In vitro capacity of different grades of chitosan derivatives to induce platelet adhesion and aggregation

Chitosan-based materials for dental implantology: A comprehensive review

Chitosan, a versatile biopolymer, has gained recognition in the discipline of dental implantology due to possessing salient properties. This comprehensive review explores the potential of chitosan in dental implants, focusing on its biocompatibility, bioactivity, and the various chitosan-based materials that have been utilized for dental implant therapy. The review also highlights the importance of surface treatment in dental implants to enhance osseointegration and inhibit bacterial biofilm formation. Additionally, the chemical structure, properties, and sources of chitosan are described, along with its different structural forms. The characteristics of chitosan particularly color, molecular weight, viscosity, and degree of deacetylation are discussed about their influence on its applications. This review provides valuable insights into the promising utilization of polymeric chitosan in enhancing the success and functionality of dental implants. This study highlights the potential applications of chitosan in oral implantology. Chitosan possesses various advantageous properties, including muco-adhesiveness, hemostatic action, biocompatibility, biodegradability, bioactivity, and antibacterial and antifungal activities, which enhance its uses in dental implantology. However, it has limited aqueous solubility at the physiological pH, which sometimes restricts its biological application, but this problem can be overcome by using modified chitosan or chitosan derivatives, which have also shown encouraging results. Recent research suggests that chitosan may act as a promising material for coating titanium-based implants, improving osteointegration together with antibacterial properties.

Chitosan: A review of molecular structure, bioactivities and interactions with the human body and micro-organisms

Chitosan has many desirable attributes e.g. antimicrobial properties and promoting wound healing, and is used in various applications. This article first discusses how degree of deacetylation (DD) and molecular weight (MW) impacts on what level of bioactivities chitosan manifests, then introduces the "molecular chain configuration" model to explain various possible mechanisms of antimicrobial interactions between chitosan with different MW and different types of bacteria. Similarly, the possible pathways of how chitosan reacts with cancer and the body's immune system to demonstrate immune and antitumor effects are also discussed by using this model. Moreover, the possible mechanisms of how chitosan enhances coagulation and wound healing are also discussed. With these beneficial bioactivities in mind, the application of chitosan in surgery, tissue engineering and oncology is outlined. This review concludes that as chitosan demonstrates many beneficial bioactivities via multiple mechanisms, it is an important polymer with a promising future in medicine.

Effects and treatment applications of polymeric nanoparticles on improving platelets' storage time: a review of the literature from 2010 to 2020

Maintaining the quality of platelet products and increasing their storage time are priorities for treatment applications. The formation of platelet storage lesions that limit the storage period and preservation temperature, which can prepare a decent environment for bacterial growth, are the most important challenges that researchers are dealing with in platelet preservation. Nanotechnology is an emerging field of science that has introduced novel solutions to resolve these problems. Here, we reviewed the reported effects of polymeric nanoparticles-including chitosan, dendrimers, polyethylene glycol (PEG), and liposome-on platelets in articles from 2010 to 2020. As a result, we concluded that the presence of dendrimer nanoparticles with a smaller size, negative charge, low molecular weight, and low concentration along with PEGylation can increase the stability and survival of platelets during storage. In addition, PEGylation of platelets can also be a promising approach to improve the quality of platelet bags during storage.

Chitin/Chitosan: Versatile Ecological, Industrial, and Biomedical Applications

Chitin is a linear polysaccharide of N-acetylglucosamine, which is highly abundant in nature and mainly produced by marine crustaceans. Chitosan is obtained by hydrolytic deacetylation. Both polysaccharides are renewable resources, simply and cost-effectively extracted from waste material of fish industry, mainly crab and shrimp shells. Research over the past five decades has revealed that chitosan, in particular, possesses unique and useful characteristics such as chemical versatility, polyelectrolyte properties, gel- and film-forming ability, high adsorption capacity, antimicrobial and antioxidative properties, low toxicity, and biocompatibility and biodegradability features. A plethora of chemical chitosan derivatives have been synthesized yielding improved materials with suggested or effective applications in water treatment, biosensor engineering, agriculture, food processing and storage, textile additives, cosmetics fabrication, and in veterinary and human medicine. The number of studies in this research field has exploded particularly during the last two decades. Here, we review recent advances in utilizing chitosan and chitosan derivatives in different technical, agricultural, and biomedical fields.

Investigation of the Effects of Molecular Parameters on the Hemostatic Properties of Chitosan

Hemorrhea is one of the major problems in war, trauma care, and surgical operation that threaten the life of the injured and patients. As a novel polymeric hemostatic agent, biodegradable chitosan can stop bleeding through a variety of approaches. In this paper, chitosan with various molecular parameters was prepared from chitin as raw material through deacetylation, oxidative degradation, hydrophilic modification, and salt formation reactions. The influence of different polymer parameters on the hemostatic effects of chitosan was investigated by in vitro coagulation time and dynamic coagulation assay. The results showed that when the molecular weights were high (10⁵⁻10⁶) and approximate, the coagulation effect of chitosan improved with a decrease of the deacetylation degree and achieved a prominent level in a moderate degree of deacetylation (68.36%). With the same degree of deacetylation, the higher the molecular weight of chitosan, the better the procoagulant effect. The substituent derivatives and acid salts of chitosan showed significant procoagulant effects, especially the acid salts of chitosan. In addition, the hemostasis mechanism of chitosan with various parameters was preliminarily explored by analyzing the plasma recalcification time (PRT). The efforts in this paper laid a basis for further study of the structure⁻activity relationship and the mechanism of chitosan hemostasis.

Efficacy of chitosan derivative films versus hydrocolloid dressing on superficial wounds

Objectives

Chitosan, the N-deacetylated derivative of chitin, has useful biological properties that promote haemostasis, analgesia, wound healing, and scar reduction; chitosan is bacteriostatic, biocompatible, and biodegradable. This study determined the efficacy of chitosan derivative film as a superficial wound dressing.

Methods

This multicentre randomised controlled trial included 244 patients, of whom 86 were treated with chitosan derivative film and 84 with hydrocolloid. The percentage of epithelisation, as well as patient comfort, clinical signs, and patient convenience in application and removal of the dressings were assessed.

Results

The primary outcome of this study was the percentage of epithelisation. Except for race (p = 0.04), there were no significant differences between groups in sex, age, antibiotic usage, or initial wound size (p > 0.05). There was no significant difference in the mean epithelisation percentage between groups (p = 0.29). Patients using chitosan derivative film experienced more pain during removal of dressing than those in the hydrocolloid group (p = 0.007). The chitosan derivative film group showed less exudate (p = 0.036) and less odour (p = 0.024) than the control group. Furthermore, there were no significant differences between groups in terms of adherence, ease of removal, wound drainage, erythema, itchiness, pain, and tenderness. No oedema or localised warmth was observed during the study.

Conclusion

This study concluded that chitosan derivative film is equivalent to hydrocolloid dressing and can be an option in the management of superficial and abrasion wounds.

Clinical trial No

NMRR-11-948-10565.

Different chemical groups modification on the surface of chitosan nonwoven dressing and the hemostatic properties

The hemostatic properties of surface modified chitosan nonwoven had been investigated. The succinyl groups, carboxymethyl groups and quaternary ammonium groups were introduced into the surface of chitosan nonwoven (obtained NSCS, CMCS and TMCS nonwoven, respectively). For blood clotting, absorbance value (0.105±0.03) of NSCS1 nonwoven was the smallest (CS 0.307±0.002, NSCS2 0.148±0.002, CMCS1 0.195±0.02, CMCS2 0.233±0.001, TMCS1 0.191±0.002, TMCS2 0.345±0.002), which indicated the stronger hemostatic potential. For platelet aggregation, adenosine diphosphate agonist was added to induce the nonwoven to adhered platelets. The aggregation of platelet with TMCS2 nonwoven was highest (10.97±0.16%). Further research of blood coagulation mechanism was discussed, which indicated NSCS and CMCS nonwoven could activate the intrinsic pathway of coagulation to accelerate blood coagulation. NSCS1 nonwoven showed the shortest hemostatic time (147±3.7s) and the lowest blood loss (0.23±0.05g) in a rabbit ear artery injury model. These results demonstrated that these surface modified chitosan nonwoven dressings could use as a promising hemostatic intervention, especially NSCS nonwoven dressing.

Hemostyptic property of chitosan: Opportunities and pitfalls

BACKGROUND

Chitosan is used in a wide field of applications and therapies and has been reported to be an effective hemostyptic. The objective of this study was to provide further information about the use of chitosan as a hemostyptic agent also taking into focus its hemocompatible effects.

METHODS

Human whole blood (n=5) was anticoagulated with heparin, treated with different chitosan concentrations (0, 2.5, 5, 7.5, 10, 12.5, 25 mg/mL) and incubated at 37°C for 30 minutes. Before and after incubation different parameters for coagulation and hemocompatibility were evaluated.

RESULTS

Blood treated with high chitosan concentrations showed enhanced coagulation, which we evaluated with activated clotting time, activated partial thromboplastin time and concentration of thrombin-antithrombin complexes. Furthermore, we observed an activation of blood platelets, complement cascade and granulocytes in the groups treated with chitosan.

CONCLUSION

Our data indicate that chitosan activates human blood coagulation and hence has good properties as a hemostyptic agent. However, inflammatory parameters were upregulated after direct contact with human blood indicating that systemic administration of chitosans should not be performed whereas the topical use of chitosan as a hemostypticum should not present any hazard with regard to adverse inflammatory reactions at the site of application.

Effect of the Novel Biodegradable N, O-Carboxymethylchitosan and Oligo-Chitosan on the Platelet Thrombogenicity Cascade in von Willebrand Disease

INTRODUCTION

Von Willebrand disease (vWD) is the second least common hemostatic disorder in Malaysia, and it has a low prevalence. This study examined the underlying platelet thrombogenicity cascades in the presence of different formulations of chitosan-derivatives in vWD patients. This paper aimed to determine the significant influence of chitosan biomaterial in stimulating the platelet thrombogenicity cascades that involve the von Willebrand factor, Factor 8, Thromboxane A2, P2Y12 and Glycoprotein IIb/IIIa in vWD.

MATERIALS AND METHODS

Variable chitosan formulations of N,O-Carboxymethylchitosan (NO-CMC) and Oligo-Chitosan (O-C) were tested. Fourteen vWD subjects voluntarily participated in this study after signing informed consent forms. The patient's demographic profiles, family history, type of vWD, clinical symptoms and laboratory profiles were recorded and analyzed. Enzyme-linked immunosorbent assay, flow cytometry and Western blot tests were used to determine the level of the chitosan-adhered-platelet-mechanisms.

RESULTS

The study revealed that most patients were predominantly affected by vWD type I. The O-C group of chitosan's scaffold pores is sufficient to allow for nutrients and cells. The O-C-stimulated-mediators are capable of initiating the platelet actions and were detected to expedite the blood coagulation processes. The oligo-group of chitosans was capable of amplifying and triggering more platelet activator's pathways via the studied mediators. The present findings suggest that the ability of each type of chitosan to coagulate blood varies depending on its chemical composition.

CONCLUSION

The oligo group of chitosans is potentially capable of triggering platelet thrombogenicity cascades by activating platelets in vWD patients to form a platelet plug for hemostasis process.

A Bilayer Engineered Skin Substitute for Wound Repair in an Irradiation-Impeded Healing Model on Rat

Objective: An engineered skin substitute is produced to accelerate wound healing by increasing the mechanical strength of the skin wound via high production of collagen bundles. During the remodeling stage of wound healing, collagen deposition is the most important event. The collagen deposition process may be altered by nutritional deficiency, diabetes mellitus, microbial infection, or radiation exposure, leading to impaired healing. This study describes the fabrication of an engineered bilayer skin substitute and evaluates its effectiveness for the production of collagen bundles in an impaired healing model. Approach: Rats were exposed to 10 Gy of radiation. Two months postirradiation, the wounds were excised and treated with one of three skin replacement products: bilayer engineered skin substitutes, chitosan skin templates, or duoderm^©. The collagen deposition was analyzed by hematoxylin and eosin staining. Results: On day 21 postwound, the irradiated wounds displayed increased collagen bundle deposition after treatment using bilayer engineered skin substitutes (3.4±0.25) and chitosan skin templates (3.2±0.58) compared with duoderm (2.0±0.63). Innovation: We provide the first report on the fabrication of bilayer engineered skin substitutes using high density human dermal fibroblasts cocultured with HFSCs on chitosan skin templates. Conclusion: The high density of fibroblasts significantly increases the penetration of cells into chitosan skin templates, contributing to the fabrication of bilayer engineered skin substitute.

Glycoprotein IIb/IIIa and P2Y12 induction by oligochitosan accelerates platelet aggregation

Platelet membrane receptor glycoprotein IIb/IIIa (gpiibiiia) is a receptor detected on platelets. Adenosine diphosphate (ADP) activates gpiibiiia and P2Y₁₂, causing platelet aggregation and thrombus stabilization during blood loss. Chitosan biomaterials were found to promote surface induced hemostasis and were capable of activating blood coagulation cascades by enhancing platelet aggregation. Our current findings show that the activation of the gpiibiiia complex and the major ADP receptor P2Y₁₂ is required for platelet aggregation to reach hemostasis following the adherence of various concentrations of chitosan biomaterials [7% N,O-carboxymethylchitosan (NO-CMC) with 0.45 mL collagen, 8% NO-CMC, oligochitosan (O-C), and oligochitosan 53 (O-C 53)]. We studied gpiibiiia and P2Y₁₂ through flow cytometric analysis and western blotting techniques. The highest expression of gpiibiiia was observed with Lyostypt (74.3 ± 7.82%), followed by O-C (65.5 ± 7.17%). Lyostypt and O-C resulted in gpiibiiia expression increases of 29.2% and 13.9%, respectively, compared with blood alone. Western blot analysis revealed that only O-C 53 upregulated the expression of P2Y₁₂ (1.12 ± 0.03-fold) compared with blood alone. Our findings suggest that the regulation of gpiibiiia and P2Y₁₂ levels could be clinically useful to activate platelets to reach hemostasis. Further, we show that the novel oligochitosan is able to induce the increased expression of gpiibiiia and P2Y₁₂, thus accelerating platelet aggregation in vitro.

Skin Tissue Surface Morphology and Quality of RNA and Protein Extracted from Fresh and Stabilized Human Cleft Lip and Palate Tissue

Cleft lip palate is a human congenital disorder worldwide and the study of this genetic disease requires molecular genetic analysis. This analysis required the use of nucleic acid and protein, thus good quality and quantity of its extraction is important. We are comparing RNA and protein extractions from tissue biopsy of cleft lip palate in both fresh and stabilized condition. Tissue morphology was also captured using Scanning Electron Microscopy (SEM) for any morphology differences. Tissue homogenization may destroy nucleic acid stability but not its morphology. Low RNA concentration from stabilized tissue was found. However, there was no crucial issue of protein extraction, degradation or concentration. Tissue morphology was slight different between normal and CL/P tissue.

Hemostatic polymers: the concept, state of the art and perspectives

This article presents a critical overview of the most significant developments in the use of polymers as hemostatic agents.

Chitosan stabilizes platelet growth factors and modulates stem cell differentiation toward tissue regeneration

The idea of using chitosan as a functional delivery aid to support simultaneously PRP, stem cells and growth factors (GF) is associated with the intention to use morphogenic biomaterials to modulate the natural healing sequence in bone and other tissues. For example, chitosan-chondroitin sulfate loaded with platelet lysate was included in a poly(D,L-lactate) foam that was then seeded with human adipose-derived stem cells and cultured in vitro under osteogenic stimulus: the platelet lysate provided to the bone tissue the most suitable assortment of GF which induces the osteogenic differentiation of the mesenchymal stem cells. PDGF, FGF, IGF and TGF-β were protagonists in the repair of callus fractures. The release of GF from the composites of chitosan-PRP and either nano-hydroxyapatite or tricalcium phosphate was highly beneficial for enhancing MSC proliferation and differentiation, thus qualifying chitosan as an excellent vehicle. A number of biochemical characteristics of chitosan exert synergism with stem cells in the regeneration of soft tissues.