1
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Witzdam L, White T, Rodriguez-Emmenegger C. Steps Toward Recapitulating Endothelium: A Perspective on the Next Generation of Hemocompatible Coatings. Macromol Biosci 2024:e2400152. [PMID: 39072925 DOI: 10.1002/mabi.202400152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 06/26/2024] [Indexed: 07/30/2024]
Abstract
Endothelium, the lining in this blood vessel, orchestrates three main critical functions such as protecting blood components, modulating of hemostasis by secreting various inhibitors, and directing clot digestion (fibrinolysis) by activating tissue plasminogen activator. No other surface can perform these tasks; thus, the contact of blood and blood-contacting medical devices inevitably leads to the activation of coagulation, often causing device failure, and thromboembolic complications. This perspective, first, discusses the biological mechanisms of activation of coagulation and highlights the efforts of advanced coatings to recapitulate one characteristic of endothelium, hereafter single functions of endothelium and noting necessity of the synergistic integration of its three main functions. Subsequently, it is emphasized that to overcome the challenges of blood compatibility an endothelium-mimicking system is needed, proposing a synergy of bottom-up synthetic biology, particularly synthetic cells, with passive- and bioactive surface coatings. Such integration holds promise for developing advanced biomaterials capable of recapitulating endothelial functions, thereby enhancing the hemocompatibility and performance of blood-contacting medical devices.
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Affiliation(s)
- Lena Witzdam
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Carrer de Baldiri Reixac, 10, 12, Barcelona, 08028, Spain
- DWI - Leibniz Institute for Interactive Materials, Forckenbeckstraße 50, 52074, Aachen, Germany
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, Worringerweg 2, 52074, Aachen, Germany
| | - Tom White
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Carrer de Baldiri Reixac, 10, 12, Barcelona, 08028, Spain
| | - Cesar Rodriguez-Emmenegger
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Carrer de Baldiri Reixac, 10, 12, Barcelona, 08028, Spain
- DWI - Leibniz Institute for Interactive Materials, Forckenbeckstraße 50, 52074, Aachen, Germany
- Catalan Institution for Research and Advanced Studies (ICREA), Passeig Lluís Companys 23, Barcelona, 08010, Spain
- Biomedical Research Networking, Center in Bioengineering, Biomaterials and Nanomedicine, The Institute of Health Carlos III, Madrid, 28029, Spain
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2
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Pandey R, Pinon V, Garren M, Maffe P, Mondal A, Brisbois EJ, Handa H. N-Acetyl Cysteine-Decorated Nitric Oxide-Releasing Interface for Biomedical Applications. ACS APPLIED MATERIALS & INTERFACES 2024; 16:24248-24260. [PMID: 38693878 PMCID: PMC11103652 DOI: 10.1021/acsami.4c02369] [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: 02/09/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Abstract
Biomedical devices are vulnerable to infections and biofilm formation, leading to extended hospital stays, high expenditure, and increased mortality. Infections are clinically treated via the administration of systemic antibiotics, leading to the development of antibiotic resistance. A multimechanistic strategy is needed to design an effective biomaterial with broad-spectrum antibacterial potential. Recent approaches have investigated the fabrication of innately antimicrobial biomedical device surfaces in the hope of making the antibiotic treatment obsolete. Herein, we report a novel fabrication strategy combining antibacterial nitric oxide (NO) with an antibiofilm agent N-acetyl cysteine (NAC) on a polyvinyl chloride surface using polycationic polyethylenimine (PEI) as a linker. The designed biomaterial could release NO for at least 7 days with minimal NO donor leaching under physiological conditions. The proposed surface technology significantly reduced the viability of Gram-negative Escherichia coli (>97%) and Gram-positive Staphylococcus aureus (>99%) bacteria in both adhered and planktonic forms in a 24 h antibacterial assay. The composites also exhibited a significant reduction in biomass and extra polymeric substance accumulation in a dynamic environment over 72 h. Overall, these results indicate that the proposed combination of the NO donor with mucolytic NAC on a polymer surface efficiently resists microbial adhesion and can be used to prevent device-associated biofilm formation.
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Affiliation(s)
- Rashmi Pandey
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Vicente Pinon
- Pharmaceutical
and Biomedical Science Department, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| | - Mark Garren
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Patrick Maffe
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Arnab Mondal
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Elizabeth J. Brisbois
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Hitesh Handa
- School
of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
- Pharmaceutical
and Biomedical Science Department, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
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3
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Zhang Y, Man J, Wang J, Liu J, Song X, Yu X, Li J, Li R, Qiu Y, Li J, Chen Y. Surface modification of polyvinyl chloride with sodium alginate/carboxymethyl chitosan and heparin for realizing the anticoagulation. Int J Biol Macromol 2024; 254:127653. [PMID: 37918597 DOI: 10.1016/j.ijbiomac.2023.127653] [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: 07/02/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Abstract
Thrombosis of extracorporeal circuits causes significant morbidity and mortality worldwide. In this study, plasma treatment technology and chemical grafting method were used to construct heparinized surfaces on the PVC substrate, which could not only reduce thrombosis but also decrease the side effects of the direct injection of anticoagulants. The PVC substrate was modified by plasma treatment technology firstly to obtain the active surface with the hydroxyl groups used for grafting. Then, heparin was grafted onto the modified PVC surface using different grafting strategies to prepare different heparinized surfaces. The experimental results indicated that the sodium alginate (SA) and carboxymethyl chitosan (CCS) used as interlayers could significantly increase the graft density of heparin to improve the anticoagulant effects and hemocompatibility of heparinized surfaces. In addition, the modification of heparin can further improve the anticoagulant effects. The CCS/low-molecular-weight heparin (LWMH) surface has the best anticoagulant properties, which can prolong the activated partial thromboplastin time (APTT) values of human plasma for about 35 s, reduce the hemolysis rates to <0.3 %, and perform well in the in-vitro blood circulation test. The heparinized surfaces prepared in this work have great application potential in anticoagulant treatment for medical devices.
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Affiliation(s)
- Yongqi Zhang
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture of Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan 250061, PR China; Key National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, PR China
| | - Jia Man
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture of Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan 250061, PR China; Key National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, PR China.
| | - Jiali Wang
- Qilu Hospital of Shandong University, Jinan 250012, PR China
| | - Jianing Liu
- Qilu Hospital of Shandong University, Jinan 250012, PR China
| | - Xinzhong Song
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture of Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan 250061, PR China; Key National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, PR China
| | - Xiaohan Yu
- School of Pharmaceutical Sciences, Hebei Medical University, Shijiazhuang 050017, PR China
| | - Jianyong Li
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture of Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan 250061, PR China; Key National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, PR China
| | - Ruijian Li
- Qilu Hospital of Shandong University, Jinan 250012, PR China
| | - Yinghua Qiu
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture of Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan 250061, PR China; Key National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, PR China
| | - Jianfeng Li
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture of Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan 250061, PR China; Key National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, PR China
| | - Yuguo Chen
- Qilu Hospital of Shandong University, Jinan 250012, PR China
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4
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Liu P, Wang B, Chen Y. Flexible Poly(vinyl chloride) with Durable Antibiofouling Property via Blending Star-Shaped Amphiphilic Poly(ε-caprolactone)- block-poly(methacryloxyethyl sulfobetaine). ACS APPLIED MATERIALS & INTERFACES 2023. [PMID: 38050820 DOI: 10.1021/acsami.3c16060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Flexible poly(vinyl chloride) (PVC) plastics have been widely used in medical devices, but the preparation of antibiofouling flexible PVC materials that can maintain their antibiofouling performance when suffering deformation is still a challenge. In this work, we synthesized a series of amphiphilic star-shaped three-arm block copolymers SPCL-b-PSB, consisting of hydrophobic inner blocks poly(ε-caprolactone) (PCL) and hydrophilic outer blocks poly(methacryloxyethyl sulfobetaine) (PSB). Then, flexible PVC films were prepared by blending SPCL-b-PSB with PVC and plasticizer. Benefiting from the specific star-shaped topological structure of SPCL-b-PSB, hydrophilic PSB blocks of the copolymer could efficiently migrate to the surface of the film via annealing treatment, which give the film surface excellent hydrophilicity, while the latch-like entanglements between hydrophobic PCL blocks and PVC give the hydrophilic surface excellent stability. Antibiofouling properties of the blended films were investigated. The optimized blended film could reduce ∼94% of bovine serum albumin adsorption, ∼ 87% of lysozyme adsorption, and ∼89% of platelet adhesion and resist bacterial adhesion effectively. What is more, the blended films could maintain their antibiofouling performance when suffering stretching, rubbing, or bending. More than 86% of bovine serum albumin adsorption could be reduced, even when the film was stretched by 50%. This work provides a new strategy for the preparation of durable antibiofouling flexible plastics.
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Affiliation(s)
- Peiyi Liu
- Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, P. R. China
| | - Bin Wang
- Department of Chemistry, School of Science, Tianjin Chengjian University, Tianjin 300384, P. R. China
| | - Yu Chen
- Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, P. R. China
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5
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Maloney SE, Grayton QE, Wai C, Uriyanghai U, Sidhu J, Roy-Chaudhury P, Schoenfisch MH. Nitric Oxide-Releasing Hemodialysis Catheter Lock Solutions. ACS APPLIED MATERIALS & INTERFACES 2023; 15:28907-28921. [PMID: 37285144 DOI: 10.1021/acsami.3c02506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In an attempt to address the significant morbidity, mortality, and economic cost associated with tunneled dialysis catheter (TDC) dysfunction, we report the development of nitric oxide-releasing dialysis catheter lock solutions. Catheter lock solutions with a range of NO payloads and release kinetics were prepared using low-molecular-weight N-diazeniumdiolate nitric oxide donors. Nitric oxide released through the catheter surface as a dissolved gas was maintained at therapeutically relevant levels for at least 72 h, supporting clinical translatability (interdialytic period). Slow, sustained NO release from the catheter surface prevented bacterial adhesion in vitro by 88.9 and 99.7% for Pseudomonas aeruginosa and Staphylococcus epidermidis, respectively, outperforming a burst NO-release profile. Furthermore, bacteria adhered to the catheter surface in vitro prior to lock solution use was reduced by 98.7 and 99.2% for P. aeruginosa and S. epidermidis, respectively, when using a slow releasing NO donor, demonstrating both preventative and treatment potential. The adhesion of proteins to the catheter surface, a process often preceding biofilm formation and thrombosis, was also lessened by 60-65% by sustained NO release. In vitro cytotoxicity of catheter extract solutions to mammalian cells was minimal, supporting the non-toxic nature of the NO-releasing lock solutions. The use of the NO-releasing lock solution in an in vivo TDC porcine model demonstrated decreased infection and thrombosis, enhanced catheter functionality, and improved outcome (i.e., likelihood of survival) as a result of catheter use.
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Affiliation(s)
- Sara E Maloney
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Quincy E Grayton
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Christine Wai
- UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Unimunkh Uriyanghai
- UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Jasleen Sidhu
- UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Prabir Roy-Chaudhury
- UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Mark H Schoenfisch
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
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6
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Ochetto A, Sun D, Siedlecki CA, Xu LC. Nucleotide Messenger Signaling of Staphylococci in Responding to Nitric Oxide - Releasing Biomaterials. ACS Biomater Sci Eng 2023. [PMID: 37155716 DOI: 10.1021/acsbiomaterials.2c01536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Nitric oxide (NO) releasing biomaterials are a promising approach against medical device associated microbial infection. In contrast to the bacteria-killing effects of NO at high concentrations, NO at low concentrations serves as an important signaling molecule to inhibit biofilm formation or disperse mature biofilms by regulating the intracellular nucleotide second messenger signaling network such as cyclic dimeric guanosine monophosphate (c-di-GMP) for many Gram-negative bacterial strains. However, Gram-positive staphylococcal bacteria are the most commonly diagnosed microbial infections on indwelling devices, but much less is known about the nucleotide messengers and their response to NO as well as the mechanism by which NO inhibits biofilm formation. This study investigated the cyclic nucleotide second messengers c-di-GMP, cyclic dimeric adenosine monophosphate (c-di-AMP), and cyclic adenosine monophosphate (cAMP) in both Staphylococcus aureus (S. aureus) Newman D2C and Staphylococcus epidermidis (S. epidermidis) RP62A after incubating with S-nitroso-N-acetylpenicillamine (SNAP, NO donor) impregnated polyurethane (PU) films. Results demonstrated that NO release from the polymer films significantly reduced the c-di-GMP levels in S. aureus planktonic and sessile cells, and these bacteria showed inhibited biofilm formation. However, the effect of NO release on c-di-GMP in S. epidermidis was weak, but rather, S. epidermidis showed significant reduction in c-di-AMP levels in response to NO release and also showed reduced biofilm formation. Results strongly suggest that NO regulates the nucleotide second messenger signaling network in different ways for these two bacteria, but for both bacteria, these changes in signaling affect the formations of biofilms. These findings provide cues to understand the mechanism of Staphylococcus biofilm inhibition by NO and suggest novel targets for antibiofilm interventions.
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Affiliation(s)
- Alyssa Ochetto
- Department of Biological and Biomedical Sciences, Rowan University, Glassboro, New Jersey 08028, United States
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7
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Yu H, Wang L, Zhang Z, Zhang X, Luan S, Shi H. Regulable Polyelectrolyte-Surfactant Complex for Antibacterial Biomedical Catheter Coating via a Readily Scalable Route. Adv Healthc Mater 2023; 12:e2202096. [PMID: 36285359 DOI: 10.1002/adhm.202202096] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/21/2022] [Indexed: 11/07/2022]
Abstract
Constructing multifunctional surfaces is one of the practical approaches to address catheter-related multiple complications but is generally time-consuming and substrate-dependent. Herein, a novel anti-adhesion, antibacterial, low friction, and robustness coating on medical catheters are developed via a universal and readily scalable method based on a regulable polyelectrolyte surfactant complex. The complex is rapidly assembled in one step by electrostatic and hydrophobic interactions between organosilicon quaternary ammonium surfactant (N+ Si ) and adjustable polyelectrolyte with cross-linkable, anti-adhesive, and anionic groups. The alcohol-soluble feature of the complex is conducive to the rapid formation of coatings on any medical device with arbitrary shapes via dip coating. Different from the conventional polyelectrolyte-surfactant complex coating, the regulated complex coating with nonleaching mode could be stable in harsh conditions (high concentration salt solution, organic reagents, etc.) because of the cross-linked structure while improving the biocompatibility and reducing the adhesion of various bacteria, proteins, and blood cells. The coated catheter exhibits good antibacterial infection in vitro and in vivo, owing to the synergistic effect of N+ Si and zwitterionic groups. Therefore, the rationally designed complex supplies a facile coating approach for the potential development in combating multiple complications of the medical catheter.
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Affiliation(s)
- Huan Yu
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, 230026, P. R. China.,State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, P. R. China
| | - Lei Wang
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, P. R. China
| | - Zhenyan Zhang
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, 230026, P. R. China.,State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, P. R. China
| | - Xu Zhang
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, P. R. China
| | - Shifang Luan
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, 230026, P. R. China.,State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, P. R. China
| | - Hengchong Shi
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, 230026, P. R. China.,State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, P. R. China
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8
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Xu LC, Siedlecki CA. Surface Texturing and Combinatorial Approaches to Improve Biocompatibility of Implanted Biomaterials. FRONTIERS IN PHYSICS 2022; 10:994438. [PMID: 38250242 PMCID: PMC10798815 DOI: 10.3389/fphy.2022.994438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Biomaterial associated microbial infection and blood thrombosis are two of the barriers that inhibit the successful use of implantable medical devices in modern healthcare. Modification of surface topography is a promising approach to combat microbial infection and thrombosis without altering bulk material properties necessary for device function and without contributing to bacterial antibiotic resistance. Similarly, the use of other antimicrobial techniques such as grafting poly(ethylene glycol) (PEG) and nitric oxide (NO) release also improve the biocompatibility of biomaterials. In this review, we discuss the development of surface texturing techniques utilizing ordered submicron-size pillars for controlling bacterial adhesion and biofilm formation, and we present combinatorial approaches utilizing surface texturing in combination with poly(ethylene glycol) (PEG) grafting and NO release to improve the biocompatibility of biomaterials. The manuscript also discusses efforts towards understanding the molecular mechanisms of bacterial adhesion responses to the surface texturing and NO releasing biomaterials, focusing on experimental aspects of the approach.
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Affiliation(s)
- Li-Chong Xu
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA 17033
| | - Christopher A. Siedlecki
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA 17033
- Department of Biomedical Engineering, The Pennsylvania State University, College of Medicine, Hershey, PA 17033
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9
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Chug MK, Brisbois EJ. Smartphone compatible nitric oxide releasing insert to prevent catheter-associated infections. J Control Release 2022; 349:227-240. [PMID: 35777483 PMCID: PMC9680949 DOI: 10.1016/j.jconrel.2022.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/13/2022] [Accepted: 06/24/2022] [Indexed: 10/17/2022]
Abstract
A large fraction of nosocomial infections is associated with medical devices that are deemed life-threatening in immunocompromised patients. Medical device-related infections are a result of bacterial colonization and biofilm formation on the device surface that affects >1 million people annually in the US alone. Over the past few years, light-based antimicrobial therapy has made substantial advances in tackling microbial colonization. Taking the advantage of light and antibacterial properties of nitric oxide (NO), for the first time, a robust, biocompatible, anti-infective approach to design a universal disposable catheter disinfection insert (DCDI) that can both prevent bacterial adhesion and disinfect indwelling catheters in situ is reported. The DCDI is engineered using a photo-initiated NO donor molecule, incorporated in polymer tubing that is mounted on a side glow fiber optic connected to an LED light source. Using a smartphone application, the NO release from DCDI is photoactivated via white light resulting in tunable physiological levels of NO for up to 24 h. When challenged with microorganisms S. aureus and E. coli, the NO-releasing DCDI statistically reduced microbial attachment by >99% versus the controls with just 4 h of exposure. The DCDI also eradicated ∼97% of pre-colonized bacteria on the CVC catheter model demonstrating the ability to exterminate an established catheter infection. The smart, mobile-operated novel universal antibacterial device can be used to both prevent catheter infections or can be inserted within an infected catheter to eradicate the bacteria without complex surgical interventions. The therapeutic levels of NO generated via illuminating fiber optics can be the next-generation biocompatible solution for catheter-related bloodstream infections.
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Affiliation(s)
- Manjyot Kaur Chug
- School of Chemical, Materials & Biomedical Engineering, University of Georgia, Athens, GA, USA
| | - Elizabeth J Brisbois
- School of Chemical, Materials & Biomedical Engineering, University of Georgia, Athens, GA, USA.
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10
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Kumar R, Chug MK, Brisbois EJ. Long-Term Storage Stability and Nitric Oxide Release Behavior of ( N-Acetyl- S-nitrosopenicillaminyl)- S-nitrosopenicillamine-Incorporated Silicone Rubber Coatings. ACS APPLIED MATERIALS & INTERFACES 2022; 14:30595-30606. [PMID: 35759508 PMCID: PMC9708111 DOI: 10.1021/acsami.2c06712] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Physical incorporation of nitric oxide (NO) releasing materials in biomedical grade polymer matrices to fabricate antimicrobial coatings and devices is an economically viable process. However, achieving long-term NO release with a minimum or no leaching of the NO donor from the polymer matrix is still a challenging task. Herein, (N-acetyl-S-nitrosopenicillaminyl)-S-nitrosopenicillamine (SNAP-SNAP), a penicillamine dipeptide NO-releasing molecule, is incorporated into a commercially available biomedical grade silicone rubber (SR) to fabricate a NO-releasing coating (SNAP-SNAP/SR). The storage stabilities of the SNAP-SNAP powder and SNAP-SNAP/SR coating were analyzed at different temperatures. The SNAP-SNAP/SR coatings with varying wt % of SNAP-SNAP showed a tunable and sustained NO release for up to 6 weeks. Further, S-nitroso-N-acetylpenicillamine (SNAP), a well-explored NO-releasing molecule, was incorporated into a biomedical grade silicone polymer to fabricate a NO-releasing coating (SNAP/SR) and a comparative analysis of the NO release and S-nitrosothiol (RSNO) leaching behavior of 10 wt % SNAP-SNAP/SR and 10 wt % SNAP/SR was studied. Interestingly, the 10 wt % SNAP-SNAP/SR coatings exhibited ∼36% higher NO release and 4 times less leaching of NO donors than the 10 wt % SNAP/SR coatings. Further, the 10 wt % SNAP-SNAP/SR coatings exhibited promising antibacterial properties against Staphylococcus aureus and Escherichia coli due to the persistent release of NO. The 10 wt % SNAP-SNAP/SR coatings were also found to be biocompatible against NIH 3T3 mouse fibroblast cells. These results corroborate the sustained stability and NO-releasing properties of the SNAP-SNAP in a silicone polymer matrix and demonstrate the potential for the SNAP-SNAP/SR polymer in the fabrication of long-term indwelling biomedical devices and implants to enhance biocompatibility and resist device-related infections.
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Affiliation(s)
- Rajnish Kumar
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Manjyot Kaur Chug
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Elizabeth J Brisbois
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia 30602, United States
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11
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He M, Wang D, Xu Y, Jiang F, Zheng J, Feng Y, Cao J, Zhou X. Nitric Oxide-Releasing Platforms for Treating Cardiovascular Disease. Pharmaceutics 2022; 14:pharmaceutics14071345. [PMID: 35890241 PMCID: PMC9317153 DOI: 10.3390/pharmaceutics14071345] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/14/2022] [Accepted: 06/22/2022] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular disease (CVD) is the first leading cause of death globally. Nitric oxide (NO) is an important signaling molecule that mediates diverse processes in the cardiovascular system, thereby providing a fundamental basis for NO-based therapy of CVD. At present, numerous prodrugs have been developed to release NO in vivo. However, the clinical application of these prodrugs still faces many problems, including the low payloads, burst release, and non-controlled delivery. To address these, various biomaterial-based platforms have been developed as the carriers to deliver NO to the targeted tissues in a controlled and sustained manner. This review aims to summarize recent developments of various therapeutic platforms, engineered to release NO for the treatment of CVD. In addition, two potential strategies to improve the effectiveness of existing NO therapy are also discussed, including the combination of NO-releasing platforms and either hydrogen sulfide-based therapy or stem cell therapy. Hopefully, some NO-releasing platforms may provide important therapeutic benefits for CVD.
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Affiliation(s)
- Mingyue He
- Department of Medical Imaging, Shanxi Medical University, Taiyuan 030001, China; (M.H.); (Y.X.)
| | - Deping Wang
- Key Laboratory of Cellular Physiology, Ministry of Education, The Department of Physiology, Shanxi Medical University, Taiyuan 030001, China; (D.W.); (F.J.); (J.Z.)
| | - Yumei Xu
- Department of Medical Imaging, Shanxi Medical University, Taiyuan 030001, China; (M.H.); (Y.X.)
| | - Fangying Jiang
- Key Laboratory of Cellular Physiology, Ministry of Education, The Department of Physiology, Shanxi Medical University, Taiyuan 030001, China; (D.W.); (F.J.); (J.Z.)
| | - Jian Zheng
- Key Laboratory of Cellular Physiology, Ministry of Education, The Department of Physiology, Shanxi Medical University, Taiyuan 030001, China; (D.W.); (F.J.); (J.Z.)
- Department of Breast Surgery, Shanxi Provincial Cancer Hospital, Shanxi Medical University, Taiyuan 030001, China
| | - Yanlin Feng
- Key Laboratory of Cellular Physiology, Ministry of Education, The Department of Physiology, Shanxi Medical University, Taiyuan 030001, China; (D.W.); (F.J.); (J.Z.)
- Correspondence: (Y.F.); (J.C.); (X.Z.)
| | - Jimin Cao
- Key Laboratory of Cellular Physiology, Ministry of Education, The Department of Physiology, Shanxi Medical University, Taiyuan 030001, China; (D.W.); (F.J.); (J.Z.)
- Correspondence: (Y.F.); (J.C.); (X.Z.)
| | - Xin Zhou
- Department of Medical Imaging, Shanxi Medical University, Taiyuan 030001, China; (M.H.); (Y.X.)
- Key Laboratory of Cellular Physiology, Ministry of Education, The Department of Physiology, Shanxi Medical University, Taiyuan 030001, China; (D.W.); (F.J.); (J.Z.)
- Correspondence: (Y.F.); (J.C.); (X.Z.)
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12
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Ashcraft M, Douglass M, Garren M, Mondal A, Bright LE, Wu Y, Handa H. Nitric Oxide-Releasing Lock Solution for the Prevention of Catheter-Related Infection and Thrombosis. ACS APPLIED BIO MATERIALS 2022; 5:1519-1527. [PMID: 35343228 PMCID: PMC9680935 DOI: 10.1021/acsabm.1c01272] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although frequently used, venous catheters are often associated with serious complications such as infection and thrombosis. Lock solution therapies are clinically used to deter these issues but generally address only infection or thrombosis with limited success. Here, we report the development of a dual-functional lock therapy using nitric oxide (NO) donor molecule, S-nitrosoglutathione (GSNO). NO is a potent, broad-spectrum antimicrobial agent that also temporarily inhibits platelet activation, preventing thrombosis. Furthermore, NO has antibiofilm actions, an ability that traditional antibiotic lock solutions lack, thus limiting their efficacy. In this work, different concentrations of GSNO were characterized via NO analysis to determine a range of NO-releasing lock solution (NOreLS) concentrations to investigate and to demonstrate prolonged potential efficacy. Tested against clinically used vancomycin and gentamicin lock solutions, GSNO-based NOreLS repeatedly outperformed in models of different stages of catheter infections. NOreLS also prevented clot formation when exposed to whole blood, showing increased efficacy compared to a heparin lock solution. Moreover, NOreLS was demonstrated to be biocompatible via hemolysis and cytotoxicity assays. NOreLS has excellent potential for safely and effectively preventing infection and thrombosis related to catheter usage.
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Affiliation(s)
- Morgan Ashcraft
- Pharmaceutical and Biomedical Sciences Department, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| | - Megan Douglass
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Mark Garren
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Arnab Mondal
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Lori Estes Bright
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Yi Wu
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Hitesh Handa
- Pharmaceutical and Biomedical Sciences Department, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States.,School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
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13
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Douglass M, Ghalei S, Brisbois E, Handa H. Potent, Broad-Spectrum Antimicrobial Effects of S-Nitroso- N-acetylpenicillamine-Impregnated Nitric Oxide-Releasing Latex Urinary Catheters. ACS APPLIED BIO MATERIALS 2022; 5:700-710. [PMID: 35119808 PMCID: PMC9680922 DOI: 10.1021/acsabm.1c01130] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Although numerous prevention and intervention techniques have been developed to counteract catheter-associated urinary tract infections (CAUTIs), urinary catheters remain one of the most common sources of hospital-acquired infections. Nitric oxide (NO), a gaseous free radical responsible for regulating many physiological functions in the body, has gained immense popularity due to its potent, broad-spectrum antimicrobial activity, which is capable of combating medical device-associated infections. In this work, a straightforward solvent-swelling method was used to load the NO donor S-nitroso-N-acetyl-penicillamine (SNAP) into commercial latex catheters (SNAP-UCs) for the first time. The effects of swelling catheters with different concentrations of SNAP solutions (25-125 mg/mL SNAP in tetrahydrofuran (THF)) were studied by measuring the NO release kinetics, SNAP loading, and SNAP leaching. SNAP-UCs impregnated with a 50 mg/mL SNAP-THF solution were found to maximize the amount of SNAP loaded into the latex (0.115 ± 0.009 mg SNAP/mg catheter) and showed physiological levels of NO release (>2 × 10-10 mol min-1 cm-2) over 7 days and minimal SNAP leaching (<2%). SNAP-UCs showed impressive in vitro contact-based and diffusible antimicrobial efficacy against three CAUTI-associated pathogens, reducing the viability of adhered and planktonic Escherichia coli, Proteus mirabilis, and Staphylococcus aureus by ∼98.0 to 99.1% (adhered) and 86.3-96.3% (planktonic) compared to control latex catheters. In vitro cytotoxicity against 3T3 mouse fibroblasts using a CCK-8 assay showed that SNAP-UCs were noncytotoxic (>90% viability). In summary, SNAP-UCs show stable, noncytotoxic NO release characteristics capable of potent, broad-spectrum antimicrobial activity, demonstrating great potential for reducing the devastating effects associated with CAUTIs.
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Affiliation(s)
- Megan Douglass
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Sama Ghalei
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Elizabeth Brisbois
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering and Pharmaceutical and Biomedical Sciences Department, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
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14
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Corrêa Carvalho G, Miguel Sábio R, Spósito L, de Jesus Andreoli Pinto T, Chorilli M. An overview of the use of central venous catheters impregnated with drugs or with inorganic nanoparticles as a strategy in preventing infections. Int J Pharm 2022; 615:121518. [DOI: 10.1016/j.ijpharm.2022.121518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/17/2022] [Accepted: 01/22/2022] [Indexed: 10/19/2022]
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15
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Xie K, Wang N, Guo Y, Zhao S, Tan J, Wang L, Li G, Wu J, Yang Y, Xu W, Chen J, Jiang W, Fu P, Hao Y. Additively manufactured biodegradable porous magnesium implants for elimination of implant-related infections: An in vitro and in vivo study. Bioact Mater 2021; 8:140-152. [PMID: 34541392 PMCID: PMC8424517 DOI: 10.1016/j.bioactmat.2021.06.032] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/08/2021] [Accepted: 06/26/2021] [Indexed: 01/05/2023] Open
Abstract
Magnesium (Mg) alloys that have both antibacterial and osteogenic properties are suitable candidates for orthopedic implants. However, the fabrication of ideal Mg implants suitable for bone repair remains challenging because it requires implants with interconnected pore structures and personalized geometric shapes. In this study, we fabricated a porous 3D-printed Mg-Nd-Zn-Zr (denoted as JDBM) implant with suitable mechanical properties using selective laser melting technology. The 3D-printed JDBM implant exhibited cytocompatibility in MC3T3-E1 and RAW267.4 cells and excellent osteoinductivity in vitro. Furthermore, the implant demonstrated excellent antibacterial ratios of 90.0% and 92.1% for methicillin-resistant S. aureus (MRSA) and Escherichia coli, respectively. The 3D-printed JDBM implant prevented MRSA-induced implant-related infection in a rabbit model and showed good in vivo biocompatibility based on the results of histological evaluation, blood tests, and Mg2+ deposition detection. In addition, enhanced inflammatory response and TNF-α secretion were observed at the bone-implant interface of the 3D-printed JDBM implants during the early implantation stage. The high Mg2+ environment produced by the degradation of 3D-printed JDBM implants could promote M1 phenotype of macrophages (Tnf, iNOS, Ccl3, Ccl4, Ccl5, Cxcl10, and Cxcl2), and enhance the phagocytic ability of macrophages. The enhanced immunoregulatory effect generated by relatively fast Mg2+ release and implant degradation during the early implantation stage is a potential antibacterial mechanism of Mg-based implant. Our findings indicate that 3D-printed porous JDBM implants, having both antibacterial property and osteoinductivity, hold potential for future orthopedic applications. Porous JDBM implants promising mechanical properties was fabricated by selective laser melting. 3D-printed JDBM implant exhibited excellent antibacterial property, osteoinductivity, and biocompatibility. Temporally enhanced immunoregulatory effect in early stage was a potential antibacterial mechanism of Mg-based implant.
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Affiliation(s)
- Kai Xie
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Nanqing Wang
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Yu Guo
- Musculoskeletal Tumor Center, Peking University People's Hospital, 100044, Beijing, China
| | - Shuang Zhao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Jia Tan
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Lei Wang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Guoyuan Li
- Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Junxiang Wu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yangzi Yang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wenyu Xu
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Juan Chen
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Wenbo Jiang
- Clinical and Translational Research Center for 3D Printing Technology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Penghuai Fu
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Yongqiang Hao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.,Clinical and Translational Research Center for 3D Printing Technology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
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16
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Delivering nitric oxide with poly(n-butyl methacrylate) films doped with S-nitroso-N-acetylpenicillamine. POLYMER 2021. [DOI: 10.1016/j.polymer.2021.123943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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17
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Hosseinnejad A, Fischer T, Jain P, Bleilevens C, Jakob F, Schwaneberg U, Rossaint R, Singh S. Enzyme mimetic microgel coating for endogenous nitric oxide mediated inhibition of platelet activation. J Colloid Interface Sci 2021; 601:604-616. [PMID: 34116469 DOI: 10.1016/j.jcis.2021.05.143] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/20/2021] [Accepted: 05/23/2021] [Indexed: 01/28/2023]
Abstract
Nitric oxide (NO) continuously generated by healthy endothelium prevents platelet activation and maintains vascular homeostasis. However, when artificial surfaces, like of extracorporeal membrane oxygenator comes in contact with blood, protein adsorption and thereby platelet activation takes place, which eventually leads to thrombus formation. To overcome this, we present an antifouling microgel coating mimicking the function of enzyme glutathione peroxidase to endogenously generate NO in the blood plasma from endogenous NO-donors and maintain a physiological NO flux. Microgels are synthesized by copolymerization of highly hydrophilic N-(2-hydroxypropyl)methacrylamide (HPMA) and glycidyl methacrylate (GMA) with diselenide crosslinks. For immobilization of the microgels on hydrophobic poly(4-methylpentene) (TPX) membranes bioengineered amphiphilic anchor peptides with free thiols are used. The anchor peptide attaches to the TPX membranes by hydrophobic interactions while the free thiols are presented for crosslinking with the microgels. The hydrophilic nature of the microgel coating prevents protein adsorption while the reversible diselenide bridges make the microgels responsive to the reducing environment and lead to the formation of reactive selenols/selenolates. The generated selenols/selenolates provide an efficient and sustained NO-release from endogenous S-nitrosothiols (RSNOs) mimicking the enzymatic function of glutathione peroxidase. On exposure to the whole blood, the microgel coating inhibited platelet activation and prolonged the blood clotting time.
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Affiliation(s)
- Aisa Hosseinnejad
- DWI-Leibniz-Institute for Interactive Materials e.V., Forckenbeckstr. 50, 52056 Aachen, Germany.
| | - Thorsten Fischer
- DWI-Leibniz-Institute for Interactive Materials e.V., Forckenbeckstr. 50, 52056 Aachen, Germany.
| | - Puja Jain
- DWI-Leibniz-Institute for Interactive Materials e.V., Forckenbeckstr. 50, 52056 Aachen, Germany.
| | - Christian Bleilevens
- Department of Anaesthesiology of the University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - Felix Jakob
- DWI-Leibniz-Institute for Interactive Materials e.V., Forckenbeckstr. 50, 52056 Aachen, Germany; Institute for Biotechnology, RWTH Aachen University, Worringerweg 3, 52074 Aachen, Germany.
| | - Ulrich Schwaneberg
- DWI-Leibniz-Institute for Interactive Materials e.V., Forckenbeckstr. 50, 52056 Aachen, Germany; Institute for Biotechnology, RWTH Aachen University, Worringerweg 3, 52074 Aachen, Germany.
| | - Rolf Rossaint
- Department of Anaesthesiology of the University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - Smriti Singh
- DWI-Leibniz-Institute for Interactive Materials e.V., Forckenbeckstr. 50, 52056 Aachen, Germany; Max-Planck-Institut für medizinische Forschung, Jahnstraße 29, 69120 Heidelberg, Germany.
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18
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Kumar R, Massoumi H, Chug MK, Brisbois EJ. S-Nitroso- N-acetyl-l-cysteine Ethyl Ester (SNACET) Catheter Lock Solution to Reduce Catheter-Associated Infections. ACS APPLIED MATERIALS & INTERFACES 2021; 13:25813-25824. [PMID: 34029456 PMCID: PMC8735666 DOI: 10.1021/acsami.1c06427] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Antimicrobial-lock therapy is an economically viable strategy to prevent/reduce the catheter-related bloodstream infections (CRBSI) that are associated with central venous catheters (CVCs). Herein, we report the synthesis and characterization of the S-nitroso-N-acetyl-l-cysteine ethyl ester (SNACET), a nitric oxide (NO)-releasing molecule, and for the first time its application as a catheter lock solution to combat issues of bacterial infection associated with indwelling catheters. Nitric oxide is an endogenous gasotransmitter that exhibits a wide range of biological properties, including broad-spectrum antimicrobial activity. The storage stability of the SNACET and the NO release behavior of the prepared lock solution were analyzed. SNACET lock solutions with varying concentrations exhibited tuneable NO release at physiological levels for >18 h, as measured using chemiluminescence. The SNACET lock solutions were examined for their efficacy in reducing microbial adhesion after 18 h of exposure toStaphylococcus aureus (Gram-positive bacteria) andEscherichia coli (Gram-negative bacteria). SNACET lock solutions with 50 and 75 mM concentrations were found to reduce >99% (ca. 3-log) of the adhered S. aureus and E. coli adhesion to the catheter surface after 18 h. The SNACET lock solutions were evaluated in a more challenging in vitro model to evaluate the efficacy against an established microbial infection on catheter surfaces using the same bacteria strains. A >90% reduction in viable bacteria on the catheter surfaces was observed after instilling the 75 mM SNACET lock solution within the lumen of the infected catheter for only 2 h. These findings propound that SNACET lock solution is a promising biocidal agent and demonstrate the initiation of a new platform technology for NO-releasing lock solution therapy for the inhibition and treatment of catheter-related infections.
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Affiliation(s)
- Rajnish Kumar
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Hamed Massoumi
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Manjyot Kaur Chug
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Elizabeth J Brisbois
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia 30602, United States
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19
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Patel H. Blood biocompatibility enhancement of biomaterials by heparin immobilization: a review. Blood Coagul Fibrinolysis 2021; 32:237-247. [PMID: 33443929 DOI: 10.1097/mbc.0000000000001011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Blood contacting materials are concerned with biocompatibility including thrombus formation, decrease blood coagulation time, hematology, activation of complement system, platelet aggression. Interestingly, recent research suggests that biocompatibility is increasing by incorporating various materials including heparin using different methods. Basic of heparin including uses and complications was mentioned, in which burst release of heparin is major issue. To minimize the problem of biocompatibility and unpredictable heparin release, present review article potentially reviews the reported work and investigates the various immobilization methods of heparin onto biomaterials, such as polymers, metals, and alloys. Detailed explanation of different immobilization methods through different intermediates, activation, incubation method, plasma treatment, irradiations and other methods are also discussed, in which immobilization through intermediates is the most exploitable method. In addition to biocompatibility, other required properties of biomaterials like mechanical and corrosion resistance properties that increase by attachment of heparin are reviewed and discussed in this article.
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Affiliation(s)
- Himanshu Patel
- Department of Applied Science and Humanities, Pacific School of Engineering, Surat, Gujarat
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20
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Devine R, Douglass M, Ashcraft M, Tayag N, Handa H. Development of Novel Amphotericin B-Immobilized Nitric Oxide-Releasing Platform for the Prevention of Broad-Spectrum Infections and Thrombosis. ACS APPLIED MATERIALS & INTERFACES 2021; 13:19613-19624. [PMID: 33904311 PMCID: PMC9683085 DOI: 10.1021/acsami.1c01330] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Indwelling medical devices currently used to diagnose, monitor, and treat patients invariably suffer from two common clinical complications: broad-spectrum infections and device-induced thrombosis. Currently, infections are managed through antibiotic or antifungal treatment, but the emergence of antibiotic resistance, the formation of recalcitrant biofilms, and difficulty identifying culprit pathogens have made treatment increasingly challenging. Additionally, systemic anticoagulation has been used to manage device-induced thrombosis, but subsequent life-threatening bleeding events associated with all available therapies necessitates alternative solutions. In this study, a broad-spectrum antimicrobial, antithrombotic surface combining the incorporation of the nitric oxide (NO) donor S-nitroso-N-acetylpenicillamine (SNAP) with the immobilization of the antifungal Amphotericin B (AmB) on polydimethylsiloxane (PDMS) was developed in a two-step process. This novel strategy combines the key advantages of NO, a bactericidal agent and platelet inhibitor, with AmB, a potent antifungal agent. We demonstrated that SNAP-AmB surfaces significantly reduced the viability of adhered Staphylococcus aureus (99.0 ± 0.2%), Escherichia coli (89.7 ± 1.0%), and Candida albicans (93.5 ± 4.2%) compared to controls after 24 h of in vitro exposure. Moreover, SNAP-AmB surfaces reduced the number of platelets adhered by 74.6 ± 3.9% compared to controls after 2 h of in vitro porcine plasma exposure. Finally, a cytotoxicity assay validated that the materials did not present any cytotoxic side effects toward human fibroblast cells. This novel approach is the first to combine antifungal surface functionalization with NO-releasing technology, providing a promising step toward reducing the rate of broad-spectrum infection and thrombosis associated with indwelling medical devices.
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Affiliation(s)
- Ryan Devine
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Megan Douglass
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Morgan Ashcraft
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
- Pharmaceutical and Biomedical Sciences Department, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| | - Nicole Tayag
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
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21
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Chug MK, Bachtiar E, Narwold N, Gall K, Brisbois EJ. Tailoring nitric oxide release with additive manufacturing to create antimicrobial surfaces. Biomater Sci 2021; 9:3100-3111. [PMID: 33690768 DOI: 10.1039/d1bm00068c] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The current use of implantable and indwelling medical is limited due to potential microbial colonization leading to severe ailments. The aim of this work is to develop bioactive polymers that can be customized based on patient needs and help prevent bacterial infection. Potential benefits of additive manufacturing technology are integrated with the antimicrobial properties of nitric oxide (NO) to develop NO-releasing biocompatible polymer interfaces for addressing bacterial infections. Using filament-based additive manufacturing and polycarbonateurethane-silicone (PCU-Sil) a range of films possessing unique porosities (Disk-60, Disk-40, solid, capped) were fabricated. The films were impregnated with S-nitroso-N-acetyl-penicillamine (SNAP) using a solvent-swelling process. The Disk-60 porous films had the greatest amount of SNAP (19.59 wt%) as measured by UV-vis spectroscopy. Scanning electron microscopy and energy-dispersive X-ray spectroscopy confirmed an even distribution of SNAP throughout the polymer. The films exhibited structure-based tunable NO-release at physiological levels ranging from 7-14 days for solid and porous films, as measured by chemiluminescence. The antibacterial efficacy of the films was studied against Staphylococcus aureus using 24 h in vitro bacterial adhesion assay. The results demonstrated a >99% reduction of viable bacteria on the surface of all the NO-releasing films compared to unmodified PCU-Sil controls. The combination of 3D-printing technology with NO-releasing properties represents a promising technique to develop customized medical devices (such as 3D-scaffolds, catheters, etc.) with distinct NO-release levels that can provide antimicrobial properties and enhanced biocompatibility.
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Affiliation(s)
- Manjyot Kaur Chug
- School of Chemical, Materials & Biomedical Engineering, University of Georgia, Athens, GA, USA.
| | - Emilio Bachtiar
- Mechanical Engineering and Materials Science, Duke University, Durham, NC, USA
| | - Nicholas Narwold
- College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Ken Gall
- Mechanical Engineering and Materials Science, Duke University, Durham, NC, USA
| | - Elizabeth J Brisbois
- School of Chemical, Materials & Biomedical Engineering, University of Georgia, Athens, GA, USA.
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22
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Estes LM, Singha P, Singh S, Sakthivel TS, Garren M, Devine R, Brisbois EJ, Seal S, Handa H. Characterization of a nitric oxide (NO) donor molecule and cerium oxide nanoparticle (CNP) interactions and their synergistic antimicrobial potential for biomedical applications. J Colloid Interface Sci 2021; 586:163-177. [DOI: 10.1016/j.jcis.2020.10.081] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/17/2022]
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23
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Ricardo SIC, Anjos IIL, Monge N, Faustino CMC, Ribeiro IAC. A Glance at Antimicrobial Strategies to Prevent Catheter-Associated Medical Infections. ACS Infect Dis 2020; 6:3109-3130. [PMID: 33245664 DOI: 10.1021/acsinfecdis.0c00526] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Urinary and intravascular catheters are two of the most used invasive medical devices; however, microbial colonization of catheter surfaces is responsible for most healthcare-associated infections (HAIs). Several antimicrobial-coated catheters are available, but recurrent antibiotic therapy can decrease their potential activity against resistant bacterial strains. The aim of this Review is to question the actual effectiveness of currently used (coated) catheters and describe the progress and promise of alternative antimicrobial coatings. Different strategies have been reviewed with the common goal of preventing biofilm formation on catheters, including release-based approaches using antibiotics, antiseptics, nitric oxide, 5-fluorouracil, and silver as well as contact-killing approaches employing quaternary ammonium compounds, chitosan, antimicrobial peptides, and enzymes. All of these strategies have given proof of antimicrobial efficacy by modifying the physiology of pathogens or disrupting their structural integrity. The aim for synergistic approaches using multitarget processes and the combination of both antifouling and bactericidal properties holds potential for the near future. Despite intensive research in biofilm preventive strategies, laboratorial studies still present some limitations since experimental conditions usually are not the same and also differ from biological conditions encountered when the catheter is inserted in the human body. Consequently, in most cases, the efficacy data obtained from in vitro studies is not properly reflected in the clinical setting. Thus, further well-designed clinical trials and additional cytotoxicity studies are needed to prove the efficacy and safety of the developed antimicrobial strategies in the prevention of biofilm formation at catheter surfaces.
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Affiliation(s)
- Susana I. C. Ricardo
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Inês I. L. Anjos
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Nuno Monge
- Centro Interdisciplinar de Estudos Educacionais (CIED), Escola Superior de Educação de Lisboa, Instituto Politécnico de Lisboa, Campus de Benfica do IPL, 1549-003 Lisboa, Portugal
| | - Célia M. C. Faustino
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Isabel A. C. Ribeiro
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
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24
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Thompson AJ, Ma LJ, Major T, Jeakle M, Lautner-Csorba O, Goudie MJ, Handa H, Rojas-Peña A, Potkay JA. Assessing and improving the biocompatibility of microfluidic artificial lungs. Acta Biomater 2020; 112:190-201. [PMID: 32434076 PMCID: PMC10168296 DOI: 10.1016/j.actbio.2020.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 02/08/2023]
Abstract
Microfluidic artificial lungs (µALs) have the potential to improve the treatment and quality of life for patients with acute or chronic lung injury. In order to realize the full potential of this technology (including as a destination therapy), the biocompatibility of these devices needs to be improved to produce long-lasting devices that are safe for patient use with minimal or no systemic anticoagulation. Many studies exist which probe coagulation and thrombosis on polydimethyl siloxane (PDMS) surfaces, and many strategies have been explored to improve surface biocompatibility. As the field of µALs is young, there are few studies which investigate biocompatibility of functioning µALs; and even fewer which were performed in vivo. Here, we use both in vitro and in vivo models to investigate two strategies to improve µAL biocompatibility: 1) a hydrophilic surface coating (polyethylene glycol, PEG) to prevent surface fouling, and 2) the addition of nitric oxide (NO) to the sweep gas to inhibit platelet activation locally within the µAL. In this study, we challenge µALs with clottable blood or platelet-rich plasma (PRP) and monitor the resistance to blood flow over time. Device lifetime (the amount of time the µAL remains patent and unobstructed by clot) is used as the primary indicator of biocompatibility. This study is the first study to: 1) investigate the effect of NO release on biocompatibility in a microfluidic network; 2) combine a hydrophilic PEG coating with NO release to improve blood compatibility; and 3) perform extended in vivo biocompatibility testing of a µAL. We found that µALs challenged in vitro with PRP remained patent significantly longer when the sweep gas contained NO than without NO. In the in vivo rabbit model, neither approach alone (PEG coating nor NO sweep gas) significantly improved biocompatibility compared to controls (though with larger sample size significance may become apparent); while the combination of a PEG coating with NO sweep gas resulted in significant improvement of device lifetime. STATEMENT OF SIGNIFICANCE: The development of microfluidic artificial lungs (µALs) can potentially have a massive impact on the treatment of patients with acute and chronic lung impairments. Before these devices can be deployed clinically, the biocompatibility of µALs must be improved and more comprehensively understood. This work explores two strategies for improving biocompatibility, a hydrophilic surface coating (polyethylene glycol) for general surface passivation and the addition of nitric oxide (NO) to the sweep gas to quell platelet and leukocyte activation. These two strategies are investigated separately and as a combined device treatment. Devices are challenged with clottable blood using in vitro testing and in vivo testing in rabbits. This is the first study to our knowledge that allows statistical comparisons of biocompatible µALs in animals, a key step towards eventual clinical use.
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Affiliation(s)
- Alex J Thompson
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI, USA, 48105; University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, USA, 48109.
| | - Lindsay J Ma
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI, USA, 48105; University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, USA, 48109
| | - Terry Major
- University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, USA, 48109
| | - Mark Jeakle
- University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, USA, 48109
| | | | - Marcus J Goudie
- University of Georgia, College of Engineering, 220 Riverbend Road, Athens, GA, USA, 30602
| | - Hitesh Handa
- University of Georgia, College of Engineering, 220 Riverbend Road, Athens, GA, USA, 30602
| | - Alvaro Rojas-Peña
- University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, USA, 48109
| | - Joseph A Potkay
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI, USA, 48105; University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, USA, 48109
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Nikam SP, Chen P, Nettleton K, Hsu YH, Becker ML. Zwitterion Surface-Functionalized Thermoplastic Polyurethane for Antifouling Catheter Applications. Biomacromolecules 2020; 21:2714-2725. [DOI: 10.1021/acs.biomac.0c00456] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Shantanu P. Nikam
- Department of Polymer Science, University of Akron, Akron, Ohio 44325, United States
| | - Peiru Chen
- Department of Polymer Science, University of Akron, Akron, Ohio 44325, United States
| | - Karissa Nettleton
- Department of Polymer Science, University of Akron, Akron, Ohio 44325, United States
| | - Yen-Hao Hsu
- Department of Polymer Science, University of Akron, Akron, Ohio 44325, United States
| | - Matthew L. Becker
- Department of Chemistry, Mechanical Engineering and Materials Science, Orthopaedic Surgery, and Biomedical Engineering, Duke University, Durham, North Carolina 27708, United States
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Dutra GVS, Neto WS, Dutra JPS, Machado F. Implantable Medical Devices and Tissue Engineering: An Overview of Manufacturing Processes and the Use of Polymeric Matrices for Manufacturing and Coating their Surfaces. Curr Med Chem 2020; 27:1580-1599. [PMID: 30215330 DOI: 10.2174/0929867325666180914110119] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/09/2016] [Accepted: 03/01/2017] [Indexed: 12/22/2022]
Abstract
Medical devices are important diagnosis and therapy tools for several diseases which include a wide range of products. Technological advances in this area have been proposed to reduce adverse complication incidences. New technologies and manufacturing processes, as well as the development of new materials or medical devices with modified surface and the use of biodegradable polymeric devices such as a substrate for cell culture in the field of tissue engineering, have attracted considerable attention in recent years by the scientific community intended to produce medical devices with superior properties and morphology. This review article focused on implantable devices, addresses the major advances in the biomedical field related to the devices manufacture processes such as 3D printing and hot melting extrusion, and the use of polymer matrices composed of copolymers, blends, nanocomposites or grafted with antiproliferative drugs for manufacturing and/or coating the devices surface.
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Affiliation(s)
- Gabriel Victor Simões Dutra
- Instituto de Quimica, Universidade de Brasilia, Campus Universitario Darcy Ribeiro, 70910-900 Brasília, DF, Brazil
| | - Weslany Silvério Neto
- Instituto de Quimica, Universidade de Brasilia, Campus Universitario Darcy Ribeiro, 70910-900 Brasília, DF, Brazil
| | - João Paulo Simões Dutra
- Departamento de Medicina, Pontificia Universidade Catolica de Goias, Avenida Universitaria 1440 Setor Universitario, 74605-070 Goiania, GO, Brazil
| | - Fabricio Machado
- Instituto de Quimica, Universidade de Brasilia, Campus Universitario Darcy Ribeiro, 70910-900 Brasília, DF, Brazil
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Devine R, Goudie MJ, Singha P, Schmiedt C, Douglass M, Brisbois EJ, Handa H. Mimicking the Endothelium: Dual Action Heparinized Nitric Oxide Releasing Surface. ACS APPLIED MATERIALS & INTERFACES 2020; 12:20158-20171. [PMID: 32271542 PMCID: PMC7962625 DOI: 10.1021/acsami.9b22277] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The management of thrombosis and bacterial infection is critical to ensure the functionality of medical devices. While administration of anticoagulants is the current antithrombotic clinical practice, a variety of complications, such as uncontrolled hemorrhages or heparin-induced thrombocytopenia, can occur. Additionally, infection rates remain a costly and deadly complication associated with use of these medical devices. It has been hypothesized that if a synthetic surface could mimic the biochemical mechanisms of the endothelium of blood vessels, thrombosis could be reduced, anticoagulant use could be avoided, and infection could be prevented. Herein, the interfacial biochemical effects of the endothelium were mimicked by altering the surface of medical grade silicone rubber (SR). Surface modification was accomplished via heparin surface immobilization (Hep) and the inclusion of a nitric oxide (NO) donor into the SR polymeric matrix to achieve synergistic effects (Hep-NO-SR). An in vitro bacteria adhesion study revealed that Hep-NO-SR exhibited a 99.46 ± 0.17% reduction in viable bacteria adhesion compared to SR. An in vitro platelet study revealed Hep-NO-SR reduced platelet adhesion by 84.12 ± 6.19% compared to SR, while not generating a cytotoxic response against fibroblast cells. In a 4 h extracorporeal circuit model without systemic anticoagulation, all Hep-NO-SR samples were able to maintain baseline platelet count and device patency; whereas 66% of SR samples clotted within the first 2 h of study. Results indicate that Hep-NO-SR creates a more hemocompatible and antibacterial surface by mimicking two key biochemical functions of the native endothelium.
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Affiliation(s)
- Ryan Devine
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA USA
| | - Marcus J. Goudie
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA USA
| | - Priyadarshini Singha
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA USA
| | - Chad Schmiedt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA USA
| | - Megan Douglass
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA USA
| | - Elizabeth J. Brisbois
- Department of Materials Science & Engineering, College of Engineering and Computer Science, University of Central Florida, Orlando, FL USA
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA USA
- Corresponding author Dr. Hitesh Handa, College of Engineering, University of Georgia, 220 Riverbend Road, Athens, GA 30602, Telephone: (706) 542-8109,
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Boubes K, Shaikh A, Alsauskas Z, Dwyer A. New Directions in Ensuring Catheter Safety. Adv Chronic Kidney Dis 2020; 27:228-235. [PMID: 32891307 DOI: 10.1053/j.ackd.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 01/20/2020] [Accepted: 02/17/2020] [Indexed: 11/11/2022]
Abstract
Tunneled dialysis catheters remain the most common vascular access used to initiate hemodialysis. Unfortunately, their use is associated with higher morbidity and mortality when compared with arteriovenous fistulae or grafts. Different types of catheters with different designs and material properties function differently. Additional devices and medications can be used to decrease the rates of infection and thrombosis. The current available tunneled dialysis catheters remain far from the desired goal and innovation in the field of dialysis vascular access remains in dire need.
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29
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Free radical-releasing systems for targeting biofilms. J Control Release 2020; 322:248-273. [PMID: 32243972 DOI: 10.1016/j.jconrel.2020.03.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 03/20/2020] [Accepted: 03/21/2020] [Indexed: 01/05/2023]
Abstract
The recent rise in antibiotic drug resistance and biofilm formation by microorganisms has driven scientists from different fields to develop newer strategies to target microorganisms responsible for infectious diseases. There is a growing interest in free radicals as therapeutic agents for antimicrobial applications. However, limitations such as short half-life has hindered their usage. Currently, several research groups are exploring various biomaterials that can prolong the half-life, increase storage duration and control the release of the therapeutic ranges of free radicals required for different applications, including biofilm eradication. This review paper initially provides a background to, and theoretical knowledge on, free radicals; and then proceeds to review studies that have employed various free radical-incorporated drug delivery systems as an approach to target biofilm formation and eradication. Some of the free radical releasing systems highlighted include polymers, nanoparticles and hydrogels, with a focus on biofilm eradication, where they impact significantly. The various challenges associated with their application are also discussed. Further, the review identifies future research and strategies that can potentiate the application of free radical-incorporated drug delivery systems for inhibiting biofilm formation and eradicating formed biofilms.
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Homeyer KH, Singha P, Goudie MJ, Handa H. S-Nitroso-N-acetylpenicillamine impregnated endotracheal tubes for prevention of ventilator-associated pneumonia. Biotechnol Bioeng 2020; 117:2237-2246. [PMID: 32215917 DOI: 10.1002/bit.27341] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/28/2020] [Accepted: 03/19/2020] [Indexed: 12/14/2022]
Abstract
The chances of ventilator-associated pneumonia (VAP) increases 6-20 folds when an endotracheal tube (ETT) is placed in a patient. VAP is one of the most common hospital-acquired infections and comprises 86% of the nosocomial pneumonia cases. This study introduces the idea of nitric oxide-releasing ETTs (NORel-ETTs) fabricated by the incorporation of the nitric oxide (NO) donor S-nitroso-N-acetylpenicillamine (SNAP) into commercially available ETTs via solvent swelling. The impregnation of SNAP provides NO release over a 7-day period without altering the mechanical properties of the ETT. The NORel-ETTs successfully reduced the bacterial infection from a commonly found pathogen in VAP, Pseudomonas aeruginosa, by 92.72 ± 0.97% when compared with the control ETTs. Overall, this study presents the incorporation of the active release of a bactericidal agent in ETTs as an efficient strategy to prevent the risk of VAP.
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Affiliation(s)
- Katie H Homeyer
- School of Chemical, Materials, and Biomedical Engineering, University of Georgia, Athens, Georgia
| | - Priyadarshini Singha
- School of Chemical, Materials, and Biomedical Engineering, University of Georgia, Athens, Georgia
| | - Marcus J Goudie
- School of Chemical, Materials, and Biomedical Engineering, University of Georgia, Athens, Georgia
| | - Hitesh Handa
- School of Chemical, Materials, and Biomedical Engineering, University of Georgia, Athens, Georgia
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31
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Singha P, Goudie MJ, Liu Q, Hopkins S, Brown N, Schmiedt CW, Locklin J, Handa H. Multipronged Approach to Combat Catheter-Associated Infections and Thrombosis by Combining Nitric Oxide and a Polyzwitterion: a 7 Day In Vivo Study in a Rabbit Model. ACS APPLIED MATERIALS & INTERFACES 2020; 12:9070-9079. [PMID: 32009376 PMCID: PMC7946114 DOI: 10.1021/acsami.9b22442] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The development of nonfouling and antimicrobial materials has shown great promise for reducing thrombosis and infection associated with medical devices with aims of improving device safety and decreasing the frequency of antibiotic administration. Here, the design of an antimicrobial, anti-inflammatory, and antithrombotic vascular catheter is assessed in vivo over 7 d in a rabbit model. Antimicrobial and antithrombotic activity is achieved through the integration of a nitric oxide donor, while the nonfouling surface is achieved using a covalently bound phosphorylcholine-based polyzwitterionic copolymer topcoat. The effect of sterilization on the nonfouling nature and nitric oxide release is presented. The catheters reduced viability of Staphylococcus aureus in long-term studies (7 d in a CDC bioreactor) and inflammation in the 7 d rabbit model. Overall, this approach provides a robust method for decreasing thrombosis, inflammation, and infections associated with vascular catheters.
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Affiliation(s)
- Priyadarshini Singha
- School of Chemical, Materials and Biomedical Engineering , The University of Georgia , Athens , Georgia 30602 , United States
| | - Marcus J Goudie
- School of Chemical, Materials and Biomedical Engineering , The University of Georgia , Athens , Georgia 30602 , United States
| | - Qiaohong Liu
- Department of Chemistry , The University of Georgia , Athens , Georgia 30602 , United States
| | - Sean Hopkins
- School of Chemical, Materials and Biomedical Engineering , The University of Georgia , Athens , Georgia 30602 , United States
| | - Nettie Brown
- School of Chemical, Materials and Biomedical Engineering , The University of Georgia , Athens , Georgia 30602 , United States
| | - Chad W Schmiedt
- College of Veterinary Medicine , The University of Georgia , Athens , Georgia 30602 , United States
| | - Jason Locklin
- School of Chemical, Materials and Biomedical Engineering , The University of Georgia , Athens , Georgia 30602 , United States
- Department of Chemistry , The University of Georgia , Athens , Georgia 30602 , United States
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering , The University of Georgia , Athens , Georgia 30602 , United States
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32
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Jeakle MM, Major TC, Meyerhoff ME, Bartlett RH. Comparison of Diazeniumdiolated Dialkylhexanediamines as Nitric Oxide Release Agents on Nonthrombogenicity in an Extracorporeal Circulation Model. ACS APPLIED BIO MATERIALS 2020; 3:466-476. [PMID: 35019463 DOI: 10.1021/acsabm.9b00924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
When blood from a patient is circulated through extracorporeal circuits (ECCs), such as in cardiopulmonary bypass or extracorporeal life support, platelets in the blood are activated and form a thrombus. This is prevented clinically with a range of different systemic anticoagulation agents (e.g., heparin); however, this increases a patient's risk of hemorrhage. Previous work with nitric oxide (NO) releasing materials using the combined diazeniumdiolated diamine, N-N-di-N'-butyl-1,6-hexanediamine (DBHD), and a polymer-linked thrombin inhibitor, argatroban (AG), showed significant nonthrombogenicity in ECCs using a 4 h rabbit model. Herein, we evaluated if diazeniumdiolated N-N-di-N'-propyl-1,6-hexanediamine (DPHDN2O2), which has a slightly lower degree of lipophilicity compared to DBHDN2O2, would provide similar nonthrombogenicity as the AG/DBHDN2O2-polymer-coated circuits. While DPHDN2O2 releases NO at a higher flux rate than DBHDN2O2 when coated (within CarboSil polymer) on the inner wall of polyvinyl chloride tubing, neither coated circuit significantly affected animal hemodynamics. Both diazeniumdiolated diamines, in combination with immobilized AG or alone, significantly reduced thrombus formation similarly in the 4 h rabbit model (vs uncoated control): AG/DBHDN2O2: 0.12 ± 0.03 cm2; DBHDN2O2: 2.57 ± 0.82 cm2; AG/DPHDN2O2: 0.68 ± 0.22 cm2; DPHDN2O2: 1.87 + 1.26 cm2; uncoated control: 6.95 ± 0.82 cm2. AG/DPHDN2O2 was no different than AG/DBHDN2O in preserving platelet count and function. In addition, AG did not leach into the systemic circulation as the total clotting times were insignificantly different from the baseline values (AG/DPHDN2O2: 12.7 + 0.5 s (n = 3); AG/DBHDN2O2: 12.3 + 0.7 s (n = 3); baseline: 13.9 + 0.3 s (n = 13)). Based on these results, both DPHDN2O2 and DPHDN2O2 are good candidates as NO donor molecules for creating nonthrombogenic polymer coatings for ECCs.
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Affiliation(s)
- Mark M Jeakle
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan 48109, United States
| | - Terry C Major
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan 48109, United States
| | - Mark E Meyerhoff
- Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Robert H Bartlett
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan 48109, United States
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Yan H, Li L, Wang Z, Wang Y, Guo M, Shi X, Yeh JM, Zhang P. Mussel-Inspired Conducting Copolymer with Aniline Tetramer as Intelligent Biological Adhesive for Bone Tissue Engineering. ACS Biomater Sci Eng 2019; 6:634-646. [PMID: 33463207 DOI: 10.1021/acsbiomaterials.9b01601] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Electrically conducting polymers have been emerging as intelligent bioactive materials for regulating cell behaviors and bone tissue regeneration. Additionally, poor adhesion between conventional implants and native bone tissue may lead to displacement, local inflammation, and unnecessary secondary surgery. Thus, a conductive bioadhesive with strong adhesion performance provides an effective approach to fulfill fixation and regeneration of comminuted bone fracture. Inspired by mussel chemistry, we designed the conductive copolymers poly{[aniline tetramer methacrylamide]-co-[dopamine methacrylamide]-co-[poly(ethylene glycol) methyl ether methacrylate]} [poly(ATMA-co-DOPAMA-co-PEGMA); AT:conductive aniline tetramer; DOPA:dopamine; PEG:poly(ethylene glycol))] with AT content 3.0, 6.0, and 9.0 mol %, respectively. The adhesive strength of this copolymer was enhanced during tensile process perhaps due to the synergistic effects of H-bonding, π-π interactions, and polymer long-chain entanglement, reaching up to 1.28 MPa with 6 mol % AT. Biological characterizations of preosteoblasts indicated that the bioadhesives exhibited desirable biocompatibility. In addition, the osteogenic differentiation was synergistically enhanced by the conductive substrate and electrical stimulation with a square wave, frequency of 100 Hz, 50% duty cycle, and electrical potential of 500 mV, as indicated by ALP activity, calcium deposition, and expression of osteogenic genes. The ALP activity at 14 days and calcium deposition at 28 days on the 9 mol % AT group were significantly higher than that on PLGA under electrical stimulation. The expression value of OPN for 9 mol % AT group was notably upregulated by 5.9-fold compared with PLGA at 7 days under electrical stimulation. Overall, the conductive polymers with strong adhesion can synergistically upregulate the cellular activity combining with electrical stimulation and might be a promising bioadhesive for orthopedic and dental applications.
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Affiliation(s)
- Huanhuan Yan
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun 130022, P. R. China.,School of Applied Chemistry and Engineering, University of Science and Technology of China, 96 Jinzhai Road, Hefei, Anhui 230026, P. R. China
| | - Linlong Li
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun 130022, P. R. China.,University of Chinese Academy of Sciences, 19 Yuquan Road, Beijing 100049, P. R. China
| | - Zongliang Wang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun 130022, P. R. China
| | - Yu Wang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun 130022, P. R. China
| | - Min Guo
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun 130022, P. R. China
| | - Xincui Shi
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun 130022, P. R. China
| | - Jui-Ming Yeh
- Department of Chemistry and Center for Nanotechnology, Chung-Yuan Christian University (CYCU), Chung Li 32023, Taiwan, Republic of China
| | - Peibiao Zhang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun 130022, P. R. China.,School of Applied Chemistry and Engineering, University of Science and Technology of China, 96 Jinzhai Road, Hefei, Anhui 230026, P. R. China
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Rong F, Tang Y, Wang T, Feng T, Song J, Li P, Huang W. Nitric Oxide-Releasing Polymeric Materials for Antimicrobial Applications: A Review. Antioxidants (Basel) 2019; 8:E556. [PMID: 31731704 PMCID: PMC6912614 DOI: 10.3390/antiox8110556] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/07/2019] [Accepted: 11/13/2019] [Indexed: 12/12/2022] Open
Abstract
Polymeric materials releasing nitric oxide have attracted significant attention for therapeutic use in recent years. As one of the gaseous signaling agents in eukaryotic cells, endogenously generated nitric oxide (NO) is also capable of regulating the behavior of bacteria as well as biofilm formation in many metabolic pathways. To overcome the drawbacks caused by the radical nature of NO, synthetic or natural polymers bearing NO releasing moiety have been prepared as nano-sized materials, coatings, and hydrogels. To successfully design these materials, the amount of NO released within a certain duration, the targeted pathogens and the trigger mechanisms upon external stimulation with light, temperature, and chemicals should be taken into consideration. Meanwhile, NO donors like S-nitrosothiols (RSNOs) and N-diazeniumdiolates (NONOates) have been widely utilized for developing antimicrobial polymeric agents through polymer-NO donor conjugation or physical encapsulation. In addition, antimicrobial materials with visible light responsive NO donor are also reported as strong and physiological friendly tools for rapid bacterial clearance. This review highlights approaches to delivery NO from different types of polymeric materials for combating diseases caused by pathogenic bacteria, which hopefully can inspire researchers facing common challenges in the coming 'post-antibiotic' era.
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Affiliation(s)
- Fan Rong
- Xi’an Institute of Flexible Electronics & Xi’an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi’an 710072, Shaanxi, China
- Department of Applied Chemistry, School of Natural and Applied Science, Northwestern Polytechnical University, 127 West Youyi Road, Xi’an 710072, Shaanxi, China
| | - Yizhang Tang
- Xi’an Institute of Flexible Electronics & Xi’an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi’an 710072, Shaanxi, China
- Department of Applied Chemistry, School of Natural and Applied Science, Northwestern Polytechnical University, 127 West Youyi Road, Xi’an 710072, Shaanxi, China
| | - Tengjiao Wang
- Xi’an Institute of Flexible Electronics & Xi’an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi’an 710072, Shaanxi, China
| | - Tao Feng
- Xi’an Institute of Flexible Electronics & Xi’an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi’an 710072, Shaanxi, China
| | - Jiang Song
- Xi’an Institute of Flexible Electronics & Xi’an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi’an 710072, Shaanxi, China
- School of Electronics & Information, Northwestern Polytechnical University, 127 West Youyi Road, Xi’an 710072, Shaanxi, China
| | - Peng Li
- Xi’an Institute of Flexible Electronics & Xi’an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi’an 710072, Shaanxi, China
| | - Wei Huang
- Xi’an Institute of Flexible Electronics & Xi’an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi’an 710072, Shaanxi, China
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35
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Tanabe H, Takemura N, Terao H, Hagiwara H, Zushi Y, Murayama R, Abe-Doi M, Sanada H. Vascular endothelium damage from catheter-induced mechanical stimulation causes catheter sleeve formation in a rabbit model. J Vasc Access 2019; 21:379-386. [PMID: 31591941 DOI: 10.1177/1129729819879317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Intravenous catheters are widely used but are often removed due to complications associated with catheter sleeve formation. A catheter sleeve can develop from a thrombus, and catheter-induced vascular endothelium damage may be a critical factor for thrombus formation. We investigated the effect of catheter-induced mechanical stimulation on venous endothelial cells and catheter sleeve formation and the efficacy of anti-thrombogenic technology for preventing catheter sleeve formation in vivo. METHODS We surgically implanted poly(2-methoxyethyl acrylate)-coated and uncoated catheters with and without a stylet into the right external jugular vein of a rabbit model for 14 days. Catheter sleeve formation and the ratio of residual venous endothelial cells were compared using histological examination and immunostaining with an anti-CD31 antibody, respectively. RESULTS Stiffening an uncoated catheter with a stylet induced catheter sleeve formation along more than two-thirds of the length of the catheter. The ratios of residual venous endothelial cells at the tip of uncoated catheters with and without a stylet were 3% and 36%, respectively. While poly(2-methoxyethyl acrylate) coating also reduced the ratio of venous endothelial cells at the tip of the stiffened catheter (12%), it prevented external thrombus and catheter sleeve formation. CONCLUSION High levels of mechanical stimulation can affect catheter-related thrombosis and promote catheter sleeve formation, and anti-thrombogenic technology such as a poly(2-methoxyethyl acrylate) coating reduces thrombus formation and can prevent catheter sleeve formation on stiffened catheters. Further studies are required to determine the maximum degree of venous endothelial cell damage before catheter sleeve formation and to compare other anti-thrombogenic technologies with poly(2-methoxyethyl acrylate) for preventing catheter sleeve formation.
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Affiliation(s)
- Hidenori Tanabe
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Research and Development Center, Terumo Corporation, Kanagawa, Japan
| | - Naoto Takemura
- Research and Development Center, Terumo Corporation, Kanagawa, Japan
| | - Hisako Terao
- Research and Development Center, Terumo Corporation, Kanagawa, Japan
| | - Hitomi Hagiwara
- Research and Development Center, Terumo Corporation, Kanagawa, Japan
| | - Yasunobu Zushi
- Research and Development Center, Terumo Corporation, Kanagawa, Japan
| | - Ryoko Murayama
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mari Abe-Doi
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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36
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Mondal A, Douglass M, Hopkins SP, Singha P, Tran M, Handa H, Brisbois EJ. Multifunctional S-Nitroso- N-acetylpenicillamine-Incorporated Medical-Grade Polymer with Selenium Interface for Biomedical Applications. ACS APPLIED MATERIALS & INTERFACES 2019; 11:34652-34662. [PMID: 31483604 PMCID: PMC8007129 DOI: 10.1021/acsami.9b10610] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Modern crises in implantable or indwelling blood-contacting medical devices are mainly due to the dual problems of infection and thrombogenicity. There is a paucity of biomaterials that can address both problems simultaneously through a singular platform. Taking cues from the body's own defense mechanism against infection and blood clotting (thrombosis) via the endogenous gasotransmitter nitric oxide (NO), both of these issues are addressed through the development of a layered S-nitroso-N-acetylpenicillamine (SNAP)-doped polymer with a blended selenium (Se)-polymer interface. The unique capability of the SNAP-Se-1 polymer composites to explicitly release NO from the SNAP reservoir as well as generate NO via the incorporated Se is reported for the first time. The NO release from the SNAP-doped polymer increased substantially in the presence of the Se interface. The Se interface was able to generate NO in the presence of S-nitrosoglutathione (GSNO) and glutathione (GSH), demonstrating the capability of generating NO from endogenous S-nitrosothiols (RSNO). Scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) traced distribution of elemental Se nanoparticles on the interface and the surface properties were evaluated by surface wettability and roughness. The SNAP-Se-1 efficiently inhibited the growth of bacteria and reduced platelet adhesion while showing minimal cytotoxicity, thus potentially eliminating the risks of systemic antibiotic and blood coagulation therapy. The SNAP-Se-1 exhibited antibacterial activity of ∼2.39 and ∼2.25 log reductions in the growth of clinically challenging adhered Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. SNAP-Se-1 also significantly reduced platelet adhesion by 85.5% compared to corresponding controls. A WST-8-based cell viability test performed on NIH 3T3 mouse fibroblast cells provided supporting evidence for the potential biocompatibility of the material in vitro. These results highlight the prospective utility of SNAP-Se-1 as a blood-contacting infection-resistant biomaterial in vitro which can be further tuned by application specificity.
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Affiliation(s)
- Arnab Mondal
- School of Chemical, Materials and Biomedical Engineering, College of Engineering , University of Georgia , Athens , Georgia 30602 , United States
| | - Megan Douglass
- School of Chemical, Materials and Biomedical Engineering, College of Engineering , University of Georgia , Athens , Georgia 30602 , United States
| | - Sean P Hopkins
- School of Chemical, Materials and Biomedical Engineering, College of Engineering , University of Georgia , Athens , Georgia 30602 , United States
| | - Priyadarshini Singha
- School of Chemical, Materials and Biomedical Engineering, College of Engineering , University of Georgia , Athens , Georgia 30602 , United States
| | - Martin Tran
- School of Chemical, Materials and Biomedical Engineering, College of Engineering , University of Georgia , Athens , Georgia 30602 , United States
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering , University of Georgia , Athens , Georgia 30602 , United States
- Corresponding Authors: Dr. Hitesh Handa, Assistant Professor, University of Georgia, 220 Riverbend Road, Athens, GA 30602, Telephone: (706) 542-8109, ; Dr. Elizabeth Brisbois, Assistant Professor, University of Central Florida, 12760 Pegasus Drive, Orlando, FL 32816, Telephone: (407) 266-7169,
| | - Elizabeth J Brisbois
- Department of Materials Science & Engineering, College of Engineering & Computer Science , University of Central Florida , Orlando , Florida 32816 , United States
- Corresponding Authors: Dr. Hitesh Handa, Assistant Professor, University of Georgia, 220 Riverbend Road, Athens, GA 30602, Telephone: (706) 542-8109, ; Dr. Elizabeth Brisbois, Assistant Professor, University of Central Florida, 12760 Pegasus Drive, Orlando, FL 32816, Telephone: (407) 266-7169,
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37
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Yang L, Jing L, Jiao Y, Wang L, Marchesan JT, Offenbacher S, Schoenfisch MH. In Vivo Antibacterial Efficacy of Nitric Oxide-Releasing Hyperbranched Polymers against Porphyromonas gingivalis. Mol Pharm 2019; 16:4017-4023. [PMID: 31361146 PMCID: PMC6752707 DOI: 10.1021/acs.molpharmaceut.9b00671] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The in vivo antibacterial activity of NO-releasing hyperbranched polymers was evaluated against Porphyromonas gingivalis, a key oral pathogen associated with periodontitis, using a murine subcutaneous chamber model. Escalating doses of NO-releasing polymers (1.5, 7.5, and 37.5 mg/kg) were administered into a P. gingivalis-infected chamber once a day for 3 days. Chamber fluids were collected on day 4, with microbiological evaluation indicating a dose-dependent bactericidal action. In particular, NO-releasing polymers at 37.5 mg/kg (1170 μg of NO/kg) achieved complete bacterial eradication (>6-log reduction in bacterial viability), demonstrating greater efficacy than amoxicillin (∼4-log reduction in bacterial viability), a commonly used antibiotic. Time-kill assays further revealed that largest dose (37.5 mg/kg; 1170 μg of NO/kg) resulted in ∼3-log killing of P. gingivalis after only a single dose. Based on these results, the potential clinical utility of NO-releasing hyperbranched polymers appears promising, particularly for oral health applications.
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Affiliation(s)
| | | | | | - Lufei Wang
- Oral and Craniofacial Biomedicine Program, School of Dentistry , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina 27599 , United States
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38
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Devine R, Singha P, Handa H. Versatile biomimetic medical device surface: hydrophobin coated, nitric oxide-releasing polymer for antimicrobial and hemocompatible applications. Biomater Sci 2019; 7:3438-3449. [PMID: 31268063 PMCID: PMC6666392 DOI: 10.1039/c9bm00469f] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In medical device design, there is a vital need for a coating that promotes treatment of the patient and simultaneously prevents fouling by biomacromolecules which in turn can progress to infections, thrombosis, and other device-related complications. In this work, hydrophobin SC3 (SC3), a self-assembling amphiphilic protein, was coated on a nitric oxide (NO) releasing medical grade polymer to provide an antifouling layer to work synergistically with NO's bactericidal and antiplatelet activity (SC3-NO). The contact angle of SC3 samples were ∼30% lesser than uncoated control samples and was maintained for a month in physiological conditions, demonstrating a stable, hydrophilic coating. NO release characteristics were not adversely affected by the SC3 coating and samples with SC3 coating maintained NO release. Fibrinogen adsorption was reduced over tenfold on SC3 coated samples when compared to non-SC3 coated samples. The viable cell count of adhered bacteria (Staphylococcus aureus) on SC3-NO was 79.097 ± 7.529% lesser than control samples and 49.533 ± 18.18% lesser than NO samples. Platelet adherence on SC3-NO was reduced by 73.407 ± 14.59% when compared to control samples and 53.202 ± 25.67 when compared to NO samples. Finally, the cytocompatibility of SC3-NO was tested and proved to be safe and not trigger a cytotoxic response. The overall favorable results from the physical, chemical and biological characterization analyses demonstrate the novelty and importance of a naturally-produced antifouling layer coated on a bactericidal and antiplatelet polymer, and thus will prove to be advantageous in a multitude of medical device applications.
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Affiliation(s)
- Ryan Devine
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA.
| | - Priyadarshini Singha
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA.
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA.
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39
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Douglass ME, Goudie MJ, Pant J, Singha P, Hopkins S, Devine R, Schmiedt CW, Handa H. Catalyzed Nitric Oxide Release Via Cu Nanoparticles Leads to an Increase in Antimicrobial Effects and Hemocompatibility for Short Term Extracorporeal Circulation. ACS APPLIED BIO MATERIALS 2019; 2:2539-2548. [PMID: 33718805 DOI: 10.1021/acsabm.9b00237] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Devices used for extracorporeal circulation are met with two major medical concerns: thrombosis and infection. A device that allows for anticoagulant-free circulation while reducing risk of infection has yet to be developed. We report the use of a copper nanoparticle (Cu NP) catalyst for the release of nitric oxide (NO) from the endogenous donor S-nitrosoglutathione (GSNO) in a coating applied to commercial Tygon S3™ E-3603 poly(vinyl chloride) tubing in order to reduce adhered bacterial viability and the occurrence thrombosis for the first time in an animal model. Cu GSNO coated material demonstrated a nitric oxide (NO) release flux ranging from an initial flux of 6.3 ± 0.9 ×10-10 mol cm-2 min-1 to 7.1 ± 0.4 ×10-10 mol cm-2 min-1 after 4 h of release, while GSNO loops without Cu NPs only ranged from an initial flux of 1.1 ± 0.2 ×10-10 mol cm-2 min-1 to 2.3 ± 0.2 ×10-10 mol cm-2 min-1 after 4 h of release, indicating that the addition of Cu NPs can increase NO flux up to five times in the same 4 h period. Additionally, a 3-log reduction in S. aureus and 1-log reduction in P. aeruginosa was observed in viable bacterial adhesion over a 24 h period compared to control loops. A Cell Counting Kit-8 (CCK-8) assay was used to validate no overall cytotoxicity towards 3T3 mouse fibroblasts. Finally, extracorporeal circuits were coated and exposed to 4 h of blood flow under an in vivo rabbit model. The Cu GSNO combination was successful in maintaining 89.3% of baseline platelet counts, while the control loops were able to maintain 67.6% of the baseline. These results suggest that the combination of Cu NPs with GSNO increases hemocompatibility and antimicrobial properties of ECC loops without any cytotoxic effects towards mammalian cells.
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Affiliation(s)
- Megan E Douglass
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Marcus J Goudie
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Jitendra Pant
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Priyadarshini Singha
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Sean Hopkins
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Ryan Devine
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Chad W Schmiedt
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA, USA
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
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40
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Zhou Y, Tan J, Wu J, Zhang Q, Andre J, Xi C, Chen Z, Meyerhoff ME. Nitric oxide releasing poly(vinylidene fluoride-co-hexafluoropropylene) films using a fluorinated nitric oxide donor to greatly decrease chemical leaching. Acta Biomater 2019; 90:112-121. [PMID: 30980938 PMCID: PMC6513704 DOI: 10.1016/j.actbio.2019.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/04/2019] [Accepted: 04/09/2019] [Indexed: 02/05/2023]
Abstract
Nitric oxide (NO) releasing polymers have been widely applied as biomaterials for a variety of biomedical implants and devices. However, the chemical leaching of NO donors and their byproduct species is almost always observed during the application of polymers doped with NO donors, unless the donor is covalently linked to the polymer. Herein, we report the first NO releasing poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) fluorinated copolymer prepared by incorporating a fluorinated S-nitrosothiol as the NO donor. Under physiological conditions, the resulting polymeric films can release NO for 16 days. Importantly, due to both fluorine-fluorine and electrostatic charge interactions between the fluorinated NO donor and the PVDF-HFP copolymer, the total chemical leaching of the fluorinated NO donor and its disulfide product after 9 day was only 0.6% (mol%) of the initial amount of NO donor loaded into the film. These new NO release PVDF-HFP films exhibit antimicrobial and anti-biofilm activities against both Gram positive S. aureus and Gram negative P. aeruginosa strains. The NO-releasing PVDF-HFP polymer can also be coated on Teflon tubing to release NO under physiological conditions for extended time periods. This NO-releasing PVDF-HFP copolymer with greatly reduced chemical leaching could help enhance the biocompatibility and antimicrobial activity of various biomedical devices. STATEMENT OF SIGNIFICANCE: Fluoropolymers have been widely used in creating various biomedical implants and devices. However, nitric oxide (NO) release fluoropolymers have not been well studied to date. Additionally, in the application of biomaterials doped with NO donors, a significant amount of NO donors and their byproducts almost always leach into aqueous environment. We now report an NO releasing poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) fluoropolymer by incorporating a new fluorinated S-nitrosothiol. The NO release can last for 16 days under physiological conditions. The total chemical leaching was determined to be only 0.6 mol% of the initial S-nitrosothiol loaded. As expected, significant antimicrobial/anti-biofilm activities of the NO release PVDF-HFP film were observed against Gram positive S. aureus and Gram negative P. aeruginosa bacterial strains.
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Affiliation(s)
- Yang Zhou
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jinyi Tan
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jianfeng Wu
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI 48109, USA
| | - Qi Zhang
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - John Andre
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Chuanwu Xi
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI 48109, USA
| | - Zhan Chen
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mark E Meyerhoff
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109, USA.
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41
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Lai A, Demarest CT, Do-Nguyen CC, Ukita R, Skoog DJ, Carleton NM, Amoako KA, Montoya PJ, Cook KE. 72-Hour in vivo evaluation of nitric oxide generating artificial lung gas exchange fibers in sheep. Acta Biomater 2019; 90:122-131. [PMID: 30953800 PMCID: PMC6513705 DOI: 10.1016/j.actbio.2019.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 03/26/2019] [Accepted: 04/02/2019] [Indexed: 12/21/2022]
Abstract
The large, densely packed artificial surface area of artificial lungs results in rapid clotting and device failure. Surface generated nitric oxide (NO) can be used to reduce platelet activation and coagulation on gas exchange fibers, while not inducing patient bleeding due to its short half-life in blood. To generate NO, artificial lungs can be manufactured with PDMS hollow fibers embedded with copper nanoparticles (Cu NP) and supplied with an infusion of the NO donor S-nitroso-N-acetyl-penicillamine (SNAP). The SNAP reacts with Cu NP to generate NO. This study investigates clot formation and gas exchange performance of artificial lungs with either NO-generating Cu-PDMS or standard polymethylpentene (PMP) fibers. One miniature artificial lung (MAL) made with 10 wt% Cu-PDMS hollow fibers and one PMP control MAL were attached to sheep in parallel in a veno-venous extracorporeal membrane oxygenation circuit (n = 8). Blood flow through each device was set at 300 mL/min, and each device received a SNAP infusion of 0.12 μmol/min. The ACT was between 110 and 180 s in all cases. Blood flow resistance was calculated as a measure of clot formation on the fiber bundle. Gas exchange experiments comparing the two groups were conducted every 24 h at blood flow rates of 300 and 600 mL/min. Devices were removed once the resistance reached 3x baseline (failure) or following 72 h. All devices were imaged using scanning electron microscopy (SEM) at the inlet, outlet, and middle of the fiber bundle. The Cu-PDMS NO generating MALs had a significantly smaller increase in resistance compared to the control devices. Resistance rose from 26 ± 8 and 23 ± 5 in the control and Cu-PDMS devices, respectively, to 35 ± 8 mmHg/(mL/min) and 72 ± 23 mmHg/(mL/min) at the end of each experiment. The resistance and SEM imaging of fiber surfaces demonstrate lower clot formation on Cu-PDMS fibers. Although not statistically significant, oxygen transfer for the Cu-PDMS MALs was 13.3% less than the control at 600 mL/min blood flow rate. Future in vivo studies with larger Cu-PDMS devices are needed to define gas exchange capabilities and anticoagulant activity over a long-term study at clinically relevant ACTs. STATEMENT OF SIGNIFICANCE: In artificial lungs, the large, densely-packed blood contacting surface area of the hollow fiber bundle is critical for gas exchange but also creates rapid, surface-generated clot requiring significant anticoagulation. Monitoring of anticoagulation, thrombosis, and resultant complications has kept permanent respiratory support from becoming a clinical reality. In this study, we use a hollow fiber material that generates nitric oxide (NO) to prevent platelet activation at the blood contacting surface. This material is tested in vivo in a miniature artificial lung and compared against the clinical standard. Results indicated significantly reduced clot formation. Surface-focused anticoagulation like this should reduce complication rates and allow for permanent respiratory support by extending the functional lifespan of artificial lungs and can further be applied to other medical devices.
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Affiliation(s)
- Angela Lai
- Carnegie Mellon University, United States.
| | | | | | - Rei Ukita
- Carnegie Mellon University, United States
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Homeyer KH, Goudie MJ, Singha P, Handa H. Liquid-Infused Nitric-Oxide-Releasing Silicone Foley Urinary Catheters for Prevention of Catheter-Associated Urinary Tract Infections. ACS Biomater Sci Eng 2019; 5:2021-2029. [DOI: 10.1021/acsbiomaterials.8b01320] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Katie H. Homeyer
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Marcus J. Goudie
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Priyadarshini Singha
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
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43
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Goudie MJ, Singha P, Hopkins SP, Brisbois EJ, Handa H. Active Release of an Antimicrobial and Antiplatelet Agent from a Nonfouling Surface Modification. ACS APPLIED MATERIALS & INTERFACES 2019; 11:4523-4530. [PMID: 30607929 PMCID: PMC7962626 DOI: 10.1021/acsami.8b16819] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Two major challenges faced by medical devices are thrombus formation and infection. In this work, surface-tethered nitric oxide (NO)-releasing molecules are presented as a solution to combat infection and thrombosis. These materials possess a robust NO release capacity lasting ca. 1 month while simultaneously improving the nonfouling nature of the material by preventing platelet, protein, and bacteria adhesion. NO's potent bactericidal function has been implemented by a facile surface covalent attachment method to fabricate a triple-action coating-surface-immobilized S-nitroso- N-acetylpenicillamine (SIM-S). Comparison of NO loading amongst the various branching configurations is shown through the NO release kinetics over time and the cumulative NO release. Biological characterization is performed using in vitro fibrinogen and Staphylococcus aureus assays. The material with the highest NO release, SIM-S2, is also able to reduce protein adhesion by 65.8 ± 8.9% when compared to unmodified silicone. SIM-S2 demonstrates a 99.99% (i.e., ∼4 log) reduction for S. aureus over 24 h. The various functionalized surfaces significantly reduce platelet adhesion in vitro, for both NO-releasing and non-NO-releasing surfaces (up to 89.1 ± 0.9%), demonstrating the nonfouling nature of the surface-immobilized functionalities. The ability of the SIM-S surfaces to retain antifouling properties despite gradual depletion of the bactericidal source, NO, demonstrates its potential use in long-term medical implants.
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Affiliation(s)
- Marcus J. Goudie
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Priyadarshini Singha
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Sean P. Hopkins
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Elizabeth J. Brisbois
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL, USA
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
- Corresponding Author: Dr. Hitesh Handa, Assistant Professor, University of Georgia, 220 Riverbend Road, Athens, GA 30602, Telephone: (706) 542-8109,
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44
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Qu B, Yuan L, Li J, Wang J, Lv H, Yang X. Selenium-containing polyurethane with elevated catalytic stability for sustained nitric oxide release. J Mater Chem B 2018; 7:150-156. [PMID: 32254959 DOI: 10.1039/c8tb02264j] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Stable and controllable nitric oxide (NO) release at the physiological level from biomedical materials remains a challenge for NO-based therapy. NO-generating polymers have great potential to achieve this goal because they can catalytically decompose endogenous S-nitrosothiols (RSNOs) into NO. However, the current catalytic surfaces based on such polymers often suffer from loss of catalytic sites, which can influence the stability of NO release in their long-term application. In this work, we proposed a novel strategy to enhance the catalytic stability of NO-catalytic materials by incorporating catalytic sites into the polymer backbone. Selenium-containing polyurethane (PU-Se) was synthesized by using the catalyst 2,2'-diselenodiethanol (SeDO) as the chain extender. A series of PU/PU-Se blend films were prepared to investigate the effect of PU-Se content on the catalytic properties. The blend films exhibited excellent catalytic activity, and also showed outstanding catalytic stability in comparison with PU coated by diselenide/dopamine (PU-PDA-Se). Among these blend films, PU-Se-10 exhibited a stable NO release rate of 5.05 × 10-10 mol cm-2 min-1 after exposure to PBS buffer for 30 days. Moreover, the PU/PU-Se films exhibited decreased platelet activation/adhesion, low hemolysis ratio, excellent biocompatibility, and similar mechanical properties to PU. It is expected that the newly designed PU-Se has great potential in generating stable NO release at the physiological level for the long-term application of blood-contacting medical devices.
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Affiliation(s)
- Baoliu Qu
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Renmin Str. 5625, Changchun 130022, P. R. China.
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45
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Pant J, Goudie MJ, Chaji SM, Johnson BW, Handa H. Nitric oxide releasing vascular catheters for eradicating bacterial infection. J Biomed Mater Res B Appl Biomater 2018; 106:2849-2857. [PMID: 29266734 PMCID: PMC6013312 DOI: 10.1002/jbm.b.34065] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/21/2017] [Accepted: 12/02/2017] [Indexed: 12/16/2022]
Abstract
The interaction of blood proteins with an implant surface is not only a fundamental phenomenon but is also key to several important medical complications. Plasma proteins binding on the surface of intravascular catheters can promote bacterial adhesion leading to the risk of local and systemic complications such as catheter-related blood infections (CRBIs). The incidences of CRBIs in the United States amount to more than 250,000 cases/year with an attributable mortality of up to 35% and an annual healthcare expenditure of $2.3 billion approximately. This demands the development of truly nonthrombogenic and antimicrobial catheters. In the present study, catheters were fabricated by incorporating a nitric oxide (NO) donor molecule, S-nitroso-N-acetyl-penicillamine (SNAP) in a hydrophobic medical grade polymer, Elasteon-E2As. NO offers antithrombotic and antibacterial attributes without promoting drug resistance and cytotoxicity. E2As-SNAP catheters were first coated with fibrinogen, a blood plasma protein plays a key role in clot formation and eventual bacterial adhesion to the implant surface. The suitability of the catheters for biomedical applications was tested in vitro for contact angle, NO release kinetics, inhibition of bacteria, and absence of cytotoxicity toward mammalian cells. The highly hydrophobic catheters released NO in the physiological range that inhibited >99% bacterial viability on fibrinogen-coated catheters in a 24 h study. No toxic response of E2As-SNAP catheters leachate was observed using a standard cytotoxicity assay with mouse fibroblast cells. Overall, the results showed that the E2As-SNAP catheters can inhibit viable bacteria even in the presence of blood proteins without causing a cytotoxic response. The fundamentals of this study are applicable to other blood-contacting medical devices as well. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2849-2857, 2018.
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Affiliation(s)
| | | | - Sarah M. Chaji
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Benjamin W. Johnson
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
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46
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Zhou Y, Zhang Q, Wu J, Xi C, Meyerhoff ME. Synthesis and Characterization of a Fluorinated S-Nitrosothiol as the Nitric Oxide Donor for Fluoropolymer-Based Biomedical Device Applications. J Mater Chem B 2018; 6:6142-6152. [PMID: 31105961 PMCID: PMC6516761 DOI: 10.1039/c8tb01814f] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Fluorinated polymers are widely used as biomaterials in various biomedical implant and device applications. However, thrombogenicity, surface-induced inflammation, and risk of microbial infection remain key issues that can limit their use. In this work, we describe the first nitric oxide (NO) releasing fluorinated polymer, in which a new fluorinated NO donor, S-nitroso-N-pentafluoropropionylpenicillamine (C2F5-SNAP), is incorporated within the polyvinylidene fluoride (PVDF) tubing. The synthesis, decomposition kinetics, and NO-release characteristics of the C2F5-SNAP species are described in detail. Then, using a simple solvent swelling method, we demonstrate that C2F5-SNAP can readily be doped into PVDF tubing. The resulting tubing can release NO for 11 days under physiological conditions, with an NO flux > 0.5 × 10-10 mol/cm2·min over the first 7 days. Due to fluorous-fluorous interactions, the leaching of the fluorinated NO donor and its decomposed products is shown to be very low (less than 5 nmol/mg, total). Further, the new NO-releasing PVDF tubing exhibits significant antimicrobial activity (compared to undoped PVDF tubing) against both gram positive and negative S. aureus and P. aeruginosa bacterial strains over a 7 d test period. This new NO-releasing fluorinated polymer is likely to have the potential to improve the biocompatibility and antimicrobial activity of various biomedical devices.
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Affiliation(s)
- Yang Zhou
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Qi Zhang
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Jianfeng Wu
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Chuanwu Xi
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Mark E Meyerhoff
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109, USA.
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47
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Hopkins SP, Pant J, Goudie MJ, Schmiedt C, Handa H. Achieving Long-Term Biocompatible Silicone via Covalently Immobilized S-Nitroso- N-acetylpenicillamine (SNAP) That Exhibits 4 Months of Sustained Nitric Oxide Release. ACS APPLIED MATERIALS & INTERFACES 2018; 10:27316-27325. [PMID: 30028941 PMCID: PMC7951114 DOI: 10.1021/acsami.8b08647] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Ever since the role of endogenous nitric oxide (NO) in controlling a wide variety of biological functions was discovered approximately three decades back, multiple NO-releasing polymeric materials have been developed. However, most of these materials are typically short lived due to the inefficient incorporation of the NO donor molecules within the polymer matrix. In the present study, S-nitroso- N-acetyl penicillamine (SNAP) is covalently attached to poly(dimethylsiloxane) (PDMS) to create a highly stable nitric oxide (NO) releasing material for biomedical applications. By tethering SNAP to the cross-linker of PDMS, the NO donor is unable to leach into the surrounding environment. This is the first time that a sustainable NO release and bacterial inhibition for over 125 days has been achieved by any NO-releasing polymer with supporting evidence of potential long-term hemocompatibility and biocompatibility. The material proves to have very high antibacterial efficacy against Staphylococcus aureus by demonstrating a 99.99% reduction in the first 3 days in a continuous flow CDC bioreactor, whereas a similar inhibitory potential of 99.50% was maintained by the end of 1 month. Hemocompatibility of SNAP-PDMS was tested using a rabbit extracorporeal circuit (ECC) model over a 4 h period. Thrombus formation was greatly reduced within the SNAP-PDMS-coated ECCs compared to the control circuits, observing a 78% reduction in overall thrombus mass accumulation. These results demonstrate the potential of utilizing this material for blood and tissue contacting biomedical devices in long-term clinical applications where infection and unwanted clotting are major issues.
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Affiliation(s)
- Sean P. Hopkins
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens 30602, United States
| | - Jitendra Pant
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens 30602, United States
| | - Marcus J. Goudie
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens 30602, United States
| | - Chad Schmiedt
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens 30602, United States
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens 30602, United States
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48
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Yang T, Zelikin AN, Chandrawati R. Progress and Promise of Nitric Oxide-Releasing Platforms. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2018; 5:1701043. [PMID: 29938181 PMCID: PMC6010811 DOI: 10.1002/advs.201701043] [Citation(s) in RCA: 149] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/24/2018] [Indexed: 05/05/2023]
Abstract
Nitric oxide (NO) is a highly potent radical with a wide spectrum of physiological activities. Depending on the concentration, it can enhance endothelial cell proliferation in a growth factor-free medium, mediate angiogenesis, accelerate wound healing, but may also lead to tumor progression or induce inflammation. Due to its multifaceted role, NO must be administered at a right dose and at the specific site. Many efforts have focused on developing NO-releasing biomaterials; however, NO short half-life in human tissues only allows this molecule to diffuse over short distances, and significant challenges remain before the full potential of NO can be realized. Here, an overview of platforms that are engineered to release NO via catalytic or noncatalytic approaches is presented, with a specific emphasis on progress reported in the past five years. A number of NO donors, natural enzymes, and enzyme mimics are highlighted, and recent promising developments of NO-releasing scaffolds, particles, and films are presented. In particular, key parameters of NO delivery are discussed: 1) NO payload, 2) maximum NO flux, 3) NO release half-life, 4) time required to reach maximum flux, and 5) duration of NO release. Advantages and drawbacks are reviewed, and possible further developments are suggested.
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Affiliation(s)
- Tao Yang
- School of Chemical EngineeringThe University of New South Wales (UNSW Sydney)SydneyNSW2052Australia
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
| | - Alexander N. Zelikin
- Department of Chemistry and iNANO Interdisciplinary Nanoscience CenterAarhus UniversityAarhusC 8000Denmark
| | - Rona Chandrawati
- School of Chemical EngineeringThe University of New South Wales (UNSW Sydney)SydneyNSW2052Australia
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
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49
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Sadrearhami Z, Nguyen TK, Namivandi-Zangeneh R, Jung K, Wong EHH, Boyer C. Recent advances in nitric oxide delivery for antimicrobial applications using polymer-based systems. J Mater Chem B 2018; 6:2945-2959. [PMID: 32254331 DOI: 10.1039/c8tb00299a] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The nitric oxide (NO) molecule has gained increasing attention in biological applications to combat biofilm-associated bacterial infections. However, limited NO loading, relatively short half-lives of low molecular weight NO donor compounds, and difficulties in targeted delivery of NO have hindered their practical clinical administration. To overcome these drawbacks, the combination of NO and scaffolds based on biocompatible polymers is an effective way towards realizing the practical utility of NO in biomedical applications. In this regard, the present overview highlights the recent developments in NO-releasing polymeric biomaterials for antimicrobial applications, focusing on antibiofilm treatments and the challenges that need to be overcome.
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Affiliation(s)
- Zahra Sadrearhami
- Centre for Advanced Macromolecular Design (CAMD) and Australian Centre for NanoMedicine (ACN), School of Chemical Engineering, UNSW Australia, Sydney, NSW 2052, Australia.
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50
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Jones A, Pant J, Lee E, Goudie MJ, Gruzd A, Mansfield J, Mandal A, Sharma S, Handa H. Nitric oxide-releasing antibacterial albumin plastic for biomedical applications. J Biomed Mater Res A 2018; 106:1535-1542. [PMID: 29377589 DOI: 10.1002/jbm.a.36349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/15/2017] [Accepted: 01/10/2018] [Indexed: 11/11/2022]
Abstract
Designing innovative materials for biomedical applications is desired to prevent surface fouling and risk of associated infections arising in the surgical care patient. In the present study, albumin plastic was fabricated and nitric oxide (NO) donor, S-nitroso-N-acetylpenicillamine (SNAP), was incorporated through a solvent swelling process. The albumin-SNAP plastic was evaluated in terms of mechanical and thermal properties, and bacterial adhesion to the plastic surface. Thermal and viscoelastic analyses showed no significant difference between albumin-SNAP plastics and pure, water-plasticized albumin samples. Bacteria adhesion tests revealed that albumin-SNAP plastic can significantly reduce the surface-bound viable gram-positive Staphylococcus aureus and gram-negative Pseudomonas aeruginosa bacterial cells by 98.7 and 98.5%, respectively, when compared with the traditional polyvinyl chloride medical grade tubing material. The results from this study demonstrate NO-releasing albumin plastic's potential as a material for biomedical device applications. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1535-1542, 2018.
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Affiliation(s)
- Alexander Jones
- Department of Textiles, Merchandising and Interiors, University of Georgia, Athens, Georgia
| | - Jitendra Pant
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia
| | - Eliza Lee
- Department of Textiles, Merchandising and Interiors, University of Georgia, Athens, Georgia
| | - Marcus J Goudie
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia
| | - Alexey Gruzd
- Department of Textiles, Merchandising and Interiors, University of Georgia, Athens, Georgia
| | - Joel Mansfield
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia
| | - Abhyuday Mandal
- Department of Statistics, University of Georgia, Athens, Georgia
| | - Suraj Sharma
- Department of Textiles, Merchandising and Interiors, University of Georgia, Athens, Georgia
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, Georgia
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