Plasma clots gelled by different amounts of calcium for stem cell delivery.

PURPOSE: Freshly prepared autologous plasma clots may serve as a carrier matrix for expanded multipotent mesenchymal stromal cells (MSCs) or bone marrow cells. By varying the calcium concentration, plasma clots with different properties can be produced. The purpose of this in vitro study was to determine the optimal calcium concentrations for the clotting process, intra-clot cell viability, and clot lysis. METHODS: Different plasma clots were prepared by adding an equal volume of RPMI1640 (with or without MSCs) to citrate plasma (either containing platelets or platelet-free). Clotting was initiated by the addition of CaCl(2) (10 g/100 ml H(2)O, 10 % solution). The final concentration of CaCl(2) ranged from 1 to 10 % by volume of plasma. Viability and distribution of the MSCs were analysed by calcein-AM/propidium iodide staining. MSC-embedded plasma clots were dissolved with trypsin (0.25 %), and recovered cells were further incubated for 1 week under cell culture conditions. RESULTS: The viability of MSCs embedded in clots formed by the addition of 1-8 % by volume CaCl2 was not affected by incubation of up to 1 week. In contrast, clots produced by higher volumes of CaCl(2) solutions (9-10 % by volume of plasma) showed decreased numbers of viable cells. Intra-clot cell proliferation was highest in clots produced by addition of 5 % CaCl(2) by plasma volume. Osteocalcin release was not influenced in platelet-free plasma but decreased in platelet-containing plasma. Morphological analysis of stained recovered MSCs revealed that lysis of the plasma clot did not affect cell morphology or subsequent spontaneous proliferation. CONCLUSIONS: Clot formation and clot stability can be controlled by changing the concentration of CaCl(2) added to plasma. The addition of 5 % CaCl(2) produced a plasma clot with optimal results for stem cell delivery.

Is the bioactivity of induced membranes time dependent?

PURPOSE: The induced membrane technique (IMT) is a two-stage surgical procedure for reconstruction of bone defects. Bone grafting (second stage of IMT) is recommend after 4-8 weeks assuming the highest bioactivity of IMs. However, larger studies concerning the biology and maturation of IMs and a potential time dependency of the bioactivity are missing. Therefore, aim of this study was the time-dependent structural and cellular characterization of cement spacer IMs concomitantly to an analysis of membrane bioactivity. METHODS: IMs from 60 patients (35-82 years) were obtained at different maturation stages (1-16 weeks). IMs were studied by histology and co-culture with mesenchymal stem cells (MSC). IM lysates were analyzed by ELISA and protein microarray. RESULTS: Increasing vascularization and fibrosis were found in membranes older than 4 and 7 weeks, respectively. MSC grew out from all membranes and all membranes enhanced proliferation of cultured MSC. Osteocalcin and osteopontin (in membrane lysates or induced in MSC by membrane tissue) were found over all time points without significant differences. In contrast to alkaline phosphatase activity, increasing levels of osteoprotegerin were found in membranes. CONCLUSION: The histological structure of IMs changes during growth and maturation, however, biologically active MSC and factors related to osteogenesis are found over all time points with minor changes. Thus, membranes older than 8 weeks exert regenerative capacities comparable to the younger ones. The postulated narrow time frame of 4-8 weeks until bone grafting can be questioned and surgeons may choose timing for the second operation more independently and based on other clinical factors.

Peripheral Blood Plasma Clot as a Local Antimicrobial Drug Delivery Matrix.

Platelet-free blood plasma clots were loaded either with antibiotics (vancomycin, gentamicin, or linezolid) at concentrations of 5-300 µg/mL or with silver ions (silver acetate) at concentrations of 3.3-129 µg/mL. The release of antibiotics or silver from the clot matrix was analyzed after repeated immersion of the plasma clots using reversed-phase high-performance liquid chromatography (RP-HPLC) or atomic absorption spectroscopy (AAS). The antimicrobial activity was tested against Staphylococcus aureus; tissue cell compatibility was analyzed using human mesenchymal stem cells (hMSC). Fibrin fiber thickness of the clots was analyzed by scanning electron microscopy. While addition of linezolid and vancomycin did not significantly change the fibrin fiber thickness, gentamicin and silver ions led to an increase in fiber thickness. All antibiotics showed a concentration-dependent burst-like release from the plasma clots within 1 h followed by a general decay in elution. The release of vancomycin and gentamicin, or silver lasted up to 7 days (depending on initial concentrations), but lasted only up to 4 h for linezolid. A correlation (p < 0.0001) was noted between the concentration of released antibiotics analyzed by HPLC and antimicrobial activity (agar diffusion test). A decrease in antibacterial activity of gentamicin- and vancomycin-containing clots occurred within 4 or 5 days. In contrast, the corresponding antibacterial activity of plasma clots containing linezolid was limited to 3 h. Antibacterial activity of plasma clots containing silver at the highest concentrations decreased after day 3, but clots with lower concentrations induced incomplete bacterial lysis or displayed no antibacterial activity. The antibiotic-containing clots did not induce cytotoxic effects on the embedded hMSC in contrast to all clots containing silver. Our results indicate that an autologous plasma clot can be used to deliver antibiotics such as vancomycin and gentamicin in combination with hMSC and the antibacterial effects persist for days without inducing cytotoxic effects on the embedded stem cells.

Cross-Linking of a Hydrophilic, Antimicrobial Polycation toward a Fast-Swelling, Antimicrobial Superabsorber and Interpenetrating Hydrogel Networks with Long Lasting Antimicrobial Properties.

A hemocompatible, antimicrobial 3,4en-ionene (PBI) derived by polyaddition of trans-1,4-dibromo-2-butene and N,N,N',N'-tetramethyl-1,3-propanediamine was cross-linked via its bromine end groups using tris(2-aminoethyl)amine (TREN) to form a fast-swelling, antimicrobial superabsorber. This superabsorber is taking up the 30-fold of its weight in 60 s and the granulated material is taking up 96-fold of its weight forming a hydrogel. It fully prevents growth of the bacterium Staphylococcus aureus. The PBI network was swollen with 2-hydroxyethyl acrylate and glycerol dimethacrylate followed by photopolymerization to form an interpenetrating hydrogel (IPH) with varying PBI content in the range of 2.0 to 7.8 wt %. The nanophasic structure of the IPH was confirmed by atomic force microscopy and transmission electron microscopy. The bacterial cells of the nosocomial strains Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa are killed on the IPH even at the lowest PBI concentration. The antimicrobial activity was retained after washing the hydrogels for up to 4 weeks. The IPHs show minor leaching of PBI far below its antimicrobial active concentration using a new quantitative test for PBI detection in solution. This leaching was shown to be insufficient to form an inhibition zone and killing bacterial cells in the surroundings of the IPH.

Alignment of the Fibrin Network Within an Autologous Plasma Clot.

Autologous plasma clots with longitudinally aligned fibrin fibers could serve as a scaffold for longitudinal axonal regrowth in cases of traumatic peripheral nerve injuries. Three different techniques for assembling longitudinally oriented fibrin fibers during the fibrin polymerization process were investigated as follows: fiber alignment was induced by the application of either a magnetic field or-as a novel approach-electric field or by the induction of orientated flow. Fiber alignment was characterized by scanning electron microscopy analysis followed by image processing using fast Fourier transformation (FFT). Besides FFT output images, area xmin to xmax, as well as full width at half maximum (FWHM) of the FFT graph plot peaks, was calculated to determine the relative degree of fiber alignment. In addition, fluorescently labeled human fibrinogen and mesenchymal stem cells (MSCs) were used to visualize fibrin and cell orientation in aligned and nonaligned plasma clots. Varying degrees of fiber alignment were achieved by the three different methods, with the electric field application producing the highest degree of fiber alignment. The embedded MSCs showed a longitudinal orientation in the electric field-aligned plasma clots. The key feature of this study is the ability to produce autologous plasma clots with aligned fibrin fibers using physical techniques. This orientated internal structure of an autologous biomaterial is promising for distinct therapeutic applications, such as a guiding structure for cell migration and growth dynamics.