Cell-free tissue engineered vascular grafts
A composition containing a macrophage inhibitor may be administered in an effective amount to prevent, inhibit or reduce restenosis, thrombus or aneurysm formation in implanted polymeric vascular grafts. The composition may be administered prior to vascular graft implantation, at the same time as vascular graft implantation, following vascular graft implantation, or any combination thereof. Exemplary macrophage inhibitors include bisphosphonates, anti-folate drugs and antibodies, preferably in a controlled release or liposomal formulation.
1. A cell-free polymeric vascular graft for vascular neotissue formation, the vascular graft consisting of
a polymeric vascular graft and
a macrophage inhibitor selected from the group of antibodies, antibody fragments and antibody conjugates inhibiting macrophages, bisphosphonates, and anti-folate inhibitors in an amount effective to reduce the recruitment of host monocytes into the vascular graft and to promote attachment and proliferation of endothelial and smooth muscle cells from adjacent vessels onto the inner surface of the graft to prevent, inhibit or reduce stenosis in the vascular graft following implantation,
the polymeric vascular graft optionally including an active agent selected from the group consisting of anti-thrombogenic agents, anti-inflammatory agents, anesthetic agents, anti-coagulants, cholesterol-lowering agents, vasodilating agents, and agents which interfere with endogenous vasoactive mechanisms.
2. The cell-free polymeric vascular graft of claim 1 , wherein the macrophage inhibitor is a bisphosphonate selected from the group consisting of alendronate, clodronate, EB-1053, etidronate, ibandronate, incadronate, neridronate, olpadronate, pamidronate, risedronate, tiludronate, YH 529, and zoledronate.
3. The cell-free polymeric vascular graft of claim 1 , wherein the macrophage inhibitor is an anti-folate inhibitor selected from the group consisting of methotrexate, trimethoprim, pyrimethamine, pemetrexed, raltitrexed, and pralatrexate.
4. The cell-free polymeric vascular graft of claim 1 wherein the macrophage inhibitor is an antibody, antibody fragments or antibody conjugates inhibiting macrophages reactive with CD14, IB4, OKM1, OKM9, or OKM10.
5. The cell-free polymeric vascular graft of claim 1 , wherein the macrophage inhibitor is encapsulated in the form of liposomes, microspheres, nanospheres, microparticles and/or microcapsules that are seeded into, onto or dispersed within the vascular graft.
6. The cell-free polymeric vascular graft of claim 1 , wherein the vascular graft includes an active agent selected from the group consisting of anti-thrombogenic agents, anti-inflammatory agents, anesthetic agents, anti-coagulants, cholesterol-lowering agents, vasodilating agents, and agents which interfere with endogenous vascoactive mechanisms.
7. The cell-free polymeric vascular graft of claim 1 , wherein the polymer forming the polymeric vascular graft is biodegradable or bioabsorbable.
8. The cell-free polymeric vascular graft of claim 1 , wherein the macrophage inhibitor is in a controlled release formulation.
9. The cell-free polymeric vascular graft of claim 7 , wherein the biodegradable or bioabsorbable polymers are formed into a fiber-based woven or non-woven mesh.