Bone healing is a multidimensional process requiring all elements of the Diamond concept combined with mechanical stability and vascularization [1-2]. The aim of osteobiologic materials is to positively influence the processes to provide a microenvironment that is conducive to bone formation.
Successful bone regeneration requires viable osteogenic cells. Cell survival and growth is “anchorage-dependent”, meaning that cells must firmly adhere and spread onto a substrate to enable their survival and growth [3-4]. Consequently, the speed and quality of bone healing and regeneration is linked directly to the number of viable cells present within the healing environment.
i-FACTOR Bone Graft combines an anorganic bone mineral with a synthetic bioactive peptide, P-15, which replicates the cell-binding domain of type I human collagen. The anorganic bone mineral provides the necessary calcium phosphate and natural anatomical scaffold required for cell invasion and supporting vascularization. The P-15 peptide modulates cell binding, migration, differentiation and proliferation. In vitro studies have shown that P-15 coated substrates are able to bind significantly higher numbers of cells and these cells, once attached, have a lower risk of apoptosis (cell death). Cellular attachment to the P-15 peptide occurs via specific surface integrins which provide secure anchorage, allows mechanotransduction and activates natural signalling pathways within the cell stimulating the secretion of chemo-attractants including transforming growth factor beta (TGF-B) and differentiation factors comprising the Bone Morphogenetic Proteins (BMPs) to recruit neighbouring stem cells and promote heightened differentiation.
Therefore, when combined with mechanical support, the action of the P-15 peptide within i-FACTOR is able to support all biological functions required for bone regeneration in accordance with the Pentagon concept.
References
1. Giannoudis PV et al. Fracture healing: the diamond concept. Injury. 2007 Sep;38 Suppl 4:S3 6, 2007
2. Giannoudis PV et al. The diamond concept-open questions. Injury. 2008 Sep;39 Suppl 2:S5-8, 2008