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Farah S, Doloff JC, Müller P, Sadraei A, Han HJ, Olafson K, Vyas K, Tam HH, Hollister-Lock J, Kowalski PS, Griffin M, Meng A, McAvoy M, Graham AC, McGarrigle J, Oberholzer J, Weir GC, Greiner DL, Langer R, Anderson DG. Long-term implant fibrosis prevention in rodents and non-human primates using crystallized drug formulations. Nat Mater 2019; 18:892-904. [PMID: 31235902 PMCID: PMC7184801 DOI: 10.1038/s41563-019-0377-5] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 04/16/2019] [Indexed: 05/02/2023]
Abstract
Implantable medical devices have revolutionized modern medicine. However, immune-mediated foreign body response (FBR) to the materials of these devices can limit their function or even induce failure. Here we describe long-term controlled-release formulations for local anti-inflammatory release through the development of compact, solvent-free crystals. The compact lattice structure of these crystals allows for very slow, surface dissolution and high drug density. These formulations suppress FBR in both rodents and non-human primates for at least 1.3 years and 6 months, respectively. Formulations inhibited fibrosis across multiple implant sites-subcutaneous, intraperitoneal and intramuscular. In particular, incorporation of GW2580, a colony stimulating factor 1 receptor inhibitor, into a range of devices, including human islet microencapsulation systems, electrode-based continuous glucose-sensing monitors and muscle-stimulating devices, inhibits fibrosis, thereby allowing for extended function. We believe that local, long-term controlled release with the crystal formulations described here enhances and extends function in a range of medical devices and provides a generalized solution to the local immune response to implanted biomaterials.
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Affiliation(s)
- Shady Farah
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Joshua C Doloff
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Biomedical and Materials Science Engineering, Translational Tissue Engineering Center, Wilmer Eye Institute and the Institute for NanoBioTechnology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter Müller
- X-Ray Diffraction Facility, MIT Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Atieh Sadraei
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Hye Jung Han
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Katy Olafson
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Keval Vyas
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Hok Hei Tam
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jennifer Hollister-Lock
- Section on Islet Cell and Regenerative Biology, Research Division, Joslin Diabetes Center, Boston, MA, USA
| | - Piotr S Kowalski
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Marissa Griffin
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Ashley Meng
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Malia McAvoy
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Harvard-MIT Division of Health Science Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Adam C Graham
- Center for Nanoscale Systems, Harvard University, Cambridge, MA, USA
| | - James McGarrigle
- Department of Surgery, Division of Transplantation, University of Illinois at Chicago, Chicago, IL, USA
| | - Jose Oberholzer
- Department of Surgery, Division of Transplantation, University of Illinois at Chicago, Chicago, IL, USA
| | - Gordon C Weir
- Section on Islet Cell and Regenerative Biology, Research Division, Joslin Diabetes Center, Boston, MA, USA
| | - Dale L Greiner
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Robert Langer
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Harvard-MIT Division of Health Science Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Daniel G Anderson
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Department of Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
- Harvard-MIT Division of Health Science Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
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Wang LJ, Kin T, O’Gorman D, Shapiro AJ, Naziruddin B, Takita M, Levy MF, Posselt AM, Szot GL, Savari O, Barbaro B, McGarrigle J, Yeh CC, Oberholzer J, Lei J, Chen T, Lian M, Markmann JF, Alvarez A, Linetsky E, Ricordi C, Balamurugan AN, Loganathan G, Wilhelm JJ, Hering BJ, Bottino R, Trucco M, Liu C, Min Z, Li Y, Naji A, Fernandez LA, Ziemelis M, Danobeitia JS, Millis JM, Witkowski P. A Multicenter Study: North American Islet Donor Score in Donor Pancreas Selection for Human Islet Isolation for Transplantation. Cell Transplant 2016; 25:1515-1523. [PMID: 26922947 PMCID: PMC5167495 DOI: 10.3727/096368916x691141] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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] [Indexed: 02/07/2023] Open
Abstract
Selection of an optimal donor pancreas is the first key task for successful islet isolation. We conducted a retrospective multicenter study in 11 centers in North America to develop an islet donor scoring system using donor variables. The data set consisting of 1,056 deceased donors was used for development of a scoring system to predict islet isolation success (defined as postpurification islet yield >400,000 islet equivalents). With the aid of univariate logistic regression analyses, we developed the North American Islet Donor Score (NAIDS) ranging from 0 to 100 points. The c index in the development cohort was 0.73 (95% confidence interval 0.70-0.76). The success rate increased proportionally as the NAIDS increased, from 6.8% success in the NAIDS < 50 points to 53.7% success in the NAIDS ≥ 80 points. We further validated the NAIDS using a separate set of data consisting of 179 islet isolations. A comparable outcome of the NAIDS was observed in the validation cohort. The NAIDS may be a useful tool for donor pancreas selection in clinical practice. Apart from its utility in clinical decision making, the NAIDS may also be used in a research setting as a standardized measurement of pancreas quality.
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Affiliation(s)
- Ling-jia Wang
- Department of Surgery, Section of Transplantation, University of Chicago, Chicago, IL
| | - Tatsuya Kin
- Clinical Islet Transplant Program, University of Alberta and Alberta Health Services, Edmonton, Alberta, Canada
| | - Doug O’Gorman
- Clinical Islet Transplant Program, University of Alberta and Alberta Health Services, Edmonton, Alberta, Canada
| | - A.M. James Shapiro
- Clinical Islet Transplant Program, University of Alberta and Alberta Health Services, Edmonton, Alberta, Canada
| | | | | | | | - Andrew M. Posselt
- UCSF Transplantation Surgery, University of California-San Francisco, CA
| | - Gregory L. Szot
- UCSF Transplantation Surgery, University of California-San Francisco, CA
| | - Omid Savari
- Department of Surgery, Section of Transplantation, University of Chicago, Chicago, IL
| | - Barbara Barbaro
- UIC Cell Isolation Program, University of Illinois at Chicago, Chicago, IL
| | - James McGarrigle
- UIC Cell Isolation Program, University of Illinois at Chicago, Chicago, IL
| | - Chun Chieh Yeh
- UIC Cell Isolation Program, University of Illinois at Chicago, Chicago, IL
| | - Jose Oberholzer
- UIC Cell Isolation Program, University of Illinois at Chicago, Chicago, IL
| | - Ji Lei
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA
| | - Tao Chen
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA
| | - Moh Lian
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA
| | - James F. Markmann
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA
| | - Alejandro Alvarez
- Diabetes Research Institute, cGMP Cell Processing Facility, University of Miami Miller School of Medicine, Miami, FL
| | - Elina Linetsky
- Diabetes Research Institute, cGMP Cell Processing Facility, University of Miami Miller School of Medicine, Miami, FL
| | - Camillo Ricordi
- Diabetes Research Institute, cGMP Cell Processing Facility, University of Miami Miller School of Medicine, Miami, FL
| | - A. N. Balamurugan
- Schulze Diabetes Institute, University of Minnesota, Minneapolis, MN
| | | | - Joshua J. Wilhelm
- Schulze Diabetes Institute, University of Minnesota, Minneapolis, MN
| | | | - Rita Bottino
- Institute of Cellular Therapeutics, Allegheny Health Network, Pittsburgh, PA
| | - Massimo Trucco
- Institute of Cellular Therapeutics, Allegheny Health Network, Pittsburgh, PA
| | - Chengyang Liu
- Division of Transplantation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Zaw Min
- Division of Transplantation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Yanjing Li
- Division of Transplantation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ali Naji
- Division of Transplantation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Luis A. Fernandez
- Division of Organ Transplantation, University of Wisconsin, Madison, WI
| | - Martynas Ziemelis
- Division of Organ Transplantation, University of Wisconsin, Madison, WI
| | | | - J. Michael Millis
- Department of Surgery, Section of Transplantation, University of Chicago, Chicago, IL
| | - Piotr Witkowski
- Department of Surgery, Section of Transplantation, University of Chicago, Chicago, IL
- Corresponding author: Piotr Witkowski, The University of Chicago Medical Center, Department of Surgery, Division of Abdominal Organ Transplantation, 5841 S. Maryland Ave. MC5027, Room J-517, Chicago, IL 60637
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