Calcium-triggered self-anchoring bilayer microneedle patch with spatiotemporally programmed TLR4 activation remodels the immune microenvironment of abdominal wall endometriosis

In: Chemical Engineering Journal · 2026 · pp. 183469 · doi:10.1016/j.cej.2026.183469 · W7223449562
Lab / animal OA: hybrid CC0
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A calcium-triggered bilayer microneedle patch sequentially activates TLR4 to shift abdominal wall endometriosis macrophages from M1 to M2, inhibiting lesion growth and fibrosis in mice without systemic toxicity.

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Abstract

Abdominal wall endometriosis (AWE), a distinct clinical subtype of endometriosis, is driven by a dysregulated immune microenvironment dominated by M2 macrophages. Current surgical and hormonal therapies are limited by high recurrence (5–20%), incomplete lesion resection, systemic side effects, and unsuitability for fertility-seeking patients. Here, we design a calcium-triggered self-anchoring bilayer microneedle patch (d-MN@DDAH) that integrates mechanical interlocking, pH-responsive drug release, and spatiotemporally programmed immunomodulation for a “first attack, then repair” AWE therapy. The lower needle layer consists of oxidized alginate grafted with a TLR4-targeting peptide (DDAH) via Schiff base bonds for acid-responsive immune activation; the upper layer comprises gelatin methacryloyl loaded with citric acid (CA) for sustained repair. The patch exhibits a well-defined bilayer structure, sufficient mechanical strength for skin penetration, and calcium-triggered swelling for tissue anchoring. DDAH shows pH-dependent release, while CA displays sustained release over 14 days. The patch is non-cytotoxic and orchestrates sequential macrophage polarization from an early M1 phenotype to a reparative M2 phenotype in vitro. In vivo dynamic monitoring further confirmed an early M1-dominant phase followed by a timely M2 transition. This reprogrammed microenvironment inhibits endometriotic cell proliferation and invasion, induces apoptosis, and downregulates key pathogenic molecules including MMP-2/9 and CYP19A1. In an AWE mouse model, the d-MN@DDAH patch achieves 92.6% lesion growth inhibition, reduces fibrosis, restores immune homeostasis (M1/M2 ≈ 0.62:1), alleviates pain, and shows no systemic toxicity. This work provides a transformative, non-hormonal, and spatiotemporally programmable platform for AWE and other immune-mediated diseases.

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