骨组织工程支架材料研究进展*

骨在组织工程中得到了非常广泛、深入的研究.支架材料与许多可降解材料一起也在进行探索性研究.用于骨组织工程的生物材料可以是三维多孔的刚硬材料,也可以是可注射材料.本文从聚合物角度综述了骨组织工程对支架材料的基本要求,用于骨组织工程的可降解生物材料、支架材料的设计和制备技术以及支架材料的表面修饰等方面的研究进展.     

Enhanced Bone Defect Repair by Polymeric Substitute Fillers of MultiArm Polyethylene Glycol‐Crosslinked Hyaluronic Acid Hydrogels

Bone regeneration is still one of the greatest challenges for the treatment of bone defects since no current clinical approach has been proven effective. To develop an alternative biodegradable bone graft material, multiarm polyethylene glycol (PEG) crosslinked hyaluronic acid (HA) hydrogels are synthesized and applied to promote osteogenesis of mesenchymal stem cells (MSCs) with the ultimate goal for bone defect repair. The multiarm PEG‐HA hydrogels provide a significant improvement of alkaline phosphatase (ALP) activity and calcium mineralization of the in vitro encapsulated MSCs under osteogenic condition after 3, 7, and 28 days. In addition, the multiarm PEG‐HA hydrogels also facilitate healing of the cranial bone defects more effectively in a Sprague Dawley rat model after 10 weeks of implantation based on histological evaluations and microcomputed tomography analysis. These promising results set the stage for the development of innovative biodegradable hydrogels to provide a more effective and versatile treatment option for bone regeneration.     

可降解自固化类骨磷灰石支架的研究

0引言一直以来,钙磷生物材料如羟基磷灰石(hy-droxyapatite,HA)由于其成份与骨的无机成份相似,具有良好的生物相容性,作为骨修复材料引起了人们广泛的兴趣。磷酸钙骨水泥是一类可在生理条件下自固化的非陶瓷型类HA人工骨材料,这种由磷酸钙骨水泥(calcium phosphate cement,CPC)转变而成的HA,与天然骨磷灰石有类似的组成结构,植入人体后可参与新陈代谢,促进骨组织生长[1,2]。一些研究显示,CPC具有成骨活性和生物降解性,在体内被吸收的同时可引导新骨的生成,从而可克服自体骨、磷酸三钙陶瓷因吸收降解过快造成的局部缺陷以及陶瓷型HA长…     

Decellularized Periosteum‐Covered Chitosan Globule Composite for Bone Regeneration in Rabbit Femur Condyle Bone Defects

Critical‐sized bone defects are incapable of self‐healing and are commonly seen in clinical practice. The authors explore a new treatment for this, decellularized periosteum is applied to chitosan globules (chitosan‐DP globules) as a hybrid material. The efficacy of chitosan‐DP globules on rabbit femoral condyle bone defects is assessed with biocompatibility, biomechanics, and osteogenic efficiency measurements, and compared with the results of chitosan globules and empty control. No difference in cytotoxicity is observed among chitosan‐DP globules, chitosan globules, and the empty control. Chitosan‐DP globules possesse a better surface for cell adhesion than did chitosan globules. Chitosan‐DP globules demonstrate superior efficiency for osteogenesis in the defect area compared to chitosan globules as per microcomputed tomography examination and push‐out testing, with relatively minor histological differences. Both chitosan globule groups show more satisfactory results than those for the empty control. The results implicate chitosan‐DP globules as a promising solution for bone defects.     

A biostimulation-based accelerated method for evaluating the biodegradability of polymers

The high cost and long duration of the existing standard tests, such as ASTM D5338 and ISO 14855, represents an important drawback in evaluating the biodegradability of polymers. This works presents a new accelerated method for this purpose, based on the use of a Bartha respirometer and biostimulation with yeast extract. The new method was applied to microcrystalline cellulose (MCC), low density polyethylene (LDPE), poly(3-hidroxybutyrate) (PHB), poly(lactic acid) (PLA), poly(vinyl alcohol) (PVOH), polypropylene (PP) and poly(ethylene terephthalate) (PET). The results obtained with these polymers were consistent with those of the standard methods in terms of differentiating biodegradable and non-biodegradable polymers and relative order of biodegradation extent. Besides, a significant reduction of test duration was achieved (from 45 to 110 days with ASTM D5338 or ISO 14855 to 28 days). These results corroborate the potential of the proposed method as a fast test for assessment of biodegradation of polymeric materials.     

Clinical Application of Resorbable Polymers in Guided Bone Regeneration

Summary : Guided bone regeneration was shown to be successful in vitro and in vivo using resorbable or nonresorbable materials. Resorbable material has the advantage of progressive substitution by bone. Resorbable polymers of ∝-hydroxy acids like polylactide or polyglycolide are commonly used for tissue engineering and in guided bone regeneration. In clinical studies, guided bone regeneration was successful in non-weight bearing bone, e.g. in dental surgery and craniofacial surgery. This paper reports the preliminary result of using resorbable poly(L/DL-lactide) 80/20% scaffolds in weight bearing bone with infected large segmental defects as well as in small bony defects of hand due to benign tumour, bone graft donor sites and as an adjunct for joint fusion. Resorbable polylactide implants were used in the form of membranes, large 3-D sponges, chips or as injectable paste. Implants were impregnated with marrow blood to add an osteoinductive component. Long-term follow up revealed that these implants are promising candidates for bone graft substitutes.     

Recent Advances in Nanomedicine for the Diagnosis and Treatment of Prostate Cancer Bone Metastasis

Patients with advanced prostate cancer can develop painful and debilitating bone metastases. Currently available interventions for prostate cancer bone metastases, including chemotherapy, bisphosphonates, and radiopharmaceuticals, are only palliative. They can relieve pain, reduce complications (e.g., bone fractures), and improve quality of life, but they do not significantly improve survival times. Therefore, additional strategies to enhance the diagnosis and treatment of prostate cancer bone metastases are needed. Nanotechnology is a versatile platform that has been used to increase the specificity and therapeutic efficacy of various treatments for prostate cancer bone metastases. In this review, we summarize preclinical research that utilizes nanotechnology to develop novel diagnostic imaging tools, translational models, and therapies to combat prostate cancer bone metastases.     

Bone Tissue Disorders: Healing Through Coordination Chemistry

Osteoporosis, Paget's disease and osteosarcoma are a few examples of bone tissue disorders that affect millions of people worldwide. These conditions can strictly limit the lifestyle of patients and may even lead to their demise. To prevent this or, at least, try to manage the situation, there are several treatments available on the market. Notwithstanding, research has been driven by the possibility to improve the existing therapies, as well as to find new approaches that could better respond to these diseases. In this Review the path is shown through which, in recent years, coordination compounds have been prepared and manufactured to be applied in the management of bone tissue disorders. Starting with the design and preparation of the coordination compounds with various dimensionalities, two approaches have been used: (1) they are prepared as three-dimensional cages that can act as delivery systems for therapeutic substances, or (2) they are constructed/prepared from compounds with intrinsic therapeutic properties. Following this, several strategies have been explored to manufacture the effective delivery to the patients. The versatility of coordination compounds has allowed their use in the preparation of drug tablets, coatings for titanium implants, or even scaffolds for bone tissue engineering. In the end, it becomes clear that these compounds can be a valuable approach to reach a better treatment for bone tissue disorders. Nonetheless, along the road, a few bumps have appeared concerning the therapeutic profile, such as the effect of the structural arrangement or particle size.     

The Use of Bone Substitutes in the Treatment of Bone Defects – the Clinical View and History

Summary: Bone has the ability to regenerate and remodel itself. In the clinic circumstances appear when bone defects do not heal spontaneously. These situations frequently result from trauma, congenital abnormities, infection or tumor resection. Hence, filling of the resulting defect by bone transplantation is a common practise with an increasing value in the re-establishment of the musculoskeletal system to promote bone healing. Since decades, efforts have been put to improve the effectiveness of bone substitutes. Conventional approaches with the use of ivory, animal and also human bone were not satisfactory. Negative effects like allergic reactions, rejection reactions, inflammations and other problems occurred. These led to implant failure, non union and amputation, to only mention a few. The introduction of bone banks and the development of standards in bone transplantation brought up the false hope to find a final solution for the treatment of bone loss. Disease transmissions (HIV) by allografts caused critical discussions. Despite all efforts, transplantation of autogenous cancellous bone is still the “gold standard” to induce bone healing. However, autografts are only limited available and are accompanied with high morbidity and mortality during the harvest. The problems associated with autologous and allogenous bone grafts promoted the development of multiple organic and inorganic bone substitutes. Well established substitutes at the present are demineralised bone matrix (DBM), composites and calcium phosphates (hydroxyl apatite and tri-calcium phosphate). These osteoconductive substances have shown to improve new bone formation. Nevertheless, clinical application of these materials is merely successful in a good bony environment but does not induce large progress in critical bone defects.     

Resveratrol in management of bone and spinal cancers

Bone cancer is a malignant primary tumour of the bone with different typing, such as, osteosarcoma, chondrosarcoma, Ewing’s sarcoma and fibrosarcoma. Despite the clinical efficacy of conventional therapies of bone cancer, most patients eventually relapse and the disease remains incurable. Therefore, new therapeutic strategies are needed to improve patient outcome. In this review article, we have discussed the role of resveratrol in preventing bone and spinal cancers and therapeutics. Resveratrol (3,5,4′-trihydroxy-trans-stilbene) is a natural polyphenol, which has been widely reported as an anticancer molecule. Resveratrol exhibits multiple tumour-suppressing activities in bone cancer by affecting a series of critical events. It has the protective effects against oxidative injury, possesses antiproliferative activity and induces apoptosis in cancer cells. Resveratrol might be a good option for the treatment of different types of bone and spinal cancers.     

Biological Activity of an Injectable Biphasic Calcium Phosphate/PMMA Bone Cement for Induced Osteogensis in Rabbit Model

Polymethylmethacrylate (PMMA) bone cement is widely used in repair of vertebral fracture because of its good biomechanical properties and fast curing. However, the bioinertness of PMMA cement may cause interfacial loosening, fatigue, fracture, and ultimate failure. In this study, biphasic calcium phosphate (BCP) is introduced into PMMA cement to prepare an injectable composite bone cement (BCP_x/PMMA) and the content of BCP is optimized to achieve appropriate rate of absorption that matches the bone regeneration. The compressive strength of BCP_x/PMMA bone cement is found to comply with the International Standardization Organization standard 5833, and can promote biomineralization as well as adhesion, proliferation, and osteogenic differentiation of Sprague‐Dawley rat bone marrow mesenchymal stem cells in vitro. Furthermore, in vivo test performed on a rabbit radius defect model demonstrates that the presence of BCP can significantly improve the osteogenic efficacy of PMMA cement. Therefore, it is anticipated that BCP_x/PMMA bone cement, as a promising injectable biomaterial, is of great potential in bone tissue regeneration.     

Hydrogels as Scaffolds in Bone-Related Tissue Engineering and Regeneration

Several years have passed since the medical and scientific communities leaned toward tissue engineering as the most promising field to aid bone diseases and defects resulting from degenerative conditions or trauma. Owing to their histocompatibility and non-immunogenicity, bone grafts, precisely autografts, have long been the gold standard in bone tissue therapies. However, due to issues associated with grafting, especially the surgical risks and soaring prices of the procedures, alternatives are being extensively sought and researched. Fibrous and non-fibrous materials, synthetic substitutes, or cell-based products are just a few examples of research directions explored as potential solutions. A very promising subgroup of these replacements involves hydrogels. Biomaterials resembling the bone extracellular matrix and therefore acting as 3D scaffolds, providing the appropriate mechanical support and basis for cell growth and tissue regeneration. Additional possibility of using various stimuli in the form of growth factors, cells, etc., within the hydrogel structure, extends their use as bioactive agent delivery platforms and acts in favor of their further directed development. The aim of this review is to bring the reader closer to the fascinating subject of hydrogel scaffolds and present the potential of these materials, applied in bone and cartilage tissue engineering and regeneration.     

Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments

After tooth loss, bone resorption is irreversible, leaving the area without adequate bone volume for successful implant treatment. Bone grafting is the only solution to reverse dental bone loss and is a well-accepted procedure required in one in every four dental implants. Research and development in materials, design and fabrication technologies have expanded over the years to achieve successful and long-lasting dental implants for tooth substitution. This review will critically present the various dental bone graft and substitute materials that have been used to achieve a successful dental implant. The article also reviews the properties of dental bone grafts and various dental bone substitutes that have been studied or are currently available commercially. The various classifications of bone grafts and substitutes, including natural and synthetic materials, are critically presented, and available commercial products in each category are discussed. Different bone substitute materials, including metals, ceramics, polymers, or their combinations, and their chemical, physical, and biocompatibility properties are explored. Limitations of the available materials are presented, and areas which require further research and development are highlighted. Tissue engineering hybrid constructions with enhanced bone regeneration ability, such as cell-based or growth factor-based bone substitutes, are discussed as an emerging area of development.     

The Role of Epigenetic Functionalization of Implants and Biomaterials in Osseointegration and Bone Regeneration—A Review

The contribution of epigenetic mechanisms as a potential treatment model has been observed in cancer and autoimmune/inflammatory diseases. This review aims to put forward the epigenetic mechanisms as a promising strategy in implant surface functionalization and modification of biomaterials, to promote better osseointegration and bone regeneration, and could be applicable for alveolar bone regeneration and osseointegration in the future. Materials and Methods: Electronic and manual searches of the literature in PubMed, MEDLINE, and EMBASE were conducted, using a specific search strategy limited to publications in the last 5 years to identify preclinical studies in order to address the following focused questions: (i) Which, if any, are the epigenetic mechanisms used to functionalize implant surfaces to achieve better osseointegration? (ii) Which, if any, are the epigenetic mechanisms used to functionalize biomaterials to achieve better bone regeneration? Results: Findings from several studies have emphasized the role of miRNAs in functionalizing implants surfaces and biomaterials to promote osseointegration and bone regeneration, respectively. However, there are scarce data on the role of DNA methylation and histone modifications for these specific applications, despite being commonly applied in cancer research. Conclusions: Studies over the past few years have demonstrated that biomaterials are immunomodulatory rather than inert materials. In this context, epigenetics can act as next generation of advanced treatment tools for future regenerative techniques. Yet, there is a need to evaluate the efficacy/cost effectiveness of these techniques in comparison to current standards of care.     

Advances in coatings on Mg alloys and their anti-microbial activity for implant applications

Magnesium matrix composites reinforced by calcium phosphate could not show the desired effect on the magnesium breakdown rate. Rapid disintegration rate limited the magnesium alloys used as biodegradable implant material. The rate of degradation can be minimized and biological activity can be improved in the magnesium alloy by Hydroxyapatite (HA) coating with the improvement of bone induction and conduction abilities. Various alkali post-treatment and conversion coating methods are applied to deposit HA coatings and biocompatible dicalcium phosphate dihydrate (DCPD) on magnesium alloy so that corrosion resistance and surface biocompatibility can be improved to be used in bone tissue engineering applications. Magnesium's corrosion resistance will weaken its antibacterial properties, which are linked to and proportional to the alkaline pH at the time of breakdown. The goal of this study is to bring together and compare contemporary research on different coatings on magnesium and related alloys in relation to antibacterial functionalized activities. A though review has been performed on in vivo and in vitro cytocompatibility, material property, corrosion resistance, and antibacterial properties of the coatings. Increased degradation behavior, biocompatibility, and bioactivity have been achieved following multiple procedures such as alkali treatment with HA electrochemical deposition on magnesium alloy. Multifunctional coatings can make safe and bioactive magnesium alloy surfaces for biodegradable implant applications.     

Applications of Vibrational Spectroscopy for Analysis of Connective Tissues

Advances in vibrational spectroscopy have propelled new insights into the molecular composition and structure of biological tissues. In this review, we discuss common modalities and techniques of vibrational spectroscopy, and present key examples to illustrate how they have been applied to enrich the assessment of connective tissues. In particular, we focus on applications of Fourier transform infrared (FTIR), near infrared (NIR) and Raman spectroscopy to assess cartilage and bone properties. We present strengths and limitations of each approach and discuss how the combination of spectrometers with microscopes (hyperspectral imaging) and fiber optic probes have greatly advanced their biomedical applications. We show how these modalities may be used to evaluate virtually any type of sample (ex vivo, in situ or in vivo) and how “spectral fingerprints” can be interpreted to quantify outcomes related to tissue composition and quality. We highlight the unparalleled advantage of vibrational spectroscopy as a label-free and often nondestructive approach to assess properties of the extracellular matrix (ECM) associated with normal, developing, aging, pathological and treated tissues. We believe this review will assist readers not only in better understanding applications of FTIR, NIR and Raman spectroscopy, but also in implementing these approaches for their own research projects.     

Development of Bioactive Sol-Gel Material Template for In Vitro and In Vivo Synthesis of Bone Material

A novel porous material produced via sol gel process is disclosed which is osteoinductive and biodegradable. Due to the fact that high temperatures are avoided during the production process, the degree of crystallinity is very low and the packing of the crystallites is relatively loose. These are important parameters for the biodegradation properties.Nanoporous silica gel is contained to the support of strength. The low degree of crystallinity and the high degree of porosity (50–70%, pores in the range of few microns) make the material resorbable. A second type of pores designed in the range of few millimetres supports the bone ingrowth.An in vitro formation of bone tissue is shown when the material is exposed to tissue culture medium and inoculated with human osteoblastic cells. Animal tests show the formation of new bone tissue and first steps of biodegradation.     

Exosome-Hydrogel System in Bone Tissue Engineering: A Promising Therapeutic Strategy

Exosomes, as messengers of cell-to-cell communication, have many functional properties similar to those of their derived cells. Because they contain a large number of bioactive components that regulate recipient cell behavior, they are inanimate and do not require external maintenance or assistance. Various cell-derived exosomes are involved in many physiological processes of bone tissue repair. Hydrogels are widely used as scaffolding materials for bone tissue repair because their 3D network structure resembles the natural extracellular matrix. Moreover, their material properties and biological functions are adjustable. Exosomes can be delivered directly to the bone tissue damage site by hydrogel, and their duration of action in vivo can be prolonged by slow release. Therefore, the exosome-loaded hydrogel (Exo-Gel) system is a promising material for bone tissue engineering. In this study, the progress of the application of Exo-Gel in bone tissue repair and the improvement strategies, problems and research prospects of the current exosomes and hydrogels that have been applied to the Exo-Gel system for bone tissue repair are reviewed.     

Cycloolefin-Copolymer/Polyethylene (COC/PE) Blend Assists with the Creation of New Articular Cartilage

It is shown that the initial biomechanical stability of the applied COC/PE blend in the treated tissue locality, the initial integrity of biomaterials substituting the subchondral bone by polymer implant, the initial bearing capacity and the vertical position of these biomaterials have a mayor influence on the regeneration of new articular cartilage and subchondral bone. These aspects are essential for a prosperous treatment of osteochondral defects. Results reveal that the initial biomechanical stiffness of materials (substituting the subchondral bone) has a fundamental influence on both the quality and the quantity of new articular cartilage and subchondral bone. Research is also aimed at the application of suitable biologically tolerated polymer material, its surface modifications, verifications of the vertical position of implants in relation to the articular cartilage surface and ensuring the initial biomechanical stability of the polymer implant.     

Investigation of Sustained BMP Delivery in the Prevention of Medication‐Related Osteonecrosis of the Jaw (MRONJ) in a Rat Model

Medication‐related osteonecrosis of the jaw (MRONJ) poses an ongoing challenge for clinicians and researchers. Currently, there is a lack of preventative measures available for at‐risk patients undergoing tooth extractions, especially those with prior bisphosphonate treatment due to osteoporosis or bone metastasis diagnoses. Here, these issues are addressed using a preventative tissue engineering strategy against MRONJ development. This study evaluates the efficacy of a poly(ethylene glycol)‐heparin hydrogel as a tool for the delivery of arginylglycylaspartic acid (RGD) and recombinant human bone morphogenic protein‐2 (rhBMP‐2). Three groups of skeletally mature rats each receive two doses of intravenous zoledronic acid prior to surgery and undergo extraction of the right first mandibular molar with gingival closure. Experimental groups either have the sockets left empty, filled with hydrogel minus rhBMP‐2, or filled with hydrogel plus rhBMP‐2. Eight weeks postoperatively specimens are analyzed using radiological, histological, and scanning electron microscopy (SEM) techniques. µCT analysis shows increased bone formation with hydrogel/rhBMP‐2 delivery compared to the empty socket. Hydrogel‐treated groups display increased presence of osteocytes and increased osteoclastic action compared to the empty sockets. These results represent the first step toward improved delivery of rhBMP‐2 and a potential MRONJ preventative for patients undergoing bisphosphonate treatment.