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The concept of precision medicine is based on the identification of hallmarks of cancer to exploit them as drug targets. The basic idea was that in this way the therapeutic modalities will be more effective and the side effects will be less. Since the majority of these novel modalities are not specific for a cancer-related biological process or a cancer-specific (mutant) target protein, it is not a surprise that we had to learn new type of side effects, because these therapeutics also affect physiological or pathological processes. Even more, in cases of some of these novel therapies we were able to discover new molecular mechanisms of physiological and pathological processes. Identification of the on-target side effects of targeted drugs can help to prevent the development of them or better manage the patients when emerge during cancer therapy.

Calcium phosphate (CaP) is the principal inorganic constituent of bone and teeth in vertebrates and has various applications in biomedical areas. Among various types of CaPs, amorphous calcium phosphate (ACP) is considered to have superior bioactivity and biodegradability. With regard to the instability of ACP, the phosphorus-containing molecules are usually adopted to solve this issue, but the specific roles of the molecules in the formation of nano-sized CaP have not been clearly clarified yet. Herein, alendronate, cyclophosphamide, zoledronate, and foscarnet are selected as the model molecules, and theoretical calculations were performed to elucidate the interaction between calcium ions and different model molecules. Subsequently, CaPs were prepared with the addition of the phosphorus-containing molecules. It is found that cyclophosphamide has limited influence on the generation of CaPs due to their weak interaction. During the co-precipitation process of Ca2+ and PO43-, the competitive relation among alendronate, zoledronate, and foscarnet plays critical roles in the produced inorganic-organic complex. Moreover, the biocompatibility of CaPs was also systematically evaluated. The DFT calculation provides a convincing strategy for predicting the structure of CaPs with various additives. This work is promising for designing CaP-based multifunctional drug delivery systems and tissue engineering materials.

Since their discovery, Black Phosphorus (BP)-based nanomaterials have received extensive attentions in the fields of electromechanics, optics and biomedicine, due to their remarkable properties and excellent biocompatibility. The most essential feature of BP is that it is composed of a single phosphorus element, which has a high degree of homology with the inorganic components of natural bone, therefore it has a full advantage in the treatment of bone defects. This review will first introduce the source, physicochemical properties, and degradation products of BP, then introduce the remodeling process of bone, and comprehensively summarize the progress of BP-based materials for bone therapy in the form of hydrogels, polymer membranes, microspheres, and three-dimensional (3D) printed scaffolds. Finally, we discuss the challenges and prospects of BP-based implant materials in bone immune regulation and outlook the future clinical application.

Layered double hydroxide nanomaterials (LDH NMs) have been dragging the researchers' attention toward biomedical applications owing to their physiochemical properties, biocompatibility, environmental sensitivity and good cellular uptake mechanisms. Various synthetic methods have been presented in brief. This paper draws attention toward the modification and functionalization of LDH nanostructures for biomedical applications in targeted and controlled drug release, anticancer, bioimaging, bone therapy and regeneration, gene delivery, ophthalmic and antitumor activities. Further, it explains the properties of conjugated LDH NMs which put forward their possibilities to be used in synthesizing the most demanding vaccine for COVID-19 pandemic. Current scenario, challenges and future perspective of LDH NMs have also been discussed. [ABSTRACT FROM AUTHOR]

With the rapid development of population ageing, bone-related diseases seriously affecting the life of the elderly. Over the past few years, organoids, cell clusters with specific functions and structures that are self-induced from stem cells after three-dimensional culture in vitro, have been widely used for bone therapy. Moreover, organoid extracellular vesicles (OEVs) have emerging as promising cell-free nanocarriers due to their vigoroso physiological effects, significant biological functions, stable loading capacity, and great biocompatibility. In this review, we first provide a comprehensive overview of biogenesis, internalisation, isolation, and characterisation of OEVs. We then comprehensively highlight the differences between OEVs and traditional EVs. Subsequently, we present the applications of natural OEVs in disease treatment. We also summarise the engineering modifications of OEVs, including engineering parental cells and engineering OEVs after isolation. Moreover, we provide an outlook on the potential of natural and engineered OEVs in bone-related diseases. Finally, we critically discuss the advantages and challenges of OEVs in the treatment of bone diseases. We believe that a comprehensive discussion of OEVs will provide more innovative and efficient solutions for complex bone diseases.

A fluidic permeable and stable in wet media, MBG-NfGel, device consisting of a mesoporous ceramic embodied in a nanofibrillar biodegradable polymer has been processed using appropriate thermally induced phase separation (TIPS) processing variables of 5.4% (wt/v) gelatin in 50/50 water/ethanol (v/v) ratio. The device comprises high surface area mesoporous bioactive glass (MBG) microparticles within a fibrous matrix of 170 nm average diameter nanofibers gelatin, forming a meshwork of 0.2–1.6 μm range voids. Gentamicin sulphate (GS) antibiotic high loading capacity and sustained release ability, as well as in vitro bioactivity and osteoprogenitor cells biocompatibility supports long-term antibacterial and bone growth stimulation properties. Antibiotic local delivery functionality in vitro of this device has been analysed and discussed in relation to other systems previously reported. The presented device properties as well as its industrial scalability potential, in terms of process reliability and absence of toxic chemical agents, low raw material biopolymer cost and immunogenicity, are other important advantages. These advantages rank MBG-NfGel device as a potential candidate to further development for application as local antibiotic device in bone surgery and therapy. [ABSTRACT FROM AUTHOR]

Chemotherapy is the most reliable treatment for osteoporosis and osseous metastases. To facilitate better drug delivery for bone treatments, a novel preparation of polymeric nanoparticles with high affinity to bone has been prepared. Two-step synthesis of cholesteryl-functionalized poly(ethylene sodium phosphate) (Ch-PEP n ·Na) was performed via ring-opening polymerization of cyclic phosphoesters and the demethylation. The molecular weight of Ch-PEP n ·Na could be well controlled by changing the ratio of cholesterol and cyclic phosphoesters. Because Ch-PEP n ·Na exhibits an amphiphilic nature in aqueous media, Ch-PEP n ·Na-bearing nanoparticles (PEP n ·Na NPs) were prepared by a solvent evaporation technique. The size of the nanoparticles investigated in the current study is approximately 100 nm, which was determined by dynamic light scattering (DLS) and transmission electron microscopy (TEM). Due to the presence of highly water-soluble polymer chains, dispersion of PEP n ·Na NPs in aqueous media was stable for at least 1 week. Hemolytic activity of PEP n ·Na NPs was found to be low and PEP n ·Na NPs did not disintegrate mammalian cell membranes. Additionally, cytotoxicity of PEP n ·Na NPs was not observed at concentrations below 100 μg/mL. The adsorption of PEP n ·Na NPs on hydroxyapatite (HAp) microparticles was studied in comparison with poly(ethylene glycol) nanoparticles (PEG NPs). Both PEP n ·Na NPs and PEG NPs adsorbed well onto HAp microparticles in distilled water with binding equilibrium constants ( K HAp ) for PEP n ·Na NPs and PEG NPs of 3.6 × 10 6 and 7.9 × 10 6 , respectively. In contrast, only PEP n ·Na NPs adsorbed onto HAp microparticles in a saline phosphate buffer. Moreover, the adsorption of PEP n ·Na NPs onto HAp microparticles occurred even in the presence of 1.2 mM calcium ions or low-pH media. The affinity of the nanoparticles to bovine bone slices was also studied, with the result that large quantities of adsorbed PEP n ·Na NPs were observed on the slices by scanning electron microscope. [ABSTRACT FROM AUTHOR]

Mesenchymal stem cells (MSC) are present in specialized niches in perivascular regions of adult tissues and are able to differentiate into various cell types, such as those committed to repairing. Bone marrow derived MSC from eight young mice C57BL/ 6 gfp+ were expanded in culture for repairing critical defects in calvarial bone produced in twenty-four young isogenic adult C57BL/6 mice. The animals were subjected to a cranial defect of 6.0mm diameter and divided into two equal experimental groups. Control group did not receive any treatment and the treated group received a MSC pellet containing 1.0 x 10(7) cells/mL into the defects. The group treated with MSC showed increased angiogenesis and amount of new bone deposited on the defect limits than that observed in the control group. The results demonstrated that transplantation of bone marrow-derived MSC of C57BL/6 gfp+ mice to bone critical defects produced in mice calvarial contributes positively to the bone repair process. MSC presets ability to influence the correct functioning of osteoblasts, increases the amount of mobilized cells for the repairing process, speeds up growth, and increases deposition of bone matrix.As células-tronco mesenquimais (MSC) estão presentes em nichos especializados nas regiões perivasculares dos tecidos adultos e são capazes de se diferenciar em diversos tipos celulares, dentre eles, os comprometidos com processos de reparação óssea. MSC oriundas da medula óssea de oito camundongos jovens C57BL/6 gfp+ foram expandidas em culturas e utilizadas na reparação de defeitos críticos produzidos em calvária de 24 camundongos isogênicos C57BL/6 adultos. Os animais foram submetidos a um defeito craniano de 6,0mm de diâmetro e separados em dois grupos experimentais iguais. O grupo controle não recebeu tratamento e no grupo tratado foi administrado, no interior do defeito, pellet de MSC contendo 1,0 x 10(7) células/mL. O grupo tratado com MSC exibiu aumento da angiogênese e maior quantidade de novo osso depositado nas bordas do defeito, comparando-se ao grupo controle. Nas condições experimentais apresentadas nesse estudo, constatou-se que o transplante de células-tronco mesenquimais (MSC) derivadas da medula óssea de camundongos C57BL/6 gfp+, aplicadas em defeitos ósseos críticos, produzidos em calvária de camundongos contribui positivamente para o processo de reparação óssea. As MSC apresentam habilidades de influenciar o correto funcionamento dos osteoblastos, aumentar a quantidade de células mobilizadas nos processos de reparação, aumentar a liberação de fatores de crescimento e aumentar a deposição de matriz óssea.

Titanium implants can fail due to inappropriate biomechanics at the bone-implant interface that leads to suboptimal osseointegration. Titania nanotubes (TNTs) fabricated on Ti implants by the electrochemical process have emerged as a promising modification strategy to facilitate osseointegration. TNTs enable augmentation of bone cell functions at the bone-implant interface and can be tailored to incorporate multiple functionalities including the loading of active biomolecules into the nanotubes to target anabolic processes in bone conditions such as osteoporotic fractures. Advanced functions can be introduced, including biopolymers, nanoparticles and electrical stimulation to release growth factors in a desired manner. This review describes the application of TNTs for enhancing osteogenesis at the bone-implant interface, as an alternative approach to systemic delivery of therapeutic agents. [ABSTRACT FROM AUTHOR]

To treat skeletal conditions such as bone infections, osteoporotic fractures, and osteosarcoma, it would be ideal to introduce drugs directly to the affected site. Localized drug delivery from the bone implants is a promising alternative to systemic drug administration. In this study we investigated electrochemically nanoengineered Ti wire implants with titania nanotubes (TNTs), as minimally invasive drug-releasing implants for the delivery of drugs directly into the bone tissue. Since trabecular bone in vivo contains a highly interconnected bone marrow, we sought to determine the influence of marrow on drug release and diffusion. Electrochemical anodization of Ti wires (length 10 mm) was performed to create an oxide layer with TNTs on the surface, followed by loading with a fluorescent model drug, Rhodamine B (RhB). Cores of bovine trabecular bone were generated from the sternum of a young steer, and were processed to have an intact bone marrow, or the marrow was removed. RhB-loaded TNTs/Ti wires were inserted into the bone cores, which were then cultured ex vivo using the ZetOS™ bioreactor system to maintain bone viability. Release and diffusion of RhB inside the bone was monitored using fluorescence imaging and different patterns of drug transport in the presence or absence of marrow were observed. Scanning electron microscopy of the implants after retrieval from bone cores confirmed survival of the TNTs structures. Histological investigation showed the presence of bone cells adherent on the implants. This study shows a potential of Ti drug-releasing implants based on TNTs technology towards localized bone therapy. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 714-725, 2016. [ABSTRACT FROM AUTHOR]

Due to the specific structure of natural bone, most of the therapeutics are incapable to be delivered into the targeted site with effective concentrations. Nanotechnology has provided a good way to improve this issue, cell membrane mimetic nanoparticles (NPs) have been emerging as an ideal nanomaterial which integrates the advantages of natural cell membranes with synthetic NPs to significantly improve the biocompatibility as well as achieving long-lasting circulation and targeted delivery. In addition, functionalized modifications of the cell membrane facilitate more precise targeting and therapy. Here, an overview of the preparation of cell membrane-coated NPs and the properties of cell membranes from different cell sources has been given to expatiate their function and potential applications. Strategies for functionalized modification of cell membranes are also briefly described. The application of cell membrane-coated NPs for bone therapy is then presented according to the function of cell membranes. Moreover, the prospects and challenges of cell membrane-coated NPs for translational medicine have also been discussed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Extracellular vesicles, which are secreted by living cells and play a critical role in cellular communication, have emerged as a promising cell-free strategy in the treatment of many diseases. Recently, EVs are considered excellent delivery systems for various therapeutic agents, including nucleic acids, proteins, drugs, and nanomaterials, owing to their superior physiochemical stability and biocompatibility. Yet, drawbacks such as the the uncertain distribution, unfavorable therapeutic efficiency and low yields are still the primary obstacles that hinder the application of EVs in the clinical. An increasing number of studies show that EVs can be "internally" engineered via cargo loading and "externally" engineered via surface modification to track their distributions, obtain scalable production and improve bone-targeting capacity for bone therapy. Herein, we provide a brief overview of the present applications and therapeutic mechanism of EVs for bone-related diseases. Thereafter, a comprehensive overview of methodological advances made recently in internally and externally engineering EVs is presented. Moreover, the potential applications of modified EVs are discussed by presenting prominent examples for the treatment of osteoarthritis, osteoporosis, and bone fracture and defects, as well as the prospective engineering approaches to address these issues. [Display omitted] • A comprehensive overview of the administration, progress and perspective of the engineered EVs for bone therapy. • Description of the methodological advances made recently in internally and externally engineering EVs. • Raw discussion of the relationship between engineered EVs and biomaterials. [ABSTRACT FROM AUTHOR]

The concept of precision medicine is based on the identification of hallmarks of cancer to exploit them as drug targets. The basic idea was that in this way the therapeutic modalities will be more effective and the side effects will be less. Since the majority of these novel modalities are not specific for a cancer-related biological process or a cancer-specific (mutant) target protein, it is not a surprise that we had to learn new type of side effects, because these therapeutics also affect physiological or pathological processes. Even more, in cases of some of these novel therapies we were able to discover new molecular mechanisms of physiological and pathological processes. Identification of the on-target side effects of targeted drugs can help to prevent the development of them or better manage the patients when emerge during cancer therapy., Competing Interests: JT is the editor-in-chief of Pathology and Oncology Research. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tímár and Uhlyarik.)

Calcium phosphate (CaP) is the principal inorganic constituent of bone and teeth in vertebrates and has various applications in biomedical areas. Among various types of CaPs, amorphous calcium phosphate (ACP) is considered to have superior bioactivity and biodegradability. With regard to the instability of ACP, the phosphorus-containing molecules are usually adopted to solve this issue, but the specific roles of the molecules in the formation of nano-sized CaP have not been clearly clarified yet. Herein, alendronate, cyclophosphamide, zoledronate, and foscarnet are selected as the model molecules, and theoretical calculations were performed to elucidate the interaction between calcium ions and different model molecules. Subsequently, CaPs were prepared with the addition of the phosphorus-containing molecules. It is found that cyclophosphamide has limited influence on the generation of CaPs due to their weak interaction. During the co-precipitation process of Ca 2+ and PO 4 3- , the competitive relation among alendronate, zoledronate, and foscarnet plays critical roles in the produced inorganic-organic complex. Moreover, the biocompatibility of CaPs was also systematically evaluated. The DFT calculation provides a convincing strategy for predicting the structure of CaPs with various additives. This work is promising for designing CaP-based multifunctional drug delivery systems and tissue engineering materials., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Jiang, Tao, Chen, Xue, Ding, Wang, Liu, Li and Su.)

This review summarizes the available evidence-based data that form the basis for therapeutic intervention and covers the current status of glucocorticoid-induced osteoporosis (GIOP) management, regulatory requirements, and risk-assessment options. Glucocorticoids are known to cause bone loss and fractures, yet many patients receiving or initiating glucocorticoid therapy are not appropriately evaluated and treated. An European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis workshop was convened to discuss GIOP management and to provide a report by a panel of experts. An expert panel reviewed the available studies that discussed approved therapeutic agents, focusing on randomized and controlled clinical trials reporting on bone mineral density and/or fracture risk of at least 48 weeks' duration. There is no evidence that GIOP and postmenopausal osteoporosis respond differently to treatments. The FRAX algorithm can be adjusted according to glucocorticoid dose. Available antiosteoporotic therapies such as bisphosphonates and teriparatide are efficacious in GIOP management. Several other agents approved for the treatment of postmenopausal osteoporosis may become available for GIOP. It is advised to stop antiosteoporotic treatment after glucocorticoid cessation, unless the patient remains at increased risk of fracture. Calcium and vitamin D supplementation as an osteoporosis-prevention measure is less effective than specific antiosteoporotic treatment. Fracture end-point studies and additional studies investigating specific subpopulations (pediatric, premenopausal, or elderly patients) would strengthen the evidence base and facilitate the development of intervention thresholds and treatment guidelines. [ABSTRACT FROM AUTHOR]

Since their discovery, Black Phosphorus (BP)-based nanomaterials have received extensive attentions in the fields of electromechanics, optics and biomedicine, due to their remarkable properties and excellent biocompatibility. The most essential feature of BP is that it is composed of a single phosphorus element, which has a high degree of homology with the inorganic components of natural bone, therefore it has a full advantage in the treatment of bone defects. This review will first introduce the source, physicochemical properties, and degradation products of BP, then introduce the remodeling process of bone, and comprehensively summarize the progress of BP-based materials for bone therapy in the form of hydrogels, polymer membranes, microspheres, and three-dimensional (3D) printed scaffolds. Finally, we discuss the challenges and prospects of BP-based implant materials in bone immune regulation and outlook the future clinical application., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 [The Author/The Authors].)

Osteoporosis involves hyperactive osteoclasts. A large number of current drugs result in side effects affecting their efficacy in the clinic. Polyphosphoesters are unique polymeric biomaterials because of their biocompatibility, biodegradability, and bone affinity. We studied the viability and ability of human osteoclasts to resorb bone when dosed with poly(ethylene sodium phosphate) (PEP·Na). This did not trigger any change in osteoblast cell viability, however the polymer diminished human osteoclasts and their ability to resorb bone at concentrations as low as 10(-4) m · mL(-1). This is the first report to validate the possibility of using polyphosphoesters for selective inhibition of human osteoclast functions, indicating its potential to be used as an effective polymer prodrug for treatment of osteoporosis., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)