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Nayak VV, Costello JP, Ehlen QT, Slavin BV, Mirsky NA, Kelly S, Suarez C, Daunert S, Witek L, Coelho PG. A rhPDGF-BB/bovine type I collagen/β-TCP mixture for the treatment of critically sized non-union tibial defects: An in vivo study in rabbits. J Orthop Res 2024. [PMID: 38598203 DOI: 10.1002/jor.25847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/08/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024]
Abstract
Non-union during healing of bone fractures affects up to ~5% of patients worldwide. Given the success of recombinant human platelet-derived growth factor-B chain homodimer (rhPDGF-BB) in promoting angiogenesis and bone fusion in the hindfoot and ankle, rhPDGF-BB combined with bovine type I collagen/β-TCP matrix (AIBG) could serve as a viable alternative to autografts in the treatment of non-unions. Defects (~2 mm gaps) were surgically induced in tibiae of skeletally mature New Zealand white rabbits. Animals were allocated to one of four groups-(1) negative control (empty defect, healing for 8 weeks), (2 and 3) acute treatment with AIBG (healing for 4 or 8 weeks), and (4) chronic treatment with AIBG (injection 4 weeks post defect creation and then healing for 8 weeks). Bone formation was analyzed qualitatively and semi-quantitatively through histology. Samples were imaged using dual-energy X-ray absorptiometry and computed tomography for defect visualization and volumetric reconstruction, respectively. Delayed healing or non-healing was observed in the negative control group, whereas defects treated with AIBG in an acute setting yielded bone formation as early as 4 weeks with bone growth appearing discontinuous. At 8 weeks (acute setting), substantial remodeling was observed with higher degrees of bone organization characterized by appositional bone growth. The chronic healing, experimental, group yielded bone formation and remodeling, with no indication of non-union after treatment with AIBG. Furthermore, bone growth in the chronic healing group was accompanied by an increased presence of osteons, osteonal canals, and interstitial lamellae. Qualitatively and semiquantitatively, chronic application of AI facilitated complete bridging of the induced non-union defects, while untreated defects or defects treated acutely with AIBG demonstrated a lack of complete bridging at 8 weeks.
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Affiliation(s)
- Vasudev Vivekanand Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Quinn T Ehlen
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Blaire V Slavin
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Sophie Kelly
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Camila Suarez
- Trinity College of Arts and Sciences, Duke University, Durham, North Carolina, USA
| | - Sylvia Daunert
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lukasz Witek
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York, USA
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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Sheng N, Xing F, Wang J, Zhang QY, Nie R, Li-Ling J, Duan X, Xie HQ. Recent progress in bone-repair strategies in diabetic conditions. Mater Today Bio 2023; 23:100835. [PMID: 37928253 PMCID: PMC10623372 DOI: 10.1016/j.mtbio.2023.100835] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 10/02/2023] [Accepted: 10/14/2023] [Indexed: 11/07/2023] Open
Abstract
Bone regeneration following trauma, tumor resection, infection, or congenital disease is challenging. Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia. It can result in complications affecting multiple systems including the musculoskeletal system. The increased number of diabetes-related fractures poses a great challenge to clinical specialties, particularly orthopedics and dentistry. Various pathological factors underlying DM may directly impair the process of bone regeneration, leading to delayed or even non-union of fractures. This review summarizes the mechanisms by which DM hampers bone regeneration, including immune abnormalities, inflammation, reactive oxygen species (ROS) accumulation, vascular system damage, insulin/insulin-like growth factor (IGF) deficiency, hyperglycemia, and the production of advanced glycation end products (AGEs). Based on published data, it also summarizes bone repair strategies in diabetic conditions, which include immune regulation, inhibition of inflammation, reduction of oxidative stress, promotion of angiogenesis, restoration of stem cell mobilization, and promotion of osteogenic differentiation, in addition to the challenges and future prospects of such approaches.
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Affiliation(s)
- Ning Sheng
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Fei Xing
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Jie Wang
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Qing-Yi Zhang
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Rong Nie
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Jesse Li-Ling
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
- Frontier Medical Center, Tianfu Jincheng Laboratory, Chengdu, 610212, China
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Xin Duan
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Hui-Qi Xie
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
- Frontier Medical Center, Tianfu Jincheng Laboratory, Chengdu, 610212, China
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Lončar SR, Halcrow SE, Swales D. Osteoimmunology: The effect of autoimmunity on fracture healing and skeletal analysis. Forensic Sci Int Synerg 2023; 6:100326. [PMID: 37091290 PMCID: PMC10120377 DOI: 10.1016/j.fsisyn.2023.100326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/27/2023] [Accepted: 03/08/2023] [Indexed: 04/25/2023]
Abstract
Understanding factors that affect bone response to trauma is integral to forensic skeletal analysis. It is essential in forensic anthropology to identify if impaired fracture healing impacts assessment of post-traumatic time intervals and whether a correction factor is required. This paper presents a synthetic review of the intersection of the literature on the immune system, bone biology, and osteoimmunological research to present a novel model of interactions that may affect fracture healing under autoimmune conditions. Results suggest that autoimmunity likely impacts fracture healing, the pathogenesis however, is under researched, but likely multifactorial. With autoimmune diseases being relatively common, significant clinical history should be incorporated when assessing skeletal remains. Future research includes the true natural healing rate of bone; effect of autoimmunity on this rate; variation of healing with different autoimmune diseases; and if necessary, development of a correction factor on the natural healing rate to account for impairment in autoimmunity.
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Affiliation(s)
- Stephie R. Lončar
- Centre for Anatomy and Human Identification, School of Science and Engineering, University of Dundee, Scotland, United Kingdom
- Department of Anatomy, University of Otago, New Zealand
- Corresponding author. Centre for Anatomy and Human Identification School of Science and Engineering, MSI/WTB Complex, University of Dundee, Dow Street, Dundee, DD1 5EH, Scotland, United Kingdom.
| | - Siân E. Halcrow
- Department of Anatomy, University of Otago, New Zealand
- Corresponding author. Biological Anthropology Research Group, Department of Anatomy, 270 Great King Street, University of Otago, Dunedin, 9016, New Zealand.
| | - Diana Swales
- Centre for Anatomy and Human Identification, School of Science and Engineering, University of Dundee, Scotland, United Kingdom
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Innella K, Levidy MF, Kadkoy Y, Lin A, Selles M, Sanchez A, Weiner A, Greendyk J, Moriarty B, Lauritsen K, Lopez J, Teitelbaum M, Fisher M, Mendiratta D, Ahn DB, Ippolitto J, Paglia DN, Cottrell J, O'Connor JP, Benevenia J, Lin SS. Local zinc treatment enhances fracture callus properties in diabetic rats. J Orthop Res 2022. [PMID: 36515300 DOI: 10.1002/jor.25499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
The effects of locally applied zinc chloride (ZnCl2 ) on early and late-stage parameters of fracture healing were evaluated in a diabetic rat model. Type 1 Diabetes has been shown to negatively impact mechanical parameters of bone as well as biologic markers associated with bone healing. Zinc treatments have been shown to reverse those outcomes in tests of nondiabetic and diabetic animals. This study is the first to assess the efficacy of a noncarrier mediated ZnCl2 on bony healing in diabetic animals. This is a promising basic science approach which may lead to benefits for diabetic patients in the future. Treatment and healing were assessed through quantification of callus zinc, radiographic scoring, microcomputed tomography (µCT), histomorphometry, and mechanical testing. Local ZnCl2 treatment increased callus zinc levels at 1 and 3 days after fracture (p ≤ 0.025). Femur fractures treated with ZnCl2 showed increased mechanical properties after 4 and 6 weeks of healing. Histomorphometry of the ZnCl2 -treated fractures found increased callus cartilage area at Day 7 (p = 0.033) and increased callus bone area at Day 10 (p = 0.038). In contrast, callus cartilage area was decreased (p < 0.01) after 14 days in the ZnCl2 -treated rats. µCT analysis showed increased bone volume in the fracture callus of ZnCl2 -treated rats at 6 weeks (p = 0.0012) with an associated increase in the proportion of µCT voxel axial projections (Z-rays) spanning the fracture site. The results suggest that local ZnCl2 administration improves callus chondrogenesis leading to greater callus bone formation and improved fracture healing in diabetic rats.
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Affiliation(s)
- Kevin Innella
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Michael F Levidy
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Yazan Kadkoy
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Anthony Lin
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Marcus Selles
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Alexandra Sanchez
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Adam Weiner
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Joshua Greendyk
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Brian Moriarty
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Katherine Lauritsen
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jonathan Lopez
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Marc Teitelbaum
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Mark Fisher
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Dhruv Mendiratta
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - David B Ahn
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Joseph Ippolitto
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - David N Paglia
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jessica Cottrell
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Department of Biological Sciences, Seton Hall University, South Orange, New Jersey, USA
| | - J Patrick O'Connor
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Joseph Benevenia
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Sheldon S Lin
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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Jing Z, Liang Z, Yang L, Du W, Yu T, Tang H, Li C, Wei W. Bone formation and bone repair: The roles and crosstalk of osteoinductive signaling pathways. Process Biochem 2022. [DOI: 10.1016/j.procbio.2022.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Campos MS, Volpon JB, Ximenez JPB, Franttini AP, Dalloul CE, Sousa-Neto MD, Silva RA, Kacena MA, Zamarioli A. Vibration therapy as an effective approach to improve bone healing in diabetic rats. Front Endocrinol (Lausanne) 2022; 13:909317. [PMID: 36060973 PMCID: PMC9437439 DOI: 10.3389/fendo.2022.909317] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the effects of vibration therapy on fracture healing in diabetic and non-diabetic rats. METHODS 148 rats underwent fracture surgery and were assigned to four groups: (1) SHAM: weight-matched non-diabetic rats, (2) SHAM+VT: non-diabetic rats treated with vibration therapy (VT), (3) DM: diabetic rats, and (4) DM+VT: diabetic rats treated with VT. Thirty days after diabetes induction with streptozotocin, animals underwent bone fracture, followed by surgical stabilization. Three days after bone fracture, rats began VT. Bone healing was assessed on days 14 and 28 post-fracture by serum bone marker analysis, and femurs collected for dual-energy X-ray absorptiometry, micro-computed tomography, histology, and gene expression. RESULTS Our results are based on 88 animals. Diabetes led to a dramatic impairment of bone healing as demonstrated by a 17% reduction in bone mineral density and decreases in formation-related microstructural parameters compared to non-diabetic control rats (81% reduction in bone callus volume, 69% reduction in woven bone fraction, 39% reduction in trabecular thickness, and 45% in trabecular number). These changes were accompanied by a significant decrease in the expression of osteoblast-related genes (Runx2, Col1a1, Osx), as well as a 92% reduction in serum insulin-like growth factor I (IGF-1) levels. On the other hand, resorption-related parameters were increased in diabetic rats, including a 20% increase in the callus porosity, a 33% increase in trabecular separation, and a 318% increase in serum C terminal telopeptide of type 1 collagen levels. VT augmented osteogenic and chondrogenic cell proliferation at the fracture callus in diabetic rats; increased circulating IGF-1 by 668%, callus volume by 52%, callus bone mineral content by 90%, and callus area by 72%; and was associated with a 19% reduction in circulating receptor activator of nuclear factor kappa beta ligand (RANK-L). CONCLUSIONS Diabetes had detrimental effects on bone healing. Vibration therapy was effective at counteracting the significant disruption in bone repair induced by diabetes, but did not improve fracture healing in non-diabetic control rats. The mechanical stimulus not only improved bone callus quality and quantity, but also partially restored the serum levels of IGF-1 and RANK-L, inducing bone formation and mineralization, thus creating conditions for adequate fracture repair in diabetic rats.
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Affiliation(s)
- Maysa S. Campos
- Department of Orthopaedics and Anaesthesiology, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - José B. Volpon
- Department of Orthopaedics and Anaesthesiology, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - João Paulo B. Ximenez
- Laboratory of Molecular Biology, Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil
- School of Pharmaceutical Sciences of Ribeirão Preto - University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Paula Franttini
- Department of Orthopaedics and Anaesthesiology, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Christopher E. Dalloul
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Manoel D. Sousa-Neto
- School of Dentistry of Ribeirão Preto - University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Raquel A. Silva
- School of Dentistry of Ribeirão Preto - University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Melissa A. Kacena
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, United States
- Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, IN, United States
| | - Ariane Zamarioli
- Department of Orthopaedics and Anaesthesiology, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, SP, Brazil
- *Correspondence: Ariane Zamarioli,
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Yamaguchi JT, Weiner JA, Minardi S, Greene AC, Ellenbogen DJ, Hallman MJ, Shah VP, Weisz KM, Jeong S, Nandurkar T, Yun C, Hsu WK, Hsu EL. Characterizing the host response to rhPDGF-BB in a rat spinal arthrodesis model. JOR Spine 2021; 4:e1173. [PMID: 35005440 PMCID: PMC8717117 DOI: 10.1002/jsp2.1173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 09/09/2021] [Accepted: 09/16/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Due to the constraints surrounding autograft bone, surgeons have turned to osteoinductive agents to augment spinal fusion. Reports of complications and questionable efficacy slowed the adoption of these alternatives. Recombinant human platelet-derived growth factor B homodimer (rhPDGF-BB) has been Food and Drug Administration (FDA)-approved (Augment) to promote fusion in other areas of orthopedics, but its characterization in spine fusion has not yet been tested. The purpose of this study is to characterize the host response to PDGF-BB in vivo. METHODS Eighty female Fischer rats underwent L4-5 posterolateral fusion using one of four implant types: (a) iliac crest syngeneic allograft harvested from syngeneic donors, (b) β-TCP/bovine collagen matrix (β-TCP/Col) with sodium acetate buffer, (c) β-TCP/Col with 0.3 mg/mL "low dose," or (d) β-TCP/Col with 3.0 mg/mL "high dose" of rhPDGF-BB. Animals underwent magnetic resonance imaging (MRI) and serum cytokine quantification at 4, 7, 10, and 21 days, postoperatively. Tissues were processed for immunofluorescence staining for Ki67 and von Willebrand factor (vWF) to assess neovascularization. RESULTS MRI demonstrated no differences in fluid accumulation among the four treatment groups at any of the time points. Serum cytokine analysis showed no clinically significant differences between treatment groups in 20 of the 27 cytokines. Inflammatory cytokines IFN-γ, IL-1β, IL-18, MCP-1, MIP-1α, TNF-α were not induced by rhPDGF-BB. Histology showed no differences in cell infiltration, and Ki67 and vWF immunofluorescence staining was similar among groups. CONCLUSIONS rhPDGF-BB delivered with a β-TCP/Col matrix exerts no exaggerated systemic or local host inflammatory response when compared to iliac crest syngeneic allograft bone or the control carrier. rhPDGF-BB mixed with a β-TCP/Col matrix could be a viable and safe biologic alternative to syngeneic allograft in spine fusion. Further studies need to be performed to evaluate efficacy in this setting.
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Affiliation(s)
- Jonathan T. Yamaguchi
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Joseph A. Weiner
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Silvia Minardi
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Allison C. Greene
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - David J. Ellenbogen
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Mitchell J. Hallman
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Vivek P. Shah
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Kevin M. Weisz
- Department of Orthopaedic SurgeryWilliam Beuamont HospitalRoyal OakMichiganUSA
| | - Soyeon Jeong
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Tejas Nandurkar
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Chawon Yun
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Wellington K. Hsu
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Erin L. Hsu
- Department of Orthopaedic SurgeryFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
- Simpson Querrey InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
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Kalra K, Eberhard J, Farbehi N, Chong JJ, Xaymardan M. Role of PDGF-A/B Ligands in Cardiac Repair After Myocardial Infarction. Front Cell Dev Biol 2021; 9:669188. [PMID: 34513823 PMCID: PMC8424099 DOI: 10.3389/fcell.2021.669188] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/20/2021] [Indexed: 01/06/2023] Open
Abstract
Platelet-derived growth factors (PDGFs) are powerful inducers of cellular mitosis, migration, angiogenesis, and matrix modulation that play pivotal roles in the development, homeostasis, and healing of cardiac tissues. PDGFs are key signaling molecules and important drug targets in the treatment of cardiovascular disease as multiple researchers have shown that delivery of recombinant PDGF ligands during or after myocardial infarction can reduce mortality and improve cardiac function in both rodents and porcine models. The mechanism involved cannot be easily elucidated due to the complexity of PDGF regulatory activities, crosstalk with other protein tyrosine kinase activators, and diversity of the pathological milieu. This review outlines the possible roles of PDGF ligands A and B in the healing of cardiac tissues including reduced cell death, improved vascularization, and improved extracellular matrix remodeling to improve cardiac architecture and function after acute myocardial injury. This review may highlight the use of recombinant PDGF-A and PDGF-B as a potential therapeutic modality in the treatment of cardiac injury.
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Affiliation(s)
- Kunal Kalra
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Joerg Eberhard
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Nona Farbehi
- Garvan Weizmann Centre for Cellular Genomics, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - James J Chong
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Munira Xaymardan
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Gadomski BC, Labus KM, Puttlitz CM, McGilvray KC, Regan DP, Nelson B, Seim HB, Easley JT. Evaluation of lumbar spinal fusion utilizing recombinant human platelet derived growth factor-B chain homodimer (rhPDGF-BB) combined with a bovine collagen/β-tricalcium phosphate (β-TCP) matrix in an ovine model. JOR Spine 2021; 4:e1166. [PMID: 34611589 PMCID: PMC8479519 DOI: 10.1002/jsp2.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/16/2021] [Accepted: 06/20/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND CONTEXT While the clinical effectiveness of recombinant human Platelet Derived Growth Factor-B chain homodimer combined with collagen and β-tricalcium phosphate (rhPDGF-BB + collagen/β-TCP) treatment for indications involving hindfoot and ankle is well-established, it is not approved for use in spinal interbody fusion, and the use of autograft remains the gold standard. PURPOSE The purpose of this study was to compare the effects of rhPDGF-BB + collagen/β-TCP treatment on lumbar spine interbody fusion in an ovine model to those of autograft bone and collagen/β-TCP treatments using biomechanical, radiographic, and histological assessment techniques. STUDY DESIGN Thirty-two skeletally mature Columbian Rambouillet sheep were used to evaluate the safety and effectiveness of rhPDGF-BB + collagen/β-TCP matrix in a lumbar spinal fusion model. Interbody polyetheretherketone (PEEK) cages contained either autograft, rhPDGF-BB + collagen/β-TCP, collagen/β-TCP matrix, or left empty. METHODS Animals were sacrificed 8- or 16-weeks post-surgery. Spinal fusion was evaluated via post-sacrifice biomechanical, micro-computed tomography (μCT), and histological analysis. Outcomes were statistically compared using a two-way analysis of variance (ANOVA) with an alpha value of 0.05 and a Tukey post-hoc test. RESULTS There were no statistically significant differences between groups within treatment timepoints for flexion-extension, lateral bending, or axial rotation range of motion, neutral zone, neutral zone stiffness, or elastic zone stiffness. μCT bone volume fraction was significantly greater between treatment groups independent of timepoint where Autograft and rhPDGF-BB + collagen/β-TCP treatments demonstrated significantly greater bone volume fraction as compared to collagen/β-TCP (P = .026 and P = .038, respectively) and Empty cage treatments (P = .002 and P = .003, respectively). μCT mean bone density fraction was most improved in rhPDGF-BB + collagen/β-TCP specimens at the 8 week and 16-week timepoints as compared to all other treatment groups. There were no statistically significant differences in histomorphometric measurements of bone, soft tissue, or empty space between rhPDGF-BB + collagen/β-TCP and autograft treatments. CONCLUSIONS The results of this study indicate that the use of rhPDGF-BB combined with collagen/β-TCP promotes spinal fusion comparable to that of autograft bone. CLINICAL SIGNIFICANCE The data indicate that rhPDGF-BB combined with collagen/β-TCP promotes spinal fusion comparably to autograft bone treatment and may offer a viable alternative in large animal spinal fusion. Future prospective clinical studies are necessary to fully understand the role of rhPDGF-BB combined with collagen/β-TCP in human spinal fusion healing.
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Affiliation(s)
- Benjamin C. Gadomski
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering and School of Biomedical EngineeringColorado State UniversityFort CollinsColoradoUSA
| | - Kevin M. Labus
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering and School of Biomedical EngineeringColorado State UniversityFort CollinsColoradoUSA
| | - Christian M. Puttlitz
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering and School of Biomedical EngineeringColorado State UniversityFort CollinsColoradoUSA
| | - Kirk C. McGilvray
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering and School of Biomedical EngineeringColorado State UniversityFort CollinsColoradoUSA
| | - Daniel P. Regan
- Department of Microbiology, Immunology, and PathologyColorado State UniversityFort CollinsColoradoUSA
| | - Brad Nelson
- Preclinical Surgical Research Laboratory, Department of Clinical SciencesColorado State UniversityFort CollinsColoradoUSA
| | - Howard B. Seim
- Preclinical Surgical Research Laboratory, Department of Clinical SciencesColorado State UniversityFort CollinsColoradoUSA
| | - Jeremiah T. Easley
- Preclinical Surgical Research Laboratory, Department of Clinical SciencesColorado State UniversityFort CollinsColoradoUSA
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10
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Ryan G, Magony R, Gortler H, Godbout C, Schemitsch EH, Nauth A. Systemically impaired fracture healing in small animal research: A review of fracture repair models. J Orthop Res 2021; 39:1359-1367. [PMID: 33580554 DOI: 10.1002/jor.25003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/09/2020] [Accepted: 02/10/2021] [Indexed: 02/04/2023]
Abstract
Fracture healing is a complex process requiring mechanical stability, an osteoconductive matrix, and osteoinductive and osteogenic biology. This intricate process is easily disrupted by various patient factors such as chronic disease and lifestyle. As the medical complexity and age of patients with fractures continue to increase, the importance of developing relevant experimental models is becoming paramount in preclinical research. The objective of this review is to describe the most common small animal models of systemically impaired fracture healing used in the orthopedic literature including osteoporosis, diabetes mellitus, smoking, alcohol use, obesity, and ageing. This review will provide orthopedic researchers with a summary of current models of systemically impaired fracture healing used in small animals and present an overview of the methods of induction for each condition.
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Affiliation(s)
- Gareth Ryan
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital - Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Richard Magony
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital - Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Hilary Gortler
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital - Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Charles Godbout
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital - Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Emil H Schemitsch
- Department of Surgery, Division of Orthopaedic Surgery, University of Western Ontario, London, Ontario, Canada
| | - Aaron Nauth
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital - Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada.,Department of Surgery, Division of Orthopaedic Surgery, St. Michael's Hospital - Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
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11
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Commercial Bone Grafts Claimed as an Alternative to Autografts: Current Trends for Clinical Applications in Orthopaedics. MATERIALS 2021; 14:ma14123290. [PMID: 34198691 PMCID: PMC8232314 DOI: 10.3390/ma14123290] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 02/08/2023]
Abstract
In the last twenty years, due to an increasing medical and market demand for orthopaedic implants, several grafting options have been developed. However, when alternative bone augmentation materials mimicking autografts are searched on the market, commercially available products may be grouped into three main categories: cellular bone matrices, growth factor enhanced bone grafts, and peptide enhanced xeno-hybrid bone grafts. Firstly, to obtain data for this review, the search engines Google and Bing were employed to acquire information from reports or website portfolios of important competitors in the global bone graft market. Secondly, bibliographic databases such as Medline/PubMed, Web of Science, and Scopus were also employed to analyse data from preclinical/clinical studies performed to evaluate the safety and efficacy of each product released on the market. Here, we discuss several products in terms of osteogenic/osteoinductive/osteoconductive properties, safety, efficacy, and side effects, as well as regulatory issues and costs. Although both positive and negative results were reported in clinical applications for each class of products, to date, peptide enhanced xeno-hybrid bone grafts may represent the best choice in terms of risk/benefit ratio. Nevertheless, more prospective and controlled studies are needed before approval for routine clinical use.
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12
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Kim HJ, Kim KH, Lee YM, Ku Y, Rhyu IC, Seol YJ. In ovariectomy-induced osteoporotic rat models, BMP-2 substantially reversed an impaired alveolar bone regeneration whereas PDGF-BB failed. Clin Oral Investig 2021; 25:6159-6170. [PMID: 33939007 DOI: 10.1007/s00784-021-03915-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/25/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES We previously suggested an ovariectomy (OVX)-induced osteoporotic rat model showing an impaired alveolar bone defect healing. This study aimed to evaluate and compare the effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) and recombinant human platelet-derived growth factor-BB (rhPDGF-BB) on alveolar bone defect healing in OVX-induced osteoporotic rats. MATERIALS AND METHODS A total of forty-one female rats were divided into four groups: a collagen group (n=10), a PDGF-BB group (n=11), a BMP-2 group (n=10), and a control group (n=10). Four months after OVX, alveolar bone drill-hole defects were created and grafted with collagen gel, rhPDGF-BB/collagen gel, or rhBMP-2/collagen gel. The defects in the control group were not grafted with any material. Defect healing was evaluated by histological, histomorphometric, and microcomputed tomographic (micro-CT) analyses at 2 and 4 weeks. RESULTS According to the micro-CT analysis, the BMP-2 group exhibited the greatest bone volume fraction among all groups, while the PDGF-BB group did not show significant differences compared with the collagen group. The histomorphometric analysis showed a significantly larger amount of new bone area in the BMP-2 group than in the control and collagen groups at 4 weeks; however, the PDGF-BB group did not reach significant superiority compared with the other groups. CONCLUSIONS Alveolar bone regeneration was significantly enhanced by the local use of rhBMP-2/collagen gel compared with the use of rhPDGF-BB/collagen gel in OVX-induced osteoporotic rats. CLINICAL RELEVANCE A treatment modality using rhBMP-2 may be a promising approach to promote alveolar bone regeneration in patients suffering from postmenopausal osteoporosis.
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Affiliation(s)
- Hyun Ju Kim
- Department of Periodontics, Seoul National University Dental Hospital, 101 Daehakno, Jongno-gu, Seoul, 03080, Korea
| | - Kyoung-Hwa Kim
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehakno, Jongno-gu, Seoul, 03080, Korea
| | - Yong-Moo Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehakno, Jongno-gu, Seoul, 03080, Korea
| | - Young Ku
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehakno, Jongno-gu, Seoul, 03080, Korea
| | - In-Chul Rhyu
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehakno, Jongno-gu, Seoul, 03080, Korea
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehakno, Jongno-gu, Seoul, 03080, Korea.
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13
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Brun J, Andreasen CM, Ejersted C, Andersen TL, Caverzasio J, Thouverey C. PDGF Receptor Signaling in Osteoblast Lineage Cells Controls Bone Resorption Through Upregulation of Csf1 Expression. J Bone Miner Res 2020; 35:2458-2469. [PMID: 32777109 DOI: 10.1002/jbmr.4150] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/25/2020] [Accepted: 07/29/2020] [Indexed: 12/15/2022]
Abstract
The physiological functions of platelet-derived growth factor receptors (PDGFRs) α and β in osteoblast biology and bone metabolism remain to be established. Here, we show that PDGFRA and PDGFRB genes are expressed by osteoblast-lineage canopy and reversal cells in close proximity to PDGFB-expressing osteoclasts within human trabecular bone remodeling units. We also report that, although removal of only one of the two PDGFRs in Osterix-positive cells does not affect bone phenotype, suppression of both PDGFRs in those osteoblast lineage cells increases trabecular bone volume in male mice as well as in female gonad-intact and ovariectomized mice. Furthermore, osteoblast lineage-specific suppression of PDGFRs reduces Csf1 expression, bone marrow level of macrophage colony-stimulating factor (M-CSF), number of osteoclasts, and, therefore, bone resorption, but does not change bone formation. Finally, abrogation of PDGFR signaling in osteoblasts blocks PDGF-induced ERK1/2-mediated Csf1 expression and M-CSF secretion in osteoblast cultures and calcitriol-mediated osteoclastogenesis in co-cultures. In conclusion, our results indicate that PDGFR signaling in osteoblast lineage cells controls bone resorption through ERK1/2-mediated Csf1 expression. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Julia Brun
- Service of Bone Diseases, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland
| | - Christina Møller Andreasen
- Clinical Cell Biology, Pathology Research Unit, Odense University Hospital, Odense C, Denmark.,Department of Molecular Medicine, University of Southern Denmark, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Charlotte Ejersted
- Department of Endocrinology, Odense University Hospital, Odense C, Denmark
| | - Thomas Levin Andersen
- Clinical Cell Biology, Pathology Research Unit, Odense University Hospital, Odense C, Denmark.,Department of Molecular Medicine, University of Southern Denmark, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Joseph Caverzasio
- Service of Bone Diseases, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland
| | - Cyril Thouverey
- Service of Bone Diseases, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland
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14
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Yalçınozan M, Türker M, Çırpar M. Effects of a novel biodegredable implant system on a rat tibia fracture model. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2020; 54:453-460. [PMID: 32812878 DOI: 10.5152/j.aott.2020.18331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed to determine the effects of a novel biodegradable implant releasing platelet-derived growth factor (PDGF) at the fracture site on fracture healing in a rat tibia fracture model. METHODS In this study, 35 male Sprague-Dawley rats weighing between 300 and 350 g were used. The rats were divided into four groups: Group A (control group without any treatment, n=10), Group B (spacer without PDGF Group, n=10), Group C (spacer with PDGF group, n=10), and Group D (healthy rat Group, n=5). Standardized fractures were created in the right tibias of rats, and then biodegradable implants made of poly-β-hydroxybutyrate-co-3-hydroxy valerate were implanted at the fracture sites in Groups B and C. In Group C, implants were loaded with 600 ng of PDGF. Animals were sacrificed 30 days after the operation, and fracture healing in each group was assessed radiologically based on the Goldberg score. Furthermore, the anteroposterior (AP) and mediolateral (ML) callus diameters were measured macroscopically, and fracture sites were mechanically tested. RESULTS In the radiological assessment, Group C showed higher fracture healing rate than Groups A and B (p=0.001), whereas no significant difference was found between group C and Group D (p>0.05). In the macroscopic assessment, while Group C exhibited the thickest AP callus diameter (p=0.02), no significant differences in ML callus diameters existed among the groups (p>0.05). Mechanical testing revealed that Group C had higher torsional strength (p=0.001) and stiffness than Groups A and B (p=0.001) while there was no significant difference between Groups C and D (p>0.05). CONCLUSION Biodegradable implant releasing PDGF may have positive effects on fracture healing.
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Affiliation(s)
- Mehmet Yalçınozan
- Department of Orthopaedics and Traumatology, Near East University Hospital, Mersin, Turkey
| | - Mehmet Türker
- Department of Orthopaedics and Traumatology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Meriç Çırpar
- Department of Orthopaedics and Traumatology, Kırıkkale University School of Medicine, Kırıkkale, Turkey
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15
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Rothe R, Hauser S, Neuber C, Laube M, Schulze S, Rammelt S, Pietzsch J. Adjuvant Drug-Assisted Bone Healing: Advances and Challenges in Drug Delivery Approaches. Pharmaceutics 2020; 12:E428. [PMID: 32384753 PMCID: PMC7284517 DOI: 10.3390/pharmaceutics12050428] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/24/2020] [Accepted: 05/01/2020] [Indexed: 02/06/2023] Open
Abstract
Bone defects of critical size after compound fractures, infections, or tumor resections are a challenge in treatment. Particularly, this applies to bone defects in patients with impaired bone healing due to frequently occurring metabolic diseases (above all diabetes mellitus and osteoporosis), chronic inflammation, and cancer. Adjuvant therapeutic agents such as recombinant growth factors, lipid mediators, antibiotics, antiphlogistics, and proangiogenics as well as other promising anti-resorptive and anabolic molecules contribute to improving bone healing in these disorders, especially when they are released in a targeted and controlled manner during crucial bone healing phases. In this regard, the development of smart biocompatible and biostable polymers such as implant coatings, scaffolds, or particle-based materials for drug release is crucial. Innovative chemical, physico- and biochemical approaches for controlled tailor-made degradation or the stimulus-responsive release of substances from these materials, and more, are advantageous. In this review, we discuss current developments, progress, but also pitfalls and setbacks of such approaches in supporting or controlling bone healing. The focus is on the critical evaluation of recent preclinical studies investigating different carrier systems, dual- or co-delivery systems as well as triggered- or targeted delivery systems for release of a panoply of drugs.
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Affiliation(s)
- Rebecca Rothe
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany; (R.R.); (S.H.); (C.N.); (M.L.)
- School of Science, Faculty of Chemistry and Food Chemistry, Technische Universität Dresden, 01069 Dresden, Germany
| | - Sandra Hauser
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany; (R.R.); (S.H.); (C.N.); (M.L.)
| | - Christin Neuber
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany; (R.R.); (S.H.); (C.N.); (M.L.)
| | - Markus Laube
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany; (R.R.); (S.H.); (C.N.); (M.L.)
| | - Sabine Schulze
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, 01307 Dresden, Germany; (S.S.); (S.R.)
- Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Stefan Rammelt
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, 01307 Dresden, Germany; (S.S.); (S.R.)
- Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
- Center for Regenerative Therapies Dresden (CRTD), Tatzberg 4, 01307 Dresden, Germany
| | - Jens Pietzsch
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany; (R.R.); (S.H.); (C.N.); (M.L.)
- School of Science, Faculty of Chemistry and Food Chemistry, Technische Universität Dresden, 01069 Dresden, Germany
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16
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Kyyak S, Blatt S, Pabst A, Thiem D, Al-Nawas B, Kämmerer PW. Combination of an allogenic and a xenogenic bone substitute material with injectable platelet-rich fibrin - A comparative in vitro study. J Biomater Appl 2020; 35:83-96. [PMID: 32237950 DOI: 10.1177/0885328220914407] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The aim of the in vitro study was a comparison of an allogenic (ABSM) and a xenogenic bone substitute material (XBSM) with and without injectable platelet-rich fibrin (ABSM-i-PRF & XBSM-i-PRF) on cell characteristics of human osteoblasts (HOB). Here, ABSM and XBSM (+ i-PRF = test; - i-PRF = control) were incubated with HOB for 3, 7 and 10 days. HOB viability, migration, proliferation and differentiation (RT-PCR on alkaline phosphatase (AP), bone morphogenetic protein 2 (BMP-2) and osteonectin (OCN)) were measured and compared between groups. At day 3, an increased viability, migration and proliferation was seen for ABSM-i-PRF. For viability and proliferation (days 7 and 10) and for migration (day 10), ABSM-i-PRF/XBSM-i-PRF showed higher values compared to ABSM/XBSM with maximum values for ABSM-i-PRF and minimum values for XBSM. At days 3 and 7, the highest expression of AP was detected in ABSM-i-PRF/XBSM-i-PRF when compared to ABSM/XBSM, whereas at day 10, AP expression levels were elevated in ABSM-i-PRF/ABSM. The highest BMP-2 expression was seen in ABSM-i-PRF whereas OCN expression showed higher levels in ABSM-i-PRF/XBSM-i-PRF at days 3 and 7 with lowest expression for ABSM. Later on, elevated OC levels were detected for ABSM-i-PRF only. In conclusion, i-PRF in combination with ABSM enhances HOB activity when compared to XBSM-i-PRF or untreated BSM in vitro. Therefore, addition of i-PRF to ABSM and - to a lower extent - to XBSM may influence osteoblast activity in vivo.
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Affiliation(s)
- Solomiya Kyyak
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Sebastian Blatt
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Andreas Pabst
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, Koblenz, Germany
| | - Daniel Thiem
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
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17
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Rothe R, Schulze S, Neuber C, Hauser S, Rammelt S, Pietzsch J. Adjuvant drug-assisted bone healing: Part III - Further strategies for local and systemic modulation. Clin Hemorheol Microcirc 2020; 73:439-488. [PMID: 31177207 DOI: 10.3233/ch-199104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In this third in a series of reviews on adjuvant drug-assisted bone healing, further approaches aiming at influencing the healing process are discussed. Local and systemic modulation of bone metabolism is pursued with use of a number of drugs with completely different indications, which are characterized by a pleiotropic spectrum of action. These include drugs used to treat lipid disorders (HMG-CoA reductase inhibitors), hypertension (ACE inhibitors), osteoporosis (bisphosphonates), cancer (proteasome inhibitors) and others. Potential applications to enhance bone healing are discussed.
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Affiliation(s)
- Rebecca Rothe
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Sabine Schulze
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany.,Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christin Neuber
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Sandra Hauser
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Stefan Rammelt
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany.,Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Center for Regenerative Therapies Dresden (CRTD), Tatzberg 4, Dresden
| | - Jens Pietzsch
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,Technische Universität Dresden, School of Science, Faculty of Chemistry and Food Chemistry, Dresden, Germany
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18
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Functionalization of Silk Fibers by PDGF and Bioceramics for Bone Tissue Regeneration. COATINGS 2019. [DOI: 10.3390/coatings10010008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Bone regeneration is a complex, well-organized physiological process of bone formation observed during normal fracture healing and involved in continuous remodeling throughout adult life. An ideal medical device for bone regeneration requires interconnected pores within the device to allow for penetration of blood vessels and cells, enabling material biodegradation and bone ingrowth. Additional mandatory characteristics include an excellent resorption rate, a 3D structure similar to natural bone, biocompatibility, and customizability to multiple patient-specific geometries combined with adequate mechanical strength. Therefore, endless silk fibers were spun from native silk solution isolated from silkworm larvae and functionalized with osteoconductive bioceramic materials. In addition, transgenic silkworms were generated to functionalize silk proteins with human platelet-derived growth factor (hPDGF). Both, PDGF-silk and bioceramic modified silk were then assembled into 3D textile implants using an additive manufacturing approach. Textile implants were characterized in terms of porosity, compressive strength, and cyclic load. In addition, osteogenic differentiation of mesenchymal stem cells was evaluated. Silk fiber-based 3D textile implants showed good cytocompatibility and stem cells cultured on bioceramic material functionalized silk implants were differentiating into bone cells. Thus, functionalized 3D interconnected porous textile scaffolds were shown to be promising biomaterials for bone regeneration.
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19
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Ma Q, Jiang N, Liang S, Chen F, Fang L, Wang X, Wang J, Chen L. Functionalization of a clustered TiO 2 nanotubular surface with platelet derived growth factor-BB covalent modification enhances osteogenic differentiation of bone marrow mesenchymal stem cells. Biomaterials 2019; 230:119650. [PMID: 31806404 DOI: 10.1016/j.biomaterials.2019.119650] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 11/19/2019] [Accepted: 11/21/2019] [Indexed: 02/05/2023]
Abstract
A multitude of micro- and nano-surface structures have been developed to improve the clinical performance of endosseous titanium (Ti) implants. However, most of these surface structures only simulate the topographic elements on a micro- or nano-scale. In this study, a nano-micro hierarchical TiO2 clustered nanotubular structure was fabricated using anodization, and then functionalized with platelet derived growth factor-BB (PDGF-BB) using PhoA (11-hydroxyundecylphosphonic acid)/CDI (carbonyldiimidazole) chemistry. The resulting 3-dimensional spatial biomimetic structure, named NTPCP, exhibited negligible cytotoxicity and satisfactory bio-activity for host cells, and significantly enhanced the attachment as well as osteogenesis-related functions (early-stage proliferation, extracellular matrix synthesis and mineralization) of human bone marrow mesenchymal stem cells (bMSCs). We observed drastically elevated expression of osteocalcin (OCN), which mirrored prominent bone formation around the NTPCP implants in a rat model. This study establishes a novel strategy to improve the osseointegration of endosseous Ti implants via surface nano-topographic modification and bio-factor covalent functionalization.
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Affiliation(s)
- Qianli Ma
- Department of Immunology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China; Center for Molecular Inflammation Research (CEMIR), Norwegian University of Science and Technology, NTNU, Trondheim, Norway; Department of Clinical and Molecular Medicine (IKOM), Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Nan Jiang
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway; Center for Eye Research, Department Ophthalmology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Shuang Liang
- Department of Immunology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Fulin Chen
- Faculty of Medicine, Northwest University, Xi'an, 710069, China
| | - Liang Fang
- Department of Immunology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Xian Wang
- Department of Orthodontics, College of Stomatology, Fourth Military Medical University, Xi'an, 710032, China
| | - Jinjin Wang
- Department of Periodontics, College of Stomatology, Fourth Military Medical University, Xi'an, 710032, China
| | - Lihua Chen
- Department of Immunology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China.
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20
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Henderson S, Ibe I, Cahill S, Chung YH, Lee FY. Bone Quality and Fracture-Healing in Type-1 and Type-2 Diabetes Mellitus. J Bone Joint Surg Am 2019; 101:1399-1410. [PMID: 31393433 DOI: 10.2106/jbjs.18.01297] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Shasta Henderson
- Department of Orthopaedics, Pennsylvania State University, Hershey, Pennsylvania
| | - Izuchukwu Ibe
- Department of Orthopaedics and Rehabilitation (I.I.), Yale School of Medicine (S.C., Y.-H.C., and F.Y.L.), New Haven, Connecticut
| | - Sean Cahill
- Department of Orthopaedics and Rehabilitation (I.I.), Yale School of Medicine (S.C., Y.-H.C., and F.Y.L.), New Haven, Connecticut
| | - Yeon-Ho Chung
- Department of Orthopaedics and Rehabilitation (I.I.), Yale School of Medicine (S.C., Y.-H.C., and F.Y.L.), New Haven, Connecticut
| | - Francis Y Lee
- Department of Orthopaedics and Rehabilitation (I.I.), Yale School of Medicine (S.C., Y.-H.C., and F.Y.L.), New Haven, Connecticut
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21
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Bolte J, Vater C, Culla AC, Ahlfeld T, Nowotny J, Kasten P, Disch AC, Goodman SB, Gelinsky M, Stiehler M, Zwingenberger S. Two-step stem cell therapy improves bone regeneration compared to concentrated bone marrow therapy. J Orthop Res 2019; 37:1318-1328. [PMID: 30628121 DOI: 10.1002/jor.24215] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 12/26/2018] [Indexed: 02/04/2023]
Abstract
Adult stem cells are a promising tool to positively influence bone regeneration. Concentrated bone marrow therapy entails isolating osteoprogenitor cells during surgery with, however, only low cells yield. Two step stem cell therapy requires an additional harvesting procedure but generates high numbers of progenitor cells that facilitate osteogenic pre-differentiation. To further improve bone regeneration, stem cell therapy can be combined with growth factors from platelet rich plasma (PRP) or its lysate (PL) to potentially fostering vascularization. The aim of this study was to investigate the effects of bone marrow concentrate (BMC), osteogenic pre-differentiation of mesenchymal stromal cells (MSCs), and PL on bone regeneration and vascularization. Bone marrow from four different healthy human donors was used for either generation of BMC or for isolation of MSCs. Seventy-two mice were randomized to six groups (Control, PL, BMC, BMC + PL, pre-differentiated MSCs, pre-differentiated MSCs + PL). The influence of PL, BMC, and pre-differentiated MSCs was investigated systematically in a 2 mm femoral bone defect model. After a 6-week follow-up, the pre-differentiated MSCs + PL group showed the highest bone volume, highest grade of histological defect healing and highest number of bridged defects with measurable biomechanical stiffness. Using expanded and osteogenically pre-differentiated MSCs for treatment of a critical-size bone defect was favorable with regards to bone regeneration compared to treatment with cells from BMC. The addition of PL alone had no significant influence; therefore the role of PL for bone regeneration remains unclear. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1318-1328, 2019.
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Affiliation(s)
- Julia Bolte
- University Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Fetscherstraße 74, TU Dresden 01307, Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, University Medicine Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
| | - Corina Vater
- University Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Fetscherstraße 74, TU Dresden 01307, Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, University Medicine Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
| | - Anna Carla Culla
- University Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Fetscherstraße 74, TU Dresden 01307, Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, University Medicine Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
| | - Tilman Ahlfeld
- Center for Translational Bone, Joint and Soft Tissue Research, University Medicine Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
| | - Jörg Nowotny
- University Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Fetscherstraße 74, TU Dresden 01307, Dresden, Germany
| | - Philip Kasten
- Orthopädisch Chirurgisches Centrum, Tübingen, Germany
| | - Alexander C Disch
- University Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Fetscherstraße 74, TU Dresden 01307, Dresden, Germany
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Michael Gelinsky
- Center for Translational Bone, Joint and Soft Tissue Research, University Medicine Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
| | - Maik Stiehler
- University Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Fetscherstraße 74, TU Dresden 01307, Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, University Medicine Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
| | - Stefan Zwingenberger
- University Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Fetscherstraße 74, TU Dresden 01307, Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, University Medicine Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
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22
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Botega II, Zamarioli A, Guedes PMSG, Silva RABD, Issa JPM, Butezloff MM, Sousa YTCS, Ximenez JPB, Volpon JB. Bone callus formation is highly disrupted by dietary restriction in growing rats sustaining a femoral fracture1. Acta Cir Bras 2019; 34:e20190010000002. [PMID: 30785503 PMCID: PMC6585920 DOI: 10.1590/s0102-865020190010000002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/05/2018] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To evaluate the effects of food restriction on fracture healing in growing rats. METHODS Sixty-eight male Wistar rats were assigned to two groups: (1) Control and (2) Dietary restriction. After weaning the dietary restricted animals were fed ad libitum for 42 days with 50% of the standard chow ingested by the control group. Subsequently, the animals underwent bone fracture at the diaphysis of the right femur, followed by surgical stabilization of bone fragments. On days 14 and 28 post-fracture, the rats were euthanized, and the fractured femurs were dissected, the callus was analyzed by dual-energy X-ray absorptiometry, micro-computed tomography, histomorphometry, mechanical tests, and gene expression. RESULTS Dietary restriction decreased body mass gain and resulted in several phenotypic changes at the bone callus (a delay in cell proliferation and differentiation, lower rate of newly formed bone and collagen deposition, reductions in bone callus density and size, decrease in tridimensional callus volume, deterioration in microstructure, and reduction in bone callus strength), together with the downregulated expression of osteoblast-related genes. CONCLUSION Dietary restriction had detrimental effects on osseous healing, with a healing delay and a lower quality of bone callus formation.
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Affiliation(s)
- Iara Inácio Botega
- Fellow Master degree, Postgraduate Program in Health Sciences Applied to the Locomotor System, School of Medicine, Universidade de São Paulo (USP), Ribeirao Preto-SP, Brazil. Design of the study, technical procedures, acquisition and interpretation of data, manuscript preparation
| | - Ariane Zamarioli
- Researcher, Laboratory of Bioengineering, School of Medicine, USP, Ribeirao Preto-SP, Brazil. Design of the study, interpretation of data, manuscript preparation, critical revision
| | - Patrícia Madalena San Gregório Guedes
- Fellow Master degree, Postgraduate Program in Health Sciences Applied to the Locomotor System, School of Medicine, USP, Ribeirao Preto-SP, Brazil. Technical procedures, acquisition of data
| | - Raquel Assed Bezerra da Silva
- PhD, Associate Professor, Department of Children's Clinic, School of Dentistry, USP, Ribeirao Preto-SP, Brazil. Technical procedures, critical revision
| | - João Paulo Mardegan Issa
- PhD, Associate Professor, Department of Morphology, Physiology and Basic Pathology, School of Dentistry, USP, Ribeirao Preto-SP, Brazil. Technical procedures, critical revision
| | - Mariana Maloste Butezloff
- Fellow PhD degree, Postgraduate Program in Health Sciences Applied to the Locomotor System, School of Medicine, USP, Ribeirao Preto-SP, Brazil. Technical procedures
| | | | - João Paulo Bianchi Ximenez
- Fellow PhD degree, Postgraduate Program in Toxicology, School of Pharmaceutical Sciences, USP, Ribeirao Preto-SP, Brazil. Statistical analysis, technical procedures, critical revision
| | - José Batista Volpon
- Full Professor, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, School of Medicine, USP, Ribeirao Preto-SP, Brazil. Design, intellectual and scientific content of the study; manuscript preparation, critical revision, final approval
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23
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Ge J, Gan M, Wu C, Yan Q, Chen Y, Yang H, Zou J. Effects of PDGF-B Overexpression on the Biological Activity of Nucleus Pulposus Cells. J HARD TISSUE BIOL 2019. [DOI: 10.2485/jhtb.28.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jun Ge
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Minfeng Gan
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Cenhao Wu
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Qi Yan
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Yufeng Chen
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Huilin Yang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Jun Zou
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
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24
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Chen W, Wang F, Tian C, Wang Y, Xu S, Wang R, Hou K, Zhao P, Yu L, Lu Z, Xia Q. Transgenic Silkworm-Based Silk Gland Bioreactor for Large Scale Production of Bioactive Human Platelet-Derived Growth Factor (PDGF-BB) in Silk Cocoons. Int J Mol Sci 2018; 19:ijms19092533. [PMID: 30150526 PMCID: PMC6164493 DOI: 10.3390/ijms19092533] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/20/2018] [Indexed: 01/17/2023] Open
Abstract
Human platelet derived growth factor (PDGF) is a major therapeutic protein with great demand in the clinical setting; however, its rate of supply is far from meeting needs. Here, we provide an effective strategy to produce PDGF-BB in large quantities using a transgenic silkworm. The codon-optimized PDGF-B gene regulated by the highly efficient sericin-1 expression system was integrated into the genome of a silkworm. The high transcriptional expression of the PDGF-BB gene in the transgenic silkworm competitively inhibited the transcription expression of the endogenous sericin-1 gene which caused a significant 37.5% decline. The PDGF-BB synthesized in the middle silk gland (MSG) of transgenic silkworms could form a homodimer through intermolecular disulfide bonds, which is then secreted into sericin lumen and finally, distributed in the sericin layer of the cocoon. In this study, a protein quantity of approximately 0.33 mg/g was found in the cocoon. Following a purification process, approximately 150.7 μg of recombinant PDGF-BB with a purity of 82% was purified from 1 g of cocoons. Furthermore, the bioactivity assays showed that the purified recombinant PDGF-BB was able to promote the growth, proliferation and migration of NIH/3T3 cells significantly. These results suggest that the silk gland bioreactor can produce active recombinant PDGF-BB as an efficient mitogen and wound healing agent.
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Affiliation(s)
- Wenjing Chen
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing 400715, China.
- Chongqing Engineering and Technology Research Center for Novel Silk Materials, Southwest University, Chongqing 400715, China.
- Chongqing Key Laboratory of Mulberry Silkworm, Southwest University, Chongqing 400715, China.
| | - Feng Wang
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing 400715, China.
- Chongqing Engineering and Technology Research Center for Novel Silk Materials, Southwest University, Chongqing 400715, China.
- Chongqing Key Laboratory of Mulberry Silkworm, Southwest University, Chongqing 400715, China.
| | - Chi Tian
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing 400715, China.
- Chongqing Engineering and Technology Research Center for Novel Silk Materials, Southwest University, Chongqing 400715, China.
- Chongqing Key Laboratory of Mulberry Silkworm, Southwest University, Chongqing 400715, China.
| | - Yuancheng Wang
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing 400715, China.
- Chongqing Engineering and Technology Research Center for Novel Silk Materials, Southwest University, Chongqing 400715, China.
- Chongqing Key Laboratory of Mulberry Silkworm, Southwest University, Chongqing 400715, China.
| | - Sheng Xu
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing 400715, China.
- Chongqing Engineering and Technology Research Center for Novel Silk Materials, Southwest University, Chongqing 400715, China.
- Chongqing Key Laboratory of Mulberry Silkworm, Southwest University, Chongqing 400715, China.
| | - Riyuan Wang
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing 400715, China.
- Chongqing Engineering and Technology Research Center for Novel Silk Materials, Southwest University, Chongqing 400715, China.
- Chongqing Key Laboratory of Mulberry Silkworm, Southwest University, Chongqing 400715, China.
| | - Kai Hou
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing 400715, China.
- Chongqing Engineering and Technology Research Center for Novel Silk Materials, Southwest University, Chongqing 400715, China.
- Chongqing Key Laboratory of Mulberry Silkworm, Southwest University, Chongqing 400715, China.
| | - Ping Zhao
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing 400715, China.
- Chongqing Engineering and Technology Research Center for Novel Silk Materials, Southwest University, Chongqing 400715, China.
- Chongqing Key Laboratory of Mulberry Silkworm, Southwest University, Chongqing 400715, China.
| | - Ling Yu
- Institute for Clean Energy & Advanced Materials, Faculty of Materials & Energy, Southwest University, Chongqing 400715, China.
| | - Zhisong Lu
- Institute for Clean Energy & Advanced Materials, Faculty of Materials & Energy, Southwest University, Chongqing 400715, China.
| | - Qingyou Xia
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing 400715, China.
- Chongqing Engineering and Technology Research Center for Novel Silk Materials, Southwest University, Chongqing 400715, China.
- Chongqing Key Laboratory of Mulberry Silkworm, Southwest University, Chongqing 400715, China.
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25
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Hu Z, Ma C, Rong X, Zou S, Liu X. Immunomodulatory ECM-like Microspheres for Accelerated Bone Regeneration in Diabetes Mellitus. ACS APPLIED MATERIALS & INTERFACES 2018; 10:2377-2390. [PMID: 29280610 PMCID: PMC6437671 DOI: 10.1021/acsami.7b18458] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Bone repair and regeneration process is markedly impaired in diabetes mellitus (DM) that affects hundreds of millions of people worldwide. As a chronic inflammatory disease, DM creates a proinflammatory microenvironment in defective sites. Most of the studies on DM-associated bone regeneration, however, neglect the importance of immunomodulation under the DM condition and adopt the same approaches to normal bone healing, leading to limited bone healing. In this study, we developed a unique bioinspired injectable microsphere as an osteoimmunomodulatory biomaterial that modulates macrophages to create a prohealing microenvironment under the DM condition. The microsphere was self-assembled with heparin-modified gelatin nanofibers, and interleukin 4 (IL4) was incorporated into the nanofibrous heparin-modified gelatin microsphere (NHG-MS). IL4 has binding domains with heparin, and the binding of IL4 to heparin stabilizes this cytokine, protects it from denaturation and degradation, and subsequently prolongs its sustained release to modulate macrophage polarization. The IL4-loaded NHG-MS switched the proinflammatory M1 macrophage into a prohealing M2 phenotype, recovered the M2/M1 ratio to a normal level, efficiently resolved the inflammation, and ultimately enhanced osteoblastic differentiation and bone regeneration. The development of osteoimmunomodulatory biomaterials that harness the power of macrophages for immunomodulation, therefore, is a novel and promising strategy to enhance bone regeneration under DM condition.
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Affiliation(s)
- Zhiai Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, Texas 75246, United States
| | - Chi Ma
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, Texas 75246, United States
| | - Xin Rong
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Shujuan Zou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Corresponding Authors (S.Z.)., (X.L.)
| | - Xiaohua Liu
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, Texas 75246, United States
- Corresponding Authors (S.Z.)., (X.L.)
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26
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Park SY, Kim KH, Park CH, Shin SY, Rhyu IC, Lee YM, Seol YJ. Enhanced Bone Regeneration by Diabetic Cell-Based Adenoviral BMP-2 Gene Therapy in Diabetic Animals. Tissue Eng Part A 2018; 24:930-942. [PMID: 29160182 DOI: 10.1089/ten.tea.2017.0101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The application of bone morphogenetic protein 2 (BMP-2) has been extensively investigated to improve diabetes-impaired bone healing; however, the delivery of BMP-2 by gene therapy for bone regeneration has rarely been investigated in diabetic animals. In this study, we aimed to evaluate which cells induce more new bone formation in diabetic animals when cell-based BMP2 gene therapy is applied. For this purpose, we harvested bone marrow stromal cells (BMSCs) twice in the same animal before (non-diabetic BMSCs; nBMSCs) and after diabetes induction (diabetic BMSCs; dBMSCs) using modified bone marrow ablation methods. And then, cells were transduced by adenoviral vectors carrying the BMP2 gene (AdBMP2). In in vitro, AdBMP2-transfected dBMSCs (B2/dBMSCs) produced higher BMP-2 mRNA levels over 48 h, whereas AdBMP2-transfected nBMSCs (B2/nBMSCs) exhibited a transient increase in BMP-2 mRNA followed by a decrease to the baseline level within 48 h. Both B2/dBMSCs and B2/nBMSCs induced secretion of BMP-2 for 3 weeks. However, B2/dBMSC BMP-2 secretion peaked from day 3 to 10, whereas B2/nBMSC BMP-2 secretion peaked from day 1 to 7. The analysis of osteogenic activity revealed that mineralization nodule formation and the expression levels of osteogenic genes were significantly higher in B2/dBMSCs than B2/nBMSCs and were accompanied by upregulation of canonical Wnt/β-catenin and Smad signaling. AdBMP2-transfected autologous cells were implanted into critical-sized calvarial defects in diabetic animals and induced significantly more bone regeneration than non-AdBMP2-transfected cells. In addition, B2/dBMSCs led to significantly more new bone formation than B2/nBMSCs. Thus, BMP2 gene therapy using diabetic cells effectively supported diabetic bone healing and it was related to the enhanced responses to AdBMP2 of dBMSCs.
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Affiliation(s)
- Shin-Young Park
- 1 Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University , Seoul, Korea.,2 Section of Dentistry, Department of Periodontology, Seoul National University Bundang Hospital , Seongnam, Gyeonggi-do, Korea
| | - Kyoung-Hwa Kim
- 1 Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University , Seoul, Korea
| | - Chan-Ho Park
- 3 Dental Research Institute, Seoul National University , Seoul, Korea
| | - Seung-Yun Shin
- 4 Department of Periodontology, Institute of Oral Biology, School of Dentistry, Kyung Hee University , Seoul, Korea
| | - In-Chul Rhyu
- 1 Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University , Seoul, Korea
| | - Yong-Moo Lee
- 1 Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University , Seoul, Korea
| | - Yang-Jo Seol
- 1 Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University , Seoul, Korea
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27
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Heldin CH, Lennartsson J, Westermark B. Involvement of platelet-derived growth factor ligands and receptors in tumorigenesis. J Intern Med 2018; 283:16-44. [PMID: 28940884 DOI: 10.1111/joim.12690] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Platelet-derived growth factor (PDGF) isoforms and their receptors have important roles during embryogenesis, particularly in the development of various mesenchymal cell types in different organs. In the adult, PDGF stimulates wound healing and regulates tissue homeostasis. However, overactivity of PDGF signalling is associated with malignancies and other diseases characterized by excessive cell proliferation, such as fibrotic conditions and atherosclerosis. In certain tumours, genetic or epigenetic alterations of the genes for PDGF ligands and receptors drive tumour cell proliferation and survival. Examples include the rare skin tumour dermatofibrosarcoma protuberance, which is driven by autocrine PDGF stimulation due to translocation of a PDGF gene, and certain gastrointestinal stromal tumours and leukaemias, which are driven by constitute activation of PDGF receptors due to point mutations and formation of fusion proteins of the receptors, respectively. Moreover, PDGF stimulates cells in tumour stroma and promotes angiogenesis as well as the development of cancer-associated fibroblasts, both of which promote tumour progression. Inhibitors of PDGF signalling may thus be of clinical usefulness in the treatment of certain tumours.
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Affiliation(s)
- C-H Heldin
- Ludwig Institute for Cancer Research, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - J Lennartsson
- Ludwig Institute for Cancer Research, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - B Westermark
- Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden
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28
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Scott RT, McAlister JE, Rigby RB. Allograft Bone: What Is the Role of Platelet-Derived Growth Factor in Hindfoot and Ankle Fusions. Clin Podiatr Med Surg 2018; 35:37-52. [PMID: 29156166 DOI: 10.1016/j.cpm.2017.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Arthrodesis of the ankle or foot is a common procedure for chronic pain and disability. Nonunion remains a prevalent complication among arthrodesis procedures. Some patients present with an inherent risk of developing a nonunion. Allograft biologics have gained popularity in an effort to reduce complications such as nonunion. Various biologics bring unique properties while maintaining a singular purpose. Platelet-derived growth factor (PDGF) may be introduced into a fusion site to facilitate healthy bony consolidation. The purpose of this article is to review the benefits and modalities of PDGF and how it can improve patient outcomes in ankle and hindfoot fusions.
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Affiliation(s)
- Ryan T Scott
- The CORE Institute, 18444 North 25th Avenue, Suite 210, Phoenix, AZ 85023, USA.
| | - Jeffrey E McAlister
- The CORE Institute, 18444 North 25th Avenue, Suite 210, Phoenix, AZ 85023, USA
| | - Ryan B Rigby
- Logan Regional Orthopedics, 1350 North 500 East, Logan, UT 84341, USA
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29
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Ippolito JA, Krell ES, Cottrell J, Meyer R, Clark D, Nguyen D, Sudah S, Muñoz M, Lim E, Lin A, Lee TJH, O'Connor JP, Benevenia J, Lin SS. Effects of local vanadium delivery on diabetic fracture healing. J Orthop Res 2017; 35:2174-2180. [PMID: 28084655 DOI: 10.1002/jor.23521] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 01/09/2017] [Indexed: 02/04/2023]
Abstract
This study evaluated the effect of local vanadyl acetylacetonate (VAC), an insulin mimetic agent, upon the early and late parameters of fracture healing in rats using a standard femur fracture model. Mechanical testing, and radiographic scoring were performed, as well as histomorphometry, including percent bone, percent cartilage, and osteoclast numbers. Fractures treated with local 1.5 mg/kg VAC possessed significantly increased mechanical properties compared to controls at 6 weeks post-fracture, including increased torque to failure (15%; p = 0.046), shear modulus (89%; p = 0.043), and shear stress (81%; p = 0.009). The radiographic scoring analysis showed increased cortical bridging at 4 weeks and 6 weeks (119%; p = 0.036 and 209%; p = 0.002) in 1.5 mg/kg VAC treated groups. Histomorphometry of the fracture callus at days 10 and 14 showed increased percent cartilage (121%; p = 0.009 and 45%; p = 0.035) and percent mineralized tissue (66%; p = 0.035 and 58%; p = 0.006) with local VAC treated groups compared to control. Additionally, fewer osteoclasts were observed in the local VAC treated animals as compared to controls at day 14 (0.45% ± 0.29% vs. 0.83% ± 0.36% of callus area; p = 0.032). The results suggest local administration of VAC acts to modulate osteoclast activity and increase percentage of early callus cartilage, ultimately enhancing mechanical properties comparably to non-diabetic animals treated with local VAC. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2174-2180, 2017.
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Affiliation(s)
- Joseph A Ippolito
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Ethan S Krell
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Jessica Cottrell
- Department of Biological Sciences, Seton Hall University, South Orange, New Jersey
| | - Ryan Meyer
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Devin Clark
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Daniel Nguyen
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Suleiman Sudah
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Maximillian Muñoz
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Elisha Lim
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Anthony Lin
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Thomas Jae Hoon Lee
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - James Patrick O'Connor
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Joseph Benevenia
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
| | - Sheldon S Lin
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 7300, Newark, New Jersey 07101
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30
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Majidinia M, Sadeghpour A, Yousefi B. The roles of signaling pathways in bone repair and regeneration. J Cell Physiol 2017; 233:2937-2948. [DOI: 10.1002/jcp.26042] [Citation(s) in RCA: 187] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 06/06/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Maryam Majidinia
- Solid Tumor Research Center; Urmia University of Medical Sciences; Urmia Iran
| | - Alireza Sadeghpour
- Department of Orthopedic Surgery, School of Medicine and Shohada Educational Hospital; Tabriz University of Medical Sciences; Tabriz Iran
- Drug Applied Research Center; Tabriz University of Medical Sciences; Tabriz Iran
| | - Bahman Yousefi
- Immunology Research Center; Tabriz University of Medical Sciences; Tabriz Iran
- Molecular Targeting Therapy Research Group; Faculty of Medicine; Tabriz University of Medical Sciences; Tabriz Iran
- Stem cell and Regenerative Medicine Institute; Tabriz University of Medical Sciences; Tabriz Iran
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Lin H, O'Connor JP. Osteoclast depletion with clodronate liposomes delays fracture healing in mice. J Orthop Res 2017; 35:1699-1706. [PMID: 27653179 PMCID: PMC7582234 DOI: 10.1002/jor.23440] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 09/15/2016] [Indexed: 02/04/2023]
Abstract
Osteoclasts are abundant within the fracture callus and also localize at the chondro-osseous junction. However, osteoclast functions during fracture healing are not well defined. Inhibition of osteoclast formation or resorptive activity impairs callus remodeling but does not prevent callus formation. Interestingly, though anti-osteoclast therapies differentially affect resolution of callus cartilage into bone. Treatments that inhibit osteoclast formation or viability tend to impair callus cartilage resolution, while treatments that target inhibition of bone resorption generally do not affect callus cartilage resolution. Here, we tested whether depletion of osteoclasts by systemic treatment with clodronate liposomes would similarly impair callus cartilage resolution. ICR mice were treated by intraperitoneal injections of clodronate-laden liposomes or control liposomes and subjected to closed femur fracture. Femurs were resected at multiple times after fracture and analyzed by radiography, histology, and mechanical testing to determine effects on healing. Clodronate liposome treatment did not prevent callus formation. However, radiographic scoring indicated that clodronate liposome treatment impaired healing. Clodronate liposome treatment significantly reduced callus osteoclast populations and delayed resolution of callus cartilage. Consistent with continued presence of callus cartilage, torsional mechanical testing found significant decreases in callus material properties after 28 days of healing. The results support a role for osteoclasts in the resolution of callus cartilage into bone. Whether the cartilage resolution role for osteoclasts is limited to simply resorbing cartilage at the chondro-osseous junction or in promoting bone formation at the chondro-osseous junction through another mechanism, perhaps similar to the reversal process in bone remodeling, will require further experimentation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1699-1706, 2017.
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Affiliation(s)
- Hsuan‐Ni Lin
- Department of OrthopaedicsGraduate School of Biomedical Sciences and New Jersey Medical School, RutgersThe State University of New JerseyNewark185 South Orange AvenueNew Jersey07103
| | - J. Patrick O'Connor
- Department of OrthopaedicsGraduate School of Biomedical Sciences and New Jersey Medical School, RutgersThe State University of New JerseyNewark185 South Orange AvenueNew Jersey07103
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Ma C, Wei Q, Cao B, Cheng X, Tian J, Pu H, Yusufu A, Cao L. A multifunctional bioactive material that stimulates osteogenesis and promotes the vascularization bone marrow stem cells and their resistance to bacterial infection. PLoS One 2017; 12:e0172499. [PMID: 28358890 PMCID: PMC5373515 DOI: 10.1371/journal.pone.0172499] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 02/06/2017] [Indexed: 12/28/2022] Open
Abstract
The main limitation of tissue engineering lies in the inability to stimulate osteogenesis, angiogenesis of stem cells and broad-spectrum antimicrobial activity. However, the development of multifunctional bioactive materials with these capabilities remains a great challenge. In this study, we prepared mesoporous silica nanoparticles encapsulated with silver nanocrystals (AG-MSN) with uniform sphere size and mesopores. Platelet-derived growth factor BB (PDGF-BB) was effectively loaded in the AG-MSN mesopores (P-AG-MSN). The silicon ions (Si) released by P-AG-MSN stimulate osteogenic differentiation of bone marrow stromal cells (BMSC) by activating the alkaline phosphatase (ALP) activity of bone-related genes and increasing protein (OCN, RUNX2 and OPN) expression. Ag+ ions could be slowly released from the interior of the shell, highlighting their durable antibacterial activity. The sustained release of PDGF-BB from P-AG-MSN stimulated the angiogenic differentiation of BMSC, as indicated by the enhanced secretion of vascular endothelial growth factor (VEGF), HIF-1α, HGF and ANG-1 and protein expression. Our results show that P-AG-MSN can clearly promote BMSC osteostimulation and vascularization. This research serves as a preliminary study of the utilization of this multifunctional mixture to fabricate a new active biological scaffold that integrates BMSC osteostimulation, vascularization and bactericidal effects by 3D printing technology.
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Affiliation(s)
- Chuang Ma
- Department of Orthopedics Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Department of Orthopedics Center, First Affiliated Hospital of Xinjiang Medical University Chang Ji Branch, Chang Ji, China
| | - Qin Wei
- Xinjiang Key Laboratory of Medical Animal Model Research, Clinical Medical Research Institute of the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Bo Cao
- Department of Orthopedics Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xinchun Cheng
- Carders Health Care No. 4 Department of Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, China
| | - Juling Tian
- Department of Clinical Laboratory, The first people's Hospital of Urumqi, Urumqi, China
| | - Hongwei Pu
- Department of Science and Research Education Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Aihemaitijiang Yusufu
- Department of Orthopedics Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- * E-mail: (AY); (LC)
| | - Li Cao
- Department of Orthopedics Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- * E-mail: (AY); (LC)
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Abstract
BACKGROUND This study examined the efficacy of calcium sulfate (CaSO4) as a carrier for intramedullary delivery of zinc chloride (ZnCl2) to treat fracture healing in a BB Wistar rat model. A non-carrier-mediated injection of 3.0 mg/kg of ZnCl2 has previously been shown to enhance fracture healing. METHODS A heterogeneous mixture of ZnCl2 and CaSO4 was administered into the intramedullary femoral canal and a mid-diaphyseal femur fracture was created unilaterally. Early and late parameters of fracture healing were assessed using biomechanical testing, radiographic scoring, quantitative histomorphometry (for percentage of new cartilage and bone within the fracture callus), and long-term histologic evaluation. RESULTS Fractures treated with 1.0 mg/kg of ZnCl2/CaSO4 demonstrated a significantly higher maximum torque to failure compared with both CaSO4 (P = 0.048) and saline (P = 0.005) controls at 4 weeks postfracture (396.4 versus 251.3 versus 178.7 N mm, respectively). Statistically significant increases in torsional rigidity, effective shear modulus, and effective shear stress were also found, as well as a 3.5 times increase in radiographic score (based on bone union). Histologic examination of the fracture callus indicated enhanced chondrogenesis at day 14 postfracture, with increased percent cartilage for the ZnCl2/CaSO4 group compared with saline (P = 0.0004) and CaSO4 (P = 0.0453) controls. Long-term radiographic and histologic evaluation revealed no abnormal bone formation or infection up to 12 weeks postoperatively. CONCLUSIONS The effective dose of ZnCl2 augmentation for the enhancement of fracture healing in rats was reduced 3-fold in this study compared with previous findings. Furthermore, CaSO4 acted synergistically with ZnCl2 to increase the mechanical strength and stability at the fracture site.
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Camargo WA, de Vries R, van Luijk J, Hoekstra JW, Bronkhorst EM, Jansen JA, van den Beucken JJJP. Diabetes Mellitus and Bone Regeneration: A Systematic Review and Meta-Analysis of Animal Studies. TISSUE ENGINEERING PART B-REVIEWS 2017; 23:471-479. [PMID: 27981888 DOI: 10.1089/ten.teb.2016.0370] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The regeneration of bone defects resulting from trauma, resection of tumors, infection, or congenital disease is a challenge, and bone grafts are utilized in a wide array of clinical settings to augment bone repair and regeneration. Diabetes mellitus (DM) is a chronic metabolic disease, which affects 8.3% of the world population, summing ∼387 million individuals. The consequences of the disease, for example, hyperglycemia, have been associated to a reduced capacity to form bone and poor bone quality, influencing bone healing. Our aim was to systematically review the literature to the effect of diabetic condition on bone regeneration in animal models, when using bone substitute materials from different origins, and perform a meta-analysis to quantitatively study the effect of DM on bone regeneration. METHODS An extensive search strategy was carried out through PubMed and EMBASE to identify the potential relevant studies published from database inception until July 1, 2015. Initially, the title and abstract of 1409 studies were screened, after which inclusion criteria sorted 29 studies for full-text evaluation. After using exclusion criteria, a final number of seven studies could be included in the review. RESULTS The seven included studies that passed our inclusion/exclusion criteria were all type 1 diabetes, comprising a total of 189 animals and 14 intrastudy comparisons. These studies presented a consistent and reduced risk of bias and showed a significant average effect size of -6.87% of bone formation for diabetes type 1 versus healthy condition [95% confidence interval: -10.55 to -3.18; I2 = 87.4%; p = 0.0003]. INTERPRETATION These findings prove that DM type 1 negatively influences bone formation compared with a healthy condition, irrespective of the bone substitute material used.
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Affiliation(s)
- Winston A Camargo
- 1 Department of Biomaterials (309), Radboud University Medical Center , Nijmegen, The Netherlands
| | - Rob de Vries
- 2 Systematic Review Centre for Laboratory Animal Experimentation, Radboud University Medical Center , Nijmegen, The Netherlands
| | - Judith van Luijk
- 2 Systematic Review Centre for Laboratory Animal Experimentation, Radboud University Medical Center , Nijmegen, The Netherlands
| | - Jan Willem Hoekstra
- 1 Department of Biomaterials (309), Radboud University Medical Center , Nijmegen, The Netherlands
| | - Ewald M Bronkhorst
- 1 Department of Biomaterials (309), Radboud University Medical Center , Nijmegen, The Netherlands
| | - John A Jansen
- 1 Department of Biomaterials (309), Radboud University Medical Center , Nijmegen, The Netherlands
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Abstract
Nonunion remains the most impactful complication following ankle and hindfoot arthrodesis. Historically, surgeons have relied on autologous bone graft (ABG) to combat nonunion risk. Although effective, ABG remains limited in quantity, varies in quality, and can be associated with harvest site pain and morbidity. Use of alternative bone-stimulating agents, however, avoids harvesting an autograft, and provides a more predictable dose-response efficacy. This article highlights findings from basic science, animal, and human clinical research that led to the approval of Augment Bone Graft. We present an adaptation of the surgical techniques described for investigators participating in the pivotal trial.
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Ye C, Zhang W, Jiang S, Yu Y, Zhou X, Zhu L, Xue D, He R. Platelet-derived growth factor-BB attenuates titanium-particle-induced osteolysis in vivo. Growth Factors 2016; 34:177-186. [PMID: 27776448 DOI: 10.1080/08977194.2016.1240680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Inflammation and osteoclastogenesis play critical roles in wear-particle-induced periprosthetic osteolysis (WPO). Platelet-derived growth factor-BB (PDGF-BB) could promote osteogenesis and inhibit inflammatory response. The aim of this study was to investigate the impact of PDGF-BB on WPO. Mice were divided into four groups, namely, sham, vehicle, low-, and high-dose PDGF-BB groups. Mice in the rhPDGF-BB groups were treated with PDGF-BB at 0.25 or 1 mg/ml/kg/day. Mice in the sham and vehicle groups received PBS daily. Two weeks after surgery, calvariae were harvested. Immunohistochemical analysis and μ-CT showed that PDGF-BB significantly reduced osteoclast formation and bone resorption. ELISA showed that rhPDGF-BB decreased the secretion of TNF-α, IL-1β, and IL-6. Western blotting revealed that rhPDGF-BB stimulated the expression of osteocalcin and osteoprotegerin. Furthermore, more VEGF and CD31 proteins were observed due to PDGF-BB by immunofluorescence. In conclusion, these findings suggest that rhPDGF-BB represents a potential treatment for WPO.
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Affiliation(s)
- Chenyi Ye
- a Department of Orthopedic Surgery , the Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , Zhejiang , China
| | - Wei Zhang
- a Department of Orthopedic Surgery , the Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , Zhejiang , China
| | - Shuai Jiang
- a Department of Orthopedic Surgery , the Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , Zhejiang , China
| | - Yuanbin Yu
- a Department of Orthopedic Surgery , the Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , Zhejiang , China
| | - Xiaoyu Zhou
- a Department of Orthopedic Surgery , the Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , Zhejiang , China
| | - Ling Zhu
- a Department of Orthopedic Surgery , the Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , Zhejiang , China
| | - Deting Xue
- a Department of Orthopedic Surgery , the Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , Zhejiang , China
| | - Rongxin He
- a Department of Orthopedic Surgery , the Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , Zhejiang , China
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Abstract
Nonunion after tibial shaft fracture and hindfoot arthrodesis remains a major problem. Known risk factors include advanced age, immunosuppression, smoking, and diabetes. Several factors must be considered in the fracture healing process. This review evaluates the efficacy of orthobiologics in improving union rates after fracture or arthrodesis. Use of compounds have shown increased cellular proliferation experimentally. Percutaneous autologous bone marrow has shown increased cellular proliferation. Matrix supplementation has shown significant improvements in bone healing. Several studies have highlighted the importance of adequate graft fill over graft type. Patients at increased risk for nonunion would benefit most from these adjuvant therapies.
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Affiliation(s)
- Sheldon S Lin
- Department of Orthopaedics, Rutgers New Jersey Medical School, 90 Bergen Street, Room 7300, Newark, NJ 07101, USA.
| | - Michael G Yeranosian
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen Street, ACC Building, Suite D-1610, Newark, NJ 07103, USA
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Luvizuto ER, Tangl S, Dobsak T, Reich K, Gruber R, Sonoda CK, Okamoto R. Effect of recombinant PDGF-BB on bone formation in the presence of β-tricalcium phosphate and bovine bone mineral matrix: a pilot study in rat calvarial defects. BMC Oral Health 2016; 16:52. [PMID: 27145819 PMCID: PMC4855859 DOI: 10.1186/s12903-016-0210-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 04/21/2016] [Indexed: 11/10/2022] Open
Abstract
Background Supplementation of bone substitutes with recombinant platelet-derived growth factor-BB (PDGF-BB) can enhance bone regeneration. The aim of the study was to evaluate the effect of PDGF-BB on bone formation in the presence of β-tricalcium phosphate and bovine bone mineral matrix in a rat calvaria defect model. Methods The authors examined 5 mm rat calvarial defects treated with β-tricalcium phosphate (TCP) or demineralized bovine bone mineral (DBBM) with and without 0.3 mg/ml recombinant PDGF-BB. Calvaria defects were randomly divided into the following treatment groups (n = 5); TCP; TCP plus PDGF-BB; DBBM; DBBM plus PDGF-BB; and untreated empty control. After 45 days, bone formation was evaluated by histomorphometry and fluorescence microscopy. Results The authors report that the area of newly formed bone was similar between the empty controls and the two bone substitutes, TCP and DBBM. Supplementation of TCP and DBBM with PDGF-BB had no significant impact on bone formation. Fluorochrome staining revealed no visible changes in the pattern of bone formation in defects filled with TCP and DBBM, irrespective of PDGF-BB. Furthermore, supplementation with PDGF-BB did not influence biomaterial degradation. Conclusions The authors concluded that PDGF-BB had no impact on bone formation and degradation of bone substitutes in the respective rodent models. Thus, possible beneficial effects of PDGF-BB may require other model situations.
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Affiliation(s)
- Eloá R Luvizuto
- Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP-Univ Estadual Paulista, São Paulo, Brazil
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Toni Dobsak
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Karoline Reich
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Reinhard Gruber
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland. .,Department of Oral Biology, Medical University of Vienna, Vienna, Austria.
| | - Celso K Sonoda
- Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP-Univ Estadual Paulista, São Paulo, Brazil
| | - Roberta Okamoto
- Department of Anatomy, Araçatuba Dental School, UNESP-Univ Estadual Paulista, São Paulo, Brazil
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Abstract
STUDY DESIGN Preclinical animal study. OBJECTIVE Determine the in vivo effects of platelet-derived growth factor BB (PDGF-BB) delivered in a thiol-modified hyaluronic acid (TMHA) hydrogel on intervertebral disk (IVD) degeneration. SUMMARY OF BACKGROUND DATA IVD degeneration is a worldwide health concern and remains without an effective treatment. Several in vitro studies have demonstrated the potential of PDGF-BB, a primary component of platelet-rich plasma, as a therapy for IVD degeneration. Our hypotheses were that treatment of injured IVDs with PDGF would inhibit degeneration and that administration of PDGF in a TMHA hydrogel would improve its efficacy. METHODS IVD degeneration was induced using the rabbit annular puncture model. Four weeks after injury, IVDs were treated with either PDGF-BB or PDGF-BB delivered within a TMHA hydrogel. The efficacy of treatment was determined using x-ray, MRI, histology, and biomechanical testing. RESULTS At 4 weeks after treatment, cell apoptosis and deposition of matrix containing type III collagen a1 (Col3a1) was demonstrated in both the nucleus pulposus and annulus fibrosus, while this was inhibited by PDGF. At 8 weeks after treatment, disc area and MRI indices of injured IVDs treated with PDGF were significantly higher (P < 0.05) than those treated with the TMHA alone. Similarly, degenerative scores for saline- and TMHA-treated IVDs demonstrated significantly more degeneration (P < 0.05) than PDGF-treated IVDs at 8 weeks. Biomechanical assessments found fewer indicators of degeneration in PDGF-TMHA-treated IVDs at both 4 and 8 weeks post-treatment, compared to saline-, TMHA-, and PDGF-only-treated IVDs. Both PDGF- and PDGF-TMHA-treated IVDs also demonstrated a significant increase (P < 0.05) in compressive strength to failure, compared with controls at 8 weeks post-treatment. CONCLUSION The results of this study suggest that PDGF-BB significantly decreases disc degeneration and when delivered in a TMHA gel scaffold, helps prevent both apoptosis and Col3 matrix production, while maintaining disc structure and biomechanical function. LEVEL OF EVIDENCE NA.
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Tollemar V, Collier ZJ, Mohammed MK, Lee MJ, Ameer GA, Reid RR. Stem cells, growth factors and scaffolds in craniofacial regenerative medicine. Genes Dis 2016; 3:56-71. [PMID: 27239485 PMCID: PMC4880030 DOI: 10.1016/j.gendis.2015.09.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 09/22/2015] [Indexed: 02/08/2023] Open
Abstract
Current reconstructive approaches to large craniofacial skeletal defects are often complicated and challenging. Critical-sized defects are unable to heal via natural regenerative processes and require surgical intervention, traditionally involving autologous bone (mainly in the form of nonvascularized grafts) or alloplasts. Autologous bone grafts remain the gold standard of care in spite of the associated risk of donor site morbidity. Tissue engineering approaches represent a promising alternative that would serve to facilitate bone regeneration even in large craniofacial skeletal defects. This strategy has been tested in a myriad of iterations by utilizing a variety of osteoconductive scaffold materials, osteoblastic stem cells, as well as osteoinductive growth factors and small molecules. One of the major challenges facing tissue engineers is creating a scaffold fulfilling the properties necessary for controlled bone regeneration. These properties include osteoconduction, osetoinduction, biocompatibility, biodegradability, vascularization, and progenitor cell retention. This review will provide an overview of how optimization of the aforementioned scaffold parameters facilitates bone regenerative capabilities as well as a discussion of common osteoconductive scaffold materials.
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Affiliation(s)
- Viktor Tollemar
- The University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USA
- Department of Orthopedic Surgery and Rehabilitation Medicine, The University of Chicago Medical Center, Chicago, IL 60637, USA
- Laboratory of Craniofacial Biology and Development, Section of Plastic and Reconstructive Surgery, Department of Surgery, The University of Chicago Medicine, Chicago, IL 60637, USA
| | - Zach J. Collier
- The University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USA
- Department of Orthopedic Surgery and Rehabilitation Medicine, The University of Chicago Medical Center, Chicago, IL 60637, USA
| | - Maryam K. Mohammed
- The University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USA
- Department of Orthopedic Surgery and Rehabilitation Medicine, The University of Chicago Medical Center, Chicago, IL 60637, USA
| | - Michael J. Lee
- Department of Orthopedic Surgery and Rehabilitation Medicine, The University of Chicago Medical Center, Chicago, IL 60637, USA
| | - Guillermo A. Ameer
- Department of Surgery, Feinberg School of Medicine, Chicago, IL 60611, USA
- Biomedical Engineering Department, Northwestern University, Evanston, IL 60208, USA
| | - Russell R. Reid
- Laboratory of Craniofacial Biology and Development, Section of Plastic and Reconstructive Surgery, Department of Surgery, The University of Chicago Medicine, Chicago, IL 60637, USA
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Xu MT, Sun S, Zhang L, Xu F, Du SL, Zhang XD, Wang DW. Diabetes mellitus affects the biomechanical function of the callus and the expression of TGF-beta1 and BMP2 in an early stage of fracture healing. ACTA ACUST UNITED AC 2015; 49:e4736. [PMID: 26628397 PMCID: PMC4681414 DOI: 10.1590/1414-431x20154736] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 08/13/2015] [Indexed: 01/08/2023]
Abstract
Transforming growth factor beta 1 (TGF-β1) and bone morphogenetic protein-2 (BMP-2)
are important regulators of bone repair and regeneration. In this study, we examined
whether TGF-β1 and BMP-2 expressions were delayed during bone healing in type 1
diabetes mellitus. Tibial fractures were created in 95 diabetic and 95 control adult
male Wistar rats of 10 weeks of age. At 1, 2, 3, 4, and 5 weeks after fracture
induction, five rats were sacrificed from each group. The expressions of TGF-β1 and
BMP2 in the fractured tibias were measured by immunohistochemistry and quantitative
reverse-transcription polymerase chain reaction, weekly for the first 5 weeks
post-fracture. Mechanical parameters (bending rigidity, torsional rigidity,
destruction torque) of the healing bones were also assessed at 3, 4, and 5 weeks
post-fracture, after the rats were sacrificed. The bending rigidity, torsional
rigidity and destruction torque of the two groups increased continuously during the
healing process. The diabetes group had lower mean values for bending rigidity,
torsional rigidity and destruction torque compared with the control group
(P<0.05). TGF-β1 and BMP-2 expression were significantly lower (P<0.05) in the
control group than in the diabetes group at postoperative weeks 1, 2, and 3. Peak
levels of TGF-β1 and BMP-2 expression were delayed by 1 week in the diabetes group
compared with the control group. Our results demonstrate that there was a delayed
recovery in the biomechanical function of the fractured bones in diabetic rats. This
delay may be associated with a delayed expression of the growth factors TGF-β1 and
BMP-2.
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Affiliation(s)
- M T Xu
- Department of Joint Surgery, Shandong Provincial Hospital, Shandong University, Jinan, Shandong Province, China
| | - S Sun
- Department of Joint Surgery, Shandong Provincial Hospital, Shandong University, Jinan, Shandong Province, China
| | - L Zhang
- Department of Orthopaedics, Liaocheng People's Hospital, Liaocheng Clinical School, Taishan Medical University, Liaocheng, Shandong Province, China
| | - F Xu
- Central Laboratory, Liaocheng People's Hospital, Liaocheng Clinical School, Taishan Medical College, Liaocheng, Shandong Province, China
| | - S L Du
- Department of Orthopaedics, Liaocheng People's Hospital, Liaocheng Clinical School, Taishan Medical University, Liaocheng, Shandong Province, China
| | - X D Zhang
- Department of Pathology, Liaocheng People's Hospital, Liaocheng Clinical School, Taishan Medical University, Liaocheng, Shandong Province, China
| | - D W Wang
- Department of Orthopaedics, Liaocheng People's Hospital, Liaocheng Clinical School, Taishan Medical University, Liaocheng, Shandong Province, China
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Kim YH, Tabata Y. Dual-controlled release system of drugs for bone regeneration. Adv Drug Deliv Rev 2015; 94:28-40. [PMID: 26079284 DOI: 10.1016/j.addr.2015.06.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/23/2015] [Accepted: 06/08/2015] [Indexed: 02/08/2023]
Abstract
Controlled release systems have been noted to allow drugs to enhance their ability for bone regeneration. To this end, various biomaterials have been used as the release carriers of drugs, such as low-molecular-weight drugs, growth factors, and others. The drugs are released from the release carriers in a controlled fashion to maintain their actions for a long time period. Most research has been focused on the controlled release of single drugs to demonstrate the therapeutic feasibility. Controlled release of two combined drugs, so-called dual release systems, are promising and important for tissue regeneration. This is because the tissue regeneration process of bone formation is generally achieved by multiple bioactive molecules, which are produced from cells by other molecules. If two types of bioactive molecules, (i.e., drugs), are supplied in an appropriate fashion, the regeneration process of living bodies will be efficiently promoted. This review focuses on the bone regeneration induced by dual-controlled release of drugs. In this paper, various dual-controlled release systems of drugs aiming at bone regeneration are overviewed explaining the type of drugs and their release materials.
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Extracellular signaling molecules to promote fracture healing and bone regeneration. Adv Drug Deliv Rev 2015; 94:3-12. [PMID: 26428617 DOI: 10.1016/j.addr.2015.09.008] [Citation(s) in RCA: 193] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 09/12/2015] [Accepted: 09/16/2015] [Indexed: 12/31/2022]
Abstract
To date, the delivery of signaling molecules for bone regeneration has focused primarily on factors that directly affect the bone formation pathways (osteoinduction) or that serve to increase the number of bone forming progenitor cells. The first commercialized growth factors approved for bone regeneration, Bone Morphogenetic Protein 2 and 7 (BMP2 and BMP7), are direct inducers of osteoblast differentiation. As well, newer generations of potential therapeutics that target the Wnt signaling pathway are also direct osteoinducers. On the other hand, some signaling molecules may play a role as mitogens and serve to increase the number of bone producing cells or may increase vascularization. This is true for factors such as Platelet Derived Growth Factor (PDGF) or Fibroblast Growth Factor (FGF). Vascular Endothelial Growth Factor (VEGF) likely has a special role. Not only does it induce new blood vessel formation, it also has direct effects on osteoblasts through endothelial cell-based BMP production. In addition to these pathways that classically have targeted bone production, there are also opportunities to target other aspects of the bone healing process such as inflammation, vascularization, and cell ingress to the fracture site. Bone regeneration is highly complex with defined, yet overlapping stages of healing. We will review established and novel extracellular signaling factors associated with various stages of fracture healing that could be targeted to promote enhanced bone regeneration. Importantly, multiple potential cell and tissues could be targeted to enhance healing in addition to focusing solely on osteoinductive therapeutics.
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Chen W, Baylink DJ, Brier-Jones J, Neises A, Kiroyan JB, Rundle CH, Lau KHW, Zhang XB. PDGFB-based stem cell gene therapy increases bone strength in the mouse. Proc Natl Acad Sci U S A 2015; 112:E3893-900. [PMID: 26150503 PMCID: PMC4517286 DOI: 10.1073/pnas.1501759112] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Substantial advances have been made in the past two decades in the management of osteoporosis. However, none of the current medications can eliminate the risk of fracture and rejuvenate the skeleton. To this end, we recently reported that transplantation of hematopoietic stem/progenitor cells (HSCs) or Sca1(+) cells engineered to overexpress FGF2 results in a significant increase in lamellar bone matrix formation at the endosteum; but this increase was attended by the development of secondary hyperparathyroidism and severe osteomalacia. Here we switch the therapeutic gene to PDGFB, another potent mitogen for mesenchymal stem cells (MSCs) but potentially safer than FGF2. We found that modest overexpression of PDGFB using a relatively weak phosphoglycerate kinase (PGK) promoter completely avoided osteomalacia and secondary hyperparathyroidism, and simultaneously increased trabecular bone formation and trabecular connectivity, and decreased cortical porosity. These effects led to a 45% increase in the bone strength. Transplantation of PGK-PDGFB-transduced Sca1(+) cells increased MSC proliferation, raising the possibility that PDGF-BB enhances expansion of MSC in the vicinity of the hematopoietic niche where the osteogenic milieu propels the differentiation of MSCs toward an osteogenic destination. Our therapy should have potential clinical applications for patients undergoing HSC transplantation, who are at high risk for osteoporosis and bone fractures after total body irradiation preconditioning. It could eventually have wider application once the therapy can be applied without the preconditioning.
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Affiliation(s)
- Wanqiu Chen
- Department of Medicine, Loma Linda University, Loma Linda, CA 92354
| | - David J Baylink
- Department of Medicine, Loma Linda University, Loma Linda, CA 92354
| | | | - Amanda Neises
- Department of Medicine, Loma Linda University, Loma Linda, CA 92354
| | - Jason B Kiroyan
- Department of Medicine, Loma Linda University, Loma Linda, CA 92354
| | - Charles H Rundle
- Department of Medicine, Loma Linda University, Loma Linda, CA 92354; Musculoskeletal Disease Center, Jerry L. Pettis Memorial VA Medical Center, Loma Linda, CA 92357
| | - Kin-Hing William Lau
- Department of Medicine, Loma Linda University, Loma Linda, CA 92354; Musculoskeletal Disease Center, Jerry L. Pettis Memorial VA Medical Center, Loma Linda, CA 92357
| | - Xiao-Bing Zhang
- Department of Medicine, Loma Linda University, Loma Linda, CA 92354;
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Christersson A, Sandén B, Larsson S. Prospective randomized feasibility trial to assess the use of rhPDGF-BB in treatment of distal radius fractures. J Orthop Surg Res 2015; 10:37. [PMID: 25888774 PMCID: PMC4396574 DOI: 10.1186/s13018-015-0174-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/22/2015] [Indexed: 11/12/2022] Open
Abstract
Background Recombinant human platelet-derived growth factor BB (rhPDGF-BB) combined with an osteoconductive scaffold (β-TCP) has been demonstrated to increase bone formation, but rhPDGF-BB has not been studied in human fractures. The purpose of this study was to evaluate the safety and potential use of locally administered rhPDGF-BB/β-TCP (Augment®) in acute wrist fractures. Methods Forty patients with unstable distal radial fracture were randomized to closed reduction and external fixation alone (n = 20) or combined with injection of rhPDGF-BB/β-TCP (Augment®) into the fracture (n = 20). All patients were followed for 24 weeks. Outcome was based on adverse events, fracture displacement on radiographs, fracture healing, range of motion, grip strength, pain, and the disability of the arm, shoulder and hand (DASH) score. Results There were no serious adverse events in the study, but the pin tract infection rate was significantly lower in the Augment® group. There was no difference between the groups in fracture healing time, based on number of healed cortices or fracture displacement. The Augment® group had an early temporary significant decrease in wrist flexion, but no difference in range of motion at 24 weeks. There were no differences between the two treatment groups for any other outcome variables. Conclusion rhPDGF-BB/β-TCP (Augment®) is safe and convenient for local administration into wrist fractures. In this pilot study, we could not detect any reduced healing time in the Augment® group although potential efficacy should be addressed in larger studies. Clinical trial registration number The clinical trial registration number for the study protocol is BMPI-2014-02-E.
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Affiliation(s)
- Albert Christersson
- Department of Orthopedics, Uppsala University, Sjukhusvägen 1, 751 85, Uppsala, Sweden.
| | - Bengt Sandén
- Department of Orthopedics, Uppsala University, Sjukhusvägen 1, 751 85, Uppsala, Sweden.
| | - Sune Larsson
- Department of Orthopedics, Uppsala University, Sjukhusvägen 1, 751 85, Uppsala, Sweden.
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Wallner C, Schira J, Wagner JM, Schulte M, Fischer S, Hirsch T, Richter W, Abraham S, Kneser U, Lehnhardt M, Behr B. Application of VEGFA and FGF-9 enhances angiogenesis, osteogenesis and bone remodeling in type 2 diabetic long bone regeneration. PLoS One 2015; 10:e0118823. [PMID: 25742620 PMCID: PMC4350939 DOI: 10.1371/journal.pone.0118823] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/09/2015] [Indexed: 02/07/2023] Open
Abstract
Although bone regeneration is typically a reliable process, type 2 diabetes is associated with impaired or delayed healing processes. In addition, angiogenesis, a crucial step in bone regeneration, is often altered in the diabetic state. In this study, different stages of bone regeneration were characterized in an unicortical bone defect model comparing transgenic type 2 diabetic (db-/db-) and wild type (WT) mice in vivo. We investigated angiogenesis, callus formation and bone remodeling at early, intermediate and late time points by means of histomorphometry as well as protein level analyses. In order to enhance bone regeneration, defects were locally treated with recombinant FGF-9 or VEGFA. Histomorphometry of aniline blue stained sections indicated that bone regeneration is significantly decreased in db-/db- as opposed to WT mice at intermediate (5 days post operation) and late stages (7 days post operation) of bone regeneration. Moreover, immunohistochemical analysis revealed significantly decreased levels of RUNX-2, PCNA, Osteocalcin and PECAM-1 in db-/db- defects. In addition, osteoclastogenesis is impaired in db-/db- indicating altered bone remodeling. These results indicate significant impairments in angiogenesis and osteogenesis in type 2 diabetic bones. Importantly, angiogenesis, osteogenesis and bone remodeling could be reconstituted by application of recombinant FGF-9 and, in part, by VEGFA application. In conclusion, our study demonstrates that type 2 diabetes affects angiogenesis, osteogenesis and subsequently bone remodeling, which in turn leads to decreased bone regeneration. These effects could be reversed by local application of FGF-9 and to a lesser degree VEGFA. These data could serve as a basis for future therapeutic applications aiming at improving bone regeneration in the type 2 diabetic patient population.
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Affiliation(s)
- Christoph Wallner
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Jessica Schira
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Johannes Maximilian Wagner
- Department of Plastic Surgery, BG Trauma Hospital Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Matthias Schulte
- Department of Plastic Surgery, BG Trauma Hospital Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Sebastian Fischer
- Department of Plastic Surgery, BG Trauma Hospital Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Tobias Hirsch
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Wiltrud Richter
- Research Centre for Experimental Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Stephanie Abraham
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Ulrich Kneser
- Department of Plastic Surgery, BG Trauma Hospital Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Marcus Lehnhardt
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Björn Behr
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
- * E-mail:
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Park TH, Anand A. Management of diabetic foot: Brief synopsis for busy orthopedist. J Clin Orthop Trauma 2015; 6:24-9. [PMID: 26549948 PMCID: PMC4551462 DOI: 10.1016/j.jcot.2014.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 10/21/2014] [Indexed: 12/28/2022] Open
Abstract
According to available medical reports, over 10% of diabetic patients will develop foot ulcers during their lifetimes. This condition still remains great challenges to many clinicians. Various mechanisms may explain treatment-resistant entity. Treatment varies widely, relying on the severity of the ulceration as well as the presence of infection or ischemia. However, the most important things to keep in mind should consist of the following: 1) appropriate debridement; 2) off-loading of pressure; 3) effective control of infection; 4) local wound care strategy; 5) timely reconstructive surgery. The ideal flap for diabetic foot reconstruction should provide a well-vascularized tissue to control infection, adequate contour for footwear, durability, and solid anchorage to resist shearing forces. A thorough assessment of patient's general condition and voluntary motivation of the patient should be warranted to prevent any sort of postoperative recurrence.
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Affiliation(s)
- Tae Hwan Park
- Buleun Health Care Center, Incheon, Republic of Korea
| | - Ashish Anand
- Staff Orthopaedic Surgeon, VAMC, Jackson, MS, USA,Corresponding author.
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Xu L, Zhang W, Lv K, Yu W, Jiang X, Zhang F. Peri-Implant Bone Regeneration Using rhPDGF-BB, BMSCs, and β-TCP in a Canine Model. Clin Implant Dent Relat Res 2015; 18:241-52. [PMID: 25644231 DOI: 10.1111/cid.12259] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The presence of insufficient bone volume remains a major clinical problem for dental implant placement to restore oral function. Tissue engineering provides a promising approach for inducing bone regeneration and enhancing osseointegration in dental implants. PURPOSE The tissue-engineered bone consisting of recombinant human platelet-derived growth factor (rhPDGF-BB), bone marrow stem cells (BMSCs), and beta-tricalcium phosphate (β-TCP) particles was validated for the first time in a preclinical large animal canine model in terms of its ability to promote new bone formation around the implants, as well as osseointegration between the tissue-engineered bone and dental implants. MATERIALS AND METHODS Proliferation and osteogenic differentiation of canine BMSCs treated with rhPDGF-BB were evaluated with an MTT, alkaline phosphatase (ALP) activity, Alizarin Red staining, and real-time quantitative PCR (RT-qPCR) analysis of osteogenic genes. The therapeutic potential of tissue-engineered bone consisting of rhPDGF-BB/BMSCs/β-TCP in bone repair was evaluated in mesial-implant defects of immediate postextraction implants in the canine mandible. RESULTS rhPDGF-BB treatment significantly increased proliferation and osteogenic differentiation of canine BMSCs. Furthermore, the tissue-engineered bone consisting of rhPDGF-BB/BMSCs/β-TCP significantly enhanced bone formation and osseointegration. CONCLUSION This study provides important evidence that supports the potential application of rhPDGF-BB/BMSCs/β-TCP tissue-engineered bone in immediate implantation for oral function restoration.
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Affiliation(s)
- Ling Xu
- Department of Prosthodontics, School of Stomatology, Shanghai Research Institute of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjie Zhang
- Oral Bioengineering Lab, Shanghai Research Institute of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kaige Lv
- Department of Prosthodontics, School of Stomatology, Shanghai Research Institute of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqiang Yu
- Department of Prosthodontics, School of Stomatology, Shanghai Research Institute of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinquan Jiang
- Department of Prosthodontics, School of Stomatology, Shanghai Research Institute of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Oral Bioengineering Lab, Shanghai Research Institute of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuqiang Zhang
- Department of Prosthodontics, School of Stomatology, Shanghai Research Institute of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kyllönen L, D’Este M, Alini M, Eglin D. Local drug delivery for enhancing fracture healing in osteoporotic bone. Acta Biomater 2015; 11:412-34. [PMID: 25218339 DOI: 10.1016/j.actbio.2014.09.006] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/30/2014] [Accepted: 09/04/2014] [Indexed: 01/08/2023]
Abstract
Fragility fractures can cause significant morbidity and mortality in patients with osteoporosis and inflict a considerable medical and socioeconomic burden. Moreover, treatment of an osteoporotic fracture is challenging due to the decreased strength of the surrounding bone and suboptimal healing capacity, predisposing both to fixation failure and non-union. Whereas a systemic osteoporosis treatment acts slowly, local release of osteogenic agents in osteoporotic fracture would act rapidly to increase bone strength and quality, as well as to reduce the bone healing period and prevent development of a problematic non-union. The identification of agents with potential to stimulate bone formation and improve implant fixation strength in osteoporotic bone has raised hope for the fast augmentation of osteoporotic fractures. Stimulation of bone formation by local delivery of growth factors is an approach already in clinical use for the treatment of non-unions, and could be utilized for osteoporotic fractures as well. Small molecules have also gained ground as stable and inexpensive compounds to enhance bone formation and tackle osteoporosis. The aim of this paper is to present the state of the art on local drug delivery in osteoporotic fractures. Advantages, disadvantages and underlying molecular mechanisms of different active species for local bone healing in osteoporotic bone are discussed. This review also identifies promising new candidate molecules and innovative approaches for the local drug delivery in osteoporotic bone.
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Schmidt-Bleek K, Petersen A, Dienelt A, Schwarz C, Duda GN. Initiation and early control of tissue regeneration - bone healing as a model system for tissue regeneration. Expert Opin Biol Ther 2014; 14:247-59. [PMID: 24397854 DOI: 10.1517/14712598.2014.857653] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Tissue regeneration in itself is a fascinating process that promises repeated renewal of tissue and organs. AREAS COVERED This article aims to illustrate the different strategies available to control tissue regeneration at a very early stage, using bone as an exemplary tissue. The aspects of a controlled inflammatory cascade to achieve a balanced immune response, cell therapeutic approaches for improved tissue formation and angiogenesis, guiding the organization of newly formed extracellular matrix by biomaterials, the relevance of mechanical signals for tissue regeneration processes, and the chances and limitations of growth factor treatments are discussed. EXPERT OPINION The currently available knowledge is reviewed and perspectives for potential new targets are given. This is done under the assumption that early identification of risk patients as well as the application of early intervention strategies is possible.
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Affiliation(s)
- Katharina Schmidt-Bleek
- Charité - Universitätsmedizin Berlin, Julius Wolff Institut and Center for Musculoskeletal Surgery , Augustenburger Platz 1, D-13353 Berlin , Germany +49 30 450 536196 ; +49 30 450 559969 ;
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