Evaluating platelet activation related to the degradation of biomaterials using molecular markers

Dialdehyde pectin-crosslinked and hirudin-loaded decellularized porcine pericardium with improved matrix stability, enhanced anti-calcification and anticoagulant for bioprosthetic heart valves

To conveniently and effectively cure heart valve diseases or defects, combined with transcatheter valve technology, bioprosthetic heart valves (BHVs) originated from the decellularized porcine pericardium (D-PP) have been broadly used in clinics. Unfortunately, most clinically available BHVs crosslinked with glutaraldehyde (GA) were challenged in their long-term tolerance, degenerative structural changes, and even failure, owing to the synergistic impact of multitudinous elements (cytotoxicity, calcification, immune responses, etc.). In this work, dialdehyde pectin (AP) was prepared by oxidizing the o-dihydroxy of pectin with sodium periodate. Hereafter, the AP-fixed PP model was obtained by crosslinking D-PP with AP with high aldehyde content (6.85 mmol g^-1), for acquiring excellent mechanical properties and outstanding biocompatibility. To further improve the hemocompatibility of the AP-fixed PP, a natural and specific inhibitor of thrombin (hirudin) was introduced to achieve surface modification of the AP-fixed PP. The feasibility of crosslinking and functionalizing AP-fixed PP, which was a potential leaflet material of BHVs, was exhaustively and systematically evaluated. In vitro studies found that hirudin-loaded and AP-fixed PP (AP + Hirudin-PP) had synchronously achieved effective fixation of collagen, highly effective anticoagulation, and good HUVECs-cytocompatibility. In vivo results revealed that the AP + Hirudin-PP specimens recruited the minimum immune cells in the implantation experiment, and also presented an excellent anti-calcification effect. Overall, AP + Hirudin-PP was endowed with competitive collagen stability (compared with GA-fixed PP), excellent hemocompatibility, good HUVECs-cytocompatibility, low immunogenicity and outstanding anti-calcification, suggesting that AP + Hirudin-PP might be a promising alternative to GA-fixed PP and exhibited a bright prospect in the clinical applications of BHVs.

Evaluating platelet activation related to the degradation products of biomaterials using molecular markers

Increasing numbers of biodegradable medical devices may be used in the circulatory system. The effects of the released degradation products from these medical devices on the blood may be gradual and cumulative. When they reach critical levels, they may cause thrombosis and other complications. For this reason, it is important to evaluate the blood compatibility of degradation products for quality control and development of these devices. In the present study, we evaluated the degradation products of four biodegradable materials (collagen, polylactic acid, calcium phosphate ceramics, and magnesium) using platelet activation molecular markers that are associated with thrombosis. We found that the degradation products activate platelets to a certain extent, and that the degradation products produced during various degradation time periods activate platelets to varying degrees. This platelet activation occurs via several mechanisms, most of which are associated with the physicochemical properties of the degradation products, including ion concentration, pH, molecular microstructure, and molecular weight. Our findings not only provide a clearer understanding of the effects of degradation products from blood-contacting biodegradable devices, but also provide material for screening of degradation behavior so as to improve quality control for these devices.