Covalent Binding of Heparin to Functionalized PET Materials for Improved Haemocompatibility

Surface Modification of PEEKs with Cyclic Peptides to Support Endothelialization and Antithrombogenicity

Synthetic polymers are often utilized in the creation of vascular devices, and need to possess specific qualities to prevent thrombosis. Traditional strategies for this include surface modification of vascular devices through covalent attachment of substrates such as heparin, antiplatelet agents, thrombolytic agents, or hydrophilic polymers. One promising prosthetic material is polyether ether ketone (PEEK), which is utilized in various FDA-approved medical devices, including vascular and endovascular prostheses. We hypothesized that surface modification of biologically inert PEEK can help improve its endothelial cell affinity and reduce its thrombogenic potential. To evaluate this, we developed an effective surface-modification approach with unique cyclic peptides, such as CCHGGVRLYC and CCREDVC. We treated the PEEK surface with ammonia plasma, which introduced amine groups onto the PEEK surface. Subsequently, we were able to conjugate these peptides to the plasma-modified PEEKs. We observed that cyclic CCHGGVRLYC conjugated on prosthetic PEEK not only supported endothelialization, but minimized platelet adhesion and activation. This technology can be potentially applied for in vivo vascular and endovascular protheses to enhance their utility and patency.

Designing Cardin-Motif Peptide and Heparin-Based Multicomponent Advanced Bioactive Hydrogel Scaffolds to Control Cellular Behavior

Recently, peptide and sugar-based multicomponent systems have gained much interest in attaining the sophisticated structure and biofunctional complexity of the extracellular matrix (ECM). To this direction, we have designed for the first time a biologically relevant minimalist Cardin-motif peptide capable of binding ECM-derived glycosaminoglycans. Herein, we explored Cardin-motif peptide and heparin-based biomolecular matrix by employing simple noncovalent interactions at the molecular level. Interestingly, this peptide was inadequate to induce hydrogelation at ambient pH due to the presence of basic amino acids. However, addition of heparin successfully triggered its gelation at physiological pH following favorable electrostatic interactions with heparin. Importantly, the newly developed scaffolds displayed tunable nanofibrous morphology and superior mechanical properties as controlled simply by the differential mixing ratio of both biomolecular entities. Additionally, these composite scaffolds could closely mimic the complexity of ECM as they demonstrated superior biocompatibility and enhanced growth and proliferation of neural cells as compared to the peptide scaffold.

Challenge of material haemocompatibility for microfluidic blood-contacting applications

Biological applications of microfluidics technology is beginning to expand beyond the original focus of diagnostics, analytics and organ-on-chip devices. There is a growing interest in the development of microfluidic devices for therapeutic treatments, such as extra-corporeal haemodialysis and oxygenation. However, the great potential in this area comes with great challenges. Haemocompatibility of materials has long been a concern for blood-contacting medical devices, and microfluidic devices are no exception. The small channel size, high surface area to volume ratio and dynamic conditions integral to microchannels contribute to the blood-material interactions. This review will begin by describing features of microfluidic technology with a focus on blood-contacting applications. Material haemocompatibility will be discussed in the context of interactions with blood components, from the initial absorption of plasma proteins to the activation of cells and factors, and the contribution of these interactions to the coagulation cascade and thrombogenesis. Reference will be made to the testing requirements for medical devices in contact with blood, set out by International Standards in ISO 10993-4. Finally, we will review the techniques for improving microfluidic channel haemocompatibility through material surface modifications-including bioactive and biopassive coatings-and future directions.

A Novel Hydrophilic, Antibacterial Chitosan-Based Coating Prepared by Ultrasonic Atomization Assisted LbL Assembly Technique

To explore the potential applicability of chitosan (CTS), we prepared aldehyde chitosan (CTS-CHO) with chitosan and sodium periodate via oxidation reaction and then a chitosan-based hydrophilic and antibacterial coating on the surface of poly (lactic acid) (PLA) film was developed and characterized. The oxidation degree was determined by Elemental analyser to be 12.53%, and a Fourier transform infrared spectroscopy was used to characterize the structure of CTS-CHO. It was evident that CTS-CHO is a biocompatible coating biomaterial with more than 80% cell viability obtained through the Live/Dead staining assay and the alamarBlue assay. The hydrophilic and antibacterial CTS-CHO coating on the PLA surface was prepared by ultrasonic atomization assisted LbL assembly technique due to Schiff's base reaction within and between layers. The CTS-CHO coating had better hydrophilicity and transparency, a more definite industrialization potential, and higher antibacterial activity at experimental concentrations than the CTS coating. All of the results demonstrated that the ultrasonic atomization-assisted LbL assembly CTS-CHO coating is a promising alternative for improving hydrophilicity and antibacterial activity on the PLA surface. The functional groups of CTS-CHO could react with active components with amino groups via dynamic Schiff's base reaction and provide the opportunity to create a drug releasing surface for biomedical applications.

Surface Properties of the Polyethylene Terephthalate (PET) Substrate Modified with the Phospholipid-Polypeptide-Antioxidant Films: Design of Functional Biocoatings

Surface properties of polyethylene terephthalate (PET) coated with the ternary monolayers of the phospholipid 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC), the immunosuppressant cyclosporine A (CsA), and the antioxidant lauryl gallate (LG) were examined. The films were deposited, by means of the Langmuir-Blodgett (LB) technique, on activated by air low temperature plasma PET plates (PET_air). Their topography and surface chemistry were determined with the help of atomic force microscopy (AFM) and time-of-flight secondary ion mass spectrometry (TOF-SIMS), respectively, while wettability was evaluated by the contact angle measurements. Then, the surface free energy and its components were calculated from the Lifshitz-van der Waals/Acid-Base (LWAB) approach. The AFM imaging showed that the Langmuir monolayers were transferred effectively and yielded smoothing of the PET_air surface. Mass spectrometry confirmed compatibility of the quantitative and qualitative compositions of the monolayers before and after the transfer onto the substrate. Moreover, the molecular arrangement in the LB films and possible mechanisms of DOPC-CsA-LG interactions were determined. The wettability studies provided information on the type and magnitude of the interactions that can occur between the biocoatings and the liquids imitating different environments. It was found that the changes from open to closed conformation of CsA molecules are driven by the hydrophobic environment ensured by the surrounding DOPC and LG molecules. This process is of significance to drug delivery where the CsA molecules can be released directly from the biomaterial surface by passive diffusion. The obtained results showed that the chosen techniques are complementary for the characterization of the molecular organization of multicomponent LB films at the polymer substrate as well as for designing biocompatible coatings with precisely defined wettability.

Contact transmission of SARS-CoV-2 on fomite surfaces: surface survival and risk reduction

There is an unprecedented concern regarding the viral strain SARS-CoV-2 and especially its respiratory disease more commonly known as COVID-19. SARS-CoV-2 virus has the ability to survive on different surfaces for extended periods, ranging from days up to months. The new infectious properties of SARS-CoV-2 vary depending on the properties of fomite surfaces. In this review, we summarize the risk factors involved in the indirect transmission pathways of SARS-CoV-2 strains on fomite surfaces. The main mode of indirect transmission is the contamination of porous and non-porous inanimate surfaces such as textile surfaces that include clothes and most importantly personal protective equipment like personal protective equipment kits, masks, etc. In the second part of the review, we highlight materials and processes that can actively reduce the SARS-CoV-2 surface contamination pattern and the associated transmission routes. The review also focuses on some general methodologies for designing advanced and effective antiviral surfaces by physical and chemical modifications, viral inhibitors, etc.

Heparin detection based on the fluorescent turn-on probe of amino carbon quantum dots

Amino-rich carbon quantum dots (CDs) were synthesized by hydrothermal treatment of ethylene glycol, glucose and polyethyleneimine. CDs have green fluorescence (excitation/emission peaks 435 nm/515 nm) and can be enhanced by the addition of heparin (Hep). A linear relationship between fluorescence intensity and heparin concentration was observed. The fluorescence turn-on probe used for Hep detection showed a very large detection range of 0.02-16 μM, covering different therapeutic ranges in clinical applications. The probe exhibited an ultra-low detection limit of 0.007 nM.

What affects the biocompatibility of polymers?

In recent decades synthetic polymers have gained increasing popularity, and nowadays they are an integral part of people's daily lives. In addition, owing to their competitive advantage and being susceptible to modification, polymers have stimulated the fast development of innovative technologies in many areas of science. Biopolymers are of particular interest in various branches of medicine, such as implantology of bones, cartilage and skin tissues as well as blood vessels. Biomaterials with such specific applications must have appropriate mechanical and strength characteristics and above all they must be compatible with the surrounding tissues, human blood and its components, i.e. exhibit high hemo- and biocompatibility, low or no thrombo- and carcinogenicity, foreign body response (host response), appropriate osteoconduction, osteoinduction and mineralization. For biocompatibility improvement many surface treatment techniques have been utilized leading to fabricate the polymer biomaterials of required properties, also at nanoscale. This review paper discusses the most important physicochemical and biological factors that affect the biocompatibility, thus the reaction of the living organism after insertion of the polymer-based biomaterials, i.e. surface modification and/or degradation, surface composition (functional groups and charge), size and shapes, hydrophilic-hydrophobic character, wettability and surface free energy, topography (roughness, stiffness), crystalline and amorphous structure, nanostructure, cell adhesion and proliferation, cellular uptake. Particularly, the application of polysaccharides (chitosan, cellulose, starch) in the tissue engineering is emphasized.

The Role of Biodegradable Poly-(L-lactide)-Based Polymers in Blood Cell Activation and Platelet-Monocyte Interaction

The main purpose of new stent technologies is to overcome unfavorable material-related incompatibilities by producing bio- and hemo-compatible polymers with anti-inflammatory and anti-thrombogenic properties. In this context, wettability is an important surface property, which has a major impact on the biological response of blood cells. However, the influence of local hemodynamic changes also influences blood cell activation. Therefore, we investigated biodegradable polymers with different wettability to identify possible aspects for a better prediction of blood compatibility. We applied shear rates of 100 s⁻¹ and 1500 s⁻¹ and assessed platelet and monocyte activation as well as the formation of CD62P+ monocyte-bound platelets via flow cytometry. Aggregation of circulating platelets induced by collagen was assessed by light transmission aggregometry. Via live cell imaging, leukocytes were tracked on biomaterial surfaces to assess their average velocity. Monocyte adhesion on biomaterials was determined by fluorescence microscopy. In response to low shear rates of 100 s⁻¹, activation of circulating platelets and monocytes as well as the formation of CD62P+ monocyte-bound platelets corresponded to the wettability of the underlying material with the most favorable conditions on more hydrophilic surfaces. Under high shear rates, however, blood compatibility cannot only be predicted by the concept of wettability. We assume that the mechanisms of blood cell-polymer interactions do not allow for a rule-of-thumb prediction of the blood compatibility of a material, which makes extensive in vitro testing mandatory.

Evaluation of human umbilical vein endothelial cells growth onto heparin-modified electrospun vascular grafts

One of the main challenges of cardiovascular tissue engineering is the development of bioresorbable and compliant small-diameter vascular grafts (SDVG) for patients where autologous grafts are not an option. In this work, electrospun bilayered bioresorbable SDVG based on blends of poly(L-lactic acid) (PLLA) and segmented polyurethane (PHD) were prepared and evaluated. The inner layer of these SDVG was surface-modified with heparin, following a methodology involving PHD urethane functional groups. Heparin was selected as anticoagulant agent, and also due to its ability to promote human umbilical vein endothelial cells (HUVECs) growth and to inhibit smooth muscle cells over-proliferation, main cause of neointimal hyperplasia and restenosis. Immobilized heparin was quantified and changes in SDVG microstructure were investigated through SEM. Tensile properties of the heparin-functionalized SDVG resembled those of saphenous vein. Vascular grafts were seeded with HUVECs and cultured on a flow-perfusion bioreactor to analyze the effect of heparin on graft endothelization under simulated physiological-like conditions. The analysis of endothelial cells attachment and gene expression (Real-Time PCR) pointed out that the surface functionalization with heparin successfully promoted a stable and functional endothelial cell layer.

Bioengineering a pre-vascularized pouch for subsequent islet transplantation using VEGF-loaded polylactide capsules

The effectiveness of cell transplantation can be improved by optimization of the transplantation site. For some types of cells that form highly oxygen-demanding tissue, e.g., pancreatic islets, a successful engraftment depends on immediate and sufficient blood supply. This critical point can be avoided when cells are transplanted into a bioengineered pre-vascularized cavity which can be formed using a polymer scaffold. In our study, we tested surface-modified poly(lactide-co-caprolactone) (PLCL) capsular scaffolds containing the pro-angiogenic factor VEGF. After each modification step (i.e., amination and heparinization), the surface properties and morphology of scaffolds were characterized by ATR-FTIR and XPS spectroscopy, and by SEM and AFM. All modifications preserved the gross capsule morphology and maintained the open pore structure. Optimized aminolysis conditions decreased the Mw of PLCL only up to 10% while generating a sufficient number of NH2 groups required for the covalent immobilization of heparin. The heparin layer served as a VEGF reservoir with an in vitro VEGF release for at least four weeks. In vivo studies revealed that to obtain highly vascularized PLCL capsules (a) the optimal VEGF dose for the capsule was 50 μg and (b) the implantation time was four weeks when implanted into the greater omentum of Lewis rats; dense fibrous tissue accompanied by vessels completely infiltrated the scaffold and created sparse granulation tissue within the internal cavity of the capsule. The prepared pre-vascularized pouch enabled the islet graft survival and functioning for at least 50 days after islet transplantation. The proposed construct can be used to create a reliable pre-vascularized pouch for cell transplantation.

Plasma Treatment of Poly(ethylene terephthalate) Films and Chitosan Deposition: DC- vs. AC-Discharge

Plasma treatment is one of the most promising tools to control surface properties of materials tailored for biomedical application. Among a variety of processing conditions, such as the nature of the working gas and time of treatment, discharge type is rarely studied, because it is mainly fixed by equipment used. This study aimed to investigate the effect of discharge type (direct vs. alternated current) using air as the working gas on plasma treatment of poly(ethylene terephthalate) films, in terms of their surface chemical structure, morphology and properties using X-ray photoelectron spectroscopy, scanning electron microscopy, atomic force microscopy and contact angle measurements. The effect of the observed changes in terms of subsequent chitosan immobilization on plasma-treated films was also evaluated. The ability of native, plasma-treated and chitosan-coated films to support adhesion and growth of mesenchymal stem cells was studied to determine the practicability of this approach for the biomedical application of poly(ethylene terephthalate) films.

Surface Modification of Polyester-Fabric with Hydrogels and Silver Nanoparticles: Photochemical Versus Gamma Irradiation Methods

A Gamma irradiation and photochemical crosslinking/grafting of poly(2-hydroxyethyl methacrylate) (PHEMA) and poly(2-hydroxyethyl methacrylate-co-poly(ethylene glycol) methacrylate) (poly(HEMA-co-PEGMA)) hydrogels onto polyethyleneterephtalate fabric (PET) surfaces were evaluated, in order to obtain a hydrophilic homogeneous coating onto PET fabrics. The materials were characterized by FTIR-ATR, SEM, EDS, and thermal analysis. Furthermore, silver nanoparticles (AgNPs) were loaded by in situ reduction of AgNO₃, and its antibacterial activity against Staphylococcus aureus and Escherichia coli was determined. Results showed a ticker coating of hydrogel using gamma radiation and stronger in deep modification of the fibers; however, by the photochemical method, a thin coating with good coverage of PET surface was obtained. The differences in hydrophilicity, thermal properties, and antibacterial activity of the coated fabrics by using both methods were rather small.

Biocompatibility of Plasma-Treated Polymeric Implants

Cardiovascular diseases are one of the main causes of mortality in the modern world. Scientist all around the world are trying to improve medical treatment, but the success of the treatment significantly depends on the stage of disease progression. In the last phase of disease, the treatment is possible only by implantation of artificial graft. Most commonly used materials for artificial grafts are polymer materials. Despite different industrial procedures for graft fabrication, their properties are still not optimal. Grafts with small diameters (<6 mm) are the most problematic, because the platelets are more likely to re-adhere. This causes thrombus formation. Recent findings indicate that platelet adhesion is primarily influenced by blood plasma proteins that adsorb to the surface immediately after contact of a synthetic material with blood. Fibrinogen is a key blood protein responsible for the mechanisms of activation, adhesion and aggregation of platelets. Plasma treatment is considered as one of the promising methods for improving hemocompatibility of synthetic materials. Another method is endothelialization of materials with Human Umbilical Vein Endothelial cells, thus forming a uniform layer of endothelial cells on the surface. Extensive literature review led to the conclusion that in this area, despite numerous studies there are no available standardized methods for testing the hemocompatibility of biomaterials. In this review paper, the most promising methods to gain biocompatibility of synthetic materials are reported; several hypotheses to explain the improvement in hemocompatibility of plasma treated polymer surfaces are proposed.

A Biomimetic Heparinized Composite Silk-Based Vascular Scaffold with sustained Antithrombogenicity

Autologous grafts, as the gold standard for vascular bypass procedures, associated with several problems that limit their usability, so tissue engineered vessels have been the subject of an increasing number of works. Nevertheless, gathering all of the desired characteristics of vascular scaffolds in the same construct has been a big challenge for scientists. Herein, a composite silk-based vascular scaffold (CSVS) was proposed to consider all the mechanical, structural and biological requirements of a small-diameter vascular scaffold. The scaffold’s lumen composed of braided silk fiber-reinforced silk fibroin (SF) sponge covalently heparinized (H-CSVS) using Hydroxy-Iron Complexes (HICs) as linkers. The highly porous SF external layer with pores above 60 μm was obtained by lyophilization. Silk fibers were fully embedded in scaffold’s wall with no delamination. The H-CSVS exhibited much higher burst pressure and suture retention strength than native vessels while comparable elastic modulus and compliance. H-CSVSs presented milder hemolysis in vitro and significant calcification resistance in subcutaneous implantation compared to non-heparinized ones. The in vitro antithrombogenic activity was sustained for over 12 weeks. The cytocompatibility was approved using endothelial cells (ECs) and vascular smooth muscle cells (SMCs) in vitro. Therefore, H-CSVS demonstrates a promising candidate for engineering of small-diameter vessels.

Effect of Immobilized Antithrombin III on the Thromboresistance of Polycarbonate Urethane

The surface of foils and vascular grafts made from a thermoplastic polycarbonate urethanes (PCU) (Chronoflex AR) were chemically modified using gas plasma treatment, binding of hydrogels—(1) polyethylene glycol bisdiamine and carboxymethyl dextran (PEG-DEX) and (2) polyethyleneimine (PEI)—and immobilization of human antithrombin III (AT). Their biological impact was tested in vitro under static and dynamic conditions. Static test methods showed a significantly reduced adhesion of endothelial cells, platelets, and bacteria, compared to untreated PCU. Modified PCU grafts were circulated in a Chandler-Loop model for 90 min at 37 °C with human blood. Before and after circulation, parameters of the hemostatic system (coagulation, platelets, complement, and leukocyte activation) were analyzed. PEI-AT significantly inhibited the activation of both coagulation and platelets and prevented the activation of leukocytes and complement. In conclusion, both modifications significantly reduce coagulation activation, but only PEI-AT creates anti-bacterial and anti-thrombogenic functionality.

Haemostatic Response of Polyethylene Terephthalate Treated by Oxygen and Nitrogen Plasma Afterglows

Samples of polymer polyethylene terephthalate were coated with heparin and the haemostatic response has been determined by optical imaging of samples after incubation with fresh blood from a healthy donor. Prior to coating the samples were treated by neutral reactive particles of the oxygen or nitrogen plasma flowing afterglow. X-ray photoelectron spectroscopy analysis showed intensive functionalization of the polymer foils upon treatment with afterglows; however, the concentration of sulphur from heparin remained below the detection limit. The optical imaging showed densely distributed blood platelets in highly activated forms on untreated samples, whereas treatment with both afterglows revealed improved hemocompatibility. Best results were obtained for oxygen-functionalized polymer, whereas additional coating with heparin caused moderate loss of hemocompatibility, that was explained by deactivation of surface functional groups upon incubation with heparin.