Elizabeth Brisbois, PhD, Assistant Professor of Materials Science and Engineering now at the University of Georgia, discusses her development of biocompatible nitric oxide releasing polymers for medical device applications.
Tell me what this new coating is and how did the idea come about?
Elizabeth Brisbois: Let me explain what the challenge is that we are trying to tackle. One of the problems with many medical devices used in patients suffer is that these devices from either clotting or infection issues. Most of the current medical devices that are on the market only address one of these problems at a time. So, our goal is to develop new materials that can prevent both clotting and infections simultaneously in order to make these medical devices more robust. One of the devices that we are really focused on is catheters because they are one of the medical devices that are so commonly used in patients and they have extremely high rates of infection and clotting issues.
Why was there never a thought that you should reduce the risk of infection as well as prevent blood clots, not just one or the other?
Elizabeth Brisbois: It goes back to the kind of materials that have been developed by the companies or the predominate issue that a particular medical device faces. For example, there are some companies who manufacture catheters that have antibiotics or silver compounds, and those compounds have the antimicrobial action to prevent infections, but they do not do anything to reduce the clotting issues.
Tell me about the coating that you are working on. What exactly is it?
Elizabeth Brisbois: One of the key material components that we are developing for these catheter applications is a small molecule that is called nitric oxide. Nitric oxide is a molecule that our body produces, and it is powerful because it has a lot of different biological functions. One thing that nitric oxide in our body does is prevents platelets from getting activated, which is key part of the clotting process. So, in our materials we can use the nitric oxide to prevent platelets from getting activated, then the clots will not form on the catheter. Another property that we are trying to take advantage of is that our immune system also produces nitric oxide to kill bacteria. So, if our materials mimic the nitric oxide production that our body does, then we can kill bacteria that might be causing infections on the catheters.
How far along in the process are you now?
Elizabeth Brisbois: Since this grant just got funded, we are in the early stage of the project where we are designing and synthesizing new compounds that we need to make these new catheter materials. So, we are really in the early stage.
With nitric oxide are there any potential side effects or downsides that might occur in some people?
Elizabeth Brisbois: I think one advantage in the way we are designing the materials is they basically mimic the nitric oxide that is already present in our body, which I would consider to be an appropriate level. Another thing people ask about is whether these materials have any toxic effects because they are synthesized in the lab. The good news that we have observed so far is that because we are mimicking the nitric oxide level in the body, we do not have any toxic effects.
Because you have the funding right now, what are the next steps?
Elizabeth Brisbois: With this funded grant, our research will have three main phases. Right now, we are in the initial design phase where we are designing the materials, synthesizing them, and optimizing the formulations. The second phase is the in-vitro testing that we do in the lab where we take the new materials that we developed and study them in simple in-vitro models. So we might work with one single strain of bacteria and see how well our materials can kill it or maybe we will work with isolated platelets to see whether the materials can function properly to prevent the platelets from being activated. We can use those simple models to help us further optimize the materials that we are developing. Then the third phase is moving our best materials into clinically relevant animal models. At that stage we would essentially fabricate test catheters and use them in an animal model just like they would be used in a human patient. This way we can see in detail how they will perform and compare them to some of the best commercial standards and see which ones perform better.
How long do you think it will be used in a clinical setting?
Elizabeth Brisbois: I always hope with medical devices that we can get these things to market fast because one of our major motivations is to help improve health care and make these devices safer for patients. But at the same time, we have a lot of regulatory standards and FDA approvals that needs to be done to get this on the market. So, it is kind of a tricky process and some of the regulatory things can slow it down quite a bit. But I hope that in the next five to 10 years, we start seeing some of our most successful materials on the market.
What implications will this have for the medical world knowing they can reduce the patient’s risk of both, getting the bacterial infection and blood clots?
Elizabeth Brisbois: I think there would be a lot of implications. It would reduce a lot of the complications that happen with patients, so their care would be a lot smoother and reduce the chances of costly and potentially deadly complications. Reducing the risks of complications that might arise when they have a simple catheter in their body will help improve the longevity of these devices. There are financial implications as well. I know some statistics say that for a single catheter infection it can cost an extra $50,000 in healthcare costs to deal with the infection. So, designing new material or new catheter that can prevent an infection and clotting will improve the patient’s care and also reduce excess costs.
Are there any other devices this could be used for besides catheters?
Elizabeth Brisbois: In our current project, we are focused on catheters because they are widely used in medicine and suffer from both infection and clotting issue when used with patients. But there are so many other medical devices that are commonly used that also suffer from these complications. We can take these materials we are developing and apply them to other devices as well. So, these materials could be applied to large devices like cardiopulmonary bypass machines or hemodialysis because those machines have a lot of clotting issues, but it also could be applied to other devices that might have infection issues like endotracheal tubes or urinary catheters. I think that one of the most exciting aspects of our research is the broad applicability of the materials we are developing and their potential to improve a wide range of medical devices that are essential to patient care.
Is there anything that I did not ask you that you want people to know?
Elizabeth Brisbois: So, I talked a bit about the nitric oxide molecule, which is particularly important. But another key component to these materials we are developing is combining the nitric oxide release with surface functionalities that prevent different blood components from sticking to the catheter surface. This enables us to have this dual mechanism to protect the catheter surfaces where the nitric oxide can actively kill bacteria and prevent the clotting, but we also have the surface modification component which prevents anything adhering to the catheter. So, one of our ultimate goals is to see how well the two mechanisms play together to prevent the clotting and infection issues.
Interview conducted by Ivanhoe Broadcast News.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Robert Wells
Sign up for a free weekly e-mail on Medical Breakthroughs called First to Know by clicking here
