Cell Proliferation to Evaluate Preliminarily the Presence of Enduring Self-Regenerative Antioxidant Activity in Cerium Doped Bioactive Glasses

Enhanced bone regeneration with cerium-doped bioactive glasses: In vitro and in vivo study

BACKGROUND

Bioactive cerium-doped (Ce-BGs) glasses with proven antioxidant properties, which may reduce post-implant oxidative stress, were studied in vitro and in vivo to evaluate their application in bone regeneration. Based on the Kokubo (K) composition, they contain 3.6 and 5.3 mol% cerium (referred to as K3.6 and K5.3, respectively).

METHODS

Ce-BGs were synthesized by melting and sieved to produce granules (size range = 200-500 µm). In vitro studies were conducted against MLO-Y4 cells using direct Neutral Red (NR) and indirect Bromo-2-deoxyUridine (BrdU) assays to assess cell viability and proliferation respectively. In vivo studies were carried out using a New Zealand white rabbit model to evaluate bone healing potential.

RESULTS AND DISCUSSION

NR results showed a significant increase in cell viability for Ce-BGs: 77% for K and 79 and 85% for K3.6 and K5.3, after 24 h. After 72 h, cell viability decreased for K to 58% and increased for K3.6 and K5.3 (76% and 116% respectively). Cerium inhibits cell proliferation in BrdU assay as explainable by the increased durability of Ce-BGs. In vivo studies, after 30 and 60 days, revealed a delayed degradation for Ce-BGs that can stimulate the osteo-regeneration without inflammatory or degenerative effects. Moreover, the new bone area (NBA) was higher for Ce-BGs compared to control; after 60 days 32% for K5.3 versus 21% for K.

CONCLUSIONS

Ce-BGs granules show improved direct cytocompatibility in vitro and enhance the long-term bone remodeling process in vivo, contributing to a more controlled and effective bone healing compared to the K granules. This improved behavior can be linked to the antioxidant and anti-inflammatory properties of cerium, that can assist bone regeneration and reduce implant-associated inflammation, and to their slower dissolution rate that supports the controlled release of ions. These results suggest Ce-BGs as a promising device for therapeutic applications on hard tissues.

Biocompatibility, Bioactivity, and Antibacterial Behaviour of Cerium-Containing Bioglass®

The main reason for the increased use of dental implants in clinical practice is associated with aesthetic parameters. Implants are also presented as the only technique that conserves and stimulates natural bone. However, there are several problems associated with infections, such as peri-implantitis. This disease reveals a progressive inflammatory action that affects the hard and soft tissues surrounding the implant, leading to implant loss. To prevent the onset of this disease, coating the implant with bioactive glasses has been suggested. In addition to its intrinsic function of promoting bone regeneration, it is also possible to insert therapeutic ions, such as cerium. Cerium has several advantages when the aim is to improve osseointegration and prevent infectious problems with dental implant placement. It promotes increased growth and the differentiation of osteoblasts, improves the mechanical properties of bone, and prevents bacterial adhesion and proliferation that may occur on the implant surface. This antibacterial effect is due to its ability to disrupt the cell wall and membrane of bacteria, thus interfering with vital metabolic functions such as respiration. In addition, its antioxidant effect reverses oxidative stress after implantation in bone. In this work, Bioglass 45S5 with CeO₂ with different percentages (0.25, 0.5, 1, and 2 mol%) was developed by the melt-quenching method. The materials were analyzed in terms of morphological, structural, and biological (cytotoxicity, bioactivity, and antibacterial activity) properties. The addition of cerium did not promote structural changes to the bioactive glass, which shows no cytotoxicity for the Saos-2 cell line up to 25 mg/mL of extract concentration for all cerium contents. For the maximum cerium concentration (2 mol%) the bioactive glass shows an evident inhibitory effect for Escherichia coli and Streptococcus mutans bacteria. Furthermore, all samples showed the beginning of the deposition of a CaP-rich layer on the surface of the material after 24 h.

Antioxidant Effects of Bioactive Glasses (BGs) and Their Significance in Tissue Engineering Strategies

Elevated levels of oxidative stress are usually observed following injuries, leading to impaired tissue repair due to oxidation-related chronic inflammation. Several attempts have been made to manage this unfavorable situation, and the use of biomaterials with antioxidant activity is showing great promise in tissue engineering and regenerative medicine approaches. Bioactive glasses (BGs) are a versatile group of inorganic substances that exhibit an outstanding regenerative capacity for both hard and soft damaged tissues. The chemical composition of BGs provides a great opportunity for imparting specific biological activities to them. On this point, BGs may easily become antioxidant substances through simple physicochemical modifications. For example, particular antioxidant elements (mostly cerium (Ce)) can be added to the basic composition of the glasses. On the other hand, grafting natural antioxidant substances (e.g., polyphenols) on the BG surface is feasible for making antioxidant substitutes with promising results in vitro. Mesoporous BGs (MBGs) were demonstrated to have unique merits compared with melt-derived BGs since they make it possible to load antioxidants and deliver them to the desired locations. However, there are actually limited in vivo experimental studies on the capability of modified BGs for scavenging free radicals (e.g., reactive oxygen species (ROS)). Therefore, more research is required to determine the actual potential of BGs in decreasing oxidative stress and subsequently improving tissue repair and regeneration. The present work aims to highlight the potential of different types of BGs in modulating oxidative stress and subsequently improving tissue healing.

Anti-inflammatory and antibacterial activities of cerium-containing mesoporous bioactive glass nanoparticles for drug-free biomedical applications

Mesoporous bioactive glass nanoparticles (MBGNPs) are attracting significant attention as suitable materials for multifunctional biomedical applications. In this study, cerium was incorporated into MBGNPs using two different approaches. In the first approach, cerium was added to the glass system directly during the synthesis, while in the second approach, cerium was added to the as-synthesized MBGNPs via the template ion-exchange method. The influence of the method of synthesis on the physicochemical properties of nanoparticles was examined by SEM, TEM, XRD, FTIR, and N₂ adsorption-desorption analyses. The MBGNPs exhibited spheroidal morphology and disordered mesoporous structure. XRD analysis confirmed the amorphous nature of the nanoparticles. The chemical composition was determined by the acid digestion method using ICP-OES. The influence of the synthesis method on the specific surface area, mesoporosity, and solubility of synthesized nanoparticles in Tris/HCl (pH 7.4) and acetate (pH 4.5) buffer has also been studied. The obtained Ce containing MBGNPs were non-cytotoxic toward ​preosteoblast MC3T3-E1 cells in contact with nanoparticles in a concentration of up to 100 ​μg/mL. The anti-inflammatory effect of Ce containing MBGNPs was tested with lipopolysaccharides (LPS)-induced proinflammatory RAW 264.7 macrophage cells. Ce containing MBGNPs decreased the release of nitric oxide, indicating the anti-inflammatory response of macrophage cells. Ce containing MBGNPs also showed antibacterial activity against S. aureus and E. coli. The mentioned features of the obtained MBGNPs make them useful in a variety of biomedical applications, considering their biocompatibility, anti-inflammatory response, and enhanced antibacterial effect.

Cerium Containing Bioactive Glasses: A Review

Bioactive glasses (BGs) for biomedical applications are doped with therapeutic inorganic ions (TIIs) in order to improve their performance and reduce the side effects related to the surgical implant. Recent literature in the field shows a rekindled interest toward rare earth elements, in particular cerium, and their catalytic properties. Cerium-doped bioactive glasses (Ce-BGs) differ in compositions, synthetic methods, features, and in vitro assessment. This review provides an overview on the recent development of Ce-BGs for biomedical applications and on the evaluation of their bioactivity, cytocompatibility, antibacterial, antioxidant, and osteogenic and angiogenic properties as a function of their composition and physicochemical parameters.

Investigation on the antimicrobial properties of cerium-doped bioactive glasses

Cerium‐doped bioactive glasses (Ce‐BGs) are implant materials that present high biocompatibility, modulate the levels of reactive oxygen species, and exert antimicrobial activity. The potential of BGs, 45S5, and K50S derived glasses doped with CeO₂ (1.2, 3.6, and 5.3 mol%) to inhibit the growth of pathogen microbes was thoroughly investigated according to the ISO 22196:2011 method properly adapted. A significant reduction of the E. coli charge was detected in all glasses, including the BGs without cerium. The evolution of pH of the medium not inoculated following the immersion of the Ce‐BGs was monitored. The presence of cerium did not affect markedly the pH trend, which increased rapidly for both compositions. The change of pH was strongly mitigated by the presence of 200 mM phosphate buffer pH 7.0 (PB) in the medium. In media buffered by PB, the growth of E. coli, Pseudomonas aeruginosa, Listeria monocytogenes, Staphylococcus aureus, and C. albicans was not affected by the presence of BGs doped or not with cerium, suggesting that the antibacterial activity of Ce‐BGs is linked to the increase of environmental pH rather than to specific ion effects. However, Ce‐BGs resulted promising biomaterials that associate low toxicity to normal cells to a considerable antimicrobial effect, albeit the latter is not directly associated with the presence of cerium.

The Advances of Ceria Nanoparticles for Biomedical Applications in Orthopaedics

The ongoing biomedical nanotechnology has intrigued increasingly intense interests in cerium oxide nanoparticles, ceria nanoparticles or nano-ceria (CeO2-NPs). Their remarkable vacancy-oxygen defect (VO) facilitates the redox process and catalytic activity. The verification has illustrated that CeO2-NPs, a nanozyme based on inorganic nanoparticles, can achieve the anti-inflammatory effect, cancer resistance, and angiogenesis. Also, they can well complement other materials in tissue engineering (TE). Pertinent to the properties of CeO2-NPs and the pragmatic biosynthesis methods, this review will emphasize the recent application of CeO2-NPs to orthopedic biomedicine, in particular, the bone tissue engineering (BTE). The presentation, assessment, and outlook of the orthopedic potential and shortcomings of CeO2-NPs in this review expect to provide reference values for the future research and development of therapeutic agents based on CeO2-NPs.

CeO2 Containing Thin Films as Bioactive Coatings for Orthopaedic Implants

Due to the fact of their ability to bond with human’s hard tissue, bioglasses have gained interest in the biomedical field with certain purposes regarding their usage in the replacement, healing or repair of bones. In the form of thin films, they trigger an increase in biocompatibility for the inert supports after implantation, based on surface engineering to ensure osteoinduction. For that, this research is focused on obtaining coatings based on cerium-enriched bioglass to generate bioactive and potential additional antimicrobial and antioxidant properties. The addressed oxide system was a novel and complex one, 46.10 SiO2–2.60 P2O5–16.90 CaO–10.00 MgO–19.40 Na2O–5.00 CeO2 (mol%), while two different synthesis methods, laser ablation and spin coating, were tackled comparatively. In the case of the first technique, substrate temperature was selected as variable parameter (room temperature or 300 °C). After conducting a complex characterization, films’ deposition was validated, their bioactive behaviour was proven by the formation of calcium phosphate after immersion in simulated body fluid for four weeks, while the impact exerted on the tested human fibroblast BJ cells (ATCC, CRL-2522) confirmed the applicative potential.