Reducing allograft contamination and disease transmission: intraosseous temperatures of femoral head allografts during autoclaving

Nanofibrous 3D Scaffolds Capable of Individually Controlled BMP and FGF Release for the Regulation of Bone Regeneration

The current clinical applications of bone morphogenetic proteins (BMPs) are limited to only a few specific indications. Locally controlled delivery of combinations of growth factors can be a promising strategy to improve BMP-based bone repair. However, the success of this approach requires the development of an effective release system and the correct choice of growth factors capable of enhancing BMP activity. Basic fibroblast growth factor (bFGF, also known as FGF-2) has shown promise in promoting bone repair, although conflicting results have been reported. Considering the complex biological activities of FGF-2, we hypothesized that FGF-2 can promote BMP-induced bone regeneration only if the dosage and kinetic parameters of the two factors are individually tailored. In this study, we conducted systematic in vitro studies on cell proliferation, differentiation, and mineralization in response to factor dose, delivery mode (sequential or simultaneous), and release rate. Subsequently, we designed individually controlled BMP-7 and FGF-2 release poly(lactide-co-glycolide) (PLGA) nanospheres attached to the poly(l-lactic acid) (PLLA) nanofibrous scaffolds. The data showed that BMP-7-induced bone formation was accelerated by a relatively higher FGF-2 dose (100 ng/scaffold) delivered at a faster release rate, or by a relatively lower FGF-2 dose (10 ng/scaffold) at a slower release rate in an in vivo bone regeneration model. In contrast, a very high dose of FGF-2 (1000 ng/scaffold) inhibited bone regeneration under all conditions. In vitro and in vivo data suggest that FGF-2 improved BMP-7-induced bone regeneration by coordinating FGF-2 dosage and release kinetics to enhance stem cell migration, proliferation, and angiogenesis. STATEMENT OF SIGNIFICANCE: Bone morphogenetic proteins (BMPs) are the most potent growth/differentiation factors in bone development and regeneration. However, the clinical applications of BMPs have been limited to only a few specific indications due to the required supraphysiological dosages with the current BMP products and their side effects. Locally controlled delivery of BMPs and additional growth factors that can enhance their osteogenic potency are highly desired. However, different growth factors act with different mechanisms. Here we report a nanofibrous scaffold that mimics collagen in size and geometry and is immobilized with biodegradable nanospheres to achieve local and distinct release profiles of BMP7 and FGF2. Systematic studies demonstrated low dose BMP7 and FGF2 with different temporal release profiles can optimally enhance bone regeneration.

Bone morphogenetic protein-2 loaded triple helix recombinant collagen-based hydrogels for enhancing bone defect healing

The development of efficacious bone substitute biomaterials remains a major challenge for research and clinical surgical. Herein, we constructed triple helix recombinant collagen (THRC) -based hydrogels loading bone morphogenetic protein-2 (BMP-2) to stimulate bone regeneration in cranial defects. A series of in situ forming hydrogels, denoted as THRC-oxidized carboxymethylcellulose (OCMC)-N-succinyl-chitosan (NSC) hydrogels, was synthesized via a Schiff base reaction involving OCMC, THRC and NSC. The hydrogels underwent rapid formation under physiological pH and temperature conditions. The composite hydrogel exhibits a network structure characterized by uniform pores, the dimensions of which can be tuned by varying THRC concentrations. The THRC-OCMC-NSC and THRC-OCMC-NSC-BMP2 hydrogels display heightened mechanical strength, substantial biodegradability, and lower swelling properties. The THRC-OCMC-NSC hydrogels show exceptional biocompatibility and bioactivity, accelerating cell proliferation, adhesion, and differentiation. Magnetic resonance imaging, computed tomography and histological analysis of rat cranial defects models revealed that the THRC-OCMC-NSC-BMP2 hydrogels substantially promote new bone formation and expedite bone regeneration. The novel THRC-OCMC-NSC-BMP2 hydrogels emerge as promising candidates for bone substitutes, demonstrating substantial potential in bone repair and regeneration applications.

Analyses of Bone Regeneration Capacity of Freeze-Dried Bovine Bone and Combined Deproteinized-Demineralized Bovine Bone Particles in Mandibular Defects: The Potential Application of Biological Forms of Bovine-Bone Filler

Objective  This study aimed to evaluate bone regeneration capacity of FDBX granules compared to composite DBBM/DFDBX granules for filling of bone defect in rabbit mandible.

Material and Methods  Critical size defects were created in 45 rabbits' mandible. The defect in the control group is left untreated, while in other groups the defects were filled with FDBX granules and composite DBBM/DFDBX granules, respectively. Specimens were collected at 2, 4, and 8 weeks for histology and immunohistochemical analyses. Significant difference is set at p -value < 0.05.

Results  The osteoblast-osteoclast quantification, osteoblast expression of Runx2, alkaline phosphatase, collagen-I, and osteocalcin, and osteoclast expression of receptor activator of NF-kB ligand (RANKL) and osteoprotegerin (OPG) in FDBX groups were statistically comparable ( p  > 0.05) with the composite group, while OPG/RANKL ratio, bone healing scores, and trabecular area were significantly higher ( p  < 0.05) in the composite compared to FDBX group.

Conclusion  Composite DBBM/DFDBX granules, within the limitation of this study, has better bone forming capacity than FDBX granules for filling of bone defects in the mandible.

In Vivo Analyses of Osteogenic Activity and Bone Regeneration Capacity of Demineralized Freeze-Dried Bovine Bone Xenograft: A Potential Candidate for Alveolar Bone Fillers

Background

Deproteinized bovine bone mineral (DBBM) particle is the commonly used bone graft substitute in implant surgery which is mainly osteoconductive and has very slow degradation. Demineralized freeze-dried bovine bone xenograft (DFDBBX) particle is being developed as a novel xenogeneic bone filler.

Objectives

The study aimed to analyze osteogenic activity and bone-forming capacity of DFDBBX particles compared to DBBM particles in alveolar bone defects in rabbit mandibles models. Material and Methods. This study investigated bone defects whether filled with DBBM particles or DFDBBX particles or left unfilled in 30 rabbit mandibles. Specimens were processed for histology, immunohistochemistry, and micro-CT scanning. Statistical difference was set at a p value < 0.05.

Results

The quantitative assessment showed a significantly lower number of osteoclasts and a higher number of osteoblasts in the DFDBBX group compared to the DBBM group in 2 and 4 weeks (p < 0.05). Immunostaining analyses showed significantly higher expression of RUNX2, collagen type I, alkaline phosphatase, and osteocalcin in the DFDBBX group compared to the DBBM group in 2 and 4 weeks. Bone healing score in the DFDBBX group was comparable to the DBBM group. Micro-CT presented no significant difference in the volume percentage of the mineralized tissue in the DBBM and DFDBBX groups in spite of the different healing patterns in both groups.

Conclusion

DFDBBX particles induced higher osteoblastic activities than DBBM particles at the early stage of healing. Meanwhile, the capacity of bone formation in DFDBBX particles was comparable with DBBM particles at the later stage of healing. Considering the limitation of this study, the results presented DFDBBX particles as potential bone filler candidates.

Study protocol for a multicentre, randomised controlled trial to compare the use of the decellularised dermis allograft in addition to standard care versus standard care alone for the treatment of venous leg ulceration: DAVE trial

INTRODUCTION

Venous leg ulceration (VLU), the most common type of chronic ulcer, can be difficult to heal and is a major cause of morbidity and reduced quality of life. Although compression bandaging is the principal treatment, it is time-consuming and bandage application requires specific training. There is evidence that intervention on superficial venous incompetence can help ulcer healing and recurrence, but this is not accessible to all patients. Hence, new treatments are required to address these chronic wounds. One possible adjuvant treatment for VLU is human decellularised dermis (DCD), a type of skin graft derived from skin from deceased tissue donors. Although DCD has the potential to promote ulcer healing, there is a paucity of data for its use in patients with VLU.

METHODS AND ANALYSIS

This is a multicentre, parallel group, pragmatic randomised controlled trial. One hundred and ninety-six patients with VLU will be randomly assigned to receive either the DCD allograft in addition to standard care or standard care alone. The primary outcome is the proportion of participants with a healed index ulcer at 12 weeks post-randomisation in each treatment arm. Secondary outcomes include the time to index ulcer healing and the proportion of participants with a healed index ulcer at 12 months. Changes in quality of life scores and cost-effectiveness will also be assessed. All analyses will be carried out on an intention-to-treat (ITT) basis. A mixed-effects, logistic regression on the outcome of the proportion of those with the index ulcer healed at 12 weeks will be performed. Secondary outcomes will be assessed using various statistical models appropriate to the distribution and nature of these outcomes.

ETHICS AND DISSEMINATION

Ethical approval was granted by the Bloomsbury Research Ethics Committee (19/LO/1271). Findings will be published in a peer-reviewed journal and presented at national and international conferences.

TRIAL REGISTRATION NUMBER

ISRCTN21541209.

Mineralized Hydrogels Induce Bone Regeneration in Critical Size Cranial Defects

Sequential mineralization enables the integration of minerals within the 3D structure of hydrogels. Hydrolyzed collagen-based hydrogels are sequentially mineralized over 10 cycles. One cycle is defined as an incubation period in calcium chloride dihydrate followed by incubation in sodium phosphate dibasic dihydrate. Separate cycles are completed at 30-minute and 24-hour intervals. For the gels mineralized for 30 min and 24 h, the compressive moduli increases from 4.25 to 87.57 kPa and from 4.25 to 125.47 kPa, respectively, as the cycle number increases from 0 to 10. As indicated by X-ray diffraction (XRD) and Fourier transform infrared analysis (FTIR) analyses, the minerals in the scaffolds are mainly hydroxyapatite. In vitro experiments, which measure mechanical properties, porous structure, mineral content, and gene expression are performed to evaluate the physical properties and osteoinductivity of the scaffolds. Real time-quantitative polymerase chain reaction (RT-qPCR) demonstrates 4-10 fold increase in the expression of BMP-7 and osteocalcin. The in vivo subcutaneous implantation demonstrates that the scaffolds are biocompatible and 90% biodegradable. The critical size cranial defects in vivo exhibit nearly complete bone regeneration. Cycle 10 hydrogels mineralized for 24 h have a volume of 59.86 mm³ and a density of 1946.45 HU. These results demonstrate the suitability of sequentially mineralized hydrogel scaffolds for bone repair and regeneration.