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DOI: 10.1055/s-0038-1655187
Adhäsivproteine und Hämokompatibilität
Publication History
Publication Date:
25 June 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034925/199002/lookinside/thumbnails/10-1055-s-0038-1655187-1.jpg)
Zusammenfassung
Die Fähigkeit von Fremdoberflächen, eine möglichst gute Verträglichkeit mit den humoralen und zellulären Systemen des Blutes aufzuweisen, bezeichnet man als »Hämokompatibilität«. Bei gestörter Hämokompatibilität wird eine Aktivierung der Hämostase-, Komplement-und Kallikrein-Kinin-Systeme sowie Hämolyse, Thrombozytopenie und Thrombozytenfunktionsstörung , Leukozytopenie und Leukozytenfunktionsstörung beobachtet. Im Extremfall kommt es zur Ausbildung einer Thrombose und an Herzklappen zu einer Kalzifizierung. Die Hämokompatibilität von Biomaterialien ist bisher nicht zufriedenstellend gelöst. Ein modernes Konzept verfolgt die Idee, Biomaterialien mit Endothelzellen zu beschichten, um eine möglichst native Oberfläche dem zirkulierenden Blut gegenüberzustellen. Die Herstellung von mit Endothelzellen beschichteten Biomaterialien ist zum einen von den physikochemischen Eigenschaften des Materials und zum anderen von der Qualität der Endothelzellen und den Adhäsivproteinen, die Endothelzellen an den Biomaterialien fixieren, abhängig. Zu den Adhäsivproteinen, die zum Anhaften von Endothelzellen an Biomaterialien wichtig sind, zählen: Fibrinogen/Fibrin, von-Willebr and- Faktor, Fibronektin, Vitronektin, Laminin, Kollagen und Thrombospondin. Bis auf Vitronektin werden alle diese Adhäsivproteine von Endothelzellen selbst synthetisiert. Bei Abwesenheit von Vitronektin können Endothelzellen nicht an einem Biomaterial haften bleiben. Für die Bindung der Adhäsivproteine an Endothelzellen sind Rezeptoren, die zu der Gruppe der Integrine gehören, verantwortlich. Neben Adhäsivproteinen dürften Proteoglykane, Elastin und vielleicht Tenascin eine Bedeutung für die ausreichende Adhäsion von Endothelzellen an Biomaterialien haben. Zukünftige Aktivitäten in der Grundlagenforschung sowie in der kliniknahen Forschung werden darauf zielen, Biomaterialien zu entwickeln, die neben den physikalischen und mechanischen Eigenschaften ideale Voraussetzungen für das Anhaften, die Ausbreitung und die Proliferation von Endothelzellen haben. Hiermit verknüpft sind Eigenschaften, die eine gute Fixierung der Adhäsivproteine am Biomaterial gewährleisten. Neben Fortschritten in der Entwicklung von guten und besseren Biomaterialien wird es notwendig sein, Techniken zur schnellen und besseren Isolierung und Züchtung von Endothelzellen zu entwickeln.
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