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Luu CH, Nguyen NT, Ta HT. Unravelling Surface Modification Strategies for Preventing Medical Device-Induced Thrombosis. Adv Healthc Mater 2024; 13:e2301039. [PMID: 37725037 DOI: 10.1002/adhm.202301039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/29/2023] [Indexed: 09/21/2023]
Abstract
The use of biomaterials in implanted medical devices remains hampered by platelet adhesion and blood coagulation. Thrombus formation is a prevalent cause of failure of these blood-contacting devices. Although systemic anticoagulant can be used to support materials and devices with poor blood compatibility, its negative effects such as an increased chance of bleeding, make materials with superior hemocompatibility extremely attractive, especially for long-term applications. This review examines blood-surface interactions, the pathogenesis of clotting on blood-contacting medical devices, popular surface modification techniques, mechanisms of action of anticoagulant coatings, and discusses future directions in biomaterial research for preventing thrombosis. In addition, this paper comprehensively reviews several novel methods that either entirely prevent interaction between material surfaces and blood components or regulate the reaction of the coagulation cascade, thrombocytes, and leukocytes.
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Affiliation(s)
- Cuong Hung Luu
- School of Environment and Science, Griffith University, Nathan, Queensland, 4111, Australia
- Queensland Micro- and Nanotechnology Centre, Griffith University, Nathan, Queensland, 4111, Australia
| | - Nam-Trung Nguyen
- School of Environment and Science, Griffith University, Nathan, Queensland, 4111, Australia
- Queensland Micro- and Nanotechnology Centre, Griffith University, Nathan, Queensland, 4111, Australia
| | - Hang Thu Ta
- School of Environment and Science, Griffith University, Nathan, Queensland, 4111, Australia
- Queensland Micro- and Nanotechnology Centre, Griffith University, Nathan, Queensland, 4111, Australia
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Huang HH, Chen ZH, Nguyen DT, Tseng CM, Chen CS, Chang JH. Blood Coagulation on Titanium Dioxide Films with Various Crystal Structures on Titanium Implant Surfaces. Cells 2022; 11:cells11172623. [PMID: 36078030 PMCID: PMC9454428 DOI: 10.3390/cells11172623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/18/2022] Open
Abstract
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.
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Affiliation(s)
- Her-Hsiung Huang
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Institute of Oral Biology, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
- Department of Stomatology, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei 103, Taiwan
- Correspondence: (H.-H.H.); (C.-S.C.)
| | - Zhi-Hwa Chen
- Institute of Oral Biology, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Diem Thuy Nguyen
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Chuan-Ming Tseng
- Department of Materials Engineering and Center for Plasma and Thin Film Technologies, Ming Chi University of Technology, New Taipei City 243, Taiwan
| | - Chiang-Sang Chen
- Department of Orthopedics, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
- Department of Materials and Textiles, Asia Eastern University of Science and Technology, New Taipei City 220, Taiwan
- Correspondence: (H.-H.H.); (C.-S.C.)
| | - Jean-Heng Chang
- Dental Department, Cheng Hsin General Hospital, Taipei 112, Taiwan
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Abraham R, Viswanathan GK, Dass J, Dhawan R, Aggarwal M, Kumar P, Seth T, Mahapatra M. Prekallikrein deficiency: Challenges in laboratory testing. Int J Lab Hematol 2022; 44:e185-e186. [PMID: 35377535 DOI: 10.1111/ijlh.13843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/02/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Reema Abraham
- Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | - Jasmita Dass
- Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Rishi Dhawan
- Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Mukul Aggarwal
- Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Pradeep Kumar
- Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Tulika Seth
- Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Manoranjan Mahapatra
- Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Strohbach A, Busch R. Predicting the In Vivo Performance of Cardiovascular Biomaterials: Current Approaches In Vitro Evaluation of Blood-Biomaterial Interactions. Int J Mol Sci 2021; 22:ijms222111390. [PMID: 34768821 PMCID: PMC8583792 DOI: 10.3390/ijms222111390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/04/2021] [Accepted: 10/18/2021] [Indexed: 12/29/2022] Open
Abstract
The therapeutic efficacy of a cardiovascular device after implantation is highly dependent on the host-initiated complement and coagulation cascade. Both can eventually trigger thrombosis and inflammation. Therefore, understanding these initial responses of the body is of great importance for newly developed biomaterials. Subtle modulation of the associated biological processes could optimize clinical outcomes. However, our failure to produce truly blood compatible materials may reflect our inability to properly understand the mechanisms of thrombosis and inflammation associated with biomaterials. In vitro models mimicking these processes provide valuable insights into the mechanisms of biomaterial-induced complement activation and coagulation. Here, we review (i) the influence of biomaterials on complement and coagulation cascades, (ii) the significance of complement-coagulation interactions for the clinical success of cardiovascular implants, (iii) the modulation of complement activation by surface modifications, and (iv) in vitro testing strategies.
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Affiliation(s)
- Anne Strohbach
- Department of Internal Medicine B Cardiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany;
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Fleischmannstr. 42-44, 17489 Greifswald, Germany
- Correspondence:
| | - Raila Busch
- Department of Internal Medicine B Cardiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany;
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Fleischmannstr. 42-44, 17489 Greifswald, Germany
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Sabino RM, Kauk K, Madruga LYC, Kipper MJ, Martins AF, Popat KC. Enhanced hemocompatibility and antibacterial activity on titania nanotubes with tanfloc/heparin polyelectrolyte multilayers. J Biomed Mater Res A 2020; 108:992-1005. [DOI: 10.1002/jbm.a.36876] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/27/2019] [Accepted: 12/31/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Roberta M. Sabino
- School of Advanced Materials Discovery Colorado State University Fort Collins Colorado
| | - Kirsten Kauk
- School of Biomedical Engineering Colorado State University Fort Collins Colorado
- Department of Mechanical Engineering Colorado State University Fort Collins Colorado
| | - Liszt Y. C. Madruga
- Institute of Chemistry, Federal University of Rio Grande do Norte Natal Brazil
- Department of Chemical and Biological Engineering Colorado State University Fort Collins Colorado
| | - Matt J. Kipper
- School of Advanced Materials Discovery Colorado State University Fort Collins Colorado
- School of Biomedical Engineering Colorado State University Fort Collins Colorado
- Department of Chemical and Biological Engineering Colorado State University Fort Collins Colorado
| | - Alessandro F. Martins
- Department of Chemical and Biological Engineering Colorado State University Fort Collins Colorado
- Laboratory of Materials Macromolecules and Composites, Federal University of Technology Maringa Brazil
| | - Ketul C. Popat
- School of Advanced Materials Discovery Colorado State University Fort Collins Colorado
- School of Biomedical Engineering Colorado State University Fort Collins Colorado
- Department of Mechanical Engineering Colorado State University Fort Collins Colorado
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Hanson SR, Tucker EI, Latour RA. Blood Coagulation and Blood–Material Interactions. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00052-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Yesudasan S, Averett RD. Recent advances in computational modeling of fibrin clot formation: A review. Comput Biol Chem 2019; 83:107148. [PMID: 31751883 DOI: 10.1016/j.compbiolchem.2019.107148] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/17/2019] [Accepted: 10/15/2019] [Indexed: 12/12/2022]
Abstract
The field of thrombosis and hemostasis is crucial for understanding and developing new therapies for pathologies such as deep vein thrombosis, diabetes related strokes, pulmonary embolisms, and hemorrhaging related diseases. In the last two decades, an exponential growth in studies related to fibrin clot formation using computational tools has been observed. Despite this growth, the complete mechanism behind thrombus formation and hemostasis has been long and rife with obstacles; however, significant progress has been made in the present century. The computational models and methods used in this context are diversified into different spatiotemporal scales, yet there is no single model which can predict both physiological and mechanical properties of fibrin clots. In this review, we list the major strategies employed by researchers in modeling fibrin clot formation using recent and existing computational techniques. This review organizes the computational strategies into continuum level, system level, discrete particle (DPD), and multi-scale methods. We also discuss strengths and weaknesses of various methods and future directions in which computational modeling of fibrin clots can advance.
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Affiliation(s)
- Sumith Yesudasan
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, 597 D.W. Brooks Drive, Athens, GA 30602
| | - Rodney D Averett
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, 597 D.W. Brooks Drive, Athens, GA 30602.
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Braune S, Latour RA, Reinthaler M, Landmesser U, Lendlein A, Jung F. In Vitro Thrombogenicity Testing of Biomaterials. Adv Healthc Mater 2019; 8:e1900527. [PMID: 31612646 DOI: 10.1002/adhm.201900527] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/15/2019] [Indexed: 12/29/2022]
Abstract
The short- and long-term thrombogenicity of implant materials is still unpredictable, which is a significant challenge for the treatment of cardiovascular diseases. A knowledge-based approach for implementing biofunctions in materials requires a detailed understanding of the medical device in the biological system. In particular, the interplay between material and blood components/cells as well as standardized and commonly acknowledged in vitro test methods allowing a reproducible categorization of the material thrombogenicity requires further attention. Here, the status of in vitro thrombogenicity testing methods for biomaterials is reviewed, particularly taking in view the preparation of test materials and references, the selection and characterization of donors and blood samples, the prerequisites for reproducible approaches and applied test systems. Recent joint approaches in finding common standards for a reproducible testing are summarized and perspectives for a more disease oriented in vitro thrombogenicity testing are discussed.
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Affiliation(s)
- Steffen Braune
- Institute of Biomaterial Science and Berlin‐Brandenburg Centre for Regenerative Therapies (BCRT)Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
| | - Robert A. Latour
- Rhodes Engineering Research CenterDepartment of BioengineeringClemson University Clemson SC 29634 USA
| | - Markus Reinthaler
- Institute of Biomaterial Science and Berlin‐Brandenburg Centre for Regenerative Therapies (BCRT)Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
- Department for CardiologyCharité UniversitätsmedizinCampus Benjamin Franklin Hindenburgdamm 30 12203 Berlin Germany
| | - Ulf Landmesser
- Department for CardiologyCharité UniversitätsmedizinCampus Benjamin Franklin Hindenburgdamm 30 12203 Berlin Germany
| | - Andreas Lendlein
- Institute of Biomaterial Science and Berlin‐Brandenburg Centre for Regenerative Therapies (BCRT)Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
- Institute of ChemistryUniversity of Potsdam Karl‐Liebknecht‐Strasse 24‐25 14476 Potsdam Germany
- Helmholtz Virtual Institute “Multifunctional Biomaterials for Medicine”Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
| | - Friedrich Jung
- Institute of Biomaterial Science and Berlin‐Brandenburg Centre for Regenerative Therapies (BCRT)Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
- Helmholtz Virtual Institute “Multifunctional Biomaterials for Medicine”Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
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Sabino RM, Kauk K, Movafaghi S, Kota A, Popat KC. Interaction of blood plasma proteins with superhemophobic titania nanotube surfaces. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2019; 21:102046. [PMID: 31279063 PMCID: PMC6814547 DOI: 10.1016/j.nano.2019.102046] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/12/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Abstract
The need to improve blood biocompatibility of medical devices is urgent. As soon as blood encounters a biomaterial implant, proteins adsorb on its surfaces, often leading to several complications such as thrombosis and failure of the device. Therefore, controlling protein adsorption plays a major role in developing hemocompatible materials. In this study, the interaction of key blood plasma proteins with superhemophobic titania nanotube substrates and the blood clotting responses was investigated. The substrate stability was evaluated and fibrinogen adsorption and thrombin formation from plasma were assessed using ELISA. Whole blood clotting kinetics was also investigated, and Factor XII activation on the substrates was characterized by an in vitro plasma coagulation time assay. The results show that superhemophobic titania nanotubes are stable and considerably decrease surface protein adsorption/Factor XII activation as well as delay the whole blood clotting, and thus can be a promising approach for designing blood contacting medical devices.
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Affiliation(s)
- Roberta Maia Sabino
- School of Advanced Materials Discovery, Colorado State University, Fort Collins, CO, USA
| | - Kirsten Kauk
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Sanli Movafaghi
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Arun Kota
- School of Advanced Materials Discovery, Colorado State University, Fort Collins, CO, USA; School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA; Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Ketul C Popat
- School of Advanced Materials Discovery, Colorado State University, Fort Collins, CO, USA; School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA; Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA.
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Xu LC, Li Z, Tian Z, Chen C, Allcock HR, Siedlecki CA. A new textured polyphosphazene biomaterial with improved blood coagulation and microbial infection responses. Acta Biomater 2018; 67:87-98. [PMID: 29229544 DOI: 10.1016/j.actbio.2017.11.056] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/20/2017] [Accepted: 11/30/2017] [Indexed: 12/16/2022]
Abstract
A new poly[bis(octafluoropentoxy) phosphazene] (OFP) was synthesized for the purpose of blood contacting medical devices. OFP was further either developed into crosslinkable polyphosphazene (X-OFP) or blended with polyurethane (PU) as the mixture (OFP/PU) for improvement of mechanical property of polyphosphazene polymers. All the materials were fabricated as smooth films or further textured with submicron pillars for the assay of antimicrobial and antithrombotic properties. Results showed that crosslinkable OFP (X-OFP) and blends of OFP/PU successfully improved the mechanical strength of OFP and fewer defects of pillars were found on the textured polyphosphazene surfaces. The antithrombotic experiments showed that polyphosphazene OFP materials reduced human Factor XII activation and platelet adhesion, thereby being resistant to plasma coagulation and thrombosis. The bacterial adhesion and biofilm experiments demonstrated that OFP materials inhibited staphylococcal bacterial adhesion and biofilm formation. The surface texturing further reduced the platelet adhesion and bacterial adhesion, and inhibited biofilm formation up to 23 days. The data suggested that textured OFP materials may provide a practical approach to improve the biocompatibility of current biomaterials in the application of blood contacting medical devices with significant reduction in risk of pathogenic infection and thrombosis. STATEMENT OF SIGNIFICANCE The thromboembolic events and microbial infection have been the significant barriers for the long term use of biomaterials in blood-contacting medical devices. The development of new materials with multiple functions including anti-thrombosis and antibacterial surfaces is a high research priority. This study synthesized new biostable and biocompatible polyphosphazene polymers, poly[bis(octafluoropentoxy)phosphazene] (OFP) and crosslinkable OFP, and successfully improved the mechanical strength of polyphosphazenes. Polymers were fabricated into textured films with submicron pillars on the surfaces. The antimicrobial and antithrombotic assays demonstrated that new materials combined with surface physical modification have significant reduction in risk of pathogenic infection and thrombosis, and improve the biocompatibility of current biomaterials in the application of blood-contacting medical devices. It would be interest to biomaterials and bioengineering related communities.
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Affiliation(s)
- Li-Chong Xu
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA 17033, United States.
| | - Zhongjing Li
- Department of Chemistry, The Pennsylvania State University, University Park, PA 16802, United States
| | - Zhicheng Tian
- Department of Chemistry, The Pennsylvania State University, University Park, PA 16802, United States
| | - Chen Chen
- Department of Chemistry, The Pennsylvania State University, University Park, PA 16802, United States
| | - Harry R Allcock
- Department of Chemistry, The Pennsylvania State University, University Park, PA 16802, United States
| | - Christopher A Siedlecki
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA 17033, United States; Department of Bioengineering, The Pennsylvania State University, College of Medicine, Hershey, PA 17033, United States
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