Icariin-loaded multilayered films deposited onto micro/nanostructured titanium enhances osteogenesis and reduces inflammation under diabetic conditions

Disordered bone metabolism and the associated inflammatory microenvironment in diabetic patients make treating bone fractures difficult in this patient population. However, the inherent bioinert properties of titanium implants result in insufficient osseointegration, making it important to develop an efficient surface modification strategy to provide titanium implants with enhanced osseointegration capabilities in diabetic conditions. Here, a micro/nanostructure was constructed on titanium through acid etching and anodic oxidation, followed by an addition of a multilayered film of chitosan (CHI), gelatin (GEL) and icariin (ICA) onto the surface of micro/nanostructured titanium using a layer-by-layer self-assembly technology. The characterization results indicated that the icariin-loaded multilayered film was successfully deposited onto titanium surface and achieved a long-term sustainable release of ICA. Cell experiments showed that the icariin-loaded multilayered films modified titanium promoted osteogenesis, inhibited osteoclast generation, and reduced inflammatory reaction under diabetic conditions. This study provides an avenue for treating fractures in patients with diabetes.