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Soft tissue defects, such as incisional hernia or pelvic organ prolapse, are prevalent pathologies characterized by a tissue microenvironment rich in fragile and dysfunctional fibroblasts. Precision medicine could improve their surgical repair, currently based on polymeric materials. Nonetheless, biomaterial-triggered interventions need first a better understanding of the cell-material interfaces that truly consider the patients’ biology. Few tools are available to study the interactions between polymers and dysfunctional soft tissue cells in vitro. Here, we propose polypropylene (PP) as a matrix to create microscale surfaces w/wo functionalization with an HBII-RGD molecule, a fibronectin fragment modified to include an RGD sequence for promoting cell attachment and differentiation. Metal mold surfaces were roughened by shot blasting with aluminum oxide, and polypropylene plates were obtained by injection molding. HBII-RGD was covalently attached by silanization. As a proof of concept, primary abdominal and vaginal wall fasciae fibroblasts from control patients were grown on the new surfaces. Tissue-specific significant differences in cell morphology, early adhesion and cytoskeletal structure were observed. Roughness and biofunctionalization parameters exerted unique and combinatorial effects that need further investigation. We conclude that the proposed model is effective and provides a new framework to inform the design of smart materials for the treatment of clinically compromised tissues., The authors acknowledge the financial support by Instituto de Salud Carlos III (ISCIII) via grant PI17/01236 from the program Acción Estratégica en Salud 2018–2020 (Spanish Ministry of Science and Innovation). This project was also supported by the Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR), file no 2021 SGR 00210, from the Department of Research and Universities (Generalitat de Catalunya, Spain). J.G.-M. acknowledges the Maria Zambrano fellowship funded by European Union-NextGeneration, EU, Ministry of Universities and Recovery, Transformation and Resilience Plan, through a call from Universitat Politècnica de Catalunya (Grant Ref. 2021UPC-MZ-67143). This research was funded by the Ministry of Science and Innovation of Spain through the PID2021-125150OB-I00 project., Peer Reviewed, Postprint (published version)

The Boston keratoprosthesis (BKPro) is a medical device used to restore vision in complicated cases of corneal blindness. This device is composed by a front plate of polymethylmethacrylate (PMMA) and a backplate usually made of titanium (Ti). Ti is an excellent biomaterial with numerous applications, although there are not many studies that address its interaction with ocular cells. In this regard, despite the good retention rates of the BKPro, two main complications compromise patients' vision and the viability of the prosthesis: imperfect adhesion of the corneal tissue to the upside of the backplate and infections. Thus, in this work, two topographies (smooth and rough) were generated on Ti samples and tested with or without functionalization with a dual peptide platform. This molecule consists of a branched structure that links two peptide moieties to address the main complications associated with BKPro: the well-known RGD peptide in its cyclic version (cRGD) as cell pro-adherent motif and the first 11 residues of lactoferrin (LF1–11) as antibacterial motif. Samples were physicochemically characterized, and their biological response was evaluated in vitro with human corneal keratocytes (HCKs) and against the gram-negative bacterial strain Pseudomonas aeruginosa. The physicochemical characterization allowed to verify the functionalization in a qualitative and quantitative manner. A higher amount of peptide was anchored to the rough surfaces. The studies performed using HCKs showed increased long-term proliferation on the functionalized samples. Gene expression was affected by topography and peptide functionalization. Roughness promoted a-smooth muscle actin (a-SMA) overexpression, and the coating notably increased the expression of extracellular matrix components (ECM). Such changes may favour the development of unwanted fibrosis, and thus, corneal haze. In contrast, the combination of the coating with a rough topography decreased the expression of a-SMA and ECM c, Peer Reviewed, Postprint (published version)

The formation of a biological seal around the neck of titanium (Ti) implants is critical for ensuring integration at the gingival site and for preventing bacterialcolonization that may lead to periimplantitis. This process is guided byactivated fibroblasts, named myofibroblasts, which secrete extracellularmatrix (ECM) proteins and ECM-degrading enzymes resolving the wound.However, in some cases, Ti is not able to attract and activate fibroblasts to asufficient extent, which may compromise the success of the implant.Fibronectin (FN) is an ECM component found in wounds that is able to guidesoft tissue healing through the adhesion of cells and attraction of growthfactors (GFs). However, clinical use of FN functionalized Ti implants isproblematic because FN is difficult to obtain, and is sensitive to degradation.Herein, functionalizing Ti with a modified recombinant heparin binding II(HBII) domain of FN, mutated to include an Arg-Gly-Asp (RGD) sequence forpromoting both fibroblast adhesion and GF attraction, is aimed at. TheHBII-RGD domain is able to stimulate fibroblast adhesion, spreading,proliferation, migration, and activation to a greater extent than the nativeHBII, reaching values closer to those of full-length FN suggesting that itmight induce the formation of a biological sealing., Peer Reviewed, Postprint (published version)

The 3D printing of titanium (Ti) offers countless possibilities for the development of personalized implants with suitable mechanical properties for different medical applications. However, the poor bioactivity of Ti is still a challenge that needs to be addressed to promote scaffold osseointegration. The aim of the present study was to functionalize Ti scaffolds with genetically modified elastin-like recombinamers (ELRs), synthetic polymeric proteins containing the elastin epitopes responsible for their mechanical properties and for promoting mesenchymal stem cell (MSC) recruitment, proliferation, and differentiation to ultimately increase scaffold osseointegration. To this end, ELRs containing specific cell-adhesive (RGD) and/or osteoinductive (SNA15) moieties were covalently attached to Ti scaffolds. Cell adhesion, proliferation, and colonization were enhanced on those scaffolds functionalized with RGD-ELR, while differentiation was promoted on those with SNA15-ELR. The combination of both RGD and SNA15 into the same ELR stimulated cell adhesion, proliferation, and differentiation, although at lower levels than those for every single moiety. These results suggest that biofunctionalization with SNA15-ELRs could modulate the cellular response to improve the osseointegration of Ti implants. Further investigation on the amount and distribution of RGD and SNA15 moieties in ELRs could improve cell adhesion, proliferation, and differentiation compared to the present study., Peer Reviewed, Postprint (published version)

Presentació del Guillem Martí (grup BBT-UPC) sobre els elements a tenir en compte alhora de desenvolupar un Pla de Gestió de Dades - Data Management Plan., Objectius de Desenvolupament Sostenible::4 - Educació de Qualitat, Objectius de Desenvolupament Sostenible::10 - Reducció de les Desigualtats

A lack of primary stability and osteointegration in metallic implants may result in implant loosening and failure. Adding porosity to metallic implants reduces the stress shielding effect and improves implant performance, allowing the surrounding bone tissue to grow into the scaffold. However, a bioactive surface is needed to stimulate implant osteointegration and improve mechanical stability. In this study, porous titanium implants were produced via powder sintering to create different porous diameters and open interconnectivity. Two strategies were used to generate a bioactive surface on the metallic foams: (1) an inorganic alkali thermochemical treatment, (2) grafting a cell adhesive tripeptide (RGD). RGD peptides exhibit an affinity for integrins expressed by osteoblasts, and have been reported to improve osteoblast adhesion, whereas the thermochemical treatment is known to improve titanium implant osseointegration upon implantation. Bioactivated scaffolds and control samples were implanted into the tibiae of rabbits to analyze the effect of these two strategies in vivo regarding bone tissue regeneration through interconnected porosity. Histomorphometric evaluation was performed at 4 and 12 weeks after implantation. Bone-to-implant contact (BIC) and bone in-growth and on-growth were evaluated in different regions of interest (ROIs) inside and outside the implant. The results of this study show that after a long-term postoperative period, the RGD-coated samples presented higher quantification values of quantified newly formed bone tissue in the implant’s outer area. However, the total analyzed bone in-growth was observed to be slightly greater in the scaffolds treated with alkali thermochemical treatment. These results suggest that both strategies contribute to enhancing porous metallic implant stability and osteointegration, and a combination of both strategies might be worth pursuing., Peer Reviewed, Postprint (author's final draft)

BACKGROUND Orthopedic implant-related infection remains one of the most serious complications after orthopedic surgery. In recent years, there has been an increased scientific interest to improve prevention and treatment strategies. However, many of these strategies have focused on chemical measures. AIM To analyze the effect of alternating current electrical fields on bacterial adherence to titanium surfaces. METHODS Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) were exposed to 6.5 V electrical currents at different frequencies: 0.5 Hz, 0.1 Hz, and 0.05 Hz. After exposure, a bacterial count was then performed and compared to the control model. Other variables registered included the presence of electrocoagulation of the medium, electrode oxidation and/or corrosion, and changes in pH of the medium. RESULTS The most effective electrical model for reducing S. aureus adhesion was 6.5 V alternating current at 0.05 Hz achieving a 90% adhesion reduction rate. For E. coli, the 0.05 Hz frequency model also showed the most effective results with a 53% adhesion reduction rate, although these were significantly lower than S. aureus. Notable adhesion reduction rates were observed for S. aureus and E.coli in the studied conditions. However, the presence of electrode oxidation makes us presume these conditions are not optimal for in vivo use. CONCLUSION Although our findings suggest electrical currents may be useful in preventing bacterial adhesion to metal surfaces, further research using other electrical conditions must be examined to consider their use for in vivo trials., Peer Reviewed, Postprint (published version)

One possibility to prevent prosthetic infections is to produce biomaterials resistant to bacterial colonization by anchoring membrane active antimicrobial peptides (AMPs) onto the implant surface. In this perspective, a deeper understanding of the mode of action of the immobilized peptides should improve the development of AMP-inspired infection-resistant biomaterials. The aim of the present study was to characterize the bactericidal mechanism against Staphylococcus epidermidis of the AMP BMAP27(1–18), immobilized on titanium disks and on a model resin support, by applying viability counts, Field Emission Scanning Electron Microscopy (FE-SEM), and a fluorescence microplate assay with a membrane potential-sensitive dye. The cytocompatibility to osteoblast-like MG-63 cells was investigated in monoculture and in co-culture with bacteria. The impact of peptide orientation was explored by using N- and C- anchored analogues. On titanium, the ~50 % drop in bacteria viability and dramatically affected morphology indicate a contact-killing action exerted by the N- and C-immobilized peptides to the same extent. As further shown by the fluorescence assay with the resin-anchored peptides, the bactericidal effect was mediated by rapid membrane perturbation, similar to free peptides. However, at peptide MBC resin equivalents the C-oriented analogue proved more effective with more than 99 % killing and maximum fluorescence increase, compared to half-maximum fluorescence with more than 90 % killing produced by the N-orientation. Confocal microscopy analyses revealed 4–5 times better MG-63 cell adhesion on peptide-functionalized titanium both in monoculture and in co-culture with bacteria, regardless of peptide orientation, thus stimulating further studies on the effects of the immobilized BMAP27(1–18) on osteoblast cells., The authors acknowledge the financial support of departmental research funds (Department of Medicine, University of Udine, Italy). The authors also gratefully thank the Generalitat de Catalunya for funding through project 2017SGR-1165 and the Ministry of Science and Innovation, Spain, for financial support through the RTI2018-098075-B-C21 project, co-funded by the EU through the European Regional Development Funds., Peer Reviewed, Postprint (author's final draft)

Implants for orthopedic applications need to be biocompatible and bioactive, with mechanical properties similar to those of surrounding natural bone. Given this scenario titanium (Ti) scaffolds obtained by Direct Ink Writing technique offer the opportunity to manufacture customized structures with controlled porosity and mechanical properties. Considering that 3D Ti scaffolds have a significant surface area, it is necessary to develop strategies against the initial bacterial adhesion in order to prevent infection in the early stages of the implantation, while promoting cell adhesion to the scaffold. The challenge is not only achieving a balance between antibacterial activity and osseointegration, it is also to develop a homogeneous coating on the inner and outer surface of the scaffold. The purpose of this work was the development of a single-step electrodeposition process in order to uniformly cover Ti scaffolds with a layer of calcium phosphate (CaP) loaded with chlorhexidine digluconate (CHX). Scaffold characterization was assessed by scanning electron microscopy, Energy dispersive X-ray spectroscopy, X-ray diffraction, micro-Raman microscopy and compressive strength tests. Results determined that the surface of scaffolds was covered by plate-like and whisker-like calcium phosphate crystals, which main phases were octacalcium phosphate and brushite. Biological tests showed that the as-coated scaffolds reduced bacteria adhesion (73 ± 3% for Staphylococcus aureus and 70 ± 2% for Escherichia coli). In vitro cell studies and confocal analysis revealed the adhesion and spreading of osteoblast-like SaOS-2 on coated surfaces. Therefore, the proposed strategy can be a potential candidate in bone replacing surgeries., Peer Reviewed, Postprint (author's final draft)

Diamond-like carbon (DLC) coatings have been extensively studied over the last two decades in the field of materials engineering. The addition of effective bactericidal agents like silver suggests the potential application of silver-doped DLC coatings in the biomedical sector. In this paper, DLC coatings containing about 2 at. % Ag were grown on CoCrMo substrates by pulsed filtered cathodic arc co-deposition using pure graphite and silver targets. Morphology, structure and chemical composition of the coatings were characterized by SEM, XPS, XRD, Raman and HRTEM. Wettability and surface free energy were also measured. Mechanical properties were analyzed by means of nanoindentation and Rockwell-C adhesion tests. Corrosion resistance of coated and uncoated samples was determined by potentio-dynamic polarization tests in Hank's solution. Cytotoxicity and antibacterial activity against S. aureus and P. aeruginosa were also studied. For comparative purposes, nitrogen-doped DLC coatings obtained by RF magnetron sputtering were also prepared and characterized. Well-adhered and corrosion resistant Ag-DLC nanostructured coatings of up to 1.5 µm thick and 21 GPa in hardness were obtained. The doping concentration of silver studied in this work seems to be optimal for the preparation of non-cytotoxic coatings with a significant bactericidal activity., This work has been financed by the Ministry of the Economy, Industry and Competitiveness of Spain under the project BIOPLASMA (MAT2015-67103-C4)., Peer Reviewed, Preprint

Gallium (Ga) has been recently proposed as a novel therapeutic agent, since it promotes bone formation and exhibits antibacterial properties. This work focuses on the optimization of a thermochemical treatment that incorporates Ga ions by the addition of the body-friendly Ga nitrate approved by the Food and Drug Administration. The objective was to simultaneously provide the inner and the outer surfaces of porous-titanium surfaces obtained by 3D-printing with bioactivity and antibacterial properties. The apatite-forming ability of the coating, as well as the antibacterial activity and SaOS-2 cell adhesion, proliferation, differentiation and mineralization were evaluated and compared with untreated Ti surfaces. The characterization of the surfaces revealed the presence of a Ga-containing calcium titanate layer, which was non cytotoxic and in simulated body fluid produced a homogeneous apatite coating well adhered to the substrate. The formation of this apatite layer was accelerated with increasing Ga amounts present on the surface, resulting also in an increase in thickness. An initial quick release of Ga ion promoted the antibacterial effect against gram positive strains, especially for Pseudomonas aeruginosa, one of the most frequent resistant pathogens in nosocomial infections. SaOS-2 cells adhered and proliferated on the Ga-doped Ti surfaces, its presence contributed to cell differentiation and to considerably increase the mineralization levels. Thus, the developed multifunctional coatings could provide bioactivity to the porous Ti implants while protecting them from the most frequent gram-negative pathogens., Peer Reviewed, Postprint (author's final draft)

Titanium (Ti) and Ti alloys have been used for decades for bone prostheses due to its mechanical reliability and good biocompatibility. However, the high stiffness of Ti implants and the lack of bioactivity are pending issues that should be improved to minimize implant failure. The stress shielding e ect, a result of the stiffness mismatch between titanium and bone, can be reduced by introducing a tailored structural porosity in the implant. In this work, porous titanium structures were produced by direct ink writing (DIW), using a new Ti ink formulation containing a thermosensitive hydrogel. A thermal treatment was optimized to ensure the complete elimination of the binder before the sintering process, in order to avoid contamination of the titanium structures. The samples were sintered in argon atmosphere at 1200 ºC, 1300 ºC or 1400 ºC, resulting in total porosities ranging between 72.3% and 77.7%. A correlation was found between the total porosity and the elastic modulus of the sca olds. The stiffness and yield strength were similar to those of cancellous bone. The functionalization of the sca old surface with a cell adhesion fibronectin recombinant fragment resulted in enhanced adhesion and spreading of osteoblastic-like cells, together with increased alkaline phosphatase expression and mineralization., Peer Reviewed, Postprint (published version)

Bacterial infection of orthopaedic implants, often caused by Staphylococcus species, may ultimately lead to implant failure. The development of infection-resistant, osteoblast-compatible biomaterials could represent an effective strategy to prevent bacterial colonization of implants, reducing the need for antibiotics. In this study, the widely used biomaterial titanium was functionalized with BMAP27(1–18), an a-helical cathelicidin antimicrobial peptide that retains potent staphylocidal activity when immobilized on agarose beads. A derivative bearing a short spacer with a free thiol at the N-terminus was coupled to silanized titanium disks via thiol-maleimide chemistry. Tethering was successful, as assessed by Contact angle, Quartz Crystal Microbalance with Dissipation monitoring (QCM-D), and X-ray Photoelectron Spectroscopy (XPS), with an average surface mass density of 456¿ng/cm2 and a layer thickness of 3¿nm. The functionalized titanium displayed antimicrobial properties against a reference strain of Staphylococcus epidermidis with well-known biofilm forming capability. Reduction of bacterial counts and morphological alterations of adhering bacteria, upon 2¿h incubation, indicate a rapid contact-killing effect. The immobilized peptide was not toxic to osteoblasts, which adhered and spread better on functionalized titanium when co-cultured with bacteria, compared to non-coated surfaces. Results suggest that functionalization of titanium with BMAP27(1–18) could be promising for prevention of bacterial colonization in bone graft applications., Peer Reviewed, Postprint (author's final draft)

El titani (Ti) és el material més utilitzat en aplicacions dentals per la seva biocompatibilitat i les seves propietats mecàniques. Tot i això, aquest no és bioactiu, i en alguns casos no s’aconsegueix la integració tissular, suposant la pèrdua de l’implant. La mimetizació amb fragments de proteïnes de la matriu extracel·lular, obtinguts amb tècniques de recombinació d’ADN és una estratègia per a millorar les interaccions cèl·lula-material. El fragment d’unió a la heparina (HBII) de la fibronectina (FN), té la capacitat de captar factors de creixement (FC), com el BMP-2 i el TGF- β1, que tenen un rol important en la regeneració de teixit ossi i teixit connectiu, però no té capacitat d’atreure les cèl·lules. Per a aconseguir-ho es va mutar la seqüència de l’HBII per a incorporar la seqüència RGD la mínima seqüència d’aminoàcids que promou l’adhesió cel·lular. En aquest projecte s’ha fabricat la proteïna mutada (HBII-RGD) i s’ha unit covalentment a la superfície per a l’estudi de la resposta biològica dels fibroblasts i la capacitat d’unió al FC TGF- β1. La mutació confereix a la proteïna la capacitat de captar més TGF- β1, i estimula l’adhesió i proliferació cel·lular, així com l’activació de fibroblasts a miofibroblasts, induint la generació i remodelació de la MEC. Aquets resultats mostren el gran potencial de la molècula HBII-RGD de promoure la fibrointegració i d’aquesta manera induir amb una sola molècula la regeneració de teixit ossi i teixit connectiu.

Apatitic bone cements have been used as a clinical bone substitutes and drug delivery vehicles for therapeutic agents in orthopedic applications. This has led to their combination with different drugs with known ability to foster bone formation. Recent studies have evaluated Simvastatin for its role in enhanced bone regeneration, but its lipophilicity hampers incorporation and release to and from the bone graft. In this study, injectable calcium phosphate foams (i-CPF) based on a-tricalcium phosphate were loaded for the first time with Pitavastatin. The stability of the drug in different conditions relevant to this study, the effect of the drug on the i-CPFs properties, the release profile, and the in vitro biological performance with regard to mineralization and vascularization were investigated. Pitavastatin did not cause any changes in neither the micro nor the macro structure of the i-CPFs, which retained their biomimetic features. PITA-loaded i-CPFs showed a dose-dependent drug release, with early stage release kinetics clearly affected by the evolving microstructure due to the setting of cement. in vitro studies showed dose-dependent enhancement of mineralization and vascularization. Our findings contribute towards the design of controlled release with low drug dosing bone grafts: i-CPFs loaded with PITA as osteogenic and angiogenic agent, Peer Reviewed, Postprint (author's final draft)

The lack of bioactivity of titanium (Ti) is one of the main drawbacks for its application in biomedical implants since it can considerable reduce its osseointegration capacities. One strategy to overcome this limitation is the coating of Ti with hydroxyapatite (HA), which presents similar chemical composition than bone. Nonetheless, most of the strategies currently used generate a non-stable coating and may produce the formation of amorphous phases when high temperatures are used. Herein, we proposed to generate a Ti-HA composite coating on Ti surface to improve the stability of the bioactive coating. The coating was produced by cold gas spraying, which uses relatively low temperatures, and compared to a Ti coating. The coating was thoroughly characterized in terms of morphology, roughness, porosity and phase composition. In addition, the coating was mechanically characterized using a tensile loading machine. Finally, biological response was evaluated after seeding SaOS-2 osteoblasts and measuring cell adhesion, proliferation and differentiation. The novel Ti-HA coating presented high porosity and high adhesion and bond strengths. No change in HA phases was observed after coating formation. Moreover, osteoblast-like cells adhered, proliferated and differentiated on Ti-HA coated surfaces suggesting that the novel coating might be a good candidate for biomedical applications., Peer Reviewed, Postprint (author's final draft)

Installing bioactivity on metallic biomaterials by mimicking the extracellular matrix (ECM) is crucial for stimulating specific cellular responses to ultimately promote tissue regeneration. Fibronectin is an ECM protein commonly used for biomaterial functionalization. The use of fibronectin recombinant fragments is an attractive alternate to the use of full-length fibronectin because of the relatively low cost and facility of purification. However, it is necessary to combine more than one fragment, for example, the cell attachment site and the heparin binding II (HBII), either mixed or in one molecule, to obtain complete activity. In the present study, we proposed to install adhesion capacity to the HBII fragment by an RGD gain-of-function DNA mutation, retaining its cell differentiation capacity and thereby producing a small and very active protein fragment. The novel molecule, covalently immobilized onto titanium surfaces, maintained the growth factor-binding capacity and stimulated cell spreading, osteoblastic cell differentiation, and mineralization of human mesenchymal stem cells compared to the HBII native protein. These results highlight the potential capacity of gain-of-function DNA mutations in the design of novel molecules for the improvement of osseointegration properties of metallic implant surfaces., Peer Reviewed, Postprint (author's final draft)

Bone apatite consists of carbonated calcium-deficient hydroxyapatite (CDHA) nanocrystals. Biomimetic routes allow fabricating synthetic bone grafts that mimic biological apatite. In this work, we explored the role of two distinctive features of biomimetic apatites, namely, nanocrystal morphology (plate vs needle-like crystals) and carbonate content, on the bone regeneration potential of CDHA scaffolds in an in vivo canine model. Both ectopic bone formation and scaffold degradation were drastically affected by the nanocrystal morphology after intramuscular implantation. Fine-CDHA foams with needle-like nanocrystals, comparable in size to bone mineral, showed a markedly higher osteoinductive potential and a superior degradation than chemically identical coarse-CDHA foams with larger plate-shaped crystals. These findings correlated well with the superior bone-healing capacity showed by the fine-CDHA scaffolds when implanted intraosseously. Moreover, carbonate doping of CDHA, which resulted in small plate-shaped nanocrystals, accelerated both the intrinsic osteoinduction and the bone healing capacity, and significantly increased the cell-mediated resorption. These results suggest that tuning the chemical composition and the nanostructural features may allow the material to enter the physiological bone remodeling cycle, promoting a tight synchronization between scaffold degradation and bone formation., Peer Reviewed, Postprint (author's final draft)

Biomaterial implantation triggers inflammatory reactions. Understanding the effect of physicochemical features of biomaterials on the release of inflammatory cytokines from immune cells would be of great interest in view of designing bone graft materials to enhance the healing of bone defects. The present work investigated the interactions of two chemically and texturally different calcium phosphate (CaPs) substrates with macrophages, one of the main innate immune cells, and its further impact on osteogenic differentiation of bone forming cells. The behaviour of macrophages seeded on biomimetic calcium deficient hydroxyapatite (CDHA) and sintered ß-tricalcium phosphate (ß-TCP) was assessed in terms of the release of inflammatory cytokines and osteoclastogenic factors. The osteogenic differentiation of bone progenitor cells (bone marrow stromal cells (BMSCs) and osteoblastic cell line (SaOS-2)) were subsequently studied by incubating with the conditioned medium induced by macrophage-CaPs interaction in order to reveal the effect of immune cell reaction to CaPs on osteogenic differentiation. It was found that the incubation of macrophages with CaPs substrates caused a decrease of pro-inflammatory cytokines, more pronounced for ß-TCP compared with CDHA showing significantly decreased IL-6, TNF-a, and iNOS. However, the macrophage-CDHA interaction resulted in a more favourable environment for osteogenic differentiation of osteoblasts with more collagen type I production and osteogenic genes (Runx2, BSP) expression, suggesting that osteogenic differentiation of bone cells is not only determined by the nature of biomaterials, but also significantly influenced by the inflammatory environment generated by the interaction of immune cells and biomaterials., Peer Reviewed, Postprint (author's final draft)

Biomaterial-associated infections (BAI) are the major cause of failure of indwelling medical devices. The risk of BAI can end dramatically in the surgical removal of the affected device. Therefore, a major effort must be undertaken to guarantee the permanence of the implant. In this regard, we have developed antimicrobial coatings for tantalum (Ta) implants, using polyhydroxyalkanoates (PHAs) as matrices for carrying an active principle. The dip-coating technique was successfully used for covering solid Ta discs. An original PHA emulsion flow process was developed for the coating of porous Ta structures, specially for the inner surfaces. The complete characterization of the biopolymer coatings, their antibacterial properties, toxicity and biointegration were analyzed. Thus, non-toxic, well-biointegrated homogeneous biopolymer coatings were attained, which showed antibacterial properties. By using biodegradable PHAs, the resulting drug delivery system assured the protection of Ta against bacterial infections for a period of time., Peer Reviewed, Postprint (author's final draft)

En el present Treball de Final de Grau es fa un estudi d’una possible tècnica de millora de la integració dels implants dentals de titani amb el teixit cel·lular, i tracta específicament l’opció de crear una superfície de titani el més antibacteriana possible. Mitjançant un atac de caràcter àcid, la superfície del titani queda modificada creant una nanoestructura que segons l’article Surface Nanoporosity has a greater influence on osteogènic and bacterial cell adhesion than crystallinity and wettability [1] esdevé antibacteriana. Així doncs, l’objectiu del projecte és replicar aquesta superfície que per si sola és antibacteriana i a més a més, tal com diu l’altre article Anhydride-functional silane immobilized onto titanium surfaces induces osteoblasts cell differentiation and reduces bacterial adhesion and biofilm formation [2], afegir un silà anomenat TESPSA que també té un efecte antibacterià; de forma que amb la combinació d’ambdós efectes, poder obtenir una superfície del titani idònia, pel seu caràcter antibacterià, pels implants dentals. Com a objectiu extra del projecte, s’intenta, també, optimitzar el temps de producció de la superfície de titani creada segons el primer dels articles [1]. Per a dur a terme aquest projecte cal un treball de laboratori que consta en la preparació de mostres de titani llises, fer sobre elles un atac àcid amb una solució anomenada Piranha, silanitzar les mostres amb TESPSA, fer una caracterització de la superfície atacada i finalment, realitzar assaigs amb bacteris amb l’objectiu de verificar si es tracta d’una superfície antibacteriana o no. A l’hora de procedir amb aquest treball de laboratori, s’ha pogut fer tot el proposat, tot i que els resultats d’alguns assajos no han estat els esperats. L’intent de rèplica de la superfície del titani de l’article de Rodriguez-Contreras, et al. 2018 [1], no ha resultat en la superfície antibacteriana esperada. De totes formes, s’ha procedit amb el projecte usant una variant de superfície

Calcium phosphate (CaP) substrates are successfully used as bone grafts due to their osteogenic properties. However, the influence of the physicochemical features of CaPs in angiogenesis is frequently neglected despite it being a crucial process for bone regeneration. The present work focuses on analyzing the effects of textural parameters of biomimetic calcium deficient hydroxyapatite (CDHA) and sintered beta-tricalcium phosphate (ß-TCP), such as specific surface area, surface roughness, and microstructure, on the behavior of rat endothelial progenitor cells (rEPCs) and their crosstalk with rat mesenchymal stem cells (rMSCs). The higher reactivity of CDHA results in low proliferation rates in monocultured and cocultured systems. This effect is especially pronounced for rMSCs alone, and for CDHA with a fine microstructure. In terms of angiogenic and osteogenic gene expressions, the upregulation of particular genes is especially enhanced for needle-like CDHA compared to plate-like CDHA and ß-TCP, suggesting the importance not only of the chemistry of the substrate, but also of its textural features. Moreover, the coculture of rEPCs and rMSCs on needle-like CDHA results in early upregulation of osteogenic modulator, i.e., protein deglycase 1 might be a possible cause of overexpression of osteogenic-related genes on the same substrate., Peer Reviewed, Postprint (published version)

Immune cells are sensitive to the microstructural and textural properties of materials. Tuning the structural features of synthetic bone grafts could be a valuable strategy to regulate the specific response of the immune system, which in turn modulates the activity of bone cells. The aim of this study was to analyse the effect of the structural characteristics of biomimetic calcium deficient hydroxyapatite (CDHA) on the innate immune response of macrophages and the subsequent impact on osteogenesis and osteoclastogenesis. Murine RAW 264.7¿cells were cultured, under standard and inflammatory conditions, on chemically identical CDHA substrates that varied in microstructure and porosity. The impact on osteogenesis was evaluated by incubating osteoblastic cells (SaOS-2) with RAW-CDHA conditioned extracts. The results showed that macrophages were sensitive to different textural and structural properties of CDHA. Under standard conditions, the impact of inflammatory cytokine production by RAW cells cultured on CDHA played a significant role in the degradation of substrates, suggesting the impact of resorptive behaviour of RAW cells on biomimetic surfaces. Osteoblast differentiation was stimulated by the conditioned media collected from RAW cells cultured on needle-like nanostructured CDHA. The results demonstrated that needle-like nanostructured CDHA was able to generate a favourable osteoimmune environment to regulate osteoblast differentiation and osteogenesis. Under inflammatory conditions, the incubation of RAW cells with less porous CDHA resulted in a decreased gene expression and release of pro-inflammatory cytokines., Peer Reviewed, Postprint (author's final draft)

Aplicat embargament des de la data de defensa fins al 31 de juliol de 2019, Bone has a natural ability to regenerate. However, it cannot bridge large defects without the additional help of a supporting material. Among the different synthetic bone grafts, calcium phosphates (CaPs) are excellent candidates for bone regeneration due to their close resemblance to the mineral phase of bone, as well as the bioactive and osteoinductive potential. The present thesis explores the effect of the physicochemical features of CaPs on the interaction with the cells involved in the different stages of the bone healing process: inflammation, angiogenesis and osteogenesis, paying special attention to biomimetic calcium deficient hydroxyapatite (CDHA). This is analysed through in vitro cell cultures with immune, endothelial and bone forming cells, respectively. An overview of bone biology and bone healing process is presented in Chapter 1. Moreover, the Chapter 1 describes synthetic bone grafts based on CaPs and the impact of their physicochemical features on cellular behaviour in vitro. Chapter 2 and Chapter 3 study the response of immune cells to calcium phosphates and its outcome on osteogenic differentiation of bone forming cells. Specifically, Chapter 2 explores the link between nanotopography, specific surface area and porosity of biomimetic CDHA and its immunomodulatory, osteoimmunomodulatory and antinflammatory features, demonstrating that neddle- like topography of CDHA stimulated the osteogenic activity of bone forming cells, whilst a reduction of porosity to CDHA substrates decreased the inflammatory state. Chapter 3 is devoted to study the interaction of two chemically and texturally different calcium phosphates i.e. biomimetic CDHA and sintered ß-tricalcium phosphate (ß-TCP) with macrophages under inflammatory environment and its further impact on osteogenic differentiation of mesenchymal (MSCs) and osteoblastic cells. Angiogenesis ensures the availability of oxygen and nutrients and controls the recruitment and osteogenic differentiation of bone, El hueso tiene una capacidad natural para regenerarse. Sin embargo, no puede restaurar grandes defectos sin la ayuda adicional de un material de soporte. Entre los distintos injertos óseos sintéticos, los fosfatos de calcio son excelentes candidatos para la regeneración ósea debido a su gran parecido con la fase mineral del hueso, así como también a su potencial bioactivo y osteoinductor. La presente tesis explora el efecto de las características fisicoquímicas de los fosfatos de calcio en la interacción con las células involucradas en las diferentes etapas del proceso de regeneración ósea, es decir, inflamación, angiogénesis y osteogénesis, prestando atención especial a la hidroxiapatita biomimética deficiente en calcio (CDHA). Dicho efecto se analiza mediante el cultivo celular in vitro de células inmunológicas, endoteliales y formadoras del hueso, respectivamente. En el Capítulo 1 se presenta una descripción general de la biología ósea y el proceso de regeneración ósea. Además, el Capítulo 1 describe el estado del arte respecto a los injertos óseos basados en fosfatos de calcio y el impacto de sus características fisicoquímicas en el comportamiento celular in vitro. En el Capítulo 2 y el Capítulo 3 se estudia la respuesta de las células inmunológicas a los fosfatos de calcio y su implicación en la diferenciación osteogénica de las células formadoras de hueso. Específicamente, el Capítulo 2 explora el vínculo entre la nanotopografía, la superficie específica (SSA) y la porosidad de la CDHA biomimética y sus características inmunomoduladoras, osteoinmunomoduladoras y antiinflamatorias, demostrando que la CDHA con topografía en forma de aguja estimuló la actividad osteogénica de las células formadoras de hueso, mientras que una reducción en la porosidad de los sustratos CDHA resultó en una disminución del estado inflamatorio. El Capítulo 3 está dedicado a estudiar la interacción de dos fosfatos de calcio químicamente y texturalmente diferentes, es decir, la CDHA bio, Postprint (published version)

In this study, highly-interconnected porous titanium implants were produced by powder sintering with different porous diameters and open interconnectivity. The actual foams were produced using high cost technologies: Chemical Vapor Deposition (CVD), Physical Vapor Deposition (PVD), and spark plasma sintering, and the porosity and/or interconnection was not optimized. The aim was to generate a bioactive surface on foams using two different strategies, based on inorganic thermo-chemical treatment and organic coating by peptide adsorption, to enhance osseointegration. Porosity was produced using NaCl as a space holder and polyethyleneglicol as a binder phase. Static and fatigue tests were performed in order to determine mechanical behaviors. Surface bioactivation was performed using a thermo-chemical treatment or by chemical adsorption with peptides. Osteoblast-like cells were cultured and cytotoxicity was measured. Bioactivated scaffolds and a control were implanted in the tibiae of rabbits. Histomorphometric evaluation was performed at 4 weeks after implantation. Interconnected porosity was 53% with an average diameter of 210 µm and an elastic modulus of around 1 GPa with good mechanical properties. The samples presented cell survival values close to 100% of viability. Newly formed bone was observed inside macropores, through interconnected porosity, and on the implant surface. Successful bone colonization of inner structure (40%) suggested good osteoconductive capability of the implant. Bioactivated foams showed better results than non-treated ones, suggesting both bioactivation strategies induce osteointegration capability., Postprint (published version)

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Biomaterials can interact with cells directly, that is, by direct contact of the cells with the material surface, or indirectly, through soluble species that can be released to or uptaken from the surrounding fluids. However, it is difficult to characterise the relevance of this fluid-mediated interaction separately from the topography and composition of the substrate, because they are coupled variables. These fluid-mediated interactions are amplified in the case of highly reactive calcium phosphates (CaPs) such as biomimetic calcium deficient hydroxyapatite (CDHA), particularly in static in vitro cultures. The present work proposes a strategy to decouple the effect of ion exchange from topographical features by adjusting the volume ratio between the cell culture medium and biomaterial (VCM/VB). Increasing this ratio allowed mitigating the drastic ionic exchanges associated to the compositional changes experienced by the material exposed to the cell culture medium. This strategy was validated using rat mesenchymal stem cells (rMSCs) cultured on CDHA and beta-tricalcium phosphate (ß-TCP) discs using different VCM/VB ratios. Whereas in the case of ß-TCP the cell response was not affected by this ratio, a significant effect on cell adhesion and proliferation was found for the more reactive CDHA. The ionic exchange, produced by CDHA at low VCM/VB, altered cell adhesion due to the reduced number of focal adhesions, caused cell shrinkage and further rMCSs apoptosis. This was mitigated when using a high VCM/VB, which attenuated the changes of calcium and phosphate concentrations in the cell culture medium, resulting in rMSCs spreading and a viability over time. Moreover, rMSCs showed an earlier expression of osteogenic genes on CDHA compared to sintered ß-TCP when extracellular calcium fluctuations were reduced. Statement of Significance Fluid mediated interactions play a significant role in the bioactivity of calcium phosphates. Ionic exchange is amplified in the case of, Peer Reviewed, Postprint (author's final draft)

Aim: To develop a nanofiber (NF)-based biomimetic coating on titanium (Ti) that mimics the complex spatiotemporal organization of the extracellular matrix (ECM). Materials & methods:Recombinant cell attachment site (CAS) of fibronectin type III8-10 domain was co-electrospun with polylactic acid (PLA) and covalently bound on polished Ti discs. Osteoblast-like SaOS-2 cells were used to evaluate their complex bioactivity. Results: A significant increase of cell spreading was found on CAS/PLA hybrid NFs, followed by control pure PLA NFs and bare Ti discs. Cell proliferation showed similar trend being about twice higher on CAS/PLA NFs. The significantly increased ALP activity at day 21 indicated an enhanced differentiation of SaOS-2 cells. Conclusion: Coating of Ti implants with hybrid CAS/PLA NFs may improve significantly their osseointegration potential., Peer Reviewed, Postprint (author's final draft)

Background Current therapies for bone cancers - either primary or metastatic – are difficult to implement and unfortunately not completely effective. An alternative therapy could be found in cold plasmas generated at atmospheric pressure which have already demonstrated selective anti-tumor action in a number of carcinomas and in more relatively rare brain tumors. However, its effects on bone cancer are still unknown. Methods Herein, we employed an atmospheric pressure plasma jet (APPJ) to validate its selectivity towards osteosarcoma cell line vs. osteoblasts & human mesenchymal stem cells. Results Cytotoxicity following direct interaction of APPJ with cells is comparable to indirect interaction when only liquid medium is treated and subsequently added to the cells, especially on the long-term (72 h of cell culture). Moreover, following contact of the APPJ treated medium with cells, delayed effects are observed which lead to 100% bone cancer cell death through apoptosis (decreased cell viability with incubation time in contact with APPJ treated medium from 24 h to 72 h), while healthy cells remain fully viable and unaffected by the treatment. Conclusions The high efficiency of the indirect treatment indicates that an important role is played by the reactive oxygen species (ROS) and reactive nitrogen species (RNS) in the gaseous plasma stage and then transmitted to the liquid phase, which overall lead to lethal and selective action towards osteosarcoma cells. These findings open new pathways for treatment of metastatic bone disease with a minimally invasive approach., Peer Reviewed, Postprint (author's final draft)

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Some biomaterials are osteoinductive, that is, they are able to trigger the osteogenic process by inducing the differentiation of mesenchymal stem cells to the osteogenic lineage. Although the underlying mechanism is still unclear, microporosity and specific surface area (SSA) have been identified as critical factors in material-associated osteoinduction. However, only sintered ceramics, which have a limited range of porosities and SSA, have been analyzed so far. In this work, we were able to extend these ranges to the nanoscale, through the foaming and 3D-printing of biomimetic calcium phosphates, thereby obtaining scaffolds with controlled micro- and nanoporosity and with tailored macropore architectures. Calcium-deficient hydroxyapatite (CDHA) scaffolds were evaluated after 6 and 12 weeks in an ectopic-implantation canine model and compared with two sintered ceramics, biphasic calcium phosphate and ß-tricalcium phosphate. Only foams with spherical, concave macropores and not 3D-printed scaffolds with convex, prismatic macropores induced significant ectopic bone formation. Among them, biomimetic nanostructured CDHA produced the highest incidence of ectopic bone and accelerated bone formation when compared with conventional microstructured sintered calcium phosphates with the same macropore architecture. Moreover, they exhibited different bone formation patterns; in CDHA foams, the new ectopic bone progressively replaced the scaffold, whereas in sintered biphasic calcium phosphate scaffolds, bone was deposited on the surface of the material, progressively filling the pore space. In conclusion, this study demonstrates that the high reactivity of nanostructured biomimetic CDHA combined with a spherical, concave macroporosity allows the pushing of the osteoinduction potential beyond the limits of microstructured calcium phosphate ceramics., Peer Reviewed, Postprint (author's final draft)

Immobilization of bioactive peptide sequences on CoCr surfaces is an effective route to improve endothelialization, which is of great interest for cardiovascular stents. In this work, we explored the effect of physical and covalent immoblization of RGDS, YIGSR and their equimolar combination peptides on endothelial cells (EC) and smooth muscle cell (SMC) adhesion and on thrombogenicity. We extensively investigated using RT-qPCR, the expression by ECs cultured on functionalised CoCr surfaces of different genes. Genes relevant for adhesion (ICAM-1 and VCAM-1), vascularization (VEGFA, VEGFR-1 and VEGFR-2) and anti-thrombogenicity (tPA and eNOS) were over-expressed in the ECs grown to covalently functionalized CoCr surfaces compared to physisorbed and control surfaces. Pro-thrombogenic genes expression (PAI-1 and vWF) decreased over time. Cell co-cultures of ECs/SMCs found that functionalization increased the amount of adhered ECs onto modified surfaces compared to plain CoCr, independently of the used peptide and the strategy of immobilization. SMCs adhered less compared to ECs in all surfaces. All studied peptides showed a lower platelet cell adhesion compared to TCPS. Covalent functionalization of CoCr surfaces with an equimolar combination of RGDS and YIGSR represented prevailing strategy to enhance the early stages of ECs adhesion and proliferation, while preventing SMCs and platelet adhesion., Postprint (author's final draft)

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© Copyright 2017, Mary Ann Liebert, Inc.The fabrication of calcium phosphates using biomimetic routes, namely, precipitation processes at body temperature, results in distinct features compared to conventional sintered calcium phosphate ceramics, such as a high specific surface area (SSA) and micro-or nanometric crystal size. The aim of this article is to analyze the effects of these parameters on cell response, focusing on two bone cell types: rat mesenchymal stem cells (rMSCs) and human osteoblastic cells (SaOS-2). Biomimetic calcium-deficient hydroxyapatite (CDHA) was obtained by a low temperature setting reaction, and a-Tricalcium phosphate (a-TCP) and ß-Tricalcium phosphate were subsequently obtained by sintering CDHA either at 1400°C or 1100°C. Sintered stoichiometric hydroxyapatite (HA) was also prepared using ceramic routes. The materials were characterized in terms of SSA, skeletal density, porosity, and pore size distribution. SaOS-2 cells and rMSCs were seeded either directly on the surfaces of the materials or on glass coverslips subsequently placed on top of the materials to expose the cells to the CaP-induced ionic changes in the culture medium, while avoiding any topography-related effects. CDHA produced higher ionic fluctuations in both cell culture media than sintered ceramics, with a strong decrease of calcium and a release of phosphate. Indirect contact cell cultures revealed that both cell types were sensitive to these ionic modifications, resulting in a decrease in proliferation rate, more marked for CDHA, this effect being more pronounced for rMSCs. In direct contact cultures, good cell adhesion was found on all materials, but, while cells were able to proliferate on the sintered calcium phosphates, cell number was significantly reduced with time on biomimetic CDHA, which was associated to a higher percentage of apoptotic cells. Direct contact of the cells with biomimetic CDHA resulted also in a higher alkaline phosphatase activity for both cel, Peer Reviewed, Postprint (author's final draft)