1
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Ma S, Sun R, Wang Y, Wei Y, Xu H, Liu X, Liang Z, Zhao L, Hu Y, Lian X, Guo M, Huang D. Improving osseointegration and antimicrobial properties of titanium implants with black phosphorus nanosheets-hydroxyapatite composite coatings for vascularized bone regeneration. J Biomed Mater Res B Appl Biomater 2024; 112:e35403. [PMID: 38520706 DOI: 10.1002/jbm.b.35403] [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: 12/21/2023] [Revised: 02/21/2024] [Accepted: 03/04/2024] [Indexed: 03/25/2024]
Abstract
For decades, titanium implants have shown impressive advantages in bone repair. However, the preparation of implants with excellent antimicrobial properties as well as better osseointegration ability remains difficult for clinical application. In this study, black phosphorus nanosheets (BPNSs) were doped into hydroxyapatite (HA) coatings using electrophoretic deposition. The coatings' surface morphology, roughness, water contact angle, photothermal properties, and antibacterial properties were investigated. The BP/HA coating exhibited a surface roughness of 59.1 nm, providing an ideal substrate for cell attachment and growth. The water contact angle on the BP/HA coating was measured to be approximately 8.55°, indicating its hydrophilic nature. The BPNSs demonstrated efficient photothermal conversion, with a temperature increase of 42.2°C under laser irradiation. The BP/HA composite coating exhibited a significant reduction in bacterial growth, with inhibition rates of 95.6% and 96.1% against Staphylococcus aureus and Escherichia coli. In addition, the cytocompatibility of the composite coating was evaluated by cell adhesion, CCK8 and AM/PI staining; the effect of the composite coating in promoting angiogenesis was assessed by scratch assay, transwell assay, and protein blotting; and the osteoinductivity of the composite coating was evaluated by alkaline phosphatase assay, alizarin red staining, and Western blot. The results showed that the BP/HA composite coating exhibited superior performance in promoting biological functions such as cell proliferation and adhesion, antibacterial activity, osteogenic differentiation, and angiogenesis, and had potential applications in vascularized bone regeneration.
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Affiliation(s)
- Shilong Ma
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
| | - Ruize Sun
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
| | - Yuhui Wang
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
| | - Yan Wei
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
- Shanxi-Zheda Institute of Advanced Materials and Chemical Engineering, Taiyuan, People's Republic of China
| | - Haofeng Xu
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
| | - Xuanyu Liu
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
| | - Ziwei Liang
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
- Shanxi-Zheda Institute of Advanced Materials and Chemical Engineering, Taiyuan, People's Republic of China
| | - Liqin Zhao
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
- Shanxi-Zheda Institute of Advanced Materials and Chemical Engineering, Taiyuan, People's Republic of China
| | - Yinchun Hu
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
- Shanxi-Zheda Institute of Advanced Materials and Chemical Engineering, Taiyuan, People's Republic of China
| | - Xiaojie Lian
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
- Shanxi-Zheda Institute of Advanced Materials and Chemical Engineering, Taiyuan, People's Republic of China
| | - Meiqing Guo
- Department of Fundamental Mechanics, College of Mechanical and Vehicle Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
| | - Di Huang
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China
- Shanxi-Zheda Institute of Advanced Materials and Chemical Engineering, Taiyuan, People's Republic of China
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2
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Xing F, Shen HY, Zhe M, Jiang K, Lei J, Xiang Z, Liu M, Xu JZ, Li ZM. Nano-Topographically Guided, Biomineralized, 3D-Printed Polycaprolactone Scaffolds with Urine-Derived Stem Cells for Promoting Bone Regeneration. Pharmaceutics 2024; 16:204. [PMID: 38399258 PMCID: PMC10892771 DOI: 10.3390/pharmaceutics16020204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/21/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
Currently, biomineralization is widely used as a surface modification approach to obtain ideal material surfaces with complex hierarchical nanostructures, morphologies, unique biological functions, and categorized organizations. The fabrication of biomineralized coating for the surfaces of scaffolds, especially synthetic polymer scaffolds, can alter surface characteristics, provide a favorable microenvironment, release various bioactive substances, regulate the cellular behaviors of osteoblasts, and promote bone regeneration after implantation. However, the biomineralized coating fabricated by immersion in a simulated body fluid has the disadvantages of non-uniformity, instability, and limited capacity to act as an effective reservoir of bioactive ions for bone regeneration. In this study, in order to promote the osteoinductivity of 3D-printed PCL scaffolds, we optimized the surface biomineralization procedure by nano-topographical guidance. Compared with biomineralized coating constructed by the conventional method, the nano-topographically guided biomineralized coating possessed more mineral substances and firmly existed on the surface of scaffolds. Additionally, nano-topographically guided biomineralized coating possessed better protein adsorption and ion release capacities. To this end, the present work also demonstrated that nano-topographically guided biomineralized coating on the surface of 3D-printed PCL scaffolds can regulate the cellular behaviors of USCs, guide the osteogenic differentiation of USCs, and provide a biomimetic microenvironment for bone regeneration.
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Affiliation(s)
- Fei Xing
- Department of Orthopedic Surgery, Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China; (F.X.); (Z.X.)
| | - Hui-Yuan Shen
- College of Polymer Science and Engineering and State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China; (H.-Y.S.); (K.J.); (J.L.); (Z.-M.L.)
| | - Man Zhe
- Animal Experiment Center, West China Hospital, Sichuan University, Chengdu 610041, China;
| | - Kai Jiang
- College of Polymer Science and Engineering and State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China; (H.-Y.S.); (K.J.); (J.L.); (Z.-M.L.)
| | - Jun Lei
- College of Polymer Science and Engineering and State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China; (H.-Y.S.); (K.J.); (J.L.); (Z.-M.L.)
| | - Zhou Xiang
- Department of Orthopedic Surgery, Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China; (F.X.); (Z.X.)
| | - Ming Liu
- Department of Orthopedic Surgery, Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China; (F.X.); (Z.X.)
| | - Jia-Zhuang Xu
- College of Polymer Science and Engineering and State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China; (H.-Y.S.); (K.J.); (J.L.); (Z.-M.L.)
| | - Zhong-Ming Li
- College of Polymer Science and Engineering and State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China; (H.-Y.S.); (K.J.); (J.L.); (Z.-M.L.)
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3
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Zhao Y, He P, Yao J, Li M, Wang B, Han L, Huang Z, Guo C, Bai J, Xue F, Cong Y, Cai W, Chu PK, Chu C. pH/NIR-responsive and self-healing coatings with bacteria killing, osteogenesis, and angiogenesis performances on magnesium alloy. Biomaterials 2023; 301:122237. [PMID: 37467596 DOI: 10.1016/j.biomaterials.2023.122237] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 06/24/2023] [Accepted: 07/02/2023] [Indexed: 07/21/2023]
Abstract
Although biodegradable polymer coatings can impede corrosion of magnesium (Mg)-based orthopedic implants, they are prone to excessive degradation and accidental scratching in practice. Bone implant-related infection and limited osteointegration are other factors that adversely impact clinical application of Mg-based biomedical implants. Herein, a self-healing polymeric coating is constructed on the Mg alloy together with incorporation of a stimuli-responsive drug delivery nanoplatform by a spin-spray layer-by-layer (SSLbL) assembly technique. The nanocontainers are based on simvastatin (SIM)-encapsulated hollow mesoporous silica nanoparticles (S@HMSs) modified with polydopamine (PDA) and polycaprolactone diacrylate (PCL-DA) bilayer. Owing to the dynamic reversible reactions, the hybrid coating shows a fast, stable, and cyclical water-enabled self-healing capacity. The antibacterial assay indicates good bacteria-killing properties under near infrared (NIR) irradiation due to synergistic effects of hyperthermia, reactive oxygens species (ROS), and SIM leaching. In vitro results demonstrate that NIR laser irradiation promotes the cytocompatibility, osteogenesis, and angiogenesis. The coating facilitates alkaline phosphatase activity and expedites extracellular matrix mineralization as well as expression of osteogenesis-related genes. This study reveals a useful strategy to develop multifunctional coatings on bioabsorbable Mg alloys for orthopedic implants.
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Affiliation(s)
- Yanbin Zhao
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China
| | - Peng He
- Department of Orthopedics, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing, 211166, China
| | - Junyan Yao
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China
| | - Mei Li
- Medical Research Center, Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Bin Wang
- Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, 210093, China
| | - Linyuan Han
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China
| | - Zhihai Huang
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China
| | - Chao Guo
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China
| | - Feng Xue
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China
| | - Yu Cong
- Jinling Hospital Department of Orthopedics, Southeast University, School of Medicine, Nanjing, 210002, China.
| | - Weihua Cai
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Paul K Chu
- Department of Physics, Department of Materials Science and Engineering, and Department of Biomedical Engineering, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China
| | - Chenglin Chu
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China; Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, China.
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4
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Bourdon L, Attik N, Belkessam L, Chevalier C, Bousige C, Brioude A, Salles V. Direct-Writing Electrospun Functionalized Scaffolds for Periodontal Regeneration: In Vitro Studies. J Funct Biomater 2023; 14:jfb14050263. [PMID: 37233373 DOI: 10.3390/jfb14050263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 05/27/2023] Open
Abstract
Multiphasic scaffolds that combine different architectural, physical, and biological properties are the best option for the regeneration of complex tissues such as the periodontium. Current developed scaffolds generally lack architectural accuracy and rely on multistep manufacturing, which is difficult to implement for clinical applications. In this context, direct-writing electrospinning (DWE) represents a promising and rapid technique for developing thin 3D scaffolds with controlled architecture. The current study aimed to elaborate a biphasic scaffold using DWE based on two polycaprolactone solutions with interesting properties for bone and cement regeneration. One of the two scaffold parts contained hydroxyapatite nanoparticles (HAP) and the other contained the cementum protein 1 (CEMP1). After morphological characterizations, the elaborated scaffolds were assessed regarding periodontal ligament (PDL) cells in terms of cell proliferation, colonization, and mineralization ability. The results demonstrated that both HAP- and CEMP1-functionalized scaffolds were colonized by PDL cells and enhanced mineralization ability compared to unfunctionalized scaffolds, as revealed by alizarin red staining and OPN protein fluorescent expression. Taken together, the current data highlighted the potential of functional and organized scaffolds to stimulate bone and cementum regeneration. Moreover, DWE could be used to develop smart scaffolds with the ability to spatially control cellular orientation with suitable cellular activity at the micrometer scale, thereby enhancing periodontal and other complex tissue regeneration.
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Affiliation(s)
- Laura Bourdon
- Laboratoire des Multimatériaux et Interfaces, UMR 5615, CNRS, Université Claude Bernard Lyon 1, Bâtiment Chevreul, 6 Rue Victor Grignard, 69622 Villeurbanne, France
| | - Nina Attik
- Laboratoire des Multimatériaux et Interfaces, UMR 5615, CNRS, Université Claude Bernard Lyon 1, Bâtiment Chevreul, 6 Rue Victor Grignard, 69622 Villeurbanne, France
- Faculté d'Odontologie, Université Lyon 1, 11 Rue Guillaume Paradin, 69008 Lyon, France
| | - Liza Belkessam
- Laboratoire des Multimatériaux et Interfaces, UMR 5615, CNRS, Université Claude Bernard Lyon 1, Bâtiment Chevreul, 6 Rue Victor Grignard, 69622 Villeurbanne, France
- Faculté d'Odontologie, Université Lyon 1, 11 Rue Guillaume Paradin, 69008 Lyon, France
| | - Charlène Chevalier
- Laboratoire des Multimatériaux et Interfaces, UMR 5615, CNRS, Université Claude Bernard Lyon 1, Bâtiment Chevreul, 6 Rue Victor Grignard, 69622 Villeurbanne, France
- Faculté d'Odontologie, Université Lyon 1, 11 Rue Guillaume Paradin, 69008 Lyon, France
| | - Colin Bousige
- Laboratoire des Multimatériaux et Interfaces, UMR 5615, CNRS, Université Claude Bernard Lyon 1, Bâtiment Chevreul, 6 Rue Victor Grignard, 69622 Villeurbanne, France
| | - Arnaud Brioude
- Laboratoire des Multimatériaux et Interfaces, UMR 5615, CNRS, Université Claude Bernard Lyon 1, Bâtiment Chevreul, 6 Rue Victor Grignard, 69622 Villeurbanne, France
| | - Vincent Salles
- Laboratoire des Multimatériaux et Interfaces, UMR 5615, CNRS, Université Claude Bernard Lyon 1, Bâtiment Chevreul, 6 Rue Victor Grignard, 69622 Villeurbanne, France
- LIMMS, CNRS-IIS UMI 2820, The University of Tokyo, Tokyo 153-8505, Japan
- Institute of Industrial Science, The University of Tokyo, Tokyo 153-8505, Japan
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5
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Wątroba M, Bednarczyk W, Szewczyk PK, Kawałko J, Mech K, Grünewald A, Unalan I, Taccardi N, Boelter G, Banzhaf M, Hain C, Bała P, Boccaccini AR. In vitro cytocompatibility and antibacterial studies on biodegradable Zn alloys supplemented by a critical assessment of direct contact cytotoxicity assay. J Biomed Mater Res B Appl Biomater 2023; 111:241-260. [PMID: 36054531 PMCID: PMC10086991 DOI: 10.1002/jbm.b.35147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 07/11/2022] [Accepted: 07/17/2022] [Indexed: 12/15/2022]
Abstract
In vitro cytotoxicity assessment is indispensable in developing new biodegradable implant materials. Zn, which demonstrates an ideal corrosion rate between Mg- and Fe-based alloys, has been reported to have excellent in vivo biocompatibility. Therefore, modifications aimed at improving Zn's mechanical properties should not degrade its biological response. As sufficient strength, ductility and corrosion behavior required of load-bearing implants has been obtained in plastically deformed Zn-3Ag-0.5Mg, the effect of simultaneous Ag and Mg additions on in vitro cytocompatibility and antibacterial properties was studied, in relation to Zn and Zn-3Ag. Direct cell culture on samples and indirect extract-based tests showed almost no significant differences between the tested Zn-based materials. The diluted extracts of Zn, Zn-3Ag, and Zn-3Ag-0.5Mg showed no cytotoxicity toward MG-63 cells at a concentration of ≤12.5%. The cytotoxic effect was observed only at high Zn2+ ion concentrations and when in direct contact with metallic samples. The highest LD50 (lethal dose killing 50% of cells) of 13.4 mg/L of Zn2+ ions were determined for the Zn-3Ag-0.5Mg. Similar antibacterial activity against Escherichia coli and Staphylococcus aureus was observed for Zn and Zn alloys, so the effect is attributed mainly to the released Zn2+ ions exhibiting bactericidal properties. Most importantly, our experiments indicated the limitations of water-soluble tetrazolium salt-based cytotoxicity assays for direct tests on Zn-based materials. The discrepancies between the WST-8 assay and SEM observations are attributed to the interference of Zn2+ ions with tetrazolium salt, therefore favoring its transformation into formazan, giving false cell viability quantitative results.
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Affiliation(s)
- Maria Wątroba
- Laboratory for Mechanics of Materials and Nanostructures, Empa, Swiss Federal Laboratories for Materials Science and Technology, Thun, Switzerland.,Faculty of Metals Engineering and Industrial Computer Science, AGH University of Science and Technology, Krakow, Poland
| | - Wiktor Bednarczyk
- Faculty of Materials Science and Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Piotr K Szewczyk
- Faculty of Metals Engineering and Industrial Computer Science, AGH University of Science and Technology, Krakow, Poland
| | - Jakub Kawałko
- Academic Centre for Materials and Nanotechnology, AGH University of Science and Technology, Krakow, Poland
| | - Krzysztof Mech
- Academic Centre for Materials and Nanotechnology, AGH University of Science and Technology, Krakow, Poland
| | - Alina Grünewald
- Department of Materials Science and Engineering, Institute of Biomaterials, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Irem Unalan
- Department of Materials Science and Engineering, Institute of Biomaterials, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Nicola Taccardi
- Institute of Chemical Reaction Engineering, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Gabriela Boelter
- Institute of Microbiology and Infection and School of Biosciences, University of Birmingham, Birmingham, UK
| | - Manuel Banzhaf
- Institute of Microbiology and Infection and School of Biosciences, University of Birmingham, Birmingham, UK
| | - Caroline Hain
- Laboratory for Mechanics of Materials and Nanostructures, Empa, Swiss Federal Laboratories for Materials Science and Technology, Thun, Switzerland.,Institute for Applied Laser Photonics and Surface Technologies ALPS, Bern University of Applied Sciences, Biel/Bienne, Switzerland
| | - Piotr Bała
- Faculty of Metals Engineering and Industrial Computer Science, AGH University of Science and Technology, Krakow, Poland.,Academic Centre for Materials and Nanotechnology, AGH University of Science and Technology, Krakow, Poland
| | - Aldo R Boccaccini
- Department of Materials Science and Engineering, Institute of Biomaterials, University of Erlangen-Nuremberg, Erlangen, Germany
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6
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Larsson L, Marattukalam JJ, Paschalidou EM, Hjörvarsson B, Ferraz N, Persson C. Biocompatibility of a Zr-Based Metallic Glass Enabled by Additive Manufacturing. ACS APPLIED BIO MATERIALS 2022; 5:5741-5753. [PMID: 36459395 PMCID: PMC9768811 DOI: 10.1021/acsabm.2c00764] [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] [Indexed: 12/04/2022]
Abstract
The present work explored the use of the selective laser melting (SLM) technique to develop a Zr-based bulk metallic glass (BMG) and investigate the influence of the process parameters on obtaining different levels of surface roughness. Moreover, the potential of the additively manufactured BMG Zr59.3Cu28.8Al10.4Nb1.5 (trade name AMLOY-ZR01) as an implant material was studied by evaluating the osteoblastic cell response to the alloy and its stability under simulated biological environments. The materials were characterized in terms of degree of crystallinity, surface roughness, and morphology, followed by a systematic investigation of the response of the MC3T3-E1 preosteoblastic cell line to the as-printed samples. The materials supported cell proliferation and differentiation of the preosteoblastic cells, with results comparable to the reference material Ti-6Al-4V. The surface microroughness and surface morphology (porous or groove-type laser tracks) investigated in this study did not have a significant effect on modulating the cell response. Ion release experiments showed a large increase in ion release under inflammatory conditions as compared to regular physiological conditions, which could be attributed to the increased local corrosion under inflammatory conditions. The findings in this work showed that the surface roughness of the additively manufactured BMG AMLOY-ZR01 can be tailored by controlling the laser power applied during the SLM process. The favorable cell response to the as-printed AMLOY-ZR01 represents of a significant advancement of the investigation of additively manufactured BMGs for orthopedic applications, while the results of the ion release study highlights the effect that inflammatory conditions could have on the degradation of the alloy.
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Affiliation(s)
- Lisa Larsson
- Department
of Materials Science and Engineering, Biomedical Engineering, Box
534, Uppsala University, SE- 75121Uppsala, Sweden
| | | | | | - Björgvin Hjörvarsson
- Department
of Physics, Materials Physics, Box 530, Uppsala University, SE-75121Uppsala, Sweden
| | - Natalia Ferraz
- Department
of Materials Science and Engineering, Nanotechnology and Functional
Materials, Box 35, Uppsala University, SE- 75103Uppsala, Sweden,
| | - Cecilia Persson
- Department
of Materials Science and Engineering, Biomedical Engineering, Box
534, Uppsala University, SE- 75121Uppsala, Sweden,
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7
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Biały M, Hasiak M, Łaszcz A. Review on Biocompatibility and Prospect Biomedical Applications of Novel Functional Metallic Glasses. J Funct Biomater 2022; 13:jfb13040245. [PMID: 36412886 PMCID: PMC9680474 DOI: 10.3390/jfb13040245] [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: 10/21/2022] [Revised: 11/10/2022] [Accepted: 11/13/2022] [Indexed: 11/17/2022] Open
Abstract
The continuous development of novel materials for biomedical applications is resulting in an increasingly better prognosis for patients. The application of more advanced materials relates to fewer complications and a desirable higher percentage of successful treatments. New, innovative materials being considered for biomedical applications are metallic alloys with an amorphous internal structure called metallic glasses. They are currently in a dynamic phase of development both in terms of formulating new chemical compositions and testing their properties in terms of intended biocompatibility. This review article intends to synthesize the latest research results in the field of biocompatible metallic glasses to create a more coherent picture of these materials. It summarizes and discusses the most recent findings in the areas of mechanical properties, corrosion resistance, in vitro cellular studies, antibacterial properties, and in vivo animal studies. Results are collected mainly for the most popular metallic glasses manufactured as thin films, coatings, and in bulk form. Considered materials include alloys based on zirconium and titanium, as well as new promising ones based on magnesium, tantalum, and palladium. From the properties of the examined metallic glasses, possible areas of application and further research directions to fill existing gaps are proposed.
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8
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Chi M, Li N, Cui J, Karlin S, Rohr N, Sharma N, Thieringer FM. Biomimetic, mussel-inspired surface modification of 3D-printed biodegradable polylactic acid scaffolds with nano-hydroxyapatite for bone tissue engineering. Front Bioeng Biotechnol 2022; 10:989729. [PMID: 36159699 PMCID: PMC9493000 DOI: 10.3389/fbioe.2022.989729] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/19/2022] [Indexed: 11/29/2022] Open
Abstract
Polylactic acid (PLA) has been widely used as filaments for material extrusion additive manufacturing (AM) to develop patient-specific scaffolds in bone tissue engineering. Hydroxyapatite (HA), a major component of natural bone, has been extensively recognized as an osteoconductive biomolecule. Here, inspired by the mussel-adhesive phenomenon, in this study, polydopamine (PDA) coating was applied to the surface of 3D printed PLA scaffolds (PLA@PDA), acting as a versatile adhesive platform for immobilizing HA nanoparticles (nHA). Comprehensive analyses were performed to understand the physicochemical properties of the 3D-printed PLA scaffold functionalized with nHA and PDA for their potent clinical application as a bone regenerative substitute. Scanning electron microscopy (SEM) and element dispersive X-ray (EDX) confirmed a successful loading of nHA particles on the surface of PLA@PDA after 3 and 7 days of coating (PLA@PDA-HA3 and PLA@PDA-HA7), while the surface micromorphology and porosity remain unchanged after surface modification. The thermogravimetric analysis (TGA) showed that 7.7 % and 12.3% mass ratio of nHA were loaded on the PLA scaffold surface, respectively. The wettability test indicated that the hydrophilicity of nHA-coated scaffolds was greatly enhanced, while the mechanical properties remained uncompromised. The 3D laser scanning confocal microscope (3DLS) images revealed that the surface roughness was significantly increased, reaching Sa (arithmetic mean height) of 0.402 μm in PLA@PDA-HA7. Twenty-eight days of in-vitro degradation results showed that the introduction of nHA to the PLA surface enhances its degradation properties, as evidenced by the SEM images and weight loss test. Furthermore, a sustainable release of Ca2+ from PLA@PDA-HA3 and PLA@PDA-HA7 was recorded, during the degradation process. In contrast, the released hydroxyl group of nHA tends to neutralize the local acidic environments, which was more conducive to osteoblastic differentiation and extracellular mineralization. Taken together, this facile surface modification provides 3D printed PLA scaffolds with effective bone regenerative properties by depositing Ca2+ contents, improving surface hydrophilicity, and enhancing the in-vitro degradation rate.
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Affiliation(s)
- Minghan Chi
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Na Li
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Junkui Cui
- Department of Earth and Environmental Studies, Montclair State University, Montclair, NJ, United States
| | - Sabrina Karlin
- Biomaterials and Technology, Department of Research, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Nadja Rohr
- Biomaterials and Technology, Department of Research, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
- *Correspondence: Nadja Rohr, ; Neha Sharma,
| | - Neha Sharma
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland
- *Correspondence: Nadja Rohr, ; Neha Sharma,
| | - Florian M. Thieringer
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland
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Filipov E, Angelova L, Vig S, Fernandes MH, Moreau G, Lasgorceix M, Buchvarov I, Daskalova A. Investigating Potential Effects of Ultra-Short Laser-Textured Porous Poly-ε-Caprolactone Scaffolds on Bacterial Adhesion and Bone Cell Metabolism. Polymers (Basel) 2022; 14:polym14122382. [PMID: 35745958 PMCID: PMC9227156 DOI: 10.3390/polym14122382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/04/2022] [Accepted: 06/10/2022] [Indexed: 12/01/2022] Open
Abstract
Developing antimicrobial surfaces that combat implant-associated infections while promoting host cell response is a key strategy for improving current therapies for orthopaedic injuries. In this paper, we present the application of ultra-short laser irradiation for patterning the surface of a 3D biodegradable synthetic polymer in order to affect the adhesion and proliferation of bone cells and reject bacterial cells. The surfaces of 3D-printed polycaprolactone (PCL) scaffolds were processed with a femtosecond laser (λ = 800 nm; τ = 130 fs) for the production of patterns resembling microchannels or microprotrusions. MG63 osteoblastic cells, as well as S. aureus and E. coli, were cultured on fs-laser-treated samples. Their attachment, proliferation, and metabolic activity were monitored via colorimetric assays and scanning electron microscopy. The microchannels improved the wettability, stimulating the attachment, spreading, and proliferation of osteoblastic cells. The same topography induced cell-pattern orientation and promoted the expression of alkaline phosphatase in cells growing in an osteogenic medium. The microchannels exerted an inhibitory effect on S. aureus as after 48 h cells appeared shrunk and disrupted. In comparison, E. coli formed an abundant biofilm over both the laser-treated and control samples; however, the film was dense and adhesive on the control PCL but unattached over the microchannels.
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Affiliation(s)
- Emil Filipov
- Institute of Electronics, Bulgarian Academy of Sciences, 72 Tzarigradsko Shousse Blvd., 1784 Sofia, Bulgaria; (L.A.); (A.D.)
- Correspondence:
| | - Liliya Angelova
- Institute of Electronics, Bulgarian Academy of Sciences, 72 Tzarigradsko Shousse Blvd., 1784 Sofia, Bulgaria; (L.A.); (A.D.)
| | - Sanjana Vig
- Faculdade de Medicina Dentaria, Universidade do Porto, Rua Dr. Manuel Pereira da Silva, 4200-393 Porto, Portugal; (S.V.); (M.H.F.)
- LAQV/REQUIMTE, University of Porto, 4160-007 Porto, Portugal
| | - Maria Helena Fernandes
- Faculdade de Medicina Dentaria, Universidade do Porto, Rua Dr. Manuel Pereira da Silva, 4200-393 Porto, Portugal; (S.V.); (M.H.F.)
- LAQV/REQUIMTE, University of Porto, 4160-007 Porto, Portugal
| | - Gerard Moreau
- Laboratoire des Matériaux Céramiques et Procédés Associés, Université Polytechnique Hauts-de-France, INSA Hauts-de-France, CERAMATHS, F-59313 Valenciennes, France; (G.M.); (M.L.)
| | - Marie Lasgorceix
- Laboratoire des Matériaux Céramiques et Procédés Associés, Université Polytechnique Hauts-de-France, INSA Hauts-de-France, CERAMATHS, F-59313 Valenciennes, France; (G.M.); (M.L.)
| | - Ivan Buchvarov
- Faculty of Physics, St. Kliment Ohridski University of Sofia, 5 James Bourchier Blvd., 1164 Sofia, Bulgaria;
| | - Albena Daskalova
- Institute of Electronics, Bulgarian Academy of Sciences, 72 Tzarigradsko Shousse Blvd., 1784 Sofia, Bulgaria; (L.A.); (A.D.)
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10
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Stratified-structural hydrogel incorporated with magnesium-ion-modified black phosphorus nanosheets for promoting neuro-vascularized bone regeneration. Bioact Mater 2022; 16:271-284. [PMID: 35386320 PMCID: PMC8965728 DOI: 10.1016/j.bioactmat.2022.02.024] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 12/17/2022] Open
Abstract
Angiogenesis and neurogenesis play irreplaceable roles in bone repair. Although biomaterial implantation that mimics native skeletal tissue is extensively studied, the nerve-vascular network reconstruction is neglected in the design of biomaterials. Our goal here is to establish a periosteum-simulating bilayer hydrogel and explore the efficiency of bone repair via enhancement of angiogenesis and neurogenesis. In this contribution, we designed a bilayer hydrogel platform incorporated with magnesium-ion-modified black phosphorus (BP) nanosheets for promoting neuro-vascularized bone regeneration. Specifically, we incorporated magnesium-ion-modified black phosphorus (BP@Mg) nanosheets into gelatin methacryloyl (GelMA) hydrogel to prepare the upper hydrogel, whereas the bottom hydrogel was designed as a double-network hydrogel system, consisting of two interpenetrating polymer networks composed of GelMA, PEGDA, and β-TCP nanocrystals. The magnesium ion modification process was developed to enhance BP nanosheet stability and provide a sustained release platform for bioactive ions. Our results demonstrated that the upper layer of hydrogel provided a bionic periosteal structure, which significantly facilitated angiogenesis via induction of endothelial cell migration and presented multiple advantages for the upregulation of nerve-related protein expression in neural stem cells (NSCs). Moreover, the bottom layer of the hydrogel significantly promoted bone marrow mesenchymal stem cells (BMSCs) activity and osteogenic differentiation. We next employed the bilayer hydrogel structure to correct rat skull defects. Based on our radiological and histological examinations, the bilayer hydrogel scaffolds markedly enhanced early vascularization and neurogenesis, which prompted eventual bone regeneration and remodeling. Our current strategy paves way for designing nerve-vascular network biomaterials for bone regeneration. Developing a periosteum-simulating bilayer hydrogel to improve the efficiency of neuro-vascularized bone repair. A magnesium-ion-modified black phosphorus (BP) nanosheets incorporated hydrogel platform was designed. Designing nerve-vascular network biomaterials for bone regeneration.
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11
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Huang R, Hao Y, Pan Y, Pan C, Tang X, Huang L, Du C, Yue R, Cui D. Using a two-step method of surface mechanical attrition treatment and calcium ion implantation to promote the osteogenic activity of mesenchymal stem cells as well as biomineralization on a β-titanium surface. RSC Adv 2022; 12:20037-20053. [PMID: 35919615 PMCID: PMC9277716 DOI: 10.1039/d2ra00032f] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/27/2022] [Indexed: 11/21/2022] Open
Abstract
Combination of the SMAT technique and Ca-ion implantation produced a β-titanium alloy with a bioactive surface layer, which was proved to effectively promote the osteogenic activity of MSCs and Ca–P mineral deposition in vitro.
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Affiliation(s)
- Run Huang
- School of Materials Science and Engineering, Anhui University of Science and Technology, Huainan 232001, China
- Institute of Environment-friendly Materials and Occupational Health of Anhui University of Science and Technology (Wuhu), Wuhu 241003, China
- Anhui International Joint Research Center for Nano Carbon-based Materials and Environmental Health, Anhui University of Science and Technology, Huainan 232001, China
| | - Yufei Hao
- School of Materials Science and Engineering, Anhui University of Science and Technology, Huainan 232001, China
| | - Yusong Pan
- School of Materials Science and Engineering, Anhui University of Science and Technology, Huainan 232001, China
| | - Chengling Pan
- School of Materials Science and Engineering, Anhui University of Science and Technology, Huainan 232001, China
- Institute of Environment-friendly Materials and Occupational Health of Anhui University of Science and Technology (Wuhu), Wuhu 241003, China
| | - Xiaolong Tang
- Institute of Environment-friendly Materials and Occupational Health of Anhui University of Science and Technology (Wuhu), Wuhu 241003, China
- Medical School, Anhui University of Science and Technology, Huainan 232001, China
| | - Lei Huang
- Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Wuhan 430060, China
| | - Chao Du
- School of Materials Science and Engineering, Anhui University of Science and Technology, Huainan 232001, China
| | - Rui Yue
- School of Materials Science and Engineering, Anhui University of Science and Technology, Huainan 232001, China
| | - Diansheng Cui
- Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Wuhan 430060, China
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12
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Large-Pore Platelet-Rich Fibrin with a Mg Ring to Allow MC3T3-E1 Preosteoblast Migration and to Improve Osteogenic Ability for Bone Defect Repair. Int J Mol Sci 2021; 22:ijms22084022. [PMID: 33919677 PMCID: PMC8070656 DOI: 10.3390/ijms22084022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022] Open
Abstract
Platelet-rich fibrin (PRF) is a natural fibrin meshwork material with multiple functions that are suitable for tissue engineering applications. PRF provides a suitable scaffold for critical-size bone defect treatment due to its platelet cytokines and rich growth factors. However, the structure of PRF not only promotes cell attachment but also, due to its density, provides a pool for cell migration into the PRF to facilitate regeneration. In our study, we used repeated freeze drying to enlarge the pores of PRF to engineer large-pore PRF (LPPRF), a type of PRF that has expanded pores for cell migration. Moreover, a biodegradable Mg ring was used to provide stability to bone defects and the release of Mg ions during degradation may enhance osteoconduction and osteoinduction. Our results revealed that cell migration was more extensive when LPPRF was used rather than when PRF was used and that LPPRF retained the growth factors present in PRF. Moreover, the Mg ions released from the Mg ring during degradation significantly enhanced the calcium deposition of MC3T3-E1 preosteoblasts. In the present study, a bone substitute comprising LPPRF combined with a Mg ring was demonstrated to have much potential for critical-size bone defect repair.
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13
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Camani PH, Souza AG, Barbosa RFS, Zanini NC, Mulinari DR, Rosa DS. Comprehensive insight into surfactant modified-PBAT physico-chemical and biodegradability properties. CHEMOSPHERE 2021; 269:128708. [PMID: 33168282 DOI: 10.1016/j.chemosphere.2020.128708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/30/2020] [Accepted: 10/19/2020] [Indexed: 06/11/2023]
Abstract
This work aimed to prepare surfactant modified-PBAT (poly(butylene adipate-co-terephthalate)) sheets with superior properties to increase the PBAT applicability and be a possible solution for plastic disposal environmental problems. Three different surfactant contents (0, 1, 5, and 10 wt%) were investigated, and their effects on PBAT chemical structure, mechanical and morphological properties, wettability, and water absorption were investigated. Modified-PBAT samples showed high hydrogen bond coefficients (0.57) than the pristine PBAT (0.54), indicating an excellent electrostatic interaction between both components and the formation of a rigid hydrogen-bonded network, as confirmed by mechanical tests, where the elastic modulus values for PBAT and PBAT+10% surfactant were 44 and 60 MPa. SEM images and roughness measurements showed changes in PBAT morphology after surfactant addition, improving the roughness and wettability by the voids and polar groups presence, altering the water absorption (WA) behavior. The higher water affinity resulted in high water absorption for PBAT-10%S (17%) compared to the pristine PBAT (2%), which improves hydrolysis tendency, which is the initial step to biodegradation. Biodegradation results indicated that the roughness and WA behavior influenced the biodegradation rate, facilitating hydrolysis and microbial attack, and accelerating modified samples weight loss. Our results suggested developing a material with superior mechanical properties, mainly for PBAT-10%S, that can be applied in several applications, such as packaging and furniture. After discharge, it is not an environmental problem, being a biodegradable material with a green character.
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Affiliation(s)
- Paulo H Camani
- Center for Engineering, Modeling, and Applied Social Sciences (CECS), Federal University of ABC (UFABC), Santo André, Brazil
| | - Alana G Souza
- Center for Engineering, Modeling, and Applied Social Sciences (CECS), Federal University of ABC (UFABC), Santo André, Brazil
| | - Rennan F S Barbosa
- Center for Engineering, Modeling, and Applied Social Sciences (CECS), Federal University of ABC (UFABC), Santo André, Brazil
| | - Noelle C Zanini
- Department of Mechanic and Energy, State University of Rio de Janeiro (UERJ), Resende, CEP 27537-000, Brazil
| | - Daniella R Mulinari
- Department of Mechanic and Energy, State University of Rio de Janeiro (UERJ), Resende, CEP 27537-000, Brazil
| | - Derval S Rosa
- Center for Engineering, Modeling, and Applied Social Sciences (CECS), Federal University of ABC (UFABC), Santo André, Brazil.
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14
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Liu W, Li X, Jiao Y, Wu C, Guo S, Xiao X, Wei X, Wu J, Gao P, Wang N, Lu Y, Tang Z, Zhao Q, Zhang J, Tang Y, Shi L, Guo Z. Biological Effects of a Three-Dimensionally Printed Ti6Al4V Scaffold Coated with Piezoelectric BaTiO 3 Nanoparticles on Bone Formation. ACS APPLIED MATERIALS & INTERFACES 2020; 12:51885-51903. [PMID: 33166458 DOI: 10.1021/acsami.0c10957] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Bone defect repair at load-bearing sites is a challenging clinical problem for orthopedists. Defect reconstruction with implants is the most common treatment; however, it requires the implant to have good mechanical properties and the capacity to promote bone formation. In recent years, the piezoelectric effect, in which electrical activity can be generated due to mechanical deformation, of native bone, which promotes bone formation, has been increasingly valued. Therefore, implants with piezoelectric effects have also attracted great attention from orthopedists. In this study, we developed a bioactive composite scaffold consisting of BaTiO3, a piezoelectric ceramic material, coated on porous Ti6Al4V. This composite scaffold showed not only appropriate mechanical properties, sufficient bone and blood vessel ingrowth space, and a suitable material surface topography but also a reconstructed electromagnetic microenvironment. The osteoconductive and osteoinductive properties of the scaffold were reflected by the proliferation, migration, and osteogenic differentiation of mesenchymal stem cells. The ability of the scaffold to support vascularization was reflected by the proliferation and migration of human umbilical vein endothelial cells and their secretion of VEGF and PDGF-BB. A well-established sheep spinal fusion model was used to evaluate bony fusion in vivo. Sheep underwent implantation with different scaffolds, and X-ray, micro-computed tomography, van Gieson staining, and elemental energy-dispersive spectroscopy were used to analyze bone formation. Isolated cervical angiography and visualization analysis were used to assess angiogenesis at 4 and 8 months after transplantation. The results of cellular and animal studies showed that the piezoelectric effect could significantly reinforce osteogenesis and angiogenesis. Furthermore, we also discuss the molecular mechanism by which the piezoelectric effect promotes osteogenic differentiation and vascularization. In summary, Ti6Al4V scaffold coated with BaTiO3 is a promising composite biomaterial for repairing bone defects, especially at load-bearing sites, that may have great clinical translation potential.
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Affiliation(s)
- Wenwen Liu
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Xiaokang Li
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Yilai Jiao
- Shenyang National Laboratory for Materials Science, Institute of Metal Research Chinese Academy of Sciences, Shenyang 110016, China
| | - Cong Wu
- Department of Materials Science and Engineering, Xi'an University of Technology, Xi'an 710048, China
| | - Shuo Guo
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Xin Xiao
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Xinghui Wei
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Jie Wu
- Department of Orthopaedics, the 8th Medical Center of Chinese PLA General Hospital, Beijing, 100091, China
| | - Peng Gao
- Department of Joint Surgery and Sports Medicine, Hunan Provincial People's Hospital and The First Affiliated Hospital of Hunan Normal University, Changsha, 410016, China
| | - Ning Wang
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Yajie Lu
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Zhen Tang
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Quanming Zhao
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Jinsong Zhang
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Yufei Tang
- Department of Materials Science and Engineering, Xi'an University of Technology, Xi'an 710048, China
| | - Lei Shi
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Zheng Guo
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
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