The influence of preadsorbed canine von Willebrand factor, fibronectin and fibrinogen on ex vivo artificial surface-induced thrombosis

Cell-friendly photo-functionalized TiO2 nano-micro-honeycombs for selectively preventing bacteria and platelet adhesion

Titanium dioxide (TiO₂) is a widely used biomaterial. It is a great challenge to confer antibacterial and antithrombotic properties to TiO₂ while maintaining its cell affinity. Here, we developed a new strategy to achieve the above goal by comprehensively controlling the chemical cues and geometrical cues of the surface of TiO₂. Using colloidal etching technology and UV irradiation treatment, we obtained the photofunctionalized nano-micro-honeycomb structured TiO₂. The honeycomb structured increased the photocatalytic activity of TiO₂, which endowed TiO₂ with photo-induced superhydrophilicity to inhibit bacterial adhesion. The high photocatalytic activity also induced the strong photocatalytic oxidation of TiO₂ surface organic adsorbates to suppress fibrinogen and platelet attachment. In addition, owing to the micropore trapping-isolation effect on the bacteria and the nano-frames' contact guidance effect on the growth and spreading of platelet pseudopods, the honeycomb structure also shows a considerable inhibiting effect on bacterial and platelet adhesion. Therefore, due to the controlled chemical and geometrical cues' synergistic effect, the photo-functionalized TiO₂ honeycomb structure shows excellent bacterial-adhesion resistance and antithrombotic properties. More importantly, the photo-functionalized TiO₂ honeycomb did not inhibit the adhesion and growth of endothelial cells (ECs) after culturing for 3 d, indicating a good cell affinity that the traditional antifouling surfaces do not possess.

Effect of Sintering Temperature of Bioactive Glass Nanoceramics on the Hemolytic Activity and Oxidative Stress Biomarkers in Erythrocytes

INTRODUCTION

The nature of the surface is critical in determining the biological activity of silica powders. A novel correlation between toxicity and surface properties of bioactive glass ceramics (BGCs) synthesized via the sol-gel method was attempted in this study.

METHODS

The behavior of BGCs after their attachment to the surface of red blood cells (RBCs) was evaluated and their toxic effects were determined based on hemolysis, membrane injury via anti-phosphotyrosine immunoblot of Band 3, lipid peroxidation, potential to generate reactive oxygen species, and antioxidant enzyme production. In particular, three BGCs were synthesized and treated at three sintering temperatures (T1 = 835 °C, T2 = 1000 °C and T3 = 1100 °C) to investigate possible relation between surface charge or structure and hemolytic potential.

RESULTS

Their toxicity based on hemolysis was dose dependent, while BGC-T2 had the best hemocompatibility in compare with the other BGCs.No BGCs in dosages lower than 0.125 mg/mL could damage erythrocytes. On the other hand, all BGCs promoted the production of reactive oxygen species in certain concentrations, with the BGC-T2 producing the lowest ROS and increasing the glutathione levels in RBCs protecting their damage.

CONCLUSIONS

The results suggest that various factors such as size, a probable different proportion of surface silanols, a balanced mechanism between calcium and magnesium cellular uptake or the different crystalline nature may have contributed to this finding; however, future research is needed to clarify the underlying mechanisms.

The blood compatibility challenge. Part 2: Protein adsorption phenomena governing blood reactivity

The adsorption of proteins is the initiating event in the processes occurring when blood contacts a "foreign" surface in a medical device, leading inevitably to thrombus formation. Knowledge of protein adsorption in this context has accumulated over many years but remains fragmentary and incomplete. Moreover, the significance and relevance of the information for blood compatibility are not entirely agreed upon in the biomaterials research community. In this review, protein adsorption from blood is discussed under the headings "agreed upon" and "not agreed upon or not known" with respect to: protein layer composition, effects on coagulation and complement activation, effects on platelet adhesion and activation, protein conformational change and denaturation, prevention of nonspecific protein adsorption, and controlling/tailoring the protein layer composition. STATEMENT OF SIGNIFICANCE: This paper is part 2 of a series of 4 reviews discussing the problem of biomaterial associated thrombogenicity. The objective was to highlight features of broad agreement and provide commentary on those aspects of the problem that were subject to dispute. We hope that future investigators will update these reviews as new scholarship resolves the uncertainties of today.

Coagulation at the blood-electrode interface: the role of electrochemical desorption and degradation of fibrinogen

The influence of electrochemistry on the coagulation of blood on metal surfaces was demonstrated several decades ago. In particular, the application of cathodic currents resulted in reduced surface thrombogenicity, but no molecular mechanism has been so far proposed to explain this observation. In this article we used for the first time the quartz crystal microbalance with dissipation monitoring technique coupled with an electrochemical setup (EQCM-D) to study thrombosis at the blood-electrode interface. We confirmed the reduced thrombus deposition at the cathode, and we subsequently studied the effect of cathodic currents on adsorbed fibrinogen (Fg). Using EQCM and mass spectrometry, we found that upon applying currents Fg desorbed from the electrode and was electrochemically degraded. In particular, we show that the flexible N-terminus of the α-chain, containing an important polymerization site, was cleaved from the protein, thus affecting its clottability. Our work proposes a molecular mechanism that at least partially explains how cathodic currents reduce thrombosis at the blood-electrode interface and is a relevant contribution to the rational development of medical devices with reduced thrombus formation on their surface.

Electrochemical modulation of plasma fibronectin surface conformation enables filament formation and control of endothelial cell–surface interactions

Electrochemical modulation of a gold surface charge induces conformational changes in fibronectin when immobilized on the surface. A negatively-charged surface yields an open and filamentous fibronectin which significantly improves endothelial cell adhesion.

The novel metalloproteinase atroxlysin-I from Peruvian Bothrops atrox (Jergón) snake venom acts both on blood vessel ECM and platelets

We report the isolation and structure-function relationship of a 23kDa metalloproteinase named atroxlysin-I from the venom of the Peruvian Bothrops atrox (Jergón). Atroxlysin is a P-I metalloproteinase and contains 204 residues. Its proteolytic activity towards dimethylcasein is enhanced by Ca2+ but inhibited by EDTA, dithiothreitol, excessive Zn2+ and alpha2-macroglobulin. Unlike other structurally homologous P-I metalloproteinases, atroxlysin-I causes hemorrhages. To examine its hemorrhagic activity mechanistically, we studied its function in vitro and in vivo. It cleaved the Ala14-Leu15 and Tyr16-Leu17 bonds in oxidized insulin B-chain and specifically hydrolyzed the alpha-chains of fibrin(ogen) in a dose- and time-dependent manner. Atroxlysin-I cleaved plasma fibronectin and other extracellular matrix proteins (collagens I and IV) and the triple-helical fragment CB3 of collagen IV, but did not degrade laminin-111. Complementarily, the laminin and collagen binding integrins alpha7beta1 and alpha1beta1 were cleaved by atroxlysin. Even without catalytic activity atroxlysin-I inhibited collagen- and ADP-triggered platelet aggregation.

Sum Frequency Generation Studies on Bioadhesion: Elucidating the Molecular Structure of Proteins at Interfaces

The study of bioadhesion is significant to applications in a variety of scientific fields. Techniques that are surface sensitive need to be utilized to examine these kinds of systems because bioadhesion occurs at the interface between two surfaces. Recently, Sum Frequency Generation (SFG) has been applied to investigate different bioadhesive processes because of its intrinsic surface specificity, excellent sensitivity and its ability to perform experiments in situ. SFG studies on the bioadhesion of fibrinogen, factor XII and mefp-3 on various surfaces will be discussed in this review.

Fibrinogen and von Willebrand factor mediated platelet adhesion to polystyrene under flow conditions

The roles of adsorbed fibrinogen (Fg) and von Willebrand factor (VWF) in mediating platelet adhesion to synthetic surfaces under flow were investigated using polystyrene (PS) as a model hydrophobic surface. We measured platelet adhesion to PS pre-adsorbed with Fg, VWF, normal plasma, afibrinogenemic plasma, VWF-deficient plasma and deficient plasmas with various concentrations of added Fg or VWF. Platelets in a red blood cell suspension were passed through a flow chamber at either low (50 or 100 s(-1)) or high (500 or 1000 s(-1)) shear. Adhesion to PS pre-adsorbed with afibrinogenemic plasma was very low under both low and high shear conditions, but was restored in a dose-dependent manner with addition of Fg. Less than 20 ng/cm(2)of adsorbed Fg was sufficient to support full-scale platelet adhesion under flow. At high shear rate, platelet adhesion on PS pre-adsorbed with VWF-deficient plasma was much less than on PS pre-adsorbed with normal plasma, but adhesion to PS pre-adsorbed with VWF-deficient plasma with added VWF was very similar to adhesion to PS pre-adsorbed with normal plasma. At low shear, adhesion to PS pre-adsorbed with VWF-deficient plasma was the same as on PS pre-adsorbed with normal plasma. As little as 1 ng/cm(2) of VWF adsorbed from plasma made platelet adhesion higher under high shear than under low shear. The effects of adsorbed Fg and VWF on the morphologies of platelets that adhered from suspensions flowing at high shear rates were also investigated. The lack of either Fg or VWF resulted in marked decreases in the extent of platelet spreading. Real-time observation of platelet adhesion under an epifluorescent microscope showed that platelets adhered to the surface in a linear pattern aligned in the direction of flow under high shear conditions.

Short term evaluation of material blood compatibility using a microchannel array

New short-term evaluation of material blood compatibility was attempted using a microchannel array with human blood under a flow condition. The microchannel array chips were made of silicon, having 8,736 microchannels of 10 microm-wide, 30 microm-long, and 4.5 microm-deep on the average, as the models of capillary blood vessels. Titanium, chromium, albumin and collagen were coated onto the chips to examine the difference of material blood compatibility and the effect of protein adsorption on it. The time for the first 100 microl portion of whole blood to pass through the channels (blood pass-through time, BPT) was measured under a pressure difference of 20 cmH2O. Simultaneously, the flow behavior of blood cells was observed by an optical microscope. The BPT tends to correlate well with the level of platelet adhesion. The highest BPT as well as platelet adhesion was observed on collagen, followed by titanium, chromium, silicon, and albumin. These results indicate that the BPT can detect the different levels of platelet adhesion and thrombus formation on microchannel surface and that the protein adsorption onto chip surface can influence BPT. We concluded that this method could be applied to evaluate initial blood compatibility of materials within several minutes in vitro.

In vitro and in vivo study of ion-implanted collagen for the substrate of small diameter artificial grafts

Ion implantation into the collagen-coated inner surface of the grafts was performed and evaluated in vitro and in vivo to develop small diameter artificial vascular grafts. He+ ion implanted collagen-coated grafts with a fluence of 1 x 1014 ions/cm2 inhibited platelet adhesion and demonstrated patency for 240 days in an animal study. The platelet adhesion test using platelet rich plasma (PRP) showed antithrombogenicity at the fluence of 1 x 1014 ions/cm2. Washed platelet adhesion test showed thrombus formation at the fluence of 1 x 1014 ions/cm2. The results suggested that plasma protein adsorption onto the ion-implanted collagen significantly improved performance of these synthetic grafts.

Co-adsorbed fibrinogen and von Willebrand factor augment platelet procoagulant activity and spreading

Previously we observed that platelets adherent to surfaces preadsorbed with blood plasma exhibited 1.3 to 2.4 times greater procoagulant activity than platelets on surfaces adsorbed with fibrinogen (Fg) only. These observations suggested that the adhesion proteins adsorbed from plasma may activate platelets in a cooperative, or synergistic manner. In the present study, polystyrene surfaces adsorbed with both Fg and vWF induced up to three times greater procoagulant activity than surfaces adsorbed with Fg or vWF only. The amounts of Fg and vWF adsorbed from binary mixtures that resulted in increased procoagulant activity were found to be similar to the amounts that adsorbed to PS from 100% plasma. The effect of adsorbed adhesion proteins on platelet spreading was also investigated. The proportion of fully spread platelets increased, depending on the adhesion protein preadsorbed to the surface, in the following order: vWF < Fg < Fn < (vWF + Fg) < Vn < plasma.

Platelet adhesion onto wettability gradient surfaces in the absence and presence of plasma proteins

A wettability gradient was prepared on lowdensity polyethylene (PE) sheets by treating them in air with a corona from a knife-type electrode the power of which increased gradually along the sample length. The PE surfaces oxidized gradually with the increasing corona power and a wettability gradient was created on the surfaces, as evidenced by the measurement of water contact angles, Fourier transform infrared spectroscopy in the attenuated total reflectance mode, and electron spectroscopy for chemical analysis. The wettability gradient surfaces prepared were used to investigate the adhesion behavior of platelets in the absence and presence of plasma proteins in terms of the surface hydrophilicity/hydrophobicity of polymeric materials. The platelets adhered to the wettability gradient surfaces along the sample length were counted and examined by scanning electron microscopy (SEM). It was observed that the platelet adhesion in the absence of plasma proteins increased gradually as the surface wettability increased along the sample length. The platelets adhered to the hydrophilic positions of the gradient surface also were more activated (possessed more pseudo pods as examined by SEM) than on the more hydrophobic ones. However, platelet adhesion in the presence of plasma proteins decreased gradually with the increasing surface wettability; the platelets adhered to the surface also were more activated on the hydrophobic positions of the gradient surface. This result is closely related to plasma protein adsorption on the surface. Plasma protein adsorption on the wettability gradient surface increased with the increasing surface wettability. More plasma protein adsorption on the hydrophilic positions of the gradient surface caused less platelet adhesion, probably due to platelet adhesion inhibiting proteins, such as high-molecular-weight kininogen, which preferably adsorbs onto the surface by the so-called Vroman effect. It seems that both the presence of plasma proteins and surface wettability play important roles for platelet adhesion and activation.

Membrane apheresis technology: historical perspective and new trends toward bioincompatible systems

During the past 25 years, membrane apheresis technology has been well developed through the use of biocompatible devices and immunomodulation. Now, however, we must move into a new era reconsidering the concepts of apheresis technology and considering the urgent need to develop a bioincompatible apheresis system. In the past, our aim in this field was to develop the best blood compatible system possible. With these systems, best efforts were made to reduce procedurally induced immunomodulation effects. However, it is these authors' opinion that procedurally induced immunomodulation effects should be augmented rather than reduced by incorporating such a bioincompatible apheresis system. Augmented immunoactivation and immunosuppression introduced by such systems should add therapeutic effects to the apheresis procedures. Therefore, we anticipate that the current marginally effective diseases may benefit from this strategic change in apheresis procedures.

Thrombus formation on polytetrafluoroethylene surfaces: the importance of von Willebrand factor

The importance of von Willebrand factor (vWf) in the formation of platelet-fibrin thrombi on expanded polytetrafluoroethylene (ePTFE) surfaces was studied in an in vitro system, perfusing non-anticoagulated human blood over ePTFE grafts for 3 min at varying shear rates (100, 500 and 1500/s shear). Platelet (111In) and fibrin (125I) deposition was assessed on ePTFE surfaces in the presence and relative absence of vWf, achieved by use of polyclonal anti-vWf antibody (anti-vWf Ab). A total of 29 perfusions were performed. Increasing shear rate was associated with greater platelet deposition in the presence of vWf (p < 0.001). This shear-dependent rise in platelet deposition was not observed when vWf was blocked by anti-vWf Ab (P < 0.1), confirming the role of vWf in platelet deposition at high shear rates. Fibrin deposition increased with increasing shear rate in the presence of vWf (P < 0.01). Inhibiting vWf abolished the shear-dependent increase in fibrin deposition. These data suggest that vWf plays a critical role in platelet and fibrin thrombus formation on ePTFE surfaces. These effects are particularly important under conditions of high shear rate. These mechanisms may lead to the observed pathologic thrombus formation and platelet-dependent neointimal processes occurring at areas of high shear rate within the anastomotic regions of ePTFE grafts.

Plasma protein adsorption to highly permeable hemodialysis membranes

Although membrane adsorption of plasma proteins is one of several factors determining the biocompatibility and mass transfer characteristics of a hemodialyzer, this process has not been evaluated rigorously. We performed an equilibrium and kinetic analysis of the binding of proteins of differing molecular weight to highly permeable membranes of differing hydrophobicity and surface change. Hydrophobic, anionic polyacrylonitrile (PAN) and hydrophilic, uncharged cellulose triacetate (CT) membrane fragments were incubated in buffer containing radioiodinated beta 2-microglobulin (beta 2m) or bovine serum albumin (BSA). From an initial solution concentration of 50 mg/liter, both membranes adsorbed significantly more beta 2m than BSA at equilibrium (PAN, 352 +/- 30 vs. 32.1 +/- 2.4 ng; CT, 87.0 +/- 0.6 vs. 30.8 +/- 1.7 ng). These results were consistent with membrane pore exclusion of BSA. Comparison of the slopes of the equilibrium isotherm lines (concentration range, 0 to 220 mg/liter) showed the PAN binding affinity for beta 2m and BSA was 28 and 1.4 times that of CT, respectively. In kinetic studies, the approach to equilibrium versus (time)1/2 was assessed. For all protein-membrane combinations, this relationship was linear, consistent with a diffusion-controlled process. This latter characteristic permitted the determination of beta 2m membrane diffusivity values for both PAN and CT, which were found to be 0.30 and 3.25 x 10(-7) cm2/sec, respectively. These data suggest membrane hydrophobicity more significantly influences the binding of low-molecular weight proteins than that of pore-excluded proteins. In addition, these results demonstrate electrostatic membrane-protein interactions may influence the kinetics of both the adsorption and transmembrane mass transfer of plasma proteins.

Use of adhesion-defective mutants of Staphylococcus aureus to define the role of specific plasma proteins in promoting bacterial adhesion to canine arteriovenous shunts

We used an ex vivo canine arteriovenous shunt model, previously developed to study plasma protein adsorption and thrombogenesis on polymeric biomaterials, to define the role of host proteins in promoting adhesion of Staphylococcus aureus. Either polyethylene or polyvinyl chloride tubings were exposed to canine blood for 5, 15, or 60 min at a flow rate of 300 ml/min and then were flushed in phosphate-buffered saline (PBS), cut into 1.5-cm segments, and stored at -70 degrees C. After thawing, each segment was preincubated in 0.5% albumin in PBS to prevent nonspecific staphylococcal attachment to surfaces that were not exposed to blood. Each segment was then incubated with 4 x 10(6) CFU of [3H]thymidine-labelled S. aureus per ml for 60 min at 37 degrees C in an in vitro adhesion assay. Two site-specific mutants of S. aureus were tested: one specifically defective in adhesion to surface-bound fibronectin (FnAd-def) and the other defective in adhesion to fibrinogen (FgAD-def) [corrected]. Compared with their respective parental strains, the FgAd-def, but not the FnAd-def, mutant of S. aureus showed a strong (> 80%) decrease in attachment to ex vivo tubings. The adhesion of each strain of S. aureus onto polyethylene was consistently more than twofold higher than the adhesion onto polyvinyl chloride segments exposed to flowing blood for 5 or 15 min, but adhesion became similar to that on polyvinyl chloride after 60 min of exposure. In conclusion, the specific adhesion-defective mutants of S. aureus suggested that fibrinogen was the most active adhesion-promoting protein in a short-term blood-material interaction. The experimental approach described in this study should prove useful for screening materials thought to be resistant to protein-mediated staphylococcal adhesion and colonization.

Integrin receptors and platelet adhesion to synthetic surfaces

The activation-independent and -dependent integrin receptors--glycoproteins GPIc-IIa (alpha 5-beta 1) and GPIIb-IIIa (alpha IIb-beta 3)--are involved in platelet adhesion and thrombus growth on damaged subendothelium through interactions with fibrinogen, fibronectin, von Willebrand factor, and other adhesive proteins. Because these receptors are used in normal in vivo hemostatic adhesion, they may also have a role for adhesion onto synthetic surfaces in the vasculature. Platelet adhesion in vitro was examined onto Formvar, glass, and four polyurethaneureas with various soft segment chemistries and surface properties. Platelets were pretreated with RGD peptides before and after adhesion. RGD peptide pretreatment inhibited spreading and close contact formation compared to treatment with saline or control RGE peptides, with no observable effect on the number of adherent platelets per area. High-voltage electron microscopy showed abnormally sparse and short microfilament structures with RGD peptide treatment, suggesting an indirect inhibition of actin filament formation. Video-enhanced light microscopy showed a cessation of spreading and a partial reversal of close contacts following RGD peptide application to adherent platelets. Because minimal amounts of plasma proteins are present in column-washed platelet suspensions, and as platelet secretion appeared to be minimal in these experiments, these observations suggest that RGD binding integrin receptors may function in platelet spreading even in the absence of exogenous ligand. As RGD peptides did not affect the numbers of adherent platelets, while producing substantial decreases in the extent of spreading, we suggest that platelet integrins, possibly GPIIb-IIIa, are involved in spreading on synthetic surfaces but not for initial adhesion.

Plasma protein adsorption to hemodialysis membranes: studies in an in vitro model

Upon interaction of whole blood with foreign materials, heterogeneous protein films are deposited onto the artificial surface (eg, hemodialysis membranes). The composition of these protein films subsequently affects various processes, eg, thrombogenesis or activation of the complement system. We developed an in vitro model with which we can identify and study proteins interacting with capillaries during hemodialysis. Using this model we studied the cuprophane dialyzer GFS 120 (CP) and the polymethylmetacrylate membrane Filtryzer B2-1.2 (PMMA). Heparinized whole blood from healthy young volunteers was dialyzed on an extracorporeal dialysis machine. After the dialysis procedure the adsorbed material was eluted from the hemodialysis membranes by different eluants and subsequently analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting. A number of proteins could be identified in the eluates of both membrane types. Interestingly, platelet glycoproteins could only be found in PMMA eluates. Albumin, IgG, and antithrombin III were mainly present in the cuprophane eluates. Fibrinogen was demonstrable in all eluates, but in relatively low amounts, and the protein was significantly degraded. Degradation products of antithrombin III and complement factor 3 could also be identified. The process causing the degradation has not yet been identified, but may be due to proteases released from damaged cells.

Fibronectin adsorpton kinetics on phase segregated polyurethaneureas

The kinetics of fibronectin (FN) adsorption upon three polyurethaneureas (PUU) were measured by Fourier transform infrared spectroscopy. The three polymers had soft blocks composed of polydimethylsiloxane (PDMS), polytetramethyleneoxide (PTMO), and polyethyleneoxide (PEO). On each polymer, the amount of adsorbate increased proportional to the square root of time, but the rates were less than that predicted for purely diffusion controlled adsorption. Adsorption rate constants and sticking coefficients (the fraction of encounters with the surface which result in adsorption) were calculated from the data. The adsorption rate constants are 4.8 x 10(-4), 1.3 x 10(-4), and 2.5 x 10(-5) cm/s on PDMS-PUU, PTMO-PUU and PEO-PUU respectively. The rate constants and sticking coefficients fall within the range of previously reported values for other protein/polymer systems. The sticking coefficients correlate in general with the amount of FN adsorbed at 120 min, and with the extent of conformational change of the adsorbed protein.

Antibody-detectable changes in fibrinogen adsorption affecting platelet activation on polymer surfaces

Reactivity of platelets with an artificial surface exposed to whole blood is correlated with the concentration of adsorbed fibrinogen detectable by antifibrinogen antibodies. To examine the effect on platelets of the organization (distribution, orientation, conformation) of fibrinogen adsorbed on a hydrophobic surface, we studied the binding of polyclonal and monoclonal antifibrinogen antibodies to polyalkyl methacrylate polymers previously exposed to purified fibrinogen solution or diluted plasma and compared the results with platelet retention in methacrylate bead columns. There was an increase in platelet retention following diluted plasma pretreatment, which was eliminated by a polyclonal antibody against fibrinogen or against a gamma-(395-411) peptide from fibrinogen and was reduced by monoclonal antibodies (4A5, 4-2) against other COOH-terminal gamma-chain epitopes. Monoclonal antibody 10E5 against the fibrinogen receptor GpIIb/IIIa totally inhibited platelet retention in the bead columns. Our data suggest that different methacrylate polymers induce different changes in adsorbed fibrinogen, which may interfere with its interaction with platelets, and that platelet retention in a methacrylate bead column involves interaction of the COOH-terminal end of the gamma-chain of adsorbed fibrinogen with platelet GpIIb/IIIa receptors.

The effects of substrate-adsorbed albumin on platelet spreading

Adsorbed albumin appears to passivate nearly all materials, minimizing platelet adhesion and thrombus formation. Since in vitro platelet spreading can be an indicator of in vivo reactivity leading to thrombosis, and as in vitro platelet adhesion investigations are routinely done in the presence of bovine or human serum albumin (BSA or HSA), we examined the influence of albumin on platelet reactivity to material substrates. Platelet spreading was examined subsequent to adherence onto several related polyurethanes, and to Formvar, in the presence of bulk albumin concentrations sufficient to form an adsorbed monolayer or a multilayer. No other exogenous proteins were present. The spreading behavior of adherent platelets was analyzed using generalized linear interactive modeling (GLIM). The models showed that the polymer type always influenced platelet responses, irrespective of the albumin concentration. In many experiments, platelet behavior could be adequately modeled without including the effects of albumin. Thus, the polymer type appeared to be the primary determinant of platelet shape-change with adsorbed albumin producing a secondary effect. Additionally, somewhat different effects on spreading were observed with HSA and BSA, suggesting qualitatively different interactions between human platelets and HSA, than with BSA, which is commonly used in platelet preparations.

Shear-induced platelet aggregation

Two platelet mechanisms contribute to haemostasis and thrombosis. (1) Compounds such as thrombin activate glycoprotein IIb/IIIa; fibrinogen is the ligand. The cyclooxygenase pathway is involved and so this process is aspirin sensitive. (2) Shearing forces alone activate a different domain on glycoprotein IIb/IIIa; von Willebrand's factor is the ligand. This process is probably non-enzymatic and is aspirin insensitive. The prevention of shear-induced platelet activation may prove to be more rewarding therapeutically than inhibition of aspirin sensitive pathways.

Bulk, surface, and blood-contacting properties of polyetherurethanes modified with polyethylene oxide

The bulk, surface, and blood-contacting properties of a series of polyether polyurethanes based on polyethylene oxide (PEO) (MW = 1450), polytetramethylene oxide (PTMO) (MW = 1000), and mixed PEO/PTMO soft segments were evaluated. The effect of varying the weight percentage of PEO, and thus the overall polarity of the mixed soft segment phase, was investigated. Two polymer blends prepared from a PTMO-based and a PEO-based polyurethane were also studied. Differential scanning calorimetry (DSC) and dynamic mechanical analysis indicated that the polyurethanes based on either the PEO or the PTMO soft segments are relatively phase mixed. The degree of phase mixing in the polymers increased with increasing weight fraction of PEO. As expected, water absorption and the hydrophilicity of the polymer increased with increasing PEO soft segment content. In vacuum, the PEO-rich polymers have a lower concentration of soft segment at the surface, possibly due to the migration of the polar PEO segments away from the polymer/vacuum interface. The blood-contacting results indicated that the higher PEO-containing polymers were more thrombogenic than the pure PTMO-based polyurethane. A threshold concentration of PEO in the polyurethane appeared to be required before the blood-contacting properties were significantly affected.

Platelet deposition in a capillary perfusion model: quantitative and morphological aspects

The capillary perfusion model according to Cazenave and co-workers was characterized by investigating the effects of protein precoating, perfusion time and shear rate on platelet deposition using 111Indium labelling of human platelets and scanning electron microscopy (SEM). Compared with uncoated polyethylene, platelet deposition was increased after precoating with purified human von Willebrand factor, fibrinogen or fibronectin, and decreased by preadsorbed immunoglobulin G, albumin or whole plasma. Platelet aggregates were observed on immunoglobulin G-coated polyethylene, whereas all other surfaces showed single adherent platelets. Complete platelet spreading was only observed after precoating with fibronectin. The quantitative data concerning platelet deposition were evaluated by using the convective-diffusion theory. Our results indicate the applicability of this perfusion model for the in vitro testing of biomaterials.