Biomimetic Functionalized Surfaces and the Induction of Bone Formation

Global morphogenesis regulating tissue architecture and organogenesis

This perspective article proposes that the induction of bone by recombinant human bone morphogenetic proteins (hBMPs), and by the recombinant human transforming growth factor-β3 (hTGF-β3), the latter only in primates, recapitulates embryonic development, whereby large ossicles de novo form in heterotopic intramuscular sites, where several responding cells are available with marked vascular invasion. The induction of bone initiates with the induction of cartilage' anlages recapitulating development. Selected recombinant hBMPs, hBMP-2 and hOP-1 (hBMP-7) on the other hand, fail to induce significant osteoinduction in orthotopic intraskeletal sites in clinical contexts. This review proposes that the failure of significant clinical bone formation in orthotopic sites is because implantation of hBMP-2 and hOP-1, as well as hTGF-β3 in human mandibular sites, does not proceed via recapitulation of embryonic development, ultimately failing the clinical translation of the "bone induction principle". Biologically, a prerogative of the osteogenic proteins of the TGF-β super family, is the heterotopic induction of bone that initiates via recapitulation of embryonic bone development. Delivery of recombinant hBMP-2 and/or hOP-1 into human bony defects fails because the induction of bone is possible only via embryonic development, which does not occur in orthotopic sites, with limited responding cells and vascular supply. The initiation and assembly of the bone/bone-marrow organ follow a multistep molecular and cellular cascades that ultimately morphogenize the assembly of skeletogenesis masterminding ambulation, body erection, masticatory functions, copulation and the preservation of vital organs and tissues such as the marrow and the cerebral hemispheres. Embryologically, bone forms either via mesenchymal osteogenesis or via endochondral osteogenesis. The former route prevalently sculpts the craniomandibulofacial bones by inducing aggregation of targeted mesenchymal cells to condensate in the primordia of the craniofacial skeleton. A critical step is the condensation of mesenchymal cells that forms around vessels, as the vessels guide the formation of bone. Endochondral osteogenesis initiates by firstly constructing cartilage' anlages that developing bone uses as struts to growth and differentiate. The cartilage anlage is an extraordinary conduit that sets into motion molecular and cellular cell-to-cell, cell-to-receptors cross-talking to initiate angiogenesis and capillary invasion within the hypertrophic cartilage, chondrolysis that initiate osteoblastic cellular differentiation and the deposition of bone, osteoid synthesis, bone marrow development and the induction of a complete mineralized bone-bone marrow organ. The assembled constructs are storage of critical ions, several structural proteins such as osteonectins and fibronectins, biological markers of osteoblast' secretion and activity, such as osteocalcin, together with an array of extraordinary morphogen initiators that de novo set into motion the molecular and cellular cascades inducing bone in heterotopic sites recapitulating embryonic development. In evolutionary molecular biology contexts however, the pleiotropic activities of both proteins' family and the induction of bone formation in heterotopic sites are developmental, and thus not suitable to induce bone when recombinant morphogens are singly implanted in orthotopic skeletal defects, the latter lacking the developmental biological platform.

Mechanistic insights into the spontaneous induction of bone formation

The grand discovery of morphogens, or "form-generating substances", revealed that tissue morphogenesis is initiated by soluble molecular signals or morphogens primarily belonging to the transforming growth factor-β (TGF-β) supergene family. The regenerative potential of bone rests on its extracellular matrix, which is the repository of several morphogens that tightly control cellular differentiating pathways, cellular matrix deposition and remodeling. Alluringly, the matrix also contains specific factors transferred from the heterotopic implanted bone matrices initiating "Tissue Induction", as provocatively described in Nature in 1945. Later, it was found that selected genes and gene products of the TGF-β supergene family singly, synchronously, and synergistically mastermind the induction of bone formation. This review describes the phenomenon of the spontaneous and/or intrinsic osteoinductivity of calcium phosphate-based biomaterials and titanium' constructs without the applications of soluble osteogenetic molecular signals. The review shows the spontaneous induction of bone formation initiated by Ca++ activating stem cell differentiation and up-regulation of bone morphogenetic proteins genes. Expressed gene products are embedded into the concavities of the calcium phosphate-based substrata, initiating bone formation as a secondary response. Pure titanium's substrata do not initiate the spontaneous induction of bone formation. The induction of bone is solely dependent on acid, alkali and heat treatments to form apatite layers on the treated titanium surfaces. The induction of bone formation is achieved exclusively by apatite-based biomaterial surfaces. The hydroxyapatite, in its various forms and geometric configurations, finely tunes the induction of bone formation in heterotopic sites. Cellular differentiation by fine-tuning of the cellular molecular machinery is initiated by specific geometric modularity of the hydroxyapatite substrata that push cellular buttons that start the ripple-like cascade of "Tissue Induction", generating newly formed ossicles with bone marrow in heterotopic extraskeletal sites. The highlighted mechanistic insights into the spontaneous induction of bone formation are a research platform invocating selected molecular elements to construct the induction of bone formation.

Fabrication and characterizations of simvastatin-containing mesoporous bioactive glass and molybdenum disulfide scaffold for bone tissue engineering

Due to the limitations of the current treatment approaches of allograft and autograft techniques, treating bone disorders is a significant challenge. To address these shortcomings, a novel biomaterial composite is required. This study presents the preparation and fabrication of a novel biomaterial composite scaffold that combines poly (D, L-lactide-co-glycolide) (PLGA), mesoporous bioactive glass (MBG), molybdenum disulfide (MoS2), and simvastatin (Sim) to address the limitations of current bone grafting techniques of autograft and allograft. The fabricated scaffold of PLGA-MBG-MoS2-Sim composites was developed using a low-cost hydraulic press and salt leaching method, and scanning electron microscopy (SEM) analysis confirmed the scaffolds have a pore size between 143 and 240 μm. The protein adsorption for fabricated scaffolds was increased at 24 h. The water adsorption and retention studies showed significant results on the PLGA-MBG-MoS2-Sim composite scaffold. The biodegradation studies of the PLGA-MBG-MoS2-Sim composite scaffold have shown 54% after 28 days. In vitro, bioactivity evaluation utilizing simulated body fluid studies confirmed the development of bone mineral hydroxyapatite on the scaffolds, which was characterized using x-ray diffraction, Fourier transform infrared, and SEM analysis. Furthermore, the PLGA-MBG-MoS2-Sim composite scaffold is biocompatible with C3H10T1/2 cells and expresses more alkaline phosphatase and mineralization activity. Additionally, in vivo research showed that PLGA-MBG-MoS2-Sim stimulates a higher rate of bone regeneration. These findings highlight the fabricated PLGA-MBG-MoS2-Sim composite scaffold presents a promising solution for the limitations of current bone grafting techniques.

Perfused Platforms to Mimic Bone Microenvironment at the Macro/Milli/Microscale: Pros and Cons

As life expectancy increases, the population experiences progressive ageing. Ageing, in turn, is connected to an increase in bone-related diseases (i.e., osteoporosis and increased risk of fractures). Hence, the search for new approaches to study the occurrence of bone-related diseases and to develop new drugs for their prevention and treatment becomes more pressing. However, to date, a reliable in vitro model that can fully recapitulate the characteristics of bone tissue, either in physiological or altered conditions, is not available. Indeed, current methods for modelling normal and pathological bone are poor predictors of treatment outcomes in humans, as they fail to mimic the in vivo cellular microenvironment and tissue complexity. Bone, in fact, is a dynamic network including differently specialized cells and the extracellular matrix, constantly subjected to external and internal stimuli. To this regard, perfused vascularized models are a novel field of investigation that can offer a new technological approach to overcome the limitations of traditional cell culture methods. It allows the combination of perfusion, mechanical and biochemical stimuli, biological cues, biomaterials (mimicking the extracellular matrix of bone), and multiple cell types. This review will discuss macro, milli, and microscale perfused devices designed to model bone structure and microenvironment, focusing on the role of perfusion and encompassing different degrees of complexity. These devices are a very first, though promising, step for the development of 3D in vitro platforms for preclinical screening of novel anabolic or anti-catabolic therapeutic approaches to improve bone health.

Orbital floor repair using patient specific osteoinductive implant made by stereolithography

The orbital floor (OF) is an anatomical location in the craniomaxillofacial (CMF) region known to be highly variable in shape and size. When fractured, implants commonly consisting of titanium meshes are customized by plying and crude hand-shaping. Nevertheless, more precise customized synthetic grafts are needed to meticulously reconstruct the patients' OF anatomy with better fidelity. As alternative to titanium mesh implants dedicated to OF repair, we propose a flexible patient-specific implant (PSI) made by stereolithography (SLA), offering a high degree of control over its geometry and architecture. The PSI is made of biodegradable poly(trimethylene carbonate) (PTMC) loaded with 40 wt % of hydroxyapatite (called Osteo-PTMC). In this work, we developed a complete work-flow for the additive manufacturing of PSIs to be used to repair the fractured OF, which is clinically relevant for individualized medicine. This work-flow consists of (i) the surgical planning, (ii) the design of virtual PSIs and (iii) their fabrication by SLA, (iv) the monitoring and (v) the biological evaluation in a preclinical large-animal model. We have found that once implanted, titanium meshes resulted in fibrous tissue encapsulation, whereas Osteo-PMTC resulted in rapid neovascularization and bone morphogenesis, both ectopically and in the OF region, and without the need of additional biotherapeutics such as bone morphogenic proteins. Our study supports the hypothesis that the composite osteoinductive Osteo-PTMC brings advantages compared to standard titanium mesh, by stimulating bone neoformation in the OF defects. PSIs made of Osteo-PTMC represent a significant advancement for patients whereby the anatomical characteristics of the OF defect restrict the utilization of traditional hand-shaped titanium mesh.

Enhancing survival, engraftment, and osteogenic potential of mesenchymal stem cells

Mesenchymal stem cells (MSCs) are promising candidates for bone regeneration therapies due to their plasticity and easiness of sourcing. MSC-based treatments are generally considered a safe procedure, however, the long-term results obtained up to now are far from satisfactory. The main causes of these therapeutic limitations are inefficient homing, engraftment, and osteogenic differentiation. Many studies have proposed modifications to improve MSC engraftment and osteogenic differentiation of the transplanted cells. Several strategies are aimed to improve cell resistance to the hostile microenvironment found in the recipient tissue and increase cell survival after transplantation. These strategies could range from a simple modification of the culture conditions, known as cell-preconditioning, to the genetic modification of the cells to avoid cellular senescence. Many efforts have also been done in order to enhance the osteogenic potential of the transplanted cells and induce bone formation, mainly by the use of bioactive or biomimetic scaffolds, although alternative approaches will also be discussed. This review aims to summarize several of the most recent approaches, providing an up-to-date view of the main developments in MSC-based regenerative techniques.

Osteogenic differentiation of human bone marrow-derived mesenchymal stem cells is enhanced by an aragonite scaffold

Bone graft substitutes and bone void fillers are predominantly used to treat bone defects and bone fusion in orthopaedic surgery. Some aragonite-based scaffolds of coralline exoskeleton origin exhibit osteoconductive properties and are described as useful bone repair scaffolds. The purpose of this study was to evaluate the in vitro osteogenic potential of the bone phase of a novel aragonite-based bi-phasic osteochondral scaffold (Agili-C™, CartiHeal Ltd.) using adult human bone marrow-derived mesenchymal stem cells (MSCs). Analyses were performed at several time intervals: 3, 7, 14, 21, 28 and 42 days post-seeding. Osteogenic differentiation was assessed by morphological characterisation using light microscopy after Alizarin red and von Kossa staining, and scanning electron microscopy. The transcript levels of alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2), bone gamma-carboxyglutamate (BGLAP), osteonectin (SPARC) and osteopontin (SPP1) were determined by quantitative PCR. Proliferation was assessed by a thymidine incorporation assay and proliferating cell nuclear antigen (PCNA) immunocytochemistry. Our results demonstrate that the bone phase of the bi-phasic aragonite-based scaffold supports osteogenic differentiation and enhanced proliferation of bone marrow-derived MSCs at both the molecular and histological levels. The scaffold was colonized by differentiating MSCs, suggesting its suitability for incorporation into bone voids to accelerate bone healing, remodelling and regeneration. The mechanism of osteogenic differentiation involves scaffold surface modification with de novo production of calcium phosphate deposits, as revealed by energy dispersive spectroscopy (EDS) analyses. This novel coral-based scaffold may promote the rapid formation of high quality bone during the repair of osteochondral lesions.

A Convenient and High-Efficient Laser Micro-Engraving Treatment for Controllable Preparation of Microstructure on Al Alloy

Surface microstructure preparation offers a promising approach for overcoming the shortcomings of Al alloy, such as poor friction resistance, low hardness and weak corrosion resistance to corrosive liquid. Though many methods for the surface microstructure preparation of Al alloy have been developed, it is difficult for most of the reported methods to regulate the as-prepared microstructure, meaning that the properties of Al alloy cannot be improved efficiently by the microstructure. Thus, the application of microstructure surface of Al alloy and microstructure preparation technology is severely limited. Aimed at this issue, a simple, convenient, high-efficient, low-cost micro-scale roughness structure construction approach that is suitable for engineering application (laser micro-engraving) was developed. The as-prepared microstructure on Al alloy surface formed by laser micro-engraving was investigated systemically. The morphology and formation mechanism of the microstructure were examined. Meanwhile, the effect of laser parameters on morphology, geometrical dimensions and composition of microstructure was investigated. The results indicate that the morphology of microstructure is affected by the overlap degree of molten pool greatly. When each molten pool does not overlap with others, successive individual pits can be constructed. When each molten pool overlaps with others for one time, successive overlapping pits will form. As the overlap degree of the molten pool further increases (overlapping with others for more than one time), the successive pits can become grooved. Because of the influence of laser beam pulse frequency and scanning speed on the diameter and distance of the molten pools, the morphology and geometrical dimensions of microstructure can vary greatly with laser parameters. As the laser beam scanning speed increases, the geometrical dimensions of as-prepared microstructure reduce significantly. In contrast, with the increase of laser beam pulse frequency, the geometrical dimensions change in a complicated manner. However, the chemical composition of microstructure is slightly affected by laser parameters. More importantly, a relationship model was successfully established, which could be used to predict and regulate the geometrical dimensions of microstructure treated by laser micro-engraving. Controllable preparation of microstructure on Al alloy is realized, leading that specific microstructure can be prepared rapidly and accurately instead of suffering from long-time experimental investigation in the future.