A Light-Driven Bioactive Nerve Conduit for Trigeminal Neuralgia: Integrated Decompression and Photosynthetic Oxygenation Restores Mitochondrial Function

Vascular compression and concomitant hypoxia exacerbate trigeminal neuralgia (TN), yet current therapies rarely target both pathologies. We developed a photosynthetic nerve guide conduit (SFM-Gel@ NGC) by embedding auto fluorescent microalgae in silk fibroin hydrogel, enabling simultaneous mechanical decompression and oxygen release. The construct exhibited suitable mechanical properties, tunable oxygen generation, and excellent biocompatibility. Under hypoxia, SFM-Gel promoted neuronal cell proliferation and function by reducing ROS and restoring mitochondrial activity, while downregulating HIF-1α and ATP/P2X3 pathways. In a rat TN model, auto fluorescent SFM-Gel@ NGC implantation alleviated mechanical allodynia, repaired nerve morphology, and suppressed BDNF/NGF and ATP/P2X3 inflammatory signaling. Transcriptomic analysis confirmed modulation of hypoxia/ROS/NF-κB pathways during immune/inflammatory responses to compression. This integrated decompression-oxygenation strategy offers a transformative therapy for TN.