Phenylalanine ammonia-lyase entrapped in fibers.

Phenylalanine ammonia-lyase extracted form Rhodotorula rubra (IFO 1101) was immobilized into cellulose triacetate fibers made hemocompatible by physical blend with a platelet anti-aggregating agent. The entrapped enzyme could operate at physiological values of phenylalanine and tyrosine reducing their level to traces within a few hours. The optimum pH value for the entrapped enzyme shifted from 8.0 to 9.0. At blood pH the activity was about 68 per cent of the maximum. The entrapped enzyme retained its original activity in blood for more than 50 days.

Covalent bonding of heparin to a vinyl copolymer for biomedical applications.

In order to prepare polymer surfaces of vinyl type, provided with long-term haemocompatibility, a commercial ethylene-vinyl alcohol copolymer (EVAL) was covalently heparinized, employing two different bifunctional reagents (adipoil chloride and hexamethylene diisocyanate). The amount and activity of the heparin bonded to the polymer films were evaluated as a function of the concentration of the heparin solutions employed. Also, the influence exerted by the presence of various hydrophilic 'spacing arms' of different molecular weights, either neutral or provided with electrical charge, was investigated. By in vitro measurements of activated partial thromboplastin time it was seen that all the heparinized samples possessed a high degree of haemocompatibility. For the sake of comparison, heparin was also bonded ionically to EVAL functionalized by introduction of quaternary ammonium groups bonded covalently (by adipoil chloride) to the hydroxyl groups of the polymer. It was seen that the covalent immobilization system provides the polymer surfaces with a superior haemocompatibility.

Synthesis and physicochemical characterization of a hydrophilic polyurethane able to bind heparin.

The synthesis of a new segmented polyurethane containing quaternary ammonium groups in the side-chain is reported. The quaternization was carried out both on the polymer dissolved in an organic solvent and on polymer films. Polymeric films quaternized by both techniques were heparinized. The amount of bonded heparin, determined by spectrophotometry, was remarkably higher than previously described. Polymer quaternized in solution bonded more heparin than that heparinized directly on film. In vitro evaluations of antithrombogenicity by activated partial thromboplastin time (APTT) carried out on the films confirmed these data. The polymers were also characterized by chemical, i.r., n.m.r., differential scanning calorimetry and viscometric techniques.

New polyurethane compositions able to bond high amounts of both albumin and heparin. II: Copolymers and polymer blends.

Haemocompatible new urethane copolymers and polymer blends containing, in the chain extender, a long chain alkyl group (able to bond albumin) or a tertiary ammonium group able, after suitable quaternization reaction, to bind ionically significant amounts of heparin, were prepared. The copolymers were characterized by differential scanning calorimetry, intrinsic viscosity determinations, infrared spectroscopy and nuclear magnetic resonance (1H and 13C). Biological in vitro evaluation has shown that the adsorption sequence for albumin and heparin, respectively, onto films of the various copolymers and blends, exerts a great influence. From scanning electron microscopy measurements it was seen that the bonding type of albumin to the polymer films plays a determining role on the platelet activation. A phase segregation occurring on the polymer blends surface was demonstrated by X-ray photoelectron spectroscopy measurements.

New polyurethane compositions able to bond high amounts of both albumin and heparin. Part I.

In order to prepare polymers provided with better haemocompatibility with respect both to the coagulative cascade and to platelet aggregation and activation, we have synthesized new polyurethanes containing in the chain-extender [di(2-hydroxyethyl)hexadecylamine] both a long chain alkyl group (able to bond albumin) and a tertiary ammonium group able, after suitable quaternization reaction, to bind ionically significant amounts of heparin. The amounts of heparin and albumin bonded to the polymer films were determined spectrophotometrically. A biological in vitro evaluation of the heparinized and albuminized films was also carried out with respect to blood coagulation factors (by activated partial thromboplastin time measurements) and to platelet adhesion and activation (by platelet count and scanning electron microscopy examination). It was seen that the type of adsorption sequence for albumin and heparin, respectively, onto the various homo- and copolymer films, plays an important role on their biological properties; the possible mechanisms involved are also discussed on the basis of X-ray photoelectron spectroscopy and attenuated transmission reflectance evaluation of the polymer surfaces.

Antimicrobial activity of polyurethanes coated with antibiotics: a new approach to the realization of medical devices exempt from microbial colonization.

Intravascular devices are widely used for vascular access but are associated with substantial risk of development of devices-related bloodstream infection (DR-BSI), which causes a considerable increase of morbidity and mortality, prolonged hospitalisation and growing medical costs. Since conventional treatment of DR-BSI fails in a significant number of cases, resulting in removal of the device, new approaches are needed to prevent bacterial colonization. In this paper, two antibiotics, rifampin and amoxicillin, have been adsorbed on polyurethanes exhibiting acidic or basic properties. The influence of the type of antibiotic-polymer interaction on the amount of adsorbed antibiotic and on the release kinetics was studied. It was seen that the antibiotic-polymer affinity increases both with the introduction in the polymer side-chain of functional groups and with the matrix hydrophilicity. The antimicrobial activity of the treated polymers, evaluated in vitro by the Kirby-Bauer test, depends on the amount of antibiotic adsorbed, on the strength of drug-matrix interaction and on the water swelling of the polymers. The inhibition zone of bacterial growth lasts only a few hours for the amoxi-coated polymers while remains at least for five months for the rifampin-coated ones. The presence of serum proteins decreases by about 30% the inhibition zone diameter of these latest matrices after two months.

New polymer-antibiotic systems to inhibit bacterial biofilm formation: a suitable approach to prevent central venous catheter-associated infections.

Intravascular catheters are widely employed in medical practice. However, complications such as local or systemic infections are frequently related to their use. The significant increase in this type of nosocomial infection has prompted the search for new strategies to prevent them. This paper reports on an experimental model to prevent catheter-related infections based on the adsorption of a beta-lactam antibiotic (cefamandole nafate) on functionalized urethane polymers. The polyurethanes synthesized were used to coat a commercial central venous catheter. The influence of functional groups on the polymer-antibiotic interaction was analyzed and the kinetics of the antibiotic release from the catheters was dynamically studied. We were able to realize a polymer-antibiotic system able to inhibit bacterial growth up to 7 days. These promising results have encouraged us to extend this experimental model to other polymer-antibiotic systems in order to identify those allowing bacterial growth inhibition for longer times.

Principle of operation, design criteria and fluid dynamics of a new bileaflet heart valve prosthesis.

Bileaflet heart valves show the best fluid dynamic behaviour among mechanical valves and, as a consequence, give the best clinical results. A new bileaflet heart valve has been designed whose main characteristics are the kind of leaflet movement, low profile, fluid dynamics and material. Two flat leaflets move freely inside a very low profile housing ring. The movement is described by the rolling without sliding of the leaflet surface around a cylindrical surface on the inner wall of the housing. The opening angle is 85 degrees. Both the leaflets and the housing are machined from a solid piece of titanium and then covered with carbon by ion beam techniques. The design phase and the first fluid dynamic evaluation were done by numerical methods.

Monitoring of metabolites applying fibre-entrapped enzymes in a calorimetric system. I -- Glucose and urea determination.

A simple device, consisting of a heat sensor placed in close contact to fibres containing enzymes and connected to a temperature measuring unit has been developed. The system monitors the temperature variations due to the enzymatic reaction when substrate solutions flow through the measuring cell. Fibres containing the enzymes glucose oxidase and catalase for the determination of glucose and fibres containing urease for the determination of urea were tested. A linear relationship between the substrate concentration and the deltaT recorded was obtained in both cases.

A simple method for ex vivo evaluation of biomaterial interaction with blood platelets.

The process of thrombus formation, as a consequence of the interaction of artificial surfaces with blood, is related to the activation of blood platelets. A simple ex vivo method, which is suitable for the evaluation of the platelet-surface interaction is described. This method has been used to compare the haemocompatibility of several artificial materials, including nylon-6, Silastic and pyrolytic carbon.

A native whole blood test for the evaluation of blood-surface interaction: determination of thromboxane production.

The method developed to evaluate the hemocompatibility of artificial materials involves the determination of thromboxane production during the clotting of rabbit blood, in test tubes of different materials. The concentration of serum TXB2 obtained after incubation of whole blood in glass test tubes, for 40 min at 37 degrees C, averaged 416.8 +/- 23.3 ng/ml (mean +/- SE). Polymethylpentene, recognised as having a relatively poor blood compatibility, elicited 309.5 +/- 17.2 ng/ml of serum TXB2, while silicone and Avcothane, considered of better hemocompatibility, showed thromboxane levels of 276.2 +/- 28.2 and 222.9 +/- 31.5 ng/ml, respectively. These values validate the usefulness of the proposed method as a preliminary in vitro screening test of artificial materials intended for biomedical application.

Preparation and evaluation of polyurethane surfaces containing immobilized plasminogen.

Plasminogen has been immobilized onto a segmented polyurethane containing amino groups, using glutaraldehyde as coupling agent. It was also aspecifically adsorbed, for sake of comparison, onto polyurethane films containing different functional groups and, in particular, epsilon-amino caproic acid and lysine residues. The differently immobilized plasminogen has been converted to plasmin by activation with urokinase, and the percentage of active plasmin for the various polymer films was determined using a tripeptide (S-2251) as a synthetic substrate. The biological behaviour of the differently treated polymer films has been evaluated in vitro by measurements of partial thromboplastin time (PTT) and platelet adhesion.