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Fang Y, Guo W, Ni P, Liu H. Recent research advances in polysaccharide-based hemostatic materials: A review. Int J Biol Macromol 2024; 271:132559. [PMID: 38821802 DOI: 10.1016/j.ijbiomac.2024.132559] [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: 01/18/2024] [Revised: 05/15/2024] [Accepted: 05/20/2024] [Indexed: 06/02/2024]
Abstract
Massive bleeding resulting from civil and martial accidents can often lead to shock or even death, highlighting the critical need for the development of rapid and efficient hemostatic materials. While various types of hemostatic materials are currently utilized in clinical practice, they often come with limitations such as poor biocompatibility, toxicity, and biodegradability. Polysaccharides, such as alginate (AG), chitosan (CS), cellulose, starch, hyaluronic acid (HA), and dextran, have exhibit excellent biocompatibility and in vivo biodegradability. Their degradation products are non-toxic to surrounding tissues and can be absorbed by the body. As a result, polysaccharides have been extensively utilized in the development of hemostatic materials and have gained significant attention in the field of in vivo hemostasis. This review offers an overview of the different forms, hemostatic mechanisms, and specific applications of polysaccharides. Additionally, it discusses the future opportunities and challenges associated with polysaccharide-based hemostats.
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Affiliation(s)
- Yan Fang
- Fujian Key Laboratory of Polymer Materials, College of Chemistry and Materials Science, Fujian Normal University, Fujian 350007, China
| | - Wei Guo
- Fujian Key Laboratory of Polymer Materials, College of Chemistry and Materials Science, Fujian Normal University, Fujian 350007, China
| | - Peng Ni
- Fujian Key Laboratory of Polymer Materials, College of Chemistry and Materials Science, Fujian Normal University, Fujian 350007, China.
| | - Haiqing Liu
- Fujian Key Laboratory of Polymer Materials, College of Chemistry and Materials Science, Fujian Normal University, Fujian 350007, China
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2
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George VPJ, Zhao K, Chen P, Hu J. Chitosan-nanoclay embolic material for catheter-directed arterial embolization. J Biomed Mater Res A 2024; 112:914-930. [PMID: 38229508 PMCID: PMC10984788 DOI: 10.1002/jbm.a.37670] [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: 08/25/2023] [Revised: 11/21/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024]
Abstract
Minimally invasive transcatheter embolization is a common nonsurgical procedure in interventional radiology. It is used for the deliberate occlusion of blood vessels for the treatment of disease or injured vasculature, including vascular malformation and malignant/benign tumors. Here, we introduce a gel embolic agent comprising chitosan nanofibers and nanoclay with excellent catheter injectability and tunable mechanical properties for embolization. The properties of the gel were optimized by varying the ratio between each individual component and also adjusting the total solid content. The rheological studies confirm the shear thinning property and gel nature of the developed gel as well as their recoverability. Injection force was measured to record the force required to pass the embolic gel through a clinically relevant catheter, evaluating for practicality of hand-injection. Theoretical predicted injection force was calculated to reduce the development time and to enhance the physician's experience. The stability of occlusion was also tested in vitro by monitoring the pressure required to displace the gel. The engineered gels exhibited sterility, hemocompatibility and cell biocompatibility, highlighting their potential for transcatheter embolization.
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Affiliation(s)
- Varghese P J George
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| | - Keren Zhao
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| | - Peng Chen
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| | - Jingjie Hu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
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3
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Perri P, Sena G, Piro P, De Bartolo T, Galassi S, Costa D, Serra R. Onyx TMGel or Coil versus Hydrogel as Embolic Agents in Endovascular Applications: Review of the Literature and Case Series. Gels 2024; 10:312. [PMID: 38786229 PMCID: PMC11120993 DOI: 10.3390/gels10050312] [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: 03/27/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
This review focuses on the use of conventional gel or coil and "new" generation hydrogel used as an embolic agent in endovascular applications. In general, embolic agents have deep or multidistrict vascular penetration properties as they ensure complete occlusion of vessels by exploiting the patient's coagulation system, which recognises them as substances foreign to the body, thus triggering the coagulation cascade. This is why they are widely used in the treatment of endovascular corrections (EV repair), arteriovenous malformations (AVM), endoleaks (E), visceral aneurysms or pseudo-aneurysms, and embolisation of pre-surgical or post-surgical (iatrogenic) lesions. Conventional gels such as Onyx or coils are now commercially available, both of which are frequently used in endovascular interventional procedures, as they are minimally invasive and have numerous advantages over conventional open repair (OR) surgery. Recently, these agents have been modified and optimised to develop new embolic substances in the form of hydrogels based on alginate, chitosan, fibroin and other polymers to ensure embolisation through phase transition phenomena. The main aim of this work was to expand on the data already known in the literature concerning the application of these devices in the endovascular field, focusing on the advantages, disadvantages and safety profiles of conventional and innovative embolic agents and also through some clinical cases reported. The clinical case series concerns the correction and exclusion of endoleak type I or type II appeared after an endovascular procedure of exclusion of aneurysmal abdominal aortic (EVAR) with a coil (coil penumbra released by a LANTERN microcatheter), the exclusion of renal arterial malformation (MAV) with a coil (penumbra coil released by a LANTERN microcatheter) and the correction of endoleak through the application of Onyx 18 in the arteries where sealing by the endoprosthesis was not guaranteed.
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Affiliation(s)
- Paolo Perri
- Department of Vascular and Endovascular Surgery, Annunziata Hospital, 1 Via Migliori, 87100 Cosenza, Italy; (P.P.); (P.P.)
| | - Giuseppe Sena
- Department of Vascular Surgery, “Pugliese-Ciaccio” Hospital, 88100 Catanzaro, Italy;
| | - Paolo Piro
- Department of Vascular and Endovascular Surgery, Annunziata Hospital, 1 Via Migliori, 87100 Cosenza, Italy; (P.P.); (P.P.)
| | - Tommaso De Bartolo
- Departement of Interventional Radiology, Annunziata Hospital, 1 Via Migliori, 87100 Cosenza, Italy; (T.D.B.); (S.G.)
| | - Stefania Galassi
- Departement of Interventional Radiology, Annunziata Hospital, 1 Via Migliori, 87100 Cosenza, Italy; (T.D.B.); (S.G.)
| | - Davide Costa
- Interuniversity Center of Phlebolymphology (CIFL), Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Raffaele Serra
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
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4
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Zhang Z, Albadawi H, Fowl RJ, Mayer JL, Chong BW, Oklu R. Treatment of Ruptured Wide-Necked Aneurysms using a Microcatheter Injectable Biomaterial. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2305868. [PMID: 37579579 PMCID: PMC10843457 DOI: 10.1002/adma.202305868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/03/2023] [Indexed: 08/16/2023]
Abstract
Ruptured wide-neck aneurysms (WNAs), especially in a setting of coagulopathy, are associated with significant morbidity and mortality. It is shown that by trapping a sub-millimeter clinical catheter inside the aneurysm sac using a flow diverter stent (FDS), instant hemostasis can be achieved by filling the aneurysm sac using a novel biomaterial, rescuing catastrophic bleeding in large-animal models. Multiple formulations of a biomaterial comprising gelatin, nanoclay (NC), and iohexol are developed, optimized, and extensively tested in vitro to select the lead candidate for further testing in vivo in murine, porcine, and canine models of WNAs, including in a subset with aneurysm rupture. The catheter-injectable and X-ray visible versions of the gel embolic agent (GEA) with the optimized mechanical properties outperform control groups, including a subset that receive a clinically used liquid embolic (Onyx, Medtronic), with and without aneurysm rupture. A combinatorial approach to ruptured WNAs with GEA and FDS may change the standard of medical practice and save lives.
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Affiliation(s)
- Zefu Zhang
- Division of Vascular & Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259. USA
| | - Hassan Albadawi
- Division of Vascular & Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259. USA
| | - Richard J. Fowl
- Chair Emeritus, Division of Vascular and Endovascular Surgery, Emeritus Professor of Surgery, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, Arizona 85054, USA
| | - Joseph L. Mayer
- Division of Vascular & Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259. USA
| | - Brian W. Chong
- Department of Neurological Surgery and Radiology Mayo Clinic, 5777 East Mayo Blvd., Phoenix, Arizona 85054, USA
| | - Rahmi Oklu
- Division of Vascular & Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259. USA
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5
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Tao S, Lin B, Zhou H, Sha S, Hao X, Wang X, Chen J, Zhang Y, Pan J, Xu J, Zeng J, Wang Y, He X, Huang J, Zhao W, Fan JB. Janus particle-engineered structural lipiodol droplets for arterial embolization. Nat Commun 2023; 14:5575. [PMID: 37696820 PMCID: PMC10495453 DOI: 10.1038/s41467-023-41322-6] [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: 02/13/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023] Open
Abstract
Embolization (utilizing embolic materials to block blood vessels) has been considered one of the most promising strategies for clinical disease treatments. However, the existing embolic materials have poor embolization effectiveness, posing a great challenge to highly efficient embolization. In this study, we construct Janus particle-engineered structural lipiodol droplets by programming the self-assembly of Janus particles at the lipiodol-water interface. As a result, we achieve highly efficient renal embolization in rabbits. The obtained structural lipiodol droplets exhibit excellent mechanical stability and viscoelasticity, enabling them to closely pack together to efficiently embolize the feeding artery. They also feature good viscoelastic deformation capacities and can travel distally to embolize finer vasculatures down to 40 μm. After 14 days post-embolization, the Janus particle-engineered structural lipiodol droplets achieve efficient embolization without evidence of recanalization or non-target embolization, exhibiting embolization effectiveness superior to the clinical lipiodol-based emulsion. Our strategy provides an alternative approach to large-scale fabricate embolic materials for highly efficient embolization and exhibits good potential for clinical applications.
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Affiliation(s)
- Sijian Tao
- Cancer Research Institute, School of Basic Medical Sciences, Southern Medical University, 510515, Guangzhou, P. R. China
- School of Biomedical Engineering, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Bingquan Lin
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Houwang Zhou
- Cancer Research Institute, School of Basic Medical Sciences, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Suinan Sha
- Cancer Research Institute, School of Basic Medical Sciences, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Xiangrong Hao
- Cancer Research Institute, School of Basic Medical Sciences, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Xuejiao Wang
- Cancer Research Institute, School of Basic Medical Sciences, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Jianping Chen
- Cancer Research Institute, School of Basic Medical Sciences, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Yangning Zhang
- Cancer Research Institute, School of Basic Medical Sciences, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Jiahao Pan
- Cancer Research Institute, School of Basic Medical Sciences, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Jiabin Xu
- Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Junling Zeng
- Laboratory Animal Research Center of Nanfang Hospital, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Ying Wang
- Cancer Research Institute, School of Basic Medical Sciences, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Xiaofeng He
- Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, P. R. China
| | - Jiahao Huang
- School of Biomedical Engineering, Southern Medical University, 510515, Guangzhou, P. R. China.
- Department of Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, 524000, Zhanjiang, P. R. China.
| | - Wei Zhao
- Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, P. R. China.
| | - Jun-Bing Fan
- Cancer Research Institute, School of Basic Medical Sciences, Southern Medical University, 510515, Guangzhou, P. R. China.
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6
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de Barros NR, Gomez A, Ermis M, Falcone N, Haghniaz R, Young P, Gao Y, Aquino AF, Li S, Niu S, Chen R, Huang S, Zhu Y, Eliahoo P, Sun A, Khorsandi D, Kim J, Kelber J, Khademhosseini A, Kim HJ, Li B. Gelatin methacryloyl and Laponite bioink for 3D bioprinted organotypic tumor modeling. Biofabrication 2023; 15:10.1088/1758-5090/ace0db. [PMID: 37348491 PMCID: PMC10683563 DOI: 10.1088/1758-5090/ace0db] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/22/2023] [Indexed: 06/24/2023]
Abstract
Three-dimensional (3D)in vitrotumor models that can capture the pathophysiology of human tumors are essential for cancer biology and drug development. However, simulating the tumor microenvironment is still challenging because it consists of a heterogeneous mixture of various cellular components and biological factors. In this regard, current extracellular matrix (ECM)-mimicking hydrogels used in tumor tissue engineering lack physical interactions that can keep biological factors released by encapsulated cells within the hydrogel and improve paracrine interactions. Here, we developed a nanoengineered ion-covalent cross-linkable bioink to construct 3D bioprinted organotypic tumor models. The bioink was designed to implement the tumor ECM by creating an interpenetrating network composed of gelatin methacryloyl (GelMA), a light cross-linkable polymer, and synthetic nanosilicate (Laponite) that exhibits a unique ionic charge to improve retention of biological factors released by the encapsulated cells and assist in paracrine signals. The physical properties related to printability were evaluated to analyze the effect of Laponite hydrogel on bioink. Low GelMA (5%) with high Laponite (2.5%-3.5%) composite hydrogels and high GelMA (10%) with low Laponite (1.0%-2.0%) composite hydrogels showed acceptable mechanical properties for 3D printing. However, a low GelMA composite hydrogel with a high Laponite content could not provide acceptable cell viability. Fluorescent cell labeling studies showed that as the proportion of Laponite increased, the cells became more aggregated to form larger 3D tumor structures. Reverse transcription-polymerase chain reaction (RT-qPCR) and western blot experiments showed that an increase in the Laponite ratio induces upregulation of growth factor and tissue remodeling-related genes and proteins in tumor cells. In contrast, cell cycle and proliferation-related genes were downregulated. On the other hand, concerning fibroblasts, the increase in the Laponite ratio indicated an overall upregulation of the mesenchymal phenotype-related genes and proteins. Our study may provide a rationale for using Laponite-based hydrogels in 3D cancer modeling.
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Affiliation(s)
- Natan Roberto de Barros
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
| | - Alejandro Gomez
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
- Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, United States of America
- Department of Biology, California State University, Northridge, CA 91330, United States of America
| | - Menekse Ermis
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
- Department of Biology, Baylor University, 101 Bagby Ave, TX 76706, United Ustates of America
| | - Natashya Falcone
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
| | - Reihaneh Haghniaz
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
| | - Patric Young
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
| | - Yaqi Gao
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
- Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, United States of America
| | - Albert-Fred Aquino
- Department of Biology, California State University, Northridge, CA 91330, United States of America
| | - Siyuan Li
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
- Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, United States of America
- METU Center of Excellence in Biomaterials and Tissue Engineering, Middle East Technical University, Ankara 06800, Turkey
| | - Siyi Niu
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
- Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, United States of America
- Department of Biomedical Engineering, Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC 27101, United States of America
| | - RunRun Chen
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
- Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, United States of America
| | - Shuyi Huang
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
- Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, United States of America
| | - Yangzhi Zhu
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
| | - Payam Eliahoo
- Department of Biology, University of California, Irvine, CA 92697, United States of America
| | - Arthur Sun
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
- Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, United States of America
- College of Pharmacy, Korea University, Sejong 30019, Republic of Korea
| | - Danial Khorsandi
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
| | - Jinjoo Kim
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
| | - Jonathan Kelber
- Department of Biology, California State University, Northridge, CA 91330, United States of America
- Department of Integrative Biology, University of California, Berkeley, CA 94720, United States of America
| | - Ali Khademhosseini
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
| | - Han-Jun Kim
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
- College of Pharmacy, Korea University, Sejong 30019, Republic of Korea
| | - Bingbing Li
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, United States of America
- Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, United States of America
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Stewart RJ, Sima M, Karz J, Jones JP. Material characterization of GPX ®: A versatile in situ solidifying embolic platform technology. Front Bioeng Biotechnol 2023; 11:1095148. [PMID: 36726745 PMCID: PMC9885798 DOI: 10.3389/fbioe.2023.1095148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023] Open
Abstract
Endovascular embolization is a minimally invasive procedure during which blood flow to targeted tissues is selectively occluded. The list of clinical indications for embolization continues to expand. Liquid embolic agents are injectable compositions that transition into a solid or semi-solid form when introduced into blood vessels. The mechanism that triggers the liquid-to-solid transition is a key distinguishing feature of liquid embolic agents. GPX is a waterborne liquid embolic agent comprising oppositely charged polyelectrolytes: polyguanidinum and inorganic polyphoshate. In situ solidification is driven by electrostatic condensation of the polyelectrolytes, triggered by ionic strength differentials. We report in vitro characterization of the material properties of GPX, it is in vivo effectiveness in acute animal studies, and its potential for chemoembolization. The viscosity of GPX can be varied over a wide range by adjusting the polyguanidinium MW and/or concentration. Formulation of GPX with either tantalum microparticles (30 wt%) or iodinated radiocontrast agents (300 mgI ml-1) did not significantly change the flow behavior of GPX; the viscosity was independent of shear rate and remained within a clinically practical range (80-160 cP). Formulation of GPX with doxorubicin substantially increased viscosity at low shear rates and resulted in a power law dependence on shear rate. High contrast and effective vascular occlusion were demonstrated in both swine kidneys and rete mirabile. Contrast from iodinated compounds was temporary, dissipating within hours. The doxorubicin in vitro release profile was linear over 90 days. The results demonstrate that GPX is a versatile liquid embolic platform that can be formulated with a wide range of viscosities injectable at clinically practical flow rates, with either transient or permanent contrast, and that can provide prolonged zero-order delivery of doxorubicin to embolized tissues.
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Affiliation(s)
- Russell J. Stewart
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States,*Correspondence: Russell J. Stewart,
| | - Monika Sima
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States
| | - Jessica Karz
- Fluidx Medical Technology, Inc., Salt Lake City, UT, United States
| | - Joshua P. Jones
- Fluidx Medical Technology, Inc., Salt Lake City, UT, United States
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8
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Go G, Yoo A, Nguyen KT, Nan M, Darmawan BA, Zheng S, Kang B, Kim CS, Bang D, Lee S, Kim KP, Kang SS, Shim KM, Kim SE, Bang S, Kim DH, Park JO, Choi E. Multifunctional microrobot with real-time visualization and magnetic resonance imaging for chemoembolization therapy of liver cancer. SCIENCE ADVANCES 2022; 8:eabq8545. [PMID: 36399561 PMCID: PMC9674283 DOI: 10.1126/sciadv.abq8545] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/30/2022] [Indexed: 05/28/2023]
Abstract
Microrobots that can be precisely guided to target lesions have been studied for in vivo medical applications. However, existing microrobots have challenges in vivo such as biocompatibility, biodegradability, actuation module, and intra- and postoperative imaging. This study reports microrobots visualized with real-time x-ray and magnetic resonance imaging (MRI) that can be magnetically guided to tumor feeding vessels for transcatheter liver chemoembolization in vivo. The microrobots, composed of a hydrogel-enveloped porous structure and magnetic nanoparticles, enable targeted delivery of therapeutic and imaging agents via magnetic guidance from the actuation module under real-time x-ray imaging. In addition, the microrobots can be tracked using MRI as postoperative imaging and then slowly degrade over time. The in vivo validation of microrobot system-mediated chemoembolization was demonstrated in a rat liver with a tumor model. The proposed microrobot provides an advanced medical robotic platform that can overcome the limitations of existing microrobots and current liver chemoembolization.
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Affiliation(s)
- Gwangjun Go
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, USA
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- School of Mechanical Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
| | - Ami Yoo
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
| | - Kim Tien Nguyen
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
| | - Minghui Nan
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
| | - Bobby Aditya Darmawan
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- School of Mechanical Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
| | - Shirong Zheng
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- School of Mechanical Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
| | - Byungjeon Kang
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- College of AI Convergence, Chonnam National University, Gwangju 34931, Korea
| | - Chang-Sei Kim
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- School of Mechanical Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
| | - Doyeon Bang
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- College of AI Convergence, Chonnam National University, Gwangju 34931, Korea
| | - Seonmin Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-Gu, Seoul 05505, Korea
| | - Kyu-Pyo Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-Gu, Seoul 05505, Korea
| | - Seong Soo Kang
- Department of Veterinary Surgery, College of Veterinary Medicine and Biomaterial R&BD Center, Chonnam National University, Gwangju 61186, Korea
| | - Kyung Mi Shim
- Department of Veterinary Surgery, College of Veterinary Medicine and Biomaterial R&BD Center, Chonnam National University, Gwangju 61186, Korea
| | - Se Eun Kim
- Department of Veterinary Surgery, College of Veterinary Medicine and Biomaterial R&BD Center, Chonnam National University, Gwangju 61186, Korea
| | - Seungmin Bang
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - Deok-Ho Kim
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Jong-Oh Park
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
| | - Eunpyo Choi
- Korea Institute of Medical Microrobotics (KIMIRo), 43-26 Cheomdangwagi-ro, Buk-gu, Gwangju 61011, Korea
- School of Mechanical Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
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9
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Zou CY, Li QJ, Hu JJ, Song YT, Zhang QY, Nie R, Li-Ling J, Xie HQ. Design of biopolymer-based hemostatic material: Starting from molecular structures and forms. Mater Today Bio 2022; 17:100468. [PMID: 36340592 PMCID: PMC9626749 DOI: 10.1016/j.mtbio.2022.100468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Uncontrolled bleeding remains as a leading cause of death in surgical, traumatic, and emergency situations. Management of the hemorrhage and development of hemostatic materials are paramount for patient survival. Owing to their inherent biocompatibility, biodegradability and bioactivity, biopolymers such as polysaccharides and polypeptides have been extensively researched and become a focus for the development of next-generation hemostatic materials. The construction of novel hemostatic materials requires in-depth understanding of the physiological hemostatic process, fundamental hemostatic mechanisms, and the effects of material chemistry/physics. Herein, we have recapitulated the common hemostatic strategies and development status of biopolymer-based hemostatic materials. Furthermore, the hemostatic mechanisms of various molecular structures (components and chemical modifications) are summarized from a microscopic perspective, and the design based on them are introduced. From a macroscopic perspective, the design of various forms of hemostatic materials, e.g., powder, sponge, hydrogel and gauze, is summarized and compared, which may provide an enlightenment for the optimization of hemostat design. It has also highlighted current challenges to the development of biopolymer-based hemostatic materials and proposed future directions in chemistry design, advanced form and clinical application. Biopolymers possess sound biocompatibility, biodegradability and bioactivity for the design of hemostatic materials. Molecular structure designs including component and chemical modification are summarized from a microscopic perspective. Design of various forms of hemostatic materials is discussed and compared synthetically from a macroscopic perspective.
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Affiliation(s)
- Chen-Yu Zou
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, Med-X Center for Materials, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Qian-Jin Li
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, Med-X Center for Materials, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Juan-Juan Hu
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, Med-X Center for Materials, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China,Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Yu-Ting Song
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, Med-X Center for Materials, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Qing-Yi Zhang
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, Med-X Center for Materials, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Rong Nie
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, Med-X Center for Materials, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Jesse Li-Ling
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, Med-X Center for Materials, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China,Department of Medical Genetics, West China Second Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Hui-Qi Xie
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, Med-X Center for Materials, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China,Corresponding author.
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10
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Liu Y, Zhong D, He Y, Jiang J, Xie W, Tang Z, Qiu J, Luo J, Wang X. Photoresponsive Hydrogel-Coated Upconversion Cyanobacteria Nanocapsules for Myocardial Infarction Prevention and Treatment. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2202920. [PMID: 36045439 PMCID: PMC9596827 DOI: 10.1002/advs.202202920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Myocardial infarction (MI) is a common disease that seriously threatens human health. It is noteworthy that oxygen is one of the key factors in the regulation of MI pathology procession: the controllable hypoxic microenvironment can enhance the tolerance of cardiac myocytes (CMs) and oxygen therapy regulates the immune microenvironment to repair the myocardial injury. Thus, the development of an oxygen-controllable treatment is critically important to unify MI prevention and timely treatment. Here, a hydrogel encapsulated upconversion cyanobacterium nanocapsule for both MI prevention and treatment is successfully synthesized. The engineered cyanobacteria can consume oxygen via respiration to generate a hypoxic microenvironment, resulting in the upregulation of heat shock protein70 (HSP70), which can enhance the tolerance of CMs for MI. When necessary, under 980 nm near-infrared (NIR) irradiation, the system releases photosynthetic oxygen through upconversion luminescence (UCL) to inhibit macrophage M1 polarization, and downregulates pro-inflammatory cytokines IL-6 and tumor necrosis factor-α (TNF-α), thereby repairing myocardial injury. To sum up, a photoresponsive upconversion cyanobacterium nanocapsule is developed, which can achieve MI prevention and treatment for only one injection via NIR-defined respiration and photosynthesis.
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Affiliation(s)
- Yu Liu
- Department of Rehabilitation Medicinethe Second Affiliated Hospital of Nanchang UniversityNanchang UniversityNanchang330006China
- The National Engineering Research Center for Bioengineering Drugs and the TechnologiesInstitute of Translational MedicineNanchang UniversityNanchang330088China
| | - Da Zhong
- The National Engineering Research Center for Bioengineering Drugs and the TechnologiesInstitute of Translational MedicineNanchang UniversityNanchang330088China
- School of Chemistry and Chemical Engineering of Nanchang UniversityNanchang UniversityNanchang330088China
| | - Yizhe He
- The National Engineering Research Center for Bioengineering Drugs and the TechnologiesInstitute of Translational MedicineNanchang UniversityNanchang330088China
| | - Junkai Jiang
- The National Engineering Research Center for Bioengineering Drugs and the TechnologiesInstitute of Translational MedicineNanchang UniversityNanchang330088China
| | - Weichang Xie
- The National Engineering Research Center for Bioengineering Drugs and the TechnologiesInstitute of Translational MedicineNanchang UniversityNanchang330088China
| | - Zhibo Tang
- The National Engineering Research Center for Bioengineering Drugs and the TechnologiesInstitute of Translational MedicineNanchang UniversityNanchang330088China
| | - Jianbin Qiu
- The National Engineering Research Center for Bioengineering Drugs and the TechnologiesInstitute of Translational MedicineNanchang UniversityNanchang330088China
| | - Jun Luo
- Department of Rehabilitation Medicinethe Second Affiliated Hospital of Nanchang UniversityNanchang UniversityNanchang330006China
| | - Xiaolei Wang
- The National Engineering Research Center for Bioengineering Drugs and the TechnologiesInstitute of Translational MedicineNanchang UniversityNanchang330088China
- School of Chemistry and Chemical Engineering of Nanchang UniversityNanchang UniversityNanchang330088China
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11
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Tan X, Gerhard E, Wang Y, Tran RT, Xu H, Yan S, Rizk EB, Armstrong AD, Zhou Y, Du J, Bai X, Yang J. Development of Biodegradable Osteopromotive Citrate-Based Bone Putty. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 18:e2203003. [PMID: 35717669 PMCID: PMC9463100 DOI: 10.1002/smll.202203003] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Indexed: 05/30/2023]
Abstract
The burden of bone fractures demands development of effective biomaterial solutions, while additional acute events such as noncompressible bleeding further motivate the search for multi-functional implants to avoid complications including osseous hemorrhage, infection, and nonunion. Bone wax has been widely used in orthopedic bleeding control due to its simplicity of use and conformation to irregular defects; however, its nondegradability results in impaired bone healing, risk of infection, and significant inflammatory responses. Herein, a class of intrinsically fluorescent, osteopromotive citrate-based polymer/hydroxyapatite (HA) composites (BPLP-Ser/HA) as a highly malleable press-fit putty is designed. BPLP-Ser/HA putty displays mechanics replicating early nonmineralized bone (initial moduli from ≈2-500 kPa), hydration induced mechanical strengthening in physiological conditions, tunable degradation rates (over 2 months), low swelling ratios (<10%), clotting and hemostatic sealing potential (resistant to blood pressure for >24 h) and significant adhesion to bone (≈350-550 kPa). Simultaneously, citrate's bioactive properties result in antimicrobial (≈100% and 55% inhibition of S. aureus and E. coli) and osteopromotive effects. Finally, BPLP-Ser/HA putty demonstrates in vivo regeneration in a critical-sized rat calvaria model equivalent to gold standard autograft. BPLP-Ser/HA putty represents a simple, off-the-shelf solution to the combined challenges of acute wound management and subsequent bone regeneration.
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Affiliation(s)
- Xinyu Tan
- Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
- Academy of Orthopedics, Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong Province, 510280, China
| | - Ethan Gerhard
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
| | - Yuqi Wang
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
| | - Richard T. Tran
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
| | - Hui Xu
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
| | - Su Yan
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
| | - Elias B. Rizk
- Department of Neurosurgery, College of Medicine, The Pennsylvania State University, Hershey, PA 17033, USA
| | - April D. Armstrong
- Department of Orthopaedics and Rehabilitation, College of Medicine, The Pennsylvania State University, Hershey, PA 17033, USA
| | - Yuxiao Zhou
- Department of Mechanical Engineering, The Pennsylvania State University, University Park, PA 16802, USA
| | - Jing Du
- Department of Mechanical Engineering, The Pennsylvania State University, University Park, PA 16802, USA
| | - Xiaochun Bai
- Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
- Academy of Orthopedics, Provincial Key Laboratory of Bone and Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong Province, 510280, China
| | - Jian Yang
- Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
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12
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Xu Z, Tian W, Wen C, Ji X, Diao H, Hou Y, Fan J, Liu Z, Ji T, Sun F, Wu D, Zhang J. Cellulose-Based Cryogel Microspheres with Nanoporous and Controllable Wrinkled Morphologies for Rapid Hemostasis. NANO LETTERS 2022; 22:6350-6358. [PMID: 35912616 DOI: 10.1021/acs.nanolett.2c02144] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
First-aid hemostatic agents for acute bleeding can save lives in emergency situations. However, rapid hemostasis remains challenging when uncontrolled hemorrhage occurs on lethal noncompressible and irregular wounds. Herein, cellulose-based cryogel microspheres with deliberately customized micromorphologies for ultrafast water transportation and diffusion, including the shark skin riblet-inspired wrinkled surface with low fluid drag and the hydrophilic nanoporous 3D networks, are developed to deal with the acute noncompressible bleeding within seconds. These cryogel microspheres can rapidly absorb a large amount of blood over 6 times their own weight in 10 s and form a robust barrier to seal a bleeding wound without applying pressure. Remarkably, massive bleeding from a cardiac penetrating hole is effectively stopped using the microspheres within 20 s and no blood leakage is observed after 30 min. Additionally, these microspheres could be readily removed without rebleeding and capillary thrombus, which is highly favorable to rapid hemostasis in emergency rescue.
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Affiliation(s)
- Zhan Xu
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Engineering Plastics, Institute of Chemistry Chinese Academy of Sciences (CAS), Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Weiguo Tian
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Engineering Plastics, Institute of Chemistry Chinese Academy of Sciences (CAS), Beijing 100190, China
| | - Chaojun Wen
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Engineering Plastics, Institute of Chemistry Chinese Academy of Sciences (CAS), Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xin Ji
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Engineering Plastics, Institute of Chemistry Chinese Academy of Sciences (CAS), Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Huailing Diao
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Engineering Plastics, Institute of Chemistry Chinese Academy of Sciences (CAS), Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuzhen Hou
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Engineering Plastics, Institute of Chemistry Chinese Academy of Sciences (CAS), Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jialiang Fan
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Engineering Plastics, Institute of Chemistry Chinese Academy of Sciences (CAS), Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zongxi Liu
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Engineering Plastics, Institute of Chemistry Chinese Academy of Sciences (CAS), Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Tianjiao Ji
- CAS Key Laboratory for Biomedical Effects of Nanomaterials & Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
| | - Feifei Sun
- CAS Key Laboratory for Biomedical Effects of Nanomaterials & Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
| | - Decheng Wu
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Engineering Plastics, Institute of Chemistry Chinese Academy of Sciences (CAS), Beijing 100190, China
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Jun Zhang
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Engineering Plastics, Institute of Chemistry Chinese Academy of Sciences (CAS), Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
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13
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Gong Y, Chen W, Chen X, He Y, Jiang H, Zhang X, Pan L, Ni B, Yang F, Xu Y, Zhang Q, Zhou L, Cheng Y. An Injectable Epigenetic Autophagic Modulatory Hydrogel for Boosting Umbilical Cord Blood NK Cell Therapy Prevents Postsurgical Relapse of Triple-Negative Breast Cancer. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2201271. [PMID: 35712750 PMCID: PMC9376812 DOI: 10.1002/advs.202201271] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/03/2022] [Indexed: 06/15/2023]
Abstract
Triple-negative breast cancer (TNBC) exhibits resistance to conventional treatments due to the presence of cancer stem cells (CSCs), causing postsurgical relapse and a dismal prognosis. Umbilical cord blood natural killer (UCB-NK) cell-based immunotherapy represents a promising strategy for cancer treatment. However, its therapeutic efficacy is greatly restrained by downregulation of the NK cell activation ligand MHC class I-related chain A/B (MICA/B) and autophagy-mediated degradation of NK cell-derived granzyme B (GZMB) in CSCs. Herein, it is demonstrated that suberoylanilide hydroxamic acid (SAHA) epigenetically downregulates let-7e-5p and miR-615-3p to increase MICA/B expression and that 3-methyl adenine (3MA) inhibits autophagy-mediated GZMB degradation, thereby sensitizing breast CSCs to UCB-NK cells. Then, an injectable hydrogel is designed to codeliver SAHA and 3MA to enhance UCB-NK cell infusion efficacy in TNBC. The hydrogel precursors can be smoothly injected into the tumor resection bed and form a stable gel in situ, allowing for a pH-sensitive sustained release of SAHA and 3MA. Moreover, UCB-NK cell infusion in combination with the hydrogel efficiently controls postsurgical relapse of TNBC. In addition, the hydrogel exhibits good hemostasis and wound-healing functions. Therefore, the work provides proof of concept that an injectable epigenetic autophagic modulatory hydrogel augments UCB-NK cell therapy to combat postsurgical relapse of TNBC.
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Affiliation(s)
- Yihang Gong
- Department of Hepatic Surgery and Liver Transplantation Center & Guangdong Provincial Key Laboratory of Liver Disease ResearchThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
| | - Wenjie Chen
- Biotherapy Centre & Cell‐Gene Therapy Translational Medicine Research CentreThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
| | - Xiuxing Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene RegulationDepartment of Medical OncologySun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhou510120China
| | - Yizhan He
- Biotherapy Centre & Cell‐Gene Therapy Translational Medicine Research CentreThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
| | - Hua Jiang
- Department of Breast & Thyroid SurgeryThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
| | - Xijian Zhang
- Department of Hepatic Surgery and Liver Transplantation Center & Guangdong Provincial Key Laboratory of Liver Disease ResearchThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
| | - Lijie Pan
- Biotherapy Centre & Cell‐Gene Therapy Translational Medicine Research CentreThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
| | - Beibei Ni
- Biotherapy Centre & Cell‐Gene Therapy Translational Medicine Research CentreThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
| | - Fan Yang
- Biotherapy Centre & Cell‐Gene Therapy Translational Medicine Research CentreThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
| | - Yan Xu
- Biotherapy Centre & Cell‐Gene Therapy Translational Medicine Research CentreThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
| | - Qi Zhang
- Biotherapy Centre & Cell‐Gene Therapy Translational Medicine Research CentreThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
| | - Lei Zhou
- Guangzhou Key Laboratory of Spine Disease Prevention and TreatmentDepartment of Spine SurgeryThe Third Affiliated HospitalGuangzhou Medical UniversityGuangzhou510150China
| | - Yusheng Cheng
- Department of Hepatic Surgery and Liver Transplantation Center & Guangdong Provincial Key Laboratory of Liver Disease ResearchThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhou510630China
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14
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Montazerian H, Davoodi E, Baidya A, Baghdasarian S, Sarikhani E, Meyer CE, Haghniaz R, Badv M, Annabi N, Khademhosseini A, Weiss PS. Engineered Hemostatic Biomaterials for Sealing Wounds. Chem Rev 2022; 122:12864-12903. [PMID: 35731958 DOI: 10.1021/acs.chemrev.1c01015] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hemostatic biomaterials show great promise in wound control for the treatment of uncontrolled bleeding associated with damaged tissues, traumatic wounds, and surgical incisions. A surge of interest has been directed at boosting hemostatic properties of bioactive materials via mechanisms triggering the coagulation cascade. A wide variety of biocompatible and biodegradable materials has been applied to the design of hemostatic platforms for rapid blood coagulation. Recent trends in the design of hemostatic agents emphasize chemical conjugation of charged moieties to biomacromolecules, physical incorporation of blood-coagulating agents in biomaterials systems, and superabsorbing materials in either dry (foams) or wet (hydrogel) states. In addition, tough bioadhesives are emerging for efficient and physical sealing of incisions. In this Review, we highlight the biomacromolecular design approaches adopted to develop hemostatic bioactive materials. We discuss the mechanistic pathways of hemostasis along with the current standard experimental procedures for characterization of the hemostasis efficacy. Finally, we discuss the potential for clinical translation of hemostatic technologies, future trends, and research opportunities for the development of next-generation surgical materials with hemostatic properties for wound management.
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Affiliation(s)
- Hossein Montazerian
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, California 90095, United States.,California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States.,Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Elham Davoodi
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, California 90095, United States.,California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States.,Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States.,Multi-Scale Additive Manufacturing Lab, Mechanical and Mechatronics Engineering Department, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Avijit Baidya
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Sevana Baghdasarian
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Einollah Sarikhani
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, California 90095, United States
| | - Claire Elsa Meyer
- Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Reihaneh Haghniaz
- Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Maryam Badv
- California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States.,Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, California 90095, United States.,Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, Alberta T2N 1N4, Canada
| | - Nasim Annabi
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, California 90095, United States.,Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Ali Khademhosseini
- Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Paul S Weiss
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, California 90095, United States.,California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States.,Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, California 90095, United States.,Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, California 90095, United States
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15
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Zhang Z, Albadawi H, Fowl RJ, Altun I, Salomao MA, Jahanyar J, Chong BW, Mayer JL, Oklu R. Treatment of Ruptured and Nonruptured Aneurysms Using a Semisolid Iodinated Embolic Agent. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2108266. [PMID: 34936720 PMCID: PMC8917094 DOI: 10.1002/adma.202108266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/18/2021] [Indexed: 06/14/2023]
Abstract
Saccular aneurysms (SAs) are focal outpouchings from the lateral wall of an artery. Depending on their morphology and location, minimally invasive treatment options include coil embolization, flow diverter stents, stent-assisted coiling, and liquid embolics. Many drawbacks are associated with these treatment options including recanalization, delayed healing, rebleeding, malpositioning of the embolic or stent, stent stenosis, and even rupture of the SA. To overcome these drawbacks, a nanoclay-based shear-thinning hydrogel (STH) is developed for the endovascular treatment of SAs. Extensive in vitro testing is performed to optimize STH performance, visualization, injectability, and endothelialization in cell culture. Femoral artery saccular aneurysm models in rats and in pigs are created to test stability, efficacy, immune response, endothelialization, and biocompatibility of STH in both ruptured and unruptured SA. Fluoroscopy and computed tomography imaging consistently confirmed SA occlusion without recanalization, migration, or nontarget embolization; STH is also shown to outperform coil embolization of porcine aneurysms. In pigs with catastrophic bleeding due to SA rupture, STH is able to achieve instant hemostasis rescuing the pigs in long-term survival experiments. STH is a promising semisolid iodinated embolic agent that can change the standard of medical practice and potentially save lives.
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Affiliation(s)
- Zefu Zhang
- Division of Vascular & Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Hassan Albadawi
- Division of Vascular & Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Richard J. Fowl
- Division of Vascular & Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
- Chair Emeritus, Division of Vascular and Endovascular Surgery, Emeritus Professor of Surgery, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, Arizona 85054, USA
| | - Izzet Altun
- Division of Vascular & Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Marcela A. Salomao
- Division of Anatomic Pathology & Laboratory Medicine, Department of Pathology, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, Arizona 85054, USA
| | - Jama Jahanyar
- Division of Cardiothoracic Surgery, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, Arizona 85054, USA
| | - Brian W. Chong
- Department of Neurological Surgery and Radiology, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, Arizona 85054, USA
| | - Joseph L. Mayer
- Division of Vascular & Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Rahmi Oklu
- Division of Vascular & Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
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16
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Young S, Larson AS, Torkian P, Golzarian J. Embolic Materials: Understanding the Ocean of Choices. THE ARAB JOURNAL OF INTERVENTIONAL RADIOLOGY 2022. [DOI: 10.1055/s-0042-1746412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
AbstractEmbolization is a fundamental procedure that interventional radiologists perform on a daily basis to treat a variety of diseases. The disease processes for which embolization is considered a safe and effective treatment are continuously expanding, as are the embolization materials available for use. To achieve optimal clinical outcomes and minimize complications, it is imperative that the interventional radiologist understands the properties, strengths, and weaknesses of each class of embolic and specific embolic products. This is a continuous process as new materials are always becoming available. This article reviews the different classes of embolic materials, discusses strengths and weaknesses, and reviews areas of innovation.
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Affiliation(s)
- Shamar Young
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Anthony S. Larson
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Pooya Torkian
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Jafar Golzarian
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States
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17
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Hu J, Albadawi H, Zhang Z, Salomao MA, Gunduz S, Rehman S, D'Amone L, Mayer JL, Omenetto F, Oklu R. Silk Embolic Material for Catheter-Directed Endovascular Drug Delivery. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2106865. [PMID: 34695275 PMCID: PMC8758542 DOI: 10.1002/adma.202106865] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/13/2021] [Indexed: 05/06/2023]
Abstract
Embolization is a catheter-based minimally invasive procedure that deliberately occludes diseased blood vessels for treatment purposes. A novel silk-based embolic material (SEM) that is developed and optimized to provide tandem integration of both embolization and the delivery of therapeutics is reported. Natural silk is processed into fibroin proteins of varying lengths and is combined with charged nanoclay particles to allow visibility and injectability using clinical catheters as small as 600 μm in diameter at lengths >100 cm. SEMs loaded with fluorochrome labeled bovine albumin and Nivolumab, which is among the most used immunotherapy drugs worldwide, demonstrate a sustained release profile in vitro over 28 days. In a porcine renal survival model, SEMs with labeled albumin and Nivolumab successfully embolize porcine arteries without recanalization and lead to the delivery of both albumin and Nivolumab into the interstitial space of the renal cortex. Mechanistically, it is shown that tissue delivery is most optimal when the internal elastic membrane of the embolized artery is disrupted. SEM is a potential next-generation multifunctional embolic agent that can achieve embolization and deliver a wide range of therapeutics to treat vascular diseases including tumors.
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Affiliation(s)
- Jingjie Hu
- Division of Vascular and Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ, 85259, USA
| | - Hassan Albadawi
- Division of Vascular and Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ, 85259, USA
| | - Zefu Zhang
- Division of Vascular and Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ, 85259, USA
| | - Marcela A Salomao
- Division of Anatomic Pathology and Laboratory Medicine, Department of Pathology, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, AZ, 85054, USA
| | - Seyda Gunduz
- Division of Vascular and Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ, 85259, USA
| | - Suliman Rehman
- Division of Vascular and Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ, 85259, USA
| | - Luciana D'Amone
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA, 02155, USA
| | - Joseph L Mayer
- Division of Vascular and Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ, 85259, USA
| | - Fiorenzo Omenetto
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA, 02155, USA
- Laboratory for Living Devices, Tufts University, Medford, MA, 02155, USA
- Department of Electrical and Computer Engineering, Tufts University, Medford, MA, 02155, USA
- Department of Physics, Tufts University, Medford, MA, 02155, USA
| | - Rahmi Oklu
- Division of Vascular and Interventional Radiology, Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ, 85259, USA
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18
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Xie R, Chen YC, Zhao Y, Yodsanit N, Wang Y, Yamamoto N, Yamanouchi D, Gong S. Injectable Hydrogel Capable of In Situ Covalent Crosslinking for Permanent Embolization. ACS APPLIED MATERIALS & INTERFACES 2021; 13:56988-56999. [PMID: 34806359 DOI: 10.1021/acsami.1c18250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Vascular embolization provides an effective approach for the treatment of hemorrhage, aneurysms, and other vascular abnormalities. However, current embolic materials, such as metallic coils and liquid embolic agents, are limited by their inability to provide safe, consistent, and controlled embolization. Here, we report an injectable hydrogel that can remain at the injection site and subsequently undergo in situ covalent crosslinking, leading to the formation of a dual-crosslinking network (DCN) hydrogel for endovascular embolization. The DCN hydrogel is simple to prepare, easy to deploy via needles and catheters, and mechanically stable at the target injection site, thereby avoiding embolization of nontarget vessels. It possesses efficient hemostatic activity and good biocompatibility. The DCN hydrogel is also clearly visible under X-ray imaging, thereby allowing for targeted embolization. In vivo tests in a rabbit artery model demonstrates that the DCN hydrogel is effective in achieving immediate embolization of the target artery with long-term occlusion by inducing luminal fibrosis. Collectively, the DCN hydrogel provides a viable, biocompatible, and cost-effective alternative to existing embolic materials with clinical translation potential for endovascular embolization.
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Affiliation(s)
- Ruosen Xie
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706, United States
- Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, Wisconsin 53715, United States
| | - Yu-Chung Chen
- Research and Development Division, SB-Kawasumi Laboratories, Inc., 3-25-4, Tonomachi, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-8602, Japan
| | - Yi Zhao
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706, United States
- Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, Wisconsin 53715, United States
| | - Nisakorn Yodsanit
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706, United States
- Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, Wisconsin 53715, United States
| | - Yuyuan Wang
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706, United States
- Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, Wisconsin 53715, United States
| | - Naoaki Yamamoto
- Research and Development Division, SB-Kawasumi Laboratories, Inc., 3-25-4, Tonomachi, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-8602, Japan
| | - Dai Yamanouchi
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin 53792, United States
| | - Shaoqin Gong
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706, United States
- Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, Wisconsin 53715, United States
- Department of Materials Science and Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706, United States
- Department of Chemistry, University of Wisconsin-Madison, Madison, Wisconsin 53706, United States
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19
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Cao Q, Wang H, Wang X, Wu D. A Versatile Crosslinking Strategy on Facile Fabrication of Fluorescent Hydrogels via
o
‐Phthalaldehyde
Ternary Condensation. CHINESE J CHEM 2021. [DOI: 10.1002/cjoc.202100297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Qingchen Cao
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry Chinese Academy of Sciences Beijing 100190 China
- University of Chinese Academy of Sciences Beijing 100049 China
| | - Hufei Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry Chinese Academy of Sciences Beijing 100190 China
- University of Chinese Academy of Sciences Beijing 100049 China
| | - Xing Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry Chinese Academy of Sciences Beijing 100190 China
| | - Decheng Wu
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry Chinese Academy of Sciences Beijing 100190 China
- Department of Biomedical Engineering Southern University of Science and Technology Shenzhen Guangdong 518055 China
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20
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Nasrollahi F, Nazir F, Tavafoghi M, Hosseini V, Ali Darabi M, Paramelle D, Khademhosseini A, Ahadian S. Graphene Quantum Dots for Fluorescent Labeling of Gelatin‐Based Shear‐Thinning Hydrogels. ADVANCED NANOBIOMED RESEARCH 2021. [DOI: 10.1002/anbr.202000113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Fatemeh Nasrollahi
- Department of Bioengineering University of California-Los Angeles Los Angeles CA 90095 USA
- Center for Minimally Invasive Therapeutics (C-MIT) University of California-Los Angeles Los Angeles CA 90095 USA
- Terasaki Institute for Biomedical Innovation (TIBI) Los Angeles CA 90024 USA
| | - Farzana Nazir
- Department of Bioengineering University of California-Los Angeles Los Angeles CA 90095 USA
- Center for Minimally Invasive Therapeutics (C-MIT) University of California-Los Angeles Los Angeles CA 90095 USA
- Department of Chemistry School of Natural Sciences National University of Science and Technology (NUST) Islamabad 44000 Pakistan
| | - Maryam Tavafoghi
- Department of Bioengineering University of California-Los Angeles Los Angeles CA 90095 USA
- Center for Minimally Invasive Therapeutics (C-MIT) University of California-Los Angeles Los Angeles CA 90095 USA
| | - Vahid Hosseini
- Department of Bioengineering University of California-Los Angeles Los Angeles CA 90095 USA
- Center for Minimally Invasive Therapeutics (C-MIT) University of California-Los Angeles Los Angeles CA 90095 USA
- Terasaki Institute for Biomedical Innovation (TIBI) Los Angeles CA 90024 USA
| | - Mohammad Ali Darabi
- Department of Bioengineering University of California-Los Angeles Los Angeles CA 90095 USA
- Center for Minimally Invasive Therapeutics (C-MIT) University of California-Los Angeles Los Angeles CA 90095 USA
- Terasaki Institute for Biomedical Innovation (TIBI) Los Angeles CA 90024 USA
| | - David Paramelle
- Institute of Materials Research and Engineering A*STAR (Agency for Science, Technology and Research) 2 Fusionopolis Way, Innovis #08-03 Singapore 138634 Singapore
| | - Ali Khademhosseini
- Terasaki Institute for Biomedical Innovation (TIBI) Los Angeles CA 90024 USA
| | - Samad Ahadian
- Terasaki Institute for Biomedical Innovation (TIBI) Los Angeles CA 90024 USA
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