Anti-Adhesion Effects and Potential Mechanisms of Polyglutamic Acid-Polylysine Crosslinked Hydrogels in a Rat Peritoneal Adhesion Model.

Peritoneal adhesions are a common complication following abdominal surgery. Their formation is associated with factors such as inflammatory responses, imbalance in the fibrinolytic system, and proliferation of fibrous tissue. Currently available anti-adhesion products on the market are primarily physical barrier membranes, which have limited functionality, can only serve as passive barriers, and have suboptimal handling and residence times. To address this issue, this study utilized 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride/N-hydroxysuccinimide (EDC/NHS) chemical crosslinking to create polyglutamic acid-polylysine (PGA-PL) hydrogels and tested their anti-adhesion and reparative effects in a cecum-abdominal wall adhesion model in Sprague-Dawley (SD) rats. Experimental results demonstrated that treatment with PGA-PL hydrogels significantly reduced the occurrence of adhesions, effectively decreased inflammatory cell infiltration, neovascularization, and collagen deposition, while exhibiting excellent biocompatibility. Additionally, it markedly reduced the expression of pro-inflammatory factors, transforming growth factor-β1 (TGF-β1), and α-smooth muscle actin (α-SMA) in both serum and local tissue, increased the levels of plasminogen activators, and promoted the proliferation of peritoneal mesothelial cells. PGA-PL hydrogel is a safe and effective anti-adhesion material; its efficacy not only relies on serving as a physical barrier but also actively modulates local inflammatory responses, fibrotic processes, and fibrinolytic balance, while promoting mesothelial repair.