The Role of Carbonated Hydroxyapatite in Modulating Osteoblast Proliferation and Differentiation in Composite Bone Scaffolds: A Narrative Review
Abstract
Carbonated hydroxyapatite (CHA) is becoming widely used in composite bone scaffolds due to better similarity of its carbonate substitution to the mineral component of natural bone when compared with stoichiometric hydroxyapatite (HA). However, the role of CHA in osteoblast proliferation and differentiation within such systems is controversially described. This paper presents a narrative review on the physicochemical features of CHA regarding osteoblast behavior, CHA usage in composite bone scaffolds, and influence of CHA on proliferation and differentiation of osteoblasts. Generally, carbonate substitution decreases crystallinity and increases solubility and ion release when compared with HA, and there is a number of recent reports regarding stimulation of osteogenic differentiation of cells (alkaline phosphatase activity, RUNX2 and collagen I expression, and mineralization) by composite bone scaffolds in dependence of the amount of carbonate ions. The influence on proliferation is rather heterogeneous and sometimes, especially during direct CHA versus HA comparison, the effect is absent. There are two major problems for making conclusions on the effect of CHA: difficulty of separating the effect of CHA from co-substituents and design of composite scaffolds, and great heterogeneity of the methods used. Therefore, future approaches should include both CHA versus HA comparison and other approaches. This enhanced knowledge on the subject will help in creating better…
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