Osteogenic differentiation of cultured rat and human bone marrow cells on the surface of zinc‐releasing calcium phosphate ceramics

Efficacy of sintered Zinc-doped fluorapatite scaffold as an antimicrobial regenerative bone filler for dental applications

OBJECTIVES

The objective of this study was to assess whether zinc-doped fluorapatite (ZnFA) could serve as an effective antimicrobial dental bone filler for bone regeneration compared to autografts.

METHODS

FA and 2 % zinc-doped FA (2ZnFA) were synthesized and characterized in-house. Compressed and sintered FA and 2ZnFA disks were incubated with bacteria to assess antimicrobial properties. Adipose-derived stem cells were cultured on these discs to evaluate the surfaces' ability to support cell growth and promote osteogenic differentiation. Surfaces exhibiting the highest expressions of the bone markers osteopontin and osteocalcin were selected for an in vivo study in a rat mandibular defect model. Twenty rats were divided into 5 groups, equally, and a 5 mm surgical defect of the jaw was left untreated or filled with 2ZnFA, FA, autograft, or demineralized bone matrix (DBM). At 12 weeks, the defects and surrounding tissues were harvested and subjected to microCT and histological evaluations.

RESULTS

Standard techniques such as FTIR, ICP-MS, fluoride probe, and XRD revealed the sintered FA and ZnFA's chemical compositions and structures. Bacterial studies revealed no significant differences in surface bacterial adhesion properties between FA and 2ZnFA, but significantly fewer bacterial loads than control titanium discs (p < 0.05). Cell culture data confirmed that both surfaces could support cell growth and promote the osteogenic differentiation of stem cells. MicroCT analysis confirmed statistical similarities in bone regeneration within FA, 2ZnFA, and autograft groups.

CONCLUSION

The data suggests that both FA and 2ZnFA could serve as alternatives to autograft materials, which are the current gold standard. Moreover, these bone fillers outperformed DBM, an allograft material commonly used as a dental bone void filler.

CLINICAL SIGNIFICANCE

The use of FA or 2ZnFA for treating mandibular defects led to bone regeneration statistically similar to autograft repair and significantly outperformed the widely used dental bone filler, DBM. Additional translational research may confirm FA-based materials as superior substitutes for existing synthetic bone fillers, ultimately enhancing patient outcomes.

Extraction of natural hydroxyapatite for biomedical applications—A review

Hydroxyapatite has recently played a crucial role in the sustainable development of biomedical applications. Publications related to hydroxyapatite as filler for biopolymers have exhibited an increasing trend due to the expanding research output. Based on the latest publications, the authors reviewed the research trends regarding hydroxyapatite use in biomedical applications. Analysis of the Scopus database using the keywords ‘hydroxyapatite” and “biomedical applications” determined that 1,714 papers were produced between 2012 and 2021. The number of publications related to these keywords more than doubled between 2012 (99) and 2021 (247). The hydrothermal method, solid-state reactions, the sol-gel process, emulsion, micro-emulsion, and mostly chemical precipitation were used to produce synthetic hydroxyapatite. Meanwhile, calcination, alkaline hydrolysis, precipitation, hydrothermal, and a combination of these techniques were used in producing natural hydroxyapatite. Studies in the current literature reveal that shell-based animal sources have been frequently used as hydroxyapatite resources during investigations concerning biomedical applications, while calcination was the extraction method most often applied. Essential trace elements of fish bone, oyster shell, and eggshell were also found in hydroxyapatite powder. Abalone mussel shell and eggshell showed Ca/P ratios closer to the stoichiometric ratio due to the use of effective extraction methods such as manipulating aging time or stirring process parameters. This review should greatly assist by offering scientific insights to support all the recommended future research works, not only that associated with biomedical applications.

Peculiarities of the formation, structural and morphological properties of zinc whitlockite (Ca18Zn2(HPO4)2(PO4)12) synthesized via a phase transformation process under hydrothermal conditions

In the present work, the formation of zinc whitlockite via a dissolution–precipitation process was investigated in detail. The influence of medium pH, reaction time, temperature and concentration of precursors on the formation of the material was studied.

Synergistic effects of immunoregulation and osteoinduction of ds-block elements on titanium surface

Ds-block elements have been gaining increasing attention in the field of biomaterials modification, owing to their excellent biological properties, such as antibiosis, osteogenesis, etc. However, their function mechanisms are not well understood and conflicting conclusions were drawn by previous studies on this issue, which are mainly resulted from the inconsistent experimental conditions. In this work, three most widely used ds-block elements, copper, zinc, and silver were introduced on titanium substrate by plasma immersion ion implantation method to investigate the rule of ds-block elements in the immune responses. Results showed that the implanted samples could decrease the inflammatory responses compared with Ti sample. The trend of anti-inflammatory effects of macrophages on samples was in correlation with cellular ROS levels, which was induced by the implanted biomaterials and positively correlated with the number of valence electrons of ds-block elements. The co-culture experiments of macrophages and bone marrow mesenchymal stem cells showed that these two kinds of cells could enhance the anti-inflammation and osteogenesis of samples by the paracrine manner of PGE2. In general, in their steady states on titanium substrate (Cu2+, Zn2+, Ag), the ds-block elements with more valence electrons exhibit better anti-inflammatory and osteogenic effects. Moreover, molecular biology experiments indicate that the PGE2-related signaling pathway may contribute to the desired immunoregulation and osteoinduction capability of ds-block elements. These findings suggest a correlation between the number of valence electrons of ds-block elements and the relevant biological responses, which provides new insight into the selection of implanted ions and surface design of biomaterials.

Bioinorganic supplementation of calcium phosphate-based bone substitutes to improve in vivo performance: a systematic review and meta-analysis of animal studies

Supplementation of CaP-based bone graft substitutes with bioinorganics such as strontium, zinc or silicon is an interesting approach to increase the biological performance in terms of bone regenerative potential of calcium phosphate (CaP)-based bone substitutes. However, the in vivo efficacy of this approach has not been systematically analyzed, yet. Consequently, we performed a systematic review using the available literature regarding the effect of bioinorganic supplementation in CaP-based biomaterials on new bone formation and material degradation in preclinical animal bone defect models and studied this effect quantitatively by performing a meta-analysis. Additional subgroup analyses were used to study the effect of different bioinorganics, animal model, or phase category of CaP-based biomaterial on bone formation or material degradation. Results show that bioinorganic supplementation increases new bone formation (standardized mean difference [SMD]: 1.43 SD, confidence interval [CI]: 1.13-1.73). Additional subgroup analysis showed that strontium, magnesium and silica significantly enhanced bone formation, while zinc did not have any effect. This effect of bioinorganic supplementation on new bone formation was stronger for DCPD or β-TCP and biphasic CaPs than for HA or α-TCP (p < 0.001). In general, material degradation was slightly hindered by bioinorganic supplementation (mean difference [MD]: 0.84%, CI: 0.01-1.66), with the exception of strontium that significantly enhanced degradation. Overall, bioinorganic supplementation represents an effective approach to enhance the biological performance of CaP-based bone substitutes.

Drug Delivery Systems Based on Titania Nanotubes and Active Agents for Enhanced Osseointegration of Bone Implants

TiO2 nanotubes (TNTs) are attractive nanostructures for localized drug delivery. Owing to their excellent biocompatibility and physicochemical properties, numerous functionalizations of TNTs have been attempted for their use as therapeutic agent delivery platforms. In this review, we discuss the current advances in the applications of TNT-based delivery systems with an emphasis on the various functionalizations of TNTs for enhancing osteogenesis at the bone-implant interface and for preventing implant-related infection. Innovation of therapies for enhancing osteogenesis still represents a critical challenge in regeneration of bone defects. The overall concept focuses on the use of osteoconductive materials in combination with the use of osteoinductive or osteopromotive factors. In this context, we highlight the strategies for improving the functionality of TNTs, using five classes of bioactive agents: growth factors (GFs), statins, plant derived molecules, inorganic therapeutic ions/nanoparticles (NPs) and antimicrobial compounds.

Osteogenic potential of poly(ethylene glycol)-amorphous calcium phosphate composites on human mesenchymal stem cells

Synthetic hydrogel-amorphous calcium phosphate composites are promising candidates to substitute biologically sourced scaffolds for bone repair. While the hydrogel matrix serves as a template for stem cell colonisation, amorphous calcium phosphate s provide mechanical integrity with the potential to stimulate osteogenic differentiation. Here, we utilise composites of poly(ethylene glycol)-based hydrogels and differently stabilised amorphous calcium phosphate to investigate potential effects on attachment and osteogenic differentiation of human mesenchymal stem cells. We found that functionalisation with integrin binding motifs in the form of RGD tripeptide was necessary to allow adhesion of large numbers of cells in spread morphology. Slow dissolution of amorphous calcium phosphate mineral in the scaffolds over at least 21 days was observed, resulting in the release of calcium and zinc ions into the cell culture medium. While we qualitatively observed an increasingly mineralised extracellular matrix along with calcium deposition in the presence of amorphous calcium phosphate-loaded scaffolds, we did not observe significant changes in the expression of selected osteogenic markers.

A systematic review of the interaction and effects generated by antimicrobial metallic substituents in bone tissue engineering

Changes brought about by metal ions and metal nanoparticles within bacterial cells and the damage caused to the cellular membrane upon contact with negatively charged surface components.

Investigation on the in vitro cytocompatibility of Mg-Zn-Y-Nd-Zr alloys as degradable orthopaedic implant materials

Mg-Zn-Y-Nd-Zr alloy has been developed as a new type of biodegradable orthopaedic implant material by the authors' research group with its excellent mechanical properties and controllable degradation rate. In this study, the cytocompatibility of Mg-Zn-Y-Nd-Zr alloy was systematically evaluated through in vitro cell culture method. MTT assay was applied to evaluate the cytotoxicity of Mg-Zn-Y-Nd-Zr alloy and no toxic effect was observed on L929 and MC3T3-E1 cells followed the protocol of ISO 10993 standard. Considering the potential ion accumulation in the bony environment, this study further investigated the cytotoxic effect of accumulated metallic ions during the alloy degradation by extending the extract preparation time. When the extract preparation time was prolonged to 1440 h, the accumulated metallic ions leaded to severe cell apoptosis, of which the combined ion concentration was determined as 39.5-65.8 µM of Mg²⁺, 3.5-5.9 µM of Zn²⁺, 0.44-0.74 µM of Y³⁺, 0.3-0.52 µM of Nd³⁺ and 0.11-0.18 µM of Zr⁴⁺ for L929, and 65.8-92.2 µM of Mg²⁺, 5.9-8.3 µM of Zn²⁺, 0.74-1.04 µM of Y³⁺, 0.52-0.73 µM of Nd³⁺ and 0.18-0.25 µM of Zr⁴⁺ for MC3T3-E1 cells. Besides the cell viability assessment, high expression of ALP activity and calcified nodules implied that metal elements in Mg-Zn-Y-Nd-Zr alloys can promote the osteogenic differentiation. Hence, excellent cytocompatibility has equipped Mg-Zn-Y-Nd-Zr alloy as a promising candidate for orthopaedic implant application, which can remarkably guide the magnesium-based alloy design and provide scientific evidence for clinical practice in future.

Effect of microporosity on scaffolds for bone tissue engineering

Microporosity has a critical role in improving the osteogenesis of scaffolds for bone tissue engineering. Although the exact mechanism, by which it promotes new bone formation, is not well recognized yet, the related hypothesis can be found in many previous studies. This review presents those possible mechanisms about how the microporosity enhances the osteogenic-related functions of cells in vitro and the osteogenic activity of scaffolds in vivo. In summary, the increased specific surface areas by microporosity can offer more protein adsorption sites and accelerate the release of degradation products, which facilitate the interactions between scaffolds and cells. Meanwhile, the unique surface properties of microporous scaffolds have a considerable effect on the protein adsorption. Moreover, capillary force generated by the microporosity can improve the attachment of bone-related cells on the scaffolds surface, and even make the cells achieve penetration into the micropores smaller than them. This review also pays attention to the relationship between the biological and mechanical properties of microporous scaffolds. Although lots of achievements have been obtained, there is still a lot of work to do, some of which has been proposed in the conclusions and perspectives part.

Bio-inspired synthesis of a hierarchical self-assembled zinc phosphate nanostructure in the presence of cowpea mosaic virus: in vitro cell cycle, proliferation and prospects for tissue regeneration

Self-assembly is an important auto-organization process used in designing structural biomaterials which have the potential capability to heal tissues after traumatic injury. Although various materials having the ability to heal after injury are available, there is still a substantial need to develop new improved materials. To address this issue, we have developed hierarchical three-dimensional (3D) self-assembled zinc phosphate (Zn₃(PO₄)₂) in the presence of cowpea mosaic virus (CPMV). Zn₃(PO₄)₂ nanoparticles are self-assembled into nanosheets with a high degree of isotropy and then self-organized into a 3D structure that can enhance surface interactions with biological entities. The self-assembled structure is formed through the auto-organization of nanoparticles of size ∼50 nm under the influence of CPMV. The cellular response of self-assembled Zn₃(PO₄)₂ and cell-particle adhesion behavior have been investigated through in vitro studies using modeled osteoblast-like MG63 cells. Self-assembled Zn₃(PO₄)₂ resulted in proliferation of MG63 cells of up to 310% within 7 days of incubation. A 15% higher proliferation was obtained than with commercially available hydroxyapatite (HAp). Immunofluorescent analysis of MG63 cells after co-culturing with self-assembled Zn₃(PO₄)₂ confirmed the healthy cytoskeletal organization and dense proliferation of MG63 cells. Further, Zn₃(PO₄)₂ exhibited ∼28% cell-cycle progression in S phase, which is higher than obtained with commercially available HAp. Overall, these results demonstrate the multiple functions of hierarchical self-assembled Zn₃(PO₄)₂ in the regeneration of bone tissue without defects and increasing the formation of cellular networks, and suggest its use in bone tissue engineering.

The role of new zinc incorporated monetite cements on osteogenic differentiation of human mesenchymal stem cells

β-Tricalcium phosphate particles were sintered in the presence of different amounts (0-0.72mol) of zinc oxide (ZnO) to prepare zinc doped β-TCP (Znβ-TCP) particles for further use in novel monetite (DCPA: CaHPO₄) zinc incorporated bone cements with osteogenic differentiation potential towards human mesenchymal stem cells (hMSCs). XRD analysis of zinc incorporated cements prepared with β-TCP reagent particles doped with different amount of ZnO (i.e. 0.03, 0.09 and 0.18mol ZnO) revealed the presence of unreacted Znβ-TCP and monetite. Furthermore, it was shown that zinc ions preferentially occupied the β-TCP crystal lattice rather than the monetite one. Release experiments indicated a burst release of ions from the different fabricated cements during the first 24h of immersion with zinc concentrations ranging between 85 and 100% of the total concentration released over a period of 21days. Cell proliferation significantly increased (P<0.05) on zinc incorporated monetite respect to control samples (Zinc-free cement) at 7 and 14days post seeding. The expression of Runx-2 was significantly up regulated (P<0.05) in the case of cells seeded on monetite prepared with β-TCP doped with 0.03 moles of ZnO. On the other hand, the cell mineralization as well as the expression of osteogenic marker genes ALP and OSC decreased significantly (P<0.05) at 14days post cell seeding. In conclusion, these results suggest that the zinc ions released from the cements during the first 24h of culture played a critical role in regulating the osteogenic differentiation of hMSCs.

Characterization of the mechanical behaviors and bioactivity of tetrapod ZnO whiskers reinforced bioactive glass/gelatin composite scaffolds

The purpose of this study is to construct bone tissue engineering scaffold with high porosity, good mechanical properties, and biological activities. Bioactive glass/gelatin composite scaffolds with different amounts of tetrapod zinc oxide whiskers were produced. The morphology, mechanical properties and in vitro bioactivity of the composite scaffolds were investigated. Results showed that, the composite scaffolds had open pores with a high degree of interconnectivity, and the porosity was higher than 80%. With the amount of ZnO whiskers increased, the mechanical properties of scaffolds increased. However, the reinforcing effect began to decrease when the addition is higher than 2wt%, which was resulted by the aggregation of the ZnO whiskers. In vitro test showed that, the composite scaffolds processed good biodegradability, and in vitro apatite-forming ability. The release of zinc ions retarded the growth of the HCA, so the HCA deposited on the scaffolds with ZnO was amorphous and worm-like. Furthermore, the composite scaffolds had good biocompatibility assessed by in vitro cell tests using rMSCs. All results are promising for the application of the composite scaffolds in bone repair.

Improvement in degradability of 58s glass scaffolds by ZnO and β-TCP modification

58s bioactive glass shows great potential for bone defects repair. However, at early repairing stage, the degradation rate of 58s glass is too fast due to the fast ion-exchange. At later repairing stage, the degradation rate of 58s glass is too slow due to the high dense mineral layer. In this work, Zinc oxide (ZnO) and β-tricalcium phosphate (β-TCP) were introduced into 58s glass bone scaffolds to improve the degradability. The results showed that ZnO could decrease the degradation rate and promote the stability of 58s glass at early repairing stage. Moreover, the presence of β-TCP appeared to increase the degradation rate at a later stage of repairing. Furthermore, in vitro biocompatibility study, carried out using human osteoblast-like cells (MG63), demonstrated that ZnO and β-TCP enhanced cell attachment and proliferation. The study provided a reference for further research in bone tissue engineering.

Zinc-modified titanium surface enhances osteoblast differentiation of dental pulp stem cells in vitro

Zinc is an essential trace element that plays an important role in differentiation of osteoblasts and bone modeling. This in vitro study aimed to evaluate the osteoblast differentiation of human dental pulp stem cells (DPSCs) on zinc-modified titanium (Zn-Ti) that releases zinc ions from its surface. Based on real-time PCR, alkaline phosphatase (ALP) activity and Western blot analysis data, we investigated osteoblast differentiation of DPSCs cultured on Zn-Ti and controls. DPSCs cultured on Zn-Ti exhibited significantly up-regulated gene expression levels of osteoblast-related genes of type I collagen (Col I), bone morphogenetic protein 2 (BMP2), ALP, runt-related transcription factor 2 (Runx2), osteopontin (OPN), and vascular endothelial growth factor A (VEGF A), as compared with controls. We also investigated extracellular matrix (ECM) mineralization by Alizarin Red S (ARS) staining and found that Zn-Ti significantly promoted ECM mineralization when compared with controls. These findings suggest that the combination of Zn-Ti and DPSCs provides a novel approach for bone regeneration therapy.

Enhanced Osteogenic Activity of TiO2 Nanorod Films with Microscaled Distribution of Zn-CaP

The topography at the micro-/nanoscale level and bioactive composition of material surfaces have been thought to play vital roles in their interactions with cells. However, it is still a challenge to further modify special topography with biodegradable composition or vice versa. In this study, TiO2 nanorod films covered with microscale-distributed Zn-containing calcium phosphate (Zn-CaP) were prepared, trying to create a micro-/nanoscale topography and Zn(2+) release capability. MC3T3-E1 cells cultured on TiO2 nanorod film with sparsely distributed Zn-CaP (TiO2/S-ZCP) had significantly higher biological responses than those on the films with densely distributed Zn-CaP (TiO2/D-ZCP) and fully covered Zn-CaP (F-ZCP). TiO2/S-ZCP film was demonstrated to facilitate osteogenic differentiation much more strongly than F-ZCP and TiO2/D-ZCP films based on evaluations of ALP, related gene expressions, and extracellular matrix mineralization. The higher osteogenic differentiation on TiO2/S-ZCP film is ascribed to the micro-/nanoscale topography from Zn-CaP coverage promoting cell adhesion and filopodia extension, and inducing differentiation-orientation in the initial stage. And consequently Zn(2+) release results in enhancement of differentiation. Therefore, we believe that better organization of the micro-/nanotopography and bioactive ion release on the surface would be a promising way to enhance osteogenic activity for orthopedic and dental implants.

Bioresorbable zinc hydroxyapatite guided bone regeneration membrane for bone regeneration

OBJECTIVES

The aim of this study was to investigate the bone regenerative properties of a heat treated cross-linked GBR membrane with zinc hydroxyapatite powders in the rat calvarial defect model over a 6-week period.

MATERIAL AND METHODS

In vitro physio-chemical characterization involved X-ray diffraction analysis, surface topology by scanning electron microscopy, and zinc release studies in physiological buffers. Bilateral rat calvarial defects were used to compare the Zn-HAp membranes against the commercially available collagen membranes and the unfilled defect group through radiological and histological evaluation.

RESULTS

The synthesized Zn-MEM (100 μm thick) showed no zinc ions released in the phosphate buffer solution (PBS) buffer, but zinc was observed under acidic conditions. At 6 weeks, both the micro-CT and histological analyses revealed that the Zn-MEM group yielded significantly greater bone formation with 80 ± 2% of bone filled, as compared with 60 ± 5% in the collagen membrane and 40 ± 2% in the unfilled control group.

CONCLUSION

This study demonstrated the use of heat treatment as an alternative method to cross-linking the Zn-MEM to be applied as a GBR membrane. Its synthesis and production are relatively simple to fabricate, and the membrane had rough surface features on one side, which might be beneficial for cellular activities. In a rat calvarial defect model, it was shown that new bone formation was accelerated in comparison with the collagen membrane and the unfilled defect groups. These results would suggest that Zn-MEM has the potential for further development in dental applications.

Zinc in calcium phosphate mediates bone induction: in vitro and in vivo model

Zinc-containing tricalcium phosphate (Zn-TCP) was synthesized to investigate the role of zinc in osteoblastogenesis, osteoclastogenesis and in vivo bone induction in an ectopic implantation model. Zinc ions were readily released in the culture medium. Zn-TCP with the highest zinc content enhanced the alkaline phosphatase activity of human bone marrow stromal cells and tartrate-resistant acid phosphatase activity, as well as multinuclear giant cell formation of RAW264.7 monocyte/macrophages. RAW264.7 cultured with different dosages of zinc supplements in medium with or without zinc-free TCP showed that zinc could influence both the activity and the formation of multinuclear giant cells. After a 12-week implantation in the paraspinal muscle of canines, de novo bone formation and bone incidence increased with increasing zinc content in Zn-TCP - up to 52% bone in the free space. However, TCP without zinc induced no bone formation. Although the observed bone induction cannot be attributed to zinc release alone, these results indicate that zinc incorporated in TCP can modulate bone metabolism and render TCP osteoinductive, indicating to a novel way to enhance the functionality of this synthetic bone graft material.

Bone regeneration of rat tibial defect by zinc-tricalcium phosphate (Zn-TCP) synthesized from porous Foraminifera carbonate macrospheres

Foraminifera carbonate exoskeleton was hydrothermally converted to biocompatible and biodegradable zinc-tricalcium phosphate (Zn-TCP) as an alternative biomimetic material for bone fracture repair. Zn-TCP samples implanted in a rat tibial defect model for eight weeks were compared with unfilled defect and beta-tricalcium phosphate showing accelerated bone regeneration compared with the control groups, with statistically significant bone mineral density and bone mineral content growth. CT images of the defect showed restoration of cancellous bone in Zn-TCP and only minimal growth in control group. Histological slices reveal bone in-growth within the pores and porous chamber of the material detailing good bone-material integration with the presence of blood vessels. These results exhibit the future potential of biomimetic Zn-TCP as bone grafts for bone fracture repair.

Effects of niobium ions released from calcium phosphate invert glasses containing Nb2O5 on osteoblast-like cell functions

The effects of niobium ions released from 60CaO-30P(2)O(5)-(10-x)Na(2)O-xNb(2)O(5) (mol %, x = 0-10) glasses on MC3T3-E1 cell functions were evaluated by culture tests with two systems; cell culture on glass plates, or in culture media containing glass extracts. Alkaline phosphatase (ALP) activity in the cells cultured on the glass plates containing 3 and 5 mol % of Nb(2)O(5) was significantly higher than that on the Nb(2)O(5)-free glass, although proliferation was not enhanced on all glasses containing Nb(2)O(5). Cells cultured in the medium containing 3 × 10(-7) M niobium ions showed the highest ALP activity in comparison with other Nb-containing media or normal medium, regardless of the presence of osteogenic factors (ascorbic acid, β-glycerophosphate and dexamethasone) in the media. Calcium deposition by the cells cultured in the medium containing 3 × 10(-7) M niobium ions was twice as high as those cultured in medium containing no niobium ions. The effects of niobium ions were thought to depend on ion concentration, and to enhance differentiation and mineralization of osteogenic cells rather than their initial adhesion or proliferation.

Biological responses of human bone marrow mesenchymal stem cells to Sr-M-Si (M = Zn, Mg) silicate bioceramics

Strontium (Sr), Zinc (Zn), magnesium (Mg), and silicon (Si) are reported to be essential trace elements for the growth and mineralization of bone. We speculated that the combination of these bioactive elements in bioceramics may be effective to regulate the osteogenic property of bone-forming cells. In this study, two Sr-containing silicate bioceramics, Sr(2)ZnSi(2)O(7) (SZS) and Sr(2)MgSi(2)O(7) (SMS), were prepared. The biological response of human bone marrow mesenchymal stem cells (BMSCs) to the two bioceramics (in the forms of powders and dense ceramic bulks) was systematically studied. In powder form, the effect of powder extracts on the viability and alkaline phosphatase (ALP) activity of BMSCs was investigated. In ceramic disc form, both direct and indirect coculture of BMSCs with ceramic discs were used to investigate their biological response, including attachment, proliferation, ALP activity, and bone-related genes expression. Beta-tricalcium phosphate (β-TCP) and akermanite (Ca(2)MgSi(2)O(7), CMS) were used as control materials. The results showed that the Sr, Zn, and Si (or Sr, Mg, and Si)-containing ionic products from SZS and SMS powders enhanced ALP activity of BMSCs, compared to those from β-TCP. Both SZS and SMS ceramic discs supported the growth of BMSCs, and most importantly, significantly enhanced the ALP activity and bone-related genes expression of BMSCs as compared to β-TCP. The results suggest that the specific combination of bioactive ions (Sr, Zn, Si, e.g.) in bioceramics is a viable way to improve the biological performance of biomaterials, and the form of materials and surface properties were nonnegligible factors to influence cell response.

Metallic ions as therapeutic agents in tissue engineering scaffolds: an overview of their biological applications and strategies for new developments

This article provides an overview on the application of metallic ions in the fields of regenerative medicine and tissue engineering, focusing on their therapeutic applications and the need to design strategies for controlling the release of loaded ions from biomaterial scaffolds. A detailed summary of relevant metallic ions with potential use in tissue engineering approaches is presented. Remaining challenges in the field and directions for future research efforts with focus on the key variables needed to be taken into account when considering the controlled release of metallic ions in tissue engineering therapeutics are also highlighted.

Use of iQPR-H₂O for bone regeneration and its potential in the improvement of osteoporosis

Background

Current treatments for osteoporosis are associated with various side effects and do not prevent the age-related decrease in osteoblast number. The objective of this study was to evaluate the effects of iQPR-H₂O on osteogenesis.

Methods

Mouse fibroblast NIH3T3 and pre-osteoblastic MC3T3-E1 cells were cultured in medium prepared with iQPR-H₂O or unprocessed mineral water (control cells), and proliferation and differentiation were assessed by MTT and alkaline phosphatase assay, respectively. Mineral deposition by the cells was determined using Alizarin red S staining. A mouse model of osteoporosis, ovariectomized SAMP8 mice, was used to evaluate the effects of iQPR-H₂O on osteogenesis in vivo. Mice were given either iQPR-H₂O or unprocessed mineral water (control group) for four months after which bone mass density (BMD) measurements were made using a bone densitometer and hematoxylin and eosin staining of bone samples.

Results

NIH3T3 cells grown in medium prepared with iQPR-H₂O exhibited significantly greater proliferation. NIH3T3 and MC3T3-E1 cells demonstrated a significant increase in alkaline phosphatase levels in the iQPR-H₂O group. MC3T3-E1 cells showed mineralization at day 28. mRNA expression levels of both osteopontin and runt-related transcription factor 2 in MC3T3-E1 cells were higher in the iQPR-H₂O group compared with the control group. After four months, significantly greater bone regeneration was evident in ovariectomized SAMP8 mice administered iQPR-H₂O as compared with control group.

Conclusions

iQPR-H₂O may reduce the symptoms of osteoporosis by improving osteogenesis.

Resveratrol effect on osteogenic differentiation of rat and human adipose derived stem cells in a 3-D culture environment

The goal of this study was to investigate the effect of resveratrol treatment on the osteogenic potential of human and rat adipose derived stem cells in a 3-D culture environment. Adipose derived stem cells (ADSCs) have been widely studied and have shown promise as a potential source of osteogenic progenitor cells. Previous work had investigated the effect of 25 μM resveratrol on the osteogenic differentiation of rat ADSCs in a 3-D environment and found that pre-treating cells for one passage prior to seeding on the scaffold yielded significantly more mineralization than untreated cells. We first sought to investigate whether this result was also observable with human ADSCs and found that the human cells did not respond to 25 μM resveratrol in a positive manner suggesting a species specific difference in resveratrol dosage. Therefore, we next investigated multiple doses at or below 25 μM resveratrol for both rat and human ADSCs. We found that doses below 25 μM caused significantly more mineralization than 0 (untreated) and 25 μM treated cells in a 3-D culture environment. Further, we observed species differences in the total amount of mineralized matrix, as well as the mean mineral density suggesting that the nature of mineralization of the extracellular matrix was different between species. Histological examination of the scaffolds showed that the human cell constructs remain highly cellular in nature with small pockets of mineralization, while rat cell constructs showed much larger and more mature mineralized nodules. Taken together, we demonstrate dose dependent differences in the mineralization response of human and rat ADSCs to resveratrol treatment, suggesting that in vitro pre-conditioning of 3D adipose-derived stem cell constructs may be an effective strategy to promote osteogenic differentiation prior to implantation.

Bioinorganics and biomaterials: bone repair

The field of bioinorganics is well established in the development of a variety of therapies. However, their application to bone regeneration, specifically by way of localized delivery from functional implants, is in its infancy and is the topic of this review. The toxicity of inorganics is species, dose and duration specific. Little is known about how inorganic ions are effective therapeutically since their use is often the result of serendipity, observations from nutritional deficiency or excess and genetic disorders. Many researchers point to early work demonstrating a role for their element of interest as a micronutrient critical to or able to alter bone growth, often during skeletal development, as a basis for localized delivery. While one can appreciate how a deficiency can cause disruption of healing, it is difficult to explain how a locally delivered excess in a preclinical model or patient, which is presumably of normal nutritional status, can evoke more bone or faster healing. The review illustrates that inorganics can positively affect bone healing but various factors make literature comparisons difficult. Bioinorganics have the potential to have just as big an impact on bone regeneration as recombinant proteins without some of the safety concerns and high costs.

Osteocalcin secretion as an early marker of in vitro osteogenic differentiation of rat mesenchymal stem cells

Osteocalcin (OC) is a bone-specific protein synthesized by osteoblasts that represents a good marker for osteogenic maturation. We examined whether in vitro osteogenic differentiation of rat bone marrow-derived mesenchymal stem cells (MSCs) could be simply assessed at earlier stages by monitoring OC secretion into the conditioned medium, rather than measuring OC deposition on the extracellular matrix (ECM), using a sandwich enzyme immunoassay system involving a specific anti-rat OC monoclonal antibody. During a 16-day culture, OC was secreted into the medium of MSCs from day 8 and increased substantially until day 16. In contrast, OC deposition on the ECM was low, even at day 13, when calcium deposition was at high levels. The histological expression pattern of OC messenger RNA provided in situ evidence that osteoblastic cells appeared at the early stages of 6 to 9 days and matured over time in vitro. Furthermore, the temporal expression of osteogenesis-specific genes, such as the transcriptional factors core-binding factor 1 and osterix, followed by increases in secretory OC proved the commitment of MSCs to osteoblastic differentiation. These results revealed that biomineralization followed secretion of OC, which may reflect early osteoblastic differentiation of cultured MSCs under osteoinductive conditions. We ascertained the osteogenic differentiation capacity of cultured MSCs in a non-destructive manner by monitoring OC secretion into the culture medium and proved that secretory OC could represent a reliable marker for predicting in vivo osteogenic potential in bone tissue engineering.

In vitro proliferation and osteogenic differentiation of human bone marrow-derived mesenchymal stem cells cultured with hardystonite (Ca2ZnSi 2O7) and {beta}-TCP ceramics

The effects of hardystonite (Ca(2)ZnSi(2)O(7), CSZn) and tricalcium phosphate (beta-TCP) on the proliferation and osteogenic differentiation of human bone marrow-derived mesenchymal stem cells (MSCs) were compared by directly culturing MSCs on ceramic disks (contact mode) or separately culturing cells with ceramic disks (non-contact mode). In non-contact mode, the CSZn ceramic supported MSC proliferation more strongly than did the beta-TCP ceramic. However, in contact mode, the MSCs proliferated more quickly on the beta-TCP ceramic than they did on the CSZn ceramic. Alkaline phosphatase (ALP) staining and osteogenic gene expression analysis showed that the CSZn and beta-TCP ceramics had significant effects on the promotion of the osteogenic differentiation of MSCs in both non-contact and contact mode. Furthermore, in contact mode, the CSZn disk promoted the osteogenic differentiation of MSCs more strongly than did the beta-TCP disks. Even without the induction of dexamethasone and beta-glycerophosphate, CSZn stimulated the osteogenic differentiation of MSCs. These results suggest that CSZn ceramic would be a useful candidate material for bone regeneration and hard tissue engineering.

Tailoring of multilayered core-shell nanostructure for multicomponent administration and controllable release of biologically active ions

The biomaterials that can control the active ions delivery to enhance cell activity are regarded as promising bone regenerative materials. In this study, a new approach aiming to layer-by-layer (LbL) assemble the bioavailable zinc ions in the core-shell-like silica@octacalcium phosphate (OCP) nanosphere and to analyze its efficacy on improving controlled-release was reported. Firstly, a pH-responsive electrostatic interaction was used to adsorb zinc ions on silica nanospheres with different zinc concentration, which was followed by coating silica gel layer. Then the nanospheres were LbL assembled with zinc ions and silica gel alternately until the desired multilayered nanospheres were achieved. Finally, the porous OCP shells were capped onto the outside surface of the nanospheres tailored by poly(aspartic acid) sodium molecules. The ion release tests in Tris buffers in vitro indicated that zinc release was controlled by pH and storage capacity, and silicon release was regulated by the OCP shell barrier. A temporal gradient within short times and sustained-dosage for a prolonged time toward the zinc and silicon ions could be obtained in this multilayer system. The results of this organized active ion assembly might open a promising future direction for effective delivery of trace elements in bone defect therapy.

Inhibitory effect of Zn2+ in zinc-containing beta-tricalcium phosphate on resorbing activity of mature osteoclasts

Long term effect of the growing instability of the bone-implant interface due to bone resorption at the interface is a problem for the implants, including bioactive ceramics. Zn2+ -containing tricalcium phosphate (ZnTCP) is a material which may overcome this problem. The present study aims to clarify whether Zn2+ -containing tricalcium phosphate (ZnTCP) ceramics with a Zn2+ content of 0.316 (ZnTCP316) and 0.633 (ZnTCP633) wt % suppress resorption by mature osteoclasts in vitro. Suppression would be due to an increase in the number of apoptotic osteoclasts and the inhibition of the resorbing activity of osteoclasts, the latter being the major mechanism of the suppression. The number of apoptotic osteoclasts was significantly 6.3 times higher with ZnTCP633 than with tricalcium phosphate ceramic (TCP) after 24-h culture. The net contribution to resorption of this change in apoptotic cell numbers is much smaller than that of the change in resorbing activity. The osteoclasts cultured on ZnTCP formed fewer actin rings than those cultured on the TCP. The mRNA expression of CAII and cathepsin K/OC2 in the osteoclasts on ZnTCP633 was downregulated 0.5-fold and 0.6-fold, respectively, compared with that on the TCP. The volume of resorption pits was downregulated 0.4-fold in the ZnTCP633 than that in TCP. These results suggest that ZnTCPs suppressed the resorbing activity of mature osteoclasts probably through a local increase in the level of Zn2+. Bone substitutes or coating layers containing ZnTCP would be promising biomaterials from the viewpoint of counteracting osteoclastic bone resorption at the bone-implant interface.

Effect of Hydroxyapatite and Zinc-Containing Hydroxyapatite on Osseous Repair of Critical Size Defect in the Rat Calvaria

Hydroxyapatite (HA), widely used as bone graft, can be modified by the incorporation of bivalent cations (Mg2+ and Zn2+) and its gradual release could favor the bone repair. The purpose of this research was to evaluate the effect of the HA and zinc-containing hydroxyapatite (Zn-HA) in the bone repair in rat calvaria in comparison to autogenous bone. Critical size defect in the calvaria was filled with the graft material and the samples were harvested at the 30, 90 and 180 days. The light microcopy observations showed the biocompatibility of the graft materials. In the Zn-HA group the area of neoformed bone was larger than in the HA group, but smaller than in the autograft. A fibrous connective tissue was more evident around HA granules. It could be conclude that the presence of zinc ions in HA crystal accelerated the osteogenesis and increased the area of newly formed bone in relation to HA.

Effect of soluble zinc on differentiation of osteoprogenitor cells

Amorphous calcium phosphates (ACPs) are attractive fillers for osseous defects and are stabilized through the incorporation of transition metals such as zirconium and zinc. As ACP converts in solution to hydroxyapatite (HAP) in a manner marked by a transient release of calcium and phosphate ions, it is capable of stimulating osteoblastic differentiation. Zinc is known to retard ACP conversion to HAP, and--when incorporated into ceramic biomaterials--has been shown to stimulate osteoblastic differentiation. Because zinc deficiency in vivo is marked by skeletal defects, we postulated that zinc ions released from ACP and other minerals could stimulate proliferation and osteoblastic differentiation of progenitor cells. To test this hypothesis, rat bone marrow stromal cells were cultured in osteogenic medium containing basal (3 x 10(-6) M) or supplemented Zn(2+) concentrations (1 x 10(-5) and 4 x 10(-5) M) for up to 3 weeks. No significant effects of zinc concentration on cell number, alkaline phosphatase activity, total protein content, collagen synthesis, or matrix mineralization were found.

Synthesis of fluoride-releasing carbonate apatites for bone substitutes

Fluoride (F-)-substituted B-type carbonate hydroxyapatite (CHAP) powders were prepared for application as bone substitute materials having the ability to enhance bone formation and to suppress bone resorption due to the therapeutic effect of F-. F- was adsorbed on CHAP in a sodium fluoride solution followed by heating at 700 degrees C in carbon dioxide flow to substitute F- for the hydroxyl ion in the CHAP structure. The F- contents in the F-substituted CHAP powders were 16-22 times greater than that in normal adult human bones. The carbonate ion contents in the F-substituted CHAP powders corresponded to or were higher than that in normal adult human bones. F-substituted CHAP powder with CO3(2-) and F- contents of 11.03 and 0.66 wt%, respectively, slowly released F- in a physiological salt solution to a sufficiently high F- level. The F- concentration slowly increased and reached 67.20 +/- 4.81 microg l(-1), which was 1.5-9.3 times higher than that in the body fluid of normal adult humans, near the therapeutic window of F-, and far lower than the estimated toxic level. Therefore, the F-substituted CHAP can promote bone formation. The present F-substituted CHAP has the advantage of slow F- release over sodium fluoride and sodium monofluorophosphate which are highly soluble salts and cannot be sintered into a ceramic body.

Zinc-containing phosphate-based glasses for tissue engineering

It has been shown that the addition of zinc to hydroxyapatite promotes osteoblast cell adhesion (Ishaug et al 1994 J. Biomed. Mater. Res. A 28 1445-53). Therefore, this study presents a series of phosphate-based glass compositions that contain varying amounts of zinc in order to promote osteoblast cell adhesion. The compositions investigated were P(50)Ca((40-x))Na(10) where x = 0, 1, 2, 3, 4 and 5 mol%. The dissolution rate and effect on pH of glass discs were investigated and ion release from the glass discs was examined in distilled water at 37 degrees C after 1, 2, 3, 4 and 7 days. The attachment of osteoblast-like cells (HOB) was observed by SEM on the glass discs. A linear decrease in the %mass of the glass discs was observed for all compositions for the duration of the study. The dissolution rates were similar for all the compositions. After 7 days, a mass loss of 3-6% was observed for all the compositions. The pH of distilled water decreased to a range of pH 4.5-5.5 from pH 7 after 1 day, and remained in this range for the duration of the study. The composition containing 0 mol% Zn reduced the pH to a lesser extent than the composition containing the highest amount of Zn. Furthermore, Zn(2+) ion release was observed from all the Zn-containing compositions. These glass compositions may therefore be suitable for tissue engineering applications.

Modulation of zinc release from bioactive sol–gel derived SiO2-CaO-ZnO glasses and ceramics

Zinc is an essential trace element which may be effective in promoting hard tissue healing. Glasses in the SiO(2)-CaO-ZnO system were synthesized via sol-gel methods. Using a constant silica content (70 mol %), the ratio of Ca to Zn was varied (1.5, 3.5, or 6.5), as was the stabilization temperature (650, 750, or 850 degrees C), to examine such effects on the bioactive response and zinc release in simulated body fluid (SBF). XRD revealed the development of CaSiO(3) and Ca(2)ZnSi(2)O(7) crystalline phases during stabilization at 850 degrees C only. N(2) adsorption analysis determined that the specific surface area (BET) varied between 14 and 179 m(2)/g and was dependent on composition and stabilization temperature, as was the average initial pore size (51-125 A). The formation of hydroxycarbonate (HCA) and amorphous calcium phosphate (ACP) was observed at 14 days for samples stabilized at 650 or 750 degrees C. Only ACP layers were observed on such samples prior to 14 day. Relative to the Ca levels at 14 day (60-485 microg/ml), Zn levels in solution were relatively low (0.06-1.18 microg/ml). EDX and ICP data suggested that released Zn was incorporated into the forming calcium phosphate reaction layer, thereby preventing concentrations of the essential trace element from reaching potentially toxic levels.

A novel route to fabricate the biomedical material: Structure strategy and the biologically active ions controllable release

The multiple biologically active trace element delivery remains a problem in regeneration medicine and tissue engineering. A novel approach to fabricate the biologically active trace elements assembly in a core-shell system for cooperative controlled-release has been proposed. Firstly, using a pH-dependent electrostatic interaction, zinc and strontium ions were incorporated into the silica gel nanospheres. Subsequently a porous octacalcium phosphate (OCP) shell was coated on the nanospheres tailored by poly(acrylate sodium) molecules. In vitro test shows that this hierarchical multilayered nanostructure can achieve a shell-/pH-dependent controlled-release of silicon, strontium and zinc ions. The wet-chemical route to selective synthesis of the core-shell Silica@OCP system may provide a general model to develop cooperative encapsulation of biologically active ions in a silica-based system by using layer-by-layer assembly technique for controlled-release in biomedical areas.

Elemental distributions in femoral bone of rat under osteoporosis preventive treatments

One of the abnormalities of bone architecture is osteoporosis as occurring in post-menopausal women. Especially long bones, such as femur, become more fragile and more prone to fracture. The efficiency of several osteoporosis preventative treatments based on oestrogen and progestin in bone structure and mineral recovery was studied using ovariectomized Wistar rats as an osteoporosis experimental model. Diagonal cross-sections of the proximal epiphysis of femoral bones were analysed using nuclear microscopy techniques in order to map and determine the concentration profiles of P, Ca, S, Fe and Zn from the epiphysis to diaphysis and across the cortical and trabecular bone structures. In control animals (not ovariectomized), the S and Zn contents significantly characterized differences between cortical and trabecular bone structures, whereas P and Ca showed increased gradients from the epiphyseal region to the diaphysis. After ovariectomy the differences observed were differential according to the type of hormonal supplementation. A significant decrease in P and Ca contents and depletion of minor and trace minerals, such as S, Fe and Zn, were found for both cortical and trabecular bone structures after ovariectomy relative to controls. Bone mineral contents were reversed to control levels by synthetic oestrogen supplementation, and combined oestrogen and progesterone treatment. Recovery was more evident in the femoral epiphysis and neck than in the diaphysis. The use of oestrogen alone did not lead to bone recovery after ovariectomy. Alterations in bone mineral composition observed for animals receiving synthetic oestrogen and combined oestrogen and progesterone supplement might reflect beneficial structural changes in critical regions of long bones, mostly affected in post-menopausal osteoporosis.

Zinc-Containing Calcium Phosphate Ceramics with a (Ca+Zn)/P Molar Ratio of 1.67

Zinc-containing calcium phosphate ceramics with a (Ca+Zn)/P molar ratio of 1.67 (ZnHAP ceramics) were synthesized to clarify the main phase for zinc release. ZnHAP ceramics with a zinc content at or more than 0.20 wt% contained zinc-containing tricalcium phosphate. The ion activity product of monophasic ZnHAP ceramic containing at or less than 0.13 wt% of zinc corresponded to that of pure HAP ceramic. The presence of tricalcium phosphate (TCP) phases was necessary condition for ZnHAP ceramics to release zinc. The coexistence of TCP phases in the ZnHAP ceramics meant that a phase with a (Ca+Zn)/P molar ratio higher than 1.67 also coexisted. Although the phase was assumed to be zinc oxide, zinc was not concentrated anywhere in the ZnHAP ceramics including grain boundaries.

Bone repair in the twenty-first century: biology, chemistry or engineering?

Increases in reconstructive orthopaedic surgery, such as total hip replacement and spinal fusion, resulting from advances in surgical practice and the ageing population, have lead to a demand for bone graft that far exceeds supply. Consequently, a number of synthetic bone-graft substitutes (BGSs) have been developed with mixed success and surgical acceptance. Skeletal tissue regeneration requires the interaction of three basic elements: cells, growth factors (GFs) and a permissive scaffold. This can be achieved by pre-loading a synthetic scaffold with GFs or pre-expanded cells; however, a 'simpler' approach is to design intrinsic 'osteoinductivity' into your BGS, i.e. the capability to recruit and stimulate the patient's own GFs and stem cells. Through investigation of the mechanisms controlling bone repair in BGSs, linking interactions between the local chemical and physical environment, scientists are currently developing osteoinductive materials that can stimulate bone regeneration through control of the scaffold chemistry and structure. Moreover, this body of research is providing the foundations for future generations of BGSs and bone-repair therapies and may ultimately contribute towards improving the quality of life through maintenance of the skeleton and reversal of disease states, as opposed to the mending of broken bones that we currently practice. Will we be able to grow our own bones in a bioreactor for use as autologous graft materials in the future? Could surgery be limited to accidental trauma cases, with greater restoration of function through biochemical or gene therapies? The technology and research probes necessary to this task are currently being developed with the advent of nanotechnology, genomics and proteomics: are we about to embark on a chemical revolution in medicine? This paper aims to discuss some of the current thinking on the mechanisms behind bioactivity and biocompatibility in bone and how a fuller understanding of the interactions between cells and the materials used today could bring about completely new approaches for the treatment of bone fracture and disease tomorrow.