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Øvrebø Ø, De Lauretis A, Ma Q, Lyngstadaas SP, Perale G, Nilsen O, Rossi F, Haugen HJ. Towards bone regeneration: Understanding the nucleating ability of proline-rich peptides in biomineralisation. BIOMATERIALS ADVANCES 2024; 159:213801. [PMID: 38401402 DOI: 10.1016/j.bioadv.2024.213801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/26/2024] [Accepted: 02/18/2024] [Indexed: 02/26/2024]
Abstract
Obtaining rapid mineralisation is a challenge in current bone graft materials, which has been attributed to the difficulty of guiding the biological processes towards osteogenesis. Amelogenin, a key protein in enamel formation, inspired the design of two intrinsically disordered peptides (P2 and P6) that enhance in vivo bone formation, but the process is not fully understood. In this study, we have elucidated the mechanism by which these peptides induce improved mineralisation. Our molecular dynamics analysis demonstrated that in an aqueous environment, P2 and P6 fold to interact with the surrounding Ca2+, PO43- and OH- ions, which can lead to apatite nucleation. Although P2 has a less stable backbone, it folds to a stable structure that allows for the nucleation of larger calcium phosphate aggregates than P6. These results were validated experimentally in a concentrated simulated body fluid solution, where the peptide solutions accelerated the mineralisation process compared to the control and yielded mineral structures mimicking the amorphous calcium phosphate crystals that can be found in lamella bone. A pH drop for the peptide groups suggests depletion of calcium and phosphate, a prerequisite for intrinsic osteoinduction, while S/TEM and SEM suggested that the peptide regulated the mineral nucleation into lamella flakes. Evidently, the peptides accelerate and guide mineral formation, elucidating the mechanism for how these peptides can improve the efficacy of P2 or P6 containing devices for bone regeneration. The work also demonstrates how experimental mineralisation study coupled with molecular dynamics is a valid method for understanding and predicting in vivo performance prior to animal trials.
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Affiliation(s)
- Øystein Øvrebø
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway; Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, 20133 Milano, Italy; Material Biomimetic AS, Oslo Science Park, 0349 Oslo, Norway
| | - Angela De Lauretis
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway; Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, 20133 Milano, Italy
| | - Qianli Ma
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
| | - Ståle Petter Lyngstadaas
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
| | - Giuseppe Perale
- Industrie Biomediche Insubri SA, Mezzovico-Vira 6805, Switzerland; Faculty of Biomedical Sciences, University of Southern Switzerland, Lugano 6900, Switzerland; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, 1200 Vienna, Austria
| | - Ola Nilsen
- Centre for Materials Science and Nanotechnology, Department of Chemistry, University of Oslo, Gaustadalléen 21, NO-0349 Oslo, Norway
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, 20133 Milano, Italy
| | - Håvard J Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway.
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Stogov MV, Dyuryagina OV, Silant'eva TA, Shipitsyna IV, Kireeva EA, Stepanov MA. Evaluation of Biocompatibility of New Osteoplastic Xenomaterials Containing Zoledronic Acid and Strontium Ranelate. TRAUMATOLOGY AND ORTHOPEDICS OF RUSSIA 2023; 30:57-73. [DOI: 10.17816/2311-2905-2035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Background. The problem of improving the functional characteristics of implanted devices and materials used in traumatology and orthopedics is a topical issue.
Aim of the study to study biocompatibility of bovine bone matrix xenomaterials modified by zoledronic acid and strontium ranelate when implanted into the bone defect cavity.
Methods. The study was performed on 24 male rabbits of the Soviet Chinchilla breed. Test blocks of bone matrix were implanted into the cavity of bone defects of the femur. Group 1 animals (n = 8, control group) were implanted with bone xenogenic material (Bio-Ost osteoplastic matrix). Group 2 animals (n = 8) were implanted with bone xenogenic material impregnated with zoledronic acid. Group 3 animals (n = 8) were implanted with bone xenogeneic material impregnated with strontium ranelate. Supercritical fluid extraction technology was used to purify the material and impregnate it with zoledronic acid and strontium ranelate. Radiological, pathomorphological, histological and laboratory (hematology and blood biochemistry) diagnostic methods were used to assess biocompatibility. Follow-up period was 182 days after implantation.
Results. It was found out that on the 182nd day after implantation the median area of the newly-formed bone tissue in the defect modeling area in Group 1 was 79%, in Group 2 0%, in Group 3 67%. In Group 2 the maximum area by this period was filled with connective tissue 77%. Median relative area of implanted material fragments in Group 1 was 4%, in Group 2 23%, in Group 3 15%. No infection or material rejection was observed in animals of all groups. There were no signs of intoxication or prolonged systemic inflammatory reaction. Laboratory parameters did not change significantly over time. One animal in each group experienced one-time increase in C-reactive protein level against the background of leukocytosis. Two animals in Group 1 had a slight migration of implanted material under the skin, one animal developed arthritis of the knee joint.
Conclusion. Osteoplastic materials based on bovine bone xenomatrix and filled with zoledronic acid and strontium ranelate have acceptable values of biocompatibility including their safety profile.
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Øvrebø Ø, Perale G, Wojciechowski JP, Echalier C, Jeffers JRT, Stevens MM, Haugen HJ, Rossi F. Design and clinical application of injectable hydrogels for musculoskeletal therapy. Bioeng Transl Med 2022; 7:e10295. [PMID: 35600661 PMCID: PMC9115710 DOI: 10.1002/btm2.10295] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/25/2022] Open
Abstract
Musculoskeletal defects are an enormous healthcare burden and source of pain and disability for individuals. With an aging population, the proportion of individuals living with these medical indications will increase. Simultaneously, there is pressure on healthcare providers to source efficient solutions, which are cheaper and less invasive than conventional technology. This has led to an increased research focus on hydrogels as highly biocompatible biomaterials that can be delivered through minimally invasive procedures. This review will discuss how hydrogels can be designed for clinical translation, particularly in the context of the new European Medical Device Regulation (MDR). We will then do a deep dive into the clinically used hydrogel solutions that have been commercially approved or have undergone clinical trials in Europe or the United States. We will discuss the therapeutic mechanism and limitations of these products. Due to the vast application areas of hydrogels, this work focuses only on treatments of cartilage, bone, and the nucleus pulposus. Lastly, the main steps toward clinical translation of hydrogels as medical devices are outlined. We suggest a framework for how academics can assist small and medium MedTech enterprises conducting the initial clinical investigation and post‐market clinical follow‐up required in the MDR. It is evident that the successful translation of hydrogels is governed by acquiring high‐quality pre‐clinical and clinical data confirming the device mechanism of action and safety.
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Affiliation(s)
- Øystein Øvrebø
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilanoItaly
- Department of BiomaterialsInstitute of Clinical Dentistry, University of OsloOsloNorway
- Material Biomimetic ASOslo Science ParkOsloNorway
| | - Giuseppe Perale
- Industrie Biomediche Insubri SAMezzovico‐ViraSwitzerland
- Faculty of Biomedical SciencesUniversity of Southern SwitzerlandLuganoSwitzerland
- Ludwig Boltzmann Institute for Experimental and Clinical TraumatologyViennaAustria
| | - Jonathan P. Wojciechowski
- Department of MaterialsImperial College LondonLondonUK
- Department of BioengineeringImperial College LondonLondonUK
- Institute of Biomedical EngineeringImperial College LondonLondonUK
| | - Cécile Echalier
- Department of MaterialsImperial College LondonLondonUK
- Department of BioengineeringImperial College LondonLondonUK
- Institute of Biomedical EngineeringImperial College LondonLondonUK
- Hybrid Technology Hub, Centre of ExcellenceInstitute of Basic Medical Science, University of OsloOsloNorway
| | | | - Molly M. Stevens
- Department of MaterialsImperial College LondonLondonUK
- Department of BioengineeringImperial College LondonLondonUK
- Institute of Biomedical EngineeringImperial College LondonLondonUK
| | - Håvard J. Haugen
- Department of BiomaterialsInstitute of Clinical Dentistry, University of OsloOsloNorway
- Material Biomimetic ASOslo Science ParkOsloNorway
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilanoItaly
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Commercial Bone Grafts Claimed as an Alternative to Autografts: Current Trends for Clinical Applications in Orthopaedics. MATERIALS 2021; 14:ma14123290. [PMID: 34198691 PMCID: PMC8232314 DOI: 10.3390/ma14123290] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 02/08/2023]
Abstract
In the last twenty years, due to an increasing medical and market demand for orthopaedic implants, several grafting options have been developed. However, when alternative bone augmentation materials mimicking autografts are searched on the market, commercially available products may be grouped into three main categories: cellular bone matrices, growth factor enhanced bone grafts, and peptide enhanced xeno-hybrid bone grafts. Firstly, to obtain data for this review, the search engines Google and Bing were employed to acquire information from reports or website portfolios of important competitors in the global bone graft market. Secondly, bibliographic databases such as Medline/PubMed, Web of Science, and Scopus were also employed to analyse data from preclinical/clinical studies performed to evaluate the safety and efficacy of each product released on the market. Here, we discuss several products in terms of osteogenic/osteoinductive/osteoconductive properties, safety, efficacy, and side effects, as well as regulatory issues and costs. Although both positive and negative results were reported in clinical applications for each class of products, to date, peptide enhanced xeno-hybrid bone grafts may represent the best choice in terms of risk/benefit ratio. Nevertheless, more prospective and controlled studies are needed before approval for routine clinical use.
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