Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L26/00—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form
  • A61L26/0009—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form containing macromolecular materials
  • A61L26/0052—Mixtures of macromolecular compounds
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
  • A61L24/001—Use of materials characterised by their function or physical properties
  • A61L24/0031—Hydrogels or hydrocolloids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
  • A61L24/001—Use of materials characterised by their function or physical properties
  • A61L24/0042—Materials resorbable by the body
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
  • A61L24/04—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials
  • A61L24/043—Mixtures of macromolecular materials
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
  • A61L24/04—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials
  • A61L24/046—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
  • A61L24/04—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials
  • A61L24/08—Polysaccharides
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L26/00—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form
  • A61L26/0009—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form containing macromolecular materials
  • A61L26/0023—Polysaccharides
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L26/00—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form
  • A61L26/0061—Use of materials characterised by their function or physical properties
  • A61L26/008—Hydrogels or hydrocolloids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L26/00—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form
  • A61L26/0061—Use of materials characterised by their function or physical properties
  • A61L26/009—Materials resorbable by the body

Definitions

• the invention relates to the field of medical adhesives. More specifically, the invention relates to a hydrogel tissue adhesive formed by reacting an aldehyde-functionalized polysaccharide containing pendant aldehyde groups with a water-dispersible, multi-arm amine.
• Tissue adhesives have many potential medical applications, including wound closure, supplementing or replacing sutures or staples in internal surgical procedures, preventing leakage of fluids such as blood, bile, gastrointestinal fluid and cerebrospinal fluid, adhesion of synthetic onlays or inlays to the cornea, drug delivery devices, and as anti-adhesion barriers to prevent post-surgical adhesions.
• Conventional tissue adhesives are generally not suitable for a wide range of adhesive applications. For example, cyanoacrylate-based adhesives have been used for topical wound closure, but the release of toxic degradation products limits their use for internal applications. Fibrin-based adhesives are slow curing, have poor mechanical strength, and pose a risk of viral infection. Additionally, fibrin-based adhesives do not bond covalently to the underlying tissue.
• hydrogel tissue adhesives have been developed, which have improved adhesive and cohesive properties and are nontoxic (see for example Sehl et al., U.S. Patent Application Publication No.
• hydrogels are generally formed by reacting a component having nucleophilic groups with a component having electrophilic groups, which are capable of reacting with the nucleophilic groups of the first component, to form a crosslinked network via covalent bonding.
• these hydrogels typically swell, dissolve away too quickly, or lack sufficient adhesion or mechanical strength, thereby decreasing their effectiveness as surgical adhesives.
• Kodokian et al. (copending and commonly owned U.S. Patent Application Publication No. 2006/0078536) describe a polysaccharide- based hydrogel tissue adhesives formed by reacting an oxidized
• polysaccharide with a water-dispersible, multi-arm polyether amine polysaccharide with a water-dispersible, multi-arm polyether amine.
• adhesives provide improved adhesion and cohesion properties, crosslink readily at body temperature, maintain dimensional stability initially, do not degrade rapidly, and are nontoxic to cells and noninflammatory to tissue.
• a more rapidly degrading hydrogel tissue adhesive is needed.
• an adhesion prevention composition should not persist at the site once the healing process has begun, typically not longer than 1 to 3 weeks.
• hydrogel tissue adhesive that has the desirable properties of the oxidized polysaccharide-based tissue adhesives described by Kodokian et al., supra, but has a shorter degradation time.
• the present invention addresses the above need by providing a hydrogel tissue adhesive that has good adhesion and cohesion properties, crosslinks readily at body temperature, maintains dimensional stability initially, is nontoxic to cells and non-inflammatory to tissue, and degrades more rapidly than the oxidized polysaccharide-based hydrogel tissue adhesives.
• the invention provides a kit comprising:
• the invention provides a dried hydrogel formed by a process comprising the steps of:
• multi-arm amine wherein at least three of the arms are terminated by at least one primary amine group, said multi-arm amine having a number-average molecular weight of about 450 to about 200,000 Daltons, to form a hydrogel;
• the invention provides a composition comprising the reaction product of:
• aldehyde-functionalized polysaccharide containing pendant aldehyde groups said aldehyde- functionalized polysaccharide having a weight- average molecular weight of about 1 ,000 to about
• the invention provides a crosslinked hydrogel composition comprising:
• aldehyde- functionalized polysaccharide having a weight-average molecular weight of about 1 ,000 to about 1 ,000,000 Daltons and having a degree of aldehyde substitution of about 10% to about 200%;
• said at least one aldehyde-functionalized polysaccharide and said at least one water-dispersible, multi-arm amine are crosslinked through covalent bonds formed between the pendant aldehyde groups of the polysaccharide and the primary amine groups of the water-dispersible, multi-arm amine.
• aldehyde-functionalized polysaccharide refers to a polysaccharide that has been chemically modified to introduce pendant aldehyde groups into the molecule.
• the pendant aldehyde groups may be single aldehyde groups or dialdehydes.
• aldehyde-functionalized polysaccharides do not include polysaccharides that are oxidized by cleavage of the polysaccharide rings to introduce aldehyde groups. Oxidation of the polysaccharide rings results in dialdehydes formed by opening the rings of the polysaccharide.
• pendant aldehyde group refers to an aldehyde group that is attached to the carbohydrate of the polysaccharide via one of the ring hydroxyl groups.
• degree of aldehyde substitution refers to the mole percent of pendant aldehyde groups per mole of carbohydrate repeat units, i.e., (moles of pendant aldehyde groups/moles of carbohydrate repeat units) x 100.
• water-dispersible, multi-arm amine refers to a polymer having three or more polymer chains ("arms”), which may be linear or branched, emanating from a central structure, which may be a single atom, a core molecule, or a polymer backbone, wherein at least three of the branches ("arms") are terminated by at least one primary amine group.
• the water-dispersible, multi-arm amine is water soluble or is able to be dispersed in water to form a colloidal suspension capable of reacting with a second reactant in aqueous solution or dispersion.
• colloidal suspension refers to a colloidal suspension capable of reacting with a second reactant in an aqueous medium.
• water-dispersible, multi-arm polyether amine refers to a water-dispersible, multi-arm amine wherein the polymer is a polyether.
• polyether refers to a polymer having the repeat unit [-O- R]-, wherein R is a hydrocarbylene group having 2 to 5 carbon atoms.
• the polyether may also be a random or block copolymer comprising different repeat units which contain different R groups.
• hydrocarbylene group refers to a divalent group formed by removing two hydrogen atoms, one from each of two different carbon atoms, from a hydrocarbon.
• branched polyether refers to a polyether having one or more branch points ("arms"), including star, dendritic, comb, highly branched, and hyperbranched polyethers. Branches radiate from one or more thfunctional or higher functional branch points.
• dendritic polyether refers to a highly branched polyether having a branching structure that repeats regularly with each successive generation of monomer radiating from a core molecule.
• comb polyether refers to a branched polyether in which linear side-chains emanate from thfunctional branch points on a linear polymer backbone.
• star polyether refers to a branched polyether in which linear side-chains emanate from a single atom or a core molecule having a point of symmetry.
• hyperbranched polyether refers to a highly branched polyether which is more branched than "highly branched,” with order approaching that of an imperfect dendrimer.
• highly branched polyether refers to a branched polyether having many branch points, such that the distance between branch points is small relative to the total length of arms.
• primary amine refers to a neutral amino group having two free hydrogens.
• the amino group may be bound to a primary, secondary or tertiary carbon.
• multi-functional amine refers to a chemical compound comprising at least two functional groups, at least one of which is a primary amine group.
• crosslink refers to a bond or chain of atoms attached between and linking two different polymer chains.
• crosslink density is herein defined as the reciprocal of the average number of chain atoms between crosslink connection sites.
• % by weight also referred to herein as “wt%” refers to the weight percent relative to the total weight of the solution or dispersion, unless otherwise specified.
• anatomical site refers to any external or internal part of the body of humans or animals.
• tissue refers to any biological tissue, both living and dead, in humans or animals.
• hydrogel refers to a water-swellable polymeric matrix, consisting of a three-dimensional network of macromolecules held together by covalent crosslinks that can absorb a substantial amount of water to form an elastic gel.
• dried hydrogel refers to a hydrogel that has been treated to remove at least a portion of the solvent contained therein. Preferably, substantially all of the solvent is removed from the hydrogel.
• PEG poly(ethylene glycol).
• M w refers to the weight-average molecular weight.
• M n refers to the number-average molecular weight.
• M z refers to the z-average molecular weight.
• medical application refers to medical applications as related to humans and animals.
• mol means mole(s)
• mmol means millimole(s)
• g means gram(s)
• mg means milligram(s)
• mol% means mole percent
• VoI means volume
• w/w means weight per weight
• Da means Daltons
• kDa means kiloDaltons
• the designation "1OK” means that a polymer molecule possesses a number-average molecular weight of 10 kiloDaltons
• M means molarity
• kPa means kilopascals
• psi means pounds per square inch
• rpm means revolutions per minute
• 1 H NMR means proton nuclear magnetic resonance spectroscopy
• 13-C NMR means carbon 13 nuclear magnetic resonance spectroscopy
• ppm means parts per million
• cP means centipoise
• PBS means phosphate- buffered saline
• MWCO means molecular weight cut
• hydrogel tissue adhesive formed by reacting an aldehyde-functionalized polysaccharide containing pendant aldehyde groups with a water-dispersible, multi-arm amine.
• the hydrogel may be useful as a tissue adhesive or sealant for medical applications that require more rapid degradation, including but not limited to, prevention of undesired tissue-to tissue adhesions resulting from trauma or surgery.
• Aldehyde-functionalized polysaccharides suitable for use herein are polysaccharides that have been chemically modified to introduce pendant aldehyde groups into the molecule.
• the pendant aldehyde groups may be single aldehyde groups or dialdehydes.
• the pendant aldehyde groups of the aldehyde-functionalized polysaccharides disclosed herein are attached to the polysaccharide through linking groups.
• the linking groups comprise carbon, hydrogen, and oxygen atoms, but do not contain a nitrogen atom, and are attached to the polysaccharide by ether linkages.
• aldehyde- functionalized polysaccharides having these types of linking groups are more stable in aqueous solution that oxidized polysaccharides or aldehyde-functionalized polysaccharides having other types of linking groups, such as those that contain a nitrogen atom or are linked to the polysaccharide by other chemical linkages (e.g., amide or urethane).
• the linking group contains an alkoxy group alpha to the pendant aldehyde group (i.e., on an adjacent carbon atom).
• the linking group does not contain an alkoxy group beta to the pendant aldehyde group (i.e., on the second carbon atom from the aldehyde group).
• aldehyde-functionalized polysaccharides do not include polysaccharides that are oxidized by cleavage of the
• dialdehyde groups formed by oxidation of polysaccharide rings are not pendant aldehyde groups as defined herein.
• Aldehyde-functionalized polysaccharides may be prepared by chemically modifying a polysaccharide to introduce pendant aldehyde groups.
• Useful aldehyde-functionalized polysaccharides include, but are not limited to, aldehyde-functionalized derivatives of: dextran,
• polysaccharides are available commercially from sources such as Sigma Chemical Co. (St. Louis, MO).
• polysaccharides are a heterogeneous mixture having a distribution of different molecular weights, and are characterized by an average molecular weight, for example, the weight-average molecular weight (M w ), or the number average molecular weight (M n ), as is known in the art.
• the aldehyde-functionalized polysaccharides prepared from these polysaccharides are also a heterogeneous mixture having a distribution of different molecular weights.
• Suitable aldehyde-functionalized polysaccharides have a weight-average molecular weight of about 1 ,000 to about 1 ,000,000 Daltons, more particularly about 3,000 to about 250,000 Daltons, more particularly about 5,000 to about 60,000 Daltons, and more particularly about 7,000 to about 20,000 Daltons.
• the aldehyde-functionalized polysaccharide is aldehyde-functionalized dextran.
• another aldehyde-functionalized dextran is aldehyde-functionalized dextran.
• the aldehyde-functionalized polysaccharide is aldehyde- functionalized inulin.
• Aldehyde-functionalized polysaccharides may be prepared using methods known in the art. Aldehyde-functionalized polysaccharides may be prepared using any of the methods described by Mehta et al. (WO 99/07744). For example, dextran may be reacted with allyl glycidyl ether in an acid aqueous medium to form allyloxy dextran which is then oxidized by ozonolysis to cleave the double bond and introduce a terminal aldehyde group, as described in detail in the Examples herein below.
• glycidol may be reacted with a polysaccharide, such as dextran, in a basic aqueous medium to give an alkylated polysaccharide, as described by Chen (Biotechnology Techniques 3:131 -134, 1989).
• a polysaccharide such as dextran
• Periodate oxidation of the alkylated polysaccharide yields an aldehyde- functionalized polysaccharide having pendant aldehyde groups.
• the aldehyde-functionalized polysaccharides may also be prepared by the method described by Solarek et al. (U.S. Patent No. 4,703,116) wherein a polysaccharide is reacted with a derivatizing acetal reagent in the presence of base and then the acetal is hydrolyzed by adjusting the pH to less than 7.0.
• Aldehyde-functionalized polysaccharides having dialdehyde functional groups can be prepared by first attaching a pendant group containing either a terminal diene or by attaching a cyclic, disubstituted olefin to the polysaccharide ring. Attachment of the pendant groups can be accomplished using a variety of methods, including reaction of the polysaccharide with glycidyl ethers containing cyclic olefins or terminal dienes, or reaction with carboxylic acids or derivatives thereof which also contain cyclic olefins or terminal dienes. Oxidation of the polysaccharides dehvatized with cyclic olefins or terminal dienes using methods known in the art, such as ozonolysis, yield polysaccharides derivatized with pendant dialdehydes.
• the degree of aldehyde substitution may be determined using methods known in the art. For example, the degree of aldehyde
• substitution may be determined by titrating the aldehyde-functionalized polysaccharide with hydroxyl amine hydrochloride according to the method of Zhao and Heindel (Pharmaceutical Research 8:400, 1991 ).
• Suitable aldehyde-functionalized polysaccharides have a degree of aldehyde substitution of about 10% to about 200%, more particularly about 30% to about 200%, more particularly about 35% to about 120%, and more particularly about 40% to about 120%.
• Suitable water-dispersible, multi-arm amines include, but are not limited to, water-dispersible multi-arm polyether amines, amino-terminated dendritic polyamidoamines, and multi-arm branched end amines.
• multi-arm amines suitable for use herein have a number- average molecular weight of about 450 to about 200,000 Daltons, more particularly from about 2,000 to about 40,000 Daltons.
• the water-dispersible, multi-arm amine is a multi-arm polyether amine, which is a water-dispersible polyether having the repeat unit [-O-R]-, wherein R is a hydrocarbylene group having 2 to 5 carbon atoms.
• Suitable multi-arm polyether amines include, but are not limited to, amino-terminated star polyethylene oxides, amino-terminated dendritic polyethylene oxides, amino-terminated comb polyethylene oxides, amino-terminated star polypropylene oxides, amino-terminated dendritic polypropylene oxides, amino-terminated comb polypropylene oxides, amino-terminated star polyethylene oxide-polypropylene oxide copolymers, amino-terminated dendritic polyethylene oxide-polypropylene oxide copolymers, amino-terminated comb polyethylene oxide- polypropylene oxide copolymers, and polyoxyalkylene thamines, sold under the trade name Jeffamine ® triamines, by Huntsman LLC.
• star polyethylene oxide amines include, but are not limited to, various multi-arm polyethylene glycol amines, and star polyethylene glycols having 3, 4, 6, or 8 arms terminated with primary amines (referred to herein as 3, 4, 6, or 8-arm star PEG amines, respectively).
• suitable Jeffamine ® triamines include, but are not limited to, Jeffamine ® T-403 (CAS No. 39423-51 -3), Jeffamine ® T-3000 (CAS No. 64852-22-8), and Jeffamine ® T-5000 (CAS No. 64852-22-8).
• the water-dispersible multi-arm polyether amine is an eight-arm polyethylene glycol having eight arms terminated by a primary amine group and having a number-average molecular weight of about 10,000 Daltons.
• multi-arm polyether amines are either available commercially, as noted above, or may be prepared using methods known in the art.
• multi-arm polyethylene glycols wherein at least three of the arms are terminated by a primary amine group, may be prepared by putting amine ends on multi-arm polyethylene glycols (e.g., 3, 4, 6, and 8- arm star polyethylene glycols, available from companies such as Nektar Transforming Therapeutics; SunBio, Inc., Anyang City, South Korea; NOF Corp., Tokyo, Japan; or JenKem Technology USA, Allen, TX) using the method described by Buckmann et al. (Makromol. Chem. 182:1379-1384, 1981 ).
• multi-arm polyethylene glycol is reacted with thionyl bromide to convert the hydroxyl groups to bromines, which are then converted to amines by reaction with ammonia at 100 0 C.
• the method is broadly applicable to the preparation of other multi-arm polyether amines.
• multi-arm polyether amines may be prepared from multi-arm polyols using the method described by Chenault (copending and commonly owned U.S. Patent Application Publication No.2007/0249870).
• the multi-arm polyether is reacted with thionyl chloride to convert the hydroxyl groups to chlorine groups, which are then converted to amines by reaction with aqueous or anhydrous ammonia.
• Other methods that may be used for preparing multi-arm polyether amines are described by Merrill et al. in U.S. Patent No. 5,830,986, and by Chang et al. in WO 97/30103.
• Water-dispersible, multi-arm amines suitable for use herein may also be amino-terminated dendritic polyamidoamines, sold under the trade name Starburst ® Dendrimers (available from Sigma-AIdrich, St Louis, MO).
• the water-dispersible, multi-arm amine is a multi-arm branched end amine, as described by Arthur (copending and commonly owned International Patent Application Publication No. WO 2008/066787).
• the multi-arm branched end amines are branched polymers having two or three primary amine groups at the end of each of the polymer arms. The multiplicity of functional groups increases the statistical probability of reaction at a given chain end and allows more efficient incorporation of the branched molecules into a polymer network.
• the starting materials used to prepare the branched end amines may be branched polymers such as multi-arm polyether polyols including, but not limited to, comb and star polyether polyols.
• the branched end amines can be prepared by attaching multiple amine groups to the ends of the polymer by reaction with the hydroxyl groups using methods well known in the art.
• a branched end amine having two amine functional groups on each end of the polymer arms can be prepared by reacting the starting material, as listed above, with thionyl chloride in a suitable solvent such as toluene to give the chloride derivative, which is subsequently reacted with tris(2-aminoethyl)amine to give the branched end reactant having two primary amine groups at the end of the polymer arms.
• the water-dispersible, multi-arm amine is an eight-arm branched end polyethylene glycol amine having two primary amine groups at the end of the polymer arms and having a number- average molecular weight of about 10,000 Daltons.
• the water-dispersible, multi-arm amine is a mixture of an eight-arm branched end polyethylene glycol amine having two primary amine groups at the end of the polymer arms and having a number-average molecular weight of about 10,000 Daltons, and an eight- arm polyethylene glycol amine having eight arms terminated by a primary amine group and having a number-average molecular weight of about 10,000 Daltons.
• the water-dispersible, multi-arm amines are generally a somewhat heterogeneous mixture having a distribution of arm lengths and in some cases, a distribution of species with different numbers of arms.
• a multi-arm amine has a distribution of species having different numbers of arms, it can be referred to based on the average number of arms in the distribution.
• the multi-arm amine is an 8-arm star PEG amine, which comprises a mixture of multi-arm star PEG amines, some having less than and some having more than 8 arms; however, the multi-arm star PEG amines in the mixture have an average of 8 arms.
• the terms "8-arm”, “6-arm”, “4-arm” and “3-arm” as used herein to refer to multi-arm amines should be construed as referring to a heterogeneous mixture having a distribution of arm lengths and in some cases, a distribution of species with different numbers of arms, in which case the number of arms recited refers to the average number of arms in the mixture.
• hydrogel tissue adhesive disclosed herein may be used in various forms.
• polysaccharide containing pendant aldehyde groups and the water- dispersible, multi-arm amine are used as components of aqueous solutions or dispersions.
• aqueous solution or dispersion comprising an aldehyde-functionalized polysaccharide (referred to herein as the "first aqueous solution or dispersion")
• at least one aldehyde- functionalized polysaccharide is added to water to give a concentration of about 5% to about 40%, more particularly from about 5% to about 30%, and more particularly from about 10% to about 30% by weight relative to the total weight of the solution or dispersion.
• a mixture of at least two different aldehyde-functionalized polysaccharides having different weight-average molecular weights, different degrees of aldehyde substitution, or both different weight-average molecular weights and degrees of aldehyde substitution may be used.
• the total concentration of the aldehyde- functionalized polysaccharides is about 5% to about 40% by weight, more particularly from about 5% to about 30%, and more particularly from about 10% to about 30% by weight relative to the total weight of the solution or dispersion.
• an aqueous solution or dispersion comprising a water-dispersible, multi-arm amine (referred to herein as the "second aqueous solution or dispersion")
• at least one water-dispersible, multi-arm amine is added to water to give a concentration of about 5% to about 70% by weight, more particularly from about 20% to about 50% by weight relative to the total weight of the solution or dispersion.
• concentration to be used depends on the intended application and on the concentration of the aldehyde-functionalized polysaccharide used in the first aqueous solution or dispersion.
• a mixture of different water-dispersible, multi-arm amines having different number-average molecular weights, different numbers of arms, or both different number- average molecular weights and different numbers of arms may be used.
• the total concentration of the multi-arm amines is about 5% to about 70% by weight, more particularly from about 20% to about 50% by weight relative to the total weight of the solution or dispersion.
• the first aqueous solution or dispersion and the second aqueous solution or dispersion be sterilized to prevent infection.
• Any suitable sterilization method known in the art that does not adversely affect the ability of the components to react to form an effective hydrogel may be used, including, but not limited to, electron beam irradiation, gamma irradiation, ethylene oxide sterilization, or filtration through a 0.2 ⁇ m pore membrane.
• the first aqueous solution or dispersion and the second aqueous solution or dispersion may further comprise various additives depending on the intended application.
• the additive does not interfere with effective gelation to form a hydrogel.
• the amount of the additive used depends on the particular application and may be readily determined by one skilled in the art using routine experimentation.
• the first aqueous solution or dispersion and/or the second aqueous solution or dispersion may comprise at least one additive selected from pH modifiers, antimicrobials, colorants, surfactants, pharmaceutical drugs and
• the first aqueous solution or dispersion and/or the second aqueous solution or dispersion may optionally include at least one pH modifier to adjust the pH of the solution(s) or dispersion(s).
• Suitable pH modifiers are well known in the art.
• the pH modifier may be an acidic or basic compound.
• acidic pH modifiers include, but are not limited to, carboxylic acids, inorganic acids, and sulfonic acids.
• Examples of basic pH modifiers include, but are not limited to, hydroxides, alkoxides, nitrogen-containing compounds other than primary and secondary amines, and basic carbonates and phosphates.
• the first aqueous solution or dispersion and/or the second aqueous solution or dispersion may optionally include at least one antimicrobial agent. Suitable antimicrobial preservatives are well known in the art.
• Suitable antimicrobials include, but are not limited to, alkyl parabens, such as methylparaben, ethylparaben, propylparaben, and butylparaben; thclosan; chlorhexidine; cresol; chlorocresol; hydroquinone; sodium benzoate; and potassium benzoate.
• the first aqueous solution or dispersion and/or the second aqueous solution or dispersion may optionally include at least one colorant to enhance the visibility of the solution(s) or dispersion(s).
• Suitable colorants include dyes, pigments, and natural coloring agents. Examples of suitable colorants include, but are not limited to, FD&C and D&C colorants, such as FD&C Violet No. 2, FD&C Blue No. 1 , D&C Green No. 6, D&C Green No. 5, D&C Violet No. 2; and natural colorants such as beetroot red, canthaxanthin, chlorophyll, eosin, saffron, and carmine.
• the first aqueous solution or dispersion and/or the second aqueous solution or dispersion may optionally include at least one surfactant.
• Surfactant refers to a compound that lowers the surface tension of water.
• the surfactant may be an ionic surfactant, such as sodium lauryl sulfate, or a neutral surfactant, such as polyoxyethylene ethers, polyoxyethylene esters, and polyoxyethylene sorbitan.
• first aqueous solution or dispersion and/or the second aqueous solution or dispersion may optionally include at least one pharmaceutical drug or therapeutic agent.
• suitable drugs and therapeutic agents are well known in the art (for example see the United States Pharmacopeia (USP), Physician's Desk Reference (Thomson Publishing), The Merck Manual of Diagnosis and Therapy 18th e ⁇ , Mark H. Beers and Robert Berkow (eds.), Merck Publishing Group, 2006; or, in the case of animals, The Merck Veterinary Manual, 9th ed., Kahn, CA. (ed.), Merck Publishing Group, 2005).
• Nonlimiting examples include anti-inflammatory agents, for example, glucocorticoids such as prednisone, dexamethasone, budesonide; non-steroidal anti-inflammatory agents such as indomethacin, salicylic acid acetate, ibuprofen, sulindac, piroxicam, and naproxen;
• glucocorticoids such as prednisone, dexamethasone, budesonide
• non-steroidal anti-inflammatory agents such as indomethacin, salicylic acid acetate, ibuprofen, sulindac, piroxicam, and naproxen
• fibrinolytic agents such as a tissue plasminogen activator and
• streptokinase anti-coagulants such as heparin, hirudin, ancrod, dicumarol, sincumar, iloprost, L-arginine, dipyramidole and other platelet function inhibitors; antibodies; nucleic acids; peptides; hormones; growth factors; cytokines; chemokines; clotting factors; endogenous clotting inhibitors; antibacterial agents; antiviral agents; antifungal agents; anticancer agents; cell adhesion inhibitors; healing promoters; vaccines;
• thrombogenic agents such as thrombin, fibrinogen, homocysteine, and estramustine
• radio-opaque compounds such as barium sulfate and gold particles and radiolabels.
• the second aqueous solution or dispersion comprising the multi-arm amine may optionally comprise at least one other multifunctional amine having one or more primary amine groups to provide other beneficial properties, such as hydrophobicity or modified crosslink density.
• the multi-functional amine is capable of inducing gelation when mixed with an oxidized polysaccharide in an aqueous solution or dispersion.
• the multi-functional amine may be a second water- dispersible, multi-arm amine, such as those described above, or another type of multi-functional amine, including, but not limited to, linear and branched diamines, such as diaminoalkanes, polyaminoalkanes, and spermine; branched polyamines, such as polyethylenimine; cyclic diamines, such as N, N'-bis(3-aminopropyl)piperazine, 5-amino-1 ,3,3- trimethylcyclohexanemethylamine, 1 ,3-bis(aminomethyl)cyclohexane, 1 , 4- diaminocyclohexane, and p-xylylenediamine; aminoalkyltrialkoxysilanes, such as 3-aminopropyltrimethoxysilane and 3-aminopropyltriethoxysilane; aminoalkyldialkoxyalkylsilanes, such as
• polyamines such as chitosan, polyallylamine, and polylysine
• di- and polyhydrazides such as bis(carboxyhydrazido)polyethers and
• poly(carboxyhydrazido) star polyethers Many of these compounds are commercially available from companies such as Sigma-Aldrich and
• the multi-functional amine is used at a concentration of about 5% by weight to about 1000% by weight relative to the weight of the multi-arm amine in the aqueous solution or dispersion.
• first aqueous solution or dispersion and the second aqueous solution or dispersion react to form a crosslinked hydrogel composition
• a crosslinked hydrogel composition comprising at least one aldehyde-functionalized polysaccharide containing pendant aldehyde groups; and at least one water-dispersible, multi-arm amine wherein at least three of the arms are terminated by at least one primary amine group, and wherein the at least one aldehyde-functionalized polysaccharide and the at least one water- dispersible, multi-arm amine are crosslinked through covalent bonds formed between the pendant aldehyde groups of the aldehyde- functionalized polysaccharide and the primary amine groups of the water- dispersible, multi-arm amine.
• the covalent bonds may be imine, aminal or hemiaminal bonds.
• the degradation time of the hydrogel may be tuned for the needs of the intended application by using different amounts of the aldehyde-functionalized polysaccharide in the first aqueous solution or dispersion and the water-dispersible, multi-arm amine in the second aqueous solution or dispersion in terms of weight percent and/or by altering the amount of funtionalization of either amine on the water- dispersible, multi-arm amine or aldehyde on the aldehyde-functionalized polysaccharide, as shown in the Examples herein below.
• the first aqueous solution or dispersion and the second aqueous solution or dispersion may be used to apply a coating to an anatomical site on tissue of a living organism.
• the two aqueous solutions or dispersions may be applied to the site in any number of ways. Once both solutions or dispersions are combined on a site, they crosslink to form a hydrogel which provides a coating on the site.
• the two aqueous solutions or dispersions are applied to the site sequentially using any suitable means including, but not limited to, spraying, brushing with a cotton swab or brush, or extrusion using a pipette, or a syringe.
• the solutions or dispersions may be applied in any order.
• the solutions or dispersions are mixed on the site using any suitable device, such as a cotton swab, a spatula, or the tip of the pipette or syringe.
• the two aqueous solutions or dispersions are mixed manually before application to the site.
• the resulting mixture is then applied to the site before it completely cures using a suitable applicator, as described above.
• the first aqueous solution or dispersion and the second aqueous solution or dispersion are applied to the site simultaneously where they mix to form a hydrogel.
• the two aqueous solutions or dispersions may be contained in separate barrels of a double-barrel syringe. In this way the two aqueous solutions or dispersions are applied simultaneously to the site with the syringe.
• Suitable double-barrel syringe applicators are known in the art.
• Redl describes several suitable applicators for use in the invention in U.S. Patent No. 6,620,125, (particularly Figures 1 , 5, and 6, which are described in Columns 4, line 10 through column 6, line 47).
• the two aqueous solutions or dispersions may also be applied to the site using a dual-lumen catheter, such as those available from Bistech, Inc. (Woburn, MA).
• injection devices for introducing two liquid components endoscopically into the body simultaneously are known in the art and may be adapted for the delivery of the two aqueous solutions or dispersions disclosed herein (see for example, Linder et al., U.S. Patent No.
• first aqueous solution or dispersion and the second aqueous solution or dispersion may be premixed and delivered to the site using a double barrel syringe containing a motionless mixer, such as that available from ConProtec, Inc. (Salem, NH) or Mixpac
• the mixing tip may be equipped with a spray head, such as that described by Cruise et al. in U.S. Patent No. 6,458,147.
• the mixture of the two aqueous solutions or dispersions from the double-barrel syringe may be applied to the site using a catheter or endoscope.
• the two aqueous solutions or dispersions may be applied to the site using a spray device, such as those described by Fukunaga et al. (U.S. Patent No. 5,582,596), Delmotte et al. (U.S.
• Patent No. 5,989,215) or Sawhney U.S. Patent No. 6,179,862.
• the two aqueous solutions or dispersions may be applied to the site using a minimally invasive surgical applicator, such as those described by Sawhney (U.S. Patent No. 7,347,850).
• the hydrogel tissue adhesive of the invention is used to bond at least two anatomical sites together.
• the first aqueous solution or dispersion is applied to at least one anatomical site
• the second aqueous solution or dispersion is applied to at least one of either the same site or one other site using the methods described above.
• the two or more sites are contacted and held together manually or using some other means, such as a surgical clamp, for a time sufficient for the mixture to cure.
• a mixture of the two aqueous solutions or dispersions is applied to at least one of the anatomical sites to be bonded using methods described above.
• the two or more sites are contacted and held together manually or using some other means, such as a surgical clamp, for a time sufficient for the mixture to cure.
• the polysaccharide, and the water-dispersible, multi-arm amine may be used in the form of finely divided powders.
• the powders may be prepared using any suitable method. For example, each of the aqueous solutions or dispersions described above may be dried using heat, vacuum, a combination of heat and vacuum, or by lyophilization, to form powders.
• the powders may be comminuted into finer particles using methods known in the art including, but not limited to, grinding, milling, or crushing with a mortar and pestle.
• the finely divided powders may be sterilized using the methods described above.
• the finely divided powders may be applied to an anatomical site on tissue of a living organism in a variety of ways.
• the powders may be individually applied to the site in any order by sprinkling or spraying. Additionally, the powders may be premixed and the resulting mixture applied to the site by sprinkling or spraying.
• the powders may be hydrated on the site by the addition of an aqueous solution such as water or a suitable buffer (e.g., phosphate- buffered saline) or by the physiological fluids present at the site.
• the finely divided powders may also be used to bond two anatomical sites together as described above for the aqueous solutions or dispersions.
• the powders may be hydrated with water or a suitable aqueous solution prior to use to form the first and second aqueous solutions or dispersions, described above.
• the hydrogel tissue adhesive disclosed herein may be used in the form of a dried hydrogel.
• a dried hydrogel is prepared by combining in a solvent at least one aldehyde-functionalized polysaccharide with at least one water- dispersible, multi-arm amine to form a hydrogel, and treating the hydrogel to remove at least a portion of the solvent to form the dried hydrogel.
• Suitable solvents include, but are not limited to, water, ethanol, isopropanol, tetrahydrofuran, hexanes, polyethylene glycol, and mixtures thereof. If two different solvents are used, the two solvents are miscible with each other. In one embodiment the solvent is water.
• the aldehyde- functionalized polysaccharide and the water-dispersible, multi-arm amine may be combined in various ways. For example, the first aqueous solution or dispersion comprising the aldehyde-functionalized
• polysaccharide and the second aqueous solution or dispersion comprising the water-dispersible, multi-arm amine may be prepared and mixed as described above to form the hydrogel.
• the solutions or dispersions used to prepare the hydrogel may further comprise various additives depending on the intended application. Any of the additives described above may be used.
• the hydrogel is then treated to remove at least a portion of the solvent contained therein to form the dried hydrogel. Preferably, substantially all of the solvent is removed from the hydrogel.
• the solvent may be removed from the hydrogel using methods known in the art, for example, using heat, vacuum, a combination of heat and vacuum, or flowing a stream of dry air or a dry inert gas such as nitrogen over the hydrogel.
• the dried hydrogel may be sterilized using the methods described above.
• the dried hydrogel may be applied to an anatomical site in a number of ways, as described below.
• the dried hydrogel may be hydrated on the site by the addition of a suitable aqueous solution such as water or a buffer (e.g., phosphate-buffered saline) or by the physiological fluids present at the site.
• a suitable aqueous solution such as water or a buffer (e.g., phosphate-buffered saline) or by the physiological fluids present at the site.
• the dried hydrogel may be used in the form of a film.
• the dried hydrogel film may be formed by casting a mixture of the solutions or dispersions, as described above, on a suitable substrate and treating the resulting hydrogel to form a dried hydrogel film.
• the dried hydrogel film may be applied directly to an anatomical site. Additionally, the dried hydrogel film may be used to bond two anatomical sites together.
• the dried hydrogel may be used in the form of finely divided particles.
• the dried hydrogel particles may be formed by comminuting the dried hydrogel using methods known in the art, including, but not limited to, grinding, milling, or crushing with a mortar and pestle.
• the dried hydrogel particles may be applied to an anatomical site in a variety of ways, such as sprinkling or spraying, and may also be used to bond two anatomical sites together.
• the invention provides a kit comprising at least one aldehyde-functionalized polysaccharide containing pendant aldehyde groups and at least one water-dispersible, multi-arm amine wherein at least three of the arms are terminated by at least one primary amine group.
• the kit comprises a first aqueous solution or dispersion comprising at least one aldehyde-functionalized polysaccharide containing pendant aldehyde groups and a second aqueous solution or dispersion comprising at least one water-dispersible, multi-arm amine wherein at least three of the arms are terminated by at least one primary amine group.
• Each of the aqueous solutions or dispersions may be contained in any suitable vessel, such as a vial or a syringe barrel.
• the kit comprises at least one aldehyde- functionalized polysaccharide containing pendant aldehyde groups and at least one water-dispersible, multi-arm amine wherein at least three of the arms are terminated by at least one primary amine group in the form of finely divided powders, as described above.
• the powders may be contained in separate containers or they may be premixed and contained in a single container.
• the kit may also comprise an aqueous solution for hydrating the powders.
• the kit comprises a dried hydrogel as described above.
• the dried hydrogel may be in the form of a film, finely divided particles, or other dried forms.
• the kit may further comprise an aqueous solution for hydrating the dried hydrogel.
• the dried hydrogel particles may be contained in any suitable container.
• the hydrogel disclosed herein may be useful as a tissue adhesive or sealant for medical applications that require a more rapid degradation time, including but not limited to, prevention of undesired tissue-to tissue adhesions resulting from trauma or surgery.
• the aldehyde-functionalized polysaccharide and the water-dispersible, multi- arm amine, or the dried hydrogel may be applied to the desired anatomical site using the methods described above.
• Dextran containing pendant aldehyde groups and having a weight- average molecular weight of about 15 kDa and a degree of aldehyde substitution of about 90% was prepared using a two step procedure.
• dextran having a weight-average molecular weight of about 9 to about 11 kDa was reacted with allyl glycidyl ether to form an olefin intermediate, which was then reacted with ozone to form the dextran containing pendant aldehyde groups.
• step 2 460 ml_ of the filtrate resulting from step 1 was added to a 3-neck, 2 L flask equipped with magnetic stir bar, and sparge tube inlet.
• the solution was cooled in an ice bath to 0-5 0 C and then sparging with ozone was begun from an ozone generator (ClearWater Tech, LLC, San Luis Obispo, CA; Model CD10) at 100% power which generates 7% ozone. Foaming occurred, which was controlled by the addition of a few drops of 1 -heptanol.
• Samples were taken at 6.25 and 7.75 hours and analyzed using 13-C NMR. Disappearance of resonances at 118 and 134 ppm indicated that the olefin had been consumed after 7.75 hours.
• the degree of aldehyde substitution of the resulting solid product was determined to be 89% using the method of Zhao and Heindel (Pharmaceutical Research 8:400, 1991 ).
• the weight-average molecular weight of the aldehyde-functionalized dextran was determined to be about 15 kDa using size exclusion chromatography (SEC). This aldehyde- functionalized dextran is referred to herein as AFD-15-90.
• a second preparation of this aldehyde-functionalized dextran was made using the same procedure.
• the degree of aldehyde substitution of the resulting product was determined to be 92% using the method of Zhao and Heindel and the weight-average molecular weight was found to be 16 kDa using SEC.
• This aldehyde-functionalized dextran is referred to herein as AFD-16-92.
• lnulin containing pendant aldehyde groups and having a weight- average molecular weight of about 12 kDa and a degree of aldehyde substitution of about 49% was prepared using the two step procedure described above.
• inulin (average molecular weight of about 4 kDa, Sigma) was suspended in 200 ml_ of water, heated to 70 0 C for 1 hour to dissolve, and then cooled to 65 0 C.
• To this solution was added 23 ml_ of sodium hydroxide solution (20 wt% in water), followed by the slow addition of allyl glycidyl ether (50.7 g) via a syringe pump at a rate of 3 mL/min. After the addition, the mixture was heated to 65 0 C for 6 hours. After which time, the reaction mixture was cooled to room temp and neutralized to pH 7 with 50% HCI.
• the reaction mixture was purified by ultrafiltration over a 1000 MWCO membrane (collect 10X volume of waste).
• the filtrate was cooled to approximately 5 0 C using an ice/water bath. Ozone was sparged into the stirred solution for 6 hours. 1 -Heptanol was added (a few drops) to control foaming.
• sodium sulfite solution (16 g in 100 ml_ water) was added to the cooled solution (cooled in an ice/water bath). The solution was stirred at room temperature overnight. The product was purified by ultrafiltration (MWCO 1000, collect 12X volume of waste). The filtrate was lyophilized to yield a white solid.
• the degree of aldehyde substitution was determined to be about 49% by titration of the hydroxylamine adduct of the inulin aldehyde using the method described by Zhao and Heindel (Pharmaceutical Research 8:400, 1991 ). This aldehyde-functionalized inulin is referred to herein as AFM 2-49.
• Dextran containing pendant aldehyde groups and having a weight- average molecular weight of about 5 to 11 kDa and a degree of aldehyde substitution of 86% was prepared using a two step procedure.
• dextran having a weight-average molecular weight of about 5 to about 11 kDa was reacted with glycidol to form alkylated dextran.
• the alkylated dextran was oxidized with sodium periodate to oxidize the terminal diol groups added in the first step to give dextran having pendant aldehyde groups.
• the resulting yellow homogeneous mixture was neutralized with 50% HCI over ice (final pH was 7.3).
• the sample was precipitated in approximately 5x volume of cold isopropanol ( ⁇ 0 0 C).
• the isopropanol layer was decanted off, the solid product washed with cold isopropanol, and the process of dissolution followed by precipitation was repeated two more times.
• the solid product was dried under vacuum for 48 hours.
• Dextran containing pendant aldehyde groups and having a weight- average molecular weight of about 9 kDa and a degree of aldehyde substitution of 120% was prepared using a two step procedure.
• dextran having a weight-average molecular weight of about 5 to about 11 kDa was reacted with glycidol to form alkylated dextran.
• the alkylated dextran was oxidized with sodium pehodate to oxidize the terminal diol groups added in the first step to give dextran having pendant aldehyde groups.
• the first step three batches of dextran were reacted with glycidol to form the alkylated dextran.
• 20 g of dextran (average molecular weight of 5-11 kDa, Sigma)
• glycidol 36 g, Aldrich
• the mole ratio of glycidol to dextran was varied.
• Dextran (10 g) was dissolved in a solution formed by combiningiO ml_ of water and 12.5 ml_ sodium hydroxide solution (20 wt%).
• Dextran containing pendant aldehyde groups and having a weight- average molecular weight of about 13 kDa and a degree of aldehyde substitution of 64% was prepared using a two step procedure.
• dextran having a weight-average molecular weight of about 5 to about 11 kDa was reacted with glycidol to form alkylated dextran.
• the alkylated dextran was oxidized with sodium pehodate to oxidize the terminal diol groups added in the first step to give dextran having pendant aldehyde groups.
• the first step was carried out as described above for AFD-9-120.
• 25 g of the solid product from the master batch of the alkylated dextran described above for AFD-9-120 was dissolved in 250 ml_ of water in a round bottom flask and then the resulting solution was cooled to 4 0 C.
• Sodium periodate solution (10.4 g in 60 ml_ of water) was added to the round bottom flask dropwise over 1 hour.
• the reaction mixture was stirred at 4 0 C for 2 hours, and then 6 g of ethylene glycol was added to the reaction mixture, which was then stirred for 30 min. Then the reaction mixture was filtered.
• the filtrate was purified using a TFF System
• Dextran containing pendant aldehyde groups and having a weight- average molecular weight of about 13 kDa and a degree of aldehyde substitution of 46% was prepared using a two step procedure.
• dextran having a weight-average molecular weight of about 9 to about 11 kDa was reacted with allyl glycidyl ether to form an olefin intermediate, which was then reacted with ozone to form the dextran containing pendant aldehyde groups.
• the mixture was diluted with an additional 200 ml_ of water and purified with a Millipore Pellicon Il ultrafiltration system (Millipore Corp., Billerica, MA) using 1 kDa cutoff filters with continuous replacement of filtrate with pure water until 5x the initial solution volume had been collected as filtrate. A small sample of the filtrate was taken and
• step 2 475 ml_ of the filtrate resulting from step 1 was added to a 3-neck, 2 L flask equipped with magnetic stir bar, and sparge tube inlet.
• the solution was cooled in an ice bath to 0-5 0 C and then sparging with ozone was begun from an ozone generator (ClearWater Tech, LLC, San Luis Obispo, CA; Model CD10) at 100% power which generates 7% ozone. Foaming occurred, which was controlled by the addition of a few drops of 1 -heptanol.
• Samples were taken at 2 and 4 hours and analyzed using 13-C NMR. Disappearance of resonances at 118 and 134 ppm indicated that the olefin had been consumed after 4 hours.
• the weight-average molecular weight of the aldehyde-functionalized dextran was determined to be about 13 kDa using size exclusion chromatography (SEC). This aldehyde- functionalized dextran is referred to herein as AFD-13-46.
• Dextran containing pendant aldehyde groups and having a weight- average molecular weight of about 19 kDa and a degree of aldehyde substitution of 60% was prepared using the two step procedure described above.
• the mixture was diluted with an additional 200 ml_ of water and purified using the Millipore Pellicon Il ultrafiltration system, by filtration through 1 kDa cutoff filters with continuous replacement of filtrate with pure water until 5x the initial solution volume had been collected as filtrate. A small sample was taken and lyophilized for analytical purposes. The remainder of the filtrate was used directly in the subsequent ozonolysis step. The degree of substitution was determined to be 0.99 by NMR from the ratio of integration between the olefin peaks and the anomehc peaks at 4.8-5.0.
• step 2 475 ml_ of the filtrate resulting from step 1 was added to a 3-neck, 2 L flask equipped with magnetic stir bar, and sparge tube inlet.
• the solution was cooled in an ice bath to 0-5 0 C and then sparging with ozone was begun from an ozone generator (ClearWater Tech, LLC, San Luis Obispo, CA; Model CD10) at 100% power which generates 7% ozone. Foaming occurred, which was controlled by the addition of a few drops of 1-heptanol.
• Samples were taken at 4 and 5.75 hours and analyzed using 13-C NMR. Disappearance of resonances at 118 and 134 ppm indicated that the olefin had been consumed after 5.75 hours.
• the weight-average molecular weight of the aldehyde-functionalized dextran was determined to be about 19 kDa using size exclusion chromatography (SEC). This aldehyde- functionalized dextran is referred to herein as AFD-19-64.
• Dialdehyde-functionalized dextran in which the pendant dialdehyde groups are linked to the dextran backbone by an ether bond was prepared using a three step procedure.
• Step 1
• reaction mixture was cooled to room temperature and the pH was adjusted to 7.0 with 0.5 M HCI.
• the resulting solution was diluted to approximately 400 ml_ with water, then purified using the Millipore Pellicon Il ultrafiltration system with a 1000 molecular weight cutoff cassette. A small aliquot was lyophilized for analysis.
• a 1 L, 3-neck flask containing 400 ml_ of the aqueous solution of functionalized dextran (from the previous step) at approximately 8 0 C was sparged with ozone for 5.5 hours.
• the ozone flow was stopped and a solution of 0.45 g of sodium sulfite in 3 ml_ of water was added to the flask at 8 0 C.
• the solution was stirred overnight and purified by ultrafiltration on the Millipore Pellicon Il ultrafiltration system using 1000 MWCO cassette.
• the final solution was frozen and lyophilized to yield 0.68 g of a foam-like solid.
• the degree of aldehyde substitution was determined to be about 16% by titration of the hydroxylamine adduct of the dialdehyde- functionalized dextran using the method described by Zhao and Heindel (Pharmaceutical Research 8:400, 1991 ).
• This dialdehyde-functionalized dextran is referred to herein as DAFD-10-16.
• Dialdehyde-functionalized dextran in which the pendant dialdehyde groups are linked to the dextran backbone by an ester bond was prepared using a two step procedure.
• Step 1
• dialdehyde-functionalized dextran is referred to herein as DAFD-Ester Linked.
• Dextran aldehyde is made by oxidizing dextran in aqueous solution with sodium metaperiodate.
• An oxidized dextran having an average molecular weight of about 10,000 Da and an oxidation conversion of about 50% (i.e., about half of the glucose rings in the dextran polymer are oxidized to dialdehydes) is prepared from dextran having a weight- average molecular weight of 8,500 to 11 ,500 Daltons (Sigma) by the method described by Cohen et al. (copending and commonly owned International Patent Application Publication No. WO 2008/133847). A typical procedure is described here.
• a 20-L reactor equipped with a mechanical stirrer, addition funnel, internal temperature probe, and nitrogen purge is charged with 1000 g of the dextran and 9.00 L of de-ionized water.
• the mixture is stirred at ambient temperature to dissolve the dextran and then cooled to 10 to 15 0 C.
• To the cooled dextran solution is added over a period of an hour, while keeping the reaction temperature below 25 0 C, a solution of 1000 g of sodium periodate dissolved in 9.00 L of de-ionized water. Once all the sodium periodate solution has been added, the mixture is stirred at 20 to 25 0 C for 4 more hours.
• the reaction mixture is then cooled to 0 0 C and filtered to clarify.
• Calcium chloride (500 g) is added to the filtrate, and the mixture is stirred at ambient temperature for 30 min and then filtered.
• Potassium iodide 400 g is added to the filtrate, and the mixture is stirred at ambient temperature for 30 min. A 3-L portion of the resulting red solution is added to 9.0 L of acetone over a period of 10 to 15 min with vigorous stirring by a mechanical stirrer during the addition. After a few more minutes of stirring, the agglomerated product is separated from the supernatant liquid. The remaining red solution obtained by addition of potassium iodide to the second filtrate is treated in the same manner as above. The combined agglomerated product is broken up into pieces, combined with 2 L of methanol in a large stainless steel blender, and blended until the solid becomes granular. The granular solid is recovered by filtration and dried under vacuum with a nitrogen purge.
• the granular solid is then hammer milled to a fine powder.
• a 20-L reactor is charged with 10.8 L of de-ionized water and 7.2 L of methanol, and the mixture is cooled to 0 0 C.
• the granular solid formed by the previous step is added to the reactor and the slurry is stirred vigorously for one hour. Stirring is discontinued, and the solid is allowed to settle to the bottom of the reactor.
• the supernatant liquid is decanted by vacuum, 15 L of methanol is added to the reactor, and the slurry is stirred for 30 to 45 min while cooling to 0 0 C.
• the slurry is filtered in portions, and the recovered solids are washed with methanol, combined, and dried under vacuum with a nitrogen purge to give about 600 g of the oxidized dextran, which is referred to herein as D10-50.
• the integrals for two ranges of peaks are determined, specifically, -O 2 CHx- at about 6.2 parts per million (ppm) to about 4.15 ppm (minus the HOD peak) and -OCHx- at about 4.15 ppm to about 2.8 ppm (minus any methanol peak if present).
• the 8-arm PEG 1 OK chloride is made by reaction of thionyl chloride with the 8-arm PEG 1 OK octaalcohol.
• the 8- arm PEG 1OK chloride is reacted with aqueous ammonia to yield the 8- arm PEG 1OK octaamine.
• a typical procedure is described here.
• the 8-arm PEG 10K octaalcohol (M n I OOOO; NOF SunBright HGEO-10000), (100 g in a 500-mL round-bottom flask) is dried either by heating with stirring at 85 0 C under vacuum (0.06 mm of mercury (8.0 Pa)) for 4 hours or by azeotropic distillation with 50 g of toluene under reduced pressure (2 kPa) with a pot temperature of 60 0 C.
• the 8-arm PEG 10K octaalcohol is allowed to cool to room temperature and thionyl chloride (35 ml_, 0.48 mol) is added to the flask, which is equipped with a reflux condenser, and the mixture is heated at 85 0 C with stirring under a blanket of nitrogen for 24 hours. Excess thionyl chloride is removed by rotary evaporation (bath temp 40 0 C). Two successive 50-mL portions of toluene are added and evaporated under reduced pressure (2 kPa, bath
• the 8-arm PEG I OK octachloride (100 g) is dissolved in 640 ml_ of concentrated aqueous ammonia (28 wt%) and heated in a pressure vessel at 60 0 C for 48 hours. The solution is sparged for 1-2 hours with dry nitrogen to drive off 50 to 70 g of ammonia. The solution is then passed through a column (500 ml_ bed volume) of strongly basic anion exchange resin (Purolite® A-860, The Purolite Co., Bala-Cynwyd, PA) in the hydroxide form. The eluant is collected and three 250-mL portions of de- ionized water are passed through the column and also collected.
• strongly basic anion exchange resin Purolite® A-860, The Purolite Co., Bala-Cynwyd, PA
• aqueous solutions are combined, concentrated under reduced pressure (2 kPa, bath temperature 60 0 C) to about 200 g, frozen in portions and lyophilized to give the 8-arm PEG 10K octaamine, referred to herein as P8-10-1 , as a colorless waxy solid.
• An 8-arm PEG 10K hexadecaamine having two primary amine groups at the end of the arms, was prepared using a two step procedure, as described by Arthur in WO 2008/066787, in which 8-arm PEG 10K was reacted with methanesulfonyl chloride in dichloromethane in the presence of triethylamine to produce 8-arm PEG 10K mesylate, which was subsequently reacted with tris(2- aminoethyl)amine to give the 8-arm PEG 10K hexadecaamine.
• a typical synthesis is described here.
• the reaction mixture is diluted with 45 ml_ of 5% (w/w) aqueous sodium bicarbonate and extracted with a total of 500 ml_ of dichloromethane divided in 3 portions.
• the dichloromethane solution is dried over sodium sulfate, and concentrated by rotary evaporation to 20 to 25 g.
• Ether 100 ml_ is added to the concentrated dichloromethane solution with vigorous stirring, and the mixture is cooled to 0 0 C, causing a waxy solid to separate from solution.
• the solvent is decanted from the waxy solid, and the waxy solid is dried under vacuum to give the 8-arm PEG 10K hexadecaamine (P8-10-2).
• a syringe pump system was used to measure the burst strength of a seal of an incision made in a section of swine uterine horn.
• the syringe pump (Model No. 22, Harvard Apparatus, Holliston, MA) was modified to be equipped with two 30 ml_ syringes, which were connected together through a "Y" junction. Water was pumped through a single piece of Tygon® R-36 tubing (0.6 cm diameter) and through a pressure gauge (Model PDG 5000L, Omega Engineering, Stamford, CT).
• the incision on the outside of the uterine horn was wider than the scalpel blade (typically 4-5 mm) while the hole through the inside wall was about 3 mm (about equal to the blade). This size incision mimics the distance between the interrupted sutures if an intestine were to be cut and later sutured.
• the uterine horn was filled with water containing a purple dye via the syringe pump until water began to leak from the open hole in the end plug and also from the scalpel puncture in the uterine horn wall. The pump was then turned off and the end plug was sealed with the machine screw.
• the scalpel incision site was blotted dry using a paper towel.
• the aldehyde-functionalized polysaccharide and multi-arm PEG amine solutions were prepared in water with shaking overnight at 37 0 C and 175 rpm.
• the two solutions were applied to the incision using a double barrel syringe (Mixpac Systems AG (Rotnch, Switzerland) fitted with a 16 or a 12 step static mixer (Mixpac Systems AG). After the application, the adhesive was allowed to cure at room temperature for no longer than 2 min.
• Burst pressure testing also referred to herein as leak pressure testing, was done by pressurizing the sealed intestine with water from the syringe pump at a flow rate of 11 mL/min until the bioadhesive seal began to leak, at which point the pressure was recorded. Adhesive failure was attributed when the water leaked under the seal between the hydrogel and the tissue surface. Cohesive failure was attributed when the water penetrated and leaked through the hydrogel itself. The results of the burst testing are summarized in Table 1. Table 1
• the testing was done using NIH3T3 human fibroblast cell cultures according to ISO10993-5:1999.
• the NIH3T3 human fibroblast cells were obtained from the American Type Culture Collection (ATCC; Manassas, VA) and were grown in Dulbecco's modified essential medium (DMEM), supplemented with 10% fetal calf serum.
• ATCC American Type Culture Collection
• DMEM Dulbecco's modified essential medium
• NIH3T3 human fibroblast cell cultures were challenged with hydrogels made by combining equal volumes of an aqueous solution of an aldehyde-funtionalized polysaccharide and an aqueous solution of multi- arm PEG amine, as shown in Table 2.
• the aqueous solutions were prepared and mixed to form hydrogels as described in Examples 1 -15.
• Each hydrogel was placed in the bottom of a well in a polystyrene culture plate such that about % of the well bottoms were covered. The wells were then sterilized under UV light and seeded with 50,000-100,000 NIH3T3 cells.
• the hydrogel samples were prepared by mixing equal volumes of an aqueous solution of an aldehyde-functionalized polysaccharide and an aqueous solution of a multi-arm PEG amine, as shown in Table 3.
• the aqueous solutions were prepared and mixed to form hydrogels as described in Examples 1 -15.
• the samples were weighed and placed inside jars containing PBS (phosphate buffered saline) at pH 7.4.
• the jars were placed inside a temperature-controlled shaker set at 80 rpm and 37 0 C.
• the samples were removed from the jars at various times, blotted to remove excess solution, and weighed. Then, the samples were returned to the jars.
• the results are summarized in Table 3.
• the percent swell reported in the table is the weight of the hydrogel measured during the course of the study divided by the initial weight of the hydrogel, multiplied by 100.
• dialdehyde functionalized dextrans form hydrogels gels with the multi-arm PEG amine P-8-10-1 and that hydrogels with a wide range of degradation rates in an aqueous environment can be obtained.
• long lived hydrogels can be formed using aldehyde-functionalized dextran having pendant dialdehyde groups where the linkage to the dextran backbone is chemically stable as in the ether linked dialdehyde-functionalized dextran (Example 38).
• Much faster degrading hydrogels can also be prepared by using aldehyde- functionalized dextran having pendant dialdehyde groups where the linkage of the the pendant dialdehyde groups is potentially hydrolytically unstable, such as an ester linkage (Example 39).
• One group of the syringes was stored at 25 0 C for various periods of time and the second group of syringes was heated at 40 0 C for various periods of time (as shown in Table 6) to provide thermally aged aqueous solutions of the aldehyde-functionalized polysaccharides.
• the storage modulus of the mixed solutions was measured as described above at various times. The results are shown in Table 6, expressed as the percent of the Day zero G'.
• Two double barrel syringes each containing an aqueous solution of AFD-13-64 (20 wt%) in one barrel and an aqueous solution of P8-10-1 (20 wt%) in the other barrel were prepared.
• One syringe was heated at 40 0 C for 19 days; the other syringe was stored at 4 0 C for the same period of time. Then, the storage modulus of the mixtures resulting from each syringe was measured using a Model APA2000 rheometer (Alpha
• Dextran having an average molecular weight of 8.5-11 kDa (Sigma) was dissolved in 123.75 mL of 6 N NaOH at 0 0 C. To this cold solution was added 30.75 g of chloroacetic acid (Aldrich). This reaction mixture was heated to 60 0 C for 20 min, then cooled, and neutralized to pH 7.0 with concentrated HCI. The product was precipitated by adding the neutralized solution dropwise to 1.0 L of methanol. The solids were collected by filtration and re-precipitated from methanol. The entire procedure was then repeated three times to raise the degree of substituion to the desired level. After the final repeat, the product was further purified by ultrafiltration.
• the solution was diafiltered using a Millipore Pellicon Il TFF system. A total of 6 volumes of permeate was collected while continuously adding water to maintain a constant retentate volume. The retentate was then collected and lyophilized to give 14.25 g of a fluffy white solid. The degree of carboxymethylation was determined by the method of Ho et al. ⁇ Anal. Chem. 52:916, 1980) to be 1.1. This
• carboxymethyldextran product is referred to herein as CMDX-11 -1.1.
• the acetal groups were removed by dissolving the solid in 400 ml_ of water and treating with 1.0 M HCI at pH 2.5 overnight. After neutralizing with NaOH, the solution was filtered on the Millipore Pellicon Il
• carboxymethyldextran containing pendant aldehyde groups attached by an amide linkage was made by dissolving 5.1 g of the solid product obtained as described above in 15.3 g of autoclaved water. The mixture was shaken at 190 rpm in an incubator at 37 0 C for 1 hour. The resulting solution was filtered through a 5.0 ⁇ m membrane and two 5 ml_ samples of the solution were placed in 55 0 C incubator. After 19 hours both samples had formed amber gels which exhibited no flow.

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