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Arif ZU, Khalid MY, Zolfagharian A, Bodaghi M. 4D bioprinting of smart polymers for biomedical applications: recent progress, challenges, and future perspectives. REACT FUNCT POLYM 2022. [DOI: 10.1016/j.reactfunctpolym.2022.105374] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Recent advances in 3D-printed polylactide and polycaprolactone-based biomaterials for tissue engineering applications. Int J Biol Macromol 2022; 218:930-968. [PMID: 35896130 DOI: 10.1016/j.ijbiomac.2022.07.140] [Citation(s) in RCA: 95] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/13/2022] [Accepted: 07/18/2022] [Indexed: 01/10/2023]
Abstract
The three-dimensional printing (3DP) also known as the additive manufacturing (AM), a novel and futuristic technology that facilitates the printing of multiscale, biomimetic, intricate cytoarchitecture, function-structure hierarchy, multi-cellular tissues in the complicated micro-environment, patient-specific scaffolds, and medical devices. There is an increasing demand for developing 3D-printed products that can be utilized for organ transplantations due to the organ shortage. Nowadays, the 3DP has gained considerable interest in the tissue engineering (TE) field. Polylactide (PLA) and polycaprolactone (PCL) are exemplary biomaterials with excellent physicochemical properties and biocompatibility, which have drawn notable attraction in tissue regeneration. Herein, the recent advancements in the PLA and PCL biodegradable polymer-based composites as well as their reinforcement with hydrogels and bio-ceramics scaffolds manufactured through 3DP are systematically summarized and the applications of bone, cardiac, neural, vascularized and skin tissue regeneration are thoroughly elucidated. The interaction between implanted biodegradable polymers, in-vivo and in-vitro testing models for possible evaluation of degradation and biological properties are also illustrated. The final section of this review incorporates the current challenges and future opportunities in the 3DP of PCL- and PLA-based composites that will prove helpful for biomedical engineers to fulfill the demands of the clinical field.
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Malone G, Abdelsayed G, Bligh F, Al Qattan F, Syed S, Varatharajullu P, Msellati A, Mwipatayi D, Azhar M, Malone A, Fatimi SH, Conway C, Hameed A. Advancements in left ventricular assist devices to prevent pump thrombosis and blood coagulopathy. J Anat 2022; 242:29-49. [PMID: 35445389 PMCID: PMC9773170 DOI: 10.1111/joa.13675] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 12/25/2022] Open
Abstract
Mechanical circulatory support (MCS) devices, such as left ventricular assist devices (LVADs) are very useful in improving outcomes in patients with advanced-stage heart failure. Despite recent advances in LVAD development, pump thrombosis is one of the most severe adverse events caused by LVADs. The contact of blood with artificial materials of LVAD pumps and cannulas triggers the coagulation cascade. Heat spots, for example, produced by mechanical bearings are often subjected to thrombus build-up when low-flow situations impair washout and thus the necessary cooling does not happen. The formation of thrombus in an LVAD may compromise its function, causing a drop in flow and pumping power leading to failure of the LVAD, if left unattended. If a clot becomes dislodged and circulates in the bloodstream, it may disturb the flow or occlude the blood vessels in vital organs and cause internal damage that could be fatal, for example, ischemic stroke. That is why patients with LVADs are on anti-coagulant medication. However, the anti-coagulants can cause a set of issues for the patient-an example of gastrointestinal (GI) bleeding is given in illustration. On account of this, these devices are only used as a last resort in clinical practice. It is, therefore, necessary to develop devices with better mechanics of blood flow, performance and hemocompatibility. This paper discusses the development of LVADs through landmark clinical trials in detail and describes the evolution of device design to reduce the risk of pump thrombosis and achieve better hemocompatibility. Whilst driveline infection, right heart failure and arrhythmias have been recognised as LVAD-related complications, this paper focuses on complications related to pump thrombosis, especially blood coagulopathy in detail and potential strategies to mitigate this complication. Furthermore, it also discusses the LVAD implantation techniques and their anatomical challenges.
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Affiliation(s)
- Grainne Malone
- Tissue Engineering Research Group (TERG)Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin 2DublinIreland
| | - Gerges Abdelsayed
- School of MedicineRCSI University of Medicine and Health Sciences, Dublin 2DublinIreland
| | - Fianait Bligh
- School of MedicineRCSI University of Medicine and Health Sciences, Dublin 2DublinIreland
| | - Fatma Al Qattan
- Tissue Engineering Research Group (TERG)Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin 2DublinIreland,School of Pharmacy and Biomolecular SciencesRCSI University of Medicine and Health Sciences, Dublin 2DublinIreland
| | - Saifullah Syed
- School of MedicineRCSI University of Medicine and Health Sciences, Dublin 2DublinIreland
| | | | - Augustin Msellati
- School of MedicineRCSI University of Medicine and Health Sciences, Dublin 2DublinIreland
| | - Daniela Mwipatayi
- School of MedicineRCSI University of Medicine and Health Sciences, Dublin 2DublinIreland
| | - Maimoona Azhar
- Department of SurgerySt. Vincent's University Hospital, Dublin 4DublinIreland
| | - Andrew Malone
- Tissue Engineering Research Group (TERG)Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin 2DublinIreland
| | - Saulat H. Fatimi
- Department of Cardiothoracic SurgeryAga Khan University HospitalKarachiPakistan
| | - Claire Conway
- Tissue Engineering Research Group (TERG)Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin 2DublinIreland,Trinity Centre for Biomedical Engineering (TCBE)Trinity College Dublin (TCD)DublinIreland
| | - Aamir Hameed
- Tissue Engineering Research Group (TERG)Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin 2DublinIreland,Trinity Centre for Biomedical Engineering (TCBE)Trinity College Dublin (TCD)DublinIreland
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Cockerill I, See CW, Young ML, Wang Y, Zhu D. Designing Better Cardiovascular Stent Materials - A Learning Curve. ADVANCED FUNCTIONAL MATERIALS 2021; 31:2005361. [PMID: 33708033 PMCID: PMC7942182 DOI: 10.1002/adfm.202005361] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 05/07/2023]
Abstract
Cardiovascular stents are life-saving devices and one of the top 10 medical breakthroughs of the 21st century. Decades of research and clinical trials have taught us about the effects of material (metal or polymer), design (geometry, strut thickness, and the number of connectors), and drug-elution on vasculature mechanics, hemocompatibility, biocompatibility, and patient health. Recently developed novel bioresorbable stents are intended to overcome common issues of chronic inflammation, in-stent restenosis, and stent thrombosis associated with permanent stents, but there is still much to learn. Increased knowledge and advanced methods in material processing have led to new stent formulations aimed at improving the performance of their predecessors but often comes with potential tradeoffs. This review aims to discuss the advantages and disadvantages of stent material interactions with the host within five areas of contrasting characteristics, such as 1) metal or polymer, 2) bioresorbable or permanent, 3) drug elution or no drug elution, 4) bare or surface-modified, and 5) self-expanding or balloon-expanding perspectives, as they relate to pre-clinical and clinical outcomes and concludes with directions for future studies.
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Affiliation(s)
- Irsalan Cockerill
- Department of Biomedical Engineering, University of North Texas, Denton, TX 76207, USA
- Department of Materials Science and Engineering, University of North Texas, Denton, TX 76207, USA
| | - Carmine Wang See
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Marcus L. Young
- Department of Materials Science and Engineering, University of North Texas, Denton, TX 76207, USA
| | - Yadong Wang
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Donghui Zhu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
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Maleknia M, Ansari N, Haybar H, Maniati M, Saki N. Inflammatory Growth Factors and In-Stent Restenosis: Effect of Cytokines and Growth Factors. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42399-020-00240-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Liu R, Dai L, Si C, Zeng Z. Antibacterial and hemostatic hydrogel via nanocomposite from cellulose nanofibers. Carbohydr Polym 2018; 195:63-70. [DOI: 10.1016/j.carbpol.2018.04.085] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/19/2018] [Accepted: 04/21/2018] [Indexed: 12/20/2022]
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Li Z, Jiang Z, Zhao L, Yang X, Zhang J, Song X, Liu B, Ding J. PEGylated stereocomplex polylactide coating of stent for upregulated biocompatibility and drug storage. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 81:443-451. [PMID: 28887996 DOI: 10.1016/j.msec.2017.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 07/24/2017] [Accepted: 08/02/2017] [Indexed: 02/05/2023]
Abstract
Treatment of coronary heart disease by percutaneous coronary intervention (PCT) is usually limited to the high restenosis rate after implantation of bare-metal stent. To solve the problem, the coating of PEGylated stereocomplex poly(l-lactide) (PEG-cPLA) was utilized on the surface modification of stainless steel (SS) sheet. Specifically, the 3-aminopropyltriethoxysilane (APTES)-modified methoxy-poly(ethylene glycol)-poly(d-lactide) (mPEG-PDLA) was grafted onto the surface of hydroxylated SS sheet through coupling reaction, and poly(l-lactide)-poly(ethylene glycol)-poly(l-lactide) (PLLA-PEG-PLLA) was coated onto the surface through stereocomplex interaction between DLA and LLA units. The increase of contact angle firstly confirmed the changes of surface composition and hydrophilicity for the PEG-scPLA-modified SS sheet. The decreased fibrinogen adsorption, down-regulated platelet activation, and improved adhesion of human umbilical vein endothelial cells (HUVECs) indicated the excellent biocompatibility of PEG-scPLA-modified SS sheet. In addition, the drug loading capability of SS sheet was greatly upregulated through the formation of scPLA coating on the surface, where fluorescein (FLU) was chosen as a model molecule. Overall, the surface modification of SS sheet with PEG-scPLA could enhance the comprehensive performances, such as biocompatibility and drug loading capability, demonstrating that PEG-scPLA is a promising coating of coronary stent for PCT.
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Affiliation(s)
- Zhibo Li
- Department of Cardiology, The Second Hospital of Jilin University, Changchun 130041, PR China
| | - Zhongyu Jiang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, PR China
| | - Lei Zhao
- Department of Cardiology, The Second Hospital of Jilin University, Changchun 130041, PR China
| | - Xianrui Yang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China
| | - Jin Zhang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, PR China; College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, PR China
| | - Xianjing Song
- Department of Cardiology, The Second Hospital of Jilin University, Changchun 130041, PR China
| | - Bin Liu
- Department of Cardiology, The Second Hospital of Jilin University, Changchun 130041, PR China.
| | - Jianxun Ding
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, PR China
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Inhibitory Effect of Propolis on Platelet Aggregation In Vitro. JOURNAL OF HEALTHCARE ENGINEERING 2017; 2017:3050895. [PMID: 29129989 PMCID: PMC5654250 DOI: 10.1155/2017/3050895] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/02/2017] [Indexed: 12/03/2022]
Abstract
Platelet hyperactivity plays an important role in arterial thrombosis and atherosclerosis. The present study was aimed to investigate the effects of different extracts of propolis and components of flavonoids on platelet aggregation. Platelet-rich plasma was prepared and incubated in vitro with different concentrations of the tested extracts and components of flavonoids. Platelets aggregation was induced by different agonists including adenosine diphosphate (ADP, 10 μM), thrombin receptor activator peptide (TRAP, 50 μM), and collagen (5 μg/mL). At 25 mg/L to 300 mg/mL, the water extract propolis (WEP) inhibited three agonists-induced platelet aggregations in a dose-dependent manner. The flavonoids isolated from the propolis also showed markedly inhibited platelet aggregation induced by collagen, ADP, and TRAP, respectively. The components including caffeic acid phenethyl ester (CAPE), galangin, apigenin, quercetin, kaempferol, ferulic acid, rutin, chrysin, pinostrobin, and pinocembrin and their abilities of inhibiting platelet aggregation were studied. It was concluded that propolis had an antiplatelet action in which flavonoids were mainly implicated.
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Silicone rubber with mussel-inspired adhesive coatings for enhancing antifouling property and blood compatibility. Macromol Res 2017. [DOI: 10.1007/s13233-017-5092-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Braune S, Sperling C, Maitz MF, Steinseifer U, Clauser J, Hiebl B, Krajewski S, Wendel HP, Jung F. Evaluation of platelet adhesion and activation on polymers: Round-robin study to assess inter-center variability. Colloids Surf B Biointerfaces 2017; 158:416-422. [PMID: 28719863 DOI: 10.1016/j.colsurfb.2017.06.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 06/28/2017] [Accepted: 06/30/2017] [Indexed: 11/19/2022]
Abstract
The regulatory agencies provide recommendations rather than protocols or standard operation procedures for the hemocompatibility evaluation of novel materials e.g. for cardiovascular applications. Thus, there is a lack of specifications with regard to test setups and procedures. As a consequence, laboratories worldwide perform in vitro assays under substantially different test conditions, so that inter-laboratory and inter-study comparisons are impossible. Here, we report about a prospective, randomized and double-blind multicenter trial which demonstrates that standardization of in vitro test protocols allows a reproducible assessment of platelet adhesion and activation from fresh human platelet rich plasma as possible indicators of the thrombogenicity of cardiovascular implants. Standardization of the reported static in vitro setup resulted in a laboratory independent scoring of the following materials: poly(dimethyl siloxane) (PDMS), poly(ethylene terephthalate) (PET) and poly(tetrafluoro ethylene) (PTFE). The results of this in vitro study provide evidence that inter-laboratory and inter-study comparisons can be achieved for the evaluation of the adhesion and activation of platelets on blood-contacting biomaterials by stringent standardization of test protocols.
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Affiliation(s)
- S Braune
- Institute of Biomaterial Science and Berlin-Brandenburg Centre for Regenerative Therapies (BCRT), Helmholtz-Zentrum Geesthacht, Teltow, Germany
| | - C Sperling
- Max Bergmann Center of Biomaterials Dresden, Leibniz Institute of Polymer Research Dresden, Dresden, Germany
| | - M F Maitz
- Max Bergmann Center of Biomaterials Dresden, Leibniz Institute of Polymer Research Dresden, Dresden, Germany
| | - U Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering Helmholtz-Institute, RWTH Aachen University, Aachen, Germany
| | - J Clauser
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering Helmholtz-Institute, RWTH Aachen University, Aachen, Germany
| | - B Hiebl
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behaviour, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - S Krajewski
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - H P Wendel
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - F Jung
- Institute of Biomaterial Science and Berlin-Brandenburg Centre for Regenerative Therapies (BCRT), Helmholtz-Zentrum Geesthacht, Teltow, Germany.
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Sukavaneshvar S. Device thrombosis and pre-clinical blood flow models for assessing antithrombogenic efficacy of drug-device combinations. Adv Drug Deliv Rev 2017; 112:24-34. [PMID: 27496706 DOI: 10.1016/j.addr.2016.07.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 05/31/2016] [Accepted: 07/26/2016] [Indexed: 12/20/2022]
Abstract
Thrombosis associated with blood-contacting devices is a complex process involving several component interactions that have eluded precise definition. Extensive investigations of individual biological modules such as protein adsorption, coagulation cascade activation and platelet activation/adhesion/aggregation have provided an initial foundation for developing biomaterials for blood-contacting devices, but a material that is intrinsically non-thrombogenic is yet to be developed. The well-recognized association between fluid dynamics parameters such as shear stress, vortices, stagnation and thrombotic processes such as platelet aggregation and coagulation aggravate thrombosis on most device geometries that elicit these flow disturbances. Thus, antithrombotic drugs that were developed to treat thrombosis associated with vascular diseases such as atherosclerosis have also been adapted to mitigate the risk of device thrombosis. However, balancing the risk of bleeding with the antithrombotic efficacy of these drugs continues to be a challenge, and surface modification of devices with these drug molecules to mitigate device thrombosis locally has been explored. Pre-clinical blood flow models to test the effectiveness of these drug-device combinations have also evolved and several in-vitro, ex-vivo, and in-vivo test configurations are available with their attendant merits and limitations. Despite considerable efforts toward iterative design and testing of blood contacting devices and antithrombogenic surface modifications, device thrombosis remains an unsolved problem.
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