Biomimetic surface modification using synthetic oligopeptides for enhanced guided bone regeneration in beagles

Stealth functionalization of biomaterials and nanoparticles by CD47 mimicry

Polymeric biomaterials and nanoparticles (NPs) have shown a potential to be widely used for medical purposes. Functional limits of their biocompatibility depend on cellular and molecular responses between host and their artificial surfaces. Accordingly, medical devices of polymer biomaterials like endovascular stents, cardiopulmonary bypass circuits, and prostheses, may trigger inflammation or can be rejected by host due to the induction of immune responses. Furthermore, the main restriction to the use of NPs for medical purposes is their short in vivo circulation time because of their rapid clearance via the reticuloendothelial system. Various methods are under investigation to produce bioinert biomaterials and NPs. Currently, PEGylation and camouflaging are the most common approaches to enhance their biocompatibility. However, the disadvantages and limitations of these methods are leading to research new strategies. The CD47 molecule is well known as a widely expressed cellular surface receptor activating the transudction of the ''don't-eat-me'' signal. This review elaborates on the role of CD47 in the immune system and the application of CD47 mimicry peptides to produce bioinert biomaterials and NPs.

Enhanced biocompatibility of CD47-functionalized vascular stents

The effectiveness of endovascular stents is hindered by in-stent restenosis (ISR), a secondary re-obstruction of treated arteries due to unresolved inflammation and activation of smooth muscle cells in the arterial wall. We previously demonstrated that immobilized CD47, a ubiquitously expressed transmembrane protein with an established role in immune evasion, can confer biocompatibility when appended to polymeric surfaces. In present studies, we test the hypothesis that CD47 immobilized onto metallic surfaces of stents can effectively inhibit the inflammatory response thus mitigating ISR. Recombinant CD47 (recCD47) or a peptide sequence corresponding to the Ig domain of CD47 (pepCD47), were attached to the surfaces of both 316L-grade stainless steel foils and stents using bisphosphonate coordination chemistry and thiol-based conjugation reactions to assess the anti-inflammatory properties of CD47-functionalized surfaces. Initial in vitro and ex vivo analysis demonstrated that both recCD47 and pepCD47 significantly reduced inflammatory cell attachment to steel surfaces without impeding on endothelial cell retention and expansion. Using a rat carotid stent model, we showed that pepCD47-functionalized stents prevented fibrin and platelet thrombus deposition, inhibited inflammatory cell attachment, and reduced restenosis by 30%. It is concluded that CD47-modified stent surfaces mitigate platelet and inflammatory cell attachment, thereby disrupting ISR pathophysiology.

Addressing the Inflammatory Response to Clinically Relevant Polymers by Manipulating the Host Response Using ITIM Domain-Containing Receptors

Tissue contacting surfaces of medical devices initiate a host inflammatory response, characterized by adsorption of blood proteins and inflammatory cells triggering the release of cytokines, reactive oxygen species (ROS) and reactive nitrogen species (RNS), in an attempt to clear or isolate the foreign object from the body. This normal host response contributes to device-associated pathophysiology and addressing device biocompatibility remains an unmet need. Although widespread attempts have been made to render the device surfaces unreactive, the establishment of a completely bioinert coating has been untenable and demonstrates the need to develop strategies based upon the molecular mechanisms that define the interaction between host cells and synthetic surfaces. In this review, we discuss a family of transmembrane receptors, known as immunoreceptor tyrosine-based inhibitory motif (ITIM)-containing receptors, which show promise as potential targets to address aberrant biocompatibility. These receptors repress the immune response and ensure that the intensity of an immune response is appropriate for the stimuli. Particular emphasis will be placed on the known ITIM-containing receptor, Signal Regulatory Protein Alpha (SIRPhα), and its cognate ligand CD47. In addition, this review will discuss the potential of other ITIM-containing proteins as targets for addressing the aberrant biocompatibility of polymeric biomaterials.

Timing of force application affects the rate of tooth movement into surgical alveolar defects with grafts in beagles

INTRODUCTION

The purpose of this study was to investigate the influence of the timing of orthodontic force application on the rates of orthodontic tooth movement into surgical alveolar defects with bone grafts in beagle dogs.

METHODS

Twelve beagles were randomly divided into 2 groups according to the surgical procedure: alveolar osteotomy alone (control) or osteotomy with bone graft (experimental group). The maxillary second premolars were protracted for 6 weeks into the surgical sites: immediately, at 2 weeks, and at 12 weeks after surgery. The orthodontic tooth movement rates and alveolar remodeling concomitant with surgical defect healing were evaluated by model measurements and histomorphometry as well as microcomputed tomography and histology. One-way analysis of variance and the Scheffé post hoc comparison were performed for investigating the rates of orthodontic tooth movement and mineralized bone formation.

RESULTS

Both the orthodontic tooth movement rate and the mean appositional length of mineralized bone in the tension side of teeth were significantly accelerated when force was applied at 2 weeks in the control group and immediately in the experimental group (P <0.001). The 2-week control group showed a dramatic increase in apposition rate during 4 to 6 weeks after force application, whereas the immediate protraction experimental group did within the first 3 weeks (P <0.001). Decreased orthodontic tooth movement rates and reduced bone remodeling activities were apparent in the 12-weeks groups, especially in nongrafted defects.

CONCLUSIONS

A bone graft into the surgical defect can not only allow immediate force application for accelerating orthodontic tooth movement with favorable periodontal regeneration, but also decrease the risk of inhibited orthodontic tooth movement in case of delayed force application after surgery.

Improvement of osteogenic potential of biphasic calcium phosphate bone substitute coated with synthetic cell binding peptide sequences

Purpose

The aim of this study was to evaluate the improvement of osteogenic potential of biphasic calcium phosphate (BCP) bone substitute coated with synthetic cell-binding peptide sequences in a standardized rabbit sinus model.

Methods

Standardized 6-mm diameter defects were created bilaterally on the maxillary sinus of ten male New Zealand white rabbits, receiving BCP bone substitute coated with synthetic cell binding peptide sequences on one side (experimental group) and BCP bone substitute without coating (control group) on the other side. Histologic and histomorphometric analysis of bone formation was carried out after a healing period of 4 or 8 weeks.

Results

Histological analysis revealed signs of new bone formation in both experimental groups (4- and 8-week healing groups) with a statistically significant increase in bone formation in the 4-week healing group compared to the control group. However, no statistically significant difference in bone formation was found between the 8-week healing group and the control group.

Conclusions

This study found that BCP bone substitute coated with synthetic cell-binding peptide sequences enhanced osteoinductive potential in a standardized rabbit sinus model and its effectiveness was greater in the 4-week healing group than in the 8-week healing group.