Abstract:
A new biodegradable polymer composed by poly(D,L)lactic acid (PDLLA) and Vitamin E (α-tocopherol) is disclosedα. This polymer shows a high degree of haemocompatibility compared to the original polymer (PDLLA) and is a good candidate as coating material of different biomaterials.

Description:
FIELD OF THE INVENTION  
       [0001]    The present invention concerns a new highly haemocompatible and biodegradable polymer and its uses, particularly, as a coating material for implantable prosthesis in the animal or human body. 
       BACKGROUND OF THE INVENTION  
       [0002]    Many biodegradable polymers are used as drug delivery systems for the coating of vascular endoprosthesis, mainly metallic stent, in order to release drugs or other agents (e.g. nucleic acids) to reduce stent thrombogenic tendency and to contrast neointima hyperplasia and consequent vascular stenosis [1], a pathobiological process that still occurs in 10% to 50% of cases currently treated [2]. 
         [0003]    One of the main challenges for this research area is to reduce the negative interactions occurring between the polymer used in the production of drug-eluting stents and the complex and fast reactive blood environment. In fact, biodegradable polymers such as polyglycolic acid/polylactic acid (PGLA) or polycaprolactone (PCL), which are considered good candidates for this kind of application on the basis of in vitro tests, after implantation have been demonstrated to induce a marked inflammation with subsequent neointimal thickening [3]. Later some other polymers were found to be biologically inert and stable for at least 6 months [4,5], and now the research is focused on the use of biomimetic substances such as phosphorylcoline [6] that does not interfere with the re-endothelization and the degree of neointimal formation. Among biodegradable polymers poly (D,L) lactic acid (P(D,L)LA), largely used in the orthopaedic field for its good mechanical property, is an interesting candidate for stent coating as it undergoes a slow scission to lactic acid in the body [7,8], but unluckily it also activates both granulocyte [9] and platelet [10]. 
         [0004]    In fact, P(D,L)LA has been recently used as a paclitaxel-eluting coronary stent with good results in inhibiting restenosis in an animal model, but the unloaded polymer induced a long lasting local inflammatory response that probably caused an underestimation of the paclitaxel effect on the restenosis [11]. 
         [0005]    Restenosis is an important tissue healing response after arterial wall injury occurring during the transluminal coronary revascularization [12]. The arterial wall response involves vessel elastic recoil, negative remodelling, thrombus formation at the site of injury, smooth muscle cell (SMC) proliferation and migration and excessive extracellular matrix production [13]. In order to reduce restenosis in the last fifteen years the use of a metallic stent has been introduced avoiding elastic recoil and negative remodelling at the site of injury [14]. Nevertheless, it has been observed in-stent restenosis in 10% to 50% of cases treated [15], a phenomenon due mainly to the SMC proliferation and migration that create the so-called neointima. In order to control neointima hyperplasia and consequent vascular stenosis, biodegradable polymers are used for metallic stent coating to deliver anti-proliferative drugs [16-18]. 
         [0006]    In the last 10 years the use of additives or drugs to improve materials biocompatibility has been widely tested. Among the various additives used, the most interesting is the Vitamin E (α-tocopherol), a potent biological and biocompatible anti-oxidant and anti-inflammatory agent [19-22], widely used in the biomaterial field [23-26]. Interestingly all the biological processes involved in the tissue response to stent implantation (mainly inflammation and smooth muscle cell proliferation) can be modulated directly by Vitamin E [19-22]. 
         [0007]    An example of the use of polylactic acid as a drug delivery system is provided i.a. in WO-A-2005/053768, wherein the use of polylactic acid as a matrix loaded with pentoxyfylline and an anti-oxidant agent (i.a. tocopherol acetate) is disclosed, particularly in connection with the use of polylactic acid as a coating material for implantable endoprosthesis in order to release at the implantation site the necessary active agents. 
       SUMMARY OF THE INVENTION  
       [0008]    Object of the present invention is a new highly haemocompatible and biodegradable polymer which overcomes the disadvantages of the prior art. 
         [0009]    A further object of the present invention is the use of the new highly haemocompatible and biodegradable polymer as a coating material for implantable prosthesis, preferably heart valves, stents. 
         [0010]    Such objects are achieved thanks to the solution claimed in the ensuing claims, which form integral part of the technical teaching of the invention herein provided. 
         [0011]    In a preferred embodiment, the present invention concerns a new biodegradable polymer composed by poly(D,L)lactic acid (PDLLA) and Vitamin E (α-tocopherol), named Polylactil-E. This polymer shows a high degree of haemocompatibility compared to the original polymer (PDLLA) and it is a good candidate for the coating of different biomaterials. In particular, Polylactil-E can be used for the coating of endovascular prosthesis in order to reduce the adhesion of platelet and granulocyte, the formation of thrombi and the inflammatory response to the endoprosthesis implantation. 
         [0012]    In a further embodiment, the new biodegradable polymer of the present invention can be used a drug delivery system for local administration of pharmaceutically active compounds, which can act i.a. as anti-restenosis agents. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS  
         [0013]      FIG. 1 . FTIR spectra of control P(D,L)LA and P(D,L)LA enriched with 10%, 20% and 40% (w/w) Vit. E. 
           [0014]      FIG. 2 . Quantification of protein adsorbed onto polystyrene (PS), control P(D,L)LA (PLA) and P(D,L)LA enriched with 10% (PLA10), 20%(PLA20) and 40% (PLA40) Vit.E. *p&lt;0.05, **p&lt;0.001, compared to control P(D,L)LA. 
           [0015]      FIG. 3 . DSC thermograms of P(DL)LA PLA) vit.E, 10% Vit.E/PLA and 40% Vit.E /PTA (Polylacyil-E) 
           [0016]      FIG. 4 . A) Quantification of platelet adhesion expressed as % of area coverage obtained from the fluorescence emitted by platelet stained with phalloidine-TRIC and adherent onto polystyrene (PS), control P(D,L)LA (PLA) and P(D,L)LA enriched with 10% (PLA10), 20% (PLA20) and 40% (PLA40) Vit.E after 0.5 hour of incubation . . . B) Platelet adhesion onto P(D,L)LA and C) PLA40. Magnification=40× 
           [0017]      FIG. 5 . A) Quantification of granulocyte adhesion expressed as cellular count of adherent granulocytes stained with Acridine Orange (AO) and scored onto PS, PLA and P(D,L)LA enriched with Vit.E (PLA10, 20, 40) after 1 hour incubation. Adherent cells were counted in 10 different fields per sample at 10× magnification and their number was expressed as adherent granulocytes/cm 2 . B) Granulocyte adhesion onto P(D,L)LA and C) PLA40. *p&lt;0.05, **p&lt;0.001, compared to control P(D,L)LA. 
           [0018]      FIG. 6 . Absorbance of haemolysed haemoglobin solutions obtained after contact with PS disks, P(D,L)LA and Vit.E-enriched P(D,L)LA films versus time of contact. 
           [0019]      FIG. 7 . Quantification of A10 cell adhesion expressed as cellular count of adherent cell stained with Acridine Orange (AO) and scored onto control P(D.L)LA (PLA) and P(D,L)LA enriched with Vit.E (PLA10, 20, 40) after 0.5, 1,2 and 4 hours of incubation. Adherent cells were counted in 10 different fields per sample at 10× magnification and their number was expressed as adherent cells/cm 2 ±standard deviation (S.D.). 
           [0020]      FIG. 8 . Quantification of A10 cell adhesion expressed as cellular count of adherent cell stained with Acridine Orange (AO) and scored onto control P(D.L)LA (PLA) and P(D,L)LA enriched with Vit.E (PLA10, 20, 30) after 24, 48 and 72 hours. Adherent cells were counted in 10 different fields per sample at 10× magnification and their number was expressed as adherent cells/cm 2 ±standard deviation (S. D.). *p&lt;0.05, **p&lt;0.001 compared to PLA. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0021]    The invention will now be described in detail in relation to some preferred embodiments by way of not limiting examples. 
         [0022]    The present inventors enriched P(D,L)LA films with Vitamin E (at various concentrations) obtaining a new kind of polymer (named Polylactil-E) with different physical and biological characteristics compared to the normal P(D,L)LA. The physical and biological behaviour of Polylactil-E makes this polymer suitable for improving surface haemocompatibility of different kinds of implantable biomaterials (e.g. metal stent). 
         [0023]    In the following examples the preparation of Polylactil E, its physical and biological behaviours will be described. 
       Example 1  
     Preparation and Physical Characterization of Polylactil-E. 
     Polylactil-E Preparation 
       [0024]    P(D,L)LA (100% D,L, averagi mol wt 75,000-120,000) and Vitamin E (α-tocopthcrol) were purchased from Sigma-Aldrich (Milwaukee, Wis. USA). P(D,L)LA was dissolved under gentle shacking in chloroform (99.8% pure, Sigma Aldrich) at a concentration of 0.05 g/ml (5% solution w/v). Vitamin E ((±)α-tocopherol, synthetic 95% pure HPLC) was dissolved 1:1 (v/v) in ethanol (absolute extrapure, Merck, Darmstadt, Germany) differente da lavoro su Biomaterials) and the added to the P(D,L)LA/chlorophorm in order to obtain a solution with 10-40% Vit.E (w/w) (highest Vit.E concentraion added=20 mg/ml final solution). After 10 min shaking the solution was sprayed onto glass dishes at a pressure of 2 atm and the solvent was evaporated at room temperature under vacuum for 3 hours in the dark. The operation was repeated to form film sheets of ˜1 mm thickness. Films were then cut under sterile conditions into square samples (˜1 cm 2 ) and stored at 4° C. for no more that 1 week. 
       FTIR Analysis 
       [0025]    The presence of Vitamin E in the films obtained was assessed using Fourier transformed infrared spectroscopy (FTIR). FTIR spectra for polymers surfaces were obtained at 4 cm −1  resolution using a Bruker IFS 113v spectrophotometer, equipped with MCT cryodetector. The spectra for IR analysis were executed on thin transparent films of control and Vit.E P(D,L)LA (area=1 cm 2  surface). IR spectra were executed in transmission and recorded in the region of mid infrared at a nominal temperature of ˜400 K. FTIR analysis. In  FIG. 1  the FTIR absorbance spectra of P(D,L)-LA and P(D,L)-LA enriched with Vit. E at various concentrations recorded in the region of 4000-1500 cm −1  are shown. 
         [0026]    The band at ˜3500 cm −1  indicates the stretching of O—H and it is present in every sample, as OH groups are present in both P(D,L)LA and Vit.E structures. Two bands at ˜4000 cm −1  represent the stretching of —CH 3 . The —CH 3  functions are also P(D,L)LA and Vit.E structures, but in the Vit.E there are both aromatic and aliphatic —CH 3 , the former emitting at slightly higher frequencies than the latter. The intensity of bands at 3500 and 4000 cm −1  increased with the Vit.E concentration added to the P(D,L)LA, indicating the dose-dependent Vit.E presence. 
       Wettability Test. 
       [0027]    Contact angle measurements were carried out in order to evaluate the wettability of the Vit.E-enriched P(D,L)LA films. An equal volume of distilled water (100 μl) was placed on every sample by means of a micropipette, forming a drop or spreading on the surface. Photos were taken through lenses (LEITZ IIA optical stage microscope equipped with LEICA DFC320 video-camera) to record drop images. Measure of the contact angle was performed by analyzing drop images (3 for each samples) using Scion Image software. In the wettability test performed using the control P(D,L)LA surface, a distilled water drop put on the polymer surface formed an angle of almost 90° (89.6°±1.5°), while the Vit.E addition decreased the water contact angle starting from 10% concentration (water contact angle=62.3°±1.5°, p&lt;0.001). The 20% Vit.E P(D,L)LA wettability (water contact angle=58.2°±1.9°) was not significantly higher than the one measured for 10% Vit.E films, while wettability increased significantly for 40% Vit. E samples (water contact angle=49.4°±2.3°). 
       Protein Adsorption. 
       [0028]    Protein adsorption assay was performed in triplicate using human plasma pool obtained from 10 healthy donors. Blood (10 ml) was centrifuged at 200×g for 10 minutes to obtain platelet rich plasma (PRP). PRP was then centrifuged at 1600×g for 10 minutes to separate platelet. Plasma was then stored at −20° C. prior to use. PS disks, P(D,L)LA and P(D,L)LA/Vit.E films (1 cm 2 ) were covered with 200 μl of undiluted human plasma pool and incubated for 1 hour at 37° C. At the end of incubation, plasma was removed and films were washed three times with PBS. Adsorbed proteins were collected by incubating samples with 1 ml of 2% sodium dodecyl sulfate (SDS) solution in PBS for 4 hours at room temperature and under vigorous shaking. Amount of adsorbed proteins was measured in triplicate using a commercial protein quantification kit (BCA, Pierce, Rockford, Ill.). The sample optical density was read at 562 nm against a calibration curve created using bovine serum albumin (BSA, 25-2000 μg/ml). The results were expressed as micrograms of total protein adsorbed for cm 2 ±standard deviation (S.D). 
         [0029]    As expected from the results of wettability test, protein adsorption assay evidenced that addition of Vit.E to P(D,L)LA induced a higher total protein adsorption compared to control P(D,L)LA (70±32.9  82  g/cm 2 ) and cell culture grade polystyrene (PS, 66.3±34.1 μg/cm 2 ) ( FIG. 2 ). In fact the adsorbed protein quantity measured for 10%, 20% and 40% Vit.E P(D,L)LA was respectively 162±6.9, 226±22.5 and 400.7±52.5 μg/cm 2 . 
       Measurement of the Glass Transition Temperature (Tg)  for Vit.E, PDLLA and PDLLA/Vit.E 10 and 40%  (Polylactil-E)  
       [0030]    The physical characteristics observed in the Vit.E enriched P(D,L)LA suggested a more deep interaction between the polymer and the Vitamin E. Therefore, Vit.E, P(D,L)LA and P(D,L)LA/Vit.E 10 and 40% (Polylactil-E) have been studied by differential scanning calorimetry (DSC). Briefly, accurate y weighed sample (˜10 mg) of the different materials were placed in aluminum DSC pans and sealed. The lids were vented with a pinhole in the center. To determine the Tq of the various samples, they were first cooled to −100° C. and then scanned from −100 to 100° C. at 10° C./min. The DSC thermograms obtained mere examined and the midpoints of the baseline shifts were taken a glass transition temperatures. As shown in  FIG. 3  the Vit.E was present in the 40% Vit.E/P(D,L)LA (Polyactil-E) in a free form (Tg:=−46° C.) and its presence altered the Tg of P(D,L)LA in a dose-dependent and saturable fashion, suggesting the creation of a kind of binding between the linear polymer and the Vitamin E. 
       Example 2  
     Biological Activity of Polylactil-E 
     a) Haemocompatibility 
     Granulocyte and Platelet Adhesion 
       [0031]    Platelets and granulocytes were obtained from human peripheral venous blood (20 ml) obtained from 10 healthy donors (age range=20-36) using EDTA as anticoagulant. All the blood samples were used within 3 hours from sampling. Granulocytes were separated from whole blood using a modification of the method of Boyum [27]. Blood (10 ml) was layered onto a Ficoll-Hypaque density gradient and centrifuged for 20 minutes at 2000 rpm to separate mononuclear cells from erythrocytes and granulocytes. The mononuclear fraction was discharged and erythrocytes were then lysed using an ammonium chloride lysing solution (150 mM NH 4 Cl, 10 mM NaHCO 3 , 1 mM EDTA, pH7.4) for 20 minutes at 4° C. Pellet containing granulocytes was then centrifuged twice in sterile phosphate buffer (PBS), cells were counted in optical microscopy using trypan blue exclusion test (viability&gt;98%) and suspended at a concentration of 1×10 6  cells/ml in RPMI 1640 (Euroclone, Milan, Italy) medium supplemented with 10% heat-inactivated fetal calf serum (Euroclone, Milan, Italy) containing penicillin (100 u/ml), streptomycin (100 mg/ml) and L-glutamine (2 mM) (Euroclone, Milan, Italy) in polypropilene tubes. Granulocyte suspension (200 μl) was seeded onto cell culture grade polystyrene disks (area ˜1 cm2) and P(D,L)LA and P(D,L)LA/Vit.E films (area=1 cm 2 ) and incubated for 1 hour in a humidified atmosphere containing 5% CO 2  at 37° C. 
         [0032]    In order to obtain platelets, whole blood (10 ml) was centrifuged at 200×g for 10 minutes to obtain platelet rich plasma (PRP). PRP was then centrifuged at 1600×g for 10 minutes to separate platelet then resuspended in 10 ml RPMI 1640 medium supplemented with 10% heat-inactivated fetal calf serum (Euroclone, Milan, Italy). Aliquots of platelet suspension (200 μl) were seeded onto PS disks, P(D,L)LA and P(D,L)LA/Vit.E films and incubated for 0.5 hour in a humidified atmosphere containing 5% CO 2  at 37° C. 
         [0033]    Cell counting and morphological analysis of adherent platelet and granulocyte were performed using a fluorescence microscope Aristoplan Leitz equipped with a digital camera Leica DFC320. At the end of the incubation time adherent platelet and granulocyte were washed three times with cold PBS (pH 7.4) and fixed for 15 minutes at room temperature using a solution of formaldehyde (3.7%) and sucrose (3%) in PBS (pH 7.4). Platelets were treated for 5 minutes with Triton X-100 solution (2% vol/vol) in PBS and stained with 0.1 μM phalloidin-TRIC (Sigma-Aldrich, Milwaukee, Wis. USA) for 1 h at 37° C. Platelets adhesion was measured as surface coverage with phalloidin-stained platelets (% area coverage±standard deviation−S.D.) by measuring the fluorescence presence in 10 different fields for sample observed using a 10× magnification. Fluorescence presence was measured using Leika QWin software. 
         [0034]    Adherent granulocytes were stained for 10 minutes at room temperature in the dark with a 0.2% solution of Acridine Orange (AO) and counted in 10 different fields per sample at 10× magnification. Scoring was performed by three separate observers, blind to the sample treatment using Leika QWin software and expressed as adherent granulocyte/cm 2 ±standard deviation (S.D.). Platelet morphology was observed using a 40× magnification while granulocytes were observed using a 25× magnification. 
         [0035]    In vitro platelet adhesion testing was performed to study the quantity and the morphology of adherent platelets onto control P(D,L)LA and Vit.E-enriched P(D,L)LA. As shown in  FIG. 4A  the percentage of area covered by platelet adherent onto PS and P(D,L)LA was 45.5±0.6% and 42.3±2.9% respectively. Platelet adhesion slightly decreased onto 10% and 20% Vit.E P(D,L)LA films (36.1±2.0% and 34.4±1.4% respectively, p&lt;0.05 compared to control P(D,L)LA), even if no statistically significant difference was observed as regards the percentages of covered area measured for the two Vit.E-enriched polymers. Besides platelet adhesion dropped dramatically onto 40% Vit.E P(D,L)LA films where only 4.4±1.7% of the polymer area was covered by platelet (p&lt;0.001). Platelet morphology was altered by the presence of high Vit.E concentration as observed by the actin staining with phalloidin. In fact as shown in  FIG. 4B  adherent platelet observed onto control P(D,L)LA formed aggregates and 50-70% of platelet showed a spread morphology, while the few adherent platelet observed onto 40% Vit.E P(D,L)LA films ( FIG. 4C ) were mostly isolated and their morphology was mainly roundish. 
         [0036]    As shown in  FIG. 5A  granulocytes adhered both to PS (619200±104840 cells/cm 2 ) and P(D,L)LA (806400±17900 cells/cm 2 ) after 1 hour incubation. The Vit.E presence in P(DL)LA films strongly decreased granulocyte adhesion at 10% (360400±4500 cells/cm 2 , p&lt;0.001) and 20% Vit.E (317000±37200 cells/cm 2 , p&lt;0.001). Also for granulocyte adhesion no statistically significant differences were observed between 10% and 20% Vit.E polymer films, and also in this case the presence of 40% Vit.E reduced the cell adhesion (11100±2890 cells/cm 2 , p&lt;0.001). 
         [0037]    Granulocyte adherent to P(D,L)LA and stained with AO showed the typical polylobate nucleus and a spread morphology observed for activated granulocyte ( FIG. 5B ), while the few adherent granulocyte observed onto 40% Vit.E P(D,L)LA films ( FIG. 5C ) showed a roundish morphology with a lower cellular size compared to the granulocyte adherent onto control P(D,L)LA. 
       Clotting Time 
       [0038]    The tromboresistant properties of the P(D,L)LA and Vit.E-enriched P(D,L)LA films were evaluated using fresh human blood using the kinetic clotting method [28]. For this test, 100 μl of fresh blood were taken directly from the plastic syringe used for the blood collection and immediately dropped onto the film specimens and onto polystyrene disks (PS). After a predetermined contact time (10, 20, 40 and 50 minutes), specimens were transferred into plastic tubes each containing 20 ml of distilled water and incubated for 5 minutes. The surface ability to induce blood clotting was deduced by the quantity of free haemoglobin measurable at every time point. In fact, the red blood cells that had not been trapped in a thrombus were haemolysed and the concentration of free haemoglobin dispersed in water was measured by monitoring the absorbance at 540 nm. The absorbance values were plotted versus the blood contacting time and the clotting times were derived using optical density curves. Each absorbance value represents the average of 10 measurements±S.D. In  FIG. 6  the blood clotting profile for PS, P(D,L)LA and Vit.E P(D,L)LA films are shown. The absorbance of the haemolyzed haemoglobin solution varied with time, and the higher the absorbance, the better the thromboresistence. The present inventors indicated as clotting time the time at which the absorbance equals 0.02. PS was able to reduce quickly haemoglobin absorbance and PS samples coagulated completely after 45-47 minutes. P(D,L)LA samples showed a similar clotting time, but the coagulation process seemed to occur more slowly compared to PS. The addition of high Vit.E concentration (40%) to P(D,L)LA slowed the coagulation process significantly compared to normal P(D,L)LA at every time point, while a statistically significant difference between absorbance values for P(D,L)LA and 10% and 20% Vit.E P(D,L)LA samples was observed only after 50 minutes (p&lt;0.001). However for all Vit.E-enriched P(D,L)LA samples coagulation time was 70-75 minutes (data not shown) indicating an increased thromboresistence compared to the normal P(D,L)LA. 
       Statistical Analysis 
       [0039]    The statistical analysis of data was performed using Graph Pad Prism 2.01 software for Windows and using the Anova test followed by Dunnett&#39;s post-hoc test, taking p&lt;0.05 as the minimum level of significance. 
       B) Neointima-Like Cells Adhesion and Proliferation 
       [0040]    One of the most investigated effects of Vit.E (in particular of the α-tocopherol) is the ability to reduce the rat and human SMC proliferation [29]. As the neointima is a scar tissue derived from hyperproliferation of SMC, the adhesion and proliferation of neointima-like rat cells A10 [30] onto Polylactil-E has been investigated. 
         [0041]    Rat clonal cell line A10 (ATCC CRL-1476) was derived from the thoracic aorta of DB1X embryonic rat and possesses many of the properties characteristic of smooth muscle cells. 
         [0042]    A10 cells were grown in culture flask (75 cm 2 ) in Dulbecco&#39;s modified Eagle&#39;s medium (DMEM, Euroclone) supplemented with 10% heat-inactivated fetal bovine serum (FBS) (Euroclone), penicillin (100 U/ml), streptomycin (100 μg/ml) and L-glutamine (2 mM) (Euroclone) in a humidified atmosphere containing 5% CO 2  at 37° C. Evaluation of A10 cells adhesion and proliferation was performed using a fluorescence microscope Aristoplan Leitz equipped with a digital camera Leica DFC320. A10 cells were seeded onto cell culture grade polystyrene dishes (PS), control (PLA) and Vit.E-enriched P(D,L)LA (PLA10, PLA20 and PLA40) at a concentration of 1.5×10 4  cells/cm 2 . The number of adherent cells was evaluated after 0.5, 1, 2 and 4 hours incubation while proliferation was estimated counting cells present onto different polymers after 24, 48 and 72 hours. 
         [0043]    At the end of incubation time adherent cells were washed three times with cold PBS (pH 7.4) and fixed for 15 minutes at room temperature using a solution of formaldehyde (3.7%) and sucrose (3%) in PBS (pH 7.4). Cells were then stained for 10 minutes at room temperature in the dark with a 0.2% solution of Acridine Orange (AO) and counted in 10 different fields per sample at 10× magnification. Scoring was performed by three separate observers, blind to the sample treatment using Leika QWin software and express as adherent cells/cm 2 +standard deviation (S.D.). 
         [0044]    As shown in  FIG. 7 , the number of A10 cells adherent onto PLA, PLA10, PLA20 and PLA40 films increased from 0.5 to 4 hours without statistically significant differences among the different polymers. 
         [0045]    In fact, the number of A10 cells±standard deviation (S.D.) scored onto 1 cm 2  PLA after 0.5 hours was 275±159 increasing after 2 (1405±505) and 3 (855±529) hours. A similar trend was observed for PLA10, 20 and 40 and the number of cells scored onto 1 cm 2  polymer surface, after 4 hours, was 4,674±1,375 for PLA, 5,040±1,920 for PLA10, 4,032±1,033 for PLA20 and 3,849±916 for PLA40, while cells adhered onto the positive control surface (PS) after 4 hours were 14,204±3,404 (data not shown). A10 cell proliferated onto every polymer but the proliferation kinetics were different ( FIG. 8 ). In particular, after 24 hours the cell number scored onto PLA and Vit.E enriched PLA was not different with the exception of PLA20 (p&lt;0.05). After 48 hours all the Vit.E enriched PLA showed a reduction in the proliferation compared to PLA (p&lt;0.05) with the exception of PLA20. The proliferation slowing or arrest was more evident after 72 hours, when cells/cm 2 ±S.D. scored onto PLA10, 20 and 40 were respectively 110,000±44,400, 136,667±40,000 and 172,222±54,440 (p&lt;0.001 compared to PLA) while a rapid proliferation occurred onto PLA (426,667±31,110 cells/cm 2 ) and, as expected, onto PS surface reaching the number 926,670±60,000 after 72 hours. No toxic effect on A10 cells (excessive number of floating dead cells) was observed during daily optical inspection performed for all the samples. 
         [0046]    Naturally, while the principle of the invention remains the same, the details of construction and the embodiments may widely vary with respect to what has been described and illustrated purely by way of example, without departing from the scope of the present invention as depicted in the appended claims. 
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