The present invention relates to methods and compositions for removing and/or separating out bio-synthetic nano-particless from body fluids and other solutions.
There is need for an artificial oxygen (O2) carrier for use when banked blood is unavailable or undesirable. To address this need, the inventors developed ErythroMer (EM), a first-in-class, bio-synthetic, nano-cyte blood substitute. EM is a self-assembled, deformable, hybrid lipid-oligomer based nanoparticle that incorporates high per particle payloads of hemoglobin (Hb) (
The EM prototype has passed rigorous initial ex vivo and in vivo “proof of concept” testing. O2 delivery has been demonstrated in a novel murine model that reports post-transfusion cellular O2 delivery using a transgenic hypoxia inducible factor (HIF-1α) bioluminescent construct. EM is also being validated in rabbit models of hemorrhagic shock and polytrauma.
Because EM introduces an acellular form of hemoglobin into the plasma portion of the circulation, it introduces unique challenges to the clinical laboratory because of serum and plasma color interference or because of the nanoparticle shell itself. Blood specimens obtained during the period that ErythroMer is present in vivo appear hemolyzed. Although, hemolysis is a well-understood problem in the clinical laboratory, patients receiving ErythroMer may achieve free hemoglobin concentrations that exceed those seen with typical hemolysis. In addition, ErythroMer is a nanoparticle that may impact light-scattering analysis methods which cannot be practically avoided during analysis, save for developing a blank prior to analysis or by removing the particle entirely.
EM is designed to be used in chiefly at the point of injury to bridge to a clinical setting where further lifesaving care is performed. To manage trauma in clinical settings, complete blood count (CBC) and comprehensive metabolic panels (CMP) are performed to assess the amounts and concentrations of various cells, proteins, and substances in blood which impact the blood's ability to acutely sustain life by delivering oxygen and energy to the rest of the body. Assessments of hemoglobin abundance (oxygen carrying capacity), platelet abundance (clotting ability), and hematocrit (hemoglobin as a percent of whole blood) are impacted by EM. These assessments are taken every 15 to 30 minutes in patients experiencing blood loss and considered alongside changes in blood pressure to determine need for further transfusion in the clinical setting. Preliminary data shows that EM strongly interferes with the optical methods used to determine CBC (
The present invention is directed toward a robust ‘bait and capture’ strategy to efficiently remove EM from whole blood specimens based on supramolecular assembly based on host-guest interaction of adamantane (“ADM”) and β-CD. This targeted capture strategy comprises adamantane tagged EM as the ‘bait’ and β-CD functionalized PS beads as the capture model. (
According to further embodiments of the invention, the adamantane-tagged EM is lyophilized for packaging, transport and/or storage. The lyophilized adamantane-baited EM is a powder comprising EM amphiphilic precursor, cholesterol and PEG-PE hemoglobin and allosteric effector, the adamantane tag, and optionally also including cryoprotectants. Reconstitution at the original EM production concentration (or concentrated) is achieved with PBS/water by simple mixing.
Thus, the invention presents a uniquely designed targeted capture strategy to address the unmet need of removing EM from whole blood specimens for the clinical monitoring of blood samples. Notwithstanding the foregoing, and the examples provided herein, it is understood that the targeted capture strategy and compositions described herein may be used to remove any type of bio-synthetic nanoparticles from whole blood, other body fluids, and any other solution. The lyophilized bait tagged EM composition of the present invention may be packaged, stored, transported, for example, in the form of pre-filled tubes or other containers for reconstitution at the site of use. Similarly, the capture composition may be packaged in the form of hemoperfusion cartridges for removing tagged EM from the bloodstream in living patients via extracorporeal circuits, e.g., dialysis systems, CPB systems, and the like. Additionally, the capture composition may be used to remove tagged EM from perfusate in ex vivo organ/organoid preparations.
According to embodiments of the invention, there is presented a bio-engineered and scalable approach to remove EM from whole blood specimens. (
Design, Synthesis and Physico-Chemical Characterization of EM Presenting With ‘bait’ Functionalities.
Example 1. Design and synthesis of ‘bait’ tagged EM. EM tagged with ADM is prepared and the small molecules and the nanoparticles are physico-chemically characterized for supramolecular host-guest chemistry with β-CD containing resins. Amino (-NH2) groups 1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine (DPPE) are functionalized with ADM tags using 1-adamantane-carboxylic acid N-hydroxysuccinimide ester (ADM-NHS). (
Example 2. Physico-chemical characterization. We evaluate hydrodynamic particle size, polydispersity, and electrophoretic potential, TEM, AFM, and stability. To determine the long-term storage stability of EM-1003-bait, a 12-month study is performed at −20° C., 5° C., 25° C., and under the accelerated condition of 40° C. (lyophilized EM is spread on a glass dish to have a thin homogeneous layer). Thermal (dry heat) accelerated stress stability analysis is performed up to 12 months at 40° C., 50° C., and 60° C. and for one month at 80° C. EM is also subjected to thermal stress at 25° C. and 40° C. under acidic (0.1 M HCl: pH 1; 0.01 M HC1: pH 2; HCl: pH 4.5) and alkaline (0.1 M NaOH: pH 13; 0.01 M NaOH: pH 12) conditions up to 7 days. The pH of all the solutions is measured using a pH meter at RT. The particle size and colloidal stability over different time intervals are measured using the Nanosizer ZS and ZetaView.
Development and Characterization of a ‘capture’ Resin and Demonstration of Separation Capability.
Example 3. Preparation and characterization of the capture resin: β-Cyclodextrin is often used as the host carrier in a host-guest supramolecular assembly because of its water solubility, low cytotoxicity and superior biocompatibility. In this context, we prefer the ADM/β-CD host—guest pair as a well-established supramolecular system. Mono-6-O-(p-toluenesulfonyl)-β-cyclodextrin is synthesized from 1-(p-Toluenesulfonyl) imidazole and β-cyclodextrin. This compound is then used for the functionalization of amino polystyrene (NH2-PS) beads to produce β-cyclodextrinylated PS (CD-PS) beads under mild alkaline condition. (
Example 4. Demonstration of EM capture from a mixture of EM and blood: To demonstrate EM capture mediated by the CD-PS beads, the optimized ADM-tagged EM particles with fluorescent NBD-PE doping is prepared. In a similar manner, CD-PS beads are treated with these fluorescently tagged EM particles, suspended in buffer, centrifuged, washed and imaged under fluorescent microscope. After successfully validating the capture of EM particles by CD-PS beads, the ADM-tagged EM particles are loaded with hemoglobin. The Hb loaded ADM-tagged EM particles are then suspended with blood and the capture of EM particles is monitored from the whole blood specimens.
Example 5. Demonstration and optimization of the EM surface: The % functionalization of β-CD to the PS beads is calculated from pH titration. The change in neutralization pH is compared between the unfunctionalized amino PS beads and CD-PS beads and the % functionalization of β-CD per gm of PS beads is calculated. The ratio of β-CD per gm of PS beads is then varied by controlling the concentration of mono-6-O-(p-toluenesulfonyl)-β-cyclodextrin reacted with amino PS beads. The optimum concentration of β-CD is then selected based on their maximum efficiency of EM removal from the whole blood specimen.
Example 6. Preliminary biocompatibility studies. Preliminary complement activation analysis and blood smear preparation studies is conducted. The CH50 enzyme immunoassay (EIA) (Sigma) is used to evaluate the magnitude of complement activation as a result of the addition of EM-1003-Bait to human serum. The kit is used according to the manufacturer's protocol. A blood smear preparation is performed to observe morphological changes in lymphocytes and blood clumping using clinical microscopy technique (conventional light microscopy) under high power field. Particular attention is paid to observe significant clumping or morphological changes in blood cells treated with EM-1003 and EM-1003-Bait (blood: NP=9:1)
Anticipated Results and Risk Factors. EM particle with ADM functional groups on the surface is synthesized. Mono-6-O-(p-toluenesulfonyl)-β-cyclodextrin is synthesized from 1-(p-Toluenesulfonyl) imidazole and β-CD and used for the functionalization of amino polystyrene (NH2-PS) beads to produce CD-PS beads. This invention validates the capture of EM particles by CD-PS beads with and without the encapsulation of Hb. The Hb loaded Ad-tagged EM particles are suspended with blood and the capture of EM particles is monitored. Further CBC and metabolic panel analyses are conducted to confirm the successful disappearance of EM interference. The supramolecular approach of the invention brings several advantages, e.g. (i) facile formation of the inclusion complex under ambient condition makes the pilot-scale study feasible without introducing any special genetic or biochemical techniques; (ii) the relatively small ADM-tag is expected to have little to none effect on the EM structures and functions and (iii) the optimal ratio of β-CD functionalization on PS beads introduces insignificant changes to the pore size of the column beads and hence safely clear the blood stream.
From our preliminary capture studies, EM was found to be successfully captured by the capture resin. (
The adamantane-tagged EM is lyophilized for packaging, transport and/or storage. The lyophilized adamantane-baited EM is a powder comprising EM amphiphilic precursor, cholesterol and PEG-PE hemoglobin and allosteric effector, the adamantane tag, and optionally also including cryoprotectants. Reconstitution at the original EM production concentration (or concentrated) is achieved with PBS/water by simple mixing and gentle vortexing/agitation.
It is noted that the bait and capture methods and compositions described herein may be used to remove any type of biosynthetic nanoparticle from any bodily fluid or constituent part thereof
While several embodiments and methodologies of the present disclosure have been described and shown in the drawings, it is not intended that the present disclosure be limited thereto, as it is intended that the present disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments and methodologies. Those skilled in the art will envision other modifications within the scope of the claims appended hereto.
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