Biomedical Engineering Reference
In-Depth Information
To examine the effects of H 2 O 2 on the phenotype of endothelial cells H 2 O 2
was added for 24 h to HDMEC growing on PS and Ti6Al4V alloy. 0.5 mM
H 2 O 2 did not induce marked changes in the phenotype of HDMEC on PS
(Fig. 4.4 ). The cells retained their spindle-like shape, organised alignment and
the degree of confluence. HDMEC grown on Ti6Al4V alloy appeared to be more
in fl uenced by H 2 O 2 . The alignment of the cells became more disordered, most
of the cells lost the spindle-like shape and appeared rounded, and the amount
and the size of the gaps in the cell monolayer increased. In general this points to
the higher toxicity of H 2 O 2 to HDMEC grown on Ti6Al4V alloy, compared to
HDMEC on PS.
As already mentioned, H 2 O 2 can induce oxidative stress in endothelial cells
by promoting ROS formation. This is achieved by several mechanisms, includ-
ing activation of ROS production by mitochondria, NADPH oxidases, xanthine
oxidase, uncoupled eNOS, etc. [ 6 ] . H 2 O 2 in the cell can also undergo the Fenton
reaction in the presence of metal ions, resulting in the formation of highly toxic
hydroxyl radicals. Using the DCF-assay higher levels of ROS was observed in
endothelial cells grown on Ti6Al4V alloy 1 h after H 2 O 2 addition compared to
the cells on PS [ 87 ]. DCF is the resulting oxidation product from DCDHF,
which is oxidised by peroxyl radical, peroxynitrite and also H 2 O 2 [ 25 ] .
Therefore, increases in DCF-fluorescence can be explained through oxidation
by H 2 O 2 , which enters the cell. However, since the H 2 O 2 concentration remain-
ing in the medium 1 h after its addition is nearly similar on both materials the
higher DCF-fluorescence in cells grown on Ti6Al4V alloy might reflect further
ROS production. One possible explanation for this could be the formation of
ROS due to the reactivity of H 2 O 2 with the TiO 2 layer. A study by Lee et al. [ 44 ]
showed that · OH were formed during the interaction of TiO 2 and H 2 O 2 in vitro,
while UV-irradiated TiO 2 reacting with H 2 O 2 could produce · O 2 −. Other stud-
ies, on the contrary, demonstrate no formation of · OH in the reaction between
H 2 O 2 and TiO 2 [ 84, 85 ]. Tengvall et al. suggested that a Ti-peroxy gel is formed
as a result of the interaction of Ti with H 2 O 2 [ 85 ]. This gel is believed to trap
· O 2 − [ 84 ]. Interestingly, in the absence of serum, Ti-peroxy gels could decrease
ROS production by activated leukocytes [ 43 ]. Opposite effects of Ti-peroxy gel
were also reported. Thus, while the TiO 2 layer was acting as a scavenger for
· OH, the Ti-peroxy gel could amplify detrimental effects of · OH on ECM pro-
teins, as well as cause these effects alone in vitro [ 83 ]. High amounts of H 2 O 2
are needed to produce Ti-peroxy gel in vitro. Such conditions are probably
unachievable in vivo, although the formation of Ti-peroxy gel and trapping of
radicals could hypothetically contribute to the tissue reactions to the implant
over longer time periods. This may also be a reason for a relatively better per-
formance of Ti materials compared to other metal materials. However, higher
ROS formation in HDMEC on Ti6Al4V alloy shown in this study favours the
interaction of H 2 O 2 with the TiO 2 layer on the alloy surface. It is also known
that traces of iron are present in titanium alloys (according to ASTM F136
Ti6Al4V is allowed to have up to 0.2 % Fe). The presence of iron in titanium
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