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Segan S, Jakobi M, Khokhani P, Klimosch S, Billing F, Schneider M, Martin D, Metzger U, Biesemeier A, Xiong X, Mukherjee A, Steuer H, Keller BM, Joos T, Schmolz M, Rothbauer U, Hartmann H, Burkhardt C, Lorenz G, Schneiderhan-Marra N, Shipp C. Systematic Investigation of Polyurethane Biomaterial Surface Roughness on Human Immune Responses in vitro. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3481549. [PMID: 32461979 PMCID: PMC7240656 DOI: 10.1155/2020/3481549] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/29/2020] [Accepted: 03/04/2020] [Indexed: 01/06/2023]
Abstract
It has been widely shown that biomaterial surface topography can modulate host immune response, but a fundamental understanding of how different topographies contribute to pro-inflammatory or anti-inflammatory responses is still lacking. To investigate the impact of surface topography on immune response, we undertook a systematic approach by analyzing immune response to eight grades of medical grade polyurethane of increasing surface roughness in three in vitro models of the human immune system. Polyurethane specimens were produced with defined roughness values by injection molding according to the VDI 3400 industrial standard. Specimens ranged from 0.1 μm to 18 μm in average roughness (Ra), which was confirmed by confocal scanning microscopy. Immunological responses were assessed with THP-1-derived macrophages, human peripheral blood mononuclear cells (PBMCs), and whole blood following culture on polyurethane specimens. As shown by the release of pro-inflammatory and anti-inflammatory cytokines in all three models, a mild immune response to polyurethane was observed, however, this was not associated with the degree of surface roughness. Likewise, the cell morphology (cell spreading, circularity, and elongation) in THP-1-derived macrophages and the expression of CD molecules in the PBMC model on T cells (HLA-DR and CD16), NK cells (HLA-DR), and monocytes (HLA-DR, CD16, CD86, and CD163) showed no influence of surface roughness. In summary, this study shows that modifying surface roughness in the micrometer range on polyurethane has no impact on the pro-inflammatory immune response. Therefore, we propose that such modifications do not affect the immunocompatibility of polyurethane, thereby supporting the notion of polyurethane as a biocompatible material.
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Affiliation(s)
- Sören Segan
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Meike Jakobi
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Paree Khokhani
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Sascha Klimosch
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
- HOT Screen GmbH, Aspenhaustraße 25, 72770 Reutlingen, Germany
| | - Florian Billing
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Markus Schneider
- University of Applied Sciences, Reutlingen, Alteburgstr. 150, 72762 Reutlingen, Germany
| | - Dagmar Martin
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Ute Metzger
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Antje Biesemeier
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
- Center for Ophthalmology, University Hospital Tübingen, Schleichstr. 12/1, 72076 Tübingen, Germany
| | - Xin Xiong
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Ashutosh Mukherjee
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Heiko Steuer
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | | | - Thomas Joos
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Manfred Schmolz
- HOT Screen GmbH, Aspenhaustraße 25, 72770 Reutlingen, Germany
| | - Ulrich Rothbauer
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
- University of Tübingen, Geschwister-Scholl-Platz, 72074 Tübingen, Germany
| | - Hanna Hartmann
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Claus Burkhardt
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Günter Lorenz
- University of Applied Sciences, Reutlingen, Alteburgstr. 150, 72762 Reutlingen, Germany
| | - Nicole Schneiderhan-Marra
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Christopher Shipp
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
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Abstract
The concept of the "smart" pacemaker has been continuously changing during 40 years of progress in technology. When we talk today about smart pacemakers, it means optimal treatment, diagnosis, and follow-up for patients fitting the current indications for pacemakers. So what is smart today becomes accepted as "state of the art" tomorrow. Originally, implantable pacemakers were developed to save lives from prolonged episodes of bradycardia and/or complete heart block. Now, in addition, they improve quality of life via numerous different functions acting under specific conditions, thanks to the introduction of microprocessors. The devices have become smaller, with the miniaturization of the electrical components, without compromising longevity. Nevertheless, there are still some unmatched objectives for these devices, for example, the optimization of cardiac output and the management of atrial arrhythmias in dual-chamber devices. Furthermore, indications continue to evolve, which in turn require new, additional functions. These functions are often very complex, necessitating computerized programming to simplify application. In addition, the follow-up of these devices is time-consuming, as appropriate system performance has to be regularly monitored. A great many of these functions could be automatically performed and documented, thus enabling physicians and paramedical staff to avoid losing time with routine control procedures. In addition, modern pacemakers offer extensive diagnostic functions to help diagnose patient symptoms and pacemaker system problems. Different types of data are available, and their presentation differs from one company to the other. This huge amount of data can only be managed with automatic diagnostic functions. Thus, the smart pacemaker of the near future should offer high flexibility to permit easy programming of available therapies and follow-up, and extensive, easily comprehensible diagnostic functions.
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Affiliation(s)
- N Saoudi
- Department of Cardiology, CHRU Charles Nicolle, Rouen, France
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Schüppel R, Binner L. Pacemaker Therapy: How do Patients Cope with the Icon of Modern Antibradycard Treatment? Int J Artif Organs 1997. [DOI: 10.1177/039139889702000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- R Schüppel
- University of Ulm, Department of Psychosomatic Medicine, Ulm
| | - L. Binner
- University of Ulm, Department of Internal Medicine II (Angiology, Cardiology, Nephrology, Pneumology), Ulm - Germany
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