Osteogenesis in cranial defects and diffusion chambers. Comparison in rabbits of bone matrix, marrow, and collagen implants

In rabbits, we compared calcification and bone formation by bone marrow, acid-demineralized bone matrix and glutaraldehyde-cross-linked Type I collagen implanted in intramuscular diffusion chambers or in trephine skull defects. The rabbits were killed 4 weeks postimplantation and calcification and osteogenesis were evaluated radiographically and histologically, and by calcium and alkaline phosphatase assays. Bone marrow produced bone and fibrous tissue within the chambers and had high alkaline phosphatase levels. Bone matrix in chambers with intact filters failed to induce bone formation within and outside the chambers, while glutaraldehyde-cross-linked collagen produced only scant calcific deposits following implantation in either diffusion chambers or skull defects. Central areas of skull defects implanted with bone marrow were partially repaired with new bone and had high calcium and alkaline phosphatase levels, but not as high as defects implanted with demineralized bone matrix.     

Osteogenesis in cranial defects and diffusion chambers: Comparison in rabbits of bone matrix,marrow, and collagen implants

In rabbits, we compared calcification and bone formation by bone marrow, acid-demineralized bone matrix and glutaraldehyde-cross-linked Type I collagen implanted in intramuscular diffusion chambers or in trephine skull defects. The rabbits were killed 4 weeks postimplantation and calcification and osteogenesis were evaluated radiographically and histologically, and by calcium and alkaline phosphatase assays. Bone marrow produced bone and fibrous tissue within the chambers and had high alkaline phosphatase levels. Bone matrix in chambers with intact filters failed to induce bone formation within and outside the chambers, while glutaraldehyde-cross-linked collagen produced only scant calcific deposits following implantation in either diffusion chambers or skull defects. Central areas of skull defects implanted with bone marrow were partially repaired with new bone and had high calcium and alkaline phosphatase levels, but not as high as defects implanted with demineralized bone matrix.     

Chondrogenesis and osteogenesis of bone marrow-derived cells by bone-inductive factor

Rat bone marrow cells were intraperitoneally implanted within a diffusion chamber with a decalcified bone matrix or a 4 M guanidine hydrochloride extracted matrix (G-res) as control. The chamber was harvested after 28 days and soft X-ray photography, histological examination, determination of alkaline phosphatase activity and calcium content were performed. With the decalcified bone matrix, cartilage and bone formation was observed and both alkaline phosphatase activity and calcium content were significantly higher than those in control chambers. Each chromatographic fraction on Sephacryl S-200 of the 4 M guanidine hydrochloride extract (G-ext) from the decalcified bone matrix was reconstituted with G-res and implanted either subcutaneously or intraperitoneally within a diffusion chamber with marrow cells. Intrachamber or subcutaneous cartilage and bone formation was detected by only one chromatographic fraction. When marrow-derived fibroblast-like cells were implanted intraperitoneally within a diffusion chamber with a decalcified bone matrix, cartilage and bone formation was detected, which was not the case with G-res. These results suggest that a certain factor, probably bone morphogenetic protein, which induces ectopic bone formation, allows marrow cells to differentiate into bone and cartilage tissues and there may exist so-called "inducible osteoprogenitor cells" in the marrow-derived fibroblast-like cell preparation.     

Biochemical differences between dystrophic calcification of cross-linked collagen implants and mineralization during bone induction

Summary Ectopic calcification of diseased tissues or around prosthetic implants can lead to serious disability. Therefore, calcification of implants of glutaraldehyde-cross-linked collagenous tissues and reconstituted collagen was compared with mineralization induced by demineralized bone matrix (DBM). Whereas implants of DBM accumulated large amounts of calcium and a bone-specific γ-carboxyglutamic acid protein (BGP or osteocalcin) following implantation in both young and older rats, implants of cross-linked pericardium calcified with only traces of BGP. Glutaraldehyde-cross-linked DBM failed to calcify after implantation in 8-month-old rats for 2–16 weeks. Implants of cross-linked type I collagen exhibited small calcific deposits 2 weeks postimplantation but calcium content eventually dropped to levels equal to those of soft tissues as the implants were resorbed. The calcium content of DBM implanted in 1- and 8-month-old rats reached comparable levels after 4 weeks, but the BGP content was approximately twice as high in the younger animals than in the older ones. Glutaraldehyde-cross-linked implants of DBM, tendon, and cartilage calcified significantly in young but not in old animals. This form of dystrophic calcification was associated with only trace amounts of BGP. Alkaline phosphatase activity was high in implants of DBM and undetectable in implants of cross-linked collagenous tissues. These results show that implants of glutaraldehyde-cross-linked collagenous tissues and reconstituted collagen calcify to different extents depending upon their origin and the age of the host, and that the mechanism of dystrophic calcification differs significantly from the process of mineralization associated with bone induction as reflected by alkaline phosphatase activity and BGP accumulation.     

The effect of decalcified bone matrix on the osteogenic potential of bone marrow

Rabbit bone marrow cells were cultured in diffusion chambers with or without decalcified bone matrix. The chambers were assayed after 28 days for alkaline phosphatase activity, deoxyribonucleic acid (DNA), calcium, and phosphorus contents. Morphologically, marrow cells incubated with or without matrix differentiated to form bone and cartilage. With bone matrix, the calcium and phosphorus contents of chambers were significantly higher than control chambers. Alkaline phosphatase activity and DNA content were not influenced by inclusion of bone matrix. These results indicate that bone matrix constituents exert a stimulatory effect on bone formation from marrow cells. This osteogenic stimulation could be due to the influence of an osteoinductive factor and/or to stimulation of osteoprogenitor cells known to be present in the marrow.     

Osteogenesis associated with bone gla protein gene expression in diffusion chambers by bone marrow cells with demineralized bone matrix.

Diffusion chambers with rat bone marrow cells and demineralized bone matrix (DBM) were implanted subcutaneously to syngeneic 8-week-old rats and were harvested every week 3-7 weeks after implantation, and histochemical examination, determination of alkaline phosphatase activity, total calcium and phosphorus, the bone-specific vitamin K-dependent gla-containing protein (BGP) content, and detection of BGP mRNA relative to mineralization were performed. Alkaline phosphatase in diffusion chamber implants reached the highest activity at 4 weeks and then decreased. Calcium and phosphorus deposits occurred at 4 weeks after implantation and were followed by marked increases until 7 weeks, which was comparable to the accumulation of BGP. The BGP gene within the diffusion chambers began to be expressed at 5 weeks, and its expression increased markedly at 7 weeks after implantation. At 4-5 weeks after implantation, new bone adjacent to the membrane filters and cartilage toward the center of the diffusion chamber were observed histochemically. Light microscopic and immunohistologic examinations of chambers with marrow cells and DBM revealed production of mineralized matrices, typical of bone characterized by the appearance of BGP and mineralized nodules. In contrast, bone marrow cells alone did not show extensive bone formation and yielded very low values for these biochemical parameters. The present experiments demonstrate the potential of bone marrow cells and DBM to produce not only cartilage formation but also membranous bone formation associated with increasing expression of BGP mRNA during the later stages of bone formation, as well as a marked accumulation of BGP.     

The effects of demineralized bone matrix and direct current on an "in vivo" culture of bone marrow cells

Bone marrow cells (BMCs) from rabbit femora and tibiae were grown in diffusion chambers implanted in rabbit muscle. At 42 days 80% of the BMC chambers exhibited cartilage formation within them. Demineralized bone matrix added to the marrow cell suspension in the chamber accelerated the appearance and increased the number of chambers with cartilage. Mineralization of the cartilage also occurred earlier in the chambers with bone matrix. In a second experiment, a 5-microA direct current cathode in the bone marrow chamber increased the number of chambers containing cartilage from 50 to 80% at day 25. Mineralization also occurred earlier in the chambers with direct current.     

Promotion of calvarial cell osteogenesis by endothelial cells

Bone development and remodeling are associated with changes in the pattern of vascularization. Here we show that endothelial cells isolated from rat liver or bovine aorta can greatly enhance bone formation when implanted in diffusion chambers with rat fetal calvarial cells. The latter cells are unable to form bone when implanted alone at low initial cell density. The amount of mineralization measured by calcium deposition was 70 times higher in chambers containing calvarial cells mixed with endothelial cells from isologous liver or bovine aorta than in chambers containing endothelial or calvarial cells alone. Alkaline phosphatase activity was increased 20-fold. Calvarial cells in the presence of demineralized bone matrix powder did not form bone when implanted under similar conditions. Endothelial cells implanted alone seemed to enhance neovascularization around the Millipore diffusion chambers.     

Induction of human osteoprogenitor chemotaxis, proliferation, differentiation, and bone formation by osteoblast stimulating factor-1/pleiotrophin: osteoconductive biomimetic scaffolds for tissue engineering.

The process of bone growth, regeneration, and remodeling is mediated, in part, by the immediate cell-matrix environment. Osteoblast stimulating factor-1 (OSF-1), more commonly known as pleiotrophin (PTN), is an extracellular matrix-associated protein, present in matrices, which act as targets for the deposition of new bone. However, the actions of PTN on human bone progenitor cells remain unknown. We examined the effects of PTN on primary human bone marrow stromal cells chemotaxis, differentiation, and colony formation (colony forming unit-fibroblastic) in vitro, and in particular, growth and differentiation on three-dimensional biodegradable porous scaffolds adsorbed with PTN in vivo. Primary human bone marrow cells were cultured on tissue culture plastic or poly(DL-lactic acid-co-glycolic acid) (PLGA; 75:25) porous scaffolds with or without addition of recombinant human PTN (1 pg-50 ng/ml) in basal and osteogenic conditions. Negligible cellular growth was observed on PLGA scaffold alone, generated using a super-critical fluid mixing method. PTN (50 microg/ml) was chemotactic to human osteoprogenitors and stimulated total colony formation, alkaline phosphatase-positive colony formation, and alkaline phosphatase-specific activity at concentrations as low as 10 pg/ml compared with control cultures. The effects were time-dependent. On three-dimensional scaffolds adsorbed with PTN, alkaline phosphatase activity, type I collagen formation, and synthesis of cbfa-1, osteocalcin, and PTN were observed by immunocytochemistry and PTN expression by in situ hybridization. PTN-adsorbed constructs showed morphologic evidence of new bone matrix and cartilage formation after subcutaneous implantation as well as within diffusion chambers implanted into athymic mice. In summary, PTN has the ability to promote adhesion, migration, expansion, and differentiation of human osteoprogenitor cells, and these results indicate the potential to develop protocols for de novo bone formation for skeletal repair that exploit cell-matrix interactions.     

Assessment of anin vivo diffusion chamber method as a quantitative assay for osteogenesis

Summary The alkaline phosphatase activity and the calcium and phosphorus content of osteogenic tissue formedin vivo following the implantation of diffusion chambers loaded with rabbit bone marrow cells is reported. (In this study the term osteogenic includes osteoblastic and chondroblastic.) Chambers examined 14–70 days after implantation revealed progressive accumulation of mineral. Alkaline phosphatase activity increased until day 30 and declined thereafter. The osteogenic potential of the marrow cells decreased with increasing weight (age) of the cell donor rabbit when measured either as the percentage of chambers containing osteogenic tissue or as the amount of calcium, phosphorus, or alkaline phosphatase activity within the chambers. The results confirm that measurements of these parameters in tissue formed by cells incubated in diffusion chambersin vivo may be used as a method for assay of osteogenesis.     

The collagens and glycosaminoglycans of the extracellular matrices secreted by bone marrow stromal cells cultured in vivo in diffusion chambers

When rabbit bone marrow cells are cultured in a diffusion chamber implanted into the peritoneal cavity of an athymic mouse, the stromal cells proliferate, differentiate, and produce tissues that have the morphological features of loose fibrous tissue, woven or chondroid bone, and cartilage. The collagens synthesized during the development of the tissues from 7 to 28 days after implantation were identified using specific antibodies to rabbit types I, II, III, and V and rat type IX collagens, while the glycosaminoglycans were characterized histochemically using the dye, Alcian blue. Fibrous tissue forms in the first week and it contains types I, III, and V collagens and hyaluronan. Bone and cartilage develop within the fibrous tissue from about 12 days onwards. The bone matrix contains types I and V collagens, and chondroitin and keratan sulphates. The cartilaginous matrix contains types II and IX collagens, and chondroitin and keratan sulphates. Small amounts of type III collagen are found in the bone, and types I, III, and V collagens in the cartilage. These are thought to be the remnants of the fibrous matrix and decrease as the matrices mature. It is concluded that the tissue in diffusion chambers, formed by a small number of early precursor cells present in the soft tissues of the endosteum and marrow of young rabbits, contains extracellular matrix macromolecules similar to those found in bone and cartilage.     

Effects of lathyritic drugs and lathyritic demineralized bone matrix on induced and sustained osteogenesis

Demineralized bone matrix was implanted in normal and lathyritic rats. At 2 weeks, the bone that formed in the lathyritic animals had an elevated alkaline phosphatase activity and a reduced calcium content compared with the controls. Four weeks after implantation, these biochemical parameters were reversed, with a decrease in alkaline phosphatase activity and an increase in calcium content to control levels. the histology of the recovered implants revealed new bone formation. Lathyritic demineralized bone matrix was prepared from bones of rats fed β-aminopropionitrile for 2 weeks (2-week BAPN-DBM) or 4 weeks (4-week BAPN-DBN), and was implanted in normal rats. Two weeks after implantation, both preparations of lathyritic demineralized bone matrix demonstrated early bone formation, although alkaline phosphatase activity and calcium content were reduced. By 4 weeks after implantation, no biochemical or histological evidence of bone formation remained at the site of the 4-week BAPN-DBM implants; continued but reduced bone formation was observed at the site of the 2-week BAPN-DBM implants. Reconstitution of inactivated normal demineralized bone matrix with the guanidine-soluble extracts restored the osteoinductive capacity. However, reconsistution of inactivated lathyritic demineralized bone matrix (4-week BAPN-DBM) failed to restore the osteoinductive capacity. These results indicate that the degree of crosslinking of the collagen matrix that acts as a carrier for osteoinductive proteins plays a key role in inducing and sustaining osteogenesis.     

A radiographical and biomechanical study of demineralized bone matrix implanted into a bone defect of rat femurs with and without bone marrow

Repair of large bone defects represents a challenge to orthopedic surgery since autogenous graft is not available in large amounts. Demineralized bone matrix (DBM) which contains bone morphogenic protein, a potent osteoinductive glycoprotein, and collagen, an osteoconductive matrix, may be an effective substitute for these graft materials. Bone marrow which contains osteoprogenitor cells could potentiate the osteoinductive and osteoconductive properties of demineralized bone matrix. This study tested the ability of demineralized bone matrix with and without bone marrow to bridge large segmental defects, and evaluated the results both radiographically and biomechanically as compared to autogenous (isogeneic) cancellous bone graft. Demineralized bone-matrix segments implanted into a plated femoral segmental defect in rats resulted in firm union in most animals. Bone marrow significantly enhanced bone formation of demineralized bone-matrix implants at an early stage but with time, differences between bone marrow-augmented and bone marrow-deprived demineralized bone implants were no longer demonstrable radiographically and biomechanically. Newly formed bone had about 50% of the strength of the contralateral control bones. Femurs implanted with cancellous bone isografts had similar evidence of absolute union rate, radiographic and mechanical properties as DBM-implanted femurs.     

Mineralization and the Expression of Matrix Proteins During In Vivo Bone Development

The in vivo expression of fibronectin, type I collagen, and several non-collagenous proteins was correlated with the development of bone in fetal and early neonatal rat calvariae. Fibronectin was the earliest matrix protein expressed in calvariae, with a peak expression in fetal 16- and 17-day (d) bones. Fibronectin expression coincided with the condensation of preosteoblasts prior to calcification and decreased once bone mineralization commenced. The expression of type I collagen, osteonectin, bone sialoprotein, and alkaline phosphatase mRNAs was found at 17 d. The increase in type I collagen mRNA levels was correlated with a 3.5-fold increase in calcium deposition at 19–20 d. Bone sialoprotein and alkaline phosphatase peaked on fetal 21 d while osteonectin remained at a low level and was localized to the osteoblast layer and the osteocyte lacunae. Osteopontin mRNA levels increased rapidly in neonatal calvariae. After birth, osteonectin and fibronectin were mainly associated with blood vessels. Thus, fibronectin is one of the earliest matrix proteins expressed in calvariae and is rapidly followed by type I collagen, bone sialoprotein, and alkaline phosphatase. Osteocalcin, osteonectin, and osteopontin mRNAs have similar patterns of expression in the developing fetal calvaria, and their synthesis coincided with mineralization. Received: 31 December 1996 / Accepted: 5 June 1997     

Osteogenesis by canine and rabbit bone marrow in diffusion chambers

Summary Osteogenic activity of canine and rabbit bone marrow and marrow stromal fibroblasts (MSF) derived from marrow culturedin vitro was evaluated using diffusion chambers. Marrow from young dogs and rabbits grown in cell culture produced confluent layers of MSF. Diffusion chambers containing 0.18–7.6×10⁶ allogeneic MSF were inserted into the peritoneal cavities of 5 dogs and 6 rabbits. Chambers recovered from the dogs (15/16) contained only loose fibrous tissue while chambers from rabbits (9/13) contained membranous bone and cartilage. Diffusion chambers implanted with 1.0–32.4×10⁷ fresh allogeneic marrow cells suspended in cell culture medium were inserted into the peritoneal cavities of 11 dogs and 9 rabbits for 3–8 weeks, and after recovery examined histologically. Membranous bone was formed in 4/40 chambers containing canine marrow while bone and hyaline cartilage was formed in 21/27 chambers containing rabbit marrow. This apparent species difference in incidence of bone marrow osteogenesis may relate to a lower concentration of osteogenic precursor cells in canine marrow, a failure of osteogenic precursor cells to differentiate to osteoblasts in a somewhat artificial environmentin vivo (viz diffusion chambers), a lack of cell-matrix interaction to stimulate cell differentiation, inappropriately short diffusion chamber implantation times post grafting, or a difference in ontogenetic stage of development of marrow donors with rabbit cells being physiologically younger.     

Characterization of cells with osteogenic potential from human marrow.

Studies using animal tissue suggest that bone marrow contains cells with the potential to differentiate into cartilage and bone. We report the extension of these studies to include human marrow. Bone marrow from male and female donors of various ages was obtained either from the femoral head or as aspirates from the iliac crest, and introduced into culture. Culture-adherent cells were expanded, subcultured, and then tested for bone and cartilage differentiation potential utilizing two different in vivo assays in nude mice. One assay involved subcutaneous implantation of porous calcium phosphate ceramics loaded with cultured, marrow-derived, mesenchymal cells; the other involved peritoneal implantation of diffusion chambers, also inoculated with cultured, marrow-derived, mesenchymal cells. Histological evaluation showed bone formation in ceramics implanted with cultured, marrow-derived, mesenchymal cells originating from both the femoral head and the iliac crest. Immunocytochemical analysis indicates that the bone is derived from the implanted human cells and not from the cells of the rodent host. No cartilage was observed in any of these ceramic grafts. In contrast, aliquots from the same preparations of cultured, marrow-derived, mesenchymal cells failed to form bone or cartilage in diffusion chambers. These data suggest that human marrow contains cells with osteogenic potential, which can be enriched and expanded in culture. Our findings also suggest that subcutaneous implantation of these cells in porous calcium phosphate ceramics may be a more sensitive in vivo assay than diffusion chambers for measuring their osteogenic lineage potential.     

Metabolic consequences of bone turnover in Paget's disease of bone

High rates of bone resorption, bone formation, and marrow fibrosis are characteristic of Paget's disease of bone. This excessive bone turnover is reflected by increased fluxes of calcium ions out of and into the skeleton. The rates of these fluxes are highly geared to each other such that calcium balances are close to zero in the absence of fracture or significant immobilization. An increased turnover of bone matrix is also evident by increased urinary excretion of collagen breakdown products (oligopeptides of hydroxyproline, hydroxylysine, and hydroxylysine glycosides) as well as products (peptides of higher molecular weight) related to collagen synthesis. Increased circulatory levels of procollagen extension fragments reflect increased synthesis of Type I collagen (bone matrix) and Type III collagen (marrow fibrosis). Increased levels of bone gamma-carboxyglutamic acid-protein presumably reflect primarily bone matrix synthesis but bone resorption as well. When bone resorption is suppressed pharmacologically, the abnormal levels of these markers of matrix turnover and osteoblastic activity (alkaline phosphatase) also decrease, presumably as a result of coupling of resorption and formation.     

Experimental osteoinduction in rats: collagen-apatite versus osteogenin-containing gelatine

An experimental study in rats was done to investigate the bone-regenerating properties of collagen apatite (Collapat) and to compare it with osteoinduction dependent on osteogenin-containing gelatine (OCG). The test substances were implanted orthotopically (calvarial defect--7 mm in diameter) and heterotopically (paravertebral muscles, abdominal muscles). The results were evaluated histologically and enzymatically (alkaline phosphatase). Collapat caused neither osteoinduction in the heterotopic site nor healing of the bone defects. Foreign body reaction without new bone formation was encountered. OCG implantation leads to new bone formation in the muscles within 3 weeks, associated with a significant increase in alkaline phosphatase activity, and to extensive new bone formation in the calvarial defect within 4 weeks. The defects did not heal if left empty. The value of clinical application of Collapat appears to be doubtful. Osteoinduction with OCG requires further experimental investigation.