Hydroxyapatite-filled osteoinductive and piezoelectric nanofibers for bone tissue engineering.

Osteoporotic-related fractures are among the leading causes of chronic disease morbidity in Europe and in the US. While a significant percentage of fractures can be repaired naturally, in delayed-union and non-union fractures surgical intervention is necessary for proper bone regeneration. Given the current lack of optimized clinical techniques to adequately address this issue, bone tissue engineering (BTE) strategies focusing on the development of scaffolds for temporarily replacing damaged bone and supporting its regeneration process have been gaining interest. The piezoelectric properties of bone, which have an important role in tissue homeostasis and regeneration, have been frequently neglected in the design of BTE scaffolds. Therefore, in this study, we developed novel hydroxyapatite (HAp)-filled osteoinductive and piezoelectric poly(vinylidene fluoride-co-tetrafluoroethylene) (PVDF-TrFE) nanofibers via electrospinning capable of replicating the tissue's fibrous extracellular matrix (ECM) composition and native piezoelectric properties. The developed PVDF-TrFE/HAp nanofibers had biomimetic collagen fibril-like diameters, as well as enhanced piezoelectric and surface properties, which translated into a better capacity to assist the mineralization process and cell proliferation. The biological cues provided by the HAp nanoparticles enhanced the osteogenic differentiation of seeded human mesenchymal stem/stromal cells (MSCs) as observed by the increased ALP activity, cell-secreted calcium deposition and osteogenic gene expression levels observed for the HAp-containing fibers. Overall, our findings describe the potential of combining PVDF-TrFE and HAp for developing electroactive and osteoinductive nanofibers capable of supporting bone tissue regeneration. In this study entitled "Hydroxyapatite-filled osteoinductive and piezoelectric nanofibers for bone tissue engineering", we describe the development of novel hydroxyapatite (HAp)-filled osteoinductive piezoelectric poly(vinylidene fluoride-cotetrafluoroethylene) (PVDF-TrFE) electrospun nanofibers as a potential strategy for supporting bone repair in delayed-union and non-union osteoporotic-related fractures, for which current clinical techniques have proven to be largely inadequate and scaffold-based tissue engineering approaches hold significant promise. While the piezoelectric properties of native bone tissue have been extensively discussed in the literature, including their key role in preserving tissue homeostasis and promoting tissue repair, they have been widely neglected in the design of scaffolds for bone tissue engineering (BTE) applications. Piezoelectric scaffolds can be used not only for mimicking the native piezoelectric features of bone but also to provide a platform for applying electrical or mechanical stimuli to damaged tissue, contributing to an accelerated regeneration process. The nanofibrous scaffolds generated in this study were capable of replicating the main electrical, structural and compositional properties of bone extracellular matrix (ECM). To the best of our knowledge, this was the first time that the combination of HAp with the piezoelectric polymer PVDF-TrFE was found to induce key shifts in the chemical structure of the polymer and promote β phase nucleation, not only enhancing the piezoelectric features of the constructs but also improving their surface properties, including their ability to support mineralization in vitro. The HAp nanoparticles also provided meaningful bone-like biological cues (osteoinduction), enhancing the osteogenic differentiation of seeded human mesenchymal stem/stromal cells (hMSCs), which was confirmed by an increased ALP activity, cellderived calcium deposition and expression of important osteogenic gene markers. Overall, our findings highlight, for the first time, the potential of combining PVDFTrFE and HAp for developing electroactive and osteoinductive nanofibrous constructs with improved piezoelectric properties, surface features and osteogenic potential capable of improving bone tissue regeneration. [ABSTRACT FROM AUTHOR]