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Lee JR, Yang SW, Kwon CI, Kim KS, Park SH, Jang MJ, Kim GH, Sung MJ, Kim G, Son JS, Joung YK. Anti-fibrotic and anti-stricture effects of biodegradable biliary stents braided with dexamethasone-impregnated sheath/core structured monofilaments. Acta Biomater 2024; 178:137-146. [PMID: 38447810 DOI: 10.1016/j.actbio.2024.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/22/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
Endoscopic biliary stent insertion has been widely used for the treatment of benign biliary stricture (BBS). Thus, the development of stent materials in the perspectives of structure, mechanical properties, and biocompatibility has been also studied. However, conventional metal and plastic stents have several disadvantages, such as repeated procedures to remove or exchange them, dislodgment, restenosis, biocompatibility, and poor mechanical properties. Sustainable effectiveness, attenuation and prevention of fibrosis, and biocompatibility are key factors for the clinical application of stents to BBS treatment. In addition, loading drugs could show synergistic effects with stents' own performance. We developed a dexamethasone-eluting biodegradable stent (DBS) consisting of a sheath/core structure with outstanding mechanical properties and sustained release of dexamethasone, which maintained its functions in a BBS duct over 12 weeks in a swine model. The insertion of our DBS not only expanded BBS areas but also healed secondary ulcers as a result of the attenuation of fibrosis. After 16 weeks from the insertion, BBS areas were totally improved, and the DBS was degraded and thoroughly disappeared without re-intervention for stent removal. Our DBS would be an effective clinical tool for non-vascular diseases. STATEMENT OF SIGNIFICANCE: This study describes the insertion of a drug-eluting biodegradable stent (DBS) into the bile duct. The sheath/core structure of DBS confers substantial durability and a sustained drug release profile. Drug released from the DBS exhibited anti-fibrotic effects without inflammatory responses in both in vitro and in vivo experiments. The DBS maintained its function over 12 weeks after insertion into the common bile duct, expanding benign biliary stricture (BBS) and reducing inflammation to heal secondary ulcers in a swine BBS model. After 16 weeks from the DBS insertion, the DBS thoroughly disappeared without re-intervention for stent removal, resulting in totally improved BBS areas. Our findings not only spotlight the understanding of the sheath/core structure of the biodegradable stent, but also pave the way for the further application for non-vascular diseases.
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Affiliation(s)
- Ju-Ro Lee
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea
| | - Seung Won Yang
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea; Division of Bio-Medical Science and Technology, University of Science and Technology, Daejeon 34113, Republic of Korea
| | - Chang-Il Kwon
- Digestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Republic of Korea.
| | - Kyu Seok Kim
- Interventional Research Center, M. I. Tech, Co. Ltd., Pyeongtaek, Republic of Korea
| | - Se Hwan Park
- Interventional Research Center, M. I. Tech, Co. Ltd., Pyeongtaek, Republic of Korea
| | - Myeong Jin Jang
- Korea Textile Development Institute, Daegu 41842, Republic of Korea
| | - Ga Hee Kim
- Korea Textile Development Institute, Daegu 41842, Republic of Korea
| | - Min Je Sung
- Digestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Republic of Korea
| | - Gwangil Kim
- Department of Pathology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Republic of Korea
| | - Jun Sik Son
- Korea Textile Development Institute, Daegu 41842, Republic of Korea.
| | - Yoon Ki Joung
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea; Division of Bio-Medical Science and Technology, University of Science and Technology, Daejeon 34113, Republic of Korea.
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2
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Feng Y, Han Z, Chen C, Wang X, Liu J, Khan Y, Xie M, Chen Y, Zhang Y, Li G. Psoralea corylifolia formula extract-loaded silk fibroin/polycaprolactone fibrous membrane for the treatment of colorectal cancer. Colloids Surf B Biointerfaces 2024; 233:113635. [PMID: 37976725 DOI: 10.1016/j.colsurfb.2023.113635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/06/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
Intestinal obstructions caused by intestinal tumors pose life-threatening risks to patients. Adjuvant treatment using intestinal stents carrying drug loaded membranes has the advantages of timely relief of intestinal obstruction, as well as effective inhibition of tumor progression. The present work is to develop an intestinal stent loaded with a combination of traditional Chinese medicines capable of good biocompatibility, degradability, sustained drug release and anti-tumor properties. The drug combination extract was obtained from Psoralea corylifolia formula (PCF) and then was loaded into silk fibroin (SF)/polycaprolactone (PCL) fibrous membranes using emulsion electrospinning technology. Results showed that the membrane prepared by emulsion electrospinning technology has apparent core-shell structure, and the mechanical property and hydrophilicity of the membrane are gradually improved with the addition of PCF. Drug sustained release results demonstrated that there were no bursting phenomena, and showed a gradual sustained release up to 400 h. The antitumor efficacy was assessed in vitro using a human colorectal cancer cell line HCT-116 and an epithelial cell line NCM-460. Results showed that this drug-loaded membrane sustained antitumor cell growth performance, indicating its great potential for clinical treatment for intestinal cancer in the near future.
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Affiliation(s)
- Yusheng Feng
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, Jiangsu, China
| | - Zhifen Han
- School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Department of Medical Oncology and Cancer Institute of Medicine, Shuguang Hospital, Shanghai 201203, China
| | - Chong Chen
- Department of General Surgery (Colorectal Surgery) & Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases & Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong, China
| | - Xuchen Wang
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, Jiangsu, China
| | - Jing Liu
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, Jiangsu, China
| | - Yousef Khan
- Department of Biomedical Engineering, 4 Colby Street, Tufts University, Medford, MA 02155, USA
| | - Maobin Xie
- The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital; Guangzhou Municipal and Guangdong Provincial Key Laboratory of Protein Modification and Degradation; School of Biomedical Engineering, Guangzhou Medical University, Guangzhou 511436, Guangdong, China
| | - Yufeng Chen
- Department of General Surgery (Colorectal Surgery) & Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases & Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong, China.
| | - Yue Zhang
- School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Department of Medical Oncology and Cancer Institute of Medicine, Shuguang Hospital, Shanghai 201203, China.
| | - Gang Li
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, Jiangsu, China.
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3
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Xu F, Li Y, Yu Y, Wang G, Cai G. Evaluation of biomechanical properties and biocompatibility: are partially absorbable cords eligible for anterior cruciate ligament reconstruction? Front Bioeng Biotechnol 2023; 11:1216937. [PMID: 37854884 PMCID: PMC10580803 DOI: 10.3389/fbioe.2023.1216937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/05/2023] [Indexed: 10/20/2023] Open
Abstract
Introduction: Independent augmentation technology based on reinforcing devices has been reported to signifi-cantly reduce the elongation behavior of graft and improve knee stability after anterior cruciate ligament reconstruction (ACLR). Using biodegradable devices could reduce the risk of severe inflammatory reactions due to particle accumulation from foreign bodies. Given the limitations of the mechanical properties of biodegradable materials, partially biodegradable composite devices may offer a compromise strategy. Methods: Three types of partially absorbable core-sheath sutures, including low-absorbable cord (LA-C), medium-absorbable cord (MA-C) and high-absorbable cord (HA-C), were braided using unabsorbable ultra-high molecular weight polyethylene (UHMWPE) yarn and absorbable polydioxanone (PDO) monofil-ament bundle based on the desired configuration. The feasibility of these partially absorbable cords were verified by biomechanical testing, material degradation testing, and cell experiments, all performed in vitro. Results: Reinforcement of an 8 mm graft with the cords decreased dynamic elongation by 24%-76%, was positively related to dynamic stiffness, and increased the failure load by 44%-105%, during which LA-C showed maximum enhancement. Human ligament-derived fibroblasts showed good proliferation and vitality on each cord over 2 weeks and aligned themselves in the direction of the fibers, especially the UHMWPE portion. Discussion: This study supports the potential of partially degradable UHMWPE/PDO cords, particularly LA-C, for graft protection. Nervertheless, a higher proportion of biodegradable material results in lower stiffness, which may impair the protective and lead to mechanical instability during degradation.
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Affiliation(s)
- Fei Xu
- Kunming Medical University, Kunming Yunnan, China
- Department of Pain Treatment, The First People’s Hospital of Yunnan Province, Kunming Yunnan, China
| | - Yanlin Li
- Kunming Medical University, Kunming Yunnan, China
- Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China
| | - Yang Yu
- Kunming Medical University, Kunming Yunnan, China
- Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China
| | - Guoliang Wang
- Kunming Medical University, Kunming Yunnan, China
- Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China
| | - Guofeng Cai
- Kunming Medical University, Kunming Yunnan, China
- Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China
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Chen E, Xiong Z, Cai X, Liu S, Qin X, Sun J, Jin X, Sun K. Bioresorbable PPDO sliding-lock stents with optimized FDM parameters for congenital heart disease treatment. J Mech Behav Biomed Mater 2023; 138:105609. [PMID: 36525876 DOI: 10.1016/j.jmbbm.2022.105609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022]
Abstract
Stent implantation has been a promising therapy for congenital heart disease (CHD) due to better efficacy. Compared to permanent metal stents, bioresorbable polymer stents have shown a great advantage in accommodating the vascular growth of pediatric patients, but the application is still limited due to inferior radial strength. Here, bioresorbable poly(p-dioxanone) (PPDO) sliding-lock stents for CHD treatment were fabricated by fused deposition modeling (FDM). The effects of FDM processing parameters, including nozzle temperature, bed temperature, layer thickness, and printing speed, on the mechanical properties of PPDO parts were investigated to optimize the processing condition to enhance the radial strength of stents. Finite element analysis (FEA) was also used to evaluate the mechanical properties of stents. PPDO sliding-lock stents fabricated under optimized FDM parameters showed radial strength of 3.315 ± 0.590 N/mm, superior to benchmark commercial metal stents. Radial strength curve and compression behavior of PPDO sliding-lock stents were investigated. Results of FEA exhibited that strut width, shape of the mesh cell and surface coverage ratio had an impact on the compression force of PPDO sliding-lock stents. PPDO sliding-lock stents fabricated with optimized FDM parameters show favorable mechanical performance and meet the requirement of CHD treatment.
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Affiliation(s)
- Enrong Chen
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhihui Xiong
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaorong Cai
- School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Shilong Liu
- School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xiji Qin
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Sun
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Xuejun Jin
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China.
| | - Kun Sun
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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5
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Jiafeng L, Pengfei J, Jianwei Y, Tiantang F, Hongbo Y, Junhui S, Lu C. Shape memory properties of 3D‐printed self‐expandable poly(lactic acid) vascular stents with long‐chain branched structures. POLYM ADVAN TECHNOL 2022. [DOI: 10.1002/pat.5840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Li Jiafeng
- China Coal Research Institute Coal Mining Branch Beijing People's Republic of China
- CCTEG Coal Mining Research Institute Beijing People's Republic of China
- State Key Laboratory of Coal Mining and Clean Utilization Beijing People's Republic of China
| | - Jiang Pengfei
- China Coal Research Institute Coal Mining Branch Beijing People's Republic of China
- CCTEG Coal Mining Research Institute Beijing People's Republic of China
- State Key Laboratory of Coal Mining and Clean Utilization Beijing People's Republic of China
| | - Yang Jianwei
- China Coal Research Institute Coal Mining Branch Beijing People's Republic of China
- CCTEG Coal Mining Research Institute Beijing People's Republic of China
- State Key Laboratory of Coal Mining and Clean Utilization Beijing People's Republic of China
| | - Fan Tiantang
- College of medical Engineering & the Key Laboratory for Medical Functional Nanomaterials Jining Medical University Jining People's Republic of China
| | - Yang Hongbo
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai Institute of Cardiovascular Diseases Shanghai China
| | - Sui Junhui
- The Key Laboratory of Biomedical Material, School of Life Science and Technology Xinxiang Medical University Xinxiang People's Republic of China
| | - Cao Lu
- Department of Orthopedic Surgery, Zhongshan Hospital Fudan University Shanghai People's Republic of China
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6
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Feng Y, Chen Y, Chen Y, He X, Khan Y, Hu H, Lan P, Li Y, Wang X, Li G, Kaplan D. Intestinal stents: Structure, functionalization and advanced engineering innovation. BIOMATERIALS ADVANCES 2022; 137:212810. [PMID: 35929235 DOI: 10.1016/j.bioadv.2022.212810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
Intestinal stents are a palliative treatment option that solves many shortcomings of traditional surgeries for cancer-induced intestinal obstructions. The present review provides an overview of the incidence, clinical manifestations and limitations in the treatment of intestinal cancers. The paper also discusses material property requirements, indications, complications and the future of stent-assisted therapy. The advantages and disadvantages of different materials and processing techniques for intestinal stents are reviewed along with new stent treatment combinations for colorectal cancer. Challenges that require further cooperative studies are also detailed. The future development of intestinal stents will depend on innovation in material designs as well as the utilization of multi-functional strategies and innovative engineering solutions.
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Affiliation(s)
- Yusheng Feng
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, Jiangsu, China
| | - Yufeng Chen
- Department of Colorectal Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong, China
| | - Ying Chen
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155, USA
| | - Xiaowen He
- Department of Colorectal Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong, China
| | - Yousef Khan
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155, USA
| | - Hong Hu
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Ping Lan
- Department of Colorectal Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong, China
| | - Yi Li
- Department of Materials, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Xiaoqin Wang
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, Jiangsu, China
| | - Gang Li
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, Jiangsu, China.
| | - David Kaplan
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155, USA.
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7
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Wang X, Zhang Y, Shen P, Cheng Z, Chu C, Xue F, Bai J. Preparation of 4D printed peripheral vascular stent and its degradation behavior under fluid shear stress after deployment. Biomater Sci 2022; 10:2302-2314. [PMID: 35373795 DOI: 10.1039/d2bm00088a] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Shape memory stents are mild intervention devices for vascular diseases as compared to balloon-dilated ones; however, their degradation behavior under blood shear stress after deployment also deserves further attention. To understand the degradation behavior, we first prepared 4D printed poly(lactic acid) (PLA) stents via 3D printing technology and studied their failure behavior in a dynamic condition after self-expandable deployment. Mechanical property tests showed that the 4D printed stents had a compression force of 0.06-0.39 N mm-1 and a recovery ratio of 85.3-93.4%, respectively, which was verified to be wall thickness dependent. The stents were then implanted in simulated blood vessels with minimal microstructural damage at 60 °C followed by 8-week degradation tests. The results showed the microstructure damage caused by deployment could accelerate the degradation of stents faster than fluid shear stress. Furthermore, we conducted microstructural analysis and numerical simulation on the stent by finite element analysis (FEA) to explain the relationship between stent injury, vascular injury, and stent deployment temperature. A physical model derived from micro-morphologies on the degradation mechanism of PLA was also proposed. These results may provide new insights for the examination of the degradation behavior of 4D printed stents and minimize medical risk.
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Affiliation(s)
- Xianli Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China. .,Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
| | - Yue Zhang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China. .,Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
| | - Peiqi Shen
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China. .,Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
| | - Zhaojun Cheng
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China. .,Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
| | - Chenglin Chu
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China. .,Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
| | - Feng Xue
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China. .,Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China. .,Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
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8
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Loskot J, Jezbera D, Zmrhalová ZO, Nalezinková M, Alferi D, Lelkes K, Voda P, Andrýs R, Fučíková AM, Hosszú T, Bezrouk A. A Complex In Vitro Degradation Study on Polydioxanone Biliary Stents during a Clinically Relevant Period with the Focus on Raman Spectroscopy Validation. Polymers (Basel) 2022; 14:polym14050938. [PMID: 35267761 PMCID: PMC8912347 DOI: 10.3390/polym14050938] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
Biodegradable biliary stents are promising treatments for biliary benign stenoses. One of the materials considered for their production is polydioxanone (PPDX), which could exhibit a suitable degradation time for use in biodegradable stents. Proper material degradation characteristics, such as sufficient stiffness and disintegration resistance maintained for a clinically relevant period, are necessary to ensure stent safety and efficacy. The hydrolytic degradation of commercially available polydioxanone biliary stents (ELLA-CS, Hradec Králové, Czech Republic) in phosphate-buffered saline (PBS) was studied. During 9 weeks of degradation, structural, physical, and surface changes were monitored using Raman spectroscopy, differential scanning calorimetry, scanning electron microscopy, and tensile and torsion tests. It was found that the changes in mechanical properties are related to the increase in the ratio of amorphous to crystalline phase, the so-called amorphicity. Monitoring the amorphicity using Raman spectroscopy has proven to be an appropriate method to assess polydioxanone biliary stent degradation. At the 1732 cm−1 Raman peak, the normalized shoulder area is less than 9 cm−1 which indicates stent disintegration. The stent disintegration started after 9 weeks of degradation in PBS, which agrees with previous in vitro studies on polydioxanone materials as well as with in vivo studies on polydioxanone biliary stents.
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Affiliation(s)
- Jan Loskot
- Department of Physics, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic; (J.L.); (D.J.)
| | - Daniel Jezbera
- Department of Physics, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic; (J.L.); (D.J.)
| | - Zuzana Olmrová Zmrhalová
- Center of Materials and Nanotechnologies, Faculty of Chemical Technology, University of Pardubice, Studentska 95, 530 02 Pardubice, Czech Republic;
| | - Martina Nalezinková
- Department of Biology, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic; (M.N.); (A.M.F.)
| | - Dino Alferi
- Department of Medical Biophysics, Faculty of Medicine in Hradec Králové, Charles University, Šimkova 870, 500 03 Hradec Králové, Czech Republic; (D.A.); (K.L.); (P.V.)
| | - Krisztina Lelkes
- Department of Medical Biophysics, Faculty of Medicine in Hradec Králové, Charles University, Šimkova 870, 500 03 Hradec Králové, Czech Republic; (D.A.); (K.L.); (P.V.)
| | - Petr Voda
- Department of Medical Biophysics, Faculty of Medicine in Hradec Králové, Charles University, Šimkova 870, 500 03 Hradec Králové, Czech Republic; (D.A.); (K.L.); (P.V.)
| | - Rudolf Andrýs
- Department of Chemistry, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic;
| | - Alena Myslivcová Fučíková
- Department of Biology, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic; (M.N.); (A.M.F.)
| | - Tomáš Hosszú
- Department of Neurosurgery, Faculty of Medicine in Hradec Králové, Charles University, Sokolská 581, 500 05 Hradec Králové, Czech Republic;
- Department of Neurosurgery, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Aleš Bezrouk
- Department of Medical Biophysics, Faculty of Medicine in Hradec Králové, Charles University, Šimkova 870, 500 03 Hradec Králové, Czech Republic; (D.A.); (K.L.); (P.V.)
- Correspondence:
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9
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Zhao G, Tian Y, Hua R, Liu Q, Cheng J, Wu G, Zhang Y, Ni Z. A poly(
l
‐lactic acid) braided stent with high mechanical properties during in vitro degradation in bile. J Appl Polym Sci 2022. [DOI: 10.1002/app.51685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Gutian Zhao
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Yuan Tian
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Rixin Hua
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Qingwei Liu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Jie Cheng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Gensheng Wu
- School of Mechanical and Electronic Engineering Nanjing Forestry University Nanjing China
| | - Yi Zhang
- Center of Interventional Radiology & Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School Southeast University Nanjing China
| | - Zhonghua Ni
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
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10
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Choudhury S, Asthana S, Homer-Vanniasinkam S, Chatterjee K. Emerging Trends in Biliary Stents: A Materials and Manufacturing Perspective. Biomater Sci 2022; 10:3716-3729. [DOI: 10.1039/d2bm00234e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Biliary stent technology has come a long way since its inception. There have been significant advancements in materials used, designs, and deployment strategies. Options have expanded from thermoplastic and metallic...
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11
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Kwon CI, Son JS, Kim KS, Moon JP, Park S, Jeon J, Kim G, Choi SH, Ko KH, Jeong S, Lee DH. Mechanical properties and degradation process of biliary self-expandable biodegradable stents. Dig Endosc 2021; 33:1158-1169. [PMID: 33319399 DOI: 10.1111/den.13916] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/03/2020] [Accepted: 12/10/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The clinical outcomes and prevalence of adverse events associated with biliary biodegradable stents (BS) can differ according to degradation process and time. The aim of this study was to observe the degradation process and time of different BS prototypes, and to evaluate sequential changes in their mechanical properties. METHODS Using an in vitro bile flow phantom model, we compared degradation time, radial force changes, and morphologic changes among four different BS prototypes: polydioxanone (PDO) BS, polyglycolide (PGA) BS, polydioxanone/poly-l-lactic acid (PDO/PLLA) sheath-core BS, and polydioxaone/magnesium (PDO/Mg) sheath-core BS. Using an in vivo swine bile duct dilation model, we performed a direct peroral cholangioscopy (DPOC) examination to observe the biodegradation process and related adverse events at regular intervals. RESULTS In the bile flow phantom model, the PGA BS and PDO/Mg BS prototypes showed rapid radial force reduction and morphological changes and complete degradation within six weeks. PDO/PLLA BS maintained high radial force and kept their original shape for longer than the PDO BS, up to 16 weeks. A total of 24 BS were inserted into the dilated bile ducts of 12 swine. In this animal model, DPOC examination revealed that PDO BS and PDO/PLLA BS maintained their original shapes for approximately 12 weeks, but PDO BS showed a greater degree of fragmentation and induced biliary stones and bile duct obstruction. CONCLUSION Our results showed that PDO/PLLA BS maintained their original shape and radial force for a relatively long time and minimized adverse events.
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Affiliation(s)
- Chang-Il Kwon
- Digestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | | | - Kyu Seok Kim
- Interventional Research Center, M.I.Tech, Co. Ltd., Pyeongtaek, Korea
| | - Jong Pil Moon
- Interventional Research Center, M.I.Tech, Co. Ltd., Pyeongtaek, Korea
| | - Sehwan Park
- Interventional Research Center, M.I.Tech, Co. Ltd., Pyeongtaek, Korea
| | - Jinkyung Jeon
- Interventional Research Center, M.I.Tech, Co. Ltd., Pyeongtaek, Korea
| | - Gwangil Kim
- Department of Pathology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Sung Hoon Choi
- Digestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Kwang Hyun Ko
- Digestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Seok Jeong
- Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine, T2B Infrastructure Center for Digestive Disorders, Incheon, Korea
| | - Don Haeng Lee
- Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine, T2B Infrastructure Center for Digestive Disorders, Incheon, Korea
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Loskot J, Jezbera D, Bezrouk A, Doležal R, Andrýs R, Francová V, Miškář D, Myslivcová Fučíková A. Raman Spectroscopy as a Novel Method for the Characterization of Polydioxanone Medical Stents Biodegradation. MATERIALS 2021; 14:ma14185462. [PMID: 34576686 PMCID: PMC8467320 DOI: 10.3390/ma14185462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 12/24/2022]
Abstract
Polydioxanone (PPDX), as an FDA approved polymer in tissue engineering, is an important component of some promising medical devices, e.g., biodegradable stents. The hydrolytic degradation of polydioxanone stents plays a key role in the safety and efficacy of treatment. A new fast and convenient method to quantitatively evaluate the hydrolytic degradation of PPDX stent material was developed. PPDX esophageal stents were degraded in phosphate-buffered saline for 24 weeks. For the first time, the changes in Raman spectra during PPDX biodegradation have been investigated here. The level of PPDX hydrolytic degradation was determined from the Raman spectra by calculating the area under the 1732 cm-1 peak shoulder. Raman spectroscopy, unlike Fourier transform infrared (FT-IR) spectroscopy, is also sensitive enough to monitor the decrease in the dye content in the stents during the degradation. Observation by a scanning electron microscope showed gradually growing cracks, eventually leading to the stent disintegration. The material crystallinity was increasing during the first 16 weeks, suggesting preferential degradation of the amorphous phase. Our results show a new easy and reliable way to evaluate the progression of PPDX hydrolytic degradation. The proposed approach can be useful for further studies on the behavior of PPDX materials, and for clinical practice.
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Affiliation(s)
- Jan Loskot
- Department of Physics, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic; (J.L.); (D.J.); (D.M.)
| | - Daniel Jezbera
- Department of Physics, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic; (J.L.); (D.J.); (D.M.)
| | - Aleš Bezrouk
- Department of Medical Biophysics, Faculty of Medicine in Hradec Králové, Charles University, 500 03 Hradec Králové, Czech Republic
- Correspondence:
| | - Rafael Doležal
- Department of Chemistry, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic; (R.D.); (R.A.)
| | - Rudolf Andrýs
- Department of Chemistry, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic; (R.D.); (R.A.)
| | - Vendula Francová
- ELLA-CS, s.r.o., Milady Horákové 504/45, 500 06 Hradec Králové, Czech Republic;
| | - Dominik Miškář
- Department of Physics, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic; (J.L.); (D.J.); (D.M.)
| | - Alena Myslivcová Fučíková
- Department of Biology, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic;
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Choi JS, Seok J, Eom MR, Jung E, Park SA, Joo SM, Jun YJ, Son KW, Kwon SK. Endoscopically Applied Biodegradable Stent in a Rabbit Model of Pediatric Tracheomalacia. Clin Exp Otorhinolaryngol 2021; 14:328-337. [PMID: 33081438 PMCID: PMC8373836 DOI: 10.21053/ceo.2020.01627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/26/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES A polydioxanone (PDO) stent was developed to treat tracheomalacia in pediatric patients. However, its safety and efficacy need to be verified in animal studies before clinical trials in patients can be conducted. This study evaluated the safety and efficacy of a PDO stent in normal and tracheomalacia-model rabbits. METHODS In total, 29 New Zealand white rabbits were used: 13 for evaluating the biocompatibility of the PDO stent in normal rabbits and 16 for the creation of a tracheomalacia model. The tracheomalacia model was successfully established in 12 rabbits, and PDO stents were placed in eight of those rabbits. RESULTS The PDO stent was successfully positioned in the trachea of the normal rabbits using an endoscopic approach, and its degradation was observed 10 weeks later. The stent fragments did not induce distal airway obstruction or damage, and the mucosal changes that occurred after stent placement were reversed after degradation. The same procedure was performed on the tracheomalacia-model rabbits. The survival duration of the tracheomalacia rabbits with and without stents was 49.0±6.8 and 1.0±0.8 days, respectively. Thus, the PDO stent yielded a significant survival gain (P=0.001). In the tracheomalacia rabbits, stent degradation and granulation tissue were observed 7 weeks after placement, leading to airway collapse and death. CONCLUSION We successfully developed a PDO stent and an endoscopic guide placement system. The degradation time of the stent was around 10 weeks in normal rabbits, and its degradation was accelerated in the tracheomalacia model. The mucosal changes associated with PDO stent placement were reversible. Placement of the PDO stent prolonged survival in tracheomalacia-model rabbits.
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Affiliation(s)
- Ji Suk Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Jungirl Seok
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
| | - Min Rye Eom
- Department of Otorhinolaryngology-Head and Neck Surgery, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Eungee Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Su A Park
- Department of Nature-Inspired Nanoconvergence Systems, Korea Institute of Machinery and Materials, Daejeon, Korea
| | | | | | | | - Seong Keun Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
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Tian Y, Liu M, Liu W, Cheng J, Wu G, Han T, Zhang Y, Zhao G, Ni Z. Effects of annealing temperature on both radial supporting performance and axial flexibility of poly(L‐lactic acid) braided stents. J Appl Polym Sci 2021. [DOI: 10.1002/app.50517] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Yuan Tian
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Muqing Liu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Wentao Liu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Jie Cheng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Gensheng Wu
- School of Mechanical and Electronic Engineering Nanjing Forestry University Nanjing China
| | - Ting Han
- Department of Thermal Analysis Instrument Mettler‐Toledo Company Shanghai China
| | - Yi Zhang
- Center of Interventional Radiology & Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School Southeast University Nanjing China
| | - Gutian Zhao
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Zhonghua Ni
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
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15
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Obiweluozor FO, Emechebe GA, Kim DW, Cho HJ, Park CH, Kim CS, Jeong IS. Considerations in the Development of Small-Diameter Vascular Graft as an Alternative for Bypass and Reconstructive Surgeries: A Review. Cardiovasc Eng Technol 2020; 11:495-521. [PMID: 32812139 DOI: 10.1007/s13239-020-00482-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Current design strategies for small diameter vascular grafts (< 6 mm internal diameter; ID) are focused on mimicking native vascular tissue because the commercially available grafts still fail at small diameters, notably due to development of intimal hyperplasia and thrombosis. To overcome these challenges, various design approaches, material selection, and surface modification strategies have been employed to improve the patency of small-diameter grafts. REVIEW The purpose of this review is to outline various considerations in the development of small-diameter vascular grafts, including material choice, surface modifications to enhance biocompatibility/endothelialization, and mechanical properties of the graft, that are currently being implanted. Additionally, we have taken into account the general vascular physiology, tissue engineering approaches, and collective achievements of the authors in this area. We reviewed both commercially available synthetic grafts (e-PTFE and PET), elastic polymers such as polyurethane and biodegradable and bioresorbable materials. We included naturally occurring materials by focusing on their potential application in the development of future vascular alternatives. CONCLUSION Until now, there are few comprehensive reviews regarding considerations in the design of small-diameter vascular grafts in the literature. Here-in, we have discussed in-depth the various strategies employed to generate engineered vascular graft due to their high demand for vascular surgeries. While some TEVG design strategies have shown greater potential in contrast to autologous or synthetic ePTFE conduits, many are still hindered by high production cost which prevents their widespread adoption. Nonetheless, as tissue engineers continue to develop on their strategies and procedures for improved TEVGs, soon, a reliable engineered graft will be available in the market. Hence, we anticipate a viable TEVG with resorbable property, fabricated via electrospinning approach to hold a greater potential that can overcome the challenges observed in both autologous and allogenic grafts. This is because they can be mechanically tuned, incorporated/surface-functionalized with bioactive molecules and mass-manufactured in a reproducible manner. It is also found that most of the success in engineered vascular graft approaching commercialization is for large vessels rather than small-diameter grafts used as cardiovascular bypass grafts. Consequently, the field of vascular engineering is still available for future innovators that can take up the challenge to create a functional arterial substitute.
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Affiliation(s)
- Francis O Obiweluozor
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea.
| | - Gladys A Emechebe
- Department of Bionanosystem Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
| | - Do-Wan Kim
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea
| | - Hwa-Jin Cho
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea
| | - Chan Hee Park
- Department of Bionanosystem Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
- Department of Mechanical Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
| | - Cheol Sang Kim
- Department of Bionanosystem Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
- Department of Mechanical Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
| | - In Seok Jeong
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea.
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16
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Li X, Liu W, Li Y, Lan W, Zhao D, Wu H, Feng Y, He X, Li Z, Li J, Luo F, Tan H. Mechanically robust enzymatically degradable shape memory polyurethane urea with a rapid recovery response induced by NIR. J Mater Chem B 2020; 8:5117-5130. [DOI: 10.1039/d0tb00798f] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
NIR-light triggered shape memory process involving PU/gold-nanorod composites is shown.
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17
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Bezrouk A, Hosszu T, Hromadko L, Olmrova Zmrhalova Z, Kopecek M, Smutny M, Selke Krulichova I, Macak JM, Kremlacek J. Mechanical properties of a biodegradable self-expandable polydioxanone monofilament stent: In vitro force relaxation and its clinical relevance. PLoS One 2020; 15:e0235842. [PMID: 32639989 PMCID: PMC7343154 DOI: 10.1371/journal.pone.0235842] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/23/2020] [Indexed: 01/21/2023] Open
Abstract
Biodegradable stents are promising treatments for many diseases, e.g., coronary artery disease, urethral diseases, tracheal diseases, and esophageal strictures. The mechanical properties of biodegradable stent materials play a key role in the safety and efficacy of treatment. In particular, insufficient creep resistance of the stent material could result in premature stent collapse or narrowing. Commercially available biodegradable self-expandable SX-ELLA stents made of polydioxanone monofilament were tested. A new, simple, and affordable method to measure the shear modulus of tiny viscoelastic wires is presented. The important mechanical parameters of the polydioxanone filament were obtained: the median Young's modulus was [Formula: see text] = 958 (922, 974) MPa and the shear modulus was [Formula: see text] = 357 (185, 387) MPa, resulting in a Poisson's ratio of ν = 0.34. The SX-ELLA stents exhibited significant force relaxation due to the stress relaxation of the polydioxanone monofilament, approximately 19% and 36% 10 min and 48 h after stent application, respectively. However, these results were expected, and the manufacturer and implanting clinician should be aware of the known behavior of these biodegradable materials. If possible, a biodegradable stent should be designed considering therapeutic force rather than initial force. Additionally, new and more advanced biodegradable shape-memory polymers should be considered for future study and use.
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Affiliation(s)
- Ales Bezrouk
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
- * E-mail:
| | - Tomas Hosszu
- Department of Neurosurgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Ludek Hromadko
- Center of Materials and Nanotechnologies, Faculty of Chemical Technology, University of Pardubice, Pardubice, Czech Republic
- Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Zuzana Olmrova Zmrhalova
- Center of Materials and Nanotechnologies, Faculty of Chemical Technology, University of Pardubice, Pardubice, Czech Republic
| | - Martin Kopecek
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Martin Smutny
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Iva Selke Krulichova
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Jan M. Macak
- Center of Materials and Nanotechnologies, Faculty of Chemical Technology, University of Pardubice, Pardubice, Czech Republic
- Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Jan Kremlacek
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
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18
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Braided bioresorbable cardiovascular stents mechanically reinforced by axial runners. J Mech Behav Biomed Mater 2019; 89:19-32. [DOI: 10.1016/j.jmbbm.2018.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 08/29/2018] [Accepted: 09/02/2018] [Indexed: 11/21/2022]
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19
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Jia H, Gu SY, Chang K. 3D printed self-expandable vascular stents from biodegradable shape memory polymer. ADVANCES IN POLYMER TECHNOLOGY 2018. [DOI: 10.1002/adv.22091] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Han Jia
- Department of Polymeric Materials; School of Materials Science and Engineering; Tongji University; Shanghai China
| | - Shu-Ying Gu
- Department of Polymeric Materials; School of Materials Science and Engineering; Tongji University; Shanghai China
- Key Laboratory of Advanced Civil Engineering Materials; Ministry of Education; Tongji University; Shanghai China
| | - Kun Chang
- Department of Polymeric Materials; School of Materials Science and Engineering; Tongji University; Shanghai China
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20
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Peirlinck M, Debusschere N, Iannaccone F, Siersema PD, Verhegghe B, Segers P, De Beule M. An in silico biomechanical analysis of the stent–esophagus interaction. Biomech Model Mechanobiol 2017; 17:111-131. [DOI: 10.1007/s10237-017-0948-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 08/03/2017] [Indexed: 12/15/2022]
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21
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Zhao F, Xue W, Wang F, Yu C, Xu H, Hao Y, Wang L. A new approach to improve the local compressive properties of PPDO self-expandable stent. J Mech Behav Biomed Mater 2017; 68:318-326. [PMID: 28237687 DOI: 10.1016/j.jmbbm.2017.02.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/11/2017] [Accepted: 02/12/2017] [Indexed: 02/07/2023]
Abstract
The radial performance of bioabsorbable polymeric intravascular stents is extremely important in assessing the efficiency of these devices in expanding narrow lumen, reducing stent recoil, and recovering to their original states after suffering from pulsating pressure. However, these stents remain inferior to metallic stents. Several thermal treatment conditions (60°C, 80°C, and 100°C for 1h) were investigated to improve the characteristics of poly(p-dioxanone) (PPDO) self-expandable stents. The local compressive force, stiffness, and viscoelasticity of these stents were also evaluated. Wide-angle X-ray diffraction and different scanning calorimetry measurements were performed to evaluate the recrystalline and thermodynamic changes of molecular chains. The declining conformer entropy of PPDO monofilaments was examined via energy analysis. The untreated stents had compressive modules of 514.80±70.59mN/mm, which was much higher than those of 80°C and 100°C treated stents (332.35±66.08mN/mm and 394.31±64.71mN/mm, respectively). Nevertheless, 100°C annealing stents had less stress relaxation and prior elastic recovery rate of 82.32±3.43mN and 92.55±1.61%, respectively, showing a much better shape stability than untreated stents (139.51±16.67mN and 86.18±3.57%, respectively). These findings present important clinical implications in the stent manufacturing process and warrant further study to develop new bioabsorbable stents with outstanding clinical efficacy.
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Affiliation(s)
- Fan Zhao
- College of Textiles, Donghua University, Shanghai 201620, China; Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, 2999 North Renmin Road, Shanghai 201620, China
| | - Wen Xue
- College of Textiles, Donghua University, Shanghai 201620, China; Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, 2999 North Renmin Road, Shanghai 201620, China
| | - Fujun Wang
- College of Textiles, Donghua University, Shanghai 201620, China; Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, 2999 North Renmin Road, Shanghai 201620, China.
| | - Chenglong Yu
- College of Textiles, Donghua University, Shanghai 201620, China
| | - Haiyan Xu
- College of Textiles, Donghua University, Shanghai 201620, China
| | - Yi Hao
- College of Textiles, Donghua University, Shanghai 201620, China
| | - Lu Wang
- College of Textiles, Donghua University, Shanghai 201620, China; Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, 2999 North Renmin Road, Shanghai 201620, China.
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22
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Park YM, Hwang KM, Lee JS. The Change of the Pathogen in Cultured Jones Tubes according to the Postoperative Periods. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.7.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Young Min Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea
- Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Kwang Myoung Hwang
- Division of International Trade, Silla University College of Global Business, Busan, Korea
| | - Jong Soo Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Department of Ophthalmology, Pusan National University Hospital, Busan, Korea
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23
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Trela JM, Dechant JE, Culp WT, Whitcomb MB, Palm CA, Nieto JE. Use of an Absorbable Urethral Stent for the Management of a Urethral Stricture in a Stallion. Vet Surg 2016; 45:O41-O48. [DOI: 10.1111/vsu.12530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 05/26/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Jan M. Trela
- School of Veterinary Medicine; University of California-Davis; Davis California
| | - Julie E. Dechant
- School of Veterinary Medicine; University of California-Davis; Davis California
| | - William T. Culp
- School of Veterinary Medicine; University of California-Davis; Davis California
| | - Mary B. Whitcomb
- School of Veterinary Medicine; University of California-Davis; Davis California
| | - Carrie A. Palm
- School of Veterinary Medicine; University of California-Davis; Davis California
| | - Jorge E. Nieto
- School of Veterinary Medicine; University of California-Davis; Davis California
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Goonoo N, Jeetah R, Bhaw-Luximon A, Jhurry D. Polydioxanone-based bio-materials for tissue engineering and drug/gene delivery applications. Eur J Pharm Biopharm 2015; 97:371-91. [PMID: 26614558 DOI: 10.1016/j.ejpb.2015.05.024] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 05/27/2015] [Accepted: 05/28/2015] [Indexed: 11/22/2022]
Abstract
Since the commercialization of polydioxanone (PDX) as a biodegradable monofilament suture by Ethicon in 1981, the polymer has received only limited interest until recently. The limitations of polylactide-co-glycolide (PLGA) coupled with the growing need for materials with enhanced features and the advent of new fabrication techniques such as electrospinning have revived interest for PDX in medical devices, tissue engineering and drug delivery applications. Electrospun PDX mats show comparable mechanical properties as the major structural components of native vascular extracellular matrix (ECM) i.e. collagen and elastin. In addition, PDX's unique shape memory property provides rebound and kink resistance when fabricated into vascular conduits. The synthesis of methyl dioxanone (MeDX) monomer and copolymers of dioxanone (DX) and MeDX have opened up new perspectives for poly(ester-ether)s, enabling the design of the next generation of tissue engineering scaffolds for application in regenerating such tissues as arteries, peripheral nerve and bone. Tailoring of polymer properties and their formulation as nanoparticles, nanomicelles or nanofibers have brought along important developments in the area of controlled drug or gene delivery. This paper reviews the synthesis of PDX and its copolymers and provides for the first time an exhaustive account of its applications in the (bio)medical field with focus on tissue engineering and drug/gene delivery.
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Affiliation(s)
- Nowsheen Goonoo
- ANDI Centre of Excellence for Biomedical and Biomaterials Research, MSIRI Building, University of Mauritius, Réduit, Mauritius
| | - Roubeena Jeetah
- ANDI Centre of Excellence for Biomedical and Biomaterials Research, MSIRI Building, University of Mauritius, Réduit, Mauritius
| | - Archana Bhaw-Luximon
- ANDI Centre of Excellence for Biomedical and Biomaterials Research, MSIRI Building, University of Mauritius, Réduit, Mauritius
| | - Dhanjay Jhurry
- ANDI Centre of Excellence for Biomedical and Biomaterials Research, MSIRI Building, University of Mauritius, Réduit, Mauritius.
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25
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Li G, Li Y, Chen G, He J, Han Y, Wang X, Kaplan DL. Silk-based biomaterials in biomedical textiles and fiber-based implants. Adv Healthc Mater 2015; 4:1134-51. [PMID: 25772248 PMCID: PMC4456268 DOI: 10.1002/adhm.201500002] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 02/04/2015] [Indexed: 01/25/2023]
Abstract
Biomedical textiles and fiber-based implants (BTFIs) have been in routine clinical use to facilitate healing for nearly five decades. Amongst the variety of biomaterials used, silk-based biomaterials (SBBs) have been widely used clinically viz. sutures for centuries and are being increasingly recognized as a prospective material for biomedical textiles. The ease of processing, controllable degradability, remarkable mechanical properties and biocompatibility have prompted the use of SBBs for various BTFIs for extracorporeal implants, soft tissue repair, healthcare/hygiene products and related needs. The present Review focuses on BTFIs from the perspective of types and physical and biological properties, and this discussion is followed with an examination of the advantages and limitations of BTFIs from SBBs. The Review covers progress in surface coatings, physical and chemical modifications of SBBs for BTFIs and identifies future needs and opportunities for the further development for BTFIs using SBBs.
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Affiliation(s)
- Gang Li
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, P.R. China
| | - Yi Li
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Guoqiang Chen
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, P.R. China
| | - Jihuan He
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, P.R. China
| | - Yifan Han
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiaoqin Wang
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, P.R. China
| | - David L. Kaplan
- Department of Biomedical Engineering, Tufts University, 4 Colby St, Room 153, Medford, MA 02155, USA
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Park JH, Song HY, Shin JH, Kim JH, Jun EJ, Cho YC, Kim SH, Park J. Polydioxanone biodegradable stent placement in a canine urethral model: analysis of inflammatory reaction and biodegradation. J Vasc Interv Radiol 2014; 25:1257-1264.e1. [PMID: 24912878 DOI: 10.1016/j.jvir.2014.03.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 03/20/2014] [Accepted: 03/21/2014] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To investigate the inflammatory reaction and perform quantitative analysis of biodegradation after placement of a polydioxanone (PDO) biodegradable stent in a canine urethral model. MATERIALS AND METHODS PDO biodegradable stents were placed in the proximal and distal urethra of nine male mongrel dogs. The dogs were euthanized 4 weeks (group A; n = 3), 8 weeks (group B; n = 3), or 12 weeks (group C; n = 3) after stent placement. The luminal diameter of the stent-implanted urethra was assessed by follow-up retrograde urethrography, and histologic findings were obtained after the dogs were killed. Stents were removed after euthanasia, and their surface morphology and molecular weight were evaluated. Hematologic examination was performed to evaluate inflammatory reaction. RESULTS Stent placement was technically successful in all dogs. The average luminal diameter gradually decreased. The average number of epithelial layers (2.93 vs 4.42; P < .001), the average thickness of papillary projection (0.80 mm vs 1.28 mm; P < .001), and the average thickness of submucosal fibrosis (0.34 mm vs 0.49 mm ; P < .001) were significantly increased in group B versus group A. There were no significant differences between group B and group C. The average inflammatory cell infiltration did not differ significantly in the three groups. Molecular weight losses were 54% in group A and 84% in group B. In group C, PDO stents were completely decomposed. CONCLUSIONS An experimental study in a canine urethral model has demonstrated acceptable inflammatory reaction with gradually increasing granulation tissue but no luminal obstruction within 12 weeks.
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Affiliation(s)
- Jung-Hoon Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Ho-Young Song
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul 138-736, Republic of Korea.
| | - Ji Hoon Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Jin Hyoung Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Eun Jung Jun
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Young Chul Cho
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Soo Hwan Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Jihong Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul 138-736, Republic of Korea
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27
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Li G, Chen Y, Hu J, Wu X, Hu J, He X, Li J, Zhao Z, Chen Z, Li Y, Hu H, Li Y, Lan P. A 5-fluorouracil-loaded polydioxanone weft-knitted stent for the treatment of colorectal cancer. Biomaterials 2013; 34:9451-61. [PMID: 24011711 DOI: 10.1016/j.biomaterials.2013.08.055] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 08/19/2013] [Indexed: 12/11/2022]
Abstract
In-stents restenosis caused by tumour ingrowth is a major problem for patients undergoing stent displacement because the conventional stents often lack a sustained anti-tumour capability. The aim of this paper was to develop a weft-knitted polydioxanone stent which can slow release 5-fluorouracil (5-FU). In order to determine the most suitable drug concentration, the 5-FU safe concentration in vivo and appropriate loading percentage in the membranes were investigated, and then 5-FU-loaded poly-l-lactide membranes at concentration of 3.2%, 6.4% and 12.8% were coated onto the stent using electro-spinning method, respectively. The morphology, chemical structure and in vitro drug release property of the coating membranes were subsequently examined. Their anti-tumour activity and mechanism were assessed in vitro and in vivo using a human colorectal cancer cell line HCT-116 and tumour-bearing BALB/c nude mice. The half maximal inhibitory concentration (IC50) and the median lethal dose (LD50) demonstrated that the 6.4% and 12.8% membranes had better anti-tumour effects than pure 5-FU due to the sustainable drug releasing property of the coated membranes on the stent. The membranes possessing appropriate drug loading doses, such as 6.4% or 12.8% also provided better anti-in-stents restenosis effects than other groups tested. Therefore, it is concluded that the drug-loaded stents have great potential for the use in the treatment of intestinal cancers in the future.
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Affiliation(s)
- Gang Li
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Kowloon, Hong Kong; Guangdong-HK International Textile Bioengineering Joint Research Center, The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, PR China
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