Feasibility and safety of a novel 3D-printed biodegradable biliary stent in an in vivo porcine model: a preliminary study

To assess the feasibility and safety of a novel 3D-printed biodegradable biliary stent using polycaprolactone (PCL) in an in vivo porcine model. In this animal study using domestic pigs, biodegradable radiopaque biliary stents made of polycaprolactone (PCL) and barium sulfate were produced using 3D printing and surgically inserted into the common bile duct (CBD) of pigs (stent group, n = 12). Another five pigs were allocated to the control group that only underwent resection and anastomosis of the CBD without stent insertion. To check the position and status of the stents and stent-related complications, follow-up computed tomography (CT) was performed every month. The pigs were sacrificed 1 or 3 months after surgery, and their excised CBD specimens were examined at both the macroscopic and microscopic levels. Three pigs (one in the stent group and two in the control group) died within one day after surgery and were excluded from further analysis; the remaining 11 in the stent group and 3 in the control group survived the scheduled follow-up period (1 month, 5 and 1; and 3 months, 6 and 2 in stent and control groups, respectively). In all pigs, no clinical symptoms or radiologic evidence of biliary complications was observed. In the stent group (n = 11), stent migration (n = 1 at 3 months; n = 2 at 1 month) and stent fracture (n = 3 at 2 months) were detected on CT scans. Macroscopic evaluation of the stent indicated no significant change at 1 month (n = 3) or fragmentation with discoloration at 3 months (n = 5). On microscopic examination of CBD specimens, the tissue inflammation score was significantly higher in the stent group than in the control group (mean ± standard deviation (SD), 5.63 ± 2.07 vs. 2.00 ± 1.73; P = 0.039) and thickness of fibrosis of the CBD wall was significantly higher than that of the control group (0.46 ± 0.12 mm vs. 0.21 ± 0.05 mm; P = 0.012). Despite mild bile duct inflammation and fibrosis, 3D-printed biodegradable biliary stents showed good feasibility and safety in porcine bile ducts, suggesting their potential for use in the prevention of postoperative biliary strictures.

(Bio)manufactured Solutions for Treatment of Bone Defects with Emphasis on US-FDA Regulatory Science Perspective

Bone defects, with second highest demand for surgeries around the globe, may lead to serious health issues and negatively influence patient lives. The advances in biomedical engineering and sciences have led to the development of several creative solutions for bone defect treatment. This review provides a brief summary of bone graft materials, an organized overview of top-down and bottom-up (bio)manufacturing approaches, plus a critical comparison between advantages and limitations of each method. We specifically discuss additive manufacturing techniques and their operation mechanisms in detail. Next, we review the hybrid methods and promising future directions for bone grafting, while giving a comprehensive US-FDA regulatory science perspective, biocompatibility concepts and assessments, and clinical considerations to translate a technology from a research laboratory to the market. The topics covered in this review could potentially fuel future research efforts in bone tissue engineering, and perhaps could also provide novel insights for other tissue engineering applications.

Clinical Application of Three-Dimensional Printing of Polycaprolactone/Beta-Tricalcium Phosphate Implants for Cranial Reconstruction

Polycaprolactone (PCL) implants are a biodegradable polymeric material with appropriate mechanical strength and durability for use in cranioplasty. They can be manufactured as patient- customized implants using a three-dimensional (3D) printer. Herein, the authors aimed to share our experience in cranioplasty of patients with deformed and asymmetric skulls using PCL/beta- tricalcium phosphate (ß-TCP) implants.

Seven patients underwent cranioplasty using patient-specific PCL/ß-TCP implants. Cranial computed tomography images were converted to a 3D model and mirrored to design a patient-specific implant. Based on the 3D simulation, an implant was 3D printed using PCL/ß-TCP. A 6-month follow-up was conducted with periodic visits and computed tomography scans. Symmetry after surgery and complications were evaluated.

Postoperatively, the soft tissue volumes increased to 15.8 ± 17.2 cm³ and 14.9 ± 15.7 cm³ at 2 weeks and 6 months of follow-up, respectively. The volume change from 2 weeks to 6 months was —4.4 ± 2.5%. Six patients achieved complete symmetry after cranioplasty, whereas 1 patient noticed partial symmetry. The symmetry remained unchanged at 6 months of follow-up. Upon palpation to assess smoothness, 6 patients exhibited a smooth edge interface, whereas 1 patient had a slightly irregular edge.

Based on these findings, 3D-printed PCL/ß-TCP implants are an excellent material for cranioplasty, and a favorable cosmetic outcome can be achieved. Specifically, these novel PCL/ß-TCP implants have good biocompatibility and mechanical strength without any postoperative foreign body reaction.

Gelatin/Polycaprolactone Electrospun Nanofibrous Membranes: The Effect of Composition and Physicochemical Properties on Postoperative Cardiac Adhesion

Cardiovascular diseases have become a major threat to human health. The adhesion formation is an inevitable pathophysiological event after cardiac surgery. We have previously shown that gelatin/polycaprolactone (GT/PCL, mass ratio 50:50) electrospun nanofibrous membranes have high potential in preventing postoperative cardiac adhesion, but the effect of GT:PCL composition on anti-adhesion efficacy was not investigated. Herein, nanofibrous membranes with different GT:PCL mass ratios of 0:100, 30:70, 50:50, and 70:30 were prepared via electrospinning. The 70:30 membrane failed to prevent postoperative cardiac adhesion, overly high GT contents significantly deteriorated the mechanical properties, which complicated the suturing during surgery and hardly maintained the structural integrity after implantation. Unexpectedly, the 0:100 membrane (no gelatin contained) could not effectively prevent either, since its large pore size allowed the penetration of numerous inflammatory cells to elicit a severe inflammatory response. Only the GT:PCL 50:50 membrane exhibited excellent mechanical properties, good biocompatibility and effective anti-cell penetration ability, which could serve as a physical barrier to prevent postoperative cardiac adhesion and might be suitable for other biomedical applications such as wound healing, guided tissue or bone regeneration.

Invitro and Invivo Study of PCL-Hydrogel Scaffold to Advance Bioprinting Translation in Microtia Reconstruction

BACKGROUND

Bioprinting has shown promise in the area of microtia reconstruction. However clinical translation has been challenged by the lack of robust techniques to control delivery of stem cells. Hybrid printing allowing multiple materials, both cell and support, to be printed together may overcome these challenges.

OBJECTIVE

This study assesses the degradation behavior and tissue compatibility of hybrid scaffolds (PCL-Hydrogel) compared to single material Polycaprolactone (PCL) scaffolds in-vitro and in-vivo. Sheep demonstrate similar fascial anatomy to humans. This is the first reported study using a sheep model to study hybrid scaffolds for microtia.

METHODS

PCL and PCL-Hydrogel samples of increasing porosity were subjected to an accelerated enzymatic degradation assay to study degradation behavior in-vitro. In addition, a 6-month study using Merino-Dorset sheep was conducted to compare the biological reaction of the host to PCL and PCL-hydrogel scaffolds.

RESULTS

In-vitro degradation showed homogenous degradation of the scaffold. PCL presented the dominating influence on degradation volume compared to hydrogel. In-vivo, there was no evidence of skin irritation or infection over 6 months in both control and test, though PCL-hydrogel scaffolds showed higher levels of tissue ingrowth.

CONCLUSION

Homogenous degradation pattern of porous scaffolds may create less surrounding tissue irritation. Hybrid scaffolds had good biological compatibility and showed better tissue ingrowth than PCL alone.

Influence of a novel scaffold composed of polyurethane, hydroxyapatite, and decellularized bone particles on the healing of fourth metacarpal defects in mares

OBJECTIVE

To determine the effect of a novel scaffold, designed for use in bone regeneration, on healing of splint bone segmental defects in mares.

STUDY DESIGN

In vivo experimental study.

SAMPLE POPULATION

Five adult mares (4-10 years old; mean weight, 437.7 kg ± 29 kg).

METHODS

Bilateral 2-cm full-thickness defects were created in the fourth metacarpal bones (MCIV) of each horse. Each defect was randomly assigned to either a novel scaffold treatment (n = 5) or an untreated control (n = 5). The scaffold was composed of polyurethane, hydroxyapatite, and decellularized bone particles. Bone healing was assessed for a period of 60 days by thermography, ultrasonography, radiography, and computed tomography (CT). Biopsies of each defect were performed 60 days after surgery for histological evaluation.

RESULTS

On the basis of radiographic analysis, scaffold-treated defects had greater filling (67.42% ± 26.7%) compared with untreated defects (35.88% ± 32.7%; P = .006). After 60 days, CT revealed that the density of the defects treated with the scaffolds (807.80 ± 129.6 Hounsfield units [HU]) was greater than density of the untreated defects (464.80 ± 81.3 HU; P = .004). Evaluation of histology slides provided evidence of bone formation within an average of 9.43% ± 3.7% of the cross-sectional area of scaffolds in contrast to unfilled defects in which connective tissue was predominant throughout the biopsy specimens.

CONCLUSION

The novel scaffold was biocompatible and supported bone formation within the MCIV segmental defects.

CLINICAL SIGNIFICANCE

This novel scaffold offers an effective option for filling bone voids in horses when support of bone healing is indicated.

Fabrication of poly (1, 8-octanediol-co-Pluronic F127 citrate)/chitin nanofibril/bioactive glass (POFC/ChiNF/BG) porous scaffold via directional-freeze-casting

The citrate-based thermoset elastomer is a promising candidate for bone scaffold material, but the harsh curing condition made it difficult to fabricate porous structure. Recently, poly (1, 8-octanediol-co-Pluronic F127 citrate) (POFC) porous scaffold was creatively fabricated by chitin nanofibrils (ChiNFs) supported emulsion-freeze-casting. Thanks to the supporting role of ChiNFs, the lamellar pore structure formed by directional freeze-drying was maintained during the subsequent thermocuring. Herein, bioactive glass (BG) was introduced into the POFC porous scaffolds to improve bioactivity. It was found the complete replacement of ChiNF particles with BG particles could not form a stable porous structure; however, existing at least 15 wt% ChiNF could ensure the formation of lamellar pore, and the interlamellar distance increased with BG ratios. Thus, the BG granules did not contribute to the formation of pore structure like ChiNFs, however, they surely endowed the scaffolds with enhanced mechanical properties, improved osteogenesis bioactivity, better cytocompatibility as well as quick degradation rate. Reasonably adjusting BG ratios could balance the requirements of porous structure and bioactivity.

Dual-modal non-invasive imaging in vitro and in vivo monitoring degradation of PLGA scaffold based gold nanoclusters

Biodegradable scaffolds play an important role in tissue engineering, and appropriate degradation and resorption rates of these scaffolds are necessary to accommodate tissue growth. Synthetic polymers are frequently used because of their ease of production, good biocompatibility and controllable degradation rates. However, monitoring the degradation of these polymers in vivo by a noninvasive approach remains limited. In this study, we designed a composite scaffold by labeling poly(lactic-co-glycolic acid) (PLGA) with gold nanoclusters (Au NCs), which were used for tracking in vivo degradation through dual-modal fluorescence/computed tomography (CT) imaging. The diameter of the Au NCs was approximately 2.5 nm, and the emission peak was at a wavelength of 700 nm. After labeling PLGA with the Au NCs, the fluorescence intensity of the Au NC/PLGA composite scaffold reached 9.0 × 10⁹ (p/s/cm²/sr)/(μW/cm²), and the CT density of the scaffold increased to 200 HU. After the composite scaffold was implanted subcutaneously into nude mice, a continuous decrease in the fluorescence signal and CT value was observed. The mean fluorescence intensity was 8.3 × 10⁹, 3.17 × 10⁹, 2.26 × 10⁹, 2.11 × 10⁹, and 1.82 × 10⁹ (p/s/cm²/sr)/(μW/cm²) from the first week to the fifth week, respectively. The mean CT value changed from 222.6 to 185.9, 149.1, 112.5, and 55.2 (Hounsfield unit, HU) at the different timepoints. Compared with the change in the fluorescence intensity, the change in the CT value was similar to the change in the weight, and the Pearson correlation coefficient between the change in the CT value and weight was 0.8626. Furthermore, the structure and morphology of the scaffolds at different timepoints were analyzed by three-dimensional (3-D) reconstruction. This novel method of noninvasive dynamic monitoring of biodegradable polymers in vivo provides insight into choosing suitable biomaterials for tissue engineering and regenerative medicine.

Computed tomography-guided additive manufacturing of Personalized Absorbable Gastrointestinal Stents for intestinal fistulae and perforations

Small bowel perforations and obstructions are relatively frequent surgical emergencies, are potentially life-threatening, and have multiple etiologies. In general, treatment requires urgent surgical repair or resection and at times can lead to further complications. Stents may be used to help with healing intestinal perforations but use is limited as currently available stents are non-absorbable, are manufactured in a narrow size range, and/or are limited to usage in locations that are accessible for endoscopic removal post-healing. The use of 3D-printed bioresorbable polymeric stents will provide patients with a stent that can prevent leakage, is tailored specifically to their geometry, and will be usable within the small bowel, which is not amenable to endoscopic stent placement. This work focused on the rapid manufacturing of gastrointestinal stents composed of a polycaprolactone-polydioxanone (PCL-PDO) composite. Dynamic Mechanical Analysis (DMA) tests were conducted to separately analyze the effects of composition, the filament formation process, and physiological temperature on the PCL-PDO material properties. The proposed stent design was then modeled using computer-aided design, and Finite Element Analysis (FEA) was used to simulate the effects of physiologically relevant forces on stent integrity. The presence of hydrolysable ester bonds was confirmed using FT-IR spectroscopy. In vitro studies were used to evaluate the biocompatibility of the polymer composite. Further analyses were conducted through stent placement in ex vivo pig intestines. PCL-PDO stents were then 3D-printed and placed in vivo in a pig model.

Biocompatibility and biodegradation properties of polycaprolactone/polydioxanone composite scaffolds prepared by blend or co-electrospinning

Electrospun polymer scaffolds are regarded as an ideal tissue engineering scaffold due to similar morphological properties with the native extracellular matrix. Among these, polycaprolactone is widely used to fabricate electrospun fibrous scaffolds due to its excellent biocompatibility, good mechanical properties, and ease of manufacture. However, its low biodegradation rate has a negative influence on its application in tissue engineering scaffold. To address this issue, this study prepared hybrid scaffolds composed of polycaprolactone and polydioxanone (a fast-degrading polyether-ester) via either the blend or co-electrospinning. Subsequently, the structural characteristics, mechanical strength, in vitro/vivo degradation, cellularization, and vascularization of two kinds of hybrid scaffolds were evaluated to decide which method is more suitable for producing tissue engineering scaffolds. The incorporation of polydioxanone increased the mechanical strength of both composite scaffolds. Moreover, co-electrospun scaffolds exhibited improved hydrophilicity compared to blend scaffolds. The results of in vitro and in vivo degradation studies showed that the degradation rate of both composite scaffolds was faster than that of neat polycaprolactone scaffolds due to the incorporated polydioxanone component. Especially in co-electrospun scaffolds, the fast degradation of polydioxanone fiber gave rise to larger pore size, thus leading to faster cellularization and better vascularization compared to blend scaffolds. Therefore, co-electrospinning was demonstrated to be superior to blend electrospinning for the preparation of composite scaffolds. Co-electrospun polycaprolactone–polydioxanone scaffolds may be promising candidates for tissue engineering.

In Vitro Regeneration of Patient-specific Ear-shaped Cartilage and Its First Clinical Application for Auricular Reconstruction

Microtia is a congenital external ear malformation that can seriously influence the psychological and physiological well-being of affected children. The successful regeneration of human ear-shaped cartilage using a tissue engineering approach in a nude mouse represents a promising approach for auricular reconstruction. However, owing to technical issues in cell source, shape control, mechanical strength, biosafety, and long-term stability of the regenerated cartilage, human tissue engineered ear-shaped cartilage is yet to be applied clinically. Using expanded microtia chondrocytes, compound biodegradable scaffold, and in vitro culture technique, we engineered patient-specific ear-shaped cartilage in vitro. Moreover, the cartilage was used for auricle reconstruction of five microtia patients and achieved satisfactory aesthetical outcome with mature cartilage formation during 2.5years follow-up in the first conducted case. Different surgical procedures were also employed to find the optimal approach for handling tissue engineered grafts. In conclusion, the results represent a significant breakthrough in clinical translation of tissue engineered human ear-shaped cartilage given the established in vitro engineering technique and suitable surgical procedure. This study was registered in Chinese Clinical Trial Registry (ChiCTR-ICN-14005469).

In Vitro Regeneration of Patient-specific Ear-shaped Cartilage and Its First Clinical Application for Auricular Reconstruction

Microtia is a congenital external ear malformation that can seriously influence the psychological and physiological well-being of affected children. The successful regeneration of human ear-shaped cartilage using a tissue engineering approach in a nude mouse represents a promising approach for auricular reconstruction. However, owing to technical issues in cell source, shape control, mechanical strength, biosafety, and long-term stability of the regenerated cartilage, human tissue engineered ear-shaped cartilage is yet to be applied clinically. Using expanded microtia chondrocytes, compound biodegradable scaffold, and in vitro culture technique, we engineered patient-specific ear-shaped cartilage in vitro. Moreover, the cartilage was used for auricle reconstruction of five microtia patients and achieved satisfactory aesthetical outcome with mature cartilage formation during 2.5 years follow-up in the first conducted case. Different surgical procedures were also employed to find the optimal approach for handling tissue engineered grafts. In conclusion, the results represent a significant breakthrough in clinical translation of tissue engineered human ear-shaped cartilage given the established in vitro engineering technique and suitable surgical procedure.

This study was registered in Chinese Clinical Trial Registry (ChiCTR-ICN-14005469).

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Patient-specific ear-shaped cartilage was engineered in vitro using expanded MCs and compound biodegradable scaffold.

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The first microtia case treated with the tissue engineered ear-shaped cartilage was follow-up for 2.5 years.

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Other four cases with similar and different surgical procedures were also presented.

Microtia is a congenital external ear malformation that can seriously influence the psychological and physiological well-being of affected children. Using expanded microtia chondrocytes, compound biodegradable scaffold, and in vitro culture technique, we engineered patient-specific ear-shaped cartilage in vitro, and performed a pilot clinical trial of auricle reconstruction using the engineered ear cartilage on five patients. Satisfactory aesthetical outcome with mature cartilage formation was achieved with the longest follow-up of 2.5 years.

Design and fabrication of porous biodegradable scaffolds: a strategy for tissue engineering

Current strategies of tissue engineering are focused on the reconstruction and regeneration of damaged or deformed tissues by grafting of cells with scaffolds and biomolecules. Recently, much interest is given to scaffolds which are based on mimic the extracellular matrix that have induced the formation of new tissues. To return functionality of the organ, the presence of a scaffold is essential as a matrix for cell colonization, migration, growth, differentiation and extracellular matrix deposition, until the tissues are totally restored or regenerated. A wide variety of approaches has been developed either in scaffold materials and production procedures or cell sources and cultivation techniques to regenerate the tissues/organs in tissue engineering applications. This study has been conducted to present an overview of the different scaffold fabrication techniques such as solvent casting and particulate leaching, electrospinning, emulsion freeze-drying, thermally induced phase separation, melt molding and rapid prototyping with their properties, limitations, theoretical principles and their prospective in tailoring appropriate micro-nanostructures for tissue regeneration applications. This review also includes discussion on recent works done in the field of tissue engineering.

WITHDRAWN: A novel nano-hydroxyapatite - PMMA hybrid scaffolds adopted by conjugated thermal induced phase separation (TIPS) and wet-chemical approach: Analysis of its mechanical and biological properties

The Publisher regrets that this article is an accidental duplication of an article that has already been published in Mater. Sci. Eng.: C, 73 (2017) 164–172, 10.1016/http://dx.doi.org/j.msec.2016.12.133. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Hierarchical polymeric scaffolds support the growth of MC3T3-E1 cells

Tissue engineering makes use of the principles of biology and engineering to sustain 3D cell growth and promote tissue repair and/or regeneration. In this study, macro/microporous scaffold architectures have been developed using a hybrid solid freeform fabrication/thermally induced phase separation (TIPS) technique. Poly(lactic-co-glycolic acid) (PLGA) dissolved in 1,4-dioxane was used to generate a microporous matrix by the TIPS method. The 3D-bioplotting technique was used to fabricate 3D macroporous constructs made of polyethylene glycol (PEG). Embedding the PEG constructs inside the PLGA solution prior to the TIPS process and subsequent extraction of PEG following solvent removal (1,4-dioaxane) resulted in a macro/microporous structure. These hierarchical scaffolds with a bimodal pore size distribution (<50 and >300 μm) contained orthogonally interconnected macro-channels generated by the extracted PEG. The diameter of the macro-channels was varied by tuning the dispensing parameters of the 3D bioplotter. The in vitro cell culture using murine MC3T3-E1 cell line for 21 days demonstrated that these scaffolds could provide a favorable environment to support cell adhesion and growth.

A review: fabrication of porous polyurethane scaffolds

The aim of tissue engineering is the fabrication of three-dimensional scaffolds that can be used for the reconstruction and regeneration of damaged or deformed tissues and organs. A wide variety of techniques have been developed to create either fibrous or porous scaffolds from polymers, metals, composite materials and ceramics. However, the most promising materials are biodegradable polymers due to their comprehensive mechanical properties, ability to control the rate of degradation and similarities to natural tissue structures. Polyurethanes (PUs) are attractive candidates for scaffold fabrication, since they are biocompatible, and have excellent mechanical properties and mechanical flexibility. PU can be applied to various methods of porous scaffold fabrication, among which are solvent casting/particulate leaching, thermally induced phase separation, gas foaming, emulsion freeze-drying and melt moulding. Scaffold properties obtained by these techniques, including pore size, interconnectivity and total porosity, all depend on the thermal processing parameters, and the porogen agent and solvents used. In this review, various polyurethane systems for scaffolds are discussed, as well as methods of fabrication, including the latest developments, and their advantages and disadvantages.

Effects of processing parameters in thermally induced phase separation technique on porous architecture of scaffolds for bone tissue engineering

Tissue engineering makes use of 3D scaffolds to sustain three-dimensional growth of cells and guide new tissue formation. To meet the multiple requirements for regeneration of biological tissues and organs, a wide range of scaffold fabrication techniques have been developed, aiming to produce porous constructs with the desired pore size range and pore morphology. Among different scaffold fabrication techniques, thermally induced phase separation (TIPS) method has been widely used in recent years because of its potential to produce highly porous scaffolds with interconnected pore morphology. The scaffold architecture can be closely controlled by adjusting the process parameters, including polymer type and concentration, solvent composition, quenching temperature and time, coarsening process, and incorporation of inorganic particles. The objective of this review is to provide information pertaining to the effect of these parameters on the architecture and properties of the scaffolds fabricated by the TIPS technique.

Recent advances in 2D and 3D in vitro systems using primary hepatocytes, alternative hepatocyte sources and non-parenchymal liver cells and their use in investigating mechanisms of hepatotoxicity, cell signaling and ADME

This review encompasses the most important advances in liver functions and hepatotoxicity and analyzes which mechanisms can be studied in vitro. In a complex architecture of nested, zonated lobules, the liver consists of approximately 80 % hepatocytes and 20 % non-parenchymal cells, the latter being involved in a secondary phase that may dramatically aggravate the initial damage. Hepatotoxicity, as well as hepatic metabolism, is controlled by a set of nuclear receptors (including PXR, CAR, HNF-4α, FXR, LXR, SHP, VDR and PPAR) and signaling pathways. When isolating liver cells, some pathways are activated, e.g., the RAS/MEK/ERK pathway, whereas others are silenced (e.g. HNF-4α), resulting in up- and downregulation of hundreds of genes. An understanding of these changes is crucial for a correct interpretation of in vitro data. The possibilities and limitations of the most useful liver in vitro systems are summarized, including three-dimensional culture techniques, co-cultures with non-parenchymal cells, hepatospheres, precision cut liver slices and the isolated perfused liver. Also discussed is how closely hepatoma, stem cell and iPS cell-derived hepatocyte-like-cells resemble real hepatocytes. Finally, a summary is given of the state of the art of liver in vitro and mathematical modeling systems that are currently used in the pharmaceutical industry with an emphasis on drug metabolism, prediction of clearance, drug interaction, transporter studies and hepatotoxicity. One key message is that despite our enthusiasm for in vitro systems, we must never lose sight of the in vivo situation. Although hepatocytes have been isolated for decades, the hunt for relevant alternative systems has only just begun.

Bone morphogenetic proteins-immobilized polydioxanone porous particles as an artificial bone graft

Bone morphogenetic proteins (BMPs)-immobilized polydioxanone (PDO)/Pluronic F127 porous particles were prepared as a bone graft using a melt-molding particulate-leaching method, and the sequential binding of heparin and BMPs (BMP-2 and BMP-7, single or dual) onto the porous particles. The prepared PDO/Pluronic F127 porous particles gradually degraded with time, with ∼30% of the initial particle weight remaining after 16 weeks. The degradation rate of the PDO/Pluronic F127 porous particles may parallel the bone-healing rate. The BMPs were easily immobilized onto the pore surfaces of PDO/Pluronic F127 particles via heparin binding and were released in a sustained manner for up to 21 days, regardless of BMP type. The BMPs (single BMP-2 or dual BMP-2/BMP-7)-immobilized porous particles were effective for in vitro osteogenesis of bone marrow stem cells (BMSCs), as analyzed by alkaline phosphatase activity, calcium content, time polymerase chain reaction using specific markers for osteogenesis (Type I collagen, osteocalcin, osteopotin, and RunX2), and immunohistochemical staining. The BMPs (single BMP-2 or dual BMP-2/BMP-7)-immobilized porous particles were also effective in promoting new bone formation, as analyzed by the preliminary animal study using a full-thickness skull defect model of Sprague-Dawley rats (microcomputed tomography). The synergistic effect of dual BMPs on the osteogenesis of BMSCs and bone regeneration was not significant in our system. The BMP-2 or dual BMPs (BMP-2/BMP-7)-immobilized PDO/Pluronic F127 porous particles may be a promising candidate as a bone graft for the delayed and insufficient bone healing in clinical fields.

Near-infrared fluorescence imaging for noninvasive trafficking of scaffold degradation

Biodegradable scaffolds could revolutionize tissue engineering and regenerative medicine; however, in vivo matrix degradation and tissue ingrowth processes are not fully understood. Currently a large number of samples and animals are required to track biodegradation of implanted scaffolds, and such nonconsecutive single-time-point information from various batches result in inaccurate conclusions. To overcome this limitation, we developed functional biodegradable scaffolds by employing invisible near-infrared fluorescence and followed their degradation behaviors in vitro and in vivo. Using optical fluorescence imaging, the degradation could be quantified in real-time, while tissue ingrowth was tracked by measuring vascularization using magnetic resonance imaging in the same animal over a month. Moreover, we optimized the in vitro process of enzyme-based biodegradation to predict implanted scaffold behaviors in vivo, which was closely related to the site of inoculation. This combined multimodal imaging will benefit tissue engineers by saving time, reducing animal numbers, and offering more accurate conclusions.

Novel approaches to bone grafting: porosity, bone morphogenetic proteins, stem cells, and the periosteum

The disadvantages involving the use of a patient's own bone as graft material have led surgeons to search for alternative materials. In this review, several characteristics of a successful bone graft material are discussed. In addition, novel synthetic materials and natural bone graft materials are being considered. Various factors can determine the success of a bone graft substitute. For example, design considerations such as porosity, pore shape, and interconnection play significant roles in determining graft performance. The effective delivery of bone morphogenetic proteins and the ability to restore vascularization also play significant roles in determining the success of a bone graft material. Among current approaches, shorter bone morphogenetic protein sequences, more efficient delivery methods, and periosteal graft supplements have shown significant promise for use in autograft substitutes or autograft extenders.