Accelerating in Situ Endothelialisation of Cardiovascular Bypass Grafts
Abstract
:1. Introduction
2. Materials for Graft Construction
3. Potential Recruits for in Situ Endothelialisation
4. Endothelial Progenitor Cells: Mobilization
Factor | Application | Model | Outcome/Effects |
---|---|---|---|
EPO [38] | Myocardial infarction was induced in wild-type mice and EPCs with or without EPO were introduced into myocardium around the infarct. | Murine | Enhanced transplanted EPC survival and improved EPC mobilization. |
SDF-1 [39] | SDF-1α was fixed onto heparin, which was conjugated onto microfibrous vascular grafts. | Murine | Increased recruitment of EPCs. Also recruited SMPCs. |
G-CSF [40] | Heparin-immobilized, decellularized grafts were implanted and subcutaneous injections introduced to subjects. | Murine | EPCs increased and endothelialisation enhanced. Significantly smaller hyperplastic neointima area. |
HMG-CoA reductase inhibitors (e.g., Atorvastatin) [41] | Subjects orally administered atorvastatin. | Murine | Circulating EPCs increased, angiogenesis induced and functional recovery improved. |
Angiotensin II antagonists [33] | Subjects treated with irbesartan. | Hypertensive-hypercholestrolaemic hamster | EPC mobilization increased. |
NGF [42] | Human mononuclear cells isolated and cultured with NGF. CD133+ progenitor cells were incubated with NGF and injected into mice with carotid artery injury. NGF treated TEBV implanted into injured mice. | In vitro & murine | In vitro, human EPCs form more colonies, are stimulated to differentiate into ECs and show improved migration. In vivo, mice EPC show improved mobilization and homing and TEBV endothelialisation enhanced. |
BDNF [32] | In vitro, BDNF introduced to early and late outgrowth EPCs. BDNF-modified TEBV introduced to murine model. | In vitro & murine | In vitro, BDNF shows ability to enhance single clone formation and paracrine functions of EPCs. BDNF also helps late EPCs proliferate, migrate and differentiate. In vivo, TEBV shows greater endothelialisation than control. |
VEGF | Covalent immobilization of VEGF onto surfaces of PLLA and PCL. | In vitro | Functionalization process created. VEGF known to increase number of EPCs [25]. |
PPAR-γ agonist [43] | Endothelial progenitor cells from rat bone marrow were cultured with pioglitazone, a PPAR-γ agonist. | In vitro | Apoptosis of EPCs reduced. |
5. EPC and EC Adhesion and Proliferation
5.1. Biofunctionalization of Graft Surfaces to Enhance EPC and EC Adhesion and Proliferation
5.1.1. Techniques to Biofunctionalize Graft Surfaces
Surface Adsorption of Molecules
Chemical Immobilisation
5.1.2. Targets that Can Be Utilized to Biofunctionalize Graft Surfaces
Immobilization of Antibodies onto Graft Surfaces
Target | Application | Model | Outcome |
---|---|---|---|
CD133+ EPCs [60] | An ePTFE graft with an anti-CD133 antibody multilayer functionalized by heparin/collagen was developed. After being tested for surface modification stability, blood compatibility, haemolysis rate, cellular proliferation and adhesion, in vivo testing was carried out as a carotid artery transplant in a porcine model. | Porcine | Endothelialisation onset and rate improved. |
CD34+ EPCs [63] | ePTFE grafts coated with anti-CD34 antibodies were implanted in 11 pigs between the carotid artery and internal jugular vein. | Porcine | Endothelialisation rate in 72 h increased but IH increased 4 weeks later. |
KDR+ EPCs and Ecs [57] | Coating of glass coverslips with monoclonal mouse anti-human KDR IgG1 and then incubated with recombinant human KDR/Fc chimera before flow study. Orientation of antibody altered using adsorbed protein G. | In vitro | VEGFR-2+ HUVECs successfully captured from flow onto solid surface at sub-arterial shear rate. However, when orientation of antibody was altered, 2.5-fold greater capture efficiency observed. |
Immobilization of Proteins and Peptide Sequences onto Graft Surfaces
Type of Ligand | Protein/Peptide | Method | Model | Outcome/Results |
---|---|---|---|---|
Peptides | cRGD [76] | Transplantation of aortic cRGD-coated self-expanding nitinol stent into rabbit model. | Rabbit | The cRGD peptide was shown to have improved EC adhesion and proliferation. |
Nap-FFGRGD [72] | RGD containing molecule coated onto electrospun biodegradable PCL grafts and the grafts implanted into rabbit carotid arteries. | Rabbit | Increased endothelial coverage, decreased platelet accumulation, and increased smooth muscle remodelling. | |
CAG [77] | Electrospun vascular graft constructed containing PCL and CAG and implanted into Sprague-Dawley rats. | Murine | Endothelialisation improved, increased expression of endothelial nitric oxide synthase, lower α-smooth muscle actin. | |
REDV [78] | Zwitterionic carboxybetaine methacrylate and butyl methacrylate were copolymerized as coating materials, spin-coated onto substrates, and immobilized with REDV. | In vitro | Increased growth of ECs. Decreased accumulation of platelets, limited smooth muscle growth. | |
YIGSR [79] | Poly(ethylene glycol) and a diazeniumdiolate NO donor incorporated into polyurethane together with YIGSR peptide sequence. | In vitro | Increased EC growth, decreased platelet adhesion. | |
TPS [80] | Zwitterionic carboxybetaine methacrylate and TPS incorporated onto electrospun PCL mats. | In vitro | Improved hydrophilicity, specifically captures EPCs, decreased platelet adhesion and increased growth of vascular cells. | |
PDAM [81] | PDAM coated on 316L stainless steel stents and tested in vitro. | In vitro | Increased HUVEC adhesion, proliferation, and migration, release of NO, and secretion of prostaglandin I(2). PDAM-modified surface shows ability to decrease the adhesion and proliferation of human umbilical artery smooth muscle cells. | |
Collagen and MAP-RGD [82] | PCL scaffolds were first coated in collagen. The collagen-coated scaffolds were then immersed in MAP-RGD solution to immobilize the MAP-RGD. DNA quantification was used to evaluate EC proliferation. | In vitro | Highest expression level shown in the PCL/collagen/MAP-RGD group, indicative of improved endothelium sheet formation. | |
Proteins | Fibronectin [83] | Decellularized rat aortic conduits coated with Alexa488-labelled fibronectin and implanted into Wistar rats for 8 weeks. | Murine | Accelerated endothelialisation but IH occurs after 8 weeks. |
Laminin type-1 [51] | Laminin type-1 is covalently bound to ePTFE grafts and implanted into rats. | Murine | Increased endothelialisation and neovascularization. | |
Collagen type-1 with fibronectin [84] | Polystyrene surfaces coated with single and double layers of collagen, fibronectin and collagen + fibronectin. | In vitro | Double coating of collagen + fibronectin shows better EC growth. | |
ELP4 [85] | ELP4 cross-linked onto polyurethane surface, subjected to reconstituted human blood. | In vitro | Enhanced EC adhesion, EC showed organized actin cytoskeleton and enhanced endothelial nitric oxide synthase expression. Decreased platelet adhesion and activation. |
Immobilization of Nucleic Acid Sequences onto Graft Surfaces
Oligosaccharides and Phospholipids
5.2. Magnetic Homing of EPCs and ECs to Site of Endothelialisation
5.3. Micropatterning, Nanopatterning, and the Surface Physical Characteristics of Grafts
5.3.1. Electrospun Fibre Diameter and Alignment
5.3.2. Surface Roughness
5.3.3. Porosity of Graft Surfaces
5.3.4. Peptide Patterning
5.4. Shear Stress Preconditioning
6. Regulating Differentiation: From Progenitor Cells to Mature Endothelium
6.1. Materials and Topography of Grafts
6.2. Utilization of Signalling Biomolecules
6.3. Shear Stress Acting on Graft Surfaces
7. Preventing Thrombogenesis, IH Formation and Inflammation during Endothelialisation
8. Conclusions and Future Directions
Conflicts of Interest
References
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Goh, E.T.; Wong, E.; Farhatnia, Y.; Tan, A.; Seifalian, A.M. Accelerating in Situ Endothelialisation of Cardiovascular Bypass Grafts. Int. J. Mol. Sci. 2015, 16, 597-627. https://doi.org/10.3390/ijms16010597
Goh ET, Wong E, Farhatnia Y, Tan A, Seifalian AM. Accelerating in Situ Endothelialisation of Cardiovascular Bypass Grafts. International Journal of Molecular Sciences. 2015; 16(1):597-627. https://doi.org/10.3390/ijms16010597
Chicago/Turabian StyleGoh, Ee Teng, Eleanor Wong, Yasmin Farhatnia, Aaron Tan, and Alexander M. Seifalian. 2015. "Accelerating in Situ Endothelialisation of Cardiovascular Bypass Grafts" International Journal of Molecular Sciences 16, no. 1: 597-627. https://doi.org/10.3390/ijms16010597