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The nitric oxide releasing bionanomatrix gel (also known as AVF GEL) is an experimental, self-assembling peptide amphiphile (PA)-based hydrogel designed to promote vascular healing and remodeling. Developed by Endomimetics (a spinout from the University of Alabama at Birmingham), the gel is formulated from two types of self-assembling peptide amphiphiles: one containing the laminin-derived YIGSR peptide sequence to promote endothelial cell adhesion and re-endothelialization, and another containing a poly-lysine sequence (KKKKK) that is chemically charged to release nitric oxide (NO) in a controlled, sustained manner. When applied locally to surgical sites, such as the anastomosis of a newly created arteriovenous fistula (AVF) for hemodialysis, the gel provides a burst of NO followed by sustained release over several weeks. This local NO delivery promotes vasodilation, enhances outward vascular remodeling, and inhibits smooth muscle cell proliferation and neointimal hyperplasia, thereby preventing AVF maturation failure.
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