CN116099034A - 一种用于眼科手术的生物粘合剂及其应用 - Google Patents
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Abstract
本发明涉及一种用于眼科手术的生物粘合剂,该生物粘合剂由主组分和辅组分组成,主组分为接枝双键的明胶和醛基化F127的复合制剂,辅组分为核黄素和L‑精氨酸,基于改性明胶和改性普朗尼克F127的透明、强韧型生物粘合剂,可应用于眼科手术技术领域,如结膜移植粘合、角膜板层植片粘合、羊膜移植粘合、白内障眼表粘合以及角膜缺损修补粘合。本发明粘合剂的特点是韧性强,角膜粘附性高,同时具有良好的透明性,用生物粘合剂替代缝合,所需手术时间短、对医生技术要求低、无异物反应。
Description
技术领域
本发明涉及眼科手术技术领域,具体地说,是关于一种用于眼科手术的生物粘合剂及其应用。
背景技术
膜移植术是治疗角膜损伤引起的视力损害的金标准。当前,无论是穿透角膜移植还是板层角膜移植,临床中都通过缝合线手术缝合以固定移植角膜。但角膜缝合手术需要高超的手术技巧,而且使用缝合线会出现一些并发症,如缝合线糜烂、缝合部位浸润、感染性角膜炎、缝合线松动并即将出现伤口裂开,以及拆线后伤口裂开等,所以利用生物粘合剂来解决上述问题很有必要。
当前大量研究和专利涉及生物粘合剂,但大部分并不适用于角膜手术,因为缺少足够的透明性。中文专利CN115554461A,公开日2023.01.03公开了一种基于明胶和多巴胺的高透明眼用粘合剂的制备方法及应用,涉及眼科手术技术领域,可应用到眼表手术后粘合中,具体为结膜移植的粘合、角膜板层植片的粘合、羊膜移植的粘合、白内障术后眼表粘合或角膜缺损修补粘合。本发明的方法通过选用安全性高的多巴胺和明胶,即避免了已有的血源性粘合剂可能潜在的病毒传染性风险,又通过选用双键自由基聚和的方式将多巴胺分散在明胶链上,避免多巴胺的自聚合,实现了粘性的同时,也保留了凝胶原有的透明状态,具有超高的透明性,从而不会在眼部手术过程中以及术后恢复中患者影响视力。另一中文专利CN105597145A,公开日2016.05.25,公开了一种视网膜细胞支架生物手术粘合剂及其制备方法。它包括层粘连蛋白、Ⅳ型胶原、巢蛋白、人硫酸肝素糖蛋白,成纤维细胞生长因子、基质金属蛋白酶和磷酸缓冲盐溶液。本发明制备了视网膜细胞支架生物手术粘合剂,利用其能将可降解人iPSCs源性视网膜神经支架(iRMP)与宿主视网膜神经层粘合,为细胞生物支架与宿主视网膜有效整合提供保证。
作为一种由胶原蛋白纤维不可逆水解产生的多分散蛋白,明胶是一种刺激细胞附着和生长的理想大分子。基于改性明胶作为角膜粘合剂或角膜替代品,受到广泛关注,甲基丙烯酰化明胶(GelMA)作为角膜替代品应用最为广泛,因为其在光照下可控交联,便于制备原位固化的水凝胶,文献(E.S.Sani,A.Kheirkhah,D.Rana,Z.Sun,W.Foulsham,A.Sheikhi,A.Khademhosseini,R.Dana,N.Annabi,Sutureless repair of corneal injuriesusingnaturally derived bioadhesive hydrogels,Sci.Adv.5(2019),eaav1281)和(I.A.Khalil,B.Saleh,D.M.Ibrahim,C.Jumelle,A.Yung,R.Dana,N.Annabi,Ciprofloxacin-loaded bioadhesive hydrogels for ocular applications,Biomater.Sci.8(2020)5196.)中报道,原位光固化GelMA基水凝胶在角膜组织上表现出一定的锚定能力。然而,考虑到眼球表面的湿度,以及眼球运动和眨眼造成的对水凝胶的频繁外部刺激,GelMA和角膜组织之间的粘附力不足,且GelMA机械强度差,易损坏,所以GelMA基生物粘合剂的角膜组织粘附力需要进一步提高。
而目前关于本发明的一种用于眼科手术的生物粘合剂及其应用还未见报道。
发明内容
本发明的第一个目的是,针对现有技术中的不足,提供一种用于眼科手术的生物粘合剂。
本发明的第二个目的是,提供一种生物粘合剂的应用。
为实现上述第一个目的,本发明采取的技术方案是:一种用于眼科手术的生物粘合剂,所述的生物粘合剂由主组分和辅组分的套装组成;所述的主组分为接枝双键的明胶和醛基化F127的复合制剂;所述的辅组分为核黄素和L-精氨酸。
作为一个优选例,所述生物粘合剂的制备包括以下步骤:
S1:合成接枝双键的明胶(GelMA):将明胶完全溶解于PBS缓冲液中,然后加入甲基丙烯酸酐,搅拌2~3h后停止反应。反应液用透析袋以2h/次的频率更换去离子水,透析10次。透析之后用滤膜过滤,冷冻干燥获得接枝双键的明胶(GelMA),备用;
S2:合成的醛基化F127(AF127):将F127溶于二氯甲烷,然后加入吡啶和对苯磺酰氯,在室温下反应24~48小时。混合物用盐酸提取,有机相用NaHCO3洗涤,从四氢呋喃/二乙醚混合溶剂中重结晶,并在真空中干燥,得到中间产品。将中间产物溶于N,N-二甲基甲酰胺,加入4-羟基苯甲醛和碳酸钾,在80℃下搅拌反应48~72小时,并冷却至室温。加水后,反应液用二氯甲烷提取。有机层用MgSO4干燥,浓缩,并在冷的二乙醚中沉淀,过滤并真空干燥,得到醛基化F127(AF127),备用;
S3:将S1合成的明胶(GelMA)和S2合成的醛基化F127(AF127)溶于生理盐水中组成复合制剂,即获得生物粘合剂的主组分;
S4:将辅组分水溶性核黄素和L-精氨酸加入至步骤S3中的主组分中混合均匀即获得生物粘合剂。。
更优选地,上述的步骤S1中的接枝双键的明胶(GelMA)的质量体积浓度范围为5w/v%~10w/v%;所述的步骤S2中醛基化F127(AF127)的质量体积浓度范围为5w/v%~10w/v%。
更优选地,上述的步骤S1中的接枝双键的明胶(GelMA)的质量体积浓度范围为10w/v%;所述的步骤S2中醛基化F127(AF127)的质量体积浓度范围为5w/v%,GelMA(10w/v%)+AF127(5w/v%)透光率最高。
更优选地,上述的步骤S1中的接枝双键的明胶(GelMA)的氨基取代度范围为50%~90%,以保证粘合剂粘合性和自身强度;所述的明胶在合成时加热至37℃后溶解于生理盐水中。
更优选地,上述步骤S2中醛基化F127的醛基化程度为100%,以保证粘合剂粘合性和自身强度;所述AF127在合成时室温溶解于生理盐水。
更优选地,所述步骤S4中的辅组分在加入前需要将主组分需预热至37℃,上下颠倒数次使辅组分均匀溶解,即可形成最终应用的生物粘合剂,上下颠倒过程应尽量避免气泡产生。
更优选地,所述步骤S4中辅组分中的水溶性核黄素在粘合剂体系中的质量体积分数为0.1w/v%;所述L-精氨酸粘合剂体系中的量为GelMA质量的0.4倍;所述辅组分的组成固定。
为实现上述第二个目的,本发明采取的技术方案是:上述任一所述的生物粘合剂在眼部手术粘合中的应用,包括但不限于结膜移植粘合、角膜板层植片粘合、羊膜移植粘合、白内障眼表粘合以及角膜缺损修补粘合。
作为一个优选例,所述的生物粘合剂在应用时使用前需预热至37℃,滴加进移植部位,并将移植物安装到位后,用紫外光(365nm,250w)对移植区域10cm处进行5~10分钟辐照,优化地操作方式为先辐照5分钟,间歇1分钟,再辐照5分钟。
本发明优点在于:
1.可用于粘合角膜组织和移植物,这一粘合性源于液态下粘合剂与角膜组织间的渗透,并在光固化后与组织形成互锁网络;同时醛基化F127的醛基能够与角膜组织形成席夫碱键合。
2.本发明粘合剂具有高韧性,可耐受非常大的形变,因此,外力作用难以破坏该生物粘合剂,因此进一步强化了其粘合力。
3.在优化地组分下,该粘合剂的透光性高于90%,对治疗期间的视力不造成负面影响。
4.辅组分中的光敏剂基于核黄素,这是一种眼科临床常用的角膜交联技术中所用到的药物,被证实安全可靠。
附图说明
附图1生物粘合制剂主组分。
附图2生物粘合剂体外角膜组织粘附性和自身韧性演示。
附图3生物粘合剂体内粘和移植角膜植片的稳定性演示(以棉棒按压、前后晃动移植片)。
具体实施方式
下面结合具体实施方式,进一步阐述本发明。应理解,这些实施例仅用于说明本发明而不用于限制本发明的范围。此外应理解,在阅读了本发明记载的内容之后,本领域技术人员可以对本发明作各种改动或修改,这些等价形式同样落于本申请所附权利要求书所限定的范围。
实施例1粘合剂的制备
一种用于无缝和角膜移植粘合剂的制备方法,包括如下步骤:
S1:主组分中接枝双键的明胶(GelMA)的制备:
在60℃下将2g明胶完全溶解于20mL的PBS缓冲液中,然后加入1.6mL甲基丙烯酸酐,搅拌2.5h后,加入80mL的PBS缓冲液,继续反应30min后停止反应。反应液用截留分子量7000的透析袋以2h/次的频率更换去离子水,透析10次。透析之后用0.22μm滤膜过滤,冷冻干燥获得接枝双键的明胶(GelMA),备用;
S2:主组分中醛基化F127(AF127)的制备:
将2g F127溶于15mL二氯甲烷,然后加入5mg吡啶和0.1g对苯磺酰氯,无氧条件下在室温下反应24小时。混合物用盐酸提取,有机相用NaHCO3洗涤,从四氢呋喃/二乙醚混合溶剂中重结晶,并在真空中干燥,得到中间产品。将中间产物溶于N,N-二甲基甲酰胺,加入过量4-羟基苯甲醛和碳酸钾,在80℃下搅拌反应72小时,并冷却至室温。加水后,反应液用二氯甲烷提取。有机层用MgSO4干燥,浓缩,并在冷的二乙醚中沉淀,过滤并真空干燥,得到醛基化F127(AF127),备用。醛基化程度为100%;
S3:复合制剂的制备:
在37℃下,将GelMA以10w/v%的质量体积浓度溶解于生理盐水中,然后将AF127以5w/v%的质量体积浓度溶解于上述溶液中,即得到生物粘合剂的主组分,如图1所示。光固化后,生物粘合剂具有极高的角膜粘附性和自身韧性,能够承受大形变,如图2所示。
实施例2粘合剂的应用
S1:生物粘合剂准备:
将主组分预热至37℃,将辅组分(水溶性核黄素(0.1w/v%)和L-精氨酸组成(主组分中GelMA质量的0.4倍))加入主组分中,颠倒数次均匀溶解后备用。
S2:角膜移植应用(新西兰白兔角膜移植):
使用飞秒激光系统(Carl Zeiss Meditec)制作角膜移植模型和移植体,重复率为500kHz,脉冲能量为230nJ,深度大约为2/3-3/4角膜厚度。移植的直径被设定为6.5毫米。移除薄层并准备移植,对受体基质床进行冲洗,用海绵擦干角膜表面的过多液体。然后将上述生物粘合剂滴加在基质床上,铺成一层薄膜。将先前用飞秒激光制备的厚度合适的供体移植物安装到位,并将多余的预水凝胶从接口处挤出,用海绵擦去。用紫外光(365nm,250w)对移植区域进行5分钟辐照,后间歇1分钟,再施加5分钟辐照。将0.5%左氧氟沙星和1.0%醋酸泼尼松龙眼药水滴在眼睛上,每天三次,持续一周,如图3所示。
S3:观察结果:
移植角膜能够稳定附着在基质上,1个月内无明显脱落;粘合剂降解周期大于4周;上皮化程度较高。
以上对实例的描述是为了便于对该发明方法的理解和应用。也可在本发明基础上做出各种修改,因此,本发明不限于上述的实施实例,本领域技术人员根据本发明的揭示,对本发明做出的改进和修改都应该在本发明的保护范围之内。
Claims (10)
1.一种用于眼科手术的生物粘合剂,其特征在于,所述的生物粘合剂由主组分和辅组分组成;所述的主组分为接枝双键的明胶和醛基化F127的复合制剂;所述的辅组分为核黄素和L-精氨酸。
2.根据权利要求1所述的生物粘合剂,其特征在于,所述生物粘合剂的制备包括以下步骤:
S1:合成接枝双键的明胶(GelMA):将明胶完全溶解于PBS缓冲液中,然后加入甲基丙烯酸酐,搅拌2~3h后停止反应。反应液用透析袋以2h/次的频率更换去离子水,透析10次。透析之后用滤膜过滤,冷冻干燥获得接枝双键的明胶(GelMA),备用;
S2:合成的醛基化F127(AF127):将F127溶于二氯甲烷,然后加入吡啶和对苯磺酰氯,在室温下反应24~48小时。混合物用盐酸提取,有机相用NaHCO3洗涤,从四氢呋喃/二乙醚混合溶剂中重结晶,并在真空中干燥,得到中间产品。将中间产物溶于N,N-二甲基甲酰胺,加入4-羟基苯甲醛和碳酸钾,在80℃下搅拌反应48~72小时,并冷却至室温。加水后,反应液用二氯甲烷提取。有机层用MgSO4干燥,浓缩,并在冷的二乙醚中沉淀,过滤并真空干燥,得到醛基化F127(AF127),备用;
S3:将S1合成的明胶(GelMA)和S2合成的醛基化F127(AF127)溶于生理盐水中组成复合制剂,即获得生物粘合剂的主组分;
S4:将辅组分水溶性核黄素和L-精氨酸加入至步骤S3中的主组分中混合均匀即获得生物粘合剂。
3.根据权利要求2所述的生物粘合剂,其特征在于,所述的步骤S1中的接枝双键的明胶(GelMA)的质量体积浓度范围为5w/v%~10w/v%;所述的步骤S2中醛基化F127(AF127)的质量体积浓度范围为5w/v%~10w/v%。
4.根据权利要求3所述的生物粘合剂,其特征在于,所述的步骤S1中的接枝双键的明胶(GelMA)的质量体积浓度范围为10w/v%;所述的步骤S2中醛基化F127(AF127)的质量体积浓度范围为5w/v%。
5.根据权利要求2所述的生物粘合剂,其特征在于,所述的步骤S1中的接枝双键的明胶(GelMA)的氨基取代度范围为50%~90%;所述的明胶在合成时加热至37℃后溶解于生理盐水中。
6.根据权利要求2所述的生物粘合剂,其特征在于,所述步骤S2中醛基化F127的醛基化程度为100%;所述AF127在合成时室温溶解于生理盐水。
7.根据权利要求2所述的生物粘合剂,其特征在于,所述步骤S4中的辅组分在加入前需要将主组分需预热至37℃,上下颠倒数次使辅组分均匀溶解,即可形成最终应用的生物粘合剂。
8.根据权利要求7所述的生物粘合剂,其特征在于,所述步骤S4中辅组分中的水溶性核黄素在粘合剂体系中的质量体积分数为0.1w/v%;所述L-精氨酸粘合剂体系中的量为GelMA质量的0.4倍;所述辅组分的组成固定。
9.权利要求1-8任一所述的生物粘合剂在眼部手术粘合中的应用。
10.根据权利要求9所述的应用,其特征在于,所述的生物粘合剂在应用时使用前需预热至37℃,滴加进移植部位,并将移植物安装到位后,用紫外光对移植区域10cm处进行5~10分钟辐照。
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