Introduction: Vascular prosthetic grafts are widely used in vascular surgery; however, graft infection remains a major concern. Silver-coated vascular grafts have demonstrated anti-infection properties in clinical settings; however, whether the silver irons influence foreign body reaction or neointimal hyperplasia remains unclear. Methods: Sodium alginate and hyaluronic acid (SA/HA) hydrogel patches loaded with rhodamine, with or without silver, were fabricated. Patches were implanted in the subcutaneous or abdominal cavity and inferior vena cava of rats. Samples were harvested on day 14 and examined via immunohistochemical and immunofluorescence analyses. Results: Silver hydrogel was found to decrease the foreign body reaction; after subcutaneous and abdominal cavity implantation in rats, the capsule was found to be thinner in the silver hydrogel group than in the control hydrogel group. The silver hydrogel group had fewer CD68-positive cells and proliferating cell nuclear antigen and interleukin-33 (IL-33) dual-positive cells than the control hydrogel group. Additionally, the silver hydrogel patch reduced the neointimal thickness after patch venoplasty in rats, and the number of IL-33- and IL-1β-positive cells was lower than that in the control patch. Conclusion: Silver-loaded SA/HA hydrogel patches decreased the foreign body reaction and venous neointimal hyperplasia in rats by the inhibition of IL-33 expression.

Artificial vascular grafts are widely used in vascular surgery, but post-graft infection remains an important clinical problem. Silver-coated vascular grafts have excellent anti-infective effects. We used silver hydrogel patches placed in the subcutaneous, abdominal, and inferior vena cava of mice and found that the capsule in the silver hydrogel group was thinner than that in the control hydrogel group. The silver hydrogel group had fewer CD68-positive cells, proliferating cell nuclear antigen and interleukin-33 (IL-33) double-positive cells, while the silver hydrogel patch also reduced the thickness of the neoplastic endothelium in rats after patch venoplasty, with fewer IL-33- and IL-1β-positive cells. Silver-loaded hydrogel patches attenuated foreign body reaction and venous intimal hyperplasia in rats, and this mechanism of action may be related to the inhibition of IL-33 expression.

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