Immobilization of bioactive complex on the surface of magnesium alloy stent material to simultaneously improve anticorrosion, hemocompatibility and antibacterial activities

A CO-releasing coating based on carboxymethyl chitosan-functionalized graphene oxide for improving the anticorrosion and biocompatibility of magnesium alloy stent materials

Due to its biofunctions similar to NO, the CO gas signaling molecule has gradually shown great potential in cardiovascular biomaterials for regulating the in vivo performances after the implantation and has received increasing attention. To construct a bioactive surface with CO-releasing properties on the surface of magnesium-based alloy to augment the anticorrosion and biocompatibility, graphene oxide (GO) was firstly modified using carboxymethyl chitosan (CS), and then CO-releasing molecules (CORM401) were introduced to synthesize a novel biocompatible nanomaterial (GOCS-CO) that can release CO in the physiological environments. The GOCS-CO was further immobilized on the magnesium alloy surface modified by polydopamine coating with Zn2+ (PDA/Zn) to create a bioactive surface capable of releasing CO in the physiological environment. The outcomes showed that the CO-releasing coating can not only significantly enhance the anticorrosion and abate the corrosion degradation rate of the magnesium alloy in a simulated physiological environment, but also endow it with good hydrophilicity and a certain ability to adsorb albumin selectively. Owing to the significant enhancement of anticorrosion and hydrophilicity, coupled with the bioactivity of GOCS, the modified sample not only showed excellent ability to prevent platelet adhesion and activation and reduce hemolysis rate but also can promote endothelial cell (EC) adhesion, proliferation as well as the expression of nitric oxide (NO) and vascular endothelial growth factor (VEGF). In the case of CO release, the hemocompatibility and EC growth behaviors were further significantly improved, suggesting that CO molecules released from the surface can significantly improve the hemocompatibility and EC growth. Consequently, the present study provides a novel surface modification method that can simultaneously augment the anticorrosion and biocompatibility of magnesium-based alloys, which will strongly promote the research and application of CO-releasing bioactive coatings for surface functionalization of cardiovascular biomaterials and devices.

Composite Nanocoatings of Biomedical Magnesium Alloy Implants: Advantages, Mechanisms, and Design Strategies

The rapid degradation of magnesium (Mg) alloy implants erodes mechanical performance and interfacial bioactivity, thereby limiting their clinical utility. Surface modification is among the solutions to improve corrosion resistance and bioefficacy of Mg alloys. Novel composite coatings that incorporate nanostructures create new opportunities for their expanded use. Particle size dominance and impermeability may increase corrosion resistance and thereby prolong implant service time. Nanoparticles with specific biological effects may be released into the peri-implant microenvironment during the degradation of coatings to promote healing. Composite nanocoatings provide nanoscale surfaces to promote cell adhesion and proliferation. Nanoparticles may activate cellular signaling pathways, while those with porous or core-shell structures may carry antibacterial or immunomodulatory drugs. Composite nanocoatings may promote vascular reendothelialization and osteogenesis, attenuate inflammation, and inhibit bacterial growth, thus increasing their applicability in complex clinical microenvironments such as those of atherosclerosis and open fractures. This review combines the physicochemical properties and biological efficiency of Mg-based alloy biomedical implants to summarize the advantages of composite nanocoatings, analyzes their mechanisms of action, and proposes design and construction strategies, with the purpose of providing a reference for promoting the clinical application of Mg alloy implants and to further the design of nanocoatings.

Influence of different postballoon expansion procedures: A finite element analysis

BACKGROUND

Postballoon expansion is considered as an appropriate procedure for adequate stent expansion for coronary bifurcation lesions. Two postballoon expansion procedures are currently recommended: proximal optimization technique (POT)/side/POT and POT/kiss/POT. However, the effects of the two postballoon expansion treatments are different. There is a lack of biomechanical study to quantify the difference.

PURPOSE

It is recognized that biomechanical factors influence the occurrence of Major Cardiovascular Adverse Events (MACE), which includes recurrent angina pectoris, acute myocardial infarction and coronary heart disease death. The current paper evaluated the two postexpansion strategies and quantified biomechanical parameters to provide a basis for clinical decisions.

METHODS

Based on the CT angiography (CTA) data of a patient diagnosed with coronary bifurcation lesions, a personalized coronary bifurcation lesion model was constructed, and the surgical procedure after two expansions was simulated. The POT/side/POT and POT/kiss/POT expansion procedures were analyzed from the perspective of biomechanics through finite element analysis. The biomechanics factors, including the percentage of stent malapposition and stent occlusion at the side branch (SB) opening, the stent ellipse index of proximal main vessel (PMV) segment, the minimum lumen area of the stent vessel segment and the stress distribution of the vessel wall, were used to quantify clinician concerns about factors affecting patient outcomes. The factors include stent adhesion, SB open stent occlusion, poor stent deformation, patency effect of vessel stenosis, and vessel wall damage.

RESULTS

Both postexpansion procedures were successfully simulated. The malapposition rate during POT/side/POT was larger (1.2% vs. 0.42%) and stent occlusion at the SB opening from the cross-section perpendicular to the SB opening after the POT/side/POT procedure was 0.20%, compared with 0.00% after POT/kiss/POT. POT/kiss/POT produced a larger PMV segment stent ellipse index. Minimum lumen area after POT/side/POT was 5.6 mm² and after POT/kiss/POT 5.9 mm² . POT/kiss/POT produces an effect of greater vascular stress than POT/side/POT.

CONCLUSION

Numerical simulations provide a quantitative analysis to inform clinicians of the differences between preoperative planning and surgical procedures. Biomechanical analysis of the differences between the two postexpansion strategies found that the POT/kiss/POT procedure resulted in better stent fit, less occlusion of the SB open stent and better vascular patency but also resulted in poor stent deformation and caused greater vessel wall stress. The current study informs rationales for clinical understanding of postexpansion strategies.

Copper-doped zeolitic imidazolate frameworks-8/hydroxyapatite composite coating endows magnesium alloy with excellent corrosion resistance, antibacterial ability and biocompatibility

Magnesium (Mg) and its alloys exhibit an excellent prospect for orthopedic clinical application due to their outstanding biodegradability and mechanical adaptability. However, the rapid corrosion rate/latent device-associated infections may lead to a failed internal fixation of Mg-based implants. Herein, a novel composite coating consisted of outer copper-doped zeolitic imidazolate frameworks-8 and inner hydroxyapatite (Cu@ZIF-8/HA) was in situ constructed on AZ31B Mg alloy via a two-step approach of hydrothermal treatment and seeded solvothermal method. The results verified that the electrochemical impedance of the obtained Cu45@ZIF-8/HA composite coating increased by two orders of magnitude to 6.6013 × 104 Ω·cm2 compared to that of bare Mg alloy. This was attributed to the reduced particle size of ZIF-8 nanoparticles due to the doped copper ions, which could be effectively grown in situ on the micro-nano flower-like structure of the HA-coated Mg alloy. Meanwhile, the Cu@ZIF-8/HA coating exhibited excellent antibacterial properties due to the release of copper ions and zinc ions from Cu@ZIF-8 dissolved in bacterial culture solution. The ICP results unraveled that the released concentration of copper and zinc ions could enhance the activity of alkaline phosphatase in the appropriate range during MC3T3-E1 cell culture in vitro for 7 days. This research revealed that the preparation of multifunctional metal-organic frameworks coating doped with antimicrobial metal ions via the seed layer solvothermal method was significant for studying the antimicrobial properties, osteogenic performance and corrosion resistance of Mg-based bioactive coatings.

Systems, Properties, Surface Modification and Applications of Biodegradable Magnesium-Based Alloys: A Review

In recent years, biodegradable magnesium (Mg) alloys have attracted the attention of many researchers due to their mechanical properties, excellent biocompatibility and unique biodegradability. Many Mg alloy implants have been successfully applied in clinical medicine, and they are considered to be promising biological materials. In this article, we review the latest research progress in biodegradable Mg alloys, including research on high-performance Mg alloys, bioactive coatings and actual or potential clinical applications of Mg alloys. Finally, we review the research and development direction of biodegradable Mg alloys. This article has a guiding significance for future development and application of high-performance biodegradable Mg alloys, promoting the future advancement of the magnesium alloy research field, especially in biomedicine.

Dual Synergistic Effects of MgO-GO Fillers on Degradation Behavior, Biocompatibility and Antibacterial Activities of Chitosan Coated Mg Alloy

The aim of this work was to establish and characterize chitosan/graphene oxide- magnesium oxide (CS/GO-MgO) nanocomposite coatings on biodegradable magnesium-zinc-cerium (Mg-Zn-Ce) alloy. In comparison to that of pure CS coatings, all composite coatings encapsulating GO-MgO had better adhesion strength to the Mg-Zn-Ce alloy substrate. The result depicted that the co-encapsulation of GO-MgO into the CS layer leads to diminish of contact angle value and hence escalates the hydrophilic characteristic of coated Mg alloy. The electrochemical test demonstrated that the CS/GO-MgO coatings significantly increased the corrosion resistance because of the synergistic effect of the GO and MgO inside the CS coating. The composite coating escalated cell viability and cell differentiation, according to cytocompatibility tests due to the presence of GO and MgO within the CS. The inclusion of GO-MgO in CS film, on the other hand, accelerates the formation of hydroxyapatite (HA) during 14 days immersion in SBF. Immersion results, including weight loss and hydrogen evolution tests, presented that CS/GO-MgO coating enables a considerably reduced degradation rate of Mg-Zn-Ce alloy when compared to the bare alloy. In terms of antibacterial-inhibition properties, the GO-MgO/CS coatings on Mg substrates showed antibacterial activity against Escherichia coli (E. coli), with a large inhibition area around the specimens, particularly for the coating containing a higher concentration of GO-MgO. Bacterial growth was not inhibited by the bare Mg alloy samples. The CS/GO-MgO composite coating is regarded as a great film to enhance the corrosion resistance, bioactivity, and antibacterial performance of Mg alloy implants.

Advances in coatings on magnesium alloys for cardiovascular stents - A review

Magnesium (Mg) and its alloys, as potential biodegradable materials, have drawn wide attention in the cardiovascular stent field because of their appropriate mechanical properties and biocompatibility. Nevertheless, the occurrence of thrombosis, inflammation, and restenosis of implanted Mg alloy stents caused by their poor corrosion resistance and insufficient endothelialization restrains their anticipated clinical applications. Numerous surface treatment tactics have mainly striven to modify the Mg alloy for inhibiting its degradation rate and enduing it with biological functionality. This review focuses on highlighting and summarizing the latest research progress in functionalized coatings on Mg alloys for cardiovascular stents over the last decade, regarding preparation strategies for metal oxide, metal hydroxide, inorganic nonmetallic, polymer, and their composite coatings; and the performance of these strategies in regulating degradation behavior and biofunction. Potential research direction is also concisely discussed to help guide biological functionalized strategies and inspire further innovations. It is hoped that this review can give assistance to the surface modification of cardiovascular Mg-based stents and promote future advancements in this emerging research field.

Apatite Formation Induced by Chitosan/Gelatin Hydrogel Coating Anchored on Poly(aryl ether nitrile ketone) Substrates to Promote Osteoblastic Differentiation

Bone-like apatite is a promising coating of poly(ether ether ketone) (PEEK) for bone implantation. Poly(aryl ether nitrile ketone) containing phthalazinone moiety (PPENK) is a novel alternative for its easy synthesis. Here, chitosan/gelatin hybrid hydrogel coating is applied to induce the formation of apatite on the surface of PPENK substrate through biomineralization to improve its biocompatibility and osteogenic property. PPENK possessing allyl groups (PPENK-d) are synthesized and spin-coated on PPENK substrate to impart reactive groups. The hydrogel coating is prepared by the ultraviolet crosslinking of gelatin methacrylate (GelMA) and chitosan methacrylate (CSMA) on PPENK substrate. PPENK-d, GelMA, and CSMA are characterized by ¹ H-NMR to confirm the designed structures. The presence of chitosan increases the chelation of calcium ions and thus induces the nucleation of apatite. The microstructural and compositional results reveal that the chitosan-containing hydrogel coating induced apatite coating yields a higher apatite quantity compared to the gelatin hydrogel coating. The apatite coatings on PPENK substrate promote the cytocompatibility and osteogenesis of MC3T3-E1 preosteoblasts in vitro.