Atherogenesis 162
What is the ideal vascular graft?Several issues demand consideration when constructing a vascular graft: the mechanical properties of the graft must resemble those of a native blood vessel, and the graft must be biocompatible with its host. One important factor is compliance, i.e., how well the vessel withstands pressure from the bloodstream and whether it can maintain systemic pressure in the vascular system. Vascular grafts should also be "invisible" to the immune system and possess non-thrombogenic properties. One interesting option is bacterial cellulose (BC), whose unique properties (strength, good integration into host tissue and flexibility that allows production in various shapes and sizes) make it an exciting candidate for vascular graft material. The most abundant biopolymer on earth, cellulose is insoluble in water and degradable by microbial enzymes. Several organisms such as plants, algae and bacteria can produce BC. Some members of the bacterial genus Acetobacter, especially Gluconacetobacter xylinum, synthesize and secrete cellulose extracellularly. The network structure of cellulose fibrils resembles that of collagen in the extracellular matrix (ECM). This chapter describes how BC interacts with human endothelial cells (EC) and blood. Specifically, we will evaluate whether surface modifications could promote adhesion of EC and also whether BC's thrombogenic properties compare favorably with conventional graft materials. These properties are critical because materials intended as vascular grafts must satisfy many important features, including blood compatibility, cell interactions and mechanical properties.