Mechanical regulation of bone remodeling

A stress-driven model for bone density evolution in rats during orthodontic tooth movement

Orthodontic bone remodeling simulations offer a scientific foundation for optimizing treatment plans and predicting outcomes in orthodontics. Since alveolar bone exhibits unique regional responses and high sensitivity to tensile and compressive stresses, traditional models often fail to account for these characteristics, limiting their accuracy in predicting the microstructural changes of alveolar bone under external forces. To address this issue, this study proposes a bone remodeling model based on equivalent stress derived from the Mohr strength theory as the mechanical stimulus. The model differentiates tension and compression zones within the alveolar bone and simulates density changes driven by the orthodontic remodeling process: bone formation in tension zone and resorption in compression zone. Orthodontic experiments on rats were conducted to monitor changes in alveolar bone density at 7 and 14 days. Results revealed a density increase of around 3.16% and 9.84% in tension zone and a decrease of approximately 4.86% and 3.61% in compression zone on days 7 and 14, respectively. A comparison between the experimental data and the simulation results of the bone remodeling algorithm demonstrated a consistent trend, validating that the proposed model effectively reflects the dynamic process of bone remodeling. This study provides a new perspective for orthodontic bone remodeling simulations and lays a foundation for further exploration of the mechanisms underlying alveolar bone density changes.

Mechanical and biological characteristics of 3D-printed auxetic structure in bone tissue engineering

The auxetic structures are highly effective in bone implants due to their unique deformation characteristics. However, ideal tissue engineering scaffolds must possess suitable mechanical properties and biocompatibility. The biological effects of auxetic structures require further study. In this study, three types of 3D re-entrant honeycomb structures with varying angles of 75°, 90°, and 105° were designed. These structures were fabricated by stereolithography 3D printing technology. Finite element simulations and compression tests were conducted to evaluate their mechanical properties. Scaffolds were inoculated with preosteoblast MC3T3-E1 cells, and cyclic loading was applied to investigate the influence of structural and mechanical stimulation on cell arrangement and proliferation. The results demonstrated that the 75° scaffold exhibited auxetic characteristics in all compression directions and possessed anti-fracture properties. The 75° scaffold also promoted cell proliferation by structural design. Cyclic compression facilitated the nuclear translocation of YAP, further enhancing cell growth. The combination of anti-fracture properties and the promotion of cell proliferation makes auxetic structures highly promising for extensive applications.

Metabolite-dependent m6A methylation driven by mechanotransduction-metabolism-epitranscriptomics axis promotes bone development and regeneration

Intramembranous ossification, a major bone development process, begins with the condensation of precursor cells through the timely structural adaption of extracellular matrix (ECM) catering to rapid cellular morphological changes. Inspired by this, we design a highly cell-adaptable hydrogel to recapitulate an ECM-dependent mechanotransduction-metabolism-epitranscriptomics axis in mesenchymal stromal cells (MSCs). This hydrogel significantly enhances the E-cadherin-mediated cell-cell interactions of MSCs and promotes glucose uptake and tricarboxylic acid (TCA) cycle activities. We further show that elevated succinate inhibits fat mass and obesity-associated protein (FTO), a N6-methyladenosine (m6A) demethylase, thereby enhancing methyltransferase-like 3 (METTL3)-driven m6A methylation. Methylated RNA immunoprecipitation sequencing (MeRIP-seq) indicates increased m6A methylation of runt-related transcription 2 (Runx2), a key osteogenic signaling factor, promoting osteogenesis of hydrogel-delivered MSCs and bone regeneration in critical-sized bone defects. Our findings reveal the mechanism underlying the critical impact of adaptable ECM structures on tissue development and provide valuable guidance for the design of ECM-mimetic cell carriers to enhance the therapeutic outcomes of regenerative medicine.

Injectable microgel and micro-granular hydrogels for bone tissue engineering

Injectable microgels, made from both natural and synthetic materials, are promising platforms for the encapsulation of cells or bioactive agents, such as drugs and growth factors, for delivery to injury sites. They can also serve as effective micro-scaffolds in bone tissue engineering (BTE), offering a supportive environment for cell proliferation or differentiation into osteoblasts. Microgels can be injected in the injury sites individually or in the form of aggregated/jammed ones named micro-granular hydrogels. This review focuses on common materials and fabrication techniques for preparing injectable microgels, as well as their characteristics and applications in BTE. These applications include their use as cell carriers, delivery systems for bioactive molecules, micro-granular hydrogels, bio-inks for bioprinting, three-dimensional microarrays, and the formation of microtissues. Furthermore, we discuss the current and potential future applications of microgels in bone tissue regeneration.

Biomechanics and Mechanobiology of Additively Manufactured Porous Load-Bearing Bone Implants

Given that they can replicate both the biomechanical and mechanobiological functions of natural bone, metal additively manufactured porous load-bearing bone implants present a significant advancement in orthopedic applications. Additive manufacturing (AM) of metals enables precise control over pore geometry, resulting in implants that provide effective mechanical support and minimize stress shielding. In addition to its mechanical benefits, the porous architecture of the implants facilitates essential mechanobiological processes, including the transmission of mechanical signals that regulate cellular processes such as adhesion, proliferation, and differentiation. Before clinical use, the implants should first be engineered to achieve a comparable elastic modulus to native bone, mitigating implant-induced bone resorption while promoting tissue regeneration. It is also noteworthy that the microstructural features of these implants support angiogenesis-a critical process for oxygen and nutrient delivery during bone healing. Despite their potential benefits, challenges remain in balancing mechanical stability for load-bearing applications with biofunctionality for effective integration and controlled degradation. This review comprehensively discusses the biomechanical and mechanobiological factors influencing the design and performance of additively manufactured porous bone implants, highlighting their potential to enhance clinical outcomes in bone repair and regeneration.

Hydrogels with programmed spatiotemporal mechanical cues for stem cell-assisted bone regeneration

Hydrogels are extensively utilized in stem cell-based tissue regeneration, providing a supportive environment that facilitates cell survival, differentiation, and integration with surrounding tissues. However, designing hydrogels for regenerating hard tissues like bone presents significant challenges. Here, we introduce macroporous hydrogels with spatiotemporally programmed mechanical properties for stem cell-driven bone regeneration. Using liquid-liquid phase separation and interfacial supramolecular self-assembly of protein fibres, the macroporous structure of hydrogels provide ample space to prevent contact inhibition during proliferation. The rigid protein fibre-coated pore shell provides sustained mechanical cues for guiding osteodifferentiation and protecting against mechanical loads. Temporally, the hydrogel exhibits tunable degradation rates that can synchronize with new tissue deposition to some extent. By integrating localized mechanical heterogeneity, macroporous structures, surface chemistry, and regenerative degradability, we demonstrate the efficacy of these stem cell-encapsulated hydrogels in rabbit and porcine models. This marks a substantial advancement in tailoring the mechanical properties of hydrogels for stem cell-assisted tissue regeneration.

Microstructural and transcriptomic characterization of trabecular bone in idiopathic osteonecrosis of the femoral head

This study aimed to investigate whether idiopathic osteonecrosis of the femoral head (ONFH) is associated with alterations in the microstructure, histological characteristics, and transcriptomic signature in the trabecular region of the femoral head. For this purpose, we obtained trabecular bone explants from the femoral head and the intertrochanteric region of patients with idiopathic ONFH and age- matched patients with primary osteoarthritis (OA). Trabecular bone from the femoral head of ONFH patients showed lower trabecular thickness, bone volume fraction and degree of anisotropy, and a higher percentage of empty lacunae than bone samples from the intertrochanteric region of the same patients and from the femoral head of the OA group. The transcriptome analysis identified a substantial number of genes exclusively regulated in the femoral head of ONFH patients. Among these genes, we found that those highly expressed around the necrotic lesion were involved in cell division and immune response. By contrast, downregulated genes were mainly involved in cell adhesion, angiogenesis and bone formation, such as those encoding collagen type I, bone sialoprotein and several bone morphogenetic proteins. These data add new insights into mechanisms involved in the pathophysiology of idiopathic ONFH.

Cystic fibrosis-related bone disease: an update on screening, diagnosis, and treatment

Cystic fibrosis-related bone disease (CFBD) is a common endocrinopathy in people living with cystic fibrosis (CF) that is complex and multifactorial in origin. People with CF experience high rates of progressive bone density loss and increased fracture risk. Focus on prevention and treatment of CFBD is of increasing importance in a now aging CF population. This review will discuss current practices in CFBD, gaps in knowledge, and potential future studies with the goal of advancing the clinical care of patients with CFBD.

Mechanical sensing protein PIEZO1 controls osteoarthritis via glycolysis mediated mesenchymal stem cells-Th17 cells crosstalk

Aberrant mechanical stimuli can cause tissue attrition and activate mechanosensitive intracellular signaling, impacting the progression of osteoarthritis (OA). However, the precise relationship between mechanical loading and bone metabolism remains unclear. Here, we present evidence that Piezo1 senses the mechanical stimuli to coordinate the crosstalk between mesenchymal stem cells (MSCs) and T helper 17 (Th17) cells, leading to the deterioration of bone and cartilage in osteoarthritis (OA). Mechanical loading impaired the property of MSCs by inhibiting their osteo-chondrogenic differentiation and promoting inflammatory signaling to enhance Th17 cells. Mechanistically, mechanical stimuli activated Piezo1, thereby facilitating Ca2+ influx which upregulated the activity of Hexokinase 2(HK2), the rate-limiting enzyme of glycolysis. The resultant increase in glycolytic activity enhanced communication between MSCs and T cells, thus promoting Th17 cell polarization in a macrophage migration inhibitory factor (MIF) dependent manner. Functionally, Wnt1cre; Piezo1fl/fl mice reduced bone and cartilage erosion in the temporomandibular joint condyle following mechanical loading compared to control groups. Additionally, we observed activated Piezo1 and HK2-mediated glycolysis in patients with temporomandibular joint OA, thereby confirming the clinical relevance of our findings. Overall, our results provide insights into how Piezo1 in MSCs coordinates with mechano-inflammatory signaling to regulate bone metabolism. The schema shows that mechanical sensing protein PIEZO1 in MSCs controls osteoarthritis via glycolysis mediated MSCs and Th17 cells crosstalk in a MIF dependent manner.

Chewing-Activated TRPV4/PIEZO1-HIF-1α-Zn Axes in a Rat Periodontal Complex

The upstream mechanobiological pathways that regulate the downstream mineralization rates in periodontal tissues are limitedly understood. Herein, we spatially colocalized and correlated compression and tension strain profiles with the expressions of mechanosensory ion channels (MS-ion) TRPV4 and PIEZO1, biometal zinc, mitochondrial function marker (MFN2), cell senescence indicator (p16), and oxygen status marker hypoxia-inducible factor-1α (HIF-1α) in rats fed hard and soft foods. The observed zinc and related cellular homeostasis in vivo were ascertained by TRPV4 and PIEZO1 agonists and antagonists on human periodontal ligament fibroblasts ex vivo. Four-week-old male Sprague-Dawley rats were fed hard (n = 3) or soft (n = 3) foods for 4 wk (in vivo). Significant changes in alveolar socket and root shapes with decreased periodontal ligament space and increased cementum volume fraction were observed in maxillae on reduced loads (soft food). Reduced loads impaired distally localized compression-stimulated PIEZO1 and mesially localized tension-stimulated TRPV4, decreased mitochondrial function (MFN2), and increased cell senescence in mesial and distal periodontal regions. The switch in HIF-1α from hard food-distal to soft food-mesial indicated a plausible effect of shear-regulated blood and oxygen flows in the periodontal complex. Blunting or activating TRPV4 or PIEZO1 MS-ion channels by channel-specific antagonists or agonists in human periodontal ligament fibroblast cultures (in vitro) indicated a positive correlation between zinc levels and zinc transporters but not with MS-ion channel expressions. The effects of reduced chewing loads in vivo were analogous to TRPV4 and PIEZO1 antagonists in vitro. Study results collectively illustrated that tension-induced TRPV4 and compression-induced PIEZO1 activations are necessary for cell metabolism. An increased hypoxic state with reduced functional loads can be a conducive environment for cementum growth. From a practical standpoint, dose rate-controlled loads can modulate tension and compression-specific MS-ion channel activation, cellular zinc, and HIF-1α transcription. These mechanobiochemical events indicate the plausible catalytic role of biometal zinc in mineralization, periodontal maintenance, and dentoalveolar joint function.

Alternating electrical fields to stimulate osteogenic cells and biomimetic calcium phosphate-coated titanium substrates-A combinatorial approach to bone regeneration

Biophysical stimuli such as alternating electrical fields can mimic endogenous electrical potentials and currents in natural bone. This can help to improve the healing and reconstruction of bone tissue. However, little is known about the combined influence of biomaterials and alternating electric fields on bone cells. Therefore, this study aimed to investigate the impact of both, biomaterials and alternating electric fields, on osteoblast as well as osteoclast differentiation. Initially, either RAW 264.7 or MC3T3-E1 cells were seeded on Ti6Al4V substrates as a load-bearing implant material, modified with biomimetic calcium phosphate (BCP), or uncoated as a reference. The cells were stimulated towards osteoclastic and osteoblastic differentiation via respective growth factors. The effects of BCP substrate modification on cell differentiation were examined after 7 days for RAW 264.7 and after 14 days for MC3T3-E1 cells. In a further series of tests, either RAW 264.7 or MC3T3-E1 cells were seeded on BCP-modified Ti6Al4V substrates, stimulated towards differentiation using growth factors, and further electrically stimulated via alternating electric fields of different voltages and frequencies. In parallel to the first test series RAW 264.7 and MC3T3-E1 cells were stimulated for 7 and 14 days, respectively. Cell morphology was examined via scanning electron microscopy. Cell viabilities were assessed via WST-8 assay. Electrically stimulated MC3T3-E1 cell orientation was evaluated based on fluorescence microscopy images. Marker genes were examined via qPCR. While BCP increased osteoclast-specific gene expression, it had the opposite effect on osteoblast-related genes compared to respective cells seeded on uncoated Ti6Al4V substrates. ES with different parameters showed a broad cellular response due to electrocoupling. While cell viability assessments and gene expression analyses showed clear differences between ES samples and unstimulated controls, only minor cell morphology and orientation differences were observed. Furthermore, there was no clear trend towards a dominant influence of either voltage or frequency as control parameters. Further studies were initiated to investigate the underlying intracellular mechanisms targeted by ES. This work provides an introduction to the targeted control of cellular processes using defined electric fields. The optimization of voltage and frequency could provide therapeutic windows to control specific cellular functions and potentially improve bone regeneration and remodeling processes.

Developmental process and homeostasis of whale long bones lacking medullary cavity using the radius of Antarctic minke whales, Balaenoptera bonaerensis

Whales, Earth's largest mammals and live in water, form long bones without marrow cavities. Body size and mechanical stress impact the bone formation and homeostasis, yet the specific developmental processes remain unclear. Here, we demonstrate the histological changes in whale long bones from fetal to mature stages using the radius of Antarctic minke whales in comparison with domestic cats and cattle. Through intramembranous ossification and remodeling, long bones enlarge their diameters and marrow cavities, respectively. It has been demonstrated that relatively small animals, such as cats, develop the radially arranged "primary osteonal bone," whereas larger animals, including cattle, form "laminar bone" initiated by the formation of circumferentially arranged hypercalcified lines during intramembranous ossification. Here, we demonstrated that whales form laminar bones, transitioning from circumferential in the fetus to radial during postnatal growth, and thereafter cortical bones become compact. After maturation, bone remodeling primarily occurs in the lateral and medial regions of long bones, while the bone layers in the cranial-caudal region never undergo complete resorption. As a result, these layers remain as a wire-netting structure composed of thin bone layers, without forming an open medullary cavity. These data suggest that whales enlarge their long bones through laminar bone formation and form long bones without a marrow cavity by regulating bone resorption areas during the developmental process and in maintaining homeostasis.

Melatonin administration on bone properties of animals under hypoestrogenism: A systematic review

PURPOSE

Hypoestrogenism is associated with loss of bone mass and strength. Melatonin has become a strategy due to its actions on bone tissue. This review summarizes the available data on the effects of chronic melatonin administration on bone tissue in animal models with hypoestrogenism.

DATA SOURCES

A systematic search of the PubMed, Web of Science, and Scopus, databases up to November 27, 2023, was conducted using specified key terms and Boolean operators (bone AND bones OR bone density OR bone diseases OR osteogenesis OR osteoporosis AND melatonin).

STUDY SELECTION

only controlled studies in English and with rodents.

STUDY DESIGN

systematic review.

DATA EXTRACTION

animals' characteristics (sex and hypoestrogenism confirmation), dose, route, and duration of administration of melatonin, and outcomes from the properties of bone.

RESULTS

A total of 25 studies were identified after the screening process. In the hypoestrogenic state, melatonin administration improved bone mineral density, bone volume ratio, trabecular number in 19 studies, and maximal load/strength and stiffness test in 7. 4 studies reported improved matrix mineralization in bone marrow mesenchymal stem cells. Melatonin increased the expression of RUNX2 in 9 studies, OCN in 6, and OPG in 4, while decreasing RANKL in 3. In 4 studies the melatonin increased the serum osteocalcin levels.

CONCLUSION

Chronic administration of melatonin appears to improve the biophysical, biomechanical, molecular, and biochemical properties of bone tissue. These benefits promote an osteogenic effect, making melatonin an efficient strategy to preserve microarchitecture and tissue mass in a state of hypoestrogenism.

[Relationship between fluid shear stress in alveolar bone under orthodontic forces and bone remodeling rate]

OBJECTIVES

This study explores the differences in fluid flow within alveolar cancellous bone at various sites under orthodontic forces and elucidates the relationship between fluid shear stress and bone remodeling. These fin-dings lay the groundwork for understanding the biomechanical mechanisms of orthodontic tooth movement.

METHODS

Stress relaxation tests were performed on human alveolar bone samples to determine material parameters by using the Prony series. An inverse model of alveolar bone was then developed for numerical simulations of fluid-structure interactions to calculate fluid flow within cancellous bone. Meanwhile, a rat model of tooth movement was established to investigate variations in bone remodeling speeds across different regions.

RESULTS

The microstructural distribution of cancellous alveolar bone was similar in humans and rats. The bone volume fraction and trabecular thickness gradually decreased from root cervical region to root apical region, while the trabecular space gradually increased. Under the influence of orthodontic forces, fluid shear stress within cancellous bone showed spatial variability across different levels, with the highest shear stress occurring at the root apical region, ranging from 0 to 0.936 6 Pa. Additionally, the rat model of tooth movement indicated that bone remodeling occurred more rapidly at the root apical region.

CONCLUSIONS

Fluid stimulation has a remarkable effect on al-veolar bone remodeling, causing changes in the structure of alveolar bone and ultimately regulating the speed of structu-ral remodeling.

Comparison of trabecular bone microarchitecture between older males with and without a running habit: A cross-sectional study

Objectives

Despite its prevalence among seniors, the impact of running on trabecular bone microarchitecture, especially in weight-bearing sites, remains relatively unexplored. This cross-sectional study aimed to investigate the impact of habitual running on bone health, specifically bone mineral density (BMD) and trabecular bone microarchitecture, in male older adults.

Methods

Twenty-five male recreational runners aged between 50 and 75 years old were recruited in this study (RUN; average running experience 7.5 ± 6.0 years, average monthly running volume 217 ± 120 km), and 25 age matched sedentary older males served as controls (CON). Dual-energy X-ray absorptiometry was used to obtain bone mineral density (BMD) measures at whole-body, bilateral proximal femur as well as lumbar spine for all participants. Magnetic resonance imaging was used to obtain trabecular bone microarchitectural parameters at distal femur and distal tibia for all participants.

Results

Findings revealed no significant difference in BMD between groups for all measured sites (all p > 0.05; d range 0.013-0.540). However, runners displayed higher bone volume fraction and trabecular thickness at the distal tibia (p = 0.012 and 0.001; 95 % CI of MD [-0.030, -0.004] and [-0.013, -0.004]; d = 0.739 and 1.034, respectively) and higher trabecular thickness at the distal femur (p = 0.002; 95 % CI of MD [-0.010, -0.002]; d = 0.907).

Conclusions

This study provides critical insights into the relationship between running and bone health in older adults, suggesting regular recreational running may positively influence trabecular bone microarchitecture, potentially enhancing bone strength and reducing fracture risk. These findings pave the way for future research to develop evidence-based exercise recommendations for an aging population.

Effects of Stress on Biological Characteristics and Metabolism of Periodontal Ligament Stem Cells of Deciduous Teeth

INTRODUCTION AND AIMS

Periodontal ligament stem cells (PDLSCs) from deciduous teeth (DePDLSCs) can perceive and respond to mechanical signals upon exposure to various environments. The effects of mechanical stress on the biological characteristics and metabolism of DePDLSCs were investigated using in vitro stress loading.

METHODS

DePDLSCs were subjected to mechanical stresses of different strengths. Cell proliferation, expression of osteogenic/osteoclastic factors, apoptosis, and oxidative stress levels were evaluated using CCK-8 assays, alkaline phosphatase staining, real-time PCR, flow cytometry, and malondialdehyde and superoxide dismutase assays. Liquid chromatography-mass spectrometry was used to perform nontargeted metabolomic detection and analysis.

RESULTS

Under stresses of 75 and 150 kPa, the expression of osteogenesis-related factors OPG, ALP, and RUNX2 decreased, and the ratio of RANKL/OPG significantly increased. A pressure of 150 kPa induced oxidative stress and caused a significant increase in cell apoptosis. Among the differential metabolites screened from the 150 kPa group, spermine, spermidine, ceramide, phosphatidylethanolamine, lysophosphatidylethanolamine, linoleic acid, and docosatrienoic acid were the most significantly upregulated. The metabolites screened from the 75 kPa group were mainly related to glycerophospholipid and sphingolipid metabolism, oxidative phosphorylation, and mineral absorption, which were common pathways affected in both experimental groups.

CONCLUSION

A certain degree of mechanical stress can inhibit the proliferative activity and osteogenic differentiation of DePDLSCs, enhance their osteoclast-inducing ability, and cause elevated levels of cell apoptosis and oxidative stress. The metabolic expression profile of DePDLSCs changed significantly under stress. Understanding changes in cellular activity and metabolic reactions may provide an experimental basis for elucidating the role of mechanical stress in root resorption and periodontal tissue remodelling of deciduous teeth.

CLINICAL RELEVANCE

Mechanical stress may affect periodontal tissue remodeling and root resorption of DePDLSc.

Biomechanical analysis of axial-radial integrated functional gradient material implants in healthy and osteoporotic bones

People with osteoporosis, common among middle-aged and elderly individuals, often need dental implants. Titanium implants, though generally safe, can cause problems due to their stiffness, especially in osteoporotic bone, leading to fractures. This study aims to identify gradient types that offer improved biological adaptation. This was achieved by comparing the mechanical properties of four new two-dimensional functional gradient materials (FGMs) implants to those of conventional and one-dimensional FGM implants in healthy and osteoporotic bone models. The new FGM implants, with reduced stiffness at the bottom and outer parts, kept strain on cancellous bone within safe limits, reducing fracture risk. Notably, the FGM RA L-H implant maintained strain levels within the optimal range (1,500-3,000 µɛ), promoting bone healing and remodeling. By evaluating the stresses and strains, it was concluded that the FGM RA L-H implant is well adapted to significantly reduce stresses and improve bone recovery in healthy and osteoporotic bones.

Optogenetic activation of mechanical nociceptions to enhance implant osseointegration

Orthopedic implants with high elastic modulus often suffer from poor osseointegration due to stress shielding, a phenomenon that suppresses the expression of intracellular mechanotransduction molecules (IMM) such as focal adhesion kinase (FAK). We find that reduced FAK expression under stress shielding is also mediated by decreased calcitonin gene-related peptide (CGRP) released from Piezo2+ mechanosensitive nerves surrounding the implant. To activate these nerves minimally invasively, we develop a fully implantable, wirelessly rechargeable optogenetic device. In mice engineered to express light-sensitive channels in Piezo2+ neurons, targeted stimulation of the L2-3 dorsal root ganglia (DRG) enhances localized CGRP release near the implant. This CGRP elevation activates the Protein Kinase A (PKA)/FAK signaling pathway in bone marrow mesenchymal stem cells (BMSCs), thereby enhancing osteogenesis and improving osseointegration. Here we show that bioelectronic modulation of mechanosensitive nerves offers a strategy to address implant failure, bridging neuroregulation and bone bioengineering.

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.

Cigarette Smoke Exposure Leads to Organic and Mineral Bone Component Changes: The Importance of Rho Kinase Function in These Events

Aberrant Rho-associated kinase function could be associated with increased bone fragility. Since cigarette smoke (CS) exposure promotes the increase in bone fragility due to changes in bone tissue components, this study aimed to investigate how CS exposure could modulate the Rho kinase-associated bone structural changes. Mice were assigned to four groups: control; smoke; control with Rho kinase inhibitor administration; and smoke with a Rho kinase inhibitor. Bone samples were obtained to assess bone histomorphometry analysis, type I collagen composition, and MEPE expression in trabeculae. We observed that CS exposure induced decreased trabecular and osteoid thickness. A concomitant increase in the osteoclastic and erosion surfaces and a decrease in the mineralization surface were observed. Additionally, CS exposure decreased the type I collagen and MEPE expression. Rho kinase inhibitor administration recovered the bone mineralization and the collagen type I deposition. Conclusions: CS exposure increases Rho kinase activity in bone cells, leading to structural changes. The administration of a Rho GTPases inhibitor partially reverses these effects, likely due to the recovery in osteoblast activity.

Bone Defect Treatment in Regenerative Medicine: Exploring Natural and Synthetic Bone Substitutes

In recent years, the management of bone defects in regenerative medicine and orthopedic surgery has been the subject of extensive research efforts. The complexity of fractures and bone loss arising from trauma, degenerative conditions, or congenital disorders necessitates innovative therapeutic strategies to promote effective healing. Although bone tissue exhibits an intrinsic regenerative capacity, extensive fractures and critical-sized defects can severely compromise this process, often requiring bone grafts or substitutes. Tissue engineering approaches within regenerative medicine have introduced novel possibilities for addressing nonunions and challenging bone defects refractory to conventional treatment methods. Key components in this field include stem cells, bioactive growth factors, and biocompatible scaffolds, with a strong focus on advancements in bone substitute materials. Both natural and synthetic substitutes present distinct characteristics and applications. Natural grafts-comprising autologous, allogeneic, and xenogeneic materials-offer biological advantages, while synthetic alternatives, including biodegradable and non-biodegradable biomaterials, provide structural versatility and reduced immunogenicity. This review provides a comprehensive analysis of the diverse bone grafting alternatives utilized in orthopedic surgery, emphasizing recent advancements and persistent challenges. By exploring both natural and synthetic bone substitutes, this work offers an in-depth examination of cutting-edge solutions, fostering further research and innovation in the treatment of complex bone defects.

[Epidemiological survey of osteoporosis in Beijing over the past decade: a single-center analysis of dual-energy X-ray absorptiometry scans from 30 599 individuals]

OBJECTIVES

To analyze bone mass distribution and the factors affecting bone mass in a general Chinese Han cohort undergoing physical examinations at our center.

METHODS

We retrospectively collected the data of bone mineral density (BMD) measurements from 30 599 healthy Han Chinese adults (age≥20 years) who underwent dual-energy X-ray absorptiometry scans at our hospital from July, 2013 to July, 2023. Basic parameters including height, body weight, and gender were recorded, and descriptive statistics and correlation analyses were performed using R software.

RESULTS

In this cohort, the male individuals had a mean peak BMD of 1.00±0.12 g/cm2 in the lumbar vertebrae, 0.94±0.14 g/cm2 in the femoral neck, and 0.99±0.13 g/cm2 in the total hip, significantly higher than the values in the female individuals [0.99±0.12 g/cm2 in the lumbar vertebrae (P=0.022), 0.79±0.11 g/cm2 in the femoral neck (P<0.001), and 0.88±0.11 g/cm2 in the total hip (P<0.001)]. In the overall cohort, the BMD values of the lumbar spine and femur decreased with age after reaching their peak levels. There was a positive correlation between BMD value and body mass index (BMI) in both male and female individuals. The 2013-2014 period recorded the lowest BMD values in the lumbar, hip, and femoral neck, which tended to increase steadily in the following years (2015-2023).

CONCLUSIONS

Our data suggest that the BMD values vary among different populations, and future multi-center studies using more accurate BMD detection technology are warranted to capture the variation patterns of BMD with demographic characteristics of specific populations.

Fabrication of 3D Biofunctional Magnetic Scaffolds by Combining Fused Deposition Modelling and Inkjet Printing of Superparamagnetic Iron Oxide Nanoparticles

BACKGROUND

Recently, magnetic composite biomaterials have raised attention in bone tissue engineering as the application of dynamic magnetic fields proved to modulate the proliferation and differentiation of several cell types.

METHODS

This study presents a novel method to fabricate biofunctional magnetic scaffolds by the deposition of superparamagnetic iron oxide nanoparticles (SPIONs) through thermal Drop-On-Demand inkjet printing on three-dimensional (3D) printed scaffolds. Firstly, 3D scaffolds based on thermoplastic polymeric composed by poly-L-lactic acid/poly-caprolactone/poly(3-hydroxybutyrate-co-3-hydroxyvalerate) were fabricated by Fused Deposition Modelling. Then, in a second step, SPIONs were incorporated onto the surface of the scaffolds by inkjet printing following a designed 2D pattern.

RESULTS

A complete characterization of the resulting magnetic scaffolds was carried out attending to the surface SPIONs deposits, demonstrating the accuracy and versatility of the production technique, as well as the stability under physiological conditions and the magnetic properties. Biological evaluation with human bone marrow mesenchymal stems cells demonstrated biocompatibility of the scaffolds and increased osteogenic capability under the application of a magnetic field, due to the activation of mechanotransduction processes.

CONCLUSION

These results show that the developed 3D magnetic biofunctional scaffolds can be a very promising tool for advanced and personalised bone regeneration treatments.

Mitochondrial oxidative stress or decreased autophagy in osteoblast lineage cells is not sufficient to mimic the deleterious effects of aging on bone mechanoresponsiveness

Exercise-induced mechanical load stimulates bone cells, including osteocytes, to promote bone formation. The bone response to loading is less effective with aging, but the cellular and molecular mechanisms responsible for the impaired mechanoresponsiveness remain unclear. Excessive mitochondrial reactive oxygen species (mtROS) and deficient autophagy are common aging mechanisms implicated in decreased bone formation in old mice. Here, we confirmed that the osteogenic effects of tibia compressive loading are lower in old versus young female mice. We also examined whether an increase in mtROS or decreased autophagy in osteoblast-lineage cells of adult female mice could mimic the deleterious effects of aging. To this end, we loaded mice lacking the antioxidant enzyme superoxide dismutase 2 (Sod2) or autophagy-related 7 (Atg7) in cells targeted by Osterix1 (Osx1)-Cre. Osteocytes in Atg7ΔOsx1 exhibited altered morphology and decreased osteocyte dendrite projections. Two weeks of loading increased cortical bone mass and bone formation rate at both periosteal and endosteal surfaces of Osx1-Cre control mice. Nonetheless, in both Atg7ΔOsx1 and Sod2ΔOsx1 mice the response to loading was identical to that observed in control mice, indicating that compromised Atg7-dependent autophagy or excessive mtROS are not sufficient to impair the bone response to tibial compressive loading. Thus, alternative mechanisms of aging might be responsible for the decreased response of the aged skeleton to mechanical stimuli. These findings also suggest that an intact osteocyte dendrite network is not required for the osteogenic response in this model of bone loading.

Bone-brain interaction: mechanisms and potential intervention strategies of biomaterials

Following the discovery of bone as an endocrine organ with systemic influence, bone-brain interaction has emerged as a research hotspot, unveiling complex bidirectional communication between bone and brain. Studies indicate that bone and brain can influence each other's homeostasis via multiple pathways, yet there is a dearth of systematic reviews in this area. This review comprehensively examines interactions across three key areas: the influence of bone-derived factors on brain function, the effects of brain-related diseases or injuries (BRDI) on bone health, and the concept of skeletal interoception. Additionally, the review discusses innovative approaches in biomaterial design inspired by bone-brain interaction mechanisms, aiming to facilitate bone-brain interactions through materiobiological effects to aid in the treatment of neurodegenerative and bone-related diseases. Notably, the integration of artificial intelligence (AI) in biomaterial design is highlighted, showcasing AI's role in expediting the formulation of effective and targeted treatment strategies. In conclusion, this review offers vital insights into the mechanisms of bone-brain interaction and suggests advanced approaches to harness these interactions in clinical practice. These insights offer promising avenues for preventing and treating complex diseases impacting the skeleton and brain, underscoring the potential of interdisciplinary approaches in enhancing human health.

Perspectives of exosomal ncRNAs in the treatment of bone metabolic diseases: Focusing on osteoporosis, osteoarthritis, and rheumatoid arthritis

Bone metabolic disorders, constituting a group of prevalent and grave conditions, currently have a scarcity of therapeutic alternatives. Over the recent past, exosomes have been at the forefront of research interest, owing to their nanoparticulate nature and potential for therapeutic intervention. ncRNAs are a class of heterogeneous transcripts that they lack protein-encoding capacity, yet they can modulate the expression of other genes through multiple mechanisms. Mounting evidence underscores the intricate role of exosomes as ncRNAs couriers implicated in the pathogenesis of bone metabolic disorders. In this review, we endeavor to elucidate recent insights into the roles of three ncRNAs - miRNAs, lncRNAs, and circRNAs - in bone metabolic ailments such as osteoporosis, osteoarthritis, and rheumatoid arthritis. Additionally, we examine the viability of exosomal ncRNAs as innovative, cell-free modalities in the diagnosis and therapeutic management of bone metabolic disorders. We aim to uncover the critical function of exosomal ncRNAs within the context of bone metabolic diseases.

Research status of biomaterials based on physical signals for bone injury repair

Bone defects repair continues to be a significant challenge facing the world. Biological scaffolds, bioactive molecules, and cells are the three major elements of bone tissue engineering, which have been widely used in bone regeneration therapy, especially with the rise of bioactive molecules in recent years. According to their physical properties, they can be divided into force, magnetic field (MF), electric field (EF), ultrasonic wave, light, heat, etc. However, the transmission of bioactive molecules has obvious shortcomings that hinder the development of the tissue-rearing process. This paper reviews the mechanism of physical signal induction in bone tissue engineering in recent years. It summarizes the application strategies of physical signal in bone tissue engineering, including biomaterial designs, physical signal loading strategies and related pathways. Finally, the ongoing challenges and prospects for the future are discussed.

Fixation Failure in Osteoporotic Bone: A Review of Complications and Outcomes

Background

Osteoporotic bone poses significant challenges for fixation of fractures due to its compromised bone quality. This issue impacts patient outcomes and, necessitate proper understanding of the biomechanical limitations and the adequacy of current fixation devices.

Objective

This article aims to address the gaps in literature by examining both the biomechanical and biological factors that contribute to fixation failure in osteoporotic bone, and by analyzing the limitations of current management strategies, with the aim of identifying effective interventions for this vulnerable patient group.

What is Already Known

Literature acknowledges that osteoporotic bones have reduced bone density and compromised structural integrity, making fixation devices less effective. Fixation failure frequently occurs in these patients due to diminished bone strength and insufficient fixation support, which collectively hinder optimal stabilization and healing.

Gap in Literature

Despite recognition of the high failure rates associated with osteoporotic bone fixation, there is limited literature detailing a comprehensive approach that integrates biomechanical, biological, and technological advancements to improve fixation outcomes. This article reviews current diagnostic techniques and explores potential innovations in materials and regenerative strategies aimed at enhancing fixation success. Which also guide us about need for future research to focus on developing and validating multifaceted approaches that combine advanced fixation materials and bone regeneration technologies to mitigate failure risks and improve patient outcomes.

Conclusion

With increasing life expectancy, the incidence of osteoporosis and hence osteoporotic fractures steadily increasing there are multiple fractures which are responsible for this, however as orthopedic surgeon we are required to deal with these fractures in increasing numbers so we need to develop a comprehensive approach to prevention of these fractures' adequate treatment and also the prevention of refractures which are far too common.

Condylar osseous changes following conservative therapies: A cone-beam computed tomography longitudinal study on adult patients with degenerative temporomandibular joint disease

This retrospective study aimed to comprehensively investigate the impact of non-surgical treatments on condylar osseous changes in adult patients with degenerative joint disease (DJD). Radiographic and clinical data were collected for analysis. Cone-beam computed tomography (CBCT) was used to diagnose DJD, including flattening, erosion, osteophytes, sclerosis and cysts. Condylar osseous changes were divided into three classifications: progression, stability and remission. Kaplan-Meier analyses were performed to evaluate progression-free probability. Hazard ratios (HRs) of overall and specific DJD progression were calculated with multivariate Cox analysis. Hyaluronic acid (HA) injection significantly reduced the progression-free probability (P = 0.0312). HRs of progression after stabilization splint (SS) treatment within one year, glucosamine treatment within six months and HA injection was 3.41 (95% CI: 1.70-6.84; P = 0.0005), 0.35 (95% CI: 0.14-0.86; P = 0.0226), and 1.84 (95% CI: 1.06-3.20; P = 0.0313), respectively. HRs of progression of flattening, erosion, osteophyte, and sclerosis adjusted for gender and age after HA injection were 2.77 (95% CI: 1.32-5.81; P = 0.0071), 2.12 (95% CI: 1.09-4.10; P = 0.0264), 3.38 (95% CI: 1.08-10.54; P = 0.0361) and 2.78 (95% CI: 1.02-7.52; P = 0.0447) respectively. HA injection and SS treatment were possible risk factors for TMJ deterioration, while glucosamine treatment was possible protective factor against TMJ deterioration.

Primary components of MCT ketogenic diet are detrimental to bone loss associated with accelerated aging and age-related neurotoxicity in mice

Medium chained triglycerides (MCT) ketogenic diet is being extensively investigated for its neuroprotective effects against adverse effects associated with aging and neurodegenerative disorders. Aging is a common risk factor for the development of both osteoporosis and neurological disorders. Hence, suppression of aging and age-related neurodegeneration might contribute to delaying skeletal aging. The present study was designed to investigate the effects of the primary components of the MCT diet, against bone resorption associated with D-gal-induced accelerated aging and D-gal /AlCl3-induced age-related toxicity. We report bone loss in accelerated aged mice and age-related neurotoxic mice through declined Sirtuin1 (SIRT1) expression, depleted bone turnover markers, (P1NP and β-CTX-1), low bone mineral density (BMD), and deterioration of trabecular bone microarchitecture in both the distal femur and proximal tibia bones. Administration of MCT dietary components decanoic acid and octanoic acid, led to a decrease in body weight and only octanoic acid increased serum levels of ketone body, β-hydroxybutyrate (β-HB), but both of them failed to reverse the diminishing effects on bone health associated with aging and age-related neurotoxicity. Surprisingly, decanoic acid, octanoic acid, and their combination also exhibited negative effects on trabecular bone microarchitecture and BMD in the distal femur and proximal tibia bones of healthy mice. The findings from this study provide supporting evidence on the deterioration of bone health associated with aging and age-related neurotoxicity, and the bone resorption potential of MCT dietary supplements that are being prescribed in healthy older populations and elderly persons diagnosed with neurological disorders.

Epigenetic Regulation of ZNF687 by miR-142a-3p and DNA Methylation During Osteoblast Differentiation and Mice Bone Development and Aging

Zinc finger protein 687 (ZNF687), a transcription factor implicated in osteoblast/osteoclast differentiation and linked to Paget's disease of bone, has unclear mechanisms in bone metabolism. Epigenetic disruptions can affect bone cell activity and contribute to bone-related diseases. This work aimed to elucidate the regulatory role of epigenetics in modulating Zfp687 expression throughout osteoblast differentiation and bone growth/aging in mice. Differentiation of the mouse-derived osteoblast precursor cell line (MC3T3-E1) showed increased expression of osteogenic markers and decreased Zfp687 expression. In the hindlimb bones of C57BL/6J mice, the expression of most bone-forming genes decreased from youth to adulthood, while Zfp687 and Runx2 expression was maintained, being only significantly reduced in old mice in comparison to young mice. Bisulfite sequencing revealed hypomethylation of the Zfp687 promoter during MC3T3-E1 differentiation and bone growth/aging. Bioinformatics predicted miR-142a-3p, miR-122b-5p, and miR-124-3p binding sites in Zfp687 3'UTR, and RT-qPCR analysis showed higher expression of these miRNAs in mature osteoblasts. Transfection of a miR-142-3p mimic reduced luciferase activity in the wildtype Zfp687 3'UTR but not the mutant 3'UTR and downregulated the Zfp687 gene and protein levels. In conclusion, miR-142a-3p directly targets the Zfp687 3'UTR, promoting its downregulation during osteoblastogenesis. Furthermore, DNA methylation does not appear to regulate Zfp687 during osteoblast differentiation or bone development in mice.

Articular cartilage degeneration and aberrant osteocyte perilacunar/canalicular remodeling in subchondral bone of patients with developmental dysplasia of the hip

BACKGROUND

Developmental dysplasia of the hip (DDH) is a congenital musculoskeletal disease that impairs the hip joint and exacerbates hip osteoarthritis. This study aims to investigate the alterations of osteocytic characteristics including apoptosis, lacuna-canalicular network, and perilacunar/canalicular remodeling (PLR) activity in subchondral bone from DDH patients, and potential relationship of these alterations between the cartilage degeneration and DDH progression.

METHODS

The femoral head specimens were acquired from 16 patients with hip fractures who received total hip arthroplasty operation, 24 patients with primary hip OA and 25 patients with DDH. The femoral head were scanned by a micro-computed tomography and the volume of interest was used for a micro-finite element analysis. Histological and immunohistochemical staining was used to observe chondrocytes in cartilage and osteocytes in subchondral bone. Terminal deoxynucleotidyl transferase dUTP nick end labeling staining was used to investigate the apoptotic osteocytes in subchondral bone. Ploton silver staining was used to visualize lacunocanalicular network and picrosirius red staining was to visualize collagen fiber orientation in subchondral bone.

RESULTS

The DDH group showed the highest apoptosis rate of osteocytes and increased PLR activity among the three groups. The micro-finite-element analysis revealed that DDH group had deteriorative microstructural and biomechanical properties of subchondral bone. The histological and immunohistochemical analyses showed that the cartilage degeneration in DDH group was the most severe. Linear regression analysis revealed a significant correlation between osteocytic activity in subchondral bone and cartilage degeneration in DDH.

CONCLUSIONS

Our findings indicate that the abnormal osteocyte activity in subchondral bone might contribute to the deterioration of subchondral bone structure, which accelerates cartilage degeneration and DDH progression. Targeting subchondral bone remodeling could offer a promising therapeutic strategy for DDH.

A Mechanically Stimulated Co-culture in 3-Dimensional Composite Scaffolds Promotes Osteogenic and Anti-osteoclastogenic Activity and M2 Macrophage Polarization

Bone is subjected to a plethora of mechanical stresses, which have been found to directly influence the equilibrium between bone resorption and formation. Taking this into account, we present herein a novel biomimicking 3-dimensional model that applies cyclic uniaxial compression onto cells co-cultured on 3-dimensionally printed scaffolds consisting of poly L-lactic acid/poly(ε-caprolactone)/poly(3-hydroxybutyrate-co-3-hydroxyvalerate)/Sr-nanohydroxyapatite. The aim is to investigate how compression can modulate the balance between osteogenesis and osteoclastogenesis in co-culture, as well as the polarization of macrophages. One of the key aspects of the current study is the unprecedented development of a growth-factor-free co-culture, sustainable solely by the cross talk between human bone marrow mesenchymal stem cells and human peripheral blood mononuclear cells for their survival and osteogenic/osteoclastogenic differentiation capacity, respectively. Real-time polymerase chain reaction gene expression analysis of the mechanically stimulated constructs revealed up-regulation of the osteogenesis-related markers osteocalcin, osteoprotegerin, and runt-related transcription factor 2, with concurrent down-regulation of the osteoclastogenic markers dendritic-cell-specific transmembrane protein, nuclear factor of activated T cells 1, and tartrate acid phosphatase. The secretion of the receptor activator of nuclear factor kappa-Β ligand and macrophage colony-stimulating factor, as determined from enzyme-linked immunosorbent assay, was also found to depict lower levels compared to static conditions. Finally, macrophage polarization was examined via confocal imaging of tumor necrosis factor-α and interleukin-10 secretion levels, as well as through nitric oxide synthase and arginase 1 markers' gene expression, with the results indicating stronger commitment toward the M2 phenotype after mechanical stimulation.

Synthetic nanointerfacial bioengineering of Ti implants: on-demand regulation of implant-bone interactions for enhancing osseointegration

Titanium and its alloys are the most commonly used biometals for developing orthopedic implants to treat various forms of bone fractures and defects, but their clinical performance is still challenged by the unfavorable mechanical and biological interactions at the implant-tissue interface, which substantially impede bone healing at the defects and reduce the quality of regenerated bones. Moreover, the impaired osteogenesis capacity of patients under certain pathological conditions such as diabetes and osteoporosis may further impair the osseointegration of Ti-based implants and increase the risk of treatment failure. To address these issues, various modification strategies have been developed to regulate the implant-bone interactions for improving bone growth and remodeling in situ. In this review, we provide a comprehensive analysis on the state-of-the-art synthetic nanointerfacial bioengineering strategies for designing Ti-based biofunctional orthopedic implants, with special emphasis on the contributions to (1) promotion of new bone formation and binding at the implant-bone interface, (2) bacterial elimination for preventing peri-implant infection and (3) overcoming osseointegration resistance induced by degenerative bone diseases. Furthermore, a perspective is included to discuss the challenges and potential opportunities for the interfacial engineering of Ti implants in a translational perspective. Overall, it is envisioned that the insights in this review may guide future research in the area of biometallic orthopedic implants for improving bone repair with enhanced efficacy and safety.

Multi-Physical Lattice Metamaterials Enabled by Additive Manufacturing: Design Principles, Interaction Mechanisms, and Multifunctional Applications

Lattice metamaterials emerge as advanced architected materials with superior physical properties and significant potential for lightweight applications. Recent developments in additive manufacturing (AM) techniques facilitate the manufacturing of lattice metamaterials with intricate microarchitectures and promote their applications in multi-physical scenarios. Previous reviews on lattice metamaterials have largely focused on a specific/single physical field, with limited discussion on their multi-physical properties, interaction mechanisms, and multifunctional applications. Accordingly, this article critically reviews the design principles, structure-mechanism-property relationships, interaction mechanisms, and multifunctional applications of multi-physical lattice metamaterials enabled by AM techniques. First, lattice metamaterials are categorized into homogeneous lattices, inhomogeneous lattices, and other forms, whose design principles and AM processes are critically discussed, including the benefits and drawbacks of different AM techniques for fabricating different types of lattices. Subsequently, the structure-mechanism-property relationships and interaction mechanisms of lattice metamaterials in a range of physical fields, including mechanical, acoustic, electromagnetic/optical, and thermal disciplines, are summarized to reveal critical design principles. Moreover, the multifunctional applications of lattice metamaterials, such as sound absorbers, insulators, and manipulators, sensors, actuators, and soft robots, thermal management, invisible cloaks, and biomedical implants, are enumerated. These design principles and structure-mechanism-property relationships provide effective design guidelines for lattice metamaterials in multifunctional applications.

Metal-phenolic network biointerface-mediated cell regulation for bone tissue regeneration

Bone tissue regeneration presents a significant challenge in clinical treatment due to inadequate coordination between implant materials and reparative cells at the biomaterial-bone interfaces. This gap underscores the necessity of enhancing interaction modulation between cells and biomaterials, which is a crucial focus in bone tissue engineering. Metal-polyphenolic networks (MPN) are novel inorganic-organic hybrid complexes that are formed through coordination interactions between phenolic ligands and metal ions. These networks provide a multifunctional platform for biomedical applications, with the potential for tailored design and modifications. Despite advances in understanding MPN and their role in bone tissue regeneration, a comprehensive overview of the related mechanisms is lacking. Here, we address this gap by focusing on MPN biointerface-mediated cellular regulatory mechanisms during bone regeneration. We begin by reviewing the natural healing processes of bone defects, followed by a detailed examination of MPN, including their constituents and distinctive characteristics. We then explore the regulatory influence of MPN biointerfaces on key cellular activities during bone regeneration. Additionally, we illustrate their primary applications in addressing inflammatory bone loss, regenerating critical-size bone defects, and enhancing implant-bone integration. In conclusion, this review elucidates how MPN-based interfaces facilitate effective bone tissue regeneration, advancing our understanding of material interface-mediated cellular control and the broader field of tissue engineering.

Melatonin antagonizes bone loss induced by mechanical unloading via IGF2BP1-dependent m6A regulation

Disuse bone loss is prone to occur in individuals who lack mechanical stimulation due to prolonged spaceflight or extended bed rest, rendering them susceptible to fractures and placing an enormous burden on social care; nevertheless, the underlying molecular mechanisms of bone loss caused by mechanical unloading have not been fully elucidated. Numerous studies have focused on the epigenetic regulation of disuse bone loss; yet limited research has been conducted on the impact of RNA modification bone formation in response to mechanical unloading conditions. In this study, we discovered that m6A reader IGF2BP1 was downregulated in both osteoblasts treated with 2D clinostat and bone tissue in HLU mice. Supplementing IGF2BP1 could promote osteoblast proliferation and partially alleviate the adverse effects of mechanical unloading on bone formation. Mechanistically, IGF2BP1 inhibited the degradation of Lef1 mRNA by directly binding to its mRNA and recognizing the m6A modification. Furthermore, LEF1 promoted osteoblast proliferation by upregulating c-Myc and Cyclin D1 expression, as well as participated in mediating IGF2BP1-induced osteoblast activity under mechanical unloading. Notably, Melatonin (MT) might participate in the regulation of the IGF2BP1/LEF1 axis, thereby regulating the proliferation of osteoblasts and bone formation. Collectively, this study revealed a new insight into the regulation of the MT/IGF2BP1/LEF1 pathway in the process of unloading-induced bone loss, which could potentially contribute to establishing therapeutic strategies for disuse osteoporosis.

The L-shaped association between body roundness index and all-cause mortality in osteoporotic patients: a cohort study based on NHANES data

Purpose

This study aims to investigate the relationship between the body roundness index (BRI) and overall mortality rates in individuals with osteoporosis (OP), utilizing information sourced from the NHANES database, in order to assess BRI's capability as an indicator for predicting mortality risk.

Methods

Data from NHANES (2005 to 2010, 2013-2014, and 2017-2018) were analyzed, including 1,596 osteoporotic individuals aged 50 and above. BRI was calculated based on waist circumference (WC) and height, categorizing participants into high (>4.07) and low (≤4.07) BRI groups. To analyze the relationship between BRI and mortality while accounting for important covariates, we employed weighted Cox proportional hazards models, conducted Kaplan-Meier survival analyses, and utilized restricted cubic splines (RCS).

Results

Higher BRI was significantly associated with better long-term survival, showing an "L"-shaped nonlinear inverse relationship with mortality, with a threshold at BRI = 5. In subgroup analyses, this association remained relatively stable.

Conclusion

The "L"-shaped association between BRI and mortality indicates that BRI may serve as a useful indicator for evaluating mortality risk in patients with OP, thereby informing clinical interventions and public health approaches.

Polycystin-1 regulates tendon-derived mesenchymal stem cells fate and matrix organization in heterotopic ossification

Mechanical stress modulates bone formation and organization of the extracellular matrix (ECM), the interaction of which affects heterotopic ossification (HO). However, the mechanically sensitive cell populations in HO and the underlying mechanism remain elusive. Here, we show that the mechanical protein Polysyctin-1 (PC1, Pkd1) regulates CTSK lineage tendon-derived mesenchymal stem cell (TDMSC) fate and ECM organization, thus affecting HO progression. First, we revealed that CTSK lineage TDMSCs are the major source of osteoblasts and fibroblasts in HO and are responsive to mechanical cues via single-cell RNA sequencing analysis and experiments with a lineage tracing mouse model. Moreover, we showed that PC1 mediates the mechanosignal transduction of CTSK lineage TDMSCs to regulate osteogenic and fibrogenic differentiation and alters the ECM architecture by facilitating TAZ nuclear translocation. Conditional gene depletion of Pkd1 or Taz in CTSK lineage cells and pharmaceutical intervention in the PC1-TAZ axis disrupt osteogenesis, fibrogenesis and ECM organization, and consequently attenuate HO progression. These findings suggest that mechanically sensitive CTSK-lineage TDMSCs contribute to heterotopic ossification through PC1-TAZ signaling axis mediated cell fate determination and ECM organization.

Implications of compressive loading of the stomach wall: Interplay between mechanical deformation and microstructure

During gastric surgery, the stomach wall is compressed with clamps and sutures or staple lines. These short- and long-term deformations can severely compromise the integrity of the tissue and make it difficult for the stomach wall to respond and remodel to the new loading conditions. Consequently, serious intra- and postoperative complications such as the formation of leaks during bariatric surgeries, can be associated with these immense tissue deformations. Hence, the study aimed to investigate the effects of compressive loading of the stomach wall in the radial direction. This was done by macroscopic mechanical loading of the stomach wall in each region of the stomach and evaluating the microstructural changes inflicted in the tissue. For this purpose, several imaging techniques were used, i.e., a histological analysis, second-harmonic generation microscopy, and X-ray micro-computed tomography. The combination of these three methods allowed us to investigate the gradual compression of the different stomach layers as well as the local reorientation and deformation of the main microstructural components, e.g., collagen fibers and muscle bundles. Importantly, this study found that the collagen bundles in the stomach wall straighten and reorient toward the circumferential-longitudinal plane and partially fan out with increased radial compressive deformation. The 3D scans of the stomach wall indicated a deterioration of the blood vessels and buckling of the mucosal glands due to compression. Statement of significance Unfortunately, little is known about the load transfer in the stomach wall during gastric surgery and the associated deformations on the macro- and microscale. The present study investigates the structural changes of the stomach wall, its layers and the inherent biological building blocks using histology, multi-photon microscopy, and micro-computed tomography. For the first time, the layer-specific response to stepwise radial compression of the stomach wall was studied, the related collagen fiber parameters were estimated, and a 3D sample structure was visualized. This clinically-oriented study links the structural changes within the wall to the postoperative remodel- ing process and the irreversibly altered gastric motility, thereby underscoring its relevance to the field of biomedical engineering, e.g., the development and improvement of surgical instruments.

Silk fibroin as a potential candidate for bone tissue engineering applications

Silk fibroin (SF), a pivotal biomaterial, holds immense promise for diverse applications within the realm of bone tissue engineering. SF is an ideal scaffold material with exceptional biocompatibility, mechanical robustness, biodegradability, and bioactivity. A plethora of investigations have corroborated SF's efficacy in supporting bone tissue repair and regeneration. This comprehensive review delves into the structural attributes, physicochemical characteristics, and extraction methodologies of SF. Moreover, it elucidates the strides taken in harnessing SF across a spectrum of forms, including films, hydrogels, scaffolds, electrospun fibers, and composites for bone tissue engineering applications. Moreover, the application bottleneck of SF as a bone repair material is highlighted, and its development prospects and potential biomedical applications are also presented in this review. We expect that this review can inspire the broad interest of a wide range of readers working in the fields of materials science, tissue engineering, biomaterials, bioengineering, and biomedicine.

Short bouts and long-term exercise reduce sedentary-induced bone loss and microstructural changes by modulating bone formation and resorption in healthy young male rats

Although the toxic effect of Sedentary behavior (SED) on bone health has been demonstrated in the previous study, the underlying mechanisms of SED, or break SED to bone health remain unclear. In this study, we aim to investigate the effects of sedentary behavior (SED) on bone health, as well as the potential favor effects of moderate to vigorous physical activity (MVPA) and periodic interruptions of SED. To simulate SED, we used small Plexiglas cages (20.0 × 9.0 × 10.0 cm) to restrict animal movement. Short bursts of exercise to break SED and continuous long-term exercise were also designed. After an 8-weeks period of SED, we observed decreased bone mass and bone microstructure. Specifically, there was a notable decrease in the bone mineral density (BMD), bone surface (BS) and cortical thickness (Ct.Th) significantly reduced in cortical bone. In the trabecular bone, parameters such as trabecular separation (Tb.Sp), trabecular number (Tb.N), BS, connectivity density (Conn.D), BS/BV, bone volume/tissue volume (BV/TV), degree of anisotropy (DA), and structural model index (SMI) were also significantly reduced. In addition, we detected an increase in serum tartrate-resistant acid phosphatase (TRAP) levels in SED rats at both 4 and 8 weeks. At 8 weeks, the osteoclast number and surface with TRAP-staining were significantly increased, however, the OPG mRNA and proteins level were significantly decreased. After daily short bouts exercise and long-term exercise, we observed improvements in bone mass and microstructure. These improvements included increasing BMD and BV/TV of cortical bone, and improving Conn.D, BV/TV, DA and SMI of trabecular. Meanwhile, we found that, at 4 and 8 weeks, there was an increase in serum ALP. At 8 weeks, the mineralized nodules surface with Alizarin Red S-staining, and OPG mRNA and proteins level in bone tissue were significantly increased. Our findings suggest that SED leads to alterations in the bone mass and microstructure, which are associated with the changes in the OPG protein and bone remodeling. Exercise, whether in short daily bouts or continuous long-term sessions, can ameliorate the harmful effects of SED. Similarly, the changes in bone mass and microstructure from exercise are also associated with the changes in the OPG protein and bone remodeling by upregulated osteoblast activity to bone formation. Overall, our findings indicate the importance of physical activity in maintaining bone health and preventing the negative impacts of prolonged SED.

Bone Regeneration: Mini-Review and Appealing Perspectives

Bone is a natural mineral-organic nanocomposite protecting internal organs and allowing mobility. Through the ages, numerous strategies have been developed for repairing bone defects and fixing fractures. Several generations of bone repair biomaterials have been proposed, either based on metals, ceramics, glasses, or polymers, depending on the clinical need, the maturity of technologies, and knowledge of the natural constitution of the bone tissue to be repaired. The global trend in bone implant research is shifting toward osteointegrative, bioactive and possibly stimuli-responsive biomaterials and, where possible, resorbable implants that actively promote the regeneration of natural bone tissue. In this mini-review, the fundamentals of bone healing materials and clinical challenges are summarized and commented on with regard to progressing scientific discoveries. The main types of bone-healing materials are then reviewed, and their specific relevance to the field is reminded, with the citation of reference works. In the final part, we highlight the promise of hybrid organic-inorganic bioactive materials and the ongoing research activities toward the development of multifunctional or stimuli-responsive implants. This contribution is expected to serve as a commented introduction to the ever-progressing field of bone regeneration and highlight trends of future-oriented research.

Aerobic exercise training-induced bone and vascular adaptations in mice lacking adiponectin

Adiponectin regulates lipid and glucose metabolism, and insulin sensitivity in various target organs; however, the effects of adiponectin on bone health remain controversial. Exercise training can enhance bone density, bone microarchitecture, and blood flow. This study aimed to elucidate the role of adiponectin in adaptations of bone microarchitecture and bone vasculature in response to aerobic exercise training. Adult male C57BL/6 wild-type (WT) and homozygous adiponectin knockout (AdipoKO) mice were either treadmill exercise trained or remained sedentary for 8-10 weeks. The trabecular structures of the distal femoral metaphysis, a weight-bearing bone, and the mandible, a non-weight-bearing bone, were examined using microcomputed tomography. The femoral principal nutrient arteries were isolated to assess vasoreactivity (vasodilation and vasoconstriction) and structural remodeling. At the femoral metaphysis, impaired trabecular bone structures, including reduced connectivity density and increased trabecular spacing, were observed in AdipoKO mice compared to WT mice. In addition, nitric oxide-mediated, endothelium-dependent vasodilation was substantially reduced, and wall-to-lumen ratio was significantly increased in the femoral principal nutrient artery of AdipoKO mice. Interestingly, although exercise training-induced enhancements in trabecular connectivity density were observed at the femoral metaphysis of both WT and AdipoKO, increased vasoconstrictor responses were only observed in the femoral principal nutrient artery of WT mice, not in the AdipoKO mice. In mandibular trabecular bone, exercise training increased trabecular bone volume fraction (BV/TV, %) and intersection surface in the mandible of both WT and AdipoKO mice. These findings indicate that adiponectin is crucial for maintaining normal bone microarchitecture and vasculature. Although the absence of adiponectin compromises bone vascular adaptation to exercise training in mice, some exercise training-induced alterations in bone microarchitecture occurred in the absence of adiponectin, suggesting contribution of compensatory mechanisms during exercise training.

Musculoskeletal Organs-on-Chips: An Emerging Platform for Studying the Nanotechnology-Biology Interface

Nanotechnology-based approaches are promising for the treatment of musculoskeletal (MSK) disorders, which present significant clinical burdens and challenges, but their clinical translation requires a deep understanding of the complex interplay between nanotechnology and MSK biology. Organ-on-a-chip (OoC) systems have emerged as an innovative and versatile microphysiological platform to replicate the dynamics of tissue microenvironment for studying nanotechnology-biology interactions. This review first covers recent advances and applications of MSK OoCs and their ability to mimic the biophysical and biochemical stimuli encountered by MSK tissues. Next, by integrating nanotechnology into MSK OoCs, cellular responses and tissue behaviors may be investigated by precisely controlling and manipulating the nanoscale environment. Analysis of MSK disease mechanisms, particularly bone, joint, and muscle tissue degeneration, and drug screening and development of personalized medicine may be greatly facilitated using MSK OoCs. Finally, future challenges and directions are outlined for the field, including advanced sensing technologies, integration of immune-active components, and enhancement of biomimetic functionality. By highlighting the emerging applications of MSK OoCs, this review aims to advance the understanding of the intricate nanotechnology-MSK biology interface and its significance in MSK disease management, and the development of innovative and personalized therapeutic and interventional strategies.

Transcriptomic profiling of human mesenchymal stem cells using a pulsed electromagnetic-wave motion bioreactor system for enhanced osteogenic commitment and therapeutic potentials

Traditional bioreactor systems involve the use of three-dimensional (3D) scaffolds or stem cell aggregates, limiting the accessibility to the production of cell-secreted biomolecules. Herein, we present the use a pulse electromagnetic fields (pEMFs)-assisted wave-motion bioreactor system for the dynamic and scalable culture of human bone marrow-derived mesenchymal stem cells (hBMSCs) with enhanced the secretion of various soluble factors with massive therapeutic potential. The present study investigated the influence of dynamic pEMF (D-pEMF) on the kinetic of hBMSCs. A 30-min exposure of pEMF (10V-1Hz, 5.82 G) with 35 oscillations per minute (OPM) rocking speed can induce the proliferation (1 × 105 → 4.5 × 105) of hBMSCs than static culture. Furthermore, the culture of hBMSCs in osteo-induction media revealed a greater enhancement of osteogenic transcription factors under the D-pEMF condition, suggesting that D-pEMF addition significantly boosted hBMSCs osteogenesis. Additionally, the RNA sequencing data revealed a significant shift in various osteogenic and signaling genes in the D-pEMF group, further suggesting their osteogenic capabilities. In this research, we demonstrated that the combined effect of wave and pEMF stimulation on hBMSCs allows rapid proliferation and induces osteogenic properties in the cells. Moreover, our study revealed that D-pEMF stimuli also induce ROS-scavenging properties in the cultured cells. This study also revealed a bioactive and cost-effective approach that enables the use of cells without using any expensive materials and avoids the possible risks associated with them post-implantation.

Pediatric Fracture Remodeling: From Wolff to Wnt

Pediatric fracture remodeling is a complex mechanobiological process in which a team of cells, including osteoclasts, osteoblasts, and osteocytes, responds to cytokine and mechanical signals to synthesize new bone in areas of high stress (concavity of a fracture) and remove older redundant bone in areas of low stress (convexity and medullary canal). Piezo1 mechanoreceptors and other pressure-sensitive membrane proteins perceive and convert mechanical strains into intracellular chemical signals. Cytokines are peptides that bind to cell membrane receptors and influence cell functions. Bone morphogenetic proteins and Wnt are the major osteogenic cytokines. Macrophage colony-stimulating factor and receptor activator of nuclear factor κB ligand (RANKL) are the major osteoclastic cytokines. The combination of mechanical stresses and cytokine concentrations stimulates osteoclasts to resorb bone and osteoblasts to make new bone, resulting in remodeling that restores bone strength and structure.

Microplasma-Sprayed Titanium and Hydroxyapatite Coatings on Ti6Al4V Alloy: in vitro Biocompatibility and Corrosion Resistance: Part I

This two-part paper investigates the bioactivity and mechanical properties of coatings applied to Ti6Al4V, a common titanium alloy used in endoprosthetic implants. Coatings made from hydroxyapatite (HA) powder and commercially pure titanium (CP-Ti) wires were applied using microplasma spraying. The study focuses on the responses of rat mesenchymal stem cells (MSCs), which are essential for bone healing, to these coatings. Part I shows how adjusting the microplasma spraying process allows coatings with varying porosity and surface roughness to be achieved.

Modeling Musculoskeletal Disorders in Zebrafish: Advancements in Muscle and Bone Research

Zebrafish (Danio rerio) have emerged as a valuable model organism for investigating musculoskeletal development and the pathophysiology of associated diseases. Key genes and biological processes in zebrafish that closely mirror those in humans, rapid development, and transparent embryos make zebrafish ideal for the in vivo studies of bone and muscle formation, as well as the molecular mechanisms underlying musculoskeletal disorders. This review focuses on the utility of zebrafish in modeling various musculoskeletal conditions, with an emphasis on bone diseases such as osteoporosis and osteogenesis imperfecta, as well as muscle disorders like Duchenne muscular dystrophy. These models have provided significant insights into the molecular pathways involved in these diseases, helping to identify the key genetic and biochemical factors that contribute to their progression. These findings have also advanced our understanding of disease mechanisms and facilitated the development of potential therapeutic strategies for musculoskeletal disorders.

Magnetically responsive micro-clustered calcium phosphate-reinforced cell-laden microbead sodium alginate hydrogel for accelerated osteogenic tissue regeneration

The rising prevalence of bone injuries has increased the demand for minimally invasive treatments. Microbead hydrogels, renowned for cell encapsulation, provide a versatile substrate for bone tissue regeneration. They deliver bioactive agents, support cell growth, and promote osteogenesis, aiding bone repair and regeneration. In this study, we synthesized superparamagnetic iron oxide nanoparticles (Sp) coated with a calcium phosphate layer (m-Sp), achieving a distinctive flower-like micro-cluster morphology. Subsequently, sodium alginate (SA) microbead hydrogels containing m-Sp (McSa@m-Sp) were fabricated using a dropping gelation strategy. McSa@m-Sp is magnetically targetable, enhance cross-linking, control degradation rates, and provide strong antibacterial activity. Encapsulation studies with MC3T3-E1 cells revealed enhanced viability and proliferation. These studies also indicated significantly elevated alkaline phosphatase (ALP) activity and mineralization in MC3T3-E1 cells, as confirmed by Alizarin Red S (ARS) and Von Kossa staining, along with increased collagen production within the McSa@m-Sp microbead hydrogels. Immunocytochemistry (ICC) and gene expression studies supported the osteoinductive potential of McSa@m-Sp, showing increased expression of osteogenic markers including RUNX-2, collagen-I, osteopontin, and osteocalcin. Thus, McSa@m-Sp microbead hydrogels offer a promising strategy for multifunctional scaffolds in bone tissue engineering.