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Deluca A, Wagner A, Heimel P, Deininger C, Wichlas F, Redl H, Rohde E, Tempfer H, Gimona M, Traweger A. Synergistic effect of umbilical cord extracellular vesicles and rhBMP-2 to enhance the regeneration of a metaphyseal femoral defect in osteoporotic rats. Stem Cell Res Ther 2024; 15:144. [PMID: 38764077 PMCID: PMC11103988 DOI: 10.1186/s13287-024-03755-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/07/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND The aim of this study was to evaluate potential synergistic effects of a single, local application of human umbilical cord MSC-derived sEVs in combination with a low dose of recombinant human rhBMP-2 to promote the regeneration of a metaphyseal femoral defect in an osteoporotic rat model. METHODS 6 weeks after induction of osteoporosis by bilateral ventral ovariectomy and administration of a special diet, a total of 64 rats underwent a distal femoral metaphyseal osteotomy using a manual Gigli wire saw. Defects were stabilized with an adapted Y-shaped mini-locking plate and were subsequently treated with alginate only, or alginate loaded with hUC-MSC-sEVs (2 × 109), rhBMP-2 (1.5 µg), or a combination of sEVs and rhBMP-2 (n = 16 for each group). 6 weeks post-surgery, femora were evaluated by µCT, descriptive histology, and biomechanical testing. RESULTS Native radiographs and µCT analysis confirmed superior bony union with callus formation after treatment with hUC-MSC-sEVs in combination with a low dose of rhBMP-2. This finding was further substantiated by histology, showing robust defect consolidation 6 weeks after treatment. Torsion testing of the explanted femora revealed increased stiffness after application of both, rhBMP-2 alone, or in combination with sEVs, whereas torque was only significantly increased after treatment with rhBMP-2 together with sEVs. CONCLUSION The present study demonstrates that the co-application of hUC-MSC-sEVs can improve the efficacy of rhBMP-2 to promote the regeneration of osteoporotic bone defects.
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Affiliation(s)
- Amelie Deluca
- Institute of Tendon and Bone Regeneration, Salzburg, 5020, Austria.
- Department of Traumatology, KABEG-Klinikum Klagenfurt am Woerthersee, Klagenfurt, 9020, Austria.
| | - Andrea Wagner
- Institute of Tendon and Bone Regeneration, Salzburg, 5020, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, 1200, Austria
| | - Patrick Heimel
- Austrian Cluster for Tissue Regeneration, Vienna, 1200, Austria
- Ludwig Boltzmann Institute for Traumatology, The Research Centre in Cooperation with AUVA, Vienna, 1200, Austria
| | - Christian Deininger
- Institute of Tendon and Bone Regeneration, Salzburg, 5020, Austria
- Department of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, 5020, Austria
| | - Florian Wichlas
- Department of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, 5020, Austria
| | - Heinz Redl
- Austrian Cluster for Tissue Regeneration, Vienna, 1200, Austria
- Ludwig Boltzmann Institute for Traumatology, The Research Centre in Cooperation with AUVA, Vienna, 1200, Austria
| | - Eva Rohde
- GMP Unit, Spinal Cord Injury and Tissue Regeneration Centre Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Transfusion Medicine, Salzburger Landeskliniken GesmbH, Paracelsus Medical University, Salzburg, Austria
| | - Herbert Tempfer
- Institute of Tendon and Bone Regeneration, Salzburg, 5020, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, 1200, Austria
| | - Mario Gimona
- GMP Unit, Spinal Cord Injury and Tissue Regeneration Centre Salzburg, Paracelsus Medical University, Salzburg, Austria
- Research Program "Nanovesicular Therapies", Paracelsus Medical University, Salzburg, Austria
| | - Andreas Traweger
- Institute of Tendon and Bone Regeneration, Salzburg, 5020, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, 1200, Austria
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Chandran M, Akesson KE, Javaid MK, Harvey N, Blank RD, Brandi ML, Chevalley T, Cinelli P, Cooper C, Lems W, Lyritis GP, Makras P, Paccou J, Pierroz DD, Sosa M, Thomas T, Silverman S. Impact of osteoporosis and osteoporosis medications on fracture healing: a narrative review. Osteoporos Int 2024:10.1007/s00198-024-07059-8. [PMID: 38587674 DOI: 10.1007/s00198-024-07059-8] [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: 10/10/2023] [Accepted: 03/06/2024] [Indexed: 04/09/2024]
Abstract
Antiresorptive medications do not negatively affect fracture healing in humans. Teriparatide may decrease time to fracture healing. Romosozumab has not shown a beneficial effect on human fracture healing. BACKGROUND Fracture healing is a complex process. Uncertainty exists over the influence of osteoporosis and the medications used to treat it on fracture healing. METHODS Narrative review authored by the members of the Fracture Working Group of the Committee of Scientific Advisors of the International Osteoporosis Foundation (IOF), on behalf of the IOF and the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT). RESULTS Fracture healing is a multistep process. Most fractures heal through a combination of intramembranous and endochondral ossification. Radiographic imaging is important for evaluating fracture healing and for detecting delayed or non-union. The presence of callus formation, bridging trabeculae, and a decrease in the size of the fracture line over time are indicative of healing. Imaging must be combined with clinical parameters and patient-reported outcomes. Animal data support a negative effect of osteoporosis on fracture healing; however, clinical data do not appear to corroborate with this. Evidence does not support a delay in the initiation of antiresorptive therapy following acute fragility fractures. There is no reason for suspension of osteoporosis medication at the time of fracture if the person is already on treatment. Teriparatide treatment may shorten fracture healing time at certain sites such as distal radius; however, it does not prevent non-union or influence union rate. The positive effect on fracture healing that romosozumab has demonstrated in animals has not been observed in humans. CONCLUSION Overall, there appears to be no deleterious effect of osteoporosis medications on fracture healing. The benefit of treating osteoporosis and the urgent necessity to mitigate imminent refracture risk after a fracture should be given prime consideration. It is imperative that new radiological and biological markers of fracture healing be identified. It is also important to synthesize clinical and basic science methodologies to assess fracture healing, so that a convergence of the two frameworks can be achieved.
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Affiliation(s)
- M Chandran
- Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, DUKE NUS Medical School, Singapore, Singapore.
| | - K E Akesson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| | - M K Javaid
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - N Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - R D Blank
- Garvan Institute of Medical Research, Medical College of Wisconsin, Darlinghurst, NSW, Australia
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - M L Brandi
- Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Largo Palagi 1, Florence, Italy
| | - T Chevalley
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - P Cinelli
- Department of Trauma Surgery, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - C Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
| | - W Lems
- Department of Rheumatology, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - G P Lyritis
- Hellenic Osteoporosis Foundation, Athens, Greece
| | - P Makras
- Department of Medical Research, 251 Hellenic Air Force & VA General Hospital, Athens, Greece
| | - J Paccou
- Department of Rheumatology, MABlab ULR 4490, CHU Lille, Univ. Lille, 59000, Lille, France
| | - D D Pierroz
- International Osteoporosis Foundation, Nyon, Switzerland
| | - M Sosa
- University of Las Palmas de Gran Canaria, Investigation Group on Osteoporosis and Mineral Metabolism, Canary Islands, Spain
| | - T Thomas
- Department of Rheumatology, North Hospital, CHU Saint-Etienne and INSERM U1059, University of Lyon-University Jean Monnet, Saint‑Etienne, France
| | - S Silverman
- Cedars-Sinai Medical Center and Geffen School of Medicine UCLA, Los Angeles, CA, USA
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Goetz JE, Brouillette MJ, Sakyi MY, Paulsen DP, Petersen EB, Fredericks DC. A New Method for Creating Impact-Induced Intra-Articular Fractures in a Rabbit Model Induces Severe Post-Traumatic Osteoarthritis. J Orthop Trauma 2024; 38:e133-e141. [PMID: 38206679 DOI: 10.1097/bot.0000000000002757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVES The objective of this work was to develop a model of intra-articular fracture (IAF) in a rabbit and document the speed and severity of degenerative joint changes after fracture fixation. METHODS With Institutional Animal Care & Use Committee approval, impact-induced IAFs were created in the distal tibia of 16 New Zealand White rabbits. Fractures were fixed with a plate and screws. Pain and function were monitored at regular postoperative intervals with limb loading analysis. Twelve or 26 weeks after fracture, animals were euthanized for histological assessment of cartilage degeneration and micro-computed tomography analysis of bone histomorphometry. RESULTS Eleven animals successfully completed the study. Maximum foot force in the fractured limb was 41% ± 21% lower than preoperative values ( P = 0.006) 12 weeks after fracture and remained 25% ± 13% lower ( P = 0.081) after 26 weeks. Cortical bone mineral density in micro-computed tomography images was 34% ± 13% lower 12 weeks after fracture ( P < 0.001) and remained (42% ± 8%) lower 26 weeks after fracture ( P < 0.001). Twelve weeks after fracture, Mankin scores of cartilage degeneration were significantly higher in the medial talus ( P = 0.007), lateral talus ( P < 0.001), medial tibia ( P = 0.017), and lateral tibia ( P = 0.002) of the fractured limb compared with the uninjured contralateral limb. Average Mankin scores in the talus increased from 12 to 26 weeks (5.9 ± 0.9 to 9.4 ± 0.4; P < 0.001 lateral; 5.4 ± 1.8 to 7.8 ± 2.0; P = 0.043 medial), indicating substantial and progressive joint degeneration. CONCLUSIONS The ankle joint of the New Zealand White rabbit provides the smallest available model of impact-induced IAF that can be treated with clinically relevant techniques and replicates key features of healing and degeneration found in human patients.
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Affiliation(s)
- Jessica E Goetz
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA
| | - Marc J Brouillette
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Maxwell Y Sakyi
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Danielle P Paulsen
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Emily B Petersen
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Douglas C Fredericks
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
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Rios BR, Barbosa S, da Silva WPP, Quirino Louzada MJ, Ervolino E, Kalil EC, Shibli JA, Faverani LP. Polydioxanone Enhances Bone Regeneration After Resection and Reconstruction of Rat Femur with rhBMP2. Tissue Eng Part C Methods 2024; 30:102-112. [PMID: 38271574 DOI: 10.1089/ten.tec.2023.0304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
The aim of this study was to assess the bone regeneration potential of a polydioxanone (PDO) scaffold together with recombinant human bone morphogenetic protein-2 (rhBMP-2) for the reconstruction of large bone defect. In total, 24 male rats (6 months old) were subjected to bilateral femoral stabilization using titanium plates to create a 2 mm gap, and reconstruction using rhBMP-2 (Infuse®; 3.25 μg). The bone defects were covered with PDO (PDO group), or with titanium mesh (Ti group). Animals were euthanized on days 14 and 60. Simultaneously, 16 rats received PDO and Ti in their dorsum for the purpose of biocompatibility analysis at 3, 5, 7, and 10 days postoperatively. X-ray densitometry showed a higher density in the PDO group on day 14. On day 60, coverage of the bone defect with PDO showed a larger quantity of newly formed bone than that found for the Ti group, a lower inflammatory infiltrate value, and a more significant number of blood vessels on day 14. By immunohistochemical assessment, runt-related transcription factor 2 (RUNX2) and osteocalcin (OCN) showed higher labeling on day 14 in the PDO group. On day 60, bone morphogenetic protein-2 (BMP-2) showed higher labeling in the PDO group, whereas Ti showed higher labeling for osteoprotegerin, nuclear factor kappa B ligand-activating receptor, RUNX2, and OCN. Furthermore, biocompatibility analysis showed a higher inflammatory response in the Ti group. The PDO scaffold enhanced bone regeneration when associated with rhBMP-2 in rat femur reconstruction. Impact statement Regeneration of segmental bone defects is a difficult task, and several techniques and materials have been used. Recent advances in the production of synthetic polymers, such as polydioxanone (PDO), produced by three-dimensional printing, have shown distinct characteristics that could improve tissue regeneration even in an important bone defect. The present preclinical study showed that PDO membranes used as scaffolds to carry recombinant human bone morphogenetic protein-2 (rhBMP-2) improved bone tissue regeneration by more than 8-fold when compared with titanium mesh, suggesting that PDO membranes could be a feasible and useful material for use in guided bone regeneration. (In English, viable is only used for living creatures capable of sustaining life.
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Affiliation(s)
- Barbara Ribeiro Rios
- Division of Oral and Maxillofacial Surgery and Implantology, Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Stéfany Barbosa
- Division of Oral and Maxillofacial Surgery and Implantology, Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - William Phillip Pereira da Silva
- Division of Oral and Maxillofacial Surgery and Implantology, Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | | | - Edilson Ervolino
- Division of Histology, Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Eduardo C Kalil
- Dental Research Division, Department of Periodontology, Guarulhos University, Centro, Guarulhos, Brazil
| | - Jamil Awad Shibli
- Dental Research Division, Department of Periodontology, Guarulhos University, Centro, Guarulhos, Brazil
| | - Leonardo P Faverani
- Division of Oral and Maxillofacial Surgery and Implantology, Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
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Ray S, Thormann U, Kramer I, Sommer U, Budak M, Schumacher M, Bernhardt A, Lode A, Kern C, Rohnke M, Heiss C, Lips KS, Gelinsky M, Alt V. Mesoporous Bioactive Glass-Incorporated Injectable Strontium-Containing Calcium Phosphate Cement Enhanced Osteoconductivity in a Critical-Sized Metaphyseal Defect in Osteoporotic Rats. Bioengineering (Basel) 2023; 10:1203. [PMID: 37892933 PMCID: PMC10604136 DOI: 10.3390/bioengineering10101203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/28/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
In this study, the in vitro and in vivo bone formation behavior of mesoporous bioactive glass (MBG) particles incorporated in a pasty strontium-containing calcium phosphate bone cement (pS100G10) was studied in a metaphyseal fracture-defect model in ovariectomized rats and compared to a plain pasty strontium-containing calcium phosphate bone cement (pS100) and control (empty defect) group, respectively. In vitro testing showed good cytocompatibility on human preosteoblasts and ongoing dissolution of the MBG component. Neither the released strontium nor the BMG particles from the pS100G10 had a negative influence on cell viability. Forty-five female Sprague-Dawley rats were randomly assigned to three different treatment groups: (1) pS100 (n = 15), (2) pS100G10 (n = 15), and (3) empty defect (n = 15). Twelve weeks after bilateral ovariectomy and multi-deficient diet, a 4 mm wedge-shaped fracture-defect was created at the metaphyseal area of the left femur in all animals. The originated fracture-defect was substituted with pS100 or pS100G10 or left empty. After six weeks, histomorphometrical analysis revealed a statistically significant higher bone volume/tissue volume ratio in the pS100G10 group compared to the pS100 (p = 0.03) and empty defect groups (p = 0.0001), indicating enhanced osteoconductivity with the incorporation of MBG. Immunohistochemistry revealed a significant decrease in the RANKL/OPG ratio for pS100 (p = 0.004) and pS100G10 (p = 0.003) compared to the empty defect group. pS100G10 showed a statistically higher expression of BMP-2. In addition, a statistically significant higher gene expression of alkaline phosphatase, osteoprotegerin, collagen1a1, collagen10a1 with a simultaneous decrease in RANKL, and carbonic anhydrase was seen in the pS100 and pS100G10 groups compared to the empty defect group. Mass spectrometric imaging by time-of-flight secondary ion mass spectrometry (ToF-SIMS) showed the release of Sr2+ ions from both pS100 and pS100G10, with a gradient into the interface region. ToF-SIMS imaging also revealed that resorption of the MBG particles allowed for new bone formation in cement pores. In summary, the current work shows better bone formation of the injectable pasty strontium-containing calcium phosphate bone cement with incorporated mesoporous bioactive glass compared to the bioactive-free bone cement and empty defects and can be considered for clinical application for osteopenic fracture defects in the future.
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Affiliation(s)
- Seemun Ray
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
| | - Ulrich Thormann
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
- Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, 35390 Giessen, Germany
| | - Inga Kramer
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
| | - Ursula Sommer
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
| | - Matthäus Budak
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
- Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, 35390 Giessen, Germany
| | - Matthias Schumacher
- Centre for Translational Bone, Joint, and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (M.S.); (A.B.); (A.L.); (M.G.)
| | - Anne Bernhardt
- Centre for Translational Bone, Joint, and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (M.S.); (A.B.); (A.L.); (M.G.)
| | - Anja Lode
- Centre for Translational Bone, Joint, and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (M.S.); (A.B.); (A.L.); (M.G.)
| | - Christine Kern
- Institute of Physical Chemistry, Justus Liebig University Giessen, 35392 Giessen, Germany; (C.K.); (M.R.)
| | - Marcus Rohnke
- Institute of Physical Chemistry, Justus Liebig University Giessen, 35392 Giessen, Germany; (C.K.); (M.R.)
| | - Christian Heiss
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
- Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, 35390 Giessen, Germany
| | - Katrin S. Lips
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
| | - Michael Gelinsky
- Centre for Translational Bone, Joint, and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (M.S.); (A.B.); (A.L.); (M.G.)
| | - Volker Alt
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
- Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, 35390 Giessen, Germany
- Department of Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
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Bhattacharjee A, Jo Y, Bose S. In vivo and In vitro properties evaluation of curcumin loaded MgO doped 3D printed TCP scaffolds. J Mater Chem B 2023; 11:4725-4739. [PMID: 37171110 PMCID: PMC10314738 DOI: 10.1039/d2tb02547g] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The lack of site-specific chemotherapeutic agents to treat bone malignancy throws a significant challenge in the design of a delivery vehicle. The major scientific question posed in this study is, can we utilize curcumin-loaded magnesium oxide (MgO) doped 3D printed tricalcium phosphate (TCP) bone grafts as a localized delivery system that improves early stage in vivo osseointegration and in vitro chemoprevention, antibacterial properties? We have utilized curcumin as an alternative natural chemopreventive agent for bone cancer-specific delivery after direct incorporation on the 3D printed tricalcium phosphate (TCP) bone grafts. The addition of MgO as a dopant to TCP leads to ∼1.3 times enhancement in compressive strength. The designed drug delivery system shows up to ∼22% curcumin release in a physiological pH of 7.4 after 30 days. The presence of curcumin leads to up to ∼8.5 times reduction in osteosarcoma viability. In vitro results indicate that these scaffolds significantly enhance bone-forming osteoblast cells while reducing the bone-resorbing osteoclast cells. The in vivo rat distal femur model surgery followed by histological assessment with H&E, vWF, and Movat pentachrome staining results show that the designed scaffolds lead to new bone formation (up to ∼2.5 times higher than the control) after successful implantation. The presence of MgO and curcumin results in up to ∼71% antibacterial efficacy against osteomyelitis causing S. aureus. These 3D printed osteogenic and chemopreventive scaffolds can be utilized in patient-specific low load-bearing defect sites.
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Affiliation(s)
- Arjak Bhattacharjee
- W. M. Keck Biomedical Materials Research Laboratory School of Mechanical and Materials Engineering Washington State University, Pullman, Washington 99164, USA.
| | - Yongdeok Jo
- W. M. Keck Biomedical Materials Research Laboratory School of Mechanical and Materials Engineering Washington State University, Pullman, Washington 99164, USA.
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory School of Mechanical and Materials Engineering Washington State University, Pullman, Washington 99164, USA.
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Li J, Leung SYS, Chung YL, Chow SKH, Alt V, Rupp M, Brochausen C, Chui CS, Ip M, Cheung WH, Wong RMY. Hydrogel Delivery of DNase I and Liposomal Vancomycin to Eradicate Fracture-related Methicillin-resistant Staphylococcus aureus Infection and Support Osteoporotic Fracture Healing. Acta Biomater 2023; 164:223-239. [PMID: 37019168 DOI: 10.1016/j.actbio.2023.03.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/24/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023]
Abstract
Fracture-related infection (FRI) is a devastating complication in orthopedic surgery. A recent study showed that FRI causes more severe infection and further delays healing in osteoporotic bone. Moreover, bacterial biofilm formed on implants cannot be eradicated by systemic antibiotics, warranting novel treatments. Here, we developed a DNase I and Vancomycin hydrogel delivery vehicle to eradicate Methicillin-resistant Staphylococcus aureus (MRSA) infection in vivo. Vancomycin was encapsulated in liposomes, and DNase I and Vancomycin/liposomal-Vancomycin was loaded on thermosensitive hydrogel. In vitro drug release test showed a burst release of DNase I (77.2%) within 72 hours and sustained release of Vancomycin (82.6%) up to day 14. The in vivo efficacy was evaluated in a clinically relevant ovariectomy (OVX) induced osteoporotic metaphyseal fracture model with MRSA infection, and a total of 120 Sprague Dawley rats were used. In the OVX with infection group, biofilm development caused a drastic inflammatory response, trabecular bone destruction, and non-union. In the DNase I and Vancomycin co-delivery hydrogel group (OVX-Inf-DVG), bacteria on bone and implant were eradicated. X-ray and micro-CT showed preservation of trabecular bone and bone union. HE staining showed the absence of inflammatory necrosis, and fracture healing was restored. The local elevation of TNF-α and IL-6 and increased number of osteoclasts were prevented in the OVX-Inf-DVG group. Our findings suggest that dual release of DNase I and Vancomycin initially followed by Vancomycin only later up to 14 days effectively eliminates MRSA infection, prevents biofilm development and provides a sterile environment to promote fracture healing in osteoporotic bone with FRI. STATEMENT OF SIGNIFICANCE: The biofilm formation on the implant is difficult to eradicate, causing recurrent infection and non-union in fracture-related infection (FRI). Here we developed a hydrogel therapy with high in vivo efficacy to eliminate MRSA biofilm infection in a clinically-relevant FRI model in osteoporotic bone. By loading DNase I and vancomycin/liposomal-vancomycin on thermosensitive poly-(DL-lactic acidco-glycolic acid) (PLGA)-polyethylene glycol (PEG)-PLGA hydrogel, a dual release of DNase I and Vancomycin was achieved whilst preserving enzyme activity. In this model, the progressive development of infection caused a drastic inflammatory response, osteoclastogenesis, trabecular bone destruction, and non-union of fracture. These pathological changes were successfully prevented by the dual delivery of DNase I and vancomycin. Our findings provide a promising strategy for FRI in osteoporotic bone.
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Affiliation(s)
- Jie Li
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Yik Lok Chung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Simon Kwoon Ho Chow
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Volker Alt
- Department of Trauma Surgery, University Hospital Regensburg, Germany
| | - Markus Rupp
- Department of Trauma Surgery, University Hospital Regensburg, Germany
| | | | - Chun Sing Chui
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Margaret Ip
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ronald Man Yeung Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Polo TOB, Fonseca-Santos JM, Momesso GAC, da Silva WPP, Barbosa S, Santos AMDS, Silva MC, Garcia VG, Theodoro LH, Faverani LP. Single intraoperative infrared laser optimized bone repair in rat femoral osteotomies with experimentally induced osteoporosis. Lasers Med Sci 2023; 38:87. [PMID: 36935455 DOI: 10.1007/s10103-023-03746-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/06/2023] [Indexed: 03/21/2023]
Abstract
This study aimed to evaluate the effect of infrared laser (IRL) on bone repair in ovariectomized rats subjected to femoral osteotomies. Of 32 rats, half underwent bilateral ovariectomy (OVX) and the other half underwent sham ovariectomy (SHAM). A period of 3 months was defined to observe the presence of osteoporosis. The rats were subjected to osteotomies in the femurs and then fixed with a miniplate and 1.5-mm system screws. Thereafter, half of the rats from both SHAM and OVX groups were not irradiated, and the other half were irradiated by IRL using the following parameters: wavelength, 808 nm; power, 100 mW; 60 s for each point; 6 J/point; and a total of 5 points of bone gap. All animals were euthanized 60 days after surgery. The femur gap was scanned using micro-computed tomography (micro-CT). The samples were then examined under a confocal laser microscope to determine the amounts of calcein and alizarin red. The slides were stained with alizarin red and Stevenel's blue for histometric analysis. In the micro-CT analysis, the OVX groups had the lowest bone volume (P < 0.05). When the laser was applied to the OVX groups, bone turnover increased (P < 0.05). New bone formation (NBF) was comparable between SHAM and OVX/IR (P > 0.05) groups; however, it was less in the OVX groups (P < 0.05). In conclusion, the results encourage the use of IRL intraoperatively as it optimizes bone repair, mainly in animals with low bone mineral density.
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Affiliation(s)
- Tárik Ocon Braga Polo
- School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | | | - Gustavo Antonio Correa Momesso
- School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
- Department of Implantology, University of Santo Amaro, Unisa, São Paulo, SP, Brazil
| | | | - Stefany Barbosa
- School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | | | - Mirela Caroline Silva
- School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Valdir Gouveia Garcia
- Diagnosis and Surgery Department, School of Dentistry, São Paulo State University (UNESP), 1193 José Bonifácio Street, Araçatuba, São Paulo, 16015-050, Brazil
| | - Letícia Helena Theodoro
- Diagnosis and Surgery Department, School of Dentistry, São Paulo State University (UNESP), 1193 José Bonifácio Street, Araçatuba, São Paulo, 16015-050, Brazil
| | - Leonardo P Faverani
- Diagnosis and Surgery Department, School of Dentistry, São Paulo State University (UNESP), 1193 José Bonifácio Street, Araçatuba, São Paulo, 16015-050, Brazil.
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Development of a Metaphyseal Non-Union Model in the Osteoporotic Rat Femur. Bioengineering (Basel) 2023; 10:bioengineering10030338. [PMID: 36978729 PMCID: PMC10045902 DOI: 10.3390/bioengineering10030338] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/15/2023] Open
Abstract
The aim of this current study was to establish a metaphyseal femoral non-union model in osteoporotic rats by comparing a power tool versus a manual tool for fracture creation. Twelve adult female Sprague Dawley rats were ovariectomized (OVX) and received a special diet for 6 weeks. Biweekly pQCT measurements confirmed a significant reduction in the cancellous and total bone mineral density in OVX rats compared to control (CTRL) animals. After 6 weeks, OVX rats underwent surgery creating a distal metaphyseal osteotomy, either using a piezoelectric- (n = 6) or a manual Gigli wire (n = 6) saw. Fractures were stabilized with a Y-shaped mini-locking plate. Within each group, three rats received Alginate directly into the fracture gap. OVX animals gained more weight over 8 weeks compared to CTRL animals. pQCT analysis showed a significant difference in the volumetric cancellous bone mineral density between OVX and CTRL rats. A histological examination of the osteoporotic phenotype was completed. Radiographic evaluation and Masson–Goldner trichrome staining with the piezoelectric saw failed to demonstrate bony bridging or a callus formation. New bone formation and complete healing were seen after 6 weeks in the Gigli group. For the creation of a metaphyseal atrophic non-union in the osteoporotic bone, a piezoelectric saw should be used.
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10
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Gao H, Huang J, Wei Q, He C. Advances in Animal Models for Studying Bone Fracture Healing. Bioengineering (Basel) 2023; 10:bioengineering10020201. [PMID: 36829695 PMCID: PMC9952559 DOI: 10.3390/bioengineering10020201] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Fracture is a common traumatic injury that is mostly caused by traffic accidents, falls, and falls from height. Fracture healing is a long-term and complex process, and the mode of repair and rate of healing are influenced by a variety of factors. The prevention, treatment, and rehabilitation of fractures are issues that urgently need to be addressed. The preparation of the right animal model can accurately simulate the occurrence of fractures, identify and observe normal and abnormal healing processes, study disease mechanisms, and optimize and develop specific treatment methods. We summarize the current status of fracture healing research, the characteristics of different animal models and the modeling methods for different fracture types, analyze their advantages and disadvantages, and provide a reference basis for basic experimental fracture modeling.
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Affiliation(s)
- Hui Gao
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jinming Huang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Quan Wei
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu 610041, China
- Correspondence: (Q.W.); (C.H.)
| | - Chengqi He
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu 610041, China
- Correspondence: (Q.W.); (C.H.)
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11
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Surgical Classification for Preclinical Rat Femoral Bone Defect Model: Standardization Based on Systematic Review, Anatomical Analysis and Virtual Surgery. Bioengineering (Basel) 2022; 9:bioengineering9090476. [PMID: 36135022 PMCID: PMC9495991 DOI: 10.3390/bioengineering9090476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/09/2022] [Accepted: 09/10/2022] [Indexed: 12/03/2022] Open
Abstract
Though surgical techniques profoundly influence in vivo experiments, significant heterogeneity exists in current surgeries for inducing rat femoral bone defects. Such variations reduce the reproducibility and comparability of preclinical studies, and are detrimental to clinical translation. The purposes of this study were: (1) to conduct a systematic review of rat femoral defect models, summarizing and analyzing the surgical techniques; (2) to analyze surgical design and potential pitfalls via 3D anatomy and virtual surgeries for fostering future precision research; and (3) to establish a surgical classification system, for improving the reproducibility and comparability among studies, avoiding unnecessary repetitive experiments. The online database PubMed was searched to identify studies from January 2000 to June 2022 using keywords, including rat, femur, bone defect. Eligible publications were included for a review of surgical methods. Anatomical analysis and virtual surgeries were conducted based on micro-CT reconstruction of the rat femur for further investigation and establishment of a classification system. A total of 545 publications were included, revealing marked heterogeneity in surgical methods. Four major surgical designs were reported for inducing defects from the proximal to distal femur: bone tunnel, cortical window, segmental defect, and wedge-shaped defect. Anatomical analysis revealed potential pitfalls hindering efficient clinical translation. A classification system was established according to the anatomical region, surgical design, and fixation devices. This systematic review in combination with 3D analysis and virtual surgery provides a general overview of current surgical approaches to inducing femoral defects in rats, and establishes a surgical classification facilitating preclinical research of quality and translational value.
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12
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Chow SKH, Wong CHW, Cui C, Li MMC, Wong RMY, Cheung WH. Modulating macrophage polarization for the enhancement of fracture healing, a systematic review. J Orthop Translat 2022; 36:83-90. [PMID: 35979176 PMCID: PMC9364046 DOI: 10.1016/j.jot.2022.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 12/04/2022] Open
Abstract
Background All fracture repairs start with the innate immune system with the inflammatory response known as the inflammatory stage guided and driven by the secretion of chemokine by the ruptured tissue, followed by the sequential recruitment of neutrophils, monocytes and macrophages. These innate immune cells would infiltrate the fracture site and secrete inflammatory cytokines to stimulate recruitment of more immune cells to arrive at the fracture site coordinating subsequent stages of the repair process. In which, subsidence of pro-inflammatory M1 macrophage and transformation to anti-inflammatory M2 macrophages promotes osteogenesis that marks the start of the anabolic endochondral stage. Methods Literature search was performed on Pubmed, Embase, and Web of Science databases (last accessed 15th April 2021) using “macrophage AND fracture”. Review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Results Eleven pre-clinical animal studies out of 429 articles were included in this systematic review according to our inclusion and exclusion criteria. All of which investigated interventions targeting to modulate the acute inflammatory response and macrophage polarization as evident by various markers in association with fracture healing outcomes. Conclusion This systematic review summarizes attempts to modulate the innate immune response with focuses on promoting macrophage polarization from M1 to M2 phenotype targeting the enhancement of fracture injury repair. Methods used to achieve the goal may include applications of damage-associated molecular pattern (DAMP), pathogen-associated molecular pattern (PAMP) or mechanical stimulation that hold high translational potentials for clinical application in the near future.
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Affiliation(s)
- Simon Kwoon-Ho Chow
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Carissa Hing-Wai Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Can Cui
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michelle Meng-Chen Li
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ronald Man Yeung Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
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Kern C, Pauli A, Rohnke M. Determination of Sr 2+ mobility in viscous bovine bone marrow by cryo-time-of-flight secondary ion mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2022; 36:e9300. [PMID: 35312121 DOI: 10.1002/rcm.9300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 06/14/2023]
Abstract
RATIONALE In osteoporosis research, strontium ions (Sr2+ ) have emerged as promising therapeutic agent in modified bone cements for better fracture healing. Modeling of Sr2+ dispersion in bone could be used as a predictive tool for the evaluation of functionalized biomaterials in future. Therefore, determination of experimental parameters for Sr2+ transport in bone is essential. In this study, we focus on the determination of Sr2+ diffusion in viscous bovine bone marrow by time-of-flight secondary ion mass spectrometry (ToF-SIMS). METHODS For this comparatively fast diffusion (FD) experiment, a specific experimental protocol of ToF-SIMS depth profiling under cryogenic conditions was developed. The validity of our experimental approach is proven by a time-dependent experimental series. Furthermore, 2D and 3D mass spectrometric imaging analysis was used to study Sr2+ surface and bulk distribution within bovine bone marrow. RESULTS Detailed 2D and 3D mass spectrometric imaging analysis revealed that Sr2+ diffusion is slower in bone marrow areas with high intensity of lipid and fatty acid signals than in areas with less lipid content. The Sr2+ transport within this passive model can be described by Fickian diffusion. Average diffusion coefficients of Sr2+ in bovine bone marrow were obtained from diffusion profiles in FD areas (Dbovine,FD = [2.09 ± 2.39]·10-9 cm2 s-1 ), slow diffusion areas (Dbovine,SD = [1.52 ± 1.80]·10-10 cm2 s-1 ), and total area diffusion (Dbovine,TA = [1.94 ± 2.40]·10-9 cm2 s-1 ). CONCLUSIONS We were able to show that cryo-ToF-SIMS is a useful tool for the characterization of rapid diffusion in water-containing highly viscous media. To the best of our knowledge, this is the first reported experimental approach for the investigation of the distribution of low concentrated therapeutic agents in bone marrow. Overall, our results provide important insights about Sr2+ diffusion in bovine bone marrow.
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Affiliation(s)
- Christine Kern
- Institute of Physical Chemistry, Justus Liebig University Giessen, Giessen, Germany
| | - Anna Pauli
- Institute of Physical Chemistry, Justus Liebig University Giessen, Giessen, Germany
| | - Marcus Rohnke
- Institute of Physical Chemistry, Justus Liebig University Giessen, Giessen, Germany
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14
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Sommer NG, Hirzberger D, Paar L, Berger L, Ćwieka H, Schwarze UY, Herber V, Okutan B, Bodey AJ, Willumeit-Römer R, Zeller-Plumhoff B, Löffler JF, Weinberg AM. Implant degradation of low-alloyed Mg-Zn-Ca in osteoporotic, old and juvenile rats. Acta Biomater 2022; 147:427-438. [PMID: 35644328 DOI: 10.1016/j.actbio.2022.05.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/27/2022] [Accepted: 05/23/2022] [Indexed: 11/27/2022]
Abstract
Implant removal is unnecessary for biodegradable magnesium (Mg)-based implants and, therefore, the related risk for implant-induced fractures is limited. Aging, on the other hand, is associated with low bone-turnover and decreased bone mass and density, and thus increased fracture risk. Osteoporosis is accompanied by Mg deficiency, therefore, we hypothesized that Mg-based implants may support bone formation by Mg2+ ion release in an ovariectomy-induced osteoporotic rat model. Hence, we investigated osseointegration and implant degradation of a low-alloyed, degrading Mg-Zn-Ca implant (ZX00) in ovariectomy-induced osteoporotic (Osteo), old healthy (OH), and juvenile healthy (JH) groups of female Sprague Dawley rats via in vivo micro-computed tomography (µCT). For the Osteo rats, we demonstrate diminished trabecular bone already after 8 weeks upon ovariectomy and significantly enhanced implant volume loss, with correspondingly pronounced gas formation, compared to the OH and JH groups. Sclerotic rim development was observed in about half of the osteoporotic rats, suggesting a prevention from foreign-body and osteonecrosis development. Synchrotron radiation-based µCT confirmed lower bone volume fractions in the Osteo group compared to the OH and JH groups. Qualitative histological analysis additionally visualized the enhanced implant degradation in the Osteo group. To date, ZX00 provides an interesting implant material for young and older healthy patients, but it may not be of advantage in pharmacologically untreated osteoporotic conditions. STATEMENT OF SIGNIFICANCE: Magnesium-based implants are promising candidates for treatment of osteoporotic fractures because of their biodegradable, biomechanical, anti-bacterial and bone regenerative properties. Here we investigate magnesium‒zinc‒calcium implant materials in a rat model with ovariectomy-induced osteoporosis (Osteo group) and compare the related osseointegration and implant degradation with the results obtained for old healthy (OH) and juvenile healthy (JH) rats. The work applied an appropriate disease model for osteoporosis and focused in particular on long-term implant degradation for different bone conditions. Enhanced implant degradation and sclerotic rim formation was observed in osteoporotic rats, which illustrates that the setting of different bone models generates significantly modified clinical outcome. It further illustrated that these differences must be taken into account in future biodegradable implant development.
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15
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Li J, Wong RMY, Chung YL, Leung SSY, Chow SKH, Ip M, Cheung WH. Fracture-related infection in osteoporotic bone causes more severe infection and further delays healing. Bone Joint Res 2022; 11:49-60. [PMID: 35100815 PMCID: PMC8882324 DOI: 10.1302/2046-3758.112.bjr-2021-0299.r1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aims With the ageing population, fragility fractures have become one of the most common conditions. The objective of this study was to investigate whether microbiological outcomes and fracture-healing in osteoporotic bone is worse than normal bone with fracture-related infection (FRI). Methods A total of 120 six-month-old Sprague-Dawley (SD) rats were randomized to six groups: Sham, sham + infection (Sham-Inf), sham with infection + antibiotics (Sham-Inf-A), ovariectomized (OVX), OVX + infection (OVX-Inf), and OVX + infection + antibiotics (OVX-Inf-A). Open femoral diaphysis fractures with Kirschner wire fixation were performed. Staphylococcus aureus at 4 × 104 colony-forming units (CFU)/ml was inoculated. Rats were euthanized at four and eight weeks post-surgery. Radiography, micro-CT, haematoxylin-eosin, mechanical testing, immunohistochemistry (IHC), gram staining, agar plating, crystal violet staining, and scanning electron microscopy were performed. Results Agar plating analysis revealed a higher bacterial load in bone (p = 0.002), and gram staining showed higher cortical bone colonization (p = 0.039) in OVX-Inf compared to Sham-Inf. OVX-Inf showed significantly increased callus area (p = 0.013), but decreased high-density bone volume (p = 0.023) compared to Sham-Inf. IHC staining showed a significantly increased expression of TNF-α in OVX-Inf compared to OVX (p = 0.049). Significantly reduced bacterial load on bone (p = 0.001), enhanced ultimate load (p = 0.001), and energy to failure were observed in Sham-Inf-A compared to Sham-Inf (p = 0.028), but not in OVX-Inf-A compared to OVX-Inf. Conclusion In osteoporotic bone with FRI, infection was more severe with more bone lysis and higher bacterial load, and fracture-healing was further delayed. Systemic antibiotics significantly reduced bacterial load and enhanced callus quality and strength in normal bone with FRI, but not in osteoporotic bone. Cite this article: Bone Joint Res 2022;11(2):49–60.
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Affiliation(s)
- Jie Li
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Ronald Man Yeung Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Yik Lok Chung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Simon Kwoon-Ho Chow
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Margaret Ip
- Department of Microbiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
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16
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Kern C, Jamous R, El Khassawna T, Rohnke M. Characterisation of Sr 2+ mobility in osteoporotic rat bone marrow by cryo-ToF-SIMS and cryo-OrbiSIMS. Analyst 2022; 147:4141-4157. [DOI: 10.1039/d2an00913g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Mass spectrometric imaging approach for ex vivo monitoring of drug transport in bone sections. Cryo-ToF-SIMS depth profiling and high-resolution imaging as well as OrbiSIMS analysis revealed inhomogeneous Sr2+ transport in rat bone marrow.
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Affiliation(s)
- Christine Kern
- Institute of Physical Chemistry, Justus Liebig University Giessen, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
| | - Reem Jamous
- Experimental Trauma Surgery, Faculty of Medicine, Justus Liebig University Giessen, Aulweg 128, 35392 Giessen, Germany
| | - Thaqif El Khassawna
- Experimental Trauma Surgery, Faculty of Medicine, Justus Liebig University Giessen, Aulweg 128, 35392 Giessen, Germany
| | - Marcus Rohnke
- Institute of Physical Chemistry, Justus Liebig University Giessen, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
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17
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Osteogenesis Differences Around Titanium Implant and in Bone Defect Between Jaw Bones and Long Bones. J Craniofac Surg 2021; 31:2193-2198. [PMID: 33136853 DOI: 10.1097/scs.0000000000006795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of this study is to evaluate the osteogenesis around titanium implant and in bone defect or fracture in jaw bones and long bones in ovariectomized (OVX) animal models. The literature on the osteogenesis around titanium implant and in bone defect or fracture in jaw bones and long bones was reviewed with charts. Fourty-eight rats were randomly divided into OVX group with ovariectomy and SHAM (sham-surgery) group with sham surgery. Titanium implants were inserted in the right mandibles and tibiae; bone defects were created in the left mandibles and tibiae. Two-week postoperatively, mandibles and tibiae of 8 rats were harvested and examined by hematoxylin and eosin staining and histological analysis; 4-week postoperatively, all mandibles and tibiae were harvested and examined by Micro-CT and histological analysis. A total of 52 articles were included in this literature review. Tibial osteogenesis around titanium implant and in bone defect in OVX group were significantly decreased compared with SHAM group. However, osteogenesis differences in the mandible both around titanium implant and in bone defect between groups were not statistically significant. OVX-induced osteoporosis suppresses osteogenesis around titanium implant and in the bone defect or fracture in long bones significantly while has less effect on that in the jaw bones.
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18
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Polo TOB, Momesso GAC, Silva WPP, Santos AMDS, Fonseca-Santos JM, da Cruz NC, Barão VAR, Garcia VG, Theodoro LH, Faverani LP. Is an anodizing coating associated to the photobiomodulation able to optimize bone healing in ovariectomized animal model? JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2021; 217:112167. [PMID: 33667733 DOI: 10.1016/j.jphotobiol.2021.112167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 01/10/2021] [Accepted: 02/23/2021] [Indexed: 10/22/2022]
Abstract
This in vivo study investigated whether the bioactivity of anodizing coating, produced by plasma electrolytic oxidation (PEO), on mini-plate in femur fracture could be improved with the association of photobiomodulation (PBM) therapy. From the 20 ovariectomized Wistar female rats, 8 were used for model characterization, and the remaining 12 were divided into four groups according to the use of PBM therapy by diode laser (808 nm; power: 100 mW; energy: 6.0 J; energy density: 212 J/cm2; power density: 3.5 W/cm2) and the type of mini-plate surface (commercially pure titanium mini-plate -cpTi- and PEO-treated mini-plate) as follow: cpTi; PEO; cpTi/PBM; and PEO/PBM. After 60 days of surgery, fracture healing underwent microstructural, bone turnover, histometric, and histologic adjacent muscle analysis. Animals of groups with PEO and PBM showed greater fracture healing than cpTi control group under histometric and microstructural analysis (P < 0.05); however, bone turnover was just improved in PBM's groups (P < 0.05). there was no difference between cpTi and PEO without PBM (P > 0.05). Adjacent muscle analysis showed no metallic particles or muscle alterations in all groups. PEO and PBM are effective strategies for bone repair in fractures, however their association does not provide additional advantages.
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Affiliation(s)
- Tárik Ocon Braga Polo
- Department of Diagnosis and Surgery, Aracatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Gustavo Antônio Correa Momesso
- Department of Diagnosis and Surgery, Aracatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - William Phillip Pereira Silva
- Department of Diagnosis and Surgery, Aracatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Anderson Maikon de Souza Santos
- Department of Diagnosis and Surgery, Aracatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - João Matheus Fonseca-Santos
- Department of Diagnosis and Surgery, Aracatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Nilson Cristino da Cruz
- Technological Plasma Laboratory (LaPTec), Experimental Campus of Sorocaba, São Paulo State University (UNESP), Sorocaba, São Paulo, Brazil
| | - Valentim A R Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Valdir Gouveia Garcia
- Department of Diagnosis and Surgery, Aracatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Letícia Helena Theodoro
- Department of Diagnosis and Surgery, Aracatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Leonardo P Faverani
- Department of Diagnosis and Surgery, Aracatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
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Genest F, Claußen L, Rak D, Seefried L. Bone mineral density and fracture risk in adult patients with hypophosphatasia. Osteoporos Int 2021; 32:377-385. [PMID: 32879991 PMCID: PMC7838076 DOI: 10.1007/s00198-020-05612-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/25/2020] [Indexed: 02/01/2023]
Abstract
UNLABELLED In adult hypophosphatasia (HPP) patients, elevated lumbar spine dual X-ray absorptiometry (DXA) values are associated with markers of disease severity and disease-specific fracture risk while femoral bone mineral density (BMD), being largely unaffected by the disease severity, may still be useful to monitor other causes of increased fracture risk due to low BMD. INTRODUCTION Hypophosphatasia (HPP) is a rare inherited metabolic disorder due to deficient activity of the tissue-nonspecific alkaline phosphatase (TNAP). Clinical manifestation in adult HPP patients is manifold including an increased risk for fractures, but data regarding clinical significance of DXA measurement and associations with fracture risk and disease severity is scarce. METHODS Retrospective single-center analysis of DXA scans in patients with confirmed HPP (documented mutation, clinical symptoms, low alkaline phosphatase activity). Further data evaluation included disease-related fractures, laboratory results (alkaline phosphatase, pyridoxalphosphate, phosphoethanolamine), and medical history. RESULTS Analysis included 110 patients (84 female, mean age of 46.2 years) of whom 37.3% (n = 41) were harboring two mutations. Average T-Score level at the lumbar spine was - 0.1 (SD 1.9), and mean total hip T-Score was - 1.07 (SD 0.15). Both lower ALP activity and higher substrate levels (pyridoxalphosphate and phosphoethanolamine) were significantly correlated with increased lumbar spine T-Score levels (p < 0.001) while BMD at the hip was not affected by indicators of disease severity. Increased lumbar spine BMD was significantly associated with an increased risk for HPP-related fractures, prevalent in 22 (20%) patients (p < 0.001) with 21 of them having biallelic mutations. CONCLUSION BMD in adult HPP patients is not systematically reduced. Conversely, increased lumbar spine BMD appears to be associated with severely compromised mineralization and increased risk for HPP-related fractures while BMD at the hip appears unaffected by indicators of disease severity, suggesting suitability of this anatomic location for assessing and discerning disorders with increased fracture risk owing to reduced BMD like osteoporosis. TRIAL REGISTRATION NUMBER German register for clinical studies (DRKS00014022) DATE OF REGISTRATION: 02/10/2018 - retrospectively registered.
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Affiliation(s)
- F Genest
- Clinical Trial Unit, Orthopedic Department, University of Wuerzburg, Brettreichstrasse 11, 97074, Wuerzburg, Germany
| | - L Claußen
- Clinical Trial Unit, Orthopedic Department, University of Wuerzburg, Brettreichstrasse 11, 97074, Wuerzburg, Germany
| | - D Rak
- Clinical Trial Unit, Orthopedic Department, University of Wuerzburg, Brettreichstrasse 11, 97074, Wuerzburg, Germany
| | - L Seefried
- Clinical Trial Unit, Orthopedic Department, University of Wuerzburg, Brettreichstrasse 11, 97074, Wuerzburg, Germany.
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20
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Wong RMY, Choy VMH, Li J, Li TK, Chim YN, Li MCM, Cheng JCY, Leung KS, Chow SKH, Cheung WH. Fibrinolysis as a target to enhance osteoporotic fracture healing by vibration therapy in a metaphyseal fracture model. Bone Joint Res 2021; 10:41-50. [PMID: 33448865 PMCID: PMC7845465 DOI: 10.1302/2046-3758.101.bjr-2020-0185.r1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Aims Fibrinolysis plays a key transition step from haematoma formation to angiogenesis and fracture healing. Low-magnitude high-frequency vibration (LMHFV) is a non-invasive biophysical modality proven to enhance fibrinolytic factors. This study investigates the effect of LMHFV on fibrinolysis in a clinically relevant animal model to accelerate osteoporotic fracture healing. Methods A total of 144 rats were randomized to four groups: sham control; sham and LMHFV; ovariectomized (OVX); and ovariectomized and LMHFV (OVX-VT). Fibrinolytic potential was evaluated by quantifying fibrin, tissue plasminogen activator (tPA), and plasminogen activator inhibitor-1 (PAI-1) along with healing outcomes at three days, one week, two weeks, and six weeks post-fracture. Results All rats achieved healing, and x-ray relative radiopacity for OVX-VT was significantly higher compared to OVX at week 2. Martius Scarlet Blue (MSB) staining revealed a significant decrease of fibrin content in the callus in OVX-VT compared with OVX on day 3 (p = 0.020). Mean tPA from muscle was significantly higher for OVX-VT compared to OVX (p = 0.020) on day 3. Mechanical testing revealed the mean energy to failure was significantly higher for OVX-VT at 37.6 N mm (SD 8.4) and 71.9 N mm (SD 30.7) compared with OVX at 5.76 N mm (SD 7.1) (p = 0.010) and 17.7 N mm (SD 11.5) (p = 0.030) at week 2 and week 6, respectively. Conclusion Metaphyseal fracture healing is enhanced by LMHFV, and one of the important molecular pathways it acts on is fibrinolysis. LMHFV is a promising intervention for osteoporotic metaphyseal fracture healing. The improved mechanical properties, acceleration of fracture healing, and safety justify its role into translation to future clinical studies. Cite this article: Bone Joint Res 2021;10(1):41–50.
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Affiliation(s)
- Ronald Man Yeung Wong
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Victoria Man Huen Choy
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jie Li
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Tsz Kiu Li
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yu Ning Chim
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Meng Chen Michelle Li
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jack Chun Yiu Cheng
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Kwok-Sui Leung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Simon Kwoon-Ho Chow
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Wing Hoi Cheung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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21
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Codrea CI, Croitoru AM, Baciu CC, Melinescu A, Ficai D, Fruth V, Ficai A. Advances in Osteoporotic Bone Tissue Engineering. J Clin Med 2021; 10:jcm10020253. [PMID: 33445513 PMCID: PMC7827332 DOI: 10.3390/jcm10020253] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 12/13/2022] Open
Abstract
The increase in osteoporotic fracture worldwide is urging bone tissue engineering research to find new, improved solutions both for the biomaterials used in designing bone scaffolds and the anti-osteoporotic agents capable of promoting bone regeneration. This review aims to report on the latest advances in biomaterials by discussing the types of biomaterials and their properties, with a special emphasis on polymer-ceramic composites. The use of hydroxyapatite in combination with natural/synthetic polymers can take advantage of each of their components properties and has a great potential in bone tissue engineering, in general. A comparison between the benefits and potential limitations of different scaffold fabrication methods lead to a raised awareness of the challenges research face in dealing with osteoporotic fracture. Advances in 3D printing techniques are providing the ways to manufacture improved, complex, and specialized 3D scaffolds, capable of delivering therapeutic factors directly at the osteoporotic skeletal defect site with predefined rate which is essential in order to optimize the osteointegration/healing rate. Among these factors, strontium has the potential to increase osseointegration, osteogenesis, and healing rate. Strontium ranelate as well as other biological active agents are known to be effective in treating osteoporosis due to both anti-resorptive and anabolic properties but has adverse effects that can be reduced/avoided by local release from biomaterials. In this manner, incorporation of these agents in polymer-ceramic composites bone scaffolds can have significant clinical applications for the recovery of fractured osteoporotic bones limiting or removing the risks associated with systemic administration.
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Affiliation(s)
- Cosmin Iulian Codrea
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University POLITEHNICA of Bucharest, 060042 Bucharest, Romania; (C.I.C.); (A.-M.C.); (A.F.)
- Department of Oxide Compounds and Materials Science, Institute of Physical Chemistry “Ilie Murgulescu” of the Romanian Academy, 060021 Bucharest, Romania;
| | - Alexa-Maria Croitoru
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University POLITEHNICA of Bucharest, 060042 Bucharest, Romania; (C.I.C.); (A.-M.C.); (A.F.)
| | - Cosmin Constantin Baciu
- Anaesthesia Intensive Care Unit (AICU/ATI), Department of Orthopedics, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania;
| | - Alina Melinescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University POLITEHNICA of Bucharest, 060042 Bucharest, Romania; (C.I.C.); (A.-M.C.); (A.F.)
- Correspondence:
| | - Denisa Ficai
- Department of Inorganic Chemistry, Physical Chemistry and Electrochemistry, Faculty of Applied Chemistry and Materials Science, University POLITEHNICA of Bucharest, 060042 Bucharest, Romania;
| | - Victor Fruth
- Department of Oxide Compounds and Materials Science, Institute of Physical Chemistry “Ilie Murgulescu” of the Romanian Academy, 060021 Bucharest, Romania;
| | - Anton Ficai
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University POLITEHNICA of Bucharest, 060042 Bucharest, Romania; (C.I.C.); (A.-M.C.); (A.F.)
- Academy of Romanian Scientists, 050094 Bucharest, Romania
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Gelatin-Modified Calcium/Strontium Hydrogen Phosphates Stimulate Bone Regeneration in Osteoblast/Osteoclast Co-Culture and in Osteoporotic Rat Femur Defects-In Vitro to In Vivo Translation. Molecules 2020; 25:molecules25215103. [PMID: 33153127 PMCID: PMC7662833 DOI: 10.3390/molecules25215103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/29/2020] [Accepted: 10/31/2020] [Indexed: 12/13/2022] Open
Abstract
The development and characterization of biomaterials for bone replacement in case of large defects in preconditioned bone (e.g., osteoporosis) require close cooperation of various disciplines. Of particular interest are effects observed in vitro at the cellular level and their in vivo representation in animal experiments. In the present case, the material-based alteration of the ratio of osteoblasts to osteoclasts in vitro in the context of their co-cultivation was examined and showed equivalence to the material-based stimulation of bone regeneration in a bone defect of osteoporotic rats. Gelatin-modified calcium/strontium phosphates with a Ca:Sr ratio in their precipitation solutions of 5:5 and 3:7 caused a pro-osteogenic reaction on both levels in vitro and in vivo. Stimulation of osteoblasts and inhibition of osteoclast activity were proven during culture on materials with higher strontium content. The same material caused a decrease in osteoclast activity in vitro. In vivo, a positive effect of the material with increased strontium content was observed by immunohistochemistry, e.g., by significantly increased bone volume to tissue volume ratio, increased bone morphogenetic protein-2 (BMP2) expression, and significantly reduced receptor activator of nuclear factor kappa-B ligand (RANKL)/osteoprotegerin (OPG) ratio. In addition, material degradation and bone regeneration were examined after 6 weeks using stage scans with ToF-SIMS and µ-CT imaging. The remaining material in the defects and strontium signals, which originate from areas exceeding the defect area, indicate the incorporation of strontium ions into the surrounding mineralized tissue. Thus, the material inherent properties (release of biologically active ions, solubility and degradability, mechanical strength) directly influenced the cellular reaction in vitro and also bone regeneration in vivo. Based on this, in the future, materials might be synthesized and specifically adapted to patient-specific needs and their bone status.
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23
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Osteogenic and Anti-Inflammatory Behavior of Injectable Calcium Phosphate Loaded with Therapeutic Drugs. NANOMATERIALS 2020; 10:nano10091743. [PMID: 32899225 PMCID: PMC7558013 DOI: 10.3390/nano10091743] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/25/2020] [Accepted: 09/01/2020] [Indexed: 12/31/2022]
Abstract
Bone fractures related to musculoskeletal disorders determine long-term disability in older people with a consequent significant economic burden. The recovery of pathologically impaired tissue architecture allows avoiding bone loss-derived consequences such as bone height reduction, deterioration of bone structure, inflamed bone pain, and high mortality for thighbone fractures. Actually, standard therapy for osteoporosis treatment is based on the systemic administration of biphosphonates and anti-inflammatory drugs, which entail several side effects including gastrointestinal (GI) diseases, fever, and articular pain. Hence, the demand of innovative therapeutic approaches for locally treating bone lesions has been increasing in the last few years. In this scenario, the development of injectable materials loaded with therapeutically active agents (i.e., anti-inflammatory drugs, antibiotics, and peptides mimicking growth factors) could be an effective tool to treat bone loss and inflammation related to musculoskeletal diseases, including osteoporosis and osteoarthritis. According to this challenge, here, we propose three different compositions of injectable calcium phosphates (CaP) as new carrier materials of therapeutic compounds such as bisphosphonates (i.e., alendronate), anti-inflammatory drugs (i.e., diclofenac sodium), and natural molecules (i.e., harpagoside) for the local bone disease treatment. Biological quantitative analyses were performed for screening osteoinductive and anti-inflammatory properties of injectable drug-loaded systems. Meanwhile, cell morphological features were analyzed through scanning electron microscopy and confocal investigations. The results exhibited that the three systems exerted an osteoinductive effect during later phases of osteogenesis. Simultaneously, all compositions showed an anti-inflammatory activity on inflammation in vitro models.
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Abstract
The present work focuses on the application of time-of-flight secondary ion mass spectrometry (ToF-SIMS) in osteoporotic bone research. In order to demonstrate the benefit, the authors present concrete application examples of ToF-SIMS in three different areas of bone research. ToF-SIMS as a mass spectrometric imaging technique allows simultaneous visualization of mineralized and nonmineralized bone tissue as well as implanted biomaterials and bone implant interphases. In the first example, the authors show that it is possible to study the incorporation and distribution of different components released from bone filler materials into bone with a single mass spectrometric measurement. This not only enables imaging of nonstained bone cross sections but also provides further insights beyond histologically obtained information. Furthermore, they successfully identified several mass fragments as markers for newly formed cartilage tissue and growth joint in bone. Different modes of ToF-SIMS as well as different SIMS instruments (IONTOF's TOF.SIMS 5 and M6 Hybrid SIMS, Ionoptika's J105) were used to identify these mass signals and highlight the high versatility of this method. In the third part, bone structure of cortical rat bone was investigated from bone sections embedded in technovit (polymethyl methacrylate, PMMA) and compared to cryosections. In cortical bone, they were able to image different morphological features, e.g., concentric arrangement of collagen fibers in so-called osteons as well as Haversian canals and osteocytes. In summary, the study provides examples of application and shows the strength of ToF-SIMS as a promising analytical method in the field of osteoporotic bone research.
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25
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Choy MHV, Wong RMY, Li MC, Wang BY, Liu XD, Lee W, Cheng JCY, Chow SKH, Cheung WH. Can we enhance osteoporotic metaphyseal fracture healing through enhancing ultrastructural and functional changes of osteocytes in cortical bone with low-magnitude high-frequency vibration? FASEB J 2020; 34:4234-4252. [PMID: 31961009 DOI: 10.1096/fj.201901595r] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 12/31/2019] [Accepted: 01/07/2020] [Indexed: 01/04/2023]
Abstract
Fragility fractures are related to the loss of bone integrity and deteriorated morphology of osteocytes. Our previous studies have reported that low-magnitude high-frequency vibration (LMHFV) promoted osteoporotic fracture healing. As osteocytes are known for mechanosensing and initiating bone repair, we hypothesized that LMHFV could enhance osteoporotic fracture healing through enhancing morphological changes in the osteocyte lacuna-canalicular network (LCN) and mineralization. A metaphyseal fracture model was established in female Sprague-Dawley rats to investigate changes in osteocytes and healing outcomes from early to late phase post-fracture. Our results showed that the LCN exhibited an exuberant outgrowth of canaliculi in the osteoporotic fractured bone at day 14 after LMHFV. LMHFV upregulated the E11, dentin matrix protein 1 (DMP1), and fibroblast growth factor 23 (FGF23), but downregulated sclerostin (Sost) in osteocytes. Moreover, LMHFV promoted mineralization with significant enhancements of Ca/P ratio, mineral apposition rate (MAR), mineralizing surface (MS/BS), and bone mineral density (BMD) in the osteoporotic group. Consistently, better healing was confirmed by microarchitecture and mechanical properties, whereas the enhancement in osteoporotic group was comparable or even greater than the normal group. This is the first report to reveal the enhancement effect of LMHFV on the osteocytes' morphology and functions in osteoporotic fracture healing.
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Affiliation(s)
- Man-Huen Victoria Choy
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ronald Man-Yeung Wong
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Meng-Chen Li
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Bai Yan Wang
- School of Biomedical Science, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiao Dong Liu
- Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wayne Lee
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jack Chun-Yiu Cheng
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.,The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, PR China
| | - Simon Kwoon-Ho Chow
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.,The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, PR China
| | - Wing-Hoi Cheung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.,The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, PR China
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26
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Sakata M, Tonomura H, Itsuji T, Ishibashi H, Takatori R, Mikami Y, Nagae M, Matsuda KI, Tanaka M, Kubo T. Osteoporotic effect on bone repair in lumbar vertebral body defects in a rat model. J Orthop Surg (Hong Kong) 2019; 26:2309499018770349. [PMID: 29661112 DOI: 10.1177/2309499018770349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The number of patients who suffered from osteoporotic vertebral fractures is increasing. Osteoporosis has been reported to affect the healing process using long bone models. However, few studies have reported using vertebrae. In this study, we created a bone defect in the anterior part of vertebral body in ovariectomized rat and evaluated the healing process. METHODS Fifty-six 12-week old Sprague Dawley rats were divided into ovariectomy (OVX) and sham operation groups. A bone defect was created in the vertebral body 8 weeks after the first surgery. In both groups, the vertebral bodies were harvested immediately or at 4, 8, or 12 weeks after the second surgery ( n = 7 at each time point). Bone volume (BV, mm3), bone volume fraction (BV/TV, %), trabecular thickness (Tb.Th, mm), trabecular number (Tb.N, 1/mm), and trabecular separation (Tb.Sp, µm) were evaluated by micro-computed tomography to assess the new bone formation. Histological analysis was also performed. RESULTS The BV and the BV/TV were significantly lower at 4 and 12 weeks in the OVX group compared with those in the sham group. The Tb.Th was significantly lower at 8 and 12 weeks in the OVX group. Histologically, at 12 weeks, in the OVX group, the bone had a thinner, layered structure on the surface of the defect, and the trabecular structure was less dense. CONCLUSION This study demonstrated that bone mass formation was suppressed and the quality of repaired bone was poor in the healing process of vertebral body defect under osteoporotic conditions. These findings could be the key to understand the pathology of osteoporotic vertebral fracture and to develop its therapies.
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Affiliation(s)
- Munehiro Sakata
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Hitoshi Tonomura
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Tomonori Itsuji
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Hidenobu Ishibashi
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Ryota Takatori
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Yasuo Mikami
- 2 Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Masateru Nagae
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Ken Ichi Matsuda
- 3 Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Masaki Tanaka
- 3 Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Toshikazu Kubo
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
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Laçin N, İzol BS, Özkorkmaz EG, Deveci B, Tuncer MC. The effect of graft application and simvastatin treatment on tibial bone defect in rats. A histological and immunohistochemical study. Acta Cir Bras 2019; 34:e201900408. [PMID: 31066788 PMCID: PMC6583937 DOI: 10.1590/s0102-865020190040000008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 03/05/2019] [Indexed: 01/27/2023] Open
Abstract
Purpose: To evaluate histologically and immunohistochemically the bone regeneration after application of simvastatin on tibial bone defects in rats. Methods: Sixty Wistar albino rats were divided into 3 groups as control (6 mm tibial bone defect), defect + graft (allograft treatment), and defect + graft + simvastatin (10 mg/kg/day) for 28 days. Results: Histopathological examination revealed inflammation in control group (defect group), congestion in blood vessels, and an increase in osteoclast cells. In defect + graft group, osteoclastic activity was observed and osteocyte cells were continued to develop. In defect + graft + simvastatin group, osteocytes and matrix formation were increased in the new bone trabeculae. Osteopontin and osteonectin expression were positive in the osteclast cells in the control group. Osteoblasts and some osteocytes showed a positive reaction of osteopontin and osteopontin. In defect + graft + simvastatin group, osteonectin and osteopontin expression were positive in osteoblast and osteocyte cells, and a positive expression in osteon formation was also seen in new bone trabeculae. Conclusion: The simvastatin application was thought to increase bone turnover by increasing the osteoinductive effect with graft and significantly affect the formation of new bone.
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Affiliation(s)
- Nihat Laçin
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Katip Çelebi, İzmir, Turkey. Technical procedures, manuscript preparation and writing, final approval
| | - Bozan Serhat İzol
- PhD, Research Assistant, Department of Periodontology, Faculty of Dentistry, University of Bingöl, Turkey. Technical procedures, manuscript preparation and writing, final approval
| | - Ebru Gökalp Özkorkmaz
- Assistant Professor, Department of Histology and Embryology, Faculty of Medicine, University of Dicle, Diyarbakır, Turkey. Technical procedures, histological examinations, manuscript preparation and writing, final approval
| | - Buşra Deveci
- PhD, Research Assistant, Department of Periodontology, Faculty of Dentistry, University of Dicle, Diyarbakir, Turkey. Technical procedures, manuscript preparation and writing, final approval
| | - Mehmet Cudi Tuncer
- PhD, Professor, Department of Anatomy, Faculty of Medicine, Dicle University, Diyarbakır, Turkey. Technical procedures, histological examinations, manuscript preparation and writing, final approval
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28
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Kern C, Quade M, Ray S, Thomas J, Schumacher M, Gemming T, Gelinsky M, Alt V, Rohnke M. Investigation of strontium transport and strontium quantification in cortical rat bone by time-of-flight secondary ion mass spectrometry. J R Soc Interface 2019; 16:20180638. [PMID: 30958183 PMCID: PMC6408337 DOI: 10.1098/rsif.2018.0638] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/16/2019] [Indexed: 02/07/2023] Open
Abstract
Next-generation bone implants will be functionalized with drugs for stimulating bone growth. Modelling of drug release by such functionalized biomaterials and drug dispersion into bone can be used as predicting tool for biomaterials testing in future. Therefore, the determination of experimental parameters to describe and simulate drug release in bone is essential. Here, we focus on Sr2+ transport and quantification in cortical rat bone. Sr2+ dose-dependently stimulates bone-building osteoblasts and inhibits bone-resorbing osteoclasts. It should be preferentially applied in the case of bone fracture in the context of osteoporotic bone status. Transport properties of cortical rat bone were investigated by dipping experiments of bone sections in aqueous Sr2+ solution followed by time-of-flight secondary ion mass spectrometry (ToF-SIMS) depth profiling. Data evaluation was carried out by fitting a suitable mathematical diffusion equation to the experimental data. An average diffusion coefficient of D = (1.68 ± 0.57) · 10-13 cm2 s-1 for healthy cortical bone was obtained. This value differed only slightly from the value of D = (4.30 ± 1.43) · 10-13 cm2 s-1 for osteoporotic cortical bone. Transmission electron microscopy investigations revealed a comparable nano- and ultrastructure for both types of bone status. Additionally, Sr2+-enriched mineralized collagen standards were prepared for ToF-SIMS quantification of Sr2+ content. The obtained calibration curve was used for Sr2+ quantification in cortical and trabecular bone in real bone sections. The results allow important insights regarding the Sr2+ transport properties in healthy and osteoporotic bone and can ultimately be used to perform a simulation of drug release and mobility in bone.
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Affiliation(s)
- Christine Kern
- Institute of Physical Chemistry, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
| | - Mandy Quade
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Seemun Ray
- Experimental Trauma Surgery, Justus-Liebig University Giessen, Aulweg 128, 35392 Giessen, Germany
| | - Jürgen Thomas
- IFW Dresden, Institute for Complex Materials, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Matthias Schumacher
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Thomas Gemming
- IFW Dresden, Institute for Complex Materials, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Michael Gelinsky
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Volker Alt
- Experimental Trauma Surgery, Justus-Liebig University Giessen, Aulweg 128, 35392 Giessen, Germany
| | - Marcus Rohnke
- Institute of Physical Chemistry, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
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Abstract
PURPOSE OF REVIEW Substantial advances have been made in understanding the biological basis of fracture healing. Yet, it is unclear whether the presence of osteoporosis or prior or current osteoporosis therapy influences the healing process or is associated with impaired healing. This review discusses the normal process of fracture healing and the role of osteoporosis and patient-specific factors in relation to fracture repair. RECENT FINDINGS The definitive association of osteoporosis to impaired fracture healing remains inconclusive because of limited evidence addressing this point. eStudies testing anabolic agents in preclinical models of ovariectomized animals with induced fractures have produced mostly positive findings showing enhanced fracture repair. Prospective human clinical trials, although few in number and limited in design and to testing only one anabolic agent, have similarly yielded modestly favorable results. Interest is high for exploring currently available osteoporosis therapies for efficacy in fracture repair. Definitive data supporting their efficacy are essential in achieving approval for this indication.
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Affiliation(s)
- Cheng Cheng
- Endocrine Research Unit, Department of Medicine, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, Room 369, San Francisco, CA, 94158, USA
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, USA
| | - Dolores Shoback
- Endocrine Research Unit, Department of Medicine, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, Room 369, San Francisco, CA, 94158, USA.
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, USA.
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30
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Sakata M, Tonomura H, Itsuji T, Ishibashi H, Takatori R, Mikami Y, Nagae M, Matsuda KI, Tabata Y, Tanaka M, Kubo T. Bone Regeneration of Osteoporotic Vertebral Body Defects Using Platelet-Rich Plasma and Gelatin β-Tricalcium Phosphate Sponges. Tissue Eng Part A 2018; 24:1001-1010. [PMID: 29272991 DOI: 10.1089/ten.tea.2017.0358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The objective of the present study was to investigate the effect of platelet-rich plasma (PRP) combined with gelatin β-tricalcium phosphate (β-TCP) sponge on bone generation in a lumbar vertebral body defect of ovariectomized rat. After creating critical-size defects in the center of the anterior vertebral body, the defects were filled with the following materials: (1) no material (control group), (2) gelatin β-TCP sponge with PRP (PRP sponge group), and (3) gelatin β-TCP sponge with phosphate-buffered saline (PBS sponge group). Microcomputed tomography and histological evaluation were performed immediately after surgery and at 4, 8, and 12 weeks to assess bone regeneration. Biomechanical test was also performed at postoperative week 12. In the PRP sponge group, both imaging and histological examination showed that visible osteogenesis was first induced and additional growth of bone tissue was observed in the transplanted sponge, compared with the PBS sponge group. There was no negative effect of either PRP sponge or PBS sponge transplantation on bone tissue generation around the periphery of the defect. Biomechanical test showed increased stiffness of the affected vertebral bodies in the PRP sponge group. These results indicate that PRP-impregnated gelatin β-TCP sponge is effective for facilitating bone regeneration in lumbar vertebral bone defect under osteoporotic condition. PRP combined with gelatin β-TCP sponges could be potentially useful for developing a new approach to vertebroplasty for osteoporotic vertebral fracture.
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Affiliation(s)
- Munehiro Sakata
- 1 Department of Orthopaedics, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Hitoshi Tonomura
- 1 Department of Orthopaedics, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Tomonori Itsuji
- 1 Department of Orthopaedics, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Hidenobu Ishibashi
- 1 Department of Orthopaedics, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Ryota Takatori
- 1 Department of Orthopaedics, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Yasuo Mikami
- 2 Department of Rehabilitation Medicine, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Masateru Nagae
- 1 Department of Orthopaedics, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Ken Ichi Matsuda
- 3 Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Yasuhiko Tabata
- 4 Laboratory of Biomaterials, Department of Regeneration Science and Engineering Institute for Frontier Life and Medical Sciences, Kyoto University , Kyoto, Japan
| | - Masaki Tanaka
- 3 Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Toshikazu Kubo
- 1 Department of Orthopaedics, Kyoto Prefectural University of Medicine , Kyoto, Japan
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Shahrezaee M, Oryan A, Bastami F, Hosseinpour S, Shahrezaee MH, Kamali A. Comparative impact of systemic delivery of atorvastatin, simvastatin, and lovastatin on bone mineral density of the ovariectomized rats. Endocrine 2018; 60:138-150. [PMID: 29372484 DOI: 10.1007/s12020-018-1531-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/12/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE In addition to lipid-lowering properties, statins have been suggested to affect bone turnover by increasing the osteoblastic bone formation and blocking the osteoclastogenesis. However, there are many controversial reports regarding the beneficial effect of statins on osteoporosis. In this study, we investigated the therapeutic effects of the most important lipophilic statins administered orally for 60 days to the ovariectomized (OVX) female Sprague-Dawley rats and compared the effects on different harvested trabecular and compact bones. METHODS Thirty female rats were divided into five equal groups including the normal rats, untreated OVX rats (negative control), and the OVX rats treated with atorvastatin (20 mg/kg/day), simvastatin (25 mg/kg/day), and lovastatin (20 mg/kg/day). The osteoporotic animals were treated daily for 60 days and euthanized at the end of experiments. The effectiveness of these treatments was evaluated by biomechanical testing, histopathologic, histomorphometric, micro-CT scan, real-time PCR, and serum biochemical analysis. Moreover, the hepatotoxicity and rhabdomyolysis related with these treatments were assessed by biochemistry analysis and histopathological evaluation. RESULTS The results and statistical analysis showed that systemic delivery of simvastatin and lovastatin significantly increased serum calcium level, expression of osteogenic genes, bone mineral density (BMD), and biomechanical properties in comparison to the untreated OVX rats, especially in trabecular bones (P < 0.05). The results of different analysis also indicated that there was no statistical difference between the atorvastatin-treated animals and the negative control. Among all treatments, only atorvastatin showed an evident hepatotoxicity and myopathy. CONCLUSIONS It was concluded that the lovastatin and simvastatin efficiently ameliorated the OVX-induced osteoporosis. Moreover, the simvastatin-treated animals showed more resemblance to the normal group in terms of BMD, expression of osteogenic genes, serum biochemical parameters, histomorphometric findings, and biomechanical performance with no significant side-effects.
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Affiliation(s)
- Mostafa Shahrezaee
- Department of Orthopedic Surgery, School of Medicine, AJA University of Medical Science, Tehran, Iran
| | - Ahmad Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Farshid Bastami
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepanta Hosseinpour
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Amir Kamali
- Department of Orthopedic Surgery, School of Medicine, AJA University of Medical Science, Tehran, Iran.
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Pilz S, Geissler D, Calin M, Eckert J, Zimmermann M, Freudenberger J, Gebert A. Thermomechanical processing of In-containing β-type Ti-Nb alloys. J Mech Behav Biomed Mater 2018; 79:283-291. [DOI: 10.1016/j.jmbbm.2017.12.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 12/15/2017] [Accepted: 12/28/2017] [Indexed: 11/28/2022]
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Kauschke V, Gebert A, Calin M, Eckert J, Scheich S, Heiss C, Lips KS. Effects of new beta-type Ti-40Nb implant materials, brain-derived neurotrophic factor, acetylcholine and nicotine on human mesenchymal stem cells of osteoporotic and non osteoporotic donors. PLoS One 2018; 13:e0193468. [PMID: 29489907 PMCID: PMC5873971 DOI: 10.1371/journal.pone.0193468] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/12/2018] [Indexed: 01/14/2023] Open
Abstract
Introduction Treatment of osteoporotic fractures is still challenging and an urgent need
exists for new materials, better adapted to osteoporotic bone by adjusted
Young’s modulus, appropriate surface modification and pharmaceuticals. Materials and methods Titanium-40-niobium alloys, mechanically ground or additionally etched and
titanium-6-aluminium-4-vanadium were analyzed in combination with
brain-derived neurotrophic factor, acetylcholine and nicotine to determine
their effects on human mesenchymal stem cells in vitro over
21 days using lactate dehydrogenase and alkaline phosphatase assays, live
cell imaging and immunofluorescence microscopy. Results Cell number of human mesenchymal stem cells of osteoporotic donors was
increased after 14 d in presence of ground titanium-40-niobium or
titanium-6-aluminium-4-vanadium, together with brain-derived neurotrophic
factor. Cell number of human mesenchymal stem cells of non osteoporotic
donors increased after 21 d in presence of titanium-6-aluminium-4-vanadium
without pharmaceuticals. No significant increase was measured for ground or
etched titanium-40-niobium after 21 d. Osteoblast differentiation of
osteoporotic donors was significantly higher than in non osteoporotic donors
after 21 d in presence of etched, ground titanium-40-niobium or
titanium-6-aluminium-4-vanadium accompanied by all pharmaceuticals tested.
In presence of all alloys tested brain-derived neurotrophic factor,
acetylcholine and nicotine increased differentiation of cells of
osteoporotic donors and accelerated it in non osteoporotic donors. Conclusion We conclude that ground titanium-40-niobium and brain-derived neurotrophic
factor might be most suitable for subsequent in vivo
testing.
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Affiliation(s)
- Vivien Kauschke
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Giessen,
Germany
- * E-mail:
| | - Annett Gebert
- Leibniz Institute for Solid State and Materials Research Dresden,
Dresden, Germany
| | - Mariana Calin
- Leibniz Institute for Solid State and Materials Research Dresden,
Dresden, Germany
| | - Jürgen Eckert
- Erich Schmid Institute of Materials Science, Austrian Academy of
Sciences, Leoben, Austria
- Department Materials Physics, Montanuniversität Leoben, Leoben,
Austria
| | - Sebastian Scheich
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Giessen,
Germany
| | - Christian Heiss
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Giessen,
Germany
- Department of Trauma Hand and Reconstructive Surgery, University Hospital
of Giessen-Marburg, Campus: Giessen, Giessen, Germany
| | - Katrin Susanne Lips
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Giessen,
Germany
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Lode A, Heiss C, Knapp G, Thomas J, Nies B, Gelinsky M, Schumacher M. Strontium-modified premixed calcium phosphate cements for the therapy of osteoporotic bone defects. Acta Biomater 2018; 65:475-485. [PMID: 29107056 DOI: 10.1016/j.actbio.2017.10.036] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/18/2017] [Accepted: 10/23/2017] [Indexed: 01/16/2023]
Abstract
In this study a premixed strontium-containing calcium phosphate bone cement for the application in osteoporotic bone defects has been developed and characterised regarding its material and in vitro properties as well as minimally invasive applicability in balloon kyphoplasty. Strontium was introduced into the cement by substitution of one precursor component, CaCO3, with its strontium analogue, SrCO3. Using a biocompatible oil phase as carrier liquid, a cement paste that only set upon contact with aqueous environment was obtained. Strontium modification resulted in an increased strength of set cements and radiographic contrast; and the cements released biologically relevant doses of Sr2+-ions that were shown to enhance osteoprogenitor cell proliferation and osteogenic differentiation. Finally, applicability of strontium-containing cement pastes in balloon kyphoplasty was demonstrated in a human cadaver spine procedure. The cement developed in this study may therefore be well suited for minimally invasive, osteoporosis-related bone defect treatment. STATEMENT OF SIGNIFICANCE Strontium-releasing calcium phosphate bone cements are promising materials for the clinical regeneration of osteoporosis-related bone defects since they have been shown to stimulate bone formation and at the same time limit osteoclastic bone resorption. Today clinical practice favours minimally invasive surgical techniques, e.g. for vertebral fracture treatment, posing special demands on such cements. We have therefore developed a premixed, strontium-releasing bone cement with enhanced mechanical properties and high radiographic visibility that releases biologically relevant strontium concentrations and thus stimulates cells of the osteogenic lineage. In a pilot experiment we also exemplify its excellent suitability for minimally invasive balloon kyphoplasty procedures.
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Wong RMY, Choy MHV, Li MCM, Leung KS, K-H Chow S, Cheung WH, Cheng JCY. A systematic review of current osteoporotic metaphyseal fracture animal models. Bone Joint Res 2018; 7:6-11. [PMID: 29305425 PMCID: PMC5805822 DOI: 10.1302/2046-3758.71.bjr-2016-0334.r2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objectives The treatment of osteoporotic fractures is a major challenge, and the enhancement of healing is critical as a major goal in modern fracture management. Most osteoporotic fractures occur at the metaphyseal bone region but few models exist and the healing is still poorly understood. A systematic review was conducted to identify and analyse the appropriateness of current osteoporotic metaphyseal fracture animal models. Materials and Methods A literature search was performed on the Pubmed, Embase, and Web of Science databases, and relevant articles were selected. A total of 19 studies were included. Information on the animal, induction of osteoporosis, fracture technique, site and fixation, healing results, and utility of the model were extracted. Results Fracture techniques included drill hole defects (3 of 19), bone defects (3 of 19), partial osteotomy (1 of 19), and complete osteotomies (12 of 19). Drill hole models and incomplete osteotomy models are easy to perform and allow the study of therapeutic agents but do not represent the usual clinical setting. Additionally, biomaterials can be filled into drill hole defects for analysis. Complete osteotomy models are most commonly used and are best suited for the investigation of therapeutic drugs or noninvasive interventions. The metaphyseal defect models allow the study of biomaterials, which are associated with complex and comminuted osteoporotic fractures. Conclusion For a clinically relevant model, we propose that an animal model should satisfy the following criteria to study osteoporotic fracture healing: 1) induction of osteoporosis, 2) complete osteotomy or defect at the metaphysis unilaterally, and 3) internal fixation. Cite this article: R. M. Y. Wong, M. H. V. Choy, M. C. M. Li, K-S. Leung, S. K-H. Chow, W-H. Cheung, J. C. Y. Cheng. A systematic review of current osteoporotic metaphyseal fracture animal models. Bone Joint Res 2018;7:6–11. DOI: 10.1302/2046-3758.71.BJR-2016-0334.R2.
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Affiliation(s)
- R M Y Wong
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital Authority, 30-32 Ngan Shing Street, Shatin, Hong Kong and Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M H V Choy
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M C M Li
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - K-S Leung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital Authority, 30-32 Ngan Shing Street, Shatin, Hong Kong and Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S K-H Chow
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - W-H Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J C Y Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong
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Schmidt R, Pilz S, Lindemann I, Damm C, Hufenbach J, Helth A, Geissler D, Henss A, Rohnke M, Calin M, Zimmermann M, Eckert J, Lee M, Gebert A. Powder metallurgical processing of low modulus β-type Ti-45Nb to bulk and macro-porous compacts. POWDER TECHNOL 2017. [DOI: 10.1016/j.powtec.2017.09.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Strontium and bisphosphonate coated iron foam scaffolds for osteoporotic fracture defect healing. Biomaterials 2017; 157:1-16. [PMID: 29216500 DOI: 10.1016/j.biomaterials.2017.11.049] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 11/23/2017] [Accepted: 11/28/2017] [Indexed: 02/08/2023]
Abstract
The purpose of this work was to investigate new bone formation in macroporous iron foams coated with strontium (FeSr) or bisphosphonate (FeBiP) compared to plain iron foam (Fe) and empty defect in a critical size metaphyseal bone defect model in ovariectomized rats. 60 female rats were subjected to bilateral ovariectomy and multi-deficient diet for 3 months. A 4 mm wedge shaped metaphyseal osteotomy was created, fixed with a mini-plate and subsequently filled with Fe, FeSr, FeBiP or left empty. After 6 weeks, μCt analysis revealed a statistically significant increased bone formation at the implant interface in FeSr compared to FeBiP (p = 0.035) and Fe (p = 0.002), respectively. Increased mineralized tissue was also seen within the pores in FeSr (p = 0.023) compared to Fe. Histomorphometry revealed significantly increased bone formation at the implant interface in FeSr (p < 0.001) and FeBiP (p = 0.006) compared to plain Fe with increased osteoblast and decreased osteoclast activity in combination with increased BMP2 and decreased RANKL/OPG in immunohistochemistry. ToF-SIMS analysis showed overlapping Ca signals with Fe for both FeSr and FeBiP thereby indicating tissue in-growth into the scaffolds. In conclusion, iron foam with strontium or bisphosphonate coating are of further interest in metaphyseal fracture defects in osteopenic bone.
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Shapiro G, Bez M, Tawackoli W, Gazit Z, Gazit D, Pelled G. Semiautomated Longitudinal Microcomputed Tomography-based Quantitative Structural Analysis of a Nude Rat Osteoporosis-related Vertebral Fracture Model. J Vis Exp 2017. [PMID: 28994771 DOI: 10.3791/55928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Osteoporosis-related vertebral compression fractures (OVCFs) are a common and clinically unmet need with increasing prevalence as the world population ages. Animal OVCF models are essential to the preclinical development of translational tissue engineering strategies. While a number of models currently exist, this protocol describes an optimized method for inducing multiple highly reproducible vertebral defects in a single nude rat. A novel longitudinal semiautomated microcomputed tomography (µCT)-based quantitative structural analysis of the vertebral defects is also detailed. Briefly, rats were imaged at multiple time points post-op. The day 1 scan was reoriented to a standard position, and a standard volume of interest was defined. Subsequent µCT scans of each rat were automatically registered to the day 1 scan so the same volume of interest was then analyzed to assess for new bone formation. This versatile approach can be adapted to a variety of other models where longitudinal imaging-based analysis could benefit from precise 3D semiautomated alignment. Taken together, this protocol describes a readily quantifiable and easily reproducible system for osteoporosis and bone research. The suggested protocol takes 4 months to induce osteoporosis in nude ovariectomized rats and between 2.7 and 4 h to generate, image, and analyze two vertebral defects, depending on tissue size and equipment.
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Affiliation(s)
- Galina Shapiro
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine
| | - Maxim Bez
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine
| | - Wafa Tawackoli
- Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center
| | - Zulma Gazit
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine; Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Department of Orthopedics, Cedars-Sinai Medical Center
| | - Dan Gazit
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine; Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center; Department of Orthopedics, Cedars-Sinai Medical Center
| | - Gadi Pelled
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine; Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center;
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Pilz S, Gebert A, Voss A, Oswald S, Göttlicher M, Hempel U, Eckert J, Rohnke M, Janek J, Calin M. Metal release and cell biological compatibility of beta-type Ti-40Nb containing indium. J Biomed Mater Res B Appl Biomater 2017; 106:1686-1697. [PMID: 28842963 DOI: 10.1002/jbm.b.33976] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/07/2017] [Accepted: 07/29/2017] [Indexed: 12/19/2022]
Abstract
Small indium (In) additions up to 5 wt % to the beta-type Ti-40Nb alloy effectively improve its mechanical biofunctionality. The impact on its biocompatibility is addressed in this work. Comparative electrochemical polarization studies and inductively coupled plasma optical emission spectrometry analyses were conducted in Tris-buffered saline (on the basis of 150 mM NaCl) with pH 7.6 and 2.0 at 310 ± 1 K with Ti-6Al-4V as reference. The metal ion releases from beta-type alloys were generally very low, for example, those of In3+ ions from (Ti-40Nb)-4In specimens were below 6 × 10-7 mmol/cm2 . X-ray photoelectron spectroscopy revealed the passivation mainly by Ti- and Nb-oxides with traces of In-oxides as the dominating surface process. In vitro studies demonstrate a better human bone marrow stromal cells (hBMSC) activity on the beta-type alloys in comparison to CP-Ti (grade 2), which is mainly due to their high Nb content. At 24 h after seeding on (Ti-40Nb)-4In the metabolic activity of hBMSC was 1.5-fold higher and after 11 days, the tissue non-specific alkaline phosphatase activity was 1.8-fold higher relative to values for CP-Ti. Surface treatments, like chemical etching or plasma oxidation, change the surface topography and the thickness and composition of the oxide layers, but they are not effective in further improving the cell response. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1686-1697, 2018.
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Affiliation(s)
- Stefan Pilz
- Institute for Complex Materials, IFW Dresden, 01069 Dresden, Germany.,Institute of Materials Science, TU Dresden, 01062 Dresden, Germany
| | - Annett Gebert
- Institute for Complex Materials, IFW Dresden, 01069 Dresden, Germany
| | - Andrea Voss
- Institute for Complex Materials, IFW Dresden, 01069 Dresden, Germany
| | - Steffen Oswald
- Institute for Complex Materials, IFW Dresden, 01069 Dresden, Germany
| | - Markus Göttlicher
- Institute of Physical Chemistry, Justus-Liebig-University of Giessen, 35392 Giessen, Germany
| | - Ute Hempel
- Carl Gustav Carus Faculty of Medicine, Institute of Physiological Chemistry, TU Dresden, 01307 Dresden, Germany
| | - Jürgen Eckert
- Institute for Complex Materials, IFW Dresden, 01069 Dresden, Germany
| | - Marcus Rohnke
- Institute of Physical Chemistry, Justus-Liebig-University of Giessen, 35392 Giessen, Germany
| | - Jürgen Janek
- Institute of Physical Chemistry, Justus-Liebig-University of Giessen, 35392 Giessen, Germany
| | - Mariana Calin
- Institute for Complex Materials, IFW Dresden, 01069 Dresden, Germany
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Rohnke M, Pfitzenreuter S, Mogwitz B, Henß A, Thomas J, Bieberstein D, Gemming T, Otto SK, Ray S, Schumacher M, Gelinsky M, Alt V. Strontium release from Sr 2+-loaded bone cements and dispersion in healthy and osteoporotic rat bone. J Control Release 2017; 262:159-169. [PMID: 28757358 DOI: 10.1016/j.jconrel.2017.07.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 12/15/2022]
Abstract
Drug functionalization of biomaterials is a modern and popular approach in biomaterials research. Amongst others this concept is used for the functionalization of bone implants to locally stimulate the bone healing process. For example strontium ions (Sr2+) are administered in osteoporosis therapy to stimulate bone growth and have recently been integrated into bone cements. Based on results of different analytical experiments we developed a two-phase model for the transport of therapeutically active Sr2+-ions in bone in combination with Korsmeyer-Peppas kinetics for the Sr2+ release from bone cement. Data of cement dissolution experiments into water in combination with inductively coupled plasma mass spectrometry (ICP-MS) analysis account for dissolution kinetics following Noyes-Whitney rule. For dissolution in α-MEM cell culture media the process is kinetically hindered and can be described by Korsmeyer-Peppas kinetics. Time of flight secondary ion mass spectrometry (ToF-SIMS) was used to determine the Sr2+ diffusion coefficient in healthy and osteoporotic trabecular rat bone. Therefore, bone sections were dipped in aqueous Sr2+-solution by one side and the Sr2+-profile was measured by classical SIMS depth profiling. The Sr2+ mobility can be described by a simple diffusion model and we obtained diffusion coefficients of (2.28±2.97)⋅10-12cm2/s for healthy and of (1.55±0.93)⋅10-10cm2/s for osteoporotic bone. This finding can be explained by a different bone nanostructure, which was observed by focused ion beam scanning electron microscopy (FIB-SEM) and transmission electron microscopy (TEM). Finally, the time and spatially resolved drug transport was calculated by finite element method for the femur of healthy and osteoporotic rats. The obtained results were compared to mass images that were obtained from sections of in vivo experiments by ToF-SIMS. The simulated data fits quite well to experimental results. The successfully applied model for the description of drug dispersion can help to reduce the number of animal experiments in the future.
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Affiliation(s)
- Marcus Rohnke
- Institute of Physical Chemistry, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 17, 35392 Giessen, Germany.
| | - Stefanie Pfitzenreuter
- Institute of Physical Chemistry, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
| | - Boris Mogwitz
- Institute of Physical Chemistry, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
| | - Anja Henß
- Institute of Physical Chemistry, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
| | - Jürgen Thomas
- IFW Dresden, Institute for Complex Materials, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Dina Bieberstein
- IFW Dresden, Institute for Complex Materials, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Thomas Gemming
- IFW Dresden, Institute for Complex Materials, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Svenja K Otto
- Institute of Physical Chemistry, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
| | - Seemun Ray
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany
| | - Matthias Schumacher
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Michael Gelinsky
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Volker Alt
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, Rudolf-Buchheim-Strasse 7, 35385 Giessen, Germany
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Sandberg O, Bernhardsson M, Aspenberg P. Earlier effect of alendronate in mouse metaphyseal versus diaphyseal bone healing. J Orthop Res 2017; 35:793-799. [PMID: 27233101 DOI: 10.1002/jor.23316] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/19/2016] [Indexed: 02/04/2023]
Abstract
Healing of injured cancellous bone is characterized by a transient stage of rapid bone formation throughout the traumatized bone volume, often followed by similarly rapid resorption. This is different from the slower diaphyseal healing via an external callus. We, therefore, hypothesized that antiresorptive treatment might have an earlier positive effect in cancellous bone healing than in diaphyseal fractures. One hundred and twenty-three male C57bl6 mice received either an internally stabilized diaphyseal osteotomy of the femur or a screw inserted into the tibial metaphysis. The mice were randomized to daily alendronate injections (200 μg/kg/day), or control injections, and killed for mechanical testing after 14, 21, or 28 days. The hypothesis was tested by a three-way Anova (time, site, and drug). The ultimate force was increased by bisphosphonate treatment in both models. There was a significant interaction between time, site, and drug (p < 0.001) so that the full positive effect of alendronate was evident in the metaphysis at 14 days, but first after 28 days in the diaphysis. While the early effect in the metaphysis might be translated into earlier healing, the late effect in the diaphysis was due to delayed remodeling of the callus, which might have less clinical importance. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:793-799, 2017.
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Affiliation(s)
- Olof Sandberg
- Orthopedics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, 581 85, Sweden
| | - Magnus Bernhardsson
- Orthopedics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, 581 85, Sweden
| | - Per Aspenberg
- Orthopedics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, 581 85, Sweden
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Postembedding Decalcification of Mineralized Tissue Sections Preserves the Integrity of Implanted Biomaterials and Minimizes Number of Experimental Animals. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2023853. [PMID: 28424781 PMCID: PMC5382295 DOI: 10.1155/2017/2023853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 02/18/2017] [Accepted: 02/28/2017] [Indexed: 01/21/2023]
Abstract
Bone histology of decalcified or undecalcified samples depends on the investigation. However, in research each method provides different information to answer the scientific question. Decalcification is the first step after sample fixation and governs what analysis is later feasible on the sections. Besides, decalcification is favored for immunostaining and in situ hybridization. Otherwise, sample decalcification can be damaging to bone biomaterials implants that contains calcium or strontium. On the other hand, after decalcification mineralization cannot be assessed using histology or imaging mass spectrometry. The current study provides a solution to the hardship caused by material presence within the bone tissue. The protocol presents a possibility of gaining sequential and alternating decalcified and undecalcified sections from the same bone sample. In this manner, investigations using histology, protein signaling, in situ hybridization, and mass spectrometry on the same sample can better answer the intended research question. Indeed, decalcification of sections and grindings resulted in well-preserved sample and biomaterials integrity. Immunostaining was comparable to that of classically decalcified samples. The study offers a novel approach that incites correlative analysis on the same sample and reduces the number of processed samples whether clinical biopsies or experimental animals.
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Abstract
Background and purpose - Studies of fracture healing have mainly dealt with shaft fractures, both experimentally and clinically. In contrast, most patients have metaphyseal fractures. There is an increasing awareness that metaphyseal fractures heal partly through mechanisms specific to cancellous bone. Several new models for the study of cancellous bone healing have recently been presented. This review summarizes our current knowledge of cancellous fracture healing. Methods - We performed a review of the literature after doing a systematic literature search. Results - Cancellous bone appears to heal mainly via direct, membranous bone formation that occurs freely in the marrow, probably mostly arising from local stem cells. This mechanism appears to be specific for cancellous bone, and could be named inter-trabecular bone formation. This kind of bone formation is spatially restricted and does not extend more than a few mm outside the injured region. Usually no cartilage is seen, although external callus and cartilage formation can be induced in meta-physeal fractures by mechanical instability. Inter-trabecular bone formation seems to be less sensitive to anti-inflammatory treatment than shaft fractures. Interpretation - The unique characteristics of inter-trabecular bone formation in metaphyseal fractures can lead to differences from shaft healing regarding the effects of age, loading, or drug treatment. This casts doubt on generalizations about fracture healing based solely on shaft fracture models.
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RAY S, KHASSAWNA TEL, SOMMER U, THORMANN U, WIJEKOON N, LIPS K, HEISS C, ALT V. Differences in expression of Wnt antagonist Dkk1 in healthy versus pathological bone samples. J Microsc 2016; 265:111-120. [DOI: 10.1111/jmi.12469] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 08/04/2016] [Accepted: 08/08/2016] [Indexed: 12/17/2022]
Affiliation(s)
- S. RAY
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University; Giessen Germany
| | - T. EL KHASSAWNA
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University; Giessen Germany
| | - U. SOMMER
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University; Giessen Germany
| | - U. THORMANN
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University; Giessen Germany
- Departments of Trauma, Hand and Reconstructive Surgery; University Hospital Giessen and Marburg; Campus Giessen Germany
| | - N.D. WIJEKOON
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University; Giessen Germany
| | - K. LIPS
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University; Giessen Germany
| | - C. HEISS
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University; Giessen Germany
- Departments of Trauma, Hand and Reconstructive Surgery; University Hospital Giessen and Marburg; Campus Giessen Germany
| | - V. ALT
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University; Giessen Germany
- Departments of Trauma, Hand and Reconstructive Surgery; University Hospital Giessen and Marburg; Campus Giessen Germany
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Alt V, Cheung WH, Chow SKH, Thormann U, Cheung ENM, Lips KS, Schnettler R, Leung KS. Bone formation and degradation behavior of nanocrystalline hydroxyapatite with or without collagen-type 1 in osteoporotic bone defects - an experimental study in osteoporotic goats. Injury 2016; 47 Suppl 2:S58-65. [PMID: 27338229 DOI: 10.1016/s0020-1383(16)47010-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The intention of the current work is to assess new bone formation and degradation behavior of nanocrystalline hydroxyapatite with (HA/col-1) or without collagen-type I (HA) in osteoporotic metaphyseal bone defects in goats. After ovariectomy and special low-calcium diet for three months, 3 drill hole defects in the vertebrae of L3, L4, L5, 4 drill hole defects in the right and left iliac crest and 1 drill hole defect at the distal femur were created in three Chinese mountain goats with a total of 24 defects. The defects were either filled with one of the biomaterials or left empty (empty defect control group). After 42 days, the animals were euthanized and the samples were assessed for new bone formation using high-resolution peripheral quantitative computed tomography (HR-pQCT) and histomorphometry with 2 regions of interest. Detail histology, enzymehistochemistry and immunohistochemistry as well as connexin-43 in situ hybridization and transmission electron microscopy were carried out for evaluation of degradation behavior of the materials and cellular responses of the surrounding tissue in respect to the implants. HR-pQCT showed the highest BV/TV ratio (p = 0.008) and smallest trabecular spacing (p = 0.005) for HA compared to the other groups in the region of interest at the interface with 1mm distance to the initially created defect. The HA/col-1 yielded the highest connectivity density (Conn.D) (p = 0.034) and the highest number of trabeculae (Tb.N) (p = 0.002) compared to the HA and the control group. Histomorphometric analysis for the core region of the initially created defect revealed a statistically higher new bone formation in the HA (p = 0.001) and HA/col-1 group (p = 0.001) compared to the empty defect group including all defect sites. This result was confirmed for site specific analysis with significant higher new bone formation for the HA group for vertebral defects compared to the empty defect group (p = 0.029). For the interface region, no statistically significant differences were found between the three groups (p = 0.08). Histology revealed a good biocompatibility without inflammatory reaction for the HA- and HA/col-1 implants with a higher fragmentation of the HA-implant compared to the HA/col-1 biomaterial and formation of new bone in the region between the biomaterial fragments by osteoblasts. Fragmentation was shown by transmission electron microscopy to be caused by multinuclear osteoclast-like cells with degradation of the implant via intracellular incorporation of degraded implant material particles. In conclusion, both nanoparticulate HA with and without collagen type-1 showed better new bone formation compared to untreated drill hole defects in metaphyseal regions of this osteoporotic Chinese mountain goat model with good biocompatibility.
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Affiliation(s)
- Volker Alt
- Department of Trauma Surgery, University Hospital of Giessen-Marburg GmbH, Campus Giessen, 35385Giessen, Germany; Laboratory of Experimental Trauma Surgery Giessen, Justus-Liebig-University Giessen, 35394Giessen, Germany.
| | - Wing Hoi Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Simon K H Chow
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Ulrich Thormann
- Laboratory of Experimental Trauma Surgery Giessen, Justus-Liebig-University Giessen, 35394Giessen, Germany
| | - Edmond N M Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Katrin S Lips
- Laboratory of Experimental Trauma Surgery Giessen, Justus-Liebig-University Giessen, 35394Giessen, Germany
| | - Reinhard Schnettler
- Department of Trauma Surgery, University Hospital of Giessen-Marburg GmbH, Campus Giessen, 35385Giessen, Germany; Laboratory of Experimental Trauma Surgery Giessen, Justus-Liebig-University Giessen, 35394Giessen, Germany
| | - Kwok-Sui Leung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
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Abstract
As the world population rises, osteoporotic fracture is an emerging global threat to the well-being of elderly patients. The process of fracture healing by intramembranous ossification or/and endochondral ossification involve many well-orchestrated events including the signaling, recruitment and differentiation of mesenchymal stem cells (MSCs) during the early phase; formation of a hard callus and extracellular matrix, angiogenesis and revascularization during the mid-phase; and finally callus remodeling at the late phase of fracture healing. Through clinical and animal research, many of these factors are shown to be impaired in osteoporotic bone. Animal studies related to post-menopausal estrogen deficient osteoporosis (type I) have shown healing to be prolonged with decreased levels of MSCs and decreased levels of angiogenesis. Moreover, the expression of estrogen receptor (ER) was shown to be delayed in ovariectomy-induced osteoporotic fracture. This might be related to the observed difference in mechanical sensitivity between normal and osteoporotic bones, which requires further experiments to elucidate. In mice fracture models related to senile osteoporosis (type II), it was observed that chondrocyte and osteoblast differentiation were impaired; and that transplantation of juvenile bone marrow would result in enhanced callus formation. Other factors related to angiogenesis and vasculogenesis have also been noted to be impaired in aged models, affecting the degradation of cartilaginous matrixes and vascular invasion; the result is changes in matrix composition and growth factors concentrations that ultimately impairs healing during age-related osteoporosis. Most osteoporotic related fractures occur at metaphyseal sites clinically, and reports have indicated that differences exist between diaphyseal and metaphyseal fractures. An animal model that satisfies three main criteria (metaphyseal region, plate fixation, osteoporosis) is suggested for future research for more comprehensive understanding of the impairment in osteoporotic fractures. Therefore, a metaphyseal fracture or osteotomy that achieves complete discontinuity fixed with metal implants is suggested on ovariectomized aged rodent models.
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Affiliation(s)
- Wing Hoi Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
| | - Theodore Miclau
- Department of Orthopaedic Surgery, University of California, San Francisco, Orthopaedic Trauma Institute, University of California, San Francisco/San Francisco General Hospital, San Francisco, CA94110, United States
| | - Simon Kwoon-Ho Chow
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Frank F Yang
- Department of Orthopaedic Surgery, University of California, San Francisco, Orthopaedic Trauma Institute, University of California, San Francisco/San Francisco General Hospital, San Francisco, CA94110, United States
| | - Volker Alt
- Department of Trauma Surgery, Giessen University Hospital, Giessen-Marburg, Germany
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Chen L, Yang L, Yao M, Cui XJ, Xue CC, Wang YJ, Shu B. Biomechanical Characteristics of Osteoporotic Fracture Healing in Ovariectomized Rats: A Systematic Review. PLoS One 2016; 11:e0153120. [PMID: 27055104 PMCID: PMC4824477 DOI: 10.1371/journal.pone.0153120] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 03/23/2016] [Indexed: 11/19/2022] Open
Abstract
Biomechanical tests are widely used in animal studies on osteoporotic fracture healing. However, the biomechanical recovery process is still unknown, leading to difficulty in choosing time points for biomechanical tests and in correctly assessing osteoporotic fracture healing. To determine the biomechanical recovery process during osteoporotic fracture healing, studies on osteoporotic femur fracture healing with biomechanical tests in ovariectomized rat (OVX) models were collected from PUBMED, EMBASE, and Chinese databases. Quadratic curves of fracture healing time and maximum load were fitted with data from the analyzed studies. In the fitted curve for normal fractures, the predicted maximum load was 145.56 N, and the fracture healing time was 88.0 d. In the fitted curve for osteoporotic fractures, the predicted maximum load was 122.30 N, and the fracture healing time was 95.2 d. The maximum load of fractured femurs in OVX rats was also lower than that in sham rats at day 84 post-fracture (D84 PF). The fracture healing time was prolonged and maximum load at D84 PF decreased in OVX rats with closed fractures. The maximum load of Wister rats was higher than that of Sprague-Dawley (SD) rats, but the fracture healing time of SD and Wister rats was similar. Osteoporotic fracture healing was delayed in rats that were < = 12 weeks old when ovariectomized, and at D84 PF, the maximum load of rats < = 12 weeks old at ovariectomy was lower than that of rats >12 weeks old at ovariectomy. There was no significant difference in maximum load at D84 PF between rats with an osteoporosis modeling time <12 weeks and > = 12 weeks. In conclusion, fracture healing was delayed and biomechanical property decreased by osteoporosis. Time points around D95.2 PF should be considered for biomechanical tests of osteoporotic femur fracture healing in OVX rat models. Osteoporotic fracture healing in OVX rats was affected by the fracture type but not by the strain of the rat.
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Affiliation(s)
- Lin Chen
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Spine Research Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Long Yang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Spine Research Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Yao
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Spine Research Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xue-Jun Cui
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Spine Research Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chun-Chun Xue
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Spine Research Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yong-Jun Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Spine Research Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bing Shu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Spine Research Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- * E-mail:
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48
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Pobloth AM, Johnson KA, Schell H, Kolarczik N, Wulsten D, Duda GN, Schmidt-Bleek K. Establishment of a preclinical ovine screening model for the investigation of bone tissue engineering strategies in cancellous and cortical bone defects. BMC Musculoskelet Disord 2016; 17:111. [PMID: 26932531 PMCID: PMC4774005 DOI: 10.1186/s12891-016-0964-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 02/24/2016] [Indexed: 12/18/2022] Open
Abstract
Background New tissue engineering strategies for bone regeneration need to be investigated in a relevant preclinical large animal model before making the translation into human patients. Therefore, our interdisciplinary group established a simplified large animal screening model for intramembranous bone defect regeneration in cancellous and cortical bone. Methods Related to a well-established model of cancellous drill hole defect regeneration in sheep, both the proximal and distal epimetaphyseal regions of the femur and the humerus were used bilaterally for eight drill hole cancellous defects (Ø 6 mm, 15 mm depth). Several improvements of the surgical procedure and equipment for an easier harvest of samples were invented. For the inclusion of cortical defect regeneration, a total of eight unicortical diaphyseal drill holes (6 mm Ø) were placed in the proximal-lateral and distal-medial parts of the metacarpal (MC) and metatarsal (MT) diaphyseal bone bilaterally. Acting moments within a normal gait cycle in the musculoskeletal lower limb model were compared with the results of the biomechanical in vitro torsion test until failure to ensure a low accidental fracture risk of utilized bones (ANOVA, p < 0.05). The model was tested in vivo, using thirteen adult, female, black-face sheep (Ø 66 kg; ± 5 kg; age ≥ 2.5 years). In a two-step surgical procedure 16 drill holes were performed for the investigation of two different time points within one animal. Defects were left empty, augmented with autologous cancellous bone or soft bone graft substitutes. Results The in vitro tests confirmed this model a high comparability between drilled MC and MT bones and a high safety margin until fracture. The exclusion of one animal from the in vivo study, due to a spiral fracture of the left MC bone led to a tolerable failure rate of 8 %. Conclusions As a screening tool, promising biomaterials can be tested in this cancellous and cortical bone defect model prior to the application in a more complex treatment site.
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Affiliation(s)
- Anne-Marie Pobloth
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353, Berlin, Germany.
| | - Kenneth A Johnson
- Faculty of Veterinary Science, University of Sydney, Sydney, 2006, NSW, Australia.
| | - Hanna Schell
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353, Berlin, Germany.
| | - Nicolai Kolarczik
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353, Berlin, Germany.
| | - Dag Wulsten
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353, Berlin, Germany
| | - Georg N Duda
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353, Berlin, Germany. .,Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353, Berlin, Germany.
| | - Katharina Schmidt-Bleek
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353, Berlin, Germany. .,Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353, Berlin, Germany.
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49
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Abstract
Osteoporosis is a global public health problem currently affecting more than 200 million people worldwide. Major research efforts are being made to improve the outcomes for patients with osteoporosis. However, the treatment of fractures associated with osteoporosis remains unsatisfactory. Animal models continue to be an important tool for establishing strategies to treat osteoporotic fractures, and various methods of inducing osteoporosis have been used. Investigators must select a model that best reflects the clinical problem being studied, and the underlying pathophysiology of the osteoporosis in the target patient group. In particular a model for Type I post-menopausal osteoporosis should mimic a fall in oestrogen and rise in osteoclast activity observed with this condition, whereas a model for type II 'senile' osteoporosis should mimic the fall in osteoblast activity. Unfortunately, there is no single all-encompassing model that precisely imitates the underlying osteoporosis or the fracture patterns seen in humans. As such the choice of species and model must be individualised to the scientific question being addressed. This article summarises general considerations when choosing an osteoporotic fracture model and outlines existing models of osteoporosis. The most appropriate model in a range of osteoporotic fracture research scenarios are subsequently considered.
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Affiliation(s)
- A Hamish Simpson
- Department of Trauma and Orthopaedics, The University of Edinburgh, Edinburgh, UK.
| | - Iain R Murray
- Department of Trauma and Orthopaedics, The University of Edinburgh, Edinburgh, UK
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50
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Ray S, Thormann U, Sommer U, Khassawna TE, Hundgeburth M, Henß A, Rohnke M, Lips KS, Heiss C, Heinemann S, Hanke T, Dürselen L, Schnettler R, Alt V. Effects of macroporous, strontium loaded xerogel-scaffolds on new bone formation in critical-size metaphyseal fracture defects in ovariectomized rats. Injury 2016; 47 Suppl 1:S52-61. [PMID: 26768293 DOI: 10.1016/s0020-1383(16)30013-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
New bone formation was studied in a metaphyseal fracture-defect in ovariectomized rats stimulated by a plain and a strontium-enriched macroporous silica/collagen scaffold (ScB30 and ScB30Sr20) and a compact silica/collagen xerogel (B30). 45 female Sprague-Dawley rats were randomly assigned to three different treatment groups: (1) ScB30 (n=15), (2) ScB30Sr20 (n=15), and (3) B30 (n=15). 12 weeks after bilateral ovariectomy and multi-deficient diet, a 4 mm wedge-shaped fracture-defect was created at the metaphyseal area of the left femur. A 7-hole T-shaped plate at the lateral aspect of the femur stabilized the bone and the defect was filled with ScB30, ScB30Sr20 or B30 subsequently. After six weeks, histomorphometrical analysis revealed a statistically significant higher bone volume/tissue volume ratio in the ScB30Sr20 group compared to ScB30 (p=0.043) and B30 (p=0.0001) indicating an improved formation of new bone by the strontium-enriched macroporous silica/collagen scaffold. Furthermore, immunohistochemical results showed increased expression of BMP2 and OPG and a decreased RANKL expression in the ScB30Sr20 group. This was further confirmed with the gene expression analysis where an increase in prominent bone formation markers (ALP, OCN, Runx2, Col1a1 and Col10a1) was seen. No material remnants were found in the scaffold group indicating an almost complete degradation process of the biomaterials. This is confirmed by ToF-SIMS analysis that did not detect any strontium in the ScB30Sr20 group neither in the defect nor in the surrounding tissue. Taken together, this study shows the stimulating effects of strontium through increased bone formation by up regulation of osteoanabolic markers. This work also indicates the importance of material porosity, geometry and biodegradability in bone healing.
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Affiliation(s)
- Seemun Ray
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Giessen, Germany
| | - Ulrich Thormann
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Giessen, Germany; Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, Germany
| | - Ursula Sommer
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Giessen, Germany
| | - Thaqif El Khassawna
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Giessen, Germany
| | - Marvin Hundgeburth
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Giessen, Germany
| | - Anja Henß
- Institute of Physical Chemistry, Justus-Liebig-University Giessen, Giessen, Germany
| | - Marcus Rohnke
- Institute of Physical Chemistry, Justus-Liebig-University Giessen, Giessen, Germany
| | - Katrin S Lips
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Giessen, Germany
| | - Christian Heiss
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Giessen, Germany; Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, Germany
| | - Sascha Heinemann
- Max-Bergmann-Center of Biomaterials, Institute of Materials Science, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hanke
- Max-Bergmann-Center of Biomaterials, Institute of Materials Science, Technische Universität Dresden, Dresden, Germany
| | - Lutz Dürselen
- Institute for Trauma Surgery Research and Biomechanics, Centre for Musculoskeletal Research Ulm, Germany
| | - Reinhard Schnettler
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Giessen, Germany; Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, Germany
| | - Volker Alt
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Giessen, Germany; Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, Germany.
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