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Albumin-binding surfaces for implantable devices.

Surfaces of implantable and blood contact-devices accumulate adsorbed and denatured proteins. This anomalous layer of proteins may help trigger unwanted events such as activation of coagulation systems and, perhaps, chronic inflammation. Because, in many experimental systems, the purposeful coating of surfaces with albumin will biologically "passivate" materials, we have attempted to develop polymers which, when exposed to blood or body fluids, will spontaneously, selectively, and reversibly adsorb host albumin. We report here a novel derivatization technique for increasing the albumin affinity of implantable polyetherurethane (PU). The technique is based on the incorporation of high-molecular-weight dextran to which the albumin-binding dye Cibacron Blue is covalently attached. Somewhat surprisingly, the amounts of human albumin adsorbed by Blue Dextran-modified and unmodified PU are quite similar. There are, however, important differences. First, the binding of albumin to derivatized PU is specific and not readily blocked by proteins in albumin-depleted human serum. Second, the majority of albumin associated with derivatized PU appears to be reversibly bound. Third, the binding of albumin to derivatized PU evidently is mediated primarily through ligand-specific binding of the protein to the albumin-binding dextran-dye conjugate. We conclude that it is possible to produce implantable polymers having surfaces which display albumin-binding dyes that selectively and reversibly bind albumin. Materials with this property, when implanted or exposed to blood, should form an infinitely renewable coating of albumin derived from physiologic fluids. This surface modification strategy may spawn a new generation of implantable materials with improved biologic compatibility.

Adsorption

Cytological observations of the ovarian epithelium in mammals during the reproductive cycle.

We have studied the ovarian epithelijm at various stages of the reproductive cycle in a number of mammalian species utilizing light microscopy, scanning microscopy, the freeze-fracture technique, transmission microscopy and by employing specialized tracers that use lanthanum and horseradish peroxidase. We found that the epithelial cells are joined by incomplete tight junctions, gap junctions, and desmosomes. The cytoplasmic matrix contains a large irregularly shaped nucleus, few microtubules, microfilaments, mitochondria, endoplasmic reticulum and a host of coated and non-coated vesicles of varying diameters. The saccules comprising the large Golgi complex and its companion vesicles are associated with a basal body-centriole complex: some of these saccules and affiliated vesicles are acid phosphatase positive. Surface modifications of ovarian epithelial cells include numerous microvilli, some of which have a bulbous tip, and plications of the lateral plasma membrane which are thought to accomodate volume changes of the ovary during follicular development. Many coated and non-coated endocytotic caveolae were found on these cells, particularly in the basal area. These caveolae internalized exogeneously administered horseradish peroxidase. We view the marked endocytotic activity as an efficient transport mechanism for partially removing substances from the interstitium of the ovary and the peritoneum.

Animals

Fine structure of the epithelia of the vomeronasal organ of horse and cattle. A comparative study.

The vomeronasal organ of both horses and cattle is a tubular structure situated bilaterally at the base of the nasal septum. In frontal plane the shape of its lumen is semilunar to crescent. The sensory epithelium lining the medial wall of the lumen contains receptor, supporting and basal cells with some surface modifications in both species. In the horse, a structure similar to a microprocess was observed among the microvilli of receptor cells. In cattle, a large mass of the cytoplasm of the receptor cell occasionally protrudes to form a bleb-like structure. The supranuclear cytoplasm of the receptor cells contain mitochondria, free ribosomes, rough endoplasmic reticula, Golgi apparatus, lysosomes and multivesicular bodies. Some receptor cells were pyknotic. In both species the respiratory epithelia of the lateral wall of the lumen contain ciliated, non-ciliated and basal cells. In the horse, this epithelium differs from that of other species in evidence of prominent secretory function.

Animals

Studies on the development of extra-endothelial and intra-endothelial pigment deposits by means of direct and indirect contact specular microscopy of the cornea.

Retro-corneal pigmentation as a result of primary (degenerative) or secondary (inflammatory, traumatic) pigment dispersion represents one of the most frequent findings in specular microscopy. The analysis of the pigment distribution patterns of dense deposits like those in Krukenberg spindle (KS) permits the postulation of a hypothesis concerning the development of such typical corneal pigmentations and the pigmentation of the posterior surface of the cornea in general, such as diffuse pigment dispersion (Vogt 1930), which is seen frequently. In a particular case of double KS with extreme myopia and cataract, endothelial morphological findings were documented over a period of 1 year, both before and after cataract extraction. This was done by means of contact and non-contact specular microscopy in various spindle areas. The morpho-metric studies (cell density/mm2; cell perimeter; largest smallest and average cell diameter; specific surface; horizontal and vertical cell orientation) were carried out automatically using a computerised video image analyser. The changes in the area of densest pigmentation in the KS centre confirm the histologically proven capacity of pigment phagocytosis by human corneal endothelium. These findings indicate that in specular microscopy, both endothelial cellular surface modifications and intra-cellular changes are documentable. The extracellular pigment deposits can also be shown by means of 'indirect' specular microscopy, the optical principle of which is described.

Aged

Enzyme activities of lung lavage in silicosis.

The cytotoxic effect of quartz on lung cells has been well documented by in vitro and animal studies, but the pertinence of these findings to humans has not yet been documented. We measured lactate dehydrogenase (LDH) activities in the lung lavage of 24 long-term workers in the Québec granite industry and 25 control subjects. We found significant increases in LDH activities in the workers' lung lavage, even in the absence of established silicosis (9 subjects). We looked at a similar observation in the sheep model of early silicosis, measured quartz content of lung lavage, and found significant correlation with LDH levels (R = 0.64, p less than 0.001). All of the quartz particles in human and sheep lung lavage were in the alveolar macrophages. To test further the relationship of macrophage damage (cytotoxicity of quartz) we measured the release of LDH by sheep alveolar macrophage in 24 h cell culture under control conditions, exposure to inert dust, titanium, minusil-5 quartz, or aluminum-treated quartz. The LDH release was at control levels during titanium exposure and showed a significantly dose-related increase during quartz exposure. The latter cytotoxic effect was largely attenuated by aluminum treatment of quartz. These in vitro data agreed with previous reports. This study presents evidence of a cytotoxic effect of quartz inhalation in humans. The effect is related to the intensity of quartz retention in the lung macrophages; it is not a nonspecific dust exposure effect and can be attenuated by surface modification of the quartz.

Adult

Contribution of complement system on destabilization of liposomes composed of hydrogenated egg phosphatidylcholine in rat fresh plasma.

Large multilamellar vesicles (MLV) composed of hydrogenated egg phosphatidylcholine (HEPC), cholesterol (CH), and dicetyl phosphate (DCP) rapidly release part of an entrapped aqueous marker when incubated with fresh rat plasma and thus have severely limited usefulness as drug carriers. The mechanisms causing the instability of liposomes in plasma were investigated in this study. The leakage of liposomal constituents was completely inhibited by pre-heating at 56 degrees C for 30 min with plasma or by treating with EDTA, K-76COOH, or anti-C3 antiserum but was not inhibited with EGTA/MgCl2. These results indicated that the destabilization of liposomes in fresh rat plasma was induced by activation of the alternative complement pathway (ACP). Furthermore, the complement third component (C3) was detected from the liposomes incubated with fresh plasma by SDS-PAGE followed by Western blotting and immune detection. The C3b deposited on the liposomal surface via ACP was rapidly cleaved to iC3b. The results obtained in the present study suggest a possibility that the liposomes composed of HEPC (without any surface modification) may be effective carriers for macrophages because C3b and its degradative products, iC3b are related to the opsonic function on phagocytosis of foreign particles by macrophages.

Animals

Electrochemistry of galvanic couples between carbon and common metallic biomaterials in the presence of crevices.

In vitro experiments were conducted upon some common metallic biomaterials and carbons, both isolated or forming galvanic couples, in a cell specially designed for crevice corrosion studies. The alloys examined were AISI 316L stainless steel, Ti6AI4V and Co-Cr-Mo. The types of carbon were glassy carbon and carbon fibre-reinforced carbon. The surface modifications were evaluated by SEM, AES and ESCA-XPS analyses. AISI 316L stainless steel suffered localized corrosion in open-circuit experiments whilst the other materials remained unattacked. Galvanic currents between metal-carbon couples were measured by zero resistance ammetry. The carbon-metal area ratio was 1:1. The results showed that 316L stainless steel and the Co-Cr-Mo alloy were prone to accelerated corrosion, whilst the Ti6AI4V alloy remained unattacked. The galvanic corrosion currents were also predicted using mixed potential theory from polarization curves obtained for each material. The experimental and theoretical values showed good agreement for the stainless steel and Co-Cr-Mo alloy. Long-term immersion tests with the same couples showed that the only metal not to suffer degradation was the Ti6AI4V alloy.

Alloys

Effect of plasma glow, glutaraldehyde and carbodiimide treatments on the enzymic degradation of poly (L-lactic acid) and poly (gamma-benzyl-L-glutamate) films.

The hydrolytic and enzymic degradation of poly(L-lactic acid) (PLA) and poly(gamma-benzyl L-glutamate) (PBGA) films, together with a series of surface treatments, were studied, as a function of exposure time. The degradation of these polymers was monitored by weight loss, contact angle, pH changes and tensile strength studies. Glutaraldehyde treatment retained the maximum strength of PLA in buffer, followed by carbodiimide, compared with control films. On the other hand, plasma glow reversed the effect. The ability of alpha-chymotrypsin, carboxypeptidase, ficin, esterase, bromelain and leucine aminopeptidase to modulate the degradation of PLA and PBGA was also investigated. Addition of these enzymes to the polymer-buffer system reduced the tensile strength of these polymers variably. Among the six enzymes studied, leucine aminopeptidase showed the highest enzymic effect on the degradation of the glutaraldehyde-treated and bare PLA or bare PBGA films. However, glutaraldehyde-cross-linked PLA demonstrated maximum stability in buffers or in all other enzyme systems studied compared with bare PLA. It is conceivable that surface treatments on these polymers might have altered their physical and chemical configuration and the subsequent degradation properties. Surface modifications may provide new ways of controlling the biodegradation of polymers for a variety of biomedical applications.

Biocompatible Materials

Sterically stabilized liposomes.

Many recent reports have demonstrated that rapid uptake of liposomes in vivo by cells of the mononuclear phagocytic system (MPS), which has restricted their therapeutic utility, can be overcome by incorporation of lipids derivatized with the hydrophilic polymer polyethylene glycol (PEG). The structure-function relationship of PEG-derivatized phosphatidylethanolamine (PEG-PE) has been examined by measurement of blood lifetime and tissue distribution in both mice and rats. The results are reviewed and contrasted with those from liposomes without PEG-PE or other surface modifications. With a PEG molecular weight in the range of 1000 to 5000, prolonged circulation and reduced MPS uptake is achieved. After 24 h, up to 35% of the injected dose remains in the blood and less than 10% is taken up by the two major organs of the MPS, liver and spleen, compared with 1% and up to 50%, respectively, for liposomes without PEG-PE. Other important advantages of PEG-PE have been identified: prolonged circulation is independent of liposome cholesterol content, degree of hydrocarbon chain saturation in either the PC or the PE lipid anchor, lipid dose, or addition of most other negatively charged lipids. This versatility in lipid composition and dose is important for controlling drug release in a liposome-based therapeutic agent. Steric stabilization has been proposed as a theoretical basis for the results and some initial results testing this hypothesis have been reported. A description of a theoretical model is presented here and evaluated with the data available. The results are compared with other particulate drug carriers and the range of potential applications are considered.

Animals

Ultrastructural observations on regenerating hair cells in the chick basilar papilla.

This experiment was designed to investigate cellular and subcellular maturational changes in regenerated immature sensory cells and support cells of the chick basilar papilla following gentamycin treatment. Scanning and transmission electron microscopy were used. The experimental animals received one subcutaneous injection of gentamycin sulfate daily (50 mg/kg) for five or 10 days. The animals receiving five days of injection were sacrificed the following day. The remaining animals were allowed to survive either seven or 28 days before sacrifice and preparation for electron microscopy. The initial lesion consisted of total degeneration of hair cells within 500 microns of the proximal tip providing the opportunity to study a 'pure' population of regenerating sensory cells. Sensory cell regeneration could be identified by one day after terminating gentamycin treatment. Early in development sensory cell precursors were morphologically very similar to supporting cells. A density gradient, based on cytoplasmic staining characteristics, was established which increased from cells displaying low density at the base of the supporting cell layer to high density cells at the luminal surface. These changes in density were equated to increase in number of and types of cytoplasmic organelles. In contrast to the empty appearing cytoplasm of the support cell, the cytoplasm of the hair cell precursor contained numerous mitochondria, clusters of ribosomes, and vesicles. As the cell approached the surface, mitochondria became more numerous as did smooth and coarse endoplasmic reticulum and Golgi apparatus. This gradient suggested that determination of the cellular phenotype occurred at the level of the basal membrane followed by migration to the surface, during which time differentiation was characterized by an increase in number and complexity of cellular organelles. Luminal surface modifications occurred as soon as the cell erupted. The development of stereocilia, rootlet, cuticular plate and cellular polarization followed the normal embryogenetic pattern. At 28 days, stereocilia organization was still incomplete as was the orientation of the bundle. To the extent that proper orientation of hair cells or bundles is necessary for normal transduction, mature function at 28 days would not be anticipated. Innervation of the presumptive hair cell precursors could be observed one day after treatment, early in the course of hair cell differentiation. Synaptogenesis followed the normal embryogenetic sequence; however, afferent and efferent nerve terminals remained immature appearing at 28 days. This observation may have physiological implications manifested by delay of hearing

Afferent Pathways

Effects of incubation time in serum and capacitation on spermatozoal reactivity with antisperm antibodies.

Sperm reside within the female reproductive tract before the occurrence of fertilization. During this time they undergo surface modifications associated with changes in their functional state. To study their antigenic expression, capacitated and acrosome-reacted sperm were incubated with sera that had previously been tested for antisperm antibodies against fresh washed sperm, as detected by indirect immunobead binding. Forty-eight percent of previously positive and 20% of previously negative sera reacted differently with sperm after an extended time (18 hours) of incubation in serum or after sperm capacitation. These results suggest that current techniques of antisperm antibodies detection be modified to include testing sera after prolonged incubation times with both capacitated as well as fresh sperm.

Acrosome

High-performance liquid chromatography of sulfur-containing amino acids and related compounds with amperometric detection at a modified electrode.

Organic disulfides generally are not oxidized at bare electrodes under conditions that are suited to routine amperometric detection, and thiols are typically oxidized in a manner that leads to partial blockage of the surface. Modification of a carbon electrode with a film of Ru(III,IV) oxide stabilized with cyanocross-links permits the amperometric detection of cystine, cysteine, glutathione, methionine, and glutathione disulfide under conditions compatible with their chromatographic separation on a strong cation-exchange column. Detection limits of 0.2-0.6 microM and linear dynamic ranges of at least 1-50 microM were obtained. The electrode was stable for at least 11 days with a pH 1 citrate, phosphate mobile phase.

Amino Acids, Sulfur

Distribution of anionic sites on the oviduct ciliary membrane.

Polycationic ferritin (PCF) was used as a visual probe for anionic sites on the oviduct ciliary membrane. The binding of PCF to ciliary membranes was dependent on the concentration of the probe in the incubation media. At low concentrations (0.08-0.16 mg/ml), PCF was bound exclusively to the tip of the cilium whereas at higher concentrations (0.32-0.64 mg/ml), ferritin was located at the tip and at the base around the transition region, with occasional scattered clumps on the remainder of the membrane. The base and tip binding was fount to be associated with special surface modifications of the membrane in these regions. At the tip, PCF was bound to a filamentous glycocalyx termed the ciliary crown. Base binding was associated with a system of five to six 140-A high ridges, each of which encircled the membrane of the transition region. The ridges were equally spaced (approxamately 245 A spacing) along the length of the transition region. Since pretreatment of oviduct with either neuraminidase or protease blocked the binding of the probe, the PCF-binding sites appear to be negatively charged glycoproteins or mucopolysaccharides.

Animals

Ultrastructural studies of surface features of human normal and tumor cells in tissue culture by scanning and transmission electron microscopy.

Human tumors of a variety of histopathologic types have been established in tissue culture. The surface features of these cell lines were investigated by scanning electron microscopy (SEM) with the use of new techniques for specimen preparation. Tumor cells demonstrated striking degrees of surface activity with numerous microvilli, filopodia, blebs, and ruffles. Intercellular contacts were also prominent in cultures of most solid tumors observed by SEM. At low cell density, normal human fibroblasts exhibited some surface features such as microvilli and blebs, but at higher cell density they lacked extensive surface modifications. By transmission electron microscopy (TEM), the cytoskeleton of normal fibroblasts was shown to be well organized, with parallel orientation of microfilaments, filaments, and microtubules. These structures were also in tumor cells, but they lacked the degree of organization of fibroblasts. Desmosomes were readily demonstrated in normal fibroblasts and carcinoma cells in culture but not in sarcomas, melanomas, or tumors of neural origin. These studies have provided the first correlative SEM and TEM analyses of solid human tumor cells of diverse pathologic types in vitro.

Carcinoma

Cell membrane and volume changes during red cell development and aging.

This paper provides a summary of our understanding of cell membrane and volume changes during red cell development and aging. Cytoskeletal structures which include microtubules and microfilaments appear to play key roles in the genesis of the anucleate reticulocyte from its nucleated precursor cell, as well as in the early stages of reticulocyte development. The maturation of reticulocyte into red cell is accompanied by marked changes in cell shape and extensive remodeling of the membrane skeleton, resulting in the mature red cell acquiring a highly deformable yet remarkably stable membrane. The volume and cell density heterogeneity seen for circulating red cells also appears to be the result of the membrane changes that occur during reticulocyte maturation. Following its genesis from reticulocyte, the mature red cell undergoes further membrane and volume changes during its life span of 120 days. While it is clear that surface area loss, decrease in cell volume and cell surface modifications leading to binding of immunoglobulins accompany red cell aging, the cardinal cellular modification responsible for the removal of senescent red cells from the circulation is yet to be defined.

Cytoskeleton

Specific absence of type 2 fimbriae on a coaggregation-defective mutant of Actinomyces viscosus T14V.

The coaggregation-defective (COG-) mutant Actinomyces viscosus T14V(PK455), which is unable to participate in lactose-sensitive adherence, and its COG+ parent were compared to structurally define the mutational loss of cell-associated lectin activity. Immunoelectrophoretic comparisons of crude extracts or isolated fimbriae from both strains demonstrated type 2 fimbriae (previously designated Ag2) in preparations obtained from the parent but none in those obtained from the mutant. This result was verified by the immunoelectron-microscopic identification of type 1 (previously designated Ag1 or VAl) and type 2 fimbriae on the parent organism but only type 1 fimbriae on the mutant. A comparison of the amounts of extractable fimbriae of each type and the capacity of the cells to bind 14C-labeled monoclonal antibodies specific for each fimbrial component showed that the mutational loss of type 2 fimbriae had no significant quantitative effect on fimbriation of the COG- mutant with type 1 structures. Cells of A. viscosus T14AV, a mutant with various adherence defects that include the COG- phenotype, displayed fimbriae of both types, but in greatly reduced amounts. Thus, the properties of mutant strain T14V(PK455) associated the lectin activity with type 2 fimbriae, whereas those of strain T14AV provided little insight into the mechanism of lactose-sensitive adherence. In addition, the precise nature of the cell surface modification displayed by strain T14V(PK455) provides clear evidence for the existence of distinct and independent fimbriae on A. viscosus T14V.

Actinomyces

Role of adherence in pathogenesis of Enterococcus faecalis urinary tract infection and endocarditis.

Enterococcus faecalis strains isolated from urinary tract infections (UTIs) and endocarditis were analyzed for their ability to adhere to urinary tract epithelial cells (ECs) and Girardi heart (GH) and human embryonic kidney (HEK) cell cultures. UTI isolates adhered to urinary tract ECs more efficiently than to the cultured cells, at the same time showing the least affinity for GH cells. In contrast, endocarditis isolates adhered to GH cell cultures more readily than to urinary tract ECs. Moreover, although strains isolated from endocarditis adhered to GH cells more efficiently than those derived from UTI, the latter strains adhered to urinary tract cells better than the former. Studies of the ability of GH and HEK cells to internalize E. faecalis showed that for UTI isolates, 9 to 74% of adhered bacteria were internalized, while for endocarditis isolates, the percentage varied from 76 to 82%. All strains were able to associate with human neutrophils; endocarditis strains, however, associated less efficiently than UTI isolates. Growth in serum raised the adherence of all tested strains by at least 1.5- to 3-fold, with the greatest increase being observed in UTI strain adherence to GH cells (8-fold). In contrast, the association of serum-grown cells with polymorphonuclear leukocytes was reduced by two- to fivefold. In both cases, the observed serum-dependent alterations were cancelled by a few subcultures in brain heart infusion broth. These results indicate that adhesive properties are important virulence factors in the pathogenesis of UTI and endocarditis and also suggest that UTI strains showing the highest invasion and adhesive potential invade the kidneys, cause bacteremia, and, after having expressed the serum-dependent surface modification, colonize the heart.

Adult