A hydrogel spinal dural patch with potential anti-inflammatory, pain relieving and antibacterial effects

Bioinspired conductive oriented nanofiber felt with efficient ROS clearance and anti-inflammation for inducing M2 macrophage polarization and accelerating spinal cord injury repair

Complete spinal cord injury (SCI) causes permanent locomotor, sensory and neurological dysfunctions. Targeting complex immunopathological microenvironment at SCI sites comprising inflammatory cytokines infiltration, oxidative stress and massive neuronal apoptosis, the conductive oriented nanofiber felt with efficient ROS clearance, anti-inflammatory effect and accelerating neural regeneration is constructed by step-growth addition polymerization and electrostatic spinning technique for SCI repair. The formation of innovative Fe3+-PDA-PAT chelate in nanofiber felt enhances hydrophilic, antioxidant, antibacterial, hemostatic and binding factor capacities, thereby regulating immune microenvironment of SCI. With the capabilities of up-regulating COX5A and STAT6 expressions, down-regulating the expressions of IL1β, CD36, p-ERK, NFκB2 and NFκB signaling pathway proteins, the nanofiber felt attenuates oxidative stress injury, promotes M2 macrophage polarization and down-regulates inflammatory response. After implantation into complete transection SCI rats, the nanofiber felt is revealed to recruit endogenous NSCs, induce the differentiation of NSCs into neurons while inhibit astrocytes formation and inflammation, reduces glia scar, and promotes angiogenesis, remyelination and neurological functional recovery. Overall, this innovative strategy provides a facile immune regulatory system to inhibit inflammatory response and accelerate nerve regeneration after SCI, and its targeted proteins and mechanisms are first elucidated, which holds great application promise in clinical treatment of complete SCI.

Designing hydrogel for application in spinal surgery

Spinal diseases and injuries are prevalent in clinical settings and impose a substantial burden on healthcare systems. Current treatments for spinal diseases are predominantly limited to surgical interventions, drug injections, and conservative treatments. Generally, these treatment modalities have limited or no long-term benefits. Hydrogel-based treatments have emerged as potentially powerful paradigms for improving therapeutic outcomes and the quality of life of patients. Hydrogels can be injected into target sites, including the epidural, intraspinal, and nucleus pulposus spaces, in a minimally invasive manner and fill defects to provide mechanical support. Hydrogels can be designed for the localized and controlled delivery of pharmacological agents to enhance therapeutic effects and reduce adverse reactions. Hydrogels can act as structural supports for transplanted cells to improve cell survival, proliferation, and differentiation, as well as integration into adjacent host tissues. In this review, we summarize recent advances in the design of hydrogels for the treatment of spinal diseases and injuries commonly found in clinical settings, including intervertebral disc degeneration, spinal cord injury, and dural membrane injury. We introduce the design considerations for different hydrogel systems, including precursor polymers and crosslinking mechanisms. Herein, we discuss the therapeutic outcomes of these hydrogels in terms of providing mechanical support, delivering cells/bioactive agents, regulating local inflammation, and promoting tissue regeneration and functional recovery.

Reduced Thermal Damage Achieved by High-Conductivity Hydrogel in RF Energy Tissue Welding

Radiofrequency (RF) tissue welding is an innovative tissue anastomosis technique that utilizes bioimpedance to convert electrical energy into thermal energy, enabling the connection and reconstruction of tissues via the denaturation and crosslinking of proteins. However, the high temperatures generated in this process often lead to excessive thermal damage to tissues, thereby adversely impacting cellular activity and impeding tissue repair in practical applications. In this study, we developed a polyacrylamide/alginate (PAAm/Alg) hydrogel with high ionic conductivity (16.8 ± 1.2 S/m) achieved by introducing Ca2+ for the purpose of reducing thermal damage in RF tissue welding. The PAAm/Alg-Ca2+0.5M hydrogel possessed excellent mechanical properties with a stress of 315.6 ± 14.1 kPa and an elongation of 382.7 ± 89.0%. Additionally, the hydrogel exhibited a high water content (83.7 ± 0.3%) and excellent stability of swelling property in water. In addition, the hydrogel extract showed good biocompatibility with no significant adverse effects on cell activity in the cytotoxicity test. At last, we conducted ex vivo experiments to investigate the effectiveness of the hydrogel as a cooling agent during RF tissue welding. The result showed that the maximum temperature was effectively reduced from 137.9 ± 4.7 to 101.8 ± 2.5 °C, while the strength of the anastomotic stoma (12.0 ± 3.2 kPa) was not affected by the intervention of this hydrogel. Histological analysis also revealed that the anastomotic structure of the tissue with hydrogel intervention was more intact than that of the control. Thus, the PAAm/Alg-Ca2+0.5M hydrogel has been demonstrated to function effectively as a cooling agent, offering a new strategy for thermal damage control in RF tissue welding.

Advances in Stimuli-Responsive Chitosan Hydrogels for Drug Delivery Systems

Sustainable and controllable drug transport is one of the most efficient ways of disease treatment. Due to high biocompatibility, good biodegradability, and low costs, chitosan and its derivatives are widely used in biomedical fields. Specifically, chitosan hydrogel enables drugs to pass through biological barriers because of their abundant amino and hydroxyl groups that can interact with human tissues. Moreover, the multi-responsive nature (pH, temperature, ions strength, and magnetic field, etc.) of chitosan hydrogels makes precise drug release a possibility. Here, the synthesis methods, modification strategies, stimuli-responsive mechanisms of chitosan-based hydrogels, and their recent progress in drug delivery are summarized. Chitosan hydrogels that carry and release drugs through subcutaneous (dealing with wound dressing), oral (dealing with gastrointestinal tract), and facial (dealing with ophthalmic, ear, and brain) are reviewed. Finally, challenges toward clinic application and the future prospects of stimuli-responsive chitosan-based hydrogels are indicated.

Dural Reconstruction Materials for the Repairing of Spinal Neoplastic Cerebrospinal Fluid Leaks

Spinal tumors often lead to more complex complications than other bone tumors. Nerve injuries, dura mater defect, and subsequent cerebrospinal fluid (CSF) leakage generally appear in spinal tumor surgeries and are followed by serious adverse outcomes such as infections and even death. The use of suitable dura mater replacements to achieve multifunctionality in fluid leakage plugging, preventing adhesions, and dural reconstruction is a promising therapeutic approach. Although there have been innovative endeavors to manage dura mater defects, only a handful of materials have realized the targeted multifunctionality. Here, we review recent advances in dura repair materials and techniques and discuss the relative merits in both preclinical and clinical trials as well as future therapeutic options. With these advances, spinal tumor patients with dura mater defects may be able to benefit from novel treatments.

Bioadhesives with Antimicrobial Properties

Bioadhesives with antimicrobial properties enable easier and safer treatment of wounds as compared to the traditional methods such as suturing and stapling. Composed of natural or synthetic polymers, these bioadhesives seal wounds and facilitate healing while preventing infections through the activity of locally released antimicrobial drugs, nanocomponents, or inherently antimicrobial polers. Although many different materials and strategies are employed to develop antimicrobial bioadhesives, the design of these biomaterials necessitates a prudent approach as achieving all the required properties including optimal adhesive and cohesive properties, biocompatibility, and antimicrobial activity can be challenging. Designing antimicrobial bioadhesives with tunable physical, chemical, and biological properties will shed light on the path for future advancement of bioadhesives with antimicrobial properties. In this review, the requirements and commonly used strategies for developing bioadhesives with antimicrobial properties are discussed. In particular, different methods for their synthesis and their experimental and clinical applications on a variety of organs are reviewed. Advances in the design of bioadhesives with antimicrobial properties will pave the way for a better management of wounds to increase positive clinical outcomes.

Plant Protein-Peptide Supramolecular Polymers with Reliable Tissue Adhesion for Surgical Sealing

The fusion of protein science and peptide science opens up new frontiers in creating innovative biomaterials. Herein, a new kind of adhesive soft materials based on a natural occurring plant protein and short peptides via a simple co-assembly route are explored. The hydrophobic zein is supercharged by sodium dodecyl sulfate to form a stable protein colloid, which is intended to interact with charge-complementary short peptides via multivalent ionic and hydrogen bonds, forming adhesive materials at macroscopic level. The adhesion performance of the resulting soft materials can be fine-manipulated by customizing the peptide sequences. The adhesive materials can resist over 78 cmH2 O of bursting pressure, which is high enough to meet the sealing requirements of dural defect. Dural sealing and repairing capability of the protein-peptide biomaterials are further identified in rat and rabbit models. In vitro and in vivo assays demonstrate that the protein-peptide adhesive shows excellent anti-swelling property, low cell cytotoxicity, hemocompatibility, and inflammation response. In particular, the protein-peptide supramolecular biomaterials can in vivo dissociate and degrade within two weeks, which can well match with the time-window of the dural repairing. This work underscores the versatility and availability of the supramolecular toolbox in the easy-to-implement fabrication of protein-peptide biomaterials.

Recent advance in bioactive hydrogels for repairing spinal cord injury: material design, biofunctional regulation, and applications

Functional hydrogels show potential application in repairing spinal cord injury (SCI) due to their unique chemical, physical, and biological properties and functions. In this comprehensive review, we present recent advance in the material design, functional regulation, and SCI repair applications of bioactive hydrogels. Different from previously released reviews on hydrogels and three-dimensional scaffolds for the SCI repair, this work focuses on the strategies for material design and biologically functional regulation of hydrogels, specifically aiming to show how these significant efforts can promoting the repairing performance of SCI. We demonstrate various methods and techniques for the fabrication of bioactive hydrogels with the biological components such as DNA, proteins, peptides, biomass polysaccharides, and biopolymers to obtain unique biological properties of hydrogels, including the cell biocompatibility, self-healing, anti-bacterial activity, injectability, bio-adhesion, bio-degradation, and other multi-functions for repairing SCI. The functional regulation of bioactive hydrogels with drugs/growth factors, polymers, nanoparticles, one-dimensional materials, and two-dimensional materials for highly effective treating SCI are introduced and discussed in detail. This work shows new viewpoints and ideas on the design and synthesis of bioactive hydrogels with the state-of-the-art knowledges of materials science and nanotechnology, and will bridge the connection of materials science and biomedicine, and further inspire clinical potential of bioactive hydrogels in biomedical fields.

Clinical management of dural defects: A review

Dural defects are common in spinal and cranial neurosurgery. A series of complications, such as cerebrospinal fluid leakage, occur after rupture of the dura. Therefore, treatment strategies are necessary to reduce or avoid complications. This review comprehensively summarizes the common causes, risk factors, clinical complications, and repair methods of dural defects. The latest research progress on dural repair methods and materials is summarized, including direct sutures, grafts, biomaterials, non-biomaterial materials, and composites formed by different materials. The characteristics and efficacy of these dural substitutes are reviewed, and these materials and methods are systematically evaluated. Finally, the best methods for dural repair and the challenges and future prospects of new dural repair materials are discussed.

Electrospun Nanofibers for Dura Mater Regeneration: A Mini Review on Current Progress

Dural defects are a common problem in neurosurgical procedures and should be repaired to avoid complications such as cerebrospinal fluid leakage, brain swelling, epilepsy, intracranial infection, and so on. Various types of dural substitutes have been prepared and used for the treatment of dural defects. In recent years, electrospun nanofibers have been applied for various biomedical applications, including dural regeneration, due to their interesting properties such as a large surface area to volume ratio, porosity, superior mechanical properties, ease of surface modification, and, most importantly, similarity with the extracellular matrix (ECM). Despite continuous efforts, the development of suitable dura mater substrates has had limited success. This review summarizes the investigation and development of electrospun nanofibers with particular emphasis on dura mater regeneration. The objective of this mini-review article is to give readers a quick overview of the recent advances in electrospinning for dura mater repair.

A review on the synthesis and development of alginate hydrogels for wound therapy

Convenient and low-cost dressings can reduce the difficulty of wound treatment. Alginate gel dressings have the advantages of low cost and safe usage, and they have obvious potential for development in biomedical materials. Alginate gel dressings are currently a research area of great interest owing to their versatility, intelligent, and their application attempts in treating complex wounds. We present a detailed summary of the preparation of alginate hydrogels and a study of their performance improvement. Herein, we summarize the various applications of alginate hydrogels. The research focuses in this area mainly include designing multifunctional dressings for the treatment of various wounds and fabricating specialized dressings to assist physicians in the treatment of complex wounds (TOC). This review gives an outlook for future directions in the field of alginate hydrogel dressings. We hope to attract more research interest and studies in alginate hydrogel dressings, thus contributing to the creation of low-cost and highly effective wound treatment materials.

Application of Single-Cell and Spatial Omics in Musculoskeletal Disorder Research

Musculoskeletal disorders, including fractures, scoliosis, heterotopic ossification, osteoporosis, osteoarthritis, disc degeneration, and muscular injury, etc., can occur at any stage of human life. Understanding the occurrence and development mechanism of musculoskeletal disorders, as well as the changes in tissues and cells during therapy, might help us find targeted treatment methods. Single-cell techniques provide excellent tools for studying alterations at the cellular level of disorders. However, the application of these techniques in research on musculoskeletal disorders is still limited. This review summarizes the current single-cell and spatial omics used in musculoskeletal disorders. Cell isolation, experimental methods, and feasible experimental designs for single-cell studies of musculoskeletal system diseases have been reviewed based on tissue characteristics. Then, the paper summarizes the latest findings of single-cell studies in musculoskeletal disorders from three aspects: bone and ossification, joint, and muscle and tendon disorders. Recent discoveries about the cell populations involved in these diseases are highlighted. Furthermore, the therapeutic responses of musculoskeletal disorders, especially single-cell changes after the treatments of implants, stem cell therapies, and drugs are described. Finally, the application potential and future development directions of single-cell and spatial omics in research on musculoskeletal diseases are discussed.