To heal or not to heal? Chemokines as determinants of constructive or destructive inflammatory microenvironments

Tailoring the immuno-responsiveness of anodized nano-engineered titanium implants

Owing to its biocompatibility and corrosion resistance, titanium is one of the most commonly used implantable biomaterials. Numerous in vitro and in vivo investigations have established that titanium surfaces with a nanoscale topography outperform conventional smooth or micro-rough surfaces in terms of achieving desirable bonding with bone (i.e. enhanced bioactivity). Among these nanoscale topographical modifications, ordered nanostructures fabricated via electrochemical anodization, especially titania nanotubes (TNTs), are particularly attractive. This is due to their ability to augment bioactivity, deliver drugs and the potential for easy/cost-effective translation into the current implant market. However, the potential of TNT-modified implants to modulate the host immune-inflammatory response, which is critical for achieving timely osseointegration, remains relatively unexplored. Such immunomodulatory effects may be achieved by modifying the physical and chemical properties of the TNTs. Furthermore, therapeutic/bioactive enhancements performed on these nano-engineered implants (such as antibacterial or osteogenic functions) are likely to illicit an immune response which needs to be appropriately controlled. The lack of sufficient in-depth studies with respect to immune cell responses to TNTs has created research gaps that must be addressed in order to facilitate the design of the next generation of immuno-modulatory titanium implants. This review article focuses on the chemical, topographical and mechanical features of TNT-modified implants that can be manipulated in order to achieve immuno-modulation, as well as providing an insight into how modulating the immune response can augment implant performance.

Leukocyte presence does not increase microbicidal activity of Platelet-rich Plasma in vitro

Background

Human platelets are a rich reservoir of molecules that promote regenerative processes and microbicidal activity. This activity might be increased by concentration in platelet-rich plasma (PRP) products and modulated by the presence of leukocytes. Despite extensive use in clinical procedures, only few studies have investigated PRP’s real microbicidal potential. Therefore, this study aimed at comparing the in vitro microbicidal activity of platelets and leukocyte-enriched PRP (L-PRP) to pure platelet-rich plasma (P-PRP) and the contribution of leukocytes to microbicidal properties.

Antimicrobial effects of P- and L-PRP were tested against Escherichia Coli, Staphylococcus Aureus, Klebsiella Pneumoniae, Pseudomonas Aeruginosa and Enterococcus Faecalis. Furthermore, L-PRP was frozen (L-PRP cryo) to assess whether the preparation maintained in vitro characteristics. Microbicidal proteins released by the three preparations were also evaluated.

Results

L-PRP, L-PRP cryo and P-PRP generally induced comparable bacterial growth inhibition for up to 4 h’ incubation, range 1–4 log. MIP-1α, RANTES, GRO-α, IL-8, NAP-2, SDF-1α and IL-6 showed strong microbicidal potential.

Conclusions

We found in vitro antibacterial activity of L-PRP and P-PRP and the possibility to cryopreserve L-PRP, without important changes to its effectiveness; similar microbicidal activity between preparations containing or not leukocytes; and the contribution of three new molecules (NAP-2, SDF-1α and IL-6).

Intramembranous bone healing process subsequent to tooth extraction in mice: micro-computed tomography, histomorphometric and molecular characterization

Bone tissue has a significant potential for healing, which involves a significant the interplay between bone and immune cells. While fracture healing represents a useful model to investigate endochondral bone healing, intramembranous bone healing models are yet to be developed and characterized. In this study, a micro-computed tomography, histomorphometric and molecular (RealTimePCRarray) characterization of post tooth-extraction alveolar bone healing was performed on C57Bl/6 WT mice. After the initial clot dominance (0h), the development of a provisional immature granulation tissue is evident (7d), characterized by marked cell proliferation, angiogenesis and inflammatory cells infiltration; associated with peaks of growth factors (BMP-2-4-7,TGFβ1,VEGFa), cytokines (TNFα, IL-10), chemokines & receptors (CXCL12, CCL25, CCR5, CXCR4), matrix (Col1a1-2, ITGA4, VTN, MMP1a) and MSCs (CD105, CD106, OCT4, NANOG, CD34, CD146) markers expression. Granulation tissue is sequentially replaced by more mature connective tissue (14d), characterized by inflammatory infiltrate reduction along the increased bone formation, marked expression of matrix remodeling enzymes (MMP-2-9), bone formation/maturation (RUNX2, ALP, DMP1, PHEX, SOST) markers, and chemokines & receptors associated with healing (CCL2, CCL17, CCR2). No evidences of cartilage cells or tissue were observed, strengthening the intramembranous nature of bone healing. Bone microarchitecture analysis supports the evolving healing, with total tissue and bone volumes as trabecular number and thickness showing a progressive increase over time. The extraction socket healing process is considered complete (21d) when the dental socket is filled by trabeculae bone with well-defined medullary canals; it being the expression of mature bone markers prevalent at this period. Our data confirms the intramembranous bone healing nature of the model used, revealing parallels between the gene expression profile and the histomorphometric events and the potential participation of MCSs and immune cells in the healing process, supporting the forthcoming application of the model for the better understanding of the bone healing process.