Hydrogen Gel Prevents Spinal Scar Tissue After Back Surgery
- Authors
- Rui Mei, Jinpeng Sun, Shuchang Cao, Mohan Shi, Zeyuan Song, Feng Hua, Gaoxin Zhou, Mingshun Zhang, Jun Liu
- Journal
- Acta Biomaterialia
- Year
- 2024
- DOI
- 10.1016/j.actbio.2024.09.006
- Study Type
- Cell Culture
- Outcome
- Positive
- Peer Reviewed
- Yes
- Country
- China
- Health Condition
- Epidural Fibrosis
- Body System
- Musculoskeletal
TL;DR
Scientists created a special gel that releases hydrogen to prevent scar tissue from forming after back surgery.
Key Finding
A hydrogen-releasing hydrogel implant reduced scarring and prevented harmful immune cell structures from forming after back surgery in mice by neutralizing damaging molecules at the surgical site.
Summary
Researchers developed a special gel containing magnesium that releases hydrogen gas to prevent scarring after back surgery. After laminectomy (a type of back surgery), immune cells called neutrophils accumulate at the surgical site and create harmful structures that lead to scarring and sometimes surgery failure. The hydrogen gas from the gel reduced harmful molecules called reactive oxygen species, which prevented these damaging structures from forming and reduced scarring in a mouse model.
Practical Takeaway
This early-stage research in mice suggests hydrogen gas may help prevent complications after back surgery, but it is not yet tested in humans. The approach would require significant additional development and clinical testing before any potential use in patients. This study demonstrates a proof-of-concept for hydrogen delivery via an implantable material rather than drinking hydrogen water.
Abstract
Epidural fibrosis is a primary contributor to the failure of laminectomy surgeries, leading to the development of failed back surgery syndrome (FBSS). Post-laminectomy, neutrophils infiltrate the surgical site, generating neutrophil extracellular traps (NETs) that contribute to epidural fibrosis. Reactive oxygen species (ROS) play a pivotal role in mediating NETs formation. Molecular hydrogen, recognized for its selective antioxidant properties and biosafety, emerges as a potential therapeutic gas in suppressing epidural fibrosis. In this study, we developed an in-situ hydrogen release hydrogel that inhibits the formation of NETs and mitigates epidural scarring. Biodegradable magnesium (Mg) microspheres served as a hydrogen source, coated with PLGA to regulate hydrogen release. These microspheres (Mg@PLGA) were then incorporated into a PLGA-PEG-PLGA thermosensitive hydrogel (Mg@PLGA@Gel), providing a surgical implant for sustained, long-term hydrogen release. In vitro experiments confirmed the biocompatibility of the system, demonstrating that hydrogen produced by Mg@PLGA effectively neutralizes neutrophil intracellular ROS and inhibits NETs formation. Histological analyses, including H&E staining, MRI, Masson staining, and immunohistochemistry, collectively indicate that Mg@PLGA@Gel is biocompatible and effectively inhibits epidural fibrosis post-laminectomy. Furthermore, Mg@PLGA@Gel inhibits ROS accumulation and NETs formation at the surgical site. These findings suggest that Mg@PLGA@Gel ensures continuous, therapeutic hydrogen concentration, providing relief from epidural fibrosis in a laminectomy mouse model. STATEMENT OF SIGNIFICANCE: •The hydrogen-releasing hydrogel combines the therapeutic effects of a physical barrier with immunomodulation. •In situ-generated molecular hydrogen scavenges ROS caused by surgical stress and suppresses NETs formation. •The hydrogen-releasing hydrogel is demonstrated to exhibit high biocompatibility and inhibit epidural scar formation in vivo.