Multilayer Amnion-PCL Nanofibrous Membrane Loaded with Celecoxib Exerts a Therapeutic Effect Against Tendon Adhesion by Improving the Inflammatory Microenvironment

Tendon injury is a common sports injury. Given the low content of cells, blood vessels, and nerves in tendon tissue and poor self-repair ability, complications such as tendon adhesions can easily occur and has become an urgent clinical problem. The inflammatory phase of tendon healing is characterized by the release of a large number of inflammatory factors, whose mediated excessive inflammatory response is an important cause of tendon adhesion. Nonsteroidal anti- inflammatory drugs were used to prevent tendon adhesions by reducing the inflammatory response. However, recent studies have shown that the nonsteroidal anti-inflammatory drugs partially impairs tendon healing. Therefore, optimizing the anti-adhesive membrane loaded with NSAIDs to mitigate the effects on tendon healing requires further in-depth study. Amniotic membranes are natural polymeric semi-permeable membranes from living organisms that are smooth; free of blood vessels, nerves, and lymph; and rich in matrix, growth factors, enzymes, and other active ingredients. In this study, we used electrostatic spinning technology to construct multifunctional nanofiber composite membranes of the PCL membrane loaded with celecoxib and amniotic membrane. Given its advantages, the composite membran can not only reduce adhesions through the barrier effect of the membrane, but also achieve a better anti-adhesion effect by affecting the exogenous healing mechanism of the tendon through the pharmacological effect of celecoxib. What is more important, we incorporated the amniotic membrane into the middle layer of the composite membrane to release multiple growth factors and promote endogenous tendon healing. The composite film has shown good results in preventing tendon adhesions, which provides a new direction to improve the repair efficiency of tendon tissue and avoid tendon adhesions.