Blood Protein Adsorption and Platelet Activation on an Ultra-hydrophilic Substrate

초친수성 표면에서 혈장 단백의 흡착 및 혈소판의 변화에 관한 연구

  • Park, Nam-Hee (Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University College of Medicine) ;
  • Chun, Bae-Hyeock (Nano-biotechnology Corporation) ;
  • Je, Hyung-Gon (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Lee, Jun-Wan (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Lee, Jae-Won (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medicine, University of Ulsan)
  • 박남희 (계명대학교 의과대학 동산의료원 흉부외과학교실) ;
  • 전배혁 ((주)N.B.T) ;
  • 제형곤 (울산대학교 의과대학 서울아산병원 흉부외과학교실) ;
  • 이준완 (울산대학교 의과대학 서울아산병원 흉부외과학교실) ;
  • 이재원 (울산대학교 의과대학 서울아산병원 흉부외과학교실)
  • Published : 2007.04.05

Abstract

Background: We evaluate the efficacy of ultra-hydrophilic coated bypass circuits in comparison with uncoated bypass circuits in a porcine cardiopulmonary bypass model. Material and Method: Normothermic cardiopulmonary bypass was peformed in 10 anesthetized pigs via the left atrium and ascending aorta with a centrifugal biopump. Ultra-hydrophilic coated bypass circuits wore used in 5 pigs (the study group) and uncoated bypass circuits were used for the control group. Platelet counts and platelet aggregation tests were peformed. The thrombin-antithrombin(TAT) complex level and total protein level were evaluated. Result: There were no significant changes En the platelet counts and aggregation ability of both groups. The TAT complex levels were not different between the two groups. The total protein level was significantly lower in the control group after cessation of cardiopulmonary bypass. Conclusion: The clinical effects of ultra-hydrophilic coating circuits were not remarkable, in terms of reducing inflammatory reaction and protection of platelet function. However, the effect of protection for blood protein adsorption might be acceptable.

배경: 체외순환으로 발생하는 전신성 염증반응을 줄이기 위해 체외순환 회로의 표면에 초친수성 표면개질을 시행한 후 혈장 단백의 흡착 및 혈소판의 변화를 관찰하였다 대상 및 방법: 60kg 내외의 돼지 10마리를 대상으로 하였다. 체외순환은 좌심방과 상행대동맥에 캐눌라를 거치하여 원심성 바이오펌프를 이용해 2시간 동안 정상체온 하에서 시행하였다. 이때 실험군(n=5)에서는 체외순환회로에 초친수성 표면처리를 하였으며 대조군(n=5)에서는 상용화된 일반적인 튜빙을 사용하였다. 체외순환에 따른 염증반응의 정도를 비교하기 위하여 혈소판 수 및 응집능 검사, 트롬빈-안티트롬빈 복합체 검사, 그리고 혈액 내 총 단백량을 측정하였다. 결과: 양 군에서 모두 혈소판의 수 및 응집능 기능검사에서 유의한 차이를 보이지 않았으며 또한 트롬빈-안티트롬빈 복합체의 농도에서도 두 군 간에 유의한 차이를 보이지 않았다. 그러나 총 단백량의 측정에서는 체외순환 후 대조군에서 실험군에 비해 유의하게 감소되었다. 결론: 초친수성 표면처리는 체외순환 시 혈장 단백의 표면흡착에 따른 혈장 단백의 감소를 줄일 수 있었으나 이로 인한 염증반응의 감소효과는 관찰할 수 없었다.

Keywords

References

  1. Edmunds LH. Inflammatory response to cardiopulmonary bypass. Ann Thorac Surg 1998;66:S12-6 https://doi.org/10.1016/S0003-4975(98)00388-9
  2. Courtney JM, Matata BM, Yin HQ, Esposito A, Mahiout A. The influence of biomaterials on inflammatory responses to cardiopulmonary bypass. Perfusion 1996;11:220-8 https://doi.org/10.1177/026765919601100307
  3. Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation: pathology and treatment. An update. Eur J Cardiothorac Surg 2002;21:232-44 https://doi.org/10.1016/S1010-7940(01)01099-5
  4. Landis RC, Asimakopoulos G, Poullis M, Haskard DO, Taylor KM. The antithrombotic and antiinflammatory mechanisms of action of aprotinin. Ann Thorac Surg 2001;72:2169-75 https://doi.org/10.1016/S0003-4975(01)02821-1
  5. Despotis GJ, Avidan MS, Hogue CW. Mechanisms and attenuation of hemostatic activation during extracorporeal circulation. Ann Thorac Surg 2001;72:S1821-31 https://doi.org/10.1016/S0003-4975(01)03211-8
  6. Gu YJ, Oeveren W, Akkerman C, Boonstra PW, Huyzen RJ, Wildevuur CR. Heparin-coated circuits reduce the inflammatory response to cardiopulmonary bypass. Ann Thorac Surg 1993;55:917-22 https://doi.org/10.1016/0003-4975(93)90117-Z
  7. Videm V, Mollnes TE, Fosse E, et al. Heparin-coated cariopulmonary bypass equipment. I. biocompatibility markers and developement of complications in a high-risk population. J Thorac Cardiovasc Surg 1999;117:794-802 https://doi.org/10.1016/S0022-5223(99)70301-6
  8. Videm V, Mollnes TE, Fosse E, et al. Heparin-coated cariopulmonary bypass equipment. II. biocompatibility markers and developement of complications in a high-risk population. J Thorac Cardiovasc Surg 1999;117:803-9 https://doi.org/10.1016/S0022-5223(99)70302-8
  9. Suhara H, Sawa Y, Nishimura M, et al. Efficacy of new coating material, PMEA, for cardiopulmonary bypass circuits in a porcine model. Ann Thoac Surg 2001;71:1603-8 https://doi.org/10.1016/S0003-4975(01)02466-3
  10. Sun K, Park KD, Baik KJ, et al. Development of Korean version of heparin-coated shunt. Korean J Thorac Cardiovasc Surg 1999;32:97-107
  11. Kang MS, Chun BH, Kim SS. Surface modification of polypropylene membrane by low-temperature plasma treatment. J Appl Polym Sci 2001;80:1555-66
  12. Bae B, Chun BH, Kim D. Surface characterization of microporous plypropylene membranes modified by plasma treatment. Polymer 2001;42:7879-85 https://doi.org/10.1016/S0032-3861(01)00245-2
  13. Andrade JD. Principles of protein adsorption. In: Andrade JD. Surface and interfacial aspects of biomaterial poymers. New York: Plenum Publ. 1985;1-80
  14. Chinn JA, Horbett TA, Ratner BD. Baboon fibrinogen adsorption and platelet adhesion to polymeric materials. Thromb Haemostas 1991;6:608-17
  15. Tsai WB, Grunemeier JM, Horbett TA. Human plasma fibrinogen adsorption and platelet adhesion to polystyrene. J Biomed Mater Res 1999;44:130-9 https://doi.org/10.1002/(SICI)1097-4636(199902)44:2<130::AID-JBM2>3.0.CO;2-9
  16. Tanaka M, Motomura T, Kawada M, et al. Blood compatible aspects of poly (2-methoxyethylacrylate)-relationship between protein adsorption and platelet adhesion on PMEA surface. Biomaterials 2000;21:1471-81 https://doi.org/10.1016/S0142-9612(00)00031-4
  17. Lee SH, Sun K, Choi JG, et al. Evaluation of biocompatibility of extracorporeal circuit-development of a quantification technique using In-vivo injection of Tc99m radioactive platelets. Korean J Thorac Cardiovasc Surg 2002;35:171-6