Unidad de Producción y Reprogramación Celular, Red Andaluza de Diseño y traslación de Terapias Avanzadas-RAdytTA, Fundación Pública Andaluza Progreso y Salud (FPS), Av. Américo Vespucio 15, 41092, Seville, Spain.
Instituto de Biomedicina de Sevilla/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.
Sci Rep. 2024 Aug 21;14(1):19411. doi: 10.1038/s41598-024-70456-w.
Uncontrolled bleeding during surgery is associated with high mortality and prolonged hospital stay, necessitating the use of hemostatic agents. Fibrin sealant patches offer an efficient solution to achieve hemostasis and improve patient outcomes in liver resection surgery. We have previously demonstrated the efficacy of a nanostructured fibrin-agarose hydrogel (NFAH). However, for the widespread distribution and commercialization of the product, it is necessary to develop an optimal preservation method that allows for prolonged stability and facilitates storage and distribution. We investigated cryopreservation as a potential method for preserving NFAH using trehalose. Structural changes in cryopreserved NFAH (Cryo-NFAH) were investigated and comparative in vitro and in vivo efficacy and safety studies were performed with freshly prepared NFAH. We also examined the long-term safety of Cryo-NFAH versus TachoSil in a rat partial hepatectomy model, including time to hemostasis, intra-abdominal adhesion, hepatic hematoma, inflammatory factors, histopathological variables, temperature and body weight, hemocompatibility and cytotoxicity. Structural analyses demonstrated that Cryo-NFAH retained most of its macro- and microscopic properties after cryopreservation. Likewise, hemostatic efficacy assays showed no significant differences with fresh NFAH. Safety evaluations indicated that Cryo-NFAH had a similar overall profile to TachoSil up to 40 days post-surgery in rats. In addition, Cryo-NFAH demonstrated superior hemostatic efficacy compared with TachoSil while also demonstrating lower levels of erythrolysis and cytotoxicity than both TachoSil and other commercially available hemostatic agents. These results indicate that Cryo-NFAH is highly effective hemostatic patch with a favorable safety and tolerability profile, supporting its potential for clinical use.
手术中无法控制的出血与高死亡率和住院时间延长有关,因此需要使用止血剂。纤维蛋白密封贴片为实现肝切除术的止血和改善患者预后提供了有效的解决方案。我们之前已经证明了纳米结构纤维蛋白-琼脂糖水凝胶(NFAH)的功效。然而,为了广泛分布和商业化该产品,有必要开发一种最佳的保存方法,使其具有更长的稳定性,并便于储存和运输。我们研究了使用海藻糖进行冷冻保存作为保存 NFAH 的一种潜在方法。研究了冷冻保存的 NFAH(Cryo-NFAH)的结构变化,并对新鲜制备的 NFAH 进行了比较的体外和体内功效和安全性研究。我们还在大鼠部分肝切除术模型中检查了 Cryo-NFAH 与 TachoSil 的长期安全性,包括止血时间、腹腔粘连、肝血肿、炎症因子、组织病理学变量、温度和体重、血液相容性和细胞毒性。结构分析表明,Cryo-NFAH 在冷冻保存后保留了其大部分宏观和微观特性。同样,止血功效测定表明与新鲜 NFAH 没有显著差异。安全性评估表明,在大鼠中,Cryo-NFAH 在手术后 40 天内的总体情况与 TachoSil 相似。此外,Cryo-NFAH 与 TachoSil 相比具有更好的止血效果,同时与 TachoSil 和其他市售止血剂相比,红细胞溶解和细胞毒性水平更低。这些结果表明,Cryo-NFAH 是一种高效的止血贴片,具有良好的安全性和耐受性,支持其在临床应用中的潜力。
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