Tissue Eng Regen Med.  2022 Aug;19(4):839-852. 10.1007/s13770-022-00434-8.

Chitosan Scaffold Containing Periostin Enhances Sternum Bone Healing and Decreases Serum Level of TNF-a and IL-6 after Sternotomy in Rat

Affiliations
  • 1Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  • 2School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
  • 3Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
  • 4Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  • 5Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  • 6School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran

Abstract

BACKGROUND
In the aftermath of bone injuries, such as cranium and sternum, bone wax (BW) is used to control bleeding from the bone surfaces during surgery. Made up of artificial substances, however, it is associated with many complications such as inflammation, increased risk for infection, and bone repair delay. We, therefore, in this study set out to design and evaluate a novel BW without the above-mentioned side-effects reported for other therapies.
METHODS
The pastes (new BW(s)) were prepared in the laboratory and examined by MTT, MIC, MBC, and degradability tests. Then, 60 adult male Wistar rats, divided into six equal groups including chitosan (CT), CT-octacalcium phosphate (OCP), CT-periostin (Post), CT-OCP-Post, Control (Ctrl), and BW, underwent sternotomy surgery. Once the surgeries were completed, the bone repair was assessed radiologically and thereafter clinically in vivo and in vitro using CT-scan, H&E, ELISA, and qRT-PCR.
RESULTS
All pastes displayed antibacterial properties and the CT-Post group had the highest cell viability compared to the control group. In contrast to the BW, CT-Post group demonstrated weight changes in the degradability test. In the CT-Post group, more number of osteocyte cells, high trabeculae percentage, and the least fibrous connective tissue were observed compared to other groups. Additionally, in comparison to the CT and Ctrl groups, higher alkaline phosphatase activity, as well as decreased level of serum tumor necrosis factor-a, interleukin-6, and OCN in the CT-Post group was evident. Finally, Runx2, OPG, and RANKL genes’ expression was significantly higher in the CT-Post group than in other groups.
CONCLUSION
Our results provide insights into the desirability of pastes in terms of cellular viability, degradability, antibacterial properties, and surgical site restoration compared to the BW group. Besides, Periostin could enhance the osteogenic properties of bone tissue defect site.

Keyword

Bone healing; Chitosan; OPG and RANKL; Periostin; Runx2
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