Optimization of photopolymerized bioerodible hydrogel properties for adhesion prevention

Poly(glutamic acid) poly(ethylene glycol) hydrogels prepared by photoinduced polymerization: Synthesis, characterization, and preliminary release studies of protein drugs

A class of new biodegradable hydrogels based on poly(ethylene glycol) methacrylate-graft-poly(glutamic acid) and poly(ethylene glycol) dimethacrylate was synthesized by photoinduced polymerization. Because all the polymeric constituents were highly hydrophilic, crosslinking could be performed in aqueous solutions. This type of crosslinked hydrogel was prepared by modifying a select number of acidic side-groups on poly(glutamic acid) with poly(ethylene glycol) methacrylate. These modified chains were then crosslinked in the presence of poly(ethylene glycol) dimethacrylate under a photoinduced polymerization at a wavelength of 365 nm. Swelling experiments were conducted to study the crosslinking density, pH-responsive behavior, and degradation of the hydrogel. Results showed that the degree of swelling of this type of hydrogels increased as the crosslinker concentration (or density) was reduced. Because of the presence of acidic side chains on poly(glutamic acid), swelling behavior was found to be pH-responsive, increasing at high pH in response to the increase in the amount of ionized acidic side chains. The degradation rate of these hydrogels also varied with pH. More rapid degradation was observed under stronger alkaline conditions because of the hydrolysis of the ester bonds between the crosslinker and the polymer backbone. Practically useful degradation rates could be achieved for such hydrogels under physiological conditions. Drug release rates from these hydrogels were found to be proportional to the protein molecular weight and the crosslinker density; increasing at lower protein molecular weight or crosslinker density. The preliminary findings presented in this article suggest that this class of biodegradable hydrogels could be an attractive avenue for drug delivery applications. The specific photoinduced crosslinking chemistry used would permit hydrogels to be synthesized in existence of the entrapped macromolecular drugs including peptides, proteins, and cells. In addition, the rapid feature of this polymerization procedure along with the ability to perform hydrogel synthesis and drug loading in an aqueous environment would offer great advantages in retaining drug activity during hydrogel synthesis.

Polylactones. 59. Biodegradable networks via ring-expansion polymerization of lactones and lactides with a spirocyclic tin initiator

Spirocyclic tin initiators were prepared by condensation of commercial hydroxyethylated pentaerythritol with Bu(2)Sn(OMe)(2). These tin-containing spirocycles served as initiators for the ring-expansion polymerization of epsilon-caprolactone, beta-D,L-butyrolactone or D,L-lactide. The in situ polycondensation of these expanded spirocycles with terephthaloyl chloride or sebacoyl chloride yielded the desired biodegradable networks with elimination of the Bu(2)Sn group. The segment length (pore size) could be controlled via the monomer-initiator ratio (M/I) of the ring-expansion polymerization. Biodegradable networks were also obtained when Sn-containing spirocyclic polylactones were polycondensed with diphenyl dichlorosilane, benzene phosphonic dichloride, and phenyl phosphoric dichloride.

Biologically engineered protein-graft-poly(ethylene glycol) hydrogels: a cell adhesive and plasmin-degradable biosynthetic material for tissue repair

To address the need for bioactive materials toward clinical applications in wound healing and tissue regeneration, an artificial protein was created by recombinant DNA methods and modified by grafting of poly(ethylene glycol) diacrylate. Subsequent photopolymerization of the acrylate-containing precursors yielded protein-graft-poly(ethylene glycol) hydrogels. The artificial protein contained repeating amino acid sequences based on fibrinogen and anti-thrombin III, comprising an RGD integrin-binding motif, two plasmin degradation sites, and a heparin-binding site. Two-dimensional adhesion studies showed that the artificial protein had specific integrin-binding capability based on the RGD motif contained in its fibrinogen-based sequence. Furthermore, heparin bound strongly to the protein's anti-thrombin III-based region. Protein-graft-poly(ethylene glycol) hydrogels were plasmin degradable, had Young's moduli up to 3.5 kPa, and supported three-dimensional outgrowth of human fibroblasts. Cell attachment in three dimensions resulted from specific cell-surface integrin binding to the material's RGD sequence. Hydrogel penetration by cells involved serine-protease mediated matrix degradation in temporal and spatial synchrony with cellular outgrowth. Protein-graft-poly(ethylene glycol) hydrogels represent a new and versatile class of biomimetic hybrid materials that hold clinical promise in serving as implants to promote wound healing and tissue regeneration.

Biodegradable injectable in situ forming drug delivery systems

The ability to inject a drug incorporated into a polymer to a localized site and have the polymer form a semi-solid drug depot has a number of advantages. Among these advantages is ease of application and localized, prolonged drug delivery. For these reasons a large number of in situ setting polymeric delivery systems have been developed and investigated for use in delivering a wide variety of drugs. In this article we introduce the various strategies that have been used to prepare in situ setting systems, and outline their advantages and disadvantages as localized drug delivery systems.

Biodegradable poly(ethylene oxide)/poly(epsilon-caprolactone) multiblock copolymers

A series of poly(ethylene oxide) (PEO)/poly(epsilon-caprolactone) (PCL) containing biodegradable poly(ether ester urethane)s, covering a wide range of compositions, were synthesized and characterized. The synthesis consisted of a two-step process. During the first step, the ring-opening reaction of epsilon-caprolactone was carried out, initiated by the hydroxyl terminal groups of the PEO chain. The second step involved the chain extension of these PCL-PEO-PCL trimers with hexamethylene diisocyanate. By varying either the ethylene oxide/epsilon-caprolactone ratio or the length of both segments, we obtained a series of polymers having different morphologies and displaying a broad range of properties.

Intestinal anastomoses detected with a photopolymerized hydrogel

BACKGROUND

This study examines the efficacy of a novel, absorbable photopolymerized hydrogel sealant, Focalseal (Focal Inc, Lexington, Mass), in protecting high-risk suture deficient intestinal anastomoses (HRA) compared with conventional sutured anastomoses (CSA).

METHODS

Twenty-four New Zealand white rabbits were either randomized to small bowel HRA constructed with 4 interrupted 5/0 polyglyconate sutures and treated with Focalseal or small bowel CSA constructed with 8 to 10 interrupted 5/0 polyglyconate sutures. Four rabbits from each group were killed at postoperative days 3, 7, and 21. Anastomoses were assessed for evidence of dehiscence, adhesion formation, stenosis, and bursting pressure; they were also examined histologically for collagen content estimation and blood vessel formation.

RESULTS

Mean operative time was 35 minutes (SD 5) for CSA and 35 minutes (SD 5) for HRA. There was 1 postoperative death in the HRA group. A postmortem examination revealed no evidence of anastomotic leak. The remaining 23 animals were assessed as planned. There was no evidence of anastomotic dehiscence in any animal. There was no significant difference in adhesion formation (P =.09), stenosis (P =.6), or bursting pressure (P =.2) between HRA and CSA groups. Collagen (P =.007) and blood vessel (P =.002) formation were significantly increased in HRA.

CONCLUSIONS

HRA treated with Focalseal heal well and have similar strength to CSA. This technique may prove valuable in procedures such as laparoscopic bowel resection.

Fabrication of poly(ethylene glycol) hydrogel microstructures using photolithography

The fabrication of hydrogel microstructures based upon poly(ethylene glycol) diacrylates, dimethacrylates, and tetraacrylates patterned photolithographically on silicon or glass substrates is described. A silicon/silicon dioxide surface was treated with 3-(trichlorosilyl)propyl methacrylate to form a self-assembled monolayer (SAM) with pendant acrylate groups. The SAM presence on the surface was verified using ellipsometry and time-of-flight secondary ion mass spectrometry. A solution containing an acrylated or methacrylated poly(ethylene glycol) derivative and a photoinitiator (2,2-dimethoxy-2-phenylacetophenone) was spin-coated onto the treated substrate, exposed to 365 nm ultraviolet light through a photomask, and developed with either toluene, water, or supercritical CO2. As a result of this process, three-dimensional, cross-linked PEG hydrogel microstructures were immobilized on the surface. Diameters of cylindrical array members were varied from 600 to 7 micrometers by the use of different photomasks, while height varied from 3 to 12 micrometers, depending on the molecular weight of the PEG macromer. In the case of 7 micrometers diameter elements, as many as 400 elements were reproducibly generated in a 1 mm2 square pattern. The resultant hydrogel patterns were hydrated for as long as 3 weeks without delamination from the substrate. In addition, micropatterning of different molecular weights of PEG was demonstrated. Arrays of hydrogel disks containing an immobilized protein conjugated to a pH sensitive fluorophore were also prepared. The pH sensitivity of the gel-immobilized dye was similar to that in an aqueous buffer, and no leaching of the dye-labeled protein from the hydrogel microstructure was observed over a 1 week period. Changes in fluorescence were also observed for immobilized fluorophore labeled acetylcholine esterase upon the addition of acetyl acholine.

Noninvasive and minimally-invasive optical monitoring technologies

With recent advancements in micro-fabrication and nano-fabrication techniques as well as advancements in the photonics industry, there is now the potential to develop less invasive portable sensors for monitoring micronutrients and other substances used to assess overall health. There have been many technology innovations in the central laboratory for these substances for overall health status but the primary motivation for the research and development of a portable field instrument has come from a diabetic patient and market-driven desire to minimally invasively or noninvasively monitor glucose concentrations in vivo. Such a sensor system has the potential to significantly improve the quality of life for the estimated 16 million diabetics in this country by making routine glucose measurements less painful and more convenient. In addition, there is a critical need for the development of less invasive portable technologies to assess micronutrient status (iron, vitamin A, iodine and folate), environmental hazards (lead) and for other disease-related substances, such as billirubin for infant jaundice. Currently, over 100 small companies and universities are working to develop improved monitoring devices, primarily for glucose, and optical methods are a big part of these efforts. In this article many of these potentially less invasive and portable optical sensing technologies, which are currently under investigation, will be reviewed including optical absorption spectroscopy, polarimetry, Raman spectroscopy and fluorescence.

Release of protein from highly cross-linked hydrogels of poly(ethylene glycol) diacrylate fabricated by UV polymerization

Highly crosslinked hydrogel spheres were fabricated using UV photopolymerization of poly(ethylene glycol) diacrylate (PEG-DA) and pentaerythritol triacrylate (PETA) with 2,2'-dimethoxy-2-phenyl-acetophenone (DMPA) as the photoinitiator. Spheres were fabricated both with and without one of three comonomers: acrylic acid, acrylamide or allylamine. Photopolymerization rates and polymer morphology were determined using attenuated total reflectance/Fourier transform infrared spectroscopy and electron microscopy, respectively. These gels were further characterized for volume change, equilibrium water content, diffusivity of the expanding gel, molecular weight between crosslinks and polymer mesh size. Hydrogels with comonomers generally demonstrated an increase in equilibrium water content, average molecular weight between crosslinks and mesh size. Bovine serum albumin was incorporated into the hydrogel to simulate delivery of a model protein drug. The protein diffusion coefficients, based a Fickian release model, were calculated to be between 10(-10) and 10(-12) cm2/s with slight variance due to PETA concentration and the type of comonomer used.

AB-polymer networks based on oligo(epsilon-caprolactone) segments showing shape-memory properties

Although shape-memory metal alloys have wide use in medicine and other areas, improved properties, particularly easy shaping, high shape stability, and adjustable transition temperature, are realizable only by polymer systems. In this paper, a polymer system of shape-memory polymer networks based on oligo(epsilon-caprolactone) dimethacrylate as crosslinker and n-butyl acrylate as comonomer was introduced. The influence of two structural parameters, the molecular weight of oligo(epsilon-caprolactone) dimethacrylate and the weight content of n-butyl acrylate, on macroscopic properties of polymer networks such as thermal and mechanical properties has been investigated. Tensile tests above and below melting temperature showed a decrease in the elastic modulus with increasing comonomer weight content. The crystallization behavior of the new materials has been investigated, and key parameters for the programming procedure of the temporary shape have been evaluated. Shape-memory properties have been quantified by thermocyclic experiments. All samples reached uniform deformation properties with recovery rates above 99% after 3 cycles. Whereas strain recovery increased with increasing n-butyl acrylate content, strain fixity decreased, reflecting the decreasing degree of crystallinity of the material.

AB-polymer networks based on oligo( -caprolactone) segments showing shape-memory properties

Although shape-memory metal alloys have wide use in medicine and other areas, improved properties, particularly easy shaping, high shape stability, and adjustable transition temperature, are realizable only by polymer systems. In this paper, a polymer system of shape-memory polymer networks based on oligo(epsilon-caprolactone) dimethacrylate as crosslinker and n-butyl acrylate as comonomer was introduced. The influence of two structural parameters, the molecular weight of oligo(epsilon-caprolactone) dimethacrylate and the weight content of n-butyl acrylate, on macroscopic properties of polymer networks such as thermal and mechanical properties has been investigated. Tensile tests above and below melting temperature showed a decrease in the elastic modulus with increasing comonomer weight content. The crystallization behavior of the new materials has been investigated, and key parameters for the programming procedure of the temporary shape have been evaluated. Shape-memory properties have been quantified by thermocyclic experiments. All samples reached uniform deformation properties with recovery rates above 99% after 3 cycles. Whereas strain recovery increased with increasing n-butyl acrylate content, strain fixity decreased, reflecting the decreasing degree of crystallinity of the material.

A pH- and ionic strength-responsive polypeptide hydrogel: synthesis, characterization, and preliminary protein release studies

A novel polypeptide hydrogel has been synthesized by crosslinking poly(L-glutamic acid) (PLG) with poly(ethylene glycol) (PEG). The PLG-PEG hydrogel was shown to be highly hydrophilic, and the extent of swelling varied with pH, increasing at higher ionization of the PLG. Aside from electrostatic effects, such as ion-ion repulsion and internal ion osmotic pressure, circular dichroism studies showed that swelling response to pH also is affected by secondary structural attributes associated with the polypeptide backbone. Modification of the polypeptide by changing its hydrophobicity and degree of ionization was an effective method for altering the overall extent of pH-responsive swelling. Rapid de-swelling (contraction) was observed when the PLG-PEG hydrogel was transferred from high to low pH buffer solution, and this swelling/de-swelling behavior was reversible over repeated cycles. Drug release from swollen hydrogels was examined using the model protein lysozyme. Rapid de-swelling of the hydrogel was found to be an effective means of facilitating lysozyme release. The crosslinking of synthetic polypeptides with PEG appears to be a highly versatile approach to the preparation of pH-responsive biodegradable hydrogels.

Seprafilm-induced peritoneal inflammation: a previously unknown complication. Report of a case

INTRODUCTION

Various substances and agents have been evaluated to prevent postoperative adhesion formation. Recently a sodium hyaluronate-based bioresorbable membrane was introduced with promising clinical results. Its application was regarded as safe and efficient.

METHODS

We present the first reported case of a severe inflammatory reaction to a bioresorbable membrane and give a review of the related literature.

CONCLUSION

Bioresorbable membranes are increasingly used by general surgeons and gynecologists to reduce postoperative adhesion formation. Bioresorbable membranes may produce extensive inflammatory reactions.

Reduction of adhesion formation with cross-linked hyaluronic acid after peritoneal surgery in rats

OBJECTIVE

To examine the effectiveness of a cross-linked hyaluronan solution (auto-cross-linked polysaccharide [ACP] gel) for the prevention of postsurgical adhesions.

DESIGN

A randomized blinded study using a rat model of laparotomy.

SETTING

Surgical Research Laboratory in a university medical school.

ANIMAL(S)

Sixty-seven sexually mature rats.

INTERVENTION(S)

Standardized surgical trauma was induced in the rat uterine horn to induce adhesion formation. After trauma, group-1 animals (n = 23) received no treatment, group 2 (n = 21) received noncross-linked hyaluronic acid (HA), and group 3 (n = 23) received cross-linked HA applied on the lesion.

MAIN OUTCOME MEASURE(S)

Six weeks after laparotomy, repeat laparotomy was performed and the adhesions were scored according to Blauer's scoring system.

RESULT(S)

Overall, 84% of the untreated animals and 65% of the animals treated with noncross-linked HA presented with severe adhesions. The mean (+/-SEM) increase in the adhesion score was 2.46+/-0.23 in the untreated group, 2.23+/-0.29 in the group receiving noncross-linked HA, and 1.27+/-0.12 in the ACP gel group.

CONCLUSION(S)

ACP gel holds promise as a novel resorbable biomaterial for the reduction of postoperative adhesions after laparotomy.

A fluorescence-based glucose biosensor using concanavalin A and dextran encapsulated in a poly(ethylene glycol) hydrogel

A fluorescence biosensor is described that is based on a photopolymerized poly(ethylene glycol) (PEG) hydrogel incorporating fluorescein isothiocyanate dextran (FITC-dextran) and tetramethylrhodamine isothiocyanate concanavalin A (TRITC-Con A) chemically conjugated into the hydrogel network using an alpha-acryloyl, omega-N-hydroxysuccinimidyl ester of PEG-propionic acid. In the absence of glucose, TRITC-Con A binds with FITC-dextran, and the FITC fluorescence is quenched through fluorescence resonance energy transfer. Competitive glucose binding to TRITC-Con A liberates FITC-dextran, resulting in increased FITC fluorescence proportional to the glucose concentration. In vitro experiments of hydrogel spheres in a solution of 0.1 M phosphate-buffered saline (pH 7.2) and glucose were conducted for multiple TRITC-Con A/FITC-dextran ratios. Hydrogels were characterized on the basis of the percent change in fluorescence intensity when FITC-dextran was liberated by increasing glucose concentrations. The optimum fluorescent change between 0 and 800 mg/dL was obtained with a TRITC-Con A/FITC-dextran mass ratio of 500:5 micrograms/mL PEG. Fluorescent response was linear up to 600 mg/dL. At higher concentrations, the response saturated due to the displacement of the majority of the FITC-dextran and to concentration quenching by free FITC-dextran. Dynamic fluorescent change upon glucose addition was approximately 10 min for a glucose concentration step change from 0 to 200 mg/dL.

Halofuginone, an inhibitor of collagen type I synthesis, prevents postoperative adhesion formation in the rat uterine horn model

OBJECTIVE

The objective of this study was to evaluate the effects of halofuginone-a specific inhibitor of collagen type I synthesis-in preventing uterine horn adhesion formation in rats.

STUDY DESIGN

Adhesions were induced by scraping the rat uterine horns until capillary bleeding occurred. Halofuginone was either injected intraperitoneally or administered orally. The number and severity of the adhesions were scored. Collagen alpha1(I) gene expression was evaluated by in situ hybridization; total collagen was estimated by sirius red staining. Collagen synthesis in response to halofuginone was evaluated in cells cultured from the adhesions.

RESULTS

Regardless of the administration procedure, halofuginone reduced significantly the number and severity of the adhesions in a dose-dependent manner. Halofuginone prevented the increase in collagen alpha1(I) gene expression observed in the rats that underwent this procedure, thus affecting only the newly synthesized collagen but not the resident collagen. In cells derived from rat uterine horn adhesions, halofuginone induced dose-dependent inhibition of collagen synthesis.

CONCLUSIONS

Upregulation of collagen synthesis appears to play a critical role in the pathophysiologic mechanism of adhesion formation. Halofuginone could be used as an important means of understanding the role of collagen in adhesion formation and might become a novel and promising antifibrotic agent for preventing adhesion formation after pelvic surgery.

Novel degradable poly(ethylene glycol) hydrogels for controlled release of protein

Hydrogels have become increasingly important in the biomedical field. This paper describes synthesis and characterization of two types of novel degradable poly(ethylene glycol) (PEG) hydrogels with potential utility as delivery carriers for bioactive drugs. The simplest gel is prepared by one-step polycondensation of difunctional PEG acid and branched PEG "polyol". The second type of the novel degradable PEG hydrogel was prepared in a two-step process, in which an ester-containing, amine-reactive PEG derivative was synthesized and then reacted with a branched PEG amine to form the gel. The two-step gels are formed in very mild conditions, and therefore fragile drugs such as proteins can be loaded during gel formation. Because most proteins have free amino groups in the sequence, these proteins can be covalently linked to the hydrogel network. This covalent attachment provides a new way to achieve long-term controlled release of proteins. These hydrogels have a wide range of degradation rates. Upon hydrolysis, these PEG hydrogels will degrade into low molecular weight PEG derivatives, which can be easily cleared by the body.

A novel hyaluronan-based gel in laparoscopic adhesion prevention: preclinical evaluation in an animal model

OBJECTIVE

To evaluate the effectiveness of a crosslinked hyaluronan solution (ACP gel) in the prevention of postsurgical adhesions in laparoscopic surgery.

DESIGN

A randomized blinded study using a rabbit model in laparoscopic surgery.

SETTING

A standardized surgical trauma in the rabbit uterine horn to induce adhesion formation.

ANIMALS

Sixty-four sexually matured female New Zealand white rabbits weighing 2.5 to 3.0 kg and aged 3-4 months.

INTERVENTION(S)

After trauma, group 1 (n = 22) received no treatment, group 2 animals (n = 20) received oxidized-regenerated cellulose (Interceed [TC7]) in group 3 (n = 22) 5 mL of ACP gel were applied on the lesion.

MAIN OUTCOME MEASURE(S)

Six weeks after laparoscopy, a laparotomy was performed and the adhesions were scored according to Blauer's scoring system.

RESULT(S)

66% of the untreated animals and 85% of the animals treated with Interceed presented with severe adhesions, whereas only 35% of the ACP gel treatment group had significant adhesions. The mean ( +/- SEM) increased adhesion score was 2.24 +/- 0.26 in the untreated group, 2.45 +/- 0.22 in the Interceed group, and was 1.25 +/- 0.28 in the ACP gel group.

CONCLUSION(S)

This study revealed that ACP gel holds promise as a novel resorbable biomaterial for the reduction of postoperative adhesions after laparoscopic surgery.

In vivo evaluation of a collagenous membrane as an absorbable adhesion barrier

An absorbable membrane made from purified, pepsin-soluble collagen was compared to Interceed, an absorbable cellulose-based product, and to a control group for effectiveness in inhibiting the formation of adhesions between peritoneal surface injuries in adult rats. An adhesion scoring system was used to evaluate and compare the performance of the test materials with the control group in regard to the extent, tenacity, and type of any adhesions evident at 28 days following surgery. The collagen group performed significantly better (p < 0.05) than either the Interceed or control groups, showing fewer, less extensive adhesions. The collagen membranes resulted in either no or weak adhesions between the body wall and caecum. Adhesions in the Interceed group were quite variable and characterized by a marked peritoneal reaction in the caecal and body walls adjacent to adhesions. Control samples were characterized by close, dense fibrotic adhesions between the caecum and body wall. Both of the test materials showed some deficiencies in respect to their physical and handling properties that could be further improved for this indication.

Characterization of photopolymerization by a holographic technique applied to a scattering hydrogel

A holographic technique, which consists of writing a phase grating onto a photopolymer layer and recording the time evolution of its diffraction efficiency, is presented for a scattering hydrogel. The influence of photopolymer thickness and writing laser intensity is investigated. Writing parameters that yield maximum diffraction efficiency are determined. A thickness greater than 1/3 of the scattering length results in the diffusion of light in the sample, leading to a decreased diffraction efficiency of the grating. This behavior can be explained by a combination of chemical diffusion and optical scattering. Finally, a calibration of diffraction efficiency with respect to a gel and sol fraction is presented.

Efficacy of a resorbable hydrogel barrier, oxidized regenerated cellulose, and hyaluronic acid in the prevention of ovarian adhesions in a rabbit model

OBJECTIVE

To compare the efficacy of a resorbable hydrogel material with oxidized regenerated cellulose and hyaluronic acid in an ovarian adhesion model.

DESIGN

Controlled, blinded, and randomized study involving female rabbits.

SETTING

Academic research environment.

INTERVENTIONS

A water-soluble hydrogen precursor was applied to the ovary as a liquid and converted to a hydrogel by exposure to long wavelength ultraviolet light, a 0.4% solution of hyaluronic acid was applied to the ovary, or an oxidized regenerated cellulose patch was applied to the ovary after wedge resectioning.

MAIN OUTCOME MEASURES

Extent and severity of adhesion formation.

RESULTS

Application of the hydrogel reduced adhesion formation by 88%. Neither oxidized regenerated cellulose nor hyaluronic acid reduced adhesion formation.

CONCLUSION

The photopolymerized, resorbable hydrogel material is highly effective for the reduction of periovarian adhesions in this model.