1
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Lee PY, Bello J, Ye C, Varadarajan S, Hossain A, Jumkhawala S, Sharma A, Allencherril J. Safety of routine protamine in the reversal of heparin in percutaneous coronary intervention: A systematic review and meta-analysis. Int J Cardiol 2023; 388:131168. [PMID: 37429445 DOI: 10.1016/j.ijcard.2023.131168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVES To determine the safety and efficacy of protamine in the reversal of heparin in percutaneous coronary intervention (PCI). BACKGROUND Heparin is routinely used for anticoagulation in PCI. Protamine is not used routinely to reverse heparin's effects in PCI, partly due to the perceived risk of stent thrombosis. METHODS Relevant studies published in English were searched for in PubMed, Embase, and Cochrane databases from inception to April 26th, 2023. Our primary outcome of interest was stent thrombosis in patients receiving PCI for all indications. Secondary outcomes included mortality, major bleeding complications, and hospitalization length. Dichotomous outcomes were analyzed using a Mantel-Haenszel random-effects model and expressed as odds ratios (OR) with their 95% confidence intervals (CI), while continuous outcomes were analyzed using an inverse variance random-effects model expressed as mean differences (MD) with their 95% CI. RESULTS 11 studies were included in our analysis. Protamine use was not associated with stent thrombosis: OR 0.58, 95% CI: 0.33, 1.01 (p = 0.05) nor with mortality (p = 0.89). Protamine administration was associated with a decreased incidence of major bleeding complications: OR 0.48; 95% CI: 0.25, 0.95 (p = 0.03) and decreased length of hospitalization (p < 0.0001). CONCLUSIONS In patients pre-treated with dual antiplatelet therapy (DAPT), protamine may be a safe and efficacious option to facilitate earlier sheath removal, reduce major bleeding complications, and reduce length of hospitalization without increased risk of stent thrombosis.
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Affiliation(s)
- Paul Y Lee
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Juan Bello
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Catherine Ye
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
| | | | - Afif Hossain
- Department of Cardiology, Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Saahil Jumkhawala
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Abhishek Sharma
- Department of Cardiology, Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Joseph Allencherril
- Department of Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX, USA.
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2
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Danek BA, Kearney KE, Chung CJ, Steinberg Z, Lombardi WL, McCabe JM, Azzalini L. The contemporary role of protamine in the cardiac catheterization laboratory. Catheter Cardiovasc Interv 2023. [PMID: 37172213 DOI: 10.1002/ccd.30679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/06/2023] [Accepted: 04/28/2023] [Indexed: 05/14/2023]
Abstract
Access to the arterial circulation and full anticoagulation carries a risk of serious bleeding during and after percutaneous coronary intervention. Important sources of bleeding include the arterial access site and coronary artery perforation. Prompt and effective management of hemorrhagic complications is an essential interventional skill. Protamine sulfate is well-known as a heparin reversal agent. Despite this, there is heterogeneity in the use of protamine during interventional procedures. While protamine is generally well-tolerated, it is associated with a risk of hypersensitivity reaction, including anaphylaxis, among others. The purpose of this review is to summarize the existing evidence about and experience with the use of protamine sulfate in the setting of percutaneous coronary and structural interventional procedures.
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Affiliation(s)
- Barbara A Danek
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Kathleen E Kearney
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Christine J Chung
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Zachary Steinberg
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - William L Lombardi
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - James M McCabe
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Lorenzo Azzalini
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
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3
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Chi M, Qi M, A L, Wang P, Weir MD, Melo MA, Sun X, Dong B, Li C, Wu J, Wang L, Xu HHK. Novel Bioactive and Therapeutic Dental Polymeric Materials to Inhibit Periodontal Pathogens and Biofilms. Int J Mol Sci 2019; 20:E278. [PMID: 30641958 PMCID: PMC6359151 DOI: 10.3390/ijms20020278] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 12/19/2022] Open
Abstract
Periodontitis is a common infectious disease characterized by loss of tooth-supporting structures, which eventually leads to tooth loss. The heavy burden of periodontal disease and its negative consequence on the patient's quality of life indicate a strong need for developing effective therapies. According to the World Health Organization, 10⁻15% of the global population suffers from severe periodontitis. Advances in understanding the etiology, epidemiology and microbiology of periodontal pocket flora have called for antibacterial therapeutic strategies for periodontitis treatment. Currently, antimicrobial strategies combining with polymer science have attracted tremendous interest in the last decade. This review focuses on the state of the art of antibacterial polymer application against periodontal pathogens and biofilms. The first part focuses on the different polymeric materials serving as antibacterial agents, drug carriers and periodontal barrier membranes to inhibit periodontal pathogens. The second part reviews cutting-edge research on the synthesis and evaluation of a new generation of bioactive dental polymers for Class-V restorations with therapeutic effects. They possess antibacterial, acid-reduction, protein-repellent, and remineralization capabilities. In addition, the antibacterial photodynamic therapy with polymeric materials against periodontal pathogens and biofilms is also briefly described in the third part. These novel bioactive and therapeutic polymeric materials and treatment methods have great potential to inhibit periodontitis and protect tooth structures.
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Affiliation(s)
- Minghan Chi
- Department of Oral Implantology, School of Dentistry, Jilin University, Changchun 130021, China.
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun 130021, China.
| | - Manlin Qi
- Department of Oral Implantology, School of Dentistry, Jilin University, Changchun 130021, China.
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun 130021, China.
| | - Lan A
- Department of Oral Implantology, School of Dentistry, Jilin University, Changchun 130021, China.
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun 130021, China.
| | - Ping Wang
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
| | - Michael D Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
| | - Mary Anne Melo
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
| | - Xiaolin Sun
- Department of Oral Implantology, School of Dentistry, Jilin University, Changchun 130021, China.
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun 130021, China.
| | - Biao Dong
- State Key Laboratory on Integrated Optoelectronics, College of Electronic Science and Engineering, Jilin University, Changchun 130012, China.
| | - Chunyan Li
- Department of Oral Implantology, School of Dentistry, Jilin University, Changchun 130021, China.
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun 130021, China.
| | - Junling Wu
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Department of Prosthodontics, School of Stomatology, Shandong University, Jinan 250012, China.
| | - Lin Wang
- Department of Oral Implantology, School of Dentistry, Jilin University, Changchun 130021, China.
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun 130021, China.
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
- Center for Stem Cell Biology and Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
- University of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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4
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Protamine to expedite vascular hemostasis after catheter ablation of atrial fibrillation: A randomized controlled trial. Heart Rhythm 2018; 15:1642-1647. [DOI: 10.1016/j.hrthm.2018.06.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Indexed: 11/18/2022]
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5
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Bioactive Dental Composites and Bonding Agents Having Remineralizing and Antibacterial Characteristics. Dent Clin North Am 2018; 61:669-687. [PMID: 28886763 DOI: 10.1016/j.cden.2017.05.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Current dental restorative materials are typically inert and replace missing tooth structures. This article reviews efforts in the development of a new generation of bioactive materials designed to not only replace the missing tooth volume but also possess therapeutic functions. Composites and bonding agents with remineralizing and antibacterial characteristics have shown promise in replacing lost minerals, inhibiting recurrent caries, neutralizing acids, repelling proteins, and suppressing biofilms and acid production. Furthermore, they have demonstrated a low cytotoxicity similar to current resins, with additional benefits to protect the dental pulp and promote tertiary dentin formation. This new class of bioactive materials shows promise in reversing lesions and inhibiting caries.
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6
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Zhang N, Zhang K, Weir MD, Xu DJ, Reynolds MA, Bai Y, Xu HHK. Effects of water-aging for 6 months on the durability of a novel antimicrobial and protein-repellent dental bonding agent. Int J Oral Sci 2018; 10:18. [PMID: 29925870 PMCID: PMC6010414 DOI: 10.1038/s41368-018-0019-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/27/2017] [Accepted: 08/01/2017] [Indexed: 12/02/2022] Open
Abstract
Biofilms at the tooth-restoration bonded interface can produce acids and cause recurrent caries. Recurrent caries is a primary reason for restoration failures. The objectives of this study were to synthesize a novel bioactive dental bonding agent containing dimethylaminohexadecyl methacrylate (DMAHDM) and 2-methacryloyloxyethyl phosphorylcholine (MPC) to inhibit biofilm formation at the tooth-restoration margin and to investigate the effects of water-aging for 6 months on the dentin bond strength and protein-repellent and antibacterial durability. A protein-repellent agent (MPC) and antibacterial agent (DMAHDM) were added to a Scotchbond multi-purpose (SBMP) primer and adhesive. Specimens were stored in water at 37 °C for 1, 30, 90, or 180 days (d). At the end of each time period, the dentin bond strength and protein-repellent and antibacterial properties were evaluated. Protein attachment onto resin specimens was measured by the micro-bicinchoninic acid approach. A dental plaque microcosm biofilm model was used to test the biofilm response. The SBMP + MPC + DMAHDM group showed no decline in dentin bond strength after water-aging for 6 months, which was significantly higher than that of the control (P < 0.05). The SBMP + MPC + DMAHDM group had protein adhesion that was only 1/20 of that of the SBMP control (P < 0.05). Incorporation of MPC and DMAHDM into SBMP provided a synergistic effect on biofilm reduction. The antibacterial effect and resistance to protein adsorption exhibited no decrease from 1 to 180 d (P > 0.1). In conclusion, a bonding agent with MPC and DMAHDM achieved a durable dentin bond strength and long-term resistance to proteins and oral bacteria. The novel dental bonding agent is promising for applications in preventive and restorative dentistry to reduce biofilm formation at the tooth-restoration margin.
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Affiliation(s)
- Ning Zhang
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
- Biomatexrials & Tissue Engineering Division, Department of Endodontics, Periodontics and Prosthodontics, University of Maryland Dental School, Baltimore, MD, USA
| | - Ke Zhang
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China.
- Biomatexrials & Tissue Engineering Division, Department of Endodontics, Periodontics and Prosthodontics, University of Maryland Dental School, Baltimore, MD, USA.
| | - Michael D Weir
- Biomatexrials & Tissue Engineering Division, Department of Endodontics, Periodontics and Prosthodontics, University of Maryland Dental School, Baltimore, MD, USA
| | - David J Xu
- Biomatexrials & Tissue Engineering Division, Department of Endodontics, Periodontics and Prosthodontics, University of Maryland Dental School, Baltimore, MD, USA
| | - Mark A Reynolds
- Biomatexrials & Tissue Engineering Division, Department of Endodontics, Periodontics and Prosthodontics, University of Maryland Dental School, Baltimore, MD, USA
| | - Yuxing Bai
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China.
| | - Hockin H K Xu
- Biomatexrials & Tissue Engineering Division, Department of Endodontics, Periodontics and Prosthodontics, University of Maryland Dental School, Baltimore, MD, USA.
- Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Mechanical Engineering, University of Maryland, Baltimore County, MD, USA.
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7
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Nanostructured Polymeric Materials with Protein-Repellent and Anti-Caries Properties for Dental Applications. NANOMATERIALS 2018; 8:nano8060393. [PMID: 29865184 PMCID: PMC6027387 DOI: 10.3390/nano8060393] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 05/22/2018] [Accepted: 05/30/2018] [Indexed: 12/13/2022]
Abstract
Dental caries is prevalent worldwide. Tooth cavity restorations cost more than $46 billion annually in the United States alone. The current generation of esthetic polymeric restorations have unsatisfactory failure rates. Replacing the failed restorations accounts for 50–70% of all the restorations. This article reviewed developments in producing a new generation of bioactive and therapeutic restorations. This includes: Protein-repellent and anti-caries polymeric dental composites, especially the use of 2-methacryloyloxyethyl phosphorylcholine (MPC) and dimethylaminododecyl methacrylate (DMAHDM); protein-repellent adhesives to greatly reduce biofilm acids; bioactive cements to inhibit tooth lesions; combining protein-repellency with antibacterial nanoparticles of silver; tooth surface coatings containing calcium phosphate nanoparticles for remineralization; therapeutic restorations to suppress periodontal pathogens; and long-term durability of bioactive and therapeutic dental polymers. MPC was chosen due to its strong ability to repel proteins. DMAHDM was selected because it had the most potent antibacterial activity when compared to a series of antibacterial monomers. The new generation of materials possessed potent antibacterial functions against cariogenic and periodontal pathogens, and reduced biofilm colony-forming units by up to 4 logs, provided calcium phosphate ions for remineralization and strengthening of tooth structures, and raised biofilm pH from a cariogenic pH 4.5 to a safe pH 6.5. The new materials achieved a long-term durability that was significantly beyond current commercial control materials. This new generation of bioactive and nanostructured polymers is promising for wide applications to provide therapeutic healing effects and greater longevity for dental restorations.
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8
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Moro T, Takatori Y, Tanaka S, Ishihara K, Oda H, Kim YT, Umeyama T, Fukatani E, Ito H, Kyomoto M, Oshima H, Tanaka T, Kawaguchi H, Nakamura K. Clinical safety and wear resistance of the phospholipid polymer-grafted highly cross-linked polyethylene liner. J Orthop Res 2017; 35:2007-2016. [PMID: 27813260 DOI: 10.1002/jor.23473] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 10/28/2016] [Indexed: 02/04/2023]
Abstract
To reduce the production of wear particles and subsequent aseptic loosening, we created a human articular cartilage-mimicked surface for a highly cross-linked polyethylene liner, whose surface grafted layer consisted of a biocompatible phospholipid polymer, poly(2-methacryloyloxyethyl phosphorylcholine). Although our previous in vitro findings showed that poly(2-methacryloyloxyethyl phosphorylcholine)-grafted particles were biologically inert and caused no subsequent bone resorptive responses, and poly(2-methacryloyloxyethyl phosphorylcholine) grafting markedly decreased wear in hip joint simulator tests, the clinical safety, and in vivo wear resistance of poly(2-methacryloyloxyethyl phosphorylcholine)-grafted highly cross-linked polyethylene liners remained open to question. Therefore, in the present study, we evaluated clinical and radiographic outcomes of poly(2-methacryloyloxyethyl phosphorylcholine)-grafted highly cross-linked polyethylene liners 5 years subsequent to total hip replacement in 68 consecutive patients. No reoperation was required for any reason, and no adverse events were associated with the implanted liners. The average Harris Hip Score increased from 38.6 preoperatively to 96.5 5 years postoperatively, and health-related quality of life, as indicated by the Short Form 36 Health Survey, improved. Radiographic analyses showed no periprosthetic osteolysis or implant migration. Between 1 and 5 years postoperatively, the mean steady-state wear rate was 0.002 mm/year, which represented a marked reduction relative to other highly cross-linked polyethylene liners, and appeared to be unaffected by patient-related or surgical factors. Although longer follow up is required, poly(2-methacryloyloxyethyl phosphorylcholine)-grafted highly cross-linked polyethylene liners improved mid-term clinical outcomes. The clinical safety and wear-resistance results are encouraging with respect to the improvement of long-term clinical outcomes with poly(2-methacryloyloxyethyl phosphorylcholine)-grafted highly cross-linked polyethylene liners. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2007-2016, 2017.
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Affiliation(s)
- Toru Moro
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Sensory and Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yoshio Takatori
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Sakae Tanaka
- Sensory and Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kazuhiko Ishihara
- Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Hiromi Oda
- Department of Orthopaedic Surgery, Saitama Medical University School of Medicine, 38 Morohongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Yoon Taek Kim
- Department of Orthopaedic Surgery, Saitama Medical University School of Medicine, 38 Morohongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Takashige Umeyama
- Department of Orthopedic Surgery, NTT Medical Center Tokyo, 5-9-22 Higashigotanda, Shinagawa-ku, Tokyo, 141-0022, Japan
| | - Eisei Fukatani
- Department of Orthopaedic Surgery, JR Tokyo General Hospital, 2-1-3 Yoyogi, Shibuya-ku, Tokyo, 151-8528, Japan
| | - Hideya Ito
- Department of Orthopaedic Surgery, Japan Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan
| | - Masayuki Kyomoto
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan.,Department of Research, KYOCERA Medical Corporation, 3-3-31 Miyahara, Yodogawa-ku, Osaka, 532-0003, Japan
| | - Hirofumi Oshima
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Sensory and Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takeyuki Tanaka
- Sensory and Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroshi Kawaguchi
- Japan Community Healthcare Organization, Tokyo Shinjuku Medical Center, Spine Center, 5-1 Tsukudo, Shinjuku-ku, Tokyo, 162-8543, Japan
| | - Kozo Nakamura
- Sensory and Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Rehabilitation Services Bureau, National Rehabilitation Center for Persons With Disabilities, 4-1, Namiki, Tokorozawa, Saitama, 359-8555, Japan
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9
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Zhang N, Melo MAS, Bai Y, Xu HHK. Novel protein-repellent dental adhesive containing 2-methacryloyloxyethyl phosphorylcholine. J Dent 2016; 42:1284-91. [PMID: 25234652 DOI: 10.1016/j.jdent.2014.07.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 07/11/2014] [Accepted: 07/18/2014] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Biofilms at tooth-restoration margins can produce acids and cause secondary caries. A protein-repellent adhesive resin can potentially inhibit bacteria attachment and biofilm growth. However, there has been no report on protein-repellent dental resins. The objectives of this study were to develop a protein-repellent bonding agent incorporating 2-methacryloyloxyethyl phosphorylcholine (MPC), and to investigate its resistance to protein adsorption and biofilm growth for the first time. METHODS MPC was incorporated into Scotchbond Multi-Purpose (SBMP) at 0%, 3.75%, 7.5%, 11.25%, and 15% by mass. Extracted human teeth were used to measure dentine shear bond strengths. Protein adsorption onto resins was determined by a micro bicinchoninic acid (BCA) method. A dental plaque microcosm biofilm model with human saliva as inoculum was used to measure biofilm metabolic activity and colony-forming unit (CFU) counts. RESULTS Adding 7.5% MPC into primer and adhesive did not decrease the dentine bond strength, compared to control (p>0.1). Incorporation of 7.5% of MPC achieved the lowest protein adsorption, which was 20-fold less than that of control. Incorporation of 7.5% of MPC greatly reduced bacterial adhesion, yielding biofilm total microorganism, total streptococci, and mutans streptococci CFU that were an order of magnitude less than control. CONCLUSIONS A protein-repellent dental adhesive resin was developed for the first time. Incorporation of MPC into primer and adhesive at 7.5% by mass greatly reduced the protein adsorption and bacterial adhesion, without compromising the dentine bond strength. CLINICAL SIGNIFICANCE The novel protein-repellent primer and adhesive are promising to inhibit biofilm formation and acid production, to protect the tooth-restoration margins and prevent secondary caries.
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Affiliation(s)
- Ning Zhang
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China; Biomaterials & Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, MD 21201, USA
| | - Mary Anne S Melo
- Biomaterials & Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, MD 21201, USA
| | - Yuxing Bai
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China.
| | - Hockin H K Xu
- Biomaterials & Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, MD 21201, USA; Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Department of Mechanical Engineering, University of Maryland, Baltimore County, MD 21250, USA.
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10
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Montaño-Machado V, Chevallier P, Mantovani D, Pauthe E. On the potential for fibronectin/phosphorylcholine coatings on PTFE substrates to jointly modulate endothelial cell adhesion and hemocompatibility properties. BIOMATTER 2015; 5:e979679. [PMID: 25785369 PMCID: PMC4581125 DOI: 10.4161/21592535.2014.979679] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The use of biomolecules as coatings on biomaterials is recognized to constitute a promising approach to modulate the biological response of the host. In this work, we propose a coating composed by 2 biomolecules susceptible to provide complementary properties for cardiovascular applications: fibronectin (FN) to enhance endothelialization, and phosphorylcholine (PRC) for its non thrombogenic properties. Polytetrafluoroethylene (PTFE) was selected as model substrate mainly because it is largely used in cardiovascular applications. Two approaches were investigated: 1) a sequential adsorption of the 2 biomolecules and 2) an adsorption of the protein followed by the grafting of phosphorylcholine via chemical activation. All coatings were characterized by immunofluorescence staining, X-Ray Photoelectron Spectroscopy and Scanning Electron Microscopy analyses. Assays with endothelial cells showed improvement on cell adhesion, spreading and metabolic activity on FN-PRC coatings compared with the uncoated PTFE. Platelets adhesion and activation were both reduced on the coated surfaces when compared with uncoated PTFE. Moreover, clotting time tests exhibited better hemocompatibility properties of the surfaces after a sequential adsorption of FN and PRC. In conclusion, FN-PRC coating improves cell adhesion and non-thrombogenic properties, thus revealing a certain potential for the development of this combined deposition strategy in cardiovascular applications.
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Affiliation(s)
- Vanessa Montaño-Machado
- a Laboratory for Biomaterials & Bioengineering (CRC-I); Department of Min-Met-Materials Engineering & CHU de Quebec Research Center; Laval University ; Quebec City , Canada
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11
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Moro T, Takatori Y, Kyomoto M, Ishihara K, Kawaguchi H, Hashimoto M, Tanaka T, Oshima H, Tanaka S. Wear resistance of the biocompatible phospholipid polymer-grafted highly cross-linked polyethylene liner against larger femoral head. J Orthop Res 2015; 33:1103-10. [PMID: 25764495 DOI: 10.1002/jor.22868] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 02/13/2015] [Indexed: 02/04/2023]
Abstract
The use of larger femoral heads to prevent the dislocation of artificial hip joints has recently become more common. However, concerns about the subsequent use of thinner polyethylene liners and their effects on wear rate have arisen. Previously, we prepared and evaluated the biological and mechanical effects of a novel highly cross-linked polyethylene (CLPE) liner with a nanometer-scaled graft layer of poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC). Our findings showed that the PMPC-grafted particles were biologically inert and caused no subsequent bone resorptive responses and that the PMPC-grafting markedly decreased wear in a hip joint simulator. However, the metal or ceramic femoral heads used in this previous study had a diameter of 26 mm. Here, we investigated the wear-resistance of the PMPC-grafted CLPE liner with a 40-mm femoral head during 10 × 10(6) cycles of loading in the hip joint simulator. The results provide preliminary evidence that the grafting markedly decreased gravimetric wear rate and the volume of wear particles, even when coupled with larger femoral heads. Thus, we believe the PMPC-grafting will prolong artificial hip joint longevity both by preventing aseptic loosening and by improving the stability of articular surface.
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Affiliation(s)
- Toru Moro
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yoshio Takatori
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masayuki Kyomoto
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan.,Research Department, KYOCERA Medical Corporation, 3-3-31 Miyahara, Yodogawa-ku, Osaka, 532-0003, Japan
| | - Kazuhiko Ishihara
- Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Hiroshi Kawaguchi
- Japan Community Health care Organization, Tokyo Shinjuku Medical Center, Spine Center, 5-1 Tsukudo, Shinjuku-ku, Tokyo, 162-8543, Japan
| | - Masami Hashimoto
- Materials Research and Development Laboratory, Japan Fine Ceramics Center, 2-4-1 Mutsuno, Atsuta-ku, Nagoya, 456-8587, Japan
| | - Takeyuki Tanaka
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hirofumi Oshima
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Sakae Tanaka
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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12
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Zhang N, Chen C, Melo MA, Bai YX, Cheng L, Xu HH. A novel protein-repellent dental composite containing 2-methacryloyloxyethyl phosphorylcholine. Int J Oral Sci 2015; 7:103-9. [PMID: 25655010 PMCID: PMC4817550 DOI: 10.1038/ijos.2014.77] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2014] [Indexed: 02/05/2023] Open
Abstract
Secondary caries due to biofilm acids is a primary cause of dental composite restoration failure. To date, there have been no reports of dental composites that can repel protein adsorption and inhibit bacteria attachment. The objectives of this study were to develop a protein-repellent dental composite by incorporating 2-methacryloyloxyethyl phosphorylcholine (MPC) and to investigate for the first time the effects of MPC mass fraction on protein adsorption, bacteria attachment, biofilm growth, and mechanical properties. Composites were synthesized with 0 (control), 0.75%, 1.5%, 2.25%, 3%, 4.5% and 6% of MPC by mass. A commercial composite was also tested as a control. Mechanical properties were measured in three-point flexure. Protein adsorption onto the composite was determined by the microbicinchoninic acid method. A human saliva microcosm biofilm model was used. Early attachment at 4 h, biofilm at 2 days, live/dead staining and colony-forming units (CFUs) of biofilms grown on the composites were investigated. Composites with MPC of up to 3% had mechanical properties similar to those without MPC and those of the commercial control, whereas 4.5% and 6% MPC decreased the mechanical properties (P<0.05). Increasing MPC from 0 to 3% reduced the protein adsorption on composites (P<0.05). The composite with 3% MPC had protein adsorption that was 1/12 that of the control (P<0.05). Oral bacteria early attachment and biofilm growth were also greatly reduced on the composite with 3% MPC, compared to the control (P<0.05). In conclusion, incorporation of MPC into composites at 3% greatly reduced protein adsorption, bacteria attachment and biofilm CFUs, without compromising mechanical properties. Protein-repellent composites could help to repel bacteria attachment and plaque build-up to reduce secondary caries. The protein-repellent method might be applicable to other dental materials.
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Affiliation(s)
- Ning Zhang
- 1] Biomaterials and Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, USA [2] Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Chen Chen
- 1] Biomaterials and Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, USA [2] State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mary As Melo
- Biomaterials and Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, USA
| | - Yu-Xing Bai
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hockin Hk Xu
- 1] Biomaterials and Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, USA [2] Center for Stem Cell Biology and Regenerative Medicine, University of Maryland School of Medicine, Baltimore, USA [3] Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, USA [4] Department of Mechanical Engineering, University of Maryland, Baltimore County, USA
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13
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Ishihara K. Highly lubricated polymer interfaces for advanced artificial hip joints through biomimetic design. Polym J 2015. [DOI: 10.1038/pj.2015.45] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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14
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Li L, Zhao F, Zhao B, Zhang J, Li C, Qiao R. Chitosan Grafted with Phosphorylcholine and Macrocyclic Polyamine as an Effective Gene Delivery Vector: Preparation, Characterization and In Vitro Transfection. Macromol Biosci 2015; 15:912-26. [PMID: 25800642 DOI: 10.1002/mabi.201400518] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 02/10/2015] [Indexed: 12/19/2022]
Abstract
Herein, an effective gene delivery vector phosphorylcholine and macrocyclic polyamine grafted chitosan (PC-g(6)-Cs-g(2)-Cyclen) was developed. Chemical characterization of product PC-g(6)-Cs-g(2)-Cyclen was performed by NMR, FT-IR, gel permeation chromatography (GPC), and X-ray photoelectron spectroscopy (XPS) analysis. PC-g(6)-Cs-g(2)-Cyclen could more efficiently bind and protect plasmid DNA than macrocyclic polyamine grafted chitosan (Cs-g-Cyclen) and phosphorylcholine grafted chitosan (Cs-g-PC), as evaluated by agarose gel electrophoresis, circular dichroism spectra, and fluorescence quenching assays. PC-g(6)-Cs-g(2)-Cyclen could wrap DNA into uniform nanoparticles in the size of 112.6 ± 8.5 nm and possessed net cationic charge. UV spectroscopy and MTT assays showed excellent water-solubility and cell viability for PC-g(6)-Cs-g(2)-Cyclen. In addition, three polymer/DNA complexes showed 5.1-15.1-fold greater uptake activity and 10-14-fold higher transfection efficiency in 293 T cells as compared to chitosan/DNA complex, in which PC-g(6)-Cs-g(2)-Cyclen demonstrated the highest transfection activity. These date demonstrated that PC-g(6)-Cs-g(2)-Cyclen is a promising vector candidate for gene delivery.
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Affiliation(s)
- Ling Li
- State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, 15 Beisanhuan East Road, Beijing, 100029, China
| | - Fangfang Zhao
- State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, 15 Beisanhuan East Road, Beijing, 100029, China
| | - Baojing Zhao
- State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, 15 Beisanhuan East Road, Beijing, 100029, China
| | - Jin Zhang
- State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, 15 Beisanhuan East Road, Beijing, 100029, China
| | - Chao Li
- State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, 15 Beisanhuan East Road, Beijing, 100029, China.
| | - Renzhong Qiao
- State Key Laboratory of Medicinal Chemical Biology, Nankai University, 94 Weijin Road, Tianjin, 300071, China.
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15
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Gurses KM, Kocyigit D, Yalcin MU, Evranos B, Yorgun H, Sahiner ML, Kaya EB, Oto MA, Ozer N, Aytemir K. Safety and efficacy outcomes of protamine administration for heparin reversal following cryoballoon-based pulmonary vein isolation. J Interv Card Electrophysiol 2015; 43:161-7. [DOI: 10.1007/s10840-015-9989-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 02/09/2015] [Indexed: 12/29/2022]
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16
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Zhang N, Ma J, Melo MAS, Weir MD, Bai Y, Xu HHK. Protein-repellent and antibacterial dental composite to inhibit biofilms and caries. J Dent 2014; 43:225-34. [PMID: 25478889 DOI: 10.1016/j.jdent.2014.11.008] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/24/2014] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Biofilm acids contribute to secondary caries, which is a main reason for dental restoration failures. The objectives of this study were to: (1) develop a protein-repellent and antibacterial composite, and (2) investigate the effects of combining 2-methacryloyloxyethyl phosphorylcholine (MPC) with quaternary ammonium dimethylaminohexadecyl methacrylate (DMAHDM) on composite mechanical properties and biofilm response for the first time. METHODS MPC, DMAHDM and glass particles were mixed into a dental resin composite. Mechanical properties were measured in three-point flexure. Protein adsorption onto the composites was measured by a micro bicinchoninic acid method. A human saliva microcosm model was used to grow biofilms on composites. Colony-forming unit (CFU) counts, live/dead assay, metabolic activity, and lactic acid production of biofilms were determined. RESULTS Incorporation of 3% MPC and 1.5% DMAHDM into composite achieved protein-repellent and antibacterial capabilities without compromising the mechanical properties. Composite with 3% MPC+1.5% DMAHDM had protein adsorption that was 1/10 that of a commercial composite (p<0.05). The composite with 3% MPC+1.5% DMAHDM had much greater reduction in biofilm growth than using MPC or DMAHDM alone (p<0.05). Biofilm CFU counts on composite with 3% MPC+1.5% DMAHDM were more than three orders of magnitude lower than that of commercial control. CONCLUSIONS Dental composite with a combination of strong protein-repellent and antibacterial capabilities was developed for the first time. Composite containing MPC and DMAHDM greatly reduced biofilm growth and lactic acid production, without compromising mechanical properties of the composite. CLINICAL SIGNIFICANCE Novel composite with MPC and DMAHDM greatly reduced biofilm activity and is promising to inhibit secondary caries. The dual agents of MPC plus DMAHDM may have wide applicability to other dental materials.
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Affiliation(s)
- Ning Zhang
- Biomaterials & Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, MD 21201, USA; Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Jianfeng Ma
- School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mary A S Melo
- Biomaterials & Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, MD 21201, USA
| | - Michael D Weir
- Biomaterials & Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, MD 21201, USA
| | - Yuxing Bai
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China.
| | - Hockin H K Xu
- Biomaterials & Tissue Engineering Division, Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland Dental School, Baltimore, MD 21201, USA; Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Department of Mechanical Engineering, University of Maryland, Baltimore County, MD 21250, USA.
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17
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Takatori Y, Moro T, Ishihara K, Kamogawa M, Oda H, Umeyama T, Kim YT, Ito H, Kyomoto M, Tanaka T, Kawaguchi H, Tanaka S. Clinical and radiographic outcomes of total hip replacement with poly(2-methacryloyloxyethyl phosphorylcholine)-grafted highly cross-linked polyethylene liners: Three-year results of a prospective consecutive series. Mod Rheumatol 2014; 25:286-91. [DOI: 10.3109/14397595.2014.941438] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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18
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Kyomoto M, Moro T, Yamane S, Watanabe K, Hashimoto M, Takatori Y, Tanaka S, Ishihara K. Poly(2-methacryloyloxyethyl phosphorylcholine) grafting and vitamin E blending for high wear resistance and oxidative stability of orthopedic bearings. Biomaterials 2014; 35:6677-86. [DOI: 10.1016/j.biomaterials.2014.04.051] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 04/12/2014] [Indexed: 11/29/2022]
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19
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Conte G, de Asmundis C, Baltogiannis G, Di Giovanni G, Ciconte G, Sieira J, Saitoh Y, Wauters K, Mugnai G, Julià J, Irfan G, Levinstein M, Cotino-Moreno HE, Chierchia GB, Brugada P. Periprocedural outcomes of prophylactic protamine administration for reversal of heparin after cryoballoon ablation of atrial fibrillation. J Interv Card Electrophysiol 2014; 41:129-34. [DOI: 10.1007/s10840-014-9922-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 05/13/2014] [Indexed: 11/24/2022]
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20
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Kyomoto M, Moro T, Yamane S, Hashimoto M, Takatori Y, Ishihara K. Effect of UV-irradiation intensity on graft polymerization of 2-methacryloyloxyethyl phosphorylcholine on orthopedic bearing substrate. J Biomed Mater Res A 2013; 102:3012-23. [PMID: 24124003 DOI: 10.1002/jbm.a.34973] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 09/24/2013] [Indexed: 12/19/2022]
Abstract
Photoinduced grafting of 2-methacryloyloxyethyl phosphorylcholine (MPC) onto cross-linked polyethylene (CLPE) was investigated for its ability to reduce the wear of orthopedic bearings. We investigated the effect of UV-irradiation intensity on the extent of poly(MPC) (PMPC) grafting, and found that it increased with increasing intensity up to 7.5 mW/cm(2), and the remained fairly constant. It was found to be extremely important to carefully control the UV intensity, as at higher values, a PMPC gel formed via homopolymerization of the MPC, resulting in the formation of cracks at the interface of the PMPC layer and the CLPE substrate. When the CLPE was exposed to UV-irradiation during the graft polymerization process, some of its physical and mechanical properties were slightly changed due to cross-linking and scission effects in the surface region; however, the results of all of the tests exceed the lower limits of the ASTM standards. Modification of the CLPE surface with the hydrophilic PMPC layer increased lubrication to levels that match articular cartilage. The highly hydrated thin PMPC films mimicked the native cartilage extracellular matrix that covers synovial joint surface, acting as an extremely efficient lubricant, and providing high-wear resistance.
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Affiliation(s)
- Masayuki Kyomoto
- Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan; Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan; Research Department, KYOCERA Medical Corporation, 3-3-31, Miyahara, Yodogawa-ku, Osaka, 532-0003, Japan
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21
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Poly(ether-ether-ketone) orthopedic bearing surface modified by self-initiated surface grafting of poly(2-methacryloyloxyethyl phosphorylcholine). Biomaterials 2013; 34:7829-39. [DOI: 10.1016/j.biomaterials.2013.07.023] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 07/06/2013] [Indexed: 12/20/2022]
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22
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Moro T, Kyomoto M, Ishihara K, Saiga K, Hashimoto M, Tanaka S, Ito H, Tanaka T, Oshima H, Kawaguchi H, Takatori Y. Grafting of poly(2-methacryloyloxyethyl phosphorylcholine) on polyethylene liner in artificial hip joints reduces production of wear particles. J Mech Behav Biomed Mater 2013; 31:100-6. [PMID: 23651567 DOI: 10.1016/j.jmbbm.2013.03.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 03/07/2013] [Accepted: 03/18/2013] [Indexed: 10/27/2022]
Abstract
Despite improvements in the techniques, materials, and fixation of total hip arthroplasty, periprosthetic osteolysis, a complication that arises from this clinical procedure and causes aseptic loosening, is considered to be a major clinical problem associated with total hip arthroplasty. With the objective of reducing the production of wear particles and eliminating periprosthetic osteolysis, we prepared a novel hip polyethylene (PE) liner whose surface graft was made of a biocompatible phospholipid polymer-poly(2-methacryloyloxyethyl phosphorylcholine (MPC)). This study investigated the wear resistance of the poly(MPC)-grafted cross-linked PE (CLPE; MPC-CLPE) liner during 15×10(6) cycles of loading in a hip joint simulator. The gravimetric analysis showed that the wear of the acetabular liner was dramatically suppressed in the MPC-CLPE liner, as compared to that in the non-treated CLPE liner. Analyses of the MPC-CLPE liner surface revealed that it suffered from no or very little wear even after the simulator test, whereas the CLPE liners suffered from substantial wears. The scanning electron microscope (SEM) analysis of the wear particles isolated from the lubricants showed that poly(MPC) grafting dramatically decreased the total number, area, and volume of the wear particles. However, there was no significant difference in the particle size distributions, and, in particular, from the SEM image, it was observed that particles with diameters less than 0.50μm were present in the range of the highest frequency. In addition, there were no significant differences in the particle size descriptors and particle shape descriptors. The results obtained in this study show that poly(MPC) grafting markedly reduces the production of wear particles from CLPE liners, without affecting the size of the particles. These results suggest that poly(MPC) grafting is a promising technique for increasing the longevity of artificial hip joints.
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Affiliation(s)
- Toru Moro
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Masayuki Kyomoto
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Research Department, KYOCERA Medical Corporation, 3-3-31 Miyahara, Yodogawa-ku, Osaka 532-0003, Japan
| | - Kazuhiko Ishihara
- Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kenichi Saiga
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Research Department, KYOCERA Medical Corporation, 3-3-31 Miyahara, Yodogawa-ku, Osaka 532-0003, Japan
| | - Masami Hashimoto
- Materials Research and Development Laboratory, Japan Fine Ceramics Center, 2-4-1 Mutsuno, Atsuta-ku, Nagoya 456-8587, Japan
| | - Sakae Tanaka
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hideya Ito
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Takeyuki Tanaka
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hirofumi Oshima
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hiroshi Kawaguchi
- Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yoshio Takatori
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Kyomoto M, Moro T, Saiga K, Hashimoto M, Ito H, Kawaguchi H, Takatori Y, Ishihara K. Biomimetic hydration lubrication with various polyelectrolyte layers on cross-linked polyethylene orthopedic bearing materials. Biomaterials 2012; 33:4451-9. [PMID: 22465336 DOI: 10.1016/j.biomaterials.2012.03.028] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 03/07/2012] [Indexed: 12/01/2022]
Abstract
Natural joints rely on fluid thin-film lubrication by the hydrated polyelectrolyte layer of cartilage. However, current artificial joints with polyethylene (PE) surfaces have considerably less efficient lubrication and thus much greater wear, leading to osteolysis and aseptic loosening. This is considered a common factor limiting prosthetic longevity in total hip arthroplasty (THA). However, such wear could be mitigated by surface modification to mimic the role of cartilage. Here we report the development of nanometer-scale hydrophilic layers with varying charge (nonionic, cationic, anionic, or zwitterionic) on cross-linked PE (CLPE) surfaces, which could fully mimic the hydrophilicity and lubricity of the natural joint surface. We present evidence to support two lubrication mechanisms: the primary mechanism is due to the high level of hydration in the grafted layer, where water molecules act as very efficient lubricants; and the secondary mechanism is repulsion of protein molecules and positively charged inorganic ions by the grafted polyelectrolyte layer. Thus, such nanometer-scaled hydrophilic polymers or polyelectrolyte layers on the CLPE surface of acetabular cup bearings could confer high durability to THA prosthetics.
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Affiliation(s)
- Masayuki Kyomoto
- Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
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Kyomoto M, Moro T, Takatori Y, Kawaguchi H, Ishihara K. Cartilage-mimicking, high-density brush structure improves wear resistance of crosslinked polyethylene: a pilot study. Clin Orthop Relat Res 2011; 469:2327-36. [PMID: 21132412 PMCID: PMC3126960 DOI: 10.1007/s11999-010-1718-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND In natural synovial joints under physiologic conditions, fluid thin-film lubrication by a hydrated layer of the cartilage is essential for the smooth motion of the joints. The considerably less efficient lubrication of artificial joints of polyethylene is prone to wear, leading to osteolysis and aseptic loosening and limiting the longevity of THA. A nanometer-scale layer of poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) with cartilage-mimicking brushlike structures on a crosslinked polyethylene (CLPE) surface may provide hydrophilicity and lubricity resembling the physiologic joint surface. QUESTIONS/PURPOSES We asked whether the photoirradiation time during graft polymerization would affect the density and stability of the PMPC layer and the PMPC-grafted surface would enhance the durability of artificial joints. We investigated the effect of photoirradiation time and the resultant characteristics of the PMPC layer on the durability of the CLPE. METHODS For each of the PMPC-grafted CLPE surfaces with various photoirradiation times (six groups: 0 [untreated CLPE], 11, 23, 45, 90, and 180 minutes), 18 sample pieces (total of 108 samples) were evaluated in surface analyses, and four cups (total of 24 samples) were evaluated in a hip simulator test. RESULTS The density of the PMPC layer increased with an increase in the photoirradiation time. The hip simulator test confirmed the PMPC-grafted CLPE with a high density of the PMPC layer exhibited minimal wear as compared with the untreated CLPE. High-density PMPC grafting appears essential for maintaining the high wear resistance of the PMPC-grafted CLPE. To obtain a high-density PMPC layer, the photoirradiation time must be greater than 45 minutes. CONCLUSIONS The cartilage-mimicking, density brushlike structure of the PMPC-grafted CLPE could extend high durability to acetabular cups in THA. CLINICAL RELEVANCE Our in vitro findings suggest the wear performance of CLPE acetabular cups in THA can be improved by this approach.
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Affiliation(s)
- Masayuki Kyomoto
- Research Department, Japan Medical Materials Corp, 3-3-31, Miyahara, Yodogawa-ku, Osaka, 532-0003, Japan.
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Kyomoto M, Moro T, Iwasaki Y, Miyaji F, Kawaguchi H, Takatori Y, Nakamura K, Ishihara K. Superlubricious surface mimicking articular cartilage by grafting poly(2-methacryloyloxyethyl phosphorylcholine) on orthopaedic metal bearings. J Biomed Mater Res A 2009; 91:730-41. [DOI: 10.1002/jbm.a.32280] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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26
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Kyomoto M, Moro T, Miyaji F, Hashimoto M, Kawaguchi H, Takatori Y, Nakamura K, Ishihara K. Effects of mobility/immobility of surface modification by 2-methacryloyloxyethyl phosphorylcholine polymer on the durability of polyethylene for artificial joints. J Biomed Mater Res A 2009; 90:362-71. [PMID: 18521890 DOI: 10.1002/jbm.a.32092] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Surface modification is important for the improvement in medical device materials. 2-Methacryloyloxyethyl phosphorylcholine (MPC) polymers have attracted considerable attention as surface modifiable polymers for several medical devices. In this study, we hypothesize that the structure of the surface modification layers might affect the long-term stability, hydration kinetics, wear resistance, and so forth, of medical devices such as artificial joints, and the poly(MPC) (PMPC) grafted surface might assure the long-term performance of such devices. Therefore, we investigate the surface properties of various surface modifications by using dip coatings of MPC-co-n-butyl methacrylate (PMB30) and MPC-co-3-methacryloxypropyl trimethoxysilane (PMSi90) polymers, or photoinduced radical grafting of PMPC and also the effects of the surface properties on the durability of cross-linked polyethylene (CLPE) for artificial joints. The PMPC-grafted CLPE has an extremely low and stable coefficient of dynamic friction and volumetric wear as compared to the untreated CLPE, PMB30-coated CLPE, and PMSi90-coated CLPE. It is concluded that the photoinduced radical graft polymerization of MPC is the best method to retain the benefits of the MPC polymer used in artificial joints under variable and multidirectional loads for long periods with strong bonding between the MPC polymer and the CLPE surface, and also to retain the high mobility of the MPC polymer.
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Affiliation(s)
- Masayuki Kyomoto
- Research Department, Japan Medical Materials Corporation, Osaka, Japan.
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Kyomoto M, Moro T, Miyaji F, Hashimoto M, Kawaguchi H, Takatori Y, Nakamura K, Ishihara K. Effect of 2‐methacryloyloxyethyl phosphorylcholine concentration on photo‐induced graft polymerization of polyethylene in reducing the wear of orthopaedic bearing surface. J Biomed Mater Res A 2008; 86:439-47. [DOI: 10.1002/jbm.a.31511] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Kyomoto M, Moro T, Konno T, Takadama H, Kawaguchi H, Takatori Y, Nakamura K, Yamawaki N, Ishihara K. Effects of photo-induced graft polymerization of 2-methacryloyloxyethyl phosphorylcholine on physical properties of cross-linked polyethylene in artificial hip joints. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2007; 18:1809-15. [PMID: 17483881 DOI: 10.1007/s10856-007-3063-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2006] [Accepted: 05/31/2006] [Indexed: 05/15/2023]
Abstract
Osteolysis caused by wear particles from polyethylene in the artificial hip joints is a serious issue. We have used photo-induced radical graft polymerization to graft 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer onto the surface of cross-linked polyethylene (CLPE-g-MPC) in order to reduce friction and wear at the bearing surface of the joint. The physical and mechanical properties of CLPE and CLPE-g-MPC were not significantly different, expect that the friction coefficient of untreated CLPE cups was 0.0075, compared with 0.0009 for CLPE-g-MPC cup, an 88% reduction. After 3.0 x 10(6) cycles in the hip joint simulator test, we could not observe any wear of CLPE-g-MPC cups. We concluded that the advantage of photo-induced radical graft polymerization technique was that the grafted MPC polymer gave a high lubricity only on the surface and has no effect on the bulk properties of the CLPE substrate.
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Affiliation(s)
- Masayuki Kyomoto
- Research and Development Corporate Division, Japan Medical Materials Corporation, Uemura Nissei Bldg 9F, 3-3-31 Miyahara, Osaka, Japan.
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Kyomoto M, Moro T, Konno T, Takadama H, Yamawaki N, Kawaguchi H, Takatori Y, Nakamura K, Ishihara K. Enhanced wear resistance of modified cross-linked polyethylene by grafting with poly(2-methacryloyloxyethyl phosphorylcholine). J Biomed Mater Res A 2007; 82:10-7. [PMID: 17265442 DOI: 10.1002/jbm.a.31134] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We developed a cross-linked polyethylene (CLPE) modified with a phospholipid polymer in order to address the serious problem of osteolysis caused by wear particles derived from the polyethylene components of artificial hip joints. Our goal of preventing aseptic loosening could be achieved by avoiding any formation of CLPE wear particles or suppressing the activation of cell systems by the wear particles. We investigated the surface and wear resistance properties of 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer grafted onto the surface of CLPE (CLPE-g-MPC). The relative density of MPC polymer chains was determined by the P-O group index. Generally, polymerization times correspond to the number of polymer chains in radical polymerization. After 3.0 x 10(6) cycles in a hip joint simulator test, the steady wear rates of the untreated CLPE and CLPE-g-MPC cups with a low P-O group index were as high as 4 mg/10(6) cycles; those of the CLPE-g-MPC cups with high P-O group indexes, that is, 0.46 and 0.48, markedly decreased to -1.12 and 0.16 mg/10(6) cycles, respectively. Therefore, the grafting of an MPC polymer with high density would be essential in order to maintain the long-term wear resistance of CLPE-g-MPC as an orthopedic bearing material.
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Affiliation(s)
- Masayuki Kyomoto
- Research and Development Corporate Division, Japan Medical Materials Corporation, Osaka, Japan.
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Shinozaki N, Yokoi H, Iwabuchi M, Nosaka H, Kadota K, Mitsudo K, Nobuyoshi M. Initial and Follow-up Results of the BiodivYsio Phosphorylcholine Coated Stent for Treatment of Coronary Artery Disease. Circ J 2005; 69:295-300. [PMID: 15731534 DOI: 10.1253/circj.69.295] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The BiodivYsio stent is coated with a phosphorylcholine containing copolymer to confer biocompatibility. The present study was designed to assess the safety and efficacy of this coronary stent for the treatment of native coronary artery lesions in patients with coronary artery disease. METHODS AND RESULTS From August 2001 to April 2003, 130 patients with lesions were treated with this stent. Elective stenting (ES) was performed in 90 patients and bailout stenting (BS) was performed in 40 patients with small vessels. Pre-interventional reference diameter, minimal lumen diameter (MLD), and lesion length were 2.68+/-0.51, 1.00+/-0.30, 12.78+/-4.32, respectively, and post-interventional MLD was 2.24+/-0.45 mm. The initial success rate was 100%. However, 2 non-Q-wave myocardial infarctions (non-QMI) occurred post-procedurally due to branch occlusion. A 6-month follow-up was performed. No subacute thrombosis occurred. In the ES group, 1 non-QMI occurred after the interventional procedure in another vessel. There was no death or coronary artery bypass grafting (CABG). The angiographic restenosis rate was 15.6%. In the BS group, there was no death, myocardial infarction or CABG. The angiographic restenosis rate was 17.5%. CONCLUSION The BiodivYsio stent is safe and effective as a primary device for the treatment of native coronary artery lesions, especially in small vessels.
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Krumsdorf U, Ostermayer S, Billinger K, Trepels T, Zadan E, Horvath K, Sievert H. Reply. J Am Coll Cardiol 2004. [DOI: 10.1016/j.jacc.2004.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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