Technological advances in nanoscale biomaterials: the future of synthetic vascular graft design

Photopolymerization strategy for the preparation of small-diameter artificial blood vessels with micro-nano structures on the inner wall

Although large diameter vessels made of polyurethane materials have been widely used in clinical practice, the biocompatibility and long-term patency of small diameter artificial vessels have not been well addressed. Any technological innovation and advancement in small-diameter artificial blood vessels is of great interest to the biomedical field. Here a novel technique is used to produce artificial blood vessels with a caliber of less than 6 mm and a wall thickness of less than 0.5 mm by rotational exposure, and to form a bionic inner wall with a periodically micro-nano structure inside the tube by laser double-beam interference. The polyethylene glycol diacrylate used is a widely recognized versatile biomaterial with good hydrophilicity, biocompatibility and low cytotoxicity. The effect of the bionic structure on the growth of hepatocellular carcinoma cells and human umbilical vein endothelial cells was investigated, and it was demonstrated that the prepared vessels with the bionic structure could largely promote the endothelialization process of the cells inside them.

Challenges and strategies for in situ endothelialization and long-term lumen patency of vascular grafts

Vascular diseases are the most prevalent cause of ischemic necrosis of tissue and organ, which even result in dysfunction and death. Vascular regeneration or artificial vascular graft, as the conventional treatment modality, has received keen attentions. However, small-diameter (diameter < 4 mm) vascular grafts have a high risk of thrombosis and intimal hyperplasia (IH), which makes long-term lumen patency challengeable. Endothelial cells (ECs) form the inner endothelium layer, and are crucial for anti-coagulation and thrombogenesis. Thus, promoting in situ endothelialization in vascular graft remodeling takes top priority, which requires recruitment of endothelia progenitor cells (EPCs), migration, adhesion, proliferation and activation of EPCs and ECs. Chemotaxis aimed at ligands on EPC surface can be utilized for EPC homing, while nanofibrous structure, biocompatible surface and cell-capturing molecules on graft surface can be applied for cell adhesion. Moreover, cell orientation can be regulated by topography of scaffold, and cell bioactivity can be modulated by growth factors and therapeutic genes. Additionally, surface modification can also reduce thrombogenesis, and some drug release can inhibit IH. Considering the influence of macrophages on ECs and smooth muscle cells (SMCs), scaffolds loaded with drugs that can promote M2 polarization are alternative strategies. In conclusion, the advanced strategies for enhanced long-term lumen patency of vascular grafts are summarized in this review. Strategies for recruitment of EPCs, adhesion, proliferation and activation of EPCs and ECs, anti-thrombogenesis, anti-IH, and immunomodulation are discussed. Ideal vascular grafts with appropriate surface modification, loading and fabrication strategies are required in further studies.

A novel peritoneum derived vascular prosthesis formed on a latex catheter in an SDF-1 chemokine enriched environment: a pilot study

INTRODUCTION

Although saphenous vein grafts are widely used conduits for coronary artery bypass graft surgery, their clinical value remains limited due to high failure rates. The aim of the study was to evaluate feasibility, safety, and biocompatibility of peritoneal derived vascular grafts (PDVG) formed on a silicone-coated, latex, Foley catheter in a stromal cell-derived factor (SDF-1)- enriched environment.

METHODS

Foley catheters were implanted into the parietal wall of 8 sheep. After 21 days the peritoneal cavity was re-opened and the newly formed tissue fragments were harvested. The animals were randomly assigned into: (1) study group in which conduits were incubated in a solution containing SDF-1, (2) control group without SDF-1 incubation. Left carotid arteries were accessed and "end-to-side" anastomoses were performed. Biological materials for histological examination were taken at 4, 7, 10, and 14 days.

RESULTS AND CONCLUSIONS

The study proved safety, feasibility, and biocompatibility of PDVG formed on the basis of a silicone-coated, latex catheter in an SDF-1 chemokine-enriched environment. These biological grafts effectively integrated with the native high-pressure arterial environment in an ovine model and provided favorable vascular profile. The potential clinical value of this technology needs to be further elucidated in long-term preclinical and clinical studies.

Biocompatibility and favorable response of mesenchymal stem cells on fibronectin-gold nanocomposites

A simple surface modification method, comprising of a thin coating with gold nanoparticles (AuNPs) and fibronectin (FN), was developed to improve the biocompatibility required for cardiovascular devices. The nanocomposites from FN and AuNPs (FN-Au) were characterized by the atomic force microscopy (AFM), UV-Vis spectrophotometry (UV-Vis), and Fourier transform infrared spectroscopy (FTIR). The biocompatibility of the nanocomposites was evaluated by the response of monocytes and platelets to the material surface in vitro. FN-Au coated surfaces demonstrated low monocyte activation and platelet activation. The behavior of human umbilical cord-derived mesenchymal stem cells (MSCs) on FN-Au was further investigated. MSCs on FN-Au nanocomposites particularly that containing 43.5 ppm of AuNPs (FN-Au 43.5 ppm) showed cell proliferation, low ROS generation, as well as increases in the protein expression levels of matrix metalloproteinase-9 (MMP-9) and endothelial nitric oxide synthase (eNOS), which may account for the enhanced MSC migration on the nanocomposites. These results suggest that the FN-Au nanocomposite thin film coating may serve as a potential and simple solution for the surface modification of blood-contacting devices such as vascular grafts.

Surface modification of biomaterials: a quest for blood compatibility

Cardiovascular implants must resist thrombosis and intimal hyperplasia to maintain patency. These implants when in contact with blood face a challenge to oppose the natural coagulation process that becomes activated. Surface protein adsorption and their relevant 3D confirmation greatly determine the degree of blood compatibility. A great deal of research efforts are attributed towards realising such a surface, which comprise of a range of methods on surface modification. Surface modification methods can be broadly categorized as physicochemical modifications and biological modifications. These modifications aim to modulate platelet responses directly through modulation of thrombogenic proteins or by inducing antithrombogenic biomolecules that can be biofunctionalised onto surfaces or through inducing an active endothelium. Nanotechnology is recognising a great role in such surface modification of cardiovascular implants through biofunctionalisation of polymers and peptides in nanocomposites and through nanofabrication of polymers which will pave the way for finding a closer blood match through haemostasis when developing cardiovascular implants with a greater degree of patency.

Teflon AF Materials

The unique combination of chemical, thermal, and mechanical stability, high fractional free volume, low refractive index, low surface energy, and wide optical transparency has led to growing interest in Teflon Amorphous Fluoropolymers (AFs) for a wide spectrum of applications ranging from chemical separations and sensors to bioassay platforms. New opportunities arise from the incorporation of nanoscale materials in Teflon AFs. In this chapter, we highlight fractional free volume - the most important property of Teflon AFs - with the aim of clarifying the unique transport behavior through Teflon AF membranes. We then review state-of-the-art developments based on Teflon AF platforms by focusing on the chemistry behind the applications.

Characterization of the in vitro macrophage response and in vivo host response to poly(ethylene glycol)-based hydrogels

Photopolymerizable poly(ethylene glycol) (PEG)- based hydrogels have great potential as in vivo cell delivery vehicles for tissue engineering. However, their success in vivo will be dependent on the host response. The objectives for this study were to explore the in vivo host response and in vitro macrophage response to commonly used PEG-based hydrogels, PEG and PEG containing RGD. Acellular hydrogels were implanted subcutaneously into c57bl/6 mice and the foreign body response (FBR) was compared to medical grade silicone. Our findings demonstrated PEG-RGD hydrogels resulted in a FBR similar to silicone, while PEG-only hydrogels resulted in a robust inflammatory reaction characterized by a thick layer of macrophages at the material surface with evidence of gel degradation. In vitro, bone marrow-derived primary macrophages adhered well and similarly to PEG-based hydrogels, silicone, and tissue culture polystyrene when cultured for 4 days. Significantly higher gene expressions of the proinflammatory cytokines, TNF-alpha and Il-1beta, were found in macrophages seeded onto PEG compared to PEG-RGD and silicone at 1 and 2 days. PEG hydrogels were also shown to be susceptible to oxidative biodegradation. Our findings indicate that PEG-only hydrogels are proinflammatory while RGD attenuates this negative reaction leading to a moderate FBR.

Development of cardiovascular bypass grafts: endothelialization and applications of nanotechnology

There is a critical clinical need for small-diameter bypass grafts, with applications involved in the coronary artery and lower limb. Commercially available materials give rise to unfavorable responses when in contact with blood and subjected to low-flow hemodynamics and, thus, are nonideal as small-diameter bypass grafts. Optimizing the mechanical properties to match both the native artery and the graft surfaces has received keen attention. Endothelialization of bypass grafts is considered a protective mechanism where the biochemicals produced from endothelial cells exert a range of favorable responses, including antithrombotic, noninflammatory responses and inhibition of intimal hyperplasia. In situ endothelialization is most desirable. Nanotechnology approaches facilitate all aspects of endothelialization, including endothelial progenitor cell mobilization, migration, adhesion, proliferation and differentiation. 'Surface nanoarchitecturing mechanisms', which mimic the natural extracellular matrix to optimize endothelial progenitor cell interaction and controlled delivery of various factors in the form of nanoparticles, which can be combined with gene therapy, are of keen interest. This article discusses the development of bypass grafts, focusing on the optimization of the biological properties of mechanically suitable grafts.

Templated growth of calcium phosphate on tyrosine derived microtubules and their biocompatibility

Microtubular structures were self-assembled in aqueous media from a newly synthesized bolaamphiphile, bis(N-alpha-amido-tyrosyl-tyrosyl-tyrosine)-1,5-pentane dicarboxylate. In order to increase the biocompatibility of the microtubules, they were functionalized with the peptide sequence GRGDSP. Further, calcium phosphate nanocrystals were grown on the microtubules. In some cases, collagen was added in order to mimic the components of natural bone tissue. The biomaterials obtained were characterized via transmission electron microscopy (TEM), atomic force microscopy (AFM), IR, and energy dispersive X-ray spectroscopy (EDX) analyses. The biocompatibility of the calcium phosphate-coated microtubules was studied by conducting in vitro cell-attachment, cell-proliferation and cytotoxicity studies using mouse embryonic fibroblast (MEF) cells. The studies revealed that the biomaterials were found to be non-toxic and biocompatible. The functionalized tubular assemblies coated with calcium phosphate nanocrystals mimic the nanoscale composition of natural bone and may potentially support bone in-growth and osseointegration when used in orthopaedic or dental applications.

Two-photon microscopes and in vivo multiphoton tomographs--powerful diagnostic tools for tissue engineering and drug delivery

Near-infrared multiphoton microscopes and in vivo femtosecond laser tomographs are novel powerful diagnostic tools for intra-tissue drug screening and high-resolution structural imaging applicable to many areas of biomedical research. Deep tissue cells and extracellular matrix (ECM) compartments can be visualized in situ with submicron resolution without the need for tissue processing. In particular, the reduced fluorescent coenzyme NAD(P)H, flavoproteins, keratin, melanin, and elastin are detected by two-photon excited autofluorescence, whereas myosin, tubulin and the ECM protein collagen can be imaged additionally by second harmonic generation (SHG). Therefore, these innovative multiphoton technologies have been used to probe architecture and state of a variety of native tissues, as well as of tissue-engineered constructs, giving insights on the interaction between scaffolds and seeded cells in vitro prior implantation. Moreover, non-invasive 4-D multiphoton tomographs are employed in clinical studies to examine the diffusion behavior, the intra-tissue accumulation of topically applied cosmetic and pharmaceutical components, and their interaction with skin cells.

α2(VIII) Collagen Substrata Enhance Endothelial Cell Retention Under Acute Shear Stress Flow via an α2β1Integrin–Dependent Mechanism

BACKGROUND

Essential to tissue-engineered vascular grafts is the formation of a functional endothelial monolayer capable of resisting the forces of blood flow. This study targeted alpha2(VIII) collagen, a major component of the subendothelial matrix, and examined the ability of and mechanisms by which endothelial cells attach to this collagen under static and dynamic conditions both in vitro and in vivo.

METHODS AND RESULTS

Attachment of human endothelial cells to recombinant alpha2(VIII) collagen was assessed in vitro under static and shear conditions of up to 100 dyne/cm2. Alpha2(VIII) collagen supported endothelial cell attachment in a dose-dependent manner, with an 18-fold higher affinity for endothelial cells compared with fibronectin. Cell attachment was significantly inhibited by function-blocking anti-alpha2 (56%) and -beta1 (98%) integrin antibodies but was not RGD dependent. Under flow, endothelial cells were retained at significantly higher levels on alpha2(VIII) collagen (53% and 51%) than either fibronectin (23% and 16%) or glass substrata (7% and 1%) at shear rates of 30 and 60 dyne/cm2, respectively. In vivo studies, using endothelialized polyurethane grafts, demonstrated significantly higher cell retention rates to alpha2(VIII) collagen-coated than to fibronectin-coated prostheses in the midgraft area (P < 0.05) after 24 hours' implantation in the caprine carotid artery.

CONCLUSIONS

These studies demonstrate that alpha2(VIII) collagen has the potential to improve both initial cell attachment and retention of endothelial cells on vascular grafts in vivo, which opens new avenues of research into the development of single-stage endothelialized prostheses and the next generation of tissue-engineered vascular grafts.