4.8 Article

A Readily Scalable, Clinically Demonstrated, Antibiofouling Zwitterionic Surface Treatment for Implantable Medical Devices

Journal

ADVANCED MATERIALS
Volume 34, Issue 20, Pages -

Publisher

WILEY-V C H VERLAG GMBH
DOI: 10.1002/adma.202200254

Keywords

antibiofouling; antimicrobial stewardship; cross-linkable coating modification; protein repellant; universal surface treatment; zwitterionic surfaces

Funding

  1. Canadian Institutes of Health Research (CIHR)
  2. National Institutes of Health [1R01EB024403, HL137193, 1R01GM126831]
  3. National Science Foundation [CBET 1337065]
  4. CERC-WET
  5. Silq Technologies, Corp.
  6. National Science Foundation CAREER [1255021]
  7. UCLA Sustainability Grand Challenge
  8. Directorate For Engineering [1255021] Funding Source: National Science Foundation
  9. Div Of Chem, Bioeng, Env, & Transp Sys [1255021] Funding Source: National Science Foundation

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A simple surface modification technique has been developed to reduce microbial and protein adhesion on artificial materials, showing promising results in clinical applications. The treated surfaces exhibit strong resistance against adhesion and are non-toxic to cells. Surface-treated catheters have been approved by the FDA and have shown good clinical efficacy in patients.
Unlike growth on tissue, microbes can grow freely on implantable devices with minimal immune system intervention and often form resilient biofilms that continuously pump out pathogenic cells. The efficacy of antibiotics used to treat infection is declining due to increased rates of pathogenic resistance. A simple, one-step zwitterionic surface modification is developed to significantly reduce protein and microbial adhesion to synthetic materials and demonstrate the successful modification of several clinically relevant materials, including recalcitrant materials such as elastomeric polydimethylsiloxane. The treated surfaces exhibit robust adhesion resistance against proteins and microorganisms in both static and flow conditions. Furthermore, the surface treatment prevents the adhesion of mammalian fibroblast cells while displaying no cytotoxicity. To demonstrate the clinical efficacy of the novel technology in the real-world, a surface-treated, commercial silicone foley catheter is developed that is cleared for use by the U.S. Food and Drug Administration (K192034). 16 long-term catheterized patients received surface-treated catheters and completed a Patient Global Impression of Improvement (PGI-I) questionnaire. 10 out of 16 patients described their urinary tract condition post implantation as much better or very much better and 72% (n = 13) of patients desire to continue using the surface-treated catheter over conventional latex or silicone catheters.

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