Biomimetic Therapeutics for Bone Regeneration: A Perspective on Antiaging Strategies

Advances in modern medicine and the significant reduction in infant mortality have steadily increased the population's lifespan. As more and more people in the world grow older, incidence of chronic, noncommunicable disease is anticipated to drastically increase. Recent studies have shown that improving the health of the aging population is anticipated to provide the most cost-effective and impactful improvement in quality of life during aging-driven disease. In bone, aging is tightly linked to increased risk of fracture, and markedly decreased regenerative potential, deeming it critical to develop therapeutics to improve aging-driven bone regeneration. Biomimetics offer a cost-effective method in regenerative therapeutics for bone, where there are numerous innovations improving outcomes in young models, but adapting biomimetics to aged models is still a challenge. Chronic inflammation, accumulation of reactive oxygen species, and cellular senescence are among three of the more unique challenges facing aging-induced defect repair. This review dissects many of the innovative biomimetic approaches research groups have taken to tackle these challenges, and discusses the further uncertainties that need to be addressed to push the field further. Through these research innovations, it can be noted that biomimetic therapeutics hold great potential for the future of aging-complicated defect repair.

Locally Delivered Metabolite Derivative Promotes Bone Regeneration in Aged Mice

Repair of large bone defects is still a major challenge, especially for the aged population. One alternative to address this issue is using the biomaterial-mediated bone morphogenetic protein 2 (BMP2) delivery technique, although high-dose BMP2 can cause serious concerns. α-Ketoglutarate (AKG) is a key intermediate in the tricarboxylic acid cycle and emerging as an intriguing antiaging molecule to extend the life/health span in different organisms. While one recent study indicates that the dietary AKG could significantly reduce bone loss and improve bone anabolism in aged mice, the therapeutic potential of AKG for bone regeneration has not been studied so far. Moreover, the poor cell permeability, large dose requirement, and long-term systemic administration of AKG hinder its applications in clinics and cellular mechanism studies. Dimethyl α-ketoglutarate (DMAKG) is a cell-permeable derivative of AKG with promising potential, although its role in osteogenesis is still elusive. Therefore, we aim to study the potential roles of DMAKG for bone regeneration using both in vitro cell culture and in vivo aged mouse models. Compared to AKG, our data indicated that DMAKG could more effectively improve osteoblastic differentiation. In addition, DMAKG significantly reduced adipogenic differentiation and improved osteogenic differentiation of a mouse multipotential mesenchymal stem cell line. Importantly, our result indicated that DMAKG significantly promoted BMP2-induced osteoblastic differentiation and mineralization in vitro. Moreover, DMAKG could not only significantly mitigate lipopolysaccharide (LPS)-stimulated inflammation in macrophages but also largely rescue LPS-inhibited osteoblastic differentiation. Consistently, our in vivo study demonstrated that gelatin scaffold-mediated local release of DMAKG significantly promoted BMP2-induced bone regeneration in aged mice, which is compromised by chronic inflammation and high adipogenesis. Overall, we, for the first time, report that locally delivered metabolite derivative, DMAKG, could improve BMP2-induced bone regeneration in aged mice. Our study suggests DMAKG has a promising therapeutic potential for bone regeneration through modulating local inflammation and stem cell differentiation.

An Elastic Mineralized 3D Electrospun PCL Nanofibrous Scaffold for Drug Release and Bone Tissue Engineering

Complex shaped and critical-sized bone defects have been a clinical challenge for many years. Scaffold-based strategies such as hydrogels provide localized drug release while filling complex defect shapes, but ultimately possess weaknesses in low mechanical strength alongside a lack of macroporous and collagen-mimicking nanofibrous structures. Thus, there is a demand for mechanically strong, extracellular matrix (ECM) mimicking scaffolds that can robustly fit complex shaped critical sized defects and simultaneously provide localized, sustained, multiple growth factor release. We therefore developed a composite, bi-phasic PCL/hydroxyapatite (HA) 3D nanofibrous (NF) scaffold for bone tissue regeneration by using our innovative electrospun-based thermally induced self-agglomeration (TISA) technique. One intriguing feature of our ECM-mimicking TISA scaffolds is that they are highly elastic and porous even after evenly coated with minerals and can easily be pressed to fit different defect shapes. Furthermore, the bio-mimetic mineral deposition technique allowed us to simultaneously encapsulate different type of drugs, e.g., proteins and small molecules, on TISA scaffolds under physiologically mild conditions. Compared to scaffolds with physically surface-adsorbed phenamil, a BMP2 signaling agonist, incorporated phenamil composite scaffolds indicated less burst release and longer lasting sustained release of phenamil with subsequently improved osteogenic differentiation of cells in vitro. Overall, our study indicated that the innovative press-fit 3D NF composite scaffold may be a robust tool for multiple-drug delivery and bone tissue engineering.