PubMed HealthSearch

Biomedical subjects

E W Merrill

Publications and source records attributed to E W Merrill.

At least 19 recordsLinked to original sources

Challenge to the concept that UHMWPE acetabular components oxidize in vivo.

Severe wear of the ultra-high molecular weight polyethylene (UHMWPE) components of total joint replacements limits their long-term success. In previous studies, the infrared spectra obtained on retrieved UHMWPE components were interpreted as evidence that the UHMWPE oxidizes in vivo. In direct contrast, infrared spectroscopy of the retrieved UHMWPE acetabular components examined in this study demonstrated adsorbed esterified fatty acids, readily extractable by hexane, and no substantial evidence of in vivo oxidation. This emphasizes that special care must be taken when using infrared spectroscopy to assess retrieved components.

Adult

Partitioning and diffusion of solutes in hydrogels of poly(ethylene oxide).

Hydrogels were created by electron beam irradiation of aqueous solutions of poly(ethylene oxide) (PEO) having a nominal molecular weight of 35,000. The molecular weight between cross-links Mc varied from 3000 to 15,000, and the equilibrium volume fractions of polymer V2,s from 0.01 to 0.08. These hydrogels were exposed to aqueous solutions of solutes: tricyclic antidepressants, cyanocobalamin, four globular proteins and three linear species of PEO. Partition coefficients and diffusion coefficients were determined. For each solute the ratio diffusion coefficient in hydrogel/diffusion coefficient in free solution was determined, and related to the hydrogel parameters Mc and v2,s and to the solute effective radius rE (Einstein radius). The diffusion coefficient ratio is greater for the flexible random coiling PEO than for the 'rigid' solutes at a given set of Mc, v2s and rE, and the disparity increases rapidly as rE increases. Among the globular proteins the diffusion coefficient ratio decreases by orders of magnitude with small changes in rE (20.6-27.6 A) and was found to be nearly zero for albumin (rE = 36.1 A). The tricyclic antidepressants had partition coefficients of around 2, whereas the other solutes had partition coefficients of about unity. By reason of the partition coefficient of around 2, the diffusion coefficient ratio of a tricyclic antidepressant having a value of rE = 5.5 A is half that of the larger cyanocobalamin, for which rE = 8.5 A.

Antidepressive Agents, Tricyclic

PEO enhancement of platelet deposition, fibrinogen deposition, and complement C3 activation.

Whereas it has been commonly thought that adding polyethylene oxide PEO to a surface would diminish the capacity of the surface to cause deposition of platelets and of fibrinogen, and to activate complement C3, we present data showing exactly the opposite. These unexpected results are obtained with low molecular weight (2000) PEO, and are not found with higher molecular weight (20,000) PEO.

Animals

Drug partitioning and release characteristics of tricyclic antidepressant drugs using a series of related hydrophilic-hydrophobic copolymers.

A series of crosslinked polymer networks formed from hydrophilic polyethylene oxide (PEO) and a hydrophobic polysiloxane (PGPMDMS) were studied with respect to the partitioning and release of five tricyclic antidepressants (TCAs) at pH 7.4. The TCAs, chemical analogues of one another, have both nonpolar and ionic characteristics at pH 7.4, but differ considerably in hydrophobicity. In PEO-PGPMDMS copolymer networks, the partition coefficient of protriptyline (the TCA studied most extensively) was observed to be higher than in networks of PEO or PGPMDMS singly. This finding, which may represent adsorption of the amphiphilic drug at interfacial sites between hydrophilic and hydrophobic phases within the copolymeric network, shows that in some cases, higher drug loadings of amphiphilic drugs can be obtained with a hydrophilic-hydrophobic copolymer compared with a material made of only one polymer. As the PEO content in PEO-PGPMDMS networks was increased from 20 to 100%, the release rate of protriptyline increased by greater than 1000-fold. Thus, a key variable in achieving a desired release rate is the PEO content of the copolymer. On the other hand, release rates of the five TCAs from PEO-PGPMDMS networks containing 50% PEO varied by a factor of less than 3. Thus, minimal effect on drug release rates was obtained by using a different TCA analogue.

Antidepressive Agents, Tricyclic

Scanning electron microscopy analysis of polyethylene oxide hydrogels for blood contact.

Hydrogels are a class of synthetic material, composed of a polymer-water matrix and have been proposed as tissue substitutes and drug delivery vehicles. Polyethylene oxide (PEO) hydrogels were synthesized and used to produce coated wires and conduits for baboon blood compatibility studies. Blood-material interactions were studied both by Scanning Electron Microscopy (SEM) and 111In labeled platelet deposition. SEM processing modifications were first evaluated in order to reduce shrinkage and surface distortion incurred during sample preparation of these high water content materials. Pretreatment with 1% tannic acid reduced bulk shrinkage associated with critical point drying by 10-20%. This effect is small, nevertheless, it prevented major sample disruption. Coated guidewires were exposed to baboon blood for one hour in the inferior vena cava and conduits were placed for either 30 or 60 minutes in an ex vivo femoral arteriovenous shunt. Reference materials included Gore-tex, polyethylene and silica-free polydimethyl siloxane (PDMS). In the guidewire studies, 111In labeled platelet levels were highest on Gore-tex (6568.97 platelets/1000 microns 2) and large thrombotic deposits were well visualized by SEM. Formulations containing PEO had low levels of platelet deposition and little evidence of platelet activation was noted by SEM. Shunt studies demonstrated that materials of high PEO content and molecular weight had the lowest levels of platelet deposition. After 60 minutes of blood flow, mean platelet deposition on PDMS and Gore-tex was 50 and 1000 fold higher than on a network composed of 65% PEO 20,000 (p less than 0.05). SEM confirmed these findings.

Analysis of Variance

Development and evaluation of a new polymeric material for small caliber vascular prostheses.

Polyethylene oxide (PEO), because of its low levels of protein and cellular adsorption, may provide a suitable coating for synthetic small caliber vascular prostheses. PEO/polysiloxane networks were synthesized via an acid-catalyzed epoxy/hydroxyl crosslinking reaction and used to produce conduits with a 4-mm internal diameter. Three networks with nominal PEO molecular weights of 2000, 8000, and 20,000 and all 65% PEO by weight were studied. Blood compatibility was assessed by measuring 111In-platelet and 125I-fibrinogen deposition in a baboon ex vivo shunt, over a 1-hr time period and at a flow rate of 50 ml/min. Differences in material performance were noted particularly after the initial 30-min blood contact period. Materials in the mid and high PEO molecular weight range (8000 and 20,000) had significantly lower levels of platelet adsorption than networks of low PEO molecular weight (2000) at 30 min (P less than 0.005) and 60 min (P less than 0.05). The lowest level of platelet deposition was noted on networks of high PEO molecular weight (20,000). During the observation period, platelet accumulation on this surface was less than one platelet per 1000 microns. Platelet deposition on Gore-Tex was two and three orders of magnitude greater than that on the high molecular weight PEO material at 30 and 60 min, respectively (P less than 0.001). Fibrinogen adsorption was also lower on materials of mid and high PEO molecular weights, when compared with low molecular weight networks (P less than 0.05) and Gore-Tex (P less than 0.05). Scanning electron micrographs confirmed these observations. Overall, platelet and fibrinogen depositions are low for PEO networks, particularly for materials of high PEO molecular weight. This latter observation may be related to increased surface molecular mobility and a relative enhancement of PEO content at the blood-material interface.

Animals

Activity toward thrombin-antithrombin of heparin immobilized on two hydrogels.

Commercially obtained (Diosynth) heparin was covalently bonded to poly (vinyl alcohol) (PVA) hydrogels and to polyethylene oxide (PEO) hydrogels activated by tresyl chloride. We found that as tresyl chloride activation of PVA increased, the specific activity of the bound heparin toward thrombin and antithrombin decreased by nearly a factor of 10 and that commercial heparin bound to PEO had nearly ten-fold greater activity than when bound to PVA at comparable concentrations. These findings suggest that the long 'leash' provided by PEO hydrogels may give the heparin more access to the thrombin-antithrombin pair than the tight bond to PVA, and that crowding of heparin units on a surface limits access of the thrombin-antithrombin pair.

Antithrombins

Hemodynamic effects of different preparations of stroma free hemolysates in the isolated perfused rat kidney.

We have examined the effects of Stroma Free Hemolysate (SFH) solutions in the isolated perfused rat kidney. Three types of SFH, stored for 6 to 8 months at 4 degrees C, were tested: 1) unmodified, 2) glyoxalated and lightly cross linked and 3) pyridoxalated and polymerized. All three SFH solutions, added to the perfusate at a concentration of approximately 420 mg/100ml, increased renal vascular resistance (RVR) and reduced glomerular filtration rate (GFR). Unmodified, glyoxalated and lightly cross linked and pyridoxalated polymerized SFH resulted in a rise in RVR of 55%, 38% and 33% respectively and a fall in GFR of 42%, 57% and 83% respectively. In order to determine whether storage had altered the effect of SFH on renal function, one of the forms of SFH (glyoxalated and lightly cross linked) was studied only 4-6 weeks after preparation. While this preparation caused an increase in RVR of 41% it did not alter GFR; filtration fraction (FF) rose. However, after further storage of this preparation for 6-7 months, the solution resulted in a marked decrease in GFR of 47% as well as a rise in RVR of 23%. We conclude that three different SFH preparations resulted in marked vasoconstriction and reductions in GFR. These deleterious effects on renal hemodynamics were noted at a concentration of hemoglobin well below that necessary to effectively improve oxygen content. Storage of the SFH solutions may cause or contribute to their effects on renal function. SFH solutions intended for use as blood substitutes should be tested for vasoconstrictor activity.

Animals

Crosslinked polyether/polysiloxane networks for blood-interfacing applications.

The interaction of blood with new artificial surfaces is an area of continual medical interest. In this study, a series of polyether/polysiloxane networks were synthesized, characterized in terms of both bulk and surface compositions, and evaluated for blood compatibility. The crosslinked networks were produced by reacting the epoxy groups of polyglycidoxy propyl methyl siloxane (PGPMS) with the hydroxyl end groups of polypropylene glycol (PPG). Blood compatibility was evaluated using an in vitro platelet retention test and fibrinogen adsorption experiments from human plasma and buffered saline. The PPG/PGPMS networks exhibit low fibrinogen adsorption and low platelet activation. Such properties make the networks potentially attractive as materials for blood-interfacing applications.

Adsorption

Fibrinogen adsorption and platelet adhesion at the surface of modified polypropylene glycol/polysiloxane networks.

The protein film adsorbed at an artificial surface ultimately affects platelet adhesion and activation. This study examines the role of fibrinogen in platelet adhesion at the surface of crosslinked polypropylene glycol (PPG)/polyglycidoxy propyl methyl siloxane (PGPMS) networks which contain polyethylene glycol monomethyl ether (PEGME) chains. These crosslinked networks were produced by reacting the epoxy groups of PGPMS with the hydroxyl groups of the polyethers. PEGME chains were attached covalently to the network at only one end while PPG chains were attached at both ends. The incorporation of PEGME resulted in a substantial reduction in fibrinogen adsorption as compared to the model network (PPG + PGPMS only), but the expected concomitant decrease in platelet adhesion was not observed.

Adsorption

Does the conformation of adsorbed fibrinogen dictate platelet interactions with artificial surfaces?

Platelet activation by polymer surfaces is thought to require preliminary adsorption of fibrinogen and perhaps changes in fibrinogen conformation. We measured fibrinogen adsorption by a series of polymers by two methods, using either 125I-labeled fibrinogen or 125I-labeled antifibrinogen antibodies, and correlated the results with platelet reactivity (retention and secretion) in columns of beads coated with the polymers. For polyalkyl methacrylates with 1 to 4 carbon side chains, platelet reactivity varied directly with increasing length of the alkyl side chain and with the quantity of bound fibrinogen recognizable by antifibrinogen antibody but not with the total quantity of fibrinogen adsorbed. The same pattern of results was seen with five antibody preparations, including affinity-purified Fab fragments against the D or E domain of fibrinogen. Tests of platelet retention and fibrinogen binding to four polyalkyl acrylates and to three unrelated polymers (polystyrene, polymethyl methacrylate, and a polyether polyurethane) indicated that platelet retention correlated positively with both total fibrinogen binding and with the amount of antibody-recognizable fibrinogen bound. Drugs that block platelet aggregation, but not adhesion, did not alter the hierarchy of platelet retention to the polyalkyl methacrylates. These data suggest that, contrary to previous views, platelet adhesion to artificial surfaces increases with increasing surface coverage of adsorbed fibrinogen if the bound fibrinogen maintains a conformation such that its functional domains remain recognizable by antibody probes.

Adsorption

Platelet aggregation by fibrinogen polymers crosslinked across the E domain.

There is evidence that platelet interactions with artificial surfaces are mediated by plasma proteins, especially fibrinogen, adsorbed on the surfaces. Multiple site interactions between fibrinogen molecules adsorbed in high concentration and receptors in the unactivated platelet may be sufficient for platelet adhesion and subsequent activation. To examine this hypothesis, we prepared soluble polymers of fibrinogen. Polymers produced by interaction of fibrinogen with Fab'2 fragments of antibodies against fibrinogen's E (central) domain (Fg-Fab'2(E] induced, in gel-filtered platelets, aggregation and serotonin release, which were blocked by monoclonal antibodies against the GPIIb/IIIa complex, by Fab fragments against the D domain, and by metabolic inhibitors; aggregation was attenuated but not abolished by enzymatic removal of ADP (with CP/CPK) or by blockage of ADP binding sites (with FSBA), and when secretion was inhibited by aspirin. Fg-Fab'2(E) also induced a dose-dependent elevation in cytoplasmic Ca2+ (measured by Aequorin luminescence) which was attenuated by CP/CPK and by FSBA, and was eliminated by metabolic inhibitors and by anti-IIb/IIIa antibody. Fibrinogen complexes crosslinked with dimethylsuberimidate or Factor XIII neither aggregated gel-filtered platelets nor inhibited platelet aggregation by ADP and fibrinogen, probably because of inaccessibility of lysine residues in the D (terminal) domain of fibrinogen, which are thought to be required for platelet binding. Thus, soluble complexes of fibrinogen having multiple available platelet receptor recognition sites activate gel-filtered platelets and may provide a useful model for platelet-surface interactions mediated by adsorbed fibrinogen.

Adenosine Diphosphate

Catalytic activity and platelet reactivity of heparin covalently bonded to surfaces.

Heparin was covalently bound to solid substrate surfaces by means of four different chemistries. It was coupled to polymethylacrylate (PMA) beads with glutaraldehyde, carbodiimide, or radical polymerization initiated by Ce4+, or to agarose beads with cyanogen bromide. Each of these chemistries produced measurable amounts of surface-bound heparin, which was minimally elutable in contact with plasma. Antithrombin (AT) binding by heparinized PMA materials (compared with PMA control beads) ranged from no AT binding for the material heparinized with carbodiimide (PMA-Alb-Hep(EDC] to 3.6 micrograms/ml packed beads for the material heparinized by radical polymerization (PMA-MA-Hep). Heparin-like catalytic activity of these materials (assayed by measuring the generation of thrombin-antithrombin complex in plasma) correlated well with the amount of heparin bound, but not as well with AT binding capacity. Heparinized agarose, which exhibited a large AT binding capacity (2.2 mg AT per milliliter of packed gel), had virtually no catalytic activity because of its inability to release thrombin-antithrombin complex from the surface. Platelet interaction with heparinized materials that exhibit high AT binding capacity was reduced by pretreatment with normal plasma but not by pretreatment with AT-depleted plasma. Platelet interaction with heparinized materials with low AT binding capacities was not reduced by pretreatment with normal plasma. We conclude that AT binding by heparin reduces the platelet reactivity of heparinized surfaces.

Antithrombin III

Platelet-compatible hydrophilic segmented polyurethanes from polyethylene glycols and cyclohexane diisocyanate.

A new type of segmented polyurethane (SPU) was synthesized from alpha, omega polyethylene oxide diols (PEG) of MW varying from 600 to 4500, by end capping with 1,4 trans cyclohexane diisocyanate (CHDI) and chain extending with ethylene diamine (ED) in toluene with dibutyl tin dilaurate as catalyst. These SPU are cast as films and coatings from hexafluroisopropanol (HFIP). Depending on PEG MW, these SPU swell two- to tenfold in water. Examined by an in vitro platelet retention test, these SPU are more bland (platelet retention -rho around 0.05) than most other polymers, whereas an alternating copolymer of CHDI and ED shows -rho around 0.80 (very active); x-ray photoelectron spectroscopy shows that the surfaces of these SPU to a depth of about 40 Ao are nearly pure PEO, unlike SPU synthesized from aromatic diisocyanates TDI and MDI.

Biocompatible Materials

Platelets and artificial surfaces: the effects of drugs.

Contact of blood with a foreign surface activates platelets and leads to their consumption. This property is shared by most non-biological materials, including air, but can be reduced by an optimal balance of hydrophobicity and hydrophilicity, minimal capacity for hydrogen bonding, avoidance of crystallinity, maintenance of polymer backbone mobility, and other manipulations of the chemistry of the polymer. None the less, no totally non-thrombogenic artificial surface has been developed. Attention has therefore turned to suppression of platelet-surface interaction by drugs that alter platelet function. Agents that block cyclo-oxygenase inhibit surface-induced secretion and aggregation but have no effect on platelet adhesion. Drugs that increase platelet cyclic AMP levels have a dose-related effect, which at high concentrations can eliminate adhesion to surfaces. The most successful agent, prostacyclin, has achieved total protection of platelets during cardiopulmonary bypass, with preservation of normal platelet number and function. Associated vasodilatation is a notable side effect, and hypotension may prove to be a significant problem in clinical practice. The development of more selective analogues with minimal vasodepressor activity is to be encouraged.

Acrylates

In vivo assessment in sheep of thromboresistant materials by determination of platelet survival.

The thromboresistance of 13 potentially blood-compatible polymers was assessed in sheep by determining survival of 51Cr-labeled platelets. Polymer tubing (120-150 cm x 2.0-2.3 mm i.d.) coiled around the neck was incorporated into the circulation through silicone rubber connectors as a carotid artery-external jugular vein shunt. The mean platelet half-life in control animals ("shunt control") was 78.2 +/- 2.8 (SEM) hours. Eleven of the 13 polymers tested significantly shortened platelet half-life. Polyvinyl chloride (T1/2 = 45.4 +/- 3.0 hours), polyperfluoro ethylene (T1/2 = 47.0 +/-1.6 hours), and a polymethylacrylate (PMA)/acrilonitrile copolymer (T1/2 = 50.7 +/- 7.0 hours) produced the greatest shortening. Only silica-free polydimethyl siloxane (T1/2 = 74.7 +/- 4.9 hours) and PMA (T1/2 = 81.5 +/- 3.4 hours) were indistinguishable from shunt controls. Pretreatment of PMA tubing with autologous plasma in a paired trial significantly increased platelet half-life (P less than 0.05 vs. untreated PMA). This system offers an economical, reproducible, sensitive, and biologically relevant method for assessment of the reactivity of artificial surfaces with platelets.

Animals