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Su L, Liu W, Wang Y, Jiang Y, Li Z, Wang M, Liu G. Corrosion behavior, antibacterial properties and in vitro and in vivo biocompatibility of biodegradable Zn-5Cu-xMg alloy for bone-implant applications. BIOMATERIALS ADVANCES 2024; 165:214000. [PMID: 39208498 DOI: 10.1016/j.bioadv.2024.214000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/10/2024] [Accepted: 08/17/2024] [Indexed: 09/04/2024]
Abstract
Reasonable optimization of degradation rate, antibacterial performance and biocompatibility is crucial for the development of biodegradable zinc alloy medical implant devices with antibacterial properties. In this study, various amounts of Mg elements were incorporated into Zn5Cu alloy to modulate the degradation rate, antibacterial properties and biocompatibility. The effects of Mg contents on the microstructure, corrosion behavior, antibacterial properties and biocompatibility of Zn-5Cu-xMg alloy were extensively investigated. The results revealed that with an increase of Mg content, the amount of Mg2Zn11 phase increased and its galvanic effect with the Zn matrix was enhanced, which accelerated the corrosion process and led to higher corrosion rate and high degradation rate of the alloy. Additionally, there was an increased release of Mg2+ and Zn2+ ions from the alloy which imparted excellent resistance against Escherichia coli and Staphylococcus aureus bacteria and improved biocompatibility, subcutaneous antibacterial and immune microenvironment regulation properties. Zn-5Cu-2 Mg exhibited superior antibacterial ability, cell compatibility, proliferation effect, subcutaneous antibacterial and immune microenvironment regulation performances, which can work as a promising candidate of biodegradable antibacterial medical implants.
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Affiliation(s)
- Lin Su
- School of Materials Science and Engineering, Central South University, Changsha 410083, China
| | - Wenbin Liu
- Department of Orthopaedics, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha 410008, China; Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Changsha, China
| | - Yanggang Wang
- School of Materials Science and Engineering, Central South University, Changsha 410083, China
| | - Yanbin Jiang
- School of Materials Science and Engineering, Central South University, Changsha 410083, China; State Key Lab for Powder Metallurgy, Central South University, Changsha 410083, China.
| | - Zhou Li
- School of Materials Science and Engineering, Central South University, Changsha 410083, China; State Key Lab for Powder Metallurgy, Central South University, Changsha 410083, China
| | - Meng Wang
- School of Materials Science and Engineering, Central South University, Changsha 410083, China
| | - Gengyan Liu
- Department of Orthopaedics, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha 410008, China.
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2
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Zhang W, Gao X, Zhang H, Sun G, Zhang G, Li X, Qi H, Guo J, Qin L, Shi D, Shi X, Li H, Zhang D, Guo W, Ding J. Maglev-fabricated long and biodegradable stent for interventional treatment of peripheral vessels. Nat Commun 2024; 15:7903. [PMID: 39256371 PMCID: PMC11387404 DOI: 10.1038/s41467-024-52288-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 08/30/2024] [Indexed: 09/12/2024] Open
Abstract
While chronic limb-threatening ischemia is a serious peripheral artery disease, the lack of an appropriate stent significantly limits the potential of interventional treatment. In spite of much progress in coronary stents, little is towards peripheral stents, which are expected to be both long and biodegradable and thus require a breakthrough in core techniques. Herein, we develop a long and biodegradable stent with a length of up to 118 mm based on a metal-polymer composite material. To achieve a well-prepared homogeneous coating on a long stent during ultrasonic spraying, a magnetic levitation is employed. In vivo degradation of the stent is investigated in rabbit abdominal aorta/iliac arteries, and its preclinical safety is evaluated in canine infrapopliteal arteries. First-in-man implantation of the stent is carried out in the below-the-knee artery. The 13 months' follow-ups demonstrate the feasibility of the long and biodegradable stent in clinical applications.
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Affiliation(s)
- Wanqian Zhang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, China
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, China
| | - Xian Gao
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, China
| | - Hongjie Zhang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, China
| | - Guoyi Sun
- Department of Vascular and Endovascular Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Gui Zhang
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, China
| | - Xin Li
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, China
| | - Haiping Qi
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, China
| | - Jingzhen Guo
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, China
| | - Li Qin
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, China
| | - Daokun Shi
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, China
| | - Xiaoli Shi
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, China
| | - Haifeng Li
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, China
| | - Deyuan Zhang
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, China.
| | - Wei Guo
- Department of Vascular and Endovascular Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China.
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, China.
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3
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Rao J, Gao H, Sun J, Yu R, Zhao D, Ding Y. A Critical Review of Biodegradable Zinc Alloys toward Clinical Applications. ACS Biomater Sci Eng 2024; 10:5454-5473. [PMID: 39082869 DOI: 10.1021/acsbiomaterials.4c00210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
Biodegradable zinc (Zn) alloys stand out as promising contenders for biomedical applications due to their favorable mechanical properties and appropriate degradation rates, offering the potential to mitigate the risks and expenses associated with secondary surgeries. While current research predominantly centers on the in vitro examination of Zn alloys, notable disparities often emerge between in vivo and in vitro findings. Consequently, conducting in vivo investigations on Zn alloys holds paramount significance in advancing their clinical application. Different element compositions and processing methods decide the mechanical properties and biological performance of Zn alloys, thus affecting their suitability for specific medical applications. This paper presents a comprehensive overview of recent strides in the development of biodegradable Zn alloys, with a focus on key aspects such as mechanical properties, toxicity, animal experiments, biological properties, and molecular mechanisms. By summarizing these advancements, the paper aims to broaden the scope of research directions and enhance the understanding of the clinical applications of biodegradable Zn alloys.
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Affiliation(s)
- Jiahui Rao
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Hairui Gao
- School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Jiwei Sun
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Ran Yu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Danlei Zhao
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, China
| | - Yumei Ding
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
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Chen YG, Dombaxe C, D'Amato AR, Van Herck S, Welch H, Fu Q, Zhang S, Wang Y. Transformation of metallo-elastomer grafts in a carotid artery interposition model over a year. Biomaterials 2024; 309:122598. [PMID: 38696943 DOI: 10.1016/j.biomaterials.2024.122598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/04/2024]
Abstract
Current vascular grafts, primarily Gore-Tex® and Dacron®, don't integrate with the host and have low patency in small-diameter vessels (<6 mm). Biomaterials that possess appropriate viscoelasticity, compliance, and high biocompatibility are essential for their application in small blood vessels. We have developed metal ion crosslinked poly(propanediol-co-(hydroxyphenyl methylene)amino-propanediol sebacate) (M-PAS), a biodegradable elastomer with a wide range of mechanical properties. We call these materials metallo-elastomers. An initial test on Zn-, Fe-, and Cu-PAS grafts reveals that Cu-PAS is the most suitable because of its excellent elastic recoil and well-balanced polymer degradation/tissue regeneration rate. Here we report host remodeling of Cu-PAS vascular grafts in rats over one year. 76 % of the grafts remain patent and >90 % of the synthetic polymer is degraded by 12 months. Extensive cell infiltration leads to a positive host remodeling. The remodeled grafts feature a fully endothelialized lumen. Circumferentially organized smooth muscle cells, elastin fibers, and widespread mature collagen give the neoarteries mechanical properties similar to native arteries. Proteomic analysis further reveals the presence of important vascular proteins in the neoarteries. Evidence suggests that Cu-PAS is a promising material for engineering small blood vessels.
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Affiliation(s)
- Ying Grace Chen
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14850, USA
| | - Catia Dombaxe
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14850, USA
| | | | - Simon Van Herck
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14850, USA
| | - Halle Welch
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14850, USA
| | - Qin Fu
- Proteomics and Metabolomics Facility, Institute of Biotechnology, Cornell University, Ithaca, NY, 14850, USA
| | - Sheng Zhang
- Proteomics and Metabolomics Facility, Institute of Biotechnology, Cornell University, Ithaca, NY, 14850, USA
| | - Yadong Wang
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14850, USA.
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5
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Meng F, Du Y. Research Progress on Laser Powder Bed Fusion Additive Manufacturing of Zinc Alloys. MATERIALS (BASEL, SWITZERLAND) 2024; 17:4309. [PMID: 39274701 PMCID: PMC11395926 DOI: 10.3390/ma17174309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/25/2024] [Accepted: 08/27/2024] [Indexed: 09/16/2024]
Abstract
Zinc, along with magnesium and iron, is considered one of the most promising biodegradable metals. Compared with magnesium and iron, pure Zn exhibits poor mechanical properties, despite its mild biological corrosion behavior and beneficial biocompatibility. Laser powder bed fusion (LPBF), unlike traditional manufacturing techniques, has the capability to rapidly manufacture near-net-shape components. At present, although the combination of LPBF and Zn has made great progress, it is still in its infancy. Element loss and porosity are common processing problems for LPBF Zn, mainly due to evaporation during melting under a high-energy beam. The formation quality and properties of the final material are closely related to the alloy composition, design and processing. This work reviews the state of research and future perspective on LPBF zinc from comprehensive assessments such as powder characteristics, alloy composition, processing, formation quality, microstructure, and properties. The effects of powder characteristics, process parameters and evaporation on formation quality are introduced. The mechanical, corrosion, and biocompatibility properties of LPBF Zn and their test methodologies are introduced. The effects of microstructure on mechanical properties and corrosion properties are analyzed in detail. The practical medical application of Zn is introduced. Finally, current research status is summarized together with suggested directions for advancing knowledge about LPBF Zn.
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Affiliation(s)
- Fuxiang Meng
- School of Mechanical Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Yulei Du
- School of Mechanical Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
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6
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Leyssens L, Lapraille N, Pyka G, Jacques PJ, Horman S, Goldman J, Kerckhofs G. Exploring the biodegradability of candidate metallic intravascular stent materials using X-ray microfocus computed tomography: An in vitro study. J Biomed Mater Res B Appl Biomater 2024; 112:e35452. [PMID: 39042645 DOI: 10.1002/jbm.b.35452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 03/07/2024] [Accepted: 07/08/2024] [Indexed: 07/25/2024]
Abstract
In vitro testing for evaluating degradation mode and rate of candidate biodegradable metals to be used as intravascular stents is crucial before going to in vivo animal models. In this study, we show that X-ray microfocus computed tomography (microCT) presents a key added value to visualize degradation mode and to evaluate degradation rate and material surface properties in 3D and at high resolution of large regions of interest. The in vitro degradation behavior of three candidate biodegradable stent materials was evaluated: pure iron (Fe), pure zinc (Zn), and a quinary Zn alloy (ZnAgCuMnZr). These metals were compared to a reference biostable cobaltchromium (CoCr) alloy. To compare the degradation mode and degradation rate evaluated with microCT, scanning electron microscopy (SEM) and inductively-coupled plasma (ICP) were included. We confirmed that Fe degrades very slowly but with desirable uniform surface corrosion. Zn degrades faster but exhibits localized deep pitting corrosion. The Zn alloy degrades at a similar rate as the pure Zn, but more homogeneously. However, the formation of deep internal dendrites was observed. Our study provides a detailed microCT-based comparison of essential surface and corrosion properties, with a structural characterization of the corrosion behavior, of different candidate stent materials in 3D in a non-destructive way.
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Affiliation(s)
- Lisa Leyssens
- Mechatronic, Electrical Energy and Dynamic Systems, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Pole of Morphology, Institute of Experimental and Clinical Research, UCLouvain, Woluwe-Saint-Lambert, Belgium
| | - Noémie Lapraille
- Mechatronic, Electrical Energy and Dynamic Systems, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
| | - Grzegorz Pyka
- Mechatronic, Electrical Energy and Dynamic Systems, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Pole of Morphology, Institute of Experimental and Clinical Research, UCLouvain, Woluwe-Saint-Lambert, Belgium
| | - Pascal J Jacques
- Materials and Process Engineering, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
| | - Sandrine Horman
- Pole of Cardiovascular Research, Institute of Experimental and Clinical Research, UCLouvain, Woluwe-Saint-Lambert, Belgium
| | - Jeremy Goldman
- Department of Biomedical Engineering, Michigan Technological University, Houghton, Michigan, USA
| | - Greet Kerckhofs
- Mechatronic, Electrical Energy and Dynamic Systems, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Pole of Morphology, Institute of Experimental and Clinical Research, UCLouvain, Woluwe-Saint-Lambert, Belgium
- Department of Materials Engineering, KU Leuven, Leuven, Belgium
- Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium
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7
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Anderson D, Le H, Vu H, Johnson J, Aslan J, Goldman J, Hinds M. Thrombogenicity of biodegradable metals. Bioact Mater 2024; 38:411-421. [PMID: 38774458 PMCID: PMC11107095 DOI: 10.1016/j.bioactmat.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/10/2024] [Accepted: 05/02/2024] [Indexed: 05/24/2024] Open
Abstract
Biodegradable metals offer a promising means to ameliorate many of the long-term risks associated with vascular devices made of conventional biostable stent metals. While numerous biodegradable metal alloys have been developed and characterized in animal models, knowledge of their blood reactivity and thrombogenicity remains unknown. Metal hemocompatibility is particularly valuable because current generation drug-eluting stents pose a significant long-term thrombosis risk. In this study, four pure metals, widely used as degradable base materials (Fe, Zn, Mg, and Mo), and three alloys commonly used in cardiovascular devices [NiTi, CoCr, and stainless steel (SS)] were evaluated. This work examined how each of these metals activate platelets, coagulation factors, and inflammation using in vitro hemocompatibility assays and a clinically relevant ex vivo non-human primate arteriovenous shunt model. Testing found that while all metals promoted a downstream activation of platelets and coagulation in flowing whole blood, platelet and fibrin attachment to Mg was markedly reduced. Additionally, Fe and Mo trended toward higher platelet attachment and contact pathway activation. Overall, the results suggest that Mg may delay clot initiation, but not eliminate clot formation, indicating the importance of understanding thrombosis in Mg alloys that are currently being developed for clinical use as biodegradable stents.
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Affiliation(s)
- D.E.J. Anderson
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
| | - H.H. Le
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
| | - H. Vu
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
| | - J. Johnson
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
| | - J.E. Aslan
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - J. Goldman
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI, USA
| | - M.T. Hinds
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
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McLennan DI, Maldonado JR, Foerster SR, Handler SS, LaDisa JF, Gudausky TM, Guillory RJ. Absorbable metal stents for vascular use in pediatric cardiology: progress and outlook. Front Cardiovasc Med 2024; 11:1410305. [PMID: 39165257 PMCID: PMC11334478 DOI: 10.3389/fcvm.2024.1410305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 06/19/2024] [Indexed: 08/22/2024] Open
Abstract
The past five years have yielded impressive advancements in fully absorbable metal stent technology. The desired ultimate ability for such devices to treat a vascular stenosis without long-term device-related complications or impeding future treatment continues to evoke excitement in clinicians and engineers alike. Nowhere is the need for fully absorbable metal stents greater than in patients experiencing vascular anomalies associated with congenital heart disease (CHD). Perhaps not surprisingly, commercially available absorbable metal stents have been implanted in pediatric cardiology patients with conditions ranging from pulmonary artery and vein stenosis to coarctation of the aorta and conduit/shunt reconstructions. Despite frequent short term procedural success, device performance has missed the mark with the commercially available devices not achieving degradation benchmarks for given applications. In this review we first provide a general overview detailing the theory of absorbable metal stents, and then review recent clinical use in CHD patients since the release of current-generation absorbable metal stents around 2019. We also discuss the challenges and our center's experience associated with the use of absorbable metal stents in this pediatric population. Lastly, we present potential directions for future engineering endeavors to mitigate existing challenges.
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Affiliation(s)
- Daniel I. McLennan
- Department of Pediatrics—Division of Cardiology, Herma Heart Institute, Children’s Wisconsin and the Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jennifer R. Maldonado
- Department of Pediatrics—Division of Cardiology, Herma Heart Institute, Children’s Wisconsin and the Medical College of Wisconsin, Milwaukee, WI, United States
| | - Susan R. Foerster
- Department of Pediatrics—Division of Cardiology, Herma Heart Institute, Children’s Wisconsin and the Medical College of Wisconsin, Milwaukee, WI, United States
| | - Stephanie S. Handler
- Department of Pediatrics—Division of Cardiology, Herma Heart Institute, Children’s Wisconsin and the Medical College of Wisconsin, Milwaukee, WI, United States
| | - John F. LaDisa
- Department of Pediatrics—Division of Cardiology, Herma Heart Institute, Children’s Wisconsin and the Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, WI, United States
- Departments of Physiology, and Medicine—Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Todd M. Gudausky
- Department of Pediatrics—Division of Cardiology, Herma Heart Institute, Children’s Wisconsin and the Medical College of Wisconsin, Milwaukee, WI, United States
| | - Roger J. Guillory
- Department of Pediatrics—Division of Cardiology, Herma Heart Institute, Children’s Wisconsin and the Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, WI, United States
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9
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Zhang W, Dai M, Zhu Y, Li S, Sun Y, Liu X, Li X. Imidazole functionalized photo-crosslinked aliphatic polycarbonate drug-eluting coatings on zinc alloys for osteogenesis, angiogenesis, and bacteriostasis in bone regeneration. Bioact Mater 2024; 37:549-562. [PMID: 38756420 PMCID: PMC11096721 DOI: 10.1016/j.bioactmat.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/31/2024] [Accepted: 03/31/2024] [Indexed: 05/18/2024] Open
Abstract
Zinc (Zn) alloys have demonstrated significant potential in healing critical-sized bone defects. However, the clinical application of Zn alloys implants is still hindered by challenges including excessive release of zinc ions (Zn2+), particularly in the early stage of implantation, and absence of bio-functions related to complex bone repair processes. Herein, a biodegradable aliphatic polycarbonate drug-eluting coating was fabricated on zinc-lithium (Zn-Li) alloys to inhibit Zn2+ release and enhance the osteogenesis, angiogenesis, and bacteriostasis of Zn alloys. Specifically, the photo-curable aliphatic polycarbonates were co-assembled with simvastatin and deposited onto Zn alloys to produce a drug-loaded coating, which was crosslinked by subsequent UV light irradiation. During the 60 days long-term immersion test, the coating showed distinguished stable drug release and Zn2+ release inhibition properties. Benefiting from the regulated release of Zn2+ and simvastatin, the coating facilitated the adhesion, proliferation, and differentiation of MC3T3-E1 cells, as well as the migration and tube formation of EA.hy926 cells. Astonishingly, the coating also showed remarkable antibacterial properties against both S. aureus and E. coli. The in vivo rabbit critical-size femur bone defects model demonstrated that the drug-eluting coating could efficiently promote new bone formation and the expression of platelet endothelial cell adhesion molecule-1 (CD31) and osteocalcin (OCN). The enhancement of osteogenesis, angiogenesis, and bacteriostasis is achieved by precisely controlling of the released Zn2+ at an appropriate level, as well as the stable release profile of simvastatin. This tailored aliphatic polycarbonate drug-eluting coating provides significant potential for clinical applications of Zn alloys implants.
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Affiliation(s)
- Wei Zhang
- Key laboratory of synthetic and biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Lihu Street 1800, Wuxi, 214122, China
| | - Miao Dai
- Key laboratory of synthetic and biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Lihu Street 1800, Wuxi, 214122, China
| | - Ye Zhu
- Key laboratory of synthetic and biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Lihu Street 1800, Wuxi, 214122, China
| | - Siyuan Li
- Key laboratory of synthetic and biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Lihu Street 1800, Wuxi, 214122, China
| | - Ying Sun
- Key laboratory of synthetic and biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Lihu Street 1800, Wuxi, 214122, China
| | - Xiaoya Liu
- Key laboratory of synthetic and biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Lihu Street 1800, Wuxi, 214122, China
| | - Xiaojie Li
- Key laboratory of synthetic and biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Lihu Street 1800, Wuxi, 214122, China
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10
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Petráková M, Gorejová R, Shepa J, Macko J, Kupková M, Mičušík M, Baláž M, Hajdučková V, Hudecová P, Kožár M, Šišková B, Sáha P, Oriňaková R. Effect of Gentamicin Sulfate and Polymeric Polyethylene Glycol Coating on the Degradation and Cytotoxicity of Iron-Based Biomaterials. ACS OMEGA 2024; 9:27113-27126. [PMID: 38947814 PMCID: PMC11209885 DOI: 10.1021/acsomega.4c01002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/17/2024] [Accepted: 05/24/2024] [Indexed: 07/02/2024]
Abstract
The work is focused on the degradation, cytotoxicity, and antibacterial properties, of iron-based biomaterials with a bioactive coating layer. The foam and the compact iron samples were coated with a polyethylene glycol (PEG) polymer layer without and with gentamicin sulfate (PEG + Ge). The corrosion properties of coated and uncoated samples were studied using the degradation testing in Hanks' solution at 37 °C. The electrochemical and static immersion corrosion tests revealed that the PEG-coated samples corroded faster than samples with the bioactive PEG + Ge coating and uncoated samples. The foam samples corroded faster compared with the compact samples. To determine the cytotoxicity, cell viability was monitored in the presence of porous foam and compact iron samples. The antibacterial activity of the samples with PEG and PEG + Ge against Escherichia coli CCM 3954 and Staphylococcus aureus CCM 4223 strains was also tested. Tested PEG + Ge samples showed significant antibacterial activity against both bacterial strains. Therefore, the biodegradable iron-based materials with a bioactive coating could be a suitable successor to the metal materials studied thus far as well as the materials used in the field of medicine.
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Affiliation(s)
- Martina Petráková
- Department
of Physical Chemistry, P. J. Šafárik
University in Košice, Moyzesova 11, 041
01 Košice, Slovakia
| | - Radka Gorejová
- Department
of Physical Chemistry, P. J. Šafárik
University in Košice, Moyzesova 11, 041
01 Košice, Slovakia
| | - Jana Shepa
- Department
of Physical Chemistry, P. J. Šafárik
University in Košice, Moyzesova 11, 041
01 Košice, Slovakia
| | - Ján Macko
- Department
of Physical Chemistry, P. J. Šafárik
University in Košice, Moyzesova 11, 041
01 Košice, Slovakia
| | - Miriam Kupková
- Institute
of Materials Research, Slovak Academy of
Sciences, Watsonova 47, 040 01 Košice, Slovakia
| | - Matej Mičušík
- Institute
of Polymers, Slovak Academy of Sciences, Dúbravská cesta 9, 845 41 Bratislava, Slovakia
| | - Matej Baláž
- Institute
of Geotechnics, Slovak Academy of Sciences, Watsonova 45, 040 01 Košice, Slovakia
| | - Vanda Hajdučková
- Department
of Microbiology and Immunology, University
of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 041 81 Košice, Slovakia
| | - Patrícia Hudecová
- Department
of Microbiology and Immunology, University
of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 041 81 Košice, Slovakia
| | - Martin Kožár
- Small Animal
Clinic, The University of Veterinary Medicine
and Pharmacy in Košice, 040 01 Košice, Slovakia
| | - Barbora Šišková
- Small Animal
Clinic, The University of Veterinary Medicine
and Pharmacy in Košice, 040 01 Košice, Slovakia
| | - Petr Sáha
- Centre
of Polymer Systems, University Institute,
Tomáš Bat’a University in Zlín, Třida Tomáše
Bati 5678, 76001 Zlín, Czech Republic
| | - Renáta Oriňaková
- Department
of Physical Chemistry, P. J. Šafárik
University in Košice, Moyzesova 11, 041
01 Košice, Slovakia
- Centre
of Polymer Systems, University Institute,
Tomáš Bat’a University in Zlín, Třida Tomáše
Bati 5678, 76001 Zlín, Czech Republic
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11
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Zhang X, Niu J, Yeung KWK, Huang H, Gao Z, Chen C, Guan Q, Zhang G, Zhang L, Xue G, Yuan G. Developing Zn-2Cu-xLi (x < 0.1 wt %) alloys with suitable mechanical properties, degradation behaviors and cytocompatibility for vascular stents. Acta Biomater 2024:S1742-7061(24)00313-1. [PMID: 38876454 DOI: 10.1016/j.actbio.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/30/2024] [Accepted: 06/06/2024] [Indexed: 06/16/2024]
Abstract
Biodegradable Zn alloys show great potential for vascular stents due to their moderate degradation rates and acceptable biocompatibility. However, the poor mechanical properties limit their applications. In this study, low alloyed Zn-2Cu-xLi (x = 0.004, 0.01, 0.07 wt %) alloys with favorable mechanical properties were developed. The microstructure consists of fine equiaxed η-Zn grains, micron, submicron-sized and coherent nano ε-CuZn4 phases. The introduced Li exists as a solute in the η-Zn matrix and ε-CuZn4 phase, and results in the increase of ε-CuZn4 volume fraction, the refinement of grains and more uniform distribution of grain sizes. As Li content increases, the strength of alloys is dramatically improved by grain boundary strengthening, precipitate strengthening of ε-CuZn4 and solid solution strengthening of Li. Zn-2Cu-0.07Li alloy has the optimal mechanical properties with a tensile yield strength of 321.8 MPa, ultimate tensile strength of 362.3 MPa and fracture elongation of 28.0 %, exceeding the benchmark of stents. It also has favorable mechanical property stability, weak tension compression yield asymmetry and strain rate sensitivity. It exhibits uniform degradation and a little improved degradation rate of 89.5 μm∙year-1, due to the improved electrochemical activity by increased ε-CuZn4 volume fraction, and generates Li2CO3 and LiOH. It shows favorable cytocompatibility without adverse influence on endothelial cell viability by trace Li+. The fabricated microtubes show favorable mechanical properties, and stents exhibit an average radial strength of 118 kPa. The present study indicates that Zn-2Cu-0.07Li alloy is a potential and promising candidate for vascular stent applications. STATEMENT OF SIGNIFICANCE: Zn alloys are promising candidates for biodegradable vascular stents. However, improving their mechanical properties is challenging. Combining the advantages of Cu and trace Li, Zn-2Cu-xLi (x < 0.1 wt %) alloys were developed for stents. As Li increases, the strength of alloys is dramatically improved by refined grains, increased volume fraction of ε-CuZn4 and solid solution of Li. Zn-2Cu-0.07Li alloy exhibits a TYS exceeding 320 MPa, UTS exceeding 360 MPa and fracture EL of nearly 30 %. It shows favorable mechanical stability, degradation behaviors and cytocompatibility. The alloy was fabricated into microtubes and stents for mechanical property tests to verify application feasibility for the first time. This indicates that Zn-2Cu-0.07Li alloy has great potential for vascular stent applications.
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Affiliation(s)
- Xiyuan Zhang
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jialin Niu
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Kelvin Wai-Kwok Yeung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong 999077, China
| | - Hua Huang
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Zhiqiang Gao
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Chun Chen
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Qingqing Guan
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Guangjian Zhang
- Shanghai MicroPort Endovascular MedTech (Group) Co., Ltd., Shanghai 200120, China
| | - Linlin Zhang
- Shanghai MicroPort Endovascular MedTech (Group) Co., Ltd., Shanghai 200120, China
| | - Guanhua Xue
- Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
| | - Guangyin Yuan
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
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12
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Hassan N, Krieg T, Kopp A, Bach AD, Kröger N. Challenges and Pitfalls of Research Designs Involving Magnesium-Based Biomaterials: An Overview. Int J Mol Sci 2024; 25:6242. [PMID: 38892430 PMCID: PMC11172609 DOI: 10.3390/ijms25116242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/21/2024] Open
Abstract
Magnesium-based biomaterials hold remarkable promise for various clinical applications, offering advantages such as reduced stress-shielding and enhanced bone strengthening and vascular remodeling compared to traditional materials. However, ensuring the quality of preclinical research is crucial for the development of these implants. To achieve implant success, an understanding of the cellular responses post-implantation, proper model selection, and good study design are crucial. There are several challenges to reaching a safe and effective translation of laboratory findings into clinical practice. The utilization of Mg-based biomedical devices eliminates the need for biomaterial removal surgery post-healing and mitigates adverse effects associated with permanent biomaterial implantation. However, the high corrosion rate of Mg-based implants poses challenges such as unexpected degradation, structural failure, hydrogen evolution, alkalization, and cytotoxicity. The biocompatibility and degradability of materials based on magnesium have been studied by many researchers in vitro; however, evaluations addressing the impact of the material in vivo still need to be improved. Several animal models, including rats, rabbits, dogs, and pigs, have been explored to assess the potential of magnesium-based materials. Moreover, strategies such as alloying and coating have been identified to enhance the degradation rate of magnesium-based materials in vivo to transform these challenges into opportunities. This review aims to explore the utilization of Mg implants across various biomedical applications within cellular (in vitro) and animal (in vivo) models.
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Affiliation(s)
- Nourhan Hassan
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Cologne, 50937 Cologne, Germany
- Institute for Laboratory Animal Science and Experimental Surgery, University of Aachen Medical Center, Faculty of Medicine, RWTH-Aachen University, 52074 Aachen, Germany
- Biotechnology Department, Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Thomas Krieg
- Translational Matrix Biology, Medical Faculty, University of Cologne, 50937 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50937 Cologne, Germany
- Center for Molecular Medicine (CMMC), University of Cologne, 50937 Cologne, Germany
| | | | - Alexander D. Bach
- Department of Plastic, Aesthetic and Hand Surgery, St. Antonius Hospital Eschweiler, 52249 Eschweiler, Germany
| | - Nadja Kröger
- Institute for Laboratory Animal Science and Experimental Surgery, University of Aachen Medical Center, Faculty of Medicine, RWTH-Aachen University, 52074 Aachen, Germany
- Department of Plastic, Aesthetic and Hand Surgery, St. Antonius Hospital Eschweiler, 52249 Eschweiler, Germany
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13
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Wen KC, Li ZA, Liu JH, Zhang C, Zhang F, Li FQ. Recent developments in ureteral stent: Substrate material, coating polymer and technology, therapeutic function. Colloids Surf B Biointerfaces 2024; 238:113916. [PMID: 38636438 DOI: 10.1016/j.colsurfb.2024.113916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/21/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024]
Abstract
The ureteral stent is an effective treatment for clinical ureteral stricture following urological surgery, and the functional coating of the stent could effectively inhibit bacterial colonization and other complications. The present review provides an analysis and description of the materials used in ureteral stents and their coatings. Emphasis is placed on the technological advancements of functional coatings, taking into consideration the characteristics of these materials and the properties of their active substances. Furthermore, recent advances in enhancing the therapeutic efficacy of functional coatings are also reviewed. It is anticipated that this article will serve as a valuable reference providing insights for future research development on new drug-loaded ureteral stents.
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Affiliation(s)
- Kai-Chao Wen
- School of Medicine, Shanghai University, Shanghai 200444, China; Department of Urology/Pharmaceutics, Shanghai Eighth People's Hospital, Shanghai 200235, China
| | - Zheng-An Li
- School of Medicine, Shanghai University, Shanghai 200444, China; Department of Urology/Pharmaceutics, Shanghai Eighth People's Hospital, Shanghai 200235, China
| | - Ji-Heng Liu
- Department of Urology/Pharmaceutics, Shanghai Eighth People's Hospital, Shanghai 200235, China
| | - Chuan Zhang
- School of Medicine, Shanghai University, Shanghai 200444, China.
| | - Feng Zhang
- Department of Urology/Pharmaceutics, Shanghai Eighth People's Hospital, Shanghai 200235, China.
| | - Feng-Qian Li
- School of Medicine, Shanghai University, Shanghai 200444, China; Department of Urology/Pharmaceutics, Shanghai Eighth People's Hospital, Shanghai 200235, China.
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14
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Zeng Y, Murali N, See CW, Liu J, Chi Y, Zhu D, Linsley CS, Wu BM, Li X. Effect of TiC Nanoparticles on a Zn-Al-Cu System for Biodegradable Cardiovascular Stent Applications. ACS Biomater Sci Eng 2024; 10:3438-3453. [PMID: 38564666 DOI: 10.1021/acsbiomaterials.3c01714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Despite being a weaker metal, zinc has become an increasingly popular candidate for biodegradable implant applications due to its suitable corrosion rate and biocompatibility. Previous studies have experimented with various alloy elements to improve the overall mechanical performance of pure Zn without compromising the corrosion performance and biocompatibility; however, the thermal stability of biodegradable Zn alloys has not been widely studied. In this study, TiC nanoparticles were introduced for the first time to a Zn-Al-Cu system. After hot rolling, TiC nanoparticles were uniformly distributed in the Zn matrix and effectively enabled phase control during solidification. The Zn-Cu phase, which was elongated and sharp in the reference alloy, became globular in the nanocomposite. The strength of the alloy, after introducing TiC nanoparticles, increased by 31% from 259.7 to 340.3 MPa, while its ductility remained high at 49.2% elongation to failure. Fatigue performance also improved greatly by adding TiC nanoparticles, increasing the fatigue limit by 47.6% from 44.7 to 66 MPa. Furthermore, TiC nanoparticles displayed excellent phase control capability during body-temperature aging. Without TiC restriction, Zn-Cu phases evolved into dendritic morphologies, and the Al-rich eutectic grew thicker at grain boundaries. However, both Zn-Cu and Al-rich eutectic phases remained relatively unchanged in shape and size in the nanocomposite. A combination of exceptional tensile properties, improved fatigue performance, better long-term stability with a suitable corrosion rate, and excellent biocompatibility makes this new Zn-Al-Cu-TiC material a promising candidate for biodegradable stents and other biodegradable applications.
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Affiliation(s)
- Yuxin Zeng
- Department of Mechanical and Aerospace Engineering, Samueli School of Engineering, University of California, Los Angeles, California 90095, United States
| | - Narayanan Murali
- Department of Materials Science and Engineering, Samueli School of Engineering, University of California, Los Angeles, California 90095, United States
| | - Carmine Wang See
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
| | - Jingke Liu
- Department of Mechanical and Aerospace Engineering, Samueli School of Engineering, University of California, Los Angeles, California 90095, United States
| | - Yitian Chi
- Department of Mechanical and Aerospace Engineering, Samueli School of Engineering, University of California, Los Angeles, California 90095, United States
| | - Donghui Zhu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
| | - Chase S Linsley
- Department of Bioengineering, Samueli School of Engineering, University of California, Los Angeles, California 90095, United States
| | - Benjamin M Wu
- Department of Materials Science and Engineering, Samueli School of Engineering, University of California, Los Angeles, California 90095, United States
- Department of Bioengineering, Samueli School of Engineering, University of California, Los Angeles, California 90095, United States
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, California 90095, United States
- Department of Orthopedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, California 90095, United States
- The ADA Forsyth Institute, Cambridge, Massachusetts 02140, United States
| | - Xiaochun Li
- Department of Mechanical and Aerospace Engineering, Samueli School of Engineering, University of California, Los Angeles, California 90095, United States
- Department of Materials Science and Engineering, Samueli School of Engineering, University of California, Los Angeles, California 90095, United States
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15
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Wiyono AV, Ardinal AP. Revolutionizing Cardiovascular Frontiers: A Dive Into Cutting-Edge Innovations in Coronary Stent Technology. Cardiol Rev 2024:00045415-990000000-00255. [PMID: 38709038 DOI: 10.1097/crd.0000000000000705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Plain balloon angioplasty was the initial method used to enlarge the intracoronary lumen size. However, it was linked to acute coronary closure due to early vessel recoil. This led to the invention of coronary stents, which offer mechanical support to open and maintain the vascular lumen. Nevertheless, the metallic scaffold introduced other issues, such as thrombosis and restenosis caused by neointimal proliferation. To address these concerns, polymers were employed to cover the scaffold, acting as drug reservoirs and regulators for controlled drug release. The use of polymers prevents direct contact between blood and metallic scaffolds. Drugs within the stent were incorporated to inhibit proliferation and expedite endothelialization in the healing process. Despite these advancements, adverse effects still arise due to the inflammatory reaction caused by the polymer material. Consequently, resorbable polymers and scaffolds were later discovered, but they have limitations and are not universally applicable. Various scaffold designs, thicknesses, materials, polymer components, and drugs have their own advantages and complications. Each stent generation has been designed to address the shortcomings of the preceding generation, yet new challenges continue to emerge. Conflicting data regarding the long-term safety and efficacy of coronary stents, especially in the extended follow-up, further complicates the assessment.
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Affiliation(s)
- Alice Valeria Wiyono
- Faculty of Life Sciences & Medicine, King's College London, School of Cardiovascular and Metabolic Medicine, London, United Kingdom
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16
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Yuan K, Deng C, Tan L, Wang X, Yan W, Dai X, Du R, Zheng Y, Zhang H, Wang G. Structural and temporal dynamics analysis of zinc-based biomaterials: History, research hotspots and emerging trends. Bioact Mater 2024; 35:306-329. [PMID: 38362138 PMCID: PMC10867564 DOI: 10.1016/j.bioactmat.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/13/2024] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
Objectives To examine the 16-year developmental history, research hotspots, and emerging trends of zinc-based biodegradable metallic materials from the perspective of structural and temporal dynamics. Methods The literature on zinc-based biodegradable metallic materials in WoSCC was searched. Historical characteristics, the evolution of active topics and development trends in the field of zinc-based biodegradable metallic materials were analyzed using the bibliometric tools CiteSpace and HistCite. Results Over the past 16 years, the field of zinc-based biodegradable metal materials has remained in a hotspot stage, with extensive scientific collaboration. In addition, there are 45 subject categories and 51 keywords in different research periods, and 80 papers experience citation bursts. Keyword clustering anchored 3 emerging research subfields, namely, #1 plastic deformation #4 additive manufacturing #5 surface modification. The keyword alluvial map shows that the longest-lasting research concepts in the field are mechanical property, microstructure, corrosion behavior, etc., and emerging keywords are additive manufacturing, surface modification, dynamic recrystallization, etc. The most recent research on reference clustering has six subfields. Namely, #0 microstructure, #2 sem, #3 additive manufacturing, #4 laser powder bed fusion, #5 implant, and #7 Zn-1Mg. Conclusion The results of the bibliometric study provide the current status and trends of research on zinc-based biodegradable metallic materials, which can help researchers identify hot spots and explore new research directions in the field.
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Affiliation(s)
- Kunshan Yuan
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China
- National United Engineering Laboratory for Biomedical Material Modification, Dezhou, 251100, China
| | - Chengchen Deng
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China
| | - Lili Tan
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China
| | - Xiangxiu Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China
| | - Wenhua Yan
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China
| | - Xiaozhen Dai
- School of Biosciences and Technology, Chengdu Medical College, Chengdu, 610500, China
| | - Ruolin Du
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China
| | - Yufeng Zheng
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Haijun Zhang
- National United Engineering Laboratory for Biomedical Material Modification, Dezhou, 251100, China
- Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Guixue Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China
- JinFeng Laboratory, Chongqing, 401329, China
- School of Biosciences and Technology, Chengdu Medical College, Chengdu, 610500, China
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17
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Van Daele L, Chausse V, Parmentier L, Brancart J, Pegueroles M, Van Vlierberghe S, Dubruel P. 3D-Printed Shape Memory Poly(alkylene terephthalate) Scaffolds as Cardiovascular Stents Revealing Enhanced Endothelialization. Adv Healthc Mater 2024; 13:e2303498. [PMID: 38329408 DOI: 10.1002/adhm.202303498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/02/2024] [Indexed: 02/09/2024]
Abstract
Cardiovascular diseases are the leading cause of death and current treatments such as stents still suffer from disadvantages. Balloon expansion causes damage to the arterial wall and limited and delayed endothelialization gives rise to restenosis and thrombosis. New more performing materials that circumvent these disadvantages are required to improve the success rate of interventions. To this end, the use of a novel polymer, poly(hexamethylene terephthalate), is investigated for this application. The synthesis to obtain polymers with high molar masses up to 126.5 kg mol-1 is optimized and a thorough chemical and thermal analysis is performed. The polymers are 3D-printed into personalized cardiovascular stents using the state-of-the-art solvent-cast direct-writing technique, the potential of these stents to expand using their shape memory behavior is established, and it is shown that the stents are more resistant to compression than the poly(l-lactide) benchmark. Furthermore, the polymer's hydrolytic stability is demonstrated in an accelerated degradation study of 6 months. Finally, the stents are subjected to an in vitro biological evaluation, revealing that the polymer is non-hemolytic and supports significant endothelialization after only 7 days, demonstrating the enormous potential of these polymers to serve cardiovascular applications.
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Affiliation(s)
- Lenny Van Daele
- Polymer Chemistry and Biomaterials Group (PBM), Centre of Macromolecular Chemistry (CMaC), Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4-bis, Ghent, B-9000, Belgium
| | - Victor Chausse
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Universitat Politècnica de Catalunya (UPC), EEBE, Barcelona, 08019, Spain
| | - Laurens Parmentier
- Polymer Chemistry and Biomaterials Group (PBM), Centre of Macromolecular Chemistry (CMaC), Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4-bis, Ghent, B-9000, Belgium
| | - Joost Brancart
- Physical Chemistry and Polymer Science (FYSC), Vrije Universiteit Brussel, Pleinlaan 2, Brussels, 1050, Belgium
| | - Marta Pegueroles
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Universitat Politècnica de Catalunya (UPC), EEBE, Barcelona, 08019, Spain
| | - Sandra Van Vlierberghe
- Polymer Chemistry and Biomaterials Group (PBM), Centre of Macromolecular Chemistry (CMaC), Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4-bis, Ghent, B-9000, Belgium
| | - Peter Dubruel
- Polymer Chemistry and Biomaterials Group (PBM), Centre of Macromolecular Chemistry (CMaC), Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4-bis, Ghent, B-9000, Belgium
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18
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Tan J, Wang H, Liu S, Li L, Liu H, Liu T, Chen J. Multifunctional nanocoatings with synergistic controlled release of zinc ions and cytokines for precise modulation of vascular intimal reconstruction. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2024; 57:102739. [PMID: 38341009 DOI: 10.1016/j.nano.2024.102739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
Vascular stent implantation remains the major therapeutic method for cardiovascular diseases currently. We here introduced crucial biological functional biological function factors (SDF-1α, VEGF) and vital metal ions (Zn2+) into the stent surface to explore their synergistic effect in the microenvironment. The combination of the different factors is known to effectively regulate cellular inflammatory response and selectively regulate cell biological behavior. Meanwhile, in the implemented method, VEGF and Zn2+ were loaded into heparin and poly-l-lysine (Hep-PLL) nanoparticles, ensuring a controlled release of functional molecules with a multi-factor synergistic effect and excellent biological functions in vitro and in vivo. Notably, after 150 days of implantation of the modified stent in rabbits, a thin and smooth new intima was obtained. This study offers a new idea for constructing a modified surface microenvironment and promoting tissue repair.
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Affiliation(s)
- Jianying Tan
- College of Materials and Chemistry & Chemical Engineering, Chengdu University of Technology, Chengdu 610059, China
| | - Huanran Wang
- Key Laboratory of Advanced Technology of Materials, Ministry of Education, Southwest Jiaotong University, Chengdu 610031, China
| | - Sainan Liu
- Key Laboratory of Advanced Technology of Materials, Ministry of Education, Southwest Jiaotong University, Chengdu 610031, China
| | - Li Li
- Key Laboratory of Advanced Technology of Materials, Ministry of Education, Southwest Jiaotong University, Chengdu 610031, China
| | - Hengquan Liu
- College of Materials and Chemistry & Chemical Engineering, Chengdu University of Technology, Chengdu 610059, China.
| | - Tao Liu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
| | - Junying Chen
- Key Laboratory of Advanced Technology of Materials, Ministry of Education, Southwest Jiaotong University, Chengdu 610031, China.
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19
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Roman AM, Cimpoeșu R, Pricop B, Cazacu MM, Zegan G, Istrate B, Cocean A, Chelariu R, Moscu M, Bădărău G, Cimpoeșu N, Ivănescu MC. Investigations on the Degradation Behavior of Processed FeMnSi-xCu Shape Memory Alloys. NANOMATERIALS (BASEL, SWITZERLAND) 2024; 14:330. [PMID: 38392703 PMCID: PMC10893035 DOI: 10.3390/nano14040330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
A new functional Fe-30Mn-5Si-xCu (x = 1.5 and 2 wt%) biomaterial was obtained from the levitation induction melting process and evaluated as a biodegradable material. The degradation characteristics were assessed in vitro using immersion tests in simulated body fluid (SBF) at 37 ± 1 °C, evaluating mass loss, pH variation that occurred in the solution, open circuit potential (OCP), linear and cyclic potentiometry (LP and CP), scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and nano-FTIR. To obtain plates as samples, the cast materials were thermo-mechanically processed by hot rolling. Dynamic mechanical analysis (DMA) was employed to evaluate the thermal properties of the smart material. Atomic force microscopy (AFM) was used to show the nanometric and microstructural changes during the hot rolling process and DMA solicitations. The type of corrosion identified was generalized corrosion, and over the first 3-5 days, an increase in mass was observed, caused by the compounds formed at the metal-solution interface. The formed compounds were identified mainly as oxides that passed into the immersion liquid. The degradation rate (DR) was obtained as a function of mass loss, sample surface area and immersion duration. The dynamic mechanical behavior and dimensions of the sample were evaluated after 14 days of immersion. The nanocompounds found on the surface after atmospheric corrosion and immersion in SBF were investigated with the Neaspec system using the nano-FTIR technique.
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Affiliation(s)
- Ana-Maria Roman
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Ramona Cimpoeșu
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Bogdan Pricop
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Marius Mihai Cazacu
- Physics Department, “Gheorghe Asachi” Technical University of Iasi, 59A Dimitrie Mangeron Blvd, 700050 Iasi, Romania;
| | - Georgeta Zegan
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (M.M.); (M.C.I.)
| | - Bogdan Istrate
- Faculty of Mechanical Engineering, “Gheorghe Asachi” Technical University of Iasi, 43 Dimitrie Mangeron Blvd, 700050 Iasi, Romania;
| | - Alexandru Cocean
- Atmosphere Optics, Spectroscopy and Laser Laboratory (LOASL), Faculty of Physics, Alexandru Ioan Cuza University, 11 Carol I Blvd, 700506 Iasi, Romania;
- Laboratory of Applied Meteorology and Climatology, A Building, Physics, Research Center with Integrated Techniques for Atmospheric Aerosol Investigation in Romania (RECENT AIR), Alexandru Ioan Cuza University of Iasi, 11 Carol I, 700506 Iasi, Romania
| | - Romeu Chelariu
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Mihaela Moscu
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (M.M.); (M.C.I.)
| | - Gheorghe Bădărău
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Nicanor Cimpoeșu
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Mircea Cătălin Ivănescu
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (M.M.); (M.C.I.)
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20
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Zhong C, Zhu H, Sheng Y, Wo J, You D, Sun G, Yu Z, Li W, Wang X. Biocompatibility and osteogenic potential of choline phosphate chitosan-coated biodegradable Zn1Mg. Acta Biomater 2024; 175:395-410. [PMID: 38096961 DOI: 10.1016/j.actbio.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/25/2023]
Abstract
Zinc alloys have demonstrated considerable potentials as implant materials for biodegradable vascular and orthopedic applications. However, the high initial release of Zn2+ can trigger intense immune responses that impede tissue healing. To address this challenge and enhance the osteogenic capacity of zinc alloys, the surface of Zn1Mg was subjected to CO2 plasma modification (Zn1Mg-PP) followed by grafting with choline phosphate chitosan (Zn1Mg-PP-PCCs). This study aims to investigate the in vitro and in vivo biocompatibility of the surface-modified Zn1Mg. The effect of the surface modification on the inflammatory response and osteogenic repair process was investigated. Compared with unmodified Zn1Mg, the degradation rate of Zn1Mg-PP-PCCs was significantly decreased, avoiding the cytotoxicity triggered by the release of large amounts of Zn2+. Moreover, PCCs significantly enhanced the cell-material adhesion, promoted the proliferation of osteoblasts (MC3T3-E1) and upregulated the expression of key osteogenic factors in vitro. Notably, the in vivo experiments revealed that the surface modification of Zn1Mg suppressed inhibited the expression of inflammatory cytokines, promoting the secretion of anti-inflammatory factors, thereby reducing inflammation and promoting bone tissue repair. Furthermore, histological analysis of tissue sections exhibited strong integration between the material and the bone, along with well-defined new bone formation and reduced osteoclast aggregation on the surface. This was attributed to the improved immune microenvironment by PCCs, which promoted osteogenic differentiation of osteoblasts. These findings highlight that the preparation of PCCs coatings on zinc alloy surfaces effectively inhibited ion release and modulated the immune environment to promote bone tissue repair. STATEMENT OF SIGNIFICANCE: Surface modification of biodegradable Zn alloys facilitates the suppression of intense immune responses caused by excessive ion release concentrations from implants. We modified the surface of Zn1Mg with choline phosphate chitosan (PCCs) and investigated the effects of surface modification on the inflammatory response and osteogenic repair process. In vitro results showed that the PCCs coating effectively reduced the degradation rate of Zn1Mg to avoid cytotoxicity caused by high Zn2+ concentration, favoring the proliferation of osteoblasts. In addition, in vivo results indicated that Zn1Mg-PP-PCCs attenuated inflammation to promote bone repair by modulating the release of inflammation-related factors. The surface-modified Zn1Mg implants demonstrated strong osseointegration, indicating that the PCCs coating effectively modulated the immune microenvironment and promoted bone healing.
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Affiliation(s)
- Chen Zhong
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China
| | - Haoran Zhu
- Guandgong Provincial Key Laboratory of Spine and Spinal Cord Reconstruction, The Fifth Affiliated Hospital (Heyuan Shenhe People's Hospital), Heyuan 517000, China
| | - Yinying Sheng
- Institute of Corrosion Science and Technology, Guangzhou 510530, China.
| | - Jin Wo
- Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Deqiang You
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China
| | - Guodong Sun
- Guandgong Provincial Key Laboratory of Spine and Spinal Cord Reconstruction, The Fifth Affiliated Hospital (Heyuan Shenhe People's Hospital), Heyuan 517000, China; Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China.
| | - Zhentao Yu
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China
| | - Wei Li
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China
| | - Xiaojian Wang
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China; Shaoguan Research Institute of Jinan University, 168 Muxi Avenue, Shaoguan 512029, China.
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21
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Roesner M, Zankovic S, Kovacs A, Benner M, Barkhoff R, Seidenstuecker M. Mechanical Properties and Corrosion Rate of ZnAg3 as a Novel Bioabsorbable Material for Osteosynthesis. J Funct Biomater 2024; 15:28. [PMID: 38391881 PMCID: PMC10890006 DOI: 10.3390/jfb15020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/12/2024] [Accepted: 01/20/2024] [Indexed: 02/24/2024] Open
Abstract
Osteosynthesis in fracture treatment typically uses hardware that remains in the patient's body, which brings a permanent risk of negative side effects such as foreign body reactions or chronic inflammation. Bioabsorbable materials, however, can degrade and slowly be replaced by autologous bone tissue. A suitable material is requested to offer great biocompatibility alongside excellent mechanical properties and a reasonable corrosion rate. Zinc-silver alloys provide these characteristics, which makes them a promising candidate for research. This study investigated the aptitude as a bioabsorbable implant of a novel zinc-silver alloy containing 3.3 wt% silver (ZnAg3). Here, the tensile strength as well as the corrosion rate in PBS solution (phosphate buffered solution) of ZnAg3 were assessed. Furthermore, shear tests, including fatigue and quasi-static testing, were conducted with ZnAg3 and magnesium pins (MAGNEZIX®, Syntellix AG, Hannover, Germany), which are already in clinical use. The detected corrosion rate of 0.10 mm/year for ZnAg3 was within the proposed range for bioabsorbable implants. With a tensile strength of 237.5 ± 2.12 MPa and a shear strength of 144.8 ± 13.2 N, ZnAg3 satisfied the mechanical requirements for bioabsorbable implants. The fatigue testing did not show any significant difference between ZnAg3 and magnesium pins, whereas both materials withstood the cyclic loading. Thus, the results support the assumption that ZnAg3 is qualified for further investigation.
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Affiliation(s)
- Maria Roesner
- G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Sergej Zankovic
- G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Adalbert Kovacs
- Limedion GmbH, Coatings and Surface Analysis, Am Schäferstock 2-4, 68163 Mannheim, Germany
| | - Moritz Benner
- Limedion GmbH, Coatings and Surface Analysis, Am Schäferstock 2-4, 68163 Mannheim, Germany
- Quadralux e.K., Am Schäferstock 2-4, 68163 Mannheim, Germany
| | - Roland Barkhoff
- Quadralux e.K., Am Schäferstock 2-4, 68163 Mannheim, Germany
| | - Michael Seidenstuecker
- G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
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22
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Sun Q, Zhang D, Tong X, Lin J, Li Y, Wen C. Mechanical properties, corrosion behavior, and cytotoxicity of biodegradable Zn/Mg multilayered composites prepared by accumulative roll bonding process. Acta Biomater 2024; 173:509-525. [PMID: 38006909 DOI: 10.1016/j.actbio.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/11/2023] [Accepted: 11/16/2023] [Indexed: 11/27/2023]
Abstract
Zinc (Zn), magnesium (Mg), and their respective alloys have attracted great attention as biodegradable bone-implant materials due to their excellent biocompatibility and biodegradability. However, the poor mechanical strength of Zn alloys and the rapid degradation rate of Mg alloys limit their clinical application. The manufacture of Zn and Mg bimetals may be a promising way to improve their mechanical and degradation properties. Here we report on Zn/Mg multilayered composites prepared via an accumulative roll bonding (ARB) process. With an increase in the number of ARB cycles, the thicknesses of the Zn layer and the Mg layer were reduced, while a large number of heterogeneous interfaces were introduced into the Zn/Mg multilayered composites. The composite samples after 14 ARB cycles showed the highest yield strength of 411±3 MPa and highest ultimate tensile strength of 501±3 MPa among all the ARB processed samples, significantly higher than those of the Zn/Zn and Mg/Mg multilayered samples. The Zn and Mg layers remained continuous in the Zn/Mg composite samples after annealing at 150 °C for 10 min, resulting in a decrease in yield strength from 411±3 MPa to 349±3 MPa but an increase in elongation from 8±1% to 28±1%. The degradation rate of the Zn/Mg multilayered composite samples in Hanks' solution was ranged from 127±18 µm/y to 6±1 µm/y. The Zn/Mg multilayered composites showed over 100% cell viability with their 25% and 12.5% extracts in relation to MG-63 cells after culturing for 3 d, indicating excellent cytocompatibility. STATEMENT OF SIGNIFICANCE: This work reports a biodegradable Zn/Mg multilayered composite prepared by accumulative roll bonding (ARB) process. The yield and ultimate tensile strength of the Zn/Mg multilayered composites were improved due to grain refinement and the introduction of a large number of heterogeneous interfaces. The composite samples after 14 ARB cycles showed the highest yield strength of 411±3 MPa and highest ultimate tensile strength of 501±3 MPa among all the ARB processed samples. The degradation rate of the Zn/Mg multilayered composite meets the required degradation rate for biodegradable bone-implant materials. The results demonstrated that it is a very promising approach to improve the strength and biocompatibility of biodegradable Zn-based alloys.
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Affiliation(s)
- Quanxiang Sun
- School of Materials Science and Engineering, Xiangtan University, Xiangtan 411105, China
| | - Dechuang Zhang
- School of Materials Science and Engineering, Xiangtan University, Xiangtan 411105, China.
| | - Xian Tong
- Key Laboratory of Low Dimensional Materials & Application Technology, Xiangtan University, Ministry of Education, Hunan 411105, China
| | - Jianguo Lin
- Key Laboratory of Low Dimensional Materials & Application Technology, Xiangtan University, Ministry of Education, Hunan 411105, China.
| | - Yuncang Li
- School of Engineering, RMIT University, Melbourne, Victoria 3001, Australia
| | - Cuie Wen
- School of Engineering, RMIT University, Melbourne, Victoria 3001, Australia.
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23
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Yang Y, Yang Y, Hou Z, Wang T, Wu P, Shen L, Li P, Zhang K, Yang L, Sun S. Comprehensive review of materials, applications, and future innovations in biodegradable esophageal stents. Front Bioeng Biotechnol 2023; 11:1327517. [PMID: 38125305 PMCID: PMC10731276 DOI: 10.3389/fbioe.2023.1327517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Esophageal stricture (ES) results from benign and malignant conditions, such as uncontrolled gastroesophageal reflux disease (GERD) and esophageal neoplasms. Upper gastrointestinal endoscopy is the preferred diagnostic approach for ES and its underlying causes. Stent insertion using an endoscope is a prevalent method for alleviating or treating ES. Nevertheless, the widely used self-expandable metal stents (SEMS) and self-expandable plastic stents (SEPS) can result in complications such as migration and restenosis. Furthermore, they necessitate secondary extraction in cases of benign esophageal stricture (BES), rendering them unsatisfactory for clinical requirements. Over the past 3 decades, significant attention has been devoted to biodegradable materials, including synthetic polyester polymers and magnesium-based alloys, owing to their exceptional biocompatibility and biodegradability while addressing the challenges associated with recurring procedures after BES resolves. Novel esophageal stents have been developed and are undergoing experimental and clinical trials. Drug-eluting stents (DES) with drug-loading and drug-releasing capabilities are currently a research focal point, offering more efficient and precise ES treatments. Functional innovations have been investigated to optimize stent performance, including unidirectional drug-release and anti-migration features. Emerging manufacturing technologies such as three-dimensional (3D) printing and new biodegradable materials such as hydrogels have also contributed to the innovation of esophageal stents. The ultimate objective of the research and development of these materials is their clinical application in the treatment of ES and other benign conditions and the palliative treatment of malignant esophageal stricture (MES). This review aimed to offer a comprehensive overview of current biodegradable esophageal stent materials and their applications, highlight current research limitations and innovations, and offer insights into future development priorities and directions.
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Affiliation(s)
- Yaochen Yang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
- Research Center for Biomedical Materials, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuanyuan Yang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhipeng Hou
- Research Center for Biomedical Materials, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tingting Wang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
| | - Peng Wu
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lufan Shen
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
| | - Peng Li
- Liaoning Research Institute for Eugenic Birth and Fertility, China Medical University, Shenyang, China
| | - Kai Zhang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liqun Yang
- Research Center for Biomedical Materials, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Research Institute for Eugenic Birth and Fertility, China Medical University, Shenyang, China
| | - Siyu Sun
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
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24
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Wu M, Xun M, Chen Y. Adaptation of Vascular Smooth Muscle Cell to Degradable Metal Stent Implantation. ACS Biomater Sci Eng 2023. [PMID: 37364226 DOI: 10.1021/acsbiomaterials.3c00637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Iron-, magnesium-, or zinc-based metal vessel stents support vessel expansion at the period early after implantation and degrade away after vascular reconstruction, eliminating the side effects due to the long stay of stent implants in the body and the risks of restenosis and neoatherosclerosis. However, emerging evidence has indicated that their degradation alters the vascular microenvironment and induces adaptive responses of surrounding vessel cells, especially vascular smooth muscle cells (VSMCs). VSMCs are highly flexible cells that actively alter their phenotype in response to the stenting, similarly to what they do during all stages of atherosclerosis pathology, which significantly influences stent performance. This Review discusses how biodegradable metal stents modify vascular conditions and how VSMCs respond to various chemical, biological, and physical signals attributable to stent implantation. The focus is placed on the phenotypic adaptation of VSMCs and the clinical complications, which highlight the importance of VSMC transformation in future stent design.
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Affiliation(s)
- Meichun Wu
- Hengyang Medical School, University of South China, Hengyang, Hunan 410001, China
- School of Nursing, University of South China, Hengyang, Hunan 410001, China
| | - Min Xun
- Institute of Pharmacy and Pharmacology, School of Pharmaceutical Science, University of South China, Hengyang, Hunan 410001, China
| | - Yuping Chen
- Hengyang Medical School, University of South China, Hengyang, Hunan 410001, China
- Institute of Pharmacy and Pharmacology, School of Pharmaceutical Science, University of South China, Hengyang, Hunan 410001, China
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25
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Li Y, Shi Y, Lu Y, Li X, Zhou J, Zadpoor AA, Wang L. Additive manufacturing of vascular stents. Acta Biomater 2023:S1742-7061(23)00338-0. [PMID: 37331614 DOI: 10.1016/j.actbio.2023.06.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
With the advancement of additive manufacturing (AM), customized vascular stents can now be fabricated to fit the curvatures and sizes of a narrowed or blocked blood vessel, thereby reducing the possibility of thrombosis and restenosis. More importantly, AM enables the design and fabrication of complex and functional stent unit cells that would otherwise be impossible to realize with conventional manufacturing techniques. Additionally, AM makes fast design iterations possible while also shortening the development time of vascular stents. This has led to the emergence of a new treatment paradigm in which custom and on-demand-fabricated stents will be used for just-in-time treatments. This review is focused on the recent advances in AM vascular stents aimed at meeting the mechanical and biological requirements. First, the biomaterials suitable for AM vascular stents are listed and briefly described. Second, we review the AM technologies that have been so far used to fabricate vascular stents as well as the performances they have achieved. Subsequently, the design criteria for the clinical application of AM vascular stents are discussed considering the currently encountered limitations in materials and AM techniques. Finally, the remaining challenges are highlighted and some future research directions are proposed to realize clinically-viable AM vascular stents. STATEMENT OF SIGNIFICANCE: Vascular stents have been widely used for the treatment of vascular disease. The recent progress in additive manufacturing (AM) has provided unprecedented opportunities for revolutionizing traditional vascular stents. In this manuscript, we review the applications of AM to the design and fabrication of vascular stents. This is an interdisciplinary subject area that has not been previously covered in the published review articles. Our objective is to not only present the state-of-the-art of AM biomaterials and technologies but to also critically assess the limitations and challenges that need to be overcome to speed up the clinical adoption of AM vascular stents with both anatomical superiority and mechanical and biological functionalities that exceed those of the currently available mass-produced devices.
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Affiliation(s)
- Yageng Li
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Yixuan Shi
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Yuchen Lu
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Xuan Li
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Jie Zhou
- Department of Biomechanical Engineering, Delft University of Technology, Delft 2628 CD, The Netherlands.
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Delft University of Technology, Delft 2628 CD, The Netherlands.
| | - Luning Wang
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China.
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26
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Pan X, Ou M, Lu Y, Nie Q, Dai X, Liu O. Immunomodulatory zinc-based materials for tissue regeneration. BIOMATERIALS ADVANCES 2023; 152:213503. [PMID: 37331243 DOI: 10.1016/j.bioadv.2023.213503] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/20/2023]
Abstract
Zinc(Zn)-based materials have contributed greatly to the rapid advancements in tissue engineering. The qualities they possess that make them so beneficial include their excellent biodegradability, biocompatibility, anti-bacterial activity, among and several others. Biomedical materials that act as a foreign body, will inevitably cause host immune response when introduced to the human body. As the osteoimmunology develops, the immunomodulatory characteristics of biomaterials have become an appealing concept to improve implant-tissue interaction and tissue restoration. Recently, Zn-based materials have also displayed immunomodulatory functions, especially macrophage polarization states. It can promote the transformation of M1 macrophages into M2 macrophages to enhance the tissue regeneration and reconstruction. This review covers mainly Zn-based materials and their characteristics, including metallic Zn alloys and Zn ceramics. We highlight the current advancements in the type of immune responses, as well as the mechanisms, that are induced by Zn-based biomaterials, most importantly the regulation of innate immunity and the mechanism of promoting tissue regeneration. To this end, we discuss their applications in biomedicine, and conclude with an outlook on future research challenges.
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Affiliation(s)
- Xiaoman Pan
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha 410005, China
| | - Mingning Ou
- Xiangya Hospital & Xiangya School of Medicine, Central South University, Changsha 410005, China
| | - Yixuan Lu
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha 410005, China
| | - Qian Nie
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha 410005, China
| | - Xiaohan Dai
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha 410005, China.
| | - Ousheng Liu
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha 410005, China.
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27
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Gąsior G, Grodzicka M, Jędrzejewski T, Wiśniewski M, Radtke A. Comparative Study of Porous Iron Foams for Biodegradable Implants: Structural Analysis and In Vitro Assessment. J Funct Biomater 2023; 14:293. [PMID: 37367257 DOI: 10.3390/jfb14060293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 06/28/2023] Open
Abstract
Biodegradable metal systems are the future of modern implantology. This publication describes the preparation of porous iron-based materials using a simple, affordable replica method on a polymeric template. We obtained two iron-based materials with different pore sizes for potential application in cardiac surgery implants. The materials were compared in terms of their corrosion rate (using immersion and electrochemical methods) and their cytotoxic activity (indirect test on three cell lines: mouse L929 fibroblasts, human aortic smooth muscle cells (HAMSC), and human umbilical vein endothelial cells (HUVEC)). Our research proved that the material being too porous might have a toxic effect on cell lines due to rapid corrosion.
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Affiliation(s)
- Gabriela Gąsior
- Faculty of Chemistry, Nicolaus Copernicus University in Toruń, Gagarina Street 7, 87-100 Toruń, Poland
| | - Marlena Grodzicka
- Faculty of Chemistry, Nicolaus Copernicus University in Toruń, Gagarina Street 7, 87-100 Toruń, Poland
| | - Tomasz Jędrzejewski
- Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Toruń, Lwowska Street 1, 87-100 Toruń, Poland
| | - Marek Wiśniewski
- Faculty of Chemistry, Nicolaus Copernicus University in Toruń, Gagarina Street 7, 87-100 Toruń, Poland
| | - Aleksandra Radtke
- Faculty of Chemistry, Nicolaus Copernicus University in Toruń, Gagarina Street 7, 87-100 Toruń, Poland
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28
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Panaghie C, Zegan G, Sodor A, Cimpoeșu N, Lohan NM, Istrate B, Roman AM, Ioanid N. Analysis of Degradation Products of Biodegradable ZnMgY Alloy. MATERIALS (BASEL, SWITZERLAND) 2023; 16:3092. [PMID: 37109928 PMCID: PMC10146815 DOI: 10.3390/ma16083092] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
Biodegradable metallic materials are increasingly gaining ground in medical applications. Zn-based alloys show a degradation rate between those recorded for Mg-based materials with the fastest degradation rate and Fe-based materials with the slowest degradation rate. From the perspective of medical complications, it is essential to understand the size and nature of the degradation products developed from biodegradable materials, as well as the stage at which these residues are eliminated from the body. This paper presents investigations conducted on the corrosion/degradation products of an experimental material (ZnMgY alloy in cast and homogenized state) after immersion tests in three physiological solutions (Dulbecco's, Ringer's and simulated body fluid (SBF)). Scanning electron microscopy (SEM) was used to highlight the macroscopic and microscopic aspects of corrosion products and their effects on the surface. An X-ray energy dispersive detector (EDS), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) provided general information about the compounds based on their non-metallic character. The pH of the electrolyte solution was recorded for 72 h during immersion. The pH variation of the solution confirmed the main reactions proposed for the corrosion of ZnMg. The agglomerations of corrosion products were on the micrometer scale, mainly oxides, hydroxides and carbonates or phosphates. The corrosion effects on the surface were homogeneously spread, with a tendency to connect and form cracks or larger corrosion zones, transforming the pitting corrosion pattern into a generalized one. It was noticed that the alloy's microstructure strongly influences the corrosion characteristics.
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Affiliation(s)
- Cătălin Panaghie
- Faculty of Materials Science and Engineering, “Gh. Asachi” Technical University from Iasi, 700050 Iasi, Romania
| | - Georgeta Zegan
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alina Sodor
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Nicanor Cimpoeșu
- Faculty of Materials Science and Engineering, “Gh. Asachi” Technical University from Iasi, 700050 Iasi, Romania
| | - Nicoleta-Monica Lohan
- Faculty of Materials Science and Engineering, “Gh. Asachi” Technical University from Iasi, 700050 Iasi, Romania
| | - Bogdan Istrate
- Faculty of Mechanics, “Gh. Asachi” Technical University from Iasi, 700050 Iasi, Romania
| | - Ana-Maria Roman
- Faculty of Materials Science and Engineering, “Gh. Asachi” Technical University from Iasi, 700050 Iasi, Romania
| | - Nicoleta Ioanid
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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Liu Q, Li A, Liu S, Fu Q, Xu Y, Dai J, Li P, Xu S. Cytotoxicity of Biodegradable Zinc and Its Alloys: A Systematic Review. J Funct Biomater 2023; 14:206. [PMID: 37103296 PMCID: PMC10144193 DOI: 10.3390/jfb14040206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/18/2023] [Accepted: 03/27/2023] [Indexed: 04/28/2023] Open
Abstract
Zinc-based biodegradable metals (BMs) have been developed for biomedical implant materials. However, the cytotoxicity of Zn and its alloys has caused controversy. This work aims to investigate whether Zn and its alloys possess cytotoxic effects and the corresponding influence factors. According to the guidelines of the PRISMA statement, an electronic combined hand search was conducted to retrieve articles published in PubMed, Web of Science, and Scopus (2013.1-2023.2) following the PICOS strategy. Eighty-six eligible articles were included. The quality of the included toxicity studies was assessed utilizing the ToxRTool. Among the included articles, extract tests were performed in 83 studies, and direct contact tests were conducted in 18 studies. According to the results of this review, the cytotoxicity of Zn-based BMs is mainly determined by three factors, namely, Zn-based materials, tested cells, and test system. Notably, Zn and its alloys did not exhibit cytotoxic effects under certain test conditions, but significant heterogeneity existed in the implementation of the cytotoxicity evaluation. Furthermore, there is currently a relatively lower quality of current cytotoxicity evaluation in Zn-based BMs owing to the adoption of nonuniform standards. Establishing a standardized in vitro toxicity assessment system for Zn-based BMs is required for future investigations.
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Affiliation(s)
- Qian Liu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - An Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Shizhen Liu
- The School of Computing Science, University of Glasgow, Glasgow G12 8RZ, UK
| | - Qingyun Fu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Yichen Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jingtao Dai
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
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30
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Adhami M, Martin NK, Maguire C, Courtenay AJ, Donnelly RF, Domínguez-Robles J, Larrañeta E. Drug loaded implantable devices to treat cardiovascular disease. Expert Opin Drug Deliv 2023; 20:507-522. [PMID: 36924328 DOI: 10.1080/17425247.2023.2190580] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
INTRODUCTION It is widely acknowledged that cardiovascular diseases (CVDs) continue to be the leading cause of death globally. Furthermore, CVDs are the leading cause of diminished quality of life for patients, frequently as a result of their progressive deterioration. Medical implants that release drugs into the body are active implants that do more than just provide mechanical support; they also have a therapeutic role. Primarily, this is achieved through the controlled release of active pharmaceutical ingredients (API) at the implementation site. AREAS COVERED In this review, the authors discuss drug-eluting stents, drug-eluting vascular grafts, and drug-eluting cardiac patches with the aim of providing a broad overview of the three most common types of cardiac implant. EXPERT OPINION Drug eluting implants are an ideal alternative to traditional drug delivery because they allow for accurate drug release, local drug delivery to the target tissue, and minimise the adverse side effects associated with systemic administration. Despite the fact that there are still challenges that need to be addressed, the ever-evolving new technologies are making the fabrication of drug eluting implants a rewarding therapeutic endeavour with the possibility for even greater advances.
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Affiliation(s)
| | | | | | - Aaron J Courtenay
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, UK
| | | | - Juan Domínguez-Robles
- School of Pharmacy, Queen's University Belfast, UK.,Department of Pharmacy and Pharmaceutical Technology, University of Seville, Seville, Spain
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31
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Barungi S, Hernández-Camarero P, Moreno-Terribas G, Villalba-Montoro R, Marchal JA, López-Ruiz E, Perán M. Clinical implications of inflammation in atheroma formation and novel therapies in cardiovascular diseases. Front Cell Dev Biol 2023; 11:1148768. [PMID: 37009489 PMCID: PMC10061140 DOI: 10.3389/fcell.2023.1148768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading causes of death and disability in the world. Among all CVD, the most common is coronary artery disease (CAD). CAD results from the complications promoted by atherosclerosis, which is characterized by the accumulation of atherosclerotic plaques that limit and block the blood flow of the arteries involved in heart oxygenation. Atherosclerotic disease is usually treated by stents implantation and angioplasty, but these surgical interventions also favour thrombosis and restenosis which often lead to device failure. Hence, efficient and long-lasting therapeutic options that are easily accessible to patients are in high demand. Advanced technologies including nanotechnology or vascular tissue engineering may provide promising solutions for CVD. Moreover, advances in the understanding of the biological processes underlying atherosclerosis can lead to a significant improvement in the management of CVD and even to the development of novel efficient drugs. To note, over the last years, the observation that inflammation leads to atherosclerosis has gained interest providing a link between atheroma formation and oncogenesis. Here, we have focused on the description of the available therapy for atherosclerosis, including surgical treatment and experimental treatment, the mechanisms of atheroma formation, and possible novel therapeutic candidates such as the use of anti-inflammatory treatments to reduce CVD.
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Affiliation(s)
- Shivan Barungi
- Department of Health Sciences, University of Jaén, Jaén, Spain
| | | | | | | | - Juan Antonio Marchal
- Centre for Biomedical Research (CIBM), Biopathology and Regenerative Medicine Institute (IBIMER), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain
- Excellence Research Unit “Modeling Nature” (MNat), University of Granada, Granada, Spain
| | - Elena López-Ruiz
- Department of Health Sciences, University of Jaén, Jaén, Spain
- Excellence Research Unit “Modeling Nature” (MNat), University of Granada, Granada, Spain
- *Correspondence: Elena López-Ruiz, ; Macarena Perán,
| | - Macarena Perán
- Department of Health Sciences, University of Jaén, Jaén, Spain
- Centre for Biomedical Research (CIBM), Biopathology and Regenerative Medicine Institute (IBIMER), University of Granada, Granada, Spain
- Excellence Research Unit “Modeling Nature” (MNat), University of Granada, Granada, Spain
- *Correspondence: Elena López-Ruiz, ; Macarena Perán,
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32
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Three-Dimensional Printing of Poly-L-Lactic Acid Composite Scaffolds with Enhanced Bioactivity and Controllable Zn Ion Release Capability by Coupling with Carbon-ZnO. Bioengineering (Basel) 2023; 10:bioengineering10030307. [PMID: 36978698 PMCID: PMC10045836 DOI: 10.3390/bioengineering10030307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/04/2023] Open
Abstract
Poly-L-lactic acid (PLLA) has gained great popularity with researchers in regenerative medicine owing to its superior biocompatibility and biodegradability, although its inadequate bioactivity inhibits the further use of PLLA in the field of bone regeneration. Zinc oxide (ZnO) has been utilized to improve the biological performance of biopolymers because of its renowned osteogenic activity. However, ZnO nanoparticles tend to agglomerate in the polymer matrix due to high surface energy, which would lead to the burst release of the Zn ion and, thus, cytotoxicity. In this study, to address this problem, carbon–ZnO (C–ZnO) was first synthesized through the carbonization of ZIF-8. Then, C–ZnO was introduced to PLLA powder before it was manufactured as scaffolds (PLLA/C–ZnO) by a selective laser sintering 3D printing technique. The results showed that the PLLA/C–ZnO scaffold was able to continuously release Zn ions in a reasonable range, which can be attributed to the interaction of Zn–N bonding and the shielding action of the PLLA scaffold. The controlled release of Zn ions from the scaffold further facilitated cell adhesion and proliferation and improved the osteogenic differentiation ability at the same time. In addition, C–ZnO endowed the scaffold with favorable photodynamic antibacterial ability, which was manifested by an efficient antibacterial rate of over 95%.
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Hua J, Yang H, Wang B, Dai Y, Li X, Yan K, You R, Ma L. Silk fibroin/chitosan coating with tunable catalytic nitric oxide generation for surface functionalization of cardiovascular stents. Int J Biol Macromol 2023; 228:261-272. [PMID: 36581022 DOI: 10.1016/j.ijbiomac.2022.12.239] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/14/2022] [Accepted: 12/20/2022] [Indexed: 12/27/2022]
Abstract
Developing a functional coating for vascular stents with sustainable and tunable NO release remains challenging. In this work, we report a silk fibroin/chitosan-based biopolymer coating incorporating copper ions as a catalyst for NO generation and demonstrate its potential for the surface functionalization of cardiovascular stents. Based on the differences in silk fibroin and chitosan coordinating with copper ions, the loading, bonding, and release of copper ions could be precisely regulated over a wide range by controlling the ratio of silk fibroin and chitosan. This system shows good cytocompatibility for endothelial cells and tunable catalytic activity to decompose S-nitroso-N-acetyl-D-penicillamine (SNAP) for NO generation. Consequently, a functionalized coating with sustainable and tunable NO catalysis generation was developed on the metallic stent. Based on good biocompatibility, tunable NO release, and simple processing, the coating is expected to have great promise in the field of intervention therapy of cardiovascular disease.
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Affiliation(s)
- Jinsheng Hua
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230036, China
| | - Hui Yang
- State Key Laboratory for Hubei New Textile Materials and Advanced Processing Technologies, School of Textile Science and Engineering, Wuhan Textile University, Wuhan 430200, China
| | - Beilei Wang
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230036, China
| | - Yunfeng Dai
- State Key Laboratory for Hubei New Textile Materials and Advanced Processing Technologies, School of Textile Science and Engineering, Wuhan Textile University, Wuhan 430200, China
| | - Xiufang Li
- State Key Laboratory for Hubei New Textile Materials and Advanced Processing Technologies, School of Textile Science and Engineering, Wuhan Textile University, Wuhan 430200, China
| | - Kun Yan
- State Key Laboratory for Hubei New Textile Materials and Advanced Processing Technologies, School of Textile Science and Engineering, Wuhan Textile University, Wuhan 430200, China
| | - Renchuan You
- State Key Laboratory for Hubei New Textile Materials and Advanced Processing Technologies, School of Textile Science and Engineering, Wuhan Textile University, Wuhan 430200, China.
| | - Likun Ma
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230036, China.
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Summers HD, Ardakani MS, Drelich JW. The Effects of Thermal Treatment on the Properties and Performance of Hot Extruded Zn-Based Bioresorbable Alloy for Vascular Stenting Applications. TMS 2023 152ND ANNUAL MEETING & EXHIBITION : SUPPLEMENTAL PROCEEDINGS. MINERALS, METALS AND MATERIALS SOCIETY. ANNUAL MEETING 2023; 2023:278-287. [PMID: 39036610 PMCID: PMC11258630 DOI: 10.1007/978-3-031-22524-6_26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
A new series of zinc alloys is in development for bioresorbable stent implantation to alleviate the current materials' long-term complications. Characterization and optimization of the microstructure and corresponding mechanical properties during manufacturing stages will help researchers meet the required values. In this study, the effect of hot extrusion on the Zn-Ag-Mn-Cu-Zr-Ti alloy is characterized. Additionally, thermal treatments at 390 °C for 15, 25, 40, 60, and 120 min were performed to evaluate the effect of intermetallic phase fractions on the corrosion resistance and mechanical strength. Quantitative analysis of X-ray diffraction data demonstrates that the fractions of the MnZn13, ZrZn22, and Zn0.75Ag0.15Mn0.10 intermetallic phases decrease as the thermal treatment time increases. Corrosion tests reveal a reduction in the corrosion rate of the extruded alloy after thermal treatment. The results of uniaxial compression tests and tensile tests show lower strength and higher ductility in all heat-treated conditions compared with the as-extruded condition.
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Affiliation(s)
- Henry D Summers
- Department of Materials Science and Engineering, Michigan Technological University, Houghton, MI 49931, USA
| | - Morteza S Ardakani
- Department of Materials Science and Engineering, Michigan Technological University, Houghton, MI 49931, USA
| | - Jaroslaw W Drelich
- Department of Materials Science and Engineering, Michigan Technological University, Houghton, MI 49931, USA
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35
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Su Y, Fu J, Zhou J, Georgas E, Du S, Qin YX, Wang Y, Zheng Y, Zhu D. Blending with transition metals improves bioresorbable zinc as better medical implants. Bioact Mater 2023; 20:243-258. [PMID: 35702610 PMCID: PMC9166432 DOI: 10.1016/j.bioactmat.2022.05.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 12/04/2022] Open
Abstract
Zinc (Zn) is a new class of bioresorbable metal that has potential for cardiovascular stent material, orthopedic implants, wound closure devices, etc. However, pure Zn is not ideal for these applications due to its low mechanical strength and localized degradation behavior. Alloying is the most common/effective way to overcome this limitation. Still, the choice of alloying element is crucial to ensure the resulting alloy possesses sufficient mechanical strength, suitable degradation rate, and acceptable biocompatibility. Hereby, we proposed to blend selective transition metals (i.e., vanadium-V, chromium-Cr, and zirconium-Zr) to improve Zn's properties. These selected transition metals have similar properties to Zn and thus are beneficial for the metallurgy process and mechanical property. Furthermore, the biosafety of these elements is of less concern as they all have been used as regulatory approved medical implants or a component of an implant such as Ti6Al4V, CoCr, or Zr-based dental implants. Our study showed the first evidence that blending with transition metals V, Cr, or Zr can improve Zn's properties as bioresorbable medical implants. In addition, three in vivo implantation models were explored in rats: subcutaneous, aorta, and femoral implantations, to target the potential clinical applications of bioresorbable Zn implants. Tensile strength and elongation of Zn alloys can reach over 220 MPa and 30%, respectively. Three in vivo implantation models to investigate and compare biodegradations behavior at different locations of the body. Zn–Zr and Zn–V alloys can induce pro-regenerative inflammation responses in aortas. All Zn alloys can promote osteointegration in femur.
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36
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Ahadi F, Azadi M, Biglari M, Bodaghi M, Khaleghian A. Evaluation of coronary stents: A review of types, materials, processing techniques, design, and problems. Heliyon 2023; 9:e13575. [PMID: 36846695 PMCID: PMC9950843 DOI: 10.1016/j.heliyon.2023.e13575] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 01/22/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
In the world, one of the leading causes of death is coronary artery disease (CAD). There are several ways to treat this disease, and stenting is currently the most appropriate way in many cases. Nowadays, the use of stents has rapidly increased, and they have been introduced in various models, with different geometries and materials. To select the most appropriate stent required, it is necessary to have an analysis of the mechanical behavior of various types of stents. The purpose of this article is to provide a complete overview of advanced research in the field of stents and to discuss and conclude important studies on different topics in the field of stents. In this review, we introduce the types of coronary stents, materials, stent processing technique, stent design, classification of stents based on the mechanism of expansion, and problems and complications of stents. In this article, by reviewing the biomechanical studies conducted in this field and collecting and classifying their results, a useful set of information has been presented to continue research in the direction of designing and manufacturing more efficient stents, although the clinical-engineering field still needs to continue research to optimize the design and construction. The optimum design of stents in the future is possible by simulation and using numerical methods and adequate knowledge of stent and artery biomechanics.
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Affiliation(s)
- Fatemeh Ahadi
- Faculty of Mechanical Engineering, Semnan University, Semnan, Iran
| | - Mohammad Azadi
- Faculty of Mechanical Engineering, Semnan University, Semnan, Iran
| | - Mojtaba Biglari
- Faculty of Mechanical Engineering, Semnan University, Semnan, Iran
| | - Mahdi Bodaghi
- Department of Engineering, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Ali Khaleghian
- Department of Biochemistry, Semnan University of Medical Sciences, Semnan, Iran
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37
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Wang M, Yang L, Zhu X, Yang L, Song Z. Influence of Enzymes on the In Vitro Degradation Behavior of Pure Zn in Simulated Gastric and Intestinal Fluids. ACS OMEGA 2023; 8:1331-1342. [PMID: 36643457 PMCID: PMC9835524 DOI: 10.1021/acsomega.2c06752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/19/2022] [Indexed: 05/26/2023]
Abstract
Zinc (Zn) alloys are being developed as the degradable biomaterial. However, the corrosion mechanism of Zn in the gastrointestinal environment is seldom investigated and needs to be addressed. In this study, the impacts of enzymes on the degradation of pure Zn via electrochemical measurements and immersion were investigated. Pepsin and pancreatin affected the degradation of pure Zn. In contrast with the solutions without enzymes, the degradation rates declined with the addition of enzymes in solutions. However, localized corrosion was observed because the adsorption of pepsin was not a perfect barrier to prevent corrosion. The adsorbed pancreatin protected the samples from corrosion mainly at the initial stage of immersion. With immersion in the simulated intestinal fluid, adsorption and desorption of pancreatin occurred simultaneously on the sample surface. These findings allow the development of Zn alloy-implanted devices for the digestive tract as well as the understanding of the Zn corrosion mechanism in the gastrointestinal environment.
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Affiliation(s)
- Manli Wang
- Key
Laboratory of Marine Materials and Related Technologies, Zhejiang
Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology and Engineering,
Chinese Academy of Sciences, Ningbo315201, China
- University
of Chinese Academy of Sciences, Beijing100049, China
| | - Lingbo Yang
- Key
Laboratory of Marine Materials and Related Technologies, Zhejiang
Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology and Engineering,
Chinese Academy of Sciences, Ningbo315201, China
| | - Xinglong Zhu
- Key
Laboratory of Marine Materials and Related Technologies, Zhejiang
Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology and Engineering,
Chinese Academy of Sciences, Ningbo315201, China
| | - Lijing Yang
- Key
Laboratory of Marine Materials and Related Technologies, Zhejiang
Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology and Engineering,
Chinese Academy of Sciences, Ningbo315201, China
| | - Zhenlun Song
- Key
Laboratory of Marine Materials and Related Technologies, Zhejiang
Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology and Engineering,
Chinese Academy of Sciences, Ningbo315201, China
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38
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Santos Beato P, Poologasundarampillai G, Nommeots-Nomm A, Kalaskar DM. Materials for 3D printing in medicine: metals, polymers, ceramics, and hydrogels. 3D Print Med 2023. [DOI: 10.1016/b978-0-323-89831-7.00002-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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39
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Baek SW, Kim DS, Song DH, Kim HB, Lee S, Kim JH, Lee JK, Hong YJ, Park CG, Han DK. Reduced restenosis and enhanced re-endothelialization of functional biodegradable vascular scaffolds by everolimus and magnesium hydroxide. Biomater Res 2022; 26:86. [PMID: 36544178 PMCID: PMC9768885 DOI: 10.1186/s40824-022-00334-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Coronary artery disease is a cardiovascular disease with a high mortality and mortality rate in modern society. Vascular stent insertion to restore blood flow is essential to treat this disease. A fully biodegradable vascular scaffold (BVS) is a vascular poly (L-lactic acid) (PLLA) stent that is receiving growing interest as this is biodegradable in the body and does not require secondary removal surgery. However, acidic byproducts composed of PLLA produced during the biodegradation of the BVS can induce an inflammatory response. Magnesium hydroxide, a basic inorganic particle, neutralizes the acidic byproducts of PLLA. METHODS: In this study, we investigated using a BVS coated with everolimus and surface-modified magnesium hydroxide that suppresses smooth muscle cell proliferation and protects endothelial cells, respectively. The various characteristics of the functional stent were evaluated using in vitro and in vivo analyses. RESULTS: The BVS was successfully prepared with evenly coated everolimus and surface-modified magnesium hydroxide. A neutral pH value was maintained by magnesium hydroxide during degradation, and everolimus was released for one month. The coated BVS effectively inhibited protein adsorption and platelet adhesion, demonstrating excellent blood compatibility. In vitro analysis showed that BVS protects endothelial cells with magnesium hydroxide and selectively inhibits smooth muscle cell proliferation via everolimus treatment. The functional BVS was inserted into porcine coronary arteries for 28 days, and the results demonstrated that the restenosis and inflammation greatly decreased and re-endothelialization was enhanced as compared to others. CONCLUSIONS This study provides new insights into the design of drug-incorporated BVS stent for coronary artery disease.
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Affiliation(s)
- Seung-Woon Baek
- grid.410886.30000 0004 0647 3511Department of Biomedical Science, CHA University, 335 Pangyo-Ro, Bundang-Gu, Seongnam-Si, Gyeonggi 13488 Korea ,grid.264381.a0000 0001 2181 989XDepartment of Biomedical Engineering, SKKU Institute for Convergence, Sungkyunkwan University (SKKU), 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi 16419 Korea ,grid.264381.a0000 0001 2181 989XDepartment of Intelligent Precision Healthcare Convergence, SKKU Institute for Convergence, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi 16419 Korea
| | - Da-Seul Kim
- grid.410886.30000 0004 0647 3511Department of Biomedical Science, CHA University, 335 Pangyo-Ro, Bundang-Gu, Seongnam-Si, Gyeonggi 13488 Korea ,grid.254224.70000 0001 0789 9563School of Integrative Engineering, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974 Korea
| | - Duck Hyun Song
- grid.410886.30000 0004 0647 3511Department of Biomedical Science, CHA University, 335 Pangyo-Ro, Bundang-Gu, Seongnam-Si, Gyeonggi 13488 Korea
| | - Han Byul Kim
- grid.412484.f0000 0001 0302 820XThe Cardiovascular Convergence Research Center of Chonnam, National University Hospital Designated By Korea Ministry of Health and Welfare, 42 Jebong-ro, Dong-gu, Gwangju, 61469 Korea
| | - Semi Lee
- grid.410886.30000 0004 0647 3511Department of Biomedical Science, CHA University, 335 Pangyo-Ro, Bundang-Gu, Seongnam-Si, Gyeonggi 13488 Korea
| | - Jun Hyuk Kim
- grid.410886.30000 0004 0647 3511Department of Biomedical Science, CHA University, 335 Pangyo-Ro, Bundang-Gu, Seongnam-Si, Gyeonggi 13488 Korea
| | - Jun-Kyu Lee
- grid.410886.30000 0004 0647 3511Department of Biomedical Science, CHA University, 335 Pangyo-Ro, Bundang-Gu, Seongnam-Si, Gyeonggi 13488 Korea
| | - Young Joon Hong
- grid.412484.f0000 0001 0302 820XDivision of Cardiology of Chonnam, Cardiovascular Convergence Research Center Nominated By Korea Ministry of Health and Welfare, National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469 Korea
| | - Chun Gwon Park
- grid.264381.a0000 0001 2181 989XDepartment of Biomedical Engineering, SKKU Institute for Convergence, Sungkyunkwan University (SKKU), 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi 16419 Korea ,grid.264381.a0000 0001 2181 989XDepartment of Intelligent Precision Healthcare Convergence, SKKU Institute for Convergence, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi 16419 Korea
| | - Dong Keun Han
- grid.410886.30000 0004 0647 3511Department of Biomedical Science, CHA University, 335 Pangyo-Ro, Bundang-Gu, Seongnam-Si, Gyeonggi 13488 Korea
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40
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Khodaei T, Schmitzer E, Suresh AP, Acharya AP. Immune response differences in degradable and non-degradable alloy implants. Bioact Mater 2022; 24:153-170. [PMID: 36606252 PMCID: PMC9793227 DOI: 10.1016/j.bioactmat.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Alloy based implants have made a great impact in the clinic and in preclinical research. Immune responses are one of the major causes of failure of these implants in the clinic. Although the immune responses toward non-degradable alloy implants are well documented, there is a poor understanding of the immune responses against degradable alloy implants. Recently, there have been several reports suggesting that degradable implants may develop substantial immune responses. This phenomenon needs to be further studied in detail to make the case for the degradable implants to be utilized in clinics. Herein, we review these new recent reports suggesting the role of innate and potentially adaptive immune cells in inducing immune responses against degradable implants. First, we discussed immune responses to allergen components of non-degradable implants to give a better overview on differences in the immune response between non-degradable and degradable implants. Furthermore, we also provide potential areas of research that can be undertaken that may shed light on the local and global immune responses that are generated in response to degradable implants.
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Affiliation(s)
- Taravat Khodaei
- Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA
| | - Elizabeth Schmitzer
- Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA
| | | | - Abhinav P. Acharya
- Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA,Biological Design, Arizona State University, Tempe, AZ, 85281, USA,Chemical Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State, University, Tempe, AZ, 85281, USA,Materials Science and Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ, 85281, USA,Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, AZ, 85281, USA,Corresponding author. Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA.
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Zong J, He Q, Liu Y, Qiu M, Wu J, Hu B. Advances in the development of biodegradable coronary stents: A translational perspective. Mater Today Bio 2022; 16:100368. [PMID: 35937578 PMCID: PMC9352968 DOI: 10.1016/j.mtbio.2022.100368] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/25/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022] Open
Abstract
Implantation of cardiovascular stents is an important therapeutic method to treat coronary artery diseases. Bare-metal and drug-eluting stents show promising clinical outcomes, however, their permanent presence may create complications. In recent years, numerous preclinical and clinical trials have evaluated the properties of bioresorbable stents, including polymer and magnesium-based stents. Three-dimensional (3D) printed-shape-memory polymeric materials enable the self-deployment of stents and provide a novel approach for individualized treatment. Novel bioresorbable metallic stents such as iron- and zinc-based stents have also been investigated and refined. However, the development of novel bioresorbable stents accompanied by clinical translation remains time-consuming and challenging. This review comprehensively summarizes the development of bioresorbable stents based on their preclinical/clinical trials and highlights translational research as well as novel technologies for stents (e.g., bioresorbable electronic stents integrated with biosensors). These findings are expected to inspire the design of novel stents and optimization approaches to improve the efficacy of treatments for cardiovascular diseases. Bioresorbable stents can overcome the limitations of non-degradable stents. 3D printing of shape-memory polymeric stents can lead to better clinical outcomes. Advances in Mg-, Fe- and Zn-based stents from a translational perspective. Electronic stents integrated with biosensors can covey stent status in real time. Development in the assessment of stent performance in vivo.
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Affiliation(s)
- Jiabin Zong
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Quanwei He
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yuxiao Liu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Min Qiu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jiehong Wu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Corresponding author.
| | - Bo Hu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Corresponding author.
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42
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Bioresorbable vascular metallic scaffolds: Current status and research trends. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2022. [DOI: 10.1016/j.cobme.2022.100411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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43
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He J, Wang Z, Zhou YX, Ni H, Sun X, Xue J, Chen S, Wang S, Niu M. The application of inferior vena cava filters in orthopaedics and current research advances. Front Bioeng Biotechnol 2022; 10:1045220. [PMID: 36479430 PMCID: PMC9719953 DOI: 10.3389/fbioe.2022.1045220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2023] Open
Abstract
Deep vein thrombosis is a common clinical peripheral vascular disease that occurs frequently in orthopaedic patients and may lead to pulmonary embolism (PE) if the thrombus is dislodged. pulmonary embolism can be prevented by placing an inferior vena cava filter (IVCF) to intercept the dislodged thrombus. Thus, IVCFs play an important role in orthopaedics. However, the occurrence of complications after inferior vena cava filter placement, particularly recurrent thromboembolism, makes it necessary to carefully assess the risk-benefit of filter placement. There is no accepted statement as to whether IVCF should be placed in orthopaedic patients. Based on the problems currently displayed in the use of IVCFs, an ideal IVCF is proposed that does not affect the vessel wall and haemodynamics and intercepts thrombi well. The biodegradable filters that currently exist come close to the description of an ideal filter that can reduce the occurrence of various complications. Currently available biodegradable IVCFs consist of various organic polymeric materials. Biodegradable metals have shown good performance in making biodegradable IVCFs. However, among the available experimental studies on degradable filters, there are no experimental studies on filters made of degradable metals. This article reviews the use of IVCFs in orthopaedics, the current status of filters and the progress of research into biodegradable vena cava filters and suggests possible future developments based on the published literature by an electronic search of PubMed and Medline databases for articles related to IVCFs searchable by October 2022 and a manual search for citations to relevant studies.
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Affiliation(s)
| | | | | | - Hongbo Ni
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - XiaoHanu Sun
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jian Xue
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shanshan Chen
- Institute of Metal Research, Chinese Academy of Sciences (CAS), Shenyang, Liaoning, China
| | - Shuai Wang
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Meng Niu
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
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Vieira D, Koushanpour A, Tilliet C, Zhang Z, Harvey E, Merle G. Towards a fully biodegradable oxygen reducing electrocatalyst. J Electroanal Chem (Lausanne) 2022. [DOI: 10.1016/j.jelechem.2022.116883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Zhang H, Zhang W, Qiu H, Zhang G, Li X, Qi H, Guo J, Qian J, Shi X, Gao X, Shi D, Zhang D, Gao R, Ding J. A Biodegradable Metal-Polymer Composite Stent Safe and Effective on Physiological and Serum-Containing Biomimetic Conditions. Adv Healthc Mater 2022; 11:e2201740. [PMID: 36057108 DOI: 10.1002/adhm.202201740] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/25/2022] [Indexed: 01/28/2023]
Abstract
The new-generation coronary stents are expected to be biodegradable, and then the biocompatibility along with biodegradation becomes more challenging. It is a critical issue to choose appropriate biomimetic conditions to evaluate biocompatibility. Compared with other candidates for biodegradable stents, iron-based materials are of high mechanical strength, yet have raised more concerns about biodegradability and biocompatibility. Herein, a metal-polymer composite strategy is applied to accelerate the degradation of iron-based stents in vitro and in a porcine model. Furthermore, it is found that serum, the main environment of vascular stents, ensured the safety of iron corrosion through its antioxidants. This work highlights the importance of serum, particularly albumin, for an in vitro condition mimicking blood-related physiological condition, when reactive oxygen species, inflammatory response, and neointimal hyperplasia are concerned. The resultant metal-polymer composite stent is implanted into a patient in clinical research via interventional treatment, and the follow-up confirms its safety, efficacy, and appropriate biodegradability.
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Affiliation(s)
- Hongjie Zhang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, P. R. China
| | - Wanqian Zhang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, P. R. China.,National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, 518110, P. R. China
| | - Hong Qiu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China
| | - Gui Zhang
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, 518110, P. R. China
| | - Xin Li
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, P. R. China
| | - Haiping Qi
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, 518110, P. R. China
| | - Jingzhen Guo
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, P. R. China
| | - Jie Qian
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China
| | - Xiaoli Shi
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, 518110, P. R. China
| | - Xian Gao
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, 518110, P. R. China
| | - Daokun Shi
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, P. R. China
| | - Deyuan Zhang
- National and Local Joint Engineering Laboratory of Interventional Medical Biotechnology and System, Biotyx Medical (Shenzhen) Co., Ltd, Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, 518110, P. R. China
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200438, P. R. China
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Vallejo-Zamora JA, Vega-Cantu YI, Rodriguez C, Cordell GA, Rodriguez-Garcia A. Drug-Eluting, Bioresorbable Cardiovascular Stents─Challenges and Perspectives. ACS APPLIED BIO MATERIALS 2022; 5:4701-4717. [PMID: 36150217 DOI: 10.1021/acsabm.2c00551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Globally, the leading causes of natural death are attributed to coronary heart disease and type 1 and type 2 diabetes. High blood pressure levels, high cholesterol levels, smoking, and poor eating habits lead to the agglomeration of plaque in the arteries, reducing the blood flow. The implantation of devices used to unclog vessels, known as stents, sometimes results in a lack of irrigation due to the excessive proliferation of endothelial tissue within the blood vessels and is known as restenosis. The use of drug-eluting stents (DESs) to deliver antiproliferative drugs has led to the development of different encapsulation techniques. However, due to the potency of the drugs used in the initial stent designs, a chronic inflammatory reaction of the arterial wall known as thrombosis can cause a myocardial infarction (MI). One of the most promising drugs to reduce this risk is everolimus, which can be encapsulated in lipid systems for controlled release directly into the artery. This review aims to discuss the current status of stent design, fabrication, and functionalization. Variables such as the mechanical properties, metals and their alloys, drug encapsulation and controlled elution, and stent degradation are also addressed. Additionally, this review covers the use of polymeric surface coatings on stents and the recent advances in layer-by-layer coating and drug delivery. The advances in nanoencapsulation techniques such as liposomes and micro- and nanoemulsions and their functionalization in bioresorbable, drug-eluting stents are also highlighted.
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Affiliation(s)
- Julio A Vallejo-Zamora
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, Nuevo León64849, Mexico
| | - Yadira I Vega-Cantu
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, Nuevo León64849, Mexico
| | - Ciro Rodriguez
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, Nuevo León64849, Mexico
- Laboratorio Nacional de Manufactura Aditiva y Digital (MADIT), Apodaca, Nuevo León66629, Mexico
| | - Geoffrey A Cordell
- Natural Products, Inc., Evanston, Illinois60201, United States
- College of Pharmacy, University of Florida, Gainesville, Florida32610, United States
| | - Aida Rodriguez-Garcia
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, Nuevo León64849, Mexico
- Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, Instituto de Biotecnología, Ciudad Universitaria, Ave. Pedro de Alba S/N, San Nicolás de los Garza, Nuevo León66455, Mexico
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47
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Huang H, Li G, Jia Q, Bian D, Guan S, Kulyasova O, Valiev RZ, Rau JV, Zheng Y. Recent advances on the mechanical behavior of zinc based biodegradable metals focusing on the strain softening phenomenon. Acta Biomater 2022; 152:1-18. [PMID: 36028200 DOI: 10.1016/j.actbio.2022.08.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 01/09/2023]
Abstract
Zinc based biodegradable metals (BMs) show great potential to be used in various biomedical applications, owing to their superior biodegradability and biocompatibility. Some high-strength (ultimate tensile strength > 600 MPa) Zn based BMs have already been developed through alloying and plastic working, making their use in load-bearing environments becomes a reality. However, different from Mg and Fe based BMs, Zn based BMs exhibit significant "strain-softening" effect that leads to limited uniform deformation. Non-uniform deformation is detrimental to Zn based devices or implants, which will possibly lead to unexpected failure. People might be misled by the considerable fracture elongation of Zn based BMs. Thus, it is important to specify uniform elongation as a term of mechanical requirements for Zn based BMs. In this review, recent advances on the mechanical properties of Zn based BMs have been comprehensively summarized, especially focusing on the strain softening phenomenon. At first, the origin and evaluation criteria of strain softening were introduced. Secondly, the effects of alloying elements (including element type, single or multiple addition, and alloying content) and microstructural characteristics (grain size, constituent phase, phase distribution, etc.) on mechanical properties (especially for uniform elongation) of Zn based BMs were summarized. Finally, how to get a good balance between strength and uniform elongation was generally discussed based on the service environment. In addition, possible ways to minimize or eliminate the strain softening effect were also proposed, such as controlling of twins, solute clusters, and grain boundary characteristics. All these items above would be helpful to understand the mechanical instability of Zn based BMs, and to make the full usage of them in the future medical device design. STATEMENT OF SIGNIFICANCE: Biodegradable metals (BMs) is a hotspot in the field of metallic biomaterials. Fracture elongation is normally adopted to quantify the deformability of Mg and Fe based BMs owing to their negligible necking strain, yet the strain softening would occur in Zn based BMs, which is extremely detrimental to performance of their medical device. In this review paper, a better understanding the mechanical performance of Zn-based BMs with the term "uniform elongation" instead of "fracture elongation" was depicted, and possible ways to minimize or eliminate the strain softening effect were also proposed, such as twins, solute clusters, self-stable dislocation network, and grain boundary characteristics. It would be helpful to understand the mechanical instability of Zn based BMs and making full usage of it in the future medical device design.
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Affiliation(s)
- He Huang
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou, 450003, China
| | - Guannan Li
- School of Materials Science and Engineering, Peking University, Beijing, 100871, China
| | - Qinggong Jia
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou, 450003, China
| | - Dong Bian
- Medical Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
| | - Shaokang Guan
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou, 450003, China
| | - Olga Kulyasova
- Institute of Physics of Advanced Materials, Ufa State Aviation Technical University, 12 K. Marx St., Ufa, 450008, Russia
| | - R Z Valiev
- Institute of Physics of Advanced Materials, Ufa State Aviation Technical University, 12 K. Marx St., Ufa, 450008, Russia
| | - Julietta V Rau
- Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche (ISM-CNR), Via del Fosso del Cavaliere, 100-00133, Rome, Italy; Sechenov First Moscow State Medical University, Institute of Pharmacy, Department of Analytical, Physical and Colloid Chemistry, Trubetskaya 8, build. 2, 119991 Moscow, Russia
| | - Yufeng Zheng
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou, 450003, China; School of Materials Science and Engineering, Peking University, Beijing, 100871, China.
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48
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Pan K, Zhang W, Shi H, Dai M, Wei W, Liu X, Li X. Zinc Ion-crosslinked polycarbonate/heparin composite coatings for biodegradable Zn-alloy stent applications. Colloids Surf B Biointerfaces 2022; 218:112725. [PMID: 35914466 DOI: 10.1016/j.colsurfb.2022.112725] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/12/2022] [Accepted: 07/24/2022] [Indexed: 12/19/2022]
Abstract
Zinc and its alloys are the best candidates for biodegradable cardiovascular stents due to their good corrosion rate and biocompatibility in vasculature. However, the cytotoxicity caused by the rapid release of zinc ions during the initial degradation stage and the lack of an anticoagulant function are huge challenges for their practical clinical applications. In this work, we developed a zinc ion-crosslinked polycarbonate/heparin composite coating via electrophoretic deposition (EPD) to improve the biocompatibility and provide anticoagulant functions for Zn-alloy stents. Both electrochemical tests and in vitro immersion tests demonstrated an enhanced corrosion resistance and lower Zn ion release rate of the coated Zn alloys. Enhanced adhesion and proliferation of endothelial cells on coated Zn alloys were also observed, indicating faster reendothelialization than that on bare Zn alloys. Moreover, the surface erosion of the composite coating led to the uniform and long-term release of heparin, which remarkably inhibited the adhesion and activation of platelets, and may have endowed the coated Zn-alloy stents with long-term anticoagulant functions.
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Affiliation(s)
- Kai Pan
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Wei Zhang
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Hui Shi
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Miao Dai
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Wei Wei
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Xiaoya Liu
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Xiaojie Li
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China.
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Fabrication and characterization of biodegradable Zn-Cu-Mn alloy micro-tubes and vascular stents: microstructure, texture, mechanical properties and corrosion behavior. Acta Biomater 2022; 151:647-660. [DOI: 10.1016/j.actbio.2022.07.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022]
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50
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Biodegradable PTX-PLGA-coated magnesium stent for benign esophageal stricture: An experimental study. Acta Biomater 2022; 146:495-505. [PMID: 35487426 DOI: 10.1016/j.actbio.2022.04.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 01/21/2023]
Abstract
Biodegradable stents can degrade step by step and thereby avoid secondary removal by endoscopic procedures in contrast to metal stents. Herein, a biodegradable composite stent, a magnesium (Mg)-based braided stent with a surface coating of poly (lactic-co-glycolic acid) (PLGA) containing paclitaxel (PTX), was designed and tested. By adding this drug-loaded polymer coating, the radial force of the stent increased from 33 Newton (N) to 83 N. PTX was continuously released as the stent degraded, and the in vitro cumulative drug release in phosphate-buffered saline for 28 days was 115 ± 13.5 μg/mL at pH = 7.4 and 176 ± 12 μg/mL at pH = 4.0. There was no statistically significant difference in the viability of fibroblasts of stent extracts with different concentration gradients (P > 0.05), while the PTX-loaded stents effectively promoted fibroblast apoptosis. In the animal experiment, the stents were able to maintain esophageal patency during the 3-week follow-up and to reduce the infiltration of inflammatory cells and the amount of fibrous tissue. These results showed that the PTX-PLGA-coated Mg stent has the potential to be a safe and effective approach for benign esophageal stricture. STATEMENT OF SIGNIFICANCE: We designed a biodegradable composite stent, having poly (lactic-co-glycolic acid) (PLGA) containing paclitaxel (PTX) coated the surface of the magnesium (Mg)-based braided stent. We evaluated in vitro and in vivo characteristics of the Mg esophageal stent having a PLGA coating plus a variable concentration of PTX in comparison with the absence of PTX PLGA coating. The PTX PLGA stents exerted higher radial force than stents without coating, degraded more quickly in an acid medium, and effectively promoted fibroblast apoptosis in vitro experiments. In a rabbit model of caustic-induced esophageal stricture, there was an increased lumen and decreased inflammation of the esophageal wall in the animals stented with PTX-PLGA versus the sham group, indicating a potential approach for benign esophageal stricture.
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