Chondroitin-4-Sulfate: A Bioactive Macromolecule to Foster Vascular Healing around Stent-Grafts after Endovascular Aneurysm Repair

Promotion of Endothelial Cell Adhesion and Antithrombogenicity of Polytetrafluoroethylene by Chemical Grafting of Chondroitin Sulfate

Polytetrafluoroethylene (PTFE) is one of the polymers extensively applied in biomedicine. However, the application of PTFE as a small-diameter vascular graft results in thrombosis and intimal hyperplasia because of the immune response. Therefore, improving the biocompatibility and anticoagulant properties of PTFE is a key to solving this problem. In this study, a hydroxyl group-rich surface was obtained by oxidizing a benzoin-reduced PTFE membrane. Then, chondroitin sulfate (CS), an anticoagulant, was grafted on the surface of the hydroxylated PTFE membrane using 3-aminopropyltriethoxysilane. The successful modification of the membrane in each step was demonstrated by Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy. Hydroxylation and the grafting of CS greatly increased the hydrophilicity and roughness of membrane samples. Moreover, the hydroxylated PTFE membrane enhanced the adhesion ability of endothelial cells, and the grafting of CS also promoted the proliferation of endothelial cells and decreased platelet adhesion. The results indicate that the PTFE membranes grafted with CS are able to facilitate rapid endothelialization and inhibit thrombus formation, which makes the proposed method outstanding for artificial blood vessel applications.

Combining Electrospun Fiber Mats and Bioactive Coatings for Vascular Graft Prostheses

The patency of small-diameter (<6 mm) synthetic vascular grafts (VGs) is still limited by the absence of a confluent, blood flow-resistant monolayer of endothelial cells (ECs) on the lumen and of vascular smooth muscle cell (VSMC) growth into the media layer. In this research, electrospinning has been combined with bioactive coatings based on chondroitin sulfate (CS) to create scaffolds that possess optimal morphological and bioactive properties for subsequent cell seeding. We fabricated random and aligned electrospun poly(ethylene terephthalate), ePET, mats with small pores (3.2 ± 0.5 or 3.9 ± 0.3 μm) and then investigated the effects of topography and bioactive coatings on EC adhesion, growth, and resistance to shear stress. Bioactive coatings were found to dominate the cell behavior, which enabled creation of a near-confluent EC monolayer that resisted physiological shear-flow conditions. CS is particularly interesting since it prevents platelet adhesion, a key issue to avoid blood clot formation in case of an incomplete EC monolayer or partial cell detachment. Regarding the media layer, circumferentially oriented nanofibers with larger pores (6.3 ± 0.5 μm) allowed growth, survival, and inward penetration of VSMCs, especially when the CS was further coated with tethered, oriented epithelial growth factor (EGF). In summary, the techniques developed here can lead to adequate scaffolds for the luminal and media layers of small-diameter synthetic VGs.

Gottron's papules exhibit dermal accumulation of CD44 variant 7 (CD44v7) and its binding partner osteopontin: a unique molecular signature

The accumulated mucin in non-Gottron’s dermatomyositis (DM) lesions is primarily chondroitin-4-sulfate (C4S), which is immunomodulatory in vitro. Gottron’s papules are a particularly resistant manifestation of DM that often persist after other lesions have resolved with therapy. We examined non-Gottron’s DM lesions and Gottron’s papule skin biopsies for C4S, CD44v7, a CS-binding isoform causally implicated in autoimmunity, and osteopontin, a CD44v7 ligand implicated in chronic inflammation. Gottron’s papule dermis contained more C4S and CD44v7 than non-Gottron’s lesions. Normal skin showed less CD44v7 over joints relative to Gottron’s lesions. All DM dermis had increased osteopontin compared to healthy skin. Mechanically stretching cultured fibroblasts for six hours induced CD44v7 mRNA and protein, while IFN-γ treatment induced OPN mRNA and protein. Osteopontin alone did not induce CD44v7, but stretching dermal fibroblasts in the presence of osteopontin increased THP-1 monocyte binding, which is blunted by anti-CD44v7 blocking antibody. C4S, CD44v7, and osteopontin are three molecules uniquely present in Gottron’s papules that contribute to inflammation individually and in association with one another. We propose that stretch-induced CD44v7 over joints, in concert with dysregulated osteopontin levels in the skin of DM patients, increases local inflammatory cell recruitment and contributes to the pathogenesis and resistance of Gottron’s papules.

Chondroitin sulfate and epidermal growth factor immobilization after plasma polymerization: a versatile anti-apoptotic coating to promote healing around stent grafts

Bioactive coatings constitute an interesting approach to enhance healing around implants, such as stent-grafts used in endovascular aneurysm repair. Three different plasma techniques, namely NH₃ plasma functionalization and atmospheric- or low-pressure plasma polymerization, are compared to create amino groups and covalently bind CS and EGF bioactive molecules on PET. The latter presents the greatest potential. CS + EGF coating is shown to strongly decrease cell apoptosis and cell depletion in serum-free medium, while increasing cell growth compared to unmodified PET. This versatile biomimetic coating holds promise in promoting vascular repair around stent-grafts, where resistance to apoptosis is a key issue.