Biodegradable multilayer constructs
09724308 · 2017-08-08
Assignee
Inventors
- Michael V. Paukshto (Foster City, CA)
- George R. Martin (Rockville, MD)
- David H. McMurtry (Felton, CA, US)
Cpc classification
A61K9/70
HUMAN NECESSITIES
A61F13/00063
HUMAN NECESSITIES
A61L2400/12
HUMAN NECESSITIES
A61L2430/38
HUMAN NECESSITIES
A61L27/54
HUMAN NECESSITIES
International classification
A61M35/00
HUMAN NECESSITIES
A61L27/54
HUMAN NECESSITIES
Abstract
Embodiments of the present invention relate generally to the field of tissue repair and regeneration. More specifically embodiments of present disclosure relate to devices or constructs and methods to prepare various devices or constructs useful in directing cellular repair and controlling tissue regeneration to prevent or minimize postsurgical or post traumatic adhesions, excessive scars and/or fibrotic reactions of injured tissues.
Claims
1. An implantable multilayer construct promoting repair and regeneration of a wounded or defective tissue, preventing an adhesion to surrounding tissue, and preventing excessive fibrotic reaction of the injured tissue and comprising: at least two fibrillar nanoweave biopolymer layers attached by intermediate biodegradable layer where the intermediate layer has a rate of degradation higher than at least one nanoweave biopolymer layer under physiological conditions.
2. The multilayer construct according to claim 1, wherein the at least two fibrillar nanoweave biopolymer layers enables cell guidance and tissue regeneration.
3. The multilayer construct according to claim 1 wherein the at least two fibrillar nanoweave biopolymer layers stimulates non-scarring phenotype for adherent cells.
4. The multilayer construct according to claim 1 wherein the at least two fibrillar nanoweave biopolymer layers is made from collagen.
5. The multilayer construct according to claim 1 wherein the at least two fibrillar nanoweave biopolymer layers is comprised of oriented fibrillar biopolymer material.
6. The multilayer construct according to claim 1 wherein one of the fibrillar nanoweave biopolymer layers has no pores with diameter greater than 0.5 micron.
7. The multilayer construct according to claim 1 or claim 6 further comprising a biopolymer layer with the pore diameter in a range 10-500 micrometers that permit repair cells to infiltrate said layer.
8. The multilayer construct according to claim 1 wherein the intermediate layer has a gradient degradation rate with slow degradation at the surface of fibrillar nanoweave biopolymer layers and the highest degradation in the median plane between nanoweave biopolymer layers such that the degradation is separating multilayer construct to at least two parts with low friction and low tissue adhesion between them.
9. The multilayer construct according to claim 1 where the intermediate layer comprises a biologically active agent being arranged to be released by the construct through a period of desired duration.
10. The multilayer construct according to claim 9 wherein the biologically active agent is effective in preventing tissue adhesions.
11. The multilayer construct according to claim 1 which has diffusive transmittance in the visible spectrum more than 20%.
12. The multilayer construct according to claim 1 further comprising at least one planar network of nanowires.
13. The multilayer construct according to claim 12 where the nanowires selected from one or more of: metal nanowires, or plastic nanowires, or piezoelectric nanowires, or the combination thereof.
14. The multilayer construct according to claim 12 wherein the nanowires form a planar array of cells or coils.
15. The multilayer construct according to the claim 12 or claim 14 where an external alternating magnetic excitation field applied to the construct after implantation of the construct into a mammal body is coupled to the planar nanowire network to monitor changes of the complex conductivity and changes of the relative magnetic permeability in the region of the planar nanowire network by suitable external receiver coils measuring a field perturbation due to the induction of Eddy currents and magnetic dipoles between the network cells.
16. The multilayer construct according to claim 12 where, after implantation of the construct into a mammal body, the network deformation under different mammal body positions is measured by a suitable x-ray stereotactic device and used to estimate post surgical or post-traumatic adhesion.
17. The multilayer construct according to claim 12 wherein an external alternating magnetic excitation field applied to the construct after implantation of the construct into a mammal body is coupled to the planar nanowire network to enhance tissue repair and regeneration and to reduce pain.
18. The multilayer construct according to claim 1 where intermediate biodegradable layer comprises electrically conductive layer.
19. The multilayer construct according to claim 1 or claim 18 further comprising: conductive layer serving as biocompatible biodegradable antibacterial electrode and scaffold for neuromuscular electromagnetic stimulation, electromagnetic stimulation for tissue repair, pain management with electromagnetic stimulation, and for transdermal drug delivery.
20. The multilayer construct according to the claim 18 wherein the electrically conductive layer triggers and controls the separation under external pulsed electromagnetic field.
21. The multilayer construct according to claim 1 which has at least one layer comprising hyaluronic acid, chondroitin 6-sulphate, keratin sulphate, dermatan sulphate, PEG, laminin, albumin, alginate, heparin, polyacrylic acids, polymethacrylic acid, polyethylene amine, polysaccharides, alginic acid, pectinic acids, carboxy methyl cellulose, chitosan, carboxymethyl chitosan, carboxymethyl starch, carboxymethyl dextran, heparin sulfate.
22. The multilayer construct according to claim 1 which has one surface promoting adhesion to tissue and the other surface inhibits adhesion to tissue under physiological conditions and act as a barrier to prevent passage of cells there through.
23. A multilayer construct according to claim 1 promoting repair and regeneration of a damaged or wounded area of patient's spinal cord and preventing an adhesion to surrounding tissue and excessive fibrotic reaction of the injured tissue.
24. The multilayer construct according to the claim 1 further comprising at least one layer which has laser diffraction pattern with at least one elongated branch.
Description
BRIEF DESCRIPTION OF THE FIGURES
(1) The foregoing and other aspects of embodiments of the present disclosure will be apparent upon consideration of the following detailed description, taken in conjunction with the accompanying drawings, in which like reference characters refer to like parts throughout, and in which:
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DETAILED DESCRIPTION OF THE INVENTION
(11) It is to be understood that both the foregoing general description and the following description are exemplary and explanatory only and are not restrictive of the methods and devices described herein. In this application, the use of the singular includes the plural unless specifically state otherwise. Also, the use of “or” means “and/or” unless stated otherwise. Similarly, “comprise,” “comprises,” “comprising,” “include,” “includes,” “including,” “has,” “have,” and “having” are not intended to be limiting.
(12) Example embodiments are described herein in the context of medical devices and biocompatible constructs, and methods of making. Those of ordinary skill in the art will realize that the following description is illustrative only and is not intended to be in any way limiting. Other embodiments will readily suggest themselves to such skilled persons having the benefit of this disclosure. Reference will now be made in detail to various implementations of the example embodiments as illustrated in the accompanying drawings. The same reference indicators will be used to the extent possible throughout the drawings and the following description to refer to the same or like items.
(13) Various embodiments of the devices and constructs of the present invention are also sometimes referred to as scaffolds, collagen scaffolds, membranes, implants and/or bio-devices. The terms biocompatible polymer and biopolymer are sometimes used interchangeably. The terms layer(s) and membrane(s) are sometimes used interchangeably.
(14) Embodiments of the present invention describe methods to produce medical devices, constructs or implants comprised of compatible polymers for implantation or applied to various tissues to provide an anti-adhesion barrier and thus enhance repair and regeneration, among other uses. In some embodiments the biopolymer constructs are comprised of at least one layer or membrane of oriented collagen. In some embodiments the biopolymer constructs are comprised of multiple layers or membranes of oriented collagen. Of particular advantage, the multiple layers can be constructed with selected orientation to provide desired properties.
(15) In another aspect, biopolymer constructs are provided comprised of at least one collagen layer and having a conductive element formed therein. In some embodiments the conductive element is one or more metal nanowires. Of particular advantage the conductivity of such devices, materials or implants may be selectively controlled by inducing magnetic fields which can be detected and monitored.
(16) As used herein the term “fibrillar nanoweave biopolymer membrane” or simply “nanoweave membrane” means a fibrillar biopolymer membrane or layer where the filling fibrils or fibril bundles pass under and over alternate warp fibrils or fibril bundles, and the typical fibrils or fibril bundles have a helical or crimp shape in the unloaded state. Examples of various fibrillar nanoweave collagen membranes are shown in
(17) The diameter of fibrils can be of any suitable size. In some embodiments, the diameter of the fibrils are in a range of 20 nm to 500 nm, depending on the tissue requirement. Methods of making these highly organized fibrillar biopolymer membranes or layers are described in U.S. patent application Ser. Nos. 11/951,324, 11/986,263, 12/106,214, and 12/539,563, the disclosures of all of which are incorporated by reference herein in their entirety.
(18) One aspect of the present disclosure relates to devices and methods for preventing post-surgical or post-traumatic adhesion between wounded tissue and adjacent tissues, thus reducing scar and adhesion formation. In one example a method is provided comprising the steps of covering the wounded tissue and separating the wounded tissue from other surrounding tissues with a biopolymer based multilayer construct which guides repair.
(19) In some embodiments the biopolymer constructs are multi-layered. Multi-layered constructs may be made from fibrillar nanoweave biopolymer membranes or layers which may exhibit different structural characteristics, such structural characteristics being selected in order to promote regeneration in the wounded tissue and block further cell migration in the direction of surrounding tissues. For example, the construct may be formed by several cross-linked collagen layers configured such that in the vicinity of the wounded tissue one or more of the collagen layers have selected porosity and mechanical properties that promote repair and regeneration, while the outer collagen layers (or collagen layers remote from the wounded tissue) are designed to ensure the mechanical strength of the whole construct. Additionally, one or more of the outer collagen layers may exhibit selected properties that promote suturability of the construct, and/or provide a water-tight covering to prevent cell migration though the construct during the time required for the wound to repair and regenerate. Example of the nanoweave collagen layers with different porosity are illustrated in
(20) In some embodiments a fibrillar nanoweave layer has uniaxial or unidirectional orientation of the fibrils (e.g., tendon-like or cornea-like membrane). In some cases a fibrillar nanoweave layer has biaxial orientation of the fibrils (e.g., basket-weave membrane) over all, or a portion of, the layer. Additionally, the fibrillar nanoweave layer can exhibit a skin-like multi domain fibril orientation over all, or a portion of, the layer.
(21) Different forms or collagen may be used. In some embodiments, monomeric collagen is used. One example of monomeric collagen is monomeric collagen I with cleaved telopeptydes or atellocollagen which has extremely low immunogenicity.
(22) It is understood that fibrillar nanoweave collagen layer may influence non-scarring cell phenotype via mechanotransduction.
(23) Biopolymer constructs according to the present disclosure are preferably biocompatible, mechanically stable, elastic, drapable, and suturable. In some embodiments, the construct or portion of the construct include a porosity gradient to provide enhance healing in the wound area and to promote a temporary barrier against uncontrolled distribution of blood, fibrinogen, necrotic material and damaged tissues.
(24) Referring to
(25) Of particular advantage, the composition and/or structure of the various layers that comprise the construct may be specifically selected to provide certain desired properties and/or function. In one example, layers 101 are comprised of a porous membrane or layer similar to that shown in
(26) Nanowires may be disposed within or on one of more of the layers in the construct. Suitable nanowires include, for example, metal nanowires, silver nanowires, piezoelectric nanowires, high density plastic nanowires, and combinations thereof.
(27) In another embodiment the biopolymer construct comprises two multilayer sub-constructs wherein each sub-construct is configured with a different porosity gradient such that one sub-construct will degrade at a higher rate than the other sub-construct. Referring again to
(28) Referring to
(29) When the biopolymer construct contains a planar network of nanowires, in situ monitoring the location of the construct using non-invasive magnetic induction spectroscopy (MIS) or other means is enabled. MIS requires an alternating magnetic excitation field which is coupled from an excitation coil to the object under investigation as shown in
(30) The presence of piezoelectric nanowires in the planar network of metal nanowires imbedded in a multilayer construct turns the multilayer construct into a smart device. The mechanical deformation caused by cell adhesion and migration excites electric current in the piezoelectric nanowires, which generate a magnetic field detected by receiving coil. In response, the excitation coil generates a magnetic field which causes an electric field in metal nanowires to release a suitable drug and/or stop cell proliferation.
(31) Of significant advantage, in another embodiment deformation of the nanowire network under different mammal body positions may be used as an indication of post surgical or post-traumatic adhesion. The deformation can be measured, for example, by x-ray stereotactic device. Suitable nanowires in this embodiment are, for example, comprised of high density plastic nanowires or metal nanowires.
(32) In one example of the present disclosure the construct preventing cell adhesion by the method according to the present disclosure can be applied to medical or veterinarian uses.
(33) Methods disclosed herein of covering and separating tissue with a multilayer construct may be carried out during the treatment of any injuries or defects, for example, the dura mater covering the brain or the spinal column. In one example of the present disclosure, the step of covering and separating the tissue with a multilayer construct may be carried out during abdominal surgery.
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EXPERIMENTAL
(35) A number of experiments were conducted as described below. These examples are shown for illustration purposes only and are not intended to limit the invention in any way.
Example 1: Preparation of Multilayer Biocompatible Construct/Implant
(36) Multiplayer constructs were prepared by the following method: liquid fibrillar biopolymer (e.g. purified medical grade collagen to substrate (glass or plastic, e.g. PET film)) was deposited to form a solid film (matrix) according to the procedure described in the patent applications: WO2010/019625A2, US2009/0069893A1, WO/2008/070166A1, WO/2008/063631A2. The typical film thickness is in the range from 1 μm to 10 μm.
(37) The film was removed from the substrate in the direction of the collagen fibrils (deposition direction, see
(38) The multiple collagen films were Cross-laminated as shown in
(39) The resulting multilayer construct can be placed into dehydration unit (e.g., vacuum of at least 50 millitorr and temperature 90° C. for 72 hours).
(40) The construct should be further sterilized (e.g. E-beam sterilization) and it is ready for use for biomedical applications.
Example 2: Preparation of Multilayer Construct/Implant
(41) In this experiment, multilayer constructs were prepared by depositing the liquid biopolymer (e.g. collagen) to substrate (glass or plastic, e.g. PET film) to form a solid film (matrix) according to the procedure described in the patent applications: WO2010/019625A2, US2009/0069893A1, WO/2008/070166A1, WO/2008/063631 A2. The typical film thickness is in the range from 1 μm to 10 μm.
(42) The coated film is attached to a carrier (e.g., to a transparent flexible film with double-sided tape area at the film perimeter or a drum with vacuum/electrostatic holder) and removing the substrate as shown in
(43) The multiple fibrillar films are transferred and laminated on a non-adhering substrate. The bonding material and additional materials including bioactive material can be sprayed or deposited between fibrillar layers (films), e.g. heparin, multi-arm activated PEG, metal or plastic nanowires can be deposited between layers.
(44) The resulting multilayer construct can be placed into dehydration unit (e.g., vacuum of at least 50 millitorr and temperature 110° C. for 72 hours under pressure).
(45) The construct should be further sterilized (e.g. E-beam sterilization).
(46) In the two examples above the lamination process is conducted in a way to avoid wrinkles or bubbles. One modification of the above procedure (step 0053) includes a spray of microparticles (e.g. low molecular weight PEG particles of 40 micron diameter) together with cross-linking droplets, such that the PEG can be dissolved after the cross-linking of the multilayer construct (at the step 0054). The purpose of this modification is to modify the porosity at the interface between layers and to control the strength of adhesion between the layers.
(47) In addition to being used as an anti-adhesion barrier during or after surgery, the multilayer construct/implant can be used as or with a tendon sheath or a dural barrier as shown in
(48) Various laminated constructs can be made from the medical grade monomeric collagen solution by methods described above. The constructs may be formed of any number of layers. In one example, and without limitation, a construct with twelve cross-laminated layers is provided having six (6) layers with aligned fibrils in one direction and six (6) layers with aligned fibrils in an orthogonal direction. In one experiment such a twelve layer construct was formed and having weight of the sample in the dry state of 14 mg, size of 25×25×0.02 mm, and density of 1.12 mg/mm.sup.3. A sample with two cross-laminated layers was formed having weight is in the dry state of 2 mg, size of 25×25×0.0025 mm, and a density of 1.28 mg/mm.sup.3. Both samples are transparent in dry and wet state with transmittance at 630 nm more than 70% and about 90% respectively. The diffraction patterns of both samples were measured and are shown in
(49) The typical collagen matrices on the market have low density and isotropic scattering/diffraction pattern. For example, typical dental collagen membrane has weight in the dry state—65 mg, size 20×30×0.1 mm, and density 1.08 mg/mm.sup.3.
Example 3: Multilayer Construct with Planar Network of Silver Nanowires
(50) A multilayer construct comprising a planar network of silver nanowires was prepared according to the procedure described in Example 1. An aqueous silver nanowire solution 2 wt % (SeaShell Technology, San Diego) was deposited between two laminated fibrillar collagen nanoweave membranes as shown in
Example 4: Use of Multilayer Construct Prepared According to Procedure Described in the Example 1 as an Adhesion Barrier in Animal Study
(51) Four types of multilayer collagen constructs are used in this experiment: constructs without additional treatment; constructs which have one side treated by activated PEG; constructs which have one side treated by heparin; and constructs which have one side treated by activated PEG and albumin such that albumin forms an external monolayer.
(52) The goal of this experiment was to test the ease of handling of the multilayer constructs; and to test whether surface-modified multilayer constructs prevent formation of adhesions.
(53) Experimental design: After induction of anesthesia, perform an adhesion induction by brushing the secum and peritoneal wall by a Perlon brush (tooth brush). In experimental animals, wrap the traumatized secum with multilayer collagen construct such that the treated surface of the construct faces peritoneal wall. In control animals, no wrapping is performed. Sacrifice in 12 days to check for adhesion formation.
(54) Animals: Balb/c, female, DOB 4/26, 20 g; CD1, male, DOB 2/27, 40-42 g.
(55) Experimental groups: A—control group (no wrap)—3 animals; B—collagen construct without treatment—3 animals; C—collagen construct treated by activated PEG—3 animals; D—collagen construct treated by heparin—3 animals; E—collagen construct treated by activated PEG and albumin—3 animals.
(56) Anesthesia. Animals were anesthetized with isoflurane following 100 mg/kg ketamine and 5 mg/kg body weight xylazine.
(57) Animal preparation. Animals were shaved on the abdominal side and the residual hair were removed with hair removal cream (diluted 1:1 w/H2O) application for 3 min. The site of the incision was disinfected with chlorhexidine gluconate.
(58) Adhesion induction. Mice were placed in a supine position and the abdomen was exposed through a ventral midline incision. Standardized surgical injuries were applied to visceral and parietal peritoneum and the secum: a 1×1-cm area of the left sidewall peritoneum was brushed with a Perlon brush until punctuate bleeding occurred. The same trauma was applied to the secum. The animals were then randomized to their groups and treated accordingly. The collagen constructs were used to wrap the traumatized secum, so that it would form a barrier between the secum and the peritoneal wall. After traumatization, the abdomen was closed with Vetbond tissue adhesive. The skin was closed with easy-clips.
(59) Post-surgery management. All animals were administered with antibiotic (cefazolin, 15 mg/kg, s.c., day 0 and 1) and analgetic (Buprenex (buprenorphine hydrochloride), 2 mg/kg, s.c., days 0 and 1).
(60) The best results with minimum adhesion were observed for the group E; the worst results with multiple adhesions were occurred in the group D. In all groups the multilayer constructs have shown excellent drapability and good mechanical strength.
Example 5: In-Vitro Model of Vascular System
(61) Cells can be analyzed in a variety of models, such as in a blood vessel model, or cornea model, and the like (see, e.g.,
(62) Embodiments of the present disclosure provide in-vitro modeling. Advantages of the present invention include: an option to use high transparency membrane; control the tension on the frame; control of rigidity and/or the structure of the nanoweave membrane. Referring again to
(63) Additional application for the multilayer constructs include, without limitation: cell culture research applications, cell/drug delivery applications, and other tissue engineering applications.
(64) In vitro assays using multilayer constructs of the present disclosure include, without limitation: stem cell attachment, proliferation on collagens 1, 4 or laminin, or fibronectin; factors inducing stem cell proliferation; quantitative stem cell migration assays/required factors; neurite formation in cells derived from neural stem cells; myoblast/cardiomyocyte differentiation and function; tubule formation by kidney derived and other cells; differentiation of IPS cells along epithelial or neuronal lines; co-culture of islets with stem cells.
(65) In vivo assays using multilayer constructs of the present disclosure include, without limitation: multilayer constructs for stem cell/islet transplantation; sheets for transplantation of bioluminescent cells to certain sites for tracking their migration and survival; sheets for transplantation of tumor cells in vivo to specific sites; transparent constructs to facilitate imaging of implanted stem cells; device for growing stem cells in culture and transferring them to specific tissue sites; implantable biocompatible collagen/silver nanowire constructs to enhance the proliferation, differentiation and vascularization of implanted stem cells using PEMF signals.
(66) Tissue damage to heart, striated muscle, skin, bone and cartilage, tendon and ligament, spinal cord and the like often progresses and causes the breakdown of normal surrounding tissue increasing the area of damage and seriously impairing tissue function. Current concepts suggest that various factors or cells could be introduced into the damaged area by direct injection and prevent further damage and even cause regeneration of the damaged area. Indeed, preclinical as well as clinical trials have shown improved heart function when mesenchymal stem cells are injected into the site of tissue damage. However, such studies have also shown that significant amounts of the injected cells leak out of the tissue and most of the cells remaining rapidly die. Thus there are uses for devices which allow delivery of various types of cells to specific sites in damaged tissue and maintain their survival and expansion. However, the physical properties of different tissues vary strikingly (compare heart muscle with striated muscle with skin or spinal cord). Thus, delivery vehicles should have sufficient strength to allow them to be placed in a specific tissue without causing alterations in tissue function due to poorly matched physical factors. This calls for materials whose physical properties are suitable for the tissue in which they are to be used. Also, cells require factors and surfaces to support their survival, migration and production of specific repair factors. In brief, the treatment of damaged tissues should be improved by novel devices which would deliver and maintain stem and other cells in specific sites to allow them to survive and produce factors that sustain tissue at risk.
(67) Multilayer constructs of the present disclosure provide cell guiding and can be used for repair and regeneration of periodontal ligament. Top layer of the construct may have the fibril orientation which blocks a migration of gingival epithelial cells to the tooth. The bottom layer has the collagen fibrils orientation which promotes repair and regeneration of the periodontal ligament (vertical fibrils). Collagen-based construct can be used effectively for a wound treatment. They can be supplemented with small molecules, peptides, PRP (platelet reach plasma), stem cells, vanadate, etc. These examples are not limiting the applications of the above constructs.
(68) The foregoing methods, materials, constructs and description are intended to be illustrative. In view of the teachings provided herein, other approaches will be evident to those of skill in the relevant art, and such approaches are intended to fall within the scope of the present invention.