Comparison of Synthetic vs. Biogenic Polymeric Process-Directing Agents for Intrafibrillar Mineralization of Collagen.

With the aging population, there is a growing need for mineralized tissue restoration and synthetic bone substitutes. Previous studies have shown that a polymer-induced liquid-precursor (PILP) process can successfully mineralize collagen substrates to achieve compositions found in native bone and dentin. This process also leads to intrafibrillar apatitic crystals with their [001] axes aligned roughly parallel to the long axis of the collagen fibril, emulating the nanostructural organization found in native bone and dentin. When demineralized bovine bone was remineralized via the PILP process using osteopontin (OPN), the samples were able to activate mouse marrow-derived osteoclasts to similar levels to those of native bone, suggesting a means for fabricating bioactive bone substitutes that could trigger remodeling through the native bone multicellular unit (BMU). In order to determine if OPN derived from bovine milk could be a cost-effective process-directing agent, the mineralization of type I collagen scaffolds using this protein was compared to the benchmark polypeptide of polyaspartic acid (sodium salt; pAsp). In this set of experiments, we found that OPN led to much faster and more uniform mineralization when compared with pAsp, making it a cheaper and commercially attractive alternative for mineralized tissue restorations.

Bradicardia y convulsiones: una relación multicausal / Bradycardia and seizures: a multi-causal relationship

La disfunción del nodo sinusal consiste en una alteración en la generación del impulso en el nodo sinusal. Su principal causa es la degeneración fibrosa del tejido sinusal. Los casos asociados a convulsiones son multicausales y se deben a los efectos cardiodepresores de los anticonvulsivantes o de sus diluyentes; así mismo se pueden presentar casos de bradicardia y asistolia inducidos por las descargas epilépticas. Se expone el caso de una paciente con status epiléptico tratada con fenitoína endovenosa, quien recibía previamente carbamazepina y desarrolló disfunción del nodo sinusal considerada como un efecto secundario tóxico de su medicación anticonvulsivante.

Sinus node dysfunction is an alteration in the impulse generation in the sinus node. Its main cause is the fibrous degeneration of the sinus tissue. Cases associated with seizures have multiple causes and are due to the cardio-depressant effects of anticonvulsants or its diluents. Likewise, there may be cases of bradycardia and asystole induced by epileptic discharges. Here is presented the case of a female patient with status epilepticus who was treated with intravenous phenytoin and was previously receiving and developed sinus node dysfunction which was considered as a toxic side effect of her anticonvulsant medication.

Multifunctional role of osteopontin in directing intrafibrillar mineralization of collagen and activation of osteoclasts.

Mineralized collagen composites are of interest because they have the potential to provide a bone-like scaffold that stimulates the natural processes of resorption and remodeling. Working towards this goal, our group has previously shown that the nanostructure of bone can be reproduced using a polymer-induced liquid-precursor (PILP) process, which enables intrafibrillar mineralization of collagen with hydroxyapatite to be achieved. This prior work used polyaspartic acid (pASP), a simple mimic for acidic non-collagenous proteins, to generate nanodroplets/nanoparticles of an amorphous mineral precursor which can infiltrate the interstices of type-I collagen fibrils. In this study we show that osteopontin (OPN) can similarly serve as a process-directing agent for the intrafibrillar mineralization of collagen, even though OPN is generally considered a mineralization inhibitor. We also found that inclusion of OPN in the mineralization process promotes the interaction of mouse marrow-derived osteoclasts with PILP-remineralized bone that was previously demineralized, as measured by actin ring formation. While osteoclast activation occurred when pASP was used as the process-directing agent, using OPN resulted in a dramatic effect on osteoclast activation, presumably because of the inherent arginine-glycine-aspartate acid ligands of OPN. By capitalizing on the multifunctionality of OPN, these studies may lead the way to producing biomimetic bone substitutes with the capability of tailorable bioresorption rates.

Association of Randall plaque with collagen fibers and membrane vesicles.

PURPOSE: Idiopathic calcium oxalate kidney stones develop by calcium oxalate crystal deposition on Randall plaque. The mechanisms involved in Randall plaque formation are still unclear. We hypothesized that Randall plaque formation is similar to that of vascular calcification, involving components of extracellular matrix, including membrane bound vesicles and collagen fibers. To verify our hypothesis we critically examined renal papillary tissue from patients with stones. MATERIALS AND METHODS: We performed 4 mm cold cup biopsy of renal papillae on 15 patients with idiopathic stones undergoing percutaneous nephrolithotomy. Tissue was immediately fixed and processed for analysis by various light and electron microscopic techniques. RESULTS: Spherulitic calcium phosphate crystals, the hallmark of Randall plaque, were seen in all samples examined, including in interstitium and laminated basement membrane of tubular epithelium. Large crystalline deposits were composed of dark elongated strands mixed with spherulites. Strands showed banded patterns similar to collagen. Crystal deposits were surrounded by collagen fibers and membrane bound vesicles. Energy dispersive x-ray microanalysis and electron diffraction identified the crystals as hydroxyapatite. Few kidneys were examined and urinary data were not available on all patients. CONCLUSIONS: Results showed that crystals in Randall plaque are associated with collagen and membrane bound vesicles. Collagen fibers appeared calcified and vesicles contained crystals. Crystal deposition in renal papillae may have started with membrane vesicle induced nucleation and grown by the further addition of crystals at the periphery in a collagen framework.

In vitro mineralization of dense collagen substrates: a biomimetic approach toward the development of bone-graft materials.

Bone is an organic-inorganic composite which has hierarchical structuring that leads to high strength and toughness. The nanostructure of bone consists of nanocrystals of hydroxyapatite embedded and aligned within the interstices of collagen fibrils. This unique nanostructure leads to exceptional properties, both mechanical and biological, making it difficult to emulate bone properties without having a bone-like nanostructured material. A primary goal of our group's work is to use biomimetic processing techniques that lead to bone-like structures. In our prior studies, we demonstrated that intrafibrillar mineralization of porous collagen sponges, leading to a bone-like nanostructure, can be achieved using a polymer-induced liquid precursor (PILP) mineralization process. The objective of this study was to investigate the use of this polymer-directed crystallization process to mineralize dense collagen substrates. To examine collagen scaffolds that truly represent the dense-packed matrix of bone, manatee bone was demineralized to isolate its collagen matrix, consisting of a dense, lamellar osteonal microstructure. This biogenic collagen scaffold was then remineralized using polyaspartate to direct the mineralization process through an amorphous precursor pathway. The various conditions investigated included polymer molecular weight, substrate dimension and mineralization time. Mineral penetration depths of up to 100 µms were achieved using this PILP process, compared to no penetration with only surface precipitates observed for the conventional crystallization process. Electron microscopy, wide-angle X-ray diffraction and thermal analysis were used to characterize the resulting hydroxyapatite/collagen composites. These studies demonstrate that the original interpenetrating bone nanostructure and osteonal microstructure could be recovered in a biogenic matrix using the PILP process.

Mimicking the Nanostructure of Bone: Comparison of Polymeric Process-Directing Agents.

The nanostructure of bone has been replicated using a polymer-induced liquid-precursor (PILP) mineralization process. This polymer-mediated crystallization process yields intrafibrillar mineralization of collagen with uniaxially-oriented hydroxyapatite crystals. The process-directing agent, an anionic polymer which we propose mimics the acidic non-collagenous proteins associated with bone formation, sequesters calcium and phosphate ions to form amorphous precursor droplets that can infiltrate the interstices of collagen fibrils. In search of a polymeric agent that produces the highest mineral content in the shortest time, we have studied the influence of various acidic polymers on the in vitro mineralization of collagen scaffolds via the PILP process. Among the polymers investigated were poly-L aspartic acid (PASP), poly-L-glutamic acid (PGLU), polyvinylphosphonic acid (PVPA), and polyacrylic acid (PAA). Our data indicate that PASP and the combination of PGLU/PASP formed stable mineralization solutions, and yielded nano-structured composites with the highest mineral content. Such studies contribute to our goal of preparing biomimetic bone graft substitutes with composition and structure that mimic bone.