A team of researchers at the University of California, San Diego have developed a hydrogel that forms a barrier that prevents heart tissue from adhering to surrounding tissue after surgery and has been successfully tested in rodents. A team of engineers, scientists and doctors also conducted a pilot study of the porcine heart with promising results.
They describe their work in the June 18, 2021 issue of Nature Communications..
In rats Hydrogel Completely prevented the formation of adhesions.small Pilot studyThe hydrogel-treated porcine heart experienced milder adhesions that could be removed more easily. In addition, hydrogel did not appear to cause chronic inflammation.
adhesion-Organ tissue Adhesion to Surrounding Tissue — A relatively common problem when the surgeon needs to perform surgery again in the same location. This occurs in 20% of cases each year. Heart surgery.. Re-surgery is especially common when the patient is a child suffering from a heart malformation. As the child’s heart grows, additional intervention is needed.
Adhesions form within the first 30 days after surgery, which can complicate surgery and increase the risk of death during intervention. In some cases, it can interfere with proper heart function or completely prevent repeated surgery. Karen Cristoman, a professor of bioengineering at the University of California, San Diego, one of the lead authors of the treatise, experienced this when one of her uncles was unable to repair the heart valve due to severe adhesions. Did.
“Our work is an engineering solution driven by medical problems,” said Christman, who co-founded a company called Karios Technologies to bring hydrogels to the clinic. “And now we are ready to significantly improve heart surgery in both adults and children.”
Not only bioengineers and doctors, but also chemists and materials scientists participated in this work.
At academic medical centers such as the University of California, San Diego, most surgeons perform repeated surgery and encounter adhesions fairly regularly. In this study, in rats, 70% of the animals in the control group developed severe adhesions.
Currently, there are no FDA-approved products on the market to prevent adhesions after heart surgery. “This product will have a significant impact on the lives of many patients who may require repeated surgery in the heart or elsewhere in the body,” said Michael M., Chairman of the Cardiovascular and Thoracic Surgery Department. Dr. Madani said. One of the co-authors of the University of California, San Diego Health and Treatise.
How to make
In contrast, hydrogels developed by bioengineers in Christman’s lab are specially designed to meet the needs of both patients and surgeons. It’s sprayable, so it’s easy to apply. When sprayed onto tissue, it binds to the heart muscle and turns into a soft, elastic coating that creates a protective barrier while allowing movement. The gel can be easily removed from the tissue and dissolves after 4-6 weeks or more.
The biggest challenge was to make sure that the hydrogel was strong enough to adhere to the heart, but not swelling because it could put dangerous pressure on the heart. To achieve this, Christman and his team used what is known as cross-linking chemistry, which consists of covalently bonding two molecules. Masaki Fujita, the lead author of the treatise and a visiting scholar at the University of California, San Diego’s Department of Biological Engineering, used a compound called catechol similar to that used by mussels to attach to rocks, with hydrogels prescribed. I thought about trying to stay in position. heart.
Catechol contains the amino acid L-dopa, a muscle-binding protein. In this case, it was added to the gel base, a water-soluble polymer known as PEG. The result is a hydrogel that attaches to the applied organ, but creates a protective barrier that lasts at least 4 weeks before it dissolves. At that point, adhesions are less likely to form. As far as researchers know, this type of formulation is the first to be used to prevent post-surgical adhesions.
Researchers have also designed a device for safely and accurately spraying hydrogel into the area where open heart surgery is being performed. The device houses the two main components of hydrogel in two different chambers. Each component is made of PEG with different reactive groups that crosslink together to form a hydrogel. One of the solutions also includes catechol-modified PEG to keep it in the heart. The two mix as they leave the device to form a gel. This process is similar to using two cans of spray paint, such as blue and yellow, to create a third color, green.
Next steps and big picture
The next step is to do a large study in pigs to improve the dose and see how hydrogel binds to sutures and drainage. The ultimate goal is to conduct a human pediatric study in 18 months to 2 years and submit the product to the FDA for approval within 5 years.
Karios Technologies is licensed for technology from the University of California, San Diego. Gregory, CEO of Karios Technologies, said: “This material is heart Ease of use by the surgeon. “
The technique requires multiple surgeries and can be easily converted to other organs that are susceptible to adhesions, the researchers said.
Nature Communications (2021). DOI: 10.1038 / s41467-021-24104-w
University of California, San Diego
Quote: Bio-inspired hydrogel was obtained from https://medicalxpress.com/news/2021-06-bio-inspired-hydrogel-heart-post-op- on June 18, 2021 for postoperative adhesions (2021). Protects the heart from (June 18th) Adhesions.html
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Bio-inspired hydrogel protects the heart from postoperative adhesions
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