Fabrication of Porous Scaffolds for Bone Tissue Engineering Using a 3-D Robotic System: Comparison with Conventional Scaffolds Fabricated by Particulate Leaching

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Porous Silk Scaffolds for Delivery of Growth Factors and Stem Cells to Enhance Bone Regeneration

Stem cell-based tissue engineering shows promise for bone regeneration and requires artificial microenvironments to enhance the survival, proliferation and differentiation of the seeded cells. Silk fibroin, as a natural protein polymer, has unique properties for tissue regeneration. The present study aimed to evaluate the influence of porous silk scaffolds on rat bone marrow stem cells (BMSCs) by lenti-GFP tracking both in vitro and in vivo in cranial bone defects. The number of cells seeded within silk scaffolds in rat cranial bone defects increased from 2 days to 2 weeks after implantation, followed by a decrease at eight weeks. Importantly, the implanted cells survived for 8 weeks in vivo and some of the cells might differentiate into endothelial cells and osteoblasts induced by the presence of VEGF and BMP-2 in the scaffolds to promote angiogenesis and osteogenesis. The results demonstrate that porous silk scaffolds provide a suitable niche to maintain long survival and function of the implanted cells for bone regeneration.     

骨形成蛋白2/珍珠层粉/壳聚糖支架制备及生物性能研究

目的:制备骨形成蛋白2/珍珠层粉/壳聚糖复合多孔支架,观察支架生物性能。方法:采用冷冻干燥法制备骨形成蛋白2/珍珠层粉/壳聚糖多孔支架。用光学显微镜和扫描电子显微镜观察支架表面形貌及孔径大小,用比重瓶法检测支架孔隙率,热重分析探讨支架的热稳定性,用微力试验机进行压缩性能测试,并将支架与兔骨髓间充质干细胞共培养检测细胞黏附性能,将支架埋置大鼠皮下观察其炎症反应。结果与结论:制备的骨形成蛋白2/珍珠层粉/壳聚糖支架孔径大小为100~300μm,孔隙率为91.64%,压缩应力达3.37MPa,与细胞共培养贴附较好,有良好的组织相容性,提示该支架可做为组织工程支架材料应用于临床上骨组织缺损的修复。     

牙源性干细胞复合微渠多孔羟基磷灰石支架成骨性能研究*

目的: 探讨牙源性干细胞复合微渠多孔羟基磷灰石支架(grooved porous hydroxyapatite scaffolds, HAG支架)的成骨性能,为骨缺损修复治疗提供新手段。方法: 从健康成人第三磨牙中提取牙周膜干细胞(periodontal ligament stem cells, PDLSCs)及牙髓干细胞(dental pulp stem cells, DPSCs)分别接种于HAG支架上,进行多向分化鉴定及碱性磷酸酶(alkaline phosphatase,ALP)活性测定;并通过CCK-8检测细胞增殖能力;逆转录聚合酶链反应(qRT-PCR)检测骨形态发生蛋白2(bone morphogenetic protein 2, BMP-2)、骨钙素(osteocalcin, OCN)和骨桥蛋白(osteopontin, OPN)等成骨相关基因的表达。体内研究中将搭载PDLSCs和DPSCs的HAG支架移植到裸鼠的背部皮下,8周后取材,组织切片后采用苏木精-伊红(HE)染色观察新骨形成,提取组织蛋白采用Western blot检测ALP、OCN等成骨相关蛋白的表达。结果: 体外研究中DPSCs复合HAG支架组的细胞增殖能力、ALP活性,以及成骨相关基因ALP、BMP2、OCN等的表达均高于PDLSCs复合HAG支架组。体内研究中HE染色显示,PDLSCs复合HAG支架组及DPSCs复合HAG支架组均较空白HAG支架组有更多细胞生长区、纤维细胞增生及骨基质形成,且DPSCs复合HAG支架组的骨基质面积更大,成纤维细胞数量更多;PDLSCs复合HAG支架组及DPSCs复合HAG支架组成骨相关蛋白的表达量均高于空白HAG组,且DPSCs复合HAG支架组中ALP蛋白表达量显著高于PDLSCs复合HAG支架组。结论: PDLSCs、DPSCs复合HAG支架在体内外均表现出良好的成骨性能,其中DPSCs复合HAG支架的成骨性能更为优异。     

Bone Allograft in Revision Total Knee Replacement

Revision total knee replacement (TKR) is often associated with the necessity to reconstruct a certain amount of bone loss. In a retrospective study we reviewed the records of 137 patients who had undergone revision TKR in our department between 1990 and 1996, due to loosening or inflection. Bone allografts were used in 91 patients (67%) to accomplish stable, new prostheses. Three types of bone loss were identified in this group: Type I - minor, Type II – moderate, and Type III – large bone defects, located on either side of the knee joint – A, or both sides – B.The treatment results of these 91 patients, according to the type of bone loss, are presented, showing good functional outcome when utilizing bone allografts in revision TKR. However, careful preoperative planning, identification of bone loss type, and a well-equipped bone bank are mandatory to the success of the operation.     

天然聚合物多孔支架的冻干工艺研究

目的 :通过改变冷冻干燥的工艺条件 ,缩短制备聚合物多孔支架的时间。方法 :把冷冻好的聚合物溶液在溶剂的冰点以上直接真空升华干燥 ,通过对支架的孔结构和外观的考察 ,评价其作为制备多孔支架工艺的可行性。结果 :制备了壳聚糖、胶原、明胶 3种不同材料的支架 ,都具有均匀的通孔结构 ,可应用于组织工程研究。结论 :在比冰点高的温度下对冷冻的样品进行真空干燥 ,可以制得多孔支架 ,并能使制备的时间大大缩短 ,但该工艺方案有时会产生开裂和塌陷 ,影响支架的质量 ,因此还有待进一步完善。     

骨髓间充质干细胞复合支架材料的骨组织工程研究进展

近年来,组织工程技术飞速发展,将种子细胞与支架材料相复合的骨组织工程研究已成为热点,并日趋走向成熟。这一全新的治疗方案将成为解决临床上各种原因造成的骨组织缺损的最有效途径之一。骨组织工程技术包括种子细胞、支架材料和生长因子三个方面。其中,BMSCs因具有多向分化能力、强大的增殖能力以及低免疫源性被认为是最理想的种子细胞,而支架材料的种类有很多种,目前对支架材料的选择也尚有分歧。如何找到理想的支架材料是骨组织工程研究中亟待解决的重要问题。本文就组织工程中与骨髓间充质干细胞(BMSCs)相复合的各类支架材料的研究现状进行综述,这些支架材料的研究将为骨组织工程支架材料的选择提供有效依据。     

3D Printing Bioceramic Porous Scaffolds with Good Mechanical Property and Cell Affinity

Artificial bone grafting is widely used in current orthopedic surgery for bone defect problems. Unfortunately, surgeons remain unsatisfied with the current commercially available products. One of the major complaints is that these products cannot provide sufficient mechanical strength to support the human skeletal structure. In this study, we aimed to develop a bone scaffold with better mechanical property and good cell affinity by 3D printing (3DP) techniques. A self-developed 3D printer with laser-aided gelling (LAG) process was used to fabricate bioceramic scaffolds with inter-porous structures. To improve the mechanical property of the bioceramic parts after heating, CaCO₃ was added to the silica ceramic slurry. CaCO₃ was blended into a homogenous SiO₂-sol dispersion at weight ratios varying from 0/100 to 5/95 to 9/91 (w/w). Bi-component CaCO₃/SiO₂-sol was prepared as a biocomposite for the 3DP scaffold. The well-mixed biocomposite was used to fabricate the bioceramic green part using the LAG method. The varied scaffolds were sintered at different temperatures ranging from 900 to 1500°C, and the mechanical property was subsequently analyzed. The scaffolds showed good property with the composite ratio of 5:95 CaCO₃:SiO₂ at a sintering temperature of 1300°C. The compressive strength was 47 MPa, and the porosity was 34%. The topography of the sintered 3DP bioceramic scaffold was examined by SEM, EDS and XRD. The silica bioceramic presented no cytotoxicity and good MG-63 osteoblast-like cell affinity, demonstrating good biocompatibility. Therefore, the new silica biocomposite is viable for fabricating 3DP bone bioceramics with improved mechanical property and good cell affinity.     

The Drug Release Study of Ceftriaxone from Porous Hydroxyapatite Scaffolds

Hydroxyapatite (HAP) is an important biomedical material that is used for grafting osseous defects. It has an excellent bioactivity and biocompatibility properties. To isolate hydroxyapatite, pieces of cleaned cattle’s bone were heated at different temperature range from 400°C up to 1,200°C. A reasonable yield of 60.32% w/w HAP was obtained at temperature range from 1,000°C to 1,200°C. Fourier transform infrared spectra and the thermogravimetric measurement showed a clear removal of organic at 600°C as well as an excellent isolation of HAP from the bones which was achieved at 1,000–1,200°C. This was also confirmed from X-ray diffraction of bone sample heated at 1,200°C. The concentration ions were found to be sodium, potassium, lithium, zinc, copper, iron, calcium, magnesium, and phosphate present in bones within the acceptable limits for its role in the bioactivity property of HAP. Glucose powder was used as a porosifier. Glucose was novel and excellent as porogen where it was completely removed by heating, giving an efficient porosity in the used scaffolds. The results exhibited that the ceftriaxone drug release was increased with increasing the porosity. It was found that a faster, higher, and more regular drug release was obtained from the scaffold with a porosity of 10%.     

移植BMMSCs-蚕丝蛋白生物支架对急性大鼠脊髓半切损伤修复的影响

目的:以蚕丝蛋白支架(silk fibroin porous scaffolds SFPS)接种骨髓基质干细胞(bone marrow mesenchymal stem cells,BMMSCs)移植入SD大鼠脊髓半切损伤模型内,观察BMMSCs-SFPS复合生物支架对损伤脊髓的修复作用.方法:密度梯度离心法提取、贴壁法培养BMMSCs,取第三代对数生长期细胞,采用注射法制备BMMSCs-SFPS复合支架,复合14天进行生物相容性检测.40只SD大鼠复制脊髓半切损伤模型后随机分配为四组(n=10):A组BMMSCs-SFPS联合移植、B组单独移植BMMSCs、C组单独移植SFPS、D组为空白对照组,移植后分别于1、2、3、4周进行运动功能评分和术后4周进行HE染色观察、免疫荧光检测.结果:BMMSCs-SFPS复合支架体外培养14天后,扫描电镜可见BMMSCs附于SFPS支架内表面生长,细胞贴附良好并互有接触.移植入脊髓半切损伤模型后4周进行HE染色,结果显示A组脊髓空洞较其余三组小,免疫荧光检测结果示A组NF200、Nestin阳性表达高于B、C、D组,A组GFAP表达则明显低于其余三组.A组术后2～4周Basso-Beattie-Bresnahan (BBB)评分均高于同期B、C、D组,比较差异有统计学意义(P＜0.01),D组评分明显低于同期其他3组,差异有统计学意义(P＜0.05).结论:BMMSCs-SPFS具有良好生物相容性,复合支架保证BMMSCs的存活数量、能抑制胶质瘢痕.BMMSCS-SFPS复合生物支架能发挥协同作用,促进脊髓半切损伤的大鼠运动功能恢复.     

Bioresorbable Scaffolds Based on Fibroin for Bone Tissue Regeneration

Using the tissue-engineered constructs based on scaffolds that imitate the extracellular matrix of living tissues unveils new opportunities in the treatment of various pathologies and injuries associated with tissue and organ damage. Silk fibroin of silkworm Bombyx mori is a biocompatible and bioresorbable polymer with high mechanical strength and elasticity that allows creating scaffolds on its basis for regeneration of various tissues, including bone. In the present work, fibroin scaffolds were obtained. They were designed in the form of porous sponges, films, and hybrid scaffolds of a bilayer structure in which the porous sponge threedimensional structure is limited on one side by a film. The structure of the scaffolds and their biocompatibility were studied: immortalized and primary fibroblasts, as well as the osteoblast-like cells, have been shown to successfully adhere and proliferate on the surface of the studied scaffolds. Numerous osteogenesis foci have been observed in the implant region 4 weeks after the fibroin porous scaffold implantation in the in vivo experiments in a rat femoral bone defect model indicating the osteoconduction of the scaffolds.     

BMSCs与PLGA三维生物支架复合修复喉软骨缺损的研究

目的 探讨骨髓间充质干细胞（bone marrow mesenchymal stem cells,BMSCs）与聚乳酸/羟基乙酸共聚物（poly (lactide-co-glycolide),PLGA）三维生物支架在软骨源性形态发生蛋白1（cartilage-derived morphogenetic protein 1,CDMP1）和转化生长因子－β1（transforming growth factor-β1,TGF-β1）作用下向软骨细胞表型分化及体内修复喉软骨缺损的能力。方法 在体外高密度细胞悬液与PLGA共同构筑的三维立体培养体系下CDMP1和（或）TGF-β1联合诱导BMSCs向软骨细胞分化,观察诱导后细胞表型的表达;将培养体系移植入动物体内,从大体、组织学方面观察其对喉软骨缺损的修复效果。结果 诱导后的培养体系可表达特异性软骨基质Ⅱ型胶原和GAG;将培养体系移植入动物体内,可有效的修复喉软骨缺损。结论 BMSCs与PLGA三维生物支架在CDMP1和TGF-β1作用下所得组织工程化软骨可以有效的修复喉软骨缺损。     

Potential of Magnetic Nanofiber Scaffolds with Mechanical and Biological Properties Applicable for Bone Regeneration

Magnetic nanofibrous scaffolds of poly(caprolactone) (PCL) incorporating magnetic nanoparticles (MNP) were produced, and their effects on physico-chemical, mechanical and biological properties were extensively addressed to find efficacy for bone regeneration purpose. MNPs 12 nm in diameter were citrated and evenly distributed in PCL solutions up to 20% and then were electrospun into nonwoven nanofibrous webs. Incorporation of MNPs greatly improved the hydrophilicity of the nanofibers. Tensile mechanical properties of the nanofibers (tensile strength, yield strength, elastic modulus and elongation) were significantly enhanced with the addition of MNPs up to 15%. In particular, the tensile strength increase was as high as ∼25 MPa at 15% MNPs vs. ∼10 MPa in pure PCL. PCL-MNP nanofibers exhibited magnetic behaviors, with a high saturation point and hysteresis loop area, which increased gradually with MNP content. The incorporation of MNPs substantially increased the degradation of the nanofibers, with a weight loss of ∼20% in pure PCL, ∼45% in 10% MNPs and ∼60% in 20% MNPs. Apatite forming ability of the nanofibers tested in vitro in simulated body fluid confirmed the substantial improvement gained by the addition of MNPs. Osteoblastic cells favored the MNPs-incorporated nanofibers with significantly improved initial cell adhesion and subsequent penetration through the nanofibers, compared to pure PCL. Alkaline phosphatase activity and expression of genes associated with bone (collagen I, osteopontin and bone sialoprotein) were significantly up-regulated in cells cultured on PCL-MNP nanofibers than those on pure PCL. PCL-MNP nanofibers subcutaneously implanted in rats exhibited minimal adverse tissue reactions, while inducing substantial neoblood vessel formation, which however, greatly limited in pure PCL. In vivo study in radial segmental defects also signified the bone regeneration ability of the PCL-MNP nanofibrous scaffolds. The magnetic, bone-bioactive, mechanical, cellular and tissue attributes of MNP-incorporated PCL nanofibers make them promising candidate scaffolds for bone regeneration.     

同种异体半关节移植治疗下肢关节端骨肿瘤

目的:探讨分析同种异体半关节移植治疗下肢关节端骨肿瘤的疗效.方法:对23例下肢累及关节端骨肿瘤,术前根据X线、CT或MRI测量肿瘤的长短和范围,选取匹配的异体半关节及固定材料,行关节端骨肿瘤切除及同种异体半关节移植修复骨缺损术,术后X线评定骨愈合,并评估其功能恢复情况.结果:手术后6～9个月在X线片显示移植骨与正常骨组织结合部间隙消失,或间隙模糊且有足够骨痂形成,可放弃支具独立行走;术后约10～12月取出内固定材料,约14月后功能活动逐渐恢复正常.结论:同种异体半关节移植治疗下肢关节端骨肿瘤切除后骨缺损是一种切实可行的有效方法.     

The Procurement Team as a Factor of Bone Allograft Contamination

We studied the effect of the procurement team on the risk of contamination in 270 large bone allografts retrieved from 53 non-living donors under strictly aseptic conditions.The overall contamination rate was 8.1%. When the procurement team was constituted by three or less members the contamination rate was 5.6%, while if there were four or more members the rate was 12.9%; this difference was significant in the statistical analysis.We conclude that a procurement team constituted by three or less trained members is a determinant factor in decreasing the bacterial contamination rate of bone allografts.     

雪旺氏细胞与同种异体骨支架的体外共培养研究

目的:探讨雪旺细胞(Schwann’s cells,SCs)在同种异体骨支架上的生物相容性,体外构建组织工程骨神经化模型。方法:利用新鲜人体骨骼制备同种异体骨支架材料,检测其物理性能;采用优化方法提取新生SD大鼠坐骨、臂丛神经培养SCs,实验分为三维培养实验组(SCs+同种异体骨)、二维培养对照组(SCs+胶原玻片),S-100抗体免疫荧光染色鉴定SCs纯度;细胞计数法检测两组细胞增殖特点;细胞接种后第3、7天取样,扫描电镜观察。结果:同种异体骨支架具有良好的三维孔隙结构,适宜细胞贴附生长;S-100免疫荧光染色证实SCs纯度95%;扫描电镜检测显示两组SCs均可正常粘附增殖,细胞间排布规律相似,培养早期实验组SCs胞体更加细长,伪足更加明显,随着培养时间的延长表现出较强的迁移能力;细胞增殖检测:两组SCs生长曲线特征基本一致,支架材料对SCs无毒性作用。结论:同种异体骨支架SCs具有良好的生物相容性,其三维立体多孔结构有利于SCs的粘附与迁移,初步构建了体外组织工程骨神经化模型。     

BSA Adsorption on Porous Scaffolds Prepared from BioPEGylated Poly(3-Hydroxybutyrate)

Porous scaffolds for tissue engineering have been prepared from poly(3-hydroxybutyrate) (PHB) and a copolymer of poly(3-hydroxybutyrate) and polyethylene glycol (PHB-PEG) produced by bioPEGylation. The morphology of the scaffolds and their capacity for adsorption of the model protein bovine serum albumin (BSA) have been studied. Scaffolds produced from bioPEGylated PHB adsorbed more BSA, whereas the share of protein irreversibly adsorbed on these scaffolds was significantly lower (33%) than in the case of PHB homopolymer-based scaffolds (47%). The effect of protein adsorption on scaffold biocompatibility in vitro was tested in an experiment that involved the cultivation of fibroblasts (line COS-1) on the scaffolds. PHB-PEG scaffolds had a higher capacity for supporting cell growth than PHB-based scaffolds. Thus, the bioPEGylated PHB-based polymer scaffolds developed in the present study have considerable potential for use in soft tissue engineering.     

Geometry Design Optimization of Functionally Graded Scaffolds for Bone Tissue Engineering: A Mechanobiological Approach

Functionally Graded Scaffolds (FGSs) are porous biomaterials where porosity changes in space with a specific gradient. In spite of their wide use in bone tissue engineering, possible models that relate the scaffold gradient to the mechanical and biological requirements for the regeneration of the bony tissue are currently missing. In this study we attempt to bridge the gap by developing a mechanobiology-based optimization algorithm aimed to determine the optimal graded porosity distribution in FGSs. The algorithm combines the parametric finite element model of a FGS, a computational mechano-regulation model and a numerical optimization routine. For assigned boundary and loading conditions, the algorithm builds iteratively different scaffold geometry configurations with different porosity distributions until the best microstructure geometry is reached, i.e. the geometry that allows the amount of bone formation to be maximized. We tested different porosity distribution laws, loading conditions and scaffold Young’s modulus values. For each combination of these variables, the explicit equation of the porosity distribution law–i.e the law that describes the pore dimensions in function of the spatial coordinates–was determined that allows the highest amounts of bone to be generated. The results show that the loading conditions affect significantly the optimal porosity distribution. For a pure compression loading, it was found that the pore dimensions are almost constant throughout the entire scaffold and using a FGS allows the formation of amounts of bone slightly larger than those obtainable with a homogeneous porosity scaffold. For a pure shear loading, instead, FGSs allow to significantly increase the bone formation compared to a homogeneous porosity scaffolds. Although experimental data is still necessary to properly relate the mechanical/biological environment to the scaffold microstructure, this model represents an important step towards optimizing geometry of functionally graded scaffolds based on mechanobiological criteria.     

A Mechanobiology-based Algorithm to Optimize the Microstructure Geometry of Bone Tissue Scaffolds

Complexity of scaffold geometries and biological mechanisms involved in the bone generation process make the design of scaffolds a quite challenging task. The most common approaches utilized in bone tissue engineering require costly protocols and time-consuming experiments. In this study we present an algorithm that, combining parametric finite element models of scaffolds with numerical optimization methods and a computational mechano-regulation model, is able to predict the optimal scaffold microstructure. The scaffold geometrical parameters are perturbed until the best geometry that allows the largest amounts of bone to be generated, is reached. We study the effects of the following factors: (1) the shape of the pores; (2) their spatial distribution; (3) the number of pores per unit area. The optimal dimensions of the pores have been determined for different values of scaffold Young''s modulus and compression loading acting on the scaffold upper surface.Pores with rectangular section were predicted to lead to the formation of larger amounts of bone compared to square section pores; similarly, elliptic pores were predicted to allow the generation of greater amounts of bone compared to circular pores. The number of pores per unit area appears to have rather negligible effects on the bone regeneration process. Finally, the algorithm predicts that for increasing loads, increasing values of the scaffold Young''s modulus are preferable.The results shown in the article represent a proof-of-principle demonstration of the possibility to optimize the scaffold microstructure geometry based on mechanobiological criteria.