Inhibition of surface induced coagulation by preadsorption of albumin-heparin conjugates

Investigation of the Sorption Capacity of Polyvinylpyrrolidone Copolymers As the Basis of Hydrogel Cosmetic Masks with Plant Biomass Extracts

The possibility of using hydrogels based on copolymers of polyvinylpyrrolidone with 2 hydroxyethylmethacrylate to saturate them with plant extracts was established. Hydrogel materials were obtained with extracts of Calendula officinalis and Arnica montana. The sorption capacity of the hydrogels regarding the extract data was determined. The bactericidal and fungicidal activity of the obtained hydrogel materials with extracts of Calendula officinalis and Arnica montana on bacterial strains of Escherichia coli, Staphylococcus aureus and fungal strains of Candida tenuis, Aspergilus niger were investigated.

Sung Wan Kim - Early events in blood/material interactions

Sung Wan Kim's initial efforts as an independent investigator were focused on improving the understanding of the early events in blood/material interactions with the goal to develop blood compatible materials for application in medical devices and prostheses. These initial efforts were centered around blood protein adsorption on biomaterials and related mechanisms of thrombus formation (thrombosis). Ultimately, Sung Wan's efforts were expanded to studies of the non-thrombogenic nature of heparinized biomaterials, prostaglandin biomaterials, and block copolymer systems. These studies were supported by two NIH grants for 22 and 19 years, respectively, and a NIH Career Development Award. Moreover, these studies resulted in over 140 peer-reviewed publications and training of many students and postdoctoral scientists. The intent of this paper is to identify key concepts, papers, and contributions by Sung Wan and his colleagues that fall within the four aforementioned research categories. In this context, many of Sung Wan's early efforts contributed directly to Utah's biomaterials efforts and the Total Artificial Heart program at the time, while providing the foundation for the productive international Triangle Collaboration as well as his following work in polymer-controlled drug releasing systems.

Polymeric Systems Based on Derivatives of Ethylene-Vinyl Alcohol Copolyiners

To obtain polymers with improved hemocompatibility properties, commercial ethylene-vinyl alcohol copolymers (EVAL) were chemically modified, by the introduction of stearoyl groups to bind albumin and quaternary ammonium groups to bind heparin. These novel polymer composites were characterized by FT-IR and 1H-NMR spectroscopy. The amount of heparin and albumin bonded by these polymers were determined and the influence of the adsorption sequence (heparin+albumin or vice versa) was evaluated. The amount of adsorbed albumin was proportional to the stearoyl content of the polymer. When heparin was exposed to polymer surfaces containing quaternary ammonium groups, the amount of bonded heparin was proportional to the content of positively charged groups. An in vitro evaluation of the anti-clotting properties and of the adhesion characteristics of the polymer surfaces containing both stearoyl groups and quaternary ammonium groups exhibited, after heparinization, good anticoagulant activity. This activity was retained after the albuminization. Platelet adhesion tests showed that albuminization of polymer films containing only stearoyl residues improved their behavior towards platelet adhesion.

Peptide-based SAMs that resist the adsorption of proteins

In this paper we present a modular approach for the fabrication of surfaces to characterize protein-protein interactions. The approach is based on azido peptides with an optimized sequence which are then thiol-functionalized using an alkynyl thiol and "click" chemistry. From these peptide thiols we fabricated SAMs on gold to evaluate the protein resistance, using surface plasmon resonance spectroscopy, toward streptavidin, bovin serum albumin (BSA), and fibronectin.

Importance of a biofouling-resistant phospholipid polymer to create a heparinized blood-compatible surface

Heparinization is believed to be one of the methods to suppress thrombus formation on blood-contacting surfaces. However, this study hypothesizes that heparinization alone might not be sufficient to provide a blood-compatible surface; that is, a surface property that resists biofouling is necessary to obtain an effective heparin-modified surface. 2-Methacryloyloxyethyl phosphorylcholine (MPC) polymers with 2-aminoethyl methacrylate (AEMA) were synthesized to immobilize heparin through ionic bonding. The primary amino groups of AEMA were considered to be the polymer surface because the zeta-potential of the surface was positive when the mole fraction of the AEMA units was above 0.2. The antithrombogenic character of the polymer surface modified with heparin was evaluated by both Lee-White and microsphere column methods. The coagulation period of human whole blood in the absence of anticoagulant in glass tubing coated with the MPC polymer was longer than that in the original glass tube. Cell adhesion was completely inhibited on the MPC polymer surface after contact with human whole blood without anticoagulant. However, many adherent blood cells were observed on poly(2-ethylhexyl methacrylate-co-AEMA) (no MPC unit) even after heparinization. These results strongly indicate that the MPC polymer is a useful substrate where the heparin works well and that the heparin-immobilized MPC polymer has superior blood compatibility to the simple MPC polymer.

Interaction of antithrombin III with surface-immobilized albumin-heparin conjugates

The interaction between antithrombin III (ATIII) and albumin-heparin conjugates covalently coupled onto carboxylated polystyrene beads either in buffer containing albumin or in plasma was studied using 14C-labeled ATIII. Binding isotherms of ATIII were modeled using a summation of two Langmuir equations. These equations describe the binding of ATIII to two different sets of binding sites, one with a high, the other with a low affinity of ATIII to these sites are 9 x 10(6) L/mol and 0.3 x 10(6) L/mol, respectively. The binding of ATIII to surface binding sites with a high affinity for ATIII was correlated with the presence of specific ATIII binding sites in the immobilized heparin. Binding of ATIII from albumin solutions to binding sites with a low affinity for ATIII was dominated by nonspecific binding of ATIII to the immobilized heparin. A third small fraction of the surface bound. ATIII is probably adsorbed to sites on the surface not covered with heparin. In the case of the binding of ATIII to the heparinized surface from plasma solutions, a fraction of initially adsorbed ATIII was desorbed by other plasma proteins. This desorption in combination with direct competition between ATIII and other plasma proteins resulted in lower ATIII surface concentrations using plasma as compared to the ATIII surface concentrations obtained using albumin solutions. The binding of ATIII to nonspecific binding sites was almost completely inhibited in the presence of plasma proteins. The amount of ATIII bound to immobilized heparin via specific ATIII binding sites was 30% lower in plasma solutions as compared to the specific binding of ATIII using albumin solutions. It is concluded that the accessibility of immobilized heparin for ATIII in plasma decreases by binding of heparin-binding proteins onto the immobilized heparin and/or adsorption of other plasma proteins on the heparinized surface.

Heparin-immobilized polyhydroxyethylmethacrylate microbeads for cholesterol removal: a preliminary report

Heparin-attached polyhydroxyethylmethacrylate (PHEMA) microbeads were investigated for specific removal of cholesterol from human and rabbit plasma. PHEMA microbeads were prepared by a suspension polymerization technique and activated by cyanogen bromide (CNBr) in an alkaline medium (pH 11.5). Heparin was then immobilized by covalent binding onto these microbeads. Cholesterol adsorption onto PHEMA microbeads containing two different amounts of immobilized heparin, i.e., 57.3 and 122.7 mg/g, from both hypercholesterolaemic human and rabbit plasma was investigated. The non-specific cholesterol adsorptions on the plain PHEMA microbeads were 0.47 mg/g and 0.30 mg/g from human and rabbit plasmas, respectively. About 35% and 32% of the cholesterol was removed from human and rabbit plasmas, respectively, when the heparin-immobilized PHEMA microbeads were used.

Heparin release from thermosensitive polymer coatings: in vivo studies

Biomer/poly(N-isopropylacrylamide)/[poly(NiPAAm)] thermosensitive polymer blends were prepared and their application as heparin-releasing polymer coatings for the prevention of surface-induced thrombosis was examined. The advantage of using poly (NiPAAm)-based coatings as heparin-releasing polymers is based on the unique temperature-dependent swelling of these materials. At room temperature, i.e., below the lower critical solution temperature (LCST) of poly (NiPAAm), the Biomer/(poly(NiPAAm) coatings are highly swollen. The high swelling enables fast loading of hydrophilic macromolecules (e.g., heparin) into the coating by a solution sorption technique. At a body temperature, i.e., above the LCST of poly (NiPAAm) the coatings are in a deswollen state and the absorbed macromolecules may be slowly released from a dense coating via a diffusion controlled mechanism. Biomer/poly(NiPAAm) coatings were obtained by blending and coprecipitation of the two linear polymers, Biomer and (poly(NiPAAm). The structure and water-swelling properties of the coatings were examined. Significant differences in water swelling at room temperature (RT) and 37 degrees C were observed as a result of the thermosensitivity of poly (NiPAAm). The surface structure of the coatings in dry and swollen states at RT and 37 degrees C was examined by scanning electron microscopy. Heparin was loaded into the coatings via a solution sorption at room temperature. Kinetic studies of heparin loading demonstrated that maximum loading was obtained within 1 h. The in vitro (37 degrees C) release profiles were characterized by a rapid initial release due to the squeezing effect of the collapsing polymer network, followed by a slower release phase controlled by heparin diffusion through the dense coating. The short-term antithrombogenicity of intravenous polyurethane catheters coated with heparin-releasing Biomer/poly(NiPAAm) thermosensitive coating was evaluated in a canine animal model. The results show that the heparin release from Biomer/poly(NiPAAm)-coated surfaces resulted in a significant reduction of thrombus formation on test surfaces in contact with venous blood as compared to control surfaces.

New polyurethane compositions able to bond high amounts of both albumin and heparin. Part I

In order to prepare polymers provided with better haemocompatibility with respect both to the coagulative cascade and to platelet aggregation and activation, we have synthesized new polyurethanes containing in the chain-extender [di(2-hydroxyethyl)hexadecylamine] both a long chain alkyl group (able to bond albumin) and a tertiary ammonium group able, after suitable quaternization reaction, to bind ionically significant amounts of heparin. The amounts of heparin and albumin bonded to the polymer films were determined spectrophotometrically. A biological in vitro evaluation of the heparinized and albuminized films was also carried out with respect to blood coagulation factors (by activated partial thromboplastin time measurements) and to platelet adhesion and activation (by platelet count and scanning electron microscopy examination). It was seen that the type of adsorption sequence for albumin and heparin, respectively, onto the various homo- and copolymer films, plays an important role on their biological properties; the possible mechanisms involved are also discussed on the basis of X-ray photoelectron spectroscopy and attenuated transmission reflectance evaluation of the polymer surfaces.

Surface modification of polymeric biomaterials with poly(ethylene oxide), albumin, and heparin for reduced thrombogenicity

Appropriate surface modification has significantly improved the blood compatibility of polymeric biomaterials. This article reviews methods of surface modification with water-soluble polymers, such as polyethylene oxide (PEO), albumin, and heparin. PEO is a synthetic, neutral, water-soluble polymer, while albumin and heparin are a natural globular protein and an anionic polysaccharide, respectively. When grafted onto the surface, all three macromolecules share a common feature to reduce thrombogenicity of biomaterials. The reduced thrombogenicity is due to the unique hydrodynamic properties of the grafted macromolecules. In aqueous medium, surface-bound water-soluble polymers are expected to be highly flexible and extend into the bulk solution. Biomaterials grafted with either PEO, albumin, or heparin are able to resist plasma protein adsorption and platelet adhesion predominantly by a steric repulsion mechanism.

Synthesis and bioactivity of copolymers with fragments of heparin

A new type of biocompatible copolymer comprising small fragments of heparin, (octa- to dodecasaccharides) copolymerized with a synthetic monomeric component, viz. acrylamide, has been prepared. The heparin fragments are produced by enzymatic or chemical means and are copolymerized, directly or after suitable derivatization, with acrylamide as the major polymerizable component. The polymeric material incorporates the heparin segments as pendant moieties such that their essential functional groups and structural features for specific binding with the selective serine protease coagulation factor inhibitor antithrombin III are preserved. An important feature of this copolymer is its biocompatibility which relates specifically to its antithrombotic and antithrombogenic activity derived from those of heparin fragments. The biological activity of heparin fragments and copolymers thereof are determined in terms of APTT and anti-Xa activity, their antithrombotic potential being expressed as a ratio of anti-Xa activity to APTT. The copolymers reported have biological activities similar to equivalent amounts of respective heparin fragments, and show higher antithrombotic activity compared to intact heparin or commercially available low-molecular-weight heparin (4,000-6,000 Da).

Laser balloon angioplasty: potential for reduction of the thrombogenicity of the injured arterial wall and for local application of bioprotective materials

Mitigation of adverse biologic reactivity after balloon angioplasty is necessary before the incidence of restenosis can be appreciably reduced. A brief review of experimental evidence supports the hypothesis that the thrombogenicity of the injured arterial wall can be reduced by a suitable level of thermal denaturation or cross-linking of thrombogenic proteins. In addition, the concept of local pharmacologic therapy, which can be provided with laser balloon angioplasty at the site of arterial injury, is introduced. Preliminary in vitro and in vivo data suggest that guide catheter-injected albumin-heparin conjugates fabricated as water-insoluble microspheres remain adherent to the injured luminal surface and deeper arterial layers after physical trapping by the inflated balloon and subsequent laser/thermal exposure. The combination of initially adequate luminal morphology, reduction of the thrombogenicity of the injured arterial wall and application of local pharmacologic therapy with laser balloon angioplasty may eventually prove helpful in reducing the incidence of restenosis.

Antithrombogenic surfaces: characterization and bioactivity of surface immobilized PGE1-heparin conjugate

A covalently bonded conjugate of commercial grade heparin and prostaglandin E1 (PGE1) was synthesized to prevent both fibrin formation and platelet aggregation during thrombus formation. The PGE1-heparin conjugate was immobilized on an imidazole carbamate derivatized sepharose bead surface through hydrophilic spacer groups (diamino-terminated polyethylene oxides). One end of the spacer group was coupled to the derivatized surface through a urethane bond between the amine group of the spacer and the derivatized surface. The free amine group of the immobilized spacers was coupled to a carboxylic group of the PGE1-heparin conjugate through an amide bond. Bioactivity of the immobilized conjugate (heparin activity) was measured in terms of increased clotting times (thrombin time assay) and for the inactivation of Factor Xa. Bioactivity of the immobilized compound (PGE1 activity) was analyzed by platelet adhesion and platelet release reactions using C14-5-hydroxytryptamine (5-HT). The conjugate immobilized via the C2 spacer showed the highest incidence of platelet adhesion, 5-HT released and the lowest activity for coagulation factors. In contrast, the 1000 and 4000 immobilized systems showed a significant reduction in platelet activation, while having the greatest effect on coagulation factors. The results of these experiments imply that the immobilized conjugate is active in preventing both pathways of thrombus formation, and the efficacy is improved through the use of long-chain hydrophilic spacer groups.

The preparation of a urokinase-AT-III-PGE1-methyldopa complex, and its effects on platelet adhesion, coagulation times, protein adsorption, and fibrinolysis

Modifications of urokinase by substances possessing useful therapeutic activity permit combined action preparations to be obtained. Here an attempt was made to develop a complex having combined action for therapeutic activity. The possibility of repeatedly modified urokinase with antithrombin-III-methyldopa-prostaglandin E1 had been experimentally demonstrated. The complex was immobilized on albuminated substrate, which showed fibrinolytic, anticoagulant, and antiplatelet effects simultaneously, in addition to the normal antihypertensive action of methyldopa. The complex immobilized substrate also demonstrated an increase in albumin-surface attachment and a reduction in fibrinogen binding. This may be one of the parameters for a reduced platelet-surface attachment, which may also improve the blood compatibility of the substrate. The approaches suggested indicate the possible new ways of creating nonthrombogenic surfaces with wider applications. A better understanding of the mechanism of these complexes are needed in in vivo conditions to correlate these findings.

Platelet adhesion onto protein-coated and uncoated polyetherurethaneurea having tertiary amino groups in the substituents and its derivatives

Interactions of platelet with novel polyetherurethaneurea and its heparinized derivative were investigated. Platelet adhesion onto the material and release of serotonin or adenosine phosphate from platelet-rich plasma (PRP) were suppressed by an introduction of amino groups to polyetherurethaneurea, by quaternization of the polymer, and further by heparinization of the polymer. When the material was precoated with one of major plasma proteins and the protein-coated materials were taken to contact with washed platelet suspension (WP), the dependence of platelet adhesion and activation on the properties of polymers was different from that observed for PRP interaction. Platelet adhesion and activation were promoted according to the nature of coating proteins in the order albumin less than gamma-globulin less than fibrinogen and with increasing degree of denaturation of coating proteins. When the polymer materials were coated with proteins by immersing in aqueous solution containing two kinds of plasma proteins, adhesion behaviors of platelet were similar to those observed for PRP-uncoated material interaction. These experimental facts indicate that the selectivity of platelet for protein-coated material cannot be assessed by the interaction of WP with materials coated with a single kind of protein. It was concluded that material surface to which albumin is selectively adsorbed without denaturation does not stimulate adhering platelets for release reactions.

Antithrombogenic heparin-bound polyurethanes

Many kinds of heparin-bound polyurethanes have been developed. Polyurethanes are a family of elastomers displaying better blood-compatibility than other polymeric materials. It is useful to modify this material by heparinization. Several approaches to heparinization have been devised: 1) a general method of heparinization, applicable to all polymeric materials, 2) a heparinization method specific to polyurethanes, and 3) the design of heparinizable polyurethane derivatives. These three approaches are first explained in detail. Then, the antithrombogenic mechanism of the heparinized polymers is discussed. Finally, the interactions of the heparinized polymers with blood coagulation factors, plasma proteins, and platelets are discussed.