Gelatin hydrogel affects the activation of microglia/macrophages and astrocytes. (A) Double immunofluorescence staining was performed with astrocyte marker GFAP (green) and microglia/macrophages marker Iba-1 (red) in brain sections, scale bar = 20 μm. (B) Representative images for Immunofluorescence staining of Iba-1, scale bar = 50 μm. (C) The percentage of Iba-1 positive area analysis. (D) Representative images for Immunofluorescence staining of GFAP, scale bar = 50 μm. (E) The percentage of GFAP positive area analysis. *Represents the hydrogel. Data are mean ± SD, n = 4 mice per group, *P < 0.05, ***P < 0.001.

Gelatin hydrogel affects the activation of microglia/macrophages and astrocytes. (A) Double immunofluorescence staining was performed with astrocyte marker GFAP (green) and microglia/macrophages marker Iba-1 (red) in brain sections, scale bar = 20 μm. (B) Representative images for Immunofluorescence staining of Iba-1, scale bar = 50 μm. (C) The percentage of Iba-1 positive area analysis. (D) Representative images for Immunofluorescence staining of GFAP, scale bar = 50 μm. (E) The percentage of GFAP positive area analysis. *Represents the hydrogel. Data are mean ± SD, n = 4 mice per group, *P < 0.05, ***P < 0.001.

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Intracerebral hemorrhage (ICH) is a devastating subtype of stroke with high morbidity and mortality. However, there is no effective therapy method to improve its clinical outcomes to date. Here we report an injectable gelatin hydrogel that is capable of suppressing inflammation and enhancing functional recovery in a mouse model of ICH. Thiolated ge...

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... Gelatin (Gel) is a fibrous protein extracted from collagen-containing materials, being rich in arginine-glycine-aspartic acid sequence [14] as peptide motif for cell adhesion [15,16]. Gel has been also attested to have a positive effect on angiogenesis [17]. However, the use of regenerated or processed Gel materials in tissue engineering is limited due to their significantly poor mechanical properties [18,19]. ...
... Similarly, a study by Ghuman and colleagues found that an ECM-based hydrogel administered at a chronic time point after ischaemic stroke was retained for several weeks and allowed host cell infiltration but had neutral effects on a battery of functional tests [51]. However, some studies using alternative hydrogels have reported a beneficial effect on the behavioural impairments seen in the neuroscore and corner test after ICH [12,48,[52][53][54], although functional benefits are sometimes seen only when the hydrogel is combined with other factors, such as growth factors ( [54]). ...
... Ki67-expressing cells appeared to be positive for DCX, indicating the presence of proliferating neural progenitors in the lesion. Several reports using hydrogels in ICH have studied the expression of neurogenic markers [15,52,54,55]. Interestingly, Lim and colleagues found a significant increase in the number of nestin-positive neural stem cells, after delivery of a EGF and gelatin-hydrogel combination therapy, but no increase with the hydrogel scaffold alone [54]. ...
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Intracerebral haemorrhage (ICH) is the deadliest form of stroke, but current treatment options are limited, meaning ICH survivors are often left with life-changing disabilities. The significant unmet clinical need and socioeconomic burden of ICH mean novel regenerative medicine approaches are gaining interest. To facilitate the regeneration of the ICH lesion, injectable biomimetic hydrogels are proposed as both scaffolds for endogenous repair and delivery platforms for pro-regenerative therapies. In this paper, the objective was to explore whether injection of a novel self-assembling peptide hydrogel (SAPH) Alpha2 was feasible, safe and could stimulate brain tissue regeneration, in a collagenase-induced ICH model in rats. Alpha2 was administered intracerebrally at 7 days post ICH and functional outcome measures, histological markers of damage and repair and RNA-sequencing were investigated for up to 8 weeks. The hydrogel Alpha2 was safe, well-tolerated and was retained in the lesion for several weeks, where it allowed infiltration of host cells. The hydrogel had a largely neutral effect on functional outcomes and expression of angiogenic and neurogenic markers but led to increased numbers of proliferating cells. RNAseq and pathway analysis showed that ICH altered genes related to inflammatory and phagocytic pathways, and these changes were also observed after administration of hydrogel. Overall, the results show that the novel hydrogel was safe when injected intracerebrally and had no negative effects on functional outcomes but increased cell proliferation. To elicit a regenerative effect, future studies could use a functionalised hydrogel or combine it with an adjunct therapy.
... Similarly, a study by Ghuman and colleagues found that an ECM-based hydrogel administered at a chronic time point after ischaemic stroke, was retained for several weeks and allowed host cell in ltration but had neutral effects on a battery of functional tests [48]. However, some studies using alternative hydrogels, have reported a bene cial effect on the behavioral impairments seen in the neuroscore and corner test after ICH [12,45,[49][50][51], although functional bene ts are sometimes seen only when the hydrogel is combined with other factors, such as growth factors ( [51]). Although this study found no detrimental or bene cial effect of hydrogel administration on functional outcomes, it is important to note that there may be other domains of impairment, such as ne motor dexterity or sickness behaviour that are not captured by the tests selected. ...
... Ki67-expressing cells appeared to be positive for DCX, indicating the presence of proliferating neural progenitors in the lesion. Several reports using hydrogels in ICH have studied the expression of neurogenic markers [15,49,51,52]. ...
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... The researchers demonstrated that inflammation was suppressed in the intervention group. Macrophage polarization was observed to shift towards the M2 phenotype leading to a decline in the secretion of inflammatory cytokines, resulting in reduced neuronal loss and enhanced functional recovery [220]. Shiratori et al. showed that drugs could polarize macrophages into different subtypes. ...
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... Native fish gelatin does not possess traceable thiol, therefore, successful thiolation was first determined through 5,5 -dithio-bis-[2-nitrobenzoic acid] (DTNB) assay ( Figure 1C). The degree of thiolation influences the amount of Gel-SH and PEG-4MAL materials required to reach an equimolar (SH:MAL) ratio, which is optimal for hydrogel formation [57,58]. With increased degree of Gel-SH thiolation, there is a higher number of click bonds between Gel-SH and PEG-4MAL that can occur using the same concentration of Gel-SH, and therefore more stability in the matrix. ...
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... Several findings showed that almost five different types of microglia morphology were identified in control and experimental status epilepticus (SE) tissues, and were categorized as follows: (1) ramified; (2) hypertrophic; (3) bushy; (4) amoeboid; and (5) rod-shaped (19) (Figure 1). Microglial polarization plays a major role in promoting brain injury and nerve recovery (20). As the main source of inflammatory cells in ischemic brain injury, microglia play a key role in the inflammatory response after stroke (21). ...
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Stroke is the leading cause of disability and death worldwide, with ischemic stroke occurring in ~5% of the global population every year. Recently, many studies have been conducted on the inflammatory response after stroke. Microglial/macrophage polarization has a dual function and is critical to the pathology of ischemic stroke. Microglial/macrophage activation is important in reducing neuronal apoptosis, enhancing neurogenesis, and promoting functional recovery after ischemic stroke. In this review, we investigate the physiological characteristics and functions of microglia in the brain, the activation and phenotypic polarization of microglia and macrophages after stroke, the signaling mechanisms of polarization states, and the contribution of microglia to brain pathology and repair. We summarize recent advances in stroke-related microglia research, highlighting breakthroughs in therapeutic strategies for microglial responses after stroke, thereby providing new ideas for the treatment of ischemic stroke.
... A 28-point neurologic deficit scale was used to assess neurologic deficits, including body symmetry, gait, climbing, circling behavior, front limb symmetry, compulsory circling, and whisker response, as previously mentioned (Fang et al., 2014;Xu et al., 2020). A higher score represents a more severe injury. ...
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... 92,93 Gel systems with anti-inflammatory and hemostatic effects were used for neuroprotection and hemostatic therapy after hemorrhagic stroke. 94,95 Exosomes are extracellular vesicles secreted by different cell types that have been used as carriers for drugs and different types of molecules (mRNA, miRNA, and protein). 96 Otero-Ortega et al used proteomics analysis to identify protein in exosomes derived from mesenchymal stem cells (MSCs). ...
... Injection of the gelatin hydrogel reduced inflammation and attenuated neurological deficits after ICH. 94 Keratin-based hydrogel with hemostatic effect have also successfully been applied in ICH therapy. 95 ...
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Hemorrhagic stroke is one of the most devastating diseases worldwide due to a high rate of disability and mortality with few effective treatments. Recent advances in nanomedicines to promote hemostasis, drug delivery, neuroprotection, and nerve regeneration may provide insight into hemorrhagic stroke treatment. In this review, we first view the pathophysiology and conventional therapeutics of hemorrhagic stroke. Second, we comprehensively summarize the current nanomedicines applied in hemorrhagic stroke, including inorganic nanomaterials, polymer-based nanomaterials, lipid-based nanomaterials, self-assembling peptide-based hydrogel, exosomes, and gel systems. Finally, the challenges, opportunities, and future perspectives of nanomedicines for hemorrhagic stroke are discussed. Thus, this review promotes greater exploration of effective therapies for hemorrhagic stroke with nanomedicines.
... Hydrogel is considered a biocompatible material that can be injected during minimally invasive surgery and form a matrix for cell infiltration and adhesion to facilitate tissue repair after stroke [214,215]. Gelatin hydrogel injection into the lesion three days post collagenase-induced ICH is reported to alleviate neurological deficits of mice due to conversion of M/M from pro-inflammatory to regulatory [216]. Moreover, hydrogels may carry medications, neurotrophic factors, and stem cells as well as receive chemical modifications to enhance therapeutic effects [215,217]. ...
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Despite marked advances in surgical techniques and understanding of secondary brain injury mechanisms, the prognosis of intracerebral hemorrhage (ICH) remains devastating. Harnessing and promoting the regenerative potential of the central nervous system may improve the outcomes of patients with hemorrhagic stroke, but approaches are still in their infancy. In this review, we discuss the regenerative phenomena occurring in animal models and human ICH, provide results related to cellular and molecular mechanisms of the repair process including by microglia, and review potential methods to promote tissue regeneration in ICH. We aim to stimulate research involving tissue restoration after ICH.