Multifunctional hyaluronic acid-based coating to direct vascular cell fate for enhanced vascular tissue healing

Ensuring excellent anticoagulant, anti-inflammatory, and endothelialization properties in vascular stents through coating construction is crucial for their satisfactory performance post-implantation. In this study, we propose a cell-membrane mimetic multifunctional hyaluronic acid (HA)-based coating by combining the aminolyzed methacryloyloxyethyl phosphorylcholine (MPC) copolymer with oxidized hyaluronic acid (Ox-HA) through Schiff base reaction. Compared with traditional anti-fouling design, the composite coating present a stage-specific ability, which can resist the adhesion of blood components, while mediating vascular cell fate with the incorporation of HA. The coating exhibited promoted endothelial cell (EC) growth and inhibited the proliferation of smooth muscle cells (SMCs) by inducing a phenotype change. Besides, the multifunctional HA-based coating can mediate macrophages to a M2 phenotype. The coated stents were implanted in rabbits, and exhibited ideal capabilities in promoting endothelialization and inhibiting inflammation and restenosis in vivo, offering a potential approach to address multifunctionality for vascular implants.