1
|
Sheng N, Xing F, Wang J, Zhang QY, Nie R, Li-Ling J, Duan X, Xie HQ. Recent progress in bone-repair strategies in diabetic conditions. Mater Today Bio 2023; 23:100835. [PMID: 37928253 PMCID: PMC10623372 DOI: 10.1016/j.mtbio.2023.100835] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 10/02/2023] [Accepted: 10/14/2023] [Indexed: 11/07/2023] Open
Abstract
Bone regeneration following trauma, tumor resection, infection, or congenital disease is challenging. Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia. It can result in complications affecting multiple systems including the musculoskeletal system. The increased number of diabetes-related fractures poses a great challenge to clinical specialties, particularly orthopedics and dentistry. Various pathological factors underlying DM may directly impair the process of bone regeneration, leading to delayed or even non-union of fractures. This review summarizes the mechanisms by which DM hampers bone regeneration, including immune abnormalities, inflammation, reactive oxygen species (ROS) accumulation, vascular system damage, insulin/insulin-like growth factor (IGF) deficiency, hyperglycemia, and the production of advanced glycation end products (AGEs). Based on published data, it also summarizes bone repair strategies in diabetic conditions, which include immune regulation, inhibition of inflammation, reduction of oxidative stress, promotion of angiogenesis, restoration of stem cell mobilization, and promotion of osteogenic differentiation, in addition to the challenges and future prospects of such approaches.
Collapse
Affiliation(s)
- Ning Sheng
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Fei Xing
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Jie Wang
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Qing-Yi Zhang
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Rong Nie
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Jesse Li-Ling
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
- Frontier Medical Center, Tianfu Jincheng Laboratory, Chengdu, 610212, China
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Xin Duan
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Hui-Qi Xie
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
- Frontier Medical Center, Tianfu Jincheng Laboratory, Chengdu, 610212, China
| |
Collapse
|
2
|
Camacho-Alonso F, Tudela-Mulero MR, Buendía AJ, Navarro JA, Pérez-Sayáns M, Mercado-Díaz AM. Bone regeneration in critical-sized mandibular symphysis defects using bioceramics with or without bone marrow mesenchymal stem cells in healthy, diabetic, osteoporotic, and diabetic-osteoporotic rats. Dent Mater 2022; 38:1283-1300. [PMID: 35717229 DOI: 10.1016/j.dental.2022.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/14/2022] [Accepted: 06/05/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To compare new bone formation in mandibular critical-sized bone defects (CSBDs) in healthy, diabetic, osteoporotic, and diabetic-osteoporotic rats filled with bioceramics (BCs) with or without bone marrow mesenchymal stem cells (BMSCs). METHODS A total of 64 adult female Sprague-Dawley rats were randomized into four groups (n = 16 per group): Group 1 healthy, Group 2 diabetic, Group 3 osteoporotic, and Group 4 diabetic-osteoporotic rats. Streptozotocin was used to induce type 1 diabetes in Group 2 and 4, while bilateral ovariectomy was used to induce osteoporosis in Group 3 and 4. The central portion of the rat mandibular symphysis was used as a physiological CSBD. In each group, eight defects were filled with BC (hydroxypatatite 60% and β-tricalcium phosphate 40%) alone and eight with BMSCs cultured on BC. The animals were sacrificed at 4 and 8 weeks, and the mandibles were processed for micro-computed tomography to analyze radiological union and bone mineral density (BMD); histological analysis of the bone union; and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2). RESULTS In all groups (healthy, diabetics, osteoporotics, and diabetics-osteoporotics), the CSBDs filled with BC + BMSCs showed greater radiological bone union, BMD, histological bone union, and more VEGF and BMP-2 positivity, in comparison with CSBDs treated with BC alone (at 4 and 8 weeks). CONCLUSIONS Application of BMSCs cultured on BCs improves bone regeneration in CSBDs compared with application of BCs alone in healthy, diabetic, osteoporotic, and diabetic-osteoporotic rats.
Collapse
Affiliation(s)
- F Camacho-Alonso
- Department of Oral Surgery, University of Murcia, Murcia, Spain.
| | | | - A J Buendía
- Department of Histology and Pathological Anatomy, University of Murcia, Murcia, Spain
| | - J A Navarro
- Department of Histology and Pathological Anatomy, University of Murcia, Murcia, Spain
| | - M Pérez-Sayáns
- Department of Oral Medicine, Oral Surgery and Implantology, University of Santiago de Compostela, Spain. MedOralRes Group, Health Research Institute of Santiago de Compostela (IDIS). Santiago de Compostela, Spain
| | | |
Collapse
|
3
|
Valencia-Llano CH, Solano MA, Grande-Tovar CD. Nanocomposites of Chitosan/Graphene Oxide/Titanium Dioxide Nanoparticles/Blackberry Waste Extract as Potential Bone Substitutes. Polymers (Basel) 2021; 13:polym13223877. [PMID: 34833175 PMCID: PMC8618967 DOI: 10.3390/polym13223877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 12/28/2022] Open
Abstract
New technologies based on nanocomposites of biopolymers and nanoparticles inspired by the nature of bone structure have accelerated their application in regenerative medicine, thanks to the introduction of reinforcing properties. Our research incorporated chitosan (CS) covalently crosslinked with glutaraldehyde (GLA) beads with graphene oxide (GO) nanosheets, titanium dioxide nanoparticles (TiO2), and blackberry processing waste extract (BBE) and evaluated them as partial bone substitutes. Skullbone defects in biomodels filled with the scaffolds showed evidence through light microscopy, scanning electron microscopy, histological studies, soft tissue development with hair recovery, and absence of necrotic areas or aggressive infectious response of the immune system after 90 days of implantation. More interestingly, newly formed bone was evidenced by elemental analysis and Masson trichromacy analysis, which demonstrated a possible osteoinductive effect from the beads using the critical size defect experimental design in the biomodels. The results of this research are auspicious for the development of bone substitutes and evidence that the technologies for tissue regeneration, including chitosan nanocomposites, are beneficial for the adhesion and proliferation of bone cells.
Collapse
Affiliation(s)
| | - Moisés A. Solano
- Grupo de Investigación de Fotoquímica y Fotobiología, Facultad de Ciencias, Programa de Química, Universidad del Atlántico, Carrera 30 Número 8-49, Puerto Colombia 081008, Colombia;
| | - Carlos David Grande-Tovar
- Grupo de Investigación de Fotoquímica y Fotobiología, Facultad de Ciencias, Programa de Química, Universidad del Atlántico, Carrera 30 Número 8-49, Puerto Colombia 081008, Colombia;
- Correspondence: ; Tel.: +57-5-3599-484
| |
Collapse
|
4
|
Jin H, Ji Y, Cui Y, Xu L, Liu H, Wang J. Simvastatin-Incorporated Drug Delivery Systems for Bone Regeneration. ACS Biomater Sci Eng 2021; 7:2177-2191. [PMID: 33877804 DOI: 10.1021/acsbiomaterials.1c00462] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Local drug delivery systems composed of biomaterials and osteogenic substances provide promising strategies for the reconstruction of large bone defects. In recent years, simvastatin has been studied extensively for its pleiotropic effects other than lowering of cholesterol, including its ability to induce osteogenesis and angiogenesis. Accordingly, several studies of simvastatin incorporated drug delivery systems have been performed to demonstrate the feasibility of such systems in enhancing bone regeneration. Therefore, this review explores the molecular mechanisms by which simvastatin affects bone metabolism and angiogenesis. The simvastatin concentrations that promote osteogenic differentiation are analyzed. Furthermore, we summarize and discuss a variety of simvastatin-loaded drug delivery systems that use different loading methods and materials. Finally, current shortcomings of and future development directions for simvastatin-loaded drug delivery systems are summarized. This review provides various advanced design strategies for simvastatin-incorporated drug delivery systems that can enhance bone regeneration.
Collapse
Affiliation(s)
- Hui Jin
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, P.R. China.,Department of Pain, The Second Hospital of Jilin University, Changchun 130041, P.R. China
| | - Youbo Ji
- Department of Pain, The Second Hospital of Jilin University, Changchun 130041, P.R. China
| | - Yutao Cui
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, P.R. China
| | - Li Xu
- Department of Orthopedics, Weihai Guanghua Hospital, Weihai 264200, P.R. China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, P.R. China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, P.R. China
| |
Collapse
|
5
|
The Effect of Autogenous Bone Graft Mixed With Recombinant Human Vascular Endothelial Growth Factor on Bone Regeneration. J Craniofac Surg 2020; 32:2233-2237. [PMID: 33290335 DOI: 10.1097/scs.0000000000007316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Bone regeneration depends on vascularization in the pertaining site. This study aims to investigate autogenous bone grafts mixed with recombinant human vascular endothelial growth factor (rhVEGF) effect on bone regeneration in rat mandibular bone defect. MATERIAL METHODS Using 32 Wistar Albino rats, our experimental study consists of 4 groups: Group1 (control group), the defect was empty; Group 2, autogenous bone graft only; Group 3, gelatin sponge plus rhVEGF applications; Group 4, autogenous bone graft plus rhVEGF applications. The rats were sacrificed on the 28th day after the operation. New bone regeneration was analyzed histologically and immunohistochemically. RESULTS Our histological analyses revealed that new bone regeneration in Group 3 was enhanced in comparison to Group 1 and Group 2. However, autogenous bone grafts combined with rhVEGF provided the best outcome in conjunction with the increased remodeling of the new bone. CONCLUSIONS In the light of our results, it can be concluded that autogenous bone grafts in combination with rhVEGF can, potentially, enhance neovascularization and bone regeneration.
Collapse
|
6
|
Autogenous Tooth Bone Graft and Simvastatin Combination Effect on Bone Healing. J Craniofac Surg 2020; 31:2350-2354. [PMID: 33136889 DOI: 10.1097/scs.0000000000006707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Autogenous tooth bone grafts (ATGM) are materials prepared from extracted teeth and have been used for bone augmentation. These graft materials are known to have similar structures and components to bone grafts. In this sense, this study aimed to evaluate all the tooth layers mixed with simvastatin without any demineralization process effect on bone formation. METHODS In 60 Wistar albino rats, a standardized 6.0 m-diameter critical size bone defect was created in their calvarium. The study consists of 1 control and 4 experimental groups. In the control group (12 rats), the defects were left empty. The defects were grafted only with ATGM in Group 1, with ATGM mixed with simvastatin in Group 2, autogenous bone graft mixed with simvastatin in Group 3, and with xenogenic bone graft mixed with simvastatin in Group 4. The animals were sacrificed at the 7th and 28th days after operation. RESULTS PCR, micro CT and histological results show that bone formation was enhanced in the experimental groups in comparison to the control group. Group 1 and Group 2 had similar bone formation rate when compared to Group 3 and Group 4 at the 28th day after operation. CONCLUSION This study concludes that mineralized teeth may be used for defect reconstruction without any demineralization process. Autogenous mineralized tooth bone graft should be mixed with simvastatin for bone regeneration like other grafts.
Collapse
|
7
|
Formulation of simvastatin chitosan nanoparticles for controlled delivery in bone regeneration: Optimization using Box-Behnken design, stability and in vivo study. Int J Pharm 2020; 577:119038. [DOI: 10.1016/j.ijpharm.2020.119038] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/08/2020] [Accepted: 01/11/2020] [Indexed: 12/18/2022]
|
8
|
Camacho-Alonso F, Martínez-Ortiz C, Plazas-Buendía L, Mercado-Díaz AM, Vilaplana-Vivo C, Navarro JA, Buendía AJ, Merino JJ, Martínez-Beneyto Y. Bone union formation in the rat mandibular symphysis using hydroxyapatite with or without simvastatin: effects on healthy, diabetic, and osteoporotic rats. Clin Oral Investig 2020; 24:1479-1491. [PMID: 31925587 DOI: 10.1007/s00784-019-03180-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/19/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective is to compare new bone formation in critical defects in healthy, diabetic, and osteoporotic rats filled with hydroxyapatite (HA) alone and HA combined with simvastatin (SV). MATERIALS AND METHODS A total of 48 adult female Sprague-Dawley rats were randomized into three groups (n = 16 per group): Group, 1 healthy; Group 2, diabetics; and Group 3, osteoporotics. Streptozotocin was used to induce type 1 diabetes in Group 2, while bilateral ovariectomy was used to induce osteoporosis in Group 3. The central portion of the rat mandibular symphysis was used as a physiological critical bone defect. In each group, eight defects were filled with HA alone and eight with HA combined with SV. The animals were sacrificed at 4 and 8 weeks, and the mandibles were processed for micro-computed tomography to analyze radiological union and bone mineral density (BMD); histological analysis of the bone union; and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2). RESULTS In all groups (healthy, diabetics, and osteoporotics), the defects filled with HA + SV presented greater radiological bone union, BMD, histological bone union, and more VEGF and BMP-2 positivity, in comparison with bone defects treated with HA alone. CONCLUSIONS Combined application of HA and SV improves bone regeneration in mandibular critical bone defects compared with application of HA alone in healthy, diabetic, and osteoporotic rats. CLINICAL RELEVANCE This study might help to patients with osteoporosis or uncontrolled diabetes type 1, but future studies should be done.
Collapse
Affiliation(s)
- F Camacho-Alonso
- Department of Oral Surgery, University of Murcia, Murcia, Spain.
| | | | | | | | | | - J A Navarro
- Department of Histology and Pathological Anatomy, University of Murcia, Murcia, Spain
| | - A J Buendía
- Department of Histology and Pathological Anatomy, University of Murcia, Murcia, Spain
| | - J J Merino
- Department of Biochemistry and Molecular Biology, Complutense University of Madrid, Madrid, Spain
| | - Y Martínez-Beneyto
- Department of Preventive and Community Dentistry, University of Murcia, Murcia, Spain
| |
Collapse
|
9
|
miRNA-21 promotes osteogenesis via the PTEN/PI3K/Akt/HIF-1α pathway and enhances bone regeneration in critical size defects. Stem Cell Res Ther 2019; 10:65. [PMID: 30795815 PMCID: PMC6387542 DOI: 10.1186/s13287-019-1168-2] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/15/2019] [Accepted: 02/06/2019] [Indexed: 02/07/2023] Open
Abstract
Background Functional reconstruction of maxillofacial bone defects is a considerable clinical challenge. Many studies have emphasized the osteogenic and angiopoietic abilities of stem cells for tissue regeneration. We previously showed that microRNA-21 (miRNA-21) can promote angiogenesis in human umbilical cord blood-derived mesenchymal stem cells (UCBMSCs). In the present study, the role of miRNA-21 in osteogenic differentiation of bone marrow-derived stem cells (BMSCs) was investigated. Methods Western blotting and qPCR were performed to investigate the influences of miRNA-21 on osteogenic differentiation of BMSCs. The effects of miRNA-21 on PTEN/PI3K/Akt/HIF-1α pathway were also assessed using western blotting. To further evaluate the roles of miRNA-21 in osteogenesis in vivo, we conducted animal experiments in rat and canine. New bone formation was assessed using micro-CT and histological methods. Results In the present study, we found that miRNA-21 promotes the migration and osteogenic differentiation of bone marrow-derived stem cells (BMSCs) in vitro. Using gain- and loss-of-function studies, we found that miRNA-21 promoted the osteogenic ability of BMSCs by increasing P-Akt and HIF-1α activation. Finally, we verified the essential role of miRNA-21 in osteogenesis by implanting a miRNA-21-modified BMSCs/β-tricalcium phosphate (β-TCP) composite into critical size defects. Radiography, micro-CT, and histology revealed significantly greater volume of new bone formation in the miRNA-21 group than in the control group. Conclusion In conclusion, our study demonstrated an essential role of miRNA-21 in promoting maxillofacial bone regeneration via the PTEN/PI3K/Akt/HIF-1α pathway. Electronic supplementary material The online version of this article (10.1186/s13287-019-1168-2) contains supplementary material, which is available to authorized users.
Collapse
|
10
|
Trejo-Iriarte CG, Serrano-Bello J, Gutiérrez-Escalona R, Mercado-Marques C, García-Honduvilla N, Buján-Varela J, Medina LA. Evaluation of bone regeneration in a critical size cortical bone defect in rat mandible using microCT and histological analysis. Arch Oral Biol 2019; 101:165-171. [PMID: 30951954 DOI: 10.1016/j.archoralbio.2019.01.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/11/2018] [Accepted: 01/15/2019] [Indexed: 12/26/2022]
Abstract
GOAL Evaluate bone regeneration in a critical size bone defect model in the jaw of healthy rats as a function of gender and defect location. DESIGN A series of microCT and histological studies were performed to evaluate the process of bone regeneration in rats with a mandibular critical size defect. Rats were placed in two groups according to gender and sorted in terms of bone defect location. Bone regeneration rate and hydroxyapatite concentration were assessed with microCT imaging at specific times after surgery. Histological analysis was also performed to evaluate bone regeneration. RESULTS No more that 85% of bone regeneration was observed after 60 days, with a low rate constant (K) indicating a slow restoration of the defect. Assessment of microCT images showed partial closure of the defect in all cases, which was confirmed by histological analysis. Hydroxyapatite concentration values revealed that regenerated bone was not fully calcified. No statistically significant differences in terms of gender or defect location were found. CONCLUSION The defect model studied here, located in the jaw of healthy rats, shows potential as a preclinical critical size bone defect model to evaluate bone regeneration therapies in the fields of dentistry and maxillofacial surgery.
Collapse
Affiliation(s)
- Cynthia G Trejo-Iriarte
- Laboratorio de Investigación en Odontología Almaraz, FES-Iztacala, Universidad Nacional Autónoma de México, 54090, México.
| | - Janeth Serrano-Bello
- Facultad de Odontología, División de Estudios de Posgrado e Investigación, Universidad Nacional Autónoma de México, 04510, México
| | - Rocío Gutiérrez-Escalona
- Laboratorio de Investigación en Odontología Almaraz, FES-Iztacala, Universidad Nacional Autónoma de México, 54090, México
| | - Crisóforo Mercado-Marques
- Unidad de Aislamiento y Bioterio, FES-Cuautitlán, Universidad Nacional Autónoma de México, Estado de México 54714, México
| | - Natalio García-Honduvilla
- Departamentos de Medicina y Especialidades Médicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centros de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) Madrid 28805, España; Centro Universitario de la Defensa de Madrid, Madrid 28047, España
| | - Julia Buján-Varela
- Departamentos de Medicina y Especialidades Médicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centros de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) Madrid 28805, España
| | - Luis Alberto Medina
- Instituto de Física, Universidad Nacional Autónoma de México, 04510, México; Unidad de Investigación Biomédica en Cáncer INCan/UNAM, Instituto Nacional de Cancerología, 14280, México.
| |
Collapse
|
11
|
Raafat SN, Amin RM, Elmazar MM, Khattab MM, El-Khatib AS. The sole and combined effect of simvastatin and platelet rich fibrin as a filling material in induced bone defect in tibia of albino rats. Bone 2018; 117:60-69. [PMID: 30208342 DOI: 10.1016/j.bone.2018.09.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/30/2022]
Abstract
Statins like simvastatin (SIM) have demonstrated to have pleiotropic actions other than their conventional use as antilipidemic drugs. Also, nowadays natural scaffolds like platelets rich fibrin (PRF) showed promising results on bone regeneration. Aim This study compare the regenerative power of SIM and PRF added locally each as a sole filling material on induced bone defect and evaluate the combined effect using PRF loaded with SIM. MATERIALS AND METHODS: A critical size bone defect was induced in 48 male albino rats of average weight 150-200 g and were divided into 4 groups according to the filling material. Control, PRF, SIM, and SIM/PRF group. Each group was subdivided according to the sacrificing period into two subgroups (one and two-months postoperatively). Tibial specimens were evaluated histologically using masson trichrome (MT) special stain to detect areas of new bone formation, immunohistochemically using anti- BMP2 and anti-VEGF, serum levels of Osteoprotegerin (OPG), RANKL, osteocalcin and alkaline phosphatase enzyme (ALP) were measured one and two months postoperatively using ELISA, Finally bone mineral density (BMD) at the bone defect area was analyzed using digital X-ray one and two-months postoperatively. RESULTS: The percentage of newly formed bone increased significantly in the three groups vs the control group with the highest significant increase (p < 0.001) in the SIM/PRF group one month postoperatively. Also, SIM/PRF group was the only group which showed significant bone maturation two-months postoperatively compared to the other groups. Immunohistochemical analysis showed significant increase in positively stained BMP-2 and VEGF expression (p < 0.001) in the three groups vs the control group with the highest significant increase (p < 0.001) in the SIM/PRF group. Serum bone anabolic markers increased significantly in the SIM and SIM/PRF groups. In contrast, RANKL serum level decreased significantly in the SIM and SIM/PRF group one month postoperatively with no significant decrease in the PRF group vs the control group. Digital X-ray results revealed the highest BMD percent change was found in the SIM/PRF group and showed complete bone healing two-months postoperatively.
Collapse
Affiliation(s)
- Shereen N Raafat
- Department of Pharmacology and Toxicology, Faculty of Dentistry, The British University in Egypt (BUE), Egypt.
| | - Reham M Amin
- Department of Oral Biology, Faculty of Dentistry, The British University in Egypt (BUE), Egypt
| | - M M Elmazar
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, The British University in Egypt (BUE), Egypt
| | - Mahmoud M Khattab
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Egypt
| | - Aiman S El-Khatib
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Egypt
| |
Collapse
|
12
|
Kim AR, Kim JH, Kim A, Sohn Y, Cha JH, Bak EJ, Yoo YJ. Simvastatin attenuates tibial bone loss in rats with type 1 diabetes and periodontitis. J Transl Med 2018; 16:306. [PMID: 30413166 PMCID: PMC6230277 DOI: 10.1186/s12967-018-1681-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/06/2018] [Indexed: 02/02/2023] Open
Abstract
Background Diabetes induces long bone loss and aggravation of periodontitis-induced alveolar bone loss. Simvastatin (SIM), which is a lipid-lowering agent is known to have an anabolic effect on bone. Therefore, we investigated effect of SIM on tibial and alveolar bone loss in type 1 diabetic rats with periodontitis. Methods Rats were divided into control (C), diabetes with periodontitis (DP), and diabetes with periodontitis treated with SIM (DPS) groups. DP and DPS groups were intravenously injected with streptozotocin (50 mg/kg), and C group was injected with citrate buffer. Seven days later (day 0), periodontitis was induced by ligatures of mandibular first molars. DP and DPS groups were orally administered vehicle or SIM (30 mg/kg) from day 0 to days 3, 10, or 20. Alveolar and tibial bone loss was measured using histological and m-CT analysis alone or in combination. Osteoclast number and sclerostin-positive osteocytes in tibiae were evaluated by tartrate-resistant acid phosphatase and immunohistochemical staining, respectively. Glucose, triglyceride (TG), cholesterol (CHO), and low-density lipoprotein (LDL) were evaluated. Results Consistent with diabetes induction, the DP group showed higher glucose and TG levels at all timepoints and higher CHO levels on day 20 than C group. Compared to the DP group, the DPS group exhibited reduced levels of glucose (day 3), TG (days 10 and 20), CHO, and LDL levels (day 20). Bone loss analysis revealed that the DP group had lower bone volume fraction, bone mineral density, bone surface density, and trabecular number in tibiae than C group at all timepoints. Interestingly, the DPS group exhibited elevation of these indices at early stages compared to the DP group. The DPS group showed reduction of osteoclasts (day 3) and sclerostin-positive osteocytes (days 3 and 20) compared with the DP group. There was no difference in alveolar bone loss between DP and DPS groups. Conclusions These results suggest that SIM attenuates tibial, but not alveolar bone loss in type 1 diabetic rats with periodontitis. Moreover, attenuation of tibial bone loss by SIM may be related to inhibition of osteoclast formation and reduction of sclerostin expression.
Collapse
Affiliation(s)
- Ae Ri Kim
- Department of Oral Biology, Yonsei University College of Dentistry, 134 Sinchon dong, Seodaemun-gu, Seoul, 120-752, Republic of Korea.,Department of Applied Life Science, The Graduate School, Yonsei University, Seoul, Republic of Korea.,BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Ji-Hye Kim
- Department of Dental Hygiene, Jeonju Kijeon College, Jeonju, Republic of Korea
| | - Aeryun Kim
- Department of Applied Life Science, The Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Yongsung Sohn
- DONG-A Pharm, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Jeong-Heon Cha
- Department of Oral Biology, Yonsei University College of Dentistry, 134 Sinchon dong, Seodaemun-gu, Seoul, 120-752, Republic of Korea.,Department of Applied Life Science, The Graduate School, Yonsei University, Seoul, Republic of Korea.,BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea.,Microbiology and Molecular Biology, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Eun-Jung Bak
- Department of Oral Biology, Yonsei University College of Dentistry, 134 Sinchon dong, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
| | - Yun-Jung Yoo
- Department of Oral Biology, Yonsei University College of Dentistry, 134 Sinchon dong, Seodaemun-gu, Seoul, 120-752, Republic of Korea. .,Department of Applied Life Science, The Graduate School, Yonsei University, Seoul, Republic of Korea.
| |
Collapse
|
13
|
Artas G, Gul M, Acikan I, Kirtay M, Bozoglan A, Simsek S, Yaman F, Dundar S. A comparison of different bone graft materials in peri-implant guided bone regeneration. Braz Oral Res 2018; 32:e59. [PMID: 29995064 DOI: 10.1590/1807-3107bor-2018.vol32.0059] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 05/16/2018] [Indexed: 01/15/2023] Open
Abstract
The aim of this study was to compare the effects of hydroxyapatite (HA), deproteinized bovine bone (DPB), human-derived allogenic bone (HALG), and calcium sulfate (CAP) graft biomaterials used with titanium barriers for bone augmentation to treat peri-implant defects in rat calvarium treated by guided bone regeneration (GBR). Thirty-two female Sprague-Dawley rats were divided into four groups: DPB, HALG, HA, and CAP. One titanium barrier was fixed to each rat's calvarium after the titanium implants had been fixed. In total, 32 titanium implants and barriers were used. Ninety days after the surgical procedure, all the barriers were removed. After decalcification of bone tissue, the titanium implants were removed gently, and new bone regeneration in the peri-implant area was analyzed histologically. Immunohistochemical staining of vascular endothelial growth factor (VEGF) was also performed. There were no statistically significant between-group differences in new bone regeneration or VEGF expression after 3 months. According to the results of the histological and immunohistochemical analyses, none of the grafts used in this study showed superiority with respect to new bone formation.
Collapse
Affiliation(s)
- Gokhan Artas
- Firat University, Faculty of Medicine, Department of Medical Pathology, Elazig, Turkey
| | - Mehmet Gul
- Harran University, Faculty of Dentistry, Department of Periodontology, Sanliurfa, Turkey
| | - Izzet Acikan
- Sütcü Imam University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Kahramanmaras, Turkey
| | - Mustafa Kirtay
- Private Practice, Oral and Maxillofacial Surgery, Toronto, Canada
| | - Alihan Bozoglan
- Firat University, Faculty of Dentistry, Department of Periodontology, Elazig, Turkey
| | - Sercan Simsek
- Ministry of Health, Tunceli State Hospital, Department of Medical Pathology, Tunceli, Turkey
| | - Ferhan Yaman
- Private Practice, Oral and Maxillofacial Surgery, Diyarbakir, Turkey
| | - Serkan Dundar
- Firat University, Faculty of Dentistry, Department of Periodontology, Elazig, Turkey
| |
Collapse
|
14
|
Caliaperoumal G, Souyet M, Bensidhoum M, Petite H, Anagnostou F. Type 2 diabetes impairs angiogenesis and osteogenesis in calvarial defects: MicroCT study in ZDF rats. Bone 2018; 112:161-172. [PMID: 29702250 DOI: 10.1016/j.bone.2018.04.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The present study was motivated by the fact that bone regeneration in the compromised vascular microenvironment of T2DM is challenging and the factors that determine the adverse bone regeneration outcomes are poorly understood. For this purpose the effect of T2DM on osteogenic and angiogenic healing potential of calvarial bone, was evaluated in Zucker diabetic fatty (ZDF) rats, an established rat model for obese T2DM. MATERIALS AND METHODS The study used 16-week-old ZDF rats and their age-matched controls, Zucker Lean (ZL). Circular defects of different sizes were created on the animal calvaria, either a single 8-mm-diameter (n = 6) defect, or 6-4-2-mm-diameter multidefects (n = 6). Bone regeneration was evaluated at 0, 4, 6 and 8 weeks post surgery using in vivo micro-CT and after animal sacrifice using ex vivo micro-CT. Vascular network parameters within the defects, were quantified by perfusing the animal vasculature with microfil® and scanning it after decalcification. RESULTS Compared to results obtained from the ZL rats, defects of 8-mm-diameter in ZDF rats displayed impaired healing kinetics and significantly reduced newly formed bone volume (p < 0.01) and surface area (p < 0.01), 8 weeks post surgery. Defects of 6-4-2-mm-diameter exhibited bone formation, which was independent of either the size or the diabetic condition. Compared to results from the ZL, in the ZDF rats, vasculature volume and surface area were significantly (p < 0.05) reduced in all size-defects. CONCLUSION The present study provided evidence that T2DM impairs bone formation in critical-size calvarial defects and markedly reduces angiogenesis in all defects regardless of the defect size tested.
Collapse
Affiliation(s)
- Guavri Caliaperoumal
- Laboratoire de Bioingénierie et Biomécanique Ostéo-articulaires, UMR CNRS 7052, CNRS INSIS, Université Paris Diderot Sorbonne Paris Cité, Paris, France
| | - Maité Souyet
- Laboratoire de Bioingénierie et Biomécanique Ostéo-articulaires, UMR CNRS 7052, CNRS INSIS, Université Paris Diderot Sorbonne Paris Cité, Paris, France
| | - Morad Bensidhoum
- Laboratoire de Bioingénierie et Biomécanique Ostéo-articulaires, UMR CNRS 7052, CNRS INSIS, Université Paris Diderot Sorbonne Paris Cité, Paris, France
| | - Herve Petite
- Laboratoire de Bioingénierie et Biomécanique Ostéo-articulaires, UMR CNRS 7052, CNRS INSIS, Université Paris Diderot Sorbonne Paris Cité, Paris, France
| | - Fani Anagnostou
- Laboratoire de Bioingénierie et Biomécanique Ostéo-articulaires, UMR CNRS 7052, CNRS INSIS, Université Paris Diderot Sorbonne Paris Cité, Paris, France; Department of Periodontology, Service of Odontology, Pitié Salpêtrière Hospital, U.F.R. of Odontology Paris 7-Denis Diderot University, Sorbonne Paris Cité Paris, France.
| |
Collapse
|
15
|
Hu Z, Ma C, Rong X, Zou S, Liu X. Immunomodulatory ECM-like Microspheres for Accelerated Bone Regeneration in Diabetes Mellitus. ACS APPLIED MATERIALS & INTERFACES 2018; 10:2377-2390. [PMID: 29280610 PMCID: PMC6437671 DOI: 10.1021/acsami.7b18458] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Bone repair and regeneration process is markedly impaired in diabetes mellitus (DM) that affects hundreds of millions of people worldwide. As a chronic inflammatory disease, DM creates a proinflammatory microenvironment in defective sites. Most of the studies on DM-associated bone regeneration, however, neglect the importance of immunomodulation under the DM condition and adopt the same approaches to normal bone healing, leading to limited bone healing. In this study, we developed a unique bioinspired injectable microsphere as an osteoimmunomodulatory biomaterial that modulates macrophages to create a prohealing microenvironment under the DM condition. The microsphere was self-assembled with heparin-modified gelatin nanofibers, and interleukin 4 (IL4) was incorporated into the nanofibrous heparin-modified gelatin microsphere (NHG-MS). IL4 has binding domains with heparin, and the binding of IL4 to heparin stabilizes this cytokine, protects it from denaturation and degradation, and subsequently prolongs its sustained release to modulate macrophage polarization. The IL4-loaded NHG-MS switched the proinflammatory M1 macrophage into a prohealing M2 phenotype, recovered the M2/M1 ratio to a normal level, efficiently resolved the inflammation, and ultimately enhanced osteoblastic differentiation and bone regeneration. The development of osteoimmunomodulatory biomaterials that harness the power of macrophages for immunomodulation, therefore, is a novel and promising strategy to enhance bone regeneration under DM condition.
Collapse
Affiliation(s)
- Zhiai Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, Texas 75246, United States
| | - Chi Ma
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, Texas 75246, United States
| | - Xin Rong
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Shujuan Zou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Corresponding Authors (S.Z.)., (X.L.)
| | - Xiaohua Liu
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, Texas 75246, United States
- Corresponding Authors (S.Z.)., (X.L.)
| |
Collapse
|
16
|
Nahass HE, Din NNE, Nasry SA. The Effect of Strontium Ranelate Gel on Bone Formation in Calvarial Critical Size Defects. Open Access Maced J Med Sci 2017; 5:994-999. [PMID: 29362634 PMCID: PMC5771310 DOI: 10.3889/oamjms.2017.164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/01/2017] [Accepted: 11/22/2017] [Indexed: 12/17/2022] Open
Abstract
AIM: The current study was designed to investigate the effectiveness of locally applied Strontium ranelate to induce bone formation. MATERIALS AND METHODS: Forty-eight female rats were divided into six groups (eight rats in each group): The three test groups included Strontium (SR) 2.5 mg, 5 mg and 10 mg that was dissolved in methylcellulose gel. The control groups included methylcellulose, simvastatin 5 mg and a negative control where the defect was left to heal without any intervention. At 44 days the groups were sacrificed, and the bone defects were assessed histomorphometically to assess bone formation. The data was statistically analysed. RESULTS: There was a statistically significant difference in the amount of new bone formation between all groups, where the 2.5 mg SR group showed the highest median bone percentage, is 41.95 %, followed by the 5, and 10 mg SR demonstrating a median bone are a percentage of 39.89%, and 30.19% respectively. Simvastatin showed a median bone percentage of 36.07 %, while the methylcellulose and the negative control groups demonstrated the lowest median area percentage of 23.12 and 20.70 % respectively. CONCLUSIONS: The study showed that the local application of an SR could up-regulate the bone formation and may prove to be a cost-effective method of bone regeneration.
Collapse
Affiliation(s)
- Hani El Nahass
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nada Nour El Din
- Department of Oral Pathology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | | |
Collapse
|
17
|
Moshiri A, Sharifi AM, Oryan A. Role of Simvastatin on fracture healing and osteoporosis: a systematic review on in vivo investigations. Clin Exp Pharmacol Physiol 2017; 43:659-84. [PMID: 27061579 DOI: 10.1111/1440-1681.12577] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 04/04/2016] [Accepted: 04/05/2016] [Indexed: 01/15/2023]
Abstract
Simvastatin is a lipid lowering drug whose beneficial role on bone metabolism was discovered in 1999. Several in vivo studies evaluated its role on osteoporosis and fracture healing, however, controversial results are seen in the literature. For this reason, Simvastatin has not been the focus of any clinical trials as yet. This systematic review clears the mechanisms of action of Simvastatin on bone metabolism and focuses on in vivo investigations that have evaluated its role on osteoporosis and fracture repair to find out (i) whether Simvastatin is effective on treatment of osteoporosis and fracture repair, and (ii) which of the many available protocols may have the ability to be translated in the clinical setting. Simvastatin induces osteoinduction by increasing osteoblast activity and differentiation and inhibiting their apoptosis. It also reduces osteoclastogenesis by decreasing both the number and activity of osteoclasts and their differentiation. Controversial results between the in vivo studies are mostly due to the differences in the route of administration, dose, dosage and carrier type. Local delivery of Simvastatin through controlled drug delivery systems with much lower doses and dosages than the systemic route seems to be the most valuable option in fracture healing. However, systemic delivery of Simvastatin with much higher doses and dosages than the clinical ones seems to be effective in managing osteoporosis. Simvastatin, in a particular range of doses and dosages, may be beneficial in managing osteoporosis and fracture injuries. This review showed that Simvastatin is effective in the treatment of osteoporosis and fracture healing.
Collapse
Affiliation(s)
- Ali Moshiri
- RAZI Drug Research Centre, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammad Sharifi
- RAZI Drug Research Centre, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Tissue Engineering Group, Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ahmad Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz, Iran
| |
Collapse
|
18
|
Magan‐Fernandez A, Fernández‐Barbero JE, O’ Valle F, Ortiz R, Galindo‐Moreno P, Mesa F. Simvastatin exerts antiproliferative and differentiating effects on MG63 osteoblast‐like cells: Morphological and immunocytochemical study. J Periodontal Res 2017; 53:91-97. [DOI: 10.1111/jre.12491] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A. Magan‐Fernandez
- Department of Periodontics School of Dentistry University of Granada Granada Spain
| | - J. E. Fernández‐Barbero
- Department of Human Anatomy and Embryology School of Medicine (IBIMER, CIBM) University of Granada Granada Spain
| | - F. O’ Valle
- Department of Pathology School of Medicine (IBIMER, CIBM) University of Granada Granada Spain
| | - R. Ortiz
- Department of Human Anatomy and Embryology School of Health Sciences (IBIMER, CIBM) University of Jaen Andalucía Spain
| | - P. Galindo‐Moreno
- Department of Oral Surgery and Implant Dentistry School of Dentistry University of Granada Andalucía Spain
| | - F. Mesa
- Department of Periodontics School of Dentistry University of Granada Granada Spain
| |
Collapse
|
19
|
Ishihara T, Miyazaki M, Notani N, Kanezaki S, Kawano M, Tsumura H. Locally Applied Simvastatin Promotes Bone Formation in a Rat Model of Spinal Fusion. J Orthop Res 2017; 35:1942-1948. [PMID: 27862237 DOI: 10.1002/jor.23479] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/07/2016] [Indexed: 02/04/2023]
Abstract
Simvastatin, an inexpensive lipid-lowering drug widely used to prevent cardiovascular disorders, is known to increase osteoblastic activity, inhibit osteoclastic activity, and stimulate osteoblastic production of bone morphogenetic protein 2. Furthermore, local simvastatin application increased bone formation in animal models of fracture or bone defects. We investigated the effect of locally applied simvastatin in a rat model of spinal fusion. We performed posterolateral lumbar fusion surgery with iliac crest autograft in 36 rats divided into group I (n = 17; implanted with a gelatin scaffold) and group II (n = 19; implanted with a gelatin scaffold infused with 0.5 mg simvastatin). The rats were euthanized at 6 or 12 weeks postoperatively, and the spines were explanted and assessed. The fusion rates in group II (16.7%: 6 weeks, 30%: 12 weeks) were considerably higher than those in groups I (0%: 6 weeks, 0%: 12 weeks). The 6- and 12-week radiographic scores were significantly higher in group II than in group I. High-resolution micro-computerized tomography revealed that the tissue and bone volumes of the callus tended to be higher in group II than in group I. Histologic analysis of the spines explanted after 12 weeks demonstrated new bone formation between the transverse processes in group II, but thicker and wider individual trabeculae with fibrotic tissue and muscle fiber between the transverse processes in group I. Locally applied simvastatin was efficacious in accelerating bone formation in our rat model of spinal fusion, supporting its potential clinical application as a promoter of bone morphogenesis in spinal fusion. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1942-1948, 2017.
Collapse
Affiliation(s)
- Toshinobu Ishihara
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| | - Masashi Miyazaki
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| | - Naoki Notani
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| | - Shozo Kanezaki
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| | - Masanori Kawano
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| | - Hiroshi Tsumura
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| |
Collapse
|
20
|
Ungaro F, Catanzano O, d'Angelo I, Diaz-Gomez L, Concheiro A, Miro A, Alvarez-Lorenzo C, Quaglia F. Microparticle-embedded fibroin/alginate beads for prolonged local release of simvastatin hydroxyacid to mesenchymal stem cells. Carbohydr Polym 2017; 175:645-653. [PMID: 28917913 DOI: 10.1016/j.carbpol.2017.08.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 07/31/2017] [Accepted: 08/09/2017] [Indexed: 12/21/2022]
Abstract
In the present work, we propose silk fibroin/alginate (SF/Alg) beads embedding simvastatin-loaded biodegradable microparticles as a versatile platform capable of tuning SVA release and in so doing osteogenic effects. In a first part of the study, microparticles of poly(lactic-co-glycolic) acid incorporating simvastatin either as lactone (SVL) or as hydroxyacid form (SVA) were prepared by spray-drying. While SVA-loaded microparticles released the drug in three days, long-term release of SVA could be obtained from SVL-loaded microparticles. In this latter case, SVL was promptly transformed to the osteogenic active SVA during release. When tested on mesenchymal stem cells, a time- and dose-dependent effect of SVL-loaded microparticles on cell proliferation and alkaline phosphatase (ALP) activity was found. Thereafter, SVL-loaded microparticles were embedded in SF/Alg beads to limit the initial simvastatin burst and to achieve easier implantation as well. Microparticle-embedded beads showed no cytotoxicity while ALP activity increased. If correctly exploited, the developed system may be suitable as osteogenic polymer scaffolds releasing correct amount of the drug locally for long time-frames.
Collapse
Affiliation(s)
- F Ungaro
- Drug Delivery Laboratory, Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Napoli, Italy
| | - O Catanzano
- Drug Delivery Laboratory, Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Napoli, Italy
| | - I d'Angelo
- Di.S.T.A.B.i.F., University of Campania "Luigi Vanvitelli", Via Vivaldi 43, 81100 Caserta, Italy
| | - L Diaz-Gomez
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, R+D Pharma Group (GI-1645), Facultad de Farmacia and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - A Concheiro
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, R+D Pharma Group (GI-1645), Facultad de Farmacia and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - A Miro
- Drug Delivery Laboratory, Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Napoli, Italy.
| | - C Alvarez-Lorenzo
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, R+D Pharma Group (GI-1645), Facultad de Farmacia and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain.
| | - F Quaglia
- Drug Delivery Laboratory, Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Napoli, Italy
| |
Collapse
|
21
|
Ezirganli S, Kazancioglu HO, Ozdemir H, Inan DS, Tek M. The Effects of Nigella Sativa Seed Extract on Bone Healing in an Experimental Model. J Craniofac Surg 2017; 27:1905-1909. [PMID: 27513784 DOI: 10.1097/scs.0000000000002986] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to histologically evaluate the effects on bone healing of nigella sativa seed extract applied on calvarial defects in an ovariectomized rat model. The study included 32 female rats weighing 280 to 310 g with an average age of 3 months. A defect was created with a trephine burr on each rat calvarium. The rats were divided into 2 groups (control and study) of 8 animals each. All the defects were grafted with a gelatin sponge mixed with normal saline. In the study group, nigella sativa seed extract was applied systemically using an oro-gastric tube. Half of the animals in each group were sacrificed after 2 weeks, and the others after 4 weeks. In the control groups, the defects were not completely filled with regenerated bone. Osteoblast cells were observed more in the study groups. A higher rate of osteoclasts was determined in the control groups. In addition, the nigella sativa group had a statistically greater amount of bone formation than the others group at both 2 weeks and 4 weeks (P <0.05). The systemic application of nigella sativa seed extract demonstrated incredibly positive effects on enhanced bone healing in this experimental osteoporotic model.
Collapse
Affiliation(s)
- Seref Ezirganli
- *Nişantasi University †Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul ‡Department of Periodontology, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir §Department of Histology and Embryology, Faculty of Medicine, Cumhuriyet University, Sivas
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey
| | | | | | | | | |
Collapse
|
22
|
Ezirganli Ş, Kazancioğlu HO, Acar AH, Özdemir H, Kuzu E, İnan DŞ. Effects of Ankaferd BloodStopper on bone healing in an ovariectomized osteoporotic rat model. Exp Ther Med 2017; 13:1827-1831. [PMID: 28565774 PMCID: PMC5443307 DOI: 10.3892/etm.2017.4166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 10/28/2016] [Indexed: 12/21/2022] Open
Abstract
Bone defects resulting from oncological surgical resections, congenital facial anomalies, trauma or infection represent a significant and common clinical problem. The present study aimed to evaluate the effects of a commercially-available medicinal plant extract product, Ankaferd BloodStopper (ABS), on bone healing. The present study was performed on 24 female ovariectomized (OVX) rats. A defect on each rat calvarium was created using a trephine burr prior to the rats being divided into two groups. Defects were grafted with a gelatin sponge soaked with normal saline (control group) or plant extract (experimental group). Half of the animals were sacrificed after 2 weeks and the others after 4 weeks. In the control group, the defects were not filled with regenerated bone. By contrast, in the experimental group, all defect areas had an increased amount of regenerated bone and connective tissue. Osteoblastic activity appeared to be greater in the experimental group however, osteoclastic activity was observed to be higher in the control group. At 2 and 4 weeks, there was a significant difference in the amount of newly regenerated bone observed in the experimental group compared with the control group (P<0.05). Therefore, the results of the present study indicated that local ABS application had a positive effect on bone healing in the OVX rat model.
Collapse
Affiliation(s)
- Şeref Ezirganli
- Program of Dental Assisting, Vocational School of Health Services, Institute of Health Science, Nişantası University, Bayrampaşa, 34030 Istanbul, Turkey
| | - Hakki Oğuz Kazancioğlu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Ahmet Hüseyin Acar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Hakan Özdemir
- Department of Periodontology, Faculty of Dentistry, Osmangazi University, 26480 Eskişehir, Turkey
| | - Emre Kuzu
- Dental Health Centre of Sivas, Rebublic of Turkey Ministry of Health, 58020 Sivas, Turkey
| | - Deniz Şahin İnan
- Department of Histology and Embryology, Faculty of Medicine, Cumhuriyet University, 58140 Sivas, Turkey
| |
Collapse
|
23
|
Kumari M, Martande SS, Pradeep A, Naik SB. Efficacy of Subgingivally Delivered 1.2% Atorvastatin in the Treatment of Chronic Periodontitis in Patients With Type 2 Diabetes Mellitus: A Randomized Controlled Clinical Trial. J Periodontol 2016; 87:1278-1285. [DOI: 10.1902/jop.2016.130227] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
24
|
Evaluation of the effects of platelet-rich fibrin on bone regeneration in diabetic rabbits. J Craniomaxillofac Surg 2016; 44:126-33. [DOI: 10.1016/j.jcms.2015.11.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/14/2015] [Accepted: 11/20/2015] [Indexed: 01/05/2023] Open
|
25
|
Zhang P, Han F, Li Y, Chen J, Chen T, Zhi Y, Jiang J, Lin C, Chen S, Zhao P. Local delivery of controlled-release simvastatin to improve the biocompatibility of polyethylene terephthalate artificial ligaments for reconstruction of the anterior cruciate ligament. Int J Nanomedicine 2016; 11:465-78. [PMID: 26869789 PMCID: PMC4734794 DOI: 10.2147/ijn.s95032] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The Ligament Advanced Reinforcement System has recently been widely used as the primary graft of choice in anterior cruciate ligament (ACL) reconstruction. But the biological graft-bone healing still remains a problem. Previous studies have shown that simvastatin (SIM) stimulates bone formation. The objective of this study was to investigate whether surface coating with collagen containing low-dose SIM microsphere could enhance the surface biocompatibility of polyethylene terephthalate (PET) artificial ligaments to accelerate graft-to-bone healing. The in vitro studies demonstrated that bone marrow stromal cells on the collagen-coated PET scaffolds (COL/PET) and simvastatin/collagen-coated PET scaffolds (SIM/COL/PET) proliferated vigorously. Compared with the PET group and the COL/PET group, SIM could induce bone marrow stromal cells' osteoblastic differentiation, high alkaline phosphatase activity, more mineralization deposition, and more expression of osteoblast-related genes, such as osteocalcin, runt-related transcription factor 2, bone morphogenetic protein-2, and vascular endothelial growth factor, in the SIM/COL/PET group. In vivo, rabbits received ACL reconstruction with different scaffolds. Histological analysis demonstrated that graft-bone healing was significantly greater with angiogenesis and osteogenesis in the SIM/COL/PET group than the other groups. In addition, biomechanical testing at the eighth week demonstrated a significant increase in the ultimate failure load and stiffness in the SIM/COL/PET group. The low dose of SIM-sustained release from SIM/COL/PET promoted the graft-bone healing via its effect on both angiogenesis and osteogenesis. This study suggested that collagen containing low-dose SIM microsphere coating on the surface of PET artificial ligaments could be potentially applied for ACL reconstruction.
Collapse
Affiliation(s)
- Peng Zhang
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Fei Han
- Shanghai East Hospital, The Institute for Biomedical Engineering and Nanoscience, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Yunxia Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jiwu Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Tianwu Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Yunlong Zhi
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jia Jiang
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Chao Lin
- Shanghai East Hospital, The Institute for Biomedical Engineering and Nanoscience, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Shiyi Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Peng Zhao
- Shanghai East Hospital, The Institute for Biomedical Engineering and Nanoscience, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| |
Collapse
|
26
|
Liu C, Sun J. Hydrolyzed tilapia fish collagen induces osteogenic differentiation of human periodontal ligament cells. Biomed Mater 2015; 10:065020. [DOI: 10.1088/1748-6041/10/6/065020] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
27
|
Bone critical defect repair with poloxamine-cyclodextrin supramolecular gels. Int J Pharm 2015; 495:463-473. [PMID: 26362078 DOI: 10.1016/j.ijpharm.2015.09.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/03/2015] [Accepted: 09/05/2015] [Indexed: 11/23/2022]
Abstract
The aim of this study was to evaluate the osteoinductive capacity of a poloxamine (Tetronic(®) 908, T) and α-cyclodextrin (αCD) supramolecular gel (T-CD) as scaffold in a critical size defect in rat calvaria. The T-CD gel was evaluated solely and after being loaded with simvastatin (SV) and bone morphogenetic protein (BMP-2) separately and in combinations in order to reduce the doses of the active substances. Three doses of SV (7.5, 75, 750 μg) and two doses of BMP-2 (3 and 6 μg) were tested. The histology and histomorphometrical analysis showed improved bone repair with T-CD compared to T, probably due to better release control of both SV and BMP-2. In addition, as T-CD eroded more slowly than poloxamine alone, it remained longer in the defect site. Although synergism was not obtained with BMP-2 and SV, according to the observed regeneration of the defect, the dose of BMP-2 and SV can be reduced to 3 μg and 7.5 μg, respectively.
Collapse
|
28
|
Effects of oestrogen deficiency and 17β-estradiol therapy on bone healing in calvarial critical size defects treated with bovine bone graft. Arch Oral Biol 2015; 60:631-41. [DOI: 10.1016/j.archoralbio.2015.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/23/2014] [Accepted: 01/20/2015] [Indexed: 11/20/2022]
|
29
|
Kyllönen L, D’Este M, Alini M, Eglin D. Local drug delivery for enhancing fracture healing in osteoporotic bone. Acta Biomater 2015; 11:412-34. [PMID: 25218339 DOI: 10.1016/j.actbio.2014.09.006] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/30/2014] [Accepted: 09/04/2014] [Indexed: 01/08/2023]
Abstract
Fragility fractures can cause significant morbidity and mortality in patients with osteoporosis and inflict a considerable medical and socioeconomic burden. Moreover, treatment of an osteoporotic fracture is challenging due to the decreased strength of the surrounding bone and suboptimal healing capacity, predisposing both to fixation failure and non-union. Whereas a systemic osteoporosis treatment acts slowly, local release of osteogenic agents in osteoporotic fracture would act rapidly to increase bone strength and quality, as well as to reduce the bone healing period and prevent development of a problematic non-union. The identification of agents with potential to stimulate bone formation and improve implant fixation strength in osteoporotic bone has raised hope for the fast augmentation of osteoporotic fractures. Stimulation of bone formation by local delivery of growth factors is an approach already in clinical use for the treatment of non-unions, and could be utilized for osteoporotic fractures as well. Small molecules have also gained ground as stable and inexpensive compounds to enhance bone formation and tackle osteoporosis. The aim of this paper is to present the state of the art on local drug delivery in osteoporotic fractures. Advantages, disadvantages and underlying molecular mechanisms of different active species for local bone healing in osteoporotic bone are discussed. This review also identifies promising new candidate molecules and innovative approaches for the local drug delivery in osteoporotic bone.
Collapse
|
30
|
Ezirganli S, Kazancioglu HO, Mihmanli A, Sharifov R, Aydin MS. Effects of different biomaterials on augmented bone volume resorptions. Clin Oral Implants Res 2014; 26:1482-8. [DOI: 10.1111/clr.12495] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Seref Ezirganli
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; Bezmialem Vakif University; İstanbul Turkey
| | - Hakki O. Kazancioglu
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; Bezmialem Vakif University; İstanbul Turkey
| | - Ahmet Mihmanli
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; Bezmialem Vakif University; İstanbul Turkey
| | - Rasul Sharifov
- Department of Radiology; Faculty of Medicine; Bezmialem Vakif University; İstanbul Turkey
| | - Mehmet S. Aydin
- Department of Histology and Embryology; Faculty of Medicine; Bezmialem Vakif University; İstanbul Turkey
| |
Collapse
|
31
|
Tai IC, Fu YC, Wang CK, Chang JK, Ho ML. Local delivery of controlled-release simvastatin/PLGA/HAp microspheres enhances bone repair. Int J Nanomedicine 2013; 8:3895-904. [PMID: 24143094 PMCID: PMC3798145 DOI: 10.2147/ijn.s48694] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Statins are used clinically for reduction of cholesterol synthesis to prevent cardiovascular disease. Previous in vitro and in vivo studies have shown that statins stimulate bone formation. However, orally administered statins may be degraded during first-pass metabolism in the liver. This study aimed to prevent this degradation by developing a locally administered formulation of simvastatin that is encapsulated in poly(lactic-co-glycolic acid)/hydroxyapatite (SIM/PLGA/HAp) microspheres with controlled-release properties. The effect of this formulation of simvastatin on bone repair was tested using a mouse model of gap fracture bridging with a graft of necrotic bone. The simvastatin released over 12 days from 3 mg and 5 mg of SIM/PLGA/HAp was 0.03-1.6 μg/day and 0.05-2.6 μg/day, respectively. SIM/PLGA/HAp significantly stimulated callus formation around the repaired area and increased neovascularization and cell ingrowth in the grafted necrotic bone at week 2 after surgery. At week 4, both 3 mg and 5 mg of SIM/PLGA/HAp increased neovascularization, but only 5 mg SIM/PLGA/HAp enhanced cell ingrowth into the necrotic bone. The low dose of simvastatin released from SIM/PLGA/HAp enhanced initial callus formation, neovascularization, and cell ingrowth in the grafted bone, indicating that SIM/PLGA/HAp facilitates bone regeneration. We suggest that SIM/PLGA/HAp should be developed as an osteoinductive agent to treat osteonecrosis or in combination with an osteoconductive scaffold to treat severe bone defects.
Collapse
Affiliation(s)
- I-Chun Tai
- Graduate Institute of Medicine, College of Life Science, Kaohsiung Medical University, Taiwan ; Department of Physiology, College of Life Science, Kaohsiung Medical University, Taiwan ; Orthopedic Research Center, College of Medicine, College of Life Science, Kaohsiung Medical University, Taiwan
| | | | | | | | | |
Collapse
|