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HPA-GM is a composite thermosensitive hydrogel system developed for the localized precision treatment of rheumatoid arthritis (RA). The system is composed of a thermosensitive hydrogel matrix (HPA) consisting of hydroxypropyl methylcellulose (HPMC), hyaluronic acid (HA), and glycerol, which embeds gelatin methacryloyl (GelMA) hydrogel microspheres (GM). This injectable platform is designed for in situ gelation and sustained release of therapeutic agents within the joint cavity. In preclinical studies, the system is loaded with sinomenine (SIN), an anti-inflammatory alkaloid, and Drynaria rhizome-derived extracellular vesicles (DR-EVs). The sinomenine component provides anti-inflammatory activity by inhibiting M1 macrophage polarization and regulating T-cell differentiation (suppressing TH17 cells and promoting Treg cells). Simultaneously, the DR-EVs enhance bone repair by upregulating osteogenesis-related genes such as Runx2 and BMP2 while inhibiting osteoclast formation. The HPA-GM system has demonstrated the ability to alleviate joint swelling, restore cartilage and bone architecture, and suppress synovial inflammation in collagen-induced arthritis (CIA) rat models.
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