The role of adsorbed fibrinogen in platelet adhesion to polyurethane surfaces: A comparison of surface hydrophobicity, protein adsorption, monoclonal antibody binding, and platelet adhesion

Enhancing cellular affinity for skin disorders: Electrospun polyurethane/collagen nanofiber mats coated with phytoceramides

Although the use of thermoplastic polyurethane (Tpu) nanofiber mats as wound dressings is of great interest due to their mechanical properties, they are hindered by their poor wettability and bioavailability. In this study, we aimed to improve the cellular affinity of Tpu nanofiber mats for skin disorders by incorporating extracted collagen (Col) from tendons and physically mixed with a layer of phytoceramides (Phyto) to produce TpuCol@X-Phyto mats in which the weight % of Phyto relatively to the weight of the solution was X = 0.5, 1, or 1.5 wt% via facile electrospinning approach. The collective observations strongly indicate the successful incorporation and retention of Phyto within the TpuCol architecture. An increase in the Phyto concentration decreased the water contact angle from 69.4° ± 3.47° to 57.9° ± 2.89°, demonstrating improvement in the hydrophilicity of Tpu and binary blend TpuCol nanofiber mats. The mechanical property of 1.0 wt% Phyto aligns with practical requirements owing to the presence of two hydroxyl groups and the amide linkage likely contributing to various hydrogen bonds, providing mechanical strength to the channel structure and a degree of rigidity essential for transmitting mechanical stress. The proliferation of human skin fibroblast (HSF) peaked significantly 100 % with TpuCol@X-Phyto mats coated for X =1.0 and 1.5 wt% of Phyto. Electrospun scaffolds with the highest Phyto content have shown the lowest degree of hemolysis, demonstrating the high level of compatibility between them and blood. The TpuCol@1.5Phyto mat also demonstrated higher efficacy in antibacterial and antioxidant activities, achieving a rate of DPPH radical scavenging of 83.3 % for this latter property. The most notable wound closure among all tested formulations was attributed to higher Phyto. Thus, the developed TpuCol@1.5Phyto nanofiber formula exhibited enhanced healing in an in vitro epidermal model.

Protein adsorption on blood-contacting surfaces: A thermodynamic perspective to guide the design of antithrombogenic polymer coatings

Blood-contacting medical devices often succumb to thrombosis, limiting their durability and safety in clinical applications. Thrombosis is fundamentally initiated by the nonspecific adsorption of proteins to the material surface, which is strongly governed by thermodynamic factors established by the nature of the interaction between the material surface, surrounding water molecules, and the protein itself. Along these lines, different surface materials (such as polymeric, metallic, ceramic, or composite) induce different entropic and enthalpic changes at the surface-protein interface, with material wettability significantly impacting this behavior. Consequently, protein adsorption on medical devices can be modulated by altering their wettability and surface energy. A plethora of polymeric coating modifications have been utilized for this purpose; hydrophobic modifications may promote or inhibit protein adsorption determined by van der Waals forces, while hydrophilic materials achieve this by mainly relying on hydrogen bonding, or unbalanced/balanced electrostatic interactions. This review offers a cohesive understanding of the thermodynamics governing these phenomena, to specifically aid in the design and selection of hemocompatible polymeric coatings for biomedical applications. STATEMENT OF SIGNIFICANCE: Blood-contacting medical devices often succumb to thrombosis, limiting their durability and safety in clinical applications. A plethora of polymeric coating modifications have been utilized for addressing this issue. This review offers a cohesive understanding of the thermodynamics governing these phenomena, to specifically aid in the design and selection of hemocompatible polymeric coatings for biomedical applications.

Understanding the "Berg limit": the 65° contact angle as the universal adhesion threshold of biomatter

Surface phenomena in aqueous environments such as long-range hydrophobic attraction, macromolecular adhesion, and even biofouling are predominantly influenced by a fundamental parameter-the water contact angle. The minimal contact angle required for these and related phenomena to occur has been repeatedly reported to be around 65° and is commonly referred to as the "Berg limit." However, the universality of this specific threshold across diverse contexts has remained puzzling. In this perspective article, we aim to rationalize the reoccurrence of this enigmatic contact angle. We show that the relevant scenarios can be effectively conceptualized as three-phase problems involving the surface of interest, water, and a generic oil-like material that is representative of the nonpolar constituents within interacting entities. Our analysis reveals that attraction and adhesion emerge when substrates display an underwater oleophilic character, corresponding to a "hydrophobicity under oil", which occurs for contact angles above approximately 65°. This streamlined view provides valuable insights into macromolecular interactions and holds implications for technological applications.

Angiogenic and immunomodulation role of ions for initial stages of bone tissue regeneration

It is widely known that bone has intrinsic capacity to self-regenerate after injury. However, the physiological regeneration process can be impaired when there is an extensive damage. One of the main reasons is due to the inability to establish a new vascular network that ensures oxygen and nutrient diffusion, leading to a necrotic core and non-junction of bone. Initially, bone tissue engineering (BTE) emerged to use inert biomaterials to just fill bone defects, but it eventually evolved to mimic bone extracellular matrix and even stimulate bone physiological regeneration process. In this regard, the stimulation of osteogenesis has gained a lot of attention especially in the proper stimulation of angiogenesis, being critical to achieve a successful osteogenesis for bone regeneration. Besides, the immunomodulation of a pro-inflammatory environment towards an anti-inflammatory one upon scaffold implantation has been considered another key process for a proper tissue restoration. To stimulate these phases, growth factors and cytokines have been extensively used. Nonetheless, they present some drawbacks such as low stability and safety concerns. Alternatively, the use of inorganic ions has attracted higher attention due to their higher stability and therapeutic effects with low side effects. This review will first focus in giving fundamental aspects of initial bone regeneration phases, focusing mainly on inflammatory and angiogenic ones. Then, it will describe the role of different inorganic ions in modulating the immune response upon biomaterial implantation towards a restorative environment and their ability to stimulate angiogenic response for a proper scaffold vascularization and successful bone tissue restoration. STATEMENT OF SIGNIFICANCE: The impairment of bone tissue regeneration when there is excessive damage has led to different tissue engineered strategies to promote bone healing. Significant importance has been given in the immunomodulation towards an anti-inflammatory environment together with proper angiogenesis stimulation in order to achieve successful bone regeneration rather than stimulating only the osteogenic differentiation. Ions have been considered potential candidates to stimulate these events due to their high stability and therapeutic effects with low side effects compared to growth factors. However, up to now, no review has been published assembling all this information together, describing individual effects of ions on immunomodulation and angiogenic stimulation, as well as their multifunctionality or synergistic effects when combined together.

Rutile facet-dependent fibrinogen conformation: Why crystallographic orientation matters

Previous studies implied that single crystalline rutile surfaces have the ability to guide the functionality of adsorbed blood plasma proteins. However, a clear relation between the rutile crystallographic orientation and conformation of adsorbed proteins is still missing. Here, we examine the adsorption characteristics of human plasma fibrinogen (HPF) on atomically flat single rutile crystals with (110), (100), (101) and (001) facets. By direct visualization of individual protein molecules through atomic force microscopy (AFM) imaging, the distinct conformations of HPF were determined depending on rutile surface crystallographic orientation. In particular, dominant trinodular and globular conformation was found on (110) and (001) facets, respectively. The observed variations of HPF conformation were reasoned from the surface water contact angle and surface energy point of view. By analyzing AFM-based force measurements, statistically significant changes in surface energies of rutile surfaces covered with HPF were determined and linked to HPF conformation. Furthermore, the facet-dependent structural rearrangement of HPF was indirectly confirmed through deconvolution of high-resolution X-ray photoelectron spectroscopy (XPS) carbon and nitrogen spectra. The globular, and thus native-like HPF conformation observed on (001) facet, was reflected in the lowest level of amino group formation. We propose that the mechanism behind the crystallographic orientation-induced HPF conformation is driven by the facet-specific surface hydrophilicity and energy. From the biomedical material perspective, our results demonstrate that the conformation of HPF can be guided by controlling the crystallographic orientation of the underlying material surface. This might be beneficial to the field of titanium-based biomaterials design and development.

XPS and ToF-SIMS Characterization of New Biodegradable Poly(Peptide-Urethane-Urea) Block Copolymers

New, linear, segmented poly(peptide-urethane-urea) (PPUU) block copolymers are synthesized and their surface compositions are characterized with angle dependent X-ray photoelectron spectroscopy (ADXPS) and time-of-flight secondary ion mass spectrometry (ToF-SIMS). These new PPUU block copolymers contain three types of segments. The soft segment (SS) is poly(caprolactone diol) (PCL). The hard segment is lysine diisocyanate with a hydrazine chain extender. The oligopeptide segment (OPS) contains three types of amino acids (proline, hydroxyproline, and glycine). Incorporation of the OPS into the polyurethane backbone is done to provide a synthetic polymer material with controllable biodegradation properties. As biodegradation processes normally are initiated at the interface between the biomaterial and the living tissue, it is important to characterize the surface composition of biomaterials. ADXPS and ToF-SIMS results show that the surfaces of all four polymers are enriched with the PCL SS, the most hydrophobic component of the three polymer segments.

Investigation on Blood Compatibility of Cu/Ti Metal Coating Prepared via Various Bias Voltages and Copper Content

Surface modification of some metal coatings is usually used to improve the blood compatibility of biomaterials; however, some aspects of the bological properties of metal coatings cannot be adjusted via the content of each component. In this work, Cu/Ti metal coatings with various amounts of copper content were prepared by the physical vapor deposition (PVD) method, and the influence of deposition bias was further investigated. Phase structure, element composition and surface morphology were investigated by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy, respectively. The hemolysis ratio, platelet adhesion and protein adsorption were applied to evaluate the blood compatibility. The results show that a Cu/Ti coating of uniform quality can be obtained; the dispersion of the deposition and copper content is regulated by the number of copper sheets, but the deposition bias does not obviously affect the copper content of the Cu/Ti coating. The hemolysis rate of the Cu/Ti coating is less than 0.4%, the degree of platelet adhesion is significantly reduced on Cu/Ti coatings compared to control samples, and the contact angle of all coatings is greater than that of pure titanium. The largest adsorption capacity of BSA was found on the coating with the deposition bias voltage of −40 V. The number of copper flakes is increased, and the adsorption of FIB on the Cu/Ti coating surface is reduced. Therefore, Cu/Ti coatings prepared via this deposition method have potential for applications to regulate blood compatibility and surface performance.

Reduced thrombogenicity of surface-treated Nitinol implants steered by altered protein adsorption

Blood-contacting medical implants made of Nitinol and other titanium alloys, such as neurovascular flow diverters and peripheral stents, have the disadvantage of being highly thrombogenic. This makes the use of systemic (dual) anti-platelet/anticoagulant therapies inevitable with related risks of device thrombosis, bleeding and other complications. Meeting the urgent clinical demand for a less thrombogenic Nitinol surface, we describe here a simple treatment of standard, commercially available Nitinol that renders its surface ultra-hydrophilic and functionalized with phosphate ions. The efficacy of this treatment was assessed by comparing standard and surface-treated Nitinol disks and braids, equivalent to flow diverters. Static and dynamic (Chandler loop) blood incubation tests showed a drastic reduction of thrombus formation on treated devices. Surface chemistry and proteomic analysis indicated a key role of phosphate and calcium ions in steering blood protein adsorption and avoiding coagulation cascade activation and platelet adhesion. A good endothelialization of the surface confirmed the biocompatibility of the treated surface. STATEMENT OF SIGNIFICANCE: Titanium alloys such as Nitinol are biocompatible and show favorable mechanical properties, which led to their widespread use in medical implants. However, in contact with blood their surface triggers the activation of the intrinsic coagulation cascade, which may result in catastrophic thrombotic events. The presented results showed that a phosphate functionalization of the titanium oxide surface suppresses the activation of both coagulation cascade and platelets, avoiding the subsequent formation of a blood clot. This novel approach has therefore a great potential for mitigating the risks associated to either thrombosis or bleeding complications (due to systemic anticoagulation) in patients with cardiovascular implants.

Predicting the In Vivo Performance of Cardiovascular Biomaterials: Current Approaches In Vitro Evaluation of Blood-Biomaterial Interactions

The therapeutic efficacy of a cardiovascular device after implantation is highly dependent on the host-initiated complement and coagulation cascade. Both can eventually trigger thrombosis and inflammation. Therefore, understanding these initial responses of the body is of great importance for newly developed biomaterials. Subtle modulation of the associated biological processes could optimize clinical outcomes. However, our failure to produce truly blood compatible materials may reflect our inability to properly understand the mechanisms of thrombosis and inflammation associated with biomaterials. In vitro models mimicking these processes provide valuable insights into the mechanisms of biomaterial-induced complement activation and coagulation. Here, we review (i) the influence of biomaterials on complement and coagulation cascades, (ii) the significance of complement-coagulation interactions for the clinical success of cardiovascular implants, (iii) the modulation of complement activation by surface modifications, and (iv) in vitro testing strategies.

Immunomodulatory biomaterials and their application in therapies for chronic inflammation-related diseases

The degree of tissue injuries such as the level of scarring or organ dysfunction, and the immune response against them primarily determine the outcome and speed of healing process. The successful regeneration of functional tissues requires proper modulation of inflammation-producing immune cells and bioactive factors existing in the damaged microenvironment. In the tissue repair and regeneration processes, different types of biomaterials are implanted either alone or by combined with other bioactive factors, which will interact with the immune systems including immune cells, cytokines and chemokines etc. to achieve different results highly depending on this interplay. In this review article, the influences of different types of biomaterials such as nanoparticles, hydrogels and scaffolds on the immune cells and the modification of immune-responsive factors such as reactive oxygen species (ROS), cytokines, chemokines, enzymes, and metalloproteinases in tissue microenvironment are summarized. In addition, the recent advances of immune-responsive biomaterials in therapy of inflammation-associated diseases such as myocardial infarction, spinal cord injury, osteoarthritis, inflammatory bowel disease and diabetic ulcer are discussed.

How Nanotopography-Induced Conformational Changes of Fibrinogen Affect Platelet Adhesion and Activation

The conformational state of adsorbed human plasma fibrinogen (HPF) has been recognized as the determinant factor in platelet adhesion and thrombus formation on blood-contacting biomaterials. Studies have highlighted the ability to control the HPF conformation merely by tailoring surface nanotopographical features. However, a clear relationship between the conformational changes of adsorbed HPF and the degree of platelet adhesion and activation achieved with different surface nanotopographies is still unclear. Here, we examined HPF assembly characteristics on nanostructured polybutene-1 (PB-1) surfaces with nanosized lamellar crystals (LCs), needle-like crystals (NLCs), and a nanostructured high-density polyethylene (HDPE) surface with shish-kebab crystals (SKCs), at a biologically relevant HPF concentration. By exposing the nanostructured surfaces with preadsorbed HPF to human platelets, significant differences in platelet response on LCs/SKCs and NLCs were identified. The former presented a uniform monolayer in the advanced stage of activation, whereas the latter exhibited minimal adhesion and the early stage of activation. Distinct platelet response was related to the postadsorption conformational changes in HPF, which were confirmed by topography-dependent shifts of the amide I band in attenuated total reflection-Fourier transform infrared (ATR-FTIR) analysis. Supported by atomic force microscopy (AFM) characterization, we propose that the mechanism behind the nanotopography-induced HPF conformation is driven by the interplay between the aspect ratios of polymeric crystals and HPF. From the biomedical perspective, our work reveals that surface structuring in a nanoscale size regime can provide a fine-tuning mechanism to manipulate HPF conformation, which can be exploited for the design of thromboresistant biomaterials surfaces.

Modulation of Platelet-Surface Activation: Current State and Future Perspectives

Modulation of platelet-surface activation is important for many biomedical applications such as in vivo performance, platelet storage, and acceptance of an implant. Reducing platelet-surface activation is challenging because they become activated immediately after short contact with nonphysiological surfaces. To date, controversies and open questions in the field of platelet-surface activation still remain. Here, we review state-of-the-art approaches in inhibiting platelet-surface activation, mainly focusing on modification, patterning, and methodologies for characterization of the surfaces. As a future perspective, we discuss how the combination of biochemical and physiochemical strategies together with the topographical modulations would assist in the search for an ideal nonthrombogenic surface.

Surface Zwitterionization of Expanded Poly(tetrafluoroethylene) via Dopamine-Assisted Consecutive Immersion Coating

Expanded polytetrafluoroethylene (ePTFE) is one of the materials widely used in the biomedical field, yet its application is being limited by adverse reactions such as thrombosis when it comes in contact with blood. Thus, a simple and robust way to modify ePTFE to be biologically inert is sought after. Modification of ePTFE without high-energy pretreatment, such as immersion coating, has been of interest to researchers for its straightforward process and ease in scaling up. In this study, we utilized a two-step immersion coating to zwitterionize ePTFE membranes. The first coating consists of the co-deposition of polyethylenimine (PEI) and polydopamine (PDA) to produce amine groups in the surface of the ePTFE for further functionalization. These amine groups from PEI will be coupled with the epoxide group of the zwitterionic copolymer, poly(GMA-co-SBMA) (PGS), via a ring-opening reaction in the second coating. The coated ePTFE membranes were physically and chemically characterized to ensure that each step of the coating is successful. The membranes were also tested for their thrombogenicity via quantification of the blood cells attached to it during contact with biological solutions. The coated membranes exhibited around 90% reduction in attachment with respect to the uncoated ePTFE for both Gram-positive and Gram-negative strains of bacteria (Staphylococcus aureus and Escherichia coli). The coating was also able to resist blood cell attachment from human whole blood by 81.57% and resist red blood cell attachment from red blood cell concentrate by 93.4%. These ePTFE membranes, which are coated by a simple immersion coating, show significant enhancement of the biocompatibility of the membranes, which shows promise for future use in biological devices.

Conjugated Linoleic Acid Grafting Improved Hemocompatibility of the Polycaprolactone Electrospun Membrane

Polycaprolactone (PCL) is a versatile biomaterial with a wide range of medical applications, but its use in blood-contacting devices is hampered due to insufficient hemocompatibility. In this work, electrospun polycaprolactone (PCL) membranes were chemically grafted with conjugated linoleic acid (CLA) to prevent induced blood coagulation. The density of grafted CLA and its effects on the morphology and wettability of the membranes were examined. The study also investigated how the membrane interacted with human whole blood and platelets to determine its antithrombotic properties. As the results suggested, the grafting caused a negligible effect on the physical properties of the membrane but greatly improved its compatibility with blood, showing that the approach can be investigated further for blood-contacting applications.

Polyurethane/polycaprolactone membrane grafted with conjugated linoleic acid for artificial vascular graft application

Constructing satisfied small-diameter vascular graft (diameter less than 6 mm) remains an unsolvable challenge in vascular tissue engineering. This study described the fabrication of electrospun polyurethane/polycaprolactone (PU/PCL) membranes chemically grafted with various densities of conjugated linoleic acid (CLA) - an antithrombotic fatty acid - for making small-diameter blood vessel. Differences in mechanical, antithrombotic properties and biocompatibility of the membranes resulting from the CLA-grafting procedure were the focus of the study. Investigation of mechanical properties relevant to vascular graft application revealed that these properties of the membranes remained unaffected and satisfied clinical criteria following the CLA graft. Blood-membrane interaction assays showed that the CLA-grafted membranes mitigated the adhesion of blood cells, as well as preventing blood coagulation. These effects were also commensurate with increasing density of CLA, suggesting an effective approach to improve antithromboticity. Cellular tests suggested that CLA has an optimal density at which it promoted cell proliferation on the surface of the membranes; however, excessive presence of CLA might cause undesirable inhibition on cells. In conclusion, PU/PCL membrane grafted with CLA could be a prospective material for vascular tissue engineering with further development and investigation.

Autoantibody testing by enzyme-linked immunosorbent assay-a case in which the solid phase decides on success and failure

BACKGROUND

The enzyme-linked immunosorbent assay (ELISA) is an indispensable tool for clinical diagnostics to identify or differentiate diseases such as autoimmune illnesses, but also to monitor their progression or control the efficacy of drugs. One use case of ELISA is to differentiate between different states (e.g. healthy vs. diseased). Another goal is to quantitatively assess the biomarker in question, like autoantibodies. Thus, the ELISA technology is used for the discovery and verification of new autoantibodies, too. Of key interest, however, is the development of immunoassays for the sensitive and specific detection of such biomarkers at early disease stages. Therefore, users have to deal with many parameters, such as buffer systems or antigen-autoantibody interactions, to successfully establish an ELISA. Often, fine-tuning like testing of several blocking substances is performed to yield high signal-to-noise ratios.

METHODS

We developed an ELISA to detect IgA and IgG autoantibodies against chitinase-3-like protein 1 (CHI3L1), a newly identified autoantigen in inflammatory bowel disease (IBD), in the serum of control and disease groups (n = 23, respectively). Microwell plates with different surface modifications (PolySorp and MaxiSorp coating) were tested to detect reproducibility problems.

RESULTS

We found a significant impact of the surface properties of the microwell plates. IgA antibody reactivity was significantly lower, since it was in the range of background noise, when measured on MaxiSorp coated plates (p < 0.0001). The IgG antibody reactivity did not differ on the diverse plates, but the plate surface had a significant influence on the test result (p = 0.0005).

CONCLUSION

With this report, we want to draw readers' attention to the properties of solid phases and their effects on the detection of autoantibodies by ELISA. We want to sensitize the reader to the fact that the choice of the wrong plate can lead to a false negative test result, which in turn has serious consequences for the discovery of autoantibodies.

In Vivo Evaluation of the Biocompatibility of Biomaterial Device

Biomaterials are widely used to produce devices for regenerative medicine. After its implantation, an interaction between the host immune system and the implanted biomaterial occurs, leading to biomaterial-specific cellular and tissue responses. These responses may include inflammatory, wound healing responses, immunological and foreign-body reactions, and even fibrous encapsulation of the implanted biomaterial device. In fact, the cellular and molecular events that regulate the success of the implant and tissue regeneration are played at the interface between the foreign body and the host inflammation, determined by innate and adaptive immune responses. This chapter focuses on host responses that must be taken into consideration in determining the biocompatibility of biomaterial devices when implanted in vivo of animal models.

Hemocompatibility of Super-Repellent surfaces: Current and Future

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

The blood compatibility challenge. Part 2: Protein adsorption phenomena governing blood reactivity

The adsorption of proteins is the initiating event in the processes occurring when blood contacts a "foreign" surface in a medical device, leading inevitably to thrombus formation. Knowledge of protein adsorption in this context has accumulated over many years but remains fragmentary and incomplete. Moreover, the significance and relevance of the information for blood compatibility are not entirely agreed upon in the biomaterials research community. In this review, protein adsorption from blood is discussed under the headings "agreed upon" and "not agreed upon or not known" with respect to: protein layer composition, effects on coagulation and complement activation, effects on platelet adhesion and activation, protein conformational change and denaturation, prevention of nonspecific protein adsorption, and controlling/tailoring the protein layer composition. STATEMENT OF SIGNIFICANCE: This paper is part 2 of a series of 4 reviews discussing the problem of biomaterial associated thrombogenicity. The objective was to highlight features of broad agreement and provide commentary on those aspects of the problem that were subject to dispute. We hope that future investigators will update these reviews as new scholarship resolves the uncertainties of today.

Biomaterials: Foreign Bodies or Tuners for the Immune Response?

The perspectives of regenerative medicine are still severely hampered by the host response to biomaterial implantation, despite the robustness of technologies that hold the promise to recover the functionality of damaged organs and tissues. In this scenario, the cellular and molecular events that decide on implant success and tissue regeneration are played at the interface between the foreign body and the host inflammation, determined by innate and adaptive immune responses. To avoid adverse events, rather than the use of inert scaffolds, current state of the art points to the use of immunomodulatory biomaterials and their knowledge-based use to reduce neutrophil activation, and optimize M1 to M2 macrophage polarization, Th1 to Th2 lymphocyte switch, and Treg induction. Despite the fact that the field is still evolving and much remains to be accomplished, recent research breakthroughs have provided a broader insight on the correct choice of biomaterial physicochemical modifications to tune the reaction of the host immune system to implanted biomaterial and to favor integration and healing.

Trifluoromethyl-functionalized poly(lactic acid): a fluoropolyester designed for blood contact applications

Fluorinated polymers are strong candidates for development of new cardiovascular medical devices, due to their lower thrombogenicity as compared to other polymers used for cardiovascular implants.

Enhancing anti-thrombogenicity of biodegradable polyurethanes through drug molecule incorporation

Sufficient and sustained anti-thrombogenicity is essential for blood-contacting materials, because blood coagulation and thrombosis caused by platelet adhesion and activation on material surfaces may lead to functional failure and even fatal outcomes. Covalently conjugating antithrombogenic moieties into polymer, instead of surface modifying or blending, can maintain the anti-thrombogenicity of polymer at a high level over a time range. In this study, series of randomly crosslinked, elastic, biodegradable polyurethanes (PU-DPA) were synthesized through a one-pot and one-step method from polycaprolactone (PCL) diol, hexamethylene diisocyanate (HDI) and anti-thrombogenic drug, dipyridamole (DPA). The mechanical properties, hydrophilicity, in vitro degradation, and anti-thrombogenicity of the resultant PU-DPA polymers can be tuned by altering the incorporated DPA amount. The surface and bulk hydrophilicity of the polyurethanes decreased with increasing hydrophobic DPA amount. All PU-DPA polymers exhibited strong mechanical properties and good elasticity. The degradation rates of the PU-DPAs decreased with increasing DPA content in both PBS and lipase/PBS solutions. Covalently incorporating DPA into the polyurethane significantly reduced the platelet adhesion and activation compared to the polyurethane without DPA, and also can achieve sustained anti-thrombogenicity. The PU-DPA films also supported the growth of human umbilical vein endothelial cells. The attractive mechanical properties, blood compatibility, and cell compatibility of this anti-thrombogenic biodegradable polyurethane indicate that it has a great potential to be utilized for blood-contacting devices, and cardiovascular tissue repair and regeneration.

A proteomics study to explore the role of adsorbed serum proteins for PC12 cell adhesion and growth on chitosan and collagen/chitosan surfaces

The aim of this article is to apply proteomics in the comparison of the molecular mechanisms of PC12 cell adhesion and growth mediated by the adsorbed serum proteins on the surfaces of chitosan and collagen/chitosan films. First, the chitosan and the collagen/chitosan films were prepared by spin coating; and their surface morphologies were characterized by scanning electron microscopy, X-ray energy dispersive spectroscopy, contact angle measurement and Fourier transform infrared spectroscopy. Subsequently, cell proliferation experiments on two materials were performed and the dynamic curves of protein adsorption on their surfaces were measured. Then, proteomics and bioinformatics were used to analyze and compare the adsorbed serum proteins on the surfaces of two biomaterials; and their effects on cell adhesion were discussed. The results showed that the optimum concentration of chitosan film was 2% w/v. When compared with chitosan film, collagen/chitosan film promoted the growth and proliferation of PC12 cells more significantly. Although the dynamic curves showed no significant difference in the total amount of the adsorbed proteins on both surfaces, proteomics and bioinformatics analyses revealed a difference in protein types: the chitosan surface adsorbed more vitronectin whereas collagen/chitosan surface adsorbed more fibronectin 1 and contained more cell surface receptor binding sites and more Leu-Asp-Val sequences in its surface structure; the collagen/chitosan surface were more conducive to promoting cell adhesion and growth.

Surface fluorination of polylactide as a path to improve platelet associated hemocompatibility

Surface-induced thrombosis is still a significant clinical concern for many types of blood-contacting medical devices. In particular, protein adsorption and platelet adhesion are important events due to their ability to trigger the coagulation cascade and initiate thrombosis. Poly(lactic acid) (PLA) has been the predominant polymer used for making bioresorbable stents. Despite long-term advantages, these stents are associated with higher rates of early thrombosis compared with permanent metallic stents. To address this issue, we modified the surface of PLA with a perfluoro compound facilitated by surface activation using radio frequency (RF) plasma. Fluoropolymers have been extensively used in blood contacting materials, such as blood vessel replacements due to their reduced thrombogenicity and reduced platelet reactivity. The compositions of plasma-treated surfaces were determined by electron spectroscopy for chemical analysis (ESCA). Also, contact angle measurements, cell cytotoxicity and the degradation profile of the treated polymers are presented. Finally, relevant blood compatibility parameters, including plasma protein adsorption, platelet adhesion and morphology, were evaluated. We hypothesized that tight binding of adsorbed albumin by fluoropolymers enhances its potential for blood-contacting applications.

STATEMENT OF SIGNIFICANCE

Although bioresorbable stents made from poly(lactic acid) (PLA) may have long-term clinical advantages, they have shown higher rates of early thrombosis as compared with permanent metallic stents. To improve the thromboresistance of PLA, we developed a novel method for surface fluorination of this polymer with a perfluoro compound. Fluoropolymers (e.g., expanded polytetrafluoroethylene) have long been used in blood-contacting applications due to their satisfactory clinical performance. This is the first report of PLA surface fluorination which might be applied to the fabrication of a new generation of fluorinated PLA stents with improved platelet interaction, tunable degradability and drug release capabilities. Also, we describe a general strategy for improving the platelet interactions with biomaterials based on albumin retention.

BIOCOMPATIBILITY EVALUATION OF DRUG RELEASING ABSORBABLE VASCULAR STENTS

This study examined the biocompatibility of blood vessels and a biodegradable drug-loaded vascular stent. The Traditional Chinese Medicine System Laboratory of Chung Yuan Christian University prepared the vascular stent, and our study verified the sustained release of drugs from the stent when it was within blood vessels. A platelet adhesion experiment revealed that stents with less surface roughness resulted in a reduction in the number of adhered platelets and decreased fibrinogen accumulation. The results of a hemolysis experiment verified that the hemolysis index was between 1% and 1.4%, within the range of no hemolysis and would not cause hypoxia. Subsequently, a drug release rate experiment indicated that the amount of released everolimus increased with time. The greatest amount of drug that was released occurred at 8[Formula: see text]h, with a release rate of 36.95%. A swelling rate experiment revealed that the degree of swelling of the hyaluronic acid (HA) that contained everolimus was 10 times less than that of the original HA; therefore, the use of a material with a low swelling rate in vascular stents did not immediately cause an obstruction in blood vessels. A lactate dehydrogenase (LDH) toxicity experiment revealed that the percentage of LDH released was 13–18%. This indicated that the cell viability was not affected and that there was no cytotoxicity; thus, the stent was suitable for use in blood vessels. This study proved that the prepared biodegradable drug-loaded vascular stent had favorable blood compatibility, no cytotoxicity, and a suitable drug release rate. Moreover, the drug release material was made from a material with a low degree of swelling. As a result of our findings, this new type of stent is suitable for application in blood vessels.

Fibrinogen adsorption to biomaterials

Fibrinogen (Fg) adsorption is an important mechanism underlying cell adhesion to biomaterials and was the major focus of the author's research career. This article summarizes our work on Fg adsorption, with citations of related work as appropriate. The molecular properties of Fg that promote adsorption and cell adhesion will be described. In addition, the adsorption behavior of Fg from buffer, binary solutions with other proteins, and blood plasma will be discussed, including the Vroman effect. Studies of platelet adhesion to surfaces preadsorbed with blood plasmas selectively deficient in Fg, vitronectin (Vn), fibronectin (Fn), or von Willebrand's factor (vWf) will be reviewed. These studies clearly showed a major role for Fg in platelet adhesion under static conditions and both Fg and vWf for adhesion from flowing suspensions, but no significant role for Vn or Fn. However, it was also shown that platelet adhesion was poorly correlated with the total amount of adsorbed Fg, but very well correlated with the binding of antibodies specific to the cell binding domains of Fg. A brief overview of nonfouling surfaces for prevention of Fg adsorption will be given. A more extensive discussion of structural changes in Fg after its adsorption is included, including changes detected with both physicochemical and biological methods. A short discussion of the state of the art of structural determination of adsorbed proteins with computational methods is also given. A final section identifies Fg adsorption as the single most important event determining the biocompatibility of implants in soft tissue and in blood. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 2777-2788, 2018.

N-halamine-based multilayers on titanium substrates for antibacterial application

Bacterial infection is one of the most severe postoperative complications leading to clinical orthopedic implants failure. To improve the antibacterial property of titanium (Ti) substrates, a bioactive coating composed of chitosan-1-(hydroxymethyl)- 5,5-dimethylhydantoin (Chi-HDH-Cl) and gelatin (Gel) was fabricated via layer-by-layer (LBL) assembly technique. The results of Fourier transform infrared spectroscopy (FTIR), nuclear magnetic resonance (¹HNMR) and X-ray photoelectron spectroscopy (XPS) showed that Chi-HHD-Cl conjugate was successfully synthesized. Scanning electron microscopy (SEM), atomic force microscope (AFM) and water contact angle measurements were employed to monitor the morphology, roughness changes and surface wettability of Ti substrates, which proved the multilayers coating formation. Antibacterial assay against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) revealed that the Gel/Chi-HDH-Cl modified Ti substrates most efficiently inhibited the adhesion and growth of bacteria. Meanwhile, in vitro cellular tests confirmed that Gel/Chi-HDH-Cl multilayers had no obvious cytotoxicity to osteoblasts. The study thus provides a promising method to fabricate antibacterial Ti-based substrates for potential orthopedic application.

Galloyl groups-regulated fibrinogen conformation: Understanding antiplatelet adhesion on tannic acid coating

Fibrinogen (Fgn) has been identified as the key protein in the process of biomaterial-induced platelet adhesion. We have recently reported a facile and effective method for constructing platelet-repellent surface using a natural polyphenol component tannic acid (TA). However, the mechanism by which the TA surface repels platelets was not fully understood. To address this issue, we investigated the adsorption of Fgn (amount and conformation) on four TA-functionalized surfaces with different amounts of galloyl groups and the potential for platelet adherence on these surfaces. The experimental results indicated that the four TA-functionalized surfaces adsorbed a similar amount of Fgn, but the conformation and bioactivity of the adsorbed Fgn and the subsequent platelet adherence were quite different among the surfaces. The TA surface with the most galloyl groups induced minimal changes in the conformation of Fgn, a result of the α and γ chains of the adsorbed Fgn being highly inactive on the surface, thus leading to an outstanding antiplatelet adhesion performance. With a decreased amount of galloyl groups, the activity of the α chain in the adsorbed Fgn remained unchanged, but the activity of the γ chain and the extent of platelet adhesion gradually increased. This work provided a new concept for controlling platelet adhesion on solid materials, and we envision that the TA film could have potential applications in the development of new blood-contacting biomaterials in the future.

STATEMENT OF SIGNIFICANCE

Reducing platelet adhesion on material surfaces is of tremendous scientific interest in the field of blood-contacting biomaterials, but it remains a big challenge due to the highly adhesive nature of the platelets. In this study, we demonstrated for the first time that tannic acid surface with abundant galloyl groups could induce minimal conformational changes of fibrinogen, eventually leading to an outstanding antiplatelet adhesion effect. In addition, the platelet adhesion response could be easily controlled through regulating the amount of galloyl groups on the surface. This work provided a new strategy for controlling platelet adhesion on solid materials, which was totally different from existing methods such as construction of physically patterned surfaces, modification of inert hydrophilic polymers or appending bioactive moieties to target surfaces.

The influence of surface chemistry on adsorbed fibrinogen conformation, orientation, fiber formation and platelet adhesion

Thrombosis is a clear risk when any foreign material is in contact with the bloodstream. Here we propose an immunohistological stain-based model for non-enzymatic clot formation that enables a facile screen for the thrombogenicity of blood-contacting materials. We exposed polymers with different surface chemistries to protease-free human fibrinogen. We observed that on hydrophilic surfaces, fibrinogen is adsorbed via αC regions, while the γ400-411 platelet-binding dodecapeptide on the D region becomes exposed, and fibrinogen fibers do not form. In contrast, fibrinogen is adsorbed on hydrophobic surfaces via the relatively hydrophobic D and E regions, exposing the αC regions while rendering the γ400-411 inaccessible. Fibrinogen adsorbed on hydrophobic surfaces is thus able to recruit other fibrinogen molecules through αC regions and polymerize into large fibrinogen fibers, similar to those formed in vivo in the presence of thrombin. Moreover, the γ400-411 is available only on the large fibers not elsewhere throughout the hydrophobic surface after fibrinogen fiber formation. When these surfaces were exposed to gel-sieved platelets or platelet rich plasma, a uniform monolayer of platelets, which appeared to be activated, was observed on the hydrophilic surfaces. In contrast, large agglomerates of platelets were clustered on fibers on the hydrophobic surfaces, resembling small nucleating thrombi. Endothelial cells were also able to adhere to the monomeric coating of fibrinogen on hydrophobic surfaces. These observations reveal that the extent and type of fibrinogen adsorption, as well as the propensity of adsorbed fibrinogen to bind platelets, may be modulated by careful selection of surface chemistry.

STATEMENTS OF SIGNIFICANCE

Thrombosis is a well-known side effect of the introduction of foreign materials into the bloodstream, as might exist in medical devices including but not limited to stents, valves, and intravascular catheters. Despite many reported studies, the body's response to foreign materials in contact with the blood remains poorly understood. Current preventive methods consist of drug eluting coatings on the devices or the systemic administration of standard anticoagulants. Here we present a potential mechanism by which surface chemistry can affects fibrinogen conformation and thus affects platelet adhesion and consequently thrombus formation. Our findings suggest a possible coating which enables endothelial cell adhesion while preventing platelet adhesion.

Transport-Limited Adsorption of Plasma Proteins on Bimodal Amphiphilic Polymer Co-Networks: Real-Time Studies by Spectroscopic Ellipsometry

Traditional hydrogels are commonly limited by poor mechanical properties and low oxygen permeability. Bimodal amphiphilic co-networks (β-APCNs) are a new class of materials that can overcome these limitations by combining hydrophilic and hydrophobic polymer chains within a network of co-continuous morphology. Applications that can benefit from these improved properties include therapeutic contact lenses, enzymatic catalysis supports, and immunoisolation membranes. The continuous hydrophobic phase could potentially increase the adsorption of plasma proteins in blood-contacting medical applications and compromise in vivo material performance, so it is critical to understand the surface characteristics of β-APCNs and adsorption of plasma proteins on β-APCNs. From real-time spectroscopic visible (Vis) ellipsometry measurements, plasma protein adsorption on β-APCNs is shown to be transport-limited. The adsorption of proteins on the β-APCNs is a multistep process with adsorption to the hydrophilic surface initially, followed by diffusion into the material to the internal hydrophilic/hydrophobic interfaces. Increasing the cross-linking of the PDMS phase reduced the protein intake by limiting the transport of large proteins. Moreover, the internalization of the proteins is confirmed by the difference between the surface-adsorbed protein layer determined from XPS and bulk thickness change from Vis ellipsometry, which can differ up to 20-fold. Desorption kinetics depend on the adsorption history with rapid desorption for slow adsorption rates (i.e., slow-diffusing proteins within the network), whereas proteins with fast adsorption kinetics do not readily desorb. This behavior can be directly related to the ability of the protein to spread or reorient, which affects the binding energy required to bind to the internal hydrophobic interfaces.

Bioinspired and biocompatible carbon nanotube-Ag nanohybrid coatings for robust antibacterial applications

The design of self-sterilizing surfaces with favorable biocompatibility is acknowledged as an effective approach to deal with the bacterial infections of biomedical devices. In this study, we report an intriguing protocol for the large-scale fabrication of self-sterilizing and biocompatible surface film coatings by using polymer shielded silver nanoparticle loaded oxidized carbon nanotube (AgNPs@oCNT) nano-dispersions. To achieve the antibacterial coatings, the bioinspired positively charged and negatively charged AgNPs@oCNTs were alternately deposited onto substrates by spray-coating assisted layer-by-layer assembly. Then the bacterial inhibitory zones, optical density value monitoring, bacterial killing efficiency and adhesion were investigated; and all the results revealed that the AgNPs@oCNTs thin film coatings exhibited robust and long-term antibacterial activity against both Gram negative and Gram positive bacteria. Moreover, due to the shielding effects of polymer layers, the coatings showed extraordinary blood compatibility and limited toxicity against human umbilical vein endothelial cells. It is believed that the proposed large-scale fabrication of bactericidal, blood and cell compatible AgNPs@oCNT based thin film coatings will have great potential to forward novel operational pathogenic inhibition strategies to avoid undesired bacterial contaminations of biomedical implants or biological devices.

STATEMENT OF SIGNIFICANCE

Bacterial infection of medical devices has been considered to be a world-wide clinical threat towards patients' health. In this study, a bioinspired and biocompatible antibacterial coating was prepared via the spray-assisted layer-by-layer (LbL) assembly. The silver nanopartilces loaded oxidized carbon nanotube (AgNPs@oCNT), which were coated by functional polymers (chitosan and synthetic heparin mimicking polymers), were prepared via mussel inspired chemistry; and the spray-assisted assembly process allowed the fast construction on devices. Owing to the antibacterial efficiency of the loaded AgNPs, the coating showed robust bacterial killing activity and resistance towards bacterial adhesion. Moreover, since that the AgNPs were shielded by the polymers, the coating exhibited no clear toxicity at blood or cellular level. Benefiting from the universal and large-scale fabrication advancements of the spray assisted LbL coating; it is believed that the proposed strategy can be applied in designing many other kinds of self-sterilizing biomedical implants and devices.

Device thrombosis and pre-clinical blood flow models for assessing antithrombogenic efficacy of drug-device combinations

Thrombosis associated with blood-contacting devices is a complex process involving several component interactions that have eluded precise definition. Extensive investigations of individual biological modules such as protein adsorption, coagulation cascade activation and platelet activation/adhesion/aggregation have provided an initial foundation for developing biomaterials for blood-contacting devices, but a material that is intrinsically non-thrombogenic is yet to be developed. The well-recognized association between fluid dynamics parameters such as shear stress, vortices, stagnation and thrombotic processes such as platelet aggregation and coagulation aggravate thrombosis on most device geometries that elicit these flow disturbances. Thus, antithrombotic drugs that were developed to treat thrombosis associated with vascular diseases such as atherosclerosis have also been adapted to mitigate the risk of device thrombosis. However, balancing the risk of bleeding with the antithrombotic efficacy of these drugs continues to be a challenge, and surface modification of devices with these drug molecules to mitigate device thrombosis locally has been explored. Pre-clinical blood flow models to test the effectiveness of these drug-device combinations have also evolved and several in-vitro, ex-vivo, and in-vivo test configurations are available with their attendant merits and limitations. Despite considerable efforts toward iterative design and testing of blood contacting devices and antithrombogenic surface modifications, device thrombosis remains an unsolved problem.

Control of interface interactions between natural rubber and solid surfaces through charge effects: an AFM study in force spectroscopic mode

Adhesion of nanoparticles (natural rubber) is monitored by slight changes in the surface charge state of the contacting solid surfaces.

Protein resistance efficacy of PEO-silane amphiphiles: Dependence on PEO-segment length and concentration

In contrast to modification with conventional PEO-silanes (i.e. no siloxane tether), silicones with dramatically enhanced protein resistance have been previously achieved via bulk-modification with poly(ethylene oxide) (PEO)-silane amphiphiles α-(EtO)3Si(CH2)2-oligodimethylsiloxane13-block-PEOn-OCH3 when n=8 and 16 but not when n=3. In this work, their efficacy was evaluated in terms of optimal PEO-segment length and minimum concentration required in silicone. For each PEO-silane amphiphile (n=3, 8, and 16), five concentrations (5, 10, 25, 50, and 100μmol per 1g silicone) were evaluated. Efficacy was quantified in terms of the modified silicones' abilities to undergo rapid, water-driven surface restructuring to form hydrophilic surfaces as well as resistance to fibrinogen adsorption. Only n=8 and 16 were effective, with a lower minimum concentration in silicone required for n=8 (10μmol per 1g silicone) versus n=16 (25μmol per 1g silicone).

STATEMENT OF SIGNIFICANCE

Silicone is commonly used for implantable medical devices, but its hydrophobic surface promotes protein adsorption which leads to thrombosis and infection. Typical methods to incorporate poly(ethylene oxide) (PEO) into silicones have not been effective due to the poor migration of PEO to the surface-biological interface. In this work, PEO-silane amphiphiles - comprised of a siloxane tether (m=13) and variable PEO segment lengths (n=3, 8, 16) - were blended into silicone to improve its protein resistance. The efficacy of the amphiphiles was determined to be dependent on PEO length. With the intermediate PEO length (n=8), water-driven surface restructuring and resulting protein resistance was achieved with a concentration of only 1.7wt%.

Diffusion-Induced Hydrophilic Conversion of Polydimethylsiloxane/Block-Type Phospholipid Polymer Hybrid Substrate for Temporal Cell-Adhesive Surface

In this study, diffusion-induced hydrophobic-hydrophilic conversion of the surface of the cross-linked polydimethylsiloxane (PDMS) substrate was realized by employing a simple swelling-deswelling process of PDMS substrate in a block-type polymer solution with the aim of development of a temporal cell-adhesive substrate. The ABA block-type polymer composed of poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) segment and PDMS segment with over 70% of dimethylsiloxane unit composition could be successfully incorporated in the PDMS substrate during the swelling-deswelling process to prepare the PDMS/phospholipid block copolymer hybrid substrates. During the aging process of the PDMS substrate for 4 days in aqueous medium, its surface property changed gradually from hydrophobic to hydrophilic. X-ray photoelectron spectroscopy and atomic force microscopy data provided strong evidence that the time-dependent hydrophilic conversion of the PDMS/block-type phospholipid polymer hybrid substrate was induced by the diffusion of the hydrophilic PMPC segment in the block-type polymer to be tethered on the substrate. During the hydrophilic conversion process, surface-adsorbed fibronectin was gradually desorbed from the substrate surface, and this resulted in successful detachment of two-dimensional connected cell crowds.

Blood compatibility assessment of polymers used in drug eluting stent coatings

Differences in thrombosis rates have been observed clinically between different drug eluting stents. Such differences have been attributed to numerous factors, including stent design, injury created by the catheter delivery system, coating application technologies, and the degree of thrombogenicity of the polymer. The relative contributions of these factors are generally unknown. This work focuses on understanding the thrombogenicity of the polymer by examining mechanistic interactions with proteins, human platelets, and human monocytes of a number of polymers used in drug eluting stent coatings, in vitro. The importance for blood interactions of adsorbed albumin and the retention of albumin was suggested by the data. Microscopic imaging and immunostaining enhanced the interpretation of results from the lactate dehydrogenase cell counting assay and provided insight into platelet interactions, total quantification, and morphometry. In particular, highly spread platelets may be surface-passivating, possibly inhibiting ongoing thrombotic events. In many of the assays used here, poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) showed a differentiated protein deposition pattern that may contribute to the explanation of the consistently thromboresistant blood-materials interaction for fluororpolymers cited in literature. These results are supportive of one of several possible factors contributing to the good thromboresistant clinical safety performance of PVDF-HFP coated drug eluting stents.

Structural Reorganization and Fibrinogen Adsorption Behaviors on the Polyrotaxane Surfaces Investigated by Sum Frequency Generation Spectroscopy

Polyrotaxanes, such as supramolecular assemblies with methylated α-cyclodextrins (α-CDs) as host molecules noncovalently threaded on the linear polymer backbone, are promising materials for biomedical applications because they allow adsorbed proteins possessing a high surface flexibility as well as control of the cellular morphology and adhesion. To provide a general design principle for biomedical materials, we examined the surface reorganization behaviors and adsorption conformations of fibrinogen on the polyrotaxane surfaces with comparison to several random copolymers by sum frequency generation (SFG) vibrational spectroscopy. We showed that the polyrotaxane (OMe-PRX-PMB) with methylated α-CDs as the host molecule exhibited unique surface structures in an aqueous environment. The hydrophobic interaction between the methoxy groups of the methylated α-CD molecules and methyl groups of the n-butyl methacrylate (BMA) side chains may dominate the surface restructuring behavior of the OMe-PRX-PMB. The orientation analysis revealed that the orientation of the fibrinogen adsorbed on the OMe-PRX-PMB surface is close to a single distribution, which is different from the adsorption behaviors of fibrinogen on other polyrotaxane or random copolymer surfaces.

Hierarchical periodic micro/nano-structures on nitinol and their influence on oriented endothelialization and anti-thrombosis

The applications of hierarchical micro/nano-structures, which possess properties of two-scale roughness, have been studied in various fields. In this study, hierarchical periodic micro/nano-structures were fabricated on nitinol, an equiatomic Ni-Ti alloy, using a femtosecond laser for the surface modification of intravascular stents. By controlling the laser fluence, two types of surfaces were developed: periodic nano- and micro/nano-structures. Evaluation of water contact angles indicated that the nano-surface was hydrophilic and the micro/nano-surface was hydrophobic. Endothelial cells aligned along the nano-structures on both surfaces, whereas platelets failed to adhere to the micro/nano-surface. Decorrelation between the responses of the two cell types and the results of water contact angle analysis were a result of the pinning effect. This is the first study to show the applicability of hierarchical periodic micro/nano-structures for surface modification of nitinol.

Fibrinogen matrix deposited on the surface of biomaterials acts as a natural anti-adhesive coating

Adsorption of fibrinogen on the luminal surface of biomaterials is a critical early event during the interaction of blood with implanted vascular graft prostheses which determines their thrombogenicity. We have recently identified a nanoscale process by which fibrinogen modifies the adhesive properties of various surfaces for platelets and leukocytes. In particular, adsorption of fibrinogen at low density promotes cell adhesion while its adsorption at high density results in the formation of an extensible multilayer matrix, which dramatically reduces cell adhesion. It remains unknown whether deposition of fibrinogen on the surface of vascular graft materials produces this anti-adhesive effect. Using atomic force spectroscopy, single cell force spectroscopy, and standard adhesion assays with platelets and leukocytes, we have characterized the adhesive and physical properties of the contemporary biomaterials, before and after coating with fibrinogen. We found that uncoated PET, PTFE and ePTFE exhibited high adhesion forces developed between the AFM tip or cells and the surfaces. Adsorption of fibrinogen at the increasing concentrations progressively reduced adhesion forces, and at ≥2 μg/ml all surfaces were virtually nonadhesive. Standard adhesion assays performed with platelets and leukocytes confirmed this dependence. These results provide a better understanding of the molecular events underlying thrombogenicity of vascular grafts.

Innate Immunity and Biomaterials at the Nexus: Friends or Foes

Biomaterial implants are an established part of medical practice, encompassing a broad range of devices that widely differ in function and structural composition. However, one common property amongst biomaterials is the induction of the foreign body response: an acute sterile inflammatory reaction which overlaps with tissue vascularisation and remodelling and ultimately fibrotic encapsulation of the biomaterial to prevent further interaction with host tissue. Severity and clinical manifestation of the biomaterial-induced foreign body response are different for each biomaterial, with cases of incompatibility often associated with loss of function. However, unravelling the mechanisms that progress to the formation of the fibrotic capsule highlights the tightly intertwined nature of immunological responses to a seemingly noncanonical “antigen.” In this review, we detail the pathways associated with the foreign body response and describe possible mechanisms of immune involvement that can be targeted. We also discuss methods of modulating the immune response by altering the physiochemical surface properties of the biomaterial prior to implantation. Developments in these areas are reliant on reproducible and effective animal models and may allow a “combined” immunomodulatory approach of adapting surface properties of biomaterials, as well as treating key immune pathways to ultimately reduce the negative consequences of biomaterial implantation.

Enhancing the protein resistance of silicone via surface-restructuring PEO-silane amphiphiles with variable PEO length

Silicones with superior protein resistance were produced by bulk-modification with poly(ethylene oxide) (PEO)-silane amphiphiles that demonstrated a higher capacity to restructure to the surface-water interface versus conventional non-amphiphilic PEO-silanes. The PEO-silane amphiphiles were prepared with a single siloxane tether length but variable PEO segment lengths: α-(EtO)3Si(CH2)2-oligodimethylsiloxane13-block-poly(ethylene oxide) n -OCH3 (n = 3, 8, and 16). Conventional PEO-silane analogues (n = 3, 8 and 16) as well as a siloxane tether-silane (i.e. no PEO segment) were prepared as controls. When surface-grafted onto silicon wafer, PEO-silane amphiphiles produced surfaces that were more hydrophobic and thus more adherent towards fibrinogen versus the corresponding PEO-silane. However, when blended into a silicone, PEO-silane amphiphiles exhibited rapid restructuring to the surface-water interface and excellent protein resistance whereas the PEO-silanes did not. Silicones modified with PEO-silane amphiphiles of PEO segment lengths n = 8 and 16 achieved the highest protein resistance.

Protein-resistance performance of amphiphilic copolymer brushes consisting of fluorinated polymers and polyacrylamide grafted from silicon surfaces

A series of random copolymer brushes of acrylamide (AM) and 2-(perfluorinated hexyl)ethyl methacrylate (FMA) were grafted from initiator-functionalized silicon wafers by surface-initiated atom transfer radical polymerization.