Carbon Nanomaterial-Based Hydrogels as Scaffolds in Tissue Engineering: A Comprehensive Review

Carbon-based nanomaterials (CBNs) are a category of nanomaterials with various systems based on combinations of sp2 and sp3 hybridized carbon bonds, morphologies, and functional groups. CBNs can exhibit distinguished properties such as high mechanical strength, chemical stability, high electrical conductivity, and biocompatibility. These desirable physicochemical properties have triggered their uses in many fields, including biomedical applications. In this review, we specifically focus on applying CBNs as scaffolds in tissue engineering, a therapeutic approach whereby CBNs can act for the regeneration or replacement of damaged tissue. Here, an overview of the structures and properties of different CBNs will first be provided. We will then discuss state-of-the-art advancements of CBNs and hydrogels as scaffolds for regenerating various types of human tissues. Finally, a perspective of future potentials and challenges in this field will be presented. Since this is a very rapidly growing field, we expect that this review will promote interdisciplinary efforts in developing effective tissue regeneration scaffolds for clinical applications.

Early In Vivo Osteogenic and Inflammatory Response of 3D Printed Polycaprolactone/Carbon Nanotube/Hydroxyapatite/Tricalcium Phosphate Composite Scaffolds

The development of advanced biomaterials and manufacturing processes to fabricate biologically and mechanically appropriate scaffolds for bone tissue is a significant challenge. Polycaprolactone (PCL) is a biocompatible and degradable polymer used in bone tissue engineering, but it lacks biofunctionalization. Bioceramics, such as hydroxyapatite (HA) and β tricalcium phosphate (β-TCP), which are similar chemically to native bone, can facilitate both osteointegration and osteoinduction whilst improving the biomechanics of a scaffold. Carbon nanotubes (CNTs) display exceptional electrical conductivity and mechanical properties. A major limitation is the understanding of how PCL-based scaffolds containing HA, TCP, and CNTs behave in vivo in a bone regeneration model. The objective of this study was to evaluate the use of three-dimensional (3D) printed PCL-based composite scaffolds containing CNTs, HA, and β-TCP during the initial osteogenic and inflammatory response phase in a critical bone defect rat model. Gene expression related to early osteogenesis, the inflammatory phase, and tissue formation was evaluated using quantitative real-time PCR (RT-qPCR). Tissue formation and mineralization were assessed by histomorphometry. The CNT+HA/TCP group presented higher expression of osteogenic genes after seven days. The CNT+HA and CNT+TCP groups stimulated higher gene expression for tissue formation and mineralization, and pro- and anti-inflammatory genes after 14 and 30 days. Moreover, the CNT+TCP and CNT+HA/TCP groups showed higher gene expressions related to M1 macrophages. The association of CNTs with ceramics at 10wt% (CNT+HA/TCP) showed lower expressions of inflammatory genes and higher osteogenic, presenting a positive impact and balanced cell signaling for early bone formation. The association of CNTs with both ceramics promoted a minor inflammatory response and faster bone tissue formation.

Carbon nanomaterials for drug delivery and tissue engineering

Carbon nanomaterials are some of the state-of-the-art materials used in drug-delivery and tissue-engineering research. Compared with traditional materials, carbon nanomaterials have the advantages of large specific surface areas and unique properties and are more suitable for use in drug delivery and tissue engineering after modification. Their characteristics, such as high drug loading and tissue loading, good biocompatibility, good targeting and long duration of action, indicate their great development potential for biomedical applications. In this paper, the synthesis and application of carbon dots (CDs), carbon nanotubes (CNTs) and graphene in drug delivery and tissue engineering are reviewed in detail. In this review, we discuss the current research focus and existing problems of carbon nanomaterials in order to provide a reference for the safe and effective application of carbon nanomaterials in drug delivery and tissue engineering.

Young’s Modulus and Vickers Hardness of the Hydroxyapatite Bioceramics with a Small Amount of the Multi-Walled Carbon Nanotubes

The Vickers hardness and Young’s modulus of the hydroxyapatite (HA) bioceramics with a small amount of the multi-walled carbon nanotubes (MWCNTs) were studied by using ultramicrotester Shimadzu for dynamic tests DUH-211. Small concentrations of MWCNTs were from 0.05 to 0.5 wt.%. The argon inert atmosphere and vacuum condition were taken for the prevention of the MWCNTs oxidation. The Brunauer–Emmett–Teller (BET) surface area S_BET of the HA-MWCNTs composites was determined by thermal adsorption-desorption of nitrogen. It was found that for HA-MWCNTs sintered in the Ar atmosphere, an increase in the concentration of nanotubes up to 0.5 wt.% leads to a decrease in porosity near 3 times in comparison to HA without MWCNTs additives. The small amount of additives of multi-walled carbon nanotubes leads to an increase in hardness of 1.3 times and compression strength of composite and compression strength of composite that is comparable in absolute values with the literature data of enamel hardness (3–5 GPa) and compression strength (95–370 MPa). The absolute values increase close to linearly with the increase of nanotube concentrations. The Young’s modulus of sintered composite slightly changes with the variation of concentrations of nanotubes and close to the enamel (75–100 GPa). The ratio of plastic work to total work and the ratio of elastic (reversible) work to the total work of deformation of composite HA/MWCNTs are practically constant at a studied range of MWCNTs concentration. The additives of the multi-walled carbon nanotubes lead to both an increase in the elasticity index of ~1.5 times and an increase in the resistance to plastic deformation of ~3 times, which improved the tribological performance of the surface. Plastic and elastic (reversible) work slightly changed.

Emerging zero-dimensional to four-dimensional biomaterials for bone regeneration

Bone is one of the most sophisticated and dynamic tissues in the human body, and is characterized by its remarkable potential for regeneration. In most cases, bone has the capacity to be restored to its original form with homeostatic functionality after injury without any remaining scarring. Throughout the fascinating processes of bone regeneration, a plethora of cell lineages and signaling molecules, together with the extracellular matrix, are precisely regulated at multiple length and time scales. However, conditions, such as delayed unions (or nonunion) and critical-sized bone defects, represent thorny challenges for orthopedic surgeons. During recent decades, a variety of novel biomaterials have been designed to mimic the organic and inorganic structure of the bone microenvironment, which have tremendously promoted and accelerated bone healing throughout different stages of bone regeneration. Advances in tissue engineering endowed bone scaffolds with phenomenal osteoconductivity, osteoinductivity, vascularization and neurotization effects as well as alluring properties, such as antibacterial effects. According to the dimensional structure and functional mechanism, these biomaterials are categorized as zero-dimensional, one-dimensional, two-dimensional, three-dimensional, and four-dimensional biomaterials. In this review, we comprehensively summarized the astounding advances in emerging biomaterials for bone regeneration by categorizing them as zero-dimensional to four-dimensional biomaterials, which were further elucidated by typical examples. Hopefully, this review will provide some inspiration for the future design of biomaterials for bone tissue engineering.

Carbon-Based Materials for Articular Tissue Engineering: From Innovative Scaffolding Materials toward Engineered Living Carbon

Carbon materials constitute a growing family of high-performance materials immersed in ongoing scientific technological revolutions. Their biochemical properties are interesting for a wide set of healthcare applications and their biomechanical performance, which can be modulated to mimic most human tissues, make them remarkable candidates for tissue repair and regeneration, especially for articular problems and osteochondral defects involving diverse tissues with very different morphologies and properties. However, more systematic approaches to the engineering design of carbon-based cell niches and scaffolds are needed and relevant challenges should still be overcome through extensive and collaborative research. In consequence, this study presents a comprehensive description of carbon materials and an explanation of their benefits for regenerative medicine, focusing on their rising impact in the area of osteochondral and articular repair and regeneration. Once the state-of-the-art is illustrated, innovative design and fabrication strategies for artificially recreating the cellular microenvironment within complex articular structures are discussed. Together with these modern design and fabrication approaches, current challenges, and research trends for reaching patients and creating social and economic impacts are examined. In a closing perspective, the engineering of living carbon materials is also presented for the first time and the related fundamental breakthroughs ahead are clarified.

Electroactive Biomaterials and Systems for Cell Fate Determination and Tissue Regeneration: Design and Applications

During natural tissue regeneration, tissue microenvironment and stem cell niche including cell-cell interaction, soluble factors, and extracellular matrix (ECM) provide a train of biochemical and biophysical cues for modulation of cell behaviors and tissue functions. Design of functional biomaterials to mimic the tissue/cell microenvironment have great potentials for tissue regeneration applications. Recently, electroactive biomaterials have drawn increasing attentions not only as scaffolds for cell adhesion and structural support, but also as modulators to regulate cell/tissue behaviors and function, especially for electrically excitable cells and tissues. More importantly, electrostimulation can further modulate a myriad of biological processes, from cell cycle, migration, proliferation and differentiation to neural conduction, muscle contraction, embryogenesis, and tissue regeneration. In this review, endogenous bioelectricity and piezoelectricity are introduced. Then, design rationale of electroactive biomaterials is discussed for imitating dynamic cell microenvironment, as well as their mediated electrostimulation and the applying pathways. Recent advances in electroactive biomaterials are systematically overviewed for modulation of stem cell fate and tissue regeneration, mainly including nerve regeneration, bone tissue engineering, and cardiac tissue engineering. Finally, the significance for simulating the native tissue microenvironment is emphasized and the open challenges and future perspectives of electroactive biomaterials are concluded.

Multi-walled carbon nanotube/hydroxyapatite nanocomposite with leukocyte- and platelet-rich fibrin for bone regeneration in sheep model

BACKGROUND

The aim of this study was to evaluate the effects of multi-walled carbon nanotubes/hydroxyapatite (MWCNT/HA) granules with or without leukocyte- and platelet-rich fibrin (L-PRF) on bone regeneration in cancellous bone of sheep model.

METHODS

Totally, 32 cylindrical holes were drilled in female sheep (n = 4) in the distal epiphysis and proximal metaphysis of right and left humerus and femur. The defects were randomly filled with (1) MWCNT/HA, (2) MWCNT/HA mixed with L-PRF, (3) L-PRF, and (4) left empty as control. After 8 weeks, defects were evaluated and compared radiographically using multi-slice computed tomographic (CT) scan and cone beam CT scans, histologically and histomorphometrically.

RESULTS

The results showed that there was no significant inflammation (> 10%) or foreign body reaction around the granules. The new lamellar bone was regenerated around the MWCNT/HA nanocomposite granules. Addition of L-PRF to MWCNT/HA demonstrated significantly improvement of new bone formation, about 27.40 ± 1.08%, in comparison with the L-PRF alone, about (12.16 ± 1.46%) (P < 0.01). Also, the rate of new bone formation was significantly greater with the use of MWCNT/HA granules (24.59 ± 1.54%) compared to the control (10.36 ± 1.17%) (P < 0.01).

CONCLUSION

Consequently, both biocompatibility and osteoconductivity of MWCNT/HA nanocomposite were demonstrated in the preclinical sheep model, and the use of L-PRF in combination with MWCNT/HA nanocomposite can improve bone regeneration.

Modulating the Biomechanical Properties of Engineered Connective Tissues by Chitosan-Coated Multiwall Carbon Nanotubes

Background

Under certain conditions, the physiological repair of connective tissues might fail to restore the original structure and function. Optimized engineered connective tissues (ECTs) with biophysical properties adapted to the target tissue could be used as a substitution therapy. This study aimed to investigate the effect of ECT enforcement by a complex of multiwall carbon nanotubes with chitosan (C-MWCNT) to meet in vivo demands.

Materials and Methods

ECTs were constructed from human foreskin fibroblasts (HFF-1) in collagen type I and enriched with the three different percentages 0.025, 0.05 and 0.1% of C-MWCNT. Characterization of the physical properties was performed by biomechanical studies using unidirectional strain.

Results

Supplementation with 0.025% C-MWCNT moderately increased the tissue stiffness, reflected by Young’s modulus, compared to tissues without C-MWCNT. Supplementation of ECTs with 0.1% C-MWCNT reduced tissue contraction and increased the elasticity and the extensibility, reflected by the yield point and ultimate strain, respectively. Consequently, the ECTs with 0.1% C-MWCNT showed a higher resilience and toughness as control tissues. Fluorescence tissue imaging demonstrated the longitudinal alignment of all cells independent of the condition.

Conclusion

Supplementation with C-MWCNT can enhance the biophysical properties of ECTs, which could be advantageous for applications in connective tissue repair.

Toxicity of Carbon Nanotubes: Molecular Mechanisms, Signaling Cascades, and Remedies in Biomedical Applications

Carbon nanotubes (CNTs) are the most studied allotropic form of carbon. They can be used in various biomedical applications due to their novel physicochemical properties. In particular, the small size of CNTs, with a large surface area per unit volume, has a considerable impact on their toxicity. Despite of the use of CNTs in various applications, toxicity is a big problem that requires more research. In this Review, we discuss the toxicity of CNTs and the associated mechanisms. Physicochemical factors, such as metal impurities, length, size, solubilizing agents, CNTs functionalization, and agglomeration, that may lead to oxidative stress, toxic signaling pathways, and potential ways to control these mechanisms are also discussed. Moreover, with the latest mechanistic evidence described in this Review, we expect to give new insights into CNTs' toxicological effects at the molecular level and provide new clues for the mitigation of harmful effects emerging from exposure to CNTs.

Carbon nanotubes and their polymeric composites: the applications in tissue engineering

Carbon nanotubes (CNTs), with unique graphitic structure, superior mechanical, electrical, optical and biological properties, has attracted more and more interests in biomedical applications, including gene/drug delivery, bioimaging, biosensor and tissue engineering. In this review, we focus on the role of CNTs and their polymeric composites in tissue engineering applications, with emphasis on their usages in the nerve, cardiac and bone tissue regenerations. The intrinsic natures of CNTs including their physical and chemical properties are first introduced, explaining the structure effects on CNTs electrical conductivity and various functionalization of CNTs to improve their hydrophobic characteristics. Biosafety issues of CNTs are also discussed in detail including the potential reasons to induce the toxicity and their potential strategies to minimise the toxicity effects. Several processing strategies including solution-based processing, polymerization, melt-based processing and grafting methods are presented to show the 2D/3D construct formations using the polymeric composite containing CNTs. For the sake of improving mechanical, electrical and biological properties and minimising the potential toxicity effects, recent advances using polymer/CNT composite the tissue engineering applications are displayed and they are mainly used in the neural tissue (to improve electrical conductivity and biological properties), cardiac tissue (to improve electrical, elastic properties and biological properties) and bone tissue (to improve mechanical properties and biological properties). Current limitations of CNTs in the tissue engineering are discussed and the corresponded future prospective are also provided. Overall, this review indicates that CNTs are promising “next-generation” materials for future biomedical applications.

Bone Tissue Engineering via Carbon-Based Nanomaterials

Bone tissue engineering (BTE) has received significant attention due to its enormous potential in treating critical-sized bone defects and related diseases. Traditional materials such as metals, ceramics, and polymers have been widely applied as BTE scaffolds; however, their clinical applications have been rather limited due to various considerations. Recently, carbon-based nanomaterials attract significant interests for their applications as BTE scaffolds due to their superior properties, including excellent mechanical strength, large surface area, tunable surface functionalities, high biocompatibility as well as abundant and inexpensive nature. In this article, recent studies and advancements on the use of carbon-based nanomaterials with different dimensions such as graphene and its derivatives, carbon nanotubes, and carbon dots, for BTE are reviewed. Current challenges of carbon-based nanomaterials for BTE and future trends in BTE scaffolds development are also highlighted and discussed.

Carbon Nanotube Reinforced Hydroxyapatite Nanocomposites As Bone Implants: Nanostructure, Mechanical Strength And Biocompatibility

PURPOSE

Hydroxyapatite (HA) is a biologically active ceramic which promotes bone growth, but it suffers from relatively weak mechanical properties. Multi-walled carbon nanotubes (MWCNTs) have high tensile strength and a degree of stiffness that can be used to strengthen HA; potentially improving the clinical utility of the bone implant.

METHODS

HA was precipitated by the wet precipitation method in the presence of pristine (p) or functionalised (f) MWCNTs, and polyvinyl alcohol (PVA) or hexadecyl trimethyl ammonium bromide (HTAB) as the surfactant. The resulting composites were characterised and the diametral tensile strength and compressive strength of the composites were measured. To determine the biocompatibility of the composites, human osteoblast cells (HOB) were proliferated in the presence of the composites for 7 days.

RESULTS

The study revealed that both the MWCNTs and surfactants play a crucial role in the nucleation and growth of the HA. Composites made with f-MWCNTs were found to have better dispersion and better interaction with the HA particles compared to composites with p-MWCNTs. The mechanical strength was improved in all the composites compared to pure HA composites. The biocompatibility study showed minimal LDH activity in the media confirming that the composites were biocompatible. Similarly, the ALP activity confirmed that the cells grown on the composites containing HTAB were comparable to the control whereas the composites containing PVA surfactant showed significantly reduced ALP activity.

CONCLUSIONS

The study shows that the composites made of f-MWCNTs HTAB are stronger than pure HA composites and biocompatible making it a suitable material to study further.

Carbon based nanomaterials for tissue engineering of bone: Building new bone on small black scaffolds: A review

Tissue engineering is a rapidly-growing approach to replace and repair damaged and defective tissues in the human body. Every year, a large number of people require bone replacements for skeletal defects caused by accident or disease that cannot heal on their own. In the last decades, tissue engineering of bone has attracted much attention from biomedical scientists in academic and commercial laboratories. A vast range of biocompatible advanced materials has been used to form scaffolds upon which new bone can form. Carbon nanomaterial-based scaffolds are a key example, with the advantages of being biologically compatible, mechanically stable, and commercially available. They show remarkable ability to affect bone tissue regeneration, efficient cell proliferation and osteogenic differentiation. Basically, scaffolds are templates for growth, proliferation, regeneration, adhesion, and differentiation processes of bone stem cells that play a truly critical role in bone tissue engineering. The appropriate scaffold should supply a microenvironment for bone cells that is most similar to natural bone in the human body. A variety of carbon nanomaterials, such as graphene oxide (GO), carbon nanotubes (CNTs), fullerenes, carbon dots (CDs), nanodiamonds and their derivatives that are able to act as scaffolds for bone tissue engineering, are covered in this review. Broadly, the ability of the family of carbon nanomaterial-based scaffolds and their critical role in bone tissue engineering research are discussed. The significant stimulating effects on cell growth, low cytotoxicity, efficient nutrient delivery in the scaffold microenvironment, suitable functionalized chemical structures to facilitate cell-cell communication, and improvement in cell spreading are the main advantages of carbon nanomaterial-based scaffolds for bone tissue engineering.

A Review on the Use of Hydroxyapatite-Carbonaceous Structure Composites in Bone Replacement Materials for Strengthening Purposes

Biomedical materials constitute a vast scientific research field, which is devoted to producing medical devices which aid in enhancing human life. In this field, there is an enormous demand for long-lasting implants and bone substitutes that avoid rejection issues whilst providing favourable bioactivity, osteoconductivity and robust mechanical properties. Hydroxyapatite (HAp)-based biomaterials possess a close chemical resemblance to the mineral phase of bone, which give rise to their excellent biocompatibility, so allowing for them to serve the purpose of a bone-substituting and osteoconductive scaffold. The biodegradability of HAp is low (Ksp ≈ 6.62 × 10-126) as compared to other calcium phosphates materials, however they are known for their ability to develop bone-like apatite coatings on their surface for enhanced bone bonding. Despite its favourable bone regeneration properties, restrictions on the use of pure HAp ceramics in high load-bearing applications exist due to its inherently low mechanical properties (including low strength and fracture toughness, and poor wear resistance). Recent innovations in the field of bio-composites and nanoscience have reignited the investigation of utilising different carbonaceous materials for enhancing the mechanical properties of composites, including HAp-based bio-composites. Researchers have preferred carbonaceous materials with hydroxyapatite due to their inherent biocompatibility and good structural properties. It has been demonstrated that different structures of carbonaceous material can be used to improve the fracture toughness of HAp, as they can easily serve the purpose of being a second phase reinforcement, with the resulting composite still being a biocompatible material. Nanostructured carbonaceous structures, especially those in the form of fibres and sheets, were found to be very effective in increasing the fracture toughness values of HAp. Minor addition of CNTs (3 wt.%) has resulted in a more than 200% increase in fracture toughness of hydroxyapatite-nanorods/CNTs made using spark plasma sintering. This paper presents a current review of the research field of using different carbonaceous materials composited with hydroxyapatite with the intent being to produce high performance biomedically targeted materials.

Synthesis of hydroxyapatite for biomedical applications

The current need for long lasting implants and bone substitutes characterized by biocompatibility, bioactivity and mechanical properties, without the immune rejection is a great challenge for scientists. These bone substitute structures should be prepared for individual patients with all details controlled on the micrometer level. Similarly, nontoxic, biocompatible targeted drug delivery systems which allow controlling the rate and time period of the drug delivery and simultaneously eliminating toxic and side effects on the healthy tissues, are of great interest. Extensive attempts have been made to develop a simple, efficient, and green method to form biofunctional scaffolds and implant coatings possessing the above mentioned significant biocompatibility, bioactivity and mechanical strength. Moreover, that could also serve as drug delivery systems. Hydroxyapatite (HA) which is a major mineral component of vertebrate bones and teeth is an excellent material for these purposes. In this literature review the biologically inspired scaffolds, bone substitutes, implants characterized by mechanical strength and biocompatibility, as well the drug delivery systems, based on hydroxyapatite are discussed.

Multi and single walled carbon nanotubes: effects on cell responses and biomineralization of osteoblasts cultures

The use of carbon nanotubes (CNTs) on the development of biomaterials has been motivated by their excellent mechanical properties that could improve synthetic bone materials. However, the toxicity of CNTs on the tissue/implant interface and their influence on the biomineralization process have some contradictions. We investigated the influence of CNTs on osteoblasts plated on titanium (Ti) discs or plastic surfaces. We evaluated osteoblasts viability, alkaline phosphatase (ALP) activity, and mineralized matrix formation in the different phases of osteoblasts growth in the presence of single-walled CNTs (SWCNTs) and multi-walled CNTs (MWCNTs). An increase in osteoblasts viability was observed at the 21st day for both CNTs on plastic surface, while viability increased for MWCNTs at the 7th and 14th days and at the 7th day for SWCNTs on Ti discs compared to control. ALP activity increased at the 14th and 21st days for MWCNTs on plastic surfaces. For cells incubated with SWCNTs, an increase in ALP activity at the 7th day for plastic surface and at the 14th day for both materials (plastic and Ti) was observed. The mineralized matrix formation increased at the 21st day on plastic surface with SWCNTs, and at the 14th and 21st days for both CNTs on Ti discs. In conclusion, both SWCNTs and MWCNTs are not toxic to osteoblasts at concentrations up to 5 × 10(-5) and 1.3 × 10(-2) mg/mL, respectively, either in Ti discs or plastic surfaces. In the long term, the cells grown in contact with both CNTs and Ti presented better results regarding bone-like nodules formation.

High strength chitosan rod reinforced by non-covalent functionalized multiwalled carbon nanotubes via an in situ precipitation method

High strength CS/MWCNTs composite rods preparedvia in situprecipitation & PaPA functionalization, with a 3D sophisticated structure and uniformly dispersed MWCNTs.