Application of plasma surface modification techniques to improve hemocompatibility of vascular grafts: A review

Thrombogenicity assessment of perfusable tissue engineered constructs: a systematic review

Vascular surgery faces a critical demand for novel vascular grafts that are biocompatible and thromboresistant. This urgency particularly applies to bypass operations involving small caliber vessels. In the realm of tissue engineering, the development of fully vascularized organs holds great promise as a solution to organ shortage for transplantation. To achieve this, it is imperative to (re-)construct a biocompatible and non-thrombogenic vascular network within these organs. In this systematic review, we identify, classify and discuss basic principles and methods used to perform in vitro/ex vivo dynamic thrombogenicity testing of perfusable tissue engineered organs and tissues. We conducted a pre-registered systematic review of studies published in the last 23 years according to PRISMA-P Guidelines, comprising a systematic data extraction, in-depth analysis and risk of bias assessment of 116 included studies. We identified shaking (n=28), flow loop (n=17), ex vivo (arterio-venous shunt, n=33) and dynamic in vitro models (n=38) as main approaches for thrombogenicity assessment. This comprehensive review unveils a prevalent lack of standardization and serves as a valuable guide in the design of standardized experimental setups.

Blood compatibility and cell response improvement of poly glycerol sebacate/poly lactic acid scaffold for vascular graft applications

Plasma surface modification is one of the new methods for improving the surface properties of the scaffold and accelerating tissue regeneration. The aim of this study was to create poly glycerol sebacate/poly lactic acid (PGS/PLA) composite scaffold by electrospun method and modified the scaffold by oxygen plasma for use as a vascular graft. Plasma surface modified PGS/PLA scaffold morphology study showed relatively uniform fibers with an average diameter of 637 ± 149.4 nm and porosity of 82%. The mechanical evaluation of the PGS/PLA scaffold showed properties close to the natural vessels. Atomic force microscopy images exhibited an increase in the roughness of the scaffold after plasma surface modification; however, hemocompatibility studies revealed that it had no adverse effect on blood compatibility. Wettability studies revealed the superhydrophilic property of the modified scaffold (contact angle near to zero). Besides, the human umbilical vein endothelial cells proliferation and adhesion were improved significantly. Obtaining mechanical properties near to the natural vessels due to the suitable composition and significant improvement in blood compatibility and cell growth make the modified PGS/PLA composite a suitable candidate for vascular tissue regeneration.

Direct photoreactive immobilization of water-soluble phospholipid polymers on substrates in an aqueous environment

The purpose of this study is to achieve a simpler and safer surface modification of substrates using a photoreactive polymer in an aqueous environment. We synthesized water-soluble photoreactive polymers with both phenylazide groups and phosphorylcholine groups, poly(2-methacryloyloxyethyl phosphorylcholine-co-4-methacryl tetra(ethylene glycol)oxycarbonyl-4-phenylazide) (PMEPAz), via reversible addition fragmentation chain transfer polymerization. PMEPAz with different polymerization degrees were synthesized with a well-defined structure. To immobilize PMEPAz on the substrate surface by photoreaction, it is necessary to adsorb the polymer on the substrate surface in an aqueous solution because the phenylazide groups chemically bind to the substrate via a hydrogen abstract reaction. The relationship between the polymer solubilization state in the aqueous solution and the adsorption behavior at the surface was investigated. PMEPAz began to form unstable molecular aggregates at a concentration of 10^-2 mg/mL and formed stable aggregates at 10⁰ mg/mL. At a concentration of 10^-1 mg/mL, unstable molecular aggregates of PMEPAz were formed in the aqueous solution, resulting in the maximization of the amount of adsorbed polymer and effective photoreaction with the substrate. The thickness of the reacted polymer layer on the substrate increased with an increase in the polymerization degree, a uniform polymer layer with a thickness of 3.4 nm was formed when the polymerization degree was 400. After surface modification, the hydrophobic surfaces of the original substrates became hydrophilic. Additionally, fibrinogen adsorption and platelet adhesion were effectively suppressed based on the characteristics of the phosphorylcholine unit.

Behaviour of Vascular Smooth Muscle Cells on Amine Plasma-Coated Materials with Various Chemical Structures and Morphologies

Amine-coated biodegradable materials based on synthetic polymers have a great potential for tissue remodeling and regeneration because of their excellent processability and bioactivity. In the present study, we have investigated the influence of various chemical compositions of amine plasma polymer (PP) coatings and the influence of the substrate morphology, represented by polystyrene culture dishes and polycaprolactone nanofibers (PCL NFs), on the behavior of vascular smooth muscle cells (VSMCs). Although all amine-PP coatings improved the initial adhesion of VSMCs, 7-day long cultivation revealed a clear preference for the coating containing about 15 at.% of nitrogen (CPA-33). The CPA-33 coating demonstrated the ideal combination of good water stability, a sufficient amine group content, and favorable surface wettability and morphology. The nanostructured morphology of amine-PP-coated PCL NFs successfully slowed the proliferation rate of VSMCs, which is essential in preventing restenosis of vascular replacements in vivo. At the same time, CPA-33-coated PCL NFs supported the continuous proliferation of VSMCs during 7-day long cultivation, with no significant increase in cytokine secretion by RAW 264.7 macrophages. The CPA-33 coating deposited on biodegradable PCL NFs therefore seems to be a promising material for manufacturing small-diameter vascular grafts, which are still lacking on the current market.

Effect of TiO2 Nanotube Pore Diameter on Human Mesenchymal Stem Cells and Human Osteoblasts

The pore diameter of uniformly structured nanotubes can significantly change the behaviour of cells. Recent studies demonstrated that the activation of integrins is affected not by only the surface chemistry between the cell-material interfaces, but also by the features of surface nanotopography, including nanotube diameter. While research has been carried out in this area, there has yet to be a single systemic study to date that succinctly compares the response of both human stem cells and osteoblasts to a range of TiO₂ nanotube pore diameters using controlled experiments in a single laboratory. In this paper, we investigate the influence of surface nanotopography on cellular behaviour and osseointegrative properties through a systemic study involving human mesenchymal stem cells (hMSCs) and human osteoblasts (HOBs) on TiO₂ nanotubes of 20 nm, 50 nm and 100 nm pore diameters using in-vitro assessments. This detailed study demonstrates the interrelationship between cellular behaviour and nanotopography, revealing that a 20 nm nanotube pore diameter is preferred by hMSCs for the induction of osteogenic differentiation, while 50 nm nanotubular structures are favourable by HOBs for osteoblastic maturation.

Atmospheric pressure cold plasma versus wet-chemical surface treatments for carboxyl functionalization of polylactic acid: A first step toward covalent immobilization of bioactive molecules

The use of polylactic acid (PLA) has attracted growing interest, particularly in recent years, for biomedical applications because of its mechanical properties, biocompatibility, and biodegradability. Despite this, features such as surface hydrophobicity and the absence of suitable functional groups for covalent immobilization of bioactive molecules, make it challenging to endow PLA-based medical devices with additional features and thus broaden their range of applicability. In the present study, we demonstrate the suitability of atmospheric pressure dielectric barrier discharges operating in the Townsend regime as a promising alternative to other surface treatments, such as diazonium and alkali hydrolytic treatments, for carboxyl functionalization of PLA. Chemical changes in PLA surfaces are evaluated by contact angle measurements and by X-ray photoelectron spectroscopy while physical changes are investigated by scanning electron microscopy and atomic force microscopy. The amount of carboxyl groups generated on PLA surfaces is assessed by toluidine blue O assay and substantiated by grafting, through carboxyl groups, a fluorescent probe containing amino functionalities. All of the surface treatments have proven to be very effective in generating carboxylic groups on the PLA surface. Nevertheless, plasma treatment is shown to not degrade the PLA surface, in sharp contrast with diazonium and alkali hydrolytic treatments.

Plasma Treatment of Poly(ethylene terephthalate) Films and Chitosan Deposition: DC- vs. AC-Discharge

Plasma treatment is one of the most promising tools to control surface properties of materials tailored for biomedical application. Among a variety of processing conditions, such as the nature of the working gas and time of treatment, discharge type is rarely studied, because it is mainly fixed by equipment used. This study aimed to investigate the effect of discharge type (direct vs. alternated current) using air as the working gas on plasma treatment of poly(ethylene terephthalate) films, in terms of their surface chemical structure, morphology and properties using X-ray photoelectron spectroscopy, scanning electron microscopy, atomic force microscopy and contact angle measurements. The effect of the observed changes in terms of subsequent chitosan immobilization on plasma-treated films was also evaluated. The ability of native, plasma-treated and chitosan-coated films to support adhesion and growth of mesenchymal stem cells was studied to determine the practicability of this approach for the biomedical application of poly(ethylene terephthalate) films.

Hemocompatibility of Super-Repellent surfaces: Current and Future

Virtually all blood-contacting medical implants and devices initiate immunological events in the form of thrombosis and inflammation. Typically, patients receiving such implants are also given large doses of anticoagulants, which pose a high risk and a high cost to the patient. Thus, the design and development of surfaces with improved hemocompatibility and reduced dependence on anticoagulation treatments is paramount for the success of blood-contacting medical implants and devices. In the past decade, the hemocompatibility of super-repellent surfaces (i.e., surfaces that are extremely repellent to liquids) has been extensively investigated because such surfaces greatly reduce the blood-material contact area, which in turn reduces the area available for protein adsorption and blood cell or platelet adhesion, thereby offering the potential for improved hemocompatibility. In this review, we critically examine the progress made in characterizing the hemocompatibility of super-repellent surfaces, identify the unresolved challenges and highlight the opportunities for future research on developing medical implants and devices with super-repellent surfaces.

Argon plasma modified nanocomposite polyurethane scaffolds provide an alternative strategy for cartilage tissue engineering

Background

Children born with a small or absent ear undergo surgical reconstruction to create a suitable replacement using rib cartilage. To overcome the donor site morbidity and long-term pain of harvesting rib cartilage, synthetic materials can be a useful alternative. Medpor, is the currently used synthetic polyethylene material to replace missing facial cartilage but unfortunately it has high levels of surgical complications including infection and extrusion, making it an unsuitable replacement. New materials for facial cartilage reconstruction are required to improve the outcomes of surgical reconstruction. This study has developed a new nanomaterial with argon surface modification for auricular cartilage replacement to overcome the complications with Medpor.

Results

Polyurethanes nanocomposites scaffolds (PU) were modified with argon plasma surface modification (Ar) and compared to Medpor in vitro and in vivo. Ar scaffolds allowed for greater protein adsorption than Medpor and PU after 48 h (p < 0.05). Cell viability and DNA assays demonstrated over 14-days greater human dermal fibroblast adhesion and cell growth on Ar than PU and Medpor nanocomposites scaffolds (p < 0.05). Gene expression using RT-qPCR of collagen-I, fibronectin, elastin, and laminin was upregulated on Ar scaffolds compared to Medpor and PU after 14-days (p < 0.05). Medpor, unmodified polyurethane and plasma modified polyurethane scaffolds were subcutaneously implanted in the dorsum of mice for 12 weeks to assess tissue integration and angiogenesis. Subcutaneous implantation of Ar scaffolds in mice dorsum, demonstrated significantly greater tissue integration by H&E and Massons trichrome staining, as well as angiogenesis by CD31 vessel immunohistochemistry staining over 12-weeks (p < 0.05).

Conclusions

Argon modified polyurethane nanocomposite scaffolds support cell attachment and growth, tissue integration and angiogenesis and are a promising alternative for facial cartilage replacement. This study demonstrates polyurethane nanocomposite scaffolds with argon surface modification are a promising biomaterial for cartilage tissue engineering applications.

Electronic supplementary material

The online version of this article (10.1186/s12951-019-0477-z) contains supplementary material, which is available to authorized users.

Surface engineering of titanium-based implants using electrospraying and dip coating methods

Titanium and its alloys due to their low density, good mechanical and biological properties are of the most common orthopedic metals. One of the main challenges regarding to titanium implants is their loosening after long term implantation in patient's body. Many methods such as alteration in surface topography with focus on improving osseointegration or biocompatibility in overall are supposed to overcome this issue. In this research, titanium surface topography is altered via electrospraying a solution of titanium salt, carrier polymer (polyvinylpyrrolidone) and solvents. The dip coated samples in the same solution are prepared and investigated as control. The electrosprayed or dip coated samples were pyrolysised in furnace at 500 °C to remove polymeric components. Then the stabilized microstructures on the surfaces were evaluated via scanning electron microscopy (SEM), water contact angle (WCA) measurement, X-ray diffraction (XRD) and atomic force microscope (AFM). Also, in order to study the bioactivity of modified samples, they were immersed in simulated body fluid (SBF) and their precipitates were studied. The cellular investigations were done by studying the cell morphology, MTT and alkaline phosphatase (ALP) activity assays. The results showed improvement in bioactivity and cellular response for DP3 and SP15 more than other samples implying the promising potential of these two approaches for titanium implant surface modification.

Polyurethane synthesis for vascular application

Abstract

Three polyurethane formulations were prepared on the basis of siloxane; two formulations contained 1% and 3% of a hydroxyl functionalized polyhedral oligomeric silsesquioxane [POSS (ROH)₂] nano-particles (as a co-chain extender) and one was without nano-particle. Structures of the polyurethanes were characterized by FTIR and SEM. The effect of POSS nano-particles on properties of the synthesized PUs was examined for vascular applications by tensile test, contact angle, SEM, AFM and endothelial cells viability evaluation. Properties of the polyurethane with 1% POSS were compared with those of PU without POSS and the results showed 66% increase in the elongation-at-break, 53% increase in tensile strength and 33% increase in modulus, 9.45% increase in contact angle, 76.7% reduction in surface roughness and 9.46% increase in cell viability. It was also shown that a polyurethane containing 1% of POSS nano-particles in its structure developed the highest hydrophobicity, which resulted in its lowest potential for thrombosis.

Graphical Abstract

Surface functionalization of polytetrafluoroethylene substrate with hybrid processes comprising plasma treatment and chemical reactions

Polytetrafluoroethylene (PTFE) exhibits excellent mechanical properties and chemical stability and has been widely used in medical fields for the preparation of implantable medical devices. However, the implantation of PTFE in living systems results in inflammation reactions and infections at the surface thus limits its long-term applications. For PTFE surface modification, we examined the effects of mussel-inspired polydopamine (PDA) coating and the further introduction of functional groups. During PDA coating, the plasma pretreatment on PTFE enhanced the stability of the PDA coating layer. Furthermore, the introduction of functional groups on the PDA layer was carried out using reactive functional groups for the photoinduced graft polymerization of methacrylate. For instance, 2-methacryloyloxyethyl phosphorylcholine (MPC) could be polymerized from the surface of the substrate. These chemical modifications were confirmed step by step using spectroscopes to obtain the hydrophilic surface of the poly(MPC)-modified PTFE. The protein adsorption behaviors on PTFE and poly(MPC)-modified PTFE were compared to understand biocompatibility characteristics of these substrates. The surface of PTFE was immediately covered with albumin and the contact between the substrate and the serum resulted in an increase in the fibrinogen composition with time. On the other hand, fewer proteins were adsorbed on the poly(MPC)-modified PTFE substrate. Thus, this modification procedure would serve as a strategy for safer alterations in PTFE surfaces to expand the life span of the PTFE-carrying medical devices in living systems.

Oxygen-plasma treatment-induced surface engineering of biomimetic polyurethane nanofibrous scaffolds for gelatin-heparin immobilization

Polyurethane (PU) has been extensively used in vascular tissue engineering due to its outstanding mechanical performance and blood compatibility behavior. Here, biomimetic PU-based scaffolds were prepared using an electrospinning technique and gelatin-heparin was introduced as a surface modifier after oxygen plasma treatment to improve cell attachment and release an anticoagulation agent. Morphology, Fourier transform infrared (FTIR) spectroscopy, compression strength, swelling and biodegradation ratio, drug release level and cellular interactions were evaluated. According to the scanning electron microscopy (SEM) micrographs, gelatin-heparin immobilized PU nanofibers exhibited a smooth surface and a bead free structure that nanofibers distributed in the range of 300–1000 nm. The mechanical strength of constructs, swelling and biodegradation ratio, and drug release level illustrated higher values for oxygen plasma-treated samples compared with bilayered scaffolds. Cellular adhesion and biocompatibility ameliorated after plasma treatment. All the mentioned findings indicated the initial physicomechanical and biological potential of biomimetic PU-based fibers in the improvements of vascular scaffolds.

Bi-layered electrospun nanofibrous polyurethane-gelatin scaffold with targeted heparin release profiles for tissue engineering applications

Tissue engineering is a biotechnology that is used to develop biological substitutes to restore, maintain, or improve functions. Thus, the porous scaffolds are used to accommodate cells in tissue engineering. In this research, three dimensional (3D) bi-layered polyurethane (PU)-gelatin nanofibrous scaffolds were prepared by the electrospinning method, after which the capability of the released heparin as an anti-coagulation factor was evaluated. Electrospinning has been extensively investigated for the preparation of fibers that exhibit a high surface area to volume ratio. Results showed that scanning electron microscopy (SEM) micrographs exhibited a smooth surface as well as a highly porous and bead-free structure, in which fibers were distributed in the range of 100–600 nm. The modulus and ultimate tensile strength (UTS) decreased and increased, respectively, after crosslinking the reaction of polymers. This process also reduced swelling ratio, the hydrolytic biodegradation rate, and the release rate as a function of time. Moreover, an in vitro assay demonstrated that 3D nanofibrous scaffolds supported L929 fibroblast cell viability and that cells adhered and spread on the fibers. Based on the obtained results, the heparin-loaded electrospinning nanofibrous scaffolds have initial physicochemical and mechanical properties to protect neo-tissue formation.

Hemocompatibility of hyaluronan enhanced linear low density polyethylene for blood contacting applications

Despite their overall success, different blood-contacting medical devices such as heart valves, stents, and so forth, are still plagued with hemocompatibility issues which often result in the need for subsequent replacement and/or life-long anticoagulation therapy. Consequently, there is a significant interest in developing biomaterials that can address these issues. Polymeric-based materials have been proposed for use in many applications due to their ability to be finely tuned through manufacturing and surface modification to enhance hemocompatibility. In this study, we have developed a novel, hydrophilic biomaterial comprised of an interpenetrating polymer network (IPN) of hyaluronan (HA) and linear low density polyethylene (LLDPE). HA is a highly lubricous, anionic polysaccharide ubiquitously found in the human body. It is currently being investigated for a vast array of biomedical applications including cardiovascular therapies such as hydrogel-based regenerative cell therapies for myocardial infarction, HA-coated stents, and surface modifications of polyurethane and metals for use in blood-contacting implants. The aim of this study was to assess the in vitro thrombogenic response of the hydrophilic polymer surface, HA-LLDPE for future potential use as flexible heart valve leaflets. The results indicate that HA-LLDPE is non-toxic and reduces thromobogenicity as compared to LLDPE surfaces, asserting its feasibility for use as a blood-contacting biomaterial. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1964-1975, 2018.

In vitro screening procedure for characterization of thrombogenic properties of plasma treated surfaces

Estimation of thrombogenic surface properties is an important aspect of hemocompatibility studies. To improve our understanding of interaction between blood and biomaterial surfaces, there is a need to employ standardized methods that are both effective and efficient. This contribution details a systematic approach for the in vitro analysis of plasma modified polymer surfaces and human blood platelet interaction, following the recently introduced ISO 10933-4 guidelines. A holistic multistep process is presented that considers all aspects of testing procedure, including blood collection, platelet function testing, and incubation parameters, right through to a comparison and evaluation of the different methods and analysis available. In terms of detection and analysis, confocal light microscopy is shown to offer many advantages over the widely used scanning electron microscopy technique; this includes simpler, less-invasive sample preparation, and less time-consuming analysis procedure. On the other hand, as an alternative to microscopy techniques, toxicology sulforhodamine B based assay (TOX assay) was also evaluated. It has been shown that the assay could be used for rapid estimation of relative concentration of blood platelets on the surface of plasma treated materials, especially when samples do not allow the implementation of microscopy techniques.

Hemocompatibility and oxygenation performance of polysulfone membranes grafted with polyethylene glycol and heparin by plasma-induced surface modification

Polyethylene glycol (PEG) and heparin (Hep) were grafted onto polysulfone (PSF) membrane by plasma-induced surface modification to prepare PSF-PEG-Hep membranes used for artificial lung. The effects of plasma treatment parameters, including power, gas type, gas flow rate, and treatment time, were investigated, and different PEG chains were bonded covalently onto the surface in the postplasma grafting process. Membrane surfaces were characterized by water contact angle, PEG grafting degree, attenuated total reflectance-Fourier transform infrared spectroscopy, ultraviolet-visible spectrophotometry, X-ray photoelectron spectroscopy, critical water permeability pressure, and scanning electron microscopy. Protein adsorption, platelet adhesion, and coagulation tests showed significant improvement in the hemocompatibility of PSF-PEG-Hep membranes compared to pristine PSF membrane. Gas exchange tests through PSF-PEG6000-Hep membrane showed that when the flow rate of porcine blood reached 5.0 L/min, the permeation fluxes of O₂ and CO₂ reached 192.6 and 166.9 mL/min, respectively, which were close to the gas exchange capacity of a commercial membrane oxygenator. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1737-1746, 2017.

Influence of non-thermal TiCl4/Ar+O2 plasma-assisted TiOx based coatings on the surface of polypropylene (PP) films for the tailoring of surface properties and cytocompatibility

The superior bulk properties (corrosion resistance, high strength to weight ratio, relatively low cost and easy processing) of hydrocarbon based polymers such as polypropylene (PP) have contributed significantly to the development of new biomedical applications such as artificial organs and cell scaffolds. However, low cell affinity is one of the main draw backs for PP due to its poor surface properties. In tissue engineering, physico-chemical surface properties such as hydrophilicity, polar functional groups, surface charge and morphology play a crucial role to enrich the cell proliferation and adhesion. In this present investigation TiOx based biocompatible coatings were developed on the surface of PP films via DC excited glow discharge plasma, using TiCl4/Ar+O2 gas mixture as a precursor. Various TiOx-based coatings are deposited on the surface of PP films as a function of discharge power. The changes in hydrophilicity of the TiOx/PP film surfaces were studied using contact angle analysis and surface energy calculations by Fowke's approximation. X-ray photo-electron spectroscopy (XPS) was used to investigate the surface chemical composition of TiOx/PP films. The surface morphology of the obtained TiOx/PP films was investigated by scanning electron and transmission electron microscopy (SEM &TEM). Moreover, the surface topography of the material was analyzed by atomic force microscopy (AFM). The cytocompatibility of the TiOx/PP films was investigated via in vitro analysis (cell viability, adhesion and cytotoxicity) using NIH3T3 (mouse embryonic fibroblast) cells. Furthermore the antibacterial activities of TiOx/PP films were also evaluated against two distinct bacterial models namely Gram positive Staphylococcus aureus (S.aureus) and Gram negative Escherichia coli DH5α. (E.coli) bacteria. XPS results clearly indicate the successful incorporation of TiOx and oxygen containing polar functional groups on the surface of plasma treated PP films. Moreover the surface of modified PP films exhibited nano structured morphology, as confirmed by SEM, TEM and AFM. The physico-chemical changes have improved the hydrophilicity of the PP films. The in-vitro analysis clearly confirms that the TiOx coated PP films performs as good as the standard tissue culture plates and also are unlikely to impact the bacterial cell viability.

Biomimetic modified clinical-grade POSS-PCU nanocomposite polymer for bypass graft applications: a preliminary assessment of endothelial cell adhesion and haemocompatibility

BACKGROUND

To date, there are no small internal diameter (<5mm) vascular grafts that are FDA approved for clinical use due to high failure rates from thrombosis and unwanted cell proliferation. The ideal conditions to enhance bioengineered grafts would be the blood contacting lumen of the bypass graft fully covered by endothelial cells (ECs). As a strategy towards this aim, we hypothesized that by immobilising biomolecules on the surface of the polyhedral oligomeric silsesquioxane-poly(carbonate-urea)urethane (POSS-PCU) nanocomposite polymers, which contain binding sites and ligands for cell surface receptors similar to extracellular matrix (ECM) will positively influence the attachment and proliferation of ECs. Since, the surface of POSS-PCU is inert and not directly suitable for immobilisation of biomolecules, plasma graft polymerisation is a suitable method to modify the surface properties ready for immobilisation and biofunctionalisation.

METHODS

POSS-PCU was activated by plasma treatment in air/O2 to from hydroperoxides (-OH, -OOH), and then carboxylated via plasma polymerisation of a 30% acrylic acid solution (Poly-AA) using a two-step plasma treatment (TSPT) process. Collagen type I, a major component of ECM, was covalently immobilised to mimic the ECM structures to ECs (5mg/ml) using a two-step chemical reaction using EDC chemistry. Successful immobilisation of poly-AA and collagen on to the nanocomposites was confirmed using Toluidine Blue staining and the Bradford assay. Un-treated POSS-PCU served as a simple control. The impact of collagen grafting on the physical, mechanical and biological properties of POSS-PCU was evaluated via contact angle (θ) measurements, scanning electron microscopy (SEM), atomic force microscopy (AFM), dynamic mechanical thermal analysis (DMTA), ECs adhesion and proliferation followed by platelet adhesion and haemolysis ratio (HR) tests.

RESULTS

Poly-AA content on each of the plasma treated nanocomposite films increased on Low, Med and High samples due to more carboxylic acid (-COOH) groups at the surface forming amide (-NH2) bonds. The amount of -COOH groups on each of the Low, Med and High nanocomposites correlated with Poly-AA grafting density at 14.7±0.9, 18.9±0.9, and 34.2±2.4 μg/cm(2). Immobilisation of collagen type I on to nanocomposite surface was also found to increase significantly on the Low, Med and High samples from 22±4, 150±15, and 219±17 μg/cm(2), respectively. The level of ECs and their adhesion efficiency were improved with increasing amounts of grafted collagen I. The maximum adhesion of ECs was found on the highest collagen type I coated nanocomposites. Platelet adhesion and activation also increased with increasing collagen density. The obtained HR values for all of the treated samples were well within the acceptable standards for biomaterials (<5% HR).

CONCLUSION

Poly-AA-g-POSS-PCU surfaces offer binding sites for the covalent bonding of collagen type I and other biomolecules such as fibronectin by exposure of RGD cell binding domains and growth factors using EDC cross-linking chemistry. Collagen type I modification can yield accelerated EC growth and enhance the endothelialisation of POSS-PCU nanocomposites, and the amount of immobilised collagen can control the level of platelet adhesion on functionalized POSS-PCU via TSPT and poly acrylic acid (poly-AA) treatment. Such surface modification procedures of polymeric surfaces can improve the patency rate of POSS-PCU nanocomposites as vascular bypass grafts in the preparation of a range of medical devices ready for pre-clinical and in vivo evaluation.

Improved in vitro blood compatibility of polycaprolactone nanowire surfaces

There are a multitude of polymeric materials currently utilized to prepare a variety of blood-contacting implantable medical devices. These devices include tissue grafts, coronary artery and vascular stents, and orthopedic implants. The thrombogenic nature of such materials can cause serious complications in patients, and ultimately lead to functional failure. To date, there is no truly hemocompatible biomaterial surface. Nanostructured surfaces improve cellular interactions but there is a limited amount of information regarding their blood compatibility. In this study, the in vitro blood compatibility of four different surfaces (control, PCL; nanowire, NW; collagen immobilized control, cPCL; collagen immobilized nanowire, cNW) were investigated for their use as interfaces for blood-contacting implants. The results presented here indicate enhanced in vitro blood compatibility of nanowire surfaces compared control surfaces. Although there were no significant differences in leukocyte adhesion, there was a decrease in platelet adhesion on NW surfaces. Scanning electron microscopy images showed a decrease in platelet/leukocyte complexes on cNW surfaces and no apparent complexes were formed on NW surfaces compared to PCL and cPCL surfaces. The increase in these complexes likely contributed to a higher expression of specific markers for platelet and leukocyte activation on PCL and cPCL surfaces. No significant differences were found in contact and complement activation on any surface. Further, thrombin antithrombin complexes were significantly reduced on NW surfaces. A significant increase in hemolysis and fibrinogen adsorption was identified on PCL surfaces likely caused by its hydrophobic surface. This work shows the improved blood-compatibility of nanostructured surfaces, identifying this specific nanoarchitecture as a potential interface for promoting the long-term success of blood-contacting biomaterials.

Strategies and techniques to enhance the in situ endothelialization of small-diameter biodegradable polymeric vascular grafts

Due to the lack of success in small-diameter (<6 mm) prosthetic vascular grafts, a variety of strategies have evolved utilizing a tissue-engineering approach. Much of this work has focused on enhancing the endothelialization of these grafts. A healthy, confluent endothelial layer provides dynamic control over homeo-stasis, influencing and preventing thrombosis and smooth muscle cell proliferation that can lead to intimal hyperplasia. Strategies to improve endothelialization of biodegradable polymeric grafts have encompassed both chemical and physical modifications to graft surfaces, many focusing on the recruitment of endothelial and endothelial progenitor cells. This review aims to provide a compilation of current and developing strategies that utilize in situ endothelialization to improve vascular graft outcomes, providing a context for the future directions of vascular tissue-engineering strategies that do not require preprocedural cell seeding.

Polystyrene surface modification using excimer laser and radio-frequency plasma: blood compatibility evaluations

Biomaterial surface modification is an efficient method to improve and control blood component-material interactions. In the present study, two different methods (ArF excimer laser irradiation and radio-frequency (RF) plasma treatment) were applied in separate procedures to create a vast range of physicochemical characteristics on the surface of polystyrene (PS) and investigate their effects on blood compatibility of treated surfaces. Atomic force microscopy (AFM) and Fourier transmission infrared analysis were applied to study the morphology and chemical characteristics of treated samples in comparison with those of the untreated PS. Contact angle and surface tension measurements with two different solvents were used to evaluate the wettability and surface energy of the treated PS films. The effect of the physicochemical properties of the PS surface on blood compatibility was investigated using lactate dehydrogenase (LDH) method. AFM studies showed that after laser treatment, some distinctive nanostructures are created on the surface of PS. The data from contact angle measurements demonstrated that ArF excimer laser irradiation and RF plasma treatment created surfaces with a vast range of properties in the wettability point of view. The LDH results revealed that after surface modification by laser irradiation and plasma treatment, blood compatibility of PS films was enhanced. In addition, these results offered that the most blood compatible samples were those which irradiated with 5 pulses of laser and the one treated 4 minutes in oxygen plasma.