Rational design of poly(peptide-ester) block copolymers for enzyme-specific surface resorption

Tissue resorption and remodeling are pivotal steps in successful healing and regeneration, and it is important to design biomaterials that are responsive to regenerative processes in native tissue. The cell types responsible for remodeling, such as macrophages in the soft tissue wound environment and osteoclasts in the bone environment, utilize a class of enzymes called proteases to degrade the organic matrix. Many hydrophobic thermoplastics used in tissue regeneration are designed to degrade and resorb passively through hydrolytic mechanisms, leaving the potential of proteolytic-guided degradation underutilized. Here, we report the design and synthesis of a tyrosol-derived peptide-polyester block copolymer where protease-mediated resorption is tuned through changing the chemistry of the base polymer backbone and protease specificity is imparted through incorporation of specific peptide sequences. Quartz crystal microbalance was used to quantify polymer surface resorption upon exposure to various enzymes. Aqueous solubility of the diacids and the thermal properties of the resulting polymer had a significant effect on enzyme-mediated polymer resorption. While peptide incorporation at 2 mol% had little effect on the final thermal and physical properties of the block copolymers, its incorporation improved polymer resorption significantly in a peptide sequence- and protease-specific manner. To our knowledge, this is the first example of a peptide-incorporated linear thermoplastic with protease-specific sensitivity reported in the literature. The product is a modular system for engineering specificity in how polyesters can resorb under physiological conditions, thus providing a potential framework for improving vascularization and integration of biomaterials used in tissue engineering.

The Use of Collagen Methacrylate in Actuating Polyethylene Glycol Diacrylate-Acrylic Acid Scaffolds for Muscle Regeneration

After muscle loss or injury, skeletal muscle tissue has the ability to regenerate and return its function. However, large volume defects in skeletal muscle tissue pose a challenge to regenerate due to the absence of regenerative elements such as biophysical and biochemical cues, making the development of new treatments necessary. One potential solution is to utilize electroactive polymers that can change size or shape in response to an external electric field. Poly(ethylene glycol) diacrylate (PEGDA) is one such polymer, which holds great potential as a scaffold for muscle tissue regeneration due to its mechanical properties. In addition, the versatile chemistry of this polymer allows for the conjugation of new functional groups to enhance its electroactive properties and biocompatibility. Herein, we have developed an electroactive copolymer of PEGDA and acrylic acid (AA) in combination with collagen methacrylate (CMA) to promote cell adhesion and proliferation. The electroactive properties of the CMA + PEGDA:AA constructs were investigated through actuation studies. Furthermore, the biological properties of the hydrogel were investigated in a 14-day in vitro study to evaluate myosin light chain (MLC) expression and metabolic activity of C2C12 mouse myoblast cells. The addition of CMA improved some aspects of material bioactivity, such as MLC expression in C2C12 mouse myoblast cells. However, the incorporation of CMA in the PEGDA:AA hydrogels reduced the sample movement when placed under an electric field, possibly due to steric hindrance from the CMA. Further research is needed to optimize the use of CMA in combination with PEGDA:AA as a potential scaffold for skeletal muscle tissue engineering.

Intra-articular injection of epigallocatechin (EGCG) crosslinks and alters biomechanical properties of articular cartilage, a study via nanoindentation

Osteoarthritis and rheumatoid arthritis are debilitating conditions, affecting millions of people. Both osteoarthritis and rheumatoid arthritis degrade the articular cartilage (AC) at the ends of long bones, resulting in weakened tissue prone to further damage. This degradation impairs the cartilage’s mechanical properties leading to areas of thinned cartilage and exposed bone which compromises the integrity of the joint. No preventative measures exist for joint destruction. Discovering a way to slow the degradation of AC or prevent it would slow the painful progression of the disease, allowing millions to live pain-free. Recently, that the articular injection of the polyphenol epigallocatechin-gallate (EGCG) slows AC damage in an arthritis rat model. It was suggested that EGCG crosslinks AC and makes it resistant to degradation. However, direct evidence that intraarticular injection of EGCG crosslinks cartilage collagen and changes its compressive properties are not known. The aim of this study was to investigate the effects of intraarticular injection of EGCG induced biomechanical properties of AC. We hypothesize that in vivo exposure EGCG will bind and crosslink to AC collagen and alter its biomechanical properties. We developed a technique of nano-indentation to investigate articular cartilage properties by measuring cartilage compressive properties and quantifying differences due to EGCG exposure. In this study, the rat knee joint was subjected to a series of intraarticular injections of EGCG and contralateral knee joint was injected with saline. After the injections animals were sacrificed, and the knees were removed and tested in an anatomically relevant model of nanoindentation. All mechanical data was normalized to the measurements in the contralateral knee to better compare data between the animals. The data demonstrated significant increases for reduced elastic modulus (57.5%), hardness (83.2%), and stiffness (17.6%) in cartilage treated with injections of EGCG normalized to those treated with just saline solution when compared to baseline subjects without injections, with a significance level of alpha = 0.05. This data provides evidence that EGCG treated cartilage yields a strengthened cartilage matrix as compared to AC from the saline injected knees. These findings are significant because the increase in cartilage biomechanics will translate into resistance to degradation in arthritis. Furthermore, the data suggest for the first time that it is possible to strengthen the articular cartilage by intraarticular injections of polyphenols. Although this data is preliminary, it suggests that clinical applications of EGCG treated cartilage could yield strengthened tissue with the potential to resist or compensate for matrix degradation caused by arthritis.

Uric acid released from poly(ε-caprolactone) fibers as a treatment platform for spinal cord injury

Spinal cord injury (SCI) is characterized by a primary mechanical phase of injury, resulting in physical tissue damage, and a secondary pathological phase, characterized by biochemical processes contributing to inflammation, neuronal death, and axonal demyelination. Glutamate-induced excitotoxicity (GIE), in which excess glutamate is released into synapses and overstimulates glutamate receptors, is a major event in secondary SCI. GIE leads to mitochondrial damage and dysfunction, release of reactive oxygen species (ROS), DNA damage, and cell death. There is no clinical treatment that targets GIE after SCI, and there is a need for therapeutic targets for secondary damage in patients. Uric acid (UA) acts as an antioxidant and scavenges free radicals, upregulates glutamate transporters on astrocytes, and preserves neuronal viability in in vitro and in vivo SCI models, making it a promising therapeutic candidate. However, development of a drug release platform that delivers UA locally to the injured region in a controlled manner is crucial, as high systemic UA concentrations can be detrimental. Here, we used the electrospinning technique to synthesize UA-containing poly(ɛ-caprolactone) fiber mats that are biodegradable, biocompatible, and have a tunable degradation rate. We optimized delivery of UA as a burst within 20 min from uncoated fibers and sustained release over 2 h with poly(ethylene glycol) diacrylate coating. We found that both of these fibers protected neurons and decreased ROS generation from GIE in organotypic spinal cord slice culture. Thus, fiber mats represent a promising therapeutic for UA release to treat patients who have suffered a SCI.

Single-walled carbon nanohorns modulate tenocyte cellular response and tendon biomechanics

Subfailure ligament and tendon injury remain a significant burden to global healthcare. Here, we present the use of biocompatible single-walled carbon nanohorns (CNH) as a potential treatment for the repair of sub-failure injury in tendons. First, in vitro exposure of CNH to human tenocytes revealed no change in collagen deposition but a significant decrease in cell metabolic activity after 14 days. Additionally, gene expression studies revealed significant downregulation of collagen Types I and III mRNA at 7 days with some recovery after 14 days of exposure. Biomechanical tests with explanted porcine digitorum tendons showed the ability of CNH suspensions to modulate tendon biomechanics, most notably elastic moduli immediately after treatment. in vivo experiments demonstrated the ability of CNH to persist in the damaged matrix of stretch-injured Sprague Dawley rat Achilles tendon but not significantly modify tendon biomechanics after 7 days of treatment. Although these results demonstrate the early feasibility of utility of CNH as a potential modality for tendon subfailure injury, additional work is needed to further validate and ensure clinical efficacy.

Characterization of a prevascularized biomimetic tissue engineered scaffold for bone regeneration

Significant bone loss due to disease or severe injury can result in the need for a bone graft, with over 500,000 procedures occurring each year in the United States. However, the current standards for grafting, autografts and allografts, can result in increased patient morbidity or a high rate of failure respectively. An ideal alternative would be a biodegradable tissue engineered graft that fulfills the function of bone while promoting the growth of new bone tissue. We developed a prevascularized tissue engineered scaffold of electrospun biodegradable polymers PLLA and PDLA reinforced with hydroxyapatite, a mineral similar to that found in bone. A composite design was utilized to mimic the structure and function of human trabecular and cortical bone. These scaffolds were characterized mechanically and in vitro to determine osteoinductive and angioinductive properties. It was observed that further reinforcement is necessary for the scaffolds to mechanically match bone, but the scaffolds are successful at inducing the differentiation of mesenchymal stem cells into mature bone cells and vascular endothelial cells. Prevascularization was seen to have a positive effect on angiogenesis and cellular metabolic activity, critical factors for the integration of a graft.

Characterization and optimization of a positively charged poly (ethylene glycol)diacrylate hydrogel as an actuating muscle tissue engineering scaffold

Hydrogels have been used for many applications in tissue engineering and regenerative medicine due to their versatile material properties and similarities to the native extracellular matrix. Poly (ethylene glycol) diacrylate (PEGDA) is an ionic electroactive polymer (EAP), a material that responds to an electric field with a change in size or shape while in an ionic solution, that may be used in the development of hydrogels. In this study, we have investigated a positively charged EAP that can bend without the need of external ions. PEGDA was modified with the positively charged molecule 2-(methacryloyloxy)ethyl-trimethylammonium chloride (MAETAC) to provide its own positive ions. This hydrogel was then characterized and optimized for bending and cellular biocompatibility with C2C12 mouse myoblast cells. Studies show that the polymer responds to an electric field and supports C2C12 viability.

Mechanical and biological evaluation of a hydroxyapatite-reinforced scaffold for bone regeneration

With over 500,000 bone grafting procedures performed annually in the United States, the advancement of bone regeneration technology is at the forefront of medical research. Many tissue-engineered approaches have been explored to develop a viable synthetic bone graft substitute, but a major challenge is achieving a load-bearing graft that appropriately mimics the mechanical properties of native bone. In this study, sintered hydroxyapatite (HAp) was used to structurally reinforce a scaffold and yield mechanical properties comparable to native bone. HAp was packed into a cylindrical framework and processed under varying conditions to maximize its mechanical properties. The resulting HAp columns were further tested in a 6-week degradation study to determine their physical and mechanical response. The cellular response of sintered HAp was determined using a murine preosteoblast cell line, MC3T3-E1. Cell viability and morphology were studied over a one-week period and MC3T3-E1 differentiation was determined by measuring the alkaline phosphatase levels. Finite element analysis was used to determine the columns' geometric configuration and arrangement within our previously developed composite bone scaffold. It was determined that incorporating four cylindrical HAp columns, fabricated under 44 MPa of pressure and sintered at 1200°C for 5 hr, led to load-bearing properties that match the yield strength of native whole bone. These preliminary results indicate that the incorporation of a mechanically enhanced HAp structural support system is a promising step toward developing one of the first load-bearing bone scaffolds that can also support cell proliferation and osteogenic differentiation. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 732-741, 2019.

Soft Robotic Manipulation and Locomotion with a 3D Printed Electroactive Hydrogel

Electroactive hydrogels (EAH) that exhibit large deformation in response to an electric field have received great attention as a potential actuating material for soft robots and artificial muscle. However, their application has been limited due to the use of traditional two-dimensional (2D) fabrication methods. Here we present soft robotic manipulation and locomotion with 3D printed EAH microstructures. Through 3D design and precise dimensional control enabled by a digital light processing (DLP) based micro 3D printing technique, complex 3D actuations of EAH are achieved. We demonstrate soft robotic actuations including gripping and transporting an object and a bidirectional locomotion.

Hypoxia Impairs Mesenchymal Stromal Cell-Induced Macrophage M1 to M2 Transition

The transition of macrophages from the pro-inflammatory M1 to the anti-inflammatory M2 phenotype is crucial for the progression of normal wound healing. Persistent M1 macrophages within the injury site may lead to an uncontrolled macrophage-mediated inflammatory response and ultimately a failure of the wound healing cascade, leading to chronic wounds. Mesenchymal stromal cells (MSCs) have been widely reported to promote M1 to M2 macrophage transition; however, it is unclear whether MSCs can drive this transition in the hypoxic environment typically observed in chronic wounds. Here we report on the effect of hypoxia (1% O₂) on MSCs' ability to transition macrophages from the M1 to the M2 phenotype. While hypoxia had no effect on MSC secretion, it inhibited MSC-induced M1 to M2 macrophage transition, and suppressed macrophage expression and production of the anti-inflammatory mediator interleukin-10 (IL-10). These results suggest that hypoxic environments may impede the therapeutic effects of MSCs.

Characterization and optimization of actuating poly(ethylene glycol) diacrylate/acrylic acid hydrogels as artificial muscles

Large volume deficiencies in skeletal muscle tissue fail to heal with conservative treatments, and improved treatment methods are needed. Tissue engineered scaffolds for skeletal muscle need to mimic the optimal environment for muscle development by providing the proper electric, mechanical, and chemical cues. Electroactive polymers, polymers that change in size or shape in response to an electric field, may be able to provide the optimal environment for muscle growth. In this study, an electroactive polymer made from poly(ethylene glycol) diacrylate (PEGDA) and acrylic acid (AA) is characterized and optimized for movement and biocompatibility. Hydrogel sample thickness, overall polymer concentration, and the ratio of PEGDA to AA were found to significantly impact the actuation response. C2C12 mouse myoblast cells attached and proliferated on hydrogel samples with various ratios of PEGDA to AA. Future experiments will produce hydrogel samples combined with aligned guidance cues in the form of electrospun fibers to provide a favorable environment for muscle development.

Investigating processing techniques for bovine gelatin electrospun scaffolds for bone tissue regeneration

Tissue engineering has emerged as a promising solution to tissue regeneration in the case of significant bone loss due to disease or injury. The ability to promote cellular attachment, migration, and differentiation into tissue is dependent on the scaffold's surface properties and composition. Bovine gelatin is a natural polymer commonly used as a scaffolding material for tissue engineering applications. Nonetheless, due to the hydrophilic behavior of gelatin, cross-linking and additives are necessary to maintain the scaffold's structure and overall strength in vivo. In this article, we discuss various processing techniques to determine the optimal electrospinning, cross-linking, sintering, and mineralization parameters necessary to yield a porous, mechanically enhanced scaffold. The scaffolds were evaluated quantitatively using compressive mechanical testing, and qualitatively using scanning electron microscopy (SEM). Mechanical data concluded the use of biocompatible microbial transglutaminase (mTG) as a cross-linking agent, led to increased compressive strength. SEM images confirmed the presence of individual gelatin and polymeric nanofibers woven into one scaffold. Sintering before leaching the scaffold yielded structured pores throughout the three-dimensional scaffold when compared to the scaffolds that were leached prior to sintering. The results presented in this article will provide novel information about processing techniques that can be utilized to develop a hybrid synthetic and biological based biomimetic mineralized scaffold for trabecular bone tissue regeneration. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1131-1140, 2017.

An overview of recent patents on musculoskeletal interface tissue engineering

Interface tissue engineering involves the development of engineered grafts that promote integration between multiple tissue types. Musculoskeletal tissue interfaces are critical to the safe and efficient transmission of mechanical forces between multiple musculoskeletal tissues, e.g., between ligament and bone tissue. However, these interfaces often do not physiologically regenerate upon injury, resulting in impaired tissue function. Therefore, interface tissue engineering approaches are considered to be particularly relevant for the structural restoration of musculoskeletal tissues interfaces. In this article, we provide an overview of the various strategies used for engineering musculoskeletal tissue interfaces with a specific focus on the recent important patents that have been issued for inventions that were specifically designed for engineering musculoskeletal interfaces as well as those that show promise to be adapted for this purpose.

Cross-Talk Between Human Tenocytes and Bone Marrow Stromal Cells Potentiates Extracellular Matrix Remodeling In Vitro

Tendon and ligament (T/L) pathologies account for a significant portion of musculoskeletal injuries and disorders. Tissue engineering has emerged as a promising solution in the regeneration of both tissues. Specifically, the use of multipotent human mesenchymal stromal cells (hMSC) has shown great promise to serve as both a suitable cell source for tenogenic regeneration and a source of trophic factors to induce tenogenesis. Using four donor sets, we investigated the bidirectional paracrine tenogenic response between human hamstring tenocytes (hHT) and bone marrow-derived hMSC. Cell metabolic assays showed that only one hHT donor experienced sustained notable increases in cell metabolic activity during co-culture. Histological staining confirmed that co-culture induced elevated collagen protein levels in both cell types at varying time-points in two of four donor sets assessed. Gene expression analysis using qPCR showed the varied up-regulation of anabolic and catabolic markers involved in extracellular matrix maintenance for hMSC and hHT. Furthermore, analysis of hMSC/hHT co-culture secretome using a reporter cell line for TGF-β, a potent inducer of tenogenesis, revealed a trend of higher TGF-β bioactivity in hMSC secretome compared to hHT. Finally, hHT cytoskeletal immunostaining confirmed that both cell types released soluble factors capable of inducing favorable tenogenic morphology, comparable to control levels of soluble TGF-β1. These results suggest a potential for TGF-β-mediated signaling mechanism that is involved during the paracrine interplay between the two cell types that is reminiscent of T/L matrix remodeling/turnover. These findings have significant implications in the clinical use of hMSC for common T/L pathologies.

Poly(3,4-ethylenedioxythiophene) nanoparticle and poly(ɛ-caprolactone) electrospun scaffold characterization for skeletal muscle regeneration

Injuries to peripheral nerves and/or skeletal muscle can cause scar tissue formation and loss of function. The focus of this article is the creation of a conductive, biocompatible scaffold with appropriate mechanical properties to regenerate skeletal muscle. Poly(3,4-ethylenedioxythiophene) (PEDOT) nanoparticles (Np) were electrospun with poly(ɛ-caprolactone) (PCL) to form conductive scaffolds. During electrospinning, ribboning, larger fiber diameters, and unaligned scaffolds were observed with increasing PEDOT amounts. To address this, PEDOT Np were sonicated prior to electrospinning, which resulted in decreased conductivity and increased mechanical properties. Multi-walled carbon nanotubes (MWCNT) were added to the 1:2 solution in an effort to increase conductivity. However, the addition of MWCNT had little effect on scaffold conductivity, and the elastic modulus and yield stress of the scaffold increased as a result. Rat muscle cells attached and were active on the 1-10, 1-2, 3-4, and 1-1 PCL-PEDOT scaffolds; however, the 3-4 scaffolds had the lowest level of metabolic activity. Although the scaffolds were cytocompatible, further development of the fabrication method is necessary to produce more highly aligned scaffolds capable of promoting skeletal muscle cell alignment and eventual regeneration.

Quantification of strain induced damage in medial collateral ligaments

In the past years, there have been several experimental studies that aimed at quantifying the material properties of articular ligaments such as tangent modulus, tensile strength, and ultimate strain. Little has been done to describe their response to mechanical stimuli that lead to damage. The purpose of this experimental study was to characterize strain-induced damage in medial collateral ligaments (MCLs). Displacement-controlled tensile tests were performed on 30 MCLs harvested from Sprague Dawley rats. Each ligament was monotonically pulled to several increasing levels of displacement until complete failure occurred. The stress-strain data collected from the mechanical tests were analyzed to determine the onset of damage and its evolution. Unrecoverable changes such as increase in ligament's elongation at preload and decrease in the tangent modulus of the linear region of the stress-strain curves indicated the occurrence of damage. Interestingly, these changes were found to appear at two significantly different threshold strains (P<0.05). The mean threshold strain that determined the increase in ligament's elongation at preload was found to be 2.84% (standard deviation (SD) = 1.29%) and the mean threshold strain that caused the decrease in the tangent modulus of the linear region was computed to be 5.51% (SD = 2.10%), respectively. The findings of this study suggest that the damage mechanisms associated with the increase in ligament's elongation at preload and decrease in the tangent modulus of the linear region in the stress-strain curves in MCLs are likely different.

In vitro evaluation of three-dimensional single-walled carbon nanotube composites for bone tissue engineering

The purpose of this study was to develop three-dimensional single-walled carbon nanotube composites (SWCNT/PLAGA) using 10-mg single-walled carbon nanotubes (SWCNT) for bone regeneration and to determine the mechanical strength of the composites, and to evaluate the interaction of MC3T3-E1 cells via cell adhesion, growth, survival, proliferation, and gene expression. PLAGA (polylactic-co-glycolic acid) and SWCNT/PLAGA microspheres and composites were fabricated, characterized, and mechanical testing was performed. MC3T3-E1 cells were seeded and cell adhesion/morphology, growth/survival, proliferation, and gene expression analysis were performed to evaluate biocompatibility. Imaging studies demonstrated microspheres with uniform shape and smooth surfaces, and uniform incorporation of SWCNT into PLAGA matrix. The microspheres bonded in a random packing manner while maintaining spacing, thus resembling trabeculae of cancellous bone. Addition of SWCNT led to greater compressive modulus and ultimate compressive strength. Imaging studies revealed that MC3T3-E1 cells adhered, grew/survived, and exhibited normal, nonstressed morphology on the composites. SWCNT/PLAGA composites exhibited higher cell proliferation rate and gene expression compared with PLAGA. These results demonstrate the potential of SWCNT/PLAGA composites for musculoskeletal regeneration, for bone tissue engineering, and are promising for orthopedic applications as they possess the combined effect of increased mechanical strength, cell proliferation, and gene expression.

In vivo skeletal muscle biocompatibility of composite, coaxial electrospun, and microfibrous scaffolds

One weakness with currently researched skeletal muscle tissue replacement is the lack of contraction and relaxation during the regenerative process. A biocompatible scaffold that can act similar to the muscle would be a pivotal innovation. Coaxial electrospun scaffolds, capable of movement with electrical stimulation, were created using poly(ɛ-caprolactone) (PCL), multiwalled carbon nanotubes (MWCNT), and a (83/17 or 40/60) poly(acrylic acid)/poly(vinyl alcohol) (PAA/PVA) hydrogel. The two scaffolds were implanted into Sprague-Dawley rat vastus lateralis muscle and compared with a phosphate-buffered saline injection sham surgery and an unoperated control. No complications or adverse effects were observed. Rats were sacrificed on days 7, 14, 21, and 28 postimplantation and biocompatibility assessed using enzymatic activity, fibrosis formation, inflammation, scaffold cellular infiltration, and neovascularization. Serum creatine kinase and lactate dehydrogenase levels were significantly higher in scaffold-implanted rats compared with the control on day 7, but returned to baseline by day 14. Day 7 scaffolds showed significant inflammation and fibrosis that decreased over time. Fibroblasts infiltrated the scaffolds early, but decreased with time, while myogenic cell numbers increased. Neovascularization of both scaffolds occurred as early as day 7. We conclude that the PCL-MWCNT-PAA/PVA scaffolds are biocompatible and suitable for muscle regeneration as myogenic cell growth was supported.

Mechanical recruitment of N- and C-crosslinks in collagen type I

Collagen type I is an extracellular matrix protein found in connective tissues such as tendon, ligament, bone, skin, and the cornea of the eyes, where it functions to provide tensile strength; it also serves as a scaffold for cells and other extracellular matrix components. A single collagen type I molecule is composed of three amino acid chains that form a triple helix for most of the molecule's length; non-triple-helical extensions called N- and C-telopeptides are located at the amino/N-terminal and carboxy/C-terminal ends of the molecule, respectively. In two of the three chains, the C-telopeptide has been reported to possess a hair-pin/hook conformation, while the three N-telopeptides display a more extended structure. These telopeptides are crucial for the formation of enzymatic covalent crosslinks that form in collagens near their N- and C-ends. Such crosslinks provide structural integrity, strength, and stiffness to collagenous tissues. However, deformation mechanisms of N- and C-crosslinks and functional roles for the N- and C-telopeptide conformations are not yet well known. By performing molecular dynamics simulations, we demonstrated that two dehydro-hydroxylysino-norleucine crosslinks, positioned at the N- and C-crosslinking sites, exhibited a two-stage response to the mechanical deformation of their parent molecules. We observed that the N-crosslink served as the first responder to mechanical deformation, followed by the C-crosslink. The results of our simulations suggest a mechanical recruitment mechanism for N- and C-crosslinks. Understanding this mechanism will be crucial for the development of larger-scale predictive models of the mechanical behavior of native collagenous tissues, engineered tissues, and collagen-based materials.

Reolysin is a novel reovirus-based agent that induces endoplasmic reticular stress-mediated apoptosis in pancreatic cancer

Activating mutation of KRas is a genetic alteration that occurs in the majority of pancreatic tumors and is therefore an ideal therapeutic target. The ability of reoviruses to preferentially replicate and induce cell death in transformed cells that express activated Ras prompted the development of a reovirus-based formulation for cancer therapy called Reolysin. We hypothesized that Reolysin exposure would trigger heavy production of viral products leading to endoplasmic reticular (ER) stress-mediated apoptosis. Here, we report that Reolysin treatment stimulated selective reovirus replication and decreased cell viability in KRas-transformed immortalized human pancreatic duct epithelial cells and pancreatic cancer cell lines. These effects were associated with increased expression of ER stress-related genes, ER swelling, cleavage of caspase-4, and splicing of XBP-1. Treatment with ER stress stimuli including tunicamycin, brefeldin A, and bortezomib (BZ) augmented the anticancer activity of Reolysin. Cotreatment with BZ and Reolysin induced the simultaneous accumulation of ubiquitinated and viral proteins, resulting in enhanced levels of ER stress and apoptosis in both in vitro and in vivo models of pancreatic cancer. Our collective results demonstrate that the abnormal protein accumulation induced by the combination of Reolysin and BZ promotes heightened ER stress and apoptosis in pancreatic cancer cells and provides the rationale for a phase I clinical trial further investigating the safety and efficacy of this novel strategy.

Three-dimensional microfluidic collagen hydrogels for investigating flow-mediated tumor-endothelial signaling and vascular organization

Hyperpermeable tumor vessels are responsible for elevated interstitial fluid pressure and altered flow patterns within the tumor microenvironment. These aberrant hydrodynamic stresses may enhance tumor development by stimulating the angiogenic activity of endothelial cells lining the tumor vasculature. However, it is currently not known to what extent shear forces affect endothelial organization or paracrine signaling during tumor angiogenesis. The objective of this study was to develop a three-dimensional (3D), in vitro microfluidic tumor vascular model for coculture of tumor and endothelial cells under varying flow shear stress conditions. A central microchannel embedded within a collagen hydrogel functions as a single neovessel through which tumor-relevant hydrodynamic stresses are introduced and quantified using microparticle image velocimetry (μ-PIV). This is the first use of μ-PIV in a tumor representative, 3D collagen matrix comprised of cylindrical microchannels, rather than planar geometries, to experimentally measure flow velocity and shear stress. Results demonstrate that endothelial cells develop a confluent endothelium on the microchannel lumen that maintains integrity under physiological flow shear stresses. Furthermore, this system provides downstream molecular analysis capability, as demonstrated by quantitative RT-PCR, in which, tumor cells significantly increase expression of proangiogenic genes in response to coculture with endothelial cells under low flow conditions. This work demonstrates that the microfluidic in vitro cell culture model can withstand a range of physiological flow rates and permit quantitative measurement of wall shear stress at the fluid-collagen interface using μ-PIV optical flow diagnostics, ultimately serving as a versatile platform for elucidating the role of fluid forces on tumor-endothelial cross talk.

In vitro angiogenesis induced by tumor-endothelial cell co-culture in bilayered, collagen I hydrogel bioengineered tumors

Although successful remission has been achieved when cancer is diagnosed and treated during its earliest stages of development, a tumor that has established neovascularization poses a significantly greater risk of mortality. The inability to recapitulate the complexities of a maturing in vivo tumor microenvironment in an in vitro setting has frustrated attempts to identify and test anti-angiogenesis therapies that are effective at permanently halting cancer progression. We have established an in vitro tumor angiogenesis model driven solely by paracrine signaling between MDA-MB-231 breast cancer cells and telomerase-immortalized human microvascular endothelial (TIME) cells co-cultured in a spatially relevant manner. The bilayered bioengineered tumor model consists of TIME cells cultured as an endothelium on the surface of an acellular collagen I hydrogel under which MDA-MB-231 cells are cultured in a separate collagen I hydrogel. Results showed that TIME cells co-cultured with the MDA-MB-231 cells demonstrated a significant increase in cell number, rapidly developed an elongated morphology, and invasively sprouted into the underlying acellular collagen I layer. Comparatively, bioengineered tumors cultured with less aggressive MCF7 breast cancer cells did not elicit an angiogenic response. Angiogenic sprouting was demonstrated by the formation of a complex capillary-like tubule network beneath the surface of a confluent endothelial monolayer with lumen formation and anastomosing branches. In vitro angiogenesis was dependent on vascular endothelial growth factor secretion, matrix concentration, and duration of co-culture. Basic fibroblast growth factor supplemented to the co-cultures augmented angiogenic sprouting. The development of improved preclinical tumor angiogenesis models, such as the one presented here, is critical for accurate evaluation and refinement of anti-angiogenesis therapies.

Poly(d-lactide)/poly(caprolactone) nanofiber-thermogelling chitosan gel composite scaffolds for osteochondral tissue regeneration in a rat model

Macroporous nanostructured scaffolds that can be made to closely mimic skeletal tissue extracellular matrix as well as have the potential to support bone and cartilage tissue regeneration. Porous poly(d-lactide)/poly(caprolactone) nanofiber scaffolds were prepared by electrospinning respective polymer solutions along with salt crystals, which were sintered into fiber mats into cylindrical shape of 1.5 mm diameter and cut into 2–3 mm length followed by salt leaching in distilled water. The poly(d-lactide)/poly(caprolactone)–chitosan composite scaffolds were prepared by impregnating the porous structure of the electrospun scaffold with a thermosensitive chitosan solution. For in vivo evaluation, the scaffolds with and without chitosan gel were press fitted into osteochondral defects in a rat model. Hematoxylin and eosin staining 6 weeks post implantation showed new bone formation within the porous scaffolds with and without chitosan gel. Significant bone formation was observed within both the scaffolds at 15 weeks post implantation compared to the control group. The results show that macroporous poly(d-lactide)/poly(caprolactone) nanofiber scaffolds can be prepared with and without chitosan hydrogel and can serve as an osteochondral scaffold. The porous scaffolds showed the ability to promote new bone formation at the defect site, and incorporation of chitosan within the pores did not adversely affect the tissue in-growth. However, the scaffolds did not support significant cartilage formation even after 15 weeks, which indicates the need for the addition of cells or bioactive molecules within the scaffold to support effective osteochondral tissue regeneration.

Cross-talk between endothelial and breast cancer cells regulates reciprocal expression of angiogenic factors in vitro

Reciprocal growth factor exchange between endothelial and malignant cells within the tumor microenvironment may directly stimulate neovascularization; however, the role of host vasculature in regulating tumor cell activity is not well understood. While previous studies have examined the angiogenic response of endothelial cells to tumor-secreted factors, few have explored tumor response to endothelial cells. Using an in vitro co-culture system, we investigated the influence of endothelial cells on the angiogenic phenotype of breast cancer cells. Specifically, VEGF, ANG1, and ANG2 gene and protein expression were assessed. When co-cultured with microvascular endothelial cells (HMEC-1), breast cancer cells (MDA-MB-231) significantly increased expression of ANG2 mRNA (20-fold relative to MDA-MB-231 monoculture). Moreover, MDA-MB-231/HMEC-1 co-cultures produced significantly increased levels of ANG2 (up to 580 pg/ml) and VEGF protein (up to 38,400 pg/ml) while ANG1 protein expression was decreased relative to MDA-MB-231 monocultures. Thus, the ratio of ANG1:ANG2 protein, a critical indicator of neovascularization, shifted in favor of ANG2, a phenomenon known to correlate with vessel destabilization and sprouting in vivo. This angiogenic response was not observed in nonmalignant breast epithelial cells (MCF-10A), where absolute protein levels of MCF-10A/HMEC-1 co-cultures were an order of magnitude less than that of the MDA-MB-231/HMEC-1 co-cultures. Results were further verified with a functional angiogenesis assay demonstrating well-defined microvascular endothelial cell (TIME) tube formation when cultured in media collected from MDA-MB-231/HMEC-1 co-cultures. This study demonstrates that the angiogenic activity of malignant mammary epithelial cells is significantly enhanced by the presence of endothelial cells.

Fabrication and characterization of three-dimensional electrospun scaffolds for bone tissue engineering

When traumatic injury, tumor removal, or disease results in significant bone loss, reconstructive surgery is required. Bone grafts are used in orthopedic reconstructive procedures to provide mechanical support and promote bone regeneration. In this study, we applied a heat sintering technique to fabricate 3D electrospun scaffolds that were used to evaluate effects of mineralization and fiber orientation on scaffold strength. We electrospun PLLA/gelatin scaffolds with a layer of PDLA and heat sintered them into three-dimensional cylindrical scaffolds. Scaffolds were mineralized by incubation in 10× simulated body fluid for 6, 24, and 48 h to evaluate the effect of mineralization on scaffolds compressive mechanical properties. The effects of heat sintering hydroxyapatite (HA) microparticles directly to the scaffolds on mineral deposition, distribution and mechanical properties of the scaffolds were also evaluated. We found that orientation of the fibers had little effect on the compressive mechanical properties of the scaffolds. However, increasing the mineralization times resulted in an increase in compressive mechanical properties. Also, the direct addition of HA microparticles had no effect on the scaffold mechanical properties, but had a significant effect on the mineral deposition on PLLA/gelatin scaffolds.

Design and analysis of braid-twist collagen scaffolds

Collagen type I fiber-based scaffolds for anterior cruciate ligament (ACL) replacement were evaluated for their mechanical properties and their ability to promote cellular proliferation. Prior to scaffold formation, two crosslinking methods were investigated on individual reconstituted collagen type I fibers, ultraviolet radiation, and 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC). Crosslinking with EDC for 4 hr yielded mechanical properties similar to the human ACL; therefore, scaffold crosslinking was done with EDC for 4 hr. A braid-twist scaffold design was used, and scaffolds were left uncrosslinked, crosslinked after the addition of gelatin, or crosslinked without gelatin. The ultimate tensile strength, Young's modulus, and viscoelastic properties of the scaffolds were then evaluated. In order to assess cellular response on the scaffolds, primary rat ligament fibroblast cells were seeded upon the scaffolds. Cell activity was evaluated at days 7, 14, and 21 using a Cell Titer 96(®) AQueous One Solution Cell Proliferation Assay (MTS Assay). The mechanical testing results showed that among the three scaffold groups, the crosslinked scaffolds without gelatin displayed an ultimate tensile strength, Young's modulus, and viscoelastic properties that were closest to the human ACL. Improvements are still desired to enhance the mechanical compliance and ductility of these scaffolds. Cell activity was observed on all cell-seeded scaffolds by day 7, but by day 21 only the crosslinked scaffolds without gelatin displayed increased cellular activity compared with the negative controls. Although improvement is still needed, the results suggest that these scaffolds have the potential to contribute toward an ACL replacement strategy.

Coaxial electrospun poly(ε-caprolactone), multiwalled carbon nanotubes, and polyacrylic acid/polyvinyl alcohol scaffold for skeletal muscle tissue engineering

Skeletal muscle repair after injury usually results in scar tissue and decreased functionality. In this study, we coaxially electrospun poly(ε-caprolactone), multiwalled carbon nanotubes, and a hydrogel consisting of polyvinyl alcohol and polyacrylic acid (PCL-MWCNT-H) to create a self-contained nanoactuating scaffold for skeletal muscle tissue replacement. This was then compared to electrospun PCL and PCL-MWCNT scaffolds. All scaffolds displayed some conductivity; however, MWCNT incorporation increased the conductivity. Only the PCL-MWCNT-H actuated when stimulated with 15 and 20 V. The PCL, PCL-MWCNT, and hydrogel only scaffolds demonstrated no reaction when 5, 8, 10, 15, and 20 V were applied. Thus, all components of the PCL-MWCNT-H scaffold are essential for movement. All three PCL-containing scaffolds were biocompatible, but the PCL-MWCNT-H scaffolds displayed more multinucleated cells with actin interaction. After tensile testing, the MWCNT-containing scaffolds had higher strength than the rat and pig skeletal muscle. Although the mechanical properties were higher than muscle, the PCL-MWCNT-H scaffold shows promise as a potential bioartificial nanoactuator for skeletal muscle.

Effect of prolotherapy on cellular proliferation and collagen deposition in MC3T3-E1 and patellar tendon fibroblast populations

Proliferative therapy, or prolotherapy, is a treatment for damaged connective tissues involving the injection of a solution (proliferant) which causes local cell death and triggers the body's wound healing cascade. Physicians vary in their use of this technique; it is employed for ligaments but has also been investigated for tissues such as cartilage. Physicians also vary in treatment regiments using different dosses of the proliferant. This study evaluates several proliferant dosages develop an optimal dosage that maximizes cell and collagen regeneration. This study also looks at cell and collagen regeneration in response to proliferant exposure outside of the healing cascade. MC3T3-E1 cells and patellar tendon fibroblasts were exposed to various amounts of the proliferant P2G and monitored over several weeks. The results showed an inverse relationship between proliferant concentration and cell viability and collagen production in MC3T3-E1 cells. Following exposure, cell populations experienced an initial decrease in cell number followed by increased proliferation. Trichrome staining over 4 weeks showed an increase in collagen production after proliferant exposure. However the cell numbers and amounts of collagen from the treated groups never surpassed those of the untreated groups, although collagen production was comparable in fibroblasts. The results of this basic study show that there is an effective proliferant dosage and point to a local response to the proliferant that increases cell proliferation and collagen production separate from the wound healing cascade. This local response may not be adequate for complete healing and assistance from the body's healing cascade may be required.

3D in vitro bioengineered tumors based on collagen I hydrogels

Cells cultured within a three-dimensional (3D) in vitro environment have the ability to acquire phenotypes and respond to stimuli analogous to in vivo biological systems. This approach has been utilized in tissue engineering and can also be applied to the development of a physiologically relevant in vitro tumor model. In this study, collagen I hydrogels cultured with MDA-MB-231 human breast cancer cells were bioengineered as a platform for in vitro solid tumor development. The cell-cell and cell-matrix interactions present during in vivo tissue progression were encouraged within the 3D hydrogel architecture, and the biocompatibility of collagen I supported unconfined cellular proliferation. The development of necrosis beyond a depth of ~150-200 μm and the expression of hypoxia-inducible factor (HIF)-1α were demonstrated in the in vitro bioengineered tumors. Oxygen and nutrient diffusion limitations through the collagen I matrix as well as competition for available nutrients resulted in growing levels of intra-cellular hypoxia, quantified by a statistically significant (p < 0.01) upregulation of HIF-1α gene expression. The bioengineered tumors also demonstrated promising angiogenic potential with a statistically significant (p < 0.001) upregulation of vascular endothelial growth factor (VEGF)-A gene expression. In addition, comparable gene expression analysis demonstrated a statistically significant increase of HIF-1α (p < 0.05) and VEGF-A (p < 0.001) by MDA-MB-231 cells cultured in the 3D collagen I hydrogels compared to cells cultured in a monolayer on two-dimensional tissue culture polystyrene. The results presented in this study demonstrate the capacity of collagen I hydrogels to facilitate the development of 3D in vitro bioengineered tumors that are representative of the pre-vascularized stages of in vivo solid tumor progression.

The Role of Type I Collagen Molecular Structure in Tendon Elastic Energy Storage

In order to facilitate locomotion and limb movement many animals store energy elastically in their tendons. The formation of crosslinked collagen fibers in tendons results in the conversion of weak, liquid-like embryonic tissues into tough elastic solids that can store energy and perform work. Collagen fibers in the form of fascicles are the major structural units found in tendons. The purpose of this paper is to review the literature on collagen self-assembly and tendon development and to relate this information to the development of elastic energy storage in nonmineralizing and mineralizing tendons. Of particular interest is the mechanism by which energy is stored in tendons during locomotion. In the turkey, much of the force generated by the gastrocnemius muscle is stored as elastic energy during tendon deformation and not within the muscle. As limbs move, the tendons are strained, causing the collagen fibers in the extracellular matrices to stretch. Through the analysis of turkey tendons, collagen fibers, and a molecular model, it is hypothesized that elastic energy is stored in the flexible regions of the collagen molecule. Data from the molecular model, mineralized fibers, and turkey tendons show that the presence of calcium and phosphate ions causes an increase in elastic energy stored per unit strain. Based on the theoretical modeling studies, the increase in stress with strain is a result of the initiation of stretching of the rigid regions of collagen molecules.

Evaluation of a hydrogel-fiber composite for ACL tissue engineering

The anterior cruciate ligament (ACL) is necessary for normal knee stability and movement. Unfortunately the ACL is also the most frequently injured ligament of the knee with severe disruptions requiring surgical intervention. In response to this, tissue engineering has emerged as an option for ACL replacement and repair. In this study we present a novel hydrogel-fibrous scaffold as a potential option for ACL replacement. The scaffold was composed of PLLA fibers, in a previously evaluated braid-twist structure, combined with a polyethylene glycol diacrylate (PEGDA) hydrogel to improve viscoelastic properties. Both hydrogel concentration (10%, 15%, and 20%) and amount of hydrogel (soaking the fibrous scaffold in hydrogel solution or encasing the scaffold in a block of hydrogel) were evaluated. It was found that the braid-twist scaffold had a greater porosity and larger number of pores above 100 μm than braided scaffolds with the same braiding angle. After testing for their effects on swelling, fiber degradation, and protein release, as well as viscoelastic and tensile testing (when combined with fibrous scaffolds), it was found that the composite scaffold soaked in 10% hydrogel had the best chemical release and mechanical properties. The optimized structure behaved similarly to natural ligament in tension with the addition of the hydrogel decreasing the ultimate tensile stress (UTS), but the UTS was still comparable to natural ACL. In addition, cellular studies showed that the hydrogel-PLLA fiber composite supported fibroblast growth.

Characterization of electrospun poly(L-lactide) and gold nanoparticle composite scaffolds for skeletal muscle tissue engineering

Traumatic injuries can interrupt muscle contraction by damaging the skeletal muscle and/or the peripheral nerves. The healing process results in scar tissue formation that impedes muscle function. Electrospinning and metal nanoparticles (Nps) can create a scaffold that will trigger muscle cell elongation, orientation, fusion, and striation. Poly(L-lactic acid) (PLLA) and gold (Au) Nps were electrospun to create three composite scaffolds, 7% Au-PLLA, 13% Au-PLLA and 21% Au-PLLA, and compared to PLLA alone. The scaffolds had a conductivity of 0.008 ± 0.003 S/cm for PLLA, 0.053 ± 0.015 S/cm for 7% Au-PLLA, 0.076 ± 0.004 S/cm for 13% Au-PLLA and 0.094 ± 0.037 S/cm for 21% Au-PLLA. Next, a cell study was conducted with rat primary muscle cells and all three Au-PLLA scaffolds. The first cell study showed low cell proliferation on all three of the Au-PLLA scaffolds; however, the second cell study showed that this was not due to Au Nps toxicity. Instead, low cell proliferation may be a marker for myotube differentiation and fusion. Values for the elastic modulus and yield stress for the Au-PLLA scaffolds on days 0, 7, 14, 21 and 28 were much higher than those for skeletal muscle tissue. Therefore, lower amounts of Au Nps may be utilized to create a biodegradable, biocompatible and conductive scaffold for skeletal muscle repair.

Fabrication and mechanical characterization of 3D electrospun scaffolds for tissue engineering

Electrospinning is a polymer processing technique that produces fibrous structures comparable to the extracellular matrix of many tissues. Electrospinning, however, has been severely limited in its tissue engineering capabilities because this technique has produced few three-dimensional structures. Sintering of electrospun materials provides a method to fabricate unique architectures and allow much larger structures to be made. Electrospun mats were sintered into strips and cylinders, and their tensile and compressive mechanical properties were measured. In addition, electrospun materials with salt pores (salt embedded within the material and then leached out) were fabricated to improve porosity of the electrospun materials for tissue engineering scaffolds. Sintered electrospun poly(D,L-lactide) and poly(L-lactide) (PDLA/PLLA) materials have higher tensile mechanical properties (modulus: 72.3 MPa, yield: 960 kPa) compared to unsintered PLLA (modulus: 40.36 MPa, yield: 675.5 kPa). Electrospun PDLA/PLLA cylinders with and without salt-leached pores had compressive moduli of 6.69 and 26.86 MPa, respectively, and compressive yields of 1.36 and 0.56 MPa, respectively. Sintering of electrospun materials is a novel technique that improves electrospinning application in tissue engineering by increasing the size and types of electrospun structures that can be fabricated.

A link between stent radial forces and vascular wall remodeling: the discovery of an optimal stent radial force for minimal vessel restenosis

Coronary and peripheral artery disease (PAD) continue to be primary causes of morbidity and mortality in western nations; percutaneous transluminal angioplasty (PTA) with stenting has become a popular treatment. Unfortunately, restenosis is a significant problem following intravascular stent placement. This study considers the contribution of stent forces in vascular stenosis and remodeling to develop an equation for identifying the optimal stent force. z-Type stents of three radial forces [low (3.4 N), high (16.4 N), and ultrahigh (19.4 N)] were deployed into the iliac arteries of a juvenile porcine model. Vessel diameters were measured before, after deployment, and again at 30 days. At 30 days animals were killed and the vessels fixed in situ. After implantation, there was a significant increase in total thickness and neointimal hyperplasia with increasing stent force. The model for vessel radius and experimental data was in agreement. The model shows that maximum late-term radius is achieved with a stent deployment stress of 480 kPa, which occurs at the end of the stress-strain curve nonlinear domain and beginning of the high-strain collagen domain. The results and calculations suggest that an optimal stent force exists that is subject to the geometry, structure, and mechanics of the target vessel. To achieve maximum late-term dilatation, stents should not produce stress in the vessel wall greater than the end of the transitional domain of the vessel's stress-strain curve. This finding is extremely important for vascular stent development and will be expanded to preliminary vessel wall injury and atherosclerotic models.

Tissue engineering of the anterior cruciate ligament: the viscoelastic behavior and cell viability of a novel braid-twist scaffold

The anterior cruciate ligament (ACL) is the most commonly injured ligament of the knee; it also contributes to normal knee function and stability. Due to its poor healing potential severe ACL damage requires surgical intervention, ranging from suturing to complete replacement. Current ACL replacements have a host of limitations that prevent their extensive use. Investigators have begun to utilize tissue-engineering techniques to create new options for ACL repair, regeneration and replacement. In this study we tested novel braid-twist scaffolds, as well as braided scaffolds, twisted fiber scaffolds and aligned fiber scaffolds, for use as ACL replacements composed of poly(L-lactic acid) fibers. Scaffolds were examined using stress relaxation tests, cell viability assays and scanning electron microscopy. The behaviors of the braid-twist scaffolds were modeled with Maxwell and quasi-linear viscoelastic (QLV) models. In stress relaxation tests, the braid-twist scaffolds behaved similarly to native ACL tissue, with final normalized stresses of 87% and 83% after an 8 N load. There was agreement between the experimental data and the Maxwell model when the model included an element for each structural element in the scaffold. There was also agreement between the experimental data and QLV model, scaffolds with similar braiding angles shared constants. In cell proliferation studies no differences were found between fibroblast growth on the braided scaffolds and the braid-twist scaffolds. SEM images showed the presence of new extracellular matrix. Data from this and previous tensile studies demonstrate that the braid-twist scaffold design may be effective in scaffolds for ACL tissue regeneration.

Elastic energy storage in an unmineralized collagen type I molecular model with explicit solvation and water infiltration

Collagen type I is a structural protein that provides tensile strength to tendons and ligaments. Type I collagen molecules form collagen fibers, which are viscoelastic and can therefore store energy elastically via molecular elongation and dissipate viscous energy through molecular rearrangement and fibrillar slippage. The ability to store elastic energy is important for the resiliency of tendons and ligaments, which must be able to deform and revert to their initial lengths with changes in load. In an earlier paper by one of the present authors, molecular modeling was used to investigate the role of mineralization upon elastic energy storage in collagen type I. Their collagen model showed a similar trend to their experimental data but with an over-estimation of elastic energy storage. Their simulations were conducted in vacuum and employed a distance-dependent dielectric function. In this study, we performed a re-evaluation of Freeman and Silver's model data incorporating the effects of explicit solvation and water infiltration, in order to determine whether the model data could be improved with a more accurate representation of the solvent and osmotic effects. We observed an average decrease in the model's elastic energy storage of 45.1%+/-6.9% in closer proximity to Freeman and Silver's experimental data. This suggests that although the distance-dependent dielectric implicit solvation approach was favored for its increased speed and decreased computational requirements, an explicit representation of water may be necessary to more accurately model solvent interactions in this particular system. In this paper, we discuss the collagen model described by Freeman and Silver, the present model building approach, the application of the present model to that of Freeman and Silver, and additional assumptions and limitations.

Tissue Engineering Options for Ligament Healing

The anterior cruciate ligament (ACL) is one of five ligaments in the knee that are important for stability and kinematics. It is also the most commonly injured ligament of the knee and due to its poor healing potential, severe damage warrants surgical intervention including complete replacement. Ligaments are longitudinally arranged, complex tissues; the mechanical properties of ligaments are a direct result of their components and the arrangement of these components in the tissue. It is these mechanics that have made ligaments so difficult to replace. Past ACL replacements have had many limitations that prevented their extensive use. These limitations range from mechanical fatigue over time to fraying of the device after implantation. In light of these problems, investigators have begun to pursue a host of new techniques to create a range of viable options for the repair, replacement, and/or regeneration of the ACL. These options include tissue engineered scaffolds with novel designs and specially treated transplanted tissues. In this article, the composition, arrangement, and mechanics of the ACL will be discussed in order to elucidate important aspects of ACL repair; past replacements will also be discussed. Afterwards, novel replacement options that look to solve problems faced by older replacement options will be presented. These devices use a wide variety of materials and designs to replicate ligament mechanics and allow for new tissue regeneration.

Tissue engineering of the anterior cruciate ligament using a braid-twist scaffold design

The anterior cruciate ligament (ACL) is the most commonly injured intra-articular ligament of the knee. The insufficient vascularization of this tissue prevents it from healing completely after extreme tearing or rupture, creating a need for ACL grafts for reconstruction. The limitations of existing grafts have motivated the investigation of tissue-engineered ACL grafts. A successful tissue-engineered graft must possess mechanical properties similar to the ACL; to date no commercially available synthetic graft has achieved this. To accomplish this goal we have combined the techniques of polymer fiber braiding and twisting to design a novel poly L-lactic acid (PLLA) braid-twist scaffold for ACL tissue engineering. The scaffold is designed to accurately mimic the biomechanical profile and mechanical properties of the ACL. In this study, braid-twist scaffolds were constructed and compared to braided scaffolds and twisted fiber scaffolds. The addition of fiber twisting to the braided scaffold resulted in a significant increase in the ultimate tensile strength, an increase in ultimate strain, and an increase in the length of the toe region in these constructs over scaffolds that were braided. Based on the findings of this study, the braid-twist scaffold studied was found to be a promising construct for tissue engineering of the ACL.

Ligament tissue engineering: an evolutionary materials science approach

The anterior cruciate ligament (ACL) is important for knee stabilization. Unfortunately, it is also the most commonly injured intra-articular ligament. Due to poor vascularization, the ACL has inferior healing capability and is usually replaced after significant damage has occurred. Currently available replacements have a host of limitations, this has prompted the search for tissue-engineered solutions for ACL repair. Presently investigated scaffolds range from twisted fiber architectures composed of silk fibers to complex three-dimensional braided structures composed of poly (L-lactic acid) fibers. The purpose of these tissue-engineered constructs is to apply approaches such as the use of porous scaffolds, use of cells, and the application of growth factors to promote ligament tissue regeneration while providing mechanical properties similar to natural ligament.

Fiber-based tissue-engineered scaffold for ligament replacement: design considerations and in vitro evaluation

The anterior cruciate ligament (ACL) is the major intraarticular ligamentous structure of the knee, which functions as a joint stabilizer. It is the most commonly injured ligament of the knee, with over 150,000 ACL surgeries performed annually in the United States. Due to limitations associated with current grafts for ACL reconstruction, there is a significant demand for alternative graft systems. We report here the development of a biodegradable, tissue-engineered ACL graft. Several design parameters including construct architecture, porosity, degradability, and cell source were examined. This graft system is based on polymeric fibers of polylactide-co-glycolide 10:90, and it was fabricated using a novel, three-dimensional braiding technology. The resultant micro-porous scaffold exhibited optimal pore diameters (175-233 microm) for ligament tissue ingrowth, and initial mechanical properties of the construct approximate those of the native ligament.

Anterior cruciate ligament regeneration using braided biodegradable scaffolds: in vitro optimization studies

The anterior cruciate ligament (ACL) is the most commonly injured intra-articular ligament of the knee, and limitations in existing reconstruction grafts have prompted an interest in tissue engineered solutions. Previously, we reported on a tissue-engineered ACL scaffold fabricated using a novel, three-dimensional braiding technology. A critical factor in determining cellular response to such a graft is material selection. The objective of this in vitro study was to optimize the braided scaffold, focusing on material composition and the identification of an appropriate polymer. The selection criteria are based on cellular response, construct degradation, and the associated mechanical properties. Three compositions of poly-alpha-hydroxyester fibers, namely polyglycolic acid (PGA), poly-L-lactic acid (PLLA), and polylactic-co-glycolic acid 82:18 (PLAGA) were examined. The effects of polymer composition on scaffold mechanical properties and degradation were evaluated in physiologically relevant solutions. Prior to culturing with primary rabbit ACL cells, scaffolds were pre-coated with fibronectin (Fn, PGA-Fn, PLAGA-Fn, PLLA-Fn), an important protein which is upregulated during ligament healing. Cell attachment and growth were examined as a function of time and polymer composition. While PGA scaffolds measured the highest tensile strength followed by PLLA and PLAGA, its rapid degradation in vitro resulted in matrix disruption and cell death over time. PLLA-based scaffolds maintained their structural integrity and exhibited superior mechanical properties over time. The response of ACL cells was found to be dependent on polymer composition, with the highest cell number measured on PLLA-Fn scaffolds. Surface modification of polymer scaffolds with Fn improved cell attachment efficiency and effected the long-term matrix production by ACL cells on PLLA and PLAGA scaffolds. Therefore based on the overall cellular response and its temporal mechanical and degradation properties in vitro, the PLLA braided scaffold pre-coated with Fn was found to be the most suitable substrate for ACL tissue engineering.

The effects of prestrain and collagen fibril alignment on in vitro mineralization of self-assembled collagen fibers

Collagen fibers are under tension in most extracellular matrices both prior to and during normal loading. This tension not only provides mechanical advantages, but also appears to establish a loading basis for the stimulation of mechanochemical transduction processes. The presence of tensile loads applied to collagen fibers also results in physical alignment of the collagen fibrils along the tensile axis. This alignment may influence biological processes such as mineralization. In this study we report a comparison between elastic and viscous stress-strain curves and mineral contents of self-assembled collagen fibers that were strained to 30% of their original lengths and then mineralized, and self-assembled collagen fibers that were not strained before being mineralized. We concluded that the application of strain changes the organization of the collagenous matrix and alters the calcium phosphate nucleation and/or growth in the matrix. In addition, when the mechanical behavior of collagen fibers is compared with mechanical data from mineralized turkey tendon, the results indicate that collagen fibril-to-fibril interactions present in turkey tendon appear to be more organized compared with self-assembled aligned collagen fibers. We concluded that organized collagen-collagen interactions appear to be an important characteristic required for elastic energy storage in tendon.