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Fibrin clot is a vital class of fibrous materials, governing the mechanical response of blood clots. Fracture behavior of fibrin clots under complex physiological load is relevant for hemostasis and thrombosis. But how they fracture under cyclic and variable rate loading has not been reported. Here we conduct cyclic fatigue and monotonic variable rate loading tests on fibrin clots to characterize their fracture properties in terms of fatigue threshold and rate-dependent fracture toughness. We demonstrate that the fracture behavior of fibrin clots is sensitive to the amplitude of cyclic load and the loading rate. The cyclic fatigue tests show the fatigue threshold of fibrin clots at 1.66 J/m2, compared to the overall fracture toughness 15.8 J/m2. Furthermore, we rationalize the fatigue threshold using a semi-empirical model parameterized by 3D morphometric quantification to account for the hierarchical molecular structure of fibrin fibers. The variable loading tests reveal rate dependence of the overall fracture toughness of fibrin clots. Our analysis with a viscoelastic fracture model suggests the viscoelastic origin of the rate-dependent fracture toughness. The toughening mechanism of fibrin clots is further compared with biological tissues and hydrogels. This study advances the understanding and modeling of fatigue and fracture of blood clots and would motivate further investigation on the mechanics of fibrous materials. Fibrin clot is a soft fibrous gel, exhibiting nonlinear mechanical responses under complex physiological loads. It is the main load-bearing constituent of blood clots where red blood cells, platelets and other cells are trapped. How the fibrin clot fractures under complex mechanical loads is critical for hemostasis and thrombosis. We study the fracture behavior of fibrin clots under cyclic fatigue and monotonic variable rate loads. We characterize the fatigue-threshold and viscous energy dissipation of fibrin clots. We compare the toughness enhancement of fibrin clots with hydrogels. The findings offer new insights into the fatigue and fracture of blood clots and fibrous materials, which could improve design guidelines for bioengineered materials. [Display omitted] [ABSTRACT FROM AUTHOR]

[Display omitted] Fibrin clots are crucial for hemostasis and the healing of wounds; nevertheless, excessive blood clotting plays an important role in many chronic diseases, including cardiovascular disease. In this study, we demonstrated the effect of the prepared AuNPs@PANI core/shell on the formed fibrin network. The synthesis of nanoparticles combining electrically conducting polymers polyaniline (PANI) and gold nanoparticles (AuNPs) is an appealing field of research currently because of their physical features and prospective applications in biochemistry. AuNPs showed surface plasmonic resonance (SPR) properties in the visible region at 520 nm then, after coating with PANI, there was a dramatic red shift to 610 nm. The morphological conformation was confirmed by characterization at the microscopic (TEM, SEM, EDX). The PANI shell plays a crucial role in this system, first enhances the stability of AuNPs core; also, the surface of the PANI shell has positive charges (zeta potential = +17.8 mV), leading to electrostatic interactions with fibrin clots that have negatively charged surfaces. The synthesized core/shell AuNPs@PANI showed good efficiency for degrading fibrin networks under 1:30 h of irradiation by an external source of laser light, which is a result of AuNPs' ability to absorb light at 520 nm. The degradation of fibrin was observed using a scanning electron microscope (SEM), which showed a clear change in the shape of the network. The appearance of fibrous endings and gaping indicates the beginning of the degradation and melting of the fibrin network in different sites of the clot. Overall, this method could have a major influence on disease states, for example, deep vein thrombosis, through a localized, catheter-based approach. [ABSTRACT FROM AUTHOR]

There have been several reports of foreign bodies being discovered in the intravenous set. In this case, the patient complained that he found a worm in his intravenous line. It was later confirmed as a long, white fibrin deposit by pathologic examination. This happened even though there was a non-return valve in the intravenous line. Also, since there were few red blood cells in the deposit, it did not look like a blood clot. In cases like this, we suggest that physicians keep this possibility in mind to reassure their patients. [ABSTRACT FROM AUTHOR]

Plasma fibrinogen includes an alternatively spliced γ-chain variant (γ’), which mainly exists as a heterodimer (γAγ’) and has been associated with thrombosis. We tested γAγ’ fibrinogen-red blood cells (RBCs) interaction using atomic force microscopy-based force spectroscopy, magnetic tweezers, fibrin clot permeability, scanning electron microscopy and laser scanning confocal microscopy. Data reveal higher work necessary for RBC-RBC detachment in the presence of γAγ’ rather than γAγA fibrinogen. γAγ’ fibrinogen–RBCs interaction is followed by changes in fibrin network structure, which forms an heterogeneous clot structure with areas of denser and highly branched fibrin fibers. The presence of RBCs also increased the stiffness of γAγ’ fibrin clots, which are less permeable and more resistant to lysis than γAγA clots. The modifications on clots promoted by RBCs-γAγ’ fibrinogen interaction could alter the risk of thrombotic disorders. [ABSTRACT FROM AUTHOR]

Matrix stiffness is known to play a pivotal role in cellular differentiation. Studies have shown that soft scaffolds (<2–3 kPa) promote cellular aggregation and chondrogenesis, whereas, stiffer ones (>10 kPa) show poor chondrogenesis in vitro . In this work we investigated if fibrin matrix from clotted blood can act as a soft surrogate which nullifies the influence of the underlying stiff scaffold, thus promoting chondrogenesis irrespective of bulk scale scaffold stiffness. For this we performed in vitro chondrogenesis on soft (∼1.5 kPa) and stiff (∼40 kPa) gelatin scaffolds in the presence and absence of pericellular plasma clot. Our results demonstrated that in absence of pericellular plasma clot, chondrocytes showed efficient condensation and cartilaginous matrix secretion only on soft scaffolds, whereas, in presence of pericellular plasma clot, cell rounding and cartilaginous matrix secretion was observed in both soft and stiff scaffolds. More specifically, significantly higher collagen II, chondroitin sulfate and aggrecan deposition was observed in soft scaffolds, and soft and stiff scaffolds with pericellular plasma clot as compared to stiff scaffolds without pericellular plasma clot. Moreover, collagen type I, a fibrocartilage/bone marker was significantly higher only in stiff scaffolds without plasma clot. Therefore, it can be concluded that chondrocytes surrounded by a soft fibrin network were unable to sense the stiffness of the underlying scaffold/substrate and hence facilitate chondrogenesis even on stiff scaffolds. This understanding can have significant implications in the design of scaffolds for cartilage tissue engineering. Statement of Significance Cell fate is influenced by the mechanical properties of cell culture substrates. Outside the body, cartilage progenitor cells express significant amounts of cartilage-specific markers on soft scaffolds but not on stiff scaffolds. However, when implanted in joints, stiff scaffolds show equivalent expression of markers as seen in soft scaffolds. This disparity in existing literature prompted our study. Our results suggest that encapsulation of cells in a soft plasma clot, present in any surgical intervention, prevents their perception of stiffness of the underlying scaffold, and hence the ability to distinguish between soft and stiff scaffolds vanishes. This finding would aid the design of new scaffolds that elicit cartilage-like biochemical properties while simultaneously being mechanically comparable to cartilage tissue. [ABSTRACT FROM AUTHOR]

After a sinus lifting procedure, the compartment around the implants under the sinus mucosal lining in the sinus floor is filled with a blood clot from surrounding bleeding. The aim of this study was to evaluate the feasibility of bone formation following graftless sinus lifting with the simultaneous placement of dental implants. Thirty graftless sinus lifting procedures were performed and 72 dental implants placed in 18 consecutive patients, using the lateral window approach. Clinical and radiological follow-up was conducted throughout the 6-month healing period. Biopsies of 30 cases were collected at 6 months post-treatment: 15 biopsies were taken from the newly formed bone near the basal floor and 15 from the newly formed bone near the elevated membrane. New bone consolidation in the maxillary sinus was apparent radiologically and histologically at 6 months after sinus augmentation, providing an average 6.14 ± 1.34 mm of bone-gain. Based on histological analysis and histomorphometric data, the consolidated bone in the augmented sinus comprised 56.7 ± 11.9% to 59.9 ± 13.4% vital bone tissue. Out of the 72 implants placed, only four failed, indicating a 94% overall implant survival rate. Based on this case series, blood clot can be considered autologous osteogenic graft material, to which osteoprogenitors can migrate, differentiate, and regenerate bone. [ABSTRACT FROM AUTHOR]

Fibrin has been used in medicine for nearly 100 years and the use of fibrin clots have been used in meniscal repairs for over 20 years. It is theorized that the concentrated levels of platelets in fibrin clot aid in healing through the release of growth factors. The use of concentrated platelets has gained recent popularity through the increase use of platelet-rich plasma; however, it is still unknown what platelet concentration constitutes an optimal level of healing. Recent studies on the healing of the anterior cruciate ligament (ACL) reconstruction and repair suggest that concentrated platelets might play a role in advanced healing in the ACL. This article will summarize the history of fibrin clots in surgery, the biochemistry of platelets, current use, and the future of fibrin clots as biological aids in healing. Techniques for preparing an exogenous clot, repairing meniscal tears with a fibrin clot, and the use of fibrin clots in ACL reconstruction will also be discussed. [Copyright &y& Elsevier]