Iron oxide nanoparticles improved biocompatibility and removal of middle molecule uremic toxin of polysulfone hollow fiber membranes

Fabrication and characterization of dual-layer hollow fibre membranes incorporating poly(citric acid)-grafted GO with enhanced antifouling properties for water treatment

Membrane fouling during the filtration process is a perennial issue and could lead to reduced separation efficiency. In this work, poly(citric acid)-grafted graphene oxide (PGO) was incorporated into a matrix of single-layer hollow fibre (SLHF) and dual-layer hollow fibrr (DLHF) membranes, respectively, aiming to improve membrane antifouling properties during water treatment. Different loadings of PGO ranging from 0 to 1 wt% were first introduced into the SLHF to identify the best PGO loading for the DLHF preparation with its outer layer modified by nanomaterials. The findings showed that at the optimized PGO loading of 0.7 wt%, the resultant SLHF membrane could achieve higher water permeability and bovine serum albumin rejection compared to the neat SLHF membrane. This is due to the improved surface hydrophilicity and increased structural porosity upon incorporation of optimized PGO loading. When 0.7 wt% PGO was introduced only to the outer layer of DLHF, the cross-sectional matrix of the membrane was altered, forming microvoids and spongy-like structures (more porous). Nevertheless, the BSA rejection of the membrane was improved to 97.7% owing to an inner selectivity layer produced from a different dope solution (without the PGO). The DLHF membrane also demonstrated significantly higher antifouling properties than the neat SLHF membrane. Its flux recovery rate is 85%, i.e. 37% better than that of a neat membrane. By incorporating hydrophilic PGO into the membrane, the interaction of the hydrophobic foulants with the membrane surface is greatly reduced.

Therapeutic Plasma Exchange in Certain Immune-Mediated Neurological Disorders: Focus on a Novel Nanomembrane-Based Technology

Therapeutic plasma exchange (TPE) is an efficient extracorporeal blood purification technique to remove circulating autoantibodies and other pathogenic substances. Its mechanism of action in immune-mediated neurological disorders includes immediate intravascular reduction of autoantibody concentration, pulsed induction of antibody redistribution, and subsequent immunomodulatory changes. Conventional TPE with 1 to 1.5 total plasma volume (TPV) exchange is a well-established treatment in Guillain-Barre Syndrome, Chronic Inflammatory Demyelinating Polyradiculoneuropathy, Neuromyelitis Optica Spectrum Disorder, Myasthenia Gravis and Multiple Sclerosis. There is insufficient evidence for the efficacy of so-called low volume plasma exchange (LVPE) (<1 TPV exchange) implemented either by the conventional or by a novel nanomembrane-based TPE in these neurological conditions, including their impact on conductivity and neuroregenerative recovery. In this narrative review, we focus on the role of nanomembrane-based technology as an alternative LVPE treatment option in these neurological conditions. Nanomembrane-based technology is a promising type of TPE, which seems to share the basic advantages of the conventional one, but probably with fewer adverse effects. It could play a valuable role in patient management by ameliorating neurological symptoms, improving disability, and reducing oxidative stress in a cost-effective way. Further research is needed to identify which patients benefit most from this novel TPE technology.

Preparation and blood compatibility of polyethersulfone dialysis membrane modified by apixaban as coagulation factor Xa inhibitor

Blood purification therapy is widely used in the treatment of critically ill patients. However, most dialysis membranes are prone to thrombosis. Activated coagulation factor X (FXa) functions at the intersection of intrinsic, extrinsic, and common coagulation pathways and plays a central role in thrombogenesis. To date, few dialysis membranes that directly inhibit FXa have been reported. We modified a polyethersulfone(PES) membrane using apixaban as an FXa inhibitor and investigated the performance of this membrane (AMPES). The contact angle of the modified membrane was reduced. PWF and retention rates of BSA were increased, demonstrating good hydrophilicity and dialysis performance. Albumin adsorption was reduced from 141.8 ± 15.5 to 114.1 ± 6.9 μg cm^-2. Reduced protein adsorption, especially targeted anti-FXa effect, inhibited the activation of intrinsic, extrinsic, and common coagulation pathways, as evidenced by significant prolongations of activated partial thromboplastin time, prothrombin time, and thrombin time by 145.04, 46.84 and 11.46 s, respectively. Furthermore, we determined the FXa concentration of each group, and found that the modified membrane had better anticoagulant performance through the inhibition of FXa. Favorable antiplatelet activity was also demonstrated. Thromboelastogram was used to comprehensively evaluate the anticoagulant and antithrombotic activities of the modified membrane. The R value was increased by 43.1 min, while the reduction in α angle was 42.5°. The coagulation comprehensive index reduction was 34.3. In addition, C3a and C5a were decreased by 15.3 % and 30.4 %, respectively. Furthermore, in vitro cytotoxicity and erythrocyte stability testing as well as in vivo murine experiments demonstrated the biosafety of the modified membrane. These results indicate that the AMPES dialysis membrane has an excellent potential for clinical applications.

Functionalized Hemodialysis Polysulfone Membranes with Improved Hemocompatibility

The field of membrane materials is one of the most dynamic due to the continuously changing requirements regarding the selectivity and the upgradation of the materials developed with the constantly changing needs. Two membrane processes are essential at present, not for development, but for everyday life-desalination and hemodialysis. Hemodialysis has preserved life and increased life expectancy over the past 60-70 years for tens of millions of people with chronic kidney dysfunction. In addition to the challenges related to the efficiency and separative properties of the membranes, the biggest challenge remained and still remains the assurance of hemocompatibility-not affecting the blood during its recirculation outside the body for 4 h once every two days. This review presents the latest research carried out in the field of functionalization of polysulfone membranes (the most used polymer in the preparation of membranes for hemodialysis) with the purpose of increasing the hemocompatibility and efficiency of the separation process itself with a decreasing impact on the body.

Recent trends in therapeutic application of engineered blood purification materials for kidney disease

Blood purification is a commonly used method to remove excess metabolic waste in the blood in renal replacement therapy. The sufficient removal of these toxins from blood can reduce complications and improve survival lifetime in dialysis patients. However, the current biological blood purification materials in clinical practice are not ideal, where there is an unmet need for producing novel materials that have better biocompatibility, reduced toxicity, and, in particular, more efficient toxin clearance rates and a lower cost of production. Given this, this review has carefully summarized newly developed engineered different structural biomedical materials for blood purification in terms of types and structure characteristics of blood purification materials, the production process, as well as interfacial chemical adsorption properties or mechanisms. This study may provide a valuable reference for fabricating a user-friendly purification device that is more suitable for clinical blood purification applications in dialysis patients.

Fouling Prevention in Polymeric Membranes by Radiation Induced Graft Copolymerization

The application of membrane processes in various fields has now undergone accelerated developments, despite the presence of some hurdles impacting the process efficiency. Fouling is arguably the main hindrance for a wider implementation of polymeric membranes, particularly in pressure-driven membrane processes, causing higher costs of energy, operation, and maintenance. Radiation induced graft copolymerization (RIGC) is a powerful versatile technique for covalently imparting selected chemical functionalities to membranes' surfaces, providing a potential solution to fouling problems. This article aims to systematically review the progress in modifications of polymeric membranes by RIGC of polar monomers onto membranes using various low- and high-energy radiation sources (UV, plasma, γ-rays, and electron beam) for fouling prevention. The feasibility of the modification method with respect to physico-chemical and antifouling properties of the membrane is discussed. Furthermore, the major challenges to the modified membranes in terms of sustainability are outlined and the future research directions are also highlighted. It is expected that this review would attract the attention of membrane developers, users, researchers, and scientists to appreciate the merits of using RIGC for modifying polymeric membranes to mitigate the fouling issue, increase membrane lifespan, and enhance the membrane system efficiency.

A Review of Commercial Developments and Recent Laboratory Research of Dialyzers and Membranes for Hemodialysis Application

Dialyzers have been commercially used for hemodialysis application since the 1950s, but progress in improving their efficiencies has never stopped over the decades. This article aims to provide an up-to-date review on the commercial developments and recent laboratory research of dialyzers for hemodialysis application and to discuss the technical aspects of dialyzer development, including hollow fiber membrane materials, dialyzer design, sterilization processes and flow simulation. The technical challenges of dialyzers are also highlighted in this review, which discusses the research areas that need to be prioritized to further improve the properties of dialyzers, such as flux, biocompatibility, flow distribution and urea clearance rate. We hope this review article can provide insights to researchers in developing/designing an ideal dialyzer that can bring the best hemodialysis treatment outcomes to kidney disease patients.