Injectable Hydrogel Capable of In Situ Covalent Crosslinking for Permanent Embolization

Hydrogel-exosome complexes: a novel strategy for cardiovascular regeneration

Cardiovascular disease (CVD) remains one of the leading causes of high mortality and morbidity worldwide, posing a substantial threat to global health. Mesenchymal stem cell (MSC) therapy has emerged as a promising treatment approach, primarily through the secretion of various bioactive factors. Exosomes (Exos), in particular, stand out as the most effective components, as their noncoding RNA and proteins play a crucial role in promoting the repair of cardiac function, positioning them a promising cell-free therapy for CVD. However, challenges such as poor stability, low delivery efficiency, weak targeting, and rapid immune-mediated clearance hinder the broader application of Exos, presenting significant obstacles for further clinical translation. Recent advancements in biomaterials, particularly hydrogels, offer new avenues for Exos-based CVD therapies. Hydrogels, with their ability to improve stability, release control, and targeting, have gained considerable attention in the biomedical field. This review explores the latest research developments regarding the treatment of CVD using Exos, and highlights their synergistic application with hydrogels, which provide valuable insights for advancing Exos-based therapies and developing novel therapeutic strategies for CVD.

In Situ Forming Supramolecular Nanofiber Hydrogel as a Biodegradable Liquid Embolic Agent for Postembolization Tissue Remodeling

Embolic agents have been widely used to treat blood vessel abnormalities in interventional radiology as a minimally invasive procedure. However, only a few biodegradable liquid embolic agents exhibit high embolization performance, biodegradability, and operability. Herein, the design of in situ-forming supramolecular nanofiber (SNF) hydrogels is reported as biodegradable liquid embolic agents with the assistance of Bayesian optimization through an active learning pipeline. Chemically modified gelatin with hydrogen-bonding moieties produces fibrin-inspired nanofiber-based hydrogels with a high blood coagulation capacity. The low viscosity of the SNF hydrogels makes them injectable using a microcatheter, and the hydrogel shows sufficient tissue adhesion to the blood vessel walls and very weak adhesion to the catheter tubes. Moreover, the SNF hydrogels exhibit high blood compatibility, cytocompatibility, cell-adhesive properties, and biodegradability (in vitro and in vivo). Intravascularly delivered SNF hydrogels induce embolization of rat femoral arteries. This biodegradable liquid embolic agent could be a powerful tool for interventional radiology in the treatment of various diseases, including aortic aneurysm stent grafting, gynecological diseases, and liver cancer.

Bidirectional Enzyme Inhibition and Activation for In Situ Formation of Injectable Hydrogel Using a Bispecific Aptamer

In situ injectable hydrogels have been explored for biomedical applications, including regenerative medicine and drug delivery. However, controlling the kinetics of their gelation to facilitate easy injection remains a challenge. The purpose of this study was to demonstrate the potential of using bispecific aptamers and complementary sequences as a bidirectional modulation system for controlling enzyme-mediated hydrogel formation kinetics. The results show that a bispecific thrombin-binding aptamer effectively inhibits thrombin activity and significantly slowed fibrin hydrogel formation. Upon interaction with its complementary sequence, this inhibition could be reversed. As a result, the aptamer-bound thrombin was activated, leading to an acceleration of the fibrin formation kinetics. Thus, bispecific aptamers and complementary sequences can effectively function as dynamic control systems for enzyme-catalyzed in situ injectable hydrogel formation.

The recent research progress in the application of the nanozyme-hydrogel composite system for drug delivery

Hydrogels, comprising 3D hydrophilic polymer networks, have emerged as promising biomaterial candidates for emulating the structure of biological tissues and delivering drugs through topical administration with good biocompatibility. Nanozymes can catalyze endogenous biomolecules, thereby initiating or inhibiting in vivo biological processes. A nanozyme-hydrogel composite inherits the biological functions of hydrogels and nanozymes, where the nanozyme serves as the catalytic core and the hydrogel forms the structural scaffold. Moreover, the composite can concentrate nanozymes in targeted lesions and catalyze the binding of a specific group of substrates, resulting in pathological microenvironment remodeling and drug-penetrating barrier impairment. The composite also shields nanozymes to prevent burst release during catalytic production and reduce related toxicity. Currently, the application of these composites has been extended to antibacterial, anti-inflammatory, anticancer, and tissue repair applications. In this review, we elucidate the preparation methods for nanozyme-hydrogel composites, provide compelling evidence of their advantages in drug delivery and provide a comprehensive overview of their biological application.

Regulation of physicochemical properties of alginate-based hydrogels and preliminary applications in wound healing

Alginate (Alg) hydrogels have demonstrated great potential in drug delivery, wound dressings, and tissue engineering. However, the practical applications of conventional Alg hydrogels suffer from rapid degradation, insufficient controlled drug release, and poor adhesion to tissues. In this paper, the physicochemical properties of Alg hydrogels were comprehensively modulated through chemical modification and the incorporation of various polymers. The results showed that introducing neutral polymers stabilized Alg hydrogels at room temperature. However, this stabilizing effect did not persist at 37 °C. The cationic chitosan (CS) can bind to Alg through electrostatic interaction. The incorporation of CS substantially improved the stability of Alg hydrogels and remarkably prolonged the release of BSA from hydrogels to 14 days at 37 °C. Meanwhile, introducing dopamine (DA)-modified Alg enhanced the adhesion of hydrogel to porcine skin. The optimized hydrogels were utilized to encapsulate platelet-rich plasma (PRP). The PRP-loaded composite hydrogel (2 wt% Alg, with a Ca2+/carboxyl group molar ratio of 0.2, a DA/carboxyl group molar ratio of 0.2, and a CS content of 30 % of Alg) exhibited an excellent therapeutic effect in the healing of rabbit shoulder cuff injury. These findings provide valuable insights into the modulation of physicochemical properties of hydrogels for biomedical applications.

Shape Self-Adaptive Liquid Embolic Agent for Ultrafast and Durable Vascular Embolization

Minimally invasive embolization greatly decreases the mortality resulting from vascular injuries while still suffering from a high risk of recanalization and systematic thrombosis due to the intrinsic hydrophobicity and poor adhesion of the clinically used liquid embolic agent of Lipiodol. In this study, a shape self-adaptive liquid embolic agent was developed by mixing biocompatible poly(acrylic acid) (PAA), two-dimensional magnesium-aluminum layered double hydroxide (LDH), and poly(ethylene glycol)200 (PEG200). Upon contact with blood, the injectable PAA-LDH@PEG200 would quickly absorb water to form an adhesive and mechanically strong PAA-LDH thin hydrogel within 5 s, which could firmly adhere to the blood vessel wall for ultrafast and durable embolization. In addition, benefiting from the "positively charged nucleic center effect" of LDH nanosheets, the liquid PAA-LDH@PEG200 could avoid vascular distension by PAA overexpansion and possess high shock-resistant mechanical strength from the blood flow. Furthermore, both in vitro and in vivo embolization experiments demonstrated the complete embolic capacity of liquid PAA-LDH@PEG200 without the occurrence of recanalization for 28 days and also the great potential to act as a platform to couple with chemotherapeutic drugs for the minimized transcatheter arterial chemoembolization (TACE) treatment of VX2 tumors without recurrence for 18 days. Thus, liquid PAA-LDH@PEG200 developed here possesses great potential to act as a shape self-adaptive liquid embolic agent for ultrafast and durable vascular embolization.

OnyxTMGel or Coil versus Hydrogel as Embolic Agents in Endovascular Applications: Review of the Literature and Case Series

This review focuses on the use of conventional gel or coil and "new" generation hydrogel used as an embolic agent in endovascular applications. In general, embolic agents have deep or multidistrict vascular penetration properties as they ensure complete occlusion of vessels by exploiting the patient's coagulation system, which recognises them as substances foreign to the body, thus triggering the coagulation cascade. This is why they are widely used in the treatment of endovascular corrections (EV repair), arteriovenous malformations (AVM), endoleaks (E), visceral aneurysms or pseudo-aneurysms, and embolisation of pre-surgical or post-surgical (iatrogenic) lesions. Conventional gels such as Onyx or coils are now commercially available, both of which are frequently used in endovascular interventional procedures, as they are minimally invasive and have numerous advantages over conventional open repair (OR) surgery. Recently, these agents have been modified and optimised to develop new embolic substances in the form of hydrogels based on alginate, chitosan, fibroin and other polymers to ensure embolisation through phase transition phenomena. The main aim of this work was to expand on the data already known in the literature concerning the application of these devices in the endovascular field, focusing on the advantages, disadvantages and safety profiles of conventional and innovative embolic agents and also through some clinical cases reported. The clinical case series concerns the correction and exclusion of endoleak type I or type II appeared after an endovascular procedure of exclusion of aneurysmal abdominal aortic (EVAR) with a coil (coil penumbra released by a LANTERN microcatheter), the exclusion of renal arterial malformation (MAV) with a coil (penumbra coil released by a LANTERN microcatheter) and the correction of endoleak through the application of Onyx 18 in the arteries where sealing by the endoprosthesis was not guaranteed.

Construction of an Injectable Composite Double-Network Hydrogel as a Liquid Embolic Agent

Conventional embolists disreputably tend to recanalization arising from the low filling ratio due to their rigidity or instability. As a result, intelligent hydrogels with a tunable modulus may meaningfully improve the therapeutic efficacy. Herein, an injectable composite double-network (CDN) hydrogel with high shear responsibility was prepared as a liquid embolic agent by cross-linking poly(vinyl alcohol) (PVA) and carboxymethyl chitosan (CMC) via dynamic covalent bonding of borate ester and benzoic-imine. A two-dimensional nanosheet, i.e., layered double hydroxide (LDH), was incorporated into the network through physical interactions which led to serious reduction of yield stress for the injection of the hydrogel and the capacity for loading therapeutic agents like indocyanine green (ICG) and doxorubicin (DOX) for the functions of photothermal therapy (PTT) and chemotherapy. The CDN hydrogel could thus be transported through a thin catheter and further in situ strengthened under physiological conditions, like in blood, by secondarily cross-linking with phosphate ions for longer degradation duration and better mechanical property. These characteristics met the requirements of arterial interventional embolization, which was demonstrated by renal embolism operation on rabbits, and meanwhile favored the inhibition of subcutaneous tumor growth on an animal model. Therefore, this work makes a breakthrough in the case of largely reducing the embolism risks, thus affording a novel generation for interventional embolization.

Micromolded honeycomb scaffold design to support the generation of a bilayered RPE and photoreceptor cell construct

Age-related macular degeneration (AMD) causes blindness due to loss of retinal pigment epithelium (RPE) and photoreceptors (PRs), which comprise the two outermost layers of the retina. Given the small size of the macula and the importance of direct contact between RPE and PRs, the use of scaffolds for targeted reconstruction of the outer retina in later stage AMD and other macular dystrophies is particularly attractive. We developed microfabricated, honeycomb-patterned, biodegradable poly(glycerol sebacate) (PGS) scaffolds to deliver organized, adjacent layers of RPE and PRs to the subretinal space. Furthermore, an optimized process was developed to photocure PGS, shortening scaffold production time from days to minutes. The resulting scaffolds robustly supported the seeding of human pluripotent stem cell-derived RPE and PRs, either separately or as a dual cell-layered construct. These advanced, economical, and versatile scaffolds can accelerate retinal cell transplantation efforts and benefit patients with AMD and other retinal degenerative diseases.

Double network hydrogels: Design, fabrication, and application in biomedicines and foods

Research on the design, fabrication, and application of double network (DN) hydrogels, assembled from pairs of polymers, has grown recently due to their unique structural, physicochemical, and functional properties. DN hydrogels can be designed to exhibit a broader range of functional attributes than single network (SN) ones, which extends their applications in various fields. There has been strong interest in the development of biopolymer DN hydrogels because of their environmental, sustainability, and safety benefits. However, there is limited knowledge on the formation and application of these novel materials. This article reviews the principles underlying the design and fabrication of hydrogels using different crosslinking approaches, including covalent and/or non-covalent bonding, and the formation mechanisms, network structures, and functional attributes of different DN hydrogels. The impact of polymer composition, structural organization, and bonding on the mechanical and functional properties of DN hydrogels is reviewed. Potential applications of these hydrogels are highlighted, including in tissue engineering, biomedicines, and foods. The functional attributes of DN hydrogels can be tailored to each of these applications by careful selection of the biopolymers and crosslinking mechanisms used to assemble them. Finally, areas where further research are needed to overcome the current limitations of DN hydrogels are highlighted.

Super-Rapid In Situ Formation of a Silver Ion-Induced Supramolecular Hydrogel with Efficient Antibacterial Activity for Root Canal Disinfection

Supramolecular hydrogels prepared using low-molecular-weight gelators have attracted considerable attention for biomedical applications. However, in situ supramolecular hydrogels are limited in terms of their prolonged gelation time and/or unstable nature at high temperatures. In this study, we constructed a stable supramolecular Ag-isoG hydrogel through super-rapid in situ formation, wherein hydrogelation process occurred instantaneously upon mixing isoG and Ag⁺ within 1 s under ambient conditions. Interestingly, unlike most nucleoside-based supramolecular hydrogels, this Ag-isoG hydrogel remains stable even at a high temperature (100 °C). Moreover, the as-designed hydrogel demonstrated significant antibacterial activity against Staphylococcus aureus and the oral bacterium Streptococcus mutans owing to the strong chelating ability of Ag ions, and the hydrogel exhibited relatively low cytotoxicity in root canal and an easy removal feature by saline. The hydrogel was then applied to a root canal infection model, which demonstrated strong antibacterial activity against Enterococcus faecalis, with performance even better than that of the regular calcium hydroxide paste. This feature makes the Ag-isoG hydrogel a prospective alternative material as intracanal medicaments for root canal treatment.

Development of Thiol-Maleimide hydrogels incorporating graphene-based nanomaterials for cancer chemo-photothermal therapy

Nano-sized materials have been widely explored in the biomedicine field, especially due to their ability to encapsulate drugs intended to be delivered to cancer cells. However, systemically administered nanomaterials face several barriers that can hinder their tumor-homing capacity. In this way, researchers are now focusing their efforts in developing technologies that can deliver the nanoparticles directly into the tumor tissue. Particularly, hydrogels assembled using Thiol-Maleimide Michael type additions are emerging for this purpose due to their capacity to incorporate high nanoparticles' doses in a compact 3D structure as well as good chemical selectivity, biocompatibility, and straightforward preparation. Nevertheless, such hydrogels have been mostly prepared using synthetic polymers, which is not ideal due to their poor biodegradability. In this work, a novel natural polymer-based Thiol-Maleimide hydrogel was produced for application in breast cancer chemo-photothermal therapy. To obtain natural polymers compatible with this crosslinking chemistry, Hyaluronic acid was endowed with Thiol groups and deacetylated Chitosan was grafted with Maleimide groups. Parallelly, Doxorubicin loaded Dopamine-reduced graphene oxide (DOX/DOPA-rGO) was prepared for attaining Near Infrared (NIR) light responsive chemo-photothermal nanoagents. By simply mixing Hyaluronic Acid-Thiol, deacetylated Chitosan-Maleimide and DOX/DOPA-rGO, Thiol-Maleimide crosslinked hydrogels incorporating this nanomaterial could be assembled (DOX/DOPA-rGO@TMgel). When breast cancer cells were incubated with DOPA-rGO@TMgel and exposed to NIR light (photothermal therapy), their viability was reduced to about 59 %. On the other hand, DOX/DOPA-rGO@TMgel (chemotherapy) reduced cancer cells' viability to 50 %. In stark contrast, the combined action of DOX/DOPA-rGO@TMgel and NIR light decreased breast cancer cells' viability to just 21 %, highlighting its chemo-photothermal potential.