Tyrosine-derived polycarbonate scaffolds for bone regeneration in a rabbit radius critical-size defect model.

The aim of the study was to determine bone regeneration in a rabbit radius critical-size defect (CSD) model using a specific polymer composition (E1001(1k)) from a library of tyrosine-derived polycarbonate scaffolds coated with a calcium phosphate (CP) formulation (E1001(1k) + CP) supplemented with recombinant human bone morphogenetic protein-2 (rhBMP-2). Specific doses of rhBMP-2 (0, 17, and 35 µg/scaffold) were used. E1001(1k) + CP scaffolds were implanted in unilateral segmental defects (15 mm length) in the radial diaphyses of New Zealand White rabbits. At 4 and 8 weeks post-implantation, bone regeneration was determined using micro-computed tomography (µCT), histology, and histomorphometry. The quantitative outcome data suggest that E1001(1k) + CP scaffolds with rhBMP-2 were biocompatible and promoted bone regeneration in segmental bone defects. Histological examination of the implant sites showed that scaffolds made of E1001(1k) + CP did not elicit adverse cellular or tissue responses throughout test periods up to 8 weeks. Noteworthy is that the incorporation of a very small amount of rhBMP-2 into the scaffolds (as low as 17 µg/defect site) promoted significant bone regeneration compared to scaffolds consisting of E1001(1k) + CP alone. This finding indicates that E1001(1k) + CP may be an effective platform for bone regeneration in a critical size rabbit radius segmental defect model, requiring only a minimal dose of rhBMP-2.

Next-generation resorbable polymer scaffolds with surface-precipitated calcium phosphate coatings.

Next-generation synthetic bone graft therapies will most likely be composed of resorbable polymers in combination with bioactive components. In this article, we continue our exploration of E1001(1k), a tyrosine-derived polycarbonate, as an orthopedic implant material. Specifically, we use E1001(1k), which is degradable, nontoxic, and osteoconductive, to fabricate porous bone regeneration scaffolds that were enhanced by two different types of calcium phosphate (CP) coatings: in one case, pure dicalcium phosphate dihydrate was precipitated on the scaffold surface and throughout its porous structure (E1001(1k) + CP). In the other case, bone matrix minerals (BMM) such as zinc, manganese and fluoride were co-precipitated within the dicalcium phosphate dihydrate coating (E1001(1k) + BMM). These scaffold compositions were compared against each other and against ChronOS (Synthes USA, West Chester, PA, USA), a clinically used bone graft substitute (BGS), which served as the positive control in our experimental design. This BGS is composed of poly(lactide co-ε-caprolactone) and beta-tricalcium phosphate. We used the established rabbit calvaria critical-sized defect model to determine bone regeneration within the defect for each of the three scaffold compositions. New bone formation was determined after 2, 4, 6, 8 and 12 weeks by micro-computerized tomography (µCT) and histology. The experimental tyrosine-derived polycarbonate, enhanced with dicalcium phosphate dihydrate, E1001(1k) + CP, supported significant bone formation within the defects and was superior to the same scaffold containing a mix of BMM, E1001(1k) + BMM. The comparison with the commercially available BGS was complicated by the large variability in bone formation observed for the laboratory preparations of E1001(1k) scaffolds. At all time points, there was a trend for E1001(1k) + CP to be superior to the commercial BGS. However, only at the 6-week time point did this trend reach statistical significance. Detailed analysis of the µCT data suggested an increase in bone formation from 2 through 12 weeks in implant sites treated with E1001(1k) + CP. At 2 and 4 weeks post-implantation, bone formation occurred at the interface where the E1001(1k) + CP scaffold was in contact with the bone borders of the implant site. Thereafter, during weeks 6, 8 and 12 bone formation progressed throughout the E1001(1k) + CP test implants. This trend was not observed with E1001(1k) + BMM scaffolds or the clinically used BGS. Our results suggest that E1001(1k) + CP should be tested further for osteoregenerative applications.

Methods to analyze bone regenerative response to different rhBMP-2 doses in rabbit craniofacial defects.

Multiple assessment methods are available to evaluate the performance of engineered scaffolds in accepted bone healing animal models. Evaluation and comparison of these methods can aid in the planning of future animal studies, as well as, inform clinical assessments as the engineered scaffolds translate into clinical studies and applications. To evaluate multiple bone assessment techniques, bone regrowth potential of tyrosine-derived polycarbonate (TyrPC) scaffolds loaded with various dosages of recombinant human bone morphogenetic protein-2 (rhBMP-2) (0, 10, 25, and 50 µg) was assessed after 16 weeks in vivo in a rabbit calvarial model. Traditional X-ray radiography and micro-computed tomography (micro-CT) analyses were used to quantify the volume and density of regenerated bone. Histomorphometric analysis was performed as the traditional gold standard of evaluation. While these techniques are fairly standard in bone tissue engineering, we also investigated 64-slice CT, a tool more commonly used clinically, for comparison and to guide translational efforts. The 64-slice CT scans were carried out at 4 and 16 weeks to monitor temporal bone healing patterns. Study results indicated a clear dose-dependent response of increasing regenerated bone volume with rhBMP-2 loaded on the TyrPC scaffolds after 16 weeks of implantation. Significantly more bone formation was observed at the highest dose of rhBMP-2 (50 µg), which is 25-50% of the previously recommended dose (100-200 µg) for this defect. A significant difference was observed between the lowest and highest doses using radiographs (p<0.001), micro-CT (p=0.002), and CT (p<0.001) and a high correlation was found between techniques (R(2) values between 0.446 and 0.911). It was found that the number of animals required per group to detect significant dose effects ranged between 6 and 8 for the imaging methods while histomorphometric analysis would require 25 animals per group to detect similar differences (desired power=0.9, α=0.05). Radiographic analysis provided quantifiable % defect coverage and radio-opacity, micro-CT provided spatial volumetric and bone density measures, histomorphometry provided biological confirmation, and 64-slice CT allowed for establishing of clinically relevant translational guidelines. These methodologies allow for a standardized and comprehensive description of bone regeneration and provide guidelines for the planning of future preclinical and clinical studies.

A cell culture system for the structure and hydrogel properties of basement membranes; Application to capillary walls.

In specialized capillary beds such as the kidney glomerulus, the sheet-like structure of the basement membrane in conjunction with opposing monolayers of endothelium and epithelium form the functioning filtration unit of the kidney. Using a novel cross-linking method on a collagen substrate, we have created a novel hydrogel scaffold to substitute for the basement membrane. Using a simple casting method to create thin films of the hydrogel scaffold (1-5µm), the scaffolds were suitable for long-term static culture, and supported cell attachment and long term cell viability similar to a standard type I collagen substrate. Bulk diffusion and protein permeability of the hydrogel scaffold were evaluated, in addition to its use in a perfusion chamber where it withstood hydraulic pressures typical for glomerular capillaries. This system thus provided a suitable cell substrate for the co-culture of renal epithelial podocytes and endothelial cells in a device that replicates the geometry of the in vivo juxtaposition of the two cell types in relation to their basement membrane.

Bone regeneration in a rabbit critical-sized calvarial model using tyrosine-derived polycarbonate scaffolds.

Porous three-dimensional tyrosine-derived polycarbonate (TyrPC) scaffolds with a bimodal pore distribution were fabricated to mimic bone architecture using a combination of salt-leaching and phase separation techniques. TyrPC scaffolds degraded in register with bone regeneration during the 6-week study period and compressive moduli of the scaffolds were maintained >0.5 MPa at 6 weeks of incubation in PBS at 37 °C. The TyrPC scaffolds either unsupplemented or supplemented with recombinant human bone morphogenetic protein-2 (rhBMP-2) were implanted in a rabbit calvarial critical-sized defect (CSD) model and the TyrPC scaffolds treated with rhBMP-2 or TyrPC coated with calcium phosphate scaffold alone promoted bone regeneration in a rabbit calvarial CSD at 6 weeks postimplantation. A synthetic TyrPC polymeric scaffold either without a biological supplement or with a minimal dose of rhBMP-2 induced bone regeneration comparable to a commercially available bone graft substitute in a nonrodent CSD animal model.

Osteogenic differentiation of pre-osteoblasts on biomimetic tyrosine-derived polycarbonate scaffolds.

The osteogenic potential of biomimetic tyrosine-derived polycarbonate (TyrPC) scaffolds containing either an ethyl ester or a methyl ester group combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) was assessed using the preosteoblast cell line MC3T3-E1. Each composition of TyrPC was fabricated into 3D porous scaffolds with a bimodal pore distribution of micropores <20 µm and macropores between 200 and 400 µm. Scanning electron microscopy (SEM) characterization suggested MC3T3-E1 cell attachment on the TyrPC scaffold surface. Moreover, the 3D TyrPC-containing ethyl ester side chains supported osteogenic lineage progression, alkaline phosphatase (ALP), and osteocalcin (OCN) expression as well as an increase in calcium content compared with the scaffolds containing the methyl ester group. The release profiles of rhBMP-2 from the 3D TyrPC scaffolds by 15 days suggested a biphasic rhBMP-2 release. There was no significant difference in bioactivity between rhBMP-2 releasate from the scaffolds and exogenous rhBMP-2. Lastly, the TyrPC containing rhBMP-2 promoted more ALP activity and mineralization of MC3T3-E1 cells compared with TyrPC without rhBMP-2. Consequently, the data strongly suggest that TyrPC scaffolds will provide a highly useful platform for bone tissue engineering.

Age-related differences in human skin proteoglycans.

Previous work has shown that versican, decorin and a catabolic fragment of decorin, termed decorunt, are the most abundant proteoglycans in human skin. Further analysis of versican indicates that four major core protein species are present in human skin at all ages examined from fetal to adult. Two of these are identified as the V0 and V1 isoforms, with the latter predominating. The other two species are catabolic fragments of V0 and V1, which have the amino acid sequence DPEAAE as their carboxyl terminus. Although the core proteins of human skin versican show no major age-related differences, the glycosaminoglycans (GAGs) of adult skin versican are smaller in size and show differences in their sulfation pattern relative to those in fetal skin versican. In contrast to human skin versican, human skin decorin shows minimal age-related differences in its sulfation pattern, although, like versican, the GAGs of adult skin decorin are smaller than those of fetal skin decorin. Analysis of the catabolic fragments of decorin from adult skin reveals the presence of other fragments in addition to decorunt, although the core proteins of these additional decorin catabolic fragments have not been identified. Thus, versican and decorin of human skin show age-related differences, versican primarily in the size and the sulfation pattern of its GAGs and decorin in the size of its GAGs. The catabolic fragments of versican are detected at all ages examined, but appear to be in lower abundance in adult skin compared with fetal skin. In contrast, the catabolic fragments of decorin are present in adult skin, but are virtually absent from fetal skin. Taken together, these data suggest that there are age-related differences in the catabolism of proteoglycans in human skin. These age-related differences in proteoglycan patterns and catabolism may play a role in the age-related changes in the physical properties and injury response of human skin.

Synthesis and characterization of tyramine-based hyaluronan hydrogels.

Hyaluronan is particularly attractive for tissue engineering and repair because it: (1) is a normal component of the extracellular matrices of most mammalian tissues; (2) contributes to the biological and physical functions of these tissues; and (3) possesses excellent biocompatibility and physiochemical properties. In the present study, we characterize a two-step enzymatic cross-linking chemistry for production of tyramine-based hyaluronan hydrogels using fluorophore-assisted carbohydrate electrophoresis, enzymatic digestion, and spectroscopy including absorbance, fluorescence and (1)H NMR. Substitution on hyaluronan of tyramine and other adducts from unproductive side reactions depends on the molar ratio of tyramine to carbodiimide used during the substitution (step 1) reaction. Results indicate that relatively low tyramine substitution is required to form stable hydrogels, leaving the majority of hyaluronan disaccharides unmodified. Sufficient native HA structure is maintained to allow recognition and binding by b-HABP, a HA binding complex typically found in normal cartilage biology. Hydrogels were formed from tyramine-substituted hyaluronan through a peroxidase-dependent cross-linking (step 2) reaction at hyaluronan concentrations of 2.5 mg/ml and above. Uncross-linked tyramine-substituted hyaluronan was characterized after hyaluronidase SD digestion. Cross-linked hydrogels showed increased resistance to digestion by testicular hyaluronidase and hyaluronidase SD with increasing hyaluronan concentration. Cells directly encapsulated within the hydrogels during hydrogel cross-linking remained metabolically active during 7 days of culture similar to cells cultured in monolayer.

Glucose utilization by the retinal pigment epithelium: evidence for rapid uptake and storage in glycogen, followed by glycogen utilization.

Glucose utilization and glycogen metabolism by human retinal pigment epithelium (RPE) cultures with high transepithelial resistance maintained on porous Millicell polycarbonate filters, were quantified by fluorophore-assisted carbohydrate electrophoresis (FACE). Glucose uptake was more efficient at the apical surface of the RPE. The utilization of glucose when restricted to either the apical or basal medium was also evaluated. Under both conditions, glucose was quickly transported to the opposite compartment and rapidly utilized. However, glucose from the apical compartment was depleted to a greater extent than from the basal compartment. The de novo synthesis and accumulation of glycogen accompanied glucose utilization. This was paralleled by a concomitant increase in lysosomal glycogen degradation measured as an increase in cell-associated maltodextrins. The highest levels of glucose in glycogen and maltodextrins occurred at 24 h, declining to basal levels at 72 h. Glucose transporter expression in the RPE cultures was evaluated with the reverse transcriptase-polymerase chain reaction. Glucose transporter-1 (GLUT 1) was the isoform expressed in these cells. GLUT 1 localization was determined by immunocytochemistry. GLUT 1 localizes to the apical and basolateral border of the RPE. The intensity of fluorescence was higher on the apical border. The rapid depletion of medium glucose suggests that RPE culture studies should replenish medium glucose more frequently than every 72 h to maintain physiologically relevant glucose concentrations. These studies are the first to demonstrate glucose, glycogen and maltodextrin metabolism by RPE cells, and their detection and quantitation by FACE.

A novel technique for functional mitral regurgitation therapy: mitral annular remodeling.

BACKGROUND: Functional mitral regurgitation (AIR) plays a pivotal role in the pathophysiology of congestive heart failure, a major cause of cardiac morbidity and mortality. We have developed a mitral annular remodeling procedure through injection of a nonabsorbable substance into the peri-annular tissue of the posterior mitral annulus to reduce the mitral annular dimension in the septal-lateral axis. The purpose of this study is to describe a novel procedure for treatment of functional AIR and report its effects on the geometry of the mitral annulus and degree of AIR. METHODS: Seven preliminary studies were performed using an epicardial approach in a healthy dog model to establish the feasibility of this injection procedure. Unexpectedly, 2 of 7 healthy dogs had a functional AIR of grade 1 to 2+. In these 2 cases, the hemodynamic, angiographic, and echocardiographic assessments were conducted. RESULTS: A nonabsorbable substance injection was successfully performed on a beating heart without instability of hemodynamics or any evidence of myocardial ischemia in all 7 dogs. In the 2 dogs with a functional AIR, it was confirmed that the septal-lateral dimension decreased from 3.2 +/- 0.2 to 2.6 +/- 0.5 cm and the observed MR was reduced (AIR area from 1.2 +/-0.1 to 0 cm2) without any adverse effects on hemodynamics or coronary circulation (circumflex artery flow, 36.5 +/- 0.4 to 40.5 +/- 0.1 mL/min). CONCLUSION: Off-pump mitral annular remodeling through substance injection may be one procedural option for treatment of functional AIR.

CS-4,6 is differentially upregulated in glial scar and is a potent inhibitor of neurite extension.

The precise contribution of different CS-GAGs to CSPG-mediated inhibition of axonal growth after CNS injury is unknown. Quantification of the CS-GAGs in uninjured and injured brain (scar tissue) using fluorophore-assisted carbohydrate electrophoresis (FACE) demonstrated that the dominant CS-GAG in the uninjured brain is CS-4 whereas, in glial scar, CS-2, CS-6, and CS-4,6 were over-expressed. To determine if the pattern of sulfation influenced neurite extension, we compared the effects of CS-GAGs with dominant CS-4, CS-6, or CS-4,6 sulfation to intact CSPG (aggrecan), chondroitin (CS-0), and hyaluronan on chick DRG neurite outgrowth. We report that CS-4,6 GAG, one of the upregulated CS-GAGs in astroglial scar, is potently inhibitory and is comparable to intact aggrecan, a CSPG with known inhibitory properties. Thus, a specific CS-GAG that is differentially over-expressed in astroglial scar is a potent inhibitor of neurite extension. These results may influence the design of more specific strategies to enhance CNS regeneration after injury.