Poly(ethylene carbonate): A thermoelastic and biodegradable biomaterial for drug eluting stent coatings?

Implantable Medical Devices and Tissue Engineering: An Overview of Manufacturing Processes and the Use of Polymeric Matrices for Manufacturing and Coating their Surfaces

Medical devices are important diagnosis and therapy tools for several diseases which include a wide range of products. Technological advances in this area have been proposed to reduce adverse complication incidences. New technologies and manufacturing processes, as well as the development of new materials or medical devices with modified surface and the use of biodegradable polymeric devices such as a substrate for cell culture in the field of tissue engineering, have attracted considerable attention in recent years by the scientific community intended to produce medical devices with superior properties and morphology. This review article focused on implantable devices, addresses the major advances in the biomedical field related to the devices manufacture processes such as 3D printing and hot melting extrusion, and the use of polymer matrices composed of copolymers, blends, nanocomposites or grafted with antiproliferative drugs for manufacturing and/or coating the devices surface.

Emerging Trends in Abdominal Wall Reinforcement: Bringing Bio-Functionality to Meshes

Abdominal wall hernia is a recurrent issue world-wide and requires the implantation of over 1 million meshes per year. Because permanent meshes such as polypropylene and polyester are not free of complications after implantation, many mesh modifications and new functionalities have been investigated over the last decade. Indeed, mesh optimization is the focus of intense development and the biomaterials utilized are now envisioned as being bioactive substrates that trigger various physiological processes in order to prevent complications and to promote tissue integration. In this context, it is of paramount interest to review the most relevant bio-functionalities being brought to new meshes and to open new avenues for the innovative development of the next generation of meshes with enhanced properties for functional abdominal wall hernia repair.

New antibiotic-eluting mesh used for soft tissue reinforcement

The surgical implantation of prostheses for soft tissue repair may be followed by post-operative mesh-related infection, a significant and dramatic complication, that is treated by mesh removal. A new antibiotic-eluting mesh has been manufactured on pre-existing polypropylene prostheses using an airbrush spraying technology. Among the degradable polymers tested as coating agents and drug reservoirs, poly(ε-caprolactone) (PCL), which is deposited after heating, provides a homogeneous, regular and smooth shell around the polypropylene filaments of the mesh without dramatically altering the biomechanical properties of the new modified mesh. An anti-infective drug (e.g. ofloxacin) is incorporated into this polymeric coating giving a limited burst effect followed by sustained drug diffusion for several days. An ofloxacin-eluting mesh has demonstrated excellent antibacterial activity in vitro on Escherichia coli adherence, biofilm formation and inhibitory diameter, even with low drug loads. Although further in vivo investigations are required to draw conclusions on the anti-infective effectiveness of the coated mesh, the airbrush coating of ofloxacin-PCL on existing prostheses is already potentially appealing in an effort to decrease post-operative infection.

Influence of the 316 L stainless steel interface on the stability and barrier properties of plasma fluorocarbon films

Coatings are known to be one of the more suited strategies to tailor the interface between medical devices and the surrounding cells and tissues once implanted. The development of coatings and the optimization of their adhesion and stability are of major importance. In this work, the influence of plasma etching of the substrate on a plasma fluorocarbon ultrathin coating has been investigated with the aim of improving the stability and the corrosion properties of coated medical devices. The 316 L stainless steel interface was subjected to two different etching sequences prior to the plasma deposition. These plasma etchings, with H(2) and C(2)F(6) as gas precursors, modified the chemical composition and the thickness of the oxide layer and influenced the subsequent polymerization. The coating properties were evaluated using flat substrates submitted to deformation, aging into aqueous medium and corrosion tests. X-ray photoelectron spectroscopy (XPS), time of flight-secondary ion mass spectrometry (ToF-SIMS), ellipsometry, and atomic force microscopy (AFM) were performed to determine the effects of the deformation and the aging on the chemistry and morphology of the coated samples. Analyses showed that plasma etchings were essential to promote reproducible polymerization and film growth. However, the oxide layer thinning due to the etching lowered the corrosion resistance of the substrate and affected the stability of the interface. Still, the deformed samples did not exhibited adhesion and cohesion failure before and after the aging.

Polymeric coating of surface modified nitinol stent with POSS-nanocomposite polymer

Stent angioplasty is a successful treatment for arterial occlusion, particularly in coronary artery disease. The clinical communities were enthusiastic about the use of drug-eluting stents; however, these stents have a tendency to be a contributory factor towards late stage thrombosis, leading to mortality in a significant number of patients per year. This work presents an innovative approach in self-expanding coronary stents preparation. We developed a new nanocomposite polymer based on polyhedral oligomeric silsesquioxanes (POSS) and poly(carbonate-urea)urethane (PCU), which is an antithrombogenic and a non-biodegradable polymer with in situ endothelialization properties. The aim of this work is to coat a NiTi stent alloy with POSS-PCU. In prolonged applications in the human body, the corrosion of the NiTi alloy can result in the release of deleterious ions which leads to unwanted biological reactions. Coating the nitinol (NiTi) surface with POSS-PCU can enhance surface resistance and improve biocompatibility. Electrohydrodynamic spraying was used as the polymer deposition process and thus a few experiments were carried out to compare this process with casting. Prior to deposition the NiTi has been surface modified. The peel strength of the deposit was studied before and after degradation of the coating. It is shown that the surface modification enhances the peel strength by 300%. It is also indicated how the adhesion strength of the POSS-PCU coating changes post-exposure to physiological solutions comprised of hydrolytic, oxidative, peroxidative and biological media. This part of the study shows that the modified NiTi presents far greater resistance to decay in peel strength compared to the non-modified NiTi.

Evaluation of two polymeric blends (EVA/PLA and EVA/PEG) as coating film materials for paclitaxel-eluting stent application

The ethylene vinyl acetate copolymer (EVA)/Poly (lactic acid) (PLA) blend and EVA/Poly (ethylene glycol) (PEG) blend were applied as the drug carrier materials for a bi-layer drug-loaded stent coating film, which consisted of a paclitaxel (PTX)-loaded layer and a drug-free EVA layer. The changes of weight and appearance of the drug-free polymeric blend films with increasing time were examined by X-ray diffraction analysis (XRD), gel permeation chromatography (GPC) tests and scanning electronic microscopy (SEM), and the results showed the degradation of PLA and the leaching of PEG from the films. The effects of PLA, PEG and drug contents on in vitro drug release were investigated, and the results demonstrated that the addition of PLA promoted the drug release while the addition of PEG almost did not. Franz cells diffusion test results indicated that the bi-layer structure successfully endowed the stent coating with the release of drug in a unidirectional fashion. The release profiles of films incorporated PTX and the mechanical performance of the film could be customized by readily adjusting the contents of the blend components. Therefore, the polymeric blends could be useful drug carrier materials for drug-loaded stent coating capable of releasing drug in a highly tunable manner.

Characterization of [4Fe-4S]-containing and cluster-free forms of Streptomyces WhiD

WhiD, a member of the WhiB-like (Wbl) family of iron-sulfur proteins found exclusively within the actinomycetes, is required for the late stages of sporulation in Streptomyces coelicolor. Like all other Wbl proteins, WhiD has not so far been purified in a soluble form that contains a significant amount of cluster, and characterization has relied on cluster-reconstituted protein. Thus, a major goal in Wbl research is to obtain and characterize native protein containing iron-sulfur clusters. Here we report the analysis of S. coelicolor WhiD purified anaerobically from Escherichia coli as a soluble protein containing a single [4Fe-4S](2+) cluster ligated by four cysteines. Upon exposure to oxygen, spectral features associated with the [4Fe-4S] cluster were lost in a slow reaction that unusually yielded apo-WhiD directly without significant concentrations of cluster intermediates. This process was found to be highly pH dependent with an optimal stability observed between pH 7.0 and pH 8.0. Low molecular weight thiols, including a mycothiol analogue and thioredoxin, exerted a small but significant protective effect against WhiD cluster loss, an activity that could be of physiological importance. [4Fe-4S](2+) WhiD was found to react much more rapidly with superoxide than with either oxygen or hydrogen peroxide, which may also be of physiological significance. Loss of the [4Fe-4S] cluster to form apoprotein destabilized the protein fold significantly but did not lead to complete unfolding. Finally, apo-WhiD exhibited negligible activity in an insulin-based disulfide reductase assay, demonstrating that it does not function as a general protein disulfide reductase.

Polymer-mesoporous silica materials templated with an oppositely charged surfactant/polymer system for drug delivery

In this paper, polymer-mesoporous silica nanoparticles have been synthesized by a dual-template technology. Cationic polymer quaternized poly[bis(2-chloroethyl)ether-alt-1,3-bis[3-(dimethylamino)propyl]urea] (PEPU) and anionic surfactant sodium dodecyl sulfate (SDS) were used to form a homogeneous comicelle system to induce mesoporous silica spherical nanoparticles with diameters of 50-180 nm. The formation mechanism was studied by transmission electron microscopy (TEM), which suggested that PEPU played a cotemplate role in the synthesis process, and no mesoporous structure was generated without it. After removing the anionic surfactant, SDS, by an ion-exchange method, the cationic polymer-mesoporous silica nanoparticles were obtained. Using the materials as the host and ibuprofen (IBU)/captopril (CapH(2)) as the model drugs, the system revealed well-sustained release profiles.

Nanoscale architectural tuning of parylene patch devices to control therapeutic release rates

The advent of therapeutic functionalized implant coatings has significantly impacted the medical device field by enabling prolonged device functionality for enhanced patient treatment. Incorporation of drug release from a stable, biocompatible surface is instrumental in decreasing systemic application of toxic therapeutics and increasing the lifespan of implants by the incorporation of antibiotics and anti-inflammatories. In this study, we have developed a parylene C-based device for controlled release of Doxorubicin, an anti-cancer chemotherapy and definitive read-out for preserved drug functionality, and further characterized the parylene deposition condition-dependent tunability of drug release. Drug release is controlled by the deposition of a layer of 20-200 nm thick parylene over the drug layer. This places a porous layer above the Doxorubicin, limiting drug elution based on drug accessibility to solvent and the solvent used. An increase in the thickness of the porous top layer prolongs the elution of active drug from the device from, in the conditions tested, the order of 10 min to the order of 2 d in water and from the order of 10 min to no elution in PBS. Thus, the controlled release of an anti-cancer therapeutic has been achieved via scalably fabricated, parylene C-encapsulated drug delivery devices.

Luminal flow patterns dictate arterial drug deposition in stent-based delivery

Endovascular stents reside in a dynamic flow environment and yet the impact of flow on arterial drug deposition after stent-based delivery is only now emerging. We employed computational fluid dynamic modeling tools to investigate the influence of luminal flow patterns on arterial drug deposition and distribution. Flow imposes recirculation zones distal and proximal to the stent strut that extend the coverage of tissue absorption of eluted drug and induce asymmetry in tissue drug distribution. Our analysis now explains how the disparity in sizes of the two recirculation zones and the asymmetry in drug distribution are determined by a complex interplay of local flow and strut geometry. When temporal periodicity was introduced as a model of pulsatile flow, the net luminal flow served as an index of flow-mediated spatio-temporal tissue drug uptake. Dynamically changing luminal flow patterns are intrinsic to the coronary arterial tree. Coronary drug-eluting stents should be appropriately considered where luminal flow, strut design and pulsatility have direct effects on tissue drug uptake after local delivery.

Localized therapeutic release via an amine-functionalized poly-p-xylene microfilm device

Developing biocompatible polymeric platforms for drug delivery with enhanced localized activity represents a key facet of advanced interventional therapy. In this work, the drug-eluting potential of an amine-functionalized poly- p-xylene commonly known as Parylene A (4-amino(2,2)paracyclophane) was conducted with the microfilm device consisting of a primary base layer, drug film, and a secondary eluting layer presenting exposed amine groups which enhance the range of modifications that can be incorporated into the film. The murine macrophage cell line RAW 264.7 served as a cellular response to dexamethasone, a synthetic anti-inflammatory glucocorticoid and doxorubicin, an anticancer therapeutic. Decreased expression of NFkappa-B-mediated cytokines Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNFalpha), resultant DNA fragmentation, and spectroscopic analysis revealed the efficient and localized drug-eluting properties of the Parylene A polymeric bilayer.