Research Progress on Gas Signal Molecules in Extracorporeal Circulation Anticoagulant Coatings

YE Peiyan; HE Zijian; ZHOU Chengbin

doi:10.13498/j.cnki.chin.j.ecls.2026.01.14

Abstract：Extracorporeal circulation(ECC)is a vital life support technology in cardiac surgery.However,the contact between circuit materials and blood can trigger coagulation cascades,leading to issues such as thrombosis—a pressing clinical challenge that requires urgent resolution.In recent years,multiple gaseous signaling molecules have been reported to play crucial roles in anticoagulation:Nitric oxide(NO)inhibits platelet activation via the cyclic guanosine monophosphate(cGMP)-protein kinase G(PKG)signaling axis and regulates vascular thrombosis through S-nitrosylation of protein disulfide isomerase(PDI);Carbon monoxide(CO)suppresses platelet activation through both cGMP-dependent and cGMP-independent pathways;while hydrogen sulfide(H2S)exerts anticoagulant effects through mediating sulfhydryl(S-sulfhydration)modification and multi-target regulation of platelets,vascular endothelial cells,and the coagulation cascade.Coating ECC circuit surfaces with gaseous signal-ing molecules represents a cutting-edge strategy to enhance their biocompatibility and anticoagulant efficacy.Current research in this field primarily focuses on integrating NO,CO,and H2S onto device surfaces through diverse coating material designs.How-ever,achieving sustained,stable,and controllable release of these gas signaling molecules remains a major challenge.This review summarizes the anticoagulation mechanisms and recent advances in coating materials incorporating NO,CO,and H2S,providing insights for the development of novel anticoagulation strategies based on gaseous signaling molecules.It also discusses the exist-ing challenges and future clinical translation prospects of gaseous signaling molecule-based anticoagulant coating technologies.