A Shape-Recovery Polycationic Fibroin for Hemostasis-Regeneration Transition by Recapitulating Natural Coagulation Networks.

Large-scale and deep trauma restricts the effective hemostasis and tissue regeneration management, even causing death. The formation of the fibrin network is the initial stage of wound control. Inspired by Fn's characteristics during coagulation, an artificial polycationic fibroin (pCSF/β) is designed to achieve hemostasis-regeneration transition. pCSF/β replicates the aggregation state and maturation process of Fn through intermolecular interaction and subsequent strain hardening originating from ethanol-inducing β-sheet to recapitulate natural coagulation networks, achieving mechanical reinforcement and shape recovery. Proteomics and transcriptomics analyses reveal that pCSF/β connects hemostasis and regeneration through platelet contents' release and the PI3K/Akt signaling pathway. The results of incompressible hemostasis, large-area skin repair, and penetrating liver regeneration in animal models such as minipigs confirm pCSF/β is superior to clinical products in rapid hemostasis and synchronous tissue regeneration. The molecular design of pCSF/β provides new insights for developing biomaterials in rapid hemostasis and simultaneous regeneration.