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Plasma protein adsorption on blood-contacting devices is associated with serious health risks, including blood coagulation and inflammation. This issue is especially critical in hemodialysis (HD) due to prolonged membrane-blood interaction. Various approaches, such as hydrophilization and superhydrophobic modification of membrane surfaces, offer promising avenues for innovation.
Hydrophilic and hydrophobic polyether sulfone (PES) membranes were synthesized and characterized for surface chemistry, membrane charge, water contact angle, hydration layer stability, and roughness. Blood samples from dialysis patients were analyzed using Luminex assays and the Bio-Plex-200 system (Bio-Rad, Hercules, CA, USA) to measure complement components C5a and C5b-9, interleukin (IL)-1α, IL-1β, IL-6, platelet factor PF-4, and Von Willebrand factor (vWF).
Hydrophobic PES membranes exhibited a significant increase in C5a levels, approximately 21-23% higher than hydrophilic PES membranes. IL-1β and IL-6 levels also increased in hydrophobic membranes, with increases of around 4.4-4.9% and 134-149%, respectively. Conversely, vWF levels were significantly reduced in hydrophobic membranes. Improved hemocompatibility in hydrophobic PES membranes led to a reduction in C5b-9 release by approximately 72-80%. Additionally, hydrophobized PES membranes reduced PF-4 release by about 38% compared to hydrophilic PES.
In assessing inflammatory biomarker release, hydrophobic membranes showed increased levels of C5a, IL-1β, and IL-6 compared to hydrophilic membranes. However, both hydrophobic membranes exhibited reduced levels of vWF, C5b-9, and PF-4. This study suggests that the reduction of vWF, C5b-9, and PF-4 by hydrophobic membranes may lead to improved health outcomes, but individual health conditions and circumstances should be considered when interpreting these implications.