Novel therapeutic intervention for osteoporosis prepared with strontium hydroxyapatite and zoledronic acid: In vitro and pharmacodynamic evaluation

Investigating the osteogenic potential of bone-targeted daidzein loaded hydroxyapatite nanoparticles for postmenopausal osteoporosis: pharmacodynamic, biochemical, and genotoxicity evaluations

Bisphosphonates and Hormone Replacement Therapy are the primary therapeutic interventions for Postmenopausal Osteoporosis (PMO), however, associated repercussions limit their usage. To address this challenge, we hypothesised the co-delivery of hydroxyapatite (HAP) with daidzein (DZ) for synergistic treatment of PMO. Propounding this bimodal approach, daidzein-loaded hydroxyapatite nanoparticles (DZHAPNPs) were prepared leveraging the oestrogenic properties of DZ while utilising HAP to facilitate biomineralization. The osteogenic potential of developed nanoparticles was validated through in vitro experiments on MG-63 cells and in vivo studies employing a "4-vinyl cyclohexene diepoxide-induced menopausal-mice model". DZHAPNPs exhibited pronounced pro-osteogenic activity, evidenced by enhanced (155.49%) alkaline phosphatase (ALP) activity in MG-63 cells. Additionally, cellular uptake studies confirmed their internalisation and targeted delivery. Following menopause induction and treatment, the mice underwent radiography, histology, micro-computed tomography (micro-CT) analysis, and biochemical evaluations. A significant reduction (p < 0.001) in biomarkers i.e., β-CTx, BALP, and TRAP-5b, post-treatment showed a substantial influence of DZ and DZHAPNPs. Better bone architectural parameters and bone mineral density in micro-CT analysis served as proof of the hypothesis. Also, the cellular biocompatibility of nanoparticles was confirmed through genotoxicity tests performed on the Drosophila melanogaster. The noteworthy results of the research substantiated the synergistic influence of DZ and HAPNPs in resilience and bone strength maintenance.

A review on innovations in hydroxyapatite: advancing sustainable and multifunctional dental implants

The increasing relevance of biomaterials in medical curements and the care of aging populations has led to significant advancements in the development and modification of these materials. Hydroxyapatite (HAp), a biocompatible ceramic that mimics the composition of bone mineral, stands out for its remarkable abilities. Its stability in body fluids and ability to integrate with bone without causing toxicity or inflammation made it a prime candidate for biomedical utilization, particularly in odontology and orthopedics. Dental implants, which necessitate a strong interface with the jawbone to effectively support prosthetic devices, are enhanced by coatings of calcium phosphate-based materials like HAp. This enhances osseointegration, ensuring a strong bond and longevity of the implant. HAp may be synthesized both synthetically and from natural sources like mammalian bones, marine shells, and plants, each offering unique trace elements that improve its bioactivity. The synthesis of HAp involves differential technique, including chemical precipitation, and hydrothermal techniques, each impacting the final abilities of the material. The use of natural sources is especially promising, providing a sustainable, cost-effective alternative that retains essential biocompatibility. Hence, this article aims to explore the synthesis, properties, and biomedical applications of hydroxyapatite (HAp), with a special emphasis on its role in improving the performance and durability of dental implants. It also addresses the challenges in manufacturing and biocompatibility, offering insights into future advancements in this field. By addressing current challenges in manufacturing and biocompatibility, HAp paves the way for more effective and long-lasting dental treatments.

Exploring the role of strontium-based nanoparticles in modulating bone regeneration and antimicrobial resistance: a public health perspective

Strontium-based nanoparticles (SrNPs) have emerged as a versatile and promising class of nanomaterials with a wide range of potential applications in healthcare, particularly in the fields of bone regeneration and combating antimicrobial resistance (AMR). Recent research has highlighted the unique properties of SrNPs, including their ability to promote osteogenesis, enhance bone healing, and exhibit strong antimicrobial activity against multidrug-resistant pathogens. These attributes position SrNPs as innovative therapeutic agents with the potential to address challenges such as osteoporosis, bone infections, and the growing global AMR crisis. This comprehensive review critically examines the dual functional potential of SrNPs by analyzing their synthesis methods, physicochemical properties, biological interactions, and translational applications in orthopedic and antimicrobial therapies. Specifically, the review emphasizes SrNPs' ability to enhance bone density, accelerate fracture healing, and reduce the economic burden associated with prolonged treatment and rehabilitation for bone-related diseases. Furthermore, their novel application as antimicrobial agents is explored, highlighting their ability to target bacterial metabolic pathways and combat the rise of antibiotic resistance. The review focuses on the synthesis methods used for SrNPs, particularly co-precipitation, hydrothermal synthesis, and sol-gel techniques. Each method is explored for its ability to produce SrNPs with controlled size, shape, and functionality, while addressing their scalability, cost-effectiveness, and environmental impact. Additionally, the toxicological risks associated with SrNPs are also explored, emphasizing the need for comprehensive preclinical and clinical evaluations to ensure safety for humans and ecosystems. The regulatory and ethical landscape of SrNPs highlights the need for global safety protocols, equitable access, and international cooperation to ensure ethical nanotechnology use. Environmental fate studies address bioaccumulation risks and ecological concerns. This review identifies opportunities and challenges in advancing bone regenerative medicine and combating AMR while emphasizing sustainable and ethical SrNP development for researchers, policymakers, and stakeholders.

The crucial role of beta-catenin in the osteoprotective effect of semaglutide in an ovariectomized rat model of osteoporosis

Postmenopausal osteoporosis is a common chronic medical illness resulting from an imbalance between bone resorption and bone formation along with microarchitecture degeneration attributed to estrogen deficiency and often accompanied by other medical conditions such as weight gain, depression, and insomnia. Semaglutide (SEM) is a recently introduced GLP-1 receptor agonist (GLP-1RA) for the treatment of obesity and type 2 diabetes mellitus by mitigating insulin resistance. It has been discovered that the beneficial effects of GLP-1 are associated with alterations in lipolysis, adipogenesis, and anti-inflammatory processes. GLP-1 analogs transmit signals directly to adipose tissue. Mesenchymal stem cells (MSCs) are multidisciplinary cells that originate from bone marrow, migrate to injury sites, and promote bone regeneration. MSCs can differentiate into osteoblasts, adipose cells, and cartilage cells. Our aim is to investigate the role of semaglutide on bone formation and the Wnt signaling pathway. Osteoporosis was induced in female rats by ovariectomy, and the ovariectomized rats were treated with alendronate as standard treatment with a dose of 3 mg/kg orally and semaglutide with two doses (150 mcg/kg and 300 mcg/kg) S.C. for 10 successive weeks. Semaglutide ameliorates bone detrimental changes induced by ovariectomy. It improves bone microarchitecture and preserves bone mineral content. Semaglutide ameliorates ovariectomy-induced osteoporosis and increases the expression of β-catenin, leading to increased bone formation and halted receptor activator of nuclear factor kappa-Β ligand (RANKL's) activation. Semaglutide can be used as a potential prophylactic and therapeutic drug against osteoporosis, possibly by activating Wnt signaling and decreasing bone resorption.

Exploring the Biological Impact of β-TCP Surface Polarization on Osteoblast and Osteoclast Activity

β-tricalcium phosphate (β-TCP) is a widely utilized resorbable bone graft material, whose surface charge can be modified by electrical polarization. However, the specific effects of such a charge modification on osteoblast and osteoclast functions remain insufficiently studied. In this work, electrically polarized β-TCP with a high surface charge density was synthesized and evaluated in vitro in terms of its physicochemical properties and biological activity. Polarization was performed to achieve a high surface charge density, which was quantified using a thermally stimulated depolarization current. The proliferation and differentiation of MC3T3-E1 osteoblast-like cells were assessed via WST-8 and alkaline phosphatase assays. Tartrate-resistant acid phosphatase (TRAP) activity and a resorption pit assay were used to evaluate the impact of surface charge on RAW264.7 osteoclast-like cell activity. Polarized β-TCP exhibited a surface charge of 1.3 mC cm-2. Electrically polarized surfaces significantly enhanced osteoblast proliferation and differentiation. TRAP activity assays demonstrated effective osteoclast differentiation of RAW264.7 cells, with enhanced activity observed on charged surfaces. Resorption pit assays further revealed improved osteoclast resorption capacity on β-TCP surfaces with a polarized charge. These findings indicate that β-TCP with a highly dense surface charge promotes osteoblast proliferation and differentiation, as well as osteoclast activity and resorption capacity.

Breaking Osteoclast-Acid Vicious Cycle to Rescue Osteoporosis via an Acid Responsive Organic Framework-Based Neutralizing and Gene Editing Platform

In the osteoporotic microenvironment, the acidic microenvironment generated by excessive osteoclasts not only causes irreversible bone mineral dissolution, but also promotes reactive oxygen species (ROS) production to induce osteoblast senescence and excessive receptor activator of nuclear factor kappa-B ligand (RANKL) production, which help to generate more osteoclasts. Hence, targeting the acidic microenvironment and RANKL production may break this vicious cycle to rescue osteoporosis. To achieve this, an acid-responsive and neutralizing system with high in vivo gene editing capacity is developed by loading sodium bicarbonate (NaHCO3) and RANKL-CRISPR/Cas9 (RC) plasmid in a metal-organic framework. This results showed ZIF8-NaHCO3@Cas9 (ZNC) effective neutralized acidic microenvironment and inhibited ROS production . Surprisingly, nanoparticles loaded with NaHCO3 and plasmids show higher transfection efficiency in the acidic environments as compared to the ones loaded with plasmid only. Finally, micro-CT proves complete reversal of bone volume in ovariectomized mice after ZNC injection into the bone remodeling site. Overall, the newly developed nanoparticles show strong effect in neutralizing the acidic microenvironment to achieve bone protection through promoting osteogenesis and inhibiting osteolysis in a bidirectional manner. This study provides new insights into the treatment of osteoporosis for biomedical and clinical therapies.

Osteogenic Potential of Nano-Hydroxyapatite and Strontium-Substituted Nano-Hydroxyapatite

Nanohydroxyapatite (nanoHA) is the major mineral component of bone. It is highly biocompatible, osteoconductive, and forms strong bonds with native bone, making it an excellent material for bone regeneration. However, enhanced mechanical properties and biological activity for nanoHA can be achieved through enrichment with strontium ions. Here, nanoHA and nanoHA with a substitution degree of 50 and 100% of calcium with strontium ions (Sr-nanoHA_50 and Sr-nanoHA_100, respectively) were produced via wet chemical precipitation using calcium, strontium, and phosphorous salts as starting materials. The materials were evaluated for their cytotoxicity and osteogenic potential in direct contact with MC3T3-E1 pre-osteoblastic cells. All three nanoHA-based materials were cytocompatible, featured needle-shaped nanocrystals, and had enhanced osteogenic activity in vitro. The Sr-nanoHA_100 indicated a significant increase in the alkaline phosphatase activity at day 14 compared to the control. All three compositions revealed significantly higher calcium and collagen production up to 21 days in culture compared to the control. Gene expression analysis exhibited, for all three nanoHA compositions, a significant upregulation of osteonectin and osteocalcin on day 14 and of osteopontin on day 7 compared to the control. The highest osteocalcin levels were found for both Sr-substituted compounds on day 14. These results demonstrate the great osteoinductive potential of the produced compounds, which can be exploited to treat bone disease.

Microgravity-Related Changes in Bone Density and Treatment Options: A Systematic Review

Space travelers are exposed to microgravity (µg), which induces enhanced bone loss compared to the age-related bone loss on Earth. Microgravity promotes an increased bone turnover, and this obstructs space exploration. This bone loss can be slowed down by exercise on treadmills or resistive apparatus. The objective of this systematic review is to provide a current overview of the state of the art of the field of bone loss in space and possible treatment options thereof. A total of 482 unique studies were searched through PubMed and Scopus, and 37 studies met the eligibility criteria. The studies showed that, despite increased bone formation during µg, the increase in bone resorption was greater. Different types of exercise and pharmacological treatments with bisphosphonates, RANKL antibody (receptor activator of nuclear factor κβ ligand antibody), proteasome inhibitor, pan-caspase inhibitor, and interleukin-6 monoclonal antibody decrease bone resorption and promote bone formation. Additionally, recombinant irisin, cell-free fat extract, cyclic mechanical stretch-treated bone mesenchymal stem cell-derived exosomes, and strontium-containing hydroxyapatite nanoparticles also show some positive effects on bone loss.

Quantification of Low Amounts of Zoledronic Acid by HPLC-ESI-MS Analysis: Method Development and Validation

Zoledronic acid (ZA) is used in the treatment of various bone pathologies, but it forms complexes with calcium ions present in body fluids, decreasing ZA bioavailability. Thereby, the study first describes the identification of ZA-calcium complexes that form in calcium-rich environments, in order to establish the bioavailable ZA concentration. Then, a new method for quantification of low ZA amounts in milieus that mimics in vivo conditions by using simulated body fluid and calcium sulfate hemihydrate was described. Almost all analytical methods of ZA quantification described in the literature require compound derivatization. At very low concentrations, derivatization is prone to analyte loss, therefore compromising the analytical results. In our study, we avoided ZA derivatization by using a high-performance liquid chromatography and electrospray ionization mass spectrometry (HPLC-ESI-MS) system, conducting the investigation based on the fragmentation mass extracted ion chromatograms specific to the ZA protonated form. The method was validated by selectivity, precision, accuracy, linearity, signal to noise ratio, and limit of detection and limit of quantification calculation. Experimentally, this method can detect ranges of 0.1–0.5 ng/mL and precisely quantify ZA concentrations as low as 0.1 ng/mL. This method could provide the basis for quantifying low amounts of ZA in the blood during long-term administration.

Impact of Whole Body Vibration and Zoledronic Acid on Femoral Structure after Ovariectomy: Morphological Evaluation

Our study aimed to evaluate the effect of whole body vibration (WBV) treatment as an non-pharmacological method of treatment for early osteopenia in ovariectomized female rats. In total, 48 female Wistar rats were assigned to two groups: sham-operated control (SHAM, n = 12) and ovariectomized (n = 36). Four weeks after ovariectomy, the animals were divided into three experimental groups (n = 12 each): ovariectomized (OVX), ovariectomized subjected to whole body vibration with acceleration level of 0.3 g (OVX + WBV), or ovariectomized subjected to i.m. injection of Zoledronic acid at a dose of 0.025 mg/kg (OVX + ZOL). After the 8th and 16th week of treatment n = 6 rats from each group were euthanized and isolated femora were subjected to histological examination of trabecular bone and analysis of the expression of collagen 1 (Col1), osteoprotegerin (OPG), and receptor activator of nuclear factor kappa-Β ligand (RANKL) involved in bone turnover. The obtained results indicated that widespread vibration therapy can provide negative outcomes such as deterioration of trabecular bone histomorphometry.

Aminopropyltriethoxysilane (APTES)-Modified Nanohydroxyapatite (nHAp) Incorporated with Iron Oxide (IO) Nanoparticles Promotes Early Osteogenesis, Reduces Inflammation and Inhibits Osteoclast Activity

Due to its increased prevalence, osteoporosis (OP) represents a great challenge to health care systems and brings an economic burden. To overcome these issues, treatment plans that suit the need of patients should be developed. One of the approaches focuses on the fabrication of personalized biomaterials, which can restore the balance and homeostasis of disease-affected bone. In the presented study, we fabricated nanometer crystalline hydroxyapatite (nHAp) and iron oxide (IO) nanoparticles stabilized with APTES and investigated whether they can modulate bone cell metabolism and be useful in the fabrication of personalized materials for OP patients. Using a wide range of molecular techniques, we have shown that obtained nHAp@APTES promotes viability and RUNX-2 expression in osteoblasts, as well as reducing activity of critical proinflammatory cytokines while inhibiting osteoclast activity. Materials with APTES modified with nHAp incorporated with IO nanoparticles can be applied to support the healing of osteoporotic bone fractures as they enhance metabolic activity of osteoblasts and diminish osteoclasts' metabolism and inflammation.

Synthesis of a graphene oxide/agarose/hydroxyapatite biomaterial with the evaluation of antibacterial activity and initial cell attachment

Various materials are used in bone tissue engineering (BTE). Graphene oxide (GO) is a good candidate for BTE due to its antibacterial activity and biocompatibility. In this study, an innovative biomaterial consists of GO, agarose and hydroxyapatite (HA) was synthesized using electrophoresis system. The characterization of the synthesized biomaterial showed that needle-like crystals with high purity were formed after 10 mA/10 h of electrophoresis treatment. Furthermore, the calcium-phosphate ratio was similar to thermodynamically stable HA. In the synthesized biomaterial with addition of 1.0 wt% of GO, the colony forming units test showed significantly less Staphylococcus aureus. Initial attachment of MC3T3-E1 cells on the synthesized biomaterial was observed which showed the safety of the synthesized biomaterial for cell viability. This study showed that the synthesized biomaterial is a promising material that can be used in BTE.

Applications of Calcium-Based Nanomaterials in Osteoporosis Treatment

With rapidly aging populations worldwide, osteoporosis has become a serious global public health problem. Caused by disordered systemic bone remodeling, osteoporosis manifests as progressive loss of bone mass and microarchitectural deterioration of bone tissue, increasing the risk of fractures and eventually leading to osteoporotic fragility fractures. As fracture risk increases, antiosteoporosis treatments transition from nonpharmacological management to pharmacological intervention, and finally to the treatment of fragility fractures. Calcium-based nanomaterials (CBNMs) have unique advantages in osteoporosis treatment because of several characteristics including similarity to natural bone, excellent biocompatibility, easy preparation and functionalization, low pH-responsive disaggregation, and inherent pro-osteogenic properties. By combining additional ingredients, CBNMs can play multiple roles to construct antiosteoporotic biomaterials with different forms. This review covers recent advances in CBNMs for osteoporosis treatment. For ease of understanding, CBNMs for antiosteoporosis treatment can be classified as locally applied CBNMs, such as implant coatings and filling materials for osteoporotic bone regeneration, and systemically administered CBNMs for antiosteoporosis treatment. Locally applied CBNMs for osteoporotic bone regeneration develop faster than the systemically administered CBNMs, an important consideration given the serious outcomes of fragility fractures. Nevertheless, many innovations in construction strategies and preparation methods have been applied to build systemically administered CBNMs. Furthermore, with increasing interest in delaying osteoporosis progression and avoiding fragility fracture occurrence, research into systemic administration of CBNMs for antiosteoporosis treatment will have more development prospects. Deep understanding of the CBNM preparation process and optimizing CBNM properties will allow for increased application of CBNMs in osteoporosis treatments in the future.

Dental Applications of Systems Based on Hydroxyapatite Nanoparticles—An Evidence-Based Update

Hydroxyapatite is one of the most studied biomaterials in the medical and dental field, because of its biocompatibility; it is the main constituent of the mineral part of teeth and bones. In dental science, hydroxyapatite nanoparticles (HAnps) or nano-hydroxyapatite (nano-HA) have been studied, over the last decade, in terms of oral implantology and bone reconstruction, as well in restorative and preventive dentistry. Hydroxyapatite nanoparticles have significant remineralizing effects on initial enamel lesions, and they have also been used as an additive material in order to improve existing and widely used dental materials, mainly in preventive fields, but also in restorative and regenerative fields. This paper investigates the role of HAnps in dentistry, including recent advances in the field of its use, as well as their advantages of using it as a component in other dental materials, whether experimental or commercially available. Based on the literature, HAnps have outstanding physical, chemical, mechanical and biological properties that make them suitable for multiple interventions, in different domains of dental science. Further well-designed randomized controlled trials should be conducted in order to confirm all the achievements revealed by the in vitro or in vivo studies published until now.

Osteoporosis and Its Nanotechnology-Based Advanced Treatment-An Overview

Human Immunodeficiency Virus (HIV) is a global pandemic that has contributed to the burden of disease, and the synergistic interaction between Herpes Simplex Virus (HSV) and HIV has assisted further in the spread of the HIV disease. Moreover, several chemotherapeutic treatment options from antiviral monotherapy to highly active antiretroviral therapy (HAART) have been adopted to manage the infection; however, HIV has developed new mechanisms against these active pharmaceutical agents (APAs), limiting the effect of the drugs. In this article, we reviewed different nanoparticles and their antiviral potency against HSV and HIV infection as well as the effect of drug encapsulated nanoparticles using different drug delivery systems as they palliate to some flaws or deficiencies that the stand-alone drugs present. Drug encapsulated nanoparticles show better treatment outcomes of HSV and HIV infection. The nanoparticles can transverse the anatomic privilege sites to exert their therapeutic effect, and a prolonged and higher dose of the encapsulated therapeutic agent can ease the dosage frequency, thus palliating low drug compliance which the stand-alone drugs fail to perform. Therefore, it is clear that nanoparticles prevent antiviral drug resistance by maintaining sustained drug release over an extended period, improving the therapeutic effect of the entrapped drug.

Effectiveness of Nanohydroxyapatite on Demineralization of Enamel and Cementum Surrounding Margin of Yttria-Stabilized Zirconia Polycrystalline Ceramic Restoration

Introduction

Prosthetic dentistry has shifted toward prevention of caries occurrence surrounding restorative margin through the anti-demineralization process. This study examines the ability of nanohydroxyapatite (NHA) gel and Clinpro (CP) on enhancing resistance to demineralization of enamel and cementum at margin of restoration.

Materials and Methods

Thirty extracted mandibular third molars were segregated at 1 mm above and below cementoenamel junction (CEJ) to separate CEJ portions and substituted with zirconia disks by bonding to crown and root portions with resin adhesive. The enamel and cementum area of 4 × 4 mm² neighboring zirconia was applied with either NHA or CP, while one group was left no treatment (NT) before demineralized with carbopal. Vickers hardness (VHN) of enamel and cementum was evaluated before material application (B_M), after material application (A_M), and after demineralization (A_D). Analysis of variance (ANOVA) and post hoc multiple comparisons were used to justify for the significant difference (α = 0.05). Scanning electron microscopy (SEM) and X-ray diffraction (XRD) were determined for surface evaluations.

Results

The mean ± SD of VHN for B_M, A_M, and A_D for enamel and cementum was 393.24 ± 26.27, 392.89 ± 17.22, 155.00 ± 5.68 and 69.89 ± 4.59, 66.28 ± 3.61, 18.13 ± 0.54 for NT groups, respectively, 390.10 ± 17.69, 406.77 ± 12.86, 181.55 ± 7.99 and 56.01 ± 9.26, 62.71 ± 6.15, 19.09 ± 1.16 for NHA groups, respectively, and 387.90 ± 18.07, 405.91 ± 9.83, 188.95 ± 7.43 and 54.68 ± 7.30, 61.81 ± 4.30, 19.22 ± 1.25 for CP groups, respectively. ANOVA indicated a significant increase in anti-demineralization of enamel and cementum upon application of NHA or CP (p < 0.05). Multiple comparisons indicated the capability in inducing surface strengthening to resist demineralization for enamel and cementum of NHA which was comparable to CP (p > 0.05) as evidenced by SEM and XRD data indicating NHA and CP deposition and crystallinity accumulation.

Conclusion

NHA and CP were capable of enhancing anti-demineralization for enamel and cementum. The capability in resisting the demineralization process of NHA was comparable with CP. NHA was highly recommended for anti-demineralization for enamel and cementum surrounding restorative margin.

Effect of zoledronic acid on bone nanocomposites organization and prevention of bone mineral density loss in ovariectomized rats

OBJECTIVES

Osteoporosis often occurs in individuals of different age groups, frequently during menopause and after ovariectomy. It increases the risk of pathological fractures almost twice. The aim of our research was to assess bone metabolism, nanocomposite structure of the tibia under conditions of ovariectomy and zoledronic acid treatment.

METHODS

X-ray diffraction has been performed for nanostructure analysis of mineral crystallites and crystal lattice of hydroxyapatite in the tibia samples of ovariectomized rats with additional application of bisphosphonate zoledronic acid (0.025 mg/kg). Markers of remodeling - osteocalcin, alkaline phosphatase, tartrate resistant acid phosphatase 5b - were determined. Quantitative amount of calcium in the bones was detected by atomic absorption method.

RESULTS

Zoledronic acid prevented loss of mineral mass after ovariectomy. Rats after ovariectomy, treated with zoledronic acid, showed statistically higher (р<0.05) values of crystalline phase and calcium content compared with the SHAM-surgery and ovariectomy groups (р<0.05). Zoledronic acid inhibited bone remodeling, which is proved by tartrate resistant acid phosphatase 5b reduction and inhibition of osteoclasts during the experiment.

CONCLUSIONS

These results enable to suggest that zoledronic acid can improve mineral mass of the bone during menopause in individuals of different age groups.

Nano-Based Biomaterials as Drug Delivery Systems Against Osteoporosis: A Systematic Review of Preclinical and Clinical Evidence

Osteoporosis (OP) is one of the most significant causes of morbidity, particularly in post-menopausal women and older men. Despite its remarkable occurrence, the search for an effective treatment is still an open challenge. Here, we systematically reviewed the preclinical and clinical progress in the development of nano-based materials as drug delivery systems against OP, considering the effects on bone healing and regeneration, the more promising composition and manufacturing methods, and the more hopeful drugs and delivery methods. The results showed that almost all the innovative nano-based delivery systems developed in the last ten years have been assessed by preclinical investigations and are still in the preliminary/early research stages. Our search strategy retrieved only one non-randomized controlled trial (RCT) on oligosaccharide nanomedicine of alginate sodium used for degenerative lumbar diseases in OP patients. Further investigations are mandatory for assessing the clinical translation and commercial purposes of these materials. To date, the main limits for the clinical translation of nano-based materials as drug delivery systems against OP are probably due to the low reproducibility of the manufacturing processes, whose specificity and complexity relies on an adequate chemical, structural, and biomechanical characterization, as the necessary prerequisite before assessing the efficacy of a given treatment or process. Finally, an unsatisfactory drug-loading capacity, an uncontrollable release kinetic, and a low delivery efficiency also limit the clinical application.

Effect of zoledronic acid and graphene oxide on the physical and in vitro properties of injectable bone substitutes

The aim of this work was to develop injectable bone substitutes (IBS) consisting of zoledronic acid (ZOL) and graphene oxide (GO) for the treatment of osteoporosis and metastasis. The powder phase was consisting of tetra calcium phosphate (TTCP), dicalcium phosphate dihyrate (DCPD) and calcium sulfate dihyrate (CSD), while the liquid phase comprised of methylcellulose (MC), gelatin and sodium citrate dihyrate (SC), ZOL and GO. The structural analysis of IBS samples was performed by Fourier Transform Infrared Spectroscopy (FTIR). Injectability, setting time and mechanical strength were investigated. Additionally, in vitro properties of synthesized IBS were analyzed by means of bioactivity, ZOL release, degradation, pH variation, PO₄^3- ion release and cell studies. Overall, all IBS exhibited excellent injectability results with no phase separation. The setting time of the IBS was prolonged with ZOL incorporation while the prolonging effect decreased with GO incorporation. The mechanical properties decreased with ZOL addition and increased with the incorporation of GO. The maximum compressive strength was found as 25.73 MPa for 1.5GO0ZOL incorporated IBS. In vitro results showed that ZOL and GO loaded IBS also revealed clinically suitable properties with controlled release of ZOL, pH value and PO₄^3- ions. In in vitro cell studies, both the inhibitory effect of ZOL and GO loaded IBS on MCF-7 cells and proliferative effect on osteoblast cells were observed. Moreover, the prepared IBS led to proliferation, differentiation and mineralization of osteoblasts. The results are encouraging and support the conclusion that developed IBS have promising physical and in vitro properties which needs to be further validated by gene expression and in vivo studies.

Association of alkali metals and Alkaline-earth metals with the risk of schizophrenia in a Chinese population: A Case-Control study

Alkali metals (AMs) and alkali earth metals (AEMs) affect levels and signaling of neurotransmitters, which potentially play a role in the etiology of schizophrenia (SCZ). The current case-control study aims to explore how AMs [i.e. Potassium (K), sodium (Na), rubidium (Rb), cesium (Cs)] and AEMs [i.e. magnesium (Mg), calcium (Ca), strontium (Sr), barium (Ba)] in serum could associate with SCZ. One hundred and five inpatients with SCZ and 106 age- and sex-matched healthy controls (HCs) were recruited from Weifang, China. Inductively Coupled Plasma-Atomic Emission Spectrometry (ICP-AES) was used to evaluate serum concentrations of Na, K, Ca, Mg and Inductively Coupled Plasma Mass Spectrometry (ICP-MS) was for Rb, Cs, Sr, Ba. Subjects with SCZ had significantly higher Mg and Sr serum concentrations than HCs (20.86 vs. 19.73 μg/mL of Mg, p < 0.001; 53.14 vs. 42.26 ng/mL of Sr, p < 0.001). After adjusting for confounders, the odds ratio of Mg and Sr remain significantly higher in the SCZ group (Mg: OR = 2.538, 95 % CI: 1.254-5.136, p=0.010; Sr: OR = 3.798, 95 % CI: 1.769-8.153, p = 0.001). No significant differences between SCZ subjects and HCs were observed for other AMs and AEMs. Higher serum concentrations of Mg and Sr were associated with SCZ. Studies are suggested to find the related mechanisms and provide clues for pathogenesis of SCZ, which would impact prevention and treatments of SCZ.

Synergistic effect of graphene oxide and zoledronic acid for osteoporosis and cancer treatment

Zoledronic acid (ZOL) is a third generation bisphosphonate which can be used as a drug for the treatment of osteoporosis and metastasis. In this study, graphene oxide (GO) is conjugated with ZOL, and the nanostructured material is evaluated in terms viability, proliferation and differentiation. Furthermore, the associated morphological changes of bone marrow-derived mesenchymal stem cells (BM-MSC), and Michigan Cancer Foundation-7 (MCF-7) breast cancer cells, as well as the effect of the drugs on mineralization of BM-MSCs are investigated using a variety of characterization techniques including Fourier Transform Infrared Spectroscopy (FTIR), scanning electron microscopy (SEM) as well as alamar blue, acridine orange, and alizarin red assays. Nanostructured ZOL-GO with an optimum performance is synthesized using ZOL and GO suspensions with the concentration of 50 µM and 2.91 ng/ml, respectively. ZOL-GO nanostructures can facilitate the mineralization of BM-MSC cells, demonstrated by the formation of clusters around the cells. The results obtained confirm the performance of ZOL-GO nanostructures as promising drug complexes for the treatment of osteoporosis and metastasis.

Fabrication and characterization of strontium-hydroxyapatite/silk fibroin biocomposite nanospheres for bone-tissue engineering applications

Osteoinductive bone filling biomaterials are in high demand for effective bone defect reconstruction. In this study, we aimed to design both organic and inorganic substances containing strontium-doped hydroxyapatite/silk fibroin (SrHA/SF) biocomposite nanospheres as an osteoinductive bone defect-filling biomaterial. SrHA/SF nanospheres were prepared with different concentration of Sr using ultrasonic coprecipitation method. The nanospheres were characterized using XRD, FTIR, SEM, TEM, ICP-AES and TGA. Solid and dense SrHA/SF nanospheres with 500-700 nm size and rough surfaces were synthesized successfully. Higher crystallinity and HA/SF phase were observed with the increase in Sr-concentration. The doping of different concentration of Sr did not affect the size and surface characteristics of the nanospheres. ICP-AES data showed that Sr/Ca ratio in SrHA/SF is very close to the nominal value. Nanospheres with higher concentration of Sr did not negatively affect the biocompatibility, but enhanced viability of mesenchymal stem cells (MSCs). Moreover, SrHA/SF nanospheres showed higher osteogenic differentiation potential compared to HA/SF nanospheres as indicated by the results from ALP staining, ALP activity, and Runx2, Alp, Col-1 and Opn gene expression assay in MSCs culture. Our findings suggest this novel design of biocompatible and osteoinductive SrHA/SF biocomposite nanospheres as a potential bone defect-filling biomaterial for bone regenerative applications.

Elucidating the role of size of hydroxyl apatite particles toward the development of competent antiosteoporotic bioceramic materials: In vitro and in vivo studies

Osteoporosis caused by overdose of steroids is one of the major concerns for the orthopedic surgeons. Current therapeutic strategies offer limited success due to their inability to regenerate damaged bone at osteoporosis site. Therefore, there is an urgent need to develop a material having bone regeneration ability and also, ability to cure osteoporosis simultaneously. In this work, nanosized and microsized hydroxyl apatite (HAp) particles doped with europium (Eu) were prepared for diagnostic and therapeutic applications in biomedical engineering. Particles were characterized by X-ray diffraction to confirm the formation of HAp phase and transmission electron microscopy technique has been used to explore the size of microparticle and nanoparticle. In vitro release of antibiotic drug and degradation behavior in two different pHs of phosphate buffered saline was checked. Controlled drug release behavior and conversion of degraded ions into HAp is estimated by Higuchi's and 3D diffusion model, respectively. Osteoporosis was induced in 36 female Wistar rats by administering dexamethasone once a week for four consecutive weeks. Rats were treated with different doses of nano-HAp (25, 50, and 100 μg/kg intravenous single dose) and single dose of microsized HAp (100 μg/kg). After treatment, authors have evaluated sensitive biochemical markers of bone in serum. Continuous improvement in ultimate stiffness and Young's modulus of femur shaft of rats was observed with the increase in the dose of nano-HAp from 25 to 100 μg/kg. Results strongly suggest that europium-doped nano-HAp is more effective for treating severe osteoporosis in humans. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1723-1735, 2019.

The facile synthesis of copper oxide quantum dots on chitosan with assistance of phyto-angelica for enhancing the human osteoblast activity to the application of osteoporosis

Osteoblasts are an important key factor for the pathogenesis of several bone-related diseases, notably in osteoporosis. Osteoporosis is a disorder categorized based on the bone mineral density (BMD) and an alteration in the bone micro-architecture had been considered as the major determinant for increasing the fracture risk. The available medicine for curing the osteoporosis shows a minimal or no activity against the genesis or function of osteoblasts. The present study was conducted to determine the influence of phyto Angelica species (Ang.) mediated synthesized copper quantum dots decorated chitosan on human osteoblast cells for application of osteoporosis. The phyto compound of Angelica sp. was extracted by ethanol as solvent and it has been characterized through spectral analyses. An Angelica sp. mediated synthesized copper oxide quantum dots (CuO QDs) and the presence of CuO QDs on chitosan have been analyzed and exhibited by important spectral investigations. The morphological observation of CuO QDs on the chitosan (CS) was visualized by the microscopic analyses. The MTT assay results showed that cell growth of CuO QDs/CS-Ang. by the concentration dependent. The highest cell growth (87%) was noted at 5 μg/mL followed by 80 and 77% at 15 and 25 μg/mL respectively. The functional groups and potential compounds of Angelica sp. with CuO QDs/CS has been improved the osteoblast cell activity as prophylactic potentials against osteoporosis.

A review of using green chemistry methods for biomaterials in tissue engineering

Although environmentally safe, or green, technologies have revolutionized other fields (such as consumables, automobiles, etc.), its use in biomaterials is still at its infancy. However, in the few cases in which safe manufacturing technology and materials have been implemented to prevent postpollution and reduce the consumption of synthesized scaffold (such as bone, cartilage, blood cell, nerve, skin, and muscle) has had a significant impact on different applications of tissue engineering. In the present research, we report the use of biological materials as templates for preparing different kinds of tissues and the application of safe green methods in tissue engineering technology. These include green methods for bone and tissue engineering-based biomaterials, which have received the greatest amount of citations in recent years. Thoughts on what is needed for this field to grow are also critically included. In this paper, the impending applications of safe, ecofriendly materials and green methods in tissue engineering have been detailed.

Remineralization potential of nano-hydroxyapatite on enamel and cementum surrounding margin of computer-aided design and computer-aided manufacturing ceramic restoration

Objective

This study investigates the effects of nano-hydroxyapatite (NHA) gel and Clinpro (CP) on remineralization potential of enamel and cementum at the cavosurface area of computer-aided design and computer-aided manufacturing ceramic restoration.

Materials and methods

Thirty extracted human mandibular third molars were sectioned at 1 mm above and below the cemento-enamel junction to remove the cemento-enamel junction portions and replaced them with zirconia ceramic disks by bonding them to the crown and root portions with resin cement. The enamel and cementum with an area of 4×4 mm² surrounding the ceramic disk was demineralized with carbopol. The demineralized surfaces were treated with either NHA or CP, while 1 group was left with no treatment. Vickers microhardness of enamel and cementum were determined before demineralization, after demineralization, and after remineralization. Analysis of variance and Tukey multiple comparisons were used to determine statistically significant differences at 95% level of confidence. Scanning electron microscopy and X-ray diffraction were used to evaluate for surface alterations.

Results

The mean ± SD of Vickers microhardness for before demineralization, after demineralization, and after remineralization for enamel and cementum were 377.37±22.99, 161.95±10.54, 161.70±5.92 and 60.37±3.81, 17.65±0.91, 17.04±1.00 for the no treatment group; 378.20±18.76, 160.72±8.38, 200.08±8.29 and 62.58±3.37, 18.38±1.33, 27.99±2.68 for the NHA groups; and 380.53±25.14, 161.94±5.66, 193.16±7.54 and 62.78±4.75, 19.07±1.30, 24.46±2.02 for the CP groups. Analysis of variance indicated significant increase in microhardness of demineralized enamel and cementum upon the application of either NHA or CP (p<0.05). Post hoc multiple comparisons indicated significantly higher remineralization capability of NHA for both enamel and cementum than CP (p<0.05), as evidenced by scanning electron microscopy, indicating NHA particle deposition in the area of remineralization, and crystallinity accumulation, as indicated by X-ray diffraction.

Conclusion

NHA gel and CP were capable of remineralization of the enamel and cementum. NHA was more capable in the remineralization process than CP. NHA was extremely capable in the remineralization process for enamel and cementum surrounding the margin of the computer-aided design and computer-aided manufacturing ceramic.

Calcium Phosphates as Delivery Systems for Bisphosphonates

Bisphosphonates (BPs) are the most utilized drugs for the treatment of osteoporosis, and are usefully employed also for other pathologies characterized by abnormally high bone resorption, including bone metastases. Due to the great affinity of these drugs for calcium ions, calcium phosphates are ideal delivery systems for local administration of BPs to bone, which is aimed to avoid/limit the undesirable side effects of their prolonged systemic use. Direct synthesis in aqueous medium and chemisorptions from solution are the two main routes proposed to synthesize BP functionalized calcium phosphates. The present review overviews the information acquired through the studies on the interaction between bisphosphonate molecules and calcium phosphates. Moreover, particular attention is addressed to some important recent achievements on the applications of BP functionalized calcium phosphates as biomaterials for bone substitution/repair.

Effect of locally administered novel biodegradable chitosan based risedronate/zinc-hydroxyapatite intra-pocket dental film on alveolar bone density in rat model of periodontitis

The aim of this study was to develop a chitosan-based risedronate/zinc-hydroxyapatite intrapocket dental film (CRZHDF) for applications in the treatment of alveolar bone loss in an animal model of periodontitis. The physical characteristics (folding endurance, pH, mucoadhesive strength, risedronate content and release) of CRZHDF, exhibited results within the limit. X-ray diffraction analysis indicates reduced or disappeared crystallinity of risedronate and zinc-hydroxyapatite in presence of chitosan. Further, FTIR studies revealed stability of CRZHDF and compatibility between risedronate, zinc-hydroxyapatite and chitosan. Periodontitis was induced by Porphyromonas gingivalis-lipopolysaccharide injections around the mandibular first molar. We divided rats into 5 groups (12 rats/group): healthy, untreated periodontitis; periodontitis plus CRZHDF-A, periodontitis plus CRZHDF-B, and periodontitis plus chitosan film. After four weeks, blood samples and mandibles were obtained for biochemical, radiographic and histological analysis. Bone specific alkaline phosphatise activity and tartrate resistant acid phosphatase 5b was statistically lower in CRZHDF-A and CRZHDF-B groups as compared to the untreated periodontitis group (p < 0.0001). The expression of osteocalcin was statistically higher in CRZHDF-A and CRZHDF-B groups as compared to the untreated periodontitis group (p < 0.0001). Alveolar bone was intact in the healthy group. Local administration of CRZHDF resulted in significant improvements in the mesial and distal periodontal bone support (MPBS and DPBS, respectively) proportions (%), bone mineral density, and also reversed alveolar bone resorption when compared to the untreated periodontitis group (p < 0.001). The study reported here reveals that novel CRZHDF treatment effectively reduced alveolar bone destruction and contributes to periodontal healing in a rat model of experimental periodontitis.

A bone-resorption surface-targeting nanoparticle to deliver anti-miR214 for osteoporosis therapy

With increasing fracture risks due to fragility, osteoporosis is a global health problem threatening postmenopausal women. In these patients, osteoclasts play leading roles in bone loss and fracture. How to inhibit osteoclast activity is the key issue for osteoporosis treatment. In recent years, miRNA-based gene therapy through gene regulation has been considered a potential therapeutic method. However, in light of the side effects, the use of therapeutic miRNAs in osteoporosis treatment is still limited by the lack of tissue/cell-specific delivery systems. Here, we developed polyurethane (PU) nanomicelles modified by the acidic peptide Asp⁸. Our data showed that without overt toxicity or eliciting an immune response, this delivery system encapsulated and selectively deliver miRNAs to OSCAR⁺ osteoclasts at bone-resorption surface in vivo. With the Asp⁸-PU delivery system, anti-miR214 was delivered to osteoclasts, and bone microarchitecture and bone mass were improved in ovariectomized osteoporosis mice. Therefore, Asp⁸-PU could be a useful bone-resorption surface-targeting delivery system for treatment of osteoclast-induced bone diseases and aging-related osteoporosis.