Exosome-Functionalized Ceramic Bone Substitute Promotes Critical-Sized Bone Defect Repair in Rats.

Ceramic biomaterials are promising alternatives to bone autografts. However, limited bioactivity affects their performance. Therefore, bioactive molecules and cells are often added to enhance their performance. Exosomes have emerged as cell-secreted vesicles, delivering proteins, lipids, and nucleic acids in a paracrine/endocrine fashion. We studied two complementary aspects required for exosome activity/therapy using purified exosomes: first, the intracellular uptake of labeled exosomes and second, the influence of delivered exosomes on cell behavior. Origin-specific differences in the characteristics of purified exosomes, quantification of time-dependent intracellular uptake of PKH-26-labeled exosomes by mesenchymal stem cells (MSCs) and preosteoblasts, and influence on cell behavior were evaluated. Furthermore, exosomes from osteoblasts and MSCs cultured under normal and osteogenic environments were isolated. There is little data available on the concentration and dose of exosomes required for bone regeneration. Therefore, equal amounts of quantified exosomes were implanted in vivo in rat tibia critical defects using a calcium sulfate-nano-hydroxyapatite nanocement (NC) bone filler as the carrier. Bone regeneration was quantified using micro-computed tomography and histology. Along with inducing early maturation and mineral deposition by primary preosteoblasts in vitro, exosome treatment also demonstrated a positive effect on bone mineralization in vivo. Our study concludes that providing a local delivery of exosomes loaded onto a slowly resorbing NC bone filler can provide a potential alternate to autografts as a bone substitute.

A minimally-invasive cryogel based approach for the development of human ectopic liver in a mouse model.

Human liver tissue is preferable over nonhuman liver tissue for preclinical drug screening, as the former can better predict side effects specific to humans. However, due to limited supply and ethical issues with human liver tissue, it is desirable to develop an animal model having functional human liver tissue. In this study, we have established an ectopic functional human liver tissue in a mouse model, using a minimally-invasive method. Firstly, a human liver tissue mass using HepG2 cells and poly(N-isopropylacrylamide) (PNIPAAm) incorporated poly(ethylene glycol)-alginate-gelatin (PAG) cryogel matrix was developed in vitro. It was later implanted in mouse peritoneal cavity using a 16 G needle. Viscoelastic nature along with low Young's modulus provided injectable properties to the cryogel. We confirmed minimal cell loss/death while injecting. Further, by in vivo study efficacy of both injectable and surgical implantation approaches were compared. No significant difference in terms of cell infiltration, human serum albumin (HSA) secretion and enzyme activity confirmed efficacy. This model developed using a minimally-invasive approach can overcome the limitations of surgical implantation due to its cost effective and user friendly nature.

Chitosan-Gelatin-Polypyrrole Cryogel Matrix for Stem Cell Differentiation into Neural Lineage and Sciatic Nerve Regeneration in Peripheral Nerve Injury Model.

With the advances in tissue engineering and regenerative medicine, various approaches have been developed for peripheral nerve tissue repair and regeneration. In the current study, we have synthesized a cryogel matrix from chitosan and gelatin incorporated with polypyrrole for neural tissue regeneration. The three-dimensional (3-D) cryogel matrix was fabricated to mimic the in vivo microenvironment and analyzed for stem cell differentiation. Isolated bone marrow stem cells (BMSCs) cultured on a 3-D cryogel matrix differentiated into neural lineage on the basis of scaffold properties, in a co-culture system and by treatment with the spent media of Neuro 2a cells. To validate the cell-cell contact and BMSCs differentiation, scanning electron micrography and fluorescent imaging were done, which revealed the differentiation of the BMSCs. Immunostaining and gene expression analysis showed the BMSCs differentiation in all of the three cases studied. However, BMSCs in the co-culture system showed increased neurotransmitter levels of dopamine (34%) and acetylcholine (16%) with a respective concentration of 2.04 ± 0.03 ng/mL and 15.06 ± 0.19 pg/mL. Based on these properties, an in vivo study explored the potential of the synthesized cryogel in regeneration of a 1.5 cm nerve gap in the sciatic nerve of rats for a period of 12 weeks. The biocompatibility analysis showed that the scaffold did not induce any adverse immune response. Moreover, the walking track analysis and electrophysiological and immunostaining analyses revealed enhanced sciatic nerve regeneration in comparison to the negative control group. This study reveals the regenerative potential of the cryogel matrix for peripheral nerve regeneration.

Endogenous Platelet-Rich Plasma Supplements/Augments Growth Factors Delivered via Porous Collagen-Nanohydroxyapatite Bone Substitute for Enhanced Bone Formation.

Polymer (acrylate) and ceramic bone cements are extensively used as bone void fillers and for implant fixation in orthopedics. These materials have micro- to nonporous architectures. Postimplantation, they may cause hypoxic and exothermic injuries to already compromised damage site. These materials also have limited interaction with surrounding tissue. In this work we have developed composite collagen-nanohydroxyapatite (CS) bone filler, mimicking porous architecture of trabecular bone. It was functionalized with clinically available bone active agents like bone morphogenetic protein-2 (rhBMP-2) and zoledronic acid (ZA). We investigated synergistic effects of the bone active molecules and endogenous platelet rich plasma (PRP), a source of growth factors on mineralization. Porous CS and collagen/gelatin/chiotosan polymer scaffold (SC) (without nanohydroxyapatite) were synthesized using cryogelation. PRP (10 µL) (∼5 × 106 cells), rhBMP-2 (5 µg) and ZA (10 µg) were used to functionalize scaffolds. Bone formation was evaluated at ectopic sites in abdominal pouch and 4.0 mm critical defect in tibia metaphysis of rats. Tissue mineralization was evaluated by micro-CT and histological analysis 12 weeks postimplantation. In vitro cell based studies revealed, PRP functionalization enhances osteoblast proliferation and activity on scaffolds. In vivo BMP+ZA+PRP functionalized scaffolds had higher amount (28 mm3) of mineralized tissue formation as compared to empty defect (20 mm3), suggesting that PRP can augment the osteoinductive properties of functionalized scaffolds both in vitro and in vivo. Enhanced cell infiltration and mineralization can be achieved via CS in comparison to SC, implying their use as porous bone void fillers and substitutes for autografts.

Biomimetic Photocurable Three-Dimensional Printed Nerve Guidance Channels with Aligned Cryomatrix Lumen for Peripheral Nerve Regeneration.

Repair and regeneration of critically injured peripheral nerves is one of the most challenging reconstructive surgeries. Currently available and FDA approved nerve guidance channels (NGCs) are suitable for small gap injuries, and their biological performance is inferior to that of autografts. Development of biomimetic NGCs with clinically relevant geometrical and biological characteristics such as topographical, biochemical, and haptotactic cues could offer better regeneration of the long-gap complex nerve injuries. Here, in this study, we present the development and preclinical analysis of three-dimensional (3D) printed aligned cryomatrix-filled NGCs along with nerve growth factor (NGF) (aCG + NGF) for peripheral nerve regeneration. We demonstrated the application of these aCG + NGF NGCs in the enhanced and successful regeneration of a critically injured rat sciatic nerve in comparison to random cryogel-filled NGCs, multichannel and clinically preferred hollow conduits, and the gold standard autografts. Our results indicated similar effect of the aCG + NGF NGCs viz-a-viz that of the autografts, and they not only enhanced the overall regenerated nerve physiology but could also mimic the cellular aspects of regeneration. This study emphasizes the paradigm that these biomimetic 3D printed NGCs will lead to a better functional regenerative outcome under clinical settings.

Decellularized Liver Matrix-Modified Cryogel Scaffolds as Potential Hepatocyte Carriers in Bioartificial Liver Support Systems and Implantable Liver Constructs.

Recent progress in the use of decellularized organ scaffolds as regenerative matrices for tissue engineering holds great promise in addressing the issue of donor organ shortage. Decellularization preserves the mechanical integrity, composition, and microvasculature critical for zonation of hepatocytes in the liver. Earlier studies have reported the possibility of repopulating decellularized matrices with hepatic cell lines or stem cells to improve liver regeneration. In this work, we study the versatility of the decellularized liver matrix as a substrate coating of three-dimensional cryogel scaffolds. The coated cryogels were analyzed for their ability to maintain hepatic cell growth and functionality in vitro, which was found to be significantly better than the uncoated cryogel scaffolds. The decellularized liver matrix-coated cryogel scaffolds were evaluated for their potential application as a cell-loaded bioreactor for bioartificial liver support and as an implantable liver construct. Extracorporeal connection of the coated cryogel bioreactor to a liver failure model showed improvement in liver function parameters. Additionally, offline clinical evaluation of the bioreactor using patient-derived liver failure plasma showed its efficacy in improving liver failure conditions by approximately 30-60%. Furthermore, implantation of the decellularized matrix-coated cryogel showed complete integration with the native tissue as confirmed by hematoxylin and eosin staining of tissue sections. HepG2 cells and primary human hepatocytes seeded in the coated cryogel scaffolds implanted in the liver failure model maintained functionality in terms of albumin synthesis and cytochrome P450 activity post 2 weeks of implantation. In addition, a 20-60% improvement in liver function parameters was observed post implantation. These results, put together, suggest a possibility of using the decellularized matrix-coated cryogel scaffolds for liver tissue engineering applications.

Synthesis of Yeast-Immobilized and Copper Nanoparticle-Dispersed Carbon Nanofiber-Based Diabetic Wound Dressing Material: Simultaneous Control of Glucose and Bacterial Infections.

Diabetic wounds are instantaneously prone to the bacterial infections that can delay healing process. An efficient wound dressing material is critical to a fast healing of wounds in diabetic patients. The present study focuses on the synthesis of the yeast extract (YE)-immobilized and copper (Cu) nanoparticle (NP)-dispersed carbon nanofibers (CNFs) as a potential diabetic wound dressing material. The biological assays, namely, platelet aggregation, hemolysis, cells viability, and proliferation of macrophage cells show the prepared biomaterial to be noncytotoxic. Chemical tests performed on the material show a significant consumption of glucose, whereas the antibacterial tests show the material to be efficiently inhibiting the E. coli and S. aureus strains, ascribed to the antibacterial characteristics of the immobilized YE and the dispersed Cu-NPs, respectively, in the CNFs. To analyze the in vivo wound healing property, a 1 cm circular full thickness skin wound was created in diabetic Wistar rats. The wounds with dressings showed enhanced healing rate compared to those in the control animals (without dressing). Maximum healing (wound closure) was observed in the Cu-CNF-YE (95%) group, followed by Cu-CNF (94%), activated carbon micronanofibers (ACF-CNF) (87%), and control animals with only 74% healing. The method of preparing Cu-CNF-YE metal-enzyme-fabric described in this study is facile, and the composite can be applied as an effective dressing material for diabetic wounds.

Characterisation of porous knitted titanium for replacement of intervertebral disc nucleus pulposus.

Effective restoration of human intervertebral disc degeneration is challenged by numerous limitations of the currently available spinal fusion and arthroplasty treatment strategies. Consequently, use of artificial biomaterial implant is gaining attention as a potential therapeutic strategy. Our study is aimed at investigating and characterizing a novel knitted titanium (Ti6Al4V) implant for the replacement of nucleus pulposus to treat early stages of chronic intervertebral disc degeneration. Specific knitted geometry of the scaffold with a porosity of 67.67 ± 0.824% was used to overcome tissue integration failures. Furthermore, to improve the wear resistance without impairing original mechanical strength, electro-polishing step was employed. Electro-polishing treatment changed a surface roughness from 15.22 ± 3.28 to 4.35 ± 0.87 µm without affecting its wettability which remained at 81.03 ± 8.5°. Subsequently, cellular responses of human mesenchymal stem cells (SCP1 cell line) and human primary chondrocytes were investigated which showed positive responses in terms of adherence and viability. Surface wettability was further enhanced to super hydrophilic nature by oxygen plasma treatment, which eventually caused substantial increase in the proliferation of SCP1 cells and primary chondrocytes. Our study implies that owing to scaffolds physicochemical and biocompatible properties, it could improve the clinical performance of nucleus pulposus replacement.

Mechanically tuned nanocomposite coating on titanium metal with integrated properties of biofilm inhibition, cell proliferation, and sustained drug delivery.

The clinical success of coated implants in executing biological functions inclusive of sustainable drug release and long term antibacterial activity without antibiotics is critical. To this aim, a nanohybrid of silver nanoparticles (AgNPs) cored in polyvinyl alcohol nanocapsules (Ag-PVA NCs) embedded in chitosan (CS) matrix loaded with anti-inflammatory drug naproxen was prepared. The synthesized nanohybrids that were subjected to coatings on (3-aminopropyl)triethoxysilane (APTES) treated titanium (Ti) metal exhibited dual role of excellent inhibition on biofilm formation and sustained drug release. These dual characteristics are achieved mainly based on intrinsic antibacterial property of AgNPs and differential entrapment of drug in PVA polymeric shell of AgNPs and CS matrix. The coatings also demonstrated enhanced mechanical properties with increasing inorganic filler and stress shielding on Ti metal. The biocompatibility tests involving adhesion, proliferation and differentiation of osteoblast cells demonstrated the efficacy of Ag-PVA NCs embedded in CS matrix as a suitable coating material for orthopedic applications.