Regeneration of anterior cruciate ligament by biodegradable scaffold combined with local controlled release of basic fibroblast growth factor and collagen wrapping

The objective of this study was to increase the therapeutic efficacy of anterior cruciate ligament (ACL) surgery using an artificial ligament material developed through a combination of tissue engineering technologies. A poly-L-lactic acid (PLLA) scaffold of plain-woven braid was incorporated with a gelatin hydrogel for controlled release of basic fibroblast growth factor (bFGF) and wrapped with a collagen membrane to allow space for ligament regeneration. For the ACL reconstruction surgery, the PLLA braid scaffold combined with the gelatin hydrogel incorporating bFGF and the collagen wrapping was applied to a tunnel prepared in the femur and tibia of rabbits. The hydrogel was placed in the bone, whereas the portion of the braid inside the joint cavity was wrapped with the membrane. As controls, the PLLA scaffold was applied with the hydrogel or the membrane, or without either material. Bone regeneration in the tunnel and ACL tissue regeneration in the joint cavity were histologically evaluated, and the mechanical strength and collagen content of the regenerated ACL were assessed. When the PLLA scaffold was integrated with both the hydrogel and the membrane, bone and ACL tissues were regenerated in the corresponding sites, in marked contrast to the control groups. Combination of bFGF-controlled release resulted in enhanced mechanical strength of the regenerated ACL tissue. In the joint cavity, it is possible that the local bFGF release inside the membrane enhanced the cell migration and collagen production, and that the surrounding PLLA scaffold results in the biological regeneration of ligament-like tissue. Additionally, significant bone regeneration around the scaffold was observed in the bone tunnel. It is therefore possible that the local controlled release of bFGF near the PLLA braid induced both osseointegration and intrascaffold cell migration in the bone tunnel and joint cavity, respectively, resulting in an overall increase in the mechanical strength of the regenerated ACL.     

纳米羟基磷灰石/聚磷酸钙纤维/聚乳酸骨组织工程复合支架的特性*

背景：近年来国内外在骨与软骨组织支架复合材料方面进行了广泛的研究,取得了积极的成果,但仍存在许多问题。 目的：观察纳米羟基磷灰石/聚磷酸钙纤维/聚乳酸(HAP/CPP/PLLA)骨组织工程支架复合材料的特性。 方法：采用溶媒浇铸、粒子滤取技术与气体发泡相结合的方法制备出纳米HAP/CPP/PLLA骨组织工程支架复合材料,测试该支架复合材料的物理力学性能,并用扫描电子显微镜对其微观结构进行观察。 结果与结论：结果表明,纳米HAP/CPP/PLLA支架复合材料具有三维、连通、微孔网状结构,并具有较高的孔隙率和较好的压缩模量,是理想的骨组织工程支架材料。     

A multiscale modeling approach to scaffold design and property prediction

The optimum scaffold architecture for bone tissue regeneration is a porous structure with a narrow range of pore sizes, pore density, and a high degree of interconnectivity among pores. To achieve such a design, the microstructure of the scaffold material must be optimized in order to satisfy both biological and mechanical function requirements. In this paper, we present a multiscale modeling approach for designing a scaffold with an optimized porosity and mechanical properties made from a two-phase composite of spherical hydroxyapatite (HAp) particles embedded in a collagen matrix. In particular, first-principles computation is used to calculate the elastic properties and theoretical strengths of nanoscaled HAp particles. The constitutive properties of the HAp/collagen composites are subsequently computed as a function of HAp content via FEM-based micromechanical modeling. The constitutive relations of the composite are then utilized to optimize the mechanical properties of a three-dimensional scaffold for either cortical or cancellous bone by varying the pore size, pore density and volume fractions of HAp in the composite. For the pore size, pore density, volume fractions of HAp considered, the scaffold can be designed to match the mechanical properties of cancellous bone, but not those of cortical bone. The optimized scaffold is one with a pore diameter of 1000 μm, a channel diameter of 100 μm, 27% pore density and at least 20% HAp by volume.     

Characterization and cytocompatibility of biphasic calcium phosphate/polyamide 6 scaffolds for bone regeneration

Porous scaffolds of biphasic calcium phosphate (BCP)/polyamide 6 (PA6) with weight ratios of 30/70, 45/55, and 55/45 have been fabricated through a modified thermally induced phase separation technique. The chemical structure properties, macrostructure, and mechanical strength of the scaffolds were characterized by Fourier transform infrared spectroscopy, X-ray diffraction, thermogravimetric analysis, scanning electron microscopy, and mechanical testing. The results indicated that the BCP/PA6 scaffolds had an interconnected porous structure with a pore size mainly ranging from 100 to 900 μm and many micropores on the rough pore walls. The mechanical property of the scaffold was significantly enhanced by the addition of BCP inorganic fillers. The 55/45 BCP/PA6 composite scaffold with 76.5% ± 2.1% porosity attained a compressive strength of 1.86 ± 0.14 MPa. Moreover, the BCP/PA6 porous scaffold was cultured with rat calvarial osteoblasts to investigate the cell proliferation, viability, and differentiation function (alkaline phosphatase). The type I collagen expression was also used to characterize the differentiation of rat calvarial osteoblasts on BCP/PA6 composite scaffold by immunocytochemistry. The in vitro cytocompatibility evaluation demonstrated that the BCP/PA6 scaffold acted as a good template for the cells adhesion, spreading, growth, and differentiation. These results suggest that the BCP/PA6 porous composite could be a candidate as an excellent substitute for damaged or defect bone.     

Optimized conditions for mesenchymal stem cells to differentiate into osteoblasts on a collagen/hydroxyapatite matrix

Collagen/hydroxyapatite (HA) composite scaffolds are known to be suitable scaffolds for seeding with mesenchymal stem cells (MSCs) differentiated into osteoblasts and for the in vitro production of artificial bones. However, the optimal collagen/HA ratio remains unclear. Our study confirmed that a higher collagen content increased scaffold stiffness but that a greater stiffness was not sufficient for bone tissue formation, a complex process evidently also dependent on scaffold porosity. We found that the scaffold pore diameter was dependent on the concentration of collagen and HA and that it could play a key role in cell seeding. In conclusion, the optimal scaffold for new bone formation and cell proliferation was found to be a composite scaffold formed from 50 wt % HA in 0.5 wt % collagen I solution.     

纳米羟基磷灰石/I型胶原复合人工骨组成结构及成骨活性的实验研究

按照仿生的方法合成纳米羟基磷灰石/I型胶原人工骨支架材料.采用扫描电镜、X线衍射分析、孔隙率测定的方法对人工骨支架材料进行分析.制作兔颅骨缺损模型,植入人工骨支架材料,组织切片观察支架材料在体内的反应.纳米羟基磷灰石/I型胶原人工骨支架材料呈疏松海绵状,具有100～300 μm的孔径和90%以上的孔隙率,具有类似天然骨的结构.植入兔颅骨缺损模型未出现急性或慢性的炎症反应,在4周左右人工骨支架内出现大量新生毛细血管,12周新生骨完全修复骨缺损,并形成成熟的骨小梁结构.纳米羟基磷灰石和I型胶原复合人工骨约3个月左右降解完全.     

基于丝素/胶原/羟基磷灰石仿生骨材料的多维结构及其性能

目的 体外构建丝素蛋白（silk fibroin,SF）、I型胶原(type I collagen,Col-I)和羟基磷灰石(hydroxyapatite, HA)共混体系制备二维复合膜和三维仿生支架,研究其理化性质和生物相容性,探讨其在组织工程支架材料中应用的可行性。方法 通过在细胞培养小室底部共混SF/Col-I/HA以及低温3D打印结合真空冷冻干燥法制备二维复合膜及三维支架。通过机械性能测试、电子显微镜和Micro-CT检测材料的理化性质,检测细胞的增殖评估其生物相容性。结果 通过共混和低温3D打印获得稳定的二维复合膜及三维多孔结构支架;力学性能具有较好的一致性,孔径、吸水率、孔隙率和弹性模量均符合构建组织工程骨的要求;支架为网格状的白色立方体,内部孔隙连通性较好; HA均匀分布在复合膜中,细胞黏附在复合膜上,呈扁平状;细胞分布在支架孔壁周围,呈梭形状,生长及增殖良好。结论 利用SF/Col-I/HA共混体系成功制备复合膜及三维支架,具有较好的孔连通性与孔结构,有利于细胞和组织的生长以及营养输送,其理化性能以及生物相容性符合骨组织工程生物材料的要求。     

Fabrication of Nano-fibrous PLLA Scaffold Reinforced with Chitosan Fibers

In this study, a nano-fibrous PLLA scaffold reinforced by micro-scale chitosan fibers was fabricated using thermally-induced phase separation (TIPS). The morphology, porosity, mechanical performance and pH changes in in vitro degradation of the scaffold were also investigated. Results showed that the mechanical properties of the scaffold increased with the amount of chitosan fibers embedded, and the pH in in vitro degradation of the scaffold changed more slowly than that of the pure nano-fibrous PLLA scaffold without chitosan fibers. The new composite scaffold might be a very promising scaffold for tissue engineering.     

Nano-composite of poly(L-lactide) and surface grafted hydroxyapatite: mechanical properties and biocompatibility

In order to improve the bonding between hydroxyapatite (HAP) particles and poly(L-lactide) (PLLA), and hence to increase mechanical properties of the PLLA/HAP composite as potential bone substitute material, the HAP nano-particles were surface-grafted with PLLA and further blended with PLLA. The structure and properties of the composites were subsequently investigated by the mechanical property testing, the differential scanning calorimeter measurements (DSC), the scanning electron microscopy (SEM), the polarized optical microscopy (POM), and the cell culture. The PLLA molecules grafted on the HAP surfaces, as inter-tying molecules, played an important role in improving the adhesive strength between the particles and the polymer matrix. At a low content (approximately 4 wt%) of surface grafted-HAP (g-HAP), the PLLA/g-HAP nano-composites exhibited higher bending strength and impact energy than the pristine PLLA, and at a higher g-HAP content (e.g., 20 wt%), the modulus was remarkably increased. It implied that PLLA could be strengthened as well as toughened by g-HAP nano-particles. The results of biocompatibility test showed that the g-HAP existing in the PLLA composite facilitated both adhesion and proliferation of chondrocytes on the PLLA/g-HAP composite film.     

Preparation,in vitro degradability,cytotoxicity, and in vivo biocompatibility of porous hydroxyapatite whisker-reinforced poly(L-lactide) biocomposite scaffolds

Biodegradable and bioactive scaffolds with interconnected macroporous structures, suitable biodegradability, adequate mechanical property, and excellent biocompatibility have drawn increasing attention in bone tissue engineering. Hence, in this work, porous hydroxyapatite whisker-reinforced poly(L-lactide) (HA-w/PLLA) composite scaffolds with different ratios of HA and PLLA were successfully developed through compression molding and particle leaching. The microstructure, in vitro mineralization, cytocompatibility, hemocompatibility, and in vivo biocompatibility of the porous HA-w/PLLA were investigated for the first time. The SEM results revealed that these HA-w/PLLA scaffolds possessed interconnected pore structures. Compared with porous HA powder-reinforced PLLA (HA-p/PLLA) scaffolds, HA-w/PLLA scaffolds exhibited better mechanical property and in vitro bioactivity, as more formation of bone-like apatite layers were induced on these scaffolds after mineralization in SBF. Importantly, in vitro cytotoxicity displayed that porous HA-w/PLLA scaffold with HA/PLLA ratio of 1:1 (HA-w₁/PLLA₁) produced no deleterious effect on human mesenchymal stem cells (hMSCs), and cells performed elevated cell proliferation, indicating a good cytocompatibility. Simultaneously, well-behaved hemocompatibility and favorable in vivo biocompatibility determined from acute toxicity test and histological evaluation were also found in the porous HA-w₁/PLLA₁ scaffold. These findings may provide new prospects for utilizing the porous HA whisker-based biodegradable scaffolds in bone repair, replacement, and augmentation applications.     

Modification and cytocompatibility of biocomposited porous PLLA/HA-microspheres scaffolds

Poly(L-lactic acid) and hydroxyapatie (PLLA/HA) composite scaffolds have good properties and suit to use as bone tissue engineering. In this work, hollow HA microspheres (HAM) with poor crystallinity were fabricated by a flame-drying method. The HAM has the potential to be used to release drugs or proteins in addition to improve osteoconductivity. Different ratios of PLLA/HAM were used to prepare porous composite scaffolds using the thermally induced phase separation technique. The HAMs were randomly incorporated into the PLLA porous scaffolds. As the HAMs ratio was increased, the porous composite scaffolds changed from ladder-like into isotropic structure. In addition, the compressive strength of PLLA/HAMs composite scaffolds improved first and declined with the increasing of HAMs ratio in the scaffolds. In vitro experiment showed that PLLA/HAMs composite scaffolds improved the attachment, migration, and differentiation of osteoblastic cells. These results demonstrated that the PLLA/HAMs composite scaffolds were superior to plain PLLA scaffold for bone tissue engineering.     

Homogeneous chitosan/poly(L-lactide) composite scaffolds prepared by emulsion freeze-drying

The combination between chitosan (CS)-based hydrophilic extracellular matrix polysaccharide and polylactide (PLA)-based hydrophobic biodegradable aliphatic polyester is a challenge in the biomaterials field. This study investigated the formation of homogeneous chitosan/poly(L-lactide) (CS/PLLA) porous composite scaffold using a novel emulsion freeze-drying technique. An oil-in-water (O/W) emulsification system was used in the presence of surfactant Tween-80, in which CS solution was used as the water phase and PLLA solution was used as the oil phase. The composite scaffolds showed well interconnected pore structures and homogenous distribution of CS and PLLA when the PLLA volume fraction was not higher than 50%. Once the PLLA content increased to 75%, SEM micrographs demonstrated that the two components present phase separation region. FT-IR analysis revealed that there are strong hydrogen bond interactions between CS and PLLA components. The porosity of the CS/PLLA composites was in the range of 85-90% and showed a slight decrease with increasing PLLA dose. The mechanical properties of the composites lay between that of the pure CS and the PLLA scaffold. The compressive strength increased from 0.17 to 0.21 MPa, while the compressive modulus increased from 2.37 to 3.38 MPa as the PLLA contents increased from 25 to 75%. In vitro cytotoxicity was evaluated by MTT assay. The results indicated that MC3T3-E1 cell viability and proliferation in the CS/PLLA scaffold were comparable to that in the CS scaffold, and much higher than that in the PLLA scaffold. The successful hydrophilic polysaccharide and hydrophobic polyester system offers a new delivery method of growth factors and a novel scaffold design for tissue engineering.     

Polylactic acid fibre-reinforced polycaprolactone scaffolds for bone tissue engineering

The employment of composite scaffolds with a well-organized architecture and multi-scale porosity certainly represents a valuable approach for achieving a tissue engineered construct to reproduce the middle and long-term behaviour of hierarchically complex tissues such as spongy bone. In this paper, fibre-reinforced composites scaffold for bone tissue engineering applications is described. These are composed of poly-L-lactide acid (PLLA) fibres embedded in a porous poly(epsilon-caprolactone) matrix, and were obtained by synergistic use of phase inversion/particulate leaching technique and filament winding technology. Porosity degree as high as 79.7% was achieved, the bimodal pore size distribution showing peaks at ca 10 and 200 microm diameter, respectively, accounting for 53.7% and 46.3% of the total porosity. In vitro degradation was carried out in PBS and SBF without significant degradation of the scaffold after 35 days, while in NaOH solution, a linear increase of weight lost was observed with preferential degradation of PLLA component. Subsequently, marrow stromal cells (MSC) and human osteoblasts (HOB) reached a plateau at 3 weeks, while at 5 weeks the number of cells was almost the same. Human marrow stromal cell and trabecular osteoblasts rapidly proliferate on the scaffold up to 3 weeks, promoting an oriented migration of bone cells along the fibre arrangement. Moreover, the role of seeded HOB and MSC on composite degradation mechanism was assessed by demonstrating a more relevant contribution to PLLA degradation of MSC when compared to HOB. The novel PCL/PLLA composite scaffolds thus showed promise whenever tuneable porosity, controlled degradability and guided cell-material interaction are simultaneously requested.     

无细胞骨胶原基质的理化性能和组织相容性研究

制备了一种无细胞骨胶原基质(Acellular bone collagen matrix,ABCM)和ABCM-PDLLA复合材料。对材料的各种理化性能进行测试,并通过酶联免疫吸附(Enzyme linked immunosorbent assay,ELISA)和兔桡骨骨干缺损修复实验评价材料的组织相容性。结果表明材料中主要的骨矿成分和有机成分分别是碳酸盐羟基磷灰石和胶原,脂肪和细胞成分被完全脱除;ABCM材料具有较好的力学强度和微孔结构,加入PDLLA有助于提高材料的力学性能;ELISA检测显示材料引起的免疫反应持续时间较短,加入PDLLA可降低免疫反应。体内移植实验表明材料主要以传导成骨方式实现骨的修复和替代。总之,两种材料均具有较好的组织相容性,ABCM-PDLLA具有更好的力学性能和较低的免疫原性,更适合用作骨移植材料或骨组织工程支架材料。     

Homogeneous Chitosan/Poly(L-Lactide) Composite Scaffolds Prepared by Emulsion Freeze-Drying

The combination between chitosan (CS)-based hydrophilic extracellular matrix polysaccharide and polylactide (PLA)-based hydrophobic biodegradable aliphatic polyester is a challenge in the biomaterials field. This study investigated the formation of homogeneous chitosan/poly(L-lactide) (CS/PLLA) porous composite scaffold using a novel emulsion freeze-drying technique. An oil-in-water (O/W) emulsification system was used in the presence of surfactant Tween-80, in which CS solution was used as the water phase and PLLA solution was used as the oil phase. The composite scaffolds showed well interconnected pore structures and homogenous distribution of CS and PLLA when the PLLA volume fraction was not higher than 50%. Once the PLLA content increased to 75%, SEM micrographs demonstrated that the two components present phase separation region. FT-IR analysis revealed that there are strong hydrogen bond interactions between CS and PLLA components. The porosity of the CS/PLLA composites was in the range of 85–90% and showed a slight decrease with increasing PLLA dose. The mechanical properties of the composites lay between that of the pure CS and the PLLA scaffold. The compressive strength increased from 0.17 to 0.21 MPa, while the compressive modulus increased from 2.37 to 3.38 MPa as the PLLA contents increased from 25 to 75%. In vitro cytotoxicity was evaluated by MTT assay. The results indicated that MC3T3-E1 cell viability and proliferation in the CS/PLLA scaffold were comparable to that in the CS scaffold, and much higher than that in the PLLA scaffold. The successful hydrophilic polysaccharide and hydrophobic polyester system offers a new delivery method of growth factors and a novel scaffold design for tissue engineering.     

天冬氨酸修饰纳米羟基磷灰石/聚乳酸复合物制备软骨组织工程支架及其生物性能研究

目的:通过天冬氨酸修饰的纳米羟基磷灰石（Asp-nHA）和左旋聚乳酸（PLLA）复合,制备软骨组织工程支架,并进行体外实验研究,探索其作为软骨组织工程支架的可行性。 方法:以碳二亚胺盐酸盐/N-羟基琥珀酰亚胺偶联法制备Asp-nHA,并与PLLA复合,获得新型Asp-nHA/PLLA纳米复合支架。比较成骨细胞在该新型材料表面的粘附、生长和增殖的情况。 结果:加入nHA后,Asp-nHA/PLLA复合材料可显著增强细胞的粘附、生长、增殖;Asp-nHA/PLLA的生物学性能明显优于PLLA及HA/PLLA,且Asp-nHA/PLLA具有最强的体外诱导成骨细胞分化能力。 结论:Asp-nHA/PLLA制备简单,具有良好的生物相容性和成骨活性,是一种性能良好的骨组织工程支架材料。     

In vitro and in vivo evaluation of porous PCL-PLLA 3D polymer scaffolds fabricated via salt leaching method for bone tissue engineering applications

Three dimensional porous scaffolds composed of various ratios of polycaprolactone and poly(L-lactic acid) (PLLA) were prepared using salt leaching method for bone regeneration applications. Surfaces of the scaffolds were visualized using scanning electron microscope (SEM) and the combination of the polymers was confirmed by FT-IR. Addition of PLLA increased the porosity and pore sizes of the scaffolds and also the scaffolds’ compressive strength initially. Osteoblast-like cells were used and it was found that the samples’ cell biocompatibility was further promoted with the increase in PLLA content as observed via cell proliferation assays using MTT, gene expression with RT-PCR, and micrographs from SEM and confocal microscopy. Samples were then implanted into male rabbits for 2 months, and histological staining and micro-CT histomorphometry show that new bone formations were detected in the site containing the implants of the scaffolds and that bone regeneration was further promoted with the increased concentration of PLLA in the scaffold.     

Self-organization mechanism in a bone-like hydroxyapatite/collagen nanocomposite synthesized in vitro and its biological reaction in vivo

When bone is lost due to injury and/or illness, the defects are generally filled with natural bone because artificial bone materials have problems of bioaffinity. However, natural bone also has supply and infection problems. If an artificial material has the same biological properties as bone, it can replace natural bone for grafting. We synthesized a hydroxyapaite (HAp) and collagen (Col) composite by a simultaneous titration coprecipitation method using Ca(OH)2, H3PO4 and porcine atelocollagen as starting materials. The composite obtained showed a self-organized nanostructure similar to bone assembled by the chemical interaction between HAp and Col. The consolidated composite by a cold isostatic pressure of 200 MPa indicated a quarter of the mechanical strength of bone. It also indicated the same biological properties as grafted bone: The material was resorbed by phagocytosis of osteoclast-like cells and conducted osteoblasts to form new bone in the surrounding area. This HAp/Col composite having similar nanostructure and composition can replace autologous bone grafts.     

Increased osteoblast function on PLGA composites containing nanophase titania

Nanotechnology creates materials that potentially outperform, at several boundaries, existing materials in terms of mechanical, electrical, catalytic, and optical properties. However, despite their promise to mimic the surface roughness cells experience in vivo, the use of nanophase materials in biological applications remains to date largely unexplored. The objective of the present in vitro study was, therefore, to determine whether when added to a polymer scaffold, nanophase compared to conventional ceramics enhance functions of osteoblasts (or bone-forming cells). Results from this study provided the first evidence that functions (specifically, adhesion, synthesis of alkaline phosphatase, and deposition of calcium-containing mineral) of osteoblasts increased on poly-lactic-co-glycolic acid (PLGA) scaffolds containing nanophase compared to conventional grain size titania with greater weight percentage (from 10-30 wt %). Because the chemistry, material phase, porosity (%), and pore size of the composites were similar, this study implies that the surface features created by adding nanophase compared to conventional titania was a key parameter that enhanced functions of osteoblasts. In this manner, the study adds another novel property of nanophase ceramics: their ability to promote osteoblast functions in vitro when added to a polymer scaffold. For this reason, nanophase ceramics (and nanomaterials in general) deserve further attention as orthopedic tissue engineering materials.