Challenges and strategies for in situ endothelialization and long-term lumen patency of vascular grafts  

作　　者：Yu Zhuang Chenglong Zhang Mengjia Cheng Jinyang Huang Qingcheng Liu Guangyin Yuan Kaili Lin Hongbo Yu 

机构地区：[1]Department of Oral and Cranio-maxillofacial Surgery,Shanghai Ninth People’s Hospital,College of Stomatology,Shanghai Jiao Tong University School of Medicine,Shanghai,200011,China [2]National Clinical Research Center for Oral Diseases,Shanghai,200011,China [3]Shanghai Key Laboratory of Stomatology&Shanghai Research Institute of Stomatology,Shanghai,200011,China [4]National Engineering Research Center of Light Alloy Net Forming&State Key Laboratory of Metal Matrix Composite,Shanghai Jiao Tong University,800 Dongchuan Road,Shanghai,200240,China

出　　处：《Bioactive Materials》2021年第6期1791-1809,共19页生物活性材料（英文）

基　　金：This work was funded by the National Natural Science Foundation of China(82072396,81871490,81571022);Shanghai Collaborative Innovation Center for Translational Medicine(TM202010);Program of Shanghai Academic/Technology Research Leader(19XD1434500);Double Hundred Plan(20191819);the Research Fund of Medicine and Engineering of Shanghai Jiao Tong University(YG2017MS06).

摘　　要：Vascular diseases are the most prevalent cause of ischemic necrosis of tissue and organ,which even result in dysfunction and death.Vascular regeneration or artificial vascular graft,as the conventional treatment modality,has received keen attentions.However,small-diameter(diameter<4 mm)vascular grafts have a high risk of thrombosis and intimal hyperplasia(IH),which makes long-term lumen patency challengeable.Endothelial cells(ECs)form the inner endothelium layer,and are crucial for anti-coagulation and thrombogenesis.Thus,promoting in situ endothelialization in vascular graft remodeling takes top priority,which requires recruitment of endothelia progenitor cells(EPCs),migration,adhesion,proliferation and activation of EPCs and ECs.Chemotaxis aimed at ligands on EPC surface can be utilized for EPC homing,while nanofibrous structure,biocompatible surface and cell-capturing molecules on graft surface can be applied for cell adhesion.Moreover,cell orientation can be regulated by topography of scaffold,and cell bioactivity can be modulated by growth factors and therapeutic genes.Additionally,surface modification can also reduce thrombogenesis,and some drug release can inhibit IH.Considering the influence of macrophages on ECs and smooth muscle cells(SMCs),scaffolds loaded with drugs that can promote M2 polarization are alternative strategies.In conclusion,the advanced strategies for enhanced long-term lumen patency of vascular grafts are summarized in this review.Strategies for recruitment of EPCs,adhesion,proliferation and activation of EPCs and ECs,anti-thrombogenesis,anti-IH,and immunomodulation are discussed.Ideal vascular grafts with appropriate surface modification,loading and fabrication strategies are required in further studies.

关 键 词：Vascular graft In situ endothelialization THROMBOGENESIS Intimal hyperplasia IMMUNOMODULATION 

分 类 号：R622.4[医药卫生—整形外科]