Formation Of New Bone Tissue Research Articles

3D printing of biomaterials with mussel-inspired nanostructures for tumor therapy and tissue regeneration

Primary bone cancer brings patients great sufferings. To deal with the bone defects resulted from cancer surgery, biomaterials with good bone-forming ability are necessary to repair bone defects. Meanwhile, in order to prevent possible tumor recurrence, it is essential that the remaining tumor cells around bone defects are completely killed. However, there are few biomaterials with the ability of both cancer therapy and bone regeneration until now. Here, we fabricated a 3D-printed bioceramic scaffold with a uniformly self-assembled Ca-P/polydopamine nanolayer surface. Taking advantage of biocompatibility, biodegradability and the excellent photothermal effect of polydopamine, the bifunctional scaffolds with mussel-inspired nanostructures could be used as a satisfactory and controllable photothermal agent, which effectively induced tumor cell death invitro, and significantly inhibited tumor growth in mice. In addition, owing to the nanostructured surface, the prepared polydopamine-modified bioceramic scaffolds could support the attachment and proliferation of rabbit bone mesenchymal stem cells (rBMSCs), and significantly promoted the formation of new bone tissues in rabbit bone defects even under photothermal treatment. Therefore, the mussel-inspired nanostructures in 3D-printed bioceramic exhibited a remarkable capability for both cancer therapy and bone regeneration, offering a promising strategy to construct bifunctional biomaterials which could be widely used for therapy of tumor-induced tissue defects.

Acellular dermal matrix loading with bFGF achieves similar acceleration of bone regeneration to BMP-2 via differential effects on recruitment, proliferation and sustained osteodifferentiation of mesenchymal stem cells

New generation of barrier membranes has been developed, which not only act as barriers but also as delivery devices to release specific growth factors. This study observed biological behaviors of bone morrow mesenchymal stem cells (BMMSCs) pretreated by bFGF or BMP-2 in vitro and evaluated differential bone regeneration process induced by bFGF and BMP-2 loaded acellular dermal matrix (ADM) membrane using critical-size rat calvarial defect model in vivo. The results showed that the proliferation capability of BMMSCs pretreated by bFGF was stronger than that by BMP-2, while there was temporally differential effect of bFGF and BMP-2 pretreatment on MSC osteogenic differentiation potentials. During healing process of rat calvarial defects, 2-fold more CD34−/CD90+ MSCs in group of bFGF-ADM was observed than in any other treatment group at 2weeks. However, there were similar amount of new bone formation and expression of osteopotin in newly-formed bone tissue in groups of bFGF- and BMP-2-ADM at 8weeks, which were more than those in ADM alone and blank control. Taken together, bFGF-ADM guided similar bone regeneration to BMP-2 through more efficient recruitment of MSCs, and moreover, BMMSCs pretreated by bFGF showed stronger proliferation at 1–5days and osteogenic differentiation potentials at 14days compared with BMP-2 pretreatment.

Synthesis and characterization of hydroxyapatite-gelatine composite materials for orthopaedic application

The composite materials based on hydroxyapatite (HA) and gelatine (Gel) with addition of silver and zirconium oxide were obtained. The study investigates a combination of low powered ultrasonic irradiation and low concentration of gelatine in the co-precipitation synthesis. These composites have different weight ratios of organic/inorganic components and may be synthesized in two ways: simple mixing and co-precipitation. Both of which were compared.The estimation of porosity, in vivo testing, surface morphology and phase composition as well as the IR-analysis were provided. Hydroxyapatite was the main crystalline phase in obtained composites.While around powdered HA-Gel composite the connective tissue capsule is formed without bone tissue formation, HA-Gel-Ag porous composite implantation leads to formation of new bone tissue and activation of cell proliferation. Addition of silver ions into composite material allows decreasing inflammation on the first stage of implantation and has positive effect on bone tissue formation. Some of the obtained composite materials containing silver or ZrO2 are biocompatible. bio-resorbable and osteoconductive with high level of porosity (75–85%).

Value of Serum Sclerostin in Osteopenia and Osteoporosis Associated with Liver Cirrhosis and Post Liver Transplantation

Background: Osteodystrophy is one of the signs of liver cirrhosis. In general, maintenance of bone over time requires balance between the formation of new bone tissue and breakdown and removal of old bone tissue. This balance is maintained by a variety of hormones. One of them is sclerostin.Sclerostin is an osteocyte-derived negative regulator of bone formation. It inhibits osteoblastic proliferation and differentiation and promotes osteoblast apoptosis. Aim of the work: Evaluation of serum sclerostin level in relation to osteopenia o serum sclerostine level, calcium phosphorus,parathyroid hormone levels were measured, in addition to Dexa scan. Results: Serum sclerostin level was present in highest concentration in group II (33.99 ± 13.8 ng/ml) compared to group I (15.01 ± 1.87 ng/ml) & group III patients (9.98 ± 1.12 ng/ml).Osteoporosis and osteopenia were significantly most frequent in Child B and C patients (59.4%) compared to Child A (25.1%)and patients post liver transplantation (12.5%).Serum sclerostin level was highest in osteoporotic patients (36.24 ± 11.9 ng/ml), followed by osteopenic patients (30.17± 11.7 ng/ml). Patients with normal Dexa scan had the lowest serum sclerostin level (14.91± 10.7 ng/ml). Conclusion: sclerostin is a good predictor for presence of bone diseases in patients with liver cirrhosis.It has sensitivity of 80.8% at serum level ≥17.7 ng/ml

Effect of physicochemical properties of a cement based on silicocarnotite/calcium silicate on in vitro cell adhesion and in vivo cement degradation

A silicon calcium phosphate cement (Si-CPC) was developed to produce a composite of calcium phosphate and calcium silicate. The silicon cements prepared with low silicon (Si) content were composed of crystalline phases of brushite and silicocarnotite. However, the cements prepared with high Si content were mainly composed of amorphous phases of silicocarnotite, hydroxyapatite and calcium silicate. The cement porosity was about 40% with a shift of the average pore diameter to the nanometric range with increasing Si content. Interestingly, this new cement system provides a matrix with a high specific surface area of up to 29 m2 g−1. The cytocompatibility of the new Si-doped cements was tested with a human osteoblast-like cell line (MG-63) showing an enhancement of cell proliferation (up to threefold) when compared with unsubstituted material. Cements with a high silica content also improved the cell attachment. The in vivo results indicated that Si-CPCs induce the formation of new bone tissue, and modify cement resorption. We conclude that this cement provides an optimal environment to enhance osteoblast growth and proliferation that could be of interest in bone engineering.

Pullulan microcarriers for bone tissue regeneration

Microcarrier systems offer a convenient way to repair bone defects as injectable cell carriers that can be applied with small incisions owing to their small size and spherical shape. In this study, pullulan (PULL) microspheres were fabricated and characterized as cell carriers for bone tissue engineering applications. PULL was cross-linked by trisodium trimetaphosphate (STMP) to enhance the stability of the microspheres. Improved cytocompatibility was achieved by silk fibroin (SF) coating and biomimetic mineralization on the surface by incubating in simulated body fluid (SBF). X-ray diffraction (XRD), scanning electron microscopy (SEM) and fluorescent microscopy analysis confirmed biomimetic mineralization and SF coating on microspheres. The degradation analysis revealed that PULL microspheres had a slow degradation rate with 8% degradation in two weeks period indicating that the microspheres would support the formation of new bone tissue. Furthermore, the mechanical tests showed that the microspheres had a high mechanical stability that was significantly enhanced with the biomimetic mineralization. In vitro cell culture studies with SaOs-2 cells showed that cell viability was higher on SF and SBF coated microspheres on 7th day compared to PULL ones under dynamic conditions. Alkaline phosphatase activity was higher for SF coated microspheres in comparison to uncoated microspheres when dynamic culture condition was applied. The results suggest that both organic and inorganic surface modifications can be applied on PULL microspheres to prepare a biocompatible microcarrier system with suitable properties for bone tissue engineering.

Teriparatide for osteoporosis: importance of the full course.

Teriparatide (TPTD) is the only currently available therapeutic agent that increases the formation of new bone tissue and can provide some remediation of the architectural defects in the osteoporotic skeleton. The use of teriparatide clinically is limited to 24 months. We review clinical findings during daily teriparatide treatment over time. Teriparatide appears to increase bone formation more than bone resorption as determined biochemically and histologically. Teriparatide exerts its positive effects on bone formation in two distinct fashions. The first is direct stimulation of bone formation that occurs within active remodeling sites (remodeling-based bone formation) and on surfaces of bone previously inactive (modeling-based bone formation). The second is an increase in the initiation of new remodeling sites. Both processes contribute to the final increase in bone density observed by non-invasive tools such as DXA. Remodeling is the repair process by which skeletal tissue is maintained in a young healthy state, and when stimulated by TPTD is associated with a positive bone balance within each remodeling cavity. It seems likely therefore that this component will contribute to the anti-fracture efficacy of TPTD. Teriparatide reduces the risk of fracture, and this effect appears to increase with longer duration of therapy. The use of novel treatment regimens, including shorter courses, should be held in abeyance until controlled clinical trials are completed to define the relative fracture benefits of such approaches in comparison to the 24-month daily use of the agent.Summary In patients with osteoporosis at high risk for fracture, the full continuous 24-month course with teriparatide results in improved skeletal health and outcomes than shorter time periods.

Three-Dimensional Printing of Hollow-Struts-Packed Bioceramic Scaffolds for Bone Regeneration

Three-dimensional printing technologies have shown distinct advantages to create porous scaffolds with designed macropores for application in bone tissue engineering. However, until now, 3D-printed bioceramic scaffolds only possessing a single type of macropore have been reported. Generally, those scaffolds with a single type of macropore have relatively low porosity and pore surfaces, limited delivery of oxygen and nutrition to surviving cells, and new bone tissue formation in the center of the scaffolds. Therefore, in this work, we present a useful and facile method for preparing hollow-struts-packed (HSP) bioceramic scaffolds with designed macropores and multioriented hollow channels via a modified coaxial 3D printing strategy. The prepared HSP scaffolds combined high porosity and surface area with impressive mechanical strength. The unique hollow-struts structures of bioceramic scaffolds significantly improved cell attachment and proliferation and further promoted formation of new bone tissue in the center of the scaffolds, indicating that HSP ceramic scaffolds can be used for regeneration of large bone defects. In addition, the strategy can be used to prepare other HSP ceramic scaffolds, indicating a universal application for tissue engineering, mechanical engineering, catalysis, and environmental materials.

Porous biphasic calcium phosphate ceramics coated with nano-hydroxyapatite and seeded with mesenchymal stem cells for reconstruction of radius segmental defects in rabbits.

The osteoconduction of porous biphasic calcium phosphate (BCP) ceramics has been widely reported. In a previous study, we demonstrated that applying a nano-hydroxyapatite (nHA) coating enhances the osteoinductive potential of BCP ceramics, making these scaffolds more suitable for bone tissue engineering applications. The aim of the present study was to determine the effects of reconstructing radius defects in rabbits using nHA-coated BCP ceramics seeded with mesenchymal stem cells (MSCs) and to compare the bone regeneration induced by different scaffolds. Radius defects were created in 20 New Zealand rabbits, which were divided into four groups by treatment: porous BCP ceramics (Group A), nHA-coated porous BCP ceramics (Group B), porous BCP ceramics seeded with rabbit MSCs (Group C), and nHA-coated porous BCP ceramics seeded with rabbit MSCs (Group D). After in vitro incubation, the cell/scaffold complexes were implanted into the defects. Twelve weeks after implantation, the specimens were examined macroscopically and histologically. Both the nHA coating and seeding with MSCs enhanced the formation of new bone tissue in the BCP ceramics, though the osteoinductive potential of the scaffolds with MSCs was greater than that of the nHA-coated scaffolds. Notably, the combination of nHA coating and MSCs significantly improved the bone regeneration capability of the BCP ceramics. Thus, MSCs seeded into porous BCP ceramics coated with nHA may be an effective bone substitute to reconstruct bone defects in the clinic.

In vivo behaviors of Ca(OH)2 activated nano SiO2 (nCa/nSi = 3) cement in rabbit model

In vivo behaviors of Ca(OH)2 activated nano SiO2 (nCa/nSi=3, TCS) cement were investigated in the rabbit femoral defects using the poly(methyl methacrylate) (PMMA) as control. The deposited apatite and CaCO3 layers round TCS paste surfaces were completely used to construct the new bone tissue. TCS paste could stimulate the formation of new bone tissue in marrow tissue. The osteostimulation was mainly attributed to the proliferation and differentiation effects of Ca and Si ions released from TCS paste on the osteoprogenitor cells. However, Calcium–Silicate–Hydrate (C–S–H) gel in TCS paste was harder to degradate than Ca(OH)2. TCS paste kept the original shape during implantation, and could not provide the pores or spaces for further formation of bone tissue. Osteolytic defects induced by wear particles from TCS paste surface could not be completely avoided, because of the interfacial strain and the extensive micromotion between TCS paste surface and new bone tissue. Overall, our results indicated that Ca(OH)2 activated nano SiO2 cement was bioactivity and osteostimulation. The further improvements of Ca(OH)2 activated nano SiO2 cement should be done by achieving a balance between biological properties and mechanical performances.

Mussel-Inspired Artificial Grafts for Functional Ligament Reconstruction.

The development of an artificial graft with distinct osteogenetic activity to enhance osseointegration and to induce the formation of biomimetic tissue structure for ligament reconstruction remains a significant challenge. Inspired by mussels, biomimetic calcium phosphate apatite/polydopamine hybridized-polyethylene terephthalate (APA/PDA-PET) grafts were successfully prepared. The efficacy and mechanism of APA/PDA-PET grafts to induce osseointegration were systematically investigated. The results from the in vitro study indicated that the prepared APA/PDA-PET grafts support the attachment of bone marrow stromal cells (BMSCs) and stimulate the proliferation and osteogenic/angiogenic differentiation of BMSCs via activation of the PKC/p-ERK1/2 signaling pathway. In vivo, histological and radiological results further demonstrate that the APA/PDA-PET grafts significantly improve osseointegration by inducing the formation of new bone tissue and the fibrocartilage transitional zone compared with pure PET grafts. In addition, the pull-out strength of the APA/PDA-PET grafts is significantly higher than that of the pure PET grafts 12 weeks after surgery. These results suggest that this mussel-inspired biomimetic method is an effective strategy for modifying artificial grafts, and the prepared APA/PDA-PET grafts, which possess a beneficial interface, can significantly improve in vivo osseointegration for ligament reconstruction via the synergistic effect of polydopamine and apatite.

Efficacy of golimumab in the treatment of patients with ankylosing spondylitis (according to the data of a long-term follow-up)

The paper summarizes the data of a randomized placebo-controlled phase 3 GO-RAISE trial of spondylitis (AS) patients receiving two different doses (50 and 100 mg) of golimumab (GLM), which evaluates its efficiency and safety and X-ray progression of changes in the axial skeleton. In AS patients, GLM therapy leads to a rapid long-lasting clinical and radiological response. The tolerability of long-term therapy with GLM generally complies with the safety profile of the entire class of tumor necrosis factor-р (TNF-р) inhibitors. The data of the GO-RAISE trial has substantiated once again the established fact that the high baseline level of C-reactive protein (CRP) and the presence of syndesmophytes are predictors for a rapider X-ray progression. At the same time, the results of the trial may question the recent assumptions that TNF-р suppression can exert a stimulating effect on the formation of new bone tissue with time. Further studies are to determine whether there is an association between the presence of syndesmophytes and elevated CRP levels and whether they have a combined effect on X-ray progression, and if so, whether the development of structural changes may be prevented with TNF-р inhibitors to be used at the earlier stages of the disease.

Block versus particulate/titanium mesh for ridge augmentation for mandibular lateral incisor defects: clinical and histologic analysis.

The purpose of this study was to clinically, histologically, and immunohistochemically evaluate the quantity and quality of newly regenerated bone by means of direct clinical measuring and biopsy specimens of alveolar ridges augmented by autogenous cortical bone or titanium micromesh-both filled with autogenous particulate bone graft in the anterior jaws. For the preliminary study, 10 alveolar bone defects in five partially edentulous patients (two men and three women), between 19 and 35 years old (mean: 25.4, SD: 5.94) were selected. Bone defects were randomly (coin toss) divided into two groups: A (micromesh) and B (bone block). The donor site was the mandibular symphysis in all cases. On the return appointment, operative grafts appeared well incorporated into the native bone, which suggests that good contact and fit between the graft and the recipient site had been obtained during the first surgery. Histologic investigations confirmed excellent integration and revascularization of the graft in both study groups, with formation of new bone tissue without any relevant inflammation.

Nanomechanical mapping of bone tissue regenerated by magnetic scaffolds.

Nanoindentation can provide new insights on the maturity stage of regenerating bone. The aim of the present study was the evaluation of the nanomechanical properties of newly-formed bone tissue at 4 weeks from the implantation of permanent magnets and magnetic scaffolds in the trabecular bone of rabbit femoral condyles. Three different groups have been investigated: MAG-A (NdFeB magnet + apatite/collagen scaffold with magnetic nanoparticles directly nucleated on the collagen fibers during scaffold synthesis); MAG-B (NdFeB magnet + apatite/collagen scaffold later infiltrated with magnetic nanoparticles) and MAG (NdFeB magnet). The mechanical properties of different-maturity bone tissues, i.e. newly-formed immature, newly-formed mature and native trabecular bone have been evaluated for the three groups. Contingent correlations between elastic modulus and hardness of immature, mature and native bone have been examined and discussed, as well as the efficacy of the adopted regeneration method in terms of "mechanical gap" between newly-formed and native bone tissue. The results showed that MAG-B group provided regenerated bone tissue with mechanical properties closer to that of native bone compared to MAG-A or MAG groups after 4 weeks from implantation. Further, whereas the mechanical properties of newly-formed immature and mature bone were found to be fairly good correlated, no correlation was detected between immature or mature bone and native bone. The reported results evidence the efficacy of nanoindentation tests for the investigation of the maturity of newly-formed bone not accessible through conventional analyses.

Autologous serum improves bone formation in a primary stable silica-embedded nanohydroxyapatite bone substitute in combination with mesenchymal stem cells and rhBMP-2 in the sheep model.

New therapeutic strategies are required for critical size bone defects, because the gold standard of transplanting autologous bone from an unharmed area of the body often leads to several severe side effects and disadvantages for the patient. For years, tissue engineering approaches have been seeking a stable, axially vascularized transplantable bone replacement suitable for transplantation into the recipient bed with pre-existing insufficient conditions. For this reason, the arteriovenous loop model was developed and various bone substitutes have been vascularized. However, it has not been possible thus far to engineer a primary stable and axially vascularized transplantable bone substitute. For that purpose, a primary stable silica-embedded nanohydroxyapatite (HA) bone substitute in combination with blood, bone marrow, expanded, or directly retransplanted mesenchymal stem cells, recombinant human bone morphogenetic protein 2 (rhBMP-2), and different carrier materials (fibrin, cell culture medium, autologous serum) was tested subcutaneously for 4 or 12 weeks in the sheep model. Autologous serum lead to an early matrix change during degradation of the bone substitute and formation of new bone tissue. The best results were achieved in the group combining mesenchymal stem cells expanded with 60 μg/mL rhBMP-2 in autologous serum. Better ingrowth of fibrovascular tissue could be detected in the autologous serum group compared with the control (fibrin). Osteoclastic activity indicating an active bone remodeling process was observed after 4 weeks, particularly in the group with autologous serum and after 12 weeks in every experimental group. This study clearly demonstrates the positive effects of autologous serum in combination with mesenchymal stem cells and rhBMP-2 on bone formation in a primary stable silica-embedded nano-HA bone grafting material in the sheep model. In further experiments, the results will be transferred to the sheep arteriovenous loop model in order to engineer an axially vascularized primary stable bone replacement in clinically relevant size for free transplantation.

Characterization of Three Calcium Phosphate Microporous Granulated Bioceramics

The calcium phosphate microporous bioceramics, and hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) biphasic compositions, in the granular form of microporous biomaterials, are research themes and present potential biomedical applications in rebuilding and repairing maxillofacial bone and tooth structure and in orthopedic applications. This is associated with microstructural characteristics of biocompatibility and bioactivity and osteoconductivity properties that these biomaterials offer when appliedin vivoor in simulated environment. Another differential point of these biomaterials is the solubilization capacity that they present when applied in the biological environment. These compositions of calcium phosphates (hydroxyapatite matrix and/or β-tricalcium phosphate) allow for the gradual release of calcium and phosphate ions for the biological environment, which are absorbed and promote the formation of new bone tissue. These materials are also promising in applications in the field of traumatology as in the repair of traumatized bone tissue and drugs controlled release and bone structure treatments. The favorable results of these biomaterials as bone reconstruction matrix and drugs controlled release are associated with crystallographic characteristics, morphology, surface and solubility that these biomaterials present when in contact with body fluids. This work aimed to describe three types of calcium phosphate microporous granulated biomaterials. The biomaterials used were provided by the Biomaterials Group from Universidade do Estado de Santa Catarina - UDESC and are: hydroxyapatite, β-tricalcium phosphate and biphasic composition 60% hydroxyapatite/40% β-tricalcium phosphate. The Scanning Electron Microscopy technique (SEM) was used for carrying out the morphological characterization and microstructure studies of granulated biomaterials. The X-Ray Diffractometry (XRD) served for characterization of crystalline phases. Arthur Method was used for determining open porosity and hydrostatic density of biomaterials. The BET technique served to support determination of the surface area of microporous granulated biomaterials. The results are encouraging and show that these biomaterials present promising morphological characteristics and microporous microstructure as wettability and capillarity. These characteristics may contribute to biomaterial osteointegration by new tissue, bone formation and mineralization process.

The effect of simvastatin on chemotactic capability of SDF-1α and the promotion of bone regeneration

The purpose of this study was to investigate the cooperative effects of simvastatin (SIM) and stromal cell-derived factor-1α (SDF-1α) on the osteogenic and migration capabilities of mesenchymal stem cells (MSCs), and construct a cell-free bone tissue engineering system comprising SIM, SDF-1α and scaffold. We found that 0.2 μm SIM significantly increased alkaline phosphatase activity (P < 0.05) of mouse bone marrow MSCs with no inhibition of cell proliferation, and enhanced the chemotactic capability of SDF-1α (P < 0.05). Next, we constructed a novel cell-free bone tissue engineering system using PLGA loaded with SIM and SDF-1α, and applied it in critical-sized calvarial defects in mice. New bone formation in the defect was evaluated by micro-CT, HE staining and immunohistochemistry. The results showed that PLGA loaded with SIM and SDF-1α promoted bone regeneration significantly more than controls. We investigated possible mechanisms, and showed that SDF-1α combined with SIM increased MSC migration and homing in vivo, promoted angiogenesis and enhanced the expression of BMP-2 in newly-formed bone tissue. In conclusion, SIM enhanced the chemotactic capability of SDF-1α and the cell-free bone tissue engineering system composed of SIM, SDF-1α and scaffold promoted bone regeneration in mouse critical-sized calvarial defects.

The Russian Council of Experts for Use of the Innovative Anabolic Agent Forsteo®(Teriparatide) in the Treatment of Severe Osteoporosis

The meeting of the Russian Council of Experts for the use of the novel anabolic agent Forsteo®(teriparatide) to treat osteoporosis (OP) was held in Moscow on June 29, 2013. The meeting was attended by leading Russian OP specialists, including the members of the Russian Osteoporosis Association and its Presidium. The participants of the Council of Experts noted the great social importance of severe OP, which was associated primarily with its consequences, such as fractures causing an increase in disability and mortality rates in elderly people, and discussed the possibilities and benefits of the new approach to treating OP with teriparatide, the first drug permitting the formation of new bone tissue. The experts have recommended teriparatide for use within the registered indications in the following groups of patients: those who have severe OP (≥1 vertebral fractures, hip fracture of vertebral bodies or a fracture of the proximal femur, multiple recurrent fractures of skeletal bones) as first-line therapy; those who had ineffective previous antiosteoporotic therapy (new fractures occurring during the treatment and/or a continuing decline in bone mineral density), those who are intolerant to other medications for OP, or who have contraindications to their use.

Improvement of in vitro physicochemical properties and osteogenic activity of calcium sulfate cement for bone repair by dicalcium silicate

Abstract An ideal bone graft substitute should have the same speed of degradation as formation of new bone tissue. To improve the properties of calcium sulfate hemihydrate (CSH) featured for its rapid resorption, a low degradation material of dicalcium silicate (DCS) was added to the CSH cement. This study examined the effect of DCS (20, 40, 60 and 80 wt%) on the in vitro physicochemical properties and osteogenic activities of the calcium-based composite cements. The diametral tensile strength, porosity and weight loss of the composite cements were evaluated before and after soaking in a simulated body fluid (SBF). The osteogenic activities, such as proliferation, differentiation and mineralization, of human mesenchymal stem cells (hMSCs) seeded on cement surfaces were also examined. As a result, the greater the DCS amount, the higher the setting time was in the cement. Before soaking in SBF, the diametral tensile strength of the composite cements was decreased due to the introduction of DCS. On 180-day soaking, the composite cements containing 20, 40, 60 and 80 wt% DCS lost 80%, 69%, 61% and 44% in strength, respectively. Regarding in vitro bioactivity, the DCS-rich cements were covered with clusters of apatite spherulites after soaking for 7 days, while there was no formation of apatite spherulites on the CSH-rich cement surfaces. The presence of DCS could reduce the degradation of the CSH cements, as evidenced in the results of weight loss and porosity. More importantly, DCS may promote effectively the cell proliferation, proliferation and mineralization. The combination of osteogenesis of DCS and degradation of CSH made the calcium-based composite cements an attractive choice for bone defect repair.

The combination of mesenchymal stem cells and a bone scaffold in the treatment of vertebral body defects

Vertebral body defects represent one of the most common orthopedic challenges. In order to advance the transfer of stem cell therapies into orthopedic clinical practice, we performed this study to evaluate the safety and efficacy of a composite bioartificial graft based on a hydroxyapatite bone scaffold (CEM-OSTETIC(®)) combined with human mesenchymal stem cells (MSCs) in a rat model of vertebral body defects. Under general isoflurane anesthesia, a defect in the body of the L2 vertebra was prepared and left to heal spontaneously (group 1), implanted with scaffold material alone (group 2), or implanted with a scaffold together with 0.5 million MSCs (group 3) or 5 million MSCs (group 4). The rats were killed 8 weeks after surgery. Histological and histomorphometrical evaluation of the implant as well as micro-CT imaging of the vertebrae were performed. We observed a significant effect on the formation of new bone tissue in the defect in group 4 when compared to the other groups and a reduced inflammatory reaction in both groups receiving a scaffold and MSCs. We did not detect any substantial pathological changes or tumor formation after graft implantation. MSCs in combination with a hydroxyapatite scaffold improved the repair of a model bone defect and might represent a safe and effective alternative in the treatment of vertebral bone defects.