Reducing Friction in the Eye: A Comparative Study of Lubrication by Surface-Anchored Synthetic and Natural Ocular Mucin Analogues

Temporal changes in parameters associated with tear film stability after instillation of long-acting diquafosol ophthalmic solution in soft contact lens wearers

PURPOSE

To investigate temporal changes in parameters associated with tear film stability after instillation of long-acting 3% diquafosol ophthalmic solution (DQS LX), which contains polyvinylpyrrolidone.

STUDY DESIGN

Prospective crossover study design.

METHODS

We enrolled 23 eyes of 23 soft contact lens (SCL) wearers (aged 25.3 ± 4.4 years). One-day disposable silicone hydrogel lenses (narafilcon A) were used in this study. DQS LX was instilled without a SCL on the first day. On the other two days, subjects received DQS or DQS LX at 7 h after wearing SCLs. Tear meniscus height (TMH), non-invasive tear break-up time (NIBUT) and ocular surface temperature (OST) were measured before and at 5, 15, 30, 45, 60, 80 and 120 min after instillation.

RESULTS

When not wearing SCLs, DQS LX instillation significantly improved TMH for up to 120 min and NIBUT for up to 80 min. When wearing SCLs, DQS and DQS LX instillation significantly increased TMH for up to 45 and 80 min, and NIBUT for up to 15 and 30 min. Compared to DQS, DQS LX administration resulted in a significantly higher TMH at 5, 60 and 80 min, as well as a significantly prolonged NIBUT at 5 and 60 min. OST with and without SCLs also varied depending on the changes in the parameters associated with tear film stability.

CONCLUSION

Compared to DQS, when wearing SCLs, DQS LX was found to increase the amount of tear fluid and improve tear film stability for longer periods.

Tribology in Nature: Inspirations for Advanced Lubrication Materials

Friction-induced energy consumption is a significant global concern, driving researchers to explore advanced lubrication materials. In nature, lubrication is vital for the life cycle of animals, plants, and humans, playing key roles in movement, predation, and decomposition. After billions of years of evolution, natural lubrication exhibits remarkable professionalism, high efficiency, durability, and intelligence, offering valuable insights for designing advanced lubrication materials. This review focuses on the lubrication mechanisms of natural organisms and significant advancements in biomimetic soft matter lubrication materials. It begins by summarizing common biological lubrication behaviors and their underlying mechanisms, followed by current design strategies for biomimetic soft matter lubrication materials. The review then outlines the development and performance of these materials based on different mechanisms and strategies. Finally, it discusses potential research directions and prospects for soft matter lubrication materials. This review will be a valuable resource for advancing research in biomimetic lubrication materials.

Low friction hydrogel with diclofenac eluting ability for dry eye therapeutic contact lenses

When placed in the eye, contact lenses (CLs) disturb the tear fluid and affect the natural tribological behaviour of the eye. The disruption in the contact mechanics between the ocular tissues can increase frictional shear stress and ocular dryness, causing discomfort. Ultimately, continuous CLs wear can trigger inflammation which is particularly critical for people suffering from dry eye. In this work, a double strategy was followed to obtain therapeutic daily disposable CLs for dry eye: a hydroxyethyl methacrylate (HEMA) based hydrogel was coated with two natural polysaccharides, chitosan (CHI) and hyaluronic acid (HA) and posteriorly loaded with an anti-inflammatory drug (diclofenac, DCF). Material sterilisation was carried out by high hydrostatic pressure (HHP) combined with moderate temperature. The friction coefficient (μ) was determined in the presence of different tear biomolecules (cholesterol, lysozyme and albumin) using a nanotribometer. Drug release experiments were performed in static and in hydrodynamic conditions. The material was extensively characterised, regarding surface morphology/topography, optical properties, water content and swelling behaviour, wettability, ionic and oxygen permeability and mechanical properties. It was found that the coating did not impair the physico-chemical properties relevant for the material's application in CLs. Besides, it also ensured a sustained release of DCF for 24 h in tests performed in hydrodynamic conditions that simulate those found in the eye, increasing significantly the amount of drug released. It reduced friction, improving the lubrication ability of the hydrogel, and presented antibacterial properties against S. aureus, P. aeruginosa and B. Cereus. The coated samples did not reveal any signs of cytotoxicity or potential eye irritation. Overall, the coating of the hydrogel may be useful to produce daily CLs able to alleviate dry eye symptoms and the discomfort of CLs wearers.

Bioinspired and Multifunctional Tribological Materials for Sliding, Erosive, Machining, and Energy-Absorbing Conditions: A Review

Friction, wear, and the consequent energy dissipation pose significant challenges in systems with moving components, spanning various domains, including nanoelectromechanical systems (NEMS/MEMS) and bio-MEMS (microrobots), hip prostheses (biomaterials), offshore wind and hydro turbines, space vehicles, solar mirrors for photovoltaics, triboelectric generators, etc. Nature-inspired bionic surfaces offer valuable examples of effective texturing strategies, encompassing various geometric and topological approaches tailored to mitigate frictional effects and related functionalities in various scenarios. By employing biomimetic surface modifications, for example, roughness tailoring, multifunctionality of the system can be generated to efficiently reduce friction and wear, enhance load-bearing capacity, improve self-adaptiveness in different environments, improve chemical interactions, facilitate biological interactions, etc. However, the full potential of bioinspired texturing remains untapped due to the limited mechanistic understanding of functional aspects in tribological/biotribological settings. The current review extends to surface engineering and provides a comprehensive and critical assessment of bioinspired texturing that exhibits sustainable synergy between tribology and biology. The successful evolving examples from nature for surface/tribological solutions that can efficiently solve complex tribological problems in both dry and lubricated contact situations are comprehensively discussed. The review encompasses four major wear conditions: sliding, solid-particle erosion, machining or cutting, and impact (energy absorbing). Furthermore, it explores how topographies and their design parameters can provide tailored responses (multifunctionality) under specified tribological conditions. Additionally, an interdisciplinary perspective on the future potential of bioinspired materials and structures with enhanced wear resistance is presented.

Ultra-low friction in soft contact lenses: Analysis of dynamic free responses measured by the dynamic oscillating tribometer

Friction coefficient is considered as a measurement for clinical comfort of soft contact lenses. One of the main challenges in the tribology field is to evaluate the friction in soft materials such as soft contact lenses. In this work, we aim to evaluate the friction at the eyelid-lens contact using a new technique. This technique is based on a single-degree-of-freedom (SDOF) mass-spring system having a sliding contact. The experimental technique measures the free responses of the mechanical system. The friction is then evaluated from the damped free responses with a high accuracy. A variety of soft contact lenses are tested with some lubricants under many physiological conditions. The results are discussed and compared with those in the literature.

Impact of the physical properties of contact lens materials on the discomfort: role of the coefficient of friction

Contact Lens Discomfort (CLD) is the main cause in contact lens (CLs) discontinuation, referred in literature as drop-out phenomenon. Despite such evidence was reported in several clinical studies, a relationship between physico-chemical properties of CLs and CLD is not still totally understood. In this regard, the friction of CLs surfaces seems to be related to discomfort feeling events, probably due to an alteration of the lubricate function of the tear film after the CL placement inside the ocular environment. In the last years, many studies have been finalized to the friction measurements of CLs surface, finding conflicting data due to a lack in standardized protocol. The aim of this review is primarily to show evident relationships between CLs surface properties (i.e. wettability, tear evaporation, tear film quality, etc.) and the coefficient of friction (CoF), resulting therefore the most relevant physical quantity in the CLs characterization. In addition, we reported the most recent studies in CLs tribology, which highlight that the introduction of a standard protocol in CoF measurements is necessary to obtain reproducible results, considering the aim to evaluate in a more precise way the relationship between this material surface property and comfort in CLs users.

Mucosa-Mimetic Materials for the Study of Intestinal Homeostasis and Disease

Mucus is a viscoelastic hydrogel that lines and protects the epithelial surfaces of the body that houses commensal microbiota and functions in host defense against pathogen invasion. As a first-line physical and biochemical barrier, intestinal mucus is involved in immune surveillance and spatial organization of the microbiome, while dysfunction of the gut mucus barrier is implicated in several diseases. Mucus can be collected from a variety of mammalian sources for study, however, established methods are challenging in terms of scale and efficiency, as well as with regard to rheological similarity to native human mucus. Therefore, there is a need for mucus-mimetic hydrogels that more accurately reflect the physical and chemical profile of the in vivo human epithelial environment to enable the investigation of the role of mucus in human disease and interactions with the intestinal microbiome. This review will evaluate the material properties of synthetic mucus mimics to date designed to address the above need, with a focus toward an improved understanding of the biochemical and immunological functions of these biopolymers related to utility for research and therapeutic applications.

Tear film dynamics of a new soft contact lens

PURPOSE

To present the objective metrics from a study that evaluated the clinical performance of a senofilcon A contact lens, both with and without a new manufacturing technique.

METHODS

This was a single-site, five-visit, controlled, randomised, subject-masked, 2 × 2 crossover study (May-August 2021) with a 2-week lens dispensing period (bilateral wear) and weekly follow-up visits. Healthy adult (18-39 years), habitual spherical silicone hydrogel contact lens wearers were included. The High-definition (HD) Analyzer™ was used to objectively measure the lens-on-eye optical system resulting from the study lenses at 1-week follow-up. Measurements assessed were vision break-up time (VBUT), modulation transfer function (MTF) cutoff, Strehl ratio (SR), potential visual acuity (PVA) for 100% contrast and objective scatter index (OSI).

RESULTS

Of the 50 enrolled participants, 47 (94.0%) were randomly assigned to one of the two possible lens wear sequences (test/control or control/test) and dispensed at least one study lens. The estimated odds ratio of VBUT > 10 s was 1.582 (95% confidence interval [CI]: 1.009 to 2.482) in test versus control lens. The least squares mean difference estimates of MTF cutoff, SR and PVA for 100% contrast between test versus control lens were 2.243 (95% CI: 0.012 to 4.475), 0.011 (95% CI: -0.002 to 0.023) and 0.073 (95% CI: -0.001 to 0.147), respectively. The estimated ratio of median OSI between test versus control lens was 0.887 (95% CI: 0.727 to 1.081). The test lens demonstrated superiority over the control lens with respect to VBUT and MTF cutoff. No serious adverse events were reported; eight adverse events (three ocular, five non-ocular) were indicated by six participants during the study.

CONCLUSION

The test lens demonstrated an increased probability of having a longer VBUT (>10 s). Future studies may be designed to assess the efficacy and long-term use of the test lens in a larger population.

Comparative hydrodynamic and nanoscale imaging study on the interactions of teicoplanin-A2 and bovine submaxillary mucin as a model ocular mucin

Glycopeptide antibiotics are regularly used in ophthalmology to treat infections of Gram-positive bacteria. Aggregative interactions of antibiotics with mucins however can lead to long exposure and increases the risk of resistant species. This study focuses on the evaluation of potential interactions of the last line of defence glycopeptide antibiotic teicoplanin with an ocular mucin model using precision matrix free hydrodynamic and microscopic techniques: sedimentation velocity in the analytical ultracentrifuge (SV-AUC), dynamic light scattering (DLS) and atomic force microscopy (AFM). For the mixtures of teicoplanin at higher doses (1.25 mg/mL and 12.5 mg/mL), it was shown to interact and aggregate with bovine submaxillary mucin (BSM) in the distributions of both sedimentation coefficients by SV-AUC and hydrodynamic radii by DLS. The presence of aggregates was confirmed by AFM for higher concentrations. We suggest that teicoplanin eye drop formulations should be delivered at concentrations of < 1.25 mg/mL to avoid potentially harmful aggregations.

[Corneal epithelial biomechanics: Resistance to stress and role in healing and remodeling]

The corneal epithelium is one of the first tissue barriers of the eye against the environment. In recent years, many studies provided better knowledge of its healing, its behavior and its essential role in the optical system of the eye. At the crossroads of basic science and clinical medicine, the study of the mechanical stresses applied to the cornea makes it possible to learn the behavior of epithelial cells and better understand ocular surface disease. We describe herein the current knowledge about the adhesion systems of the corneal epithelium and their resistance to mechanical stress. We will also describe the involvement of these mechanisms in corneal healing and their role in epithelial dynamics. Adhesion molecules of the epithelial cells, especially hemidesmosomes, allow the tissue cohesion required to maintain the integrity of the corneal epithelium against the shearing forces of the eyelids as well as external forces. Their regeneration after a corneal injury is mandatory for the restoration of a healthy epithelium. Mechanotransduction plays a significant role in regulating epithelial cell behavior, and the study of the epithelium's response to mechanical forces helps to better understand the evolution of epithelial profiles after refractive surgery. A better understanding of corneal epithelial biomechanics could also help improve future therapies, particularly in the field of tissue engineering.

Composition controls soft hydrogel surface layer dimensions and contact mechanics

Hydrogels are soft hydrated polymer networks that are widely used in research and industry due to their favorable properties and similarity to biological tissues. However, it has long been difficult to create a hydrogel emulating the heterogeneous structure of special tissues, such as cartilage. One potential avenue to develop a structural variation in a hydrogel is the “mold effect,” which has only recently been discovered to be caused by absorbed oxygen within the mold surface interfering with the polymerization. This induces a dilute gradient-density surface layer with altered properties. However, the precise structure of the gradient-surface layer and its contact response have not yet been characterized. Such knowledge would prove useful for designs of composite hydrogels with altered surface characteristics. To fully characterize the hydrogel gradient-surface layer, we created five hydrogel compositions of varying monomer and cross-linker content to encompass variations in the layer. Then, we used particle exclusion microscopy during indentation and creep experiments to probe the contact response of the gradient layer of each composition. These experiments showed that the dilute structure of the gradient layer follows evolving contact behavior allowing poroelastic squeeze-out at miniscule pressures. Stiffer compositions had thinner gradient layers. This knowledge can potentially be used to create hydrogels with a stiff load-bearing bulk with altered surface characteristics tailored for specific tribological applications.

Design of Topical Moxifloxacin Mucoadhesive Nanoemulsion for the Management of Ocular Bacterial Infections

Ocular bacterial infections can lead to serious visual disability without proper treatment. Moxifloxacin (MOX) has been approved by the US Food and Drug Administration as a monotherapy for ocular bacterial infections and is available commercially as an ophthalmic solution (0.5% w/v). However, precorneal retention, drainage, and low bioavailability remain the foremost challenges associated with current commercial eyedrops. With this study, we aimed to design a MOX-loaded nanoemulsion (NE; MOX-NE) with mucoadhesive agents (MOX-NEM) to sustain MOX release, as well as to overcome the potential drawbacks of the current commercial ophthalmic formulation. MOX-NE and MOX-NEM formulations were prepared by hot homogenization coupled with probe sonication technique and subsequently characterized. The lead formulations were further evaluated for in vitro release, ex vivo transcorneal permeation, sterilization, and antimicrobial efficacy studies. Commercial MOX ophthalmic solution was used as a control. The lead formulations showed the desired physicochemical properties and viscosity. All lead formulations showed sustained release profiles a period of more than 12 h. Filtered and autoclaved lead formulations were stable for one month (the last time point tested) under refrigeration and at room temperature. Ex vivo transcorneal permeation studies revealed a 2.1-fold improvement in MOX permeation of the lead MOX-NE formulation compared with Vigamox^® eyedrops. However, MOX-NEM formulations showed similar flux and permeability coefficients to those of Vigamox^® eyedrops. The lead formulations showed similar in vitro antibacterial activity as the commercial eyedrops and crude drug solution. Therefore, MOX-NE and MOX-NEM formulations could serve as effective delivery vehicles for MOX and could improve treatment outcomes in different ocular bacterial infections.

Effects of hydrophilic coated catheters on urethral trauma, microtrauma and adverse events with intermittent catheterization in patients with bladder dysfunction: a systematic review and meta-analysis

Background

Hydrophilic coated catheters are recommended to reduce the side effects of intermittent catheterization (IC) in patients with bladder dysfunction. However, there is lack of Level one evidence to support the use of this intervention.

Search methods

Several electronic databases were systematically searched to evaluate complication incidences for hydrophilic coated (HC) and non-hydrophilic catheters (NHC).

Results

Twelve studies were eligible for inclusion in the review. The meta-analyses exploring microscopic hematuria frequencies (RR = 0.69; 95% CI 0.52–0.90) and urethral stricture frequencies (RR = 0.28; 95% CI 0.13–0.60) showed a lower risk ratio associated with HC in comparison to NHC, whereas gross hematuria was no statistically significant difference in two groups. Subgroup analyses of gross hematuria which was grouped according to "catheterization frequency", "single/multiple catheterization" and "self/other catheterization” were performed and the values of combined RR were also no statistically significant difference.

Conclusions

Compared with non-hydrophilic catheters, the hydrophilic coated catheters have positive significance in reducing the incidence of urethral microtrauma and the urethral stricture. However, more studies are warranted for evaluating effects of hydrophilic coated catheters on the incidence of gross hematuria.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11255-022-03172-x.

Evaluation of the Lubricating Effect of Hyaluronic Acid on Contact Lenses Using a Pendulum-Type Friction Tester Under Mimicking Physiological Conditions

OBJECTIVE

To evaluate the lubricating effect of hyaluronic acid (HA) on soft contact lenses (SCLs) measured using a pendulum-type friction tester.

METHODS

We measured the coefficient of friction (CoF) of narafilcon A, delefilcon A, and etafilcon A with polyvinylpyrrolidone (PVP), daily disposable SCL material, using a modified pendulum-type friction tester. Sample SCLs were set on an acrylic plastic half-ball and placed into the polyethylene terephthalate hemisphere cup filled with 0.4 mL of test lubricants that included saline and 0.05%, 0.1%, 0.2%, 0.3%, 0.4%, and 0.5% (wt/vol) HA (molecular weight, 850 kDa). The viscosities of saline and HA were measured using an Ubbelohde viscometer.

RESULTS

The CoF of the SCL under a low concentration (0.05%) of HA was the lowest and significantly lower than saline in narafilcon A and delefilcon A (P<0.05, Steel multiple comparison test). Under higher HA concentrations (0.3%, 0.4%, and 0.5%), the CoF was significantly higher than that of saline (P<0.01, Steel' multiple comparison test) in all three SCLs. There were no significant differences of CoF among three SCLs in saline and all concentrations of HA. The HA viscosities increased exponentially with the concentration (Y=1.2829e9.286X).

CONCLUSION

The viscosity of a high concentration of HA may increase the friction of SCLs, which may have a deleterious effect on the ocular surface.

Gellan gum modified hyaluronic acid hydrogel as viscosupplement with lubrication maintenance and enzymatic resistance

Osteoarthritis (OA) is a common disease caused by damage to articular cartilage and underlying bone tissues. Early OA can be treated by intra-articular injection of viscosupplements to restore the lost...

Correlation between surface friction and the hydrophobicity of structure-related side-chain exposure of albumin on contact lens

The management of contact lens discomfort remains a challenge leading to the increased contact lens dropout rates. Tear protein accumulates on the lens surfaces with different configurations observed are correlated to the lens friction, with the improved comfort experienced by reduced surface friction in the eye. However, protein adsorption is a complex process with the combined protein-protein interactions (PPI) and protein-surface interactions (PSI) involved, which is difficult to explain the complicated tribological behavior in terms of protein structural shifts alone on lens surfaces. On the other hand, the type of solvent-exposed side chains from specific protein conformations on lens surfaces should be more important to the lens friction involved. We aim to investigate the correlation between the structure-related side-chain exposure and corresponding lens friction of adsorbed tear proteins on lens surfaces under varied PPI and PSI. Albumin was the model protein adsorbed onto the conventional lens material. Such as polymethylmethacrylate (PMMA) or the poly-2-hydroxyethyl methacrylate (PHEMA) surfaces applied here. Adsorption was conducted under varying protein solution concentrations to saturate the model surface to change the PPI effects over a wide range. Our results indicate that PPI effects help stabilize protein structures on both surfaces. When PPI is minimized, a distinct correlation was observed between the surface friction and the hydrophobicity of structure-related side-chain exposure of albumin on lens surfaces depending on the different PSI involved. At a fundamental understanding, our results would provide insights for developing new lens materials or the lens care solution designs to reduce the lens discomfort.

Non-clinical assessment of lubrication and free radical scavenging of an innovative non-animal carboxymethyl chitosan biomaterial for viscosupplementation: An in-vitro and ex-vivo study

OBJECTIVE

Lubrication and free radical scavenging are key features of biomaterials used for viscosupplementation (VS) of joints affected by osteoarthritis (OA). The objective of this study was to describe the non-clinical performance characterization of KiOmedine® CM-Chitosan, a non-animal carboxymethyl chitosan, in order to assess its intended action in VS and to compare it to existing viscosupplements based on crosslinked hyaluronan (HA) formulations.

METHOD

The lubrication capacity of the tested viscosupplements (VS) was evaluated in-vitro and ex-vivo. In-vitro, the coefficient of friction (COF) was measured using a novel tribological system. Meanwhile, an ex-vivo biomechanical model in ovine hindlimbs was developed to assess the recovery of join mobility after an intra-articular (IA) injection. Free radical scavenging capacity of HA and KiOmedine® CM-Chitosan formulations was evaluated using the Trolox Equivalent Antioxidant Capacity (TEAC) assay.

RESULTS

In the in-vitro tribological model, KiOmedine® CM-Chitosan showed high lubrication capacity with a significant COF reduction than crosslinked HA formulations. In the ex-vivo model, the lubrication effect of KiOmedine® CM-Chitosan following an IA injection in the injured knee was proven again by a COF reduction. The recovery of joint motion was optimal with an IA injection of 3 ml of KiOmedine® CM-Chitosan, which was significantly better than the crosslinked HA formulation at the same volume. In the in-vitro TEAC assay, KiOmedine® CM-Chitosan showed a significantly higher free radical scavenging capacity than HA formulations.

CONCLUSION

Overall, the results provide a first insight into the mechanism of action in terms of lubrication and free radical scavenging for the use of KiOmedine® CM-Chitosan as a VS treatment of OA. KiOmedine® CM-Chitosan demonstrated a higher capacity to scavenge free radicals, and it showed a higher recovery of mobility after a knee lesion than crosslinked HA formulations. This difference could be explained by the difference in chemical structure between KiOmedine® CM-Chitosan and HA and their formulations.

Insight into the Lubrication and Adhesion Properties of Hyaluronan for Ocular Drug Delivery

Hyaluronan (HA) is widely used for eye drops as lubricant to counteract dry eye disease. High and low molecular weight HA are currently used in ophthalmology. However, a large portion of the current literature on friction and lubrication addresses articular (joint) cartilage. Therefore, eye drops compositions based on HA and its derivatized forms are extensively characterized providing data on the tribological and mucoadhesive properties. The physiochemical properties are investigated in buffers used commonly in eye drops formulations. The tribological investigation reveals that amphiphilic HA-C12 decreases the friction coefficient. At the same time, the combination of trehalose/HA or HAC12 enhances up to eighty-fold the mucoadhesiveness. Thus, it is predicted a prolonged residence time on the surface of the eye. The incorporation of trehalose enhances the protection of human keratinocytes (HaCaT) cells, as demonstrated in an in-vitro cell-desiccation model. The presence of trehalose increases the friction coefficient. Medium molecular weight HA shows significantly lower friction coefficient than high molecular weight HA. This research represents a first, wide array of features of diverse HA forms for eye drops contributing to increase the knowledge of these preparations. The results here presented also provide valuable information for the design of highly performing HA-formulations addressing specific needs before preclinic.

Tribological Properties of Micropored Poly(2-hydroxyethyl methacrylate) Hydrogels in a Biomimetic Aqueous Environment

The applications of hydrogels in tissue engineering as implants have rapidly grown in the last decade. However, the tribological properties of hydrogels under physiologically relevant conditions, especially those of textured hydrogels, have remained largely unknown due to the complexity of their mechanical and chemical properties. In this study, we experimentally investigated the tribological properties of micopored poly(2-hydroxyethyl methacrylate) (pHEMA) with the lateral pore dimensions varied compared to untextured pHEMA, the most commonly used hydrogel in ophthalmology, under physiologically relevant conditions. The pHEMA specimens were slid against a smooth glass curve under varying loads (6-60 mN, leading to an average contact pressure of 10-21 kPa) and sliding speeds (1-10 mm/s) in phosphate-buffered saline (pH 7.4) at 33 °C to mimic the physiological conditions in human eyes. At relatively low loads and sliding speeds (e.g., 6 mN and 1 mm/s), the micopored pHEMA did not reduce the dissipated frictional energy significantly. However, at relatively high loads and sliding speeds (e.g., 60 mN and 100 mm/s), the micopored pHEMA resulted in significantly lower frictional energy (reduced by up to 68%) dissipation than the untextured pHEMA. The effect was more pronounced with the micropores with smaller dimensions. These are attributed to the greater amount and retentivity of the interfacial fluid supported by the free water squeezed out of the micropores with the smaller dimensions under the higher load and sliding speed. These results suggest that the use of micropore texturing on hydrogels in practice, such as for ocular applications, can be leveraged to reduce friction and wear under physiological conditions and hence lower the chance of inflammation near eye implants or keratoprosthesis.

Recent Progress in Cartilage Lubrication

Healthy articular cartilage, covering the ends of bones in major joints such as hips and knees, presents the most efficiently-lubricated surface known in nature, with friction coefficients as low as 0.001 up to physiologically high pressures. Such low friction is indeed essential for its well-being. It minimizes wear-and-tear and hence the cartilage degradation associated with osteoarthritis, the most common joint disease, and, by reducing shear stress on the mechanotransductive, cartilage-embedded chondrocytes (the only cell type in the cartilage), it regulates their function to maintain homeostasis. Understanding the origins of such low friction of the articular cartilage, therefore, is of major importance in order to alleviate disease symptoms, and slow or even reverse its breakdown. This progress report considers the relation between frictional behavior and the cellular mechanical environment in the cartilage, then reviews the mechanism of lubrication in the joints, in particular focusing on boundary lubrication. Following recent advances based on hydration lubrication, a proposed synergy between different molecular components of the synovial joints, acting together in enabling the low friction, has been proposed. Additionally, recent development of natural and bio-inspired lubricants is reviewed.

Linking polymer hydrophobicity and molecular interactions to rheology and tribology in phospholipid-containing complex gels

HYPOTHESIS

The rheological behavior and frictional properties (macroscopic level) of systems containing a hydrophobically modified polymer and phospholipids depend on the hydrophobic association that occur between the hydrophobic moiety of the polymer and the phospholipid tails (molecular level). The hydrophobicity of the polymer can thus be used to control its interactions with phospholipids, and manipulate complex gel macroscopic behavior.

EXPERIMENTS

By using systems composed of a crosslinked hydrophobically modified polyacrylic acid (HMPAA) or a crosslinked polyacrylic acid polymer (PAA) and phospholipids, we examine the underlying mechanisms through which the components interact using isothermal titration calorimetry (ITC) and their effect on rheological and tribological characteristics of complex gels.

FINDINGS

We find the systems containing HMPAA and phospholipid exhibit gel-like behavior with the elastic modulus increasing substantially upon phospholipid addition due to hydrophobic interactions that result in a more interconnected network formation, as evidenced by ITC measurements. Similar experiments with a crosslinked polyacrylic acid polymer (PAA) show no interactions, lending credence to our hypothesis. In addition, soft tribological behavior shows lower friction coefficients at low entrainment speeds with HMPAA concentration and the addition of phospholipid, while no change in friction coefficient was observed in the case of increasing PAA concentration, indicating HMPAA and phospholipids to be interacting with the soft PDMS contacts.

Friction between soft contacts at nanoscale on uncoated and protein-coated surfaces

The understanding of friction on soft sliding biological surfaces at the nanoscale is poorly understood as hard interfaces are frequently used as model systems. Herein, we studied the influence of elastic modulus on the frictional properties of model surfaces at the nanoscale for the first time. We prepared model silicone-based elastomer surfaces with tuneable modulus ranging from hundreds of kPa to a few MPa, similar to those found in real biological surfaces, and employed atomic force microscopy to characterize their modulus, adhesion, and surface morphology. Consequently, we used friction force microscopy to investigate nanoscale friction in hard-soft and soft-soft contacts using spherical colloidal probes covered by adsorbed protein films. Unprecedented results from this study reveal that modulus of a surface can have a significant impact on the frictional properties of protein-coated surfaces with higher deformability leading to lower contact pressure and, consequently, decreased friction. These important results pave the way forward for designing new functional surfaces for serving as models of appropriate deformability to replicate the mechanical properties of the biological structures and processes for accurate friction measurements at nanoscale.

Polymeric Materials for Eye Surface and Intraocular Applications

Ocular applications of polymeric materials have been widely investigated for medical diagnostics, treatment, and vision improvement. The human eye is a vital organ that connects us to the outside world so when the eye is injured, infected, or impaired, it needs immediate medical treatment to maintain clear vision and quality of life. Moreover, several essential parts of the eye lose their functions upon aging, causing diminished vision. Modern polymer science and polymeric materials offer various alternatives, such as corneal and scleral implants, artificial ocular lenses, and vitreous substitutes, to replace the damaged parts of the eye. In addition to the use of polymers for medical treatment, polymeric contact lenses can provide not only vision correction, but they can also be used as wearable electronics. In this Review, we highlight the evolution of polymeric materials for specific ocular applications such as intraocular lenses and current state-of-the-art polymeric systems with unique properties for contact lens, corneal, scleral, and vitreous body applications. We organize this Review paper by following the path of light as it travels through the eye. Starting from the outside of the eye (contact lenses), we move onto the eye's surface (cornea and sclera) and conclude with intraocular applications (intraocular lens and vitreous body) of mostly synthetic polymers and several biopolymers. Initially, we briefly describe the anatomy and physiology of the eye as a reminder of the eye parts and their functions. The rest of the Review provides an overview of recent advancements in next-generation contact lenses and contact lens sensors, corneal and scleral implants, solid and injectable intraocular lenses, and artificial vitreous body. Current limitations for future improvements are also briefly discussed.

Ophthalmic Drops with Nanoparticles Derived from a Natural Product for Treating Age-Related Macular Degeneration

There is a continuing, urgent need for an ophthalmic (eye) drop for the clinical therapy of age-related macular degeneration (AMD), a leading cause of blindness. Here, we report the first formulation of an eye drop that is effective via autophagy for AMD treatment. This eye drop is based on a single natural product derivative (ACD), which is an amphiphilic molecule containing a 6-aminohexanoate group (H₂N(CH₂)₅COO-). We demonstrate that this eye drop reverses the abnormal angiogenesis induced in a primate model of AMD that has the pathological characteristics close to that of human AMD. The ACD molecule was self-assembled in an aqueous environment leading to nanoparticles (NPs) about 9.0 nm in diameter. These NPs were encapsulated in calcium alginate hydrogel. The resulting eye drop effectively slowed the release of ACD and displayed extended release periods in both simulated blood (pH 7.4) and inflammatory (pH 5.2) environments. We show that the eye drop penetrated both the corneal and blood-eye barriers and reached the fundus. With low cellular toxicity, the drop targeted S1,25D₃-membrane-associated rapid response steroid-binding protein (1,25D₃-MARRS) promoting autophagy in a dose-dependent manner. In addition, the drop inhibited cell migration and tubular formation. On the other hand, when protein 1,25D₃-MARRS was knocked down, the eye drop did not exhibit such inhibition functionalities. Our study indicates that the 6-aminohexanoate group on self-assembled NPs encapsulated in hydrogel leads to the positive in vivo outcomes. The present formulation offers a promising approach for clinical treatment of human AMD.

Advances in Understanding Hydrogel Lubrication

Since their inception, hydrogels have gained popularity among multiple fields, most significantly in biomedical research and industry. Due to their resemblance to biological tribosystems, a significant amount of research has been conducted on hydrogels to elucidate biolubrication mechanisms and their possible applications as replacement materials. This review is focused on lubrication mechanisms and covers friction models that have attempted to quantify the complex frictional characteristics of hydrogels. From models developed on the basis of polymer physics to the concept of hydration lubrication, assumptions and conditions for their applicability are discussed. Based on previous models and our own experimental findings, we propose the viscous-adhesive model for hydrogel friction. This model accounts for the effects of confinement of the polymer network provided by a solid surface and poroelastic relaxation as well as the (non) Newtonian shear of a complex fluid on the frictional force and quantifies the frictional response of hydrogels-solid interfaces. Finally, the review delineates potential areas of future research based on the current knowledge.

Highly improved aqueous lubrication of polymer surface by noncovalently bonding hyaluronic acid-based hydration layer for endotracheal intubation

Hydration lubrication is the key responsible for the exceptionally low boundary friction between biosurfaces. However, it is a challenge to settle a hydration layer on a polymer surface via a noncovalent manner. Herein, we develop a highly lubricated coating absorbed onto the polymer surface via intermolecular association of hyaluronic acid (HA)-based micelles. A poly(ethylene oxide)-b-poly(propylene oxide)-b-poly(ethylene oxide) triblock copolymer (Pluronic, F127) is recruited to complex with HA and further self-assembled to form a thick micelle layer. High water-retaining capacity of the HA/F127 coating enables the decorated surface with excellent hydrophilicity and boundary lubrication, where the coefficient of friction in aqueous media is reduced by 60% compared with the bare polymer surface. The HA/F127 coating suppresses nonspecific protein adsorption and exhibits good biocompatibility. More remarkably, an in vivo cynomolgus monkey model, demonstrates the utility of the HA/F127 coating in alleviating or preventing complications of endotracheal intubation, such as foreign irritation, airway mucosal damage, and inflammatory response. This cost-effective and scalable approach is suitable to manufacture interventional devices especially disposable medical devices with highly lubricated surface.

Novel Poly(vinylpyrrolidone)-Coated Silicone Contact Lenses to Improve Tear Volume During Lens Wear: In Vitro and In Vivo Studies

Poly(vinylpyrrolidone) (PVP-K90) is widely used to manage dry eye syndrome (DES). The marketed eye drop solutions (high dose) need frequent instillation, affecting the routine lifestyle of patients. PVP-K90-laden contact lenses can be used to overcome the limitations of eye drop solutions (low bioavailability and frequent instillation). However, the conventional methods of PVP-K90 loading show poor loading capacity and short duration of effect. In the present study, we have developed PVP-K90-coated contact lenses via a short curing approach to increase the PVP-K90 loading capacity with a sustained release profile to manage dry eye syndrome. PVP-K90 was loaded by a soaking method (SM-PVP), direct loading (during fabrication, DL-PVP), a combination of soaking and direct loading (DL-SM-PVP), and a novel coating process (SM-PVP-C and DL-SM-PVP-C). The swelling studies suggested improvement in the water uptake (hydration) property of the contact lenses due to the presence of PVP-K90. The optical transparency was within an acceptable range. The in vitro release of PVP-K90 was in the following order: PVP-coated contact lens (168 h) > DL-SM-PVP (168 h) > DL-PVP (96 h) > SM-PVP (72-96 h). PVP-coated contact lenses showed a high burst effect (lubricating effect) and sustained release (3161-448 ng/h between 24 and 168 h) due to high PVP loading/coating in comparison to the uncoated respective contact lenses (964-113 ng/h between 24 and 96 h). In animal studies, the PVP-K90-coated contact lens showed higher tear volume in comparison to the respective uncoated contact lenses and an eye drop solution. This study demonstrates a novel approach of coating a high amount of PVP-K90 on contact lenses for sustained release to manage several ocular diseases like dry eye syndrome, conjunctivitis, and other ocular injuries.

Contribution of Mucins towards the Physical Properties of the Tear Film: A Modern Update

Instability of the tear film (TF) protecting the ocular surface results in dry eye syndrome (DES), the most prevalent public health ophthalmic disease affecting the quality of life of 10 to 30% of the human population worldwide. Although the impact of the tear film lipid layer (TFLL) and of the aqueous tears (AT) to the TF stability is extensively studied, in contrast the contribution of the secretory mucins (SM) and of the membrane-associated mucins (MAM), i.e., one of the most abundant molecular classes in AT and in the corneal epithelium respectively, remains poorly defined. However, it is well known that in DES both types of mucins are quantitatively or qualitatively deficient. Numerous studies since the 1990s until now have proposed direct involvement of SM and MAM in the material properties (viscoelasticity, hydration, and protection of the ocular surface; synergistic cooperation with the rest of the TF layers; etc.) and stability of TF. These theories will be reviewed here in the context of the classical and modern in vitro and in vivo results that allow their reappraisal and in view of the novel mucin secretion enhancing pharmaceuticals, which have opened innovative routes for the therapy of DES.

Microgels as viscosity modifiers influence lubrication performance of continuum

Biocompatible microgels have been demonstrated to act as excellent lubricants, however, the influence of the continuum on their overall mechanical performance has been neglected so far. In this work, the mechanical performance of colloidal whey protein microgels (hydrodynamic diameter ∼100 nm measured using dynamic light scattering and atomic force microscopy) of different rigidity dispersed in Newtonian (buffer and corn syrup) or complex non-Newtonian fluids (xanthan gum) is investigated for the first time via rheology and soft tribology. Dispersions of both soft microgels (G' ∼ 100.0 Pa) and hard microgels (G' ∼ 10.0 kPa) were observed to act as thickeners in buffer as well as in low viscosity corn syrup and correspondingly reduced the friction, latter decreased as a function of the increased rigidity of the microgels. Differently, in high viscosity continuum, the microgels acted as thinning agents and increased the friction. In the lubrication limit, microgels in buffer or corn syrup behaved as Newtonian fluids with effective viscosity corresponding to their second Newtonian plateau value (η∞). However, the lubrication performance of the microgels dispersed in the complex fluid (xanthan gum) could not be described quantitatively by η∞. For the low viscosity xanthan gum, the microgels had no influence on friction. Nevertheless, for the high viscosity counterparts, the soft microgels acted as thinning agents whilst the hard microgels accelerated the onset of elastohydrodynamic regime. This study demonstrates that microgels act as viscosity modifiers directly influencing the tribological performance, depending upon a subtle interplay of rheological properties of the particles and continuum.

The impact of contact lens wear on ocular surface mucins using a novel clinical fluorescence imaging system

PURPOSE

Fluorescein-labelled wheat germ agglutinin (F-WGA) acts as a marker for ocular surface mucins. This clinical study sought to investigate whether the degree of F-WGA fluorescence observed at the ocular surface differed between symptomatic contact lens wearers, asymptomatic contact lens wearers and non-contact lens wearers, using a novel imaging system.

METHODS

Twenty-five participants (10 symptomatic contact lens wearers, 10 asymptomatic contact lens wearers and 5 non-contact lens wearers) attended a single study visit. Photographs of the cornea, bulbar and tarsal conjunctiva were captured following application of F-WGA solution.

RESULTS

The imaging system captured high-resolution images of F-WGA fluorescence at the ocular surface. The degree of fluorescence differed between the ocular surface regions (p < 0.001). A significant difference in fluorescence was observed between participant groups for the cornea (p = 0.01), with both the symptomatic and asymptomatic contact lens wearers showing lower fluorescence than the non-lens wearers. F-WGA associated fluorescence appeared diminished in the lid wiper region of the symptomatic lens wearers, compared to the asymptomatic group (p = 0.025).

CONCLUSION

The use of F-WGA as a clinical marker for ocular surface mucins allows an improved understanding of their distribution across the ocular surface. Contact lens wear appears to negatively impact mucin density across the ocular surface, with the most marked effect on the cornea. F-WGA fluorescence appeared diminished in the lid wiper region for the symptomatic contact lens wearing group, indicating that mechanical interaction in this region may play a role in the aetiology of contact lens discomfort. Given the ability of F-WGA to disclose mucin distribution across the ocular surface it is likely to be a key clinical tool in furthering our understanding of (i) the aetiology of contact lens related discomfort, (ii) contact lens designs/materials to minimise interaction with the ocular surface and (iii) dry eye disease and other ocular surface diseases.

Engineering mucus to study and influence the microbiome

Mucus is a 3D hydrogel that houses the majority of the human microbiome. The mucous environment plays an important role in the differentiation and behaviour of microbial phenotypes and enables the creation of spatial distributions. Dysregulation of mucus is further associated with various diseases. Therefore, mucus is the key ingredient to study the behaviour of commensal and pathogenic microbiota in vitro. Indeed, microorganisms cultured in mucus exhibit phenotypes substantially different from those exhibited in standard laboratory media. In this Review, we discuss the impact of mucus on the microbiome and examine the structure and glycosylation of mucins - the main building blocks of mucus. We investigate the impact of glycans on mucin function and highlight different approaches for the engineering of synthetic mucins, including synthesis of the backbone, the design of mucin-mimetic hydrogels and the engineering of glycans. Finally, mucin mimetics for 3D in vitro cell culture and for modulating microbial community structure and function are discussed.

Effect of counterface on cartilage boundary lubricating ability by proteoglycan 4 and hyaluronan: Cartilage-glass versus cartilage-cartilage

The objective of this study was to determine the effect of different sliding interface materials (counterface) on the cartilage lubricating ability of proteoglycan 4 (PRG4) and hyaluronan (HA) by measuring the kinetic coefficient of friction on cartilage-glass and cartilage-cartilage interfaces over a wide range of sliding velocities. The lubrication properties of PRG4 and HA were assessed at cartilage-glass and cartilage-cartilage interfaces using a previously described test setup with a stationary area of contact. Samples were articulated at varying effective sliding velocities of 10, 3, 1, 0.3, 0.1, and 0.01 mm/s. The response of PRG4 and HA as effective friction-reducing cartilage boundary lubricants was varied and was dependent primarily on the test counterface. At a physiological cartilage-cartilage interface both HA and PRG4 effectively reduced friction compared to PBS at slower speeds while at higher speeds PRG4 was similar to PBS, and HA similar to SF. Conversely, at a cartilage-glass interface HA demonstrated no friction reducing ability compared to PBS, and PRG4 appeared just as effective as SF. Cartilage-glass friction coefficients were also significantly greater than cartilage-cartilage friction coefficients. These results indicate the in vitro friction coefficient of putative cartilage boundary lubricants can be affected by the test counterface and suggest that use of synthetic surfaces in studying cartilage boundary lubrication may not always be appropriate for all molecules of interest. As such, care should be taken when interpreting such data, specifically when comparing to in vitro data obtained at a cartilage-cartilage interface, and especially when extrapolating to in vivo situations. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2923-2931, 2018.

Friction-lowering capabilities and human subject preferences for a hydrophilic surface coating on latex substrates: implications for increasing condom usage

Personal lubricants can increase user satisfaction with male condoms by reducing friction and yielding a slippery sensation. However, lubricants pose disadvantages of dilution in physiologic fluids and sloughing away over repeated articulations. To address these drawbacks, a latex surface modification, which becomes lubricious in the presence of physiologic fluid, has been developed and evaluated. This study assesses (i) the frictional performance of the lubricious coating compared to non-coated latex and latex lubricated by personal lubricant, (ii) the level of agreement between human-perceived slipperiness and machine-measured friction, and (iii) human preference for a hypothetical male condom containing the lubricious coating. Friction coefficient of the lubricious coating was 53% lower than that of non-coated latex and approximately equal to that afforded by personal lubricant. A touch test and survey of a small population sample (N = 33) revealed a strong correlation (R ² = 0.83) between human-perceived slipperiness and machine-measured friction. A majority of participants (73%) expressed a preference for a condom containing the lubricious coating, agreeing that an inherently slippery condom that remained slippery for a long duration would increase their condom usage. Such a coating shows potential to be an effective strategy for decreasing friction-associated pain, increasing user satisfaction and increasing condom usage.

Emulsion Microgel Particles as High-Performance Bio-Lubricants

Starch-based emulsion microgel particles with different starch (15 and 20 wt %) and oil contents (0-15 wt %) were synthesized, and their lubrication performance under physiological conditions was investigated. Emulsion microgels were subjected to skin mimicking or oral cavity mimicking conditions, i.e., smooth hydrophobic polydimethylsiloxane ball-on-disc tribological tests, in the absence or presence of salivary enzyme (α-amylase). In the absence of enzyme, emulsion microgel particles (30-60 vol % particle content) conserved the lubricating properties of emulsion droplets, providing considerably lower friction coefficients (μ ≤ 0.1) in the mixed lubrication regime compared to plain microgel particles (0 wt % oil). Upon addition of enzyme, the lubrication performance of emulsion microgel particles became strongly dependent on the particles' oil content. Microgel particles encapsulating 5-10 wt % oil showed a double plateau mixed lubrication regime having a lowest friction coefficient μ ∼ 0.03 and highest μ ∼ 0.1, the latter higher than with plain microgel particles. An oil content of 15 wt % was necessary for the microgel particles to lubricate similarly to the emulsion droplets, where both systems showed a normal mixed lubrication regime with μ ≤ 0.03. The observed trends in tribology, theoretical considerations, and the combined results of rheology, light scattering, and confocal fluorescence microscopy suggested that the mechanism behind the low friction coefficients was a synergistic enzyme- and shear-triggered release of the emulsion droplets, improving lubrication. The present work thus demonstrates experimentally and theoretically a novel biolubricant additive with stimuli-responsive properties capable of providing efficient boundary lubrication between soft polymeric surfaces. At the same time, the additive should provide an effective delivery vehicle for oil soluble ingredients in aqueous media. These findings demonstrate that emulsion microgel particles can be developed into multifunctional biolubricant additives for future use in numerous soft matter applications where both lubrication and controlled release of bioactives are essential.

Synthesis of Modular Brush Polymer-Protein Hybrids Using Diazotransfer and Copper Click Chemistry

Proteoglycans are important brush-like biomacromolecules, which serve a variety of functions in the human body. While protein-bottlebrush hybrids are promising proteoglycan mimics, many challenges still exist to robustly produce such polymers. In this paper, we report the modular synthesis of protein-brush hybrids containing elastin-like polypeptides (ELP) as model proteins by copper-catalyzed azide-alkyne cycloaddition. We exploit the recently discovered imidazole-1-sulfonyl azide (ISA) in a diazotransfer reaction to introduce an N-terminal azide onto an ELP. Next, we use a click reaction to couple the azido-ELP to an alkyne-terminated amine-rich polymer followed by a second diazotransfer step to produce an azide-rich backbone that serves as a scaffold. Finally, we used a second click reaction to graft alkyne-terminated poly(oligoethylene glycol methacrylate) (POEGMA) bristles to the azide-rich backbone to produce the final protein-bottlebrush hybrid. We demonstrate the effectiveness of this synthetic path at each step through careful characterization with ¹H NMR, FTIR, GPC, and diagnostic test reactions on SDS-PAGE. Final reaction products could be consistently obtained for a variety of different molecular weight backbones with final total grafting efficiencies around 70%. The high-yielding reactions employed in this highly modular approach allow for the synthesis of protein-bottlebrush hybrids with different proteins and brush polymers. Additionally, the mild reaction conditions used have the potential to avoid damage to proteins during synthesis.

Development of an in vitro model to study the biological effects of blinking

PURPOSE

To develop a mechanical model in which a contact lens is swept over ocular surface cells under conditions that mimic the force and speed of the blink, and to investigate the resulting biological changes.

METHODS

A computer controlled mechanical instrument was developed to hold a dish containing 3D cultured stratified human ocular surface epithelial cells, across which an arm bearing a contact lens was swept back and forth repeatedly at a speed and force mimicking the human blink. Cells were subjected to repeated sweep cycles for up to 1 h at a speed of 120 mm/s with or without an applied force of 19.6 mN (to mimic pressure exerted by upper eyelid), after which the cell layer thickness was measured, the cell layer integrity was investigated using fluorescent quantum dots (6 and 13 nm) and the phosphorylation levels of various protein kinases were analyzed by human phospho-kinase arrays. Data for selected kinases were further quantitated by enzyme immunoassays.

RESULTS

The thickness of the cell layers did not change after exposure to sweep cycles with or without applied force. Quantum dots (6 and 13 nm) were able to penetrate the layers of cells exposed to sweep cycles but not layers of untreated control cells. The phosphorylation levels of HSP27 and JNK1/2/3 increased for cells exposed to sweep cycles with applied force compared to untreated control cells.

CONCLUSIONS

The in vitro mechanical instrument is a useful tool to investigate the effects of blinking on the ocular surface.