1
|
Ozkan E, Estes Bright LM, Kumar A, Pandey R, Devine R, Francis D, Ghalei S, Ashcraft M, Maffe P, Brooks M, Shome A, Garren M, Handa H. Bioinspired superhydrophobic surfaces with silver and nitric oxide-releasing capabilities to prevent device-associated infections and thrombosis. J Colloid Interface Sci 2024; 664:928-937. [PMID: 38503078 PMCID: PMC11025530 DOI: 10.1016/j.jcis.2024.03.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 03/21/2024]
Abstract
Bacteria-associated infections and thrombus formation are the two major complications plaguing the application of blood-contacting medical devices. Therefore, functionalized surfaces and drug delivery for passive and active antifouling strategies have been employed. Herein, we report the novel integration of bio-inspired superhydrophobicity with nitric oxide release to obtain a functional polymeric material with anti-thrombogenic and antimicrobial characteristics. The nitric oxide release acts as an antimicrobial agent and platelet inhibitor, while the superhydrophobic components prevent non-specific biofouling. Widely used medical-grade silicone rubber (SR) substrates that are known to be susceptible to biofilm and thrombus formation were dip-coated with fluorinated silicon dioxide (SiO2) and silver (Ag) nanoparticles (NPs) using an adhesive polymer as a binder. Thereafter, the resulting superhydrophobic (SH) SR substrates were impregnated with S-nitroso-N-acetylpenicillamine (SNAP, an NO donor) to obtain a superhydrophobic, Ag-bound, NO-releasing (SH-SiAgNO) surface. The SH-SiAgNO surfaces had the lowest amount of viable adhered E. coli (> 99.9 % reduction), S. aureus (> 99.8 % reduction), and platelets (> 96.1 % reduction) as compared to controls while demonstrating no cytotoxic effects on fibroblast cells. Thus, this innovative approach is the first to combine SNAP with an antifouling SH polymer surface that possesses the immense potential to minimize medical device-associated complications without using conventional systemic anticoagulation and antibiotic treatments.
Collapse
Affiliation(s)
- Ekrem Ozkan
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA
| | - Lori M Estes Bright
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA
| | - Anil Kumar
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA
| | - Rashmi Pandey
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA
| | - Ryan Devine
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA
| | - Divine Francis
- Department of Chemistry, University of Georgia, Athens, GA 30602, USA
| | - Sama Ghalei
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA
| | - Morgan Ashcraft
- Pharmaceutical and Biomedical Sciences Department, College of Pharmacy, University of Georgia, Athens, GA 30602, USA
| | - Patrick Maffe
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA
| | - Megan Brooks
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA
| | - Arpita Shome
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA
| | - Mark Garren
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA
| | - Hitesh Handa
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, USA; Pharmaceutical and Biomedical Sciences Department, College of Pharmacy, University of Georgia, Athens, GA 30602, USA.
| |
Collapse
|
2
|
Griffin L, Garren MRS, Maffe P, Ghalei S, Brisbois EJ, Handa H. Preventing Staphylococci Surgical Site Infections with a Nitric Oxide-Releasing Poly(lactic acid- co-glycolic acid) Suture Material. ACS Appl Bio Mater 2024. [PMID: 38652779 DOI: 10.1021/acsabm.4c00128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Of the 27 million surgeries performed in the United States each year, a reported 2.6% result in a surgical site infection (SSI), and Staphylococci species are commonly the culprit. Alternative therapies, such as nitric oxide (NO)-releasing biomaterials, are being developed to address this issue. NO is a potent antimicrobial agent with several modes of action, including oxidative and nitrosative damage, disruption of bacterial membranes, and dispersion of biofilms. For targeted antibacterial effects, NO is delivered by exogenous donor molecules, like S-nitroso-N-acetylpenicillamine (SNAP). Herein, the impregnation of SNAP into poly(lactic-co-glycolic acid) (PLGA) for SSI prevention is reported for the first time. The NO-releasing PLGA copolymer is fabricated and characterized by donor molecule loading, leaching, and the amount remaining after ethylene oxide sterilization. The swelling ratio, water uptake, static water contact angle, and tensile strength are also investigated. Furthermore, its cytocompatibility is tested against 3T3 mouse fibroblast cells, and its antimicrobial efficacy is assessed against multiple Staphylococci strains. Overall, the NO-releasing PLGA copolymer holds promise as a suture material for eradicating surgical site infections caused by Staphylococci strains. SNAP impregnation affords robust antibacterial properties while maintaining the cytocompatibility and mechanical integrity.
Collapse
Affiliation(s)
- Lauren Griffin
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Mark Richard Stephen Garren
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Patrick Maffe
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Sama Ghalei
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Elizabeth J Brisbois
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| |
Collapse
|
3
|
Wu Y, Xu LC, Yeager E, Beita KG, Crutchfield N, Wilson SN, Maffe P, Schmiedt C, Siedlecki CA, Handa H. In vivo assessment of dual-function submicron textured nitric oxide releasing catheters in a 7-day rabbit model. Acta Biomater 2024:S1742-7061(24)00182-X. [PMID: 38614415 DOI: 10.1016/j.actbio.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 04/15/2024]
Abstract
Catheter-induced thrombosis is a major contributor to infectious and mechanical complications of biomaterials that lead to device failure. Herein, a dualfunction submicron textured nitric oxide (NO)-releasing catheter was developed. The hemocompatibility and antithrombotic activity of vascular catheters were evaluated in both 20 h in vitro blood loop and 7 d in vivo rabbit model. Surface characterization assessments via atomic force microscopy show the durability of the submicron pattern after incorporation of NO donor S-nitroso-N-acetylpenicillamine (SNAP). The SNAP-doped catheters exhibited prolonged and controlled NO release mimicking the levels released by endothelium. Fabricated catheters showed cytocompatibility when evaluated against BJ human fibroblast cell lines. After 20h in vitro evaluation of catheters in a blood loop, textured-NO catheters exhibited a 13-times reduction in surface thrombus formation compared to the control catheters, which had 83% of the total area covered by clots. After the 7 d in vivo rabbit model, analysis on the catheter surface was examined via scanning electron microscopy, where significant reduction of platelet adhesion, fibrin mesh, and thrombi can be observed on the NO-releasing textured surfaces. Moreover, compared to relative controls, a 63% reduction in the degree of thrombus formation within the jugular vein was observed. Decreased levels of fibrotic tissue decomposition on the jugular vein and reduced platelet adhesion and thrombus formation on the texture of the NO-releasing catheter surface are indications of mitigated foreign body response. This study demonstrated a biocompatible and robust dual-functioning textured NO PU catheter in limiting fouling-induced complications for longer-term blood-contacting device applications. STATEMENT OF SIGNIFICANCE: Catheter-induced thrombosis is a major contributor to infectious and mechanical complications of biomaterials that lead to device failure. This study demonstrated a robust, biocompatible, dual-functioning textured nitric oxide (NO) polyurethane catheter in limiting fouling-induced complications for longer-term blood-contacting device applications. The fabricated catheters exhibited prolonged and controlled NO release that mimics endothelium levels. After the 7 d in vivo model, a significant reduction in platelet adhesion, fibrin mesh, and thrombi was observed on the NO-releasing textured catheters, along with decreased levels of fibrotic tissue decomposition on the jugular vein. Results illustrate that NO-textured catheter surface mitigates foreign body response.
Collapse
Affiliation(s)
- Yi Wu
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States
| | - Li-Chong Xu
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA 17033, United States
| | - Eric Yeager
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA 17033, United States
| | - Keren Gabriela Beita
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, United States
| | - Natalie Crutchfield
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States
| | - Sarah N Wilson
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States
| | - Patrick Maffe
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States
| | - Chad Schmiedt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, United States
| | - Christopher A Siedlecki
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA 17033, United States; Department of Biomedical Engineering, The Pennsylvania State University, College of Medicine, Hershey, PA 17033, United States.
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States; Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, GA 30602, United States.
| |
Collapse
|
4
|
Maffe P, Devine R, Garren M, Handa H. Varying material thickness of silicone rubber for tunable nitric oxide release. J Biomed Mater Res B Appl Biomater 2024; 112:e35377. [PMID: 38359174 DOI: 10.1002/jbm.b.35377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/05/2023] [Accepted: 01/07/2024] [Indexed: 02/17/2024]
Abstract
Silicone rubber (SR), a common medical-grade polymer used in medical devices, has previously been modified for nitric oxide (NO) releasing capabilities. However, the effects of material properties such as film thickness on NO release kinetics are not well explored. In this study, SR is used in the first analysis of how a polymer's thickness affects the storage and uptake of an NO donor and subsequent release properties. Observed NO release trends show that a polymer's thickness results in tunable NO release. These results indicate how crucial a polymer's thickness is to optimize the NO release in an efficient and effective method.
Collapse
Affiliation(s)
- Patrick Maffe
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia, USA
| | - Ryan Devine
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia, USA
| | - Mark Garren
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia, USA
| | - Hitesh Handa
- School of Chemical, Materials, and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia, USA
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia, USA
| |
Collapse
|
5
|
Wilson SN, Maffe P, Pant J, Grommersch BM, Handa H. S-Nitroso-N-acetylpenicillamine impregnated latex: A new class of barrier contraception for the prevention of intercourse-associated UTIs. J Biomed Mater Res B Appl Biomater 2024; 112:e35371. [PMID: 38359176 PMCID: PMC10919893 DOI: 10.1002/jbm.b.35371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/31/2023] [Accepted: 01/02/2024] [Indexed: 02/17/2024]
Abstract
Urinary tract infections (UTIs) are some of the most common infections seen in humans, affecting over half of the female population. Though easily and quickly treatable, if gone untreated for too long, UTIs can lead to narrowing of the urethra as well as bladder and kidney infections. Due to the disease potential, it is crucial to mitigate the development of UTIs throughout healthcare. Unfortunately, sexual activity and the use of condoms have been identified as common risk factors for the development of sexually acquired UTIs. Therefore, this study outlines a potential alteration to existing condom technology to decrease the risk of developing sexually acquired UTIs using S-nitroso-N-acetylpenicillamine (SNAP), a nitric oxide (NO) donor. Herein, varying concentrations of SNAP are integrated into commercialized condoms through a facile solvent swelling method. Physical characterization studies showed that 72%-100% of the ultimate tensile strength was maintained with lower SNAP concentrations, validating the modified condom's mechanical integrity. Additionally, the evaluation of room-temperature storage stability via NO release analysis outlined a lack of special storage conditions needed compared to commercial products. Moreover, these samples exhibited >90% relative cell viability and >96% bacterial killing, proving biocompatibility and antimicrobial properties. SNAP-Latex maintains the desired condom durability while demonstrating excellent potential as an effective new contraceptive technology to mitigate the occurrence of sexually acquired UTIs.
Collapse
Affiliation(s)
- Sarah N. Wilson
- School of Chemical, Materials and Biological Engineering, College of Engineering, University of Georgia, Athens, GA 30602, US
| | - Patrick Maffe
- School of Chemical, Materials and Biological Engineering, College of Engineering, University of Georgia, Athens, GA 30602, US
| | - Jitendra Pant
- School of Chemical, Materials and Biological Engineering, College of Engineering, University of Georgia, Athens, GA 30602, US
| | - Bryan M. Grommersch
- School of Chemical, Materials and Biological Engineering, College of Engineering, University of Georgia, Athens, GA 30602, US
| | - Hitesh Handa
- School of Chemical, Materials and Biological Engineering, College of Engineering, University of Georgia, Athens, GA 30602, US
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, GA 30602, US
| |
Collapse
|
6
|
Wu Y, Garren MR, Estes Bright LM, Maffe P, Brooks M, Brisbois EJ, Handa H. Enhanced antibacterial efficacy against antibiotic-resistant bacteria via nitric oxide-releasing ampicillin polymer substrates. J Colloid Interface Sci 2024; 653:1763-1774. [PMID: 37832467 PMCID: PMC10593200 DOI: 10.1016/j.jcis.2023.09.188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/05/2023] [Accepted: 09/30/2023] [Indexed: 10/15/2023]
Abstract
The emergence of antibiotic-resistant bacteria poses a pressing threat to global health and is a leading cause of healthcare-related morbidity and mortality. Herein, we report the fabrication of medical-grade polymers incorporated with a dual-action S-nitroso-N-acetylpenicillamine-functionalized ampicillin (SNAPicillin) conjugated molecule through a solvent evaporation process. The resulting SNAPicillin-incorporated polymer materials act as broad-spectrum antibacterial surfaces that improve the administration efficacy of conventional antibiotics through the targeted release of both nitric oxide and ampicillin. The polymer surfaces were characterized by scanning electron microscopy and static contact angle measurements. The nitric oxide (NO) release profile and diffusion of SNAPicillin from polymers were quantified using a chemiluminescence-based nitric oxide analyzer (NOA) and ultraviolet-visible (UV-vis) spectroscopy. As a result, the films had up to 2.96 × 10-7 mol cm-2 of total NO released within 24 hr. In addition, >79 % of the SNAPicillin reservoir was preserved in the polymers after 24 hr of incubation in the physiological environment, indicating their longer-term NO release ability and therapeutic window for antibacterial effects. The SNAPicillin-incorporated polymers reduced the viability of adhered bacteria in culture, with >95 % reduction found against clinically relevant strains of Staphylococcus aureus (S. aureus). Furthermore, SNAPicillin-modified surfaces did not elicit a cytotoxic effect toward 3T3 mouse fibroblast cells, supporting the material's biocompatibility in vitro. These results indicate that the complementary effects of NO-release and ampicillin in SNAPicillin-eluting polymers can enhance the properties of commonly infected medical device surfaces for antibacterial purposes.
Collapse
Affiliation(s)
- Yi Wu
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States
| | - Mark R Garren
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States
| | - Lori M Estes Bright
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States
| | - Patrick Maffe
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States
| | - Megan Brooks
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States
| | - Elizabeth J Brisbois
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States.
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA 30602, United States; Pharmaceutical and Biomedical Science Department, College of Pharmacy, University of Georgia, Athens, GA 30602, United States.
| |
Collapse
|
7
|
Mondal A, Maffe P, Wilson SN, Ghalei S, Palacio R, Handa H, Brisbois EJ. Catalytic effect of transition metal-doped medical grade polymer on S-nitrosothiol decomposition and its biological response. Mater Adv 2023; 4:3197-3206. [PMID: 38013687 PMCID: PMC10388399 DOI: 10.1039/d3ma00191a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/04/2023] [Indexed: 11/29/2023]
Abstract
Nitric oxide (NO)-release from polymer metal composites is achieved through the incorporation of NO donors such as S-nitrosothiols (RSNO). Several studies have shown that metal nanoparticles catalytically decompose RSNO to release NO. In polymer composites, the NO surface flux from the surface can be modulated by the application of metal nanoparticles with a varying degree of catalytic activity. In this study, we compare the NO-releasing polymer composite design strategy - demonstrating how different ways of incorporating RSNO and metal nanoparticles can affect NO flux, donor leaching, or biological activity of the films. The first approach included blending both the RSNO and metal nanoparticle in the matrix (non-layered), while the second approach involved dip-coating metal nanoparticle/polymer layer on the RSNO-containing polymer composite (layered). Secondly, we compare both designs with respect to metal nanoparticles, including iron (Fe), copper (Cu), nickel (Ni), zinc (Zn), and silver (Ag). Differential NO surface flux is observed for each metal nanoparticle, with the Cu-containing polymer composites showing the highest flux for layered composites, whereas Fe demonstrated the highest NO flux for non-layered composites in 24 h. Additionally, a comparative study on NO flux modulation via the choice of metal nanoparticles is shown. Furthermore, mouse fibroblast cell viability when exposed to leachates from the polymer metal composites was dependent on (1) the design of the polymer composite where the layered approach performed better than non-layered composites (2) diffusion of metal nanoparticles from the composites plays a key role. Antibacterial activity on methicillin-resistant Staphylococcus aureus was also dependent on individual metal nanoparticles and flux levels in a 24 h in vitro CDC bioreactor study. Therefore, the study establishes the need for a layered polymer metal composite strategy that synergizes NO flux without negatively affecting biocompatibility.
Collapse
Affiliation(s)
- Arnab Mondal
- School of Chemical, Materials & Biomedical Engineering, University of Georgia 302 E Campus Road, Suite 2212 GA 30605 Athens 30602 USA
| | - Patrick Maffe
- School of Chemical, Materials & Biomedical Engineering, University of Georgia 302 E Campus Road, Suite 2212 GA 30605 Athens 30602 USA
| | - Sarah N Wilson
- School of Chemical, Materials & Biomedical Engineering, University of Georgia 302 E Campus Road, Suite 2212 GA 30605 Athens 30602 USA
| | - Sama Ghalei
- School of Chemical, Materials & Biomedical Engineering, University of Georgia 302 E Campus Road, Suite 2212 GA 30605 Athens 30602 USA
| | - Ricky Palacio
- School of Chemical, Materials & Biomedical Engineering, University of Georgia 302 E Campus Road, Suite 2212 GA 30605 Athens 30602 USA
| | - Hitesh Handa
- School of Chemical, Materials & Biomedical Engineering, University of Georgia 302 E Campus Road, Suite 2212 GA 30605 Athens 30602 USA
- Department of Pharmaceutical & Biomedical Sciences, University of Georgia Athens 30602 USA
| | - Elizabeth J Brisbois
- School of Chemical, Materials & Biomedical Engineering, University of Georgia 302 E Campus Road, Suite 2212 GA 30605 Athens 30602 USA
| |
Collapse
|
8
|
Roberts TR, Harea GT, Zang Y, Devine RP, Maffe P, Handa H, Batchinsky AI. A dual-action nitric oxide-releasing slippery surface for extracorporeal organ support: Dynamic in vitro hemocompatibility evaluation. J Biomed Mater Res B Appl Biomater 2023; 111:923-932. [PMID: 36404401 DOI: 10.1002/jbm.b.35202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/01/2022] [Accepted: 11/13/2022] [Indexed: 11/22/2022]
Abstract
Numerous biomaterials have been developed for application in blood-contacting medical devices to prevent thrombosis; however, few materials have been applied to full-scale devices and evaluated for hemocompatibility under clinical blood flow conditions. We applied a dual-action slippery liquid-infused (LI) nitric oxide (NO)-releasing material modification (LINO) to full-scale blood circulation tubing for extracorporeal lung support and evaluated the tubing ex vivo using swine whole blood circulated for 6 h at a clinically relevant flow. LINO tubing was compared to unmodified tubing (CTRL) and isolated LI and NO-releasing modifications (n = 9/group). The primary objective was to evaluate safety and blood compatibility of this approach, prior to progression to in vivo testing of efficacy in animal models. The secondary objective was to evaluate coagulation outcomes relevant to hemocompatibility. No untoward effects of the coating, such as elevated methemoglobin fraction, were observed. Additionally, LINO delayed platelet loss until 6 h versus the reduction in platelet count in CTRL at 3 h. At 6 h, LINO significantly reduced the concentration of platelets in an activated P-selectin expressing state versus CTRL (32 ± 1% decrease, p = .02). Blood clot deposition was significantly reduced on LINO blood pumps (p = .007) and numerically reduced on tubing versus CTRL. Following blood exposure, LINO tubing continued to produce a measurable NO-flux (0.20 ± 0.06 × 10-10 mol cm-2 min-1 ). LINO is a potential solution to reduce circuit-related bleeding and clotting during extracorporeal organ support, pending future extended testing in vivo using full-scale extracorporeal lung support devices.
Collapse
Affiliation(s)
- Teryn R Roberts
- Autonomous Reanimation and Evacuation Research Program, The Geneva Foundation, San Antonio, Texas, USA
| | - George T Harea
- Autonomous Reanimation and Evacuation Research Program, The Geneva Foundation, San Antonio, Texas, USA
| | - Yanyi Zang
- Autonomous Reanimation and Evacuation Research Program, The Geneva Foundation, San Antonio, Texas, USA
| | - Ryan P Devine
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia, USA
| | - Patrick Maffe
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia, USA
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia, USA.,Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia, USA
| | - Andriy I Batchinsky
- Autonomous Reanimation and Evacuation Research Program, The Geneva Foundation, San Antonio, Texas, USA
| |
Collapse
|
9
|
Garren M, Maffe P, Melvin A, Griffin L, Wilson S, Douglass M, Reynolds M, Handa H. Surface-Catalyzed Nitric Oxide Release via a Metal Organic Framework Enhances Antibacterial Surface Effects. ACS Appl Mater Interfaces 2021; 13:56931-56943. [PMID: 34818503 PMCID: PMC9728615 DOI: 10.1021/acsami.1c17248] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
It has been previously demonstrated that metal nanoparticles embedded into polymeric materials doped with nitric oxide (NO) donor compounds can accelerate the release rate of NO for therapeutic applications. Despite the advantages of elevated NO surface flux for eradicating opportunistic bacteria in the initial hours of application, metal nanoparticles can often trigger a secondary biocidal effect through leaching that can lead to unfavorable cytotoxic responses from host cells. Alternatively, copper-based metal organic frameworks (MOFs) have been shown to stabilize Cu2+/1+ via coordination while demonstrating longer-term catalytic performance compared to their salt counterparts. Herein, the practical application of MOFs in NO-releasing polymeric substrates with an embedded NO donor compound was investigated for the first time. By developing composite thermoplastic silicon polycarbonate polyurethane (TSPCU) scaffolds, the catalytic effects achievable via intrapolymeric interactions between an MOF and NO donor compound were investigated using the water-stable copper-based MOF H3[(Cu4Cl)3(BTTri)8-(H2O)12]·72H2O (CuBTTri) and the NO donor S-nitroso-N-acetyl-penicillamine (SNAP). By creating a multifunctional triple-layered composite scaffold with CuBTTri and SNAP, the surface flux of NO from catalyzed SNAP decomposition was found tunable based on the variable weight percent CuBTTri incorporation. The tunable NO surface fluxes were found to elicit different cytotoxic responses in human cell lines, enabling application-specific tailoring. Challenging the TSPCU-NO-MOF composites against 24 h bacterial growth models, the enhanced NO release was found to elicit over 99% reduction in adhered and over 95% reduction in planktonic methicillin-resistant Staphylococcus aureus, with similar results observed for Escherichia coli. These results indicate that the combination of embedded MOFs and NO donors can be used as a highly efficacious tool for the early prevention of biofilm formation on medical devices.
Collapse
Affiliation(s)
- Mark Garren
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Patrick Maffe
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Alyssa Melvin
- Department of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Lauren Griffin
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Sarah Wilson
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Megan Douglass
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Melissa Reynolds
- Department of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
- School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado 80523, United States
- Chemical and Biological Engineering, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| |
Collapse
|
10
|
Pogliani EM, Rossini F, Casaroli I, Maffe P, Corneo G. Thrombotic complications in acute promyelocytic leukemia during all-trans-retinoic acid therapy. Acta Haematol 1997; 97:228-30. [PMID: 9158667 DOI: 10.1159/000203689] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A case of acute renal failure, due to occlusion of renal vessels in a patient with acute promyelocytic leukemia (APL) treated with all-trans-retinoic acid (ATRA) and tranexamic acid has been described recently. We report a case of acute renal failure in an APL patient treated with ATRA alone. This case further supports the concern about thromboembolic complications associated with ATRA therapy in APL patients. The patients, a 43-year-old man, presented all the signs and symptoms of APL and was included in a treatment protocol with ATRA. After 10 days of treatment, he developed acute renal failure that was completely reversible after complete remission of APL was achieved and therapy discontinued. We conclude that ATRA is a valid therapeutic choice for patients with APL, although the procoagulant tendency is not completely corrected. Thrombotic events, however, could be avoided by using low-dose heparin.
Collapse
Affiliation(s)
- E M Pogliani
- Department of Internal Medicine, S. Gerardo Hospital, Monza, Italy
| | | | | | | | | |
Collapse
|