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Cited by 42Magnesium Alloys: Properties and ApplicationsTitanium Alloys Microstructure and PropertiesBone Tissue Engineering Materials

Magnesium implant degradation provides immunomodulatory and proangiogenic effects and attenuates peri-implant fibrosis in soft tissues

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Ben Amara, Heithem, Martinez, Diana C., Shah, Furqan A., Loo, Anna Johansson, Emanuelsson, Lena, Norlindh, Birgitta, Willumeit-Römer, Regine, Plocinski, Tomasz +4 more·2023·Bioactive Materials
DOI 10.1016/j.bioactmat.2023.02.014PMC PMC10024189
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Abstract

Implants made of magnesium (Mg) are increasingly employed in patients to achieve osteosynthesis while degrading in situ. Since Mg implants and Mg2+ have been suggested to possess anti-inflammatory properties, the clinically observed soft tissue inflammation around Mg implants is enigmatic. Here, using a rat soft tissue model and a 1–28 d observation period, we determined the temporo-spatial cell distribution and behavior in relation to sequential changes of pure Mg implant surface properties and Mg2+ release. Compared to nondegradable titanium (Ti) implants, Mg degradation exacerbated initial inflammation. Release of Mg degradation products at the tissue-implant interface, culminating at 3 d, actively initiated chemotaxis and upregulated mRNA and protein immunomodulatory markers, particularly inducible nitric oxide synthase and toll-like receptor-4 up to 6 d, yet without a cytotoxic effect. Increased vascularization was demonstrated morphologically, preceded by high expression of vascular endothelial growth factor. The transition to appropriate tissue repair coincided with implant surface enrichment of Ca and P and reduced peri-implant Mg2+ concentration. Mg implants revealed a thinner fibrous encapsulation compared with Ti. The detailed understanding of the relationship between Mg material properties and the spatial and time-resolved cellular processes provides a basis for the interpretation of clinical observations and future tailoring of Mg implants.

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Authors
Ben Amara, H., Martinez, D. C., Shah, F. A., Loo, A. J., Emanuelsson, L., Norlindh, B., Willumeit-Römer, R., Plocinski, T., Swieszkowski, W., Palmquist, A., Omar, O., & Thomsen, P.
Affiliations
  • Warsaw University of Technology (PL)
  • University of Gothenburg (SE)
Corresponding author
Thomsen, Peter
ORCID
Venue
Bioactive Materials
Publisher
Elsevier BV
Published
2023-08
Volume
26
Pages
353-369
ISSN
  • 2097-1192 (ISSN-L)
  • 2452-199X
DOI
10.1016/j.bioactmat.2023.02.014
PMC
PMC10024189
OpenAlex
W4324394047
Cited by
42
References
3
Citations by year
2026: 7 · 2025: 19 · 2024: 12 · 2023: 4
FWCI
2.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Bioactive Materials (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Stiftelsen Handlanden Hjalmar Svenssons (2020\u201395)
  • Swedish Research Council (2018\u201302891, 2020\u201304715)
  • IngaBritt och Arne Lundbergs Forskningsstiftelse
  • Horizon 2020 Marie Skłodowska-Curie Actions (811226)
Topics
  • Physical Sciences › Materials Science › Biomaterials › Magnesium Alloys: Properties and Applications
  • Physical Sciences › Materials Science › Materials Chemistry › Titanium Alloys Microstructure and Properties
  • Physical Sciences › Engineering › Biomedical Engineering › Bone Tissue Engineering Materials
Keywords
magnesium implants, biodegradable implants, implant degradation, soft tissue inflammation, immunomodulation, angiogenesis, vascular endothelial growth factor, inducible nitric oxide synthase, TLR4, magnesium ion release, implant surface properties, calcium and phosphorus deposition, titanium implants, fracture fixation, chemotaxis

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