineering. Our data, for the first time, indicated that both low (L-pGlu) and high molecular weight pGlu (H-pGlu) were able to significantly improve the BMP2-induced early osteoblastic differentiation marker (ALP) in MC3T3-E1 preosteoblasts. Importantly, the matrix mineralization was more rapidly enhanced by H-pGlu compared to L-pGlu. Additionally, our data indicated that only α-H-pGlu could significantly improve BMP2's activity, whereas γ-H-pGlu failed to do so. Moreover, both gene expression and mineralization data demonstrated that α-H-pGlu enabled a single dose of BMP2 to induce a high level of osteoblastic differentiation without multiple doses of BMP2. To study the potential application of pGlu in tissue engineering, we incorporated the H-pGlu+BMP2 nanocomplexes into the collagen hydrogel with significantly elevated osteoblastic differentiation. Furthermore, H-pGlu-coated 3D porous gelatin and chitosan scaffolds significantly enhanced osteogenic differentiation through enabling sustained release of BMP2. Thus, our findings suggest that H-pGlu is a promising new alternative with great potential for bone tissue engineering applications.
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Affiliation(s)
- Jue Hu
- Department of Oral and Maxillofacial Surgery, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
- Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
| | - Zhuozhi Wang
- Department of Oral and Maxillofacial Surgery, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
- Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
| | - Jacob M. Miszuk
- Department of Oral and Maxillofacial Surgery, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
- Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
| | - Erliang Zeng
- Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
| | - Hongli Sun
- Department of Oral and Maxillofacial Surgery, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
- Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
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Foley JP, Fred EJ, Minardi S, Yamaguchi JT, Greene AC, Furman AA, Lyons JG, Paul JT, Nandurkar TS, Blank KR, Havey RM, Muriuki M, Patwardhan AG, Hsu WK, Stock SR, Hsu EL. Sex-based Difference in Response to Recombinant Human Bone Morphogenetic Protein-2 in a Rat Posterolateral Fusion Model. Spine (Phila Pa 1976) 2022; 47:1627-1636. [PMID: 35943241 PMCID: PMC9643612 DOI: 10.1097/brs.0000000000004454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/26/2022] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN This was a preclinical study. OBJECTIVE Evaluate sex-dependent differences in the bone healing response to recombinant human bone morphogenetic protein-2 (rhBMP-2) in a rat posterolateral spinal fusion model. SUMMARY OF BACKGROUND DATA Minimal and conflicting data exist concerning potential sex-dependent differences in rhBMP-2-mediated bone regeneration in the context of spinal fusion. MATERIALS AND METHODS Forty-eight female and male Sprague-Dawley rats (N=24/group), underwent L4-L5 posterolateral fusion with bilateral placement of an absorbable collagen sponge, each loaded with 5 µg of bone morphogenetic protein-2 (10 µg/animal). At eight weeks postoperative, 10 specimens of each sex were tested in flexion-extension with quantification of range of motion and stiffness. The remaining specimens were evaluated for new bone growth and successful fusion via radiography, blinded manual palpation and microcomputed tomography (microCT). Laboratory microCT quantified bone microarchitecture, and synchrotron microCT examined bone microstructure at the 1 µm level. RESULTS Manual palpation scores differed significantly between sexes, with mean fusion scores of 2.4±0.4 in females versus 3.1±0.6 in males ( P <0.001). Biomechanical stiffness did not differ between sexes, but range of motion was significantly greater and more variable for females versus males (3.7±5.6° vs. 0.27±0.15°, P <0.005, respectively). Laboratory microCT showed significantly smaller volumes of fusion masses in females versus males (262±87 vs. 732±238 mm 3 , respectively, P <0.001) but significantly higher bone volume fraction (0.27±0.08 vs. 0.12±0.05, respectively, P <0.001). Mean trabecular thickness was not different, but trabecular number was significantly greater in females (3.1±0.5 vs. 1.5±0.4 mm -1 , respectively, P <0.001). Synchrotron microCT showed fine bone structures developing in both sexes at the eight-week time point. CONCLUSIONS This study demonstrates sex-dependent differences in bone regeneration induced by rhBMP-2. Further investigation is needed to uncover the extent of and mechanisms underlying these sex differences, particularly at different doses of rhBMP-2.
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Affiliation(s)
- James P Foley
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
| | - Elianna J Fred
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
| | - Silvia Minardi
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
| | - Jonathan T Yamaguchi
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
| | - Allison C Greene
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
| | - Andrew A Furman
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
| | - Joseph G Lyons
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
| | - Jonathan T Paul
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
| | - Tejas S Nandurkar
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
| | | | - Robert M Havey
- Edward Hines Jr. VA Hospital, Hines, IL
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago, Maywood, IL
| | | | - Avinash G Patwardhan
- Edward Hines Jr. VA Hospital, Hines, IL
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago, Maywood, IL
| | - Wellington K Hsu
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
| | - Stuart R Stock
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
- Department of Cell & Developmental Biology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Erin L Hsu
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Center for Regenerative Nanomedicine, Simpson Querrey Institute, Northwestern University, Chicago, IL
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50
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Wang YW, Lin WY, Wu FJ, Luo CW. Unveiling the transcriptomic landscape and the potential antagonist feedback mechanisms of TGF-β superfamily signaling module in bone and osteoporosis. Cell Commun Signal 2022; 20:190. [PMID: 36443839 PMCID: PMC9703672 DOI: 10.1186/s12964-022-01002-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/22/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND TGF-β superfamily signaling is indispensable for bone homeostasis. However, the global expression profiles of all the genes that make up this signaling module in bone and bone-related diseases have not yet been well characterized. METHODS Transcriptomic datasets from human bone marrows, bone marrow-derived mesenchymal stem cells (MSCs) and MSCs of primary osteoporotic patients were used for expression profile analyses. Protein treatments, gene quantification, reporter assay and signaling dissection in MSC lines were used to clarify the interactive regulations and feedback mechanisms between TGF-β superfamily ligands and antagonists. Ingenuity Pathway Analysis was used for network construction. RESULTS We identified TGFB1 in the ligand group that carries out SMAD2/3 signaling and BMP8A, BMP8B and BMP2 in the ligand group that conducts SMAD1/5/8 signaling have relatively high expression levels in normal bone marrows and MSCs. Among 16 antagonist genes, the dominantly expressed TGF-β superfamily ligands induced only NOG, GREM1 and GREM2 via different SMAD pathways in MSCs. These induced antagonist proteins further showed distinct antagonisms to the treated ligands and thus would make up complicated negative feedback networks in bone. We further identified TGF-β superfamily signaling is enriched in MSCs of primary osteoporosis. Enhanced expression of the genes mediating TGF-β-mediated SMAD3 signaling and the genes encoding TGF-β superfamily antagonists served as significant features to osteoporosis. CONCLUSION Our data for the first time unveiled the transcription landscape of all the genes that make up TGF-β superfamily signaling module in bone. The feedback mechanisms and regulatory network prediction of antagonists provided novel hints to treat osteoporosis. Video Abstract.
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Affiliation(s)
- Ying-Wen Wang
- grid.260539.b0000 0001 2059 7017Department of Life Sciences and Institute of Genome Sciences, National Yang Ming Chiao Tung University, 155 Li-Nong Street, Section 2, Beitou, Taipei, 112 Taiwan
| | - Wen-Yu Lin
- grid.260539.b0000 0001 2059 7017Department of Life Sciences and Institute of Genome Sciences, National Yang Ming Chiao Tung University, 155 Li-Nong Street, Section 2, Beitou, Taipei, 112 Taiwan
| | - Fang-Ju Wu
- grid.260539.b0000 0001 2059 7017Department of Life Sciences and Institute of Genome Sciences, National Yang Ming Chiao Tung University, 155 Li-Nong Street, Section 2, Beitou, Taipei, 112 Taiwan
| | - Ching-Wei Luo
- grid.260539.b0000 0001 2059 7017Department of Life Sciences and Institute of Genome Sciences, National Yang Ming Chiao Tung University, 155 Li-Nong Street, Section 2, Beitou, Taipei, 112 Taiwan
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