Suppression of platelet activity on microdomain surfaces of 2-hydroxyethyl methacrylate-polyether block copolymers

Synthesis and Antiplatelet Adhesion Behavior of a Poly(L-lactide-co-glycolide)-Poly(1,5-dioxepan-2-one) Multiblock Copolymer

Platelet adhesion and denaturation on artificial medical implants induce thrombus formation. In this study, bioabsorbable copolymers composed of poly(l-lactide-co-glycolide) (PLGA) and poly(1,5-dioxepan-2-one) (PDXO) were synthesized and evaluated for their antiplatelet adhesive properties. The PLGA-PXO multiblock copolymer (PLGA-PDXO MBC) and its random copolymer (PLGA-PDXO RC) showed effective antiplatelet adhesive properties, and the number of adhered platelets was similar to those adhered on poly(2-methoxyethylacrylate), a known antiplatelet adhesive polymer, although a large number of denatured platelets were observed on a PLGA-poly(ε-caprolactone) multiblock copolymer (PLGA-PCL MBC). Using monoclonal antifibrinogen IgG antibodies, we also found that both αC and γ-chains, the binding sites of fibrinogen for platelets, were less exposed on the PLGA-PDXO MBC surface compared to PLGA-PCL MBC. Furthermore, free-standing films of PLGA-PDXO MBC were prepared by casting the polymer solution on glass plates and showed good tensile properties and slow hydrolytic degradation in phosphate-buffered saline (pH = 7.4). We expect that the unique properties of PLGA-PDXO MBC, i.e., antiplatelet adhesive behavior, good tensile strength, and hydrolytic degradation, will pave the way for the development of new bioabsorbable implanting materials suitable for application at blood-contacting sites.

A review of block copolymer-based biomaterials that control protein and cell interactions

Block copolymers posses the ability to phase separate into micro and nanoscale patterns resulting in nonhomogeneous surfaces and solids. This nonhomogeneity has been harnessed to improve mechanical properties, control degradation, and add functionality to biomaterials. The ability of block copolymers to generate a wide variety of surface chemistries and morphologies can also be harnessed to control protein adsorption, protein conformation, and cell adhesion. Proteins and cells will respond to periodically structured surfaces, so block copolymers have a great deal of potential as biomaterials. This review will explore the ability of block copolymers to control specific biological responses such as cell adhesion, protein adsorption and conformation, parameters that govern the overall host response to a material. In addition, some of the specific applications of block copolymer, antithrombogenic materials and their ability to pattern proteins, will be discussed.

Poly-(L-lactic acid) and citric acid-crosslinked gelatin composite matrices as a drug-eluting stent coating material with endothelialization, antithrombogenic, and drug release properties

Biodegradable composite matrices comprising poly-(L-lactic acid) (PLLA) and citric acid-crosslinked alkali-treated gelatin (AlGelatin) with endothelialization, antithrombogenic, and drug release properties were prepared. The characterization of composite matrices with various mixing ratios was performed by evaluating their swelling ratio, endothelial cell culture, antithrombogenic tests, and drug release behavior. Tamibarotene (Am80), which specifically inhibits smooth muscle cell proliferation, was employed as the drug. The swelling ratio of composite matrices decreased as the PLLA content decreased. The number of endothelial cells cultured on the surfaces of composite matrices was maximal at the PLLA/AlGelatin-TSC ratio of 80/20. Antithrombogenic tests revealed that the levels of platelets and fibrin network formation decreased as the AlGelatin-TSC content increased. The Am80 release test indicated that the release rate decreased as PLLA content increased. Using the resulting composite matrix, Am80-eluting stents possessing a smooth surface and a coating thickness of ∼15 μm were successfully obtained. Am80 was continuously released from the resulting stent at ∼40%, up to 28 days without burst release. Therefore, Am80-eluting stent with its antithrombogenic and endothelialization properties has great potential for clinical use.

Designing nanostructured block copolymer surfaces to control protein adhesion

The profile and conformation of proteins that are adsorbed onto a polymeric biomaterial surface have a profound effect on its in vivo performance. Cells and tissue recognize the protein layer rather than directly interact with the surface. The chemistry and morphology of a polymer surface will govern the protein behaviour. So, by controlling the polymer surface, the biocompatibility can be regulated. Nanoscale surface features are known to affect the protein behaviour, and in this overview the nanostructure of self-assembled block copolymers will be harnessed to control protein behaviour. The nanostructure of a block copolymer can be controlled by manipulating the chemistry and arrangement of the blocks. Random, A-B and A-B-A block copolymers composed of methyl methacrylate copolymerized with either acrylic acid or 2-hydroxyethyl methacrylate will be explored. Using atomic force microscopy (AFM), the surface morphology of these block copolymers will be characterized. Further, AFM tips functionalized with proteins will measure the adhesion of that particular protein to polymer surfaces. In this manner, the influence of block copolymer morphology on protein adhesion can be measured. AFM tips functionalized with antibodies to fibronectin will determine how the surfaces will affect the conformation of fibronectin, an important parameter in evaluating surface biocompatibility.

Surface Engineered Polymeric Biomaterials with Improved Biocontact Properties

We present many examples of surface engineered polymeric biomaterials with nanosize modified layers, controlled protein adsorption, and cellular interactions potentially applicable for tissue and/or blood contacting devices, scaffolds for cell culture and tissue engineering, biosensors, biological microchips as well as approaches to their preparation.

Interfacial interactions between calcined hydroxyapatite nanocrystals and substrates

Interfacial interactions between calcined hydroxyapatite (HAp) nanocrystals and surface-modified substrates were investigated by measuring adsorption behavior and adhesion strength with a quartz crystal microbalance (QCM) and a contact-mode atomic force microscope (AFM), respectively. The goal was to develop better control of HAp-nanocrystal coatings on biomedical materials. HAp nanocrystals with rodlike or spherical morphology were prepared by a wet chemical process followed by calcination at 800 degrees C with an antisintering agent to prevent the formation of sintered polycrystals. The substrate surface was modified by chemical reaction with a low-molecular-weight compound, or graft polymerization with a functional monomer. QCM measurement showed that the rodlike HAp nanocrystals adsorbed preferentially onto anionic COOH-modified substrates compared to cationic NH2- or hydrophobic CH3-modified substrates. On the other hand, the spherical nanocrystals adsorbed onto NH2- and COOH-modified substrates, which indicates that the surface properties of the HAp nanocrystals determined their adsorption behavior. The adhesion strength, which was estimated from the force required to move the nanocrystal in contact-mode AFM, on a COOH-grafted substrate prepared by graft polymerization was almost 9 times larger than that on a COOH-modified substrate prepared by chemical reaction with a low-molecular-weight compound, indicating that the long-chain polymer grafted on the substrate mitigated the surface roughness mismatch between the nanocrystal and the substrate. The adhesion strength of the nanocrystal bonded covalently by the coupling reaction to a Si(OCH3)-grafted substrate prepared by graft polymerization was approximately 1.5 times larger than that when adsorbed on the COOH-grafted substrate.

Preparation of hydroxyapatite-nanocrystal-coated stainless steel, and its cell interaction

Calcined nanocrystals of hydroxyapatite (HAp) having spherical or rod-shaped morphologies were coated through covalent linkage on a type 316L stainless steel substrate, which was chemically modified by the graft polymerization of gamma-methacryloxypropyl triethoxysilane (MPTS) at 70-110 degrees C. The grafting of poly(MPTS) on the substrate was confirmed by X-ray photoelectron spectroscopy (XPS) and attenuated total reflection Fourier transform infrared spectroscopy (ATR FT-IR). In order to coat the substrate with the HAp crystals through covalent linkage, the reactionbetween the alkoxysilyl groupsin the poly (MPTS) grafted on the substrate and the OH groups on the HAp crystals was conducted at 80 degrees C. The poly(MPTS)-grafted substrate was strongly coated with the HAp nanocrystals, although the HAp crystals adsorbed physically on the original substrate without poly(MPTS) grafting were removed by ultrasonic treatment. Human umbilical vein endothelial cells (HUVEC) adhered in larger numbers on the HAp-coated stainless steel substrate as compared with the original substrate after 24 h of initial incubation. The number of HUVEC adhered on the rod-shaped HAp-coated substrate was not significantly different from that on the spherical HAp-coated substrate under the present conditions.

Adhesion and growth of endothelial cell on amphiphilic PU/PS IPN surface: effect of amphiphilic balance and immobilized collagen

Since natural blood vessels are lined with an endothelial cell (EC) monolayer, it is proposed that synthetic biomaterial surfaces be covered or seeded with endothelial cells for ideal nonthrombogenicity under normal conditions. The effects of the surface energy of hydrophilic-hydrophobic IPN on EC adhesion and growth were investigated. The human umbilical vein endothelial cells (HUVECs) were cultured on polyurethane (PU)/polystyrene (PS) IPN prepared by changing only the amphiphilic balance and controlling the microphase separated surface structure. The collagens were immobilized on the IPN surfaces for enhanced adhesion of HUVECs, and the morphology of the collagens immobilized highly depended on the surface energy of the IPNs. The stranded rope structure of the collagen molecules in the solution state was maintained only on the surface of the IPN with intermediate hydrophilicity. The adhesion and the proliferation of ECs on the nontreated IPN surfaces increased by increasing the hydrophobicity of the IPNs, and they were optimized on the collagen-treated IPN surface having an intermediate hydrophilicity. Finally, platelet adhesion was significantly reduced on the EC-hybridized surface of the IPNs.

Hydrophilic hybrid IPNs of segmented polyurethanes and copolymers of vinylpyrrolidone for applications in medicine

The preparation and biocompatibility properties of thermoplastic apparent interpenetrating polymer networks (T-IPNs) of a segmented polyurethaneurea, Biospan (BS), and vinylpyrrolidone-dimethylacrylamide (VP-DMAm) copolymers, are described. The biological interaction between the obtained materials and blood was studied by in vitro methods. The addition of the VP-DMAm copolymers to form T-IPNs with BS substantially increased the equilibrium water uptake and water diffusion coefficients. Investigation of the proteins adsorption, platelet adhesion, thrombus formation and factor XII activation is presented. Investigations of the proteins adsorption of the BS/VP-DMAm T-IPNs surfaces show that the segmented polyurethane (BS) containing VP-DMAm copolymers with higher VP content adsorb more albumin than fibrinogen and gamma-globulin. The platelets adhesion, thrombus formation and factor XII activation are effectively suppressed with respect to the segmented polyurethane when VP-DMAm copolymers with high VP contents are incorporated into BS as T-IPNs.

Experimental study of ectopic-free tissue transfer of rabbit epigastric flap using small-caliber vascular grafts

Ectopic intraperitoneal free-tissue grafting using small-caliber artificial vascular grafts is reported. The vascular grafts were polyurethane tubes (inner diameter 1.4 mm; outer diameter 1.9 mm; length 15 mm) with a coating of the antithrombotic agents argatroban and 2-hydroxyethylmethacrylate-styrene block copolymer (HS)on the inner surface. The patency of the artificial vessels was investigated in an ectopic-free rabbit epigastric flap in which grafts were used for anastomosis between the femoral and renal vessels. The mean patent duration of uncoated controls (n = 10) was 128 +/- 37 min. Flap viability after one week (n = 17) and the patency of the coated grafts were investigated histologically. The flap take rate was 65%, the arterial graft patency rate 41%, and the venous graft patency rate 24%. The HS-treated surface combined with the argatroban slow-release system exhibited improvement of flap survival in an intraperitoneal ectopic -free grafting model.

Effect of cross-link density and hydrophilicity of PU on blood compatibility of hydrophobic PS/hydrophilic PU IPNs

To investigate the effect of the hydrophilic and hydrophobic microdomain structure on blood compatibility, a series of interpenetrating polymer networks (IPNs) composed of hydrophilic polyurethane (PU) and hydrophobic polystyrene (PS) was prepared. One series was prepared with varying cross-link densities of each network, the other with varying hydrophilicity of the PU component. All PU/PS IPNs exhibited microphase-separated structures that had dispersed PS domains in the continuous PU matrix. The domain size decreased with decreasing the hydrophilicity of the PU component and increasing the cross-link density of each network. As the cross-link density and hydrophobicity of the PU component was increased, an inward shift of Tgs was observed, which was due to the decrease in phase separation between the hydrophobic PS component and hydrophilic PU component. In the in vitro platelet adhesion test, as the microdomain size of PU/PS IPN surface decreased, the number of adhered platelets on the PU/PS IPN surface was reduced and deformation of the adhered platelets decreased. It could be concluded that blood compatibility of PU/PS IPN was mainly affected by the degree of mixing between PU and PS component, which was reflected by the domain size of PS rich phase.

Biomaterials and cardiovascular devices

In the field of cardiovascular surgery there is presently a lack of biomaterials possessing essential characteristics of the native tissue or organ which is to be replaced. This paper describes various biomaterials that have been introduced into the circulatory system and the complex reactions that subsequently occur. The risk of infection is also discussed as well as prevention and treatment regimes that can be used. Examples of future biomaterial development are outlined in an attempt to achieve biocompatibility.

Reduction of surface-induced platelet activation on phospholipid polymer

omega-Methacryloyloxyalkyl phosphorylcholine (MA-PC) polymers which have been synthesized with attention to the surface structure of a biomembrane show excellent blood compatibility, i.e., resistance to protein adsorption and blood cell adhesion. To clarify the stability of platelets in contact with the MAPC polymer surfaces, cytoplasmic free calcium concentration ([Ca2+],) in the platelets was measured. A platelet suspension was passed through a column packed with various polymer beads after treatment with plasma, and the [Ca2+]i in the platelets eluted from the column was measured. The [Ca2+]i in contact with the MAPC polymers, i.e., poly[2-methacryloyloxyethyl phosphorylcholine-co-nbutyl methacrylate (BMA)] (PMEB) and poly(6-methacryloyloxyhexyl phosphorylcholine-co-BMA) (PMHB), was less than that in contact with poly(BMA). However, poly(10-methacryloyloxydecyl phosphorylcholine-co-BMA) (PMDB) was not effective in suppressing the increase in [Ca2+]i, and thus was at the same level as in the poly(BMA). This result indicated that platelets in contact with PMEB or PMHB were less activated compared with those in contact with PMDB and poly(BMA). Moreover, the state of the platelets adhered to these polymer surfaces, both morphologically and immunologically, was examined. Scanning electron microscopic observation of the polymer surface after contact with a platelet suspension revealed that many platelets adhered and changed their shape on the poly(BMA). The numbers of adhetent platelets were reduced on all MAPC polymer surface. The relative amount of alpha-granule membrane glycoprotein (GMP-140) which appears on the cell membrane by activation of platelets on the PMEB surfaces was less than that on poly(BMA) and poly(2-hydroxyethyl methacrylate). These results suggest that PMEB and PMHB suppressed not only platelet adhesion but also activation of the platelets in contact with these surface.

In vivo evaluation of a fluorine-acryl-stylene-urethane-silicone antithrombogenic coating material copolymer for intravascular stents

RATIONALE AND OBJECTIVES

We evaluated the effectiveness of a fluorine-acryl-styrene-urethane-silicone (FASUS) copolymer as an antithrombogenic coating material for intravascular stents in dogs.

METHODS

FASUS copolymer-coated stents were placed in the right iliac veins, and uncoated 304 stainless steel stents were placed in the left iliac veins. We examined platelet deposition, microthrombus formation, and neointimal hyperplasia 4 weeks after stent placement by measuring the activity of 111In-labeled platelets, by using scanning electron microscopy, and by measuring neointimal thickness.

RESULTS

Platelet deposition was significantly decreased on coated than on uncoated stents (p < .05). A less pronounced increase in red blood cell deposition was observed at the sites of the coated than uncoated stents (p < .05). Neointimal thickness 4 weeks after stent placement also was significantly less at the sites of the coated stents (0.27 +/- 0.08 mm versus 0.48 +/- 0.23 mm, p < .05).

CONCLUSION

FASUS copolymer coating over the vascular stent is effective for preventing thrombus formation and neointimal hyperplasia.

Cytoplasmic calcium level and membrane fluidity of platelets contacting poly(acrylamide-co-methacrylic acid) particles with different surface properties

Changes in cytoplasmic free calcium levels and membrane fluidity of platelets in contact with poly(acrylamide-co-methacrylic acid) (PAAmMAc) particles were examined to analyze the mechanistic aspect of regulating platelet function. Our previous studies demonstrated interesting features of PAAmMAc particles during interaction with platelets: (1) PAAmMAc particles induce no calcium increase but enhance membrane fluidity of platelets: (2) thrombin induces no calcium increase in platelets when the platelets were mixed previously with PAAmMAc particles; and (3) PAAmMAc particles induce a calcium increase in platelets when they were treated previously with sodium azide (NaN3). These results suggest the possibility that PAAmMAc surfaces may regulate the calcium level by influencing platelet metabolism. In this study, non-cross-linked PAAmMAc solution with the same chemical composition as the particles showed a suppressive effect on thrombin-induced calcium increase, but, no influence on membrane fluidity. This result indicates that aggregated macromolecular surface assemblies of PAAmMAc may dominate the increase in membrane fluidity of platelets although the calcium change is induced by discrete molecular level interaction between the PAAmMAc and platelet membranes. It was also revealed that the suppression of thrombin-induced calcium increase and the membrane fluidity increase in platelets by PAAmMAc particles were reduced by albumin-treatment of the particles. This result suggests that such phenomena may be due to a decrease in any physicochemical interaction of PAAmMAc surfaces with albumin, rather than platelet metabolic change. PAAmMAc particle surfaces with higher carboxyl groups exhibited a more suppressive effect on thrombin-induced calcium increase, whereas those with lower carboxyl groups derived a higher calcium increase when the platelets were treated previously with NaN3. These results suggest the importance of electrostatic and any other physicochemical interaction of PAAmMAc chains on regulating cytoplasmic calcium levels.

Densely crosslinked polymer networks of poly(ethylene glycol) in trimethylolpropane triacrylate for cell-adhesion-resistant surfaces

Densely crosslinked semi-interpenetrating polymer networks (semi-IPNs) of poly(ethylene glycol) (PEG) were synthesized by photopolymerizing a melt of PEG of various molecular weights and end-group functionalities in neat trimethylolpropane triacrylate (TMPTA). Increasing the molecular weight of PEG in the matrix from 1000 to 100,000 g/mol reduced the advancing and receding contact angles, contact angle hysteresis, and adsorption of human fibrinogen and bovine serum albumin. Crosslinked TMPTA homonetworks supported human fibroblast adhesion in vitro, whereas the resistance to cell adhesion of the semi-IPNs depended upon PEG molecular weight: Lower molecular weight PEG reduced the number of adherent cells; higher molecular weight PEG further reduced and eliminated cell adhesion, as did networks containing acrylate-functionalized PEG. A polymer system incorporated with PEG throughout a hydrophobic, densely crosslinked matrix, rather than as a blend or surface treatment, may be particularly useful for limiting biologic interactions when bulk material properties must be independent of the solvent environment and where surface abrasion may occur.

Nonthrombogenic polymer vascular prosthesis

Although many synthetic vascular grafts have been developed and evaluated experimentally or clinically, none of them have met long-term patency when applied as a small diameter vascular substitute. We have recently developed a small caliber vascular graft (3 mm i.d.) using a nonthrombogenic polymer coating. The graft consists of three layered structures: Dacron for the outer layer, polyurethane in the middle layer, and a HEMA/styrene block copolymer (HEMA-st) coating for the inner layer. HEMA-st is an amphiphilic block copolymer composed of 2-hydroxyethyl methacrylate and styrene which has demonstrated improved blood compatibility over existing biomedical polymers in both in vitro and ex vivo experiments. Ten grafts were evaluated in a dog bilateral carotid replacement model. The grafts were electively retrieved at 7, 14, 30, 92, and 372 days after implantation. All grafts were patent without detectable thrombi along the graft length including anastomotic sites. Scanning electron micrographs of retrieved graft lumen showed fairly clean surfaces covered with a homogenous protein-like layer without microthrombi or endothelial cell lining. The thickness of the surface protein layer measured by a transmission electron microscopy was what can be described as monolayer protein adsorption regardless of implantation periods of as much as 372 days. A stable monolayer adsorbed protein layer formed on HEMA-st surfaces demonstrated nonthrombogenic activities in vivo and secure long-term patency of small caliber vascular grafts with the absence of an endothelial cell lining.

Antithrombogenicity of hydrophilic polyurethane-hydrophobic polystyrene IPNs. I. Synthesis and characterization

A series of interpenetrating polymer networks (IPNs) composed of hydrophilic polyurethane (PU) and hydrophobic polystyrene (PS) were prepared by the simultaneous polymerization method. The PU network was synthesized via the isocyanate-terminated PU prepolymer based on polyethylene glycol (PEG), a highly hydrophilic oligomer, and hexamethylene diisocyanate (HDI). The bulk and surface characteristics of these materials were analyzed by differential scanning calorimetry (DSC), tensile testing, scanning electron microscopy (SEM), attenuated total reflectance-Fourier transform infrared (ATR-FTIR), electron spectroscopy for chemical analysis (ESCA), and contact angle measurement. The PU/PS IPNs prepared in this study exhibited phase separated structures, which had dispersed PS domains in the continuous PU matrix, in both the bulk and surface showing two transition temperatures. The IPN containing 50 wt% of PS showed good mechanical properties. The enrichment of PU phase in the surface was revealed by SEM, ATR-FTIR, ESCA, and contact angle measurement.

Antithrombogenicity of hydrophilic polyurethane-hydrophobic polystyrene IPNs. II. In vitro and ex vivo studies

To investigate the effect of hydrophilic and hydrophobic surfaces with phase separated structure on their blood responses, interpenetrating polymer networks (IPNs) composed of hydrophilic polyurethane (PU) and hydrophobic polystyrene (PS) were prepared by simultaneous polymerization. In vitro protein adsorption, in vitro platelet adhesion, and ex vivo A-A shunt test were carried out to evaluate the blood compatibility of the PU/PS IPNs. The results of protein adsorption on the PU/PS IPN surfaces indicated that albumin preferentially adsorbed on the hydrophilic surface (PU), while fibrinogen preferentially adsorbed on the hydrophobic surface (PS). The PU/PS IPNs exhibited suppressive properties for both platelet adhesion and activation. The occlusion time of U50S50 IPN containing 50 wt% of PS was twice as long as that of the PU control (50 min), indicating enhanced blood compatibility, presumably due to the selective adsorption of plasma proteins and the suppression of the adhesion and activation of platelets.

Phase studies of a urethane model compound and polyether macroglycols by infrared spectroscopy and the relationship between eutectic composition of soft segment and blood compatibility

The binary mixtures of a urethane model compound, diethyl 4,4'-methylenebis(N-phenylcarbamate) (MDU), and various polyether macroglycols have been investigated mainly by infrared (IR) spectroscopy. The mixtures of macroglycol and MDU showed two C=O bands (free C=O at higher wave number, hydrogen bonded C=O at lower wave number), and the intensity of free C=O increased while that of hydrogen bonded C=O decreased linearly with increasing molar ratio of macroglycol/MDU. The slope of the increase or decrease suddenly changed at the specific molar ratio around the eutectic composition. The eutectic molar composition for PTMO1000/MDU was determined as 1.15 or 1.1 by differential scanning calorimetry (DSC) or infrared (IR) studies while that for PTMO3000/MDU as 0.345 or 0.55 by DSC or IR, respectively. The eutectic compositions for other sets were determined by IR studies as follows: PEO1000/MDU, 0.4; PEO3000/MDU, 0.16; PPO1000/MDU, 1.4; PPO3000/MDU, 0.45. The number of ethylene oxide, tetramethylene oxide, and propylene oxide units to form a eutectic with MDU calculated from these values were 15-20, 10-11, and 23-24, respectively. The similar DSC or IR changes were observed in the various kinds of polyurethanes such as MDI/BD, MDI/PTMO/BD, and MDI/PTMO polymers. The relationship between the eutectic compositions of soft segments (MDI/macroglycol) and the ideal Mn of the macroglycols in blood compatibility of segmented polyurethanes are discussed.

Study of blood compatible polymers. III. Copolymers of N-benzyl, N-(2-hydroxyethyl) acrylamide and 2-hydroxyethyl methacrylate

Copolymerization of 2-hydroxyethyl methacrylate (HEMA) and N-benzyl, N-(2-hydroxyethyl) acrylamide (BENAAm) was carried out at different mole ratios of the monomers to obtain copolymers of varying composition. BENAAm content of the copolymers varies between 13 and 70%. Investigation of the interaction of rabbit platelets with these polymer surfaces showed that copolymers with higher BENAAm content inhibit the platelet deformation. Human umbilical cord fibroblast cells proliferated very well on the copolymer surfaces. The cell growth rate on polyHEMA was relatively low. Maximum cell growth was observed on the copolymer having 87% HEMA.

Does polyethylene oxide possess a low thrombogenicity?

Because of the 'bland' nature of polyethylene oxide towards proteins and cells, considerable effort has been devoted to preparing surfaces rich in polyethylene oxide, using block copolymers, surface immobilization or other methods. It is clear that these modifications result in reduced levels of cell (including platelet) adhesion and protein adsorption, when compared to unmodified and typically hydrophobic substrates. It is far less clear whether the reduced adhesion or adsorption is due specifically to the thermodynamic effects of polyethylene oxide or to the increase in surface hydrophilicity after its immobilization. Even more so, it is unclear whether the reduction in such parameters is evidence of a reduced thrombogenicity.

Mechanism of cytoplasmic calcium changes in platelets in contact with polystyrene and poly(acrylamide-co-methacrylic acid) surfaces

Changes in cytoplasmic free calcium levels ([Ca2+]i) in platelets in contact with polystyrene (PSt) and poly(acrylamide-co-methacrylic acid) (PAAmMAc) particles were evaluated and results were compared with those from two representative biological calcium agonists; thrombin and calcium ionophore A23187. PSt particles stimulated a steep increase in cytoplasmic calcium levels in platelets as much as thrombin and A23187. Serratia protease-treated platelets showed a steep increase in [Ca2+]i by PSt particles, suggesting that PSt surfaces can initiate platelet activation independent of a glycoprotein Ib (GPIb)-mediated pathway. By contrast, dibucaine-treated platelets showed little increase in [Ca2+]i by PSt particles, indicating that microfilament assembly, including binding of GPIb with actin binding protein, should be required for platelet activation in contact with PSt surfaces. PAAmMAc particles induced little increase in cytoplasmic calcium levels in platelets. However, PAAmMAc particle-treated platelets demonstrated little response to thrombin in terms of an increase in [Ca2+]i and ATP release, suggesting the possibility that PAAmMAc surfaces may regulate [Ca2+]i by influencing platelet metabolism. Furthermore, sodium azide-treated platelets showed an increase in [Ca2+]i in platelets when contacting PAAmMAc particles, supporting the suggestion that PAAmMAc surfaces could regulate platelet functions. Fluorescence polarization measurements using 1,6-diphenyl-1,3,5-hexatriene-loaded platelets revealed that PAAmMAc particles increased membrane fluidity in platelets, which may be due to physicochemical interaction with PAAmMAc surfaces.

Surface characterization of 2-hydroxyethyl methacrylate/styrene copolymers by angle-dependent X-ray photoelectron spectroscopy and static secondary ion mass spectrometry

The surface composition and structure of three structurally distinct amphiphilic copolymers of 2-hydroxyethyl methacrylate (HEMA) and styrene have been examined with angle-dependent X-ray photoelectron spectroscopy (XPS) and static secondary ion mass spectrometry (SIMS). The phase-separated block copolymer made by anionic living polymerization, HSH-A50, showed significant surface enrichment of styrene. The outermost 2-3 A appeared to be approximately 100% styrene, with the styrene concentration decreasing to its bulk value at a depth of approximately 50 A from the surface. However, HEMA was detected in the outer 20 A of this copolymer. The presence of HEMA in the surface region implies this copolymer may undergo significant restructuring when hydrated in a hydrophilic environment (as opposed to the hydrophobic environment in which the sample was prepared and analyzed). The phase-separated block copolymer made by telechelic coupling of free radical polymerized functionalized oligomers, HSH-B60, showed only slight styrene enrichment at the surface. Both HEMA and styrene were detected at all sampling depths, including the outermost surface layer, consistent with the presence of discrete HEMA and styrene domains at the copolymer surface. Since both components are already present at the surface under hydrophobic conditions, the degree of restructuring this copolymer may undergo upon hydration should be minor. The random HEMA--styrene copolymer made by conventional free radical initiation techniques, HS-RAN50, had a surface composition that was similar to the bulk composition and independent of depth, as expected for a homogeneously mixed copolymer film.

Study of blood compatible polymers. II. poly(N,N-disubstituted) acrylamides

Poly(N,N-disubstituted) acrylamides with both hydrophilic and hydrophobic groups as substituents were synthesized. Different degrees of hydrophilicity were achieved by varying the bulk of the hydrophobic substituent. N-alkyl, N-(2-hydroxyethyl) acrylamides with alkyl substituents propyl (PROPAAm), octyl (OCTAAm) and benzyl (BENAAm) were synthesized. The swelling capacity of the polymers decreased with increase in bulk of the hydrophobic substituent. In vitro studies showed that the surfaces of these polymers did not induce platelet aggregation. Cell compatibility of these polymers was assessed by following the growth of human umbilical cord fibroblast cells. Pronounced cell growth and spreading was observed on the surfaces of polyOCTAAm and polyBENAAm. The relatively low cell growth on polyPROPAAm was ascribed to its high water content.

Blood compatibility of PEO grafted polyurethane and HEMA/styrene block copolymer surfaces

HEMA/styrene (HEMA/STY) block copolymers and poly(ethylene oxide) 4,000 M.W. (PEO4K) grafted Biomer (B-PEO4K) surfaces have been synthesized, characterized, and evaluated as blood-contacting materials. These surfaces have demonstrated improved blood compatibility, compared to Biomer, in in vitro and ex vivo experiments. Biomer vascular grafts (6 mm I.D. 7 cm in length) were fabricated by a dip coating process. The luminal surface was modified either with PEO grafting, HEMA/STY coating, or Biomer coating (control). These surface-modified grafts were implanted in the abdominal aortas of dogs and evaluated for graft patency and protein adsorption. Surface protein layer thickness was measured by transmission electron microscopy (TEM). B-PEO4K and Biomer showed thick multilayers of adsorbed proteins (1000-2000 A) after 3 weeks to 1 month implantation. In contrast, HEMA/STY only showed a monolayer protein thickness (less than 200 A), even after 3 months. Visualization of adsorbed plasma proteins (albumin, IgG, and fibrinogen) was performed with scanning electron microscopy (SEM)/TEM using an immunogold double antibody technique. The pattern of protein distribution showed high concentrations of fibrinogen and IgG, and less albumin adsorbed onto Biomer and B-PEO4K. In contrast, HEMA/STY showed a patchy protein distribution pattern with high concentrations of albumin and IgG, and relatively less fibrinogen. Adsorbed monolayer patterns showed improved compatibility over multilayered proteins. The Biomer and B-PEO4K grafts occluded within 1 month, while HEMA/STY grafts were patent for over 3 months. The thin and stable adsorbed protein layer on HEMA/STY surfaces may be associated with the microdomain structures of the surface, and will play an important role in long-term in vivo blood compatibility. This manuscript will evaluate the long-term in vivo performance of these polymers, analyze the extent of protein adsorption onto the surfaces, and correlate protein layer thickness to the thrombogenicity of the polymer surfaces.

Poly(dimethylsiloxane)-poly(ethylene oxide)-heparin block copolymers. III: Surface and bulk compositional differences

Previously observed bioactivity of poly(dimethylsiloxane)-poly(ethylene oxide)-heparin (PDMS-PEO-Hep) triblock copolymers has prompted studies of the surface and bulk character of this copolymer using angular-dependent electron spectroscopy for chemical analysis (ADESCA), static secondary mass spectroscopy (SIMS), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA). Because the low-energy PDMS phase dominates surfaces of this copolymer when solvent cast under air or vacuum conditions, attempts were made to explain surface restructuring and rearrangements induced in hydrated or aqueous environments that permit surface accessibility and bioactivity of heparin moieties. Based on comparisons with PDMS, PEO, and heparin homopolymers, PEO/heparin blends, and an unheparinized PDMS-PEO diblock copolymer, PDMS-PEO-heparin demonstrates both phase-mixed and phase-separated regions in DSC analysis. During annealing cycles above the Tg values of the copolymer constituents, phase-mixed regions become increasingly phase separated and PEO enriched. TGA analysis confirmed the presence block copolymer constituents and presented evidence of intermolecular segmental interactions, hence phase-mixing in the copolymers. ADESCA analysis indicates that the outer 5 A of both the PDMS-PEO and PDMS-PEO-Hep copolymers is essentially pure PDMS. However, significant amounts of PEO are detected 5 to 20 A below the surface. Static SIMS also detects the presence of PDMS at the surfaces of the PDMS-PEO and PDMS-PEO-Hep copolymers. Compositional models based on ADESCA, SIMS, and DSC data are presented for desiccated and hydrated copolymer surfaces.

Synthesis and adsorption of a poly(N-acetylethyleneimine)-polyethyleneoxide-poly (N-acetylethyleneimine) triblock-copolymer at a silica/solution interface. Influence of its preadsorption on platelet adhesion and fibrinogen adsorption

The synthesis of a triblock copolymer poly-(N-acetylethyleneimine)-polyethylenoxide-poly(N-acet ylethyleneimine) includes two successive steps: the first is the functionalization of a poly(ethyleneglycol) precursor by creating sulfonic esters at its chain ends, the second uses these esters to initiate the cationic polymerization of 2-methyl-2-oxazoline. Homopolymers appear in the raw product; hence successive selective extractions of the copolymer with benzene and dioxane are necessary. The final yield in pure copolymer was 11%. The copolymer was characterized by UV and 1H-NMR spectrometry and light scattering. Adsorption isotherms were determined on silica, for varying pH and salt concentration. Optimum conditions for coating silica with the polymer were determined. The efficiency of this precoating to reduce the adsorption of fibrinogen was very high (99.2% reduction with respect to bare silica). Steric exclusion chromatography of a variety of proteins gave a satisfactory calibration curve. Platelet accumulation on copolymer precoated glass was reduced to 10-20% of its value on bare glass, a result superior to that obtained by albumin passivation of the same glass surface.

In vitro and ex vivo platelet interactions with hydrophilic-hydrophobic poly(ethylene oxide)-polystyrene multiblock copolymers

Hydrophilic-hydrophobic multiblock copolymers synthesized from telechelic oligomers of poly(ethylene oxide) (PEO) and polystyrene (PS) have been used to study the influence of hydrophilic and hydrophobic balance on interfacial interactions of these surfaces with blood components. In vitro coagulation assays show no inherent ability of these amphiphilic surfaces to affect contact activation or coagulation factors. In vitro platelet adhesion and release reactions from rabbit platelet-rich plasma were shown to be greatest on Biomer and PS homopolymer surfaces and least on cross-linked PEO surfaces, with the PEO-PS block copolymers demonstrating intermediate responses. These same substrates were tested in a new low-flow, low-shear arterio-artery shunt system in rabbits. Whole blood occlusion times were not a direct function of hydrophilic content as both PEO and PS homopolymers and Biomer showed short occlusion times, while PEO-PS block copolymers prolonged occlusion times considerably, depending on composition. Overall, results suggest that PEO-PS block copolymers promote unique whole blood responses in contrast to homopolymer and Biomer controls which are more complex than direct correlations to bulk hydrophilic and hydrophobic contents.

Surface modification for improved blood compatibility

Several surface modification techniques are currently being used to improve the biocompatibility of blood-contacting devices. These include the immobilization of bioactive materials to prevent thrombus generation and platelet activation, the incorporation of hydrophilic grafts onto practical hydrophobic surfaces (polyurethanes) to reduce protein adsorption, and the concept of microdomain-phase separated surfaces to regulate cellular and protein adhesion.

Poly(dimethylsiloxane)-poly(ethylene oxide)-heparin block copolymers. I. Synthesis and characterization

Amphiphilic block copolymers containing poly(dimethylsiloxane), poly(ethylene oxide), and heparin (PDMS-PEO-Hep) have been prepared via a series of coupling reactions using functionalized prepolymers, diisocyanates, and derivatized heparins. All intermediate steps of the synthesis yield quantifiable products with reactive end-groups, while the final products demonstrate bioactive, covalently bound heparin moieties. Due to the solvent systems required, commercial sodium heparin was converted to its benzyltrimethyl ammonium salt to enhance its solubility. The same procedure was applied to heparin degraded by nitrous acid in order to covalently couple it in solutions with the semitelechelic copolymers. As might be expected, this derivatization reduces the apparent bioactivity of the heparin. However, preliminary findings suggest that the bioactivity can be restored by reforming the heparin sodium salt.