Evaluation of long-term biocompatibility and osteogenic differentiation of graphene nanosheet doped calcium phosphate-chitosan AZ91D composites

Progress in the application of graphene and its derivatives to osteogenesis

As bone and joint injuries from various causes become increasingly prominent, how to effectively reconstruct and repair bone defects presents a difficult problem for clinicians and researchers. In recent years, graphene and its derivatives have been the subject of growing body of research and have been found to promote the proliferation and osteogenic differentiation of stem cells. This provides a new idea for solving the clinical problem of bone defects. However, as as numerous articles address various aspects and have not been fully systematized, there is an urgent need to classify and summarize them. In this paper, for the first time, the effects of graphene and its derivatives on stem cells in solution, in 2D and 3D structures and in vivo and their possible mechanisms are reviewed, and the cytotoxic effects of graphene and its derivatives were summarized and analyzed. The toxicity of graphene and its derivatives is further reviewed. In addition, we suggest possible future development directions of graphene and its derivatives in bone tissue engineering applications to provide a reference for further clinical application.

Composite Nanocoatings of Biomedical Magnesium Alloy Implants: Advantages, Mechanisms, and Design Strategies

The rapid degradation of magnesium (Mg) alloy implants erodes mechanical performance and interfacial bioactivity, thereby limiting their clinical utility. Surface modification is among the solutions to improve corrosion resistance and bioefficacy of Mg alloys. Novel composite coatings that incorporate nanostructures create new opportunities for their expanded use. Particle size dominance and impermeability may increase corrosion resistance and thereby prolong implant service time. Nanoparticles with specific biological effects may be released into the peri-implant microenvironment during the degradation of coatings to promote healing. Composite nanocoatings provide nanoscale surfaces to promote cell adhesion and proliferation. Nanoparticles may activate cellular signaling pathways, while those with porous or core-shell structures may carry antibacterial or immunomodulatory drugs. Composite nanocoatings may promote vascular reendothelialization and osteogenesis, attenuate inflammation, and inhibit bacterial growth, thus increasing their applicability in complex clinical microenvironments such as those of atherosclerosis and open fractures. This review combines the physicochemical properties and biological efficiency of Mg-based alloy biomedical implants to summarize the advantages of composite nanocoatings, analyzes their mechanisms of action, and proposes design and construction strategies, with the purpose of providing a reference for promoting the clinical application of Mg alloy implants and to further the design of nanocoatings.

Graphene and its derivatives: "one stone, three birds" strategy for orthopedic implant-associated infections

Orthopedic implants provide an avascular surface for microbial attachment and biofilm formation, impeding the entry of immune cells and the diffusion of antibiotics. The above is an important cause of dental and orthopedic implant-associated infection (IAI). For the prevention and treatment of IAI, the drawbacks of antibiotic resistance and surgical treatment are increasingly apparent. Due to their outstanding biological properties such as biocompatibility, immunomodulatory effects, and antibacterial properties, graphene-based nanomaterials (GBNs) have been applied to bone tissue engineering to deal with IAI, and in particular have great potential application in drug/gene carriers, multi-functional platforms, and coating forms. Here we review the latest research progress and achievements in GBNs for the prevention and treatment of IAI, mainly including their biomedical applications for antibacterial and immunomodulation effects, and for inducing osteogenesis. Furthermore, the biosafety of graphene family materials in bone tissue regeneration and the feasibility of clinical application are critically analyzed and discussed.

Pro-Myogenic Environment Promoted by the Synergistic Effect of Conductive Polymer Nanocomposites Combined with Extracellular Zinc Ions

A new strategy based on the combination of electrically conductive polymer nanocomposites and extracellular Zn²⁺ ions as a myogenic factor was developed to assess its ability to synergically stimulate myogenic cell response. The conductive nanocomposite was prepared with a polymeric matrix and a small amount of graphene (G) nanosheets (0.7% wt/wt) as conductive filler to produce an electrically conductive surface. The nanocomposites' surface electrical conductivity presented values in the range of human skeletal muscle tissue. The biological evaluation of the cell environment created by the combination of the conductive surface and extracellular Zn²⁺ ions showed no cytotoxicity and good cell adhesion (murine C2C12 myoblasts). Amazingly, the combined strategy, cell-material interface with conductive properties and Zn bioactive ions, was found to have a pronounced synergistic effect on myoblast proliferation and the early stages of differentiation. The ratio of differentiated myoblasts cultured on the conductive nanocomposites with extracellular Zn²⁺ ions added in the differentiation medium (serum-deprived medium) was enhanced by more than 170% over that of non-conductive surfaces (only the polymeric matrix), and more than 120% over both conductive substrates (without extracellular Zn²⁺ ions) and non-conductive substrates with extracellular Zn²⁺. This synergistic effect was also found to increase myotube density, myotube area and diameter, and multinucleated myotube formation. MyoD-1 gene expression was also enhanced, indicating the positive effect in the early stages of myogenic differentiation. These results demonstrate the great potential of this combined strategy, which stands outs for its simplicity and robustness, for skeletal muscle tissue engineering applications.

Mapping knowledge structure and themes trends of biodegradable Mg-based alloy for orthopedic application: A comprehensive bibliometric analysis

Background: Since Lambotte and Payr first studied Mg-based alloys for orthopedics in 1900, the research of this field has finally ushered in vigorous development in the 21st century. From the perspective of quantitative analysis, this paper clearly demonstrated the global research trend from 2005 to 2021 by using bibliometrics and scientometric analysis.

Methods: We obtained the publications from the Web of Science Core Collection (WoSCC) database. The bibliometric and scientometric analysis was conducted by using R software, CiteSpace software, VOSviewer software, Pajek software and Microsoft Excel program.

Results: In total, 1921 publications were retrieved. It can be found that the number of publications is gradually increasing year by year. We can find that the most prolific countrie, institution and researcher are China, Chinese Academy of Sciences and Zheng Yufeng, respectively. The most influential journals in this field are Acta Biomaterialia and Biomaterials, with 16,511 and 12,314 total citations, respectively. By conducting the co-cited documents-based clustering analysis, 16 research hotspots and their representative studies have been identified. Besides, by conducting analysis of keywords, we divided the keyword citation bursts representing the development of the field into three stages.

Conclusion: The number of researches on the biodegradable Mg-based alloys increased sharply all over the world in the 21st century. China has made significant progress in biodegradable Mg-based alloy research. More focus will be placed on osteogenic differentiation, fabrication, graphene oxide, antibacterial property, bioactive glass and nanocomposite, which may be the next popular topics in the field.

Development of Graphene-Based Materials in Bone Tissue Engineaering

Bone regeneration-related graphene-based materials (bGBMs) are increasingly attracting attention in tissue engineering due to their special physical and chemical properties. The purpose of this review is to quantitatively analyze mass academic literature in the field of bGBMs through scientometrics software CiteSpace, to demonstrate the rules and trends of bGBMs, thus to analyze and summarize the mechanisms behind the rules, and to provide clues for future research. First, the research status, hotspots, and frontiers of bGBMs are analyzed in an intuitively and vividly visualized way. Next, the extracted important subjects such as fabrication techniques, cytotoxicity, biodegradability, and osteoinductivity of bGBMs are presented, and the different mechanisms, in turn, are also discussed. Finally, photothermal therapy, which is considered an emerging area of application of bGBMs, is also presented. Based on this approach, this work finds that different studies report differing opinions on the biological properties of bGBMS due to the lack of consistency of GBMs preparation. Therefore, it is necessary to establish more standards in fabrication, characterization, and testing for bGBMs to further promote scientific progress and clinical translation.

Osteoinductive and antimicrobial mechanisms of graphene-based materials for enhancing bone tissue engineering

Graphene-based materials (GMs) have great application prospects in bone tissue engineering due to their osteoinductive ability and antimicrobial activity. GMs induce osteogenic differentiation through several mechanisms and pathways in bone tissue engineering. First of all, the surface and high hardness of the porous folds of graphene or graphene oxide (GO) can generate mechanical stimulation to initiate a cascade of reactions that promote osteogenic differentiation without any chemical inducers. In addition, change of the extracellular matrix (ECM), regulation of macrophage polarization, the oncostatin M (OSM) signaling pathway, the MAPK signaling pathway, the BMP signaling pathway, the Wnt/β-catenin signaling pathway, and other pathways are involved in GMs' regulation of osteogenesis. In bone tissue engineering, GMs prevent the formation of microbial biofilms mainly through preventing microbial adhesion and killing them. The former is mainly achieved by reducing surface free energy (SFE) and increasing hydrophobicity. The latter mainly includes oxidative stress and photothermal/photodynamic effects. Graphene and its derivatives (GDs) are mainly combined with bioactive ceramic materials, metal materials and macromolecular polymers to play an antimicrobial effect in bone tissue engineering. Concentration, number of layers, and type of GDs often affect the antimicrobial activity of GMs. In this paper, we reviewed relevant osteoinductive and antimicrobial mechanisms of GMs and their applications in bone tissue engineering.

Formulation and Characterization of a New Injectable Bone Substitute Composed PVA/Borax/CaCO3 and Demineralized Bone Matrix

The occurrence of bone-related disorders and diseases has dramatically increased in recent years around the world. Demineralized bone matrix (DBM) has been widely used as a bone implant due to its osteoinduction and bioactivity. However, the use of DBM is limited because it is a particulate material, which makes it difficult to manipulate and implant with precision. In addition, these particles are susceptible to migration to other sites. To address this situation, DBM is commonly incorporated into a variety of carriers. An injectable scaffold has advantages over bone grafts or preformed scaffolds, such as the ability to flow and fill a bone defect. The aim of this research was to develop a DBM carrier with such viscoelastic properties in order to obtain an injectable bone substitute (IBS). The developed DBM carrier consisted of a PVA/glycerol network cross-linked with borax and reinforced with CaCO3 as a pH neutralizer, porosity generator, and source of Ca. The physicochemical properties were determined by an injectability test, FTIR, SEM, and TGA. Porosity, degradation, bioactivity, possible cytotoxic effect, and proliferation in osteoblasts were also determined. The results showed that the developed material has great potential to be used in bone tissue regeneration.

A biodegradable, mechanically tunable micro-arc oxidation AZ91D-based composite implant with calcium phosphate/chitosan coating promotes long-term bone tissue regeneration

BACKGROUND

To reduce the biodegradable rate and develop the long-term osteogenic ability of magnesium (Mg) alloy, we prepared a new biodegradable micro arc oxidation AZ91D-based composite implant with calcium phosphate/chitosan coating (CaP-CS/MAO/AZ91D) and investigated its mechanical property and long-term bone tissue regeneration ability.

MAIN METHODS AND MAJOR RESULTS

The results showed that the binding force and bioactivity of CaP-CS/MAO/AZ91D was better when the ratio of water to ethanol was 4:6 and MAO constant current was 0.1 A cm^-2 . Compressive strengths of 4:6 sample were more than 1300 N when the soaking time was increased to 21 days. CaP-CS/MAO/AZ91D extracts promoted differentiation and proliferation of rat mesenchymal stem cells (RMSC), which achieved higher proliferation rates over 16 days of culture and exhibited early alkaline phosphatase activity and late bone sialoprotein markers.

CONCLUSIONS AND IMPLICATIONS

CaP-CS/MAO/AZ91D was established to promote RMSC osteogenic differentiation within a proper range for at least 90 days through Wnt/β-catenin pathway activation, which would allow sufficient time for bone healing. Collectively, our findings suggest that the CaP-CS/MAO/AZ91D coating could not only reduce the corrosion rate and lead to better long-term biocompatibility but also promote osteogenic mineralization.

CNTs-CaP/chitosan-coated AZ91D magnesium alloy extract promoted rat dorsal root ganglia neuron growth via activating ERK signalling pathway

Increasing attention has been paid on the application of biodegradable materials such as magnesium and its alloys in neuron repair. AZ91D magnesium alloy coated with carbon nanotubes (CNTs) and/or calcium phosphate (CaP)/chitosan (CS) was fabricated in this study. To evaluate the bioactivity of these AZ91D-based composites, the extracts were prepared by immersing samples in modified simulated body fluid (m-SBF) for 0, 2, 8, 16, 24, 34, 44, 60, or 90 days. Immunofluorescence staining for neuronal class III β-tubulin (TUJ1) revealed that both CNTs-CaP/CS-AZ91D and CaP/CS-AZ91D extracts promoted axon outgrowth of dorsal root ganglia (DRG) neurons, accompanied with increased expression of phosphorylated focal adhesion kinase (p-FAK) and growth associated protein-43 (GAP-43). Besides, the extracts increased the expression and the release of neurotrophic factors including nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF). ERK signalling was activated in DRG neurons after treating with either CNTs-CaP/CS-AZ91D or CaP/CS-AZ91D extracts, and its inhibition with U0126 counteracted the beneficial effects of these extracts on DRG neuron. Overall, the extracts from these AZ91D-based composites might promote DRG neuron growth via activating ERK signalling pathway. Notably, CNTs-CaP/CS-AZ91D extracts showed a better promoting effect on neuron growth than CaP/CS-AZ91D. Assessment of ion elements showed that the addition of CNTs coating enhanced magnesium corrosion resistance and reduced the deposition of calcium and phosphorus on the surface of CaP/CS-AZ91D alloy. These findings demonstrate that CNTs-CaP/CS-AZ91D likely provide a more suitable environment for neuron growth, which suggests a potential implantable biomaterial for the treatment of nerve injury. SIGNIFICANCE: AZ91D magnesium alloy coated with carbon nanotubes (CNTs) and/or calcium phosphate (CaP)/chitosan (CS) was fabricated and their immersion extracts were prepared using modified simulated body fluid in this study. Both extracts from CNTs-CaP/CS and CaP/CS-coated AZ91D magnesium alloy promotes rat dorsal root ganglia (DRG) neuron growth via activating ERK signalling pathway. Notably, the addition of CNTs improves the performance of CaP/CS-AZ91D. For the first time, our research demonstrates that CNTs-CaP/CS-AZ91D likely provide a suitable environment for neuron growth, suggesting these AZ91D-based composites as potential implantable biomaterials for the treatment of nerve injury.

In vivo and in simulated body fluid degradation behavior and biocompatibility evaluation of anodic oxidation-silane-chitosan-coated Mg-4.0Zn-0.8Sr alloy for bone application

With the development and progress of science and technology, magnesium and magnesium alloys have attracted more and more researchers' attention because of their excellent biocompatibility. However, rapid degradation rate of magnesium alloy in vivo seriously limits its application (Arthanari et al., n.d.; Cui et al., 2013 [1,2]). In order to solve this problem, the surface modification of Mg-4.0Zn-0.8Sr alloy was adopted in this paper. According to the requirements of orthopedic materials, anodizing coating (AO), silane coating (SA) and chitosan coating (CS) coating were prepared on its surface, and magnesium alloy was prepared into intramedullary nail, and the corrosion resistance and biocompatibility of the corresponding samples was evaluated. The experimental results show that the AO-SA-CS coating sample has higher corrosion resistance, in addition, it also shows good biocompatibility, such as lower hemolysis rate and normal platelet adhesion morphology. After implantation into the femur, the femur of rats recovered well and the kidney tissue was normal.

A novel multifunctional carbon aerogel-coated platform for osteosarcoma therapy and enhanced bone regeneration

Nowadays, groundbreaking strategies are urgently needed to address drug resistance, osteolysis, bone defects and other predicaments impeding the therapeutic efficacy of osteosarcoma. Among them, photothermal therapy (PTT), using systematically administrated nanoagents, exhibits attractive therapeutic efficacy, yet is powerless in bone defect regeneration. Herein, a novel multifunctional beta-tricalcium phosphate (β-Ca3(PO4)2, β-TCP) bioceramic platform-coated with carbon aerogel (CA), which was initially developed for tumor therapy, was fabricated. On account of the desirable photothermal capabilities of CA, sufficient hyperthermia is generated under the irradiation of an 808 nm laser to achieve a thorough ablation of osteosarcoma tumors. Furthermore, CA-coated surfaces provide extra roughness and a higher specific surface area, which promoted the protein recruitment ability and osteogenesis via a fibronectin (FN)-mediated signaling pathway. The photothermal therapeutic efficacy and osteogenesis capability of CA-coated β-TCP-C suggests a novel approach for the treatment of osteosarcoma and provides provoking inspiration for the prospective bio-application of CA.

Applications of Graphene and Its Derivatives in Bone Repair: Advantages for Promoting Bone Formation and Providing Real-Time Detection, Challenges and Future Prospects

During continuous innovation in the preparation, characterization and application of various bone repair materials for several decades, nanomaterials have exhibited many unique advantages. As a kind of representative two-dimensional nanomaterials, graphene and its derivatives (GDs) such as graphene oxide and reduced graphene oxide have shown promising potential for the application in bone repair based on their excellent mechanical properties, electrical conductivity, large specific surface area (SSA) and atomic structure stability. Herein, we reviewed the updated application of them in bone repair in order to present, as comprehensively, as possible, their specific advantages, challenges and current solutions. Firstly, how their advantages have been utilized in bone repair materials with improved bone formation ability was discussed. Especially, the effects of further functionalization or modification were emphasized. Then, the signaling pathways involved in GDs-induced osteogenic differentiation of stem cells and immunomodulatory mechanism of GDs-induced bone regeneration were discussed. On the other hand, their applications as contrast agents in the field of bone repair were summarized. In addition, we also reviewed the progress and related principles of the effects of GDs parameters on cytotoxicity and residues. At last, the future research was prospected.

Biological evaluation of bone substitute

Critical-sized defects (CSDs) caused by trauma, tumor resection, or skeletal abnormalities create a high demand for bone repair materials (BRMs). Over the years, scientists have been trying to develop BRMs and evaluate their efficacy using numerous developed methods. BRMs are characterized by osteogenesis and angiogenesis promoting properties, the latter of which has rarely been studied in vitro and in vivo. While blood vessels are required to provide nutrients. Bone mass maintains a dynamic balance under the joint action of osteolytic and osteogenic activity in which monocytes differentiate into osteolytic cells, and osteoprogenitor cells differentiate into osteogenic cells. This review would be helpful for inexperienced researchers as well as present a comprehensive overview of methods used to investigate the effect of BRMs on osteogenic cells, osteolytic cells, and blood vessels, as well as their biocompatibility and biological performance. This review is expected to facilitate further research and development of new BRMs.

Recent advances of two-dimensional materials in smart drug delivery nano-systems

Smart drug delivery nano-systems show significant changes in their physical or chemical properties in response to slight change in environmental physical and/or chemical signals, and further releasing drugs adjusted to the progression of the disease at the right target and rate intelligently. Two-dimensional materials possess dramatic status extend all over various scientific and technological disciplines by reason of their exceptional unique properties in application of smart drug delivery nano-systems. In this review, we summarized current progress to highlight various kinds of two-dimensional materials drug carriers which are widely explored in smart drug delivery systems as well as classification of stimuli responsive two-dimensional materials and the advantages and disadvantages of their applications. Consequently, we anticipate that this review might inspire the development of new two-dimensional materials with smart drug delivery systems, and deepen researchers' understanding of smart nano-carries based on two-dimensional materials.

Stimulation of bone formation by monocyte-activator functionalized graphene oxide in vivo

Nanosystems are able to enhance bone regeneration, a complex process requiring the mutual interplay between immune and skeletal cells. Activated monocytes can communicate pro-osteogenic signals to mesenchymal stem cells and promote osteogenesis. Thus, the activation of monocytes is a promising strategy to improve bone regeneration. Nanomaterials specifically selected to provoke immune-mediated bone formation are still missing. As a proof of concept, we apply here the intrinsic immune-characteristics of graphene oxide (GO) with the well-recognized osteoinductive capacity of calcium phosphate (CaP) in a biocompatible nanomaterial called maGO-CaP (monocytes activator GO complexed with CaP). In the presence of monocytes, the alkaline phosphatase activity and the expression of osteogenic markers increased. Studying the mechanisms of action, we detected an up-regulation of Wnt and BMP signaling, two key osteogenic pathways. The role of the immune activation was evidenced by the over-production of oncostatin M, a pro-osteogenic factor produced by monocytes. Finally, we tested the pro-osteogenic effects of maGO-CaP in vivo. maGO-CaP injected into the tibia of mice enhanced local bone mass and the bone formation rate. Our study suggests that maGO-CaP can activate monocytes to enhance osteogenesis ex vivo and in vivo.