| REN Xingrong,YU Tao,WANG Yunbing.Application and Prospects of Coating Modification Strategies in Blood Contact Material Research[J],53(23):46-60 |
| Application and Prospects of Coating Modification Strategies in Blood Contact Material Research |
| Received:September 30, 2024 Revised:December 05, 2024 |
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| DOI：10.16490/j.cnki.issn.1001-3660.2024.23.004 |
| KeyWord:blood contact materials surface-modified coatings coagulation inflammation bionic endothelialization hemocompatibility |
| Author | Institution |
| REN Xingrong |
Tianfu Jincheng Laboratory Frontiers Medical Center, Chengdu , China |
| YU Tao |
Tianfu Jincheng Laboratory Frontiers Medical Center, Chengdu , China |
| WANG Yunbing |
Tianfu Jincheng Laboratory Frontiers Medical Center, Chengdu , China;College of Biomedical Engineering, Sichuan University, Chengdu , China |
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| Abstract: |
| Cardiovascular diseases (CVDs) are the leading cause of death globally, making the development of effective treatments a critical focus for researchers and clinicians. Blood contact materials are indispensable in managing these diseases, particularly in devices like vascular stents, heart valves, and artificial blood vessels. However, their clinical application is often hindered by significant challenges, including thrombosis, inflammatory reactions, and eventual device failure. These issues primarily stem from the complex interactions between blood components and material surfaces, which triggers adverse biological responses. To address these challenges, researchers have devoted considerable effort to surface modification strategies aimed at enhancing the hemocompatibility of blood contact materials. The mechanisms of coagulation and inflammation that underlie these complications are reviewed, followed by a comprehensive discussion of the strategies designed to overcome the complications. Surface modification techniques are categorized into bioinert coatings, bioactive coatings, and biomimetic endothelialization. Bioinert coatings are designed to reduce protein adsorption, platelet adhesion, and immune system activation by altering surface properties such as wettability, charge, and roughness. Ceramic coatings like silicon carbide (SiC), diamond-like carbon (DLC), and titanium nitride (TiN) are commonly used for this purpose. These materials have shown significant promise in minimizing platelet adhesion and inflammatory responses. For example, DLC coatings, characterized by their smooth and hydrophobic properties, are widely employed in cardiovascular devices due to their ability to enhance hemocompatibility. Such coatings are particularly effective in reducing the risk of thrombosis and prolonging the functional lifespan of medical implants. Bioactive coatings take a more interactive approach, leveraging biological agents to actively modulate the responses of the body. These coatings incorporate anticoagulants like heparin and warfarin or anti-inflammatory drugs such as dexamethasone to directly mitigate thrombosis and inflammation. Heparin coatings, for instance, inhibit thrombin activation and fibrin formation, significantly improving the compatibility between devices and blood. Furthermore, bioactive coatings can promote endothelialization—the growth of endothelial cells on the device surface—by integrating growth factors like vascular endothelial growth factor (VEGF) or peptides such as RGD. These additions stimulate endothelial cell proliferation and migration, thereby accelerating the healing process and enhancing vascular integration. A particularly innovative direction in surface modification is biomimetic endothelialization. This approach seeks to replicate the natural functions of healthy endothelial cells, including nitric oxide (NO) release and antithrombotic signaling. Biomimetic coatings often use bioactive molecules and layered structures to provide controlled release of agents like NO and heparin, achieving synergistic effects. Such strategies not only prevent thrombosis but also foster a favorable environment for endothelial cell growth and function, addressing both immediate and long-term complications associated with blood contact devices. Despite these advancements, challenges remain in ensuring the long-term stability, durability, and multifunctionality of surface coatings, especially in the dynamic environment of blood flow. Future research must focus on understanding the intricate interactions between materials and biological systems to further optimize these strategies. Biomimetic endothelialization, with its potential to mimic natural biological processes, represents a particularly promising avenue for advancing the performance and integration of blood contact materials in clinical applications. As the field progresses, these surface modification strategies will likely play an increasingly pivotal role in improving patient outcomes and extending the functional lifespan of cardiovascular devices. |
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