Dexamethasone eluting polydopaminated polycaprolactone‐poly (lactic‐co‐glycolic) acid for treatment of tracheal stenosis

Author:

Morand Jacob1,McClellan Phillip2,Isali Ilaha2ORCID,Dikici Yusuf3,Fan Di3,Li Longshun14,Shoffstall Andrew J.14,Akkus Ozan345,Weidenbecher Mark16

Affiliation:

1. Advanced Platform Center Louis Stokes Cleveland Veteran Affairs Medical Center Cleveland Ohio USA

2. Department of Urology Case Western Reserve University Cleveland Ohio USA

3. Department of Mechanical and Aerospace Engineering Case Western Reserve University Cleveland Ohio USA

4. Department of Biomedical Engineering Case Western Reserve University Cleveland Ohio USA

5. Department of Orthopedic Surgery University Hospitals Cleveland Medical Center Cleveland Ohio USA

6. Department of Otolaryngology Case Western Reserve University Cleveland Ohio USA

Abstract

AbstractTracheal stenosis is commonly caused by injury, resulting in inflammation and fibrosis. Inhibiting inflammation and promoting epithelization can reduce recurrence after initial successful treatment of tracheal stenosis. Steroids play an important role in tracheal stenosis management. This study in vitro evaluated effectiveness of a polydopaminated polycaprolactone stent coated with dexamethasone‐eluting poly(lactic‐co‐glycolic) acid microparticles (μPLGA) for tracheal stenosis management. Polydopamination was characterized by Raman spectroscopy and promoted epithelialization while dexamethasone delivery reduced macrophage activity, assessed by individual cell area measurements and immunofluorescent staining for inducible nitric oxide synthase (iNOS). Dexamethasone release was quantified by high‐performance liquid chromatography over 30 days. Activation‐related increase in cell area and iNOS production by RAW 264.7 were both reduced significantly (p < .05) through dexamethasone release. Epithelial cell spreading was higher on polydopaminated polycaprolactone (PCL) than PCL‐alone (p < .05). Force required for stent migration was measured by pullout tests of PCL‐μPLGA stents from cadaveric rabbit and porcine tracheas (0.425 ± 0.068 N and 1.082 ± 0.064 N, respectively) were above forces estimated to occur during forced respiration. Biomechanical support provided by stents to prevent airway collapse was assessed by comparing compressive circumferential stiffness, and stiffness of the stent was about 1/10th of the rabbit trachea (0.156 ± 0.023 N/mm vs. 1.420 ± 0.194 N/mm, respectively). A dexamethasone‐loaded PCL‐μPLGA stent platform can deliver dexamethasone and exhibits sufficient mechanical properties to anchor within the trachea and polydopamination of PCL is conducive to epithelial layer formation. Therefore, a polydopaminated PCL‐μPLGA stent is a promising candidate for in vivo evaluation for treatment of tracheal restenosis.

Funder

National Institute of Arthritis and Musculoskeletal and Skin Diseases

National Institutes of Health

Publisher

Wiley

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