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Roka-Moiia Y, Walk R, Palomares DE, Ammann KR, Dimasi A, Italiano JE, Sheriff J, Bluestein D, Slepian MJ. Platelet Activation via Shear Stress Exposure Induces a Differing Pattern of Biomarkers of Activation versus Biochemical Agonists. Thromb Haemost 2020; 120:776-792. [PMID: 32369849 DOI: 10.1055/s-0040-1709524] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Implantable cardiovascular therapeutic devices, while hemodynamically effective, remain limited by thrombosis. A driver of device-associated thrombosis is shear-mediated platelet activation (SMPA). Underlying mechanisms of SMPA, as well as useful biomarkers able to detect and discriminate mechanical versus biochemical platelet activation, are poorly defined. We hypothesized that SMPA induces a differing pattern of biomarkers compared with biochemical agonists. METHODS Gel-filtered human platelets were subjected to mechanical activation via either uniform constant or dynamic shear; or to biochemical activation by adenosine diphosphate (ADP), thrombin receptor-activating peptide 6 (TRAP-6), thrombin, collagen, epinephrine, or arachidonic acid. Markers of platelet activation (P-selectin, integrin αIIbβ3 activation) and apoptosis (mitochondrial membrane potential, caspase 3 activation, and phosphatidylserine externalization [PSE]) were examined using flow cytometry. Platelet procoagulant activity was detected by chromogenic assay measuring thrombin generation. Contribution of platelet calcium flux in SMPA was tested employing calcium chelators, ethylenediaminetetraacetic acid (EDTA), and BAPTA-AM. RESULTS Platelet exposure to continuous shear stress, but not biochemical agonists, resulted in a dramatic increase of PSE and procoagulant activity, while no integrin αIIbβ3 activation occurred, and P-selectin levels remained barely elevated. SMPA was associated with dissipation of mitochondrial membrane potential, but no caspase 3 activation was observed. Shear-mediated PSE was significantly decreased by chelation of extracellular calcium with EDTA, while intracellular calcium depletion with BAPTA-AM had no significant effect. In contrast, biochemical agonists ADP, TRAP-6, arachidonic acid, and thrombin were potent inducers of αIIbβ3 activation and/or P-selectin exposure. This differing pattern of biomarkers seen for SMPA for continuous uniform shear was replicated in platelets exposed to dynamic shear stress via circulation through a ventricular assist device-propelled circulatory loop. CONCLUSION Elevated shear stress, but not biochemical agonists, induces a differing pattern of platelet biomarkers-with enhanced PSE and thrombin generation on the platelet surface. This differential biomarker phenotype of SMPA offers the potential for early detection and discrimination from that mediated by biochemical agonists.
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Affiliation(s)
- Yana Roka-Moiia
- Department of Medicine, Sarver Heart Center, University of Arizona, Tucson, Arizona, United States
| | - Ryan Walk
- Department of Medicine, Sarver Heart Center, University of Arizona, Tucson, Arizona, United States
| | - Daniel E Palomares
- Department of Medicine, Sarver Heart Center, University of Arizona, Tucson, Arizona, United States
| | - Kaitlyn R Ammann
- Department of Medicine, Sarver Heart Center, University of Arizona, Tucson, Arizona, United States
| | - Annalisa Dimasi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Joseph E Italiano
- Brigham and Woman's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Jawaad Sheriff
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, United States
| | - Danny Bluestein
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, United States
| | - Marvin J Slepian
- Department of Medicine, Sarver Heart Center, University of Arizona, Tucson, Arizona, United States.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, United States
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Meskin M, Dimasi A, Votta E, Jaworek M, Fusini L, Muratori M, Montorsi P, Zappa E, Epifani I, Pepi M, Redaelli A. A Novel Multiparametric Score for the Detection and Grading of Prosthetic Mitral Valve Obstruction in Cases With Different Disc Motion Abnormalities. Ultrasound Med Biol 2019; 45:1708-1720. [PMID: 31060859 DOI: 10.1016/j.ultrasmedbio.2019.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 02/15/2019] [Accepted: 03/16/2019] [Indexed: 06/09/2023]
Abstract
Prosthetic mechanical valves are the elective choice in mitral valve (MV) replacement, because of their reliability and easiness of implantation. However, these prostheses can suffer from complications, the major one being prosthetic mitral valve thrombosis (PMVT). In these cases, transthoracic doppler echocardiogram (TDE) is the standard diagnostic workup for diagnosis of valve malfunction. The American Society of Echocardiography (ASE) indicates the possible TDE-derived indexes, which can help in identifying insurgence of MV replacement complications. Unfortunately, in some cases, it is not possible to detect PMVT based on these criteria. In these cases, we speak of Doppler silent thrombosis and only more accurate and invasive analyses, such as fluoroscopy, allow for a correct diagnosis. In this work, computational fluid dynamic models were implemented to simulate valve fluid dynamics in different clinical scenarios in order to improve the reliability of PMVT diagnosis based on TDE. In detail, seven mechanical valve configurations, associated to different potential thrombotic conditions (symmetric and asymmetric stenosis), were designed and tested using five pathologic transmitral velocity profile, extracted from real TDE images; to obtain the flow rate profiles, each TDE velocity profile was scaled to yield a mean flow rate (MFR) of 4, 5 and 6 L/min, respectively. As a result, 105 (7 × 5 × 3) synthetic cases, accounting for different velocity profiles, MFRs and valve configurations, were simulated. TDE-derived indexes were calculated according to the ASE guidelines that were extracted. Advanced statistical methods were applied to propose a new diagnostic algorithm for detecting PMVT. Our results showed that there isn't any significant difference between symmetric and asymmetric stenosis, probe location and flow rate waveform and confirmed that the single modality diagnostic is not able to predict thrombosis in a relevant number of cases, referable to mild and mild-severe stenosis cases. To overcome the problem, a novel multi-parametric discrete score based on the designed diagnostic algorithm was attained and tested; the percentage of stenosis (POS) was predicted with an accuracy rate of 90.5%. Even more interestingly, the error rate of 9.5% is related to four false positive cases corresponding to mild stenosis (POS = 15%) which were erroneously classified as mild-severe stenosis. No false negatives were obtained. Our results suggest that a reliable estimation must take into account the mean flow rate as well as the transmitral velocity profile in order to provide a correct diagnosis.
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Affiliation(s)
- Masoud Meskin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy; Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy
| | - Annalisa Dimasi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Emiliano Votta
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Michal Jaworek
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | | | | | - Piero Montorsi
- Centro Cardiologico Monzino IRCCS, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Emanuele Zappa
- Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy
| | - Ilenia Epifani
- Department of Mathematics, Politecnico di Milano, Milan, Italy
| | - Mauro Pepi
- Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
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Dimasi A, Piloni D, Spreafico L, Votta E, Vismara R, Fiore G, Meskin M, Fusini L, Muratori M, Montorsi P, Pepi M, Redaelli A. Fluid-structure interaction and in vitro analysis of a real bileaflet mitral prosthetic valve to gain insight into Doppler-silent thrombosis. J Biomech Eng 2019; 141:2733242. [PMID: 31053843 DOI: 10.1115/1.4043664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Indexed: 12/25/2022]
Abstract
Prosthetic valve thrombosis (PVT) is a serious complication affecting prosthetic heart valves. The transvalvular mean pressure gradient (MPG) derived by Doppler echocardiography is a crucial index to diagnose PVT, but may result in false negatives mainly in case of bileaflet mechanical valves (BMVs) in mitral position. This may happen because MPG estimation relies on simplifying assumptions on the transvalvular fluid dynamics or because Doppler examination is manual and operator-dependent. A deeper understanding of these issues may allow for improving PVT diagnosis and management. To this aim, we used in vitro and fluid-structure interaction (FSI) modeling to simulate the function of a real mitral BMV in different configurations: normally functioning and stenotic with symmetric and completely asymmetric leaflet opening, respectively. In each condition, the MPG was measured in vitro, computed directly from FSI simulations and derived from the corresponding velocity field through a Doppler-like post-processing approach. Following verification vs. in vitro data, MPG computational data were analyzed to test their dependency on the severity of fluid-dynamic derangements and on the measurement site. Computed MPG clearly discriminated between normally functioning and stenotic configurations. They did not depend markedly on the site of measurement, yet differences below 3 mmHg were found between MPG values at the central and lateral orifices of the BMV. This evidence suggests a mild uncertainty of the Doppler-based evaluation of the MPG due to probe positioning, which yet may lead to false negatives when analyzing subjects with almost normal MPG.
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Affiliation(s)
- Annalisa Dimasi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
| | - Daniela Piloni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
| | - Laura Spreafico
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
| | - Emiliano Votta
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
| | - Riccardo Vismara
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
| | - Gianfranco/B Fiore
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
| | - Masoud Meskin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
| | - Laura Fusini
- Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy
| | - Manuela Muratori
- Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy
| | - Piero Montorsi
- Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy
| | - Mauro Pepi
- Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
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Apostoli A, Bianchi V, Bono N, Dimasi A, Ammann KR, Moiia YR, Montisci A, Sheriff J, Bluestein D, Fiore GB, Pappalardo F, Candiani G, Redaelli A, Slepian MJ, Consolo F. Prothrombotic activity of cytokine-activated endothelial cells and shear-activated platelets in the setting of ventricular assist device support. J Heart Lung Transplant 2019; 38:658-667. [PMID: 30846234 DOI: 10.1016/j.healun.2019.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/11/2019] [Accepted: 02/13/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND We systematically analyzed the synergistic effect of: (i) cytokine-mediated inflammatory activation of endothelial cells (ECs) with and (ii) shear-mediated platelet activation (SMPA) as a potential contributory mechanism to intraventricular thrombus formation in the setting of left ventricular assist device (LVAD) support. METHODS Intact and shear-activated human platelets were exposed to non-activated and cytokine-activated ECs. To modulate the level of LVAD-related shear activation, platelets were exposed to shear stress patterns of varying magnitude (30, 50, and 70 dynes/cm2, 10 minutes) via a hemodynamic shearing device. ECs were activated via exposure to inflammatory tumor necrosis factor-α (TNF-α 10 and 100 ng/ml, 24 hours), consistent with inflammatory activation recorded in patients on LVAD circulatory support. RESULTS Adhesivity of shear-activated platelets to ECs was significantly higher than that of intact/unactivated platelets, regardless of the initial activation level (70 dynes/cm2 shear-activated platelets vs intact platelets: +80%, p < 0.001). Importantly, inflammatory activation of ECs amplified platelet prothrombinase activity progressively with increasing shear stress magnitude and TNF-α concentration: thrombin generation of 70 dynes/cm2 shear-activated platelets was 2.6-fold higher after exposure and adhesion to 100 ng/ml TNF-α‒activated ECs (p < 0.0001). CONCLUSIONS We demonstrated synergistic effect of SMPA and cytokine-mediated EC inflammatory activation to enhance EC‒platelet adhesion and platelet prothrombotic function. These mechanisms may contribute to intraventricular thrombosis in the setting of mechanical circulatory support.
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Affiliation(s)
- Alice Apostoli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Valentina Bianchi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Nina Bono
- Politecnico di Milano Research Unit, National Interuniversity Consortium of Materials Science and Technology, Milano, Italy
| | - Annalisa Dimasi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Kaitlyn R Ammann
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA
| | - Yana Roka Moiia
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA
| | - Andrea Montisci
- Anesthesia and Intensive Care, Sant'Ambrogio Cardiothoracic Center, Milano, Italy
| | - Jawaad Sheriff
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Danny Bluestein
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Gianfranco B Fiore
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Federico Pappalardo
- Advanced Heart Failure and Mechanical Circulatory Support Program, San Raffaele Scientific Institute, Milano, Italy; Università Vita Salute San Raffaele, Milano, Italy
| | - Gabriele Candiani
- Biocompatibility and Cell Culture Laboratory "BioCell," Department of Chemistry, Materials and Chemical Engineering "Giulio Natta," Politecnico di Milano, Milano, Italy
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Marvin J Slepian
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA
| | - Filippo Consolo
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy; Advanced Heart Failure and Mechanical Circulatory Support Program, San Raffaele Scientific Institute, Milano, Italy; Università Vita Salute San Raffaele, Milano, Italy.
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5
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Dimasi A, Roka-Moiia Y, Consolo F, Rasponi M, Fiore GB, Slepian MJ, Redaelli A. Microfluidic flow-based platforms for induction and analysis of dynamic shear-mediated platelet activation-Initial validation versus the standardized hemodynamic shearing device. Biomicrofluidics 2018; 12:042208. [PMID: 29861819 PMCID: PMC5963949 DOI: 10.1063/1.5024500] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/07/2018] [Indexed: 06/08/2023]
Abstract
A microfluidic flow-based platform (μFP), able to stimulate platelets via exposure of shear stress patterns pertinent to cardiovascular devices and prostheses, was compared to the Hemodynamic Shearing Device (HSD)-a state-of-the-art bench-top system for exposure of platelets to defined levels and patterns of shear. Platelets were exposed to time-varying shear stress patterns in the two systems; in detail, platelets were recirculated in the μFP or stimulated in the HSD to replicate comparable exposure time. Shear-mediated platelet activation was evaluated via (i) the platelet activity state assay, allowing the measurement of platelet-mediated thrombin generation and associated prothrombotic tendencies, (ii) scanning electron microscopy to evaluate morphological changes of sheared platelets, and (iii) flow cytometry for the determination of platelet phosphatidylserine exposure as a marker of shear activation. The results revealed good matching and comparability between the two systems, with similar trends of platelet activation, formation of microaggregates, and analogous trends of activation marker exposure for both the HSD and microfluidic-stimulated samples. These findings support future translation of the microfluidic platform as a Point-of-Care facsimile system for the diagnosis of thrombotic risk in patients implanted with cardiovascular devices.
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Affiliation(s)
- Annalisa Dimasi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milano, Italy
| | - Yana Roka-Moiia
- Department of Medicine and Biomedical Engineering, Sarver Heart Center, University of Arizona, 1501 N Campbell Ave, Tucson, Arizona 85724, USA
| | | | - Marco Rasponi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milano, Italy
| | - Gianfranco B. Fiore
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milano, Italy
| | - Marvin J Slepian
- Department of Medicine and Biomedical Engineering, Sarver Heart Center, University of Arizona, 1501 N Campbell Ave, Tucson, Arizona 85724, USA
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milano, Italy
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Dimasi A, Rasponi M, Consolo F, Fiore GB, Bluestein D, Slepian MJ, Redaelli A. Microfludic platforms for the evaluation of anti-platelet agent efficacy under hyper-shear conditions associated with ventricular assist devices. Med Eng Phys 2017; 48:31-38. [PMID: 28869117 DOI: 10.1016/j.medengphy.2017.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 07/31/2017] [Accepted: 08/09/2017] [Indexed: 01/06/2023]
Abstract
Thrombus formation is a major adverse event affecting patients implanted with ventricular assist devices (VADs). Despite anti-thrombotic drug administration, thrombotic events remain frequent within the first year post-implantation. Platelet activation (PA) is an essential process underling thrombotic adverse events in VAD systems. Indeed, abnormal shear forces, correlating with specific flow trajectories of VADs, are strong agonists mediating PA. To date, the ability to determine efficacy of anti-platelet (AP) agents under shear stress conditions is limited. Here, we present a novel microfluidic platform designed to replicate shear stress patterns of a clinical VAD, and use it to compare the efficacy of two AP agents in vitro. Gel-filtered platelets were incubated with i) acetylsalicylic acid (ASA) and ii) ticagrelor, at two different concentrations (ASA: 125 and 250 µM; ticagrelor: 250 and 500 nM) and were circulated in the VAD-emulating microfluidic platform using a peristaltic pump. GFP was collected after 4 and 52 repetitions of exposure to the VAD shear pattern and tested for shear-mediated PA. ASA significantly inhibited PA only at 2-fold higher concentration (250 µM) than therapeutic dose (125 µM). The effect of ticagrelor was not dependent on drug concentration, and did not show significant inhibition with respect to untreated control. This study demonstrates the potential use of microfluidic platforms as means of testing platelet responsiveness and AP drug efficacy under complex and realistic VAD-like shear stress conditions.
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Affiliation(s)
- Annalisa Dimasi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133, Milano, Italy.
| | - Marco Rasponi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133, Milano, Italy
| | - Filippo Consolo
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133, Milano, Italy; Anesthesia and Cardiothoracic Intensive Care Unit. Università Vita Salute, San Raffaele Scientific Institute, Via Olgettina 58, 20132, Milano, Italy
| | - Gianfranco B Fiore
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133, Milano, Italy
| | - Danny Bluestein
- Department of Biomedical Engineering, StonyBrook University, Stony Brook, NY, USA
| | - Marvin J Slepian
- Department of Biomedical Engineering, StonyBrook University, Stony Brook, NY, USA; Department of Medicine and Biomedical Engineering, Sarver Heart Center, University of Arizona, 1501 N Campbell Ave, 85724, Tucson, AZ, USA
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133, Milano, Italy
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Dimasi A, Rasponi M, Consolo F, Redaelli A, Slepian M. Platelet Membrane-Related Morphologic Alterations: An Early Marker of Supra-Physiologic Shear-Mediated Platelet Activation Associated with VADs. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Dimasi A, Rasponi M, Sheriff J, Chiu WC, Bluestein D, Tran PL, Slepian MJ, Redaelli A. Microfluidic emulation of mechanical circulatory support device shear-mediated platelet activation. Biomed Microdevices 2015; 17:117. [PMID: 26578003 PMCID: PMC4855287 DOI: 10.1007/s10544-015-0015-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Thrombosis of ventricular assist devices (VADs) compromises their performance, with associated risks of systemic embolization, stroke, pump stop and possible death. Anti-thrombotic (AT) drugs, utilized to limit thrombosis, are largely dosed empirically, with limited testing of their efficacy. Further, such testing, if performed, typically examines efficacy under static conditions, which is not reflective of actual shear-mediated flow. Here we adopted our previously developed Device Thrombogenicity Emulation methodology to design microfluidic platforms able to emulate representative shear stress profiles of mechanical circulatory support (MCS) devices. Our long-term goal is to utilize these systems for point-of-care (POC) personalized testing of AT efficacy under specific, individual shear profiles. First, we designed different types of microfluidic channels able to replicate sample shear stress patterns observed in MCS devices. Second, we explored the flexibility of microfluidic technology in generating dynamic shear stress profiles by modulating the geometrical features of the channels. Finally, we designed microfluidic channel systems able to emulate the shear stress profiles of two commercial VADs. From CFD analyses, the VAD-emulating microfluidic systems were able to replicate the main characteristics of the shear stress waveforms of the macroscale VADs (i.e., shear stress peaks and duration). Our results establish the basis for development of a lab-on-chip POC system able to perform device-specific and patient-specific platelet activation state assays.
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Affiliation(s)
- Annalisa Dimasi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, 20133, Italy
| | - Marco Rasponi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, 20133, Italy
| | - Jawaad Sheriff
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-8151, USA
| | - Wei-Che Chiu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-8151, USA
| | - Danny Bluestein
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-8151, USA
| | - Phat L Tran
- Department of Medicine and Biomedical Engineering, Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA
| | - Marvin J Slepian
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-8151, USA.
- Department of Medicine and Biomedical Engineering, Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA.
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, 20133, Italy
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Leung SL, Dimasi A, Heiser S, Dunn A, Bluestein D, Slepian M. Modulation of platelet membrane function via exogenous lipid moiety exposure alters platelet responsiveness to shear. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2015:266-269. [PMID: 26736251 DOI: 10.1109/embc.2015.7318351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Shear-induced platelet activation may cause life-threatening thrombosis, particularly in patients with mechanical support devices or coronary atherosclerosis. The majority of present anti-platelet agents target or interfere with biochemical, rather than physical mechanisms of platelet activation. Less data and understanding exists with regard to pharmacologic modulation of shear-mediated platelet activation. In this work, we hypothesized that modulating cell membrane properties, via alteration of membrane composition through addition of exogenous lipid moieties, would alter platelet responsiveness to shear. Here we tested fatty acids, lecithin and cholesterol as additive lipid compounds. We demonstrated that incorporation of fatty acids (DHA/EPA) or lecithin into the platelet membrane triggered enhanced sensitivity of platelets to shear-mediated activation. On the other hand, cholesterol incorporation provides significant protection, limiting the effect of shear on platelet activation. These findings provide valuable insight for the development of therapeutic strategies that can modulate shear-mediated platelet activation.
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