Influence of UV‐irradiation intensity and exposure duration on the hemobiocompatibility enhancement of a novel synthesized phosphobetaine zwitterions polyethersulfone clinical hemodialysis membranes

Abstract

To improve the biocompatibility of polyethersulfone (PES) membranes utilized for biomedical hemodialysis (HD) applications, surface grafting with hydrophilic polymers has become a reliable modification strategy. Like most photochemical catalyzed reactions, UV-assisted grafting is distinctly advantageous for inducing permanent surface chemistry, enhancing hydrophilicity, improving morphology, and surface charge of membranes. PES membranes may be hydrophilic and chemically stable; however, they also have low protein-binding capacity and very susceptible to fouling and target analyte binding. In this study, novel zwitterionic polymers (PVP-ZW) have been synthesized by UV-assisted grafting PVP to a phosphobetaine monomer in a reaction involving dimethylamino and dioxaphospholane-2-oxide terminal groups in an NVP monomer solution at varying UV exposure conditions. The highlight of the present study is the investigation of the hemocompatibility of coated PES HD membranes at varying UV exposure conditions with respect to membrane chemistry and morphology and its influence on human serum protein adsorption. A clinical investigation of inflammatory biomarker release from incubated coated membranes within uremic blood samples of HD patients reveals they are weak complement and coagulation activators compared to bare PES membrane. The trend of fibrinogen adsorption on coated PES membranes was observed to increase with reducing UV intensity and exposure duration. Fibrinogen adhesion only increased with roughened membrane surfaces, and this also led to the formation of biological activation pathways hindering biocompatibility. Resistance against fibrinogen absorption on zwitterionic modified PES membrane could be linked with the creation of electrostatically induced neutral zwitterionic PVP-phosphobetaine hydration layer with hydrophilic character.Experimental results are accompanied by spectroscopic and morphological imaging evidence. Zwitterion coated PES membranes (PES-PVP-ZW) fabricated from higher UV intensities through longer exposure durations showed significant presence of surface deformations in the forms of inherent exfoliations due to harsh UV reaction conditions. The zeta potential and surface roughness of coated membranes also played significant role in the fibrinogen adsorption on PES membranes during ultrafiltration.

Impact of Dialysis Clinical Operating Conditions on Human Serum Protein-Mediated Inflammatory Biomarkers Released in Patients Using Polyarylethersulfone Membranes

“…For low blood flow rates, the time of contact between blood components and the dialyzer membrane is prolonged, leading to more activation. The impact of the hydrophilic nature of the PAES membrane surface is also important; dehydration of RBCs is expected at the zeta potential of −68 mV, which favors rupture and hemolysis [33][34][35]. Hemolysis leads to negative effects on the immune system, promoting the release of cytokine and leukocytes such as IL-6, TNF-α, IL-1α, and IL-1β [36][37][38].…”

Recent Developments and Current Challenges of Heparin-Grafted Hemodialysis Membranes

“…Furthermore, the use of heparin is also limited by its high price, activity degradation with time, and strong dependence on antithrombin, whose concentration broadly varies across patients with different diseases [7]. The opposite effect of heparin treatment as well as for all forms of anticoagulants is acute hemorrhaging [3].…”

“…Furthermore, the use of heparin is also limited by its high price, activity degradation with time, and strong dependence on antithrombin, whose concentration broadly varies across patients with different diseases [7].…”

“…Several research efforts for hemodialysis membrane coatings have been developed to improve the blood compatibility of biomaterials [6][7][8][9]. Heparin is a widely used anticoagulant substance that increases the clotting time and increases the membrane hemocompatibility in terms of platelet adhesion and protein adsorption and anti-clotting activity.…”

Quality of Life of Dialysis Patients: Exploring the Influence of Membrane Hemocompatibility and Dialysis Practices on Psychosocial and Physical Symptoms

“…We highlighted the main reasons related to membrane chemistry and morphology. Our research group has conducted extensive studies on hemodialysis membrane modification to improve its compatibility [30][31][32][33][34][35][36][37][38][39][40][41]. However, it is crucial to correlate the key factors of membrane compatibility and its morphological structures with the aim of enhancing the quality of life of dialysis patients.…”