A coenzyme-based self-stabilized Janus adhesive patch for spatiotemporal regulation of sutureless diabetic tendon healing.

Ouyang, Chenguang; Ni, Zhipeng; Yu, Haojie; Wang, Li; Meng, Yuan; Xu, Zijian; Yi, Hong; Yuan, Xunchun et al. · Biomaterials · 2026

basic_science · Level V

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Abstract

Chronic inflammation and adhesion formation severely impede the healing process of diabetic tendons, while current surgical sutures and pharmacological interventions often fail to restore microenvironmental homeostasis. Here, we report a coenzyme-based self-stabilized Janus adhesive patch for spatiotemporal regulation of sutureless diabetic tendon healing. Unlike strategies relying on exogenous agents, we utilized the strong hydrogen bonding interactions between endogenous coenzyme α-lipoic acid (LA) and its potassium salt (LAK) to engineer a stable binary supramolecular adhesive layer (P (L<sub>x</sub>-K<sub>y</sub>)) without exogenous additives, enabling sustained release of bioactive LAK molecules. Temporally, the P (L<sub>x</sub>-K<sub>y</sub>) adhesive layer tightly adhered to injured diabetic tendons. The sustainably released LAK could directly scavenge ROS and provide antibacterial protection, thereby driving the polarization of macrophages from the pro-inflammatory M1 phenotype to the reparative M2 phenotype. Spatially, the poly (lactic-co-glycolic acid) barrier layer (PLGA) provides mechanical support and prevents fibroblast infiltration and the formation of peritendinous adhesions. The Janus adhesive patch achieves a paradigm shift from exogenous drug delivery to endogenous spatiotemporal metabolic regulation in diabetic tendon healing. It offers a promising sutureless solution for diabetic tissue regeneration.