Can Combining Hyaluronic Acid and Physiotherapy in Knee Osteoarthritis Improve the Physicochemical Properties of Synovial Fluid?

Known as the degenerative disease of the knee with the highest prevalence, knee osteoarthritis (KOA) is characterized by a gradual destructive mechanism that, in severe cases, can provoke the need for total knee substitution. As the disease progresses, various enzymatic, immunological, and inflammatory processes abnormally degrade hyaluronic acid (HA), SF's main component, and affect the concentrations of specific proteins, with the final results seriously endangering synovial fluid (SF)'s rheological and tribological features and characteristics. No effective treatments have been found to stop the progression of KOA, but the injection of HA-based viscoelastic gels has been considered (alone or combined with physiotherapy (PT)) as an alternative to symptomatic therapies. In order to evaluate the effect of viscosupplementation and PT on the characteristics of SF, SF aspirated from groups treated for KOA (HA Kombihylan® and groups that received Kombihylan® and complex PT) was analyzed and compared from analytical, spectrophotometrical, and rheological perspectives. In the patients treated with PT, the SF extracted 6 weeks after viscosupplementation had a superior elastic modulus (G') and viscous moduli (G″), as well as a homogeneous distribution of proteins and polysaccharides. The viscosupplementation fluid improved the bioadhesive properties of the SF, and the use of the viscosupplementation fluid in conjunction with PT was found to be favorable for the distribution of macromolecules and phospholipids, contributing to the lubrication process and the treatment of OA-affected joints.

The Impact of the Addition of Vitamins on a Silicone Lining Material to the Oral Mucosa Tissue-Evaluation of the Biocompatibility, Hydrolytic Stability and Histopathological Effect.

Background and Objectives: One's quality of life depends on overall health, and in particular, oral health, which has been and continues to become a public health issue through frequent manifestations in various forms, from simple oral stomatitis (inflammations of the oral cavity) to the complicated oral health pathologies requiring medical interventions and treatments (caries, pulp necrosis and periodontitis). The aim of this study focused on the preparation and evaluation of vitamins (vitamin A, B1 and B6) incorporated into several silicone-based lining materials as a new alternative to therapeutically loaded materials designed as oral cavity lining materials in prosthodontics. Materials and Methods: Silicone-based liners containing vitamins were prepared by mixing them in solution and becoming crosslinked, and then they were characterized using Fourier-transform infrared (FT-IR) spectroscopy to confirm the incorporation of the vitamins into the silicone network; scanning electron microscopy (SEM) to evidence the morphology of the liner materials; dynamic vapor sorption (DVS) to evaluate their internal hydrophobicity, swelling in environments similar to biological fluids and mechanical test to demonstrate tensile strength; MTT to confirm their biocompatibility on normal cell cultures (fibroblast) and mucoadhesivity; and histopathological tests on porcine oral mucosa to highlight their potential utility as soft lining materials with improved efficiency. Results: FT-IR analysis confirmed the structural peculiarities of the prepared lining materials and the successful incorporation of vitamins into the silicone matrix. The surface roughness of the materials was lower than 0.2 µm, while in cross-section, the lining materials showed a compact morphology. It was found that the presence of vitamins induced a decrease in the main mechanical parameters (strength and elongation at break, Young's modulus) and hydrophobicity, which varied from one vitamin to another. A swelling degree higher than 8% was found in PBS 6.8 (artificial saliva) and water. Hydrolytic stability studies in an artificial saliva medium showed the release of low concentrations of silicone and vitamin fragments in the first 24 h, which increased the swelling behavior of the materials, diffusion and solubility of the vitamins. The microscopic images of fibroblast cells incubated with vitamin liners revealed very good biocompatibility. Also, the silicone liners incorporating the vitamins showed good mucoadhesive properties. The appearance of some pathological disorders with autolysis processes was more pronounced in the case of vitamin A liners. Conclusions: The addition of the vitamins was shown to have a beneficial effect that was mainly manifested as increased biocompatibility, hydrolytic stability and mucoadhesiveness with the mucosa of the oral cavity and less of an effect on the mechanical strength. The obtained lining materials showed good resistance in simulated biological media but caused a pronounced autolysis phenomenon, as revealed by histopathological examination, showing that these materials may have broad implications in the treatment of oral diseases.

Polysaccharides-Calcium Phosphates Composite Beads as Bone Substitutes for Fractures Repair and Regeneration.

The tendency of population aging is continuously increasing, which is directly correlated with a significative number of associated pathologies. Several metabolic bone diseases such as osteoporosis or chronic kidney disease-mineral and bone disorders involve a high risk of fractures. Due to the specific fragility, bones will not self-heal and supportive treatments are necessary. Implantable bone substitutes, a component of bone tissue engineering (BTE) strategy, proved to be an efficient solution for this issue. The aim of this study was to develop composites beads (CBs) with application in the complex field of BTE, by assembling the features of both biomaterials' classes: biopolymers (more specific, polysaccharides: alginate and two different concentrations of guar gum/carboxymethyl guar gum) and ceramics (more specific, calcium phosphates), in a combination described for the first time in the literature. The CBs prepared by double crosslinking (ionic and physically) showed adequate physico-chemical characteristics and capabilities (morphology, chemical structure and composition, mechanical strength, and in vitro behaviour in four different acellular simulated body fluids) for bone tissue repair. Moreover, preliminary in vitro studies on cell cultures highlighted that the CBs were free of cytotoxicity and did not affect the morphology and density of cells. The results indicated that the beads based on a higher concentration of guar gum have superior properties than those with carboxymetilated guar, especially in terms of mechanical properties and behaviour in simulated body fluids.

Exploring the Surface Potential of Recycled Polyethylene Terephthalate Composite Supports on the Collagen Contamination Level.

With a significant number of features (namely being multipurpose, inexpensive and durable), thermoplastic polymers, most often named plastics, are part of our daily routine, with an increasing production over the last decade. Among them, polyethylene terephthalate (PET), high-density polyethylene (HDPE) and polypropylene (PP) are distinguished as the five most commonly used plastics in various fields, mainly in the packaging industry. Even if it is difficult to imagine the world without plastics, the boosted plastic assembly comes with huge plastic waste, creating a number of challenges, as the most important threat for our environment, but also opportunities for recycling. Currently, a special attention is dedicated on how to improve the current recycling methods or to find new ones, since the quality of recycled plastics and potential chemical or biological contaminations are two problematic aspects. Understanding the properties of each thermoplastic polymer and the interaction with possible contaminants may be the key for an efficient recycling process. The aim of this paper was to evaluate the surface behaviour of different composite supports based on recycled PET before and after interaction with collagen (used as a biological contaminant). The surface contamination bias of PET supports was studied through different techniques: scanning electron microscopy (SEM), water uptake through swelling studies, contact angle measurements and attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR).

Assessing the Antioxidant Properties, In Vitro Cytotoxicity and Antitumoral Effects of Polyphenol-Rich Perilla leaves Extracts.

(1) Background: This study aimed to outline the antioxidant, antitumoral, and cytotoxic proprieties of various types of Perilla frutescens extracts obtained from the leaves of the species. (2) Methods: We determined total polyphenols, flavonoids and anthocyanins contents, as well as the in vitro antioxidant, antitumoral, and cytotoxic actions in three types of ethanolic extracts (E1, E2, E3) and in three types of acetone: ethanol extracts (A1, A2, A3) of Perilla frutescens according to standardized procedures. (3) Results: We found that Perilla frutescens ethanolic extracts had the highest total phenol and anthocyanins concentrations. The flavonoids concentration was not statistically different between the extracts. The iron chelating capacity, hydroxyl radical scavenging capacity, superoxide anion radical scavenging capacity, and lipoxygenase inhibition capacity showed a significant increase with higher concentrations of Perilla frutescens extracts, particularly the ethanolic extracts. Perillyl alcohol had greater cytotoxic capacity in the MG-63 cell line and E1 extract showed similar significant cytotoxic effects in the A431 cell line. (4) Conclusions: Both ethanolic and acetone-ethanol extracts from Perilla frutescens exhibited important antioxidant and antitumoral actions in vitro, which proportionally increased with concentration. The cytotoxic threshold determined in this study for various types of extracts could help determine the best dosage with the maximum antioxidant and antitumoral potential. Our results could serve as a basis for further studies that will investigate the cytotoxic effects of Perilla frutescens variants on various types of cancer cell lines.

Advanced 3D Magnetic Scaffolds for Tumor-Related Bone Defects.

The need for bone substitutes is a major challenge as the incidence of serious bone disorders is massively increasing, mainly attributed to modern world problems, such as obesity, aging of the global population, and cancer incidence. Bone cancer represents one of the most significant causes of bone defects, with reserved prognosis regarding the effectiveness of treatments and survival rate. Modern therapies, such as hyperthermia, immunotherapy, targeted therapy, and magnetic therapy, seem to bring hope for cancer treatment in general, and bone cancer in particular. Mimicking the composition of bone to create advanced scaffolds, such as bone substitutes, proved to be insufficient for successful bone regeneration, and a special attention should be given to control the changes in the bone tissue micro-environment. The magnetic manipulation by an external field can be a promising technique to control this micro-environment, and to sustain the proliferation and differentiation of osteoblasts, promoting the expression of some growth factors, and, finally, accelerating new bone formation. By incorporating stimuli responsive nanocarriers in the scaffold's architecture, such as magnetic nanoparticles functionalized with bioactive molecules, their behavior can be rigorously controlled under external magnetic driving, and stimulates the bone tissue formation.

Borrowing the Features of Biopolymers for Emerging Wound Healing Dressings: A Review.

Wound dressing design is a dynamic and rapidly growing field of the medical wound-care market worldwide. Advances in technology have resulted in the development of a wide range of wound dressings that treat different types of wounds by targeting the four phases of healing. The ideal wound dressing should perform rapid healing; preserve the body's water content; be oxygen permeable, non-adherent on the wound and hypoallergenic; and provide a barrier against external contaminants-at a reasonable cost and with minimal inconvenience to the patient. Therefore, choosing the best dressing should be based on what the wound needs and what the dressing does to achieve complete regeneration and restoration of the skin's structure and function. Biopolymers, such as alginate (ALG), chitosan (Cs), collagen (Col), hyaluronic acid (HA) and silk fibroin (SF), are extensively used in wound management due to their biocompatibility, biodegradability and similarity to macromolecules recognized by the human body. However, most of the formulations based on biopolymers still show various issues; thus, strategies to combine them with molecular biology approaches represent the future of wound healing. Therefore, this article provides an overview of biopolymers' roles in wound physiology as a perspective on the development of a new generation of enhanced, naturally inspired, smart wound dressings based on blood products, stem cells and growth factors.

Assessment of the Effects of Si Addition to a New TiMoZrTa System.

Ti-based alloys are widely used in medical applications. When implant devices are used to reconstruct disordered bone, prevent bone resorption and enhance good bone remodeling, the Young's modulus of implants should be close to that of the bone. To satisfy this requirement, many titanium alloys with different biocompatible elements (Zr, Ta, Mo, Si etc.) interact well with adjacent bone tissues, promoting an adequate osseointegration. Four new different alloys were obtained and investigated regarding their microstructure, mechanical, chemical and biological behavior (in vitro and in vivo evaluation), as follows: Ti20Mo7Zr15Ta, Ti20Mo7Zr15Ta0.5Si, Ti20Mo7Zr15Ta0.75Si and Ti20Mo7Zr15TaSi. 60 days after implantation, both in control and experimental rabbits, at the level of implantation gap and into the periimplant area were found the mesenchymal stem cells which differentiate into osteoblasts, then osteocytes and osteoclasts which are involved in the new bone synthesis and remodeling, the periimplant fibrous capsule being continued by newly spongy bone tissue, showing a good osseointegration of alloys. A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay confirmed the in vitro cytocompatibility of the prepared alloys.

Nanomaterials Designed for Antiviral Drug Delivery Transport across Biological Barriers.

Viral infections are a major global health problem, representing a significant cause of mortality with an unfavorable continuously amplified socio-economic impact. The increased drug resistance and constant viral replication have been the trigger for important studies regarding the use of nanotechnology in antiviral therapies. Nanomaterials offer unique physico-chemical properties that have linked benefits for drug delivery as ideal tools for viral treatment. Currently, different types of nanomaterials namely nanoparticles, liposomes, nanospheres, nanogels, nanosuspensions and nanoemulsions were studied either in vitro or in vivo for drug delivery of antiviral agents with prospects to be translated in clinical practice. This review highlights the drug delivery nanosystems incorporating the major antiviral classes and their transport across specific barriers at cellular and intracellular level. Important reflections on nanomedicines currently approved or undergoing investigations for the treatment of viral infections are also discussed. Finally, the authors present an overview on the requirements for the design of antiviral nanotherapeutics.

Vibrational Spectroscopy Fingerprinting in Medicine: from Molecular to Clinical Practice.

In the last two decades, Fourier Transform Infrared (FTIR) and Raman spectroscopies turn out to be valuable tools, capable of providing fingerprint-type information on the composition and structural conformation of specific molecular species. Vibrational spectroscopy's multiple features, namely highly sensitive to changes at the molecular level, noninvasive, nondestructive, reagent-free, and waste-free analysis, illustrate the potential in biomedical field. In light of this, the current work features recent data and major trends in spectroscopic analyses going from in vivo measurements up to ex vivo extracted and processed materials. The ability to offer insights into the structural variations underpinning pathogenesis of diseases could provide a platform for disease diagnosis and therapy effectiveness evaluation as a future standard clinical tool.

Magnetic Composite Scaffolds for Potential Applications in Radiochemotherapy of Malignant Bone Tumors.

Background and objectives: Cancer is the second leading cause of death globally, an alarming but expected increase. In comparison to other types of cancer, malignant bone tumors are unusual and their treatment is a real challenge. This paper's main purpose is the study of the potential application of composite scaffolds based on biopolymers and calcium phosphates with the inclusion of magnetic nanoparticles in combination therapy for malignant bone tumors. Materials and Methods: The first step was to investigate if X-rays could modify the scaffolds' properties. In vitro degradation of the scaffolds exposed to X-rays was analyzed, as well as their interaction with phosphate buffer solutions and cells. The second step was to load an anti-tumoral drug (doxorubicin) and to study in vitro drug release and its interaction with cells. The chemical structure of the scaffolds and their morphology were studied. Results: Analyses showed that X-ray irradiation did not influence the scaffolds' features. Doxorubicin release was gradual and its interaction with cells showed cytotoxic effects on cells after 72 h of direct contact. Conclusions: The obtained scaffolds could be considered in further studies regarding combination therapy for malignant bone tumors.

Interpenetrated polymer network with modified chitosan in composition and self-healing properties.

Smart hydrogels endowed with self-healing performance, enhanced stability and unique environmental responsiveness were prepared by interpenetrating the crosslinked poly(2-dimethylaminoethyl methacrylate) between the chains of the water-soluble maleoyl-chitosan. The influence of the ratio between the modified polysaccharide and the homopolymer upon the morphological structure and water uptake behaviour of the hydrogels was put in evidence by Scanning electron microscopy and swelling measurements in simulated body fluids. In addition, the synthesised compounds exhibited responsive properties, self-healing behaviour, and great availability like drug delivery systems. The in vitro study evidenced the dependence of the released procaine on the MAC content in the hydrogels, the release mechanism being controlled mainly by Fickian diffusion. The cytotoxicity assay on fibroblast demonstrated improved viability of cells by increasing the modified polysaccharide ratio into hydrogels. The self-repair capacity along with dual pH/thermo-responsiveness and biocompatibility of the hydrogels demonstrate their viability for various bio-applications.