EP2741713A2 - Matrice composite pour applications de réparation osseuse - Google Patents
Matrice composite pour applications de réparation osseuseInfo
- Publication number
- EP2741713A2 EP2741713A2 EP20120822682 EP12822682A EP2741713A2 EP 2741713 A2 EP2741713 A2 EP 2741713A2 EP 20120822682 EP20120822682 EP 20120822682 EP 12822682 A EP12822682 A EP 12822682A EP 2741713 A2 EP2741713 A2 EP 2741713A2
- Authority
- EP
- European Patent Office
- Prior art keywords
- matrix
- bone
- composite
- composite bone
- defect
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
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- QORWJWZARLRLPR-UHFFFAOYSA-H tricalcium bis(phosphate) Chemical compound [Ca+2].[Ca+2].[Ca+2].[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O QORWJWZARLRLPR-UHFFFAOYSA-H 0.000 claims description 7
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Classifications
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- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
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- A61L27/3604—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
- A61L27/3608—Bone, e.g. demineralised bone matrix [DBM], bone powder
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- A61L27/38—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
- A61L27/3804—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells characterised by specific cells or progenitors thereof, e.g. fibroblasts, connective tissue cells, kidney cells
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- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
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- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
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- A61L2400/00—Materials characterised by their function or physical properties
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-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/02—Materials or treatment for tissue regeneration for reconstruction of bones; weight-bearing implants
Definitions
- the invention relates generally to composite matrices for use in bone repai r appl ications.
- Bone graft harvesti ng is associated with significant clinical morbidity in terms of pain, scarring, increased surgical time, prolonged hospitalization, delayed rehabilitation, increased blood loss, increased i nfection risk, and surgical complications ⁇ I.e. fracture, hematoma, neuroma etc.).
- a review of the literature reveals that complications arise in 31% of the procedures and 27% of the patients continue to feel pain at 24 months after surgery (Gupta, A.R., Int'l. Medical Journal 8: 163-166, 2001) .
- the quantity of available graft is subopti mal and requires augmentation with allograft.
- Allograft bone procedu res are also associated with high compl ication rates due to lack of graft incorporation, delayed union at junction site, inflammatory immune issues, and potential for infectious diseases (Norman-Taylor, F.H. and Villar, R.N .,, Journal of Bone and Joint Surgery, Series B 79: 178-180, 1997) .
- In a series of 1100 non-pelvic massive cadaveric allografts pri marily for treatment of bone tumors, only 61% were successful (Mankin, H .J ., Chir. Organi Mov. 88: 101 -113, 2003) .
- a biocompati ble and biodegradable composite bone matrix capable of supporting cell and tissue growth having at least one electrospun or solvent-cast synthetic polymer havi ng nanoceram ics uniformly dispersed throughout the polymer and a method of making the bone matrix are presented.
- the composite bone matrix is prepa red by the steps of
- step (e) freeze-drying the matrix of step (c) or step (d) to provide a dried matrix; wherein the matrix is capabl e of supporti ng cell and tissue growth .
- a first method involves the steps of
- a second method involves the steps of
- step (a) introducing the composite bone matrix into the interior of a section of graft bone; (b) inserting the bone graft of step (a) into the bone defect;
- a third method involves the steps of
- step (b) inserting the bone graft of step (a) into the bone defect
- Each of these methods may further involve introducing whole bone marrow or isolated mesenchymal stem cells into the composite bone matrix before applying the composite bone matrix to the bone defect or graft bone.
- Electrospun fiber of A showing uniform distribution of ceramics within the fiber of A, imaged by energy dispersive X-ray a nalysis (EDXA) targeti ng calcium
- Biocompatible, biodegradabl e, matrices for bone regeneration have been developed that can be utilized for periosteal and endosteal tissue engineered constructs.
- the matrices are designed to house mesenchymal progenitor cells and promote bone tissue formation.
- the composite matrices are composed of synthetic polymers contai ning bioactive nanoceramics and are mechanically flexible.
- bioactive refers to synthetic materials that form an interfacial bond with biological tissue upon implantation and enhance bone tissue formation as a result of surface modification when exposed to i nterstitial fluids.
- the matrices are entirely synthetic and do not induce an inflammatory response in the host subject.
- the matrices can be used alone or in combination with bone graft.
- the composite matrices can be prepared with a single polymer or blended polymers.
- Suitable polymers include poly (a-hydroxy acids), such as the polyesters, polylactic acid (PLA), poly L-lactic acid (PLLA), polyglycolic acid (PGA), polylactic co- glycolic acid (PLGA), poly ⁇ -caprolactone (PCL), poly methacrylate co-n-butyl methacrylate (PMMA), polydimethylsiloxane (PD S), and polyethylene oxide (PEO) .
- Polymer blending can be used to increase or decrease the degradati on time of a matrix.
- PCL degrades more slowly (1-1.5 years) than PGA (3 months) and the rate of degradation can be adjusted by using a blended combi nation of these polymers to form the matrix.
- the matrices have a final total concentration of polymer ranging from 5-30 wt %, preferably 10-25 wt %.
- Nanoparticulate ceramics are present in the matrices at a final total concentration of 5-70 wt %, preferably 30-50 wt %, and range from 50 - 200 n m in diameter.
- Suitable nanoceramics include, but are not limited to, hydroxyapatite, tricalcium phosphate, biphasic calcium phosphate, calcium carbonate, calcium sulfate, bioactive glass, and biphasic bioceramics.
- a matrix may contain one or more nanoceramics.
- a preferred nanoceramic is the biphasic ceramic, hydroxyapatite/ ⁇ - tricalcium phosphate (HA/PTCP), preferably at 20 HA/80 &TCP weight percent.
- Nanoceramics can be purchased or can be prepared according to known methods, e.g., Santos, G., et a/., J. R. Soc. Interface, July 18, 2012, Epu blication .
- Matrices are preferably produced from matrix solutions by electrospinning as described in Example 1A, or by solvent casti ng as described in Example IB, using conventional methods, such as those described in Patlolla, A., et al. , Acta Biomaterialia 6: 90- 101, 2010, wh ich is incorporated herein, in entirety, by reference.
- the polymer(s) is added to an appropri ate solvent and the nanoceramic(s) is subsequently added to form a matrix sol ution .
- solvents for specific polymers include methylene chloride (IMC), l, l, l,3,3,3-hexafluoro-2-propanol (HFIP), acetone, chloroform, dimethyl formam ide (DMF), tetrahydrofuran (THF), and ethyl acetate.
- IMC methylene chloride
- HFIP HFIP
- acetone chloroform
- DMF dimethyl formam ide
- THF tetrahydrofuran
- ethyl acetate ethyl acetate
- Preferred embodi ments of the matrix solution include, but are not limited to, (1) 17 wt % PCL and 30 wt % HA/pTCP (20/80 wt %) in IMC solvent; (2) 22 wt % PLGA (75 % polylactide/25 % gylcolic acid) and 30 wt % HA/PTCP (20/80 wt %) in MC solvent; (3) 17 wt % PCL and 30 wt % HA/pTCP (20/80 wt %) in HFIP solvent; and (4) 22 wt % PLGA (75/25) and 30 wt % HA/PTCP (20/80 wt %) in HFIP solvent.
- the matrix solution may also contain a non-ionic surfactant, e.g., Span® 80, or a cationic surfactant, e.g., cetyl trimethylammonium bromide (CTAB) .
- CTAB cety
- the matrices are prepared from the matrix solution by electrospinning or solvent casti ng. Electrospun matrices are fibrous, whereas solvent-cast matrices are spongelike, as shown in Figure 1. Formed matri ces can be air dried or freeze-dried to remove remai ning solvent. Freeze-drying is the more effective method . The dried matrices remain functional after storage u nder vacuum at room temperature for at least two years.
- Matrix pore size and matrix porosity can be i ncreased by addi ng particulate porogens to the matrix solution prior to electrospinning or solvent casti ng and then leaching the porogen out of the formed matrix, as described in Example 1. Pore size and matrix porosity can be modified by adjusting the size and concentration of the porogen used .
- Suitable porogens include inorganic salts such as CaC0 3 and NaCI, sugar crystals, such as saccharose, gelatin spheres and paraffin spheres.
- the electrospun composite matrices exhibit fibers ranging from 100 nanometers to 100 m icrometers i n diameter.
- the fibers exhibit a uniform dispersion of the nanoceram ic(s), as shown in Figure 2, which enhances cellular attachm ent, infiltration and bone bioactivity.
- Interfiber spaci ng of the matrix ranges from 150 to 400 p m, preferably 150 - 250 pm. Interfiber spacing is determined, in part, by the polymer concentration.
- Matrix porosity ranges from 60 to 90%, preferably 80-85%.
- the Young's modu lus of the composite matrix is similar to trabecu lar bone, and the matrix has an ultimate tensile strai n of approxi mately 30%, demonstrating mechanical flexibility.
- Electrospun PCL and PCL composite matrices are shown in Figure 3. Solvent cast matrices subjected to porogen leaching also exhibit a uniform dispersion of the nanoceramic(s) and You ng's modulus similar to that of electrospun matrices. Porosity of solvent cast matrices is also 60 to 90%, preferably 80-85%, and pore sizes range from 150-400 ⁇ , preferably 150-250 ⁇ . Solvent-cast, porogen leached (SC/PL) PCL and PCL composite matrices are shown in Figure 4.
- the matrices are useful for stimulati ng regeneration of bone tissue and repairing bone defects and may be used alone or in combination with whole bone marrow or isolated mesenchymal stem cells (MSCs) .
- Bone marrow and MSCs may be isolated from the host subject or be acquired from donors. Methods for isolating MSCs are described in Example 2.
- Bone cell differentiation can be stimulated in vitro by addi ng whole bone marrow or isolated MSCs to the matrices and culturing in appropri ate conditions, as described in Example 3 and shown in Figures 5-7.
- the matrices are also useful for sti mulating bone differentiation and repairing bone defects in vivo.
- Composite matrix may be implanted alone, or in combination with whole bone marrow or isolated MSCs, into a defect site as described i n Example 4.
- the matrices sti mulate blood vessel formation, bone and cartilage differentiation in vivo as shown in Figures 8 and 9.
- the matrices are used in combination with bone allografts to repair bone defects in vivo.
- the composite matrix can be cut to an appropriate size and can be shaped to fit inside the medullary canal lining the inner surface of the allograft or to wrap around the outside of the bone allograft, as described in Example 5.
- the composite matrix forms a contiguous interface with the allograft due to the ability of the nanoceramics to faci litate bonding of the material to bone, which may improve osteoconduction and integration of the allograft with the host bone.
- the composite matrix may be used alone or in combination with whole bone marrow or isolated MSCs.
- the matrix houses mesenchymal progenitor cells and promotes bone tissue formation, which is a primary cha racteristic of the natu ral periosteum and endosteum.
- the composite matrix When wrapped arou nd the outside of the allograft, the composite matrix appea rs to act as a substitute periosteum and, when inserted i nside the allograft, acts as a substitute endosteum .
- the composite matrix promotes bone differentiation and tissue formation within the bone defect and in the endosteal and periosteal regions of the host bone, as shown in Figure 10.
- the composite matrices described above are characterized by pore sizes and/or interfiber spacing that al lows cell infiltration and bone tissue in-growth, a maximum concentration of ceramic for improved bioactivity, and homogeneous dispersion of the ceramic in the fibers for improved molecular interaction and mechanical properties.
- the combination of synthetic polymers with ceramics provides mechanically flexible matrices that can easily be sized and shaped for use within bone defects and in combi nation with bone grafts to provide complete repai r of bone defects and full return of function to the repai red bone.
- Composite electrospu n fibers were prepared by the methods of Patlolla, A., et al. , Acta Biomaterialia 6 : 90-101, 2010. Briefly, poly ⁇ -caprolactone (PCL) or polylactide- co-glycolic acid (PLGA, 75% polylactide/25% glycolic acid) were combined with the ceramic, hydroxy-apatite/3-tricalcium phosphate (HA/3TCP, 20/80 wt %) in the solvent, methylene chloride. Polymer was present in the resulting solution at 17 wt % and HA/ TCP was present at 30 wt %.
- PCL poly ⁇ -caprolactone
- PLGA polylactide- co-glycolic acid
- HA/3TCP hydroxy-apatite/3-tricalcium phosphate
- Polymer was present in the resulting solution at 17 wt % and HA/ TCP was present at 30 wt %.
- an electrospu n matrix containing PCL alone was prepared having a similar porosity and pore size/interfiber spaci ng as the PCL composite.
- a solution of PCL alone was prepared.
- CaC0 3 with a particle size of 20 nm was added to this PCL solution as a particulate porogen to increase porosity and pore size/interfiber spacing of the matrix.
- CaC0 3 was leached from the mats by treati ng the mats with 3M HCI for several hours. After leaching, the mats were washed with deionized water to remove excess acid and were air dried.
- Figure 3 presents scanning electron micrographs of espun, PCL-leached (A,B) and PCL composite (C,D) mats. Both PCL-leached mats and PCL composite mats exhibited a bimodal distribution of fibers of both micron and sub-micron dimensions, which favors cell infiltration . In both types of mats, interfiber spacing was about 200-250 ⁇ , and porosity was about 79%.
- Figure 4 presents scanning electron micrographs of solvent-cast, porogen - leached, PCL (A,B) and PCL composite (C,D) mats. In both types of mats pore size averaged about 300 ⁇ and porosity was about 84%.
- MSCs were obtai ned from human whole bone marrow (healthy male donors, 18- 35 years old), purchased from Lonza, Inc. Rat and Human MSCs were isolated from the bone marrow and processed according to previously published protocols. (Arinzeh, T.L., et al. , Biomaterials 26: 3631 -3638, 2005; Breitbart, E.A., et ai. , 3. Orthopaedic
- MSCs from both species were isolated and cultured in standard growth media (Dulbecco's Modified Eagle's Medium (DMEM) contai ning 10% fetal bovine serum and 1% antibiotic for human and alpha-MEM with 15% fetal bovine serum and 1% antibiotic for rat) .
- DMEM Dulbecco's Modified Eagle's Medium
- MSCs were characterized for multipotency by performing osteogenesis, chondrogenesis and adi pogenesis assays.
- MSCs were characterized by flow cytometry for MSC surface antigens (positive for CD44 and CD29 and negative for CD14, CD45, and CD34) and were used at passage 2 for all in vitro differentiation studies.
- Discs with a thickness of 0.3 mm and diameter of 6 mm were prepared from composite electrospun or solvent-cast matrices, prepared as described in Example 1, sterilized with 100% eth anol, and air dried. Discs were placed in 96 well plates and MSCs prepared as described i n Example 2 were seeded on each disc at about 10,000 cells/well as previously described in Arinzeh, T.T., et al. , Biomaterials 26 : 3631 -3638, 2005. Cells were cultured in humidified incubators at 37°C/5% C0 2 .
- discs were fixed with 4% formaldehyde, washed and stained for cytoskeleton actin filaments with ALEXA FLUOR ® 488 phalloidon (Invitrogen Molecular Probes) and with 4'-6-diamidino-2-phenylindole (DAPI) (Invitrogen Molecular Probes) for cell nuclei .
- ALEXA FLUOR ® 488 phalloidon Invitrogen Molecular Probes
- DAPI 4'-6-diamidino-2-phenylindole
- Electrospun composite fiber mats appeared to initially provide more rapid attachment and growth than solvent-cast mats (Figure 5B,D) or espun, leached PCL mats ( Figure 5A), but cell density on electrospun and solvent-cast composite mats was similar at 14 days ( Figure 6) .
- the espun, leached, PCL only mat showed poor cell attach ment and growth at both 7 and 14 days, Cells infiltrated the full depth of the matrix for both electrospun and solvent cast mats (data not shown).
- Rat, femoral segmental defects were treated with the composite matrices with or without MSCs in combi nation with an allograft.
- This defect model is well establ ished and has been described i n Azad, V., et al. , J. Orthopaedic Trauma 23 : 267-276, 2009; and Breitbart, E.A., et al. , J. Orthopaedic Research 28: 942-949, 2010.
- This model was chosen because it is a load-beari ng, critical sized defect which results in a non-union if left untreated.
- Male, Fisher 344 rats approxi mately 80 days old were utilized for these experiments.
- Allograft bone was obtai ned from the femurs of the treated Fisher 344 rats. A 5 mm bone section was removed from the diaphysis of the right femur and was cleaned, processed and ⁇ -irradiated prior to use.
- Femoral segmental defects were created unilateral ly and treated with bulk allograft associated with electrospun PCL composite and PLGA composite matrices loaded with isolated MSCs.
- the composite matrix was wrapped around the outer surface of the graft (periosteum), or placed i nside the graft adjacent to the inner surface (endosteum).
- transverse serial sections of the grafted regions were prepared, stai ned with hematoxylin and eosin, and observed by light microscopy. Serial sections were analyzed to determine the area of new bone formed within the defects.
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Abstract
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| US201161521456P | 2011-08-09 | 2011-08-09 | |
| US201261598197P | 2012-02-13 | 2012-02-13 | |
| PCT/US2012/050156 WO2013023064A2 (fr) | 2011-08-09 | 2012-08-09 | Matrice composite pour applications de réparation osseuse |
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| EP2696806B1 (fr) * | 2011-04-13 | 2017-12-27 | New Jersey Institute of Technology | Système et procédé pour échafaudage biodégradable électrofilé destiné à la réparation osseuse |
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