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Granat MM, Eifler-Zydel J, Kolmas J. Statins-Their Role in Bone Tissue Metabolism and Local Applications with Different Carriers. Int J Mol Sci 2024; 25:2378. [PMID: 38397055 PMCID: PMC10888549 DOI: 10.3390/ijms25042378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
Statins, widely prescribed for lipid disorders, primarily target 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase competitively and reversibly, resulting in reduced low-density lipoprotein cholesterol (LDL-C). This mechanism proves effective in lowering the risk of lipid-related diseases such as ischemic cerebrovascular and coronary artery diseases. Beyond their established use, statins are under scrutiny for potential applications in treating bone diseases. The focus of research centers mainly on simvastatin, a lipophilic statin demonstrating efficacy in preventing osteoporosis and aiding in fracture and bone defect healing. Notably, these effects manifest at elevated doses (20 mg/kg/day) of statins, posing challenges for systematic administration due to their limited bone affinity. Current investigations explore intraosseous statin delivery facilitated by specialized carriers. This paper outlines various carrier types, characterizing their structures and underscoring various statins' potential as local treatments for bone diseases.
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Affiliation(s)
- Marcin Mateusz Granat
- Department of Clinical and Experimental Pharmacology, Faculty of Medicine, Medical University of Warsaw, Banacha 1 Str., 02-097 Warsaw, Poland;
| | - Joanna Eifler-Zydel
- Department of Pharmaceutical Chemistry and Biomaterials, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1 Str., 02-097 Warsaw, Poland;
| | - Joanna Kolmas
- Department of Pharmaceutical Chemistry and Biomaterials, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1 Str., 02-097 Warsaw, Poland;
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Yu C, Feng S, Li Y, Chen J. Application of Nondegradable Synthetic Materials for Tendon and Ligament Injury. Macromol Biosci 2023; 23:e2300259. [PMID: 37440424 DOI: 10.1002/mabi.202300259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023]
Abstract
Tendon and ligament injuries, prevalent requiring surgical intervention, significantly impact joint stability and function. Owing to excellent mechanical properties and biochemical stability, Nondegradable synthetic materials, including polyethylene terephthalate (PET) and polytetrafluoroethylene (PTFE), have demonstrated significant potential in the treatment of tendon and ligament injuries. These above materials offer substantial mechanical support, joint mobility, and tissue healing promotion of the shoulder, knee, and ankle joint. This review conclude the latest development and application of nondegradable materials such as artificial patches and ligaments in tendon and ligament injuries including rotator cuff tears (RCTs), anterior cruciate ligament (ACL) injuries, and Achilles tendon ruptures.
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Affiliation(s)
- Chengxuan Yu
- Department of Sports Medicine, Huashan Hospital, Fudan University; Sports Medicine Institute of Fudan University, Shanghai, 200040, China
| | - Sijia Feng
- Department of Sports Medicine, Huashan Hospital, Fudan University; Sports Medicine Institute of Fudan University, Shanghai, 200040, China
| | - Yunxia Li
- Department of Sports Medicine, Huashan Hospital, Fudan University; Sports Medicine Institute of Fudan University, Shanghai, 200040, China
| | - Jun Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University; Sports Medicine Institute of Fudan University, Shanghai, 200040, China
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Xiang D, Jin W, Li H, Zhao G, Li B, Du S, Liu X. Biomechanical improvement of anterior talofibular ligament by augmentation repair of ligament advance reinforcement system: a cadaver study. BMC Surg 2023; 23:307. [PMID: 37817132 PMCID: PMC10566038 DOI: 10.1186/s12893-023-02136-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/02/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Ankle sprain are one of the most frequent sports injuries. Some individuals will develop chronic lateral ankle instability (CLAI) after ankle sprain and suffer from recurrent ankle sprain. Current surgical treatment of CAI with anterior talofibular ligament (ATFL) rupture fails to restore the stability of the native ATFL. Ligament Advance Reinforcement System (LARS) augmentation repair of ATFL was developed to improve its primary stability after repaired. METHODS This study was performed to evaluate whether LARS augmentation repair of ATFL had similar stability as the modified Broström repair and the intact ATFL to maintain ankle construct stability. Standardized surgical techniques were performed on eighteen fresh frozen cadaver ankle specimens. The intact ATFL group has just undergone an ATFL exploratory surgery. The modified Broström procedure is based on anatomical repair of the ATFL with a 2.9 mm suture anchor, and the LARS procedure is an augmentation procedure of the ATFL using LARS ligaments based on the modified Broström procedure. A dynamic tensile test machine was used to assess load-to-failure testing in the three groups. The ultimate failure load and stiffness were calculated and reported from the load-displacement curve. A one-way analysis of variance was used to detect significant differences (p < 0.05) between the LARS augmentation repair, the modified Broström repair and the intact ATFL, followed by least significant difference (LSD) post-hoc tests. RESULTS The LARS augmentation repair group showed an increased in ultimate failure to load and stiffness compared to the other two groups. There were no significant differences in ultimate failure to load and stiffness between the modified Broström and the intact ATFL, the LARS ligament for ATFL augmentation allows for improved primary stability after repair and reduced stress on the repaired ATFL, which facilitates healing of the remnant ligament. CONCLUSIONS The LARS augmentation repair of ATFL represents a stable technique that may allow for the ankle stability to be restored in patients with CAI after surgery.
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Affiliation(s)
- Dulei Xiang
- Department of orthopedics, General Hospital of North Theater Command, 83 Wenhua Road, Shenyang, Liaoning, China
| | - Wenming Jin
- Department of orthopedics, General Hospital of North Theater Command, 83 Wenhua Road, Shenyang, Liaoning, China
| | - Han Li
- Department of orthopedics, General Hospital of North Theater Command, 83 Wenhua Road, Shenyang, Liaoning, China
| | - Gen Zhao
- Department of orthopedics, General Hospital of North Theater Command, 83 Wenhua Road, Shenyang, Liaoning, China
| | - Bao Li
- Department of orthopedics, General Hospital of North Theater Command, 83 Wenhua Road, Shenyang, Liaoning, China
| | - Shuyuan Du
- Department of orthopedics, General Hospital of North Theater Command, 83 Wenhua Road, Shenyang, Liaoning, China
| | - Xinwei Liu
- Department of orthopedics, General Hospital of North Theater Command, 83 Wenhua Road, Shenyang, Liaoning, China.
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Legnani C, Ventura A. Synthetic grafts for anterior cruciate ligament reconstructive surgery. Med Eng Phys 2023; 117:103992. [PMID: 37331747 DOI: 10.1016/j.medengphy.2023.103992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 05/06/2023] [Accepted: 05/11/2023] [Indexed: 06/20/2023]
Abstract
The quest for a good and durable substitute to anterior cruciate ligament (ACL) is driving scientists to explore new promising areas of research. Autologous and allogenic ligament reconstruction bring satisfactory results in managing ACL surgery although their use is associated with significant drawbacks. To overcome the limitations of biologic grafts, many artificial devices have been developed and implanted as a substitute to the native ACL over the past decades. Although many synthetic grafts used in the past have been withdrawn from the market due to early mechanical failures ultimately leading to synovitis and osteoarthritis, there is recently a resurgence of interest in the use of synthetic ligaments for ACL reconstruction. However, this new generation of artificial ligaments, despite promising initial results, have shown to produce serious side effects such as high rupture rates, insufficient tendon-bone healing and loosening. For these reasons, recent advancements in biomedical engineering are focusing on improving technical features of artificial ligaments combining mechanical properties to biocompatibility. Bioactive coatings and surface modification methods have been proposed to enhance synthetic ligament biocompatibility and promote osseointegration. The path to the development of a safe and effective artificial ligament is still full of challenges, however recent advancements are leading the way towards a tissue-engineered substitute to the native ACL.
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Affiliation(s)
- Claudio Legnani
- IRCCS Istituto Ortopedico Galeazzi, Sports Traumatology and Minimally Invasive Articular Surgery Center, Milan, Italy.
| | - Alberto Ventura
- IRCCS Istituto Ortopedico Galeazzi, Sports Traumatology and Minimally Invasive Articular Surgery Center, Milan, Italy
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Karahaliloglu Z, Ercan B, Hazer B. Impregnation of polyethylene terephthalate (PET) grafts with BMP-2 loaded functional nanoparticles for reconstruction of anterior cruciate ligament. J Microencapsul 2023; 40:197-215. [PMID: 36881484 DOI: 10.1080/02652048.2023.2188940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Current artificial ligaments based on polyethylene terephthalate (PET) are associated with some disadvantages due to their hydrophobicity and low biocompatibility. In this study, we aimed to modify the surface of PET using polyethylene glycol (PEG)-terminated polystyrene (PS)-linoleic nanoparticles (PLinaS-g-PEG-NPs). We accomplished that BMP-2 in two different concentrations encapsulated in nanoparticles with an efficiency of 99.71 ± 1.5 and 99.95 ± 2.8%. While the dynamic contact angle of plain PET surface reduced from 116° to 115° after a measurement periods of 10 s, that of PLinaS-g-PEG-NPs modified PET from 80° to 17.5° within 0.35 s. According to in vitro BMP2 release study, BMP-2 was released 13.12 ± 1.76% and 45.47 ± 1.78% from 0.05 and 0.1BMP2-PLinaS-g-PEG-NPs modified PET at the end of 20 days, respectively. Findings from this study revealed that BMP2-PLinaS-g-PEG-NPs has a great potential to improve the artificial PET ligaments, and could be effectively applied for ACL reconstruction.
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Affiliation(s)
| | - Batur Ercan
- Department of Metallurgical and Materials Engineering, Middle East Technical University, Çankaya, Ankara, Turkey
- Biomedical Engineering Program, Middle East Technical University, Çankaya, Ankara, Turkey
- BIOMATEN, Center of Excellence in Biomaterials and Tissue Engineering, Middle East Technical University, Çankaya, Ankara, Turkey
| | - Baki Hazer
- Department of Aircraft Airframe Engine Maintenance, Kapadokya University, Ürgüp, Nevsehir, Turkey
- Department of Chemistry, Bulent Ecevit University, Zonguldak, Turkey
- Department of Nanotechnology Engineering, Bulent Ecevit University, Zonguldak, Turkey
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Huang H, Chen J, Lin Z, Lin X. Rubiadin Regulates Bone Metabolism in Ovariectomized Rat Model by Inhibition of osteoclast formation and differentiation. ChemistrySelect 2023. [DOI: 10.1002/slct.202300115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Affiliation(s)
- Hui Huang
- Department of Rehabilitation Zhongshan Hospital Xiamen University Xiamen 361004 China
| | - Jian Chen
- Department of Rehabilitation Zhongshan Hospital Xiamen University Xiamen 361004 China
| | - Zhengkun Lin
- Department of Rehabilitation Zhongshan Hospital Xiamen University Xiamen 361004 China
| | - Xiaomei Lin
- Department of Rehabilitation Zhongshan Hospital Xiamen University Xiamen 361004 China
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Sun Y, Huang Z, Zhang P, Xie H, Wang C, Deng Z, Chen K, Zhu W. Comparative Study of Graft Healing in 2 Years after “Tension Suspension” Remnant-Preserving and Non-Remnant-Preserving Anatomical Reconstruction for Sherman Type II Anterior Cruciate Ligament Injury. J Pers Med 2023; 13:jpm13030477. [PMID: 36983659 PMCID: PMC10059742 DOI: 10.3390/jpm13030477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 02/25/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
Purpose: To evaluate the degree of graft healing after “tension suspension” reconstruction of “Sherman II” anterior cruciate ligament injuries versus non-remnant preserving anatomical reconstruction and to compare the clinical outcomes of the two procedures. Method: The clinical data of 64 patients were retrospectively included. There were 31 cases in the “tension suspension” remnant-preserving reconstruction group and 33 cases in the non-remnant-preserving anatomical reconstruction group. The International Knee Documentation Committee (IKDC) score, the Tegner score, and the Lysholm activity score were assessed preoperatively and at 6 months, 1 year, and 2 years postoperatively, respectively. The signal/noise quotient (SNQ) of the grafts was measured at 6 months, 1 year, and 2 years after surgery to quantitatively evaluate the maturity of the grafts after ACL reconstruction; the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the reconstructed ACL region of interest (ROI) were measured using DTI. Result: A total of 64 patients were included in the study. The mean SNQ values of the grafts in the 6 months, 1 year, and 2 years postoperative remnant-preserving reconstruction (RP) groups were lower than those in the non-remnant-preserving (NRP) reconstruction group, with a statistically significant difference (p < 0.05). At each postoperative follow-up, the SNQ values of the tibial and femoral sides of the RP group were lower than those of the NRP group; the SNQ values of the femoral side of the grafts in both groups were higher than those of the tibial side, and the differences were statistically significant (p < 0.05). At 6 months, 1 year, and 2 years postoperatively, the FA and ADC values of the grafts were lower in the RP group than in the NRP group, and the differences were statistically significant (p < 0.05); the IKDC score and Lysholm score of the RP group were higher than the NRP group, which was statistically significant (p < 0.05). Conclusion: For Sherman II ACL injury, the graft healing including ligamentization and revascularization at 2 years after the “tension suspension” remnant-preserving reconstruction was better than that of non-remnant-preserving anatomic reconstruction.
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Affiliation(s)
- Yijia Sun
- Clinical College of the Second Shenzhen Hospital, Anhui Medical University, Shenzhen 518025, China
- Department of Sports Medicine, Shenzhen Second People’s Hospital, Shenzhen 518025, China
| | - Zirong Huang
- Department of Sports Medicine, Shenzhen Second People’s Hospital, Shenzhen 518025, China
- Clinical Medical College, Guangzhou Medical University, Guangzhou 511436, China
| | - Pingquan Zhang
- Clinical College of the Second Shenzhen Hospital, Anhui Medical University, Shenzhen 518025, China
- Department of Sports Medicine, Shenzhen Second People’s Hospital, Shenzhen 518025, China
| | - Huanyu Xie
- Department of Sports Medicine, Shenzhen Second People’s Hospital, Shenzhen 518025, China
| | - Chen Wang
- Department of Sports Medicine, Shenzhen Second People’s Hospital, Shenzhen 518025, China
| | - Zhenhan Deng
- Department of Sports Medicine, Shenzhen Second People’s Hospital, Shenzhen 518025, China
| | - Kang Chen
- Department of Sports Medicine, Shenzhen Second People’s Hospital, Shenzhen 518025, China
- Correspondence: (K.C.); (W.Z.)
| | - Weimin Zhu
- Clinical College of the Second Shenzhen Hospital, Anhui Medical University, Shenzhen 518025, China
- Department of Sports Medicine, Shenzhen Second People’s Hospital, Shenzhen 518025, China
- Correspondence: (K.C.); (W.Z.)
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Advanced Graft Development Approaches for ACL Reconstruction or Regeneration. Biomedicines 2023; 11:biomedicines11020507. [PMID: 36831043 PMCID: PMC9953332 DOI: 10.3390/biomedicines11020507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/12/2023] Open
Abstract
The Anterior Cruciate Ligament (ACL) is one of the major knee ligaments, one which is greatly exposed to injuries. According to the British National Health Society, ACL tears represent around 40% of all knee injuries. The number of ACL injuries has increased rapidly over the past ten years, especially in people from 26-30 years of age. We present a brief background in currently used ACL treatment strategies with a description of surgical reconstruction techniques. According to the well-established method, the PubMed database was then analyzed to scaffold preparation methods and materials. The number of publications and clinical trials over the last almost 30 years were analyzed to determine trends in ACL graft development. Finally, we described selected ACL scaffold development publications of engineering, medical, and business interest. The systematic PubMed database analysis indicated a high interest in collagen for the purpose of ACL graft development, an increased interest in hybrid grafts, a numerical balance in the development of biodegradable and nonbiodegradable grafts, and a low number of clinical trials. The investigation of selected publications indicated that only a few suggest a real possibility of creating healthy tissue. At the same time, many of them focus on specific details and fundamental science. Grafts exhibit a wide range of mechanical properties, mostly because of polymer types and graft morphology. Moreover, most of the research ends at the in vitro stage, using non-certificated polymers, thus requiring a long time before the medical device can be placed on the market. In addition to scientific concerns, official regulations limit the immediate introduction of artificial grafts onto the market.
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Simvastatin promotes rat Achilles tendon-bone interface healing by promoting osteogenesis and chondrogenic differentiation of stem cells. Cell Tissue Res 2023; 391:339-355. [PMID: 36513828 DOI: 10.1007/s00441-022-03714-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/19/2022] [Indexed: 12/15/2022]
Abstract
To investigate the effect and mechanism of simvastatin on cell components of tendon-bone healing interface. The tendon-bone healing model was established by inserting the end of the Achilles tendon into the tibial tunnel on 24 rats, and simvastatin was used locally at the tendon-bone interface. Healing was evaluated at 8 weeks by mechanical testing, micro-CT, and qualitative histology including H&E, Toluidine blue, and immunohistochemical staining. In vitro, bone marrow stromal cells (BMSCs) and tendon-derived mesenchymal stem cells (TDSCs) underwent osteogenic and chondrogenic differentiation respectively by plate co-culture. An analysis was performed on days 7 and 14 of cell differentiation. Biomechanical testing demonstrated a significant increase in maximum stiffness in the simvastatin-treated group. Micro-CT analysis showed that the bone tunnels in the simvastatin group were smaller in diameter and had higher bone density. H&E and Toluidine blue staining demonstrated that tendon-bone healing was significantly greater with better tissue arrangement and more extracellular matrix in the simvastatin-treated group than that in the control group, and immunohistochemical staining showed the expression of VEGF in simvastatin group was significantly higher. Histological staining and RT-PCR confirmed that simvastatin could promote the differentiation of co-cultured BMSCs and TDSCs into osteoblasts and chondroblasts, respectively. The effect of promoting osteogenic differentiation was more tremendous at 14 days, while its effect on promoting chondroblast differentiation was more evident on the 7th day of differentiation. In conclusion, local administration of simvastatin can promote the tendon-bone healing by enhancing neovascularization, chondrogenesis, and osteogenesis in different stages of the tendon-bone healing process.
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The evaluation of cytotoxicity and cytokine IL-6 production of root canal sealers with and without the incorporation of simvastatin: an invitro study. BMC Oral Health 2022; 22:6. [PMID: 35012572 PMCID: PMC8751161 DOI: 10.1186/s12903-022-02039-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/28/2021] [Indexed: 12/07/2022] Open
Abstract
Background Freshly mixed root canal sealers when proximate the periapical tissues, trigger varying degrees of cytotoxicity/inflammatory reactions. Simvastatin, a class of the drug statin, is a widely used cholesterol-lowering agent with additional anti-inflammatory activities. This study assessed the effects of simvastatin on cytotoxicity and the release of IL-6 (Interleukin-6) production when incorporated in zinc oxide eugenol and methacrylate resin-based sealers. Methods Experimental groups consisted of conventional zinc oxide eugenol and methacrylate based-EndoREZ sealers (ZE & ER respectively) and 0.5 mg/mL simvastatin incorporated sealers (ZES & ERS). L929 mouse fibroblast cells were exposed to freshly mixed experimental sealers and evaluated for cytotoxicity (MTT assay) and inflammation levels (inflammatory marker IL-6 for ELISA) at various time intervals (0h, 24h and 7th day). The values were compared to the cell control (CC; L929 cells alone) and solvent control (SC; L929 cells + DMSO) groups. All the experiments were conducted in triplicates and subjected to statistical analysis using IBM SPSS Statistics software. Non parametric tests were conducted using Kruskal-Wallis and Friedman tests for inter-group and intra-group comparisons respectively. Pairwise comparison was conducted by post hoc Dunn test followed by Bonferroni correction. P values < 0.05 were considered statistically significant. Results All the experimental groups (ZE, ER, ZES, ERS) exhibited varying degree of cytotoxicity and IL-6 expression compared to the control groups CC and SC. The cell viability for ZE and ER decreased on day 7 as compared to 24 h. ZES and ERS had higher viable cells (75.93% & 79.90%) compared to ZE and ER (54.39% & 57.84%) at all time periods. Increased expression of IL-6 was observed in ZE & ER (25.49 pg/mL & 23.14 pg/mL) when compared to simvastatin incorporated ZE & ER (ZES-12.70 pg/mL & ERS-14.68 pg/mL) at all time periods. Highest level of cytotoxicity and inflammation was observed in ZE compared to all the other groups on day 7. Conclusions Addition of 0.5 mg/mL of simvastatin to the sealers (ZES and ERS) decreased the cytotoxicity in the freshly mixed state and reduces their inflammatory effect.
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Chen DS, Wang TF, Zhu JW, Zhu B, Wang ZL, Cao JG, Feng CH, Zhao JW. A Novel Application of Unsupervised Machine Learning and Supervised Machine Learning-Derived Radiomics in Anterior Cruciate Ligament Rupture. Risk Manag Healthc Policy 2021; 14:2657-2664. [PMID: 34188576 PMCID: PMC8236276 DOI: 10.2147/rmhp.s312330] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/09/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose We aim to present an unsupervised machine learning application in anterior cruciate ligament (ACL) rupture and evaluate whether supervised machine learning-derived radiomics features enable prediction of ACL rupture accurately. Patients and Methods Sixty-eight patients were reviewed. Their demographic features were recorded, radiomics features were extracted, and the input dataset was defined as a collection of demographic features and radiomics features. The input dataset was automatically classified by the unsupervised machine learning algorithm. Then, we used a supervised machine learning algorithm to construct a radiomics model. The t-test and least absolute shrinkage and selection operator (LASSO) method were used for feature selection, random forest and support vector machine (SVM) were used as machine learning classifiers. For each model, the sensitivity, specificity, accuracy, and the area under the curve (AUC) of receiver operating characteristic (ROC) curves were calculated to evaluate model performance. Results In total, 5 demographic features were recorded and 106 radiomics features were extracted. By applying the unsupervised machine learning algorithm, patients were divided into 5 groups. Group 5 had the highest incidence of ACL rupture and left knee involvement. There were significant differences in left knee involvement among the groups. Forty-three radiomics features were extracted using t-test and 7 radiomics features were extracted using LASSO method. We found that the combination of LASSO selection method and random forest classifier has the highest sensitivity, specificity, accuracy, and AUC. The 7 radiomics features extracted by LASSO method were potential predictors for ACL rupture. Conclusion We validated the clinical application of unsupervised machine learning involving ACL rupture. Moreover, we found 7 radiomics features which were potential predictors for ACL rupture. The study indicated that radiomics could be a valuable method in the prediction of ACL rupture.
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Affiliation(s)
- De-Sheng Chen
- Department of Sports Medicine and Arthroscopy, Tianjin Hospital of Tianjin University, Tianjin, People's Republic of China
| | - Tong-Fu Wang
- Department of Sports Medicine and Arthroscopy, Tianjin Hospital of Tianjin University, Tianjin, People's Republic of China
| | - Jia-Wang Zhu
- Department of Sports Medicine and Arthroscopy, Tianjin Hospital of Tianjin University, Tianjin, People's Republic of China
| | - Bo Zhu
- Department of Sports Medicine and Arthroscopy, Tianjin Hospital of Tianjin University, Tianjin, People's Republic of China
| | - Zeng-Liang Wang
- Department of Sports Medicine and Arthroscopy, Tianjin Hospital of Tianjin University, Tianjin, People's Republic of China
| | - Jian-Gang Cao
- Department of Sports Medicine and Arthroscopy, Tianjin Hospital of Tianjin University, Tianjin, People's Republic of China
| | - Cai-Hong Feng
- Department of Sports Medicine and Arthroscopy, Tianjin Hospital of Tianjin University, Tianjin, People's Republic of China
| | - Jun-Wei Zhao
- Department of Sports Medicine and Arthroscopy, Tianjin Hospital of Tianjin University, Tianjin, People's Republic of China
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Jin W, Cai J, Sheng D, Liu X, Chen J, Chen S. Establishment of near and non isometric anterior cruciate ligament reconstruction with artificial ligament in a rabbit model. J Orthop Translat 2021; 29:78-88. [PMID: 34136347 PMCID: PMC8165294 DOI: 10.1016/j.jot.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background Tunnel position deicide the isometry of graft attachment in synthetic anterior cruciate ligament (ACL) reconstruction. Near-isometric tunnel position may have advantage in graft integration and knee function in ACL reconstruction (ACLR) with polyethylene terephthalate (PET) ligament. Few studies focused on tunnel position isometry when conduct ACLR with an animal model. This study aimed to establish a preclinical rabbit model of near and non isometric ACLR with PET ligament and investigate the advantage of near-isometric ACLR compared to non-isometric ACLR. Methods Nine hind limbs of rabbit were used in tunnel position study. Two femoral(anatomic, nonanatomic) tunnels and three tibial(anterior, middle, posterior) tunnels were used to measure tunnel position isometry during knee full range of motion. The tunnel position combination with minimal isometry was considered as near-isometric tunnel position. Then, 48 rabbits divided into two groups were conducted near or non isometric ACLR with PET ligament with graft fixation angle of 30° and constant tension of 5N. PET ligament isometry, range of motion(ROM) restriction, knee laxity were recorded after operation and followed up with macroscopic observation, microcomputed tomography (micro-CT) analysis, histology assessment and biomechanical test at 4 and 8 weeks postoperatively. Results The tunnel combination with minimal isometry was femoral anatomic position and tibial posterior position(5.19 ± 1.78%) and considered as near-isometric tunnel position. ROM restriction were observed in non-isometric group (22.50 ± 14.14°) while none in near-isometric group. However, no ROM restriction observed at 8 weeks in both group. Knee laxity compared to contralateral knee were better in near-isometric group than non-isometric group (stable/slack/total 10/2/12 VS 3/9/12, p = 0.012) at 8 weeks postoperatively. Supeiror PET ligament integration were also observed in near-isometric group through macroscopic observation, micro-CT analysis, histology assessment at both 4 and 8 weeks. The failure load in the Near-Isometric group at 8 weeks were higher than timezero reconstruction with statistical difference (156.8N ± 25.98N vs.102.6 ± 22.96N, p = 0.02). Conclusion A rabbit model of ACLR based on tunnel position isometry was successfully established in this study. The near-isometric tunnel position in rabbit model was femoral anatomic position and tibial posterior position. A near-isometric ACLR with PET ligament did not cause ROM restriction and had a better graft integration and follow-up stability than non-isometric ACLR with ROM restriction. The Translational Potential of this Article The study demonstrate the establishmentof near-isometric tunnel position and non-isometric tunnel position with significant difference of ROM restriction and graft-bone integration. The described tunnel positions with differential isometry in a rabbit ACLR provides a reproducible and translational small animal model and enables preclinical research between tunnel position isometry and its affection on variable grafts, graft integration and knee function.
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Affiliation(s)
- Wenhe Jin
- Sports Medicine Center of Fudan University, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiangyu Cai
- Sports Medicine Center of Fudan University, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Dandan Sheng
- Sports Medicine Center of Fudan University, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xingwang Liu
- Sports Medicine Center of Fudan University, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jun Chen
- Sports Medicine Center of Fudan University, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shiyi Chen
- Sports Medicine Center of Fudan University, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Jin H, Ji Y, Cui Y, Xu L, Liu H, Wang J. Simvastatin-Incorporated Drug Delivery Systems for Bone Regeneration. ACS Biomater Sci Eng 2021; 7:2177-2191. [PMID: 33877804 DOI: 10.1021/acsbiomaterials.1c00462] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Local drug delivery systems composed of biomaterials and osteogenic substances provide promising strategies for the reconstruction of large bone defects. In recent years, simvastatin has been studied extensively for its pleiotropic effects other than lowering of cholesterol, including its ability to induce osteogenesis and angiogenesis. Accordingly, several studies of simvastatin incorporated drug delivery systems have been performed to demonstrate the feasibility of such systems in enhancing bone regeneration. Therefore, this review explores the molecular mechanisms by which simvastatin affects bone metabolism and angiogenesis. The simvastatin concentrations that promote osteogenic differentiation are analyzed. Furthermore, we summarize and discuss a variety of simvastatin-loaded drug delivery systems that use different loading methods and materials. Finally, current shortcomings of and future development directions for simvastatin-loaded drug delivery systems are summarized. This review provides various advanced design strategies for simvastatin-incorporated drug delivery systems that can enhance bone regeneration.
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Affiliation(s)
- Hui Jin
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, P.R. China.,Department of Pain, The Second Hospital of Jilin University, Changchun 130041, P.R. China
| | - Youbo Ji
- Department of Pain, The Second Hospital of Jilin University, Changchun 130041, P.R. China
| | - Yutao Cui
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, P.R. China
| | - Li Xu
- Department of Orthopedics, Weihai Guanghua Hospital, Weihai 264200, P.R. China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, P.R. China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, P.R. China
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Shi S, Fan W, Tao R, Xu H, Lu Y, Han F, Yang S, Zhou X, Zhou Z, Wan F. Natural Biomineralization-Inspired Magnesium Silicate Composite Coating Upregulates Osteogenesis, Enabling Strong Anterior Cruciate Ligament Graft-Bone Healing In Vivo. ACS Biomater Sci Eng 2020; 7:133-143. [PMID: 33332969 DOI: 10.1021/acsbiomaterials.0c01441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Artificial ligaments prepared from polyethylene terephthalate (PET) are widely accepted for clinical anterior cruciate ligament (ACL) reconstruction to recover the native function of knee joints. However, due to the chemical inertness and hydrophobicity of PET, improving its bioactivity and promoting graft-bone integration are still great challenges. Inspired by the natural biomineralization process on the surface of a historical stone, in this study, a bioactive organic/inorganic composite coating that is composed of poly(allylamine hydrochloride) and chondroitin sulfate with magnesium silicate (MgSiO3) doping is developed for surface modification of PET (MSPC-PET). This composite coating promotes adhesion and proliferation of bone marrow mesenchymal stem cells (BMSCs) and its bioactive inorganic components (MgSiO3) could induce osteogenic differentiation of BMSCs. Furthermore, an in vivo experiment indicated that this composite coating might afford superior graft-bone integration between MSPC-PET and the host bone tunnel, and fibrous scar tissue formation was also inhibited. More importantly, a biomechanical analysis proved that there was a strong integration between the MSPC-PET graft and the bone tunnel, which will improve biomechanical properties for the restoration of ACL function. This study shows that this bioactive composite coating-modified PET graft for the ACL reconstruction can effectively achieve good integration of ACL artificial grafts and bone tunnels and prevent surgical failure.
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Affiliation(s)
- Song Shi
- Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, People's Republic of China
| | - Wentao Fan
- Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, People's Republic of China
| | - Ran Tao
- Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, People's Republic of China
| | - Hua Xu
- Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, People's Republic of China
| | - Yue Lu
- Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, People's Republic of China
| | - Fei Han
- Institute for Translational Medicine, Institute for Biomedical Engineering and Nanoscience, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China
| | - Shuaijie Yang
- Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, People's Republic of China
| | - Xinyu Zhou
- Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, People's Republic of China
| | - Zhenyu Zhou
- Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, People's Republic of China
| | - Fuyin Wan
- Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, People's Republic of China
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Zhang P, Han F, Chen T, Wu Z, Chen S. "Swiss roll"-like bioactive hybrid scaffolds for promoting bone tissue ingrowth and tendon-bone healing after anterior cruciate ligament reconstruction. Biomater Sci 2020; 8:871-883. [PMID: 31820744 DOI: 10.1039/c9bm01703h] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The choice of grafts for anterior cruciate ligament (ACL) reconstruction is a critical issue in sports medicine. Previous studies have revealed that scaffolds prepared from a single material could not achieve complete integration between the graft and autogenous bone tunnel. To solve this problem, we hypothesize that combining degradable scaffolds with nondegradable scaffolds can produce a novel hybrid ligament with the advantages of both types of scaffolds. In this study, a bone morphogenetic protein 7 (BMP-7)-loaded polycaprolactone (PCL) nanofibrous membrane was first manufactured as the degradable part of the hybrid ligament by using layer-by-layer (LbL) self-assembly. Then, we fabricated a multifunctional novel hybrid ligament by rolling up this nanofibrous membrane and polyethylene terephthalate (PET) mesh fabric (nondegradable part) into a "swiss roll" structure. The in vitro experimental results showed that this hybrid ligament could significantly improve the biocompatibility of pure PET ligament and further promote cell mineralization. The in vivo experimental results showed that this unique structure significantly promoted the integration of hybrid ligaments and bone tunnels, thereby achieving real "ligamentization" after ACL reconstruction surgery. These results suggest that this novel hybrid biomimetic artificial ligament scaffold provides a new direction for graft selection for ACL reconstruction.
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Affiliation(s)
- Peng Zhang
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, PR China.
| | - Fei Han
- Institute for Translational Medicine, Institute for Biomedical Engineering and Nanoscience, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200092, PR China
| | - Tianwu Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, PR China.
| | - Ziying Wu
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, PR China.
| | - Shiyi Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, PR China.
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Zhu K, Zhao F, Yang Y, Mu W. Effects of simvastatin-loaded PLGA microspheres on treatment of rats with intervertebral disk degeneration and on 6-K-PGF1α and HIF-1α. Exp Ther Med 2019; 19:579-584. [PMID: 31897100 PMCID: PMC6923742 DOI: 10.3892/etm.2019.8267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/01/2019] [Indexed: 12/15/2022] Open
Abstract
Effects of simvastatin-loaded PLGA sustained release microspheres on the treatment of rats with intervertebral disk degeneration (IVDD) and on 6-keto-prostaglandin F1α (6-K-PGF1α) and hypoxia inducible factor-1α (HIF-1α) were investigated. Eighty female rats were selected and randomized into a model group (modeled for IVDD), a treatment group (modeled and treated with simvastatin-loaded PLGA sustained release microspheres), a sham operation group (only operated without excision), and a control group (not treated) (n=20 each). After modeling, 6-K-PGF1α and HIF-1α in the peripheral blood of the rats were, respectively, detected before simvastatin injection (T0), at 2 weeks (T1) and 4 weeks (T2) after simvastatin injection. The bone mineral density (BMD) of L5 and L6 was detected by X-ray. The trabecular thickness, number, and separation of the vertebral body were detected. Changes in the sagittal T2-weighted signal of intervertebral disc nucleus pulposus were detected by MRI. There were no differences between the control and sham operation groups in the indices (P>0.050). Compared with those in the model group during the treatment, BMD, 6-K-PGF1α, HIF-1α, and trabecular number in the treatment group significantly increased (P<0.050), while the trabecular separation significantly decreased (P<0.050). The sagittal T2-weighted MRI signal in the model group was the lowest between the four groups (P<0.050). Simvastatin-loaded PLGA sustained release microspheres can improve the BMD of the vertebral body and increase the contents of 6-K-PGF1α and HIF-1α in the treatment of rats with IVDD, so they are important for the clinical treatment of the disease.
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Affiliation(s)
- Kai Zhu
- Department of Traumatic Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China.,Department of Spine Surgery, Binzhou Medical University Hospital, Binzhou, Shandong 256603, P.R. China
| | - Futing Zhao
- Department of Orthopedics, Qingyun County People's Hospital, Dezhou, Shandong 253700, P.R. China
| | - Yanhua Yang
- Department of Pathology, Qingdao Municipal Hospital, Qingdao, Shandong 266011, P.R. China
| | - Weidong Mu
- Department of Traumatic Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
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Ding X, Wang S, Jin W, Liu X, Chen J, Chen S. Encapsulation of a nanoporous simvastatin-chitosan composite to enhance osteointegration of hydroxyapatite-coated polyethylene terephthalate ligaments. Int J Nanomedicine 2019; 14:4881-4893. [PMID: 31308664 PMCID: PMC6613541 DOI: 10.2147/ijn.s210687] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/11/2019] [Indexed: 01/13/2023] Open
Abstract
PURPOSE This study was designed to evaluate the in vitro and in vivo biocompatibility and osteointegration of plasma-sprayed hydroxyapatite (HA)-coated polyethylene terephthalate (PET) ligaments encapsulated with a simvastatin (SV)-chitosan (CS) composite. METHODS This study compared the in vitro and in vivo bone responses to three different PET ligaments: SV/CS/PET-HA, CS/PET-HA and PET-HA. A field emission scanning electron microscope was used to characterize the morphology, and the in vitro SV release profile was analyzed. MC3T3 cells were cocultured with SV/CS/PET-HA, CS/PET-HA and PET-HA to test their biocompatibility using CCK-8 tests. Osteogenic differentiation was investigated by the expression of marker genes using qPCR. Osteointegration was performed by implanting the PET ligaments into the proximal tibia bone tunnels of male Sprague-Dawley rats for 3 weeks and 6 weeks. The bone-implant interface was evaluated by micro-computed tomography (micro-CT) and histological analysis. RESULTS The characteristic nanoporous structures mainly formed on the surface of the plasma-sprayed HA particles in the SV/CS/PET-HA and CS/PET-HA groups. The SV release test showed that the sustained release of simvastatin lasted for 25 days in the SV/CS/PET-HA group. The in vitro studies demonstrated that the SV/CS/PET-HA ligaments induced osteogenic differentiation in the MC3T3 cells, with higher mRNA expression levels of collagen-1, bone morphogenetic protein-2, osteocalcin and alkaline phosphatase than those in the CS/PET-HA and PET-HA ligament groups. The in vivo tests showed that both micro-CT analysis (bone mineral density and bone volume per total volume) and histological analysis (bone implant contact and interface area) revealed significantly higher peri-implant bone formation and less interface area in the SV/CS/PET-HA group than in the other groups. CONCLUSION The SV-CS composite nanoporous structure was associated with the improved biocompatibility and osteogenic differentiation in vitro and enhanced osteointegration process in vivo of plasma-sprayed HA-coated PET ligaments.
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Affiliation(s)
- Xiaoquan Ding
- Center of Sports Medicine, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai200040, People’s Republic of China
| | - Siheng Wang
- Center of Sports Medicine, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai200040, People’s Republic of China
| | - Wenhe Jin
- Center of Sports Medicine, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai200040, People’s Republic of China
| | - Xingwang Liu
- Center of Sports Medicine, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai200040, People’s Republic of China
| | - Jun Chen
- Center of Sports Medicine, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai200040, People’s Republic of China
| | - Shiyi Chen
- Center of Sports Medicine, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai200040, People’s Republic of China
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Yu D, Zhao D, Yang D, Yang G. [Simvastatin promotes murine osteoclasts apoptosis in vitro through NFATc1 pathway]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:672-678. [PMID: 31270045 DOI: 10.12122/j.issn.1673-4254.2019.06.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the mechanism by which simvastatin (SIM) regulates osteoclast apoptosis. METHODS Murine macrophage RAW264.7 cells were divided into 5 groups, namely group A (control group), group B (sRANKL+ M-CSF), group C (SIM+sRANKL+M-CSF), group D (VIVIT peptide+sRANKL+ M-CSF), and group E (SIM+VIVIT peptide+sRANKL+M-CSF). WST-1 assay was used to assess the effects of simvastatin on the proliferation activity of the osteoclasts, and flow cytometry was performed to analyze the effects of SIM and VIVIVIT peptide (a NFATc1 pathway inhibitor) on apoptosis of the osteoclasts. The translocation of NFATc1 into the nucleus was investigated using immunofluorescence assay, and Western blotting was employed to assess the effect of SIM on the phosphorylation of NFATc1 in the nucleus. RESULTS WST-1 assay showed that SIM (1×10-6 mol/L) treatment for 24 and 48 h significantly inhibited the proliferation of the osteoclasts (P=0.039 and 0.022, respectively). Compared with the control group, the SIM-treated osteoclasts exhibited significantly reduced cell percentage in G0/G1 phase (P=0.041) and increased cells in sub-G1 phase (P=0.028) with obvious cell apoptosis. DAPI staining and flow cytometry showed that both SIM and VIVIVIT peptide alone significantly promoted osteoclast apoptosis (P=0.002 and 0.015, respectively), and their combination produced a similar pro-apoptosis effect (P=0.08). Immunofluorescence and Western blotting showed that SIM significantly inhibited the intranuclear translocation of NFATc1 and the phosphorylation of NFATc1 pathway protein (P=0.013). CONCLUSIONS SIM promotes osteoclast apoptosis through NFATc1 signaling pathway.
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Affiliation(s)
- Dongdong Yu
- Department of Orthopedics, Liaoning University of Traditional Chinese Medicine, Shenyang 110032, China
| | - Danyang Zhao
- Department of Neurology, Shenyang First People's Hospital, Shenyang 110041, China
| | - Dongxiang Yang
- Department of Orthopedics, Liaoning University of Traditional Chinese Medicine, Shenyang 110032, China
| | - Guanlin Yang
- Liaoning University of Traditional Chinese Medicine, Shenyang City, Liaoning Province, 110847
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Yang J, Dong Y, Wang J, Chen C, Zhu Y, Wu Y, Zhang P, Chen T, Zhou W, Wu P, Thanh NTK, Ngoc Quyên Trân, Chen J, Chen S. Hydroxypropylcellulose Coating to Improve Graft-to-Bone Healing for Anterior Cruciate Ligament Reconstruction. ACS Biomater Sci Eng 2019; 5:1793-1803. [PMID: 33405554 DOI: 10.1021/acsbiomaterials.8b01145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Jianjun Yang
- Department of Orthopaedics, Tenth People’s Hospital of Tongji University, Shanghai 200072, People’s Republic of China
| | - Yu Dong
- Fudan University Sports Medicine Center and Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People’s Republic of China
| | - Jianguang Wang
- Department of Orthopaedics, Tenth People’s Hospital of Tongji University, Shanghai 200072, People’s Republic of China
| | - Chen Chen
- Sports Medicine Center, Shanghai Six People’s Hospital and Six People’s Hospital Affiliated with Shanghai Jiaotong University, Shanghai 200233, People’s Republic of China
| | - Yuchang Zhu
- Department of Orthopaedics, Tenth People’s Hospital of Tongji University, Shanghai 200072, People’s Republic of China
| | - Yang Wu
- Fudan University Sports Medicine Center and Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People’s Republic of China
| | - Peng Zhang
- Fudan University Sports Medicine Center and Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People’s Republic of China
| | - Tianwu Chen
- Fudan University Sports Medicine Center and Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People’s Republic of China
| | - Weifeng Zhou
- Department of Orthopaedics, Cixi People’s Hospital and Cixi Hospital Affiliated with Wenzhou Medical University, Ningbo 315300, People’s Republic of China
| | - Peiyi Wu
- Key Laboratory of Molecular Engineering of Polymers of Ministry of Education, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai 200433, People’s Republic of China
| | - Nguyen T. K. Thanh
- Biophysics Group, Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Ngoc Quyên Trân
- Institute of Applied Materials Science, Vietnam Academy Science and Technology, Ho Chi Minh City, 700000, Vietnam
- Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Ho Chi Minh City, 700000, Vietnam
| | - Jun Chen
- Fudan University Sports Medicine Center and Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People’s Republic of China
| | - Shiyi Chen
- Fudan University Sports Medicine Center and Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People’s Republic of China
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Lai M, Yan X, Jin Z. The response of bone cells to titanium surfaces modified by simvastatin-loaded multilayered films. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2018; 29:1895-1908. [PMID: 30156968 DOI: 10.1080/09205063.2018.1517483] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this study was to enhance cytocompatibility of titanium substrates by loading a multilayer film of chitosan (Chi), gelatin (Gel) and simvastatin (SV). This was fabricated using a spin-assisted layer-by-layer (LBL) technique. The surface properties of the different substrates were characterized by field emission scanning electron microscopy (FE-SEM), atomic force microscope (AFM), X-ray photoelectron spectroscopy (XPS) and contact angle measurement, respectively. Simvastatin release in vitro was measured by ultraviolet-visible spectrophotometer. A well morphology with filopodia extensions was observed in mesenchymal stem cells (MSCs) grown on simvastatin loaded multilayered films-modified titanium substrates. After 7, 14 and 21 days of culture, the simvastatin loaded multilayered films increased cell proliferation, improved osteoblastic differentiation of alkaline phosphatase (ALP) and mineralization. Additionally, osteoclast diffentiation marker tartrate-resistant acid phosphatase (TRAP) was decreased in simvastatin loaded multilayered films. This study provides a new insight for the fabrication of titanium-based implants to enhance osseointegration especially for osteoporosis patients in orthopedic application.
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Affiliation(s)
- Min Lai
- a School of Life Science , Jiangsu Normal University , Xuzhou , Jiangsu , China
| | - Xufeng Yan
- a School of Life Science , Jiangsu Normal University , Xuzhou , Jiangsu , China
| | - Ziyang Jin
- a School of Life Science , Jiangsu Normal University , Xuzhou , Jiangsu , China
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Hexter AT, Thangarajah T, Blunn G, Haddad FS. Biological augmentation of graft healing in anterior cruciate ligament reconstruction: a systematic review. Bone Joint J 2018; 100-B:271-284. [PMID: 29589505 DOI: 10.1302/0301-620x.100b3.bjj-2017-0733.r2] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Aims The success of anterior cruciate ligament reconstruction (ACLR) depends on osseointegration at the graft-tunnel interface and intra-articular ligamentization. Our aim was to conduct a systematic review of clinical and preclinical studies that evaluated biological augmentation of graft healing in ACLR. Materials and Methods In all, 1879 studies were identified across three databases. Following assessment against strict criteria, 112 studies were included (20 clinical studies; 92 animal studies). Results Seven categories of biological interventions were identified: growth factors, biomaterials, stem cells, gene therapy, autologous tissue, biophysical/environmental, and pharmaceuticals. The methodological quality of animal studies was moderate in 97%, but only 10% used clinically relevant outcome measures. The most interventions in clinical trials target the graft-tunnel interface and are applied intraoperatively. Platelet-rich plasma is the most studied intervention, but the clinical outcomes are mixed, and the methodological quality of studies was suboptimal. Other biological therapies investigated in clinical trials include: remnant-augmented ACLR; bone substitutes; calcium phosphate-hybridized grafts; extracorporeal shockwave therapy; and adult autologus non-cultivated stem cells. Conclusion There is extensive preclinical research supporting the use of biological therapies to augment ACLR. Further clinical studies that meet the minimum standards of reporting are required to determine whether emerging biological strategies will provide tangible benefits in patients undergoing ACLR. Cite this article: Bone Joint J 2018;100-B:271-84.
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Affiliation(s)
- A T Hexter
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, and Royal National Orthopaedic Hospital Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - T Thangarajah
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, and Royal National Orthopaedic Hospital Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - G Blunn
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, and Royal National Orthopaedic Hospital Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - F S Haddad
- University College London Hospitals, 235 Euston Road, London, NW1 2BU, UK and NIHR University College London Hospitals Biomedical Research Centre, UK
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Li Y, Zhang Z, Zhang Z. Porous Chitosan/Nano-Hydroxyapatite Composite Scaffolds Incorporating Simvastatin-Loaded PLGA Microspheres for Bone Repair. Cells Tissues Organs 2018; 205:20-31. [PMID: 29393155 DOI: 10.1159/000485502] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 12/11/2022] Open
Abstract
The combination of bone tissue scaffolds with osteogenic induction factors is an effective strategy to facilitate bone healing processes. Here, chitosan (CS)/nano-hydroxyapatite (HA) scaffolds containing simvastatin (SIM)-loaded PLGA microspheres were fabricated by combining a freeze-drying technique with a modified water-oil-water emulsion method. The CS/HA weight ratio of 1:2 was selected by analyzing the effect of HA content on the micro-architecture, mechanical strength, and biocompatibility of the scaffold. Drug release kinetics showed that the SIM encapsulated in the scaffold was released in a sustained manner for up to 30 days. In vitro bioactivity study in rat bone marrow-derived mesenchymal stem cells showed that the SIM-loaded scaffolds had a strong ability in accelerating cell proliferation and inducing osteogenic differentiation. Moreover, an in vivo experiment using a rat calvarial defect model also documented that the SIM-loaded scaffolds had a remarkable effect on bone-promoting regeneration. The results of this study suggest that the SIM-loaded CS/HA scaffold is feasible and effective in bone repair and thus may provide a promising route for the treatment of critical-sized bone defects.
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Rimington RP, Capel AJ, Christie SDR, Lewis MP. Biocompatible 3D printed polymers via fused deposition modelling direct C 2C 12 cellular phenotype in vitro. LAB ON A CHIP 2017; 17:2982-2993. [PMID: 28762415 DOI: 10.1039/c7lc00577f] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The capability to 3D print bespoke biologically receptive parts within short time periods has driven the growing prevalence of additive manufacture (AM) technology within biological settings, however limited research concerning cellular interaction with 3D printed polymers has been undertaken. In this work, we used skeletal muscle C2C12 cell line in order to ascertain critical evidence of cellular behaviour in response to multiple bio-receptive candidate polymers; polylactic acid (PLA), acrylonitrile butadiene styrene (ABS), polyethylene terephthalate (PET) and polycarbonate (PC) 3D printed via fused deposition modelling (FDM). The extrusion based nature of FDM elicited polymer specific topographies, within which C2C12 cells exhibited reduced metabolic activity when compared to optimised surfaces of tissue culture plastic, however assay viability readings remained high across polymers outlining viable phenotypes. C2C12 cells exhibited consistently high levels of morphological alignment across polymers, however differential myotube widths and levels of transcriptional myogenin expression appeared to demonstrate response specific thresholds at which varying polymer selection potentiates cellular differentiation, elicits pre-mature early myotube formation and directs subsequent morphological phenotype. Here we observed biocompatible AM polymers manufactured via FDM, which also appear to hold the potential to simultaneously manipulate the desired biological phenotype and enhance the biomimicry of skeletal muscle cells in vitro via AM polymer choice and careful selection of machine processing parameters. When considered in combination with the associated design freedom of AM, this may provide the opportunity to not only enhance the efficiency of creating biomimetic models, but also to precisely control the biological output within such scaffolds.
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Affiliation(s)
- Rowan P Rimington
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK.
| | - Andrew J Capel
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK. and Department of Chemistry, School of Science, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
| | - Steven D R Christie
- Department of Chemistry, School of Science, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
| | - Mark P Lewis
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK.
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Wu Z, Li Q, Pan Y, Yao Y, Tang S, Su J, Shin JW, Wei J, Zhao J. Nanoporosity improved water absorption, in vitro degradability, mineralization, osteoblast responses and drug release of poly(butylene succinate)-based composite scaffolds containing nanoporous magnesium silicate compared with magnesium silicate. Int J Nanomedicine 2017; 12:3637-3651. [PMID: 28553104 PMCID: PMC5439988 DOI: 10.2147/ijn.s132778] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Bioactive composite macroporous scaffold containing nanoporosity was prepared by incorporation of nanoporous magnesium silicate (NMS) into poly(butylene succinate) (PBSu) using solvent casting-particulate leaching method. The results showed that the water absorption and in vitro degradability of NMS/PBSu composite (NMPC) scaffold significantly improved compared with magnesium silicate (MS)/PBSu composite (MPC) scaffold. In addition, the NMPC scaffold showed improved apatite mineralization ability, indicating better bioactivity, as the NMPC containing nanoporosity could induce more apatite and homogeneous apatite layer on the surfaces than MPC scaffold. The attachment and proliferation of MC3T3-E1 cells on NMPC scaffold increased significantly compared with MPC scaffold, and the alkaline phosphatase (ALP) activity of the cells on NMPC scaffold was expressed at considerably higher levels compared with MPC scaffold. Moreover, NMPC scaffold with nanoporosity not only had large drug loading (vancomycin) but also exhibited drug sustained release. The results suggested that the incorporation of NMS into PBSu could produce bioactive composite scaffold with nanoporosity, which could enhance water absorption, degradability, apatite mineralization and drug sustained release and promote cell responses.
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Affiliation(s)
- Zhaoying Wu
- Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology
| | - Quan Li
- Department of Orthopaedics Trauma, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China
| | - Yongkang Pan
- Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology
| | - Yuan Yao
- Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology
| | - Songchao Tang
- Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology
| | - Jiacan Su
- Department of Orthopaedics Trauma, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China
| | - Jung-Woog Shin
- Department of Biomedical Engineering, Inje University, Gimhae, Republic of Korea
| | - Jie Wei
- Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology
| | - Jun Zhao
- Department of Orthodontics
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China
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Li H, Li J, Jiang J, Lv F, Chang J, Chen S, Wu C. An osteogenesis/angiogenesis-stimulation artificial ligament for anterior cruciate ligament reconstruction. Acta Biomater 2017; 54:399-410. [PMID: 28315493 DOI: 10.1016/j.actbio.2017.03.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 03/05/2017] [Accepted: 03/09/2017] [Indexed: 12/13/2022]
Abstract
To solve the poor healing of polyethylene terephthalate (PET) artificial ligament in bone tunnel, copper-containing bioactive glass (Cu-BG) nanocoatings on PET artificial ligaments were successfully prepared by pulsed laser deposition (PLD). It was hypothesized that Cu-BG coated PET (Cu-BG/PET) grafts could enhance the in vitro osteogenic and angiogenic differentiation of rat bone marrow mesenchymal stem cells (rBMSCs) and in vivo graft-bone healing after anterior cruciate ligament (ACL) reconstruction in a goat model. Scanning electron microscope and EDS mapping analysis revealed that the prepared nanocoatings had uniform element distribution (Cu, Ca, Si and P) and nanostructure. The surface hydrophilicity of PET grafts was significantly improved after depositing Cu-BG nanocoatings. The in vitro study displayed that the Cu-BG/PET grafts supported the attachment and proliferation of rBMSCs, and significantly promoted the expression of HIF-1α gene, which up-regulated the osteogenesis-related genes (S100A10, BMP2, OCN) and angiogenesis-related genes (VEGF) in comparison with PET or BG coated PET (BG/PET) grafts which do not contain Cu element. Meanwhile, Cu-BG/PET grafts promoted the bone regeneration at the graft-host bone interface and decreased graft-bone interface width, thus enhancing the bonding strength as well as angiogenesis (as indicated by CD31 expression) in the goat model as compared with BG/PET and pure PET grafts. The study demonstrates that the Cu-containing biomaterials significantly promote osteogenesis and angiogenesis in the repair of bone defects of large animals and thus offering a promising method for ACL reconstruction by using Cu-containing nanobioglass modified PET grafts. STATEMENT OF SIGNIFICANCE It remains a significant challenge to develop an artificial graft with distinct osteogenetic/angiogenetic activity to enhance graft-bone healing for ligament reconstruction. To solve these problems, copper-containing bioactive glass (Cu-BG) nanocoatings on PET artificial ligaments were successfully prepared by pulsed laser deposition (PLD). It was found that the prepared Cu-BG/PET grafts significantly stimulated the proliferation and osteogenic/angiogenic differentiation of bone marrow stromal cells (BMSCs) through activating HIF-1α/S100A10/Ca2+ signal pathway. The most important is that the in vivo bone-forming ability of Cu-containing biomaterials was, for the first time, elucidated in a large animal model, revealing the enhanced capacity of osteogenesis and angiogenesis with incorporation of bioactive Cu element. It is suggested that the copper-containing biomaterials significantly promote osteogenesis and angiogenesis in large animal defects and thus offering a promising method for ACL reconstruction by using Cu-containing nanobioglass modification of PET grafts, paving the way to apply Cu-containing biomaterials for tissue engineering and regenerative medicine.
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Sun Y, Han F, Zhang P, Zhi Y, Yang J, Yao X, Wang H, Lin C, Wen X, Chen J, Zhao P. A synthetic bridging patch of modified co-electrospun dual nano-scaffolds for massive rotator cuff tear. J Mater Chem B 2016; 4:7259-7269. [PMID: 32263728 DOI: 10.1039/c6tb01674j] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
An electrospun nano-scaffold with two different segments is fabricated to bridge a massive rotator cuff tear successfully.
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