Graphene oxide-doping improves the biocompatibility and separation performance of polyethersulfone hollow fiber membranes for bioartificial kidney application

Fabrication and characterization of dual-layer hollow fibre membranes incorporating poly(citric acid)-grafted GO with enhanced antifouling properties for water treatment

Membrane fouling during the filtration process is a perennial issue and could lead to reduced separation efficiency. In this work, poly(citric acid)-grafted graphene oxide (PGO) was incorporated into a matrix of single-layer hollow fibre (SLHF) and dual-layer hollow fibrr (DLHF) membranes, respectively, aiming to improve membrane antifouling properties during water treatment. Different loadings of PGO ranging from 0 to 1 wt% were first introduced into the SLHF to identify the best PGO loading for the DLHF preparation with its outer layer modified by nanomaterials. The findings showed that at the optimized PGO loading of 0.7 wt%, the resultant SLHF membrane could achieve higher water permeability and bovine serum albumin rejection compared to the neat SLHF membrane. This is due to the improved surface hydrophilicity and increased structural porosity upon incorporation of optimized PGO loading. When 0.7 wt% PGO was introduced only to the outer layer of DLHF, the cross-sectional matrix of the membrane was altered, forming microvoids and spongy-like structures (more porous). Nevertheless, the BSA rejection of the membrane was improved to 97.7% owing to an inner selectivity layer produced from a different dope solution (without the PGO). The DLHF membrane also demonstrated significantly higher antifouling properties than the neat SLHF membrane. Its flux recovery rate is 85%, i.e. 37% better than that of a neat membrane. By incorporating hydrophilic PGO into the membrane, the interaction of the hydrophobic foulants with the membrane surface is greatly reduced.

Advances in Enhancing Hemocompatibility of Hemodialysis Hollow-Fiber Membranes

Hemodialysis, the most common modality of renal replacement therapy, is critically required to remove uremic toxins from the blood of patients with end-stage kidney disease. However, the chronic inflammation, oxidative stress as well as thrombosis induced by the long-term contact of hemoincompatible hollow-fiber membranes (HFMs) contribute to the increase in cardiovascular diseases and mortality in this patient population. This review first retrospectively analyzes the current clinical and laboratory research progress in improving the hemocompatibility of HFMs. Details on different HFMs currently in clinical use and their design are described. Subsequently, we elaborate on the adverse interactions between blood and HFMs, involving protein adsorption, platelet adhesion and activation, and the activation of immune and coagulation systems, and the focus is on how to improve the hemocompatibility of HFMs in these aspects. Finally, challenges and future perspectives for improving the hemocompatibility of HFMs are also discussed to promote the development and clinical application of new hemocompatible HFMs.

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Biocompatibility evaluation of polyethersulfone-pyrolytic carbon composite membrane in artificial pancreas

Polyethersulfone (PES) membranes are widely used in medical devices, especially intravascular devices such as intravascular bioartificial pancreases. In the current work, the pure PES and PES-pyrolytic carbon (PyC) composite membranes were synthesized and permeability studies were conducted. In addition, the cytocompatibility and hemocompatibility of the pure PES and PES-PyC membranes were investigated. These materials were characterized using peripheral blood mononuclear cell (PBMC) activation, platelet activation, platelet adhesion, ß-cell viability and proliferation, and ß-cell response to hyperglycemia. The results showed that platelet activation decreased from 87.3% to 27.8%. Any alteration in the morphology of sticking platelets was prevented, and the number of attached platelets decreased by modification with PyC. The 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay corroborated that PBMC activation was encouraged by the PyC-modified PES membrane surface. It can be concluded that PES-modified membranes show higher hemocompatibility than pure PES membranes. ß-cells cultured on all the three membranes displayed a lower rate of proliferation although the cells on the PES-PyC (0.1 wt. %) membrane indicated a slightly higher viability and proliferation than those on the pure PES and PES-PyC (0.05 wt. %) membranes. It shows that the PES-PyC (0.1 wt. %) membrane possesses superior cytocompatibility over the other membranes.

Surface Engineering of a Bioartificial Membrane for Its Application in Bioengineering Devices

Membrane technology is playing a crucial role in cutting-edge innovations in the biomedical field. One such innovation is the surface engineering of a membrane for enhanced longevity, efficient separation, and better throughput. Hence, surface engineering is widely used while developing membranes for its use in bioartificial organ development, separation processes, extracorporeal devices, etc. Chemical-based surface modifications are usually performed by functional group/biomolecule grafting, surface moiety modification, and altercation of hydrophilic and hydrophobic properties. Further, creation of micro/nanogrooves, pillars, channel networks, and other topologies is achieved to modify physio-mechanical processes. These surface modifications facilitate improved cellular attachment, directional migration, and communication among the neighboring cells and enhanced diffusional transport of nutrients, gases, and waste across the membrane. These modifications, apart from improving functional efficiency, also help in overcoming fouling issues, biofilm formation, and infection incidences. Multiple strategies are adopted, like lysozyme enzymatic action, topographical modifications, nanomaterial coating, and antibiotic/antibacterial agent doping in the membrane to counter the challenges of biofilm formation, fouling challenges, and microbial invasion. Therefore, in the current review, we have comprehensibly discussed different types of membranes, their fabrication and surface modifications, antifouling/antibacterial strategies, and their applications in bioengineering. Thus, this review would benefit bioengineers and membrane scientists who aim to improve membranes for applications in tissue engineering, bioseparation, extra corporeal membrane devices, wound healing, and others.

Artificial Kidney Engineering: The Development of Dialysis Membranes for Blood Purification

The artificial kidney, one of the greatest medical inventions in the 20th century, has saved innumerable lives with end stage renal disease. Designs of artificial kidney evolved dramatically in decades of development. A hollow-fibered membrane with well controlled blood and dialysate flow became the major design of the modern artificial kidney. Although they have been well established to prolong patients’ lives, the modern blood purification system is still imperfect. Patient’s quality of life, complications, and lack of metabolic functions are shortcomings of current blood purification treatment. The direction of future artificial kidneys is toward miniaturization, better biocompatibility, and providing metabolic functions. Studies and trials of silicon nanopore membranes, tissue engineering for renal cell bioreactors, and dialysate regeneration are all under development to overcome the shortcomings of current artificial kidneys. With all these advancements, wearable or implantable artificial kidneys will be achievable.

Influence of Dialysis Membranes on Clinical Outcomes: From History to Innovation

Dialysis membranes were traditionally classified according to their material compositions (i.e., as cellulosic or synthetic) and on the basis of the new concept of the sieving coefficient (determined by the molecular weight retention onset and molecular weight cut-off). The advantages of synthetic polymer membranes over cellulose membranes are also described on the basis of their physical, chemical, and structural properties. Innovations of dialysis membrane in recent years include the development of medium cutoff membranes; graphene oxide membranes; mixed-matrix membranes; bioartificial kidneys; and membranes modified with vitamin E, lipoic acid, and neutrophil elastase inhibitors. The current state of research on these membranes, their effects on clinical outcomes, the advantages and disadvantages of their use, and their potential for clinical use are outlined and described.

Insights from molecular dynamics simulations of albumin adsorption on hydrophilic and hydrophobic surfaces

Protein adsorption at the surface affects the material biocompatibility directly as it is the first reaction that happens when a foreign material comes in contact with blood. In this study, the mechanism of albumin adsorption on hydrophilic and hydrophobic surfaces is investigated. Although it is studied extensively and has been of keen interest for decades, the adsorptive nature of albumin is still not fully understood with contradicting reported studies. This problem results from previous works focusing on mostly qualitative and quantitative adsorption properties of albumin, rather than the specific interaction mechanisms. The variable local surface properties across albumin can significantly impact adsorption and must be explored. In this work, the effect of hydration is found to significantly increase adsorption with minor reductions. The adsorption of albumin on hydrophilic or hydrophobic surfaces is dependent on albumin orientation, which is dictated by local charge effects. Based on these findings, an optimized material surface is proposed to minimize albumin adsorption using functional groups to limit surface availability for hydrophobic interactions while inhibiting excess electrostatic effects at hydrophilic sites. The extent of albumin adsorption and shape change are characterized herein using the heat capacity. Current study identifies interaction mechanisms previously missing in literature, which are responsible for inconsistent adsorption results.

A Review of Commercial Developments and Recent Laboratory Research of Dialyzers and Membranes for Hemodialysis Application

Dialyzers have been commercially used for hemodialysis application since the 1950s, but progress in improving their efficiencies has never stopped over the decades. This article aims to provide an up-to-date review on the commercial developments and recent laboratory research of dialyzers for hemodialysis application and to discuss the technical aspects of dialyzer development, including hollow fiber membrane materials, dialyzer design, sterilization processes and flow simulation. The technical challenges of dialyzers are also highlighted in this review, which discusses the research areas that need to be prioritized to further improve the properties of dialyzers, such as flux, biocompatibility, flow distribution and urea clearance rate. We hope this review article can provide insights to researchers in developing/designing an ideal dialyzer that can bring the best hemodialysis treatment outcomes to kidney disease patients.

Graphene Oxide Coating Improves the Mechanical and Biological Properties of Decellularized Umbilical Cord Arteries

The lack of small-diameter vascular grafts (inner diameter <5 mm) to substitute autologous grafts in arterial bypass surgeries has a massive impact on the prognosis and progression of cardiovascular diseases, the leading cause of death globally. Decellularized arteries from different sources have been proposed as an alternative, but their poor mechanical performance and high collagen exposure, which promotes platelet and bacteria adhesion, limit their successful application. In this study, these limitations were surpassed for decellularized umbilical cord arteries through the coating of their lumen with graphene oxide (GO). Placental and umbilical cord arteries were decellularized and perfused with a suspension of GO (C/O ratio 2:1) with ∼1.5 μm lateral size. A homogeneous GO coating that completely covered the collagen fibers was obtained for both arteries, with improvement of mechanical properties being achieved for umbilical cord decellularized arteries. GO coating increased the maximum force in 27%, the burst pressure in 29%, the strain in 25%, and the compliance in 10%, compared to umbilical cord decellularized arteries. The achieved theoretical burst pressure (1960 mmHg) and compliance (13.9%/100 mmHg) are similar to the human saphenous vein and mammary artery, respectively, which are used nowadays as the gold standard in coronary and peripheral artery bypass surgeries. Furthermore, and very importantly, coatings with GO did not compromise the endothelial cell adhesion but decreased platelet and bacteria adhesion to decellularized arteries, which will impact on the prevention of thrombosis and infection, until full re-endothetialization is achieved. Overall, our results reveal that GO coating has an effective role in the improvement of decellularized umbilical cord artery performance, which is a huge step toward their application as a small-diameter vascular graft.

Graphene-based materials: the key for the successful application of pHEMA as a blood-contacting device

Thrombosis and infection are the leading causes of blood-contacting device (BCD) failure, mainly due to the poor performance of existing biomaterials. Poly(2-hydroxyethyl methacrylate) (pHEMA) has excellent hemocompatibility but the weak mechanical properties impair its use as a bulk material for BCD. As such, pHEMA has been explored as a coating, despite the instability and difficulty of attachment to the underlying polymer compromise its success. This work describes the hydrogel composites made of pHEMA and graphene-based materials (GBM) that meet the biological and mechanical requirements for a stand-alone BCD. Five GBM differing in thickness, oxidation degree, and lateral size were incorporated in pHEMA, revealing that only oxidized-GBM can reinforce pHEMA. pHEMA/oxidized-GBM composites are cytocompatible and prevent the adhesion of endothelial cells, blood platelets, and bacteria (S. aureus), thus maintaining pHEMA's anti-adhesive properties. As a proof of concept, the thrombogenicity of the tubular prototypes of the best formulation (pHEMA/Graphene oxide (GO)) was evaluated in vivo, using a porcine arteriovenous-shunt model. pHEMA/GO conduits withstand the blood pressure and exhibit negligible adhesion of blood components, revealing better hemocompatibility than ePTFE, a commercial material for vascular access. Our findings reveal pHEMA/GO, a synthetic and off-the-shelf hydrogel, as a preeminent material for the design of blood-contacting devices that prevent thrombosis and bacterial adhesion.

Vorapaxar-modified polysulfone membrane with high hemocompatibility inhibits thrombosis

Hemodialysis therapy is intended for patients suffering from renal insufficiency, pancreatitis, and other serious diseases. Platelets are an important active ingredient in the thrombosis induced by hemodialysis membranes. So far, there are few studies of hemodialysis membranes focusing on the effects of protease-activated receptor 1 (PAR1) activation on the platelet membrane. Among various antithrombotic agents, vorapaxar is a novel PAR1 inhibitor with high efficacy. In this study, we constructed a vorapaxar-modified polysulfone (VMPSf) membrane using immersion-precipitation phase transformation methods and characterized the microstructure in terms of hydrophilicity and mechanical properties. The water contact angle of the VMPSf membrane was 22.45% lower than that of the PSf membrane. A focused determination of platelet morphology was obtained using scanning electron microscopy. Meanwhile, we evaluated the effects of a VMPSf membrane on platelet adhesion. We observed that the VMPSf membrane could reduce the number of adhered platelets without altering their spherical or elliptical shape. The PAR1 levels in VMPSf membranes were 7.4 MFI lower than those in PSf membranes, suggesting that this modified membrane can effectively inhibit platelet activation. Activated partial thromboplastin time (APTT, 5.3 s extension) and thrombin time (TT, 2.1 s extension) reflect good anticoagulant properties. Recalcification time (80.6 s extension) and fibrinogen adsorption (9.9 μg/cm² reduction) were related to antithrombotic properties. To determine the biosafety of VMPSf membranes, we investigated antianaphylactic and anti-inflammatory properties in vitro and acute toxicity in vivo, it was obvious that C3a and C5a had decreased to 9.6 and 0.8 ng/mL, respectively. The results indicated that the VMPSf membrane has potential for clinical application.

Extracellular matrix-coated polyethersulfone-TPGS hollow fiber membranes showing improved biocompatibility and uremic toxins removal for bioartificial kidney application

In this study, L-3, 4-dihydroxyphenylalanine and human collagen type IV were coated over the outer surface of the custom-made hollow fiber membranes (HFMs) with the objective of simultaneously improving biocompatibility leading to proliferation of human embryonic kidney cells-293 (HEK-293) and improving separation of uremic toxins, thereby making them suitable for bioartificial kidney application. Physicochemical characterization showed the development of coated HFMs, resulting in low hemolysis (0.25 ± 0.10%), low SC5b-9 marker level (7.95 ± 1.50 ng/mL), prolonged blood coagulation time, and minimal platelet adhesion, which indicated their improved human blood compatibility. Scanning electron microscopy and confocal laser scanning microscopy showed significantly improved attachment and proliferation of HEK-293 cells on the outer surface of the coated HFMs, which was supported by the results of glucose consumption and MTT cell proliferation assay. The solute rejection profile of these coated HFMs was compared favorably with that of the commercial dialyzer membranes. These coated HFMs showed a remarkable 1.6-3.2 fold improvement in reduction ratio of uremic toxins as compared to standard dialyzer membranes. These results clearly demonstrated that these extracellular matrix-coated HFMs can be a potential biocompatible substrate for the attachment and proliferation of HEK-293 cells and removal of uremic toxins from the simulated blood, which may find future application for bioartificial renal assist device.

Lactobionic acid-functionalized polyethersulfone hollow fiber membranes promote HepG2 attachment and function

Surface modification of polyethersulfone hollow fibers, which are important in bio-artificial liver, is increasingly used to improve biocompatibility and promote the adhesion and proliferation of hepatocytes resulting in improved cell functionality. Hepatocytes are anchorage-dependent cells, and membrane surface modification enhances the hepatic cell adhesion and proliferation. Specific interaction of the asialoglycoprotein receptor on hepatocyte cell surfaces with a galactose moiety enhances the attachment of the cells on a biocompatible substrate. In this study, the outer surface of the polyethersulfone (P) hollow fiber membranes (HFMs) was chemically modified by covalent coupling with lactobionic acid (LBA). The energy dispersive X-ray spectrometry elemental mapping, attenuated total reflectance-Fourier transform infrared spectroscopy, and X-ray photoelectron spectroscopy confirmed the LBA-coupling on the outer surface of P-LBA HFMs. Hemocompatibility study indicated the suitability of the modified membranes with human blood. These membranes showed remarkably improved biocompatibility with human primary mesenchymal stem cells and HepG2 cells. Characteristic multi-cellular spheroids of HepG2 cells were observed under scanning electron and confocal microscopy. HepG2 cell functional activity was measured by quantifying the urea synthesis, albumin secretion and glucose consumption in the culture media, which indicated the improved HepG2 functions. These experimental results clearly suggest the potentiality of these LBA-modified P HFMs as a suitable biocompatible substrate for promoting HepG2 attachment and function leading to their application in bioreactors and bio-artificial liver devices.

Surface modification of polyethersulfone hollow fibers, which are important in bio-artificial liver, is increasingly used to improve biocompatibility and promote the adhesion and proliferation of hepatocytes resulting in improved cell functionality.