RESUMEN
INTRODUCTION: It is widely acknowledged that cardiovascular diseases (CVDs) continue to be the leading cause of death globally. Furthermore, CVDs are the leading cause of diminished quality of life for patients, frequently as a result of their progressive deterioration. Medical implants that release drugs into the body are active implants that do more than just provide mechanical support; they also have a therapeutic role. Primarily, this is achieved through the controlled release of active pharmaceutical ingredients (API) at the implementation site. AREAS COVERED: In this review, the authors discuss drug-eluting stents, drug-eluting vascular grafts, and drug-eluting cardiac patches with the aim of providing a broad overview of the three most common types of cardiac implant. EXPERT OPINION: Drug eluting implants are an ideal alternative to traditional drug delivery because they allow for accurate drug release, local drug delivery to the target tissue, and minimize the adverse side effects associated with systemic administration. Despite the fact that there are still challenges that need to be addressed, the ever-evolving new technologies are making the fabrication of drug-eluting implants a rewarding therapeutic endeavor with the possibility for even greater advances.
Asunto(s)
Enfermedades Cardiovasculares , Stents Liberadores de Fármacos , Humanos , Enfermedades Cardiovasculares/tratamiento farmacológico , Preparaciones Farmacéuticas , Calidad de Vida , Sistemas de Liberación de Medicamentos , Implantes de MedicamentosRESUMEN
Cardiovascular diseases constitute a number of conditions which are the leading cause of death globally. To combat these diseases and improve the quality and duration of life, several cardiac implants have been developed, including stents, vascular grafts and valvular prostheses. The implantation of these vascular prosthesis has associated risks such as infection or blood clot formation. In order to overcome these limitations medicated vascular prosthesis have been previously used. The present paper describes a 3D printing method to develop medicated vascular prosthesis using fused deposition modelling (FDM) technology. For this purpose, rifampicin (RIF) was selected as a model molecule as it can be used to prevent vascular graft prosthesis infection. Thermoplastic polyurethane (TPU) and RIF were combined using hot melt extrusion (HME) to obtain filaments containing RIF concentrations ranging between 0 and 1% (w/w). These materials are capable of providing RIF release for periods ranging between 30 and 80 days. Moreover, TPU-based materials containing RIF were capable of inhibiting the growth of Staphylococcus aureus. This behaviour was observed even for TPU-based materials containing RIF concentrations of 0.1% (w/w). TPU containing 1% (w/w) of RIF showed antimicrobial properties even after 30 days of RIF release. Alternatively, these methods were used to prepare dipyridamole containing TPU filaments. Finally, using a dual extrusion 3D printer vascular grafts containing both drugs were prepared.
Asunto(s)
Antibacterianos/farmacocinética , Sistemas de Liberación de Medicamentos/métodos , Poliuretanos/química , Rifampin/farmacocinética , Tecnología Farmacéutica/métodos , Células Sanguíneas/efectos de los fármacos , Prótesis Vascular/efectos adversos , Preparaciones de Acción Retardada/química , Dipiridamol/farmacocinética , Liberación de Fármacos , Diseño de Equipo/métodos , Células Endoteliales de la Vena Umbilical Humana , Humanos , Inhibidores de Agregación Plaquetaria/farmacocinética , Poliuretanos/uso terapéutico , Impresión Tridimensional , Infecciones Estafilocócicas/etiología , Infecciones Estafilocócicas/prevención & control , Staphylococcus aureus/efectos de los fármacos , Trombosis/etiología , Trombosis/prevención & controlRESUMEN
Lignin (LIG) is a renewable biopolymer with well-known antimicrobial and antioxidant properties. In the present work LIG was combined with poly(butylene succinate) (PBS), a biocompatible/biodegradable polymer, to obtain composites with antimicrobial and antioxidant properties. Hot melt extrusion was used to prepare composites containing up to 15% (w/w) of LIG. Water contact angle measurements suggested that the incorporation of LIG did not alter the wettability of the material. The material density increased slightly when LIG was incorporated (<1%). Moreover, the melt flow index test showed an increase in the fluidity of the material (from 6.9 to 27.7â¯g/10â¯min) by increasing the LIG content. The Young's modulus and the tensile deformation of the material were practically unaffected when LIG was added. Infrared spectroscopy and differential scanning calorimeter confirmed that there were interactions between LIG and PBS. The DPPH assay was used to evaluate the antioxidant properties of the materials. The results suggested that all the materials were capable of reducing the DPPH concentrations up to 80% in <5â¯h. Finally, LIG-containing composites showed resistance to adherence of the common nosocomial pathogen, Staphylococcus aureus. All tested materials showed ca. 90% less bacterial adherence than PBS.
Asunto(s)
Alquenos/química , Antibacterianos/química , Antioxidantes/química , Materiales Biocompatibles/química , Lignina/química , Polímeros/química , Ácido Succínico/química , Antibacterianos/farmacología , Plásticos Biodegradables/química , Rastreo Diferencial de Calorimetría/métodos , Módulo de Elasticidad , Ensayo de Materiales/métodos , Poliésteres/química , Staphylococcus aureus/efectos de los fármacosRESUMEN
Lignin (LIG) is a natural biopolymer with well-known antioxidant capabilities. Accordingly, in the present work, a method to combine LIG with poly(lactic acid) (PLA) for fused filament fabrication applications (FFF) is proposed. For this purpose, PLA pellets were successfully coated with LIG powder and a biocompatible oil (castor oil). The resulting pellets were placed into an extruder at 200 °C. The resulting PLA filaments contained LIG loadings ranging from 0% to 3% (w/w). The obtained filaments were successfully used for FFF applications. The LIG content affected the mechanical and surface properties of the overall material. The inclusion of LIG yielded materials with lower resistance to fracture and higher wettabilities. Moreover, the resulting 3D printed materials showed antioxidant capabilities. By using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method, the materials were capable of reducing the concentration of this compound up to ca. 80% in 5 h. This radical scavenging activity could be potentially beneficial for healthcare applications, especially for wound care. Accordingly, PLA/LIG were used to design meshes with different designs for wound dressing purposes. A wound healing model compound, curcumin (CUR), was applied in the surface of the mesh and its diffusion was studied. It was observed that the dimensions of the meshes affected the permeation rate of CUR. Accordingly, the design of the mesh could be modified according to the patient's needs.