Abstract
Despite magnesium based metal materials are widely used in bone defect repair, there are still various deficiencies, and their properties need to be optimized. Composites synthesized with magnesium based metal as matrix are the research hotspot, and the host immune response after biomaterial implantation is very important for bone binding. By studying the immunoregulation of bone biomaterials, it can regulate the immune response in the process of osteogenesis and create a good local immune microenvironment, which is conducive to biomaterials to reduce inflammatory response and promote good bone binding. This article introduces the osteogenic mechanism of magnesium based metal materials and its regulation on bone immune microenvironment in detail.
Introduction
Applications of Magnesium(Mg) Matrix Composites
Mg is a light metal with low density, high strength/weight ratio, in addition Mg and its alloys exhibit good biocompatibility as a kind of degradable and absorbable biomaterials (). Compared with metallic materials that are now widely used in the clinic, the elastic modulus of Mg based metallic materials is closer to the bone cortex, structurally and mechanically similar to trabecular bone, favoring the growth of bone tissue toward its interior and obtaining early fixation effects, thus reducing the “stress shielding effect”. However, Mg based metal is a double-edged sword as a biomaterial. Due to the poor corrosion resistance, Mg alloys degrade too fast and do not match the time of bone tissue healing, making it difficult to exert the osteogenic effect of Mg alloys, and the gas generated during the degradation process may cause a local inflammatory response, which greatly limits the application of Mg alloys in the clinic. There are many methods to reduce the degradation rate of Mg metal materials, such as Mg purity, alloying components, surface modification and increasing coatings ().
High Purity Mg
Since the purity of Mg metal reached higher (99.99% or 99.999%), it can have a degradation rate suitable for the internal fixation material of bone repair. At the same time, high-pure Mg in vivo degradation will not release other alloying elements, avoiding the disadvantages of other non degradable elements aggregation in vivo, these advantages make the application of high-pure Mg in bone repair gradually attract attention. In the related research process, it was found that pure Mg has a series of problems, such as pitting corrosion, degradation rate faster so that hydrogen gas accumulation around the implant delays the healing of the tissue (; ).
Mg Alloys
Alloying is a general and effective method to improve the corrosion resistance and mechanical properties of Mg, and considerable work has focused on this method, such as the addition of aluminum (Al), zinc (Zn), strontium (Sr), yttrium (Y), and cerium (Ce) elements (; ; Wu et al., 2016). However, the use of some alloying elements is still potentially hazardous to human body, such as the high concentration of Ce, the hepatotoxicity of Y as well as the neurotoxicity of Al (Zain et al., 2012). As a neurotoxicant, the accumulation of Al is associated with various neurological diseases, such as dementia, senile dementia and Alzheimer’s disease ().
Calcium (Ca) is a major component of bone, and Ca ions are also necessary for each cell they regulate various biochemical reactions in vivo, such as in the absence of serum in culture medium, and the addition of Ca ions can enhance the proliferation of stem cells and induce osteogenic differentiation (; ). Multiple in vitro studies have also reported the enhancing effects of Mg or Ca on osteoblast activity, such as improving cell growth status and alkaline phosphatase (ALP) expression ().
Both oral and in vitro studies confirm that Sr can pharmacologically increase bone formation and decrease bone resorption at the cellular level (; ) and Sr compounds can activate osteoblast and osteoclast activity through different signaling pathways (). Li studies proved that Sr can promote osteogenic differentiation of stem cells, and up regulation of several osteogenic genes as well as an increase in ALP protein expression was observed when rat mesenchymal stem cell (MSCs) were cultured in Sr supplemented medium (). An increase in the gene and protein expression of various osteogenic markers was detected in osteogenic human stem cells (hMSCs) cultures treated with Sr by Sila et al. (). In addition to this small amount of strontium can promote the regeneration of grains and thus improve the mechanical properties of pure Mg ().
Surface Modification/Coating Treatment of Mg Alloy
Pure Mg or Mg alloys can be treated physically or chemically to form a “protective film” on their surface that can reduce the degradation rate of the substrate, which can include micro arc oxidation coating (MAO), chemical conversion coating, electroplating coating, biomimetic deposition coating, polymer coating, etc. (). Among all these methods, MAO is a promising new surface treatment method, and the MAO technique shows excellent adhesion to the base metal. In addition, this technique has many advantages, such as simple surface pretreatment, simple process, low cost, and comprehensive properties, which can improve corrosion resistance, wear resistanceand microhardness of Mg alloys (Zhu et al., 2016). In immersion tests, the mechanical properties of MAO coated samples remain unchanged and have good biocompatibility. However, MAO coatings on Mg alloys are composed of micro pores and cracks, which may affect the protective properties of the coatings and accelerate the corrosion rate (; ). The coating process of the self-assembly technique resulted in the formation of a double-layer PEI/KC: Mao coating on the surface of AZ91 Mg alloy, which led to an increase in the thickness of the coating and improved the coating and filling of pores, and the bonding strength of the double-layer PEI/KC: MAO coating was significantly higher (about 1.3-fold) than that of the MAO coating, the double-layer PEI/KC: MAO coating improved the anti-corrosion ability of AZ91 Mg alloy with the potential for application in biomedicine by prohibiting the corrosive ion transport. In some studies, zirconia (ZrO2) materials have been used in biomedicine to obtain implants or various coatings. It is bioneutral, and its result is equivalent to titanium, but it does not affect the growth rate of osteoblasts. At the same time, ZrO2 nanoparticles have antibacterial properties. ZrO2 is an important biomaterial, widely used in applications such as dental implants, where osteointegration is of minor importance compared to the requirements. The effects of 100 nm thick titanium dioxide (TiO2), ZrO2 and hafnium oxide (HfO2) coatings on the corrosion behavior and cytotoxicity of AZ31Mg alloy were evaluated. The results show that ZrO2 has the higher corrosion resistance and cell viability ().
Other Types of Composites
Recent studies have shown that customized poly lactic-co- glycolic acid (PLGA)/MgO alendronate microspheres are used to study the bone immune regulation of extracellular bioactive cations (Mg2+) in the bone tissue microenvironment. The microspheres give a controllable release of Mg2+. The results show that Mg2+ controlled tissue microenvironment can enhance anti-inflammatory (IL-10) and promote bone protein (BMP-2 and TGF-β1). The production of cytokines effectively induced macrophages to polarize from M0 phenotype to M2. It can also produce a good bone immune microenvironment. The newly formed bone tissues in the Mg TME possess a superior microstructure, bone mineral density, and mechanical property (). In addition, injectable in-situ formed hydrogels have been extensively studied in bone regeneration applications. This hydrogel can not only be quickly and locally formed in any geometric target, but also play an important role in minimally invasive treatment, and it is also used to enhance the damage of bone tissue as a carrier for delivery of therapeutic drugs and cells. Gelatin, collagen, gelatin, hyaluronic acid and alginate, injectable hydrogels, which are prepared from natural polymers, have been widely used in bone tissue engineering due to their physical and chemical properties, excellent biocompatibility and structural similarity with extracellular matrix. Studies have shown that Injectable in-situ formed hydrogels as a carrier of Mg matrix composites helps to promote osteoblast differentiation ().
The Role of Mg Matrix Composites in Macrophage-Mediated Inflammatory Response
Biomaterials trigger a foreign body response (FBR) upon implantation, involving a series of inflammatory events and repair processes including protein adsorption, immune cell infiltration, cytokine and chemokine release, cell recruitment, and fiber encapsulation (Zhang et al., 2016). Therefore, the study of “bone immune microenvironment” of bone repair materials is a major issue to be faced. Timely and appropriate protection and adequate immune response will promote the integration of implant surface and host bone tissue, creating a microenvironment that promotes osteogenesis, which is conducive to promoting bone repair of implant materials (). The development of bone immunology has become one of the greatest achievements in the field of bone biology, which reveals the important role of immune cells in regulating bone dynamics (). By studying the immune regulation of bone biomaterials, it can regulate the immune response in the process of osteogenesis, create a good local immune microenvironment, and help biomaterials reduce inflammatory response and promote good bone binding (). As shown in Figure 1, with the introduction of the concept of bone immunity and its development in the field of bone regeneration, researchers gradually found that immune cells play a central role in the formation of local bone microenvironment. By regulating the expression of growth factors, chemokines, inflammatory factors and other factors, osteogenic differentiation, osteoclast differentiation, fibrosis, vascularization and other processes closely related to bone regeneration are regulated in bone regeneration. Moreover, immune cells are the central regulators of bone immune microenvironment, and affect the process of osteogenesis, osteofragmentation and fibrosis in the process of bone regeneration by secreting various cytokines into the bone regeneration microenvironment ().
FIGURE 1
Polarization of Macrophage Phenotype Plays a Central Role in the Regulation of Inflammatory Response
Macrophages, especially monocyte derived macrophages, are key regulators. Traditionally, these cells have been known to remove foreign bodies and cell debris—both pathogens and tiny matter. Increasingly, they are found to play important roles in a wide range of processes from host defense, inflammation, wound healing, and tissue remodeling (
FIGURE 2

Macrophages have high plasticity and exhibit pro-inflammatory M1 or anti-inflammatory M2 types (
Regulatory Role of Mg in Macrophage-Mediated Inflammatory Response
Studies have shown that Mg2+, a major degradation product of Mg, is the most abundant divalent cation in cells, which can regulate cell growth, metabolism, proliferation and other cellular functions, and has the function of anti-inflammatory regulation of bone immune microenvironment (
Mechanisms of Osteogenesis of Mg Matrix Composites
Promotion of ERK Signaling Pathway in Osteoblasts by Degradation Products From Mg-Ca-Sr Alloys
In osteoblasts, a critical member of mitogen-activated protein kinase cascades (MAPK) plays an important role in cell proliferation and differentiation. ERK1/2 is a positive regulator for osteoblast differentiation and bone formation. Studies have shown that C3G may act through ERK1/2 signaling pathways in various cells (
FIGURE 3

Mg2+, Ca2+ and Sr2+could promote osteogenic gene expression via binding to calcium-sensing receptor (CaSR) and activating ERK signaling pathway through Ras/Raf/MEK/ERK pathway (
The Underlying Mechanism of Mg Ions Promoting Osteogenesis May be Achieved by Activating the MAPK/ERK Signaling Pathway or Promoting Osteoblast Proliferation and Differentiation via Wnt/β - Catenin
MAPK/ERK is an important signaling pathway that regulates the processes of bone development, bone remodeling, and bone metabolism (
FIGURE 4

Mg ions promoting osteogenesis may be achieved by activating the MAPK/ERK signaling pathway or promoting osteoblast proliferation and differentiation via Wnt/β-Catenin (
Mg Ions is Involved in the PI3K/Akt Signaling Pathway Through the Ion Channel Functional Protein Kinase TRPM7
Two cation channels of the transient receptor potential hormone (TRPM) family have been characterized as Mg2+ transporters: TRPM6 and TRPM7. TRPM7 is both an ion channel and a phosphokinase active transmembrane protein, it has been implicated in cell proliferation and cell motility in various normal tissues (Yang et al., 2013;
Mg Ions Promote Osteogenic Differentiation via the Notch Signaling Pathway
As shown in Figure 5, these effects were not observed after inhibition of the Mg2+ channel TRPM7 by 2-APB confirming the crucial role of intracellular Mg2+ during MSCs osteogenesis, and Mg supplementation enhances MSCs proliferation. Mechanistically, Mg ions enter MSCs through TRPM7 channels and increase Notch intracellular domain (NICD) nuclear translocation. Proliferation of MSCs contributes to subsequent osteogenesis, and inhibition of 2-APB channels decreases the osteogenic potential of Mg (
FIGURE 5

Mg ions enter into MSC through TRPM7 channel, increasing Notch Intracellular Domain (NICD) nuclear translocation (
Activation of CREB1 and SP7 by Mg Mediated CGRP
Calcitonin peptide (CGRP) primarily located in small sensory fibers, most usually found in nerves that are closely associated with blood vessels. The periosteum contains sensory nerves and releases neuropeptides, such as CGRP, which are known as involving in bone healing (). It has been demonstrated that magnesium ion release implantation enhances the synthesis of CGRP in the dorsal root ganglion (DRG) and its release at the end of the sensory nerve periosteum, and the CGRP mediated pathway has been identified as a major mechanism of potential magnesium to promote bone formation in fracture healing. Some study also demonstrates that CGRP processes an equal effect on migration and tube formation compared with VEGF, accompanied by increased VEGF expression, and activation of focal adhesion kinase (FAK), thereby acting as a strong proangiogenic growth factor during bone healing (
FIGURE 6

Activation of CREB1 and SP7 by Mg mediated CGRP (Zhang et al., 2016).
Conclusion
In conclusion, The synthesis of Mg matrix composites is a hot research topic nowadays, and the host immune response is very important for bone bonding after biomaterial implantation. By studying the immune regulation of bone biomaterials, it can regulate the immune response in the process of osteogenesis, create a good local immune microenvironment, and help biomaterials reduce inflammatory response and promote good bone bonding. This study provides basic evidence for the development or modification of advanced Mg-based bone biomaterials and suggests new strategies. It has broad prospects and application value in the field of bone repair. It will provide experimental basis for exploring new bone tissue engineering materials with good antibacterial activity, excellent bone conductivity and suitable biodegradability, and further improve the application effect and scope of guided bone regeneration technology and bone tissue engineering materials in the field of implantation, It lays a good foundation for the final development of international advanced domestic bone tissue engineering materials.
Statements
Author contributions
XN: Formal analysis, Writing Reviewing and Editing. XZ, YS: Literature review. JY: Examination and polishing of articles. All authors contributed to the article and approved the submitted version.
Funding
This work was supported by the Academic Research Projects of Beijing Union University (No.ZK70202006) and Beijing Youth top individual project (2016000026833ZK04), the National Natural Science Foundation of China (No. 5177050098), the collaborative innovation project of Chaoyang District, Beijing (CYXC2102). Xinjiang Uygur Autonomous Region Youth Science Foundation Project (2022D01C208).
Acknowledgments
The authors are grateful for the Xinjiang Medical University and College of Robotics, Beijing Union University.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
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Summary
Keywords
magnesium, functionalmaterials, coating, osteogenesis, osteogenic mechanism, bone immunity
Citation
Nie X, Zhang X, Lei B, Shi Y and Yang J (2022) Regulation of Magnesium Matrix Composites Materials on Bone Immune Microenvironment and Osteogenic Mechanism. Front. Bioeng. Biotechnol. 10:842706. doi: 10.3389/fbioe.2022.842706
Received
24 December 2021
Accepted
10 February 2022
Published
14 March 2022
Volume
10 - 2022
Edited by
Yuangang Liu, Huaqiao University, China
Reviewed by
Qiang Lu, Soochow University, China
Fengxuan Han, Soochow University, China
Junchao Wei, Nanchang University, China
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Copyright
© 2022 Nie, Zhang, Lei, Shi and Yang.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Xiaojing Nie, 2441209094@qq.com; Jingxin Yang, myxin825@163.com
This article was submitted to Biomaterials, a section of the journal Frontiers in Bioengineering and Biotechnology
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