Interactions of thrombin and antithrombin III with artificial surfaces

Biomaterials for blood-contacting applications

Consideration of biomaterials for blood-contacting applications should take into account blood-biomaterial interactions, factors influencing the blood response and evaluation procedures. Examination of blood-biomaterial interactions indicates that relevant features are protein adsorption, platelet reactions, intrinsic coagulation, fibrinolytic activity, erythrocytes, leucocytes and complement activation. Factors influencing the blood response to a biomaterial in clinical application are the biomaterial structure, the presence of an antithrombotic agent, the patient status as determined by the disease and drug therapy, and the nature of the application. Evaluation options for biomaterials are clinical, in vivo, ex vivo and in vitro, with ex vivo and in vitro procedures relevant for biomaterial development.

Biomaterials in cardiopulmonary bypass

The improved utilization of biomaterials in cardiopulmonary bypass is dependent on polymer science and technology, procedures for blood compatibility assessment, optimization of biomaterial/antithrombotic agent combinations and the interpretation of clinical data.

Thrombin and albumin adsorption to PVA and heparin-PVA hydrogels. I. Single protein isotherms

More radiolabeled thrombin was adsorbed to heparin-polyvinyl alcohol (PVA) than to PVA, consistent with a specific interaction with the immobilized heparin. The maximum surface concentration on heparin-PVA was estimated to be approximately 450 nmol/m2 with an apparent affinity constant (Ka) of 2.5 microM-1; on PVA, the plateau concentration was 10 nmol/m2 with a Ka less than 1 nM-1. There was little difference in bovine serum albumin (BSA) adsorption between PVA and heparin-PVA. Interestingly, thrombin adsorption to polyethylene was indistinguishable from that to PVA despite the large difference in surface chemistry. BSA adsorbed to polyethylene with higher affinity than to the hydrogels, although the plateau concentrations were comparable. The adsorbed thrombin was biologically inactive at least towards chromogenic substrate, with the residual activity on PVA unaffected by subsequent incubations with antithrombin III. PVA and heparin-PVA presented a heterogeneous and complex substrate for interaction with proteins. The adsorbed protein was likely present in multiple states depending on the groups with which it interacted.

Protein adsorption to polymer particles: role of surface properties

Adsorption isotherms of four plasma proteins (fibrinogen, IgG, human serum albumin, and bovine serum albumin) using four different types of small particles as substrates (siliconized glass, Teflon, polyvinylchloride, and Nylon-6,6) are reported. The suspending liquid medium was phosphate-buffered saline, with a surface tension higher than that of any of the proteins. In keeping with the thermodynamic expectations for these systems, protein adsorption decreases for all solids in sequence from fibrinogen (the most hydrophobic) to IgG, human serum albumin, and bovine serum albumin (the most hydrophilic). Furthermore, the extent of protein adsorption also decreases from the low surface tension (hydrophobic) to the higher surface tension solids, again as expected on thermodynamic grounds. There is one minor yet interesting exception to the thermodynamic pattern: In spite of the slightly lower surface tension of siliconized glass, the extent of protein adsorption is slightly higher to Teflon than to siliconized glass. This result is attributed to the theoretically well known phenomenon of "screening."

Why small caliber vascular grafts fail: a review of clinical and experimental experience and the significance of the interaction of blood at the interface

The results using polytetrafluoroethylene (PTFE) and tanned human umbilical cord vein (HUV) grafts are discussed. These two grafts perform well for reconstructions above the knee and the results are similar to the autogenous saphenous vein (ASV) grafts in several series; however, in more distal reconstructions the PTFE and HUV are far inferior to ASV grafts. The factors responsible for graft failure including the events which take place at the blood interface are reviewed. New material surfaces under investigation such as degradable grafts, heparin-bonded surfaces, and endothelial-seeded fabrics are also addressed.

Immunochemical detection by specific antibody to thrombin of prothrombin conformational changes upon adsorption to artificial surfaces

Polyclonal antihuman alpha-thrombin antibodies produced in rabbits reacted minimally (less than 0.05%) in solution with human prothrombin. However, when prothrombin was adsorbed to artificial surfaces such as polyvinyl chloride (PVC), the cross-reactivity of surface-bound prothrombin with antibody IgG to thrombin (greater than 95% purity) was shown to be significantly enhanced. On PVC, the molar ratios of antibody IgG to thrombin/prothrombin approached the same level as that of antibody IgG to thrombin/thrombin when thrombin was adsorbed to the same material. The analyses of antigen-antibodies interaction, in solution with a direct binding assay by immune precipitation at high-speed centrifugation (160,000 g, 30 min), and on solid-phase PVC, were accomplished by use of double-labeling technique, i.e., 131I-thrombin (or 131I-prothrombin) and 125I-antibody IgG to thrombin. The results appear to suggest that prothrombin adsorption to PVC has resulted in some molecular conformational changes so that immunologically the adsorbed prothrombin resembles that of adsorbed thrombin on the same PVC surface.

Adsorption and reactivity of human prothrombin to artificial surfaces

Human prothrombin in Tyrode's solution, in mock plasma (albumin, fibrinogen, and IgG mixture), and in citrated plasma adsorbs to Cuprophane, polyvinylchloride, and polyacrylonitrile surfaces. The adsorption of prothrombin is maximal in Tyrode's solution and minimal in plasma. The surface concentrations of prothrombin are highest on polyacrylonitrile, second on polyvinylchloride, and lowest on Cuprophane at all prothrombin concentrations tested in the bulk solution. Qualitative tests show that prothrombin adsorbed to polyvinylchloride can be activated by Taipan snake venom to generate thrombin that clots fibrinogen. However, more quantitative tests indicate that only part of the adsorbed prothrombin on all three materials can be activated to form thrombin exhibiting amidolytic activity. The partial reactivity of adsorbed prothrombin is further confirmed by release of 125I-peptide from surface bound 125I-prothrombin after treatment with Australian Taipan snake venom. Prothrombin bound to Cuprophane seems to promote granulocyte adhesion, but has no effect on platelet adhesion.