Multifunctional Response of Piezoelectric Sodium Potassium Niobate (NKN)-Toughened Hydroxyapatite-Based Biocomposites

Promotion of quiescence and maintenance of function of mesenchymal stem cells on substrates with surface potential

The widespread use of human mesenchymal stem cells(hMSCs) is impeded by functional loss during prolonged expansion. Although multiple approaches have been attempted to preserve hMSCs stemness, a suitable culture system remains to be modified. The interaction between electrical signals and stem cells is expected to better maintain the function of stem cells. However, it remains unclear whether the surface potential of substrates has the potential to preserve stem cell function during in vitro expansion. In our study, hMSCs cultured on materials with different surface potentials could be induced into a reversible quiescent state, and we demonstrated that quiescent hMSCs could be reactivated and transitioned back into the proliferation cell cycle. hMSCs cultured under appropriate potential displayed superior differentiation and proliferation abilities within the same generation compared to conventional conditions. These findings underscore the importance of surface potential as a critical physical factor regulating hMSCs stemness. Manipulating the surface potential of hMSCs culture substrates holds promise for optimising preservation and culture conditions, thereby enhancing their application in tissue repair and regeneration engineering.

Evolution in Bone Tissue Regeneration: From Grafts to Innovative Biomaterials

Bone defects caused by various traumas and diseases such as osteoporosis, which affects bone density, and osteosarcoma, which affects the integrity of bone structure, are now well known. Given this situation, several innovative research projects have been reported to improve orthopedic methods and technologies that positively contribute to the regeneration of affected bone tissue, representing a significant advance in regenerative medicine. This review article comprehensively analyzes the transition from existing methods and technologies for implants and bone tissue regeneration to innovative biomaterials. These biomaterials have been of great interest in the last decade due to their physicochemical characteristics, which allow them to overcome the most common limitations of traditional grafting methods, such as the availability of biomaterials and the risk of rejection after their application in regenerative medicine. This could be achieved through an exhaustive study of the applications and properties of various materials with potential applications in regenerative medicine, such as using magnetic nanoparticles and hydrogels sensitive to external stimuli, including pH and temperature. In this regard, this review article describes the most relevant compounds used in bone tissue regeneration, promoting the integration of these biomaterials with the affected area's bone structure, thereby allowing for regeneration and preventing amputation. Additionally, the types of interactions between biomaterials and mesenchymal stem cells and their effects on bone tissue are discussed, which is critical for developing biomaterials with optimal regenerative properties. Furthermore, the mechanisms of action of the various biomaterials that enhance osteoconduction and osteoinduction, ensuring the success of orthopedic therapies, are analyzed. This enables the treatment of bone defects tailored to each patient's condition, thereby avoiding limb amputation. Consequently, a promising future for regenerative medicine is emerging, with various therapies that could revolutionize the management of bone defects, offering more efficient and safer solutions.

Injectable Piezoelectric Hydrogel Promotes Tendon-Bone Healing via Reshaping the Electrophysiological Microenvironment and M2 Macrophage Polarization

Rotator cuff tear (RCT) is a common musculoskeletal disease that poses challenges for functional regeneration of the tendon-bone interface (TBI). The transition of TBI between soft and hard tissues determines its structural and physiological environment complexity. Here, we present an injectable biopiezoelectric material PVA/CNF/BTO@PDA (Piezoelectric) hydrogel based on three-dimensional (3D) printing inspired by the "muscle-electrical coupling". This Piezoelectric hydrogel indicated desirable piezoelectric and mechanical properties, excellent biodegradability, and biosafety. In vitro, electrical stimulation from Piezoelectric hydrogel by the Flexcell Tissue Train system promoted the polarization of macrophages to the M2 phenotype, directing the targeted aggregation and zonal-specific differentiation of bone mesenchymal stem cells (BMSCs) for TBI formation. Also, optimal piezoelectric stimulation of the Piezoelectric hydrogel could alleviate inflammatory factor expression and regulate the osteotendinogenic differentiation of BMSCs under an H2O2/IL-1β inflammation environment. Furthermore, in vivo application of injectable Piezoelectric hydrogel demonstrates its regenerative potential, indicating that physiological repair with Piezoelectric hydrogel significantly accelerates and promotes TBI healing in a chronic RCT model. Therefore, our findings propose a new therapeutic strategy for functional TBI regeneration and enhance the treatment outcomes for RCT.

From electricity to vitality: the emerging use of piezoelectric materials in tissue regeneration

The unique ability of piezoelectric materials to generate electricity spontaneously has attracted widespread interest in the medical field. In addition to the ability to convert mechanical stress into electrical energy, piezoelectric materials offer the advantages of high sensitivity, stability, accuracy and low power consumption. Because of these characteristics, they are widely applied in devices such as sensors, controllers and actuators. However, piezoelectric materials also show great potential for the medical manufacturing of artificial organs and for tissue regeneration and repair applications. For example, the use of piezoelectric materials in cochlear implants, cardiac pacemakers and other equipment may help to restore body function. Moreover, recent studies have shown that electrical signals play key roles in promoting tissue regeneration. In this context, the application of electrical signals generated by piezoelectric materials in processes such as bone healing, nerve regeneration and skin repair has become a prospective strategy. By mimicking the natural bioelectrical environment, piezoelectric materials can stimulate cell proliferation, differentiation and connection, thereby accelerating the process of self-repair in the body. However, many challenges remain to be overcome before these concepts can be applied in clinical practice, including material selection, biocompatibility and equipment design. On the basis of the principle of electrical signal regulation, this article reviews the definition, mechanism of action, classification, preparation and current biomedical applications of piezoelectric materials and discusses opportunities and challenges for their future clinical translation.

Progress in the development of piezoelectric biomaterials for tissue remodeling

Piezoelectric biomaterials have demonstrated significant potential in the past few decades to heal damaged tissue and restore cellular functionalities. Herein, we discuss the role of bioelectricity in tissue remodeling and explore ways to mimic such tissue-like properties in synthetic biomaterials. In the past decade, biomedical engineers have adopted emerging functional biomaterials-based tissue engineering approaches using innovative bioelectronic stimulation protocols based on dynamic stimuli to direct cellular activation, proliferation, and differentiation on engineered biomaterial constructs. The primary focus of this review is to discuss the concepts of piezoelectric energy harvesting, piezoelectric materials, and their application in soft (skin and neural) and hard (dental and bone) tissue regeneration. While discussing the prospective applications as an engineered tissue, an important distinction has been made between piezoceramics, piezopolymers, and their composites. The superiority of piezopolymers over piezoceramics to circumvent issues such as stiffness mismatch, biocompatibility, and biodegradability are highlighted. We aim to provide a comprehensive review of the field and identify opportunities for the future to develop clinically relevant and state-of-the-art biomaterials for personalized and remote health care.

Accelerated Osteogenic Response of Electrodynamically Stimulated Mg1-xCaxSi1-xZrxO3 (x = 0-0.4) Bioelectrets

MgSiO3-based biodegradable ceramics demonstrated remarkable potential for treating small-scale bone defects and temporary bone replacement. In addition, the dissolution behavior of MgSiO3 bioceramics can be tuned by doping of Ca and Zr elements at Mg and Si sites, respectively. The present study reported the influence of formation of Ca- and Zr-codoped Mg1-xCaxSi1-xZrxO3 (x = 0, 0.1, 0.2, 0.3, and 0.4) bioelectrets and electrodynamic stimulation toward improving their osteogenic response. Mg1-xCaxSi1-xZrxO3 electrets were successfully synthesized by a solid-state route. A detailed X-ray photoelectron spectroscopy (XPS) analyses revealed that the electrets produced oxygen-deficient active sites. The formation of Mg1-xCaxSi1-xZrxO3 electrets significantly increased the surface hydrophilicity. Inductively coupled plasma (ICP) analyses were used to examine the leaching behavior of Ca/Zr-codoped MgSiO3 bioceramics. In vitro cell culture analyses indicated that the osteogenesis of MG-63 cells was remarkably enhanced on the electrodynamic field-treated Mg1-xCaxSi1-xZrxO3 bioelectrets as compared to hydroxyapatite (HA). Moreover, a better osteogenic response was observed for higher concentrations of Ca (0.3 and 0.4) and Zr (0.3 and 0.4) doping in the MgSiO3 bioelectrets. Further, the mechanism of enhanced cellular functionality was revealed by the measurement of intracellular Ca2+.

Exploring Multifunctional Response of Ca10(PO4)6(OH)2-K0.5Na0.5NbO3 Ceramic Composite for Biomedical Applications

This study focuses on investigating the intriguing properties of Ca10(PO4)6(OH)2 (HAP)-K0.5Na0.5NbO3 (KNN) bioceramic composites, seeking to elucidate the relationship between their structural, electrical, biological, and optical behavior. The article begins with a close inspection of the O 1s spectra of the specimens obtained from X-ray photoelectron spectroscopy (XPS). The spectra reveal the peak related to lattice oxygen, O vacancy and the surface adsorbed O. The formed O vacancy strongly influences the changes in lattice parameters as observed from the X-ray diffraction (XRD) patterns. The frequency variation of the dielectric response for the composites in the radio frequency (RF) regime has electrical polarization effective for biomedical applications. Nyquist plots along with equivalent RC circuits further confirm that those electrical responses are mainly contributed from the grain boundaries. Adsorption dynamics of protein on the ceramic surface are investigated using bovine serum albumin (BSA), which established the major role of electrostatic interaction. Surface charge and O vacancies are modeled to understand the adsorption of protein and a linear correlation is reported. The role of O vacancies in modulating adsorption dynamics adds a new dimension to this study. The conformational change of BSA has also been considered by constructing the secondary structure following the protein-ceramic interaction. Excitingly, the composites are also found to be fluorescent active, a courtesy of the defects and vacancies leading to electron-hole recombination in the forbidden region. These promising properties envision an exciting future for HAP-KNN composites, especially in the domain of bioimaging and bone-tissue engineering.

Synthesis and in vitro antibacterial behavior of curcumin-conjugated gold nanoparticles

Owing to the rise in multidrug-resistant bacterial diseases and the dwindling supply of newer antibiotics, it is crucial to discover newer compounds or modify current compounds for more effective antimicrobial therapies. According to reports, more than 80% of bacterial infections have been linked to bacterial biofilms. In addition to having antimicrobial properties, the hydrophobic polyphenol curcumin (Cur) also inhibits quorum sensing. The application of curcumin was constrained by its weak aqueous solubility and quick degradation. Over the past years, nanotechnology-based biomaterials with multi-functional characteristics have been engineered with high interest. The present study focused on the development of nano-biomaterials with excellent testifiers for bacterial infection in vitro. In this study, water dispersibility and stability of curcumin were improved through conjugation with gold nanoparticles. The successful synthesis of curcumin-conjugated gold nanoparticles (Cur-AuNPs) was confirmed using X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, and UV-vis absorbance spectroscopy. Transmission electron microscopy (TEM) revealed an average particle size of about 10-13 nm. The antibacterial characteristics in terms of the minimum inhibitory concentration (MIC) of Cur-AuNP treatments were found to be lowest than those with AuNPs and Cur treatments. The quantitative analysis revealed the superior antibacterial characteristics of Cur-AuNP-treated bacterial cells compared to the untreated samples. In addition, curcumin-conjugated AuNPs, produced more reactive oxygen species and increased the membrane permeability. Besides, the biocompatibility of Cur-AuNPs was also assessed quantitatively and qualitatively. Statistical analyses revealed the augmented MG-63 cell proliferation in Cur-AuNPs compared to those with Cur and AuNPs treatments. Overall, Cur-AuNPs exhibited enhanced antibacterial, and antibiofilm characteristics and cytocompatibility.

A biomimetic piezoelectric scaffold with sustained Mg2+ release promotes neurogenic and angiogenic differentiation for enhanced bone regeneration

Natural bone is a composite tissue made of organic and inorganic components, showing piezoelectricity. Whitlockite (WH), which is a natural magnesium-containing calcium phosphate, has attracted great attention in bone formation recently due to its unique piezoelectric property after sintering treatment and sustained release of magnesium ion (Mg²⁺). Herein, a composite scaffold (denoted as PWH scaffold) composed of piezoelectric WH (PWH) and poly(ε-caprolactone) (PCL) was 3D printed to meet the physiological demands for the regeneration of neuro-vascularized bone tissue, namely, providing endogenous electric field at the defect site. The sustained release of Mg²⁺ from the PWH scaffold, displaying multiple biological activities, and thus exhibits a strong synergistic effect with the piezoelectricity on inhibiting osteoclast activation, promoting the neurogenic, angiogenic, and osteogenic differentiation of bone marrow mesenchymal stromal cells (BMSCs) in vitro. In a rat calvarial defect model, this PWH scaffold is remarkably conducive to efficient neo-bone formation with rich neurogenic and angiogenic expressions. Overall, this study presents the first example of biomimetic piezoelectric scaffold with sustained Mg²⁺ release for promoting the regeneration of neuro-vascularized bone tissue in vivo, which offers new insights for regenerative medicine.

An in vivo toxicity assessment of piezoelectric sodium potassium niobate [NaxK1-xNbO3 (x = 0.2-0.8)] nanoparticulates towards bone tissue engineering approach

One of the recent challenges in the design/development of prosthetic orthopedic implants is to address the concern of local/systemic toxicity of debris particles, released due to wear or degradation. Such debris particles often lead to inflammation at the implanted site or aseptic loosening of the prosthesis which results in failure of the implant during long run. Several in vitro studies demonstrated the potentiality of piezoelectric sodium potassium niobate [Na_xK_1-xNbO₃ (x = 0.2, 0.5, 0.8), NKN] as an emerging next-generation polarizable orthopedic implant. In this perspective, we performed an in vivo study to examine the local and systemic toxicity of NKN nanoparticulates, as a first report. In the present study, male Wistar rats were intra-articularly injected to the knee joint with 100 μl of NKN nanoparticulates (25 mg/ml in normal saline). After 7 days of exposure, the histopathological analyses demonstrate the absence of any inflammation or dissemination of nanoparticulates in vital organs such as heart, liver, kidney and spleen. The anti-inflammatory cytokines (IL-4 and IL-10) profile analyses suggest the increased anti-inflammatory response in the treated rats as compared to non-injected (control) rats, preferably for the sodium and potassium rich NKN i.e., Na_0.8K_0.2NbO₃ and Na_0.2K_0.8NbO₃. The biochemical analyses revealed no pathological changes in the liver and kidney of particulate treated rats. The present study is the first proof to confirm the non-toxic nature of NKN nanoparticulates which provides a step forward towards the development of prosthetic orthopedic implants using biocompatible piezoelectric NKN ceramics.

Interplay of surface polarization charge, dynamic electrical stimulation and compositional modification towards accelerated osteogenic response of NaxK1-xNbO3 piezo-bioceramics

Bone remodeling processes involve endogenous bioelectrical signals such as piezoelectric charges. Moreover, external electrical stimulation helps in improving the healing capability of injured tissues by modulating the metabolic signaling pathways of cells. Towards this end, the present study reveals the influence of the combined action of electrostatic surface polarization charge and dynamic pulsed electrical stimulation alongwith compositional modification towards improving the osteogenic response of emerging piezo-bioceramics, sodium potassium niobate [Na_xK_1-xNbO₃ (x = 0.2-0.8), NKN]. The dependence of crystal structure on compositions (x) was retrieved by Rietveld refinement and X-ray peak profile analyses. The surface charge, stored in the polarized (@ 25 kV at 500 °C) Na_xK_1-xNbO₃ (x = 0.2, 0.5, 0.8) samples were measured to be 0.52, 0.50 and 0.47 μC/cm², respectively, using thermally stimulated depolarized current (TSDC). X-ray photoelectron spectroscopy (XPS) survey scan spectra revealed that the polarization process does not alter the surface chemistry of NKN. Negatively charged surfaces are observed to accelerate early-stage adhesion of osteoblast-like cells which further results in enhanced spreading of adhered cells. Subsequently, the dynamic pulsed electrical stimulation of 1 V/cm with the pulse duration of 400 μs was applied, while the cells were being adhered on electrostatically charged surfaces. The quantitative and qualitative analyses revealed that the synergistic action of electrostatic surface polarization charge and dynamic pulsed electrical stimulation further accelerates cell proliferation and differentiation on negatively charged surfaces of Na and K-rich compositions of NKN. The mechanism of augmented cellular activity was analyzed using intracellular Ca²⁺ measurement.

Comparative review of piezoelectric biomaterials approach for bone tissue engineering

Bone as a minerals' reservoir and rigid tissue of the body generating red and white blood cells supports various organs. Although the self-regeneration property of bone, it cannot regenerate spontaneously in severe damages and still remains as a challenging issue. Tissue engineering offers several techniques for regenerating damaged bones, where various biomaterials are examined to fabricate scaffolds for bone repair. Piezoelectric characteristic plays a crucial role in repairing and regenerating damaged bone by mimicking the bone niche behavior. Piezoelectric biomaterials show significant potential for bone tissue engineering. Herein we try to have a comparative review on piezoelectric and non-piezoelectric biomaterials used in bone tissue engineering, classified them, and discussed their effects on implanted cells and manufacturing techniques. Especially, Polyvinylidene fluoride (PVDF) and its composites are the most practically used piezoelectric biomaterials for bone regeneration. PVDF and its composites have been summarized and discussed to repair damaged bone tissues.

A healing promoting wound dressing with tailor-made antibacterial potency employing piezocatalytic processes in multi-functional nanocomposites

Developing a novel antibiotics-free antibacterial strategy is essential for minimizing bacterial resistance. Materials that not only kill bacteria but also promote tissue healing are especially challenging to achieve. Inspired by chemical conversion processes in living organisms, we develop a piezoelectrically active antibacterial device that converts ambient O₂ and H₂O to ROS by piezocatalytic processes. The device is achieved by mounting nanoscopic polypyrrole/carbon nanotube catalyst multilayers onto piezoelectric-dielectric films. Under stimuli by a hand-held massage device, the sterilizing rates for S. aureus and E. coli reach 84.11% and 94.85% after 10 minutes of operation, respectively. The antibacterial substrate at the same time preserves and releases drugs and presents negligible cytotoxicity. Animal experiments demonstrate that daily treatment for 10 minutes using the device effectively accelerates the healing of infected wounds on the backs of mice, promoting hair follicle generation and collagen deposition. We believe that this report provides a novel design approach for antibacterial strategies in medical treatment.

Improved antibacterial and cellular response of electrets and piezobioceramics

The bacterial contamination in implants has been recognized as one of the key issues in orthopedics. In this article, a new technique of electrical polarization of various non-piezoelectric and piezoelectric biocompatible ceramics has been explored to develop antibacterial implants. Optimally processed hydroxyapatite (HA), BaTiO₃ (BT), CaTiO₃ (CT), Na_0.5K_0.5NbO₃ (NKN) and their composites have been used as model biomaterials to verify the concept. The phase evolution analyses and microstructural characterizations were performed for sintered samples. The samples were polarized at polarizing voltage and temperature of 20 kV and 500°C, respectively, for 30 min. The hydrophilicity of polarized surfaces was examined using deionized water and culture media. The polarization induced in-vitro antibacterial study was performed for both, gram positive and gram negative bacteria. The viability of Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) bacteria reduces significantly on the polarized surfaces. In addition, the influence of polarization on antibacterial response has been explored via various mechanisms such as development of reactive oxygen species (ROS), catalase activity and lipoperoxidation. Furthermore, the cellular response of polarized surfaces was also examined using SaOS2 and MG-63 cells. The viability of SaOS2 and MG-63 cells was observed to increase significantly on negatively polarized surfaces. Overall, the surface treatment enhances the antibacterial response of HA, NKN, BT, CT and their composites surfaces with positive influence on cellular response.

Bright Luminescent Carbon Dots for Multifunctional Selective Sensing and Imaging Applications in Living Cells

Luminescent carbon dots (CDs) have become attractive materials because of their superior photophysical properties and various potential applications. However, most of the formerly developed CDs only have strong blue emission, which limits their further applications, particularly in bioimaging. Herein luminescent CDs have been successfully synthesized via a one-pot solvothermal process using 4-bromoaniline and ethylenediamine as starting materials. The luminescent CDs emit strong green fluorescence with high quantum yield as well as excellent biocompatibility and biolabeling potentials. At first, the luminescent CDs exhibited high selectivity for phosgene with a turn-off fluorescence detection. The limit of detection was 81 nM, which is sensitive for the determination of phosgene over other competing toxic pollutants. In addition, the luminescent CDs have shown a three-state "on-off-on" emission with the stepwise addition of Ag⁺ and cysteine (Cys). Luminescent CDs show fluorescence quenching by Ag⁺ and fluorescence regaining with further addition of Cys, with lower detection limits of 3.9 μM (Ag⁺) and 3.4 μM (Cys), respectively. The luminescent CDs were utilized to obtain a clear fingerprint. During the drying process, the coffee ring effect and electrostatic interaction between the positive surface charge of amine-functionalized CDs and negatively charged fingerprint residues facilitate the formation of clear fingerprints on different platforms.