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Nanomédecine régénérative de l'articulation temporo-mandibulaire

Abstract : The temporomandibular joint (TMJ) is an articulation formed between the temporal bone and the mandibular condyle which is commonly affected. These affections are often so painful during fundamental oral activities that patients have lower quality of life. Limitations of therapeutics for severe TMJ diseases have led to increased interest in regenerative strategies combining stem cells, implantable scaffolds and well-targeting bioactive molecules. To succeed in functional and structural regeneration of TMJ is very challenging. Innovative strategies and biomaterials are absolutely crucial because TMJ can be considered as one of the most difficult tissues to regenerate due to its limited healing capacity, its unique histological and structural properties and the necessity for long-term prevention of its ossified or fibrous adhesions. A first in vitro study was conducted to develop a pro-regenerative nanostructured cartilage implant bearing human mesenchymal stem cells. The nanoreservoirs of TGFβ3 within a jellyfish type II collagen matrix showed their chondrogenic capacity. They allowed colonization, then differentiation and matrix maturation favorable to cartilaginous regeneration. These results are encouraging given the difficulty of culturing chondrocytes and the need for rapid restoration of the cartilaginous layer of articular surfaces. A second in vivo study was conducted to develop a nanostructured pro-regenerative anti-inflammatory bone implant. Nanofibrous and microporous biomimetic matrices of polycaprolactone (PCL) were functionalized by nanoreservoirs of BMP-2 and ibuprofen. They have been implanted in mouse models of maxillary bone lesions. The acceleration of regeneration induced by these nanofunctionalized implants has been demonstrated in wild-type mice and Tabby mutant mice. The benefit thus established of functionalization of implants by BMP-2 and ibuprofen is of particular interest in the frequent chronic inflammatory pathologies of TMJ. These promising results follow three-dimensional orchestration approaches for different TMJ tissues.
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Submitted on : Wednesday, October 23, 2019 - 4:08:28 PM
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Xavier van Bellinghen. Nanomédecine régénérative de l'articulation temporo-mandibulaire. Ingénierie biomédicale. Université de Strasbourg, 2019. Français. ⟨NNT : 2019STRAJ011⟩. ⟨tel-02329622⟩

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