Endogenous bone morphogenetic protein expression in transplants of urinary bladder

Tissue engineering for bone regeneration and osseointegration in the oral cavity

OBJECTIVE

The focus of this review is to summarize recent advances on regenerative technologies (scaffolding matrices, cell/gene therapy and biologic drug delivery) to promote reconstruction of tooth and dental implant-associated bone defects.

METHODS

An overview of scaffolds developed for application in bone regeneration is presented with an emphasis on identifying the primary criteria required for optimized scaffold design for the purpose of regenerating physiologically functional osseous tissues. Growth factors and other biologics with clinical potential for osteogenesis are examined, with a comprehensive assessment of pre-clinical and clinical studies. Potential novel improvements to current matrix-based delivery platforms for increased control of growth factor spatiotemporal release kinetics are highlighting including recent advancements in stem cell and gene therapy.

RESULTS

An analysis of existing scaffold materials, their strategic design for tissue regeneration, and use of growth factors for improved bone formation in oral regenerative therapies results in the identification of current limitations and required improvements to continue moving the field of bone tissue engineering forward into the clinical arena.

SIGNIFICANCE

Development of optimized scaffolding matrices for the predictable regeneration of structurally and physiologically functional osseous tissues is still an elusive goal. The introduction of growth factor biologics and cells has the potential to improve the biomimetic properties and regenerative potential of scaffold-based delivery platforms for next-generation patient-specific treatments with greater clinical outcome predictability.

Osteoinductive nanohydroxyapatite bone substitute prepared via in situ hydrothermal transformation of cuttlefish bone

The capacity to induce a rapid and controlled healing of bone defects is critical for a bone substitute. Previous studies have reported hydrothermal transformation (HT) of aragonite from cuttlebone (CB) to cuttlebone hydroxyapatite (CBHA). However, the biocompatibility and in vivo characteristic of CBHA have not been fully investigated. We fabricated CBHA via the in situ HT of aragonite from CB. This CBHA exhibited a highly porous structure and nanoscaled surface morphology with a significantly higher protein adsorption rate than CB. Marrow mesenchymal stem cells (MSCs) were seeded and cultured on the CBHA and CB to evaluate their influence on cell proliferation and differentiation. According to scanning electronic microscopy observation and MTT assay, the MSCs adhered and proliferated well on both the CBHA and CB. Compared with the cells on the CB, the MSCs on CBHA exhibited enhanced alkaline phosphatase activity and osteocalcin levels after 13 days of culture. In vivo testing revealed that CBHA could induce ectopic bone formation after implantation, while no bone formation being observed in the CB. These findings demonstrated that a nanoscaled and osteoinductive bone substitute could be produced by hydrothermally transforming an aragonite of CB into a hydroxyapatite.

Demineralized bone matrix in bone repair: history and use

Demineralized bone matrix (DBM) is an osteoconductive and osteoinductive commercial biomaterial and approved medical device used in bone defects with a long track record of clinical use in diverse forms. True to its name and as an acid-extracted organic matrix from human bone sources, DBM retains much of the proteinaceous components native to bone, with small amounts of calcium-based solids, inorganic phosphates and some trace cell debris. Many of DBM's proteinaceous components (e.g., growth factors) are known to be potent osteogenic agents. Commercially sourced as putty, paste, sheets and flexible pieces, DBM provides a degradable matrix facilitating endogenous release of these compounds to the bone wound sites where it is surgically placed to fill bone defects, inducing new bone formation and accelerating healing. Given DBM's long clinical track record and commercial accessibility in standard forms and sources, opportunities to further develop and validate DBM as a versatile bone biomaterial in orthopedic repair and regenerative medicine contexts are attractive.

Urinary bladder wall substitution using autologous tunica vaginalis in male dogs

Fresh autologous tunica vaginalis was experimentally used for partial substitution of the excised urinary bladder wall in ten male mongrel dogs. The substituted areas of two dogs were examined macroscopically and histologically at 2, 4, 6, 8, and 10 weeks after surgery. Two control dogs underwent partial cystectomy and primary wall closure without substitution. The regenerated transitional epithelium completely covered the substituted portion and smooth muscle regeneration was present at 6 weeks. The bladder walls at the closure area of one control dog and at the substituted portions of two dogs at 10 weeks were indistinguishable macroscopically from the native bladder with all layers of the bladder wall present histologically. According to the macroscopic and histological findings and simplicity of the technique, tunica vaginalis can be used as an alternative graft for bladder wall substitution. Calcification and bone metaplasia observed were similar to those found after using other tissue grafts.

Possible involvement of bone morphogenetic protein 2 in heterotopic ossification in metastatic lesion from urothelial carcinoma of bladder

Heterotopic bone formation caused by urothelial carcinoma is rare. The precise mechanism of heterotopic ossification is still unknown. We report a case of urothelial carcinoma with heterotopic bone formation in a metastatic site and investigate the expression of bone morphogenetic protein 2 (BMP-2) and the BMP receptor (BMPR)-Ib using immunohistochemistry. Positive staining of BMP-2 was observed in the cytoplasm of tumor cells in both bladder and psoas lesions. In addition, positive staining of BMPR-Ib was seen in osteoblast-like cells adjacent to bone formation in the psoas metastasis. The heterotopic ossification may result from the metaplasia of pluripotent stem cells into osteoblast cells induced by BMP-2 in a paracrine fashion.

Laminin, VEGF, and bone matrix protein expression in uroepithelial bone induction--a canine model

A biological and embryological bone induction from epithelial-mesenchymal cell interactions has been noticed in some developing tissues. However, the mechanism for bone formation induced by the epithelial-mesenchymal cell interactions is not clear. The aim of our study was to reveal the role of laminin, vascular endothelial growth factor (VEGF), and bone matrix proteins in mesenchymal cell differentiation during uroepithelial bone induction using a well-established canine model. In this model, a myoperitoneal muscle flap from the abdominal rectus sheath was transplanted into the bladder wall. After 6 weeks, the bladder samples were removed and assessed by histology and immunohistochemistry. This study demonstrated that bone formation occurred in two different directions with two distinct mechanisms. We noted that bone-forming cells in two types of bone formation derived from mesenchymal stem cell differentiation induced either from uroepithelium or bone autoinduction. Laminin was only expressed in peripheral regions of uroepithelium bone formation. Type II collagen was expressed both intracellularly and extracellularly around hypertrophic chondrocytes, whereas VEGF was mostly expressed in proliferating chondrocytes. This study indicates that components in basement membrane like laminin play a role in transitional epithelium-induced differentiation of mesenchymal cells to chondrocytes in muscle tissue. The sequential expression of bone matrix proteins by differentiated osteogenetic cells indicates a subsequent sequence of bone autoinduction.

Transplantation of the urinary bladder and other organs in the subcutaneous tissue induces cyst formation and epithelialization: its potential usefulness in regenerative medicine

Certain hollow organs are known to form cysts when heterologously transplanted. In order to examine the usefulness of the phenomenon for regenerative medicine, rat urinary bladders and other organs were allo-transplanted under the subcutaneous tissue of the back. These transplanted tissues very often formed cysts covered with epithelia. The epithelia covered an area about twice the original size. In the case of the urinary bladder, the epithelium started moving from the edge of the transplants around day 3 after the operation, and as time proceeded, the tela submucosa and tunica muscularis also moved to encircle the epithelium, and formed the wall of the cyst. The basal laminae were formed under the newly expanded epithelium slightly behind the leading tip. All of the organs tested had the capability of cyst formation and epithelialization, although their rate differed between organs. The results are discussed with reference to the potential use of cyst formation for regenerating damaged organs.

BMP-4 and BMP-6 involvement in the osteogenic properties of the HeLa cell line

The heterotopically induced ossicles are used in our research on bone tissue. The ossicles are formed in the thigh muscle of BALB/c mice under the influence of injected suspension of 3 x 10(6) HeLa cells. We postulate that the mechanism of bone induction is based on the secretion of bone morphogenetic proteins BMP-4 and BMP-6 by the grafted HeLa cells. This was proved by the use of specific immunohistochemical reaction and Western blots of conditioned culture medium. It seems that HeLa cells secrete BMPs continuously into the culture medium, even without contact with the mice muscle tissue, were induction of bone tissue is observed.

All for one and one for all: condensations and the initiation of skeletal development

Condensation is the pivotal stage in the development of skeletal and other mesenchymal tissues. It occurs when a previously dispersed population of cells gathers together to differentiate into a single cell/tissue type such as cartilage, bone, muscle, tendon, kidney, and lung and is the earliest stage during organ formation when tissue-specific genes are upregulated. We present a synopsis of our current understanding of how condensations are initiated and grown, how their boundaries and sizes are set, how condensation ceases, and how overt differentiation begins. Extracellular matrix molecules, cell surface receptors and cell adhesion molecules, such as fibronectin, tenascin, syndecan, and N-CAM, initiate condensation formation and set condensation boundaries. Hox genes (Hoxd-11-13) and other transcription factors (CFKH-1, MFH-1, osf-2), modulate the proliferation of cells within condensations. Cell adhesion is ensured indirectly through Hox genes (Hoxa-2, Hoxd-13), and directly via cell adhesion molecules (N-CAM and N-cadherin). Subsequent growth of condensations is regulated by BMPs, which activate Pax-2, Hoxa-2 and Hoxd-11 among other genes. Growth of a condensation ceases when Noggin inhibits BMP signalling, setting the stage for transition to the next stage of skeletal development, namely overt cell differentiation. BioEssays 22:138-147, 2000.