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Xu H, Yan S, Gerhard E, Xie D, Liu X, Zhang B, Shi D, Ameer GA, Yang J. Citric Acid: A Nexus Between Cellular Mechanisms and Biomaterial Innovations. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2402871. [PMID: 38801111 PMCID: PMC11309907 DOI: 10.1002/adma.202402871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/07/2024] [Indexed: 05/29/2024]
Abstract
Citrate-based biodegradable polymers have emerged as a distinctive biomaterial platform with tremendous potential for diverse medical applications. By harnessing their versatile chemistry, these polymers exhibit a wide range of material and bioactive properties, enabling them to regulate cell metabolism and stem cell differentiation through energy metabolism, metabonegenesis, angiogenesis, and immunomodulation. Moreover, the recent US Food and Drug Administration (FDA) clearance of the biodegradable poly(octamethylene citrate) (POC)/hydroxyapatite-based orthopedic fixation devices represents a translational research milestone for biomaterial science. POC joins a short list of biodegradable synthetic polymers that have ever been authorized by the FDA for use in humans. The clinical success of POC has sparked enthusiasm and accelerated the development of next-generation citrate-based biomaterials. This review presents a comprehensive, forward-thinking discussion on the pivotal role of citrate chemistry and metabolism in various tissue regeneration and on the development of functional citrate-based metabotissugenic biomaterials for regenerative engineering applications.
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Affiliation(s)
- Hui Xu
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Su Yan
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Ethan Gerhard
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Denghui Xie
- Department of Histology and Embryology, School of Basic Medical Sciences, Department of Orthopedic Surgery, The Third Affiliated Hospital of Southern Medical University, Southern Medical University, Guangzhou, 510515, P. R. China
- Academy of Orthopedics of Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, 510630, P. R. China
| | - Xiaodong Liu
- Research Center for Industries of the Future, Westlake University, Hangzhou, Zhejiang, 310030, P. R. China
- School of Life Sciences, Westlake University, Hangzhou, Zhejiang, 310030, P. R. China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, 310030, P. R. China
- Westlake Institute for Advanced Study, Hangzhou, Zhejiang, 310030, P. R. China
| | - Bing Zhang
- Research Center for Industries of the Future, Westlake University, Hangzhou, Zhejiang, 310030, P. R. China
- School of Life Sciences, Westlake University, Hangzhou, Zhejiang, 310030, P. R. China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, 310030, P. R. China
- Westlake Institute for Advanced Study, Hangzhou, Zhejiang, 310030, P. R. China
| | - Dongquan Shi
- Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, P. R. China
| | - Guillermo A Ameer
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
- Center for Advanced Regenerative Engineering, Northwestern University, Evanston, IL, 60208, USA
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Jian Yang
- Research Center for Industries of the Future, Westlake University, Hangzhou, Zhejiang, 310030, P. R. China
- Biomedical Engineering Program, School of Engineering, Westlake University, Hangzhou, Zhejiang, 310030, P. R. China
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Wang M, Xu P, Lei B. Engineering multifunctional bioactive citrate-based biomaterials for tissue engineering. Bioact Mater 2023; 19:511-537. [PMID: 35600971 PMCID: PMC9096270 DOI: 10.1016/j.bioactmat.2022.04.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 12/21/2022] Open
Abstract
Developing bioactive biomaterials with highly controlled functions is crucial to enhancing their applications in regenerative medicine. Citrate-based polymers are the few bioactive polymer biomaterials used in biomedicine because of their facile synthesis, controllable structure, biocompatibility, biomimetic viscoelastic mechanical behavior, and functional groups available for modification. In recent years, various multifunctional designs and biomedical applications, including cardiovascular, orthopedic, muscle tissue, skin tissue, nerve and spinal cord, bioimaging, and drug or gene delivery based on citrate-based polymers, have been extensively studied, and many of them have good clinical application potential. In this review, we summarize recent progress in the multifunctional design and biomedical applications of citrate-based polymers. We also discuss the further development of multifunctional citrate-based polymers with tailored properties to meet the requirements of various biomedical applications. Multifunctional bioactive citrate-based biomaterials have broad applications in regenerative medicine. Recent advances in multifunctional design and biomedical applications of citate-based polymers are summarized. Future challenge of citrate-based polymers in various biomedical applications are discussed.
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Kawai K, Virmani R, Finn AV. In-Stent Restenosis. Interv Cardiol Clin 2022; 11:429-443. [PMID: 36243488 DOI: 10.1016/j.iccl.2022.02.005] [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] [Indexed: 06/16/2023]
Abstract
In-stent restenosis (ISR) remains a potential complication after percutaneous coronary intervention, even in the era of drug-eluting stents, and its treatment remains suboptimal. Neoatherosclerosis is an important component of the pathology of ISR and is accelerated in drug-eluting stents compared with bare-metal stents. Coronary angiography is the gold standard for evaluating the morphology of ISR, although computed tomography angiography is emerging as an alternative noninvasive modality to evaluate the presence of ISR. Drug-coated balloons and stent reimplantation are the current mainstays of treatment for ISR, and the choice of treatment should be based on clinical background and lesion morphology.
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Affiliation(s)
- Kenji Kawai
- CVPath Institute, 19 Firstfield Road, Gaithersburg, MD 20878, USA
| | - Renu Virmani
- CVPath Institute, 19 Firstfield Road, Gaithersburg, MD 20878, USA
| | - Aloke V Finn
- CVPath Institute, 19 Firstfield Road, Gaithersburg, MD 20878, USA; University of Maryland, School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA.
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Turner B, Ramesh S, Menegatti S, Daniele M. Resorbable elastomers for implantable medical devices: highlights and applications. POLYM INT 2021. [DOI: 10.1002/pi.6349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Brendan Turner
- Joint Department of Biomedical Engineering North Carolina State University and University of Chapel Hill Raleigh NC USA
- Department of Chemical and Biomolecular Engineering North Carolina State University Raleigh NC USA
| | - Srivatsan Ramesh
- Department of Chemical and Biomolecular Engineering North Carolina State University Raleigh NC USA
| | - Stefano Menegatti
- Department of Chemical and Biomolecular Engineering North Carolina State University Raleigh NC USA
| | - Michael Daniele
- Joint Department of Biomedical Engineering North Carolina State University and University of Chapel Hill Raleigh NC USA
- Department of Electrical and Computer Engineering North Carolina State University Raleigh NC USA
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Koper F, Swiergosz T, Żaba A, Flis A, Trávníčková M, Bačáková L, Pamuła E, Bogdał D, Kasprzyk WP. Advancements in structure-property correlation studies of cross-linked citric acid-based elastomers from the perspective of medical application. J Mater Chem B 2021; 9:6425-6440. [PMID: 34323912 DOI: 10.1039/d1tb01078f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Herein, a renewed prominence towards the synthesis of poly(alkylene citrate) (PAC) biomaterials and their detailed chemical, structural and mechanical characterization has been reported. Based on the modifications to the PAC synthesis protocol introduced in this study, the fabrication process was significantly streamlined, the reaction yields were increased, and the homogeneity of the final materials was found to be substantially improved. Comprehensive nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS) studies of the fabricated prepolymers shed light on the mechanism of the PAC cross-linking process and supported the design of materials with enhanced biocompatibility. Therefore, the initial molar ratio of the reagents involved in the synthesis of PAC materials was found to be pivotal to both the biological and mechanical properties of the final products. Moreover, cell viability and proliferation assays revealed enhanced biocompatibility of the materials formulated with a molar ratio of diol over citric acid (3 : 2 mol/mol) in comparison to the most commonly described 1 : 1 analogue without affecting the possibility of further functionalization. Furthermore, this work creates a new paradigm for prospective studies on the properties of modified PAC materials and their application in medicine and tissue engineering.
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Affiliation(s)
- Filip Koper
- Department of Biotechnology and Physical Chemistry, Faculty of Chemical Engineering and Technology, Cracow University of Technology, Warszawska 24, 31-155 Kraków, Poland.
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In-Stent Restenosis and a Drug-Coated Balloon: Insights from a Clinical Therapeutic Strategy on Coronary Artery Diseases. Cardiol Res Pract 2020; 2020:8104939. [PMID: 33163230 PMCID: PMC7605950 DOI: 10.1155/2020/8104939] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/29/2020] [Accepted: 10/10/2020] [Indexed: 12/14/2022] Open
Abstract
Coronary heart disease is a major cause of death and disability in developed countries. Stent implantation has become an efficacious treatment for a culprit lesion vessel of the coronary artery. However, 10%–20% restenosis is still an important complication that restricts the clinical safety and efficacy of drug-eluting stents. In-stent restenosis may lead to the recurrence of major cardiovascular adverse events, including angina pectoris, acute myocardial infarction, and even sudden cardiac death. These events are currently serious problems that occur after coronary stent implantation. Clinical physicians face a difficult choice for in-stent restenosis treatment. Recent studies indicate that a drug-coated balloon has promising clinical efficacy similar to the drug-eluting stents for treating coronary in-stent restenosis. Therefore, in this study, we highlight the progress of coronary intervention and the use of drug-coated balloons in the treatment of in-stent restenosis (ISR).
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Poly-ε-caprolactone/polysulfhydrylated polyester blend: A platform for topical and degradable nitric oxide-releasing materials. Eur Polym J 2018. [DOI: 10.1016/j.eurpolymj.2018.09.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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8
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Zhou Y, Zhou X, Liang K, Ji Y. Degradable Bioelastomers Prepared by a Facile Melt Polycondensation of Citric Acid and Polycaprolactone-diol. J MACROMOL SCI B 2018. [DOI: 10.1080/00222348.2018.1511296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Yajing Zhou
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Material Science and Engineering, Donghua University, Shanghai, China
| | - Xin Zhou
- Department of Pulmonary Medicine, The Third Clinical Medical College of Xinjiang Medical University, Urumqi, China
| | - Kai Liang
- Key Lab of Science & Technology of Eco-textile, Ministry of Education, Donghua University, Shanghai, China
| | - Yali Ji
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Material Science and Engineering, Donghua University, Shanghai, China
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Boddu SR, Gobin P, Oliveira C, Dinkin M, Patsalides A. Contrast enhanced magnetic resonance venography in the follow-up evaluation of idiopathic intracranial hypertension patients with cerebral venous sinus stenting. Clin Imaging 2018; 50:330-335. [PMID: 29754068 DOI: 10.1016/j.clinimag.2018.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/05/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Role of contrast-enhanced magnetic resonance venography (CE-MRV) in the follow-up of venous sinus stenting (VSS) among the idiopathic intracranial hypertension (IIH) patients. MATERIALS AND METHODS Prospective evaluation of VSS patients with CE-MRV, DRCV and DSA for follow-up of clinically suspected recurrent stenosis. CE-MRV was evaluated against DRCV and DSA. RESULTS Ten patients with twelve episodes of recurrent symptoms. Sensitivity, specificity, PPV, NPV and accuracy of the CE-MRV for the detection of recurrent stenosis were: 100%, 33.33%, 81.82%, 100% and 83.3% respectively. CONCLUSION CE-MRV was a reliable first-line investigation for the detection of recurrent stenosis following VSS.
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Affiliation(s)
- Srikanth R Boddu
- Division of Interventional Neuroradiology, Department of Neurological Surgery, New York Presbyterian Hospital/Weill Cornell Medical Center, 525 East, 68th Street, New York, NY 10065, United States; Interventional Neuroradiology, New York Presbyterian Queens Hospital, Flushing, NY 11355, United States.
| | - Pierre Gobin
- Division of Interventional Neuroradiology, Department of Neurological Surgery, New York Presbyterian Hospital/Weill Cornell Medical Center, 525 East, 68th Street, New York, NY 10065, United States.
| | - Cristiano Oliveira
- Department of Ophthalmology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY 10021, United States.
| | - Marc Dinkin
- Department of Ophthalmology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY 10021, United States.
| | - Athos Patsalides
- Division of Interventional Neuroradiology, Department of Neurological Surgery, New York Presbyterian Hospital/Weill Cornell Medical Center, 525 East, 68th Street, New York, NY 10065, United States.
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Lee J, Kim DH, Lee KJ, Seo IH, Park SH, Jang EH, Park Y, Youn YN, Ryu W. Transfer-molded wrappable microneedle meshes for perivascular drug delivery. J Control Release 2017; 268:237-246. [PMID: 29030224 DOI: 10.1016/j.jconrel.2017.10.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 09/11/2017] [Accepted: 10/06/2017] [Indexed: 12/27/2022]
Abstract
After surgical procedures such as coronary/peripheral bypass grafting or endarterectomy for the treatment of organ ischemia derived from atherosclerosis, intimal hyperplasia (IH) which leads to restenosis or occlusion at the site of graft anastomosis frequently occurs. In order to inhibit IH caused by abnormal growth of smooth muscle cells (SMCs) in tunica media, various perivascular drug delivery devices are reported for delivery of anti-proliferation drugs into vascular tissue. However, there still remain conflicting requirements such as local and unidirectional delivery vs device porosity, and conformal tight device installation vs pulsatile expansion and constriction of blood vessels. In this study, a biodegradable microneedle (MN) array is developed on a flexible woven surgical mesh using a transfer molding method. Mechanical properties of 'wrappable' MN meshes are investigated and compared to the properties of blood vessels. Ex vivo and in vivo animal studies demonstrate enhanced drug delivery efficiency, efficacy for IH reduction, and safety of MN mesh. In particular, MN mesh showed significantly reduced neointiamal formation (11.1%) compared to other competitive groups (23.7 and 22.2%) after 4-week in vivo animal study. Additionally, wrappable MN meshes effectively suppressed side effects such as IH due to mechanical constriction, loss of toxic drug to the surroundings, and cell death that were frequently observed with other previous perivascular drug delivery devices.
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Affiliation(s)
- JiYong Lee
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Dae-Hyun Kim
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Kang Ju Lee
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Il Ho Seo
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Seung Hyun Park
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Eui Hwa Jang
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Youngjoo Park
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Young-Nam Youn
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - WonHyoung Ryu
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
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Washington KS, Bashur CA. Delivery of Antioxidant and Anti-inflammatory Agents for Tissue Engineered Vascular Grafts. Front Pharmacol 2017; 8:659. [PMID: 29033836 PMCID: PMC5627016 DOI: 10.3389/fphar.2017.00659] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 09/05/2017] [Indexed: 01/21/2023] Open
Abstract
The treatment of patients with severe coronary and peripheral artery disease represents a significant clinical need, especially for those patients that require a bypass graft and do not have viable veins for autologous grafting. Tissue engineering is being investigated to generate an alternative graft. While tissue engineering requires surgical intervention, the release of pharmacological agents is also an important part of many tissue engineering strategies. Delivery of these agents offers the potential to overcome the major concerns for graft patency and viability. These concerns are related to an extended inflammatory response and its impact on vascular cells such as endothelial cells. This review discusses the drugs that have been released from vascular tissue engineering scaffolds and some of the non-traditional ways that the drugs are presented to the cells. The impact of antioxidant compounds and gasotransmitters, such as nitric oxide and carbon monoxide, are discussed in detail. The application of tissue engineering and drug delivery principles to biodegradable stents is also briefly discussed. Overall, there are scaffold-based drug delivery techniques that have shown promise for vascular tissue engineering, but much of this work is in the early stages and there are still opportunities to incorporate additional drugs to modulate the inflammatory process.
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Affiliation(s)
| | - Chris A. Bashur
- Department of Biomedical Engineering, Florida Institute of Technology, MelbourneFL, United States
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Albaghdadi MS, Yang J, Brown JH, Mansukhani NA, Ameer GA, Kibbe MR. A Tailorable In-Situ Light-Activated Biodegradable Vascular Scaffold. ADVANCED MATERIALS TECHNOLOGIES 2017; 2:1600243. [PMID: 29578542 PMCID: PMC5860681 DOI: 10.1002/admt.201600243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Biodegradable vascular scaffolds (BVS) are novel treatments for obstructive atherosclerotic cardiovascular disease that have been developed to overcome the limitations of traditional metallic drug-eluting stents (DES). The mechanical properties of bioabsorbable polymers used for the production of novel BVS are a key consideration for the clinical translation of this emerging technology. Herein, we describe the engineering of an in situ light-activated vascular scaffold (ILVS) comprised of a biodegradable citric acid-based elastomeric polymer, referred to as methacrylated poly-diol citrate (mPDC), and a diazeniumdiolate chitosan nitric oxide donor (chitoNO). In vitro studies demonstrate that the mechanical properties of the ILVS can be tailored to meet or exceed those of commercially available self-expanding bare metal stents (BMS). The radial compression strength of the ILVS is higher than that of a BMS despite undergoing degradation at physiologic conditions for 7 months. ILVS containing chitoNO provides sustained supraphysiologic levels of NO release. Lastly, ILVS were successfully cast in porcine arteries ex vivo using a custom designed triple balloon catheter, demonstrating translational potential. In conclusion, these data demonstrate the ability of an ILVS to provide tunable mechanical properties and drug-delivery capabilities for the vasculature, and thereby support mPDC as a promising material for the development of novel BVS platforms.
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Affiliation(s)
- Mazen S. Albaghdadi
- Department of Medicine, Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago Illinois
| | - Jian Yang
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois
| | - Jessica H. Brown
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago Illinois
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Neel A. Mansukhani
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago Illinois
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Guillermo A. Ameer
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago Illinois
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois
- Chemistry of Life Processes Institute, Northwestern University, Evanston, Illinois
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- International Institute for Nanotechnology, Northwestern University, Evanston, Illinois
| | - Melina R. Kibbe
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago Illinois
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Mylonaki I, Allémann É, Saucy F, Haefliger JA, Delie F, Jordan O. Perivascular medical devices and drug delivery systems: Making the right choices. Biomaterials 2017; 128:56-68. [PMID: 28288349 DOI: 10.1016/j.biomaterials.2017.02.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 02/13/2017] [Accepted: 02/26/2017] [Indexed: 12/31/2022]
Abstract
Perivascular medical devices and perivascular drug delivery systems are conceived for local application around a blood vessel during open vascular surgery. These systems provide mechanical support and/or pharmacological activity for the prevention of intimal hyperplasia following vessel injury. Despite abundant reports in the literature and numerous clinical trials, no efficient perivascular treatment is available. In this review, the existing perivascular medical devices and perivascular drug delivery systems, such as polymeric gels, meshes, sheaths, wraps, matrices, and metal meshes, are jointly evaluated. The key criteria for the design of an ideal perivascular system are identified. Perivascular treatments should have mechanical specifications that ensure system localization, prolonged retention and adequate vascular constriction. From the data gathered, it appears that a drug is necessary to increase the efficacy of these systems. As such, the release kinetics of pharmacological agents should match the development of the pathology. A successful perivascular system must combine these optimized pharmacological and mechanical properties to be efficient.
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Affiliation(s)
- Ioanna Mylonaki
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland
| | - Éric Allémann
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland
| | - François Saucy
- Department of Vascular Surgery, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland
| | - Jacques-Antoine Haefliger
- Department of Vascular Surgery, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland
| | - Florence Delie
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland
| | - Olivier Jordan
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, rue Michel Servet 1, CH-1211 Geneva 4, Switzerland.
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Periadventitial drug delivery for the prevention of intimal hyperplasia following open surgery. J Control Release 2016; 233:174-80. [PMID: 27179635 DOI: 10.1016/j.jconrel.2016.05.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/02/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Intimal hyperplasia (IH) remains a major cause of poor patient outcomes after surgical revascularization to treat atherosclerosis. A multitude of drugs have been shown to prevent the development of IH. Moreover, endovascular drug delivery following angioplasty and stenting has been achieved with a marked diminution in the incidence of restenosis. Despite advances in endovascular drug delivery, there is currently no clinically available method of periadventitial drug delivery suitable for open vascular reconstructions. Herein we provide an overview of the recent literature regarding innovative polymer platforms for periadventitial drug delivery in preclinical models of IH as well as insights about barriers to clinical translation. METHODS A comprehensive PubMed search confined to the past 15years was performed for studies of periadventitial drug delivery. Additional searches were performed for relevant clinical trials, patents, meeting abstracts, and awards of NIH funding. RESULTS Most of the research involving direct periadventitial delivery without a drug carrier was published prior to 2000. Over the past 15years there have been a surge of reports utilizing periadventitial drug-releasing polymer platforms, most commonly bioresorbable hydrogels and wraps. These methods proved to be effective for the inhibition of IH in various animal models (e.g. balloon angioplasty, wire injury, and vein graft), but very few have advanced to clinical trials. There are a number of barriers that may account for this lack of translation. Promising new approaches including the use of nanoparticles will be described. CONCLUSIONS No periadventitial drug delivery system has reached clinical application. For periadventitial delivery, polymer hydrogels, wraps, and nanoparticles exhibit overlapping and complementary properties. The ideal periadventitial delivery platform would allow for sustained drug release yet exert minimal mechanical and inflammatory stresses to the vessel wall. A clinically applicable strategy for periadventitial drug delivery would benefit thousands of patients undergoing open vascular reconstruction each year.
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Yang Y, Qi P, Yang Z, Huang N. Nitric oxide based strategies for applications of biomedical devices. BIOSURFACE AND BIOTRIBOLOGY 2015. [DOI: 10.1016/j.bsbt.2015.08.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Tran RT, Yang J, Ameer GA. Citrate-Based Biomaterials and Their Applications in Regenerative Engineering. ANNUAL REVIEW OF MATERIALS RESEARCH 2015; 45:277-310. [PMID: 27004046 PMCID: PMC4798247 DOI: 10.1146/annurev-matsci-070214-020815] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Advances in biomaterials science and engineering are crucial to translating regenerative engineering, an emerging field that aims to recreate complex tissues, into clinical practice. In this regard, citrate-based biomaterials have become an important tool owing to their versatile material and biological characteristics including unique antioxidant, antimicrobial, adhesive, and fluorescent properties. This review discusses fundamental design considerations, strategies to incorporate unique functionality, and examples of how citrate-based biomaterials can be an enabling technology for regenerative engineering.
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Affiliation(s)
- Richard T. Tran
- Department of Biomedical Engineering, Materials Research Institute, and The Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, Pennsylvania 16802
| | - Jian Yang
- Department of Biomedical Engineering, Materials Research Institute, and The Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, Pennsylvania 16802
| | - Guillermo A. Ameer
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois 60208
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611
- Chemistry of Life Processes Institute, Northwestern University, Evanston, Illinois 60208
- Simpson Querrey Institute for Bionanotechnology, Northwestern University, Chicago, Illinois 60611
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Gregory EK, Webb AR, Vercammen JM, Flynn ME, Ameer GA, Kibbe MR. Periadventitial atRA citrate-based polyester membranes reduce neointimal hyperplasia and restenosis after carotid injury in rats. Am J Physiol Heart Circ Physiol 2014; 307:H1419-29. [PMID: 25239800 DOI: 10.1152/ajpheart.00914.2013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Oral all-trans retinoic acid (atRA) has been shown to reduce the formation of neointimal hyperplasia; however, the dose required was 30 times the chemotherapeutic dose, which already has reported side effects. As neointimal formation is a localized process, new approaches to localized delivery are required. This study assessed whether atRA within a citrate-based polyester, poly(1,8 octanediolcitrate) (POC), perivascular membrane would prevent neointimal hyperplasia following arterial injury. atRA-POC membranes were prepared and characterized for atRA release via high-performance liquid chromatography with mass spectrometry detection. Rat adventitial fibroblasts (AF) and vascular smooth muscle cells (VSMC) were exposed to various concentrations of atRA; proliferation, apoptosis, and necrosis were assessed in vitro. The rat carotid artery balloon injury model was used to evaluate the impact of the atRA-POC membranes on neointimal formation, cell proliferation, apoptosis, macrophage infiltration, and vascular cell adhesion molecule 1 (VCAM-1) expression in vivo. atRA-POC membranes released 12 μg of atRA over 2 wk, with 92% of the release occurring in the first week. At 24 h, atRA (200 μmol/l) inhibited [(3)H]-thymidine incorporation into AF and VSMC by 78% and 72%, respectively (*P = 0.001), with negligible apoptosis or necrosis. Histomorphometry analysis showed that atRA-POC membranes inhibited neointimal formation after balloon injury, with a 56%, 57%, and 50% decrease in the intimal area, intima-to-media area ratio, and percent stenosis, respectively (P = 0.001). atRA-POC membranes had no appreciable effect on apoptosis or proliferation at 2 wk. Regarding biocompatibility, we found a 76% decrease in macrophage infiltration in the intima layer (P < 0.003) in animals treated with atRA-POC membranes, with a coinciding 53% reduction in VCAM-1 staining (P < 0.001). In conclusion, perivascular delivery of atRA inhibited neointimal formation and restenosis. These data suggest that atRA-POC membranes may be suitable as localized therapy to inhibit neointimal hyperplasia following open cardiovascular procedures.
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Affiliation(s)
- Elaine K Gregory
- Division of Vascular Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Simpson Querrey Institute for Bionanotechnology, Northwestern University, Chicago, Illinois
| | - Antonio R Webb
- Biomedical Engineering Department, McCormick School of Engineering, Northwestern University, Evanston, Illinois; Simpson Querrey Institute for Bionanotechnology, Northwestern University, Chicago, Illinois; VesselTek Biomedical, Chicago, Illinois; University of Florida, Gainesville, Florida
| | - Janet M Vercammen
- Division of Vascular Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Simpson Querrey Institute for Bionanotechnology, Northwestern University, Chicago, Illinois
| | - Megan E Flynn
- Division of Vascular Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Simpson Querrey Institute for Bionanotechnology, Northwestern University, Chicago, Illinois
| | - Guillermo A Ameer
- Biomedical Engineering Department, McCormick School of Engineering, Northwestern University, Evanston, Illinois; Simpson Querrey Institute for Bionanotechnology, Northwestern University, Chicago, Illinois
| | - Melina R Kibbe
- Division of Vascular Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Simpson Querrey Institute for Bionanotechnology, Northwestern University, Chicago, Illinois;
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18
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Yu X, Takayama T, Goel SA, Shi X, Zhou Y, Kent KC, Murphy WL, Guo LW. A rapamycin-releasing perivascular polymeric sheath produces highly effective inhibition of intimal hyperplasia. J Control Release 2014; 191:47-53. [PMID: 24852098 DOI: 10.1016/j.jconrel.2014.05.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/30/2014] [Accepted: 05/08/2014] [Indexed: 01/02/2023]
Abstract
Intimal hyperplasia produces restenosis (re-narrowing) of the vessel lumen following vascular intervention. Drugs that inhibit intimal hyperplasia have been developed, however there is currently no clinical method of perivascular drug-delivery to prevent restenosis following open surgical procedures. Here we report a poly(ε-caprolactone) (PCL) sheath that is highly effective in preventing intimal hyperplasia through perivascular delivery of rapamycin. We first screened a series of bioresorbable polymers, i.e., poly(lactide-co-glycolide) (PLGA), poly(lactic acid) (PLLA), PCL, and their blends, to identify desired release kinetics and sheath physical properties. Both PLGA and PLLA sheaths produced minimal (<30%) rapamycin release within 50days in PBS buffer. In contrast, PCL sheaths exhibited more rapid and near-linear release kinetics, as well as durable integrity (>90days) as evidenced in both scanning electron microscopy and subcutaneous embedding experiments. Moreover, a PCL sheath deployed around balloon-injured rat carotid arteries was associated with a minimum rate of thrombosis compared to PLGA and PLLA. Morphometric analysis and immunohistochemistry revealed that rapamycin-loaded perivascular PCL sheaths produced pronounced (85%) inhibition of intimal hyperplasia (0.15±0.05 vs 1.01±0.16), without impairment of the luminal endothelium, the vessel's anti-thrombotic layer. Our data collectively show that a rapamycin-loaded PCL delivery system produces substantial mitigation of neointima, likely due to its favorable physical properties leading to a stable yet flexible perivascular sheath and steady and prolonged release kinetics. Thus, a PCL sheath may provide useful scaffolding for devising effective perivascular drug delivery particularly suited for preventing restenosis following open vascular surgery.
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Affiliation(s)
- Xiaohua Yu
- Department of Biomedical Engineering, University of Wisconsin, 5009 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA
| | - Toshio Takayama
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA
| | - Shakti A Goel
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA
| | - Xudong Shi
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA
| | - Yifan Zhou
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA
| | - K Craig Kent
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA; Department of Surgery, University of Wisconsin Hospital and Clinics, 600 Highland Avenue, Madison, WI 53792, USA
| | - William L Murphy
- Department of Biomedical Engineering, University of Wisconsin, 5009 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA.
| | - Lian-Wang Guo
- Department of Surgery, University of Wisconsin, 5151 Wisconsin Institute of Medical Research, 1111 Highland Ave, Madison, WI 53705, USA.
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19
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Wang Y, Kibbe MR, Ameer GA. Photo-crosslinked Biodegradable Elastomers for Controlled Nitric Oxide Delivery. Biomater Sci 2013; 1:625-632. [PMID: 24707352 PMCID: PMC3972038 DOI: 10.1039/c3bm00169e] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The delivery of nitric oxide (NO) has important applications in medicine, especially for procedures that involve the vasculature. We report photo-curable biodegradable poly(diol citrate) elastomers capable of slow release of NO. A methacrylated poly(diol citrate) macromonomer was prepared by polycondensation of citric acid with 1, 8-octanediol or 1, 12-dodecanediol followed by functionalization with 2-aminoethyl methacrylate. A miscible NO donor, diazeniumdiolated N, N-diethyldiethylenetriamine, was synthesized and incorporated into the polymer matrix. An elastomeric network was obtained via photo-polymerization of macromonomers upon UV irradiation within three minutes. Films and tubes of the NO-releasing crosslinked macromonomers exhibited strong tensile strength and radial compressive strength, respectively. They also exhibited cell compatibility and biodegradability in vitro. Sustained NO release under physiological conditions was achieved for at least one week. NO release enhanced the proliferation of human umbilical vein endothelial cells but inhibited the proliferation of human aortic smooth muscle cells. Photo-polymerizable NO-releasing materials provide a new approach for the localized and sustained delivery of NO to treat thrombosis and restenosis in the vasculature.
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Affiliation(s)
- Ying Wang
- Biomedical Engineering Department, Northwestern University, Evanston, IL 60208
| | - Melina R. Kibbe
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University Chicago, IL 60611
- Institute for Bionanotechnology in Medicine, Northwestern University, Chicago, IL 60611
| | - Guillermo A. Ameer
- Biomedical Engineering Department, Northwestern University, Evanston, IL 60208
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University Chicago, IL 60611
- Institute for Bionanotechnology in Medicine, Northwestern University, Chicago, IL 60611
- The Chemistry of Life Processes Institute, Northwestern University, Evanston, IL 60208
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Jen MC, Serrano MC, van Lith R, Ameer GA. Polymer-Based Nitric Oxide Therapies: Recent Insights for Biomedical Applications. ADVANCED FUNCTIONAL MATERIALS 2012; 22:239-260. [PMID: 25067935 PMCID: PMC4111277 DOI: 10.1002/adfm.201101707] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Since the discovery of nitric oxide (NO) in the 1980s, this cellular messenger has been shown to participate in diverse biological processes such as cardiovascular homeostasis, immune response, wound healing, bone metabolism, and neurotransmission. Its beneficial effects have prompted increased research in the past two decades, with a focus on the development of materials that can locally release NO. However, significant limitations arise when applying these materials to biomedical applications. This Feature Article focuses on the development of NO-releasing and NO-generating polymeric materials (2006-2011) with emphasis on recent in vivo applications. Results are compared and discussed in terms of NO dose, release kinetics, and biological effects, in order to provide a foundation to design and evaluate new NO therapies.
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Affiliation(s)
- Michele C Jen
- Biomedical Engineering Department, Northwestern University, Evanston IL, 60208, USA
| | - María C Serrano
- Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas Cantoblanco, Madrid 28049, Spain
| | - Robert van Lith
- Biomedical Engineering Department, Northwestern University, Evanston IL, 60208, USA
| | - Guillermo A Ameer
- Biomedical Engineering Department, Northwestern University, Evanston IL, 60208, USA
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