Novel enzyme-sensitive poly-tioxolone membranes for peritendinous anti-adhesion

Posttraumatic peritendinous adhesions cause limb disability, for which no proven effective treatment is available in the clinic. Physical barriers or anti-adhesion medicine was respectively used for treatment, but finding a right combined anti-adhesion way may lead to a better outcome. Electrospun anti-adhesion membranes are widely used as physical barriers, however, without ability of inhibition of adhesion formation, while the role of tioxolone in adhesion needs investigation. In this study, we incorporated poly-tioxolone into an electrospun membrane and investigated its anti-adhesion effects and associated molecular pathway. The results showed that the polymerized tioxolone-loaded electrospun membrane showed an obvious enzyme-sensitive release profile. Additionally, the in vivo results showed that tioxolone not only prevented fibroblast proliferation and adhesion but also blocked peritendinous adhesion formation by inhibiting the JAK3/STAT3/CyclinD1 pathway. The histological scores of the 3% and 6% poly-tioxolone fibrous membrane groups were 2.250 ± 0.433 and 2.125 ± 0.331, which, respectively, decreased by 47.1% and 50.0% compared to the control group. More importantly, tioxolone did not significantly affect tendon healing. Thus, tioxolone may be a candidate for peritendinous adhesion with a new anti-adhesion mechanism. Furthermore, electrospun membranes loaded with poly-tioxolone may be useful as a therapeutic material for inhibiting peritendinous adhesion in patients with tendon injury.