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Huang Z, Zhang D, Tong L, Gao F, Zhang S, Wang X, Xie Y, Chen F, Liu C. Protonated-chitosan sponge with procoagulation activity for hemostasis in coagulopathy. Bioact Mater 2024; 41:174-192. [PMID: 39131629 PMCID: PMC11314896 DOI: 10.1016/j.bioactmat.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/20/2024] [Accepted: 07/07/2024] [Indexed: 08/13/2024] Open
Abstract
Hemostatic materials are essential for managing acute bleeding in medical settings. Chitosan (CS) shows promise in hemostasis but its underlying mechanism remains incompletely understood. We unexpectedly discovered that certain protonated-chitosan (PCS) rapidly assembled plasma proteins to form protein membrane (PM) upon contact with platelet-poor plasma (PPP). We hypothesized that the novel observation was intricately related to the procoagulant effect of chitosan. Herein, the study aimed to elucidate the conditions necessary and mechanism for PM formation, identify the proteins within the PM and PCS's procoagulant action at the molecule levels. We confirmed that the amount of -NH3 + groups (>4.9 mmol/g) on PCS molecules played a crucial role in promoting coagulation. The -NH3 + group interacted with blood's multiple active components to exert hemostatic effects: assembling plasma proteins including coagulation factors such as FII, FV, FX, activating blood cells and promoting the secretion of coagulation-related substances (FV, ADP, etc) by platelets. Notably, the hemostatic mechanism can be extended to protonated-chitosan derivatives like quaternized, alkylated, and catechol-chitosan. In the blood clotting index (BCI) experiment, compared to other groups, PCS95 achieved the lowest BCI value (∼6 %) within 30 s. Protonated-chitosan exhibited excellent biocompatibility and antibacterial properties, with PCS95 demonstrating inhibition effectiveness of over 95 % against Escherichia coli (E.coil) and Staphylococcus aureus (S. aureus). Moreover, PCS performed enhanced hemostatic effectiveness over chitosan-based commercially agents (Celox™ and ChitoGauze®XR) in diverse bleeding models. In particular, PCS95 reduced bleeding time by 70 % in rabbit models of coagulopathy. Overall, this study investigated the coagulation mechanism of materials at the molecular level, paving the way for innovative approaches in designing new hemostatic materials.
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Affiliation(s)
- Zhenhua Huang
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Dong Zhang
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Laiqiang Tong
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Fan Gao
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Shaozan Zhang
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Xinqing Wang
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Yina Xie
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Fangping Chen
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Changsheng Liu
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai, 200237, PR China
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Zhou M, Yuan T, Shang L. 3D Printing of Naturally Derived Adhesive Hemostatic Sponge. RESEARCH (WASHINGTON, D.C.) 2024; 7:0446. [PMID: 39119591 PMCID: PMC11309851 DOI: 10.34133/research.0446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 07/17/2024] [Indexed: 08/10/2024]
Abstract
Hydrogel hemostatic sponges have been recognized for its effectiveness in wound treatment due to its excellent biocompatibility, degradability, as well as multi-facet functionalities. Current research focuses on optimizing the composition and structure of the sponge to enhance its therapeutic effectiveness. Here, we propose an adhesive hydrogel made from purely natural substances extracted from okra and Panax notoginseng. We utilize 3-dimensional (3D) printing technology to fabricate the hemostatic hydrogel scaffold, incorporating gelatin into the hydrogel and refining the mixing ratio. The interaction between gelatin and okra polyphenols contributes to successful injectability as well as stability of the printed scaffold. The okra in the scaffold exhibits favorable adhesion and hemostatic effects, and the total saponins of Panax notoginseng facilitate angiogenesis. Through in vitro experiments, we have substantiated the scaffold's excellent stability, adhesion, biocompatibility, and angiogenesis-promoting ability. Furthermore, in vivo experiments have demonstrated its dual functionality in rapid hemostasis and wound repair. These features suggest that the 3D-printed, natural substance-derived hydrogel scaffolds have valuable potential in wound healing and related applications.
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Affiliation(s)
- Minyu Zhou
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, China
| | - Tao Yuan
- Department of Spine Surgery,
Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Luoran Shang
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, China
- Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, and the Shanghai Key Laboratory of Medical Epigenetics, the International Co-laboratory of Medical Epigenetics and Metabolism (Ministry of Science and Technology), Institutes of Biomedical Sciences,
Fudan University, Shanghai, China
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Li S, Gong L, Chen J, Wu X, Liu X, Fu H, Shou Q. Fabricating the multibranch carboxyl-modified cellulose for hemorrhage control. Mater Today Bio 2024; 24:100878. [PMID: 38188645 PMCID: PMC10767497 DOI: 10.1016/j.mtbio.2023.100878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/16/2023] [Accepted: 11/20/2023] [Indexed: 01/09/2024] Open
Abstract
Excessive bleeding is associated with a high mortality risk. In this study, citric acid and ascorbic acid were sequentially modified on the surface of microcrystalline cellulose (MCAA) to increase its carboxyl content, and their potential as hemostatic materials was investigated. The MCAA exhibited a carboxylic group content of 9.52 %, higher than that of citric acid grafted microcrystalline cellulose (MCA) at 4.6 %. Carboxyl functionalization of microcrystalline cellulose surfaces not only plays a fundamental role in the structure of composite materials but also aids in the absorption of plasma and stimulation of platelets. Fourier -transform infrared (FT-IR), thermogravimetric analysis (TGA) and X-ray photoelectron spectroscopy (XPS) spectra confirmed that carboxyl groups were successfully introduced onto the cellulose surface. Physical properties tests indicated that the MCAA possessed higher thermal stability (Tmax = 472.2 °C) compared to microcrystalline cellulose (MCC). Additionally, in vitro hemocompatibility, cytotoxicity and hemostatic property results demonstrated that MCAA displayed good biocompatibility (hemolysis ratio <1 %), optimal cell compatibility (cell viability exceeded 100 % after 72 h incubation), and impressive hemostatic effect (BCIMCAA = 31.3 %). Based on these findings, the hemostatic effect of covering a wound with MCAA was assessed, revealing enhanced hemostatic properties using MCAA in tail-amputation and liver-injury hemorrhage models. Furthermore, exploration into hemostatic mechanisms revealed that MCAA can significantly accelerate coagulation through rapid platelet aggregation and activation of the clotting cascade. Notably, MCAA showed remarkable biocompatibility and induced minimal skin irritation. In conclusion, the results affirmed that MCAA is a safe and potentially effective hemostatic agent for hemorrhage control.
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Affiliation(s)
- Shengyu Li
- The Second Affiliated Hospital & Second Clinical Medical School, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Lihong Gong
- Third Clinical Medical School of Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Jianglin Chen
- School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 311402, China
| | - Xijin Wu
- The Second Affiliated Hospital & Second Clinical Medical School, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Xia Liu
- The Second Affiliated Hospital & Second Clinical Medical School, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Huiying Fu
- The Second Affiliated Hospital & Second Clinical Medical School, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Qiyang Shou
- The Second Affiliated Hospital & Second Clinical Medical School, Zhejiang Chinese Medical University, Hangzhou, 310053, China
- Jinghua Academy, Zhejiang Chinese Medicine University, Jinghua, 321000, China
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