Local H2 release remodels senescence microenvironment for improved repair of injured bone

Macrophage response to fibrin structure mediated by Tgm2-dependent mitochondrial mechanosensing

Following an injury at the implantation position, blood-material interactions form a fibrin architecture, which serves as the initial activator of foreign body response (FBR). However, there is limited knowledge regarding how the topography of fibrin architectures regulates macrophage behavior in mitigating FBR. Mechanical cues of the microenvironment have been reported to shape immune cell functions. Here, we investigated macrophage mechanobiology at the organelle level by constructing heterogeneous fibrin networks. Based on findings in vivo, we demonstrated that adhesion-mediated differentiation of mitochondrial function modulated macrophage polarization. The finite activation of integrin signaling upregulated transglutaminase 2 (Tgm2) in a trans-manner, augments PGC1α-mediated mitochondrial biogenesis. Our study highlighted the previously overlooked spatial structures of host proteins adsorbed on material surfaces, advocating for a paradigm shift in material design strategies, from focusing solely on physical properties to considering the modification of host proteins.

Micro-nano bubble hydrogen water irrigation improves the Cd tolerance of Ipomoea aquatica Forssk.: Rhizosphere micro-biotas modulation and oxidative stress alleviation

The application of exogenous hydrogen has been found to be beneficial for plant resistance to cadmium (Cd) stress; however, it is difficult to apply hydrogen-rich water for long-term application in agriculture due to the low solubility and rapid fugacity of H2 in water. The integration of micro-nano bubble hydrogen (MNBH) water with subsurface drip irrigation (SDI) technology could address such problems. However, the adaptation and response mechanisms of plants and soil to MNBH are still poorly understood. Here, by focusing on a Cd-susceptible plant water spinach (Ipomoea aquatica Forssk.), we found that MNBH (applied via an SDI system) significantly improved yield, plant height, and root morphological traits; increased chlorophyll content and photosynthetic rate; and increased levels of metallothioneins and stress-response phytohormones (ABA and SA), which was helpful in scavenging reactive oxygen species, decreasing the uptake of Cd by the plants, and alleviating Cd-induced oxidative stress. More importantly, MNBH application significantly improved the rhizosphere soil environment (pH, enzyme activities) and reconstituted the soil microbial community, which may play a critical role in reducing soil Cd bioavailability and promoting plant growth. This is the first case of MNBH water irrigation to mitigate soil Cd contamination, and the results of this study could contribute to the understanding of the potential effects of MNBH on the soil environment and the mechanism of action on plant resistance to Cd stress.

Hydrogen activates ACOD1-itaconate pathway to ameliorate steroid-associated osteonecrosis

Steroid-associated osteonecrosis (SAON) remains a challenging clinical condition as there are few effective preventive measures. This study investigates the effects of hydrogen (H2) administrated via saturated hydrogen-rich water (HRW) in mice received high dose of glucocorticoids (for inducing SAON model). Here we find that HRW treatment significantly reduces osteocyte apoptosis, improves deteriorated trabecular architecture, increases osteoblast numbers and the bone formation, while decreases osteoclast numbers and the bone resorption. Additionally, HRW-treated mice exhibit improved serum lipid profiles, including decreased levels of low-density lipoprotein (LDL), triglycerides (TG), and total cholesterol (T-CHO), as well as reduced lipid accumulation. HRW treatment also enhances blood perfusion and increases formation of type H vessels in SAON mice. We further demonstrate that HRW shifts the polarization of macrophages from M1 to M2 phenotype and suppresses inflammatory marker TNF-α. RNA sequencing data and subsequent validation reveal that HRW upregulates ACOD1 mRNA and protein levels in bone tissues. The protective effects of HRW are mimicked by supplementation with the itaconate derivative dimethyl itaconate in a dose-dependent manner, highlighting the importance of the ACOD1-itaconate pathway in the prevention of SAON by HRW. These findings indicate that HRW ameliorates SAON by modulating the ACOD1-itaconate pathway, presenting a novel avenue for the cost-effective prevention of osteonecrosis.

Micro/nanomotors for active inflammatory disease therapy

Inflammation is a carefully orchestrated response of the immune system to repair injured tissues and clear various damage factors. However, dysregulated inflammation can eventually contribute to the development and progression of various inflammatory diseases. Although anti-inflammatory drugs have demonstrated certain therapeutic efficacy in clinical settings, significant limitations still persist, highlighting the necessity for the development of improved approaches to address complex inflammatory conditions. Micro/nanomotors (MNMs) have shown significant promise for applications in the biomedical field due to their micro/nano-scale sizes and autonomous movement. Unlike traditional nanoparticles, which exhibit passive diffusion in biological fluids, MNMs can convert external energy into a driving force for self-propulsion. This capability not only enhances the tissue penetration depth and retention rates but also facilitates interaction with inflammatory lesions. Recent efforts have suggested that MNMs for inflammatory disease therapy could provide an efficient therapeutic effect. Herein, we mainly introduce the recent advances in inflammatory disease therapy based on MNMs. We conclude by discussing both the obstacles and potential opportunities for MNMs innovations in addressing inflammation.

Nanoconfinement of Ammonia Borane via Hybrid-Phased Titanate Nanocrystals Enables Sustained H2 Release for Diabetic Bone Repair

Despite its potential in hydrogen (H2) therapy, ammonia borane (AB) has limited biomedical applications due to its uncontrolled hydrolysis rate and potential to cause cytotoxicity. Existing material-based delivery strategies focus on accelerating AB hydrolysis for H2 production, hence exacerbating these issues. A new nanoconfinement strategy is reported, which loads AB onto oxygen-deficient, hybrid-phased titanate nanocrystals on implant surfaces through a unique one-end-anchored docking (OEAD) mechanism. This nanoconfinement strategy effectively restricts the release of AB molecules, allowing only water molecules to infiltrate the interlayer space for slow hydrolysis and sustained H2 release. This significantly prolongs the duration of H2 release and effectively circumvents the cytotoxicity associated with AB interacting with hydrogen peroxide (H2O2) in the inflammatory microenvironment. In vitro and in vivo have shown that sustained H2 release from the implant surface effectively alleviates diabetes-related oxidative stress, and combined with the release of magnesium ions (Mg2+) synergistically promotes innervated-vascularized bone regeneration.

Treating critical bone defects by using core-shell biological scaffold to regulate Fibrosis-Osteogenic homeostasis

Critical bone defects pose a significant challenge in the realm of bone defect repair. During the repair process, bone formation is crucial, as the occurrence of invasive tissue growth into the defect, known as fibrosis, is also a possibility. Excessive fibrosis can lead to a "filling effect," wherein fibrous tissue occupies the bone defect area, thereby impeding the bone formation and repair processes. Hence, regulating the dynamic balance between fibrosis and osteogenesis is pivotal to effectively treat critical bone defects. To mitigate the rapid fibrosis rate at the bone defect site, which may result in repair failure, we have devised and fabricated a biomimetic core-shell scaffold-PCL-FAPI/GelMA/HAMA-GBA@plasmid-knockdown SHN-3 (PCL-FAPI/GH-GBA@pk SHN-3)-aimed at modulating fibrosis and vascularization processes within the new callus. The outer "shell" structure of the scaffold employs polycaprolactone (PCL) electrospun nanofibers loaded with fibroblast activating protein inhibitor (FAPI). Utilizing hydrophobic PCL electrospun fibers effectively impedes the growth of exogenous fibrous tissue, while releasing FAPI to inhibit the growth of endogenous fibroblasts. The inner layer "nucleus" structure comprises GelMA/HAMA hydrogel-supported plasmid/polyamideamine (GBA@plasmid-knockdown SHN-3), which enhances the secretion of Slit3 protein and promotes the formation of Type H blood vessels by silencing the SHN-3 gene in osteoblasts. The biomimetic "core-shell" scaffold PCL-FAPI/GH-GBA@pkSHN-3 serves to prevent excessive fibrosis of the callus and foster the formation of Type H blood vessels within the new callus, effectively averting bone nonunion and expediting the repair process of critical bone defects.

Hydrogen-Bonded Organic Framework-Based NIR-II Activated Hydrogen Production for Treatment of Alzheimer's Disease Model Mice

Oxidative stress is the crucial pathologic factor for causing neuron death and cognitive impairment in the progression of Alzheimer's disease (AD). As a special antioxidant, molecular hydrogen (H2) is responsible for alleviating oxidative stress and associated inflammatory symptoms. However, in vivo continuous and efficient hydrogen accumulation is rather difficult to realize, thus frequent dosing is required to ensure the desired therapeutic effect. Herein, hydrogen-bonded organic frameworks (HOFs) composites are rationally designed to achieve sustainable near-infrared II (NIR-II) photocatalytic hydrogen evolution reaction for relieving neuroinflammation in AD model mice. The HOFs composites mainly consist of three parts: building block porphyrin as the photocatalyst, DSM (NIR-II-absorbing pyridinium hemicyanine dye) as fluorescent emitter, and platinum nanoparticles as co-catalyst. Under NIR-II laser illumination, DSM acts as an energy transducer to activate porphyrin to produce reductive hydrogen in situ. Specially, porphyrin selectively binds with the accumulated Cu ions in Aβ plaques and boosts H2 evolution. KLVFFAED (KD8) is covalently grafted on the HOFs to improve the blood-brain barrier permeability in vivo. This designed system exhibits an admirable therapeutic effect for relieving inflammation and recovering cognitive disorder in AD model mice, thus providing a new way for exploring HOFs used for sustainable hydrogen therapy.

Galvanic Cell Bipolar Microneedle Patches for Reversing Photoaging Wrinkles

Excessive exposure to ultraviolet (UV) radiation is a major factor in the development of skin photoaging wrinkles. While current treatments can slow the progression of photoaging, it is very difficult to achieve complete reversal. This study introduces galvanic cell microneedle (GCMN) patches with magnesium-containing bipolar electrodes. These patches operate through a galvanic cell mechanism, generating microcurrents and releasing hydrogen gas and magnesium ions via a redox reaction. The combination of hydrogen's antioxidant and anti-inflammatory properties, microcurrent-induced stimulation of cell migration, and magnesium's promotion of angiogenesis and macrophage M2 anti-inflammatory polarization synergistically works to reverse photoaging wrinkles and rejuvenate the skin. Furthermore, this work examines how GCMNs may influence the transforming growth factor-β/Smad (TGF-β/Smad) pathway. This approach shows promise for advancing research and development in the field of medical cosmetology.

3D printed shape-memory piezoelectric scaffolds with in-situ self-power properties for bone defect repair

Electrical stimulation has been shown to regulate early immunity and late-stage osteogenesis in bone repair. However, achieving in-situ electrical stimulation in the form of self-power in vivo during the initial postoperative stages when the patients have limited mobility remains challenging. In this study, we developed a 3D-printed in-situ self-powered composite scaffold composed of shape memory polyurethane elastomers (SMPU) and polyvinylidene fluoride (PVDF) piezoelectric nanofibers. The composite scaffold demonstrates excellent shape memory performance, allowing for minimally invasive implantation. During the shape memory process, the composite scaffold can provide mechanical force stimulation to PVDF nanofibers to generate charge. Therefore, self-power was achieved through the integration of the shape memory process and piezoelectric effects, and it can be used for in-situ electrical stimulation during the initial postoperative period. Additionally, the composite scaffold can output voltage under continuous mechanical force stimulation, indicating that the patients can apply sustained mechanical force stimulation to the composite scaffold to output voltage through rehabilitation exercises when the patients regain mobility. Both cell experiments and animal studies confirmed that this composite scaffold can effectively regulate the immune microenvironment and enhance osteogenesis. This study successfully achieves in-situ electrical stimulation in the form of self-power by integrating the shape memory process and piezoelectric effects, which is expected to be an effective repair strategy for bone tissue engineering.

3D printed scaffolds with multistage osteogenic activity for bone defect repair

The bone defect repair is a complex process including immune regulation, stem cell osteogenic differentiation and extracellular matrix mineralization. Current bone tissue engineering approaches often fail to adapt throughout the above osteogenic process, resulting in suboptimal repair outcomes. To address this problem, a 3D-printed scaffold with multistage osteogenic activity based on shape-memory elastomer and electroactive material is developed. The scaffold exhibits excellent shape memory performance and can trigger shape recovery by physiological temperature. The physiological temperature-triggered shape-memory behavior makes the scaffold promising for minimally invasive implantation. After electric field polarization, the scaffold's surface carries the negative charge, which can activate the PI3K/Akt signaling pathway to promote the polarization of macrophages to M2 phenotype and activate the FAK/ERK signaling pathway to promote osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), indicating that the scaffold can effectively participate in immune microenvironment regulation and stem cell osteogenic differentiation. Additionally, the negative charge on the scaffold's surface can attract calcium and phosphate ions, forming a mineralized matrix and promoting late-stage extracellular matrix mineralization by continuously supplying mineralizing ions such as calcium and phosphate. Overall, this study introduces a 3D-printed scaffold with multistage osteogenic activity, offering a promising strategy for bone defect repair.

Material-Mediated Immunotherapy to Regulate Bone Aging and Promote Bone Repair

As the global population ages, an increasing number of elderly people are experiencing weakened bone regenerative capabilities, resulting in slower bone repair processes and associated risks of various complications. This review outlines the research progress on biomaterials that promote bone repair through immunotherapy. This review examines how manufacturing technologies such as 3D printing, electrospinning, and microfluidic technology contribute to enhancing the therapeutic effects of these biomaterials. Following this, it provides detailed introductions to various anti-osteoporosis drug delivery systems, such as injectable hydrogels, nanoparticles, and engineered exosomes, as well as bone tissue engineering materials and coatings used in immunomodulation. Moreover, it critically analyzes the current limitations of biomaterial-mediated bone immunotherapy and explores future research directions for material-mediated bone immunotherapy. This review aims to inspire new approaches and broaden perspectives in addressing the challenges of bone repair and aging by exploring innovative biomaterial-mediated immunotherapy strategies.

A Sustained H2/Fluorouracil-Releasing Suppository for High-efficacy and Low-Toxicity Hydrogenochemotherapy of Colon Cancer

To attenuate the intestinal toxicity of chemotherapeutic drugs from rectal suppositories and enhance their chemotherapeutic outcome is greatly significant, but maintains a challenge. In this work, a new strategy of local synergistic hydrogenochemotherapy is proposed to attenuate side effects and enhance therapeutic efficacy based on the anti-cancer selectivity and normal cells-protecting effect of H2, and construct a novel anti-cancer formulation of rectal suppository (5-FU/CSN@FAG) by fatty acid glycerides (FAG) encapsulating 5-fluorouracil (5-FU, a first-line drug for colorectal cancer treatment) and cerium silicide nanoparticles (CSN) with a sustained hydrolytic H2 release behavior which is synchronous with 5-FU release. The 3-week treatment with the suppository once a day can not only completely eradicate colon tumors without tumor recurrence after suppository administration withdrawal, but also efficiently protect the intestinal tract from chemotherapeutic damage. Mechanistically, H2 generated by CSN reduces the toxicity of 5-FU to normal cells in the intestinal tract by scavenging over-expressed reactive oxygen species and correcting energy metabolism, and also assists 5-FU to promote the apoptosis of colon tumor cells by inhibiting their respiration through a CO signaling pathway. High biosafety and therapeutic validity endow the developed suppository with a high potential for clinical translation.

Hydrolysis of 2D Nanosheets Reverses Rheumatoid Arthritis Through Anti-Inflammation and Osteogenesis

Rheumatoid arthritis (RA) is a kind of inflammation homeostasis disorder that dysfunctions the joints. Clinically, medications against RA focus simply on mitigating the focal inflammation, without considering pro-osteogenesis re-modeling of the bone microenvironment. In the present work, 2D layered calcium disilicide nanoparticles (CSNs) are fabricated by facile aqueous exfoliation. The hydrolysis of CSNs produces anti-oxidative H2, alkaline Ca(OH)2, and silica. These moieties play significant roles in anti-oxidation, anti-inflammation, and pro-osteogenesis resulting in considerably better RA therapeutic consequences than anti-inflammation alone. Hydrogen gas is validated to eliminate excessive hydroxyl radicals and regulate macrophage re-polarization; the generated Ca(OH)2 can neutralize the acidic microenvironment and inhibit the osteoclast activity; and, the dissolved Ca2+ can effectively complex with phosphates to mineralize Ca3(PO4)2, promoting the osteogenesis of the focal joint. The multifunctional performances of CSNs are further confirmed in arthritic mouse and rabbit models, providing an advanced and robust therapeutic strategy against RA with high biocompatibility and clinical transformable promises.

Cordycepin-Loaded Dental Pulp Stem Cell-Derived Exosomes Promote Aged Bone Repair by Rejuvenating Senescent Mesenchymal Stem Cells and Endothelial Cells

Aging impairs bone marrow mesenchymal stem cell (BMSC) functions as well as associated angiogenesis which is critical for bone regeneration and repair. Hence, repairing bone defects in elderly patients poses a formidable challenge in regenerative medicine. Here, the engineered dental pulp stem cell-derived exosomes loaded with the natural derivative of adenosine Cordycepin (CY@D-exos) are fabricated by means of the intermittent ultrasonic shock, which dually rejuvenates both senescent BMSCs and endothelial cells and significantly improve bone regeneration and repair in aged animals. CY@D-exos can efficiently overcome the senescence of aged BMSCs and enhance their osteogenic differentiation by activating NRF2 signaling and maintaining heterochromatin stability. Importantly, CY@D-exos also potently overcomes the senescence of vascular endothelial cells and promotes angiogenesis. In vivo injectable gelatin methacryloyl (GelMA) hydrogels with sustained release of CY@D-exos can accelerate bone injury repair and promote new blood vessel formation in aged animals. Taken together, these results thus demonstrate that cordycepin-loaded dental pulp stem cell-derived exosomes display considerable potential to be developed as a next-generation therapeutic agent for promoting aged bone regeneration and repair.

Palladium-Based Nanocomposites Remodel Osteoporotic Microenvironment by Bone-Targeted Hydrogen Enrichment and Zincum Repletion

Osteoporosis presents a marked global public health challenge, characterized by deficient osteogenesis and a deteriorating immune microenvironment. Conventional clinical interventions primarily target osteoclast-mediated bone damage, yet lack a comprehensive therapeutic approach that balances bone formation and resorption. Herein, we introduce a bone-targeted nanocomposite, A-Z@Pd(H), designed to address these challenges by integrating diverse functional components. The nanocomposite incorporates internal hydrogen-carrying nanozymes, which effectively scavenge multiple reactive oxygen species (ROS) and synergistically engage the autophagy-lysosome pathway to accelerate endogenous ROS degradation in macrophages. This mechanism disrupts the vicious cycle of autophagic dysfunction-ROS accumulation-macrophage inflammation. In addition, external metal-organic frameworks release zinc ions (Zn2+) in response to the acidic osteoporotic environment, thereby promoting osteogenesis. In a murine model of osteoporosis, intravenous administration of A-Z@Pd(H) leads to preferential accumulation in the femur, thereby remodeling the osteoporotic microenvironment through immune regulation, osteogenesis promotion, and osteoclast inhibition. These findings suggest that this system composed of hydrogen therapy and ion therapy may be a promising candidate for bone-targeted comprehensive therapy in osteoporosis.

Sandwich-Structured Nanofiber Dressings Containing MgB2 and Metformin Hydrochloride With ROS Scavenging and Antibacterial Properties for Wound Healing in Diabetic Infections

The treatment of chronic diabetic wounds is a major challenge due to oxidative stress, persistent hyperglycemia, and susceptibility to bacterial infection. In this study, multifunctional sandwich-structured nanofiber dressings (SNDs) are prepared via electrospinning. The SNDs consisted of an outer layer of hydrophobic polylactic acid (PLA) fibers encapsulating MgB2 nanosheets (MgB2 NSs), a middle layer of PLA and polyvinylpyrrolidone (PVP) fibers encapsulating the MgB2 NSs and metformin hydrochloride complex (MgB2-Met), and an inner layer of water-soluble PVP fibers encapsulating MgB2-Met. Because of their special sandwich structure, SNDs have high photothermal conversion efficiency (24.13%) and photothermal cycle performance. SNDs also exhibit a photothermal effect, bacteria-targeting effect of MgB2, electrostatic attraction ability of metformin hydrochloride (Met), and strong antibacterial activity against Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA). SNDs can eliminate intracellular reactive oxygen species (ROS) by regulating the hydrogen release from MgB2. In addition, SNDs have good biocompatibility, can effectively inhibit the inflammatory factor Interleukin-6 (IL-6), and promote granulation tissue formation, collagen deposition, and diabetic wound healing. These findings offer a promising approach for clinical treatment of diabetic wounds.

Hydrogen regulated pyroptosis through NLRP3-GSDMD pathway to improve airway mucosal oxidative stress injury induced by endotracheal tube cuff compression

The cuff of endotracheal tube (ETT) is an indispensable device for establishing an artificial airway, yet cuff-induced compression often causes damage to the airway mucosa. The mechanism of this damage involves mucosal compression ischemia and the oxidative stress injury following reperfusion. Currently, there is a lack of effective strategies to protect the mucosa. Hydrogen, as a natural antioxidant, has demonstrated significant potential in the prevention and treatment of oxidative stress injuries. This study aimed to determine the protective effects of hydrogen on compressed airway mucosa. We found that the damage to the airway mucosa caused by ETT cuff compression was associated with oxidative stress-induced pyroptosis of airway epithelial cells. Inhalation of hydrogen effectively reduced the levels of reactive oxygen species, significantly ameliorating changes in epithelial cell pyroptosis, and this protective effect is linked to the inhibition of the NLRP3-GSDMD pathway. Further cellular studies, involving knockdown and overexpression of NLRP3, clarified that hydrogen exerts its protective effects on the airway mucosa by inhibiting epithelial cell pyroptosis. Additionally, we observed that using hydrogen-rich saline to inflate the ETT cuff in patients under general anesthesia significantly reduced postoperative sore throat. This study confirms that hydrogen effectively enhances tolerance of airway mucosa to oxidative stress injuries, offering a potential preventive and therapeutic strategy for protecting the airway mucosa in patients undergoing endotracheal intubation.

Multifunctional Bone Regeneration Membrane with Flexibility, Electrical Stimulation Activity and Osteoinductive Activity

The use of membrane-based guided bone regeneration techniques has great potential for single-stage reconstruction of critical-sized bone defects. Here, a multifunctional bone regeneration membrane combining flexible elasticity, electrical stimulation (ES) and osteoinductive activity is developed by in situ doping of MXene 2D nanomaterials with conductive functionality and β-TCP particles into a Poly(lactic acid-carbonate (PDT) composite nano-absorbable membrane (P/T/MXene) via electrostatic spinning technique. The composite membrane has good feasibility due to its temperature sensitivity, elastic memory capacity, coordinated degradation profile and easy preparation process. In vitro experiments showed the P/T/MXene membrane effectively promoted the recruitment and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) under ES and enhanced the angiogenic capacity of endothelial cells, which synergistically promoted bone regeneration through neovascularization. In addition, an in vivo rat model of cranial bone defects further confirmed the bone regeneration efficacy of the P/T/MXene membrane. In conclusion, the developed P/T/MXene membrane can effectively promote bone regeneration through their synergistic multifunctional effects, suggesting the membranes have great potential for guiding tissue regeneration and providing guidance for the biomaterials design.

Microorganism microneedle micro-engine depth drug delivery

As a transdermal drug delivery method, microneedles offer minimal invasiveness, painlessness, and precise in-situ treatment. However, current microneedles rely on passive diffusion, leading to uncontrollable drug penetration. To overcome this, we developed a pneumatic microneedle patch that uses live Enterobacter aerogenes as microengines to actively control drug delivery. These microbes generate gas, driving drugs into deeper tissues, with adjustable glucose concentration allowing precise control over the process. Our results showed that this microorganism-powered system increases drug delivery depth by over 200%, reaching up to 1000 μm below the skin. In a psoriasis animal model, the technology effectively delivered calcitriol into subcutaneous tissues, offering rapid symptom relief. This innovation addresses the limitations of conventional microneedles, enhancing drug efficiency, transdermal permeability, and introducing a creative paradigm for on-demand controlled drug delivery.

In-situ hydrogen-generating injectable short fibers for osteoarthritis treatment by alleviating oxidative stress

Hydrogen (H₂) has great potential in the treatment of osteoarthritis, but its rapid diffusion and short retention time make it difficult to exert stable therapeutic effects. This study developed a short-fiber injectable material that can continuously generate hydrogen in situ to eliminate reactive oxygen species (ROS), alleviate oxidative stress and inflammation, and promote tissue repair. We prepared H-Si nanosheets with high hydrogen generation efficiency using a wet chemical exfoliation method and combined them with GelMA short fibers via electrospinning technology, achieving the in situ delivery of H-Si nanosheets and regulated hydrogen generation rate through the encapsulation and degradation of GelMA, ultimately achieving continuous and controlled hydrogen supply and stable therapeutic effects for osteoarthritis. In vitro and in vivo experiments confirmed the safety and efficacy of this material. The results showed that the material could continuously and efficiently generate hydrogen in simulated physiological environments (100 mg of material could generate 8.6 % hydrogen), effectively eliminate cellular reactive oxygen species (ROS positive rate reduced by 85.89 %), reduce cellular senescence and apoptosis (cell death rate decreased by 52 %, SA-βgal expression decreased by 78.3 %), promote normal chondrocyte function (Col II expression increased by 67.4 %, Ki67 expression increased by 87.5 %), and improve osteoarthritis in rats (OARSI score increased by 216 %). The in situ hydrogen generation and control system designed in this study provides a new method for the hydrogen's local and stable treatment of osteoarthritis. STATEMENT OF SIGNIFICANCE: Hydrogen (H₂) has great potential in the treatment of osteoarthritis by alleviating oxidative stress, but its rapid diffusion and short retention time make it difficult to exert stable therapeutic effects. This study introduces an innovative injectable material combining H-Si nanosheets and GelMA short fibers to address this issue. By enabling continuous in situ hydrogen generation, this material effectively eliminates reactive oxygen species, reduces oxidative stress and inflammation, and promotes tissue repair. In vitro and in vivo experiments demonstrate its high hydrogen generation efficiency, safety, and therapeutic efficacy, offering a promising new approach for osteoarthritis management.

A hydrogen generator composed of poly (lactic-co-glycolic acid) nanofibre membrane loaded iron nanoparticles for infectious diabetic wound repair

Diabetic wound, which is chronic skin disease, poses a significant challenge in clinical practice because of persistent inflammation and impaired angiogenesis. Recently, hydrogen has emerged as a novel therapeutic agent due to its superior antioxidant and anti-inflammatory properties. In this study, we engineered a poly (lactic-co-glycolic acid) (PLGA) electrospun nanofibre membrane loaded with citric acid (CA) and iron (Fe) nanoparticles, referred to as Fe@PLGA + CA. Our in vitro assays demonstrated that the Fe@PLGA + CA membrane continuously generated and released hydrogen molecules via a chemical reaction between Fe and CA in an acidic microenvironment created by CA. We also discovered that hydrogen can ameliorate fibroblast migration disorders by reducing the levels of matrix metalloproteinase 9 (MMP9). Furthermore, we confirmed that hydrogen can scavenge or biochemically neutralise accumulated reactive oxygen species (ROS), inhibit pro-inflammatory responses, and induce anti-inflammatory reactions. This, in turn, promotes vessel formation, wound-healing and accelerates skin regeneration. These findings open new possibilities for using elemental iron in skin dressings and bring us one step closer to implementing hydrogen-releasing biomedical materials in clinical practice.

Site-specific bioorthogonal regulation of bone morphogenetic protein 2 expression for effective bone regeneration

Growth factor holds great promise for bone regeneration, and spatiotemporal control of their expressing through site-specific reactions is crucial but challenging for on-demand therapy. In this study, we present the development of a novel unnatural amino acids (UAAs)-triggered therapeutic switch (UATS) system, composed of an orthogonal aminoacyl-tRNA-synthase (aaRS)-tRNA pair and a bone morphogenetic protein 2 (BMP2) gene harboring premature stop codon, which enable in situ and on-demand initiation of the expression of BMP2. The resulting UATS system allowed specifically control of base expressing on the BMP2 mRNA that switched to the BMP2 protein with complete structure and function to facilitate bone regeneration. Our investigations showed that the UATS system exhibits remarkable attributes of rapid, sensitive, reversible, and sustained BMP2 expression both in vitro and in vivo settings. Moreover, the implantation of microencapsulated cells with UATS system is applied to a mouse femur defect model, demonstrating high effciency in controlled expressing of BMP2 protein and substantial repair of bone defect following oral administration of UAAs. Therefore, our findings underscore the great potential of UATS system for on-demand awakening of functional growth factor, thus offering promising prospects in the realm of regenerative medicine.

Bone targeted nano-drug and nano-delivery

There are currently no targeted delivery systems to satisfactorily treat bone-related disorders. Many clinical drugs consisting of small organic molecules have a short circulation half-life and do not effectively reach the diseased tissue site. This coupled with repeatedly high dose usage that leads to severe side effects. With the advance in nanotechnology, drugs contained within a nano-delivery device or drugs aggregated into nanoparticles (nano-drugs) have shown promises in targeted drug delivery. The ability to design nanoparticles to target bone has attracted many researchers to develop new systems for treating bone related diseases and even repurposing current drug therapies. In this review, we shall summarise the latest progress in this area and present a perspective for future development in the field. We will focus on calcium-based nanoparticle systems that modulate calcium metabolism and consequently, the bone microenvironment to inhibit disease progression (including cancer). We shall also review the bone affinity drug family, bisphosphonates, as both a nano-drug and nano-delivery system for bone targeted therapy. The ability to target and release the drug in a controlled manner at the disease site represents a promising safe therapy to treat bone diseases in the future.

Microbiota-bone axis in ageing-related bone diseases

Bone homeostasis in physiology depends on the balance between bone formation and resorption, and in pathology, this homeostasis is susceptible to disruption by different influences, especially under ageing condition. Gut microbiota has been recognized as a crucial factor in regulating host health. Numerous studies have demonstrated a significant association between gut microbiota and bone metabolism through host-microbiota crosstalk, and gut microbiota is even an important factor in the pathogenesis of bone metabolism-related diseases that cannot be ignored. This review explores the interplay between gut microbiota and bone metabolism, focusing on the roles of gut microbiota in bone ageing and aging-related bone diseases, including osteoporosis, fragility fracture repair, osteoarthritis, and spinal degeneration from different perspectives. The impact of gut microbiota on bone metabolism during aging through modification of endocrinology system, immune system and gut microbiota metabolites are summarized, facilitating a better grasp of the pathogenesis of aging-related bone metabolic diseases. This review offers innovative insights into targeting the gut microbiota for the treatment of bone ageing-related diseases as a clinical therapeutic strategy.

Poly(ionic liquid)-Flocculated Chlorella Loading Bactericidal and Antioxidant Hydrogel as a Biological Hydrogen Therapy for Diabetic Wound Dressing

Infection and oxidative stress seriously hinder the healing of diabetic wounds, resulting in various serious health and clinical problems. Herein, a sustainable biological hydrogen (H2)-producing hyaluronic acid-based hydrogel patch (HAP-Chl) was constructed by loading an imidazolium-based poly(ionic liquid) (PIL) flocculated live Chlorella as a diabetic wound dressing. The PIL can flocculate Chlorella through electrostatic interactions between PIL and Chlorella to form Chlorella agglomerates, endowing the Chlorella in the central agglomerates with the ability to continuously produce H2 for 24 h under mild conditions. Combining the membrane disruption-related bactericidal mechanism of PIL and the antioxidant properties of the produced H2, HAP-Chl was determined to be antibacterial and antioxidant. In addition to exhibiting biocompatible and nontoxic activities, subsequent Staphylococcus aureus-infected chronic wound studies revealed that HAP-Chl is capable of promoting the healing of chronic wounds by effectively killing bacteria, reducing extensive ROS, relieving inflammation, and promoting the deposition of mature collagen and angiogenesis. This study provides a new strategy for constructing an in situ sustainable H2-producing hydrogel, enabling the formation of novel antibacterial and antioxidant material platforms with potential for wound dressing applications.

Application of Antioxidant Compounds in Bone Defect Repair

Bone defects caused by trauma, tumor resection, and infections are significant clinical challenges. Excessive reactive oxygen species (ROS) usually accumulate in the defect area, which may impair the function of cells involved in bone formation, posing a serious challenge for bone repair. Due to the potent ROS scavenging ability, as well as potential anti-inflammatory and immunomodulatory activities, antioxidants play an indispensable role in the maintenance and protection of bone health and have gained increasing attention in recent years. This narrative review aims to give an overview of the main research directions on the application of antioxidant compounds in bone defect repair over the past decade. In addition, the positive effects of various antioxidants and their biomaterial delivery systems in bone repair are summarized to provide new insights for exploring antioxidant-based strategies for bone defect repair.

Gases and gas-releasing materials for the treatment of chronic diabetic wounds

Chronic non-healing wounds are a common consequence of skin ulceration in diabetic patients, with severe cases such as diabetic foot even leading to amputations. The interplay between pathological factors like hypoxia-ischemia, chronic inflammation, bacterial infection, impaired angiogenesis, and accumulation of advanced glycosylation end products (AGEs), resulting from the dysregulation of the immune microenvironment caused by hyperglycemia, establishes an unending cycle that hampers wound healing. However, there remains a dearth of sufficient and effective approaches to break this vicious cycle within the complex immune microenvironment. Consequently, numerous scholars have directed their research efforts towards addressing chronic diabetic wound repair. In recent years, gases including Oxygen (O2), Nitric oxide (NO), Hydrogen (H2), Hydrogen sulfide (H2S), Ozone (O3), Carbon monoxide (CO) and Nitrous oxide (N2O), along with gas-releasing materials associated with them have emerged as promising therapeutic solutions due to their ability to regulate angiogenesis, intracellular oxygenation levels, exhibit antibacterial and anti-inflammatory effects while effectively minimizing drug residue-induced damage and circumventing drug resistance issues. In this review, we discuss the latest advances in the mechanisms of action and treatment of these gases and related gas-releasing materials in diabetic wound repair. We hope that this review can provide different ideas for the future design and application of gas therapy for chronic diabetic wounds.

An injectable magnesium-loaded hydrogel releases hydrogen to promote osteoporotic bone repair via ROS scavenging and immunomodulation

Background: The repair of osteoporotic bone defects remains challenging due to excessive reactive oxygen species (ROS), persistent inflammation, and an imbalance between osteogenesis and osteoclastogenesis. Methods: Here, an injectable H2-releasing hydrogel (magnesium@polyethylene glycol-poly(lactic-co-glycolic acid), Mg@PEG-PLGA) was developed to remodel the challenging bone environment and accelerate the repair of osteoporotic bone defects. Results: This Mg@PEG-PLGA gel shows excellent injectability, shape adaptability, and phase-transition ability, can fill irregular bone defect areas via minimally invasive injection, and can transform into a porous scaffold in situ to provide mechanical support. With the appropriate release of H2 and magnesium ions, the 2Mg@PEG-PLGA gel (loaded with 2 mg of Mg) displayed significant immunomodulatory effects through reducing intracellular ROS, guiding macrophage polarization toward the M2 phenotype, and inhibiting the IκB/NF-κB signaling pathway. Moreover, in vitro experiments showed that the 2Mg@PEG-PLGA gel inhibited osteoclastogenesis while promoting osteogenesis. Most notably, in animal experiments, the 2Mg@PEG-PLGA gel significantly promoted the repair of osteoporotic bone defects in vivo by scavenging ROS and inhibiting inflammation and osteoclastogenesis. Conclusions: Overall, our study provides critical insight into the design and development of H2-releasing magnesium-based hydrogels as potential implants for repairing osteoporotic bone defects.

Reactive oxygen species-scavenging nanomaterials for the prevention and treatment of age-related diseases

With increasing proportion of the elderly in the population, age-related diseases (ARD) lead to a considerable healthcare burden to society. Prevention and treatment of ARD can decrease the negative impact of aging and the burden of disease. The aging rate is closely associated with the production of high levels of reactive oxygen species (ROS). ROS-mediated oxidative stress in aging triggers aging-related changes through lipid peroxidation, protein oxidation, and DNA oxidation. Antioxidants can control autoxidation by scavenging free radicals or inhibiting their formation, thereby reducing oxidative stress. Benefiting from significant advances in nanotechnology, a large number of nanomaterials with ROS-scavenging capabilities have been developed. ROS-scavenging nanomaterials can be divided into two categories: nanomaterials as carriers for delivering ROS-scavenging drugs, and nanomaterials themselves with ROS-scavenging activity. This study summarizes the current advances in ROS-scavenging nanomaterials for prevention and treatment of ARD, highlights the potential mechanisms of the nanomaterials used and discusses the challenges and prospects for their applications.

Multifunctional biomimetic hydrogel dressing provides anti-infection treatment and improves immunotherapy by reprogramming the infection-related wound microenvironment

The advancement of biomaterials with antimicrobial and wound healing properties continues to present challenges. Macrophages are recognized for their significant role in the repair of infection-related wounds. However, the interaction between biomaterials and macrophages remains complex and requires further investigation. In this research, we propose a new sequential immunomodulation method to enhance and expedite wound healing by leveraging the immune properties of bacteria-related wounds, utilizing a novel mixed hydrogel dressing. The hydrogel matrix is derived from porcine acellular dermal matrix (PADM) and is loaded with a new type of bioactive glass nanoparticles (MBG) doped with magnesium (Mg-MBG) and loaded with Curcumin (Cur). This hybrid hydrogel demonstrates controlled release of Cur, effectively eradicating bacterial infection in the early stage of wound infection, and the subsequent release of Mg ions (Mg2+) synergistically inhibits the activation of inflammation-related pathways (such as MAPK pathway, NF-κB pathway, TNF-α pathway, etc.), suppressing the inflammatory response caused by infection. Therefore, this innovative hydrogel can safely and effectively expedite wound healing during infection. Our design strategy explores novel immunomodulatory biomaterials, offering a fresh approach to tackle current clinical challenges associated with wound infection treatment.