Research advances in intelligent microenvironment-responsive hydrogels for myocardial infarction therapy

Myocardial infarction (MI) poses a severe threat to human life and health. During acute MI, persistent myocardial ischemia and hypoxia induce pathological alterations in the microenvironment. Traditional therapeutic approaches exhibit limited capacity for targeted modulation of this infarcted microenvironment. Consequently, developing therapeutic strategies capable of precisely responding to the pathological microenvironment holds significant importance. Hydrogels, as a class of polymeric biomaterials with excellent biocompatibility, can be engineered into intelligent responsive hydrogels by incorporating environmentally responsive functional groups or constructing intelligent network architectures. These hydrogels are designed to sense and respond to key features of the MI pathological microenvironment, such as temperature, pH, reactive oxygen species, and enzyme concentrations. This review systematically summarizes the design strategies and research advances in intelligent responsive hydrogels for MI therapy over recent years, focusing on their distinct functional capabilities: alleviating oxidative damage, suppressing excessive inflammatory responses, enabling precise drug delivery, and modulating immune activity. Although current research predominantly remains at the preclinical stage and faces numerous challenges, the convergence of materials science and biomedical engineering positions smart responsive hydrogels as promising candidates to deliver innovative solutions for the precise treatment of MI.