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Pichon TJ, White NJ, Pun SH. ENGINEERED INTRAVENOUS THERAPIES FOR TRAUMA. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2023; 27:100456. [PMID: 37456984 PMCID: PMC10343715 DOI: 10.1016/j.cobme.2023.100456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Trauma leading to severe hemorrhage and shock on average kills patients within 3 to 6 hours after injury. With average prehospital transport times reaching 1-6 hours in low- to middle-income countries, stopping the bleeding and reversing hemorrhagic shock is vital. First-generation intravenous hemostats rely on traditional drug delivery platforms, such as self-assembling systems, fabricated nanoparticles, and soluble polymers due to their active targeting, biodistribution, and safety. We discuss some challenges translating these therapies to patients, as very few have successfully made it through preclinical evaluation in large-animals, and none have translated to the clinic. Finally, we discuss the physiology of hemorrhagic shock, highlight a new low volume resuscitant (LVR) PEG-20k, and end with considerations for the rational design of LVRs.
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Affiliation(s)
- Trey J. Pichon
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, 3720 15 Avenue NE, Box 355061, Seattle, Washington 98105, United States
- Resuscitation Engineering Science Unit (RESCU), Harborview Research and Training Building, Seattle, Washington 98104, United States
| | - Nathan J. White
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington 98105, United States
- Resuscitation Engineering Science Unit (RESCU), Harborview Research and Training Building, Seattle, Washington 98104, United States
| | - Suzie H. Pun
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, 3720 15 Avenue NE, Box 355061, Seattle, Washington 98105, United States
- Resuscitation Engineering Science Unit (RESCU), Harborview Research and Training Building, Seattle, Washington 98104, United States
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2
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Han CY, Wang X, Ringgold KM, Bennett JC, St John AE, Berenson R, Stern SA, White NJ. A novel melanocortin fusion protein inhibits fibrinogen oxidation and degradation during trauma-induced coagulopathy. Blood 2023; 142:724-741. [PMID: 37363829 DOI: 10.1182/blood.2022019164] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/04/2023] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
Immune cell inflammation is implicated in the pathophysiology of acute trauma-induced coagulopathy (TIC). We hypothesized that leukocyte inflammation contributes to TIC through the oxidation and proteolysis of fibrinogen. To test this hypothesis, antioxidants and a novel anti-inflammatory melanocortin fusion protein (AQB-565) were used to study the effects of interleukin-6 (IL-6)-stimulated human leukocytes on fibrinogen using single-cell imaging flow cytometry and multiplex fluorescent western blotting. We also studied the effects of AQB-565 on fibrinogen using an in vivo rat trauma model of native TIC. IL-6 induced cellular inflammation and mitochondrial superoxide production in human monocytes, causing fibrinogen oxidation and degradation in vitro. Antioxidants suppressing mitochondrial superoxide reduced oxidative stress and inflammation and protected fibrinogen. AQB-565 decreased inflammation, inhibited mitochondrial superoxide, and protected fibrinogen in vitro. Trauma with hemorrhagic shock increased IL-6 and other proinflammatory cytokines and chemokines, selectively oxidized and degraded fibrinogen, and induced TIC in rats in vivo. AQB-565, given at the onset of hemorrhage, blocked inflammation, protected fibrinogen from oxidation and degradation, and prevented TIC. Leukocyte activation contributes to TIC through the oxidation and degradation of fibrinogen, which involves mitochondrial superoxide and cellular inflammation. Suppression of inflammation by activation of melanocortin pathways may be a novel approach for the prevention and treatment of TIC.
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Affiliation(s)
- Chang Yeop Han
- Department of Emergency Medicine and Resuscitation Engineering Science Unit, University of Washington School of Medicine, Seattle, WA
| | - Xu Wang
- Department of Emergency Medicine and Resuscitation Engineering Science Unit, University of Washington School of Medicine, Seattle, WA
| | - Kristyn M Ringgold
- Department of Emergency Medicine and Resuscitation Engineering Science Unit, University of Washington School of Medicine, Seattle, WA
| | - Jennifer C Bennett
- Department of Emergency Medicine and Resuscitation Engineering Science Unit, University of Washington School of Medicine, Seattle, WA
| | - Alexander E St John
- Department of Emergency Medicine and Resuscitation Engineering Science Unit, University of Washington School of Medicine, Seattle, WA
| | | | - Susan A Stern
- Department of Emergency Medicine and Resuscitation Engineering Science Unit, University of Washington School of Medicine, Seattle, WA
| | - Nathan J White
- Department of Emergency Medicine and Resuscitation Engineering Science Unit, University of Washington School of Medicine, Seattle, WA
- Bloodworks Northwest Research Institute, Seattle, WA
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3
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Chen Z, Han L, Meng G, Li H, Shan C, Du G, Li M. Intravenous Hemostats: Foundation, Targeting, and Controlled-Release. Bioconjug Chem 2022; 33:2269-2289. [PMID: 36404605 DOI: 10.1021/acs.bioconjchem.2c00492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Uncontrollable blood loss is the greatest cause of mortality in prehospital patients and the main source of disability and death in hospital care. Compared with external hemostats, intravenous hemostats are more appropriate for preventing and treating uncontrolled bleeding in vivo and large bleeding on the body surface. This Review initially establishes intravenous hemostats' response basis, including the coagulation mechanism, fibrinolytic pathway, and protein corona. Second, the study of advancement of intravenous hemostat targeting was expanded from two perspectives, cellular hemostatic agents and synthetic hemostatic agents. Meanwhile, after discussing the progress of controlled-release intravenous hemostats with platelets as the stimuli, this Review offers insight into the possibility of controlled-release intravenous hemostats with microenvironment as the stimuli, combining the studies of controlled-release targeted thrombolysis.
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Affiliation(s)
- Zihao Chen
- Department of Special Operations Medicine, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Lei Han
- Department of Special Operations Medicine, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Guo Meng
- Department of Special Operations Medicine, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Huaiyong Li
- Department of Special Operations Medicine, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Chao Shan
- Department of Special Operations Medicine, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Ge Du
- Department Of Geriatric Rehabilitation Center, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144, China
| | - Minggao Li
- Department of Special Operations Medicine, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China
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Leukocyte activation primes fibrinogen for proteolysis by mitochondrial oxidative stress. Redox Biol 2022; 51:102263. [PMID: 35158163 PMCID: PMC8844908 DOI: 10.1016/j.redox.2022.102263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 11/21/2022] Open
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5
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Engineered Molecular Therapeutics Targeting Fibrin and the Coagulation System: a Biophysical Perspective. Biophys Rev 2022; 14:427-461. [PMID: 35399372 PMCID: PMC8984085 DOI: 10.1007/s12551-022-00950-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/25/2022] [Indexed: 02/07/2023] Open
Abstract
The coagulation cascade represents a sophisticated and highly choreographed series of molecular events taking place in the blood with important clinical implications. One key player in coagulation is fibrinogen, a highly abundant soluble blood protein that is processed by thrombin proteases at wound sites, triggering self-assembly of an insoluble protein hydrogel known as a fibrin clot. By forming the key protein component of blood clots, fibrin acts as a structural biomaterial with biophysical properties well suited to its role inhibiting fluid flow and maintaining hemostasis. Based on its clinical importance, fibrin is being investigated as a potentially valuable molecular target in the development of coagulation therapies. In this topical review, we summarize our current understanding of the coagulation cascade from a molecular, structural and biophysical perspective. We highlight single-molecule studies on proteins involved in blood coagulation and report on the current state of the art in directed evolution and molecular engineering of fibrin-targeted proteins and polymers for modulating coagulation. This biophysical overview will help acclimatize newcomers to the field and catalyze interdisciplinary work in biomolecular engineering toward the development of new therapies targeting fibrin and the coagulation system.
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Ghimire S, Sarkar P, Rigby K, Maan A, Mukherjee S, Crawford KE, Mukhopadhyay K. Polymeric Materials for Hemostatic Wound Healing. Pharmaceutics 2021; 13:2127. [PMID: 34959408 PMCID: PMC8708336 DOI: 10.3390/pharmaceutics13122127] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 02/04/2023] Open
Abstract
Hemorrhage is one of the greatest threats to life on the battlefield, accounting for 50% of total deaths. Nearly 86% of combat deaths occur within the first 30 min after wounding. While external wound injuries can be treated mostly using visual inspection, abdominal or internal hemorrhages are more challenging to treat with regular hemostatic dressings because of deep wounds and points of injury that cannot be located properly. The need to treat trauma wounds from limbs, abdomen, liver, stomach, colon, spleen, arterial, venous, and/or parenchymal hemorrhage accompanied by severe bleeding requires an immediate solution that the first responders can apply to reduce rapid exsanguinations from external wounds, including in military operations. This necessitates the development of a unique, easy-to-use, FDA-approved hemostatic treatment that can deliver the agent in less than 30 s and stop bleeding within the first 1 to 2 min at the point of injury without application of manual pressure on the wounded area.
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Affiliation(s)
- Suvash Ghimire
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
| | - Pritha Sarkar
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
| | - Kasey Rigby
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
| | - Aditya Maan
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
- Department of Chemistry, University of Central Florida, Orlando, FL 32816, USA
| | - Santanu Mukherjee
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
| | - Kaitlyn E. Crawford
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
- Department of Chemistry, University of Central Florida, Orlando, FL 32816, USA
- NanoScience Technology Center, University of Central Florida, Orlando, FL 32816, USA
- Biionix Cluster, University of Central Florida, Orlando, FL 32816, USA
| | - Kausik Mukhopadhyay
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
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7
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Cau MF, Strilchuk AW, Kastrup CJ. Nanomedicines for hemorrhage control. J Thromb Haemost 2021; 19:887-891. [PMID: 33694243 DOI: 10.1111/jth.15211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Massimo F Cau
- Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
| | - Amy W Strilchuk
- Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
| | - Christian J Kastrup
- Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
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8
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Lamm RJ, Pichon TJ, Huyan F, Wang X, Prossnitz AN, Manner KT, White NJ, Pun SH. Optimizing the Polymer Chemistry and Synthesis Method of PolySTAT, an Injectable Hemostat. ACS Biomater Sci Eng 2020; 6:7011-7020. [PMID: 33320636 DOI: 10.1021/acsbiomaterials.0c01189] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
There is a lack of prehospital hemostatic agents, especially for noncompressible hemorrhage. We previously reported PolySTAT, a unimeric, injectable hemostatic agent, that physically cross-links fibrin to strengthen clots. In this work, we sought to improve the water-solubility and synthesis yield of PolySTAT to increase the likelihood of clinical translation, reduce cost, and facilitate future mass production. First, we focused on side-chain engineering of the carrier polymer backbone to improve water-solubility. We found that substitution of the 2-hydroxyethyl methacrylate (HEMA) monomer with glycerol monomethacrylate (GmMA) significantly improved the water-solubility of PolySTAT without compromising efficacy. Both materials increased clot firmness and decreased lysis as measured by rotational thromboelastometry (ROTEM). Additionally, we confirmed the in vivo activity of GmMA-based PolySTAT by improving rat survival in a femoral artery bleed model. Second, to reduce waste, we evaluated PolySTAT synthesis via direct polymerization of peptide monomers. Methacrylamide and methacrylate peptide-monomers were synthesized and polymerized via reversible addition-fragmentation chain transfer (RAFT) polymerization. This approach markedly improved the yield of PolySTAT synthesis while maintaining its biological activity in ROTEM. This work demonstrates the flexibility of PolySTAT to a variety of comonomers and synthetic routes and establishes direct RAFT polymerization of peptide monomers as a potential route of mass production.
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Affiliation(s)
- Robert J Lamm
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, 3720 15th Avenue NE, Box 355061, Seattle, Washington 98195, United States
| | - Trey J Pichon
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, 3720 15th Avenue NE, Box 355061, Seattle, Washington 98195, United States
| | - Frederick Huyan
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, 3720 15th Avenue NE, Box 355061, Seattle, Washington 98195, United States
| | - Xu Wang
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington 98195, United States
| | - Alexander N Prossnitz
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, 3720 15th Avenue NE, Box 355061, Seattle, Washington 98195, United States
| | - Karl T Manner
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, 3720 15th Avenue NE, Box 355061, Seattle, Washington 98195, United States
| | - Nathan J White
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington 98195, United States
| | - Suzie H Pun
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, 3720 15th Avenue NE, Box 355061, Seattle, Washington 98195, United States
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9
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Lee J, Zhao T, Peeler DJ, Lee DC, Pichon TJ, Li D, Weigandt KM, Horner PJ, Pozzo LD, Sellers DL, Pun SH. Formulation of thrombin-inhibiting hydrogels via self-assembly of ionic peptides with peptide-modified polymers. SOFT MATTER 2020; 16:3762-3768. [PMID: 32239011 PMCID: PMC7204513 DOI: 10.1039/d0sm00209g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cell therapy for spinal cord injuries offers the possibility of replacing lost cells after trauma to the central nervous system (CNS). In preclinical studies, synthetic hydrogels are often co-delivered to the injury site to support survival and integration of the transplanted cells. These hydrogels ideally mimic the mechanical and biochemical features of a healthy CNS extracellular matrix while also providing the possibility of localized drug delivery to promote healing. In this work, we synthesize peptide-functionalized polymers that contain both a peptide sequence for incorporation into self-assembled peptide hydrogels along with bioactive peptides that inhibit scar formation. We demonstrate that peptide hydrogels formulated with the peptide-functionalized polymers possess similar mechanical properties (soft and shear-thinning) as peptide-only hydrogels. Small angle neutron scattering analysis reveals that polymer-containing hydrogels possess larger inhomogeneous domains but small-scale features such as mesh size remain the same as peptide-only hydrogels. We further confirm that the integrated hydrogels containing bioactive peptides exhibit thrombin inhibition activity, which has previously shown to reduce scar formation in vivo. Finally, while the survival of encapsulated cells was poor, cells cultured on the hydrogels exhibited good viability. Overall, the described composite hydrogels formed from self-assembling peptides and peptide-modified polymers are promising, user-friendly materials for CNS applications in regeneration.
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Affiliation(s)
- Jason Lee
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA.
| | - Tianyu Zhao
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA.
| | - David J Peeler
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA.
| | - Daniel C Lee
- Molecular Engineering and Sciences, University of Washington, Seattle, WA 98195, USA
| | - Trey J Pichon
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA.
| | - David Li
- Department of Chemical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Kathleen M Weigandt
- NIST Center for Neutron Research, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - Philip J Horner
- Center for Neuroregeneration and Department of Neurosurgery, Houston Methodist Research Institute, Houston, TX 77030, USA
| | - Lilo D Pozzo
- Department of Chemical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Drew L Sellers
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA.
| | - Suzie H Pun
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA. and Molecular Engineering and Sciences, University of Washington, Seattle, WA 98195, USA
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Abstract
Hemorrhage is the leading cause of preventable death in combat trauma and the secondary cause of death in civilian trauma. A significant number of deaths due to hemorrhage occur before and in the first hour after hospital arrival. A literature search was performed through PubMed, Scopus, and Institute of Scientific Information databases for English language articles using terms relating to hemostatic agents, prehospital, battlefield or combat dressings, and prehospital hemostatic resuscitation, followed by cross-reference searching. Abstracts were screened to determine relevance and whether appropriate further review of the original articles was warranted. Based on these findings, this paper provides a review of a variety of hemostatic agents ranging from clinically approved products for human use to newly developed concepts with great potential for use in prehospital settings. These hemostatic agents can be administered either systemically or locally to stop bleeding through different mechanisms of action. Comparisons of current hemostatic products and further directions for prehospital hemorrhage control are also discussed.
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Affiliation(s)
- Henry T Peng
- Defence Research and Development Canada, Toronto Research Centre, 1133 Sheppard Avenue West, Toronto, ON, M3K 2C9, Canada.
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11
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Roberts IV, Bukhary D, Valdivieso CYL, Tirelli N. Fibrin Matrices as (Injectable) Biomaterials: Formation, Clinical Use, and Molecular Engineering. Macromol Biosci 2019; 20:e1900283. [PMID: 31769933 DOI: 10.1002/mabi.201900283] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/14/2019] [Indexed: 12/19/2022]
Abstract
This review focuses on fibrin, starting from biological mechanisms (its production from fibrinogen and its enzymatic degradation), through its use as a medical device and as a biomaterial, and finally discussing the techniques used to add biological functions and/or improve its mechanical performance through its molecular engineering. Fibrin is a material of biological (human, and even patient's own) origin, injectable, adhesive, and remodellable by cells; further, it is nature's most common choice for an in situ forming, provisional matrix. Its widespread use in the clinic and in research is therefore completely unsurprising. There are, however, areas where its biomedical performance can be improved, namely achieving a better control over mechanical properties (and possibly higher modulus), slowing down degradation or incorporating cell-instructive functions (e.g., controlled delivery of growth factors). The authors here specifically review the efforts made in the last 20 years to achieve these aims via biomimetic reactions or self-assembly, as much via formation of hybrid materials.
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Affiliation(s)
- Iwan Vaughan Roberts
- Division of Pharmacy and Optometry, School of Health Science, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Deena Bukhary
- Division of Pharmacy and Optometry, School of Health Science, University of Manchester, Oxford Road, Manchester, M13 9PT, UK.,Department of Pharmaceutical Science, Faculty of Pharmacy, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | | | - Nicola Tirelli
- Division of Pharmacy and Optometry, School of Health Science, University of Manchester, Oxford Road, Manchester, M13 9PT, UK.,Laboratory of Polymers and Biomaterials, Fondazione Istituto Italiano di Tecnologia, via Morego 30, 16163, Genova, Italy
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12
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Liu GW, Prossnitz AN, Eng DG, Cheng Y, Subrahmanyam N, Pippin JW, Lamm RJ, Ngambenjawong C, Ghandehari H, Shankland SJ, Pun SH. Glomerular disease augments kidney accumulation of synthetic anionic polymers. Biomaterials 2018; 178:317-325. [DOI: 10.1016/j.biomaterials.2018.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/31/2018] [Accepted: 06/02/2018] [Indexed: 12/22/2022]
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13
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Mizuta R, Taguchi T. Hemostatic properties of in situ gels composed of hydrophobically modified biopolymers. J Biomater Appl 2018; 33:315-323. [DOI: 10.1177/0885328218790313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Hemorrhaging often occurs during cardiac surgery, and postoperative bleeding is associated with medical complications or even death. Medical complications resulting from hemorrhaging can lead to longer hospital stays, thus increasing costs. Hemostatic agents are the main treatment for bleeding. In the present study, hemostatic agents composed of aldehyde groups and hydrophobically modified with hyaluronic acid (ald-hm-HyA) and hydrophobically modified gelatin (hm-ApGltn) were developed and their hemostatic effects were evaluated. These modified hemostatic agents formed more stable blood clots compared with the nonhydrophobically modified HyA-based hemostatic agent. The bulk strength of the whole blood clot using the aldehyde and stearoyl group-modified hyaluronic acid (ald-C18-HyA)/hm-ApGltn-based hemostatic agent was higher than that of the aldehyde group only modified HyA (ald-HyA)/hm-ApGltn-based hemostatic agent. Rheological experiments using α-cyclodextrin showed that hydrophobic modification of HyA with C18 groups effectively enhanced anchoring to the red blood cell surface. Therefore, the ald-hm-HyA/hm-ApGltn-based hemostatic agent has potential applications in cardiac surgery.
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Affiliation(s)
- Ryo Mizuta
- Graduate School of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Biomaterials Field, Research Center for Functional Materials, National Institute for Materials Science, Tsukuba, Ibaraki, Japan
| | - Tetsushi Taguchi
- Graduate School of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Biomaterials Field, Research Center for Functional Materials, National Institute for Materials Science, Tsukuba, Ibaraki, Japan
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14
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Deci MB, Ferguson SW, Scatigno SL, Nguyen J. Modulating Macrophage Polarization through CCR2 Inhibition and Multivalent Engagement. Mol Pharm 2018; 15:2721-2731. [PMID: 29791797 DOI: 10.1021/acs.molpharmaceut.8b00237] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Excessive or prolonged recruitment of inflammatory monocytes to damaged tissue can significantly worsen patient outcomes. Monocytes migrate to sites of tissue inflammation in response to high local concentrations of CCL2, a chemokine that binds to and signals through the CCR2 receptor. While the role of CCR2 in cellular migration is well studied, it is unclear how CCR2 inhibition affects macrophage polarization and if multivalency can increase downstream signaling effects. Using affinity selection with a phage library, we identified a novel single-chain variable fragment (scFv) (58C) that binds specifically and with high affinity to the N-terminal domain of CCR2 ( KD = 59.8 nM). The newly identified 58C-scFv bound to native CCR2 expressed on macrophages and MDA-MB-231 cells, inhibited migration, and induced a pro-inflammatory M1-phenotype in macrophages. The M1/M2 macrophage phenotype ratio for monomeric 58C-scFv was significantly increased over the negative control by 1.0 × 104-fold (iNOS/Arg-1), 5.1 × 104-fold (iNOS/Mgl2), 3.4 × 105-fold (IL-6/Arg-1), and 1.7 × 106-fold (IL-6/Mgl2). The multivalent display of 58C-scFv on liposomes further reduced migration of both cell types by 25-40% and enhanced M1 polarization by 200% over monomeric 58C-scFv. These studies demonstrate that CCR2 inhibition polarizes macrophages toward an inflammatory M1 phenotype, and that multivalent engagement of CCR2 increases the effects of 58C-scFv on polarization and migration. These data provide important insights into the role of multivalency in modulating binding, downstream signaling, and cellular fate.
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Affiliation(s)
- Michael B Deci
- Department of Pharmaceutical Sciences, School of Pharmacy , University at Buffalo, The State University of New York , Buffalo , NY 14214 , United States
| | - Scott W Ferguson
- Department of Pharmaceutical Sciences, School of Pharmacy , University at Buffalo, The State University of New York , Buffalo , NY 14214 , United States
| | - Sydney L Scatigno
- Department of Pharmaceutical Sciences, School of Pharmacy , University at Buffalo, The State University of New York , Buffalo , NY 14214 , United States
| | - Juliane Nguyen
- Department of Pharmaceutical Sciences, School of Pharmacy , University at Buffalo, The State University of New York , Buffalo , NY 14214 , United States
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