Spinal fusion of biodegradable poly(propylene fumarate) and poly(propylene fumarate-co-caprolactone) copolymers in rabbits

Background

Autologous bone grafts are currently the standard in orthopedic surgery despite limited donor sources and the prevalence of donor site morbidity. Other alternatives such as allografts are more readily available than autografts but have lower rates of graft incorporation.

Methods

Here, we propose a novel graft alternative consisting of an injectable poly(propylene fumarate) (PPF) and poly(propylene fumarate-co-caprolactone) P(PF-co-CL) copolymer with a recombinant human bone morphogenetic protein-2 (rhBMP-2)/vascular epithelial growth factor (VEGF) release system accompanied by hydroxyapatite (HA). The efficacy of scaffold formulations was studied using a standard, bilateral, L-level (L5-L6) posterolateral transverse spinal fusion using New Zealand white rabbits. Rabbits were divided into 4 experimental groups: group I, negative control; group II, autograft (positive control); group III, injectable PPF scaffold with rhBMP-2/VEGF release system and HA; group IV, injectable P(PF-co-CL)scaffold with rhBMP-2/VEGF release system and HA. Spines were harvested at 6 weeks and 12 weeks after surgery, and spinal fusions were assessed using manual palpation, radiographic analysis, micro-computed tomography (μCT) assessment, and histologic analysis.

Results

Of the 4 experimental groups, the injectable P(PF-co-CL) scaffold displayed superior initial strength and faster degradation than scaffolds constructed from PPF alone and facilitated the fusion of lateral processes in the rabbit standard posterolateral spinal fusion model. The results obtained from manual palpation, radiology, and μCT showed no difference between the P(PF-co-CL) group and the PPF group. However, histologic sections showed more osteogenesis with the new injectable P(PF-co-CL) scaffold.

Conclusion

Injectable P(PF-co-CL) polymers showed promising spine fusion abilities in rabbits after 12 weeks of posterolateral implantation.

Poly(propylene fumarate)/magnesium calcium phosphate injectable bone composite: Effect of filler size and its weight fraction on mechanical properties

This study aimed to produce a composite of poly(propylene fumarate)/magnesium calcium phosphate as a substitutional implant in the treatment of trabecular bone defects. So, the effect of magnesium calcium phosphate particle size, magnesium calcium phosphate:poly(propylene fumarate) weight ratio on compressive strength, Young's modulus, and toughness was assessed by considering effective fracture mechanisms. Micro-sized (∼30 µm) and nano-sized (∼50 nm) magnesium calcium phosphate particles were synthesized via emulsion precipitation and planetary milling methods, respectively, and added to poly(propylene fumarate) up to 20 wt.%. Compressive strength, Young's modulus, and toughness of the composites were measured by compressive test, and effective fracture mechanisms were evaluated by imaging fracture surface. In both micro- and nano-composites, the highest compressive strength was obtained by adding 10 wt.% magnesium calcium phosphate particles, and the enhancement in nano-composite was superior to micro-one. The micrographs of fracture surface revealed different mechanisms such as crack pinning, void plastic growth, and particle cleavage. According to the results, the produced composite can be considered as a candidate for substituting hard tissue.

Molecular Mass-Dependent Resorption and Bone Regeneration of 3D Printed PPF Scaffolds in a Critical-Sized Rat Cranial Defect Model

The emergence of additive manufacturing has afforded the ability to fabricate intricate, high resolution, and patient-specific polymeric implants. However, the availability of biocompatible resins with tunable resorption profiles remains a significant hurdle to clinical translation. In this study, 3D scaffolds are fabricated via stereolithographic cDLP printing of poly(propylene fumarate) (PPF) and assessed for bone regeneration in a rat critical-sized cranial defect model. Scaffolds are printed with two different molecular mass resin formulations (1000 and 1900 Da) with narrow molecular mass distributions and implanted to determine if these polymer characteristics influence scaffold resorption and bone regeneration in vivo. X-ray microcomputed tomography (µ-CT) data reveal that at 4 weeks the lower molecular mass polymer degrades faster than the higher molecular mass PPF and thus more new bone is able to infiltrate the defect. However, at 12 weeks, the regenerated bone volume of the 1900 Da formulation is nearly equivalent to the lower molecular mass 1000 Da formulation. Significantly, lamellar bone bridges the defect at 12 weeks with both PPF formulations and there is no indication of an acute inflammatory response.

Strontium-substituted hydroxyapatite stimulates osteogenesis on poly(propylene fumarate) nanocomposite scaffolds

Incorporation of hydroxyapatite (HA) into polymer networks is a promising strategy to enhance the mechanical properties and osteoinductivity of the composite scaffolds for bone tissue engineering. In this study, we designed a group of nanocomposite scaffolds based on cross-linkable poly(propylene fumarate) (PPF) and 30 wt % strontium-hydroxyapatite (Sr-HA) nanoparticles. Four different Sr contents [Sr:(Sr + Ca), molar ratio] in the Sr-HA particles were studied: 0% (HA), 5% (Sr5-HA), 10% (Sr10-HA), and 20% (Sr20-HA). Two-dimensional (2D) disks were prepared using a thermal crosslinking method. The structure and surface morphology of different Sr-HA and PPF/Sr-HA composites were characterized using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), transmission electron microscopy (TEM), and atomic force microscopy (AFM). To detect cellular responses in vitro, MC3T3-E1 cells were seeded and cultured on the different PPF/Sr-HA composite disks. Cell morphology after 24 h and 5 days were imaged using Live/Dead live cell staining and SEM, respectively. Cell proliferation was quantified using an MTS assay at 1, 4, and 7 days. Osteogenic differentiation of the cells was examined by alkaline phosphatase (ALP) staining at 10 days and quantified using ALP activity and osteocalcin assays at 7, 14, and 21 days. The sizes of the HA, Sr5-HA, Sr10-HA, and Sr20-HA particles were mainly between 10 × 20 nm and 10 × 250 nm, and these nanoparticles were dispersed or clustered in the composite scaffolds. in vitro cell studies showed that the PPF/Sr10-HA scaffold was significantly better than the other three groups (PPF/HA, PPF/Sr5-HA, and PPF/Sr20-HA) in supporting MC3T3-E1 cell adhesion, proliferation, and differentiation. PPF/Sr10-HA may, therefore, serve as a promising scaffold material for bone tissue engineering. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 631-642, 2019.

Synthesis and 3D Printing of PEG-Poly(propylene fumarate) Diblock and Triblock Copolymer Hydrogels

PEG-based hydrogels are used widely in exploratory tissue engineering applications but in general lack chemical and structural diversity. Additive manufacturing offers pathways to otherwise unattainable scaffold morphologies but has been applied sparingly to cross-linked hydrogels. Herein, mono methyl ether poly(ethylene glycol) (PEG) and PEG-diol were used to initiate the ring-opening copolymerization (ROCOP) of maleic anhydride and propylene oxide to yield well defined diblock and triblock copolymers of PEG-poly(propylene maleate) (PPM) and ultimately poly(propylene fumarate) (PPF) with different molecular mass PEG macroinitiators and block length ratios. Using continuous digital light processing (cDLP) hydrogels were photochemically printed from an aqueous solution which resulted in a 10-fold increase in elongation at break compared to traditional diethyl fumarate (DEF) based printing. Furthermore, PPF-PEG-PPF triblock hydrogels were also found to be biocompatible in vitro across a number of engineered MC3T3, NIH3T3, and primary Schwann cells.

Tissue Engineering Bionanocomposites Based on Poly(propylene fumarate)

Poly(propylene fumarate) (PPF) is a linear and unsaturated copolyester based on fumaric acid that has been widely investigated for tissue engineering applications in recent years due to its tailorable mechanical performance, adjustable biodegradability and exceptional biocompatibility. In order to improve its mechanical properties and spread its range of practical applications, novel approaches need to be developed such as the incorporation of fillers or polymer blending. Thus, PPF-based bionanocomposites reinforced with different amounts of single-walled carbon nanotubes (SWCNT), multi-walled carbon nanotubes (MWCNT), graphene oxide nanoribbons (GONR), graphite oxide nanoplatelets (GONP), polyethylene glycol-functionalized graphene oxide (PEG-GO), polyethylene glycol-grafted boron nitride nanotubes (PEG-g-BNNTs) and hydroxyapatite (HA) nanoparticles were synthesized via sonication and thermal curing, and their morphology, biodegradability, cytotoxicity, thermal, rheological, mechanical and antibacterial properties were investigated. An increase in the level of hydrophilicity, biodegradation rate, stiffness and strength was found upon increasing nanofiller loading. The nanocomposites retained enough rigidity and strength under physiological conditions to provide effective support for bone tissue formation, showed antibacterial activity against Gram-positive and Gram-negative bacteria, and did not induce toxicity on human dermal fibroblasts. These novel biomaterials demonstrate great potential to be used for bone tissue engineering applications.

Effect of different sustained bone morphogenetic protein-2 release kinetics on bone formation in poly(propylene fumarate) scaffolds

To investigate the effect of sustained bone morphogenetic protein-2 (BMP-2) release kinetics on bone formation in poly(propylene fumarate) (PPF) scaffolds, different poly(lactic-co-glycolic acid) (PLGA) microspheres were used as delivery vehicles. All PPF scaffolds had the same 75% porous structure, while the degradation rate of the embedded PLGA microspheres was changed to tailor BMP-2 release by varying the lactic-to-glycolic acid (L:G) ratio in the copolymer. Four PLGA microsphere formulations with 50/50, 65/35, 75/25, and 85/15 L:G ratios and varying in vivo degradation rates were fabricated. The in vitro and in vivo BMP-2 release kinetics were determined by analyzing radiolabeled ¹²⁵ I-BMP-2. Biological activity of released BMP-2 was tested using a W20-17 cell culture model in vitro and a subcutaneous rat model in vivo. Corresponding outcome parameters were defined as capacity to increase the in vitro AP activity in weekly consecutive cell cultures over 14 weeks and the in vivo bone formation after 7 and 14 weeks. The PLGA/PPF composites showed similar biological activity and BMP-2 release profiles in vitro. In vivo, PPF/PLGA 85:15 composite released significantly less BMP-2 per time point in the first weeks. Micro-CT and histological analysis after 7 and 14 weeks of implantation showed bone formation, which significantly increased over time for all composites. No significant differences were seen between the composites. Overall, the results of this study show that small differences in BMP-2 sustained release had no significant effect on BMP-2 osteogenic efficacy in PPF/PLGA composites. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 477-487, 2018.

Poly(propylene fumarate)/Polyethylene Glycol-Modified Graphene Oxide Nanocomposites for Tissue Engineering

Poly(propylene fumarate) (PPF)-based nanocomposites incorporating different amounts of polyethylene glycol-functionalized graphene oxide (PEG-GO) have been prepared via sonication and thermal curing, and their surface morphology, structure, thermal stability, hydrophilicity, water absorption, biodegradation, cytotoxicity, mechanical, viscoelastic and antibacterial properties have been investigated. SEM and TEM images corroborated that the noncovalent functionalization with PEG caused the exfoliation of GO into thinner flakes. IR spectra suggested the presence of strong hydrogen-bonding interactions between the nanocomposite components. A gradual rise in the level of hydrophilicity, water uptake, biodegradation rate, surface roughness, protein absorption capability and thermal stability was found upon increasing GO concentration in the composites. Tensile tests revealed improved stiffness, strength and toughness for the composites compared to unfilled PPF, ascribed to a homogeneous GO dispersion within the matrix along with a strong PPF/PEG-GO interfacial adhesion via polar and hydrogen bonding interactions. Further, the nanocomposites retained enough stiffness and strength under a biological state to provide effective support for bone tissue formation. The antibacterial activity was investigated against Gram-positive Staphylococcus aureus and Staphylococcus epidermidis as well as Gram-negative Pseudomonas aeruginosa and Escherichia coli microorganisms, and it rose sharply upon increasing GO concentration; systematically, the biocide effect was stronger versus Gram-positive bacteria. Cell viability data demonstrated that PPF/PEG-GO composites do not induce toxicity over human dermal fibroblasts. These novel materials show great potential to be applied in the bone tissue engineering field.

Synthesis of Chiral Oligomer-Grafted Biodegradable Polyurethanes and Their Chiral-Dependent Influence on Bone Marrow Stem Cell Behaviors

Chirality is one of the most fascinating and ubiquitous features in nature, especially in biological systems. The effects of chiral surfaces, especially in combination with degradable materials of good biocompatibility, on stem cell behaviors has not yet been tackled. In this communication, the chiral monomers N-acryloyl-l(d)-valine (l(d)-AV) are synthesized and are polymerized to obtain chiral (l(d)-PAV-SH) oligomers, which are covalently immobilized onto electron-deficient poly(propylene fumarate) polyurethane (PPFU) via Michael addition. The PPFU-l-PAV can interact more strongly and actively with bone marrow stem cells (BMSCs) than PPFU-d-PAV, leading to a larger cell spreading area, faster migration velocity, and stronger osteodifferentiation tendency.

Extrusion-Based 3D Printing of Poly(propylene fumarate) in a Full-Factorial Design

3D printing has emerged as an important technique for fabricating tissue engineered scaffolds. However, systematic evaluations of biomaterials for 3D printing have not been widely investigated. We evaluated poly(propylene fumarate) (PPF) as a model material for extrusion-based printing applications. A full-factorial design evaluating the effects of four factors (PPF concentration, printing pressure, printing speed, and programmed fiber spacing) on viscosity, fiber diameter, and pore size was performed layer-by-layer on 3D scaffolds. We developed a linear model of printing solution viscosity, where concentration of PPF had the greatest effect on viscosity, and the polymer exhibited shear thinning behavior. Additionally, linear models of pore size and fiber diameter revealed that fiber spacing and pressure had the greatest effect on pore size and fiber diameter, respectively, but interplay among the factors also influenced scaffold architecture. This study serves as a platform to determine if novel biomaterials are suitable for extrusion-based 3D printing applications.

3D-Printed Biodegradable Polymeric Vascular Grafts

Congenital heart defect interventions may benefit from the fabrication of patient-specific vascular grafts because of the wide array of anatomies present in children with cardiovascular defects. 3D printing is used to establish a platform for the production of custom vascular grafts, which are biodegradable, mechanically compatible with vascular tissues, and support neotissue formation and growth.