School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, 220 Riverbend Road, Athens, Georgia 30602, United States.
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 220 Riverbend Road, Athens, Georgia 30602, United States.
ACS Appl Mater Interfaces. 2022 Mar 9;14(9):11116-11123. doi: 10.1021/acsami.1c24557. Epub 2022 Feb 28.
Blood-contacting medical devices (BCMDs) are inevitably challenged by thrombi formation, leading to occlusion of flow and device failure. Ideal BCMDs seek to mimic the intrinsic antithrombotic properties of the human vasculature to locally prevent thrombotic complications, negating the need for systemic anticoagulation. An emerging category of BCMD technology utilizes nitric oxide (NO) as a hemocompatible agent, as the vasculature's endothelial layer naturally releases NO to inhibit platelet activation and consumption. In this paper, we report for the first time the novel impregnation of -nitrosoglutathione (GSNO) into polymeric poly(vinyl chloride) (PVC) tubing via an optimized solvent-swelling method. Material testing revealed an optimized GSNO-PVC material that had adequate GSNO loading to achieve NO flux values within the physiological endothelial NO flux range for a 4 h period. Through hemocompatibility testing, the optimized material was deemed nonhemolytic (hemolytic index <2%) and capable of reducing platelet activation, suggesting that the material is suitable for contact with whole blood. Furthermore, an 4 h extracorporeal circulation (ECC) rabbit thrombogenicity model confirmed the blood biocompatibility of the optimized GSNO-PVC. Platelet count remained near 100% for the novel GSNO-impregnated PVC loops (1 h, 91.08 ± 6.27%; 2 h, 95.68 ± 0.61%; 3 h, 97.56 ± 8.59%; 4 h, 95.11 ± 8.30%). In contrast, unmodified PVC ECC loops occluded shortly after the 2 h time point and viable platelet counts quickly diminished (1 h, 85.67 ± 12.62%; 2 h, 54.46 ± 10.53%; 3 h, n/a; 4 h, n/a). The blood clots for GSNO-PVC loops (190.73 ± 72.46 mg) compared to those of unmodified PVC loops (866.50 ± 197.98 mg) were significantly smaller ( < 0.01). The results presented in this paper recommend further investigation in long-term animal models and suggest that GSNO-PVC has the potential to serve as an alternative to systemic anticoagulation in BCMD applications.
接触血液的医疗器械(BCMD)不可避免地会受到血栓形成的挑战,导致血流阻塞和器械失效。理想的 BCMD 旨在模仿人体血管的内在抗血栓特性,以局部预防血栓并发症,从而无需全身抗凝。一种新兴的 BCMD 技术类别利用一氧化氮(NO)作为血液相容性试剂,因为血管的内皮层自然释放 NO 以抑制血小板激活和消耗。在本文中,我们首次报告了通过优化的溶剂溶胀法将 -亚硝基谷胱甘肽(GSNO)新颖地浸渍到聚合物聚氯乙烯(PVC)管中。材料测试表明,GSNO-PVC 材料具有足够的 GSNO 负载量,可在 4 小时内达到生理内皮 NO 通量范围内的 NO 通量值。通过血液相容性测试,该优化材料被认为是非溶血的(溶血指数<2%),并且能够减少血小板激活,这表明该材料适合与全血接触。此外,4 小时的体外循环(ECC)兔血栓形成模型证实了优化的 GSNO-PVC 的血液生物相容性。新型 GSNO 浸渍 PVC 环的血小板计数在 1 小时时保持在接近 100%(91.08 ± 6.27%);2 小时时为 95.68 ± 0.61%;3 小时时为 97.56 ± 8.59%;4 小时时为 95.11 ± 8.30%)。相比之下,未经修饰的 PVC ECC 环在 2 小时后很快闭塞,并且存活的血小板计数迅速减少(1 小时时为 85.67 ± 12.62%;2 小时时为 54.46 ± 10.53%;3 小时时为 n/a;4 小时时为 n/a)。GSNO-PVC 环的血栓(190.73 ± 72.46 mg)与未修饰的 PVC 环的血栓(866.50 ± 197.98 mg)相比明显更小(<0.01)。本文介绍的结果建议在长期动物模型中进一步研究,并表明 GSNO-PVC 有可能替代 BCMD 应用中的全身抗凝。