Li Hao, Lyu Yuanning, Wang Ruinan, Yu Hong, Lin Mingxin, Li Zhuo, Zhong Yanlin, Sheng Puyi, Zhang Kunyu, Liao Weiming, Bian Liming
Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.
Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.
Bioact Mater. 2025 Jul 26;53:495-506. doi: 10.1016/j.bioactmat.2025.07.039. eCollection 2025 Nov.
Rheumatoid arthritis (RA) is a major autoimmune disease characterized by significant joint inflammation and bone destruction. Many first-line RA treatment drugs such as methotrexate (MTX) have limited solubility in major solvents and are difficult to be delivered to RA joints in a sustained manner. Meanwhile, the efficient co-delivery of osteoinductive ions such as magnesium ions (Mg) for RA treatment is also challenging due to the uncontrolled burst release. By capitalizing on the enhanced supramolecular interactions of cyanuric acid (CYA) upon the pH-induced keto-enol tautomerization, a supramolecular hydrogel (Gel-MTX/Mg) with efficient co-delivery of MTX and Mg is proposed. This hydrogel features pH-responsive on-demand release of MTX and Mg in RA joints triggered by the pathological pH-induced keto-enol tautomerization of CYA. The release of MTX and Mg from the Gel-MTX/Mg hydrogel induces anti-inflammatory M2 macrophage polarization, inhibits osteoclast differentiation, and enhances osteoblastic differentiation. Furthermore, RNA-seq results reveal that the Gel-MTX/Mg hydrogel promotes the enrichment of signaling pathways related to anti-inflammatory and bone-remodeling activities. One-time intra-articular administration of the Gel-MTX/Mg hydrogel significantly suppresses inflammation symptoms and protects bone and cartilage in a rat model. This supramolecular hydrogel that is capable of simultaneously delivering both therapeutic drugs and ions in response to pathological conditions has promising potential for the treatment of RA and other inflammatory and bone-degenerative diseases.
类风湿性关节炎(RA)是一种主要的自身免疫性疾病,其特征是严重的关节炎症和骨质破坏。许多一线RA治疗药物,如甲氨蝶呤(MTX),在主要溶剂中的溶解度有限,难以持续递送至RA关节。同时,由于无法控制的突释,有效共递送骨诱导离子如镁离子(Mg)用于RA治疗也具有挑战性。通过利用氰尿酸(CYA)在pH诱导的酮-烯醇互变异构作用下增强的超分子相互作用,提出了一种具有MTX和Mg高效共递送功能的超分子水凝胶(Gel-MTX/Mg)。这种水凝胶具有pH响应性,可在病理pH诱导的CYA酮-烯醇互变异构作用下,在RA关节中按需释放MTX和Mg。MTX和Mg从Gel-MTX/Mg水凝胶中的释放诱导抗炎M2巨噬细胞极化,抑制破骨细胞分化,并增强成骨细胞分化。此外,RNA测序结果表明,Gel-MTX/Mg水凝胶促进了与抗炎和骨重塑活性相关信号通路的富集。在大鼠模型中,一次性关节内注射Gel-MTX/Mg水凝胶可显著抑制炎症症状,并保护骨骼和软骨。这种能够响应病理状况同时递送治疗药物和离子的超分子水凝胶在治疗RA以及其他炎症性和骨退行性疾病方面具有广阔的应用前景。
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