3D Printed Ti-6Al-4V Scaffolds with Hydrogel Matrix
20180133368 ยท 2018-05-17
Assignee
Inventors
- Raja Devesh Kumar Misra (El Paso, TX, US)
- Alok Kumar (El Paso, TX, US)
- Krishna Chaitanya Nune (El Paso, TX, US)
- Lawrence E. Murr (El Paso, TX, US)
Cpc classification
A61L27/3821
HUMAN NECESSITIES
A61L2300/204
HUMAN NECESSITIES
C08L89/00
CHEMISTRY; METALLURGY
A61L2430/02
HUMAN NECESSITIES
C08L89/00
CHEMISTRY; METALLURGY
International classification
A61L27/36
HUMAN NECESSITIES
Abstract
Embodiments of the invention are directed to a vascular structure forming implant produced by additive manufactured Ti-6Al-4V scaffolds a living implant.
Claims
1. An injectable hydrogel comprising: (a) 0.005 to 0.02 g/ml alginate; (b) 0.005 to 0.02 g/ml gelatin; (c) 1 to 10 mg/ml nanocrystalline hydroxyapatite; and (d) water to volume.
2. The hydrogel of claim 1, further comprising osteoblast or osteoblast precursor cells.
3. The hydrogel of claim 1, comprising 0.01 g/ml alginate.
4. The hydrogel of claim 1, comprising 0.01 g/ml gelatin.
5. The hydrogel of claim 1, comprising 5 mg/ml nanocrystalline hydroxyapatite.
6. The hydrogel of claim 1, wherein the hydrogel is crosslinked using CaCl.sub.2.
7. The hydrogel of claim 1, further comprising 2 to 3 mg/ml EDC and 1 to 2 mg/ml NHS.
8. The hydrogel of claim 1, wherein the nanocrystalline hydroxyapatite is in the form of elongated particles having a length of about 80 nm and a diameter of about 30 nm.
9. A bone replacement implant comprising: (a) a three dimensional support; and (b) a hydrogel matrix of claim 1 comprising a hypoxia inducer and glucose; wherein the implant is capable of promoting vascularization and osteogenesis.
10. The implant of claim 9, wherein the three dimensional support is a scaffold structure of Ti-6Al-4V.
11. The implant of claim 10, wherein the scaffold structure has a porosity of 50 to 70%.
12. The implant of claim 10, wherein the scaffold structure has an average pore size of 200 to 500 m.
13. The implant of claim 10, wherein the scaffold structure has a thickness of 0.25 to 5 cm.
14. The implant of claim 10, wherein the scaffold structure has a density of 1 to 2 g/cm.sup.2.
15. The implant of claim 9, wherein the hydrogel further comprises proteins of extracellular matrix.
16. The implant of claim 9, wherein the hydrogel further comprises natural, synthetic, or natural and synthetic polymers.
17. The implant of claim 16, wherein the natural polymers are one or more of polyhyaluronic acid, alginate, polypeptides, collagen, elastin, polylactic acid, polyglycolic acid, or chitin.
18. The implant of claim 16, wherein the synthetic polymers are one or more of polyethylene oxide, polyethylene glycol, polyvinyl alcohol, polyacrylic acid, polyacrylamide, poly(N-vinyl-2-pyrrolidone), polyurethane, or polyacrylonitrile.
19. The implant of claim 9, wherein the hydrogel further comprises one or more growth factors.
20. The implant of claim 9, wherein the hydrogel further comprises an antibiotic.
21. The implant of claim 9, wherein the hypoxia inducer is deferoxamine mesylate (DFM).
22. The implant of claim 21, wherein the DFM is present at a concentration of about 2 to 5 M.
23. The implant of claim 9, further comprising a cell component.
24. The implant of claim 23, wherein the cell component comprises an osteoblast or osteoblast progenitor cell.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] The following drawings form part of the present specification and are included to further demonstrate certain aspects of the present invention. The invention may be better understood by reference to one or more of these drawings in combination with the detailed description of the specification embodiments presented herein.
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DETAILED DESCRIPTION OF THE INVENTION
[0035] Scaffolds provide an ideal substrate for substitute bone due to their random distribution and interconnection, which is largely similar to that of real bone. Ti-6Al-4V has been a popular alloy used in the biomedical industry and research and has been extensively characterized. The limitation of free iron availability through exposure of DFM seems to be a driving factor to enhance the synthesis of hydroxyapatite by cells. It has been previously demonstrated that pre-osteoblasts proliferate, differentiate and are able to synthesize hydroxyapatite when grown on scaffold and mesh structures of this alloy. However, described herein for the first time is an implant that supports formation of a vascular network in the context of a scaffold alloy.
[0036] The process of vascular structure initiation has a key step that involves proteolytic degradation of the ECM so that endothelial cells can migrate to form the microcapillarities. DFM has proven to be a suitable candidate molecule to promote vascularization of endothelial cells. Immediate biomedical applications of this iron chelating agent are viable, seeing as it is already been FDA approved for the treatment of iron poisoning. Described herein is the concept of a living implant as it pertains to various cellular molecular mechanisms, mainly involved in wound healing and the regeneration of tissue. Tissue that has undergone extensive damage needs to endure harsh environments that stimulate apoptosis rather than cell survival. A tissue-solid metal interface is not sufficient to promote a wound healing process, the ingrowth of bone, and eventually the formation of a vascular network. Implanted solid metal bars present a physical limitation to the availability of nutrients and, most notably, oxygen. The wounded tissue then suffers from hypoxia, triggering an irreversible response that eventually leads to cellular death. In a heavily wounded tissue metabolic demands differ vastly from that of normal tissue. To create a fully living implant that mimics real tissue, this issue needs to be addressed and thoroughly understood. Therefore, the addition of molecules that can compensate for the metabolic high demands is required. It is to this end that D(+) glucose can be added to cells undergoing a hypoxia mimetic response.
[0037] The materials chosen and tested herein prove to be a combination that is suitable to develop a fully living bone replacement implant. Ti-6Al-4V scaffolds provide structural support, while an ECM-like hydrogel simulates an aqueous microenvironment that drives wound healing, bone ingrowth and vascularization. Despite the attractive properties of Matrigel, this product is not intended for anything other than research purposes. However, its main constituents may be further utilized with the focus of creating a hydrogel capable of driving the before mentioned processes. Collagen and gelatin hydrogels can be tailored to maintain their solid stability under physiological conditions.
[0038] Embodiments of the invention include materials comprising a base support coupled to a hydrogel that includes reagents for supporting vascularization and enhancing bone repair, while maintaining mechanical and structural similarities with real bone. Certain aspects are directed to a mixture of additive manufactured Ti-6Al-4V scaffold in combination with a collagen based hydrogel matrix containing DFM; a hypoxia mimetic compound, that can form vasculature under physiological conditions, while maintaining osteoblast cell differentiation and proliferation. This approach induces a hypoxia mimetic stress that will trigger cellular survival signals that ultimately enhances wound healing processes in bone.
I. STRUCTURED SCAFFOLD SUPPORT
[0039] A structured scaffold can be rapidly built from a base powder material. For example, the scaffold structure can be manufactured using three-dimensional (3D) printing. A direct metal laser sintering process can be used to 3D print (i.e. build) the scaffold structure. The scaffold structure can be made from a base material, such as a Ti-6Al-4V alloy. In other embodiments the scaffold structure can comprise other suitable alloys or combination of alloys (e.g., 316 stainless steel, commercially pure titanium (TiCP) and aluminum alloy (AlSi10Mg), austenitic steels, ferrous steels, aluminum alloys, titanium alloys, pure aluminum and pure titanium and the like).
[0040] The scaffold structure can be three-dimensionally printed with a direct metal laser sintering process (or any other suitable process, such as electron beam melting). The scaffold structure can be three-dimensionally printed with at least a Ti-6Al-4V alloy (or any other suitable alloy or combination of alloys). The scaffold structures can be produced using electron beam melting or any other additive manufacturing process.
II. EXTRACELLULAR MATRIX-LIKE HYDROGELS FOR BONE REPAIR
[0041] The ingrowth of bone into the implant is essential in order to achieve what is conceptually a living implant. Although the main goal of this research is to stimulate the formation of vascular structures within the porous metal implant, the nature of wound healing must also be addressed. This includes, but is not limited to the mineralization of calcium by osteoblasts, the inhibition of bone resorption by osteoclasts, and avoiding debris release by the implant itself. Bone has elastic properties, and its elasticity can be attributed to the collagen in which hydroxyapatite grows. The molecular arrangement of collagen is regulated by fibroblasts and endothelial cells in tissue, and this arrangement directs the synthesis and growth of hydroxyapatite. Bone is capable of self-repair, but this natural process is limited to the extents to which it can generate new tissue. This is the case for the large portion of bone that has been surgically removed. However, with the assistance of engineered biomaterials, bone tissue repair can be directed by stimulating the appropriate wound healing response. The microenvironment of bone has been widely reported to be hypoxic. A hypoxia mimetic environment has been reported to enhance bone repair, along with restoring endothelium integrity. This was determined by injecting DFM on mandibular fractures that had been exposed to radiotherapy. DFM improved healing and augmented vascularity. Iron chelation by DFM administration has also shown that bone resorption is inhibited by limiting osteoclastic differentiation. It is to this end that a collagen based hydrogel material is ideal to, not only serve as a mimetic of an ECM, but to also serve as an aqueous solution in which to deliver hypoxia mimetic inducing compounds such as DFM.
[0042] The implementation of a hydrogel matrix also eliminates the issue of seeding efficiency of cells into the scaffold structure. When cells are added to the structure, they will be in a liquid suspension that will eventually become a solid hydrogel matrix. Because the proposed model will have a solid matrix, cells will not fall through the porous metal scaffold at the moment of seeding. Instead, they will remain suspended in the ECM-like gel.
[0043] Certain embodiments are directed to design a bone replacement implant capable of forming vascular structures in a hydrogel matrix, while allowing for osteoblast proliferation and cell differentiation. Osteoblasts can also successfully synthesize hydroxyapatite and retain their adhesion to the Ti-6Al-4V scaffold. The hydrogel matrix should contain all of the necessary supplements to favor angiogenesis and vascular structure maturation.
[0044] A hydrogel is a three dimensional network of polymer chains with water filling the void space between the macromolecules. In certain aspects the hydrogel includes a water soluble polymer that is crosslinked to prevent its dissolution in water. The water content of the hydrogel may range from 20-80%. In certain aspects the hydrogel may include natural or synthetic polymers. Examples of natural polymers include polyhyaluronic acid, alginate, polypeptide, collagen, elastin, polylactic acid, polyglycolic acid, chitin, and/or other suitable natural polymers and combinations thereof. Examples of synthetic polymers include polyethylene oxide, polyethylene glycol, polyvinyl alcohol, polyacrylic acid, polyacrylamide, poly(N-vinyl-2-pyrrolidone), polyurethane, polyacrylonitrile, and/or other suitable synthetic polymers and combinations thereof. For example, the hydrogel may include a crosslinked blend of polyvinyl alcohol (PVA) and poly(N-vinyl-2-pyrrolidone) (PVP). The hydrogel may also include beneficial additives that are released at the surgical site. For example, the hydrogel may include analgesics, antibiotics, growth factors, and/or other suitable additives.
III. ANGIOGENESIS
[0045] The process of the development of new vasculature (angiogenesis) is one component of the wound healing process. Vascular structures serve as transport pathways for oxygen, nutrients and signaling molecules throughout the organismal systems. Because of the significance of this process, the capacity of implant to induce vascularization is essential to develop an ideal substitute of the original biological matter. It has been recently studied that cell-cell differentiation in developing organs is key for the development of angiogenesis. These interactions are mediated by Endothelial Cells (EC). It is these cells that form the first liner that becomes the basic template for the formation of veins and arteries. The main role of an endothelium is to serve as a transport pathway for oxygen. Therefore, ECs are equipped with oxygen sensor molecules such as Prolyl Hydroxylase Domain Enzymes (PHDs), and Hypoxia Inducible Factors-1 (Hif-1). Despite the biological importance of vascular structure formation, achieving this remains a challenge in tissue engineering.
[0046] Angiogenesis can be initiated by certain growth factors, the most widely acknowledged signaling pathway being triggered by Vascular Endothelial Growth Factor (VEGF). Research has demonstrated that certain proteins, regulate the levels of VEGF secretion and play key roles in angiogenesis, the most important of these being the Hif-1. Hif-1 acts as a transcription factor, translocating to the cell's nucleus under depravation of oxygen. This transcription factor increases the number of type HECs and osteoprogenitors through the process of hypoxia.
[0047] Hypoxia is defined as the deficiency of oxygen in tissues. When oxygen is depleted in tissue, a highly regulated process concerning cell survival becomes activated. Hif-1 is highly down-regulated by PHD-2 which target Hif-1 for degradation. During hypoxia, there is lack of oxygen in cells, which inactivates the prolyl hydroxylase domain proteins PHD1-3, which are oxygen-sensing. When this occurs, Hif-1 and Hif-2 proteins are no longer targeted for protein degradation and transcriptional responses are then activated to increase oxygen supply by angiogenesis through upregulation of VEGF. In general, Hif-1 promotes vessel sprouting, whereas Hif-2 mediates vascular maintenance. Hif-1 abrogation by siRNAs in HUVECs disrupts the formation of microcapillaries, but not Hif-2. This is because Hif-2 does not stimulate the production of VEGF.
[0048] ECs migrate to reorganize themselves under hypoxia. The secretion of VEGF stimulates this reorganization. When VEGF is secreted, ECs also secrete metalloproteinases, whose role is to rearrange the ECM. After the ECM rearrangement, they begin to express CD44, allowing for an increased cell adhesion that enables the endothelium to maintain is microcapillar structure. Despite the high level of cellular organization to form microcapillaries, microvessel maturity is an issue as well. When microcapillaries form, endothelial cells may become quiescent (increased cellular half-life). However, the microsvascular structure may not always be retained, unless the endothelium recruits a pericyte liner. Pericytes are recruited by the endothelium when endothelial cell quiescence is achieved, which is determined by the secretion of Angiopoetin 1 & 2 (ANG-1 & ANG-2). The secretion of ANG-1 signals endothelium quiescence, whereas ANG-2 is secreted by Endothelial Tip Cells (ETCs). An ETC is a single endothelial cell randomly selected to commence the progression of a sprouting microvasculature. This process promotes vascular branching. In a physiological environment, ECs are held together by the Extracellular Matrix (ECM). This is a matrix represents a physical barrier that the endothelium can manipulate.
[0049] It has been previously reported that hypoxia induced by exposing cells in vitro and in vivo to CoCl.sub.2 causes severe inflammatory response, resulting in the recruiting of macrophages. This has been observed in failed implanted structures that consist mainly of Cobalt-Molybdenum-Nickel alloys. In this particular research, particulate debris from the implanted alloy was analyzed against macrophages, resulting in hypoxia. The effects of cobalt ions on cells have been analyzed, but not the effects of hypoxia mimetic cellular responses with anything other than cobalt based materials. Despite these results, there have been a myriad of results demonstrating that hypoxic stress does not mediate cell death, instead, it promotes cell survival. It has been widely studied that Cobalt ions can stimulate the production of Reactive Oxygen Species (ROS), thus leading to mitochondrial insult, resulting in apoptosis. This leads to a controversial issue: does a hypoxia mimetic environment necessarily cause an undesirable response in wound healing?
IV. HYPOXIA IN WOUND HEALING
[0050] Cells have evolved to respond to varied environments. Lack of free oxygen is one of them. Because oxygen is required for many cellular metabolic processes, such as the production of Adenosine Triphosphate (ATP), fatty acid synthesis and oxidative phosphorylation, cells are prepared to activate transcription factors that promote cell survival. Under a hypoxic response, the Hif-1 intracellular levels increase, as it is no longer targeted for degradation by PHD enzymes. Hif-1 can then dimerize with Hif-1 in the cell nucleus and initiate the transcription process that results in the expression of the VEGF gene. VEGF has been reported to promote an angiogenic response, and increase the activation of the Phosphatidyl Inositol-3-Kinase (PI3K)-Akt signaling pathway. It has been broadly researched and acknowledged that this particular signaling pathway is actively involved in the progression of tumor invasiveness and metastasis in a variety of cancer models. Hypoxia has been reported to increase the viability of cells and progression of survival signaling pathways. However, on a normal cell line, inhibiting the degradation of Hif-1 inhibits apoptosis, does not produce ROS (as Cobalt does), but results in promoting cellular differentiation and migration. Moreover, because the PI3K-Akt pathway becomes activated while a cell is experiencing a hypoxic response, therefore, diligent care must be taken in order to, not only select an appropriate hypoxic inducer, but to employ it at the correct concentrations. Despite the molecular signaling similarities between hypoxia stressed cells and cancer, the metabolic profiles of each are different. This suggests that, though the PI3K/AKT pathway is expressed, no adverse effects such as the immortalization of cells should be observed. The viability, proliferation, and population doublings of the cells exposed to various hypoxia inducing molecules must be addressed, and must not be limited to endothelial cells.
[0051] Deferoxamine Mesylate (DFM), also referred to as Deferoxamine (DFO) is an iron chelating agent; meaning that it binds to free iron ions in solution. This particular molecule is employed to regulate iron homeostasis in cells by chelating excess iron in solution. DFM is a well know inhibitor of PHD enzymes and has also been shown to increase bone density in osteoporosis mouse models. Despite there being other chemicals that may induce hypoxia in cells, i.e. CoCl.sub.2, DFM has little known adverse effects.
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[0052] Because DFM binds to iron co-factors, the catalytic ability of PHD enzymes becomes hindered, leading to the stabilization of Hif-1. DFM has been approved by the Food and Drug Administration (FDA) and is available for clinical use in the US. Currently, it is being used as an iron chelating agent to treat iron overdose from blood transfusions. As previously mentioned CoCl.sub.2 triggers a hypoxic response and stabilized Hif-1 because it competes with iron for enzymatic active sites.
[0053] In recent years a wide number research papers have been published with promising applications for hypoxia in wound healing. These approaches include but are not limited to diabetic wound healing in fibroblasts, several mitochondrial related metabolic diseases such as Leigh Syndrome, and more recently to treat brain hemorrhage. The biomedical applications of hypoxia can be tailored to combat a variety of wound healing situations. It has also been recently reported that inhibiting PHD2 enzymes and stabilizing Hif-1 a increases the survival rate of newly implanted cells in bone. It has been reported that the levels of ROS species in endothelial cells decreases, enabling cells to undergo redox homeostasis and glycogen storage. This further suggests that a hypoxia mimetic, but not hypoxia as a lack of oxygen maintains the integrity of cellular metabolism by stabilizing Glutathione S Transferase (GST). Because of the ever increasing evidence that hypoxia can support regenerative medicine, in this research, a hypoxia mimetic will be applied to promote vascularization, pre-osteoblast differentiation and wound healing for newly implanted bone replacement implants.
V. EXAMPLES
[0054] The following examples as well as the figures are included to demonstrate preferred embodiments of the invention. It should be appreciated by those of skill in the art that the techniques disclosed in the examples or figures represent techniques discovered by the inventors to function well in the practice of the invention, and thus can be considered to constitute preferred modes for its practice. However, those of skill in the art should, in light of the present disclosure, appreciate that many changes can be made in the specific embodiments which are disclosed and still obtain a like or similar result without departing from the spirit and scope of the invention.
[0055] A. Materials & Methods
[0056] Materials. Type-A gelatin (Cat. No. 901771) was procured from MP Biomedicals, France. Alginate (alginic acid sodium salt from Brown Algae, Cat. No. A0682), N-hydroxy-succinimide (NHS, Cat. No. 130672), and 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC, Cat. No. 22980) were obtained from Sigma-Aldrich, USA. Nanocrystalline hydroxyapatite was synthesized in-house using suspension-precipitation method using precursors: calcium oxide (CaO) and orthophosphoric acid (H.sub.3PO.sub.4).
[0057] Synthesis of nanocrystalline hydroxyapatite (nHA). Nanocrystalline hydroxyapatite powder was synthesized using suspension-precipitation approach involving reaction between CaO and H.sub.3PO.sub.4 (Tagai and Aoki, Preparation of synthetic hydroxyapatite and sintering of apatite ceramics: John Wiley and Sons, 1980). In this approach, a solution of CaO was first prepared in high purity deionized water (19.6 g/l) and the solution temperature maintained at 80 C. during the reaction. The solution was titrated with 0.15 M H.sub.3PO.sub.4 acid. A 0.15M solution of H.sub.3PO.sub.4 was prepared by adding 9.5 ml H.sub.3PO.sub.4 in 1 L of deionized water. The pH of the solution was adjusted to 12 using ammonium hydroxide solution (NH.sub.4OH). After completion of reaction, the solution was filtered and precipitate (nanocrystalline hydroxyapatite) was collected, followed by drying at 80 C. for 24 h in an electric oven. HA powder was calcined at 800 C. for 2 h in air using muffle furnace. The calcined powder was ball milled for 16 h at 200 rpm using agate milling media (Pulveristte 7 premium line, Fritsch, Germany). The ball to powder ratio was 4:1. Toluene was added during milling to avoid the sticking of powder (Kumar et al., Journal of Biomedical Materials Research Part B: Applied Biomaterials. 2013, 101B:223-36). Ball milled powder was characterized by the X-ray diffraction (Bruker's D8 Discover, Germany). The XRD data was analyzed and compared with hydroxyapatite standard (pdf no. 74-0566, International Committee for Diffraction Data). Furthermore, transmission electron microscopy (TEM) and selected area diffraction pattern (SAED) were used to characterize the particle size and morphology of ball-milled nHA particles (Kumar et al., Acta Materialia 2013, 61:5198-215).
[0058] Synthesis of hybrid injectable pre-hydrogel reinforced with nHA. A pre-hydrogel was synthesized, followed by final cross-linking with CaCl.sub.2. It may be noted that to synthesize pre-hydrogel, CaCl.sub.2 was not used for cross-linking during gel synthesis. It was only after cell encapsulation (cell loading in pre-hydrogel), that final cross-linking was carried out using 0.05 M CaCl.sub.2 to further enhance the strength. Four compositions were prepared and based on preliminary study of osteoblast cell culture, composition A was selected (Table 1). To synthesize 100 ml pre-hydrogel, an aqueous solution of nanocrystalline hydroxyapatite (nHA) was prepared by mixing 500 mg nHA powder in 100 ml high purity deionized water and solution was kept on magnetic stirrer (1000 rpm) at 40 C. After 15 min of mixing, 2% gelatin (20 mg/ml of nHA suspension) and 2% alginate (20 mg/ml of nHA suspension) were added and stirred at 40 C. for another 15 min. Furthermore, 250 mg EDC and 150 mg NHS were added and stirred at 40 C. for 24 h. The prepared pre-hydrogel reinforced with nHA was filled in a sterilized syringe and kept under UV for 12 h for sterilization. After sterilization, the pre-hydrogel was loaded with cells and cross-linked with 0.05 M CaCl.sub.2 for 5, 10, or 15 min. Pre-hydrogel without cells, cross-linked with 0.05 M CaCl.sub.2 for 5, 10, or 15 min were considered as controls. Next, the prepared hydrogels (cross-linked with 0.05 M CaCl.sub.2) were kept in 1 PBS for 15 min to remove excess CaCl.sub.2 and then transferred to culture medium and incubated for 5 days in 5% CO.sub.2 and 95% humidity at 37 C. in a sterilized environment. After incubation, cell-loaded hydrogels were characterized for cell viability and proliferation, while hydrogels without cells were characterized for phase assemblage and porous structure. The prepared hydrogel (loaded with cells) was infiltrated in to Ti-6Al-4V scaffolds of 2 mm mesh size (55% porosity and 300 m pore size). The dimensions of sample were 8 mm8 mm2 mm. Prior to this, the scaffold surface was polished using 0.25 m alumina suspension, followed by ultrasonication of scaffolds in distilled water, acetone, and 70% ethanol for a total duration of 180 min.
[0059] Phase assemblage and pore architecture. To determine the phase assemblage and pore architecture, the hydrogel (cross-linked with 0.05 M CaCl.sub.2 for 10 min) was studied by X-ray diffraction (XRD), Fourier transform-infrared spectroscopy (FT-IR), and scanning electron microscope (SEM) in secondary electron (SE) mode. For SEM, samples were coated with gold to avoid charging during imaging. For SEM, XRD, and FT-IR, the hydrogel sample was kept at 80 C. for 12 h, followed by freeze drying for 12 h to get a dried porous scaffold. To characterize by XRD and FT-IR, the scaffolds were ground in agate mortar and pestle to make fine powder. In the case of FT-IR (FT/IR-4600LE, Jasco, Japan), freeze dried hydrogel powder sample was mixed with KBr in the ratio of 1:200, and a thin pellet of 3 mm diameter was made. The absorption of IR radiation was recorded from 4000 to 600 cm.sup.1 XRD (D8 Discover, Bruker's diffractometer, Germany) was carried out at 40 kV voltage and 40 mA current using CuK wavelength (1.54056 ) from (2) 20 to 90 at a scanning rate of 2/min and with an increment (step size) of 0.02.
[0060] Effect of cross-linking time on the dissolution behavior of hydrogel. To determine the stability and integrity of the hydrogels, dissolution study in cell culture media was carried out for 2, 4, 6, and 8 days. In this regard, 8 well plate (Cat. No. 267062, Thermo Scientific Nunc, USA) was used as a mold to obtain a hydrogel sample of 2 mm thickness. In each well, 4 ml pre-hydrogel was added, followed by cross-linking with 0.05 CaCl.sub.2 for 5 (category I), 10 (category II), and 15 min (category III). Cross-linked samples were washed with 1 PBS, followed by immersion of samples in 1 PBS for 15 min to ensure the removal of excess CaCl.sub.2. The molded hydrogel samples were cut in to dimension of 8 mm8 mm2 mm. Next, the samples were transferred to 24 well plate and well plate was sealed with parafilm (Cat. No. PM-996) to avoid the loss of water during the test period, followed by UV sterilization for overnight. After sterilization, samples were immersed in equal volume (2 ml) of 1 PBS and well plates were sealed again by parafilm and kept in a hot air oven at 37 C. for 2, 4, 6, and 8 days. Experiments were carried out on triplicates and repeated for at least three times to obtain statistically relevant data. After 2, 4, 6, and 8 days of incubation, solution from each well was carefully removed and absorption was measured at 210 nm. 1xPBS was used as a reference.
[0061] To estimate the amount of dissolved hydrogel, a standard curve was plotted using different amount of alginate in 1 PBS in the range of 0.05 mg/ml to 5 mg/ml and optical density of solution was measured at 210 nm. A curve between dissolved amount of alginate and optical density was plotted using Excel (Office 2013, Microsoft, USA). Corresponding to the plotted curve, a trend line was drawn to estimate the equation using curve trend and slope. This equation was used to estimate the amount of dissolved alginate from hydrogel during dissolution. Since, both gelatin and alginate indicate absorption at 210 nm, thus, obtained OD corresponded to the total amount of dissolved material (sum of alginate and gelatin) from hydrogel. Thus, dissolved amount of alginate was half of the total dissolved hydrogel.
[0062] Study of sorption kinetics of monocrystalline hydroxyapatite reinforced hydrogel (nanocomposite) in PBS. To study sorption kinetics, nanocrystalline hydroxyapatite reinforced hydrogel (nanocomposite) was filled in 8 well plate (4 ml in each well) and 0.05 M CaCl.sub.2 was added for 10 min for cross-linking. Next, cross-linked hydrogel was kept in 1 PBS for 15 min to remove excess CaCl.sub.2. The nanocomposite was cut in a rectangular shape of dimensions 30 mm20 mm4 mm and refrigerated at 80 C. for 5 h, followed by freeze drying for overnight. The dried samples were weighed and immersed in 1 PBS at 37 C. The swollen nanocomposite samples were removed from 1 PBS after 30 min and excess surface water was removed using filter paper, and weighed. After this, the samples were again immersed in a fresh 1 PBS at 37 C. This process was repeated until equilibrium swelling was reached. The change in weight during this process was recorded as a function of time. All the measurements were carried out in triplicate to obtain statistically relevant data. Using these data, swelling ratio, equilibrium swelling ratio, swelling rate, and equilibrium water content were calculated using following equations:
where, m.sub.d, m.sub.t, and m.sub.equ are the weight of the dried nanocomposite, weight of the swollen nanocomposite at time t, and weight of the swollen nanocomposite at equilibrium state, respectively.
[0063] PBS desorption kinetics for swelled nanocomposite. Samples were removed from 1 PBS after attaining swelling equilibrium. The excess water from the samples surface was removed using a filter paper. Next, the nanocomposite samples were weighed. This weight is considered as swollen weight (w.sub.). Following this, the samples were kept at 37 C. with constant humidity for 30 min. The process was repeated until the samples were completely dried and a constant weight was obtained. The amount of PBS desorption from nanocomposite was documented as a function of time and PBS desorption was calculated using following equation:
Where, wt, w.sub.9, and w.sub. are the weight of nanocomposite at time t, initial time 0, and completely dried time , respectively.
[0064] Cytocompatibility assessment. Alginate-gelatin hydrogel reinforced with nanocrystalline hydroxyapatite (nanocomposite), loaded with MC3T3-E1 pre-osteoblast cells (cell density 10.sup.6 cells/ml of hydrogel) was infiltrated in Ti-6Al-4V scaffolds, followed by cross-linking with 0.05 M CaCl.sub.2 for 5, 10, and 20 minutes. These samples with 3D-porous architecture (Ti-6Al-4V) infiltrated with hydrogel (comprised of cells and nanocrystalline hydroxyapatite) are referred as hybrid nanocomposite. These hybrid nanocomposites were incubated in complete culture medium for 5 days, followed by studies involving live/dead assay, cell morphology (expression of actin, vinculin and staining of nucleus), and MTT assay (to study metabolically active cells and thus measure the cell proliferation).
[0065] Live/dead assay. Pre-hydrogel samples (nHA reinforced hydrogel and loaded with osteoblasts, infiltrated in Ti-6Al-4V scaffold) were subjected to cross-linking by 0.05 M CaCl.sub.2 for 5, 10, and 15 min. Following the cell culture protocol described above, after 6 days of incubation, samples were analyzed using live/dead assay to study the effect of cross-linking time on cell viability and to select appropriate samples for further study based on cell viability and cross-linking time data. The details of live/dead assay are reported elsewhere (Kumar et al., Journal of biomaterials applications 2016, 0885328216658376). Briefly, staining agent for live cells (live green) and dead cells (dead red) (Cat. No. R37601, Live/Dead imaging kit, Life Technologies, USA) was used to make the stock solution. Next, the samples were washed with 1 PBS and each sample was treated with equal volume of stock solution. The samples were incubated for 15 min at room temperature (20-25 C.), stored at 6 C., and studied using fluorescence microscopy within 2 h. Green and red colors in the micrograph denoted live and dead cells, respectively. On the basis of these results and stability of hydrogel in culture medium, 10 min cross-linking time was considered optimal for further studies. Thus, further studies were carried out on the samples cross-linked with 0.05 M CaCl.sub.2 for 10 minutes (category II).
[0066] MTT assay/cell proliferation assay. For MTT assay, samples were prepared by the addition of 1 ml pre-hydrogel in each well of 24 well plate, followed by cross-linking with 0.05 M CaCl.sub.2 for 10 min. The cross-linked samples were washed with 1 PBS for 15 min and kept under UV for overnight. To avoid the water sorption, well plate was sealed with parafilm. After UV sterilization, samples were again washed with 1 PBS, followed by a treatment with 1 ml complete culture medium for 1 h. After 1 h, media was removed and MC3T3-E1 cells with a cell density of 50,000 cells/ml were seeded on the hydrogel surface. After 4 h of incubation, 1 ml complete culture media was added in each well to maintain total 2 ml solution in each well. Cells seeded on hydrogel surface were incubated for 2, 4, 6, and 8 days. During the incubation period, old media was replaced with new media on each day. To evaluate cell viability and cell proliferation, MTT (3(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide)) assay was used after 2, 4, 6, and 8 days of incubation of samples of category II. The details of MTT protocol has been reported elsewhere (Kumar et al., Materials Science and Engineering C 2012, 32:464-9). Briefly, after pre-determined incubation period, culture media was replaced with 10% MTT reagent (in 1 PBS), followed by incubation of samples in CO.sub.2 incubator for 6 h. This resulted in reduction of MTT salt into insoluble formazan crystals. After incubation, MTT reagent was removed carefully and violet colored formazan crystals were dissolved using DMSO (dimethyl sulfoxide, D8418, Sigma Aldrich, France). The violet color solution was transferred to a 96 well plate to measure the optical density of solution at 570 nm wavelength using ELISA (enzyme-linked immunosorbent assay) plate reader (ELx800, BioTek, USA). The data obtained was normalized by the optical density of DMSO solution. Furthermore, obtained optical density was normalized with the amount of formazan crystals absorbed in to hydrogel due to porous nature of the hydrogel. For this, hydrogel was transferred to 50 ml centrifuge tube and diluted 5 times. Next, probe sonication was used to dissolve the hydrogel. Now, the dissolved hydrogel with formazan crystals was centrifuged for 10 minutes at 10,000 rpm. The 200 l of supernatant was transferred to 96 well plate and optical density was measured at 570 nm. The obtained optical density was multiplied by 5 to equalize the dilution factor. This value of optical density was added to the original value of optical density to obtain the final value of optical density.
[0067] Cell-cell and cell-material interactions. An actin cytoskeleton and focal adhesion staining kit (cat. No. FAK100, Millipore, USA) was used to study the cell-cell and cell-material interaction, after 2 and 6 days of incubation, the samples were washed twice with 1 PBS. To fix the cells, the samples were kept in 4% formaldehyde at room temperature for 20 min. Next, samples were washed twice with 1 PBS. These samples were treated with 0.1% tritonx 100 for 6 min. This resulted in cell wall permeabilization. To reduce the non-specific binding of staining agents, after washing the samples with 1 PBS twice, samples were further treated with 5% FBS for 30 min, followed by washing twice with 1 PBS. These samples were stained for 60 min by a staining agent (green color, specific for focal adhesion contact points of cells) to study the expression of vinculin. Furthermore, after washing twice with 1 PBS, the samples were stained for 60 min with a staining agent (red color), specific for actin stress fibers to study the reorganization of cytoskeleton. After washing twice with 1 PBS, cell nucleus was stained with DAPI (blue color) for 10 min. The stained samples were washed three times with 1 PBS and stored at 6 C. in 1 PBS in dark until imaging by florescence microscope.
[0068] Alkaline phosphatase (ALP) assay. An APL assay kit (cat. No. DALP-250, BioAssay Systems, USA) was used to study the efficacy of bone formation of the designed nanocomposite hydrogel, hydrogel samples crosslinked for 10 min, followed by culture of osteoblasts (50,000 Cells/ml) for 4 days, and then differentiation for 6, 12, and 18 days were selected for ALP assay. In an alkaline environment, ALP catalyzes the hydrolysis of phosphate esters. In this method, ALP present in the solution (due to differentiation of osteoblast on the biomaterial surface) hydrolyzes the p-nitrophenyl phosphate (pNPP) in to p-nitrophenol and phosphate. This yellow colored product shows maximum absorbance at 405 nm. Since, ALP enzyme is present in bone and the rate of hydrolysis is directly proportional to the activity of ALP, therefore, recorded OD using ELISA plate reader can be correlated with the bone formation ability of the biomaterial. Briefly, protocol comprises of preparation of working solution, cell lysis, followed by optical density measurement at 405 nm. The working solution was prepared by mixing 5 l magnesium acetate and 2 l pNPP in to 200 l assay buffer. Solution was stored at 4 C. At this temperature, solution can be stored for not more than 48 h. Next step, sample was washed with 1 PBS and 500 l of 0.2% Triton-X100 (in distilled water) was added on each sample. The samples were incubated for 30 min at room temperature to lysis the cells. This lysed cell solution in Triton-X is designated as sample solution. Next 50 l of sample solution and 150 l of working solution was mixed in a centrifuge tube and transferred to 96 well plate to measure the absorption at 405 nm at time 0 and 5 min. Further, 200 l of calibration solution was added in another 96 well plate and absorption was recorded at 405 nm. In a similar way, 200 l of distilled water was added in another 96 well plate and absorption was recorded at 405 nm. Using these values, ALP activity of the sample can be calculated using following equation.
[0069] Where, t is the incubation time (min), is extinction coefficient (molar absorption coefficient) of -nitrophenol (=18.75 mmol.sup.1.Math.cm.sup.1), l is the light path (cm) and for 96 well plate is equal to (OD.sub.calibratorOD.sub.distilled water)/.Math.c; where, c is the concentration of calibrator.
[0070] After substituting the values of , equation 6 becomes,
[0071] Statistical Analysis. The data obtained was analyzed using a statistical analysis software (SPSS 19.0, IBM, USA). Post-hoc tests (multivariate comparison) was used to compare the mean values of samples. Two way ANOVA (Analysis of Variance) was used with Dunnett t (represented by symbol *) and Dunnett C (represented by symbol **) tests to estimate the significant difference between the samples mean and in comparison with control at p<0.05, respectively (Yuksel et al., International Journal of Pharmaceutics, 2000, 209:57-67). All data presented as meanstandard error of mean using Origin software (version 8.5, Origin Lab Corporation, USA).
[0072] B. Results
[0073] Synthesis of hydrogel. First, nanocrystalline hydroxyapatite was synthesized in lab using suspension-precipitation method, prior to synthesis of alginate and gelatin based hydrogel, reinforced with nanocrystalline hydroxyapatite (
[0074] Microstructure and phase assemblage. The scanning electron micrographs of freeze-dried hydrogel after final cross-linking with CaCl.sub.2 for 10 min revealed highly porous structure with 2 m wall thickness of the pores (
[0075] In XRD data, it is very difficult to identify the presence of alginate and gelatin because of high intensity peaks of hydroxyapatite in comparison to alginate and gelatin. Therefore, FT-IR was used as a complimentary tool to identify the presence of alginate and gelatin in the hydrogel (
[0076] Sorption and desorption kinetics. Sorption and desorption kinetics of synthesized hydrogel was studied by measuring the swelling ratio (
[0077] On drying of hydrogel at 37 C. in hot air oven, an increase in desorption ratio of 1 PBS was noted from 30 to 90 min. Beyond 90 min incubation, the desorption ratio was stable with time.
[0078] Dissolution study in 1 PBS. To study the effect of cross-linking time on the dissolution behavior of hydrogel samples, equal sized pre-hydrogel samples were cross-linked for three different time scale (5, 10, or 15 min) and kept in 24 well plate in 1 PBS at 37 C. for 2, 4, 6, and 8 days, with one sample in one well and 2 ml 1 PBS in each well. After 2, 4, 6, and 8 days of immersion, solution containing the dissolved hydrogel was removed carefully from well plate without disturbing the integrity of the hydrogel samples and diluted with MQ water, followed by measuring the absorption at 210 nm. The amount of dissolved hydrogel was calculated using a standard plot between amount of dissolved material vs. absorption at 210 nm. It is important to mention that both gelatin and alginate indicated absorption peak at 210 nm. Thus, the observed absorption value was directly proportional to the sum of absorption of radiation (=210 nm) by alginate and gelatin. Thus, the amount of dissolved alginate or gelatin was equal to half of total absorption value.
[0079] The standard plot was used to calculate the dissolved amount of alginate. For this, different amount of alginate (0.05, 0.1, 0.5, 1.5, 2.5, 4, and 5 mg) was dissolved in 2 ml 1 PBS. The corresponding absorption at 210 nm was 0.145, 0.215, 0.412, 0.804, 1.706, 2.361, and 3.086.
[0080]
[0081] Effect of cross-linking time on cell viability. As mentioned in previous section, stability of hydrogel and hydroxyapatite-based nanocomposite depends on the cross-linking time. It was noted that 10 min cross-linking time was optimum with stable dissolution profile and no burst degradation of material. To further investigate the effect of cross-linking time on cell viability, cells were cultured for 6 days in a-MEM-based complete culture media at 37 C. and 5% CO.sub.2 and 95% relative humidity. Old culture media was replaced with fresh media every second day. After 6 days, following live/dead assay, cells were stained to distinguish the live and dead cells (
[0082] Due to the aforementioned reasons a higher number of cells were observed in the vicinity of struts in samples cross-linked for 10 min as compared to the samples cross-linked for 5 and 15 min.
[0083] Cell viability and proliferation. The expression of prominent proteins, actin and vinculin as well as nucleus density was studied using immunofluorescence microscopy. In
[0084] Furthermore, MTT assay was used to study cell proliferation because optical density is directly proportional to the metabolically active cells. The MTT assay was also used to compare the cell viability on samples. In the present study, in the individual group, an increase in cell viability with time was noted (
[0085] Alkaline phosphate activity. Alkaline phosphate activity (ALP) activity is a direct measure of activity of alkaline phosphatase enzyme. The higher value of ALP is associated with higher bone formation on implant. As mentioned above, optical density of the solution after 6, 12, and 18 days of differentiation was measured, followed by the calculation of ALP activity using equation 7. The calculation revealed a higher ALP activity on the hydrogel sample than control sample (
TABLE-US-00001 TABLE 1 Detail of composition used to prepare the hybrid hydrogel Calculation for 20 ml hydrogel Nano- Alginate Gelatin hydroxyapatite EDC NHS Samples (g) (g) (mg) (mg) (mg) CaCl.sub.2 A 0.2 0.2 100 50 30 0.05M B 0.2 0.2 20 50 30 0.05M C 0.2 0.1 20 50 30 0.05M D 0.1 0.2 20 50 30 0.05M