This study was aimed at designing a cell carrier from an intelligent polymer to achieve loading of mechanical stress for the purpose of improving the tissue engineering capability in vitro. Ethyleneglycoldimethacrylate (EGDMA) crosslinked poly(Nisopropylacrylamide) (pNIPAM) films were prepared by radical polymerization with ultraviolet light (UV) in the presence of photoinitiator 2,2&#039 / -azoisobutyronitrile (AIBN) in isopropanol/water (1:1). Patterns were formed on the surface of the polymers by using silicon wafers with microridges (2 &amp / #956 / m) and grooves (10 &amp / #956 / m) that were prepared by photolithography technique as the template. The surfaces of the films were also modified by adsorption of ELP-RGD6 polypeptide. Bone marrow stem cells (BMSCs) isolated from 6 week old Sprague-Dawley rats were seeded onto the pNIPAM films with different surface topography and chemistry and cultured under static and dynamic conditions. Dynamic conditions were generated by cyclic temperature changes (15 min at 29&deg / C, 30 min at 37&deg / C) for 10 times a day during 5 days starting on the second day post-cell seeding. ELP-RGD6 on the films enhanced initial cell attachment but had no effect on proliferation in long term culturing. However, for the dynamic culturing, ELP was crucial for both retaining cells attached on the surface when the surface became hydrophilic and resulted in weakened cell attachment, and for better communication between cell and material which enhanced the ability of pNIPAM films to transfer mechanical stress on the cells. Dynamic conditions improved cell proliferation but decreased differentiation. Presence of the patterns also influenced the differentiation but did not affected proliferation.

During last decade, polyurethanes (PUs) which are able to degrade into harmless molecules upon implantation have received a significant level of attention as a biomaterial in tissue engineering applications. Many studies are focused especially on development of PUs based on amino acid derivatives / however, there are only few applications of amino acid based PUs in tissue engineering. In this study, a biocompatible and biodegradable thermoplastic poly(ester-urethane) (PEU) based on L-lysine diisocyanate (LDI) and polycaprolactone diol (PCL) was synthesized and used for the preparation of two dimensional (2D) films and three dimensional (3D) scaffolds. The resulting polymer was casted as 2D films for full characterization purpose and it was found that it is highly elastic with modulus of elasticity ~12 MPa. Surfaces of 2Ds were modified via micropatterning and fibrinogen coating to check the material-cell interaction. The 3D scaffolds were obtained by salt leaching and rapid prototyping (bioplotting) techniques. The 3D scaffolds had various pore size and porosity with different mechanical strength. The bioplotted scaffolds had uniform pore size of ~450 &micro / m and exhibited higher compressive modulus (~4.7 MPa) compared to those obtained by salt leaching (~147 kPa). Salt leached 3D scaffolds had inhomogenous pore size distribution in the range of 5 &micro / m - 350 &micro / m and demonstrated greatest degradation profile compared to 2D films and 3D bioplotted samples under enzymatic condition. Rat bone marrow stem cells (BMSCs) were used to investigate the biocompatibility of the polymer and suitability of fabricated scaffolds for osteogenesis. Presence of micropatterns on 2D matrices did not show any influence on osteoblastic function, but presence of fibrinogen enhanced cell attachment and proliferation. All of the fabricated 3D PEU matrices supported proliferation, osteoblastic differentiation and extracellular matrix (ECM) deposition with highest osteoblastic activity on bioplotted scaffolds which confirmed by von Kossa staining and EDX analysis. The results indicated that the synthesized PEU based scaffolds were able to induce osteoblastic differentiation and mineralization of BMSC and therefore these scaffolds can be good candidates to be used in bone tissue engineering

Large bone defects pose a significant clinical challenge currently lacking an adequate therapeutic solution. Bone tissue engineering (BTE) therapies aim to provide that solution by combining structural scaffolds, bioactive factors, and/or osteogenic cells. Cellular therapies are likely vital to repair severe defects in patients lacking sufficient endogenous cells. Stem cells are attractive cell choices due to their osteogenic differentiation and extensive proliferation abilities, but their therapeutic potential is still uncertain, as studies comparing stem cell sources and delivery methods have produced inconsistent results. In this thesis, we developed a challenging in vivo large bone defect model for quantitative comparison of human stem cell-based therapies and then evaluated the abilities of adult or fetal stem cell-seeded constructs to enhance defect repair, with or without added osteogenic cues. First, we showed that cellular construct treatment enhanced defect healing over acellular construct treatment, although there were no differences between adult or fetal cell sources. We next labeled stem cells with a fluorescent tracking agent, the quantum dot, to determine biodistribution of implanted cells during the repair process. While quantum dots effectively labeled cells in vitro, they were ineffective in vivo tracking agents due to false positive signals and detrimental effects on stem cell-mediated repair. Finally, we developed a novel gene therapy technique using virus-coated scaffolds to deliver the osteogenic factor bone morphogenetic protein 2 (BMP2) to defect sites, either by in vitro (BMP2 transduction of seeded stem cells pre-implantation) or in vivo (BMP2 transduction of defect-site host cells) means. While defect-site BMP2 delivery through gene therapy methods improved repair, in vivo therapy enhanced healing more than stem cell-based in vitro therapy. This finding does not rule out the potential of stem cell-based in vitro gene therapy treatment for functional bone repair, as increases in viral dose may improve stem cell-mediated healing, but it does present evidence of a novel acellular BTE therapy with potential off-the-shelf clinical application in large bone defect repair, as scaffolds could be virally coated with the gene for BMP2 expression and frozen until implantation.

This work examines the osteogenic potential and immune-privileged properties of human umbilical cord perivascular cells (HUCPVCs) in normal Wistar rats and athymic rnu/rnu rats for up to 60 days. HUCPVCs demonstrated a mesenchymal stromal cell phenotype, assayed through flow cytometry, and RT-PCR analysis detected their expression of osteogenic genes. A bone tissue engineering construct was developed through centrifugal seeding of HUCPVCs onto calcium phosphate-coated PLGA scaffolds. These cell-scaffold constructs were transplanted into bilateral femoral defects. HUCPVCs did not induce any systemic biological response in normal rats; however, they did not engraft and impaired bone healing up to 60 days. When transplanted into athymic rats, HUCPVCs were detected up to 30 days in the femoral defects, improved bone regeneration at 15 and 30 days, as measured by micro computed tomography, and expressed osteogenic proteins. These findings demonstrate that HUCPVCs are suitable for bone tissue engineering studies in larger animals.

This work examines the osteogenic potential and immune-privileged properties of human umbilical cord perivascular cells (HUCPVCs) in normal Wistar rats and athymic rnu/rnu rats for up to 60 days. HUCPVCs demonstrated a mesenchymal stromal cell phenotype, assayed through flow cytometry, and RT-PCR analysis detected their expression of osteogenic genes. A bone tissue engineering construct was developed through centrifugal seeding of HUCPVCs onto calcium phosphate-coated PLGA scaffolds. These cell-scaffold constructs were transplanted into bilateral femoral defects. HUCPVCs did not induce any systemic biological response in normal rats; however, they did not engraft and impaired bone healing up to 60 days. When transplanted into athymic rats, HUCPVCs were detected up to 30 days in the femoral defects, improved bone regeneration at 15 and 30 days, as measured by micro computed tomography, and expressed osteogenic proteins. These findings demonstrate that HUCPVCs are suitable for bone tissue engineering studies in larger animals.

This study aimed at guiding osteoblast cells on biodegradable polymer carriers with well-defined surface microtopography and chemistry, and investigating the effect of cell alignment on osteoblast phenotype expression. A blend of two different polyesters, one being natural in origin (PHBV) and the other synthetic (P(L/DL)LA), was used to form a film with parallel macro- (250 &micro / m wide) or microgrooves (27 &micro / m wide) on its surface, by solvent casting on patterned templates. The micropatterned Si template was produced by photolithography, while the Teflo macropatterned template was lathe cut. Fibrinogen (Fb) was adsorbed or immobilized via epichlorohydrin spacer/crosslinker on the film surfaces to enhance cell attachment by increasing the surface hydrophilicity and by providing RGD amino acid sequence for integrin binding. Surface hydrophilicity was assessed by water contact angle measurements. Adsorption of Fb caused an increase in hydrophilicity, while the opposite was achieved with its covalent immobilization. Fb was homogeneously immobilized throughout the whole micropatterned film surface with amount of 153.1 &plusmn / 42.4 g Fb/cm2, determined with the Bradford assay, while it was adsorbed within the grooves of the micropattern. Surface characteristics of the films were studied with Scanning Electron (SEM) and Light microscopy. Osteoblast cells derived from rat bone marrow were seeded on the polymeric films with different surface topography and chemistry and were grown for one and three weeks. Osteoblast proliferation on the films was determined with Cell Titer 96 TM Non-Radioactive Cell Proliferation (MTS) test. Alkaline Phosphatase (ALP) assay and tetracycline labelling of mineralized matrix were carried out to determine osteoblast phenotype expression on different surfaces. SEM and fluorescence microscopy were used to evaluate the cell alignment. Osteoblasts on the micropatterned films with adsorbed Fb aligned along the groove axis with a mean deviation angle of 13.1o, while on the unpatterned films deviation from horizontal axis was 63.2o and cells were randomly distributed. Cell alignment did not affect cell proliferation. However, the highest ALP specific activity and the most homogeneous mineral distribution were obtained on the Fb adsorbed micropatterned films.

Various members of the insulin-like growth factor (IGF) family of growth factors are highly expressed in bone tissue and are vitally important for the normal development and function of bone. Recent studies have shown that IGF-I can associate with the extra-cellular matrix proteins vitronectin (VN) and fibronectin (FN) via IGF binding protein-5 (IGFBP-5). Furthermore, when these complexes are pre-bound to a tissue culture surface they can stimulate enhanced responses in epithelial cell types in vitro. More recently, transforming growth factor-beta 1 (TGF-β1), epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) have also been shown to interact with VN and to elicit functional responses in various cell types. Taken together, these findings indicate that exploitation of the adhesive properties of these ECM proteins might allow immobilisation of various growth factors at the culture surface. This may provide a novel means of coating engineered biomaterial constructs with agents which can elicit specific functional effects in therapeutically important cells, such as those used in cell-based therapeutics for the replacement and / or regeneration of damaged bone tissue. Since both VN and FN are also important matrix components of bone, this study sought to investigate the hypothesis that select pre-bound combinations of these matrix proteins and growth factors could also stimulate functional responses in bone cells and the therapeutically important so called mesenchymal stem cells. Thus it is reported here that pre-bound combinations of VN, IGFBP-5 and IGF-I or FN IGFBP-5 and IGF-I significantly stimulate cell migration in the osteoblast-like SaOS-2 cells. While, VN, IGFBP-5 and IGF-I stimulated cell proliferation over 72 hr, FN, IGFBP-5 and IGF-I did not. Moreover, I found that VN, IGFBP-5 and IGF-I could facilitate alkaline phosphatase (ALP) expression in SaOS-2 cells. VN, FN and EGF on the other hand could sustain SaOS-2 cells for up to 12 days in culture, but could not sustain ALP expression; hence it is possible that these cells may have entered a state of quiescence in response to this treatment. Extending these studies to cells derived from clinical samples, pre-bound combinations of VN / IGFBP-5 / IGF-I were not able to support initiation of human mesenchymal stem cell (hMSC) cultures. Nevertheless, VN alone in serum free media stimulated substantial metabolic activity and protein synthesis in hMSCs once the cultures were established. Moreover, the addition of IGFBP-3 or -5 together with IGF-I can enhance the response to levels equivalent to that observed with 10% FCS. I also report that the responses to VN and TGF-β1 are synergistic and stimulate greater hMSC metabolic activity than 10% FCS. Interestingly, hMSCs cultured in IGF-I or TGF-β1 and low concentrations of VN aggregated, an effect that was not observed when higher concentrations of VN were used. I hypothesise that this aggregation effect was due to endogenous protease activity, and therefore examined MMP-2 and 9 activity in hMSC conditioned media. Both pro-MMP-2 and pro-MMP-9 were constitutively expressed by hMSCs but there was no evidence of the active forms in the conditioned media, indicating that neither IGF-I nor TGF-β1 affect MMP-2 or -9 expression or activation in serum-free media. However, hMSC conditioned media could degrade IGFBP-5, suggesting that there is proteolytic activity within the conditioned media which may impact on the function of ECM / growth factor components in serum-free media settings. Thus, while ECM and growth factors may stimulate desirable responses in therapeutically important cells in serum-free culture, the role that endogenously expressed proteases have on the efficacy of such media supplements needs to be examined closely. Taken together, the studies reported in this thesis provide proof of principle data indicating that select combinations of ECM proteins and growth factors could be utilised in bone tissue engineering applications. This may be achieved for example, as a biomaterial coating, or could form the basis of a viable alternative media supplement for the serum-free culture of hMSCs.

En chirurgie reconstructive osseuse les biomatériaux remplacent le tissu osseux manquant et dans le cas de pathologies ils peuvent également délivrer des molécules actives. L’élément semi-métallique, gallium (Ga), est utilisé dans le traitement de différentes pathologies liées à la résorption accélérée de l’os dû à son effet inhibiteur sur les ostéoclastes (cellules résorbantes de l’os). Le Ga peut être incorporé dans la structure des biomatériaux osseux et nous nous sommes intéressés aux propriétés biologiques de ces derniers. In vitro, en présence de Ga nous avons mis en évidence une diminution de la différentiation des ostéoclastes, ainsi qu’une sur-expression de plusieurs marqueurs des ostéoblastes (cellules formatrices d’os). In vivo, le modèle murin de comblement du défaut osseux a montré une augmentation de la quantité de tissu osseux néoformé avec un biomatériau chargé en Ga vs. contrôle. Ces données démontrent que les biomatériaux chargés en Ga sont compatibles avec la survie et la prolifération des cellules osseuses et que le Ga peut améliorer la reconstruction osseuse. D’autre part, étant donné que des effets anti-tumoraux du Ga sont largement décrits, nous avons étudié ces effets sur une lignée cellulaire cancéreuse, choisie pour son affinité pour le tissu osseux. Nous avons montré que le Ga réduit la prolifération et probablement le potentiel tumoral de cette lignée, mais aussi la différentiation ostéoclastique induite par les cellules cancéreuses. Ces effets inhibiteurs observés dans un contexte tumoral indiquent que le Ga est un candidat intéressant pour le couplage avec des biomatériaux destinés au comblement osseux après une résection tumorale. / In bone reconstructive surgery biomaterials commonly replace the missing tissue and in case of pathologies can also serve as vectors for drug delivery. The semi-metallic element gallium (Ga) is used for the treatment of several disorders associated with accelerated bone resorption, due to its inhibitory action on bone-resorbing cells (osteoclasts). Since Ga can be incorporated into the structure of bone biomaterials, we embarked on characterising the biological properties of novel Ga-loaded materials. In vitro, we observed a decrease in osteoclast differentiation and the upregulated expression of several osteoblastic markers (bone-forming cells) in the presence of Ga-loaded biomaterial. In vivo, using a rat bone defect model, we showed an increase in newly formed bone tissue in implants filled with Ga-loaded biomaterial vs. control. Taken together, our data indicate that Ga-loaded biomaterials provide biocompatible substrates allowing bone cells survival and improved bone reconstruction in vivo. Taking into account antitumoral effects of Ga, largely described in literature, we also investigated its impact on a bone metastatic model. Using an aggressive human cancer cell line selected for its ability to invade bone tissue, we showed that Ga could reduce cancer cell proliferation and viability and reverse excessive osteoclastogenesis in bone metastatic environment. Moreover, we demonstrated that Ga modulated the expression of several marker genes hindering the tumour-propagating potential of cancer cells. Thus, due to its inhibitory action on cancer cells, Ga could represent an attractive additive to biomaterials used for tissue reconstruction after tumour resection.

Fabrication of scaffold is the key for bone tissue engineering, which is commonly regarded as the most potential route for repairing bone defects. Previously, porous ceramic scaffolds were fabricated through a variety of traditional methods, like moulding and casting, but most of them cannot produce customised tissue-engineered scaffolds. Therefore, 3D printing methods are gaining more attention and are currently being explored and developed to make scaffolds with acceptable biocompatibility. With the considerable development of bone tissue engineering, the bioactivity of scaffolds is becoming increasingly demanded, which leads to new methods and techniques to produce highly biomimetic bone scaffolds. In this study, a new fabrication process to optimise the structures of scaffolds was developed, and intensive researches were performed on the porous scaffolds to confirm their advantages in biological performance. Specifically, by combination of motor assisted extrusion deposition and gas-foaming (graphite as the porogen) technique, hierarchically porous scaffolds with improved microstructures, i.e. multi-scaled pores from nanometre to millimetre (nm-μm-mm), was successfully developed. In this thesis, the optimal content of porogen for scaffolds was studied in terms of compressive strength and in-rod porosities. The most concerned physicochemical properties of scaffolds were carefully examined and the results revealed that such scaffolds exhibit excellent physicochemical properties owing to hierarchically porous structures. Due to additional in-rod micropores and increased specific surface area, along with better hydrophilicity, hierarchically porous scaffolds exerted complete superiority in biological activity, including promoting cellular proliferation of osteoblasts, adhesion and spreading status, as well as the ability to induce cellular differentiation.

Introduction: Bone defects and non-unions caused by trauma, tumor resection, pathological degeneration, or congenital deformity pose a great challenge in the field of orthopedics. Traditionally, these defects have been repaired by using autografts and allografts. Autografts have set the gold standard for clinical bone repair because of their osteoconductivity, osteoinductivity and osteogenicity. Nevertheless, the application of autografts is limited because of donor availability and donor site morbidity. Allografts have the advantage that the tissues are readily available and can be easily applied, especially when large segments of bone are to be reconstructed. However, their use is also limited by the risk of disease transfer and immune rejection. To circumvent these limitations tissue engineering has evolved as a means to develop viable bone grafts. An ideal bone graft should be both osteoconductive and osteoinductive, biomechanically strong, minimally antigenic, and eliminates donor site morbidity and quantity issues. The biodegradable polymer, Poly lactic-co-glycolic acid (PLAGA) was chosen because of its commercial availability, biocompatibility, non-immunogenicity, controlled degradation rate, and its ability to promote optimal cell growth. To improve the mechanical properties of PLAGA, Single Walled Carbon Nanotubes (SWCNT) were used as a reinforcing material to fabricate composite scaffolds. The overall goal of this project is to develop a Single Walled Carbon Nanotube composite (SWCNT/PLAGA) for bone regeneration and to examine the interaction of MC3T3-E1 cells (mouse fibroblasts) and hBMSCs (human bone marrow derived stem cells) with the SWCNT/PLAGA composite via focusing on extracellular matrix production and mineralization; and to evaluate its toxicity and bio-compatibility in-vivo in a rat subcutaneous implant model. We hypothesize that reinforcement of PLAGA with SWCNT to fabricate SWCNT/PLAGA composites increases both the mechanical strength of the composites as well as the cell proliferation rate on the surface of the composites while expressing osteoblasts phenotypic, differentiation and mineralization markers; and SWCNT/PLAGA composites are biocompatible and non-toxic, and are ideal candidates for bone tissue engineering. Methods: PLAGA and SWCNT/PLAGA composites were fabricated with various amounts of SWCNT (5, 10, 20, 40 and 100mg), characterized and degradation studies were performed. PLAGA (poly lactic-co-glycolic acid) and SWCNT/PLAGA microspheres and composites were fabricated; characterized and mechanical testing was performed. Cells were seeded and cell adhesion/morphology, growth/survival, proliferation and gene expression analysis were performed to evaluate biocompatibility. Sprague-Dawley rats were implanted subcutaneously with Sham, poly lactic-co-glycolic acid (PLAGA) and SWCNT/PLAGA composites, and sacrificed at 2, 4, 8 and 12 week post-implantation. The animals were observed for signs of morbidity, overt toxicity, weight gain, food consumption, hematological and urinalysis parameters, and histopathology. Results: Imaging studies demonstrated uniform incorporation of SWCNT into the PLAGA matrix and addition of SWCNT did not affect the degradation rate. Composites with 10mg SWCNT resulted in highest rate of cell proliferation (p<0.05) among all composites. Imaging studies demonstrated microspheres with uniform shape and smooth surfaces, and uniform incorporation of SWCNT into PLAGA matrix. The microspheres bonded in a random packing manner while maintaining spacing, thus resembling trabeculae of cancellous bone. Addition of 10mg SWCNT led to greater compressive modulus and ultimate compressive strength. Imaging studies revealed that MC3T3-E1 cells adhered, grew/survived, and exhibited normal, non-stressed morphology on the composites. SWCNT/PLAGA composites exhibited higher cell proliferation rate and gene expression compared to PLAGA. No mortality and clinical signs were observed. All the groups showed consistent weight gain and rate-of-gain for each group was similar. All the groups exhibited similar pattern for food consumption. No difference in urinalysis parameters, hematological parameters; and absolute and relative organ weight was observed. A mild to moderate summary toxicity (sumtox) score was observed for animals treated with the PLAGA and SWCNT/PLAGA whereas the sham animals did not show any response. At all the time intervals both PLAGA and SWCNT/PLAGA showed a significantly higher sumtox score compared to the Sham group. However, there was no significant difference between PLAGA and SWCNT/PLAGA groups. Conclusion: Our SWCNT/PLAGA composites, which possess high mechanical strength and mimic the microstructure of human trabecular bone, displayed tissue compatibility similar to PLAGA, a well known biocompatible polymer over the 12 week study. Thus, the results obtained demonstrate the potential of SWCNT/PLAGA composites for application in BTE and musculoskeletal regeneration. Future studies will be designed to evaluate the efficacy of SWCNT/PLAGA composites in bone regeneration in a non-union ulnar bone defect rabbit model. As interest in carbon nanotube technology increases, studies must be performed to fully evaluate these novel materials at a nonclinical level to assess their safety. The ability to produce composites capable of promoting bone growth will have a significant impact on tissue regeneration and will allow greater functional recovery in injured patients.