Natural polymer based drug-loaded hydrogel platform for comprehensive care of acute spinal cord injury

Traumatic spinal cord injury typically occurs at significant depths and triggers rapid and severe physiological responses. It is commonly accompanied by oxidative stress disorders, lipid peroxidation, accumulation of toxic aldehydes, and edema among other symptoms. The management of this condition requires intricate surgical procedures and vigilance against postoperative complications. Slow wound healing is a major clinical challenge. In this study, we developed an injectable hydrogel-based smart drug delivery platform (OPDL gel) for the treatment of cord injuries and integrated postoperative wound care. The hydrogel encapsulates the glucocorticoid dexamethasone (Dex) through a borate ester bond and can respond to degradation caused by reactive oxygen species (ROS) and pH changes in the microenvironment of spinal cord injuries. The OPDL gel was injected into the lesion with a degradation period of 60 h, enabling a controlled and intelligent release of Dex. Additionally, poly-ε-lysine macromolecules within the gel can absorb toxic aldehydes present in the microenvironment via Schiff base reactions, thereby mitigating secondary progression of spinal cord injury. When locally applied to spinal cord injuries, the gel demonstrated good biocompatibility and had a protective effect on damaged neural structures. In addition, OPDL gel also exhibited excellent bactericidal properties, achieving a 100% kill rate against microorganisms within 80 min and providing wound healing care comparable to a commercial product, Tegaderm™. Therefore, this multifunctional hydrogel drug-loading platform represents a novel approach for integrated treatment strategies in the clinical setting to address spinal cord injuries.