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Vol. 16 (2024)

Diamond-Like Carbon Depositing on the Surface of Polylactide Membrane for Prevention of Adhesion Formation During Tendon Repair

https://doi.org/10.1007/s40820-024-01392-7
Yao Xiao
Department of Orthopaedics, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, 600 Yishan Rd, Shanghai 200233, People’s Republic of China
Zaijin Tao
Department of Orthopaedics, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, 600 Yishan Rd, Shanghai 200233, People’s Republic of China
Yufeng Ju
Shanghai Tongji Hospital, 389 Xincun Rd, Shanghai 200065, People’s Republic of China
Xiaolu Huang
Key Laboratory for Thin Film and Microfabrication of Ministry of Education, Research Institute of Micro/Nano Science and Technology, Shanghai Jiao Tong University, Shanghai 200240, People’s Republic of China
Xinshu Zhang
Department of Orthopaedics, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, 600 Yishan Rd, Shanghai 200233, People’s Republic of China
Xiaonan Liu
Department of Orthopaedics, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, 600 Yishan Rd, Shanghai 200233, People’s Republic of China
Pavel A. Volotovski
Orthopedic Trauma Department, Belarus Republic Scientific and Practical Center for Traumatology and Orthopedics, Kizhevatova str., 60/4, 220024 Minsk, Belarus
Chao Huang
Shanghai Haohai Biological Technology Limited Liability Company, 1386 Hongqiao Rd, Shanghai 200336, People’s Republic of China
Hongqi Chen
Department of General Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, 600 Yishan Rd, Shanghai 200233, People’s Republic of China
Yaozhong Zhang
Shanghai Key Laboratory for High Temperature Materials and Precision Forming, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, People’s Republic of China
Shen Liu
Department of Orthopaedics, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, 600 Yishan Rd, Shanghai 200233, People’s Republic of China

Corresponding Author: Shen Liu

liushensjtu@sjtu.edu.cn

Nano-Micro Letters, Vol. 16 (2024), Article Number: 186

Abstract

Post-traumatic peritendinous adhesion presents a significant challenge in clinical medicine. This study proposes the use of diamond-like carbon (DLC) deposited on polylactic acid (PLA) membranes as a biophysical mechanism for anti-adhesion barrier to encase ruptured tendons in tendon-injured rats. The results indicate that PLA/DLC composite membrane exhibits more efficient anti-adhesion effect than PLA membrane, with histological score decreasing from 3.12 ± 0.27 to 2.20 ± 0.22 and anti-adhesion effectiveness increasing from 21.61% to 44.72%. Mechanistically, the abundant C=O bond functional groups on the surface of DLC can reduce reactive oxygen species level effectively; thus, the phosphorylation of NF-κB and M1 polarization of macrophages are inhibited. Consequently, excessive inflammatory response augmented by M1 macrophage-originated cytokines including interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) is largely reduced. For biocompatibility evaluation, PLA/DLC membrane is slowly absorbed within tissue and displays prolonged barrier effects compared to traditional PLA membranes. Further studies show the DLC depositing decelerates the release of degradation product lactic acid and its induction of macrophage M2 polarization by interfering esterase and PLA ester bonds, which further delays the fibrosis process. It was found that the PLA/DLC membrane possess an efficient biophysical mechanism for treatment of peritendinous adhesion.


Highlights:
1 The anti-adhesion effect of polylactic acid (PLA) membrane with diamond-like carbon (DLC) depositing is 44.72%, enhanced by 23.11% compared to PLA.
2 DLC deposited on PLA membranes has been shown to effectively reduce the levels of reactive oxygen species, leading to a decrease in the expression of pro-inflammatory cytokines within peritendinous adhesion tissue.
3 DLC decelerates PLA biodegradation and lactic production, which reduces the number of CD68+CD206+ macrophages within peritendinous adhesion tissue.

Keywords

Diamond-like carbon Reactive oxygen species scavenging Foreign body reaction Biodegradation Antioxidant Peritendinous adhesion
Xiao, Yao, Zaijin Tao, Yufeng Ju, Xiaolu Huang, Xinshu Zhang, Xiaonan Liu, Pavel A. Volotovski, Chao Huang, Hongqi Chen, Yaozhong Zhang, and Shen Liu. 2024. “Diamond-Like Carbon Depositing on the Surface of Polylactide Membrane for Prevention of Adhesion Formation During Tendon Repair”. Nano-Micro Letters 16 (April):186. https://doi.org/10.1007/s40820-024-01392-7.
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