An anti-fibroblast adhesion and anti-inflammatory hydrogel film combined with VEGF for intrauterine adhesion prevention

Intrauterine adhesions (IUA) are a common gynecologic disease worldwide that can lead to menstrual irregularities, infertility, or repeated pregnancy loss. Biomaterials are used as a physical barrier to separate damaged uterine walls and prevent tissue adhesion. However, most biomaterials cannot prevent or even increase inflammation and fibrosis during implantation, which is crucial for IUA development, limiting their application in treatment. To address this, we developed a hydrophilic hydrogel film with a negative surface potential that can absorb excess positive proinflammatory cytokines to alleviate the inflammatory response and limit endometrial fibre formation. In vitro, the hydrogel film exhibits good biocompatibility and anti-fibroblast adhesion properties, and in vivo, they downregulate the expression level of proinflammatory cytokines and reduce the degree of fibrosis. After loading the hydrogel film with vascular endothelial growth factor (VEGF) and implanting it into the injured rat endometrial cavity, the increased local microvessels and higher endometrial thickness indicated improved endometrial regeneration during IUA treatment. In summary, the hydrogel film capable of efficiently reducing inflammation and decreasing fibrosis provides a promising strategy for treating and preventing IUA difficulties, with broad clinical application potential.