place a considerable burden on healthcare systems (> $2 billion annually, and post-surgery complications result in nearly 1 million additional days of inpatient care each year). [1][2][3] Surgical intervention via direct end-to-end repair using sutures and biological or synthetic grafts represents the gold standard in treatment, and despite the relative success, these repairs frequently fail to restore full tendon functionality. Following injury, disorganized tissue deposition leads to scar tissue formation, proteoglycan accumulation, and calcification, resulting in poor biomechanical properties and impaired function that triggers chronic inflammatory signaling pathways and progresses into tendinopathy. Hence, to achieve long-term repair, innovative functional solutions that focus on the activation of endogenous tissuerepair signaling pathways represents a paradigm shift in the field of biomedical devices and regenerative medicine (RM). [4] Many studies confirm that resident tendon cell populations are highly mechanosensitive and are responsible for orchestrating the repair processes after injury through specialized sensory machinery, including mechanosensitive ion channels. [5][6][7][8] Critically, mechanotherapy (i.e., low-level exercise or extracorporeal shock waves) has been reported to promote tendon Tendon disease constitutes an unmet clinical need and remains a critical challenge in the field of orthopaedic surgery. Innovative solutions are required to overcome the limitations of current tendon grafting approaches, and bioelectronic therapies show promise in treating musculoskeletal diseases, accelerating functional recovery through the activation of tissue regenerationspecific signaling pathways. Self-powered bioelectronic devices, particularly piezoelectric materials, represent a paradigm shift in biomedicine, negating the need for battery or external powering and complementing existing mechanotherapy to accelerate the repair processes. Here, the dynamic response of tendon cells to a piezoelectric collagen-analogue scaffold comprised of aligned nanoscale fibers made of the ferroelectric material poly(vinylidene fluoride-co-trifluoroethylene) is shown. It is demonstrated that motionpowered electromechanical stimulation of tendon tissue through piezobioelectric device results in ion channel modulation in vitro and regulates specific tissue regeneration signaling pathways. Finally, the potential of the piezo-bioelectronic device in modulating the progression of tendinopathyassociated processes in vivo, using a rat Achilles acute injury model is shown. This study indicates that electromechanical stimulation regulates mechanosensitive ion channel sensitivity and promotes tendon-specific over non-tenogenic tissue repair processes.
The main drawbacks of cardiovascular bare-metal stents (BMS) are in-stent restenosis and stent thrombosis as a result of an incomplete endothelialization after stent implantation. Nano- and microscale modification of implant surfaces is a strategy to recover the functionality of the artery by stimulating and guiding molecular and biological processes at the implant/tissue interface. In this study, cobalt-chromium (CoCr) alloy surfaces are modified via direct laser interference patterning (DLIP) in order to create linear patterning onto CoCr surfaces with different periodicities (≈3, 10, 20, and 32 µm) and depths (≈20 and 800 nm). Changes in surface topography, chemistry, and wettability are thoroughly characterized before and after modification. Human umbilical vein endothelial cells' adhesion and spreading are similar for all patterned and plain CoCr surfaces. Moreover, high-depth series induce cell elongation, alignment, and migration along the patterned lines. Platelet adhesion and aggregation decrease in all patterned surfaces compared to CoCr control, which is associated with changes in wettability and oxide layer characteristics. Cellular studies provide evidence of the potential of DLIP topographies to foster endothelialization without enhancement of platelet adhesion, which will be of high importance when designing new BMS in the future.
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