Triple Function of Amelogenin Peptide-Chitosan Hydrogel for Dentin Repair.

Biomimetic strategies like peptide-guided collagen mineralization promise to enhance the effectiveness of dentin remineralization. We recently reported that rationally designed amelogenin-derived peptides P26 and P32 promoted apatite nucleation, mineralized collagen, and showed potential in enamel regrowth and dentin remineralization. To facilitate the clinical application of amelogenin-derived peptides and to uncover their effectiveness in repairing dentin, we have now implemented a chitosan (CS) hydrogel for peptide delivery and have investigated the effects of P26-CS and P32-CS hydrogels on dentin remineralization using 2 in situ experimental models that exhibited different levels of demineralization. The efficacy of the peptide-CS hydrogels in dentin repair was evaluated by characterizing the microstructure, mineral density, mineral phase, and nanomechanical properties of the remineralized samples. The new strategy of atomic force microscopy PeakForce quantitative nanomechanical mapping was used for direct visualization and nanomechanical analysis of repaired dentin lesions across the lesion depth. Results from the 2 models indicated the potential triple functions of peptide-CS hydrogels for dentin repair: building a highly organized protective mineralized layer on dentin, occluding dentinal tubules by peptide-guided in situ mineralization, and promoting biomimetic dentinal collagen remineralization. Importantly, peptides released from the CS hydrogel could diffuse into the dentinal matrix and penetrate the dentinal tubules, leading to both surface and subsurface remineralization and tubule occlusion. Given our previous findings on peptide-CS hydrogels' potential for remineralizing enamel, we see further promise for hydrogels to treat tooth defects involving multiple hard tissues, as in the case of noncarious cervical lesions.

Biomineralization of Enamel and Dentin Mediated by Matrix Proteins.

Biomineralization of enamel, dentin, and bone involves the deposition of apatite mineral crystals within an organic matrix. Bone and teeth are classic examples of biomaterials with unique biomechanical properties that are crucial to their function. The collagen-based apatite mineralization and the important function of noncollagenous proteins are similar in dentin and bone; however, enamel is formed in a unique amelogenin-containing protein matrix. While the structure and organic composition of enamel are different from those of dentin and bone, the principal molecular mechanisms of protein-protein interactions, protein self-assembly, and control of crystallization events by the organic matrix are common among these apatite-containing tissues. This review briefly summarizes enamel and dentin matrix components and their interactions with other extracellular matrix components and calcium ions in mediating the mineralization process. We highlight the crystallization events that are controlled by the protein matrix and their interactions in the extracellular matrix during enamel and dentin biomineralization. Strategies for peptide-inspired biomimetic growth of tooth enamel and bioinspired mineralization of collagen to stimulate repair of demineralized dentin and bone tissue engineering are also addressed.

An Evolutionarily Conserved Helix Mediates Ameloblastin-Cell Interaction.

Ameloblastin (Ambn) has the potential to regulate cell-matrix adhesion through familiar cell-binding domains, but the proposed sequence motifs are not highly conserved across species. Here, we report that Ambn binds to ameloblast-like cell membranes through a highly evolutionary conserved amphipathic helix-forming (AH) motif encoded by exon 5. We applied high-resolution confocal microscopy to show colocalization of Ambn with ameloblast membrane surfaces in developing mouse incisors. Using a series of Ambn-derived peptides and Ambn variants, we showed that Ambn binds to cell membranes through a motif within the sequence encoded by exon 5. Using peptides derived from the N- or C-termini of this sequence, as well as Ambn variants that lacked or had a disrupted AH motif, we demonstrated that the AH motif located at the N-terminus of the sequence is involved in cell-Ambn adhesion. Sequence analysis revealed that this highly conserved AH motif is absent from other enamel matrix proteins, including amelogenin, enamelin, and amelotin. Collectively, these data suggest that Ambn binds to the cell surface membrane via a helix-forming motif and provide insight into the molecular mechanism and function of Ambn in enamel cell-matrix interaction.

The Presence of MMP-20 Reinforces Biomimetic Enamel Regrowth.

Biomimetic synthesis of artificial enamel is a promising strategy for the prevention and restoration of defective enamel. We have recently reported that a hydrogel system composed of chitosan-amelogenin (CS-AMEL) and calcium phosphate is effective in forming an enamel-like layer that has a seamless interface with natural tooth surfaces. Here, to improve the mechanical system function and to facilitate the biomimetic enamel regrowth, matrix metalloproteinase-20 (MMP-20) was introduced into the CS-AMEL hydrogel. Inspired by our recent finding that MMP-20 prevents protein occlusion inside enamel crystals, we hypothesized that addition of MMP-20 to CS-AMEL hydrogel could reinforce the newly grown layer. Recombinant human MMP-20 was added to the CS-AMEL hydrogel to cleave full-length amelogenin during the growth of enamel-like crystals on an etched enamel surface. The MMP-20 proteolysis of amelogenin was studied, and the morphology, composition, and mechanical properties of the newly grown layer were characterized. We found that amelogenin was gradually degraded by MMP-20 in the presence of chitosan. The newly grown crystals in the sample treated with MMP-20-CS-AMEL hydrogel showed more uniform orientation and greater crystallinity than the samples treated with CS-AMEL hydrogel without MMP-20. Stepwise processing of amelogenin by MMP-20 in the CS-AMEL hydrogel prevented undesirable protein occlusion within the newly formed crystals. As a result, both the modulus and hardness of the repaired enamel were significantly increased (1.8- and 2.4-fold, respectively) by the MMP-20-CS-AMEL hydrogel. Although future work is needed to further incorporate other enamel matrix proteins into the system, this study brings us one step closer to biomimetic enamel regrowth.

Amelogenin-Ameloblastin Spatial Interaction around Maturing Enamel Rods.

Amelogenin and ameloblastin are 2 extracellular matrix proteins that are essential for the proper development of enamel. We recently reported that amelogenin and ameloblastin colocalized during the secretory stage of enamel formation when nucleation of enamel crystallites occurs. Direct interactions between the 2 proteins have been also demonstrated in our in vitro studies. Here, we explore interactions between their fragments during enamel maturation. We applied in vivo immunofluorescence imaging, quantitative co-localization analysis, and a new FRET (fluorescence resonance energy transfer) technique to demonstrate ameloblastin and amelogenin interaction in the maturing mouse enamel. Using immunochemical analysis of protein samples extracted from 8-d-old (P8) first molars from mice as a model for maturation-stage enamel, we identified the ~17-kDa ameloblastin (Ambn-N) and the TRAP (tyrosine-rich amelogenin peptide) fragments. We used Ambn-N18 and Ambn-M300 antibodies raised against the N-terminal and C-terminal segments of ameloblastin, as well as Amel-FL and Amel-C19 antibodies against full-length recombinant mouse amelogenin (rM179) and C-terminal amelogenin, respectively. In transverse sections, co-localization images of N-terminal fragments of amelogenin and ameloblastin around the prism boundary revealed the "fish net" pattern of the enamel matrix. Using in vivo FRET microscopy, we further demonstrated spatial interactions between amelogenin and ameloblastin N-terminal fragments. In the maturing mouse enamel, the association of these residual protein fragments created a discontinuity between enamel rods, which we suggest is important for support and maintenance of enamel rods and eventual contribution to unique enamel mechanical properties. We present data that support cooperative functions of enamel matrix proteins in mediating the structural hierarchy of enamel and that contribute to our efforts to design and develop enamel biomimetic material.

Extracts of irradiated mature human tooth crowns contain MMP-20 protein and activity.

OBJECTIVES: We recently demonstrated a significant correlation between enamel delamination and tooth-level radiation dose in oral cancer patients. Since radiation can induce the synthesis and activation of matrix metalloproteinases, we hypothesized that irradiated teeth may contain active matrix metalloproteinases. MATERIALS AND METHODS: Extracted teeth from oral cancer patients treated with radiotherapy and from healthy subjects were compared. Extracted mature third molars from healthy subjects were irradiated in vitro and/or incubated for 0-6 months at 37°C. All teeth were then pulverized, extracted, and extracts subjected to proteomic and enzymatic analyses. RESULTS: Screening of irradiated crown extracts using mass spectrometry identified MMP-20 (enamelysin) which is expressed developmentally in dentine and enamel but believed to be removed prior to tooth eruption. MMP-20 was composed of catalytically active forms at Mr=43, 41, 24 and 22kDa and was immunolocalized predominantly to the morphological dentine enamel junction. The proportion of different sized MMP-20 forms changed with incubation and irradiation. While the pattern was not altered directly by irradiation of healthy teeth with 70Gy, subsequent incubation at 37°C for 3-6 months with or without prior irradiation caused the proportion of Mr=24-22kDa MMP-20 bands to increase dramatically. Extracts of teeth from oral cancer patients who received >70Gy radiation also contained relatively more 24 and 22kDa MMP-20 than those of healthy age-related teeth. CONCLUSION: MMP-20 is a radiation-resistant component of mature tooth crowns enriched in the dentine-enamel. We speculate that MMP-20 catalyzed degradation of organic matrix at this site could lead to enamel delamination associated with oral cancer radiotherapy.

Chymotrypsin C (caldecrin) is associated with enamel development.

Two main proteases cleave enamel extracellular matrix proteins during amelogenesis. Matrix metalloprotease-20 (Mmp20) is the predominant enzyme expressed during the secretory stage, while kallikrein-related peptidase-4 (Klk4) is predominantly expressed during maturation. Mutations to both Mmp20 and Klk4 result in abnormal enamel phenotypes. During a recent whole-genome microarray analysis of rat incisor enamel organ cells derived from the secretory and maturation stages of amelogenesis, the serine protease chymotrypsin C (caldecrin, Ctrc) was identified as significantly up-regulated (> 11-fold) during enamel maturation. Prior reports indicate that Ctrc expression is pancreas-specific, albeit low levels were also noted in brain. We here report on the expression of Ctrc in the enamel organ. Quantitative PCR (qPCR) and Western blot analysis were used to confirm the expression of Ctrc in the developing enamel organ. The expression profile of Ctrc is similar to that of Klk4, increasing markedly during the maturation stage relative to the secretory stage, although levels of Ctrc mRNA are lower than for Klk4. The discovery of a new serine protease possibly involved in enamel development has important implications for our understanding of the factors that regulate enamel biomineralization.

Apatite reduces amelogenin proteolysis by MMP-20 and KLK4 in vitro.

Two enamel proteases, matrix metalloproteinase-20 (MMP-20) and kallikrein 4 (KLK4), are known to cleave amelogenin and are necessary for proper enamel formation. However, the effect of hydroxyapatite (HAP) on the proteolytic activity of these enzymes remains unclear. To investigate whether apatite affects normal amelogenin proteolysis, we used 2 different isoforms of amelogenin combined with the appropriate enzymes to analyze proteolytic processing rates in the presence or absence of synthetic hydroxyapatite (HAP) crystals (N = 3). We found a distinct dose-dependent relationship between the amount of HAP present in the proteolysis mixture and the rate of rP172 degradation by rpMMP-20, whereas the effect of HAP on proteolysis of either rP172 or rP148 by rhKLK4 was less prominent.

Effect of fluoride on the morphology of calcium phosphate crystals grown on acid-etched human enamel.

The aim of this study was to examine the effect of fluoride ion concentration on the morphology of calcium phosphate crystals grown on acid-etched enamel as a model for tooth enamel erosion. Samples were immersed in calcification solution for 16 h and changes in crystal morphology were monitored by field emission scanning electron microscopy. Without fluoride, plate-like octacalcium phosphate crystals (20 nm thick, 2-10 microm wide) were formed. With 1-10 mg/l fluoride, arrays of denser needle-like nanocrystals (20-30 nm wide, >500 nm in length) were formed. We conclude that there is a minimal fluoride concentration (1 mg/l) that dramatically affects the morphology of calcium phosphate crystals grown on etched enamel in vitro.

Enamel proteases reduce amelogenin-apatite binding.

Organic matrix degradation and crystal maturation are extracellular events that occur simultaneously during enamel biomineralization. We hypothesized that enamel proteases control amelogenin-mineral interaction, which, in turn can affect crystal nucleation, organization, and growth. We used a recombinant amelogenin (rP172), a homolog of its major cleavage product (rP148), and a native amelogenin lacking both N- and C-termini (13k). We compared apatite binding affinity between amelogenins and their digest products during proteolysis. We further compared binding affinity among the 3 amelogenins using a Langmuir model for protein adsorption. Amelogenin-apatite binding affinity was progressively reduced with the proteolysis at the C- and N- termini by recombinant pig MMP-20 (rpMMP20) and recombinant human kallikrein-4 (rhKLK4), respectively. The binding affinity of amelogenin to apatite was found to be in the descending order of rP172, rP148, and 13k. Analysis of our data suggests that, before its complete degradation during enamel maturation, stepwise processing of amelogenin by MMP-20 and then KLK4 reduces amelogenin-apatite interaction.

Apatite/amelogenin coating on titanium promotes osteogenic gene expression.

Osteoblast differentiation and extracellular matrix production are pivotal processes for implant osseointegration or bone tissue engineering. We hypothesized that a biomimetic coating on titanium surfaces, consisting of apatite and amelogenin, would promote such processes. Human Embryonic Palatal Mesenchymal pre-osteoblasts were used as a model for the evaluation of cell adhesion and spreading patterns, as well as mRNA expression of certain osteoblastic gene products. Real-time PCR showed significant (p < 0.05) increase in expression of type I collagen, alkaline phosphatase, and osteocalcin from cells grown on titanium with an apatite/amelogenin composite, as compared with that from cells grown on a pure titanium or apatite coating only. Osteocalcin expression was specifically stimulated by amelogenin added to the culture media. Enhanced attachment and cell spreading were also observed. The biomimetic coating promoting cell adhesion and osteoblast differentiation may have great potential for future dental and biomedical applications.

Control of apatite crystal growth in a fluoride containing amelogenin-rich matrix.

To study how crystal growth in dental enamel is controlled by the components of the extracellular matrix, we investigated the functional roles of amelogenins and fluoride ions in apatite formation occurring through an octacalcium phosphate (OCP)-precursor pathway. Using a cation selective membrane system as a model of tooth enamel formation, we evaluated the resulting mineral habit grown in native porcine amelogenins and fluoride ions. In the absence of amelogenin and in the presence of 1 or 2 ppm F, we obtained OCP + apatite and apatite, respectively. Without amelogenins, the crystals were hexagonal prisms and cones with diameters of approximately 100-200 nm. In the presence of 10% amelogenins and in the absence of fluoride, rod-like OCP with a diameter of 35 nm were obtained. Remarkably, a combination of amelogenin and fluoride created the formation of rod-like apatite crystals with dimensions similar to the former crystals. These observations indicate a cooperative role of amelogenin and fluoride in the regulation of habit, size orientation and phase of the calcium-phosphate crystals, resulting in the formation of fine rod-like apatite whose habit and orientation were similar to that of authentic tooth enamel crystals. The significant modulating effect of the amelogenin matrix combined with fluoride ions suggests the potential for this artificial system to contribute to the engineering of novel enamel-like biomaterials in vitro.

Interactions of amelogenins with octacalcium phosphate crystal faces are dose dependent.

Amelogenins, the major protein components of the enamel extracellular matrix, are postulated to be involved in controlling the elongated and oriented growth of enamel carbonated apatite crystals. In order to clarify the functional role of amelogenin during the early stage of enamel biomineralization, octacalcium phosphate (OCP) crystals, known to be potent precursors of hydroxyapatite, were grown in 1-10% (w/w) native bovine and two recombinant murine amelogenins. Amelogenins were solution-like at 1% and formed gel at 10%, while 5% amelogenins became gel after reaction and it was inhomogeneous and porous. Morphological changes of OCP crystals were evaluated as the function of amelogenin concentration by analyzing the mean values of length, width, thickness, their reduction ratios (L/Lc, W/Wc, T/Tc) as well as L/W and W/T ratios. Length, width, and thickness decreased in a does-dependent manner. Length decreased almost linearly in 1%-10%, whereas width decreased drastically in 1%-5% while the decrease from 5% to 10% was small. As a result, elongated morphology of OCP crystal was most emphasized in 5% bovine amelogenins and rM166 and 2%-5% rM179. The size reduction was in the order of W/Wc < L/Lc < T/Tc. We therefore concluded that amelogenin interaction with crystal faces was in the order (010) > (001) > (100). At all concentrations, W/ Wc was significantly the smallest. This indicated that the primary role of amelogenin was to decrease the width of OCP by blocking the hydrophobic (010) faces. We suggest that the drastic decrease of crystal width is the result of interaction of the densely packed nanospheres in 5%-10% amelogenin.

Induction of apatite by the cooperative effect of amelogenin and the 32-kDa enamelin.

Extracellular matrix proteins are considered to play essential roles in controlling the nucleation, growth, and organization of hydroxyapatite crystals during enamel formation. The effects of amelogenin and the 32-kDa enamelin proteins on apatite nucleation were investigated by a steady-state gel diffusion device containing 10% gelatin gels loaded with 0, 0.75%, and 1.5% (w/w) native porcine amelogenins. It was found that the induction time for hydroxyapatite precipitation was strongly increased by the presence of amelogenins, suggesting an inhibitory effect of apatite nucleation. Addition of 18 micro g/mL of 32-kDa enamelin to 10% gelatin also caused inhibition of nucleation. Remarkably, addition of 18 and 80 micro g/mL of 32-kDa enamelin in gels containing 1.5% amelogenin accelerated the nucleation process in a dose-dependent manner. Our observations strongly suggest that the 32-kDa enamelin and amelogenins cooperate to promote nucleation of apatite crystals and propose a possible novel mechanism of mineral nucleation during enamel biomineralization.

Assembly of amelogenin proteolytic products and control of octacalcium phosphate crystal morphology.

The formation of enamel apatite crystals involves extracellular molecular events among which matrix assembly, interactions with growing crystals, and protein processing and removal are the subject of numerous investigations. Following the description of amelogenin nanospheres and the evidence for their presence in vivo as the principal structural component of developing dental enamel, we have focused our studies on investigating at the molecular level the process of nanosphere assembly and evaluating the effects of amelogenin on crystal growth and morphology. This paper is a short review of our recent studies with a focus on the assembly of amelogenin proteolytic products and their modulating effect on octacalcium phosphate (OCP) crystal morphology. In addition, we report that incorporation of amelogenins into 10% gelatin gel does not affect diffusion of calcium. This remarkable finding indicates that the observed modulation effect by amelogenin on OCP crystal morphology is not due to alteration of calcium diffusion into the gels but is the result of direct amelogenin-mineral interactions.

Analysis of hydroxyapatite surface coverage by amelogenin nanospheres following the Langmuir model for protein adsorption.

The assembly of amelogenin protein into nanospheres is postulated to be a key factor in the stability of enamel extracellular matrix framework, which provides the scaffolding for the initial enamel apatite crystals to nucleate and grow. Adsorption isotherms were evaluated in order to investigate the nature of interactions of amelogenin nanospheres with hydroxyapaite crystals in solution, where their assembly status and particle size distribution are defined. We report that the adsorption isotherm of a recombinant mouse amelogenin (rM179) on synthetic hydroxyapatite crystals can be described using a Langmuir model indicating that amelogenin nanospheres adsorb onto the surface of apatite crystals as binding units with defined adsorption sites. The adsorption affinity and the maximum adsorption sites were 19.7 x 10(5) L/mol and 6.09 x 10(-7) mol/m2, respectively, with an r2 value of 0.99. Knowing the composition and particle size distribution of amelogenin nanospheres under the condition of adsorption experiments, we have calculated the number of nanospheres and the crystal surface area covered by each population of nanospheres at their maximum adsorption. It was found that total maximum binding covers 64% of the area unit. This observation supports the speculation that amelogenin binding onto apatite surface is selective and occurs only at certain sites.

Modification of calcium-phosphate coatings on titanium by recombinant amelogenin.

Amelogenin proteins, the principal components of the developing dental enamel extracellular matrix, have been postulated to facilitate the elongated and oriented growth of the carbonated apatite crystals during enamel formation. We previously reported that amelogenin caused modulation of apatite crystals nucleated on a bioactive glass (Bioglass(R)) in vitro. Here, the effects of amelogenin on the growth morphology of calcium-phosphate crystals nucleated on a titanium surface were investigated in order to gain a better understanding of the role of amelogenins during enamel biomineralization and to explore their potential application in the design and development of novel biomaterials. The dose-dependent effects of a recombinant mouse amelogenin (rM179) were found to be different from those of bovine serum albumin, which significantly inhibited apatite crystal growth and caused the octacalcium phosphate (OCP) crystals to change from a plate-like shape to a curved shape, indicating a general inhibitory effect. The effects of rM179 on the crystal growth of OCP at 12.5-100 microg/mL and of apatite at 50 microg/mL were insignificant while the apatite crystals were remarkably elongated along their c-axes upon the use of 100 microg/mL of rM179. The unique modulation of the calcium-phosphate coatings on titanium by rM179 supports the view that amelogenins have a great potential for applications designed to develop novel biomimetic materials.

Limited proteolysis of amelogenin: toward understanding the proteolytic processes in enamel extracellular matrix.

This article is a short review of our recent study on controlled proteolysis of amelogenins by a series of commercially available proteinases as well as the tooth-specific metalloproteinase enamelysin. A limited proteolysis approach and mass spectrometry were applied in order to determine the surface accessibility of conserved domains of amelogenin nanospheres. Furthermore, this study was aimed at exploring the factors that affect the activity of enamel proteases to process amelogenins and at providing insight into the mechanisms of amelogenin degradation during amelogenesis. We found that, under limited conditions, certain amino acid residues at both the C- and N-termini of amelogenin are accessible to proteolytic action by a series of proteinases, suggesting that these regions are exposed on the surface of amelogenin nanospheres. Recombinant enamelysin cleaved amelogenin at the C-terminal region, showing a preference of the enzyme to cleave the S/M and F/S bonds. This result of enamelysin activity on amelogenin explains the abundance of the p148 (20k) pig amelogenin during the secretory stage of amelogenesis.

Assessment of enamelysin (MMP-20) selectivity to three peptide bonds on amelogenin sequence.

Recent studies have highlighted the potential role of the metalloproteinase enamelysin (MMP-20) in controlling some of the most critical stages during enamel development. This study was aimed to assess the selectivity of enamelysin to the three most abundant cleavage sites on the amelogenin sequence, and to gain insight into the factors that control the pattern of amelogenin processing during enamel mineralization. Three deca-peptides with sequences based on pig amelogenin and including the proteolytic cleavage sites W/L, S/M, and P/A were synthesized as substrates. Statistical analysis revealed no significant differences in the rates of cleavage among the three peptides, indicating comparable selectivity of enamelysin for these peptide bonds. Considering the selective appearance of amelogenin proteolytic products, we suggest that amelogenin folding and assembly are the primary factors in controlling the pattern of its proteolysis during the secretory stage of enamel development.

Elongated growth of octacalcium phosphate crystals in recombinant amelogenin gels under controlled ionic flow.

Amelogenin proteins constitute the primary structural entity of the extracellular protein framework of the developing enamel matrix. Recent data on the interactions of amelogenin with calcium phosphate crystals support the hypothesis that amelogenins control the oriented and elongated growth of enamel carbonate apatite crystals. To exploit further the molecular mechanisms involved in amelogenin-calcium phosphate mineral interactions, we conducted in vitro experiments to examine the effect of amelogenin on synthetic octacalcium phosphate (OCP) crystals. A 10% (wt/vol) recombinant murine amelogenin (rM179, rM166) gel was constructed with nanospheres of about 10- to 20-nm diameter, as observed by atomic force microscopy. The growth of OCP was modulated uniquely in 10% rM179 and rM166 amelogenin gels, regardless of the presence of the hydrophilic C-terminal residues. Fibrous crystals grew with large length-to-width ratio and small width-to-thickness ratio. Both rM179 and rM166 enhanced the growth of elongated OCP crystals, suggesting a relationship to the initial elongated growth of enamel crystals.