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Calcium-modified microporous starch with potent hemostatic efficiency and excellent degradability for hemorrhage
Fangping Chen1, Xiaoyan Cao, Xiaolong Chen
1The State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, P. R. China. fpchen@ecust.edu.cn liucs@ecust.edu.cn.
Abstract:
Effective hemorrhage control is vital for reducing mortality after major trauma both in civilian life and in the military. In recent years microporous starch (MS) has been used as a hemostatic agent. However, MS has an insufficient hemostatic capacity to stop severe bleeding. To improve its hemostatic performance, in this study calcium-modified microporous starch (CaMS) was firstly developed via oxidization and self-assembly with calcium ions (Ca2+) on MS, and the hemostasis efficiency and degradation behaviour were evaluated. The results showed that the carboxyl groups and Ca2+ had been modified successfully onto MS. MS and CaMS both initiated the hemostatic response by rapid absorption and swelling due to their porous structure and high surface area. It is noteworthy that CaMS activated an intrinsic pathway of coagulation cascade and induced platelet adhesion because of the modified Ca2+ and carboxyl groups. The synergistic effects of the chemical activation mechanism and physical absorption mechanism resulted in a dramatic improvement in the hemostatic capacity of CaMS, and thus achieved an effective hemorrhage control in rabbit liver and femoral artery injuries. Additionally, the degradation of CaMS was improved greatly by the modification. In conclusion, CaMS effectively improved hemostatic performance and degradability. CaMS is a promising candidate for designing hemostatic agents in more extensive clinical applications.
Insights
Calcium-modified microporous starch (CaMS) enhances hemostasis by activating coagulation and improving absorption. This novel hemostatic agent shows improved performance and degradability for severe bleeding control.
Area of Science:
- Biomaterials Science
- Trauma Care
- Hemostatic Agents
Background:
- Effective hemorrhage control is critical for reducing trauma-related mortality.
- Microporous starch (MS) is a hemostatic agent with limited capacity for severe bleeding.
- Improving hemostatic performance and degradability is essential for clinical applications.
Purpose of the Study:
- To develop and evaluate calcium-modified microporous starch (CaMS) as an improved hemostatic agent.
- To investigate the hemostasis efficiency and degradation behavior of CaMS.
- To assess CaMS for controlling severe bleeding in preclinical models.
Main Methods:
- Calcium modification of MS via oxidation and self-assembly with calcium ions (Ca2+).
- Evaluation of hemostatic efficiency through absorption, swelling, coagulation cascade activation, and platelet adhesion.
- Assessment of degradation behavior.
- In vivo testing in rabbit liver and femoral artery injury models.
Main Results:
- Successful modification of MS with carboxyl groups and Ca2+ to form CaMS.
- CaMS demonstrated rapid absorption and swelling, similar to MS.
- CaMS activated the intrinsic coagulation pathway and promoted platelet adhesion.
- CaMS achieved effective hemorrhage control in rabbit injury models.
- CaMS exhibited significantly improved degradation properties compared to MS.
Conclusions:
- CaMS effectively enhances hemostatic performance and degradability.
- The synergistic physical absorption and chemical activation mechanisms contribute to CaMS's efficacy.
- CaMS is a promising candidate for developing advanced hemostatic agents for clinical use.
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