Vascularization and biocompatibility of poly(ε-caprolactone) fiber mats for rotator cuff tear repair.

Rotator cuff tear is the most frequent tendon injury in the adult population. Despite current improvements in surgical techniques and the development of grafts, failure rates following tendon reconstruction remain high. New therapies, which aim to restore the topology and functionality of the interface between muscle, tendon and bone, are essentially required. One of the key factors for a successful incorporation of tissue engineered constructs is a rapid ingrowth of cells and tissues, which is dependent on a fast vascularization. The dorsal skinfold chamber model in female BALB/cJZtm mice allows the observation of microhemodynamic parameters in repeated measurements in vivo and therefore the description of the vascularization of different implant materials. In order to promote vascularization of implant material, we compared a porous polymer patch (a commercially available porous polyurethane based scaffold from Biomerix™) with electrospun polycaprolactone (PCL) fiber mats and chitosan-graft-PCL coated electrospun PCL (CS-g-PCL) fiber mats in vivo. Using intravital fluorescence microscopy microcirculatory parameters were analyzed repetitively over 14 days. Vascularization was significantly increased in CS-g-PCL fiber mats at day 14 compared to the porous polymer patch and uncoated PCL fiber mats. Furthermore CS-g-PCL fiber mats showed also a reduced activation of immune cells. Clinically, these are important findings as they indicate that the CS-g-PCL improves the formation of vascularized tissue and the ingrowth of cells into electrospun PCL scaffolds. Especially the combination of enhanced vascularization and the reduction in immune cell activation at the later time points of our study points to an improved clinical outcome after rotator cuff tear repair.

Possibilities and limitations of electrospun chitosan-coated polycaprolactone grafts for rotator cuff tear repair.

Acute and chronic rotator cuff tears remain challenging for therapy. A wide range of therapeutic approaches were developed but re-tears and postoperative complications occur regularly. Especially in elderly people, the natural regeneration processes are decelerated, and graft materials are often necessary to stabilize the tendon-to-bone attachment and to improve the healing process. We here investigated in a small animal model a newly developed electrospun polycaprolactone fiber implant coated with a chitosan-polycaprolactone graft copolymer and compared these implants biomechanically and histologically with either a commercially available porous polyurethane implant (Biomerix 3D Scaffold) or suture-fixed tendons. Fifty-one rats were divided into three groups of 17 animals each. In the first surgery, the left infraspinatus tendons of all rats were detached, and the animals recovered for 4 weeks. In the second surgery, the tendons were fixed with suture material only (suture-fixed group; n = 17), whereas in the two experimental groups, the tendons were fixed with suture material and the polyurethane implant (Biomerix scaffold group; n = 17) or the modified electrospun polycaprolactone fiber implant (CS-g-PCL scaffold group; n=17), respectively. The unaffected right infraspinatus tendons were used as native controls. After a recovery of 8 weeks, all animals were clinically inconspicuous. In 12 animals of each group, repaired entheses were biomechanically tested for force at failure, stiffness, and modulus of elasticity, and in five animals, repaired entheses were analyzed histologically. Biomechanically, all parameters did not differ statistically significant between both implant groups, and the entheses failed typically at the surgical site. However, with respect to the force at failure, the median values of the two implant groups were smaller than the median value of the suture-fixed group. Histologically, the modified polycaprolactone fiber implant showed no acute inflammation processes, a good infiltration with cells, ingrowth of blood vessels and tendinous tissue, and a normal fibrous ensheathment. Further improvement of the implant material could be achieved by additional implementation of drug delivery systems. Therewith, the used CS-g-PCL fiber mat is a promising basic material to reach the goal of a clinically usable graft for rotator cuff tear repair.

Mueller Matrix Measurement of Electrospun Fiber Scaffolds for Tissue Engineering.

Electrospun fiber scaffolds are gaining in importance in the area of tissue engineering. They can be used, for example, to fabricate graded implants to mimic the tendon bone junction. For the grading of the tensile strength of the fiber scaffolds, the orientation of the fibers plays a major role. This is currently measured by hand in scanning electron microscope (SEM) images. In this work, a correlation between polarimetric information generated by measuring the Mueller matrix (MM) and the orientation of the fibers of electrospun fiber scaffolds is reported. For this, the MM of fiber scaffolds, which were manufactured with different production parameters, was measured and analyzed. These data were correlated with fiber orientation and mechanical properties, which were evaluated in an established manner. We found that by measurement of the MM the production parameters as well as the relative orientation of the fibers in space can be determined. Thus, the MM measurement is suitable as an alternative tool for non-contact, non-destructive determination of the production parameters and, thus, the degree of alignment of electrospun fiber scaffolds.

In vivo analysis of vascularization and biocompatibility of electrospun polycaprolactone fibre mats in the rat femur chamber.

In orthopaedic medicine, connective tissues are often affected by traumatic or degenerative injuries, and surgical intervention is required. Rotator cuff tears are a common cause of shoulder pain and disability among adults. The development of graft materials for bridging the gap between tendon and bone after chronic rotator cuff tears is essentially required. The limiting factor for the clinical success of a tissue engineering construct is a fast and complete vascularization of the construct. Otherwise, immigrating cells are not able to survive for a longer period of time, resulting in the failure of the graft material. The femur chamber allows the observation of microhaemodynamic parameters inside implants located in close vicinity to the femur in repeated measurements in vivo. We compared a porous polymer patch (a commercially available porous polyurethane-based scaffold from Biomerix™) with electrospun polycaprolactone (PCL) fibre mats and chitosan (CS)-graft-PCL modified electrospun PCL (CS-g-PCL) fibre mats in vivo. By means of intravital fluorescence microscopy, microhaemodynamic parameters were analysed repetitively over 20 days at intervals of 3 to 4 days. CS-g-PCL modified fibre mats showed a significantly increased vascularization at Day 10 compared with Day 6 and at Day 14 compared with the porous polymer patch and the unmodified PCL fibre mats at the same day. These results could be verified by histology. In conclusion, a clear improvement in terms of vascularization and biocompatibility is achieved by graft-copolymer modification compared with the unmodified material.

Impact of sterilization by electron beam, gamma radiation and X-rays on electrospun poly-(ε-caprolactone) fiber mats.

Biodegradable polymers such as polycaprolactone (PCL) are increasingly used for electrospinning substrates for tissue engineering. These materials offer great advantages such as biocompatibility and good mechanical properties. However, in order to be approved for human implantation they have to be sterilized. The impact of commonly used irradiation sterilization methods on electrospun PCL fiber mats was investigated systematically. Electron beam (ß-irradiation), gamma and X-ray irradiation with two different doses (25 and 33 kGy) were investigated. To determine the impact on the fiber mats, mechanical, chemical, thermal properties and crystallinity were investigated. Irradiation resulted in a significant decrease in molecular weight. At the same time, crystallinity of fiber mats increased significantly. However, the mechanical properties did not change significantly upon irradiation, mostly likely because effects of a lower molecular weight were balanced with the higher degree of crystallinity. The irradiation effects were dose dependent, a higher irradiation dose led to stronger changes. Gamma irradiation seemed to be the least suited method, while electron beams (ß irradiation) had a lower impact. Therefore, ß irradiation is recommended as sterilization method for electrospun PCL fiber mats.

Layer-by-layer deposition of chitosan nanoparticles as drug-release coatings for PCL nanofibers.

Nanogels were prepared by ionotropic gelation of chitosan (CS) with tripolyphosphate (TPP). The use of such nanogels to prepare coatings by layer-by-layer deposition (LbL) was studied. The nanogels were characterized in terms of particle size, zeta-potential and stability. Nanogel suspensions were used to build polyelectrolyte multilayers on silicon wafers and on PCL fiber mats by LbL-deposition. Three different polysaccharides were used as polyanions, namely chondroitin sulfate, alginate and hyaluronic acid. The ellipsometric thickness was demonstrated to depend significantly on the type of polyanion. XPS analysis with depth profiling further substantiated the differences in the chemical composition of the films with the different polyanions. Furthermore, XPS data clearly indicated a strong penetration of the polyanions into the CS-TPP layer, resulting in a complete exchange and release of the TPP ions. The LbL-deposition also was studied with PCL fiber mats, which were modified with a chitosan-PCL-graft polymer and alginate. The possibility to create graded coatings on the fiber mats was shown employing fluorescently labelled CS-TPP nanoparticles. The potential of the coatings as drug delivery system for therapeutic proteins was exemplified with the release of Transforming Growth Factor ß3 (TGF-ß3). The CS-TPP nanogels were shown to encapsulate and release therapeutic proteins. In combination with the layer-by-layer deposition they will allow the creation of PCL fiber mat implants having with drug gradients for applications at tissue transitions.

Attachment of nanoparticulate drug-release systems on poly(ε-caprolactone) nanofibers via a graftpolymer as interlayer.

Electrospun poly(ε-caprolactone) (PCL) fiber mats are modified using a chitosan grafted with PCL (CS-g-PCL), to improve the biological performance and to enable further modifications. The graft copolymer is immobilized by the crystallization of the PCL grafts on the PCL fiber surface as binding mechanism. In this way, the surface of the fibers is covered with chitosan bearing cationic amino groups, which allow adsorption of oppositely charged nanoparticulate drug-delivery systems. The modification of the fiber mats and the attachment of the drug delivery systems are easy and scalable dip processes. The process is also versatile; it is possible to attach different polymeric and inorganic nanoparticulate drug-release systems of cationic or anionic nature. The modifications are verified using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). As proof of principle, the release of ciprofloxacin from silica nanoparticles attached to the modified fiber mats is shown; however, the method is also suited for other biologically active substances including growth factors. The initial cellular attachment and proliferation as well as vitality of the cells is improved by the modification with CS-g-PCL and is further influenced by the type of the drug delivery system attached. Hence, this method can be used to transfer PCL fiber mats into bioactive implants for in-situ tissue engineering applications.