Research ArticlesBIOMATERIALS

Vascular Catheters with a Nonleaching Poly-Sulfobetaine Surface Modification Reduce Thrombus Formation and Microbial Attachment

Science Translational Medicine  26 Sep 2012:
Vol. 4, Issue 153, pp. 153ra132
DOI: 10.1126/scitranslmed.3004120

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Surface Modification Pulls Double Duty

Marketing experts know that consumers can’t resist a good deal: Two-for-one; buy one, get one (or BOGO, if you’re up-to-date on your lingo); twice as nice, half the price. Similarly, engineers know that, if they can package twice the functionality in one medical device, they have a valuable product that clinicians cannot ignore. In this issue, Smith et al. designed one polymer coating for catheters that resolves two major challenges in biomaterials by preventing both blood clot accumulation (thrombosis) and bacterial adhesion (infection).

Smith and colleagues created the zwitterionic polymer “polySB” (poly-sulfobetaine) surface modification, which, they hypothesized, can coordinate water and therefore resist protein adsorption and cell adhesion. PolySB was used to modify the inner and outer surfaces of common polyurethane peripherally inserted central catheters (PICCs). In vitro, the polySB-modified catheter reduced adherence and activation of human red and white blood cells compared with commercially available PICCs without the polySB surface. In addition, modified PICCs that had been soaked in serum for 60 days displayed no thrombus accumulation when exposed to bovine blood, thus demonstrating the long-term activity of the polySB. In vivo, in a canine model, polySB-modified PICCs had little thrombus accumulation: a reduction of ~99% compared to unmodified control devices. Last, polySB-modified PICCs showed up to 99.9% reduction in microbial attachment (both Gram-positive and Gram-negative bacteria) compared to unmodified PICCs; in rabbits, this translated to less inflammation. By preventing both infection and thrombosis, this multifunctional polymeric coating is just the BOGO the doctor ordered.