An Injectable Photosensitive Bone Cement Based on Oyster Shell-derived Mesoporous Nanoflowers Loaded With Glucose Oxidase for the Treatment of Diabetic Nonunion.

Abstract

Diabetic nonunion, a significant clinical challenge with notably increasing incidence, arises primarily from cellular metabolic dysregulation and chronic inflammation induced by persistent hyperglycemia, leading to compromised self-stabilization at the nonunion site, diminished osteogenic capacity, and impaired angiogenesis. Currently, there are no effective clinical interventions established for managing diabetic nonunion. To address these issues, this work proposes an injectable, rapidly photocurable bone cement composed of methacrylated gelatin (GelMA) and methacrylated hyaluronic acid (HAMA), which is unconstrained by local geometry. This system is integrated with glucose oxidase (GOx)-loaded mesoporous nano-flower stacked particles derived from oyster shell powder (nHAP), referred to as GOx@nHAP-GelMA&HAMA. The incorporation of nHAP enhances the mechanical properties of GelMA&HAMA, while its slow degradation characteristics provide essential elements for bone growth and pro-angiogenic metal ions. GOx loaded on nHAP is gradually released to metabolize local glucose, achieving a moderate reduction in regional blood glucose levels and synergistically promoting angiogenesis. In summary, this study establishes a multifunctional platform for diabetic nonunion therapy, combining biomechanical support with microenvironmental modulation to offer a promising strategy for diabetic bone regeneration through localized intervention.