Biodegradation and Biocompatibility of Poly L-lactic Acid Implantable Mesh

Accelerated degradation testing impacts the degradation processes in 3D printed amorphous PLLA

Additive manufacturing and electrospinning are widely used to create degradable biomedical components. This work presents important new data showing that the temperature used in accelerated tests has a significant impact on the degradation process in amorphous 3D printed poly-l-lactic acid (PLLA) fibres. Samples (c. 100 μ m diameter) were degraded in a fluid environment at37 ° C,50 ° C and80   ° C over a period of 6 months. Our findings suggest that across all three fluid temperatures, the fibres underwent bulk homogeneous degradation. A three-stage degradation process was identified by measuring changes in fluid pH, PLLA fibre mass, molecular weight and polydispersity index. At37   ° C, the fibres remained amorphous but, at elevated temperatures, the PLLA crystallised. A short-term hydration study revealed a reduction in glass transition (Tg), allowing the fibres to crystallise, even at temperatures below the dry Tg. The findings suggest that degradation testing of amorphous PLLA fibres at elevated temperatures changes the degradation pathway which, in turn, affects the sample crystallinity and microstructure. The implication is that, although higher temperatures might be suitable for testing bulk material, predictive testing of the degradation of amorphous PLLA fibres (such as those produced via 3D printing or electrospinning) should be conducted at37   ° C.

Advanced Immunomodulatory Biomaterials for Therapeutic Applications

The multifaceted biological defense system modulating complex immune responses against pathogens and foreign materials plays a critical role in tissue homeostasis and disease progression. Recently developed biomaterials that can specifically regulate immune responses, nanoparticles, graphene, and functional hydrogels have contributed to the advancement of tissue engineering as well as disease treatment. The interaction between innate and adaptive immunity, collectively determining immune responses, can be regulated by mechanobiological recognition and adaptation of immune cells to the extracellular microenvironment. Therefore, applying immunomodulation to tissue regeneration and cancer therapy involves manipulating the properties of biomaterials by tailoring their composition in the context of the immune system. This review provides a comprehensive overview of how the physicochemical attributes of biomaterials determine immune responses, focusing on the physical properties that influence innate and adaptive immunity. This review also underscores the critical aspect of biomaterial-based immune engineering for the development of novel therapeutics and emphasizes the importance of understanding the biomaterials-mediated immunological mechanisms and their role in modulating the immune system.

Fibroblast matrix implants-a better alternative for incisional hernia repair?

The standard surgical procedure for abdominal hernia repair with conventional prosthetic mesh still results in a high recurrence rate. In the present study, we propose a fibroblast matrix implant (FMI), which is a three-dimensional (3D) poly-L-lactic acid scaffold coated with collagen (matrix) and seeded with fibroblasts, as an alternative mesh for hernia repair. The matrix was seeded with fibroblasts (cellularized) and treated with a conditioned medium (CM) of human Umbilical Cord Mesenchymal Stem Cells (hUC-MSC). Fibroblast proliferation and function were assessed and compared between treated with CM hUC-MSC and untreated group, 24 h after seeding onto the matrix (n= 3). To study the matricesin vivo,the hernia was surgically created on male Sprague Dawley rats and repaired with four different grafts (n= 3), including a commercial mesh (mesh group), a matrix without cells (cell-free group), a matrix seeded with fibroblasts (FMI group), and a matrix seeded with fibroblasts and cultured in medium treated with 1% CM hUC-MSC (FMI-CM group).In vitroexamination showed that the fibroblasts' proliferation on the matrices (treated group) did not differ significantly compared to the untreated group. CM hUC-MSC was able to promote the collagen synthesis of the fibroblasts, resulting in a higher collagen concentration compared to the untreated group. Furthermore, thein vivostudy showed that the matrices allowed fibroblast growth and supported cell functionality for at least 1 month after implantation. The highest number of fibroblasts was observed in the FMI group at the 14 d endpoint, but at the 28 d endpoint, the FMI-CM group had the highest. Collagen deposition area and neovascularization at the implantation site were observed in all groups without any significant difference between the groups. FMI combined with CM hUC-MSC may serve as a better option for hernia repair, providing additional reinforcement which in turn should reduce hernia recurrence.

Effect of Poly-L-Lactic Acid Mesh Augmentation on Cyclic Gap Formation in Transosseous Patellar Tendon Repair: A Biomechanical Study

No previous study has investigated poly-L-lactic acid (PLLA) surgical mesh augmentation in the repair of inferior pole patellar tendon rupture. We compared the biomechanical properties of transosseous patellar tendon repair with PLLA surgical mesh augmentation to transosseous repair without augmentation. Ten matched pairs of cadaveric knees were used. Specimens in each pair were randomized to undergo the transosseous technique alone or the transosseous technique augmented with a PLLA surgical mesh. An inferior pole patellar tendon rupture was simulated and the repair procedure was performed. Specimens were cyclically loaded for 500 cycles. Gap formation was measured using two sensors placed medial and lateral to the repair site. After cyclic loading, load to failure was determined by pulling the tendon at a constant rate until a sudden decrease in load occurred. The primary outcome measure was cyclic gap formation at the medial and lateral sensors. Compared with controls, specimens that underwent PLLA mesh-augmented repair had significantly lower medial gap formation at all testing intervals up to 500 cycles (p < 0.05) and significantly lower lateral gap formation at all testing intervals from 10 to 500 cycles (p < 0.05). Transosseous patellar tendon repair augmented with a PLLA woven mesh device provided significantly greater resistance to gap formation compared with transosseous repair alone. These results suggest that PLLA mesh augmentation of the transosseous technique is biomechanically effective for patellar tendon repair.

Degradation of Poly(ε-caprolactone) Resorbable Multifilament Yarn under Physiological Conditions

Poly(ε-caprolactone) (PCL) is a hydrophobic, resorbable aliphatic polymer recognized for its low tenacity and extensive elongation at break, making it a popular choice for fabricating biodegradable tissue engineering scaffolds. PCL's slow degradation rate typically results in a complete resorption period of 2 to 3 years. While numerous studies have examined the degradation of PCL in various forms such as films and webs, no study to date has investigated its physiological degradation in multifilament yarn form. In this study, we subjected PCL multifilament yarn samples to physiological conditions in phosphate-buffered saline (PBS) maintained at a consistent temperature of 37 ± 2 °C and agitated at 45 rpm for a period of 32 weeks. We retrieved samples at five different intervals to analyze the degradation profile of the multifilament yarn. This allowed us to estimate the complete resorption time and rate under these in vitro conditions. Over the 32-week period, the multifilament yarn's mass decreased by 4.8%, its elongation at break declined by 42%, the tenacity dropped by 40%, and the peak load at break fell by 46.5%. Based on these findings, we predict that a scaffold structure incorporating PCL multifilament yarn would undergo complete resorption in approximately 14 months under physiological conditions, such as in PBS solution at a pH of approximately 7 and a temperature of 37 °C.

Polymeric biomaterials for wound healing

Skin indicates a person's state of health and is so important that it influences a person's emotional and psychological behavior. In this context, the effective treatment of wounds is a major concern, since several conventional wound healing materials have not been able to provide adequate healing, often leading to scar formation. Hence, the development of innovative biomaterials for wound healing is essential. Natural and synthetic polymers are used extensively for wound dressings and scaffold production. Both natural and synthetic polymers have beneficial properties and limitations, so they are often used in combination to overcome overcome their individual limitations. The use of different polymers in the production of biomaterials has proven to be a promising alternative for the treatment of wounds, as their capacity to accelerate the healing process has been demonstrated in many studies. Thus, this work focuses on describing several currently commercially available solutions used for the management of skin wounds, such as polymeric biomaterials for skin substitutes. New directions, strategies, and innovative technologies for the design of polymeric biomaterials are also addressed, providing solutions for deep burns, personalized care and faster healing.

Stereocomplexed microparticles loaded with Salvia cadmica Boiss. extracts for enhancement of immune response towards Helicobacter pylori

Controlled delivery of therapeutic substance gives numerous advantages (prevents degradation, improves uptake, sustains concentration, lowers side effects). To encapsulate Salvia cadmica extracts (root or aerial part), enriched with polyphenols with immunomodulatory activity, in stereocomplexed microparticles (sc-PLA), for using them to enhance the immune response towards gastric pathogen Helicobacter pylori. Microparticles were made of biodegradable poly(lactic acid) (PLA) and poly(D-lactic acid) (PDLA). Their stereocomplexation was used to form microspheres and enhance the stability of the obtained particles in acidic/basic pH. The release of Salvia cadmica extracts was done in different pH (5.5, 7.4 and 8.0). The obtained polymers are safe in vitro and in vivo (guinea pig model). The sc-PLA microparticles release of S. cadmica extracts in pH 5.5, 7.4, and 8.0. S. cadmica extracts enhanced the phagocytic activity of guinea pig bone marrow-derived macrophages, which was diminished by H. pylori, and neutralized H. pylori driven enhanced production of tumor necrosis factor (TNF)-α and interleukin (IL)-10. The sc-PLA encapsulated S. cadmica extracts can be recommended for further in vivo study in guinea pigs infected with H. pylori to confirm their ability to improve an immune response towards this pathogen.

Poly (l-lactic acid)-based modified nanofibrous membrane with dual drug release capability for GBR application

Electrospun multilayer nanofibers guided bone regeneration (GBR) with a new design were developed in this study. The synthesized multilayer GBR was composed of two distinct layers. Poly l-lactic acid (PLA) incorporated with simvastatin (SIM) was designed as PLA/SIM layer to contact with a bone defect. In addition, the hydrophilic gelatin (GT) containing thymol (THY) was fabricated as GT/THY layer to contact connective tissue, potentially for bacterial gathering. Due to the different chemical nature and weak cohesion of the hydrophilic and hydrophobic layers, hybrid fibers made of PLA/SIM and GT/THY were electrospun as cohesion promoters between these layers. The microstructure and characteristics of the synthesized multilayer substrate, named GT/PLA, were evaluated, and different fibrous monolayers were fabricated to determine the optimal concentrations of drugs. Scanning electron microscopy (SEM) images showed continuous, smooth, randomly aligned, and bead-free fibers. In addition, there were no drug particles on the fiber surfaces which displayed the good placement of those inside the fibers. The mats exhibited satisfactory tensile strength (4.60 ± 0.14 MPa) and favorable physicochemical properties, including proper porosity percentage (<50 %) and appropriate pore size. Suitable swelling behavior (293 ± 0.05 %) and adequate degradation rates were also approved by characterizing swelling and degradability in vitro. The GT/PLA membrane exhibited a prolonged and sustained SIM release and controlled THY release with high antibacterial efficiency. Cell viability, cell attachment assay, and nuclear staining using 4',6-diamidino-2-phenylindole (DAPI) showed that the designed GT/PLA substrate had good biocompatibility and cell attachment. Cell infiltration testing also showed that the cells were finely prevented by the outer layer (GT/THY). Overall, the obtained results in this study indicated the great potential of the prepared GT/PLA for use as a GBR which can develop osteogenic and antibacterial biomimetic periosteum optimizing the clinical application of GBR strategies.

Characterization of 3D printed biodegradable piezoelectric scaffolds for bone regeneration

OBJECTIVE

The primary objective of this research was to develop a poly(l-lactic acid) (PLLA) scaffold and evaluate critical characteristics essential for its biologic use as a craniofacial implant.

MATERIALS AND METHODS

PLLA scaffolds were designed and fabricated using fused deposition modeling technology. The surface morphology and microarchitecture were analyzed using scanning electron microscopy (SEM) and microCT, respectively. Crystallography, compressive modulus, and the piezoelectric potential generated upon mechanical distortion were characterized. Hydrolytic degradation was studied. MG63 osteoblast-like cell proliferation and morphology were assessed.

RESULTS

The porosity of the scaffolds was 73%, with an average pore size of 450 µm and an average scaffold fiber thickness of 130 µm. The average compressive modulus was 244 MPa, and the scaffolds generated an electric potential of 25 mV upon cyclic/repeated loading. The crystallinity reduced from 27.5% to 13.9% during the 3D printing process. The hydrolytic degradation was minimal during a 12-week period. Osteoblast-like cells did not attach to the uncoated scaffold but attached well after coating the scaffold with fibrinogen. They then proliferated to cover the complete scaffold by Day 14.

CONCLUSION

The PLLA scaffolds were designed and printed, proving the feasibility of 3D printing as a method of fabricating PLLA scaffolds. The elastic modulus was comparable to that of trabecular bone, and the piezoelectric properties of the PLLA were retained after 3D printing. The scaffolds were cytocompatible. These 3D-printed PLLA scaffolds showed promising properties akin to the natural bone, and they warrant further investigation for bone regeneration.

Electrospun fiber-mediated delivery of neurotrophin-3 mRNA for neural tissue engineering applications

Aligned electrospun fibers provide topographical cues and local therapeutic delivery to facilitate robust peripheral nerve regeneration. mRNA delivery enables transient expression of desired proteins that promote axonal regeneration. However, no prior work delivers mRNA from electrospun fibers for peripheral nerve regeneration applications. Here, we developed the first aligned electrospun fibers to deliver pseudouridine-modified (Ψ) neurotrophin-3 (NT-3) mRNA (ΨNT-3mRNA) to primary Schwann cells and assessed NT-3 secretion and bioactivity. We first electrospun aligned poly(L-lactic acid) (PLLA) fibers and coated them with the anionic substrates dextran sulfate sodium salt (DSS) or poly(3,4-dihydroxy-L-phenylalanine) (pDOPA). Cationic lipoplexes containing ΨNT-3mRNA complexed to JetMESSENGER® were then immobilized to the fibers, resulting in detectable ΨNT-3mRNA release for 28 days from all fiber groups investigated (PLLA+mRNA, 0.5DSS4h+mRNA, and 2pDOPA4h+mRNA). The 2pDOPA4h+mRNA group significantly increased Schwann cell secretion of NT-3 for 21 days compared to control PLLA fibers (p < 0.001-0.05) and, on average, increased Schwann cell secretion of NT-3 by ≥ 2-fold compared to bolus mRNA delivery from the 1µgBolus+mRNA and 3µgBolus+mRNA groups. The 2pDOPA4h+mRNA fibers supported Schwann cell secretion of NT-3 at levels that significantly increased dorsal root ganglia (DRG) neurite extension by 44% (p < 0.0001) and neurite area by 64% (p < 0.001) compared to control PLLA fibers. The data show that the 2pDOPA4h+mRNA fibers enhance the ability of Schwann cells to promote neurite growth from DRG, demonstrating this platform's potential capability to improve peripheral nerve regeneration. STATEMENT OF SIGNIFICANCE: Aligned electrospun fibers enhance axonal regeneration by providing structural support and guidance cues, but further therapeutic stimulation is necessary to improve functional outcomes. mRNA delivery enables the transient expression of therapeutic proteins, yet achieving local, sustained delivery remains challenging. Previous work shows that genetic material delivery from electrospun fibers improves regeneration; however, mRNA delivery has not been explored. Here, we examine mRNA delivery from aligned electrospun fibers to enhance neurite outgrowth. We show that immobilization of NT-3mRNA/JetMESSENGER® lipoplexes to aligned electrospun fibers functionalized with pDOPA enables local, sustained NT-3mRNA delivery to Schwann cells, increasing Schwann cell secretion of NT-3 and enhancing DRG neurite outgrowth. This study displays the potential benefits of electrospun fiber-mediated mRNA delivery platforms for neural tissue engineering.

Conductive and Semiconductive Nanocomposite-Based Hydrogels for Cardiac Tissue Engineering

Cardiovascular disease is the leading cause of death worldwide and the most common cause is myocardial infarction. Therefore, appropriate approaches should be used to repair damaged heart tissue. Recently, cardiac tissue engineering approaches have been extensively studied. Since the creation of the nature of cardiovascular tissue engineering, many advances have been made in cellular and scaffolding technologies. Due to the hydrated and porous structures of the hydrogel, they are used as a support matrix to deliver cells to the infarct tissue. In heart tissue regeneration, bioactive and biodegradable hydrogels are required by simulating native tissue microenvironments to support myocardial wall stress in addition to preserving cells. Recently, the use of nanostructured hydrogels has increased the use of nanocomposite hydrogels and has revolutionized the field of cardiac tissue engineering. Therefore, to overcome the limitation of the use of hydrogels due to their mechanical fragility, various nanoparticles of polymers, metal, and carbon are used in tissue engineering and create a new opportunity to provide hydrogels with excellent properties. Here, the types of synthetic and natural polymer hydrogels, nanocarbon-based hydrogels, and other nanoparticle-based materials used for cardiac tissue engineering with emphasis on conductive nanostructured hydrogels are briefly introduced.

A micro-channel array in a tissue engineered vessel graft guides vascular morphogenesis for anastomosis with self-assembled vascular networks

Vascularization of 3D engineered tissues poses a great challenge in the field of tissue engineering. One promising approach for vascularizing engineered tissue is cocultivation with endothelial cells (ECs), which spontaneously self-assemble into a natural capillary network in the presence of supportive cells. However, the ECs do not self-assemble according to physiological hierarchy which is required to support blood supply. This work describes the design and fabrication of an AngioTube, a biodegradable engineered macro-vessel surrounded by cylindrical micro-channel array, which is designed to support physiological flow distribution and enable the integration with living capillaries. The well-defined geometry of the engineered micro-channels guides endothelial cells to form patent micro-vessels which sprouted in accordance with the channel orientation. Three different in-vitro models were used to demonstrate anastomosis of these engineered micro-vessels with self-assembled vascular networks. Finally, in-vivo functionality was demonstrated by direct anastomosis with the femoral artery in a rat hindlimb model. This unique approach proposes a new micro-fabrication strategy which introduces uncompromised micro-fluidic device geometrical accuracy at the tissue-scale level. STATEMENT OF SIGNIFICANCE: This study proposes a micro-fabrication strategy suitable for processing real-scale cylindrical implants with very high accuracy, which will enable translation of the high-resolution geometry of micro-fluidic devices to clinically relevant implants containing functional multi-scale vascular networks. Moreover, this approach promises to advance the field of tissue engineering by opening new opportunities to explore the impact of well controlled and uncompromised 3D micro-geometry on cellular behavior.

Immature Testicular Tissue Engineered from Weaned Mice to Adults for Prepubertal Fertility Preservation—An In Vivo Translational Study

Male pediatric survivors of cancers and bone marrow transplantation often require adjuvant chemoradiation therapy that may be gonadotoxic. The optimal methods to preserve fertility in these prepubertal males are still under investigation. This manuscript presents an in vivo experiment which involved transplantation of immature testicular tissues (ITT) from transgenic donor, to wild-type recipient mice. Donors and recipients were age-mismatched (from 20-week-old donors to 3-week-old recipients, and vice versa) and the transplantation sites involved the abdomen, skin of the head, back muscle, and scrotum. The application of poly-l-lactic acid (PLLA) scaffold was also evaluated in age-matched donors and recipients (both 3-weeks-old). To quantitively evaluate the process of spermatogenesis after ITT transplantation and scaffold application, bioluminescence imaging (BLI) was employed. Our result showed that ITT from 3-week-old mice had the best potential for spermatogenesis, and the optimal transplantation site was in the scrotum. Spermatogenesis was observed in recipient mice up to 51 days after transplantation, and up to the 85th day if scaffold was used. The peak of spermatogenesis occurred between the 42nd and 55th days in the scaffold group. This animal model may serve as a framework for further studies in prepubertal male fertility preservation.

Transcrystalline growth of PLLA on carbon fiber grafted with nano-SiO2 towards boosting interfacial bonding in bone scaffold

BACKGROUND

The reinforcement effect of fiber-reinforced polymer composites is usually limited because of the poor interfacial interaction between fiber and polymer, though fiber reinforcement is regarded as an effective method to enhance the mechanical properties of polymer.

METHODS

In this study, nano-SiO2 particles grafted by 3-Glycidoxypropyltrimethoxysilane (KH560) were introduced onto the surface of 3-Aminopropyltriethoxysilane (KH550) modified carbon fiber (CF) by a self-assembly strategy to improve the interfacial bonding between CF and biopolymer poly (lactic acid) (PLLA).

RESULTS

The results indicated that PLLA chains preferred to anchor at the surface of nano-SiO2 particles and then formed high order crystalline structures. Subsequently, PLLA spherulites could epitaxially grow on the surface of functionalized CF, forming a transcrystalline structure at the CF/PLLA interface. Meanwhile, the nano-SiO2 particles were fixed in the transcrystalline structure, which induced a stronger mechanical locking effect between CF and PLLA matrix. The results of tensile experiments indicated that the PLLA/CF-SiO2 scaffold with a ratio of CF to SiO2 of 9:3 possessed the optimal strength and modulus of 10.11 MPa and 1.18 GPa, respectively. In addition, in vitro tests including cell adhesion and fluorescence indicated that the scaffold had no toxicity and could provide a suitable microenvironment for the growth and proliferation of cell.

CONCLUSION

In short, the PLLA/CF-SiO2 scaffold with good mechanical properties and cytocompatibility had great potential in the application of bone tissue engineering.

Assessing the combination of magnetic field stimulation, iron oxide nanoparticles, and aligned electrospun fibers for promoting neurite outgrowth from dorsal root ganglia in vitro

Magnetic fiber composites combining superparamagnetic iron oxide nanoparticles (SPIONs) and electrospun fibers have shown promise in tissue engineering fields. Controlled grafting of SPIONs to the fibers post-electrospinning generates biocompatible magnetic composites without altering desired fiber morphology. Here, for the first time, we assess the potential of SPION-grafted scaffolds combined with magnetic fields to promote neurite outgrowth by providing contact guidance from the aligned fibers and mechanical stimulation from the SPIONs in the magnetic field. Neurite outgrowth from primary rat dorsal root ganglia (DRG) was assessed from explants cultured on aligned control and SPION-grafted electrospun fibers as well as on non-grafted fibers with SPIONs dispersed in the culture media. To determine the optimal magnetic field stimulation to promote neurite outgrowth, we generated a static, alternating, and linearly moving magnet and simulated the magnetic flux density at different areas of the scaffold over time. The alternating magnetic field increased neurite length by 40% on control fibers compared to a static magnetic field. Additionally, stimulation with an alternating magnetic field resulted in a 30% increase in neurite length and 62% increase in neurite area on SPION-grafted fibers compared to DRG cultured on PLLA fibers with untethered SPIONs added to the culture media. These findings demonstrate that SPION-grafted fiber composites in combination with magnetic fields are more beneficial for stimulating neurite outgrowth on electrospun fibers than dispersed SPIONs. STATEMENT OF SIGNIFICANCE: Aligned electrospun fibers improve axonal regeneration by acting as a passive guidance cue but do not actively interact with cells, while magnetic nanoparticles can be remotely manipulated to interact with neurons and elicit neurite outgrowth. Here, for the first time, we examine the combination of magnetic fields, magnetic nanoparticles, and aligned electrospun fibers to enhance neurite outgrowth. We show an alternating magnetic field alone increases neurite outgrowth on aligned electrospun fibers. However, combining the alternating field with magnetic nanoparticle-grafted fibers does not affect neurite outgrowth compared to control fibers but improves outgrowth compared to freely dispersed magnetic nanoparticles. This study provides the groundwork for utilizing magnetic electrospun fibers and magnetic fields as a method for promoting axonal growth.

Histopathological and Radiographic Features of Osteolysis After Fixation of Osteochondral Fragments Using Poly-L-Lactic Acid Pins for Osteochondral Lesions of the Talus

BACKGROUND

Fixation of osteochondral fragments is a potential option for treating an osteochondral lesion of the talus (OLT) involving large lesions in the remaining articular cartilage surface. Bioabsorbable devices, especially those made of poly-L-lactic acid (PLLA), can be used for the fixation of an OLT. Postoperative osteolysis surrounding the PLLA pins is occasionally observed; however, the significance of osteolysis remains unknown.

PURPOSE

To elucidate the association between osteolysis surrounding the PLLA pins, histopathological findings in subchondral bone, and preoperative Hounsfield unit (HU) values at the pin fixation site.

STUDY DESIGN

Case Series; Level of evidence, 4.

METHODS

This retrospective analysis included 20 patients with OLT (11 men and 9 women; mean age, 20.9 years; 1 bilateral case). Tissue from the osteochondral fragment was collected intraoperatively using a bone biopsy needle for histological evaluation. The fragment was fixed through the biopsy hole using a PLLA pin. Osteolysis surrounding the PLLA pin was assessed at 1 year postoperatively using magnetic resonance imaging (MRI). Histopathological scores were assigned based on trabecular bone loss, empty lacunae, inflammatory granulation tissue, cartilage-like tissue, and the presence of osteoclasts. The HU values around the pin insertion site, detected on the postoperative MRI scans, were measured using the region of interest based on the preoperative coronal and sagittal computed tomography (CT) images.

RESULTS

Osteolysis was observed postoperatively in 9 ankles (42.9%). Histopathological evaluation revealed that the osteolysis group had a significantly higher pathological score than the nonosteolysis group (10.2 vs 6.3; P < .001). Lower HU values were identified in the osteolysis group on preoperative coronal and sagittal CT images (P < .05). The histopathological score negatively correlated with preoperative HU values (Pearson r = -0.46; P = .037).

CONCLUSION

Intraoperative biopsy of the OLT allowed for histopathological evaluation of the same site as that of the PLLA pin fixation. Our findings suggest that preoperative subchondral trabecular deterioration is associated with the incidence of postoperative osteolysis surrounding the PLLA pin. Additionally, low preoperative HU values in subchondral bone under OLT may serve as a predictor of osteolysis surrounding the PLLA pin.

Co-delivery of inhalable therapies: Controlling active ingredients spatial distribution and temporal release

The management of respiratory diseases relies on the daily administration of multiple active pharmaceutical ingredients (APIs), leading to a lack of patient compliance and impaired quality of life. The frequency and dosage of the APIs result in increased side effects that further worsens the overall patient condition. Here, the manufacture of polymer-polymer core-shell microparticles for the sequential delivery of multiple APIs by inhalation delivery is reported. The microparticles, composed of biodegradable polymers silk fibroin (shell) and poly(L-lactic acid) (core), incorporating ciprofloxacin in the silk layer and ibuprofen (PLLA core) as the antibiotic and anti-inflammatory model APIs, respectively. The polymer-polymer core-shell structure and the spatial distribution of the APIs have been characterized using cutting-edge synchrotron macro ATR-FTIR technique, which was correlated with the respective API sequential release profiles. The APIs microparticles had a suitable size and aerosol properties for inhalation therapies (≤4.94 ± 0.21μm), with low cytotoxicity and immunogenicity in healthy lung epithelial cells. The APIs compartmentalization obtained by the microparticles not only could inhibit potential actives interactions but can provide modulation of the APIs release profiles via an inhalable single administration.

Enhanced mechanical and biological characteristics of PLLA composites through surface grafting of oligolactide on magnesium hydroxide nanoparticles

Poly(l-lactic acid) (PLLA) is a biocompatible and biodegradable polymer that has received much attention as a biomedical material. However, PLLA also produces by-products that acidify the surrounding tissues during in vivo degradation, which induces inflammatory responses. To overcome these problems, magnesium hydroxide nanoparticles (nano-magnesium hydroxide; nMH) were added to the PLLA matrix as a bioactive filler that can suppress inflammatory responses by neutralizing the acidified environment caused by the degradation of PLLA. Despite the advantages of nMH, the strong cohesion of these nanoparticles toward each other makes it difficult to manufacture a polymer matrix containing homogeneous nanoparticles through thermal processing. Here, we prepared two types of surface-modified nMH with oligolactide (ODLLA) utilizing grafting to (GT) and grafting from (GF) strategies to improve the mechanical and biological characteristics of the organic-inorganic hybrid composite. The incorporation of surface-modified nMH not only enhanced mechanical properties, such as Young's modulus, but also improved homogeneity of magnesium hydroxide particles in the PLLA matrix due to the increase in interfacial interaction. Additionally, the PLLA composites with surface-modified nMH exhibited reduced bulk erosion during hydrolytic degradation with lower cytotoxicity and immunogenicity. Hemocompatibility tests on the PLLA composites with nMH showed a higher albumin to fibrinogen ratio (AFR) and a lower influence of platelet activation, when compared with unmodified control samples. Taken all together, the surface-modified nMH could be seen to successfully improve the physical and biological characteristics of polymer composites. We believe this technology has great potential for the development of hybrid nanocomposites for biomedical devices, including cardiovascular implants.

ICG-loaded gold nano-bipyramids with NIR activatable dual PTT-PDT therapeutic potential in melanoma cells

A great amount of effort is directed towards the progress of cancer treatment approaches aspiring to develop non-invasive, targeted and highly efficient therapies. In this context, Photothermal (PTT) and Photodynamic (PDT) Therapies were proven as promising. This work aims to integrate the therapeutic activities of two near-infrared (NIR) photoactive biomaterials - gold nano-bipyramids (AuBPs) and Indocyanine Green (ICG) - into one single targeted hybrid nanosystem able to operate as dual PTT-PDT agent with higher efficiency compared with each one alone. Firstly, different aspect ratio' AuBPs were systematically investigated in water solution for their intrinsic ability to efficiently generate toxic reactive oxygen species, namely oxygen singlet (¹O₂), under NIR laser irradiation, as this effect is less investigated in literature. Interestingly, the photodynamic activity of AuBPs measured by monitoring the photooxidation of 9,10-Anthracenediyl-bis(methylene)dimalonic acid (ABDA) - a well-known ¹O₂ sensor, is important, counting for 30 % decrease in ABDA optical absorbance for the most active AuBPs, well-correlating with the previously determined photothermal conversion efficiency. Furthermore, ICG was successfully grafted onto the Poly-lactic acid (PLA) coating of plasmonic nanoparticles and, consequently, the as-designed fully integrated hybrid nanosystem shows improved PTT-PDT performance in solution. Specifically, by triggering simultaneous PTT-PDT activities, the ¹O₂ amount is doubled, while the heating monitoring shows higher and faster increase in temperature compared to AuBPs alone. Finally, the efficiency of the combined PTT-PDT therapeutic activity was validated in vitro against B16-F10 cell line by covalent conjugation of the nanosystem with Folic Acid, which ensures the cellular recognition by overexpression of folate receptor.

Biocompatibility analysis of PLA based candidate materials for cardiovascular stents in a rat subcutaneous implant model

Modification of Polylactic acid (PLA), a biopolymer, is a strategy still to be fully explored for the next generation of bioresorbable vascular stent (BVS) biomaterials. With this focus, inclusions upto 5% of Polycaprolactone (PCL) and Magnesium in PLA were tested in the rat subcutaneous model and their cellular and tissue interactions characterized, specifically with respect to inflammatory response, angiogenesis and capsularization. The cytokines IL6, TNF Alpha and IL-1Beta were estimated in the peri-implant tissue, all of which showed a non-significant difference between the non-implanted animals and those containing PLA by 8 weeks, speaking to the benign nature of PLA as an implant biomaterial. Both modified materials, had increased macrophage counts and cytokine levels, except IL6 at 8 weeks. Vascularization only at 8 weeks in PLA PCL containing tissue was significantly higher than pure PLA, which may be more carefully controlled along with the material hydrophobicity for possible efforts towards therapeutic angiogenesis. Capsule thickness, measured by staining with both Hematoxylin & Eosin and Masson's Trichome did not show any differences between materials, including PLA.

Preparation of PBS/PLLA/HAP Composites by the Solution Casting Method: Mechanical Properties and Biocompatibility

The use of biodegradable polymeric scaffolds for tissue regeneration is becoming a common practice in the clinic. Therefore, an inclined trend is developing with regards to improving the mechanical properties of these scaffolds. Here, we aim to improve the mechanical properties of poly (butylene succinate) (PBS)/poly (l-lactic acid) (PLLA) blends by incorporating hydroxyapatite nanoparticles (HAP) in the blends to form composites. PBS/PLLA = 100/0, 95/5, 90/10, 85/15, and 0/100 wt% blends, along-with the loadings of a few mg of HAPs, were prepared using the solution casting method. A scanning electron microscope showed the voids and droplets, indicating the immiscibility of blends. Due to this immiscibility, the tensile strength values of the blends were found to be in between that of pure PBS (42.85 MPa) and pure PLLA (31.39 MPa). HAPs act as a compatibilizer by incorporating themselves in the voids and spaces caused by the immiscibility, thus increasing the overall tensile strength of the resulting composite to a certain extent, e.g., the tensile strength of PBS/PLLA = 95/5 loaded with 50 mg HAPs was found to be 51.16 MPa. The structural analysis employing the X-ray diffraction (XRD) patterns confirmed the formation of polymer blends and composites. The contact angle analysis showed that the addition of HAPs increased the hydrophilicity of the resulting composites. Selective samples were investigated based on mechanical properties to see if the blends and composites are biocompatible. The obtained results showed that all of the samples with better mechanical properties demonstrated good biocompatibility. This indicates the effectiveness of scaffolds for tissue regeneration.

Coating Topologically Complex Electrospun Fibers with Nanothin Silk Fibroin Enhances Neurite Outgrowth in Vitro

Electrospun poly-l-lactic acid (PLLA) fibers are commonly used for tissue engineering applications because of their uniform morphology, and their efficacy can be further enhanced via surface modification. In this study, we aimed to increase neurite outgrowth along electrospun fibers by coating with silk fibroin (SF), a bioinert protein derived from Bombyx mori cocoon threads, shown to be neurocompatible. Aligned PLLA fibers were electrospun with smooth, pitted, and divoted surface nanotopographies and coated with SF by immersion in coating solution for either 12 or 24 h. Specifically, thin-film coatings of SF were generated by leveraging the controlled self-assembly of SF in aqueous conditions that promote β-sheet assembly. For both 12- and 24-h coatings, Congo Red staining for β-sheet structures confirmed the presence of SF coatings on PLLA fibers. Confocal imaging of fluorescein-labeled SF further demonstrated a homogeneous coating formation on PLLA fibers. No change in the water contact angle of the surfaces was observed after coating; however, an increase in the isoelectric point (pI) to values comparable with the theoretical pI of SF was seen. Notably, there was a significant trend of increased dorsal root ganglia (DRG) adhesion on scaffolds coated with SF, as well as greater neurite outgrowth on pitted and divoted fibers that had been coated with SF. Ultimately, this work demonstrated that thin-film SF coatings formed by self-assembly uniformly coat electrospun fibers, providing a new strategy to increase the neuroregenerative capacity of electrospun scaffolds. To our knowledge, this is the first instance of biomedical modification of topologically complex substrates using noncovalent methods.

ECM Mimetic Electrospun Porous Poly (L-lactic acid) (PLLA) Scaffolds as Potential Substrates for Cardiac Tissue Engineering

Cardiac tissue engineering (CTE) aims to generate potential scaffolds to mimic extracellular matrix (ECM) for recreating the injured myocardium. Highly porous scaffolds with properties that aid cell adhesion, migration and proliferation are critical in CTE. In this study, electrospun porous poly (l-lactic acid) (PLLA) porous scaffolds were fabricated and modified with different ECM derived proteins such as collagen, gelatin, fibronectin and poly-L-lysine. Subsequently, adult human cardiac fibroblasts (AHCF) were cultured on the protein modified and unmodified fibers to study the cell behavior and guidance. Further, the cytotoxicity and reactive oxygen species (ROS) assessments of the respective fibers were performed to determine their biocompatibility. Excellent cell adhesion and proliferation of the cardiac fibroblasts was observed on the PLLA porous fibers regardless of the surface modifications. The metabolic rate of cells was on par with the conventional cell culture ware while the proliferation rate surpassed the latter by nearly two-folds. Proteome profiling revealed that apart from being an anchorage platform for cells, the surface topography has modulated significant expression of the cellular proteome with many crucial proteins responsible for cardiac fibroblast growth and proliferation.

Early results of comparison of polypropylene mesh and 75% resorbable mesh (monofilament polypropylene and poly-L-lactic acid (PLLA) mesh) for laparoscopic total extraperitoneal (TEP) inguinal hernia repair

OBJECTIVE

Laparoscopic totally extraperitoneal (TEP) hernia repair has become increasingly widespread. Faster recovery than conventional open methods shortens the return to work. Polypropylene (PP) mesh is still in use in hernia surgery because it is an inexpensive and easily accessible patch. The post-operative chronic pain and foreign body sensation are the disadvantages of these PP patches. Poly-L-lactic acid and polypropylene (PLLA) were used in this study because of the good biocompatibility and low tissue inflammation response. We compared the early clinical outcomes of PP patch and PLLA patches.

METHODS

Between January 2013 and April, 2018,469 patients with inguinal hernia underwent TEP procedure. Patients were divided into two groups. PP mesh (n=211) in group 1, PLLA mesh (n=258) in group 2. Patients were compared regarding age, gender, hernia side, ASA scores, the duration of operation, pain, time to return to work, the sensation of foreign body, seroma and hematoma.

RESULTS

A total of 469 patients were analyzed retrospectively (426 male, 43 female). The mean age was 52.23±13.66 years. The operative times of the patients were 40.92±8.9 minutes in group 1, and 38.82±8.5 minutes in group 2 (p<0.05). The time to return to work was 10.2±1.47 days in Group 1 and 8.4±1.0 days in Group 2 (p<0.05). Visual Analog Scale (VAS) in group 2 was lower than in group 1 (p<0.005). In group 2, the feeling of the organic body decreased in the early and late period (p<0.005). Seroma and hematoma were less in Group 2 than in Group 1 (p<0.005). The mean follow-up period of the patients was 18 (3-63) months, two patients in Group 1, two patients in Group 2 recurred.

CONCLUSION

The PLLA patch used in the TEP method is thought to be a herniated patch that can be safely used because of its ease of application and less postoperative complication rates and more rapid return to work.

Electroactive nanofibers mats based on poly(l-lactic acid)/poly(ortho-ethoxyaniline) blends for biological applications

The combination of scaffolds with desirable topographic characteristics and the use of electrical stimulus consist of a strategy to repair and regenerate tissues. An interesting approach to obtain electroactive scaffolds with the aforementioned features comprises on the use of conducting polymers which can be blended with other biocompatible polymers. In this work, poly(l-lactic acid) (PLLA) and poly(ortho-ethoxyaniline) (POEA) were synthesized and PLLA/POEA mats were prepared for the first time by electrospinning technique. Topographic characterization of PLLA/POEA showed a tunable mean diameter of the nanofibers by changing the electrospinning parameters. The presence of POEA into the blend was confirmed by X-ray photoelectron and Fourier-transform infrared spectroscopy analyses. Differential scanning calorimetry curves of PLLA/POEA exhibited shift positions of T_c and absence of the exothermic peak related to the characteristic isomerization process of POEA at high temperatures. The thermal analysis results indicate a favored miscibility between the polymers which is likely resulted from the strong interaction between polymers functionalities. The homogenous distribution of POEA chains throughout the scaffold rendered redox reversibility property for the mats. Biocompatibility results showed non-cytotoxic features for PLLA/POEA, attesting this novel system as a promising candidate for biological applications.

Lactonic Sophorolipid Increases Surface Wettability of Poly-l-lactic Acid Electrospun Fibers

The hydrophobicity of electrospun poly-l-lactic acid (PLLA) fibers hinders their integration with surrounding tissue for a variety of applications. In this study, we increased PLLA fiber hydrophilicity by incorporating the natural surfactant, lactonic sophorolipid (LSL). PLLA+LSL fibers had similar fiber morphology but significantly greater surface wettability, which suggested LSL accumulation on the fiber surface. Differential scanning calorimetry results also suggested that LSL was phase separated from PLLA. Despite the altered surface wettability of these fibers, there was no change in fibroblast adhesion. Future studies may explore the use of this natural surfactant to deliver bioactive factors to enhance fibroblast adhesion.

Poly(D,L-Lactic Acid) Nanoparticle Size Reduction Increases Its Immunotoxicity

Polylactic acid (PLA), a biodegradable and biocompatible polymer produced from renewable resources, has been widely used as a nanoparticulate platform for antigen and drug delivery. Despite generally regarded as safe, its immunotoxicological profile, when used as a polymeric nanoparticle (NP), is not well-documented. Thus, this study intends to address this gap, by evaluating the toxicity of two different sized PLA NPs (PLA_A NPs and PLA_B NPs), produced by two nanoprecipitation methods and extensively characterized regarding their physicochemical properties in in vitro experimental conditions. After production, PLA_A NPs mean diameter (187.9 ± 36.9 nm) was superior to PLA_B NPs (109.1 ± 10.4 nm). Interestingly, when in RPMI medium, both presented similar mean size (around 100 nm) and neutral zeta potential, possibly explaining the similarity between their cytotoxicity profile in PBMCs. On the other hand, in DMEM medium, PLA_A NPs presented smaller mean diameter (75.3 ± 9.8 nm) when compared to PLA_B NPs (161.9 ± 8.2 nm), which may explain its higher toxicity in RAW 264.7. Likewise, PLA_A NPs induced a higher dose-dependent ROS production. Irrespective of size differences, none of the PLA NPs presented an inflammatory potential (NO production) or a hemolytic activity in human blood. The results herein presented suggest the hypothesis, to be tested in the future, that PLA NPs presenting a smaller sized population possess increased cytotoxicity. Furthermore, this study emphasizes the importance of interpreting results based on adequate physicochemical characterization of nanoformulations in biological medium. As observed, small differences in size triggered by the dispersion in cell culture medium can have repercussions on toxicity, and if not correctly evaluated can lead to misinterpretations, and subsequent ambiguous conclusions.

Incorporation of simvastatin in PLLA membranes for guided bone regeneration: effect of thermal treatment on simvastatin release

Electrospun membranes based on biodegradable polymers are promising materials to be used for guided bone regeneration (GBR) therapy. The incorporation of osteostimulatory compounds can improve the biofunctionality of those membranes, making them active players in bone regeneration. Simvastatin has been shown to promote osteogenic differentiation both in vitro and in vivo. However, in most of these systems, the drug was quickly released, not matching the pace of bone regeneration. The aim of this study was to develop poly(l-lactic acid) (PLLA) membranes containing simvastatin (SV) that have a prolonged drug release rate, compatible with GBR applications. To this end, SV was mixed with PLLA and electrospun. The membranes were subjected to a thermal treatment in order to increase the crystallinity of PLLA. Morphological, structural and chemical properties of the electrospun membranes were characterized. The effect of the thermal treatment on the release profile of SV was evaluated by near physiological release experiments at 37 °C. The osteostimulatory potential was determined by in vitro culture of the membranes with rat bone marrow stromal cells (rBMSCs). The results confirmed that the thermal treatment led to an increase in polymer crystallinity and a more sustained release of SV. In vitro assays demonstrate cellular proliferation over time for all the membranes and a significant increase in osteogenic differentiation for the membranes containing SV subjected to thermal treatment.

Thermal treatment resulted in a sustained release of simvastatin and a positive response from rBMSCs.