Polyvinyl alcohol-silk fibroin composite stents: A comprehensive investigation into biocompatibility and mechanical performance
Bioresorbable stents (BRS) are manufactured using biodegradable materials. As an alternative to those commonly used in commercial stents, this study explored the development of BRS using polyvinyl alcohol (PVA) and silk fibroin (SF). PVA is a promising material for the fabrication of BRS due to its biocompatibility and mechanical attributes, closely resembling those of aortic vessels. However, its application presents challenges in terms of cell adhesion and proliferation. SF has been extensively studied for its potential to enhance cell adhesion and proliferation, making it a promising biomaterial in the field of medical devices. SF was introduced by dissolving it in a PVA solution or by coating the hydrogel surface with a layer of SF. Initial tests revealed that overnight incubation of fetal bovine serum significantly increased cell viability in hydrogels. Viability assays confirmed that SF substantially improved cell viability compared to PVA alone. The method was extended to fabricate SF-coated stents, which demonstrated robust cell proliferation and improved performance compared to electrospun polycaprolactone scaffolds. In addition, the SF-coated stents displayed an increase in compressive strength, demonstrating improved biocompatibility and mechanical performance. Dynamic mechanical analysis evaluated the positive impact of SF on stent properties at physiological temperatures. The study revealed that PVA-SF stents offer a compromise between biocompatibility, mechanical strength, and elastic recovery, positioning them as a valuable alternative for cardiovascular stent applications. The dual benefits of enhanced biocompatibility and improved mechanical performance make SF-coated stents promising candidates for bioresorbable stent design.
- Zong J, He Q, Liu Y, Qiu M, Wu J, Hu B. Advances in the development of biodegradable coronary stents: a translational perspective. Mater Today Bio. 2022;16:100368. doi: 10.1016/J.MTBIO.2022.100368
- Guerra AJ, Ciurana J. Three-dimensional tubular printing of bioabsorbable stents: the effects process parameters have on in vitro degradation. 3D Print Additive Manuf. 2019;6(1):50-56. doi: 10.1089/3DP.2018.0020
- Paunović N, Bao Y, Coulter FB, et al. Digital light 3D printing of customized bioresorbable airway stents with elastomeric properties. Sci Adv. 2021;7(6):eabe9499. doi: 10.1126/SCIADV.ABE9499
- Finazzi V, Berti F, Guillory RJ, Petrini L, Previtali B, Demir AG. Patient-specific cardiovascular superelastic NiTi stents produced by laser powder bed fusion. Procedia CIRP. 2022;110(C):242-246. doi: 10.1016/J.PROCIR.2022.06.044
- Hua W, Shi W, Mitchell K, et al. 3D printing of biodegradable polymer vascular stents: a review. Chin J Mech Eng Addit Manuf Front. 2022;1(2):100020. doi: 10.1016/J.CJMEAM.2022.100020
- Chausse V, Schieber R, Raymond Y, et al. Solvent-cast direct-writing as a fabrication strategy for radiopaque stents. Addit Manuf. 2021;48:102392. doi: 10.1016/J.ADDMA.2021.102392
- Chausse V, Casanova-Batlle E, Canal C, Ginebra MP, Ciurana J, Pegueroles M. Solvent-cast direct-writing and electrospinning as a dual fabrication strategy for drug-eluting polymeric bioresorbable stents. Addit Manuf. 2023;71:103568. doi: 10.1016/J.ADDMA.2023.103568
- Casanova-Batlle E, Guerra AJ, Ciurana J. Continuous based direct ink write for tubular cardiovascular medical devices. Polymers (Basel). 2020;13(1):1-16. doi: 10.3390/POLYM13010077
- Lin MC, Lou CW, Lin JY, Lin TA, Chen YS, Lin JH. Biodegradable polyvinyl alcohol vascular stents: structural model and mechanical and biological property evaluation. Mater Sci Eng C Mater Biol Appl. 2018;91:404-413. doi: 10.1016/J.MSEC.2018.05.030
- Rizwan M, Yao Y, Gorbet MB, et al. One-pot covalent grafting of gelatin on poly(vinyl alcohol) hydrogel to enhance endothelialization and hemocompatibility for synthetic vascular graft applications. ACS Appl Bio Mater. 2020;3(1):693-703. doi: 10.1021/ACSABM.9B01026/ASSET/IMAGES/LARGE/ MT9B01026_0007.JPEG
- Marei I, Ahmetaj-Shala B, Triggle CR. Biofunctionalization of cardiovascular stents to induce endothelialization: implications for in-stent thrombosis in diabetes. Front Pharmacol. 2022;13:982185. doi: 10.3389/FPHAR.2022.982185
- Habib A, Finn AV. Endothelialization of drug eluting stents and its impact on dual anti-platelet therapy duration. Pharmacol Res. 2015;93:22-27. doi: 10.1016/J.PHRS.2014.12.003
- Koyano T, Minoura N, Nagura M, Kobayashi KI. Attachment and growth of cultured fibroblast cells on PVA/chitosan-blended hydrogels. J Biomed Mater Res. 1998;39:486-490. doi: 10.1002/(SICI)1097-4636(19980305)39:3
- Ino JM, Chevallier P, Letourneur D, Mantovani D, Visage C Le. Plasma functionalization of poly(vinyl alcohol) hydrogel for cell adhesion enhancement. Biomatter. 2013;3(4):e25414. doi: 10.4161/BIOM.25414
- Hou R, Wang Y, Han J, et al. Structure and properties of PVA/ silk fibroin hydrogels and their effects on growth behavior of various cell types. Mater Res Express. 2020;7(1):015413. doi: 10.1088/2053-1591/AB69C4
- Reizabal A, Costa CM, Pérez-Álvarez L, Vilas-Vilela JL, Lanceros-Méndez S. Silk fibroin as sustainable advanced material: material properties and characteristics, processing, and applications. Adv Funct Mater. 2023;33(3): 2210764. doi: 10.1002/ADFM.202210764
- Vettori L, Sharma P, Rnjak-Kovacina J, Gentile C. 3D bioprinting of cardiovascular tissues for in vivo and in vitro applications using hybrid hydrogels containing silk fibroin: state of the art and challenges. Curr Tissue Microenviron Rep. 2020;1(4):261-276. doi: 10.1007/S43152-020-00026-5
- Thurber AE, Omenetto FG, Kaplan DL. In vivo bioresponses to silk proteins. Biomaterials. 2015;71:145-157. doi: 10.1016/J.BIOMATERIALS.2015.08.039
- Casanova-Batlle E, Montero-Coedo S, Bosch A, Guerra AJ, Ciurana J. Feasibility assessment of polyvinyl alcohol-based bioresorbable cardiovascular stents manufactured via solvent-cast direct writing extrusion. Polym Test. 2024;134:108440. doi: 10.1016/J.POLYMERTESTING.2024.108440
- Sun W, Gregory DA, Tomeh MA, Zhao X. Silk fibroin as a functional biomaterial for tissue engineering. Int J Mol Sci. 2021;22(3):1-28. doi: 10.3390/IJMS22031499
- Rajesha Shetty G, Lakshmeesha Rao B. Preparation and characterization of silk fibroin-polyvinyl alcohol (PVA) blend films for food packaging materials. Mater Today Proc. 2022;55:194-200. doi: 10.1016/J.MATPR.2022.02.034
- Rockwood DN, Preda RC, Yücel T, Wang X, Lovett ML, Kaplan DL. Materials fabrication from Bombyx mori silk fibroin. Nat Protoc. 2011;6(10):1612-1631. doi: 10.1038/nprot.2011.379
- Marelli B, Brenckle MA, Kaplan DL, Omenetto FG. Silk fibroin as edible coating for perishable food preservation. Sci Rep. 2016;6:25263. doi: 10.1038/SREP25263
- Casanova-Batlle E, Guerra AJ, Ciurana J. Characterization of direct ink write pure silk fibroin based on alcohol post-treatments. Polym Test. 2022;116:107784. doi: 10.1016/J.POLYMERTESTING.2022.107784
- Polonio-alcalá E, Rabionet M, Ruiz-martínez S, et al. Polycaprolactone electrospun scaffolds produce an enrichment of lung cancer stem cells in sensitive and resistant egfrm lung adenocarcinoma. Cancers (Basel). 2021;13(21):5320. doi: 10.3390/CANCERS13215320
- ISO 25539-2:2020 - Cardiovascular Implants — Endovascular Devices — Part 2: Vascular Stents. Accessed June 21, 2023. https://www.iso.org/standard/69835.html
- Schmedlen RH, Masters KS, West JL. Photocrosslinkable polyvinyl alcohol hydrogels that can be modified with cell adhesion peptides for use in tissue engineering. Biomaterials. 2002;23(22):4325-4332. doi: 10.1016/S0142-9612(02)00177-1
- Wilson CJ, Clegg RE, Leavesley DI, Pearcy MJ. Mediation of biomaterial-cell interactions by adsorbed proteins: a review. Tissue Eng. 2005;11(1-2):1-18. doi: 10.1089/TEN.2005.11.1
- Paul B, Lode A, Placht AM, et al. Cell-material interactions in direct contact culture of endothelial cells on biodegradable iron-based stents fabricated by laser powder bed fusion and impact of ion release. ACS Appl Mater Interfaces. 2022;14(1):439-451. doi: 10.1021/ACSAMI.1C21901
- Verdanova M, Sauerova P, Hempel U, Kalbacova MH. Initial cell adhesion of three cell types in the presence and absence of serum proteins. Histochem Cell Biol. 2017;148(3):273-288. doi: 10.1007/S00418-017-1571-7
- Jacobsen MM, Li D, Gyune Rim N, Backman D, Smith ML, Wong JY. Silk-fibronectin protein alloy fibres support cell adhesion and viability as a high strength, matrix fibre analogue. Sci Rep. 2017;7(1):1-11. doi: 10.1038/srep45653
- Smetana K. Cell biology of hydrogels. Biomaterials. 1993;14(14):1046-1050. doi: 10.1016/0142-9612(93)90203-E
- Lyu Y, Liu Y, He H, Wang H. Application of silk-fibroin-based hydrogels in tissue engineering. Gels. 2023;9(5):431. doi: 10.3390/GELS9050431
- Li X, Qin J, Ma J. Silk fibroin/poly (vinyl alcohol) blend scaffolds for controlled delivery of curcumin. Regen Biomater. 2015;2(2):97-105. doi: 10.1093/RB/RBV008
- Jin D, Takai S, Li Z, et al. Outside fibroblasts play a key role in the development of inner neointima after the implantation of polytetrafluoroethylene grafts. J Pharmacol Sci. 2012;119(2):139-149. doi: 10.1254/JPHS.11242FP
- Wang GX, Deng XY, Tang CJ, et al. The adhesive properties of endothelial cells on endovascular stent coated by substrates of poly-l-lysine and fibronectin. Artif Cells Blood Substit Immobil Biotechnol. 2006;34(1):11-25. doi: 10.1080/10731190500428283
- Shirota T, Yasui H, Shimokawa H, Matsuda T. Fabrication of endothelial progenitor cell (EPC)-seeded intravascular stent devices and in vitro endothelialization on hybrid vascular tissue. Biomaterials. 2003;24(13):2295-2302. doi: 10.1016/S0142-9612(03)00042-5
- Weber J, Weber M, Feile A, Schlensak C, Avci-Adali M. Development of an in vitro blood vessel model using autologous endothelial cells generated from footprint-free hipscs to analyze interactions of the endothelium with blood cell components and vascular implants. Cells. 2023;12(9):1217. doi: 10.3390/CELLS12091217
- Guerra AJ, Cano P, Rabionet M, Puig T, Ciurana J. 3D-printed PCL/PLA composite stents: towards a new solution to cardiovascular problems. Materials (Basel). 2018;11(9):1679. doi: 10.3390/MA11091679
- Chausse V, Mas-Moruno C, Martin-Gómez H, et al. Functionalization of 3D printed polymeric bioresorbable stents with a dual cell-adhesive peptidic platform combining RGDS and YIGSR sequences. Biomater Sci. 2023;11(13):4602-4615. doi: 10.1039/D3BM00458A
- Kang CK, Lim WH, Kyeong S, et al. Fabrication of biofunctional stents with endothelial progenitor cell specificity for vascular re-endothelialization. Colloids Surf B Biointerfaces. 2013;102:744-751. doi: 10.1016/J.COLSURFB.2012.09.008
- Tenekecioglu E, Torii R, Bourantas C, et al. The effect of strut thickness on shear stress distribution in a preclinical model. Int J Cardiovasc Imaging. 2017;33(11):1675-1676. doi: 10.1007/S10554-017-1173-4
- Ding C, Ma J, Teng Y, Chen S. The effect of plasma treatment on the mechanical and biological properties of polyurethane artificial blood vessel. Materials (Basel). 2023;16(22):7231. doi: 10.3390/MA16227231
- Yang CC, Lee YJ. Preparation of the acidic PVA/MMT nanocomposite polymer membrane for the direct methanol fuel cell (DMFC). Thin Solid Films. 2009;517(17): 4735-4740. doi: 10.1016/J.TSF.2009.03.138
- Yuan Q, Yao J, Chen X, Huang L, Shao Z. The preparation of high performance silk fiber/fibroin composite. Polymer (Guildf). 2010;51(21):4843-4849. doi: 10.1016/J.POLYMER.2010.08.042
- Niu C, Li X, Wang Y, Liu X, Shi J, Wang X. Design and performance of a poly(vinyl alcohol)/silk fibroin enzymatically crosslinked semi-interpenetrating hydrogel for a potential hydrophobic drug delivery. RSC Adv. 2019;9(70):41074-41082. doi: 10.1039/C9RA09344C
- Wang X, Yucel T, Lu Q, Hu X, Kaplan DL. Silk nanospheres and microspheres from silk/pva blend films for drug delivery. Biomaterials. 2010;31(6):1025-1035. doi: 10.1016/J.BIOMATERIALS.2009.11.002
- Bosch A, Casanova-Batlle E, Rodríguez-Rego JM, Ciurana J, Guerra AJ. Silk fibroin dip coating as drug delivery material for medical devices. Key Eng Mater. 2023;957:113-121. doi: 10.4028/P-P004JO
- Chausse V, Iglesias C, Bou-Petit E, Ginebra MP, Pegueroles M. Chemical vs thermal accelerated hydrolytic degradation of 3D-printed PLLA/PLCL bioresorbable stents: Characterization and influence of sterilization. Polym Test. 2023;117:107817. doi: 10.1016/J.POLYMERTESTING.2022.107817
- Wu Z, Zhao J, Wu W, et al. Radial compressive property and the proof-of-concept study for realizing self-expansion of 3D printing polylactic acid vascular stents with negative Poisson’s ratio structure. Materials (Basel). 2018; 11(8):1357. doi: 10.3390/MA11081357
- Chelazzi D, Badillo-Sanchez D, Giorgi R, Cincinelli A, Baglioni P. Self-regenerated silk fibroin with controlled crystallinity for the reinforcement of silk. J Colloid Interface Sci. 2020;576:230-240. doi: 10.1016/J.JCIS.2020.04.114