Injectable bioactive glass/sodium alginate hydrogel with immunomodulatory and angiogenic properties for enhanced tendon healing

Abstract

Tendon healing is a complex process involving inflammation, proliferation, and remodeling, eventually achieving a state of hypocellularity and hypovascularity. Currently, few treatments can satisfactorily restore the structure and function of native tendon. Bioactive glass (BG) has been shown to possess immunomodulatory and angiogenic properties. In this study, we investigated whether an injectable hydrogel fabricated of BG and sodium alginate (SA) could be applied to enhance tenogenesis following suture repair of injured tendon. We demonstrated that BG/SA hydrogel significantly accelerated tenogenesis without inducing heterotopic ossification based on histological analysis. The therapeutic effect could attribute to increased angiogenesis and M1 to M2 phenotypic switch of macrophages within 7 days post‐surgery. Morphological characterization demonstrated that BG/SA hydrogel partially reverted the pathological changes of Achilles tendon, including increased length and cross‐sectional area (CSA). Finally, biomechanical test showed that BG/SA hydrogel significantly improved ultimate load, failure stress, and tensile modulus of the repaired tendon. In conclusion, administration of an injectable BG/SA hydrogel can be a novel and promising therapeutic approach to augment Achilles tendon healing in conjunction with surgical intervention.

A Double Cross-Linked Injectable Hydrogel Derived from Muscular Decellularized Matrix Promotes Myoblast Proliferation and Myogenic Differentiation

“…Hydrogels have attracted considerable interest as scaffolds for muscle regeneration due to their exceptional biocompatibility, low immunogenicity, plasticity, and resemblance to the three-dimensional porous extracellular matrix [16,17]. Compared to traditional scaffolds, hydrogels offer unique advantages, such as the ability to be administered via injection, facilitating minimally invasive procedures for accessing challenging sites.…”

Organic–inorganic composite hydrogels: compositions, properties, and applications in regenerative medicine

“…BG finds wide applications in the regeneration of both soft and hard tissues due to its immunomodulatory, angiogenesis-promoting properties and biomineralization inductivity. Xu et al 141 mixed BG into SA solution to prepare an injectable hydrogel, whose immunomodulatory and angiogenic properties help enhance tendon healing via accelerating blood vessel formation and upregulating the M2/M1 phenotype ratio. MMT is also a kind of silicate-type mineral with a high surface area and aspect ratio; elements such as Ca, Mg, Al, and Na are located within the layered silicate structure.…”

Understanding Tendon Fibroblast Biology and Heterogeneity

“…In terms of injectable treatments, hydrogels are widely used because they are biodegradable and resemble the physical properties of biological tissue, such that they do not interfere but still deliver the drug of interest. Examples of hydrogels used include hyaluronic acid and bioactive glass/sodium alginate, and delivery agents include fibromodulin and Mg 2+ with curcumin [74][75][76].…”