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Lee JS, Kim HS, Nah H, Lee SJ, Moon HJ, Bang JB, Lee JB, Do SH, Kwon IK, Heo DN. The Effectiveness of Compartmentalized Bone Graft Sponges Made Using Complementary Bone Graft Materials and Succinylated Chitosan Hydrogels. Biomedicines 2021; 9:biomedicines9121765. [PMID: 34944581 PMCID: PMC8698467 DOI: 10.3390/biomedicines9121765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 11/24/2022] Open
Abstract
Bone defects can occur from many causes, including disease or trauma. Bone graft materials (BGMs) have been used to fill damaged areas for the reconstruction of diseased bone tissues since they are cost effective and readily available. However, BGMs quickly disperse around the tissue area, which ultimately leads to it migrating away from the defect after transplantation. We tested chitosan hydrogels as a useful carrier to hold BGMs in the transplantation area. In this study, we synthesized succinylated chitosan (SCS)-based hydrogels with a high decomposition rate and excellent biocompatibility. We confirmed that BGMs were well distributed inside the SCS hydrogel. The SCS-B hydrogel showed a decrease in mechanical properties, such as compressive strength and Young’s modulus, as the succinylation rate increased. SCS-B hydrogels also exhibited a high cell growth rate and bone differentiation rate. Moreover, the in vivo results showed that the SCS hydrogel resorbed into the surrounding tissues while maintaining the BGMs in the transplantation area for up to 6 weeks. These data support the idea that SCS hydrogel can be useful as a bioactive drug carrier for a broad range of biomedical applications.
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Affiliation(s)
- Jae Seo Lee
- Department of Dentistry, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (J.S.L.); (H.N.)
| | - Hyo-Sung Kim
- Department of Clinical Pathology, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (H.-S.K.); (S.H.D.)
| | - Haram Nah
- Department of Dentistry, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (J.S.L.); (H.N.)
| | - Sang Jin Lee
- Department of Dental Materials, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (S.J.L.); (H.-J.M.)
| | - Ho-Jin Moon
- Department of Dental Materials, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (S.J.L.); (H.-J.M.)
| | - Jae Beum Bang
- Department of Dental Education, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemum-gu, Seoul 02447, Korea;
| | - Jung Bok Lee
- Department of Biological Science, Sookmyung Women’s University, Cheongpa-ro 47-gil 100 (Cheongpa-dong 2(i)-ga), Yongsan-gu, Seoul 04310, Korea;
| | - Sun Hee Do
- Department of Clinical Pathology, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (H.-S.K.); (S.H.D.)
| | - Il Keun Kwon
- Department of Dental Materials, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (S.J.L.); (H.-J.M.)
- Correspondence: (I.K.K.); (D.N.H.)
| | - Dong Nyoung Heo
- Department of Dental Materials, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (S.J.L.); (H.-J.M.)
- Correspondence: (I.K.K.); (D.N.H.)
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2
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Haghighi P, Shamloo A. Fabrication of a novel 3D scaffold for cartilage tissue repair: In-vitro and in-vivo study. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 128:112285. [PMID: 34474836 DOI: 10.1016/j.msec.2021.112285] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/03/2021] [Accepted: 06/25/2021] [Indexed: 01/02/2023]
Abstract
Self-repairing is not an advanced ability of articular cartilage. Tissue engineering has provided a novel way for reconstructing cartilage using natural polymers because of their biocompatibility and bio-functionality. The purpose of cartilage tissue engineering is to design a scaffold with proper pore structure and similar biological and mechanical properties to the native tissue. In this study, porous scaffolds prepared from gelatin, chitosan and silk fibroin were blended with varying ratios. Between the blends of chitosan (C), gelatin (G) and silk fibroin (S), the scaffold with the weight per volume ratio of 2:2:3 (w/v) showed the most favorable and higher certain properties than the other blends. The CGS 2:2:3 scaffold showed the best pore size that is between 100 μm and 300 μm. The water absorption and degradation rate of the CGS 2:2:3 scaffold were found suitable for cartilage tissue engineering. Cell culture study using human chondrocytes showed good cell adhesion and proliferation. To further study the effect of this scaffold on the living tissue, 36 rabbits were randomly assigned to CGS 2:2:3 scaffold with and without seeded chondrocytes and control groups. Hematoxylin and Eosin (H&E), Masson's trichrome (MT), and safranin O (SO) staining showed 65 ± 9.1% new cartilage tissue present in the defect filled with cell-seeded scaffold and most of the cartilaginous tissue was hyaline cartilage, while the control group showed no new cartilage tissue.
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Affiliation(s)
- Paniz Haghighi
- School of Mechanical Engineering, Sharif University of Technology, Tehran, Iran; Stem Cell and Regenerative Medicine Institute, Sharif University of Technology, Tehran, Iran
| | - Amir Shamloo
- School of Mechanical Engineering, Sharif University of Technology, Tehran, Iran; Stem Cell and Regenerative Medicine Institute, Sharif University of Technology, Tehran, Iran.
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3
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Mellgren T, Trbakovic A, Thor A, Ekman S, Ley C, Öhman-Mägi C, Johansson PH, Jensen-Waern M, Hedenqvist P. Guided bone tissue regeneration using a hollow calcium phosphate based implant in a critical size rabbit radius defect. Biomed Mater 2021; 16. [PMID: 33477115 DOI: 10.1088/1748-605x/abde6f] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 01/21/2021] [Indexed: 11/11/2022]
Abstract
Long bone fractures are common and sometimes difficult to treat. Autologous bone (AB), bovine bone and calcium phosphates are used to stimulate bone growth with varying results. In the present study, a calcium phosphate cement (CPC) that previously showed promising grafting capabilities was evaluated for the first time in a long bone defect. A radius defect of 20 mm was created in twenty rabbits. The defect was filled by either a hollow CPC implant that had been previously manufactured as a replica of a rabbit radius through indirect 3D printing, or by particulate AB as control. Defect filling and bone formation was evaluated after 12 weeks by combining micro computed tomography (μCT) and scoring of 3D images, together with histomorphometry and histology. The μCT and histomorphometric evaluations showed a similar amount of filling of the defect (combining graft and bone) between the CPC and AB group, but the scoring of 3D images showed that the filling in the CPC group was significantly larger. Histologically the AB graft could not be distinguished from the new bone. The AB treated defects were found to be composed of more bone than the CPC group, including reorganised cancellous and cortical bone. Both the CPC and AB material was associated with new bone formation, also in the middle of the defect, which could result in closing of the otherwise critically sized gap. This study shows the potential for an indirectly 3D printed implant in guided bone regeneration in critically sized long bone defects.
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Affiliation(s)
- Torbjörn Mellgren
- Department of Engineering Sciences, Uppsala University, PO Box 534, Uppsala, 75121, SWEDEN
| | - Amela Trbakovic
- Surgical Sciences, Plastic & Oral Maxillofacial Surgery, Uppsala University, Käkkirurgiska kliniken, Akademiska sjukhuset ingång 79, Uppsala, 751 85, SWEDEN
| | - Andreas Thor
- Surgical Sciences, Plastic & Oral Maxillofacial Surgery, Uppsala University, Käkkirurgiska kliniken, Akademiska sjukhuset ingång 79, Uppsala, 751 85, SWEDEN
| | - Stina Ekman
- Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, PO Box 7028, Uppsala, 750 07, SWEDEN
| | - Cecilia Ley
- Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, PO Box 7028, Uppsala, 750 07, SWEDEN
| | | | - Petra Hammarström Johansson
- Prosthodontics, Institution for odontology, Sahlgrenska Academy at University of Gothenburg , Medicinaregaran 12, 413 90 Göteborg, Sweden, Gothenburg, 413 90, SWEDEN
| | - Marianne Jensen-Waern
- Clinical Sciences, Swedish University of Agricultural Sciences, PO Box 7054, Uppsala, 750 07, SWEDEN
| | - Patricia Hedenqvist
- Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, SWEDEN
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4
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Everding J, Stolberg-Stolberg J, Raschke MJ, Stange R. [Stimulation of fracture healing by growth factors and cell-based technologies]. Unfallchirurg 2019; 122:534-543. [PMID: 31201492 DOI: 10.1007/s00113-019-0686-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Bone has the special capability to completely regenerate after trauma and to re-establish its original geometry and biomechanical stability corresponding to the pretrauma conditions. Nevertheless, in daily clinical practice impaired fracture healing and nonunions are regular complications as a result of inadequate mechanical stability and/or insufficient biological processes around the fracture region. Since the beginning of the millennium, intensive research on the physiological processes in bone healing as well as the production and clinical administration of growth factors have enabled the possibility to improve the local biological processes during fracture healing by osteoinduction. Although the initial clinical results, particularly of bone morphogenetic proteins, in fracture healing were promising, growth factors did not become established for unrestricted use in the clinical application. Currently, additional growth factors are being investigated with respect to the potential supportive and osteoinductive characteristics for enhancement of fracture healing and possible clinical applications. Furthermore, the development of cell-based technologies is another promising approach to positively stimulate fracture healing. In addition to the gold standard of autologous bone grafting, harvesting of mesenchymal stroma cells by aspiration has gained in importance in recent years. Allogeneic bone cell transplantation procedures and in particular gene therapy are promising new strategies for the treatment of disorders of fracture healing. This review gives an overview of present and future possibilities for modulation of fracture healing by growth factors and cell-based technologies.
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Affiliation(s)
- J Everding
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Deutschland
| | - J Stolberg-Stolberg
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Deutschland
| | - M J Raschke
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Deutschland
| | - R Stange
- Abteilung für Regenerative Muskuloskelettale Medizin, Universitätsklinikum Münster, Münster, Deutschland.
- Institut für Muskuloskelettale Medizin (IMM), Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
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5
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Olthof MGL, Kempen DHR, Liu X, Dadsetan M, Tryfonidou MA, Yaszemski MJ, Dhert WJA, Lu L. Effect of Biomaterial Electrical Charge on Bone Morphogenetic Protein-2-Induced In Vivo Bone Formation. Tissue Eng Part A 2019; 25:1037-1052. [PMID: 30612538 DOI: 10.1089/ten.tea.2018.0140] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
IMPACT STATEMENT Biomaterials can play a dual role in bone regeneration: they enable local sustained delivery of growth factors, such as bone morphogenetic protein-2 (BMP-2), while they provide structural support as scaffold. By better imitating the properties of native bone tissue, scaffolds may be both osteoconductive and osteoinductive. The latter can be achieved by modifying the electrical charge of the surface. The present work uses tunable oligo[(polyethylene glycol) fumarate] hydrogel and demonstrates that negative charge enhances BMP-2-induced bone formation compared with neutral or positive charge. Altogether, this indicates that tissue-specific surface charge modifications of biomaterials hold great promise in the field of tissue regeneration.
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Affiliation(s)
- Maurits G L Olthof
- 1Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota.,2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.,3Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,4Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | | | - Xifeng Liu
- 1Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota.,2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Mahrokh Dadsetan
- 1Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota.,2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
| | | | - Michael J Yaszemski
- 1Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota.,2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Wouter J A Dhert
- 3Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,4Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | - Lichun Lu
- 1Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota.,2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
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6
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Mittal H, Ray SS, Kaith BS, Bhatia JK, Sukriti, Sharma J, Alhassan SM. Recent progress in the structural modification of chitosan for applications in diversified biomedical fields. Eur Polym J 2018. [DOI: 10.1016/j.eurpolymj.2018.10.013] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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7
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Olthof MGL, Lu L, Tryfonidou MA, Loozen LD, Pouran B, Yaszemski MJ, Meij BP, Dhert WJA, Alblas J, Kempen DHR. The Osteoinductive Effect of Controlled Bone Morphogenic Protein 2 Release Is Location Dependent. Tissue Eng Part A 2018; 25:193-202. [PMID: 30101676 DOI: 10.1089/ten.tea.2017.0427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
IMPACT STATEMENT The main challenge in bone morphogenic protein 2 (BMP-2)-based application lies in finding strategies to prolong its biologic activity as it has a short biological half-life. The present study uses a phosphate-modified oligo[(polyethylene glycol) fumarate] hydrogel that can be tuned to achieve differential release profiles of biologically active BMP-2 release. We demonstrate that this platform outperforms Infuse®, currently used in the clinic and that the osteoinductive effect of BMP-2 is location dependent. Altogether, this study stresses the importance of evaluating efficacy of bone tissue engineering strategies at an orthotopic location rather than subcutaneously. Even more so, it emphasizes the role of biomaterials as a scaffold to achieve proper bone tissue engineering.
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Affiliation(s)
- Maurits G L Olthof
- 1 Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands.,2 Department of Physiology and Biomedical Engineering and Mayo Clinic College of Medicine, Rochester, Michigan.,3 Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Michigan.,4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,5 Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Lichun Lu
- 2 Department of Physiology and Biomedical Engineering and Mayo Clinic College of Medicine, Rochester, Michigan.,3 Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Michigan
| | - Marianna A Tryfonidou
- 4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Loek D Loozen
- 1 Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | - Behdad Pouran
- 1 Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands.,6 Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | - Michael J Yaszemski
- 2 Department of Physiology and Biomedical Engineering and Mayo Clinic College of Medicine, Rochester, Michigan.,3 Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Michigan
| | - Björn P Meij
- 4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Wouter J A Dhert
- 1 Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands.,4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Jacqueline Alblas
- 1 Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | - Diederik H R Kempen
- 7 Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
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8
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Ye Y, Pang Y, Zhang Z, Wu C, Jin J, Su M, Pan J, Liu Y, Chen L, Jin K. Decellularized Periosteum-Covered Chitosan Globule Composite for Bone Regeneration in Rabbit Femur Condyle Bone Defects. Macromol Biosci 2018; 18:e1700424. [PMID: 29931763 DOI: 10.1002/mabi.201700424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 05/17/2018] [Indexed: 12/24/2022]
Abstract
Critical-sized bone defects are incapable of self-healing and are commonly seen in clinical practice. The authors explore a new treatment for this, decellularized periosteum is applied to chitosan globules (chitosan-DP globules) as a hybrid material. The efficacy of chitosan-DP globules on rabbit femoral condyle bone defects is assessed with biocompatibility, biomechanics, and osteogenic efficiency measurements, and compared with the results of chitosan globules and empty control. No difference in cytotoxicity is observed among chitosan-DP globules, chitosan globules, and the empty control. Chitosan-DP globules possesse a better surface for cell adhesion than did chitosan globules. Chitosan-DP globules demonstrate superior efficiency for osteogenesis in the defect area compared to chitosan globules as per microcomputed tomography examination and push-out testing, with relatively minor histological differences. Both chitosan globule groups show more satisfactory results than those for the empty control. The results implicate chitosan-DP globules as a promising solution for bone defects.
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Affiliation(s)
- Yiheng Ye
- Department of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.,Wenzhou Medical University, Wenzhou, 325000, China
| | - Yichuan Pang
- Department of Oral and Maxillofacial Surgery, Affiliated Shanghai 9th People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200000, China
| | - Zeng Zhang
- First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, China
| | - Congcong Wu
- First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, China
| | - Jianfeng Jin
- First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, China
| | - Mingzhen Su
- First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, China
| | - Junle Pan
- First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, China
| | - Yangbo Liu
- Department of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.,Wenzhou Medical University, Wenzhou, 325000, China
| | - Lei Chen
- Department of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.,Wenzhou Medical University, Wenzhou, 325000, China
| | - Keke Jin
- Department of Pathophysiology, Wenzhou Medical University, Wenzhou, 325000, China
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9
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Olthof MGL, Kempen DHR, Liu X, Dadsetan M, Tryfonidou MA, Yaszemski MJ, Dhert WJA, Lu L. Bone morphogenetic protein-2 release profile modulates bone formation in phosphorylated hydrogel. J Tissue Eng Regen Med 2018; 12:1339-1351. [PMID: 29603878 DOI: 10.1002/term.2664] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/30/2017] [Accepted: 03/13/2018] [Indexed: 11/05/2022]
Abstract
The optimal release profile of locally delivered bone morphogenetic protein-2 (BMP-2) for safe and effective clinical application is unknown. In this work, the effect of differential BMP-2 release on bone formation was investigated using a novel biomaterial oligo[(polyethylene glycol) fumarate] bis[2-(methacryloyloxy) ethyl] phosphate hydrogel (OPF-BP) containing poly(lactic-co-glycolic acid) microspheres. Three composite implants with the same biomaterial chemistry and structure but different BMP-loading methods were created: BMP-2 encapsulated in microspheres (OPF-BP-Msp), BMP-2 encapsulated in microspheres and adsorbed on the phosphorylated hydrogel (OPF-BP-Cmb), and BMP-2 adsorbed on the phosphorylated hydrogel (OPF-BP-Ads). These composites were compared with the clinically used BMP-2 carrier, Infuse® absorbable collagen sponge (ACS). Differential release profiles of bioactive BMP-2 were achieved by these composites. In a rat subcutaneous implantation model, OPF-BP-Ads and ACS generated a large BMP-2 burst release (>75%), whereas a more sustained release was seen for OPF-BP-Msp and OPF-BP-Cmb (~25% and 50% burst, respectively). OPF-BP-Ads generated significantly more bone than did all other composites, and the bone formation was 12-fold higher than that of the clinically used ACS. Overall, this study clearly shows that BMP-2 burst release generates more subcutaneous bone than do sustained release in OPF-BP-microsphere composites. Furthermore, composites should not only function as a delivery vehicle but also provide a proper framework to achieve appropriate bone formation.
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Affiliation(s)
- Maurits G L Olthof
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA.,Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | - Diederik H R Kempen
- Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Xifeng Liu
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Mahrokh Dadsetan
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Michael J Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Wouter J A Dhert
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
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10
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Pountos I, Giannoudis PV. Drug-eluting implants for the suppression of metastatic bone disease: current insights. Expert Rev Med Devices 2018; 15:301-311. [PMID: 29561689 DOI: 10.1080/17434440.2018.1456336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION The fixation of impending or pathologic fractures is challenging and their successful management can have a favourable impact on the quality of life of the patient. The progression of the metastatic bone disease can cause significant pain and disability but also could result in the loosening and subsequent failure of the implants. To prevent the additional local growth, postoperative radiotherapy is often recommended, and many patients receive endocrine or chemotherapy. AREAS COVERED Several reports support the antineoplastic drugs to bone cement as an adjuvant to improve implant stability as well as to prevent local cancer progression and failure of reconstructive devices used to treat patients with pathologic fractures. The aim of the present review is to present our current understanding on the effect of local delivery of antineoplastic drugs at the bone site. EXPERT COMMENTARY Encouraging evidence support the application of bone cement loaded with antineoplastic drugs to fill defects and strengthen the fixation of orthopaedic implants. This is an inexpensive and safe method that can improve implant stability, prevent local cancer progression and failure of reconstructive devices. To fully evaluate its clinical effectiveness randomized clinical studies are needed.
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Affiliation(s)
- Ippokratis Pountos
- a Academic Department of Trauma & Orthopaedics, School of Medicine , University of Leeds , Leeds , UK
| | - Peter V Giannoudis
- a Academic Department of Trauma & Orthopaedics, School of Medicine , University of Leeds , Leeds , UK
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11
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Rodríguez-Méndez I, Fernández-Gutiérrez M, Rodríguez-Navarrete A, Rosales-Ibáñez R, Benito-Garzón L, Vázquez-Lasa B, San Román J. Bioactive Sr(II)/Chitosan/Poly(ε-caprolactone) Scaffolds for Craniofacial Tissue Regeneration. In Vitro and In Vivo Behavior. Polymers (Basel) 2018; 10:E279. [PMID: 30966314 PMCID: PMC6415099 DOI: 10.3390/polym10030279] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/23/2018] [Accepted: 03/02/2018] [Indexed: 01/16/2023] Open
Abstract
In craniofacial tissue regeneration, the current gold standard treatment is autologous bone grafting, however, it presents some disadvantages. Although new alternatives have emerged there is still an urgent demand of biodegradable scaffolds to act as extracellular matrix in the regeneration process. A potentially useful element in bone regeneration is strontium. It is known to promote stimulation of osteoblasts while inhibiting osteoclasts resorption, leading to neoformed bone. The present paper reports the preparation and characterization of strontium (Sr) containing hybrid scaffolds formed by a matrix of ionically cross-linked chitosan and microparticles of poly(ε-caprolactone) (PCL). These scaffolds of relatively facile fabrication were seeded with osteoblast-like cells (MG-63) and human bone marrow mesenchymal stem cells (hBMSCs) for application in craniofacial tissue regeneration. Membrane scaffolds were prepared using chitosan:PCL ratios of 1:2 and 1:1 and 5 wt % Sr salts. Characterization was performed addressing physico-chemical properties, swelling behavior, in vitro biological performance and in vivo biocompatibility. Overall, the composition, microstructure and swelling degree (≈245%) of scaffolds combine with the adequate dimensional stability, lack of toxicity, osteogenic activity in MG-63 cells and hBMSCs, along with the in vivo biocompatibility in rats allow considering this system as a promising biomaterial for the treatment of craniofacial tissue regeneration.
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Affiliation(s)
- Itzia Rodríguez-Méndez
- Faculty of Chemistry, Autonomous University of San Luis Potosi, San Luis Potosi 6, Salvador Nava Martínez, 78210 San Luis, S.L.P., Mexico.
| | - Mar Fernández-Gutiérrez
- Institute of Polymer Science and Technology, ICTP-CSIC, C/Juan de la Cierva 3, 28006 Madrid, Spain.
- CIBER, Carlos III Health Institute, C/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
| | - Amairany Rodríguez-Navarrete
- Faculty of Higher Studies, National Autonomous University of Mexico, Av. Chalma s/n Col. La Pastora, Cuautepec Barrio Bajo. Delegación Gustavo A. Madero, Ciudad de México 07160, Mexico.
| | - Raúl Rosales-Ibáñez
- Faculty of Higher Studies, National Autonomous University of Mexico, Av. Chalma s/n Col. La Pastora, Cuautepec Barrio Bajo. Delegación Gustavo A. Madero, Ciudad de México 07160, Mexico.
| | - Lorena Benito-Garzón
- Faculty of Medicine, University of Salamanca, C/Alfonso X el Sabio, s/n, 37007 Salamanca, Spain.
| | - Blanca Vázquez-Lasa
- Institute of Polymer Science and Technology, ICTP-CSIC, C/Juan de la Cierva 3, 28006 Madrid, Spain.
- CIBER, Carlos III Health Institute, C/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
| | - Julio San Román
- Institute of Polymer Science and Technology, ICTP-CSIC, C/Juan de la Cierva 3, 28006 Madrid, Spain.
- CIBER, Carlos III Health Institute, C/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
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12
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The Elution Kinetics of BMP-2, BMP-4, and BMP-7 From a Commercial Human Demineralized Bone Matrix Putty. J Craniofac Surg 2017; 28:2183-2188. [DOI: 10.1097/scs.0000000000004016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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13
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Lowe B, Nam SY. Synthesis and biocompatibility assessment of a cysteine-based nanocomposite for applications in bone tissue engineering. Biomed Eng Lett 2016. [DOI: 10.1007/s13534-016-0239-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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14
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Sukhodub LF, Sukhodub LB, Chorna IV. Chitosan-apatite composites: synthesis and properties. ACTA ACUST UNITED AC 2016. [DOI: 10.7124/bc.000910] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - L. B. Sukhodub
- Mechnikov Institute of Microbiology and Immunology, NAMS of Ukraine
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15
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16
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Biodegradable Materials for Bone Repair and Tissue Engineering Applications. MATERIALS 2015; 8:5744-5794. [PMID: 28793533 PMCID: PMC5512653 DOI: 10.3390/ma8095273] [Citation(s) in RCA: 354] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 08/09/2015] [Accepted: 08/24/2015] [Indexed: 12/21/2022]
Abstract
This review discusses and summarizes the recent developments and advances in the use of biodegradable materials for bone repair purposes. The choice between using degradable and non-degradable devices for orthopedic and maxillofacial applications must be carefully weighed. Traditional biodegradable devices for osteosynthesis have been successful in low or mild load bearing applications. However, continuing research and recent developments in the field of material science has resulted in development of biomaterials with improved strength and mechanical properties. For this purpose, biodegradable materials, including polymers, ceramics and magnesium alloys have attracted much attention for osteologic repair and applications. The next generation of biodegradable materials would benefit from recent knowledge gained regarding cell material interactions, with better control of interfacing between the material and the surrounding bone tissue. The next generations of biodegradable materials for bone repair and regeneration applications require better control of interfacing between the material and the surrounding bone tissue. Also, the mechanical properties and degradation/resorption profiles of these materials require further improvement to broaden their use and achieve better clinical results.
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17
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Seo BB, Choi H, Koh JT, Song SC. Sustained BMP-2 delivery and injectable bone regeneration using thermosensitive polymeric nanoparticle hydrogel bearing dual interactions with BMP-2. J Control Release 2015; 209:67-76. [PMID: 25910579 DOI: 10.1016/j.jconrel.2015.04.023] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 04/15/2015] [Accepted: 04/20/2015] [Indexed: 11/17/2022]
Abstract
Localized and continuous osteogenic stimulation to defected sites is required for effective bone regeneration. Here, we suggest an injectable and sustained bone morphogenetic protein-2 (BMP-2) release system using thermosensitive polymeric nanoparticles bearing dual interacting forces with BMP-2. For sustained BMP-2 release, hydrophobic and ionic interactions were introduced to thermosensitive poly(phosphazene). Hydrophobic isoleucine ethyl ester and hydrophilic poly-ethylene glycol were mainly substituted to the poly(phosphazene) back bone for amphiphilicity and hydrophobic interaction with BMP-2. Carboxylic acid moiety was additionally substituted to the back bone for ionic interaction with BMP-2. These dual interacting polymeric nanoparticles (D-NPs) formed compact nanocomplexes with BMP-2. The aqueous solution of BMP-2/D-NP nanocomplexes was transformed to hydrogel when the temperature of the solution increased. Loaded BMP-2 was sustain-released for three weeks from the BMP-2/D-NP nanocomplex hydrogel. The extended BMP-2 exposure caused higher osteocalcin secretion in C2C12 cells. Significant bone generations were observed at the target site by single injection of BMP-2/D-NP nanocomplexes in vivo.
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Affiliation(s)
- Bo-Bae Seo
- Center for Biomaterials, Korea Institute of Science & Technology, Seoul 130-650, Republic of Korea; Department of Biomolecular Science, University of Science and Technology (UST), Seoul 136-791, Republic of Korea
| | - Hyuck Choi
- Department of Pharmacology and Dental Therapeutics, and Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju 500-757, Republic of Korea
| | - Jeong-Tae Koh
- Department of Pharmacology and Dental Therapeutics, and Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju 500-757, Republic of Korea
| | - Soo-Chang Song
- Center for Biomaterials, Korea Institute of Science & Technology, Seoul 130-650, Republic of Korea; Department of Biomolecular Science, University of Science and Technology (UST), Seoul 136-791, Republic of Korea.
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18
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Shen ZS, Cui X, Hou RX, Li Q, Deng HX, Fu J. Tough biodegradable chitosan–gelatin hydrogels via in situ precipitation for potential cartilage tissue engineering. RSC Adv 2015. [DOI: 10.1039/c5ra06835e] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Chitosan/gelatin composite hydrogels with high strength are prepared by a precipitation method, possess controlled structures and biodegradability, support chondrocyte adhesion and growth, and may have potentials to cartilage tissue engineering.
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Affiliation(s)
- Zhi-Sen Shen
- School of Medicine
- Ningbo University
- Ningbo 315211
- China
- Li Huili Hospital Affiliated to Medicine of Ningbo University
| | - Xiang Cui
- School of Medicine
- Ningbo University
- Ningbo 315211
- China
- Cixi Institute of Biomedical Engineering
| | - Rui-Xia Hou
- Cixi Institute of Biomedical Engineering
- Ningbo Institute of Materials Technology and Engineering
- Chinese Academy of Sciences
- Cixi
- China
| | - Qun Li
- School of Medicine
- Ningbo University
- Ningbo 315211
- China
| | - Hong-Xia Deng
- Li Huili Hospital Affiliated to Medicine of Ningbo University
- Ningbo 315041
- China
| | - Jun Fu
- Cixi Institute of Biomedical Engineering
- Ningbo Institute of Materials Technology and Engineering
- Chinese Academy of Sciences
- Cixi
- China
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19
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Taraballi F, Minardi S, Corradetti B, Yazdi IK, Balliano MA, Van Eps JL, Allegri M, Tasciotti E. Potential avoidance of adverse analgesic effects using a biologically "smart" hydrogel capable of controlled bupivacaine release. J Pharm Sci 2014; 103:3724-3732. [PMID: 25266282 DOI: 10.1002/jps.24190] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 08/08/2014] [Accepted: 08/29/2014] [Indexed: 11/11/2022]
Abstract
Acute pain remains a tremendous clinical and economic burden, as its prevalence and common narcotic-based treatments are associated with poorer outcomes and higher costs. Multimodal analgesia portends great therapeutic promise, but rarely allows opioid sparing, and new alternatives are necessary. Microparticles (MPs) composed of biodegradable polymers [e.g., poly(lactic-co-glycolic acid) or PLGA] have been applied for controlled drug release and acute pain treatment research. However, foreign particles' presence within inflamed tissue may affect the drug release or targeting, and/or cause a secondary inflammatory reaction. We examined how small alterations in the particulate nature of MPs affect both their uptake into and subsequent activation of macrophages. MPs composed of PLGA and chitosan (PLGA-Chi) loaded with bupivacaine (BP) were engineered at different sizes and their opsonization by J774 macrophages was assessed. Uptake of PLGA-Chi by macrophages was found to be size dependent, but they were not cytotoxic or proinflammatory in effect. Moreover, encapsulation of MPs in a thermoresponsive loading gel (pluronic F-127) effectively prevented opsonization. Finally, MPs displayed sustained, tunable release of BP up to 7 days. These results demonstrate our ability to develop a drug delivery system capable of controlled release of local anesthetics to treat acute/subacute pain while concurrently avoiding enhanced inflammation.
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Affiliation(s)
- Francesca Taraballi
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas 77030; Pain Therapy Service, University of Pavia-Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Silvia Minardi
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas 77030; Bioceramics and Bio-Hybrid Materials, National Research Council of Italy - ISTEC, Faenza, Ravenna 48018, Italy
| | - Bruna Corradetti
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas 77030; Department of Life and Environmental Sciences, Università Politecnica delle Marche, Ancona 60131, Italy
| | - Iman K Yazdi
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas 77030; Department of Biomedical Engineering, University of Houston, Houston, Texas
| | - Marta A Balliano
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas 77030
| | - Jeffrey L Van Eps
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas 77030; Department of Surgery, Houston Methodist Hospital, Houston, Texas 77030
| | - Massimo Allegri
- Pain Therapy Service, University of Pavia-Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinic Surgical Pediatric and Diagnostic Sciences, University of Pavia, Pavia, Italy
| | - Ennio Tasciotti
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas 77030.
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20
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Tendon-to-bone healing using an injectable calcium phosphate cement combined with bone xenograft/BMP composite. Biomaterials 2013; 34:9926-36. [DOI: 10.1016/j.biomaterials.2013.09.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 09/04/2013] [Indexed: 12/26/2022]
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21
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Saito W, Uchida K, Ueno M, Matsushita O, Inoue G, Nishi N, Ogura T, Hattori S, Fujimaki H, Tanaka K, Takaso M. Acceleration of bone formation during fracture healing by injectable collagen powder and human basic fibroblast growth factor containing a collagen-binding domain fromClostridium histolyticumcollagenase. J Biomed Mater Res A 2013; 102:3049-55. [DOI: 10.1002/jbm.a.34974] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 09/10/2013] [Accepted: 09/23/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Wataru Saito
- Department of Orthopedic Surgery; Kitasato University School of Medicine; 1-15-1 Minami-ku Kitasato Kanagawa Japan
| | - Kentaro Uchida
- Department of Orthopedic Surgery; Kitasato University School of Medicine; 1-15-1 Minami-ku Kitasato Kanagawa Japan
| | - Masaki Ueno
- Department of Orthopedic Surgery; Kitasato University School of Medicine; 1-15-1 Minami-ku Kitasato Kanagawa Japan
| | - Osamu Matsushita
- Department of Bacteriology; Okayama University Graduate School of Medicine; 2-5-1 Kita-ku Shikata-cho Okayama Japan
| | - Gen Inoue
- Department of Orthopedic Surgery; Kitasato University School of Medicine; 1-15-1 Minami-ku Kitasato Kanagawa Japan
| | - Nozomu Nishi
- Life Science Research Center; Kagawa University; 1750-1 Kita-gun Miki-cho Kagawa Japan
| | - Takayuki Ogura
- Nippi Research Institute of Biomatrix and Protein Engineering Project; 520-11 Kuwabara Toride-shi Ibaraki-ken Japan
| | - Shunji Hattori
- Nippi Research Institute of Biomatrix and Protein Engineering Project; 520-11 Kuwabara Toride-shi Ibaraki-ken Japan
| | - Hisako Fujimaki
- Department of Orthopedic Surgery; Kitasato University School of Medicine; 1-15-1 Minami-ku Kitasato Kanagawa Japan
| | - Keisuke Tanaka
- Nippi Research Institute of Biomatrix and Protein Engineering Project; 520-11 Kuwabara Toride-shi Ibaraki-ken Japan
| | - Masashi Takaso
- Department of Orthopedic Surgery; Kitasato University School of Medicine; 1-15-1 Minami-ku Kitasato Kanagawa Japan
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22
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Hamilton PT, Jansen MS, Ganesan S, Benson RE, Hyde-DeRuyscher R, Beyer WF, Gile JC, Nair SA, Hodges JA, Grøn H. Improved bone morphogenetic protein-2 retention in an injectable collagen matrix using bifunctional peptides. PLoS One 2013; 8:e70715. [PMID: 23950987 PMCID: PMC3738572 DOI: 10.1371/journal.pone.0070715] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 06/28/2013] [Indexed: 11/19/2022] Open
Abstract
To promote healing of many orthopedic injuries, tissue engineering approaches are being developed that combine growth factors such as Bone Morphogenetic Proteins (BMP) with biomaterial carriers. Although these technologies have shown great promise, they still face limitations. We describe a generalized approach to create target-specific modular peptides that bind growth factors to implantable biomaterials. These bifunctional peptide coatings provide a novel way to modulate biology on the surface of an implant. Using phage display techniques, we have identified peptides that bind with high affinity to BMP-2. The peptides that bind to BMP-2 fall into two different sequence clusters. The first cluster of peptide sequences contains the motif W-X-X-F-X-X-L (where X can be any amino acid) and the second cluster contains the motif F-P-L-K-G. We have synthesized bifunctional peptide linkers that contain BMP-2 and collagen-binding domains. Using a rat ectopic bone formation model, we have injected rhBMP-2 into a collagen matrix with or without a bifunctional BMP-2: collagen peptide (BC-1). The presence of BC-1 significantly increased osteogenic cellular activity, the area of bone formed, and bone maturity at the site of injection. Our results suggest that bifunctional peptides that can simultaneously bind to a growth factor and an implantable biomaterial can be used to control the delivery and release of growth factors at the site of implantation.
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Affiliation(s)
- Paul T. Hamilton
- Department of Microbiology, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Michelle S. Jansen
- Affinergy, LLC, Research Triangle Park, North Carolina, United States of America
| | - Sathya Ganesan
- Affinergy, LLC, Research Triangle Park, North Carolina, United States of America
| | - R. Edward Benson
- Platform Technology and Science, GlaxoSmithKline, Research Triangle Park, North Carolina, United States of America
| | - Robin Hyde-DeRuyscher
- Manufacturing Sciences, Biogen Idec, Research Triangle Park, North Carolina, United States of America
| | - Wayne F. Beyer
- QNS Group, LLC, Durham, North Carolina, United States of America
| | - Joseph C. Gile
- Gile Surgical Support, Bangor, Maine, United States of America
| | - Shrikumar A. Nair
- Affinergy, LLC, Research Triangle Park, North Carolina, United States of America
| | - Jonathan A. Hodges
- Affinergy, LLC, Research Triangle Park, North Carolina, United States of America
- * E-mail:
| | - Hanne Grøn
- Haemophilia Biochemistry, Novo Nordisk, Måløv, Denmark
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23
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Van Schepdael A, Vander Sloten J, Geris L. Mechanobiological modeling can explain orthodontic tooth movement: Three case studies. J Biomech 2013. [DOI: 10.1016/j.jbiomech.2012.10.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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24
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Jo S, Kim S, Cho TH, Shin E, Hwang SJ, Noh I. Effects of recombinant human bone morphogenic protein-2 and human bone marrow-derived stromal cells onin vivobone regeneration of chitosan-poly(ethylene oxide) hydrogel. J Biomed Mater Res A 2012; 101:892-901. [DOI: 10.1002/jbm.a.34354] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 05/30/2012] [Accepted: 06/26/2012] [Indexed: 01/22/2023]
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25
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Markel DC, Guthrie ST, Wu B, Song Z, Wooley PH. Characterization of the inflammatory response to four commercial bone graft substitutes using a murine biocompatibility model. J Inflamm Res 2012; 5:13-8. [PMID: 22334792 PMCID: PMC3278258 DOI: 10.2147/jir.s21411] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Bone grafting is utilized in nearly all orthopedic subspecialties and in most anatomic regions. Bone graft substitutes have the potential to offer similar efficacy as autogenous grafts without the morbidity of harvest. Several studies have noted the efficacy of new-generation bone substitute products, but few studies have evaluated their safety. This study characterizes and quantifies the inflammatory reaction to four different commercially available bone graft substitutes, which were examined using the in vivo murine air pouch biocompatibility model. One coralline hydroxyapatite product was chosen as an example of a purely osteoconductive material. Three demineralized bone matrix products were chosen to represent products that are both osteoconductive and osteoinductive. Samples were implanted in a murine air pouch and harvested after 14 days in situ. Pouch fluid was extracted, mRNA isolated, and reverse transcription polymerase chain reactions carried out to detect interleukin-1 gene expression as a marker for inflammation. In addition, multiple histological characteristics were examined to quantify cellular responses to the implanted materials. All bone graft substitutes induced a significant inflammatory response compared with negative controls. Histology and polymerase chain reaction data indicated that the level of inflammatory reaction was elevated in materials with a higher demineralized bone matrix to carrier proportion. The hydroxyapatite product generated a low inflammatory reaction. In conclusion, this study used an in vivo model of biocompatibility to demonstrate that a significant inflammatory reaction occurs when using implanted bone graft substitutes. When choosing a bone grafting method, surgeons should consider both the efficacy and safety of methods and materials used. Further studies are necessary to determine the ideal bone graft material to maximize efficacy while minimizing morbidity.
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Affiliation(s)
- David C Markel
- Department of Orthopaedics, Providence Hospital and Medical Centers, Southfield, MI
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26
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Dash M, Chiellini F, Ottenbrite R, Chiellini E. Chitosan—A versatile semi-synthetic polymer in biomedical applications. Prog Polym Sci 2011. [DOI: 10.1016/j.progpolymsci.2011.02.001] [Citation(s) in RCA: 1932] [Impact Index Per Article: 148.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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27
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UENO M, UCHIDA K, TAKASO M, MINEHARA H, SUTO K, TAKAHIRA N, STECK R, SCHUETZ MA, ITOMAN M. Distribution of Bone Marrow-Derived Cells in the Fracture Callus during Plate Fixation in a Green Fluorescent Protein-Chimeric Mouse Model. Exp Anim 2011; 60:455-62. [DOI: 10.1538/expanim.60.455] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Masaki UENO
- Kitasato University School of Medicine, Department of Orthopaedic Surgery
| | - Kentaro UCHIDA
- Kitasato University School of Medicine, Department of Orthopaedic Surgery
| | - Masashi TAKASO
- Kitasato University School of Medicine, Department of Orthopaedic Surgery
| | - Hiroaki MINEHARA
- Kitasato University School of Medicine, Department of Orthopaedic Surgery
| | - Kaori SUTO
- Kitasato University School of Medicine, Department of Orthopaedic Surgery
| | - Naonobu TAKAHIRA
- Kitasato University School of Medicine, Department of Orthopaedic Surgery
| | - Roland STECK
- Institute of Health and Biomedical Innovation, Queensland University of Technology
| | - Michael A. SCHUETZ
- Institute of Health and Biomedical Innovation, Queensland University of Technology
- Trauma Services, The Princess Alexandra Hospital
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28
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Luca L, Rougemont AL, Walpoth BH, Boure L, Tami A, Anderson JM, Jordan O, Gurny R. Injectable rhBMP-2-loaded chitosan hydrogel composite: osteoinduction at ectopic site and in segmental long bone defect. J Biomed Mater Res A 2010; 96:66-74. [PMID: 21105153 DOI: 10.1002/jbm.a.32957] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 07/06/2010] [Accepted: 07/08/2010] [Indexed: 01/21/2023]
Abstract
Carriers for bone morphogenetic protein-2 (BMP-2) used in clinical practice still suffer from limitations such as insufficient protein retention. In addition, there is a clinical need for injectable carriers. The main objective of this study was to assess bone forming ability of rhBMP-2 combined either with chitosan hydrogel (rhBMP-2/CH) or chitosan hydrogel containing β-tricalcium phosphate (β-TCP) (rhBMP-2/CH/TCP). Formulations were first compared in a rat ectopic intramuscular bone formation model, and the optimal formulation was further evaluated in healing of 15-mm critical size defect in the radius of a rabbit. Three weeks after injection ectopically formed bone was analyzed by microcomputerized tomography (micro-CT) and histology. Significantly higher (4.7-fold) mineralized bone formation was observed in the rhBMP-2/CH/TCP group compared to rhBMP-2/CH group. In a pilot study, defect in a rabbit radius treated with rhBMP-2/CH/TCP showed incomplete regeneration at 8 weeks with composite leakage from the defect, indicating the need for formulation refinement when segmental defect repair is foreseen.
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Affiliation(s)
- Ludmila Luca
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
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29
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García Cruz DM, Gomes M, Reis RL, Moratal D, Salmerón-Sánchez M, Gómez Ribelles JL, Mano JF. Differentiation of mesenchymal stem cells in chitosan scaffolds with double micro and macroporosity. J Biomed Mater Res A 2010; 95:1182-93. [DOI: 10.1002/jbm.a.32906] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 04/22/2010] [Accepted: 05/25/2010] [Indexed: 11/12/2022]
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30
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Kempen DHR, Lu L, Hefferan TE, Creemers LB, Heijink A, Maran A, Dhert WJA, Yaszemski MJ. Enhanced bone morphogenetic protein-2-induced ectopic and orthotopic bone formation by intermittent parathyroid hormone (1-34) administration. Tissue Eng Part A 2010; 16:3769-77. [PMID: 20666615 DOI: 10.1089/ten.tea.2010.0173] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Bone morphogenetic proteins (BMPs) play a central role in local bone regeneration strategies, whereas the anabolic features of parathyroid hormone (PTH) are particularly appealing for the systemic treatment of generalized bone loss. The aim of the current study was to investigate whether local BMP-2-induced bone regeneration could be enhanced by systemic administration of PTH (1-34). Empty or BMP-2-loaded poly(lactic-co glycolic acid)/poly(propylene fumarate)/gelatin composites were implanted subcutaneously and in femoral defects in rats (n = 9). For the orthotopic site, empty defects were also tested. Each of the conditions was investigated in combination with daily administered subcutaneous PTH (1-34) injections in the neck. After 8 weeks of implantation, bone mineral density (BMD) and bone volume were analyzed using microcomputed tomography and histology. Ectopic bone formation and almost complete healing of the femoral defect were only seen in rats that received BMP-2-loaded composites. Additional treatment of the rats with PTH (1-34) resulted in significantly (p < 0.05) enhanced BMD and bone volume in the BMP-2 composites at both implantation sites. Despite its effect on BMD in the humerus and vertebra, PTH (1-34) treatment had no significant effect on BMD and bone volume in the empty femoral defects and the ectopically or orthotopically implanted empty composites. Histological analysis showed that the newly formed bone had a normal woven and trabecular appearance. Overall, this study suggests that intermittent administration of a low PTH dose alone has limited potential to enhance local bone regeneration in a critical-sized defect in rats. However, when combined with local BMP-2-releasing scaffolds, PTH administration significantly enhanced osteogenesis in both ectopic and orthotopic sites.
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Affiliation(s)
- Diederik H R Kempen
- Tissue Engineering and Biomaterials Laboratory, Department of Orthopedic Surgery and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA
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31
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A hybrid bioregulatory model of angiogenesis during bone fracture healing. Biomech Model Mechanobiol 2010; 10:383-95. [PMID: 20827500 DOI: 10.1007/s10237-010-0241-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 06/30/2010] [Indexed: 01/15/2023]
Abstract
Bone fracture healing is a complex process in which angiogenesis or the development of a blood vessel network plays a crucial role. In this paper, a mathematical model is presented that simulates the biological aspects of fracture healing including the formation of individual blood vessels. The model consists of partial differential equations, several of which describe the evolution in density of the most important cell types, growth factors, tissues and nutrients. The other equations determine the growth of blood vessels as a result of the movement of leading endothelial (tip) cells. Branching and anastomoses are accounted for in the model. The model is applied to a normal fracture healing case and subjected to a sensitivity analysis. The spatiotemporal evolution of soft tissues and bone, as well as the development of a blood vessel network are corroborated by comparison with experimental data. Moreover, this study shows that the proposed mathematical framework can be a useful tool in the research of impaired healing and the design of treatment strategies.
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32
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Geris L, Reed AAC, Vander Sloten J, Simpson AHRW, Van Oosterwyck H. Occurrence and treatment of bone atrophic non-unions investigated by an integrative approach. PLoS Comput Biol 2010; 6:e1000915. [PMID: 20824125 PMCID: PMC2932678 DOI: 10.1371/journal.pcbi.1000915] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 08/03/2010] [Indexed: 12/15/2022] Open
Abstract
Recently developed atrophic non-union models are a good representation of the clinical situation in which many non-unions develop. Based on previous experimental studies with these atrophic non-union models, it was hypothesized that in order to obtain successful fracture healing, blood vessels, growth factors, and (proliferative) precursor cells all need to be present in the callus at the same time. This study uses a combined in vivo-in silico approach to investigate these different aspects (vasculature, growth factors, cell proliferation). The mathematical model, initially developed for the study of normal fracture healing, is able to capture essential aspects of the in vivo atrophic non-union model despite a number of deviations that are mainly due to simplifications in the in silico model. The mathematical model is subsequently used to test possible treatment strategies for atrophic non-unions (i.e. cell transplant at post-osteotomy, week 3). Preliminary in vivo experiments corroborate the numerical predictions. Finally, the mathematical model is applied to explain experimental observations and identify potentially crucial steps in the treatments and can thereby be used to optimize experimental and clinical studies in this area. This study demonstrates the potential of the combined in silico-in vivo approach and its clinical implications for the early treatment of patients with problematic fractures. In light of the ageing population, the occurrence of bone fractures is expected to rise substantially in the near future. In 5 to 10% of these cases, the healing process does not succeed in repairing the bone, leading to the formation of delayed unions or even non-unions. In this study we used a combination of an animal model mimicking a clinical non-union situation and a mathematical model developed for normal fracture healing to investigate both the causes of non-union formation and potential therapeutic strategies that can be applied to restart the healing process. After showing that the mathematical model is able to simulate key aspects of the non-union formation, we have used it to investigate several treatment strategies. One of these strategies, the treatment of a non-union involving a transplantation of cells from the bone marrow to the fracture site, was also tested in a pilot animal experiment. Both the simulations and the experiments showed the formation of a bony union between the fractured bone ends. In addition, we used the mathematical model to explain some unexpected experimental observations. This study demonstrates the added value of using a combination of mathematical modelling and experimental research as well the potential of using cell transplantation for the treatment of non-unions.
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Affiliation(s)
- Liesbet Geris
- Division of Biomechanics and Engineering Design, Department of Mechanical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium.
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Li M, Liu X, Liu X, Ge B. Calcium phosphate cement with BMP-2-loaded gelatin microspheres enhances bone healing in osteoporosis: a pilot study. Clin Orthop Relat Res 2010; 468:1978-85. [PMID: 20306162 PMCID: PMC2881991 DOI: 10.1007/s11999-010-1321-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Accepted: 03/08/2010] [Indexed: 01/31/2023]
Abstract
BACKGROUND The capacity for bone healing reportedly is limited in osteoporosis with a less than ideal environment for healing of bone grafts. We therefore developed a composite bone substitute with rhBMP-2 loaded gelatin microsphere (GM) and calcium phosphate cement (CPC) to use in osteoporosis. QUESTIONS/PURPOSES We asked whether (1) controlled release of rhBMP-2 could be improved in this composite bone substitute and (2) increasing factors released from the bone substitute could accelerate osteoporotic bone healing. METHODS We soaked rhBMP-2/GM/CPC and rhBMP-2/CPC composites in simulated body fluid for 28 days and then determined the amount of rhBMP-2 released. Both composites were implanted in bone defects of osteoporotic goats and left in place for 45 and 140 days; the specimens then were evaluated mechanically (pushout test) and morphologically (CT scanning, histology). RESULTS The in vitro study showed the new composite released more rhBMP-2 compared with rhBMP-2/CPC. CT showed the defects healed more quickly with new grafts. The bone mineralization rate was greater in rhBMP-2/GM/CPC than in rhBMP-2/CPC after 45 days of implantation and the pushout test was stronger after 45 and 140 days of implantation. CONCLUSIONS The new graft composite released more loaded factors and appeared to repair osteoporotic bone defects. CLINICAL RELEVANCE These preliminary data suggest the new composite can be used as a bone substitute to accelerate healing of fractures and bone defects in osteoporosis.
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Affiliation(s)
- Meng Li
- Orthopedic Trauma Institute of CPLA, Lanzhou General Hospital of CPLA, 333 Bing-he-nan Road, Lanzhou, 730050 Gansu Province People’s Republic of China
| | - Xingyan Liu
- Orthopedic Trauma Institute of CPLA, Lanzhou General Hospital of CPLA, 333 Bing-he-nan Road, Lanzhou, 730050 Gansu Province People’s Republic of China
| | - Xudong Liu
- Orthopedic Trauma Institute of CPLA, Lanzhou General Hospital of CPLA, 333 Bing-he-nan Road, Lanzhou, 730050 Gansu Province People’s Republic of China
| | - Baofeng Ge
- Orthopedic Trauma Institute of CPLA, Lanzhou General Hospital of CPLA, 333 Bing-he-nan Road, Lanzhou, 730050 Gansu Province People’s Republic of China
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Ge H, Zhao B, Lai Y, Hu X, Zhang D, Hu K. From crabshell to chitosan-hydroxyapatite composite material via a biomorphic mineralization synthesis method. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2010; 21:1781-1787. [PMID: 20237825 DOI: 10.1007/s10856-010-4045-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 03/01/2010] [Indexed: 05/28/2023]
Abstract
Hydroxyapatite-polymer composite materials, as biological bone tissue materials, have become an important research direction. In this paper, the calcium carbonate from the crabshells was transformed into hydroxyapatite by a hydrothermal process. According to the method that we called Biomorphic Mineralization synthesis, we obtained a novel kind of hydroxyapatite-chitosan composite materials which reserved the natural perfect structure of the original crabshells. Benefited from its fine micro-structure as the crabshells, this kind of materials held a high value of tensile modulus, which is expected to be promising bone tissue engineering applications.
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Affiliation(s)
- Haoran Ge
- State Key Lab of Metal Matrix Composites, Department of Materials Science and Engineering, Shanghai Jiaotong University, 800 Dongchuan Road, 200240 Shanghai, People's Republic of China
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Affiliation(s)
- Thorsten Schinke
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Salamon A, Toldy E. [Use of mesenchymal stem cells from adult bone marrow for injured tissue repair]. Orv Hetil 2009; 150:1259-65. [PMID: 19531459 DOI: 10.1556/oh.2009.28666] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Mesenchymal stem cells are known as being multipotent and exhibit the potential for differentiation into different cells/tissue lineages, including cartilage, bone, adipose tissue, tendon, and ligament. These pluripotent mesenchymal progenitor cells are denoted as stromal or mesenchymal stem cells. Bone marrow contains two main cell types: hematopoietic cells and stromal cells. The stem cells for non hematopoietic tissues are referred as mesenchymal cells because of their ability to differentiate as mesenchymal or stromal cells. Mesenchymal cells are easily obtainable from bone marrow by means of minimally invasive approach and can be expanded in culture and permitted to differentiate into the desired lineage. The differentiation can be reached by the application of bioactive signaling molecules, specific growth factors. The transforming growth factor beta (TGF-beta) superfamily member proteins such as the bone morphogenetic proteins (BMP-s) are the most important factors of chondrogenic and osteogenic differentiation of mesenchymal stem cells. From the series of recently identified factors, BMP 2,4 and 7 may play an important role in chondrogenic and osteogenic differentiation proteins. Little is known, however, about the signaling pathway involved in tenogenesis of mesenchymal stem cells, but there are some encouraging data about fibroblastic differentiation. The success of growth factor therapy needs a delivery system with biomaterials. Mesenchymal stem cells have become promising vehicles for gene therapy, cell therapy and tissue engineering. In present review, authors deal with the experimental investigations and with the clinical application of the adult bone marrow derived mesenchymal stem cells with bioactive molecules, growth factors.
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Affiliation(s)
- Antal Salamon
- Vas Megyei Markusovszky Lajos Altalános és Rehabilitációs Gyógyfürdo Kórház, Egyetemi Oktató Kórház, Baleseti, Helyreállító és Kézsebészeti Osztály, Szombathely.
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BMP-2-Based Repair of Large-Scale Calvarial Defects in an Experimental Model. J Craniofac Surg 2008; 19:1315-22. [DOI: 10.1097/scs.0b013e3181843369] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Kempen DHR, Lu L, Classic KL, Hefferan TE, Creemers LB, Maran A, Dhert WJA, Yaszemski MJ. Non-invasive screening method for simultaneous evaluation of in vivo growth factor release profiles from multiple ectopic bone tissue engineering implants. J Control Release 2008; 130:15-21. [PMID: 18554743 DOI: 10.1016/j.jconrel.2008.05.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Revised: 04/29/2008] [Accepted: 05/06/2008] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to develop and validate a screening method based on scintillation probes for the simultaneous evaluation of in vivo growth factor release profiles of multiple implants in the same animal. First, we characterized the scintillation probes in a series of in vitro experiments to optimize the accuracy of the measurement setup. The scintillation probes were found to have a strong geometric dependence and experience saturation effects at high activities. In vitro simulation of 4 subcutaneous limb implants in a rat showed minimal interference of surrounding implants on local measurements at close to parallel positioning of the probes. These characteristics were taken into consideration for the design of the probe setup and in vivo experiment. The measurement setup was then validated in a rat subcutaneous implantation model using 4 different sustained release carriers loaded with (125)I-BMP-2 per animal. The implants were removed after 42 or 84 days of implantation, for comparison of the non-invasive method to ex vivo radioisotope counting. The non-invasive method demonstrated a good correlation with the ex vivo counting method at both time-points of all 4 carriers. Overall, this study showed that scintillation probes could be successfully used for paired measurement of 4 release profiles with minimal interference of the surrounding implants, and may find use as non-invasive screening tools for various drug delivery applications.
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Affiliation(s)
- Diederik H R Kempen
- Tissue Engineering and Biomaterials Laboratory, Departments of Orthopedic Surgery and Biomedical Engineering, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Verma D, Katti KS, Katti DR, Mohanty B. Mechanical response and multilevel structure of biomimetic hydroxyapatite/polygalacturonic/chitosan nanocomposites. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2008. [DOI: 10.1016/j.msec.2007.04.026] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Robertson WJ, Hatch JD, Rodeo SA. Evaluation of tendon graft fixation using alpha-BSM calcium phosphate cement. Arthroscopy 2007; 23:1087-92. [PMID: 17916474 DOI: 10.1016/j.arthro.2007.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Revised: 04/05/2007] [Accepted: 04/05/2007] [Indexed: 02/02/2023]
Abstract
PURPOSE Many ligament reconstruction procedures require tendon healing within a surgically prepared bone tunnel. The interface between the graft and tunnel wall is the "weak link" in the initial phase of this process. By providing additional fixation and serving as a carrier for bone-derived growth factors, calcium phosphate cements may augment healing. The purpose of this study was to evaluate alpha-BSM calcium phosphate cement as the sole method of fixation for tendon and bone-tendon-bone grafts in an in vitro porcine model. METHODS Ten tendon grafts and ten bone-tendon-bone grafts were fixed within porcine femoral and tibial bone tunnels by use of alpha-BSM calcium phosphate cement. The grafts were then loaded to failure. The ultimate pullout strength and the site of failure were recorded for each specimen. RESULTS The bone-tendon-bone grafts achieved a mean pullout strength of 224.8 N (+/-79.9 N). Of the grafts, 6 failed at the cement-bone plug interface, 2 failed because of fracture of the bone plug, and 2 failed at the tendon-bone plug interface. The tendon grafts had a mean load to failure of 81.2 N (+/-23.7 N), and all 10 failed at the tendon-cement interface. The difference in fixation strength between these graft types was significant (P < .05). CONCLUSIONS Though inadequate as the sole means of graft fixation, alpha-BSM calcium phosphate cement can help to augment bone plug fixation during the early phase of tendon-bone healing. In addition, alpha-BSM may provide added graft fixation and increased stiffness and act as a growth factor carrier for both tendon grafts and bone-tendon-bone grafts in ligament reconstruction surgery. CLINICAL RELEVANCE This study evaluated the ability of alpha-BSM cement to augment tendon-bone healing because it may play a role as a growth factor carrier in future tendon healing models.
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Abstract
The role of bone morphogenetic proteins (BMPs) in bone healing has been shown in numerous animal models. To date, at least 20 BMPs have been identified, some of which have been shown in vitro to stimulate the process of stem cell differentiation into osteoblasts in human and animal models. Having realized the osteoinductive properties of BMPs and having identified their genetic sequences, recombinant gene technology has been used to produce BMPs for clinical application - most commonly, as alternatives or adjuncts in the treatment of cases in which fracture healing is compromised. BMP-2 and BMP-7 are approved for clinical use in open fractures of long bones, non-unions and spinal fusion. However, despite significant evidence of their potential benefit to bone repair and regeneration in animal and preclinical studies, there is, to date, a dearth of convincing clinical trials. The purpose of this paper is to give a brief overview of BMPs and to critically review the clinical data currently available on the use of BMP-2 and BMP-7 in fracture healing.
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Affiliation(s)
- Oliver P Gautschi
- Department of Orthopaedic and Trauma Surgery, Royal Perth Hospital, School of Anatomy and Human Biology, University of Western Australia, Perth, Western Australia, Australia.
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Bauer TW. An overview of the histology of skeletal substitute materials. Arch Pathol Lab Med 2007; 131:217-24. [PMID: 17284105 DOI: 10.5858/2007-131-217-aootho] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2006] [Indexed: 11/06/2022]
Abstract
CONTEXT Orthopedic and spine surgeons are in frequent need of bone for skeletal reconstruction. The amount of autograft is limited, and conventional allograft has some disadvantages, so surgeons are now using increasing amounts of demineralized allograft and a variety of synthetic materials to replace or "extend" autograft. OBJECTIVE To provide an overview of the composition and histology of the materials most likely to be seen by pathologists today. DATA SOURCES The review is based on published literature and the author's experience with preclinical studies and human biopsies. CONCLUSIONS Pathologists are likely to find these skeletal substitute materials in biopsy and resection specimens from patients who have undergone prior treatment, and recognizing a synthetic bone substitute can help explain an otherwise confusing specimen. Pathologists also play an important role in helping define the safety and efficacy of new bioactive materials.
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Affiliation(s)
- Thomas W Bauer
- Department of Pathology, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106, USA.
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Takahashi Y, Yamamoto M, Yamada K, Kawakami O, Tabata Y. Skull Bone Regeneration in Nonhuman Primates by Controlled Release of Bone Morphogenetic Protein-2 from a Biodegradable Hydrogel. ACTA ACUST UNITED AC 2007; 13:293-300. [PMID: 17504062 DOI: 10.1089/ten.2006.0088] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The objective of this study was to investigate the feasibility of biodegradable gelatin hydrogels as the controlled-release carrier of bone morphogenetic protein-2 (BMP-2) to enhance bone regeneration at a skull defect of nonhuman primates. Hydrogels with 3 different water contents were prepared through glutaraldehyde crosslinking of gelatin with an isoelectric point of 9.0 under varied reaction conditions. A critical-sized defect (6 mm in diameter) was prepared at the skull bone of skeletally mature cynomolgus monkeys, and gelatin hydrogels incorporating various doses of BMP-2 were applied to the defects. When the bone regeneration was evaluated by soft radiography and bone mineral density (BMD) examinations, the gelatin hydrogel incorporating BMP-2 exhibited significantly higher osteoinduction activity than did an insoluble bone matrix that incorporated BMP-2 (one of the best osteoinduction systems), although the activity depended on the water content of hydrogels. BMD enhancement was highest for the gelatin hydrogel that had a water content of 97.8 wt% among all types of hydrogels. Moreover, the gelatin hydrogel enabled BMP-2 to induce the bone regeneration in nonhuman primates even at low doses. We conclude that the controlled release of BMP-2 for a certain time period was essential to inducing the osteoinductive potential of BMP-2.
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Affiliation(s)
- Yoshitake Takahashi
- Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
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Abstract
BACKGROUND Stem cells have been isolated from a variety of embryonic and postnatal (adult) tissues, including bone marrow. Bone marrow stromal cells (BMSCs), which are non-blood-forming cells in marrow, contain a subset of skeletal stem cells (SSCs) that are able to regenerate all types of skeletal tissue: bone, cartilage, blood-supportive stromal cells and marrow fat cells. METHODS Bone marrow suspensions are placed into culture for analysis of their biological character and for expansion of their number. The resulting populations of cells are used in a variety of assays to establish the existence of an adult SSC, and the ability of BMSC populations to regenerate hard tissues in the craniofacial region, in conjunction with appropriate scaffolds. RESULTS Single-cell analysis established the existence of a true adult SSC in bone marrow. Populations of ex vivo expanded BMSCs (a subset of which are SSCs) are able to regenerate a bone/marrow organ. In conjunction with appropriate scaffolds, these cells can be used to regenerate bone in a variety of applications. CONCLUSIONS BMSCs have the potential to re-create tissues of the craniofacial region to restore normal structure and function in reconstructing the hard tissues of a face. Ex vivo expanded BMSCs with scaffolds have been used in a limited number of patients to date, but likely will be used more extensively in the near future.
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Affiliation(s)
- Pamela Gehron Robey
- Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
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Ginebra MP, Traykova T, Planell JA. Calcium phosphate cements as bone drug delivery systems: A review. J Control Release 2006; 113:102-10. [PMID: 16740332 DOI: 10.1016/j.jconrel.2006.04.007] [Citation(s) in RCA: 378] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Accepted: 04/06/2006] [Indexed: 11/21/2022]
Abstract
Since calcium phosphate cements were proposed, several formulations have been developed, some of them commercialised, and they have proven to be very efficient bone substitutes in different applications. Some of their properties, such as the injectability, or the low-temperature setting, which allows the incorporation of different drugs, make them very attractive candidates as drug carriers. In this article, the performance of calcium phosphate cements as carriers of different types of drugs, such as antibiotics, analgesics, anticancer, anti-inflammatory, as well as growth factors is reviewed.
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Affiliation(s)
- M P Ginebra
- Biomedical Engineering Research Centre, Department of Materials Science and Metallurgical Engineering, Technical University of Catalonia, 08028 Barcelona, Spain.
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Simpson AHRW, Mills L, Noble B. The role of growth factors and related agents in accelerating fracture healing. ACTA ACUST UNITED AC 2006; 88:701-5. [PMID: 16720758 DOI: 10.1302/0301-620x.88b6.17524] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- A H R W Simpson
- The Musculoskeletal Tissue Engineering Consortium, Room SU304, University of Edinburgh, Chancellors Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK.
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Abstract
Hydroxyapatite/hyaluronic acid (HAp/HyA) and hydroxyapatite/chondroitin sulfate (HAp/ChS) microparticles, which show the high adsorption ability of proteins, high biocompatibility and osteoconductivity, are potential scaffolds for a time-controlled BMP release. The present study evaluated the biocompatibility and osteoconductivity of the composites after injection into bone defect. Drilled bone holes were made at tibia and femur of Japanese white rabbits, and HAp/HyA or HAp/ChS was implanted into each bone hole using an injection syringe. After 2 and 4 weeks of implantation, rabbits were sacrificed and histological observations were conducted with HE, TRAP, and ALP staining. Histological observations revealed that HAp/ChS has superior biocompatibility compared with HAp/HyA, and 20% HAp/ChS promotes bone formation as well as osteoblast activities compared with lower ratios of HAp/ChS.
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Affiliation(s)
- J M Wozney
- Wyeth Research, 87 CambridgePark Dr., Cambridge, MA 02140, USA.
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Geris L, Gerisch A, Maes C, Carmeliet G, Weiner R, Vander Sloten J, Van Oosterwyck H. Mathematical modeling of fracture healing in mice: comparison between experimental data and numerical simulation results. Med Biol Eng Comput 2006; 44:280-9. [PMID: 16937169 DOI: 10.1007/s11517-006-0040-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2005] [Accepted: 02/27/2006] [Indexed: 10/24/2022]
Abstract
The combined use of experimental and mathematical models can lead to a better understanding of fracture healing. In this study, a mathematical model, which was originally established by Bailón-Plaza and van der Meulen (J Theor Biol 212:191-209, 2001), was applied to an experimental model of a semi-stabilized murine tibial fracture. The mathematical model was implemented in a custom finite volumes code, specialized in dealing with the model's requirements of mass conservation and non-negativity of the variables. A qualitative agreement between the experimentally measured and numerically simulated evolution in the cartilage and bone content was observed. Additionally, an extensive parametric study was conducted to assess the influence of the model parameters on the simulation outcome. Finally, a case of pathological fracture healing and its treatment by administration of growth factors was modeled to demonstrate the potential therapeutic value of this mathematical model.
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Affiliation(s)
- Liesbet Geris
- Faculty of Engineering, Division of Biomechanics and Engineering Design, K.U. Leuven, Celestijnenlaan 300C, 3001, Leuven, Belgium.
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Obert L, Deschaseaux F, Garbuio P. Critical analysis and efficacy of BMPs in long bones non-union. Injury 2005; 36 Suppl 3:S38-42. [PMID: 16188548 DOI: 10.1016/j.injury.2005.07.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2005] [Accepted: 07/25/2005] [Indexed: 02/02/2023]
Abstract
Non-union of long bone fractures is considered as multifactorial. The management of this entity continues to be difficult often requiring multiple procedures with unpredictable results. Bone morphogenetic proteins (BMPs) are power agents being used in the clinical setting for a variety of pathological conditions where tissue regeneration is required. This article analyses the currently existing evidence of the efficacy of BMPs for the management of non-union of long bone fractures.
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Affiliation(s)
- L Obert
- Orthopaedic unit, Hop J Minjoz, CHRU Besançon F-25020, France.
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