Mineralised collagen regulated the secretion of adrenomedullin by macrophages to activate the PI3K/AKT signalling pathway to promote bone defect repair

Biomaterials can affect the osteogenic process by regulating the function of macrophages and transforming the bone immune microenvironment. Mineralised collagen (MC) is an artificial bone that is highly consistent to the microstructure of the native osseous matrix. The studies have confirmed that MC can achieve effective regeneration of bone defects, but the potential mechanism of MC regulating osteogenesis is still unclear. This study confirmed that MC regulate the high expression of adrenomedullin (ADM) in macrophages and promote the osteogenic differentiation, proliferation and migration of BMSCs. Moreover, ADM activated the PI3K/Akt pathway, while the inhibition of PI3K/Akt hindered the proliferation, migration and osteogenic differentiation of BMSCs promoted by ADM. Additionally, the rat mandibular defect model confirmed that ADM promote the repair of mandibular defects, and the inhibition of PI3K/Akt pathway hinders the osteogenic effect of ADM. Our study suggests that MC regulates ADM secretion by macrophages, creates an ideal bone immune microenvironment, activates the PI3K/AKT signalling pathway, and promotes osteogenesis.