Comparing the regeneration potential between PLLA/Aragonite and PLLA/Vaterite pearl composite scaffolds in rabbit radius segmental bone defects

Mussel-derived nacre and pearl, which are natural composites composed CaCO₃ platelets and interplatelet organic matrix, have recently gained interest due to their osteogenic potential. The crystal form of CaCO₃ could be either aragonite or vaterite depending on the characteristics of mineralization template within pearls. So far, little attention has been paid on the different osteogenic capacities between aragonite and vaterite pearl. In the current work, aragonite or vaterite pearl powders were incorporated into poly-l-lactic acid (PLLA) scaffold as bio-functional fillers for enhanced osteogenesis. In intro results revealed that PLLA/aragonite scaffold possessed stronger stimulatory effect on SaOS-2 cell proliferation and differentiation, evidenced by the enhanced cell viability, alkaline phosphatase activity, collagen synthesis and gene expressions of osteogenic markers including osteocalcin, osteopotin and bone sialoprotein. The bone regeneration potential of various scaffolds was evaluated in vivo employing a rabbit critical-sized radial bone defect model. The X-ray and micro-CT results showed that significant bone regeneration and bridging were achieved in defects implanted with composite scaffolds, while less bone formation and non-bridging were found for pure PLLA group. Histological evaluation using Masson's trichrome and hematoxylin/eosin (H&E) staining indicated a typical endochondral bone formation process conducted at defect sites treated with composite scaffolds. Through three-point bending test, the limbs implanted with PLLA/aragonite scaffold were found to bear significantly higher bending load compared to other two groups. Together, it is suggested that aragonite pearl has superior osteogenic capacity over vaterite pearl and PLLA/aragonite scaffold can be employed as a potential bone graft for bone regeneration.

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PLLA/pearl powder composite scaffolds with interconnected pores were fabricated.

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PLLA/aragonite scaffold stimulated SaOS-2 cell proliferation and differentiation.

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PLLA/aragonite scaffold promoted bone regeneration in vivo.

PLA composites: From production to properties

Poly(lactic acid) or polylactide (PLA), a biodegradable polyester produced from renewable resources, is used for various applications (biomedical, packaging, textile fibers and technical items). Due to its inherent properties, PLA has a key-position in the market of biopolymers, being one of the most promising candidates for further developments. Unfortunately, PLA suffers from some shortcomings, whereas for the different applications specific end-use properties are required. Therefore, the addition of reinforcing fibers, micro- and/or nanofillers, and selected additives within PLA matrix is considered as a powerful method for obtaining specific end-use characteristics and major improvements of properties. This review highlights recent developments, current results and trends in the field of composites based on PLA. It presents the main advances in PLA properties and reports selected results in relation to the preparation and characterization of the most representative PLA composites. To illustrate the possibility to design the properties of composites, a section is devoted to the production and characterization of innovative PLA-based products filled with thermally-treated calcium sulfate, a by-product from the lactic acid production process. Moreover, are emphasized the last tendencies strongly evidenced in the case of PLA, i.e., the high interest to diversify its uses by moving from biomedical and packaging (biodegradation properties, "disposables") to technical applications ("durables").

Isocyanate-terminated Lactic Acid Oligomers as a New Means to Conjugate Functional Drugs or Polymers with Bioresorbable Hydrophobic Segments

The use of poly(lactic acid) with activated chain ends is an alternative strategy to polymerizing lactides using coordination-insertion polymerizations in the presence of alcohols or amines when one wants to create a macromolecular prodrug or to create self-assembling amphiphilic polymers or to modify a surface. A new route to functionalized poly(a-hydroxy acid) end groups is described based on successive reactions; the activation of chain ends via the formation of a mixed anhydride, the conversion to azide, and finally the formation of isocyanate by the Curtius rearrangement, all in one pot. The various stages are monitored using FTIR spectrometry. To exemplify the potential of the method, activated lactic acid oligomers are reacted with model alcohols and amine-bearing small molecules that are bound via carbamate or urea bonds, respectively. FTIR, 1H NMR, and SEC with a refractometric/photo diode array or refractometric/ fluorimetric double detections are used to assess the binding of the drug model on oligomers. Based on the results, the method is easily applied to small molecules, macromolecules, and surfaces bearing chemical functional groups that react with isocyanate.

Silica xerogels and hydroxyapatite nanocrystals for the local delivery of platinum-bisphosphonate complexes in the treatment of bone tumors: a mini-review

The present review focuses on the "drug targeting and delivery" approach of the selective transportation of cisplatin to bone tumors and bone metastases. This aim is realized by binding cisplatin to (bis)phosphonate ligands or their derivatives. Geminal bisphosphonates are in clinical use in the treatment of several bone-related diseases because of their high affinity for calcium ions and hence for bones. Platinum-bisphosphonate complexes may be easily loaded onto calcium-containing inorganic matrices, such as calcium-doped sol-gel derived silica xerogels and hydroxyapatite nanocrystals, for local administration at the site of the bone malignancy. The composites may be used as bone-filler materials that, in addition to their action as bone substitutes, can also act as controlled platinum-drug releasing agents. The release kinetics of the drug can be tailored for specific therapeutic applications modulating the physico-chemical features of the inorganic matrices. Moreover, apatite nanocrystals loaded with platinum-bisphosphonate prodrugs can be used as injectable material for nanomedical applications (e.g. intracellular drug delivery).

Evaluation of nano-biphasic calcium phosphate ceramics for bone tissue engineering applications: in vitro and preliminary in vivo studies

Reconstruction of critical sized bone injuries is a major problem that continues to inspire the design of new materials and grafts. Natural ceramics (hydroxyapatite (HA) coralline HA, or synthetic HA) and β-tricalcium phosphate (β-TCP) are being explored for use as scaffolds in bone tissue engineering, among several other materials. The present study evaluated the bone forming capacity of nanosize bioceramics synthesized in situ in poly-vinyl alcohol (PVA) with different ratios of HA and β-TCP; the Ca/P ratio was 1.62 for bioceramic P1, 1.60 for P2 and 1.58 for P3. Further osteogenesis in vitro with mesenchymal stem cells (MSC) acquired from different sources for osteogenesis in vitro and their bone healing properties in vivo were also evaluated. MSC isolated from human placenta, Wharton's jelly from umbilical cord, fetal bone marrow and adipose tissue, cultured in the presence of nanosize bioceramic particles, were monitored for osteogenic differentiation. Placental cells showed the best osteogenic potential of the different MSC studied on the basis of expression of osteogenic markers. Complete regeneration of the damaged region was observed in vivo when MSC derived from placenta were used with nanoceramic (Ca/P ratio 1.58) in the experimental defect created in the femur of Wistar rats. Even small variation in the Ca/P ratio can alter the outcome of tissue constructs.

Osteogenesis of mineralized collagen bone graft modified by PLA and calcium sulfate hemihydrate: in vivo study

In this study, the biocompatibility and bone regeneration performance of nano-hydroxyapatite/collagen/poly(L-lactide) (nHAC/PLA) and nano-hydroxyapatite/collagen/calcium sulfate hemihydrate (nHAC/CSH) as bone-filling materials were evaluated and compared in a critical box-shaped defect model in the mandible of the rabbits. In vivo results indicated that there was significant difference in early bone remodeling between two types of bone substitutes. nHAC/PLA has shown excellent biocompatibility, but no adequate handling properties. The addition of CSH to nHAC provided better manipulability compared to nHAC/PLA. Furthermore, nHAC/CSH possesses superior properties in restoring critical-sized bone defects of maxillofacial region at the early stage of remodeling over nHAC/PLA. Our results suggested that nHAC/CSH could be an alternative to the conventionally used bone tissue engineering materials.

Posterolateral spinal fusion with nano-hydroxyapatite-collagen/PLA composite and autologous adipose-derived mesenchymal stem cells in a rabbit model

Spinal fusion is routinely performed to treat low back pain caused by degeneration of intervertebral discs. An autologous bone graft derived from the iliac crest is the standard procedure used for spinal fusion. However, several shortcomings, including pseudarthrosis, pain and the need for blood transfusion are known to be associated with the procedure. Our study analysed the effectiveness of a new mineralized collagen matrix, nano-hydroxyapatite-collagen-polylactic acid (nHAC-PLA), combined with autologous adipose-derived mesenchymal stem cells (ADMSCs) as a graft material for posterolateral spinal fusion in a rabbit model. Forty rabbits were randomly divided into four groups: autologous iliac crest bone group (ACB), nHAC-PLA composite group (nHAC-PLA), autologous iliac crest bone mixed with nHAC-PLA composite group (ACB + nHAC-PLA), and nHAC-PLA composite combined with ADMSCs (ADMSCs + nHAC-PLA). The viability and the proliferation of the ADMSCs seeded on the scaffolds were evaluated by live/dead kit and MTT assay in vitro, respectively. Lumbar posterolateral fusions were assessed by manual palpation, radiographical and histological procedures, mechanical strength and scanning electronic microscopy (SEM) in 10 weeks of observation. The results showed that the rate of fusion was significantly higher in the ACB and ADMSCs + nHAC-PLA groups than that in the nHAC-PLA and ACB + nHAC-PLA groups. It was not significantly higher in the ACB group than in the ADMSCs + nHAC-PLA group. From microstructural analysis of the samples using histological staining methods, there was more new bone-like tissue formation in the ACB and ADMSCs + nHAC-PLA groups than that in the other two groups at the 10th postoperative week. Our study demonstrated the effective impact of nHAC-PLA combined with ADMSCs in rabbit posterolateral spinal fusion.

Biocomposites and hybrid biomaterials based on calcium orthophosphates

The state-of-the-art of biocomposites and hybrid biomaterials based on calcium orthophosphates that are suitable for biomedical applications is presented in this review. Since these types of biomaterials offer many significant and exciting possibilities for hard tissue regeneration, this subject belongs to a rapidly expanding area of biomedical research. Through successful combinations of the desired properties of matrix materials with those of fillers (in such systems, calcium orthophosphates might play either role), innovative bone graft biomaterials can be designed. Various types of biocomposites and hybrid biomaterials based on calcium orthophosphates, either those already in use or being investigated for biomedical applications, are extensively discussed. Many different formulations, in terms of the material constituents, fabrication technologies, structural and bioactive properties as well as both in vitro and in vivo characteristics, have already been proposed. Among the others, the nanostructurally controlled biocomposites, those containing nanodimensional compounds, biomimetically fabricated formulations with collagen, chitin and/or gelatin as well as various functionally graded structures seem to be the most promising candidates for clinical applications. The specific advantages of using biocomposites and hybrid biomaterials based on calcium orthophosphates in the selected applications are highlighted. As the way from the laboratory to the hospital is a long one, and the prospective biomedical candidates have to meet many different necessities, this review also examines the critical issues and scientific challenges that require further research and development.

Size effect of calcium phosphate coated with poly-DL-lactide- co-glycolide on healing processes in bone reconstruction

In this article, synthesis and application of calcium phosphate/poly-DL-lactide-co-glycolide (CP/PLGA) composite biomaterial in particulate form, in which each CP granule/particle is coated with PLGA, are described. Two types of the particulate material having different particle sizes were synthesized: one with an average particle diameter between 150 and 250 mum (micron-sized particles, MPs) and the other with an average particle diameter smaller than 50 nm (nanoparticles, NPs). A comparative in vivo analysis was done by reconstructing defects in osteoporotic alveolar bones using both composites. The material, CP granules/particles covered with polymer, was characterized using X-ray structural analysis, scanning electron microscopy, and atomic force microscopy. Changes in reparatory functions of tissues affected by osteoporosis were examined in mice in vivo, using these two kinds of composite materials, with and without autologous plasma. Having defined the target segment, histomorphometric parameters-bone area fraction, area, and mean density-were determined. The best results in the regeneration and recuperation of alveolar bone damaged by osteoporosis were achieved with the implantation of a mixture of nanoparticulate CP/PLGA composite and autologous plasma. After the implantation of microparticulate CP/PLGA, in the form of granules, mixed with autologous plasma, into an artificial defect in alveolar bone, new bone formation was also observed, although its formation rate was slower.

Bone Regeneration with BMP-2 Gene-modified Mesenchymal Stem Cells Seeded on Nano-hydroxyapatite/Collagen/ Poly(L-Lactic Acid) Scaffolds

In this study, the capacity of bone morphogenetic protein 2 (BMP-2) gene-transfected bone marrow-derived mesenchymal stem cells (MSCs) in combination with nano-hydroxyapatite/collagen/poly(L-lactic acid) (nHAC/ PLA) to improve the repair of bone defects in rabbit was explored. MSCs from New Zealand White rabbits were cultured and injected with pIRES2-EGFPhBMP-2 or pIRES2-EGFP by electroporation. After the transfer efficiency was determined through the expression of EGFP, the MSCs were seeded on scaffolds to generate an in vitro 3D cell/scaffold construct. The adhesion and proliferation of the MSCs cultured in the scaffold was assessed by SEM. The cellular constructs obtained were allografted into the 15 mm critical-sized segmental bone defects in the radius of New Zealand White rabbits for 12 weeks. The bone regeneration was assessed by radiographical and histological analyses. In vitro, nHAC/PLA facilitated MSC adhesion and proliferation on the scaffold, and gene transfer efficiency reached a maximum of 35.5 ± 3.8%. In vivo, the implantation of BMP-2 transfected MSCs/nHAC/PLA construct significantly enhanced the formation of new bone in the segmental defect, compared to the control groups. This novel 3D BMP-2 transfected MSCs/nHAC/PLA construct has the potential for bone repair by genetic tissue engineering approach.

Nanosized and nanocrystalline calcium orthophosphates

Recent developments in biomineralization have already demonstrated that nanosized crystals and particles play an important role in the formation of hard tissues of animals. Namely, it is well established that the basic inorganic building blocks of bones and teeth of mammals are nanosized and nanocrystalline calcium orthophosphates in the form of apatites. In mammals, tens to hundreds nanocrystals of a biological apatite have been found to be combined into self-assembled structures under the control of bioorganic matrixes. Therefore, application and prospective use of the nanosized and nanocrystalline calcium orthophosphates for a clinical repair of damaged bones and teeth are also well known. For example, greater viability and better proliferation of various types of cells have been detected on smaller crystals of calcium orthophosphates. Thus, the nanosized and nanocrystalline forms of calcium orthophosphates have great potential to revolutionize the hard tissue-engineering field, starting from bone repair and augmentation to controlled drug delivery systems. This paper reviews the current state of art and recent developments of various nanosized and nanocrystalline calcium orthophosphates, starting from synthesis and characterization to biomedical and clinical applications. The review also provides possible directions for future research and development.

Fabrication and biocompatibility of nano non-stoichiometric apatite and poly(epsilon-caprolactone) composite scaffold by using prototyping controlled process

Nano biocomposite scaffolds of non-stoichiometric apatite (ns-AP) and poly(epsilon-caprolactone) (PCL) were prepared by a prototyping controlled process (PCP). The results show that the composite scaffolds with 40 wt% ns-AP contained open and well interconnected pores with a size of 400-500 mum, and exhibited a maximum porosity of 76%. The ns-AP particles were not completely embedded in PCL matrix while exposed on the composite surface, which might be useful for cell attachment and growth. Proliferation of MG(63) cells was significantly better on the composite scaffolds with porosity of 76% than that those with porosity of 53%, indicating that the scaffolds with high porosity facilitated cell growth, and could promote cell proliferation. The composite scaffolds were implanted into rabbit thighbone defects to investigate the in vivo biocompatibility and osteogenesis. Radiological and histological examination confirmed that the new bony tissue had grown easily into the entire composite scaffold. The results suggest that the well-interconnected pores in the scaffolds might encourage cell proliferation, and migration to stimulate cell functions, thus enhancing bone formation in the scaffolds. This study shows that bioactive and biocompatible ns-AP/PCL composite scaffolds have potential applications in bone tissue engineering.

Nanodimensional and Nanocrystalline Apatites and Other Calcium Orthophosphates in Biomedical Engineering, Biology and Medicine

Recent developments in biomineralization have already demonstrated that nanosized particles play an important role in the formation of hard tissues of animals. Namely, the basic inorganic building blocks of bones and teeth of mammals are nanodimensional and nanocrystalline calcium orthophosphates (in the form of apatites) of a biological origin. In mammals, tens to hundreds nanocrystals of a biological apatite were found to be combined into self-assembled structures under the control of various bioorganic matrixes. In addition, the structures of both dental enamel and bones could be mimicked by an oriented aggregation of nanosized calcium orthophosphates, determined by the biomolecules. The application and prospective use of nanodimensional and nanocrystalline calcium orthophosphates for a clinical repair of damaged bones and teeth are also known. For example, a greater viability and a better proliferation of various types of cells were detected on smaller crystals of calcium orthophosphates. Thus, the nanodimensional and nanocrystalline forms of calcium orthophosphates have a great potential to revolutionize the field of hard tissue engineering starting from bone repair and augmentation to the controlled drug delivery devices. This paper reviews current state of knowledge and recent developments of this subject starting from the synthesis and characterization to biomedical and clinical applications. More to the point, this review provides possible directions of future research and development.

Injectable Poly(ethylene glycol) Dimethacrylate-based Hydrogels with Hydroxyapatite

Injectable hydrogels are attractive materials for tissue engineering as they provide fast reaction rates, low heat release, and biocompatibility for cell proliferation and permanent interface with surrounding tissue. A series of injectable poly(ethylene glycol) dimethacrylate (PEGDMA) hydrogels with four different weight fractions of hydroxyapatite (HA) particles were prepared and thermal and mechanical properties evaluated. The cytocompatibility was assessed by examining the viability and morphology of human mesenchymal stem cells (hMSCs) seeded on the hydrogels. The in situ crosslink process displayed a vast decrease in the maximal temperature and an increase in the maximal temperature time. Cytocompatibility evaluation by MTT assay, scanning electron microscopy (SEM) and laser scanning confocal microscopy (LSCM) showed that the cells on the composite hydrogels possessed better viability and adherence than the hydrogels without HA. The results indicated that composite hydrogels have potential as injectable materials for tissue engineering application.

Rat Cartilage Repair Using Nanophase PLGA/HA Composite and Mesenchymal Stem Cells

Biodegradable polymer/bioceramic composite poly(lactide- coglycolide)/hydroxyapatite(PLGA/HA) was studied for bone tissue engineering. The PLGA/HA composite was evaluated as a scaffold with the ability for mesenchymal stem cells (MSC) to participate in cartilage repair. The PLGA/HA composite and the PLGA/HA composite cultured with MSC were transplanted into cartilage defects created in rats. The PLGA/HA-MSC and PLGA/HA had better tissue morphology, structure integrity, matrix staining, and much thicker newly formed cartilage than the control group. The histological score for PLGA/ HA-MSC better than that for PLGA/HA; it appears that the MSC plays an important role in tissue repair. Based on these results, using PLGA/HA as the tissue scaffold and the addition of MSC significantly enhances cartilage repair.

Bioactivity of a Novel Nano— composite of Hydroxyapatite and Chitosan—Phosphorylated Chitosan Polyelectrolyte Complex

The bioactivity of a novel composite of carbonate-containing low-crystallinity nanoparticle hydroxyapatite (HA) and a chitosan—phosphorylated chitosan polyelectrolyte complex (PEC) was evaluated in vitro and in vivo. The HA—PEC nanocomposite with complicated porous structure was prepared by a biomimetic method. An acidic chitosan (polycation) solution containing calcium and phosphate ions (6 mM Ca2+, Ca/P: 1.67) was added into phosphorylated chitosan (polyanion) solution; the formation of PEC and the controlled HA crystal growth were co-organized in alkaline solution. The material was co-cultured with rat osteoblasts in vitro, and implanted into rabbit femur marrow cavities. The results indicate that the PEC—HA composite promoted osteoblast adhesion, morphology, proliferation, and differentiation in vitro; the bone tissue response to the material histologically showed that it was bioactive, as well as biodegradable. The HA—PEC composite shows promise as a bone-repair material.

Recombinant Human Bone Morphogenetic Protein-2 as an Osteoinductive Biomaterial and a Biodegradable Carrier in a Rabbit Ulnar Defect Model

We investigated early local changes induced by recombinant human bone morphogenetic protein (rhBMP)-2 and a novel carrier, poly[L-lactide-co-glycolide] copolymer-coated gelatin sponge (PGS). A 1.5 cm segmental bone defect was created in the diaphysis of the right ulna of male Japanese white rabbit. Defects received PGS with or without rhBMP-2 (0, 0.4, or 1 mg/cm3) and were harvested at 3, 7, 14, 21, or 28 days post implantation for histological examination. Immuno-staining for vascular endothelial growth factor (VEGF) was also performed. Spindle-shaped cells were observed in the rhBMP-2-treated groups 3 and 7 days after implantation. Bone regeneration was detected after 14 days in the rhBMP-2-treated groups and the bone area increased with time and dose. Expression of VEGF was observed in all groups at 3 days and was maintained by 14 days only in the defects treated with rhBMP-2 at a dose of 1 mg. These results indicate that rhBMP-2 exert its osteo-inductive activities via the promotion of osteogenic cell mobilization, and possibly via angiogenesis based on VEGF induction. Foreign-body reactions to the implanted PGS were similar to those observed when either poly[L-lactide-co-glycolide] copolymer or gelatin was individually implanted. These results indicate that the PGS is a useful and safe carrier for rhBMP-2.

In Vitro Osteogenic Differentiation of Rat Mesenchymal Stem Cells in a Microgravity Bioreactor

Mesenchymal stem cells (MSCs) are multipotent progenitor cells with the ability to differentiate into osteoblasts, chondroblasts, myocytes, and adipocytes. They have potential for bone tissue engineering by the utilization of in vitro expanded cells with osteogenic capacity and their delivery to the appropriate sites via biomaterial scaffolds. The objective was to evaluate the potential of rat bone marrow MSCs to form 3D bone-like tissue by the use of mineralized poly(DL-lactic-co-glycolic acid) (PLGA) foam and osteoinductive medium under rotating culture conditions. PLGA foams were prepared by solvent casting and particulate leaching, then mineralized by incubating in simulated body fluid. MSCs isolated from the bone marrow of young Wistar rats were expanded and seeded on the mineralized scaffolds. The cell-polymer constructs were then cultured in a slow turning lateral vessel-type rotating bioreactor for 4 weeks under the effect of osteogenic inducers, β-glycerophosphate, ascorbic acid and dexamethasone. Mineralization was evaluated using FT-IR and increases in dry mass; morphology changes of the mineralized foams and cell adhesion was characterized by SEM; cell viability was monitored by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide). Osteogenic differentiation was determined by using immunohistochemistry (anti-osteopontin). Results indicate the feasibility of bone tissue engineering with MSCs and mineralized PLGA scaffolds supporting cell adhesion, viability and osteogenic differentiation properties of cells in hybrid structures under appropriate bioreactor conditions.

Preparation of fibroin/recombinant human-like collagen scaffold to promote fibroblasts compatibility

Recombinant human-like collagen (RHLC) was added to fibroin solution to prepare a novel hybrid scaffold material for skin tissue engineering. The morphology of the scaffold had highly homogeneous and interconnected pores with pore sizes 136 +/- 32 mum measured by scanning electron microscopy (SEM). FTIR analysis indicated intermolecular crosslinkages between fibroin and RHLC formed. The viscosity of the blend solution increased because of the interaction between fibroin and RHLC, and then it restrained the unwanted fibroin aggregation in freezing process that generally appeared in fibroin scaffold preparation with freeze drying method. After methanol treatment the fibroin/RHLC scaffold became water-stable. The porosity of scaffolds was >>90%, the compressive strength and modulus were up to 662 +/- 32 KPa and 7.8 +/- 0.64 MPa, respectively. Fibroblasts cultured within fibroin/RHLC scaffolds were investigated by SEM, laser scanning confocal microscopy (LSCM), and MTT assay, which showed that the adding of RHLC significantly enhanced the cells adhesion, proliferation, and viability compare with fibroin scaffolds. These results suggest that the hybrid scaffolds have favorable characteristics for skin tissue engineering.