Sustained Release of Voriconazole Using 3D-Crosslinked Hydrogel Rings and Rods for Use in Corneal Drug Delivery

Corneal disorders and diseases are prevalent in the field of clinical ophthalmology. Fungal keratitis, one of the major factors leading to visual impairment and blindness worldwide, presents significant challenges for traditional topical eye drop treatments. The objective of this study was to create biocompatible 3D-crosslinked hydrogels for drug delivery to the cornea, intending to enhance the bioavailability of ophthalmic drugs. Firstly, a series of flexible and porous hydrogels were synthesized (free-radical polymerization), characterized, and evaluated. The materials were prepared by the free-radical polymerization reaction of 1-vinyl-2-pyrrolidinone (also known as N-vinylpyrrolidone or NVP) and 1,6-hexanediol dimethacrylate (crosslinker) in the presence of polyethylene glycol 1000 (PEG-1000) as the porogen. After the physicochemical characterization of these materials, the chosen hydrogel demonstrated outstanding cytocompatibility in vitro. Subsequently, the selected porous hydrogels could be loaded with voriconazole, an antifungal medication. The procedure was adapted to realize a loading of 175 mg voriconazole per ring, which slightly exceeds the amount of voriconazole that is instilled into the eye via drop therapy (a single eye drop corresponds with approximately 100 mg voriconazole). The voriconazole-loaded rings exhibited a stable zero-order release pattern over the first two hours, which points to a significantly improved bioavailability of the drug. Ex vivo experiments using the established porcine eye model provided confirmation of a 10-fold increase in drug penetration into the cornea (after 2 h of application of the hydrogel ring, 35.8 ± 3.2% of the original dose is retrieved from the cornea, which compares with 3.9 ± 1% of the original dose in the case of eye drop therapy). These innovative hydrogel rods and rings show great potential for improving the bioavailability of ophthalmic drugs, which could potentially lead to reduced hospitalization durations and treatment expenses.

Application of blood purification based on a new type of nanofiber membrane in critically ill patients and comparative analysis of its nursing methods

Blood purification technology is one of the main treatment methods to prolong the life of severe patients. The traditional blood purification membrane materials have the disadvantages of non-selective adsorption, single pore size and low permeability, and need to develop new and efficient blood purification membrane materials. To explore the application of a new type of nanofiber membrane in blood purification of critically ill patients and compare and analyze its nursing methods. When the experimental subjects are performing blood purification, a new nanofiber membrane material is used in the purification machine. The control group adopted conventional nursing methods, while the experimental group adopted targeted nursing methods based on the nursing methods of the control group. After intervention, the eight indicators of quality of life in the experimental group were significantly improved (P < 0.05), for example, the score of physiological function was increased from 41.042 ± 7.625 to 54.236 ± 2.544, and the energy status was increased from 46.094 ± 7.192 to 59.768 ± 4.241. The physiological and biochemical indexes of both groups tend to be normal, but the experimental group is more obvious. The patients in the experimental group were more satisfied with the nursing services provided in the process. The new blood purification method of nanofiber membrane can overcome the shortcomings of traditional purification and remove toxic small and medium-sized molecules to the maximum extent.

Elimination of Uremic Toxins by Functionalized Graphene-Based Composite Beads for Direct Hemoperfusion

Conventional absorbents for hemoperfusions suffer from low efficiency and slow absorption with numerous side effects. In this research, we developed cellulose acetate (CA) functionalized graphene oxide (GO) beads (∼1.5-2 mm) that can be used for direct hemoperfusion, aiming at the treatment of kidney dysfunction. The CA-functionalized GO bead facilitates adsorption of toxins with high biocompatibility and high-efficiency of hemoperfusion while maintaining high retention for red blood cell, white blood cells, and platelets. Our in vitro results show that the toxin concentration for creatinine reduced from 0.21 to 0.12 μM (p < 0.005), uric acid from 0.31 to 0.15 mM (p < 0.005), and bilirubin from 0.36 to 0.09 mM (p < 0.005), restoring to normal levels within 2 h. Our in vivo study on rats (Sprague-Dawley, n = 30) showed that the concentration for creatinine reduced from 83.23 to 54.87 μmol L^-1 (p < 0.0001) and uric acid from 93.4 to 54.14 μmol L^-1 (p < 0.0001), restoring to normal levels within 30 min. Results from molecular dynamics (MD) simulations using free-energy calculations reveal that the presence of CA on GO increases the surface area for adsorption and enhances penetration of toxins in the binding cavities because of the increased electrostatic and van der Waals force (vdW) interactions. These results provide critical insight to fabricate graphene-based beads for hemoperfusion and to have the potential for the treatment of blood-related disease.

Ex vivo evaluation of the blood compatibility of mixed matrix haemodialysis membranes

The patients with end stage kidney disease need haemodialysis therapies, using an artificial kidney. Nevertheless, the current therapies cannot remove a broad range of uremic toxins compared to the natural kidney. Adsorption therapies, using sorbent-based columns, can improve the clearance of uremic toxins, but the sorbent particles often require polymeric coatings to improve their haemocompatibility leading to mass transfer limitations and to lowering of their performance. Earlier, we have developed a dual layer Mixed Matrix fiber Membrane (MMM) based on polyethersulfone/polyvinylpyrrolidone (PES/PVP) polymer blends. There, the sorbent activated carbon particles are embedded in the outer membrane layer for achieving higher removal whereas the inner blood contacting selective membrane layer should achieve optimal blood compatibility. In this work, we evaluate in detail the haemocompatibility of the MMM following the norm ISO 10993-4. We study two generations of MMM having different dimensions and transport characteristics; one with low flux and no albumin leakage and another with high flux but some albumin leakage. The results are compared to those of home-made PES/PVP single layer hollow fiber and to various control fibers already applied in the clinic. Our results show that the low flux MMM successfully avoids contact of blood with the activated carbon and has good haemocompatibility, comparable to membranes currently used in the clinic. STATEMENT OF SIGNIFICANCE: Haemodialysis is a life-sustaining extracorporeal treatment for renal disease, however a broad range of uremic toxins cannot still be removed. In our previous works we showed that a double layer Mixed Matrix Membrane (MMM) composed of polyethersulfone/polyvinylpyrrolidone and activated carbon can achieve higher removal of uremic toxics compared to commercial haemodialysers. In this work we evaluate the haemocompatibility profile of the MMM in order to facilitate its clinical implementation. The lumen particle-free layer of the MMM successfully avoids the contact of blood with the poorly blood-compatible activated carbon. Moreover, thanks to the high amount of polyvinylpyrrolidone and to the smoothness of the lumen layer, the MMM has very good haemocompatibility, comparable to membranes currently used in the clinic.

Supermacroporous Composite Cryogels in Biomedical Applications

Supermacroporous gels, called cryogels, are unique scaffolds that can be prepared by polymerization of monomer solution under sub-zero temperatures. They are widely used in many applications and have significant potential biomaterials, especially for biomedical applications due to their inherent interconnected supermacroporous structures and easy formation of composite polymers in comparison to other porous polymer synthesis techniques. This review highlights the fundamentals of supermacroporous cryogels and composite cryogels, and then comprehensively summarizes recent studies in preparation, functionalization, and utilization with mechanical, biological and physicochemical features, according to the biomedical applications. Furthermore, conclusions and outlooks are discussed for the use of these promising and durable supermacroporous composite cryogels.

Nanofibrous Tubular Membrane for Blood Hemodialysis

As the most important components of a hemodialysis device, nanofibrous membranes enjoy high interconnected porosity and specific surface area as well as excellect permeability. In this study, a tubular nanofibrous membrane of polysulfone nanofibers was produced via electrospinning method to remove urea and creatinine from urine and blood serums of dialysis patients. Nanofibrous membranes were electrospun at a concentration of 11.5 wt% of polysulfone (PS) and dimethylformamide (DMF)/tetrahydrofuran (THF) with a ratio of 70/30. The effects of the rotational speed of collectors, electrospinning duration, and inner diameter of the tubular nanofibrous membrane on the urea and creatinine removal efficiency of the tubular membrane were investigated through the hemodialysis simulation experiments. It was found that the tubular membrane with an inner diameter of 3 mm elecrospun at shorter duration with lower collecting speed had the highest urea and creatinine removal efficiency. The hemodialysis simulation experiment showed that the urea and creatinine removal efficiency of the tubular membrane with a diameter of 3 mm were 90.4 and 100%, respectively. Also, three patients' blood serums were tested with the nanofibrous membrane. The results showed that the creatinine and urea removal rates were 93.2 and 90.3%, respectively.

Biocompatibility of polymer-based biomaterials and medical devices – regulations,in vitroscreening and risk-management

Biomaterials play an increasing role in modern health care systems.

Graphene oxide and sulfonated polyanion co-doped hydrogel films for dual-layered membranes with superior hemocompatibility and antibacterial activity

GO based dual-layered membranes with superior hemocompatibility and antibacterial activity have potential application for clinical hemodialysis and many other biomedical therapies.

Graphene oxide linked sulfonate-based polyanionic nanogels as biocompatible, robust and versatile modifiers of ultrafiltration membranes

A GO linked sulfonate-based polyanionic nanogel as a membrane modifier has application potential in clinical hemodialysis and other biomedical therapies.

Development of a living membrane comprising a functional human renal proximal tubule cell monolayer on polyethersulfone polymeric membrane

The need for improved renal replacement therapies has stimulated innovative research for the development of a cell-based renal assist device. A key requirement for such a device is the formation of a "living membrane", consisting of a tight kidney cell monolayer with preserved functional organic ion transporters on a suitable artificial membrane surface. In this work, we applied a unique conditionally immortalized proximal tubule epithelial cell (ciPTEC) line with an optimized coating strategy on polyethersulfone (PES) membranes to develop a living membrane with a functional proximal tubule epithelial cell layer. PES membranes were coated with combinations of 3,4-dihydroxy-l-phenylalanine and human collagen IV (Coll IV). The optimal coating time and concentrations were determined to achieve retention of vital blood components while preserving high water transport and optimal ciPTEC adhesion. The ciPTEC monolayers obtained were examined through immunocytochemistry to detect zona occludens 1 tight junction proteins. Reproducible monolayers were formed when using a combination of 2 mg ml(-1) 3,4-dihydroxy-l-phenylalanine (4 min coating, 1h dissolution) and 25 μg ml(-1) Coll IV (4 min coating). The successful transport of (14)C-creatinine through the developed living membrane system was used as an indication for organic cation transporter functionality. The addition of metformin or cimetidine significantly reduced the creatinine transepithelial flux, indicating active creatinine uptake in ciPTECs, most likely mediated by the organic cation transporter, OCT2 (SLC22A2). In conclusion, this study shows the successful development of a living membrane consisting of a reproducible ciPTEC monolayer on PES membranes, an important step towards the development of a bioartificial kidney.

Preparation, characterization and antifouling properties of polyacrylonitrile/polyurethane blend membranes for water purification

70% PAN and 30% PU blend membrane shows the maximum antifowling characteristics during filtration of turbed surface water.

Construction of d-α-tocopheryl polyethylene glycol succinate/PEO core–shell nanofibers on a blood-contacting surface to reduce the hemolysis of preserved erythrocytes

The TPGS released from the electrospun SEBS protected the preserved red blood cells from oxidative damage, resulting in low hemolysis and mechanical fragility.

Adsorption of albumin on flax fibers increases endothelial cell adhesion and blood compatibility in vitro

The physical and chemical properties of flax (linen) are attractive from the perspective of biomaterials science and engineering. Flax textiles uniquely combine hydrophilicity and strength, with the technical know-how to produce precisely engineered two- and three-dimensional knitted or woven structures. It is, however, extremely difficult to completely remove endotoxins from the flax, and this essentially precludes the use of linen for implant purposes. Herein, the potential utility of flax textiles for blood-contacting applications is investigated, using purified two-dimensional mesh specimens, with and without an albumin surface coating. It was hypothesized that the albumin coating will abolish the effect of adherent endotoxins at the flax's surface. In vitro cell viability assays showed that the flax mesh ± albumin is not cytotoxic. The albumin coating reduced (but not abolished) the effect of surface-exposed endotoxins (Limulus amebocyte lysate test). Under dynamic conditions, the albumin coating favors coverage with endothelial cells. Experiments with fresh human blood plasma (platelet-rich and platelet-free) showed that the albumin coating reduces the thrombogenicity in vitro. Platelets adhered to the albumin-coated flax mesh showed a less flattened structure. Although the results of this work cannot be extrapolated easily to in vivo situations, the data reveal that woven or knitted tubular structures produced from flax fibers may hold promise as implantable blood contacting devices like for instance vascular grafts.