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Bozza A, Bernardi M, Catanzaro D, Chieregato K, Merlo A, Astori G. Enalaprilat and losartan decrease erythroid precursors frequency in cells from patients with polycythemia vera. Hematology 2023; 28:2182056. [PMID: 36856520 DOI: 10.1080/16078454.2023.2182056] [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: 03/02/2023] Open
Abstract
OBJECTIVE Polycythemia Vera (PV) is a myeloproliferative neoplasm characterized by the overproduction of red blood cells. First-line therapies are directed at lowering hematocrit levels. After the discovery of a mutation in the Janus kinase 2 (JAK2V617F), JAK2 inhibitors have been tested as second-line therapies. Despite these approaches, there is still the need for a major comprehension of the mechanisms involved in PV erythrocytosis and of more effective therapies. Angiotensin-converting enzyme (ACE) stimulates hematopoietic precursors proliferation and erythroid differentiation. We thus hypothesized that ACE inhibition could help in controlling erythrocytosis in PV. METHODS We assessed the clonogenic potential by colony-forming unit (CFU) assay of mononuclear cells isolated from PV JAK2 positive or JAK2 negative patients with erythrocytosis treated with enalaprilat or losartan. RESULTS Treatment with drugs led to a decrease of erythroid precursor frequency both in the presence and absence of JAK2 mutation, with a high extent in JAK2 positive cells and without affecting other types of precursors. No dose-dependent effect was observed. CONCLUSIONS Our results demonstrate that ACE inhibition reduces erythroid precursor frequency, confirming the involvement of ACE in erythrocytosis despite the presence of JAK2 mutation and encouraging the hypothesis that ACE inhibitors and AT1R antagonists could help in directly managing erythrocytosis in PV.
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Affiliation(s)
- Angela Bozza
- Advanced Cellular Therapy Laboratory, Haematology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Martina Bernardi
- Advanced Cellular Therapy Laboratory, Haematology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Daniela Catanzaro
- Advanced Cellular Therapy Laboratory, Haematology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Katia Chieregato
- Advanced Cellular Therapy Laboratory, Haematology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Anna Merlo
- Advanced Cellular Therapy Laboratory, Haematology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Giuseppe Astori
- Advanced Cellular Therapy Laboratory, Haematology Unit, San Bortolo Hospital, Vicenza, Italy
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MDM2 antagonist idasanutlin in patients with polycythemia vera: results from a single-arm phase 2 study. Blood Adv 2021; 6:1162-1174. [PMID: 34933330 PMCID: PMC8864654 DOI: 10.1182/bloodadvances.2021006043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/19/2021] [Indexed: 12/01/2022] Open
Abstract
Idasanutlin showed clinical activity in patients with HU-resistant/-intolerant PV, but chronic toxicity led to a high discontinuation rate. Significant reductions in JAK2 allele burden occurred after 3 treatment cycles and were greatest in patients with clinical response.
Idasanutlin, an MDM2 antagonist, showed clinical activity and a rapid reduction in JAK2 V617F allele burden in patients with polycythemia vera (PV) in a phase 1 study. This open-label phase 2 study evaluated idasanutlin in patients with hydroxyurea (HU)-resistant/-intolerant PV, per the European LeukemiaNet criteria, and phlebotomy dependence; prior ruxolitinib exposure was permitted. Idasanutlin was administered once daily on days 1 through 5 of each 28-day cycle. The primary end point was composite response (hematocrit control and spleen volume reduction > 35%) in patients with splenomegaly and hematocrit control in patients without splenomegaly at week 32. Key secondary end points included safety, complete hematologic response (CHR), patient-reported outcomes, and molecular responses. All patients (n = 27) received idasanutlin; 16 had response assessment (week 32). Among responders with baseline splenomegaly (n = 13), 9 (69%) attained any spleen volume reduction, and 1 achieved composite response. Nine patients (56%) achieved hematocrit control, and 8 patients (50%) achieved CHR. Overall, 43% of evaluable patients (6/14) showed a ≥50% reduction in the Myeloproliferative Neoplasm Symptom Assessment Form Total Symptom Score (week 32). Nausea (93%), diarrhea (78%), and vomiting (41%) were the most common adverse events, with grade ≥ 3 nausea or vomiting experienced by 3 patients (11%) and 1 patient (4%), respectively. Reduced JAK2 V617F allele burden occurred early (after 3 cycles), with a median reduction of 76%, and was associated with achieving CHR and hematocrit control. Overall, the idasanutlin dosing regimen showed clinical activity and rapidly reduced JAK2 allele burden in patients with HU-resistant/- intolerant PV but was associated with low-grade gastrointestinal toxicity, leading to poor long-term tolerability. This trial was registered at www.clinincaltrials.gov as #NCT03287245.
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3
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Ojagh SMA, Vahabzadeh F, Karimi A. Synthesis and characterization of bacterial cellulose-based composites for drug delivery. Carbohydr Polym 2021; 273:118587. [PMID: 34560988 DOI: 10.1016/j.carbpol.2021.118587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 01/10/2023]
Abstract
Bacterial cellulose (BC) was produced via the static fermentation process using G. xylinus. Cellulose and diethylaminoethyl cellulose (DEAEC) were converted to carboxymethyl cellulose (CMC) and carboxymethylated diethylaminoethyl cellulose (CMDEAEC) while to prepare the composites, two different methods were used: by either direct addition of the materials to the fermentation medium or addition of the materials after the fermentation process. Structural characteristics of composites were determined using instrumental techniques. Potential application of BC, BC/CMC, and BC/CMDEAEC in drug delivery system was examined using methylene blue (MB) as a model drug where the loading capacity and swelling ratio for the samples were as follows: BC/CMC > BC/CMDEAEC > BC. The result of the in-vitro study was in favor of the release behavior of BC/CMDEAEC composite. The MB loading data were fitted using Langmuir and Freundlich equations and kinetic behavior of the release was described by Higuchi and Korsmeyer-Peppas models.
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Affiliation(s)
| | - Farzaneh Vahabzadeh
- Department of Chemical Engineering, Amirkabir University of Technology, Tehran, Iran.
| | - Afzal Karimi
- Department of biotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
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4
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Shwaylia H, Ali E, Yassin MA. Interferon-Alpha 2-a and Its Dual Effect in Treating Two Diseases (Hepatitis C and Polycythemia Vera). Case Rep Oncol 2021; 14:851-854. [PMID: 34248550 PMCID: PMC8255747 DOI: 10.1159/000515782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 11/19/2022] Open
Abstract
Hepatitis C and polycythemia vera (PV) co-existence is not rare; it has been reported in the literature. Treatment with interferon (IFN) has been used to treat both conditions; however, the use of IFN in concomitant hepatitis C infection with PV and its outcome are rarely described in the literature. Here, we report a 56-years-old male patient with hepatitis C virus infection and PV, who was treated with IFN for his chronic hepatitis C, which resulted in significant improvement of HB as well as normalization of his bone marrow and eradication of the clone (Jak2 V617F).
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Affiliation(s)
- Hawraa Shwaylia
- Department of Medical Oncology, Hamad Medical Corporation, Doha, Qatar
| | - Elrazi Ali
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A Yassin
- Department of Medical Oncology, Hamad Medical Corporation, Doha, Qatar
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5
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Büyükaşık Y, Ali R, Turgut M, Saydam G, Yavuz AS, Ünal A, Ar MC, Ayyıldız O, Altuntaş F, Okay M, Çiftçiler R, Meletli Ö, Soyer N, Mastanzade M, Güven Z, Soysal T, Karakuş A, Yiğenoğlu TN, Uçar B, Gökçen E, Tuğlular T. Patterns of Hydroxyurea Prescription and Use in Routine Clinical Management of Polycythemia Vera: A Multicenter Chart Review Study. Turk J Haematol 2020; 37:177-185. [PMID: 32075363 PMCID: PMC7463219 DOI: 10.4274/tjh.galenos.2020.2019.0431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: This study aimed to evaluate real-life data on patterns of hydroxyurea prescription/use in polycythemia vera (PV). Materials and Methods: This retrospective chart review study included PV patients who had received hydroxyurea therapy for at least 2 months after PV diagnosis. Data were collected from 10 representative academic medical centers. Results: Of 657 patients, 50.9% were in the high-risk group (age ≥60 years and/or history of thromboembolic event). The median duration of hydroxyurea therapy was 43.40 months for all patients; 70.2% of the patients had ongoing hydroxyurea therapy at last follow-up. Hydroxyurea was discontinued in 22.4% of the patients; the most common reason was death (38.5%). The predicted time until hydroxyurea discontinuation was 187.8 months (standard error: ±21.7) for all patients. This duration was shorter in females (140.3±37.7 vs. 187.8±29.7) (p=0.08). This trend was also observed in surviving patients aged ≥50 years at hydroxyurea initiation (122.2±12.4 vs. 187.8±30.7, p=0.03). Among the patients who were still on hydroxyurea therapy, 40.3% had a hematocrit concentration of ≥45% at their last follow-up visit, and the rate of patients with at least one elevated blood cell count was 67.8%. Conclusion: Hydroxyurea prescription patterns and treatment aims are frequently not in accordance with the guideline recommendations. Its discontinuation rate is higher in females.
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Affiliation(s)
- Yahya Büyükaşık
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Rıdvan Ali
- Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
| | - Mehmet Turgut
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Güray Saydam
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Akif Selim Yavuz
- İstanbul University, İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Ali Ünal
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Muhlis Cem Ar
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Orhan Ayyıldız
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Fevzi Altuntaş
- Yıldırım Beyazıt University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey,Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Division of Hematology, Ankara, Turkey
| | - Müfide Okay
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Rafiye Çiftçiler
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Özgür Meletli
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Nur Soyer
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Metban Mastanzade
- İstanbul University, İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Zeynep Güven
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Teoman Soysal
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Abdullah Karakuş
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Tuğçe Nur Yiğenoğlu
- Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Division of Hematology, Ankara, Turkey
| | | | | | - Tülin Tuğlular
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
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Molina V, Rodríguez-Vázquez L, Martí J. Patterns of Apoptosis and Autophagy Activation After Hydroxyurea Exposure in the Rat Cerebellar External Granular Layer: an Immunoperoxidase and Ultrastructural Analysis. Neurotox Res 2019; 37:93-99. [DOI: 10.1007/s12640-019-00094-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/24/2019] [Accepted: 07/30/2019] [Indexed: 12/14/2022]
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Brusson M, De Grandis M, Cochet S, Bigot S, Marin M, Leduc M, Guillonneau F, Mayeux P, Peyrard T, Chomienne C, Le Van Kim C, Cassinat B, Kiladjian JJ, El Nemer W. Impact of hydroxycarbamide and interferon-α on red cell adhesion and membrane protein expression in polycythemia vera. Haematologica 2018; 103:972-981. [PMID: 29599206 PMCID: PMC6058771 DOI: 10.3324/haematol.2017.182303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 03/21/2018] [Indexed: 01/13/2023] Open
Abstract
Polycythemia vera is a chronic myeloproliferative neoplasm characterized by the JAK2V617F mutation, elevated blood cell counts and a high risk of thrombosis. Although the red cell lineage is primarily affected by JAK2V617F, the impact of mutated JAK2 on circulating red blood cells is poorly documented. Recently, we showed that in polycythemia vera, erythrocytes had abnormal expression of several proteins including Lu/BCAM adhesion molecule and proteins from the endoplasmic reticulum, mainly calreticulin and calnexin. Here we investigated the effects of hydroxycarbamide and interferon-α treatments on the expression of erythroid membrane proteins in a cohort of 53 patients. Surprisingly, while both drugs tended to normalize calreticulin expression, proteomics analysis showed that hydroxycarbamide deregulated the expression of 53 proteins in red cell ghosts, with overexpression and downregulation of 37 and 16 proteins, respectively. Within over-expressed proteins, hydroxycarbamide was found to enhance the expression of adhesion molecules such as Lu/BCAM and CD147, while interferon-α did not. In addition, we found that hydroxycarbamide increased Lu/BCAM phosphorylation and exacerbated red cell adhesion to its ligand laminin. Our study reveals unexpected adverse effects of hydroxycarbamide on red cell physiology in polycythemia vera and provides new insights into the effects of this molecule on gene regulation and protein recycling or maturation during erythroid differentiation. Furthermore, our study shows deregulation of Lu/BCAM and CD147 that are two ubiquitously expressed proteins linked to progression of solid tumors, paving the way for future studies to address the role of hydroxycarbamide in tissues other than blood cells in myeloproliferative neoplasms.
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Affiliation(s)
- Mégane Brusson
- Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles.,Institut National de la Transfusion Sanguine, F-75015 Paris.,Laboratoire d'Excellence GR-Ex, Paris
| | - Maria De Grandis
- Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles.,Institut National de la Transfusion Sanguine, F-75015 Paris.,Laboratoire d'Excellence GR-Ex, Paris
| | - Sylvie Cochet
- Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles.,Institut National de la Transfusion Sanguine, F-75015 Paris.,Laboratoire d'Excellence GR-Ex, Paris
| | - Sylvain Bigot
- Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles.,Institut National de la Transfusion Sanguine, F-75015 Paris.,Laboratoire d'Excellence GR-Ex, Paris
| | - Mickaël Marin
- Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles.,Institut National de la Transfusion Sanguine, F-75015 Paris.,Laboratoire d'Excellence GR-Ex, Paris
| | - Marjorie Leduc
- Plateforme de Protéomique de l'Université Paris Descartes (3P5), Institut Cochin, INSERM U1016, CNRS UMR 8104, Université Sorbonne Paris Cité, Laboratoire d'Excellence GR-Ex, Paris
| | - François Guillonneau
- Plateforme de Protéomique de l'Université Paris Descartes (3P5), Institut Cochin, INSERM U1016, CNRS UMR 8104, Université Sorbonne Paris Cité, Laboratoire d'Excellence GR-Ex, Paris
| | - Patrick Mayeux
- Plateforme de Protéomique de l'Université Paris Descartes (3P5), Institut Cochin, INSERM U1016, CNRS UMR 8104, Université Sorbonne Paris Cité, Laboratoire d'Excellence GR-Ex, Paris
| | - Thierry Peyrard
- Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles.,Institut National de la Transfusion Sanguine, F-75015 Paris.,Laboratoire d'Excellence GR-Ex, Paris
| | - Christine Chomienne
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm UMR-S1131, Hôpital Saint Louis, Institut Universitaire d'Hématologie, Laboratoire de Biologie Cellulaire, Paris.,AP-HP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris
| | - Caroline Le Van Kim
- Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles.,Institut National de la Transfusion Sanguine, F-75015 Paris.,Laboratoire d'Excellence GR-Ex, Paris
| | - Bruno Cassinat
- AP-HP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris
| | - Jean-Jacques Kiladjian
- Centre d'Investigations Cliniques, Hôpital Saint-Louis, Université Paris Diderot, Paris, France
| | - Wassim El Nemer
- Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, Université Paris Diderot, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles .,Institut National de la Transfusion Sanguine, F-75015 Paris.,Laboratoire d'Excellence GR-Ex, Paris
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Comorbidity, Physical Function, and Quality of Life in Older Adults with Acute Myeloid Leukemia. CURRENT GERIATRICS REPORTS 2017; 6:247-254. [PMID: 29479516 DOI: 10.1007/s13670-017-0227-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose of review To describe the pathology, impact of comorbidities, functional limitations, symptoms, and quality of life (QOL) related to treatment of acute myeloid leukemia (AML) in older adults. Recent findings AML is a rare aggressive hematologic disease that occurs most often in older adults. The prognosis for older patients with AML is markedly worse due to genetic mutations and patient characteristics such as comorbidities and functional limitations. Patient characteristics may influence treatment decisions, as well as impact symptoms, functional ability, health-related outcomes and (QOL). Summary As the population continues to age, the number of people diagnosed with AML is expected to increase. Better management of comorbidities is imperative to improving QOL and other treatment related outcomes. Prospective, longitudinal and multi-site studies are warranted to further understand the interaction between these characteristics on symptoms, outcomes and QOL.
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9
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Treesuppharat W, Rojanapanthu P, Siangsanoh C, Manuspiya H, Ummartyotin S. Synthesis and characterization of bacterial cellulose and gelatin-based hydrogel composites for drug-delivery systems. ACTA ACUST UNITED AC 2017; 15:84-91. [PMID: 28736723 PMCID: PMC5508509 DOI: 10.1016/j.btre.2017.07.002] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 06/16/2017] [Accepted: 07/04/2017] [Indexed: 11/04/2022]
Abstract
Gelatin and bacterial cellulose based hydrogel composite was successfully prepared as drug delivery system. Utilization of glutaraldehyde was employed as crosslinking agent for hydrogel formation. Green hydrogel presented the excellent swelling ratio.
Bacterial cellulose and gelatin were successfully used to develop a hydrogel composite material. Hydrogel was synthesized by copolymerization between bacterial cellulose and gelatin. Scanning electron microscopy (SEM) images showed that the bacterial cellulose chain was uniform in size and shape. Glutaraldehyde was employed as a crosslinking agent. H-bonds were formed via the reaction between the amine and hydroxyl groups, which were the functional groups of the gelatin and bacterial cellulose, respectively. The hydrogel composite presented excellent properties in terms of its thermal stability, chemical resistance, and mechanical properties. Moreover, the swelling ratio of the hydrogel network, in water, was estimated to be 400–600%. Importantly, the hydrogel composite developed during this study is considered a good candidate for drug-delivery systems.
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Affiliation(s)
- W Treesuppharat
- Drug Discovery and Development Center, Office of Advanced Science and Technology, Thammasat University, Patumtani 12120, Thailand
| | - P Rojanapanthu
- Drug Discovery and Development Center, Office of Advanced Science and Technology, Thammasat University, Patumtani 12120, Thailand
| | - C Siangsanoh
- Materials and Textile Technology, Faculty of Science and Technology, Thammasat University, Patumtani 12120, Thailand
| | - H Manuspiya
- The Petroleum and Petrochemical College, Center of Excellence on Petrochemical and Materials Technology, Chulalongkorn University, Bangkok 10330, Thailand
| | - S Ummartyotin
- Materials and Textile Technology, Faculty of Science and Technology, Thammasat University, Patumtani 12120, Thailand
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