Bioactive coating with low-fouling polymers for the development of biocompatible vascular implants

The replacement of occluded blood vessels and endovascular aneurysm repair (EVAR) are performed with the use of synthetic vascular grafts and stent grafts, respectively. Both implants lead to frequent clinical complications that are different but due to a similar problem, namely the inadequate surface properties of the polymeric biomaterials used (generally polyethylene terephthalate (PET) or expanded polytetrafluoroethylene (ePTFE)). Therefore the general objective of this thesis was to create a versatile bioactive coating on vascular biomaterials that reduce material-induced thrombosis and promote desired cell interactions favorable to tissue healing around implants. The use of low-fouling backgrounds was decided in order to reduce platelet adhesion as well as the non-specific protein adsorption and thus increase the bioactivity of immobilized biomolecules.;As part of the preliminary objective, a multi-arm polyethylene glycol (PEG) was chosen to create a versatile low-fouling surface, since the current coating methods are far from being versatile and rely on the availability of compatible functional groups on both PEG and the host surface. This PEG coating method was developed by taking advantage of novel primary amine-rich plasma polymerized coatings (LP). As demonstrated by quartz crystal microbalance with dissipation (QCM-D), fluorescence measurements and platelet adhesion assays, our PEG coatings exhibited low protein adsorption and almost no platelet adhesion after 15 min perfusion in whole blood. Although protein adsorption was not completely abrogated and short-term platelet adhesion assay was clearly insufficient to draw conclusions for long-term prevention of thrombosis in vivo, the low-fouling properties of this PEG coating were sufficient to be exploited for further coupling of bioactive molecules to create bioactive coatings. Therefore, as a part of the second objective, an innovative and versatile bioactive coating was developed on PEG and carboxymethylated dextran (CMD), using the combination of an adhesive peptide (KQAGDV/RGD) and epidermal growth factor (EGF). CMD was chosen as an alternative to PEG due to its better low-fouling properties and the presence of abundant carboxyl terminal groups. Although the QCM-D technique enabled us to optimize the combined immobilization of KQAGDV/RGD and EGF, cell adhesion assay results did not show improvement of vascular smooth muscle cell (VSMC) adhesion on peptide-modified PEG or CMD surfaces.;Among the reasons explaining low cell adhesion on peptides grafted low-fouling surfaces is the difficulty of preventing protein adsorption/platelet adhesion without significantly reducing cell adhesion. Preliminary data in our laboratory indicated that CS could be an ideal substrate to find this compromise. For that reason, the final objective of this PhD consisted in evaluating the potential of chondroitin sulfate (CS) coating by comparing its properties with well-known low-fouling polymers such as PEG and CMD. It was shown that CS presents selective low-fouling properties, low-platelet adhesion and pro-endothelial cell (EC) adhesive properties As demonstrated by QCM-D and fluorescence measurements, CS was as effective as PEG in reducing fibrinogen adsorption, but it reduced adsorption of bovine serum albumin (BSA) and fetal bovine serum (FBS) to a lower extent than PEG and CMD surfaces. Whole blood perfusion assays indicated that all three surfaces drastically decreased platelet adhesion and activation to levels significantly lower than PET surfaces. However, while EC adhesion and growth were found to be very limited on PEG and CMD, cell attachment on CS was strong, with focal adhesion points and resistance to shear stress. CS coatings therefore form a low-thrombogenic background promoting the formation of a confluent endothelium layer, which may then act as an active anti-thrombogenic surface. CS coating can also be used to further graft biomolecules. Combination of LP, CS coating followed by GF immobilization shows great promise as a bioactive coating to optimize the biocompatibility and clinical outcome of vascular implants, in particular vascular grafts.