Bioinspired Smart Nanogels for Rapid Blue Laser-Activated Hemostasis in Gastrointestinal Bleeding

Abstract

Gastrointestinal bleeding (GIB) is a critical condition that requires rapid and effective intervention. Although thrombin is a widely used hemostatic agent, its efficacy is limited in the harsh environment of the digestive tract, especially in patients with chronic liver disease or coagulation disorders. Current treatment techniques often fall short, particularly when faced with severe blood loss and coagulation challenges. Here, a novel solution: waxberry-inspired smart nanogels that offer a cost-effective, highly efficient, and mechanically stable approach for local hemostasis is presented. Drawing inspiration from the microfibrous structures of waxberry, a waxberry-like nano-silica with a radially fibrous structure is synthesized for effective thrombin loading and release upon emergency. This nano-silica, coated with GelMA, forms a stable nanogel network activated by blue laser during endoscopy. Within just 5 s, the nanogel effectively triggers coagulation, even in patients with coagulation disorders. The formed blood clots are stable enough to withstand the challenging conditions of the digestive tract, preventing secondary bleeding. Upon injection, thrombin rapidly converts fibrinogen to fibrin, creating a secondary network that reinforces clot stability. This dual-network system demonstrates strong adhesive properties and effective hemostasis in the blood of cirrhotic patients, as well as in gastrointestinal bleeding scenarios involving the esophagus, stomach, and duodenum of mini-pigs.