Blood in contact with artificial surfaces: where have we been and where are we going? A modest proposal

Heparin-induced lipoprotein precipitation apheresis in dyslipidemic patients: A multiparametric assessment

Low-density lipoprotein (LDL) apheresis (LA) selectively eliminates lipoproteins containing apolipoprotein B 100 (ApoB100) on patients affected by severe dyslipidemia. In addition to lowering lipids, LA is thought to exert pleiotropic effects altering a number of other compounds associated with atherosclerosis, such as pro- and anti-inflammatory cytokines or pro-thrombotic factors. More knowledge needs to be gathered on the effects of LA, and particularly on its ability to modify blood components other than lipids. We performed a multiparametric assessment of the inflammatory, metabolic and proteomic profile changes after Heparin-induced lipoprotein precipitation (H.E.L.P.) apheresis on serum samples from nine dyslipidemic patients evaluating cholesterol and lipoproteins, plasma viscosity and density, metabolites, cytokines, PCSK9 levels and other proteins selectively removed after the treatment. Our results show that H.E.L.P. apheresis is effective in lowering lipoprotein and PCSK9 levels. Although not significantly, complement and inflammation-related proteins are also affected, indicating a possible transient epiphenomenon induced by the extracorporeal procedure.

Stirred, shaken, or stagnant: What goes on at the blood-biomaterial interface

There is a widely recognized need to improve the performance of vascular implants and external medical devices that come into contact with blood by reducing adverse reactions they cause, such as thrombosis and inflammation. These reactions lead to major adverse cardiovascular events such as heart attacks and strokes. Currently, they are managed therapeutically. This need remains unmet by the biomaterials research community. Recognized stagnation of the blood-biomaterial interface research translates into waning interest from clinicians, funding agencies, and practitioners of adjacent fields. The purpose of this contribution is to stir things up. It follows the 2014 BloodSurf meeting (74th International IUVSTA Workshop on Blood-Biomaterial Interactions), offers reflections on the situation in the field, and a three-pronged strategy integrating different perspectives on the biological mechanisms underlying blood-biomaterial interactions. The success of this strategy depends on reengaging clinicians and on the renewed cooperation of the funding agencies to support long-term efforts.

2-Acylimino-3H-thiazoline derivatives: a novel template for platelet GPIIb/IIIa receptor antagonists

In the course of our research for the low-molecular weight RGD peptide mimics, we have found that a rigid 2-acylimino-3H-thiazoline structure is suitable for the peptide backbone mimics. Introduction of amidinophenyl and beta-alanine moiety as arginine and aspartic acid side-chain surrogates to this backbone mimic resulted in a highly potent fibrinogen receptor antagonist 2-(4-amidinobenzoylimino)-3,4-dimethyl-N-(2-carboxyethyl)-3H-thiazoline-5-carboxamide (7c), namely PS-028 (Ki = 46.5 +/- 5.8 microM).

Protein adsorption on low temperature isotropic carbon: V. How is it related to its blood compatibility?

Based on our research on blood protein interactions with low temperature isotropic carbon (LTIC) and data from the literature, we propose that the carbon surface has strong interactions with adsorbed proteins. In this paper we focus on how a relatively blood-compatible material interacts with plasma proteins. We present our results on the structure and properties of the LTIC surface utilizing SEM, STM, XPS, and contact angle measurements. We briefly review protein adsorption on LTIC using DSC, impedance, radioisotopes, and two-dimensional gel electrophoresis. LTIC is characterized by a microporous, oxidized, hydrophobic, and domain mosaic structure. Surface polishing smoothens the roughness and removes the porosity, while largely destroying the ordered atomic texture, making the surface more random and more amorphous. The LTIC surface denatures all adsorbed proteins studied. The rate of protein adsorption is high and the surface concentration is large. The LTIC surface adsorbs all proteins without preference. The surface also tenaciously retains proteins such that they cannot be displaced by buffer or exchanged by proteins in solution. We conclude that LTIC accomplishes its blood compatibility through a passivating film of strongly adsorbed bland proteins, which do not interact with platelets nor participate in blood coagulation. We also suggest mechanisms for the production of such a film by the LTIC surface.

Adsorption of coagulation proteins from whole blood on to polymer materials: relation to platelet activation

A combination of methods, immunoassays of plasma proteins and platelet release of beta-thromboglobulin and chromogenic substrates for enzymatically active coagulation factors, was used to measure the reactions of coagulation proteins upon contact between whole blood and artificial surfaces as a function of time and surface material. Four types of well-known polymer surfaces, polyvinylchloride, polytetrafluoroethylene, polyurethane and silicone rubber, were investigated to elucidate if a simple and fast in vitro experimental set-up can be of guidance in the selection of materials for use in vivo. Platelets were activated at the polymer surfaces whereas the coagulation enzymes showed little activity on the polymer surfaces tested. There was a correlation between the adsorption of adhesins (fibrinogen, fibronectin and factor VIII-related antigen) at the surfaces and the release of beta-thromboglobulin from platelets, suggesting that adsorption of adhesins is a major determinant of blood compatibility of polymer materials. Significant differences between the surfaces were seen--polyurethane being the surface with the least protein adsorbed and least platelet activation initiated. This study shows that it is possible to make a first in vitro choice of possible blood compatible artificial surfaces before expensive and cumbersome in vivo experiments.