The Utility of Miniaturized Adsorbers in Exploring the Cellular and Molecular Effects of Blood Purification: A Pilot Study with a Focus on Immunoadsorption in Multiple Sclerosis.

Immunoadsorption (IA) has proven to be clinically effective in the treatment of steroid-refractory multiple sclerosis (MS) relapses, but its mechanism of action remains unclear. We used miniaturized adsorber devices with a tryptophan-immobilized polyvinyl alcohol (PVA) gel sorbent to mimic the IA treatment of patients with MS in vitro. The plasma was screened before and after adsorption with regard to disease-specific mediators, and the effect of the IA treatment on the migration of neutrophils and the integrity of the endothelial cell barrier was tested in cell-based models. The in vitro IA treatment with miniaturized adsorbers resulted in reduced plasma levels of cytokines and chemokines. We also found a reduced migration of neutrophils towards patient plasma treated with the adsorbers. Furthermore, the IA-treated plasma had a positive effect on the endothelial cell barrier's integrity in the cell culture model. Our findings suggest that IA results in a reduced infiltration of cells into the central nervous system by reducing leukocyte transmigration and preventing blood-brain barrier breakdown. This novel approach of performing in vitro blood purification therapies on actual patient samples with miniaturized adsorbers and testing their effects in cell-based assays that investigate specific hypotheses of the pathophysiology provides a promising platform for elucidating the mechanisms of action of those therapies in various diseases.

In Vitro Corrosion of Polyester-Coated Magnesium Alloy under pH-Static Conditions.

The resorption rate of bioresorbable implants requires tuning to match the desired field of application. The use of Mg as implant material is highly advantageous, as it provides sufficient mechanical strength combined with its biodegradability. Consequently, the implant vanishes after it has served its intended purpose, allowing the complete restoration of natural tissue and organ function. However, a biodegradable Mg implant requires a biodegradable coating to slow the rate of Mg corrosion, as a permanent coating would negate the benefits of using Mg as an implant material. Therefore, degradable polymers are the materials of choice, especially polyester-based coatings, such as PLLA, as they have been proven in clinical practice over the long term. Within this work, the degradation retarding effect of a physical barrier in form of four clinically relevant polyester-based coatings, poly-l-lactide (PLLA), poly-l-lactide-co-glycolide (PLGA), poly(l-lactide-co-PEG) triblock copolymer (PLLA-co-PEG), and polydioxanone (PDO), is investigated in vitro under pH-static conditions using CO2 gas to compensate pH changes due to Mg corrosion. Coating thicknesses of 7.5 to 8.3 µm were comparable to commercially available stent systems. Quantitative analysis of magnesium concentration in buffered test medium by a photometric assay allows real-time monitoring. Shielding effect of different polyesters through polymer coating and formation of a protective passivation layer beneath the polymer coating was observed and characterized using SEM and EDX techniques. Our finding was that even imperfect polymer layers provide a considerable protective effect, and the used in vitro setup matches reported in vivo observations regarding elemental composition of corrosion products.

Decellularization of precision-cut kidney slices-application of physical and chemical methods.

The extracellular matrix (ECM) obtained by decellularization provides scaffolds with the natural complex architecture and biochemical composition of the target organ. Whole kidney decellularization by perfusion uses the vasculature to remove cells leaving a scaffold that can be recellularized with patient-specific cells. However, decellularization and recellularization are highly complex processes that require intensive optimization of various parameters. In pursuit of this, a huge number of animals must be sacrificed. Therefore, we used precision-cut kidney slices (PCKS) as a source of natural scaffolds, which were decellularized by immersion in chemical reagents allowing the examination of more parameters with less animals. However, chemical reagents have a damaging effect on the structure and components of the ECM. Therefore, this study aimed at investigating the effects of physical treatment methods on the effectiveness of PCKS decellularization by immersion in chemical reagents (CHEM). PCKS were treated physically before or during immersion in chemicals (CHEM) with high hydrostatic pressure (HHP), freezing-thawing cycles (FTC) or in an ultrasonic bath system (UBS). Biochemical and DNA quantification as well as structural evaluation with conventional histology and scanning electron microscopy (SEM) were performed. Compared to decellularization by CHEM alone, FTC treatment prior to CHEM was the most effective in reducing DNA while also preserving glycosaminoglycan (GAG) content. Moreover, while UBS resulted in a comparable reduction of DNA, it was the least effective in retaining GAGs. In contrast, despite the pretreatment with HHP with pressures up to 200 MPa, it was the least effective in DNA removal. Histological scoring showed that HHP scaffolds received the best score followed by UBS, FTC and CHEM scaffolds. However further analysis with SEM demonstrated a higher deterioration of the ultrastructure in UBS scaffolds. Altogether, pretreatment with FTC prior to CHEM resulted in a better balance between DNA removal and structural preservation.