Nanomaterial Nitric Oxide Delivery in Traumatic Orthopedic Regenerative Medicine.
Abstract
Achieving bone fracture union after trauma represents a major challenge for the orthopedic
surgeon. Fracture non-healing has a multifactorial etiology and there are many risk
factors for non-fusion. Environmental factors such as wound contamination, infection,
and open fractures can contribute to non-healing, as can patient specific factors
such as poor vascular status and improper immunologic response to fracture. Nitric
oxide (NO) is a small, neutral, hydrophobic, highly reactive free radical that can
diffuse across local cell membranes and exert paracrine functions in the vascular
wall. This molecule plays a role in many biologic pathways, and participates in wound
healing through decontamination, mediating inflammation, angiogenesis, and tissue
remodeling. Additionally, NO is thought to play a role in fighting wound infection
by mitigating growth of both Gram negative and Gram positive pathogens. Herein, we
discuss recent developments in NO delivery mechanisms and potential implications for
patients with bone fractures. NO donors are functional groups that store and release
NO, independent of the enzymatic actions of NOS. Donor molecules include organic nitrates/nitrites,
metal-NO complexes, and low molecular weight NO donors such as NONOates. Numerous
advancements have also been made in developing mechanisms for localized nanomaterial
delivery of nitric oxide to bone. NO-releasing aerogels, sol- gel derived nanomaterials,
dendrimers, NO-releasing micelles, and core cross linked star (CCS) polymers are all
discussed as potential avenues of NO delivery to bone. As a further target for improved
fracture healing, 3d bone scaffolds have been developed to include potential for nanoparticulated
NO release. These advancements are discussed in detail, and their potential therapeutic
advantages are explored. This review aims to provide valuable insight for translational
researchers who wish to improve the armamentarium of the feature trauma surgeon through
use of NO mediated augmentation of bone healing.
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Journal articlePermalink
https://hdl.handle.net/10161/26284Published Version (Please cite this version)
10.3389/fbioe.2020.592008Publication Info
Anastasio, Albert Thomas; Paniagua, Ariana; Diamond, Carrie; Ferlauto, Harrison R;
& Fernandez-Moure, Joseph S (2020). Nanomaterial Nitric Oxide Delivery in Traumatic Orthopedic Regenerative Medicine.
Frontiers in bioengineering and biotechnology, 8. pp. 592008. 10.3389/fbioe.2020.592008. Retrieved from https://hdl.handle.net/10161/26284.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Joseph Steven Fernandez-Moure
Assistant Professor of Surgery

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