Experimental study on osteoconductive properties of a chitosan-bonded hydroxyapatite self-hardening paste

The effects of the molecular weight of chitosan on the tissue inflammatory response

The molecular weight of chitosan (CS) may affect its physical properties and its ability to induce an appropriate host response. The biocompatibilities of CS membranes of low (LMWCS) and high (HMWCS) molecular weight were investigated by inserting these materials into the subcutaneous tissue of rats for 1-28 days and evaluating leukocyte infiltration, granulation tissue, fibrosis, arginase-1 immunostaining, as well as nuclear factor-κB (NF-κΒ) and fibroblast growth factor (FGF)-2 expressions. Both CS membranes induced a peak of leukocyte infiltration on the first day of insertion and stimulated granulation and fibrous tissue generation when compared to control. LMWCS induced more collagen deposition a week earlier, when compared to the control and HMWCS membrane. The membranes also increased arginase-1 immunostaining, a M2 macrophage marker. M2 macrophage is recognized as anti-inflammatory and pro-regenerative. NF-κB is an essential biomarker of the inflammatory process and induces the expression of several pro-inflammatory cytokines. The LMWCS membrane reduced inflammation, as indicated by a reduced nucleus/cytoplasm NF-κB ratio in surrounding tissue from days 7 to 14 when compared to control. On the first day, the expression of FGF-2, a biomarker of inflammatory resolution, was increased in the tissue of the LWMCS group, when compared with HMWCS, which was consistent with the type I collagen deposition. Thus, LWMCS was associated with a prior reduction of the inflammatory response and improved wound healing.

Chitosan and Hydroxyapatite Based Biomaterials to Circumvent Periprosthetic Joint Infections

Every year, worldwide, millions of people suffering from joint pain undergo joint replacement. For most patients, joint arthroplasty reduces pain and improve function, though a small fraction will experience implant failure. One of the main reasons includes prosthetic joint infection (PJI), involving the prosthesis and adjacent tissues. Few microorganisms (MO) are required to inoculate the implant, resulting in the formation of a biofilm on its surface. Standard treatment includes not only removal of the infected prosthesis but also the elimination of necrotic bone fragments, local and/or systemic administration of antibiotics, and revision arthroplasty with a new prosthesis, immediately after the infection is cleared. Therefore, an alternative to the conventional therapeutics would be the incorporation of natural antimicrobial compounds into the prosthesis. Chitosan (Ch) is a potential valuable biomaterial presenting properties such as biocompatibility, biodegradability, low immunogenicity, wound healing ability, antimicrobial activity, and anti-inflammatory potential. Regarding its antimicrobial activity, Gram-negative and Gram-positive bacteria, as well as fungi are highly susceptible to chitosan. Calcium phosphate (CaP)-based materials are commonly utilized in orthopedic and dentistry for their excellent biocompatibility and bioactivity, particularly in the establishment of cohesive bone bonding that yields effective and rapid osteointegration. At present, the majority of CaP-based materials are synthetic, which conducts to the depletion of the natural resources of phosphorous in the future due to the extensive use of phosphate. CaP in the form of hydroxyapatite (HAp) may be extracted from natural sources as fish bones or scales, which are by-products of the fish food industry. Thus, this review aims to enlighten the fundamental characteristics of Ch and HAp biomaterials which makes them attractive to PJI prevention and bone regeneration, summarizing relevant studies with these biomaterials to the field.

How is Biodegradable Scaffold Effective in Gap Non-union? Insights from an Experiment

OBJECTIVE

To evaluate the role of composite (Chitosan/Chondroitin sulphate/gelatin/nano-bioglass) scaffold in the union of critical size bone defect created in the rabbit's ulna.

METHODS

The composite (Chitosan/Chondroitin sulphate/gelatin/nano-bioglass) scaffold was fabricated using the freeze-drying technique under standard laboratory conditions. The scaffold was cut into the appropriate size and transferred into the defect created (critical bone size defect 1 cm) over the right ulna in the rabbit. The scaffold was not implanted on the left side thus the left side ulna served as control. Results were assessed on serial radiological examination. Rabbits were sacrificed at 20 weeks for histopathological examination (Haematoxylin-Eosin staining and Mason's trichrome staining) and scanning electron microscope observation. Radiological scoring was done by Lane and Sandhu's scoring.

RESULTS

Among 12 rabbits, 10 could complete the follow-up. Among those 10 rabbits, 8 among the test group showed good evidence of bone formation at the gap non-union scaffold implanted site. Histological evidence of new bone formation, collagen synthesis, scaffold resorption, minimal chondrogenesis was evident by 20 weeks in the test group. Two rabbits had poor bone formation.

CONCLUSION

The chitosan-chondroitin sulphate-gelatin-nano-bioglass composite scaffold is efficient in osteoconduction and osteoinduction in the gap non-union model as it is biocompatible, bioactive, and non-immunogenic as well.

Generation of scaffold incorporated with nanobioglass encapsulated in chitosan/chondroitin sulfate complex for bone tissue engineering

Over the past decade, various composite materials fabricated using natural or synthetic biopolymers incorporated with bioceramic have been widely investigated for the regeneration of segmental bone defect. In the present study, nano-bioglass incorporated osteoconductive composite scaffolds were fabricated through polyelectrolyte complexation/phase separation and resuspension of separated complex in gelatin matrix. Developed scaffold exhibits controlled bioreactivity, minimize abrupt pH rise (~7.8), optimal swelling behavior (2.6+-3.1) and enhances mechanical strength (0.62 ± 0.18 MPa) under wet condition. Moreover, in-vitro cell study shows that the fabricated scaffold provide suitable template for cellular attachment, spreading, biomineralization and collagen based matrix deposition. Also, the developed scaffold was evaluated for biocompatibility and bone tissue regeneration potential through implantation in non-union segmental bone defect created in rabbit animal model. The obtained histological analysis indicates strong potential of the composite scaffold for bone tissue regeneration, vascularization and reconstruction of defects. Thus, the developed composite scaffold might be a suitable biomaterial for bone tissue engineering applications.

Using zeta potential to study the ionisation behaviour of polymers employed in modified-release dosage forms and estimating their pKa

A range of enteric polymers is used in pharmaceutical industry for developing gastro-resistant formulations. It is generally implied that these coatings are interchangeable due to similar dissolution pH thresholds reported by suppliers. Despite rapid dissolution in compendial phosphate buffers, these products can take up to 2 h to disintegrate in-vivo in the human small intestine. The factors primarily responsible for such variability in dissolution of these polymeric coatings are the differences in ionisation of acidic functional groups on polymer chains and their interplay with ions and buffer species present in gastrointestinal fluids. In this study, we aim to develop a novel, simple and inexpensive technique that can be used under various in-vitro conditions to study the ionisation behaviour of commonly used polymers (EUDRAGIT-E100, L100, S100, HPMC AS-LF, AS-HF, HP-50, HP-55) and to estimate their pK_a. Moreover, this method was successfully applied to study the ionisation behaviour of a range of natural polymers (Guar, Tara, locust bean, Konjac gums, gum Arabic, citrus pectin, chitosan and alginate) and their pK_a was also estimated. The proposed method would allow a better understanding of the dissolution behaviour of these polymers within gastrointestinal tract and will aid rational design of modified release dosage forms.

Chitosan as a Bone Scaffold Biomaterial

The current standard of care for bone reconstruction, whether secondary to injury, nonunion, cancer resection, or idiopathic bone loss, is autologous bone grafting. Alternatives to autograft and allograft bone substitutes currently being researched are synthetic and natural graft materials that are able to guide bone regeneration. One promising material currently being researched is chitosan, a highly versatile, naturally occurring polysaccharide, derived from the exoskeleton of arthropods that is comprised of glucosamine and N-acetylglucosamine. Research on chitosan as a bone scaffold has been promising. Chitosan is efficacious in bone regeneration due to its lack of immunogenicity, its biodegradability, and its physiologic features. Chitosan combined with growth factors and/or other scaffold materials has proven to be an effective alternative to autologous bone grafts. Additionally, current studies have shown that it can provide the additional benefit of a local drug delivery system. As research in the area of bone scaffolding continues to grow, further clinical research on chitosan in conjunction with growth factors, proteins, and alloplastic materials will likely be at the forefront.

Chitosan in viscosupplementation: in vivo effect on rabbit subchondral bone

Background

To investigate the effect of intra-articular injection of Chitosan (Cs) added to hyaluronic acid (HA) on subchondral bone during osteoarthritis (OA), microarchitectural parameters and mineral density were measured in a rabbit model of early OA. A novel hybrid hydrogel adding reacetylated Cs of fungal origin to HA was compared to high molecular weight HA commercial formulation.

Method

Eighteen rabbits underwent unilateral anterior cruciate ligament transection (ACLT) and were divided into three groups (Saline-group, HA-group and Hybrid-group) depending on the intra-articular injection compound. Eight contralateral knees were used as non-operated controls (Contralateral-group). Micro-computed tomography was performed six weeks post-ACLT to study subchondral bone microarchitectural parameters and mineral density at an early stage of OA development.

Results

Cartilage thickness mean value was reduced only in Saline-group compared to Contralateral-group. When the Hybrid-group was compared to Saline-group, subchondral bone microarchitectural parameters (trabecular thickness and trabecular bone volume fraction) were significantly changed; subchondral bone plate and trabecular bone mineral densities (bone mineral density and tissue mineral density) were reduced. When the Hybrid-group was compared to HA-group, subchondral bone microarchitectural parameters (subchondral plate thickness and trabecular thickness) and trabecular bone mineral densities (bone mineral density and tissue mineral density) were significantly decreased.

Conclusion

Conclusion: Compared to HA alone, the novel hybrid hydrogel, constituted of Cs added to HA, enhanced microarchitectural parameters and mineral density changes, leading to subchondral bone loss in a rabbit model of early experimental OA.

Hydroxyapatite-polymer biocomposites for bone regeneration: A review of current trends

Bone tissue engineering has emerged as one of the most indispensable approaches to address bone trauma in the past few decades. This approach offers an efficient and a risk-free alternative to autografts and allografts by employing a combination of biomaterials and cells to promote bone regeneration. Hydroxyapatite (HA) is a ceramic biomaterial that mimics the mineral composition of bones and teeth in vertebrates. HA, commonly produced via several synthetic routes over the years has been found to exhibit good bioactivity, biocompatibility, and osteoconductivity under both in vitro and in vivo conditions. However, the brittle nature of HA restricts its usage for load bearing applications. To address this problem, HA has been used in combination with several polymers in the form of biocomposite implants to primarily improve its mechanical properties and also enhance the implants' overall performance by simultaneously exploiting the positive effects of both HA and the polymer involved in making the biocomposite. This review article summarizes the past and recent developments in the evolution of HA-polymer biocomposite implants as an "ideal" biomaterial scaffold for bone regeneration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2046-2057, 2018.

Original article. Development of chitosan/nanosized apatite composites for bone cements

Background: Calcium phosphate cements (CPC) is a promising materials for bone defect repair. Nanosized apatite or calcium orthophosphate has a better bioactivity than coarser crystals. Chitosan is produced commercially from chitin that is the structural element in the exoskeleton of crustaceans such as crabs and shrimp. The mixing of nanosized apatite and chitosan may provide the consistency cement, improving mechanical properties of the set bone cement.

Objective: Develop nanosized apatite powder with chitosan for bone composite cement.

Materials and method: Nanosized apatite was synthesized by chemical method at low temperature and used as the single-component for bone cement. The nanosized apatite powder was characterized using X-ray diffraction method, Fourier transform infrared spectroscopy, and transmission electron microscopy. CPCs were developed based on chitosan/nanosized apatite and calcium sulfate hemihydrate. The compressive strength of the set cement was measured after one to four weeks. The phase composition and the morphology of the set cements were investigated.

Results: Calcium sulfate hemihydrate was effective in increasing the compressive strength after setting in a simulated body fluid for seven days. The compressive strength of chitosan/nanosized apatite composite was about 18 MPa after soaking.

Conclusion: The workability and setting time of this composite were suitable to handling for bone cement. These composite cements had a significant clinical advantage for substitution of the regenerated bone.

The Effects of S-Chitosan on the Physical Properties of Calcium Phosphate Cements

Water-soluble disodium (1→4)-2-deoxy-2-sulfoamino-β-d-glucopyranuronan (S-chitosan) was prepared from chitin by successive N-deacetylation, specific carboxylation at C-6 and sulfonation. Its structure was characterized by IR spectra and elemental analysis. The S-chitosan was added to two easily developed calcium phosphate cements (CPCs). One cement was monocalcium phosphate monohydrate (MPCM) with calcium oxide (CaO) in a 1M phosphate buffer (pH 7.4)(CPC-I); the other cement was dicalcium phosphate dihydrate (DCPD) with calcium hydroxide [Ca(OH)2] in a 1M Na2HPO4 solution (CPC-II). In vitro experiments showed that when S-chitosan where added to the liquid phases that the resulting S-chitosan containing CPCs had higher mechanical strengths and slightly prolonged setting times. The polyanion enhanced the mechanical strength of the CPCs by increasing the dissolubility of the cement start materials and binding the calcium ions strongly afterwards. An excess of the polyanion destroys the balances of the formulations of CPCs and lead to very slow setting processes or no setting at all.

The mechanics of PLGA nanofiber scaffolds with biomimetic gradients in mineral for tendon-to-bone repair

Attachment of dissimilar materials is prone to failure due to stress concentrations that can arise their interface. A compositionally or structurally graded transition can dissipate these stress concentrations and thereby toughen an attachment. The interface between compliant tendon and stiff bone utilizes a monotonic change in hydroxylapatite mineral ("mineral") content to produce a gradient in mechanical properties and mitigate stress concentrations. Previous efforts to mimic the natural tendon-to-bone attachment have included electrospun nanofibrous polymer scaffolds with gradients in mineral. Mineralization of the nanofiber scaffolds has typically been achieved using simulated body fluid (SBF). Depending on the specific formulation of SBF, mineral morphologies ranged from densely packed small crystals to platelike crystal florets. Although this mineralization of scaffolds produced increases in modulus, the peak modulus achieved remained significantly below that of bone. Missing from these prior empirical approaches was insight into the effect of mineral morphology on scaffold mechanics and on the potential for the approach to ultimately achieve moduli approaching that of bone. Here, we applied two mineralization methods to generate scaffolds with spatial gradations in mineral content, and developed methods to quantify the stiffening effects and evaluate them in the context of theoretical bounds. We asked whether either of the mineralization methods we developed holds potential to achieve adequate stiffening of the scaffold, and tested the hypothesis that the smoother, denser mineral coating could attain more potent stiffening effects. Testing this hypothesis required development of and comparison to homogenization bounds, and development of techniques to estimate mineral volume fractions and spatial gradations in modulus. For both mineralization strategies, energy dispersive X-ray analysis demonstrated the formation of linear gradients in mineral concentration along the length of the scaffolds, and Raman spectroscopic analysis revealed that the mineral produced was hydroxylapatite. Mechanical testing showed that the stiffness gradient using the new method was significantly steeper. By analyzing the scaffolds using micromechanical modeling techniques and extrapolating from our experimental results, we present evidence that the new mineralization protocol has the potential to achieve levels of stiffness adequate to contribute to enhanced repair of tendon-to-bone attachments.

A new injectable in situ forming hydroxyapatite and thermosensitive chitosan gel promoted by Na₂CO₃

A new injectable in situ forming hydroxyapatite and thermosensitive chitosan gel (chitosan/HA/Na2CO3 gel) promoted by Na2CO3 was preliminarily synthesized. This study was the first to use Na2CO3 as coagulant to construct the chitosan thermosensitive gel. The sol–gel phase transition, degradation, and morphology of the gel were examined. We found that chitosan/HA/Na2CO3 sol with 1.4% Na2CO3 has a suitable gelation time (9 min) and degradation rate. SEM images of the dried gel show a porous netlike framework. TEM, EDS, and XRD were combined to confirm the presence of hydroxyapatite. In vitro cell culture was performed by using rat bone mesenchymal stem cells (rBMSCs). rBMSCs survived well on the chitosan gel scaffold that formed in vitro and in vivo, indicating that the chitosan gel was a suitable substrate for the attachment and proliferation of rBMSCs. Subcutaneous implantation of the chitosan gel formed in situ into a nude mouse revealed that the chitosan gel loaded with rBMSCs could lead to angiogenesis.

Self-setting calcium orthophosphate formulations

In early 1980s, researchers discovered self-setting calcium orthophosphate cements, which are bioactive and biodegradable grafting bioceramics in the form of a powder and a liquid. After mixing, both phases form pastes, which set and harden forming either a non-stoichiometric calcium deficient hydroxyapatite or brushite. Since both of them are remarkably biocompartible, bioresorbable and osteoconductive, self-setting calcium orthophosphate formulations appear to be promising bioceramics for bone grafting. Furthermore, such formulations possess excellent molding capabilities, easy manipulation and nearly perfect adaptation to the complex shapes of bone defects, followed by gradual bioresorption and new bone formation. In addition, reinforced formulations have been introduced, which might be described as calcium orthophosphate concretes. The discovery of self-setting properties opened up a new era in the medical application of calcium orthophosphates and many commercial trademarks have been introduced as a result. Currently such formulations are widely used as synthetic bone grafts, with several advantages, such as pourability and injectability. Moreover, their low-temperature setting reactions and intrinsic porosity allow loading by drugs, biomolecules and even cells for tissue engineering purposes. In this review, an insight into the self-setting calcium orthophosphate formulations, as excellent bioceramics suitable for both dental and bone grafting applications, has been provided.

Synthesis and characterization of chitosan-multiwalled carbon nanotubes/hydroxyapatite nanocomposites for bone tissue engineering

Chitosan-multiwalled carbon nanotubes/hydroxyapatite nanocomposites were synthesized by a novel in situ precipitation method. The electrostatic adsorption between multiwalled carbon nanotubes and chitosan was investigated and explained by Fourier transform infrared spectroscopy analysis. Morphology studies showed that uniform distribution of hydroxyapatite particles and multiwalled carbon nanotubes in the polymer matrix was observed. In chitosan-multiwalled carbon nanotubes/hydroxyapatite nanocomposites, the diameters of multiwalled carbon nanotubes were about 10 nm. The mechanical properties of the composites were evaluated by measuring their compressive strength and elastic modulus. The elastic modulus and compressive strength increased sharply from 509.9 to 1089.1 MPa and from 33.2 to 105.5 MPa with an increase of multiwalled carbon/chitosan weight ratios from 0 to 5 %, respectively. Finally, the cell biocompatibility of the composites was tested in vitro, which showed that they have good biocompatibility. These results suggest that the chitosan-multiwalled carbon nanotubes/hydroxyapatite nanocomposites are promising biomaterials for bone tissue engineering.

Osteoconductive Nanocomposite Materials for Bone Regeneration

Bone defect is one of the most important problem in orthopaedic therapy in which application of a biomaterial filling is necessary. Such material should be biocompatible, osteoconductive and porous as well as bioactive and compatible with the bone tissue. Subject of the work was investigations on nanocomposite membrane materials which consisted on synthetic polymer – poly-e-caprolactone (PCL) matrix and ceramic nanoparticles; tricalcium phosphate (TCP) and silica (SiO2) as a nano-filler. The nanocomposite membrane materials were produced by two-step dispersion of the nanoparticles in the biopolymer matrix. Characteristic of nanoparticles were made using transmission electron microscope (TEM), distribution of nanoparticles size (DLS) and specific surface area (BET). The morphology of nanocomposites and homogenous distribution of nanoadditives were made using scanning electron microscope with EDS analysis. Introduction of the nanofillers into the polymer matrix was monitored by thermal analysis method (TG-DCS). It was shown that the TCP nanoparticles affected stronger pore size and distribution but also the polymer structure (crystallity, physicochemical properties of the surface). Treatment of the nanocomposite samples in the simulated body fluid (SBF) induced some changes on the surface of the material containing bioactive ceramic nanoparticles. The results of the tests with SBF showed that the material is able to produce apatite structure on its surface (EDS analysis)

Delivery of demineralized bone matrix powder using a thermogelling chitosan carrier

Demineralized bone matrix (DBM) powder is widely used for bone regeneration due to its osteoinductivity and osteoconductivity. However, difficulties with handling, its tendency to migrate from graft sites, and lack of stability after surgery can sometimes limit the clinical utility of this material. In this work, the possibility of using a thermogelling chitosan carrier to deliver DBM powder was assessed. The DBM-thermogelling putty improved handling and formed a gel-like composite in situ at body temperature within a clinically relevant time period. The properties of the formed composite, including morphology, porosity, mechanical properties, equilibrium swelling as well as degradability, are significantly influenced by the ratio of DBM to thermogelling chitosan. The in vitro study showed that the alkaline phosphatase activity of C2C12 cells encapsulated in the composite was steadily increased with culture time. The in vivo study showed that increased DBM content in the DBM-thermogelling chitosan induced ectopic bone formation in a nude rat model. The diffusion of growth factor from the DBM-thermogelling chitosan as well as the host-implant interactions are discussed.

Bioactivity of a Chitosan Based Nanocomposite

In this work, experiments to produce a series of nanocomposites based on natural chitosan and nano-clay (MMT) were conducted. Commercially available montmorillonite (MMT) was used as a nanofiller. CS-MMT nanocomposites were prepared using the casting method. Thin nanocomposite foils were neutralized in NaOH solution, then the nanocomposite foils were soaked in simulated body fluid (SBF). Kinetics of crystallization of the apatite structure was observed using PIXE, FTIR-ATR and SEM/EDS techniques. It was shown that high concentrations of calcium and phosphate ions were located inside the nanocomposite structure. Bioactivity phenomena was initiated first in the nanocomposite foils (CS/MMT) and then in pure chitosan foils. These results suggest that the nano-clay particles (MMT) distributed in the biopolymer matrix acted as nucleaction centers of apatite. An apatite layer on pure chitosan crystallized much more slowly than in the case of nanocomposite materials. The CS-MMT nanocomposites therefore seem to be promising materials for bone repair implants because of their inherent bioactivity.

Spherical N-carboxyethylchitosan/hydroxyapatite nanoparticles prepared by ionic diffusion process in a controlled manner

The nanocomposites containing hydroxyapatite (HA) and biomacromolecules have attracted considerable research interest in implants, tissue scaffolds and drug controlled delivery. In this study, the N-carboxyethylchitosan/hydroxyapatite (NCECS/HA) nanoparticles were prepared by the ionic diffusion process in a controlled manner. The crystallization, particle size, size distribution and aggregation morphology of the NCECS/HA nanocomposites were dependent on the mole ratio of the glucosamine unit in NCECS to the Ca(2+). Fourier transform-infrared spectroscopic (FTIR) result indicated that there are chemical bonds formed between NCECS and HA. X-ray diffraction (XRD) analysis showed that the crystallization of HA in NCECS matrix was significantly retarded. Transmission electron microscopy (TEM) results revealed that NCECS/HA nanocomposites have the spherical morphology with the diameter ranging from 10 to 40 nm. The NCECS mineralization is driven by the self-assembly of NCECS and HA. These NCECS/HA nanocomposites have potential applications as the carrier for the controlled delivery of growth factors and drugs.

Thermogelling chitosan and collagen composite hydrogels initiated with beta-glycerophosphate for bone tissue engineering

Chitosan and collagen type I are naturally derived materials used as cell carriers because of their ability to mimic the extracellular environment and direct cell function. In this study beta-glycerophosphate (beta-GP), an osteogenic medium supplement and a weak base, was used to simultaneously initiate gelation of pure chitosan, pure collagen, and chitosan-collagen composite materials at physiological pH and temperature. Adult human bone marrow-derived stem cells (hBMSC) encapsulated in such hydrogels at chitosan/collagen ratios of 100/0, 65/35, 25/75, and 0/100 wt% exhibited high viability at day 1 after encapsulation, but DNA content dropped by about half over 12 days in pure chitosan materials while it increased twofold in materials containing collagen. Collagen-containing materials compacted more strongly and were significantly stiffer than pure chitosan gels. In monolayer culture, exposure of hBMSC to beta-GP resulted in decreased cell metabolic activity that varied with concentration and exposure time, but washing effectively removed excess beta-GP from hydrogels. The presence of chitosan in materials resulted in higher expression of osterix and bone sialoprotein genes in medium with and without osteogenic supplements. Chitosan also increased alkaline phosphatase activity and calcium deposition in osteogenic medium. Chitosan-collagen composite materials have potential as matrices for cell encapsulation and delivery, or as in situ gel-forming materials for tissue repair.

Preparation and characterization of homogeneous chitosan-polylactic acid/hydroxyapatite nanocomposite for bone tissue engineering and evaluation of its mechanical properties

Homogeneous nanocomposites composed of hydroxyapatite and chitosan in the presence of polylactic acid were synthesized by a novel in situ precipitation method. The morphological and compositional properties of composites were investigated. Hydroxyapatite nanoparticles in a special rod-like shape with a diameter of about 50nm and a length of about 300nm were distributed homogeneously within the chitosan-polylactic acid matrix. The interaction between the organic matrix and the inorganic crystallite and the formation mechanism of the rod-like nanoparticles were also studied. The results suggested that the formation of the special rod-like nanoparticles could be controlled by a multiple-order template effect. High-resolution images showed that the rod-like inorganic particles were composed of randomly orientated subparticles about 10nm in diameter. The mechanical properties of the composites were evaluated by measuring their compressive strength and elastic modulus. The data indicated that the addition of polylactic acid can make homogeneous composites scaffold resist significantly higher stress. The elastic modulus of the composites was also improved by the addition of polylactic acid, which can make them more beneficial for surgical applications.

Chitosan and its derivatives for tissue engineering applications

Tissue engineering is an important therapeutic strategy for present and future medicine. Recently, functional biomaterial researches have been directed towards the development of improved scaffolds for regenerative medicine. Chitosan is a natural polymer from renewable resources, obtained from shell of shellfish, and the wastes of the seafood industry. It has novel properties such as biocompatibility, biodegradability, antibacterial, and wound-healing activity. Furthermore, recent studies suggested that chitosan and its derivatives are promising candidates as a supporting material for tissue engineering applications owing to their porous structure, gel forming properties, ease of chemical modification, high affinity to in vivo macromolecules, and so on. In this review, we focus on the various types of chitosan derivatives and their use in various tissue engineering applications namely, skin, bone, cartilage, liver, nerve and blood vessel.

A Novel Piezoelectric Immunosensor for CA125 Using a Hydroxyapatite/Chitosan Nanocomposite-Based Biomolecular Immobilization Method

The ideal immobilization methods that are suitable for binding immunoactive materials with high efficiency onto a sensing surface are the key target to pursue in current biosensor design. In the present paper, the formation of a hydroxyapatite/chitosan (HA/CS) hybrid nanocomposite is described and a general design strategy for immunosensing platforms is proposed on the basis of HA/CS nanocomposite and nanogold particle adsorption of antibodies. A quartz crystal microbalance used as a model transducer and the detection performances of the resulting immunosensor were investigated by using the immuno-system of CA125, an important indicator in the diagnosis of clinical cancers. The hybrid nanocomposite was characterized by scanning electron microscopy and transmission electron microscopy measurements. The frequency response characteristics for the processes of immobilization and immunoreaction of anchored anti-CA125 antibodies were studied in detail. It was found that the developed sensing interface has some advantages, such as activation-free immobilization and high antigen-binding activities of antibodies. The as-prepared immunosensor can allow the determination of CA125 in the concentration range 15.3–440.0 U mL–1. Such an interface design with the hybrid nanocomposite could be tailored as a new alternative used for biosensor design.

Histological evaluation of novel ossicular chain replacement prostheses: an animal study in rabbits

CONCLUSION

The improved biocompatibility of Bioverit II coated with a nanostructured surface shows promising qualities for use in human reconstructive middle ear surgery. In the case of chitosan-hydroxyapatite composite prostheses, further investigations regarding composition of the material, degree of purity and design are necessary before clinical application.

OBJECTIVE

The selection of optimal materials for reconstructive middle ear surgery continues to be a problem. In the present study novel materials were tested as total ossicular replacement prostheses (TORPs) in an animal model.

MATERIALS AND METHODS

Bioverit II coated with a nanostructured surface and chitosan-hydroxyapatite composites were placed in the middle ear of 40 rabbits. Uncoated Bioverit II was used as control. After an implantation period of 28, 84 or 300 days petrous bones were extracted, embedded in epoxy resin and examined by light microscopy.

RESULTS

Uncoated and coated Bioverit prostheses revealed a mucosal coverage and a little osseogenic response after 28 days. The results of the coated Bioverit prostheses slightly surpassed those of the plain prostheses. Chitosan-hydroxyapatite composite prostheses were mostly found to be dislocated after 28 days. Formations of granulation tissue and fibrotic capsules were observed around these implants. This reaction could be caused by the instability of the composite material or may be due to impurities present in the chitosan.

Growth of osteoblast-like cells on biomimetic apatite-coated chitosan scaffolds

Porous scaffold materials that can provide a framework for the cells to adhere, proliferate, and create extracellular matrix are considered to be suitable materials for bone regeneration. Interconnected porous chitosan scaffolds were prepared by freeze-drying method, and were mineralized by calcium and phosphate solution by double-diffusion method to form nanoapatite in chitosan matrix. The mineralized chitosan scaffold contains hydroxyapatite nanocrystals on the surface and also within the pore channels of the scaffold. To assess the effect of apatite and porosity of the scaffolds on cells, human osteoblast (SaOS-2) cells were cultured on unmineralized and mineralized chitosan scaffolds. The cell growth on the mineralized scaffolds and on the pure chitosan scaffold shows a similar growth trend. The total protein content and alkaline phosphatase enzyme activity of the cells grown on scaffolds were quantified, and were found to increase over time in mineralized scaffold after 1 and 3 weeks of culture. The electron microscopy of the cell-seeded scaffolds showed that most of the outer macropores became sealed off by a continuous layer of cells. The cells spanned around the pore wall and formed extra cellular matrix, consisting mainly of collagen in mineralized scaffolds. The hydroxyproline content also confirmed the formation of the collagen matrix by cells in mineralized scaffolds. This study demonstrated that the presence of apatite nanocrystals in chitosan scaffolds does not significantly influence the growth of cells, but does induce the formation of extracellular matrix and therefore has the potential to serve for bone tissue engineering.

The effect of chitosan bead encapsulating calcium sulfate as an injectable bone substitute on consolidation in the mandibular distraction osteogenesis of a dog model

PURPOSE

The purpose of this project was to study the effect of chitosan bead encapsulating calcium sulfate, which provides a sustained release of chitosan and calcium sulfate after implantation, on early bony consolidation in distraction osteogenesis of a dog model.

MATERIALS AND METHODS

Forty-five dogs were used for this study. An external distraction device was applied to the mandibular body after a vertical osteotomy and mandibular distraction was initiated 5 days after the operation at a rate of 1 mm/day up to a 10-mm distraction. The experimental group was divided into a control group (I), hyaluronic acid group (II), chitosan group (III), calcium sulfate group (IV), and chitosan bead encapsulating calcium sulfate group (V). Normal saline was injected in group I. In group II, 1 mL of hyaluronic acid solution was injected into the distracted region. In group III, 1 mL of injectable solution of chitosan mixed with hyaluronic acid was implanted. In group IV, 1 mL of injectable solution of calcium sulfate mixed with hyaluronic acid was implanted. In group V, an injectable form of powdered chitosan bead encapsulating calcium sulfate mixed with 1 mL volume of hyaluronic acid was implanted.

RESULTS

Bone mineral density was 12% of the contralateral normal mandible at 3 weeks, 23.4% at 6 weeks in group I, 15% at 3 weeks, 29.1% at 6 weeks in group II, 16% at 3 weeks and 32% at 6 weeks in group III, 30.4% at 3 weeks and 52.8% at 6 weeks in group IV, and 33.6% at 3 weeks and 55% at 6 weeks in group V with statistical significance (P < .005). The mean 3-point failure load was compared with the intact contralateral mandible and noted to be 12% in the control group, 16% in group II, 18% in group III, 34.3% in group IV, and 31.7% in group V. Difference of mean percentages between one group and another was statistically significant (P < .005). In the histologic findings, new bone was generated in all groups. In groups IV and V, the formation of active woven bone was observed throughout the distracted region at 6 weeks. The amount of new bone formation in the distracted zone was in the order of group IV and V, III and II, and the control group.

CONCLUSIONS

These findings suggest that chitosan bead encapsulating calcium sulfate appears to facilitate early bony consolidation in distraction osteogenesis.

Chitosan: a versatile biopolymer for orthopaedic tissue-engineering

Current tissue engineering strategies are focused on the restoration of pathologically altered tissue architecture by transplantation of cells in combination with supportive scaffolds and biomolecules. In recent years, considerable attention has been given to chitosan (CS)-based materials and their applications in the field of orthopedic tissue engineering. Interesting characteristics that render chitosan suitable for this purpose are a minimal foreign body reaction, an intrinsic antibacterial nature, and the ability to be molded in various geometries and forms such as porous structures, suitable for cell ingrowth and osteoconduction. Due to its favorable gelling properties chitosan can deliver morphogenic factors and pharmaceutical agents in a controlled fashion. Its cationic nature allows it to complex DNA molecules making it an ideal candidate for gene delivery strategies. The ability to manipulate and reconstitute tissue structure and function using this material has tremendous clinical implications and is likely to play a key role in cell and gene therapies in coming years. In this paper we will review the current applications and future directions of CS in articular cartilage, intervertebral disk and bone tissue engineering.

The bone regenerative effect of chitosan microsphere-encapsulated growth hormone on bony consolidation in mandibular distraction osteogenesis in a dog model

The purpose of this project was to study the effect of chitosan microsphere-encapsulated human growth hormone, which causes sustained release of chitosan and human growth hormone after implantation on early bony consolidation in distraction osteogenesis of a canine model. Forty-eight dogs were used for this study. An external distraction device was applied to the mandibular body after a vertical osteotomy, and the mandibular distraction was started 5 days after the operation at a rate of 1 mm/d up to a 10-mm distraction. The experimental group was divided into a control group (I), hyaluronic acid group (II), chitosan microsphere group (III), and chitosan microsphere-encapsulated human growth hormone group (IV). Normal saline was injected in group I. In group II, a 1-ml volume of hyaluronic acid solution was injected into the distracted area. In the group III, powder of chitosan microspheres and hGH were mixed with a 1-ml volume of hyaluronic acid to make an injectable form, and it was implanted into the distracted area. In group IV, powder of chitosan microsphere-encapsulated hGH was mixed with a 1-ml volume of hyaluronic acid. A total of 1-ml volume of the solution mix was implanted into the distracted area. Five dogs in each group (total of 20 dogs) were killed 3 weeks after completion of distraction. Twenty-eight dogs were killed at 6 weeks. Bone mineral density was 13.1% of the contralateral normal mandible at 3 weeks and 29.6% at 6 weeks in group I, 16.4% at 3 weeks and 40.4% at 6 weeks in group II, 16.6% at 3 weeks and 45.95% at 6 weeks in group III, and 29.6% at 3 weeks and 66.7% at 6 weeks in group IV. The mean three-point failure load was 16.1% in the control group, 34.7% in group II, 41.5% in group III, and 52.1% in group IV compared with the intact contralateral mandible, with statistical significance. In the histological findings, new bone was generated in all groups. In group IV, the formation of active woven bone was observed throughout the distracted area at 6 weeks. The amount of new bone formation in the distracted zone was in the order of group IV, group III, group II, and the control group. In conclusion, these findings suggest that chitosan microsphere-encapsulated hGH seems to be quite effective in early bone consolidation in distraction osteogenesis.

The role of hyaluronic acid, chitosan, and calcium sulfate and their combined effect on early bony consolidation in distraction osteogenesis of a canine model

The purpose of this project was to study the effect of hyaluronic acid, calcium sulfate, and chitosan on early bony consolidation in distraction osteogenesis of a canine model. Sixteen dogs were used for this study. The lateral surface of the mandibular body was exposed in the subperiosteal plane, and the vertical osteotomy on the mandibular body was extended downward. An external distraction device was applied to the mandibular body, and the mandibular distraction was started 5 days after the operation at a rate of 1 mm/d up to a 10-mm distraction. The experimental group was then divided into a control group, chitosan group, hyaluronic acid group, calcium sulfate combined with hyaluronic acid group, and calcium sulfate combined with chitosan group, depending on the type of implantation material in the distracted area. After completing the distraction, implantation material was injected into the distracted area, although no material was implanted into the distracted area of the control group. After implanting the materials, the distraction device was left in place for 6 weeks to allow for bony consolidation. Four dogs were allocated to each group. Two dogs in each group (total of 8 dogs) were killed 3 weeks after implantation of the material, and the other 8 dogs were killed after 6 weeks. New bone was generated in the distracted zone of all groups. In the calcium sulfate combined with chitosan group and calcium sulfate combined with hyaluronic acid group, the formation of active woven bone was observed throughout the distracted zone. Moreover, the new bone seemed to be nearly normal cortical bone at 6 weeks after implantation. In the chitosan group and hyaluronic acid group, the development of new bone was observed in the distracted zone at 6 weeks. The amount was less than that in the calcium sulfate combined with hyaluronic acid group and calcium sulfate combined with chitosan group. These findings suggest that calcium sulfate and its combined materials seem to be quite effective in early bony consolidation in distraction osteogenesis.

Chitosan supports the expression of extracellular matrix proteins in human osteoblasts and chondrocytes

The search for biocompatible materials that can support the growth and phenotypic expression of osteoblasts and chondrocytes is a major challenge in the application of tissue engineering techniques for the repair of bone and cartilage defects. Chitosan, a copolymer of glucosamine and N-acetylglucosamine, may provide an answer to this search. Chitosan is the deacetylated product of chitin, a ubiquitous biopolymer found in the exoskeleton of insects and marine invertebrates. Little is known about the utility of chitosan in propagating human osteoblasts and chondrocytes. In this study, we test the hypothesis that chitosan promotes the survival and function of osteoblasts and chondrocytes. Chitosan (4%, w/v in 2% HAc) was coated onto plastic coverslips that had been fitted into 24-well plates. Human osteoblasts and articular chondrocytes were seeded on either uncoated or chitosan-coated coverslips at 1 x 10(5)/cells per well. Cultures were incubated at 37 degrees C, 5% CO(2) for a period of 7 days. Cell viability was assessed at that time using a fluorescent molecular probe. The phenotypic expression of osteoblasts and chondrocytes was analyzed by reverse transcriptase-polymerase chain reaction and immunocytochemistry. Osteoblasts and chondrocytes appeared spherical and refractile on chitosan-coated coverslips. In contrast, greater than 90% of cells on plastic coverslips were elongated and spindle shaped after 7 days of culture. Similar to cells propagated on uncoated control wells, greater than 90% of human osteoblasts and chondrocytes propagated on chitosan remained viable. Human osteoblasts propagated on chitosan films continued to express collagen type I whereas chondrocytes expressed collagen type II and aggrecan, as shown by reverse transcriptase-polymerase chain reaction analysis and immunostaining. The present in vitro work demonstrates the biocompatibility of chitosan as a substrate for the growth and continued function of human osteoblasts and chondrocytes. Chitosan may have potential use as a tissue engineering tool for the repair of osseous and chondral defects.

The bone regenerative effect of platelet-derived growth factor-BB delivered with a chitosan/tricalcium phosphate sponge carrier

BACKGROUND

In order to achieve optimal effects, growth factors including platelet-derived growth factor (PDGF) should be delivered with a biodegradable carrier that will release therapeutic concentrations over a sufficient length of time. The purpose of this study was to evaluate the bone regenerative effect of PDGF-BB delivered with a chitosan/tricalcium phosphate (TCP) sponge carrier in a rat calvarial defect model.

METHODS

The PDGF-BB-loaded chitosan/TCP sponge carrier was fabricated by freeze-drying a mixture of chitosan solution and TCP powder and soaking in a PDGF-BB solution. The release kinetics of PDGF-BB loaded onto the sponge were measured in vitro with 125I-labeled PDGF-BB. Chitosan/TCP sponges with and without PDGF-BB were implanted into 8 mm calvarial defects in rats. Rats were sacrificed at 2 and 4 weeks following implantation, and histologic and histomorphometrical examinations were performed.

RESULTS

In vitro evaluation demonstrated that an effective therapeutic concentration of PDGF-BB following a high initial burst release was maintained throughout the examination period. In the histologic examination, the chitosan/TCP sponge carrier promoted osseous healing of the rat calvarial defects as compared to controls. The addition of PDGF-BB to the carrier further enhanced bone regeneration. Evidence of the degraded sponge matrix was observed mingled within the newly formed bone without connective tissue encapsulation.

CONCLUSIONS

The results of this study support the use of chitosan/TCP sponges as a delivery system for growth factors and demonstrate that PDGF-BB loaded onto chitosan/TCP sponge carriers has an osteogenic effect on bone regeneration in vivo.

Histopathological and immunohistochemical studies of membranes of deacetylated chitin derivatives implanted over rat calvaria

Membranes made of 65, 70, 80, 94, and 100% deacetylated chitin (chitosan) were implanted subperiosteally over the calvaria of 100 rats. Reactions were studied at 1, 2, 4, and 8 weeks after implantation. Membranes prepared with 65, 70, and 80% deacetylated chitin initially elicited marked inflammatory reactions that subsided in time with granulation tissue formation and osteogenesis. Osteocalcin-positive cells were detected immunohistochemically in the granulation tissue. On the other hand, membranes made of 94% deacetylated chitin and chitosan showed mild inflammation and minimal osteogenesis. The results indicate that membranes made of 65, 70, and 80% deacetylated chitin enhance osteogenesis at the site of their implantation. However, the initially severe inflammatory reaction associated with these materials needs to be controlled before the materials would be suitable for clinical application.

Histologic and histometric evaluation of rat alveolar wound healing around polyurethane resin implants

The biocompatibility of polyurethane resin-implants derived from castor bean (Ricinus communis) was analyzed in the rat dental alveolus. Histometric evaluation of trial areas adjacent to the implants showed, by week 1, the polymer granules encircled by a conspicuous capsule and surrounded by immature connective tissue. By weeks 2 and 3, the implants were surrounded by less prominent fibrous capsules and most of the tested area was occupied by mature trabecular bone. By week 6, the fibrous capsule was thinner and the tested area was almost totally covered with bone, which in several places was in close contact with the implants. The results suggest that the material is compatible, as it was progressively integrated into alveolar bone in the wound-healing process.

In vitro properties of a chitosan-bonded self-hardening paste with hydroxyapatite granules

A new self-hardening paste was made by using a combination of chitosan, hydroxyapatite (HA) granules, ZnO, and CaO. The sol was made by dissolving 0.1 g of chitosan in a solution of 0.1 g malic acid and 2.0 mL physiological saline solution. Mixed with 0.03 g of CaO and 0.04 g of ZnO powders was 2.77 g (55 wt %) of HA granules which had a homogeneous pore distribution and a porosity of 35-48%. The size of the granules was set for 0.1-0.3 mm. Kneading and setting of the paste generated a little amount of heat (32.8 degrees C) as compared with the heat produced by polymethyl-methacrylate (PMMA) bone cement (114.5 degrees C). The pH value of chitosan-HA-hardened composite after setting was nearly equal to that of human plasma (pH 7.4), while that of PMMA bone cement maintained an acid pH of 4.7. Hydroxyapatite granules less than 0.1 mm, 0.1-0.3 mm, or 0.3-0.6 mm were set using chitosan sol. The size of the granules did not influence the compressive strength of the set chitosan-HA-hardened composite. The greatest compressive strength of chitosan-HA-hardened composite was obtained by using 55 wt % of HA granules. The strength of the chitosan-HA-hardened composite was comparable to that of the cancellous bone derived from tibial eminentia, but was considerably lower than that of the PMMA bone cement.

Osteogenesis enhanced by chitosan (poly-N-acetyl glucosaminoglycan) in vitro

Chitosan, with a chemical structure similar to hyaluronic acid, has been implicated as a wound healing agent. The purpose of this research was to evaluate the effect of chitosan on osteoblast differentiation and bone formation in vitro. Mesenchymal stem cells were harvested from fetal Swiss Webster mice calvariae prior to osteoblast differentiation and calcification (12 to 13 days in utero). Stem cells were seeded into 6-well culture plates at a density of 350,000 cells per well. Using this model, it was possible to quantify the influence of chitosan on osteoprogenitor differentiation and osteogenesis. Experimental wells were pretreated with 200 microliters chitosan (2 mg/ml in 0.2% acetic acid vehicle). Control wells were pretreated with 200 microliters vehicle (0.2% acetic acid) or remained untreated. Cells were allowed to grow under optimal conditions for 14 days. Cell cultures were fixed with glutaraldehyde and stained with Von Kossa stain to identify bone forming colonies. Positive staining colonies were identified and counted under light microscopy. Histologic cross-sections of representative positively stained colonies identified osteoblasts and confirmed bone formation. Examination of control wells revealed 3.6 +/- 0.6 colonies per well while experimental wells revealed a significantly greater average of 6.2 +/- 1.2 colonies per well (P < or = 0.01). Computer-assisted image analysis of the average area of bone formed by control colonies was 0.34 +/- 0.09 (relative units) while that of experimental colonies was 0.39 +/- 0.06 (relative units) per average bone forming colony. The difference in mean size (control versus chitosan bone forming colony) was not statistically significant (P = 0.4691). The results of this in vitro experiment suggest that chitosan potentiates the differentiation of osteoprogenitor cells and may facilitate the formation of bone.