Abstract

Treating large bone defects represents a major challenge in traumatic and orthopedic surgery. Bone tissue engineering provides a promising therapeutic option to improve the local bone healing response. In the present study tissue biocompatibility, systemic toxicity and tumorigenicity of a newly developed composite material consisting of polylactic acid (PLA) and 20% or 40% bioglass (BG20 and BG40), respectively, were analyzed. These materials were seeded with mesenchymal stem cells (MSC) and endothelial progenitor cells (EPC) and tested in a rat calvarial critical size defect model for 3 months and compared to a scaffold consisting only of PLA. Serum was analyzed for organ damage markers such as GOT and creatinine. Leukocyte count, temperature and free radical indicators were measured to determine the degree of systemic inflammation. Possible tumor occurrence was assessed macroscopically and histologically in slides of liver, kidney and spleen. Furthermore, the concentrations of serum malondialdehyde (MDA) and sodium oxide dismutase (SOD) were assessed as indicators of tumor progression. Qualitative tissue response towards the implants and new bone mass formation was histologically investigated. BG20 and BG40, with or without progenitor cells, did not cause organ damage, long-term systemic inflammatory reactions or tumor formation. BG20 and BG40 supported bone formation, which was further enhanced in the presence of EPCs and MSCs.This investigation reflects good biocompatibility of the biomaterials BG20 and BG40 and provides evidence that additionally seeding EPCs and MSCs onto the scaffold does not induce tumor formation.

Highlights

  • Large bone defects are still a major challenge in orthopaedic and trauma patients

  • The aim of the present study was to carry out a comprehensive safety evaluation of a newly developed composite material consisting of polylactic acid (PLA) and 20 or 40% bioglass (BG20 and BG40, respectively), seeded with endothelial progenitor cells (EPC) and differentially pretreated mesenchymal stem cells (MSC)

  • BG20 demonstrated a clefty surface with bulgy structures in the size of 6 to 26 mm

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Summary

Introduction

Large bone defects are still a major challenge in orthopaedic and trauma patients. If the defect exceeds a critical size, endogenous rengeneration processes fail to bridge the gap [1,2,3]. At present, such critical size bone defects are best treated using autologous bone grafts harvested from the patient’s own iliac crest. Tissue engineering can potentially provide treatment alternatives for conventional large bone defects [5]. The application of different combinations of osteoconductive biomaterials, osteoprogenitor cells and growth factors, directly into the defect, holds great potential for achieving optimal bone healing under difficult circumstances [5]

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