Recombinant Humanized Collagen V-Engineered Implant Interfaces Drive in situ Low-Thrombogenic Vascular Repair via Selective Bioadhesion

Abstract Cardiovascular implants (e.g., vascular stents, occluders) face persistent challenges of thrombosis, immune activation, and delayed endothelial healing. Moreover, functional surfaces that can synergistically balance the demands of antithrombosis and pro-endothelialization remain suboptimal. Here, we develop a genetically engineered, recombinant humanized collagen V (rhCol V) that promotes vascular endothelial cell proliferation via the αvβ3-FAK pathway and induces smooth muscle contractile transition. Proteomics indicates reduced platelet adhesion via αIIbβ3 inhibition, thereby reducing thrombogenicity. In rabbit models, rhCol V-coated stents outperformed drug-eluting stents in long-term endothelial repair and remodeling, while suppressing acute thrombosis and immune activation. This engineered biomaterial has the potential to enhance the safety and efficacy of cardiovascular implantable devices.