Protein adsorption, lymphocyte adhesion and platelet adhesion/activation on polyurethane ureas is related to hard segment content and composition

Non-isocyanate polyurethane-co-polyglycolic acid electrospun nanofiber membrane wound dressing with high biocompatibility, hemostasis, and prevention of chronic wound formation

The prevention of chronic wound formation has already been a primary subject in wound management, particularly for deep wounds. The electrospun nanofiber membranes hold tremendous potential in the prevention of chronic wounds due to their micro/nano pore structures. Currently, many natural and synthetic materials have been utilized in the fabrication of nanofiber membranes. However, striking a balance between the structural stability and the biocompatibility remains challenging. It is necessary not only to ensure the long-term durability of nanofiber membranes but also to enhance their biocompatibility for alleviating patients' suffering. In this study, we reported a nanofiber membrane dressing with excellent biocompatibility and mechanical properties, which is potential for the treatment of deep wounds. The basal material chosen for the preparation of the nanofiber membrane was a co-polyester (NI-LPGD5) synthesized by non-isocyanate polyurethane (NIPU) and polyglycolic acid with a dihydroxy structure (LPGD-synthesized from glycolic acid and neopentyl glycol). Moreover, curcumin was also added as a bioactive substance to enhance the pro-healing effect of dressings. The physicochemical properties of the prepared nanofiber membranes were characterized through various physicochemical tools. Our results demonstrated that the NI-LPGD5 co-polymer can be electrospun into smooth fibers. Meanwhile, curcumin-loaded nanofiber membranes (Cur/NI-LPGD5) also exhibited a favorable microscopic morphology. The fabricated membranes exhibited suitable mechanical properties, outstanding hygroscopic-swelling rate and water vapor transmittance. Besides, in vitro cell culturing, the cells on the NI-LPGD5 membrane maintained their maximum viability. The potential of in vivo wound healing was further demonstrated through animal experiments. The experimental results showed that the nanofiber membranes effectively prevented chronic wounds from forming and promoted granulation tissue growth without replacing the dressing throughout the healing process. We also found that these nanofiber membranes could effectively promote the expression of related biomarkers to accelerate wound healing, particularly the Cur/NI-LPGD5 membrane. In conclusion, the fabricated membranes possess suitable physicochemical properties and promising bioactivity. As a result, it effectively prevented the formation of chronic wounds and demonstrated significant potential in reducing the frequency of dressing changes.

Control of Blood Coagulation by Hemocompatible Material Surfaces-A Review

Hemocompatibility of biomaterials in contact with the blood of patients is a prerequisite for the short- and long-term applications of medical devices such as cardiovascular stents, artificial heart valves, ventricular assist devices, catheters, blood linings and extracorporeal devices such as artificial kidneys (hemodialysis), extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass. Although lower blood compatibility of materials and devices can be handled with systemic anticoagulation, its side effects, such as an increased bleeding risk, make materials that have a better hemocompatibility highly desirable, particularly in long-term applications. This review provides a short overview on the basic mechanisms of blood coagulation including plasmatic coagulation and blood platelets, as well as the activation of the complement system. Furthermore, a survey on concepts for tailoring the blood response of biomaterials to improve the hemocompatibility of medical devices is given which covers different approaches that either inhibit interaction of material surfaces with blood components completely or control the response of the coagulation system, blood platelets and leukocytes.

Proteins, platelets, and blood coagulation at biomaterial interfaces

Blood coagulation and platelet adhesion remain major impediments to the use of biomaterials in implantable medical devices. There is still significant controversy and question in the field regarding the role that surfaces play in this process. This manuscript addresses this topic area and reports on state of the art in the field. Particular emphasis is placed on the subject of surface engineering and surface measurements that allow for control and observation of surface-mediated biological responses in blood and test solutions. Appropriate use of surface texturing and chemical patterning methodologies allow for reduction of both blood coagulation and platelet adhesion, and new methods of surface interrogation at high resolution allow for measurement of the relevant biological factors.

Poly(urethane-dimethylsiloxane) copolymers displaying a range of soft segment contents, noncytotoxic chemistry, and nonadherent properties toward endothelial cells

Polyurethane copolymers based on α,ω-dihydroxypropyl poly(dimethylsiloxane) (PDMS) with a range of soft segment contents were prepared by two-stage polymerization, and their microstructures, thermal, thermomechanical, and surface properties, as well as in vitro hemo- and cytocompatibility were evaluated. All utilized characterization methods confirmed the existence of moderately microphase separated structures with the appearance of some microphase mixing between segments as the PDMS (i.e., soft segment) content increased. Copolymers showed higher crystallinity, storage moduli, surface roughness, and surface free energy, but less hydrophobicity with decreasing PDMS content. Biocompatibility of copolymers was evaluated using an endothelial EA.hy926 cell line by direct contact, an extraction method and after pretreatment of copolymers with multicomponent protein mixture, as well as by a competitive protein adsorption assay. Copolymers showed no toxic effect to endothelial cells and all copolymers, except that with the lowest PDMS content, exhibited resistance to endothelial cell adhesion, suggesting their unsuitability for long-term biomedical devices which particularly require re-endothelialization. All copolymers exhibited excellent resistance to fibrinogen adsorption and adsorbed more albumin than fibrinogen in the competitive adsorption assay, suggesting their good hemocompatibility. The noncytotoxic chemistry of these synthesized materials, combined with their nonadherent properties which are inhospitable to cell attachment and growth, underlie the need for further investigations to clarify their potential for use in short-term biomedical devices.

A review of block copolymer-based biomaterials that control protein and cell interactions

Block copolymers posses the ability to phase separate into micro and nanoscale patterns resulting in nonhomogeneous surfaces and solids. This nonhomogeneity has been harnessed to improve mechanical properties, control degradation, and add functionality to biomaterials. The ability of block copolymers to generate a wide variety of surface chemistries and morphologies can also be harnessed to control protein adsorption, protein conformation, and cell adhesion. Proteins and cells will respond to periodically structured surfaces, so block copolymers have a great deal of potential as biomaterials. This review will explore the ability of block copolymers to control specific biological responses such as cell adhesion, protein adsorption and conformation, parameters that govern the overall host response to a material. In addition, some of the specific applications of block copolymer, antithrombogenic materials and their ability to pattern proteins, will be discussed.

Cell-material interactions on biphasic polyurethane matrix

Cell-matrix interaction is a key regulator for controlling stem cell fate in regenerative tissue engineering. These interactions are induced and controlled by the nanoscale features of extracellular matrix and are mimicked on synthetic matrices to control cell structure and functions. Recent studies have shown that nanostructured matrices can modulate stem cell behavior and exert specific role in tissue regeneration. In this study, we have demonstrated that nanostructured phase morphology of synthetic matrix can control adhesion, proliferation, organization and migration of human mesenchymal stem cells (MSCs). Nanostructured biodegradable polyurethanes (PU) with segmental composition exhibit biphasic morphology at nanoscale dimensions and can control cellular features of MSCs. Biodegradable PU with polyester soft segment and hard segment composed of aliphatic diisocyanates and dipeptide chain extender were designed to examine the effect polyurethane phase morphology. By altering the polyurethane composition, morphological architecture of PU was modulated and its effect was examined on MSC. Results show that MSCs can sense the nanoscale morphology of biphasic polyurethane matrix to exhibit distinct cellular features and, thus, signifies the relevance of matrix phase morphology. The role of nanostructured phases of a synthetic matrix in controlling cell-matrix interaction provides important insights for regulation of cell behavior on synthetic matrix and, therefore, is an important tool for engineering tissue regeneration.

Dynamics of hydrated polyurethane biomaterials: Surface microphase restructuring, protein activity and platelet adhesion

Microphase separation is a central feature of segmented polyurethane biomaterials and contributes to the biological response to these materials. In this study we utilized atomic force microscopy (AFM) to study the dynamic restructuring of three polyurethanes having soft segment chemistries of interest in biomedical applications. For each of the materials we followed the changes in near surface mechanical properties during hydration, as well as fibrinogen activity and platelet adhesion on these surfaces. Both AFM phase imaging and force mode analysis demonstrated that these polyurethane biomaterials underwent reorientation and rearrangement resulting in a net enrichment of hard domains at the surface. Fibrinogen activity and platelet adhesion on the polyurethane surfaces were found to decrease with increasing hydration time. The findings suggest that water-induced enrichment of hydrophilic hard domains at the surface changes the local surface physical and chemical properties in a way that influences the conformation of fibrinogen, changing the availability of the platelet-binding sites in the protein. This work demonstrates that the hydrated polyurethane biomaterial interface is a complex and dynamic environment where the surface chemistry is changing, altering the activity of fibrinogen and affecting blood platelet adhesion.

Immobilization of heparin on polysulfone surface for selective adsorption of low-density lipoprotein (LDL)

A versatile method was developed to immobilize heparin covalently on polysulfone sheets (PSu) to achieve selective adsorption of low-density lipoprotein (LDL). This was achieved by activation of PSu with successive treatments of chlorodimethyl ether and ethylenediamine, and subsequent chemical binding of heparin with bifunctional linker molecules. A heparin density up to 0.86 microg cm(-2) on a dense PSu film was achieved. The modified PSu films were characterized by attenuated total reflectance Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy. The hydrophilicity of the PSu film was improved greatly by covalent immobilization of heparin. The water contact angle of PSu film was decreased from 86.6 + or - 3.7 degrees to 50.5 + or - 3.2 degrees after binding of 0.36 microg cm(-2) heparin. An enzyme-linked immunosorbent assay was used to measure the binding of LDL on plain and modified PSu films. It was found that the heparin-modified PSu film could selectively recognize LDL from binary protein solutions. Furthermore, it was possible to desorb LDL from heparinized PSu, but not from plain PSu, with heparin, sodium chloride or urea solution, which indicates a selective but reversible binding of LDL to heparin. The results suggest that heparin-modified PSu membranes are promising for application in simultaneous hemodialysis and LDL apheresis therapy.

Platelet compatibility of PLGA, chitosan and PLGA-chitosan nanoparticles

AIM

The increasing interest in biodegradable nanoparticles containing biomaterials such as poly(D,L-lactide-co-glycolide) (PLGA) and chitosan for drug delivery raises issues regarding the blood compatibility of these nanoparticles, since some nanoparticles, including carbon nanoparticles, can affect human platelet aggregation and cause vascular thrombosis. Therefore, the aim of this work was to investigate the effect of polymeric nanoparticles on human platelet function by measuring aggregation and receptor expression in vitro.

MATERIALS & METHOD

PLGA, chitosan-PLGA and a series of chitosan nanoparticles were prepared by the single emulsion technique and ionotropic gelation method. The effects of these nanoparticles (0.01-100 microg/ml) on resting platelets, as well as on platelet aggregation and expression of receptors (GPIIb/IIIa and P-selectin) induced by agonists in platelet-rich plasma were examined using light aggregometry and flow cytometry.

RESULTS & CONCLUSION

All tested nanoparticles at concentrations below 10 microg/ml did not modify platelet aggregation, showing that they may be used for the delivery of active molecules to the bloodstream.

A Phospholipid-modified Polystyrene—Polyisobutylene— Polystyrene (SIBS) Triblock Polymer for Enhanced Hemocompatibility and Potential Use in Artificial Heart Valves

Poly(styrene-block-isobutylene-block-styrene) (`SIBS') is selected for a novel trileaflet heart valve due to its high resistance to oxidation, hydrolysis, and enzyme attack. SIBS is modified using six different phospholipids and its mechanical properties characterized by tensile stress, peel strength, shear strength, contact angle, and surface energy, and then for hemocompatibility by studying the adhesion of fluorescently labeled platelets in a parallel plate chamber under physiological flow conditions. Phospholipid modification decreases SIBS tensile stress (at 45% strain) by 30% and reduces platelet adhesion by a factor of 10, thereby improving its hemocompatibility and its potential use as a synthetic heart valve.

Wettability of substrata controls cell–substrate and cell–cell adhesions

The maintenance of endothelial cell (EC) monolayer architecture requires stable adhesions not only between neighboring cells but also between cells and the extracellular matrix. While the influence of biomaterials surface wettability on cell-substratum adhesion is rather well studied, its impact on cell-cell cohesion has not been extensively investigated. In the present study a model system consisting of hydrophilic and hydrophobic glass pre-coated with fibronectin and fibrinogen was used to study the influence of surface wettability on both types of cell adhesions. It was demonstrated that the substrate wettability controls the adhesion and cytoskeletal organization of endothelial cells, which has an impact on the subsequent ability of cells to establish stable cell-cell cohesions. These effects were related to the accessibility of specific domains of the adsorbed proteins. While the hydrophobic substratum promoted cell-cell cohesion, on hydrophilic substrata cell-substrate adhesion was dominant. In addition, evidence for an influence of surface wettability on the cross talk between integrins and cadherins was found.

Chitosan based surfactant polymers designed to improve blood compatibility on biomaterials

We developed chitosan based surfactant polymers that could be used to modify the surface of existing biomaterials in order to improve their blood compatibility. These polymers consist of a chitosan backbone, PEG side chains to repel non-specific protein adsorption, and hexanal side chains to facilitate adsorption and proper orientation onto a hydrophobic substrate via hydrophobic interactions. Since chitosan is a polycationic polymer, and it is thrombogenic, the surface charge was altered to determine the role of this charge in the hemocompatibility of chitosan. Charge had a notable effect on platelet adhesion. The platelet adhesion was greatest on the positively charged surface, and decreased by almost 50% with the neutralization of this charge. A chitosan surface containing the negatively charged SO(3)(-) exhibited the fewest number of adherent platelets of all surfaces tested. Coagulation activation was not altered by the neutralization of the positive charge, but a marked increase of approximately 5-6 min in the plasma recalcification time (PRT) was displayed with the addition of the negatively charged species. Polyethylene (PE) surfaces were modified with the chitosan surfactant resulting in a significant improvement in blood compatibility, which correlated to the increasing PEG content within the polymer. Adsorption of the chitosan surfactants onto PE resulted in approximately an 85-96% decrease in the number of adherent platelets. The surfactant polymers also reduced surface induced coagulation activation, which was indicated by the PEG density dependent increase in PRTs. These results indicate that surface modification with our chitosan based surfactant polymers successfully improves blood compatibility. Moreover, the inclusion of either negatively charged SO(3)(-) groups or a high density of large water-soluble PEG side chains produces a surface that may be suitable for cardiovascular applications.

Fibrinogen adsorption and platelet interactions on polymer membranes

The hemocompatibility of four different wettable polymer membranes, namely Cuprophan (CE), polyether-polycarbonate (PC-PE), polysulfone (PSU), and polyetherimide (PEI), was investigated with respect to fibrinogen (Fng) adsorption and platelet adhesion/activation. In order to estimate the polar and dispersion components of the surface free energy, contact angles using water/vapor and water/n-hexadecane systems were measured. Adsorption of fibrinogen was studied using fluorescence-labeled protein. The adsorption isotherms showed that the amount and the affinity of adsorbed Fng increased with decreasing surface wettability of the membranes, which correlates with the dispersion and polar components of the surface free energy. The conformational changes of adsorbed Fng were detected by measuring the difference between monoclonal antibody binding to the conformation-sensitive epitope in the D-domain and the binding of polyclonal anti-Fng antibody. The anticipated conformational/orientational changes were greater for PEI and PSU membranes (the least wettable membranes) and negligible for the more wettable PC-PE and CE membranes. In addition, a possible relationship with the degree of platelet activation was found, showing negligible platelet adhesion on PC-PE and CE, but high platelet adhesion on PEI and PSU. Furthermore, platelets were spread to a large extent on PEI, while the formation of aggregates was observed on PSU. This may correspond to the anticipated differences in the conformational state of Fng on both membranes.

Shear-induced platelet activation and adhesion on human pulmonary artery endothelial cells seeded onto hydrophilic polymers

We evaluated platelet activation and adhesion on two plasma polymerized surfaces, N-vinyl pyrrolidone (NVP) and gamma-butyro lactone (GBL), which have been shown previously to promote endothelial cell growth and adhesion as well as fibronectin-coated glass (1 microg/cm(2)) coverslips. Human pulmonary artery endothelial cells were seeded onto coverslips at a low density ( approximately 20,000 cells/cm(2)) and grown to confluence (3-5 days). The materials, both with and without ECs, were then exposed to a shear rate of 400 s(-1) in a closed loop recirculating flow system containing human platelet-rich plasma. Plasma samples were taken at 0, 5, 15, 30, and 60 min and analyzed for platelet and coagulation activation. The coverslips were examined for EC coverage and platelet adherence. EC retention over a 1-h period was approximately 75% for all three materials. All three materials without ECs were highly platelet activating having similar P-selectin expression, platelet factor 4 (PF4) release, mepacrine uptake, and microparticle production. Both microparticle production and platelet adhesion were significantly lower in EC-seeded materials. Dense granule and PF4 release were both slightly diminished in all three materials seeded with ECs. P-selectin expression was reduced slightly for GBL, but remained the same for the other two materials. The EC-seeded materials displayed favorable characteristics with respect to platelet activation and adhesion; however, they still demonstrated some thrombogenic tendencies due to EC loss and exposure of the underlying substrate. Therefore, both EC coverage and EC hemostatic function are important factors in determining the thromboresistance of an EC-seeded surface.

Preparation of PEG-coated surfaces and a study for their interaction with living cells

Cell-biomaterial interaction is of great importance for the development of bioinert as well as of hybrid surfaces. This study represents our results of human fibroblast interaction with PEG-coated surfaces of differing length and structure (linear or branched) of the oxyethylene chain. We employed three PEGs -- PEG 1500 and PEG 6000, both lineal but with different chain lengths, and PEG 12500 which was branched. The PEGs were deposited on silica plates using branched poly(ethylene imine) as an anchoring polymer. Fibroblasts were plated and studied by immunofluorescence to evaluate the overall cell morphology, the organisation of the actin cytoskeleton, and the beta1-integrin (fibronectin receptor). The particular effect of fibronectin (FN) pre-adsorption was studied. Our results suggest that PEG 6000 surface is to be preferable with respect to the initial interaction with the cells. The overall cell morphology was almost normal on bare surfaces. FN pre-coating additionally improved cell adhesion and spreading as well as the organization of the actin cytoskeleton and focal adhesion formation; the PEG 12500 surface showed relatively poor initial properties. Almost no cell spreading was found on the bare surface, but FN pre-adsorption completely restored normal cell morphology. In contrast, PEG 1500 had to be considered is 'the worst' material, because of lower initial cell adhesion and spreading and FN pre-adsorption did not restore normal cell morphology.

Investigation of plasma protein adsorption on functionalized nanoparticles for application in apheresis

Particles with specific ligands for the adsorption of plasma proteins can be used in therapeutic or preparative apheresis. The development of these particles may benefit from an improved knowledge of the relationship between protein adsorption and the structure of ligands. Nanoparticles were functionalized with aliphatic diamines of increasing chain length; with the amino acids lysine, tryptophan, histidine, and their corresponding amines; and with tryptophan and histidine spaced with diamines of different length. Suitable protocols were developed for the washing of particles and the subsequent desorption of proteins adsorbed from human plasma. The adsorption pattern, as well as the quantification of the overall adsorption of proteins on these modified particles, was investigated with gel electrophoresis. This was followed by immunoblotting which yielded specific assessments of bound human serum albumin and fibrinogen. The comparison of protein adsorption with surface charge density and measured hydrophobicities yielded no simple correlations although in general more hydrophobic ligands bound higher quantities of protein. The detection of human serum albumin yielded similar results because it was observed for overall protein adsorption while the adsorption of fibrinogen expressed a different pattern. In this case, particular nanoparticles functionalized with aliphatic diamines bound significantly higher amounts of fibrinogen than all other ligands.

Albumin-binding surfaces: in vitro activity

Immobilized monoclonal antibodies (Mabs) have been used to attract specific molecules to a solid surface from complex mixtures such as blood, plasma or serum, thereby directing the response to the modified substrate, a key goal in rational biomaterial design. The nature of the Mab dictated the nature of the response: anti-albumin antibodies were used to prevent cell and platelet adhesion in vitro, whilst anti-fibronectin Mabs promoted attachment. Patterned surfaces could be formed, bearing Mabs that generated adhesive and non-adhesive regions. Fibrinogen adsorption from plasma showed a Vroman peak on unmodified control polymer, which was reduced by 64% in the presence of surface-bound anti-albumin Mab. Immobilization of a control Mab reduced fibrinogen adsorption only slightly, implying an albumin-mediated effect. In static tests, platelet adhesion from human platelet rich plasma was significantly reduced by the immobilization of anti-HSA Mab when compared to the untreated FEP surface (p < 0.0001). This effect was also seen with citrated blood flowing through Mab-treated polyurethane tubing at a shear rate of 132 s(-1) (p=0.034). Since platelets and proteins (as blood, plasma or serum) were introduced to the surface simultaneously, the generation of a defined protein film must have been sufficiently rapid as to shape the platelet or cell response.

Protein adsorption on solid surfaces

The research field of protein adsorption on surfaces appears to be as popular as ever. In the past year, several hundred published papers tackled problems ranging from fundamental aspects of protein surface interactions to applied problems of surface blood compatibility and protein surface immobilization. Although some parts of the protein adsorption process, such as kinetics and equilibrium interactions, can be accurately predicted, other aspects, such as the extent and the rate of protein conformational change, are still somewhat uncertain. The whole field is ripe for a comprehensive theory on protein adsorption.

Modification of poly(ether urethane)elastomers by incorporation of poly(isobutylene)glycol. Relation between polymer properties and thrombogenicity

Non-polar hydrophobic poly(isobutylene)glycol (PIBG) was substituted for poly(tetramethylene ether)glycol (PTMEG) in poly(ether urethanes) based on 4,4'-methylenebis-(phenylisocyanate) (MDI) and 1,4-butanediol (BD) as chain extender. Two series of polyurethanes differing in their soft segment length, polymer composition, and hard segment content were studied by dynamic mechanical analysis (DMA) and static, as well as dynamic, contact angle measurements. The thrombogenicity of these polymers was characterized by studying the adhesion and activation of platelets using ELISA for GMP 140 and fluorescence microscopy. It was found by DMA that in PIBG-containing polyurethanes (PUE) exist soft domains containing hard segments, strictly separated hard segment domains, and hard segments partially mixed with soft segments. Contact angle measurements revealed that 25% PIBG or even less, are sufficient for a remarkable enrichment of these non-polar soft segments on the polymer surface. The platelet adhesion/activation on these materials was demonstrated to increase with the rise in hard segment content, as well as with an enhancement of the PIBG content. However, comparison of PIBG-containing PUE with medical applied polypropylene and pellethane expressed that PUE with PIBG content equal or less 25% have excellent haemocompatibility.

Immobilization of heparin on polylactide for application to degradable biomaterials in contact with blood

The poly-(D, L-lactide) RESOMER R208 (Boehringer-Ingelheim, Germany) was modified with heparin to improve the blood contacting properties of the material. The immobilization of herapin was carried out by covalent binding with glutaraldehyde as the coupling agent. The reaction conditions, such as temperature and time, were varied to optimize the binding of heparin. The efficiency of the immobilization was monitored with respect to the total amount of coupled herapin with a toluidine blue assay and the anticoagulant activity of immobilized heparin with a factor Xa assay. The hemocompatibility of the modified polylactide was estimated after blood-material contact by the activation of platelets measured with an enzyme immuno assay for GMP140. Immobilization at ambient temperature and a reaction time of 2 h resulted in maximal heparin binding, high anticoagulant activity, and low thrombogenicity. Since the remaining unsaturated aldehyde groups of the coupling agent may cause a low hemocompatibility of the material, washing of the heparinized polylactide was carried out with ethanol. However, it was shown that washing diminished the anticoagulant activity of heparin and increased the thrombogenicity. The prolonged storage of heparinized polylactide in phosphate buffered saline for 8 days demonstrated that small quantities of heparin were released but the hemocompatibility was further improved, indicated by an increasing anticoagulant potential and a decrease in platelet activation with incubation time. A comparison of polylactide, heparinized polylactide, polypropylene, and Pellethane with respect to platelet activation by GMP140 assay and scanning electron microscopy, revealed that the heparinization of polylactide substantially improved the hemocompatibility of RESOMER R208, making the material comparable to Pellethane.