Tailored Extracellular Matrix-Biomimetic Coating Favors Tissue Healing by Modulating the Microenvironment

Minimally invasive occluder implantation effectively treats congenital heart disease by sealing cardiac defects. However, it still faces issues of inadequate endothelialization and tissue healing capabilities in clinical practice. In this study, we propose an extracellular matrix (ECM)-biomimetic microenvironment-regulating coating, where a polyethylene glycol linker (alkyne-PEG-silane) with antifouling effects is used to graft tailored recombinant humanized collagen type I (rhCol I) possessing high cell-adhesive activity <i>via</i> an efficient click reaction. <i>In vitro</i> blood and cell experiments reveal that this coating improves hemocompatibility, promotes endothelial cell growth, and enhances cardiomyocyte function. Subcutaneous and intravascular implantations confirm the coating's ability to alleviate inflammation by polarizing inflammatory cells into an anti-inflammatory phenotype, accelerate endothelialization, and facilitate tissue repair. This work highlights the potential effectiveness of the coating in optimizing the performance of cardiac occluders, which could be a promising strategy for improving the clinical efficacy of occluders.