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Sun L, Shen Y, Li M, Wang Q, Li R, Gong S. Comprehensive Assessment of Collagen/Sodium Alginate-Based Sponges as Hemostatic Dressings. Molecules 2024; 29:2999. [PMID: 38998951 PMCID: PMC11243721 DOI: 10.3390/molecules29132999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/17/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
In our search for a biocompatible composite hemostatic dressing, we focused on the design of a novel biomaterial composed of two natural biological components, collagen and sodium alginate (SA), cross-linked using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide/N-hydroxysuccinimide (EDC/NHS) and oxidized sodium alginate (OSA). We conducted a series of tests to evaluate the physicochemical properties, acute systemic toxicity, skin irritation, intradermal reaction, sensitization, cytotoxicity, and in vivo femoral artery hemorrhage model. The results demonstrated the excellent biocompatibility of the collagen/sodium alginate (C/SA)-based dressings before and after crosslinking. Specifically, the femoral artery hemorrhage model revealed a significantly shortened hemostasis time of 132.5 ± 12.82 s for the EDC/NHS cross-linked dressings compared to the gauze in the blank group (hemostasis time of 251.43 ± 10.69 s). These findings indicated that C/SA-based dressings exhibited both good biocompatibility and a significant hemostatic effect, making them suitable for biomedical applications.
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Affiliation(s)
- Leilei Sun
- College of Life Science, Yantai University, Yantai 264005, China; (Y.S.); (M.L.); (Q.W.); (R.L.); (S.G.)
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Sharma A, Verma C, Singh P, Mukhopadhyay S, Gupta A, Gupta B. Alginate based biomaterials for hemostatic applications: Innovations and developments. Int J Biol Macromol 2024; 264:130771. [PMID: 38467220 DOI: 10.1016/j.ijbiomac.2024.130771] [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: 11/10/2023] [Revised: 02/18/2024] [Accepted: 03/08/2024] [Indexed: 03/13/2024]
Abstract
Development of the efficient hemostatic materials is an essential requirement for the management of hemorrhage caused by the emergency situations to avert most of the casualties. Such injuries require the use of external hemostats to facilitate the immediate blood clotting. A variety of commercially available hemostats are present in the market but most of them are associated with limitations such as exothermic reactions, low biocompatibility, and painful removal. Thus, fabrication of an ideal hemostatic composition for rapid blood clot formation, biocompatibility, and antimicrobial nature presents a real challenge to the bioengineers. Benefiting from their tunable fabrication properties, alginate-based hemostats are gaining importance due to their excellent biocompatibility, with >85 % cell viability, high absorption capacity exceeding 500 %, and cost-effectiveness. Furthermore, studies have estimated that wounds treated with sodium alginate exhibited a blood loss of 0.40 ± 0.05 mL, compared to the control group with 1.15 ± 0.13 mL, indicating its inherent hemostatic activity. This serves as a solid foundation for designing future hemostatic materials. Nevertheless, various combinations have been explored to further enhance the hemostatic potential of sodium alginate. In this review, we have discussed the possible role of alginate based composite hemostats incorporated with different hemostatic agents, such as inorganic materials, polymers, biological agents, herbal agents, and synthetic drugs. This article outlines the challenges which need to be addressed before the clinical trials and give an overview of the future research directions.
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Affiliation(s)
- Ankita Sharma
- Bioengineering Laboratory, Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Chetna Verma
- Bioengineering Laboratory, Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Pratibha Singh
- Bioengineering Laboratory, Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Samrat Mukhopadhyay
- Bioengineering Laboratory, Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India
| | - Amlan Gupta
- Sikkim Manipal Institute of Medical Sciences, Tadong, Gangtok, Sikkim 737102, India
| | - Bhuvanesh Gupta
- Bioengineering Laboratory, Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi 110016, India.
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Han T, Chen L, Gao F, Wang S, Li J, Fan G, Cong H, Yu B, Shen Y. Preparation of thrombin-loaded calcium alginate microspheres with dual-mode imaging and study on their embolic properties in vivo. Eur J Pharm Biopharm 2023; 189:98-108. [PMID: 37330116 DOI: 10.1016/j.ejpb.2023.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023]
Abstract
Transcatheter arterial embolization (TAE) has played a huge role in the interventional treatment of organ bleeding and accidental bleeding. Choosing bio-embolization materials with good biocompatibility is an important part of TAE. In this work, we prepared a calcium alginate embolic microsphere using high-voltage electrostatic droplet technology. The microsphere simultaneously encapsulated silver sulfide quantum dots (Ag2S QDs) and barium sulfate (BaSO4), and fixed thrombin on its surface. Thrombin can achieve an embolic effect while stopping bleeding. The embolic microsphere has good near-infrared two-zone (NIR-II) imaging and X-ray imaging effects, and the luminous effect of NIR-II is better than that of X-rays. This breaks the limitations of traditional embolic microspheres that only have X-ray imaging. And the microspheres have good biocompatibility and blood compatibility. Preliminary application results show that the microspheres can achieve a good embolization effect in the ear arteries of New Zealand white rabbits, and can be used as an effective material for arterial embolization and hemostasis. This work realizes the clinical embolization application of NIR-II combined with X-ray multimodal imaging technology in biomedical imaging, achieving complementary advantages and excellent results, more suitable for studying biological changes and clinical applications.
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Affiliation(s)
- Tingting Han
- School of Materials Science and Engineering, Shandong University of Technology, Zibo 255000, China; Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China
| | - Luping Chen
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China
| | - Fengyuan Gao
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China
| | - Song Wang
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China
| | - Jian Li
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China
| | - Guangwen Fan
- Jimo Hospital of Traditional Chinese Medicine of Qingdao City, Qingdao 266299, China
| | - Hailin Cong
- School of Materials Science and Engineering, Shandong University of Technology, Zibo 255000, China; Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China.
| | - Bing Yu
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China.
| | - Youqing Shen
- Institute of Biomedical Materials and Engineering, College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Affiliated Hospital of Qingdao University, State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China; Center for Bionanoengineering and Key Laboratory of Biomass Chemical Engineering of Ministry of Education, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China
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Song Y, Li S, Chen H, Han X, Duns GJ, Dessie W, Tang W, Tan Y, Qin Z, Luo X. Kaolin-loaded carboxymethyl chitosan/sodium alginate composite sponges for rapid hemostasis. Int J Biol Macromol 2023; 233:123532. [PMID: 36740110 DOI: 10.1016/j.ijbiomac.2023.123532] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
There are several factors that contribute to the mortality of people who suffer from unmanageable bleeding. Therefore, the development of rapid hemostatic materials is necessary. Herein, novel rapid hemostatic composite sponges were developed by incorporation of kaolin (K) into carboxymethyl chitosan (CMCS)/sodium alginate (SA) via a combination of methods that includes ionic crosslinking, polyelectrolyte action, and freeze-drying. The CMCS/SA-K composite sponges were cross-linked with calcium ions provided by a sustained-release system consisting of D-gluconolactone (GDL) and Ca-EDTA, and the hemostatic ability of the sponges was enhanced by loading the inorganic hemostatic agent-kaolin (K). It was demonstrated that the CMCS/SA-K composite sponges had a good porous structure and water absorption properties, excellent mechanical properties, outstanding biodegradability, and biocompatibility. Simultaneously, they exhibited rapid hemostatic properties, both in vitro and in vivo. Significantly, the hemostatic time of the CMCS/SA-K60 sponge was improved by 82.76 %, 191.82 %, and 153.05 %, compared with those of commercially available gelatin sponges in the rat tail amputation, femoral vein, and liver injury hemorrhage models respectively, indicating that its hemostatic ability was superior to that of commercially available hemostatic materials. Therefore, CMCS/SA-K composite sponges show great promise for rapid hemostasis.
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Affiliation(s)
- Yannan Song
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Shuo Li
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China
| | - Huifang Chen
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Xinyi Han
- Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Gregory J Duns
- Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Wubliker Dessie
- Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Wufei Tang
- Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Yimin Tan
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China
| | - Zuodong Qin
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China.
| | - Xiaofang Luo
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China.
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Xie Y, Gao P, He F, Zhang C. Application of Alginate-Based Hydrogels in Hemostasis. Gels 2022; 8:109. [PMID: 35200490 PMCID: PMC8871293 DOI: 10.3390/gels8020109] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 12/24/2022] Open
Abstract
Hemorrhage, as a common trauma injury and clinical postoperative complication, may cause serious damage to the body, especially for patients with huge blood loss and coagulation dysfunction. Timely and effective hemostasis and avoidance of bleeding are of great significance for reducing body damage and improving the survival rate and quality of life of patients. Alginate is considered to be an excellent hemostatic polymer-based biomaterial due to its excellent biocompatibility, biodegradability, non-toxicity, non-immunogenicity, easy gelation and easy availability. In recent years, alginate hydrogels have been more and more widely used in the medical field, and a series of hemostatic related products have been developed such as medical dressings, hemostatic needles, transcatheter interventional embolization preparations, microneedles, injectable hydrogels, and hemostatic powders. The development and application prospects are extremely broad. This manuscript reviews the structure, properties and history of alginate, as well as the research progress of alginate hydrogels in clinical applications related to hemostasis. This review also discusses the current limitations and possible future development prospects of alginate hydrogels in hemostatic applications.
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Affiliation(s)
| | | | | | - Chun Zhang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (Y.X.); (P.G.); (F.H.)
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Wang Y, Wang P, Ji H, Ji G, Wang M, Wang X. Analysis of Safety and Effectiveness of Sodium Alginate/Poly(γ-glutamic acid) Microspheres for Rapid Hemostasis. ACS APPLIED BIO MATERIALS 2021; 4:6539-6548. [PMID: 35006904 DOI: 10.1021/acsabm.1c00671] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Most preventable deaths after trauma are related to hemorrhage and occur early after injury. Timely hemostatic treatment is essential to minimize blood loss and improve survival. Among the various treatment methods, the most economical and effective is to use a hemostatic agent. A powdered hemostatic agent can be used for wounds of any shape or depth with high compactness and excellent accumulation effect. Herein, we chose the natural, hydrophilic polymer poly(γ-glutamic acid) (γ-PGA) to form composite hemostatic microspheres with sodium alginate (SA), which show good biocompatibility, water absorptivity, and viscosity. The morphology and structure of the hemostatic microspheres were determined using Fourier transform infrared spectroscopy and scanning electron microscopy. The overall safety, hemolysis, pyrogenic, and intradermal irritation tests were examined. The relationship between hemostatic pressure and hemostatic time during microsphere use was also measured. The hemostatic effect was analyzed with a liver, spleen, and femoral artery bleeding model. The composite microspheres were well tolerated in vivo and exhibited better hemostatic effects in animal experiments than a microporous polysaccharide powder compound. Research results showed that SA/γ-PGA microspheres are materials with good hemostatic effect, high safety, and great potential in clinical applications.
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Affiliation(s)
- Yun Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China
| | - Pei Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China
| | - Haoran Ji
- Department of Thoracic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China
| | - Guangyu Ji
- Department of Thoracic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China
| | - Mingsong Wang
- Department of Thoracic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China
| | - Xiansong Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China.,Department of Thoracic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, People's Republic of China
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Zhu YX, Jia HR, Guo Y, Liu X, Zhou N, Liu P, Wu FG. Repurposing Erythrocytes as a "Photoactivatable Bomb": A General Strategy for Site-Specific Drug Release in Blood Vessels. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2100753. [PMID: 34259382 DOI: 10.1002/smll.202100753] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/20/2021] [Indexed: 06/13/2023]
Abstract
Tumor vasculature has long been considered as an extremely valuable therapeutic target for cancer therapy, but how to realize controlled and site-specific drug release in tumor blood vessels remains a huge challenge. Despite the widespread use of nanomaterials in constructing drug delivery systems, they are suboptimal in principle for meeting this demand due to their easy blood cell adsorption/internalization and short lifetime in the systemic circulation. Here, natural red blood cells (RBCs) are repurposed as a remote-controllable drug vehicle, which retains RBC's morphology and vessel-specific biodistribution pattern, by installing photoactivatable molecular triggers on the RBC membrane via covalent conjugation with a finely tuned modification density. The molecular triggers can burst the RBC vehicle under short and mild laser irradiation, leading to a complete and site-specific release of its payloads. This cell-based vehicle is generalized by loading different therapeutic agents including macromolecular thrombin, a blood clotting-inducing enzyme, and a small-molecule hypoxia-activatable chemodrug, tirapazamine. In vivo results demonstrate that the repurposed "anticancer RBCs" exhibit long-term stability in systemic circulation but, when tumors receive laser irradiation, precisely releases their cargoes in tumor vessels for thrombosis-induced starvation therapy and local deoxygenation-enhanced chemotherapy. This study proposes a general strategy for blood vessel-specific drug delivery.
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Affiliation(s)
- Ya-Xuan Zhu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
| | - Hao-Ran Jia
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
| | - Yuxin Guo
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
| | - Xiaoyang Liu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
| | - Ningxuan Zhou
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
| | - Peidang Liu
- School of Medicine, Southeast University, Nanjing, 210009, P. R. China
| | - Fu-Gen Wu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing, 210096, P. R. China
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Lv C, Li L, Jiao Z, Yan H, Wang Z, Wu Z, Guo M, Wang Y, Zhang P. Improved hemostatic effects by Fe 3+ modified biomimetic PLLA cotton-like mat via sodium alginate grafted with dopamine. Bioact Mater 2021; 6:2346-2359. [PMID: 33553820 PMCID: PMC7840473 DOI: 10.1016/j.bioactmat.2021.01.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/17/2020] [Accepted: 01/04/2021] [Indexed: 12/25/2022] Open
Abstract
The development of an excellent, bioabsorbable hemostatic material for deep wound remains a challenge. In this work, a biodegradable cotton-like biomimetic fibrous mat of poly (l-lactic acid) (PLLA) was made by melt spinning. Subsequently, SD composite was prepared by cross-linking sodium alginate (SA) with dopamine (DA). It was immobilized on the fibre surface, which inspired by mussel byssus. Finally, Fe3+ was loaded onto the 0.5SD/PLLA composite by chelation with the carboxyl of alginate and phenolic hydroxy of dopamine. The haemostasis experiment found that the hemostatic time 47 s in vitro. However, the bleeding volume was 0.097 g and hemostatic time was 23 s when 20Fe3+-0.5SD/PLLA was applied in the haemostasis of the rat liver. As a result of its robust hydrophilicity and bouffant cotton-like structure, it could absorb a large water from blood, which could concentrate the component of blood and reduce the clotting time. Furthermore, the addition of Fe3+ in the 0.5SD/PLLA had a significant effect on improve hemostatic property. It also displayed excellent antibacterial property for Escherichia coli and Staphylococcus aureus. Notably, it possesses superior hemocompatibility, cytocompatibility and histocompatibility. Hence, 20Fe3+-0.5SD/PLLA has high potential application in haemostasis for clinical settings due to its outstanding properties.
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Affiliation(s)
- Caili Lv
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, 96 Jinzhai Road, Hefei, Anhui, 230026, PR China
| | - Linlong Li
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
- University of Chinese Academy of Sciences, 19 Yuquan Road, Beijing, 100049, PR China
| | - Zixue Jiao
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
| | - Huanhuan Yan
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, 96 Jinzhai Road, Hefei, Anhui, 230026, PR China
| | - Zongliang Wang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
| | - Zhenxu Wu
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
| | - Min Guo
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
| | - Yu Wang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
| | - Peibiao Zhang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, 96 Jinzhai Road, Hefei, Anhui, 230026, PR China
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Mu Y, Fu Y, Li J, Shao K, Pang J, Su C, Cai Y, Sun X, Cong X, Chen X, Feng C. Thrombin immobilized polydopamine-diatom biosilica for effective hemorrhage control. Biomater Sci 2021; 9:4952-4967. [PMID: 34075916 DOI: 10.1039/d0bm02116d] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In this study, an efficient composite hemostatic material (DA-diatom-T) was prepared, using a polydopamine layer as a linker to immobilize thrombin on the surface of diatom biosilica. DA-diatom-T retained the porous structure of the diatom with high water absorption capacity, which can absorb 31 times its own weight of water. The thrombin activity of DA-diatom-T was as high as 5.81 U mg-1 that could be maintained at 67% after 30 days at room temperature. DA-diatom-T exhibited non-toxicity to mouse fibroblast cell lines, favorable hemocompatibility and fast procoagulant ability. DA-diatom-T could promote the initiation of the coagulation process and increase platelet activity and blood clot strength to form a physical barrier at the wound. In an in vivo study, DA-diatom-T could significantly reduce the clotting time and reduce the bleeding volume. The above results showed that DA-diatom-T had potential as a new hemostatic material.
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Affiliation(s)
- Yuzhi Mu
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Yangmu Fu
- Department of Orthopaedics, Hainan Hospital of Chinese PLA General Hospital, Jianglin Road, Sanya 572013, P. R. China
| | - Jing Li
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Kai Shao
- Department of Central Laboratory, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758# Hefei Road, Qingdao 266035, Shandong Province, China
| | - Jianhui Pang
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Chang Su
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Yibo Cai
- Department of Orthopaedics, Hainan Hospital of Chinese PLA General Hospital, Jianglin Road, Sanya 572013, P. R. China
| | - Xiaojie Sun
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Xin Cong
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Xiguang Chen
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China. and Qingdao National Laboratory for Marine Science and Technology, 1# Wenhai Road, Qingdao 266000, Shandong Province, China
| | - Chao Feng
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
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10
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Wang D, Wu Q, Guo R, Lu C, Niu M, Rao W. Magnetic liquid metal loaded nano-in-micro spheres as fully flexible theranostic agents for SMART embolization. NANOSCALE 2021; 13:8817-8836. [PMID: 33960346 DOI: 10.1039/d1nr01268a] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Transcatheter arterial chemoembolization (TACE) has become one of the preferred choices for advanced liver cancer patients. Current clinically used microsphere embolic agents, such as PVA, gelatin, and alginate microspheres, have limited therapeutic efficacy and lack the function of real-time imaging. In this work, we fabricated magnetic liquid metal nanoparticle (Fe@EGaIn NP) loaded calcium alginate (CA) microspheres (denoted as Fe@EGaIn/CA microspheres), which integrate CT/MR dual-modality imaging and photothermal/photodynamic functions of the Fe@EGaIn NP core, as well as embolization and drug-loading functions of CA microspheres. Namely, such nano-in-micro spheres can be used as fully flexible theranostic agents to achieve smart-chemoembolization. It has been confirmed by in vitro and in vivo experiments that Fe@EGaIn/CA microspheres have advantageous morphology, favorable biocompatibility, splendid versatility, and advanced embolic efficacy. Benefiting from these properties, excellent therapeutic efficiency was achieved with a tumor growth-inhibiting value of 100% in tumor-bearing rabbits. As a novel microsphere embolic agent with promising therapeutic efficacy and diagnostic capability, Fe@EGaIn/CA microspheres have shown potential applications in clinical transcatheter arterial chemoembolization. And the preparation strategy presented here provides a generalized paradigm for achieving multifunctional and fully flexible theranostics.
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Affiliation(s)
- Dawei Wang
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, China. and School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Qirun Wu
- Department of Interventional Medical, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai 519000, China
| | - Rui Guo
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Chennan Lu
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, China. and School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Meng Niu
- Department of Radiology, First Hospital of China Medical University, Shenyang 110001, China
| | - Wei Rao
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, China. and School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
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11
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Wang L, You X, Dai C, Tong T, Wu J. Hemostatic nanotechnologies for external and internal hemorrhage management. Biomater Sci 2020; 8:4396-4412. [PMID: 32658944 DOI: 10.1039/d0bm00781a] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
An uncontrolled hemorrhage can easily lead to death during surgery and military operations. Despite the significant advances in hemostatic research, there is still an urgent and increasing need for safer and more effective hemostatic materials. Recently, nanotechnologies have been receiving increasing interest owing to their unique advantages and have been propelling the developement of hemostatic materials. This review summarizes the fundamentals of hemostasis and emphasizes the recent developments regarding hemorrhage-related hemostatic nanotechnologies. In terms of external accessible hemorrhage management, natural and synthetic polymers and inorganic components that have been used in traditional hemostats provide novel nanoscale solutions. Regarding internal noncompressible hemorrhage management, current research endeavors are dedicated to the development of substitutes for blood components, and nanoformulated hemostatic drugs. This review also briefly discusses the main and persistent problems of hemostatic nanomaterials, including safety concerns and clinical translation challenges. This review is hoped to provide critical insight into hemostatic nanomaterial development.
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Affiliation(s)
- Liying Wang
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, Guangdong 510006, PR China.
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Stechele M, Wittgenstein H, Stolzenburg N, Schnorr J, Neumann J, Schmidt C, Günther RW, Streitparth F. Novel MR-Visible, Biodegradable Microspheres for Transcatheter Arterial Embolization: Experimental Study in a Rabbit Renal Model. Cardiovasc Intervent Radiol 2020; 43:1515-1527. [PMID: 32514611 DOI: 10.1007/s00270-020-02534-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/18/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To assess feasibility, embolization success, biodegradability, reperfusion, biocompatibility and in vivo visibility of novel temporary microspheres (MS) for transcatheter arterial embolization. MATERIAL AND METHODS In 9 New Zealand white rabbits unilateral superselective embolization of the lower kidney pole was performed with biodegradable MS made of polydioxanone (PDO) (size range 90-300 and 200-500 µm) impregnated with super-paramagnetic iron oxide (SPIO). Magnetic resonance imaging (MRI) was performed post-interventionally to assess in vivo visibility. Embolization success was assessed on digital subtraction angiography, MRI and gross pathology. One animal was killed immediately after embolization to assess original particle appearance. 8 animals were randomly assigned to different observation periods (1, 4, 8, 12 and 16 weeks), after which control angiography and MRI were obtained to determine recanalization. Histopathological analysis was performed to determine biodegradability and biocompatibility by using dedicated quantitative assessment analysis. RESULTS Ease of injection was moderate. Embolization was technically successful in 7 of 8 animals, one rabbit received non-selective embolization of the whole kidney and abdominal off-target embolization. Arterial occlusion was achieved in all kidneys, infarct areas in macro- and microscopic analysis confirmed embolization success. Control angiograms showed evidence of partial reperfusion. The microspheres showed extensive degradation over the course of time along with increasing inflammatory response and giant cell formation. SPIO-loaded MS were visible on MRI at all time points. CONCLUSIONS SPIO-impregnated biodegradable PDO-MS achieved effective embolization with in vivo visibility on MRI and increasing biodegradation over time while demonstrating good biocompatibility, i.e., a physiologically immune response without transformation into chronic inflammation. Further studies are needed to provide clinical applicability.
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Affiliation(s)
- Matthias Stechele
- Department of Radiology, University Hospital, Ludwig Maximilians University, Marchioninistraße 15, 81377, Munich, Germany
| | - Helena Wittgenstein
- Evidensia Veterinary Clinic for Small Animals GmbH, Kabels Stieg 41, 22850, Norderstedt, Germany
| | - Nicola Stolzenburg
- Department of Radiology, Charité School of Medicine and University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jörg Schnorr
- Department of Radiology, Charité School of Medicine and University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jens Neumann
- University Hospital, Institute of Pathology, Ludwig Maximilians University, Marchioninistraße 15, 81377, Munich, Germany
| | | | - Rolf W Günther
- Department of Radiology, Charité School of Medicine and University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Florian Streitparth
- Department of Radiology, University Hospital, Ludwig Maximilians University, Marchioninistraße 15, 81377, Munich, Germany.
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A biodegradable multifunctional porous microsphere composed of carrageenan for promoting imageable trans-arterial chemoembolization. Int J Biol Macromol 2020; 142:866-878. [DOI: 10.1016/j.ijbiomac.2019.10.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/16/2019] [Accepted: 10/01/2019] [Indexed: 12/24/2022]
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Zheng C, Zeng Q, Pimpi S, Wu W, Han K, Dong K, Lu T. Research status and development potential of composite hemostatic materials. J Mater Chem B 2020; 8:5395-5410. [DOI: 10.1039/d0tb00906g] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Through the discussion of the coagulation mechanism of compositehemostatic materials, the future development potential of hemostatic materials is proposed.
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Affiliation(s)
- Caiyun Zheng
- School of Life Sciences
- Northwestern Polytechnical University
- Xi'an Shaanxi
- P. R. China
| | - Qingyan Zeng
- School of Life Sciences
- Northwestern Polytechnical University
- Xi'an Shaanxi
- P. R. China
| | - SaHu Pimpi
- School of Life Sciences
- Northwestern Polytechnical University
- Xi'an Shaanxi
- P. R. China
| | - Wendong Wu
- School of Life Sciences
- Northwestern Polytechnical University
- Xi'an Shaanxi
- P. R. China
| | - Kai Han
- School of Life Sciences
- Northwestern Polytechnical University
- Xi'an Shaanxi
- P. R. China
| | - Kai Dong
- School of Life Sciences
- Northwestern Polytechnical University
- Xi'an Shaanxi
- P. R. China
| | - Tingli Lu
- School of Life Sciences
- Northwestern Polytechnical University
- Xi'an Shaanxi
- P. R. China
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15
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Biocompatibility of a New Kind of Polyvinyl Alcohol Embolic Microspheres: In Vitro and In Vivo Evaluation. Mol Biotechnol 2019; 61:610-621. [PMID: 31144113 DOI: 10.1007/s12033-019-00166-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of this study is to investigate the biocompatibility of polyvinyl alcohol (PVA) embolic microspheres by in vivo and in vitro evaluations. Two specifications of PVA microspheres including colorless microspheres (1 g microspheres with 7 mL 0.9% sodium chloride (SC) per vial, size: 500-700 µm) and blue microspheres (2 g microspheres with 7 mL 0.9% SC per vial, size: 500-700 µm) were assessed for biocompatibility. The vitro cytotoxicity was evaluated in L929 cells by MTT assay. Acute systemic toxicity and 28-repeat dose intravenous subchronic toxicity were assessed in 20 ICR mice and 40 SD rates, respectively. Skin sensitization was conducted in 30 adult albino guinea pigs by maximization test, in addition, intracutaneous reaction test was performed in New Zealand white rabbits. Hemolysis ratio of PVA microspheres was evaluated with rabbit blood. Moreover, test for genotoxicity was assessed by bacterial reverse mutation test and mouse lymphoma mutagenesis assay. No cytotoxicity, hemolysis, or acute toxicity of PVA microspheres was found, and slight fluctuations of biochemical indexes were observed in test of 28-day repeat dose intravenous subchronic toxicity, while these changes remained within our historical permitted range. Maximization test and intracutaneous reactivity test disclosed no irritation to skin or tissues. According to bacterial reverse mutation test and mouse lymphoma mutagenesis assay, no genotoxicity of PVA microspheres was observed. PVA microspheres showed excellent biocompatibility both in vivo and in vitro, and they were promising embolic materials for drug-eluting beads transarterial chemoembolization (DEB-TACE) therapy.
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Huang H, Chen H, Wang X, Qiu F, Liu H, Lu J, Tong L, Yang Y, Wang X, Wu H. Degradable and Bioadhesive Alginate-Based Composites: An Effective Hemostatic Agent. ACS Biomater Sci Eng 2019; 5:5498-5505. [PMID: 33464069 DOI: 10.1021/acsbiomaterials.9b01120] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The perfect hemostatic material should be capable of rapidly controlling substantial hemorrhaging from visceral organs, veins, and arteries. Ideally, it should be biodegradable, biocompatible, easily applied, and inexpensive. Herein, taking advantages of sodium alginate (SA), carboxymethyl chitosan (CMC), and collagen, a degradable powdery hemostatic composite (SACC) was synthesized using emulsification and cross-linking technology. The morphology and structure of SACC were determined using Fourier transform infrared spectroscopy and scanning electron microscopy (SEM). This hemostatic material exhibited a typical generic sphere shape with narrow size distribution, rough surface, and satisfactory water absorption. Using in vitro bleeding and in vivo bleeding models (rat liver injury model and rat tail amputation model), it was shown that SACC had superior hemostatic actions compared to CMC and SA. Excellent cytocompatibility was proven during cytotoxicity tests and SEM observations. Histomorphological evaluation during the wound healing process proved the superior biocompatibility of SACC in a rat liver injury model. Biodegradability of SACC was demonstrated by immunofluorescence techniques both in vitro and in vivo. In summary, we have demonstrated the enormous potential of SACC, which has excellent hemostatic activity, biodegradability, and biocompatibility properties for use in clinical hemostasis applications.
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Affiliation(s)
- He Huang
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200125, China.,Department of Plastic and Reconstructive Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230032, China
| | - Hongsai Chen
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200125, China
| | - Xueling Wang
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200125, China
| | - Fangxia Qiu
- Zhejiang Sanchuang Biotechnology Company, Limited, Jiaxing, Zhejiang 314031, China
| | - Huihui Liu
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200125, China
| | - Jiawen Lu
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200125, China
| | - Ling Tong
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200125, China
| | - Yuming Yang
- Zhejiang Sanchuang Biotechnology Company, Limited, Jiaxing, Zhejiang 314031, China
| | | | - Hao Wu
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200125, China
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Shi M, Zhang H, Song T, Liu X, Gao Y, Zhou J, Li Y. Sustainable Dual Release of Antibiotic and Growth Factor from pH-Responsive Uniform Alginate Composite Microparticles to Enhance Wound Healing. ACS APPLIED MATERIALS & INTERFACES 2019; 11:22730-22744. [PMID: 31141337 DOI: 10.1021/acsami.9b04750] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Hydrogel-based wound dressings provided a moist microenvironment and local release of bioactive molecules. Single drug loading along with fast release rates and usually in hydrogel sheets limited their performance. Hence, uniform alginate/CaCO3 composite microparticles (∼430 μm) with tunable compositions for sustainable release of drug and pH-sensitivity were successfully fabricated using microfluidic technology. Due to the presence of CaCO3 and the strong interactions with alginate molecules, lyophilized composite microparticles reverted to hydrogel state after rehydration. Regardless of microparticle states (hydrogel or lyophilized) and pH values (6.4 or 7.4), in vitro release rates of model drug were inversely related with CaCO3 concentrations and much lower than that for pure alginate microparticles. The release rate at pH 6.4 (simulating wound microenvironment) was always slower than that at pH 7.4 for the same type of microparticles. Rifamycin and basic fibroblast growth factor (bFGF) were independently encapsulated into AD-5-R and AD-40-F to achieve a fast release of rifamycin and a slower, more sustained release of bFGF, respectively; CD-F-R was a mixture of AD-5-R and AD-40-F at weight ratio 1/1. For AD-5-R and CD-F-R, inhibition zones of S. aureus were observed until day 5, showing a sustained antibacterial property. On the basis of in vitro wound healing model of NIH-3T3 cell micropattern on glass coverslips with a hole array, it was found that AD-40-F and CD-F-R significantly promoted cell proliferation and migration rates. In a full-thickness skin wound model of rats, CD-F-R microparticles significantly accelerated wound healing with higher granulation tissue thickness and better bioactivity to stimulate angiogenesis than the control group. Furthermore, CD-F-R microparticles demonstrated a good biocompatibility and biodegradability in vivo. Taken together, CD-F-R composite microparticles may ideally meet the requirements for different stages during wound healing and demonstrated a good potential to be used as dressing materials.
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Affiliation(s)
- Ming Shi
- Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, School of Biomedical Engineering , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
- Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
| | - Hao Zhang
- Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, School of Biomedical Engineering , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
- Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
| | - Ting Song
- Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, School of Biomedical Engineering , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
- Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
| | - Xiaofang Liu
- Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, School of Biomedical Engineering , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
- Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
| | - Yunfen Gao
- Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, School of Biomedical Engineering , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
- Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
| | - Jianhua Zhou
- Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, School of Biomedical Engineering , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
- Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital , Harvard Medical School , Cambridge , Massachusetts 02139 , United States
| | - Yan Li
- Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, School of Biomedical Engineering , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
- Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices , Sun Yat-sen University , Guangzhou 510006 , Guangdong , P.R. China
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