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- Abteilung für Funktionswerkstoffe der Medizin und der Zahnheilkunde (24) (remove)
The implantation of any foreign material into the body automatically starts an immune reaction that serves as the first, mandatory step to regenerate tissue. The course of this initial immune reaction decides on the fate of the implant: either the biomaterial will be integrated into the host tissue to subsequently fulfill its intended function (e.g., tissue regeneration), or it will be repelled by fibrous encapsulation that determines the implant failure. Especially neutrophils and macrophages play major roles during this inflammatory response and hence mainly decide on the biomaterial's fate. For clinically relevant tissue engineering approaches, biomaterials may be designed in shape and morphology as well as in their surface functionality to improve the healing outcome, but also to trigger stem cell responses during the subsequent tissue regeneration phase.
The main focus of this thesis was to unravel the influence of scaffold characteristics, including scaffold morphology and surface functionality, on primary human innate immune cells (neutrophils and macrophages) and human mesenchymal stromal cells (hMSCs) to assess their in vitro immune response and tissue regeneration capacity, respectively. The fiber-based constructs were produced either via melt electrowriting (MEW), when the precise control over scaffold morphology was required, or via solution electrospinning (ES), when the scaffold design could be neglected. All the fiber-based scaffolds used throughout this thesis were composed of the polymer poly(ε caprolactone) (PCL).
A novel strategy to model and alleviate the first direct cell contact of the immune system with a peptide-bioactived fibrous material was presented in chapter 3 by treating the material with human neutrophil elastase (HNE) to imitate the neutrophil attack. The main focus of this study was put on the effect of HNE towards an RGDS-based peptide that was immobilized on the surface of a fibrous material to improve subsequent L929 cell adhesion. The elastase efficiently degraded the peptide-functionality, as evidenced by a decreased L929 cell adhesion, since the peptide integrated a specific HNE-cleavage site (AAPV-motif). A sacrificial hydrogel coating based on primary oxidized hyaluronic acid (proxHA), which dissolved within a few days after the neutrophil attack, provided an optimal protection of the peptide-bioactivated fibrous mesh, i.e, the hydrogel alleviated the neutrophil attack and largely ensured the biomaterial's integrity. Thus, according to these results, a means to protect the biomaterial is required to overcome the neutrophil attack.
Chapter 4 was based on the advancement of melt electrowriting (MEW) to improve the printing resolution of MEW scaffolds in terms of minimal inter-fiber distances and a concomitant high stacking precision. Initially, to gain a better MEW understanding, the influence of several parameters, including spinneret diameter, applied pressure, and collector velocity on mechanical properties, crystallinity, fiber diameter and fiber surface morphology was analyzed. Afterward, innovative MEW designs (e.g., box-, triangle-, round , and wall-shaped scaffolds) have been established by pushing the printing parameters to their physical limits. Further, the inter-fiber distance within a standardized box-structured scaffold was successfully reduced to 40 µm, while simultaneously a high stacking precision was maintained. In collaboration with a co-worker of my department (Tina Tylek, who performed all cell-based experiments in this study), these novel MEW scaffolds have been proven to facilitate human monocyte-derived macrophage polarization towards the regenerative M2 type in an elongation-driven manner with a more pronounced effect with decreasing pore sizes.
Finally, a pro-adipogenic platform for hMSCs was developed in chapter 5 using MEW scaffolds with immobilized, complex ECM proteins (e.g., human decellularized adipose tissue (DAT), laminin (LN), and fibronectin (FN)) to test for the adipogenic differentiation potential in vitro. Within this thesis, a special short-term adipogenic induction regime enabled to more thoroughly assess the intrinsic pro-adipogenic capacity of the composite biomaterials and prevented any possible masking by the commonly used long-term application of adipogenic differentiation reagents. The scaffolds with incorporated DAT consistently showed the highest adipogenic outcome and hence provided an adipo-inductive microenvironment for hMSCs, which holds great promise for applications in soft tissue regeneration.
Future studies should combine all three addressed projects in a more in vivo-related manner, comprising a co-cultivation setup of neutrophils, macrophages, and MSCs. The MEW-scaffold, particularly due to its ability to combine surface functionality and adjustable morphology, has been proven to be a successful approach for wound healing and paves the way for subsequent tissue regeneration.
Adipose tissue defects and related pathologies still represent major challenges in reconstructive surgery. Based on to the paradigm ‘replace with alike’, adipose tissue is considered the ideal substitute material for damaged soft tissue [1-3]. Yet the transfer of autologous fat, particularly larger volumes, is confined by deficient and unpredictable long term results, as well as considerable operative morbidity at the donor and recipient site [4-6], calling for innovative treatment options to improve patient care.
With the aim to achieve complete regeneration of soft tissue defects, adipose tissue engineering holds great promise to provide functional, biologically active adipose tissue equivalents. Here, especially long-term maintenance of volume and shape, as well as sufficient vascularization of engineered adipose tissue represent critical and unresolved challenges [7-9]. For adipose tissue engineering approaches to be successful, it is thus essential to generate constructs that retain their initial volume in vivo, as well as to ensure their rapid vascularization to support cell survival and differentiation for full tissue regeneration [9,10]. Therefore, it was the ultimate goal of this thesis to develop volume-stable 3D adipose tissue constructs and to identify applicable strategies for sufficient vascularization of engineered constructs. The feasibility of the investigated approaches was verified by translation from in vitro to in vivo as a critical step for the advancement of potential regenerative therapies.
For the development of volume-stable constructs, the combination of two biomaterials with complementary properties was successfully implemented. In contrast to previous approaches in the field using mainly non-degradable solid structures for mechanical protection of developing adipose tissue [11-13], the combination of a cell-instructive hydrogel component with a biodegradable porous support structure of adequate texture was shown advantageous for the generation of volume-stable adipose tissue. Specifically, stable fibrin hydrogels previously developed in our group [14] served as cell carrier and supported the adipogenic development of adipose-derived stem cells (ASCs) as reflected by lipid accumulation and leptin secretion. Stable fibrin gels were thereby shown to be equally supportive of adipogenesis compared to commercial TissuCol hydrogels in vitro. Using ASCs as a safe source of autologous cells [15,16] added substantial practicability to the approach. To enhance the mechanical strength of the engineered constructs, porous biodegradable poly(ε caprolactone)-based polyurethane (PU) scaffolds were introduced as support structures and shown to exhibit adequately sized pores to host adipocytes as well as interconnectivity to allow coherent tissue formation and vascularization. Low wettability and impaired cell attachment indicated that PU scaffolds alone were insufficient in retaining cells within the pores, yet cytocompatibility and differentiation of ASCs were adequately demonstrated, rendering the PU scaffolds suitable as support structures for the generation of stable fibrin/PU composite constructs (Chapter 3).
Volume-stable adipose tissue constructs were generated by seeding the pre-established stable fibrin/PU composites with ASCs. Investigation of size and weight in vitro revealed that composite constructs featured enhanced stability relative to stable fibrin gels alone. Comparing stable fibrin gels and TissuCol as hydrogel components, it was found that TissuCol gels were less resilient to degradation and contraction. Composite constructs were fully characterized, showing good cell viability of ASCs and strong adipogenic development as indicated by functional analysis via histological Oil Red O staining of lipid vacuoles, qRT-PCR analysis of prominent adipogenic markers (PPARγ, C/EBPα, GLUT4, aP2) and quantification of leptin secretion. In a pilot study in vivo, investigating the suitability of the constructs for transplantation, stable fibrin/PU composites provided with a vascular pedicle gave rise to areas of well-vascularized adipose tissue, contrasted by insufficient capillary formation and adipogenesis in constructs implanted without pedicle. The biomaterial combination of stable fibrin gels and porous biodegradable PU scaffolds was thereby shown highly suitable for the generation of volume-stable adipose tissue constructs in vivo, and in addition, the effectiveness of immediate vascularization upon implantation to support adipose tissue formation was demonstrated (Chapter 4).
Further pursuing the objective to investigate adequate vascularization strategies for engineered adipose tissue, hypoxic preconditioning was conducted as a possible approach for in vitro prevascularization. In 2D culture experiments, analysis on the cellular level illustrated that the adipogenic potential of ASCs was reduced under hypoxic conditions when applied in the differentiation phase, irrespective of the oxygen tension encountered by the cells during expansion. Hypoxic treatment of ASCs in 3D constructs prepared from stable fibrin gels similarly resulted in reduced adipogenesis, whereas endothelial CD31 expression as well as enhanced leptin and vascular endothelial growth factor (VEGF) secretion indicated that hypoxic treatment indeed resulted in a pro-angiogenic response of ASCs. Especially the observed profound regulation of leptin production by hypoxia and the dual role of leptin as adipokine and angiogenic modulator were considered an interesting connection advocating further study. Having confirmed the hypothesis that hypoxia may generate a pro-angiogenic milieu inside ASC-seeded constructs, faster vessel ingrowth and improved vascularization as well as an enhanced tolerance of hypoxia-treated ASCs towards ischemic conditions upon implanatation may be expected, but remain to be verified in rodent models in vivo (Chapter 5).
Having previously been utilized for bone and cartilage engineering [17-19], as well as for revascularization and wound healing applications [20-22], stromal-vascular fraction (SVF) cells were investigated as a novel cell source for adipose tissue engineering. Providing cells with adipogenic differentiation as well as vascularization potential, the SVF was applied with the specific aim to promote adipogenesis and vascularization in engineered constructs in vivo. With only basic in vitro investigations by Lin et al. addressing the SVF for adipose repair to date [23], the present work thoroughly investigated SVF cells for adipose tissue construct generation in vitro, and in particular, pioneered the application of these cells for adipose tissue engineering in vivo.
Initial in vitro experiments compared SVF- and ASC-seeded stable fibrin constructs in different medium compositions employing preadipocyte (PGM-2) and endothelial cell culture medium (EGM-2). It was found that a 1:1 mixture of PGM-2 and EGM-2, as previously established for co-culture models of adipogenesis [24], efficiently maintained cells with adipogenic and endothelial potential in SVF-seeded constructs in short and long-term culture setups. Observations on the cellular level were supported by analysis of mRNA expression of characteristic adipogenic and endothelial markers. In preparation of the evaluation of SVF-seeded constructs under in vivo conditions, a whole mount staining (WMS) method, facilitating the 3D visualization of adipocytes and blood vessels, was successfully established and optimized using native adipose tissue as template (Chapter 6).
In a subcutaneous nude mouse model, SVF cells were, for the first time in vivo, elucidated for their potential to support the functional assembly of vascularized adipose tissue. Investigating the effect of adipogenic precultivation of SVF-seeded stable fibrin constructs in vitro prior to implantation on the in vivo outcome, hormonal induction was shown beneficial in terms of adipocyte development, whereas a strong vascularization potential was observed when no adipogenic inducers were added. Via histological analysis, it was proven that the developed structures were of human origin and derived from the implanted cells. Applying SVF cells without precultivation in vitro but comparing two different fibrin carriers, namely stable fibrin and TissuCol gels, revealed that TissuCol profoundly supported adipose formation by SVF cells in vivo. This was contrasted by only minor SVF cell development and a strong reduction of cell numbers in stable fibrin gels implanted without precultivation. Histomorphometric analysis of adipocytes and capillary structures was conducted to verify the qualitative results, concluding that particularly SVF cells in TissuCol were highly suited for adipose regeneration in vivo. Employing the established WMS technique, the close interaction of mature adipocytes and blood vessels in TissuCol constructs was impressively shown and via species-specific human vimentin staining, the expected strong involvement of implanted SVF cells in the formation of coherent adipose tissue was confirmed (Chapter 7).
With the development of biodegradable volume-stable adipose tissue constructs, the application of ASCs and SVF cells as two promising cell sources for functional adipose regeneration, as well as the thorough evaluation of strategies for construct vascularization in vitro and in vivo, this thesis provides valuable solutions to current challenges in adipose tissue engineering. The presented findings further open up new perspectives for innovative treatments to cure soft tissue defects and serve as a basis for directed approaches towards the generation of clinically applicable soft tissue substitutes.
Intraperitoneal adhesions are fibrous bands that connect tissues in the peritoneal cavity that are usually separated. These adhesions form as a consequence of trauma, inflammation or surgical interventions and often result in severe consequences such as chronic pain, small bowel obstructions or female infertility.
The aim of this thesis was to develop a synthetic barrier device for adhesion prevention made of modified poly(lactide) [PLA]. Solid PLA films (SurgiWrap®) are already successfully in clinical use due to the good biocompatibility and the biodegradability of the material resulting in non-toxic degradation products since lactic acid is naturally part of the metabolic circles of the human body. Considering the brittleness and stiffness of the films, the long degradation time of several months as well as the need for suturing, there is potential for optimization. Through a copolymerization with the hydrophilic poly(ethylene glycol) [PEG], a reduction of the degradation time was intendend. Moreover, the copolymerization should also lead to an improvement of the mechanical properties of the films since PEG acts as plasticizer for PLA. Linear PLA-PEG-PLA triblock copolymers as well as star-shaped PEG-PLA copolymers were synthesized via standard ring opening polymerization to tailor the barrier properties. Besides solid films, solution electrospun meshes from PLA and the synthesized PEG-PLA copolymers were investigated for a potential application as well. Since suturing of a barrier additionally induces adhesion formation, alginate coated membranes were prepared in order to achieve self-adhesiveness. With the intention to reduce infections and consequently inflammation, electrospun meshes and solvent cast films were loaded with the antibacterial drug triclosan and drug release as well as antibacterial efficacy was investigated.
Mechanical tests confirmed that through the variation of the PEG content and branching the mechanical properties can be tailored and are in good accordance with the glass transition temperatures [Tg] of the polymers. Consequently, potentially adequate mechanical properties for surgical handling as well as for the performance within the patient’s body were successfully achieved. Degradation studies revealed that the degradation time was significantly shorter for PEG-PLA membranes than for PLA films and with an appropriate PEG content could be adjusted to the intended time frame. Cell adhesion and viability tests confirmed the non-toxicity of the clinically used PLA films as well as of PEG-PLA films and meshes. With a bioadhesion test the benefit of an alginate coated side towards the pure PLA film concerning self-adhesiveness was successfully demonstrated. Moreover, optical evaluations and a T-peel test of different alginate coated PLA films showed that the cohesion between the chemically different layers was distinctly enhanced by the use of an appropriate PEG-PLA mesh as intermediate cohesion promoting layer. In in vitro release studies with triclosan loaded films a higher release was determined for PEG-PLA than for PLA films. In agar diffusion tests a higher and longer inhibition of staphylococcus aureus growth was observed confirming the release results. Moreover, drug loaded meshes (especially drug loaded after electrospinning) showed enhanced and elongated bacterial inhibition in comparison to films.
In modern medicine hip and knee joint replacement are common surgical procedures. However, about 11 % of hip implants and about 7 % of knee implants need re-operations. The comparison of implant registers revealed two major indications for re-operations: aseptic loosening and implant infections, that both severely impact the patients’ health and are an economic burden for the health care system. To address these problems, a calcium hydroxide coating on titanium was investigated in this thesis. Calcium hydroxide is a well-known antibacterial agent and used with success in dentistry. The coatings were applied with electrochemically assisted deposition, a versatile tool that combines easiness of process with the ability to coat complex geometries homogeneously. The pH-gradient during coating was investigated and showed the surface confinement of the coating process. Surface pre-treatment altered the surface morphology and chemistry of the titanium substrates and was shown to affect the morphology of the calcium hydroxide coatings. The influence of the coating parameters stirring speed and current pulsing were examined in various configurations and combinations and could also affect the surface morphology. A change in surface morphology results in a changed adhesion and behavior of cells and bacteria. Thus, the parameters surface pre-treatment, stirring speed and current pulsing presented a toolset for tailoring cellular response and antibacterial properties. Microbiological tests with S. aureus and S. epidermidis were performed to test the time-dependent antibacterial activity of the calcium hydroxide coatings. A reduction of both strains could be achieved for 13 h, which makes calcium hydroxide a promising antibacterial coating. To give insight into biofilm growth, a protocol for biofilm staining was investigated on titanium disks with S. aureus and S. epidermidis. Biofilm growth could be detected after 5 days of bacterial incubation, which was much earlier than the 3 weeks that are currently assumed in medical treatment. Thus, it should be considered to treat infections as if a biofilm were present from day 5 on. The ephemeral antibacterial properties of calcium hydroxide were further enhanced and prolonged with the addition of silver and copper ions. Both ionic modifications significantly enhanced the bactericidal potential. The copper modification showed higher antibacterial effects than the silver modification and had a higher cytocompatibility which was comparable to the pure calcium hydroxide coating. Thus, copper ions are an auspicious option to enhance the antibacterial properties. Calcium hydroxide coatings presented in this thesis have promising antibacterial properties and can easily be applied to complex geometries, thus they are a step in fighting aseptic loosening and implant infections.
Synthetic bone replacement materials have their application in non-load bearing defects with the function of (re-)construction or substitution of bone. This tissue itself represents a biological composite material based on mineralized collagen fibrils and combines the mechanical strength of the mineral with the ductility of the organic matrix. By mimicking these outstanding properties with polymer-cement-composites, an imitation of bone is feasible. A promising approach for such replacement materials are dual setting systems, which are generated by dissolution-precipitation reaction with cement setting in parallel to polymerization and gelation of the organic phase forming a coherent hydrogel network. Hereby, the high brittleness of the pure inorganic network was shifted to a more ductile and elastic behavior.
The aim of this thesis was focused on the development of different dual setting systems to modify pure calcium phosphate cements’ (CPCs’) mechanical performance by incorporation of a hydrogel matrix.
A dual setting system based on hydroxyapatite (HA) and cross-linked 2-hydroxyethyl methacrylate (HEMA) via radical polymerization was advanced by homogenous incorporation of a degradable cross-linker composed of poly(ethylene glycol) (PEG) as well as poly(lactic acid) (PLA) with reactive terminal methacrylate functionalities (PEG-PLLA-DMA). By integration of this high molecular weight structure in the HEMA-hydrogel network, a significant increase in energy absorption (toughness) under 4-point bending testing was observed. An addition of only 10 wt% hydrogel precursor (referred to the liquid phase) resulted in a duplication of stress over a period of 8 days. Additionally, the calculated elasticity was positively affected and up to six times higher compared to pure HA. With a constantly applied force during compressive strength testing, a deformation and thus strain levels of about 10 % were reached immediately after preparation.
For higher degradability, the system was modified in a second approach regarding organic as well as inorganic phase. The latter component was changed by brushite forming cement that is resorbable in vivo due to solubility processes. This CPC was combined with a hydrogel based on PEG-PLLA-DMA and other dimethacrylated PEGs with different molecular weights and concentrations. Hereby, new reaction conditions were created including a shift to acidic conditions. On this ground, the challenge was to find a new radical initiator system. Suitable candidates were ascorbic acid and hydrogen peroxide. that started the polymerization and successful gelation in this environment. These highly flexible dual set composites showed a very high ductility with an overall low strength compared to HA-based models. After removal of the applied force during compressive strength testing, a complete shape recovery was observed for the samples containing the highest polymeric amount (50 wt%) of PEG-PLLA-DMA.
Regarding phase distribution in the constructs, a homogenously incorporated hydrogel network was demonstrated in a decalcifying study with ethylenediaminetetraacetic acid. Intact, coherent hydrogels remained after dissolution of the inorganic phase via calcium ion complexation.
In a third approach, the synthetic hydrogel matrix of the previously described system was replaced by the natural biopolymer gelatin. Simultaneously to brushite formation, physical as well as chemical cross-linking by the compound genipin was performed in the dual setting materials. Thanks to the incorporation of gelatin, elasticity increased significantly, in which concentrations up to 10.0 w/v% resulted in a certain cohesion of samples after compressive strength testing. They did not dissociate in little pieces but remained intact cuboid specimens though having cracks or fissures. Furthermore, the drug release of two active pharmaceutical ingredients (vancomycin and rifampicin) was investigated over a time frame of 5 weeks. The release exponent was determined according to Korsmeyer-Peppas with n = 0.5 which corresponds to the drug liberation model of Higuchi. A sustained release was observed for the antibiotic vancomycin encapsulated in composites with a gelatin concentration of 10.0 w/v% and a powder-to-liquid ratio of 2.5 g/mL.
With respect to these developments of different dual setting systems, three novel approaches were successfully established by polymerization of monomers and cross-linking of precursors forming an incorporated, homogenous hydrogel matrix in a calcium phosphate network. All studies showed an essential transfer of mechanical performance in direction of flexibility and bendability.
This thesis aimed to evaluate the possibility to use nanoparticles as antifungal drug carriers as well as their potential application in screening and diagnostics of invasive aspergillosis. The interaction of nanogels, superparamagnetic iron oxide nanoparticles (SPIOs) and gold nanoparticles (GNP) with fungal-specific polysaccharides, cells and biofilms was investigated.
Firstly, it was evaluated how the charge of nanogels influence their interaction with fungal cells. Linear poly(glycidol)s (pG) and poly(2-methyl-2-oxazoline) (pMOx) polymers were synthesized and further functionalized with thiol groups for preparation of redox responsive nanogels. Results showed that negatively charged nanogels were internalized by the fungi to a much greater extent than positively charged ones.
Furthermore, it was investigated how amphiphilicity of polymers used for preparation of nanogels influences nanogel-fungi interaction. It was concluded that nanogels prepared from polymers with degree of functionalization of 10% had the strongest interaction, regardless the length of the alkyl chain. Moreover, amphotericin B-loaded nanogels had a higher antifungal effect and lower toxicity towards mammalian cells than the free drug. In addition, inverse nanoprecipitation of thiol functionalized pGs was shown to be successful for preparation of nanogels with narrow size distribution.
It was also demonstrated that crosslinking of the polymeric coating in hydrogel-like network with thiol functionalized pGs improved the SPIOs imaging performance.
Finally, it was investigated whether GNPs could be used as model particles for the assessment of targeting to fungi. Fc dectin-1 was conjugated covalently to GNPs decorated with pGs, and binding affinity towards β-glucans was tested by surface plasmon resonance.
In summary, this thesis demonstrated evidence for the potential of pG nanogels and pG coated nanoparticles for antifungal therapy and diagnostics of fungal infections caused by A. fumigatus.
Biofabrication is an advancing new research field that might, one day, lead to complex products like tissue replacements or tissue analogues for drug testing. Although great progress was made during the last years, there are still major hurdles like new types of materials and advanced processing techniques. The main focus of this thesis was to help overcoming this hurdles by challenging and improving existing fabrication processes like extrusion-based bioprinting but also by developing new techniques. Furthermore, this thesis assisted in designing and processing materials from novel building blocks like recombinant spider silk proteins or inks loaded with charged nanoparticles.
A novel 3D printing technique called Melt Electrospinning Writing (MEW) was used in Chapter 3 to create tubular constructs from thin polymer fibers (roughly 12 μm in diameter) by collecting the fibers onto rotating and translating cylinders. The main focus was put on the influence of the collector diameter and its rotation and translation on the morphology of the constructs generated by this approach. In a first step, the collector was not moving and the pattern generated by these settings was analyzed. It could be shown that the diameter of the stationary collectors had a big impact on the morphology of the constructs. The bigger the diameter of the mandrel (smallest collector diameters 0.5 mm, biggest 4.8 mm) got, the more the shape of the generated footprint converged into a circular one known from flat collectors. In a second set of experiments the mandrels were only rotated. Increasing the rotational velocity from 4.2 to 42.0 rpm transformed the morphology of the constructs from a figure-of-eight pattern to a sinusoidal and ultimately to a straight fiber morphology. It was possible to prove that the transformation of the pattern was comparable to what was known from increasing the speed using flat collectors and that at a critical speed, the so called critical translation speed, straight fibers would appear that were precisely stacking on top of each other. By combining rotation and translation of the mandrel, it was possible to print tubular constructs with defined winding angles. Using collections speeds close to the critical translation speed enabled higher control of fiber positioning and it was possible to generate precisely stacked constructs with winding angles between 5 and 60°.
In Chapter 4 a different approach was followed. It was based on extrusion-based bioprinting in combination with a hydrogel ink system. The ink was loaded with nanoparticles and the nanoparticle release was analyzed. In other words, two systems, a printable polyglycidol/hyaluronic acid ink and mesoporous silica nanoparticles (MSN), were combined to analyze charge driven release mechanism that could be fine-tuned using bioprinting. Thorough rheological evaluations proved that the charged nanoparticles, both negatively charged MSN-COOH and positively charged MSN-NH2, did not alter the shear thinning properties of the ink that revealed a negative base charge due to hyaluronic acid as one of its main components. Furthermore, it could be shown that the particles did also not have a negative effect on the recovery properties of the material after exposure to high shear. During printing, the observations made via rheological testing were supported by the fact that all materials could be printed at the same settings of the bioprinter. Using theses inks, it was possible to make constructs as big as 12x12x3 mm3 composed of 16 layers. The fiber diameters produced were about 627±31 μm and two-component constructs could be realized utilizing the two hydrogel print heads of the printer to fabricate one hybrid construct. The particle distribution within those constructs was homogeneous, both from a microscopic and a macroscopic point of view. Particle release from printed constructs was tracked over 6 weeks and revealed that the print geometry had an influence on the particle release. Printed in a geometry with direct contact between the strands containing different MSN, the positively charged particles quickly migrated into the strand previously containing only negatively charged MSN-COOH. The MSN-COOH seemed to be rather released into the surrounding liquid and also after 6 weeks no MSN-COOH signal could be detected in the strand previously only containing MSN-NH2. In case of a geometry without direct contact between the strands, the migration of the positively charged nanoparticles into the MSN-COOH containing strand was strongly delayed. This proved that the architecture of the printed construct can be used to fine-tune the particle release from nanoparticle containing printable hydrogel ink systems.
Chapter 5 discusses an approach using hydrogel inks based on recombinant spider silk proteins processed via extrusion-based bioprinting. The ink could be applied for printing at protein concentrations of 3 % w/v without the addition of thickeners or any post process crosslinking. Both, the recombinant protein eADF4(C16) and a modification introducing a RGD-sequence to the protein (eADF4(C16)-RGD), could be printed revealing a very good print fidelity. The RGD modification had positive effect on the adhesion of cells seeded onto printed constructs. Furthermore, human fibroblasts encapsulated in the ink at concentrations of 1.2 million cells per mL did not alter the print fidelity and did not interfere with the crosslinking mechanism of the ink. This enabled printing cell laden constructs with a cell survival rate of 70.1±7.6 %. Although the cell survival rate needs to be improved in further trials, the approach shown is one of the first leading towards the shift of the window of biofabrication because it is based on a new material that does not need potentially harmful post-process crosslinking and allows the direct encapsulation of cells staying viable throughout the print process.
This thesis identifies how the printing conditions for a high-resolution additive manufacturing technique, melt electrowriting (MEW), needs to be adjusted to process electroactive polymers (EAPs) into microfibers. Using EAPs based on poly(vinylidene difluoride) (PVDF), their ability to be MEW-processed is studied and expands the list of processable materials for this technology.
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.
Metals are the most used materials for implant devices, especially in orthopedics, but despite their long history of application issues such as material failure through wear and corrosion remain unsolved leading to a certain number of revision surgeries. Apart from the problems associated with insufficient material properties, another serious issue is an implant associated infection due to the formation of a biofilm on the surface of the material after implantation. Thus, improvements in implant technology are demanded, especially since there is a projected rise of implants needed in the future. Surface modification methods such as physical vapour deposition (PVD), oxygen diffusion hardening and electrochemical anodization have shown to be efficient methods to improve the surfaces of metallic bulk materials regarding biomedical issues. This thesis was focused on the development of functional PVD coatings that are suitable for further treatment with surface modification techniques originally developed for bulk metals. The aim was to precisely adjust the surface properties of the implant according to the targeted application to prevent possible failure mechanisms such as coating delamination, wear or the occurrence of post-operative infections.
Initially, tantalum layers with approx 5 µm thickness were deposited at elevated substrate temperatures on cp Ti by RF magnetron sputtering. Due to the high affinity of tantalum to oxygen, these coatings are known to provide a self healing capacity since the rapid oxide formation is known to close surface cracks. Here, the work aimed to reduce the abrupt change of mechanical properties between the hard and brittle coating and the ductile substrate by creating an oxygen diffusion zone. It was found that the hardness and adhesion could be significantly increased when the coatings were treated afterwards by oxygen diffusion hardening in a two step process. Firstly, the surface was oxidized at a pressure of 6.7•10-3 mbar at 350 450 °C, followed by 1-2 h annealing in oxygen-free atmosphere at the same temperature leading to a diffusion of oxygen atoms into deeper parts of the substrate as proved by X-ray diffraction (XRD) analysis. The hereby caused mechanical stress in the crystal lattice led to an increase in Vickers hardness of the Ta layers from 570 HV to over 900 HV. Investigations into the adhesion of oxygen diffusion treated samples by Rockwell measurements demonstrated an increase of critical force for coating delamination from 12 N for untreated samples up to 25 N for diffusion treated samples.
In a second approach, the development of modular targets aimed to produce functional coatings by metallic doping of titanium with biologically active agents. This was demonstrated by the fabrication of antimicrobial Ti(Ag) coatings using a single magnetron sputtering source equipped with a titanium target containing implemented silver modules under variation of bias voltage and substrate temperature. The deposition of both Ti and Ag was confirmed by X-ray diffraction and a clear correlation between the applied sputtering parameters and the silver content of the coatings was demonstrated by ICP-MS and EDX. Surface-sensitive XPS measurements revealed that higher substrate temperatures led to an accumulation of Ag in the near-surface region, while the application of a bias voltage had the opposite effect. SEM and AFM microscopy revealed that substrate heating during film deposition supported the formation of even and dense surface layers with small roughness values, which could even be enforced by applying a substrate bias voltage. Additional elution measurements using ICP-MS showed that the release kinetics depended on the amount of silver located at the film surface and hence could be tailored by variation of the sputter parameters.
In a final step, the applied Ti and Ti(Ag) coatings deposited on cp Ti, stainless steel (316L) and glass substrates were subsequently nanostructured using a self-ordering process induced by electrochemical anodization in aqueous fluoride containing electrolytes. SEM analysis showed that nanotube arrays could be grown from the Ti and Ti(Ag) coatings deposited at elevated temperatures on any substrate, whereby no influence of the substrate on nanotube morphology could be observed. EDX measurements indicated that the anodization process led to the selective etching of Ti from Ti(Ag) coating. Further experiments on coatings deposited on glass surfaces revealed that moderate substrate temperatures during deposition resulting in smooth Ti layers as determined by AFM measurements, are favorable for the generation of highly ordered nanotube arrays. Such arrays exhibited superhydrophilic behavior as proved by contact angle measurements. XRD analysis revealed that the nanostructured coatings were amorphous after anodization but could be crystallized to anatase structure by thermal treatment at temperatures of 450°C.