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Wang X, Liu Z, Sandoval-Salaiza DA, Afewerki S, Jimenez-Rodriguez MG, Sanchez-Melgar L, Güemes-Aguilar G, Gonzalez-Sanchez DG, Noble O, Lerma C, Parra-Saldivar R, Lemos DR, Llamas-Esperon GA, Shi J, Li L, Lobo AO, Fuentes-Baldemar AA, Bonventre JV, Dong N, Ruiz-Esparza GU. Nanostructured Non-Newtonian Drug Delivery Barrier Prevents Postoperative Intrapericardial Adhesions. ACS APPLIED MATERIALS & INTERFACES 2021; 13:29231-29246. [PMID: 34137251 DOI: 10.1021/acsami.0c20084] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
With the increasing volume of cardiovascular surgeries and the rising adoption rate of new methodologies that serve as a bridge to cardiac transplantation and that require multiple surgical interventions, the formation of postoperative intrapericardial adhesions has become a challenging problem that limits future surgical procedures, causes serious complications, and increases medical costs. To prevent this pathology, we developed a nanotechnology-based self-healing drug delivery hydrogel barrier composed of silicate nanodisks and polyethylene glycol with the ability to coat the epicardial surface of the heart without friction and locally deliver dexamethasone, an anti-inflammatory drug. After the fabrication of the hydrogel, mechanical characterization and responses to shear, strain, and recovery were analyzed, confirming its shear-thinning and self-healing properties. This behavior allowed its facile injection (5.75 ± 0.15 to 22.01 ± 0.95 N) and subsequent mechanical recovery. The encapsulation of dexamethasone within the hydrogel system was confirmed by 1H NMR, and controlled release for 5 days was observed. In vitro, limited cellular adhesion to the hydrogel surface was achieved, and its anti-inflammatory properties were confirmed, as downregulation of ICAM-1 and VCAM-1 was observed in TNF-α activated endothelial cells. In vivo, 1 week after administration of the hydrogel to a rabbit model of intrapericardial injury, superior efficacy was observed when compared to a commercial adhesion barrier, as histological and immunohistochemical examination revealed reduced adhesion formation and minimal immune infiltration of CD3+ lymphocytes and CD68+ macrophages, as well as NF-κβ downregulation. We presented a novel nanostructured drug delivery hydrogel system with unique mechanical and biological properties that act synergistically to prevent cellular infiltration while providing local immunomodulation to protect the intrapericardial space after a surgical intervention.
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Affiliation(s)
- Xichi Wang
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zongtao Liu
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Diego A Sandoval-Salaiza
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- School of Engineering and Science, Tecnologico de Monterrey, Monterrey, Nuevo Leon 64849, Mexico
| | - Samson Afewerki
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Department of Chemical Engineering and Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Mildred G Jimenez-Rodriguez
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- School of Engineering and Science, Tecnologico de Monterrey, Monterrey, Nuevo Leon 64849, Mexico
| | - Lorena Sanchez-Melgar
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- School of Engineering and Science, Tecnologico de Monterrey, Monterrey, Nuevo Leon 64849, Mexico
| | - Gabriela Güemes-Aguilar
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- School of Medicine and Health Science, Tecnologico de Monterrey, Monterrey, Nuevo Leon 64849, Mexico
| | - David G Gonzalez-Sanchez
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- School of Medicine and Health Science, Tecnologico de Monterrey, Monterrey, Nuevo Leon 64849, Mexico
| | - Oscar Noble
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- School of Medicine and Health Science, Tecnologico de Monterrey, Monterrey, Nuevo Leon 64849, Mexico
| | - Cecilia Lerma
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- School of Engineering and Science, Tecnologico de Monterrey, Monterrey, Nuevo Leon 64849, Mexico
| | - Roberto Parra-Saldivar
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- School of Engineering and Science, Tecnologico de Monterrey, Monterrey, Nuevo Leon 64849, Mexico
| | - Dario R Lemos
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Guillermo A Llamas-Esperon
- Department of Interventional Cardiology, Hospital Cardiológica, Aguascalientes, Aguascalientes 20230, Mexico
| | - Jiawei Shi
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Li Li
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Anderson O Lobo
- LIMAV-Interdisciplinary Laboratory for Advanced Materials, BioMatLab group, Material Science and Engineering Graduate Program, UFPI- Federal University of Piauí, Teresina, Piauí 64049-550, Brazil
| | - Andres A Fuentes-Baldemar
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Joseph V Bonventre
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Nianguo Dong
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Guillermo U Ruiz-Esparza
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Health Sciences and Technology, Harvard University - Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
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