Graduation date: 2008
As a major natural component of the extracellular matrix (ECM),
hyaluronic acid (HA) is an excellent choice for biomimetic, biocompatible
therapeutic materials. Furthermore, thiol-modified forms of HA are capable of
forming macroporous hydrogels that allow for both controlled cytokine release and
extensive vessel in-growth. It has previously been shown that this HA controlled
cytokine release may be extended significantly by including thiol-modified heparin
(Hp) in the hydrogel matrix. We therefore hypothesized that that the inclusion of
minute quantities of Hp in both HA and HA+Gelatin cytokine-loaded hydrogels
would, in turn, result in extended levels of elicited microvascular stability and
maturity in vivo. To test this hypothesis we formulated several single and dual
cytokine-loaded hydrogels and implanted them into the Balb/c mouse ear pinna.
These preloaded hydrogels contained vascular endothelial growth factor (VEGF),
angiopoietin-1 (Ang-1), keratinocyte growth factor (KGF) or platelet derived growth
factor (PDGF) either individually or in combination with VEGF. At 7 and 14 days
post surgery, elicited vascular maturity levels were quantified using
immunohistochemical (IHC) staining techniques. The degree of circumferential
pericyte ensheathement as indicated by alpha smooth muscle actin (α-SMA) IHC
signal, together with basement membrane morphology, allowed for a graded
determination of elicited microvasculature maturity. The progress of maturation was
separated from the natural wound response (sham surgery) and then normalized to the
steady state (contralateral ear), and reported as a vascular maturity index (VMI). It
was discovered that in both gel types at both time points, the dual cytokine
combination elicited greater maturity levels than either cytokine administered
individually. For example, VEGF and KGF-containing implants at day 7 yielded
VMI values of -0.1375 and -0.092, respectively, whereas their combination resulted
in a VMI of 0.176 (p < 0.007). At day 7, only one of the seven HA:Hp experimental
cases yielded a positive VMI (VEGF+KGF), whereas four of the seven HA:Hp cases
yielded positive VMI values at day 14. This shift from predominantly negative to
predominantly positive VMI values suggested not only a sustained microvascular
maturity response, but also a gradual improvement in microvessel maturity relative to
the sham tissue. Although sustained, and in some cases elevated from 7 to 14 days
post film implantation, the microvascular maturity response elicited by HA:Hp films
was not invariably higher than that elicited by the HA controls. The levels of elicited
microvascular maturity in tissue treated with dual cytokine loaded HA:Hp films were
instead found to depend on the identity of the late stage cytokine, suggesting specific
heparin-cytokine interactions were responsible for the observed differences.