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Finze R, Laubach M, Russo Serafini M, Kneser U, Medeiros Savi F. Histological and Immunohistochemical Characterization of Osteoimmunological Processes in Scaffold-Guided Bone Regeneration in an Ovine Large Segmental Defect Model. Biomedicines 2023; 11:2781. [PMID: 37893154 PMCID: PMC10604530 DOI: 10.3390/biomedicines11102781] [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: 08/21/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Large-volume bone defect regeneration is complex and demands time to complete. Several regeneration phases with unique characteristics, including immune responses, follow, overlap, and interdepend on each other and, if successful, lead to the regeneration of the organ bone's form and function. However, during traumatic, infectious, or neoplastic clinical cases, the intrinsic bone regeneration capacity may exceed, and surgical intervention is indicated. Scaffold-guided bone regeneration (SGBR) has recently shown efficacy in preclinical and clinical studies. To investigate different SGBR strategies over periods of up to three years, we have established a well-characterized ovine large segmental tibial bone defect model, for which we have developed and optimized immunohistochemistry (IHC) protocols. We present an overview of the immunohistochemical characterization of different experimental groups, in which all ovine segmental defects were treated with a bone grafting technique combined with an additively manufactured medical-grade polycaprolactone/tricalcium phosphate (mPCL-TCP) scaffold. The qualitative dataset was based on osteoimmunological findings gained from IHC analyses of over 350 sheep surgeries over the past two decades. Our systematic and standardized IHC protocols enabled us to gain further insight into the complex and long-drawn-out bone regeneration processes, which ultimately proved to be a critical element for successful translational research.
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Affiliation(s)
- Ronja Finze
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (R.F.)
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany;
| | - Markus Laubach
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (R.F.)
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, 81377 Munich, Germany
| | - Mairim Russo Serafini
- Department of Pharmacy, Universidade Federal de Sergipe, Sao Cristovao 49100-000, Brazil;
| | - Ulrich Kneser
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany;
| | - Flavia Medeiros Savi
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (R.F.)
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Max Planck Queensland Center for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD 4059, Australia
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2
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Laubach M, Hildebrand F, Suresh S, Wagels M, Kobbe P, Gilbert F, Kneser U, Holzapfel BM, Hutmacher DW. The Concept of Scaffold-Guided Bone Regeneration for the Treatment of Long Bone Defects: Current Clinical Application and Future Perspective. J Funct Biomater 2023; 14:341. [PMID: 37504836 PMCID: PMC10381286 DOI: 10.3390/jfb14070341] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
The treatment of bone defects remains a challenging clinical problem with high reintervention rates, morbidity, and resulting significant healthcare costs. Surgical techniques are constantly evolving, but outcomes can be influenced by several parameters, including the patient's age, comorbidities, systemic disorders, the anatomical location of the defect, and the surgeon's preference and experience. The most used therapeutic modalities for the regeneration of long bone defects include distraction osteogenesis (bone transport), free vascularized fibular grafts, the Masquelet technique, allograft, and (arthroplasty with) mega-prostheses. Over the past 25 years, three-dimensional (3D) printing, a breakthrough layer-by-layer manufacturing technology that produces final parts directly from 3D model data, has taken off and transformed the treatment of bone defects by enabling personalized therapies with highly porous 3D-printed implants tailored to the patient. Therefore, to reduce the morbidities and complications associated with current treatment regimens, efforts have been made in translational research toward 3D-printed scaffolds to facilitate bone regeneration. Three-dimensional printed scaffolds should not only provide osteoconductive surfaces for cell attachment and subsequent bone formation but also provide physical support and containment of bone graft material during the regeneration process, enhancing bone ingrowth, while simultaneously, orthopaedic implants supply mechanical strength with rigid, stable external and/or internal fixation. In this perspective review, we focus on elaborating on the history of bone defect treatment methods and assessing current treatment approaches as well as recent developments, including existing evidence on the advantages and disadvantages of 3D-printed scaffolds for bone defect regeneration. Furthermore, it is evident that the regulatory framework and organization and financing of evidence-based clinical trials remains very complex, and new challenges for non-biodegradable and biodegradable 3D-printed scaffolds for bone regeneration are emerging that have not yet been sufficiently addressed, such as guideline development for specific surgical indications, clinically feasible design concepts for needed multicentre international preclinical and clinical trials, the current medico-legal status, and reimbursement. These challenges underscore the need for intensive exchange and open and honest debate among leaders in the field. This goal can be addressed in a well-planned and focused stakeholder workshop on the topic of patient-specific 3D-printed scaffolds for long bone defect regeneration, as proposed in this perspective review.
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Affiliation(s)
- Markus Laubach
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Sinduja Suresh
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Michael Wagels
- Department of Plastic Surgery, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia;
- The Herston Biofabrication Institute, The University of Queensland, Herston, QLD 4006, Australia
- Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, QLD 4102, Australia
- Department of Plastic and Reconstructive Surgery, Queensland Children’s Hospital, South Brisbane, QLD 4101, Australia
- The Australian Centre for Complex Integrated Surgical Solutions, Woolloongabba, QLD 4102, Australia
| | - Philipp Kobbe
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Fabian Gilbert
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Boris M. Holzapfel
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Dietmar W. Hutmacher
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD 4000, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies (CTET), Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
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3
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Sparks DS, Savi FM, Dlaska CE, Saifzadeh S, Brierly G, Ren E, Cipitria A, Reichert JC, Wille ML, Schuetz MA, Ward N, Wagels M, Hutmacher DW. Convergence of scaffold-guided bone regeneration principles and microvascular tissue transfer surgery. SCIENCE ADVANCES 2023; 9:eadd6071. [PMID: 37146134 PMCID: PMC10162672 DOI: 10.1126/sciadv.add6071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A preclinical evaluation using a regenerative medicine methodology comprising an additively manufactured medical-grade ε-polycaprolactone β-tricalcium phosphate (mPCL-TCP) scaffold with a corticoperiosteal flap was undertaken in eight sheep with a tibial critical-size segmental bone defect (9.5 cm3, M size) using the regenerative matching axial vascularization (RMAV) approach. Biomechanical, radiological, histological, and immunohistochemical analysis confirmed functional bone regeneration comparable to a clinical gold standard control (autologous bone graft) and was superior to a scaffold control group (mPCL-TCP only). Affirmative bone regeneration results from a pilot study using an XL size defect volume (19 cm3) subsequently supported clinical translation. A 27-year-old adult male underwent reconstruction of a 36-cm near-total intercalary tibial defect secondary to osteomyelitis using the RMAV approach. Robust bone regeneration led to complete independent weight bearing within 24 months. This article demonstrates the widely advocated and seldomly accomplished concept of "bench-to-bedside" research and has weighty implications for reconstructive surgery and regenerative medicine more generally.
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Affiliation(s)
- David S Sparks
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Department of Plastic and Reconstructive Surgery, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, QLD, Australia
| | - Flavia M Savi
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Constantin E Dlaska
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Siamak Saifzadeh
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- Medical Engineering Research Facility, Queensland University of Technology, Chermside, QLD, Australia
| | - Gary Brierly
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Edward Ren
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Amaia Cipitria
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Potsdam, Germany
- Biodonostia Health Research Institute, San Sebastian, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Johannes C Reichert
- Department of Orthopaedics and Orthopaedic Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald, Germany
| | - Marie-Luise Wille
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Michael A Schuetz
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, QLD, Australia
| | - Nicola Ward
- Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Michael Wagels
- Department of Plastic and Reconstructive Surgery, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, QLD, Australia
- Australian Centre for Complex Integrated Surgical Solutions (ACCISS), Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Dietmar W Hutmacher
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Additive Biomanufacturing, Queensland University of Technology, Kelvin Grove, QLD, Australia
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Thomas PK, Caffrey J, Afetse KE, Habet NA, Ondar K, Weaver CM, Kleinberger M, Brown P, Gayzik FS. Micro-CT Imaging and Mechanical Properties of Ovine Ribs. Ann Biomed Eng 2023:10.1007/s10439-023-03156-7. [PMID: 36841890 DOI: 10.1007/s10439-023-03156-7] [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: 11/15/2022] [Accepted: 01/29/2023] [Indexed: 02/27/2023]
Abstract
The use of ovine animal models in the study of injury biomechanics and modeling is increasing, due to their favorable size and other physiological characteristics. Along with this increase, there has also been increased interest in the development of in silico ovine models for computational studies to compliment physical experiments. However, there remains a gap in the literature characterizing the morphological and mechanical characteristics of ovine ribs. The objective of this study therefore is to report anatomical and mechanical properties of the ovine ribs using microtomography (micro-CT) and two types of mechanical testing (quasi-static bending and dynamic tension). Using microtomography, young ovine rib samples obtained from a local abattoir were cut into approximately fourteen 38 mm sections and scanned. From these scans, the cortical bone thickness and cross-sectional area were measured, and the moment of inertia was calculated to enhance the mechanical testing data. Based on a standard least squares statistical model, the cortical bone thickness varied depending on the region of the cross-section and the position along the length of the rib (p < 0.05), whereas the cross-sectional area remained consistent (p > 0.05). Quasi-static three-point bend testing was completed on ovine rib samples, and the resulting force-displacement data was analyzed to obtain the stiffness (44.67 ± 17.65 N/mm), maximum load (170.54 ± 48.28 N) and displacement at maximum load (7.19 ± 2.75 mm), yield load (167.81 ± 48.12 N) and displacement at yield (6.10 ± 2.25 mm), and the failure load (110.90 ± 39.30 N) and displacement at failure (18.43 ± 2.10 mm). The resulting properties were not significantly affected by the rib (p > 0.05), but by the animal they originated from (p < 0.05). For the dynamic testing, samples were cut into coupons and tested in tension with an average strain rate of 18.9 strain/sec. The resulting dynamic testing properties of elastic modulus (5.16 ± 2.03 GPa), failure stress (63.29 ± 14.02 MPa), and failure strain (0.0201 ± 0.0052) did not vary based on loading rate (p > 0.05).
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Affiliation(s)
- Patricia K Thomas
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, USA
| | - Juliette Caffrey
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, USA
| | - K Eddie Afetse
- Musculoskeletal Research Institute, Atrium Health, Charlotte, USA
| | - Nahir A Habet
- Musculoskeletal Research Institute, Atrium Health, Charlotte, USA
| | - Kyle Ondar
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, USA
| | - Caitlin M Weaver
- Army Research Directorate, DEVCOM Army Research Laboratory, Adelphi, USA
| | | | - Philip Brown
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, USA
| | - F Scott Gayzik
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, USA.
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5
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Saunders WB, Dejardin LM, Soltys-Niemann EV, Kaulfus CN, Eichelberger BM, Dobson LK, Weeks BR, Kerwin SC, Gregory CA. Angle-stable interlocking nailing in a canine critical-sized femoral defect model for bone regeneration studies: In pursuit of the principle of the 3R’s. Front Bioeng Biotechnol 2022; 10:921486. [PMID: 36118571 PMCID: PMC9479202 DOI: 10.3389/fbioe.2022.921486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction: Critical-sized long bone defects represent a major therapeutic challenge and current treatment strategies are not without complication. Tissue engineering holds much promise for these debilitating injuries; however, these strategies often fail to successfully translate from rodent studies to the clinical setting. The dog represents a strong model for translational orthopedic studies, however such studies should be optimized in pursuit of the Principle of the 3R’s of animal research (replace, reduce, refine). The objective of this study was to refine a canine critical-sized femoral defect model using an angle-stable interlocking nail (AS-ILN) and reduce total animal numbers by performing imaging, biomechanics, and histology on the same cohort of dogs. Methods: Six skeletally mature hounds underwent a 4 cm mid-diaphyseal femoral ostectomy followed by stabilization with an AS-ILN. Dogs were assigned to autograft (n = 3) or negative control (n = 3) treatment groups. At 6, 12, and 18 weeks, healing was quantified by ordinal radiographic scoring and quantified CT. After euthanasia, femurs from the autograft group were mechanically evaluated using an established torsional loading protocol. Femurs were subsequently assessed histologically. Results: Surgery was performed without complication and the AS-ILN provided appropriate fixation for the duration of the study. Dogs assigned to the autograft group achieved radiographic union by 12 weeks, whereas the negative control group experienced non-union. At 18 weeks, median bone and soft tissue callus volume were 9,001 mm3 (range: 4,939–10,061) for the autograft group and 3,469 mm3 (range: 3,085–3,854) for the negative control group. Median torsional stiffness for the operated, autograft treatment group was 0.19 Nm/° (range: 0.19–1.67) and torque at failure was 12.0 Nm (range: 1.7–14.0). Histologically, callus formation and associated endochondral ossification were identified in the autograft treatment group, whereas fibrovascular tissue occupied the critical-sized defect in negative controls. Conclusion: In a canine critical-sized defect model, the AS-ILN and described outcome measures allowed refinement and reduction consistent with the Principle of the 3R’s of ethical animal research. This model is well-suited for future canine translational bone tissue engineering studies.
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Affiliation(s)
- W. B. Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
- *Correspondence: W. B. Saunders,
| | - L. M. Dejardin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - E. V. Soltys-Niemann
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - C. N. Kaulfus
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - B. M. Eichelberger
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - L. K. Dobson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - B. R. Weeks
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - S. C. Kerwin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - C. A. Gregory
- Department of Molecular and Cellular Medicine, Institute for Regenerative Medicine, School of Medicine, Texas A & M Health Science Center, College Station, TX, United States
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Sparks DS, Medeiros Savi F, Saifzadeh S, Wille ML, Wagels M, Hutmacher DW. Bone Regeneration Exploiting Corticoperiosteal Tissue Transfer for Scaffold-Guided Bone Regeneration. Tissue Eng Part C Methods 2022; 28:202-213. [PMID: 35262425 DOI: 10.1089/ten.tec.2022.0015] [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: 11/12/2022] Open
Abstract
Contemporary reconstructive approaches for critical size bone defects carry significant disadvantages. As a result, clinically driven research has focused on the development and translation of alternative therapeutic concepts. Scaffold-guided tissue regeneration (SGTR) is an emerging technique to heal critical size bone defects. However, issues synchronizing scaffold vascularization with bone-specific regenerative processes currently limit bone regeneration for extra large (XL, 19 cm3) critical bone defects. To address this issue, we developed a large animal model that incorporates a corticoperiosteal flap (CPF) for sustained scaffold neovascularization and bone regeneration. In 10 sheep, we demonstrated the efficacy of this approach for healing medium (M, 9 cm3) size critical bone defects as demonstrated on plain radiography, microcomputed tomography, and histology. Furthermore, in two sheep, we demonstrate how this approach can be safely extended to heal XL critical size defects. This article presents an original CPF technique in a well-described preclinical model, which can be used in conjunction with the SGTR concept, to address challenging critical size bone defects in vivo. Impact statement This article describes a novel scaffold-guided tissue engineering approach utilizing a corticoperiosteal flap for bone healing in critical size long bone defects. This approach will be of use for tissue engineers and surgeons exploring vascularized tissue transfer as an option to regenerate large volumes of bone for extensive critical size bone defects both in vivo and in the clinical arena.
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Affiliation(s)
- David S Sparks
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia.,Department of Plastic & Reconstructive Surgery, Princess Alexandra Hospital, Woolloongabba, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, Australia
| | - Flavia Medeiros Savi
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia.,ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia
| | - Siamak Saifzadeh
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia.,Medical Engineering Research Facility, Queensland University of Technology, Chermside, Australia
| | - Marie-Luise Wille
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia.,ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia
| | - Michael Wagels
- Department of Plastic & Reconstructive Surgery, Princess Alexandra Hospital, Woolloongabba, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, Australia.,Australian Centre for Complex Integrated Surgical Solutions (ACCISS), Princess Alexandra Hospital, Woolloongabba, Australia.,Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Australia
| | - Dietmar W Hutmacher
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia.,ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia.,Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Australia
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7
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Henkel J, Medeiros Savi F, Berner A, Fountain S, Saifzadeh S, Steck R, Epari DR, Woodruff MA, Knackstedt M, Schuetz MA, Hutmacher DW. Scaffold-guided bone regeneration in large volume tibial segmental defects. Bone 2021; 153:116163. [PMID: 34461285 DOI: 10.1016/j.bone.2021.116163] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
Large volume losses in weight bearing long bones are a major challenge in clinical practice. Despite multiple innovations over the last decades, significant limitations subsist in current clinical treatment options which is driving a strong clinical demand for clinically translatable treatment alternatives, including bone tissue engineering applications. Despite these shortcomings, preclinical large animal models of large volume segmental bone defects to investigate the regenerative capacity of bone tissue engineering strategies under clinically relevant conditions are rarely described in literature. We herein present a newly established preclinical ovine animal model for the treatment of XL volume (19 cm3) segmental tibial defects. In eight aged male Merino sheep (age > 6 years) a mid-diaphyseal tibial segmental defect was created and stabilized with a 5.6 mm Dynamic Compression Plate (DCP). We present short-term (3 months) and long-term (12-15 months) results of a pilot study using medical grade Polycaprolactone-Tricalciumphosphate (mPCL-TCP) scaffolds combined with a dose of 2 mg rhBMP-7 delivered in Platelet-Rich- Plasma (PRP). Furthermore, detailed analyses of the mechanical properties of the scaffolds as well as interfragmentary movement (IFM) and DCP-surface strain in vitro and a comprehensive description of the surgical and post-surgery protocol and post-mortem analysis is given.
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Affiliation(s)
- Jan Henkel
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, Kelvin Grove, Australia; Department of Trauma Surgery, Lutheran Hospital Goettingen-Weende, Goettingen, Germany
| | - Flavia Medeiros Savi
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, Kelvin Grove, Australia; ARC Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing, Australia; Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia
| | - Arne Berner
- Department of Trauma Surgery, University Hospital of Regensburg, Regensburg, Germany; Australian Research Council Industrial Transformation Training Centre in Additive Biomanufacturing, Australia
| | - Stephanie Fountain
- Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia
| | - Siamak Saifzadeh
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, Kelvin Grove, Australia; Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia; Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Australia
| | - Roland Steck
- Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Australia
| | - Devakar R Epari
- Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia
| | - Maria A Woodruff
- Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia
| | - Mark Knackstedt
- Department of Applied Mathematics, Australian National University (ANU), Canberra, Australia
| | - Michael A Schuetz
- Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Australia
| | - Dietmar W Hutmacher
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, Kelvin Grove, Australia; ARC Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing, Australia; Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia; Australian Research Council Industrial Transformation Training Centre in Additive Biomanufacturing, Australia; Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Australia.
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8
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Liu X, Wang Z, Xu C, Guan J, Wei B, Liu Y. [Study on the gelatin methacryloyl composite scaffold with exogenous transforming growth factor β 1 to promote the repair of skull defects]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2021; 35:904-912. [PMID: 34308601 DOI: 10.7507/1002-1892.202102008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective To prepare a bone tissue engineering scaffold for repairing the skull defect of Sprague Dawley (SD) rats by combining exogenous transforming growth factor β 1 (TGF-β 1) with gelatin methacryloyl (GelMA) hydrogel. Methods Firstly, GelMA hydrogel composite scaffolds containing exogenous TGF-β 1 at concentrations of 0, 150, 300, 600, 900, and 1 200 ng/mL (set to groups A, B, C, D, E, and F, respectively) were prepared. Cell counting kit 8 (CCK-8) method was used to detect the effect of composite scaffold on the proliferation of bone marrow mesenchymal stem cells (BMSCs) in SD rats. ALP staining, alizarin red staining, osteocalcin (OCN) immunofluorescence staining, and Western blot were used to explore the effect of scaffolds on osteogenic differentiation of BMSCs, and the optimal concentration of TGF-β 1/GelMA scaffold was selected. Thirty-six 8-week-old SD rats were taken to prepare a 5 mm diameter skull bone defect model and randomly divided into 3 groups, namely the control group, the GelMA group, and the GelMA+TGF-β 1 group (using the optimal concentration of TGF-β 1/GelMA scaffold). The rats were sacrificed at 4 and 8 weeks after operation, and micro-CT, HE staining, and OCN immunohistochemistry staining were performed to observe the repair effect of skull defects. Results The CCK-8 method showed that the TGF-β 1/GelMA scaffolds in each group had a promoting effect on the proliferation of BMSCs. Group D had the strongest effect, and the cell activity was significantly higher than that of the other groups ( P<0.05). The results of ALP staining, alizarin red staining, OCN immunofluorescence staining, and Western blot showed that the percentage of ALP positive area, the percentage of alizarin red positive area, and the relative expressions of ALP and OCN proteins in group D were significantly higher than those of the other groups ( P<0.05), the osteogenesis effect in group D was the strongest. Therefore, in vitroexperiments screened out the optimal concentration of TGF-β 1/GelMA scaffold to be 600 ng/mL. Micro-CT, HE staining, and OCN immunohistochemistry staining of rat skull defect repair experiments showed that the new bone tissue and bone volume/tissue volume ratio in the TGF-β 1+GelMA group were significantly higher than those in the GelMA group and control group at 4 and 8 weeks after operation ( P<0.05). Conclusion The TGF-β 1/GelMA scaffold with a concentration of 600 ng/mL can significantly promote the osteogenic differentiation of BMSCs, can significantly promote bone regeneration at the skull defect, and can be used as a bioactive material for bone tissue regeneration.
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Affiliation(s)
- Xiangyu Liu
- Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P.R.China.,Bengbu Medical College, Bengbu Anhui, 233000, P.R.China.,Key Laboratory of Anhui Province for Tissue Transplantation, Bengbu Anhui, 233000, P.R.China
| | - Zhaodong Wang
- Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P.R.China.,Key Laboratory of Anhui Province for Tissue Transplantation, Bengbu Anhui, 233000, P.R.China
| | - Chen Xu
- Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P.R.China.,Key Laboratory of Anhui Province for Tissue Transplantation, Bengbu Anhui, 233000, P.R.China
| | - Jianzhong Guan
- Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P.R.China.,Key Laboratory of Anhui Province for Tissue Transplantation, Bengbu Anhui, 233000, P.R.China
| | - Bangguo Wei
- Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P.R.China.,Bengbu Medical College, Bengbu Anhui, 233000, P.R.China.,Key Laboratory of Anhui Province for Tissue Transplantation, Bengbu Anhui, 233000, P.R.China
| | - Yajun Liu
- Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P.R.China.,Key Laboratory of Anhui Province for Tissue Transplantation, Bengbu Anhui, 233000, P.R.China
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9
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Marcondes GDM, Paretsis NF, Souza AFD, Ruivo MRBA, Rego MAF, Nóbrega FS, Cortopassi SRG, De Zoppa ALDV. Locking compression plate fixation of critical-sized bone defects in sheep. Development of a model for veterinary bone tissue engineering. Acta Cir Bras 2021; 36:e360601. [PMID: 34190837 PMCID: PMC8232063 DOI: 10.1590/acb360601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/03/2021] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To develop a segmental tibial bone defect model for tissue engineering studies in veterinary orthopedics using single locking compression plate (LCP) fixation and cast immobilization. METHODS A 3-cm bone defect was created in the right tibia of 18 adult Suffolk sheep. A 10-hole, 4.5-mm LCP was applied to the dorsomedial aspect of the bone. Four locking screws were inserted into the proximal and three into the distal bone fragment. Operated limbs were immobilized with casts. Animals were submitted to stall rest, but were allowed to bear weight on the operated limb. During the recovery period, animals were checked daily for physiological parameters, behavior and lameness. Follow-up radiographs were taken monthly. RESULTS Surgical procedures and postoperative recovery were uneventful. Animals adapted quickly to casts and were able to bear weight on the operated limb with no signs of discomfort or distress. No clinical or radiographic complications were detected over a 90-day follow-up period. CONCLUSIONS Surgical creation of tibial segmental bone defects followed by fixation with single LCP and cast immobilization was deemed a feasible and appropriate model for veterinary orthopedic research in tissue engineering.
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10
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Choi YS, Ham DS, Lim JY, Lee YK. Validation of the Osteomyelitis Induced by Methicillin-Resistant Staphylococcus aureus (MRSA) on Rat Model with Calvaria Defect. Tissue Eng Regen Med 2021; 18:671-683. [PMID: 34165776 DOI: 10.1007/s13770-021-00340-5] [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: 04/09/2020] [Revised: 03/21/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Osteomyelitis resulting from bacterial strains, such as methicillin-resistant Staphylococcus aureus (MRSA) that are resistant to multiple drugs, brings further clinical challenges. There is currently no model of osteomyelitis induced by MRSA using rats with calvaria defects. So, We induced osteomyelitis in rat models with the calvaria bone defect. METHODS The rats were randomly divided into six groups according to inoculation dose levels, which ranged from 6 × 100 to 6 × 105 CFU/5 µl. Bone tissues were retrieved from all rats used in the study and assessed using histology, microbiology, and radiobiology 4 weeks after surgery to evaluate the relationship between inoculation dose and infectivity. RESULTS In Histological results, high levels of inflammatory responses, bone necrosis, and bacteria were observed in treatment groups G3 to G5. In IHC staining, high levels of cox-2 expression were observed in treatment groups G3. Microbiological observations also indicated that significantly higher numbers of CFUs were found in G3 to G5. In radiography results, the bone mineral density in G3 to G5 was significantly higher than in the control group, G1, and G2. Our results indicate that an inoculating dose of 6 × 103 CFU/5 μl is sufficient to induce the development of osteomyelitis in rat models. CONCLUSION This study suggests that the minimum dose (6 × 103 CFU/5 µl) can induce osteomyelitis in calvaria rat model. This can offer information and ability of more accurately modeling osteomyelitis and simulating the challenge of osteomyelitis treat.
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Affiliation(s)
- Young Suk Choi
- Department of Biology, Soonchunhyang University, Soonchunhyang-ro, Sinchang-myeon, Asan-si, Chungcheongnam-do, 31538, Republic of Korea.,Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 4 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, 14584, Republic of Korea
| | - Dae Sung Ham
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 4 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, 14584, Republic of Korea.,Department of Medical Sciences, Soonchunhyang University, Soonchunhyang-ro, Sinchang-myeon, Asan-si, Chungcheongnam-do, 31538, Republic of Korea
| | - Ji Yun Lim
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 4 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, 14584, Republic of Korea.,Department of Medical Sciences, Soonchunhyang University, Soonchunhyang-ro, Sinchang-myeon, Asan-si, Chungcheongnam-do, 31538, Republic of Korea
| | - Young Koo Lee
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 4 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, 14584, Republic of Korea.
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11
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Carreras-Sánchez I, López-Fernández A, Rojas-Márquez R, Vélez R, Aguirre M, Vives J. Derivation of Mesenchymal Stromal Cells from Ovine Umbilical Cord Wharton's Jelly. Curr Protoc 2021; 1:e18. [PMID: 33484488 DOI: 10.1002/cpz1.18] [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: 11/10/2022]
Abstract
The methods described herein allow for the isolation and expansion of fibroblastic-like ovine Wharton's jelly-derived mesenchymal stromal cells (oWJ-MSC) that, similarly to their human counterparts, adhere to standard plastic surfaces in culture; show a mesenchymal profile for specific surface antigens (i.e., positive for CD44 and CD166); and lack expression of endothelial (CD31) and hematopoietic (CD45) markers as well as major histocompatibility complex (MHC) class-II. Homogeneous cell cultures result from a two-phase bioprocess design that starts with the isolation of mesenchymal stromal cells (MSC) from the Wharton's jelly of ovine umbilical cords up to a first step of cryopreservation. The second phase allows for further expansion of ovine WJ-MSC up to sufficient numbers for further studies. Overall, this methodology encompasses a 2-week bioprocess design that encompasses two cell culture passages ensuring sufficient cells for the generation of a Master Cell Bank. Further thawing and scale expansion results in large quantities of oWJ-MSC that can be readily used in proof of efficacy and safety studies in the preclinical development stage of the development of cell-based medicines. © 2021 Wiley Periodicals LLC. Basic Protocol 1: Isolation and expansion of ovine mesenchymal stromal cells from Wharton's jelly of the umbilical cord Basic Protocol 2: Characterization of ovine mesenchymal stromal cells Basic Protocol 3: Growth profile determination of ovine mesenchymal stromal cells from Wharton's jelly.
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Affiliation(s)
- Irene Carreras-Sánchez
- Servei de Teràpia Cel·lular, Banc de Sang i Teixits, Edifici Dr. Frederic Duran i Jordà, Passeig Taulat, Barcelona, Spain.,Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, Barcelona, Spain
| | - Alba López-Fernández
- Servei de Teràpia Cel·lular, Banc de Sang i Teixits, Edifici Dr. Frederic Duran i Jordà, Passeig Taulat, Barcelona, Spain.,Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, Barcelona, Spain
| | - Raquel Rojas-Márquez
- Servei de Teràpia Cel·lular, Banc de Sang i Teixits, Edifici Dr. Frederic Duran i Jordà, Passeig Taulat, Barcelona, Spain.,Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, Barcelona, Spain
| | - Roberto Vélez
- Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, Barcelona, Spain
| | - Màrius Aguirre
- Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, Barcelona, Spain
| | - Joaquim Vives
- Servei de Teràpia Cel·lular, Banc de Sang i Teixits, Edifici Dr. Frederic Duran i Jordà, Passeig Taulat, Barcelona, Spain.,Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, Barcelona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, Barcelona, Spain
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12
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An Overview of Bone Replacement Materials – Biological Mechanisms and Translational Research. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021. [DOI: 10.2478/sjecr-2021-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Bone defects might develop as a result of various pathological entities. Bone grafting is a widely used procedure that involves replacement of the missing tissue with natural or artificial substitute. The idea for artificial replacement of the missing bone tissue has been known for centuries and the evidence for these treatments has been found ever since prehistoric period. Bone grafting has been practiced for centuries with various non-osseous natural materials. The skeletal system plays a crucial role in the structural support, body movement and physical protection of the inner organs. Regeneration of bone defects is crucial for reestablishing of the form and function of the skeletal system,. While most bone defects can heal spontaneously under suitable conditions, bone grafts or substitute biomaterials are commonly used therapeutic strategies for reconstruction of large bone segments or moderate bone defect. An ideal bone grafting material should provide mechanical strength, be both osteoinductive and osteoconductive and should provide space for vascularization. In order to overcome limitations associated with the standard treatment of bone grafts, there is an increasing interest in studying substitute biomaterials, made of naturally derived or synthetic materials. Bone substitutes can be derived from biological products or from synthetic materials. Prior to testing in human subjects, the bone substitute materials should be tested in vitro and in vivo using animal models. Establishing of a suitable animal model is an essential step in the investigation and evaluation of the bone graft materials.
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13
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Zhang Y, Fang C, Zhang S, Campbell RE, Serpe MJ. Controlled Osteogenic Differentiation of Human Mesenchymal Stem Cells Using Dexamethasone-Loaded Light-Responsive Microgels. ACS APPLIED MATERIALS & INTERFACES 2021; 13:7051-7059. [PMID: 33528987 DOI: 10.1021/acsami.0c17664] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Human mesenchymal stem cells (hMSCs), which have the ability to differentiate into osteoblasts, show promise for bone tissue engineering and bone defect treatment. While there are a number of approaches currently available to accomplish this, e.g., utilizing biodegradable materials loaded with the synthetic glucocorticoid osteogenic inducer dexamethasone (DEX), there are still many disadvantages with the current technologies. Here, we generated light-responsive microgels that we showed are capable of loading and releasing DEX in a light-triggered fashion, with the released DEX being able to induce hMSC differentiation into osteoblasts. Specifically, light-responsive poly(N-isopropylacrylamide-co-nitrobenzyl methacrylate) (pNIPAm-co-NBMA) microgels were synthesized via free radical precipitation polymerization and their size, morphology, and chemical composition were characterized. We then went on to show that the microgels could be loaded with DEX (via what we think are hydrophobic interactions) and released upon exposure to UV light. We went on to show that the DEX released from the microgels was still capable of inducing osteogenic differentiation of hMSCs using an alamarBlue assay and normalized alkaline phosphatase (ALP) activity assay. We also investigated how hMSC differentiation was impacted by intermittent DEX released from UV-exposed microgels. Finally, we confirmed that the microgels themselves were not cytotoxic to hMSCs. Taken together, the DEX-loaded light-responsive microgels reported here may find a use for niche clinical applications, e.g., bone tissue repair.
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Affiliation(s)
- Yingnan Zhang
- Department of Chemistry, University of Alberta, Edmonton, Alberta T6G 2G2, Canada
| | - Changhao Fang
- Department of Chemistry, University of Alberta, Edmonton, Alberta T6G 2G2, Canada
| | - Shuce Zhang
- Department of Chemistry, University of Alberta, Edmonton, Alberta T6G 2G2, Canada
| | - Robert E Campbell
- Department of Chemistry, University of Alberta, Edmonton, Alberta T6G 2G2, Canada
| | - Michael J Serpe
- Department of Chemistry, University of Alberta, Edmonton, Alberta T6G 2G2, Canada
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14
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Ramallo M, Carreras-Sánchez I, López-Fernández A, Vélez R, Aguirre M, Feldman S, Vives J. Advances in translational orthopaedic research with species-specific multipotent mesenchymal stromal cells derived from the umbilical cord. Histol Histopathol 2020; 36:19-30. [PMID: 32914860 DOI: 10.14670/hh-18-249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Compliance with current regulations for the development of innovative medicines require the testing of candidate therapies in relevant translational animal models prior to human use. This poses a great challenge when the drug is composed of cells, not only because of the living nature of the active ingredient but also due to its human origin, which can subsequently lead to a xenogeneic response in the animals. Although immunosuppression is a plausible solution, this is not suitable for large animals and may also influence the results of the study by altering mechanisms of action that are, in fact, poorly understood. For this reason, a number of procedures have been developed to isolate homologous species-specific cell types to address preclinical pharmacodynamics, pharmacokinetics and toxicology. In this work, we present and discuss advances in the methodologies for derivation of multipotent Mesenchymal Stromal Cells derived from the umbilical cord, in general, and Wharton's jelly, in particular, from medium to large animals of interest in orthopaedics research, as well as current and potential applications in studies addressing proof of concept and preclinical regulatory aspects.
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Affiliation(s)
- Melina Ramallo
- School of Medicine, LABOATEM, - Osteoarticular Biology, Tissue Engineering and Emerging Therapies Laboratory, Biological Chemistry Cat., School of Medicine, National Rosario University, Rosario, Argentina
| | | | - Alba López-Fernández
- Servei de Teràpia Cellular, Banc de Sang i Teixits, Barcelona, Spain.,Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roberto Vélez
- Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Orthopedic Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - Màrius Aguirre
- Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Orthopedic Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - Sara Feldman
- School of Medicine, LABOATEM, - Osteoarticular Biology, Tissue Engineering and Emerging Therapies Laboratory, Biological Chemistry Cat., School of Medicine, National Rosario University, Argentina.,Researh Council of the Rosario National University, (CIUNR) and CONICET, Rosario, Argentina.
| | - Joaquim Vives
- Servei de Teràpia Cellular, Banc de Sang i Teixits, Barcelona, Spain.,Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
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15
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Identification of ultrasound imaging markers to quantify long bone regeneration in a segmental tibial defect sheep model in vivo. Sci Rep 2020; 10:13646. [PMID: 32788593 PMCID: PMC7423946 DOI: 10.1038/s41598-020-70426-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 07/27/2020] [Indexed: 12/11/2022] Open
Abstract
The healing of large bone defects has been investigated for decades due to its complexity and clinical relevance. Ultrasound (US) methods have shown promise in monitoring bone healing, but no quantitative method to assess regenerated bone morphology in US images has been presented yet. In this study, we investigate new US morphometric parameters to quantify bone regeneration in vivo. A segmental tibial defect was surgically created and stabilized in a sheep animal model. US and computed tomography (CT) imaging data were collected two months post-surgery. New bone was assessed, reconstructed and quantified from the US and CT data using 3 morphometric parameters: the new-bone bulk (NBB), new-bone surface (NBS) and new-bone contact (NBC). The distance (mm) between surface reconstructions from repeated US was \documentclass[12pt]{minimal}
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\begin{document}$$0.49\pm 0.30$$\end{document}0.49±0.30 and from US and CT was \documentclass[12pt]{minimal}
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\begin{document}$$0.89\pm 0.49$$\end{document}0.89±0.49. In the mid-shaft of the defected tibia, US measurements of NBB, NBS and NBC were significantly higher than the corresponding CT measurements (\documentclass[12pt]{minimal}
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\begin{document}$$p < 0.001$$\end{document}p<0.001). Based on our results, we conclude that US may complement CT to reconstruct and quantify bone regrowth, especially in its early stages.
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16
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Black C, Kanczler JM, de Andrés MC, White LJ, Savi FM, Bas O, Saifzadeh S, Henkel J, Zannettino A, Gronthos S, Woodruff MA, Hutmacher DW, Oreffo ROC. Characterisation and evaluation of the regenerative capacity of Stro-4+ enriched bone marrow mesenchymal stromal cells using bovine extracellular matrix hydrogel and a novel biocompatible melt electro-written medical-grade polycaprolactone scaffold. Biomaterials 2020; 247:119998. [PMID: 32251928 PMCID: PMC7184676 DOI: 10.1016/j.biomaterials.2020.119998] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 12/15/2022]
Abstract
Many skeletal tissue regenerative strategies centre around the multifunctional properties of bone marrow derived stromal cells (BMSC) or mesenchymal stem/stromal cells (MSC)/bone marrow derived skeletal stem cells (SSC). Specific identification of these particular stem cells has been inconclusive. However, enriching these heterogeneous bone marrow cell populations with characterised skeletal progenitor markers has been a contributing factor in successful skeletal bone regeneration and repair strategies. In the current studies we have isolated, characterised and enriched ovine bone marrow mesenchymal stromal cells (oBMSCs) using a specific antibody, Stro-4, examined their multipotential differentiation capacity and, in translational studies combined Stro-4+ oBMSCs with a bovine extracellular matrix (bECM) hydrogel and a biocompatible melt electro-written medical-grade polycaprolactone scaffold, and tested their bone regenerative capacity in a small in vivo, highly vascularised, chick chorioallantoic membrane (CAM) model and a preclinical, critical-sized ovine segmental tibial defect model. Proliferation rates and CFU-F formation were similar between unselected and Stro-4+ oBMSCs. Col1A1, Col2A1, mSOX-9, PPARG gene expression were upregulated in respective osteogenic, chondrogenic and adipogenic culture conditions compared to basal conditions with no significant difference between Stro-4+ and unselected oBMSCs. In contrast, proteoglycan expression, alkaline phosphatase activity and adipogenesis were significantly upregulated in the Stro-4+ cells. Furthermore, with extended cultures, the oBMSCs had a predisposition to maintain a strong chondrogenic phenotype. In the CAM model Stro-4+ oBMSCs/bECM hydrogel was able to induce bone formation at a femur fracture site compared to bECM hydrogel and control blank defect alone. Translational studies in a critical-sized ovine tibial defect showed autograft samples contained significantly more bone, (4250.63 mm3, SD = 1485.57) than blank (1045.29 mm3, SD = 219.68) ECM-hydrogel (1152.58 mm3, SD = 191.95) and Stro-4+/ECM-hydrogel (1127.95 mm3, SD = 166.44) groups. Stro-4+ oBMSCs demonstrated a potential to aid bone repair in vitro and in a small in vivo bone defect model using select scaffolds. However, critically, translation to a large related preclinical model demonstrated the complexities of bringing small scale reported stem-cell material therapies to a clinically relevant model and thus facilitate progression to the clinic.
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Affiliation(s)
- C Black
- Bone & Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Human Development & Health, Institute of Developmental Sciences, University of Southampton, SO16 6YD, UK
| | - J M Kanczler
- Bone & Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Human Development & Health, Institute of Developmental Sciences, University of Southampton, SO16 6YD, UK
| | - M C de Andrés
- Bone & Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Human Development & Health, Institute of Developmental Sciences, University of Southampton, SO16 6YD, UK; Cartilage Epigenetics Group, Rheumatology Division, Biomedical Research Institute of A Coruña (INIBIC), Hospital Universitario de A Coruña-CHUAC, 15006 A Coruña ,Spain
| | - L J White
- School of Pharmacy, Biodiscovery Institute, University Park, University of Nottingham, Nottingham, NG7 2RD, UK
| | - F M Savi
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia; Institute of Health Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - O Bas
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia; Institute of Health Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - S Saifzadeh
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia
| | - J Henkel
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia
| | - A Zannettino
- Myeloma Research Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia and Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia and Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - S Gronthos
- Mesenchymal Stem Cell Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia and Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - M A Woodruff
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia
| | - D W Hutmacher
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia; Institute of Health Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - R O C Oreffo
- Bone & Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Human Development & Health, Institute of Developmental Sciences, University of Southampton, SO16 6YD, UK; College of Biomedical Engineering, China Medical University, Taichung, 40402, Taiwan.
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17
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Sparks DS, Saifzadeh S, Savi FM, Dlaska CE, Berner A, Henkel J, Reichert JC, Wullschleger M, Ren J, Cipitria A, McGovern JA, Steck R, Wagels M, Woodruff MA, Schuetz MA, Hutmacher DW. A preclinical large-animal model for the assessment of critical-size load-bearing bone defect reconstruction. Nat Protoc 2020; 15:877-924. [PMID: 32060491 DOI: 10.1038/s41596-019-0271-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 11/11/2019] [Indexed: 12/31/2022]
Abstract
Critical-size bone defects, which require large-volume tissue reconstruction, remain a clinical challenge. Bone engineering has the potential to provide new treatment concepts, yet clinical translation requires anatomically and physiologically relevant preclinical models. The ovine critical-size long-bone defect model has been validated in numerous studies as a preclinical tool for evaluating both conventional and novel bone-engineering concepts. With sufficient training and experience in large-animal studies, it is a technically feasible procedure with a high level of reproducibility when appropriate preoperative and postoperative management protocols are followed. The model can be established by following a procedure that includes the following stages: (i) preoperative planning and preparation, (ii) the surgical approach, (iii) postoperative management, and (iv) postmortem analysis. Using this model, full results for peer-reviewed publication can be attained within 2 years. In this protocol, we comprehensively describe how to establish proficiency using the preclinical model for the evaluation of a range of bone defect reconstruction options.
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Affiliation(s)
- David S Sparks
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Department of Plastic & Reconswrapping a sterile Coban wrap around the limb distallytructive Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, Queensland, Australia
| | - Siamak Saifzadeh
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Medical Engineering Research Facility, Queensland UCoban wrap only comes non-sterile. Sterilize Coban wrap before use.niversity of Technology, Chermside, Queensland, Australia
| | - Flavia Medeiros Savi
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,ARC Centre for Additive Biomanufactthe mounting resin base cement. Use it only in a laboratory fume cabinet and withuring, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Constantin E Dlaska
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Queensland, Australia
| | - Arne Berner
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Department of Trauma Surgery, University Hospital of Regensburg, Regensburg, Germany
| | - Jan Henkel
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Johannes C Reichert
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, König-Ludwig-Haus, Julius-Maximilians-University, Würzburg, Germany.,Department of Orthopaedic and Trauma Surgery, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany
| | - Martin Wullschleger
- Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Queensland, Australia.,Griffith University, School of Medicine, Southport, Queensland, Australia
| | - Jiongyu Ren
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Amaia Cipitria
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Potsdam, Germany
| | - Jacqui A McGovern
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Roland Steck
- Medical Engineering Research Facility, Queensland UCoban wrap only comes non-sterile. Sterilize Coban wrap before use.niversity of Technology, Chermside, Queensland, Australia
| | - Michael Wagels
- Department of Plastic & Reconswrapping a sterile Coban wrap around the limb distallytructive Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, Queensland, Australia.,Australian Centre for Complex Integrated Surgical Solutions (ACCISS), Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Maria Ann Woodruff
- ARC Centre for Additive Biomanufactthe mounting resin base cement. Use it only in a laboratory fume cabinet and withuring, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Biofabrication and Tissue Morphology Group, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Michael A Schuetz
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Queensland, Australia
| | - Dietmar W Hutmacher
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia. .,ARC Centre for Additive Biomanufactthe mounting resin base cement. Use it only in a laboratory fume cabinet and withuring, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
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18
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Animal Surgery and Care of Animals. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00060-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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19
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Li JJ, Dunstan CR, Entezari A, Li Q, Steck R, Saifzadeh S, Sadeghpour A, Field JR, Akey A, Vielreicher M, Friedrich O, Roohani‐Esfahani S, Zreiqat H. A Novel Bone Substitute with High Bioactivity, Strength, and Porosity for Repairing Large and Load-Bearing Bone Defects. Adv Healthc Mater 2019; 8:e1801298. [PMID: 30773833 DOI: 10.1002/adhm.201801298] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/18/2019] [Indexed: 12/18/2022]
Abstract
Achieving adequate healing in large or load-bearing bone defects is highly challenging even with surgical intervention. The clinical standard of repairing bone defects using autografts or allografts has many drawbacks. A bioactive ceramic scaffold, strontium-hardystonite-gahnite or "Sr-HT-Gahnite" (a multi-component, calcium silicate-based ceramic) is developed, which when 3D-printed combines high strength with outstanding bone regeneration ability. In this study, the performance of purely synthetic, 3D-printed Sr-HT-Gahnite scaffolds is assessed in repairing large and load-bearing bone defects. The scaffolds are implanted into critical-sized segmental defects in sheep tibia for 3 and 12 months, with bone autografts used for comparison. The scaffolds induce substantial bone formation and defect bridging after 12 months, as indicated by X-ray, micro-computed tomography, and histological and biomechanical analyses. Detailed analysis of the bone-scaffold interface using focused ion beam scanning electron microscopy and multiphoton microscopy shows scaffold degradation and maturation of the newly formed bone. In silico modeling of strain energy distribution in the scaffolds reveal the importance of surgical fixation and mechanical loading on long-term bone regeneration. The clinical application of 3D-printed Sr-HT-Gahnite scaffolds as a synthetic bone substitute can potentially improve the repair of challenging bone defects and overcome the limitations of bone graft transplantation.
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Affiliation(s)
- Jiao Jiao Li
- Biomaterials and Tissue Engineering Research Unit School of Aerospace, Mechanical and Mechatronic Engineering University of Sydney Sydney NSW 2006 Australia
- Raymond Purves Bone and Joint Research Laboratories Institute of Bone and Joint Research Kolling Institute Northern Sydney Local Health District Faculty of Medicine and Health University of Sydney St Leonards NSW 2065 Australia
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
| | - Colin R. Dunstan
- Biomaterials and Tissue Engineering Research Unit School of Aerospace, Mechanical and Mechatronic Engineering University of Sydney Sydney NSW 2006 Australia
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
| | - Ali Entezari
- School of Aerospace, Mechanical and Mechatronic Engineering University of Sydney Sydney NSW 2006 Australia
| | - Qing Li
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
- School of Aerospace, Mechanical and Mechatronic Engineering University of Sydney Sydney NSW 2006 Australia
| | - Roland Steck
- Medical Engineering Research Facility (MERF) Institute of Health and Biomedical Innovation (IHBI) Queensland University of Technology Prince Charles Hospital Campus Brisbane QLD 4000 Australia
| | - Siamak Saifzadeh
- Medical Engineering Research Facility (MERF) Institute of Health and Biomedical Innovation (IHBI) Queensland University of Technology Prince Charles Hospital Campus Brisbane QLD 4000 Australia
| | - Ameneh Sadeghpour
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
- Allegra Orthopaedics Limited Sydney NSW 2000 Australia
| | - John R. Field
- Centre for Orthopaedic Trauma and Research University of Adelaide Adelaide SA 5000 Australia
| | - Austin Akey
- Center for Nanoscale Systems Harvard University Cambridge MA 02138 USA
| | - Martin Vielreicher
- Institute of Medical Biotechnology Department of Chemical and Biological Engineering Friedrich Alexander University of Erlangen‐Nürnberg Erlangen 91052 Germany
| | - Oliver Friedrich
- Institute of Medical Biotechnology Department of Chemical and Biological Engineering Friedrich Alexander University of Erlangen‐Nürnberg Erlangen 91052 Germany
| | | | - Hala Zreiqat
- Biomaterials and Tissue Engineering Research Unit School of Aerospace, Mechanical and Mechatronic Engineering University of Sydney Sydney NSW 2006 Australia
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
- Radcliffe Institute for Advanced Study Harvard University Cambridge MA 02138 USA
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20
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Hettwer W, Horstmann PF, Bischoff S, Güllmar D, Reichenbach JR, Poh PSP, van Griensven M, Gras F, Diefenbeck M. Establishment and effects of allograft and synthetic bone graft substitute treatment of a critical size metaphyseal bone defect model in the sheep femur. APMIS 2019; 127:53-63. [PMID: 30698307 PMCID: PMC6850422 DOI: 10.1111/apm.12918] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 12/10/2018] [Indexed: 01/17/2023]
Abstract
Assessment of bone graft material efficacy is difficult in humans, since invasive methods like staged CT scans or biopsies are ethically unjustifiable. Therefore, we developed a novel large animal model for the verification of a potential transformation of synthetic bone graft substitutes into vital bone. The model combines multiple imaging methods with corresponding histology in standardized critical sized cancellous bone defect. Cylindrical bone voids (10 ml) were created in the medial femoral condyles of both hind legs (first surgery at right hind leg, second surgery 3 months later at left hind leg) in three merino‐wool sheep and either (i) left empty, filled with (ii) cancellous allograft bone or (iii) a synthetic, gentamicin eluting bone graft substitute. All samples were analysed with radiographs, MRI, μCT, DEXA and histology after sacrifice at 6 months. Unfilled defects only showed ingrowth of fibrous tissue, whereas good integration of the cancellous graft was seen in the allograft group. The bone graft substitute showed centripetal biodegradation and new trabecular bone formation in the periphery of the void as early as 3 months. μCT gave excellent insight into the structural changes within the defects, particularly progressive allograft incorporation and the bone graft substitute biodegradation process. MRI completed the picture by clearly visualizing soft tissue ingrowth into unfilled bone voids and presence of fluid collections. Histology was essential for verification of trabecular bone and osteoid formation. Conventional radiographs and DEXA could not differentiate details of the ongoing transformation process. This model appears well suited for detailed in vivo and ex vivo evaluation of bone graft substitute behaviour within large bone defects.
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Affiliation(s)
- Werner Hettwer
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Peter F Horstmann
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sabine Bischoff
- Central Experimental Animal Facility, University Hospital Jena, Jena, Germany
| | - Daniel Güllmar
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Patrina S P Poh
- Experimental Trauma Surgery, Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Martijn van Griensven
- Experimental Trauma Surgery, Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Florian Gras
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany
| | - Michael Diefenbeck
- BONESUPPORT AB, Lund, Sweden.,Scientific Consulting in Orthopaedic Surgery and Traumatology, Hamburg, Germany
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21
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Zhang Q, Qin M, Zhou X, Nie W, Wang W, Li L, He C. Porous nanofibrous scaffold incorporated with S1P loaded mesoporous silica nanoparticles and BMP-2 encapsulated PLGA microspheres for enhancing angiogenesis and osteogenesis. J Mater Chem B 2018; 6:6731-6743. [PMID: 32254690 DOI: 10.1039/c8tb02138d] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Repair of bone defects remains a major clinical challenge due to inadequate or abnormal vascularization in bone substitutes, which commonly leads to inferior bone formation or bone nonunion. Therefore, healing of bone defects requires the coordinated processes of angiogenesis and osteogenesis. In this study, sphingosine-1-phosphate (S1P) was initially loaded into mesoporous silica nanoparticles (MSNs) to form angiogenic microcarriers, which were subsequently embedded into porous nanofibrous poly-l-lactide (PLLA) scaffolds during a thermally induced phase separation (TIPS) process, while bone morphogenetic protein-2 (BMP-2) was encapsulated into poly(lactic-co-glycolic acid) (PLGA) microspheres to obtain osteogenic microcarriers, which were then integrated onto a MSNs/PLLA nanofibrous scaffold by a post seeding method. The osteogenic and angiogenic activities of the resulting dual-bioactive factor containing scaffolds were evaluated both in vitro and in vivo. The simulated drug release studies indicated that both bioactive factors will be released simultaneously and continuously from the fabricated composite scaffold. Moreover, the ectopic bone formation results showed that the sustained release of S1P and BMP-2 from the composite scaffold resulted in a synergistic effect on blood vessel formation and bone regeneration. Taken together, the results showed the promising application of the dual-bioactive factor loaded nanofibrous scaffold for enhanced bone regeneration.
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Affiliation(s)
- Qianqian Zhang
- Key Laboratory of Science and Technology of Eco-Textiles, Ministry of Education, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, China.
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22
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Tufekci P, Tavakoli A, Dlaska C, Neumann M, Shanker M, Saifzadeh S, Steck R, Schuetz M, Epari D. Early mechanical stimulation only permits timely bone healing in sheep. J Orthop Res 2018; 36:1790-1796. [PMID: 29159911 DOI: 10.1002/jor.23812] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/11/2017] [Indexed: 02/04/2023]
Abstract
Bone fracture healing is sensitive to the fixation stability. However, it is unclear which phases of healing are mechano-sensitive and if mechanical stimulation is required throughout repair. In this study, a novel bone defect model, which isolates an experimental fracture from functional loading, was applied in sheep to investigate if stimulation limited to the early proliferative phase is sufficient for bone healing. An active fixator controlled motion in the fracture. Animals of the control group were unstimulated. In the physiological-like group, 1 mm axial compressive movements were applied between day 5 and 21, thereafter the movements were decreased in weekly increments and stopped after 6 weeks. In the early stimulatory group, the movements were stopped after 3 weeks. The experimental fractures were evaluated with mechanical and micro-computed tomography methods after 9 weeks healing. The callus strength of the stimulated fractures (physiological-like and early stimulatory) was greater than the unstimulated control group. The control group was characterized by minimal external callus formation and a lack of bone bridging at 9 weeks. In contrast, the stimulated groups exhibited advanced healing with solid bone formation across the defect. This was confirmed quantitatively by a lower bone volume in the control group compared to the stimulated groups.The novel experimental model permits the application of a well-defined load history to an experimental bone fracture. The poor healing observed in the control group is consistent with under-stimulation. This study has shown early mechanical stimulation only is sufficient for a timely healing outcome. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1790-1796, 2018.
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Affiliation(s)
- Pelin Tufekci
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Aramesh Tavakoli
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Constantin Dlaska
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Mirjam Neumann
- Trauma Service, Princess Alexandra Hospital, Brisbane, Australia
| | - Mihir Shanker
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Siamak Saifzadeh
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Roland Steck
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Michael Schuetz
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia.,Trauma Service, Princess Alexandra Hospital, Brisbane, Australia
| | - Devakar Epari
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
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23
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McGovern JA, Griffin M, Hutmacher DW. Animal models for bone tissue engineering and modelling disease. Dis Model Mech 2018; 11:11/4/dmm033084. [PMID: 29685995 PMCID: PMC5963860 DOI: 10.1242/dmm.033084] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Tissue engineering and its clinical application, regenerative medicine, are instructing multiple approaches to aid in replacing bone loss after defects caused by trauma or cancer. In such cases, bone formation can be guided by engineered biodegradable and nonbiodegradable scaffolds with clearly defined architectural and mechanical properties informed by evidence-based research. With the ever-increasing expansion of bone tissue engineering and the pioneering research conducted to date, preclinical models are becoming a necessity to allow the engineered products to be translated to the clinic. In addition to creating smart bone scaffolds to mitigate bone loss, the field of tissue engineering and regenerative medicine is exploring methods to treat primary and secondary bone malignancies by creating models that mimic the clinical disease manifestation. This Review gives an overview of the preclinical testing in animal models used to evaluate bone regeneration concepts. Immunosuppressed rodent models have shown to be successful in mimicking bone malignancy via the implantation of human-derived cancer cells, whereas large animal models, including pigs, sheep and goats, are being used to provide an insight into bone formation and the effectiveness of scaffolds in induced tibial or femoral defects, providing clinically relevant similarity to human cases. Despite the recent progress, the successful translation of bone regeneration concepts from the bench to the bedside is rooted in the efforts of different research groups to standardise and validate the preclinical models for bone tissue engineering approaches.
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Affiliation(s)
- Jacqui Anne McGovern
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane 4059, Australia
| | - Michelle Griffin
- Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, NW3 2QG, UK.,UCL Centre for Nanotechnology and Regenerative Medicine, Division of Surgery and Interventional Science, University College London, London, WC1E 6BT, UK
| | - Dietmar Werner Hutmacher
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane 4059, Australia .,George W Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA.,Institute for Advanced Study, Technical University Munich, Garching 85748, Germany
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24
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Abstract
Bone defects are common and are associated with a significant burden of disease. The treatment of these injuries remains controversial, particularly those defects which are critical sized. Despite the need for decision making to be evidence based, a lack of consensus around definitions of critical-sized defects still exists, particularly around those defects in the 1-3 cm range. There is a need to define "critical" in bone defect size because noncritical defects may heal without planned reconstruction and secondary surgery. This article reviews the current evidence around the definition of a critical-sized bone defect and concludes that defects in the order of 2.5 cm or greater seem to have a poor natural history.
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25
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Lammens J, Maréchal M, Geris L, Van der Aa J, Van Hauwermeiren H, Luyten FP, Delport H. Warning About the Use of Critical-Size Defects for the Translational Study of Bone Repair: Analysis of a Sheep Tibial Model. Tissue Eng Part C Methods 2017; 23:694-699. [PMID: 28594312 DOI: 10.1089/ten.tec.2017.0147] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The repair of large long bone defects requires complex surgical procedures as the bone loss cannot simply be replaced by autologous grafts due to an insufficient bone stock of the human body. Tissue engineering strategies and the use of Advanced Therapy Medicinal Products (ATMPs) for these reconstructions remain a considerable challenge, in particular since robust outcomes in well-defined large animal models are lacking. To be suitable as a model for treatment of human sized bone defects, we developed a large animal model in both skeletally immature and mature sheep and made close observations on the spontaneous healing of defects. We warn for the spontaneous repair of large defects in immature animals, which can mask the (in)effectiveness of ATMP therapies, and propose the use of large 4.5 cm defects that are pretreated with a polymethylmethacrylate (PMMA) spacer in skeletally mature animals.
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Affiliation(s)
- Johan Lammens
- 1 Department of Orthopaedic Surgery, University Hospitals KU Leuven , Leuven, Belgium .,2 Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium
| | - Marina Maréchal
- 2 Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium
| | - Lisbet Geris
- 2 Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium .,3 Biomechanics Section, Department of Mechanical Engineering, KU Leuven, Leuven, Belgium .,6 Biomechanics Research Unit, GIGA in Silico Medicine, University of Liège, Liège, Belgium
| | | | | | - Frank P Luyten
- 2 Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium
| | - Hendrik Delport
- 1 Department of Orthopaedic Surgery, University Hospitals KU Leuven , Leuven, Belgium .,2 Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium
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26
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Rücker C, Kirch H, Pullig O, Walles H. Strategies and First Advances in the Development of Prevascularized Bone Implants. CURRENT MOLECULAR BIOLOGY REPORTS 2016; 2:149-157. [PMID: 27617188 PMCID: PMC4996880 DOI: 10.1007/s40610-016-0046-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Despite the great regenerative potential of human bone, large bone defects are a serious condition. Commonly, large defects are caused by trauma, bone disease, malignant tumor removal, and infection or medication-related osteonecrosis. Large defects necessitate clinical treatment in the form of autologous bone transplantation or implantation of biomaterials as well as the application of other available methods that enhance bone defect repair. The development and application of prevascularized bone implants are closely related to the development animal models and require dedicated methods in order to reliably predict possible clinical outcomes and the efficacy of implants. Cell sheet engineering, 3D-printing, arteriovenous loops, and naturally derived decellularized scaffolds and their respective testings in animal models are presented as alternative to the autologous bone graft in this article.
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Affiliation(s)
- Christoph Rücker
- Translational Center Würzburg ‘Regenerative therapies in oncology and musculoskeletal diseases’, Würzburg Branch of the Fraunhofer-Institute Interfacial Engineering and Biotechnology, IGB, Würzburg, Germany
| | - Holger Kirch
- Department Tissue Engineering and Regenerative Medicine (TERM), University Hospital Würzburg, Würzburg, Germany
| | - Oliver Pullig
- Translational Center Würzburg ‘Regenerative therapies in oncology and musculoskeletal diseases’, Würzburg Branch of the Fraunhofer-Institute Interfacial Engineering and Biotechnology, IGB, Würzburg, Germany
| | - Heike Walles
- Translational Center Würzburg ‘Regenerative therapies in oncology and musculoskeletal diseases’, Würzburg Branch of the Fraunhofer-Institute Interfacial Engineering and Biotechnology, IGB, Würzburg, Germany
- Department Tissue Engineering and Regenerative Medicine (TERM), University Hospital Würzburg, Würzburg, Germany
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27
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Quent VM, Theodoropoulos C, Hutmacher DW, Reichert JC. Differential osteogenicity of multiple donor-derived human mesenchymal stem cells and osteoblasts in monolayer, scaffold-based 3D culture and in vivo. ACTA ACUST UNITED AC 2016; 61:253-66. [DOI: 10.1515/bmt-2014-0159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 02/13/2015] [Indexed: 11/15/2022]
Abstract
Abstract
We set out to compare the osteogenicity of human mesenchymal stem (hMSCs) and osteoblasts (hOBs). Upon osteogenic induction in monolayer, hMSCs showed superior matrix mineralization expressing characteristic bone-related genes. For scaffold cultures, both cell types presented spindle-shaped, osteoblast-like morphologies forming a dense, interconnected network of high viability. On the scaffolds, hOBs proliferated faster. A general upregulation of parathyroid hormone-related protein (PTHrP), osteoprotegrin (OPG), receptor activator of NF-κB ligand (RANKL), sclerostin (SOST), and dentin matrix protein 1 (DMP1) was observed for both cell types. Simultaneously, PTHrP, RANKL and DMP-1 expression decreased under osteogenic stimulation, while OPG and SOST increased significantly. Following transplantation into NOD/SCID mice, μCT and histology showed increased bone deposition with hOBs. The bone was vascularized, and amounts further increased for both cell types after recombinant human bone morphogenic protein 7 (rhBMP-7) addition also stimulating osteoclastogenesis. Complete bone organogenesis was evidenced by the presence of osteocytes and hematopoietic precursors. Our study results support the asking to develop 3D cellular models closely mimicking the functions of living tissues suitable for in vivo translation.
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28
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Kirby GTS, White LJ, Steck R, Berner A, Bogoevski K, Qutachi O, Jones B, Saifzadeh S, Hutmacher DW, Shakesheff KM, Woodruff MA. Microparticles for Sustained Growth Factor Delivery in the Regeneration of Critically-Sized Segmental Tibial Bone Defects. MATERIALS 2016; 9:ma9040259. [PMID: 28773384 PMCID: PMC5502923 DOI: 10.3390/ma9040259] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 03/18/2016] [Accepted: 03/18/2016] [Indexed: 11/16/2022]
Abstract
This study trialled the controlled delivery of growth factors within a biodegradable scaffold in a large segmental bone defect model. We hypothesised that co-delivery of vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF) followed by bone morphogenetic protein-2 (BMP-2) could be more effective in stimulating bone repair than the delivery of BMP-2 alone. Poly(lactic-co-glycolic acid) (PLGA ) based microparticles were used as a delivery system to achieve a controlled release of growth factors within a medical-grade Polycaprolactone (PCL) scaffold. The scaffolds were assessed in a well-established preclinical ovine tibial segmental defect measuring 3 cm. After six months, mechanical properties and bone tissue regeneration were assessed. Mineralised bone bridging of the defect was enhanced in growth factor treated groups. The inclusion of VEGF and PDGF (with BMP-2) had no significant effect on the amount of bone regeneration at the six-month time point in comparison to BMP-2 alone. However, regions treated with VEGF and PDGF showed increased vascularity. This study demonstrates an effective method for the controlled delivery of therapeutic growth factors in vivo, using microparticles.
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Affiliation(s)
- Giles T S Kirby
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
- School of Pharmacy, University Park, The University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Lisa J White
- School of Pharmacy, University Park, The University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Roland Steck
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| | - Arne Berner
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
- Department of Trauma Surgery, University of Regensburg, Regensburg 93164, Germany.
| | - Kristofor Bogoevski
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| | - Omar Qutachi
- School of Pharmacy, University Park, The University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Brendan Jones
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| | - Siamak Saifzadeh
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| | - Dietmar W Hutmacher
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| | - Kevin M Shakesheff
- School of Pharmacy, University Park, The University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Maria A Woodruff
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
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Li JJ, Roohani-Esfahani SI, Dunstan CR, Quach T, Steck R, Saifzadeh S, Pivonka P, Zreiqat H. Efficacy of novel synthetic bone substitutes in the reconstruction of large segmental bone defects in sheep tibiae. ACTA ACUST UNITED AC 2016; 11:015016. [PMID: 26894676 DOI: 10.1088/1748-6041/11/1/015016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The treatment of large bone defects, particularly those with segmental bone loss, remains a significant clinical challenge as current approaches involving surgery or bone grafting often do not yield satisfactory long-term outcomes. This study reports the evaluation of novel ceramic scaffolds applied as bone graft substitutes in a clinically relevant in vivo model. Baghdadite scaffolds, unmodified or modified with a polycaprolactone coating containing bioactive glass nanoparticles, were implanted into critical-sized segmental bone defects in sheep tibiae for 26 weeks. Radiographic, biomechanical, μ-CT and histological analyses showed that both unmodified and modified baghdadite scaffolds were able to withstand physiological loads at the defect site, and induced substantial bone formation in the absence of supplementation with cells or growth factors. Notably, all samples showed significant bridging of the critical-sized defect (average 80%) with evidence of bone infiltration and remodelling within the scaffold implant. The unmodified and modified baghdadite scaffolds achieved similar outcomes of defect repair, although the latter may have an initial mechanical advantage due to the nanocomposite coating. The baghdadite scaffolds evaluated in this study hold potential for use as purely synthetic bone graft substitutes in the treatment of large bone defects while circumventing the drawbacks of autografts and allografts.
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Affiliation(s)
- Jiao Jiao Li
- Biomaterials and Tissue Engineering Research Unit, School of AMME, University of Sydney, Sydney, NSW 2006, Australia. These authors contributed equally
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30
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Fountain S, Windolf M, Henkel J, Tavakoli A, Schuetz MA, Hutmacher DW, Epari DR. Monitoring Healing Progression and Characterizing the Mechanical Environment in Preclinical Models for Bone Tissue Engineering. TISSUE ENGINEERING PART B-REVIEWS 2015; 22:47-57. [PMID: 26507933 DOI: 10.1089/ten.teb.2015.0123] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The treatment of large segmental bone defects remains a significant clinical challenge. Due to limitations surrounding the use of bone grafts, tissue-engineered constructs for the repair of large bone defects could offer an alternative. Before translation of any newly developed tissue engineering (TE) approach to the clinic, efficacy of the treatment must be shown in a validated preclinical large animal model. Currently, biomechanical testing, histology, and microcomputed tomography are performed to assess the quality and quantity of the regenerated bone. However, in vivo monitoring of the progression of healing is seldom performed, which could reveal important information regarding time to restoration of mechanical function and acceleration of regeneration. Furthermore, since the mechanical environment is known to influence bone regeneration, and limb loading of the animals can poorly be controlled, characterizing activity and load history could provide the ability to explain variability in the acquired data sets and potentially outliers based on abnormal loading. Many approaches have been devised to monitor the progression of healing and characterize the mechanical environment in fracture healing studies. In this article, we review previous methods and share results of recent work of our group toward developing and implementing a comprehensive biomechanical monitoring system to study bone regeneration in preclinical TE studies.
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Affiliation(s)
| | - Markus Windolf
- 1 Queensland University of Technology , Brisbane, Australia .,2 AO Research Institute Davos , Davos, Switzerland
| | - Jan Henkel
- 1 Queensland University of Technology , Brisbane, Australia
| | | | - Michael A Schuetz
- 1 Queensland University of Technology , Brisbane, Australia .,3 Trauma Service, Princess Alexandra Hospital , Brisbane, Australia
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31
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Abstract
Bone defects do not heal in 5-10% of the fractures. In order to enhance bone regeneration, drug delivery systems are needed. They comprise a scaffold with or without inducing factors and/or cells. To test these drug delivery systems before application in patients, they finally need to be tested in animal models. The choice of animal model depends on the main research question; is a functional or mechanistic evaluation needed? Furthermore, which type of bone defects are investigated: load-bearing (i.e. orthopedic) or non-load-bearing (i.e. craniomaxillofacial)? This determines the type of model and in which type of animal. The experiments need to be set-up using the 3R principle and must be reported following the ARRIVE guidelines.
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32
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Surgical Fixation Hardware for Regeneration of Long Bone Segmental Defects: Translating Large Animal Model and Human Experiences. Clin Rev Bone Miner Metab 2015. [DOI: 10.1007/s12018-015-9195-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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33
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Zhou X, Feng W, Qiu K, Chen L, Wang W, Nie W, Mo X, He C. BMP-2 Derived Peptide and Dexamethasone Incorporated Mesoporous Silica Nanoparticles for Enhanced Osteogenic Differentiation of Bone Mesenchymal Stem Cells. ACS APPLIED MATERIALS & INTERFACES 2015; 7:15777-15789. [PMID: 26133753 DOI: 10.1021/acsami.5b02636] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Bone morphogenetic protein-2 (BMP-2), a growth factor that induces osteoblast differentiation and promotes bone regeneration, has been extensively investigated in bone tissue engineering. The peptides of bioactive domains, corresponding to residues 73-92 of BMP-2 become an alternative to reduce adverse side effects caused by the use of high doses of BMP-2 protein. In this study, BMP-2 peptide functionalized mesoporous silica nanoparticles (MSNs-pep) were synthesized by covalently grafting BMP-2 peptide on the surface of nanoparticles via an aminosilane linker, and dexamethasone (DEX) was then loaded into the channel of MSNs to construct nanoparticulate osteogenic delivery systems (DEX@MSNs-pep). The in vitro cell viability of MSNs-pep was tested with bone mesenchymal stem cells (BMSCs) exposure to different particle concentrations, revealing that the functionalized MSNs had better cytocompatibility than their bare counterparts, and the cellular uptake efficiency of MSNs-pep was remarkably larger than that of bare MSNs. The in vitro results also show that the MSNs-pep promoted osteogenic differentiation of BMSCs in terms of the levels of alkaline phosphatase (ALP) activity, calcium deposition, and expression of bone-related protein. Moreover, the osteogenic differentiation of BMSCs can be further enhanced by incorporating of DEX into MSNs-pep. After intramuscular implantation in rats for 3 weeks, the computed tomography (CT) images and histological examination indicate that this nanoparticulate osteogenic delivery system induces effective osteoblast differentiation and bone regeneration in vivo. Collectively, the BMP-2 peptide and DEX incorporated MSNs can act synergistically to enhance osteogenic differentiation of BMSCs, which have potential applications in bone tissue engineering.
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Affiliation(s)
- Xiaojun Zhou
- †College of Chemistry, Chemical Engineering and Biotechnology; State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai 201620, China
- ‡College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Wei Feng
- ‡College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Kexin Qiu
- †College of Chemistry, Chemical Engineering and Biotechnology; State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai 201620, China
- ‡College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Liang Chen
- ‡College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Weizhong Wang
- ‡College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Wei Nie
- ‡College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Xiumei Mo
- †College of Chemistry, Chemical Engineering and Biotechnology; State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai 201620, China
- ‡College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Chuanglong He
- †College of Chemistry, Chemical Engineering and Biotechnology; State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai 201620, China
- ‡College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
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Li Y, Chen SK, Li L, Qin L, Wang XL, Lai YX. Bone defect animal models for testing efficacy of bone substitute biomaterials. J Orthop Translat 2015; 3:95-104. [PMID: 30035046 PMCID: PMC5982383 DOI: 10.1016/j.jot.2015.05.002] [Citation(s) in RCA: 197] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/21/2015] [Accepted: 05/21/2015] [Indexed: 12/25/2022] Open
Abstract
Large bone defects are serious complications that are most commonly caused by extensive trauma, tumour, infection, or congenital musculoskeletal disorders. If nonunion occurs, implantation for repairing bone defects with biomaterials developed as a defect filler, which can promote bone regeneration, is essential. In order to evaluate biomaterials to be developed as bone substitutes for bone defect repair, it is essential to establish clinically relevant in vitro and in vivo testing models for investigating their biocompatibility, mechanical properties, degradation, and interactional with culture medium or host tissues. The results of the in vitro experiment contribute significantly to the evaluation of direct cell response to the substitute biomaterial, and the in vivo tests constitute a step midway between in vitro tests and human clinical trials. Therefore, it is essential to develop or adopt a suitable in vivo bone defect animal model for testing bone substitutes for defect repair. This review aimed at introducing and discussing the most available and commonly used bone defect animal models for testing specific substitute biomaterials. Additionally, we reviewed surgical protocols for establishing relevant preclinical bone defect models with various animal species and the evaluation methodologies of the bone regeneration process after the implantation of bone substitute biomaterials. This review provides an important reference for preclinical studies in translational orthopaedics.
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Affiliation(s)
- Ye Li
- Centre for Translational Medicine Research and Development, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Shu-Kui Chen
- Centre for Translational Medicine Research and Development, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Long Li
- Centre for Translational Medicine Research and Development, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Ling Qin
- Centre for Translational Medicine Research and Development, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xin-Luan Wang
- Centre for Translational Medicine Research and Development, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yu-Xiao Lai
- Centre for Translational Medicine Research and Development, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai, China
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35
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Zhang P, Zhu Q. Important topics in the future of biomaterials and stem cells for bone tissue engineering: Comments from the participants of the International Symposium on Recent Trend of Biomaterials and Stem Cells for Bone Tissue Engineering at Changchun, China. Regen Biomater 2015; 2:153-8. [PMID: 26816638 PMCID: PMC4669021 DOI: 10.1093/rb/rbv004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 03/31/2015] [Accepted: 03/29/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peibiao Zhang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Changchun, 130022, P.R. China and Department of Orthopaedics, China-Japan Union Hospital, Jilin University, Changchun, 130033, P.R. China
| | - QingSan Zhu
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Changchun, 130022, P.R. China and Department of Orthopaedics, China-Japan Union Hospital, Jilin University, Changchun, 130033, P.R. China
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36
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Berner A, Henkel J, Woodruff MA, Steck R, Nerlich M, Schuetz MA, Hutmacher DW. Delayed minimally invasive injection of allogenic bone marrow stromal cell sheets regenerates large bone defects in an ovine preclinical animal model. Stem Cells Transl Med 2015; 4:503-12. [PMID: 25834121 DOI: 10.5966/sctm.2014-0244] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 01/28/2015] [Indexed: 12/23/2022] Open
Abstract
Cell-based tissue engineering approaches are promising strategies in the field of regenerative medicine. However, the mode of cell delivery is still a concern and needs to be significantly improved. Scaffolds and/or matrices loaded with cells are often transplanted into a bone defect immediately after the defect has been created. At this point, the nutrient and oxygen supply is low and the inflammatory cascade is incited, thus creating a highly unfavorable microenvironment for transplanted cells to survive and participate in the regeneration process. We therefore developed a unique treatment concept using the delayed injection of allogenic bone marrow stromal cell (BMSC) sheets to regenerate a critical-sized tibial defect in sheep to study the effect of the cells' regeneration potential when introduced at a postinflammatory stage. Minimally invasive percutaneous injection of allogenic BMSCs into biodegradable composite scaffolds 4 weeks after the defect surgery led to significantly improved bone regeneration compared with preseeded scaffold/cell constructs and scaffold-only groups. Biomechanical testing and microcomputed tomography showed comparable results to the clinical reference standard (i.e., an autologous bone graft). To our knowledge, we are the first to show in a validated preclinical large animal model that delayed allogenic cell transplantation can provide applicable clinical treatment alternatives for challenging bone defects in the future.
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Affiliation(s)
- Arne Berner
- Institute of Health and Biomedical Innovation and Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Trauma Surgery, University of Regensburg, Regensburg, Germany
| | - Jan Henkel
- Institute of Health and Biomedical Innovation and Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Trauma Surgery, University of Regensburg, Regensburg, Germany
| | - Maria A Woodruff
- Institute of Health and Biomedical Innovation and Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Trauma Surgery, University of Regensburg, Regensburg, Germany
| | - Roland Steck
- Institute of Health and Biomedical Innovation and Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Trauma Surgery, University of Regensburg, Regensburg, Germany
| | - Michael Nerlich
- Institute of Health and Biomedical Innovation and Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Trauma Surgery, University of Regensburg, Regensburg, Germany
| | - Michael A Schuetz
- Institute of Health and Biomedical Innovation and Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Trauma Surgery, University of Regensburg, Regensburg, Germany
| | - Dietmar W Hutmacher
- Institute of Health and Biomedical Innovation and Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Trauma Surgery, University of Regensburg, Regensburg, Germany
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37
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Smith JO, Tayton ER, Khan F, Aarvold A, Cook RB, Goodship A, Bradley M, Oreffo ROC. Large animal in vivo evaluation of a binary blend polymer scaffold for skeletal tissue-engineering strategies; translational issues. J Tissue Eng Regen Med 2015; 11:1065-1076. [PMID: 25690518 PMCID: PMC6680145 DOI: 10.1002/term.2007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 08/30/2014] [Accepted: 01/12/2015] [Indexed: 01/11/2023]
Abstract
Binary blend polymers offer the opportunity to combine different desirable properties into a single scaffold, to enhance function within the field of tissue engineering. Previous in vitro and murine in vivo analysis identified a polymer blend of poly(l‐lactic acid)–poly(ε‐caprolactone) (PLLA:PCL 20:80) to have characteristics desirable for bone regeneration. Polymer scaffolds in combination with marrow‐derived skeletal stem cells (SSCs) were implanted into mid‐shaft ovine 3.5 cm tibial defects, and indices of bone regeneration were compared to groups implanted with scaffolds alone and with empty defects after 12 weeks, including micro‐CT, mechanical testing and histological analysis. The critical nature of the defect was confirmed via all modalities. Both the scaffold and scaffold/SSC groups showed enhanced quantitative bone regeneration; however, this was only found to be significant in the scaffold/SSCs group (p = 0.04) and complete defect bridging was not achieved in any group. The mechanical strength was significantly less than that of contralateral control tibiae (p < 0.01) and would not be appropriate for full functional loading in a clinical setting. This study explored the hypothesis that cell therapy would enhance bone formation in a critical‐sized defect compared to scaffold alone, using an external fixation construct, to bridge the scale‐up gap between small animal studies and potential clinical translation. The model has proved a successful critical defect and analytical techniques have been found to be both valid and reproducible. Further work is required with both scaffold production techniques and cellular protocols in order to successfully scale‐up this stem cell/binary blend polymer scaffold. © 2015 The Authors. Journal of Tissue Engineering and Regenerative Medicine published by John Wiley & Sons, Ltd.
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Affiliation(s)
- James O Smith
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, University of Southampton, UK
| | - Edward R Tayton
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, University of Southampton, UK
| | - Ferdous Khan
- School of Chemistry, University of Edinburgh, UK
| | - Alexander Aarvold
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, University of Southampton, UK
| | - Richard B Cook
- nCATS, Faculty of Engineering and the Environment, University of Southampton, UK
| | - Allen Goodship
- UCL Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Mark Bradley
- School of Chemistry, University of Edinburgh, UK
| | - Richard O C Oreffo
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, University of Southampton, UK
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38
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Peric M, Dumic-Cule I, Grcevic D, Matijasic M, Verbanac D, Paul R, Grgurevic L, Trkulja V, Bagi CM, Vukicevic S. The rational use of animal models in the evaluation of novel bone regenerative therapies. Bone 2015; 70:73-86. [PMID: 25029375 DOI: 10.1016/j.bone.2014.07.010] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 06/30/2014] [Accepted: 07/05/2014] [Indexed: 12/31/2022]
Abstract
Bone has a high potential for endogenous self-repair. However, due to population aging, human diseases with impaired bone regeneration are on the rise. Current strategies to facilitate bone healing include various biomolecules, cellular therapies, biomaterials and different combinations of these. Animal models for testing novel regenerative therapies remain the gold standard in pre-clinical phases of drug discovery and development. Despite improvements in animal experimentation, excessive poorly designed animal studies with inappropriate endpoints and inaccurate conclusions are being conducted. In this review, we discuss animal models, procedures, methods and technologies used in bone repair studies with the aim to assist investigators in planning and performing scientifically sound experiments that respect the wellbeing of animals. In the process of designing an animal study for bone repair investigators should consider: skeletal characteristics of the selected animal species; a suitable animal model that mimics the intended clinical indication; an appropriate assessment plan with validated methods, markers, timing, endpoints and scoring systems; relevant dosing and statistically pre-justified sample sizes and evaluation methods; synchronization of the study with regulatory requirements and additional evaluations specific to cell-based approaches. This article is part of a Special Issue entitled "Stem Cells and Bone".
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Affiliation(s)
- Mihaela Peric
- University of Zagreb School of Medicine, Center for Translational and Clinical Research, Department for Intercellular Communication, Salata 2, Zagreb, Croatia.
| | - Ivo Dumic-Cule
- University of Zagreb School of Medicine, Center for Translational and Clinical Research, Laboratory for Mineralized Tissues, Salata 11, Zagreb, Croatia
| | - Danka Grcevic
- University of Zagreb School of Medicine, Department of Physiology and Immunology, Salata 3, Zagreb, Croatia
| | - Mario Matijasic
- University of Zagreb School of Medicine, Center for Translational and Clinical Research, Department for Intercellular Communication, Salata 2, Zagreb, Croatia
| | - Donatella Verbanac
- University of Zagreb School of Medicine, Center for Translational and Clinical Research, Department for Intercellular Communication, Salata 2, Zagreb, Croatia
| | - Ruth Paul
- Paul Regulatory Services Ltd, Fisher Hill Way, Cardiff CF15 8DR, UK
| | - Lovorka Grgurevic
- University of Zagreb School of Medicine, Center for Translational and Clinical Research, Laboratory for Mineralized Tissues, Salata 11, Zagreb, Croatia
| | - Vladimir Trkulja
- University of Zagreb School of Medicine, Department of Pharmacology, Salata 11, Zagreb, Croatia
| | - Cedo M Bagi
- Pfizer Inc., Global Research and Development, Global Science and Technology, 100 Eastern Point Road, Groton, CT 06340, USA
| | - Slobodan Vukicevic
- University of Zagreb School of Medicine, Center for Translational and Clinical Research, Laboratory for Mineralized Tissues, Salata 11, Zagreb, Croatia.
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39
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Viateau V, Decambron A, Manassero M. Animal Models for Orthopedic Applications of Tissue Engineering. Biomaterials 2014. [DOI: 10.1002/9781119043553.ch8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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40
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Malhotra A, Pelletier MH, Yu Y, Christou C, Walsh WR. A sheep model for cancellous bone healing. Front Surg 2014; 1:37. [PMID: 25593961 PMCID: PMC4286987 DOI: 10.3389/fsurg.2014.00037] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 08/25/2014] [Indexed: 11/23/2022] Open
Abstract
Appropriate well-characterized bone defect animal models remain essential for preclinical research. This pilot study demonstrates a relevant animal model for cancellous bone defect healing. Three different defect diameters (8, 11, 14 mm) of fixed depth (25 mm) were compared in both skeletally immature (18-month-old) and aged sheep (5-year-old). In each animal, four defects were surgically created and placed in the cancellous bone of the medial distal femoral and proximal tibial epiphyses bilaterally. Animals were euthanized at 4 weeks post-operatively to assess early healing and any biological response. Defect sites were graded radiographically, and new bone formation quantified using μCT and histomorphometry. Fibrous tissue was found within the central region in most of the defects with woven bone normally forming near the periphery of the defect. Bone volume fraction [bone volume (BV)/TV] significantly decreased with an increasing defect diameter. Actual BV, however, increased with defect diameter. Bone ingrowth was lower for all defect diameters in the aged group. This pilot study proposes that the surgical creation of 11 mm diameter defects in the proximal tibial and distal femoral epiphyses of aged sheep is a suitable large animal model to study early healing of cancellous bone defects. The refined model allows for the placement of four separate bone defects per animal and encourages a reduction in animal numbers required for preclinical research.
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Affiliation(s)
- Angad Malhotra
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales , Sydney, NSW , Australia
| | - Matthew Henry Pelletier
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales , Sydney, NSW , Australia
| | - Yan Yu
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales , Sydney, NSW , Australia
| | - Chris Christou
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales , Sydney, NSW , Australia
| | - William Robert Walsh
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales , Sydney, NSW , Australia
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41
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Tayton E, Purcell M, Smith JO, Lanham S, Howdle SM, Shakesheff KM, Goodship A, Blunn G, Fowler D, Dunlop DG, Oreffo ROC. The scale-up of a tissue engineered porous hydroxyapatite polymer composite scaffold for use in bone repair: An ovine femoral condyle defect study. J Biomed Mater Res A 2014; 103:1346-56. [DOI: 10.1002/jbm.a.35279] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 07/03/2014] [Indexed: 12/18/2022]
Affiliation(s)
- Edward Tayton
- Bone and Joint Research Group; Centre for Human Development, Stem Cells and Regeneration, Human Development and Health, University of Southampton Medical School; Southampton SO16 6YD United Kingdom
| | - Matthew Purcell
- School of Chemistry, University Park, University of Nottingham; Nottingham NG7 2RD United Kingdom
| | - James O. Smith
- Bone and Joint Research Group; Centre for Human Development, Stem Cells and Regeneration, Human Development and Health, University of Southampton Medical School; Southampton SO16 6YD United Kingdom
| | - Stuart Lanham
- Bone and Joint Research Group; Centre for Human Development, Stem Cells and Regeneration, Human Development and Health, University of Southampton Medical School; Southampton SO16 6YD United Kingdom
| | - Steven M. Howdle
- School of Chemistry, University Park, University of Nottingham; Nottingham NG7 2RD United Kingdom
| | - Kevin M. Shakesheff
- School of Pharmacy, University Park, University of Nottingham; Nottingham NG7 2RD United Kingdom
| | - Allen Goodship
- Institute of Orthopaedics and Musculoskeletal Science; Brockley Hill Stanmore HA7 4LP United Kingdom
| | - Gordon Blunn
- Institute of Orthopaedics and Musculoskeletal Science; Brockley Hill Stanmore HA7 4LP United Kingdom
| | - Darren Fowler
- Department of Histopathology; University Hospital Southampton; Tremona Road Southampton SO16 6YD United Kingdom
| | - Douglas G. Dunlop
- Bone and Joint Research Group; Centre for Human Development, Stem Cells and Regeneration, Human Development and Health, University of Southampton Medical School; Southampton SO16 6YD United Kingdom
| | - Richard O. C Oreffo
- Bone and Joint Research Group; Centre for Human Development, Stem Cells and Regeneration, Human Development and Health, University of Southampton Medical School; Southampton SO16 6YD United Kingdom
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42
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Costi JJ, Stanley RM, Ding B, Solomon LB. Assessment of the initial viscoelastic properties of a critical segmental long bone defect reconstructed with impaction bone grafting and intramedullary nailing. Med Eng Phys 2014; 36:39-48. [DOI: 10.1016/j.medengphy.2013.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/18/2013] [Accepted: 09/03/2013] [Indexed: 11/25/2022]
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Holzapfel BM, Thibaudeau L, Hesami P, Taubenberger A, Holzapfel NP, Mayer-Wagner S, Power C, Clements J, Russell P, Hutmacher DW. Humanised xenograft models of bone metastasis revisited: novel insights into species-specific mechanisms of cancer cell osteotropism. Cancer Metastasis Rev 2013; 32:129-45. [PMID: 23657538 DOI: 10.1007/s10555-013-9437-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The determinants and key mechanisms of cancer cell osteotropism have not been identified, mainly due to the lack of reproducible animal models representing the biological, genetic and clinical features seen in humans. An ideal model should be capable of recapitulating as many steps of the metastatic cascade as possible, thus facilitating the development of prognostic markers and novel therapeutic strategies. Most animal models of bone metastasis still have to be derived experimentally as most syngeneic and transgeneic approaches do not provide a robust skeletal phenotype and do not recapitulate the biological processes seen in humans. The xenotransplantation of human cancer cells or tumour tissue into immunocompromised murine hosts provides the possibility to simulate early and late stages of the human disease. Human bone or tissue-engineered human bone constructs can be implanted into the animal to recapitulate more subtle, species-specific aspects of the mutual interaction between human cancer cells and the human bone microenvironment. Moreover, the replication of the entire "organ" bone makes it possible to analyse the interaction between cancer cells and the haematopoietic niche and to confer at least a partial human immunity to the murine host. This process of humanisation is facilitated by novel immunocompromised mouse strains that allow a high engraftment rate of human cells or tissue. These humanised xenograft models provide an important research tool to study human biological processes of bone metastasis.
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Affiliation(s)
- Boris Michael Holzapfel
- Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Brisbane, Australia.
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Cipitria A, Reichert JC, Epari DR, Saifzadeh S, Berner A, Schell H, Mehta M, Schuetz MA, Duda GN, Hutmacher DW. Polycaprolactone scaffold and reduced rhBMP-7 dose for the regeneration of critical-sized defects in sheep tibiae. Biomaterials 2013; 34:9960-8. [DOI: 10.1016/j.biomaterials.2013.09.011] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
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Henkel J, Woodruff MA, Epari DR, Steck R, Glatt V, Dickinson IC, Choong PFM, Schuetz MA, Hutmacher DW. Bone Regeneration Based on Tissue Engineering Conceptions - A 21st Century Perspective. Bone Res 2013; 1:216-48. [PMID: 26273505 PMCID: PMC4472104 DOI: 10.4248/br201303002] [Citation(s) in RCA: 460] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 07/20/2013] [Indexed: 12/18/2022] Open
Abstract
The role of Bone Tissue Engineering in the field of Regenerative Medicine has been the topic of substantial research over the past two decades. Technological advances have improved orthopaedic implants and surgical techniques for bone reconstruction. However, improvements in surgical techniques to reconstruct bone have been limited by the paucity of autologous materials available and donor site morbidity. Recent advances in the development of biomaterials have provided attractive alternatives to bone grafting expanding the surgical options for restoring the form and function of injured bone. Specifically, novel bioactive (second generation) biomaterials have been developed that are characterised by controlled action and reaction to the host tissue environment, whilst exhibiting controlled chemical breakdown and resorption with an ultimate replacement by regenerating tissue. Future generations of biomaterials (third generation) are designed to be not only osteoconductive but also osteoinductive, i.e. to stimulate regeneration of host tissues by combining tissue engineering and in situ tissue regeneration methods with a focus on novel applications. These techniques will lead to novel possibilities for tissue regeneration and repair. At present, tissue engineered constructs that may find future use as bone grafts for complex skeletal defects, whether from post-traumatic, degenerative, neoplastic or congenital/developmental "origin" require osseous reconstruction to ensure structural and functional integrity. Engineering functional bone using combinations of cells, scaffolds and bioactive factors is a promising strategy and a particular feature for future development in the area of hybrid materials which are able to exhibit suitable biomimetic and mechanical properties. This review will discuss the state of the art in this field and what we can expect from future generations of bone regeneration concepts.
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Affiliation(s)
- Jan Henkel
- Institute of Health & Biomedical Innovation, Queensland University of Technology , Brisbane, Queensland, Australia
| | - Maria A Woodruff
- Institute of Health & Biomedical Innovation, Queensland University of Technology , Brisbane, Queensland, Australia
| | - Devakara R Epari
- Institute of Health & Biomedical Innovation, Queensland University of Technology , Brisbane, Queensland, Australia
| | - Roland Steck
- Institute of Health & Biomedical Innovation, Queensland University of Technology , Brisbane, Queensland, Australia
| | - Vaida Glatt
- Institute of Health & Biomedical Innovation, Queensland University of Technology , Brisbane, Queensland, Australia
| | - Ian C Dickinson
- Orthopaedic Oncology Service, Princess Alexandra Hospital , Brisbane, Australia
| | - Peter F M Choong
- Department of Surgery, University of Melbourne, St. Vincent's Hospital , Melbourne, Australia ; Department of Orthopaedics, St. Vincent's Hospital , Melbourne, Australia ; Bone and Soft Tissue Sarcoma Service, Peter MacCallum Cancer Centre , Melbourne, Australia
| | - Michael A Schuetz
- Institute of Health & Biomedical Innovation, Queensland University of Technology , Brisbane, Queensland, Australia ; Orthopaedic and Trauma Services, Princess Alexandra Hospital , Brisbane, Australia
| | - Dietmar W Hutmacher
- Orthopaedic Oncology Service, Princess Alexandra Hospital , Brisbane, Australia ; George W Woodruff School of Mechanical Engineering, Georgia Institute of Technology , Atlanta, GA, USA
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Santo VE, Gomes ME, Mano JF, Reis RL. Controlled release strategies for bone, cartilage, and osteochondral engineering--Part I: recapitulation of native tissue healing and variables for the design of delivery systems. TISSUE ENGINEERING. PART B, REVIEWS 2013; 19:308-26. [PMID: 23268651 PMCID: PMC3690094 DOI: 10.1089/ten.teb.2012.0138] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 12/11/2012] [Indexed: 12/12/2022]
Abstract
The potential of growth factors to stimulate tissue healing through the enhancement of cell proliferation, migration, and differentiation is undeniable. However, critical parameters on the design of adequate carriers, such as uncontrolled spatiotemporal presence of bioactive factors, inadequate release profiles, and supraphysiological dosages of growth factors, have impaired the translation of these systems onto clinical practice. This review describes the healing cascades for bone, cartilage, and osteochondral interface, highlighting the role of specific growth factors for triggering the reactions leading to tissue regeneration. Critical criteria on the design of carriers for controlled release of bioactive factors are also reported, focusing on the need to provide a spatiotemporal control over the delivery and presentation of these molecules.
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Affiliation(s)
- Vítor E. Santo
- 3Bs Research Group—Biomaterials, Biodegradables, and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Guimarães, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Manuela E. Gomes
- 3Bs Research Group—Biomaterials, Biodegradables, and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Guimarães, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - João F. Mano
- 3Bs Research Group—Biomaterials, Biodegradables, and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Guimarães, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rui L. Reis
- 3Bs Research Group—Biomaterials, Biodegradables, and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Guimarães, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Rentsch C, Schneiders W, Hess R, Rentsch B, Bernhardt R, Spekl K, Schneider K, Scharnweber D, Biewener A, Rammelt S. Healing properties of surface-coated polycaprolactone-co-lactide scaffolds: A pilot study in sheep. J Biomater Appl 2013; 28:654-66. [DOI: 10.1177/0885328212471409] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this pilot study was to evaluate the bioactive, surface-coated polycaprolactone-co-lactide scaffolds as bone implants in a tibia critical size defect model. Polycaprolactone-co-lactide scaffolds were coated with collagen type I and chondroitin sulfate and 30 piled up polycaprolactone-co-lactide scaffolds were implanted into a 3 cm sheep tibia critical size defect for 3 or 12 months ( n = 5 each). Bone healing was estimated by quantification of bone volume in the defects on computer tomography and microcomputer tomography scans, plain radiographs, biomechanical testing as well as by histological evaluations. New bone formation occurred at the proximal and distal ends of the tibia in both groups. The current pilot study revealed a mean new bone formation of 63% and 172% after 3 and 12 months, respectively. The bioactive, surface coated, highly porous three-dimensional polycaprolactone-co-lactide scaffold stack itself acted as a guide rail for new bone formation along and into the implant. These preliminary data are encouraging for future experiments with a larger group of animals.
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Affiliation(s)
- Claudia Rentsch
- Department of Trauma and Reconstructive Surgery, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Wolfgang Schneiders
- Department of Trauma and Reconstructive Surgery, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Ricarda Hess
- Max Bergmann Center of Biomaterials, Dresden, Germany
| | | | | | | | - Konrad Schneider
- Department of Mechanic und Structure, Leibniz Institute of Polymer Research Dresden e.V., Dresden, Germany
| | - Dieter Scharnweber
- Max Bergmann Center of Biomaterials, Dresden, Germany
- DFG-Center for Regenerative Therapies Dresden, Dresden, Germany
| | - Achim Biewener
- Department of Trauma and Reconstructive Surgery, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Stefan Rammelt
- Department of Trauma and Reconstructive Surgery, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
- DFG-Center for Regenerative Therapies Dresden, Dresden, Germany
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Can bone tissue engineering contribute to therapy concepts after resection of musculoskeletal sarcoma? Sarcoma 2013; 2013:153640. [PMID: 23509421 PMCID: PMC3556880 DOI: 10.1155/2013/153640] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 12/10/2012] [Indexed: 01/08/2023] Open
Abstract
Resection of musculoskeletal sarcoma can result in large bone defects where regeneration is needed in a quantity far beyond the normal potential of self-healing. In many cases, these defects exhibit a limited intrinsic regenerative potential due to an adjuvant therapeutic regimen, seroma, or infection. Therefore, reconstruction of these defects is still one of the most demanding procedures in orthopaedic surgery. The constraints of common treatment strategies have triggered a need for new therapeutic concepts to design and engineer unparalleled structural and functioning bone grafts. To satisfy the need for long-term repair and good clinical outcome, a paradigm shift is needed from methods to replace tissues with inert medical devices to more biological approaches that focus on the repair and reconstruction of tissue structure and function. It is within this context that the field of bone tissue engineering can offer solutions to be implemented into surgical therapy concepts after resection of bone and soft tissue sarcoma. In this paper we will discuss the implementation of tissue engineering concepts into the clinical field of orthopaedic oncology.
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Reichert JC, Berner A, Saifzadeh S, Hutmacher DW. Preclinical Animal Models for Segmental Bone Defect Research and Tissue Engineering. Regen Med 2013. [DOI: 10.1007/978-94-007-5690-8_40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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50
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Reichert JC, Cipitria A, Epari DR, Saifzadeh S, Krishnakanth P, Berner A, Woodruff MA, Schell H, Mehta M, Schuetz MA, Duda GN, Hutmacher DW. A tissue engineering solution for segmental defect regeneration in load-bearing long bones. Sci Transl Med 2012; 4:141ra93. [PMID: 22764209 DOI: 10.1126/scitranslmed.3003720] [Citation(s) in RCA: 243] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The reconstruction of large defects (>10 mm) in humans usually relies on bone graft transplantation. Limiting factors include availability of graft material, comorbidity, and insufficient integration into the damaged bone. We compare the gold standard autograft with biodegradable composite scaffolds consisting of medical-grade polycaprolactone and tricalcium phosphate combined with autologous bone marrow-derived mesenchymal stem cells (MSCs) or recombinant human bone morphogenetic protein 7 (rhBMP-7). Critical-sized defects in sheep--a model closely resembling human bone formation and structure--were treated with autograft, rhBMP-7, or MSCs. Bridging was observed within 3 months for both the autograft and the rhBMP-7 treatment. After 12 months, biomechanical analysis and microcomputed tomography imaging showed significantly greater bone formation and superior strength for the biomaterial scaffolds loaded with rhBMP-7 compared to the autograft. Axial bone distribution was greater at the interfaces. With rhBMP-7, at 3 months, the radial bone distribution within the scaffolds was homogeneous. At 12 months, however, significantly more bone was found in the scaffold architecture, indicating bone remodeling. Scaffolds alone or with MSC inclusion did not induce levels of bone formation comparable to those of the autograft and rhBMP-7 groups. Applied clinically, this approach using rhBMP-7 could overcome autograft-associated limitations.
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Affiliation(s)
- Johannes C Reichert
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland 4059, Australia
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