Ionotronic Tough Adhesives with Intrinsic Multifunctionality

Composite Hydrogel Sealants for Annulus Fibrosus Repair

Intervertebral disc (IVD) herniation is a leading cause of disability and lower back pain, causing enormous socioeconomic burdens. The standard of care for disc herniation is nucleotomy, which alleviates pain but does not repair the annulus fibrosus (AF) defect nor recover the biomechanical function of the disc. Existing bioadhesives for AF repair are limited by insufficient adhesion and significant mechanical and geometrical mismatch with the AF tissue, resulting in the recurrence of protrusion or detachment of bioadhesives. Here, we report a composite hydrogel sealant constructed from a composite of a three-dimensional (3D)-printed thermoplastic polyurethane (TPU) mesh and tough hydrogel. We tailored the fiber angle and volume fraction of the TPU mesh design to match the angle-ply structure and mechanical properties of native AF. Also, we proposed and tested three types of geometrical design of the composite hydrogel sealant to match the defect shape and size. Our results show that the sealant could mimic native AF in terms of the elastic modulus, flexural modulus, and fracture toughness and form strong adhesion with the human AF tissue. The bovine IVD tests show the effectiveness of the composite hydrogel sealant for AF repair and biomechanics recovery and for preventing herniation with its heightened stiffness and superior adhesion. By harnessing the combined capabilities of 3D printing and bioadhesives, these composite hydrogel sealants demonstrate promising potential for diverse applications in tissue repair and regeneration.

Bioadhesives with Antimicrobial Properties

Bioadhesives with antimicrobial properties enable easier and safer treatment of wounds as compared to the traditional methods such as suturing and stapling. Composed of natural or synthetic polymers, these bioadhesives seal wounds and facilitate healing while preventing infections through the activity of locally released antimicrobial drugs, nanocomponents, or inherently antimicrobial polers. Although many different materials and strategies are employed to develop antimicrobial bioadhesives, the design of these biomaterials necessitates a prudent approach as achieving all the required properties including optimal adhesive and cohesive properties, biocompatibility, and antimicrobial activity can be challenging. Designing antimicrobial bioadhesives with tunable physical, chemical, and biological properties will shed light on the path for future advancement of bioadhesives with antimicrobial properties. In this review, the requirements and commonly used strategies for developing bioadhesives with antimicrobial properties are discussed. In particular, different methods for their synthesis and their experimental and clinical applications on a variety of organs are reviewed. Advances in the design of bioadhesives with antimicrobial properties will pave the way for a better management of wounds to increase positive clinical outcomes.

Programming hydrogel adhesion with engineered polymer network topology

Hydrogel adhesion that can be easily modulated in magnitude, space, and time is desirable in many emerging applications ranging from tissue engineering and soft robotics to wearable devices. In synthetic materials, these complex adhesion behaviors are often achieved individually with mechanisms and apparatus that are difficult to integrate. Here, we report a universal strategy to embody multifaceted adhesion programmability in synthetic hydrogels. By designing the surface network topology of a hydrogel, supramolecular linkages that result in contrasting adhesion behaviors are formed on the hydrogel interface. The incorporation of different topological linkages leads to dynamically tunable adhesion with high-resolution spatial programmability without alteration of bulk mechanics and chemistry. Further, the association of linkages enables stable and tunable adhesion kinetics that can be tailored to suit different applications. We rationalize the physics of polymer chain slippage, rupture, and diffusion at play in the emergence of the programmable behaviors. With the understanding, we design and fabricate various soft devices such as smart wound patches, fluidic channels, drug-eluting devices, and reconfigurable soft robotics. Our study presents a simple and robust platform in which adhesion controllability in multiple aspects can be easily integrated into a single design of a hydrogel network.

Tissue-mimetic hybrid bioadhesives for intervertebral disc repair

Intervertebral disc (IVD) degeneration and herniation often necessitate surgical interventions including a discectomy with or without a nucleotomy, which results in a loss of the normal nucleus pulposus (NP) and a defect in the annulus fibrosus (AF). Due to the limited regenerative capacity of the IVD tissue, the annular tear may remain a persistent defect and result in recurrent herniation post-surgery. Bioadhesives are promising alternatives but show limited adhesion performance, low regenerative capacity, and inability to prevent re-herniation. Here, we report hybrid bioadhesives that combine an injectable glue and a tough sealant to simultaneously repair and regenerate IVD post-nucleotomy. The glue fills the NP cavity while the sealant seals the AF defect. Strong adhesion occurs with the IVD tissues and survives extreme disc loading. Furthermore, the glue can match native NP mechanically, and support the viability and matrix deposition of encapsulated cells, serving as a suitable cell delivery vehicle to promote NP regeneration. Besides, biomechanical tests with bovine IVD motion segments demonstrate the capacity of the hybrid bioadhesives to restore the biomechanics of bovine discs under cyclic loading and to prevent permanent herniation under extreme loading. This work highlights the synergy of bioadhesive and tissue-engineering approaches. Future works are expected to further improve the tissue specificity of bioadhesives and prove their efficacy for tissue repair and regeneration.

Bio-inspired ionic skins for smart medicine

Ionic skins are developed to mimic the mechanical properties and functions of natural skins. They have demonstrated substantial advantages to serve as the crucial interface to bridge the gap between humans and machines. The first-generation ionic skin is a stretchable capacitor comprising hydrogels as the ionic conductors and elastomers as the dielectrics, and realizes pressure and strain sensing through the measurement of the capacitance. Subsequent advances have been made to improve the mechanical properties of ionic skins and import diverse functions. For example, ultrahigh stretchability, strong interfacial adhesion, self-healing, moisturizing ability, and various sensing capabilities have been achieved separately or simultaneously. Most ionic skins are attached to natural skins to monitor bio-electrical signals continuously. Ionic skins have also been found with significant potential to serve as a smart drug-containing reservoir, which can release drugs spatially, temporally, and in a controllable way. Herein, this review focuses on the design and fabrication of ionic skins, and their applications related to smart medicine. Moreover, challenges and opportunities are also discussed. It is hoped that the development of bio-inspired ionic skins will provide a paradigm shift for self-diagnosis and healthcare.

Cytoskeleton-inspired hydrogel ionotronics for tactile perception and electroluminescent display in complex mechanical environments

The emerging applications of hydrogel ionotronics (HIs) in devices and machines require them to maintain their robustness under complex mechanical environments. Nevertheless, existing HIs still suffer from various mechanical limitations, such as the lack of balance between softness, strength, toughness, and fatigue fracture under cyclic loads. Inspired by the structure of the cytoskeleton, this study develops a sustainable HI supported by a double filamentous network. This cytoskeleton-like structure can enhance the strength of the HI by 26 times and its toughness by 3 times. It also enables HI to tolerate extreme mechanical stimuli, such as severe deformation, long-term cyclic loading, and high-frequency shearing and shocking. The advantages of these structurally- and mechanically-optimized HI devices in tactile perception and electroluminescent display, i.e., two practical applications where complex mechanical stimuli need to be sustained, are demonstrated. The findings reported in this study can inspire the design of human skin-like robust and anti-fatigue-fracture HI devices for long-term stable use.

Liquid-infused microstructured bioadhesives halt non-compressible hemorrhage

Non-compressible hemorrhage is an unmet clinical challenge that accounts for high mortality in trauma. Rapid pressurized blood flows under hemorrhage impair the function and integrity of hemostatic agents and the adhesion of bioadhesive sealants. Here, we report the design and performance of bioinspired microstructured bioadhesives, formed with a macroporous tough xerogel infused with functional liquids. The xerogel can rapidly absorb interfacial fluids such as whole blood and promote blood clotting, while the infused liquids facilitate interfacial bonding, sealing, and antibacterial function. Their synergy enables the bioadhesives to form tough adhesion on ex vivo human and porcine tissues and diverse engineered surfaces without the need for compression, as well as on-demand instant removal and storage stability. We demonstrate a significantly improved hemostatic efficacy and biocompatibility in rats and pigs compared to non-structured counterparts and commercial products. This work opens new avenues for the development of bioadhesives and hemostatic sealants.

A double-network strategy for the tough tissue adhesion of hydrogels with long-term stability under physiological environment

Achieving tough and stable tissue adhesion under a physiological environment is of great significance for the clinical applications of hydrogel adhesives. The current tough hydrogel adhesives face challenges in the preservation of the maximal adhesion for a long time due to swelling. Here, we propose a double-network strategy for tough tissue adhesion by a hydrogel with long-term stability under a physiological environment. A double-network hydrogel consisting of a covalently crosslinked primary network with tunable hydrophilicity and a non-covalently crosslinked secondary network with functional groups is designed. The primary network exhibited hydrophobicity in the physiological environment, which could constrict the secondary network and limit the swelling of the entire hydrogel. The secondary network could form strong interlinks with tissue and provide large energy dissipation through the unzipping of its noncovalent crosslinks when separated by a force. The combination of the two networks resulted in a tough and stable tissue adhesion. A poly(N-isopropylacrylamide)/calcium alginate hydrogel synthesized based on this strategy realized an adhesion energy of 300-500 J m^-2 with porcine tissues, and the maximal adhesion could be maintained for over 1000 min after submerging in a PBS solution at 37 °C. The swelling behavior of the hydrogel and changes in mechanical properties under the physiological environment are studied, and its application in repairing the aorta wound is demonstrated.

Body Temperature Enhanced Adhesive, Antibacterial and Recyclable Ionic Hydrogel for Epidermal Electrophysiological Monitoring

Hydrogel-based epidermal electrodes have attracted widespread attention in health monitoring and human-machine interfaces for their good biocompatibility, skin-matched Young's modulus, and stable in situ electrophysiological recording performance. However, it is difficult to make the exact conformal attachment between skin and electrodes because of the hair, wrinkles as well as complex, curved contours of the skin. This also results in signal distortion and large noise. Here, a body temperature enhanced skin-adhesive epidermal electrode is proposed based on non-covalent cross-linked network ionic hydrogel. The ionic hydrogel is fabricated by the polyvinyl alcohol (PVA), branched polyethyleneimine (b-PEI) and calcium chloride (CaCl₂ ), which demonstrates impressive performances including ultra-stretchability of 1291%, great adhesion to skin and other non-biological materials, stable conductivity of 3.09 S/m, recyclability and outstanding antibacterial ability, simultaneously. Specifically, the adhesion of the ionic hydrogel behaves as temperature-sensitive and could be enhanced by body temperature. Furthermore, the ionic hydrogel is utilized as epidermal electrodes, which displays seductive capability to record multifarious electrophysiological signals with high signal-to-noise ratio and ultra-low detection limit, including electrocardiogram (ECG), electromyogram (EMG) and electroencephalogram (EEG). The as-proposed body temperature enhanced skin-adhesive ionic hydrogel brings intelligent functions and broadens the way for epidermal electronics, promoting the development of healthcare electronics. This article is protected by copyright. All rights reserved.

Injectable, Pore-Forming, Perfusable Double-Network Hydrogels Resilient to Extreme Biomechanical Stimulations

Biological tissues hinge on blood perfusion and mechanical toughness to function. Injectable hydrogels that possess both high permeability and toughness have profound impacts on regenerative medicine but remain a long-standing challenge. To address this issue, injectable, pore-forming double-network hydrogels are fabricated by orchestrating stepwise gelation and phase separation processes. The interconnected pores of the resulting hydrogels enable direct medium perfusion through organ-sized matrices. The hydrogels are amenable to cell encapsulation and delivery while promoting cell proliferation and spreading. They are also pore insensitive, tough, and fatigue resistant. When tested in biomimetic perfusion bioreactors, the hydrogels maintain physical integrity under prolonged, high-frequency biomechanical stimulations (>6000 000 cycles at 120 Hz). The excellent biomechanical performance suggests the great potential of the new injectable hydrogel technology for repairing mechanically dynamic tissues, such as vocal folds, and other applications, such as tissue engineering, biofabrication, organs-on-chips, drug delivery, and disease modeling.

Emerging Technologies in Multi-Material Bioprinting

Bioprinting, within the emerging field of biofabrication, aims at the fabrication of functional biomimetic constructs. Different 3D bioprinting techniques have been adapted to bioprint cell-laden bioinks. However, single-material bioprinting techniques oftentimes fail to reproduce the complex compositions and diversity of native tissues. Multi-material bioprinting as an emerging approach enables the fabrication of heterogeneous multi-cellular constructs that replicate their host microenvironments better than single-material approaches. Here, bioprinting modalities are reviewed, their being adapted to multi-material bioprinting is discussed, and their advantages and challenges, encompassing both custom-designed and commercially available technologies are analyzed. A perspective of how multi-material bioprinting opens up new opportunities for tissue engineering, tissue model engineering, therapeutics development, and personalized medicine is offered.