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Mehrizi TZ, Mirzaei M, Ardestani MS. Pegylation, a Successful Strategy to Address the Storage and Instability Problems of Blood Products: Review 2011-2021. Curr Pharm Biotechnol 2024; 25:247-267. [PMID: 37218184 DOI: 10.2174/1389201024666230522091958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/24/2023] [Accepted: 02/06/2023] [Indexed: 05/24/2023]
Abstract
Conjugation of polyethylene glycol (PEGylation) to blood proteins and cells has emerged as a successful approach to address some of the issues attributed to the storage of blood products, including their short half-life and instability. In this regard, this review study aims to compare the influence of different PEGylation strategies on the quality of several blood products like red blood cells (RBCs), platelets, plasma proteins, i.e., albumin, coagulation factor VIII, and antibodies. The results indicated that conjugating succinimidyl carbonate methoxyPEG (SCmPEG) to platelets could improve blood transfusion safety by preventing these cells from being attached to low-load hidden bacteria in blood products. Moreover, coating of 20 kD succinimidyl valerate (SVA)-mPEG to RBCs was able to extend the half-life and stability of these cells during storage, as well as immune camouflage their surface antigens to prevent alloimmunisation. As regards albumin products, PEGylation improved the albumin stability, especially during sterilization, and there was a relationship between the molecular weight (MW) of PEG molecules and the biological half-life of the conjugate. Although coating antibodies with short-chain PEG molecules could enhance their stabilities, these modified proteins were cleared from the blood faster. Also, branched PEG molecules enhanced the retention and shielding of the fragmented and bispecific antibodies. Overall, the results of this literature review indicate that PEGylation can be considered a useful tool for enhancing the stability and storage of blood components.
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Affiliation(s)
| | - Mehdi Mirzaei
- Iran Ministry of Health and Medical Education, Deputy Ministry for Education, Tehran, Iran
| | - Mehdi Shafiee Ardestani
- Department of Radiopharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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Experimental and Numerical Study of Blood Flow in μ-vessels: Influence of the Fahraeus–Lindqvist Effect. FLUIDS 2019. [DOI: 10.3390/fluids4030143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The study of hemodynamics is particularly important in medicine and biomedical engineering as it is crucial for the design of new implantable devices and for understanding the mechanism of various diseases related to blood flow. In this study, we experimentally identify the cell free layer (CFL) width, which is the result of the Fahraeus–Lindqvist effect, as well as the axial velocity distribution of blood flow in microvessels. The CFL extent was determined using microscopic photography, while the blood velocity was measured by micro-particle image velocimetry (μ-PIV). Based on the experimental results, we formulated a correlation for the prediction of the CFL width in small caliber (D < 300 μm) vessels as a function of a modified Reynolds number (Re∞) and the hematocrit (Hct). This correlation along with the lateral distribution of blood viscosity were used as input to a “two-regions” computational model. The reliability of the code was checked by comparing the experimentally obtained axial velocity profiles with those calculated by the computational fluid dynamics (CFD) simulations. We propose a methodology for calculating the friction loses during blood flow in μ-vessels, where the Fahraeus–Lindqvist effect plays a prominent role, and show that the pressure drop may be overestimated by 80% to 150% if the CFL is neglected.
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Meng F, Kaul D, Thangaswamy S, Bhutoria S, Gerfen G, Branch C, Intaglietta M, Acharya SA. Semisynthetic supra plasma expanders: a new class of therapeutics to improve microcircualtion in sickle cell anaemia. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2019; 47:73-82. [DOI: 10.1080/21691401.2018.1543194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Fantao Meng
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
- Laboratory of Biochemistry and Vascular Biology, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MA, USA
| | - Dhananjaya Kaul
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Savita Bhutoria
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Gary Gerfen
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Craig Branch
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Radiology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marcos Intaglietta
- Department of Bioengineering, University of California, San Diego, CA, USA
| | - Seetharama A. Acharya
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY, USA
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A Mechanistic Analysis of Possible Blood Transfusion Failure to Increase Circulatory Oxygen Delivery in Anemic Patients. Ann Biomed Eng 2019; 47:1094-1105. [PMID: 30659435 DOI: 10.1007/s10439-019-02200-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/05/2019] [Indexed: 10/27/2022]
Abstract
The effects of changing hematocrit (Hct) on the rate of circulatory oxygen ([Formula: see text]) delivery were modeled analytically to describe transfusion of 0.5-3.0 units of packed red blood cells (pRBC, 300 mL/unit, 60% Hct) to anemic patients. In our model, Hct affects [Formula: see text] delivery to the microcirculation by changing blood [Formula: see text] carrying capacity and blood viscosity, which in turn affects blood flow velocity and, therefore, [Formula: see text] delivery. Changing blood velocity impacts the [Formula: see text] delivery by affecting the oxygen diffusive losses as blood transits through the arteriolar vasculature. An increase in Hct has two opposite effects: it increases the blood [Formula: see text] carrying capacity and decreases the flow velocity. This suggests the existence of an optimal Hct that maximizes [Formula: see text] delivery. Our results show that maximal [Formula: see text] delivery occurs in the anemic range, where [Formula: see text]%. Optimal blood management is associated with transfusing enough units up to reaching maximal [Formula: see text] delivery. Although somewhat complex to implement, this practice would result in both substantial blood savings and improved [Formula: see text] delivery.
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Supra-plasma expanders: the future of treating blood loss and anemia without red cell transfusions? JOURNAL OF INFUSION NURSING 2016; 38:217-22. [PMID: 25871869 DOI: 10.1097/nan.0000000000000103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Oxygen delivery capacity during profoundly anemic conditions depends on blood's oxygen-carrying capacity and cardiac output. Oxygen-carrying blood substitutes and blood transfusion augment oxygen-carrying capacity, but both have given rise to safety concerns, and their efficacy remains unresolved. Anemia decreases oxygen-carrying capacity and blood viscosity. Present studies show that correcting the decrease of blood viscosity by increasing plasma viscosity with newly developed plasma expanders significantly improves tissue perfusion. These new plasma expanders promote tissue perfusion, increasing oxygen delivery capacity without increasing blood oxygen-carrying capacity, thus treating the effects of anemia while avoiding the transfusion of blood.
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D’souza AA, Shegokar R. Polyethylene glycol (PEG): a versatile polymer for pharmaceutical applications. Expert Opin Drug Deliv 2016; 13:1257-75. [DOI: 10.1080/17425247.2016.1182485] [Citation(s) in RCA: 335] [Impact Index Per Article: 41.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Anisha A. D’souza
- Department of Bioscience and Bioengineering, Indian Institute of Technology, Mumbai, India
| | - Ranjita Shegokar
- Department Pharmaceutics, Biopharmaceutics & NutriCosmetics, Freie Universität Berlin, Institute of Pharmacy, Kelchstr. 31, 12169 Berlin, Germany
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Abuchowski A. PEGylated Bovine Carboxyhemoglobin (SANGUINATE™): Results of Clinical Safety Testing and Use in Patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 876:461-467. [DOI: 10.1007/978-1-4939-3023-4_58] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Sriram K, Intaglietta M, Tartakovsky DM. Non-Newtonian flow of blood in arterioles: consequences for wall shear stress measurements. Microcirculation 2015; 21:628-39. [PMID: 24703006 DOI: 10.1111/micc.12141] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 04/02/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our primary goal is to investigate the effects of non-Newtonian blood properties on wall shear stress in microvessels. The secondary goal is to derive a correction factor for the Poiseuille-law-based indirect measurements of wall shear stress. METHODS The flow is assumed to exhibit two distinct, immiscible and homogeneous fluid layers: an inner region densely packed with RBCs, and an outer cell-free layer whose thickness depends on discharge hematocrit. The cell-free layer is assumed to be Newtonian, while rheology of the RBC-rich core is modeled using the Quemada constitutive law. RESULTS Our model provides a realistic description of experimentally observed blood velocity profiles, tube hematocrit, core hematocrit, and apparent viscosity over a wide range of vessel radii and discharge hematocrits. CONCLUSIONS Our analysis reveals the importance of incorporating this complex blood rheology into estimates of WSS in microvessels. The latter is accomplished by specifying a correction factor, which accounts for the deviation of blood flow from the Poiseuille law.
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Affiliation(s)
- Krishna Sriram
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, California, USA
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Polanczyk A, Podyma M, Stefanczyk L, Szubert W, Zbicinski I. A 3D model of thrombus formation in a stent-graft after implantation in the abdominal aorta. J Biomech 2014; 48:425-31. [PMID: 25543277 DOI: 10.1016/j.jbiomech.2014.12.033] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 11/22/2014] [Accepted: 12/10/2014] [Indexed: 11/25/2022]
Abstract
Here we present a 3D kinetic model of thrombus formation in an endovascular prosthesis after implantation in an abdominal aorta with an aneurysm. The computational fluid dynamic technique (CFD) was used to determine the process of thrombus formation and growth in the stent-graft on the basis of the medical data from computed tomography angiography and Doppler ultrasound examination of 10 patients. The Quemada model was used to describe rheological properties of blood. Results of the CFD simulations were validated based on actual data from patients with diagnosed thrombi in aortic implants. The results show that the elaborated CFD model correctly predicted thrombus formation, shape and deposition site in an endovascular prosthesis. The developed CFD model of thrombus growth can be applied to predict the risk of thrombus formation in stent-grafts and assist in selection of geometry of the endovascular prosthesis to reduce possible complications after stent-graft implantation using only basic medical data.
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Affiliation(s)
- Andrzej Polanczyk
- Lodz University of Technology, Faculty of Process and Environmental Engineering, Department of Heat and Mass Transfer, Poland.
| | - Marek Podyma
- Lodz University of Technology, Faculty of Process and Environmental Engineering, Department of Heat and Mass Transfer, Poland
| | - Ludomir Stefanczyk
- Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Poland
| | - Wojciech Szubert
- Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Poland
| | - Ireneusz Zbicinski
- Lodz University of Technology, Faculty of Process and Environmental Engineering, Department of Heat and Mass Transfer, Poland
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Replacing the Transfusion of 1-2 Units of Blood with Plasma Expanders that Increase Oxygen Delivery Capacity: Evidence from Experimental Studies. J Funct Biomater 2014; 5:232-45. [PMID: 25350267 PMCID: PMC4285404 DOI: 10.3390/jfb5040232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 09/17/2014] [Accepted: 10/15/2014] [Indexed: 12/14/2022] Open
Abstract
At least a third of the blood supply in the world is used to transfuse 1–2 units of packed red blood cells for each intervention and most clinical trials of blood substitutes have been carried out at this level of oxygen carrying capacity (OCC) restoration. However, the increase of oxygenation achieved is marginal or none at all for molecular hemoglobin (Hb) products, due to their lingering vasoactivity. This has provided the impetus for the development of “oxygen therapeutics” using Hb-based molecules that have high oxygen affinity and target delivery of oxygen to anoxic areas. However it is still unclear how these oxygen carriers counteract or mitigate the functional effects of anemia due to obstruction, vasoconstriction and under-perfusion. Indeed, they are administered as a low dosage/low volume therapeutic Hb (subsequently further diluted in the circulatory pool) and hence induce extremely small OCC changes. Hyperviscous plasma expanders provide an alternative to oxygen therapeutics by increasing the oxygen delivery capacity (ODC); in anemia they induce supra-perfusion and increase tissue perfusion (flow) by as much as 50%. Polyethylene glycol conjugate albumin (PEG-Alb) accomplishes this by enhancing the shear thinning behavior of diluted blood, which increases microvascular endothelial shear stress, causes vasodilation and lowering peripheral vascular resistance thus facilitating cardiac function. Induction of supra-perfusion takes advantage of the fact that ODC is the product of OCC and blood flow and hence can be maintained by increasing either or both. Animal studies suggest that this approach may save a considerable fraction of the blood supply. It has an additional benefit of enhancing tissue clearance of toxic metabolites.
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Affiliation(s)
- Andre F. Palmer
- William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, Ohio 43210;
| | - Marcos Intaglietta
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093;
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Meng F, Tsai AG, Intaglietta M, Acharya SA. PEGylation of αα-Hb using succinimidyl propionic acid PEG 5K: Conjugation chemistry and PEG shell structure dictate respectively the oxygen affinity and resuscitation fluid like properties of PEG αα-Hbs. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2014; 43:270-81. [PMID: 24597567 DOI: 10.3109/21691401.2014.885443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PEGylation of intramolecularly crosslinked Hb has been studied here to overcome the limitation of dissociation of Hb tetramers. New hexa and deca PEGylated low oxygen affinity PEG-ααHbs have been generated. Influence of PEG conjugation chemistry and the PEG shell structure on the functional properties as well as PEGylation induced plasma expander like properties of the protein has been delineated. The results have established that in the design of PEG-Hbs as oxygen therapeutics, the influence of conjugation chemistry and the PEG shell structure on the oxygen affinity of Hb needs to be optimized independently besides optimizing the PEG shell structure for inducing resuscitation fluid like properties.
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Affiliation(s)
- Fantao Meng
- Hematology Division, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University , Bronx, NY , USA
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Abstract
The development of oxygen (O2)-carrying blood substitutes has evolved from the goal of replicating blood O2 transport properties to that of preserving microvascular and organ function, reducing the inherent or potential toxicity of the material used to carry O2, and treating pathologies initiated by anemia and hypoxia. Furthermore, the emphasis has shifted from blood replacement fluid to "O2 therapeutics" that restore tissue oxygenation to specific tissues regions. This review covers the different alternatives, potential and limitations of hemoglobin-based O2 carriers (HBOCs) and perfluorocarbon-based O2 carriers (PFCOCs), with emphasis on the physiologic conditions disturbed in the situation that they will be used. It describes how concepts learned from plasma expanders without O2-carrying capacity can be applied to maintain O2 delivery and summarizes the microvascular responses due to HBOCs and PFCOCs. This review also presents alternative applications of HBOCs and PFCOCs namely: 1) How HBOC O2 affinity can be engineered to target O2 delivery to hypoxic tissues; and 2) How the high gas solubility of PFCOCs provides new opportunities for carrying, dissolving, and delivering gases with biological activity. It is concluded that the development of current blood substitutes has amplified their applications horizon by devising therapeutic functions for O2 carriers requiring limited O2 delivery capacity restoration. Conversely, full, blood-like O2-carrying capacity reestablishment awaits the control of O2 carrier toxicity.
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Affiliation(s)
- Pedro Cabrales
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093-0412, USA.
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Sriram K, Salazar Vázquez BY, Tsai AG, Cabrales P, Intaglietta M, Tartakovsky DM. Autoregulation and mechanotransduction control the arteriolar response to small changes in hematocrit. Am J Physiol Heart Circ Physiol 2012; 303:H1096-106. [PMID: 22923620 DOI: 10.1152/ajpheart.00438.2012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Here, we present an analytic model of arteriolar mechanics that accounts for key autoregulation mechanisms, including the myogenic response and the vasodilatory effects of nitric oxide (NO) in the vasculature. It couples the fluid mechanics of blood flow in arterioles with solid mechanics of the vessel wall and includes the effects of wall shear stress- and stretch-induced endothelial NO production. The model can be used to describe the regulation of blood flow and NO transport under small changes in hematocrit and to analyze the regulatory response of arterioles to small changes in hematocrit. Our analysis revealed that the experimentally observed paradoxical increase in cardiac output with small increases in hematocrit results from the combination of increased NO production and the effects of a strong myogenic response modulated by elevated levels of WSS. Our findings support the hypothesis that vascular resistance varies inversely with blood viscosity for small changes in hematocrit in a healthy circulation that responds to shear stress stimuli. They also suggest beneficial effects independent of changes in O(2) carrying capacity associated with the postsurgical transfusion of one or two units of blood.
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Affiliation(s)
- Krishna Sriram
- Department of Mechanical and Aerospace Engineering, University of California-San Diego, La Jolla, California 92093-0412, USA
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Chatpun S, Nacharaju P, Cabrales P. Improving cardiac function with new-generation plasma volume expanders. Am J Emerg Med 2012; 31:54-63. [PMID: 22867830 DOI: 10.1016/j.ajem.2012.05.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 05/24/2012] [Accepted: 05/25/2012] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Plasma expander (PE) based on polyethylene glycol (PEG) conjugated to albumin has shown positive results maintaining blood volume during hemodilution and restoring blood volume during resuscitation from hemorrhagic shock. Polyethylene glycol conjugation to human serum albumin (HSA), PEG-HSA, increases size, weight, and colloidal osmotic pressure, with minor effects on solution viscosity. METHODS This study was designed to test the hypothesis that PEG-HSA (2 g/dL) produced by direct PEGylation chemistry improves cardiac function during 2 experimental models, (i) moderate hemodilution and (ii) resuscitation from hemorrhagic shock, compared with a conventional colloidal PE (Dextran 70 kd [Dx70], 6 g/dL). Cardiac function was studied using a miniaturized pressure volume conductance catheter implanted in the left ventricle and evaluated in terms of cardiac indices derived from the pressure volume measurements. RESULTS Polyethylene glycol-HSA increased cardiac output, stroke volume, and stroke work and decreased systemic vascular resistance compared with Dx70 in both experimental models. The improvements induced by PEG-HSA in cardiac function were sustained over the observation time. Polyethylene glycol-HSA cardiac mechanoenergetics changes are the result of increased energy transferred per stroke and decreased resistance of the vasculature connecting the heart. In summary, PEG-HSA decreased left ventricle ejection impedance. CONCLUSION Ejection of blood diluted with PEG-HSA presented a reduced load to the heart, increased contractile function, and lowered the energy consumed per unit volume compared with Dx70. Our results emphasize the importance of heart function as a parameter to be included in the evaluation changes induced by new PEs.
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Affiliation(s)
- Surapong Chatpun
- Department of Bioengineering, University of California-San Diego, La Jolla, CA 92093, USA
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