The relatively new and still growing field of 3D-printing has opened up the possibilities to manufacture patient-specific medical devices with high geometrical accuracy in a precise and quick manner. Additionally, biocompatible materials are a demand for all medical applications while biodegradability is of importance when developing scaffolds for tissue growth for instance. With respect to this, this project consisted of developing biocompatible and bioresorbable polymer blend and composite filaments, for fused deposition modeling (FDM) printing. Poly(lactic acid) (PLA) and polycaprolactone (PCL) were used as supporting polymer matrix while hydroxyapatite (HA), a calcium phosphate with similar chemical composition to the mineral phase of human bone, was added to the composites to enhance the biological activity. PLA and PCL content was varied between 90–70 wt% and 10-30 wt%, respectively, while the HA content was 15 wt% in all composites. All materials were characterized in terms of mechanical properties, thermal stability, chemical composition and morphology. An accelerated degradation study of the materials was also executed in order to investigate the degradation behavior as well as the impact of the degradation on the above mentioned properties. The results showed that all processed materials exhibited higher mechanical properties compared to the human trabecular bone, even after degradation with a mass loss of around 30% for the polymer blends and 60% for the composites. It was also apparent that the mineral accelerated the polymer degradation significantly, which can be advantageous for injuries with faster healing time, requiring only support for a shorter time period.

People suffering from certain types of arrhythmia may benefit from the implantation of a cardiac pacemaker. Pacemakers artificially stimulate the heart by applying short electrical pulses to the cardiac tissue to restore and maintain a steady heart rhythm. By adjusting the pulse delivery rate the heart is stimulated to beat at desired pace. The stimulation pulses are transferred from the pacemaker to the heart via an electrode, which is implanted into the cardiac tissue. Additionally, the electrode must also sense the cardiac response and transfer those signals back to the electronics in the pacemaker for processing. The communication between the electrode and the tissue takes place on the electrode/electrolyte (tissue) interface. This interface serves as the contact point where the electronic current in the electrode is converted to ionic currents capable to operate in the body. The stimulation/sensing signals are transferred across the interface via three electrochemical mechanisms: i) non-faradaic charging/discharging of the electrochemical double layer, ii) reversible and iii) irreversible faradaic reactions. It is necessary to study the contribution of each mechanism to the total charge transferred to evaluate the pacing/sensing performance of the pacemaker electrode. In this thesis, the electrochemical properties and performance of stimulation/sensing electrodes for pacemaker applications have been investigated by electrochemical impedance spectroscopy, cyclic voltammetry and transient electrochemical techniques. All measurements were performed in synthetic body fluid with buffer capacity. Complementary surface analysis was performed with scanning electron microscopy, energy dispersive spectroscopy and X-ray photoelectron spectroscopy. The results reveal different interfacial behaviour and stability for electrode materials such as Pt, TiN, porous carbon, conducting oxides (RuO2 and IrO2 and mixed oxides) and porous Nb2O5 oxide. The influence of the charge/discharge rate on the electrode characteristics also has been evaluated. Although the rough and porous electrodes provide a high interfacial capacitance, the maximum capacitance cannot be fully employed at high charge/discharge rates because only a small part of the effective surface area is accessible. The benefit of pseudo-capacitive material properties on charge delivery was observed. However, these materials suffer similar limitations at high charge/discharge rate and, hence, are only utilising the surface bound pseudo-capacitive sites. Porous Nb2O5 electrodes were investigated to study the performance of capacitor electrodes. These electrodes predominantly deliver the charge via reversible non-faradaic mechanisms and hence do not produce irreversible by-products. They can deliver very high potential pulses while maintaining high impedance and, thus, charge lost by faradaic currents are kept low. By producing Nb oxide by plasma electrolysis oxidation a porous surface structure is obtained which has the potential to provide a biocompatible interface for cell adherence and growth. This thesis covers a multidisciplinary area. In an attempt to connect diverse fields, such as electrophysiology, materials science and electrochemistry, the first chapters have been attributed to explaining fundamental aspects of the respective fields. This thesis also reviews the current opinion of pacing and sensing theory, with special focus on some areas where detailed explanation is needed for the fundamental nature of electrostimulation/sensing. / QC 20101014

The extracellular matrix is (ECM) is a network of large, structural proteins and polysaccharides, important for cellular behavior, tissue development and maintenance. Present thesis describes work exploring ECM as scaffolds for tissue engineering by manipulating cells cultured in vitro or by influencing ECM expression in vivo. By culturing cells on polymer meshes under dynamic culture conditions, deposition of a complex ECM could be achieved, but with low yields. Since the major part of synthesized ECM diffused into the medium the rate limiting step of deposition was investigated. This quantitative analysis showed that the real rate limiting factor is the low proportion of new proteins which are deposited as functional ECM. It is suggested that cells are pre-embedded in for example collagen gels to increase the steric retention and hence functional deposition. The possibility to induce endogenous ECM formation and tissue regeneration by implantation of growth factors in a carrier material was investigated. Bone morphogenetic protein-2 (BMP-2) is a growth factor known to be involved in growth and differentiation of bone and cartilage tissue. The BMP-2 processing and secretion was examined in two cell systems representing endochondral (chondrocytes) and intramembranous (mesenchymal stem cells) bone formation. It was discovered that chondrocytes are more efficient in producing BMP-2 compared to MSC. The role of the antagonist noggin was also investigated and was found to affect the stability of BMP-2 and modulate its effect. Finally, an injectable gel of the ECM component hyaluronan has been evaluated as delivery vehicle in cartilage regeneration. The hyaluronan hydrogel system showed promising results as a versatile biomaterial for cartilage regeneration, could easily be placed intraarticulary and can be used for both cell based and cell free therapies.

Indiana University-Purdue University Indianapolis (IUPUI) / Hydrogels prepared from photopolymerization have been used for a variety of tissue engineering and controlled release applications. Polymeric biomaterials with high cytocompatibility, versatile degradation behaviors, and diverse material properties are particularly useful in studying cell fate processes. In recent years, step-growth thiol-ene photochemistry has been utilized to form cytocompatible hydrogels for tissue engineering applications. This radical-mediated gelation scheme utilizes norbornene functionalized multi-arm poly(ethylene glycol) (PEGNB) as the macromer and di-thiol containing molecules as the crosslinkers to form chemically crosslinked hydrogels. While the gelation mechanism was well-described in the literature, the network properties and degradation behaviors of these hydrogels have not been fully characterized. In addition, existing thiol-ene photopolymerizations often used type I photoinitiators in conjunction with an ultraviolet (UV) light source to initiate gelation. The use of cleavage type initiators and UV light often raises biosafety concerns. The first objective of this thesis was to understand the gelation and degradation properties of thiol-ene hydrogels. In this regard, two types of step-growth hydrogels were compared, namely thiol-ene hydrogels and Michael-type addition hydrogels. Between these two step-growth gel systems, it was found that thiol-ene click reactions formed hydrogels with higher crosslinking efficiency. However, thiol-ene hydrogels still contained significant network non-ideality, demonstrated by a high dependency of hydrogel swelling on macromer contents. In addition, the presence of ester bonds within the PEGNB macromer rendered thiol-ene hydrogels hydrolytically degradable. Through validating model predictions with experimental results, it was found that the hydrolytic degradation of thiol-ene hydrogels was not only governed by ester bond hydrolysis, but also affected by the degree of network crosslinking. In an attempt to manipulate network crosslinking and degradation rate of thiol-ene hydrogels, different macromer contents and peptide crosslinkers with different amino acid sequences were used. A chymotrypsin-sensitive peptide was also used as part of the hydrogel crosslinkers to render thiol-ene hydrogels enzymatically degradable. The second objective of this thesis was to develop a visible light-mediated thiol-ene hydrogelation scheme using a type II photoinitiator, eosin-Y, as the only photoinitiator. This approach eliminates the incorporation of potentially cytotoxic co-initiator and co-monomer that are typically used with a type II initiator. In addition to investigating the gelation kinetics and properties of thiol-ene hydrogels formed by this new gelation scheme, it was found that the visible light-mediated thiol-ene hydrogels were highly cytocompatible for human mesenchymal stem cells (hMSCs) and pancreatic MIN6 beta-cells. It was also found that eosin-Y could be repeatedly excited for preparing step-growth hydrogels with multilayer structures. This new gelation chemistry may have great utilities in controlled release of multiple sensitive growth factors and encapsulation of multiple cell types for tissue regeneration.

Indiana University-Purdue University Indianapolis (IUPUI) / Dicalcium phosphate dihydrate (DCPD) cements have been used for bone repair due to its excellent biocompatibility and resorbability. However, DCPD cements are typically weak and brittle. To overcome these limitations, the sodium citrate used as a setting regulator and the coating of poly-L-lactide acid (PLLA) technique have been proposed in this study. The first purpose of this thesis is to develop composite PLLA/DCPD scaffolds with enhanced toughness by PLLA coating. The second purpose is to examine the biocompatibility of the scaffolds. The final purpose is to investigate the degradation behaviors of DCPD and PLLA/DCPD scaffolds. In this experiment, DCPD cements were synthesized from monocalcium phosphate monohydrate (MCPM) and 𝛽-tricalcium phosphate (𝛽 –TCP) by using deionized water and sodium citrate as liquid components. The samples were prepared with powder to liquid ratio (P/L) at 1.00, 1.25 and 1.50. To fabricate the PLLA/DCPD composite samples, DCPD samples were coated with 5 % PLLA. The samples were characterized mechanical properties, such as porosity, diametral tensile strength, and fracture energy. The mechanical properties of DCPD scaffolds with and without PLLA coating after the in vitro static degradation (day 1, week1, 4, and 6) and in vitro dynamic degradation (day 1, week 1, 2, 4, 6, and 8) were investigated by measuring their weight loss, fracture energy, and pH of phosphate buffer solution. In addition, the dog bone marrow stromal stem cells (dBMSCs) adhesion on DCPD and PLLA/DCPD composite samples were examined by scanning electron microscopy. The cell proliferation and differentiation in the medium conditioned with DCPD and PLLA/DCPD composite samples were studied by XTT (2,3-Bis(2-methoxy-4- nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide inner salt), and alkaline phosphatase (ALP) assay, respectively. The addition of sodium citrate and PLLA coating played a crucial role in improving the mechanical properties of the samples by increasing the diametral tensile strength from 0.50 ± 0.15 MPa to 2.70 ± 0.54 MPa and increasing the fracture energy from 0.76 ± 0.18 N-mm to 12.67 ± 4.97 N-mm. The DCPD and PLLA/DCPD composite samples were compatible with dBMSCs and the cells were able to proliferate and differentiate in the conditioned medium. The degradation rate of DCPD and PLLA/DCPD samples were not significant different (p > 0.05). However, the DCPD and PLLA/DCPD composite samples those used sodium citrate as a liquid component was found to degrade faster than the groups that use deionized water as liquid component

Recombinant human bone morphogenic proteins (rhBMPs) are extensively studied and employed clinically for treatment of various bone defects. Current clinical delivery vehicles suffer wasteful burst releases that mandate supra-physiological dosing driving concerns over safety and cost. It was therefore investigated whether a unique drug delivery vehicle sequestered within a composite scaffold could lower the burst release of rhBMP-2. PLGA-calcium phosphate tri-phasic composite scaffolds delivered model protein BSA with burst release of ~13% and sustained kinetics of 0.5-1.5% BSA/day up to 45 days. rhBMP-2 was delivered with zero burst release however at much lower levels, totaling 0.09% to 0.9 % release over 10 days, but had up to 6.3-fold greater bioactivity than fresh rhBMP-2 (p<0.05). In conclusion, the three-phase composite scaffold can deliver bioactive proteins with a reduced burst release and sustained secondary kinetics.

Recombinant human bone morphogenic proteins (rhBMPs) are extensively studied and employed clinically for treatment of various bone defects. Current clinical delivery vehicles suffer wasteful burst releases that mandate supra-physiological dosing driving concerns over safety and cost. It was therefore investigated whether a unique drug delivery vehicle sequestered within a composite scaffold could lower the burst release of rhBMP-2. PLGA-calcium phosphate tri-phasic composite scaffolds delivered model protein BSA with burst release of ~13% and sustained kinetics of 0.5-1.5% BSA/day up to 45 days. rhBMP-2 was delivered with zero burst release however at much lower levels, totaling 0.09% to 0.9 % release over 10 days, but had up to 6.3-fold greater bioactivity than fresh rhBMP-2 (p<0.05). In conclusion, the three-phase composite scaffold can deliver bioactive proteins with a reduced burst release and sustained secondary kinetics.