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The proposed protocol entails a global approach to assess bone formation in the context of bone regeneration using multimodal analyses. It aims to provide qualitative and quantitative information on new bone formation, enhancing the rigor and validity of basic and pre-clinical investigations.
The extensive characterization of tissue mineralization in the context of bone regeneration represents a significant challenge, given the numerous modalities that are currently available for analysis. Here, we propose a workflow for a comprehensive evaluation of new bone formation using a relevant large animal osseous ex vivo explant. A bone defect (diameter = 3.75 mm; depth = 5.0 mm) is created in an explanted sheep femoral head and injected with a macroporous bone substitute loaded with a pro-osteogenic growth factor (bone morphogenetic protein 2 - BMP2). Subsequently, the explant is maintained in culture for a 28-day period, allowing cellular colonization and subsequent bone formation. To evaluate the quality and structure of newly mineralized tissue, the following successive methods are set up: (i) Characterization and high-resolution 3D images of the entire explant using micro-CT, followed by deep learning image analyses to enhance the discrimination of mineralized tissues; (ii) Nano-indentation to determine the mechanical properties of the newly formed tissue; (iii) Histological examinations, such as Hematoxylin/Eosin/Saffron (HES), Goldner's trichrome, and Movat's pentachrome to provide a qualitative assessment of mineralized tissue, particularly with regard to the visualization of the osteoid barrier and the presence of bone cells; (iv) Back-scattering scanning electron microscopy (SEM) mapping with internal reference to quantify the degree of mineralization and provide detailed insights into surface morphology, mineral composition, and bone-biomaterial interface; (v) Raman spectroscopy to characterize the molecular composition of the mineralized matrix and to provide insights into the persistence of BMP2 within the cement through the detection of peptide bonds. This multimodal analysis will provide an effective assessment of newly formed bone and comprehensive qualitative and quantitative insights into mineralized tissues. Through the standardization of these protocols, we aim to facilitate interstudy comparisons and improve the validity and reliability of research findings.
Bone defects, whether caused by trauma, tumor resection, congenital anomalies, or infection, represent a major challenge for regenerative medicine. These alterations compromise the structural integrity of the skeletal system, leading to discomfort, functional impairment, and a reduction in patients' quality of life.
To overcome these challenges, innovative bone repair strategies have emerged, with a focus on enhancing osteogenesis and bone tissue regeneration. These approaches include the use of implantable, injectable, or 3D-printable bone substitutes, which can be of natural origin (e.g., bio-sourced macromolecules, animal-derived hydroxyapatite) or synthetic (e.g., bioglasses, calcium phosphates)1. To enhance their low inherent ability to guide and stimulate bone regeneration, bone substitutes can be loaded with osteoinductive factors, such as bone morphogenetic proteins (BMPs), to promote osteogenic differentiation of progenitor cells and enhance bone formation2.
Bone formation is based on the initial formation of a collagen matrix, which is then mineralized by hydroxyapatite crystals, thereby reinforcing the bone structure3. This process confers specific stiffness and strength to the bone. The quality of the mineralized tissue is intricately governed by its microstructural attributes and degree of mineralization4. This quality plays a pivotal role in bone healing and the functionality of the regenerated bone5. However, characterizing bone mineralization remains a challenging task due to the inherent variability across multivariate studies6,7,8.
In addition, initial evaluations of the biocompatibility, cytocompatibility, and differentiation potential of bone graft substitutes are typically conducted in vitro. However, methodological disparities impede the seamless comparison of outcomes. Furthermore, these in vitro studies do not fully capture the multicellular interactions and complex dialogue between cell populations, including bone marrow cells, which are essential for regulating the bone regeneration process9. This lack of accurate representation of the bone microenvironment may compromise the accuracy of subsequent preclinical studies10.
Although in vivo assessments provide a more accurate representation of physiological contexts, they are constrained by ethical, logistical, and financial considerations. Consequently, ex vivo evaluations play a pivotal role as an interface between in vitro and in vivo studies, serving as a necessary intermediate step before moving on to experiments on living subjects11,12,13.
In this context, the implementation of comprehensive characterization methodologies is needed to appraise the quality of regenerated bone tissue and to ensure the relevance of the strategy before moving on to a preclinical model. Consequently, we propose a protocol based on the analysis of an explant model using sheep knee joint tissue. This innovative methodology involves implanting BMP2-loaded cement into the explants and conducting a detailed analysis of tissue mineralization after 28 days of culture.
The technical approaches employed in this study are diverse and complementary, collectively providing a comprehensive approach to evaluating the quality of regenerated bone tissue (Figure 1). High-resolution micro-CT imaging enables detailed 3D visualization of the bone structure, providing valuable insights into the mineral density, morphology, and integrity of the newly formed tissue. This technique is crucial for assessing the efficacy of bone regeneration and monitoring the progression of mineralization over time. Nanoindentation is a precise approach for determining the mechanical properties of the tissue, such as its hardness and strength. By measuring the response of the material to a force applied on a nanometric scale, this method enables the assessment of the robustness and quality of the mineralized tissue. Histological examinations using common staining such as hematoxylin/eosin/saffron (HES), Goldner's trichrome, and Movat's pentachrome provide invaluable insights into tissue structure and composition. These stainings' allow differentiation of the various tissue components, including cells, extracellular matrix, and mineral deposits, thereby enabling a comprehensive qualitative assessment of the bone regeneration process. Backscatter scanning electron microscopy (SEM) mapping offers a high-resolution visualization of the surface of the samples, allowing detailed analysis of the degree of mineralization of the bone matrix, as well as the interfaces between the implanted material and the host tissue. Finally, Raman spectroscopy provides information regarding the molecular composition of the tissue, particularly through the identification of specific components such as proteins, lipids, and minerals. This approach enables the characterization of the mineralized matrix and the detection of growth factors such as BMP2, thereby providing crucial information on the persistence of pro-osteogenic stimuli in the regeneration medium.
Using a multi-disciplinary approach, integrating various analytical techniques, our study aims to provide a thorough and comprehensive assessment of the quality of regenerated bone tissue, thus providing a solid basis for the evaluation of bone graft substitutes and their potential clinical application.
This study has been approved by an ethics and animal welfare committee and by the French National Veterinary and Food Administration under number G44171.
1. Preparation and culture of osteochondral explants
2. Micro-CT analysis
3. Deep-learning image analyzes
4. Embedding
5. Scanning electron microscopy (SEM) - quantitative backscattered electron imaging (qBEI)
6. Histology
7. Raman microspectroscopy
8. Nanoindentation
NOTE: Due to the destructive nature of nanoindentation, it is usually performed at the end of the sample analysis routine. The nanoindentation system that we own is equipped with a pyramidal Berkovitch diamond indenter. However, several indenter shapes exist, and no consensus in the literature has been determined for bone or biomaterial specimens.
A micro-CT image of the explant is shown in Figure 2. Using Manual segmentation cannot optimally separate bone from cement, present in the central canal, using global thresholding. To improve the recognition of trabecular bone and cement, we propose to use deep learning. Deep learning is powerful for recognizing biomaterial characteristics and helps to improve the separation between bone and cement, enabling a better assessment of cement-bone interactions. This is of the utmost importance in...
Repair of bone defects is a major challenge in regenerative medicine to restore mobility, reduce pain, and improve the quality of life of affected individuals. The use of explant models offers a number of advantages compared to in vivo studies for the investigation of bone defect repair. In addition to ethical considerations, this model allows for the rigorous control of experimental conditions and the reduction of biological variability, thereby facilitating the generation of more accurate and reproducible resu...
The authors have no conflicts of interest to disclose.
We want to thank the technical facilities involved in the collection and processing of specimens, including SC3M (SFR Francois Bonamy (UMS 016), University of Nantes), SFR ICAT (University of Angers), BIO3, HiMolA, and SC4BIO. The Inserm UMR_S 1229 RMeS is supported by grants from the French Government through Inserm, Nantes Université, Univ Angers and Oniris VetAgroBio institutions. CL is also grateful to HTL Biotechnology.
Name | Company | Catalog Number | Comments |
0.20 filters | VWR | 28145-501 | |
18 G needle (1,2x40 mm) | Sterican | 4665120 | |
3 mL syringe | HENKE-JECT | 8300005762 | |
37% hydrochloric acid | VWR | 1.00317.1000 | |
Acetic acid (glacial) | Sigma | A6283 | |
Acetone | VWR | 20063-365 | |
Alcian Blue 8GX | VWR | 361186 | |
Ammonium hydroxide | VWR | 318612 | |
Apatitic tricalcium phosphate | Centre for Biomedical and Healthcare Engineering (Mines Saint Etienne, France) | TV26U | |
Azophloxine | Sigma | 210633 | |
Benzoyl peroxide | Sigma | 8.01641.0250 | |
BMP2 | Medtronic | InductOs 1.5 mg/mL | |
Brillant crocein | Aldrich | 2107507 | |
CTVox | Bruker | - | |
DataViewer | Skyscan | - | |
Diamond blade | Struers | MOD13 | |
Diamond saw | Struers | Accutom-50 | |
DiaPro Mol B3 diamond solution | Struers | 40600379 | |
DiaPro Nap B1 diamond solution | Struers | 40600373 | |
Dibasic sodium phosphate (Na2HPO4) | Sigma | 102404598 | |
Dibutyl Phtalate | Chimie-Plus Laboratoires | 28656 | |
DragonFly software | ORS | 2022.1.0.1231. | |
Dulbecco's Modified Eagle Medium (DMEM) high glucose, GlutaMAX(TM), pyruvate | ThermoFisher Scientific | 31966-021 | |
Eosine Y- Surgipath | Sigma | 1002830105 | |
Erythrosin B | Sigma | 102141057 | |
Ethanol absolute | VWR | 20820362 | |
Eukitt | Dutscher | 6.00.01.0003.06.01.01 | |
Falcon 50 mL | Sarstedt | 62.547.254 | |
Ferric chloride hexahydrate (FeCl3, 6H2O) | Merck | 1.03943.0250 | |
Fetal Bovine Serum (FBS) | Eurobio | CVFSVF00 | |
Fuchsine acid | Merck | 1.05231.0025 | |
Hank's Balanced Salt Solution (HBSS) | Biosera | MS01NG100J | |
Hematoxylin | Sigma | 86.118.9 | |
Isostatic press | Nova Suisse | Pmax 1500 bars | |
Laser diffraction granulometry | Malvern | Mastersizer 3000 | |
Light green | Prolabo | 28947135 | |
Lithium carbonate | Sigma | A13149 | |
MD-Mol polishing cloth | Struers | 40500077 | |
Methylcyclohexane | VWR | 8.06147.1000 | |
Methylcyclohexane | VWR | 8.06147.1000 | |
Methylcyclohexane | VWR | 8.06147.1000 | |
Methylmethacrylate | Sigma | 8.00590.2500 | |
Micro-CT, micro-scanner | Bruker | Skyscan 1272 | |
Monobasic sodium phosphate (NAH2PO4) | Sigma | 71496 | |
Mortar | Fritsch | Pulverisette 6 | |
N,N, Dimethylanilin | Sigma | 803060 | |
Nanoindentation station | Anton Paar | NHT2 | |
ND-Nap polishing cloth | Struers | 40500080 | |
OATS Osteochondral Autograft Transfer System Set, 4,75 mm | Arthrex | AR-1981-04S | |
OATS Osteochondral Autograft Transfer System Set, 8 mm | Arthrex | AR-1981-08S | |
Orange G | Ral | M15 | |
Paraformaldehyde (PFA) | Sigma | P6148 | |
Peel-a-way disposable embbedding moulds | Polysciences, Inc | 18646C-1 | |
Penicillin/Streptomycin (P/S) | ThermoFisher Scientific | 15140122 | |
Phosphate Buffered Saline (PBS) | ThermoFisher Scientific | 10010023 | |
Phosphomolybdic acid | Sigma | 221856-100 g | |
Phosphotungstic acid | Aldrich | 12863-5 | |
Polishing machine | Sturers | Dap V | |
Poupinel | MEMMERT | TV26U | |
Raman microspectrometer | Renishaw | InVia Qontor | |
Safran du Gâtinais | Labonord | 11507737 | |
Scanning electron microscope | Carl Zeiss | Evo LS 10 | |
SEM | Zeiss | Carl Zeiss Evo LS10 | |
SiC foils/Grinding papers | Struers | 40400008 (#320), 40400011 (#1000), 40400122 (#2000), 40400182 (#4000) | |
Silver paint | Electron microscopy sciences | 12686-15 | |
Standard stub with Faraday cup, carbon, aluminium and silicon standards | Micro-Analysis Consultants Ltd | 8602 | |
T25 flask | Corning | 430639 | |
Xylene | VWR | 28975.325 | |
Xylidine Ponceau | Aldrich | 19.976-1 |
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