Multi-Mineral Supplement for Improved Bone Density

Abstract

Compositions and methods are provided in which magnesium, copper, zinc, and strontium are provided to enhance osteogenesis, improve bone growth, and/or improve bone density. Magnesium, copper, zinc, and strontium are provided in a defined molar ratio providing synergistic effects that permit the use of small amounts of individual metal species, and without the need for supplemental calcium.

Claims

1. A mineral supplement for enhancing bone growth or density, comprising: a source of magnesium; a source of copper; a source of zinc; and a source of strontium, wherein the mineral supplement is formulated to provide magnesium, strontium, copper, and zinc to a subject in a Mg:Sr:Cu:Zn molar ratio of 0.8-2.4:5.3-15.8:1:1.3-5, and wherein the mineral supplement is formulated to provide an increase in bone density or bone volume relative to a mineral supplement comprising magnesium in the absence of copper, zinc, and strontium.

2. The mineral supplement of claim 1, wherein the mineral supplement does not include calcium.

3. The mineral supplement of claim 1, wherein the source of magnesium is not an organic magnesium salt, the source of copper is not an organic copper salt, the source of zinc is not an organic zinc salt, and the source of strontium is not an organic strontium salt.

4. The mineral supplement of claim 1, wherein the mineral supplement is formulated for application by at least one of injection, oral administration, and topical application.

5. The mineral supplement of claim 4, wherein the content of at least one of the source of magnesium, the source of copper, the source of zinc, and the source of strontium is adjusted by one or more oral absorption factor to provide an absorbed Mg:Sr:Cu:Zn molar ratio of 0.8-2.4:5.3-15.8:1:1.3-5.

6. The mineral supplement of claim 1, wherein the composition is formulated as a surgical implant.

7. The mineral supplement of claim 6, wherein the content of at least one of the source of magnesium, the source of copper, the source of zinc and the source of strontium is adjusted by one or more implant absorption factor to provide an absorbed Mg:Sr:Cu:Zn molar ratio of 0.8-2.4:5.3-15.8:1:1.3-5.

8. The mineral supplement of claim 6, wherein the Mg:Cu:Zn:Sr molar ratio is 1.2:7.2-7.9:1:2.5.

9. The mineral supplement of claim 6, wherein the surgical implant further comprises an absorbable carrier.

10. The mineral supplement of claim 1, further comprising an element selected from the group consisting of barium, boron, calcium, potassium, and vanadium.

11. A method of increasing bone density or improving osteogenesis, comprising: providing a mineral supplement comprising a source of magnesium, a source of copper, a source of zinc, and a source of strontium; and applying the mineral supplement to an individual in need of increased bone density or improved osteogenesis, wherein the mineral supplement is formulated to provide magnesium, copper, zinc, and strontium to the individual at a Mg:Sr:Cu:Zn molar ratio of 0.8-2.4:5.3-15.8:1:1.3-5, and wherein the mineral supplement is formulated to provide an increase in bone density or bone volume relative to a mineral supplement comprising magnesium in the absence of copper, zinc, and strontium.

12. The method of claim 11, wherein the mineral supplement does not include calcium.

13. The method of claim 11, wherein the source of magnesium is not an organic magnesium salt, the source of copper is not an organic copper salt, the source of zinc is not an organic zinc salt, and the source of strontium is not an organic strontium salt.

14. The method of claim 11, wherein the mineral supplement is applied by injection or infusion of a solution comprising the mineral supplement.

15. The method of claim 11, wherein the mineral supplement is applied by topical application of a lotion, gel, suspension, or solution comprising the mineral supplement.

16. The method of claim 11, wherein the mineral supplement is applied by oral administration of a pill, tablet, capsule, solution, or suspension comprising the mineral supplement.

17. The method of claim 11, wherein the mineral supplement is applied as a surgical implant, wherein at least a portion of the surgical implant comprises the mineral supplement.

18. The method of claim 11, wherein the mineral supplement further comprises an element selected from the group consisting of barium, boron, calcium, potassium, and vanadium.

19. The method of claim 11, further comprising the step of coadministering a supplementary formulation comprising an element selected from the group consisting of barium, boron, calcium, potassium, and vanadium.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0013] FIGS. 1A to 1D: FIGS. 1A to 1D depict the results of cell viability studies utilizing human mescenchymal stem cell (hMSCs) cultured with different metal ions at various concentrations. FIG. 1A depicts typical results observed with magnesium ions. FIG. 1B depicts typical results observed with copper ions. FIG. 1C depicts typical results observed with zinc ions. FIG. 1D depicts typical results observed with strontium ions.

[0014] FIGS. 2A and 2B: FIGS. 2A and 2B depict normalized alkaline phosphatase (ALP) activity of human mescenchymal stem cell (hMSCs) cultured with different metal ions. FIG. 2A shows typical results for various combinations of Mg, Zn, Cu, and Sr ions at specified concentrations on day 7 and day 14 of exposure. FIG. 2B shows typical results for Mg ion at various concentrations and time points.

[0015] FIG. 3: FIG. 3 depicts the position of an implant of the inventive subject matter within a femur of a test subject.

[0016] FIGS. 4A and 4B: FIGS. 4A and 4B depict results of in vivo bone growth studies performed using metal ion containing implants. FIG. 4A shows typical Micro-CT images obtained from femurs implanted with the indicated implants at respective time points. FIG. 4B depicts the percentage change in bone volume adjacent to the implants. Significantly more bone is found adjacent to Mg/Sr/Cu/Zn containing implants in weeks 3, 4, and 8 as relative to a Mg-only implant.

[0017] FIGS. 5A and 5B: FIGS. 5A and 5B depict results of in vivo bone growth studies performed using metal ion containing implants of the inventive concept having different of Mg, Sr, Cu, and Zn contents. FIG. 5A shows typical Micro-CT images obtained from femurs implanted with the indicated implants at respective time points. FIG. 5B depicts the percentage change in bone volume adjacent to the implants.

[0018] FIG. 6A to 6C: FIGS. 6A, 6B, and 6C depict results of in vivo bone growth, femur elastic modulus, and femur stiffness studies performed using metal ion containing implants of the inventive concept having different relative amounts of Mg, Sr, Cu, and Zn ions. FIG. 6A shows typical results for percentage change in cortical bone volume adjacent to the indicated implant compositions at respective time points. FIG. 6B shows typical results for measurements of the elastic modulus of intact femurs implanted with the indicated implant compositions. FIG. 6B shows typical results for measurements of the stiffness of intact femurs implanted with the indicated implant compositions.

DETAILED DESCRIPTION

[0019] The following discussion provides many example embodiments of the inventive subject matter. Although each embodiment represents a single combination of inventive elements, the inventive subject matter is considered to include all possible combinations of the disclosed elements. Thus if one embodiment comprises elements A, B, and C, and a second embodiment comprises elements B and D, then the inventive subject matter is also considered to include other remaining combinations of A, B, C, or D, even if not explicitly disclosed.

[0020] Calcium supplementation (generally in the form of orally administered calcium carbonate) has long been used to treat or prevent bone growth disorders, such as osteoporosis in menopause and post-menopause. Surprisingly, Inventors have found that other metals (for example magnesium and other metal salts) can have a significant and unanticipated positive effect on bone growth and density, particularly when administered in combination. While this effect is found in the absence of calcium supplementation such a combination of metals or metal salts can be provided with supplemental calcium and/or other elements (either as part of a mixed metal formulation or administered as an independent formulation).

[0021] The inventive subject matter provides compositions and methods in which a mixture of non-calcium metal ions (for example Mg, Cu, Sr, and Zn ions) is provided in amounts and molar ratios that result in increased bone growth and/or density relative to non-treated tissue. While Ca is commonly used as a supplement to support bone growth and development, the Inventors have surprisingly found that Mg, Cu, Sr, and Zn ions, when administered in a specified range of molar ratios, can provide a synergistic (i.e. greater than additive) effect enhances bone growth and density. The synergistic effect so obtained advantageously permits use of the individual metals in non-toxic and/or non-cytotoxic concentrations while providing enhanced bone growth and/or density. Formulations that include Mg, Cu, Sr, and Zn in such molar ratios can be provided with or without supplemental calcium (for example, carbonate, bicarbonate, and/or chloride salts of calcium) and/or other elements (for example, barium, boron, potassium, and/or vanadium). Such supplemental calcium or other elements can form part of an Mg, Cu, Sr, and Zn containing formulation or can be administered separately. Formulations of the inventive concept can be provided as an infusion, an orally administrable form, as a topical formulation, and/or as an implant or artificial graft.

[0022] In compositions and methods of the inventive concept a combination of four metallic elements (e.g. magnesium (Mg), strontium (Sr), copper (Cu), and zinc (Zn)) are utilized to induce osteogenesis and/or increase bone density. Such elements can be provided in the form of ionic compounds (i.e. salts), complexes, and/or covalent compounds. In some embodiments these metallic elements are provided using localized delivery (e.g. local application, use of an implant, etc.) rather than systemic delivery (e.g. oral administration, intravenous administration, etc.). While various mineral compositions have been utilized for similar purposes, Inventors have surprisingly found that a synergistic effect on osteogenesis and/or bone density occurs when these metallic elements are provided within a specified range of molar ratios.

[0023] One should appreciate that the identification of the synergistic effects of multiple metals in specific ratios in the modification of bone growth advantageously permits the effective use of such metals at individual concentrations well below those associated with cytotoxicity, thereby reducing risk to a person in need of treatment while retaining the therapeutic effects.

[0024] While the use of specific salts of magnesium, strontium, copper, and zinc are noted below, it should be appreciated that any suitable inorganic salt of such metals can be used. Examples of suitable anions for such magnesium, strontium, copper, and/or zinc salts include chloride, fluoride, carbonate, bicarbonate, sulfate, phosphate, borate, and/or nitrate. In some embodiments magnesium, strontium, copper, and/or zinc can be provided as oxides. It should be appreciated that the metal salts and/or oxides can be selected to provide the metals at different rates. For example, relatively insoluble magnesium, strontium, copper, and zinc salts (for example, phosphates and/or sulfates) can be selected where a long term effect is desired, such as an implant. Alternatively, relatively soluble magnesium, strontium, copper, and zinc salts (for example, nitrates and/or chlorides) can be selected where an immediate effect is desired, such as an infusion.

[0025] In some embodiments, the numbers expressing quantities of ingredients, properties such as concentration, reaction conditions, and so forth, used to describe and claim certain embodiments of the invention are to be understood as being modified in some instances by the term about. Accordingly, in some embodiments, the numerical parameters set forth in the written description and attached claims are approximations that can vary depending upon the desired properties sought to be obtained by a particular embodiment. In some embodiments, the numerical parameters should be construed in light of the number of reported significant digits and by applying ordinary rounding techniques. Notwithstanding that the numerical ranges and parameters setting forth the broad scope of some embodiments of the invention are approximations, the numerical values set forth in the specific examples are reported as precisely as practicable. The numerical values presented in some embodiments of the invention may contain certain errors necessarily resulting from the standard deviation found in their respective testing measurements.

[0026] As used in the description herein and throughout the claims that follow, the meaning of a, an, and the includes plural reference unless the context clearly dictates otherwise. Also, as used in the description herein, the meaning of in includes in and on unless the context clearly dictates otherwise.

[0027] Unless the context dictates the contrary, all ranges set forth herein should be interpreted as being inclusive of their endpoints, and open-ended ranges should be interpreted to include only commercially practical values. Similarly, all lists of values should be considered as inclusive of intermediate values unless the context indicates the contrary.

[0028] The recitation of ranges of values herein is merely intended to serve as a shorthand method of referring individually to each separate value falling within the range. Unless otherwise indicated herein, each individual value with a range is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g. such as) provided with respect to certain embodiments herein is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention otherwise claimed. No language in the specification should be construed as indicating any non-claimed element essential to the practice of the invention.

[0029] Groupings of alternative elements or embodiments of the invention disclosed herein are not to be construed as limitations. Each group member can be referred to and claimed individually or in any combination with other members of the group or other elements found herein. One or more members of a group can be included in, or deleted from, a group for reasons of convenience and/or patentability. When any such inclusion or deletion occurs, the specification is herein deemed to contain the group as modified thus fulfilling the written description of all Markush groups used in the appended claims.

[0030] Inventors have found that cytotoxic effects can be induced by Mg, Sr, Cu, and/or Zn ions. The MTT colorimetric cell viability provides a straightforward and quantifiable method for determining cell viability in a wide variety of cell types. An MTT assay was used to determine the cytotoxicity of Mg, Sr, Cu, and/or Zn ions in human mescenchymal stem cells. In a typical assay 2.810.sup.4 cells/cm.sup.2 human mescenchymal stem cell (hMSCs) were cultured in a low glucose DMEM culture medium supplemented with 10% (v/v) fetal bovine serum (FBS, Biowest, France), antibiotics (100 U/ml of penicillin and 100 g/ml of streptomycin), and 2 mM L-glutamine using 96-well tissue culture plates. After one day of cell culture, testing solutions with a range of concentrations (Table 1) of different potential ions were added to the wells. The MTT solution was prepared by adding thiazolyl blue tetrazolium bromide powder to the phosphate buffered saline (PBS, OXOID Limited, England) and 10 L of 5 mg/mL MTT solution was added on the next day. 100 L of 10% sodium dodecyl sulfate (SDS, Sigma, USA) in 0.01 M hydrochloric acid was added to each well after four hours of culturing and incubated at 37 C. in an atmosphere of 5% CO.sub.2 and 95% air overnight. Finally, the absorbance was recorded by a multimode detector at a wavelength of 570 nm with a reference wavelength of 640 nm. Cell viability was quantified from the absorbance readings.

TABLE-US-00001 TABLE 1 Test Species Test solution Testing concentration (ppm) Magnesium ion (Mg.sup.2+) MgCl.sub.2 50 to 1,000 Copper ion (Cu.sup.2+) CuSO.sub.4 5 to 200 Zinc ion (Zn.sup.2+) ZnCl.sub.2 1 to 400 Strontium ion (Sr.sup.2+) SrCl.sub.2 50 to 1,000

[0031] Mg, Sr, Cu, and/or Zn were evaluated for cytotoxicity in the form of ions, and were tested independently to identify effective concentration ranges that did not have cytotoxic effects. Results are shown in FIG. 1A to 1D. FIG. 1A shows typical results of studies performed using magnesium ions. FIG. 1B shows typical results of studies performed using copper ions. FIG. 1C shows typical results of studies performed using zinc ions. FIG. 1D shows typical results of studies performed using strontium ions. Typically, maximum human mescenchymal stem cell (hMSC) viability was observed when the Mg ion concentration was from 50 to 200 ppm and viability began to decrease when the concentration exceeded 400 ppm. Most of the cells became non-viable when the Mg ion concentration exceeded 1000 ppm. Human mescenchymal stem cells were only viable at 5 to 10 ppm Cu ions, with loss of viability found when at a concentration of 25 ppm or higher. Surprisingly, human mescenchymal stem cell (hMSC) were found to be particularly sensitive to Zn ions. Significant cell death was found when Zn ion concentration exceeded 1 ppm. On the other hand human mescenchymal stem cells were found to be tolerant of strontium ions, as treatment with up to 1,000 ppm Sr+ resulted in a cell viability that was close to 100%. Surprisingly, human mescenchymal stem cell viability was typically found increase to 115% (relative to control cells) at Sr ion concentrations of 100 to 400 ppm.

[0032] The impact Mg, Sr, Cu, and/or Zn on osteogenic differentiation of human mescenchymal stem cells was determined using alkaline phosphatase (ALP) activity of such cells as an indicator of such differentiation. Accordingly, an ALP assay can be utilized to characterize the osteogenic differentiation properties of Mg, Sr, Cu, and/or Zn, either individually or in combination. In a typical ALP assay 110.sup.4 hMSC cells/cm.sup.2 were cultured in a low glucose DMEM culture medium supplemented with 10% (v/v) fetal bovine serum (FBS, Biowest, France), antibiotics (100 U/ml of penicillin and 100 g/ml of streptomycin), and 2 mM L-glutamine on the first day. On the second day, all the culture media in each well was replaced with a differentiation DMEM medium containing 50 g/ml ascorbic acid (Sigma, USA), 10 mM of -glycerol phosphate (MP Biomedicals, France), and 0.1 M dexamethasone (Sigma, USA) together with different combination of Mg, Sr, Cu, and/or Zn ions and incubated at 37 C. in an atmosphere of 5% CO.sub.2 for 3, 7 and 14 days. The testing concentration(s) of each ion and testing groups are shown in Table 2 and 3, respectively. These culture media were changed every 3 days. After incubation the cells were washed with phosphate buffered saline (PBS) 3 times and lysed with 0.1% Triton X-100 at 4 C. for 30 minutes. The cell lysates were centrifuged at 574 g and at 4 C. for 10 minutes (2-5 Sartorius, Sigma, USA) and 10 l of the supernatant of each sample was transferred to a 96-well tissue culture plate. ALP activity was determined by a colorimetric assay using an ALP reagent containing p-nitrophenyl phosphate (p-NPP) (Stanbio, USA) as the substrate. The absorbance was recorded by the multimode detector on the Beckman Coulter DTX 880 at a wavelength of 405 nm. The observed ALP activity was normalized to the total protein concentration of the samples, as determined measured using the Bio-Rad Protein Assay (Bio-Rad, USA).

TABLE-US-00002 TABLE 2 Independent Working effective concentration (ppm) Test concentration (10% of independent Test Species solution (ppm) working concentration) Magnesium ion (Mg.sup.2+) MgCl.sub.2 50 5 Copper ion (Cu.sup.2+) CuSO.sub.4 10 1 Zinc ion (Zn.sup.2+) ZnCl.sub.2 1 0.1 Strontium ion (Sr.sup.2+) SrCl.sub.2 400 40

TABLE-US-00003 TABLE 3 Testing group Testing concentrations (ppm) Cu only 10 ppm Sr only 400 ppm Zn only 1 ppm Cu + Sr 1 ppm + 40 ppm Cu + Mg 1 ppm + 5 ppm Zn + Sr 0.1 ppm + 40 ppm Zn + Mg 0.1 ppm + 5 ppm Cu + Sr + Mg 1 ppm + 40 ppm + 5 ppm Zn + Sr + Mg 0.1 ppm + 40 ppm + 5 ppm Cu + Zn + Sr + Mg 1 ppm + 0.1 ppm + 40 ppm + 5 ppm

[0033] Typical results of osteogenic differentiation studies are shown in FIGS. 2A and 2B. FIG. 2A shows typical normalized ALP activities measured from cells exposed to various combinations and concentrations of Cu, Zn, Sr, and Mg ions. FIG. 2B shows typical results for cells exposed to Mg ions. Surprisingly, treatment with a combination of Cu, Zn, Sr, and Mg ions produced consistent increases in ALP activity relative to control cells (indicative of osteogenic differentiation) for up to 14 days of exposure. This was achieved using Cu, Zn, Sr, and Mg supplied as simple salts, and in the absence of organic salts of these metals (e.g. Cu, Zn, Sr, and/of Mg salts of an organic compound, where the organic compound has a pharmaceutical effect on osteogenesis). The Applicant considers that such differentiation would result in an increase in bone density and/or bone volume in vivo. This consistent increase in osteogenic differentiation was not found for other combinations of two or three of these ions, indicating the combination of Cu, Zn, Sr, and Mg is necessary. In addition the effect was found at concentrations of the individual ions that are far below those found to be cytotoxic. Remarkably, no need for supplemental calcium (Ca) and/or phosphate was found. Similarly, complexation with organic compounds was found to be unnecessary.

[0034] Inventors have determined that similar metal element combinations are also effective when delivered locally in vivo. To deliver the combined metal element in vivo, salts of Cu, Zn, Sr, and Mg can be combined with a biocompatible carrier (such as polycaprolactone (PCL). In a typical application specific amounts of selected metal salts can be mixed with PCL. In typical studies implants were fabricated from such materials as rods of 2 mm in diameter by 6 mm in length. The metal content of implants used in initial studies is shown in Table 4.

TABLE-US-00004 TABLE 4 MgCl.sub.2 SrCl.sub.2 CuSO.sub.4 ZnCl.sub.2 Weight of 0.01 g 0.11 g 0.014 g 0.03 g Mg/Sr/Cu/Zn compound in 1 g PCL carrier Molar ratio of 1.20 7.91 1.00 2.51 Mg/Sr/Cu/Zn PCL carrier Weight of Mg 0.1 g compound in 1 g PCL carrier (control)

[0035] In typical studies 2-month old female Sprague-Dawley rats (SD rats) from the Laboratory Animal Unit of The University of Hong Kong were implanted. Their average weights were 200-250 g and the chosen operation site was the lateral epicondyle. Each rat was implanted with the combined ions (Mg/Sr/Cu/Zn)/PCL, or Mg/PCL composites on the right lateral epicondyle. In order to monitor new bone formation around the implants, serial time points of 1, 2, 3, 4 and 8 weeks were set. An Mg/PCL composite served as the control.

[0036] The rats were anesthetized with ketamine (67 mg/kg) and xylazine (6 mg/kg) by intraperitoneal injection. The operation sites of the rats were shaved and also underwent decortication. A hole measuring 2 mm in diameter and 6 mm in depth was made by a hand driller at the lateral epicondyle using a minimally invasive approach. Subsequently, the samples were implanted into the prepared holes on the right femur of the rats. The wound was then sutured layer by layer, and a proper dressing was applied over the incision. After the operation, the rats received subcutaneous injections of 1 mg/kg terramycin (antibiotics) and 0.5 mg/kg of ketoprofen. The rats were euthanized in 8 weeks of post-surgery.

[0037] At each time point (i.e. 1, 2, 3, 4 and 8 weeks), micro-computed tomography (micro-CT) (SKYSCAN 1076, Skyscan Company) was conducted at the operation site to monitor the healing process and examine new bone formation around the implants. The 2D planes were reconstructed using the NRecon (Skyscan Company).

[0038] In some studies, to further evaluate the osteogenic effect of the released ions, the thickness of cortical bone was also measured in addition to the new bone formation around the implant. The limb without implantation was served a control. Micro-CT was conducted at week 4 and week 8 to monitor the new bone formation and cortical bone thickness. The rats were scanned in the micro-CT device (SKYSCAN 1076, Skyscan Company) at these two time points and bone volume was analyzed by the CTAn software (Skyscan Company).

[0039] In other studies, flexural stiffness and strength properties of the harvested femurs were determined by using 3-point bending test (MTS 858.02Mini Bionix) based on ASTM D7264-01 standard protocol. The testing speed was 1 mm/min.

[0040] Typical results of initial studies, performed with a single combination of concentrations of Mg, Sr, Cu, and Zn (as described in Table 4) are shown in FIGS. 4A and 4B. FIG. 4A shows typical micro-CT images of rat femurs implanted with the samples from Day 0 to post-op week 8. FIG. 4B shows the percentage change of bone volume adjacent to the sample implants. Typically a 40%-87% increase in bone volume adjacent to the Mg/Sr/Cu/Zn implant (relative to a Mg-only control) was observed in post-op weeks 2, 4, and 8. This indicates that local application of combined Mg, Sr, Cu, and Zn is highly effective in inducing new bone formation. Remarkably, this was achieved without providing supplemental calcium or phosphate. In addition, Cu, Zn, Mg, and Sr were found to be effective when supplied as simple chemical salts (as opposed to metal salts of pharmaceutically active organic compounds).

[0041] Similar studies were performed to determine the maximum dosage of metal ions. The sample preparation, surgical procedures and Micro-CT scanning after surgery were essentially identical to those of the studies summarized in FIGS. 4A and 4B. The metal salt content of the implants used are shown in Tables 5A and 5B, which show salt content by weight and ratios of metallic elements to one another, respectively.

TABLE-US-00005 TABLE 5A Weight of metallic compounds in 1 g PCL carrier MgCl.sub.2 SrCl.sub.2 CuSO.sub.4 ZnCl.sub.2 Mg 0.1 g N/A N/A N/A Mg/Sr/Cu/Zn 0.01 g 0.11 g 0.014 g 0.03 g (Mg/Sr/Cu/Zn)+ 0.02 g 0.2 g 0.028 g 0.06 g (Mg/Sr/Cu/Zn)++ 0.1 g 1.1 g 0.14 g 0.3 g PCL only N/A N/A N/A N/A

TABLE-US-00006 TABLE 5B Molar ratio of metallic elements PCL carrier Mg Sr Cu Zn Mg N/A N/A N/A N/A Mg/Sr/Cu/Zn 1.20 7.91 1.00 2.51 (Mg/Sr/Cu/Zn)+ 1.20 7.19 1.00 2.51 (Mg/Sr/Cu/Zn)++ 1.20 7.91 1.00 2.51 PCL only N/A N/A N/A N/A

[0042] The first and second groups (i.e. Mg and Mg/Sr/Cu/Zn) served to replicate earlier studies, whereas the samples of third (i.e. (Mg/Sr/Cu/Zn)+) and fourth (i.e. (Mg/Sr/Cu/Zn)++) groups were increased with respect to certain metal ions (as shown in Table 5). The increased concentrations ranged from 2-fold to 10-fold higher. The pure PCL group without any metallic ion incorporated served as the control. Typically, at least a 30% to 50% increase of bone volume was found in the Mg/Sr/Cu/Zn group throughout the implantation period as compared with the g Mg/PCL and PCL-only implants, respectively (see FIG. 5). However, 25% or more bone loss was found at one week-post operation when (Mg/Sr/Cu/Zn)+and (Mg/Sr/Cu/Zn)++implants were used. Though the bone loss was reduced at later time points, no new bone formation was identified in association with such implants. This suggests that new bone formation was inhibited at higher concentration metal ion concentrations.

[0043] Similar studies were performed to further optimize the concentrations of the metal salt content of the implants. The metal salt compositions of implants utilized in such studies are shown in Table 6A and 6B. Table 6A shows salt content by weight in the implant, whereas Table 6B shows ratios of metallic elements to one another in the implant. In such studies the implants were rods of 1.3 mm in diameter and 2 cm in length. In addition the implant site was the intramedullary of the femur rather than the lateral epicondyle. This permits testing of the mechanical properties of the whole femur.

TABLE-US-00007 TABLE 6A Weight of metallic compounds in 1 g PCL carrier MgCl.sub.2 SrCl.sub.2 CuSO.sub.4 ZnCl.sub.2 Mg/Sr/Cu/Zn 0.01 g 0.11 g 0.014 g 0.03 g (MSCZ) (Mg/Sr/Cu/Zn)-1 0.01 g 0.11 g 0.0105 g 0.03 g MSCZ-1 (25%) (Mg/Sr/Cu/Zn)-2 0.01 g 0.11 g 0.007 g 0.003 g MSCZ-2 (50%) (Mg/Sr/Cu/Zn)-3 0.01 g 0.11 g 0.0175 g 0.003 g MSCZ-3 (+25%) (Mg/Sr/Cu/Zn)-4 0.01 g 0.11 g 0.021 g 0.003 g MSCZ-4 (+50%) (Mg/Sr/Cu/Zn)-5 0.01 g 0.11 g 0.014 g 0.0225 g MSCZ-5 (25%) (Mg/Sr/Cu/Zn)-6 0.01 g 0.11 g 0.014 g 0.015 g MSCZ-6 (50%) (Mg/Sr/Cu/Zn)-7 0.01 g 0.11 g 0.014 g 0.0375 g MSCZ-7 (+25%) (Mg/Sr/Cu/Zn)-8 0.01 g 0.11 g 0.014 g 0.045 g MSCZ-8 (+50%)

TABLE-US-00008 TABLE 6B Molar ratio of metallic elements PCL carrier Mg Sr Cu Zn Mg/Sr/Cu/Zn 1.20 7.91 1.00 2.51 (MSCZ) (Mg/Sr/Cu/Zn)-1 1.60 10.55 1.00 3.35 MSCZ-1 (Mg/Sr/Cu/Zn)-2 2.39 15.82 1.00 5.02 MSCZ-2 (Mg/Sr/Cu/Zn)-3 0.96 6.33 1.00 2.01 MSCZ-3 (Mg/Sr/Cu/Zn)-4 0.80 5.27 1.00 1.67 MSCZ-4 (Mg/Sr/Cu/Zn)-5 1.20 7.91 1.00 1.88 MSCZ-5 (Mg/Sr/Cu/Zn)-6 1.20 7.91 1.00 1.25 MSCZ-6 (Mg/Sr/Cu/Zn)-7 1.20 7.91 1.00 3.14 MSCZ-7 (Mg/Sr/Cu/Zn)-8 1.20 7.91 1.00 3.76 MSCZ-8

[0044] For the surgical procedures, the distal femur was exposed until the patella is seen. The patella tendon was then displaced to the lateral epicondyle. A hole with 0.5 mm in diameter and 3 mm in length was drilled at the distal end of the right femur through the lateral epicondyle. The sample was then implanted to the drilled hole. The left side (without implantation) was used as the control. The wound was then sutured layer by layer, and a proper dressing was applied over the incision. After the operation, the rats received subcutaneous injections of 1 mg/kg terramycin (antibiotics) and 0.5 mg/kg of ketoprofen. The rats were euthanized 8 weeks of post-surgery.

[0045] Since magnesium and strontium ions are largely available in the body, the tolerance for these ions can be considered to be relatively high as compared with copper and zinc ions. The inventors, therefore, contemplate that the concentrations of copper and zinc can be critical. Further optimization studies therefore focused on optimization of copper and/or zinc. As noted above, the implants (310) formulated with various amounts of Mg, Sr, Cu, and Zn were surgically implanted into intramedullary canal of femur as shown in FIG. 3 so as to study the effect of the combined metal ions on cortical bone thickness. The non-implanted femur was used as control. Typical results are shown in FIGS. 6A, 6B, and 6C. FIG. 6A shows the percentage of change of the cortical bone volume, and shows that all Mg, Sr, Cu, and Zn formulations tested provided an increase in mean cortical bone volume relative to the non-implanted and Mg-only controls. Surprisingly, the mean bone volume is increased relative to controls for all combinations of Mg, Sr, Cu, and Zn tested. As shown in Table 6B the Mg, Sr, and Zn molar ratios, relative to Cu, can range from 0.8 to 2.4, 5.3 to 15.8, and 1.2 to 5 (respectively) relative to Cu content and provide this effect. In particular, implant formulations MSCZ 2, MSCZ 3, and MSCZ 8 demonstrated a significantly higher cortical bone volume relative to a Mg/PCL control. The increase was approximately by 4-8% in post-op week 4 and 6-11% in post-op week 8. Moreover, implant formulation MSCZ 7 was also able to demonstrate a significantly higher cortical bone thickness, which was approximately 9% higher relative to a Mg/PCL control 8 weeks after implantation. FIG. 6C and FIG. 6C show the elastic modulus and stiffness of the implanted and non-implanted femurs, respectively. The MSCZ 3 implants showed a significantly higher elastic modulus and stiffness when compared with the control. Typically, an increase of 16% in elastic modulus and 14% in stiffness was found in femurs implanted with MSCZ 3 implants relative to the femur without surgical implantation. Therefore, in terms of the cortical bone thickness, mechanical stiffness and elasticity, the MSCZ 2 (Mg:Sr:Cu:Zn=2.4:15.8:1:5), MSCZ 3 (Mg:Sr:Cu:Zn=1.0:6.3:1:2), MSCZ 7 (Mg:Sr:Cu:Zn=1.2:7.9:1:3.1), and MSCZ 8 (Mg:Sr:Cu:Zn =1.2:7.9:1:3.8)implant formulations have particular utility for osteogenesis.

[0046] Although embodiments utilizing implants are described above, other embodiments of the inventive concept include methods, devices, and compositions that provide localized delivery of Mg, Sr, Cu, and/or Zn without the use of an implant. In such embodiments Mg, Sr, Cu, and/or Zn can be provided in a flowable formulation, such as a gel or other semisolid, that can be applied at or near a site where increased or enhanced osteogenesis is desired. For example, such a gel or semisolid can be introduced by injection or a minimally invasive surgical procedure. In some embodiments the flowable formulation can solidify following application in order to improve localization. In preferred embodiments such flowable formulations are absorbable.

[0047] In other embodiments of the inventive concept, Mg, Sr, Cu, and/or Zn can be provided systemically. Examples of suitable systemic formulations include injectables suitable for parenteral administration, and formulations that can be consumed orally. Suitable orally consumable formulations can be liquid, solid, or semi-solid. In such oral formulations the amounts and/or ratios of Mg, Sr, Cu, and/or Zn provided can be adjusted by an absorption factor in order to provide the desired amount and/or molar ratio of such ions. For example, an absorption factor of about 30% can be applied to water soluble Mg salts that are consumed orally. Similarly, an absorption factor of about 15% to about 30% can be applied to Sr that is consumed orally. An absorption factor of about 20% to 40% can be applied to Zn that is consumed orally. In some embodiments, the absorption factor can vary relative to the amount of Mg, Sr, Cu, and/or Zn provided. For example, the absorption factor for orally ingested Cu can range from about 30% to about 65% as the Cu content decreases. In some embodiments an absorption can vary depending on the specific Mg, Sr, Cu, and/or Zn compound utilized in the formulation. Similar absorption factors can be determined for topical formulations and for implant formulations, and applied to such formulations to provide the desired molar ratio of Cu:Zn:Sr:Mg.

[0048] In some embodiments of the inventive concept Mg, Sr, Cu, and/or Zn can be provided along with additional elements that can support bone formation and/or suppress bone resorption. Such additional elements include barium, boron, calcium, potassium, and/or vanadium. Such additional elements can be provided as organic or inorganic salts, complexes, or compounds. For example, barium, calcium, potassium and/or vanadium can be provided as cationic components of salts. Such salts can include an anion such as chloride, fluoride, carbonate, bicarbonate, phosphate, sulfate, borate, or nitrate. In another example, boron can be provided as a borate salt and/or as a boron/carbohydrate complex.

[0049] It should be apparent to those skilled in the art that many more modifications besides those already described are possible without departing from the inventive concepts herein. The inventive subject matter, therefore, is not to be restricted except in the spirit of the appended claims. Moreover, in interpreting both the specification and the claims, all terms should be interpreted in the broadest possible manner consistent with the context. In particular, the terms comprises and comprising should be interpreted as referring to elements, components, or steps in a non-exclusive manner, indicating that the referenced elements, components, or steps may be present, or utilized, or combined with other elements, components, or steps that are not expressly referenced. Where the specification claims refers to at least one of something selected from the group consisting of A, B, C . . . and N, the text should be interpreted as requiring only one element from the group, not A plus N, or B plus N, etc.

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