109 Exploring an Angiogenic Biomaterial Strategy for the Treatment of Moyamoya Disease

Abstract

INTRODUCTION: Moyamoya disease is a rare cerebrovascular disorder characterized by progressive intracranial artery narrowing followed by a net of smaller fibrous root like blood vessels created in response to the scarcity of oxygen. Current treatment options for moyamoya disease are limited and often involve invasive surgical procedures. Recent studies have shown that hyaluronic acid (HA) gels can enhance angiogenesis and improve blood flow in ischemic tissues. Our laboratory has demonstrated that delivering angiogenic biomaterials in previously damaged brain tissue can generate a vascularized bed laying the groundwork for the use of angiogenic materials to other ischemic conditions. METHODS: We used C57/B6 mice, male and females, divided into 4 groups: 1. Controls – no surgery, no treatment; 2. Vehicle – unilateral occlusion of the internal carotid artery (ICA) and contralateral stenosis of the ICA, 2mm craniotomy, treated with saline solution; 3. Surgery as previously described, treated with a HA gel 4. Surgery as before, treated with Cluvena. Brains were dissected 2 weeks after treatment, sectioned and stained with CD31 to label new endothelial cells. RESULTS: Area fraction was used to calculate CD31 fluorescence. We found that animals subjected to occlusion/stenosis with no treatment had a statistically significant lower vessel percent area in comparison with normal animals. In contrast, animals treated with HA or Cluvena had a statistically significant higher vessel percent area than untreated animals. CONCLUSIONS: The use of biomaterials showed to be effective restoring vascularity in brains subjected to ischemia. There is a positive trend in favor of Cluvena versus HA restoring endothelial cells, suggesting that biomaterials including HA could provide enough angiogenic effect. Further research is needed to confirm the benefits of Cluvena.