TY - JOUR A1 - Weißenberger, Manuel A1 - Wagenbrenner, Mike A1 - Nickel, Joachim A1 - Ahlbrecht, Rasmus A1 - Blunk, Torsten A1 - Steinert, Andre F. A1 - Gilbert, Fabian T1 - Comparative in vitro treatment of mesenchymal stromal cells with GDF-5 and R57A induces chondrogenic differentiation while limiting chondrogenic hypertrophy JF - Journal of Experimental Orthopaedics N2 - Purpose Hypertrophic cartilage is an important characteristic of osteoarthritis and can often be found in patients suffering from osteoarthritis. Although the exact pathomechanism remains poorly understood, hypertrophic de-differentiation of chondrocytes also poses a major challenge in the cell-based repair of hyaline cartilage using mesenchymal stromal cells (MSCs). While different members of the transforming growth factor beta (TGF-β) family have been shown to promote chondrogenesis in MSCs, the transition into a hypertrophic phenotype remains a problem. To further examine this topic we compared the effects of the transcription growth and differentiation factor 5 (GDF-5) and the mutant R57A on in vitro chondrogenesis in MSCs. Methods Bone marrow-derived MSCs (BMSCs) were placed in pellet culture and in-cubated in chondrogenic differentiation medium containing R57A, GDF-5 and TGF-ß1 for 21 days. Chondrogenesis was examined histologically, immunohistochemically, through biochemical assays and by RT-qPCR regarding the expression of chondrogenic marker genes. Results Treatment of BMSCs with R57A led to a dose dependent induction of chondrogenesis in BMSCs. Biochemical assays also showed an elevated glycosaminoglycan (GAG) content and expression of chondrogenic marker genes in corresponding pellets. While treatment with R57A led to superior chondrogenic differentiation compared to treatment with the GDF-5 wild type and similar levels compared to incubation with TGF-ß1, levels of chondrogenic hypertrophy were lower after induction with R57A and the GDF-5 wild type. Conclusions R57A is a stronger inducer of chondrogenesis in BMSCs than the GDF-5 wild type while leading to lower levels of chondrogenic hypertrophy in comparison with TGF-ß1. KW - bone marrow KW - cartilage KW - chondrogenesis KW - chondrogenic hypertrophy KW - mesenchymal stromal cell KW - GDF-5 KW - R57A Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357770 VL - 10 ER - TY - JOUR A1 - Heinz, Tizian A1 - Meller, Felix A1 - Luetkens, Karsten Sebastian A1 - Anderson, Philip Mark A1 - Stratos, Ioannis A1 - Horas, Konstantin A1 - Rudert, Maximilian A1 - Reppenhagen, Stephan A1 - Weißenberger, Manuel T1 - The AMADEUS score is not a sufficient predictor for functional outcome after high tibial osteotomy JF - Journal of Experimental Orthopaedics N2 - Purpose The Area Measurement And Depth Underlying Structures (AMADEUS) classification system has been proposed as a valuable tool for magnetic resonance (MR)-based grading of preoperatively encountered chondral defects of the knee joint. However, the potential relationship of this novel score with clinical data was yet to determine. It was the primary intention of this study to assess the correlative relationship of the AMADEUS with patient reported outcome scores in patients undergoing medial open-wedge high tibial valgus osteotomy (HTO). Furthermore, the arthroscopic ICRS (International Cartilage Repair Society) grade evaluation was tested for correlation with the AMADEUS classification system. Methods This retrospective, monocentric study found a total of 70 individuals that were indicated for HTO due to degenerative chondral defects of the medial compartment between 2008 and 2019. A preoperative MR image as well as a pre-osteotomy diagnostic arthroscopy for ICRS grade evaluation was mandatory for all patients. The Knee Osteoarthritis Outcome Score (KOOS) including its five subscale scores (KOOS-ADL, KOOS-QOL, KOOS-Sports, KOOS-Pain, KOOS-Symptoms) was obtained preoperatively and at a mean follow-up of 41.2 ± 26.3 months. Preoperative chondral defects were evaluated using the AMADEUS classification system and the final AMADEUS scores were correlated with the pre- and postoperative KOOS subscale sores. Furthermore, arthroscopic ICRS defect severity was correlated with the AMADEUS classification system. Results There was a statistically significant correlation between the AMADEUS BME (bone marrow edema) subscore and the KOOS Symptoms subscore at the preoperative visit (r = 0.25, p = 0.04). No statistically significant monotonic association between the AMADEUS total score and the AMADEUS grade with pre- and postoperative KOOS subscale scores were found. Intraoperatively obtained ICRS grade did reveal a moderate correlative relation with the AMADEUS total score and the AMADEUS grade (r = 0.28, p = 0.02). Conclusions The novel AMADEUS classification system largely lacks correlative capacity with patient reported outcome measures in patients undergoing HTO. The MR tomographic appearance of bone marrow edema is the only parameter predictive of the clinical outcome at the preoperative visit. KW - cartilage KW - AMADEUS KW - KOOS KW - knee KW - high tibial osteotomy KW - chondral defect KW - osteoarthritis KW - PROM KW - correlation Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357765 VL - 10 ER - TY - JOUR A1 - Weißenberger, Manuel A1 - Wagenbrenner, Mike A1 - Schote, Fritz A1 - Horas, Konstantin A1 - Schäfer, Thomas A1 - Rudert, Maximilian A1 - Barthel, Thomas A1 - Heinz, Tizian A1 - Reppenhagen, Stephan T1 - The 3-triangle method preserves the posterior tibial slope during high tibial valgus osteotomy: first preliminary data using a mathematical model JF - Journal of Experimental Orthopaedics N2 - Purpose Despite much improved preoperative planning techniques accurate intraoperative assessment of the high tibial valgus osteotomy (HTO) remains challenging and often results in coronal over- and under-corrections as well as unintended changes of the posterior tibial slope. Noyes et al. reported a novel method for accurate intraoperative coronal and sagittal alignment correction based on a three-dimensional mathematical model. This is the first study examining preliminary data via the proposed Noyes approach for accurate intraoperative coronal and sagittal alignment correction during HTO. Methods From 2016 to 2020 a total of 24 patients (27 knees) underwent HTO applying the proposed Noyes method (Noyes-Group). Radiographic data was analyzed retrospectively and matched to patients that underwent HTO using the conventional method, i.e., gradual medial opening using a bone spreader under fluoroscopic control (Conventional-Group). All operative procedures were performed by an experienced surgeon at a single orthopaedic university center. Results From the preoperative to the postoperative visit no statistically significant changes of the posterior tibial slope were noted in the Noyes-Group compared to a significant increase in the Conventional-Group (p = 0.01). Regarding the axial alignment no significant differences between both groups were observed pre- and postoperatively. The number of over- and under-corrections did not differ significantly between both groups. Linear regression analysis showed a significant correlation of the postoperative medial proximal tibial angle (MPTA) with the position of the weightbearing line on the tibial plateau. Conclusion The 3-triangle method by Noyes seems to be a promising approach for preservation of the posterior tibial slope during HTO. KW - knee KW - high tibial valgus osteotomy KW - axial alignment KW - posterior tibial slope KW - weight bearing line KW - cartilage KW - triangle method KW - osteoarthritis Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-300806 SN - 2197-1153 VL - 9 ER - TY - THES A1 - Frischholz, Sebastian T1 - Resveratrol Counteracts IL-1β-mediated Impairment of Extracellular Matrix Deposition in 3D Articular Chondrocyte Constructs T1 - Resveratrol wirkt der IL-1β-vermittelten Beeinträchtigung von Extrazellulärmatrix-Deposition in 3D Konstrukten aus artikulären Chondrozyten entgegen N2 - Articular cartilage is an exceptional connective tissue which by a network of fibrillar collagen and glycosaminoglycan (GAG) molecules allows both low- friction articulation and distribution of loads to the subchondral bone (Armiento et al., 2018, Ulrich-Vinther et al., 2003). Because of its very limited ability to self-repair, chondral defects following traumatic injury increase the risk for secondary osteoarthritis (OA) (Muthuri et al., 2011). Still, current OA treatments such as common nonsteroidal anti-inflammatory drugs (NSAIDs) and joint replacement primarily address end-stage symptoms (Tonge et al., 2014). As low-grade inflammation plays a pivotal role in the pathogenesis of OA (Robinson et al., 2016), there is a strong demand for novel therapeutic concepts, such as integrating application of anti-inflammatory agents into cartilage cell- based therapies in order to effectively treat OA affected joints in early disease stages. The polyphenolic phytoalexin resveratrol (RSV), found in the skin of red grapes, berries, and peanuts, has been shown to have effective anti-inflammatory properties (Shen et al., 2012). However, its long-term effects on 3D chondrocyte constructs cultured in an inflammatory environment with regard to tissue quality have remained unexplored so far. Therefore, in this study, pellets made from expanded porcine articular chondrocytes were cultured for 14 days with either the pro-inflammatory cytokine interleukin-1β (IL-1β) (1 - 10 ng/ml) or RSV (50 μM) alone, or a co-treatment with both agents. Constructs treated with chondrocyte medium only served as control. Treatment with IL-1β at 10 ng/ml resulted in a significantly smaller pellet size and reduced DNA content. However, RSV counteracted the IL-1β-induced decrease and significantly enhanced diameter and DNA content. Also, in terms of GAG deposition, treatment with IL-1β at 10 ng/ml resulted in a tremendous depletion of absolute GAG content and GAG/DNA. Again, RSV co-treatment counteracted the inflammatory stimulus and led to a partial recovery of GAG content. Histological analysis utilizing safranin-O staining confirmed these findings. Marked expression of the cartilage-degrading enzyme matrix metalloproteinase 13 (MMP13) was detected in IL-1β-treated pellets, but none upon RSV co- treatment. Moreover, co-treatment of IL-1β-challenged constructs with RSV significantly increased absolute collagen content. However, under non- inflammatory conditions, RSV induced gene expression and protein accumulation of collagen type X, a marker for undesirable hypertrophy. Taken together, in the present thesis, RSV was demonstrated to elicit marked beneficial effects on the extracellular matrix composition of 3D cartilaginous constructs in long-term inflammatory culture in vitro, but also induced hypertrophy under non-inflammatory conditions. Based on these findings, further experiments examining multiple concentrations of RSV under various inflammatory conditions appear desirable concerning potential therapeutic applicability in OA. N2 - Gelenkknorpel ermöglicht als spezielles Bindegewebe aus Kollagenfasern und Glykosaminoglykanen (GAG) sowohl die reibungsarme Beweglichkeit in Gelenken als auch die Lastübertragung auf angrenzende Knochen (Armiento et al., 2018, Ulrich-Vinther et al., 2003). Aufgrund der sehr begrenzten Fähigkeit zur intrinsischen Erneuerung erhöhen chondrale Defekte nach traumatischen Verletzungen das Risiko für sekundäre Arthrose (Osteoarthritis; OA) (Muthuri et al., 2011). Dennoch konzentrieren sich derzeitige Behandlungsansätze, einschließlich nichtsteroidaler Antirheumatika (NSAR) und des operativen Gelenkersatzes, hauptsächlich auf Symptome im Endstadium der Erkrankung (Tonge et al., 2014). Da eine geringgradige Entzündung eine entscheidende Rolle in der Pathogenese der Arthrose spielt (Robinson et al., 2016), besteht ein starker Bedarf an neuartigen Therapiekonzepten, wie der Kombination von anti- inflammatorischen Wirkstoffen mit knorpelzellbasierten Therapien, um von Arthrose betroffene Gelenke in frühen Krankheitsstadien wirksam zu behandeln. Das polyphenolische Phytoalexin Resveratrol (RSV), welches in der Schale roter Weintrauben, in Beeren und Erdnüssen vorkommt, besitzt starke entzündungshemmende Eigenschaften (Shen et al., 2012). Langzeiteffekte auf 3D-Knorpelkonstrukte unter inflammatorischen Bedingungen sind hinsichtlich der Gewebequalität jedoch bislang unerforscht geblieben. Daher wurden in der vorliegenden Studie Pellets aus expandierten porcinen Gelenkknorpelzellen über einen Zeitraum von 14 Tagen entweder mit dem pro-inflammatorischen Zytokin Interleukin-1β (IL-1β) (1 - 10 ng/ml) oder RSV (50 μM) allein, oder mit beiden Agenzien kombiniert behandelt. Konstrukte, welche nur serumfreies Chondrozytenmedium erhielten, dienten als Kontrolle. Die Behandlung mit IL- 1β in einer Konzentration von 10 ng/ml führte zu einem signifikant geringeren Durchmesser der Pellets sowie einem verringerten DNA-Gehalt. RSV wirkte dieser IL-1β-vermittelten Reduktion entgegen und steigerte signifikant sowohl Durchmesser als auch DNA-Gehalt der untersuchten Konstrukte. Auch in Bezug auf die Deposition von GAG-Molekülen führte die Kultur mit IL-1β (10 ng/ml) zu einer massiven Abnahme des absoluten GAG-Gehaltes und der GAG/DNA- Ratio. Abermals wirkte die gleichzeitige Behandlung mit RSV dem Entzündungsreiz deutlich entgegen und resultierte in einer partiellen Wiederherstellung des GAG-Gehaltes. Die histologische Analyse unter Verwendung von Safranin-O-Färbungen bestätigte diese Ergebnisse. Darüber hinaus manifestierte sich eine ausgeprägte Expression des knorpelabbauenden Enzyms Matrix-Metalloproteinase 13 (MMP13) in IL-1β behandelten Pellets, nicht jedoch in denen, die simultan mit RSV behandelt wurden. Außerdem resultierte die gleichzeitige Behandlung von IL-1β-stimulierten Konstrukten mit RSV in einer signifikanten Erhöhung des absoluten Kollagengehaltes. Unter nicht-inflammatorischen Bedingungen induzierte RSV die Genexpression und Proteinakkumulation von Kollagen Typ X, einem Marker für unerwünschte Hypertrophie. Zusammengefasst wurde in der vorliegenden Arbeit gezeigt, dass RSV deutliche positive Effekte auf die Extrazellulärmatrix von 3D- Knorpelkonstrukten in einer Langzeit-Entzündungskultur in vitro hervorruft, allerdings unter nicht-inflammatorischen Bedingungen Hypertrophie induziert. Basierend auf diesen Befunden erscheinen weitere Experimente zur Untersuchung unterschiedlicher RSV-Konzentrationen unter verschiedenen Entzündungsbedingungen hinsichtlich einer möglichen therapeutischen Anwendbarkeit bei OA wünschenswert. KW - Resveratrol KW - Interleukin 1-beta KW - Gelenkknorpel KW - Extrazelluläre Matrix KW - Osteoarthritis KW - IL-1β KW - articular chondrocytes KW - cartilage KW - cell-based therapy KW - extracellular matrix KW - inflammation KW - osteoarthritis KW - resveratrol Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237453 ER - TY - JOUR A1 - Paudel, Rupesh A1 - Fusi, Lorenza A1 - Schmidt, Marc T1 - The MEK5/ERK5 pathway in health and disease JF - International Journal of Molecular Sciences N2 - The MEK5/ERK5 mitogen-activated protein kinases (MAPK) cascade is a unique signaling module activated by both mitogens and stress stimuli, including cytokines, fluid shear stress, high osmolarity, and oxidative stress. Physiologically, it is mainly known as a mechanoreceptive pathway in the endothelium, where it transduces the various vasoprotective effects of laminar blood flow. However, it also maintains integrity in other tissues exposed to mechanical stress, including bone, cartilage, and muscle, where it exerts a key function as a survival and differentiation pathway. Beyond its diverse physiological roles, the MEK5/ERK5 pathway has also been implicated in various diseases, including cancer, where it has recently emerged as a major escape route, sustaining tumor cell survival and proliferation under drug stress. In addition, MEK5/ERK5 dysfunction may foster cardiovascular diseases such as atherosclerosis. Here, we highlight the importance of the MEK5/ERK5 pathway in health and disease, focusing on its role as a protective cascade in mechanical stress-exposed healthy tissues and its function as a therapy resistance pathway in cancers. We discuss the perspective of targeting this cascade for cancer treatment and weigh its chances and potential risks when considering its emerging role as a protective stress response pathway. KW - atherosclerosis KW - bone KW - cartilage KW - endothelium KW - extracellular-regulated kinase 5 KW - Krüppel-like factor KW - mechanotransduction KW - mitogen-activated protein kinase KW - stress signaling KW - tumor Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-261638 SN - 1422-0067 VL - 22 IS - 14 ER - TY - JOUR A1 - Frischholz, Sebastian A1 - Berberich, Oliver A1 - Böck, Thomas A1 - Meffert, Rainer H. A1 - Blunk, Torsten T1 - Resveratrol counteracts IL‐1β‐mediated impairment of extracellular matrix deposition in 3D articular chondrocyte constructs JF - Journal of Tissue Engineering and Regenerative Medicine N2 - When aiming at cell‐based therapies in osteoarthritis (OA), proinflammatory conditions mediated by cytokines such as IL‐1β need to be considered. In recent studies, the phytoalexin resveratrol (RSV) has exhibited potent anti‐inflammatory properties. However, long‐term effects on 3D cartilaginous constructs under inflammatory conditions with regard to tissue quality, especially extracellular matrix (ECM) composition, have remained unexplored. Therefore, we employed long‐term model cultures for cell‐based therapies in an in vitro OA environment and evaluated effects of RSV. Pellet constructs made from expanded porcine articular chondrocytes were cultured with either IL‐1β (1–10 ng/ml) or RSV (50 μM) alone, or a cotreatment with both agents. Treatments were applied for 14 days, either directly after pellet formation or after a preculture period of 7 days. Culture with IL‐1β (10 ng/ml) decreased pellet size and DNA amount and severely compromised glycosaminoglycan (GAG) and collagen content. Cotreatment with RSV distinctly counteracted the proinflammatory catabolism and led to partial rescue of the ECM composition in both culture systems, with especially strong effects on GAG. Marked MMP13 expression was detected in IL‐1β‐treated pellets, but none upon RSV cotreatment. Expression of collagen type I was increased upon IL‐1β treatment and still observed when adding RSV, whereas collagen type X, indicating hypertrophy, was detected exclusively in pellets treated with RSV alone. In conclusion, RSV can counteract IL‐1β‐mediated degradation and distinctly improve cartilaginous ECM deposition in 3D long‐term inflammatory cultures. Nevertheless, potential hypertrophic effects should be taken into account when considering RSV as cotreatment for articular cartilage repair techniques. KW - articular chondrocytes KW - cartilage KW - cell‐based therapy KW - extracellular matrix KW - IL‐1β KW - inflammation KW - osteoarthritis KW - resveratrol Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-215471 VL - 14 IS - 7 SP - 897 EP - 908 ER - TY - JOUR A1 - Schmidt, Stefanie A1 - Abinzano, Florencia A1 - Mensinga, Anneloes A1 - Teßmar, Jörg A1 - Groll, Jürgen A1 - Malda, Jos A1 - Levato, Riccardo A1 - Blunk, Torsten T1 - Differential production of cartilage ECM in 3D agarose constructs by equine articular cartilage progenitor cells and mesenchymal stromal cells JF - International Journal of Molecular Sciences N2 - Identification of articular cartilage progenitor cells (ACPCs) has opened up new opportunities for cartilage repair. These cells may be used as alternatives for or in combination with mesenchymal stromal cells (MSCs) in cartilage engineering. However, their potential needs to be further investigated, since only a few studies have compared ACPCs and MSCs when cultured in hydrogels. Therefore, in this study, we compared chondrogenic differentiation of equine ACPCs and MSCs in agarose constructs as monocultures and as zonally layered co-cultures under both normoxic and hypoxic conditions. ACPCs and MSCs exhibited distinctly differential production of the cartilaginous extracellular matrix (ECM). For ACPC constructs, markedly higher glycosaminoglycan (GAG) contents were determined by histological and quantitative biochemical evaluation, both in normoxia and hypoxia. Differential GAG production was also reflected in layered co-culture constructs. For both cell types, similar staining for type II collagen was detected. However, distinctly weaker staining for undesired type I collagen was observed in the ACPC constructs. For ACPCs, only very low alkaline phosphatase (ALP) activity, a marker of terminal differentiation, was determined, in stark contrast to what was found for MSCs. This study underscores the potential of ACPCs as a promising cell source for cartilage engineering. KW - ACPC KW - chondroprogenitors KW - tissue engineering KW - MSC KW - agarose KW - hypoxia KW - ECM KW - co-culture KW - zonal KW - cartilage Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236180 SN - 1422-0067 VL - 21 IS - 19 ER - TY - JOUR A1 - Jessberger, Steffen A1 - Högger, Petra A1 - Genest, Franca A1 - Salter, Donald M. A1 - Seefried, Lothar T1 - Cellular pharmacodynamic effects of Pycnogenol\(^{®}\) in patients with severe osteoarthritis: a randomized controlled pilot study JF - BMC Complementary and Alternative Medicine N2 - Background: The standardized maritime pine bark extract (Pycnogenol\(^{®}\)) has previously shown symptom alleviating effects in patients suffering from moderate forms of knee osteoarthritis (OA). The cellular mechanisms for this positive impact are so far unknown. The purpose of the present randomized pilot controlled study was to span the knowledge gap between the reported clinical effects of Pycnogenol\(^{®}\) and its in vivo mechanism of action in OA patients. Methods: Thirty three patients with severe OA scheduled for a knee arthroplasty either received 100 mg of Pycnogenol\(^{®}\) twice daily or no treatment (control group) three weeks before surgery. Cartilage, synovial fluid and serum samples were collected during surgical intervention. Relative gene expression of cartilage homeostasis markers were analyzed in the patients' chondrocytes. Inflammatory and cartilage metabolism mediators were investigated in serum and synovial fluid samples. Results: The oral intake of Pycnogenol\(^{®}\) downregulated the gene expression of various cartilage degradation markers in the patients' chondrocytes, the decrease of MMP3, MMP13 and the pro-inflammatory cytokine IL1B were statistically significant (p ≤ 0.05). Additionally, protein concentrations of ADAMTS-5 in serum were reduced significantly (p ≤ 0.05) after three weeks intake of the pine bark extract. Conclusions: This is the first report about positive cellular effects of a dietary supplement on key catabolic and inflammatory markers in patients with severe OA. The results provide a rational basis for understanding previously reported clinical effects of Pycnogenol\(^{®}\) on symptom scores of patients suffering from OA. KW - maritime pine bark extract KW - qPCR KW - ADAMTS KW - cartilage KW - clinical study KW - osteoarthritis KW - Pycnogenol KW - serum KW - synovial fluid Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-159532 VL - 17 IS - 537 ER - TY - THES A1 - Stuckensen, Kai T1 - Fabrication of hierarchical cell carrier matrices for tissue regeneration by directional solidification T1 - Herstellung hierarchischer Zellträger-Matrices zur Geweberegeneration mittels gerichteter Erstarrung N2 - The key hypothesis of this work represented the question, if mimicking the zonal composition and structural porosity of musculoskeletal tissues influences invading cells positively and leads to advantageous results for tissue engineering. Conventional approaches in tissue engineering are limited in producing monolithic “scaffolds” that provide locally variating biological key signals and pore architectures, imitating the alignment of collagenous fibres in bone and cartilage tissues, respectively. In order to fill this gap in available tissue engineering strategies, a new fabrication technique was evolved for the production of scaffolds to validate the hypothesis. Therefore, a new solidification based platform procedure was developed. This process comprises the directional solidification of multiple flowable precursors that are “cryostructured” to prepare a controlled anisotropic pore structure. Porous scaffolds are attained through ice crystal removal by lyophilisation. Optionally, electrostatic spinning of polymers may be applied to provide an external mesh on top or around the scaffolds. A consolidation step generates monolithic matrices from multi zonal structures. To serve as matrix for tissue engineering approaches or direct implantation as medical device, the scaffold is sterilized. An Adjustable Cryostructuring Device (ACD) was successively developed; individual parts were conceptualized by computer aided design (CAD) and assembled. During optimisation, a significant performance improvement of the ACDs accessible external temperature gradient was achieved, from (1.3 ± 0.1) K/mm to (9.0 ± 0.1) K/mm. Additionally, four different configurations of the device were made available that enabled the directional solidification of collagenous precursors in a highly controlled manner with various sample sizes and shapes. By using alginate as a model substance the process was systematically evaluated. Cryostructuring diagraphs were analysed yielding solidification parameters, which were associated to pore sizes and alignments that were determined by image processing. Thereby, a precise control over pore size and alignment through electrical regulation of the ACD could be demonstrated. To obtain tissue mimetic scaffolds for the musculoskeletal system, collagens and calcium phosphates had to be prepared to serve as raw materials. Extraction and purification protocols were established to generate collagen I and collagen II, while the calcium phosphates brushite and hydroxyapatite were produced by precipitation reactions. Besides the successive augmentation of the ACD also an optimization of the processing steps was crucial. Firstly, the concentrations and the individual behaviour of respective precursor components had to be screened. Together with the insights gained by videographic examination of solidifying collagen solutions, essential knowledge was gained that facilitated the production of more complex scaffolds. Phenomena of ice crystal growth during cryostructuring were discussed. By evolutionary steps, a cryostructuring of multi-layered precursors with consecutive anisotropic pores could be achieved and successfully transferred from alginate to collagenous precursors. Finally, very smooth interfaces that were hardly detectable by scanning electron microscopy (SEM) could be attained. For the used collagenous systems, a dependency relation between adjustable processing parameters and different resulting solidification morphologies was created. Dehydrothermal-, diisocyanate-, and carbodiimide- based cross linking methods were evaluated, whereby the “zero length” cross linking by carbodiimide was found to be most suitable. Afterwards, a formulation for the cross linking solution was elaborated, which generated favourable outcomes by application inside a reduced pressure apparatus. As a consequence, a pore collapse during wet chemical cross linking could be avoided. Complex monolithic scaffolds featuring continuous pores were fabricated that mimicked structure and respective composition of different areas of native tissues by the presence of biochemical key stimulants. At first, three types of bone scaffolds were produced from collagen I and hydroxyapatite with appropriate sizes to fit critical sized defects in rat femurs. They either featured an isotropic or anisotropic porosity and partly also contained glycosaminoglycans (GAGs). Furthermore, meniscus scaffolds were prepared by processing two precursors with biomimetic contents of collagen I, collagen II and GAGs. Here, the pore structures were created under boundary conditions, which allowed an ice crystal growth that was nearly orthogonal to the external temperature gradient. Thereby, the preferential alignment of collagen fibres in the natural meniscus tissue could be mimicked. Those scaffolds owned appropriate sizes for cell culture in well plates or even an authentic meniscus shape and size. Finally, osteochondral scaffolds, sized to either fit well plates or perfusion reactors for cell culture, were fabricated to mimic the composition of subchondral bone and different cartilage zones. Collagen I and the resorbable calcium phosphate brushite were used for the subchondral zone, whereas the cartilage zones were composed out of collagen I, collagen II and tissue mimetic contents of GAGs. The pore structure corresponded to the one that is dominating the volume of natural osteochondral tissue. Energy dispersive X-ray spectroscopy (EDX) and SEM were used to analyse the composition and pore structure of the individual scaffold zones, respectively. The cross section pore diameters were determined to (65 ± 25) µm, (88 ± 35) µm and(93 ± 42) µm for the anisotropic, the isotropic and GAG containing isotropic bone scaffolds. Furthermore, the meniscus scaffolds showed pore diameters of (93 ± 21) µm in the inner meniscus zone and (248 ± 63) µm inside the outer meniscus zone. Pore sizes of (82 ± 25) µm, (83 ± 29) µm and (85 ± 39) µm were present inside the subchondral, the lower chondral and the upper chondral zone of osteochondral scaffolds. Depending on the fabrication parameters, the respective scaffold zones were also found to feature a specific micro- and nanostructure at their inner surfaces. Degradation studies were carried out under physiological conditions and resulted in a mean mass loss of (0.52 ± 0.13) %, (1.56 ± 0.10) % and (0.80 ± 0.10) % per day for bone, meniscus and osteochondral scaffolds, respectively. Rheological measurements were used to determine the viscosity changes upon cooling of different precursors. Micro computer tomography (µ-CT) investigations were applied to characterize the 3D microstructure of osteochondral scaffolds. To obtain an osteochondral scaffold with four zones of tissue mimetic microstructure alignment, a poly (D, L-lactide-co-glycolide) mesh was deposited on the upper chondral zone by electrostatic spinning. In case of the bone scaffolds, the retention / release capacity of bone morphogenetic protein 2 (BMP-2) was evaluated by an enzyme linked immunosorbent assay (ELISA). Due to the high presence of attractive BMP binding sites, only less than 0.1 % of the initially loaded cytokine was released. The suitability of combining the cryostructuring process with 3D powder printed calcium phosphate substrates was evaluated with osteochondral scaffolds, but did not appear to yield more preferable results than the non-combined approach. A new custom build confined compression setup was elaborated together with a suitable evaluation procedure for the mechanical characterisation under physiological conditions. For bone and cartilage scaffolds, apparent elastic moduli of (37.6 ± 6.9) kPa and (3.14 ± 0.85) kPa were measured. A similar behaviour of the scaffolds to natural cartilage and bone tissue was demonstrated in terms of elastic energy storage. Under physiological frequencies, less than 1.0 % and 0.8 % of the exerted energy was lost for bone and cartilage scaffolds, respectively. With average relaxation times of (0.613 ± 0.040) sec and (0.815 ± 0.077) sec, measured for the cartilage and bone scaffolds, they respond four orders of magnitude faster than the native tissues. Additionally, all kinds of produced scaffolds were able to withstand cyclic compression at un-physiological frequencies as high as 20 Hz without a loss in structural integrity. With the presented new method, scaffolds could be fabricated whose extent in mimicking of native tissues exceeded the one of scaffolds producible by state of the art methods. This allowed a testing of the key hypothesis: The biological evaluation of an anisotropic pore structure in vivo revealed a higher functionality of immigrated cells and led finally to advantageous healing outcomes. Moreover, the mimicking of local compositions in combination with a consecutive anisotropic porosity that approaches native tissue structures could be demonstrated to induce zone specific matrix remodelling in stem cells in vitro. Additionally, clues for a zone specific chondrogenic stem cell differentiation were attained without the supplementation of growth factors. Thereby, the hypothesis that an increased approximation of the hierarchically compositional and structurally anisotropic properties of musculoskeletal tissues would lead to an improved cellular response and a better healing quality, could be confirmed. With a special focus on cell free in situ tissue engineering approaches, the insights gained within this thesis may be directly transferred to clinical regenerative therapies. N2 - Die Schlüsselhypothese dieser Arbeit bestand darin zu überprüfen, ob eine Nachahmung der zonalen Zusammensetzungen und Porenstruktur muskulo-skelettaler Gewebe einwandernde Zellen beeinflusst und zu vorteilhafteren Ergebnissen im Tissue Engineering führt. Obwohl bereits zahlreiche konventionelle Ansätze existieren, so sind diese in ihrem Vermögen spezielle Zellträgermatrices („Scaffolds“) herzustellen limitiert. Insbesondere können dabei lokal variierende biologische Schlüsselreize nicht mit einer Porenstruktur, welche die Ausrichtung der Kollagenfasern in Knochen- und Knorpelgeweben imitiert, kombiniert werden. Um diese Lücke in den verfügbaren Tissue Engineering Strategien zu schließen, wurde ein neues Verfahren entwickelt. Dieses erlaubte die Herstellung monolithischer Scaffolds, welche eine Validierung der Hypothese ermöglichten. Das neue Plattform-Verfahren basiert auf der gerichteten Erstarrung mehrerer fließfähiger Vorstufen, um somit eine kontrollierte anisotrope Porenstruktur vorzubereiten. Ein Entfernen der erstarrten Lösungsmittel durch Lyophilisation führt zu porösen Scaffolds. Optional besteht die Möglichkeit, Polymere mittels elektrostatischem Verspinnen als umhüllendes Vlies zu inkorporieren. Nach einem Vernetzungsschritt resultieren monolithische Matrices, bestehend aus mehreren Zonen mit unterschiedlichen Zusammensetzungen. Vor einer Verwendung als Tissue Engineering Matrix oder implantierbares Medizinprodukt erfolgt eine Sterilisation. Hierfür wurde ein “Adjustable Cryostructuring Device“ (ACD) entwickelt, einzelne Bauteile mit Computer Aided Design entworfen und zu einer Apparatur montiert. Die Optimierung der Anlage ermöglichte eine signifikante Erhöhung des verfügbaren externen Temperaturgradienten von (1.3 ± 0.1) K/mm auf (9.0 ± 0.1) K/mm. Außerdem erlauben vier unterschiedliche Konfigurationen des ACD die gerichtete Erstarrung von kollagenen Vorstufen in einer besonders kontrollierten Art und Weise bei einer Vielzahl an Probengrößen und Formen. Die systematische Evaluation des Prozesses erfolgte mit Alginat als Modell-Substanz. Aus den zeitlichen Verläufen der Gefrierstrukturierung resultierten Erstarrungsparameter, die mittels Bildverarbeitung den entstandenen Porengrößen und -ausrichtungen zugeordnet wurden. Dies demonstrierte eine präzise Kontrolle der Ergebnisse durch elektrische Ansteuerung der ACD. Zur Erzeugung von Rohmaterialien war eine Etablierung von Extraktions- und Aufreinigungsprotokollen für Kollagen I und Kollagen II notwendig, während eine Herstellung der Calciumphosphate Bruschit und Hydroxylapatit mittels Präzipitations-Reaktionen verlief. Neben der sukzessiven Verbesserung des ACD, stellte auch die Optimierung einzelner Prozessschritte wichtige Aspekte dar. Die Untersuchung und Diskussion des Verhaltens einzelner Vorstufenkomponenten sowie der Erstarrungs-phänomene von Kollagenlösungen führte zu einem Verständnis welches die Produktion von komplexeren Scaffolds zuließ. Somit war es auch möglich eine Abhängigkeitsrelation der einstellbaren Prozessparameter zu den resultierenden Erstarrungsmorphologien der verwendeten Kollagensysteme abzuleiten. Die Gefrierstrukturierung von mehreren Lagen unterschiedlicher Vorstufen konnte erfolgreich von Alginat- auf Kollagenvorstufen transferiert werden. Nach einer Optimierung der jeweiligen Grenzflächenübergänge, waren diese selbst mittels Rasterelektronenmikroskopie kaum noch zu erkennen. Eine Evaluierung von dehydrothermal-, diisocyanat- und carbodiimid- basierten Quervernetzungs-methoden zeigte die vorteilhaftesten Ergebnisse für die Vernetzung durch Carbodiimide. Zusätzlich wurde eine Zusammensetzung der Vernetzungslösung ermittelt, welche beim Einsatz in einer Unterdruckapparatur einen Porenstrukturkollaps durch nasschemische Vernetzung vermeidet. Eine erweiterte Kontrolle der Gefrierprozesse erlaubte es Struktur und Zusammensetzung verschiedener Zonen nativer Gewebe durch eine monolithische Zellträgermatrix mit durchgängiger Porenstruktur und biochemischen Schlüsselreizen nachzuahmen. Zuerst wurden drei Arten von Knochenscaffolds aus Kollagen I und Hydroxylapatit hergestellt, die Defekten kritischer Größe in Rattenoberschenkel-knochen entsprachen. Diese zeichneten sich durch eine isotrope oder eine anisotrope Porenstruktur aus und enthielten teilweise Glycosaminoglycane (GAGs). Weiterhin erfolgte die Produktion von Meniskusscaffolds aus zwei Vorstufen mit biomimetischen Anteilen an Kollagen I, Kollagen II und GAGs. Dabei verlief die Gefrierstrukturierung unter Grenzbedingungen, welche ein nahezu senkrechtes Eiskristallwachstum zu dem äußeren Temperaturgradienten erlaubten. Somit konnte der bevorzugte Verlauf von Kollagenfasern in nativem Meniskusgewebe nachgeahmt werden. Die Scaffolds waren entweder passend für „Well Plates“ der Zellkultur bemaßt oder besaßen sogar Form und Größe von authentischen Menisken. Zuletzt wurden osteochondrale Scaffolds hergestellt, deren Zusammensetzung den jeweiligen Bereichen von Subchondralzone und verschiedenen Gelenkknorpelzonen entsprach. Kollagen I und die bioresorbierbare Calciumphosphatphase Bruschit fanden Verwendung in der Subchondralzone, während die Knorpelzonen aus Kollagen I, Kollagen II und entsprechenden biomimetischen Anteilen an GAGs bestanden. Außerdem bildete die Scaffoldporenstruktur die Volumendominierende in natürlichem Osteochondralgewebe nach, wobei die Dimensionierungen der Scaffolds Well Plates oder Perfusionsreaktoren der Zellkultur angepasst waren. Mittels energiedispersiver Röntgenspektroskopie und Rasterelektronenmikroskopie erfolgte die Analyse von Zusammensetzung und Porenstruktur der jeweiligen Scaffoldzonen. Die Größe der Porenquerschnitte betrug (65 ± 25) µm, (88 ± 35) µm und (93 ± 42) µm für die anisotropen, die isotropen und die GAG-haltigen isotropen Knochenscaffolds. Die Meniskusscaffolds besaßen Porendurchmesser von (93 ± 21) µm in der inneren Meniskuszone und (248 ± 63) µm innerhalb der äußeren Meniskuszone. Im Falle der osteochondralen Scaffolds wurden Porengrößen von (82 ± 25) µm, (83 ± 29) µm und (85 ± 39) µm in der subchondralen, der unteren chondralen und der oberen chondralen Zone gemessen. In Abhängigkeit von den Prozessparametern zeigten die inneren Oberflächen der jeweiligen Scaffoldzonen eine spezifische Mikro- und Nanostruktur. Eine Prüfung des Degradationsverhaltens unter physiologischen Bedingungen ergab einen mittleren Massenverlust von (0.52 ± 0.13) %, (1.56 ± 0.10) % und (0.80 ± 0.10) % pro Tag für die Knochen-, Meniskus- und osteochondralen Scaffolds. Die Untersuchung der Viskositätsveränderungen während der Abkühlung unterschiedlicher Vorstufen geschah mit rheologischen Messungen. Weiterhin wurde die 3D Mikrostruktur von osteochondralen Matrices mit Mikro Computer Tomographie charakterisiert. Um einen osteochondralen Scaffold mit vier Zonen gewebeähnlich ausgerichteter Mikrostruktur zu erhalten, konnte die Scaffoldoberfläche durch ein elektroversponnenes Poly (D, L-Lactid-co-Glycolid) Vlies modifiziert werden. Ein „enzyme linked immunosorbent assay“ (ELISA) diente zur Evaluation des Rückhalte- bzw. Freisetzungsverhaltens von „bone morphogenetic protein 2“ (BMP-2) in Knochenscaffolds. Bedingt durch die hohe Präsenz von attraktiven BMP Bindungsstellen betrug die freigesetzte Menge des initial beladenen Zytokins nur weniger als 0.1 %. Die Eignung einer Kombination des Gefrierstrukturierungsprozesses mit 3D gedruckten Calciumphosphatsubstraten wurde anhand von osteochondralen Scaffolds überprüft, aber zeigte keine vorteilhafteren Resultate als die nicht kombinierte Vorgehensweise. Für die mechanische Charakterisierung unter physiologischen Bedingungen konnte ein neues Test-Setup mitsamt Auswertungsverfahren entwickelt werden. Die gemessenen Elastizitätsmoduln betrugen (37.6 ± 6.9) kPa für Knochen- und (3.14 ± 0.85) kPa für Knorpelscaffolds. Da unter physiologischen Frequenzen nur weniger als 1.0 % der eingebrachten Energie verloren ging, entsprach die Fähigkeit der Zellträgermatrices zur elastischen Energiespeicherung dem von natürlichem Knochen- und Knorpelgewebe. Bei mittleren Relaxationszeiten von (0.613 ± 0.040) sec und (0.815 ± 0.077) sec für Knorpel- und Knochenscaffolds reagieren diese vier Größenordnungen schneller als die nativen Gewebe. Außerdem waren alle produzierten Matrices dazu in der Lage zyklischen Kompressionen bei unphysiologisch hohen Frequenzen von 20 Hz zu wiederstehen, ohne an struktureller Integrität zu verlieren. Mit dem vorgestellten neuen Verfahren konnten Scaffolds hergestellt werden, deren Ausmaß in der Nachahmung nativer Gewebe mit etablierten Methoden nicht erreichbar war und welche eine Überprüfung der Schlüsselhypothese erlaubten: Die biologische Evaluation einer anisotropen Porenstruktur in vivo zeigte eine höhere Funktionalität eingewanderter Zellen, was zu vorteilhafteren Heilungsergebnissen führte. Darüber hinaus demonstrierte eine Imitation der lokalen Zusammensetzungen in Kombination mit einer durchgängigen anisotropen Porenstruktur, welche an diejenige in nativen Geweben angenähert ist, eine Induktion von zonenspezifischer Matrixremodellierung von Stammzellen in vitro. Außerdem waren Hinweise auf eine zonale chondrogene Stammzelldifferenzierung ohne eine gesonderte Zugabe von Wachstumsfaktoren zu beobachten. Somit konnte die Hypothese, dass eine verbesserte Nachahmung der hierarchischen Zusammensetzung und anisotroper Struktur von muskuloskelettalen Geweben zu einer optimierten zellulären Reaktion und somit einer besseren Heilungsqualität führt, bestätigt werden. Mit einem speziellen Fokus auf zellfreies in situ Tissue Engineering, könnten die Erkenntnisse dieser Arbeit direkt für klinische Therapien eingesetzt werden. KW - directional solidification KW - collagen KW - cartilage KW - bone KW - scaffold KW - Tissue Engineering KW - Knochen KW - Knorpel KW - Gerichtete Erstarrung Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-145510 ER -