Yumao Chen1, Ming Chen2, Yang Gao3, Feng Zhang2, Min Jin1, Shijun Lu1,4, Minxuan Han4,5. 1. Suzhou Stomatological Hospital, Suzhou Medical College of Soochow University, Suzhou 215005, China. 2. National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, China. 3. Department of Stomatology, The First Affiliated Hospital of Soochow University, Suzhou 215005, China. 4. Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China. 5. Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China.
Abstract
Biopolymer nanofiber membranes are attracting interest as promising biomaterial scaffolds with a remarkable range of structural and functional performances for guided bone regeneration (GBR). In this study, tussah silk nanofiber (TSn) and Bombyx mori silk nanofiber (BSn) membranes were prepared by physical shearing. The diameters of the TSn and BSn membranes were 146.09 ± 63.56 and 120.99 ± 91.32 nm, respectively. TSn showed a Young's modulus of 3.61 ± 0.64 GPa and a tensile strength of 74.27 ± 5.19 MPa, which were superior to those of BSn, with a Young's modulus of 0.16 ± 0.03 GPa and a tensile strength of 4.86 ± 0.61 MPa. The potential of TSn and BSn membranes to guide bone regeneration was explored. In vitro, the TSn membrane exhibited significantly higher cell proliferation for MC3T3-E1 cells than the BSn membrane. In a cranial bone defect in a rat model, the TSn and BSn membranes displayed superior bone regeneration compared to the control because the membrane prevented the ingrowth of soft tissue to the defective area. Compared to the BSn membrane, the TSn membrane improved damaged bone regeneration, presumably due to its superior mechanical properties, high osteoconductivity, and increased cell proliferation. The TSn membrane has a bionic structure, excellent mechanical properties, and greater biocompatibility, making it an ideal candidate for GBR.
Biopolymer nanofiber membranes are attracting interest as promising biomaterial scaffolds with a remarkable range of structural and functional performances for guided bone regeneration (GBR). In this study, tussah silk nanofiber (TSn) and Bombyx mori silk nanofiber (BSn) membranes were prepared by physical shearing. The diameters of the TSn and BSn membranes were 146.09 ± 63.56 and 120.99 ± 91.32 nm, respectively. TSn showed a Young's modulus of 3.61 ± 0.64 GPa and a tensile strength of 74.27 ± 5.19 MPa, which were superior to those of BSn, with a Young's modulus of 0.16 ± 0.03 GPa and a tensile strength of 4.86 ± 0.61 MPa. The potential of TSn and BSn membranes to guide bone regeneration was explored. In vitro, the TSn membrane exhibited significantly higher cell proliferation for MC3T3-E1 cells than the BSn membrane. In a cranial bone defect in a rat model, the TSn and BSn membranes displayed superior bone regeneration compared to the control because the membrane prevented the ingrowth of soft tissue to the defective area. Compared to the BSn membrane, the TSn membrane improved damaged bone regeneration, presumably due to its superior mechanical properties, high osteoconductivity, and increased cell proliferation. The TSn membrane has a bionic structure, excellent mechanical properties, and greater biocompatibility, making it an ideal candidate for GBR.
Guided bone regeneration
(GBR) is a procedure aiming for the reconstruction
of impaired bone tissue. The GBR technique makes use of a membrane
that is used in the interface between soft tissue and restoration
areas, aiming to resist the migration of faster-growing connective
tissue into the bone defect. Meanwhile, the membrane provides a protected
space for bone defects, thus allowing the migration of osteoblasts
and the ingrowth of a new bone.[1,2] The membrane is a critical
component of the GBR technique for successful bone regeneration. The
ideal GBR membrane should have several desirable properties, including
biocompatibility, structural and mechanical stability, tissue integration,
and proper degradation rate.[3,4] Therefore, many studies
have been conducted on GBR membranes from various natural and synthetic
sources to meet clinical needs.[5]Generally, two types of GBR membranes (resorbable and nonresorbable)
have been used in terms of their degradation characteristics.[6] Nonresorbable membranes, mainly titanium mesh
and polytetrafluoroethylene, exhibit high biocompatibility, mechanical
properties, and stability.[7] However, the
lack of biodegradability requires a secondary surgical procedure for
removal,[8] which may cause soft tissue dehiscence,
resulting in the likelihood of wound infection and an extended healing
period. Thereafter, the resorbable membrane, aiming to obviate the
need for additional surgery, has been developed and widely used in
clinical practice. These membranes are usually made of natural or
synthetic polymers, such as polyglycolic acid, polylactic acid, polycaprolactone,
and their copolymers or collagen.[9] As the
representative resorbable GBR membrane, collagen shows excellent biocompatibility
and positive results in clinical use. However, collagen still have
several disadvantages, including antigenicity, rapid degradation,
and low stiffness.[8] Many studies are being
conducted to develop new membranes for GBR.Silk fibroin (SF),
secreted by silkworms, is a representative biomaterial.[10] Recently, SF has gained increasing attention
for potential application as a GBR membrane because of several characteristics,
including good biocompatibility, controllable degradation, remarkable
mechanical properties, and less foreign body reaction.[10−12] Compared to Bombyx mori silk, tussah
silk is a more promising candidate for GBR due to its natural arginine–lysine–aspartate
(RGD) known as a cell adhesion sequence.[13] It has been found that tussah silk exhibits osteoconductivity superior
to that of B. mori silk in defected
bone regeneration.[14] Recently, the electrospun
SF nanofiber membrane has aroused great interest in GBR because its
interconnected porous structure can prevent ingrowth of soft tissue
and support the transport of metabolic nutrients and waste.[11] However, the time-consuming process, poor mechanical
properties of electrospun SF nanofibers, and a toxic solvent limit
the wide application of the electrospinning method for preparing SF
GBR membranes. Therefore, it is necessary to develop an efficient
and green method to prepare SF nanofibrous membranes with superior
performance.To achieve high performance, a hierarchically complex
structure
was assembled in native materials.[15] For
example, silk consists of tens of thousands of nanofibers with a diameter
of approximately 20 nm, which endows silk with ultrastrong properties.[16] Nanofibrous materials have great potential application
in regenerative medicine because of their extracellular matrix (ECM)-mimetic
structure. Recently, a facile versatile top-down method using physical
shearing was reported to extract nanofibers directly from natural
silk.[17] Compared with electrostatic spinning,
the preparation of silk nanofibers by physical shearing does not require
the use of toxic solvents, causes less damage to the protein molecular
structure of SF, and is greener and safer, and the mechanical properties
of the nanofibers are superior. In addition, it also has the advantages
of large yield, low energy consumption, and short preparation time.[18,19]In the present study, tussah silk nanofiber (TSn) and B. mori silk nanofiber (BSn) membranes were prepared
using the high-speed shear method. The morphology, structure, and
mechanical properties of the membranes were characterized. In vitro
cell biocompatibility and osteogenic generation in rat cranial defect
were studied on the TSn membrane and compared with the BSn membrane.
The study is of great significance given the promising application
of SF nanofibrous membranes in GBR.
Materials
and Methods
Materials
Tussah silk (Jiangsu, China), B. mori silk (Jiangsu, China), anhydrous sodium carbonate
(Na2CO3, China National Pharmaceutical Group
Corporation), anhydrous ethanol (China National Pharmaceutical Group
Corporation), mouse embryonic osteogenic precursor cells (MC3T3-E1,
BNCC), DMEM high-sugar medium (Gibco), fetal bovine serum (FBS, Procell),
penicillin–streptomycin (Sigma), 0.25% trypsin digestive solution
(Sigma), dimethyl sulfoxide (Sigma), paraformaldehyde (PFA) (Sigma),
rhodamine–phalloidin (Sigma), Hoechst 33258 (Beijing Solarbio
Technology Co., LTD.), Triton X-100 (Sigma), and a CCK-8 kit (Shanghai
Beyotime Biotechnology Co., Ltd.) are the materials and instruments
used in this study.
Preparation of Silk Nanofiber
Membranes
Tussah silk was boiled in 0.5 wt % Na2CO3 solution for 0.5 h at a bath ratio of 1:50, repeated
three times
to remove sericin and then put into a 60 °C oven for drying. B. mori silk was degummed with 0.05 wt % Na2CO3 solution and dried after degumming through the same
steps. The degummed tussah silk and B. mori silk were cut into 0.5 cm pieces, mixed with deionized water at
a bath ratio of 1:100, and then put into a 32,000 rpm high-speed blender
with a four-blade blunt knife (Joyoung, Shandong, China) for 30 min
to obtain tussah silk nanofiber slurry and B. mori silk nanofiber slurry. The concentration of silk nanofiber slurry
was about 1 wt %, and 20 g slurry was poured into a Petri dish with
a diameter of 9 mm and then dried in oven at 60 °C for about
4 h to obtain TSn and BSn.[17,20]
Characterization
The morphology of
the TSn and BSn membranes was observed using a scanning electron microscope
(8100, Hitachi, Tokyo, Japan) at 3 kV. SEM images of TSn and BSn were
measured by ImageJ software to obtain the average diameter of the
fibers. The secondary structure of the TSn and BSn membranes was determined
by Fourier transform infrared spectroscopy (FTIR) in the range of
400–4000 cm–1.
Mechanical
Properties
The TSn and
BSn membranes were cut into 50 mm × 10 mm rectangles. The thickness
of the membrane was measured with a vernier caliper at five different
positions of the membrane, and then the average value was taken. An
Instron 5967 universal material testing machine (Boston, USA) was
used to test the mechanical properties. Before the test, the sample
was placed in a room with constant temperature and humidity (25 ±
0.5 °C; 60 ± 5% relative humidity) for 24 h. During the
test, the instrument clamping distance was 30 mm, the tensile rate
was 5 mm/min, and the pretension was 0.2 CN. The number of each sample
was 5.
Biocompatibility
Cell
Culture and Proliferation
The TSn and BSn membranes were
cut into 5 mm discs, placed in 48-well
plates after high temperature and pressure (121 °C and 200 kPa)
sterilization for 30 min, and soaked in α-modified Eagle’s
medium (a-MEM, Gibco, USA). MC3T3-E1 was cultured in a-MEM supplemented
with 10% FBS and 1% penicillin/streptomycin under standard conditions
(37 °C, 5% CO2, and 95% humidity) up to 80% confluency
before passaging. The cells growing to the third generation were digested,
and the concentration of the cell suspension was adjusted to 800 cells
per microliter. 50 μL of cell suspension was inoculated on the
membrane surface and incubated for 2 h to promote cell adhesion, and
then, the cell culture medium was added. The culture medium was changed
every 2 days. After 1, 3, and 7 days, the membrane with cells was
moved into a new well for a CCK-8 test. The CCK-8 solution was added
to each well and incubated for 2 h. After that, 100 μL of supernatant
was removed from each well and added to a 96-well plate and then transferred
to a microplate meter to test the absorbance value at 450 nm (OD).
Laser Confocal Microscopy Observation
The cell culture solution containing the sample was absorbed and
placed in a waste liquid bottle after 1 d, 3 d, and 7 d of culture.
The sample was washed gently with sterile PBS buffer at least 3 times.
After that, the cells on the sample were fixed with 300 μL of
4% PFA solution for 30 min, which was treated with 500 μL of
Triton X-100 solution for 15 min; the Triton X-100 solution was removed
and the cells were gently washed with PBS buffer 3 times. The rhodamine–phalloidin
solution was configured at a ratio of 1:800. Then, 500 μL of
rhodamine solution was added and incubated for 40 min under dark conditions
for staining. Rhodamine solution was desorbed and washed with PBS
buffer 3 times for 5 min each time. Hoechst 33258 solution was prepared
at a ratio of 1:1000, and 500 μL of Hoechst 33258 solution was
added to avoid light and incubated for 15 min. The Hoechst 33258 solution
was desorbed and cleaned with PBS buffer 3 times. The cytoskeleton
was observed under a laser confocal microscope, and the nucleus was
blue.
In Vivo Study
Surgical Procedure
To evaluate
the properties of membranes in vivo, 15 7–8 week-old male rats
were used. All procedures in this study were performed in accordance
with the Animal Care and Experiment Committee of Institute of Soochow
University (Suzhou, China). Fifteen healthy male Sprague-Dawley rats
with an average body weight of 250 g (≈7–8 weeks) were
used in this study. The rats were randomly divided into three groups:
(1) TSn; (2) BSn; and (3) control. The rats were given general anesthesia
by intraperitoneal injection of 4% chloral hydrate (1 mL/100 g body
weight). Once completely anesthetized, the animals were positioned
on the operating table in a prone position. The cranium was exposed
through a midline skin incision. The surgical site was carefully shaved
and disinfected with povidone iodine, and a longitudinal incision
was made along the midline in the skull from the nasal to the occipital
region. After separating the full-thickness skin and skin-periosteal
muscle, the cranial surface on both sides of the midline was exposed.
Five millimeter-diameter bilateral full-thickness cranial defects
were made in the bones using a standardized dental-trephine bur under
copious sterile saline irrigation. Two 5 mm-diameter defects were
created, one on each side of the midline.During the punching
process, extreme care was taken to avoid perforation of the dura mater.
After removal of the trephined cranial bone. Then, cranial defects
were covered with TSn and BSn membranes on the bone surface (test
group). No membranes were placed in the control group defects (control
group). Later, all membranes were trimmed into rectangles (14 mm ×
7 mm in size) to fit the defects well. The pericranium and skin were
sutured in layers with 3–0 silk sutures. After surgery, the
rats were caged and received food and water individually. Five animals
were used in every group. The rats were sacrificed at 4 and 12 weeks.
Then, the cranial samples, including both the defects, the membranes,
and the surrounding tissue, were removed from the bodies. These samples
were fixed with 4% PFA for 24 h at room temperature.
Microcomputed Tomography Analysis
The prepared samples
were scanned by microcomputed tomography (CT)
(SkyScan 1176; Bruker-microCT, Kontich, Belgium). The scanning conditions
were set at a voltage of 65 kV, current of 100 μA, 600 ms exposure
time, and Al filter of 1 mm. The width of scanning was 50 mm, and
the radiator axis was perpendicular to the surface of the bone defect.
The system software was used to reconstruct three-dimensional images.
The upper and lower threshold values for bone were 255 and 75 gray,
respectively. The images were reconstructed from the axial, sagittal,
and coronal planes. Since the initial bone defect was round with a
diameter of 5 mm, the region of interest (ROI) was selected to reflect
the initial shape. Bone volume (BV) and tissue volume (TV) analyses
were performed for the ROI in each sample. Four samples at 4 weeks
and six samples at 12 weeks were taken for micro-CT.
Histological Staining
Following
micro-CT testing, samples were decalcified in 10% ethylenediaminetetraacetic
acid for 2–4 weeks and dehydrated in a fractional series of
ethanol. Then, samples were embedded in paraffin wax and cut into
5 μm sections from the center area of the bone defects. For
histological staining, the sections were stained with hematoxylin
and eosin (H&E) and Masson’s trichrome staining and then
evaluated using a microscope (Axioveter 40 CFL, Zeiss, Germany). Four
samples at 4 weeks and six samples at 12 weeks were taken for histological
analysis.
Statistical Analysis
All quantitative
data are presented as the mean ± standard deviation. The t-test and one-way analysis of variance were performed to
assess the statistical significance of the results, and p < 0.05 was considered to be significant.
Results and Discussion
Morphology Observation
Figure shows the
TSn and BSn membranes
derived from native tussah and B. mori silk. The surface of the two membranes was a network structure formed
by random interlacing of nanofibers. The surface and interior of the
TSn membrane were more compact than those of the BSn membrane, which
showed a rougher surface. Although Ca(NO3)2/CH3CH2OH/H2O solution treatment had been
used to assist nanofiber exfoliation,[20] it was not a necessary step to obtain silk nanofibers. In this study,
the degummed silk was directly used to fabricate nanofiber membranes
by physical shearing, avoiding the time-consuming process and potential
solvent residual. The thicknesses of TSn and BSn were about 0.21 and
0.19 mm, respectively, and the corresponding average diameters were
146.09 ± 63.56 and 120.99 ± 91.32 nm, respectively. Note
that the diameter of BSn obtained in this study was smaller than that
derived from Ca(NO3)2/CH3CH2OH/H2O-treated silk reported previously.[20] After high-speed shear treatment, the original structure
of silk was disrupted to form silk nanofibers through destroying the
interaction forces between nanofibrils.[21,22] The membrane
formed by the nanofibers had a large specific surface area, which
made the cells have a larger contact area when growing on the membrane
surface.[22] Meanwhile, the nanoscale fiber
was similar to the nanofibrous structure of the ECM, which was conducive
to cell adhesion, migration, and proliferation.[23]
Figure 1
SEM images and diameter distribution of the silk nanofiber membrane.
(A,B) TSn membrane and (C,D) BSn membrane.
SEM images and diameter distribution of the silk nanofiber membrane.
(A,B) TSn membrane and (C,D) BSn membrane.
Structure Analysis
The secondary
structure of the TSn and BSn membranes was determined by using FTIR,
as shown in Figure . The TSn membrane showed absorption peaks at 1628 cm–1 (amide I), 1517 cm–1 (amide II), 1240 cm–1 (amide III), and 965 cm–1 (amide IV), corresponding
to the β-sheet structure.[24−26] The BSn membrane exhibited absorption
peaks at 1625 cm–1 (amide I), 1517 cm–1 (amide II), and 1261 cm–1 (amide III), which were
also ascribed to the β-sheet structure.[25,27] The processing of TSn and BSn membranes was a physical method that
only destroyed the interfacial forces of the nanofibers. It can be
observed in Figure that the IR spectra of TSn and BSn were similar to those of native
tussah silk and B. mori silk. Therefore,
the β-sheet structure in native silk was mainly retained in
the resulting silk nanofiber membrane. The main β-sheet structure
endowed the silk nanofiber membrane with structural stability and
good mechanical properties.[26]
Figure 2
FTIR spectra
of TSn and BSn membranes.
FTIR spectra
of TSn and BSn membranes.
Mechanical Properties
The mechanical
properties of the TSn and BSn membranes were measured, as shown in Figure . Young’s
modulus, stress, and strain of the BSn membrane were 0.16 ± 0.03
GPa, 4.86 ± 0.61 MPa, and 6.24 ± 0.41%, respectively. Compared
with the BSn membrane, the TSn membrane showed superior mechanical
properties. Young’s modulus, stress, and strain of the TSn
membrane were 3.61 ± 0.64 GPa, 74.27 ± 5.19 MPa, and 2.51
± 0.24%, which were significantly higher than those of silk GBR
films prepared by electrospinning.[1−3,28] As can be seen from Figure , the structure of TSn was relatively loose and the fiber
was stretched, while the structure of BSn was relatively compact and
the fiber was curved. During stretching, most fibers in TSn resisted
the external force together, while only partial fibers in BSn bear
stretching due to the curved state of the fibers. In addition, the
breaking stress and toughness of native tussah silk was significantly
higher than that of native B. mori silk.[22] The superior mechanical properties of native
tussah silk and the different fiber state of SF nanofibers made the
strength and Young’s modulus of TSn higher than that of BSn.
The fracture of the nanofiber membrane was mainly dominated by nanofiber
fracture and pull-out.[29] TSn was easier
to pull out under stretching than BSn due to its looser structure
(Figure ), resulting
in a low friction effect. The strain-to-failure was significantly
decreased in TSn due to its weak interfiber interaction, and it increased
in BSn because of its interlaced nanofiber structure. Therefore, compared
with BSn, TSn showed higher breaking strength and lower strain in
the tensile test. It was reported that the stresses of the electrospun
silk nanofiber membrane and collagen membrane were about 9[28] and 27 MPa,[5] which
were lower than that of the TSn membrane. The excellent mechanical
properties of the silk nanofiber membrane, especially the TSn membrane,
could provide effective protection for bone defects, thus allowing
the ingrowth of new bone.[18]
Figure 3
Mechanical properties
of TSn and BSn membranes. (A) Strain–stress
curves, (B) breaking stress, (C) breaking strain, and (D) Young’s
modulus (***p < 0.001, n = 5).
Mechanical properties
of TSn and BSn membranes. (A) Strain–stress
curves, (B) breaking stress, (C) breaking strain, and (D) Young’s
modulus (***p < 0.001, n = 5).The morphologies
of MC3T3-E1 cells grown on TSn and BSn membranes at 1, 3, and 7 days
were observed using a laser confocal microscope, as shown in Figure A. The cells displayed
a spindle shape, and the number of cells on the nanofiber membranes
increased gradually with time. Figure B shows that the numbers of cells that grew on TSn
and BSn membranes increased gradually with increasing culture time.
It was noted that the cell numbers grown on the TSn membrane were
significantly higher than those grown on the BSn membrane at 3 and
7 d.
Figure 4
Laser confocal images (A) and CCK-8 TEST of the proliferation activity
(B) of MC3T3-E1 cells grown on TSn and BSn membranes (*p < 0.05, n = 5).
Laser confocal images (A) and CCK-8 TEST of the proliferation activity
(B) of MC3T3-E1 cells grown on TSn and BSn membranes (*p < 0.05, n = 5).Although SF is biocompatible and biodegradable, the lack of a bioactive
domain limits its therapeutic efficacy.[30] RGD is a highly effective cell recognition sequence to modulate
cell–material interactions, such as cell adhesion, migration,
angiogenesis, and differentiation.[13] Cell
adhesion and proliferation are crucial for biomaterials in repairing
damaged tissue. Attempts have been made to incorporate the RGD sequence
in the B. mori SF scaffold to improve
its bioactivity.[13,31] The SF scaffold derived from
tussah silk contains a natural RGD sequence, which has been found
to significantly promote cell adhesion, osteogenic differentiation,
and mineralization.[32] In this study, tussah
silk was disintegrated into nanofibers by physical shearing, and then
these silk nanofibers were processed into membranes by air drying.
The silk nanofiber membrane, mimicking the structure of the ECM, was
conducive to cell adhesion, proliferation, and migration.[33] In addition, TSn contained an RGD tripeptide
sequence, which was a cell adhesion recognition signal. Therefore,
the TSn membrane displayed an intrinsic propensity to improve cell
adhesion and proliferation compared with the BSn membrane.[14]
Micro-CT Analysis
We prepared a rat
cranial bone defect model to investigate the bone regeneration capacity
of silk nanofiber membranes. After surgery, all rats regained consciousness
and remained healthy until the end of the study, and no significant
weight loss, membrane rejection, or other postoperative infections
happened. The micro-CT images are shown in Figure A. Overall, the bone formation increased
gradually from 4 to 12 weeks, suggesting the intrinsic regeneration
capacity of native bone. Negligible new bone formation was observed
in the inner edge of the control group without membrane cover mostly
due to the ingrowth of the surrounding soft tissue.[34] Compared to the control group, the bone area newly formed
was significantly bigger in the silk nanofiber membrane group, achieving
the best bone reconstruction in the TSn group.
Figure 5
Micro-CT analysis of
bone reconstruction in a calvarial defect
model of rat using silk nanofiber membranes. (A) μCT images
and (B) BV/TV ratio (*p < 0.05, **p < 0.01, n = 3).
Micro-CT analysis of
bone reconstruction in a calvarial defect
model of rat using silk nanofiber membranes. (A) μCT images
and (B) BV/TV ratio (*p < 0.05, **p < 0.01, n = 3).The quantitative analysis from μCT images for regenerated
bone is shown in Figure B. The BV/TV ratio increased gradually in all groups and showed a
significant difference among the three groups. The BV/TV values 12
weeks after operation were 17.40 ± 1.11, 15.35 ± 0.57, and
13.99 ± 0.38% in the TSn, BSn, and control groups, respectively.
The best bone reconstruction was achieved for TSn, followed by BSn
and then the control group. The silk nanofiber membrane achieved better
results than the control group because of the barrier membranes preventing
soft tissue invasion and facilitating new bone regeneration.[34] In addition, TSn showed higher bone regeneration
compared to BSn. It was believed that the different osteogenesis was
attributed to the presence of an RGD sequence in TSn and a lack in
BSn. The RGD sequence was known to promote the adhesion and spreading
of osteoblasts and colony formation.[13] In
addition, the combination of α5β1 integrin and RGD present
in TSn could activate the BMP-2 signaling pathway.[14] The improved cell adhesion, proliferation and colony formation,
and activated BMP-2 signaling pathway may contribute to the enhanced
bone regeneration in vivo.[14,35]
Histological
Analysis
In order to
validate the μCT observation, histological studies were conducted.
The results of H&E and Masson’s trichrome staining at 4
and 12 weeks are shown in Figures and 7. The control group without
membranes was invaded by thin, loosely organized connective tissues.
Only a limited amount of bone regeneration was observed in the defect
rim at both 4 and 12 weeks. In contrast, a visible new bone regeneration
at 4 weeks and nearly a bone bridge crossed the defect areas formed
at 12 weeks for both BSn and TSn groups. However, some inflammatory
cells (including neutrophils, lymphocytes, and macrophages) were observed
at the defect boundary of the SF groups. The immune response and adverse
reaction of the biomaterial after in vivo implantation are important.
Despite local inflammation, a new bone tissue was formed under the
guidance of BSn and TSn, suggesting that the immune response of the
SF was acceptable.[36] In TSn and BSn groups,
abundant blood vessels formed near the new bone (Figures and 7, black arrows). In addition, many osteoblasts appearing around and
inside the new bone was observed (Figures and 7, white arrows).
Meanwhile, numerous fiber-like structures (Figure , yellow arrows) surrounded the new bone,
suggesting typical collagen deposition, which served as nucleation
sites for bone mineralization.[37]
Figure 6
Histological
observation with HE staining of control and TSn and
BSn membrane groups at 4 and 12 weeks after surgery. M: nanofiber
membrane, NB: new bone, OB: old bone. Black arrows indicate blood
vessels and white arrows indicate osteoblasts.
Figure 7
Histological
observation with Masson trichromatic staining of control
and TSn and BSn membrane groups at 4 and 12 weeks after surgery. M:
nanofiber membrane, NB: new bone, OB: old bone. Black arrows indicate
blood vessels; white arrows indicate osteoblasts; yellow arrows indicate
collagen fibers.
Histological
observation with HE staining of control and TSn and
BSn membrane groups at 4 and 12 weeks after surgery. M: nanofiber
membrane, NB: new bone, OB: old bone. Black arrows indicate blood
vessels and white arrows indicate osteoblasts.Histological
observation with Masson trichromatic staining of control
and TSn and BSn membrane groups at 4 and 12 weeks after surgery. M:
nanofiber membrane, NB: new bone, OB: old bone. Black arrows indicate
blood vessels; white arrows indicate osteoblasts; yellow arrows indicate
collagen fibers.Many studies have demonstrated
that the SF membrane is suitable
for GBR.[1,11,23,38] The SF membrane can provide mechanical stability
and structural integrity to prevent tissue invasion and to retain
space for bone regeneration.[23,38] In the present study,
BSn and TSn membranes all appeared intact under the microscope (Figures and 7), showing few signs of resorption or distortion after 12
weeks of operation. The degradation time for regenerated SF scaffolds
in vivo was more than 1 year,[39] while the
natural silk fiber, especially nonmulberry silk, presented a longer
degradation period.[40] Therefore, the BSn
and TSn membranes retained in the bone defect could be responsible
for the less soft and more bone tissue ingrowth. A large number of
blood vessels around the new bone were observed, which could provide
enough nutrition for bone formation. Collagen fibers are the central
component in the natural bone matrix.[37] The abundance of collagen fibers was found near the new bone (Figure ), which could act
as a template for further formation of hydroxyapatite. In addition,
tussah silk exhibits superior osteoconductivity than B. mori silk, including cell proliferation and osteoblast
differentiation in vitro[32] and bone regeneration
in vivo.[14] As a result, the osteogenic
tissue formation was significantly promoted and guided by the biomimetic,
biocompatible, high-strength, and highly stable TSn membrane.GBR has become the standard procedure for periodontal regeneration
threatment.[23] From an immunological point
of view, SF is consistent with a good clinical experience. More importantly,
SF materials are widely used in clinical research and application.[41] Many studies by us and other groups have assumed
that SF materials are proper materials for application in GBR.[11] In the present study, the TSn group exhibited
superior osteoconductivity compared to that of the BSn group. Therefore,
the excellent biocompatibility, biomimetic nanofibrous structure,
and good mechanical properties made TSn a promising material for application
in GBR.
Conclusions
In summary,
natural TSn and BSn membranes were developed and compared
for efficacious bone tissue regeneration. TSn and BSn showed a network
structure with interwoven nanofibers, and the fiber diameters were
146.09 ± 63.56 and 120.99 ± 91.32 nm, respectively. TSn
showed a higher tensile strength and a modulus of 74.27 ± 5.19
MPa and 3.61 ± 0.64 GPa, which were superior to those of BSn
and electrospun SF nanofiber membranes reported previously. In vitro
studies demonstrated that enhanced cell adhesion and proliferation
was achieved on TSn compared to that on BSn. Consistent with the in
vitro results, TSn promoted bone regeneration in rat skull defect
model. The aqueous-derived TSn has inherently RGD sequence, nanofibrous
structure, and excellent mechanical properties, which is suitable
for bone tissue repair. Further study is warranted to evaluate the
degradation of TSn and tune it to match bone regeneration, making
it a more promising membrane of GBR.