Extracellular Matrix Coatings on Cardiovascular Materials—A Review

Abstract

Vascular transplantation is an effective and common treatment for cardiovascular disease (CVD). However, the low biocompatibility of implants is a major problem that hinders its clinical application. Surface modification of implants with extracellular matrix (ECM) coatings is an effective approach to improve the biocompatibility of cardiovascular materials. The complete ECM seems to have better biocompatibility, which may give cardiovascular biomaterials a more functional surface. The use of one or several ECM proteins to construct a surface allows customization of coating composition and structure, possibly resulting in some unique functions. ECM is a complex three-dimensional structure composed of a variety of functional biological macromolecules, and changes in the composition will directly affect the function of the coating. Therefore, understanding the chemical composition of the ECM and its interaction with cells is beneficial to provide new approaches for coating surface modification. This article reviews novel ECM coatings, including coatings composed of intact ECM and biomimetic coatings tailored from several ECM proteins, and introduces new advances in coating fabrication. These ECM coatings are effective in improving the biocompatibility of vascular grafts.

Surface Engineering of Bioactive Coatings for Improved Stent Hemocompatibility: A Comprehensive Review

“…Inadequate re-endothelialization can lead to complications such as restenosis, thrombosis, inflammation, and impaired vasomotor function, emphasizing the importance of supporting this regenerative process in medical interventions and treatments to avoid adverse vascular outcomes. One approach is the use of biomimetic coatings composed of an endothelial extracellular matrix (EC-ECM) and specific micropatterns [74]. These coatings have shown good blood compatibility, anti-inflammatory properties, and the ability to promote endothelialization while inhibiting smooth muscle cell proliferation and macrophage attachment.…”

“…Researchers have successfully created biomimetic coatings by culturing endothelial cells (ECs) on micropatterned surfaces and then decellularizing the resulting ECM. By incorporating hyaluronic acid (HA) micropatterns, cell morphology is prolonged, leading to increased release of anticoagulant factors and limiting the contractile phenotype of smooth muscle cells (SMCs) [74]. This approach improves the biocompatibility of the EC-ECM coating, as demonstrated by its anticoagulation, endothelialization, and anti-inflammatory properties.…”

“…To facilitate the application of ECM coatings on biodegradable or uneven materials, researchers have developed methods of dispersing the ECM into a solution and selfassembling it onto the material surface [74]. Heparin, a natural polysaccharide with antithrombotic properties, can be immobilized on the ECM coating to selectively promote EC proliferation while inhibiting SMC growth, further enhancing blood compatibility [40].…”

“…The molecular weight (MW) of hyaluronic acid has an important role in the biocompatibility of the coatings. High MW HA inhibits the adhesion of platelets, SMC, and macrophages, providing anticoagulant, anti-proliferative, anti-inflammatory, and non-immunogenic properties [74]. Extremely high MW HA may hinder endothelialization.…”

Advances in Measurement and Data Analysis of Surfaces with Functionalized Coatings

“…All of the medical studies seem to be different from those with the tribological point of view that many various requirements must be met, such as antibacterial [49] properties. Another issue, the biocompatibility of implants [50,51], can be mentioned as a major problem that can hinder the clinical application of surfaces. Some actions, such as, e.g., chemical bonding [52], can improve the bioactivity of selected types of surfaces.…”