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Bone defects are a pervasive complication arising from many clinical conditions, both mechanical and pathological. Current treatments for large bony defects focus on applying bone grafts or synthetic materials to the defect area. Cell-based—and especially stem-cell—therapies have advanced greatly thanks to increasing attention focused on their ability to generate new tissues in situ with biomechanical properties approaching that of native tissue, but they suffer from their own shortcomings as well. Exosomes have been shown to play critical roles in cell-signaling and tissue regeneration and are therefore potentially ideal therapeutic vehicles for treating bone defects. Exosomes are small microvesicles counted amongst stem cells’ paracrine factors capable of delivering nucleic acid and enzymatic protein cargoes in a targeted 2 manner. Our previous studies have shown that hMSC-Exosomes are both proliferative and chemotactic, inhibit inflammatory cytokine production, and suppress osteoclast differentiation. Our long term goal is to develop hMSC-Exosome as a clinical therapy for bone regeneration. The objectives of this study were to determine the ability of hMSC-Exosome to enhance bone healing in a rat calvarial defect model, and to further investigate the integrity of the exosome under certain storage conditions. The specific aims of this study were: 1) To determine the osteogenic potential of hMSC-Exosomes in rat calvarial defects, and 2) To determine the impact of variable storage conditions on the integrity of exosomes. To investigate in vivo regenerative potential, rats with surgically-created craniotomy defects were treated with hMSC-Exosome suspension via a collagen gel matrix. After 4 weeks, the calvaria were harvested and analyzed via micro-CT. Volumetric micro-CT analysis showed that hMSC-Exosome could significantly enhance center healing, structural integrity, and growth uniformity in a calvarial defect model. Western blot and TEM showed thorough destruction of surface protein markers and decreased membrane integrity in lyophilized exosome fraction; moderate progressive surface protein marker loss and aggregation were observed with increasing freeze-thaw cycles. In summary, hMSC-Exosome is a promising therapeutic for treatment of bone defects.

Parathyroid hormone (PTH) analogs are the main anabolic pharmacological agent for osteoporosis. PTH is an endogenous hormone, of which amino acids 1-34 bind the parathyroid hormone receptor (PTH1r), a G-coupled protein receptor expressed in kidney, fat, and bone. PTH increases trabecular bone mass by promoting the differentiation of the mesenchymal stem cell (MSC) into the osteogenic lineage. The Zinc Finger Protein 467 (Zfp467) is a potential downstream target of PTH1r and an important mediator of the MSC into the adipogenic lineage. Taken together, we ask whether Zfp467 knockout cells will show greater osteogenic potential and increased sensitivity to PTH treatment. We also seek to investigate a mechanistic signaling pathway of PTH1r involving Zfp467. Calvarial osteoblast (COB) and bone marrow stromal cells (BMSCs) from Zfp467 wild type (WT) and knockout (KO) mice were osteogenically differentiated and treated with either continuous (48h) or intermittent (6h/42h) PTH for 7-14 days. At 7 and 14 days, alkaline phosphatase (ALP) and von Kossa staining were conducted, respectively. At 7 days after differentiation, qPCR was used to analyze genes involved in osteogenesis, adipogenesis, WNT signaling, and mitochondrial respiration. ELISA was used to measure cAMP levels. Seahorse XF96 assays were used to measure oxygen consumption rates (OCRs) and extracellular acidification rates (ECARs). Western blot was used to measure PTH1r. Additionally, adipogenic differentiation and Oil Red O staining were performed on BMSCs. ALP and von Kossa results showed that Zfp467 KO cells exhibited increased osteogenesis and an increased response to PTH treatment (continuous and intermittent) as compared to WT controls. qPCR analysis of Alp, Rankl, and Sp7 further supported an increased osteogenic potential of the KO. Also, Oil Red O staining revealed suppressed adipogenesis in KO BMSCs and qPCR analysis showed suppressed Adiponectin and Ppary in KO COBs. Additionally, Pth1r and PTH1r expressions were significantly higher in KO and short PTH treatments (~10m) induced a remarkable reduction in Zfp467 of WT cells. Furthermore, the KO showed suppressed Pgc1a, similar OCR, and increased ECAR as compared to WT. The KO also exhibited higher cAMP levels and was more responsive to PTH-induced increases of cAMP at 10 minutes of PTH exposure. However, qPCR analysis of Lef1 and Sost showed no difference regarding the WNT pathway. Our data support an anti-osteogenic and pro-adipogenic role for Zfp467. The KO displays less adipogenesis, more osteogenesis, and is consistently more sensitive to the osteogenic effects of PTH. The upregulation of Pth1r and PTH1r in KO cells offers an explanation for this increased sensitivity. We propose a mechanism where the suppression of Zfp467 upregulates Pth1r and PTH1r activation suppresses Zfp467, resulting in a constitutively active positive feedback loop. Further still, the KO shows potentially suppressed mitochondrial biogenesis (through Pgc1a analysis), similar oxidative phosphorylation (through OCRs), increased glycolysis (through ECARs), and increased PKA signaling (through cAMP assays), yet their exact connections to the PTH1r-Zfp467 signaling pathway have yet to be investigated.

The objective of the present study was to synthesize porous, biodegradable poly (D, l- lactide-co-glycolide) PLGA-B-HA (Bovine hydroxyapatite) composite and evaluate the effect of ceramic content on bone marrow cell differentiation in vitro. A macroporous biodegradable PLGA-B-HA composite with the pore size varying from 0.1 to 1000?? and a highly interconnected structure was fabricated using the freeze-drying/lyophilization technique. A pilot study was done to determine the effects of B-HA on to the osteoblast function. The main study was done to determine the effect of the increase in B-HA concentration on to the mesenchymal stem cell differentiation. Morphological characteristics of the composites were analyzed using FTIR and SEM/EDX analysis. The composites were seeded with neonatal rat calvarial osteoblasts (NRCO). The polymer: ceramic ratio in this study was 35%:65%. For comparison parallel experiments involving pure HA-200 discs were performed. SEM results indicated a higher proliferation and mineralization on PLGA-B-HA composites than pure HA discs. In addition, we evaluated the in vitro characteristics of PLGA-B-HA composites with varying ratios, i.e., 1:1, 1:2 and 1:3, seeded with rat marrow cells. FTIR indicated an increase in the area under the ceramic peak as ceramic concentration was increased. In addition, the average roughness values increased in the order of 1:3 andgt; 1:2 andgt; 1:1. Both compressive strength and modulus of 1:1 were significantly higher than 1:2 and 1:3 PLGA-B-HA composites. No significant difference in compressive modulli and strengths could be observed for 1:2 and 1:3 PLGA-B-HA composites. Cellular activity was determined by measuring AP activity, total protein analysis and osteocalcin concentration. Evaluation of alkaline phosphatase activity showed bone cells attached to 1:3 (PLGA-B-HA) expressed significantly higher alkaline phosphatase as compared to 1:1 and 1:2 PLGA-B-HA composites. In addition, cells seeded on to 1:3 composites secreted significantly higher osteocalcin and at a relatively short time period as compared to the other samples. Corrosion studies (ICP) and pH values indicate minimal difference in the concentration of Ca and P and pH in tissue culture media for all the samples at the end of all time periods. Hence we conclude that an increase in the ceramic concentration stimulated mesenchymal stem cell differentiation thereby promoting osteogenesis.

Tissue engineering is limited by inability to create early and adequate blood supply. In-vivo DCE-MRI has imaged angiogenesis in soft tissues, yet has not been considered in hard tissues. Bilateral critical defects created in parietal bones of eighteen adult rabbits were left void, treated with haluronic acid acellular matrix (HA-ACM), or HA-ACM impregnated with vascular endothelial growth factor (VegF). DCE- MRI was acquired at weeks 1,2,3,6, and 12. Histologic analysis of HA-ACM treated defects demonstrated quantitatively greater immature bone formation, increased quantity and larger blood vessels compared to void. Statistically significant greater angiogenesis evidenced by quantitative perfusion on MRI supported histologic findings. DCE MRI is a novel means of imaging angiogenesis in grafted bone defects. DCE-MRI discerns physiologically important phases of angiogenesis: Initial vasoactive response, vessel network initiation, establishment, and pruning. DCE-MRI is adaptable to non-invasive study of candidate tissue engineered constructs and in evaluating scaffolds and treatments on angiogenesis.

Tissue engineering is limited by inability to create early and adequate blood supply. In-vivo DCE-MRI has imaged angiogenesis in soft tissues, yet has not been considered in hard tissues. Bilateral critical defects created in parietal bones of eighteen adult rabbits were left void, treated with haluronic acid acellular matrix (HA-ACM), or HA-ACM impregnated with vascular endothelial growth factor (VegF). DCE- MRI was acquired at weeks 1,2,3,6, and 12. Histologic analysis of HA-ACM treated defects demonstrated quantitatively greater immature bone formation, increased quantity and larger blood vessels compared to void. Statistically significant greater angiogenesis evidenced by quantitative perfusion on MRI supported histologic findings. DCE MRI is a novel means of imaging angiogenesis in grafted bone defects. DCE-MRI discerns physiologically important phases of angiogenesis: Initial vasoactive response, vessel network initiation, establishment, and pruning. DCE-MRI is adaptable to non-invasive study of candidate tissue engineered constructs and in evaluating scaffolds and treatments on angiogenesis.

MicroRNAs (miRNAs) are short, non-coding RNAs involved in the regulation of several processes associated with inflammatory diseases and infection. Bacterial infection modulates miRNA expression to subvert innate immune response. In this study, we analyzed bacterial modulation of miRNAs in bone-marrow-derived macrophages (BMMs), in which activity was induced by infection with Porphyromonas gingivalis (Pg) through a microarray analysis. Several miRNA expressions levels were modulated 3 hours post infection (at a multiplicity of infection (MOI) of 25). A bioinformatics analysis was performed to further identify pathways related to the innate immune host-response pathways that are under the influence of the selected miRNAs. To assess the effects of the identified miRNAs on cytokines secretion (pro inflammatory TNF-α and anti-inflammatory IL-10), BMMs were transfected with selected miRNAs mimics or inhibitors. Transfection with mmu-miR-155 and mmu-miR- 2137 did not modify TNF-α secretion while their inhibitors increased it. Inhibitors of mmumiR-2137 and mmu-miR-7674 increased the secretion of the anti-inflammatory IL-10. In Pginfected BMMs, mmu-miR-155-5p significantly decreased TNF-α secretion while inhibitor of mmu-miR-2137 increased IL-10 secretion. In vivo, in a Pg-induced calvarial bone resorption mouse model, injection of mmu-miR-155-5p or anti-mmu-miR-2137 reduced the size of the lesion significantly. Furthermore, anti-mmu-miR-2137 significantly reduced inflammatorycell infiltration, osteoclast activity and bone loss. Bioinformatics analysis demonstrated that pathways related to cytokines and chemokines related pathways but also osteoclast differentiation may be involved in the observed effects. The study highlights the potential therapeutic merits of targeting mmu-miR-155-5p and mmu-miR-2137 to control inflammation induced by Pg infection. To assess the regenerative process in the same animal model, we aimed to compare the effect of Bone Morphogenic Protien 2 (BMP2), Platelets Rich Plasma (PRP), Leukocyte-Platelets Rich Fibrin (L-PRF), and Polygucosamine (PGIcNAc) on bone formation in critical size bone defects in mice. One-hundred-thirty-eight mice were divided into 23 groups (n=6), negative control, different combinations of the PGIcNAc with or without of BMP2, Collagen Sponge (SurgiFoam), PRP, and L-PRF. The 5mm defect, then, was allowed to heal. After six weeks, samples were analyzed for bone formation utilizing radiographs, H&E staining, alkaline phosphatase staining. Our results show that BMP2 were able to produce 90-95% healing of critical size defects after six weeks histologically and radiographically. However, SurgiFoam, PRP and L-PRF with or without PGIcNAc were able to close 60% of the original defect. This study supports that BMP2 is more effective for bone regeneration than SurgiFoam, PRP, L-PRF and PGIcNAc.

Vários estudos têm abordado fatores que governam a longevidade dos enxertos ósseos \"onlay\". Entretanto, poucas informações têm sido disponibilizadas sobre eventos moleculares que ocorrem ao longo do tempo. Os enxertos de calota craniana têm sido reportados produzir respostas superiores em relação a outras regiões doadoras nas reconstruções maxilo-faciais, mas sem a devida comprovação científica. Este estudo tem por objetivos (1) estudar o padrão morfológico de enxertos ósseos \"onlay\" de calota craniana e compará-los com os eventos biológicos através de respostas imunoistoquímicas e (2) estabelecer os efeitos das perfurações no leito receptor sobre a manutenção do volume e densidade óssea. Sessenta coelhos do tipo New-Zealand White foram submetidos à enxertia óssea \"onlay\" de calota craniana na mandíbula. Em trinta coelhos o leito receptor foi perfurado (grupo perfurado) enquanto nos demais o leito foi mantido intacto (grupo não perfurado). Seis animais de cada grupo foram sacrificados aos 5, 7, 10, 20 e 60 dias após a cirurgia. Cortes histológicos foram preparados da região enxertada para análises imunoistoquímica e histológica. Na avaliação imunoistoquímica se observou marcações das proteínas Osteoprotegerina (OPG), \"Receptor Activator of Nuclear Factor-ß ligand\" (RANKL), Fosfatase Alcalina (ALP), Osteopontina (OPN), \"Vascular Endothelial Growth Factor\" (VEGF), \"Tartrate-Resistant Acid Phosphatase\" (TRAP), Colágeno do tipo I (COL I) e Osteocalcina (OC). O exame tomográfico foi realizado após a cirurgia e no sacrifício dos animais. Os achados histológicos revelaram que as perfurações contribuíram para uma maior deposição óssea nos períodos iniciais na interface entre o enxerto e o leito receptor, acelerando o processo de incorporação. Os resultados tomográficos mostraram menor reabsorção para o grupo perfurado (P≤0,05) e ambos os grupos mostraram altas taxas de densidade óssea aos 60 dias. Estas evidências são corroboradas pelos resultados imunoistoquímicos que mostraram maior marcação de proteínas ligadas a revascularização e osteogênese (VEGF, OPN, TRAP e ALP) no grupo perfurado. Esses achados indicam que o volume ósseo de enxertos da calota craniana é mais bem conservado quando o leito receptor é perfurado, provavelmente em razão de uma mais efetiva revascularização do enxerto e maior deposição óssea. / Several studies have discussed factors that govern the longevity of onlay bone grafts. However, little information has been made available on molecular events that occur over time. Cranial bone grafts have been reported to produce greater responses compared to other donor regions in maxillofacial reconstructions, but necessary scientific verification was still lacking. The objectives of this study are (1) to study the morphological pattern of cranial onlay bone grafts and compare them to the biological events through immunohistochemical responses, and (2) to establish the effects of perforations on maintaining the volume and bone density of the receptor bed. Sixty New Zealand White rabbits were submitted to cranial onlay bone grafts of the mandible. In thirty rabbits, the receptor bed was perforated (perforated group), while for the remaining specimens the bed was kept intact (non-perforated group). Six animals from each group were culled at 5, 7, 10, 20 and 60 days after surgery. Histological cuts from the grafted area were prepared for immunohistochemical and histological analyses. During the immunohistochemical evaluation, markers were found for proteins Osteoprotegerin (OPG), Receptor Activator of Nuclear Factor-ß ligand (RANKL), Alkaline Phosphatase (ALP), Osteopontin (OPN), Vascular Endothelial Growth Factor (VEGF), Tartrate-Resistant Acid Phosphatase (TRAP), Type I Collagen (COL I) and Osteocalcin (OC). The tomography examination (CT scan) was conducted after surgery and at culling. The histological findings revealed that the perforations contributed to higher bone deposition during the initial stages at the graft-receptor bed interface, accelerating the incorporation process. The results of the CT scan showed lower resorption for the perforated group (P≤0.05), and both groups showed high bone density rates at 60 days. This set of evidence is corroborated by the immunohistochemical results, which showed more markers of proteins associated with revascularization and osteogenesis (VEGF, OPN, TRAP and ALP) in the perforated group. These findings indicate that the bone volume of cranial dome grafts is better maintained when the receptor bed is perforated, probably resulting from more effective graft revascularization and greater bone deposition.

Vários estudos têm abordado fatores que governam a longevidade dos enxertos ósseos \"onlay\". Entretanto, poucas informações têm sido disponibilizadas sobre eventos moleculares que ocorrem ao longo do tempo. Os enxertos de calota craniana têm sido reportados produzir respostas superiores em relação a outras regiões doadoras nas reconstruções maxilo-faciais, mas sem a devida comprovação científica. Este estudo tem por objetivos (1) estudar o padrão morfológico de enxertos ósseos \"onlay\" de calota craniana e compará-los com os eventos biológicos através de respostas imunoistoquímicas e (2) estabelecer os efeitos das perfurações no leito receptor sobre a manutenção do volume e densidade óssea. Sessenta coelhos do tipo New-Zealand White foram submetidos à enxertia óssea \"onlay\" de calota craniana na mandíbula. Em trinta coelhos o leito receptor foi perfurado (grupo perfurado) enquanto nos demais o leito foi mantido intacto (grupo não perfurado). Seis animais de cada grupo foram sacrificados aos 5, 7, 10, 20 e 60 dias após a cirurgia. Cortes histológicos foram preparados da região enxertada para análises imunoistoquímica e histológica. Na avaliação imunoistoquímica se observou marcações das proteínas Osteoprotegerina (OPG), \"Receptor Activator of Nuclear Factor-ß ligand\" (RANKL), Fosfatase Alcalina (ALP), Osteopontina (OPN), \"Vascular Endothelial Growth Factor\" (VEGF), \"Tartrate-Resistant Acid Phosphatase\" (TRAP), Colágeno do tipo I (COL I) e Osteocalcina (OC). O exame tomográfico foi realizado após a cirurgia e no sacrifício dos animais. Os achados histológicos revelaram que as perfurações contribuíram para uma maior deposição óssea nos períodos iniciais na interface entre o enxerto e o leito receptor, acelerando o processo de incorporação. Os resultados tomográficos mostraram menor reabsorção para o grupo perfurado (P≤0,05) e ambos os grupos mostraram altas taxas de densidade óssea aos 60 dias. Estas evidências são corroboradas pelos resultados imunoistoquímicos que mostraram maior marcação de proteínas ligadas a revascularização e osteogênese (VEGF, OPN, TRAP e ALP) no grupo perfurado. Esses achados indicam que o volume ósseo de enxertos da calota craniana é mais bem conservado quando o leito receptor é perfurado, provavelmente em razão de uma mais efetiva revascularização do enxerto e maior deposição óssea. / Several studies have discussed factors that govern the longevity of onlay bone grafts. However, little information has been made available on molecular events that occur over time. Cranial bone grafts have been reported to produce greater responses compared to other donor regions in maxillofacial reconstructions, but necessary scientific verification was still lacking. The objectives of this study are (1) to study the morphological pattern of cranial onlay bone grafts and compare them to the biological events through immunohistochemical responses, and (2) to establish the effects of perforations on maintaining the volume and bone density of the receptor bed. Sixty New Zealand White rabbits were submitted to cranial onlay bone grafts of the mandible. In thirty rabbits, the receptor bed was perforated (perforated group), while for the remaining specimens the bed was kept intact (non-perforated group). Six animals from each group were culled at 5, 7, 10, 20 and 60 days after surgery. Histological cuts from the grafted area were prepared for immunohistochemical and histological analyses. During the immunohistochemical evaluation, markers were found for proteins Osteoprotegerin (OPG), Receptor Activator of Nuclear Factor-ß ligand (RANKL), Alkaline Phosphatase (ALP), Osteopontin (OPN), Vascular Endothelial Growth Factor (VEGF), Tartrate-Resistant Acid Phosphatase (TRAP), Type I Collagen (COL I) and Osteocalcin (OC). The tomography examination (CT scan) was conducted after surgery and at culling. The histological findings revealed that the perforations contributed to higher bone deposition during the initial stages at the graft-receptor bed interface, accelerating the incorporation process. The results of the CT scan showed lower resorption for the perforated group (P≤0.05), and both groups showed high bone density rates at 60 days. This set of evidence is corroborated by the immunohistochemical results, which showed more markers of proteins associated with revascularization and osteogenesis (VEGF, OPN, TRAP and ALP) in the perforated group. These findings indicate that the bone volume of cranial dome grafts is better maintained when the receptor bed is perforated, probably resulting from more effective graft revascularization and greater bone deposition.