Novel hemostatic agents based on gelatin-microbial transglutaminase mix

Preparation of physically crosslinked polyelectrolyte Gelatin-Tannic acid-κ-Carrageenan (GTC) microparticles as hemostatic agents

In humans, excessive bleeding during civilian accidents, and surgery account for 40% of the mortality worldwide. Hence, the development of biocompatible hemostatic materials useful for rapid hemorrhage control has become a fundamental research problem in the biomedicine community. In this study, we prepared biocompatible gelatin-tannic acid-κ-carrageenan (GTC) microparticles using a facile Tween 80 stabilized water-in-oil (W/O) emulsion method for rapid hemostasis. The formation of GTC microparticles occurs via polyelectrolyte interactions between gelatin and k-carrageenan as well as hydrogen bonding from tannic acid. In addition, the GTC microparticles formulated in our study showed high water adsorption ability with a low volume-swelling ratio for a particle size of 46 μm. In addition, the GTC microparticles displayed >80% biocompatibility in NIH 3T3 cells and <5% hemocompatibility in hemolysis ratio tests. Notably, the GTC microparticles induced rapid blood clotting in 50 s and blood loss of approximately 46 mg in the femoral artery of BALB/c female mice with a 100% survival rate that was significantly better than the control group (blood clot time:250 s; blood loss: 259 mg). Thus, the findings from our study collectively suggest that GTC microparticles may play a promising clinical role in medical applications to tackle hemorrhage control.

Advances in the development of hemostatic biomaterials for medical application

BACKGROUND

Medical hemostatic biological materials are necessary for the development of the process of preventing and stopping damaged intravascular bleeding. In the process, some red blood cells and white blood cells are trapped in nets. The resulting plug is called a blood clot. This is often a good step in wound healing, but separation of blood clots from blood vessel walls can cause serious health problems.

MAIN BODY

The advance in the development of hemostatic biomaterials is necessary for biomedical application. Firstly, the historical background of artificial hemostasis has been included and the current research of hemostasis has been included in more detail. Secondly, the current research of hemostasis has been included on the oxidized cellulose-based hemostatic biomaterials such as starch based on composite cross-linking hemostatic networks, hemostatic materials on NHS-esters, hemostatic agent from local materials and biomaterials for hemostatic management. Thirdly, polysaccharide hemostatic materials, bio-inspired adhesive catechol-conjugated chitosan, mesoporous silica and bioactive glasses for improved hemostasis, minimally invasive hemostatic biomaterials and chitosan-base materials for hemostatic application have been included. Fourthly, the biological properties of natural hemostatic agent by plasma technology and the hemostatic agents based on gelatin-microbial transglutaminase mixes have been also included.

CONCLUSION

Current research on hemostasis includes hemostatic biomaterials such as cellulose-based hemostatic starch based on a complex cross-linked hemostatic network. It also includes polysaccharide hemostatic materials, biomimetic adhesive catechol-binding chitosan, mesoporous silica or physiologically active glass for hemostatic improvement, minimally invasive hemostatic chitosan-based materials, and gelatin-microbial transglutaminase-based hemostatic agents. Future studies should focus on modular combination of hemostatic imitation and reinforcement mechanisms of different materials and technologies to find the optimal system to promote and strengthen active platelet or platelet imitation aggregation in bleeding sites. The second optionally increases the production of thrombin and fiber formation at the site. Third, the formed fibrin biopolymer network has strengthened to reduce thrombosis and amplify hemostasis.

Advances in Topical Hemostatic Agent Therapies: A Comprehensive Update

Severe hemorrhage causes significant metabolic and cellular dysfunction secondary to deficient tissue perfusion and oxygen delivery. If bleeding continues, hemodynamic destabilization, hypoxemia, multiple organ failure, and death will occur. Techniques employed to promote hemostasis include surgical suture ligatures, cautery, chemical agents, self-assembling nanoparticles, and physical methods, like mechanical pressure. Improved understanding of the natural clotting cascade has allowed newly designed agents to become more targeted for clinical and military use. Topically-applied hemostatic agents have enormous clinical applications in achieving hemostasis. This manuscript describes currently available and developing topical hemostatic materials, including topical active agents, mechanical agents, synthetic/hemisynthetic hemostatic agents, and external hemostatic dressings for clinical practice.

Use of hemostatic agents for surgical bleeding in laparoscopic partial nephrectomy: Biomaterials perspective

In recent years, there was an abrupt increase in the incidence of renal tumors, which prompt up the appearance of cutting-edge technology, including minimally invasive and organ-preserving approaches, such as laparoscopic partial nephrectomy (LPN). LPN is an innovative technique used to treat small renal masses that have been gaining popularity in the last few decades due to its promissory results. However, the bleeding control remains the main challenge since the majority of currently available hemostatic agents (HAs) used in other surgical specialities are inefficient in LPN. This hurried the search for effective HAs adapted for LPN surgical peculiarities, which resulted on the emergence of different types of topical HAs. The most promising are the natural origin HAs because of their inherent biodegradability, biocompatibility, and lowest toxicity. These properties turn them top interests' candidates as HAs in LPN. In this review, we present a deep overview on the progress achieved in the design of HAs based on natural origin polymers, highlighting their distinguishable characteristics and providing a clear understanding of their hemostat's role in LPN. This way it may be possible to establish a structure-composition properties relation, so that novel HAs for LPN can be designed to explore current unmet medical needs.

Composite Hemostatic Nonwoven Textiles Based on Hyaluronic Acid, Cellulose, and Etamsylate

The achievement of rapid hemostasis represents a long-term trend in hemostatic research. Specifically, composite materials are now the focus of attention, based on the given issues and required properties. In urology, different materials are used to achieve fast and effective hemostasis. Additionally, it is desirable to exert a positive influence on local tissue reaction. In this study, three nonwoven textiles prepared by a wet spinning method and based on a combination of hyaluronic acid with either oxidized cellulose or carboxymethyl cellulose, along with the addition of etamsylate, were introduced and assessed in vivo using the rat partial nephrectomy model. A significantly shorter time to hemostasis in seconds (p < 0.05), was attributed to the effect of the carboxymethyl cellulose material. The addition of etamsylate did not noticeably contribute to further hemostasis, but its application strengthened the structure and therefore significantly improved the effect on local changes, while also facilitating any manipulation by the surgeons. Specifically, the hyaluronic acid supported the tissue healing and regeneration, and ensured the favorable results of the histological analysis. Moreover, the prepared textiles proved their bioresorbability after a three-day period. In brief, the fabrics yielded favorable hemostatic activity, bioresorbability, non-irritability, and had a beneficial effect on the tissue repair.

Effects of Yak skin gelatin on platelet activation

Studies have shown that gelatin is not only a good hemostatic material, but also a food additive with potentially broad use. Yak skin gelatin is a new gelatin resource, but its oral coagulant effects have not been studied. Given the central role of platelets in hemostasis, in this study we examined the pharmacodynamical differences between different molecular Yak skin gelatins on platelet activation. The hemostatic effects of Yak skin gelatins with different molecular weight distributions were evaluated for bleeding time (BT), clotting time (CT), and platelet activity by measuring the contents of P-selectin, platelet membrane glycoprotein Ia/IIa (GP Ia/IIa), platelet membrane glycoprotein IIb/IIIa (GP IIb/IIIa), and platelet membrane glycoprotein IV (GP IV). Intragastric administration of Yak skin gelatin resulted in a significant reduction in CT and BT, and an increase in the contents of P-selectin, GP Ia/IIa, GP IIb/IIIa, and GP IV in all groups in comparison with the control group. The strongest activation of platelets by Yak skin gelatin was observed with size between 0.1 μm and 0.22 μm, and activation may have been in response to improving GP IIb/IIIa and GP IV levels. When measuring the levels of an established indicator of platelet activation, platelet activation-dependent granule membrane protein (CD62P), its promotion was observed for all molecular weight ranges of Yak skin gelatins. In brief, Yak skin gelatin has hemostatic effects, and Yak skin gelatin fractions between 0.1 μm and 0.22 μm are the primary effectors of hemostasis via promoting platelet membrane glycoprotein activities and strengthening platelet function.

Bioengineering of microbial transglutaminase for biomedical applications

Microbial transglutaminase (mTGase) is commonly known in the food industry as meat glue due to its incredible ability to "glue" meat proteins together. Aside from being widely exploited in the meat processing industries, mTGase is also widely applied in other food and textile industries by catalysing the formation of isopeptide bonds between peptides or protein substrates. The advancement of technology has opened up new avenues for mTGase in the field of biomedical engineering. Efforts have been made to study the structural properties of mTGase in order to gain an in-depth understanding of the structure-function relationship. This review highlights the developments in mTGase engineering together with its role in biomedical applications including biomaterial fabrication for tissue engineering and biotherapeutics.

Nanotechnology-enabled materials for hemostatic and anti-infection treatments in orthopedic surgery

The hemostatic and anti-infection treatments in the field of orthopedics are always the pivotal yet challenging topics. In the first part of this review, synthesized or naturally derived nanoscale agents and materials for hemostatic treatment in orthopedic surgery are introduced. The hemostatic mechanisms and the safety concerns of these nanotechnology-enabled materials are discussed. Beside the materials to meet hemostatic needs in orthopedic surgery, the need for antimicrobial or anti-infection strategy in orthopedic surgery also becomes urgent. Nanosilver and its derivatives have the most consistent anti-infective effect and thus high translational potential for clinical applications. In the second part, the factors affecting the antimicrobial effect of nanosilver and its application status are summarized. Finally, the status and translational potential of various nanotechnology-enabled materials and agents for hemostatic and anti-infective treatments in orthopedic surgery are discussed.