Hemocompatibility of Super-Repellent surfaces: Current and Future

Color morphing surfaces with effective chemical shielding

Color morphing refers to color change in response to an environmental stimulus. Photochromic materials allow color morphing in response to light, but almost all photochromic materials suffer from degradation when exposed to moist/humid environments or harsh chemical environments. One way of overcoming this challenge is by imparting chemical shielding to the color morphing materials via superomniphobicity. However, simultaneously imparting color morphing and superomniphobicity, both surface properties, requires a rational design. In this work, we systematically design color morphing surfaces with superomniphobicity through an appropriate combination of a photochromic dye, a low surface energy material, and a polymer in a suitable solvent (for one-pot synthesis), applied through spray coating (for the desired texture). We also investigate the influence of polymer polarity and material composition on color morphing kinetics and superomniphobicity. Our color morphing surfaces with effective chemical shielding can be designed with a wide variety of photochromic and thermochromic pigments and applied on a wide variety of substrates. We envision that such surfaces will have a wide range of applications including camouflage soldier fabrics/apparel for chem-bio warfare, color morphing soft robots, rewritable color patterns, optical data storage, and ophthalmic sun screening.

Alginate based biomaterials for hemostatic applications: Innovations and developments

Development of the efficient hemostatic materials is an essential requirement for the management of hemorrhage caused by the emergency situations to avert most of the casualties. Such injuries require the use of external hemostats to facilitate the immediate blood clotting. A variety of commercially available hemostats are present in the market but most of them are associated with limitations such as exothermic reactions, low biocompatibility, and painful removal. Thus, fabrication of an ideal hemostatic composition for rapid blood clot formation, biocompatibility, and antimicrobial nature presents a real challenge to the bioengineers. Benefiting from their tunable fabrication properties, alginate-based hemostats are gaining importance due to their excellent biocompatibility, with >85 % cell viability, high absorption capacity exceeding 500 %, and cost-effectiveness. Furthermore, studies have estimated that wounds treated with sodium alginate exhibited a blood loss of 0.40 ± 0.05 mL, compared to the control group with 1.15 ± 0.13 mL, indicating its inherent hemostatic activity. This serves as a solid foundation for designing future hemostatic materials. Nevertheless, various combinations have been explored to further enhance the hemostatic potential of sodium alginate. In this review, we have discussed the possible role of alginate based composite hemostats incorporated with different hemostatic agents, such as inorganic materials, polymers, biological agents, herbal agents, and synthetic drugs. This article outlines the challenges which need to be addressed before the clinical trials and give an overview of the future research directions.

Fast Blood Oxygenation through Hemocompatible Asymmetric Polymer of Intrinsic Microporosity Membranes

Membrane technology has attracted considerable attention for chemical and medical applications, among others. Artificial organs play important roles in medical science. A membrane oxygenator, also known as artificial lung, can replenish O₂ and remove CO₂ of blood to maintain the metabolism of patients with cardiopulmonary failure. However, the membrane, a key component, is subjected to inferior gas transport property, leakage propensity, and insufficient hemocompatibility. In this study, we report efficient blood oxygenation by using an asymmetric nanoporous membrane that is fabricated using the classic nonsolvent-induced phase separation method for polymer of intrinsic microporosity-1. The intrinsic superhydrophobic nanopores and asymmetric configuration endow the membrane with water impermeability and gas ultrapermeability, up to 3,500 and 1,100 gas permeation units for CO₂ and O₂, respectively. Moreover, the rational hydrophobic-hydrophilic nature, electronegativity, and smoothness of the surface enable the substantially restricted protein adsorption, platelet adhesion and activation, hemolysis, and thrombosis for the membrane. Importantly, during blood oxygenation, the asymmetric nanoporous membrane shows no thrombus formation and plasma leakage and exhibits fast O₂ and CO₂ transport processes with exchange rates of 20 to 60 and 100 to 350 ml m^-2 min^-1, respectively, which are 2 to 6 times higher than those of conventional membranes. The concepts reported here offer an alternative route to fabricate high-performance membranes and expand the possibilities of nanoporous materials for membrane-based artificial organs.

Bilirubin Removal by Polymeric Adsorbents for Hyperbilirubinemia Therapy

Hyperbilirubinemia, presenting as jaundice, is a life-threatening critical illness in newborn babies and acute severe hepatic failure patients. Over the past few decades, extracorporeal hemoadsorption by adsorbent therapy has been widely applied in the treatment of hyperbilirubinemia. The capability of hemoadsorption depends on the adsorbents. Most of the clinically used bilirubin adsorbents are made up of styrene/divinylbenzene copolymer and quaternary ammonium salt, which usually have poor biocompatibility and weak mechanical strength. To overcome the drawbacks of commercial polymer adsorbents, advanced synthetic and natural polymers with/without nanomaterials have been designed, and novel adsorbent fabrication technologies have also been developed. In this review, the adsorption mechanism of bilirubin adsorbents has been summarized, which is the basic criterion in adsorbent development. Furthermore, the preparation method, adsorption mechanism, relative merits and practicability of the emerging bilirubin adsorbents have been evaluated. Based on the existing studies, this work highlights the future direction of the efforts on how to design and develop bilirubin adsorbents with good overall clinical performance. Perhaps this study can change traditional perspectives and propose new strategies for bilirubin clearance from the aspects of pathogenic mechanisms, metabolic pathways, and material-based innovation.

Hemp-Based Sustainable Slippery Surfaces: Icephobic and Antithrombotic Properties

With the passage of the 2018 Farm Bill that removed hemp from the Controlled Substances Act altogether, production of hemp is experiencing a renaissance. Building on this revival and re-emergence of hemp, we designed and fabricated hemp-based sustainable and robust slippery surfaces by coating hemp paper with beeswax and subsequently infusing it with hemp oil. A wide variety of aqueous liquids and beverages easily slide on our hemp-based sustainable slippery surfaces, without leaving a trace. We also fabricated hemp-based sustainable slippery surfaces using different textured metals. Our hemp-based sustainable slippery metal surfaces display good icephobic and antithrombotic properties. With these attributes, we envision that our hemp-based sustainable slippery surfaces will pave the path to more safe, non-toxic, and biodegradable or recyclable slippery surfaces for applications in food packaging, anti-icing or de-icing coatings, and antithrombotic medical devices.

Improved Hemocompatibility on Superhemophobic Micro-Nano-Structured Titanium Surfaces

Blood-contacting titanium-based implants such as endovascular stents and heart valve casings are prone to blood clotting due to improper interactions at the surface level. In complement, the current clinical demand for cardiovascular implants is at a new apex. Hence, there is a crucial necessity to fabricate an implant with optimal mechanical properties and improved blood compatibility, while simultaneously interacting differentially with cells and other microbial agents. The present study intends to develop a superhydrophobic implant surface with the novel micro-nano topography, developed using a facile thermochemical process. The surface topography, apparent contact angle, and crystal structure are characterized on different surfaces. The hemo/blood compatibility on different surfaces is assessed by evaluating hemolysis, fibrinogen adsorption, cell adhesion and identification, thrombin generation, complement activation, and whole blood clotting kinetics. The results indicate that the super-hemo/hydrophobic micro-nano titanium surface improved hemocompatibility by significantly reducing fibrinogen adsorption, platelet adhesion, and leukocyte adhesion. Thus, the developed surface has high potential to be used as an implant. Further studies are directed towards analyzing the mechanisms causing the improved hemocompatibility of micro/nano surface features under dynamic in vitro and in vivo conditions.

Designing Non-Textured, All-Solid, Slippery Hydrophilic Surfaces

Slippery surfaces are sought after due to their wide range of applications in self-cleaning, drag reduction, fouling-resistance, enhanced condensation, biomedical implants etc. Recently, non-textured, all-solid, slippery surfaces have gained significant attention because of their advantages over super-repellent surfaces and lubricant-infused surfaces. Currently, almost all non-textured, all-solid, slippery surfaces are hydrophobic. In this work, we elucidate the systematic design of non-textured, all-solid, slippery hydrophilic (SLIC) surfaces by covalently grafting polyethylene glycol (PEG) brushes to smooth substrates. Furthermore, we postulate a plateau in slipperiness above a critical grafting density, which occurs when the tethered brush size is equal to the inter-tether distance. Our SLIC surfaces demonstrate exceptional performance in condensation and fouling-resistance compared to non-slippery hydrophilic surfaces and slippery hydrophobic surfaces. Based on these results, SLIC surfaces constitute an emerging class of surfaces with the potential to benefit multiple technological landscapes ranging from thermofluidics to biofluidics.

Superhydrophobic Biological Fluid-Repellent Surfaces: Mechanisms and Applications

Superhydrophobic biological fluid-repellent surfaces (SBFRSs) have attracted great attention in the treatment of blood and urine-related diseases because of their unique wettability and compatibility, which creates a new path for the development of medical apparatus and instruments, and are expected to create advances in various fields. Here, this review provides an up-to-date summary of research progress on the repellent mechanism and application of SBFRSs. The underlying physical and chemical principles for designing superhydrophobic surfaces are first introduced. Then, the dialectical influences of solid-liquid interactions between superhydrophobic surfaces and biological fluids on the wettability and compatibility are emphatically expounded. Subsequently, attention is drawn to the recent applications of SBFRSs in biomedical fields, such as surgical medical apparatus, implant materials, extracorporeal circulation devices, and biological fluid detection. Finally, the outlook and challenges in terms of employing SBFRSs are also discussed. This review is expected to provide a comprehensive guidance for the preparation of SBFRSs with compatibility and long-term superhydrophobic stability that is closely related to clinical applications.

Mechanisms for Reduced Fibrin Clot Formation on Liquid-Infused Surfaces

Biomedical devices are prone to blood clot formation (thrombosis), and liquid-infused surfaces (LIS) are effective in reducing the thrombotic response. However, the mechanisms that underpin this performance, and in particular the role of the lubricant, are not well understood. In this work, it is investigated whether the mechanism of LIS action is related to i) inhibition of factor XII (FXII) activation and the contact pathway; ii) reduced fibrin density of clots formed on surfaces; iii) increased mobility of proteins or cells on the surface due to the interfacial flow of the lubricant. The chosen LIS is covalently tethered, nanostructured layers of perfluorocarbons, infused with thin films of medical-grade perfluorodecalin (tethered-liquid perfluorocarbon), prepared with chemical vapor deposition previously optimized to retain lubricant under flow. Results show that in the absence of external flow, interfacial mobility is inherently higher at the liquid-blood interface, making it a key contributor to the low thrombogenicity of LIS, as FXII activity and fibrin density are equivalent at the interface. The findings of this study advance the understanding of the anti-thrombotic behavior of LIS-coated biomedical devices for future coating design. More broadly, enhanced interfacial mobility may be an important, underexplored mechanism for the anti-fouling behavior of surface coatings.

Blood Coagulation on Titanium Dioxide Films with Various Crystal Structures on Titanium Implant Surfaces

Background: Titanium (Ti) is one of the most popular implant materials, and its surface titanium dioxide (TiO₂) provides good biocompatibility. The coagulation of blood on Ti implants plays a key role in wound healing and cell growth at the implant site; however, researchers have yet to fully elucidate the mechanism underlying this process on TiO₂. Methods: This study examined the means by which blood coagulation was affected by the crystal structure of TiO₂ thin films (thickness < 50 nm), including anatase, rutile, and mixed anatase/rutile. The films were characterized in terms of roughness using an atomic force microscope, thickness using an X-ray photoelectron spectrometer, and crystal structure using transmission electron microscopy. The surface energy and dielectric constant of the surface films were measured using a contact angle goniometer and the parallel plate method, respectively. Blood coagulation properties (including clotting time, factor XII contact activation, fibrinogen adsorption, fibrin attachment, and platelet adhesion) were then assessed on the various test specimens. Results: All of the TiO₂ films were similar in terms of surface roughness, thickness, and surface energy (hydrophilicity); however, the presence of rutile structures was associated with a higher dielectric constant, which induced the activation of factor XII, the formation of fibrin network, and platelet adhesion. Conclusions: This study provides detailed information related to the effects of TiO₂ crystal structures on blood coagulation properties on Ti implant surfaces.

Hemocompatibility Evaluation of Thai Bombyx mori Silk Fibroin and Its Improvement with Low Molecular Weight Heparin Immobilization

Bombyx mori silk fibroin (SF), from Nangnoi Srisaket 1 Thai strain, has shown potential for various biomedical applications such as wound dressing, a vascular patch, bone substitutes, and controlled release systems. The hemocompatibility of this SF is one of the important characteristics that have impacts on such applications. In this study, the hemocompatibility of Thai SF was investigated and its improvement by low molecular weight heparin (LMWH) immobilization was demonstrated. Endothelial cell proliferation on the SF and LMWH immobilized SF (Hep/SF) samples with or without fibroblast growth factor-2 (FGF-2) was also evaluated. According to hemocompatibility evaluation, Thai SF did not accelerate clotting time, excess stimulate complement and leukocyte activation, and was considered a non-hemolysis material compared to the negative control PTFE sheet. Platelet adhesion of SF film was comparable to that of the PTFE sheet. For hemocompatibility enhancement, LMWH was immobilized successfully and could improve the surface hydrophilicity of SF films. The Hep/SF films demonstrated prolonged clotting time and slightly lower complement and leukocyte activation. However, the Hep/SF films could not suppress platelet adhesion. The Hep/SF films demonstrated endothelial cell proliferation enhancement, particularly with FGF-2 addition. This study provides fundamental information for the further development of Thai SF as a hemocompatible biomaterial.

Materials Perspectives for Self-Powered Cardiac Implantable Electronic Devices toward Clinical Translation

Represented by pacemakers, implantable electronic devices (CIEDs) are playing a vital life-saving role in modern society. Although the current CIEDs are evolving quickly in terms of performance, safety, and miniaturization, the bulky and rigid battery creates the largest hurdle toward further development of a soft system that can be attached and conform to tissues without causing undesirable physiologic changes. Over 50% of patients with pacemakers require additional surgery procedures to replace a drained battery. Abrupt battery malfunction and failure contributes up to 2.4% of implanted leadless pacemakers. The battery also has risks of lethal interference with diagnostic magnetic resonance imaging (MRI). Applying the implantable nanogenerators (i-NGs) technology to CIEDs is regarded as a promising solution to the battery challenge and enables self-powering capability. I-NGs based on the principle of either triboelectricity (TENG) or piezoelectricity (PENG) can convert biomechanical energy into electricity effectively. Meanwhile, a complete heartbeat cycle provides a biomechanical energy of ~0.7 J or an average power of 0.93 W, which is sufficient for the operation of CIEDs considering the power consumption of 5-10 μW for a pacemaker and 10-100 μW for a cardiac defibrillator. It is therefore practical to leverage the effective, soft, flexible, lightweight, and biocompatible i-NGs to eliminate the bulky battery component in CIEDs and achieve self-sustainable operation. In this rapidly evolving interdisciplinary field, materials innovation acts as a cornerstone that frames the technology development. Here we bring a few critical perspectives regarding materials design and engineering, which are essential in leading the NG-powered CIEDs toward clinical translations. This Account starts with a brief introduction of the cardiac electrophysiology, as well as its short history to interface the state-of-the-art cardiac NG technologies. Three key components of NG-powered CIEDs are discussed in detail, including the NG device itself, the packaging material, and the stimulation electrodes. Cardiac NG is the essential component that converts heartbeat energy into electricity. It demands high-performance electromechanical coupling materials with long-term dynamic stability. The packaging material is critical to ensure a long-term stable operation of the device on a beating heart. Given the unique operation environment, a few criteria need to be considered in its development, including flexibility, biocompatibility, antifouling, hemocompatibility, and bioadhesion. The stimulation electrodes are the only material interfacing the heart tissue electrically. They should provide capacitive charge injection and mimic the soft and wet intrinsic tissues for the sake of stable biointerfaces. Driven by the rapid materials and device advancement, we envision that the evolution of NG-based CIEDs will quickly move from epicardiac to intracardiac, from single-function to multifunction, and with a minimal-invasive implantation procedure. This trend of development will open many research opportunities in emerging materials science and engineering, which will eventually lead the NG technology to a prevailing strategy for powering future CIEDs.

Surface modification strategies to improve titanium hemocompatibility: a comprehensive review

Titanium and its alloys are widely used in different biomaterial applications due to their remarkable mechanical properties and bio-inertness. However, titanium-based materials still face some challenges, with an emphasis on hemocompatibility. Blood-contacting devices such as stents, heart valves, and circulatory devices are prone to thrombus formation, restenosis, and inflammation due to inappropriate blood-implant surface interactions. After implantation, when blood encounters these implant surfaces, a series of reactions takes place, such as protein adsorption, platelet adhesion and activation, and white blood cell complex formation as a defense mechanism. Currently, patients are prescribed anticoagulant drugs to prevent blood clotting, but these drugs can weaken their immune system and cause profound bleeding during injury. Extensive research has been done to modify the surface properties of titanium to enhance its hemocompatibility. Results have shown that the modification of surface morphology, roughness, and chemistry has been effective in reducing thrombus formation. The main focus of this review is to analyze and understand the different modification techniques on titanium-based surfaces to enhance hemocompatibility and, consequently, recognize the unresolved challenges and propose scopes for future research.

Fabrication of a gradient hydrophobic surface with parallel ridges on pyrolytic carbon for artificial heart valves

Effective surface modification to endow pyrolytic carbon (PYC) with long-term anti-thrombotic performance is highly demanded. In this work, a gradient hydrophobic surface on PYC was prepared by creating parallel ridges via the combination of laser etching technology and surface fluorosilanization. Scanning electron microscopy (SEM) observation confirms that the gradient hydrophobic surface is composed of a bare PYC region and four regions of parallel ridges with varying distances. The gradient hydrophobic surface is stable in air, phosphate buffer solution (PBS), and flowing PBS. Additionally, the gradient hydrophobic surface on PYC shows spontaneous droplet motion and much lower flow resistance than bare PYC. Compared to bare PYC, the gradient hydrophobic surface on PYC exhibits better blood compatibility and anti-adhesion performance. The results presented in this paper confirm that creating a gradient hydrophobic surface is an effective way of achieving long-lasting anti-thrombosis property.

Modification strategies to improve the membrane hemocompatibility in extracorporeal membrane oxygenator (ECMO)

ABSTRACT

Since extracorporeal membrane oxygenator (ECMO) has been utilized to save countless lives by providing continuous extracorporeal breathing and circulation to patients with severe cardiopulmonary failure. In particular, it has played an important role during the COVID-19 epidemic. One of the important composites of ECMO is membrane oxygenator, and the core composite of the membrane oxygenator is hollow fiber membrane, which is not only a place for blood oxygenation, but also is a barrier between the blood and gas side. However, the formation of blood clots in the oxygenator is a key problem in the using process. According to the study of the mechanism of thrombosis generation, it was found that improving the hemocompatibility is an efficient approach to reduce thrombus formation by modifying the surface of materials. In this review, the corresponding modification methods (surface property regulation, anticoagulant grafting, and bio-interface design) of hollow fiber membranes in ECMO are classified and discussed, and then, the research status and development prospects are summarized.

Impact of superhydrophobicity on the fluid dynamics of a bileaflet mechanical heart valve

OBJECTIVE

The objective of this study is to evaluate the impact of superhydrophobic coating on the hemodynamics and turbulence characteristics of a bileaflet mechanical valve in the context of evaluating blood damage potential.

METHODS

Two 3D printed bileaflet mechanical valves were hemodynamically tested in a pulse duplicator under physiological pressure and flow conditions. The leaflets of one of the two valves were sprayed with a superhydrophobic coating. Particle Image Velocimetry was performed. Pressure gradients (PG), effective orifice areas (EOA), Reynolds shear stresses (RSS) and instantaneous viscous shear stresses (VSS) were calculated.

RESULTS

(a) Without SH coating, the PG was found to be 14.53 ± 0.7 mmHg and EOA 1.44 ± 0.06 cm2. With coating, the PG obtained was 15.21 ± 1.7 mmHg and EOA 1.39 ± 0.07 cm2; (b) during peak systole, the magnitude of RSS with SH coating (110Pa) exceeded that obtained without SH coating (40 Pa) with higher probabilities to develop higher RSS in the immediate wake of the leaflet; (c) The magnitudes range of instantaneous VSS obtained with SH coating were slightly larger than those obtained without SH coating (7.0 Pa versus 5.0 Pa).

CONCLUSION

With Reynolds Shear Stresses and instantaneous Viscous Shear Stresses being correlated with platelet damage, SH coating did not lead to their decrease. While SH coating is known to improve surface properties such as reduced platelet or clot adhesion, the relaxation of the slip condition does not necessarily improve overall hemodynamic performance for the bileaflet mechanical valve design.

Modulation of Platelet-Surface Activation: Current State and Future Perspectives

Modulation of platelet-surface activation is important for many biomedical applications such as in vivo performance, platelet storage, and acceptance of an implant. Reducing platelet-surface activation is challenging because they become activated immediately after short contact with nonphysiological surfaces. To date, controversies and open questions in the field of platelet-surface activation still remain. Here, we review state-of-the-art approaches in inhibiting platelet-surface activation, mainly focusing on modification, patterning, and methodologies for characterization of the surfaces. As a future perspective, we discuss how the combination of biochemical and physiochemical strategies together with the topographical modulations would assist in the search for an ideal nonthrombogenic surface.

Anchorable phosphorylcholine copolymer synthesis and cell membrane mimetic antifouling coating fabrication for blood compatible applications

Protein adsorption and platelet activation on biomedical devices contacting blood may lead to the formation of thrombus. The thrombogenicity of biomaterials could be minimized or prevented by anchoring a cell membrane mimetic antifouling coating (CMMAC). Here, we report the construction of a CMMAC by a newly designed 2-methacryloyloxyethyl phosphorylcholine (MPC) copolymer (PMPCC) containing 5-20 carboxylic long arm side chains. The long arm provides its end carboxylic group with more freedom and a larger reaction space for an easier and more efficient surface anchoring. With the assistance of mussel-inspired universal adhesive polydopamine (PDA), different material surfaces precoated with PDA can immobilize the PMPCC via multipoint anchoring of the randomly distributed carboxylic side chains. The multipoint anchoring results in a stabilized and condensed PDA-PMPCC coating. The phosphorylcholine zwitterions of the densely immobilized PMPCC polymers form a cell outer membrane mimetic interface in an aqueous environment, endowing excellent properties of resisting protein adsorption, platelet activation and blood cell adhesion. More importantly, the PDA-PMPCC-coated glass surface can suppress thrombus formation for more than 24 h, while the bare glass surface forms obvious thrombus in 6 h tested in the same blood. Furthermore, the fabrication of the PDA-PMPCC coating is simple and material-independent. Therefore, the simple synthesis, facile surface coating and excellent hemocompatibility of the PMPCC make it a promising material for biomimetic surface modification.