Nitric oxide-releasing fumed silica particles: synthesis, characterization, and biomedical application

Biodegradable poly(lactic-co-glycolic acid) microspheres loaded with S-nitroso-N-acetyl-D-penicillamine for controlled nitric oxide delivery

Nitric oxide (NO) is a fascinating and important endogenous free-radical gas with potent antimicrobial, vasodilating, smooth muscle relaxant, and growth factor stimulating effects. However, its wider biomedical applicability is hindered by its cumbersome administration, since NO is unstable especially in biological environments. In this work, to ultimately develop site-specific controlled release vehicles for NO, the NO donor S-nitroso-N-acetyl-D-penicillamine (SNAP) was encapsulated within poly(lactic-co-glycolic acid) 50:50 (PLGA) microspheres by using a solid-in-oil-in-water emulsion solvent evaporation method. The highest payload was 0.56(±0.01) μmol SNAP/mg microspheres. The in vitro release kinetics of the donor were controlled by the bioerosion of the PLGA microspheres. By using an uncapped PLGA (Mw=24,000-38,000) SNAP was slowly released for over 10days, whereas by using the ester capped PLGA (Mw=38,000-54,000) the release lasted for over 4weeks. The presence of copper ions and/or ascorbate in solution was necessary to efficiently decompose the released NO donor and obtain sustained NO release. It was also demonstrated that light can be used to induce rapid NO release from the microspheres over several hours. SNAP exhibited excellent storage stability when encapsulated in the PLGA microspheres. These new microsphere formulations may be useful for site-specific administration and treatment of pathologies associated with dysfunction in endogenous NO production, e.g. treatment of diabetic wounds, or in diseases involving other biological functions of NO including vasodilation, antimicrobial, anticancer, and neurotransmission.

S-Nitrosothiol-modified hyperbranched polyesters

S-Nitrosothiol-modified hyperbranched polyesters as a novel biodegradable nitric oxide-releasing scaffold.

MOF Crystal Chemistry Paving the Way to Gas Storage Needs: Aluminum-Based soc-MOF for CH4, O2, and CO2 Storage

The molecular building block approach was employed effectively to construct a series of novel isoreticular, highly porous and stable, aluminum-based metal–organic frameworks with soc topology. From this platform, three compounds were experimentally isolated and fully characterized: namely, the parent Al-soc-MOF-1 and its naphthalene and anthracene analogues. Al-soc-MOF-1 exhibits outstanding gravimetric methane uptake (total and working capacity). It is shown experimentally, for the first time, that the Al-soc-MOF platform can address the challenging Department of Energy dual target of 0.5 g/g (gravimetric) and 264 cm³ (STP)/cm³ (volumetric) methane storage. Furthermore, Al-soc-MOF exhibited the highest total gravimetric and volumetric uptake for carbon dioxide and the utmost total and deliverable uptake for oxygen at relatively high pressures among all microporous MOFs. In order to correlate the MOF pore structure and functionality to the gas storage properties, to better understand the structure–property relationship, we performed a molecular simulation study and evaluated the methane storage performance of the Al-soc-MOF platform using diverse organic linkers. It was found that shortening the parent Al-soc-MOF-1 linker resulted in a noticeable enhancement in the working volumetric capacity at specific temperatures and pressures with amply conserved gravimetric uptake/working capacity. In contrast, further expansion of the organic linker (branches and/or core) led to isostructural Al-soc-MOFs with enhanced gravimetric uptake but noticeably lower volumetric capacity. The collective experimental and simulation studies indicated that the parent Al-soc-MOF-1 exhibits the best compromise between the volumetric and gravimetric total and working uptakes under a wide range of pressure and temperature conditions.

Nitric oxide- and cisplatin-releasing silica nanoparticles for use against non-small cell lung cancer

Nitric oxide (NO) and cisplatin releasing wrinkle-structured amine-modified mesoporous silica (AMS) nanoparticles have been developed for the treatment of non-small cell lung cancer (NSCLC). The AMS and NO- and cisplatin-loaded AMS materials were characterized using TEM, BET surface area, FTIR and ICP-MS, and tested in cell culture. The results show that for NSCLC cell lines (i.e., H596 and A549), the toxicity of NO- and cisplatin-loaded silica nanoparticles (NO-Si-DETA-cisplatin-AMS) is significantly higher than that of silica nanoparticles loaded with only cisplatin (Si-DETA-cisplatin-AMS). In contrast, the toxicity of NO-Si-DETA-cisplatin-AMS toward normal lung cell lines is not significantly different from that of Si-DETA-cisplatin-AMS (normal lung fibroblast cells WI-38) or is even lower than that of Si-DETA-cisplatin-AMS (normal lung epithelial cells BEAS-2B). The NO-induced sensitization of tumor cell death demonstrates that NO is a promising enhancer of platinum-based lung cancer therapy.

Nitric oxide as a surgical adjuvant

Advances in surgical technology have allowed for previously unconsidered therapeutic interventions. However, the complexity and invasiveness of surgical procedures are not without adverse consequences. Nitric oxide's fundamental role in a host of physiological processes, including angiogenesis, wound and bone healing, thromboresistance, smooth muscle relaxation and inflammation makes it a significant player in accelerating wound healing and mitigating the inflammation of ischemia reperfusion injury common to surgical procedures. In addition, the therapeutic properties of NO have been harnessed for the prophylactic treatment of implant infection and graft failure. In this article, we will discuss the mechanism by which NO mediates these processes, and its perioperative translational applications.

Silica/polymer microspheres and hollow polymer microspheres as scaffolds for nitric oxide release in PBS buffer and bovine serum

SiO₂/P(AmEMA-co-EGDMA) core–shell microspheres and hollow P(AmEMA-co-EGDMA) nanospheres are prepared as NO donors.

Development and hemocompatibility testing of nitric oxide releasing polymers using a rabbit model of thrombogenicity

Hemocompatibility is the goal for any biomaterial contained in extracorporeal life supporting medical devices. The hallmarks for hemocompatibility include nonthrombogenicity, platelet preservation, and maintained platelet function. Both in vitro and in vivo assays testing for compatibility of the blood/biomaterial interface have been used over the last several decades to ascertain if the biomaterial used in medical tubing and devices will require systemic anticoagulation for viability. Over the last 50 years systemic anticoagulation with heparin has been the gold standard in maintaining effective extracorporeal life supporting. However, the biomaterial that maintains effective ECLS without the use of any systemic anticoagulant has remained elusive. In this review, the in vivo 4-h rabbit thrombogenicity model genesis will be described with emphasis on biomaterials that may require no systemic anticoagulation for extracorporeal life supporting longevity. These novel biomaterials may improve extracorporeal circulation hemocompatibility by preserving near resting physiology of the major blood components, the platelets and monocytes. The rabbit extracorporeal circulation model provides a complete assessment of biomaterial interactions with the intrinsic coagulation players, the circulating platelet and monocytes. This total picture of blood/biomaterial interaction suggests that this rabbit thrombogenicity model could provide a standardization for biomaterial hemocompatibility testing.

Direct formation of S-nitroso silica nanoparticles from a single silica source

Nitric oxide (NO) is a ubiquitous molecule in the body. Because of its multiple pathophysiologic roles, the potential for treating various diseases by the exogenous administration of NO has been under intensive investigation. However, the unstable, radical nature of NO poses a major challenge to the effective delivery of NO. Previously, silica nanoparticles synthesized by the traditional method have been developed into NO-carrying systems. In the present study, for the first time NO-carrying silica nanoparticles were prepared from a single silica precursor using a simple nanoprecipitation method. (3-Mercaptopropyl)-trimethoxysilane (MPTMS) was used as the sole silane source, which was subjected to acid-catalyzed S-nitrosation and condensation reactions in a one-pot organic phase. S-Nitroso silica nanoparticles (SNO-SiNPs) were then produced by injecting a smaller quantity of the organic phase into a larger amount of water without surfactants. Various preparation parameters were tested to obtain optimized conditions. Moreover, a phase diagram demonstrating the ouzo effect was constructed. The prepared SNO-SiNPs were spherical particles with a tunable size in the range of 100-400 nm. The nanoparticles in aqueous dispersions exhibited high colloid stability, possibly resulting from highly negatively charged surfaces. The result of solid-state (29)Si NMR shows the predominance of T(2) and T(3) silicon structures, suggesting that nanoparticles were formed from polycondensed silica species. In conclusion, NO-loaded silica nanoparticles have been directly prepared from a single silane precursor using a surfactant-free, low-energy, one-step nanoprecipitation approach. The method precludes the need for the initial formation of bare particles and subsequent functionalization steps.

Nitric oxide releasing Tygon materials: studies in donor leaching and localized nitric oxide release at a polymer-buffer interface

Tygon is a proprietary plasticized poly(vinyl chloride) polymer that is used widely in bioapplications, specifically as extracorporeal circuits. To overcome issues with blood clot formation and infection associated with the failure of these medical devices upon blood contact, we consider a Tygon coating with the ability to release the natural anticlotting and antibiotic agent, nitric oxide (NO), under simulated physiological conditions. These coatings are prepared by incorporating 20 w/w% S-nitrosoglutathione (GSNO) donor into a Tygon matrix. These films release NO on the order of 0.64 ± 0.5 × 10(-10) mol NO cm(-2) min(-1), which mimics the lower end of natural endothelium NO flux. We use a combination of assays to quantify the amount of GSNO that is found intact at different time points throughout the film soak, as well as monitor the total thiol content in the soaking solution due to any analyte that has leached from the polymer film. We find that a burst of GSNO is released from the material surface within 5 min to 1 h of soaking, which only represents 0.25% of the total GSNO contained in the film. After 1 h of film soak, no additional GSNO is detected in the soaking solution. By further considering the total thiol content in solution relative to the intact GSNO, we demonstrate that the amount of GSNO leached from the material into the buffer soaking solution does not contribute significantly to the total NO released from the GSNO-incorporated Tygon film (<10% total NO). Further surface analysis using SEM-EDS traces the elemental S on the material surface, demonstrating that within 5 min -1 h soaking time, 90% of the surface S is removed from the material. Surface wettability and roughness measurements indicate no changes between the GSNO-incorporated films pre- to postsoak that will be significant toward the adsorption of biological components, such as proteins, relative to the presoaked donor-incorporated film. Overall, we demonstrate that, for a 20 w/w% GSNO-incorporated Tygon film, relatively minimal GSNO leaching is experienced, and the lost GSNO is from the material surface. Varying the donor concentration from 5 to 30 w/w% GSNO within the film does not result in significantly different NO release profiles. Additionally, the steady NO flux associated with the system is predominantly due to localized release from the material, and not donor lost to soaking solution. The surface properties of these materials generally imply that they are useful for blood-contacting applications.

Role of size and shape on biofilm eradication for nitric oxide-releasing silica nanoparticles

Nitric oxide (NO), a reactive free radical, has proven effective in eradicating bacterial biofilms with reduced risk of fostering antibacterial resistance. Herein, we evaluated the efficacy of NO-releasing silica nanoparticles against Gram-negative Pseudomonas aeruginosa and Gram-positive Staphylococcus aureus biofilms as a function of particle size and shape. Three sizes of NO-releasing silica nanoparticles (i.e., 14, 50, and 150 nm) with identical total NO release (∼0.3 μmol/mg) were utilized to study antibiofilm eradication as a function of size. To observe the role of particle shape on biofilm killing, we varied the aspect ratio of the NO-releasing silica particles from 1 to 8 while maintaining constant particle volume (∼0.02 μm(3)) and NO-release totals (∼0.7 μmol/mg). Nitric oxide-releasing particles with decreased size and increased aspect ratio were more effective against both P. aeruginosa and S. aureus biofilms, with the Gram-negative species exhibiting the greatest susceptibility to NO. To further understand the influence of these nanoparticle properties on NO-mediated antibacterial activity, we visualized intracellular NO concentrations and cell death with confocal microscopy. Smaller NO-releasing particles (14 nm) exhibited better NO delivery and enhanced bacteria killing compared to the larger (50 and 150 nm) particles. Likewise, the rod-like NO-releasing particles proved more effective than spherical particles in delivering NO and inducing greater antibacterial action throughout the biofilm.

Nitric oxide donors for cardiovascular implant applications

In an era of increased cardiovascular disease burden in the ageing population, there is great demand for devices that come in to contact with the blood such as heart valves, stents, and bypass grafts that offer life saving treatments. Nitric oxide (NO) elution from healthy endothelial tissue that lines the vessels maintains haemostasis throughout the vasculature. Surgical devices that release NO are desirable treatment options and N-diazeniumdiolates and S-nitrosothiols are recognized as preferred donor molecules. There is a keen interest to investigate newer methods by which NO donors can be retained within biomaterials so that their release and kinetic profiles can be optimized. A range of polymeric scaffolds incorporating microparticles and nanomaterials are presenting solutions to current challenges, and have been investigated in a range of clinical applications. This review outlines the application of NO donors for cardiovascular therapy using biomaterials that release NO locally to prevent thrombosis and intimal hyperplasia (IH) and enhance endothelialization in the fabrication of next generation cardiovascular device technology.

Novel quantum dots-carboxymethyl chitosan nanocomposite nitric oxide donors capable of detecting release of nitric oxide in situ

Nitric oxide (NO) donor compounds are primarily monofunctional in that they release NO under the requisite conditions. To detect the amount and duration of NO released, subsequent analysis methods are required. It would be advantageous if a NO donor compound could both release and detect NO at the same time. This would eliminate potential errors in the analysis. In this paper, novel cadmium telluride quantum dots (CdTe QD)-carboxymethyl chitosan (CMCS) nanocomposite NO donors, including both diazeniumdiolates and fluorescence probes, were fabricated by first synthesizing CdTe QD in CMCS aqueous solution and then reacting NO as well as ethyl bromide with the resultant CdTe QD-CMCS nanocomposites. Transmission electron microscopy, scanning electron microscopy and particle size analysis were used to examine the morphology and size distribution of the CdTe QD-CMCS nanocomposite NO donors. The donors are nanospheres with CdTe QD encapsulated and have dimensions of ~300 nm. Fourier transform infrared spectroscopy, X-ray diffraction, X-ray photoelectron spectroscopy and contact angle tests were employed to characterize the chemical structure of the donors, and the results also show that CdTe QD are well incorporated into CMCS, and many of them are close to the surface of the donors. The precursors of the donors exhibit a fluorescent effect, and the fluorescence can be quenched by NO. The donors can release NO spontaneously in a phosphate-buffered saline solution similar to a physiological environment, and can quantitatively detect the release of NO in situ based on fluorescence quenching of the donors by the NO.

Nitric oxide delivery by core/shell superparamagnetic nanoparticle vehicles with enhanced biocompatibility

We report the synthesis of Fe(3)O(4)/silica core/shell nanoparticles and their functionalization with S-nitrosothiols. These nanoparticles are of immense interest because of their nitric oxide (NO) release capabilities in human alveolar epithelial cells. Moreover, they act as large storage reservoirs of NO that can be targeted magnetically to the specific site with a sustainable release of NO for up to 50 h. Such nanoparticles provide an enhancement of the biocompatibility with released NO while allowing intracellular accumulation ascribed to their small size.

Electromodulated Release of Nitric Oxide Through Polymer Material from Reservoir of Inorganic Nitrite Salt

Herein, we report a new approach to electromodulate the release of NO at physiological levels through polymeric materials from a stable nitrite electrolyte reservoir, with potential application in controlling biofilm formation and clotting on intravascular catheters. The NO flux can be turned 'on' and 'off' electrochemically, on demand.

Advances in neonatal extracorporeal support: the role of extracorporeal membrane oxygenation and the artificial placenta

This review addresses the history and evolution of neonatal extracorporeal membrane oxygenation (ECMO), with a discussion of the indications, contraindications, modalities, outcomes, and impact of ECMO. Controversies surrounding novel uses of ECMO in neonates, namely ECMO for premature infants and ex utero intrapartum therapy with transition to ECMO, are discussed. The development of an extracorporeal artificial placenta for support of premature infants is presented, including the rationale, research, and challenges. ECMO has had a dramatic effect on the care of critically ill neonates over the past 4 decades, and there is great potential to expand these benefits in the future.

Nitric oxide release: part I. Macromolecular scaffolds

The roles of nitric oxide (NO) in physiology and pathophysiology merit the use of NO as a therapeutic for certain biomedical applications. Unfortunately, limited NO payloads, too rapid NO release, and the lack of targeted NO delivery have hindered the clinical utility of NO gas and low molecular weight NO donor compounds. A wide-variety of NO-releasing macromolecular scaffolds has thus been developed to improve NO's pharmacological potential. In this tutorial review, we provide an overview of the most promising NO release scaffolds including protein, organic, inorganic, and hybrid organic-inorganic systems. The NO release vehicles selected for discussion were chosen based on their enhanced NO storage, tunable NO release characteristics, and potential as therapeutics.

Nitric oxide release: part II. Therapeutic applications

A wide range of nitric oxide (NO)-releasing materials has emerged as potential therapeutics that exploit NO's vast biological roles. Macromolecular NO-releasing scaffolds are particularly promising due to their ability to store and deliver larger NO payloads in a more controlled and effective manner compared to low molecular weight NO donors. While a variety of scaffolds (e.g., particles, dendrimers, and polymers/films) have been cleverly designed, the ultimate clinical utility of most NO-releasing macromolecules remains unrealized. Although not wholly predictive of clinical success, in vitro and in vivo investigations have enabled a preliminary evaluation of the therapeutic potential of such materials. In this tutorial review, we review the application of macromolecular NO therapies for cardiovascular disease, cancer, bacterial infections, and wound healing.

Nitric oxide release: part III. Measurement and reporting

Nitric oxide's expansive physiological and regulatory roles have driven the development of therapies for human disease that would benefit from exogenous NO administration. Already a number of therapies utilizing gaseous NO or NO donors capable of storing and delivering NO have been proposed and designed to exploit NO's influence on the cardiovascular system, cancer biology, the immune response, and wound healing. As described in Nitric oxide release: Part I. Macromolecular scaffolds and Part II. Therapeutic applications, the preparation of new NO-release strategies/formulations and the study of their therapeutic utility are increasing rapidly. However, comparison of such studies remains difficult due to the diversity of scaffolds, NO measurement strategies, and reporting methods employed across disciplines. This tutorial review highlights useful analytical techniques for the detection and measurement of NO. We also stress the importance of reporting NO delivery characteristics to allow appropriate comparison of NO between studies as a function of material and intended application.

Influence of scaffold size on bactericidal activity of nitric oxide-releasing silica nanoparticles

A reverse microemulsion synthesis was used to prepare amine-functionalized silica nanoparticles of three distinct sizes (i.e., 50, 100, and 200 nm) with similar amine content. The resulting hybrid nanoparticles, consisting of N-(6-aminohexyl)aminopropyltrimethoxysilane and tetraethoxysilane, were highly monodisperse in size. N-Diazeniumdiolate nitric oxide (NO) donors were subsequently formed on secondary amines while controlling reaction conditions to keep the total amount of NO released constant for each particle size. The bactericidal efficacy of the NO-releasing nanoparticles against Pseudomonas aeruginosa increased with decreasing particle size. Additionally, smaller diameter nanoparticles were found to associate with the bacteria at a faster rate and to a greater extent than larger particles. Neither control (non-NO-releasing) nor NO-releasing particles exhibited toxicity toward L929 mouse fibroblasts at concentrations above their respective minimum bactericidal concentrations. This study represents the first investigation of the bactericidal efficacy of NO-releasing silica nanoparticles as a function of particle size.

Poly(diol-co-citrate)s as novel elastomeric perivascular wraps for the reduction of neointimal hyperplasia

The synthesis of poly(diol-co-citrate) elastomers that are biocompatible with vascular cells and can modulate the kinetics of the NO release based on the diol of selection is reported. NO-mediated cytostatic or cytotoxic effects can be controlled depending on the NO dose and the exposure time. When implanted in vivo in a rat carotid artery injury model, these materials demonstrate a significant reduction of neointimal hyperplasia. This is the first report of a NO-releasing polymer fabricated in the form of an elastomeric perivascular wrap for the treatment of neointimal hyperplasia. These elastomers also show promise for other cardiovascular pathologies where NO-based therapies could be beneficial.

Stöber Synthesis of Nitric Oxide-Releasing S-Nitrosothiol-Modified Silica Particles

We report the synthesis of S-nitrosothiol-modified silica particles capable of nitric oxide (NO) release. The thiol precursor modification to form S-nitrosothiol NO donors was introduced into the silica network via co-condensation of mercaptosilane and alkoxysilane precursors. Both the concentrations of reactants (i.e., water, ammonia, and silane) and the silane feed rate into the reaction proved important in the yield of monodisperse, spherical particles with tunable diameters ranging from 241-718 nm. Subsequent nitrosation resulted in NO storage approaching ~4.40 μmol NO mg(-1), as determined by total NO release. Behaving similar to low molecular weight S-nitrosothiol NO donors, the NO release from the macromolecular silica vehicles was influenced by light, temperature, and metal ions.

The artificial endothelium

As the world of critical care medicine advances, extracorporeal therapies (ECC) have become commonplace in the management of the high risk intensive care patient. ECC encompasses a wide variety of technologies from hemodialysis, continuous renal replacement therapy (CRRT) and plasmapheresis, to cardiopulmonary bypass (CPB), extracorporeal life support (ECLS) and hepatic support. The development of internal man made organs is the next step with ventricular assist devices and artificial lungs. As we advance the technologies with smaller devices, and more intricate circuitry, we lack the keystone necessary to control the blood-biomaterial interface. For the last 50 years much has been learned about surface induced thrombosis and attempts have been made to prevent it with alternative systemic anticoagulation, circuitry surface modifications, or a combination of both. Despite these efforts, systemic or regional anticoagulation remain necessary for both laboratory and clinical application of ECC. As such, the development of an endothelial-like, biomimetic surface to reduce or perhaps even eliminate the blood activation/thrombus formation events that occur upon exposure to artificial surfaces is paramount.

Recent progress in inorganic and composite coatings with bactericidal capability for orthopaedic applications

This review covers the most recent developments of inorganic and organic-inorganic composite coatings for orthopedic implants, providing the interface with living tissue and with potential for drug delivery to combat infections. Conventional systemic delivery of drugs is an inefficient procedure that may cause toxicity and may require a patient's hospitalization for monitoring. Local delivery of antibiotics and other bioactive molecules maximizes their effect where they are required, reduces potential systemic toxicity and increases timeliness and cost efficiency. In addition, local delivery has broad applications in combating infection-related diseases. Polymeric coatings may present some disadvantages. These disadvantages include limited chemical stability, local inflammatory reactions, uncontrolled drug-release kinetics, late thrombosis and restenosis. As a result, embedding of bioactive compounds and biomolecules within inorganic coatings (bioceramics, bioactive glasses) is attracting significant attention. Recently nanoceramics have attracted interest because surface nanostructuring allows for improved cellular adhesion, enhances osteoblast proliferation and differentiation, and increases biomineralization. Organic-inorganic composite coatings, which combine biopolymers and bioactive ceramics that mimick bone structure to induce biomineralization, with the addition of biomolecules, represent alternative systems and ideal materials for "smart" implants. In this review, emphasis is placed on materials and processing techniques developed to advance the therapeutic use of biomolecules-eluting coatings, based on nanostructured ceramics. One part of this report is dedicated to inorganic and composite coatings with antibacterial functionality.

FROM THE CLINICAL EDITOR

Inorganic and composite nanotechnology-based coating methods have recently been developed for orthopedic applications, with the main goal to provide bactericide and other enhanced properties, which may result in reduced need for pharmaceutical interventions and overall more cost effective orthopedic procedures. This review discusses key aspects of the above developments.

Biodegradable nitric oxide-releasing poly(diol citrate) elastomers

We have developed novel poly(diol citrate) elastomers, which are capable of providing localized and sustained release of nitric oxide (NO). The elastomer prepolymer was obtained by condensation of citric acid, 1,8-octanediol, and N,N'-bis(2-hydroxyethyl)ethylenediamine at 130 degrees C for 40 min. Films were prepared by solvent casting followed by crosslinking at 80 degrees C for 4 days. Mechanical properties were tested. NO-releasing expanded poly(tetrafluoroethylene) (ePTFE) vascular grafts were fabricated by coating the graft's lumen with the prepolymer and crosslinking it at 80 degrees C for 4 days prior to diazeniumdiolation. Samples were diazeniumdiolated via exposure to pressurized NO. Cell compatibility was assessed by monitoring the proliferation of porcine aortic smooth muscle cells (PASMC) on the elastomers. Degradation in phosphate buffer saline (PBS) (pH = 7) at 37 degrees C was evaluated for up to 6 weeks. The secondary amine-containing poly(diol citrate) films had a Young's modulus that ranged from 5.91 to 32.64 MPa, an ultimate tensile stress that ranged from 1.47 to 10.71 MPa, and an elongation at break from 200 to 260%, depending on the content of secondary amine in the feed monomer. These elastomers were degradable and compatible with PASMC. Furthermore, degradation rate was found to be independent of the content of secondary amines in the prepolymer. The NO release from diazeniumdiolated films and ePTFE grafts was sustained for two days. In conclusion, these novel diazeniumdiolated polyester elastomers may be useful in medical devices that require blood contact or control of cell proliferation.

Competitive formation of N-diazeniumdiolates and N-nitrosamines via anaerobic reactions of polyamines with nitric oxide

Reactions of amines with nitric oxide (NO) at high pressures form diverse NO donor species, highly dependent on the precursor structure. While monoamine precursors favor the formation of N-diazeniumdiolates in high yield, polyamines exhibit competitive formation of N-nitrosamines and diazeniumdiolates, resulting in mixed products containing significant percentages of undesired N-nitroso compounds.

Development of cardiovascular bypass grafts: endothelialization and applications of nanotechnology

There is a critical clinical need for small-diameter bypass grafts, with applications involved in the coronary artery and lower limb. Commercially available materials give rise to unfavorable responses when in contact with blood and subjected to low-flow hemodynamics and, thus, are nonideal as small-diameter bypass grafts. Optimizing the mechanical properties to match both the native artery and the graft surfaces has received keen attention. Endothelialization of bypass grafts is considered a protective mechanism where the biochemicals produced from endothelial cells exert a range of favorable responses, including antithrombotic, noninflammatory responses and inhibition of intimal hyperplasia. In situ endothelialization is most desirable. Nanotechnology approaches facilitate all aspects of endothelialization, including endothelial progenitor cell mobilization, migration, adhesion, proliferation and differentiation. 'Surface nanoarchitecturing mechanisms', which mimic the natural extracellular matrix to optimize endothelial progenitor cell interaction and controlled delivery of various factors in the form of nanoparticles, which can be combined with gene therapy, are of keen interest. This article discusses the development of bypass grafts, focusing on the optimization of the biological properties of mechanically suitable grafts.

In situ synthesis of hybrid nanocomposite with highly order arranged amorphous metallic copper nanoparticle in poly(2-hydroxyethyl methacrylate) and its potential for blood-contact uses

A hybrid consisting of a highly ordered nanostructure of metallic Cu(0) nanoparticles embedded in a poly(2-hydroxyethyl methacrylate) (pHEMA) matrix was successfully synthesized by in situ photopolymerization, followed by in situ chemical reduction. The evolution of an ordered nanostructure of Cu(0) showing a nearly amorphous nature is discussed, and it is proposed that it is due to a coupling interaction between the Cu precursor and the unpaired O of the COOR group, associated with water molecules, among pHEMA molecules. The hybrids showed a negative surface charge and considerable improvement in blood compatibility compared to neat pHEMA and the widely used biomaterial polysulfonate.

Basic science review: nitric oxide--releasing prosthetic materials

Prosthetic devices that come into contact with blood ultimately fail secondary to thrombus formation. This limits the utility of a variety of materials used to surgically treat cardiovascular disease, including vascular grafts and stents, as well as sensors and catheters placed within the circulatory system. Moreover, systemic anticoagulation that is used to prevent malfunction of these devices has potential for serious complications. It is known that nitric oxide (NO) produced via the endothelium imparts thromboresistant properties to native blood vessels. Thus, if NO were delivered locally to the site of the prosthetic material, it has the potential to halt thrombus formation while limiting life-threatening side effects. This review serves to examine the variety of NO-releasing materials that have been created with the two different classes of NO donors, the diazeniumdiolates and S-nitrosothiols, and the clinical applications of these prosthetics for potential future use.

Nitric oxide-releasing/generating polymers for the development of implantable chemical sensors with enhanced biocompatibility

The development of reliable in vivo chemical sensors for real-time clinical monitoring of blood gases, electrolytes, glucose, etc. in critically ill and diabetic patients remains a great challenge owing to inherent biocompatibility problems that can cause errant analytical results upon sensor implantation (e.g., cell adhesion, thrombosis, inflammation). Nitric oxide (NO) is a well-known inhibitor of platelet activation and adhesion, and also a potent inhibitor of smooth muscle cell proliferation. In addition, NO mediates inflammatory response and promotes angiogenesis. Polymers that release or generate NO at their surfaces have been shown to exhibit greatly enhanced thromboresistance in vivo when in contact with flowing blood, as well as reduce inflammatory response when placed subcutaneously, and thus have the potential to improve the biocompatibility of implanted chemical sensors. Locally elevated NO levels at the surface of implanted devices can be achieved by using polymers that incorporate NO donor species that can decompose and release NO spontaneously when in contact with physiological fluids, or NO-generating polymers that possess an immobilized catalyst that decompose endogenous S-nitrosothiols to generate NO in situ. The potential use of such NO-releasing/generating materials for preparing in vivo sensors implanted either intravascularly or subcutaneously, is examined in this review.

Nitric oxide: what a vascular surgeon needs to know

Atherosclerosis in the form of peripheral arterial disease results in significant morbidity and mortality. Surgical treatment options for peripheral arterial disease include angioplasty with and without stenting, endarterectomy, and bypass grafting. Unfortunately, all of these procedures injure the vascular endothelium, which impairs its ability to produce nitric oxide (NO) and ultimately leads to neointimal hyperplasia and restenosis. To improve on current patency rates after vascular procedures, investigators are engaged in research to improve the bioavailability of NO at the site of vascular injury in an attempt to reduce the risk of thrombosis and restenosis after successful revascularization. This article reviews some of the previous research that has aimed to improve NO bioavailability after vascular procedures whether through systemic or local delivery, as well as to describe some of the NO-releasing products that are currently undergoing study for use in clinical practice.