A new biodegradable patch for closure of atrial septal defect. An experimental study

Graphene Nanoplatelets Render Poly(3-Hydroxybutyrate) a Suitable Scaffold to Promote Neuronal Network Development

The use of composite biomaterials as innovative bio-friendly neuronal interfaces has been poorly developed so far. Smart strategies to target neuro-pathologies are currently exploiting the mixed and complementary characteristics of composite materials to better design future neural interfaces. Here we present a polymer-based scaffold that has been rendered suitable for primary neurons by embedding graphene nanoplatelets (GnP). In particular, the growth, network formation, and functionality of primary neurons on poly(3-hydroxybutyrate) [P(3HB)] polymer supports functionalized with various concentrations of GnP were explored. After growing primary cortical neurons onto the supports for 14 days, all specimens were found to be biocompatible, revealing physiological growth and maturation of the neuronal network. When network functionality was investigated by whole patch-clamp measurements, pure P(3HB) led to changes in the action potential waveform and reduction in firing frequency, resulting in decreased neuronal excitability. However, the addition of GnP to the polymer matrix restored the electrophysiological parameters to physiological values. Interestingly, a low concentration of graphene was able to promote firing activity at a low level of injected current. The results indicate that the P(3HB)/GnP composites show great potential for electrical interfacing with primary neurons to eventually target central nervous system disorders.

Application of Polyhydroxyalkanoates in Medicine and the Biological Activity of Natural Poly(3-Hydroxybutyrate)

Biodegradable and biocompatible polymers, polyhydroxyalkanoates (PHAs), are actively used in medicine to produce a wide range of medical devices and dosage formulations. The medical industry mainly utilizes PHAs obtained by chemical synthesis, but interest in the medical application of natural PHAs obtained biotechnologically is also growing. Synthetic PHAs are the biomimetic analogs of bacterial poly(3-hydroxybutyrate) (PHB) and other natural PHAs. This paper addresses the issue of the presence of biological activity in synthetic and natural PHAs (stimulation of cell proliferation and differentiation, tissue regeneration) and their possible association with various biological functions of PHB in bacteria and eukaryotes, including humans.

Biological Properties of Low-Toxic PLGA and PLGA/PHB Fibrous Nanocomposite Scaffolds for Osseous Tissue Regeneration. Evaluation of Potential Bioactivity

The aim of the study was to evaluate the biocompatibility and bioactivity of two new prototype implants for bone tissue regeneration made from biodegradable fibrous materials. The first is a newly developed poly(l-lactide-co-glycolide), (PLGA), and the second is a blend of PLGA with synthetic poly([R,S]-3-hydroxybutyrate) (PLGA/PHB). The implant prototypes comprise PLGA or PLGA/PHB nonwoven fabrics with designed pore structures to create the best conditions for cell proliferation. The bioactivity of the proposed implants was enhanced by introducing a hydroxyapatite material and a biologically active agent, namely, growth factor IGF1, encapsulated in calcium alginate microspheres. To assess the biocompatibility and bioactivity, allergenic tests and an assessment of the local reaction of bone tissue after implantation were performed. Comparative studies of local tissue response after implantation into trochanters for a period of 12 months were performed on New Zealand rabbits. Based on the results of the in vivo evaluation of the allergenic effects and the local tissue reaction 12 months after implantation, it was concluded that the two implant prototypes, PLGA + IGF1 and PLGA/PHB + IGF1, were characterized by high biocompatibility with the soft and bone tissues of the tested animals.

Small Intestinal Submucosa Intracardiac Patch: An Experimental Study

In this experimental study, small intestinal submucosa was implanted as an atrial prosthesis in calves. Echocardiography and histology showed this to be an impermeable prosthesis that develops a neointimal nonthrombogenic surface making it safe for repair of defects in a low-pressure system. Further study with small intestinal submucosa in an intracardiac position is warranted.

Application of Biodegradable Polyhydroxyalkanoates as Surgical Films for Ventral Hernia Repair in Mice

The cytotoxicity and biosafety of poly-(3-hydroxybutyrate) (P3HB) and poly-(3-hydroxybutyrate-co-3-hydroxyvalerate) (P3HBV) films were investigated in vitro using 3T3 fibroblast cells and in vivo through subcutaneous implantation of the film in mice. The in vitro test revealed that endotoxin-free P3HB and P3HBV films allowed cell attachment and growth. Film-soaked conditional media showed no significant inhibitory or cytotoxic effects on cell proliferation. The in vivo absorption test showed that both the P3HB and P3HBV films slowly degraded and that P3HB had a slower degradation rate than that of P3HBV. Applying a P3HB film in hernia repair demonstrated a favorable outcome: the film was able to correct the abdominal ventral hernia by inducing connective tissue and fat ingrowth and exhibited an extremely slow rate of degradation. Furthermore, the P3HB film demonstrated the advantage of lower intestinal adhesion to the ventral hernia site compared with the P3HBV and PP commercial films.

Current requirements for polymeric biomaterials in otolaryngology

In recent years otolaryngology was strongly influenced by newly developed implants which are based on both, innovative biomaterials and novel implant technologies. Since the biomaterials are integrated into biological systems they have to fulfill all technical requirements and accommodate biological interactions. Technical functionality relating to implant specific mechanical properties, a sufficiently high stability in terms of physiological conditions, and good biocompatibility are the demands with regard to suitability of biomaterials. The goal in applying biomaterials for implants is to maintain biofunctionality over extended periods of time. These general demands to biomaterials are equally valid for use in otolaryngology. Different classes of materials can be utilized as biomaterials. Metals belong to the oldest biomaterials. In addition, alloys, ceramics, inorganic glasses and composites have been tested successfully. Furthermore, natural and synthetic polymers are widely used materials, which will be in the focus of the current article with regard to their properties and usage as cochlear implants, osteosynthesis implants, stents, and matrices for tissue engineering. Due to their application as permanent or temporary implants materials are differentiated into biostable and biodegradable polymers. The here identified general and up to date requirements for biomaterials and the illustrated applications in otolaryngology emphasize ongoing research efforts in this area and at the same time demonstrate the high significance of interdisciplinary cooperation between natural sciences, engineering, and medical sciences.

Natural Poly(Hydroxybutyrate-Hydroxyvalerate) Polymers as Degradable Biomatertals

Poly(ß-hydroxybutyrate-co-13-hydroxyvalerate) have been recently proposed as degradable biomaterials for drug delivery systems, sutures, bone plates and short-term implants. Three P-B\HV (7, 14 & 22 % HV) films were analyzed for in vitro cytotoxicity and aqueous accelerated degradation, in vivo degradation and tissue reactions. The PHB/HV materials and extracts elicit few or mild toxic responses, do not lead in vivo to tissue necrosis or abscess formation, but provoke acute inflammatory reactions slightly decreasing with the time. The degradation of PHB/HV polymers present low rates in vitro as well as in vivo. The weight loss rate generally increases with the copolymer composition (HV content) and ranges from 0.15- 0.30 (in vitro) to 0.25 %/day (in vivo). Compositional and physico-chemical changes in PHB/HV materials were rapidly detected during the accelerated hydrolysis, but were much slower to appear in vivo. The structural and mechanical integrity of PHB/HV materials tend to disappear early in vitro as well as in vivo. After 90 wks in dorsal muscular tissues of adult sheep, there was no significant dissolution of the PHB/HV polymer, 50–60% of the initial weight still remaining. PHB/HV polymers are biodegradable materials, either by hydrolysis or implantation, but with extremely low dissolution or degradation rates.

Poly(3-hydroxybutyrate) and biopolymer systems on the basis of this polyester

Biodegradable biopolymers attract much attention in biology and medicine due to its wide application. The present review is designed to be a comprehensive source for research of biodegradable and biocompatible bacterial polymer, poly(3-hydroxybutyrate). This paper focuses on basic properties of biopolymer: biodegradability and biocompatibility, as well as on biopolymer systems: various materials, devices and compositions on the basis of biopolymer. Application of biopolymer systems based on poly(3-hydroxybutyrate) in medicine as surgical implants, in bioengineering as scaffold for cell cultures, and in pharmacy as drug dosage forms and drug systems is observed in the present review.

Growing tissue-like constructs with Hep3B/HepG2 liver cells on PHBV microspheres of different sizes

In this study, an oil-in-water emulsion solvent evaporation technique was used to fabricate poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV, 8% PHV), microspheres as scaffold, to guide liver cell growth. Human hepatoma cell lines, HepG2 and Hep3B, were cultured in vitro on both the microspheres and polymer films. SEM and optical microscope images showed that multilayer cells were formed among the microspheres to bridge them together and developed into cell-construct aggregates after 1 week of culture. MTT results showed that the cell proliferation on the microspheres was more than two times higher than that on the films after 12 days of culture. The cells seeded on microspheres secreted albumin 2-4 times more than that on the positive control after 1 week of culture, which indicated that this hepatic function was greatly improved by the aggregation of cells on microspheres. Although HepG2 failed to express P-450 activity, this hepatic function was preserved when Hep3B cultured on microspheres. All the results indicated that PHBV microspheres are appropriate scaffolds for liver tissue engineering.

Fabrication, characterization, and in vitro degradation of composite scaffolds based on PHBV and bioactive glass

Composite scaffolds of polyhydroxybutyrate-polyhydroxyvalerate (PHBV) with sol-gel-derived bioactive glass (BG, 58S) are fabricated by compression molding, thermal processing, and salt particulate leaching method. Structure and mechanical properties of the scaffolds are determined. The bioactivity of the composites is evaluated by soaking the scaffolds in a simulated body fluid (SBF), and the formation of the apatite layer on the scaffolds is determined by scanning electron microscopy (SEM) and energy-dispersive spectrometry (EDS). The results show that the PHBV/BG composites are bioactive as they induce the formation of apatite on the composite scaffolds after soaking in SBF for 3 days. In addition, the measurements of the water contact angles suggest that incorporation of BG into PHBV can improve the hydrophilicity of the composites and the enhancement is dependent on the BG content. Furthermore, the degradation assessment of the scaffolds is performed in phosphate-buffered saline (PBS) solution at 37 C. Weight loss and water absorption of the scaffolds, pH of the incubation media, and molecular weight measurements of the PHBV in the scaffolds are used to monitor the degradation of the scaffolds during a nine-week incubation in PBS. It has been found that the incorporation of bioactive glass into the PHBV delayed the degradation of PHBV in the composite scaffolds for the period investigated. The present results show not only a useful method to prepare composite scaffolds with improved properties but also a way of adjusting the in vitro degradation behavior of composite scaffolds by tailoring the content of bioactive glass.

Tissue engineered cartilage on collagen and PHBV matrices

Cartilage engineering is a very novel approach to tissue repair through use of implants. Matrices of collagen containing calcium phosphate (CaP-Gelfix), and matrices of poly(3-hydroxybutyric acid-co-3-hydroxyvaleric acid) (PHBV) were produced to create a cartilage via tissue engineering. The matrices were characterized by scanning electron microscopy (SEM) and electron diffraction spectroscopy (EDS). Porosity and void volume analysis were carried out to characterize the matrices. Chondrocytes were isolated from the proximal humerus of 22 week-old male, adult, local albino rabbits. For cell type characterization, Type II collagen was measured by Western Blot analysis. The foams were seeded with 1x10(6) chondrocytes and histological examinations were carried out to assess cell-matrix interaction. Macroscopic examination showed that PHBV (with or without chondrocytes) maintained its integrity for 21 days, while CaP-Gelfix was deformed and degraded within 15 days. Cell-containing and cell-free matrices were implanted into full thickness cartilage defects (4.5 mm in diameter and 4 mm in depth) at the patellar groove on the right and left knees of eight rabbits, respectively. In vivo results at 8 and 20 weeks with chondrocyte seeded PHBV matrices presented early cartilage formation resembling normal articular cartilage and revealed minimal foreign body reaction. In CaP-Gelfix matrices, fibrocartilage formation and bone invasion was noted in 20 weeks. Cells maintained their phenotype in both matrices. PHBV had better healing response than CaP-Gelfix. Both matrices were effective in cartilage regeneration. These matrices have great potential for use in the repair of joint cartilage defects.

In Vivo Tissue Engineering of Bone Using Poly(3-hydroxybutyric acid-co-3-hydroxyvaleric acid) and Collagen Scaffolds

Porous poly(3-hydroxybutyric acid-co-3-hydroxyvaleric acid) (PHBV) and calcium phosphate-loaded collagen (CaP-Gelfix) foams were seeded with rat bone marrow stromal cells and implanted into defects created in rat femurs to study in vivo bone formation and to test their suitability for use in bone tissue engineering. At 3 and 6 weeks, new bone formation was evaluated by macroscopy, radiography, dual-energy X-ray absorptiometry (DEXA), and quantitative computerized tomography (QCT). Atomic contents of the implants were further assessed by QCT. Some initial inflammation that significantly decreased with time was observed in the CaP-Gelfix group. PHBV inflammation was minimal at all stages. Fibrous tissue formation in the CaP-Gelfix group was more than in the PHBV group. Both cell-loaded and cell-free PHBV matrices elicited minimal fibrous tissue formation during the 6-week implantation duration. Macroscopic and radiological studies demonstrated better healing with PHBV matrices than with CaP-Gelfix in 3 weeks. Histologically, fibrous connective tissue establishment and inflammation scores were significantly higher in the CaP-Gelfix group when compared with the PHBV group at both time intervals. At 6 weeks, however, the extent of healing was almost the same with both implants. DEXA and QCT results indicated that there was an increase in bone mineral density in both PHBV and CaP-Gelfix implants at the end of 6 weeks. This study suggests that even though PHBV and CaP-Gelfix have different bulk and surface chemistries they both are promising cell carriers that may be suitable for use in bone tissue engineering.

Macroporous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) matrices for bone tissue engineering

Macroporous poly(3-hydroxybutyric acid-co-3-hydroxyvaleric acid) (PHBV) matrices were prepared after solvent evaporation and solute leaching. PHBV solutions with different concentrations were prepared in chloroform: dichloromethane (1:2, v/v). In order to create a matrix with high porosity and uniform pore sizes, sieved sucrose crystals (75-300 or 300-500 microm) were used. PHBV foams were treated with rf-oxygen plasma to modify their surface chemistry and hydrophilicity with the aim of increasing the reattachment of osteoblasts. Surface characteristics, pore sizes and their distribution on PHBV surface were studied by scanning electron microscopy (SEM) and Scion Image Analysis Program. Void volume, pore sizes and density of foams were found to be significantly affected by foam preparation conditions. Stability of PHBV foams in aqueous media was studied. Their weight and density were unchanged for a period of 120 days and then a significant decrease was observed for the rest of the study (60 days). Osteoblasts were seeded onto the foams and their proliferation inside the matrices was also determined by SEM. After 29 and 60 days of incubation, growth of osteoblasts on matrices was observed.

Thrombosis of a patent foramen ovale closure device: thrombolytic management

Transcatheter closure of a patent foramen ovale (PFO) offers a valuable alternative to surgery in selected patients with presumed paradoxical embolism. Like for all other devices, several complications have been described. Although the majority of these complications are caused by technical problems of the device itself, thrombosis is a relatively infrequent but feared finding, as it may result in recurrent embolic events and persistent neurological deficits. The majority of the complications after implantation are dealt with by surgical removal of the device and subsequent surgical closure of the PFO. The present case report describes biatrial thrombosis of a PFO device that was successfully treated with thrombolytics and GP IIb/IIIa receptor blockers. In stable patients, this pharmaco-therapeutic approach should be attempted to save the thrombosed PFO device and could therefore offer a valuable alternative to surgical removal of the device.

Biomaterial patches sutured onto the rat stomach induce a set of genes encoding pancreatic enzymes

Asymmetric patches of polyhydroxybutyric acid with one smooth and one rough surface were produced by a dipping procedure. These patches were implanted into the rat gastrointestine and tissue samples were generated at distinct time intervals after surgery. The host's response towards the foreign material was analyzed by Differential Display and RNA profiles were compared to each other. One to two weeks after surgery a group of mRNAs encoding pancreatic enzymes was transiently present after biomaterial implantation.

Neuronal survival using a resorbable synthetic conduit as an alternative to primary nerve repair

Clinically optimal situations for primary nerve repair are rarely observed. Crushed nerve ends result in either suboptimal repair or a need for nerve grafting. Functional results after nerve surgery are relatively poor, including major sensory deficits, which may be due to the death of primary sensory neurons that follows the nerve injury. The aim of this study was to determine if using polyhydroxybutyrate (PHB), a resorbable nerve conduit, could be an alternative to primary nerve repair in reducing loss of neurons. The superficial radial nerves in 20 cats were sectioned bilaterally and primarily repaired microsurgically by the use of two different strategies; either wrapping the nerve ends in sheets of PHB or epineurally suturing of the nerve. After 6 or 12 months, the surviving neurons within the dorsal root ganglia [C5-T1] were counted. No statistically significant differences were found between the two methods. This may imply a future possibility of using PHB as a synthetic nerve graft in situations where suboptimal primary repair or nerve grafts are the alternatives.