Kinetic Clotting Research Articles

Granular Hemostatic Composite of Alginate, Calcium, and Zinc for Rapid and Effective Management of Post-Traumatic Hemorrhage.

Post-traumatic hemorrhage, which can result from accidents or battlefield injuries, is a significant global concern due to the high prehospital mortality rate. Substantial efforts have been made to develop hemostatic agents that can effectively reduce hemorrhage in the immediate aftermath of a traumatic event. The present study investigated the potential efficacy of Ca2+ and Zn2+ supplemented sodium alginate-based dry hemostatic particles (SA-CZ DHP) to manage excessive blood loss or post-traumatic hemorrhage. SA-CZ DHP were developed, followed by their physical and biochemical characterization, cytocompatibility and hemocompatibility testing, and critical evaluation of the hemostatic potential in vitro and in vivo. The safe SA-CZ DHP showed high absorption and accelerated blood clotting kinetics with reduced coagulation time (≈70%, p < 0.0001) in whole human blood, observed with insignificant hemolysis and uninterrupted RBC morphology. SA-CZ DHP significantly reduced the mean blood loss (≈90% in SD rats tail incision), and bleeding time (≈60% in BALB/c mice tail incision) was at par with commercially available Celox hemostatic granules. In conclusion, the biocompatible SA-CZ DHP exhibited rapid and effective management of excessive blood loss. It is also pertinent to note that the developed formulation could be a cost-effective alternative to its commercial counterparts.

Effect of Atomic-Layer-Deposited Hydroxyapatite Coating on Surface Thrombogenicity of Titanium

This study aimed to evaluate the surface characteristics of a nanocrystalline hydroxyapatite coating made through atomic layer deposition (ALD-HA) on titanium surfaces and to investigate its effect on blood coagulation and platelet adhesion. Grade 2 square titanium discs (0.7 cm, 1 mm thick) were used (n = 108). Half of the substrates (n = 54) were coated with ALD-HA, and the other half were used as the non-coated control. Surface free energy (SFE), contact angle (CA), surface roughness (Ra), and chemical composition were evaluated. Blood thrombogenic properties were assessed on ALD-HA and non-coated surfaces using the kinetic clotting time method. The platelets’ adhesion and morphology were also evaluated. The ALD-HA-coated surfaces demonstrated significantly higher polar SFE (p &lt; 0.001) and lower CA (p &lt; 0.001) values compared to the non-coated surfaces. In addition, the surface roughness was significantly lower for the ALD-HA (p &lt; 0.001) than for the non-coated surfaces. Platelets adhered to both surfaces; however, there was variability in platelet morphologies in different areas with higher platelet density on the ALD-HA surfaces. There was no significant difference in the overall absorbance values of the hemolyzed hemoglobin for both substrates, and the total clotting time was achieved at 60 min. It can be concluded that the ALD-HA coating of titanium can enhance surface wettability, increase surface free energy, and support blood coagulation and platelet adhesion.

Physico-chemical and pro-wound healing properties of microporous cellulosic sponge from Gleditsia triacanthos pods functionalized with Phytolacca americana fruit extract

This study aimed to exploit two invasive plant species to develop a novel, multifunctional, bioactive wound dressing based on a microporous cellulosic sponge (CS) from Gleditsia triacanthos pods and functionalizing them with Phytolacca americana fruit extract. The CS was functionalized, lyophilized, and characterized by Attenuated total reflectance–Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy, contact angle, water absorption, and retention capacity. In addition, two parameters were evaluated in temporal dynamics: controlled release of phenolic compounds and antioxidant activities. The hemolytic index, blood clotting kinetics, lactate dehydrogenase release, and wound scratch assays proved their hemo- and biocompatibility, as well as their ability to promote cell proliferation and migration promoting-activity and to inhibit microbial growth. Furthermore, the obtained spongious material exhibited an anti-inflammatory effect by modulating the macrophages’ secretion profile of IL-6 and IL-10. In conclusion, the microporous cellulosic sponge obtained from G. triacanthos could be used as a vehicle to ensure the controlled release of bioactive principles with pro-wound healing activities extracted from invasive plants.Graphical abstract:

Chitosan-coated halloysite nanotube magnetic microspheres for carcinogenic colorectal hemorrhage and liver laceration in albino rats.

Carcinogenic colorectal hemorrhage can cause severe blood loss and longitudinal ulcer, which ultimately become fatal if left untreated. The present study was aimed to formulate targeted release gemcitabine (GC)-containing magnetic microspheres (MM) of halloysite nanotubes (MHMG), chitosan (MCMG), and their combination (MHCMG). The preparation of MM by magnetism was confirmed by vibrating sample magnetometry (VSM), the molecular arrangement of NH2, alumina, and silica groups was studied by X-ray diffraction (XRD) and energy-dispersive spectroscopy (EDS), the hollow spherical nature of the proposed MM was observed by scanning electron microscopy (SEM), functional groups were characterized by Fourier transform infrared (FTIR) spectroscopy and thermochemical modification was studied by thermogravimetric analysis (TGA). In vitro thrombus formation showed a decreasing trend of hemostatic time for MMs in the order of MHMG3 < MCMG3 < MHCMG7, which was confirmed by whole blood clotting kinetics. Interestingly, rat tail amputation and liver laceration showed 3 folds increased clotting efficiency of optimized MHCMG7 compared to that of control. In vivo histopathological studies and cell viability assays confirmed the regeneration of epithelial cells. The negligible systemic toxicity of MHCMG7, more than 90% entrapment of GC and high % release in alkaline medium made the proposed MM an excellent candidate for the control of hemorrhage in colorectal cancer. Conclusively, the healing of muscularis and improved recovery of the colon from granulomas ultimately improved the therapeutic effects of GC-containing MMs. The combination of both HNT and CTS microspheres made them more targeted.

Improved Hemocompatibility on Superhemophobic Micro-Nano-Structured Titanium Surfaces.

Blood-contacting titanium-based implants such as endovascular stents and heart valve casings are prone to blood clotting due to improper interactions at the surface level. In complement, the current clinical demand for cardiovascular implants is at a new apex. Hence, there is a crucial necessity to fabricate an implant with optimal mechanical properties and improved blood compatibility, while simultaneously interacting differentially with cells and other microbial agents. The present study intends to develop a superhydrophobic implant surface with the novel micro-nano topography, developed using a facile thermochemical process. The surface topography, apparent contact angle, and crystal structure are characterized on different surfaces. The hemo/blood compatibility on different surfaces is assessed by evaluating hemolysis, fibrinogen adsorption, cell adhesion and identification, thrombin generation, complement activation, and whole blood clotting kinetics. The results indicate that the super-hemo/hydrophobic micro-nano titanium surface improved hemocompatibility by significantly reducing fibrinogen adsorption, platelet adhesion, and leukocyte adhesion. Thus, the developed surface has high potential to be used as an implant. Further studies are directed towards analyzing the mechanisms causing the improved hemocompatibility of micro/nano surface features under dynamic in vitro and in vivo conditions.

Erythrocyte interaction with titanium nanostructured surfaces

Titanium and its alloys are used to make different medical devices such as stents, artificial heart valves, and catheters for cardiovascular diseases due to their superior biocompatibility. Thrombus formation begins on the surface of these devices as soon as they encounter blood. This leads to the formation of blood clots, which obstructs the flow of blood that leads to severe complications. Recent advancements in nanoscale fabrication and superhydrophobic surface modification techniques have demonstrated that these surfaces have antiadhesive properties and the ability to reduce thrombosis. In this study, the interaction of erythrocytes and whole blood clotting kinetics on superhydrophobic titanium nanostructured surfaces was investigated. These surfaces were characterized for their wettability (contact angle), surface morphology and topography (scanning electron microscopy (SEM)), and crystallinity (glancing angled X-ray diffraction (GAXRD)). Erythrocyte morphology on different surfaces was characterized using SEM, and overall cell viability was demonstrated through fluorescence microscopy. The hemocompatibility of these surfaces was characterized using commercially available assays: thrombin generation assay thrombin generation, hemolytic assay hemolysis, and complement convertase assay complement activity. The results indicate that superhydrophobic titanium nanostructured surfaces had lower erythrocyte adhesion, less morphological changes in adhered cells, lower thrombin generation, lower complement activation, and were less cytotoxic compared to control surfaces. Thus, superhydrophobic titanium nanostructured surfaces may be a promising approach to prevent thrombosis for several medical devices.

Platelet dysfunction after trauma: From mechanisms to targeted treatment.

Platelet dysfunction after trauma: From mechanisms to targeted treatment.

The influence of sodium hypochlorite concentration on the fibrin structure of human blood clots and transforming growth factor-beta 1 release: an ex vivo study.

This study investigated the effects of various concentrations of sodium hypochlorite (NaOCl) on human whole-blood clotting kinetics, the structure of the blood clots formed, and transforming growth factor (TGF)-β1 release. Human whole blood was collected from 5 healthy volunteers and divided into 4 groups: CG (control, 0.5 mL of blood), BN0.5 (0.5 mL of blood with 0.5 mL of 0.5% NaOCl), BN3 (0.5 mL of blood with 0.5 mL of 3% NaOCl), and BN5.25 (0.5 mL of blood with 0.5 mL of 5.25% NaOCl). The effects of NaOCl on clotting kinetics, structure of fibrin and cells, and release of TGF-β1 were assessed using thromboelastography (TEG), scanning electron microscopy (SEM), and enzyme-linked immunosobent assay, respectively. Statistical analysis was conducted using the Kruskal Wallis and Mann-Whitney U tests, followed by the post hoc Dunn test. A p value < 0.05 indicated statistical significance. The blood samples in BN0.5 and BN3 did not clot, whereas the TEG of BN5.25 showed altered clot formation. Samples from the CG and BN3 groups could only be processed with SEM, which showed that the latter lacked fibrin formation and branching of fibers, as well as clumping of red blood cells with surface roughening and distortion. TGF-β1 release was significantly highest in BN3 when all groups were compared to CG (p < 0.05). Each concentration of NaOCl affected the release of TGF-β1 from blood clots and altered the clotting mechanism of blood by affecting clotting kinetics and cell structure.

Poly(N-vinyl imidazole) Cross-Linked β-Cyclodextrin Hydrogel for Rapid Hemostasis in Severe Renal Arterial Hemorrhagic Model.

A unique facile process has been adopted for fast assembly of a poly(N-vinyl imidazole) cross-linked β-cyclodextrin hydrogel through microwave-assisted free radical polymerization, using N,N'-methylenebis(acrylamide) cross-linker. The copolymer possesses positive surface charge, one of the characteristic properties of an ideal hemostatic hydrogel. The functionalized imidazole-based hydrogel demonstrates rapid, superior blood coagulation kinetics under in vitro and in vivo conditions. On application to a major renal arterial hemorrhagic model, this hydrogel shows better blood clotting kinetics, leading to complete hemostasis in as few as ∼144 ± 7 s. Additionally, 350 μL of whole blood was clotted instantly, in ∼35 s, and therefore, reinforcing its hemostatic potential. The hydrogel demonstrates excellent biocompatibility, when seeded with human dermal fibroblast cells, retaining the native property of its predecessor. In addition, the hydrogel presents excellent hemocompatibility when tested with whole blood with the highest hemolytic ratio of 1.07 ± 0.05%. Moreover, it also demonstrates potential as a carrier for sustained release of an anesthetic drug, lidocaine hydrochloride monohydrate (∼83% in 24 h). The rapid hemostatic behavior of the hydrogel is coupled with its cytocompatibility and hemocompatibilty properties along with controlled drug release characteristics. These behaviors evidently demonstrate it to be an excellent alternative for a superior hemostatic material for severe hemorrhagic conditions.

Pulmonary arterial hypertension patients display normal kinetics of clot formation using thrombelastography.

Pulmonary arterial hypertension is characterized by endothelial dysfunction and microthrombi formation. The role of anticoagulation remains controversial, with studies demonstrating inconsistent effects on pulmonary arterial hypertension mortality. Clinical anticoagulation practices are currently heterogeneous, reflecting physician preference. This study uses thrombelastography and hematology markers to evaluate whether clot formation and fibrinolysis are abnormal in pulmonary arterial hypertension patients. Venous blood was collected from healthy volunteers (n = 20) and patients with pulmonary arterial hypertension (n = 20) on stable medical therapy for thrombelastography analysis. Individual thrombelastography parameters and a calculated coagulation index were used for comparison. In addition, hematologic markers, including fibrinogen, factor VIII activity, von Willebrand factor activity, von Willebrand factor antigen, and alpha2-antiplasmin, were measured in pulmonary arterial hypertension patients and compared to healthy volunteers. Between group differences were analyzed using t tests and linear mixed models, accounting for repeated measures when applicable. Although the degree of fibrinolysis (LY30) was significantly lower in pulmonary arterial hypertension patients compared to healthy volunteers (0.3% ± 0.6 versus 1.3% ± 1.1, p = 0.04), all values were within the normal reference range (0–8%). All other thrombelastography parameters were not significantly different between pulmonary arterial hypertension patients and healthy volunteers (p ≥ 0.15 for all). Similarly, alpha2-antiplasmin activity levels were higher in pulmonary arterial hypertension patients compared to healthy volunteers (103.7% ± 13.6 versus 82.6% ± 9.5, p < 0.0001), but all individual values were within the normal range (75–132%). There were no other significant differences in hematologic markers between pulmonary arterial hypertension patients and healthy volunteers (p ≥ 0.07 for all). Sub-group analysis comparing thrombelastography results in patients treated with or without prostacyclin pathway targeted therapies were also non-significant. In conclusion, treated pulmonary arterial hypertension patients do not demonstrate abnormal clotting kinetics or fibrinolysis by thrombelastography.

Antithrombogenic properties of Tulbaghia violacea aqueous leaf extracts: assessment of platelet activation and whole blood clotting kinetics.

Tulbaghia violacea plant extracts have been investigated for their potential therapeutic effects in the management of various ailments, among which are cardiovascular diseases, due to the wide range of phytocompounds that the plant possesses. One of the major challenges in clinical practice is the inability to control platelet activation and clotting caused by cardiovascular disease interventions. Current treatment methods to inhibit platelet aggregation and thromboxane formation have been associated with major undesirable side effects. This has led to increased research studies on the development of newer and more effective antiplatelet agents. In particular, there has been a growing interest on the potential antiplatelet activity of plant-derived extracts. Hence this study methodically evaluates the anticlotting and antiplatelet properties of T. violacea aqueous leaf extracts. The platelet activity of the plant extracts was assessed using total platelet adhesion, platelet morphology and whole blood clotting kinetics. The 0.1 mg ml−1T. violacea extract mixed with blood plasma demonstrated the lowest platelet adhesion and activation and also reduced whole blood clotting kinetics. There was a reduction of about 70% in platelet adhesion for the 0.1 mg ml−1 treatment compared to the control in the first 15 min which was supported by morphological characterization under SEM. These observations suggest that T. violacea may be a potential antiplatelet therapeutic agent to inhibit the initial step of platelet adhesion and ultimately reduce the incidence of cardiovascular events.

Fabrication of chitosan@calcium alginate microspheres with porous core and compact shell, and application as a quick traumatic hemostat

A quick control of heavy hemorrhaging is critical to save the life of injured person. Herein we developed a hemostat of chitosan@calcium alginate microspheres through combination of microemulsion, polyelectrolyte complexation coating, and thermally induced phase separation. The alginate coated microspheres featured a structure of a porous chitosan core and a compact calcium alginate shell layer. Their in vitro and in vivo hemostatic properties were evaluated by the whole blood clotting kinetics, and rat tail amputation and liver laceration models. Compared to the porous chitosan microspheres, the alginate coated microspheres showed much enhanced hemostatic efficiency. The latter formed bigger blood clots; its hemostatic time on the liver laceration was substantially shortened to 53 ± 10 s from 107 ± 9 s of the former. It was shown that calcium ions released from the calcium alginate layer may accelerate the formation of blood clots. Such a biocompatible microsphere is a promising quick hemostat for controlling traumatic bleeding.

A Textile Pile Debridement Material Consisting of Polyester Fibers for in Vitro Removal of Biofilm.

Biofilms formed on skin wound lead to inflammation and a delay of healing. In the present work, a novel textile pile debridement material was prepared and treated by plasma. Samples before and after plasma treatment were characterized by a series of methods, including scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), and water uptake capacity. Besides, mechanical, coagulation, and in vitro biofilm removal performances of the textile pile debridement material were evaluated, with a medical gauze as a control. The results demonstrate that the plasma treatment produced corrosions and oxygen-containing polar groups on the fiber surface, offering an enhanced water uptake capacity of the textile pile debridement material. In addition, compressive tests certify the mechanical performances of the textile pile debridement material in both dry and wet conditions. The results from a kinetic clotting time test suggest a favorable ability to promote blood coagulation. Furthermore, the results of an MTT cell viability assay, SEM, and confocal laser scanning microscopy (CLSM) illustrate that the textile pile debridement material demonstrates a more superior in vitro biofilm removal performance than medical gauze. All of these characterizations suggest that the textile pile debridement material can offer a feasible application for clinical wound debridement.

Polyelectrolyte multilayers containing a tannin derivative polyphenol improve blood compatibility through interactions with platelets and serum proteins.

To develop hemocompatible surfaces, a cationic tannin derivate (TN) was used to prepare polyelectrolyte multilayers (PEMs) with the glycosaminoglycans heparin (HEP) and chondroitin sulfate (CS). The surface chemistry of the PEMs was characterized using X-ray photoelectron spectroscopy and water contact angle measurements. PEMs assembled with chitosan (CHI) and HEP or CS were used as controls. We investigate the hemocompatibility of PEMs by analyzing the adsorption of key blood serum proteins, adhesion and activation of platelets, and blood clotting kinetics. TN- and CHI-based PEMs adsorb similar amounts of albumin, whereas fibrinogen adsorption was more pronounced on TN-based PEMs, due to strong association with catechol groups. However, TN-based PEMs significantly reduce both platelet adhesion and platelet activation, while CHI-based PEMs promote platelet adhesion and activation. The whole-blood clotting kinetics assay also shows lower blood coagulation on TN-based PEMs. TN is an amphoteric, cationic, condensed tannin derivative with resonance structures. It also contains catechol groups, which are similar to those in mussel adhesive protein. These chemical features enable strong association with fibrinogen, which promotes the platelet-repelling effect. This study provides a new perspective for understanding platelet adhesion and activation on biomaterial surfaces, toward the development of new blood-compatible surfaces using a tannin derivative-based polymer.

Direct interaction of fibrinogen with lipid microparticles modulates clotting kinetics and clot structure

Extensive studies revealed the role of blood lipid microparticles (liposomes, microvesicles) in activation of coagulation cascade. The direct interaction of fibrinogen/fibrin with lipid surfaces and its consequence for hemostasis received much less attention. We observed pronounced changes in both clot morphology and kinetics of fibrin clotting in the presence of artificial liposomes. The evidence was obtained that lipid microparticles per se present a diffusion barrier to the three-dimensional fibril assembling and pose spatial restrictions for fiber elongation. On the other hand, fibrinogen adsorption results in its high local concentration on liposome surface that accelerates fibrin polymerization. Adsorption induces Fg secondary structure alterations which may contribute to the abnormal clot morphology. In dependence on lipid composition and size of microparticles, the interplay of all the outlined mechanisms determines functionally important changes of clot morphology. The obtained results contribute to the knowledge of clotting mechanisms in the presence of artificial and natural lipid microparticles.

The Antithrombotic Function of Sphingosine-1-Phosphate on Human Adipose-Stem-Cell-Recellularized Tissue Engineered Vascular Graft In Vitro.

Adipose stem cells (ASCs) show potential in the recellularization of tissue engineerined vascular grafts (TEVGs). However, whether sphingosine-1-phosphate (S1P) could further enhance the adhesion, proliferation, and antithrombosis of ASCs on decellularized vascular scaffolds is unknown. This study investigated the effect of S1P on the recellularization of TEVGs with ASCs. Human ASCs were derived from lipoaspirate. Scaffolds were derived from human umbilical arteries (HUAs) with treatment of 0.1% sodium dodecyl sulfate (SDS) for 48 h (decellularized HUAs; DHUAs). The adhesion, proliferation, and antithrombotic functions (kinetic clotting time and platelet adhesion) of ASCs on DHUAs with S1P or without S1P were evaluated. The histology and DNA examination revealed a preserved structure and the elimination of the nuclear component more than 95% in HUAs after decellularizaiton. Human ASCs (hASCs) showed CD29(+), CD73(+), CD90(+), CD105(+), CD31(–), CD34(–), CD44(–), HLA-DR(–), and CD146(–) while S1P-treated ASCs showed marker shifting to CD31(+). In contrast to human umbilical vein endothelial cells (HUVECs), S1P didn’t significantly increase proliferation of ASCs on DHUAs. However, the kinetic clotting test revealed prolonged blood clotting in S1P-treated ASC-recellularized DHUAs. S1P also decreased platelet adhesion on ASC-recellularized DHUAs. In addition, S1P treatment increased the syndecan-1 expression of ASCs. TEVG reconstituted with S1P and ASC-recellularized DHUAs showed an antithrombotic effect in vitro. The preliminary results showed that ASCs could adhere to DHUAs and S1P could increase the antithrombotic effect on ASC-recellularized DHUAs. The antithrombotic effect is related to ASCs exhibiting an endothelial-cell-like function and preventing of syndecan-1 shedding. A future animal study is warranted to prove this novel method.

Platelet Lyophilization and Cryopreservation: A Means of Generating a Standardized In-Vitro Human Blood Clot

Background and Hypothesis: Numerous models, both in-vitro and in-vivo, exist for the analysis of blood-clotting pharmacodynamics. However, reliance on animal models, fresh blood, or lack of a complete component profile translates to little standardization/reproducibility of clotting parameters. Given the above limitations, the goal of our study was to generate a reproducible, physiologic human blood clot through cryopreservation and lyophilization of platelets. We hypothesized that the platelets exposed to either lyophilization or cryopreservation would have a prolonged ability to generate reproducible clots; however, clotting functionality might exhibit a setvalue decrease resulting from storage procedures.&#x0D; Experimental Design or Project Methods: Initial efforts focused on understanding the metabolic effects of storing platelets, plasma, and red blood cells (RBCs) at either 25°C or 4°C over a period of 25days. Glucose consumption was utilized as a proxy for metabolic activity and assessed using a glucose-hexokinase assay. Secondly, RBCs, platelets, and plasma were stored with the aim of maximizing functionality for longer periods: RBCs – 4°C+CPDA1 solution and platelets – cryopreserved (-80°C) or lyophilized. Functionality of stored blood components was assessed over a period of 1-week via Thromboelastographic (TEG) kinetic clotting readouts. Blood samples were provided by healthy volunteers (n=6).&#x0D; Results: Utilization of glucose by RBCs and platelets was significantly increased during storage at 25°C versus 4°C, with RBCs maintaining very consistent glucose consumption rates compared to platelets. Lastly, by 1-week of storage, wholeblood is able to maintain consistent clotting better than samples utilizing cryopreserved platelets.&#x0D; Conclusion and Potential Impact: Through our work, we were able to generate a reproducible synthetic human blood clot after 1-week of whole-blood storage as described by TEG parameters; a major stride in the ultimate goal of generating a model for pharmaceutical testing. Although not all parameters were preserved, we were able to maintain relative differences, ensuring consistent coagulability even with cryopreserved platelets. Further work will be conducted to understand the effects of greater storage durations.

Interaction of blood plasma proteins with superhemophobic titania nanotube surfaces

The need to improve blood biocompatibility of medical devices is urgent. As soon as blood encounters a biomaterial implant, proteins adsorb on its surfaces, often leading to several complications such as thrombosis and failure of the device. Therefore, controlling protein adsorption plays a major role in developing hemocompatible materials. In this study, the interaction of key blood plasma proteins with superhemophobic titania nanotube substrates and the blood clotting responses was investigated. The substrate stability was evaluated and fibrinogen adsorption and thrombin formation from plasma were assessed using ELISA. Whole blood clotting kinetics was also investigated, and Factor XII activation on the substrates was characterized by an in vitro plasma coagulation time assay. The results show that superhemophobic titania nanotubes are stable and considerably decrease surface protein adsorption/Factor XII activation as well as delay the whole blood clotting, and thus can be a promising approach for designing blood contacting medical devices.

Nanofibrous vascular scaffold prepared from miscible polymer blend with heparin/stromal cell-derived factor-1 alpha for enhancing anticoagulation and endothelialization

There is an urgent clinical demand to develop a functional small diameter vascular graft with long-term patency, which mainly relies on the anticoagulation and endothelialization of the vascular graft. In addition, improved degradation of vascular graft provides more space for cell infiltration and facilitates remodeling of blood vessel. In this study, an elastic and biomimetic nanofibrous vascular scaffold with improved degradability was prepared by adding poly(lactic-co-glycolic acid) (PLGA) into the poly(L-lactic acid) (PLLA)/poly(L-lactide-co-ε-caprolactone) (PLCL) blend using thermally induced phase separation (TIPS) technique. The incorporation of PLGA also improved the hydrophilicity of the composite scaffold. Then the vascular scaffold was surface modified by combination of heparin and stromal cell-derived factor-1 alpha (SDF-1α). The results of whole blood clotting kinetics and plasma recalcification profiles indicated that heparinized modification significantly enhanced the anticoagulation of vascular scaffold. In vitro cell culture assays demonstrated the immobilized SDF-1α facilitated recruitment of endothelial progenitor cells (EPCs), migration and proliferation of mature endothelial cells, human umbilical vein endothelial cells (HUVECs), and expression of VE-cadherin/CD144 and endothelial nitric oxide synthase (eNOS) genes in HUVECs, thereby accelerating the endothelialization of the modified vascular scaffold. Besides, the nanofibrous vascular scaffold modified with heparin and SDF-1α inhibited the proliferation of human vascular smooth muscle cells (HVSMCs). Therefore, the phase separated nanofibrous vascular scaffold modified with heparin and SDF-1α shows the promising in vitro performance as a functional small diameter vascular graft.

TiO2 Coating and UV Photofunctionalization Enhance Blood Coagulation on Zirconia Surfaces.

This in vitro study was designed to evaluate the effect of sol-gel derived TiO2 coating on blood coagulation, blood protein adsorption, and platelet response on zirconia surfaces. Square-shaped zirconia (n=96) (10x10x2 mm) was cut, ground, sintered, and finally cleansed ultrasonically in each of acetone and ethanol for 5 minutes. Three experimental groups (n=32) were fabricated: (a) zirconia coated with sol-gel derived TiO2, (b) zirconia coated with sol-gel derived TiO2 and treated with ultraviolet (UV) irradiation for 1 hour, and (c) non-coated zirconia as control. The coatings were prepared from tetraisopropyl orthotitanate solution by dip-coating. The thrombogenicity of the specimens was evaluated using a whole blood kinetic clotting time method where the extent of blood clotting was evaluated at 10, 20, 30, 40, 50, and 60 minutes (n=4/time point, total n=24/group). Scanning electron microscope images were taken to observe platelet morphologies after 1-hour incubation with platelet-rich plasma (PRP) (n=5/group). Surface characteristics were visualized using atomic force microscopy (n=1/group). Adsorption of plasma proteins and fibronectin on each surface was studied by gel electrophoresis (n=2/group). Significant differences were observed in blood coagulation between the test groups at 20-, 30-, 40-, and 50-minute time points (p<0.005). UV treated TiO2 coated specimens showed fastest blood coagulation followed by TiO2 coated and non-coated specimens. Furthermore, platelets appeared at a higher activation state on coated specimens. Gel electrophoresis revealed no difference in protein adsorption among the experimental groups. In summary, TiO2 coatings promoted blood coagulation, and it was further enhanced by UV treatment, which has the potential to hasten the wound healing process in vivo.