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Wagner MS, Kranz M, Krenkel L, Pointner D, Foltan M, Lubnow M, Lehle K. Computer based visualization of clot structures in extracorporeal membrane oxygenation and histological clot investigations for understanding thrombosis in membrane lungs. Front Med (Lausanne) 2024; 11:1416319. [PMID: 38962744 PMCID: PMC11219572 DOI: 10.3389/fmed.2024.1416319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024] Open
Abstract
Extracorporeal membrane oxygenation (ECMO) was established as a treatment for severe cardiac or respiratory disease. Intra-device clot formation is a common risk. This is based on complex coagulation phenomena which are not yet sufficiently understood. The objective was the development and validation of a methodology to capture the key properties of clots deposed in membrane lungs (MLs), such as clot size, distribution, burden, and composition. One end-of-therapy PLS ML was examined. Clot detection was performed using multidetector computed tomography (MDCT), microcomputed tomography (μCT), and photography of fiber mats (fiber mat imaging, FMI). Histological staining was conducted for von Willebrand factor (vWF), platelets (CD42b, CD62P), fibrin, and nucleated cells (4', 6-diamidino-2-phenylindole, DAPI). The three imaging methods showed similar clot distribution inside the ML. Independent of the imaging method, clot loading was detected predominantly in the inlet chamber of the ML. The μCT had the highest accuracy. However, it was more expensive and time consuming than MDCT or FMI. The MDCT detected the clots with low scanning time. Due to its lower resolution, it only showed clotted areas but not the exact shape of clot structures. FMI represented the simplest variant, requiring little effort and resources. FMI allowed clot localization and calculation of clot volume. Histological evaluation indicated omnipresent immunological deposits throughout the ML. Visually clot-free areas were covered with leukocytes and platelets forming platelet-leukocyte aggregates (PLAs). Cells were embedded in vWF cobwebs, while vWF fibers were negligible. In conclusion, the presented methodology allowed adequate clot identification and histological classification of possible thrombosis markers such as PLAs.
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Affiliation(s)
- Maria S. Wagner
- Department of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Michael Kranz
- Department of Biofluid Mechanics, Faculty of Mechanical Engineering, Technical University of Applied Sciences (OTH) Regensburg, Regensburg, Germany
- Regensburg Center of Biomedical Engineering, Facility of University Regensburg and Technical University of Applied Sciences (OTH) Regensburg, Regensburg, Germany
| | - Lars Krenkel
- Department of Biofluid Mechanics, Faculty of Mechanical Engineering, Technical University of Applied Sciences (OTH) Regensburg, Regensburg, Germany
- Regensburg Center of Biomedical Engineering, Facility of University Regensburg and Technical University of Applied Sciences (OTH) Regensburg, Regensburg, Germany
| | - Daniel Pointner
- Department of Biofluid Mechanics, Faculty of Mechanical Engineering, Technical University of Applied Sciences (OTH) Regensburg, Regensburg, Germany
- Regensburg Center of Biomedical Engineering, Facility of University Regensburg and Technical University of Applied Sciences (OTH) Regensburg, Regensburg, Germany
| | - Maik Foltan
- Department of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Matthias Lubnow
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Karla Lehle
- Department of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany
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2
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Tonev D, Momchilova A. Therapeutic Plasma Exchange and Multiple Sclerosis Dysregulations: Focus on the Removal of Pathogenic Circulatory Factors and Altering Nerve Growth Factor and Sphingosine-1-Phosphate Plasma Levels. Curr Issues Mol Biol 2023; 45:7749-7774. [PMID: 37886933 PMCID: PMC10605592 DOI: 10.3390/cimb45100489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/28/2023] Open
Abstract
Multiple sclerosis (MS) is predominantly an immune-mediated disease of the central nervous system (CNS) of unknown etiology with a possible genetic predisposition and effect of certain environmental factors. It is generally accepted that the disease begins with an autoimmune inflammatory reaction targeting oligodendrocytes followed by a rapid depletion of their regenerative capacity with subsequent permanent neurodegenerative changes and disability. Recent research highlights the central role of B lymphocytes and the corresponding IgG and IgM autoantibodies in newly forming MS lesions. Thus, their removal along with the modulation of certain bioactive molecules to improve neuroprotection using therapeutic plasma exchange (TPE) becomes of utmost importance. Recently, it has been proposed to determine the levels and precise effects of both beneficial and harmful components in the serum of MS patients undergoing TPE to serve as markers for appropriate TPE protocols. In this review we discuss some relevant examples, focusing on the removal of pathogenic circulating factors and altering the plasma levels of nerve growth factor and sphingosine-1-phosphate by TPE. Altered plasma levels of the reviewed molecular compounds in response to TPE reflect a successful reduction of the pro-inflammatory burden at the expense of an increase in anti-inflammatory potential in the circulatory and CNS compartments.
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Affiliation(s)
- Dimitar Tonev
- Department of Anesthesiology and Intensive Care, University Hospital “Tzaritza Yoanna—ISUL”, Medical University of Sofia, 1527 Sofia, Bulgaria
| | - Albena Momchilova
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Science, 1113 Sofia, Bulgaria;
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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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4
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Entezari S, Shakiba A, Niazmand H. Numerical investigation of the effects of cannula geometry on hydraulic blood flow to prevent the risk of thrombosis. Comput Biol Med 2021; 134:104484. [PMID: 34004574 DOI: 10.1016/j.compbiomed.2021.104484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 01/17/2023]
Abstract
Despite significant advances in left ventricular assist devices and the cannula, unfavorable events leading to the death of patients, including bleeding, infection, neurological disorders, hemolysis, and thrombosis, are still being reported. Local parameters of blood flow, including static flow, vorticity and critical values of shear stress on the wall of ventricle and cannula, increase the risk of thrombosis. Therefore, the analysis of blood flow domains inside the ventricle and cannula is necessary to investigate the probability of forming thrombosis in the cannula of left ventricular assist devices. In this study, blood flow is investigated in a Medtronic DLP 16F clinical cannula by using computational fluid dynamics through three-dimensional modeling of the left ventricle and cannula based on real geometry. Apart from the fact that blood is considered non-Newtonian fluid, the effect of heart movement in the left ventricle is also applied. In this research, blood flow in the cannula has been examined and some problems resulting from the use of the cannulas have been investigated. The results indicate that changing the geometry of input holes, such as their number and size, on the tip of the cannula, alter the probability of forming thrombosis and the standard mode shows a better performance.
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Affiliation(s)
- Soroush Entezari
- Department of Mechanical Engineering, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Ali Shakiba
- Department of Mechanical Engineering, Ferdowsi University of Mashhad, Mashhad, Iran.
| | - Hamid Niazmand
- Department of Mechanical Engineering, Ferdowsi University of Mashhad, Mashhad, Iran.
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5
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Rizwan M, Yao Y, Gorbet MB, Tse J, Anderson DEJ, Hinds MT, Yim EKF. One-Pot Covalent Grafting of Gelatin on Poly(Vinyl Alcohol) Hydrogel to Enhance Endothelialization and Hemocompatibility for Synthetic Vascular Graft Applications. ACS APPLIED BIO MATERIALS 2020; 3:693-703. [PMID: 32656504 PMCID: PMC7351135 DOI: 10.1021/acsabm.9b01026] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Cardiovascular diseases remain the leading cause of death worldwide. Patency rates of clinically-utilized small diameter synthetic vascular grafts such as Dacron® and expanded polytetrafluoroethylene (ePTFE) to treat cardiovascular disease are inadequate due to lack of endothelialization. Sodium trimetaphosphate (STMP) crosslinked PVA could be potentially employed as blood-compatible small diameter vascular graft for the treatment of cardiovascular disease. However, PVA severely lacks cell adhesion properties, and the efforts to endothelialize STMP-PVA have been insufficient to produce a functioning endothelium. To this end, we developed a one-pot method to conjugate cell-adhesive protein via hydroxyl-to-amine coupling using carbonyldiimidazole by targeting residual hydroxyl groups on crosslinked STMP-PVA hydrogel. Primary human umbilical vascular endothelial cells (HUVECs) demonstrated significantly improved cells adhesion, viability and spreading on modified PVA. Cells formed a confluent endothelial monolayer, and expressed vinculin focal adhesions, cell-cell junction protein zonula occludens 1 (ZO1), and vascular endothelial cadherin (VE-Cadherin). Extensive characterization of the blood-compatibility was performed on modified PVA hydrogel by examining platelet activation, platelet microparticle formation, platelet CD61 and CD62P expression, and thrombin generation, which showed that the modified PVA was blood-compatible. Additionally, grafts were tested under whole, flowing blood without any anticoagulants in a non-human primate, arteriovenous shunt model. No differences were seen in platelet or fibrin accumulation between the modified-PVA, unmodified PVA or clinical, ePTFE controls. This study presents a significant step in the modification of PVA for the development of next generation in situ endothelialized synthetic vascular grafts.
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Affiliation(s)
- Muhammad Rizwan
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - Yuan Yao
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - Maud B. Gorbet
- Systems Design Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
- Centre for Bioengineering and Biotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - John Tse
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - Deirdre E. J. Anderson
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Monica T. Hinds
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Evelyn K. F. Yim
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
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6
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Hardersen R, Enebakk T, Christiansen D, Ludviksen JK, Mollnes TE, Lappegård KT, Hovland A. Comparison of cytokine changes in three different lipoprotein apheresis systems in an ex vivo whole blood model. J Clin Apher 2019; 35:104-116. [DOI: 10.1002/jca.21765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/24/2019] [Accepted: 11/12/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Randolf Hardersen
- Department of Nephrology, Division of Internal MedicineNordland Hospital Trust Bodø Norway
| | - Terje Enebakk
- Department of Nephrology, Division of Internal MedicineNordland Hospital Trust Bodø Norway
| | | | | | - Tom E. Mollnes
- Research LaboratoryNordland Hospital Trust Bodø Norway
- Institute of Clinical MedicineUniversity of Tromsø Tromsø Norway
- Centre of Molecular Inflammation ResearchNorwegian University of Science and Technology Trondheim Norway
- Department of Immunology and University of Oslo, Institute of Clinical Medicine, Faculty of MedicineOslo University Hospital Oslo Norway
| | - Knut Tore Lappegård
- Institute of Clinical MedicineUniversity of Tromsø Tromsø Norway
- Department of Cardiology, Division of Internal MedicineNordland Hospital Trust Bodø Norway
| | - Anders Hovland
- Institute of Clinical MedicineUniversity of Tromsø Tromsø Norway
- Department of Cardiology, Division of Internal MedicineNordland Hospital Trust Bodø Norway
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7
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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: 44] [Impact Index Per Article: 8.8] [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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8
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Sotiri I, Robichaud M, Lee D, Braune S, Gorbet M, Ratner BD, Brash JL, Latour RA, Reviakine I. BloodSurf 2017: News from the blood-biomaterial frontier. Acta Biomater 2019; 87:55-60. [PMID: 30660001 DOI: 10.1016/j.actbio.2019.01.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/09/2019] [Accepted: 01/14/2019] [Indexed: 12/26/2022]
Abstract
From stents and large-diameter vascular grafts, to mechanical heart valves and blood pumps, blood-contacting devices are enjoying significant clinical success owing to the application of systemic antiplatelet and anticoagulation therapies. On the contrary, research into material and device hemocompatibility aimed at alleviating the need for systemic therapies has suffered a decline. This research area is undergoing a renaissance fueled by recent fundamental insights into coagulation and inflammation that are offering new avenues of investigation, the growing recognition of the limitations facing existing therapeutic approaches, and the severity of the cardiovascular disorders epidemic. This Opinion article discusses clinical needs for hemocompatible materials and the emerging research directions for fulfilling those needs. Based on the 2017 BloodSurf conference that brought together clinicians, scientists, and engineers from academia, industry, and regulatory bodies, its purpose is to draw the attention of the wider clinical and scientific community to stimulate further growth. STATEMENT OF SIGNIFICANCE: The article highlights recent fundamental insights into coagulation, inflammation, and blood-biomaterial interactions that are fueling a renaissance in the field of material hemocompatibility. It will be useful for clinicians, scientists, engineers, representatives of industry and regulatory bodies working on the problem of developing hemocompatible materials and devices for treating cardiovascular disorders.
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9
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Leukocyte Adhesion as an Indicator of Oxygenator Thrombosis During Extracorporeal Membrane Oxygenation Therapy? ASAIO J 2018; 64:24-30. [DOI: 10.1097/mat.0000000000000586] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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10
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Radley G, Pieper IL, Thornton CA. The effect of ventricular assist device-associated biomaterials on human blood leukocytes. J Biomed Mater Res B Appl Biomater 2017; 106:1730-1738. [PMID: 28888071 DOI: 10.1002/jbm.b.33981] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 08/01/2017] [Accepted: 08/16/2017] [Indexed: 12/29/2022]
Abstract
Ventricular assist devices (VADs) are an effective bridging or destination therapy for patients with advanced stage heart failure. These devices remain susceptible to adverse events including infection, bleeding, and thrombus; events linked to the foreign body response. Therefore, the biocompatibility of all biomaterials used is crucial to the success of medical devices. Biomaterials common in VADs-DLC: diamond-like carbon coated stainless steel; Sap: single-crystal sapphire; SiN: silicon nitride; Ti: titanium alloy; and ZTA: zirconia-toughened alumina-were tested for their biocompatibility through incubation with whole human blood for 2 h with mild agitation. Blood was then removed and used for: complete cell counts; leukocyte activation and death, and the production of key inflammatory cytokines. All were compared to time 0 and an un-exposed 2 h sample. Monocyte numbers were lower after exposure to DLC, SiN, and ZTA and monocytes showed evidence of activation with DLC, Sap, and SiN. Neutrophils and lymphocytes were unaffected. This approach allows comprehensive analysis of the potential blood damaging effects of biomaterials. Monocyte activation by DLC, Sap, ZTA, and SiN warrants further investigation linking effects on this cell type to unfavorable inflammatory/thrombogenic responses to VADs and other blood handling devices. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1730-1738, 2018.
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Affiliation(s)
- Gemma Radley
- Institute of Life Science, Swansea University Medical School, Swansea, Wales, UK.,Calon Cardio - Technology Ltd., Institute of Life Science, Swansea, Wales, UK
| | - Ina Laura Pieper
- Institute of Life Science, Swansea University Medical School, Swansea, Wales, UK.,Calon Cardio - Technology Ltd., Institute of Life Science, Swansea, Wales, UK
| | - Catherine A Thornton
- Institute of Life Science, Swansea University Medical School, Swansea, Wales, UK
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11
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The Influence of Different Operating Conditions on the Blood Damage of a Pulsatile Ventricular Assist Device. ASAIO J 2015; 61:656-63. [DOI: 10.1097/mat.0000000000000261] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Reyes-Garcés N, Bojko B, Hein D, Pawliszyn J. Solid phase microextraction devices prepared on plastic support as potential single-use samplers for bioanalytical applications. Anal Chem 2015; 87:9722-30. [PMID: 26340252 DOI: 10.1021/acs.analchem.5b01849] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study presents new thin-film solid phase microextraction (SPME) devices prepared on plastic as potential single-use samplers for bioanalysis. Polybutylene terephthalate (PBT) was selected as a support due to its well-known chemical resistance, low cost, and suitability as a material for different medical grade components. The herein proposed samplers were prepared by applying a hydrophilic-lipophilic balanced (HLB)-polyacrylonitrile (PAN) coating on rounded and flat PBT pieces previously sanded with regular sandpaper. SPME devices prepared on PBT were evaluated in terms of robustness, chemical stability, and possible interferences upon exposure to different solvents and matrixes. Rewarding results were found when these samplers were employed for the quantitative analysis of multiple doping substances in common biological matrixes such as urine, plasma, and whole blood. Finally, the proposed thin-film SPME devices made on a PBT were evaluated by conducting multiple extractions from whole blood and plasma using the Concept 96 system. Results showed that more than 20 extractions from plasma and whole blood can be performed without observed decreases in coating performance or peeling of the extraction phase from the plastic surface. These findings demonstrate the robustness of PAN-based coatings applied on such polymeric substrate and open up the possibility of introducing new alternatives and cost-effective materials as support to manufacture SPME biocompatible devices for a wide range of applications, particularly in the clinical field.
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Affiliation(s)
- Nathaly Reyes-Garcés
- Department of Chemistry, University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
| | - Barbara Bojko
- Department of Chemistry, University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
| | - Dietmar Hein
- Professional Analytical System (PAS) Technology , Richard-Wagner St. 10, 99441, Magdala, Germany
| | - Janusz Pawliszyn
- Department of Chemistry, University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
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Milleret V, Buzzi S, Gehrig P, Ziogas A, Grossmann J, Schilcher K, Zinkernagel AS, Zucker A, Ehrbar M. Protein adsorption steers blood contact activation on engineered cobalt chromium alloy oxide layers. Acta Biomater 2015; 24:343-51. [PMID: 26102336 DOI: 10.1016/j.actbio.2015.06.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/12/2015] [Accepted: 06/16/2015] [Indexed: 12/01/2022]
Abstract
Biomaterials upon implantation are immediately covered by blood proteins which direct the subsequent blood activation. These early events determine the following cascade of biological reactions and consequently the long-term success of implants. The ability to modulate surface properties of biomaterials is therefore of considerable clinical significance. Goal of this study was an in-depth understanding of the biological response to cobalt chromium stent alloys with engineered surface oxide layers, which showed altered body reactions in vivo. We analyzed in vitro the biological events following initial blood contact on engineered cobalt chromium surfaces featuring said oxide layers. Surface-specific blood reactions were confirmed by scanning electron microscopy and the adsorbed protein layers were characterized by mass spectrometry. This powerful proteomics tool allowed the identification and quantification of over hundred surface-adhering proteins. Proteins associated with the coagulation cascade, platelet adhesion and neutrophil function correlated with the various blood surface activations observed. Furthermore, results of pre-coated surfaces with defined fibrinogen-albumin mixtures suggest that neutrophil adhesion was controlled by fibrinogen orientation and conformation rather than quantity. This study highlights the importance of controlling the biological response in the complex protein-implant surface interactions and the potential of the surface modifications to improve the clinical performance of medical implants. STATEMENT OF SIGNIFICANCE The blood contact activation of CoCr alloys is determined by their surface oxide layer properties. Modifications of the oxide layer affected the total amount of adsorbed proteins and the composition of the adsorbed protein layer. Additionally fibrinogen coatings mediated the surface-dependent neutrophil adhesion in a concentration-independent manner, indicating the influence of conformation and/or orientation of the adsorbed protein. Despite the complexity of protein-implant interactions, this study highlights the importance of understanding and controlling mechanisms of protein adhesion in order to improve and steer the performance of medical implants. It shows that modification of the surface oxide layer is a very attractive strategy to directly functionalize metallic implant surfaces and optimize their blood interaction for the desired orthopedic or cardiovascular applications.
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Affiliation(s)
- Vincent Milleret
- Department of Obstetrics, University Hospital Zurich, University of Zurich, Switzerland
| | | | - Peter Gehrig
- Functional Genomics Center Zurich, University of Zurich/ETH Zurich, Switzerland
| | - Algirdas Ziogas
- Department of Obstetrics, University Hospital Zurich, University of Zurich, Switzerland
| | - Jonas Grossmann
- Functional Genomics Center Zurich, University of Zurich/ETH Zurich, Switzerland
| | - Katrin Schilcher
- Division of Infectious Diseases and Hospital Epidemiology, University of Zurich, Switzerland
| | - Annelies S Zinkernagel
- Division of Infectious Diseases and Hospital Epidemiology, University of Zurich, Switzerland
| | | | - Martin Ehrbar
- Department of Obstetrics, University Hospital Zurich, University of Zurich, Switzerland.
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14
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Multi-objective optimization of pulsatile ventricular assist device hemocompatibility based on neural networks and a genetic algorithm. Int J Artif Organs 2015; 38:325-336. [PMID: 26242848 DOI: 10.5301/ijao.5000419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE Given the benefit of pulsatile blood flow for perfusion of coronary arteries and end organs, pulsatile ventricular assist devices (VADs) are still widely used as paracorporeal mechanical circulatory support devices in clinical applications. However, poor hemocompatibility limits the service period of the VADs. Most previous improvements on VAD hemocompatibility were conducted by trial-and-error CFD analysis, which does not easily arrive at the best solution. METHODS In this paper, a multi-objective optimization method integrating neural networks and NSGA-II (Non-dominated Sorted Genetic Algorithm-II) based on FSI simulation was developed and applied to a pulsatile VAD to optimize its hemocompatibility. First, the VAD blood chamber was parameterized with the principal geometrical parameters. Three hemocompatibility indices including hemolysis, platelet activation, and platelet deposition were chosen as goal functions. The neural networks were built to fit the nonlinear relationship between goal functions and geometrical parameters. Next, a multi-objective optimization algorithm (NSGA-II) was used to search out the Pareto optimal solutions in the built neural networks. Finally, the best compromise solution was selected from the Pareto optimal solutions by a fuzzy membership approach and validated by FSI simulation. RESULTS The best compromise solution simultaneously possesses an acceptable hemolysis index, platelet activation index, and platelet deposition index, and the corresponding relative errors between the indices predicted by optimization algorithm and the one calculated by FSI simulations are all less than 5%. CONCLUSIONS The results suggest that the proposed multi-objective optimization method has the potential for application in optimizing pulsatile VAD hemocompatibility, and may also be applied to other blood-wetted devices.
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Abstract
Polymers have found widespread applications in cardiology, in particular in coronary vascular intervention as stent platforms (scaffolds) and coating matrices for drug-eluting stents. Apart from permanent polymers, current research is focussing on biodegradable polymers. Since they degrade once their function is fulfilled, their use might contribute to the reduction of adverse events like in-stent restenosis, late stent-thrombosis, and hypersensitivity reactions. After reviewing current literature concerning polymers used for cardiovascular applications, this review deals with parameters of tissue and blood cell functions which should be considered to evaluate biocompatibility of stent polymers in order to enhance physiological appropriate properties. The properties of the substrate on which vascular cells are placed can have a large impact on cell morphology, differentiation, motility, and fate. Finally, methods to assess these parameters under physiological conditions will be summarized.
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Effect of Rotary Blood Pump Pulsatility on Potential Parameters of Blood Compatibility and Thrombosis in Inflow Cannula Tips. Int J Artif Organs 2014; 37:875-87. [DOI: 10.5301/ijao.5000361] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2014] [Indexed: 11/20/2022]
Abstract
Purpose Rotary Blood Pump (RBP) pulsatile strategies relative to the native cardiac cycle have been widely studied because of their benefits to hemodynamics. However, the effects that inducing pulses has on the blood compatibility of ventricular assist device (VAD) support have not yet been understood. Inflow cannulae have been found to be associated with thrombosis under conventional constant speed support of RBPs. To prevent further risks to blood compatibility, it is necessary to understand the relationship between cannula tip design and the induced pulsatility. The purpose of this study was to evaluate the flow field of 5 different tip geometries under RBP pulsatile support using stereo-particle image velocimetry (PIV). Methods Inflow cannulae with conventional tip geometries (blunt, blunt with 4 side ports, beveled with 3 side ports, and cage) and a custom designed crown tip were studied. All cannulae were interposed between a mixed-flow RBP and a silicone left ventricle. The contractile function and hemodynamics were reproduced in a mock circulation loop (MCL). The RBP was configured to induce synchronous and counter-synchronous pulses relative to cardiac cycles while supporting the failing ventricle. Results Between both pulsing strategies, low shear volume ([Formula: see text], potential parameter of thrombus formation) showed no significant difference. However, counter-synchronous pulsatile mode induced less increase of both high shear volume ([Formula: see text], potential parameter of platelet activation) and recirculation volume (Vz>0, potential parameter of thrombus formation). Conclusions Although the clinical relationship cannot be inferred from this measurement, when considering the inflow tips only, a necessary trade-off should be made between adverse effects on blood compatibility and benefits for hemodynamics during RBP pulsatile mode.
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Pulletikurthi C, Munroe N, Stewart D, Haider W, Amruthaluri S, Rokicki R, Dugrot M, Ramaswamy S. Utility of magneto-electropolished ternary nitinol alloys for blood contacting applications. J Biomed Mater Res B Appl Biomater 2014; 103:1366-74. [DOI: 10.1002/jbm.b.33317] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 10/02/2014] [Accepted: 10/18/2014] [Indexed: 01/23/2023]
Affiliation(s)
- Chandan Pulletikurthi
- Department of Mechanical and Materials Engineering; Florida International University; Miami Florida
| | - Norman Munroe
- Department of Mechanical and Materials Engineering; Florida International University; Miami Florida
| | - Danique Stewart
- Tissue Engineered Mechanics; Imaging and Materials Laboratory (TEMIM Lab); Department of Biomedical Engineering; Florida International University; Miami Florida
| | - Waseem Haider
- Department of Mechanical Engineering; University of Texas - Pan American; Edinburg Texas
| | - Sushma Amruthaluri
- Department of Mechanical and Materials Engineering; Florida International University; Miami Florida
| | | | | | - Sharan Ramaswamy
- Tissue Engineered Mechanics; Imaging and Materials Laboratory (TEMIM Lab); Department of Biomedical Engineering; Florida International University; Miami Florida
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Wong KC, Büsen M, Benzinger C, Gäng R, Bezema M, Greatrex N, Schmitz-Rode T, Steinseifer U. Effect of Inflow Cannula Tip Design on Potential Parameters of Blood Compatibility and Thrombosis. Artif Organs 2014; 38:810-7. [DOI: 10.1111/aor.12369] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kai Chun Wong
- Department of Cardiovascular Engineering; Institute of Applied Medical Engineering; Helmholtz Institute; RWTH Aachen; Aachen Germany
| | - Martin Büsen
- Department of Cardiovascular Engineering; Institute of Applied Medical Engineering; Helmholtz Institute; RWTH Aachen; Aachen Germany
| | - Carrie Benzinger
- Department of Cardiovascular Engineering; Institute of Applied Medical Engineering; Helmholtz Institute; RWTH Aachen; Aachen Germany
| | - René Gäng
- Department of Cardiovascular Engineering; Institute of Applied Medical Engineering; Helmholtz Institute; RWTH Aachen; Aachen Germany
| | - Mirko Bezema
- Department of Cardiovascular Engineering; Institute of Applied Medical Engineering; Helmholtz Institute; RWTH Aachen; Aachen Germany
| | - Nicholas Greatrex
- Department of Cardiovascular Engineering; Institute of Applied Medical Engineering; Helmholtz Institute; RWTH Aachen; Aachen Germany
| | - Thomas Schmitz-Rode
- Department of Cardiovascular Engineering; Institute of Applied Medical Engineering; Helmholtz Institute; RWTH Aachen; Aachen Germany
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering; Institute of Applied Medical Engineering; Helmholtz Institute; RWTH Aachen; Aachen Germany
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Gaamangwe T, Peterson SD, Gorbet MB. Investigating the Effect of Blood Sample Volume in the Chandler Loop Model: Theoretical and Experimental Analysis. Cardiovasc Eng Technol 2014. [DOI: 10.1007/s13239-014-0179-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Braune S, Grunze M, Straub A, Jung F. Are there sufficient standards for the in vitro hemocompatibility testing of biomaterials? Biointerphases 2013; 8:33. [PMID: 24706143 DOI: 10.1186/1559-4106-8-33] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/06/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- Steffen Braune
- Institute of Biomaterial Science and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Geesthacht, Kantstrasse 55, Teltow, 14513, Germany,
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