Indocyanine green and iohexol loaded hydroxyapatite in poly(L-lactide-co-caprolactone)-based composite for bimodal near-infrared fluorescence- and X-ray-based imaging.

This study aimed to develop material for multimodal imaging by means of X-ray and near-infrared containing FDA- and EMA-approved iohexol and indocyanine green (ICG). The mentioned contrast agents (CAs) are hydrophilic and amphiphilic, respectively, which creates difficulties in fabrication of functional polymeric composites for fiducial markers (FMs) with usage thereof. Therefore, this study exploited for the first time the possibility of enhancing the radiopacity and introduction of the NIR fluorescence of FMs by adsorption of the CAs on hydroxyapatite (HAp) nanoparticles. The particles were embedded in the poly(L-lactide-co-caprolactone) (P[LAcoCL]) matrix resulting in the composite material for bimodal near-infrared fluorescence- and X-ray-based imaging. The applied method of material preparation provided homogenous distribution of both CAs with high iohexol loading efficiency and improved fluorescence signal due to hindered ICG aggregation. The material possessed profound contrasting properties for both imaging modalities. Its stability was evaluated during in vitro experiments in phosphate-buffered saline (PBS) and foetal bovine serum (FBS) solutions. The addition of HAp nanoparticles had significant effect on the fluorescence signal. The X-ray radiopacity was stable within minimum 11 weeks, even though the addition of ICG contributed to a faster release of iohexol. The stiffness of the material was not affected by iohexol or ICG, but incorporation of HAp nanoparticles elevated the values of bending modulus by approximately 70%. Moreover, the performed cell study revealed that all tested materials were not cytotoxic. Thus, the developed material can be successfully used for fabrication of FMs.

Development of three-dimensionally printed vascular stents of bioresorbable poly(l-lactide-co-caprolactone).

With the ripening of 3D printing technology and the discovery of a variety of printable materials, 3D-printed vascular stents provide new treatment options for patients with angiocardiopathy. Bioresorbable stent not only combines the advantages of metallic stent and drug-coated balloon, but also avoids the disadvantages of them. 3D printing is also an economical and efficient way to produce stents and makes it possible to construct complex structures. In this study, stents made from poly(l-lactic acid) (PLLA), poly(ε-caprolactone) (PCL) and poly(l-lactide-co-caprolactone) (PLCL) were manufactured by 3D printing and evaluated for radial strength, crystallinity and molecular weight. PLCL copolymerized by different proportions of lactic acid and caprolactone showed different mechanical and degradation properties. This demonstrated the potential of 3D printing as a low-cost and high throughput method for stent manufacturing. The PLLA and PLCL 95/5 stents had similar mechanical properties, whereas PLCL 85/15 and PCL stents both had relatively low radial strength. In general, PLCL 95/5 had a faster degradation rate than PLLA. These two materials were made into peripheral vascular bioresorbable scaffolds (BRS) and further studied by additional bench testing. PLCL 95/5 peripheral BRS had superior mechanical properties in terms of flexural/bending fatigue and compression resistance.

Effect of Degradation in Small Intestinal Fluids on Mechanical Properties of Polycaprolactone and Poly-l-lactide-co-caprolactone.

Polycaprolactone and poly-l-lactide-co-caprolactone are promising degradable biomaterials for many medical applications. Their mechanical properties, especially a low elastic modulus, make them particularly interesting for implantable devices and scaffolds that target soft tissues like the small intestine. However, the specific environment and mechanical loading in the intestinal lumen pose harsh boundary conditions on the design of these devices, and little is known about the degradation of those mechanical properties in small intestinal fluids. Here, we perform tensile tests on injection molded samples of both polymers during in vitro degradation of up to 70 days in human intestinal fluids. We report on yield stress, Young's modulus, elongation at break and viscoelastic parameters describing both materials at regular time steps during the degradation. These characteristics are bench-marked against degradation studies of the same materials in other media. As a result, we offer time dependent mechanical properties that can be readily used for the development of medical devices that operate in the small intestine.

Preclinical animal study of electrospun poly (l-lactide-co-caprolactone) and formulated porcine fibrinogen for full-thickness diabetic wound regeneration.

Diabetic foot ulcer is one of the most serious chronic complications of diabetes mellitus. It may lead to amputation of the lower extremities for diabetics. Our study was to evaluate the effect of electrospun poly (L-lactide-co-caprolactone) and formulated porcine fibrinogen (PLCL/Fg) wound dressing on animal wound model. A blend ratio of PLCL/Fg scaffold was 4 (PLCL):1 (Fg). The scanning electron microscopy findings showed that the fibers' diameter was 122.5 ± 80.3 nm, and the tensile strength was 9.2 ± 0.2 MPa. In-vivo study of the hog normal model demonstrated that PLCL/Fg dressing had better biocompatibility, degradability, and ability to restore the skin's normal structure. We evaluated the wound healing processes in the rat diabetic model by macroscopic observation and histological observation at 1, 2, and 3 post-operation weeks. In our study, the PLCL/Fg group performed better 3 weeks after surgery, in terms of macroscopic healing and scarring. After surgery, the PLCL/Fg group showed better fibroblast accumulation, tissue granulation, and collagen expression than the control group. Topical treatment with PLCL/Fg dressing effectively enhanced wound healing in both normal and hyperglycemic conditions, suggesting that it may possess wound-healing potential.

Characterization of Biological Properties of Dental Pulp Stem Cells Grown on an Electrospun Poly(l-lactide-co-caprolactone) Scaffold.

Poly(l-lactide-co-caprolactone) (PLCL) electrospun scaffolds with seeded stem cells have drawn great interest in tissue engineering. This study investigated the biological behavior of human dental pulp stem cells (hDPSCs) grown on a hydrolytically-modified PLCL nanofiber scaffold. The hDPSCs were seeded on PLCL, and their biological features such as viability, proliferation, adhesion, population doubling time, the immunophenotype of hDPSCs and osteogenic differentiation capacity were evaluated on scaffolds. The results showed that the PLCL scaffold significantly supported hDPSC viability/proliferation. The hDPSCs adhesion rate and spreading onto PLCL increased with time of culture. hDPSCs were able to migrate inside the PLCL electrospun scaffold after 7 days of seeding. No differences in morphology and immunophenotype of hDPSCs grown on PLCL and in flasks were observed. The mRNA levels of bone-related genes and their proteins were significantly higher in hDPSCs after osteogenic differentiation on PLCL compared with undifferentiated hDPSCs on PLCL. These results showed that the mechanical properties of a modified PLCL mat provide an appropriate environment that supports hDPSCs attachment, proliferation, migration and their osteogenic differentiation on the PLCL scaffold. The good PLCL biocompatibility with dental pulp stem cells indicates that this mat may be applied in designing a bioactive hDPSCs/PLCL construct for bone tissue engineering.

Synthesis and Characterization of PU/PLCL/CMCS Electrospun Scaffolds for Skin Tissue Engineering.

As tissue regeneration material, electrospun fibers can mimic the microscale and nanoscale structure of the natural extracellular matrix (ECM), which provides a basis for cell growth and achieves organic integration with surrounding tissues. At present, the challenge for researchers is to develop a bionic scaffold for the regeneration of the wound area. In this paper, polyurethane (PU) is a working basis for the subsequent construction of tissue-engineered skin. poly(L-lactide-co-caprolactone) (PLCL)/carboxymethyl chitosan (CMCS) composite fibers were prepared via electrospinning and cross-linked by glutaraldehyde. The effect of CMCS content on the surface morphology, mechanical properties, hydrophilicity, swelling degree, and cytocompatibility were explored, aiming to assess the possibility of composite scaffolds for tissue engineering applications. The results showed that randomly arranged electrospun fibers presented a smooth surface. All scaffolds exhibited sufficient tensile strength (5.30-5.60 MPa), Young's modulus (2.62-4.29 MPa), and swelling degree for wound treatment. The addition of CMCS improved the hydrophilicity and cytocompatibility of the scaffolds.

The effect of blending poly (l-lactic acid) on in vivo performance of 3D-printed poly(l-lactide-co-caprolactone)/PLLA scaffolds.

Blending poly (l-lactic acid, PLLA) with poly (l-lactide-co-caprolactone, PLCL) is an effective strategy for developing new PLCL/PLLA blend based biomaterials. However, the effect of PLLA on in vivo performance of PLCL/PLLA blends is unclear yet. To address this issue, in this study, the effect of PLLA on in vivo biodegradability and biocompatibility of 3D-printed scaffolds of PLCL/PLLA blend was investigated. Three kinds of different 3D-printed PLCL/PLLA scaffolds using different blends with different mass ratios of the polymers, were prepared and implanted subcutaneously. The shrinkage and tissue responses were monitored by ultrasonography after the implantation. 2 months post-operation, the in vivo performances of the scaffolds were investigated histologically. All scaffolds showed good biocompatibility and allowed fast tissues ingrowth, however PLCL50/PLLA50 scaffold with the highest PLLA ratio induced the thickest the fibrous capsule surrounding the scaffolds and highest inflammatory scores. Furthermore, it was found that the fine porous structures of all scaffolds were well maintained, indicating the 3D-printed scaffolds were degraded through a surface erosion but not bulk erosion way. However, different scaffolds showed different shrinkage and degradation ratios, and PLCL50/PLLA50 scaffold resulted in a significant shrinkage, while PLCL90/PLLA10 scaffold showed the better structural stability. Therefore, PLLA at blending different ratio had different effects on the in vivo performance of 3D-printed PLCL/PLLA scaffolds. Particularly, PLCL/PLLA scaffolds blending with low ratio of PLLA, such as PLCL90/PLLA10 scaffold showed better application potential in tissue engineering. Our findings provide a new insight on the rational design, constrcution and application of the 3D-printed PLCL/PLLA scaffolds.

Reconstruction of abdominal wall with scaffolds of electrospun poly (l-lactide-co caprolactone) and porcine fibrinogen: An experimental study in the canine.

BACKGROUND: The use of permanent synthetic materials for abdominal wall repair is currently the method of choice. However, they are not ideal as short-term and long-term complications have been reported for these materials including chronic groin pain (pain that lasted longer than 3 months), which occurred in 10-12% of patients, and host immunological responses to foreign body grafts. In the present randomized paired study we compared an electrospun composite scaffold composed of poly (l-lactide-co-caprolactone) [PLCL] blended with porcine fibrinogen (F-Fg) (PLCL/F-Fg), with a polypropylene mesh (PPM) as the control in a canine abdominal wall defect model (in 36 Beagle dogs). RESULTS: A blend ratio of 4:1 PLCL: F-Fg1 scaffold possessed optimal physical characteristics including shrinkage rate, mechanical strength, porosity and super-hydrophilic properties. Macroscopic, histological and biomechanical evaluations were performed over a period of 36 weeks and the results indicated that the resorbable PLCL/F-Fg1 electrospinning scaffold could effectively induce and augment abdominal skeletal muscle regeneration. The degradation rate of the PLCL/F-Fg1 scaffold and the rate of new tissue growth reached a balance and the biomechanical strength returned to baseline within 2 weeks of implantation. The immunohistological data demonstrated the presence of regenerated skeletal muscle tissue for PLCL/F-Fg1 scaffolds, whereas the PPM exhibited dense fibrous encapsulation along the perimeter of the mesh. CONCLUSIONS: The data provides the foundation for future clinical applications of PLCL/F-Fg1 composite scaffolds for reconstructive surgery of abdominal wall defects.

Leptin-Induced Angiogenesis of EA.Hy926 Endothelial Cells via the Akt and Wnt Signaling Pathways In Vitro and In Vivo.

Angiogenesis involves the activation of endothelial cells followed by capillary formation. Leptin, the protein product of the ob gene, can induce the angiogenic potential of endothelial cells. However, the underlying cellular mechanism still remains to be elicited. We firstly evaluated the in vitro effects of leptin on proliferation and angiogenic differentiation of endothelial cell line EA.hy926. Leptin was found to potently induced cell proliferation, expression of angiogenic gene, migration and tube formation. Then we investigated the roles of the Akt and Wnt signaling pathways in the aforementioned processes. It showed that Akt and Wnt signaling pathways could be activated by leptin, while inhibition of the Akt and Wnt signaling pathways by siRNAs effectively blocked the leptin-induced angiogenesis. Finally, we used electrospinning to fabricated leptin-immobilized linear poly(L-lactide-co-caprolactone) (PLCL)-leptin. The in vivo vessel formation of PLCL-leptin was evaluated using subcutaneous implants in Sprague-Dawley rats. The histological and immunofluorescence revealed that cell infiltration with PLCL-leptin was much more significant than that with the control PLCL group. More importantly, the number of laminin+ vessels and CD31+ cells in PLCL-leptin grafts was significantly higher than in control grafts. The study demonstrated that it is via Akt and Wnt signaling pathways that leptin promotes the proliferation and angiogenic differentiation of endothelial cells and the capacity of endogenous tissue regeneration makes the novel leptin-conjugated PLCL promising materials for grafts.

A Fibrous Hybrid Patch Couples Cell-Derived Matrix and Poly(l-lactide-co-caprolactone) for Endothelial Cells Delivery and Skin Wound Repair.

Skin wound healing is an intricate orchestration that involves different cell types, an extracellular matrix (ECM), cytokines, and growth factors. On the basis of the great benefits of cell-derived ECM in regenerative applications, here we propose an electrospun fibrous membrane that combines poly(l-lactide-co-caprolactone) (PLCL) and human fibroblast-derived ECM (hFDM). hFDM-deposited PLCL (hFDM-PLCL) was obtained via decellularization of a confluent layer of fibroblasts cultivated on PLCL. An organized assembly of fibrillar structure on hFDM-PLCL was notable via immunostaining. As human umbilical vein endothelial cells (HUVECs) were seeded on the hFDM-PLCL, they proliferated faster and exhibited more elongated, capillary-like morphology than those on PLCL or fibronectin-coated PLCL (Fn-PLCL). HUVECs have a relatively large aspect ratio, spreading area, and vinculin-positive area per cell on the fibrillary structure of hFDM-PLCL. In addition, transwell cell migration assay showed the chemoattractant effect of hFDM for HUVECs and human dermal fibroblasts. Furthermore, HUVECs-loaded hFDM-PLCL membranes showed the most promising therapeutic effects on a mouse skin wound model as proved via the wound closure rate, neovascularization effect, regenerated epidermis, and skin appendage. This study shows that biodegradable PLCL fibers not only support the weak mechanical properties of hFDM but also allow hFDM to reserve ECM macromolecules and to maintain structural integrity. Current results also demonstrate the critical role of hFDM with biochemical and biophysical cues on HUVECs adhesion, proliferation, and vascular morphogenesis in vitro and even on the wound healing process in vivo. Taken together, hFDM-functionalized PLCL patch should be a promising platform for cell delivery and regenerative applications.

Mesenchymal stem cell interacted with PLCL braided scaffold coated with poly-l-lysine/hyaluronic acid for ligament tissue engineering.

The challenge of finding an adapted scaffold for ligament tissue engineering remains unsolved after years of researches. A technology to fabricate a multilayer braided scaffold with flexible and elastic poly (l-lactide-co-caprolactone) (PLCL 85/15) has been recently pioneered by our team. In this study, polyelectrolyte multilayer films (PEM) with poly-l-lysine (PLL)/ hyaluronic acid (HA) were deposited on this scaffold. After PEM modification, polygonal (PLL) and particle-like (HA) structures were present on the braided scaffold with no significant variation of fibers Young's modulus. Wharton's jelly mesenchymal stem cells (WJ-MSC) and bone marrow mesenchymal stem cells (BM-MSC) showed good metabolic activity on scaffolds. They presented a spindled shape along the fiber longitudinal direction, and crossed the fibers to form cell bridges. Collagen type I, collagen type III, and tenascin-C secreted by MSCs were detected on day 14. Moreover, one-layer modified scaffold presented increased chemotaxis. As a conclusion, our results indicate that this braided PLCL scaffold with one-layer PEM modification shows inspiring potential with satisfying mechanical properties and biocompatibility. It opens new perspectives to incorporate growth factors within PEM-modified braided PLCL scaffold for ligament tissue engineering and to recruit endogenous cells after implantation. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 3042-3052, 2018.

Preclinical animal study and human clinical trial data of co-electrospun poly(L-lactide-co-caprolactone) and fibrinogen mesh for anterior pelvic floor reconstruction.

Synthetic and biological materials are commonly used for pelvic floor reconstruction. In this study, host tissue response and biomechanical properties of mesh fabricated from co-electrospun poly(L-lactide-co-caprolactone) (PLCL) and fibrinogen (Fg) were compared with those of polypropylene mesh (PPM) in a canine abdominal defect model. Macroscopic, microscopic, histological, and biomechanical evaluations were performed over a 24-week period. The results showed that PLCL/Fg mesh had similar host tissue responses but better initial vascularization and graft site tissue organization than PPM. The efficacy of the PLCL/Fg mesh was further examined in human pelvic floor reconstruction. Operation time, intraoperative blood loss, and pelvic organ prolapse quantification during 6-month follow-up were compared for patients receiving PLCL/Fg mesh versus PPM. According to the pelvic organ prolapse quantification scores, the anterior vaginal wall 3 cm proximal to the hymen point (Aa point), most distal edge of the cervix or vaginal cuff scar point (C point), and posterior fornix point (D point) showed significant improvement (P<0.01) at 1, 3, and 6 months for both groups compared with preoperatively. At 6 months, improvements at the Aa point in the PLCL/Fg group were significantly more (P<0.005) than the PPM group, indicating that, while both materials improve the patient symptoms, PLCL/Fg mesh resulted in more obvious improvement.

An in vitro study of composites of poly(L-lactide-co-ε-caprolactone), ß-tricalcium phosphate and ciprofloxacin intended for local treatment of osteomyelitis.

Osteomyelitis is a bacterial disease that can become chronic, and treatment often includes a surgical operation to remove infected bone. The aim of this study was to develop and investigate in vitro bone filling composite materials that release ciprofloxacin to kill any remaining bacteria and contain bioceramic to help the bone to heal. Three composites of poly(L-lactide-co-ε-caprolactone), ß-tricalcium phosphate and ciprofloxacin were compounded using twin-screw extrusion and sterilized by gamma irradiation. Drug release and degradation of the composites were investigated in vitro for 52 weeks. The composite with 50 wt% of ß-TCP had the most promising ciprofloxacin release profile. The ceramic component accelerated the drug release that occurred in three phases obeying first-order kinetics. Inhibition zone testing using bioluminescence showed that the released ciprofloxacin had effect in eradicating a common osteomyelitis causing bacteria Pseudomonas aeruginosa. During the in vitro degradation test series, molar weight of the polymer matrix of the composites decreased rapidly. Additionally, (1)H-NMR analysis showed that the polymer had blocky structure and the comonomer ratio changed during hydrolysis. The tested composites showed great potential to be developed into bone filler materials for the treatment of osteomyelitis or other bone related infections.

Processing and sustained in vitro release of rifampicin containing composites to enhance the treatment of osteomyelitis.

The objective in this study was to develop an osteoconductive, biodegradable and rifampicin releasing bone filling composite material for the treatment of osteomyelitis, a bacterial infection of bone that is very difficult and expensive to treat. The composite material will be used together with a ciprofloxacin releasing composite, because of the rapid development of resistant bacteria when rifampicin is used alone. Three composites were manufactured by twin-screw extrusion. The polymer matrix for the composites was poly(L-lactide-co-ε-caprolactone) 70/30 and all the composites contained 8 wt% (weight percent) of rifampicin antibiotic. The ß-TCP contents of the composites were 0 wt%, 50 wt% and 60 wt%. The composites were sterilized by gamma irradiation before in vitro degradation and drug release tests. The hydrolytical degradation of the studied composites proceeded quickly and the molecular weight of the polymer component of the composites decreased rapidly. Rifampicin release occurred in four phases in which the high ß-TCP content of the samples, polymer degradation and mass loss all played a role in determining the phases. The ceramic component was seen to have a positive effect on the drug release. The composite with 50 wt% of ß-TCP showed the most promising rifampicin release profile and it also showed activity against a common osteomyelitis causing bacteria Pseudomonas aeruginosa. A clear inhibition zone was formed in 16 h incubation. Overall, the tested materials showed great potential to be developed into a bone filler material for the treatment of osteomyelitis or other bone related infections in combination with the ciprofloxacin releasing materials.