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The limited intrinsic self-healing capability of articular cartilage requires treatment of
cartilage defects. Material assisted and cell based therapies are in clinical practice but
tend to result in formation of mechanical inferior fibro-cartilage in long term follow up. If
a lesion has not been properly restored degenerative diseases are diagnosed as late sequela
causing pain and loss in morbidity. Complex three dimensional tissue models mimicking
physiological situation allow investigation of cartilage metabolism and mechanisms involved
in repair. A standardized and reproducible model cultured under controllable conditions
ex vivo to maintain tissue properties is of relevance for comparable studies.
Topic of this thesis was the establishment of an cartilage defect model that allows for
testing novel biomaterials and investigate the effect of defined defect depths on formation
of repair tissue.
In part I an ex vivo osteochondral defect model was established based on isolation of
porcine osteochondral explants (OCE) from medial condyles, 8 mm in diameter and 5 mm
in height. Full thickness cartilage defects with 1 mm to 4 mm in diameter were created
to define ex vivo cartilage critical size after 28 days culture with custom developed static
culture device. In part II of this thesis hydrogel materials, namely collagen I isolated from
rat tail, commercially available fibrin glue, matrix-metalloproteinase clevable poly(ethylene
glycol) polymerized with heparin (starPEGh), methacrylated poly(N-(2-hydroxypropyl)
methacrylamide mono-dilactate-poly(ethylene glycol) triblock copolymer/methacrylated
hyaluronic acid (MP/HA), thiol functionalized HA/allyl functionalized poly(glycidol)
(P(AGE/G)-HA-SH), were tested cell free and chondrocyte loaded (20 mio/ml) as implant
in 4 mm cartilage defects to investigate cartilage regeneration. Reproducible chondral
defects, 8 mm in diameter and 1 mm in height, were generated with an artificial tissue
cutter (ARTcut®) to investigate effect of defect depth on defect regeneration in part III.
In all approaches OCE were analyzed by Safranin-O staining to visualize proteoglycans
in cartilage and/or hydrogels. Immuno-histological and -fluorescent stainings (aggrecan,
collagen II, VI and X, proCollagen I, SOX9, RUNX2), gene expression analysis (aggrecan,
collagen II and X, SOX9, RUNX2) of chondrocyte loaded hydrogels (part II) and proteoglycan
and DNA content (Part I & II) were performed for detailed analysis of cartilage
regeneration.
Part I: The development of custom made static culture device, consisting of inserts in which OCE is fixed and deep well plate, allowed tissue specific media supply without
supplementation of TGF . Critical size diameter was defined to be 4 mm.
Part II: Biomaterials revealed differences in cartilage regeneration. Collagen I and fibrin
glue showed presence of cells migrated from OCE into cell free hydrogels with indication
of fibrous tissue formation by presence of proCollagen I. In chondrocyte loaded study
cartilage matrix proteins aggrecan, collagen II and VI and transcription factor SOX9 were
detected after ex vivo culture throughout the two natural hydrogels collagen I and fibrin
glue whereas markers were localized in pericellular matrix in starPEGh. Weak stainings resulted
for MP/HA and P(AGE/G)-HA-SH in some cell clusters. Gene expression data and
proteoglycan quantification supported histological findings with tendency of hypertrophy
indicated by upregulation of collagen X and RunX2 in MP/HA and P(AGE/G)-HA-SH.
Part III: In life-dead stainings recruitment of cells from OCE into empty or cell free
collagen I treated chondral defects was seen.
Separated and tissue specific media supply is critical to maintain ECM composition in
cartilage. Presence of OCE stimulates cartilage matrix synthesis in chondrocyte loaded
collagen I hydrogel and reduces hypertrophy compared to free swelling conditions and
pellet cultures. Differences in cartilage repair tissue formation resulted in preference of
natural derived polymers compared to synthetic based materials. The ex vivo cartilage
defect model represents a platform for testing novel hydrogels as cartilage materials, but
also to investigate the effect of cell seeding densities, cell gradients, cell co-cultures on
defect regeneration dependent on defect depth. The separated media compartments allow
for systematic analysis of pharmaceutics, media components or inflammatory cytokines on
bone and cartilage metabolism and matrix stability.
The basement membrane separates the epithelium from the stroma of any given barrier tissue and is essential in regulating cellular behavior, as mechanical barrier and as structural support. It further plays an important role for new tissue formation, homeostasis, and pathological processes, such as diabetes or cancer. Breakdown of the basement membrane is believed to be essential for tumor invasion and metastasization. Since the basement membrane is crucial for many body functions, the development of artificial basement membranes is indispensable for the ultimate formation of engineered functional tissue, however, challenging due to their complex structure.
Electrospinning enables the production of fibers in the nano- or microscale range with morphological similarities to the randomly orientated collagen and elastic fibers in the basement membrane. However, electrospun fibers often lack the functional similarity to guide cells and maintain tissue-specific functions. Hence, their possible applications as matrix structure for tissue engineering are limited.
Herein, the potential of polyester meshes, modified with six armed star-shaped pre-polymers and cell-adhesion-mediating peptides, was evaluated to act as functional isotropic and bipolar artificial basement membranes. Thereby, the meshes were shown to be biocompatible and stable including under dynamic conditions, and the degradation profile to correlate with the rate of new tissue formation. The different peptide sequences did not influence the morphology and integrity of the fibers. The modified membranes exhibited protein-repellent properties over 12 months, indicating the long-term stability of the cross-linked star-polymer surfaces.
Cell culture experiments with primary fibroblasts and a human keratinocyte cell line (HaCaT) revealed that cell adhesion and growth strongly depends on the peptide sequences and their combinations employed. HaCaT cells grew to confluence on membranes modified with a combination of laminin/collagen type IV derived binding sequences and with a combination of fibronectin/laminin/collagen type IV derived peptide sequences. Fibroblasts strongly adhered to the fibronectin derived binding sequence and to membranes containing a combination of fibronectin/laminin/collagen type IV derived peptide sequences. The adhesion and growth of fibroblasts and HaCaT cells were significantly reduced on membranes modified with laminin, as well as collagen IV derived peptide sequences. HaCaT cells and fibroblasts barely adhered onto meshes without peptide sequences.
Co-culture experiments at the air-liquid interface with fibroblasts and HaCaT cells confirmed the possibility of creating biocompatible, biofunctional and biomimetic isotropic and bipolar basement membranes, based on the functionalized fibers. HaCaT cells grew in several layers, differentiating towards the surface and expressing cytokeratin 10 in the suprabasal and cytokeratin 14 in the basal layers. Migration of fibroblasts into the electrospun membrane was shown by vimentin staining. Moreover, specific staining against laminin type V, collagen type I, III, IV and fibronectin illustrated that cells started to remodel the electrospun membrane and produced new extracellular matrix proteins following the adhesion to the synthetic surface structures.
The culturing of primary human skin keratinocytes proved to be difficult on electrospun fibers. Cells attached to the membrane, but failed to form a multilayered, well-stratified, and keratinized epidermal layer. Changing the fiber composition and fixation methods did not promote tissue development. Further investigations of the membrane demonstrated the tremendous influence of the pore size of the membrane on epithelial formation. Furthermore, primary keratinocytes reacted more sensitive to pH changes in the medium than HaCaT cells did.
Since primary keratinocytes did not adequately develop on the functionalized meshes, polycarbonate membranes were used instead of electrospun meshes to establish oral mucosa models. The tissue-engineered models represented important features of native human oral mucosa. They consisted of a multilayered epithelium with stratum basale, stratum spinosum, stratum granulosum, and stratum corneum. The models formed a physical barrier and the expression of characteristic cell markers was comparable with that in native human oral mucosa. The results from the ET-50 assay and the irritation study reflected the reproducibility of the tissue equivalents.
Altogether, electrospinning enables the production of fibers with structural similarity to the basement membrane. Incorporating extracellular matrix components to mimic the functional composition offers a safe and promising way to modify the fibers so that they can be used for different tissue engineering applications. The resultant biomimetic membranes that can be functionalized with binding sequences derived from widely varying proteins can be used as a toolbox to study the influence of isotropic and bipolar basement membranes on tissue formation and matrix remodeling systematically, with regards to the biochemical composition and the influence and importance of mono- and co-culture. The oral mucosa models may be useful for toxicity and permeation studies, to monitor the irritation potential of oral health care products and biomaterials or as a disease model.
Calcium phosphate biocements are inherently brittle materials due to their ceramic nature. Hence, currently applied cement formulations are only indicated for non-load bearing application sites. An approach to reduce cement brittleness is based on the use of cement – polymer composites, which combine the flexibility of a polymeric phase with the hardness and compression strength of a cement matrix. Here, a relatively new strategy is the use of “dual-setting” cements, in which the polymeric phase is simultaneously build up from monomers or prepolymers during cement setting. This approach largely maintains basic properties of the fresh paste such as rheology or setting time. Previous works on such dual setting cements were dealing with a radical polymerization reaction to create the polymeric network. This type of reaction requires the addition of a suitable initiator system (e.g. a tertiary amine in conjunction with ammonium peroxosulfate), which are often cytotoxic and may interfere with the cement setting conditions. The current thesis dealt with alternative strategies, in which the cross-linking and gelation of the second (polymeric or inorganic) cement phase is initiated by the chemical conditions of the setting reaction such that no additional initiator has to be added to the cement paste.
In a first approach a six armed star molecule functionalized with isocyanate groups as reactive termini (NCO–sP(EO-stat-PO)) was used to build up a hydrogel matrix, which was then subsequently mineralized with hydroxyapatite nanocrystals following the hydrolysis of incorporated -tricalcium phosphate particles. The stimulus to initiate hydrogel cross-linking are water molecules, which subsequently hydrolyzed isocyanate groups to amines, which then cross-linked with unreacted isocyanate to form urea-bonds. Here, it was possible to show the advantages features of a dual setting system in comparison to the simple combination of hydrogels with unreactive filler particles. By the formation of the cement matrix within the hydrogel a strength improvement by the factor of 30 could be observed. Furthermore, by applying a dual setting system higher mineral concentrations are realizable. The mechanical properties such as elasticity, compression strength and E-modulus of a composite with 30 wt% NCO–sP(EO-stat-PO) were found to be similar to the properties of cancellous bone.
With the motivation to develop a dual setting and resorbable cement, a brushite (CaHPO4·2H2O) forming cement was modified with a second inorganic silica based precursor. The latter was obtained by pre-hydrolysing tetraethyl orthosilicate (TEOS) under acidic conditions. This silica precursor was mixed with a cement powder composed of ß-tricalcium phosphate and monocalcium phosphate, whereas cement setting occurred by a dissolution–precipitation process to form a matrix of brushite. Simultaneously, the increase of the pH during setting from initially 1-2 to values > 4 initiated the condensation reaction of the hydrolysed TEOS. This resulted in an interpenetrating phase composite material in which the micropores of the cement were filled with the nanoporous silica gel. This resulted in a higher density and a compressive strength of 24 MPa, which is approximately 5-10 times higher than the CPC reference at the same powder to liquid ratio. The microporous character of the composites also altered the release of vancomycin as a model drug, whereby in contrast to the quantitative release from the CPC reference, approx. 25 % of the immobilised drug remained in the composite matrix. It was also observed, that a variation of the TEOS content in the composite enabled a control over cement phase composition to form either brushite, anhydrous monetite or a biphasic mixture of both. Cytocompatibility tests revealed that composites with the highest silicate content showed an increased cell proliferation compared to the silica-free brushite reference. Proliferation was found to be similar to a hydroxyapatite reference with a significant higher activity per cell. Mechanistically, the improved biological response could not be attributed to the released silicate ions, but to a decreased release of phosphate and adsorption of magnesium ions from the cell culture medium.
Finally, an investigated dual setting cement system was based on the combination of a brushite forming cement powder with an aqueous silk fibroin solution. Here, changes of both ion concentration and pH during cement setting were shown to build up an interpenetrating fibroin – brushite composite with combined properties of the elastic polymer and the rigid cement. Mechanistically, the low pH of the cement paste (2) as well as the free Ca2+ ions during setting resulted in a conformation change of the dissolved fibroin from random coil to ß-sheet structure. This leads to a rapid gelation and contraction of the fibroin phase with a self-densifying effect on the cement paste. The set composites showed typical ductile fracture behavior under dry testing conditions and a high elasticity under wet conditions with a mechanical strength nearly an order of magnitude higher than the fibroin free cement reference. Cell number and activity against MG63 cells were strongly increased on silk fibroin cement composite surfaces at later time points, which could be again attributed to a decreased ion release and adsorption compared to the fibroin free cements. This in turn slowed down the in vitro degradation of the CPC phase in such composites.