Attenuation of thrombosis and bacterial infection using dual function nitric oxide releasing central venous catheters in a 9 day rabbit model

Brisbois, Elizabeth J.; Major, Terry C.; Goudie, Marcus J.; Meyerhoff, Mark E.; Bartlett, Robert H.; Handa, Hitesh

doi:10.1016/j.actbio.2016.08.009

Cited by 62 publications

(76 citation statements)

References 46 publications

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“…The NO release profiles of the 5 and 10 wt % E2As‐SNAP catheters were measured both with and without previous exposure to plasma fibrinogen over a 24 h period. The results indicated no significant effect on NO release (Figure ) due to prior exposure to fibrinogen and were found to be consistent with the previous findings . The fibrinogen‐coated catheters exhibited NO release in the physiological flux range of 0.5–4.0 × 10 −10 mol/mincm 2 .…”

Section: Resultssupporting

confidence: 90%

Nitric oxide releasing vascular catheters for eradicating bacterial infection

et al. 2017

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The interaction of blood proteins with an implant surface is not only a fundamental phenomenon but is also key to several important medical complications. Plasma proteins binding on the surface of intravascular catheters can promote bacterial adhesion leading to the risk of local and systemic complications such as catheter-related blood infections (CRBIs). The incidences of CRBIs in the United States amount to more than 250,000 cases/year with an attributable mortality of up to 35% and an annual healthcare expenditure of $2.3 billion approximately. This demands the development of truly nonthrombogenic and antimicrobial catheters. In the present study, catheters were fabricated by incorporating a nitric oxide (NO) donor molecule, S-nitroso-N-acetyl-penicillamine (SNAP) in a hydrophobic medical grade polymer, Elasteon-E2As. NO offers antithrombotic and antibacterial attributes without promoting drug resistance and cytotoxicity. E2As-SNAP catheters were first coated with fibrinogen, a blood plasma protein plays a key role in clot formation and eventual bacterial adhesion to the implant surface. The suitability of the catheters for biomedical applications was tested in vitro for contact angle, NO release kinetics, inhibition of bacteria, and absence of cytotoxicity toward mammalian cells. The highly hydrophobic catheters released NO in the physiological range that inhibited >99% bacterial viability on fibrinogen-coated catheters in a 24 h study. No toxic response of E2As-SNAP catheters leachate was observed using a standard cytotoxicity assay with mouse fibroblast cells. Overall, the results showed that the E2As-SNAP catheters can inhibit viable bacteria even in the presence of blood proteins without causing a cytotoxic response. The fundamentals of this study are applicable to other blood-contacting medical devices as well. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2849-2857, 2018.

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Section: Resultssupporting

confidence: 90%

Nitric oxide releasing vascular catheters for eradicating bacterial infection

et al. 2017

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“…The incorporation of SNAP in medical grade polymers have been shown to be hemocompatible and possesses stability during long-term storage at room temperature and physiological conditions [63, 72, 73]. …”

Section: Resultsmentioning

confidence: 99%

“…Another report has also shown that hydrophobic polymers with SNAP have extended NO-release at physiological levels (up to 20 days) [70]. Furthermore, the incorporation of SNAP in medical grade polymers are not only hemocompatible and biocompatible but also stable during long-term storage (6 months) at room temperature [63, 72, 73]. …”

Section: Resultsmentioning

confidence: 99%

A multi-defense strategy: Enhancing bactericidal activity of a medical grade polymer with a nitric oxide donor and surface-immobilized quaternary ammonium compound

et al. 2017

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Although the use of biomedical devices in hospital-based care is inevitable, unfortunately, it is also one of the leading causes of the nosocomial infections, and thus demands development of novel antimicrobial materials for medical device fabrication. In the current study, a multi-defense mechanism against Gram-positive and Gram-negative bacteria is demonstrated by combining a NO releasing agent with a quaternary ammonium antimicrobial that can be covalently grafted to medical devices. Antibacterial polymeric com posites were fabricated by incorporating a nitric oxide (NO) donor, S-nitroso-N-acetyl-penicillamine (SNAP) in CarboSil® polymer and top coated with surface immobilized benzophenone based quaternary ammonium antimicrobial (BPAM) small molecule. The results suggest that SNAP and BPAM have a different degree of toxicity towards Gram-positive and Gram-negative bacteria, and the SNAP-BPAM combination is effective in reducing both types of adhered viable bacteria equally well. SNAP-BPAM combinations reduced the adhered viable Pseudomonas aeruginosa by 99.0% and Staphylococcus aureus by 99.98% as compared to the control CarboSil films. Agar diffusion tests demonstrate that the diffusive nature of NO kills bacteria beyond the direct point of contact which the non-leaching BPAM cannot achieve alone. This is important for potential application in biofilm eradication. The live-dead bacteria staining shows that the SNAP-BPAM combination has more attached dead bacteria (than live) as compared to the controls. The SNAP-BPAM films have increased hydrophilicity and higher NO flux as compared to the SNAP films useful for preventing blood protein and bacterial adhesion. Overall the combination of SNAP and BPAM imparts different attributes to the polymeric composite that can be used in the fabrication of antimicrobial surfaces for various medical device applications.

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“…NO plays a crucial role in many physiological and pathological processes, including platelet activation and adhesion, vasodilation, wound healing, and inflammation . Because NO is a natural antimicrobial agent, it has been incorporated into different medical grade polymers to not only improve the hemocompatibility but also prevent infection in blood‐contacting devices such as sensors, catheters, vascular grafts, extracorporeal circuits and in medical device coatings . Moreover, NO releasing polymers have not been reported to cause any hemocompatibility, biocompatibility, or long‐term storage stability issues …”

Section: Introductionmentioning

confidence: 99%

Nitric oxide‐releasing antibacterial albumin plastic for biomedical applications

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Pant

Lee

et al. 2018

J Biomedical Materials Res

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Designing innovative materials for biomedical applications is desired to prevent surface fouling and risk of associated infections arising in the surgical care patient. In the present study, albumin plastic was fabricated and nitric oxide (NO) donor, S-nitroso-N-acetylpenicillamine (SNAP), was incorporated through a solvent swelling process. The albumin-SNAP plastic was evaluated in terms of mechanical and thermal properties, and bacterial adhesion to the plastic surface. Thermal and viscoelastic analyses showed no significant difference between albumin-SNAP plastics and pure, water-plasticized albumin samples. Bacteria adhesion tests revealed that albumin-SNAP plastic can significantly reduce the surface-bound viable gram-positive Staphylococcus aureus and gram-negative Pseudomonas aeruginosa bacterial cells by 98.7 and 98.5%, respectively, when compared with the traditional polyvinyl chloride medical grade tubing material. The results from this study demonstrate NO-releasing albumin plastic's potential as a material for biomedical device applications. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1535-1542, 2018.

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Attenuation of thrombosis and bacterial infection using dual function nitric oxide releasing central venous catheters in a 9 day rabbit model

Cited by 62 publications

References 46 publications

Nitric oxide releasing vascular catheters for eradicating bacterial infection

Nitric oxide releasing vascular catheters for eradicating bacterial infection

A multi-defense strategy: Enhancing bactericidal activity of a medical grade polymer with a nitric oxide donor and surface-immobilized quaternary ammonium compound

Nitric oxide‐releasing antibacterial albumin plastic for biomedical applications

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