1
|
McClendon MT, Ji W, Greene AC, Sai H, Sangji MH, Sather NA, Chen CH, Lee SS, Katchko K, Jeong SS, Kannan A, Weiner J, Cook R, Driscoll A, Lubbe R, Chang K, Haleem M, Chen F, Qiu R, Chun D, Stock SR, Hsu WK, Hsu EL, Stupp SI. A supramolecular polymer-collagen microparticle slurry for bone regeneration with minimal growth factor. Biomaterials 2023; 302:122357. [PMID: 37879188 PMCID: PMC10897953 DOI: 10.1016/j.biomaterials.2023.122357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/05/2023] [Accepted: 10/15/2023] [Indexed: 10/27/2023]
Abstract
Recombinant bone morphogenetic protein-2 (BMP-2) is a potent osteoinductive growth factor that can promote bone regeneration for challenging skeletal repair and even for ectopic bone formation in spinal fusion procedures. However, serious clinical side effects related to supraphysiological dosing highlight the need for advances in novel biomaterials that can significantly reduce the amount of this biologic. Novel biomaterials could not only reduce clinical side effects but also expand the indications for use of BMP-2, while at the same time lowering the cost of such procedures. To achieve this objective, we have developed a slurry containing a known supramolecular polymer that potentiates BMP-2 signaling and porous collagen microparticles. This slurry exhibits a paste-like consistency that stiffens into an elastic gel upon implantation making it ideal for minimally invasive procedures. We carried out in vivo evaluation of the novel biomaterial in the rabbit posterolateral spine fusion model, and discovered efficacy at unprecedented ultra-low BMP-2 doses (5 μg/implant). This dose reduces the growth factor requirement by more than 100-fold relative to current clinical products. This observation is significant given that spinal fusion involves ectopic bone formation and the rabbit model is known to be predictive of human efficacy. We expect the novel biomaterial can expand BMP-2 indications for difficult cases requiring large volumes of bone formation or involving patients with underlying conditions that compromise bone regeneration.
Collapse
Affiliation(s)
- Mark T McClendon
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States
| | - Wei Ji
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States
| | - Allison C Greene
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Hiroaki Sai
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States
| | - M Hussain Sangji
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, United States
| | - Nicholas A Sather
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States
| | - Charlotte H Chen
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States
| | - Sungsoo S Lee
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States
| | - Karina Katchko
- Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Soyeon Sophia Jeong
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Abhishek Kannan
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Joseph Weiner
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Ralph Cook
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Adam Driscoll
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Ryan Lubbe
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Kevin Chang
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Meraaj Haleem
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Feng Chen
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States
| | - Ruomeng Qiu
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Chemistry, Northwestern University, Evanston, IL, 60208, United States
| | - Danielle Chun
- Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Stuart R Stock
- Department of Cell and Molecular Biology, Northwestern University, Chicago, IL, 60611, United States
| | - Wellington K Hsu
- Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Erin L Hsu
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, 60611, United States
| | - Samuel I Stupp
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, United States; Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, United States; Department of Chemistry, Northwestern University, Evanston, IL, 60208, United States; Department of Materials Science and Engineering, Northwestern University, Evanston, IL, 60208, United States; Department of Medicine, Northwestern University, Chicago, IL, 60611, United States.
| |
Collapse
|
2
|
Jeong SS, Chen T, Nguyen SA, Edwards TS, Schlosser RJ. Correlation of polyp grading scales with patient symptom scores and olfaction in chronic rhinosinusitis: a systematic review and meta-analysis. Rhinology 2022; 0:2995. [PMID: 35438689 DOI: 10.4193/rhin22.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
BACKGROUND Various nasal polyp (NP) scoring systems have been proposed and used in the literature. However, no single system has been identified as superior. Correlations between NP scoring systems and patient symptoms, quality of life (QOL) or olfaction vary widely. METHODS A systematic search of PubMed, CINAHL, Scopus, and Cochrane Library was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Any study examining endoscopy scores and symptom, QOL or olfaction measures in cross sectional manner or after therapeutic intervention were included. RESULTS This review identified 55 studies for a pooled meta-analysis of Lund-Kennedy (LK-NP) polyp scores (N = 6), Meltzer scores (N = 6), Nasal polyp scores (NPS; N = 19), Total polyp score (TPS; N=8) Lilholdt scores (N = 8), Olfactory cleft endoscopy score (OCES; N =4), Discharge, inflammation, polyp/edema score (DIP; N = 2), and Perioperative sinus endoscopy score (POSE; N = 2). Meta-regression assessed correlations between NP grading systems and SNOT-22, nasal congestion scores, total nasal symptom scores (TNSS), and Smell Identification Test-40 (SIT40). None of the NP grading systems correlated significantly with any symptom, QOL or olfactory metric. In intervention studies of surgery or monoclonal antibody treatment, changes in NPS scores did not correlate with any patient reported outcome measure (PROM) or olfactory outcomes. CONCLUSION Current NP endoscopic scoring systems are not associated with PROMs such as SNOT-22, nasal congestion scores, and TNSS as well as objective measures of olfaction. NP grading systems with improved clinical utility are needed.
Collapse
Affiliation(s)
- S S Jeong
- 1 Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA and 2 Albert Einstein College of Medicine, Bronx, NY, USA
| | - T Chen
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - S A Nguyen
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - T S Edwards
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - R J Schlosser
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| |
Collapse
|
3
|
Ji Y, Adeola O, Strawn TL, Jeong SS, Chen R, Fay WP. Recombinant soluble apyrase APT102 inhibits thrombosis and intimal hyperplasia in vein grafts without adversely affecting hemostasis or re-endothelialization. J Thromb Haemost 2017; 15:814-825. [PMID: 28079982 PMCID: PMC5378664 DOI: 10.1111/jth.13621] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Indexed: 12/15/2022]
Abstract
Essentials New strategies are needed to inhibit thrombosis and intimal hyperplasia (IH) in vein grafts (VG). We studied effects of apyrase (APT102) on VGs and smooth muscle and endothelial cells (SMC/EC). APT102 inhibited thrombosis, SMC migration, and IH without impairing hemostasis or EC recovery. Apyrase APT102 is a single-drug approach to inhibit multiple processes that cause VG failure. SUMMARY Background Occlusion of vein grafts (VGs) after bypass surgery, owing to thrombosis and intimal hyperplasia (IH), is a major clinical problem. Apyrases are enzymes that scavenge extracellular ATP and ADP, and promote adenosine formation at sites of vascular injury, and hence have the potential to inhibit VG pathology. Objectives To examine the effects of recombinant soluble human apyrase, APT102, on platelets, smooth muscle cells (SMCs) and endothelial cells (ECs) in vitro, and on thrombosis and IH in murine VGs. Methods SMC and EC proliferation and migration were studied in vitro. Inferior vena cava segments from donor mice were grafted into carotid arteries of recipient mice. Results APT102 potently inhibited ADP-induced platelet aggregation and VG thrombosis, but it did not impair surgical hemostasis. APT102 did not directly inhibit SMC or EC proliferation, but significantly attenuated the effects of ATP on SMC and EC proliferation. APT102 significantly inhibited SMC migration, but did not inhibit EC migration, which may be mediated, at least in part, by inhibition of SMC, but not EC, migration by adenosine. At 4 weeks after surgery, there was significantly less IH in VGs of APT102-treated mice than in control VGs. APT102 significantly inhibited cell proliferation in VGs, but did not inhibit re-endothelialization. Conclusions Systemic administration of a recombinant human apyrase inhibits thrombosis and IH in VGs without increasing bleeding or compromising re-endothelialization. These results suggest that APT102 has the potential to become a novel, single-drug treatment strategy to prevent multiple pathologic processes that drive early adverse remodeling and occlusion of VGs.
Collapse
Affiliation(s)
- Y Ji
- Departments of Medicine and Medical Pharmacology and Physiology, University of Missouri School of Medicine and the Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA
| | - O Adeola
- Departments of Medicine and Medical Pharmacology and Physiology, University of Missouri School of Medicine and the Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA
| | - T L Strawn
- Departments of Medicine and Medical Pharmacology and Physiology, University of Missouri School of Medicine and the Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA
| | | | - R Chen
- APT Therapeutics, St Louis, MO, USA
| | - W P Fay
- Departments of Medicine and Medical Pharmacology and Physiology, University of Missouri School of Medicine and the Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA
| |
Collapse
|
15
|
Abstract
Structures of 8-(2-hydroxyethyl)pterins (8-11) investigated using 1H- and 13C-NMR and UV/vis spectroscopies showed a complex dependence on pH, solvent and 6,7-substitution pattern. In acid, only one cation was observed for all the pterins. In neutral aqueous solution, only one neutral form, the normal quinonoid tautomer, was observed for 7-unsubstituted pterins 9 & 11, but two neutral tautomeric forms, quinonoid and 7-exo-methylene, were observed for 7-CH3 substituted pterins 8 & 10 with 70% and 92%, respectively, of quinonoid. The neutral pterins in MeOH, however, showed a different distribution of structural forms: quinonoid and a five-membered intramolecular ether forms were observed for 7-unsubstituted pterins 9 & 11 as 60% and 25%, respectively, of quinonoid, while quinonoid and 7-exomethylene forms were observed for 7-CH3 substituted pterins 8 & 10 as 10% and 50%, respectively, of quinonoid. In base, for 7-unsubstituted pterins 9 & 11 only the intramolecular ether forms were observed, while for the 7-CH3 substituted pterins 8 & 10 two anion forms, the 7-exo-methylene and intramolecular ether, were observed in the ratio 2:1. Investigation of the distinctive proton-resonance pattern of the ethanomoiety of the intramolecular ether anion of 9 using 600 MHz NMR and spectrum simulation, indicated all four protons have different chemical environments. One conformation of the cyclic-ether ring satisfying the experimental data has been deduced, and the conformational energetics of the ring studied further using AM1 semiempirical quantum chemical calculations. Structural distributions of 8-methylpterins 12-15 were also studied in base only. These showed the 7-unsubstituted pterins 13 & 15 existed solely as the hydrated anion forms, while the 7-CH3 substituted pterins 12 & 14 existed predominantly as the 7-exo-methylene anions. Spectroscopic investigations of the degradation processes of 8-(2-hydroxyethyl)pterins and 8-methylpterins in base indicated a complex pattern of oxidation, ring opening and elimination reactions as a function of time. Using authentic samples, the 7-oxo compounds 16 & 17 and ethanolamine were identified, and evidence for ring-opened forms was obtained by comparison with the relevant 2,5-diamino-6-alkyl-aminopyrimidin-4(3H)-ones 1 & 2. Characteristically different degradation pathways for 7-CH3 and 7-unsubstituted compounds were established.
Collapse
Affiliation(s)
- S S Jeong
- Department of Biochemistry, University of Sydney, Australia
| | | |
Collapse
|