Interfacial Adsorption Controls Particle Formation in Antibody Formulations Subjected to Extensional Flows and Hydrodynamic Shear

During their manufacturing and delivery to patients, therapeutic proteins are commonly exposed to various interfaces and to hydrodynamic shear forces. Although adsorption of proteins to solid-liquid interfaces is known to foster formation of protein aggregates and particles, the impact of shear remains controversial, in part because of experimental challenges in separating the effects of shear from those caused by simultaneous exposure to interfaces. Extensional flows (occurring when solutions flow through sudden contractions) exert localized elongational forces that have been suspected to be damaging to proteins. In this work, we measured aggregation and particle formation in formulations of polyclonal and monoclonal antibodies subjected to extensional flow, high shear (105 s-1) and exposure to stainless-steel/water interfaces. Modification of the surface charge at the stainless steel/water interface changed protein adsorption characteristics without altering shear profiles, enabling shear and interfacial interactions to be separated. Even under conditions where antibodies were subjected to high hydrodynamic shear and extensional flow, production of subvisible particles could be inhibited by modifying the stainless-steel surface charge to minimize antibody adsorption. Digital images of particles recorded by flow imaging microscopy (FIM) and analyzed with machine learning algorithms were consistent with a particle formation mechanism by which antibodies adsorb and aggregate at the stainless-steel/water interface and subsequently form particles when shear displaces the interfacial aggregates, transporting them into the bulk solution. Topographical differences measured using atomic force microscopy (AFM) supported the proposed mechanism by showing reduced levels of protein adsorption on surface-charge-modified stainless-steel.

Distribution and history of extensional stresses on vWF surrogate molecules in turbulent flow

The configuration of proteins is critical for their biochemical behavior. Mechanical stresses that act on them can affect their behavior leading to the development of decease. The von Willebrand factor (vWF) protein circulating with the blood loses its efficacy when it undergoes non-physiological hemodynamic stresses. While often overlooked, extensional stresses can affect the structure of vWF at much lower stress levels than shear stresses. The statistical distribution of extensional stress as it applies on models of the vWF molecule within turbulent flow was examined here. The stress on the molecules of the protein was calculated with computations that utilized a Lagrangian approach for the determination of the molecule trajectories in the flow filed. The history of the stresses on the proteins was also calculated. Two different flow fields were considered as models of typical flows in cardiovascular mechanical devises, one was a Poiseuille flow and the other was a Poiseuille–Couette flow field. The data showed that the distribution of stresses is important for the design of blood flow devices because the average stress can be below the critical value for protein damage, but tails of the distribution can be outside the critical stress regime.

Elongational Stresses and Cells

Fluid forces and their effects on cells have been researched for quite some time, especially in the realm of biology and medicine. Shear forces have been the primary emphasis, often attributed as being the main source of cell deformation/damage in devices like prosthetic heart valves and artificial organs. Less well understood and studied are extensional stresses which are often found in such devices, in bioreactors, and in normal blood circulation. Several microfluidic channels utilizing hyperbolic, abrupt, or tapered constrictions and cross-flow geometries, have been used to isolate the effects of extensional flow. Under such flow cell deformations, erythrocytes, leukocytes, and a variety of other cell types have been examined. Results suggest that extensional stresses cause larger deformation than shear stresses of the same magnitude. This has further implications in assessing cell injury from mechanical forces in artificial organs and bioreactors. The cells' greater sensitivity to extensional stress has found utility in mechanophenotyping devices, which have been successfully used to identify pathologies that affect cell deformability. Further application outside of biology includes disrupting cells for increased food product stability and harvesting macromolecules for biofuel. The effects of extensional stresses on cells remains an area meriting further study.

Hemolysis estimation in turbulent flow for the FDA critical path initiative centrifugal blood pump

Hemolysis in medical devices and implants has been a primary concern over the past fifty years. Turbulent flow in particular can cause cell trauma and hemolysis in such devices. In this work, the effects of turbulence on red blood cell (RBC) damage are examined by simulating the flow field through a centrifugal blood pump that has been identified as a case study through the critical path initiative of the US Food and Drug Administration (FDA). In this study, a new model was employed to predict hemolysis in the turbulent flow environment in the pump selected for the FDA critical path initiative. The operating conditions for a centrifugal blood pump were specified by the FDA for rotational speeds of 2500 and 3500 rpm. The model is based on the analysis of the smaller eddies within the turbulent flow field, since it is assumed that turbulent flow eddies with sizes comparable to the dimensions of the RBCs lead to cell trauma. The Kolmogorov length scale of the velocity field is used to identify such small eddies. Using model parameters obtained in prior work through comparisons to capillary and jet flow, it is found that hemolysis for the 2500-rpm pump was predicted well, while hemolysis for the 3500-rpm pump was overpredicted. Results indicate refinement of the model and empirical constants with better experimental data is needed.

Investigation of Leukocyte Viability and Damage in Spiral Microchannel and Contraction-Expansion Array

Inertial separation techniques in a microfluidic system have been widely employed in the field of medical diagnosis for a long time. Despite no requirement of external forces, it requires strong hydrodynamic forces that could potentially cause cell damage or loss during the separation process. This might lead to the wrong interpretation of laboratory results since the change of structures and functional characteristics of cells due to the hydrodynamic forces that occur are not taken into account. Therefore, it is important to investigate the cell viability and damage along with the separation efficacy of the device in the design process. In this study, two inertial separation techniques—spiral microchannel and contraction-expansion array (CEA)—were examined to evaluate cell viability, morphology and intracellular structures using a trypan blue assay (TB), Scanning Electron Microscopy (SEM) and Wright-Giemsa stain. We discovered that cell loss was not significantly found in a feeding system, i.e., syringe, needle and tube, but mostly occurred in the inertial separation devices while the change of cell morphology and intracellular structures were found in the feeding system and inertial separation devices. Furthermore, percentage of cell loss was not significant in both devices (7–10%). However, the change of cell morphology was considerably increased (30%) in spiral microchannel (shear stress dominated) rather than in CEA (12%). In contrast, the disruption of intracellular structures was increased (14%) in CEA (extensional and shear stress dominated equally) rather than spiral microchannel (2%). In these experiments, leukocytes of canine were used as samples because their sizes are varied in a range between 7–12 µm, and they are commonly used as a biomarker in many clinical and medical applications.

Deformation of human red blood cells in extensional flow through a hyperbolic contraction

Flow-induced damage to red blood cells has been an issue of considerable importance since the introduction of the first cardiovascular devices. Early blood damage prediction models were based on measurements of damage by shear stress only. Subsequently, these models were extrapolated to include other components of the fluid stress tensor. However, the expanded models were not validated by measurements of damage in response to the added types of stress. Recent investigations have proposed that extensional stress might be more damaging to red cells than shear stress. In this study, experiments were conducted to compare human red cell deformation under laminar extensional stress versus laminar shear stress. It was found that the deformation caused by shear stress is matched by that produced by an extensional stress that is approximately 34 times smaller. Assuming that blood damage scales directly with cell deformation, this result indicates that mechanistic blood damage prediction models should weigh extensional stress more than shear stress.

Normal fluid stresses are prevalent in rotary ventricular assist devices: A computational fluid dynamics analysis

Despite the evolution of ventricular assist devices, ventricular assist device patients still suffer from complications due to the damage to blood by fluid dynamic stress. Since rotary ventricular assist devices are assumed to exert mainly shear stress, studies of blood damage are based on shear flow experiments. However, measurements and simulations of cell and protein deformation show normal and shear stresses deform, and potentially damage, cells and proteins differently. The aim was to use computational fluid dynamics to assess the prevalence of normal stress, in comparison with shear stress, in rotary ventricular assist devices. Our calculations showed normal stresses do occur in rotary ventricular assist devices: the fluid volumes experiencing normal stress above 10 Pa were 0.011 mL (0.092%) and 0.027 mL (0.39%) for the HeartWare HVAD and HeartMate II (HMII), and normal stresses over 100 Pa were present. However, the shear stress volumes were up to two orders of magnitude larger than the normal stress volumes. Considering thresholds for red blood cell and von Willebrand factor deformation by normal and shear stresses, the fluid volumes causing deformation by normal stress were between 2.5 and 5 times the size of those causing deformation by shear stress. The exposure times to the individual normal stress deformation regions were around 1 ms. The results clearly show, for the first time, that while blood within rotary ventricular assist devices experiences more shear stress at much higher magnitudes as compared with normal stress, there is sufficient normal stress exposure present to cause deformation of, and potentially damage to, the blood components. This study is the first to quantify the fluid stress components in real blood contacting devices.