Effect of hyaluronic acid (HA) in a HA/PLGA scaffold on annulus fibrosus regeneration: In vivo tests

Evaluation of Tissue Engineering Approaches for Intervertebral Disc Regeneration in Relevant Animal Models

Translation of tissue engineering strategies for the regeneration of intervertebral disc (IVD) requires a strong understanding of pathophysiology through the relevant animal model. There is no relevant animal model due to differences in disc anatomy, cellular composition, extracellular matrix components, disc physiology, and mechanical strength from humans. However, available animal models if used correctly could provide clinically relevant information for the translation into humans. In this review, we have investigated different types of strategies for the development of clinically relevant animal models to study biomaterials, cells, biomolecular or their combination in developing tissue engineering-based treatment strategies. Tissue engineering strategies that utilize various animal models for IVD regeneration are summarized and outcomes have been discussed. The understanding of animal models for the validation of regenerative approaches is employed to understand and treat the pathophysiology of degenerative disc disease (DDD) before proceeding for human trials. These animal models play an important role in building a therapeutic regime for IVD tissue regeneration, which can serve as a platform for clinical applications.

Comparative Analyses of Inflammatory Response and Tissue Integration of 14 Hyaluronic Acid-Based Fillers in Mini Pigs

Purpose

Hyaluronic acid (HA)-based dermal fillers have been approved for various clinical indications, both cosmetic and medical. Previous studies that have assessed the performance of HA dermal fillers have primarily focused on evaluating filler durability, and only a few have studied their distribution within the tissues. The present study aimed to compare tissue integration of various types of HA dermal fillers having different clinical indications and varying injection depths.

Methods

To examine the local inflammatory response and distribution pattern of 14 HA dermal fillers (six Neuramis [NEU], one Belotero [BEL], three Juvéderm [JUV], and four Restylane [RES]), each product was injected intradermally and subcutaneously at the backs of two male miniature pigs. Histopathological evaluation and visual examination of the tissue sections were conducted 1 and 4 weeks after injection.

Results

Mean inflammatory cell infiltration scores tended to be lower in response to fillers from the NEU and BEL series than to those from the JUV and RES series after intradermal and subcutaneous injection. Furthermore, the inflammatory response to fillers with higher physicochemical properties specifically designed for injection into deeper layers of the skin tended to be slightly higher than those designated for injection into more superficial layers. There was no significant difference in tissue integration according to clinical indication and injection depth, although fillers from the NEU and BEL series exhibited better tissue integration than those from the JUV and RES series.

Conclusion

Our findings not only suggest that the local inflammatory response and tissue integration differ across HA dermal filler products, but also that these parameters could vary according to the recommended clinical indication and injection depth of the products.

Highly Cross-Linked Shape Memory Polymers with Tunable Oxidative and Hydrolytic Degradation Rates and Selected Products Based on Succinic Acid

Minimally invasive medical devices are of great interest, with shape memory polymers (SMPs) representing one such possibility for producing these devices. Previous work with low density, highly porous SMPs has demonstrated oxidative degradation, while attempts to incorporate hydrolytic degradation have resulted in rapidly decreasing glass transition temperature (T _g ), ultimately preventing strain fixity of the materials at clinically relevant temperatures. Through esterification of the amino alcohol triethanolamine, an alcohol containing network was synthesized and incorporated into SMPs. These ester networks were used to control the bulk morphology of the SMP, with the T _g remaining above 37 °C when 50% of the alcohol was contributed by the ester network. This methodology also yielded SMPs that could degrade through both hydrolysis and oxidation; by oxidation, the SMPs degrade at a similar rate as the control materials (0.2%/day mass) for the first 30 days, at which point the rate changes to 3.5%/day until the samples become too fragile to examine at 80 days. By comparison, control materials have lost approximately 30% of mass by 140 days, at a constant rate of degradation, demonstrating that the ester SMPs are a promising material system for producing more rapidly degradable, soft, porous biomaterials.

Fabrication and characterization of three-dimensional poly(lactic acid-co-glycolic acid), atelocollagen, and fibrin bioscaffold composite for intervertebral disk tissue engineering application

The use of synthetically derived poly(lactic- co-glycolic acid) scaffold and naturally derived materials in regeneration of intervertebral disks has been reported in many previous studies. However, the potential effect of poly(lactic- co-glycolic acid) in combination with atelocollagen or fibrin or both atelocollagen and fibrin bioscaffold composite have not been mentioned so far. This study aims to fabricate and characterize three-dimensional poly(lactic- co-glycolic acid) scaffold incorporated with (1) atelocollagen, (2) fibrin, and (3) both atelocollagen and fibrin combination for intervertebral disk tissue engineering application. The poly(lactic- co-glycolic acid) without any natural, bioscaffold composites was used as control. The chemical conformation, morphology, cell–scaffold attachment, porosity, water uptake capacity, thermal properties, mechanical strength, and pH level were evaluated on all scaffolds using attenuated total reflectance Fourier transform infrared, scanning electron microscope, gravimetric analysis, swelling test, differential scanning calorimetry, and Instron E3000, respectively. Biocompatibility test was conducted to assess the intervertebral disk, annulus fibrosus cells viability using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The attenuated total reflectance Fourier transform infrared results demonstrated notable peaks of amide bond suggesting interaction of atelocollagen, fibrin, and both atelocollagen and fibrin combination into the poly(lactic- co-glycolic acid) scaffold. Based on the scanning electron microscope observation, the pore size of the poly(lactic- co-glycolic acid) structure significantly reduced when it was incorporated with atelocollagen and fibrin. The poly(lactic- co-glycolic acid)–atelocollagen scaffolds demonstrated higher significant swelling ratios, mechanical strength, and thermal stability than the poly(lactic- co-glycolic acid) scaffold alone. All the three bioscaffold composite groups exhibited the ability to reduce the acidic poly(lactic- co-glycolic acid) by-product. In this study, the biocompatibility assessment using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide cells proliferation assay demonstrated a significantly higher annulus fibrosus cells viability in poly(lactic- co-glycolic acid)–atelocollagen–fibrin compared to poly(lactic- co-glycolic acid) alone. The cellular attachment is comparable in poly(lactic- co-glycolic acid)–atelocollagen–fibrin and poly(lactic- co-glycolic acid)–fibrin scaffolds. Overall, these results may suggest potential use of poly(lactic- co-glycolic acid) combined with atelocollagen and fibrin bioscaffold composite for intervertebral disk regeneration.

The potential of 3-dimensional construct engineered from poly(lactic-co-glycolic acid)/fibrin hybrid scaffold seeded with bone marrow mesenchymal stem cells for in vitro cartilage tissue engineering

Articular cartilage is well known for its simple uniqueness of avascular and aneural structure that has limited capacity to heal itself when injured. The use of three dimensional construct in tissue engineering holds great potential in regenerating cartilage defects. This study evaluated the in vitro cartilaginous tissue formation using rabbit's bone marrow mesenchymal stem cells (BMSCs)-seeded onto poly(lactic-co-glycolic acid) PLGA/fibrin and PLGA scaffolds. The in vitro cartilaginous engineered constructs were evaluated by gross inspection, histology, cell proliferation, gene expression and sulphated glycosaminoglycan (sGAG) production at week 1, 2 and 3. After 3 weeks of culture, the PLGA/fibrin construct demonstrated gross features similar to the native tissue with smooth, firm and glistening appearance, superior histoarchitectural and better cartilaginous extracellular matrix compound in concert with the positive glycosaminoglycan accumulation on Alcian blue. Significantly higher cell proliferation in PLGA/fibrin construct was noted at day-7, day-14 and day-21 (p<0.05 respectively). Both constructs expressed the accumulation of collagen type II, collagen type IX, aggrecan and sox9, showed down-regulation of collagen type I as well as produced relative sGAG content with PLGA/fibrin construct exhibited better gene expression in all profiles and showed significantly higher relative sGAG content at each time point (p<0.05). This study suggested that with optimum in vitro manipulation, PLGA/fibrin when seeded with pluripotent non-committed BMSCs has the capability to differentiate into chondrogenic lineage and may serve as a prospective construct to be developed as functional tissue engineered cartilage.