Titania nanotube arrays as interfaces for blood-contacting implantable devices: A study evaluating the nanotopography-associated activation and expression of blood plasma components

The constant exposure of implantable biomaterials such as titanium and titanium alloys to blood-introducesserious and ongoing concerns regarding poor blood-material interactions. To date, all blood-contacting materials have been shown to initiate immunological events in the form of inflammation, thrombosis, fibrosis and infection; potentially leading to complete implant failure. Material surfaces that provide biomimetic cues such as nanoscale architectures have been shown to elicit improved cellular interaction; and thus, may provide possible solutions for enhancing bloodcompatibility. However, limited information exists about the thrombogenicityof nanoscalesurface architectures. In this study, we have evaluated the efficacy of titania nanotube arrays as interfaces for blood contacting devices by investigating the thrombogenic effects using whole blood plasma. Thus, platelet/leukocyte adhesion, activation and interaction, morphology, complement activation, contact activation, platelet release reaction, fibrinogen expression and material cytotoxicity were evaluated to determine the in vitro thrombogenicity. The results presented here indicate a decrease in thrombogenic effects oftitania nanotube arrays as compared to biomedical grade titanium after 2 hours of contact with whole blood plasma. This work shows the improved blood-compatibility of titania nanotube arrays, identifying this specific nanoarchitecture as a potentially optimal interface for promoting the long-term success of blood contacting biomaterials.