Functional Mechanics of a Pectin-Based Pleural Sealant after Lung Injury

Abstract

Pleural injury and associated air leaks are a major influence on patient morbidity and healthcare costs after lung surgery. Pectin, a plant-derived heteropolysaccharide, has recently demonstrated potential as an adhesive binding to the glycocalyx of visceral mesothelium. Since bioadhesion is a process likely involving the interpenetration of the pectin-based polymer with the glycocalyx, we predicted that the pectin-based polymer may also be an effective sealant for pleural injury. To explore the potential role of an equal (weight%) mixture of high-methoxyl pectin and carboxymethylcellulose as a pleural sealant, we compared the yield strength of the pectin-based polymer to commonly available surgical products. The pectin-based polymer demonstrated significantly greater adhesion to the lung pleura than the comparison products (p < 0.001). In a 25 g needle-induced lung injury model, pleural injury resulted in an air leak and a loss of airway pressures. After application of the pectin-based polymer, there was a restoration of airway pressure and no measurable air leak. Despite the application of large sheets (50 mm) of the pectin-based polymer, multifrequency lung impedance studies demonstrated no significant increase in tissue damping (G) or hysteresivity (η)(p > 0.05). In 7-day survival experiments, the application of the pectin-based polymer after pleural injury was associated with no observable toxicity, 100% survival (N = 5), and restored lung function. We conclude that this pectin-based polymer is a strong and nontoxic bioadhesive with the potential for clinical application in the treatment of pleural injuries.

Structural heteropolysaccharides as air‐tight sealants of the human pleura

“…In previous work, we showed that structural heteropolysaccharides function as pleural sealants in mice. 10 The similarity between the human and murine glycocalyx suggested the possibility of a comparable sealant function in humans. Here, we show the efficacy of structural heteropolysaccharides in sealing human pleura.…”

“…Mouse studies have demonstrated an effectively sealed pleural injury, with no pleural adhesions or evidence of toxicity, when studied over 7 days. 10 Finally, the presence of pectin-based mixtures in human food and oral medication capsules [30][31][32] suggests that the pectin-based sealant will be similarly nontoxic in humans.…”

“…9 Pectins differ from typical pressure sensitive adhesives as they do not bind to most nonbiologic compounds. 10 The selective and strong binding of pectins to the mesothelial glycocalyx 8 is likely the result of a mechanism of interdiffusion or interpenetration; 11 that is, adhesivity results from the entanglement of branched chain polysaccharides 12 based on chemical bonds and weak chemical interactions. [13][14][15] Pectin-based mixtures have been shown to effectively bind mouse pleural mesothelium; 8,10 the potential utility of these pectin adhesives in human applications is unknown.…”

Seeking Answers from Tradition: Facile Preparation of Durable Adhesive Hydrogel Using Natural Quercetin

“…First, pectin interpenetrates the PAA networks and strengthens the hydrogel. Second, pectin contains a large number of -OH and -COOH groups, which are important active sites of hydrogen bonds in the noncovalent interaction with acrylic acid and quercetin ( Servais et al., 2008 ). Thus, quercetin, PAA, and pectin form noncovalent interactions, which dissipate energy under large deformation and improve the mechanical properties of the hydrogel.…”

Pectin biopolymer mechanics and microstructure associated with polysaccharide phase transitions

“…The practical implications of these phase transitions are relevant to biomedical applications. For example, the ability to recover from large elastic strains during deformation is a crucial feature of pectin's functional utility as a mesothelial sealant (Servais, Valenzuela, Kienzle, et al, ). The mesothelium, the surface layer of internal organs, is associated with extraordinary stresses during normal organ function; these stresses include the movement associated with the beating heart, ventilating lung, and peristaltic bowel.…”