Bone & Joint Research (Jul 2021)

3D-printed titanium implant combined with interleukin 4 regulates ordered macrophage polarization to promote bone regeneration and angiogenesis

  • Da-Wang Zhao,
  • Bing Ren,
  • Hong-Wei Wang,
  • Xiao Zhang,
  • Ming-Zhi Yu,
  • Lei Cheng,
  • Yuan-Hua Sang,
  • Shuai-Shuai Cao,
  • Florian M. Thieringer,
  • Dong Zhang,
  • Yi Wan,
  • Chao Liu

DOI
https://doi.org/10.1302/2046-3758.107.BJR-2020-0334.R4
Journal volume & issue
Vol. 10, no. 7
pp. 411 – 424

Abstract

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Aims: The use of 3D-printed titanium implant (DT) can effectively guide bone regeneration. DT triggers a continuous host immune reaction, including macrophage type 1 polarization, that resists osseointegration. Interleukin 4 (IL4) is a specific cytokine modulating osteogenic capability that switches macrophage polarization type 1 to type 2, and this switch favours bone regeneration. Methods: IL4 at concentrations of 0, 30, and 100 ng/ml was used at day 3 to create a biomimetic environment for bone marrow mesenchymal stromal cell (BMMSC) osteogenesis and macrophage polarization on the DT. The osteogenic and immune responses of BMMSCs and macrophages were evaluated respectively. Results: DT plus 30 ng/ml of IL4 (DT + 30 IL4) from day 3 to day 7 significantly (p < 0.01) enhanced macrophage type 2 polarization and BMMSC osteogenesis compared with the other groups. Local injection of IL4 enhanced new bone formation surrounding the DT. Conclusion: DT + 30 IL4 may switch macrophage polarization at the appropriate timepoints to promote bone regeneration.

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