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Applewhite B, Andreopoulos F, Vazquez-Padron RI. Periadventitial biomaterials to improve arteriovenous fistula and graft outcomes. J Vasc Access 2024; 25:713-727. [PMID: 36349745 DOI: 10.1177/11297298221135621] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
Periadventitial biomaterials have been employed for nearly three decades to promote adaptive venous remodeling following hemodialysis vascular access creation in preclinical models and clinical trials. These systems are predicated on the combination of scaffolds, hydrogels, and/or particles with therapeutics (small molecules, proteins, genes, and cells) to prevent venous stenosis and subsequent maturation failure. Periadventitial biomaterial therapies have evolved from simple drug delivery vehicles for traditional drugs to more thoughtful designs tailored to the pathophysiology of access failure. The emergence of tissue engineering strategies and gene therapies are another exciting new direction. Despite favorable results in experimental and preclinical studies, no periadventitial therapy has been clinically approved to improve vascular access outcomes. After conducting an exhaustive review of the literature, we identify the seminal studies and clinical trials that utilize periadventitial biomaterials and discuss the key features of each biomaterial format and their respective shortcomings as they pertain to access maturation. This review provides a foundation from which clinicians, surgeons, biologists, and engineers can refer to and will hopefully inspire thoughtful, translatable treatments to finally address access failure.
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Affiliation(s)
- Brandon Applewhite
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Fotios Andreopoulos
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Roberto I Vazquez-Padron
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
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Hernandez DR, Applewhite B, Martinez L, Laurito T, Tabbara M, Rojas MG, Wei Y, Selman G, Knysheva M, Velazquez OC, Salman LH, Andreopoulos FM, Shiu YT, Vazquez-Padron RI. Inhibition of Lysyl Oxidase with β-aminopropionitrile Improves Venous Adaptation after Arteriovenous Fistula Creation. KIDNEY360 2020; 2:270-278. [PMID: 34322674 PMCID: PMC8315119 DOI: 10.34067/kid.0005012020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The arteriovenous fistula (AVF) is the preferred hemodialysis access for end-stage renal disease (ESRD) patients. Yet, establishment of a functional AVF presents a challenge, even for the most experienced surgeons, since postoperative stenosis frequently occludes the AVF. Stenosis results from the loss of compliance in fibrotic areas of the fistula which turns intimal hyperplasia into an occlusive feature. Fibrotic remodeling depends on deposition and crosslinking of collagen by lysyl oxidase (LOX), an enzyme that catalyzes the deamination of lysine and hydroxylysine residues, facilitating intra/intermolecular covalent bonds. We postulate that pharmacological inhibition of lysyl oxidase (LOX) increases postoperative venous compliance and prevents stenosis in a rat AVF model. METHODS LOX gene expression and vascular localization were assayed in rat AVFs and human pre-access veins, respectively. Collagen crosslinking was measured in humans AVFs that matured or failed, and in rat AVFs treated with β-aminopropionitrile (BAPN), an irreversible LOX inhibitor. BAPN was either injected systemically or delivered locally around rat AVFs using nanofiber scaffolds. The major endpoints were AVF blood flow, wall fibrosis, collagen crosslinking, and vascular distensibility. RESULTS Non-maturation of human AVFs was associated with higher LOX deposition in pre-access veins (N=20, P=0.029), and increased trivalent crosslinks (N=18, P=0.027) in human AVF tissues. Systemic and local inhibition of LOX increased AVF distensibility, while reducing wall fibrosis and collagen crosslinking in rat fistulas. CONCLUSIONS Our results demonstrate that BAPN-mediated inhibition of LOX significantly improves vascular remodeling in experimental fistulas.
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Affiliation(s)
- Diana R. Hernandez
- DeWitt Daughtry Family Department of Surgery, Division of Vascular Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
| | - Brandon Applewhite
- DeWitt Daughtry Family Department of Surgery, Division of Vascular Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida,Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, Florida
| | - Laisel Martinez
- DeWitt Daughtry Family Department of Surgery, Division of Vascular Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
| | - Tyler Laurito
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, Florida
| | - Marwan Tabbara
- DeWitt Daughtry Family Department of Surgery, Division of Vascular Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
| | - Miguel G. Rojas
- DeWitt Daughtry Family Department of Surgery, Division of Vascular Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
| | - Yuntao Wei
- DeWitt Daughtry Family Department of Surgery, Division of Vascular Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
| | - Guillermo Selman
- Division of Nephrology and Hypertension, Albany Medical College, Albany, New York
| | - Marina Knysheva
- Division of Nephrology and Hypertension, University of Utah, Salt Lake City, Utah
| | - Omaida C. Velazquez
- DeWitt Daughtry Family Department of Surgery, Division of Vascular Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
| | - Loay H. Salman
- Division of Nephrology and Hypertension, Albany Medical College, Albany, New York
| | - Fotios M. Andreopoulos
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, Florida
| | - Yan-Ting Shiu
- Division of Nephrology and Hypertension, University of Utah, Salt Lake City, Utah
| | - Roberto I. Vazquez-Padron
- DeWitt Daughtry Family Department of Surgery, Division of Vascular Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
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Moreno-Estar S, Serrano S, Arévalo-Martínez M, Cidad P, López-López JR, Santos M, Pérez-Garcia MT, Arias FJ. Elastin-like recombinamer-based devices releasing Kv1.3 blockers for the prevention of intimal hyperplasia: An in vitro and in vivo study. Acta Biomater 2020; 115:264-274. [PMID: 32771595 DOI: 10.1016/j.actbio.2020.07.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/25/2020] [Accepted: 07/30/2020] [Indexed: 12/16/2022]
Abstract
Coronary artery disease (CAD) is the most common cardiovascular disorder. Vascular surgery strategies for coronary revascularization (either percutaneous or open) show a high rate of failure because of restenosis of the vessel, due to phenotypic switch of vascular smooth muscle cells (VSMCs) leading to proliferation and migration. We have previously reported that the inhibition of Kv1.3 channel function with selective blockers represents an effective strategy for the prevention of restenosis in human vessels used for coronary angioplasty procedures. However, delivery systems for controlled release of these drugs have not been investigated. Here we tested the efficacy of several formulations of elastin like recombinamers (ELRs) hydrogels to deliver the Kv1.3 blocker PAP-1 in various restenosis models. The dose and time course of PAP-1 release from ELRs click hydrogels was able to inhibit human VSMC proliferation in vitro as well as remodeling of human vessels in organ culture and restenosis in in vivo models. We conclude that this combination of active compound and advanced delivery method could improve the outcomes of vascular surgery in patients. STATEMENT OF SIGNIFICANCE: Vascular surgery strategies for coronary revascularization show a high rate of failure, because of occlusion (restenosis) of the vessel, due to vascular smooth muscle cells proliferation and migration. We have previously reported that blockers of Kv1.3 channels represent an effective anti-restenosis therapy, but delivery systems for their controlled release have not being explored. Here we tested the efficacy of several formulations of elastin like recombinamers (ELRs) hydrogels to deliver the Kv1.3 blocker PAP-1 in various restenosis models, both in vivo and in vitro, and also in human vessels. We demonstrated that combination of active compound and advanced delivery method could improve the outcomes of vascular surgery in patients.
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van Oirschot BAJA, Jansen JA, van de Ven CJJM, Geven EJW, Gossen JA. Evaluation of Collagen Membranes Coated with Testosterone and Alendronate to Improve Guided Bone Regeneration in Mandibular Bone Defects in Minipigs. J Oral Maxillofac Res 2020; 11:e4. [PMID: 33262883 PMCID: PMC7644271 DOI: 10.5037/jomr.2020.11304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/27/2020] [Indexed: 04/19/2023]
Abstract
OBJECTIVES The purpose of the present in vivo study was to evaluate whether pericard collagen membranes coated with ancillary amounts of testosterone and alendronate in a poly-lactic glycolic acid (PLGA) carrier as compared to uncoated membranes will improve early bone regeneration. MATERIAL AND METHODS In each of 16 minipigs, four standardized mandibular intraosseous defects were made bilaterally. The defects were filled with Bio-Oss® granules and covered with a non-coated or coated membrane. Membranes were spray-coated with 4 layers of PLGA containing testosterone and alendronate resulting in 20, 50 or 125 μg/cm2 of testosterone and 20 µg/cm2 alendronate (F20, F50, F125). Non-coated membranes served as controls (F0). Animals were sacrificed at 6 and 12 weeks after treatment. Qualitative and quantitative histological evaluations of bone regeneration were performed. Differences between groups were assessed by paired Student's t-test. RESULTS Light microscopical analysis showed new bone formation that was in close contact with the Bio-Oss® surface without an intervening non-mineralized tissue layer. Histomorphometric analysis of newly formed bone showed a significant 20% increase in area in the F125 coated membrane treated defects (40 [SD 10]%) compared to the F0 treated defects after 6 weeks (33 [SD 10]%, P = 0.013). At week 12, the total percentage of new bone was increased compared to week 6, but no increase in newly formed bone compared to F0 was observed. CONCLUSIONS The data from this in vivo study indicate that F125 collagen membranes coated with testosterone and alendronate resulted in superior bone formation (+24%) when normalized to control sites using uncoated membranes.
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Affiliation(s)
- Bart A J A van Oirschot
- Department of Dentistry - Biomaterials, Radboudumc, Radboud University Nijmegen, NijmegenThe Netherlands
| | - John A Jansen
- Department of Dentistry - Biomaterials, Radboudumc, Radboud University Nijmegen, NijmegenThe Netherlands
| | - Cindy J J M van de Ven
- Department of Dentistry - Biomaterials, Radboudumc, Radboud University Nijmegen, NijmegenThe Netherlands
- Osteo-Pharma BV, OssThe Netherlands
| | - Edwin J W Geven
- Department of Dentistry - Biomaterials, Radboudumc, Radboud University Nijmegen, NijmegenThe Netherlands
- Osteo-Pharma BV, OssThe Netherlands
| | - Jan A Gossen
- Department of Dentistry - Biomaterials, Radboudumc, Radboud University Nijmegen, NijmegenThe Netherlands
- Osteo-Pharma BV, OssThe Netherlands
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Alfaifi MY, Shati AA, Alshehri MA, Elbehairi SEI, Fahmy UA, Alshehri OY. Atorvastatin-TPGS-PLGA Nanoparticles Cytotoxicity Augmentation Against Liver Cancer HepG2 cells. INT J PHARMACOL 2020. [DOI: 10.3923/ijp.2020.79.86] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bode C, Kranz H, Siepmann F, Siepmann J. Coloring of PLGA implants to better understand the underlying drug release mechanisms. Int J Pharm 2019; 569:118563. [DOI: 10.1016/j.ijpharm.2019.118563] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 11/29/2022]
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Vijayakrishna K, Patil S, Shaji LK, Panicker RR. Gentamicin Loaded PLGA based Biodegradable Material for Controlled Drug Delivery. ChemistrySelect 2019. [DOI: 10.1002/slct.201900737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Kari Vijayakrishna
- School of Basic SciencesIndian Institute of Technology Bhubaneswar PIN-752050, Odisha India
| | - Shrikant Patil
- Department of ChemistrySchool of Advanced SciencesVellore Institute of Technology Vellore – 632 014, Tamil Nadu India
| | - Leyana K Shaji
- Department of ChemistrySchool of Advanced SciencesVellore Institute of Technology Vellore – 632 014, Tamil Nadu India
| | - Rakesh R Panicker
- Department of ChemistrySchool of Advanced SciencesVellore Institute of Technology Vellore – 632 014, Tamil Nadu India
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Kim BH, Huh BK, Lee WS, Kim CR, Lee KS, Nam SY, Lee M, Heo CY, Choy YB. Silicone Implant Coated with Tranilast-Loaded Polymer in a Pattern for Fibrosis Suppression. Polymers (Basel) 2019; 11:polym11020223. [PMID: 30960207 PMCID: PMC6419080 DOI: 10.3390/polym11020223] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/25/2019] [Accepted: 01/26/2019] [Indexed: 12/17/2022] Open
Abstract
Pathologic fibrosis around silicone implants is problematic, and thus, these implants have been coated with a mixture of a biocompatible polymer and antifibrotic drug for sustained drug release to prevent fibrosis. However, a coating applied over an entire surface would be subject to mechanical instability as the implant would be severely crumpled for implant insertion. Therefore, in this work, we proposed localized, patterned coating dots, each composed of poly(lactic-co-glycolic acid) (PLGA) and tranilast, to be applied on the surface of silicone implants. The drug loaded in the pattern-coated implant herein was well retained after a cyclic tensile test. Due to the presence of PLGA in each coating dot, the tranilast could be released in a sustained manner for more than 14 days. When implanted in a subcutaneous pocket in living rats for 12 weeks, compared with the intact implant, the pattern-coated implant showed a decreased capsule thickness and collagen density, as well as less transforming growth factor-β (TGF-β) expression and fewer fibroblasts; importantly, these changes were similar between the surfaces with and without the coating dots. Therefore, we conclude that the pattern-coating strategy proposed in this study can still effectively prevent fibrosis by maintaining the physical stability of the coatings.
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Affiliation(s)
- Byung Hwi Kim
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul 03080, Korea.
| | - Beom Kang Huh
- Interdisciplinary Program for Bioengineering, College of Engineering, Seoul National University, Seoul 08826, Korea.
| | - Won Suk Lee
- Interdisciplinary Program for Bioengineering, College of Engineering, Seoul National University, Seoul 08826, Korea.
| | - Cho Rim Kim
- Interdisciplinary Program for Bioengineering, College of Engineering, Seoul National University, Seoul 08826, Korea.
| | - Kyu Sang Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Sun-Young Nam
- Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Miji Lee
- Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Chan Yeong Heo
- Interdisciplinary Program for Bioengineering, College of Engineering, Seoul National University, Seoul 08826, Korea.
- Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
- Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul 03080, Korea.
| | - Young Bin Choy
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul 03080, Korea.
- Interdisciplinary Program for Bioengineering, College of Engineering, Seoul National University, Seoul 08826, Korea.
- Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Korea.
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