Improving cytocompatibility of Co28Cr6Mo by TiO2 coating: gene expression study in human endothelial cells

Cell-Material Interactions in Direct Contact Culture of Endothelial Cells on Biodegradable Iron-Based Stents Fabricated by Laser Powder Bed Fusion and Impact of Ion Release

Additive manufacturing is a promising technology for the fabrication of customized implants with complex geometry. The objective of this study was to investigate the initial cell-material interaction of degradable Fe-30Mn-1C-0.02S stent structures in comparison to conventional 316L as a reference, both processed by laser powder bed fusion. FeMn-based alloys have comparable mechanical properties with clinically applied AISI 316L for a corrosion-resistant stent material. Different corrosion stages of the as-built Fe-30Mn-1C-0.02S stent surfaces were simulated by pre-conditioning in DMEM under cell culture conditions for 2 h, 7 days, and 28 days. Human umbilical vein endothelial cells (HUVECs) were directly seeded onto the pre-conditioned samples, and cell viability, adherence, and morphology were analyzed. These studies were accompanied by measurements of iron and manganese ion release and Auger electron spectroscopy to evaluate the influence of corrosion products and degradation on the cells. In the initial phase (2 h of pre-conditioning), HUVECs were able to attach but the cell number decreased over the cultivation period of 14 days and the CD31 staining pattern of intercellular contacts was disordered. At later time points of corrosion (7 and 28 days of pre-conditioning), CD31 staining was distinctly located at the intercellular contacts, and the cell density increased after seeding and was stable for up to 14 days. Formation of a complex degradation layer, which had a composition and thickness dependent on the pre-conditioning time, led to a reduced ion release and finally showed a positive effect on cell survival. Concluding, our data suggest the suitability of Fe-30Mn-1C-0.02S for in vivo applications.

Development of In Vitro Endothelialised Stents - Review

Endovascular treatment is prevalent as a primary treatment for coronary and peripheral arterial diseases. Although the introduction of drug-eluting stents (DES) dramatically reduced the risk of in-stent restenosis, stent thrombosis persists as an issue. Notwithstanding improvements in newer generation DES, they are yet to address the urgent clinical need to abolish the late stent complications that result from in-stent restenosis and are associated with late thrombus formation. These often lead to acute coronary syndromes with high mortality in coronary artery disease and acute limb ischemia with a high risk of limb amputation in peripheral arterial disease. Recently, a significant amount of research has focused on alternative solutions to improve stent biocompatibility by using tissue engineering. There are two types of tissue engineering endothelialisation methods: in vitro and in vivo. To date, commercially available in vivo endothelialised stents have failed to demonstrate antithrombotic or anti-stenosis efficacy in clinical trials. In contrast, the in vitro endothelialisation methods exhibit the advantage of monitoring cell type and growth prior to implantation, enabling better quality control. The present review discusses tissue-engineered candidate stents constructed by distinct in vitro endothelialisation approaches, with a particular focus on fabrication processes, including cell source selection, stent material composition, stent surface modifications, efficacy and safety evidence from in vitro and in vivo studies, and future directions.

The microstructure, mechanical properties, corrosion performance and biocompatibility of hydroxyapatite reinforced ZK61 magnesium-matrix biological composite

Magnesium (Mg)-based composites, as biomaterials, have attracted widespread attention due to their adjustable mechanical properties like elastic modulus, ductility, ultimate tensile strength, and corrosion resistance. In this study, hydroxyapatite (HA) reinforced ZK61 Mg-matrix composites were prepared by powder metallurgy and hot extrusion methods. The influence of the content of HA (10 wt%, 20 wt%, and 30 wt%) on the microstructure, density, mechanical properties, corrosion property and biocompatibility were investigated. The results showed that the density and yield strength of the composites match those of natural bone. Moreover, the composite with 10 % HA (ZK61-10HA) exhibited the best corrosion resistance, as determined by the electrochemical measurement and immersion test in simulated body fluid (SBF) at 37 °C. In addition, the ZK61-10HA composite significantly enhanced the cell viability (≥78 %) compared with ZK61 alloy in vitro testing. It is demonstrated that the mechanical properties, corrosion resistance and biocompatibility of Mg alloy can be effectively controlled by adjusting the content of HA, which suggested that the ZK61-HA composites were promising candidates for degradable implant materials.

In vitro and in vivo evaluation of a novel polymer-free everolimus-eluting stent by nitrogen-doped titanium dioxide film deposition

Inflammation and thrombosis are linked to the use of polymer-based drug-eluting stents (DES). The aim of this study was to develop a polymer-free everolimus (EVL)-eluting stent using nitrogen-doped titanium dioxide (N-TiO₂) and verify its efficacy by in vitro and in vivo assessment in a porcine coronary model. Various analytical approaches such as scanning electron microscopy and atomic force microscopy, electron spectroscopy, Fourier transform infrared spectrometry and contact angle measurement were employed for the characterization. As a part of biocompatibility assessment, platelet adhesion and smooth muscle cell (SMC) proliferation were examined. Bare metal stent (BMS), N-TiO₂ stent, everolimus-eluting N-TiO₂ (N-TiO₂-EVL) stent, and commercialized EVL-eluting stent (EES) were randomly placed in forty coronary arteries in twenty pigs. After four weeks of implantation, the stents were subjected to histological and quantitative analysis. The N-TiO₂ film used in this study was well coated without any cracks or peeling. Surface hydrophilicity (88.8% of angle decrement) could be associated with the decrease in surface roughness post N-TiO₂ deposition (37.0%). The platelet adhesion on the N-TiO₂ surfaces was less than that on the BMS surface. The proliferation of SMC was suppressed in the N-TiO₂-EVL group (30.2%) but not in the BMS group. In the animal study, the percent area restenosis was significantly decreased in the N-TiO₂-EVL group compared to that in the BMS group. The results (BMS; 47.0 ± 11.00%, N-TiO₂-EVL; 31.7 ± 10.50%, and EES; 29.1 ± 11.21%, n = 10, p < 0.05) were almost at par with those of the commercialized EVL-eluting stent. The introduction of N-TiO₂ deposition during fabrication of polymer-free DES may be an efficient accessorial process for preventing in-stent restenosis and thrombosis.

Differences in the expression of cell cycle genes in osteoblasts and endothelial cells cultured on the surfaces of Ti6Al4V and Ti6Al7Nb alloys

Three medically used alloys (Ti6Al4V, Ti6Al7Nb, and AISI 316 L) are compared due to proliferative potential and metabolic response of human cells (osteoblasts line Saos-2 and endothelial cells line EA.hy-926) seeded on the surfaces of these alloys. Although no statistically significant difference in the proliferative potential of the cells cultured on the surfaces of examined biomaterials was observed, it does not exclude relevant differences in metabolic response of these cells assessed as changes in genes' expression. As a result of our studies it was demonstrated that the changes in the expression of examined genes were very common. Our observation suggests the presence of the process of selective recognition of the contacted biomaterials by the cells seeded on their surfaces. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1607-1617, 2017.

The synergistic effect of TiO2 nanoporous modification and platelet-rich plasma treatment on titanium-implant stability in ovariectomized rats

For several decades, titanium and its alloys have been commonly utilized for endosseous implantable materials, because of their good mechanical properties, chemical resistance, and biocompatibility. But associated low bone mass, wear and loss characteristics, and high coefficients of friction have limited their long-term stable performance, especially in certain abnormal bone-metabolism conditions, such as postmenopausal osteoporosis. In this study, we investigated the effects of platelet-rich plasma (PRP) treatment and TiO₂ nanoporous modification on the stability of titanium implants in osteoporotic bone. After surface morphology, topographical structure, and chemical changes of implant surface had been detected by scanning electron microscopy (SEM), atomic force microscopy, contact-angle measurement, and X-ray diffraction, we firstly assessed in vivo the effect of PRP treatment on osseointegration of TiO₂-modified implants in ovariectomized rats by microcomputed tomography examinations, histology, biomechanical testing, and SEM observation. Meanwhile, the potential molecular mechanism involved in peri-implant osseous enhancement was also determined by quantitative real-time polymerase chain reaction. The results showed that this TiO₂-modified surface was able to lead to improve bone implant contact, while PRP treatment was able to increase the implant surrounding bone mass. The synergistic effect of both was able to enhance the terminal force of implants drastically in biomechanical testing. Compared with surface modification, PRP treatment promoted earlier osteogenesis with increased expression of the RUNX2 and COL1 genes and suppressed osteoclastogenesis with increased expression of OPG and decreased levels of RANKL. These promising results show that PRP treatment combined with a TiO₂-nanomodified surface can improve titanium-implant biomechanical stability in ovariectomized rats, suggesting a beneficial effect to support the success of implants in osteoporotic bone.

Investigation on the mechanism of non-photocatalytically TiO2 -induced reactive oxygen species and its significance on cell cycle and morphology

Titanium dioxide (TiO2 ) nanoparticles are widely used in daily human life, and were reported to elicit biological effects such as oxidative stress either generating reactive oxygen species (ROS) or causing cell necrosis without generating ROS, whose underlying molecular mechanisms are not yet known. In this study, the role of dissolved oxygen in TiO2 catalytic activity in dark environment, and long-term cytotoxic effects of TiO2 exposure were investigated. To determine the effect of dissolved oxygen, the anatase-TiO2 nanoparticle suspension was prepared both in deoxygenated and regular MilliQ water, and a ~ 9-fold higher ROS in regular MilliQ samples was observed compared to deoxygenated samples while in the dark, which suggested dissolved oxygen as the driving agent behind the TiO2 catalytic reaction. On the other hand, the differential cell viability and endogenous ROS activity was demonstrated through a sensitive macrophage-based assay, on a dose- and time-dependent manner. Both the cell number and endogenous ROS activity increased with increase in time till 48 h, followed by a reduction at 72 h exposure period. Long-term exposures to these nanoparticles even at low concentrations were found detrimental to cells, where late apoptosis until 48 h and necrosis at 72 h leading to cell death were noted. Late apoptotic events and cell membrane cytoskeletal actin rearrangement observed were hypothesized to be induced by particle-mediated cellular ROS. This in addition to radical generation ability of TiO2 in the dark will help further in better understanding of the toxicity mechanism in cells beyond ROS generation. Copyright © 2016 John Wiley & Sons, Ltd.

Development of a novel biomimetic micro/nano-hierarchical interface for enhancement of osseointegration

In the present study, a novel biomimetic micro/nano-hierarchical interface was obtained and an unexpected trabecular bone-like interface was given.

Mesenchymal stem cell response to topographically modified CoCrMo

Surface roughness on implant materials has been shown to be highly influential on the behavior of osteogenic cells. Four surface topographies were engineered on cobalt chromium molybdenum (CoCrMo) in order to examine this influence on human mesenchymal stem cells (MSC). These treatments were smooth polished (SMO), acid etched (AE) using HCl 7.4% and H₂SO₄ 76% followed by HNO₃ 30%, sand blasted, and acid etched using either 50 μm Al₂O₃ (SLA50) or 250 μm Al₂O₃ grit (SLA250). Characterization of the surfaces included energy dispersive X‐ray analysis (EDX), contact angle, and surface roughness analysis. Human MSCs were cultured onto the four CoCrMo substrates and markers of cell attachment, retention, proliferation, cytotoxicity, and osteogenic differentiation were studied. Residual aluminum was observed on both SLA surfaces although this appeared to be more widely spread on SLA50, whilst SLA250 was shown to have the roughest topography with an R_a value greater than 1 μm. All substrates were shown to be largely non‐cytotoxic although both SLA surfaces were shown to reduce cell attachment, whilst SLA50 also delayed cell proliferation. In contrast, SLA250 stimulated a good rate of proliferation resulting in the largest cell population by day 21. In addition, SLA250 stimulated enhanced cell retention, calcium deposition, and hydroxyapatite formation compared to SMO (p < 0.05). The enhanced response stimulated by SLA250 surface modification may prove advantageous for increasing the bioactivity of implants formed of CoCrMo. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 103A: 3747–3756, 2015.

Cytocompatibility and early osseointegration of nanoTiO2-modified Ti-24 Nb-4 Zr-7.9 Sn surfaces

This study aimed to evaluate the cytocompatibility and early osseointegration of Ti-24 Nb-4 Zr-7.9 Sn (Ti-2448) surfaces that were modified with a nanoscale TiO2 coating. The coating was fabricated using a hydrothermal synthesis method to generate nanoTiO2/Ti-2448. The surface characteristics of the samples were evaluated using scanning electron microscopy (SEM), energy dispersive spectrometry (EDS) and X-ray diffraction (XRD). The cytotoxicity of the fabricated nanoTiO2/Ti-2448 was determined using MTT assays. The proliferation and alkaline phosphatase (ALP) activity of MC3T3-E1 osteoblasts cultured on nanoTiO2/Ti-2448 were compared with those cultured on Ti-2448. Disk-shaped implants were placed in Wistar rats. The histological sections were stained with haematoxylin and eosin (HE), and the histocompatibility was analysed at 4 and 12weeks post-implantation. Cylindrical implants were embedded in Japanese white rabbits, and the histological sections were stained with HE and anti-TGF-β1 to evaluate the histocompatibility and early osseointegration at 4, 12 and 26weeks post-implantation. NanoTiO2/Ti-2448 exhibited a rougher surface than did Ti-2448. NanoTiO2/Ti-2448 was determined to be non-cytotoxic. More osteoblasts and higher ALP activity were observed for nanoTiO2/Ti-2448 than Ti-2448 (p<0.05). Few inflammatory cells were detected around nanoTiO2/Ti-2448, and the expression of TGF-β1 on nanoTiO2/Ti-2448 peaked at earlier time than that on Ti-2448. The results indicate that the cytocompatibility and early osseointegration were enhanced by the nanoTiO2 coating.

Mesenchymal stem cell response to UV-photofunctionalized TiO2coated CoCrMo

UV photofunctionalization of TiO₂coated implant surfaces enhanced markers of cell adhesion. This may prove to be advantageous for orthopaedic implants by supporting the colonisation and adhesion of cells capable of facilitating in bone healing.