BACKGROUND Critically sized bone defects represent a significant challenge to orthopaedic surgeons worldwide.These defects generally result from severe trauma or resection of a whole large tumour.Autologous bone graft...BACKGROUND Critically sized bone defects represent a significant challenge to orthopaedic surgeons worldwide.These defects generally result from severe trauma or resection of a whole large tumour.Autologous bone grafts are the current gold standard for the reconstruction of such defects.However,due to increased patient morbidity and the need for a second operative site,other lines of treatment should be introduced.To find alternative unconventional therapies to manage such defects,bone tissue engineering using a combination of suitable bioactive factors,cells,and biocompatible scaffolds offers a promising new approach for bone regeneration.AIM To evaluate the healing capacity of platelet-rich fibrin(PRF)membranes seeded with allogeneic mesenchymal bone marrow-derived stem cells(BMSCs)on critically sized mandibular defects in a rat model.METHODS Sixty-three Sprague Dawley rats were subjected to bilateral bone defects of critical size in the mandibles created by a 5-mm diameter trephine bur.Rats were allocated to three equal groups of 21 rats each.Group I bone defects were irrigated with normal saline and designed as negative controls.Defects of group II were grafted with PRF membranes and served as positive controls,while defects of group III were grafted with PRF membranes seeded with allogeneic BMSCs.Seven rats from each group were killed at 1,2 and 4 wk.The mandibles were dissected and prepared for routine haematoxylin and eosin(HE)staining,Masson's trichrome staining and CD68 immunohistochemical staining.RESULTS Four weeks postoperatively,the percentage area of newly formed bone was significantly higher in group III(0.88±0.02)than in groups I(0.02±0.00)and II(0.60±0.02).The amount of granulation tissue formation was lower in group III(0.12±0.02)than in groups I(0.20±0.02)and II(0.40±0.02).The number of inflammatory cells was lower in group III(0.29±0.03)than in groups I(4.82±0.08)and II(3.09±0.07).CONCLUSION Bone regenerative quality of critically sized mandibular bone defects in rats was better promoted by PRF membranes seeded with BMSCs than with PRF membranes alone.展开更多
The healing of critical-sized bone defects(CSD)remains a challenge in orthopedic medicine.In recent years,scaffolds with sophisticated microstructures fabricated by the emerging three-dimensional(3D)printing technolog...The healing of critical-sized bone defects(CSD)remains a challenge in orthopedic medicine.In recent years,scaffolds with sophisticated microstructures fabricated by the emerging three-dimensional(3D)printing technology have lighted up the treatment of the CSD due to the elaborate microenvironments and support they may build.Here,we established a magnesium oxide-reinforced 3D-printed biocompos-ite scaffold to investigate the effect of magnesium-enriched 3D microenvironment on CSD repairing.The composite was prepared using a biodegradable polymer matrix,polycaprolactone(PCL),and the disper-sion phase,magnesium oxide(MgO).With the appropriate surface treatment by saline coupling agent,the MgO dispersed homogeneously in the polymer matrix,leading to enhanced mechanical performance and steady release of magnesium ion(Mg^(2+))for superior cytocompatibility,higher cell viability,advanced osteogenic differentiation,and cell mineralization capabilities in comparison with the pure PCL.The in-vivo femoral implantation and critical-sized cranial bone defect studies demonstrated the importance of the 3D magnesium microenvironment,as a scaffold that released appropriate Mg^(2+) exhibited remarkably increased bone volume,enhanced angiogenesis,and almost recovered CSD after 8-week implantation.Overall,this study suggests that the magnesium-enriched 3D scaffold is a potential candidate for the treatment of CSD in a cell-free therapeutic approach.展开更多
Additive manufacturing has received attention for the fabrication of medical implants that have customized and complicated structures.Biodegradable Zn metals are revolutionary materials for orthopedic implants.In this...Additive manufacturing has received attention for the fabrication of medical implants that have customized and complicated structures.Biodegradable Zn metals are revolutionary materials for orthopedic implants.In this study,pure Zn porous scaffolds with diamond structures were fabricated using customized laser powder bed fusion(L-PBF)technology.First,the mechanical properties,corrosion behavior,and biocompatibility of the pure Zn porous scaffolds were characterized in vitro.The scaffolds were then implanted into the rabbit femur critical-size bone defect model for 24 weeks.The results showed that the pure Zn porous scaffolds had compressive strength and rigidity comparable to those of cancellous bone,as well as relatively suitable degradation rates for bone regeneration.A benign host response was observed using hematoxylin and eosin(HE)staining of the heart,liver,spleen,lungs,and kidneys.Moreover,the pure Zn porous scaffold showed good biocompatibility and osteogenic promotion ability in vivo.This study showed that pure Zn porous scaffolds with customized structures fabricated using L-PBF represent a promising biodegradable solution for treating large bone defects.展开更多
A novel biodegradable metal system,ZnLiCa ternary alloys,were systematically investigated both in vitro and in vivo.The ultimate tensile strength(UTS)of Zn0.8Li0.1Ca alloy reached 567.60±9.56 MPa,which is compara...A novel biodegradable metal system,ZnLiCa ternary alloys,were systematically investigated both in vitro and in vivo.The ultimate tensile strength(UTS)of Zn0.8Li0.1Ca alloy reached 567.60±9.56 MPa,which is comparable to pure Ti,one of the most common material used in orthopedics.The elongation of Zn0.8Li0.1Ca is 27.82±18.35%,which is the highest among the ZnLiCa alloys.The in vitro degradation rate of Zn0.8Li0.1Ca alloy in simulated body fluid(SBF)showed significant acceleration than that of pure Zn.CCK-8 tests and hemocompatibility tests manifested that ZnLiCa alloys exhibit good biocompatibility.Real-time PCR showed that Zn0.8Li0.1Ca alloy successfully stimulated the expressions of osteogenesis-related genes(ALP,COL-1,OCN and Runx-2),especially the OCN.An in vivo implantation was conducted in the radius of New Zealand rabbits for 24 weeks,aiming to treat the bone defects.The Micro-CT and histological evaluations proved that the regeneration of bone defect was faster within the Zn0.8Li0.1Ca alloy scaffold than the pure Ti scaffold.Zn0.8Li0.1Ca alloy showed great potential to be applied in orthopedics,especially in the load-bearing sites.展开更多
BACKGROUND Bone tissue engineering is an area of continued interest within orthopaedic surgery,as it promises to create implantable bone substitute materials that obviate the need for autologous bone graft.Recently,ox...BACKGROUND Bone tissue engineering is an area of continued interest within orthopaedic surgery,as it promises to create implantable bone substitute materials that obviate the need for autologous bone graft.Recently,oxysterols–oxygenated derivatives of cholesterol-have been proposed as a novel class of osteoinductive small molecules for bone tissue engineering.Here,we present the first systematic review of the in vivo evidence describing the potential therapeutic utility of oxysterols for bone tissue engineering.AIM To systematically review the available literature examining the effect of oxysterols on in vivo bone formation.METHODS We conducted a systematic review of the literature following PRISMA guidelines.Using the PubMed/MEDLINE,Embase,and Web of Science databases,we queried all publications in the English-language literature investigating the effect of oxysterols on in vivo bone formation.Articles were screened for eligibility using PICOS criteria and assessed for potential bias using an expanded version of the SYRCLE Risk of Bias assessment tool.All full-text articles examining the effect of oxysterols on in vivo bone formation were included.Extracted data included:Animal species,surgical/defect model,description of therapeutic and control treatments,and method for assessing bone growth.Primary outcome was fusion rate for spinal fusion models and percent bone regeneration for critical-sized defect models.Data were tabulated and described by both surgical/defect model and oxysterol employed.Additionally,data from all included studies were aggregated to posit the mechanism by which oxysterols may mediate in vivo bone formation.RESULTS Our search identified 267 unique articles,of which 27 underwent full-text review.Thirteen studies(all preclinical)met our inclusion/exclusion criteria.Of the 13 included studies,5 employed spinal fusion models,2 employed critical-sized alveolar defect models,and 6 employed critical-sized calvarial defect models.Based upon SYRCLE criteria,the included studies were found to possess an overall“unclear risk of bias”;54%of studies reported treatment randomization and 38%reported blinding at any level.Overall,seven unique oxysterols were evaluated:20(S)-hydroxycholesterol,22(R)-hydroxycholesterol,22(S)-hydroxycholesterol,Oxy4/Oxy34,Oxy18,Oxy21/Oxy133,and Oxy49.All had statistically significant in vivo osteoinductive properties,with Oxy4/Oxy34,Oxy21/Oxy133,and Oxy49 showing a dose-dependent effect in some cases.In the eight studies that directly compared oxysterols to rhBMP-2-treated animals,similar rates of bone growth occurred in the two groups.Biochemical investigation of these effects suggests that they may be primarily mediated by direct activation of Smoothened in the Hedgehog signaling pathway.CONCLUSION Present preclinical evidence suggests oxysterols significantly augment in vivo bone formation.However,clinical trials are necessary to determine which have the greatest therapeutic potential for orthopaedic surgery patients.展开更多
Despite the regenerative capabilities of peripheral nerves, severe injuries or neuronal trauma of critical size impose immense hurdles for proper restoration of neuro-muscular circuitry. Autologous nerve grafts improv...Despite the regenerative capabilities of peripheral nerves, severe injuries or neuronal trauma of critical size impose immense hurdles for proper restoration of neuro-muscular circuitry. Autologous nerve grafts improve re-establishment of connectivity, but also comprise substantial donor site morbidity. We developed a rat model which allows the testing of different cell applications, i.e., mesenchymal stem cells, to improve nerve regeneration in vivo. To mimic inaccurate alignment of autologous nerve grafts with the injured nerve, a 20 mm portion of the sciatic nerve was excised, and sutured back in place in reversed direction. To validate the feasibility of our novel model, a fibrin gel conduit containing autologous undifferentiated adipose-derived stem cells was applied around the coaptation sites and compared to autologous nerve grafts. After evaluating sciatic nerve function for 16 weeks postoperatively, animals were sacrificed, and gastrocnemius muscle weight was determined along with morphological parameters（g-ratio, axon density ＆ diameter） of regenerating axons. Interestingly, the addition of undifferentiated adipose-derived stem cells resulted in a significantly improved re-myelination, axon ingrowth and functional outcome, when compared to animals without a cell seeded conduit. The presented model thus displays several intriguing features： it imitates a certain mismatch in size, distribution and orientation of axons within the nerve coaptation site. The fibrin conduit itself allows for an easy application of cells and, as a true critical-size defect model, any observed improvement relates directly to the performed intervention. Since fibrin and adipose-derived stem cells have been approved for human applications, the technique can theoretically be performed on humans. Thus, we suggest that the model is a powerful tool to investigate cell mediated assistance of peripheral nerve regeneration.展开更多
The scarcity of native periosteum poses a significant clinical barrier in the repair of critical-sized bone defects.The challenge of enhancing regenerative potential in bone healing is further compounded by oxidative ...The scarcity of native periosteum poses a significant clinical barrier in the repair of critical-sized bone defects.The challenge of enhancing regenerative potential in bone healing is further compounded by oxidative stress at the fracture site.However,the introduction of artificial periosteum has demonstrated its ability to promote bone regeneration through the provision of appropriate mechanical support and controlled release of proosteogenic factors.In this study,a poly(L-lactic acid)(PLLA)/hyaluronic acid(HA)-based nanofibrous membrane was fabricated using the coaxial electrospinning technique.The incorporation of irisin into the core-shell structure of PLLA/HA nanofibers(PLLA/HA@Irisin)achieved its sustained release.In vitro experiments demonstrated that the PLLA/HA@Irisin membranes exhibited favorable biocompatibility.The osteogenic differentiation of bone marrow mesenchymal stem cells(BMMSCs)was improved by PLLA/HA@Irisin,as evidenced by a significant increase in alkaline phosphatase activity and matrix mineralization.Mechanistically,PLLA/HA@Irisin significantly enhanced the mitochondrial function of BMMSCs via the activation of the sirtuin 3 antioxidant pathway.To assess the therapeutic effectiveness,PLLA/HA@Irisin membranes were implanted in situ into critical-sized calvarial defects in rats.The results at 4 and 8 weeks post-surgery indicated that the implantation of PLLA/HA@Irisin exhibited superior efficacy in promoting vascularized bone formation,as demonstrated by the enhancement of bone matrix synthesis and the development of new blood vessels.The results of our study indicate that the electrospun PLLA/HA@Irisin nanofibers possess characteristics of a biomimetic periosteum,showing potential for effectively treating critical-sized bone defects by improving the mitochondrial function and maintaining redox homeostasis of BMMSCs.展开更多
Magnesium phosphate bone cements(MPC)have been recognized as a viable alternative for bone defect repair due to their high mechanical strength and biodegradability.However,their poor porosity and permeability limit os...Magnesium phosphate bone cements(MPC)have been recognized as a viable alternative for bone defect repair due to their high mechanical strength and biodegradability.However,their poor porosity and permeability limit osteogenic cell ingrowth and vascularization,which is critical for bone regeneration.In the current study,we constructed a novel hierarchically-porous magnesium phosphate bone cement by incorporating extracellular matrix(ECM)-mimicking electrospun silk fibroin(SF)nanofibers.The SF-embedded MPC(SM)exhibited a heterogeneous and hierarchical structure,which effectively facilitated the rapid infiltration of oxygen and nutrients as well as cell ingrowth.Besides,the SF fibers improved the mechanical properties of MPC and neutralized the highly alkaline environment caused by excess magnesium oxide.Bone marrow stem cells(BMSCs)adhered excellently on SM,as illustrated by formation of more pseudopodia.CCK8 assay showed that SM promoted early proliferation of BMSCs.Our study also verified that SM increased the expression of OPN,RUNX2 and BMP2,suggesting enhanced osteogenic differentiation of BMSCs.We screened for osteogenesis-related pathways,including FAK signaing,Wnt signaling and Notch signaling,and found that SM aided in the process of bone regeneration by suppressing the Notch signaling pathway,proved by the downregulation of NICD1,Hes1 and Hey2.In addition,using a bone defect model of rat calvaria,the study revealed that SM exhibited enhanced osteogenesis,bone ingrowth and vascularization compared with MPC alone.No adverse effect was found after implantation of SM in vivo.Overall,our novel SM exhibited promising prospects for the treatment of critical-sized bone defects.展开更多
Bone tissue regeneration in critical-size defects is possible after implantation of a 3D scaffold and can be additionally enhanced once the scaffold is enriched with drugs or other factors supporting bone remodelling ...Bone tissue regeneration in critical-size defects is possible after implantation of a 3D scaffold and can be additionally enhanced once the scaffold is enriched with drugs or other factors supporting bone remodelling and healing.Sodium alendronate(Aln),a widely used anti-osteoporosis drug,exhibits strong inhibitory effect on bone resorption performed by osteoclasts.Thus,we propose a new approach for the treatment of bone defects in craniofacial region combining biocompatible titanium dioxide scaffolds and poly(L-lactide-co-glycolide)microparticles(MPs)loaded with Aln.The MPs were effectively attached to the surface of the scaffolds’pore walls by human recombinant collagen.Drug release from the scaffolds was characterized by initial burst(2466% of the drug released within first 24 h)followed by a sustained release phase(on average 5 mg of Aln released per day from Day 3 to Day 18).In vitro tests evidenced that Aln at concentrations of 5 and 2.5 mg/ml was not cytotoxic for MG-63 osteoblast-like cells(viability between 8166% and 9863% of control),but it prevented RANKL-induced formation of osteoclast-like cells from macrophages derived from peripheral blood mononuclear cells,as shown by reduced fusion capability and decreased tartrateresistant acid phosphatase 5b activity(5665% reduction in comparison to control after 8 days of culture).Results show that it is feasible to design the scaffolds providing required doses of Aln inhibiting osteoclastogenesis,reducing osteoclast activity,but not affecting osteoblast functions,which may be beneficial in the treatment of critical-size bone tissue defects.展开更多
Recent developments in synthetic bone grafting materials and adjuvant therapeutic agents have opened the door to the regenerative reconstruction of critical-size long bone segmental defects resulting from trauma,osteo...Recent developments in synthetic bone grafting materials and adjuvant therapeutic agents have opened the door to the regenerative reconstruction of critical-size long bone segmental defects resulting from trauma,osteoporotic fractures or tumour resections.Polymeric scaffolds with controlled macroporosities,degradability,useful surgical handling characteristics,and the ability to deliver biotherapeutics to promote new bone ingrowth have been developed for this challenging orthopaedic application.This review highlights major classes of degradable synthetic polymers and their biomineral composites,including conventional and amphiphilic polyesters,polyanhydrides,polycarbonates,and polyethylene glycol-based hydrogels,that have been explored for the regenerative reconstruction of critical-size long bone segmental defects over the past two decades.The pros and cons of these synthetic scaffold materials are presented in the context of enabling or impeding the functional(mechanical and radiographic)repair of a long bone segmental defect,with the long bone regeneration outcomes compared with healthy long bone controls or results achieved with current grafting standards.展开更多
Bone tissue regeneration in critical-size defects is possible after implantation of a 3D scaffold and can be additionally enhanced once the scaffold is enriched with drugs or other factors supporting bone remodelling ...Bone tissue regeneration in critical-size defects is possible after implantation of a 3D scaffold and can be additionally enhanced once the scaffold is enriched with drugs or other factors supporting bone remodelling and healing.Sodium alendronate(Aln),a widely used anti-osteoporosis drug,exhibits strong inhibitory effect on bone resorption performed by osteoclasts.Thus,we propose a new approach for the treatment of bone defects in craniofacial region combining biocompatible titanium dioxide scaffolds and poly(L-lactide-co-glycolide)microparticles(MPs)loaded with Aln.The MPs were effectively attached to the surface of the scaffolds’pore walls by human recombinant collagen.Drug release from the scaffolds was characterized by initial burst(2466%of the drug released within first 24 h)followed by a sustained release phase(on average 5 mg of Aln released per day from Day 3 to Day 18).In vitro tests evidenced that Aln at concentrations of 5 and 2.5 mg/ml was not cytotoxic for MG-63 osteoblast-like cells(viability between 8166%and 9863%of control),but it prevented RANKL-induced formation of osteoclast-like cells from macrophages derived from peripheral blood mononuclear cells,as shown by reduced fusion capability and decreased tartrateresistant acid phosphatase 5b activity(5665%reduction in comparison to control after 8 days of culture).Results show that it is feasible to design the scaffolds providing required doses of Aln inhibiting osteoclastogenesis,reducing osteoclast activity,but not affecting osteoblast functions,which may be beneficial in the treatment of critical-size bone tissue defects.展开更多
文摘BACKGROUND Critically sized bone defects represent a significant challenge to orthopaedic surgeons worldwide.These defects generally result from severe trauma or resection of a whole large tumour.Autologous bone grafts are the current gold standard for the reconstruction of such defects.However,due to increased patient morbidity and the need for a second operative site,other lines of treatment should be introduced.To find alternative unconventional therapies to manage such defects,bone tissue engineering using a combination of suitable bioactive factors,cells,and biocompatible scaffolds offers a promising new approach for bone regeneration.AIM To evaluate the healing capacity of platelet-rich fibrin(PRF)membranes seeded with allogeneic mesenchymal bone marrow-derived stem cells(BMSCs)on critically sized mandibular defects in a rat model.METHODS Sixty-three Sprague Dawley rats were subjected to bilateral bone defects of critical size in the mandibles created by a 5-mm diameter trephine bur.Rats were allocated to three equal groups of 21 rats each.Group I bone defects were irrigated with normal saline and designed as negative controls.Defects of group II were grafted with PRF membranes and served as positive controls,while defects of group III were grafted with PRF membranes seeded with allogeneic BMSCs.Seven rats from each group were killed at 1,2 and 4 wk.The mandibles were dissected and prepared for routine haematoxylin and eosin(HE)staining,Masson's trichrome staining and CD68 immunohistochemical staining.RESULTS Four weeks postoperatively,the percentage area of newly formed bone was significantly higher in group III(0.88±0.02)than in groups I(0.02±0.00)and II(0.60±0.02).The amount of granulation tissue formation was lower in group III(0.12±0.02)than in groups I(0.20±0.02)and II(0.40±0.02).The number of inflammatory cells was lower in group III(0.29±0.03)than in groups I(4.82±0.08)and II(3.09±0.07).CONCLUSION Bone regenerative quality of critically sized mandibular bone defects in rats was better promoted by PRF membranes seeded with BMSCs than with PRF membranes alone.
基金The authors would like to thank Li LI and H.Z.Xie for the technical support.This work was financially supported by the National Natural Science Foundation of China(Nos.82002303 and 81702171)the Guangdong Basic and Applied Basic Research Foundation(Nos.2022A1515011536,2021A1515220093,2021A1515220086,2019A1515111156,and 2022A1515011815)+7 种基金the Scientific Research Foundation of Peking University Shenzhen hospital(No.KYQD2021064)the Health and Medical Research Fund(No.19180712)the Shenzhen Double Chain Project for Innovation and Development Industry supported by the Bureau of Industry and Information Technology of Shenzhen(No.201806081018272960)the Shenzhen Science and Technology Innovation Committee Projects(Nos.JCYJ20190809182213535 and JSGG20180507183242702)the program from Shanghai Municipal Health Commission(No.201740165)the National Key R&D Program of China(No.2018YFC1105100)the Hong Kong Innovation Technology Fund(Nos.ITS/287/17 and ITS/405/18)the Hong Kong Research Grant Council General Research Fund(No.17214516).
文摘The healing of critical-sized bone defects(CSD)remains a challenge in orthopedic medicine.In recent years,scaffolds with sophisticated microstructures fabricated by the emerging three-dimensional(3D)printing technology have lighted up the treatment of the CSD due to the elaborate microenvironments and support they may build.Here,we established a magnesium oxide-reinforced 3D-printed biocompos-ite scaffold to investigate the effect of magnesium-enriched 3D microenvironment on CSD repairing.The composite was prepared using a biodegradable polymer matrix,polycaprolactone(PCL),and the disper-sion phase,magnesium oxide(MgO).With the appropriate surface treatment by saline coupling agent,the MgO dispersed homogeneously in the polymer matrix,leading to enhanced mechanical performance and steady release of magnesium ion(Mg^(2+))for superior cytocompatibility,higher cell viability,advanced osteogenic differentiation,and cell mineralization capabilities in comparison with the pure PCL.The in-vivo femoral implantation and critical-sized cranial bone defect studies demonstrated the importance of the 3D magnesium microenvironment,as a scaffold that released appropriate Mg^(2+) exhibited remarkably increased bone volume,enhanced angiogenesis,and almost recovered CSD after 8-week implantation.Overall,this study suggests that the magnesium-enriched 3D scaffold is a potential candidate for the treatment of CSD in a cell-free therapeutic approach.
基金supported by the National Key R&D Program of China[grant number 2018YFE0104200]the National Natural Science Foundation of China[grant numbers 51901003,51931001,52171233,51875310]+1 种基金the Beijing Natural Science Foundation[grant number L212014]the Open Project of NMPA Key Laboratory for Dental Materials[grant number PKUSS20200401].
文摘Additive manufacturing has received attention for the fabrication of medical implants that have customized and complicated structures.Biodegradable Zn metals are revolutionary materials for orthopedic implants.In this study,pure Zn porous scaffolds with diamond structures were fabricated using customized laser powder bed fusion(L-PBF)technology.First,the mechanical properties,corrosion behavior,and biocompatibility of the pure Zn porous scaffolds were characterized in vitro.The scaffolds were then implanted into the rabbit femur critical-size bone defect model for 24 weeks.The results showed that the pure Zn porous scaffolds had compressive strength and rigidity comparable to those of cancellous bone,as well as relatively suitable degradation rates for bone regeneration.A benign host response was observed using hematoxylin and eosin(HE)staining of the heart,liver,spleen,lungs,and kidneys.Moreover,the pure Zn porous scaffold showed good biocompatibility and osteogenic promotion ability in vivo.This study showed that pure Zn porous scaffolds with customized structures fabricated using L-PBF represent a promising biodegradable solution for treating large bone defects.
基金National Natural Science Foundation of China(Grant No.51931001)International Cooperation and Exchange project between NSFC(China)and CNR(Italy)(NSFC-CNR Grant No.52011530392).
文摘A novel biodegradable metal system,ZnLiCa ternary alloys,were systematically investigated both in vitro and in vivo.The ultimate tensile strength(UTS)of Zn0.8Li0.1Ca alloy reached 567.60±9.56 MPa,which is comparable to pure Ti,one of the most common material used in orthopedics.The elongation of Zn0.8Li0.1Ca is 27.82±18.35%,which is the highest among the ZnLiCa alloys.The in vitro degradation rate of Zn0.8Li0.1Ca alloy in simulated body fluid(SBF)showed significant acceleration than that of pure Zn.CCK-8 tests and hemocompatibility tests manifested that ZnLiCa alloys exhibit good biocompatibility.Real-time PCR showed that Zn0.8Li0.1Ca alloy successfully stimulated the expressions of osteogenesis-related genes(ALP,COL-1,OCN and Runx-2),especially the OCN.An in vivo implantation was conducted in the radius of New Zealand rabbits for 24 weeks,aiming to treat the bone defects.The Micro-CT and histological evaluations proved that the regeneration of bone defect was faster within the Zn0.8Li0.1Ca alloy scaffold than the pure Ti scaffold.Zn0.8Li0.1Ca alloy showed great potential to be applied in orthopedics,especially in the load-bearing sites.
文摘BACKGROUND Bone tissue engineering is an area of continued interest within orthopaedic surgery,as it promises to create implantable bone substitute materials that obviate the need for autologous bone graft.Recently,oxysterols–oxygenated derivatives of cholesterol-have been proposed as a novel class of osteoinductive small molecules for bone tissue engineering.Here,we present the first systematic review of the in vivo evidence describing the potential therapeutic utility of oxysterols for bone tissue engineering.AIM To systematically review the available literature examining the effect of oxysterols on in vivo bone formation.METHODS We conducted a systematic review of the literature following PRISMA guidelines.Using the PubMed/MEDLINE,Embase,and Web of Science databases,we queried all publications in the English-language literature investigating the effect of oxysterols on in vivo bone formation.Articles were screened for eligibility using PICOS criteria and assessed for potential bias using an expanded version of the SYRCLE Risk of Bias assessment tool.All full-text articles examining the effect of oxysterols on in vivo bone formation were included.Extracted data included:Animal species,surgical/defect model,description of therapeutic and control treatments,and method for assessing bone growth.Primary outcome was fusion rate for spinal fusion models and percent bone regeneration for critical-sized defect models.Data were tabulated and described by both surgical/defect model and oxysterol employed.Additionally,data from all included studies were aggregated to posit the mechanism by which oxysterols may mediate in vivo bone formation.RESULTS Our search identified 267 unique articles,of which 27 underwent full-text review.Thirteen studies(all preclinical)met our inclusion/exclusion criteria.Of the 13 included studies,5 employed spinal fusion models,2 employed critical-sized alveolar defect models,and 6 employed critical-sized calvarial defect models.Based upon SYRCLE criteria,the included studies were found to possess an overall“unclear risk of bias”;54%of studies reported treatment randomization and 38%reported blinding at any level.Overall,seven unique oxysterols were evaluated:20(S)-hydroxycholesterol,22(R)-hydroxycholesterol,22(S)-hydroxycholesterol,Oxy4/Oxy34,Oxy18,Oxy21/Oxy133,and Oxy49.All had statistically significant in vivo osteoinductive properties,with Oxy4/Oxy34,Oxy21/Oxy133,and Oxy49 showing a dose-dependent effect in some cases.In the eight studies that directly compared oxysterols to rhBMP-2-treated animals,similar rates of bone growth occurred in the two groups.Biochemical investigation of these effects suggests that they may be primarily mediated by direct activation of Smoothened in the Hedgehog signaling pathway.CONCLUSION Present preclinical evidence suggests oxysterols significantly augment in vivo bone formation.However,clinical trials are necessary to determine which have the greatest therapeutic potential for orthopaedic surgery patients.
基金financially supported by the Faculty of Medicine,LMU(to TH and MMSFöFole,Project 843 and 955)
文摘Despite the regenerative capabilities of peripheral nerves, severe injuries or neuronal trauma of critical size impose immense hurdles for proper restoration of neuro-muscular circuitry. Autologous nerve grafts improve re-establishment of connectivity, but also comprise substantial donor site morbidity. We developed a rat model which allows the testing of different cell applications, i.e., mesenchymal stem cells, to improve nerve regeneration in vivo. To mimic inaccurate alignment of autologous nerve grafts with the injured nerve, a 20 mm portion of the sciatic nerve was excised, and sutured back in place in reversed direction. To validate the feasibility of our novel model, a fibrin gel conduit containing autologous undifferentiated adipose-derived stem cells was applied around the coaptation sites and compared to autologous nerve grafts. After evaluating sciatic nerve function for 16 weeks postoperatively, animals were sacrificed, and gastrocnemius muscle weight was determined along with morphological parameters（g-ratio, axon density ＆ diameter） of regenerating axons. Interestingly, the addition of undifferentiated adipose-derived stem cells resulted in a significantly improved re-myelination, axon ingrowth and functional outcome, when compared to animals without a cell seeded conduit. The presented model thus displays several intriguing features： it imitates a certain mismatch in size, distribution and orientation of axons within the nerve coaptation site. The fibrin conduit itself allows for an easy application of cells and, as a true critical-size defect model, any observed improvement relates directly to the performed intervention. Since fibrin and adipose-derived stem cells have been approved for human applications, the technique can theoretically be performed on humans. Thus, we suggest that the model is a powerful tool to investigate cell mediated assistance of peripheral nerve regeneration.
基金supported by the Natural Science Foundation of Jiangsu Province(BK20220046)Key Laboratory of Orthopaedics of Suzhou(SZS2022017)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD).
文摘The scarcity of native periosteum poses a significant clinical barrier in the repair of critical-sized bone defects.The challenge of enhancing regenerative potential in bone healing is further compounded by oxidative stress at the fracture site.However,the introduction of artificial periosteum has demonstrated its ability to promote bone regeneration through the provision of appropriate mechanical support and controlled release of proosteogenic factors.In this study,a poly(L-lactic acid)(PLLA)/hyaluronic acid(HA)-based nanofibrous membrane was fabricated using the coaxial electrospinning technique.The incorporation of irisin into the core-shell structure of PLLA/HA nanofibers(PLLA/HA@Irisin)achieved its sustained release.In vitro experiments demonstrated that the PLLA/HA@Irisin membranes exhibited favorable biocompatibility.The osteogenic differentiation of bone marrow mesenchymal stem cells(BMMSCs)was improved by PLLA/HA@Irisin,as evidenced by a significant increase in alkaline phosphatase activity and matrix mineralization.Mechanistically,PLLA/HA@Irisin significantly enhanced the mitochondrial function of BMMSCs via the activation of the sirtuin 3 antioxidant pathway.To assess the therapeutic effectiveness,PLLA/HA@Irisin membranes were implanted in situ into critical-sized calvarial defects in rats.The results at 4 and 8 weeks post-surgery indicated that the implantation of PLLA/HA@Irisin exhibited superior efficacy in promoting vascularized bone formation,as demonstrated by the enhancement of bone matrix synthesis and the development of new blood vessels.The results of our study indicate that the electrospun PLLA/HA@Irisin nanofibers possess characteristics of a biomimetic periosteum,showing potential for effectively treating critical-sized bone defects by improving the mitochondrial function and maintaining redox homeostasis of BMMSCs.
基金support of the Provincial Key Resaearch and Development Program of Hubei,China (No.2020BCB058)Youth Science and Technology Talent Project of Hubei Province (2023DJC163).
文摘Magnesium phosphate bone cements(MPC)have been recognized as a viable alternative for bone defect repair due to their high mechanical strength and biodegradability.However,their poor porosity and permeability limit osteogenic cell ingrowth and vascularization,which is critical for bone regeneration.In the current study,we constructed a novel hierarchically-porous magnesium phosphate bone cement by incorporating extracellular matrix(ECM)-mimicking electrospun silk fibroin(SF)nanofibers.The SF-embedded MPC(SM)exhibited a heterogeneous and hierarchical structure,which effectively facilitated the rapid infiltration of oxygen and nutrients as well as cell ingrowth.Besides,the SF fibers improved the mechanical properties of MPC and neutralized the highly alkaline environment caused by excess magnesium oxide.Bone marrow stem cells(BMSCs)adhered excellently on SM,as illustrated by formation of more pseudopodia.CCK8 assay showed that SM promoted early proliferation of BMSCs.Our study also verified that SM increased the expression of OPN,RUNX2 and BMP2,suggesting enhanced osteogenic differentiation of BMSCs.We screened for osteogenesis-related pathways,including FAK signaing,Wnt signaling and Notch signaling,and found that SM aided in the process of bone regeneration by suppressing the Notch signaling pathway,proved by the downregulation of NICD1,Hes1 and Hey2.In addition,using a bone defect model of rat calvaria,the study revealed that SM exhibited enhanced osteogenesis,bone ingrowth and vascularization compared with MPC alone.No adverse effect was found after implantation of SM in vivo.Overall,our novel SM exhibited promising prospects for the treatment of critical-sized bone defects.
基金supported by National Science Centre,Poland(2013/09/N/ST8/00309)Norwegian Research Council(228415)BMBF,Germany(GoBone German-Polish bilateral project 01DS16010A).
文摘Bone tissue regeneration in critical-size defects is possible after implantation of a 3D scaffold and can be additionally enhanced once the scaffold is enriched with drugs or other factors supporting bone remodelling and healing.Sodium alendronate(Aln),a widely used anti-osteoporosis drug,exhibits strong inhibitory effect on bone resorption performed by osteoclasts.Thus,we propose a new approach for the treatment of bone defects in craniofacial region combining biocompatible titanium dioxide scaffolds and poly(L-lactide-co-glycolide)microparticles(MPs)loaded with Aln.The MPs were effectively attached to the surface of the scaffolds’pore walls by human recombinant collagen.Drug release from the scaffolds was characterized by initial burst(2466% of the drug released within first 24 h)followed by a sustained release phase(on average 5 mg of Aln released per day from Day 3 to Day 18).In vitro tests evidenced that Aln at concentrations of 5 and 2.5 mg/ml was not cytotoxic for MG-63 osteoblast-like cells(viability between 8166% and 9863% of control),but it prevented RANKL-induced formation of osteoclast-like cells from macrophages derived from peripheral blood mononuclear cells,as shown by reduced fusion capability and decreased tartrateresistant acid phosphatase 5b activity(5665% reduction in comparison to control after 8 days of culture).Results show that it is feasible to design the scaffolds providing required doses of Aln inhibiting osteoclastogenesis,reducing osteoclast activity,but not affecting osteoblast functions,which may be beneficial in the treatment of critical-size bone tissue defects.
基金This work is supported by an Alex Lemonade Stand Foundation Innovation Grant and a BRIDGE Award from the University of Massachusetts Medical School.
文摘Recent developments in synthetic bone grafting materials and adjuvant therapeutic agents have opened the door to the regenerative reconstruction of critical-size long bone segmental defects resulting from trauma,osteoporotic fractures or tumour resections.Polymeric scaffolds with controlled macroporosities,degradability,useful surgical handling characteristics,and the ability to deliver biotherapeutics to promote new bone ingrowth have been developed for this challenging orthopaedic application.This review highlights major classes of degradable synthetic polymers and their biomineral composites,including conventional and amphiphilic polyesters,polyanhydrides,polycarbonates,and polyethylene glycol-based hydrogels,that have been explored for the regenerative reconstruction of critical-size long bone segmental defects over the past two decades.The pros and cons of these synthetic scaffold materials are presented in the context of enabling or impeding the functional(mechanical and radiographic)repair of a long bone segmental defect,with the long bone regeneration outcomes compared with healthy long bone controls or results achieved with current grafting standards.
基金This work was supported by National Science Centre,Poland(2013/09/N/ST8/00309)Norwegian Research Council(228415)BMBF,Germany(GoBone German-Polish bilateral project 01DS16010A)。
文摘Bone tissue regeneration in critical-size defects is possible after implantation of a 3D scaffold and can be additionally enhanced once the scaffold is enriched with drugs or other factors supporting bone remodelling and healing.Sodium alendronate(Aln),a widely used anti-osteoporosis drug,exhibits strong inhibitory effect on bone resorption performed by osteoclasts.Thus,we propose a new approach for the treatment of bone defects in craniofacial region combining biocompatible titanium dioxide scaffolds and poly(L-lactide-co-glycolide)microparticles(MPs)loaded with Aln.The MPs were effectively attached to the surface of the scaffolds’pore walls by human recombinant collagen.Drug release from the scaffolds was characterized by initial burst(2466%of the drug released within first 24 h)followed by a sustained release phase(on average 5 mg of Aln released per day from Day 3 to Day 18).In vitro tests evidenced that Aln at concentrations of 5 and 2.5 mg/ml was not cytotoxic for MG-63 osteoblast-like cells(viability between 8166%and 9863%of control),but it prevented RANKL-induced formation of osteoclast-like cells from macrophages derived from peripheral blood mononuclear cells,as shown by reduced fusion capability and decreased tartrateresistant acid phosphatase 5b activity(5665%reduction in comparison to control after 8 days of culture).Results show that it is feasible to design the scaffolds providing required doses of Aln inhibiting osteoclastogenesis,reducing osteoclast activity,but not affecting osteoblast functions,which may be beneficial in the treatment of critical-size bone tissue defects.
