Ultrasmall ruthenium nanozyme with RONS scavenging and anti-inflammatory effects for effective prevention of postoperative peritoneal adhesion

Postoperative peritoneal adhesion is one of the most common complications after abdominal and pelvic surgery. Early inflammatory response and oxidative stress induced by peritoneal injury play important roles in adhesion formation. However, current research mainly focuses on developing barrier materials to physically separate injury sites for preventing peritoneal adhesions, but often ignores the pathologic changes promoting adhesion formation, resulting in unsatisfactory outcomes. Herein we report a versatile nanozyme (ultrasmall ruthenium nanoparticles, RuNPs) with great antioxidant and anti-inflammatory effects targeting the intrinsic causes of peritoneal adhesions. RuNPs sufficiently protect mesothelial cells from oxidative stress by scavenging reactive species and suppress inflammatory response via NF-κB pathway blockade. In rats with cecum abrasion-abdominal wall defect, RuNPs alone or combined with barrier material effectively prevent adhesion formation and promote injured tissue healing through alleviating oxidative stress and inflammation. This study not only generates a promising nano-agent for preventing adhesions but also provides a novel therapeutic strategy by targeting the underlying causation of adhesion formation.