El conocimiento de las interacciones entre célula/proteína/biomaterial es fundamental para la ingeniería de superficies debido a las numerosas aplicaciones biomédicas y biotecnológicas que se están desarrollando así como al éxito clínico que han alcanzado muchos implantes. La respuesta biológica final inducida por los implantes está fuertemente influenciada por las interacciones superficiales entre los componentes biológicos y el material sintético. Las propiedades físicas y químicas de la superficie de un biomaterial, en lugar de las propiedades en su masa, influyen directamente en la capa de proteínas que se adsorben sobre el biomaterial y, como consecuencia de ello, en la respuesta celular a la misma, tanto in vitro como in vivo.El objetivo de esta tesis doctoral es profundizar en el conocimiento de las interacciones material-biosistema, con el énfasis en el descubrimiento de relaciones entre las propiedades superficiales de las superficies de titanio y su respuesta biológica in vitro.El titanio comercialmente puro (Ti c.p.) está siendo ampliamente utilizado con éxito durante muchos años como biomaterial para implantes en cirugía ósea. Su excelente biocompatibilidad se basa en sus adecuadas propiedades mecánicas y, con mayor importancia, en su excelente resistencia a la corrosión. Esta última se debe principalmente a la formación espontanea de una fina película de óxido de titanio que le confiere protección natural contra los ataques degradativos. La modificación de la topografía de la superficie del titanio ha sido objeto de investigación en el pasado con el fin de mejorar la osteointegración. El granallado de partículas es una de las tecnologías más utilizadas para conferir rugosidad a las superficies del titanio. La rugosidad óptima y el tipo de partículas abrasivas del granallado para una respuesta óptima in vitro e in vivo fue previamente determinada en nuestro laboratorio. Sin embargo, todavía están por determinar cuáles son las causas últimas que llevan al biomaterial a su exitosa respuesta biológica.En este trabajo se han estudiado superficies pulidas y rugosas de Ti c.p. obtenidas mediante el granallado con partículas abrasivas de diferente composición química(Al2O3 y SiC) y diferentes tamaños (212-300μm; 425-600μm; 1000-1400μm). La completa caracterización de las propiedades física y química de la superficie, incluyendo la rugosidad, la composición química, la mojabilidad/energía libre y la carga eléctrica de las superficies ensayadas ha llevado a una serie de relevantes conclusiones. Entre ellas, cabe destacar que a) la composición química de las partículas de granallado, así como el método de esterilización fueron los principales factores que influyeron en la mojabilidad y la energía libre superficial de las superficies de titanio estudiadas, b) el método de esterilización cambió en la energía superficial el carácter de donante de electrones de las superficies mediante el cambio de la cantidad y la naturaleza de las sustancias adsorbidas, y c) la composición química de las partículas de granallado no influyó en la carga eléctrica a pH fisiológico ni en el punto isoeléctrico de las superficies.Un segundo paso consistió en el uso de una microbalanza de cristal de cuarzo con monitorización de la energía de disipación, para el estudio de la cinética de adsorción (cantidad y conformación) y de los procesos de adsorción competitiva de tres proteínas de especial interés en los procesos de curación del hueso - la albúmina de suero bovino (BSA), el fibrinógeno (Fbg), y la fibronectina (Fn)- en sensores lisos recubiertos de TiO2. Se determinaron diferentes modelos de procesos de adsorción con una, dos o múltiples pasos distinguibles en función de las proteínas en solución. La capa adsorbida de BSA mostró los cambios más significativos en sus propiedades mecánicas, de conformación y de incorporación de agua hasta que se alcanzaron las condiciones estables de adsorción de proteínas. La BSA, la más pequeña de las proteínas ensayadas, desplazó la Fn y el Fbg cuando se ensayó en condiciones de la competencia por la adsorción, indicando su mayor afinidad por las superficies de TiO2. También se emplearon técnicas de marcaje fluorescente para el estudio de la adsorción proteica en superficies rugosas granalladas. En este estudio, por un parte, se pudo determinar que la cantidad de Fn y BSA adsorbidas en las superficies granalladas está directamente correlacionada con su energía superficial. Por otra parte, se visualizó la adsorción de fibronectina en solución sobre muestras granalladas rugosas de Ti. La Fn formó un patrón irregular de adsorción con una mayor cantidad de proteína adsorbida en los picos que en los valles de la topografía.También se evaluó la organización espacial de la matriz extracelular de los osteoblastos, ECM, sobre superficies de Ti lisas y rugosas por medio de la visualización de las fibrillas de Fn teñidas con marcador fluorescente. Las células osteoblásticas depositaron las fibrillas de Fn con un determinado patrón organizado dentro de la matriz total secretada. Aparecen como una película que cubre la parte superior de las diferentes superficies rugosas de titanio. Un resultado relevante es que el espesor de esta capa aumentó con la rugosidad de la topografía subyacente. Sin embargo no más de la mitad de la máxima distancia pico-valle se cubrió con la proteína secretada y/o reorganizada.Por último, teniendo en cuenta las diferencias en la organización de la ECM y laadsorción de Fn en las superficies ensayadas de Ti, se realizó un estudio de qRT-PCR para determinar la influencia de las propiedades superficiales del titanio, con y sin preadsorción de Fn, en la respuesta osteoblástica. La expresión génica de la subunidad 5 de la integrina celular, como marcador de la adhesión celular, se incrementó en las superficies granalladas con SiC en comparación con las granalladas con alúmina. Este resultado fue correlacionado con la mayor cantidad de Fn adsorbida debido a la mayor energía superficial de las superficies granalladas con SiC. El aumento de la rugosidad, así como la presencia de partículas de alúmina en las superficies rugosas incrementó la actividad de ALP y la expresión génica de ALP mRNA por los osteoblastos, y por lo tanto su diferenciación. / The understanding of cell/protein/biomaterial interactions is critical to the engineering of substrates for numerous biomedical and biotechnological applications and to the clinical success of implants. The final biological response induced by implants is strongly influenced by the biological-components/synthetic-material surface interactions. It is well accepted that the physical and chemical surface properties of a biomaterial rather than its bulk properties will influence the protein adlayer and then the cell response to it, both in vitro and in vivo.The aim of this PhD thesis is to gain an increased understanding of the materialbiosystem interactions, with an emphasis on establishing correlations between surface properties of titanium surfaces and its in vitro biological response.Commercially pure titanium (c.p. Ti) is being widely and successfully used implant biomaterial in bone surgery over many years. Its excellent biocompatibility is based in its appropriate mechanical properties and, more importantly, in its excellent corrosion resistance, which is mainly due to the presence of a naturally-occurring thin protective titanium oxide film. Modification of titanium surface topography has been a subject of research in the past with the purpose of improving its osseointegration. Grit blasting is one of the most used technologies to roughen titanium surfaces for this purpose. The optimal roughness and type of abrasive blasting-particles for a better in vitro and in vivo response was previously determined in our lab. However, which and how different relevant surface properties of the blasted titanium surfaces induce that optimal biological behavior is still poorly understood.Smooth/polished and rough c.p. Ti surfaces obtained by blasting with abrasiveparticles of different chemical composition (Al2O3 and SiC) and different sizes (212-300μm; 425-600μm; 1000-1400μm) were studied. The comprehensive characterization of physical and chemical surface properties, including roughness, chemical composition, wettability/free energy and electrical charge of the tested surfaces led to a series of relevant conclusions. Among them, it is worth noting that a) the chemical composition of the grit-blasting particles as well as the method of sterilization were found the main factors influencing wettability and surface free energy of the titanium surfaces; b) the sterilization method changed the electron donor character of the surfaces by changing the amount/nature of physisorbed substances on the surfaces, and c) the chemical composition of the blasting particles did not influence on the electrical charge at physiological pH and the isoelectric point of the surfaces.A second step consisted in the use of a quartz crystal microbalance with monitoring of the energy dissipation to study the adsorption kinetics (amount and conformation) and adsorption competition processes of three proteins of special interest in the healing processes of bone -bovine serum albumin (BSA), fibrinogen (Fbg), and fibronectin (Fn)-on smooth TiO2-coated sensors. Different patterns of adsorption with processes in one, two or multiple distinguishable steps were determined depending of the protein in solution. The BSA adlayers showed the most significant changes in their mechanical properties/conformation/incorporation of water until steady protein-adsorption conditions were reached. BSA, the smallest of the tested proteins, displaced Fn and Fbg when in competition for adsorption, which is an indication of its higher affinity for TiO2 surfaces. Fluorescent labelling techniques where used to study protein adsorption on blasted rough surfaces. Most significantly, the amount of Fn and BSA adsorbed on blasted surfaces was positively correlated with their surface energy. The adsorption of fibronectin from solution on shot-blasted rough titanium surfaces resulted in an irregular pattern of adsorption with a higher amount of protein adsorbed on peaks than on valleys of the topography.Further, the spatial organization of the osteoblast extracellular matrix, ECM, on smooth and rough Ti surfaces was evaluated by visualizing fluorescently-stained Fn-fibrils. Osteoblast-like cells deposited Fn- fibrils in a specific facet-like pattern that was organized within the secreted total matrix. It appeared as a film overlying the top of the different rough titanium surfaces. Interestingly, the thickness of this layer increased with the roughness of the underlying topography, but no more than half of the total maximum peak-to-alley distance was covered.Finally, taking into consideration the differences in ECM organization and Fn adsorption on the tested Ti surfaces a qRT-PCR study was carried out to elucidate the influence of titanium surface properties with and without Fn-precoatings on the osteoblast response. The expression of 5 integrin subunit gene, as a marker for cell adhesion, was increased in SiC-blasted surfaces compared to alumina-blasted surfaces. This was related to the higher amount of adhesive-protein Fn adsorbed caused by the higher surface energy of SiC-blasted surfaces. The increase of roughness as well as the presence of alumina particles on blasted surfaces increased ALP activity and ALP mRNA gene expression by osteoblasts, and so their differentiation.This research work contribute to increase our knowledge on the interactions taking place at the bio/non-bio interface between different biological components -water, proteins, cells- and materials of clinical relevance, such as rough titanium. Theintertwined effects of the different properties of the synthetic surfaces appear as a challenge to unravel the ultimate causes that determine the fate of cells on synthetic biomaterials.

A comprehensive understanding of the interactions between orthopaedic and dental implant surfaces with the surrounding host tissue is essential in the design of advanced biomaterials that better promote bone growth and osseointegration of implants. Dental implants with roughened surfaces and high surface energy are well known to promote osteoblast differentiation in vitro and promote increased bone-to-implant contact in vivo. In addition, increased surface roughness increases osteoblasts response to the vitamin D metabolite 1α,25(OH)2D3. However, the exact mechanisms mediating cell response to surface properties and 1α,25(OH)2D3 are still being elucidated. The central aim of the thesis is to investigate whether integrin signaling in response to rough surface microtopography enhances osteoblast differentiation and responsiveness to 1α,25(OH)2D3. The hypothesis is that the integrin α5β1 plays a role in osteoblast response to surface microtopography and that 1α,25(OH)2D3 acts through VDR-independent pathways involving caveolae to synergistically enhance osteoblast response to surface roughness and 1α,25(OH)2D3. To test this hypothesis the objectives of the studies performed in this thesis were: 1) to determine if α5β1 signaling is required for osteoblast response to surface microstructure; 2) to determine if increased responsiveness to 1α,25(OH)2D3 requires the vitamin D receptor, 3) to determine if rough titanium surfaces functionalized with the peptides targeting integrins (RGD) and transmembrane proteoglycans (KRSR) will enhance both osteoblast proliferation and differentiation, and 4) to determine whether caveolae, which are associated with integrin and 1α,25(OH)2D3 signaling, are required for enhance osteogenic response to surface microstructure and 1α,25(OH)2D3. The results demonstrate that integrins, VDR, and caveolae play important roles in mediating osteoblast response to surface properties and 1α,25(OH)2D3. Silencing of the β1 integrin in osteoblast-like MG63 cells significantly reduced osteogenic response to surface topography and 1α,25(OH)2D3. Silencing of the α5 subunit did not alter the response of MG63 cells to changing surface roughness or chemistry, although future work must confirm these results given similar cell surface α5 integrin expression observed in control and α5-silenced cells. Multifunctional RGD, KRSR, and KSSR coated surfaces show that RGD increased osteoblast proliferation and reduced differentiation, KRSR had no affect on osteoblast phenotype, and KSSR increased osteoblast differentiation. These results suggest that titanium surfaces can be modified to manipulate proliferation and differentiation and that RGD/KSSR functionalized surfaces could be further investigated for use as osteointegrative surfaces. The results using VDR deficient osteoblasts demonstrate that 1α,25(OH)2D3 acts via VDR-dependent mechanisms in cells cultured on titanium surfaces that support terminal differentiation. In caveolae deficient osteoblasts, 1α,25(OH)2D3 affected cell number, alkaline phosphatase activity, and TGF-β1 levels, although levels of osteocalcin and PGE2 were not affected. These results are consistent with the hypothesis that VDR is required for the actions of 1α,25(OH)2D3, but that caveolae-dependent membrane 1α,25(OH)2D3 signaling modulates traditional VDR signaling. The exact mechanisms for this interaction remain to be shown. Overall, these results are important in better understanding the role of β1 integrin partners in mediating osteoblast response to implant surfaces and in understanding how integrin signaling can alter osteoblast differentiation and responsiveness to 1α,25(OH)2D3 via genomic and non-genomic pathways.

Células-tronco mesenquimais derivadas de medula óssea (CTMs-MO) e de tecido adiposo (CTMs-TA) são uma ferramenta atrativa para a reparação do tecido ósseo baseada na terapia celular. No presente estudo, foi investigado o potencial osteogênico e adipogênico de CTMs-MO e CTMs-TA, assim como o efeito da intercomunicação entre osteoblastos e adipócitos na expressão do fenótipo celular. CTMs-MO e CTMs-TA de ratos foram cultivadas em meios de crescimento, osteogênico e adipogênico para avaliar a diferenciação osteoblástica e adipocítica. Adicionalmente, osteoblastos e adipócitos foram cocultivados de forma indireta para investigar o efeito dos adipócitos sobre os osteoblastos e vice versa. CTMs-MO e CTMs-TA apresentaram potencial tanto osteogênico quanto adipogênico em condições não indutoras de diferenciação. No entanto, quando expostas ao meio osteogênico, as CTMs-MO exibiram maior expressão gênica de RUNX2, fosfatase alcalina e osteocalcina, expressão proteíca de RUNX2 e maior formação de matriz extracelular mineralizada comparadas às CTMs-TA. Por outro lado, em condições adipogênicas, as CTMs-TA apresentaram maior expressão gênica de PPARγ, proteína adipocítica 2 e resistina, expressão proteíca de PPARγ e maior formação de acúmulo lipídico comparadas às CTMs-MO. A presença de adipócitos em coculturas indiretas inibiu a expressão do fenótipo osteoblástico, enquanto os osteoblastos não apresentaram um efeito marcante sobre a expressão do fenótipo adipocítico. Em conclusão, o presente estudo mostrou que as CTMs-MO são mais osteogênicas enquanto as CTMs-TA são mais adipogênicas. Adicionalmente, foi observado que a intercomunicação entre osteoblastos e adipócitos pode afetar negativamente o reparo ósseo. Assim, postulamos que o maior potencial osteogênico das CTMs-MO as tornam a escolha mais adequada para a indução do reparo ósseo baseado na terapia celular. / Mesenchymal stem cells from bone marrow (BM-MSCs) and adipose tissue (AT-MSCs) are attractive tools for cell-based therapies to repair bone tissue. In the present study, we investigated the osteogenic and adipogenic potential of BM-MSCs and AT-MSCs as well as the effect of crosstalk between osteoblasts and adipocytes on cell phenotype expression. Rat BM-MSCs and AT-MSCs were cultured either in growth, osteogenic or adipogenic medium to evaluate osteoblast and adipocyte differentiation. Also, osteoblasts and adipocytes were indirectly cocultured to investigate the effect of adipocytes on osteoblast differentiation and vice versa. BM-MSCs and AT-MSCs exhibit osteogenic and adipogenic potential under non-differentiation-inducing conditions. However, when exposed to osteogenic medium, BM-MSCs exhibited higher gene expression of RUNX2, alkaline phosphatase and osteocalcin, RUNX2 protein expression and more extracellular matrix mineralization compared with AT-MSCs. Conversely, under adipogenic conditions, AT-MSCs displayed higher gene expression of PPARγ, fatty acid binding protein 4 and resistin, PPARγ protein expression and more lipid accumulation compared with BM-MSCs. The presence of adipocytes as indirect coculture repressed the expression of osteoblast phenotype while osteoblasts did not exert remarkable effect on adipocyte phenotype expression. In conclusion, the present study showed that BM-MSCs are more osteogenic while AT-MSCs are more adipogenic. Also, we observed that the crosstalk between osteoblasts and adipocytes may negatively impact bone repair. Thus, we postulate that the higher osteogenic potential of BM-MSCs makes them the first choice for inducing bone repair in cell-based therapies.

A crescente demanda clínica para regeneração óssea tem dirigido esforços significativos para o desenvolvimento de novos biomateriais, incluindo aqueles aplicados em terapias baseadas em engenharia de tecidos. Neste contexto, os biovidros são considerados uma boa alternativa mas as suas propriedades mecânicas têm limitado a sua aplicação. Para melhorar tais propriedades sem afetar a biocompatibilidade, um novo material vitrocerâmico bioativo do sistema P2O5-Na2O-CaO-SiO2, chamado Biosilicato® com duas fases cristalinas (BioS-2P) foi desenvolvido. No entanto, os efeitos da adição das fases cristalinas sobre o comportamento biológico do BioS-2P ainda não foram estudados. Assim, os objetivos deste estudo foram investigar a capacidade do BioS-2P em induzir, in vitro, a diferenciação osteoblástica de células-tronco mesenquimais (CTMs); a capacidade do BioS-2P em aumentar, in vitro, a atividade dos osteoblastos em fase inicial de diferenciação (OBs) e osteoblastos da linhagem UMR-106 (UMRs); e a capacidade do BioS-2P em conduzir e induzir a neoformação óssea, in vivo, associado ou não a células. Células derivadas da medula óssea obtidas de fêmures de ratos foram cultivadas em meio de crescimento para obtenção de CTMs ou em meio osteogênico para obtenção de OBs. Essas células e UMRs foram cultivadas sobre discos de BioS-2P, Bioglass® 45S5 (45S5) e plástico de cultura (Controle) e utilizadas nas avaliações in vitro. Para as avaliações in vivo, defeitos de 5 mm criados em calotas de ratos foram implantados somente com arcabouços de BioS-2P ou com arcabouços de BioS-2P associados às CTMs ou aos OBs. Os dados foram comparados por teste não paramétrico de Kruskal-Wallis seguido pelo teste de Student Newman-Keuls, e o nível de significância adotado foi de 5%. As CTMs foram caracterizadas por apresentarem alta porcentagem de células expressando os marcadores de superfície CD29 e CD90 e baixa porcentagem expressando CD31, CD34, CD45 e CD106. A diferenciação osteoblástica das CTMs foi confirmada pela expressão dos genes marcadores da diferenciação osteoblástica fosfatase alcalina (ALP), runt-related transcriptor factor-2 (RUNX2), sialoproteína óssea (BSP) e osteocalcina (OC). CTMs cultivadas sobre discos de BioS-2P em meio não-osteogênico apresentaram diminuição da proliferação e aumento da atividade de ALP e da expressão dos genes marcadores da diferenciação osteoblástica ALP, RUNX2, osterix (OSX), proteína óssea morfogenética-4 (BMP-4), osteopontina (OPN) e OC, comprovando seu potencial osteoindutor similar ao 45S5. O BioS-2P foi capaz de aumentar a atividade de OBs e UMRs de maneira similar àqueles cultivados sobre o 45S5. OBs apresentaram diminuição na proliferação e aumento da atividade da ALP e da expressão dos genes marcadores da diferenciação osteoblástica RUNX2, OSX, BMP-4, OPN e OC. A análise em larga escala da expressão de mais de 23.000 genes mostrou que o BioS-2P induziu a sobre-expressão de genes envolvidos no aumento da atividade osteoblástica e a repressão de genes envolvidos na diminuição dessa atividade, em comparação com o Controle. Ao menos em parte, esse aumento da atividade osteoblástica foi atribuído à modulação das vias de sinalização proteíno-quinases ativadas por mitógenos (MAPK) e Wnt Canônica, e à modulação da expressão de microRNAs. UMRs crescidos sobre o BioS-2P corroboraram esses achados, pela capacidade em formar matriz mineralizada e por apresentarem aumento na expressão das proteínas ALP, RUNX2, dentin matrix protein-1 (DMP-1) e OPN. Arcabouços de BioS-2P (5 mm de diâmetro e 2 mm de altura com porosidade de 76 ± 5% e com tamanhos de poros variando entre 100 e 800 µm) implantados em defeitos na calota de ratos estimularam a formação de tecido ósseo, que ocorreu tanto na periferia como no interior dos defeitos e em íntimo contato com o material. A morfometria por microtomografia computadorizada não evidenciou qualquer diferença entre os parâmetros volume ósseo, volume ósseo/volume total, superfície óssea, superfície/volume ósseo, número de trabéculas, separação trabecular e espessura trabecular, avaliados na 4a, 8a e 12a semanas de implantação. As CTMs e os OBs foram carreados para os arcabouços de BioS- 2P (com eficiência de 90% e 81%, respectivamente) e essas células permaneceram nos defeitos por 14 dias. A combinação de arcabouços de BioS-2P com CTMs ou OBs, implantados por 8 semanas, resultou no mesmo padrão de formação óssea daquele observado para o arcabouço sem células. No entanto, essa combinação não resultou em aumento na quantidade de osso formado. Os resultados evidenciaram a capacidade do BioS-2P em induzir a diferenciação osteoblástica de CTMs e estimular a atividade osteoblástica de OBs, o que resultaria na neoformação óssea observada in vivo. No entanto, a combinação de BioS-2P com CTMs e OBs não foi capaz de aumentar a formação óssea e induzir o reparo dos defeitos ósseos. / The increasing clinical demand for bone regeneration has driven significant efforts to develop new biomaterials including those for tissue engineeringbased therapies. In this context, bioglasses emerges as a good alternative, but their use has been limited mainly due their poor mechanical properties. To improve these mechanical properties without affecting biocompatibility, a novel bioactive glass-ceramic of the P2O5-Na2O-CaO-SiO2 system, named Biosilicate® with two cristallyne phases (BioS-2P) was developed. However, the effects of these two phases on BioS- 2P biological behavior have not yet been evaluated. Thus, the aims of this study were to investigate the BioS-2P capability of inducing in vitro mesenquimal stem cell differentiation (MSC) towards osteoblasts; the BioS-2P capability to increase in vitro activity of osteoblasts derived from rat bone marrow at early stages of differentiation (OBs) and osteoblasts from rat cell line UMR- 106 (UMRs); and the BioS-2P capability to drive and induce bone formation in vivo, associated or not with cells. Bone marrow cells harvested from rat femurs were cultured either in growth media to obtain MSCs or in osteogenic media to obtain OBs. MSCs, OBs and UMRs were cultured on discs of BioS-2P, Bioglass® 45S5 (45S5) and tissue culture polystyrene (Control). For in vivo evaluations, 5-mm rat calvarial surgical defects were filled with BioS-2P with or without MSCs or OBs. Data were compared by non-parametric Kruskal-Wallis test followed by Student Newman- Keuls test and the significance level was set at 5%. MSCs were characterized by presenting high percentage of CD29 and CD90 surface markers and low percentage of CD31, CD34, CD45 and CD106 surface markers. Osteoblastic differentiation of MSCs was detected by gene expression of bone markers alkaline phosphatase (ALP), runt-related transcritption factor 2 (RUNX2), bone sialoprotein (BSP) and osteocalcin (OC). MSCs cultured on Bios-2P discs under non-osteogenic conditions exhibited a decrease on cell proliferation and an increase on ALP activity and gene expression of bone markers ALP, RUNX2, osterix (OSX), bone morphogenetic protein-4 (BMP-4), osteopontin (OPN) and OC, confirming its osteoinductive potential similar to 45S5. Also, BioS-2P increased the OBs and UMRs activity, similar to 45S5. OBs cultured on Bios-2P discs presented a decrease in cell proliferation and an increase on ALP activity and gene expression of bone markers RUNX2, OSX, BMP-4, OPN and OC. The large-scale analysis of over 23,000 genes showed that the BioS-2P induced overexpression of genes positively related to osteoblastic activity and repression of genes negatively related with its activity, compared with control. At least in part, the increase on OBs activity was associated to the modulation of two main signaling pathways, the mitogen activated protein kinases (MAPK) and the Canonical Wnt, and the modulation of microRNAs expression. These findings were corroborated by UMRs grown on BioS-2P, which produced mineralized matrix and exhibited increased expression of the ALP, RUNX2, dentin matrix protein-1 (DMP-1) and OPN proteins, than on control. BioS-2P scaffolds (5 mm diameter and 2 mm heigh, presenting 76 ± 5% of total porosity, with poros size ranging from 100 to 800 µm) implanted in calvarial defects promoted new bone formation in close contatc to BioS-2P, both on periphery and in the center of the defect. The computed microtomography morphometry showed no difference between the evaluated parameters bone volume, bone volume / total volume, bone surface, surface / bone volume, number of trabeculae, trabecular separation and trabecular thickness, measured at 4, 8 and 12 weeks. MSCs and OBs were seeded into the scaffold (with efficiency of incorporation 90% e 81%, respectively) and they remained on the defects for 14 days. After 8 weeks, the same pattern of bone formation was observed, however, the combination of BioS-2P with cells did not increase the amount of new bone. The results showed the BioS-2P ability to induce osteoblastic differentiation of MSCs and to stimulate osteoblastic activity, resulting in new bone formation in vivo. However, the combination of BioS-2P with MSCs and OBs was not able to increase bone formation and induce the repair of bone defects.

No description available.

Bone is a dynamic tissue that is continuously remodelled, a process that requires equal amounts of osteoclastic bone resorption and osteoblastic bone formation. Inflammation may disturb the equilibrium and result in local and/or systemic bone loss. Negative bone mass balance occurs in several chronic inflammatory diseases, e.g. periodontitis and rheumatoid arthritis (RA). The aetiology of periodontitis is infectious, while RA is an autoimmune disease. Despite aetiological differences, an association between the two diseases has been established but it is not known if they are causally related. Periodontitis may develop when the inflammatory process, initially restricted to the gingiva (gingivitis), further invades the periodontium and causes bone resorption. The cellular and molecular mechanisms underlying the transition from gingivitis to periodontitis are not fully elucidated. Osteoclast formation is dependent on receptor activator of nuclear factor kappa B ligand (RANKL), but how osteoclast precursors are recruited to the jawbone is poorly understood. A family of cytokines named chemokines has been reported to possess such properties and increasing evidence points towards their involvement in the pathogenesis of chronic inflammatory diseases. The overall aim of this thesis was to gain extended knowledge about the role of chemokines and a newly discovered family of leukocytes named innate lymphoid cells (ILCs) in periodontitis and concomitant inflammatory disturbed bone remodelling. Furthermore, the aim was also to study the association between periodontitis and RA. We identified increased serum levels of monocyte chemoattractant protein (MCP)-1 and CCL11 in individuals with periodontitis. Moreover, a robust correlation between the two chemokines and periodontitis was detected in a weighted analysis of inflammatory markers, subject characteristics and periodontitis parameters. We detected higher MCP-1 levels in periodontitis tissue compared to non-inflamed. Furthermore we demonstrated that human gingival fibroblasts express MCP-1 and CCL11 in response to pro-inflammatory cytokines through NF-κB signalling. Using an inflammatory bone lesion model and primary cell cultures, we discovered that osteoblasts express CCL11 in vivo and in vitro and that the expression increased under inflammatory conditions. Osteoclasts did not express CCL11, but its high affinity receptor CCR3 was upregulated during osteoclast differentiation and found to co-localise with CCL11 on the surface of osteoclasts. Exogenous CCL11 was internalised in osteoclasts, stimulated the migration of osteoclast precursors and increased bone resorption in vitro. To analyse if periodontitis precedes RA we analysed marginal jawbone loss in dental radiographs taken in pre-symptomatic RA cases and matched controls. The prevalence of jawbone loss was higher among cases, and the amount of jawbone loss correlated with plasma levels of RANKL. In the search of the newly discovered ILCs, we performed flow cytometry analyses on gingivitis and periodontitis tissue samples. We detected twice as many ILCs in periodontitis as in gingivitis. In addition we found RANKL expression on ILC1s (an ILC subset). In conclusion, we demonstrated that CCL11 is systemically and locally increased in periodontitis and that the CCL11/CCR3 axis may be activated in inflammatory disturbed bone remodelling. We also found that marginal jawbone loss correlated with plasma levels of RANKL and preceded clinical onset of symptoms of RA. Furthermore, we demonstrated that ILCs are present in periodontitis and represent a previously unknown source of RANKL. / Skelettet har flera viktiga funktioner i kroppen såsom att möjliggöra en upprätt hållning, utgöra fäste för muskler och mediera rörelse, skydda benmärgen och de inre organen samt reglera mängden av lösligt mineral i blodet. Med tiden uppstår mikroskador i skelettet vilket innebär att benvävnaden måste byggas om för att vara fortsatt funktionell. Ombyggnaden kallas remodellering och är en kontinuerlig process som huvudsakligen utförs av benbildande celler kallade osteoblaster och bennedbrytande celler kallade osteoklaster. Remodelleringen är strikt reglerad av olika signalmolekyler och under friska förhållanden råder jämvikt mellan mängden ben som bryts ner och mängden ben som bildas, vilket innebär att benmassan hålls konstant. Vid sjukdomar som medför långvariga inflammationsprocesser i benvävnad eller i närheten av benvävnad, exempelvis parodontit (tandlossningssjukdom) och ledssjukdomen reumatoid artrit (RA), kan den rådande jämvikten rubbas, vilket oftast resulterar i minskad benmängd. Vid parodontit är den bakomliggande orsaken till inflammationen bakterier som finns i placket på tänderna, men vid RA tros anledningen vara att immunförsvaret attackerar kroppsegna celler. Trots olikheterna delar de två sjukdomarna flera gemensamma drag med avseende på riskfaktorer, vilka signalmolekyler som återfinns i blodet samt hur inflammationsprocessen fortskrider. Parodontit föregås av gingivit (tandköttsinflammation). Hos vissa individer övergår gingivit till parodontit, en process som inkluderar nedbrytning av tandens stödjevävnader inklusive käkben. Det är inte helt klarlagt vilka celler och molekyler som finns närvarande vid gingivit respektive parodontit eller vilka mekanismer som ligger bakom skiftet mellan de två tillstånden. Det är sedan tidigare känt att molekylen RANKL är viktig för osteoklastbildning, men det är delvis okänt hur osteoklastförstadieceller rekryteras från blodcirkulationen till käkbenet. En grupp av molekyler kallade kemokiner, som även finns i förhöjda nivåer i blod vid parodontit och RA, har visat sig ha sådana egenskaper. För att finna läkemedel som kan förhindra bennedbrytning till följd av den inflammatoriskt störda benremodellering som sker vid både parodontit och RA är det viktigt att studera sambandet mellan sjukdomarna och få en tydlig bild av vilka celler som är närvarande vid inflammationsprocessen. Det är även av betydelse att kartlägga vilka celler och molekyler som främjar rekrytering av osteoklastförstadieceller och bidrar till bennedbrytning. Syftet med den här avhandlingen var att undersöka betydelsen av kemokiner vid inflammatoriskt störd benremodellering och vid parodontit samt att undersöka sambandet mellan parodontit och RA. För att skapa en tydligare bild av vilka cellertyper som är närvarande vid inflammationsprocessen vid parodontit undersöktes även förekomsten av en nyligen upptäckt celltyp vid namn ILCimmunceller (ILCs) samt om dessa celler uttrycker RANKL. Först analyserades förekomsten av olika inflammatoriska signalmolekyler i blod från individer med parodontit samt från friska kontroller. Individer med parodontit hade förhöjda nivåer av kemokinerna MCP-1 och CCL11. Genom att använda en statistisk analysmetod som utöver inflammatoriska signalmolekyler även inkluderade kliniska variabler kunde ett samband mellan de två kemokinerna och parodontit påvisas. Vidare undersöktes möjliga ursprung till de i blodet förhöjda kemokinnivåerna genom att analysera tandkött från tänder med parodontit samt friskt tandkött. Vid parodontit uppmättes högre nivåer av MCP-1. Gingivala fibroblaster (en celltyp som producerar bindväv och ansvarar för tandköttets uppbyggnad) från människa bildade MCP-1 och CCL11 när de stimulerats med inflammationsfrämjande substanser, vilket krävde aktivering en intracellulär signaleringsväg kallad NF-κB. För att utreda betydelsen av CCL11 vid inflammatoriskt störd benremodellering analyserades bencellers bildning av CCL11 in vivo i skalltak från möss samt in vitro i cellodlingar. Osteoblaster bildade CCL11 in vivo och in vitro och bildningen ökade under inflammatoriska förhållanden. Osteoklaster bildade inte CCL11, men däremot fanns ett uttryck av receptorn CCR3, vilket är en mottagarmolekyl till CCL11. I vävnadssnitt från skalltak visades att CCL11 och CCR3 ser ut att binda till varandra på osteoklasternas yta. Dessutom hade CCL11 en positiv effekt på rekrytering av osteoklastförstadieceller och CCL11 som tillsattes till cellodlingar togs upp av osteoklaster och stimulerade benresorption. För att studera sambandet mellan parodontit och RA analyserades käkbensförlust vid tänder med hjälp av röntgenbilder tagna på individer som senare utvecklade RA (pre-symptomatiska) samt matchade kontroller. De presymptomatiska individerna hade en högre grad av käkbenförlust och det fanns också ett samband mellan käkbensförlust och nivåer av RANKL i blodet. Förekomsten av ILCs i tandkött från tänder med gingivit respektive parodontit analyserades med flödescytometri. Dubbelt så många ILCs återfanns vid parodontit än vid gingivit, varav majoriteten bestod av ILC1 (en undergrupp till ILCs). Vidare analyser visade att ILC1 cellerna bildar RANKL. Sammanfattningsvis, vid parodontit finns förhöjda nivåer av CCL11 i vävnaden och i blodet, och interaktionen mellan CCL11 CCR3 kan vara av betydelse vid inflammatoriskt störd benremodellering. Käkbensförlust föregår RA och korrelerar med nivåer av den osteoklaststimulerande molekylen RANKL i blodet, vilket stödjer teorin om att det finns ett samband mellan de två sjukdomarna. De nyligen upptäckta ILCs återfinns vid både gingivit och parodontit och utgör dessutom en tidigare okänd källa till RANKL.

The chemical properties of calcium phosphate cements (CPCs) are very similar to the mineral phase of bone. CPCs are, consequently, very effective substrates (scaffolds) for tissue engineering; bone and stem cells attach readily, and can proliferate and differentiate to form new bone tissue. Unlike other CPCs that may remain largely unchanged in the body for years, such as hydroxyapatite, dicalcium phosphates are remodelled by the body and rapidly converted to new bone. Unfortunately, the dicalcium phosphates are also typically too weak to support load bearing in the human body. Our laboratory has recently developed a novel, high strength brushite CPC, (hsCPC), which can reach 10-50 fold higher failure strength than many commercially available CPCs. The aim of this thesis was to investigate the physical, chemical and biological performance of hsCPCs in physiologically relevant model of drug release, load bearing, osteoconductivity, and as a scaffold for bone tissue engineering. Multiple CPCs were compared in a model of screw augmentation to determine whether the physical properties of the cement, such as bulk strength and porosity, affected orthopedic screw holding strength. In an in vitro model of bone regeneration stem cells were grown on macroporous scaffolds that were fabricated from hsCPC. Drug releasing scaffolds were fabricated to examine whether the low porosity of hsCPC impeded drug release during a 4 week incubation period. The biological activity of an incorporated drug, Rebamipide, was examined after acute and chronic incubation periods. In the drug release study it was noted that the biological response to hsCPC was significantly better than tissue culture grade polystyrene, even in groups without drug. The mechanism underlying this biological response was further investigated by testing the effect of pyrophosphate, a common cement additive, on bone cell proliferation and differentiation. This thesis concludes that a high strength cement can produce significant improvement in screw augmentation strength, if there is sufficient cortical bone near the augmentation site. The hsCPC is also cytocompatible, and can support bone and stem cell proliferation and differentiation. hsCPC scaffolds stimulated osteogenic gene expression comparable to native bone scaffolds. hsCPC scaffolds are also capable of delivering drug for up to 4 weeks, in vitro. Finally, a cement additive, pyrophosphate, stimulated differentiation, but not proliferation of bone cells.

No description available.

Abstract Orthodontic tooth movement is a biological response to a mechanical force. One of the challenges in orthodontics is obtaining desired tooth movement during treatment. Accelerating tooth movement and decreasing demands on anchorage can reduce treatment times and overall satisfaction for patient and doctor. Low-level laser therapy (LLLT) is emerging as a technology that may decrease orthodontic treatment time. Many in vitro and in vivo studies have reported the effects of low level lasers at random time points and energy densities. None of the studies have optimized the dose required for osteoblast proliferation and differentiation. The purpose of this study was to find the optimum stimulatory dose of low level laser irradiation (LLLI) on human osteoblast cell proliferation and differentiation and to analyze our findings with reference to the Arndt-Shultz Law of applied energy. In this in vitro study a GaAlAs laser at 830nm, 20 mW with continuous exposure at various doses were used on a human osteoblast cell line. According to the Arndt-Shulz Law weak stimuli initiate vital activity, moderate stimuli enhance the cellular activity with subsequent peak stimulation and greater stimuli (beyond a threshold value) may not have any influence or inhibit the vital activity. The implications of LLLI on human osteoblasts and influencing tooth movement in orthodontics were discussed. Human osteoblasts were cultured in minimum essential medium (MEM) complete medium consisting 10% fetal bovine serum and 1% antibiotics. Cells grown in complete medium were plated onto 96 well plate, allowed to adhere for 4-5 hours and were exposed to GaAlAs lasers at 6 , 12, 18, 24, 30, 36, 45, 60, 75, and 90 seconds. The cells treated with xiii LLLI were assessed for cell proliferation at 24, 48 and 72 hour intervals. A calorimetric cell proliferation assay (WST-1) assay was performed according to manufacture's instructions. The results indicated that at 24 hours the 6 and 12 seconds doses significantly inhibited proliferation compared to the control. At 48 hours the 30 seconds exposure significantly increased proliferation. At 72 hours time interval, cell proliferation was observed in a dose dependent pattern with a minimum at 6 seconds with peak proliferation at 18 seconds. A gradual decrease in cell viability was observed in the cells treated beyond this dose with a maximum inhibition seen at 60 seconds. At 75 and 90 seconds no difference was observed between the control and experimental group. To establish efficient acquisition of adequate quantities of alkaline phosphatase, cells were grown in 12 well plates in complete medium or osteogenic medium. These cells were exposed to LLLI for 18, 48, and 60 seconds. The activity of early osteogenic differentiation marker alkaline phosphatase (ALP) was investigated 10 days post exposure. Our results demonstrated that alkaline phosphatase activity at 2.4 - 7.3 J/cm2 with 48 - 60 seconds of exposure, and an incident power ranging from 85-269mw significantly increased. The findings suggest that these irradiated cells obeyed the Arndt Shulz Law governing cellular response to applied energy. Further this research indicates the possible role of LLLT to accelerate tooth movement in orthodontics. Complete disclosure of low level laser parameters is essential in order to accurately compare findings of researchers.

Indiana University-Purdue University Indianapolis (IUPUI) / Multiple myeloma (MM) is an incurable malignancy characterized by the proliferation of neoplastic plasma cells in the bone marrow (BM) and by multiple osteolytic lesions throughout the skeleton. We previously reported that CD166 is a functional molecule on normal hematopoietic stem cells (HSC) that plays a critical role in HSC homing and engraftment, suggesting that CD166 is involved in HSC trafficking and lodgment. CD166, a member of the immunoglobulin superfamily capable of mediating homophilic interactions, has been shown to enhance metastasis and invasion in several tumors. However, whether CD166 is involved in MM and plays a role in MM progression has not been addressed. We demonstrated that a fraction of all human MM cell lines tested and MM patients’ BM CD138+ cells express CD166. Additionally, CD166+ cells preferentially home to the BM of NSG mice. Knocking-down (KD) CD166 expression on MM cells with shRNA reduced their homing to the BM. Furthermore, in a long-term xenograft model, NSG mice inoculated with CD166KD cells showed delayed disease progression and prolonged survival compared to mice receiving mock transduced cells. To examine the potential role of CD166 in osteolytic lesions, we first used a novel Ex Vivo Organ Culture Assay (EVOCA) which creates an in vitro 3D system for the interaction of MM cells with the bone microenvironment. EVOCA data from MM cells lines as well as from primary MM patients’ CD138+ BM cells demonstrated that bone osteolytic resorption was significantly reduced when CD166 was absent on MM cells or calvarial cells. We then confirmed our ex vivo findings with intra-tibial inoculation of MM cells in vivo. Mice inoculated with CD166KD cells had significantly less osteolytic lesions. Further analysis demonstrated that CD166 expression on MM cells alters bone remodeling by inhibiting RUNX2 gene expression in osteoblast precursors and increasing RANKL to OPG ratio in osteoclast precursors. We also identified that CD166 is indispensable for osteoclastogenesis via the activation of TRAF6-dependent signaling pathways. These results suggest that CD166 directs MM cell homing to the BM and promotes MM disease progression and osteolytic disease. CD166 may serve as a therapeutic target in the treatment of MM.