Osteoporotic Bone Regeneration Research Articles

Injectable double-crosslinked bone cement with enhanced bone adhesion and improved osteoporotic pathophysiological microenvironment for osteoregeneration in osteoporosis

The osteoporotic bone defect caused by excessive activity of osteoclasts has posed a challenge for public healthcare. However, most existing bioinert bone cement fails to effectively regulate the pathological bone microenvironment and reconstruct bone homeostasis in the presence of osteoclast overactivity and osteoblast suppression. Herein, inspired by natural bone tissue, an in-situ modulation system for osteoporotic bone regeneration is developed by fabricating an injectable double-crosslinked PEGylated poly(glycerol sebacate) (PEGS)/calcium phosphate cement (CPC) loaded with sodium alendronate (ALN) (PEGS/CPC@ALN) adhesive bone cement. By incorporating ALN, the organic-inorganic interconnection within PEGS/CPC@ALN results in a 100 % increase in compression modulus and energy dissipation efficiency. Additionally, PEGS/CPC@ALN effectively adheres to the bone by bonding with amine and calcium ions present on the bone surface. Moreover, this in-situ regulation system comprehensively mitigates excessive bone resorption through the buffering effect of CPC to improve the acidic microenvironment of osteoporotic bone and the release of ALN to inhibit hyperactive osteoclasts, and facilitates stem cell proliferation and differentiation into osteoblasts through calcium ion release. Overall, the PEGS/CPC@ALN effectively regulates the pathological microenvironment of osteoporosis while promoting bone regeneration through synergistic effects of drugs and materials, thereby improving bone homeostasis and enabling minimally invasive treatment for osteoporotic defects.

Honeycomb Bionic Graphene Oxide Quantum Dot/Layered Double Hydroxide Composite Nanocoating Promotes Osteoporotic Bone Regeneration via Activating Mitophagy.

Abnormal osteogenic and remodeling microenvironment due to osteoblast apoptosis are the primary causes of delayed fracture healing in osteoporotic patients. Magnesium (Mg) alloys exhibit biodegradability and appropriate elastic moduli for bone defects in osteoporosis, but the effect on the local bone remodeling disorder is still insufficient. Inspired by the "honeycomb," layered double hydroxide (LDH) with regular traps with graphene oxide quantum dots (GOQDs) inlayed is constructed by pulsed electrodeposition to generate GOQD/LDH composite nanocoatings on the surfaces of Mg alloy substrates. The honeycomb bionic multi-layer stereoscopic structure shows good regulation of the degradation of Mg alloy for the support of healing time required for osteoporotic bone defect. Within its lattice, the local microenvironment conducive to osteogenesis is provided by both the rescue effect of GOQD and LDH. The osteoblast apoptosis is rescued due to the activation of mitophagy to clear dysfunctional mitochondria, where the upregulation of BNIP3 phosphorylation played a key role. The osteoporotic rat model of femoral defects confirmed the improvement of bone regeneration and osseointegration of GOQD/LDH coating. In summary, honeycomb bionic composite nanocoatings with controllable degradation and excellent pro-osteogenic performance demonstrated a promising design strategy on Mg alloy implants in the therapy of osteoporotic bone defects.

Fishnet-Inspired 3D Scaffold Fabricated from Mesh-like Electrospun Membranes Promoted Osteoporotic Bone Regeneration

Fishnet-Inspired 3D Scaffold Fabricated from Mesh-like Electrospun Membranes Promoted Osteoporotic Bone Regeneration

Hydrophilic silsesquioxane nanocages toughened extracellular matrix biomimetic Poly(γ-Glutamic acid) multidimensional self-polymerizable and osteogenic hybrid hydrogel for osteoporotic bone regeneration

Rapid bone defect regeneration in osteoporotic conditions remains a significant challenge due to the fragile mechanical stability and pathological microenvironment. The absence of bone matrix is the primary characteristic of these defects, and advanced strategies for treating osteoporotic bone defects focus on remodeling the bone matrix's spatial structure and regulating the microenvironment. While many hydrogels have been developed for bone regeneration, their use in repairing osteoporotic bone defects is constrained by deficiencies in shape-adaptivity, weak osteogenic bioactivity, and lack of physiological mechanical support. Herein, a novel bioactive hydrophilic semi-caged NH2-T4 silsesquioxane (NH2-T4-POSS) nanocage was developed, which was used to modify γ-polyglutamic acid (γ-PGA) together with dopamine, to give an organic/inorganic hybrid hydrogel PGA-DA&T4 for osteoporotic bone regeneration. The developed PGA-DA&T4 hydrogel possesses favorable injectability, shape-adaptivity, self-healability, and strong antioxidant ability. Benefited from organic/inorganic hybridation and multidimensional molecular interacting mechanism, PGA-DA&T4 exhibites enhanced thermal stability and longer degradation period, unique self-polymerizability, high elasticity, and considerable tissue adhesion ability. In vitro experiments proved that PGA-DA&T4 is biocompatible, and is able to promote cell migration and neovascularization, and possesses favorable immunoregulatory to promote macrophage polarization towards anti-inflammatory M2 phenotype. Furthermore, PGA-DA&T4 has been demonstrated to accelerate osteogenic differentiation and inhibit osteoclastogenesis, thereby promoting the repair of osteoporotic bone defects. Our research successfully developed a novel hybrid γ-PGA hydrogel with therapeutic effects and supplied a promising biomaterial with potential clinical application for repairing osteoporotic bone defects.

Injectable and high-strength PLGA/CPC loaded ALN/MgO bone cement for bone regeneration by facilitating osteogenesis and inhibiting osteoclastogenesis in osteoporotic bone defects

Osteoporosis (OP) can result in slower bone regeneration than the normal condition due to the imbalance between osteogenesis and osteoclastogenesis, making osteoporotic bone defects healing a significant clinical challenge. Calcium phosphate cement (CPC) is a promising bone substitute material due to its good osteoinductive activity, however, the drawbacks such as fragility, slow degradation rate and incapability to control bone loss restrict its application in osteoporotic bone defects treatment. Currently, we developed the PLGA electrospun nanofiber sheets to carry alendronate (ALN) and magnesium oxide nanoparticle (nMgO) into CPC, therefore, to obtain a high-strength bone cement (C/AM-PL/C). The C/AM-PL/C bone cement had high mechanical strength, anti-washout ability, good injection performance and drug sustained release capacity. More importantly, the C/AM-PL/C cement promoted the osteogenic differentiation of bone marrow mesenchymal stem cells and neovascularization via the release of Mg2+ (from nMgO) and Ca2+ (during the degradation of CPC), and inhibited osteoclastogenesis via the release of ALN in vitro. Moreover, the injection of C/AM-PL/C cement significantly improved bone healing in an OP model with femur condyle defects in vivo. Altogether, the injectable C/AM-PL/C cement could facilitate osteoporotic bone regeneration, demonstrating its capacity as a promising candidate for treatment of osteoporotic bone defects.

Advancing Osteoporotic Bone Regeneration Through Tailored Tea Polyphenols Functionalized Micro‐/Nano‐ Hydroxyapatite Bioceramics

AbstractEfforts to develop advanced bone substitutes for effective bone regeneration in substantial defects have led to the fabrication of tissue‐engineered scaffolds. These scaffolds, featuring hierarchical structures, specific chemical compositions, and functional qualities, are essential in mimicking native bone tissue. Inspired by the biomineralization process, hydrothermal treatment is used to synthesize micro‐/nano‐hydroxyapatite bioceramics functionalized with tea polyphenols (TP‐nwHA), closely resembling the structure of bone‐like apatite induced by hydroxyapatite bioceramics in vivo. The in vitro results demonstrate TP‐nwHA's superior biocompatibility, enhancing cell proliferation and adhesion. Furthermore, TP‐nwHA scaffolds significantly influence mesenchymal stem cells, promoting osteogenic differentiation while inhibiting osteoclastogenic differentiation. The upregulation of osteogenic proteins BMP2 and ITGB1, along with the downregulation of osteoclastic proteins FGF21 and IGFBP1, demonstrate the synergistic effect of the biomimetic structure and polyphenols on the activation of the MAPK signaling pathway. In vivo, TP‐nwHA showe early angiogenic capabilities, leading to improved bone regeneration in critical‐size femoral bone defects in osteoporotic rats. Histological staining confirms the complete bridging of defects with new bone tissue in the TP‐nwHA group, and nanoindentation tests indicate the formation of mature mineralized bone tissue. Collectively, these findings suggest a novel strategy for fabricating bone‐mimicking constructs with potential applications in disease modeling.

Hypoxia preconditioning of adipose stem cell-derived exosomes loaded in gelatin methacryloyl (GelMA) promote type H angiogenesis and osteoporotic fracture repair

The challenges posed by delayed atrophic healing and nonunion stand as formidable obstacles in osteoporotic fracture treatment. The processes of type H angiogenesis and osteogenesis emerge as pivotal mechanisms during bone regeneration. Notably, the preconditioning of adipose-derived stem cell (ADSC) exosomes under hypoxic conditions has garnered attention for its potential to augment the secretion and functionality of these exosomes. In the present investigation, we embarked upon a comprehensive elucidation of the underlying mechanisms of hypo-ADSC-Exos within the milieu of osteoporotic bone regeneration. Our findings revealed that hypo-ADSC-Exos harboured a preeminent miRNA, namely, miR-21-5p, which emerged as the principal orchestrator of angiogenic effects. Through in vitro experiments, we demonstrated the capacity of hypo-ADSC-Exos to stimulate the proliferation, migration, and angiogenic potential of human umbilical vein endothelial cells (HUVECs) via the mediation of miR-21-5p. The inhibition of miR-21-5p effectively attenuated the proangiogenic effects mediated by hypo-ADSC-Exos. Mechanistically, our investigation revealed that exosomal miR-21-5p emanating from hypo-ADSCs exerts its regulatory influence by targeting sprouly1 (SPRY1) within HUVECs, thereby facilitating the activation of the PI3K/AKT signalling pathway. Notably, knockdown of SPRY1 in HUVECs was found to potentiate PI3K/AKT activation and, concomitantly, HUVEC proliferation, migration, and angiogenesis. The culminating stage of our study involved a compelling in vivo demonstration wherein GelMA loaded with hypo-ADSC-Exos was validated to substantially enhance local type H angiogenesis and concomitant bone regeneration. This enhancement was unequivocally attributed to the exosomal modulation of SPRY1. In summary, our investigation offers a pioneering perspective on the potential utility of hypo-ADSC-Exos as readily available for osteoporotic fracture treatment.Graphical

Composite demineralized bone matrix nanofiber scaffolds with hierarchical interconnected networks via eruptive inorganic catalytic decomposition for osteoporotic bone regeneration

Demineralized bone matrix (DBM) is one of the standard biomaterials used to fill surgical bone defects in general orthopedic procedures. However, current DBM products come in the form of powder or viscous solutions that fail to mimic the natural hierarchical structure of bone while also using large amounts of valuable material. To overcome this, compact fibrous DBM/polymer (fDBM) composites were prepared via electrospinning. Then, by exploiting the catalytic decomposition of hydrogen peroxide, oxygen pockets are formed in the scaffold imparting it with a hierarchical porous structure similar to bone (Op-fDBM). These pockets created by bubbles of oxygen help give the scaffold a mechanically stable shape while the incorporated DBM supports cell adhesion and growth. In vivo evaluations reveal that fDBM increased bone volume by 41.7 % while Op-fDBM increased bone volume by 68.6 %. Significant increases in regenerated bone volume with the use of minimal amounts of DBM in fiber form go to show the great potential of this work in the field of bone regeneration.

Electrochemical technique to develop surface-controlled polyaniline nano-tulips (PANINTs) on PCL-reinforced chitosan functionalized (CS-f-Fe2O3) scaffolds for stimulating osteoporotic bone regeneration

Bone defects pose significant challenges in orthopedic surgery, often leading to suboptimal outcomes and complications. Addressing these challenges, we employed a three-electrode electrochemical system to fabricate surface-controlled polyaniline nano-tulips (PANINTs) decorated polycaprolactone (PCL) reinforced chitosan functionalized iron oxide nanoparticles (CS-f-Fe2O3) scaffolds. These structures were designed to emulate the natural extracellular matrix (ECM) and promote enhanced osseointegration by establishing a continuous interface between host bone and graft, thereby improving both biological processes and mechanical stability. In vitro experiments demonstrated that PANINTs-PCL/CS-f-Fe2O3 substrates significantly promoted the proliferation, differentiation, and spontaneous outgrowth and extension of MC3T3-E1 cell activity. The nanomaterials exhibited increased cell viability and osteogenic differentiation, as evidenced by elevated expression of bone-related markers such as ALP, ARS, COL-I, RUNX2, and SPP-I, as determined by qRT-PCR. Our findings underscore the regenerative potential of in situ cell culture systems for bone defects, emphasizing the targeted stimulation of essential cell subpopulations to facilitate rapid bone tissue regeneration.

A personalized biomimetic dual-drug delivery system via controlled release of PTH1-34 and simvastatin for in situ osteoporotic bone regeneration.

Patients with osteoporosis often encounter clinical challenges of poor healing after bone transplantation due to their diminished bone formation capacity. The use of bone substitutes containing bioactive factors that increase the number and differentiation of osteoblasts is a strategy to improve poor bone healing. In this study, we developed an in situ dual-drug delivery system containing the bone growth factors PTH1-34 and simvastatin to increase the number and differentiation of osteoblasts for osteoporotic bone regeneration. Our system exhibited ideal physical properties similar to those of natural bone and allowed for customizations in shape through a 3D-printed scaffold and GelMA. The composite system regulated the sustained release of PTH1-34 and simvastatin, and exhibited good biocompatibility. Cell studies revealed that the composite system reduced osteoblast death, and promoted expression of osteoblast differentiation markers. Additionally, by radiographic analysis and histological observation, the dual-drug composite system demonstrated promising bone regeneration outcomes in an osteoporotic skull defect model. In summary, this composite delivery system, comprising dual-drug administration, holds considerable potential for bone repair and may serve as a safe and efficacious therapeutic approach for addressing bone defects in patients with osteoporosis.

Osteoporotic Bone Regeneration via Plenished Biomimetic PLGA Scaffold with Sequential Release System.

Achieving satisfactory bone tissue regeneration in osteoporotic patients with ordinary biomaterials is challenging because of the decreased bone mineral density and aberrant bone microenvironment. In addressing this issue, a biomimetic scaffold (PMEH/SP), incorporating 4-hexylresorcinol (4HR), and substance P (SP) into the poly(lactic-go-glycolic acid) (PLGA) scaffold with magnesium hydroxide (M) and extracellular matrix (E) is introduced, enabling the consecutive release of bioactive agents. 4HR and SP induced the phosphorylation of p38 MAPK and ERK in human umbilical vein endothelial cells (HUVECs), thereby upregulating VEGF expression level. The migration and tube-forming ability of endothelial cells can be promoted by the scaffold, which accelerates the formation and maturation of the bone. Moreover, 4HR played a crucial role in the inhibition of osteoclastogenesis by interrupting the IκB/NF-κB signaling pathway and exhibiting SP, thereby enhancing the migration and angiogenesis of HUVECs. Based on such a synergistic effect, osteoporosis can be suppressed, and bone regeneration can be achieved by inhibiting the RANKL pathway in vitro and in vivo, which is a commonly known mechanism of bone physiology. Therefore, the study presents a promising approach for developing a multifunctional regenerative material for sophisticated osteoporotic bone regeneration.

Bioactive composite hydrogel with effects of robust promoting osteogenesis and immunomodulation for osteoporotic bone regeneration

Osteoporotic bone defect is an intractable challenge in clinical practice, involving impaired bone repair ability and abnormal immune response. Despite the development of various tissue-engineered scaffolds for osteoporotic bone repair, the pathogenesis of osteoporosis has been lacking consideration, resulting in poor efficacy. Here, we integrated short-chain chitosan (CS) and nanoparticulate hydroxyapatite (nHAp) into a covalent tetra-armed poly (ethylene glycol) (tetra-PEG) network to create a composite hydrogel (PEG/nHAp/CS, PHC). The constructed PHC hydrogel exhibited ability of enhancing osteogenesis with high mechanical strength, excellent surface properties, and good biocompatibility. PHC hydrogel also had immunomodulatory effects of promoting M2 macrophage polarization and suppressing M1 macrophage polarization via antagonizing TLR4/NF-κB signaling. PHC hydrogel further increased osteogenic capacity and inhibited osteoclast formation and resorption indirectly. Parathyroid hormone (PTH) could be effective loaded and sustainable released in the PHC hydrogel (PTH@PHC), in which the osteogenic ability was further enhanced via activation of cAMP/PKA/CREB signaling. By using an osteoporotic calvaria bone defect rat model, we demonstrated that the PTH@PHC hydrogel was able to improve bone regeneration and bone defects healing. Findings of this study indicated that the bioactive composite hydrogel has powerful osteogenic-promoting potency and immunomodulation, which provides a promising therapeutic strategy for future clinical repair of osteoporotic bone defect.

Autophagy mediates osteoporotic bone regeneration induced by micro-/nano-structured modification on hydroxyapatite bioceramics

Autophagy mediates osteoporotic bone regeneration induced by micro-/nano-structured modification on hydroxyapatite bioceramics

Curcumin delivery using tetrahedral framework nucleic acids enhances bone regeneration in osteoporotic rats

Osteoporosis is an age-related disorder characterized by progressive bone loss and impaired bone regeneration following surgery. The key to the treatment of osteoporosis is the ability to promote bone differentiation of bone marrow mesenchymal stem cells (BMSCs). Curcumin (Cur) is a class of flavonoids with antioxidant and anti-apoptotic ability to promote osteogenesis in osteoporosis. However, Cur has deficiencies such as low cell entry efficiency, easy degradation and hydrophobicity, and new drug delivery strategies are urgently needed to improve the application prospects of Cur. Tetrahedral framework nucleic acids (tFNAs) are a class of anti-inflammatory and antioxidant nanomedicines with spatial structure, as well as small molecule drug delivery systems with good biosafety. tFNAs can bind herbal monomers and small molecule peptides through electrostatic interaction and grooves to promote drug utilization. Meanwhile, tFNAs can connect miRNAs and siRNAs through specially designed sticky ends to regulate the biological functions and activities of cells. In this study, we synthesized tFNAs/Cur complexes, a novel nucleic acid drug system for promoting osteoporotic bone regeneration, to deliver Cur into BMSCs and to exert antioxidant and anti-apoptotic effects. tFNAs/Cur complexes reverse TNF-α-promoted osteogenic inhibition, and facilitate the expression of alkaline phosphatase (Alp), runt-related transcription factor 2 (Runx2), and osterix (Osx). The effect of tFNAs/Cur on the repair of tibial defects in rats with postmenopausal osteoporosis was studied. The experimental group exhibited a higher bone-formation capacity than the control group after 14 and 21 days. In conclusion, tFNAs improve Cur utilization, promote bone repair, and are promising osteoporosis-treatment interventions.

Repurpose dasatinib and quercetin: Targeting senescent cells ameliorates postmenopausal osteoporosis and rejuvenates bone regeneration.

Clinical therapies developed for estrogen-deficiency-driven postmenopausal osteoporosis (PMO) and related diseases, such as bone degeneration, show multiple adverse effects nowadays. Targeting senescent cells (SnCs) and the consequent senescence-associated secretory phenotype (SASP) with a combination of dasatinib and quercetin (DQ) is a recently developed novel therapy for multiple age-related diseases. Herein, we found that estrogen deficiency induced-bone loss was attributed to a pro-inflammatory microenvironment with SASP secretions and accelerated SnC accumulation, especially senescent mesenchymal stem cells (MSCs) characterized by exhaustion and dysfunction in middle aged rats. Systematically targeting SnCs with DQ strikingly ameliorated PMO and restored MSC function. Local administration of DQ and bone morphogenetic protein 2 (BMP2) in combination promoted osteogenic differentiation of MSCs and rejuvenated osteoporotic bone regeneration. Our results repurposed DQ as an attractive therapy for treating PMO and related diseases.

Multifunctional Scaffold for Osteoporotic Pathophysiological Microenvironment Improvement and Vascularized Bone Defect Regeneration.

Osteoporosis is a degenerative bone disease resulting from bone homeostasis imbalance regulated by osteoblasts and osteoclasts. Treating osteoporotic bone defects tends to be more difficult due to suppressed osteogenic differentiation, hyperactive osteoclastogenesis, and impaired angiogenesis. Hence, a drug carrier system composed of gelatin-coated hollow mesoporous silica nanoparticles (HMSNs/GM) loaded with pro-osteogenic parathyroid (PTH) and anti-osteoclastogenic alendronate (ALN) is constructed and compounded into calcium magnesium phosphate cement (MCPC). The spatial-temporal release of ions and drugs, controllable degradation rate, and abundant pore structure of MCPC composites enhance osteoporotic bone regeneration in ovariectomized rats by accelerating vascularization, promoting osteogenic differentiation and mineralization, and inhibiting osteoclastogenesis and bone resorption. The MCPC/HMSNs@ALN-PTH/GM demonstrates a synergistic threefold effect on osteogenesis, osteoclastogenesis, and angiogenesis. It improves the osteoporotic pathophysiological microenvironment and promotes osteoporotic vascularized bone defect regeneration, holding huge potential for other functional biomaterials design and clinical management.

Injectable magnesium oxychloride cement foam-derived scaffold for augmenting osteoporotic defect repair

HypothesisCement augmentation has been widely applied to promote osteoporotic fracture healing, whereas the existing calcium-based products suffer from the excessively slow degradation, which may impede bone regeneration. Magnesium oxychloride cement (MOC) shows promising biodegradation tendency and bioactivity, which is expected to be a potential alternative to the classic calcium-based cement for hard-tissue-engineering applications. ExperimentsHere, a hierarchical porous MOC foam (MOCF)-derived scaffold with favorable bio-resorption kinetic and superior bioactivity is fabricated through Pickering foaming technique. Then, a systematic characterization in terms of material properties and in vitro biological performance have been conducted to evaluate the feasibility of the as-prepared MOCF scaffold to be a bone-augmenting material for treating osteoporotic defects. FindingsThe developed MOCF shows excellent handling performance in the paste state, while exhibiting sufficient load-bearing capacity after solidification. In comparison with the traditional bone cement, calcium deficient hydroxyapatite (CDHA), our porous MOCF scaffold demonstrates a much higher biodegradation tendency and better cell recruitment ability. Additionally, the eluted bioactive ions by MOCF commits to a biologically inductive microenvironment, where the in vitro osteogenesis is significantly enhanced. It is anticipated that this advanced MOCF scaffold will be competitive for clinical therapies to augment osteoporotic bone regeneration.

Nitric Oxide-Releasing Bioinspired Scaffold for Exquisite Regeneration of Osteoporotic Bone via Regulation of Homeostasis.

Osteoporotic bone regeneration is a challenging process which involves the occurrence of sophisticated interactions. Although various polymeric scaffolds have been proposed for bone repair, research on osteoporotic bone regeneration remains practically limited. In particular, achieving satisfactory bone regeneration when using osteoporotic drugs is challenging including bisphosphonates. Here, a novel nitric oxide-releasing bioinspired scaffold with bioactive agents for the exquisite regeneration of osteoporotic bone is proposed. The bone-like biomimetic poly(lactic-co-glycolic acid) scaffold is first prepared in combination with organic/inorganic ECM and magnesium hydroxide as the base implant material. Nanoparticles containing bioactive agents of zinc oxide (ZO), alendronate, and BMP2 are incorporated to the biomimetic scaffold to impart multifunctionality such as anti-inflammation, angiogenesis, anti-osteoclastogenesis, and bone regeneration. Especially, nitric oxide (NO) generated from ZO stimulates the activity of cGMP and protein kinase G; in addition, ZO downregulates the RANKL/osteoprotegerin ratio by suppressing the Wnt/β-catenin signaling pathway. The new bone is formed much better in the osteoporotic rat model than in the normal model through the regulation of bone homeostasis via the scaffold. These synergistic effects suggest that such a bioinspired scaffold could be a comprehensive way to regenerate exceptionally osteoporotic bones.

Enhanced osteogenesis, angiogenesis and inhibited osteoclastogenesis of a calcium phosphate cement incorporated with strontium doped calcium silicate bioceramic

Biologically active ions doped calcium phosphates to stimulate osteogenesis, angiogenesis and suppress osteoclastogenesis is a promising strategy for accelerating osteoporotic bone repair. Among them, silicon (Si) and strontium (Sr) ions are beneficial for new bone and vessel regeneration. In this study, Si and Sr were jointly introduced into calcium phosphate cement (CPC) by incorporating strontium doped calcium silicate (Sr-CS) to stimulate osteoporotic bone repair. Sr-CS prolonged the setting time of CPC, but hardly altered the compressive strength and injectability. More thin-lamellar and cluster-like apatite crystals were formed on the surface of Si and Sr co-doped CPC during in vitro mineralization. Besides, CPC with Sr-CS could controllably and sustainedly release Ca, Si and Sr ions. The cell experiments showed 10Sr-CS/CPC and 20Sr-CS/CPC (10 and 20 mol.% doping content of Sr in Sr-CS, respectively) significantly promoted the proliferation, ALP activity, osteogenesis-related genes (ALP, Runx2, Col-I and OC) and proteins (Col I and OC) expression of mBMSCs. The extracts of 10Sr-CS/CPC and 20Sr-CS/CPC also effectively enhanced the angiogenesis-related gene (eNOs) of human umbilical vein endothelial cells (HUVECs) and more interconnected circles formed when the 20Sr-CS/CPC extract was added. Furthermore, the release of Si and Sr ions from 20Sr-CS/CPC extract suppressed the TRAP activity and the expression of osteoclastogenesis-related genes (TRAP and MMP9) in RAW264.7 cells. These results together indicate 20Sr-CS/CPC with enhanced osteogenesis and angiogenesis, proper setting properties and suppressed osteoclastogenesis has a great potential for stimulating osteoporotic bone regeneration.

Bioactive Scaffold Fabricated by 3D Printing for Enhancing Osteoporotic Bone Regeneration.

We develop a poly (lactic-co-glycolic acid)/β-calcium phosphate (PLGA/TCP)-based scaffold through a three-dimensional (3D) printing technique incorporating icaritin (ICT), a unique phytomolecule, and secretome derived from human fetal mesenchymal stem cells (HFS), to provide mechanical support and biological cues for stimulating bone defect healing. With the sustained release of ICT and HFS from the composite scaffold, the cell-free scaffold efficiently facilitates the migration of MSCs and promotes bone regeneration at the femoral defect site in the ovariectomy (OVX)-induced osteoporotic rat model. Furthermore, mechanism study results indicate that the combination of ICT and HFS additively activates the Integrin–FAK (focal adhesion kinase)–ERK1/2 (extracellular signal-regulated kinase 1/2)–Runx2 (Runt-related transcription factor 2) axis, which could be linked to the beneficial recruitment of MSCs to the implant and subsequent osteogenesis enhancement. Collectively, the PLGA/TCP/ICT/HFS (P/T/I/S) bioactive scaffold is a promising biomaterial for repairing osteoporotic bone defects, which may have immense implications for their translation to clinical practice.