Bifunctional Hydrogel-Integrated 3D Printed Scaffold for Repairing Infected Bone Defects

"Monitor-and-treat" that integrates bacterio-therapeutics and bio-optics for infected wound management

Wound infections are one of the major threats to human health, accounting for millions of deaths annually. Real-time monitoring, accurate diagnosis, and on-demand therapy are crucial to minimizing complications and saving lives. Herein, we propose a "monitor-and-treat" strategy for infected wound management by integrating the emerging development of bacterio-therapeutics and bio-optics. The upper layer consists of gelatin methacryloyl (GelMA)-collagen III methacryloyl (Col3MA) (GC), Reuterin (Reu) isolated from the probiotic Lactobacillus reuteri (L. reuteri) and microfluidic safflower polysaccharide (SPS)@GelMA microspheres using 3D printing technology. The lower layer is made of acryloylated glycine (ACG) hydrogel with tissue adhesion capability, which enables the hydrogel to adapt to the movement and stretching of the skin. By integrating temperature-sensitive polydimethylsiloxane (PDMS) optical fibers, the ACG-GC/Reu/SPS-PDMS hydrogel could accurately and steadily sense and send wound temperature information to intelligent devices for real-time monitoring of the healing status ("monitor"). The double-layered hydrogel not only inhibited bacterial survival and colonization (97.4 % against E. coli and 99 % against S. aureus), but also exhibited remarkable hemostatic properties. Furthermore, it was conducive to L929 cell proliferation and pro-angiogenesis, and promoted the polarization of pro-inflammatory M1 macrophages to the anti-inflammatory M2-phenotype, therefore creating a favorable immune microenvironment at the wound site. Animal experiments using SD rats and Bama minipigs demonstrated that this hydrogel promoted wound closure, directed polarization to M2 macrophages, alleviated inflammation, enhanced neovascularization, therefore accelerating infected wound healing ("treat"). In addition, RNA-Seq analysis revealed the mechanism of action of ACG-GC/Reu/SPS-PDMS hydrogel in modulating key signaling pathways, including down-regulation of AMPK, IL-17, and NF-κB signaling pathways, activation of NLRP3 inflammatory vesicles, and enrichment of MAPK, TGF-β, PI3K-Akt, TNF, and VEGF signaling pathways. The modulation of these signaling pathways suggests that hydrogels play an important role in the molecular mechanisms that promote wound healing and tissue regeneration. Therefore, the design of this study provides an innovative and multifunctional bandage strategy that can significantly improve pathologic diagnosis and wound treatment.

Addressing the challenges of infectious bone defects: a review of recent advances in bifunctional biomaterials

Infectious bone defects present a substantial clinical challenge due to the complex interplay between infection control and bone regeneration. These defects often result from trauma, autoimmune diseases, infections, or tumors, requiring a nuanced approach that simultaneously addresses infection and promotes tissue repair. Recent advances in tissue engineering and materials science, particularly in nanomaterials and nano-drug formulations, have led to the development of bifunctional biomaterials with combined osteogenic and antibacterial properties. These materials offer an alternative to traditional bone grafts, minimizing complications such as multiple surgeries, high antibiotic dosages, and lengthy recovery periods. This review examines the repair mechanisms in the infectious microenvironment and highlights various bifunctional biomaterials that foster both anti-infective and osteogenic processes. Emerging design strategies are also discussed to provide a forward-looking perspective on treating infectious bone defects with clinically significant outcomes.

Advancements in 3D gel culture systems for enhanced angiogenesis in bone tissue engineering

Angiogenesis-osteogenesis coupling is a crucial process in bone tissue engineering, requiring a suitable material structure for vessel growth. Recently, the 3D culture system has gained significant attention due to its benefits in cell growth, proliferation and tissue regeneration. Its most notable advantage is its ECM-like function, which supports endothelial cell adhesion and facilitates the formation of vascular-like networks-crucial for angiogenesis-osteogenesis coupling. Hydrogels, with their highly hydrophilic polymer network resembling the extracellular matrix, make the 3D gel culture system an ideal approach for angiogenesis due to its cellular integrity and adjustable properties. This article reviews the current use of 3D gel culture systems in bone tissue engineering, covering substrates, characteristics and processing technologies, thereby offering readers profound insights into these systems.

Dentin tubules as a long-term sustained release carrier to accelerate bone repair by loading FTY720

The controlled release of drugs remains a huge challenge in the field of tissue engineering. Current research focuses on the construction of drug carriers by using various advanced technologies. However, the pore-like structure that exists within our human body is ignored. Herein, a dental particle loaded with FTY720 by using dentin tubules (Dent-FTY720) was successfully prepared, which could achieve long-term sustained release of drugs. Meanwhile, Dent-FTY720 significantly promoted bone defect repair because of the similarity in composition to bone including hydroxyapatite and collagen. Furthermore, the loaded drugs exhibited both anti-immune and anti-inflammatory properties. This research introduces a novel concept in drug loading, highlighting the potential of dentin tubules as a drug delivery system.

A review of self-healing hydrogels for bone repair and regeneration: Materials, mechanisms, and applications

Bone defects, which arise from various factors such as trauma, tumor resection, and infection, present a significant clinical challenge. There is an urgent need to develop new biomaterials capable of repairing a wide array of damage and defects in bone tissue. Self-healing hydrogels, a groundbreaking advancement in the field of biomaterials, displaying remarkable ability to regenerate damaged connections after partial severing, thus offering a promising solution for bone defect repair. This review first presents a comprehensive overview of the progress made in the design and preparation of these hydrogels, focusing on the self-healing mechanisms based on physical non-covalent interactions and dynamic chemical covalent bonds. Subsequently, the applications of self-healing hydrogels including natural polymers, synthetic polymers, and nano-hybrid materials, are discussed in detail, emphasizing their mechanisms in promoting bone tissue regeneration. Finally, the review addresses current challenges as well as future prospects for the use of hydrogels in bone repair and regeneration, identifying osteogenic properties, mechanical performance, and long-term biocompatibility as key areas for further improvement. In summary, this paper provides an in-depth analysis of recent advances in self-healing hydrogels for bone repair and regeneration, underscoring their immense potential for clinical application.

Progress in the Application of Multifunctional Composite Hydrogels in Promoting Tissue Repair

Tissue repair is an extremely complex process, and effectively promoting tissue regeneration remains a significant clinical challenge. Hydrogel materials, which exhibit physical properties closely resembling those of living tissues, including high water content, oxygen permeability, and softness, have the potential to revolutionize the field of tissue repair. However, the presence of various complex conditions, such as infection, ischemia, and hypoxia in tissue defects, means that hydrogels with simple structures and functions are often insufficient to meet the diverse needs of tissue repair. Researchers have focused on integrating multiple drugs, nanomaterials, bioactive substances, and stem cells into hydrogel matrices to develop novel multifunctional composite hydrogels for addressing these challenges, which have superior antibacterial properties, hemostatic abilities, self-healing capacities, and excellent mechanical properties. These composite hydrogels are designed to enhance tissue repair and have become an important direction in the current research. This review provides a comprehensive review of the recent advances in the application of multifunctional composite hydrogels in promoting tissue repair, including drug-loaded hydrogels, nanomaterial composite hydrogels, bioactive substance composite hydrogels, and stem cell composite hydrogels.

Advances in 3D printing technology for preparing bone tissue engineering scaffolds from biodegradable materials

Introduction

Bone tissue engineering (BTE) provides an effective repair solution by implanting osteoblasts or stem cells into biocompatible and biodegradable scaffolds to promote bone regeneration. In recent years, the rapid development of 3D bioprinting has enabled its extensive application in fabricating BTE scaffolds. Based on three-dimensional computer models and specialized "bio-inks," this technology offers new pathways for customizing BTE scaffolds. This study reviews the current status and future prospects of scaffold materials for BTE in 3D bioprinting.

Methods

This literature review collected recent studies on BTE and 3D bioprinting, analyzing the advantages and limitations of various scaffold materials for 3D printing, including bioceramics, metals, natural polymers, and synthetic polymers. Key characteristics like biocompatibility, mechanical properties, and degradation rates of these materials were systematically compared.

Results

The study highlights the diverse performances of materials used in BTE scaffolds. Bioceramics exhibit excellent biocompatibility but suffer from brittleness; metals offer high strength but may induce chronic inflammation; natural polymers are biocompatible yet have poor mechanical properties, while synthetic polymers offer strong tunability but may produce acidic by-products during degradation. Additionally, integrating 3D bioprinting with composite materials could enhance scaffold biocompatibility and mechanical properties, presenting viable solutions to current challenges.

Discussion

This review summarizes recent advances in 3D bioprinting for BTE scaffold applications, exploring the strengths and limitations of various materials and proposing composite material combinations to improve scaffold performance. By optimizing material selection and combinations, 3D bioprinting shows promise for creating customized scaffolds, offering a new technical route for clinical applications of BTE. This research provides a unique perspective and theoretical support for advancing 3D bioprinting technology in bone regeneration, outlining future directions for BTE materials and 3D bioprinting technology development.

Vancomycin-Loaded in situ Gelled Hydrogel as an Antibacterial System for Enhancing Repair of Infected Bone Defects

Purpose

During treatment of infected bone defects, control of infection is necessary for effective bone repair, and hence controlled topical application of antibiotics is required in clinical practice. In this study, a biodegradable drug delivery system with in situ gelation at the site of infection was prepared by integrating vancomycin into a polyethylene glycol/oxidized dextran (PEG/ODEX) hydrogel matrix.

Methods

In this work, PEG/ODEX hydrogels were prepared by Schiff base reaction, and vancomycin was loaded into them to construct a drug delivery system with controllable release and degradability. We first examined the microstructure, degradation time and drug release of the hydrogels. Then we verified the biocompatibility and in vitro ability of the release system. Finally, we used a rat infected bone defect model for further experiments.

Results

The results showed that this antibacterial system could be completely biodegradable in vivo for 56 days, and its degradation products did not cause specific inflammatory response. The cumulative release of vancomycin from the antibacterial system was 58.3% ± 3.8% at 14 days and 78.4% ± 3.2% at 35 days. The concentration of vancomycin in the surrounding environment was about 1.2 mg/mL, which can effectively remove bacteria. Further studies in vivo showed that the antibacterial system cleared the infection and accelerated repair of infected bone defects in the femur of rats. There was no infection in rats after 8 weeks of treatment. The 3D image analysis of the experimental group showed that the bone volume fraction (BV/TV) was 1.39-fold higher (p < 0.001), the trabecular number (Tb.N) was 1.31-fold higher (p < 0.05), and the trabecular separation (Tb.Sp) was 0.58-fold higher than those of the control group (p < 0.01).

Conclusion

In summary, this study clearly demonstrates that a clinical strategy based on biological materials can provide an innovative and effective approach to treatment of infected bone defects.

3D Printing of Polysaccharide-Based Hydrogel Scaffolds for Tissue Engineering Applications: A Review

In tissue engineering, 3D printing represents a versatile technology employing inks to construct three-dimensional living structures, mimicking natural biological systems. This technology efficiently translates digital blueprints into highly reproducible 3D objects. Recent advances have expanded 3D printing applications, allowing for the fabrication of diverse anatomical components, including engineered functional tissues and organs. The development of printable inks, which incorporate macromolecules, enzymes, cells, and growth factors, is advancing with the aim of restoring damaged tissues and organs. Polysaccharides, recognized for their intrinsic resemblance to components of the extracellular matrix have garnered significant attention in the field of tissue engineering. This review explores diverse 3D printing techniques, outlining distinctive features that should characterize scaffolds used as ideal matrices in tissue engineering. A detailed investigation into the properties and roles of polysaccharides in tissue engineering is highlighted. The review also culminates in a profound exploration of 3D polysaccharide-based hydrogel applications, focusing on recent breakthroughs in regenerating different tissues such as skin, bone, cartilage, heart, nerve, vasculature, and skeletal muscle. It further addresses challenges and prospective directions in 3D printing hydrogels based on polysaccharides, paving the way for innovative research to fabricate functional tissues, enhancing patient care, and improving quality of life.

Silicon-containing nanomedicine and biomaterials: materials chemistry, multi-dimensional design, and biomedical application

The invention of silica-based bioactive glass in the late 1960s has sparked significant interest in exploring a wide range of silicon-containing biomaterials from the macroscale to the nanoscale. Over the past few decades, these biomaterials have been extensively explored for their potential in diverse biomedical applications, considering their remarkable bioactivity, excellent biocompatibility, facile surface functionalization, controllable synthesis, etc. However, to expedite the clinical translation and the unexpected utilization of silicon-composed nanomedicine and biomaterials, it is highly desirable to achieve a thorough comprehension of their characteristics and biological effects from an overall perspective. In this review, we provide a comprehensive discussion on the state-of-the-art progress of silicon-composed biomaterials, including their classification, characteristics, fabrication methods, and versatile biomedical applications. Additionally, we highlight the multi-dimensional design of both pure and hybrid silicon-composed nanomedicine and biomaterials and their intrinsic biological effects and interactions with biological systems. Their extensive biomedical applications span from drug delivery and bioimaging to therapeutic interventions and regenerative medicine, showcasing the significance of their rational design and fabrication to meet specific requirements and optimize their theranostic performance. Additionally, we offer insights into the future prospects and potential challenges regarding silicon-composed nanomedicine and biomaterials. By shedding light on these exciting research advances, we aspire to foster further progress in the biomedical field and drive the development of innovative silicon-composed nanomedicine and biomaterials with transformative applications in biomedicine.

Insights into Translational and Biomedical Applications of Hydrogels as Versatile Drug Delivery Systems

Hydrogels are a network of crosslinked polymers which can hold a huge amount of water in their matrix. These might be soft, flexible, and porous resembling living tissues. The incorporation of different biocompatible materials and nanostructures into the hydrogels has led to emergence of multifunctional hydrogels with advanced properties. There are broad applications of hydrogels such as tissue culture, drug delivery, tissue engineering, implantation, water purification, and dressings. Besides these, it can be utilized in the field of medical surgery, in biosensors, targeted drug delivery, and drug release. Similarly, hyaluronic acid hydrogels have vast applications in biomedicines such as cell delivery, drug delivery, molecule delivery, micropatterning in cellular biology for tissue engineering, diagnosis and screening of diseases, tissue repair and stem cell microencapsulation in case of inflammation, angiogenesis, and other biological developmental processes. The properties like swellability, de-swellability, biodegradability, biocompatibility, and inert nature of the hydrogels in contact with body fluids, blood, and tissues make its tremendous application in the field of modern biomedicines nowadays. Various modifications in hydrogel formulations have widened their therapeutic applicability. These include 3D printing, conjugation, thiolation, multiple anchoring, and reduction. Various hydrogel formulations are also capable of dual drug delivery, dental surgery, medicinal implants, bone diseases, and gene and stem cells delivery. The presented review summarizes the unique properties of hydrogels along with their methods of preparation and significant biomedical applications as well as different types of commercial products available in the market and the regulatory guidance.

Potential Applications and Additive Manufacturing Technology-Based Considerations of Mesoporous Silica: A Review

Nanoporous materials are categorized as microporous (pore sizes 0.2-2 nm), mesoporous (pore sizes 2-50 nm), and macroporous (pore sizes 50-1000 nm). Mesoporous silica (MS) has gained a significant interest due to its notable characteristics, including organized pore networks, specific surface areas, and the ability to be integrated in a variety of morphologies. Recently, MS has been widely accepted by range of manufacturer and as drug carrier. Moreover, silica nanoparticles containing mesopores, also known as mesoporous silica nanoparticles (MSNs), have attracted widespread attention in additive manufacturing (AM). AM commonly known as three-dimensional printing is the formalized rapid prototyping (RP) technology. AM techniques, in comparison to conventional methods, aid in reducing the necessity for tooling and allow versatility in product and design customization. There are generally several types of AM processes reported including VAT polymerization (VP), powder bed fusion (PBF), sheet lamination (SL), material extrusion (ME), binder jetting (BJ), direct energy deposition (DED), and material jetting (MJ). Furthermore, AM techniques are utilized in fabrication of various classified fields such as architectural modeling, fuel cell manufacturing, lightweight machines, medical, and fabrication of drug delivery systems. The review concisely elaborates on applications of mesoporous silica as versatile material in fabrication of various AM-based pharmaceutical products with an elaboration on various AM techniques to reduce the knowledge gap.

Research progress on biodegradable polymeric platforms for targeting antibiotics to the bone

The treatment of bone infections still involves systemic or local antibiotic therapy in high doses for prolonged periods. Current research focuses on the application of different drug delivery systems to the bone, aiming at a targeted local administration that will decrease the number of drugs used and their toxicity, compared to the systemic route. The gold standard in clinical practice is currently poly(methyl methacrylate) (PMMA) cement. The main drawback of PMMA, however, is that it is non-biodegradable, requiring a second follow-up surgery to remove the implant. Biodegradable delivery systems, on the other hand, are easily resorbable within the organism, and less invasive alternative with better patient compliance. Among biodegradable materials, natural and synthetic polymers are being studied as local drug delivery systems due to their excellent biocompatibility, sustained effect, and antibiotic release with high penetrability to infected bone and soft tissue. In this review, we focus on biodegradable polymeric platforms, such as micro- and nanoparticles, scaffolds, and hydrogels, as well as multi-delivery systems for targeting antibiotics to the bone. Additionally, we discuss the reported drug release profiles that provide important information about the systems' functionality.