Thromboinflammation as bioactivity assessment of H 2 O 2 -alkali modified titanium surfaces
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B I O M A T E R I A L S S Y N T H E S I S A N D CH A R A C T E R I Z A T I O N Original Research
Thromboinflammation as bioactivity assessment of H2O2-alkali modified titanium surfaces Gry Hulsart-Billström
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Oscar Janson1 Håkan Engqvist1 Ken Welch2 Jaan Hong3 ●
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Received: 25 September 2018 / Accepted: 27 March 2019 / Published online: 24 May 2019 © The Author(s) 2019
Abstract The release of growth factors from platelets, mediated by the coagulation and the complement system, plays an important role in the bone formation around implants. This study aimed at exploring the thromboinflammatory response of H2O2-alkali soaked commercially pure titanium grade 2 discs exposed to whole human blood, as a way to assess the bioactivity of the discs. Commercially pure titanium grade 2 discs were modified by soaking in H2O2, NaOH and Ca(OH)2. The platelet aggregation, coagulation activation and complement activation was assessed by exposing the discs to fresh whole blood from human donors. The platelet aggregation was examined by a cell counter and the coagulation and complement activation were assessed by ELISA-measurements of the concentration of thrombin-antithrombin complex, C3a and terminal complement complex. The modified surface showed a statistically significant increased platelet aggregation, coagulation activation and complement activation compared to unexposed blood. The surface also showed a statistically significant increase of coagulation activation compared to PVC. The results of this study showed that the H2O2-alkali soaked surfaces induced a thromboinflammatory response that indicates that the surfaces are bioactive.
Graphical Abstract
These authors contributed equally: Gry Hulsart-Billström, Oscar Janson * Jaan Hong [email protected] 1
Department of Engineering Sciences, Division of Applied Material Science, Uppsala University, 751 21 Uppsala, Sweden
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Department of Engineering Sciences, Division of Nanotechnology and Functional Materials, Uppsala University, 751 21 Uppsala, Sweden
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Department of Immunology, Genetics and Pathology, Rudbeck Laboratory C5, Uppsala University, 75185 Uppsala, Sweden
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1 Introduction Bacterial infections in conjunction with dental and orthopedic devices are a big concern in healthcare. The material surface that is implanted in the body constitutes an attractive site for bacterial biofilm formation, which can lead to very intractable chronic infections. Consequently, antibiotic treatments are normally used as prevention, both locally and systemically. However, antibiotic treatments often induce adverse side effects and some bacterial strains have been seen to develop resistance against multiple antibiotics, e.g., methicillin-resistant Staphylococcus aureus [1]. Therefore, there exists a tremendous incentive to develop new antibacterial treatments for biomedical purposes. Titanium is a material that has been employed in biomedical implants since the middle of the last century. An advantage of titanium over other metals
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