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Open AccessReview

Adjuvant Drug-Assisted Bone Healing: Advances and Challenges in Drug Delivery Approaches

1
Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany
2
School of Science, Faculty of Chemistry and Food Chemistry, Technische Universität Dresden, 01069 Dresden, Germany
3
University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, 01307 Dresden, Germany
4
Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
5
Center for Regenerative Therapies Dresden (CRTD), Tatzberg 4, 01307 Dresden, Germany
*
Author to whom correspondence should be addressed.
S.R. and J.P. share senior authorship.
Pharmaceutics 2020, 12(5), 428; https://doi.org/10.3390/pharmaceutics12050428
Received: 31 March 2020 / Revised: 24 April 2020 / Accepted: 1 May 2020 / Published: 6 May 2020
Bone defects of critical size after compound fractures, infections, or tumor resections are a challenge in treatment. Particularly, this applies to bone defects in patients with impaired bone healing due to frequently occurring metabolic diseases (above all diabetes mellitus and osteoporosis), chronic inflammation, and cancer. Adjuvant therapeutic agents such as recombinant growth factors, lipid mediators, antibiotics, antiphlogistics, and proangiogenics as well as other promising anti-resorptive and anabolic molecules contribute to improving bone healing in these disorders, especially when they are released in a targeted and controlled manner during crucial bone healing phases. In this regard, the development of smart biocompatible and biostable polymers such as implant coatings, scaffolds, or particle-based materials for drug release is crucial. Innovative chemical, physico- and biochemical approaches for controlled tailor-made degradation or the stimulus-responsive release of substances from these materials, and more, are advantageous. In this review, we discuss current developments, progress, but also pitfalls and setbacks of such approaches in supporting or controlling bone healing. The focus is on the critical evaluation of recent preclinical studies investigating different carrier systems, dual- or co-delivery systems as well as triggered- or targeted delivery systems for release of a panoply of drugs. View Full-Text
Keywords: angiogenesis; bioactive scaffolds; bone grafting; critical-size bone defects; drugs; inflammation; tissue regeneration; osteoconduction; osteoinduction; osseointegration angiogenesis; bioactive scaffolds; bone grafting; critical-size bone defects; drugs; inflammation; tissue regeneration; osteoconduction; osteoinduction; osseointegration
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MDPI and ACS Style

Rothe, R.; Hauser, S.; Neuber, C.; Laube, M.; Schulze, S.; Rammelt, S.; Pietzsch, J. Adjuvant Drug-Assisted Bone Healing: Advances and Challenges in Drug Delivery Approaches. Pharmaceutics 2020, 12, 428.

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