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[beta-TCP and beta-TCMP osteoregenerators. New perspectives].

The Authors present personal histological findings on a beta-tricalcium phosphate Mg substituted (beta-TCMP) prepared as sintered granules and unsintered powder. A mixture of these materials was used to fill bone cavities or defects in oral surgery. The beta-TCMP represents a biocompatible ceramic material able to accelerate and enhance bone repair of bone defects. It provides a completely biodegradable matrix for new bone growth as well as releasing mineral ions into the tissue during mineralization. Newly formed bone tissue is described in direct contact with residual beta-TCMP granules. No connective tissue layer is present between the new bone and the surface of the alloplastic material.

Animals

The influence of fibrin sealant on demineralized bone matrix-dependent osteoinduction. A quantitative and qualitative study in rats.

Allogeneic demineralized bone matrix (DBM) and bone matrix gelatin (BMG) were implanted with or without fibrin sealant (FS) ectopically (abdominal wall) and orthotopically (7-mm trepanation defect) in 38 male Sprague-Dawley rats. Evaluation was done by descriptive histology, histomorphometry of orthotopic implants, and determination of alkaline phosphatase in ectopic implants. The observation period was 21 days with ectopic implantation and 26 days with orthotopic implantation. In all ectopic specimens, new bone developed without any qualitative difference between specimens with and without FS. The alkaline phosphatase activity did not change significantly upon addition of FS. Morphometry revealed slight differences between the groups with and without FS. The peripheral bone deposits in the BMG + FS group, was significantly larger than in the BMG group. These investigations demonstrated neither a clearly positive nor negative effect of FS on ectopic osteoinduction or BMG-dependent osteoregeneration.

Alkaline Phosphatase

Glycocalyx-edited mesenchymal stem/stromal cell therapy in advanced osteoporosis.

Mesenchymal stem/stromal cells (MSCs) are osteoregenerative; however, their therapeutic efficacy for skeletal conditions is hampered by poor bone-homing ("osteotropism"). In preclinical models, this deficit is correctable by MSC glycocalyx editing to enforce sialylated Lewis X (sLeX) expression, thereby programming osteotropism. We conducted a first-in-human clinical trial (ClinicalTrials.gov: NCT02566655) involving a single intravenous infusion of glycocalyx-edited autologous bone marrow-derived MSCs in ten women with advanced-stage osteoporosis. The protocol-mandated evaluation spanned 2 years and included clinical assessments, radiographic studies, and measurements of bone turnover markers (BTMs), bone tissue area (BTA), and bone mineral density (BMD). Thereafter, fracture and safety monitoring continued for >3 additional years for each patient. No serious adverse events occurred. Fragility fractures were markedly and durably reduced, amidst increased osteoanabolic BTM levels, BTA, and volumetric BMD. These findings indicate that glycocalyx editing effectuates MSC-based osteoporosis therapy and also refute notions that MSCs derived from older persons and/or diseased-tissue sites are biologically compromised.

E-selectin ligand