Biodegradable polymer scaffolds for cartilage tissue engineering

PLCL/SF/NGF nerve conduit loaded with RGD-TA-PPY hydrogel promotes regeneration of sciatic nerve defects in rats through PI3K/AKT signalling pathways

Peripheral nerve defect are common clinical problem caused by trauma or other diseases, often leading to the loss of sensory and motor function in patients. Autologous nerve transplantation has been the gold standard for repairing peripheral nerve defects, but its clinical application is limited due to insufficient donor tissue. In recent years, the application of tissue engineering methods to synthesize nerve conduits for treating peripheral nerve defect has become a current research focus. This study introduces a novel approach for treating peripheral nerve defects using a tissue-engineered PLCL/SF/NGF@TA-PPy-RGD conduit. The conduit was fabricated by combining electrospun PLCL/SF with an NGF-loaded conductive TA-PPy-RGD gel. The gel, synthesized from RGD-modified tannic acid (TA) and polypyrrole (PPy), provides growth anchor points for nerve cells. In vitro results showed that this hybrid conduit could enhance PC12 cell proliferation, migration, and reduce apoptosis under oxidative stress. Furthermore, the conduit activated the PI3K/AKT signalling pathway in PC12 cells. In a rat model of sciatic nerve defect, the PLCL/SF/NGF@TA-PPy-RGD conduit significantly improved motor function, gastrocnemius muscle function, and myelin sheath axon thickness, comparable to autologous nerve transplantation. It also promoted angiogenesis around the nerve defect. This study suggests that PLCL/SF/NGF@TA-PPy-RGD conduits provide a conducive environment for nerve regeneration, offering a new strategy for peripheral nerve defect treatment, this study provided theoretical basis and new strategies for the research and treatment of peripheral nerve defect.

Enhanced Degradability of Thiol-Ene Composites through the Inclusion of Isosorbide-Based Polycarbonates

Open reduction internal fixation metal plates and screws remain the established standard-of-care for complex fracture fixation. They, however, have drawbacks such as limited customization, soft-tissue adhesions, and a lack of degradation. Bone cements and composites are being developed as alternative fixation techniques in order to overcome these issues. One such composite is a strong, stiff, and shapeable hydroxyapatite-containing material consisting of 1,3,5-triazine-2,4,6-trione (TATO) monomers, which cures through high energy visible light-induced thiol-ene coupling (TEC) chemistry. Previous human cadaver and in vivo studies have shown that patches of this composite provide sufficient fixation for healing bone fractures; however, the composite lacks degradability. To promote degradation through hydrolysis, new allyl-functionalized isosorbide-based polycarbonates have been added into the composite formulation, and their impact has been evaluated. Three polycarbonates with allyl functionalities, located at the termini (aPC1 and aPC2) or in the backbone (aPC3), were synthesized. Composites containing 1, 3, and 5 wt % of aPCs 1-3 were formulated and evaluated with regard to mechanical properties, water absorption, hydrolytic degradation, and cytotoxicity. Allyl-functionalized polycaprolactone (aPCL) was synthesized and used as a comparison. When integrated into the composite, aPC3 significantly impacted the material's properties, with the 5 wt % aPC3 formulation showing a significant increase in degradation of 469%, relative to the formulation not containing any aPCs after 8 weeks' immersion in PBS, along with a modest decrease in modulus of 28% to 4.01 (0.3) GPa. Osteosyntheses combining the aPC3 3 and 5 wt % formulations with screws on synthetic bones with ostectomies matched or outperformed the ones made with the previously studied neat composite with regard to bending stiffness and strength in four-point monotonic bending before and after immersion in PBS. The favorable mechanical properties, increased degradation, and nontoxic characteristics of the materials present aPC3 as a promising additive for the TATO composite formulations. This combination resulted in stiff composites with long-term degradation that are suitable for bone fracture repair.

3D printed osteochondral scaffolds: design strategies, present applications and future perspectives

Articular osteochondral (OC) defects are a global clinical problem characterized by loss of full-thickness articular cartilage with underlying calcified cartilage through to the subchondral bone. While current surgical treatments can relieve pain, none of them can completely repair all components of the OC unit and restore its original function. With the rapid development of three-dimensional (3D) printing technology, admirable progress has been made in bone and cartilage reconstruction, providing new strategies for restoring joint function. 3D printing has the advantages of fast speed, high precision, and personalized customization to meet the requirements of irregular geometry, differentiated composition, and multi-layered boundary layer structures of joint OC scaffolds. This review captures the original published researches on the application of 3D printing technology to the repair of entire OC units and provides a comprehensive summary of the recent advances in 3D printed OC scaffolds. We first introduce the gradient structure and biological properties of articular OC tissue. The considerations for the development of 3D printed OC scaffolds are emphatically summarized, including material types, fabrication techniques, structural design and seed cells. Especially from the perspective of material composition and structural design, the classification, characteristics and latest research progress of discrete gradient scaffolds (biphasic, triphasic and multiphasic scaffolds) and continuous gradient scaffolds (gradient material and/or structure, and gradient interface) are summarized. Finally, we also describe the important progress and application prospect of 3D printing technology in OC interface regeneration. 3D printing technology for OC reconstruction should simulate the gradient structure of subchondral bone and cartilage. Therefore, we must not only strengthen the basic research on OC structure, but also continue to explore the role of 3D printing technology in OC tissue engineering. This will enable better structural and functional bionics of OC scaffolds, ultimately improving the repair of OC defects.

Low-Friction Hybrid Hydrogel with Excellent Mechanical Properties for Simulating Articular Cartilage Movement

Hydrogels, which can withstand large deformations and have stable chemical properties, are considered a potential material for cartilage repair. However, hydrogels still face some challenges regarding their mechanical properties, tribological behavior, and biocompatibility. Thus, we synthesized a hybrid hydrogel by means of chemical cross-linking and transesterification using glycerol ethoxylate (GE) and zwitterionic polysulfobetaine methacrylate (PSBMA) as raw materials. The hybrid hydrogel showed excellent compressive stress at approximately 3.50 MPa and low loss factors (0.023-0.049). Moreover, because GE has good water binding properties, helping to form a stable hydration layer and maintain low energy dissipation, a low friction coefficient (μ ≈ 0.028) was obtained with the "soft-soft contact mode" of a hydrogel hemisphere and hydrogel disc under reciprocating motion. In vitro cytotoxicity, skin sensitization, and irritation reaction tests were carried out to show good biocompatibility of the GE-PSBMA hybrid hydrogel. In this study, a hybrid hydrogel with no potential cytotoxicity, strong compressive capacity, and excellent lubricity was obtained to provide a potential alternative for developing polymer hybrids, as well as demonstrating an idea for the application of hybrid hydrogels in cartilage replacement.

Feasibility study on intact human umbilical cord Wharton's jelly as a scaffold for human autologous chondrocyte: In-vitro study

OBJECTIVES

Placental tissue is an established biomaterial used in many clinical applications. However, its use for tissue engineering purposes has not been fully realized. Though articular cartilage extracellular matrix (ECM)-derived oriented scaffolds for cartilage tissue engineering were developed, resources are a hindrance to its application. In this regard, the present study investigated the feasibility of using intact decellularized human umbilical cord Wharton's jelly (hUC-WJ) as a new material for chondrocyte carrier in cartilage tissue engineering. The developed hUC-WJ scaffold provides a good microenvironment for the attachment, viability, and delivery of seeded human autologous chondrocytes. It has an advantage over other biomaterials in terms of abundant availability and similar biochemistry to cartilage ECM.

MATERIALS AND METHODS

hUC-WJ obtained from fresh human placenta were decellularized and gamma sterilized. Human cartilage tissue was obtained from the patients with a total knee replacement. The chondrocytes were isolated and expanded in-vitro and seeded onto the hUC-WJ scaffold. The efficiency of the decellularized tissue as a delivery system for human cartilage cells was investigated by histology, immunohistochemistry, cell count, flow cytometry, and scanning electron microscopy (SEM).

RESULTS

The results showed that the decellularized hUC-WJ scaffold has supported the microenvironment for chondrocyte attachment and viability without losing its phenotype. In addition, the cells were spread through the hUC-WJ scaffold as confirmed by histology and SEM.

CONCLUSION

Based on obtained results, the hUC-WJ scaffold has great potential as a 3D scaffold for human autologous chondrocyte carriers in tissue engineering and regenerative medicine applications.

3D printed bioresorbable scaffolds for articular cartilage tissue engineering: a comparative study between neat polycaprolactone (PCL) and poly(lactide-b-ethylene glycol) (PLA-PEG) block copolymer

This work identifies and describes different material-scaffold geometry combinations for cartilage tissue engineering (CTE). Previously reported potentially interesting scaffold geometries were tuned and printed using bioresorbable polycaprolactone and poly(lactide-b-ethylene) block copolymer. Medical grades of both polymers were 3D printed with fused filament fabrication technology within an ISO 7 classified cleanroom. Resulting scaffolds were then optically, mechanically and biologically tested. Results indicated that a few material-scaffold geometry combinations present potential for excellent cell viability as well as for an enhance of the chondrogenic properties of the cells, hence suggesting their suitability for CTE applications.

Meniscal Repair Using Fibrin Clots Made From Bone Marrow Blood Wrapped in a Polyglycolic Acid Sheet

Meniscal repair is one of the most common procedures for meniscal tears; however, a previous systematic review showed meniscal repairs have a greater reoperation rate compared with partial meniscectomies. Therefore, an improvement of existing meniscal repair techniques is warranted. Clinical results of polyglycolic acid (PGA) sheets have been reported for rotator cuff repairs. In recent years, we have performed meniscal repairs using wrapped fibrin clots in PGA sheet. We considered the use of wrapped fibrin clots with a PGA sheet to treat meniscus tears. The purpose of this paper is to introduce a step-by-step guide to our new delivery technique using fibrin clots.

Terpolymer-chitosan membranes as biomaterial

The present study shows a novel copolymer synthesis, its application in the membrane design and the physicochemical and biological characterization of the biomaterial obtained. Terpolymer starting diisopropyl fumarate (F), vinyl benzoate (V) and 2-hydroxyethyl methacrylate (H) was prepared by thermal radical polymerization. This polymer (FVH) was obtained in several monomer ratios and characterized by spectroscopic and chromatographic methods (FTIR, ¹ H-NMR and SEC). The best relationship of F:V:H was 5:4:1, which allows efficient interaction with chitosan through cross-linking with borax to achieve scaffolds for potential biomedical applications. The membranes were obtained by solvent casting and analyzed by scanning electron microscopy (SEM), swelling behavior and mechanical properties. In addition, we studied the possible cytotoxicity and biocompatibility of these materials using a murine macrophage-like cell line (RAW 264.7) and bone marrow mesenchymal progenitor cells (BMPC), respectively, taking into account their intended applications. The results of this study show that the terpolymer obtained and its combination with a natural polymer is a very interesting strategy to obtain a biomaterial with possible applications in regenerative medicine and this could be extended to other structurally related systems.

Polydioxanone-Based Membranes for Bone Regeneration

Resorbable synthetic and natural polymer-based membranes have been extensively studied for guided tissue regeneration. Alloplastic biomaterials are often used for tissue regeneration due to their lower immunoreactivity when compared with allogeneic and xenogeneic materials. Plenum^® Guide is a synthetic membrane material based on polydioxanone (PDO), whose surface morphology closely mimics the extracellular matrix. In this study, Plenum^® Guide was compared with collagen membranes as a barrier material for bone-tissue regeneration in terms of acute and subchronic systemic toxicity. Moreover, characterizations such as morphology, thermal analysis (Tm = 107.35 °C and crystallinity degree = 52.86 ± 2.97 %, final product), swelling (thickness: 0.25 mm ≅ 436% and 0.5 mm ≅ 425% within 24 h), and mechanical tests (E = 30.1 ± 6.25 MPa; σ = 3.92 ± 0.28 MPa; ε = 287.96 ± 34.68%, final product) were performed. The in vivo results revealed that the PDO membranes induced a slightly higher quantity of newly formed bone tissue than the control group (score: treated group = 15, control group = 13) without detectable systemic toxicity (clinical signs and evaluation of the membranes after necropsy did not result in differences between groups, i.e., non-reaction -> tissue-reaction index = 1.3), showing that these synthetic membranes have the essential characteristics for an effective tissue regeneration. Human adipose-derived stem cells (hASCs) were seeded on PDO membranes; results demonstrated efficient cell migration, adhesion, spread, and proliferation, such that there was a slightly better hASC osteogenic differentiation on PDO than on collagen membranes. Hence, Plenum^® Guide membranes are a safe and efficient alternative for resorbable membranes for tissue regeneration.

Engineering of Optimized Hydrogel Formulations for Cartilage Repair

The ideal scaffold for cartilage regeneration is expected to provide adequate mechanical strength, controlled degradability, adhesion, and integration with the surrounding native tissue. As it does this, it mimics natural ECMs functions, which allow for nutrient diffusion and promote cell survival and differentiation. Injectable hydrogels based on tyramine (TA)-functionalized hyaluronic acid (HA) and dextran (Dex) are a promising approach for cartilage regeneration. The properties of the hydrogels used in this study were adjusted by varying polymer concentrations and ratios. To investigate the changes in properties and their effects on cellular behavior and cartilage matrix formation, different ratios of HA- and dextran-based hybrid hydrogels at both 5 and 10% w/v were prepared using a designed mold to control generation. The results indicated that the incorporation of chondrocytes in the hydrogels decreased their mechanical properties. However, rheological and compression analysis indicated that 5% w/v hydrogels laden with cells exhibit a significant increase in mechanical properties after 21 days when the constructs are cultured in a chondrogenic differentiation medium. Moreover, compared to the 10% w/v hydrogels, the 5% w/v hybrid hydrogels increased the deposition of the cartilage matrix, especially in constructs with a higher Dex-TA content. These results indicated that 5% w/v hybrid hydrogels with 25% HA-TA and 75% Dex-TA have a high potential as injectable scaffolds for cartilage tissue regeneration.

Low-temperature extrusion-based 3D printing of icariin-laden scaffolds for osteogenesis enrichment

Despite the accessibility to porous architectures through various biofabrication approaches for tissue engineering, incorporating various active growth regulators within their matrices that act as biochemical cues is also an essential attribute for effective tissue growth. To address these facts, icariin (ICA)-encapsulated polymeric scaffolds are fabricated using a low-temperature extrusion-based three-dimensional (3D) printing technology for efficiently promoting osteogenesis. This approach not only resulted in the generation of porous architectures but also substantially maintained the bio-efficacy of the encapsulated ICA. Moreover, these composite scaffolds based on poly(ε-caprolactone) (PCL) and tricalcium phosphate (β-TCP) encapsulated with ICA (ITP scaffolds) are systematically characterized using various techniques before and after printing. Furthermore, various investigations relevant to biodegradability, biocompatibility, ICA release, and osteogenic ability of the ITP scaffolds are explored. The intact physiochemical properties of the materials, sustained release of ICA from the scaffolds, and high biosafety at various levels ranging from cellular to animal efficiently promoted the proliferation of mouse bone marrow mesenchymal stem cells (BMSCs) and their differentiation to osteoblasts. Together, the utilization of low-temperature extrusion approach provides a convenient and eco-friendly means of fabricating highly porous 3D architectures that supply the required growth regulators in their active form for tissue regeneration.

HEMA and alginate-based chondrogenic semi-interpenetrated hydrogels: synthesis and biological characterization

Cartilage tissue engineering (CTE) has the general objective of restoring and improving damaged cartilage. A very interesting strategy of CTE is to combine different polymers to obtain a viscoelastic material. In this study, we have evaluated the applicability of poly(2-hydroxyethyl methacrylate) networks semi-interpenetrated with sodium alginate for CTE. Alginate-containing hydrogels show an increase in scaffold porosity and swelling capacity, when compared with nonporous poly(2-hydroxyethyl methacrylate) scaffolds. Primary chondrocytes from young rats were cultured on the hydrogels, and an increase in chondrocyte proliferation and chondrocytic markers was observed in alginate-containing hydrogels. Chondrocytic phenotype was preserved on hydrogels containing the lowest amount of crosslinker and initiator (SEMI 3 and SEMI 4). In addition, nitric oxide production by RAW264.7 macrophages grown on hydrogels was tested, and none of the hydrogels showed high levels of this inflammatory marker after 2 days. These results indicate that our alginate-containing hydrogels could be useful for CTE.

Exquisite design of injectable Hydrogels in Cartilage Repair

Cartilage damage is still a threat to human beings, yet there is currently no treatment available to fully restore the function of cartilage. Recently, due to their unique structures and properties, injectable hydrogels have been widely studied and have exhibited high potential for applications in therapeutic areas, especially in cartilage repair. In this review, we briefly introduce the properties of cartilage, some articular cartilage injuries, and now available treatment strategies. Afterwards, we propose the functional and fundamental requirements of injectable hydrogels in cartilage tissue engineering, as well as the main advantages of injectable hydrogels as a therapy for cartilage damage, including strong plasticity and excellent biocompatibility. Moreover, we comprehensively summarize the polymers, cells, and bioactive molecules regularly used in the fabrication of injectable hydrogels, with two kinds of gelation, i.e., physical and chemical crosslinking, which ensure the excellent design of injectable hydrogels for cartilage repair. We also include novel hybrid injectable hydrogels combined with nanoparticles. Finally, we conclude with the advances of this clinical application and the challenges of injectable hydrogels used in cartilage repair.

Bombyx mori derived scaffolds and their use in cartilage regeneration: a systematic review

For the last two decades, silk has been extensively used as scaffolds in tissue engineering because of its remarkable properties. Unfortunately, the aneural property of cartilage limits its regenerative potential which can be achieved using tissue engineering approach. A lot of research has been published searching for the optimization of silk fibroin (SF) and its blends in order to get the best cartilage mimicking properties. However, according to our best knowledge, there is no systematic review available regarding the use of Bombyx mori derived biomaterials limited to cartilage related studies. This systematic review highlights the in vitro and in vivo work done for the past 7 years on structural and functional properties of B. mori derived biomaterials together with different parameters for cartilage regeneration. PubMed database was searched focusing on in vitro and in vivo studies using the search thread "silk fibroin" and "cartilage". A total of 40 articles met the inclusion criteria. All the articles were deeply studied for cell types, scaffold types and animal models used along with study design and results. Five types of cells were used for in vitro while seven types of cells were used for in vivo studies. Three types of animal models were used for scaffold implantation purpose. Moreover, different types of scaffolds either seeded with cells or supplemented with various factors were explored and discussed in detail. Results suggest the suitability of silk as a better biomaterial because of its cartilage mimicking properties.

Mechanically Reinforced Extracellular Matrix Scaffold for Application of Cartilage Tissue Engineering

Scaffolds with cartilage-like environment and suitable physical properties are critical for tissue-engineered cartilage repair. In this study, decellularized porcine cartilage-derived extracellular matrix (ECM) was utilized to fabricate ECM scaffolds. Mechanically reinforced ECM scaffolds were developed by combining salt-leaching and crosslinking for cartilage repair. The developed scaffolds were investigated with respect to their physicochemical properties and their cartilage tissue formation ability. The mechanically reinforced ECM scaffold showed similar mechanical strength to that of synthetic PLGA scaffold and expressed higher levels of cartilage-specific markers compared to those expressed by the ECM scaffold prepared by simple freeze-drying. These results demonstrated that the physical properties of ECM-derived scaffolds could be influenced by fabrication method, which provides suitable environments for the growth of chondrocytes. By extension, this study suggests a promising approach of natural biomaterials in cartilage tissue engineering.

BMP-7-Loaded PGLA Microspheres as a New Delivery System for the Cultivation of Human Chondrocytes in a Collagen Type I Gel: The Common Nude Mouse Model

Purpose

Bone morphogenic protein 7 (BMP-7) released from polylactide (PLGA) microspheres has proven to be a potent system in cartilage tissue engineering in vitro. However, in vivo data are still lacking. The aim of this study was to investigate this BMP-7 release system utilizing the nude mouse as a small animal model.

Methods

Human osteoarthritic chondrocytes of 10 patients were enzymatically released and transferred into a collagen type-I gel. A concentration of 2×105 cells/mL was used. BMP-7 encapsulated in PGLA microspheres was added at an initial concentration of 500 ng BMP-7/mL gel. Untreated specimens and specimens with empty microspheres served as control. Samples were cultivated subcutaneously in nude mice for 6 weeks.

Results

After recovery, chondrocytes of all groups displayed a spheroid morphology without signs of dedifferentiation. The proteoglycan and collagen type II content of the control groups was restricted to the immediate pericellular region, whereas treatment group samples showed enhanced collagen type II production. Collagen type II and aggrecan gene expression was enhanced in treatment group samples with respect to the two control groups (mean ± SD: 0.268 ± 0.450 to 0.152 ± 0.129 and 0.155 ± 0.216 ng/ng β-actin for collagen type II; 0.535 ± 0.731 to 0.367 ± 0.651 and 0.405 ± 0.326 ng/ng β-actin for aggrecan), whereas collagen type I gene expression decreased by a factor of 10. Relative protein quantification of collagen type II, collagen type I and proteoglycan was in accordance.

Conclusions

Our data suggest that BMP-7 release from PGLA microspheres led to an improved tissue-engineered cartilage analogue in vivo with an increase in hyaline-cartilage-specific components.

Concise Review: The Use of Adipose-Derived Stromal Vascular Fraction Cells and Platelet Rich Plasma in Regenerative Plastic Surgery

Tissue engineering has emerged at the intersection of numerous disciplines to meet a global clinical need for technologies to promote the regeneration of tissues. Recently, many authors have focused their attention on mesenchymal stem/stromal cells (MSCs) for their capacity to differentiate into many cell lineages. The most widely studied cell types are bone marrow mesenchymal stem cells and adipose-derived stem cells (ASCs), which display similar results. Biomaterials, cells, and growth factors are needed to design a regenerative plastic surgery approach in the treatment of organ and tissue defects, but not all tissues are created equal. The aim of this article is to describe the advances in tissue engineering through the use of ASCs, platelet rich plasma, and biomaterials to enable regeneration of damaged complex tissue. Stem Cells 2017;35:117-134.

Bilayer Implants: Electromechanical Assessment of Regenerated Articular Cartilage in a Sheep Model

OBJECTIVE

To compare the regenerative capacity of 2 distinct bilayer implants for the restoration of osteochondral defects in a preliminary sheep model.

METHODS

Critical sized osteochondral defects were treated with a novel biomimetic poly-ε-caprolactone (PCL) implant (Treatment No. 2; n = 6) or a combination of Chondro-Gide and Orthoss (Treatment No. 1; n = 6). At 19 months postoperation, repair tissue (n = 5 each) was analyzed for histology and biochemistry. Electromechanical mappings (Arthro-BST) were performed ex vivo.

RESULTS

Histological scores, electromechanical quantitative parameter values, dsDNA and sGAG contents measured at the repair sites were statistically lower than those obtained from the contralateral surfaces. Electromechanical mappings and higher dsDNA and sGAG/weight levels indicated better regeneration for Treatment No. 1. However, these differences were not significant. For both treatments, Arthro-BST revealed early signs of degeneration of the cartilage surrounding the repair site. The International Cartilage Repair Society II histological scores of the repair tissue were significantly higher for Treatment No. 1 (10.3 ± 0.38 SE) compared to Treatment No. 2 (8.7 ± 0.45 SE). The parameters cell morphology and vascularization scored highest whereas tidemark formation scored the lowest.

CONCLUSION

There was cell infiltration and regeneration of bone and cartilage. However, repair was incomplete and fibrocartilaginous. There were no significant differences in the quality of regeneration between the treatments except in some histological scoring categories. The results from Arthro-BST measurements were comparable to traditional invasive/destructive methods of measuring quality of cartilage repair.

Cartilage tissue engineering: Role of mesenchymal stem cells along with growth factors & scaffolds

Articular cartilage injury poses a major challenge for both the patient and orthopaedician. Articular cartilage defects once formed do not regenerate spontaneously, rather replaced by fibrocartilage which is weaker in mechanical competence than the normal hyaline cartilage. Mesenchymal stem cells (MSCs) along with different growth factors and scaffolds are currently incorporated in tissue engineering to overcome the deficiencies associated with currently available surgical methods and to facilitate cartilage healing. MSCs, being readily available with a potential to differentiate into chondrocytes which are enhanced by the application of different growth factors, are considered for effective repair of articular cartilage after injury. However, therapeutic application of MSCs and growth factors for cartilage repair remains in its infancy, with no comparative clinical study to that of the other surgical techniques. The present review covers the role of MSCs, growth factors and scaffolds for the repair of articular cartilage injury.

Osteochondral scaffold combined with aligned nanofibrous scaffolds for cartilage regeneration

Osteochondral defect repair poses a significant challenge in its reconstruction as the damage is presented in both articular cartilage and the underlying subchondral bone. Thus we present a osteochondral scaffold for articular cartilage repair.

Guided differentiation of bone marrow stromal cells on co-cultured cartilage and bone scaffolds

Focal chondral defects that result from traumatic injuries to the knee remain one of the most common causes of disability in patients. Current solutions for healing focal cartilage defects are mainly limited by the production of inferior cartilage-like tissue and subsequent delamination due to incomplete healing of the subchondral bone. In this experiment a polymeric osteochondral implant for guiding autologous bone marrow stem cells (BMSCs) to populate the scaffold to create distinctive bone and cartilage tissue is used. The cartilage component presents bioactive aligned nanofibers containing chondroitin sulfate and hyaluronic acid while the bone component includes hydroxyapatite to promote chondrogenic and osteogenic differentiation of the rat BMSCs in vitro. The different cartilage and bone components resulted in the elevated expression of osteogenic markers such as bone sialoprotein, runt related transcription factor 2, and bone morphogenetic protein 2 in the deeper bone layer and chondrogenic markers such as collagen type II and aggrecan in the cartilage layer. Through immunofluorescence imaging, the alignment of the secreted collagen type II fibrils and aggrecan was visualized and quantified on the cartilage component of the scaffold. These current studies show that the biodegradable biphasic osteochondral implant may be effective in promoting more hyaline-like tissue to fill in chondral defects of the knee.

Chondrogenic potential of physically treated bovine cartilage matrix derived porous scaffolds on human dermal fibroblast cells

Extracellular matrices have drawn attention in tissue engineering as potential biomaterials for scaffold fabrication because of their bioactive components. Noninvasive techniques of scaffold fabrication and cross-linking treatments are believed to maintain the integrity of bioactive molecules while providing proper architectural and mechanical properties. Cartilage matrix derived scaffolds are designed to support the maintenance of chondrocytes and provide proper signals for differentiation of chondroinducible cells. Chondroinductive potential of bovine articular cartilage matrix derived porous scaffolds on human dermal fibroblasts and the effect of scaffold shrinkage on chondrogenesis were investigated. An increase in sulfated glycosaminoglycans production along with upregulation of chondrogenic genes confirmed that physically treated cartilage matrix derived scaffolds have chondrogenic potential on human dermal fibroblasts.

Programmed cell delivery from biodegradable microcapsules for tissue repair

Injectable and resorbable hydrogels are an extremely attractive class of biomaterials. They make it possible to fill tissue defects accurately with an undoubtedly minimally invasive approach and to locally deliver cells that support repair or regeneration processes. However, their use as a cell carrier is often hindered by inadequate diffusion in bulk. A possible strategy for overcoming this transport limitation might be represented by injection of rapidly degradable cell-loaded microcapsules, so that maximum material thickness is limited by sphere radius. Here, the possibility of achieving programmable release of viable cells from alginate-based microcapsules was explored in vitro, by evaluating variations in material stability resulting from changes in hydrogel composition and assessing cell viability after encapsulation and in vitro release from microcapsules. Degradation of pure alginate microspheres was varied from a few days to several weeks by varying sodium alginate and calcium chloride concentrations. The addition of poloxamer was also found to accelerate degradation significantly, with capsule breakdown almost complete by two weeks, while chitosan was confirmed to strengthen alginate cross-linking. The presence of viable cells inside microspheres was revealed after encapsulation, and released cells were observed for all the formulations tested after a time interval dependent on bead degradation speed. These findings suggest that it may be possible to fine tune capsule breakdown by means of simple changes in material formulation and regulate, and eventually optimize, cell release for tissue repair.

Tracheoplasty with cartilage-engineered esophagus environments

PURPOSE

Our objective was to investigate the feasibility of engineering cartilage on the esophagus layer and outside the esophagus. Moreover, we investigated the feasibility of tracheoplasty with cartilage engineered on the esophagus in rabbits.

METHODS

Chondrocytes were isolated from auricular cartilages. 1. Engineered cartilage formation by histological findings on/into the esophageal layer was compared with that of injectable scaffold and preformed scaffold with chondrocytes. 2. Chondrocytes adhered to gelatin+vicryl mesh™ and b-FGF, were implanted on the outer esophageal surface. Four weeks after seeding, we found that cartilage was implanted in the midposterior portion of the cervical trachea (n=5), and it was retrieved 8weeks after seeding.

RESULTS

1. A gelatin sponge incorporating β-TCP with vicryl mesh™ showed the best performance for fabricating engineered cartilage on the outer side of the esophagus. 2. Two of 5 rabbits died due to obstructed esophagus. Cartilage engineered outside the esophagus by a composite scaffold as the main material in the gelatin sponge, maintained the airway structure for up to 1month after implantation. Tracheal epithelial regeneration occurred in the internal lumen of this engineered cartilage.

CONCLUSION

Tracheoplasty with cartilage engineered outside the esophagus may be useful for reconstructing airways.

Injectable in situ forming hydrogels based on natural and synthetic polymers for potential application in cartilage repair

Injectable hydrogels based on hyaluronic acid, elastin and a biocompatible polyaspartamide are optimal scaffolds of viable chondrocytes for potential cartilage repair.

A comparison study of different physical treatments on cartilage matrix derived porous scaffolds for tissue engineering applications

Native cartilage matrix derived (CMD) scaffolds from various animal and human sources have drawn attention in cartilage tissue engineering due to the demonstrable presence of bioactive components. Different chemical and physical treatments have been employed to enhance the micro-architecture of CMD scaffolds. In this study we have assessed the typical effects of physical cross-linking methods, namely ultraviolet (UV) light, dehydrothermal (DHT) treatment, and combinations of them on bovine articular CMD porous scaffolds with three different matrix concentrations (5%, 15% and 30%) to assess the relative strengths of each treatment. Our findings suggest that UV and UV-DHT treatments on 15% CMD scaffolds can yield architecturally optimal scaffolds for cartilage tissue engineering.

Tissue engineering

Ultimately much work remains to be done in the companion fields of biomaterials and stem cells. Nonetheless, the monumental progress in TE that has been reported in the studies summarized here demonstrates that regenerative approaches to problems in general surgery need to be explored in more depth. Furthermore, the surgical disciplines of reconstruction and transplantation need to recognize their research counterparts in TE, given its potential to actualize freedom from immunosuppression, one of the most elusive goals in modern surgery. The engineering and proliferation of autologous cells, tissues, and organs ex vivo before surgical operation can significantly reduce the obstacles current practitioners are intimately familiar with: donor site morbidity and immunologic rejection. Therefore, in addition to the truly exciting research and development prospects and implications for the commercial sector, patients with end-stage diseases and debilitating injury stand to gain the most from clinically adapted TE therapies.

Novel nano-rough polymers for cartilage tissue engineering

This study presents an innovative method for creating a highly porous surface with nanoscale roughness on biologically relevant polymers, specifically polyurethane (PU) and polycaprolactone (PCL). Nanoembossed polyurethane (NPU) and nanoembossed polycaprolactone (NPCL) were produced by the casting of PU and PCL over a plasma-deposited, spiky nanofeatured crystalline titanium (Ti) surface. The variables used in the process of making the spiky Ti surface can be altered to change the physical properties of the spiky particles, and thus, the cast polymer substrate surface can be altered. The spiky Ti surface is reusable to produce additional nanopolymer castings. In this study, control plain PU and PCL polymers were produced by casting the polymers over a plain Ti surface (without spikes). All polymer surface morphologies were characterized using both scanning electron microscopy and atomic force microscopy, and their surface energies were measured using liquid contact angle measurements. The results revealed that both NPU and NPCL possessed a higher degree of nanometer surface roughness and higher surface energy compared with their respective unaltered polymers. Further, an in vitro study was carried out to determine chondrocyte (cartilage-producing cells) functions on NPU and NPCL compared with on control plain polymers. Results of this study provided evidence of increased chondrocyte numbers on NPU and NPCL compared with their respective plain polymers after periods of up to 7 days. Moreover, the results provide evidence of greater intracellular protein production and collagen secretion by chondrocytes cultured on NPU and NPCL compared with control plain polymers. In summary, the present in vitro results of increased chondrocyte functions on NPU and NPCL suggest these materials may be suitable for numerous polymer-based cartilage tissue-engineering applications and, thus, deserve further investigation.

Bacterial cellulose and hyaluronic acid hybrid membranes: Production and characterization

In this study, the effect of the addition of hyaluronic acid (HA) on bacterial cellulose (BC) production, under static conditions was evaluated in terms of the properties of the resulting BC hybrid membranes. HA was added to the fermentation process in three distinct time points: first day (BC-T0), third day (BC-T3) and sixth day (BC-T6). Analyses of FT-IR and CP/MAS (13)C NMR confirmed the presence of HA in bacterial cellulose membranes. The crystal structure, crystallinity index (Ic) surface roughness, thermal stability and hybrophobic/hydrophilic character changed. Membranes with higher roughness were produced with HA added on the first and third day of fermentation process. The surface energy of BC/HA membranes was calculated and more hydrophilic membranes were produced by the addition of HA on the third and sixth day, also resulting in more thermally stable materials. The results demonstrate that bacterial cellulose/hyaluronic acid hybrid membranes can be produced in situ and suggest that HA interacts with the sub-elementary bacterial cellulose fibrils, changing the properties of the membranes. The study and understanding of the factors that affect those properties are of utmost importance for the safe and efficient use of BC as biomaterials in numerous applications, specifically in the biological field.

Study on nano-structured hydroxyapatite/zirconia stabilized yttria on healing of articular cartilage defect in rabbit

PURPOSE

Articular Cartilage has limited potential for self-repair and tissue engineering approaches attempt to repair articular cartilage by scaffolds. We hypothesized that the combined hydroxyapatite and zirconia stabilized yttria would enhance the quality of cartilage healing.

METHODS

In ten New Zealand white rabbits bilateral full-thickness osteochondral defect, 4 mm in diameter and 3 mm depth, was created on the articular cartilage of the patellar groove of the distal femur. In group I the scaffold was implanted into the right stifle and the same defect was created in the left stifle without any transplant (group II). Specimens were harvested at 12 weeks after implantation, examined histologically for morphologic features, and stained immunohistochemically for type-II collagen.

RESULTS

In group I the defect was filled with a white translucent cartilage tissue In contrast, the defects in the group II remained almost empty. In the group I, the defects were mostly filled with hyaline-like cartilage evidenced but defects in group II were filled with fibrous tissue with surface irregularities. Positive immunohistochemical staining of type-II collagen was observed in group I and it was absent in the control group.

CONCLUSION

The hydroxyapatite/yttria stabilized zirconia scaffold would be an effective scaffold for cartilage tissue engineering.

Description of a novel approach to engineer cartilage with porous bacterial nanocellulose for reconstruction of a human auricle

In this study, we investigated the effects of human primary chondrocytes, derived from routine septorhino- and otoplasties on a novel nondegradable biomaterial. This biomaterial, porous bacterial nanocellulose, is produced by Gluconacetobacter xylinus. Porosity is generated by paraffin beads embedded during the fermentation process. Human primary chondrocytes were able to adhere to bacterial nanocellulose and produce cartilaginous matrix proteins such as aggrecan (after 14 days) and collagen type II (after 21 days) in the presence of differentiation medium. Cells were located within the pores and in a dense cell layer covering the surface of the biomaterial. Cells were able to re-differentiate, as cell shape and extra cellular matrix gene expression showed a chondrogenic phenotype in three-dimensional bacterial nanocellulose culture. Collagen type I and versican expression decreased during three-dimensional culture. Variations in pore sizes of 150–300 µm and 300–500 µm did not influence cartilaginous extra cellular matrix synthesis. Varying seeding densities from 9.95 × 102 to 1.99 × 103 cells/mm2 and 3.98 × 103 cells/mm2 did not result in differences in quality of extra cellular matrix neo-synthesis. Our results demonstrated that both nasal and auricular chondrocytes are equally suitable to synthesize new extra cellular matrix on bacterial nanocellulose. Therefore, we propose both cell sources in combination with bacterial nanocellulose as promising candidates for the special needs of auricular reconstruction.

Perspectives on the role of nanotechnology in bone tissue engineering

OBJECTIVE

This review surveys new developments in bone tissue engineering, specifically focusing on the promising role of nanotechnology and describes future avenues of research.

METHODS

The review first reinforces the need to fabricate scaffolds with multi-dimensional hierarchies for improved mechanical integrity. Next, new advances to promote bioactivity by manipulating the nanolevel internal surfaces of scaffolds are examined followed by an evaluation of techniques using scaffolds as a vehicle for local drug delivery to promote bone regeneration/integration and methods of seeding cells into the scaffold.

RESULTS

Through a review of the state of the field, critical questions are posed to guide future research toward producing materials and therapies to bring state-of-the-art technology to clinical settings.

SIGNIFICANCE

The development of scaffolds for bone regeneration requires a material able to promote rapid bone formation while possessing sufficient strength to prevent fracture under physiological loads. Success in simultaneously achieving mechanical integrity and sufficient bioactivity with a single material has been limited. However, the use of new tools to manipulate and characterize matter down to the nano-scale may enable a new generation of bone scaffolds that will surpass the performance of autologous bone implants.

Engineering an in-vitro model of rodent cartilage

OBJECTIVES

The purpose of this study was to identify a cell source, scaffold substrate and culture environment suitable for use in engineering an in-vitro model of rodent cartilage.

METHODS

The chondrogenic activity and stability of cells isolated at Day 18 of gestation was assessed under normoxia and hypoxia using a cytokine stimulation assay and gene expression analysis. The ability of the selected cells seeded in fibrous electrospun scaffolds to form cartilaginous tissue during longterm static and dynamic culture was assessed using immunocytochemistry and biochemical analysis.

KEY FINDINGS

Rodent fetal chondrocytes appear to have enhanced phenotypic stability compared with other cell sources. Following 16 weeks under static culture, the engineered constructs were found to have greater cellularity and collagen content that native rodent cartilage.

CONCLUSIONS

A cell source, scaffold and culture environment have been identified that support the generation of in-vitro rodent cartilage. In future work, cytokine treatment of the engineered tissues will take place to generate in-vitro osteoarthritis models.

REPAIR OF ARTICULAR CARTILAGE INJURY

Articular cartilage defects heal poorly and lead to consequences as osteoarthritis. Clinical experience has indicated that no existing medication would substantially promote the healing process, and the cartilage defect requires surgical replacement. Allograft decays quickly for multiple reasons including the preparation process and immune reaction, and the outcome is disappointing. The extreme shortage of sparing in articular cartilage has much discouraged the use of autograft, which requires modification. The concept that constructs a chondral or osteochondral construct for the replacement of injured native tissue introduces that of tissue engineering. Limited number of cells are expanded either in vitro or in vivo, and resided temporally on a scaffold of biomaterial, which also acts as a vehicle to transfer the cells to the recipient site. Three core elements constitute this technique: the cell, a biodegradable scaffold, and an environment suitable for cells to present their proposed activity. Modern researches have kept updating those elements for a better performance of such cultivation of living tissue.

Advancing regenerative surgery in orthopaedic sports medicine: the critical role of the surgeon

The constant desire to improve outcomes in orthopaedic sports medicine requires us to continuously consider the challenges faced in the surgical repair or reconstruction of soft tissue and cartilaginous injury. In many cases, surgical efforts targeted at restoring normal anatomy and functional status are ultimately impaired by the biological aspect of the natural history of these injuries, which acts as an obstacle to a satisfactory repair process after surgery. The clinical management of sports injuries and the delivery of appropriate surgical intervention are continuously evolving, and it is likely that the principles of regenerative medicine will have an increasing effect in this specialized field of orthopaedic practice going forward. Ongoing advances in arthroscopy and related surgical techniques should facilitate this process. In contrast to the concept of engineered replacement of entire tissues, it is probable that the earliest effect of regenerative strategies seen in clinical practice will involve biological augmentation of current operative techniques via a synergistic process that might be best considered "regenerative surgery." This article provides an overview of the principles of regenerative surgery in cartilage repair and related areas of orthopaedic surgery sports medicine. The possibilities and challenges of a gradual yet potential paradigm shift in treatment through the increased use of biological augmentation are considered. The translational process and critical role to be played by the specialist surgeon are also addressed. We conclude that increased understanding of the potential and challenges of regenerative surgery should allow those specializing in orthopaedic surgery sports medicine to lead the way in advancing the frontiers of biological strategies to enhance modern clinical care in an evidence-based manner.

Physiological cartilage tissue engineering effect of oxygen and biomechanics

In vitro engineering of cartilaginous tissues has been studied for many years, and tissue-engineered constructs are sought to be used clinically for treating articular cartilage defects. Even though there is a plethora of studies and data available, no breakthroughs have been achieved yet that allow for implanting in vivo cultured articular cartilaginous tissues in patients. A review of contributions to cartilage tissue engineering over the past decades emphasizes that most of the studies were performed under environmental conditions neglecting the physiological situation. This is specifically pronounced in the use of bioreactor systems which neither allow for application of near physiomechanical stimulations nor for controlling a hypoxic environment as it is experienced in synovial joints. It is suspected that the negligence of these important parameters has slowed down progress and prevented major breakthroughs in the field. This review focuses on the main aspects of cartilage tissue engineering with emphasis on the relation and understanding of employing physiological conditions.

TISSUE ENGINEERING APPROACH TO OSTEOCHONDRAL REPAIR AND REGENERATION

Repair of osteochondral lesions remains difficult in current clinical medicine. This is due to the lack of self-reparatory capacity in adult cartilage to respond to injuries. Furthermore, current surgical based treatment is unable to achieve long-term satisfactory results. Cell therapies combined with scaffolds has become a promising tissue engineering approach for osteochondral regeneration. This article briefly outlines the approaches and limitations in osteochondral tissue engineering from three key aspects, namely: (1) Cells and Cell Source; (2) Biomaterials and Scaffold design and fabrication; and (3) Mechanical and Biochemical Stimulus. Current optimal candidate cells for tissue engineering include bone marrow and adipose tissue derived mesenchymal stem cells. As for scaffolds, the structural design and biomaterials used should support cell growth and the organization of new functional tissue formation. Using Fused Deposition Modeling (FDM) technique, the authors developed a novel polycaprolactone osteochondral scaffold which was shown to have the ability to recruit mesenchymal stem cells and the potential for repairing defects in vivo. The article also discussed mechanical and biological stimulus for enhancing in vitro growth of tissue-engineered constructs. The final challenge is the integration of the tissue-engineered tissues into a living system as a functional device.

Hydrogels for the repair of articular cartilage defects

The repair of articular cartilage defects remains a significant challenge in orthopedic medicine. Hydrogels, three-dimensional polymer networks swollen in water, offer a unique opportunity to generate a functional cartilage substitute. Hydrogels can exhibit similar mechanical, swelling, and lubricating behavior to articular cartilage, and promote the chondrogenic phenotype by encapsulated cells. Hydrogels have been prepared from naturally derived and synthetic polymers, as cell-free implants and as tissue engineering scaffolds, and with controlled degradation profiles and release of stimulatory growth factors. Using hydrogels, cartilage tissue has been engineered in vitro that has similar mechanical properties to native cartilage. This review summarizes the advancements that have been made in determining the potential of hydrogels to replace damaged cartilage or support new tissue formation as a function of specific design parameters, such as the type of polymer, degradation profile, mechanical properties and loading regimen, source of cells, cell-seeding density, controlled release of growth factors, and strategies to cause integration with surrounding tissue. Some key challenges for clinical translation remain, including limited information on the mechanical properties of hydrogel implants or engineered tissue that are necessary to restore joint function, and the lack of emphasis on the ability of an implant to integrate in a stable way with the surrounding tissue. Future studies should address the factors that affect these issues, while using clinically relevant cell sources and rigorous models of repair.

Sustained delivery of dibutyryl cyclic adenosine monophosphate to the transected spinal cord via oligo [(polyethylene glycol) fumarate] hydrogels

This study describes the use of oligo [(polyethylene glycol) fumarate] (OPF) hydrogel scaffolds as vehicles for sustained delivery of dibutyryl cyclic adenosine monophosphate (dbcAMP) to the transected spinal cord. dbcAMP was encapsulated in poly(lactic-co-glycolic acid) (PLGA) microspheres, which were embedded within the scaffolds architecture. Functionality of the released dbcAMP was assessed using neurite outgrowth assays in PC12 cells and by delivery to the transected spinal cord within OPF seven channel scaffolds, which had been loaded with Schwann cells or mesenchymal stem cells (MSCs). Our results showed that encapsulation of dbcAMP in microspheres lead to prolonged release and continued functionality in vitro. These microspheres were then successfully incorporated into OPF scaffolds and implanted in the transected thoracic spinal cord. Sustained delivery of dbcAMP inhibited axonal regeneration in the presence of Schwann cells but rescued MSC-induced inhibition of axonal regeneration. dbcAMP was also shown to reduce capillary formation in the presence of MSCs, which was coupled with significant functional improvements. Our findings demonstrate the feasibility of incorporating PLGA microsphere technology for spinal cord transection studies. It represents a novel sustained delivery mechanism within the transected spinal cord and provides a platform for potential delivery of other therapeutic agents.