Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Injectable tissue prosthesis for instantaneous closed-loop rehabilitation

Abstract

To construct tissue-like prosthetic materials, soft electroactive hydrogels are the best candidate owing to their physiological mechanical modulus, low electrical resistance and bidirectional stimulating and recording capability of electrophysiological signals from biological tissues1,2. Nevertheless, until now, bioelectronic devices for such prostheses have been patch type, which cannot be applied onto rough, narrow or deep tissue surfaces3,4,5. Here we present an injectable tissue prosthesis with instantaneous bidirectional electrical conduction in the neuromuscular system. The soft and injectable prosthesis is composed of a biocompatible hydrogel with unique phenylborate-mediated multiple crosslinking, such as irreversible yet freely rearrangeable biphenyl bonds and reversible coordinate bonds with conductive gold nanoparticles formed in situ by cross-coupling. Closed-loop robot-assisted rehabilitation by injecting this prosthetic material is successfully demonstrated in the early stage of severe muscle injury in rats, and accelerated tissue repair is achieved in the later stage.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Design of an injectable tissue prosthesis (IT-IC hydrogel) and its interfacing applications.
Fig. 2: Physicochemical and electrical characterization of the IT-IC hydrogel.
Fig. 3: Skeletal muscle-tissue prosthesis through IT-IC hydrogel injection.
Fig. 4: Bidirectional sensory and motor signalling of IT-IC hydrogels in the neuromuscular system.
Fig. 5: C-RAR system using IT-IC hydrogel.

Similar content being viewed by others

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author upon reasonable request. Source data are provided with this paper.

Code availability

All customized MATLAB code used for in vivo demonstration in this work is available in a repository at https://github.com/chwchw2/C-RAR-demo.git.

References

  1. Jiang, Y. et al. Wireless, closed-loop, smart bandage with integrated sensors and stimulators for advanced wound care and accelerated healing. Nat. Biotechnol. 41, 652–662 (2022).

    Article  PubMed  Google Scholar 

  2. Mickle, A. D. et al. A wireless closed-loop system for optogenetic peripheral neuromodulation. Nature 565, 361–365 (2019).

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  3. Won, S. M., Song, E., Reeder, J. T. & Rogers, J. A. Emerging modalities and implantable technologies for neuromodulation. Cell 181, 115–135 (2020).

    Article  CAS  PubMed  Google Scholar 

  4. Yuk, H., Lu, B. & Zhao, X. Hydrogel bioelectronics. Chem. Soc. Rev. 48, 1642–1667 (2019).

    Article  CAS  PubMed  Google Scholar 

  5. Deng, J. et al. Electrical bioadhesive interface for bioelectronics. Nat. Mater. 20, 229–236 (2021).

    Article  ADS  CAS  PubMed  Google Scholar 

  6. Boys, A. J. et al. 3D bioelectronics with a remodellable matrix for long‐term tissue integration and recording. Adv. Mater. 35, 2207847 (2022).

    Article  Google Scholar 

  7. Strakosas, X. et al. Biostack: nontoxic metabolite detection from live tissue. Adv. Sci. 9, 2101711 (2022).

    Article  CAS  Google Scholar 

  8. Lim, C. et al. Tissue-like skin-device interface for wearable bioelectronics by using ultrasoft, mass-permeable, and low-impedance hydrogels. Sci. Adv. 7, eabd3716 (2021).

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  9. Lacour, S. P., Courtine, G. & Guck, J. Materials and technologies for soft implantable neuroprostheses. Nat. Rev. Mater. 1, 16063 (2016).

    Article  ADS  CAS  Google Scholar 

  10. Squair, J. W. et al. Neuroprosthetic baroreflex controls haemodynamics after spinal cord injury. Nature 590, 308–314 (2021).

    Article  ADS  CAS  PubMed  Google Scholar 

  11. Yang, Q. et al. Photocurable bioresorbable adhesives as functional interfaces between flexible bioelectronic devices and soft biological tissues. Nat. Mater. 20, 1559–1570 (2021).

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  12. Liu, Y. et al. Soft and elastic hydrogel-based microelectronics for localized low-voltage neuromodulation. Nat. Biomed. Eng. 3, 58–68 (2019).

    Article  ADS  CAS  PubMed  Google Scholar 

  13. Wang, L. et al. Injectable and conductive cardiac patches repair infarcted myocardium in rats and minipigs. Nat. Biomed. Eng. 5, 1157–1173 (2021).

    Article  CAS  PubMed  Google Scholar 

  14. Zhou, L. et al. Soft conducting polymer hydrogels cross-linked and doped by tannic acid for spinal cord injury repair. ACS Nano 12, 10957–10967 (2018).

    Article  CAS  PubMed  Google Scholar 

  15. Liang, S. et al. Paintable and rapidly bondable conductive hydrogels as therapeutic cardiac patches. Adv. Mater. 30, 1704235 (2018).

    Article  Google Scholar 

  16. Trevathan, J. K. et al. An injectable neural stimulation electrode made from an in‐body curing polymer/metal composite. Adv. Healthcare Mater. 8, 1900892 (2019).

    Article  CAS  Google Scholar 

  17. Yu, Q., Jin, S., Wang, S., Xiao, H. & Zhao, Y. Injectable, adhesive, self-healing and conductive hydrogels based on MXene nanosheets for spinal cord injury repair. Chem. Eng. J. 452, 139252 (2023).

    Article  CAS  Google Scholar 

  18. Zhao, X., Guo, B., Wu, H., Liang, Y. & Ma, P. X. Injectable antibacterial conductive nanocomposite cryogels with rapid shape recovery for noncompressible hemorrhage and wound healing. Nat. Commun. 9, 2784 (2018).

    Article  ADS  PubMed  PubMed Central  Google Scholar 

  19. Sun, J.-Y. et al. Highly stretchable and tough hydrogels. Nature 489, 133–136 (2012).

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  20. Guan, Y. & Zhang, Y. Boronic acid-containing hydrogels: synthesis and their applications. Chem. Soc. Rev. 42, 8106–8121 (2013).

    Article  CAS  PubMed  Google Scholar 

  21. Golestanzadeh, M. & Naeimi, H. Palladium decorated on a new dendritic complex with nitrogen ligation grafted to graphene oxide: fabrication, characterization, and catalytic application. RSC Adv. 9, 27560–27573 (2019).

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  22. Liu, C.-H. et al. Metal oxide-containing SBA-15-supported gold catalysts for base-free aerobic homocoupling of phenylboronic acid in water. J. Catal. 336, 49–57 (2016).

    Article  ADS  CAS  Google Scholar 

  23. Guimarães, C. F., Gasperini, L., Marques, A. P. & Reis, R. L. The stiffness of living tissues and its implications for tissue engineering. Nat. Rev. Mater. 5, 351–370 (2020).

    Article  ADS  Google Scholar 

  24. Han, I. K. et al. Electroconductive, adhesive, non‐swelling, and viscoelastic hydrogels for bioelectronics. Adv. Mater. 35, 2203431 (2023).

    Article  CAS  Google Scholar 

  25. Martin-Drumel, M. et al. Low-energy vibrational spectra of flexible diphenyl molecules: biphenyl, diphenylmethane, bibenzyl and 2-, 3-and 4-phenyltoluene. Phys. Chem. Chem. Phys. 16, 22062–22072 (2014).

    Article  CAS  PubMed  Google Scholar 

  26. Gao, Z., Su, R., Huang, R., Qi, W. & He, Z. Glucomannan-mediated facile synthesis of gold nanoparticles for catalytic reduction of 4-nitrophenol. Nanoscale Res. Lett. 9, 1–8 (2014).

    Article  ADS  Google Scholar 

  27. Schoenmakers, D. C., Rowan, A. E. & Kouwer, P. H. Crosslinking of fibrous hydrogels. Nat. Commun. 9, 2172 (2018).

    Article  ADS  PubMed  PubMed Central  Google Scholar 

  28. Dawn, A. et al. Investigating the effect of supramolecular gel phase crystallization on gel nucleation. Soft Matter 14, 9489–9497 (2018).

    Article  ADS  CAS  PubMed  Google Scholar 

  29. Urciuolo, A. et al. Intravital three-dimensional bioprinting. Nat. Biomed. Eng. 4, 901–915 (2020).

    Article  CAS  PubMed  Google Scholar 

  30. Aurora, A., Garg, K., Corona, B. T. & Walters, T. J. Physical rehabilitation improves muscle function following volumetric muscle loss injury. BMC Sports Sci. Med. Rehabilitation 6, 1–10 (2014).

    Article  Google Scholar 

  31. Jin, Y. et al. Functional skeletal muscle regeneration with thermally drawn porous fibers and reprogrammed muscle progenitors for volumetric muscle injury. Adv. Mater. 33, 2007946 (2021).

    Article  CAS  Google Scholar 

  32. Zhou, L. et al. Injectable muscle-adhesive antioxidant conductive photothermal bioactive nanomatrix for efficiently promoting full-thickness skeletal muscle regeneration. Bioact. Mater. 6, 1605–1617 (2021).

    CAS  PubMed  Google Scholar 

  33. Song, K.-I. et al. Adaptive self-healing electronic epineurium for chronic bidirectional neural interfaces. Nat. Commun. 11, 4195 (2020).

    Article  ADS  PubMed  PubMed Central  Google Scholar 

  34. Berendsen, H. J., Grigera, J. R. & Straatsma, T. P. The missing term in effective pair potentials. J. Phys. Chem. 91, 6269–6271 (1987).

    Article  CAS  Google Scholar 

  35. Dodda, L. S. et al. LigParGen web server: an automatic OPLS-AA parameter generator for organic ligands. Nucleic Acids Res. 45, W331–W336 (2017).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Evans, D. J. & Holian, B. L. The Nose–Hoover thermostat. J. Chem. Phys. 83, 4069–4074 (1985).

    Article  ADS  CAS  Google Scholar 

  37. Parrinello, M. & Rahman, A. Polymorphic transitions in single crystals: a new molecular dynamics method. J. Appl. Phys. 52, 7182–7190 (1981).

    Article  ADS  CAS  Google Scholar 

  38. Plimpton, S. Fast parallel algorithms for short-range molecular dynamics. J. Comput. Phys. 117, 1–19 (1995).

    Article  ADS  CAS  MATH  Google Scholar 

Download references

Acknowledgements

This study was financially supported by the National Research Foundation of Korea grant funded by the Korean government (MSIT) (nos. RS-2023-00208262 (M.S.) and 2020R1C1C1005567 (D.S.)). This research was also supported by the Institute for Basic Science (no. IBS-R015-D1). This research was also supported by the Korean Fund for Regenerative Medicine grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Health & Welfare) (23B0102L1).

Author information

Authors and Affiliations

Authors

Contributions

S.J. conducted experiments for synthesis of the polymers and their characterization. S.J. and H.C. performed all in vivo experiments. D.S. and H.C. conducted electrochemical characterization of the materials. C.-L.Y. and J.-S.K. performed histological analysis and discussed the results. S.R. and W.B.L. conducted computational MD simulations. S.J., H.C., D.S. and M.S. wrote the first draft of the manuscript. M.S. and D.S. conceived and supervised the project. All authors discussed and commented on the data.

Corresponding authors

Correspondence to Donghee Son or Mikyung Shin.

Ethics declarations

Competing interests

The authors declare no competing interests.

Peer review

Peer review information

Nature thanks Milica Radisic and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Extended data figures and tables

Extended Data Fig. 1 The RAR system based on muscle IT-IC interfacing without the sciatic nerve stimulation.

a, Schematics of the RAR system based on the TA muscle-tissue conduction by the IT-IC hydrogel without using the peripheral nerve interface. The TA muscle EMG signal evoked by voluntary walking is recorded by the EMG electrode. When specific TA muscle EMG signals are detected, the robotic assistance is activated. The rat’s leg movement is then fully supported by the robotic assistance. b, Recorded EMG signals and waveforms (inset) of untreated rats using the RAR system. c, Photographs of unsynchronized robot activation and the corresponding abnormal steps. d, Recorded EMG signals and waveforms (inset) of IT-IC hydrogel-treated rats using RAR. e, Photographs of robotic assistance and the corresponding normal steps.

Source Data

Supplementary information

Supplementary Information

Supplementary Methods, figures, notes, legends for Supplementary Videos and references.

Reporting Summary

Supplementary Data

Source data for supplementary figures.

Supplementary Video 1

Supplementary Video 2

Supplementary Video 3

Supplementary Video 4

Supplementary Video 5

Supplementary Video 6

Source data

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jin, S., Choi, H., Seong, D. et al. Injectable tissue prosthesis for instantaneous closed-loop rehabilitation. Nature 623, 58–65 (2023). https://doi.org/10.1038/s41586-023-06628-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41586-023-06628-x

This article is cited by

Comments

By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing