Next Generation Nanomedicine in the Genesis of “Ankaferd Blood Stopper Nanohemostat”

In a recent issue of your journal, Aktop et al ¹ brilliantly evaluated the hemostatic effects of Ankaferd blood stopper (ABS) by measuring the tissue factor activities in warfarin-treated rats. Based on the recent developments in surgical hemostatic interventions, the authors successfully evaluate the unique hemostatic effects of ABS, which is a novel hemostatic agent of plant origin used for centuries in Anatolia for the management of clinical hemorrhages. ^2,3 Although as already mentioned by the authors, ABS is currently used topically by spraying over the bleeding area, there is still a need for alternative application methods and techniques to achieve a better hemostasis. In order to achieve these goals, we recently developed a chimeric ABS nanohemostat gel that could be applied over the bleeding area topically. ⁴ We think that this new formulation could be more effective than the current form of this agent by also developing a mechanical barrier over the injured tissue.

The use of nanomaterials in medicine involves the applications of nanoparticles and manufactured nanosystems to provide regeneration at the cellular and tissue levels. Biomaterials used as tissue-engineering scaffolds have specific physical properties and might form fibrous networks similar to collagenous extracellular matrix. In order to broaden the contact surface and to achieve an active hemostasis with ABS, our team has recently generated a chimeric hemostatic agent, ABS nanohemostat, via combining a self-assembling peptide amphiphile molecule with the traditional Ankaferd hemostat. ⁴ With the intention to develop an ABS gel formation with nanomedicinal approach, we first synthesized a self-assembling peptide molecule capable of being a part of the combined ABS nanohemostat compound. Second, we aimed to assemble the peptide nanofibers and ABS to generate the ABS nanohemostat. And finally, we have tested the hemostatic potential of this chimeric compound in a surgical experimental trial in the kidney tissue with significant success. ⁴

Ongoing rigorous search for new techniques or treatments that are effective, safe, easy to apply, and “potentially life saving” in the distinct settings of clinical hemorrhages, the production of ABS nanohemostat in gel formation is of great importance for opening significant new avenues for further studies. Apart from its current liquid formulation, ABS gel has several advantages in clinical hemorrhagic situations. The major advantage of gel formulation is the aptitude of water absorption in the bleeding site and composing a physical barrier over the bleeding mucosa.

Based on those observations, the gel formulation of ABS nanohemostat generated by nanotechnology seems to be a candidate hemostatic agent for controlling clinical hemorrhages, and experimental studies are now in progress to establish clinical backgrounds for this novel chimeric compound in the near future. Moreover, in order to achieve this goals, intraluminal gel-forming drug delivery systems of ABS nanohemostat are currently under development for the optimum feasibility of the endoscopic drug applications on the actively bleeding tissues.