■骨科植入物制造的革命正在由钛植入物的3D打印驱动,以用于大型骨缺损,例如由糖尿病Charcot关节病引起的缺损。与传统的减法制造骨科植入物不同,3D打印熔断钛粉逐层,创造一个独特的表面粗糙度,可能会增强骨整合。然而,糖尿病引起的代谢障碍,包括骨代谢的负面改变,传统制造的骨科植入物会导致骨不连和骨整合减少。这项研究旨在表征在高和低葡萄糖条件下在医疗级3D打印钛表面上培养的健康和糖尿病原代人成骨细胞的反应。
■从6名患者中获取骨样本,三个患有2型糖尿病,三个没有。将原代成骨细胞分离并在3D打印的钛盘上在高(4.5g/L的D-葡萄糖)和低葡萄糖(lg/L的D-葡萄糖)培养基中培养。细胞形态学,基质沉积,和矿化使用扫描电子显微镜和茜素红染色进行评估。在体外测量碱性磷酸酶活性和L-乳酸浓度以评估功能性成骨细胞活性和细胞代谢。BGLAP的成骨基因表达,使用逆转录定量聚合酶链反应分析COL1A1和BMP7。
■与健康的成骨细胞相比,糖尿病成骨细胞对葡萄糖水平的变化无反应。碱性磷酸酶活性,L-乳酸生产,矿物沉积,在两种葡萄糖条件下,糖尿病成骨细胞中的成骨基因表达保持不变。相比之下,健康的成骨细胞在高糖环境中表现出增强的功能反应性,并显示BGLAP的成骨基因表达显着增加,COL1A1和BMP7(p<0.05)。
■我们的研究结果表明,糖尿病成骨细胞对葡萄糖浓度变化的反应性受损,强调糖尿病患者潜在的成骨细胞功能障碍。这可能对糖尿病患者术后血糖管理策略有影响。尽管3D打印对骨科植入物有潜在的好处,特别是糖尿病Charcot塌陷,我们的研究结果需要进一步研究,以优化这些干预措施,从而改善患者预后.
UNASSIGNED: The revolution of orthopedic implant manufacturing is being driven by 3D printing of titanium implants for large bony defects such as those caused by diabetic Charcot arthropathy. Unlike traditional subtractive manufacturing of orthopedic implants, 3D printing fuses titanium powder layer-by-layer, creating a unique surface roughness that could potentially enhance osseointegration. However, the metabolic impairments caused by diabetes, including negative alterations of bone metabolism, can lead to nonunion and decreased osseointegration with traditionally manufactured orthopedic implants. This study aimed to characterize the response of both healthy and diabetic primary human osteoblasts cultured on a medical-grade 3D-printed titanium surface under high and low glucose conditions.
UNASSIGNED: Bone samples were obtained from six patients, three with Type 2 Diabetes Mellitus and three without. Primary osteoblasts were isolated and cultured on 3D-printed titanium discs in high (4.5 g/L D-glucose) and low glucose (1 g/L D-Glucose) media. Cellular morphology, matrix deposition, and mineralization were assessed using scanning electron microscopy and alizarin red staining. Alkaline phosphatase activity and L-lactate concentration was measured in vitro to assess functional osteoblastic activity and cellular metabolism. Osteogenic gene expression of BGLAP, COL1A1, and BMP7 was analyzed using reverse-transcription quantitative polymerase chain reaction.
UNASSIGNED: Diabetic osteoblasts were nonresponsive to variations in glucose levels compared to their healthy counterparts. Alkaline phosphatase activity, L-lactate production, mineral deposition, and osteogenic gene expression remained unchanged in diabetic osteoblasts under both glucose conditions. In contrast, healthy osteoblasts exhibited enhanced functional responsiveness in a high glucose environment and showed a significant increase in osteogenic gene expression of BGLAP, COL1A1, and BMP7 (p<.05).
UNASSIGNED: Our findings suggest that diabetic osteoblasts exhibit impaired responsiveness to variations in glucose concentrations, emphasizing potential osteoblast dysfunction in diabetes. This could have implications for post-surgery glucose management strategies in patients with diabetes. Despite the potential benefits of 3D printing for orthopedic implants, particularly for diabetic Charcot collapse, our results call for further research to optimize these interventions for improved patient outcomes.