Porous Aromatic Framework with Tailored Binding Sites and Pore Sizes as a High-Performance Hemoperfusion Adsorbent for Bilirubin Removal

An Evolutionary Review of Hemoperfusion Adsorbents: Materials, Preparation, Functionalization, and Outlook

Accumulation of pathogenic factors in the blood may cause irreversible damage and may even be life-threatening. Hemoperfusion is an effective technique for eliminating pathogenic factors, which is widely used in the treatment of various diseases including liver failure, renal failure, sepsis, and others. Hemoperfusion adsorbents are crucial in this process as they specifically bind and remove the target pathogenic factors. This review describes the development of hemoperfusion adsorbents, detailing the different properties exhibited by inorganic materials, organic polymers, and new materials. Advances in natural and synthetic polymers and novel materials manufacturing techniques have driven the expansion of hemoperfusion adsorbents in clinical applications. Stimuli-responsive (smart responsive) adsorbents with controllable molecular binding properties have many promising and environmentally friendly biomedical applications. Knowledge gaps, future research directions, and prospects for hemoperfusion adsorbents are discussed.

Theory-Driven Tailoring of the Microenvironment of Quaternary Ammonium Binding Sites on Electrospun Nanofibers for Efficient Bilirubin Removal in Hemoperfusion

Efficient adsorbents for excess bilirubin removal are extremely important for the treatment of hyperbilirubinemia. However, traditional adsorbents, such as activated carbons and ion-exchange resins, still suffer from dissatisfactory adsorption performance and poor blood compatibility. Herein, we adopted a rational design strategy guided by density functional theory (DFT) calculations to prepare blood-compatible quaternary ammonium group grafted electrospun polyacrylonitrile nanofiber adsorbents. The calculation analysis and adsorption experiments were used to investigate the structure-function relationship between group types and bilirubin adsorption, both indicating that quaternary ammonium groups with suitable configurations played a crucial role in bilirubin binding. The obtained nanofiber adsorbents showed the bilirubin removal efficiency above 90% even at a coexisting BSA concentration of 50 g L-1. The maximum adsorption capacities were 818.9 mg g-1 in free bilirubin solution and 163.7 mg g-1 in albumin bound bilirubin solution. The nanofiber adsorbents also showed considerable bilirubin removal in dynamic adsorption to reduce the bilirubin concentration to a normal level, which was better than commercial activated carbons. Our study demonstrates the high feasibility of a theory-driven design method for the development of grafted electrospun nanofibers, which have good potential as bilirubin adsorbents in hemoperfusion applications.

Application of Nanoparticles as Novel Adsorbents in Blood Purification Strategies

BACKGROUND

Blood purification therapy for patients overloaded with metabolic toxins or drugs still needs improvement. Blood purification therapies, such as in hemodialysis or peritoneal dialysis can profit from a combined application with nanoparticles.

SUMMARY

In this review, the published literature is analyzed with respect to nanomaterials that have been customized and functionalized as nano-adsorbents during blood purification therapy. Liposomes possess a distinct combined structure composed of a hydrophobic lipid bilayer and a hydrophilic core. The liposomes which have enzymes in their aqueous core or obtain specific surface modifications of the lipid bilayer can offer appreciated advantages. Preclinical and clinical experiments with such modified liposomes show that they are highly efficient and generally safe. They may serve as indirect and direct adsorption materials both in hemodialysis and peritoneal dialysis treatment for patients with renal or hepatic failure. Apart from dialysis, nanoparticles made of specially designed metal and activated carbon have also been utilized to enhance the removal of solutes during hemoadsorption. Results are a superior adsorption capacity and good hemocompatibility shown during the treatment of patients with toxication or end-stage renal disease. In summary, nanomaterials are promising tools for improving the treatment efficacy of organ failure or toxication.

KEY MESSAGES

(i) The pH-transmembrane liposomes and enzyme-loaded liposomes are two representatives of liposomes with modified aqueous inner core which have been put into practice in dialysis. (ii) Unmodified or physiochemically modified liposomal bilayers are ideal binders for lipophilic protein-bound uremic toxins or cholestatic solutes, thus liposome-supported dialysis could become the next-generation hemodialysis treatment of artificial liver support system. (iii) Novel nano-based sorbents featuring large surface area, high adsorption capacity and decent biocompatibility have shown promise in the treatment of uremia, hyperbilirubinemia, intoxication, and sepsis. (vi) A major challenge of production lies in avoiding changes in physical and chemical properties induced by manufacturing and sterilizing procedures.

Nanofibrous Porous Organic Polymers and Their Derivatives: From Synthesis to Applications

Engineering porous organic polymers (POPs) into 1D morphology holds significant promise for diverse applications due to their exceptional processability and increased surface contact for enhanced interactions with guest molecules. This article reviews the latest developments in nanofibrous POPs and their derivatives, encompassing porous organic polymer nanofibers, their composites, and POPs-derived carbon nanofibers. The review delves into the design and fabrication strategies, elucidates the formation mechanisms, explores their functional attributes, and highlights promising applications. The first section systematically outlines two primary fabrication approaches of nanofibrous POPs, i.e., direct bulk synthesis and electrospinning technology. Both routes are discussed and compared in terms of template utilization and post-treatments. Next, performance of nanofibrous POPs and their derivatives are reviewed for applications including water treatment, water/oil separation, gas adsorption, energy storage, heterogeneous catalysis, microwave absorption, and biomedical systems. Finally, highlighting existent challenges and offering future prospects of nanofibrous POPs and their derivatives are concluded.

Rigid crosslink improves the surface area and porosity of β-cyclodextrin beads for enhanced adsorption of flavonoids

Many reported β-cyclodextrin (β-CD) polymers have poor flavonoid adsorption performance due to their low surface area and porosity resulting from the compact stack of the β-CD molecules crosslinked by flexible crosslinkers. Here, we propose a rigid crosslink strategy that uses phytic acid (PA) having rigid cyclic group as crosslinkers, achieving a high-surface-area (61.42-140.23 m2/g) and porous β-CD beads. The improved surface area and porosity are attributed to the rigid cyclic groups in PA, which expand the network structure of β-CD polymers. Benefitting from the advantages, the optimized PA-crosslinked β-CD (PA-β-CD) beads have an over tenfold increased adsorption amount and an threefold increased diffusivity for rutin compared with traditional non-porous β-CD beads crosslinked by epichlorohydrin. Moreover, dynamic adsorption experiments reveal that PA-β-CD beads are able to treat about 1100 mL of rutin solution (0.05 mg/mL), over 5 times higher than that of the non-porous β-CD beads (200 mL). These results demonstrate the promise of PA-β-CD beads for rapid and high-capacity adsorption of rutin.

Metal-organic framework-based adsorbents for blood purification: progress, challenges, and prospects

Blood purification, such as hemodialysis (HD), plasma exchange (PE), and hemoperfusion (HP), is widely applied in patients with organ failure (such as kidney and liver failure). Among them, HP mainly relies on porous adsorbents to efficiently adsorb accumulated metabolic wastes and toxins, thus improving purification efficiency. Metal-organic frameworks (MOFs), with a high porosity, large surface area, high loading capacity, and tailorable topology, are emerging as some of the most promising materials for HP. Compared with non-metal framework counterparts, the self-built metal centers of MOFs feature the intrinsic advantages of coordination with toxin molecules. However, research on MOFs in blood purification is insufficient, particularly in contrast to materials applied in other biomedical applications. Thus, to broaden this area, this review first discusses the essential characteristics, potential mechanisms, and structure-function relationship between MOFs and toxin adsorption based on porosity, topology, ligand functionalization, metal centers, and toxin types. Moreover, the stability, utilization safety, and hemocompatibility of MOFs are illustrated for adsorbent selection. The current development and progress in MOF composites for HD, HP, and extracorporeal membrane oxygenation (ECMO) are also summarized to highlight their practicability. Finally, we propose future opportunities and challenges from materials design and manufacture to the computational prediction of MOFs in blood purification. It is anticipated that our review will expand the interest of researchers for more impact in this area.

Novel hemoperfusion adsorbents based on collagen for efficient bilirubin removal - A thought from yellow skin of patients with hyperbilirubinemia

Hemoperfusion is a well-developed method for removing bilirubin from patients with hyperbilirubinemia. The performance of adsorbents is crucial during the process. However, most adsorbents used for bilirubin removal are not suitable for clinical applications, because they either have poor adsorption performance or limited biocompatibility. Patients with hyperbilirubinemia usually have distinctive yellow skin, indicating that collagen, a primary component of the skin, may be an effective material for absorbing bilirubin from the blood. Based on this idea, we designed and synthesized collagen (Col) and collagen-polyethyleneimine (Col-PEI) microspheres and employed them as hemoperfusion adsorbents for bilirubin removal. The microspheres have an efficient adsorption rate, higher bilirubin adsorption capacity, and competitive adsorption of bilirubin in the bilirubin/bovine serum albumin (BSA) solution. The maximum adsorption capacities of Col and Col-PEI microspheres for bilirubin are 150.2 mg/g and 258.4 mg/g, respectively, which are higher than those of most traditional polymer microspheres. Additionally, the microspheres exhibit excellent blood compatibility originating from collagen. Our study provides a new collagen-based strategy for the hemoperfusion treatment of hyperbilirubinemia.

Reusable Zwitterionic Porous Organic Polymers for Bilirubin Removal in Serum

Herein, we report a straightforward strategy to construct reusable, hemocompatible, and highly efficient bilirubin adsorbents by installing zwitterionic modules into a porous organic polymer (POP) for hemoperfusion application. Three types of zwitterions with different amounts are used to evaluate their impacts on the characteristics of POPs, including carboxybetaine methacrylate (CB), sulfobetaine methacrylate (SB), and 2-methacryloyloxyethyl phosphorylcholine (MPC). Results show that zwitterions can improve hemocompatibility, hydrophilicity, and bilirubin uptake of the POP. Among all zwitterionic POPs, POP-CB-40% exhibits the best bilirubin uptake, ∼46.5 times enhancement compared with the non-zwitterionic POP in 100% serum. This enhancement can be attributed to the improved hydrophilicity and protein resistance ability in biological solutions. More importantly, the reusability test shows that POP-CB-40% maintains ∼99% of bilirubin uptake capacity at fifth recycling in 100% serum. Findings in this work provide a guideline for the design of biocompatible and efficient POP-based bilirubin adsorbents for hemoperfusion therapy.

Metal-organic framework (UiO-66 and UiO-66-NH2)-based adsorbents for bilirubin removal used in hemoperfusion

Excessive accumulation of bilirubin in patients with hyperbilirubinemia can lead to tissue and organ damage and neurological diseases, and is even life-threatening in severe cases. Hemoperfusion is an effective method for removing bilirubin, but clinically used hemoperfusion adsorbents have unsatisfactory adsorption capacity and kinetics. In order to obtain a safe and efficient bilirubin adsorbent, Zr-based Metal-Organic Framework (MOF) material UiO-66 with high specific surface area and aqueous medium stability was prepared and modified with varying degrees of amination to improve its adsorption capacity. According to adsorption experiments in aqueous solution and simulated plasma, it was confirmed that the unsaturated coordinated zirconium in UiO-66 can effectively induce the aggregation and precipitation of free bilirubin unbound to albumin and the amino group on UiO-66-NH2 has a strong affinity for albumin bound bilirubin. The adsorption effect of UiO-66-NH2 with a high degree of amino modification is significantly stronger than that of UiO-66-NH2 with a low degree of modification. In simulated plasma with a bilirubin concentration of 40 mg dL-1, the adsorption capacities of UiO-66 and UiO-66-NH2-1.9 can reach 69.08 mg g-1 and 81.13 mg g-1. The adsorption isotherm fitting and adsorption kinetics fitting results also show that UiO-66 and UiO-66-NH2 are good adsorbents for bilirubin. In dynamic adsorption, the adsorbents also showed good performance and did not affect the protein in the plasma. The hemolysis test, coagulation time test, and cytotoxicity test confirmed that the bilirubin adsorbents based on UiO-66 and UiO-66-NH2 have good blood compatibility and biocompatibility. This study provides new ideas for the development of a novel bilirubin adsorbent and a theoretical basis for the study of bilirubin adsorption mechanisms.

Protein/Polysaccharide Composite toward Multi-in-One Toxin Removal in Blood with Self-Anticoagulation and Biocompatibility

Biocompatible adsorbents play an essential role in hemoperfusion. Nevertheless, there are no hemoperfusion adsorbents that can simultaneously remove small and medium toxins, including bilirubin, urea, phosphor, heavy metals, and antibiotics. This bottleneck significantly impedes the miniaturization and portability of hemoperfusion materials and devices. Herein, a biocompatible protein-polysaccharide complex is reported that exhibits "multi-in-one" removal efficacy for liver and kidney metabolism wastes, toxic metal ions, and antibiotics. Through electrostatic interactions and polysaccharide-mediated coacervation, adsorbents can be prepared by simply mixing lysozyme (LZ) and sodium alginate (SA) together in seconds. The LZ/SA absorbent presented high adsorption capacities for bilirubin, urea, and Hg2+ of up to 468, 331, and 497 mg g-1 , respectively, and the excellent anti-protein adsorption endowed LZ/SA with a record-high adsorption capacity for bilirubin in the interference of serum albumin to simulate the physiological environment. The LZ/SA adsorbent also has effective adsorption capacity for heavy metals (Pb2+ , Cu2+ , Cr3+ , and Cd2+ ) and multiple antibiotics (terramycin, tetracycline, enrofloxacin, norfloxacin, roxithromycin, erythromycin, sulfapyrimidine, and sulfamethoxazole). Various adsorption functional groups exposed on the adsorbent surface significantly contribute to the excellent adsorption capacity. This fully bio-derived protein/alginate-based hemoperfusion adsorbent has great application prospects in the treatment of blood-related diseases.

A novel recyclable hemoperfusion adsorbent based on TiO2 nanotube arrays for the selective removal of β2-microglobulin

Prolonged and excessive accumulation of β2-microglobulin (β2m) in the blood can lead to various kidney-related and other diseases. Currently, the most effective method of removing β2m from the blood is hemoperfusion. Although some traditional hemoperfusion adsorbents such as cellulose and polystyrene microspheres have been used for the removal of β2m, their selectivity still needs improvement. Immunosorbents have been developed to address this issue, but high cost and limited application are concerns. TiO2 nanotube arrays (TNTAs) have shown great potential in adsorption-related biomedical applications. In this study, we designed and developed a novel TNTA-based hemoperfusion adsorbent for the removal of β2m, which has demonstrated good biocompatibility, selectivity, and reusability. We investigated the β2m adsorption capacities of TNTAs with different pore sizes. The results indicate that TNTAs with a pore size matching the size of β2m exhibit higher adsorption capacity while also having lower adsorption capacity for albumin, showing the importance of pore size on the selectivity of adsorbents. Additionally, green regeneration of TNTAs is achieved via the photocatalytic activity originating from TiO2. Even after five cycles, the adsorption capacity of TNTAs remained above 70%. Our work demonstrates that inorganic materials with ordered pores are capable to be candidates for hemoperfusion, possessing advantages over traditional organic materials such as high stability, security, and low cost.

MOFs-alginate/polyacrylic acid/poly (ethylene imine) heparin-mimicking beads as a novel hemoadsorbent for bilirubin removal in vitro and vivo models

Metal-organic frameworks (MOFs) have a potential application in blood purification, but their microcrystalline nature has hampered their industrial application. Here, novel MOFs-polymer beads based on UiO, sodium alginate, polyacrylic acid, and poly (ethylene imine) were prepared and applied as a whole blood hemoadsorbent for the first time. The amidation among polymers immobilized UiO66-NH₂ into the network of the optimal product (SAP-3), and the NH₂ of UiO66-NH₂ significantly increased the removal rate (70 % within 5 min) of SAP-3 on bilirubin. The adsorption of SAP-3 on bilirubin mainly obeyed the pseudo-second-order kinetic, Langmuir isotherm and Thomas models with a maximum adsorption capacity (q_m) of 63.97 mg·g^-1. Experimental and density functional theory simulation results show that bilirubin was mainly adsorbed by UiO66-NH₂via electrostatic force, hydrogen bonding, and π-π interactions. Notably, the adsorption in vivo show that the total bilirubin removal rate in the whole blood of the rabbit model was up to 42 % after 1 h of adsorption. Given its excellent stability, cytotoxicity, and hemocompatibility, SAP-3 has a great potential in hemoperfusion therapy. This study proposes an effective strategy for settling the powder property of MOFs and could provide experimental and theoretical references for application of MOFs in blood purification.

Bilirubin Removal by Polymeric Adsorbents for Hyperbilirubinemia Therapy

Hyperbilirubinemia, presenting as jaundice, is a life-threatening critical illness in newborn babies and acute severe hepatic failure patients. Over the past few decades, extracorporeal hemoadsorption by adsorbent therapy has been widely applied in the treatment of hyperbilirubinemia. The capability of hemoadsorption depends on the adsorbents. Most of the clinically used bilirubin adsorbents are made up of styrene/divinylbenzene copolymer and quaternary ammonium salt, which usually have poor biocompatibility and weak mechanical strength. To overcome the drawbacks of commercial polymer adsorbents, advanced synthetic and natural polymers with/without nanomaterials have been designed, and novel adsorbent fabrication technologies have also been developed. In this review, the adsorption mechanism of bilirubin adsorbents has been summarized, which is the basic criterion in adsorbent development. Furthermore, the preparation method, adsorption mechanism, relative merits and practicability of the emerging bilirubin adsorbents have been evaluated. Based on the existing studies, this work highlights the future direction of the efforts on how to design and develop bilirubin adsorbents with good overall clinical performance. Perhaps this study can change traditional perspectives and propose new strategies for bilirubin clearance from the aspects of pathogenic mechanisms, metabolic pathways, and material-based innovation.

A breakthrough trial of an artificial liver without systemic heparinization in hyperbilirubinemia beagle models

The development of wearable artificial livers was restricted to device miniaturization and bleeding risk with water-soluble anticoagulants. Herein, a double-deck column filled with solid anticoagulant microspheres and Kevlar porous microspheres (KPMs, bilirubin adsorbents) was connected with the principle machine of wearable artificial liver (approximately 9 kg) to treat hyperbilirubinemia beagles for the first time. With the initial normal dose of heparin, the double-deck column could afford 3 h hemoperfusion in whole blood without thrombus formation. The removal efficiency of the double-deck column for total bilirubin (TBIL) was 31.4%. Interestingly, the excessive amounts of hepatocyte metabolites were also decreased by approximately 25%. The “anticoagulant + column” realized safe and effective whole blood hemoperfusion without the plasma separation system and heparin pump; however, the proposed principle machine of wearable artificial liver and “anticoagulant + column” cannot completely replace the bio-liver now. The intelligence of the device and the versatility of the adsorbent need to be improved; moreover, advanced experimental techniques need to be developed to validate the survival rates in animals. Overall, this study is a meaningful trial for the development of wearable artificial livers in the future.

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This is a breakthrough trial of a wearable artificial liver to perform in hyperbilirubinemia beagle models without systemic heparinization treatment.

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We proposed the “solid anticoagulant microspheres” to supersede water-soluble anticoagulant medications in the artificial liver, which could reduce the bleeding risks for patients and supersede heparin pump to further reduce the weight of wearable artificial liver.

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The “anticoagulant + column” could provide a safe, efficient and low-cost blood purification method, which will be a milestone in the clinical development of wearable artificial livers.

Supramolecular Organic Frameworks as Adsorbents for Efficient Removal of Excess Bilirubin in Hemoperfusion

Excess bilirubin accumulates in the bodies of patients suffering from acute liver failure (ALF) to cause much irreversible damage and bring about serious clinical symptoms such as kernicterus, hepatic coma, or even death. Hemoperfusion is a widely used method for removing bilirubin from the blood, but clinically used adsorbents have unsatisfactory adsorption capacity and kinetics. In this study, we prepared four supramolecular organic framework microcrystals SOF-1-4 via slow evaporation of their aqueous solutions under infrared light. SOF-1-4 possess good regularity and excellent stability. We demonstrate that all the four SOFs could serve as adsorbents for bilirubin with fast adsorption kinetics within 20 min and ultrahigh adsorption capacity of 609.1 mg g^-1, driven by electrostatic interaction and hydrophobicity. The superior adsorption performance of the SOFs outperformed most of the reported bilirubin adsorbents. Remarkably, SOF-3 could remove about 90% of bilirubin in the presence of 40 g L^-1 BSA with a minimal loss of albumin and was thus further processed to a bead-shaped composite with a diameter of 2 mm with poly(ether sulfone) (PES). This PES-loaded SOF could efficiently adsorb bilirubin to the normal level from human plasma with an adsorption equilibrium concentration of 7.8 mg L^-1 in 6 h through a dynamic hemoperfusion process. This work provides a new vitality for the development of novel bilirubin adsorbents for hemoperfusion therapy.

Microfluidic electrospray generation of porous magnetic Janus reduced graphene oxide/carbon composite microspheres for versatile adsorption

HYPOTHESIS

Graphene-based microparticles materials are broadly utilized in all sorts of fields owing to their outstanding properties. Despite great progress, the present graphene microparticles still face challenges in the aspects of size uniformity, motion flexibility, and tailorable surface chemistry, which limit their application in some specific fields, such as versatile adsorption. Hence, the development of novel graphene microparticles with the aforementioned characteristics is urgently required.

EXPERIMENTS

We presented a simple microfluidic electrospray strategy to generate magnetic Janus reduced graphene oxide/carbon (rGO/C) composite microspheres with a variety of unique features. Specifically, the microfluidic electrospray method endowed the obtaiend microspheres with sufficient size uniformity as well as magnetic responsive motion ability. Additionally, magnetic-mediated surface assembly of phase transition lysozyme (PTL) nanofilm on the microspheres rendered the deposited area hydrophilic while non-deposited area hydrophobic.

FINDINGS

Such magnetic Janus rGO/C composite microspheres with regionalized wettability characteristics not only showed prominent performance in adsorbing organic liquids with high adsorption capacity and remarkable reusability but also displayed satisfying biocompatibility for the efficient uptake of bilirubin. More encouragingly, the microspheres could serve as adsorbents in a simulative hemoperfusion setup, which further demonstrated the clinical application potential of the magnetic Janus rGO/C microspheres. Thus, we anticipate that the obtained magnetic Janus rGO/C composite microspheres could show multifunctional properties toward water treatment and blood molecule cleaning.

Microporous polymer adsorptive membranes with high processing capacity for molecular separation

Trade-off between permeability and nanometer-level selectivity is an inherent shortcoming of membrane-based separation of molecules, while most highly porous materials with high adsorption capacity lack solution processability and stability for achieving adsorption-based molecule separation. We hereby report a hydrophilic amidoxime modified polymer of intrinsic microporosity (AOPIM-1) as a membrane adsorption material to selectively adsorb and separate small organic molecules from water with ultrahigh processing capacity. The membrane adsorption capacity for Rhodamine B reaches 26.114 g m⁻², 10–1000 times higher than previously reported adsorptive membranes. Meanwhile, the membrane achieves >99.9% removal of various nano-sized organic molecules with water flux 2 orders of magnitude higher than typical pressure-driven membranes of similar rejections. This work confirms the feasibility of microporous polymers for membrane adsorption with high capacity, and provides the possibility of adsorptive membranes for molecular separation.

Trade-off between permeability and nanometer-level selectivity is an inherent shortcoming of membrane-based separation of molecules. Here, the authors report a membrane adsorption material based on hydrophilic amidoxime modified polymer of intrinsic microporosity to selectively adsorb and separate small organic molecules from water with ultrahigh processing capacity

Biocompatible Composite Microspheres of Chitin/Ordered Mesoporous Carbon CMK3 for Bilirubin Adsorption and Cell Microcarrier Culture

Extra bilirubin in the blood can provoke serious illness in patients with severe liver disease. Hemoperfusion is an effective method to remove the extra bilirubin, but its application is limited by the low adsorption efficiency and poor biocompatibility of available adsorbent materials. In this study, chitin/ordered mesoporous carbon CMK3 (Ch/CMK3) microspheres were successfully prepared. Results of characterization experiments indicated that these composite microspheres possess a multilayered porous nanofibrous structure with an extremely large specific surface area (300.19 m² g^-1 ) and large pore size. Notably, the Ch/CMK3 microspheres demonstrated a high bilirubin adsorption capacity (228.19 mg g^-1 ) in phosphate buffer solution, and an outstanding bilirubin removal ratio (76.78%±4.40%) in the plasma of rabbits with hyperbilirubinemia without affecting the protein components. More importantly, the Ch/CMK3 microspheres showed no effect on other blood components, no cytotoxicity, and no systemic toxicity to mice. Cell coculture experiments revealed that the microspheres could provide a three-dimensional (3D) space to promote cell adhesion, proliferation, and nutrient exchange. These Ch/CMK3 microspheres featuring a strong ability for bilirubin adsorption and good biocompatibility could be a promising candidate in biomedical applications such as hemoperfusion, cell microcarrier, and 3D tissue engineering. This article is protected by copyright. All rights reserved.

Flexible organic frameworks sequester neuromuscular blocking agents in vitro and reverse neuromuscular block invivo

Supramolecular sequestration and reversal of neuromuscular block (NMB) have great clinical applications. Water-soluble flexible organic frameworks (FOFs) cross-linked by disulfide bonds are designed and prepared. Different linker lengths are introduced to FOFs to give them varied pore sizes. FOFs are anionic nanoscale polymers and capable of encapsulating cationic neuromuscular blocking agents (NMBAs), including rocuronium (Roc), vecuronium (Vec), pancuronium (Panc) and cisatracurium (Cis). A host–guest study confirms that FOFs bind NMBAs in water. The multivalency interaction between FOFs and NMBAs is able to sequester NMBAs, and prevent them from escaping. These FOFs are non-toxic and biocompatible. Animal studies show that FOFs are effective for the reversal of NMB induced by Roc, Vec and Cis, which shorten the time to a train-of-four ratio of 0.9 by 2.6, 3.8 and 5.7-fold compared to a placebo, respectively.

Water-soluble flexible organic frameworks are prepared and used to sequester neuromuscular blocking agents, and reverse their neuromuscular block in vivo.

Recent advances in porous organic frameworks for sample pretreatment of pesticide and veterinary drug residues: a review

Rapid and accurate detection of pesticide and veterinary drug residues is a continuing challenge because of the complex matrix effects. Thus, appropriate sample pretreatment is a crucial step for the effective extraction of the analytes and removal of the interferences. Recently, the development of nanomaterial adsorbents has greatly promoted the innovation of food sample pretreatment approaches. Porous organic frameworks (POFs), including polymers of intrinsic microporosity, covalent organic frameworks, hyper crosslinked polymers, conjugated microporous polymers, and porous aromatic frameworks, have been widely utilized due to their tailorable skeletons and pores as well as fascinating features. This review summarizes the recent advances for POFs to be utilized in adsorption and sample preparation of pesticide and veterinary drug residues. In addition, future prospects and challenges are discussed, hoping to offer a reference for further study on POFs in sample pretreatment.

Hydroxyapatite reinforced inorganic-organic hybrid nanocomposite as high-performance adsorbents for bilirubin removal in vitro and in pig models

Highly efficient removal of bilirubin from whole blood directly by hemoperfusion for liver failure therapy remains a challenge in the clinical field due to the low adsorption capacity, poor mechanical strength and low biocompatibility of adsorbents. In this work, a new class of nanocomposite adsorbents was constructed through an inorganic-organic co-crosslinked nanocomposite network between vinyltriethoxysilane (VTES)-functionalized hydroxyapatite nanoparticles (V-Hap) and non-ionic styrene-divinylbenzene (PS-DVB) resins (PS-DVB/V-Hap) using suspension polymerization. Notably, our adsorbent demonstrated substantially improved mechanical performance compared to the pure polymer, with the hardness and modulus increasing by nearly 3 and 2.5 times, respectively. Moreover, due to the development of a mesoporous structure, the prepared PS-DVB/V-Hap3 exhibited an ideal adsorption capacity of 40.27 mg g-1. More importantly, the obtained adsorbent beads showed outstanding blood compatibility and biocompatibility. Furthermore, in vivo extracorporeal hemoperfusion verified the efficacy and biosafety of the adsorbent for directly removing bilirubin from whole blood in pig models, and this material could potentially prevent liver damage and improve clinical outcomes. Taken together, the results suggest that PS-DVB/V-Hap3 beads can be used in commercial adsorption columns to threat hyperbilirubinemia patients through hemoperfusion, thus replacing the existing techniques where plasma separation is initially required.

Biological Application of Porous Aromatic Frameworks: State of the Art and Opportunities

Porous aromatic frameworks (PAFs) were first reported in 2009 and have quickly attracted much attention because of their exceptionally ultrahigh specific surface area (5800 m²·g^-1). Uniquely, PAFs are constructed from carbon-carbon-bond-linked aromatic-based building units, which render PAFs extremely stable in various environments. At present, PAFs have been applied in many fields, such as adsorption, catalysis, ion exchange, electrochemistry, and so on. However, for such a unique material, its application in the biological fields is still rarely explored. Therefore, this Perspective introduces the reported application of PAFs in biological fields, for instance, diagnosis and treatment of diseases, artificial enzymes, drug delivery, and extraction of bioactive substances. Major challenges and opportunities for future research on PAFs in biology and biomedicine are identified in diagnostic platforms, novel drug carriers/antidotes, and novel artificial enzymes.

Molecularly-imprinted hydrogel beads via self-sacrificing micro-reactors as safe and selective bilirubin adsorbents

For patients who are suffering from liver dysfunction or metabolic obstruction, excessive bilirubin (BIL) in their bodies may cause jaundice with irreversible cerebral injury. Traditional exchange transfusion and photodynamic therapy pose a risk of serious adverse reactions or limited curative effects. Therefore, as a generally used treatment, hemoperfusion (HP) purifies patients' blood with solid adsorbents. However, the development of clinical BIL absorbents is greatly impeded by low selectivity and unsatisfactory blood compatibility. Herein, inspired by oviparity, we propose BIL-imprinted poly(acrylic acid-co-sodium p-styrenesulfonate)-reduced graphene oxide (PAA-SS-rGO@BIL) hydrogel beads as BIL adsorbents via self-sacrificing micro-reactors. In the micro-reactors, cross-linked polymerization is achieved and a solidified gel is formed. The received hydrogel beads show outstanding selective adsorption capabilities toward BIL due to the recognition sites, and π-π and hydrophobic interactions. Such hydrogel beads possess superior blood compatibility owing to their bioinspired heparin-mimicking gel structure. Simulated BIL selective adsorption experiments in vitro demonstrate that the BIL concentrations in the plasma of a patient with severe jaundice can be restored to a moderate level within 3 hours. Therefore, hydrogel beads offer new options for clinical BIL adsorption.

Highly Efficient Adsorption of Bilirubin by Ti3 C2 Tx MXene

We discovered that the 2D Ti₃ C₂ T_x MXene sheet displays an ultra-high removal capability for bilirubin (BR). In particular, MXene shows 47.6 times higher removal efficiency over traditional activated carbon absorbents. The effect of MXene on the removal rate of BR in BR solution containing different concentrations of bovine serum albumin (BSA) was studied. The adsorption capacity of BSA for BR at high concentration of 5 g L^-1 was about 85% of the best adsorption capacity. The MXene before and after adsorption was characterized by SEM, FT-IR and XPS. Furthermore, MXene beads were prepared, and the hemoperfusion simulation experiment was carried out. The results show that the adsorption capacity of MXene for bilirubin can reach 1192.9 mg g^-1 . This study suggests that MXene may be promising in the treatment of hyperbilirubinemia.

Ultraefficiently Calming Cytokine Storm Using Ti3C2T x MXene

During the global outbreak of COVID-19 pandemic, "cytokine storm" conditions are regarded as the fatal step resulting in most mortality. Hemoperfusion is widely used to remove cytokines from the blood of severely ill patients to prevent uncontrolled inflammation induced by a cytokine storm. This article discoveres, for the first time, that 2D Ti3C2T x MXene sheet demonstrates an ultrahigh removal capability for typical cytokine interleukin-6. In particular, MXene shows a 13.4 times higher removal efficiency over traditional activated carbon absorbents. Molecular-level investigations reveal that MXene exhibits a strong chemisorption mechanism for immobilizing cytokine interleukin-6 molecules, which is different from activated carbon absorbents. MXene sheet also demonstrates excellent blood compatibility without any deleterious side influence on the composition of human blood. This work can open a new avenue to use MXene sheets as an ultraefficient hemoperfusion absorbent to eliminate the cytokine storm syndrome in treatment of severe COVID-19 patients.

Polymyxin B engineered polystyrene-divinylbenzene microspheres for the adsorption of bilirubin and endotoxin

Hemoperfusion is an important strategy for liver disease treatment. Polystyrene-divinylbenzene (PS-DVB) microspheres are widely applied as absorbents in hemoperfusion to efficiently remove the important toxin bilirubin. However, as another common toxin, endotoxin will remain during this process and cause endotoxemia. Therefore, simultaneous removal of both bilirubin and endotoxin is highly desirable. In the present study, we engineered PS-DVB microspheres with polymyxin B sulfate (PMB) to meet this goal. After modification, the novel PMB-engineered (P-PMB) microspheres displayed excellent biocompatibility and hemocompatibility. Notably, compared to PS-DVB microspheres, P-PMB microspheres exhibited markedly stronger detoxification of both bilirubin and endotoxin, increasing by 17.03% and 42.57%, respectively. Overall, we believe that the novel P-PMB microspheres have considerable potential for liver disease treatment in clinical practice.

A new adsorbent for hemoperfusion was successfully prepared by grafting polymyxin B (PMB) on the surface of polystyrene divinylbenzene (PS-DVB) microspheres. It showed good biocompatibility and could adsorb both bilirubin and endotoxin.