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Tagaya M, Murataka T, Okano S, Handa H, Takahashi S. Comparison of complement consumption and platelet accumulation between membrane oxygenators coated with a polymer or heparin. Perfusion 2024; 39:1143-1151. [PMID: 37216953 DOI: 10.1177/02676591231177912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
INTRODUCTION The membrane oxygenator in extracorporeal circulation circuits is coated with acrylate-copolymer (ACP) or immobilized heparin (IHP) to enhance hemocompatibility. To evaluate the relative features of both coatings, we compared blood components circulated in the circuits with ACP-and IHP-coated membranes in vitro using whole human blood. METHODS Whole human blood was heparinized and circulated in two experimental circuits with an ACP-coated reservoir, tubes, and an ACP- or IHP-coated membrane. Platelet (PLT) counts and the amount of total protein (TP), complement component 3 (C3), and complement component 4 (C4) were measured at 0, 8, 16, 24, and 32 h in each experiment (n = 5). RESULTS The PLT count at 0-h circulation was lower in the IHP-coated than in the ACP-coated circuits (p = 0.034); however, no significant difference was observed at other time points. Reduction in TP at 8-h and 16-h circulation and in C3 at 32-h circulation was lesser in the ACP-coated than in the IHP-coated circuits (p = 0.004, 0.034, and 0.027, respectively); reduction in TP and C3 at other time points and C4 at each time point was not significantly different. There were significant interactions between coating type and circulation duration in the PLT, TP, and C3 transitions (p = 0.008, 0.020, and 0.043, respectively). CONCLUSIONS Our findings suggest that ACP-coated membranes can prevent the initial drop in PLT count and C3 consumption over 32 h, whereas IHP-coated membranes could not prevent this drop in extracorporeal circulation. Therefore, ACP-coated membranes are suitable for short- and long-term extracorporeal life support.
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Affiliation(s)
- Masashi Tagaya
- Department of Medical Engineering, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Takuo Murataka
- Department of Medical Engineering, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Shinya Okano
- Department of Medical Engineering, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Hiroki Handa
- Department of Medical Engineering, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Shunsuke Takahashi
- Department of Nephrology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
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Munoz M, El-Khoury A, Eren Cimenci C, Gonzalez-Gomez M, Hunter RA, Lomboni D, Variola F, Rotstein BH, Vono LLR, Rossi LM, Edwards AM, Alarcon EI. Riboflavin Surface Modification of Poly(vinyl chloride) for Light-Triggered Control of Bacterial Biofilm and Virus Inactivation. ACS APPLIED MATERIALS & INTERFACES 2021; 13:32251-32262. [PMID: 34181389 DOI: 10.1021/acsami.1c08042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Poly(vinyl chloride) (PVC) is the most used biomedical polymer worldwide. PVC is a stable and chemically inert polymer. However, microorganisms can colonize PVC producing biomedical device-associated infections. While surface modifications of PVC can help improve the antimicrobial and antiviral properties, the chemically inert nature of PVC makes those modifications challenging and potentially toxic. In this work, we modified the PVC surface using a derivative riboflavin molecule that was chemically tethered to a plasma-treated PVC surface. Upon a low dosage of blue light, the riboflavin tethered to the PVC surface became photochemically activated, allowing for Pseudomonas aeruginosa bacterial biofilm and lentiviral in situ eradication.
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Affiliation(s)
- Marcelo Munoz
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario K1Y4W7, Canada
| | - Antony El-Khoury
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario K1Y4W7, Canada
| | - Cagla Eren Cimenci
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario K1Y4W7, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
| | - Mayte Gonzalez-Gomez
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario K1Y4W7, Canada
| | - Robert A Hunter
- Ottawa-Carleton Institute for Biomedical Engineering, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - David Lomboni
- Department of Mechanical Engineering, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Fabio Variola
- Department of Mechanical Engineering, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Benjamin H Rotstein
- Molecular Imaging Probes and Radiochemistry Laboratory, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y4W7, Canada
| | - Lucas L R Vono
- Institute of Chemistry, University of São Paulo, USP, São Paulo, SP 05508-000, Brazil
| | - Liane M Rossi
- Institute of Chemistry, University of São Paulo, USP, São Paulo, SP 05508-000, Brazil
| | - Ana Maria Edwards
- Departamento de Química Física, Facultad de Química, Pontificia Universidad Católica de Chile, Santiago 7820244, Chile
| | - Emilio I Alarcon
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario K1Y4W7, Canada
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine University of Ottawa, Ottawa, Ontario K1H8M5, Canada
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Nitric oxide-mediated fibrinogen deposition prevents platelet adhesion and activation. Biointerphases 2018; 13:06E403. [DOI: 10.1116/1.5042752] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Tagaya M, Hara K, Takahashi S, Nagoshi S, Handa H, Okano S, Murataka T. Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer. Int J Artif Organs 2018; 42:88-94. [PMID: 30486706 PMCID: PMC6343425 DOI: 10.1177/0391398818815480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: Extracorporeal circulation devices are coated with a biocompatible polymer coating agent (BPCA) that has a hydrophilic blood-contacting layer, but hemofilters are not. We aimed to investigate the antithrombotic properties of a BPCA-coated hemofilter. METHODS: Four experiments using BPCA-coated circuits and non-coated hemofilters and four experiments using BPCA-coated circuits and BPCA-coated hemofilters were performed with whole human blood and compared by measuring the circuit pressure every 5 min, antithrombin activity every 40 min, and thrombin-antithrombin complex every 40 min, for a total of 240 min of recirculation. RESULTS: The mean time required for the pressure at the inlet of the hemofilter to increase sharply was longer in BPCA-coated than in non-coated hemofilters (66 ± 11 min vs 25 ± 9 min, p < 0.01). The mean antithrombin activity value at 200 and 240 min of recirculation was significantly higher in the experiments with BPCA-coated versus non-coated hemofilters (43.3 ± 2.87 vs 33.3 ± 5.74, p = 0.04; 42.8 ± 3.59 vs 31.0 ± 5.35, p = 0.01, respectively); the antithrombin activity values at the other time points were not significantly different. Furthermore, all thrombin-antithrombin complex values in experiments with the BPCA-coated hemofilters achieved overrange at 80 min of recirculation, whereas those with the non-coated hemofilter achieved overrange at 40 min. CONCLUSION: This study suggests that BPCA-coated hemofilters can inhibit antithrombin consumption, contributing to antithrombotic effects in extracorporeal circulation circuits.
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Affiliation(s)
- Masashi Tagaya
- 1 Department of Medical Engineering, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Kazunobu Hara
- 1 Department of Medical Engineering, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Shunsuke Takahashi
- 2 Department of Nephrology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Saki Nagoshi
- 3 Department of Clinical Laboratory, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Hiroki Handa
- 1 Department of Medical Engineering, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Shinya Okano
- 1 Department of Medical Engineering, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Takuo Murataka
- 1 Department of Medical Engineering, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
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Hemodialysis membrane coated with a polymer having a hydrophilic blood-contacting layer can enhance diffusional performance. Int J Artif Organs 2017; 40:665-669. [PMID: 28777393 PMCID: PMC6159844 DOI: 10.5301/ijao.5000631] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 12/02/2022]
Abstract
Purpose Currently, the foreign surfaces of various extracorporeal circulation devices are coated with a biocompatible polymer coating agent (BPA), which creates a hydrophilic blood-contacting layer to reduce thrombogenicity, while the membranes in hemodialyzers are not. We aimed to clarify other side effects of BPA-coated membranes by examining the diffusion performance in in vitro experiments. Methods We used a polyethersulfone membrane (sieving coefficient of albumin is ≤0.01) coated with BPA product, SEC-1™ (Toyobo), in a hemodialyzer. To estimate the diffusion rates of a wide range of molecules, 2 L of saline containing vancomycin, lysozyme, and albumin were recirculated in the circuit configured with a hemodialyzer, and dialyzed continuously using water. The concentrations of sodium, vancomycin, lysozyme, and albumin were measured every 5 minutes for 30 minutes and compared in experiments with BPA-coated (n = 4) and BPA-noncoated (n = 4) membranes. Results The removal rates of sodium and vancomycin after 5 minutes of dialysis (n = 24) were significantly higher in BPA-coated than noncoated membranes, while those of lysozyme and albumin were not significantly different. The removal rates of sodium and vancomycin after 30 minutes of dialysis (n = 4) were significantly higher, and those of lysozyme were significantly lower in BPA-coated than noncoated membranes, while those of albumin were not significantly different. Conclusions The preliminary study suggests that BPA-coated membranes enhanced the diffusion rate of molecules with low and middle molecular weight without affecting the sieving coefficient of albumin. Thus, BPA coating can enhance the dialysis performance of membranes.
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Materials, Surfaces, and Systems for Extracorporeal Therapies and Beyond. Int J Artif Organs 2017; 40:1-3. [DOI: 10.5301/ijao.5000576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2017] [Indexed: 11/20/2022]
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Prospects for Clinical Applications of Polymer-Coated Haemoconcentrator on Extracorporeal Circuit in Cardiopulmonary Bypass Surgeries. Int J Artif Organs 2016; 39:415-420. [DOI: 10.5301/ijao.5000519] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2016] [Indexed: 11/20/2022]
Abstract
Purpose Extracorporeal circulation circuits used in cardiopulmonary bypass surgeries are increasingly being coated with polymer materials to reduce the thrombogenicity of extracorporeal devices. However, a haemoconcentrator, which corrects haematocrit and electrolyte imbalances, is not coated with polymers. In this study, we sought to assess the filtration performance of polymer-coated haemoconcentrators in order to obtain insight into their prospects for use in clinical applications. Methods In vitro experiments were performed to evaluate the water pressure and flow properties of polymer-coated haemoconcentrators by comparing 3 polymer-coated haemoconcentrators with 3 non-coated haemoconcentrators. The cross-sectional surfaces of both types of haemoconcentrators were observed using a scanning electron microscope (SEM). Results The slopes of the regression lines for estimating the filtrated fluid flow as a function of the transmembrane pressure were 6.286 ± 0.320 for polymer-coated haemoconcentrators and 3.712 ± 0.170 for non-coated haemoconcentrators. These slopes were found to be significantly different and indicate that the filtration velocity is enhanced in polymer-coated haemoconcentrators over that in non-coated haemoconcentrators. However, the hollow fibre damage observed by SEM was not shown to contribute to higher filtration flow in the polymer-coated haemoconcentrator. Taking these results into consideration, we hypothesise that a polymer coating makes a foreign surface on a hollow fibre slippery, owing to the hydrophobicity of the polymer, thereby enhancing the velocity of the filtration. Conclusions The results of this preliminary investigation suggest that a polymer coating can enhance the filtration performance of a haemoconcentrator and that polymer-coated haemoconcentrators might be useful in clinical applications.
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Major TC, Handa H, Annich GM, Bartlett RH. Development and hemocompatibility testing of nitric oxide releasing polymers using a rabbit model of thrombogenicity. J Biomater Appl 2014; 29:479-501. [PMID: 24934500 DOI: 10.1177/0885328214538866] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Hemocompatibility is the goal for any biomaterial contained in extracorporeal life supporting medical devices. The hallmarks for hemocompatibility include nonthrombogenicity, platelet preservation, and maintained platelet function. Both in vitro and in vivo assays testing for compatibility of the blood/biomaterial interface have been used over the last several decades to ascertain if the biomaterial used in medical tubing and devices will require systemic anticoagulation for viability. Over the last 50 years systemic anticoagulation with heparin has been the gold standard in maintaining effective extracorporeal life supporting. However, the biomaterial that maintains effective ECLS without the use of any systemic anticoagulant has remained elusive. In this review, the in vivo 4-h rabbit thrombogenicity model genesis will be described with emphasis on biomaterials that may require no systemic anticoagulation for extracorporeal life supporting longevity. These novel biomaterials may improve extracorporeal circulation hemocompatibility by preserving near resting physiology of the major blood components, the platelets and monocytes. The rabbit extracorporeal circulation model provides a complete assessment of biomaterial interactions with the intrinsic coagulation players, the circulating platelet and monocytes. This total picture of blood/biomaterial interaction suggests that this rabbit thrombogenicity model could provide a standardization for biomaterial hemocompatibility testing.
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Affiliation(s)
- Terry C Major
- Department of Surgery, University of Michigan Health System, Ann Arbor, USA
| | - Hitesh Handa
- Department of Surgery, University of Michigan Health System, Ann Arbor, USA
| | - Gail M Annich
- Department of Pediatrics, University of Michigan Health System, Ann Arbor, USA
| | - Robert H Bartlett
- Department of Surgery, University of Michigan Health System, Ann Arbor, USA
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Asadinezhad A, Lehocký M, Sáha P, Mozetič M. Recent Progress in Surface Modification of Polyvinyl Chloride. MATERIALS 2012. [PMCID: PMC5449055 DOI: 10.3390/ma5122937] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Surface modification of polymers has become a vibrant field of research on account of a myriad of rationales which stimulated numerous efforts. The current paper serves as a condensed survey of the advances made through different approaches adopted for tuning the surface properties of polyvinyl chloride as a homopolymer extensively used on a large scale. Though it does not address all challenges involved, this paper communicates and highlights, through concise discussion, the findings of the efforts undertaken in recent decades. It is ultimately concluded with a perspective of the huge capacities and promising future directions.
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Affiliation(s)
- Ahmad Asadinezhad
- Department of Chemical Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran; E-Mail:
| | - Márian Lehocký
- Centre of Polymer Systems, University Institute, Tomas Bata University in Zlín, Zlín 76001, Czech Republic; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +420-608-616-048; Fax: +420-576-031-444
| | - Petr Sáha
- Centre of Polymer Systems, University Institute, Tomas Bata University in Zlín, Zlín 76001, Czech Republic; E-Mail:
| | - Miran Mozetič
- Plasma Laboratory, Department of Surface Engineering, Jožef Stefan Institute, Jamova Cesta 39, Ljubljana SI1000, Slovenia; E-Mail:
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Jansen P, van Oeveren W, Capel A, Carpentier A. In vitro haemocompatibility of a novel bioprosthetic total artificial heart. Eur J Cardiothorac Surg 2012; 41:e166-72. [PMID: 22491668 DOI: 10.1093/ejcts/ezs187] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The CARMAT total artificial heart (TAH) is an implantable, electro-hydraulically driven, pulsatile flow device with four bioprosthetic valves. Its blood-pumping surfaces consist of processed bioprosthetic pericardial tissue and expanded polytetrafluorethylene (ePTFE), potentially allowing for the reduction of anti-coagulation. This pre-clinical study assessed the in vitro haemocompatibility of these surfaces. METHODS Coupons of pericardial tissue and ePTFE were placed in closed tubular circuits filled with 12.5 ml of fresh human blood exposed to the pulsatile flow at 120 ml/min for 4 h (37°C). Silicone- and heparin-coated polyvinyl chloride (PVC) tubes served as positive and negative controls, respectively. Fresh blood from six donors was used to fill four sets of 12 circuits. Blood samples were taken at baseline and from each circuit after 4 h. Coupons of materials were examined with scanning electron microscopy. RESULTS The platelet count was 202 ± 45 10(9) l(-1) at baseline. Four hours after circulation, the platelet counts were 161 ± 30 10(9) l(-1) (compared with baseline, P = 0.0207) for pericardial tissue, 162 ± 35 10(9) l(-1) (P = 0.0305) for ePTFE and 136 ± 42 10(9) l(-1) for positive controls (P = 0.0021). Baseline plasma fibrinogen was 2.9 ± 0.5 mg/dl compared with 3.0 ± 0.5 mg/dl for pericardial tissue and 3.1 ± 0.7 mg/dl for ePTFE, indicating no marked fibrinogen consumption. Thromboxane B2 levels for positive controls were 33.3 ± 8.7 ng/ml compared with 16.2 ± 11.5 ng/ml for pericardial tissue (P = 0.0015) and 15.2 ± 4.7 ng/ml for ePTFE (P < 0.0001). Platelet adhesion was 2.87 ± 1.01 10(9) cm(-2) for positive controls compared with 1.06 ± 0.73 10(9) cm(-2) for pericardial tissue (P < 0.0001) and 0.79 ± 0.75 10(9) cm(-2) for ePTFE (P < 0.0001). Thrombin-antithrombin III complex levels were 3.8 ± 0.5 μg/ml for positive controls compared with 1.9 ± 0.9 for pericardial tissue (P < 0.0001) and 2.1 ± 1.0 for ePTFE (P < 0.0001). With an electro-microscopic examination at ×600, only small depositions of platelets, erythrocytes and fibrin were noticed on the pericardial tissue samples and ePTFE samples. Silicone surfaces showed marked areas of thrombi, and PVC tubings a thin protein layer. CONCLUSIONS Haemocompatibility of the TAH blood-contacting surfaces was confirmed by in vitro studies showing a limited consumption of fibrin, limited thromboxane B2 release and platelet adhesion, and minor blood cell depositions on the surfaces. These results will be validated in clinical studies, with the aim of reducing anti-coagulation when using the CARMAT TAH.
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Tanaka M, Mochizuki A. Clarification of the Blood Compatibility Mechanism by Controlling the Water Structure at the Blood–Poly(meth)acrylate Interface. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2012; 21:1849-63. [DOI: 10.1163/092050610x517220] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Masaru Tanaka
- a Department of Biochemical Engineering, Graduate School of Science and Technology, Yamagata University, Yonezawa 992-8510, Japan
| | - Akira Mochizuki
- b Department of Bio-Medical Engineering, School of High-Technology for Human Welfare, Tokai University, 317 Nishino, Numazu, Shizuoka 410-03, Japan
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The effect of CD47 modified polymer surfaces on inflammatory cell attachment and activation. Biomaterials 2011; 32:4317-26. [PMID: 21429575 DOI: 10.1016/j.biomaterials.2011.02.053] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 02/25/2011] [Indexed: 02/04/2023]
Abstract
CD47 is a transmembrane protein that is a marker of "self". CD47 binding to its cognate receptor in leukocytes and macrophages, signal-regulatory protein alpha (SIRPα), causes inhibition of inflammatory cell attachment. We hypothesized that immobilization of recombinant CD47 on polymeric surfaces would reduce inflammation. Recombinant CD47 was appended to polyvinyl chloride (PVC) or polyurethane (PU) surfaces via photoactivation chemistry. Cell culture studies showed that CD47 immobilization significantly reduced human neutrophil (HL-60) and human monocyte derived macrophage (MDM) (THP-1) attachment to PVC and PU respectively. A neutralizing antibody, directed against SIRPα, inhibited THP-1 and HL-60 binding to PU and PVC surfaces respectively. This antibody also increased the level of SIRPα tyrosine phosphorylation, thereby indicating a direct role for SIRPα mediated signaling in preventing inflammatory cell attachment. Studies using human blood in an ex vivo flow-loop showed that CD47 modified PVC tubing significantly reduced cell binding and neutrophil activation compared to unmodified tubing or poly-2-methoxy-ethylacrylate (PMEA) coated tubing. In ten-week rat subdermal implants, CD47 functionalized PU films showed a significant reduction in markers of MDM mediated oxidative degradation compared to unmodified PU. In conclusion, CD47 functionalized surfaces can resist inflammatory cell interactions both in vitro and in vivo.
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