Hypoxia-mimicking scaffolds with controlled release of DMOG and PTHrP to promote cartilage regeneration via the HIF-1α/YAP signaling pathway

Emerging Technologies to Enhance Osteogenic Differentiation of Bone Marrow Mesenchymal Stem Cells: Focus on Nanomaterials and Bioactive Compounds

Bone tissue damage and associated disorders significantly compromise the quality of life of affected patients, and existing therapeutic options remain limited. Bone marrow mesenchymal stem cells (BMSCs) play a crucial role in bone regenerative medicine, owing to their ability to differentiate into osteoblasts. Utilizing cutting-edge technologies, nanomaterials, and bioactive compounds can emulate the natural bone tissue microenvironment, offer a three-dimensional scaffold that facilitates the osteogenic differentiation of BMSCs, and modulate signals at the molecular level, thereby showing promise for applications in bone regeneration and repair. This review seeks to discuss the latest research advancements, elucidate the underlying mechanisms, and highlight the potential benefits of these technologies in augmenting the osteogenic capacity of BMSCs. Furthermore, the challenges and future directions for integrating these technologies in practical settings are discussed to pioneer new vistas in bone regenerative medicine.

Single BMSC-derived cartilage organoids for gradient heterogeneous osteochondral regeneration by leveraging native vascular microenvironment

Heterogeneous osteochondral regeneration remains a significant challenge due to the distinct microenvironments across the cartilage, calcified cartilage, and subchondral bone layers. The natural gradient of vascularization from the superficial to deep layers of osteochondral tissue plays a critical role in guiding the differentiation of bone marrow stem cells (BMSCs) into chondrocytes and osteoblasts. In this study, we propose a strategy for gradient heterogeneous osteochondral regeneration using cartilage organoids derived from single BMSCs, leveraging the natural vascularization gradient within osteochondral tissue. We successfully isolated BMSCs from rabbits and generated cartilage organoids via in vitro three-dimensional chondrogenic culture. To mimic the pro-vascular microenvironment, we introduced vascular endothelial growth factor, which promoted the hypertrophic differentiation of the cartilage organoids. We then prepared cartilage organoid/GelMA complexes, with or without the anti-vascular drug Axitinib, and implanted them subcutaneously in nude mice. The vascularized subcutaneous microenvironment induced osteogenic differentiation, while Axitinib treatment created an anti-vascular microenvironment, inhibiting osteogenesis and preserving chondrogenesis within the complexes. Both in vitro and in vivo data demonstrated the crucial role of the vascular microenvironment in regulating osteogenic differentiation of cartilage organoids. Finally, organoid/GelMA cylinders were implanted into a rabbit osteochondral defect, where the gradient vascularization at the defect site guided the organoids to differentiate into both cartilage and bone. This single BMSC-derived cartilage organoid approach enables precise gradient heterogeneous osteochondral regeneration, guided by the natural microenvironment within the osteochondral defect site, representing a significant advancement for clinical applications.

Control and interplay of scaffold-biomolecule interactions applied to cartilage tissue engineering

Cartilage tissue engineering based on the combination of biomaterials, adult or stem cells and bioactive factors is a challenging approach for regenerative medicine with the aim of achieving the formation of a functional neotissue stable in the long term. Various 3D scaffolds have been developed to mimic the extracellular matrix environment and promote cartilage repair. In addition, bioactive factors have been extensively employed to induce and maintain the cartilage phenotype. However, the spatiotemporal control of bioactive factor release remains critical for maximizing the regenerative potential of multipotent cells, such as mesenchymal stromal cells (MSCs), and achieving efficient chondrogenesis and sustained tissue homeostasis, which are essential for the repair of hyaline cartilage. Despite advances, the effective delivery of bioactive factors is limited by challenges such as insufficient retention at the site of injury and the loss of therapeutic efficacy due to uncontrolled drug release. These limitations have prompted research on biomolecule-scaffold interactions to develop advanced delivery systems that provide sustained release and controlled bioavailability of biological factors, thereby improving therapeutic outcomes. This review focuses specifically on biomaterials (natural, hybrid and synthetic) and biomolecules (molecules, proteins, nucleic acids) of interest for cartilage engineering. Herein, we review in detail the approaches developed to maintain the biomolecules in scaffolds and control their release, based on their chemical nature and structure, through steric, non-covalent and/or covalent interactions, with a view to their application in cartilage repair.

Differentiation of stem cells into chondrocytes and their potential clinical application in cartilage regeneration

Cartilage diseases and injuries are considered difficult to treat owing to the low regenerative capacity of this tissue. Using stem cells (SCs) is one of the potential methods of treating cartilage defects and creating functional cartilage models for transplants. Their ability to proliferate and to generate functional chondrocytes, a natural tissue environment, and extracellular cartilage matrix, makes SCs a new opportunity for patients with articular injuries or incurable diseases, such as osteoarthritis (OA). The review summarizes the most important scientific reports on biology and mechanisms of SC-derived chondrogenesis and sources of SCs for chondrogenic purposes. Additionally, it focuses on the genetic mechanisms, microRNA (miRNA) regulation, and epigenetic processes steering the chondrogenic differentiation of SCs. It also describes the attempts to create functional cartilage with tissue engineering using growth factors and scaffolds. Finally, it presents the challenges that researchers will have to face in the future to effectuate SC differentiation methods into clinical practice for treating cartilage diseases.

True-bone-ceramics / type I collagen scaffolds for repairing osteochondral defect

In recent years, the incidence of cartilage defects has increased dramatically, and its etiology is complex and varied. Osteochondritis dissecans (OCD), as one of the main etiologies, damages both cartilage and bone tissues and can progress to severe osteoarthritis, which has been one of the difficult problems for clinicians. The vigorous development of material science and tissue engineering provides new ideas for the treatment of OCD, in which the selection of scaffold materials is particularly important. In this study, true-bone-ceramics (TBC), which has good mechanical strength and osteoconductivity, and type I collagen (COL1), which has excellent biocompatibility, were chosen as scaffold materials to co-construct the TBC/COL1 scaffold for osteochondral repair. In order to ensure the most appropriate collagen coating concentration, three experimental groups (1, 5, 12 mg/ml) were set up. Through the physicochemical property test, biocompatibility analysis and in vivo implantation experiments of composite scaffolds, 12 mg/ml TBC/COL1 scaffolds present the best repair effect among the three groups.

The hippo-YAP1/HIF-1α pathway mediates arsenic-induced renal fibrosis

Epidemiological evidence reveals that arsenic increases the risk of chronic kidney disease (CKD) in humans, but its mechanism of action has so far been unclear. Fibrosis is the manifestation of end-stage renal disease. Hypoxia is recognized as a vital event accompanying the progression of renal fibrosis. KM mice were exposed to 0, 20, 40, and 80 mg/L NaAsO2 for 12 weeks. HK-2 cells were treated with 1 μM NaAsO2 for 4 weeks. The results showed that arsenic increased the expression of hypoxia-inducible factor 1α (HIF-1α) (P < 0.05), which is involved in inorganic arsenic-induced renal fibrosis. The Hippo signaling pathway is the upstream signal of HIF-1α and the kinase cascade of Large tumor suppressor kinase 1 (LATS1) and Yes-associated protein 1 (YAP1) is the heart of the Hippo pathway. Our results showed that protein expressions of LATS1 and phosphorylated YAP1 were decreased, and dephosphorylated YAP1 expression increased in arsenic-treated mouse kidneys and human HK-2 cells (P < 0.05). Our research manifested that arsenic treatment suppressed the Hippo signaling and induced high expression of YAP1 into the nucleus. We also found that YAP1 was involved in arsenic-induced renal fibrosis by forming a complex with HIF-1α and maintaining HIF-1α stability. Our findings indicate that YAP1 is a potential target for molecular-based therapy for arsenic-mediated renal fibrosis.

In vitro and in vivo degradation profile, biocompatibility of poly-L-lactic acid porous microspheres

The objective of this study is to evaluate the in vitro and in vivo degradation profile and biocompatibility of poly-L-lactic acid (PLLA) porous microspheres (PMs) for their potential application as injectable microcarrier or micro-scaffolds materials in the research and clinical use of craniofacial cartilage repair. In this study, PLLA PMs prepared exhibited spherical shape and uniform surface pores followed by 24-week evaluations for degradation behavior and biocompatibility. In vitro degradation analysis encompassed morphological examination, pH monitoring, molecular weight analysis, thermodynamic assessment, and chemical structure analysis. After 12 weeks of in vitro degradation, PMs maintained a regular porous spherical structure. Molecular weight and glass transition temperature of PLLA PMs decreased over time, accompanying with an initial increase and subsequent decrease in crystallinity. Enzymatic degradation caused morphological changes and accelerated degradation in the in vitro studies. Finally, in vivo evaluations involved subcutaneous implantation of PLLA PMs in rats, demonstrating biocompatibility by enhancing type I and type III collagen regeneration as observed in histological analysis. The results demonstrated that PLLA PMs were able to maintain their spherical structure for 12 weeks, promoting the generation of collagen at the implantation site, meeting the time requirements for craniofacial cartilage repair.

Effect of Dimethyloxalylglycine on Stem Cells Osteogenic Differentiation and Bone Tissue Regeneration-A Systematic Review

Dimethyloxalylglycine (DMOG) has been found to stimulate osteogenesis and angiogenesis of stem cells, promoting neo-angiogenesis in bone tissue regeneration. In this review, we conducted a comprehensive search of the literature to investigate the effects of DMOG on osteogenesis and bone regeneration. We screened the studies based on specific inclusion criteria and extracted relevant information from both in vitro and in vivo experiments. The risk of bias in animal studies was evaluated using the SYRCLE tool. Out of the 174 studies retrieved, 34 studies met the inclusion criteria (34 studies were analyzed in vitro and 20 studies were analyzed in vivo). The findings of the included studies revealed that DMOG stimulated stem cells' differentiation toward osteogenic, angiogenic, and chondrogenic lineages, leading to vascularized bone and cartilage regeneration. Addtionally, DMOG demonstrated therapeutic effects on bone loss caused by bone-related diseases. However, the culture environment in vitro is notably distinct from that in vivo, and the animal models used in vivo experiments differ significantly from humans. In summary, DMOG has the ability to enhance the osteogenic and angiogenic differentiation potential of stem cells, thereby improving bone regeneration in cases of bone defects. This highlights DMOG as a potential focus for research in the field of bone tissue regeneration engineering.

Tolerant and Rapid Endochondral Bone Regeneration Using Framework-Enhanced 3D Biomineralized Matrix Hydrogels

Tissue-engineered bone has emerged as a promising alternative for bone defect repair due to the advantages of regenerative bone healing and physiological functional reconstruction. However, there is very limited breakthrough in achieving favorable bone regeneration due to the harsh osteogenic microenvironment after bone injury, especially the avascular and hypoxic conditions. Inspired by the bone developmental mode of endochondral ossification, a novel strategy is proposed for tolerant and rapid endochondral bone regeneration using framework-enhanced 3D biomineralized matrix hydrogels. First, it is meticulously designed 3D biomimetic hydrogels with both hypoxic and osteoinductive microenvironment, and then integrated 3D-printed polycaprolactone framework to improve their mechanical strength and structural fidelity. The inherent hypoxic 3D matrix microenvironment effectively activates bone marrow mesenchymal stem cells self-regulation for early-stage chondrogenesis via TGFβ/Smad signaling pathway due to the obstacle of aerobic respiration. Meanwhile, the strong biomineralized microenvironment, created by a hybrid formulation of native-constitute osteogenic inorganic salts, can synergistically regulate both bone mineralization and osteoclastic differentiation, and thus accelerate the late-stage bone maturation. Furthermore, both in vivo ectopic osteogenesis and in situ skull defect repair successfully verified the high efficiency and mechanical maintenance of endochondral bone regeneration mode, which offers a promising treatment for craniofacial bone defect repair.

Injectable hydrogel loaded with bilayer microspheres to inhibit angiogenesis and promote cartilage regeneration for repairing growth plate injury

Introduction: The repair and regeneration of growth plate injuries using tissue engineering techniques remains a challenge due to large bone bridge formation and low chondrogenic efficiency. Methods: In this study, a bilayer drug-loaded microspheres was developed that contains the vascular endothelial growth factor (VEGF) inhibitor, Bevacizumab, on the outer layer and insulin-like growth factor-1 (IGF-1), a cartilage repair factor, on the inner layer. The microspheres were then combined with bone marrow mesenchymal stem cells (BMSCs) in the gelatin methacryloyl (GelMA) hydrogel to create a composite hydrogel with good injectability and biocompatibility. Results: The in vitro drug-release profile of bilayer microspheres showed a sequential release, with Bevacizumab released first followed by IGF-1. And this hydrogel simultaneously inhibited angiogenesis and promoted cartilage regeneration. Finally, in vivo studies indicated that the composite hydrogel reduced bone bridge formation and improved cartilage regeneration in the rabbit model of proximal tibial growth plate injury. Conclusion: This bilayer microsphere-based composite hydrogel with sequential controlled release of Bevacizumab and IGF-1 has promising potential for growth plate injury repair.