Tribomechanical Comparison between PVA Hydrogels Obtained Using Different Processing Conditions and Human Cartilage

Advancement of 3D biofabrication in repairing and regeneration of cartilage defects

Three-dimensional (3D) bioprinting, an additive manufacturing technology, fabricates biomimetic tissues that possess natural structure and function. It involves precise deposition of bioinks, including cells, and bioactive factors, on basis of computer-aided 3D models. Articular cartilage injuries, a common orthopedic issue. Current repair methods, for instance microfracture procedure (MF), autologous chondrocyte implantation (ACI), and osteochondral autologous transfer surgery have been applied in clinical practice. However, each procedure has inherent limitation. For instance, MF surgery associates with increased subchondral cyst formation and brittle subchondral bone. ACI procedure involves two surgeries, and associate with potential risks infection and delamination of the regenerated cartilage. In addition, chondrocyte implantation's efficacy depends on the patient's weight, joint pathology, gender-related histological changes of cartilage, and hormonal influences that affect treatment and prognosis. So far, it is a still a grand challenge for achieving a clinical satisfactory in repairing and regeneration of cartilage defects using conditional strategies. 3D biofabrication provide a potential to fabricate biomimetic articular cartilage construct that has shown promise in specific cartilage repair and regeneration of patients. This review reported the techniques of 3D bioprinting applied for cartilage repair, and analyzed their respective merits and demerits, and limitations in clinical application. A summary of commonly used bioinks has been provided, along with an outlook on the challenges and prospects faced by 3D bioprinting in the application of cartilage tissue repair. It provided an overall review of current development and promising application of 3D biofabrication technology in articular cartilage repair.

Copper nanoparticles loaded gelatin/ polyvinyl alcohol/ guar gum-based 3D printable multimaterial hydrogel for tissue engineering applications

Hydrogels are becoming increasingly significant in tissue engineering because of their numerous benefits, including biocompatibility, biodegradability, and their ability to provide a supportive structure for cell proliferation. This study presents the synthesis and characterization of a new multimaterial hydrogel with 3D-printing capabilities composed of copper nanoparticle-reinforced gelatin, polyvinyl alcohol (PVA), and guar gum-based biomaterials intended for tissue engineering applications. Combining CuNPs aims to enhance the hydrogel's antibacterial properties, mechanical strength, and bioactivity, which are essential for successful tissue regeneration. Hydrogels are chemically cross-linked with glyoxal and analyzed through different assessments to examine the compressive behavior, surface morphology, sorbing capacity, biocompatibility, thermal stability, and degradation properties. The results demonstrated that including CuNPs significantly improved the hydrogel's compressive modulus (4.18 MPa) for the hydrogel with the CuNPs and provided better antibacterial activity against common pathogens with controlled degradation. All the hydrogels exhibited a lower coefficient of friction, which was below 0.1. In vitro cell culture studies using chondrocytes indicated that the CuNPs-loaded hydrogel supported cell proliferation and growth of chondrogenic genes such as collagen type II (COL2) and aggrecan (ACAN). The biocompatibility and enhanced mechanical properties of the multimaterial hydrogel make it a promising candidate for developing customized, patient-specific tissue engineering scaffolds.

Influence of Glycerol on the Surface Morphology and Crystallinity of Polyvinyl Alcohol Films

The structure and physicochemical properties of polyvinyl alcohol (PVA) and PVA/glycerol films have been investigated by Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), thermogravimetry/differential thermal analysis (TG/DTA), and advanced scanning probe microscopy (SPM). In the pure PVA films, SPM allowed us to observe ribbon-shaped domains with a different frictional and elastic contrast, which apparently originated from a correlated growth or assembly of PVA crystalline nuclei located within individual PVA clusters. The incorporation of 22% w/w glycerol led to modification in shape of those domains from ribbon-like in pure PVA to rounded in PVA/glycerol 22% w/w films; changes in the relative intensities of the XRD peaks and a decrease in the amorphous halo in the XRD pattern were also detected, while the DTA peak corresponding to the melting point remained at almost the same temperature. For higher glycerol content, FT-IR revealed additional glycerol-characteristic peaks presumably related to the formation of glycerol aggregates, and XRD, FT-IR, and DTA all indicated a reduction in crystallinity. For more than 36% w/w glycerol, the plasticization of the films complicated the acquisition of SPM images without tip-induced surface modification. Our study contributes to the understanding of crystallinity in PVA and how it is altered by a plasticizer such as glycerol.

Release of natural extracts from PVA and PVA-CMC hydrogel wound dressings: a power law swelling/delivery

Introduction

PVA hydrogels present many characteristics of the ideal dressing, although without antimicrobial properties. The present work aims to study the physical, mechanical and release characteristics of hydrogel wound dressings loaded with either of two natural herbal products, sage extract and dragon's blood.

Methods

Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC) and tensile mechanical testing were used to investigate the structure and properties of the gels. Swelling and degradation tests were conducted according to ISO 10993-9. Release characteristics were studied using UV Spectrophotometry.

Results

PVA matrices incorporating sage extract or dragon's blood (DB) present hydrogen bonding between these components. PVA-CMC hydrogels containing sage present similar spectra to PVA-CMC alone, probably indicating low miscibility or interaction between the matrix and sage. The opposite is found for DB, which exhibits more pronounced interference with crystallinity than sage. DB and NaCMC negatively affect Young's modulus and failure strength. All samples appear to reach equilibrium swelling degree (ESD) in 24 h. The addition of DB and sage to PVA increases the gels' swelling capacity, indicating that the substances likely separate PVA chains. The inclusion of CMC contributes to high media uptake. The kinetics profile of media uptake for 4 days is described by a power-law model, which is correlated to the drug delivery mechanism.

Discussion

A PVA-CMC gel incorporating 15% DB, the highest amount tested, shows the most favorable characteristics for flavonoid delivery, as well as flexibility and swelling capacity.

Tribomechanical Properties of PVA/Nomex® Composite Hydrogels for Articular Cartilage Repair

Due to the increasing prevalence of articular cartilage diseases and limitations faced by current therapeutic methodologies, there is an unmet need for new materials to replace damaged cartilage. In this work, poly(vinyl alcohol) (PVA) hydrogels were reinforced with different amounts of Nomex® (known for its high mechanical toughness, flexibility, and resilience) and sterilized by gamma irradiation. Samples were studied concerning morphology, chemical structure, thermal behavior, water content, wettability, mechanical properties, and rheological and tribological behavior. Overall, it was found that the incorporation of aramid nanostructures improved the hydrogel's mechanical performance, likely due to the reinforcement's intrinsic strength and hydrogen bonding to PVA chains. Additionally, the sterilization of the materials also led to superior mechanical properties, possibly related to the increased crosslinking density through the hydrogen bonding caused by the irradiation. The water content, wettability, and tribological performance of PVA hydrogels were not compromised by either the reinforcement or the sterilization process. The best-performing composite, containing 1.5% wt. of Nomex®, did not induce cytotoxicity in human chondrocytes. Plugs of this hydrogel were inserted in porcine femoral heads and tested in an anatomical hip simulator. No significant changes were observed in the hydrogel or cartilage, demonstrating the material's potential to be used in cartilage replacement.

Eco-Friendly Production of Polyvinyl Alcohol/Carboxymethyl Cellulose Wound Healing Dressing Containing Sericin

Wound dressing production represents an important segment in the biomedical healthcare field, but finding a simple and eco-friendly method that combines a natural compound and a biocompatible dressing production for biomedical application is still a challenge. Therefore, the aim of this study is to develop wound healing dressings that are environmentally friendly, low cost, and easily produced, using natural agents and a physical crosslinking technique. Hydrogel wound healing dressings were prepared from polyvinyl alcohol/carboxymethyl cellulose and sericin using the freeze-thawing method as a crosslinking method. The morphological characterization was carried out by scanning electron microscopy (SEM), whereas the mechanical analysis was carried out by dynamic mechanical analysis (DMA) to test the tensile strength and compression properties. Then, the healing property of the wound dressing material was tested by in vitro and ex vivo tests. The results show a three-dimensional microporous structure with no cytotoxicity, excellent stretchability with compressive properties similar to those of human skin, and excellent healing properties. The proposed hydrogel dressing was tested in vitro with HaCaT keratinocytes and ex vivo with epidermal tissues, demonstrating an effective advantage on wound healing acceleration. Accordingly, this study was successful in developing wound healing dressings using natural agents and a simple and green crosslinking method.

Polyvinyl alcohol/collagen composite scaffold reinforced with biodegradable polyesters/gelatin nanofibers for adipose tissue engineering

Breast cancer has become the most diagnosed cancer type, endangering the health of women. Patients with breast resection are likely to suffer serious physical and mental trauma. Therefore, breast reconstruction becomes an important means of postoperative patient rehabilitation. Polyvinyl alcohol hydrogel has great potential in adipose tissue engineering for breast reconstruction. However, its application is limited because of the lack of bioactive factors and poor structural stability. In this study, we prepared biodegradable polylactic acid-glycolic acid copolymer/polycaprolactone/gelatin (PPG) nanofibers. We then combined them with polyvinyl alcohol/collagen to create tissue engineering scaffolds to overcome limitations. We found that PPG fibers formed amide bonds with polyvinyl alcohol/collagen scaffolds. After chemical crosslinking, the number of amide bonds increased, leading to a significant improvement in their mechanical properties and thermal stability. The results showed that compared with pure PVA scaffolds, the maximum compressive stress of the scaffold doped with 0.9 g nanofibers increased by 500 %, and the stress loss rate decreased by 40.6 % after 10 cycles of compression. The presence of natural macromolecular gelatin and the changes in the pore structure caused by nanofibers provide cells with richer and more three-dimensional adsorption sites, allowing them to grow in three dimensions on the scaffold. So, the hydrogel scaffold by reinforcing polyvinyl alcohol hydrogel with PPG fibers is a promising breast reconstruction method.

Hydrogel-Based Strategies for Intervertebral Disc Regeneration: Advances, Challenges and Clinical Prospects

Millions of people worldwide suffer from low back pain and disability associated with intervertebral disc (IVD) degeneration. IVD degeneration is highly correlated with aging, as the nucleus pulposus (NP) dehydrates and the annulus fibrosus (AF) fissures form, which often results in intervertebral disc herniation or disc space collapse and related clinical symptoms. Currently available options for treating intervertebral disc degeneration are symptoms control with therapy modalities, and/or medication, and/or surgical resection of the IVD with or without spinal fusion. As such, there is an urgent clinical demand for more effective disease-modifying treatments for this ubiquitous disorder, rather than the current paradigms focused only on symptom control. Hydrogels are unique biomaterials that have a variety of distinctive qualities, including (but not limited to) biocompatibility, highly adjustable mechanical characteristics, and most importantly, the capacity to absorb and retain water in a manner like that of native human nucleus pulposus tissue. In recent years, various hydrogels have been investigated in vitro and in vivo for the repair of intervertebral discs, some of which are ready for clinical testing. In this review, we summarize the latest findings and developments in the application of hydrogel technology for the repair and regeneration of intervertebral discs.

Multifunctional injectable hydrogels with controlled delivery of bioactive factors for efficient repair of intervertebral disc degeneration

Millions of people worldwide suffer from intervertebral disc degeneration (IVDD), which imposes a significant socioeconomic burden on society. There is an urgent clinical demand for more effective treatments for IVDD because conventional treatments can only alleviate the symptoms rather than preventing the progression of IVDD. Hydrogels, a class of elastic biomaterials with good biocompatibility, are promising candidates for intervertebral disc repair and regeneration. In recent years, various hydrogels have been investigated in vitro and in vivo for the repair of intervertebral discs, some of which are ready for clinical testing. This review summarizes the latest findings and developments in using bioactive factors-released bioactive injectable hydrogels for the repair and regeneration of intervertebral discs. It focuses on the analysis and summary of the use of multifunctional injectable hydrogels to delivery bioactive factors (cells, exosomes, growth factors, genes, drugs) for disc regeneration, providing guidance for future study. Finally, we discussed and analyzed the optimal timing for the application of controlled-release hydrogels in the treatment of IVDD to meet the high standards required for intervertebral disc regeneration and precision medicine.

Super-Strong Hydrogel Composites Reinforced with PBO Nanofibers for Cartilage Replacement

Cartilage replacement materials exhibiting a set of demanding properties such as high water content, high mechanical stiffness, low friction, and excellent biocompatibility are quite difficult to achieve. Here, poly(p-phenylene-2,6-benzobisoxazole) (PBO) nanofibers are combined with polyvinyl alcohol (PVA) to form a super-strong structure with a performance that surpasses the vast majority of previously existing hydrogels. PVA-PBO composites with water contents in the 59-76% range exhibit tensile and compressive moduli reaching 20.3 and 4.5 MPa, respectively, and a coefficient of friction below 0.08. Further, they are biocompatible and support the viability of chondrocytes for 1 week, with significant improvements in cell adhesion, proliferation, and differentiation compared to PVA. The new composites can be safely sterilized by steam heat or gamma radiation without compromising their integrity and overall performance. In addition, they show potential to be used as local delivery platforms for anti-inflammatory drugs. These attractive features make PVA-PBO composites highly competitive engineered materials with remarkable potential for use in the design of load-bearing tissues. Complementary work has also revealed that these composites will be interesting alternatives in other industrial fields where high thermal and mechanical resistance are essential requirements, or which can take advantage of the pH responsiveness functionality.

Functionalized Nanocomposite Gel Polymer Electrolyte with Strong Alkaline-Tolerance and High Zinc Anode Stability for Ultralong-Life Flexible Zinc-Air Batteries

Increasing pursuit of next-generation wearable electronics has put forward the demand of reliable energy devices with high flexibility, durability, and enhanced electrochemical performances. Flexible aqueous zinc-air batteries (FAZABs) have attracted great interests owing to the high energy density, safety, and environmental benignity, for which quasi-solid-state gel polymer electrolytes (QSGPEs) are state-of-the-art electrolytes with high ionic conductivity, flexibility, and resistance to leakage problems of traditional liquid electrolytes. Compared to commonly used PVA-KOH electrolyte with poor electrolyte retention capability and cycling stability, a new type of sulfonate functionalized nanocomposite QSGPE is applied in FAZABs with high ionic conductivity, strong alkaline tolerance, and high zinc anode stability. Notably, the existence of (1) strong anionic sulfonate groups of QSGPEs, contributing to the exposure of preferred Zn (002) plane that is more resistant to zinc dendrite formation, and (2) nano-attapulgite electrolyte additives, beneficial for the enhancement of ionic conductivity, electrolyte uptake, and retention capability, endows a ultralong cycling life of 450 h for the fabricated FAZAB. Furthermore, flexible energy belts and knittable energy wires fabricated with a series/parallel unit of several FAZABs can be used to power various wearable electronics.

Corneal sustained delivery of hyaluronic acid from nanofiber-containing ring-implanted contact lens

Dry eye syndrome, as a persist corneal epithelial defect (PED), is an inconvenient ocular disorder that is generally treated by high-dosage, conventional eye drops. Addressing low efficacy and rather restricted bioavailability of the conventional eye drops, drug-eluting contact lenses (CLs) are widely used as alternatives in ophthalmic drug delivery applications. In the present study, a nanofiber-containing ring implant poly (vinyl alcohol) (PVA) hydrogel is designed as a carrier for hyaluronic acid (HA) delivery. hyaluronic acid is physically encapsulated in a nanofiber-containing ring-shaped hydrogel with a 2 mm width that is implanted in the final CLs hydrogel. The designed CL has 59% porosity, 275% swelling ratio and undergoes no weight loss at physiological conditions in14 days. In-vitro release studies were performed on the CLs with and without nanofibers. The results showed that nanofiber incorporation in the designed CL was highly influential in decreasing burst release and supported sustained release of HA over 14 days. In addition, nanofiber incorporation in the designed system strengthened the lens, and the young modulus of the PVA hydrogel increased from 6 to 10 kPa. Cell viability study also revealed no cell cytotoxicity and cell attachment. Overall, the study demonstrated the effective role of nanofibers in the physical strengthening of the CL. Also, the designed system holds promise as a potential candidate for HA delivery over an extended period for treating dry eye syndrome.

Effects of Non-Conventional Sterilisation Methods on PBO-Reinforced PVA Hydrogels for Cartilage Replacement

Articular cartilage (AC) degradation is a recurrent pathology that affects millions of people worldwide. Polyvinyl alcohol (PVA) hydrogels have been widely explored for AC replacement. However, their mechanical performance is generally inadequate, and these materials need to be reinforced. Moreover, to be used in a clinical setting, such materials must undergo effective sterilisation. In this work, a PVA hydrogel reinforced with poly(p-phenylene-2,6-benzobisoxazole) (PBO) nanofibres was submitted to three non-conventional sterilisation methods: microwave (MW), high hydrostatic pressure (HHP), and plasma (PM), in order to evaluate their impact on the properties of the material. Sterilisation was achieved in all cases. Properties such as water content and hydrophilicity were not affected. FTIR analysis indicated some changes in crystallinity and/or crosslinking in all cases. MW was revealed to be the most suitable method, since, unlike to PM and HHP, it led to a general improvement of the materials' properties: increasing the hardness, stiffness (both in tensile and compression), and shear modulus, and also leading to a decrease in the coefficient of friction against porcine cartilage. Furthermore, the samples remained non-irritant and non-cytotoxic. Moreover, this method allows terminal sterilisation in a short time (3 min) and using accessible equipment.

Hydroxyapatite Reinforced Polyvinyl Alcohol/Polyvinyl Pyrrolidone Based Hydrogel for Cartilage Replacement

Polyvinyl alcohol (PVA) and Polyvinyl Pyrrolidone (PVP) hydrogels are desirable biomaterials for soft tissue repair and replacement. However, the bio-inertness and poor cell adhesive potency of the PVA and PVP hinder the wide range of biomedical applications. In the present work, PVA and PVP were blended with a one-dimensional hydroxyapatite nanorod (HNr), and PVA/PVP/HNr composite hydrogel was synthesized by the freeze-thaw process. The developed hydrogels were characterized by Scanning Electron Microscope (SEM). The bio-ceramic nanohydroxyapatite content was optimized, and it was found that reinforcement improves mechanical strength as well as bioactivity. The compression strength values are 2.47 ± 0.73 MPa for the composite having 2 wt% of nanohydroxyapatite. The storage modulus was much higher than the loss modulus, which signifies the elastic dominancy similar to cartilage. Besides, the antimicrobial activity of nanohydroxyapatite reinforced PVA hydrogel towards bacterial species, Escherichia coli (E. Coli), Staphylococcus aureus (S. aureus) was satisfactory, and the in vitro biocompatibility response towards Human Mesenchymal stem cells(hMSC) after 72 h of culture confirms nanohydroxyapatite reinforced PVA/PVP hydrogels are the promising alternatives for next-generation cartilage substitutes.

Hydrogels for Treatment of Different Degrees of Osteoarthritis

Osteoarthritis (OA) is a common disease that severely restricts human activities and degrades the quality of life. Every year, millions of people worldwide are diagnosed with osteoarthritis, placing a heavy burden on society. Hydrogels, a polymeric material with good biocompatibility and biodegradability, are a novel approach for the treatment of osteoarthritis. In recent years, this approach has been widely studied with the development of materials science and tissue engineering technology. We reviewed the research progress of hydrogels in the treatment of osteoarthritis in the past 3 years. We summarized the required hydrogel properties and current applications according to the development and treatment of osteoarthritis. Furthermore, we listed the challenges of hydrogels for different types of osteoarthritis and presented prospects for future development.

Polymeric Hydrogels for Controlled Drug Delivery to Treat Arthritis

Rheumatoid arthritis (RA) and osteoarthritis (OA) are disabling musculoskeletal disorders that affect joints and cartilage and may lead to bone degeneration. Conventional delivery of anti-arthritic agents is limited due to short intra-articular half-life and toxicities. Innovations in polymer chemistry have led to advancements in hydrogel technology, offering a versatile drug delivery platform exhibiting tissue-like properties with tunable drug loading and high residence time properties This review discusses the advantages and drawbacks of polymeric materials along with their modifications as well as their applications for fabricating hydrogels loaded with therapeutic agents (small molecule drugs, immunotherapeutic agents, and cells). Emphasis is given to the biological potentialities of hydrogel hybrid systems/micro-and nanotechnology-integrated hydrogels as promising tools. Applications for facile tuning of therapeutic drug loading, maintaining long-term release, and consequently improving therapeutic outcome and patient compliance in arthritis are detailed. This review also suggests the advantages, challenges, and future perspectives of hydrogels loaded with anti-arthritic agents with high therapeutic potential that may alter the landscape of currently available arthritis treatment modalities.

Development of polycarbonate urethane-based materials with controlled diclofenac release for cartilage replacement

Hydrogels are very promising human cartilage replacement materials since they are able to mimic its structure and properties. Besides, they can be used as platforms for drug delivery to reduce inflammatory postsurgical reactions. Polycarbonate urethane (PCU) has been used in orthopedic applications due to its long-term biocompatibility and bio-durability. In this work, PCU-based hydrogels with the ability to release an anti-inflammatory (diclofenac) were developed, for the first time, for such purpose. The materials were reinforced with different amounts of cellulose acetate (CA, 10%, 15%, and 25% w/w) or carbon nanotubes (CNT, 1% and 2% w/w) in order to improve their mechanical properties. Samples were characterized in terms of compressive and tensile mechanical behavior. It was found that 15% CA and 2% CNT reinforcement led to the best mechanical properties. Thus, these materials were further characterized in terms of morphology, wettability, and friction coefficient (CoF). Contrarily to CNTs, the addition of CA significantly increased the material's porosity. Both materials became more hydrophilic, and the CoF slightly increased for PCU + 15%CA. The materials were loaded by soaking with diclofenac, and drug release experiments were conducted. PCU, PCU + 15%CA and PCU + 2%CNT presented similar release profiles, being able to ensure a controlled release of DFN for at least 4 days. Finally, in vitro cytotoxicity tests using human chondrocytes were also performed and confirmed a high biocompatibility for the three studied materials.

PVA-Based Hydrogels Loaded with Diclofenac for Cartilage Replacement

Polyvinyl alcohol (PVA) hydrogels have been widely studied for cartilage replacement due to their biocompatibility, chemical stability, and ability to be modified such that they approximate natural tissue behavior. Additionally, they may also be used with advantages as local drug delivery systems. However, their properties are not yet the most adequate for such applications. This work aimed to develop new PVA-based hydrogels for this purpose, displaying improved tribomechanical properties with the ability to control the release of diclofenac (DFN). Four types of PVA-based hydrogels were prepared via freeze-thawing: PVA, PVA/PAA (by polyacrylic acid (PAA) addition), PVA/PAA+PEG (by polyethylene glycol (PEG) immersion), and PVA/PAA+PEG+A (by annealing). Their morphology, water uptake, mechanical and rheological properties, wettability, friction coefficient, and drug release behavior were accessed. The irritability of the best-performing material was investigated. The results showed that the PAA addition increased the swelling and drug release amount. PEG immersion led to a more compact structure and significantly improved the material’s tribomechanical performance. The annealing treatment led to the material with the most suitable properties: besides presenting a low friction coefficient, it further enhanced the mechanical properties and ensured a controlled DFN release for at least 3 days. Moreover, it did not reveal irritability potential for biological tissues.

An Artificial PVA-BC Composite That Mimics the Biomechanical Properties and Structure of a Natural Intervertebral Disc

Disc herniation is one of the most ubiquitous healthcare problems in modern cities—severe patients eventually require surgical intervention. However, the existing operations—spinal fusion and artificial disc replacement—alter the biomechanics of the spine, leaving much room for improvement. The appropriateness of polyvinyl alcohol (PVA) for biomedical applications has been recognised due to its high water content, excellent biocompatibility, and versatile mechanical properties. In this study, a newly-designed PVA–bacterial cellulose (PVA-BC) composite was assembled to mimic both the biomechanics and annular structure of natural intervertebral discs (IVDs). PVA-BC composites of various concentrations were fabricated and tested under unconfined compression and compressive creep in order to acquire the values of the normalised compressive stiffness and whole normalised deformation. The normalised compressive stiffness increased considerably with an increasing PVA concentration, spanning from 1.82 (±0.18) to 3.50 (±0.14) MPa, and the whole normalised deformation decreased from 0.25 to 0.13. Formulations of 40% PVA provided the most accurate mimicry of natural human IVDs in normalised whole deformation, and demonstrated higher dimensional stability. The biocompatible results further confirmed that the materials had excellent biocompatibility. The novel bionic structure and formulations of the PVA-BC materials mimicked the biomechanics and structure of natural IVDs, and ensured dimensional stability under prolonged compression, reducing the risk of impingement on the surrounding tissue. The PVA-BC composite is a promising material for third-generation artificial IVDs with integrated construction.

High-performance bilayer composites for the replacement of osteochondral defects

Two novel bilayer constructs for the repair of osteochondral defects were developed from nanofibers and ceramic particles embedded into PVA matrices, exhibiting multiple promising properties similar to those of corresponding natural tissues.

Dynamic hyaluronic acid hydrogel with covalent linked gelatin as an anti-oxidative bioink for cartilage tissue engineering

In the past decade, cartilage tissue engineering has arisen as a promising therapeutic option for degenerative joint diseases, such as osteoarthritis, in the hope of restoring the structure and physiological functions. Hydrogels are promising biomaterials for developing engineered scaffolds for cartilage regeneration. However, hydrogel-delivered mesenchymal stem cells or chondrocytes could be exposed to elevated levels of reactive oxygen species (ROS) in the inflammatory microenvironment after being implanted into injured joints, which may affect their phenotype and normal functions and thereby hinder the regeneration efficacy. To attenuate ROS induced side effects, a multifunctional hydrogel with an innate anti-oxidative ability was produced in this study. The hydrogel was rapidly formed through a dynamic covalent bond between phenylboronic acid grafted hyaluronic acid (HA-PBA) and poly(vinyl alcohol) and was further stabilized through a secondary crosslinking between the acrylate moiety on HA-PBA and the free thiol group from thiolated gelatin. The hydrogel is cyto-compatible and injectable and can be used as a bioink for 3D bioprinting. The viscoelastic properties of the hydrogels could be modulated through the hydrogel precursor concentration. The presence of dynamic covalent linkages contributed to its shear-thinning property and thus good printability of the hydrogel, resulting in the fabrication of a porous grid construct and a meniscus like scaffold at high structural fidelity. The bioprinted hydrogel promoted cell adhesion and chondrogenic differentiation of encapsulated rabbit adipose derived mesenchymal stem cells. Meanwhile, the hydrogel supported robust deposition of extracellular matrix components, including glycosaminoglycans and type II collagen, by embedded mouse chondrocytesin vitro. Most importantly, the hydrogel could protect encapsulated chondrocytes from ROS induced downregulation of cartilage-specific anabolic genes (ACAN and COL2) and upregulation of a catabolic gene (MMP13) after incubation with H₂O₂. Furthermore, intra-articular injection of the hydrogel in mice revealed adequate stability and good biocompatibilityin vivo. These results demonstrate that this hydrogel can be used as a novel bioink for the generation of 3D bioprinted constructs with anti-ROS ability to potentially enhance cartilage tissue regeneration in a chronic inflammatory and elevated ROS microenvironment.

In Vitro Wound Dressing Stack Model as a First Step to Evaluate the Behavior of Dressing Materials in Wound Bed-An Assessment of Mass Transport Phenomena in Hydrogel Wound Dressings

Wound dressings when applied are in contact with wound exudates in vivo or with acceptor fluid when testing drug release from wound dressing in vitro. Therefore, the assessment of bidirectional mass transport phenomena in dressing after application on the substrate is important but has never been addressed in this context. For this reason, an in vitro wound dressing stack model was developed and implemented in the 3D printed holder. The stack was imaged using magnetic resonance imaging, i.e., relaxometric imaging was performed by means of T2 relaxation time and signal amplitude 1D profiles across the wound stack. As a substrate, fetal bovine serum or propylene glycol were used to simulate in vivo or in vitro cases. Multi-exponential analysis of the spatially resolved magnetic resonance signal enabled to distinguish components originating from water and propylene glycol in various environments. The spatiotemporal evolution of these components was assessed. The components were related to mass transport (water, propylene glycol) in the dressing/substrate system and subsequent changes of physicochemical properties of the dressing and adjacent substrate. Sharp changes in spatial profiles were detected and identified as moving fronts. It can be concluded that: (1) An attempt to assess mass transport phenomena was carried out revealing the spatial structure of the wound dressing in terms of moving fronts and corresponding layers; (2) Moving fronts, layers and their temporal evolution originated from bidirectional mass transport between wound dressing and substrate. The setup can be further applied to dressings containing drugs.

Preparation, mechanical properties, fatigue and tribological behavior of double crosslinked high strength hydrogel

Polyvinyl alcohol hydrogel (PVA-H) has been widely used in clinical transplantation because of its high water content, good biocompatibility and mechanical properties. However, PVA-H have some problems, such as low elongation at break, low fatigue resistance and high friction coefficient, which hinders its application in clinic. In this paper, a novel high-performance PVA hydrogel enhanced by chemical double crosslinking (CDC) method had been synthesized. The influences of chemical crosslinking agent concentration on mechanical properties, friction properties and fatigue properties of materials were systematically investigated, in order to meet the clinical application of artificial meniscus, artificial cartilage, nucleus pulposus and so on. As a result, due to the introduction of chemical bonds, CDC hydrogels have over 600% elongation at break, modulus loss after fatigue test was reduced by 42%, average coefficient during friction was reduced to 0.048, and biocompatibility performance was excellent. The PVA hydrogel enhanced by CDC method provides a new concept for us to prepare high-performance PVA hydrogel and a promising material to replace cartilage, meniscus, nucleus pulposus and other tissues.

Combinations of Hydrogels and Mesenchymal Stromal Cells (MSCs) for Cartilage Tissue Engineering-A Review of the Literature

Cartilage offers limited regenerative capacity. Cell-based approaches have emerged as a promising alternative in the treatment of cartilage defects and osteoarthritis. Due to their easy accessibility, abundancy, and chondrogenic potential mesenchymal stromal cells (MSCs) offer an attractive cell source. MSCs are often combined with natural or synthetic hydrogels providing tunable biocompatibility, biodegradability, and enhanced cell functionality. In this review, we focused on the different advantages and disadvantages of various natural, synthetic, and modified hydrogels. We examined the different combinations of MSC-subpopulations and hydrogels used for cartilage engineering in preclinical and clinical studies and reviewed the effects of added growth factors or gene transfer on chondrogenesis in MSC-laden hydrogels. The aim of this review is to add to the understanding of the disadvantages and advantages of various combinations of MSC-subpopulations, growth factors, gene transfers, and hydrogels in cartilage engineering.

Applications of Functionalized Hydrogels in the Regeneration of the Intervertebral Disc

Intervertebral disc degeneration (IDD) is caused by genetics, aging, and environmental factors and is one of the leading causes of low back pain. The treatment of IDD presents many challenges. Hydrogels are biomaterials that possess properties similar to those of the natural extracellular matrix and have significant potential in the field of regenerative medicine. Hydrogels with various functional qualities have recently been used to repair and regenerate diseased intervertebral discs. Here, we review the mechanisms of intervertebral disc homeostasis and degeneration and then discuss the applications of hydrogel-mediated repair and intervertebral disc regeneration. The classification of artificial hydrogels and natural hydrogels is then briefly introduced, followed by an update on the development of functional hydrogels, which include noncellular therapeutic hydrogels, cellular therapeutic hydrogel scaffolds, responsive hydrogels, and multifunctional hydrogels. The challenges faced and future developments of the hydrogels used in IDD are discussed as they further promote their clinical translation.

Fabrication and characterization of microstructure-controllable COL-HA-PVA hydrogels for cartilage repair

Polyvinyl alcohol (PVA) hydrogel has gained interest in cartilage repair because of its highly swollen, porosity, and viscoelastic properties. However, PVA has some deficiencies, such as its poor biocompatibility and microstructure. This research aimed to design novel hydroxyapatite (HA)-collagen (COL)-PVA hydrogels. COL was added to improve cell biocompatibility, and the microstructure of the hydrogels was controlled by fused deposition modeling (FDM). The feasibility of the COL-HA-PVA hydrogels in cartilage repair was evaluated by in vitro and in vivo experiments. The scanning electron microscopy results showed that the hybrid hydrogels had interconnected macropore structures that contained a COL reticular scaffold. The diameter of the macropore was 1.08-1.85 mm, which corresponds to the diameter of the denatured PVA column. The chondrocytes were then seeded in hydrogels to assess the cell viability and formation of the cartilage matrix. The in vitro results revealed excellent cellular biocompatibility. Osteochondral defects (8 mm in diameter and 8 mm in depth) were created in the femoral trochlear of goats, and the defects were implanted with cell-seeded hydrogels, cell-free hydrogels, or a blank control. The in vivo results showed that the COL-HA-PVA hydrogels effectively repaired cartilage defects, especially the conditions inoculated with chondrocyte in advance. This research suggests that the COL-HA-PVA hydrogels have promising application in cartilage repair.

PVA-Based Hydrogels: Promising Candidates for Articular Cartilage Repair

The complex, gradient physiological structure of articular cartilage is a severe hindrance of its self-repair, leaving the clinical treatment of cartilage defects a demanding issue to be addressed. Currently applied tissue engineering treatments and traditional non-tissue engineering treatments have different limitations, for example, cell dedifferentiation, immune rejection, and prosthesis-related complications. Thus, studies have been focusing on seeking promising candidates for novel cartilage repair methods. Polyvinyl alcohol (PVA) hydrogels with excellent biocompatibility and tunable material properties have become the alternatives. For pure PVA hydrogels, the mechanical strength and lubricity are not capable of replacing articular cartilage until proper modifications are done. This paper summarizes the research progress in PVA hydrogels, including the preparation, modification, and cartilage-repair-aimed biomimetic improvements. Design guidance of PVA hydrogels is put forward as assistance to functional hydrogel preparation. Finally, the prospects and main obstacles of PVA hydrogels are discussed.

Polymer-Based Carriers in Dental Local Healing-Review and Future Challenges

Polymers in drug formulation technology and the engineering of biomaterials for the treatment of oral diseases constitute a group of excipients that often possess additional properties in addition to their primary function, i.e., biological activity, sensitivity to stimuli, mucoadhesive properties, improved penetration of the active pharmaceutical ingredient (API) across biological barriers, and effects on wound healing or gingival and bone tissue regeneration. Through the use of multifunctional polymers, it has become possible to design carriers and materials tailored to the specific conditions and site of application, to deliver the active substance directly to the affected tissue, including intra-periodontal pocket delivery, and to release the active substance in a timed manner, allowing for the improvement of the form of application and further development of therapeutic strategies. The scope of this review is polymeric drug carriers and materials developed from selected multifunctional groups of natural, semi-synthetic, and synthetic polymers for topical therapeutic applications. Moreover, the characteristics of the topical application and the needs for the properties of carriers for topical administration of an active substance in the treatment of oral diseases are presented to more understand the difficulties associated with the design of optimal active substance carriers and materials for the treatment of lesions located in the oral cavity.

Influence of the Mechanical Environment on the Regeneration of Osteochondral Defects

Articular cartilage is a highly specialised connective tissue of diarthrodial joints which provides a smooth, lubricated surface for joint articulation and plays a crucial role in the transmission of loads. In vivo cartilage is subjected to mechanical stimuli that are essential for cartilage development and the maintenance of a chondrocytic phenotype. Cartilage damage caused by traumatic injuries, ageing, or degradative diseases leads to impaired loading resistance and progressive degeneration of both the articular cartilage and the underlying subchondral bone. Since the tissue has limited self-repairing capacity due its avascular nature, restoration of its mechanical properties is still a major challenge. Tissue engineering techniques have the potential to heal osteochondral defects using a combination of stem cells, growth factors, and biomaterials that could produce a biomechanically functional tissue, representative of native hyaline cartilage. However, current clinical approaches fail to repair full-thickness defects that include the underlying subchondral bone. Moreover, when tested in vivo, current tissue-engineered grafts show limited capacity to regenerate the damaged tissue due to poor integration with host cartilage and the failure to retain structural integrity after insertion, resulting in reduced mechanical function. The aim of this review is to examine the optimal characteristics of osteochondral scaffolds. Additionally, an overview on the latest biomaterials potentially able to replicate the natural mechanical environment of articular cartilage and their role in maintaining mechanical cues to drive chondrogenesis will be detailed, as well as the overall mechanical performance of grafts engineered using different technologies.

Advanced hydrogels for the repair of cartilage defects and regeneration

Cartilage defects are one of the most common symptoms of osteoarthritis (OA), a degenerative disease that affects millions of people world-wide and places a significant socio-economic burden on society. Hydrogels, which are a class of biomaterials that are elastic, and display smooth surfaces while exhibiting high water content, are promising candidates for cartilage regeneration. In recent years, various kinds of hydrogels have been developed and applied for the repair of cartilage defects in vitro or in vivo, some of which are hopeful to enter clinical trials. In this review, recent research findings and developments of hydrogels for cartilage defects repair are summarized. We discuss the principle of cartilage regeneration, and outline the requirements that have to be fulfilled for the deployment of hydrogels for medical applications. We also highlight the development of advanced hydrogels with tailored properties for different kinds of cartilage defects to meet the requirements of cartilage tissue engineering and precision medicine.

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The biotechnology of developing hydrogels for cartilage defects repair is promising.

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The principle for cartilage regeneration using hydrogels and requirements for clinical transformation are summarized.

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Advanced hydrogels with tailored properties for different kinds of cartilage defects are discussed.

In Vivo Imaging of Click-Crosslinked Hydrogel Depots Following Intratympanic Injection

In this study, we developed injectable intratympanic hyaluronic acid (HA) depots for the treatment of hearing loss. We prepared an injectable click-crosslinking formulation by modifying HA with tetrazine (HA-TET) and trans-cyclooctene (HA-TCO), which crosslinked to form an HA depot (Cx-HA). Preparation of the click-crosslinking HA formulation was facile, and Cx-HA depot formation was reproducible. Additionally, the Cx-HA hydrogel was significantly stiffer than HA hydrogel. To monitor the degradation pattern of hydrogels, we mixed a zwitterionic near-infrared (NIR) fluorophore (e.g., ZW800-1C) in the click-crosslinking HA formulation. Then, HA-TET and HA-TCO solutions containing ZW800-1C were loaded separately into the compartments of a dual-barrel syringe for intratympanic injection. The Cx-HA depots formed quickly, and an extended residence time in the tympanic cavity was confirmed by performing NIR fluorescence imaging. We have successfully prepared an injectable click-crosslinking HA formulation that has promise as an intratympanic drug depot.

Tough and Low Friction Polyvinyl Alcohol Hydrogels Loaded with Anti-inflammatories for Cartilage Replacement

The development of new materials that mimic cartilage and its function is an unmet need that will allow replacing the damaged parts of the joints, instead of the whole joint. Polyvinyl alcohol (PVA) hydrogels have raised special interest for this application due to their biocompatibility, high swelling capacity and chemical stability. In this work, the effect of post-processing treatments (annealing, high hydrostatic pressure (HHP) and gamma-radiation) on the performance of PVA gels obtained by cast-drying was investigated and, their ability to be used as delivery vehicles of the anti-inflammatories diclofenac or ketorolac was evaluated. HHP damaged the hydrogels, breaking some bonds in the polymeric matrix, and therefore led to poor mechanical and tribological properties. The remaining treatments, in general, improved the performance of the materials, increasing their crystallinity. Annealing at 150 °C generated the best mechanical and tribological results: higher resistance to compressive and tensile loads, lower friction coefficients and ability to support higher loads in sliding movement. This material was loaded with the anti-inflammatories, both without and with vitamin E (Vit.E) or Vit.E + cetalkonium chloride (CKC). Vit.E + CKC helped to control the release of the drugs which occurred in 24 h. The material did not induce irritability or cytotoxicity and, therefore, shows high potential to be used in cartilage replacement with a therapeutic effect in the immediate postoperative period.

Osteoarthritis Severely Decreases the Elasticity and Hardness of Knee Joint Cartilage: A Nanoindentation Study

The nanoindentation method was applied to determine the elastic modulus and hardness of knee articular cartilage. Cartilage samples from both high weight bearing (HWB) and low weight bearing (LWB) femoral condyles were collected from patients diagnosed with osteoarthritis (OA). The mean elastic modulus of HWB cartilage was 4.46 ± 4.44 MPa in comparison to that of the LWB region (9.81 ± 8.88 MPa, p < 0.001). Similarly, the hardness was significantly lower in HWB tissue (0.317 ± 0.397 MPa) than in LWB cartilage (0.455 ± 0.434 MPa, p < 0.001). When adjusted to patients’ ages, the mean elastic modulus and hardness were both significantly lower in the age group over 70 years (p < 0.001). A statistically significant difference in mechanical parameters was also found in grade 3 and 4 OA. This study provides an insight into the nanomechanical properties of the knee articular cartilage and provides a starting point for personalized cartilage grafts that are compatible with the mechanical properties of the native tissue.