The blood compatibility challenge. Part 3: Material associated activation of blood cascades and cells

• Published in: Acta biomaterialia Vol. 94; pp. 25 - 32
• Main Authors: Gorbet, Maud, Sperling, Claudia, Maitz, Manfred F., Siedlecki, Christopher A., Werner, Carsten, Sefton, Michael V.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2019; Elsevier BV
• Subjects: Blood; Blood clots; Blood compatibility; Cascades; Cell activation; Coagulation cascade; Compatibility; Complement; Complement activation; Fibrin; Fibrinogen; Leukocyte activation; Leukocytes; Platelet activation; Platelets; Protein adsorption; Thrombogenicity; Thrombosis; Blood compatibility; Complement; Platelet activation; Leukocyte activation; Thrombogenicity; Coagulation cascade
• ISSN: 1742-7061; 1878-7568; 1878-7568
• DOI: 10.1016/j.actbio.2019.06.020

[Display omitted] Following protein adsorption/activation which is the first step after the contact of material surfaces and whole blood (part 2), fibrinogen is converted to fibrin and platelets become activated and assembled in the form of a thrombus. This thrombus formation is the key feature that needs to be minimized in the creation of materials with low thrombogenicity. Further aspects of blood compatibility that are important on their own are complement and leukocyte activation which are also important drivers of thrombus formation. Hence this review summarizes the state of knowledge on all of these cascades and cells and their interactions. For each cascade or cell type, the chapter distinguishes statements which are in widespread agreement from statements where there is less of a consensus. This paper is part 3 of a series of 4 reviews discussing the problem of biomaterial associated thrombogenicity. The objective was to highlight features of broad agreement and provide commentary on those aspects of the problem that were subject to dispute. We hope that future investigators will update these reviews as new scholarship resolves the uncertainties of today.