Mechanistic investigation of a hemostatic keratin biomaterial.

摘要

Traumatic injury leads to more productive years lost than heart disease, cancer and stroke combined. Trauma is often accompanied and complicated by uncontrolled bleeding. Human hair keratin biomaterials have demonstrated efficacy in controlling hemorrhage in both small and large animal models; however little is known about the mechanism by which these proteins aid in blood clotting. Inspection of the amino acid sequence of known keratins shows the presence of several cellular binding motifs, suggesting a possible mechanism and potentially eliminating the need to functionalize the material's surface for cellular interaction. In addition to small animal studies, the hemostatic activity of keratin hydrogels was explored through porcine hemorrhage models representing both a high flow and low flow bleed. In both studies, keratin hydrogels appeared to lead to a significant reduction in blood loss. The promising results from these in vivo studies provided the motivation for this project. The objective of this dissertation work was to assess the mechanism of action of a hemostatic keratin biomaterial, and more broadly assess the biomaterial-cellular interaction(s). It is our hypothesis that keratin biomaterials have the capacity to specifically interact with cells and lead to propagation of intracellular signaling pathway, specifically contributing to hemostasis. Through application of biochemical and molecular tools, we demonstrate here that keratin biomaterials contribute to hemostasis through two probable mechanisms; integrin mediated platelet adhesion and increased fibrin polymerization.;Platelets are the major cell type involved in coagulation both by acting as a catalytic surface for the clotting cascade and adhering to extracellular matrix (ECM) proteins providing a soft platelet plug. Because keratin biomaterials have structural and biochemical characteristics similar to ECM proteins, we utilized several adhesion assays to investigate platelet adhesion to keratin biomaterial surfaces. While other groups have discussed keratin's capacity to specifically adhere cells, this work was the first to utilize function blocking antibodies to deduce the specific receptors involved in mediating the cell-keratin interaction. To explore keratin's role in the second arm of coagulation, the clotting cascade, we followed the kinetic behavior of fibrin generation in the presence and absence of keratin. Confirmed with samples of plasma and a purified system of fibrinogen and thrombin, we observed an increased rate of fibrin polymerization in the presence of keratin proteins. The final goal of this project was to utilize a Chinese hamster ovary cell line to more specifically explore integrin-mediated cell interactions with keratin biomaterials in a controlled, biologically relevant system. Together, this work provides key details regarding keratin's hemostatic characteristics, providing the foundations for further development and optimizing of the material's unique characteristics for use as a hemostatic agent. More broadly, application of the CHO cell model could provide a useful tool for developing a receptor-ligand profile for keratin biomaterials.