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微粒血液相容性测试策略。

Strategy for the hemocompatibility testing of microparticles.

作者信息

Braune S, Basu S, Kratz K, Johansson J Bäckemo, Reinthaler M, Lendlein A, Jung F

机构信息

Institute of Biomaterial Science and Berlin-Brandenburg Centre for Regenerative Therapies (BCRT), Helmholtz-Zentrum Geesthacht, Teltow, Germany.

Institute of Chemistry, University of Potsdam, Potsdam, Germany.

出版信息

Clin Hemorheol Microcirc. 2016;64(3):345-353. doi: 10.3233/CH-168114.

Abstract

Polymer-based microparticles are applied as non-thrombogenic or thrombogenic materials in a wide variety of intra- or extra-corporeal medical devices. As demanded by the regulatory agencies, the hemocompatibility of these blood contacting biomaterials has to be evaluated in vitro to ensure that the particle systems appropriately fulfill the envisioned function without causing undesired events such as thrombosis or inflammation. Currently described in vitro assays for hemocompatibility testing of particles comprise tests with different single cell types (e.g. erythrocytes or leukocytes), varying concentrations/dilutions of the used blood cells or whole blood, which are not standardized.Here, we report about an in vitro dynamic test system for studying the hemocompatibility of polymeric microparticles utilizing fresh human whole blood from apparently healthy subjects, collected and processed under standardized conditions. Spherical poly(ether imide) microparticles with an average diameter of 140±30 μm were utilized as model systems. Reported as candidate materials for the removal of uremic toxins, these microparticles are anticipated to facilitate optimal flow conditions in a dialyzer with minimal backflow and blood cell damage. Pristine (PEI) and potassium hydroxide (PEI-KOH) functionalized microparticles exhibited similarly nanoporous surfaces (PEI: ØExternal pore = 90±60 nm; PEI-KOH ØExternal pore = 150±130 nm) but varying water wettabilities (PEI: θadv = 112±10° PEI-KOH θadv = 60±2°). The nanoporosity of the microparticle surfaces allows the exchange of toxic solutes from blood towards the interconnective pores in the particle core, while an immigration of the substantially larger blood cells is inhibited.Sterilized PEI microparticles were incorporated -air-free -in a syringe-based test system and exposed to whole blood for 60 minutes under gentle agitation. Thereafter, thrombi formation on the particles surfaces were analyzed microscopically. In the collected whole blood the non-adherent/circulating single blood cells were quantified via a differentiated complete blood cell count and the activation of platelets (P-Selectin expression, secretion and release), platelet function (PFA100 closure time) as well as thrombin formation (thrombin-antithrombin-complex) was analyzed. Free hemoglobin (HGB) levels were quantified as a measure of hemolysis.Microscopic evaluation revealed thrombi formation and particle aggregates for all tested microparticles. Reduction of circulating blood cells differed significantly between the particle types. Particularly, platelet and monocyte counts decreased up to 50% compared to the control (syringe filled with whole blood but without microparticles). In accordance, platelet activation, thrombin levels and degrees of hemolysis were clearly elevated in the particle loaded test systems and allowed a differentiation between the particle types. Increased PFA100 closure times (as activating agent a combination of collagen/ADP was used) indicated a similarly reduced ability of platelets to adhere and form stable aggregates independent from the particle type tested. This observation is most probably a consequence of the strong thrombus formation in the test system, which is associated with a reduction of the circulating blood cells.The reported in vitro dynamic whole blood test system allowed the sensitive analysis of the hemocompatibility of polymer-based microparticles and was successfully validated for porous PEI microparticles with different water wettabilities. Beyond the qualitative and quantitative analysis of cell-material interactions, the test also allowed the functional evaluation of platelets in whole blood.

摘要

基于聚合物的微粒作为非血栓形成或血栓形成材料应用于各种体内或体外医疗设备中。根据监管机构的要求,必须在体外评估这些与血液接触的生物材料的血液相容性,以确保微粒系统能够适当地履行预期功能,而不会引发诸如血栓形成或炎症等不良事件。目前描述的用于微粒血液相容性测试的体外试验包括针对不同单一细胞类型(如红细胞或白细胞)、所用血细胞或全血的不同浓度/稀释度进行的测试,这些测试尚未标准化。在此,我们报告一种体外动态测试系统,该系统利用在标准化条件下采集和处理的明显健康受试者的新鲜人全血来研究聚合物微粒的血液相容性。平均直径为140±30μm的球形聚醚酰亚胺微粒被用作模型系统。作为去除尿毒症毒素的候选材料,预计这些微粒将在透析器中促进最佳流动条件,同时使回流和血细胞损伤最小化。原始(PEI)和氢氧化钾(PEI-KOH)功能化的微粒表现出相似的纳米多孔表面(PEI:外部孔径=90±60nm;PEI-KOH外部孔径=150±130nm),但水润湿性不同(PEI:前进角=112±10°,PEI-KOH前进角=60±2°)。微粒表面的纳米多孔性允许有毒溶质从血液向微粒核心中的连通孔交换,同时抑制明显更大的血细胞的移入。将经过灭菌的PEI微粒在无空气条件下纳入基于注射器的测试系统,并在轻轻搅拌下使其与全血接触60分钟。此后,通过显微镜分析微粒表面的血栓形成情况。在采集的全血中,通过差异化全血细胞计数对非黏附/循环的单个血细胞进行定量,并分析血小板的激活(P-选择素表达、分泌和释放)、血小板功能(PFA100闭合时间)以及凝血酶形成(凝血酶-抗凝血酶复合物)情况。将游离血红蛋白(HGB)水平定量作为溶血的指标。显微镜评估显示,所有测试微粒均有血栓形成和微粒聚集现象。不同类型微粒的循环血细胞减少情况存在显著差异。特别是,与对照组(装有全血但无微粒的注射器)相比,血小板和单核细胞计数减少高达50%。相应地,在装有微粒的测试系统中,血小板激活、凝血酶水平和溶血程度明显升高,并且能够区分不同类型的微粒。PFA100闭合时间增加(使用胶原蛋白/ADP组合作为激活剂)表明,无论测试的微粒类型如何,血小板黏附和形成稳定聚集体的能力同样降低。这一观察结果很可能是测试系统中强烈血栓形成的结果,而血栓形成与循环血细胞的减少有关。所报告的体外动态全血测试系统能够对基于聚合物的微粒的血液相容性进行灵敏分析,并已成功验证用于具有不同水润湿性的多孔PEI微粒。除了对细胞-材料相互作用进行定性和定量分析外,该测试还能够对全血中的血小板进行功能评估。

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