Вы находитесь на странице: 1из 11

View Article Online

View Journal

Journal of
Materials Chemistry B
Accepted Manuscript

This article can be cited before page numbers have been issued, to do this please use: L. Xu, T. Zhang, H.
Dong, D. Cai, H. Han, Q. Meng, Y. Tang, Q. Meng, Z. Gong, T. Zhang, Z. Zhang, H. Yan and K. Liu, J. Mater.
Chem. B, 2016, DOI: 10.1039/C6TB00235H.

This is an Accepted Manuscript, which has been through the


Royal Society of Chemistry peer review process and has been
accepted for publication.

Accepted Manuscripts are published online shortly after


acceptance, before technical editing, formatting and proof reading.
Using this free service, authors can make their results available
to the community, in citable form, before we publish the edited
article. We will replace this Accepted Manuscript with the edited
and formatted Advance Article as soon as it is available.

You can find more information about Accepted Manuscripts in the


Information for Authors.

Please note that technical editing may introduce minor changes


to the text and/or graphics, which may alter content. The journal’s
standard Terms & Conditions and the Ethical guidelines still
apply. In no event shall the Royal Society of Chemistry be held
responsible for any errors or omissions in this Accepted Manuscript
or any consequences arising from the use of any information it
contains.

www.rsc.org/materialsB
Page 1 of 10 Please
Journal ofdo not adjustChemistry
Materials margins B
View Article Online
DOI: 10.1039/C6TB00235H

Journal Name

Journal of Materials Chemistry B Accepted Manuscript


ARTICLE
Published on 06 May 2016. Downloaded by University of Pennsylvania Libraries on 11/05/2016 03:45:19.

Cross-linking strategy provides a new generation of biodegradable


and biocompatible cyanoacrylate medical adhesives
Received 00th January 20xx,
Accepted 00th January 20xx
Liang Xua, Tao Zhanga, Huajin Donga, Dazheng Caiab, Han Hana, Qingbin Menga, Yongjia Tanga,
DOI: 10.1039/x0xx00000x Qingguo Mengb, Zehui Gonga, Tianhong Zhanga, Zhenqing Zhanga, Husheng Yanc*, Keliang Liua*
www.rsc.org/ Addition polymerization usually results in polymers with long carbon-carbon main chains. Cyanoacrylate (CA) is arguably
an important example of such polymerization and has obtained widespread acceptance as an all-purpose adhesive.
However, CA-based medical adhesives have never been approved by the U.S. Federal Drug Administration for use below
the skin, mainly due to the low biodegradability and biocompatibility of their solid glue after polymerization. In this
research, a cross-linking strategy involving the combination of alkyl-CA and the cross-linking agent poly(ethylene glycol)-
di(cyanoacrylate) (CA-PEG-CA) to form a copolymeric network was used to synthesize a new generation of biodegradable
CA medical adhesives. The degradability could be modulated by adjusting the ratio of CA-PEG-CA to alkyl-CA and the
length of PEG. An optimal composite adhesive, LKJ11, was shown to have excellent biodegradability, adhesive capability,
and biocompatibility. Importantly, the molecular weight of the polycyanoacrylate chains in the polymerized LKJ11 was
greatly reduced than those polymerized from pure butyl-CA. Thus, the degradation product could be readily extracted. The
results showed that LKJ11 represents a new generation of CA-based biodegradable medical adhesives to date. This
advance also provides a general strategy to facilitate the conversion of other polymers with long carbon-carbon main
chains to a biodegradable form, thereby expanding the novel applications available for traditional polymeric materials.

biodegradable. In addition, the polymers always have huge


Introduction molecular weights (hundreds of thousands of Daltons), far beyond
[12]
the extent that the human kidney can filter. A long-time
Addition polymerization usually results in polymers with long
persistence in vivo may cause inflammation, tissue necrosis, or even
carbon-carbon main chains, which are not very biodegradable [13,14]
potential carcinogenicity. Furthermore, the persistence will
under most normal conditions. Cyanoacrylate (CA) is an important
cause continuous generation and accumulation of formaldehyde in
example of such polymerization and has obtained widespread
treated sites by a reverse-Knoevenagel reaction pathway (although
acceptance as an all-purpose adhesive since it was first synthesized [15]
[1-7] with low efficiency), which is also responsible for the
in 1949. The liquid monomers can undergo an almost [16,17]
cytotoxicity. Chemically modifying the alkyl chain with moieties
instantaneous polymerization when applied to amine or water- [18,19]
including etheric oxygen or ester groups and physically
containing substances such as skin and tissues, resulting in a stable
blending with other components such as a plasticizer have been
material with water-resistant adhesive strength; these properties [20]
reported to improve the elasticity and toxicity. However, these
thus facilitate medical applications such as closing surgical incisions
[8,9] modifications do not affect the chemical characteristics of CA-based
or trauma lacerations. However, commercialized CA medical
polymerization, and most of them do not shorten the long carbon-
adhesives (mainly butyl-CA, octyl-CA, and 2-octyl-CA) have never
carbon main chains in PCA. Therefore, the drawback of poor
been approved by the U.S. Federal Drug Administration for use
biodegradability of CA-based medical adhesives remains to be
below the skin, mainly due to the low biodegradability of their solid
[10,11] resolved.
glue after polymerization. Polycyanoacrylates (PCAs) usually
In this research, a cross-linking strategy was used to build up a
contain long carbon-carbon main chains and are almost non-
network structure for developing a new generation of CA-based
biodegradable medical adhesives (Figure 1). For this purpose,
poly(ethylene glycol)-di(cyanoacrylate) (CA-PEG-CA) was designed
as the cross-linking agent in the CA-based copolymer. The two
hydrolytically labile ester bonds and the flexible and water-soluble
PEG segment in the agent provide the potential for the polymer to
be biodegradable and biocompatible when it is copolymerized with
the alkyl-CA monomer. Specifically, during the copolymerization,
the steric hindrance of the PEG segments in the cross-linking agents
would hinder the diffusion of monomers and lower the efficiency of

This journal is © The Royal Society of Chemistry 20xx J. Name., 2013, 00, 1-3 | 1

Please do not adjust margins


Please
Journal ofdo not adjustChemistry
Materials margins B Page 2 of 10
View Article Online
DOI: 10.1039/C6TB00235H
ARTICLE Journal Name

H, I, and J: 100.0%, 61.2%, 61.6%, 36.1%, and 14.1, respectively)


than that of the control (Group K, 4.3%). It was also observed that

Table 1.Degradability of composite adhesives

Journal of Materials Chemistry B Accepted Manuscript


a)
Group Composite ratio Apparent degradation rate(%)

A 1:4 BCA:CA-TEG-CAb) 4.0±0.4


Published on 06 May 2016. Downloaded by University of Pennsylvania Libraries on 11/05/2016 03:45:19.

B 1:1 BCA:CA-TEG-CA 1.4±0.4

C 4:1 BCA:CA-TEG-CA 1.4±1.2


Figure 1.Graphical scheme of a biodegradable CA-based copolymer.
D 1:4 BCA:CA-PEG600-CA 100.0±0.0

linear polymerization; as a result, the PCA chains would become E 1:1 BCA:CA-PEG600-CA 61.2±1.6
much shorter than those polymerized from pure alkyl-CA. Since 4:1 BCA:CA-PEG600-CA 1.8±1.7
F
these short PCA chains are cross-linked by PEG, the PCA-PEG
network structure would still possess a huge molecular weight, G 1:4 BCA:CA-PEG2000-CA --C)
which is important for a strong adhesive capability. First, the cross- H 1:1 BCA:CA-PEG2000-CA 61.6±1.9
linked copolymer would be degraded in the interface into small
I 2:1 BCA:CA-PEG2000-CA 36.1±10.1
pieces at the ester sites between the PEG and PCA chains. Because
the PEG segments are water-soluble and would interrupt the tight J 4:1 BCA:CA-PEG2000-CA 14.1±3.8
alignment of pure PCAs, the copolymer would be partially swollen 100% BCA(control) 4.3±1.0
K
near the interface so that molecules around the copolymer would
exchange in and out in vivo. As a result, the copolymer degradation a)
Apparent degradation rate (100%) = (W0 – W1) / W0. W0 is the weight of the
would be further promoted into deep sites of the material. The polymerized composite adhesive before degradation, and W1 is the weight of the
degradation products, PEG and short PCA segments, both have residual glue after degradation. Data were collected after degradation in PBS
[21-23]
been approved for safety in the clinic and would be readily buffer (pH 7.0) for 14 days and are given as mean ± standard deviation; b)BCA,
excreted via the renal filtration process once their molecular butyl-cyanoacrylate; CA, cyanoacrylate; TEG, tetra(ethylene glycol); PEG,
weights were small enough. Moreover, this copolymer would elicit poly(ethylene glycol); C)
the two components could not mix uniformly and retain
improved biocompatibility with tissues over pure PCA because the transparent liquid state at room temperature.
PEG segments inside of the network would change the
physicochemical and metabolic properties. For the reasons stated
as the weight ratio of CA-PEG600-CA and CA-PEG2000-CA
above, it was reasonable to hypothesize that this cross-linked
increased, the apparent degradation rate increased as well. For
copolymer would be biodegradable and biocompatible so that
example, the apparent degradation rate of Group H (61.6%; 1:1 BCA
employing CA-based materials in vivo might become feasible.
to CA-PEG2000-CA) was higher than that of Group I and J (36.1%
and 14.1%, 2:1 and 4:1 of BCA to CA-PEG2000-CA, respectively).
Results and discussion A copolymer with a higher CA-PEG-CA content means that it
contains more ester groups or longer PEG chains. The former would
Three monomers, CA-tetra(ethylene glycol)-CA (CA-TEG-CA), CA-
have more hydrolytically labile sites, while the latter would result in
PEG600-CA, and CA-PEG2000-CA, were designed and synthesized
a looser and more hydrophilic network; therefore, both would
with different PEG lengths (supporting information). Butyl-CA (BCA)
favour network degradation. These results indicated that the
and CA-PEG-CA combined in appropriate weight ratios (Table 1,
degradability could be modulated both by adjusting the ratio of CA-
except group G) could mix uniformly and retain the transparent
PEG-CA to BCA and the length of the PEG chain. In addition, the
liquid state at room temperature. All these composite adhesives
adhesive capabilities were also found to be modulated by the
could polymerize to solid glue within 5–15 s once they made
composite ratios (Table S1, supporting information).
contact with skin or tissue.
Group H (named as LKJ11 below) was selected to clarify our
proposed strategy due to its excellent general properties as a
Apparent degradation rates in vitro
medical adhesive, including high monomer purity, proper
biodegradability, and adhesive capability.
A degradation test was carried out in vitro to evaluate the
degradability of each polymer. As shown in Table 1, different
Biodegradability of LKJ11
apparent degradation rates were observed for various composite
ratios of BCA to CA-PEG-CA. The composite adhesives containing
Molecular weight of PCA chains in the copolymer
CA-TEG-CA all showed low apparent degradation rates (Groups A, B,
and C: 4.0%, 1.4%, and 1.4%, respectively). While the composite To determine in vitro degradation, polymerized LKJ11 (P-LKJ11)
adhesives containing longer PEG chains (CA-PEG600-CA and CA- was detected by gel permeation chromatography (GPC) analysis. P-
PEG2000-CA) showed much higher degradation rates (Groups D, E, LKJ11 could swell but not dissolve in tetrahydrofuran (THF) before

2 | J. Name., 2012, 00, 1-3 This journal is © The Royal Society of Chemistry 20xx

Please do not adjust margins


Page 3 of 10 Please
Journal ofdo not adjustChemistry
Materials margins B
View Article Online
DOI: 10.1039/C6TB00235H
Journal Name ARTICLE

degradation due to its cross-linked structure; as a result, no obvious carbon-carbon main chains should not be degraded under these
peak was observed in the GPC chromatogram (Figure 2, line 1). conditions.
After incubation in phosphate-buffered saline (PBS) for 7 days, the The residues of adhesives with good apparent degradation rates

Journal of Materials Chemistry B Accepted Manuscript


Published on 06 May 2016. Downloaded by University of Pennsylvania Libraries on 11/05/2016 03:45:19.

(Table 1, Groups E and I) were also tested by GPC. Similarly, the


molecular weights were found to be lower than that of PBCA
Figure 2. GPC chromatogram results of the degradation test in vitro. Lines1,
2, and 3 designate P-LKJ11 before incubation in PBS, after incubation in PBS
for 7 days, and after incubation in PBS for 14 days, respectively; lines 4, 5,
and 6 designate PBCA before incubation in PBS, after incubation in PBS for 7
days, and after incubation in PBS for 14 days, respectively.

Figure 4. Photographs of muscle injected with LKJ11 or BCA at 1 day, 14


days, and 3 months after injection; the arrows and the dashed lines indicate
the polymers.

Figure 5. Pathological analysis of muscle applied with LKJ11 or BCA. Pictures


were taken at 1 month, 3 months, 6 months, and 15 months after injection.
Figure 3. Percentages of residual P-LKJ11 and PBCA in the long-term
degradation test. (Figure S3, supporting information). Together, these GPC results
indicated that copolymerization of alkyl-CA with a proper cross-
linking agent did result in a low degree of linear polymerization. In
residual solid glue could dissolve in THF; thus, polymers with a other words, the PCA chains in the copolymer were much shorter
molecular weight less than 4 kDa were detected in the GPC than those polymerized from pure alkyl-CA.
chromatogram (Figure 2, line 2). 1H-NMR analysis of the residue
further demonstrated the typical spectra of polybutylcyanoacrylate Long-term in vitro degradation test
(PBCA) and PEG (Figure S1, supporting information). Moreover,
polymers with a molecular weight of 2.3 kDa were detected in the The long-term in vitro degradation test was carried out in PBS
PBS buffer, which was revealed to be mainly PEG by 1H-NMR (Figure containing 50% bovine serum. As shown in Figure 3. The
S2, supporting information). This result indicated that the cross- percentages of P-LKJ11 residue at 7, 14, and 21 days were
linked structure degraded into linear or branched segments. In 36.7±3.2%, 3.3±2.5%, and 1.2±0.4%, respectively. After incubation
addition, the molecular weight of the residual glue was further for 28 days, the solid glue was completely dissolved in PBS solution,
reduced when the incubation time was extended to 14 days (Figure indicating that P-LKJ11 could be completely degraded in vitro. In
2, line 3). Subsequently, the molecular weights of these degradation contrast, the percentages of PBCA residue at 7, 14, 21, and 28 days
products were determined to be much less than the limit of the were 91.5±2.4%, 83.7±3.5%, 76.4±4.6%, and 74.0±5.7%,
human renal system (approximately 50–70 kDa). Therefore, they respectively. In addition, the higher degradation rate of either P-
would have the potential to be excreted in vivo. In contrast, the LKJ11 or PBCA in serum-containing PBS than in pure PBS indicated
control PBCA had a molecular weight of 367 kDa before that enzymatic hydrolysis might take place (the percentages of P-
degradation, as shown in the chromatogram (Figure 2, line 4), LKJ11 residue in pure PBS at 7, 14, 21, and 28 days were 51.5±0.5%,
indicating its huge linear structure after polymerization. After 38.4±1.9%, 30.1±3.4%, and 24.3±4.1%, respectively; the PBCA group
incubation for 7 days or 14 days in PBS, the molecular weight of the were 96.8±0.5%, 95.7±1.0%, 94.1±2.1%, and 91.7±2.4%,
residual polymers was still huge, 288 kDa and 242 kDa (lines 5 and respectively).
6), respectively. The decrease in molecular weight can be mainly
explained by hydrolysis of the butyl ester groups because the long Degradation tests in rabbit models and in rat models

This journal is © The Royal Society of Chemistry 20xx J. Name., 2013, 00, 1-3 | 3

Please do not adjust margins


Please
Journal ofdo not adjustChemistry
Materials margins B Page 4 of 10
View Article Online
DOI: 10.1039/C6TB00235H
ARTICLE Journal Name

An intramuscular degradation test was carried out in a rabbit increased the specific surface area and might facilitate the
model. LKJ11 or BCA was injected into the legs of rabbits, and the approach of solvent and enzyme molecules during degradation of P-
injected muscle was cut open at 1 day, 14 days, and 3 months after LKJ11. A water-vapor permeability test (Table S2, supporting
injection to observe the in vivo degradability of P-LKJ11 and PBCA. information) did demonstrate that P-LKJ11 possessed higher water

Journal of Materials Chemistry B Accepted Manuscript


As shown in Figure 4, both LKJ11 and BCA polymerized quickly into permeability than PBCA. These results provided further explanation
solid glue at the injection sites and looked the same after 1 day. P- to the better biodegradability of P-LKJ11compared to PBCA.
Published on 06 May 2016. Downloaded by University of Pennsylvania Libraries on 11/05/2016 03:45:19.

Table 2. The adhesive capability of LKJ11 and BCAa


Group shear tension T-peel Tension Wound
strength (kPa) strength strength closure
(N/cm) (kPa) strength(N)

LKJ11 190.8±31.4 1.21±0.36 418.1±39.3 9.75±3.2


LKJ11 was enlarged at 14 days, and the solid glue finally
Figure 6. Rate of radioactivity in urine, feces, stomach residue, and blood.
BCA 310.4±26.2 1.36±0.25 511.5±67.8 13.1±5.9

disappeared at 3 months. In contrast, PBCA still remained at the a


For each sample, six parallel experiments were performed to derive the
injection site after 3 months, and no significant changes were means ± standard deviations (SD).
observed under the same conditions.
A degradation test in a rat model was also carried out, and
sections were pathologically analyzed. As shown in Figure 5, for the Together, these in vitro and in vivo results revealed that our
LKJ11 group, only a small amount of gel remained visible after 3 cross-linking strategy did endow LKJ11 with biodegradability. The
months. The muscles on both sides of the original gel film almost copolymeric material could be degraded into small fragments, then
completely reconnected and regenerated, with only a few absorbed, and finally excreted. Key factors that enabled this
inflammatory cells. As time progressed, the inflammatory cells copolymeric material to be degraded included both the small
gradually disappeared and the muscle was able to recover molecular weight of the PCAs and the hydrolytic ester bonds in the
completely. In contrast, the solid glue of PBCA was still detectable copolymer network. However, it should be noted that difunctional
even after 15 months. As a result, the muscle tissue in the control bis(cyanoacrylate) monomers have been used previously to
BCA group did not recover, and inflammatory cell accumulation and increase the solvent resistance and mechanical strength of CA-
granulation tissue growth were detected. based materials.[26-28] These results can be mainly attributed to the
different structures of the cross-linking agents used. In addition,
Excretion test of radioactively labeled LKJ11 different ratios of cross-linking agents might also provide discrepant
biodegradabilities.
A radioactive LKJ11 biodegradation test was carried out to
further demonstrate that the partially or completely hydrolyzed Adhesive capability of LKJ11
PCA could be excreted from the rat body. One month after applying
the radioactive LKJ11 onto the stomach, 70.1% of the radioactivity The adhesive capability of LKJ11 was tested both in vivo and in vitro.
was detected in the urine and feces collected daily (62.1% and 8%,
respectively), with only 0.06% in the blood and 13.7% in the In vitro adhesive intensity test
stomach residue (Figure 6). In contrast, in the control BCA group,
only 20.2% of radioactive PBCA was excreted, and 70.3% remained The adhesive intensity of LKJ11 was tested according to national
on the stomach (Figure S4, supporting information). As standards of the medicine industry (YY/T 0729-2009). The results of
hypothesized above, the degradation products would be readily shear tension strength, T-peel strength, tension strength, and
excreted once the molecular weights were small enough. This result wound closure strength are given in Table 2. The bond strength of
was in line with the GPC analysis as the small molecular weight of LKJ11 was a little lower than that of BCA. However, it should be
the degradation products facilitated the excretion. As most of the pointed out that when used as tissue sealant or for small incision
radioactivity was detected in the urine and little was noticed in the adhesion, an effective adhesive capability should be interpreted as
blood, it might also be concluded that the degradation products stronger than the essential physiological requirement; as a result,
were mainly excreted by the glomerular filtration process. LKJ11 was further tested in vivo. As shown in the animal models
below, LKJ11 did provide enough adhesive capability when
Scanning electron microscopy test and water-vapor permeability used as a tissue sealant or for small incision adhesion.
test
Burst pressure of the rat intestinal wound test
In addition, a scanning electron microscopy test (Figure S5,
supporting information) showed that the P-LKJ11 membrane Because the adhesive effectivity might be affected by the
presented a rough and loose morphology, compared to the smooth degradation of LKJ11 in vivo, a burst pressure test in a rat intestinal
and compact morphology for PBCA. This physical characteristic

4 | J. Name., 2012, 00, 1-3 This journal is © The Royal Society of Chemistry 20xx

Please do not adjust margins


Page 5 of 10 Please
Journal ofdo not adjustChemistry
Materials margins B
View Article Online
DOI: 10.1039/C6TB00235H
Journal Name ARTICLE

wound model was carried out to assay the mechanical support Acute toxicity test
whether being maintained until the wound is cicatrized. Quickly
after application, the polymeric film of P-LKJ11 could firmly No acute toxicity was observed in a rat model. As shown in Figure
agglutinate the tissue wound. As shown in Figure 7, the burst 8, the body weight of the rats in the LKJ11 group increased as time

Journal of Materials Chemistry B Accepted Manuscript


pressure of the LKJ11 group at 0 h was 118.6±37.4 mmHg. As the progressed, similar to those in the control group fed a normal diet.
physiological intestinal peristaltic pressure of rats in vivo is 15 After 14 days, the rats were killed for pathological examination, and
mmHg, this result indicated that P-LKJ11 allowed the intestinal
wound to sustain the pressure to which it would be exposed. The no abnormalities were observed.
Published on 06 May 2016. Downloaded by University of Pennsylvania Libraries on 11/05/2016 03:45:19.

Figure7. The maximum tolerated pressure in the rat intestinal wound test.

burst pressure remained at a high level (more than 130mmHg)


during the wound recovery period (7-10 days), meaning that P-
LKJ11 maintained its efficacy throughout this timeframe. These
results also indicated that the degradation of P-LKJ11 during the
Figure8. Body weights of rats in the acute toxicity test.
wound recovery period did not influence the mechanical support
and that the degradation rate met the clinical requirements of
wound cicatrization. In the control group, animals injured but
without further treatment showed no burst pressure after
operation (0 h), and the burst pressure only increased gradually as
time progressed. Furthermore, intestinal fluid leakage was
observed before the wound fully recovered.

Guinea pig skin wound healing test


Figure9. Skin histopathology. A, normal rabbit skin; B, rabbit skin treated
The effectiveness of LKJ11 in maintaining adhesion was also with LKJ11.
demonstrated in a guinea pig surface wound model. As shown in
Figure S6 (supporting information), both LKJ11 and BCA
polymerized within 15s after application, generating a solid
polymeric film that adhered the incision together. Daily movement Skin irritation test
of the guinea pigs did not cause wound dehiscence or secondary
hemorrhage. The wounds treated with LKJ11 or BCA healed well No symptoms of erythema or edema in the treated area were
within 5–7 days, and the solid films gradually sloughed off observed after the skin irritation test in rabbits. The tissue section
spontaneously in approximately 5–10 days. Wounds without results showed that the epidermal structure of the skin of the LKJ11
treatment recovered slowly, and dehiscence was still detected after group was intact, and an obvious cutinized layer was visible. Cells of
7 days. epidermal appendages, such as dermal follicles and sebaceous
In addition, it was observed that the gel film of P-LKJ11 had glands, were arranged in an orderly manner; and vascular tissue,
better flexibility and plasticity than that of PBCA in this test. The collagen fibers, and other structures did not present proliferation,
polymeric film of P-LKJ11 felt soft when touched by hand. By which was in line with the normal tissue results (Figure9).
comparison, obvious shrinking (a hard lump) of PBCA was observed
on the skin surface, which even remained after 7 days. Moreover, Intracutaneous irritation test
as time progressed, partial loss of the gel films was more frequent
in the PBCA group due to its frangibility and hardness. This result No symptoms of erythema or edema in the test area were
might be due to the PEG2000 fragments introduced by our cross- observed after the intracutaneous irritation test in rabbits. The
linking strategy. This advantage is especially beneficial for use on results did not depend on whether sodium chloride solution or
soft tissue and will likely reduce the surface tension on wound sites. vegetable oil was used for the extraction, indicating that no
intracutaneous irritation occurred with the application of LKJ11.
Safety of LKJ11

This journal is © The Royal Society of Chemistry 20xx J. Name., 2013, 00, 1-3 | 5

Please do not adjust margins


Please
Journal ofdo not adjustChemistry
Materials margins B Page 6 of 10
View Article Online
DOI: 10.1039/C6TB00235H
ARTICLE Journal Name

Cytotoxicity Anthracene/ethyl α-cyanoacrylate adduct (A/ECA); ethyl 9,10-


dihydro-9,10-endoethanoanthracene-11-cyano-11-carboxylate (2)
The Hs27 cells that came into contact with medium exposed to P-
To a 250-mL three-neck flask fitted with a magnetic stirrer and
LKJ11 were observed to be normal, with no obvious cell death
condenser that was protected with the drying agent SO2 was added

Journal of Materials Chemistry B Accepted Manuscript


under microscopic examination (FigureS7, supporting information).
150 mL of anhydrous toluene, 60 g (0.48 mol) of ethyl 2-
The cell counting kit-8 assay further indicated that the cell growth
cyanoacrylate (ECA), and 87 g(0.48 mol) of anthracene. The
inhibition of LKJ11 was 16.42±9.26% (for PBCA, and positive control,
suspension was refluxed with stirring for 48 h, and the solvent was
this data was 22.57±16.76%, and 93.01±2.22% respectively). This
Published on 06 May 2016. Downloaded by University of Pennsylvania Libraries on 11/05/2016 03:45:19.

evaporated. After recrystallization of the residue twice with 200 mL


result indicated that LKJ11 was cytocompatible under the evaluated
of 95% ethanol, 130 g of the crude A/ECA adduct (2) was obtained
conditions.
in 88% yield and was used directly without further purification in
1
the next step.m.p.120–122 °C; H-NMR (400 MHz, CDCl3, 25 °C,
Conclusions TMS): δ 7.48 ppm (m, 1H; Ar-H), 7.30 ppm (m, 2H; Ar-H), 7.21 ppm
(m, 5 H; Ar-H), 4.87ppm (s, 1H;Ar-CH-C-CN), 4.43ppm (d, 3J(H,H)
In conclusion, a cross-linking strategy was utilized to develop
biodegradable CA-based medical adhesives. The biodegradation
rate of the copolymers could be modulated by changing the length
of the PEG chain and the ratio of CA-PEG-CA to BCA. An optimal
composite adhesive, LKJ11, was shown to have excellent
biodegradability, adhesive capability, and biocompatibility.
Importantly, the molecular weight of the PCA main chains in the
copolymer of P-LKJ11 was greatly reduced than those polymerized
from pure butyl-CA. Thus, the degradation product could be readily
extracted in vitro and excreted in vivo. LKJ11 represents a new
generation of CA-based biodegradable materials to date, and it has
the potential to be used in vivo as a sealant or tissue adhesive. For
example, its application may reduce the risk of anastomotic leakage
Scheme 1. The synthesis of CA-PEG-CA. Conditions: (i) anthracene, toluene,
in most general surgeries. To the best of our knowledge, this is the reflux, 48h; (ii) KOH; (iii)HCl; (iv)EDCI, DMAP; (v) maleic anhydride, xylene,
first detailed report of safely employing a nonbiodegradable reflux, 6h.
carbon-carbon polymeric material, in this case PCA, in vivo.
Moreover, this advance provides a general strategy to facilitate the
conversion of other polymers with long carbon-carbon main chains =2.4Hz,1H;Ar-CH-CH2), 4.15ppm (m, 2H;OCH2CH3), 2.80ppm (dd,
to a biodegradable form, thereby expanding the novel applications 2 2
J(H,H)=-12.8Hz, 1H;CH2CCN), 2.20ppm (dd, J(H,H)=-
available for traditional macromolecule materials that are 3
12.8Hz,1H;CH2CCN), 1.27ppm(t, J(H,H)=14.0Hz,3H;CH3); MS (50
polymerized from addition polymerization. +
eV):m/z(%):321.4 [M+NH4 ].

Anthracene/α-cyanoacrylic acid adduct (A/CAA); 9,10-dihydro-9,10-


Materials and methods endoethanoanthracene-11-cyano-11-carboxylaic acid (3)

Chemicals To a 1-L flask fitted with a stirrer and condenser was added 130 g
of the crude A/ECA product (2) and 400 mL of 95% ethanol. The
PEG was obtained from Sigma. Benzene and dimethylbenzene suspension was refluxed, 200 mL of KOH solution (3.6 M) was
were used after refluxing with sodium. Other commercially added slowly, and the solution was heated at reflux for 3 h. The
available reagents were used without further purification. Silica gel solution was quenched into 1500 mL of water and filtered, and the
TLC was carried out on HS GF254 plates (Yantai Institute of filtrate was washed with 600 mL of dichloromethane (DCM) to
Chemical Industry, China) and visualized under a UV light. Silica gel remove free anthracene. Next, the aqueous phase was acidified
(200–300 mesh, Qingdaohaiyang Chemical. Co., China) was used for with 6N HCl to pH 2 to precipitate the adduct. The solids were
1
flash column chromatography. The H-NMR spectra were recorded filtered, washed with water, and dried to afford 104 g of the A/CAA
on a JNM-ECA-400 spectrometer (JEOL, Japan). Chemical shifts are 1
adduct (3) in 78.8% yield. m.p.199–201 °C; H-NMR (400 MHz,
reported in ppm downfield from an internal TMS standard. CDCl3, 25 °C, TMS): δ 7.48 ppm (m, 1H; Ar-H), 7.30 ppm (m, 2H; Ar-
Synthesis of BCA H), 7.21 ppm (m, 4 H; Ar-H), 7.11 ppm (m,1H; Ar-H), 4.87 ppm (s,
3
1H;Ar-CH-C-CN), 4.43 ppm (d, J(H,H) =2.4Hz,1H; Ar-CH-CH2), 2.80
Butyl-CA (BCA) was synthesized according to a conventional 2
ppm (dd, J(H,H)=-12.8Hz, 1H;CH2CCN), 2.20 ppm (dd, J(H,H)=-
2
[24]
method and was purified by decompression distillation. 12.8Hz,1H;CH2CCN); MS (50 eV): m/z(%):274.3 [M+H ].
+

Synthesis of CA-PEG-CA Bis-anthracene/tetraethyene glycol bis(α-cyanoacrylate) adduct


CA-TEG-BCA (5a), CA-PEG600-CA (5b), and CA-PEG2000-CA (5c) (bis-A/tetraethyene glycol BCA); tetraethyene glycol bis(9,10-
[25] dihydro-9,10-endoethanoanthracene-11-cyano-11-carboxylate) (4a)
were synthesized according to Scheme 1.

6 | J. Name., 2012, 00, 1-3 This journal is © The Royal Society of Chemistry 20xx

Please do not adjust margins


Page 7 of 10 Please
Journal ofdo not adjustChemistry
Materials margins B
View Article Online
DOI: 10.1039/C6TB00235H
Journal Name ARTICLE

To 600 mL of DCM in a 1000-mLround-bottom flask was added Compound (5b) was obtained similar to compound 5a (74.2%
1
10.5 g (0.0382 mol) of A/CAA (3), 2.96 g (0.0152 mol) of yield). H-NMR (400 MHz, CDCl3, 25 °C, TMS): δ 7.08 ppm
tetraethyene glycol, 7.37 g (0.0384 mol) of EDC, and 0.49 g (0.004 (s,2H,H2C=C), 6.66 ppm (s,2H,H2C=C), 4.43 ppm (m,4H,COOCH2CH2),
mol) of DMAP. The solution was stirred at room temperature for 7 h 3.68 ppm (m, 54H; OCH2CH2).

Journal of Materials Chemistry B Accepted Manuscript


and washed with 200 mL of saturated NaHCO3 solution followed by
Polyethylene glycol 2000 bis(α-cyanoacrylate) (5c, CA-PEG2000-CA)
200 mL of saturated NaCl solution. The organic phase was dried
with anhydrous sodium sulfate overnight. The organic phase was Compound (5c) was obtained similar to compound 5a (89.0%
1
concentrated for flash column chromatography (3:1 petroleum yield). H-NMR (400 MHz, CDCl3, 25 °C, TMS): δ 7.09 (s,2H,H2C=C),
Published on 06 May 2016. Downloaded by University of Pennsylvania Libraries on 11/05/2016 03:45:19.

3
ether/ethyl acetate as the eluent). The product was obtained as a 6.66 ppm (s,2H,H2C=C), 4.43 ppm (t, J(H,H)=8.3Hz,4H; COOCH2),
1
white solid (8.02g, 74.3% yield). m.p.51–54 °C; H-NMR (400 MHz, 3.68 ppm (m, 232H; OCH2CH2).
CDCl3, 25 °C, TMS): δ 7.48 (m, 2H; Ar-H), 7.1–7.4 ppm (m, 14H; Ar-
In vitro apparent degradation rate test
H), 4.92 ppm (s, 2H, Ar-CH-C-CN), 4.42 ppm (s, 2H, Ar-CH-CH2), 4.87
3
ppm (s, 1H;Ar-CH-C-CN), 4.43 ppm (d, J(H,H) =2.4Hz, 1H;Ar-CH- A total of 100 mg of composite adhesive was polymerized into a
2
CH2), 4.22 ppm (m, 4H, COOCH2), 3.63 ppm (m, 12H; Ar-H), 2.80 piece of solid glue (2.5×3cm ), dried, and weighed. The solid glue
2 2
ppm (dd, J(H,H)=-12.8Hz, 1H;CH2CCN), 2.20 ppm (dd, J(H,H)=- was immersed into a continuously shaking conical flask containing
+
12.8Hz,1H;CH2CCN); MS (50 eV): m/z(%):731.6 [M+Na ]. 100mL of phosphate-buffered saline (PBS). After certain days at 37
°C, the residue was filtered, washed, dried, and weighed to
Bis-anthracene/polyethylene glycol 600 bis(α-cyanoacrylate)adduct
calculate the apparent degradation rate. Long term degradation
(bis-A/PEG600BCA); polyethylene glycol 600 bis(9,10-dihydro-9,10-
test was carried out in PBS containing 50% bovine serum that was
endoethanoanthracene-11-cyano-11-carboxylate) (4b)
changed every 2 days. For each sample, 6 parallel experiments were
Compound (4b) was obtained similar to compound 4a. The performed to derive the means ± standard deviations (SD) of
1
product was obtained as a yellowish oily liquid (57.3% yield). H- apparent degradation rate. 1.5 GPC analysis
NMR (400 MHz, CDCl3, 25 °C, TMS): δ 7.49 ppm (m, 2H; Ar-H), 7.1– R
GPC was performed on Waters 1515,Styragel HT2~4. The solid
7.4 ppm (m, 14H; Ar-H), 4.92 ppm (s, 2H, Ar-CH-C-CN), 4.42 ppm (s,
glue (25 mg) before and after incubation in PBS in the in vitro
2H, Ar-CH-CH2), 4.22 ppm (m, 4H, COOCH2), 3.63 ppm (m, 86H;
2 apparent degradation rate test was dissolved in dry THF (0.5 mL) for
CH2OCH2CH2), 2.80 ppm (dd, J(H,H)=-12.8Hz, 1H; CH2-C-CN), 2.20
2 testing, respectively. The mother liquor was evaporated and then
ppm (dd, J(H,H)=-12.8Hz,1H; CH2CCN); MS (50 eV):
extracted by THF for the test. At least 3 repeated experiments were
m/z(%):1166.76±44n[M+].
preformed.
Bis-anthracene/polyethylene glycol 2000 bis(α-cyanoacrylate)
Intramuscular degradation test in a rabbit model
adduct (bis-A/PEG2000BCA); polyethylene glycol 2000 bis(9,10-
dihydro-9,10-endoethanoanthracene-11-cyano-11-carboxylate) (4c) Healthy rabbits were anesthetized with Nembutal (30mg/kg, i.v.),
and a 10-mm-long incision on the lateral skin of the rear leg was cut
Compound (4c) was obtained similar to compound 4a (87.67%
1 to expose the muscles, without damaging the dermis.
yield. m.p. 28–31 °C). H-NMR (400 MHz, CDCl3, 25 °C, TMS): δ 7.50
Subsequently, 30 μL of adhesive was administered by intramuscular
ppm (m, 2H; Ar-H), 7.1–7.4 ppm (m, 14H; Ar-H), 4.93 ppm (s, 2H, Ar-
injection. LKJ11 and BCA (as the control) were injected,
CH-C-CN), 4.43 ppm (s, 2H, Ar-CH-CH2), 4.22 ppm (m, 4H, COOCH2),
2 respectively, into the left and right legs of the same rabbit. Next,
3.63 ppm (m, 172H; CH2OCH2CH2), 2.79 ppm (dd, J(H,H)=-12.8Hz,
2 the skins were sutured, and the rabbits were fed normally. The
1H; CN-C-CH2), 2.22 ppm (dd, J(H,H)=-12.8Hz,1H;CH2CCN); MS (50
injected muscle was cut open to observe the degradability at 1d,
eV): m/z(%):2225.98 [M+].
14d and 3 months, respectively. In total, 18 animals were used and
Tetraethyene glycol bis(α-cyanoacrylate) (5a, CA-TEG-CA) 6 animals were cut each time.
A solution consisting of 4.00 g (5.65 mmol) of bis-A/tetraethyene In vivo biodegradation test in a rat model
glycol BCA (4a), 3.32 g (33.8 mmol) of maleic anhydride, 5mg
Sprague Dawley rats were anesthetized with Nembutal (45
(0.0454mmol) of hydroquinone, and 15 mg (0.106mmol) of
mg/kg, i.p.), and a 2–3 cm incision in the skin was made on the back
phosphorous pentoxide in 50 mL of anhydrous xylene was stirred at
to expose the psoas major. An incision of 5–8 mm in length and 3–5
reflux for 6h. The solvent was evaporated in vacuo, and 30 mL of
mm deep on the psoas was made. A total of 10 μL of adhesive was
dry benzene was added to the residue; this process was repeated
applied on the inner sites of the incision, which bound the wound
three times. After another 30mL of dry benzene was added, the
together. LKJ11 and BCA (as the control) were used on each side of
slurry was filtered and the solvent was removed in vacuo again.
the same rat, respectively. Next, the skins were sutured, and the
DCM and anhydrous diethyl ether were used to precipitate the
rats were fed normally. The skins were cut open at certain time
product 5a (1.71 g, 75.3% yield).
points(1 month, 3 months, 6 months and 15 months), and the
1
H-NMR (400 MHz, CDCl3, 25 °C, TMS): δ 7.08 ppm (s, 2H,H2C=C), tissues at the incision sites were prepared into pathological sections
3
6.66 ppm (s, 2H,H2C=C), 4.43 ppm (t, J(H,H)=9.6Hz,4H; for observation of both the solid glue degradation and the tissue
3
COOCH2CH2), 3.80 ppm (t, J(H,H)=6.0Hz, 4H;COOCH2), 3.68 ppm regeneration status. In total, 28 animals were used and 7 animals
(m, 8H; OCH2CH2). were cut each time.

Polyethylene glycol 600 bis(α-cyanoacrylate) (5b, CA-PEG600-CA) Excretion test of radioactively labeled LKJ11

This journal is © The Royal Society of Chemistry 20xx J. Name., 2013, 00, 1-3 | 7

Please do not adjust margins


Please
Journal ofdo not adjustChemistry
Materials margins B Page 8 of 10
View Article Online
DOI: 10.1039/C6TB00235H
ARTICLE Journal Name
14 14
Radioactive C-labelled BCA was synthesized from C- These tests were carried out according to national standard of
[25]
formaldehyde according to methods published previously. The medicine industry (YY/T 0729-2009). For each sample, 10 parallel
-1
product with specific activity 33 MBq·ml was used to prepare experiments were performed to derive the means ± SD.
radioactive LKJ11. 5 rats (male 190-210 g) were anesthetized with
Acute toxicity test

Journal of Materials Chemistry B Accepted Manuscript


Nembutal (50 mg/kg, i.v.). Following abdominal incision, the
stomach was separated. A total of 5 μL of radioactive LKJ11 (about 12 male mice were used, including 6 in the LKJ11 group and 6 in
88 kBq) was applied onto the stomach surface. Next, the skin was the control group. All mice fasted for 24h before the test. P-LKJ11
sutured, and the rats were individually housed in motabolic cages. was ground to a powder and suspended in 0.5%
Published on 06 May 2016. Downloaded by University of Pennsylvania Libraries on 11/05/2016 03:45:19.

The urine and feces were collected every 24 hours for 30 days. carboxymethylcellulose aqueous solution to make a final
Finally, the rats were sacrificed, and the stomach and blood were concentration of 20%. A dose of 10g/kg (maximum tolerated dose)
collected. The radioactivity of the standard, blank or unknown was administered intragastrically to each mouse in the LKJ11 group.
sample (urine, blood, feces or stomach) was measured by LSC in a The control group received only 0.5% carboxymethylcellulose
Tri-Carb 2910TR liquid scintillation counter (PerkinElmer Inc., USA). aqueous solution. The mice were fed normally, and dynamic
Aliquots of urine (50 μl) were directly mixed with scintillation fluid changes of animal body weight were recorded.
cocktails and counted. Feces and stomach were homogenized with
Skin irritation test
addition of ethanol/water (50/50) at approximately 3 times of
original sample weight. Aliquots of fecal and stomach homogenates 6 healthy rabbits were selected. At 24h before the test, hair at
(approximately 0.3 g) and whole blood (approximately 0.2g) were both sides of the midline of the back was removed by sodium
14 2
combusted in a Packard Sample Oxidizer. The resulting CO2 was sulfide to prepare an area of approximately 8×8 cm . It was
trapped with scintillation fluid cocktails and assayed by LSC. The required that the skin was intact. A total of 0.1mL of LKJ11 was
radioactive recovery in each sample was calculated by dividing the coated onto the skin within a circular area with a diameter of 2.5
total radioactivity administrated. cm. The skin was covered with two layers of gauze and fixed with
nonirritant tape and a bandage. After 4h, the polymer was removed
Burst pressure of the rat intestinal wound test with warm water. Next, skin reactions were observed at 1h, 24h,
Sprague Dawley rats were anesthetized (50 mg/kg, i.v.), and their 48h, and 72h.
abdominal cavities were opened to separate a segment of the small
Intracutaneous irritation test
intestine (45 mm) for use. A hole of 2 mm in diameter on the small
intestine was made using a syringe needle. A total of 5 μL of LKJ11 6 rabbits used in the intracutaneous irritation test were prepared
was applied to seal the wound, after drying with cotton. The rabbits in the same manner as described in 2.12. P-LKJ11 was extracted
were then sutured and were fed normally. At certain time points, with 0.9% sodium chloride solution or vegetable oil (0.2 g in 6 mL,
the rat was opened again, one end of the operated small intestine 37 °C, 72 h). The extract was injected intracutaneously into the back
was ligated by silk sutures, and a small incision was made at the of a rabbit, and the injected area was observed at 24 h, 48 h, and
other end. A three-way tube, a pressure gauge, and a 72 h post injection.
tonotransducer were connected. The pressure was gradually
Cytotoxicity
increased until the small intestine was damaged to cause gas
leakage, namely the burst pressure value. Animals in the control Hs27 cells, obtained from Zhongyuan Union Cell and Gene
group had a hole created but not sealed. In total, 72 animals were Engineering Corp., Ltd, were cultured in Dulbecco’s modified Eagle
used and each group contained 36 animals. 6 animals in each group medium (DMEM) supplemented with 10% fetal bovine serum (FBS)
were cut each time. under standard conditions (37°C, 5% CO2). Cells were digested with
5
0.25% typsin-EDTA and were seeded at 1 × 10 cells/well in a 96-
Guinea pig skin wound healing test
well plate overnight. Compound Treatment: LKJ11 (100 μL) was
6 adult guinea pigs were sampled, and their back hair was polymerized in a 24-well plate. Then, 1.0 mL of DMEM containing
removed. The animals were anesthetized with Nembutal (50mg/kg, 10% FBS was added to each well, and the plate was incubated at
i.v.). After the back was disinfected, two incisions were made on 37°C for 24 h. Next, the extract was added to Hs27 cells to test the
each side of the back along the animal ridge; each incision was20 cytotoxicity of LKJ11 (100μL/well). After incubation for 72 h, a CCK-8
mm in length and reached the muscular layer. After hemostasis, the assay was used to determine the cell number. CCK-8 Assay: The old
skin incisions were aligned closely, and LKJ11 and BCA (as the culture medium was discarded, the Hs27 cells were washed with
control) were uniformly applied onto each wound surface, fresh PBS three times, 100 μL of new culture medium and 10μL of
respectively. The wounds were kept aligned manually for CCK-8 reagent were added, and the plate was incubated at 37 °C for
approximately 30s until the adhesive fully solidified. The guinea pigs 1.5 h before the optical density at 450 nm was measured. All
were fed normally, and the wound healing was observed over time. experiments were done in triplicate and repeated three times.
Negative control was DMEM containing 10% FBS. Positive control
T-peel strength test, tension strength test and wound closure
was DMEM containing 5% DMSO.
strength test
Animals

8 | J. Name., 2012, 00, 1-3 This journal is © The Royal Society of Chemistry 20xx

Please do not adjust margins


Page 9 of 10 Please
Journal ofdo not adjustChemistry
Materials margins B
View Article Online
DOI: 10.1039/C6TB00235H
Journal Name ARTICLE

Animals were supplied by Beijing Experimental Animal Center 19 China Patent: CN 101180085A.
(Beijing China). All of the procedures were carried out in accordance 20 P. Fadaie, M. Atai, M. Imani, A. Karkhaneh, S. Ghasaban.
with the standards established in the Guide for the Care and Use of Dent. Mater. 2013, 29, 61-69.
Laboratory Animals published by the Institute of Laboratory Animal 21 J. J. Verhoef, J. F. Carpenter, T. J. Anchordoguy, H.

Journal of Materials Chemistry B Accepted Manuscript


Resources of the National Research Council (United States), and Schellekens. Drug. Discov. Today. 2014, 19, 1945-1952.
also approved by the Animal Care and Use Committee of the Beijing 22 S. Abbad, C. Wang, A. Y. Waddad, H. Lv, J. Zhou. Int. J.
Institute of Pharmacology and Toxicology. All the efforts were made Nanomedicine. 2015, 10, 305-320.
to minimize the number of animals used and their suffering. 23 Q. Zhou, X. Sun, L. Zeng, J. Liu, Z. Zhang.
Published on 06 May 2016. Downloaded by University of Pennsylvania Libraries on 11/05/2016 03:45:19.

Nanomedicine, 2009, 5, 419-423.


24 F. Leonard, R. K. Kulkarni, G. Brandes, J. Nelson and J. J.
Cameron. J. Appl. Polym. Sci. 1966, 10, 259-272.
25 U.S. Patent 1959, No. 2,912,454.
26 C. J. Buck. J. Polym. Sci. Polym. Chem. Ed. 1978, 16, 2475-
Acknowledgements 2507.
Financial support from the National Science and Technology Major 27 P. Klemarczyk. J. Adhesion, 1999, 69, 293-306.
Project of China (2012ZX09301003) and the National Natural 28 A. Basu, I. Veprinsky-Zuzulia, M. Levinman, Y. Barkan, J.
Science Foundation of China (81573345) are gratefully appreciated. Golenser, AJ. Domb. Macromol Rapid Commun. 2015,
doi:10.1002/marc.201500567.

Notes and references


1 J. Kim, H. Singh Maan, A. J. Cool, A. M. Hanlon, D. J. Leffell. J.
Clin. Aesthet. Dermatol. 2015, 8, 24-29.
2 A. M. Imbuldeniya, A. Rashid, J. P. Murphy. J. Wound Care.
2014, 23, 456-458.
3 A. J. Singer, L. C. Perry, R. L. Jr. Allen. Acad. Emerg. Med. 2008,
15, 1290-1294.
4 L. Elemen, N. Sarimurat, B. Ayik, S. Aydin, H. Uzun. J. Pediatr.
Surg. 2009, 44, 581-586.
5 S. Spencker, N. Coban, L. Koch, A. Schirdewan, D. Mueller.
Europace. 2011, 13, 416-420.
6 A. Q. Fenger, H. C. Pommergaard, J. Burcharth, J. Rosenberg.
Ugeskr. Laeger. 2015, 177, V09140484.
7 M. R. Idle, A. M. Monaghan, S. M. Lamin, S. W. Grant. Br. J.
Oral. Maxillofac. Surg. 2013, 51, 565-567.
8 S. Hur, H. J. Jae, M. Lee, H. C. Kim, J. W. Chung. J. Vasc. Interv.
Radiol. 2014, 25, 10-19.
9 Z. E. Labby, N. Chaudhary, J. J. Gemmete, A. S. Pandey, D. A.
Roberts. Med. Phys. 2015, 42, 1739-1744.
10 P. I. Ellman, T. Brett Reece, T. S. Maxey, C. Tache-leon, J. L.
Taylor, D. J. Spinosa, et al. J. Surg. Rev. 2005, 125, 161-167.
11 G. Schneider, K. Otto. Eur. Arch. Otorhinolaryngol. 2012, 269,
1783-1789.
12 D. H. Park, S. B. Kim, K. D. Ahn, E. Y. Kim, Y. J. Kim, D. K. Han.
J. Appl. Polym. Sci. 2003, 89, 3272-3278.
13 M. N. Breshah, A. A. Sadakah, E. A. Eedrienv, K. A. Saad.
Tanta Dental J. 2013, 10, 67-74.
14 K. B. Bac, S. H. Kim, S. J. Jung, K. H. Hong. Int. J. Colorectal Dis.
2010, 25, 601-606.
15 F. Leonard, R. K. Kulkarni, G. Brandes, J. Nelson, J. J.
Cameron. J. Appl. polym. Sci. 2006, 10, 259-272.
16 C. Vauthier, C. Dubernet, E. Fattal, H. Pinto-Alphandary, P.
Couvreur. Adv. Drug Deliv. Rev. 2003, 55, 519-548.
17 B. Bakar, H. H. Oruckaptan, B. D. Hazer, I. Saatci, P. Atilla, K.
Kilic, et al. Neuroradiology, 2010, 52, 125-134.
18 B. Mizrahi, C. F. Stefanescu, C. Yang, M. W. Lawlor, D. Ko, R.
Langer, et al. Biomater. 2011, 7, 3150-3257.

This journal is © The Royal Society of Chemistry 20xx J. Name., 2013, 00, 1-3 | 9

Please do not adjust margins


Published on 06 May 2016. Downloaded by University of Pennsylvania Libraries on 11/05/2016 03:45:19.

67x29mm (300 x 300 DPI)


Journal of Materials Chemistry B
DOI: 10.1039/C6TB00235H
View Article Online

Journal of Materials Chemistry B Accepted Manuscript


Page 10 of 10

Вам также может понравиться