He Ye, Qu Qing, Luo Tiantian, Gong Yuhua, Hou Zongkun, Deng Jia, Xu Yingqian, Wang Bochu, Hao Shilei
Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China.
College of Environment and Resources, Chongqing Technology and Business University, Chongqing 400067, China.
ACS Biomater Sci Eng. 2019 Feb 11;5(2):1113-1122. doi: 10.1021/acsbiomaterials.8b01609. Epub 2019 Jan 31.
Surgery is an important therapeutic strategy for intracerebral hemorrhage (ICH) in the clinic and is theoretically beneficial for the outcome of ICH by decreasing hematoma, reducing nervous tissue damage, and removing harmful chemicals. However, the outcome of ICH surgery is always unsatisfactory due to postoperative rebleeding. We hypothesized that the injection of hemostatic agents in situ after aspiration surgery could immediately activate hemostasis once rebleeding occurs. Therefore, keratin hydrogels (K-gels) were easily prepared as a hemostatic material via a rehydration method and had a porous structure. Collagenase was injected into the basal lamina to mimic ICH rebleeding, and the K-gels were then injected into the same injured site after 2 h for hemostatic therapy. The hematoma volume was significantly reduced by K-gel treatment, indicating that in situ infusion of the K-gels inhibited hematoma enlargement when rebleeding occurred. Moreover, brain damage, including cell apoptosis, neuroinflammatory reactions, and neurological deficits, was also relieved after K-gel treatment. These results suggested that in situ injection of the K-gels into the hematoma area after ICH surgery improves the therapeutic outcome by stopping postoperative rebleeding. K-gels have great potential for clinical hemostatic application because of their excellent hemostatic properties and biocompatibility.
手术是临床上治疗脑出血（ICH）的重要策略，理论上通过减少血肿、减轻神经组织损伤和清除有害化学物质，对脑出血的预后有益。然而，由于术后再出血，脑出血手术的结果总是不尽人意。我们假设在抽吸手术后原位注射止血剂，一旦发生再出血，可立即激活止血机制。因此，通过复水法很容易制备角蛋白水凝胶（K-凝胶）作为止血材料，其具有多孔结构。将胶原酶注入基底层以模拟脑出血再出血，然后在2小时后将K-凝胶注入同一损伤部位进行止血治疗。K-凝胶治疗可显著减少血肿体积，表明原位注入K-凝胶可在再出血发生时抑制血肿扩大。此外，K-凝胶治疗后，包括细胞凋亡、神经炎症反应和神经功能缺损在内的脑损伤也得到缓解。这些结果表明，脑出血手术后将K-凝胶原位注入血肿区域可通过阻止术后再出血改善治疗效果。由于其优异的止血性能和生物相容性，K-凝胶在临床止血应用中具有巨大潜力。
