Mesoporous bioactive glass as a multifunctional system for bone regeneration and controlled drug release

Rod-Shaped Mesoporous Zinc-Containing Bioactive Glass Nanoparticles: Structural, Physico-Chemical, Antioxidant, and Immuno-Regulation Properties

Bioactive glass nanoparticles (BGNs) are applied widely in tissue regeneration. Varied micro/nanostructures and components of BGNs have been designed for different applications. In the present study, nanorod-shaped mesoporous zinc-containing bioactive glass nanoparticles (ZnRBGNs) were designed and developed to form the bioactive content of composite materials for hard/soft tissue repair and regeneration. The nanostructure and components of the ZnRBGNs were characterized, as were their cytocompatibility and radical-scavenging activity in the presence/absence of cells and their ability to modulate macrophage polarization. The ZnRBGNs possessed a uniform rod shape (length ≈ 500 nm; width ≈ 150 nm) with a mesoporous structure (diameter ≈ 2.4 nm). The leaching liquid of the nanorods at a concentration below 0.5 mg/mL resulted in no cytotoxicity. More significant improvements in the antioxidant and M1-polarization-inhibiting effects and the promotion of M2 polarization were found when culturing the cells with the ZnRBGNs compared to when culturing them with the RBGNs. The doping of the Zn element in RBGNs may lead to improved antioxidant and anti-inflammatory effects, which may be beneficial in tissue regeneration/repair.

The Use of Simulated Body Fluid (SBF) for Assessing Materials Bioactivity in the Context of Tissue Engineering: Review and Challenges

Some special implantable materials are defined as “bioactive” if they can bond to living bone, forming a tight and chemically-stable interface. This property, which is inherent to some glass compositions, or can be induced by applying appropriate surface treatments on otherwise bio-inert metals, can be evaluated in vitro by immersion studies in simulated body fluid (SBF), mimicking the composition of human plasma. As a result, apatite coating may form on the material surface, and the presence of this bone-like “biomimetic skin” is considered predictive of bone-bonding ability in vivo. This review article summarizes the story and evolution of in vitro bioactivity testing methods using SBF, highlighting the influence of testing parameters (e.g., formulation and circulation of the solution) and material-related parameters (e.g., composition, geometry, texture). Suggestions for future methodological refinements are also provided at the end of the paper.

Biocompatible Nanobioglass Reinforced Poly(ε-Caprolactone) Composites Synthesized via In Situ Ring Opening Polymerization

Poly(ε-caprolactone) (PCL) is a bioresorbable synthetic polyester widely studied as a biomaterial for tissue engineering and controlled release applications, but its low bioactivity and weak mechanical performance limits its applications. In this work, nanosized bioglasses with two different compositions (SiO₂–CaO and SiO₂–CaO–P₂O₅) were synthesized with a hydrothermal method, and each one was used as filler in the preparation of PCL nanocomposites via the in situ ring opening polymerization of ε-caprolactone. The effect of the addition of 0.5, 1 and 2.5 wt % of the nanofillers on the molecular weight, structural, mechanical and thermal properties of the polymer nanocomposites, as well as on their enzymatic hydrolysis rate, bioactivity and biocompatibility was systematically investigated. All nanocomposites exhibited higher molecular weight values in comparison with neat PCL, and mechanical properties were enhanced for the 0.5 and 1 wt % filler content, which was attributed to extensive interactions between the filler and the matrix, proving the superiority of in situ polymerization over solution mixing and melt compounding. Both bioglasses accelerated the enzymatic degradation of PCL and induced bioactivity, since apatite was formed on the surface of the nanocomposites after soaking in simulated body fluid. Finally, all samples were biocompatible as Wharton jelly-derived mesenchymal stem cells (WJ-MSCs) attached and proliferated on their surfaces.

Potential of Bioactive Glasses for Cardiac and Pulmonary Tissue Engineering

Repair and regeneration of disorders affecting cardiac and pulmonary tissues through tissue-engineering-based approaches is currently of particular interest. On this matter, different families of bioactive glasses (BGs) have recently been given much consideration with respect to treating refractory diseases of these tissues, such as myocardial infarction. The inherent properties of BGs, including their ability to bond to hard and soft tissues, to stimulate angiogenesis, and to elicit antimicrobial effects, along with their excellent biocompatibility, support these newly proposed strategies. Moreover, BGs can also act as a bioactive reinforcing phase to finely tune the mechanical properties of polymer-based constructs used to repair the damaged cardiac and pulmonary tissues. In the present study, we evaluated the potential of different forms of BGs, alone or in combination with other materials (e.g., polymers), in regards to repair and regenerate injured tissues of cardiac and pulmonary systems.

Preparation of Nanofibrous Structure of Mesoporous Bioactive Glass Microbeads for Biomedical Applications

A highly ordered, mesoporous (pore size 2~50 nm) bioactive glass (MBG) structure has a greater surface area and pore volume and excellent bone-forming bioactivity compared with traditional bioactive glasses (BGs). Hence, MBGs have been used in drug delivery and bone tissue engineering. MBGs can be developed as either a dense or porous block. Compared with a block, microbeads provide greater flexibility for filling different-shaped cavities and are suitable for culturing cells in vitro. In contrast, the fibrous structure of a scaffold has been shown to increase cell attachment and differentiation due to its ability to mimic the three-dimensional structure of natural extracellular matrices. Hence, the aim of this study is to fabricate MBG microbeads with a fibrous structure. First, a sol-gel/electrospinning technique was utilized to fabricate the MBG nanofiber (MBGNF) structure. Subsequently, the MBGNF microbeads (MFBs) were produced by an electrospraying technology. The results show that the diameter of the MFBs decreases when the applied voltage increases. The drug loading and release profiles and mechanisms of the MFBs were also evaluated. MFBs had a better drug entrapment efficiency, could reduce the burst release of tetracycline, and sustain the release over 10 days. Hence, the MFBs may be suitable drug carriers. In addition, the cellular attachment of MG63 osteoblast-like cells is significantly higher for MFBs than for glass microbeads after culturing for 4 h. The nanofibrous structure of MFBs could provide an appropriate environment for cellular spreading. Therefore, MFBs have great potential for use as a bone graft material in bone tissue engineering applications.

One-step method for the preparation of poly(methyl methacrylate) modified titanium-bioactive glass three-dimensional scaffolds for bone tissue engineering

A novel three-dimensional (3D) titanium (Ti)-doping meso-macroporous bioactive glasses (BGs)/poly(methyl methacrylate) (PMMA) composite was synthesised using PMMA and EO20PO70EO20 (P123) as the macroporous and mesoporous templates, respectively. Unlike the usual calcination method, the acid steam technique was used to improve the polycondensation of Ti-BGs, and then PMMA was partially extracted via chloroform to induce the macroporous structure. Simultaneously, the residual PMMA which remained in the wall enhanced the compressive strength to 2.4 MPa (0.3 MPa for pure BGs). It is a simple and green method to prepare the macro-mesoporous Ti-BGs/PMMA. The materials showed the 3D interconnected hierarchical structure (250 and 3.4 nm), making the fast inducing-hydroxyapatite growth and the controlled drug release. Besides mentioned above, the good antimicrobial property and biocompatible of the scaffold also ensure it is further of clinical use. Herein, the fabricated materials are expected to have potential application on bone tissue regeneration.

Biodegradable mesoporous calcium-magnesium silicate-polybutylene succinate scaffolds for osseous tissue engineering

The structural features of bone engineering scaffolds are expected to exhibit osteoinductive behavior and promote cell adhesion, proliferation, and differentiation. In the present study, we employed synthesized ordered mesoporous calcium-magnesium silicate (om-CMS) and polybutylene succinate (PBSu) to develop a novel scaffold with potential applications in osseous tissue engineering. The characteristics, in vitro bioactivity of om-CMS/PBSu scaffold, as well as the cellular responses of MC3T3-E1 cells to the composite were investigated. Our results showed that the om-CMS/PBSu scaffold possesses a large surface area and highly ordered channel pores, resulting in improved degradation and biocompatibility compared to the PBSu scaffold. Moreover, the om-CMS/PBSu scaffold exhibited significantly higher bioactivity and induced apatite formation on its surface after immersion in the simulated body fluid. In addition, the om-CMS/PBSu scaffold provided a high surface area for cell attachment and released Ca, Mg, and Si ions to stimulate osteoblast proliferation. The unique surface characteristics and higher biological efficacy of the om-CMS/PBSu scaffold suggest that it has great potential for being developed into a system that can be employed in osseous tissue engineering.

Evaluation of implant sonication as a diagnostic tool in implant-associated infections

Infections of implants pose a severe problem in the field of orthopedic surgery, because they can cause bone degradation with subsequent loosening of the implant. The discrimination between septic implant loosening and aseptic loosening can be a challenge, and hence novel diagnostic methods have been introduced to improve the detection of bacteria. Because a major problem is their firm adherence to implants due to biofilm formation, sonication has been introduced, followed by identification of bacteria by culture or genetic methods. In this study, we compared the results obtained after sonication pretreatment with those of microbiological testing of tissue samples and histopathological evaluation of the same tissue. Furthermore, we related the results obtained following sonication to the clinical diagnosis of septic or aseptic implant loosening, respectively. Sonication of explanted devices also enhances the likelihood of detecting bacterial growth in patients who were considered "aseptic" based on the clinical evaluation.

Risk factors for failure in early prosthetic joint infection treated with debridement. Influence of etiology and antibiotic treatment

PURPOSES

The aim of the present study was to evaluate the importance of isolated microorganisms according to the Gram stain and the type of antibiotic received on the outcome of early prosthetic joint infection (PJI) treated with debridement, antibiotics and implant retention (DAIR).

METHODS

From January 1999 to December 2009, all patients with an early PJI were prospectively registered in a database and they were retrospectively reviewed for this study.

RESULTS

During the study period, 160 patients met the inclusion criteria of the study. After a mean (SD) post-debridement follow-up of 5.2 (2.5) years, 117 patients (73.1%) were considered to be in remission and 43 (26.9%) were classified as failure. Variables associated with failure were liver cirrhosis (66.7% vs. 22.8%, p=0.001), diagnosis within the first 30 days from arthroplasty (30.4% vs. 8.0%, p=0.020), C-reactive protein (CRP) >12 mg/dl (46.7% vs. 21.2%, p=0.005), microorganism isolated in all deep samples (31.1% vs. 16.0%, p=0.047) and Gram-negative (GN) infection not treated with a fluoroquinolone (57.1% vs. 20.0%, P=0.004). Gram-positive (GP) infection not treated with rifampin was close to be statistically significantly associated with failure (34.4% vs. 19.2%, p=0.067). A multivariate analysis identified liver cirrhosis (OR: 12.4 CI95%: 3.1-49.7, p<0.001), CRP-value (OR: 1.06 CI95%: 1.0-1.11, p=0.049), and when a GN-infection was not treated with a fluoroquinolone (OR: 6.5, CI95%: 1.8-23.8, p=0.005) as independent predictors of failure.

CONCLUSION

The remission rate of PJI treated with DAIR after 3 years of follow-up was 73%. The main predictors of failure were liver cirrhosis, the selected antibiotic most specially fluoroquinolones for GN and rifampin for GP infections, the C-reactive protein and the number of samples culture positive as a potential surrogate markers of bacterial density.

Adherence of S. epidermidis on different metals. A comparative in vitro study

AIM

Staphylococcus epidermidis is the most common cause of orthopedic infections. Adhesion and biofilm formation on orthopedic implant surfaces play an important role in the physiopathology of these infections. The aim of our study was to evaluate the adhesion of S. epidermidis on the surface of metals usually used in orthopedics.

METHODS

Previously sterilized circular metal plates of titanium (Ti), porous titanium (p-Ti), cobalt chromium (CoCr) and stainless steel (SS) were hung completely submerged in a liquid medium with a known concentration of S. epidermidis (RP62A). They were incubated for 1 h or 24 h at 36°C. After incubation, each plate was washed with PBS and sonicated during 5 minutes in 10 mL of saline. Different dilutions were performed and 100 µL from each sample was cultured on agar plates.

RESULTS

26 metal plates were incubated for 1 h and other 55 metal plates for 24 h. The lowest bacterial count (cfu/mm2) at 1 h was observed in CoCr plates while in p-Ti it was 6 times higher. At 24 h the highest bacterial count was observed in SS plates while the lowest in Ti. However, these differences were not statistically significant.

CONCLUSIONS

After 1 h and 24 h of exposure, the lowest adherence was observed in CoCr and Ti plates, respectively. However, bacterial attachment occurred with all materials. It is necessary to further investigate new materials able to avoid bacterial attachment.

Spine-Ghost: A New Bioactive Cement for Vertebroplasty

An innovative, resorbable and injectable composite cement (Spine-Ghost) to be used for augmentation and restoration of fractured vertebrae was developed. Type III α-calcium sulfate hemihydrate (CSH) was selected as the bioresorbable matrix, while spray-dried mesoporous bioactive particles (SD-MBP, composition 80/20% mol SiO2/CaO), were added to impart high bioactive properties to the cement; a glass-ceramic containing zirconia was chosen as a second dispersed phase, in order to increase the radiopacity of the material. After mixing with water, an injectable paste was obtained. The developed cement proved to be mechanically compatible with healthy cancellous bone, resorbable and bioactive by soaking in simulated body fluid (SBF), cytocompatible through in-vitro cell cultures and it could be injected in ex-vivo sheep vertebra. Comparisons with a commercial control were carried out.

Hydrogel-based nanocomposites and mesenchymal stem cells: a promising synergistic strategy for neurodegenerative disorders therapy

Hydrogel-based materials are widely employed in the biomedical field. With regard to central nervous system (CNS) neurodegenerative disorders, the design of injectable nanocomposite hydrogels for in situ drug or cell release represents an interesting and minimally invasive solution that might play a key role in the development of successful treatments. In particular, biocompatible and biodegradable hydrogels can be designed as specific injectable tools and loaded with nanoparticles (NPs), to improve and to tailor their viscoelastic properties upon injection and release profile. An intriguing application is hydrogel loading with mesenchymal stem cells (MSCs) that are a very promising therapeutic tool for neurodegenerative or traumatic disorders of the CNS. This multidisciplinary review will focus on the basic concepts to design acellular and cell-loaded materials with specific and tunable rheological and functional properties. The use of hydrogel-based nanocomposites and mesenchymal stem cells as a synergistic strategy for nervous tissue applications will be then discussed.

Preparation and Characterization of Magnetic Mesoporous Bioactive Glass/Carbon Composite Scaffolds

The magnetic Fe-MBG/C composite scaffolds with enhanced mechanical strength and multifunctionality have been successfully prepared. The study showed that the Fe-MBG/C composite scaffolds with the porosity of ca. 80% had interconnected macropores (200–500 µm) and mesopores (3.7–4.4 nm) and significantly enhanced the compressive strength compared to the pure MBG scaffolds. Importantly, the Fe-MBG/C composite scaffolds exhibited good bioactivity and sustained drug release property. At the same time, the Fe-MBG/C composite scaffolds could generate heat to raise the temperature of surrounding environment in an alternating magnetic field due to their superparamagnetic behavior. Therefore, the magnetic Fe-MBG/C composite scaffolds could form a multifunctional platform with bone regeneration, magnetic hyperthermia, and local drug delivery and have more potential for use in the regeneration of the critical-sized bone defects caused by bone tumors.