title: Perivascular graft heparin delivery using biodegradable polymer wraps.
abstract: Heparin remains the gold-standard inhibitor of the processes involved in the vascular response to injury. Though this compound has profound and wide-reaching effects on vascular cells in culture and animal models, its clinical utility has been questionable at best. It is clear that the mode of heparin delivery is critical to its potential and it may well be that routine forms of administration are insufficient to observe benefit given the heparin's short half-life and complex pharmacokinetics. When ingested orally, heparin is degraded to inactive oligomer fragments while systemic administration is complicated by the need for continuous infusion and the potential for uncontrolled hemorrhage. Thus alternative heparin delivery systems have been proposed to maximize regional effects while limiting systemic toxicity. Yet, as heparin is such a potent antithrombotic compound and since existing local delivery systems lack the ability to precisely regulate release kinetics, even site-specific therapy is prone to bleeding. We now describe the design and development of a novel biodegradable system for the perivascular delivery of heparin to the blood vessel wall with well-defined release kinetics. This system consists of heparin-encapsulated poly(DL lactide-co-glycolide) (pLGA) microspheres sequestered in an alginate gel. Controlled release of heparin from this heterogeneous system could be obtained over a period of 25 days in vitro. The experimental variables affecting heparin release from these matrices were investigated. Gel permeation chromatography (GPC) and scanning electron microscopy (SEM) were used to monitor the degradation process and found to correlate well with the release kinetics. Heparin-releasing gels inhibited growth of bovine vascular smooth muscle cells in tissue culture in a dose-dependent manner. Moreover, gel release controlled vascular injury in denuding and interposition vascular graft animal models of disease even when uncontrolled bleeding was evident with standard matrix-type release. This system may therefore provide an effective means of examining the effects of various compounds in the control of smooth muscle cell proliferation in accelerated arteriopathies and also shed light on the biologic nature of these processes.
authors.affiliation: Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge 02139, USA. eedelman@mit.edu
authors.forename: E R
authors.initials: ER
authors.lastname: Edelman
authors.forename: A
authors.initials: A
authors.lastname: Nathan
authors.forename: M
authors.initials: M
authors.lastname: Katada
authors.forename: J
authors.initials: J
authors.lastname: Gates
authors.forename: M J
authors.initials: MJ
authors.lastname: Karnovsky
mesh_terms: D000800:Angioplasty, Balloon; D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology; D001672:Biocompatible Materials / Q000493:pharmacokinetics; D001673:Biodegradation, Environmental; D017536:Carotid Artery, Common / Q000166:cytology / Q000187:drug effects / Q000502:physiology*; D002417:Cattle; D002455:Cell Division; D002478:Cells, Cultured; D004337:Drug Carriers; D004730:Endothelium, Vascular / Q000502:physiology; D006493:Heparin / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology*; D006965:Hyperplasia; D007262:Infusions, Intravenous; D019344:Lactic Acid / Q000493:pharmacokinetics; D008297:Male; D008863:Microspheres; D009131:Muscle, Smooth, Vascular / Q000166:cytology* / Q000187:drug effects; D011100:Polyglycolic Acid / Q000493:pharmacokinetics; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011108:Polymers / Q000493:pharmacokinetics; D051381:Rats; D017207:Rats, Sprague-Dawley; D017539:Tunica Intima / Q000166:cytology / Q000187:drug effects* / Q000473:pathology
chemical_list: D000925:Anticoagulants; D001672:Biocompatible Materials; D004337:Drug Carriers; D011108:Polymers; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D006493:Heparin