Anchorable phosphorylcholine copolymer synthesis and cell membrane mimetic antifouling coating fabrication for blood compatible applications

Stability Study of Anticoagulant Hydrogel Coatings Toward Long-Term Cardiovascular Devices

Implantable cardiovascular devices have revolutionized the treatment of cardiovascular diseases, yet their long-term functionality without causing thrombosis is a persistent challenge. Although the surface modification of anticoagulant coating has greatly improved the biocompatibility of the devices, its long-term stability in complex physiological environments still remains questionable. Herein, the stability of three anticoagulant hydrogel coatings, poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC), poly(sodium 2-acryloyl-2-methylpropanesulfonate) (PAMPS), and poly(4-styrenesulfonate sodium) (PSS), is studied. The fabrication of these coatings onto device surfaces is validated by using X-ray photoelectron spectroscopy (XPS) and attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy. In vitro anticoagulation assays confirm the coatings' significant anticoagulant effects. Among all three coatings, the PSS coating demonstrated superior chemical and mechanical stability in the comprehensive tests, showing great potential for improving the long-term anticoagulant performance of implantable cardiovascular devices.

An endothelium membrane mimetic antithrombotic coating enables safer and longer extracorporeal membrane oxygenation application

Thrombosis and plasma leakage are two of the most frequent dysfunctions of polypropylene (PP) hollow fiber membrane (PPM) used in extracorporeal membrane oxygenation (ECMO) therapy. In this study, a superhydrophilic endothelial membrane mimetic coating (SEMMC) was constructed on polydopamine-polyethyleneimine pre-coated surfaces of the PPM oxygenator and its ECMO circuit to explore safer and more sustainable ECMO strategy. The SEMMC is fabricated by multi-point anchoring of a phosphorylcholine and carboxyl side chained copolymer (PMPCC) and grafting of heparin (Hep) to form PMPCC-Hep interface, which endows the membrane superior hemocompatibility and anticoagulation performances. Furthermore, the modified PPM reduces protein adsorption amount to less than 30 ng/cm2. More significantly, the PMPCC-Hep coated ECMO system extends the anti-leakage and non-clotting oxygenation period to more than 15 h in anticoagulant-free animal extracorporeal circulation, much better than the bare and conventional Hep coated ECMO systems with severe clots and plasma leakage in 4 h and 8 h, respectively. This SEMMC strategy of grafting bioactive heparin onto bioinert zwitterionic copolymer interface has great potential in developing safer and longer anticoagulant-free ECMO systems. STATEMENT OF SIGNIFICANCE: A superhydrophilic endothelial membrane mimetic coating was constructed on surfaces of polypropylene hollow fiber membrane (PPM) oxygenator and its ECMO circuit by multi-point anchoring of a phosphorylcholine and carboxyl side chain copolymer (PMPCC) and grafting of heparin (Hep). The strong antifouling nature of the PMPCC-Hep coating resists the adsorption of plasma bio-molecules, resulting in enhanced hemocompatibility and anti-leakage ability. The grafted heparin on the zwitterionic PMPCC interface exhibits superior anticoagulation property. More significantly, the PMPCC-Hep coating achieves an extracorporeal circulation in a pig model for at least 15 h without any systemic anticoagulant. This endothelial membrane mimetic anticoagulation strategy shows great potential for the development of safer and longer anticoagulant-free ECMO systems.

Bioinspired Dopamine and N-Oxide-Based Zwitterionic Polymer Brushes for Fouling Resistance Surfaces

Biofouling is a great challenge for engineering material in medical-, marine-, and pharmaceutical-related applications. In this study, a novel trimethylamine N-oxide (TMAO)-analog monomer, 3-(2-methylacrylamido)-N,N-dimethylpropylamine N-oxide (MADMPAO), was synthesized and applied for the grafting of poly(MADMPAO) (pMPAO) brushes on quartz crystal microbalance (QCM) chips by the combination of bio-inspired poly-dopamine (pDA) and surface-initiated atom transfer radical polymerization technology. The result of ion adsorption exhibited that a sequential pDA and pMPAO arrangement from the chip surface had different characteristics from a simple pDA layer. Ion adsorption on pMPAO-grafted chips was greatly inhibited at low salt concentrations of 1 and 10 mmol/L due to strong surface hydration in the presence of charged N+ and O- of zwitterionic pMPAO brushes on the outer layer on the chip surface, well known as the "anti-polyelectrolyte" effect. During BSA adsorption, pMPAO grafting also led to a marked decrease in frequency shift, indicating great inhibition of protein adsorption. It was attributed to weaker BSA-pMPAO interaction. In this study, the Au@pDA-4-pMPAO chip with the highest coating concentration of DA kept stable dissipation in BSA adsorption, signifying that the chip had a good antifouling property. The research provided a novel monomer for zwitterionic polymer and demonstrated the potential of pMPAO brushes in the development and modification of antifouling materials.

Poly(sulfobetaine) versus poly(ethylene glycol) based copolymer modified polyurethane catheters for antifouling

Polyurethane (PU) catheters are commonly used in clinical treatment. However, the hydrophobic nature of the PU catheter surface leads to adhesion or adsorption to platelets, proteins, bacteria, and other molecules when used in human treatment. To achieve a surface with strong hydrophilicity, high stability and excellent biocompatibility, it is necessary to functionalize the PU catheters. In this paper, a coating with antifouling function was constructed on the surface of PU catheters using plasma technology and an amide coupling reaction. A series of characterization methods, including X-ray photoelectron spectroscopy (XPS), water contact angles (WCA), and atomic force microscopy (AFM), were used to prove the successful modification of the polymer coatings. The coatings showed good stability under conditions such as PBS (pH 7.4, 720 h), 75% ethanol (6 h) and 1 wt% SDS (10 min). Additionally, the coatings exhibit excellent hemocompatibility and antibacterial properties. The PU/PEI/PCSB coating has the best anti-fouling performance among them, which means that using the PCSB copolymer has the potential to modify different clinical catheters into highly effective antifouling coatings.

Functional Zwitterionic Polyurethanes: State-of-the-Art Review

Recent advancements in bioengineering and medical devices have been greatly influenced and dominated by synthetic polymers, particularly polyurethanes (PUs). PUs offer customizable mechanical properties and long-term stability, but their inherent hydrophobic nature poses challenges in practically biological application processes, such as interface high friction, strong protein adsorption, and thrombosis. To address these issues, surface modifications of PUs for generating functionally hydrophilic layers have received widespread attention, but the durability of generated surface functionality is poor due to irreversible mechanical wear or biodegradation. As a result, numerous researchers have investigated bulk modification techniques to incorporate zwitterionic polymers or groups onto the main or side chains of PUs, thereby improving their hydrophilicity and biocompatibility. This comprehensive review presents an extensive overview of notable zwitterionic PUs (ZPUs), including those based on phosphorylcholine, sulfobetaine, and carboxybetaine. The review explores their wide range of biomedical applications, from blood-contacting devices to antibacterial coatings, fouling-resistant marine coatings, separation membranes, lubricated surfaces, and shape memory and self-healing materials. Lastly, the review summarizes the challenges and future prospects of ZPUs in biological applications.

Achieving superior anticoagulation of endothelial membrane mimetic coating by heparin grafting at zwitterionic biocompatible interfaces

Thrombosis and bleeding are common complications of blood-contacting medical device therapies. In this work, an endothelium membrane mimetic coating (PMPCC/Hep) has been created to address these challenges. The coating is fabricated by multi-point anchoring of a phosphorylcholine copolymer (poly-MPC-co-MSA, PMPCC) with carboxylic side chains and end-group grafting of unfractionated heparin (Hep) onto polydopamine precoated blood-contacting material surfaces. The PMPCC coating forms an ultrathin cell outer membrane mimetic layer to resist protein adsorption and platelet adhesion. The tiny defects/pores of the PMPCC layer provide entrances for heparin end-group to be inserted and grafted onto the sub-layer amino groups. The combination of the PMPCC cell membrane mimetic anti-fouling nature with the grafted heparin bioactivity further enhances the anticoagulation performance of the formed endothelium membrane mimetic PMPCC/Hep coating. Compared to conventional Hep coating, the PMPCC/Hep coating further decreases protein adsorption and platelet adhesion by 50 % and 90 %, respectively. More significantly, the PMPCC/Hep coating shows a superior anticoagulation activity, even significantly higher than that of an end-point-attached heparin coating. Furthermore, the blood coagulation function is well preserved in the PMPCC/Hep coating anticoagulation strategy. All the results support that the PMPCC/Hep coating strategy has great potential in developing more efficient and safer blood-contacting medical devices.

Unravelling Surface Modification Strategies for Preventing Medical Device-Induced Thrombosis

The use of biomaterials in implanted medical devices remains hampered by platelet adhesion and blood coagulation. Thrombus formation is a prevalent cause of failure of these blood-contacting devices. Although systemic anticoagulant can be used to support materials and devices with poor blood compatibility, its negative effects such as an increased chance of bleeding, make materials with superior hemocompatibility extremely attractive, especially for long-term applications. This review examines blood-surface interactions, the pathogenesis of clotting on blood-contacting medical devices, popular surface modification techniques, mechanisms of action of anticoagulant coatings, and discusses future directions in biomaterial research for preventing thrombosis. In addition, this paper comprehensively reviews several novel methods that either entirely prevent interaction between material surfaces and blood components or regulate the reaction of the coagulation cascade, thrombocytes, and leukocytes.

Antifouling polymers for nanomedicine and surfaces: recent advances

Antifouling polymers are materials that can resist nonspecific interactions with cells, proteins, and other biomolecules. Typically, they are hydrophilic polymers with polar or charged moieties that are capable of strong nonbonding interactions with water molecules. This propensity to bind water generates a surface hydration layer that reduces nonspecific interactions with other molecules and is paramount to the antifouling behavior. This property is especially useful for nanoscale applications such as nanomedicine and surface modifications at the molecular level. In nanomedicine, antifouling polymers such as poly(ethylene glycol) and its alternatives play a key role in shielding drug molecules and therapeutic proteins/genes from the immune system within nanoassemblies, thereby enabling effective delivery to target tissues. For coatings, antifouling polymers help to prevent adhesion of cells and molecules to surfaces and are thus valued in marine and biomedical device applications. In this Review, we survey recent advances in antifouling polymers in the context of nanomedicine and coatings, while shining the spotlight on the major polymer classes such as PEG, polyzwitterions, poly(oxazoline)s, and other nonionic hydrophilic polymers.

Crosslinked biomimetic coating modified stainless-steel-mesh enables completely self-cleaning separation of crude oil/water mixtures

The development of high-flux, durable and completely self-cleaning membranes is highly desired for separation of massive oil/water mixtures. Herein, differently crosslinked poly(2-methacryloyloxylethyl phosphorylcholine) (PMPC) brush grafted stainless steel mesh (SSM) membranes (SSM/PMPCs) were fabricated by integrating of mussel inspired universal adhesion and crosslinking chemistry with surface-initiated activators regenerated by electron transfer atom transfer radical polymerization (SI-ARGET-ATRP). The durability and self-cleaning performance of the prepared SSM membranes were evaluated by separating sticky crude oil/water mixtures in a continuous recycling dead-end filtration device. The water filtration flux driven by gravity reached 60,000 L⋅m^-2⋅h^-1 with a separation efficiency of over 99.98%. Furthermore, zero-flux-decline was observed during a 5 h continuous filtration when assisted by mechanical stirring. More significantly, such a completely self-cleaning separation of the well crosslinked SSM/PMPC2 membrane under optimized flux and stirring conditions had been operated cumulatively for 190 h in 30 days without any additional cleaning. These significant advances are more promising for practical applications in crude oil-contaminated water treatments and massive oil/water mixture separation.

Bio-inspired hemocompatible surface modifications for biomedical applications

When blood first encounters the artificial surface of a medical device, a complex series of biochemical reactions is triggered, potentially resulting in clinical complications such as embolism/occlusion, inflammation, or device failure. Preventing thrombus formation on the surface of blood-contacting devices is crucial for maintaining device functionality and patient safety. As the number of patients reliant on blood-contacting devices continues to grow, minimizing the risk associated with these devices is vital towards lowering healthcare-associated morbidity and mortality. The current standard clinical practice primarily requires the systemic administration of anticoagulants such as heparin, which can result in serious complications such as post-operative bleeding and heparin-induced thrombocytopenia (HIT). Due to these complications, the administration of antithrombotic agents remains one of the leading causes of clinical drug-related deaths. To reduce the side effects spurred by systemic anticoagulation, researchers have been inspired by the hemocompatibility exhibited by natural phenomena, and thus have begun developing medical-grade surfaces which aim to exhibit total hemocompatibility via biomimicry. This review paper aims to address different bio-inspired surface modifications that increase hemocompatibility, discuss the limitations of each method, and explore the future direction for hemocompatible surface research.

Zwitterionic/active ester block polymers as multifunctional coating for polyurethane-based substrates

Bacterial associated infection, blood coagulation, and tissue adhesion are severe issues associated with biomedical implants & devices in clinic applications. Here, we report a general strategy to simultaneously tackle these...

Bio-inspired zwitterionic polymeric chelating assembly for treatment of copper-induced cytotoxicity and hemolysis

We developed a hemocompatible, bio-inspired, multivalent, polymeric-chelating assembly based on the poly(2-methacryloyloxyethyl phosphorylcholine)-b-poly(serinyl acrylate) (PMPC-b-PserA) zwitterionic diblock copolymer. Functional PMPC-b-PserA was synthesized via reversible addition-fragmentation chain transfer (RAFT) polymerization to catch and encapsulate free copper ions (Cu²⁺) in a solution. PMPC with an identical polar group to phospholipids exhibits high hydrophilicity and fouling resistance against non-specific adsorption, and inertness to the metal ions. On the other hand, PserA with pendant groups of amino acids possesses a strong capability to react with Cu²⁺ by coordination interaction. Therefore, when PMPC-b-PserA was brought into contact with Cu²⁺, a hydrophobic core with multiple coordination "bridges" between polymers and Cu²⁺ was formed, leading to self-assembly of core-shell polymer-metal nanoparticles. As a result, free Cu²⁺ ions can be removed from the solution to prevent damage to cells and tissues. The synthesis and chemical structure of PMPC-b-PserA were characterized, and the formation of self-assembled polymer-Cu²⁺ nanoparticles and colloidal stability were analyzed. More importantly, the detoxification of PMPC-b-PserA in presence of Cu²⁺ with fibroblast cells was demonstrated by increased cell viability >80%. In addition, the hemolysis, which occurred due to disruption of RBC membranes by free Cu²⁺, was effectively suppressed by adding PMPC-b-PserA. The bio-inspired and biocompatible chelating agent of PMPC-b-PserA provides a new treatment approach to encapsulate and detoxify heavy metals in complex media for chelation therapy.

Smart MSN-Drug-Delivery System for Tumor Cell Targeting and Tumor Microenvironment Release

Tumor-targeted delivery and controlled release of antitumor drugs are promising strategies for increasing chemotherapeutic efficacy and reducing adverse effects. Although mesoporous silica nanoparticles (MSNs) have been known as a potential delivery system for doxorubicin (DOX), they have restricted applications due to their uncontrolled leakage and burst release from their large open pores. Herein, we engineered a smart drug-delivery system (smart MSN-drug) based on MSN-drug loading, cell membrane mimetic coating, on-demand pore blocking/opening, and tumor cell targeting strategies. The pore size of DOX-loaded MSNs was narrowed by polydopamine coating, and the pores/channels were blocked with tumor-targeting ligands anchored by tumor environment-rupturable -SS- chains. Furthermore, a cell membrane mimetic surface was constructed to enhance biocompatibility of the smart MSN-drug. Confocal microscopy results demonstrate highly selective uptake (12-fold in comparison with L929 cell) of the smart MSN-drug by HeLa cells and delivery into the HeLa cellular nuclei. Further in vitro IC₅₀ studies showed that the toxicity of the smart MSN-drug to HeLa cells was 4000-fold higher than to the normal fibroblast cells. These exciting results demonstrate the utility of the smart MSN-drug capable of selectively killing tumor cells and saving the normal cells.

Surface Zwitterionization of Expanded Poly(tetrafluoroethylene) via Dopamine-Assisted Consecutive Immersion Coating

Expanded polytetrafluoroethylene (ePTFE) is one of the materials widely used in the biomedical field, yet its application is being limited by adverse reactions such as thrombosis when it comes in contact with blood. Thus, a simple and robust way to modify ePTFE to be biologically inert is sought after. Modification of ePTFE without high-energy pretreatment, such as immersion coating, has been of interest to researchers for its straightforward process and ease in scaling up. In this study, we utilized a two-step immersion coating to zwitterionize ePTFE membranes. The first coating consists of the co-deposition of polyethylenimine (PEI) and polydopamine (PDA) to produce amine groups in the surface of the ePTFE for further functionalization. These amine groups from PEI will be coupled with the epoxide group of the zwitterionic copolymer, poly(GMA-co-SBMA) (PGS), via a ring-opening reaction in the second coating. The coated ePTFE membranes were physically and chemically characterized to ensure that each step of the coating is successful. The membranes were also tested for their thrombogenicity via quantification of the blood cells attached to it during contact with biological solutions. The coated membranes exhibited around 90% reduction in attachment with respect to the uncoated ePTFE for both Gram-positive and Gram-negative strains of bacteria (Staphylococcus aureus and Escherichia coli). The coating was also able to resist blood cell attachment from human whole blood by 81.57% and resist red blood cell attachment from red blood cell concentrate by 93.4%. These ePTFE membranes, which are coated by a simple immersion coating, show significant enhancement of the biocompatibility of the membranes, which shows promise for future use in biological devices.