Role of Pyridoxal 5′-Phosphate at the Titanium Implant Interface In Vivo: Increased Hemophilicity, Inactive Platelet Adhesion, and Osteointegration

Titanium is the most biocompatible inorganic biomaterial with a long history of use in orthopedic and dental implants. However, promoting rapid and effective bone formation and integration onto etched, rough TiO2 surfaces has been a challenging topic. Here, 21 commercially available molecules are examined that met the following criteria: (1) contain phosphonic acid for stable immobilization onto TiO2 surfaces and (2) have a molecular weight less than 500 Da for negligible coating thickness. Of these molecules, the surface immobilization of pyridoxal 5'-phosphate (PLP), an active form of vitamin B6 , dramatically increases the hemophilic property of the surface and accelerated osteointegration in vivo. Analysis shows that PLP promotes surface binding of serum albumin and other plasma proteins by Schiff-base formations via its aldehyde group, providing a platform suitable for osteoblast adhesion. PLP also retards blood coagulation more than the widely used citric acid at the TiO2 surface. As PLP is capable of maintaining an inactivated status of surface-adsorbed platelets, delayed coagulation at the implant-blood interface allows for sufficient supply of growth factors from blood plasma and migration of osteoblasts. The results suggest that PLP can be widely applicable as a biocompatible, effective coating compound to promote osteointegration of titanium-based implants.