Abstract Intrauterine adhesions (IUA) lead to infertility and require treatments that promote endometrial repair and prevent re-adhesion. This study developed an injectable, thermosensitive silk fibroin/poloxamer hydrogel (CN-SFNs/SP) loaded with Callicarpa nudiflora (CN) extract. The CN extract demonstrated potent antibacterial effects in vitro . At 10 mg/mL, it significantly enhanced the expression of pro-angiogenic factors VEGFA/VEGFR2 and suppressed the expression of inflammatory markers (TNF-α, IL-1β, NF-κB p65) in HUVECs. In a mifepristone-injured endometrial stromal cell model, CN effectively modulated the mRNA expression of TNF-α, IL-6 and NF-κB. In vivo, the CN-SFNs/SP hydrogel shortened clotting time in a hemorrhage model and in a mechanical rat IUA model, markedly improved endometrial morphology, increased gland number, and reduced fibrosis area, as confirmed by H&E and Masson staining. The biocompatible hydrogel adheres to the uterine wall, enabling sustained CN release to provide integrated hemostatic, anti-inflammatory, and antibacterial effects, presenting a novel and promising therapeutic strategy for IUA.
Yin et al. (Thu,) studied this question.