Synthesis of novel polyaminoetherurethaneureas and development of antithrombogenic material by their chemical modifications

Recent advances in the design and immobilization of heparin for biomedical application: A review

Heparin, a member of the glycosaminoglycan family, is renowned as the most negatively charged biomolecule discovered within the realm of human biology. This polysaccharide serves a vital role as a regulator for various proteins, cells, and tissues within the human body, positioning itself as a pivotal macromolecule of significance. The domain of biology has witnessed substantial interest in the intricate design of heparin and its derivatives, particularly focusing on heparin-based polymers and hydrogels. This intrigue spans a wide spectrum of applications, encompassing diverse areas such as protein adsorption, anticoagulant properties, controlled drug release, development of implants, stent innovation, enhancement of blood compatibility, acceleration of wound healing, and pioneering strides in tissue engineering. This comprehensive overview delves into a multitude of developed heparin conjugates, employing various methods, and explores their functions in both the biomedicine and electronics fields. The efficacy of materials derived from heparin is also thoroughly investigated, encompassing considerations such as thrombogenicity, drug release kinetics, affinity for growth factors (GFs), biocompatibility, and electrochemical analyses. We firmly believe that by redirecting focus towards research and advancements in heparin-related polymers/hydrogels, this study will ignite further research and accelerate potential breakthroughs in this promising and evolving field of discovery.

Recent advances in thromboresistant and antimicrobial polymers for biomedical applications: just say yes to nitric oxide (NO)

Biomedical devices are essential for patient diagnosis and treatment; however, when blood comes in contact with foreign surfaces or homeostasis is disrupted, complications including thrombus formation and bacterial infections can interrupt device functionality, causing false readings and/or shorten device lifetime. Here, we review some of the current approaches for developing antithrombotic and antibacterial materials for biomedical applications. Special emphasis is given to materials that release or generate low levels of nitric oxide (NO). Nitric oxide is an endogenous gas molecule that can inhibit platelet activation as well as bacterial proliferation and adhesion. Various NO delivery vehicles have been developed to improve NO's therapeutic potential. In this review, we provide a summary of the NO releasing and NO generating polymeric materials developed to date, with a focus on the chemistry of different NO donors, the polymer preparation processes, and in vitro and in vivo applications of the two most promising types of NO donors studied thus far, N-diazeniumdiolates (NONOates) and S-nitrosothiols (RSNOs).

Tailored Synthesis of Nitric Oxide-Releasing Polyurethanes Using O-Protected Diazeniumdiolated Chain Extenders

Nitric oxide (NO) has been shown to exhibit significant anti-platelet activity and its release from polymer matrices has been already utilized to increase the biocompatibility of various blood-contacting devices. Herein, details of a new synthetic approach for preparing NO-releasing diazeniumdiolated polyurethanes (PU) are described. The method's utility is demonstrated by the incorporation of methoxymethyl- or sugar-protected pre-formed diazeniumdiolate moieties directly into chain extender diols which are then incorporated into the polyurethane backbone. This approach provides the ability to control the number of diazeniumdiolate groups incorporated into the polymer backbone, and hence the surface flux of NO that can ultimately be liberated from polymeric films prepared from the new PU materials. The method provides a means of covalently attaching diazeniumdiolate groups to polyurethanes in a form that resists dissociation of NO during processing but can be activated for spontaneous NO release via hydrolysis of the carbohydrate or methoxymethyl moieties under basic and acidic conditions, respectively.

Nitric Oxide Releasing Polyurethanes with Covalently Linked Diazeniumdiolated Secondary Amines

Two novel strategies for synthesizing stable polyurethanes (PUs) capable of generating bioactive nitric oxide (NO) are described. The methods rely on covalently attaching diazeniumdiolate (N(2)O(2)(-)) groups onto secondary amine nitrogens at various positions within the polymer chain such that, when in contact with water or physiological fluids, only the two molecules of NO available from each diazeniumdiolate moiety are released into the surrounding medium, with potential byproducts remaining covalently bound to the matrix. Extensive analysis of the NO(x)() products released from the polymers was employed to develop appropriate strategies to better stabilize the diazeniumdiolate-based polymer structures. In one approach, diazeniumdiolate groups are attached to secondary amino nitrogens of alkane diamines inserted within the diol chain extender of a PU material. Oxidative loss of NO was minimized by blending the polymer with a biocompatible, relatively nonnucleophilic salt before exposing solutions of the polymer to NO during the diazeniumdiolation step. Fluxes of molecular NO from such materials during immersion in physiological buffer reached levels as high as 19 pmol x cm(-2) x s(-1) with a total recovery of 21 nmol of NO/mg of PU. A second general synthetic strategy involved omega-haloalkylating the urethane nitrogens and then displacing the halide from the resulting polymer with a nucleophilic polyamine to form a PU with pendent amino groups suitable for diazeniumdiolation. Commercially available Pellethane 2363-80AE that was bromobutylated and then reacted with diethylenetriamine and further exposed to gaseous NO proved stable in solid form for several months, but released NO with a total recovery of 17 nmol/mg upon immersion in physiological buffer. This material showed an initial NO flux of 14 pmol x cm(-2) x s(-1) when immersed in pH 7.4 buffer at 37 degrees C, with gradually decreasing but still observable fluxes for up to 6 days.

In vitro haemocompatibility and stability of two types of heparin-immobilized silicon surfaces

Heparin was covalently immobilized onto a silicon surface by two different methods, carbodiimide-based immobilization and photo-immobilization. In the former method, a (3-aminopropyl) trimethoxysilane (APTMS) self-assembled monolayer (SAM) or multilayer was first coated onto the silicon surface as the bridging layer, and heparin was then attached to the surface in the presence of water-soluble carbodiimide. In the latter method, an octadecyltrichlorosilane (OTS) SAM was coated on the silicon surface as the bridging layer, and heparin was modified by attaching photosensitive aryl azide groups. Upon UV illumination, the modified heparin was then covalently immobilized onto the surface. The hydrophilicity of the silicon surface changed after each coating step, and heparin aggregates on APTMS SAM and OTS SAM were observed by atomic force microscopy (AFM). In vitro haemocompatibility assays demonstrated that the deposition of APTMS SAM, APTMS multilayer and OTS SAM enhanced the silicon's haemocompatibility, which was further enhanced by the heparin immobilization. There is no evident distinction regarding the haemocompatibility between the heparin-immobilized surfaces by both methods. However, heparin on silicon with APTMS SAM and multilayer as the bridging layers is very unstable when tested in vitro with a saline solution at 37 degrees C, due to the instability of APTMS SAM and multilayer on silicon. Meanwhile, photo-immobilized heparin on silicon with OTS SAM as the bridging layer showed superb stability.

Preparation and evaluation of polyurethane surfaces containing immobilized plasminogen

Plasminogen has been immobilized onto a segmented polyurethane containing amino groups, using glutaraldehyde as coupling agent. It was also aspecifically adsorbed, for sake of comparison, onto polyurethane films containing different functional groups and, in particular, epsilon-amino caproic acid and lysine residues. The differently immobilized plasminogen has been converted to plasmin by activation with urokinase, and the percentage of active plasmin for the various polymer films was determined using a tripeptide (S-2251) as a synthetic substrate. The biological behaviour of the differently treated polymer films has been evaluated in vitro by measurements of partial thromboplastin time (PTT) and platelet adhesion.

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.

Conformation of human plasma proteins at polymer surfaces: the effectiveness of surface heparinization

Studies were made on the adsorption of two human plasma proteins, albumin (HSA) and fibrinogen (HFg), onto three different polymeric surfaces: commercial pellethane 2363-80AE (PU); pellethane crosslinked with a poly(amido-amine) (PUPA); and heparinized PUPA, using in situ ATR/FTIR spectroscopy (attenuated total reflection Fourier transform infrared spectroscopy). Conformational changes were found to occur on the two proteins upon adsorption onto bare PU and PUPA, and the protein unfolding on bare PU was also found to be time dependent. On the contrary, the two proteins do not change conformation when they are adsorbed onto the heparinized surface, emphasising the effectiveness of surface heparinization.

A novel microporous polyurethane blood conduit: biocompatibility assessment of the UTA arterial prosthesis by an organo-typic culture technique

An organotypic culture assay has been used to assess the biocompatibility and cytotoxicity of an arterial prosthesis developed at the University of Texas-Arlington (the UTA graft) from a structurally modified polyurethane (PU) elastomer (Tecoflex). The cell culture test was applied to the UTA graft after sterilization by ethylene oxide and by gamma radiation in two separate series. First, small specimens of the prosthesis were incubated for 7 days on a semisolid nutrient medium with their luminal surface in direct contact with endothelium explanted from the aorta of chick embryos. Second, the possibility of cytotoxic contaminants being leached from the polyurethane was assessed by immersing the biomaterial in the liquid culture medium for 5 days at 37 degrees C prior to conducting the organo-typic culture assay on a standard control surface. The structure of the UTA polyurethane prosthesis is porous, but the graft wall is impervious because it contains closed (i.e., noncommunicating) pores. In addition, four other vascular prostheses were included in the study for comparison. They were the Hydrophilic Mitrathane PU graft with a similar impervious, closed pore structure, an experimental Hydrophobic Mitrathane PU graft with a fibrous, open pore structure, and the commercial Impra and Reinforced Goretex expanded PTFE grafts. Following 7 days of cell culture, the biocompatibility and cytotoxicity of the various biomaterials were measured in terms of the area of migrating cells, the density of cells surrounding the explants, and the level of cell adhesion. Comparison of the results against control cultures demonstrated that the UTA graft, along with the other four prostheses, does not release cytotoxic extractables. Microscopic observations of its cultured surface indicated that the UTA graft promotes a high density of cell growth over a limited area, similar to the Hydrophilic Mitrathane graft. This level of biocompatibility is considered inferior to that of the two PTFE and the Hydrophobic Mitrathane prostheses, which promote more extensive cell migration, greater cell adhesion, and cell growth in a continuous single layer.

Synthesis and physicochemical characterization of a hydrophilic polyurethane able to bind heparin

The synthesis of a new segmented polyurethane containing quaternary ammonium groups in the side-chain is reported. The quaternization was carried out both on the polymer dissolved in an organic solvent and on polymer films. Polymeric films quaternized by both techniques were heparinized. The amount of bonded heparin, determined by spectrophotometry, was remarkably higher than previously described. Polymer quaternized in solution bonded more heparin than that heparinized directly on film. In vitro evaluations of antithrombogenicity by activated partial thromboplastin time (APTT) carried out on the films confirmed these data. The polymers were also characterized by chemical, i.r., n.m.r., differential scanning calorimetry and viscometric techniques.

Biocompatibility of the Vascugraft: evaluation of a novel polyester urethane vascular substitute by an organotypic culture technique

To evaluate the biocompatibility of chemically and structurally modified polyurethane elastomers for use as blood vessel replacements, small squares of vascular prostheses were cultured in direct contact with endothelium from chick embryo aorta using an organotypic culture assay. The polyurethane materials tested were: Vascugraft (fibrous, open pore structure); commercial Hydrophilic Mitrathane prosthesis (high porosity, smooth surface, non-permeable, closed pore structure); experimental hydrophobic Mitrathane (less porosity but a fibrous, open pore structure, similar to Vascugraft). The commercial expanded polytetrafluoroethylene prostheses Impra and reinforced GORETEX were included as controls on account of their extensive clinical application in the femoropopliteal position. After 5 d incubation at 37 degrees C biocompatibility was assessed in terms of average area of migrating cells on the biomaterial, total number of cells surrounding the explant and level of adhesion between the cells and the biomaterial. The Vascugraft prosthesis promoted the growth of a continuous monolayer of cells on its surface. This behaviour was equivalent to Impra and reinforced GORETEX materials in terms of cell density and area of cell migration but appeared to be superior for cell adhesion. From a second series of cell culture tests, in which the extractables leached from the biomaterials were added to the nutrient medium, it was concluded that none of the biomaterials tested released cytotoxic contaminants.

Synthesis and antithrombogenicity of heparinized polyurethanes with intervening spacer chains of various kinds

Heparin was immobilized to polyetherurethaneurea membrane by covalent or ionic bondings with intervening spacer chains having different lengths and different terminal functional groups. The amount of immobilization of heparin and the release rate of immobilized heparin were controlled by the nature and the mode of bonding of spacer chains. The heparinized polyetherurethaneurea membranes became more in vitro antithrombogenic and suppressed more strongly the adhesion and activation of platelets, as the amount of immobilization increased. It was also shown that the membrane to which the low-molecular-weight fraction of heparin was immobilized was less stimulating to platelets.

Adsorption of plasma proteins and adhesion of platelets onto novel polyetherurethaneureas--relationship between denaturation of adsorbed proteins and platelet adhesion

Novel polyetherurethaneureas which have been synthesized by the present authors were chosen for the substrate polymers, on which adhesion of platelets was investigated. The number of adhered platelets and the amount of serotonin released from platelets adhered on the polymers and the protein-coated polymers were determined by radioisotope method. Both of them were enhanced with increasing content of urea linkages in the polyetherurethaneureas. The platelet adhesion was discussed in terms of the denaturation of plasma proteins upon adsorption, which was determined by Fourier-transform infrared spectroscopy. With increasing degree of protein denaturation, the platelet adhesion and the serotonin release were enhanced. This relationship was particularly evident in the case of albumin adsorption. It was shown that the surface properties of substrate polymers affect the protein adsorption, which in turn influences the adhesion of platelets.

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.

Platelet adhesion onto polyether-urethane urea derivatives: effect of cytoskeleton proteins of the platelet

Adhesion and activation of platelets upon adhesion onto synthetic polymers were investigated with reference to participation of the cytoskeleton proteins. Platelets were treated with cytoskeleton breakers, and then the adhesion of platelets onto polyetherurethane urea derivatives and serotonin release from adhered platelets were investigated. In the adhesion onto glass, platelets were strongly stimulated and accompanied rearrangement of the cytoskeleton system, and also serotonin release involved the action of the cytoskeleton system. On the other hand, platelets were not strongly stimulated upon adhering onto polyetherurethane urea derivatives. The platelet adhesion onto cationic polymers exceptionally accompanied the rearrangement of the cytoskeleton system. The participation of the cytoskeleton in platelet adhesion onto polyetherurethane urea derivatives was influenced by the presence of plasma proteins. It was found that protein layers deposited on the material surface play an important role in platelet adhesion.

Attachment and proliferation of fibroblast cells on polyetherurethane urea derivatives

Interactions of novel polyetherurethane urea derivatives with fibroblast cells as well as with plasma proteins were investigated. Fibronectin, which is a cell adhesion protein, was found to be very active in attaching fibroblast cells onto a heparinized polyetherurethane urea: its activity was found to be strongly dependent on the surface properties of the material. Fibronectin was easily adsorbed by the heparinized polyetherurethane urea, but the degree of its adsorption to the material in competition with other proteins was so low that cell attachment to polyetherurethane ureas was decreased by heparinization. Different degrees of cell attachment onto different materials due to different adsorptivities of plasma proteins were considered. Proliferation of fibroblast cells was suppressed on cationic polyetherurethane urea but unaffected on other derivatives of polyetherurethane urea. Since specific suppression of cell proliferation was not observed on the heparinized polyetherurethane urea, the latter material was expected to be useful as a long-term antithrombogenic material in vivo.

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.

Inhibition of platelet adhesion to glow discharge modified surfaces

Plasma glow technique has created much interest in the field of surface modification of polymers due to its versatility of generating active polar groups on the surface without affecting the bulk properties. Here an attempt is made to inter-relate the surface properties and platelet adhesion on various polymeric substrates due to plasma treatments. Initially, a critical review of the process and development of thrombosis upon contact of an artificial surface with blood, has been provided, which has been extended with the need for surface modifications to improve their blood compatibility and the versatility of plasma treatments for such modifications have been emphasized. Phospholipids like phosphoryl choline, phosphatidyl choline and phosphoryl ethanolamine were attached to Angioflex surface by plasma glow. The role of such modified substrates to interact with platelets were investigated using Tyrode washed calf platelets. It seems, glow discharge modified phosphoryl choline bilayers dramatically inhibited the platelet-surface binding, which may be due to their biochemical resemblance with thromboresistant surfaces of human blood cells. Further, the behaviour of all phospholipids towards bloodpolymer interaction is not similar and may change depending on the nature of their functional groups, net charge of the phospholipid adsorbed surface and their interaction with platelets and its activation. It is possible to chemically immobilize lipid bilayers on standard polymers, using plasma glow, to improve their biological performance; by suitably selecting the phospholipid combinations.

Synthesis and antithrombogenicity of anionic polyurethanes and heparin-bound polyurethanes

Two kinds of novel antithrombogenic polyurethane materials were synthesized. One of them is a polyetherurethane with anionic charges on the film surface, and the other is a polyetherurethaneurea to which heparin was covalently bound. The mechanism of their antithrombogenicity was investigated. The anionic polyetherurethane selectively adsorbed albumin, did not cause a conformational change of plasma proteins adsorbed, and suppressed the adherence and deformation of platelets but did not deactivate the blood-clotting system, thus leading to a moderate antithrombogenicity. The heparin-bound polyetherurethaneurea was not favorable for the selective adsorption of albumin, caused the denaturation of plasma proteins adsorbed, and induced the adherence and deformation of platelets but deactivated the blood-clotting system, leading to excellent antithrombogenicity. For the investigation of blood-material interaction, the importance of a multiparameter estimation of the activation of platelets and the blood-clotting system was indicated.

Adsorption of plasma proteins to the derivatives of polyaminoetherurethaneurea: the effect of hydrogen-bonding property of the material surface

Polyaminoetherurethaneureas bearing tertiary amino groups in the main chain (M-PAEUU) were synthesized, quaternized (Q-M-PAEUU) and heparinized (H-M-PAEUU). With increasing portions of diisocyanate and with decreasing portions of polyaminoether in the feed, M-PAEUU containing more hydrogen-bonded urea carbonyl groups was prepared. With increasing hydrogen-bonding character of M-PAEUU, the adsorbed bovine serum albumin (BSA) was more denatured. By quaternization of M-PAEUU, the protein adsorption increased, but the denaturation of adsorbed proteins was suppressed. With increasing ratio of hydrogen-bonded urea carbonyl groups in Q-M-PAEUU, the adsorptions of BSA, bovine serum gamma-globulin (B gamma G), and bovine plasma fibrinogen (BPF) were decreased, but the degree of denaturation of adsorbed proteins was increased. In the adsorption to H-M-PAEUU, both the amount and the degree of denaturation of adsorbed proteins were strongly decreased. The dynamic adsorption experiments of plasma proteins showed the behaviors which are similar to the equilibrium adsorption experiments. The decrease of hydrogen-bonded urea linkages and the increase of hydrophilicity by quaternization and heparinization of the polymer surface may be favorable for building up a hydration layer on the surface, thus suppressing the denaturation of plasma proteins which may trigger blood clotting and thrombus formation.

Synthesis and antithrombogenicity of polyetherurethaneurea containing quaternary ammonium groups in the side chains and of the polymer/heparin complex

Novel polyetherurethaneureas containing tertiary amino groups in the side chains (PAEUU) were synthesized, quaternized with different alkyl halides (Q-PAEUU), and heparinized (H-PAEUU). The antithrombogenicity of PAEUU in vitro was improved by quaternization, and further by heparinization. The excellent antithrombogenicity of H-PAEUU was controlled by the kind of quaternizing agent through the polar effect of quaternizing agent on the water content and through the steric effect of quaternizing agent on the heparin content of H-PAEUU. The antithrombogenicity of H-PAEUU was found to be affected by the water content more strongly than by the heparin content. H-PAEUUs containing tertiary amino groups in the main chain, which were synthesized previously, showed a little better short-term antithrombogenicity than the present H-PAEUUs containing tertiary amino groups in the side chains. Since ammonium groups in the side chains of Q-PAEUU impose little steric hindrance against the heparin adsorption, the release of heparin from the side chains of H-PAEUU was slower but lasted longer than that from the main chain. Therefore, the present H-PAEUU is expected to be a long-term antithrombogenic material.