Take silk, add microRNAs (miRNAs) and you have a delivery system that can improve bone growth and mineralization at the site of the repair.
New Bone Remodeling Approach With Silk Tested

Researchers from Tufts University have used bioresorbable, silk-based medical devices such as screws and plates, and combined them with bioactive miRNA-based therapeutics. Their work, “Silk Biomaterials‐Mediated miRNA Functionalized Orthopedic Devices,” is published in Tissue Engineering, Part A.
According to the researchers, they coated the surface of bioresorbable silk-based devices used in bone repair with antisense-miR-214 and also studied the use of antisense-miR-214 silk films seeded with human mesenchymal stem cells (hMSCs). They found that miR-214 was released continuously for up to 7 days in vitro and could block the production of proteins that down regulate new bone formation.
“This study leverages tissue engineering principles for the design of medical devices with enhanced biocompatibility,” says Tissue Engineering co-editor-in-chief Antonios G. Mikos, Ph.D., Louis Calder Professor at Rice University in Houston, Texas.
David Kaplan, Ph.D., professor and chair in the department of Biomedical Engineering at Tufts University in Medford, Massachusetts, told OTW, “The post doc that led the work, Eric James, had prior miRNA experience. Thus, upon joining the lab where we focus a lot of effort on functionalized biomaterials to guide cell and tissue responses for regenerative medicine goals, this was considered a new and useful strategy to evaluate.”
“Silk is mechanically robust and also quite hydrophobic yet binds reasonably well with the RNA. Further, we have previously shown that silk-based protein scaffolds support excellent bone remodeling. Finally, RNA remains bioactive during silk processing, due to the aqueous-based and ambient conditions used during scaffold preparation.”
“This is a new approach to direct bone remodeling with a lot of promise as the technology is further developed in the future.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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