Acellular dermal matrix hydrogels promote healing of radiation-induced skin injury in a rat model†

Background: radiation-induced skin injury (RISI) is a common complication of radiotherapy, affecting 85–95% of patients. Current treatments lack sufficient evidence of efficacy. Acellular dermal matrix (ADM) hydrogels have shown promise in treating chronic wounds, burns, and ulcers, but their potential in RISI remains unexplored. Methods: ADM hydrogels were prepared from porcine dermis and characterized using histological staining, scanning electron microscopy (SEM), and rheological assessments. A rat model of RISI was established, and the therapeutic effects of the ADM hydrogel were evaluated by gross observation, histological analysis, and immunofluorescence staining. Oxidative stress, angiogenesis, apoptosis, macrophage infiltration, and inflammatory responses were also assessed. Results: ADM hydrogel treatment significantly reduced wound area, radiation injury scores, and apoptosis while increasing epithelial thickness and hair follicle regeneration compared to the control group. The hydrogel promoted angiogenesis, vascular maturation, and M2 macrophage polarization. It also decreased the expression of pro-inflammatory cytokines (IL-1β and IL-6) and increased the expression of the anti-inflammatory cytokine IL-10. No significant differences in antioxidant effects were observed between the groups. Conclusion: The ADM hydrogel effectively promotes the healing of RISI in a rat model by modulating the inflammatory microenvironment and enhancing angiogenesis. These findings suggest that the ADM hydrogel could serve as a promising novel biomaterial for the management of RISI.