Recently, people older than 50 years old in developed countries have suffered from musculoskeletal diseases, including a wide majority of chronic pain. Based on research, bone tissue injuries can cause trauma, infection, tumors, and local disorders (1). Treatment of bone lesions through surgery, autotransplantation, and allotransplantation has a lot of problems, such as limited supply, donor site morbidity, unsuitability for large bone grafts, and unpleasant feelings at the injury site (2). World Health Organization (WHO) officials have introduced 2000 to 2010 as the golden time for developing bone defect regeneration in worldwide tissue engineering studies. Accordingly, tissue engineering was considered to be interdisciplinary knowledge in sciences such as chemistry, physics, engineering, biology, and medicine to solve musculoskeletal problems (3). Nowadays, adipose-derived mesenchymal stem cells (AD-MSCs) have been utilized in various tissue engineering applications. These cells have a high potential for repairing and regenerating damaged tissues. Adipose tissue is a suitable source of MSCs because of the relative abundance of AD-MSCs, multipotential ability, and easy harvest. Since MSCs are highly active primary cells, they can be differentiated into various cells, such as adipocytes, osteoblasts, and chondrocytes (4). The self-renewal potential of MSCs increases the number of isolated AD-MSCs for researchers in an administered procedure at in vitro conditions. Since the amount of tissue essential during the primary extraction is restricted, cell proliferation develops after culturing on scaffolds (5).
Nanofibers are desirable candidates for providing a simple system in vitro experiments. Using nanofibers in scaffolds is a natural imitation of tissue in which fibers are embedded in a matrix. Electrospinning, with the ability to create micro-nano polymeric fibers similar to the extracellular matrix (ECM) structure, has attracted much attention in tissue engineering. In this line, electrospinning is an easy, scalable, versatile, and cost-effective method to develop fibers with various diameters, from nanometers to a few micrometers, in different forms (6). Recently, electrospinning nanofibers have been used as a suitable clamp in bone regeneration and repair studies (7). These scaffolds used to support bone cell growth could improve the mechanical properties, act as structural support for cell proliferation, show morphological behavior similar to ECM, and help the cultured cells maintain their phenotype (8).
Cellulose acetate (CA) is a synthetic polymer that comes from esterifying acetic acid with cellulose. The acetate ester of cellulose imparts several benefits such as biodegradability, high affinity with other substances containing hydroxyl groups, biocompatibility, and adequate flexural and tensile strength, which develops its practicability for the production of nanofiber mats. CA is a widely applied biopolymer for bone ingrowth due to its characteristics, such as hydrophilicity, biodegradability, and mineralization. Taken together, CA demonstrates great potential in tissue engineering due to its biocompatibility and its ability to advance osteogenic cell differentiation and osteoblast proliferation (9). However, due to its high modulus, low breaking stress, poor resistance, and strain, CA has typically been used as a portion of complex composites; thereby, it cannot be used alone as a biomedical material for load-bearing applications (6).
Polyurethane is one of the most widely used polymers in bone tissue engineering, which has been used in combination with CA to augment its biocompatibility and mechanical properties (10). In this line, thermoplastic polyurethane (TPU) is a category of PU with linear molecular chains defined by a wide range of mechanical, physicochemical, structural, and morphological attributes that are used more extensively than biodegradable polymers in the biomedical field. Depending on the raw materials used to produce the PU, it is a biocompatible, biodegradable, and non-toxic polymer with a high tensile strength that causes more resistance. Polyurethanes originate from three portions: 1) the polyol, 2) the chain extender, and 3) the diisocyanate. Polyol is a soft part with hydroxyl (-OH) end groups. The chain extender contains a small molecule with amine terminal or hydroxyl groups. Diisocyanate is a low molecular weight segment that reacts with either a chain extender or polyol (11). PU is utilized with a broad range of mechanical attributes, from tough to flexible, in different chemical compositions. A broad category of products, such as coatings, foams, films, fibers, etc., can be gained from PU in bone regeneration (12). In this line, many researchers represented that PU is one of the most important materials in bone tissue engineering applications, while its hydrophobic nature limits its ability to stimulate cell proliferation and adhesion activities (10), (13). Hence, combining CA and PU can reduce the restriction of both polymers.
Researchers to improve the mechanical strength combined with graphene derivatives within the scaffolds. Besides increasing the physical attributes, the graphene derivatives also improve cell differentiation and proliferation due to their great biocompatibility under specified and restricted concentrations. It is also believed that graphene could provide the differentiation of cells by changing the surface of the materials. In this way, graphene enhances osteoblast growth, proliferation, differentiation, and adhesion (14). Graphene oxide (GO) is a type of graphite sheet with the thickness of an atom, which contains groups of reactive oxygen at the edges (Carbonyl and Carboxyl) and the surface (hydroxyl and epoxide). According to its unique chemical, physical, and mechanical attributes and good biocompatibility, GO creates modern bone regeneration trends (14). Due to stimulating the differentiation process of cells bone-like stem cells, this nanoparticle can be considered a suitable candidate for bone tissue engineering (15). This research aimed to evaluate the effects of these three scaffolds on the regeneration, proliferation, and osteogenic differentiation of ADMSCs. Taken together, the present study was used to realize the definite effect of GO in electrospun scaffolds for the regeneration and repair of bone tissues. Figure 1 represents the graphical abstract of the study.