A Novel Scaffold Material Accelerates Bone Regeneration in Rats
Researchers here demonstrate accelerated healing of bone loss in rats, using a novel implanted scaffolding material that provides a nanostructure to encourage cell growth and repair activities. As described in this paper, bone is made up of both harder and softer small-scale structures, and suitable choices of material and structure that better mimic these features can provoke osteogenic cells into greater activity than would otherwise be the case.
Several studies have shown that nanosilicate-reinforced scaffolds are suitable for bone regeneration. However, hydrogels are inherently too soft for load-bearing bone defects of critical sizes, and hard scaffolds typically do not provide a suitable three-dimensional (3D) microenvironment for cells to thrive, grow, and differentiate naturally. In this study, we bypass these long-standing challenges by fabricating a cell-free multi-level implant consisting of a porous and hard bone-like framework capable of providing load-bearing support and a softer native-like phase that has been reinforced with nanosilicates.
The system was tested with rat bone marrow mesenchymal stem cells in vitro and as a cell-free system in a critical-sized rat bone defect. Overall, our combinatorial and multi-level implant design displayed remarkable osteoconductivity in vitro without differentiation factors, expressing significant levels of osteogenic markers compared to unmodified groups. Moreover, after 8 weeks of implantation, histological and immunohistochemical assays indicated that the cell-free scaffolds enhanced bone repair up to approximately 84% following a near-complete defect healing. Overall, our results suggest that the proposed nanosilicate bioceramic implant could herald a new age in the field of orthopedics.
"The patient is a 42-year-old female with a five-year history of RA who had been treated with a weekly dose of 8 mg MTX and 5 mg prednisolone daily. On her visit to our clinic she was noted to have a DAS28 score of 6.43. An X-ray of the hand [See "Before" image (left) in Figure] demonstrated severe joint and bone destruction, especially of the third and fourth proximal phalanges and bone demineralization. We prescribed tacrolimus at 1 mg daily. After three months, she described improvement. The DAS28 score was 2.82 and her C-reactive protein level had normalized, allowing us to wean her off prednisolone. Over the next seven years, the dose of tacrolimus has been maintained and the MTX dose was reduced to 6 mg per week. A hand X-ray showed marked bone remodeling of the phalanges [See "After" image (right) in Figure]."
https://www.the-rheumatologist.org/article/tacrolimus-aids-joint-remodeling-in-rheumatoid-arthritis/