U.S. patent application number 15/510235 was filed with the patent office on 2017-10-26 for method for treating a medical implant.
The applicant listed for this patent is ALBERT-LUDWIGS-UNIVERSITAET FREIBURG, BIOTRONIK SE & CO. KG. Invention is credited to Michael Bergmann, Andreas Bunge, Josef Horak, Loic Ledernez, Gerald Urban.
Application Number | 20170304501 15/510235 |
Document ID | / |
Family ID | 54337292 |
Filed Date | 2017-10-26 |
United States Patent
Application |
20170304501 |
Kind Code |
A1 |
Bunge; Andreas ; et
al. |
October 26, 2017 |
METHOD FOR TREATING A MEDICAL IMPLANT
Abstract
A method for treating a medical implant uses plasma
polymerization to apply a coating At least one treatment parameter
is selected so that the reactive chemical groups of the coating are
chemically modified to prevent an adsorption of interfering
substances into the coating. An implant includes a plasma polymer
coating that is biocompatible, and includes a antibiotically acting
metal. The coating is free from aldehyde groups
Inventors: |
Bunge; Andreas; (Leipzig,
DE) ; Bergmann; Michael; (Freiburg, DE) ;
Ledernez; Loic; (Freiburg, DE) ; Horak; Josef;
(Brno, CZ) ; Urban; Gerald; (Freiburg,
DE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
BIOTRONIK SE & CO. KG
ALBERT-LUDWIGS-UNIVERSITAET FREIBURG |
Berlin
Freiburg |
|
DE
DE |
|
|
Family ID: |
54337292 |
Appl. No.: |
15/510235 |
Filed: |
October 21, 2015 |
PCT Filed: |
October 21, 2015 |
PCT NO: |
PCT/EP2015/074359 |
371 Date: |
March 9, 2017 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61L 31/125 20130101;
A61L 31/146 20130101; A61L 27/44 20130101; A61L 31/128 20130101;
A61L 2300/406 20130101; A61L 2300/606 20130101; A61L 2400/12
20130101; A61L 2420/02 20130101; A61L 31/16 20130101; A61L 2400/18
20130101; A61L 27/54 20130101; A61L 27/56 20130101; A61L 2300/102
20130101; A61L 27/505 20130101; A61L 31/10 20130101; A61L 27/446
20130101; A61L 31/143 20130101; A61L 27/303 20130101; A61L 27/34
20130101; A61L 27/3616 20130101; A61L 27/507 20130101 |
International
Class: |
A61L 27/44 20060101
A61L027/44; A61L 27/30 20060101 A61L027/30; A61L 27/36 20060101
A61L027/36 |
Foreign Application Data
Date |
Code |
Application Number |
Oct 23, 2014 |
DE |
10 2014 221 587.0 |
Oct 23, 2014 |
DE |
10 2014 221 588.9 |
Claims
1. A method for treating a medical implant, the method comprising
the steps of: placing the implant into a plasma reactor; and
applying at least one coating to at least a portion of a surface of
the implant by plasma polymerization in the presence of oxygen and
at least one saturated hydrocarbon.
2. The method according claim 1, wherein said applying is carried
out in the presence of at least one saturated hydrocarbon selected
from the group consisting of saturated C1 to C6 hydrocarbons.
3. The method according to claim 1, wherein the coating is treated
with at least one reducing agent selected from the group consisting
of sodium borohydride, tris(hydroxymethyl)aminomethane (TRIS),
ethanolamine and glycine.
4. The method according to claim 1, wherein said applying is
conducted with coating parameters of 1 pascal (Pa) to 10 Pa, flow
rate of oxygen and at least one saturated hydrocarbon: 0 standard
cubic centimeters per minute (sccm) to 10 sccm, current intensity
of the plasma polymerization system: 100 milliamperes (mA) to 500
mA.
5. The method according to claim 1, wherein the plasma
polymerization is carried out in the presence of a metal, which is
thereby partially incorporated into the coating.
6. The method according to claim 5, wherein the metal is selected
from the group consisting of titanium, silver, copper, zinc,
mercury, tin, lead, bismuth, cadmium, chromium, and thallium, and
the alloys thereof.
7. The method according to claim 1, wherein said applying is
conducted in the presence of methane using the following coating
parameters: pressure: 5 Pa, flow rate of the methane coating gas:
2.5 sccm, flow rate of the oxygen coating gas: 1.3 sccm, current
intensity of the plasma polymerization system: 200 mA, electrode of
the plasma polymerization system: 100% titanium.
8. The method according to claim 1, further comprising sterilizing
the coating on the surface of the implant.
9. (canceled)
10. The implant according to claim 11, wherein the implant is
selected from the group comprising or consisting of: a biosensor, a
dialysis device, a drug delivery system, an electrode, a vascular
sleeve, a pacemaker, a cardiac pacemaker, a defibrillator, a
cardioverter, a brain pacemaker, a neuroprosthesis,
electrodes/electronics for artificial extremities, a
neurostimulator, a barostimulator, a kidney pacemaker, a duodenal
pacemaker, a cardiac implant, a tumor monitoring implant, an
artificial heart, an artificial heart valve, a shunt, a brain
shunt, a hydrocephalus implant, a telemetry unit, a receiver, a
transmitter, a pressure sensor, an organ substitute, an energy
harvesting implant, a bio fuel cell, a catheter, a cochlear
implant, a retinal implant, a dental implant, an artificial
implantable lens system, an implant for joint replacement, a
vascular prosthesis and a stent.
11. An implant comprising a coating, the coating comprising carbon,
nitrogen, oxygen and a metal, which is selected from the group
consisting of titanium, silver, copper, zinc, mercury, tin, lead,
bismuth, cadmium, chromium, and thallium, and the alloys
thereof.
12. The implant according to claim 11, wherein the metal is
titanium or a titanium alloy.
13. The implant according to claim 11, wherein the coating has a
layer thickness of 1 nanometer (nm) to 200 nm.
14. (canceled)
15. The implant according to claim 11, wherein the coating is free
from aldehyde groups.
16. An implant comprising a plasma polymer coating that is
biocompatible and includes a antibiotically acting metal, wherein
the coating is free from aldehyde groups.
Description
TECHNICAL FIELD
[0001] The invention relates to a method for treating a medical
implant and to coated medical implants.
BACKGROUND
[0002] Implants are used in medicine, which are introduced
permanently or at least for an extended period into an animal body
and/or a human body to fulfill replacement functions. Numerous
implants and systems may be considered for this purpose, such as
biosensors, dialysis tubing, drug delivery systems, pacemakers,
cardiac implants, implants for joint replacement, vascular
prostheses or stents.
[0003] Implants are typically identified by the organism as being
foreign after they are introduced in the body. In response to the
artificial surfaces, proteins aggregate thereon only a short time
after implantation due to non-specific protein adsorption. These
adsorbed proteins at least partially lose their three-dimensional
structures and serve as anchoring substrates for the aggregation of
cells. These proteins are recognized by cells (including by
thrombocytes, if the implant is introduced into the blood stream).
This triggers non-defined cell coverage and/or an extracellular
matrix of protein fibers (such as collagen) on the surface of the
implant. This process is generally referred to as a foreign body
reaction or fouling. Quite frequently, even collagen-containing
encapsulation of the implant can be observed.
[0004] Implants encapsulated in tissue may lose intended
functionality (for example, an analyte is able to reach the
biosensor only partially, with time delay, or not at all, pores of
a polymer membrane of the biosensor become clogged, or a stimulus
threshold for stimulating implants changes). Moreover, encapsulated
implants are more difficult to explant (for example, defective
stimulation electrodes are not explanted, but remain in the body).
In the human body, the described protein adsorption furthermore
acts as an initiator for a foreign body reaction and may ultimately
also lead to the formation of encapsulations and thrombi, which can
be life-threatening for the patient.
[0005] However, this is not the only severe risk for the patient.
Despite extensive progress in surgical medicine, infections
following the introduction of a sterilized implant still represent
very frequent complications. The adhesion of microorganisms
(adhesion phase) always marks the beginning of an implant infection
following implantation. The surface morphology and the
physicochemical properties of the implant material are relevant for
the adhesion of organisms to the implant surfaces. Binding is
favored if biopolymers (in particular polysaccharides) have already
adhered to the surface. Reproduction of the microorganisms results
in extensive, and later explosive, three-dimensional colonization
of the surface. The simultaneous bacterial synthesis of epoxy
polysaccharides and other organic molecules causes the bacteria to
be sheathed by a mucus-like matrix, which is referred to as a
biofilm. If the biofilm is formed across a large area, the body's
own antibacterial mechanisms as well as antibiotics are no longer
able to prevent the organisms from spreading further on the implant
and throughout the entire body. At times, this may result in
life-threatening situations. An infection manifests itself to the
patient by necrosis, chronic inflammations, abscesses,
endocarditis, myocarditis, sepsis and the like. As many as one in
five patients suffering from such infection dies within one year of
becoming infected.
[0006] The bacteria causing the infection are usually introduced
during implantation/revision surgery and cause either acute or
latent infections. Staphylococci are responsible for these
infections in 60 to 80% of cases (S. epidermis and S. aureus), but
other bacteria such as E. coli also play a role. If typical
antibiotic-(multi)resistant nosocomial microbes are introduced into
the body, the situation can become particularly critical. If an
infection involving biofilms occurs, it is frequently necessary to
replace the implant with a new implant (referred to as revision
surgery), since an antibiotics therapy alone is generally not
sufficient. From the point of view of health care costs, infections
pose a major problem; the administration of antibiotics alone may
result in costs of approximately 5000 euros in certain situations,
to which the costs for the new implant and the implantation are
added. Infections of the pacemaker pocket and/or of an electrode
system can occur with an incidence rate of up to 12%, for example.
Often times a single implant replacement does not suffice since
biofilms represent a focus of continuously recurring
infections.
[0007] If a combination of an encapsulation of the implant and a
bacterial infection occurs, the patient's immune system is
substantially defenseless since immune cells are not able to
penetrate to the bacterial center. This is particularly critical
when replacing the implant (for example, when the service life of
the implant is exhausted). During these replacements, the implant
is typically introduced into the capsule formed by the previous
implant. In general, this automatically also results in bacteria
being introduced into the body and the collagen capsule. An
infection of what is known as the pacemaker pocket generally forms
just the starting point. The infection can then spread along the
electrodes that are anchored in the heart. Medical procedures to
disrupt or even remove the collagen-containing capsule are complex
and presumably associated with a longer healing process.
[0008] In view of an aging and multimorbid population, the
complications that occur are particularly critical, and more
implant replacements are needed at the same lifetime of the
implants given patients' higher life expectancy. Multimorbidities,
which is to say the simultaneous occurrence of multiple chronic
diseases in a patient, pose additional risks. The risk of infection
of patients with pacemakers/defibrillators/CRT devices is
increased, for example, if they suffer from diabetes and renal
insufficiency.
[0009] It is therefore of great importance to improve the
compatibility of implants and substantially minimize a defense
reaction of the patient's body against the implant. An improvement
in the compatibility of visual prostheses, such as contact lenses,
that can be attached externally to the body is known to be
achievable by way of a coating, applied by way of plasma
polymerization (Evaluation of plasma polymer-coated contact lenses
by electrochemical impedance spectroscopy. Weikart C M, Matsuzawa
Y, Winterton L, Yasuda H K. J Biomed Mater Res. 2001 Mar. 15;
54(4):597-607.). While the coating protocols established for this
purpose achieved a successful reduction in accumulations,
adsorption still remains on such a critical scale that it is not
suitable for implants.
SUMMARY OF THE INVENTION
[0010] The invention provides methods for treating a medical
implant which drastically reduce, or else completely suppress,
non-specific adhesion of proteins and/or bacteria and consequently
allow a long-term use of implants that is low-risk for a patient.
The invention also provides an implant that evokes few to no
defense responses in the patient's body, and can thus be used to
treat pathological or undesirable disorders of a patient without
risk, the implant optionally being explantable again.
[0011] A preferred embodiment is a method for treating a medical
implant. At least one coating is applied to at least one surface of
the implant by way of plasma polymerization, and more particularly
to at least a portion of a surface. The coating generally includes
reactive chemical groups that are chemically modified to prevent an
adsorption of interfering substances into the coating.
[0012] A preferred embodiment medical implant is coated, at least
partially, with plasma polymer coating that is biocompatible and
mechanically, chemically and biologically stable. The coating
suppresses non-specific adhesion of proteins and/or bacteria.
Particular preferred coatings include at least aldehyde groups that
are chemically modified to suppress adhesion. A preferred
embodiment coating include carbon, nitrogen, oxygen and a metal,
which is selected from the group comprising or consisting of
titanium, silver, copper, zinc, mercury, tin, lead, bismuth,
cadmium, chromium, and thallium, and the alloys thereof.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] The invention will be described in more detail hereafter by
way of example based on exemplary embodiments illustrated in the
drawings. In the drawings:
[0014] FIG. 1 shows a schematic view of a magnetic field-enhanced
plasma polymer system in the low-pressure range;
[0015] FIG. 2 shows a sectional view through an implant in the form
of a biosensor, coated in the plasma polymer system of FIG. 1 with
a plasma polymer layer by way of the method according to the
invention;
[0016] FIG. 3 shows a diagram representing the atomic composition
of four different plasma polymer layers (Formulations I to IV),
which were generated by way of the plasma polymer system of FIG.
1;
[0017] FIG. 4 shows a diagram illustrating a progressing contact
angle as a function of a composition of respective used process
gases;
[0018] FIG. 5 shows a diagram illustrating a swelling factor as a
function of a composition of respective used process gases;
[0019] FIG. 6 shows a diagram illustrating the protein adsorption
as a function of a composition of respective used process
gases;
[0020] FIG. 7 shows a diagram illustrating the protein adsorption
as a function of a layer thickness of the coating;
[0021] FIG. 8 shows a diagram illustrating a vapor pressure curve
of different substances and of glycerol as a function of a
temperature;
[0022] FIG. 9 shows a diagram illustrating a pressure measurement
of four different arrangements in the plasma polymer system of FIG.
1;
[0023] FIG. 10 shows a diagram illustrating a sensor signal of a
polymer membrane of the biosensor of FIG. 2 for three differently
treated polymer membranes;
[0024] FIG. 11 shows a diagram representing the colonization with
E. coli bacteria as a function of the type of colonized
coating;
[0025] FIG. 12 shows a microscopic image with a 1:200 magnification
of an uncoated silicon surface having high bacterial
colonization;
[0026] FIG. 13 shows a microscopic image with a 1:200 magnification
of a silicon surface coated with a coating according to Formulation
III of FIG. 3 having low bacterial colonization;
[0027] FIG. 14 shows a diagram illustrating the colonization with
E. coli bacteria as a function of a layer thickness of the
coating;
[0028] FIG. 15 shows a diagram illustrating the progressing contact
angle as a function of the time for a sterilized coating and a
non-sterilized coating;
[0029] FIG. 16 shows a diagram representing a Fourier transform
infrared spectroscopy of a coating according to Formulation I of
FIG. 3;
[0030] FIG. 17 shows a diagram illustrating the results of an
immunoassay in which the protein adsorption as a function of a
treatment of the coating according to Formulation I of FIG. 3 was
examined;
[0031] FIG. 18 shows a perspective schematic drawing of an
alternative implant in the form of a model titanium cylinder,
coated in the plasma polymer system of FIG. 1 with a plasma polymer
layer by way of the method according to the invention, a biosensor
comprising a silicone cuff, and a cable;
[0032] FIG. 19 shows a photograph of the implant of FIG. 18 after
explantation;
[0033] FIG. 20 shows a schematic contour drawing of the explanted
implant of FIG. 19;
[0034] FIG. 21 shows a schematic drawing of a further alternative
implant in the form of a vascular sleeve;
[0035] FIG. 22 shows a schematic drawing of a vascular sleeve of
FIG. 21 placed around a blood vessel;
[0036] FIG. 23 shows a photograph of the uncoated implant of FIG.
22 after explantation;
[0037] FIG. 24 shows a schematic contour drawing of the explanted
implant of FIG. 23;
[0038] FIG. 25 shows a photograph of the implant of FIG. 22 coated
in the plasma polymer system of FIG. 1 with a plasma polymer layer
by way of the method according to the invention and after
explantation; and
[0039] FIG. 26 shows a schematic contour drawing of the explanted
implant of FIG. 25.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0040] Preferred methods of treatment select at least one treatment
parameter so that the reactive chemical groups of the coating are
chemically modified in a suitable manner. In this way, the
adsorption of interfering substances on the coating can be
prevented or minimized. As a result of the embodiment according to
the invention, it is possible to considerably reduce the adsorption
of interfering substances compared to surface modifications from
the related art. The method is used to generate a mechanically,
chemically and biologically stable coating, which was deposited in
the form of a plasma polymer and is treated such that it represents
a biocompatible interface, wherein the basic properties of the
surface, such as adhesion to the coated surface or a general
camouflaging function of the surface (for details see below),
remain intact over time. The modification of the coating is a
surface modification for implants to reduce the implantation risk.
The specifically selected physicochemical properties of the
coating, and thus of the implant surface, in combination with the
modification according to the invention of the reactive chemical
groups, reduce the aggregation of biomolecules and/or cells. This
prevents interactions with interfering substances, such as
constituent components of structures, such as tissue and/or body
fluids, which may come in contact with the implant, and more
particularly cells and/or molecular components, such as proteins,
salts, ions and/or any other interfering substance deemed harmful
by a person skilled in the art. This improves the suitability of
the implant for long-term uses in the body compared to coatings
from the related art. In particular, implants coated by way of a
method described herein are particularly suited for implantation,
preferably for long-term implantation, since the coating prevents
or minimizes ingrowth into the organism, whereby complication-free,
or at least complication-minimized, explantation is made possible.
This represents a significant advantage with respect to a
replacement of the implant compared to implants that were coated
according to a method from the prior art. Due to the method
proposed herein, it is furthermore possible to provide implants
that are not biocompatible with a biocompatible coating and prepare
a later explantation by way of the proposed coating.
[0041] A reactive chemical group shall be understood to mean a
group that has binding properties that favor an attachment to other
structures. Possible groups include, for example, van der Waals
forces, hydrogen bonds, ionic bonds, hydrophobic interactions,
interactions between charge-dipole, dipole-dipole, charge-nonpolar,
dipole-nonpolar, polar-polar or an entropy gain due to structural
changes of the protein (such as conformational entropy). A
modification represents a reversible or irreversible change, which
in particular transforms the reactive chemical group into another
group, and more particularly into a less reactive group or into a
group having lower binding energies. The modification in particular
causes a masking of the selected reactive chemical group of the
coating. Possible reactive chemical groups of the plasma polymer
layer would be hydroxyl, carboxyl, amine and/or aldehyde groups,
for example.
[0042] An implant here represents an aid that is introduced
permanently, or at least for an extended time period, into an
animal body and/or a human body, in particular invasively, to
fulfill a replacement function (long-term implant). The replacement
function is to be assumed over multiple days or weeks, and
preferably over multiple years or decades. The implant can be any
implant deemed appropriate by a person skilled in the art and may
be inserted intravenously, intraarterially, subcutaneously,
intracardially and epicardially, intravascularly and
extravascularly, for example. The implant is in particular selected
from the group consisting of: a biosensor, a dialysis device, a
drug delivery system, an electrode, a vascular sleeve, a pacemaker,
a cardiac pacemaker, a defibrillator, a cardioverter, a brain
pacemaker, a neuroprosthesis, electrodes/electronics for artificial
extremities, a neurostimulator, a barostimulator, a kidney
pacemaker, a duodenal pacemaker, a cardiac implant, a tumor
monitoring implant, an artificial heart, an artificial heart valve,
a shunt, a brain shunt, a hydrocephalus implant, a telemetry unit,
a receiver, a transmitter, a pressure sensor, an organ substitute,
an energy harvesting implant, a bio fuel cell, a catheter, a
cochlear implant, a retinal implant, a dental implant, an
artificial implantable lens system, an implant for joint
replacement, a vascular prosthesis or a stent. The method proposed
herein may furthermore be used to coat contact lenses and bone
implants, such as nails or screws. Preferred fields of use include,
for example, cardiac rhythmic management (CRM) devices, cardiac
pacemakers/defibrillators, implants for cardiac resynchronization
therapy (CRT), leadless pacers/defibrillators, as well as
implantable sensors (biosensors, pressure sensors), and drug
delivery systems. The implant can in particular also include
electrical components since it has been shown that these can also
be coated by way of the coating protocols according to the
invention without loss of unction.
[0043] In a preferred embodiment, the implant is selected from the
group comprising or consisting of a drug delivery system, a cardiac
pacemaker, a defibrillator, a biosensor, an electrode, an
artificial heart valve, a pacemaker, a receiver, and a transmitter,
or parts thereof.
[0044] In a further preferred embodiment, the implant is selected
from the group comprising or consisting of a drug delivery system,
a defibrillator, and an electrode.
[0045] Accordingly, the invention is furthermore based on an
implant treated by way of a method according to the invention
proposed herein, wherein the implant is selected from one of the
above-mentioned groups of possible implants.
[0046] An implant thus treated evokes few to no defense responses
in the patient's body and can thus be used to treat pathological or
undesirable disorders without risk. Moreover, the risks of
encapsulation and/or of a bacterial infection are minimized,
whereby, in the event of a loss of function, such an implant can
also be replaced in a way that is gentle on the patient. It was
therefore found that implants, which were coated according to a
method proposed herein, can advantageously be explanted since
growth of biological material on the implant is prevented, or
minimized to such an extent that explantation is possible without
complications.
[0047] Without being bound to this theory, it is assumed that
aldehyde groups, serving as reactive chemical groups, are
responsible, among other things, for the interaction activity of
the coating with adhering structures. It is thus particularly
advantageous if at least one treatment parameter is selected so
that at least aldehyde groups of the coating are chemically
modified. In this way, a less reactive coating is generated.
Effective modification can be achieved when the reactive chemical
groups or the aldehyde groups are reduced by way of a reducing
reagent. This process can moreover take place easily and quickly
when done chemically. The reduction can be carried out by way of
any reagent deemed appropriate by a person skilled in the art. The
reactive chemical groups of the coating or the aldehyde groups are
preferably reduced by way of at least one reducing reagent from the
group comprising or consisting of sodium borohydride,
tris(hydroxymethyl)aminomethane (TRIS), ethanolamine and glycine.
This selection allows usage of proven substances having well-known
properties. Sodium borohydride proved to be the most effective for
this purpose. The approach of subsequently chemically masking
reactive chemical groups that may interact with biomolecules helps
significantly improve the properties of the surfaces compared to
coatings from the related art. The treatment is carried out as
follows: dissolve 1 mg/ml NaBH.sub.4 in 10 mM PBS buffer, incubate
the surface to be modified for 1 hour at room temperature, followed
by one or more washing steps.
[0048] An interesting field of use would be that of modifying the
coating a biosensor, which includes at least one medical sensor
system, for example. A biosensor here shall be understood to mean a
sensor that is used to qualitatively and quantitatively ascertain
one or more medically relevant parameters. Furthermore, a sensor
system shall be understood to mean a system comprising at least one
sensor and/or a specific configuration or arrangement of measuring
or ascertaining components--this being a detection system--of the
biosensor. This sensor is described in more detail hereafter by way
of example. Such an implant can be used in particular to better
monitor and treat diseases, such as cardiac insufficiency, high
blood pressure, renal insufficiency and/or diabetes mellitus, which
are frequent, treatment-intensive and consequently expensive
chronic diseases. The described modification of the surface
coating, for example of a membrane of the biosensor, is suited
particularly well for an implant since many of the implant surfaces
come in contact with body fluid on a regular basis, in particular
blood, where defined ingrowth, or precisely no ingrowth, is of
particularly high significance.
[0049] Implant surfaces susceptible to adsorption include, for
example, those made of metal, metal alloys and/or transition
metals, compound materials, and resorbable materials. For example,
surfaces made of titanium, medical stainless steel, such as
preferably 316L, CoCr, gold, magnesium and polymers, are
conceivable for this purpose. Polymers may be either degradable in
the body under usage conditions or remain permanently in the body.
Furthermore, the sensor system may include further components, such
as additional sensors, a housing, electronic components, a power
supply unit, a telemetry unit, a control unit comprising evaluation
electronics, an anchoring element and/or any other component that
appears appropriate to a person skilled in the art.
[0050] Proteins represent a class of substances that are of medical
interest. These are involved in many important processes in the
blood in the body, for example as enzymes, transport means for
other molecules, or as clotting factors. It is of great interest,
in particular when a disease is present, to detect such proteins,
or the quantity or concentration of the same, in the blood, for
example. For this purpose, diagnostics employs, for example,
chemical, enzymatic, biochemical, molecular biological,
biotechnological, microbiological, nanotechnological, radioactive,
physical or optical methods. Proteins have a three-dimensional
structure that is defined by the amino acid sequence of the same
and that is used by the immune system employing specific antibody
recognition, wherein antibodies are able to distinguish foreign
from native proteins. This interaction between the antibody and
what is known as the antigen can be used for immunological
detection and has become established as a common method in in
vitrodiagnostics. This principle is also used in what is known as a
competitive displacement assay ("competition assay") to determine a
concentration of the antigen. Furthermore, in vitro methods using
no optically measurable markings for molecule detection are known.
For this purpose, field effect transistors (FETs) are used in
vitro, for example.
[0051] In recent decades, it has been shown that an in vitro
determination of analytes is often not sufficient to reliably
ascertain a current and up-to-date state of the analyte and a
condition of a patient associated therewith. Rapid intervention is
needed in particular with acute changes, for example in chronically
ill patients. In particular, continuous monitoring of analytes and
of the concentrations of the same over months, or even years, is
advisable. Accordingly, a need exists for a sensor system that is
able to reliably and quickly monitor analytes, for example, in vivo
over an extended period. It is particularly important in this
regard that the functionality is preserved for the longest time
possible, which can be ensured by the coating applied according to
the invention.
[0052] Using such a biosensor, it is possible to ascertain numerous
parameters, such as a pH value, an osmolality, a charge, such as of
an ion, a polyelectrolyte or a protein, a temperature, a
configuration, such as of a binding site, a size, a mass, a state
of matter, the water content, the hematocrit level, the partial
thromboplastin time, the plasma thrombin clotting time, the Quick's
value, a presence or an absence and/or a quantity of a substance
and/or of an analyte and/or any other parameter that is deemed
useful by a person skilled in the art.
[0053] In the majority of cases, however, a specific analyte is
measured, such as an electrolyte, a fat, a salt, an ion, a
polyelectrolyte, a carbohydrate, a fatty acid, a lipid, a sugar, a
nucleotide, a deoxyribonucleic acid, a ribonucleic acid, an amino
acid, a peptide, a protein, an antibody, a hormone, a
neurotransmitter, a metabolite, a metabolic product, an antigen, an
active ingredient, a drug, a nanoparticle, a toxin, water and/or
any other substance that is deemed expedient by a person skilled in
the art. It is also possible to ascertain a certain state of a
molecule, or what is known as a biomarker, which form a variable
component of the human or animal body, such as albumins/globulins,
alkaline phosphatase, alpha-1-globulin, alpha-2-globulin,
alpha-1-antitrypsin, alpha-1-fetoprotein, alpha-amylase,
alpha-hydroxybutyrate-dehydrogenase, ammonia, antithrombin III,
bicarbonate, bilirubin, carbohydrate antigen 19-9, carcinoembryonic
antigen, chloride, cholesterol, cholinesterase, chylomicron
remnants, cobalamin/Vitamin B12, coeruloplasmin, C-reactive
proteins, cystatin C, d-dimers, iron, erythropoetin, erythrocytes,
ferritin, fetuin A, fibrinogen, folic acid/Vitamin B9, free
tetraiodothyronine (fT4), free triiodothyronine (fT3),
gamma-glutamyltransferase, glucose, glutamate dehydrogenase,
glutamate oxalacetate transaminase, glutamate pyruvate
transaminase, glycohemoglobin, packed cell volume, hemoglobin,
haptoglobin, uric acid, urea, HDL cholesterol, homocysteine,
immunoglobulin A, immunoglobulin E, immunoglobulin G,
immunoglobulin M, INR, potassium, calcium, creatinine, creatine
kinase, copper, lactate, lactate dehydrogenase, LDL cholesterol,
leukocytes, lipase, lipoprotein, magnesium, corpuscular
hemoglobins, myoglobin, sodium, NT-proBNP/BNP, phosphate,
prostate-specific antigens, reticulocytes, rheumatoid factor,
thrombocytes, thyreoidea stimulating hormone, transferrin,
triglycerides, troponin T, and VLDL cholesterol.
[0054] An analyte shall also be understood to mean an "active
ingredient," wherein the term "active ingredient" includes typical
pharmaceuticals, or else metabolites, which are administered for
treating diseases, such as muscarinic receptor antagonists,
neuromuscular blocking agents, cholesterol esterase inhibitors,
adrenoceptor agonists, indirectly acting sympathomimetic drugs,
methylxanthine, alpha-adrenoreceptor antagonists, ergot alkaloids,
beta-adrenoceptor antagonists, inactivator inhibitors,
antisympathonic drugs, 5-HT receptor agonists, histamine receptor
agonists, histamine receptor antagonists, analgesics, local
anesthetics, sedatives, anticonvulsant drugs, convulsant drugs,
muscle relaxers, anti-Parkinson's drugs, neuroleptics,
antidepressants, lithium, tranquillizers, immunosuppressants,
anti-rheumatism drugs, antiarrhythmic drugs, antibiotics, ACE
inhibitors, aldosterone receptor antagonists, diuretics,
vasodilators, positive inotropic agents,
antithrombotic/thrombolytic substances, laxatives, antidiarrheal
drugs, pharmaceuticals for adiposity, uricostatic drugs, uricosuric
drugs, lipid lowering drugs, antidiabetics, antihypoglycemic drugs,
hormones, iodized salts, threostatic drugs, iron, vitamins, trace
elements, virostatics, antimycotics, antitubercular drugs, and
substances for tumor chemotherapy. The feature to be analyzed
preferably relates to a variable component of the animal and/or
human body. Many of these analytes can be determined in a body
fluid, such as lymph fluid, saliva, urine, gastric juice,
secretions of the pancreas, bile, sudor, lacrimal fluid and the
interstitial fluid, extracellular fluid, breast milk, female
vaginal secretion, lacrimal fluid, nasal discharge, ejaculate,
menstrual fluid, aqueous humor of the eye, cerebrospinal fluid,
ascites, pleural fluid, pericardial fluid, synovial fluid, amniotic
fluid, cerumen, pus, liquor and/or in particular blood, so as to
characterize the state of health of individuals, in particular in
the case of chronic diseases, such as cardiac insufficiency, or
renal insufficiency. The sensor system could be used, for example,
to detect a member of the cystatin family of the cysteine protease
inhibitors or to detect cystatin C, and would thus be a cystatin C
sensor.
[0055] A sensor shall in particular be understood to mean a
component that is able to qualitatively and/or quantitatively
detect an optical, physical, chemical, biochemical, molecular
biological, biotechnological, microbiological, nanotechnological,
radioactive, enzymatic and/or electrochemical property of the
feature in an environment of the sensor, for example in the form of
a measured variable. The detection system integrated into the
sensor is specifically tailored to the parameter to be
ascertained/measured, or the desired property, for this
purpose.
[0056] Such a sensor can include at least one semiconductor
component, for example. A semiconductor component here shall be
understood to mean a FET-based (field effect transistor-based)
active component, such as an seFET (extended gate field effect
transistor), an ISFET (ion-sensitive field effect transistor), an
EPROM (electrically erasable programmable read-only memory) or an
EEPROM (electrically erasable programmable read-only memory), a
capacitor, a nanotube, a nanowire and/or any other semiconductor
component deemed appropriate by a person skilled in the art. As an
alternative, an impedimetric, amperometric, potentiometric,
conductometric or capacitive system may be used as the sensor. This
design allows the sensor system to be implemented particularly
easily in a miniaturized format.
[0057] If implantable biosensors and dialysis devices are used, the
membranes have pores on a nanometer scale. The size or the diameter
of these pores is dependent on the size of the structure or
substance that is to pass the membrane. If the structures are in
the nanometer range, the pores can have a maximum diameter of 500
nm, preferably a maximum of 100 nm, more preferably a maximum of 50
nm, advantageously a maximum of 10 nm, and particularly preferably
a maximum of 1 nm. In larger structures, in contrast, a pore
diameter in the micrometer range, and more particularly of up to 50
.mu.m, preferably a maximum of 10 .mu.m, more preferably a maximum
of 1 .mu.m, and advantageously a maximum of 800 nm is
conceivable.
[0058] The membrane can be made of any material deemed appropriate
by a person skilled in the art, such as polysulfone,
polyarylethersulfone (PAES), polyethersulfone (PES), cellulose
ester (cellulose acetate, cellulose triacetate, cellulose nitrate),
regenerated cellulose (RC), nanocellulose silicone, polyamide
(nylon), polyamide imide, polyimide, polyamide urea, polycarbonate,
ceramic, titanium oxide, aluminum oxide, silicon, zeolite
(alumosilicate), polyarylonitrile (PAN), polyethylene (PE),
polypropylene (PP), polytetrafluoroethylene (PTFE), polyvinylidene
fluoride (PVDF), polyvinylchloride (PVC), polypiperazine amide,
polyethylene terephthalate (PET), polycarbonate (PC), hydrogels,
and the complexes and mixtures thereof.
[0059] The membrane is preferably an organic membrane. In this
connection, the term "organic membrane" shall be understood to mean
a separating layer and/or a thin film, which includes at least one
carbon compound-based component. The organic membrane preferably
includes a polymeric substance and/or is formed by a polymeric
substance, wherein this substance can be chemically produced so
that a pore size of the pores of the membrane is adapted to the
molecules used and the measuring principle. The membrane is
preferably a polymer membrane made of polyethersulfone.
[0060] As described above, the membrane, for example in the form of
a polymer membrane, includes at least pores in the nanometer range.
To prevent these membrane pores from collapsing in air, the pores
are stabilized with at least one stabilizer. This stabilizer may be
formed by any substance and/or organic compound deemed appropriate
by a person skilled in the art, such as glycerol, glycerol
stearates, glycerol esters, other alcohols, salts, or also
carbohydrates, for example. The pores are preferably stabilized
with glycerol, whereby a sufficiently characterized substance is
used. The coating parameter, or the coating parameters, must be
selected such here that the glycerol is preserved in the pores and
the membrane pores do not collapse. 100% glycerol, or else glycerol
diluted with deionized water, may be used for this purpose. The
stabilization further serves to support a site-directed coating of
the membrane. During the coating process proposed herein, the
stabilizer remains in the pores and not only prevents the membrane
from collapsing, and thus clogging, but coating of the interior of
the pores in the plasma is also prevented. Thus, it becomes
possible for an implant having permeability to be provided with a
biocompatible, bioinert and antibiotic coating on the surface,
whereby explanting can be implemented without complications, and
moreover no loss of function for separation properties of the
permeability region is suffered.
[0061] As mentioned above, the implant can include an organic
membrane in the coated surface. At least one reservoir of the
sensor can be closed off by way of this membrane. The term "closed
off" here shall not mean that a transport of substances between the
reservoir and an external region is entirely prevented; it merely
means that a space is defined, in which certain components of the
sensor system are disposed and/or retained. A "reservoir of a
sensor" or a "sensor reservoir" here shall be understood to mean a
space, a chamber and/or a cavity of the sensor, which the detection
system of the sensor is in contact with and/or on, and preferably
in, which the detection system or the competition assay is
disposed. A bottom of the reservoir, located opposite the
semipermeable membrane, preferably has what is known as a "gate" of
a semiconductor component or of an seFET. The sensor reservoir
furthermore encloses at least one volume, and more particularly a
sample volume, which can include or contain the feature that is to
be detected. The organic membrane can advantageously be used to
establish which molecules can come in contact with the sensor, and
which cannot. This again demonstrates how crucial it is that the
functionality of the membrane in the body is preserved.
[0062] The goal of coating the implant surface and of the
subsequent modification or reduction is that the membrane pores
remain freely passable to the analyte or the molecules migrating
during dialysis, and are not closed by what is known as fouling,
when in contact with body fluids and tissue.
[0063] It was found that the composition of the coating on the
surface, applied by way of plasma polymerization, decisively
influences the adhesion of interfering substances to the implant
surfaces. It is possible to vary or specifically adapt different
coating parameters for this purpose. A coating parameter here
represents any parameter of a plasma polymerization system,
preferably a magnetic field-enhanced plasma polymerization system,
deemed settable or variable by a person skilled in the art
considers. With respect to the methods proposed herein, it is
particularly advantageous for the coating of implants if the
coating process by way of plasma polymerization is carried out in
the presence of oxygen. In a further preferred embodiment of the
methods proposed herein, it is particularly advantageous for the
coating of implants if the coating process by way of plasma
polymerization is carried out in the presence of at least one
saturated hydrocarbon, which is preferably selected from the group
comprising or consisting of saturated C1 to C6 hydrocarbons, and
more preferably selected from the group comprising or consisting of
methane, ethane, propane and butane. In a particularly preferred
embodiment, the coating process is carried out in the presence of
methane. Hydrocarbons here shall be understood to mean traditional
compounds composed of carbon and hydrogen, which moreover include
only single bonds when in the "saturated" form. Moreover, for
example, the pressure, composition of the coating gas, flow rates
(rate of fluid flow) of the coating gas or of the different
components thereof, current intensity or output of the plasma
polymerization system, frequency and curve progression of the
electrical field (pulsed, periodic) of the electrical field of the
plasma polymerization system, rotational speed or angular position
of a sample holder of the plasma polymerization system, material of
the electrodes, presence of further materials influencing the
plasma process, process duration, and the like, so as to obtain an
advantageous coating. Advantageously, a plurality of coating
parameters are specifically selected.
[0064] The method proposed herein furthermore preferably includes a
step in the form of treating the coating with a reducing reagent.
For this purpose, the coating was applied by way of a plasma
polymerization process proposed herein. By treating the coating by
way of a reducing reagent, reactive chemical groups on the surface
of the coating can be modified so that the biocompatibility is
drastically increased and ingrowth of the implant is prevented. As
already described herein, this also furthermore allows the implant
to be explanted.
[0065] If interfering substances should nonetheless still adsorb in
low quantities onto the modified surface, despite modification of
the reactive chemical groups, these adhering biomolecules are
present in a native three-dimensional structure, whereby the
surface (coating) presented to the body is not identified as being
foreign at any time. There is natural "camouflaging" of the
material with the body's own components. As a result, the surface
is advantageously not sheathed/encapsulated in the body's own
tissue. Moreover, the surface is likewise not thrombogenic. This
coating is long-term stable even in a biological environment.
[0066] It has been shown that an adhesion of interfering substances
can be prevented particularly efficiently if the surface is coated
using the following coating parameters: pressure: 1 pascal (Pa) to
10 Pa, flow rate of a coating gas: 0 standard cubic centimeters per
minute (sccm) to 10 sccm, current intensity of the plasma
polymerization system: 100 milliamperes (mA) to 500 mA, rotational
speed of the sample holder: 0 revolutions per minute (rpm) to 5
rpm, coating time: 1 minute (min) to 200 min, preferably 20 min to
100 min, and particularly preferably 60 min, electrode of the
plasma polymerization system: titanium, titanium content: between
50% and 100% titanium. The flow rate can also be referred to as the
rate of fluid flow and is indicated in ml/min. It shall be noted
that the rotational speed of the sample holder becomes negligible
at coating times of greater than 5 minutes.
[0067] In a preferred embodiment, a coating is applied according to
a method proposed herein using the following coating parameters: 1
pascal (Pa) to 10 Pa, flow rate of oxygen and at least one
saturated hydrocarbon: 0 standard cubic centimeters per minute
(sccm) to 10 sccm, current intensity of the plasma polymerization
system: 100 milliamperes (mA) to 500 mA.
[0068] In a preferred implementation, the at least one coating
parameter is selected so that an oxygen-containing hydrocarbon
coating or layer is formed. This can be achieved in particular when
the coating process is carried out in the presence of oxygen and at
least one saturated hydrocarbon, which is preferably selected from
the group comprising or consisting of methane, ethane, propane and
butane, and more preferably methane. The high hydrophilicity and
the further advantageous physical and chemical properties of such
layers make these particularly suitable for "camouflaging" the
implant surface. The few adhering proteins remain in the native
structure thereof, whereby the body does not identify these implant
surfaces as being foreign at any time. Ingrowth of an implant that
is coated according to the invention is thus in particular made
more difficult or prevented.
[0069] It has been shown that a coating using the following coating
parameters is advantageous for an implant: pressure: 5 Pa, flow
rate of the methane coating gas: 2.5 sccm, flow rate of the oxygen
coating gas: 1.3 sccm, current intensity of the plasma
polymerization system: 200 mA, electrode of the plasma
polymerization system: 100% titanium. A rotational speed of the
sample holder is preferably 2 rpm. A coating time is advantageously
1 min to 200 min, preferably 20 min to 100 min, and particularly
preferably 60 min. Potential pretreatments, such as special
cleaning steps (hydrofluoric acid bath, for example) or the
application of an adhesion promoter layer (see below), are not
absolutely necessary. An implant thus coated essentially exhibits
an inconspicuous behavior of the implant surface in the body, which
is particularly important in an implant that can be introduced into
a bloodstream of an animal body and/or a human body, since a
life-threatening formation of thrombi is possible here.
[0070] As described above, when coating a membrane, and more
particularly a polymer membrane, in particular the presence of the
stabilizer (preferably glycerol) is critical, or the integrity of
the same during the coating process is decisive for ensuring that
the biosensor continues to operate reliably. The coating parameters
are selected so that the glycerol on the surface of the membrane
evaporates, and the glycerol in the pores is preserved, prior to
applying the plasma polymer layer. In this way, the surface of the
membrane may be coated with plasma polymers, while the stabilizer
remains preserved in the pores. This was successfully achieved by
optimizing the method parameters, in which the glycerol on the
surface of the membrane is removed, not however in the pores. This
approach takes advantage of the fact that the vapor pressure of
glycerol is in the pressure range that prevails or is set during
the coating process in the plasma polymerization system. When the
vacuum is generated by a butterfly valve to the vacuum pump being
opened, the optimized vacuum cycle can be influenced, for example
by way of the pumping capacity, whereby the glycerol begins to
evaporate due to the vapor pressure. This can be monitored based on
the progression of the pressure curve. In general, it can be
observed that the time period until the desired final pressure is
reached is longer in the presence of glycerol, compared to test
conditions without glycerol.
[0071] It has been shown that it is particularly advantageous when
a membrane of an implant is coated using the following coating
parameters, wherein the membrane includes pores in the nanometer
range: pressure: 1 Pa to 3 Pa, flow rate of the methane coating
gas: 2.5 sccm, flow rate of the oxygen coating gas: 1.3 sccm,
current intensity of the plasma polymerization system: between 200
mA and 400 mA, preferably 375 mA, electrode of the plasma
polymerization system: 100% titanium. A rotational speed of the
sample holder is preferably 2 rpm. A coating time is advantageously
1 min to 200 min, preferably 20 min to 100 min, and particularly
preferably 60 min. Potential pretreatments, such as special
cleaning steps (hydrofluoric acid bath, for example) or the
application of an adhesion promoter layer (see below), are not
absolutely necessary.
[0072] According to a further embodiment of the invention, the at
least one coating parameter is selected so that a layer thickness
of the coating of 1 nanometer (nm) to 200 nm, preferably of 2 nm to
100 nm, and particularly preferably of 15 nm to 50 nm is obtained.
These layer thicknesses have proven particularly useful in
experiments. A good balance between stable adhesion of the plasma
polymer layer and reduced protein adsorption was found in
particular in the medium layer range (15 nm to 50 nm). Moreover,
thinner layers result in the advantage that shorter coating times
suffice to obtain an adequate layer thickness. A layer thickness of
approximately 25 nm was found to be particularly advantageous.
[0073] The present invention thus also relates to implants
comprising a coating, wherein the coating includes the elements
carbon, nitrogen, oxygen and a metal, which is selected from the
group comprising or consisting of titanium, silver, copper, zinc,
mercury, tin, lead, bismuth, cadmium, chromium, and thallium, and
the alloys thereof. In a preferred embodiment, the metal is
titanium or a titanium alloy. In a further preferred embodiment,
the coating has a layer thickness of 1 nanometer (nm) to 200 nm,
preferably of 2 nm to 100 nm, and particularly preferably of 15 nm
to 50 nm. In a further preferred embodiment, the implants proposed
herein include coatings that are free from aldehyde groups.
[0074] A surprising effect that was furthermore found was that
sensitive electrical components, such as those of a cardiac
pacemaker, are not damaged by the coating conditions. The
possibility of applying the plasma polymer coatings onto electrical
components significantly increases the compatibility of implants
with such components. If care is taken that the plasma polymer
coatings do not have insulator properties at these layer
thicknesses, it is also possible to apply plasma polymer coatings
to electrodes (such as stimulation electrodes) or sensor
electrodes. In this regard, in particular the layer thickness is
the decisive factor. Thin layer thicknesses between 3 nm and 100 nm
have negligible insulator properties. The selection of the output
of the plasma polymer system has little influence on the formation
of insulator properties. It has been shown that both encapsulation
of the electrodes and a bacterial infection are prevented, while
dielectric properties of the electrode remain substantially
unimpaired.
[0075] As indicated above, it would be possible to subject the
surface of the implant to a pretreatment prior to the plasma
polymer coating process. For this purpose, any pretreatment deemed
appropriate by a person skilled in the art would be conceivable,
such as a special cleaning step (referred to as a hydrofluoric acid
dip), an application of a primer by way of spraying, immersion,
brushing, and the like.
[0076] The application of a plasma polymer layer having the
above-described positive properties is only possible with
difficulty, or insufficiently successful, on certain substrates. An
increased range of materials can only be covered by improving
adhesion properties. A particularly advantageous pretreatment,
however, is the application of an adhesion promoter layer. By
coating the substrates with adhesion-promoting layers (referred to
as layer stacks), the plasma polymers can be applied to any
conceivable substrate. Moreover, the use of adhesion-promoting
layers allows the spectrum of coatable materials to be broadened by
matching the surface energies of the individual layers in the layer
stack to each other. Moreover, this yields a general improvement in
the adhesion of the plasma polymer layers to the implant surface.
To accomplish this, all that is needed is to adapt the material
properties of the adhesion promoter layer to the coating by way of
plasma polymerization. In this way, a universal coating protocol is
obtained for all implant surfaces, which is merely dependent on the
adhesion promoter layer. By using the layer stack, it is possible
to coat any conceivable material with plasma polymers, wherein
clever selection of the individual layers allows drastically
improved adhesion to be achieved. An adhesion promoter layer here
shall be understood to mean a layer that "mediates" an adhesion of
the plasma polymer layer to the surface, or is needed to make the
same possible in a stable and permanent manner. In principle, these
may also be several consecutive--firmly adhering--layers.
[0077] In principle, the pretreatment to promote adhesion may also
be a non-layer-forming pretreatment. This would be possible by way
of plasma treatment using oxygen or argon, for example. A surface
energy is likewise matched thereby, which enables coating with a
plasma polymer layer.
[0078] The adhesion promoter layer is particularly preferably a
polymer layer, and more particularly a plasma polymer layer, which
is applied by way of plasma polymerization. Using the same
technology for the target coating (interface interacting with the
body) and the adhesion promoter layer reduces the apparatus-related
complexity for generating these layers. An adhesion promoter layer
that can be used for numerous implant surfaces and that is also
easy to coat by way of plasma polymerization can be obtained when
the adhesion promoter layer is applied using the following coating
parameters: pressure: 5 Pa, flow rate of the methane coating gas:
2.5 sccm to 5 sccm, flow rate of the oxygen coating gas: 0 sccm to
2 sccm, current intensity of the plasma polymerization system: 200
mA. The electrode material can be any arbitrary conductive
material, such as titanium, aluminum, stainless steel, copper, or
gold. A rotational speed of the sample holder is preferably 2 rpm.
A coating time is advantageously 1 min to 200 min.
[0079] The final interface, which is in contact with the biological
environment, is applied to the adhesion promoter layer using the
following coating parameters: pressure: 5 Pa, flow rate of the
methane coating gas: 2.5 sccm, flow rate of the oxygen coating gas:
1.3 sccm, current intensity of the plasma polymerization system:
200 mA, electrode of the plasma polymerization system: 100%
titanium. A rotational speed of the sample holder is preferably 2
rpm. A coating time is advantageously 1 min to 200 min, preferably
20 min to 100 min, and particularly preferably 60 min.
[0080] To further improve the compatibility of the implant, the
coating on the surface of the implant is sterilized, and more
particularly the reduced coating that has been treated with a
reducing reagent is sterilized. According to an advantageous
embodiment, the coating is sterilized by means of ethylene oxide.
This represents an important advantage since there is no adverse
effect of the ethylene oxide on the plasma polymer layer, and the
reduced interaction of the same is also preserved after
sterilization. In this way, a health risk of the implant for the
body may be further reduced. Sterilization by way of ethylene oxide
moreover has the advantage that, after the sterilization, the
plasma polymer layer returns quickly to the original state, which
is to say a state having a high degree of swelling and a small
contact angle. This is attributed to the fact that the plasma
polymer layer and ethylene oxide have similar chemical
compositions.
[0081] In principle, it is possible to coat all implant surfaces or
to modify all these coatings. However, it would also be conceivable
to coat or modify only individual portions or regions of the
implant. For this purpose, the resulting coating-free regions could
be covered or taped off prior to the coating process. It would also
be conceivable to apply an inhibiting substance so as to prevent
the deposition of the plasma polymer layer or the modification. It
would also be possible to apply a substance to the surface which is
dissolved after the plasma polymer layer has been applied, whereby
the substance and the plasma polymer layer are removed. Moreover
reactive ion etching, wet-chemical etching, laser ablation, or
electropolishing would be possible.
[0082] The implant can include at least one functional sector, for
example in the form of an analysis sector or a delivery sector (for
releasing substances), and at least one attachment sector or an
anchoring component. So as to take the different functions into
consideration, these regions can also be treated differently with
respect to the coating of the surfaces of the same. They can be
coated using different conditions and thus include coatings that
differ from each other. Or it would be possible to coat only one of
the regions. So as to ensure the reliable function of the
functional sector or analysis sector (preventing the encapsulation
at the functional (measuring) part so as to preserve the measuring
function), the same is preferably coated. The attachment sector, in
contrast, remains uncoated, whereby the same will be at least
partially encapsulated, whereby a desirable improvement in or
stabilization of the anchoring of the implant in the tissue may be
enabled.
[0083] To reduce the risk of infection, it is particularly
advantageous if the coating, and thus the implant surface, in
addition to the reduced absorption property, has suitable
properties that suppress the initial adhesion of microorganisms, or
at least prevent the explosive reproduction and the formation of
the biofilm. Accordingly, the at least one coating parameter is
selected so that a coating having antibiotic properties is
obtained. The antibiotic properties of the coating/of the surface
result in fewer complications with implants, or the implantation
thereof, or the replacement thereof. In this context, the term
antibiotic shall be understood to mean "inhibiting the growth of
microorganisms or killing the same."
[0084] According to one advantageous implementation, it is provided
that at least one antibiotically acting metal is introduced into
the coating. This allows the antibiotic action to be preserved over
a long period since the antibiotically acting reagent is
implemented in one piece with the coating, and thus is inseparable
from the same. It is possible for this purpose to carry out the
introduction into the coating during or after the coating process.
The method proposed herein thus furthermore includes the step of
applying a coating by way of plasma polymerization in the presence
of a metal, which is at least partially incorporated into the
coating. Any method deemed appropriate by a person skilled in the
art would be conceivable to introduce and/or apply the metal or the
particles thereof. All--chemical or physical--methods for
depositing thin films (thin-film deposition) would be conceivable
for this purpose, such as a sol-gel process (dip coating, spraying,
spin coating); plating (electroplating, electroless plating);
chemical vapor deposition, metal-organic chemical vapor deposition
(MOCVD), plasma-enhanced chemical vapor deposition (PECVD), low
pressure chemical vapor deposition (LPCVD), thermal vapor
deposition (thermal VD), atomic layer deposition (ALD);
evaporation, ion plating, laser ablation, molecular beam epitaxy
(MBE), electron beam evaporation, thermal evaporation, ion assisted
deposition (IAD); sputtering (radio frequency sputtering (RF
sputtering), direct current sputtering (DC sputtering), magnetron
sputtering, and ion beam sputtering (IBS)).
[0085] The introduction is preferably carried out by applying the
coating in the presence of at least one antibiotically acting
metal. The embedding essentially results on its own by virtue of
the coating conditions. It would be possible, for example, to place
a small amount of the antibiotically acting metal in the reaction
chamber, from which metal ions are knocked out by the excited field
during operation of the plasma reactor and embedded in the
coating.
[0086] As an alternative and/or in addition, it would be possible,
and this would be achievable using a particularly simple design, to
knock the antibiotically acting metal out of the electrode of the
plasma polymerization system during the coating process. Metals
selected from the group comprising or consisting of titanium,
silver, copper, zinc, mercury, tin, lead, bismuth, cadmium,
chromium, and thallium, and the alloys thereof, can be used for the
method proposed herein. Suitable metals that could be used further
include silver, copper, zinc, mercury, tin, lead, bismuth, cadmium,
chromium, and thallium, and the alloys thereof, or preferably
titanium and titanium alloys. In a preferred embodiment, titanium
or a titanium alloy is introduced into the coating. It was found
that the use of titanium or of a titanium alloy results in titanium
particles or titanium alloy particles being found in the coating.
While titanium or titanium alloys per se are not known to be
antibiotic, it was furthermore surprisingly found that these
coatings develop an antibiotic action. This antibiotic action also
occurs, or remains, without any further irradiation of UV
light.
[0087] A coating using the following coating parameters has proven
to be particularly advantageous for a coating having antibiotic
properties: pressure: 1 Pa to 10 Pa, flow rate of the methane
coating gas: 1 sccm to 5 sccm, flow rate of the oxygen coating gas:
0.5 sccm to 2 sccm, current intensity of the plasma polymerization
system: 100 mA to 300 mA, coating time: 1 minute (min) to 200 min,
electrode of the plasma polymerization system: titanium, titanium
content: >50%.
[0088] Considerably better results were achieved using the
following coating parameters: pressure: 4 Pa to 6 Pa, flow rate of
the methane coating gas: 2.5 sccm to 3 sccm, flow rate of the
oxygen coating gas: 1 sccm to 1.5 sccm, current intensity of the
plasma polymerization system: 150 mA to 250 mA, coating time: 10
min to 200 min, electrode of the plasma polymerization system:
titanium, titanium content: 100%.
[0089] The best results were yielded using the following coating
parameters: pressure: 4 Pa to 6 Pa, flow rate of the methane
coating gas: 3 sccm, flow rate of the oxygen coating gas: 1 sccm,
current intensity of the plasma polymerization system: 150 mA to
250 mA, coating time: 30 min to 200 min, electrode of the plasma
polymerization system: titanium, titanium content: 100%. In all
three listed protocols, a rotational speed of the sample holder was
preferably 2 rpm. It was found, for example, that, by way of the
layers thus generated, a layer thickness of approximately 20 nm,
and embedded titanium of approximately 1%, allowed an improvement
in the antibiotic action compared to control layers of 65% to 99%
to be achieved.
[0090] A preferred embodiment of the invention is thus the use of
the method of magnetic field-enhanced plasma polymerization to
generate a biocompatible and antibacterial coating on an implant
surface, which is then in turn modified so as to further reduce the
properties of the adsorption of interfering factors. Or, in other
words, a surface coating is to be obtained which not only
suppresses the encapsulation of the implants and does not act
thrombogenically, but is also antibiotically active.
[0091] To amplify the antibiotic action of the plasma polymer
layer, it may be additionally advantageous for the method proposed
herein to include a step in which the coating is treated with UV or
near-UV light. This can take place during or after the treatment in
the plasma reactor. The UV light, preferably having a wavelength of
less than 385 nm, causes photocatalysis. This, in turn, leads to
the formation of oxygen radicals, which have a damaging effect on
bacteria. The antibiotic action of the plasma polymer layer can in
particular be increased when a coating containing an antibiotically
acting metal, as proposed herein, is treated with UV light or
near-UV light. Due to the presence of the antibiotically acting
metals, the formation of oxygen radicals can be drastically
increased with UV light or near-UV light.
[0092] In the figures, functionally equivalent or equivalently
acting elements are denoted by the same reference numerals. The
figures are schematic illustrations of the invention. They depict
non-specific parameters of the invention. In addition, the figures
only reflect typical embodiments of the invention and are not
intended to limit the invention to the shown embodiments.
[0093] To avoid unnecessary repetitions, elements in a figure that
are not described in detail are provided with a reference to the
respective description of the elements in the preceding
figures.
[0094] FIG. 1 shows a schematic view of a magnetic field-enhanced
plasma polymerization system 22 for carrying out the method
according to the invention. Plasma polymerization is generally
understood to mean the formation of a material resulting from an
organic gas or gas mixture under the action of an electric
discharge. A wide variety of collisions, such as excitation,
ionization and recombination of the involved species, take place in
the plasma. The plasma polymerization system 22, also referred to
as a plasma reactor, includes two opposing electrodes 24, which are
preferably made of titanium. Magnets 44 disposed in a circle are
situated on the side of these electrodes 24. The resulting magnetic
field focuses the glow discharge between the electrodes 24 and
increases conductivity. This is achieved by an increased ion
density, electron density, and electron temperature. A so-called
"race track" forms on the electrode material with the aid of
magnetic field enhancement. This race track is created in a
position where the vertical component of the magnetic field is
zero, since the magnetic field is perpendicular to the electrical
field lines here.
[0095] The plasma polymerization system 22 is used to deposit a
coating 12, 12', 12'', 12''' in the form of a nanofilm onto a
substrate, such as a surface 14, 16 of an implant 10 (see below).
The deposition is carried out at a pressure of 1 pascal (Pa) to 10
Pa in fine vacuum. A starting substance of the coating 12, 12',
12'', 12''' used here is a gas mixture composed of the coating
gases methane 18 and oxygen 20. These gases are metered by way of
mass flow regulators and conducted via a feed system 46 into a
reactor volume 48 of the plasma polymer system 22. A flow rate of
the coating gases 18, 20, or the rate of fluid flow, or also the
mass flow, is between 0 standard cubic centimeters per minute
(sccm) and 10 sccm, and preferably between 0 sccm and 5 sccm. The
flow rate can also be indicated in ml/min. A current intensity of
the plasma polymerization system 22 is between 100 milliampere (mA0
and 500 mA. In addition, the coating is carried out in the AF range
(1000 to 2000 hertz (Hz)). The introduced power of the system is
between 20 and 100 watt (W). The samples, or the implant 10 to be
coated, are located on a sample holder 50 in the form of a wheel
rotating in the rotational direction 52 axially between the
electrodes 24 on what is known as a "floating" potential.
[0096] As mentioned above, the plasma polymerization system 22 is
used to apply a coating 12, 12', 12'', 12''' onto a surface 14, 16
of an implant 10. Before going into greater detail of the coating
process, first the operating principle of the implant 10 will be
described to better illustrate the advantages of the method
according to the invention.
[0097] As can be seen in FIG. 2, which shows a sectional view
through the implant 10, the implant 10 is designed as a biosensor.
This biosensor includes a sensor system 54 including a reservoir
58, which is substantially closed off or surrounded by a housing 56
and encloses a sample volume. A detection system 60 is disposed in
the reservoir 58 or on a lateral surface. The biosensor moreover
includes a selection structure in the form of a membrane 26, and
specifically in this embodiment in the form of an organic
semipermeable polymer membrane 26 made of polyethersulfone, which
according to this exemplary embodiment is disposed on a side of the
reservoir 58 located opposite the lateral surface comprising the
detection system 60. A polymer membrane 26 made of polysulfone is
described hereafter as one embodiment. However, the membrane 26 can
also be made of any material deemed appropriate by a person skilled
in the art, such as polysulfone, polyarylethersulfone (PAES),
polyethersulfone (PES), cellulose ester (cellulose acetate,
cellulose triacetate, cellulose nitrate), nanocellulose,
regenerated cellulose (RC), silicone, polyamide (nylon), polyamide
imide, polyamide urea, polycarbonate, ceramic, titanium oxide,
aluminum oxide, silicon, zeolite (alumosilicate), polyarylonitrile
(PAN), polyethylene (PE), polypropylene (PP),
polytetrafluoroethylene (PTFE), polyvinylidene fluoride (PVDF),
polyvinylchloride (PVC), polypiperarinamis, polyethylene
terephthalate (PET), polycarbonate (PC), and the complexes and
mixtures thereof.
[0098] The detection system 60 includes a plurality of receptors
62, which are used to coat the lateral surface in a density known
to a person skilled in the art, serving as the receptor layer. The
bottom includes a semiconductor component 64 in the form of an
extended gate field effect transistor (seFET) known from the prior
art comprising a gate. The receptor 62 is formed by a molecule,
which has an antigen recognition site and is a Fab fragment of a
monoclonal antibody against a protein to be detected or an analyte
66 containing the antigen to be recognized.
[0099] The analyte 66, which in the present case is cystatin C by
way of example, has a feature to be detected by the detection
system 60, which is a positive charge here. Depending on the
analyte used, the charge may also be negative. In addition, an
antagonist 68 of the analyte 66 is present in the reservoir 58, the
antagonist likewise carrying the antigen to be recognized by the
receptor 62. This antagonist 68 is an artificial and recombinant
protein developed with epitope mapping, which carries a
poly-L-lysine modification. The antagonist 68 furthermore also
carries the feature to be detected, or the positive charge. The
antagonist 68 and the receptor 62 are moreover molecular
biologically modified so that several amino acids, which are
present in the sequences of the same and not important for binding
of the respective opponent, however which are recognized as
starting points for degradation by internal metabolic enzymes (such
as serine of serine proteases), are replaced by other amino acids
that do not change the protein structure. This will protect the
molecules from enzymatic degradation in the body, whereby the
long-term stability is increased (not shown in detail).
[0100] The organic polymer membrane 26 is designed so that the
antagonist 68 is retained in the reservoir 58 at all times, and
that the analyte 66 is able to pass the membrane. For this purpose,
the polymer membrane 26 includes a plurality of pores 28, which are
homogeneously distributed over the surface. The pores 28 are not
shown true to scale, but are enlarged. A diameter 70 of the pore 28
of the polymer membrane 26 must be larger than approximately 5 nm
for the analyte 66, this being cystatin C, to diffuse through.
However, it must be smaller than 20 nm, so as to retain the
antagonist 68 in the reservoir 58. Additional cells 72 or molecules
72, or interfering substances 72 in general, which are larger than
the pore diameter 70, are retained by the polymer membrane 26.
However, micromolecules 74 are able to pass the polymer membrane
26. The polymer membrane 26 and the semiconductor component 64 are
connected to the housing 56 so that a mass transfer is possible
only via the pores 28 of the polymer membrane 26, and not via a
connecting point between the polymer membrane 26 and the housing
56.
[0101] If a sensor were to be used to detect or determine glucose
or similarly small molecules, for example, a pore diameter of
approximately 1 nm would suffice for the glucose to pass the
membrane.
[0102] As mentioned above, both the analyte 66 and the antagonist
58 carry the feature to be detected or the positive charge. As a
result of the poly-L-lysine modification, the antagonist 68 has a
large positive charge and a higher charge than the analyte 66.
These consequently differ in terms of the charge intensity.
[0103] The sensor principle is based on a marking-free
immunological detection method, in which the analyte 66 can be
measured reversibly and as a function of the concentration. The
gate of the seFET includes the bound receptors 62 selectively
recognizing the analyte 66. These are saturated by the antagonist
68 present in the sample volume when the analyte 66 is absent, and
in particular also prior to the first measurement. The high charge
of the antagonist 68 generates a measurable charge transfer on the
sensitive surface of the semiconductor component 64, whereby a
measurement signal is generated on the seFET, which can be
ascertained by a measuring unit 94. Due to the saturation of the
sensor with the antagonist 68, the measurement signal is 100% in
the absence of the analyte 66.
[0104] If analyte 66 from the measuring substance, which surrounds
the sensor and is blood, for example, now enters the sample volume
of the sensor via the polymer membrane 26, this analyte may
interfere with the existing bond between the antagonist 68 and the
receptor 64. If the analyte 66 is present on the active surface,
the analyte 66 and the antagonist 68, due to the similar respective
antigen of the same, compete substantially equally and with equal
intensity for the antigen recognition site of the antibody fragment
(Receptor 64). The antigen of the analyte 66 thus causes a
reversible displacement of several of the antagonists 68 that have
a high charge and are bound to the receptor 64. A
concentration-dependent equilibrium develops between bound analyte
66 and bound antagonist 68, wherein the charge transfer for the
analyte 66 and the antagonist 68 is different. Overall, the more
analyte 66 is bound, the lower is the measurement signal that can
be derived.
[0105] The sensor ascertains the electrical state variable or a
change in voltage. Due to the large difference in charge between
the analyte 66 and the antagonist 68, the change in the
concentration is clearly detectable. The analyte concentration is
proportional to the measured signal. In the detection process, the
sensor thus ascertains a change in charge, which is caused by the
reversible displacement of the antagonist 68 from the receptor 64
by the analyte 66. If the concentration of analyte 66 in the blood,
and thus also in the interior of the sensor, decreases, primarily
antagonists 68 again bind to the receptor 64, and the measurement
signal at the seFET rises again. FIG. 2 also shows that the
analytes 66 and antagonists 68 that have not bound precisely to the
antigen recognition site of the receptor 64 do not contribute to
the generation of the measurement signal.
[0106] The receptor layer applied to the gate of the seFET does not
occupy all binding valences of the surface of the gate. Additional
free or unsaturated binding sites 76 of the seFET that are still
present must be saturated, so that interferences by other charged
molecules, such as micromolecules 78, can be effectively prevented.
A passivation layer 78 is therefore applied to the seFET, which is
designed to saturate non-specific binding sites 76. The passivation
layer 88 is formed by a polymer, such as polyethylene glycol
(PEG).
[0107] To prevent fouling caused by contact with tissue or
measuring substances, surfaces 14, 16 of the implant, such as
surfaces 14 of lateral walls of the housing 56 of the biosensor,
made of titanium, for example, or the outer surface 16 of the
polymer membrane 26, are coated with a coating 12 (Formulation I,
see below) or a plasma polymer layer by way of plasma
polymerization. The coating 12 is shown only in the right portion
of the illustration of FIG. 2 on the first sections of the polymer
membrane 26 and an upper portion of the surface 14 of the housing
56 in an oversized manner.
[0108] The surfaces 14, 16 to be coated do not have a smooth
surface. These have at least nanoroughness or are porous. Such
surface properties or structures require a specially developed
coating protocol so as to yield a coating 12 that adheres well and
additionally has further advantageous properties (suppressing
fouling, antibiotic property).
[0109] Four different coatings 12, 12', 12'', 12''' having
different formulations (Formulations I, II, III, IV) were generated
(layer thickness 24 nm.+-.2 nm) and analyzed for the suitability of
the same. The differences in the formulations and the resulting
layer properties can be derived from Table 1 below.
TABLE-US-00001 TABLE 1 Differences in the coating formulations and
the resulting layer properties For- Flow Growth Atomic composition
mula- rates rate [%] .+-. 1 Roughness tion [sccm] [nm/min] C O N Ti
Rms [nm] I 2.5 CH.sub.4 + 0.2 65 31 1.9 2.1 0.3 1.3 O.sub.2 II. 2.8
CH.sub.4 + 0.9 71 26 1.5 1.5 2.3 1.1 O.sub.2 III 3.0 CH.sub.4 + 1.2
72 24 2.5 1.5 2.4 1.0 O.sub.2 IV 5.0 CH.sub.4 2.0 89 9 2.0 0.0
0.4
[0110] The atomic compositions of the four coatings 12, 12', 12'',
12''' listed in Table 1 can also be seen in FIG. 3, which shows a
diagram in which the chemical elements of the coatings 12, 12',
12'', 12''' are plotted on the x axis, and the atomic compositions
of the coatings 12, 12', 12'', 12''' in % are plotted on the y
axis. The respective first (left) bar shows the coating 12
according to Formulation I, the second bar shows the coating 12'
according to Formulation II, the third bar shows the coating 12''
according to Formulation II, and the fourth and last bar shows the
coating 12''' according to Formulation IV.
[0111] Without being bound to this theory, it is assumed that
nitrogen becomes embedded in the coating at the point in time at
which the reactor, in which the plasma polymerization is carried
out, is flooded after plasma polymerization, so that, after the
plasma polymerization, the coating is surrounded by a nitrogen
atmosphere, and more particularly an oxygen-free and/or waterless
nitrogen atmosphere.
[0112] A discernible connection can be found between the
formulations and the atomic compositions of coatings 12, 12', 12'',
12'''. If the oxygen fraction is increased in the precursor gas,
more oxygen is also integrated into the coatings 12, 12', 12'',
12''', wherein the carbon fraction, in terms of percent, decreases.
A look at the element titanium shows that the fraction thereof, in
terms of percent, likewise increases as the oxygen fraction in the
starting material increases. It can be assumed that primarily
conglomerates composed of titanium and oxygen are embedded into the
plasma polymer. No trend can be observed for the different
formulations with respect to the element nitrogen.
[0113] An examination of the coatings 12, 12', 12'', 12''' for the
type of compounds or groups that are present in the plasma polymer
based on a peak analysis shows the results listed by way of example
in Table 2 for the coatings 12 and 12''' of formulations I and
IV.
TABLE-US-00002 TABLE 2 Results of the peak analysis of coatings 12
and 12''' of formulations I and IV Peak C.sub.1 C.sub.2 C.sub.3
C.sub.4 Binding energy 285.0 286.5 288.0 289.3 (eV) Bond C--C,
and/or C--H C--OH or --C.dbd.O O--C.dbd.O C--O--C Formulation I
4.7% 61.3% -- 34.0% Formulation IV 63.4% 36.6% -- --
[0114] It was found that the C.sub.2 component is of particular
importance. A distinction must be made between the two possible
groups of this component. Deliberations made, which are not
described in greater detail here, result in the assumption that the
C.sub.2 component is primarily present in these coatings 12, 12',
12'', 12''' in the form of a C--O--C bond. However, it is also
possible for smaller amounts of C--OH bonds to be present. This
means that essentially oxygen-containing hydrocarbon coatings are
formed.
[0115] Another option for characterizing the surface properties is
to examine the interaction of two media having different states of
matter, which make contact with each other at the interface, for
example based on a dynamic contact angle measurement. The result of
this examination is shown in the diagram of FIG. 4, in which the
Formulations I to IV of coatings 12, 12', 12'', 12''' are plotted
on the x axis, and the progressing contact angles .theta. in
.degree. is plotted on the y axis.
[0116] As can be seen in FIG. 4, a relationship exists between the
gas ratio of the starting material and the wetting property of the
resulting coating 12, 12', 12'', 12'''. The higher the oxygen
fraction in the starting material, the lower is the contact angle
.theta.. From this, it can be derived that the higher the oxygen
content in the coating 12, 12', 12'', 12''', the better is the
wetting property. In other words, the higher the oxygen content in
the coating 12, 12', 12'', 12''', the greater is the
hydrophilicity. The contact angle is a measure of
hydrophilicity.
[0117] To supplement the determination of the hydrophilicity, what
is known as the swelling factor of the coatings 12, 12', 12'',
12''' was ascertained. The result of this examination is
discernible from the diagram of FIG. 5, in which the Formulations I
to IV of coatings 12, 12', 12'', 12''' are plotted on the x axis,
and the swelling factor .alpha.=d.sub.swelled/d.sub.dry is plotted
on the y axis. This measurement as well shows a distinct
relationship between the composition of the coating 12, 12', 12'',
12''' and the interaction of these plasma polymers with water, or
swelling. Nanofilms having a high oxygen fraction have a swelling
factor of up to 2.2 (coating 12); in plasma polymers having a very
low oxygen fraction, almost no swelling exists (coating 12'''). The
penetration of water, and the swelling associated therewith,
decisively depend on the number of polar groups.
[0118] For the ascertainment of the non-specific protein absorption
of the coatings 12, 12', 12'', 12''' was ascertained. For this
purpose, the coatings 12, 12', 12'', 12''' were incubated with the
protein fibrinogen occurring in blood (2 mg/ml in PBS buffer), and
thereafter the layer thickness of the adhering fibrinogen was
ascertained by way of surface plasmon resonance spectroscopy. As
can be seen in the diagram of FIG. 6, in which the Formulations I
to IV of the coatings 12, 12', 12'', 12''' as well as a gold
coating (Au) and a polystyrene coating (PS), serving as references,
are plotted on the x axis, and the layer thickness of the
fibrinogen in nm is plotted on the y axis, a relationship is
apparent between the particular nanofilm and the layer thickness of
the adsorbed fibrinogen. The measurement results differ from each
other, ranging from almost no protein on coating 12 using
Formulation I to a layer thickness of 8.8 nm on coating 12'''
according to Formulation IV. An uncoated gold surface and
polystyrene were used as references. As described above, the
coating 12 has a high oxygen content and a high swelling factor.
This is associated with very low protein adsorption. The good water
wetting property minimizes the hydrophobic interactions between the
protein and the surface. The polar and nonpolar groups, which are
located directly at the interface between the coating and the
water, fit the lattice structure of water very well. This results
in a stable structure or orientation of the water molecules on the
surface, and thus in a disadvantageous energy balance of the
protein adsorption.
[0119] It is further proposed for the coating to have a moderate
swelling factor, preferably a swelling factor in the range of 1.2
to 3.5, and more preferably in the range of 1.5 to 3.0. The
advantage of such a coating is that a swelling factor of this
magnitude keeps the adsorption of the body's own proteins low,
while the few proteins that do adsorb remain in the native
conformal structure thereof. In this way, particularly effective
masking of an implant by the body is achieved, which makes ingrowth
of the implant more difficult or prevents the same, and thereby
furthermore enables explantation without complications.
[0120] The adsorption of fibrinogen allowed the progression from an
elevated amount of protein on surfaces low in oxygen to little
protein on surfaces rich in oxygen to be tracked very well. The
reduction in the amount of protein is associated with an increased
degree of swelling and increasing hydrophilicity. It is now of
interest to explore the structure in which the proteins are present
after adsorption, and whether the secondary structure thereof is
preserved. In this respect, a structure that is similar to the
native structure in solution was able to be shown both for albumin
and for fibrinogen on oxygen-rich coatings (not shown). Despite
this native structure on the surface, it was not possible to wash
these proteins off the surface; instead, they bind to the same.
This native structure of the proteins on the surface represents the
principle of good biological compatibility. They ultimately form
the direct interface, and no foreign body reaction is triggered by
virtue of the native structure. The proteins on the surface are
bound firmly, wherein the hydrophilicity and swelling ensure that
liquid surrounds the proteins on the surface and that the mobility
of the polymer chains favors the formation of a bond with the
protein, however that this bond does not exceed the intramolecular
forces of the protein, and consequently as little a deformation of
the proteins as possible occurs on the foreign body surface.
[0121] In addition, the influence of the layer thicknesses 30 of
the coatings 12, 12', 12'', 12''' on the absorption of fibrinogen
was examined. So as to obtain an adequate measurement range, these
measurements were carried out using varying thicknesses of the
coatings 12'', produced according to Formulation III. The result is
shown in the diagram of FIG. 7, in which the varying layer
thicknesses 30 of the coating 12'' according to Formulation III are
plotted on the x axis, and the layer thickness of the fibrinogen in
nm is plotted on the y axis. The measurement results show a
constant layer thickness of the adsorbed fibrinogen at layer
thicknesses 30 of the coating 12'' between 3.6 nm and 24 nm.
[0122] It is assumed that low or no protein adsorption can be
equated to good biocompatibility. The low adsorption of fibrinogen
on the coating 12, produced according to Formulation I, was
therefore taken as an opportunity to provide the implant 10, or the
surfaces 14 and 16, with such a coating 12. For this purpose, the
coating parameters were, or coating time was, selected so that a
layer thickness 30 of 15 nm to 25 nm was deposited (see FIG. 2). A
coating time of approximately 60 min was sufficient for this
purpose.
[0123] The surfaces 14 of the housing 56 of the implant 10, which
can be introduced into a bloodstream of an animal body and/or a
human body, were coated using the following coating parameters:
pressure: 5 Pa, flow rate of the methane coating gas 18: 2.5 sccm,
flow rate of the oxygen coating gas 20: 1.3 sccm, current intensity
of the plasma polymerization system 22: 200 mA, electrodes 24 of
the plasma polymerization system 22: 100% titanium, rotational
speed of the sample holder 50: 2 rpm, and coating duration 1 min to
200 min, preferably 20 min to 100 min, and particularly preferably
60 min.
[0124] In the coating of the surface 16 or of the polymer membrane
26, it had to be taken into consideration that the pores 28 of the
polymer membrane 26 are stabilized with a stabilizer 42 in the form
of glycerol so as to prevent collapsing on air (In FIG. 2,
indicated only for one pore 28). This glycerol must still be intact
after the coating process. Accordingly, the coating process must be
deliberately adapted. The coating parameters are selected so that
the glycerol on the surface of the membrane 26 is evaporated, and
the glycerol in the pores 28 is preserved, prior to applying the
plasma polymer layer 12. In this way, the surface 16 of the
membrane 26 may be coated with plasma polymers, while the
stabilizer 42 remains preserved in the pores 28. This was
successfully achieved by optimizing the method parameters, in which
the glycerol on the surface 16 of the membrane 26 is removed, not
however in the pores 28. This approach takes advantage of the fact
that the vapor pressure of glycerol is in the pressure range that
prevails or is set during the coating process in the plasma
polymerization system. This is discernible from the diagram of FIG.
8, in which the temperature in .degree. C. is plotted on the x
axis, and the pressure in Pa is plotted on the y axis, and the
vapor pressure curves of various substance are shown (pairings:
symbol-substance: squares-hexane, diamonds-glycerol,
triangles-ethanol, crosses-isopropanol, stars-water). It can be
seen that the vapor pressure of glycerol (diamond symbol) is in the
range of the optimized pressure generated in the chamber (arrow).
As a result, the glycerol is evaporated in the reaction chamber of
the plasma polymerization system 22.
[0125] For the actual coating process of the membrane 26, the
sample is mounted on the sample holder 50 as is customary.
Thereafter, the vacuum is generated by the butterfly valve to the
vacuum pump being opened (not shown in detail). The optimized
vacuum cycle is influenced by way of the pumping capacity, among
other things. The glycerol thus begins to evaporate due to the
vapor pressure. This can be observed based on a curve progression
of the pressure in the coating chamber of the plasma polymerization
system 22 when evacuating the coating chamber.
[0126] A curve progression of the pressure as a function of the
time is shown in the diagram of FIG. 9, in which the time in
min:sec is plotted on the x axis, and the pressure in Pa is plotted
on the y axis, for four different loadings (A, B, C, D) of the
coating chamber. Loading A represents an evacuation of the coating
chamber without the presence of a membrane, loading B represents
the presence of a membrane 26, loading C represents the presence of
two membranes 26, and loading D represents the presence of one
membrane 26 where previously the glycerol was already evaporated
(using the same process).
[0127] When a membrane 26, which is stabilized with glycerol, is
introduced into the coating chamber (curve B), it is apparent
compared to a reference measurement without membrane (curve A) that
the time until the final pressure is achieved is reached not until
after a long time period (see arrow). Based on the shape of the
curve progression with membrane 26 (curves B and C), a clearly
reduced gradient at the beginning of the process is apparent. In
the case of multiple membranes (curve C), the "belly" of the curve
becomes larger since more glycerol is being evaporated. The curve
progression for loading D, in which the glycerol of the membrane 26
was already evaporated in advance, is similar to that of the
control without membrane in the coating chamber (curve A). The
shape of the membrane is observed as a control measure to ensure
that the amount of glycerol that was evaporated is not
excessive--the membrane 26 would bend if a loss of glycerol in the
pores 28 were to occur. When a constant final pressure is reached,
the plasma polymer coating commences.
[0128] It has been shown that such a polymer membrane 26 can be
coated using the following coating parameters: pressure: 1 Pa to 3
Pa, flow rate of the methane coating gas 18: 2.5 sccm, flow rate of
the oxygen coating gas 20: 1.3 sccm, current intensity of the
plasma polymerization system 22: 100 mA to 400 mA, for example 375
mA, electrodes 24 of the plasma polymerization system 22: 100%
titanium, rotational speed of the sample holder 50: 2 rpm, and
coating duration 1 min to 200 min, preferably 60 min to 160 min,
particularly preferably 140 min. A good layer thickness 30 of
approximately 15 nm to 25 nm can be achieved with a coating time of
140 min. The coating protocol differs slightly from the
above-described protocol for Formulation I and is denoted by
Ia.
[0129] Accordingly, the coating parameters were selected so that it
was possible to coat a rough surface 14, 16. In addition, the
coating parameters were selected so that it was possible to coat a
surface 16 having permeability, which is to say the polymer
membrane 26. Furthermore, so as to obtain the coating 12 according
to Formulation I, the coating parameters were selected so that an
oxygen-containing hydrocarbon coating 12 is formed.
[0130] The coated polymer membrane 26 of the implant 10 was
subjected to a functional test. In this test, the permeabilities of
the coated biosensor or of the polymer membrane 26 thereof were
compared to those of an uncoated sensor. In addition, the
permeability of a coated membrane 26 was examined after
explantation in an in vivo incubation. As can be seen in the
diagram of FIG. 10, in which the membrane property is plotted on
the x axis, and a sensor signal is plotted on the y axis, the
sensor signal of the coated implant 10 (white bar in the middle)
does not differ significantly from the sensor signal of the
uncoated implant (left bar with thick stripes). Even after
implantation or explantation (right bar with thin stripes), the
sensor signal remains substantially the same compared to the coated
condition without implantation (white bar in the middle) and the
uncoated condition (left bar with thick stripes). It was therefore
possible to successfully demonstrate that the polymer membrane 26,
and thus the biosensor, is intact and fully functional even after
the coating process. It is also apparent from the figure that, in
contact with body fluids, the membrane pores 28 remain passable to
the analyte 66 to be detected, and the plasma polymer coating 12
thus also maintains its function in vivo.
[0131] The application of a plasma polymer layer having the
above-described positive properties is only possible with
difficulty on some substrates. This may be remedied by pretreating
the surface 14, 16 to be coated. For example, one or more
adhesion-supporting layers could be applied. To this end, an
adhesion promoter layer 32 is applied as a mediating layer between
the surface 14, 16 of the implant 10 which is to be coated and the
plasma polymer layer or the coating 12, 12', 12'', 12'''. This is
shown by way of example in FIG. 2 on the left surface 14 of the
implant 10. The properties of the adhesion promoter layer 32, and
thus the coating parameters, are selected so that a subsequent
application of the layer 12 can be carried out successfully, and in
particular the positive properties are imparted to the same.
[0132] The coating with the adhesion promoter layer 32 is carried
out using the following coating parameters: pressure: 5 Pa, flow
rate of the methane coating gas 18: 2.5 sccm to 5 sccm, flow rate
of the oxygen coating gas 20: 0 sccm to 2 sccm, current intensity
of the plasma polymerization system 22: 200 mA, electrodes 24 of
the plasma polymerization system 22: 100% titanium, rotational
speed of the sample holder 50: 2 rpm, and coating duration 1 min to
200 min. By coating the surface 14 with an adhesion-promoting layer
or with adhesion-promoting layers (referred to as layer stacks),
the plasma polymers can be applied to any conceivable
substrate.
[0133] A protocol having the following coating parameters has
proven useful for applying the coatings 12, 12', 12'', 12''' to the
adhesion promoter layer 32: pressure: 5 Pa, flow rate of the
methane coating gas 18: 2.5 sccm, flow rate of the oxygen coating
gas 20: 1.3 sccm, current intensity of the plasma polymerization
system 22: 200 mA, electrodes 24 of the plasma polymerization
system 22: 100% titanium. rotational speed of the sample holder 50:
2 rpm, and coating duration 1 min to 200 min, preferably 20 min to
100 min, and particularly preferably 60 min.
[0134] When using implants such as the implant 10/biosensor
described here, it is also desirable, in addition to minimizing
accumulations of interfering substances 72 and a resulting
encapsulation, to reduce, or even entirely prevent, an adherence of
bacteria and the attendant inflammation at the implantation site.
Accordingly, the four coatings 12, 12', 12'', 12''', produced
according to Formulations I to IV, were examined with respect to
the antibiotic action thereof, which is to say the action thereof
to inhibit or prevent bacterial growth. For this purpose, the
adhesion of the bacteria on the different coatings 12, 12', 12'',
12''' (applied to a silicon substrate, which also serves as a
positive control) was ascertained over a time period of 24
hours.
[0135] As can be seen in the diagram of FIG. 11, which shows the
colonization with E. coli bacteria as a function of the type of the
colonized coating 12, 12', 12'', 12''', considerable differences
can be found in the adhesion of E. coli bacteria to the different
coatings 12, 12', 12'', 12'''. The positive silicon control (left
bar) contains the maximum of adhering bacteria. Considerable
adhesion can also be found on the coating 12''' according to
Formulation VI. The lowest colonization is found on coating 12'',
applied using Formulation III, wherein the coatings 12'
(Formulation II) and 12 (Formulation I) likewise have a
considerable reduction in adhering bacteria. Compared to the
positive control, a value of 98.7% can be reported in terms of the
reduction of bacteria on coating 12'' according to Formulation
III.
[0136] The difference in bacterial adhesion can also be seen well
in the fluorescence microscopy images of GRP (green fluorescent
protein)-marked bacteria 72 (magnification 1:200) of FIGS. 12 and
13. As can be seen in FIG. 12, which shows a bacterial colonization
of an uncoated silicon substrate, a high level of colonization
occurs here (number of bacteria 72 per substrate 7265). In
contrast, as is shown in FIG. 13, only minimal colonization takes
place on a substrate coated with coating 12'' (number of bacteria
72 per substrate 12).
[0137] When examining the influence of the layer thickness 30 of
the coating 12'' according to Formulation III on the adhesion of
bacteria, the results shown in the diagram of FIG. 14 are obtained,
which illustrate the colonization with E. coli bacteria as a
function of a layer thickness 30 of the coating 12''. An uncoated
silicon substrate (right bar) again serves as the reference.
[0138] Starting at a layer thickness 30 of 24 nm (left bar), a
reduction in the number of bacteria on the coating 12'' of 99% can
likewise be seen. This value holds up to a layer thickness 30 of 6
nm. It is only starting at a layer thickness 30 of 3.6 nm and 2.4
nm that more bacteria can be found on the surface. This involves
insular growth, where polymerized species or clusters, resembling
the later nanofilm in terms of the properties of the same, form on
the surface. These clusters already influence the settling of
bacteria, but cannot prevent growth across the entire area. It has
thus been shown that the antibacterial property of the coating 12''
occurs starting at a layer thickness of 6 nm.
[0139] These results were now used to coat the implant 10 such that
a coating 12, 12', 12'', 12''' having antibiotic properties is
obtained. For this purpose, the following coating parameters were
used: pressure: 1 Pa to 10 Pa, flow rate of the methane coating gas
18: 1 sccm to 5 sccm, flow rate of the oxygen coating gas 20: 0.5
sccm to 2 sccm, current intensity of the plasma polymerization
system 22: 100 mA to 300 mA, coating time 1 minute (min) to 200
min, electrodes 24 of the plasma polymerization system 22:
titanium, titanium content: >50%, rotational speed of the sample
holder 50: 0 rpm to 5 pm.
[0140] Particularly good results were achieved using the following
coating protocol: pressure: 4 Pa to 6 Pa, flow rate of the methane
coating gas 18: 3 sccm, flow rate of the oxygen coating gas 20: 1
sccm, current intensity of the plasma polymerization system 22: 150
mA to 250 mA, coating time: 1 min to 200 min, electrodes 24 of the
plasma polymerization system 22: titanium, titanium content: 100%,
rotational speed of the sample holder 50: 2 rpm.
[0141] It was found that the antibiotic action of the plasma
polymer layers is based on titanium becoming embedded in the
polymer layer. The coating parameters are thus selected such that
at least one antibiotically acting metal 40 is introduced into the
coating 12, 12', 12'', 12'''. The fact that this takes place during
the plasma polymerization process is apparent from the resulting
atomic compositions of the coatings 12, 12', 12'', 12''' (see Table
1 and FIG. 3). This can be achieved by applying the coating 12,
12', 12'', 12''' in the presence of at least one antibiotically
acting metal 40, and more particularly by knocking the
antibiotically acting metal 40 out of the electrodes 24 of the
plasma polymerization system 22 during the coating process.
[0142] As described above, a wide variety of collisions, such as
excitation, ionization and recombination of the involved species,
take place in the plasma during plasma polymerization. Likewise,
electrode material (such as titanium) is "sputtered out" during
these processes, which is then likewise embedded in the
nanofilm/the coating 12, 12', 12'', 12'''. If the parameters are
selected correctly, a polymer is formed from the starting
substances, this being methane and oxygen, and titanium becomes
embedded therein. During the incorporation of titanium oxide into
the polymer network, photocatalysis takes place as a result of UV
light or near-UV light. This photocatalysis can already take place
during the process. This, in turn, leads to the formation of oxygen
radicals, which have a damaging effect on bacteria 72. The
photocatalysis then forms radicals, which can destroy bacteria 72.
A particular result that was able to be shown is that the surface
maintains the antibacterial properties thereof even when the
coating is stored under dark conditions directly after the coating
process.
[0143] As is apparent from FIG. 2 and the description above, it is
possible for only individual surfaces 14, 16 of the implant 10 to
be coated. The coatings 12, 12', 12'', 12''' may also differ from
each other, or adhesion promoter layers 32 may be used on certain
surfaces 14.
[0144] So as to yield sectional and/or only partial coating,
regions that are to remain uncoated can be covered during the
coating process.
[0145] An embodiment comprising coated and uncoated regions may
even be advantageous, since these regions can individually assume
different functions. For example, if the implant 10 includes a
functional sector 36 in the form of an analysis sector, such as the
sensor system 54, it is advantageous to coat this analysis sector
or functional sector 36 to suppress fouling, which may interfere
with the measurement process or render it impossible. If the
implant 10 moreover includes an attachment sector 38, it may be
useful to leave the same uncoated (see FIG. 2). In this way, the
implant 10 can be attached by an encapsulation of the attachment
sector 38 or anchored in the tissue.
[0146] Moreover, a compatibility of the implant 10 can be improved
by sterilizing the implant 10, and more particularly by way of
ethylene oxide. This is particularly advantageous, since the
coating 12 or plasma polymer coatings can also be sterilized by way
of ethylene oxide, without impairing the structure or properties of
the same.
[0147] It was even shown that the properties of the plasma polymer
layers improve as a result of the treatment with ethylene oxide.
The coatings 12, 12', 12'', 12''' exhibit an aging process when
stored on air. During this aging process, slowly increasing contact
angles .theta. develop over the course of weeks. This is caused by
translatory movements of polar groups in the polymer matrix. In a
nonpolar environment (air), these groups become oriented in the
direction of the bulk or in the polymer network. This manifests
itself in an increased contact angle .theta.. This aging process
can be reversed by storing this coating 12, 12', 12'', 12''' in a
polar liquid (such as water) (revitalization process). The
preceding paragraphs explained that hydration of the plasma polymer
layer is needed for the positive effects of the coating 12, 12',
12'', 12'''. In contact with water, the hydration of the layer can
be observed based on the contact angle .theta.. It was possible to
demonstrate that sterilization by way of ethylene oxide
particularly advantageously affects this "revitalization
process."
[0148] As can be seen in the diagram of FIG. 15, in which the time
in days is plotted on the x axis, and a progressing contact angle
.theta. is plotted on the y axis, the progression of the contact
angle .theta. as a function of the time differs for a coating 12
with ethylene oxide sterilization (squares) and a coating 12
without ethylene oxide sterilization (circles). Compared to the
non-sterilized samples (circles), the required contact angles
.theta. are achieved more quickly in the sterilized samples
(squares), and it is also apparent that even smaller contact angles
.theta. can be achieved by way of ethylene oxide sterilization. It
can be assumed that the positive effects of the plasma polymer
coating can be enhanced even further by a sterilization by way of
ethylene oxide.
[0149] As a result of the physicochemical properties of the
surfaces 14, 16 of the implant 10, no encapsulation of the implant
10 in collagen-containing tissue structures takes place, and
additionally no thrombi are formed. On the other hand, the
properties of the surfaces 14, 16 of the implant 10 allow a
drastically reduced adhesion of bacteria 72 to be achieved.
[0150] To ascertain which chemical groups could be involved in the
attachment of interfering substances 72, the coating 12 was
examined based on a Fourier transform infrared spectroscopy. The
result of the same is shown in FIG. 16, wherein here the
transmission is plotted on the x axis, and the wavenumber in
cm.sup.-1 is plotted on the y axis. The aldehyde group was
identified as a reactive chemical group 34 in terms of potential
binding sites for non-specific adsorption.
[0151] A considerable reduction in the adsorption of interfering
substances 72 can be achieved when the coating 12, 12', 12'', 12'''
is treated using a treatment parameter that is selected such that
reactive chemical groups 34, and more particularly aldehyde groups
34, of the coating 12 are chemically modified. In terms of the
chemical modification, a reduction of the groups 34 is a good
approach. Possible reducing reagents include, for example, sodium
borohydride, tris(hydroxymethyl)aminomethane (TRIS), ethanolamine
or glycine.
[0152] For examination, the coating 12 was treated differently and
then an immunoassay was carried out for analysis purposes, which
shows the degree of protein adsorption on the differently treated
coatings 12. The result is shown in the diagram of FIG. 17, in
which a measurement signal at a wavelength of 650 nm is plotted on
the y axis, and the treatment of the coating 12 is plotted on the x
axis.
[0153] The substrates used included uncoated and untreated surfaces
14, untreated coatings 12, and coatings 12-red reduced with sodium
borohydride (NaBH.sub.4), and with sodium borohydride
(NaBH.sub.4).
[0154] The functional principle of the immunoassay is based on the
detection of binding between a substrate or a surface and a
protein, in this case an antibody, which is coupled with a marker
enzyme (by way of example here: antibody: goat anti-rabbit (GAR),
marker enzyme: horseradish peroxidase (HRP). If the substrates are
incubated with the antibody, the antibody individual adsorbs onto
the substrate. Unbound antibody can be washed away using a washing
step. The amount of bound GAR/HRP can now be examined by
interaction with a fluorescence marker in the immunoassay. The
antibody complex was used in two dilutions (1:1000, 1:2000). All
incubation times were one hour. The coating time of the microtiter
plate that was used was 5 minutes.
[0155] The uncoated surface 14 served as the positive control. As
expected, a large amount of protein or antibodies adsorbs thereon,
which is apparent from the two high measurement signals (first
group of bars on the left). The approach using bovine serum albumin
(BSA) is used to ascertain the background signal of the
non-specific bonds of GAR/HRP with arbitrary proteins. The binding
structures of the surface 14 were blocked by BSA prior to the
incubation with antibodies. Since all binding structures are
blocked by BSA, and only minimal accumulations of the antibody can
take place, the measurement signals are low, as expected (second
group of bars from left). However, the effect of the variably
diluted GAR/HRP is already apparent here; the measurement signal of
the left bar (dilution 1:1000) is approximately twice that of the
measurement signal of the right bar (dilution 1:2000). A reduction
in antibody attachment takes place in the approaches with the
coating 12 (see also FIG. 6). The difference in signals for the
dilutions (second group of bars from right) is also very visible
here.
[0156] If the reactive chemical groups 34 of the coating 12 are now
reduced using sodium borohydride (coating 12-red), the absorption
of the antibody decreases further (first group of bars from
right).
[0157] It was thus possible to impressively and surprisingly
demonstrate that the adsorption of interfering substances 72 onto
the coating 12 can be reduced considerably, or to approximately 24%
to 20%, by reducing the same, for example by way of sodium
borohydride.
[0158] FIGS. 18 to 26 show two alternative exemplary embodiments of
the implant 10. Identical components, features and functions are
denoted by the same reference numerals. However, in order to
distinguish the exemplary embodiments, the letters a and b have
been added to the reference numerals in the exemplary embodiments.
The description below is substantially limited to these differences
compared to the exemplary embodiment of FIGS. 1 to 17, wherein
reference is made to the description of the exemplary embodiment in
FIGS. 1 to 17 with respect to identical components, features, and
functions.
[0159] The implant 10a of the exemplary embodiment of FIGS. 18 to
20 differs from the implant 10 of FIGS. 1 to 17 in that it is a
model of an electrical sensor comprising a housing and a cable
connected thereto, which is to be introduced into a bloodstream.
This may also be a biosensor.
[0160] As a model of this sensor system, an implant 10a was
developed, which includes a titanium cylinder 80 serving as the
housing, having a silicone cuff 82 disposed around the rear portion
of the titanium cylinder 80 (see FIG. 18, which shows the implant
10a in a perspective schematic drawing). An electrical cable 84 is
embedded in the silicone cuff 82. All sections can have the same
diameter or differ with respect to the diameters thereof. A front
portion of the titanium cylinder 80 was coated with a coating 12
according to Formulation I using the following coating parameters:
pressure: 5 Pa, flow rate of the methane coating gas 18: 2.5 sccm,
flow rate of the oxygen coating gas 20: 1.3 sccm, current intensity
of the plasma polymerization system: 200 mA, electrodes of the
plasma polymerization system: 100% titanium, rotational speed of
the sample holder 50: 2 rpm, coating time 1 min to 200 min,
preferably 20 min to 100 min, and particularly preferably 60 min.
The layer thickness was 20 nm.
[0161] As is apparent from FIGS. 19 and 20, which show a photograph
of the implant 10a following explantation and a schematic contour
drawing of the explanted implant 10a, no encapsulation of the front
portion of the titanium cylinder 80, which is provided with the
coating 12, takes place. The rear portion of the titanium cylinder
80 and the silicone cuff 82, in contrast, were completely
encapsulated by the body of the test animal. A particularly large
encapsulation 86 has even formed around the uncoated titanium of
the titanium cylinder 80. This again illustrates how effective the
coating 12 is.
[0162] The implant 10b of the exemplary embodiment of FIGS. 21 to
26 differs from the implant 10 of FIGS. 1 to 17 in that it is a
model of a sensor system for continuously monitoring cardiovascular
vital parameters. The task of this sensor system is to monitor
cardiovascular parameters. This is an implantable sensor system for
monitoring the blood pressure, the pulse, the pulse shape, and the
oxygen saturation. The sensor is applied intracorporeally,
extravasally using a highly elastic ring.
[0163] As a model of the sensor, an implant 10b was designed, which
includes a band-shaped silicone carrier 88, which can be closed by
a Kapton closure 90 (see FIG. 21, which shows a schematic drawing
of an implant 10b). As is shown in FIG. 22, the silicone carrier 88
can be placed around a blood vessel, such as an artery 92. So as to
analyze the ingrowth behavior of the implant 10b in the body, two
silicone carriers 88 were coated with coatings 12, 12'' according
to Formulations I and III and implanted into the tissue of test
animals.
[0164] After explantation of the implants 10b, electron microscopic
images of the coatings 12, 12'' were created. In the case of the
uncoated substrate, it can be seen that interfering substances 72
have adsorbed onto the surface, even in the form of large
conglomerates. Considerably fewer interfering substances 72 have
settled on the coatings 12, 12''.
[0165] As is apparent from FIGS. 23 to 26, which each show
photographs and schematic contour drawings of an uncoated implant
10b (FIGS. 23 and 24) and of an implant 10b coated with the coating
12 according to Formulation I (FIGS. 25 and 26) after explantation
of the explanted implant 10b, the uncoated implant 10b is
completely enclosed by an encapsulation 86. In contrast, if the
implant 10b is coated with a coating 12, considerably less of the
same is enclosed by encapsulations 86. In the case of Formulation
I, the majority of the silicone carrier 88 remains free.
Encapsulation 86 takes place merely in the region of the closure
90, which may be due to the uncoated polyimide. These results
confirm the in vitro experiments on protein adsorption very well.
The more natively the proteins adsorb on the coating 12, the less
will the foreign body response will be.
[0166] It will be apparent to those skilled in the art that
numerous modifications and variations of the described examples and
embodiments are possible in light of the above teaching. The
disclosed examples and embodiments may include some or all of the
features disclosed herein. Therefore, it is the intent to cover all
such modifications and alternate embodiments as may come within the
true scope of this invention.
TABLE-US-00003 List of reference cited 10 implant 12 coating 14
surface 16 surface 18 coating gas - methane 20 coating gas - oxygen
22 plasma polymerization system 24 electrode 26 membrane 28 pore 30
layer thickness 32 adhesion promoter layer 34 group 36 functional
sector 38 attachment sector 40 metal 42 stabilizer 44 magnet 46
feed system 48 reactor volume 50 sample holder 52 rotational
direction 54 sensor system 56 housing 58 reservoir 60 detection
system 62 receptor 64 semiconductor component 66 analyte 68
antagonist 70 diameter 72 molecule/cell/bacterium/impurity 74
micromolecule 76 binding site 78 passivation layer 80 titanium
cylinder 82 silicone cuff 84 cable 86 encapsulation 88 silicone
carrier 90 Kapton closure 92 artery 94 measuring unit A loading B
loading C loading D loading
* * * * *