BONEFILL ® block as alternative for bone substitute: a toxicological evaluation

ABSTRACT Bone substitutes based on hydroxyapatite (HA) and Bonefill® (BO - inorganic bovine bone) associated with poly(lactic-co-glycolic acid) (PLGA) (HA/PLGA and BO/PLGA) were evaluated concerning cytotoxicity, genotoxicity and mutagenicity as potential candidates for bone repair. The materials were developed and provided by Bionnovation Biomedical Products Ltda. Eluates from these bone substitutes were prepared for toxicity evaluations using eukaryotic cell cultures. HA/PLGA was used as a comparison for Bonefill®. Cell viability was evaluated by XTT assay and surviving fraction was calculated for clonogenic survival. Additionally, tail moment was used to assess genotoxicity (comet assay). The frequencies of binucleated cells with micronucleus (FBMN), micronucleus (FMN), nucleoplasmic bridges (NPBs), and nuclear buds (NBUDs) were analysed by cytokinesis-block micronucleus assay (CBMN assay). Results showed no statistical difference in cell viability compared with negative control (NC) The eluates did not promote delayed cytotoxicity whereas the surviving fraction rate for cultured cells was similar to NC. Furthermore, no genotoxicity or mutagenicity effects were observed for cultured cells with the Bonefill/PLGA and HA/PLGA eluates. In conclusion, the negative cytotoxicity, genotoxicity and mutagenicity results indicate that these bone substitutes presented interesting preliminary results as potential biomaterials for bone repair.

Role of the gene Slc11a1 and selected genotypes for minimum and maximum inflammatory reactivity in the process of alveolar bone healing in mice / Papel do gene Slc11a1 e de genótipos selecionados para mínima e máxima reatividade inflamatória no processo de reparo ósseo alveolar em camundongos

The process of alveolar bone healing can be influenced by several local and systemic factors, which include the immune system and healing related genes. However, the exact role of host inflammatory responsiveness and genetic background in bone healing process remains unclear. In this context, we evaluated the influence inflammation in alveolar bone healing taking advantage of mice strains genetically selected for maximum (AIRmax) or minimum (AIRmin) acute inflammatory response, as well AIR strains homozygous for RR/SS Slc11a1 genotypes. Experimental groups (N=5/time/group) comprised 8-week-old male or female AIRmax and AIRmin; and substrains AIRminRR, AIRminSS and AIRmaxRR and AIRmaxSS; submitted to extraction of upper right incisor and evaluated at 0, 3, 7, 14 and 21 days after upper incision extraction by micro-computed tomography (CT), histomorphometry, birefringence, immunohistochemistry and molecular (PCRArray) analysis. Initially, our results demonstrated that AIRmin mice presented an early increase (p<0.05) in bone volume, hyperdense regions, density of bone matrix and osteoblasts, increased (p<0.05) expressed of BMP4, BMP7 and RUNX2 when compared to AIRmax strain. AIRmin mice also presented lower counts of GR1+ and CD80+ cells, and higher counts of F4/80+ and CD206+ cells, in parallel with higher mRNA expression of CX3CL1, CCL5, CCR5 and ARG when compared to AIRmax animals. In late repair stages, the AIRmin strain presented a decreased (p<0.05) density of osteoclast and blood vessels than AIRmax, along lower RANKL and Catepk and higher PHEX and SOST mRNA expression, but the healing outcome at the endpoint was similar in AIRmin and AIRmax strains. When analyzed the effect of RR/SS Slc11a1 genotypes was evaluated in parallel with the influence AIRmin/AIRmax background, we initially observed that the AIRmax strain, associated with both RR and SS Slc11a1 genotypes, presented a more effective bone healing, characterized by increased (p<0.05) of bone volume and predominance of red fiber in analysis in contrast to AIRmin strains. AIRmaxRR presented increased (p<0.05) F4/80+ and decreased CD80+ e CD206+ cells count, while AIRmaxSS presented increased (p<0.05) GR1+, F4/80+ and CD80+ and decreased CD206+ cells. When the analysis was performed in order to address the influence Slc11a1 variants, AIRmaxSS strain presented a bone healing delay when compared to AIRmaxRR; characterized by decreased (p<0.05) of bone volume, trabecular number and red collagen fibers, increased (p<0.05) GR1+ and CD80+ and decreased F4/80+ and CD206+. Conversely, AIRminSS presented a more effective healing when compared with AIRminRR mice; characterized by increased (p<0.05) of bone volume, trabecular number/separation and red birefringence, increased GR1+ and decreased CD206+ cells count. In conclusion, while AIRmin and AIRmax strains presents a similar healing outcome at the endpoint, the early repair in AIRmin strain was associated with decreased presence of neutrophils and M1 macrophages, and increased M2 macrophages. Additionally, our while results showed that AIRmax inflammatory background was associated to a more effective bone healing process irrespective of the presence of RR/SS Slc11a1 genotypes, RR genotype favors the healing in AIRmax background and SS genotype was found to favor the healing in the AIRmin background.(AU)

O processo de reparo ósseo alveolar pode ser influenciado por vários fatores locais e sistêmicos, que incluem o sistema imunológico e os genes relacionados ao reparo. No entanto, o exato papel da resposta inflamatória do hospedeiro e genético background no processo de reparo ósseo ainda não está claro. Neste contexto, avaliamos a influência da inflamação no reparo óssea alveolar, em camundongos selecionadas geneticamente para uma resposta inflamatória aguda máxima (AIRmax) ou mínima (AIRmin), como também em camundongos AIR homozigoto para os alelos RR/SS do gene Slc11a1.Neste estudo foram utilizados camundongos machos e fêmeas (N=5/tempo/grupo), das linhagens selecionados para máxima e mínima (AIRmax e AIRmin) reação inflamatória, e também as sublinhagens AIRminRR, AIRminSS, AIRmaxRR e AIRmaxSS com idade aproximada de 8 semanas. Todos foram submetidos à extração do incisivo superior direito e avaliados nos períodos de 0, 3, 7, 14 e 21 dias pós extração, seguido pela análise tomografia computadorizada (CT), análise histomorfometria, análise de birrefringência, análise imuno-histoquímica e análise molecular (PCRArray). Inicialmente, nossos resultados demonstraram que a linhagem AIRmin, no período inicial, apresentou um aumento (p<0.05) no volume ósseo, nas regiões hiperdensas, na densidade de matriz óssea e osteoblastos, seguido pelo aumento (p<0.05) na expressão de BMP4, BMP7 e RUNX2 quando comparado a linhagem AIRmax. Camundongos AIRmin também apresentou uma menor contagem de células GR1+ e CD80+ e aumento da contagem de células F4/80+ e CD206+, em paralelo com aumento da expressão de mRNA de CX3CL1, CCL5, CCR5 e ARG quando comparado aos camundongos AIRmax. Nos períodos tardios, a linhagem AIRmin apresentou uma diminuição (p<0.05) na densidade de osteoclastos e vasos sanguíneos em comparação AIRmax, seguido por uma diminuição na expressão de mRNA de RANKL e Catepk e aumento de PHEX e SOST, mas o processo de reparo ósseo alveolar, no período final foi semelhante entres as linhagens AIRmin e AIRmax. Quando analisamos o efeito dos alelos RR/SS do gene Slc11a1 em paralelo com a influência do background AIRmin/AIRmax, nós inicialmente observamos que a linhagem AIRmax associada com ambos os alelos RR/SS do gene Slc11a1 apresentaram um processo de reparo mais efetivo, caracterizado pelo aumento (p<0.05) volume ósseo e predominância de fibras vermelhas em comparação com a linhagem AIRmin. Camundongos AIRmaxRR apresentaram aumento (p<0.05) na contagem de células F4/80+ e diminuição na contagem de células CD80+ e CD206+, enquanto, camundongos AIRmaxSS apresentou um aumento (p<0.05) na contagem de células GR1+, F4/80+, CD80+ e diminuição na contagem de células CD206+. Quando analisamos a influência dos alelos do gene Slc11a1, a linhagem AIRmaxSS apresentaram um atraso no reparo óssea quando comparado ao AIRmaxRR; caracterizado pela diminuição (p<0.05) do volume ósseo, número trabecular e fibras colágenas vermelhas, seguido pelo aumento (p<0.05) da contagem de células GR1+ e CD80+ e diminuição de células F4/80+ e CD206+. Por outro lado, camundongos AIRminSS apresentaram um reparo ósseo mais efetivo quando comparada com AIRminRR; caracterizada pelo aumento (p<0.05) do volume ósseo, número / separação trabecular e birrefringência das fibras colágenas no espectro vermelho, seguido pelo aumento da contagem de células GR1+ e diminuição das células CD206+. Diante disso, os nossos resultados demonstraram que as linhagens AIRmin e AIRmax apresentaram um processo de reparo ósseo alveolar semelhantes no período final do reparo, enquanto no reparo inicial a linhagem AIRmin estava associada com a diminuição de neutrófilos e macrófagos M1 e aumento dos macrófagos M2. Além disso, nossos resultados demonstraram que background AIRmax estava associado a um processo de reparo mais efetivo, independentemente da presença de genótipos RR/SS Slc11a1, o genótipo RR favorece o reparo no background AIRmax e o genótipo SS favoreceu a reparo no background AIRmin.(AU)

Evaluation of electrospun PLLA-ECM scaffolds as biomaterials for bone regeneration / Avaliação de suportes eletrofiados de PLLA-ECM para regeneração óssea

The extracellular matrix (ECM) is secreted by the host tissue and is an important key for mechanisms of cell responses. The main properties of the ECM materials include biodegradability, biocompatibility, and nanostructured in a 3D fibre network. In addition, ECM is composed of important molecules like growth factors, glycosaminoglycans (GAGs), collagens, fibronectin, and lamin, while final composition depends on the native tissue. We have selected for this study ECMs from cortical bone (B-ECM) and pericardium (P-ECM) tissue. These ECMs were digested by collagenase, pepsin and trypsin. Each of these digested ECMs was used to produce PLLA-ECM based electrospun scaffolds by two different methodologies (1) non-crosslinked (NCLK) hybrid electrospun scaffolds composed of PLLA and digested ECMs and (2) PLLA-collagen electrospun scaffolds crosslinked with digested ECMs (CLK scaffolds). This research proposes the characterization of the digestion promoted by collagenase, pepsin and trypsin on the ECMs, followed by the evaluation of the potential of the digested ECMs and of the PLLA-ECM scaffolds for bone regeneration. The proteinaceous mixture, produced from the ECM digestion, had compositions, which were dependent on the type of ECM, and on the enzymatic treatment, as shown by protein quantification, GAGs quantification, TGA, SDS-page and TPEF-SHG. All the results point to an extensive digestion caused by collagenase and pepsin and a milder digestion caused by trypsin. The digested ECMs were incorporated into nanofibrous scaffolds, and the products were characterized by SEM, TGA, DSC and TPEF-SHG. The porous nanofibrous mesh from non-crosslinked scaffolds exhibited fibres without beads and a uniform diameter. However, the crosslinked scaffolds presented non-organized agglomerates around the fibres making a less porous surface. TGA and DSC suggest the incorporation of the ECMs on the scaffolds. However, the distribution of the protein on the polymer was mostly dependent on the incorporation method, as showed by TPEF-SHG. To access the biomaterial ability for bone regeneration, bone marrow mesenchymal stem cells (BMMSCs) were cultured on the scaffolds over 21 days. Osteogenic markers such as ALP activity, mineral nodule formation by ARS staining, col1a2 immunostaining, and gene expression were analysed to access how the materials could induce BMMSCs osteodifferentiation. Comparing NCLK to CLK scaffolds the key factor for osteogenesis is the release of soluble factors, showing NCLK scaffolds with a higher ability to induce mineralization than CLK scaffolds. However, when comparing the effect of the enzymatic digestion on the mineralization of the scaffolds over the days, it is possible to establish that the effect of the enzymatic treatment is also related to the type of ECM. Despite all those differences, some PLLA-ECM scaffolds exhibited potential to induce earlier mineralization, observed by the analysis of bglap, runX2, Osx, sparc and col1a2 genes as osteogenic markers

A matriz extracelular (ECM) é secretada pela células no tecido nativo e reúne propriedades chave para respostas celulares. Entre suas principais propriedades destacam-se: biodegradabilidade, biocompatibilidade e nanoestruturada tridimensionalmente. Além disso, é rica em sinalizadores celulares tais como: fatores de crescimento, glicosaminaglicanas (GAGs), colágeno, fibronectina e laminina, no entanto sua composição depende do tecido na qual se encontra. Para este estudo, foram selecionadas ECMs provenientes de osso cortical e de pericárdio. Estas ECMs foram digeridas por colagenase, pepsina e tripsina. Cada um dos produtos de digestão foi utlizado para a produção de suportes eletrofiados de PLLA-ECM, utilizando-se dois diferentes métodos de incorporação, (1) Suportes eletrofiados híbridos de PLLA-ECM obtidos a partir da eletrofiação da co-solução em 1,1,1,3,3,3-hexafluor-2-propanol, e (2) imobilização das ECM digeridas sobre suportes eletrofiados de PLLA-colágeno. O presente trabalho propõe-se a caracterizar as ECMs digeridas e a avaliar o potencial dos suportes eletrofiados de PLLA-ECM para a regeneração óssea. A mistura proteinácea obtida a partir da digestão das ECMs, mostrou que a sua composição é dependentes do tipo de ECM e da digestão enzimática, resultado este confirmado através da quantificação de proteínas, quantificação de glicosaminoglicanas, TGA, SDS-page e TPEF-SHG. A partir destes, foi observada que a colagenase é a enzima que promove a maior degradação das ECMs, enquanto que a tripsina promove uma degradação em menor escala. As matrizes digeridas foram incorporadas no material nanoestruturado, estes foram caraterizados por SEM, TGA, DSC e TPEF-SHG. Observou-se que a malha eletrofiada a partir da co-solução de PLLA-ECM exibiu a formação de fibras de diâmetro uniforme, enquanto que os suportes imobilizados apresentaram a formação de aglomerados sólidos ao redor das fibras, originando uma malha menos porosa. As análises de TGA e DSC confirmaram a incoporação das ECMs nas malhas eletrofiadas, e através da técnica de TPEF-SHG observou-se a distribuição das proteinas no polímero. O potencial dos materiais para a regeneração óssea foi avaliado através da cultura de células tronco mesenquimais de medula óssea sobre os suportes eletrofiados durante 21 dias, e em seguida, medidas de ALP, quantificação de coloração com vermelho de alizarina, imunofluorescência com anticorpo col1a2, e expressão de gênica foram analisadas para a avaliação de como os materiais eletrofiados de PLLA-ECM induzem a osteodiferenciação. Comparando-se materiais produzidos por co-solução e os materiais imobilizados foi possível observar que a resposta osteogênica é maior nos materiais híbridos devido a liberação de fatores solúveis dos suportes eletrofiados. No entanto, comparando-se o efeito da digestão enzimática na capacidade de mineralização dos suportes , é possível observar que o efeito da digestão enzimática é dependente do tipo de ECM. Em geral, foi possível observar que os suportes eletrofiados de PLLA-ECM exibem potencial para uso em engenharia de tecidos, em específico, regeneração óssea, uma vez que apresentaram-se regulados o conjunto de genes bglap, RunX2, Osx, sparc e col1a2

Produção de suportes poliméricos para o crescimento de células-tronco mesenquimais e sua aplicação em regeneração óssea / Polymer scaffolds production for stem cell growing and their application in bone regeneration

Um novo método de modificação da superfície de nanopartículas de hidroxiapatita (HAP) por reação com cloreto de lauroíla foi desenvolvido, gerando a nanopartícula funcionalizada por laurato (HAP-CL). A superfície modificada da HAP foi confirmada por infravermelho, termogravimetria, ressonância magnética nuclear e análise elementar. Provamos por testes mecânicos a capacidade de criar compósitos com alto teor de HAP-CL em matrizes poliméricas de poli(L-acido láctico) (PLLA) e poli(succinato de isosorbídeo-b-L-lactídeo) (PLLA-co-PIS) sem perda significativa de propriedades mecânicas. Diferentes quantidades de HAP-CL, HAP enxertado com PLLA (PLLA-g-HAP) e HAP puro foram dispersadas em soluções de PLLA para formar fibras eletrofiadas. Para comparar a dispersão destas nanopartículas nas fibras e a sua morfologia, análise de microscopia eletrônica de varredura e de transmissão foram empregadas. A HAP-CL exibiu melhor dispersão na matriz polimérica do que o PLLA-g-HAP e HAP, e permitiu a produção de fibras com grande quantidade de HAP-CL (até 30% massa da fase mineral em relação à massa do polímero(mm/mp)), tanto para o PLLA como para o PLLA-co-PIS. Células tronco mesenquimais derivadas de polpa de dente foram cultivadas em fibras de PLLA com alto teor de HAP-CL, resultando em um aumento significativo da atividade de fosfatase alcalina (ALP), nos dias 14 e 21 (p <0,001) quando comparados com conteúdos mais baixos de HAP-CL, assim como um melhor processo de mineralização apresentado pelos teste de vermelho de alizarina depois de 21 dias (p <0,001). As células cultivadas nas fibras de PLLA-co-PIS contendo 30% de HAP-CL (mm/mp) apresentaram maior atividade de ALP após 21 dias (p <0,05), e melhor processo de mineralização, depois de 14 e 21 dias (p <0,05) do que as fibras de PLLA com 30% de HAP-CL (mm/mp). PLLA e PLLA-co-PIS, ambos contendo 30% de HAP-CL (mm/mp) induziram uma maior expressão de osteocalcina e osteopontina, dois marcadores de diferenciação osteoblástica, quando comparados ao PLLA e PLLA-co-PIS (controle). Finalmente, em experimentos in vivo, as fibras de PLLA-co-PIS contendo 30% de HAP-CL (mm/mp) apresentaram um desempenho superior no processo de neoformação óssea do que as fibras de PLLA com o mesmo conteúdo de nanopartículas. Em conclusão, os nossos resultados in vitro demonstraram que os suportes construídos de compósitos de PLLA-co-PIS contendo 30% de HAP-CL (mm/mp) se mostraram superiores tanto na adesão e proliferação quanto na diferenciação de células mesenquimais de polpa de dente em osteoblastos. Além disso, experimentos in vivo confirmaram estes resultados, demonstrando que estes nanocompósitos são excelentes modelos para implantes destinados a regeneração óssea

A new method of surface modification of hydroxyapatite nanoparticles (HAP) by reaction with lauroyl chloride was developed, producing the laurate functionalized nanoparticle (HAP-CL). The surface modified HAP was confirmed by infrared, thermogravimetric analysis, nuclear magnetic resonance and elemental analysis. We proved by mechanical tests the ability to create composites with high HAP-CL content in poly(L-lactic acid) (PLLA) and poly(isosorbide succinate-b-L-lactide) (PLLA-co-PIS) polymeric matrixes without significant loss of mechanical properties. Different amounts of HAP-CL, HAP grafted with PLLA (PLLA-g-HAP) and HAP were dispersed in pure PLLA solutions to form nanofibers. To compare the dispersion of these nanoparticles in the fibers and their morphology, scanning and transmission electron microscopies were employed. HAP-CL showed better dispersion in the polymer matrix than the PLLA-g-HAP and HAP, and allowed fiber production with large amounts of HAP-CL (up to 30% mineral to polymer weight (wm/wp)) for both PLLA and PLLA-co-PIS. Mesenchymal stem cells derived from dental pulp were cultured in PLLA fibers with high levels of HAP-CL, resulting in a significant increase in alkaline phosphatase activity (ALP), on days 14 and 21 (p <0.001) as compared to those with lower content HAP-CL, as well as a better mineralization process shown by alizarin red test after 21 days (p <0.001). Cells grown in PLLA-co-PIS fibers containing 30% of HAP-CL showed higher ALP activity after 21 days (p <0.05) and a better mineralization process, after 14 and 21 days (p <0.05 ) than fibers of PLLA with 30% HAP-CL. PLLA and PLLA-co-PIS, both containing 30% of HAP-CL (wm/wp) induced a higher expression of osteocalcin and osteopontin, two osteoblast differentiation markers when compared with PLLA and PLLA-co-PIS (control). Finally, in the in vivo experiments, the PLLA-co-PIS fibers containing 30% HAP-CL (wm/wp) outperformed the process of bone formation than PLLA fibers with the same content of nanoparticles. In conclusion, our in vitro results demonstrated that scaffolds from composites of PLLA-co-PIS containing 30% HAP-CL (wm/wp) were superior both in adhesion and in the differentiation and proliferation of dental pulp stem cells in osteoblasts. Furthermore, in vivo experiments confirmed these results, demonstrating that these nanocomposites are excellent models for implants for bone regeneration

Comparison between heparin-conjugated fibrin and collagen sponge as bone morphogenetic protein-2 carriers for bone regeneration

Bone morphogenetic protein-2 (BMP-2) is used to promote bone regeneration. However, the bone regeneration ability of BMP-2 relies heavily on the delivery vehicle. Previously, we have developed heparin-conjugated fibrin (HCF), a vehicle for long-term delivery of BMP-2 and demonstrated that long-term delivery of BMP-2 enhanced its osteogenic efficacy as compared to short-term delivery at an equivalent dose. The aim of this study was to compare the bone-forming ability of the BMP-2 delivered by HCF to that delivered by clinically utilized BMP-2 delivery vehicle collagen sponge. An in vitro release profile of BMP-2 showed that HCF released 80% of the loaded BMP-2 within 20 days, whereas collagen sponge released the same amount within the first 6 days. Moreover, the BMP-2 released from the HCF showed significantly higher alkaline phosphatase activity than the BMP-2 released from collagen sponge at 2 weeks in vitro. Various doses of BMP-2 were delivered with HCF or collagen sponge to mouse calvarial defects. Eight weeks after the treatment, bone regeneration was evaluated by computed tomography, histology, and histomorphometric analysis. The dose of BMP-2 delivered by HCF to achieve 100% bone formation in the defects was less than half of the BMP-2 dose delivered by collagen sponge to achieve a similar level of bone formation. Additionally, bone regenerated by the HCF-BMP-2 had higher bone density than bone regenerated by the collagen sponge-BMP-2. These data demonstrate that HCF as a BMP-2 delivery vehicle exerts better osteogenic ability of BMP-2 than collagen sponge, a clinically utilized delivery vehicle.

Osteogénesis inperfecta: presentación de dos casos / Osteogenesis Imperfecta Presentation of two cases

La Osteognesis Imperfecta (01) es un grupo de enfermedades relacionadas, hereditarias, causadas por deficiencias cuali ocuantitativas en la síntesis de colágeno tipo 1 Se caracteriza por fragilidad ósea que se acompaña por otras alteraciones evidentes en el tejido conectivo. La heterogeneidad clínica es extensa, la cual va desde la muerte en el periodo perinatal a una talla pequeña y vera deformidad ósea, hasta una vida normal con solo leve disminución de la masa ósea.

Influence of the microenvironment on gene and protein expression of odontogenic-like and osteogenic-like cells

Progenitor cells play an important biological role in tooth and bone formation, and previous analyses during bone and dentine induction have indicated that they may be a good alternative for tissue engineering. Thus, to clarify the influence of the microenvironment on protein and gene expression, MDPC-23 cells (mouse dental papilla cell line) and KUSA/A1 cells (bone marrow stromal cell line) were used, both in vitro cell culture and in intra-abdominal diffusion chambers implanted in 4-week-old male immunodefficient mice (SCID mice). Our results indicate that KUSA/A1 cells differentiated into osteoblast-like cells and induced bone tissue inside the chamber, whereas, MDPC-23 showed odontoblast-like characteristics but with a low ability to induce dentin formation. This study shows that MDPC-23 cells are especial cel ls, which possess morphological and functional characteristics of odontoblast-like cells expressing dentin sialophosphoprotein in vivo. In contrast, dentin sialophosphoprotein gene and protein expression was not detected in both cell lines in vitro. The intra-abdominal diffusion chamber appears as an interesting experimental model for studying phenotypic expression of dental pulp cells in vivo.