A Gas Therapy Strategy for Intestinal Flora Regulation and Colitis Treatment by Nanogel-Based Multistage NO Delivery Microcapsules.

Current approaches to treating inflammatory bowel disease focus on the suppression of overactive immune responses, the removal of reactive intestinal oxygen species, and regulation of the intestinal flora. However, owing to the complex structure of the gastrointestinal tract and the influence of mucus, current small-molecule and biologic-based drugs for treating colitis cannot effectively act at the site of colon inflammation, and as a result, they tend to exhibit low efficacies and toxic side effects. In this study, nanogel-based multistage NO delivery microcapsules are developed to achieve NO release at the inflammation site by targeting the inflammatory tissues using the nanogel. Surprisingly, oral administration of the microcapsules suppresses the growth of pathogenic bacteria and increases the abundance of probiotic bacteria. Metabolomics further show that an increased abundance of intestinal probiotics promotes the production of metabolites, including short-chain fatty acids and indole derivatives, which modulate the intestinal immunity and restore the intestinal barrier via the interleukin-17 and PI3K-Akt signaling pathways. This work reveals that the developed gas therapy strategy based on multistage NO delivery microcapsules modulates the intestinal microbial balance, thereby reducing inflammation and promoting intestinal barrier repair, ultimately providing a new therapeutic approach for the clinical management of colitis.

Synthetic poly(vinyl alcohol)-chitosan as a new type of highly efficient hemostatic sponge with blood-triggered swelling and high biocompatibility.

Rapid and effective hemostasis for a noncompressible hemorrhage is the key to control bleeding and reduce mortality. Chitosan (CS) has been widely used as a popular hemostatic dressing; however, irregularly shaped wounds present in emergencies limit the performance of CS powder. To improve the hemostatic effect of CS, we modified it with poly(vinyl alcohol) (PVA), a fast-swelling sponge triggered by water. The novel synthetic PVA-CS was prepared by cross-linking PVA and CS during foaming and crosslinking reactions. Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and X-ray diffraction were utilized to analyze the characteristics of PVA-CS. In vitro, the swelling ratio and blood clotting ability were evaluated in different groups with various weight ratios or degrees of deacetylation of the CS, and the cytocompatibility and cell attachment on the material were analyzed by human dermal fibroblast (HDF) cell testing. In vivo, the hemostatic effects were evaluated in Sprague-Dawley rats and Bama miniature pigs in a femoral artery hemorrhage model or gunshot wound experiment. PVA-CS presents robust mechanical strength, rapid water-triggered swelling and a fast absorption speed. As compared with gauze and PVA, which are widely used in first aid, PVA-CS sponges showed an improved blood clotting ability and increased blood cell and platelet adhesion and activation. The PVA-CS sponges also showed high biocompatibility in cell viability, cell proliferation and cell attachment bioassays. Furthermore, in vivo evaluation of the PVA-CS sponges revealed excellent hemostatic performance and enhanced wound healing with increased re-epithelialization and decreased granulation tissues. The results of this study strongly support the use of these composite sponges for noncompressible hemorrhage in acute trauma and ballistic injuries.