WO2024251364A1 - Implantable composition for use in cartilage defects reapair in post-surgery rehabilitation - Google Patents
Implantable composition for use in cartilage defects reapair in post-surgery rehabilitation Download PDFInfo
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- WO2024251364A1 WO2024251364A1 PCT/EP2023/065364 EP2023065364W WO2024251364A1 WO 2024251364 A1 WO2024251364 A1 WO 2024251364A1 EP 2023065364 W EP2023065364 W EP 2023065364W WO 2024251364 A1 WO2024251364 A1 WO 2024251364A1
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- composition according
- biocompatible
- biocompatible composition
- piezoelectric
- polymer
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/40—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material
- A61L27/44—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix
- A61L27/446—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix with other specific inorganic fillers other than those covered by A61L27/443 or A61L27/46
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/38—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
- A61L27/3804—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells characterised by specific cells or progenitors thereof, e.g. fibroblasts, connective tissue cells, kidney cells
- A61L27/3817—Cartilage-forming cells, e.g. pre-chondrocytes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2400/00—Materials characterised by their function or physical properties
- A61L2400/12—Nanosized materials, e.g. nanofibres, nanoparticles, nanowires, nanotubes; Nanostructured surfaces
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/06—Materials or treatment for tissue regeneration for cartilage reconstruction, e.g. meniscus
Definitions
- the invention relates to a composition
- a composition comprising, as main components, a piezoelectric polymer loaded with magnetic micro- or nanoparticles and cellularized with stem cells, chondrocyte progenitors, or adult chondrocytes; the composition is useful in the post-surgery regenerative rehabilitation as part of the treatment of articular diseases caused by chondral defects (e.g. osteoarthritis).
- the invention was first disclosed at the 13 th Annual The Orthobiologic Institute (TOBI) Conference organized by The Orthobiologic Institute (TOBI), held June 09 - 11 , 2022, at The Diplomat Beach Resort Hollywood, Curio Collection by Hilton, Hollywood, Florida, United States of America.
- Musculo-skeletal diseases secondary to chondral-defects are disabling conditions that represents an extensive and increasing health burden with remarkable implications both for patients and for health-care systems and related costs.
- osteoarthritis is one of the most representative; due to the relevance and incidence of osteoarthritis, in the description that follows reference will mainly be made to this condition, but the invention may find general applicability in all diseases connected to chondral defects.
- TJR total joint replacement
- RCT reparative cartilage techniques
- MF microfracture
- ACI autologous chondrocytes implantation
- MACI matrix-assisted autologous chondrocyte implantation
- RCTs approaches still suffer high percentage of unsuccess that drastically limits the post-surgery outcomes, especially in young people.
- a biocompatible material working as an active support in the RCTs surgery.
- Such kind of matrix is able to promote the pro-regenerative potential of cells through the simultaneous delivery of physical pro-regenerative cues in situ.
- the matrix will make it possible to perform a personalized pro-regenerative regimen at cellular level, with a cost-effective and minimally invasive approach.
- the matrix described in this patent is ultimately intended for the use in postsurgery pro-regenerative rehabilitation as part of the treatment of the diseases etiologically linked to chondral defects (e.g. osteoarthritis).
- a biocompatible composition for use in implants in an area of the body subjected to surgery for the treatment of pathologies characterized from chondral defects, comprising: a) a matrix comprising a biocompatible polymer that is intrinsically piezoelectric, or a biocompatible polymer non-intrinsically piezoelectric loaded with an inorganic or organic filler imparting piezoelectric properties to the non- intrinsically piezoelectric polymer; b) between 1 x 10 5 - 1 x 10 9 nanoparticles/ml of a magnetic material; and c) between 1 x 10 5 and 1 x 10 8 cells chosen from the group consisting of mesenchymal stem cells, adult chondrocytes, and chondrocyte progenitors per milliliter of composition.
- the present invention describes a method for the treatment of an articular disease in a subject in need thereof, said method comprising the step of using the biocompatible composition as herein described.
- Figure 1 shows the electric cues generated in a material of the invention upon compressive stress, without a pre-load (Fig. 1a) and with a pre-load of 5 N (Fig. 1 b);
- Figure 2 shows the results of MRI imaging on one scaffold of the invention, respectively in a coronal view (Fig. 2a) and in sagittal view (Fig. 2b);
- Figure 3 shows X-ray measurements obtained on one scaffold of the invention, respectively before magnetic excitation (Fig. 3a) and after magnetic excitation (Fig. 3b).
- NPs nanoparticles
- PBS Phosphate-buffered Saline
- hACs human articular chondrocytes
- the percentages of components described below are weight/volume (w/v) percentages, indicating the grams of a component dissolved (or dispersed) in 100 ml of the composition;
- the cell density is described as cell/m I, indicating the number of cells dispersed in 1 ml of suspending medium;
- chondrocyte progenitor cells e.g., perichondroblasts, synoviocytes, ...
- mesenchymal stem cells or adult chondrocytes, implanted by MF/MACI in the site of a surgery intervention
- Magnetic nanoparticles embedded in the polymeric matrix vibrate in response to a pulsatile external magnetic field and trigger a controlled deformation of the matrix.
- the piezoelectric polymer reacts to the deformation by generating an electrical discharge promoting type II collagen production and the progenitor cells differentiation toward chondrocyte-like phenotype (direct effect). Moreover, the cyclic deformation of the matrix, reproduces therapeutic shear/compressive deformation induced by the regenerative rehabilitative therapy (indirect effect). This approach allows for a strong in situ chondroinduction through a personalized and non-invasive approach.
- the first component of the composition of the invention is or comprises a biocompatible polymer.
- the polymer may be intrinsically piezoelectric, such as polyvinylidene difluoride (known in the field of polymers as PVDF), poly(vinylidene fluoride-trifluorethylene) (P(VDF-TrFE)), poly(L-lactic acid) (PLLA), poly(3-hydroxybutyrate-co-3- hydroxyvalerate) (PHBV), cellulose, collagen, polyacrylonitrile (PAN), and nylon-11 , or mixtures thereof.
- PVDF polyvinylidene difluoride
- P(VDF-TrFE) poly(vinylidene fluoride-trifluorethylene)
- PLLA poly(L-lactic acid)
- PHBV poly(3-hydroxybutyrate-co-3- hydroxyvalerate)
- cellulose collagen
- PAN polyacrylonitrile
- nylon-11 or mixtures thereof.
- polymers may be used dissolved or suspended in suitable solvents, for instance water, PBS at pH 7.4, culture media (cellulose, collagen), tetrahydrofuran, diethyl ether (in particular when the polymer is PLLA), dimethylformamide, exafluoroisopropanol, methyl ethyl ketone (especially in combination with P(VDF-TrFE), in particular in the form of ES fibers), or mixtures thereof; the amount of polymer is typically between 10 and 20% w/v.
- suitable solvents for instance water, PBS at pH 7.4, culture media (cellulose, collagen), tetrahydrofuran, diethyl ether (in particular when the polymer is PLLA), dimethylformamide, exafluoroisopropanol, methyl ethyl ketone (especially in combination with P(VDF-TrFE), in particular in the form of ES fibers), or mixtures thereof; the amount of polymer is typically between 10 and 20% w/v.
- the biocompatible polymer may not be piezoelectric in itself, in which case it is loaded with micro- or nanoparticles of an inorganic filler.
- the polymer may be any, and preferred ones are polymers of natural origin, such as animal gelatins. These polymers may be employed in the form of a hydrogel, that is a polymer phase swelled by and incorporating water, PBS or culture media.
- a hydrogel typically the amount of polymer ranges between about 2 and 30% w/v of the overall composition; a typical water-based phase for the preparation of hydrogels is a phosphate buffer with pH between 6 and 10.
- the non-piezoelectic polymers must be loaded with one or more inorganic fillers having piezoelectric properties; examples of these materials are barium titanate (BaTiOs), lead zirconate titanate (Pb[Zr x Tii- x ]O3, 0 ⁇ x ⁇ 1 ), zinc stannate (ZnSnOs), lithium niobate (LiNbOs) and sodium niobate (NaNbOs).
- These inorganic compounds are in form of NPs, that is, particles with diameter (or maximum axis) between 1 nm and 100 nm or in the form of microparticles with a diameter or maximum axis between 101 nm and 100 pm.
- the inorganic filler may be present in the composition in amounts between 4 and 40% w/v.
- the second component of the composition of the invention is a magnetic material, in its turn in form of NPs and dispersed in the matrix.
- TCNE tetracyanoethylene
- preferred for the objects of the present invention are magnetic metals, metal oxides or metal alloys.
- Examples of magnetic metals are iron, nickel and cobalt; examples of oxides are the oxides of the metals above, such as ferric oxide (Fe2O3), magnetite (FesC ) or mixed oxides including these metals; examples of magnetic alloys are steel, the alloys known as “AINiCo” (comprising iron, nickel, cobalt and aluminum as main components), “TiCoNiAl” (comprising iron, nickel, cobalt, aluminum and titanium as main components), or the alloys based on rare-earth elements such as samariumcobalt and neodymium-iron-boron magnets.
- AINiCo comprising iron, nickel, cobalt and aluminum
- TiCoNiAl comprising iron, nickel, cobalt, aluminum and titanium as main components
- rare-earth elements such as samariumcobalt and neodymium-iron-boron magnets.
- the magnetic NPs may be present in the composition in amounts between 1 x 10 5 and 1 x 10 9 NPs/ml.
- composition of the invention comprises between 1 x 10 5 and 1 x 10 8 cells chosen from the group consisting of mesenchymal stem cells, chondrocyte progenitors, or adult chondrocytes per milliliter.
- the invention comprises between 2 x 10 6 and 2 x 10 7 cells chosen from the group consisting of mesenchymal stem cells, adult chondrocytes and chondrocyte progenitors cells per milliliter.
- the composition of the invention may comprise one or more additional components, such as antioxidants (e.g., ascorbic acid), preservatives (e.g., ethyl alcohol, benzyl alcohol, sodium benzoate, ... ), or bioactive agents such as growth factors, drugs, antibiotics, antivirals, enzymes, and vitamins.
- antioxidants e.g., ascorbic acid
- preservatives e.g., ethyl alcohol, benzyl alcohol, sodium benzoate, ...
- bioactive agents such as growth factors, drugs, antibiotics, antivirals, enzymes, and vitamins.
- the patient or subject in need of being treated with the method for the treatment of an articular disease may be suffering from a chondral defect or from diseases etiologically linked to chondral defects, in particular the chondral defect may be osteoarthritis.
- This example refers to the fabrication of a scaffold based on gelatin from porcine skin enriched with a piezoelectric filler made of BaTiOs formulated as nanopowder.
- a 5% w/v gelatin solution was prepared dissolving 500 mg of gelatin (Sigma-Aldrich, USA) with 10 ml of a 0.15% w/v genipin (Sigma-Aldrich, USA) solution in phosphate buffer saline (PBS) 1 M at pH 7.4 under magnetic stirring (600 rpm) at 60 °C.
- PBS phosphate buffer saline
- EXAMPLE 2 Measurement of the electric field generated from the gelatin/genipin/BaTiOs scaffold after controlled deformation
- the main aim of this Example was to test the induced piezoelectricity properties on the scaffold produced in Example 1.
- One of the scaffolds produced in Example 1 was subjected to controlled deformation using an electromechanical testing system (Instron 5943, load measurement accuracy: +/- 0.5% of reading, up to 2.5 kHz data acquisition rate option simultaneous on load, extension, and strain channels, speed range of 0.05 - 2500 mm/min (0.002 - 100 in/min), 1 kN (225 Ibf) capacity, 1123 mm (44.2 in) vertical test space, INSTRON - USA).
- the produced electric field was measured using a digital multimeter GBC KDM-120 (GBC, Australia). Specifically, a 10% deformation was induced on the scaffold above described, reading out an electric field of 3 mV.
- Figs. 1 a and 1 b The results of this test are reproduced graphically in Figs. 1 a and 1 b.
- the dashed line refers to the applied strain
- the solid line to the generated voltage.
- Fig. 1 a shows the voltage generated upon controlled compression cycles using a strain control approach. This kind of deformation generated a 2 mV variation of voltage (Fig. 1 a).
- Fig. 1 b shows the variation of voltage when the same deformation was applied after a 5 N pre-load; in this case the difference of voltage increased up to 10 mV.
- EXAMPLE 3 Gelatin based hydrogel enriched with ferromagnetic microparticles to be responsive to external magnetic fields
- a hydrogel composed of gelatin from porcine skin crosslinked with genipin was produced using the methodic described in Example 1 . Briefly, a 5% w/v gelatin solution was prepared dissolving 500 mg of gelatin (Sigma-Aldrich, USA) with 10 ml of a 0.15% w/v genipin (Sigma-Aldrich, USA) solution in phosphate buffer saline (PBS) 1 M at pH 7.4 under magnetic stirring (600 rpm) at 60 °C. When the mixture polymer/genipin was completely dissolved, a suspension of magnetic microparticles DynabeadsTM M-280 Streptavidin (Thermofisher, USA) was added under magnetic stirring. Specifically, 500 pl/ml of the microparticles suspension from a stock at 6.7 x 10 8 beads/ml were used.
- PBS phosphate buffer saline
- EXAMPLE 4 Evaluation of the deformation of a gelatin-based hydrogel enriched with ferromagnetic microparticles after application of controlled external magnetic fields
- the hydrogel composed of gelatin/genipin enriched with magnetic microparticles was subjected to controlled external fields using a 0.3 T magnetic resonance imaging (MRI) apparatus. Specifically, each scaffold was subjected to cyclic magnetic fields, and the diameter was measured both in coronal and in sagittal view.
- MRI magnetic resonance imaging
- Fig. 2 shows the results of MRI imaging on one scaffold of the invention: in Fig. 2a the scaffold is shown in a coronal view, in Fig. 2b in sagittal view.
- the diameter of each hydrogel immediately before and after the MRI cycle via X-ray analyses was measured.
- Fig. 3 reproduces the X-ray measurements obtained on one of the produced scaffolds.
- Fig. 3a shows the diameter of the scaffold (in a Petri dish), of 23.83 mm before excitation;
- Fig. 3b shows the diameter of the scaffold after excitation, resulting in this case 24.72 mm.
- EXAMPLE 5 Cellularization of a crosslinked gelatin-based scaffold with human articular chondrocytes (hACs)
- hACs Human chondrocytes
- tissues were harvested from 3 female donors (64, 71 , and 82 years old), selected on the basis of definite inclusion criteria (unicompartimental osteoarthritis, no previous knee surgery, no relevant comorbidities).
- Surgery waste was carefully washed with sterile PBS and placed in a sterile plate containing dissection medium (Diss-M: DMEM high glucose - Gibco USA, Penicillin/Streptomycin/Amphotericin 1 % v/v - Gibco USA, Fetal Bovine Serum 10% v/v - Gibco USA).
- Chondrocytes were allowed to grow until 80% confluency using chondro-FBS medium (cFBS-M: DMEM high glucose - Gibco USA, Penicillin/Streptomycin/Amphotericin 1 % v/v - Gibco USA, Insulin/transfemn/selenium 1 % v/v - Thermofisher USA, Dexamethasone 0.1 pM - Sigma-Aldrich USA, L-prolin 40 pg/ml - Sigma-Aldrich USA, Fetal Bovine Serum 10% v/v- Gibco USA).
- cFBS-M DMEM high glucose - Gibco USA, Penicillin/Streptomycin/Amphotericin 1 % v/v - Gibco USA, Insulin/transfemn/selenium 1 % v/v - Thermofisher USA, Dexamethasone 0.1 pM - Sigma-Aldrich USA, L-
- GelMA GelMA
- Li phenyl-2,4,6-trimethylbenzoyl- phosphinate Liphenyl-2,4,6-trimethylbenzoyl- phosphinate
- each scaffold was provided with 1 ml of cFBS-M, and incubated at 37 °C, 5% CO2 for 24 hours.
- the cFBS-M was switched into chondro complete medium (cCM: cFBS-M + TGF0-3 10 ng/ml, Ascorbic Acid 50 pg/ml, NO FBS).
- Cells or cell-laden scaffolds were washed twice in PBS samples to remove any culture medium residual, then stained using a LIVE/DEAD assay (Abeam, UK).
- This kit contained two fluorescent dyes, calcein AM and ethidium homodimer-1 (Ethd-1 ) that selectively stain living (green) and dead (red) cells respectively. Samples were stained using 4 pM calcein and 2 pM Ethd-1 (final concentration) in PBS for 30 minutes at 37 °C and 5% CO2. After staining, samples were rinsed twice in PBS to remove dye excess and imaged using an inverted epifluorescence microscope EVOS M5000 (Thermofisher, USA).
- the same material enriched with BaTiOs as piezoelectric filler showed a responsiveness to a mechanical compression within the same range of deformation.
- the experiments show that the material of the invention reacts to compression regimens performed using a strain-control set-up, producing an electric effect in terms of generation of a voltage difference, that is capable to stimulate and promote a pro-regenerative response in the adjoining tissues.
- the pro-regenerative signals are delivered in situ by the cells loaded in the material itself, allowing to perform personalized treatments for the patients.
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Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| AU2023451540A AU2023451540A1 (en) | 2023-06-08 | 2023-06-08 | Implantable composition for use in cartilage defects reapair in post-surgery rehabilitation |
| PCT/EP2023/065364 WO2024251364A1 (en) | 2023-06-08 | 2023-06-08 | Implantable composition for use in cartilage defects reapair in post-surgery rehabilitation |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| PCT/EP2023/065364 WO2024251364A1 (en) | 2023-06-08 | 2023-06-08 | Implantable composition for use in cartilage defects reapair in post-surgery rehabilitation |
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| Publication Number | Publication Date |
|---|---|
| WO2024251364A1 true WO2024251364A1 (en) | 2024-12-12 |
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|---|---|---|---|
| PCT/EP2023/065364 Ceased WO2024251364A1 (en) | 2023-06-08 | 2023-06-08 | Implantable composition for use in cartilage defects reapair in post-surgery rehabilitation |
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| AU (1) | AU2023451540A1 (en) |
| WO (1) | WO2024251364A1 (en) |
Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20220168470A1 (en) * | 2019-02-25 | 2022-06-02 | Vimex Spolka Z Ograniczona Odpowiedzialnoscia (Vimex) | Material and system for the therapeutic treatment of joints |
-
2023
- 2023-06-08 WO PCT/EP2023/065364 patent/WO2024251364A1/en not_active Ceased
- 2023-06-08 AU AU2023451540A patent/AU2023451540A1/en active Pending
Patent Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20220168470A1 (en) * | 2019-02-25 | 2022-06-02 | Vimex Spolka Z Ograniczona Odpowiedzialnoscia (Vimex) | Material and system for the therapeutic treatment of joints |
Non-Patent Citations (4)
| Title |
|---|
| ELAHEH ESMAEILI ET AL: "Magnetoelectric nanocomposite scaffold for high yield differentiation of mesenchymal stem cells to neural-like cells", JOURNAL OF CELLULAR PHYSIOLOGY, WILEY SUBSCRIPTION SERVICES, INC, US, vol. 234, no. 8, 5 January 2019 (2019-01-05), pages 13617 - 13628, XP071335151, ISSN: 0021-9541, DOI: 10.1002/JCP.28040 * |
| HILTON: "Conference organized by The Orthobiologic Institute (TOBI", 9 June 2022, article "Annual The Orthobiologic Institute (TOBI" |
| MOUSAVI S JAMALEDDIN ET AL: "Encapsulated piezoelectric nanoparticle-hydrogel smart material to remotely regulate cell differentiation and proliferation: a finite element model", COMPUTATIONAL MECHANICS, SPRINGER, BERLIN, DE, vol. 63, no. 3, 17 July 2018 (2018-07-17), pages 471 - 489, XP036711123, ISSN: 0178-7675, [retrieved on 20180717], DOI: 10.1007/S00466-018-1604-7 * |
| ZHANG YUSHENG ET AL: "Magnetoelectric Nanoparticles Incorporated Biomimetic Matrix for Wireless Electrical Stimulation and Nerve Regeneration", ADVANCED HEALTHCARE MATERIALS, vol. 10, no. 16, 1 August 2021 (2021-08-01), DE, XP093111401, ISSN: 2192-2640, Retrieved from the Internet <URL:https://onlinelibrary.wiley.com/doi/full-xml/10.1002/adhm.202100695> DOI: 10.1002/adhm.202100695 * |
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| AU2023451540A1 (en) | 2026-01-15 |
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