期刊
ACS NANO
卷 17, 期 1, 页码 111-126出版社
AMER CHEMICAL SOC
DOI: 10.1021/acsnano.2c05247
关键词
Gastric perforation and bleeding; mushroom-inspired hyperboloid-shaped reducible hydrogel; endoscopy deliverable and compressible-expandable; nanosilica enhanced adhesiveness; stomach pH regulation and healing in rabbits and minipigs
This study reports a self-expandable gel device for blocking gastric perforation. The device, with a nanosilica coating and drug-loading capabilities, can enhance adhesive strength, regulate intragastric pH, and promote wound healing. The experiments demonstrated the excellent performance of the gel device in animal models.
Gastrointestinal tract perforation is a full-thickness injury that causes bleeding and fatal infection of the peritoneum. This condition worsens in an acidic gastric environment which interferes with the normal coagulation cascade. Current endoscopic clips to repair gastric perforations are ineffective, and metal or plastic occluders need secondary surgery to remove them. Herein, we report a self-expandable, endoscopy deliverable, adhesive hydrogel to block gastric perforation. We found the nanosilica coating significantly enhanced the adhesive strength even under a simulated strong acidic stomach environment. The developed device was disulfide cross-linked for the reducible degraded gel. By loading with vonoprazan fumarate (VF) and acidic fibroblast growth factor (AFGF), the hyperboloid-shaped device can have a sustained drug release to regulate intragastric pH and promote wound healing. The gel device can be compressed and then expanded like a mushroom when applied in an acute gastric perforation model in both rabbits and minipigs. By utilizing a stomach capsule robot for remotely monitoring the pH and by immunohistochemical analysis, we demonstrated that the compressible hyperboloid-shaped gel could stably block the perforation and promoted wound healing during the 28 days of observation. The real-time pH meter demonstrated that the gel could control intragastric pH above 4 for nearly 60 h to prevent bleeding.
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