A Review of Conventional and Novel Treatments for Osteoporotic Hip Replacements.

INTRODUCTION: Osteoporosis is a skeletal disease that severely affects the mechanical properties of bone. It increases the porosity of cancellous bone and reduces the resistance to fractures. It has been reported in 2009 that there are approximately 500 million osteoporotic patients worldwide. Patients who suffer fractures due to fragility cost the National Healthcare Systems in the United Kingdom £4.4 billion in 2018, in Europe €56 billion in 2019, and in the United States $57 billion in 2018. Thus, osteoporosis is problematic for both patients and healthcare systems. AIM: This review is conducted for the purpose of presenting and discussing all articles introducing or investigating treatment solutions for osteoporotic patients undergoing total hip replacement. METHODS: Searches were implemented using three databases, namely Scopus, PubMed, and Web of Science to extract all relevant articles. Predetermined eligibility criteria were used to exclude articles out of the scope of the study. RESULTS: 29 articles out of 183 articles were included in this review. These articles were organised into three sections: (i) biomechanical properties and structure of osteoporotic bones, (ii) hip implant optimisations, and (iii) drug, cells, and bio-activators delivery through hydrogels. DISCUSSION: The findings of this review suggest that diagnostic tools and measurements are crucial for understanding the characteristics of osteoporosis in general and for setting patient-specific treatment plans. It was also found that attempts to overcome complications associated with osteoporosis included design optimisation of the hip implant; however, only short-term success was reported, while the long-term stability of implants was compromised by the progressive nature of osteoporosis. Finally, it was also found that targeting implantation sites with cells, drugs, and growth factors has been outworked using hydrogels, where promising results have been reported regarding enhanced osteointegration and inhibited bacterial and osteoclastic activities. CONCLUSIONS: These results may encourage investigations that explore the effects of these impregnated hydrogels on osteoporotic bones beyond metallic scaffolds and implants.

Aromatic Stacking Facilitated Self-Assembly of Ultrashort Ionic Complementary Peptide Sequence: ß-Sheet Nanofibers with Remarkable Gelation and Interfacial Properties.

Understanding peptide self-assembly mechanisms and stability of the formed assemblies is crucial for the development of functional nanomaterials. Herein, we have adopted a rational design approach to demonstrate how a minimal structural modification to a nonassembling ultrashort ionic self-complementary tetrapeptide FEFK (Phe4) remarkably enhanced the stability of self-assembly into ß-sheet nanofibers and induced hydrogelation. This was achieved by replacing flexible phenylalanine residue (F) by the rigid phenylglycine (Phg), resulting in a constrained analogue PhgEPhgK (Phg4), which positioned aromatic rings in an orientation favorable for aromatic stacking. Phg4 self-assembly into stable ß-sheet ladders was facilitated by π-staking of aromatic side chains alongside hydrogen bonding between backbone amides along the nanofiber axis. The contribution of these noncovalent interactions in stabilizing self-assembly was predicted by in silico modeling using molecular dynamics simulations and semiempirical quantum mechanics calculations. In aqueous medium, Phg4 ß-sheet nanofibers entangled at a critical gelation concentration ≥20 mg/mL forming a network of nanofibrous hydrogels. Phg4 also demonstrated a unique surface activity in the presence of immiscible oils and was superior to commercial emulsifiers in stabilizing oil-in-water (O/W) emulsions. This was attributed to interfacial adsorption of amphiphilic nanofibrils forming nanofibrilized microspheres. To our knowledge, Phg4 is the shortest ionic self-complementary peptide rationally designed to self-assemble into stable ß-sheet nanofibers capable of gelation and emulsification. Our results suggest that ultrashort ionic-complementary constrained peptides or UICPs have significant potential for the development of cost-effective, sustainable, and multifunctional soft bionanomaterials.

Polylysine Enriched Matrices: A Promising Approach for Vascular Grafts.

Cardiovascular diseases represent the leading cause of death in developed countries. Modern surgical methods show poor efficiency in the substitution of small-diameter arteries (<6 mm). Due to the difference in mechanical properties between the native artery and the substitute, the behavior of the vessel wall is a major cause of inefficient substitutions. The use of decellularized scaffolds has shown optimal prospects in different applications for regenerative medicine. The purpose of this work was to obtain polylysine-enriched vascular substitutes, derived from decellularized porcine femoral and carotid arteries. Polylysine acts as a matrix cross-linker, increasing the mechanical resistance of the scaffold with respect to decellularized vessels, without altering the native biocompatibility and hemocompatibility properties. The biological characterization showed an excellent biocompatibility, while mechanical tests displayed that the Young's modulus of the polylysine-enriched matrix was comparable to native vessel. Burst pressure test demonstrated strengthening of the polylysine-enriched matrix, which can resist to higher pressures with respect to native vessel. Mechanical analyses also show that polylysine-enriched vessels presented minimal degradation compared to native. Concerning hemocompatibility, the performed analyses show that polylysine-enriched matrices increase coagulation time, with respect to commercial Dacron vascular substitutes. Based on these findings, polylysine-enriched decellularized vessels resulted in a promising approach for vascular substitution.

Methylcellulose Hydrogel with Melissa officinalis Essential Oil as a Potential Treatment for Oral Candidiasis.

Candida spp. are the most prevalent fungi of the human microbiota and are opportunistic pathogens that can cause oral candidiasis. Management of such infections is limited due to the low number of antifungal drugs available, their relatively high toxicity and the emergence of antifungal resistance. Therefore, much interest in the antimicrobial potential of natural compounds has recently been evident. The use of hydrogels in the delivery of biocides has been explored due to their biocompatibility, ease with drug encapsulation, and due to their potential to confer mechanical and structural properties similar to biological tissue. Methylcellulose hydrogels (10% (w/v)) with 1% (v/v) and 2% (v/v) Melissa officinalis oil were synthesised. The rheological properties and gelation time of the hydrogels were evaluated. Antimicrobial action, the antifungal potential and ability to displace Candida were determined. Rheological tests revealed that the hydrogel jellified in three minutes at 37 °C. Loaded hydrogels successfully inhibited Candida albicans growth as evident by zone of inhibition and time-kill assays. A significant reduction in retained C. albicans was demonstrated with the hydrogel at 2% Melissa officinalis concentration. This work demonstrated that an essential oil-loaded hydrogel had the potential to provide a novel antimicrobial therapy for the treatment of oral candidiasis.

Bioinspired Materials 2018: Conference Report.

The Bioinspired Materials conference 2018 was organized for the third time by a team of researchers from Manchester Metropolitan University. This international conference aims to bring together the scientific committee in the fields of biomimetic sensors, bioinspired materials, materials chemistry, three-dimensional (3D) printing, and tissue engineering. The 2018 edition was held at the John Dalton Building of Manchester Metropolitan University, Manchester, UK, and took place on the 10th of October 2018. There were over 60 national and international attendees, with the international attendees participating in a lab tour through the synthetic facilities and Fuel Cell Innovation Centre on the 9th of October. The three conference sessions encompassed a wide range of topics, varying from biomimetic sensors, hydrogels, and biofabrics and bioengineering.

Small diameter helical vascular scaffolds support endothelial cell survival.

There is an acute clinical need for small-diameter vascular grafts as a treatment option for cardiovascular disease. Here, we used an intelligent design system to recreate the natural structure and hemodynamics of small arteries. Nano-fibrous tubular scaffolds were fabricated from blends of polyvinyl alcohol and gelatin with inner helices to allow a near physiological spiral flow profile, using the electrospinning technique. Human coronary artery endothelial cells (ECs) were seeded on the inner surface and their viability, distribution, gene expression of mechanosensitive and adhesion molecules compared to that in conventional scaffolds, under static and flow conditions. We show significant improvement in cell distribution in helical vs. conventional scaffolds (94% ±â€¯9% vs. 82% ±â€¯7.2%; P < 0.05) with improved responsiveness to shear stress and better ability to withhold physiological pressures. Our helical vascular scaffold provides an improved niche for EC growth and may be attractive as a potential small diameter vascular graft.