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用于预防导管相关感染和血栓形成的一氧化氮释放锁定溶液

Nitric Oxide-Releasing Lock Solution for the Prevention of Catheter-Related Infection and Thrombosis.

作者信息

Ashcraft Morgan, Douglass Megan, Garren Mark, Mondal Arnab, Bright Lori Estes, Wu Yi, Handa Hitesh

机构信息

Pharmaceutical and Biomedical Sciences Department, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States.

School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States.

出版信息

ACS Appl Bio Mater. 2022 Apr 18;5(4):1519-1527. doi: 10.1021/acsabm.1c01272. Epub 2022 Mar 27.

Abstract

Although frequently used, venous catheters are often associated with serious complications such as infection and thrombosis. Lock solution therapies are clinically used to deter these issues but generally address only infection or thrombosis with limited success. Here, we report the development of a dual-functional lock therapy using nitric oxide (NO) donor molecule, S-nitrosoglutathione (GSNO). NO is a potent, broad-spectrum antimicrobial agent that also temporarily inhibits platelet activation, preventing thrombosis. Furthermore, NO has antibiofilm actions, an ability that traditional antibiotic lock solutions lack, thus limiting their efficacy. In this work, different concentrations of GSNO were characterized via NO analysis to determine a range of NO-releasing lock solution (NOreLS) concentrations to investigate and to demonstrate prolonged potential efficacy. Tested against clinically used vancomycin and gentamicin lock solutions, GSNO-based NOreLS repeatedly outperformed in models of different stages of catheter infections. NOreLS also prevented clot formation when exposed to whole blood, showing increased efficacy compared to a heparin lock solution. Moreover, NOreLS was demonstrated to be biocompatible via hemolysis and cytotoxicity assays. NOreLS has excellent potential for safely and effectively preventing infection and thrombosis related to catheter usage.

摘要

尽管静脉导管使用频繁,但常伴有感染和血栓形成等严重并发症。封管溶液疗法在临床上用于预防这些问题,但通常仅针对感染或血栓形成,效果有限。在此,我们报告了一种使用一氧化氮(NO)供体分子S-亚硝基谷胱甘肽(GSNO)的双功能封管疗法的研发情况。NO是一种强效的广谱抗菌剂,还能暂时抑制血小板活化,预防血栓形成。此外,NO具有抗生物膜作用,这是传统抗生素封管溶液所缺乏的能力,从而限制了它们的疗效。在这项工作中,通过NO分析对不同浓度的GSNO进行了表征,以确定一系列释放NO的封管溶液(NOreLS)浓度,从而研究并证明其具有延长的潜在疗效。与临床使用的万古霉素和庆大霉素封管溶液相比,基于GSNO的NOreLS在不同阶段的导管感染模型中表现始终更优。当暴露于全血时,NOreLS还能防止血凝块形成,与肝素封管溶液相比,显示出更高的疗效。此外,通过溶血和细胞毒性试验证明NOreLS具有生物相容性。NOreLS在安全有效地预防与导管使用相关的感染和血栓形成方面具有巨大潜力。

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