The improved biological response of shark tooth bioapatites in a comparative in vitro study with synthetic and bovine bone grafts

In vivo assessment of marine vs bovine origin collagen-based composite scaffolds promoting bone regeneration in a New Zealand rabbit model

The ability of human tissues to self-repair is limited, which motivates the scientific community to explore new and better therapeutic approaches to tissue regeneration. The present manuscript provides a comparative study between a marine-based composite biomaterial, and another composed of well-established counterparts for bone tissue regeneration. Blue shark skin collagen was combined with bioapatite obtained from blue shark's teeth (mColl:BAp), while bovine collagen was combined with synthetic hydroxyapatite (bColl:Ap) to produce 3D composite scaffolds by freeze-drying. Collagens showed similar profiles, while apatite particles differed in their composition, being the marine bioapatite a fluoride-enriched ceramic. The marine-sourced biomaterials presented higher porosities, improved mechanical properties, and slower degradation rates when compared to synthetic apatite-reinforced bovine collagen. The in vivo performance regarding bone tissue regeneration was evaluated in defects created in femoral condyles in New Zealand rabbits twelve weeks post-surgery. Micro-CT results showed that mColl:BAp implanted condyles had a slower degradation and an higher tissue formation (17.9 ± 6.9 %) when compared with bColl:Ap implanted ones (12.9 ± 7.6 %). The histomorphometry analysis provided supporting evidence, confirming the observed trend by quantifying 13.1 ± 7.9 % of new tissue formation for mColl:BAp composites and 10.4 ± 3.2 % for bColl:Ap composites, suggesting the potential use of marine biomaterials for bone regeneration.

Enhanced Bone Healing in Critical-Sized Rabbit Femoral Defects: Impact of Helical and Alternate Scaffold Architectures

This study investigates the effect of scaffold architecture on bone regeneration, focusing on 3D-printed polylactic acid-bioceramic calcium phosphate (PLA-bioCaP) composite scaffolds in rabbit femoral condyle critical defects. We explored two distinct scaffold designs to assess their influence on bone healing and scaffold performance. Structures with alternate (0°/90°) and helical (0°/45°/90°/135°/180°) laydown patterns were manufactured with a 3D printer using a fused deposition modeling technique. The scaffolds were meticulously characterized for pore size, strut thickness, porosity, pore accessibility, and mechanical properties. The in vivo efficacy of these scaffolds was evaluated using a femoral condyle critical defect model in eight skeletally mature New Zealand White rabbits. Then, the results were analyzed micro-tomographically, histologically, and histomorphometrically. Our findings indicate that both scaffold architectures are biocompatible and support bone formation. The helical scaffolds, characterized by larger pore sizes and higher porosity, demonstrated significantly greater bone regeneration than the alternate structures. However, their lower mechanical strength presented limitations for use in load-bearing sites.

Vancomycin-Loaded 3D-Printed Polylactic Acid-Hydroxyapatite Scaffolds for Bone Tissue Engineering

The regeneration of bone remains one of the main challenges in the biomedical field, with the need to provide more personalized and multifunctional solutions. The other persistent challenge is related to the local prevention of infections after implantation surgery. To fulfill the first one and provide customized scaffolds with complex geometries, 3D printing is being investigated, with polylactic acid (PLA) as the biomaterial mostly used, given its thermoplastic properties. The 3D printing of PLA in combination with hydroxyapatite (HA) is also under research, to mimic the native mechanical and biological properties, providing more functional scaffolds. Finally, to fulfill the second one, antibacterial drugs locally incorporated into biodegradable scaffolds are also under investigation. This work aims to develop vancomycin-loaded 3D-printed PLA-HA scaffolds offering a dual functionality: local prevention of infections and personalized biodegradable scaffolds with osseointegrative properties. For this, the antibacterial drug vancomycin was incorporated into 3D-printed PLA-HA scaffolds using three loading methodologies: (1) dip coating, (2) drop coating, and (3) direct incorporation in the 3D printing with PLA and HA. A systematic characterization was performed, including release kinetics, Staphylococcus aureus antibacterial/antibiofilm activities and cytocompatibility. The results demonstrated the feasibility of the vancomycin-loaded 3D-printed PLA-HA scaffolds as drug-releasing vehicles with significant antibacterial effects for the three methodologies. In relation to the drug release kinetics, the (1) dip- and (2) drop-coating methodologies achieved burst release (first 60 min) of around 80-90% of the loaded vancomycin, followed by a slower release of the remaining drug for up to 48 h, while the (3) 3D printing presented an extended release beyond 7 days as the polymer degraded. The cytocompatibility of the vancomycin-loaded scaffolds was also confirmed.

Physicochemical Properties of 3D-Printed Polylactic Acid/Hydroxyapatite Scaffolds

The reconstruction or regeneration of damaged bone tissue is one of the challenges of orthopedic surgery and tissue engineering. Among all strategies investigated, additive manufacturing by fused deposition modeling (3D-FDM printing) opens the possibility to obtain patient-specific scaffolds with controlled architectures. The present work evaluates in depth 3D direct printing, avoiding the need for a pre-fabricated filament, to obtain bone-related scaffolds from direct mixtures of polylactic acid (PLA) and hydroxyapatite (HA). For it, a systematic physicochemical characterization (SEM-EDS, FT-Raman, XRD, micro-CT and nanoindentation) was performed, using different PLA/HA ratios and percentages of infill. Results prove the versatility of this methodology with an efficient HA incorporation in the 3D-printed scaffolds up to 13 wt.% of the total mass and a uniform distribution of the HA particles in the scaffold at the macro level, both longitudinal and cross sections. Moreover, an exponential distribution of the HA particles from the surface toward the interior of the biocomposite cord (micro level), within the first 80 µm (10% of the entire cord diameter), is also confirmed, providing the scaffold with surface roughness and higher bioavailability. In relation to the pores, they can range in size from 250 to 850 µm and can represent a percentage, in relation to the total volume of the scaffold, from 24% up to 76%. The mechanical properties indicate an increase in Young's modulus with the HA content of up to ~50%, compared to the scaffolds without HA. Finally, the in vitro evaluation confirms MG63 cell proliferation on the 3D-printed PLA/HA scaffolds after up to 21 days of incubation.

Biomaterials from the sea: Future building blocks for biomedical applications

Marine resources have tremendous potential for developing high-value biomaterials. The last decade has seen an increasing number of biomaterials that originate from marine organisms. This field is rapidly evolving. Marine biomaterials experience several periods of discovery and development ranging from coralline bone graft to polysaccharide-based biomaterials. The latter are represented by chitin and chitosan, marine-derived collagen, and composites of different organisms of marine origin. The diversity of marine natural products, their properties and applications are discussed thoroughly in the present review. These materials are easily available and possess excellent biocompatibility, biodegradability and potent bioactive characteristics. Important applications of marine biomaterials include medical applications, antimicrobial agents, drug delivery agents, anticoagulants, rehabilitation of diseases such as cardiovascular diseases, bone diseases and diabetes, as well as comestible, cosmetic and industrial applications.

Preclinical Evaluation of an Innovative Bone Graft of Marine Origin for the Treatment of Critical-Sized Bone Defects in an Animal Model

Autogenous cancellous bone graft is the current gold standard of treatment for the management of bone defects since it possesses the properties of osteoinduction, osteoconduction, and osteogenesis. Xenografts and synthetic grafts have been widely reported as available and low-cost alternatives, which retain good osteoconductive and mechanical properties. Given the rich biodiversity of ocean organisms, marine sources are of particular interest in the search for alternative bone grafts with enhanced functionalities. The purpose of this paper is to assess the biocompatibility of a marine-derived bone graft obtained from shark tooth, which is an environmentally sustainable and abundant raw material from fishing. This research presents the findings of a preclinical trial—following UNE-EN ISO 10993—that induced a critical-sized bone defect in a rabbit model and compared the results with a commercial bovine-derived bone graft. Evaluation by micro-computed tomography and histomorphometric analysis 12 weeks after implantation revealed good osseointegration, with no signs of inflammatory foreign body reactions, fibrosis, or necrosis in any of the cases. The shark tooth-derived bone graft yielded significantly higher new bone mineral density values (54 ± 6%) than the control (27 ± 8%). Moreover, the percentage of intersection values were much higher (86 ± 8%) than the bovine-derived bone graft (30 ± 1%) used as control. The area of occupancy by bone tissue in the test material (38 ± 5%) also gave higher values than the control (30 ± 6%). The role of physicochemical properties, biphasic structure, and composition on the stimulation of bone regeneration is also discussed.

Case Report: First Evidence of a Benign Bone Cyst in an Adult Teckel Dog Treated With Shark Teeth-Derived Bioapatites

Bone cysts are a very rare orthopedic pathology in veterinary medicine, the general prevalence of which is unknown. A unicameral bone cyst was diagnosed in an adult female Teckel dog with a limp that was treated surgically by filling the defect with marine bioapatites. The treatment was effective and at 8 weeks the defect had remodeled 50.24%. Eighteen months after surgery, the defect had remodeled 94.23%. The limp disappeared after surgery, and functional recovery was good in all stages after surgery. No adverse reactions were observed at the local or systemic level. This is the first report of a benign bone cyst in an lame adult female Teckel successfully treated with a novel marine bioapatite.

Optimal Recovery of Valuable Biomaterials, Chondroitin Sulfate and Bioapatites, from Central Skeleton Wastes of Blue Shark

The industrial filleting of blue shark (Prionace glauca) led to the generation of a large number of central skeletons of low interest to fishmeal plants handling such wastes. In this context, the present study describes the optimization of the hydrolysis process (pH 8.35, T 58 °C, 1% (v/w) of alcalase and t = 4 h) to produce chondroitin sulfate (CS) together with the recovery of bioapatites. Then, that hydrolysate was chemically treated with an optimal alkaline-hydroalcoholic-saline solution (0.48 M of NaOH, 1.07 volumes of EtOH and 2.5 g/L of NaCl) and finally purified by ultrafiltration-diafiltration (30 kDa) to obtain glycosaminoglycan with a purity of 97% and a productive yield of 2.8% (w/w of skeleton). The size of the biopolymer (CS) was of 58 kDa with prevalence of 6S-GalNAc sulfation (4S/6S ratio of 0.25), 12% of GlcA 2S-GalNAc 6S and 6% of non-sulfated disaccharides. Crude bioapatites were purified by pyrolysis and FT-Raman and XRD techniques confirm the presence of hydroxyapatite [Ca₅(PO₄)₃(OH)], with a molar mass of 502.3 g/mol, embedded in the organic matrix of the skeleton. The mineralized tissues of blue shark are promising marine sources for the extraction of high value biomaterials with clinical application in bone and tissue regeneration and are still completely unexplored.

Application of Shark Teeth-Derived Bioapatites as a Bone Substitute in Veterinary Orthopedics. Preliminary Clinical Trial in Dogs and Cats

Background: The autograft is still considered the gold standard for the treatment of bone defects. However, given the significant morbidity of the donor site with which it has been associated, alternative substitutes for bone grafts have been developed. In the present study, a bone substitute composed of CaP biphasic bioceramics obtained from shark teeth was used (BIOFAST-VET). Objective: The objective of this study is to evaluate the efficacy of a marine bioapatite in the veterinary clinical field using it as a bone-grafting scaffold in dogs and cats. Methods: The biomaterial was randomly distributed in 6 veterinary clinical centers in Spain and was used in 24 cases (20 dogs and 4 cats) including 14 fractures, 9 arthrodesis, and 1 bone cyst. Grains between 500 and 2,000 μm were used. Inclusion and exclusion criteria were established. The time of consolidation and functional recovery were quantitatively and qualitatively assessed. For this, a follow-up was carried out at 2, 4, 8, and 12 weeks, included radiographic images, physical examination and sharing the feedback with the owners. Results: Nineteen cases completed the study (18 dogs and 1 cat; 11 fractures, 7 arthrodesis, and 1 bone cyst). The remaining five were excluded because they did not complete the radiographic follow-up (three cats and two dogs), being three arthrodesis and two fractures. In 18 of 19 cases, the use of the biomaterial was successful; the remaining one failed due to causes not related to the biomaterial. There were no systemic or local adverse reactions. Eighteen patients had a good functional recovery. The average consolidation time was 5.94 weeks in dogs with fractures and arthrodesis, not finding statistically significant differences between sex, weight, and procedure. Conclusions: This biomaterial is presented as a very suitable candidate for orthopedic surgery in the veterinary field. Preliminary results showed that its use reduces consolidation time in dogs with fractures and arthrodesis. In addition, no adverse systemic or local reactions have been observed derived from its use.

Chondroitin sulfate and hydroxyapatite from Prionace glauca shark jaw: Physicochemical and structural characterization

In the present work, the potential of the Prionace glauca jaw as a source of both chondroitin sulfate and bioapatite is explored. The sandwich-type structure in cross section of the jaw based on alternate layers with prevalence in organic tissue or mineralized is shown and these bands respectively confirmed as CS or hydroxyapatite -enriched zones. As result of this, an optimized process in sequential steps for the recovery of both biomaterials and their purification process is proposed, by combining enzymatic proteolysis, chemical precipitation and separation using ultrafiltration membrane for CS production together with controlled thermal treatment for hydroxyapatite obtaining. The purified CS was characterized by Gel Permeation Chromatography, Nuclear Magnetic Resonance and Strong Anion Exchange Chromatography, revealing a polymeric material with a molecular weight of 67 kDa, and prevalent 6S-GalNAc sulfation (68%), followed by 4S-GalNAc (13%), a significant proportion of disulfated disaccharides (12%) and only 7% of non-sulfated units. In the case of the bioapatite a purified biphasic 60:40 porous calcium phosphate of hydroxyapatite: whitlockite/β-TCP was confirmed. Hydroxyapatite as major component (85%) was also obtained for jaws directly subjected to the thermal treatment. This proved the influence of the enzymatic hydrolysis and centrifugation on the composition of the mineral fraction.

Current Stage of Marine Ceramic Grafts for 3D Bone Tissue Regeneration

Bioceramic scaffolds are crucial in tissue engineering for bone regeneration. They usually provide hierarchical porosity, bioactivity, and mechanical support supplying osteoconductive properties and allowing for 3D cell culture. In the case of age-related diseases such as osteoarthritis and osteoporosis, or other bone alterations as alveolar bone resorption or spinal fractures, functional tissue recovery usually requires the use of grafts. These bone grafts or bone void fillers are usually based on porous calcium phosphate grains which, once disposed into the bone defect, act as scaffolds by incorporating, to their own porosity, the intergranular one. Despite their routine use in traumatology and dental applications, specific graft requirements such as osteoinductivity or balanced dissolution rate are still not completely fulfilled. Marine origin bioceramics research opens the possibility to find new sources of bone grafts given the wide diversity of marine materials still largely unexplored. The interest in this field has also been urged by the limitations of synthetic or mammalian-derived grafts already in use and broadly investigated. The present review covers the current stage of major marine origin bioceramic grafts for bone tissue regeneration and their promising properties. Both products already available on the market and those in preclinical phases are included. To understand their clear contribution to the field, the main clinical requirements and the current available biological-derived ceramic grafts with their advantages and limitations have been collected.

Current Status on Pulsed Laser Deposition of Coatings from Animal-Origin Calcium Phosphate Sources

The aim of this paper is to present the current status on animal-origin hydroxyapatite (HA) coatings synthesized by Pulsed Laser Deposition (PLD) technique for medical implant applications. PLD as a thin film synthesis method, although limited in terms of surface covered area, still gathers interest among researchers due to its advantages such as stoichiometric transfer, thickness control, film adherence, and relatively simple experimental set-up. While animal-origin HA synthesized by bacteria or extracted from animal bones, eggshells, and clams was tested in the form of thin films or scaffolds as a bioactive agent before, the reported results on PLD coatings from HA materials extracted from natural sources were not gathered and compared until the present study. Since natural apatite contains trace elements and new functional groups, such as CO32− and HPO42− in its complex molecules, physical-chemical results on the transfer of animal-origin HA by PLD are extremely interesting due to the stoichiometric transfer possibilities of this technique. The points of interest of this paper are the origin of HA from various sustainable resources, the extraction methods employed, the supplemental functional groups, and ions present in animal-origin HA targets and coatings as compared to synthetic HA, the coatings’ morphology function of the type of HA, and the structure and crystalline status after deposition (where properties were superior to synthetic HA), and the influence of various dopants on these properties. The most interesting studies published in the last decade in scientific literature were compared and morphological, elemental, structural, and mechanical data were compiled and interpreted. The biological response of different types of animal-origin apatites on a variety of cell types was qualitatively assessed by comparing MTS assay data of various studies, where the testing conditions were possible. Antibacterial and antifungal activity of some doped animal-origin HA coatings was also discussed.

Marine Collagen/Apatite Composite Scaffolds Envisaging Hard Tissue Applications

The high prevalence of bone defects has become a worldwide problem. Despite the significant amount of research on the subject, the available therapeutic solutions lack efficiency. Autografts, the most commonly used approaches to treat bone defects, have limitations such as donor site morbidity, pain and lack of donor site. Marine resources emerge as an attractive alternative to extract bioactive compounds for further use in bone tissue-engineering approaches. On one hand they can be isolated from by-products, at low cost, creating value from products that are considered waste for the fish transformation industry. One the other hand, religious constraints will be avoided. We isolated two marine origin materials, collagen from shark skin (Prionace glauca) and calcium phosphates from the teeth of two different shark species (Prionace glauca and Isurus oxyrinchus), and further proposed to mix them to produce 3D composite structures for hard tissue applications. Two crosslinking agents, 1-[3-(dimethylamino)propyl]-3-ethylcarbodiimide hydrochloride/N-Hydroxysuccinimide (EDC/NHS) and hexamethylene diisocyanate (HMDI), were tested to enhance the scaffolds' properties, with EDC/NHS resulting in better properties. The characterization of the structures showed that the developed composites could support attachment and proliferation of osteoblast-like cells. A promising scaffold for the engineering of bone tissue is thus proposed, based on a strategy of marine by-products valorisation.

In vivo evaluation of shark teeth-derived bioapatites

OBJECTIVE

The present work proposes the shark teeth as a new source of bioapatites for bone filler applications in maxillary sinus elevation, periodontal regeneration or implants placement. This abundant fishing by-product provides an improved hydroxyapatite (HA) with fluorine contributions. The in vivo evaluation of osteointegration and bone mineral density levels promoted by these marine bioapatites was the main objective.

MATERIALS AND METHODS

Marine bioapatite granules of two sizes (1 mm, <20 μm) were obtained and characterized (XRD, SEM, ICP-OES) to determine morphology and composition. In vivo evaluation was performed, after bioapatites implantation in critical defects of parietal bone of 25 rats, for 3 weeks. Commercial synthetic HA/βTCP (60/40%) material and unfilled defects were used as controls. Radiology, micro-CT, histology and quantification of bone mineral density are presented.

RESULTS

These marine bioapatites presented a globular porous morphology. A biphasic composition ~70% apatitic (HA, apatite-CaF, fluorapatite) and ~30% non-apatitic phase (whitlockite, tricalcium bis(orthophosphate)), with contributions of F (1.0 ± 0.5%wt), Na (0.9 ± 0.2%wt) and Mg (0.65 ± 0.04%wt) was confirmed. After implantation period, higher osteointegration of 1-mm marine bioapatites than commercial synthetic granules was observed, together with bone formation from the defect surroundings but also at central area (potential osteoinductive properties). New bone cells penetrated inside pores and inter-granular cavities. Higher bone mineral density, in both 1-mm and <20-μm granules, than on commercial synthetic graft was determined, being significant in 1-mm bioapatites (a P < 0.05).

CONCLUSION

Shark teeth bioapatites were successfully validated as new functionally efficient bone filler in rat model, promoting significantly increased bone mineral density than synthetic control.