Dental and Craniofacial Trauma Research & Tissue Regeneration Directorate , United States Army Institute of Surgical Research , JBSA Fort Sam Houston , Texas 78234 , United States.
Department of Head & Neck Surgery , Greenville Health System , Greenville , South Carolina 29615 , United States.
ACS Appl Mater Interfaces. 2018 Mar 14;10(10):8426-8435. doi: 10.1021/acsami.7b14888. Epub 2018 Mar 5.
The surgical connection of blood vessels, anastomosis, is a critical procedure in many reparative, transplantation, and reconstructive surgical procedures. However, effective restoration of circulation is complicated by pathological clotting (thrombosis) or progressive occlusion due to excess cell proliferation that often leads to additional surgeries and increases morbidity and mortality risk for patients. Pharmaceutical agents have been tested to prevent these complications, but many have unacceptable systemic side effects. Therefore, an alternative approach to deliver these drugs at the site of injury in a controlled manner is necessary. The objective of this study was to develop electrospun nanofibers composed of polyester poly(lactide- co-glycolide) (PLGA), poly(ethylene oxide) (PEO), and positively charged copolymer, poly(lactide- co-glycolide)- graft-polyethylenimine (PgP) for electrostatic binding and release of heparin for application as an antithrombotic microvascular suture. PgP was synthesized with different coupling ratios between PLGA and branched polyethylenimine (bPEI) to obtain PgP (∼1 PLGA grafted to 1 bPEI) and PgP (∼3.7 PLGA grafted to 1 bPEI). Nanofiber yarns (PLGA/PEO/PgP and PLGA/PEO/PgP) were fabricated by electrospinning. Heparin immobilization on the positively charged nanofiber yarns was visualized using fluorescein-conjugated heparin (F-Hep), and the amount of immobilized F-Hep was higher on both PLGA/PEO/PgP and PLGA/PEO/PgP than yarns without PgP (PLGA/PEO). We also found that F-Hep was released from both PgP-containing yarns in a sustained manner over 20 days, while over 60% of F-Hep was released within 4 h from PLGA/PEO. Finally, we observed that heparin-eluting nanofiber yarns with both PgP and PgP showed significantly longer clotting times than nanofiber yarns without PgP. The clotting time of PLGA/PEO/PgP was not significantly different than that of free heparin (0.5 μg/mL). These results show that heparin-eluting electrospun nanofiber yarns may offer a basis for the development of microvascular sutures with anticoagulant activity.
血管的外科吻合,即吻合术,是许多修复、移植和重建手术中的关键程序。然而,有效的循环恢复因病理性血栓形成(血栓形成)或由于细胞过度增殖导致的渐进性闭塞而变得复杂,这通常导致需要进行额外的手术,并增加患者的发病率和死亡率风险。已经测试了药物制剂来预防这些并发症,但许多药物制剂具有不可接受的全身副作用。因此,需要一种替代方法以受控方式在损伤部位递送这些药物。本研究的目的是开发由聚酯聚(乳酸-共- 羟基乙酸)(PLGA)、聚(氧化乙烯)(PEO)和带正电荷的共聚物聚(乳酸-共- 羟基乙酸)-接枝-聚亚乙基亚胺(PgP)组成的静电纺纳米纤维,用于静电结合和释放肝素,作为一种抗血栓微血管缝合线。用不同的 PLGA 和支化聚亚乙基亚胺(bPEI)之间的偶联比来合成 PgP(1 PLGA 接枝到 1 bPEI)和 PgP(3.7 PLGA 接枝到 1 bPEI)。通过静电纺丝制备纳米纤维纱线(PLGA/PEO/PgP 和 PLGA/PEO/PgP)。使用荧光素标记的肝素(F-Hep)可视化带正电荷的纳米纤维纱线上的肝素固定化,并且在含有 PgP 的纱线(PLGA/PEO/PgP 和 PLGA/PEO/PgP)上固定的 F-Hep 量高于没有 PgP 的纱线(PLGA/PEO)。我们还发现,F-Hep 能够从两种含 PgP 的纱线中以持续的方式释放超过 20 天,而从 PLGA/PEO 中超过 60%的 F-Hep 在 4 小时内释放。最后,我们观察到含有 PgP 和 PgP 的肝素洗脱纳米纤维纱线的凝血时间明显长于不含 PgP 的纳米纤维纱线。PLGA/PEO/PgP 的凝血时间与游离肝素(0.5 μg/mL)没有显著差异。这些结果表明,肝素洗脱的静电纺纳米纤维纱线可能为开发具有抗凝活性的微血管缝合线提供基础。