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Huang Z, Zhang D, Tong L, Gao F, Zhang S, Wang X, Xie Y, Chen F, Liu C. Protonated-chitosan sponge with procoagulation activity for hemostasis in coagulopathy. Bioact Mater 2024; 41:174-192. [PMID: 39131629 PMCID: PMC11314896 DOI: 10.1016/j.bioactmat.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/20/2024] [Accepted: 07/07/2024] [Indexed: 08/13/2024] Open
Abstract
Hemostatic materials are essential for managing acute bleeding in medical settings. Chitosan (CS) shows promise in hemostasis but its underlying mechanism remains incompletely understood. We unexpectedly discovered that certain protonated-chitosan (PCS) rapidly assembled plasma proteins to form protein membrane (PM) upon contact with platelet-poor plasma (PPP). We hypothesized that the novel observation was intricately related to the procoagulant effect of chitosan. Herein, the study aimed to elucidate the conditions necessary and mechanism for PM formation, identify the proteins within the PM and PCS's procoagulant action at the molecule levels. We confirmed that the amount of -NH3 + groups (>4.9 mmol/g) on PCS molecules played a crucial role in promoting coagulation. The -NH3 + group interacted with blood's multiple active components to exert hemostatic effects: assembling plasma proteins including coagulation factors such as FII, FV, FX, activating blood cells and promoting the secretion of coagulation-related substances (FV, ADP, etc) by platelets. Notably, the hemostatic mechanism can be extended to protonated-chitosan derivatives like quaternized, alkylated, and catechol-chitosan. In the blood clotting index (BCI) experiment, compared to other groups, PCS95 achieved the lowest BCI value (∼6 %) within 30 s. Protonated-chitosan exhibited excellent biocompatibility and antibacterial properties, with PCS95 demonstrating inhibition effectiveness of over 95 % against Escherichia coli (E.coil) and Staphylococcus aureus (S. aureus). Moreover, PCS performed enhanced hemostatic effectiveness over chitosan-based commercially agents (Celox™ and ChitoGauze®XR) in diverse bleeding models. In particular, PCS95 reduced bleeding time by 70 % in rabbit models of coagulopathy. Overall, this study investigated the coagulation mechanism of materials at the molecular level, paving the way for innovative approaches in designing new hemostatic materials.
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Affiliation(s)
- Zhenhua Huang
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Dong Zhang
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Laiqiang Tong
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Fan Gao
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Shaozan Zhang
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Xinqing Wang
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Yina Xie
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Fangping Chen
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai, 200237, PR China
| | - Changsheng Liu
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, PR China
- Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology, Shanghai, 200237, PR China
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Zhang W, Xu H, Feng F, Zhao Z, Wang Z, Wang G, Zhang X, Li J, Chen W. A multifunctional gingival retraction cord with antibacterial and hemostasis properties based on Chitosan/Propolis/Tranexamic acid for dental treatment. Int J Biol Macromol 2024; 277:134237. [PMID: 39084424 DOI: 10.1016/j.ijbiomac.2024.134237] [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: 04/09/2024] [Revised: 07/09/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024]
Abstract
A novel gingival retraction cord named P/TA@CSy was prepared using chitosan yarns (CSy) loaded with tranexamic acid (TA) and Propolis (P). P/TA@CSy has good toughness with a breaking strength of 41.3 Pa, benefiting from the twisting structure and Propolis coating. A short coagulation time of 456 s was achieved for P/TA@CSy because of the potent blood absorption ability from the effective attachment of tranexamic acid. Moreover, excellent antibacterial ability was obtained with the antibacterial rates against E. coli of 94.73 %, S. aureus of 99.99 % and S. mutans of 99.99 %, contributing to Propolis's antibacterial ability. In addition, suppression of the expression of pro-inflammatory cytokines (IL-6 and TNF-α) was found, which could prevent wound infection. P/TA@CSy displayed excellent cytocompatibility with the cell activity of 100 % after 24 h. Therefore, P/TA@CSy could rapidly respond to gingival hemostasis and infection prevention, showing excellent potential in dental treatment.
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Affiliation(s)
- Wenjing Zhang
- Shandong Key Laboratory of Medical and Health Textile Materials, Laboratory for Manufacturing Low Carbon and Functionalized Textiles in the Universities of Shandong Province, College of Textiles & Clothing, Qingdao University, Qingdao 266071, China
| | - Hongxing Xu
- Shandong Key Laboratory of Medical and Health Textile Materials, Laboratory for Manufacturing Low Carbon and Functionalized Textiles in the Universities of Shandong Province, College of Textiles & Clothing, Qingdao University, Qingdao 266071, China
| | - Fan Feng
- Shandong Key Laboratory of Medical and Health Textile Materials, Laboratory for Manufacturing Low Carbon and Functionalized Textiles in the Universities of Shandong Province, College of Textiles & Clothing, Qingdao University, Qingdao 266071, China
| | - Zhihui Zhao
- Shandong Key Laboratory of Medical and Health Textile Materials, Laboratory for Manufacturing Low Carbon and Functionalized Textiles in the Universities of Shandong Province, College of Textiles & Clothing, Qingdao University, Qingdao 266071, China
| | - Zunyuan Wang
- Qingdao Xinwei Textile Development Co., Ltd, Qingdao 266000, China
| | - Guoxin Wang
- Qingdao Xinwei Textile Development Co., Ltd, Qingdao 266000, China
| | - Xiangyan Zhang
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao 266003, China
| | - Jiwei Li
- Shandong Key Laboratory of Medical and Health Textile Materials, Laboratory for Manufacturing Low Carbon and Functionalized Textiles in the Universities of Shandong Province, College of Textiles & Clothing, Qingdao University, Qingdao 266071, China.
| | - Weichao Chen
- Shandong Key Laboratory of Medical and Health Textile Materials, Laboratory for Manufacturing Low Carbon and Functionalized Textiles in the Universities of Shandong Province, College of Textiles & Clothing, Qingdao University, Qingdao 266071, China; State Key Laboratory for Biofibers and Eco-textiles, Collaborative Innovation Center for Eco-textiles of Shandong Province and the Ministry of Education, Qingdao University, Qingdao 266071, China.
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Fang R, Yu N, Wang F, Ding Z, Xu X, Zhang J. A hemoadhican-based sponge with anti-heparin interference for treating uncontrollable massive hemorrhage. Int J Biol Macromol 2024; 279:135097. [PMID: 39197604 DOI: 10.1016/j.ijbiomac.2024.135097] [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: 05/16/2024] [Revised: 08/23/2024] [Accepted: 08/24/2024] [Indexed: 09/01/2024]
Abstract
Hemoadhican (HD) is an exopolysaccharide with a branched structure that has been reported for its high hemostatic ability. In this study, a HD-based hemostatic sponge was prepared through ultrasonic dissolution and freeze-drying without using any cross-linking agent. The sponge could spontaneously cross-link using hydrogen bonds to form adhesive mud within 3 s upon contact with blood. This sponge-mud mixture adhered tightly to the wound tissue, forming a pressure-resistant physical barrier that captures and locks in blood cells and platelets. Simultaneously, the hydrophobic methyl groups of HD sponges repel blood inwardly, effectively sealing the wound. The brush-like structure of HD molecules was suspected to penetrate wet tissues through topological entanglement, thereby enhancing wet adhesion. Compared with gauze and gelatin sponges, HD sponges achieved more effective hemostasis in animal models using rat and rabbit femoral arteries. In particular, HD sponges showed excellent hemostasis in heparin-induced hemorrhage models in mice and pigs. The in vivo experiment demonstrated the excellent biosafety of the HD sponge. Conclusively, the HD sponge is a safe and efficient rapid hemostatic material that is expected to become an alternative material for clinical hemostatic procedures.
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Affiliation(s)
- Rui Fang
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China; Key laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, 210094, China
| | - Ning Yu
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China; Key laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, 210094, China
| | - Fa Wang
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China; Key laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, 210094, China
| | - Zhao Ding
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China; Key laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, 210094, China
| | - Xi Xu
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China; Key laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, 210094, China
| | - Jianfa Zhang
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, 210094, China; Key laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, 210094, China.
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Huang H, Liao S, Zhang D, Liang W, Xu K, Zhang Y, Lang M. A macromolecular cross-linked alginate aerogel with excellent concentrating effect for rapid hemostasis. Carbohydr Polym 2024; 338:122148. [PMID: 38763731 DOI: 10.1016/j.carbpol.2024.122148] [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: 12/15/2023] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 05/21/2024]
Abstract
Alginate-based materials present promising potential for emergency hemostasis due to their excellent properties, such as procoagulant capability, biocompatibility, low immunogenicity, and cost-effectiveness. However, the inherent deficiencies in water solubility and mechanical strength pose a threat to hemostatic efficiency. Here, we innovatively developed a macromolecular cross-linked alginate aerogel based on norbornene- and thiol-functionalized alginates through a combined thiol-ene cross-linking/freeze-drying process. The resulting aerogel features an interconnected macroporous structure with remarkable water-uptake capacity (approximately 9000 % in weight ratio), contributing to efficient blood absorption, while the enhanced mechanical strength of the aerogel ensures stability and durability during the hemostatic process. Comprehensive hemostasis-relevant assays demonstrated that the aerogel possessed outstanding coagulation capability, which is attributed to the synergistic impacts on concentrating effect, platelet enrichment, and intrinsic coagulation pathway. Upon application to in vivo uncontrolled hemorrhage models of tail amputation and hepatic injury, the aerogel demonstrated significantly superior performance compared to commercial alginate hemostatic agent, yielding reductions in clotting time and blood loss of up to 80 % and 85 %, respectively. Collectively, our work illustrated that the alginate porous aerogel overcomes the deficiencies of alginate materials while exhibiting exceptional performance in hemorrhage, rendering it an appealing candidate for rapid hemostasis.
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Affiliation(s)
- Huanxuan Huang
- Shanghai Key Laboratory of Advanced Polymeric Materials, School of Materials Science and Engineering, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237, PR China
| | - Shiyang Liao
- Department of Orthopedics, The First Affiliated Hospital of Anhui University of Science and Technology, 203 Huaibin Hwy, Anhui 232000, PR China
| | - Dong Zhang
- Shanghai Key Laboratory of Advanced Polymeric Materials, School of Materials Science and Engineering, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237, PR China
| | - Wencheng Liang
- College of chemical and material engineering, Quzhou University, 78 North Jiuhua Road, Zhejiang 324000, PR China
| | - Keqing Xu
- Department of Orthopedics, The First Affiliated Hospital of Anhui University of Science and Technology, 203 Huaibin Hwy, Anhui 232000, PR China.
| | - Yadong Zhang
- Department of Spine, Center for Orthopaedic Surgery, The Third Affiliated Hospital of Southern Medical University, 183 West Zhongshan Avenue, Guangzhou 510515, PR China.
| | - Meidong Lang
- Shanghai Key Laboratory of Advanced Polymeric Materials, School of Materials Science and Engineering, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237, PR China.
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Yang J, Cai F, Lv Y, Jiang T, Zhao X, Hu X, Zheng Y, Shi X. Chitosan nonwoven fabric composited calcium alginate and adenosine diphosphate as a hemostatic bandage for acute bleeding wounds. Int J Biol Macromol 2024; 257:128561. [PMID: 38056735 DOI: 10.1016/j.ijbiomac.2023.128561] [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: 08/10/2023] [Revised: 10/23/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
Acute bleeding following accidental injury is a leading cause of mortality. However, conventional hemostatic bandages impede wound healing by inducing excessive blood loss, dehydration, and adherence to granulation tissue. Strategies such as incorporating active hemostatic agents and implementing chemical modifications can augment the properties of these bandages. Nevertheless, the presence of remote thrombosis and initiators may pose risks to human health. Here, a hemostatic bandage was developed by physically combined chitosan nonwoven fabric, calcium alginate sponge, and adenosine diphosphate. The presented hemostatic bandage not only exhibits active and passive mechanisms for promoting clotting but also demonstrates excellent mechanical properties, breathability, ease of removal without causing damage to the wound bed or surrounding tissues, as well as maintaining an optimal moist environment conducive to wound healing. In vitro evaluation results indicated that the hemostatic bandage possesses favorable cytocompatibility with low levels of hemolysis. Furthermore, it effectively aggregates various blood cells while activating platelets synergistically to promote both extrinsic and intrinsic coagulation pathways. In an in vivo rat model study involving liver laceration and femoral artery injury scenarios, our developed hemostatic bandage demonstrated rapid clot formation capabilities along with reduced blood loss compared to commercially available fabrics.
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Affiliation(s)
- Jianmin Yang
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou 350108, China; Fujian Key Laboratory of Medical Instrument and Pharmaceutical Technology, Fuzhou University, No. 2 Xueyuan Road, Fuzhou 350108, China.
| | - Fengying Cai
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou 350108, China
| | - Yicheng Lv
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou 350108, China
| | - Ting Jiang
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou 350108, China
| | - Xingkai Zhao
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou 350108, China
| | - Xueli Hu
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou 350108, China
| | - Yunquan Zheng
- Fujian Key Laboratory of Medical Instrument and Pharmaceutical Technology, Fuzhou University, No. 2 Xueyuan Road, Fuzhou 350108, China
| | - Xianai Shi
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou 350108, China; Fujian Key Laboratory of Medical Instrument and Pharmaceutical Technology, Fuzhou University, No. 2 Xueyuan Road, Fuzhou 350108, China.
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Fang Y, Chen J, Li Q, Chen Q. Chitosan based Janus cryogel with anisotropic wettability, antibacterial activity, and rapid shape memory for effective hemostasis. Int J Biol Macromol 2024; 254:127821. [PMID: 37926326 DOI: 10.1016/j.ijbiomac.2023.127821] [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: 07/20/2023] [Revised: 10/11/2023] [Accepted: 10/23/2023] [Indexed: 11/07/2023]
Abstract
Excessive bleeding and bacterial infection leading to death is a major concern worldwide, particularly in cases of deep and narrow noncompressible hemorrhage. Herein, a novel Janus cryogel with anisotropic surface wettability, antibacterial activity, and rapid shape recovery was designed by constructing a hydrophilic porous cryogel using chitosan (CS), acacia gum (AG), and quaternized mesoporous bioglass (QMBG), with subsequent surface hydrophobic modification using octadecanol. The asymmetric hydrophobic surface modification of octadecanal endowed OCAQ with outstanding antiblood and antibacterial permeability, effectively preventing blood outflow and the invasion of bacteria to the wound. The hydrophilic parts with interconnected macroporous structure give the cryogel with ultra-high water uptake (5167 ± 182 %) and rapid water-trigged shape recover ability (≈2.1 s). The presence of active CS, AG, and QMBG in cryogel contributes to its exceptional blood clotting ability. Janus cryogel presents outstanding hemostatic performance (0.14 ± 0.03 g) in rat's liver injury model. Moreover, Janus cryogel exhibits excellent antibacterial properties due to the combination of its hydrophobic surface and antimicrobial quaternary amine groups. Meanwhile, the Janus cryogel has favorable hemocompatibility and biocompatibility. A Therefore, the Janus cryogel will become a candidate with great potential for clinical application of noncompressible wound as a multifunctional dressing.
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Affiliation(s)
- Yan Fang
- College of Chemistry and Materials Science, Fujian Normal University, Fuzhou 350007, People's Republic of China
| | - Jiawen Chen
- College of Chemistry and Materials Science, Fujian Normal University, Fuzhou 350007, People's Republic of China.
| | - Qinglin Li
- College of Chemistry and Materials Science, Fujian Normal University, Fuzhou 350007, People's Republic of China
| | - Qinhui Chen
- College of Chemistry and Materials Science, Fujian Normal University, Fuzhou 350007, People's Republic of China.
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Deng J, Wang Z, Xing J. Rapid hemostatic antibacterial self-gelling powder based on methacryloylsulfonyl betaine and quaternized carboxymethyl chitosan. J Mech Behav Biomed Mater 2023; 146:106079. [PMID: 37634426 DOI: 10.1016/j.jmbbm.2023.106079] [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: 06/28/2023] [Revised: 08/15/2023] [Accepted: 08/20/2023] [Indexed: 08/29/2023]
Abstract
Hemostatic powders can be used for deep wounds and wounds with irregular shapes that are frequently inaccessible to traditional hemostatic dressings like hemostatic gauze, sponges, and foams. In this study, sulfobetaine methacrylate (SBMA) and quaternized carboxymethyl chitosan (QCCS) were combined to create an antibacterial hemostatic hydrogel through photopolymerization under green LED irradiation, which was then changed into PSBMA/QCCS powder. PSBMA/QCCS powder could quickly form hydrogel with strong wet adhesion. The internal structure, water absorption capacity, and adhesion properties of the powder were evaluated. The coagulation ability, antimicrobial properties, and biocompatibility of the powder were also characterized. The PSBMA/QCCS powder could aggregate blood cells and platelets to enhance hemostasis. Meanwhile, PSBMA/QCCS powder also showed effective antibacterial ability against both gram-positive bacteria (Staphylococcus aureus) and gram-negative bacteria (Escherichia coli). In summary, PSBMA/QCCS powder is a promising hemostatic agent with the characteristics of quick hemostasis, tough wet adhesion, satisfactory biocompatibility, considerable antibacterial effect, and adaptability to any irregularly shaped wounds.
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Affiliation(s)
- Junxia Deng
- School of Chemical Engineering and Technology, Tianjin University, No. 135 Yaguan Road, Haihe Education Park, Jinnan District, Tianjin 300350, China
| | - Zhen Wang
- School of Chemical Engineering and Technology, Tianjin University, No. 135 Yaguan Road, Haihe Education Park, Jinnan District, Tianjin 300350, China
| | - Jinfeng Xing
- School of Chemical Engineering and Technology, Tianjin University, No. 135 Yaguan Road, Haihe Education Park, Jinnan District, Tianjin 300350, China.
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