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Nature Nanotechnology · Dec 05, 2025

Bioengineered photosynthetic nanothylakoids reshape the inflammatory microenvironment for rheumatoid arthritis therapy

Reducing individual inflammatory factors does not always translate into clinical efficacy in rheumatoid arthritis (RA), an autoimmune disease characterized by joint inflammation. Proinflammatory M1 macrophages are a key driver of the hyperinflammatory joint microenvironment, which also promotes the progression of RA. Here we show that folate-receptor-targeted photosynthetic nanothylakoid (FA-PEG-NTK)-based phototherapy reprogrammes macrophages from M1 to anti-inflammatory M2, and successfully remodels the inflammatory RA microenvironment. The nanothylakoids were sourced from plant-derived thylakoids and developed by surface modification with distearoyl phosphoethanolamine–polyethylene glycol (PEG) via hydrophobic interactions to preserve their photocatalytic enzymes. We show that upon light irradiation in a mouse macrophage model of inflammation, the FA-PEG-NTK system generates oxygen and nicotinamide adenine dinucleotide phosphate, alleviating hypoxia and reducing reactive oxygen species. This rebalances the oxidative stress in M1 macrophages, thereby remodelling the inflammatory microenvironment in RA. We also show that in a collagen-induced arthritis rat model, FA-PEG-NTK-mediated phototherapy notably alleviated synovial hyperplasia and enhanced bone and cartilage regeneration, outperforming the clinical treatment methotrexate, with no apparent side effects.

Biomedical engineering Drug delivery Nanostructures Tissue engineering and regenerative medicine biology mouse experiments


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Nature · Nov 26, 2025

Slipknot-gauged mechanical transmission and robotic operation

Mechanical transmission is essential in force-related activities ranging from the daily tying of shoe laces1to sophisticated surgical2and robotic operations3,4. Modern machines and robots typically use complex electronic devices designed to sense and limit force5, some of which still face challenges when operating space is limited (for example, in minimally invasive surgeries)6or when resources are scarce (for example, operations in remote areas without electricity). Here we describe an alternative slipknot-based mechanical transmission mechanism to control the intelligent operation of both human and robotic systems. Through topological design, slipknot tying and release can encode and deliver force with a consistency of 95.4% in repeating operations, which circumvents the need for additional sensors and controllers. When applied to surgical repair, this mechanism helped inexperienced surgeons to improve their knotting-force precision by 121%, enabling them to perform surgical knots as good as those of experienced surgeons. Moreover, blood supply and tissue healing after surgery were improved. The mechano-intelligence exhibited in slipknots may inspire investigations of knotted structures across multiple length scales. This slipknot-gauged mechanical transmission strategy can be widely deployed, opening up opportunities for resource-limited healthcare, science education and field exploration.

Biomedical engineering


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Nature · Nov 19, 2025

A skin-permeable polymer for non-invasive transdermal insulin delivery

Non-invasive skin permeation is widely used for convenient transdermal delivery of small-molecule therapeutics (less than 500 Da) with appropriate hydrophobicities1. However, it has long been deemed infeasible for large molecules—particularly polymers, proteins and peptides2,3—due to the formidable barrier posed by the skin structure. Here we show that the fast skin-permeable polyzwitterion poly[2-(N-oxide-N,N-dimethylamino)ethyl methacrylate] (OP) can efficiently penetrate the stratum corneum, viable epidermis and dermis into circulation. OP is protonated to be cationic and is therefore enriched in the acidic sebum and paracellular stratum corneum lipids containing fatty acids, and subsequently diffuses through the intercorneocyte lipid lamella. Beneath the stratum corneum, at the normal physiological pH, OP becomes a neutral polyzwitterion, ‘hopping’ on cell membranes, enabling its efficient migration through the epidermis and dermis and ultimately entering dermal lymphatic vessels and systemic circulation. As a result, OP-conjugated insulin efficiently permeates through the skin into the blood circulation; transdermal administration of OP-conjugated insulin at a dose of 116 U kg−1into mice with type 1 diabetes quickly lowers their blood glucose levels to the normal range, and a transdermal dose of 29 U kg−1normalizes the blood glucose levels of diabetic minipigs. Thus, the skin-permeable polymer may enable non-invasive transdermal delivery of insulin, relieving patients with diabetes from subcutaneous injections and potentially facilitating patient-friendly use of other protein- and peptide-based therapeutics through transdermal delivery.

Biomedical engineering Drug delivery Peptide delivery Protein delivery

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Nature Biotechnology · Nov 10, 2025

Clearance of intracranial debris by ultrasound reduces inflammation and improves outcomes in hemorrhagic stroke models

Impaired clearance of neurotoxic debris in the brain exacerbates neurologic disease and presents a promising therapeutic target. Pharmacologic therapies can enhance meningeal lymphatic clearance in preclinical models but may be limited by systemic toxicities or invasive administration. Here we report a low-intensity, focused ultrasound protocol that noninvasively clears pathogenic substances from the cerebrospinal fluid and brain interstitium in mice. Using two models of hemorrhagic stroke, we demonstrate that this protocol clears the cerebrospinal fluid and interstitium of blood cells, which accumulate in the deep cervical lymph nodes via meningeal lymphatics. The protocol directly modulates molecular processes, including mechanosensitive channels, to shift microglial phenotypes and astrocytic aquaporin localization to reduce neuroinflammation and neurocytotoxicity. In the intracerebral hemorrhage model, it improves behavioral outcomes and increases survival with greater efficacy than a pharmacologic benchmark. The protocol satisfies Food and Drug Administration safety guidelines, supporting clinical translatability. If demonstrated effective clinically, it may provide therapeutic benefit not only in hemorrhagic stroke but also in other neurologic disorders that involve impaired debris clearance.

Biomedical engineering Stroke



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Nature Biomedical Engineering · Nov 03, 2025

Nonexpansive biodegradable matrix promotes blood vessel organoid development for neurovascular repair and functional recovery in ischaemic stroke

Tissue engineering-based vascular reconstruction represents a promising therapeutic strategy for ischaemic stroke. However, in the confined stroke cavity, conventional implants are unable to simultaneously provide swelling-resistant support and growth-permissive internal space, which are crucial for effective revascularization. To address this limitation, we develop a bioinspired, non-expansive biodegradable matrix (NEBM) through covalent–non-covalent assembly of commercially available, clinical-grade natural polymers. We show that NEBM recapitulates key features of brain extracellular matrix—including porous microstructure and tissue-matched stiffness—to deliver structural stability. Moreover, its progressively degradable structure establishes a dynamic remodelling niche that directs cellular behaviour towards promoting angiogenesis. Compared with commercial Matrigel-based matrix, NEBM fosters blood vessel organoid development with higher vascular density, larger vessel diameters and more distinct arterial features. In both subcutaneous and stroke transplantation models, we find that NEBM facilitates the integration of blood vessel organoids with the host vasculature. Strikingly, this revascularization in stroke cavity stimulates neurogenesis, contributing to significant functional recovery. As such, our study provides valuable guidance to design clinically translatable matrices for organ repair and regeneration in confined environments.

Bioinspired materials Biomedical engineering Gels and hydrogels Implants

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Nature Biomedical Engineering · Nov 03, 2025

Engineered human induced pluripotent stem cell models reveal altered podocytogenesis in congenital heart disease-associatedSMAD2mutations

Clinical observations of patients with congenital heart disease carryingSMAD2genetic variants revealed correlations with multi-organ impairments at the developmental and functional levels. Many patients with congenital heart disease present with glomerulosclerosis, periglomerular fibrosis and albuminuria. It remains largely unknown whetherSMAD2variants associated with congenital heart disease can directly alter kidney cell fate, tissue patterning and organ-level function. Here we investigate the role of pathogenicSMAD2variants in podocytogenesis, nephrogenic cell lineage specification and glomerular filtration barrier function using a combination of CRISPR-based disease modelling, stem cell and microfluidic organ-on-a-chip technologies. We show that the abrogation ofSMAD2results in altered patterning of the mesoderm and intermediate mesoderm cell lineages, which give rise to nearly all kidney cell types. Following further differentiation of intermediate mesoderm cells, the mutant podocytes failed to develop arborizations and interdigitations. A reconstituted glomerulus-on-a-chip system showed substantial albumin leakage, as observed in glomerulopathies. This study implicates chronic heart disease-associatedSMAD2mutations in kidney tissue malformation that might inform targeted regenerative therapies.

Biomedical engineering Development Paediatric kidney disease Stem-cell differentiation Urological manifestations


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Nature Biomedical Engineering · Oct 24, 2025

Implanted microelectrode arrays in reinnervated muscles allow separation of neural drives from transferred polyfunctional nerves

Targeted muscle reinnervation surgery reroutes residual nerve signals into spare muscles, enabling the recovery of neural information through electromyography (EMG). However, EMG signals are often overlapping, making the interpretation of limb functions complicated. Regenerative peripheral nerve interfaces surgically partition the nerve into individual fascicles that reinnervate specific muscle grafts, isolating distinct neural sources for precise control and interpretation of EMG signals. Here we combine targeted muscle reinnervation surgery of polyvalent nerves with a high-density microelectrode array implanted at a single site within a reinnervated muscle, and via mathematical source separation methods, we separate all neural signals that are redirected into a single muscle. In participants with upper-limb amputation, the deconvolution of EMG signals from four reinnervated muscles into motor unit spike trains revealed distinct clusters of motor neurons associated with diverse functional tasks. Our method enabled the extraction of multiple neural commands within a single reinnervated muscle, eliminating the need for surgical nerve division. This approach holds promises for enhancing control over prosthetic limbs and for understanding how the central nervous system encodes movement after reinnervation.

Biomedical engineering Computational neuroscience Machine learning Microarrays Motor neuron




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Nature Biomedical Engineering · Sep 24, 2025

Invasive neurophysiology and whole brain connectomics for neural decoding in patients with brain implants

Brain–computer interface research can inspire closed-loop neuromodulation therapies, promising spatiotemporal precision for the treatment of brain disorders. Decoding dynamic patient states from brain signals with machine learning is required to leverage this precision, but a standardized framework for invasive brain signal decoding from neural implants does not exist. Here we develop a platform that integrates brain signal decoding with magnetic resonance imaging connectomics and demonstrate its use across 123 h of invasively recorded brain data from 73 neurosurgical patients treated with brain implants for movement disorders, depression and epilepsy. We introduce connectomics-informed movement decoders that generalize across cohorts with Parkinson’s disease and epilepsy from the United States, Europe and China. We reveal network targets for emotion decoding in left prefrontal and cingulate circuits in deep brain stimulation patients with major depression. Finally, we showcase opportunities to improve seizure detection in responsive neurostimulation for epilepsy. Our study highlights the clinical use of brain signal decoding for deep brain stimulation and provides methods that allow for rapid, high-accuracy decoding for precision medicine approaches that can dynamically adapt neurotherapies in response to the individual needs of patients.

Biomedical engineering Computational neuroscience


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Nature Biomedical Engineering · Sep 23, 2025

An immune-competent lung-on-a-chip for modelling the human severe influenza infection response

Severe influenza affects 3–5 million people worldwide each year, resulting in more than 300,000 deaths annually. However, standard-of-care antiviral therapeutics have limited effectiveness in these patients. Current preclinical models of severe influenza fail to accurately recapitulate the human immune response to severe viral infection. Here we develop an immune-competent, microvascularized, human lung-on-a-chip device to model the small airways, successfully demonstrating the cytokine storm, immune cell activation, epithelial cell damage, and other cellular- and tissue-level human immune responses to severe H1N1 infection. We find that interleukin-1β and tumour necrosis factor-α play opposing roles in the initiation and regulation of the cytokine storm associated with severe influenza. Furthermore, we discover the critical stromal–immune CXCL12–CXCR4 interaction and its role in immune response to infection. Our results underscore the importance of stromal cells and immune cells in microphysiological models of severe lung disease, describing a scalable model for severe influenza research. We expect the immune-competent human lung-on-a-chip device to enable critical discoveries in respiratory host–pathogen interactions, therapeutic side effects, vaccine potency evaluation, and crosstalk between systemic and mucosal immunity in human lung.

Biomedical engineering Influenza virus Tissue engineering


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Nature Biomedical Engineering · Sep 18, 2025

Systematic functional screening of switchable aptamer beacon probes

Immunoassays using affinity binders such as antibodies and aptamers are crucial for molecular biology. However, the advancement of analytical methods based on these affinity probes is often hampered by complex operational steps that can introduce errors, particularly in intricate environments such as intracellular settings and microfluidic systems. There is growing interest in developing molecular probes for wash-free assays that activate signals upon target detection. Here we report a systematic functional screening platform for switchable aptamer beacon probes that can achieve target-responsive detection. A stem–loop, hairpin-shaped beacon library was constructed on microbeads and screened using target-responsive fluorescence-activated sorting. The selected aptamer beacons exhibit strong affinities, triggering fluorescence only upon binding, thus enabling wash-free immunoassays for the detection of intracellular and membrane proteins. Computational modelling offers insights into aptamer binding and structural switching mechanisms, revealing how specific protein–aptamer interactions drive stem–loop unwinding and postbinding conformational changes critical for functional activation. This approach establishes a standardized platform for generating switchable aptameric tools, supporting their potential in advanced diagnostics and research.

Biochemical assays Biomedical engineering

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Nature · Sep 17, 2025

High-density soft bioelectronic fibres for multimodal sensing and stimulation

There is an increasing demand for multimodal sensing and stimulation bioelectronic fibres for both research and clinical applications1,2. However, existing fibres suffer from high rigidity, low component layout precision, limited functionality and low density of active components. These limitations arise from the challenge of integrating many components into one-dimensional fibre devices, especially owing to the incompatibility of conventional microfabrication methods (for example, photolithography) with curved, thin and long fibre structures2. As a result, limited applications have been demonstrated so far. Here we use ‘spiral transformation’ to convert two-dimensional thin films containing microfabricated devices into one-dimensional soft fibres. This approach allows for the fabrication of high-density multimodal soft bioelectronic fibres, termed Spiral-NeuroString (S-NeuroString), while enabling precise control on the longitudinal, angular and radial positioning and distribution of the functional components. Taking advantage of the biocompatibility of our soft fibres with the dynamic and soft gastrointestinal system, we proceed to show the feasibility of our S-NeuroString for post-operative multimodal continuous motility mapping and tissue stimulation in awake pigs. We further demonstrate multi-channel single-unit electrical recording in mouse brain for up to 4 months, and a fabrication capability to produce 1,280 channels within a 230-μm-diameter soft fibre. Our soft bioelectronic fibres offer a powerful platform for minimally invasive implantable electronics, where diverse sensing and stimulation functionalities can be effectively integrated.

Biomedical engineering Electronic devices