Biomedical researchers have designed an injectable microgel to reduce bleeding in infants requiring surgical treatment. In animal models, engineered microgels reduced bleeding by at least 50%.
When adults cut themselves, a multistep process called hemostasis stops bleeding from the injured blood vessels. However, hemostasis in infants is different from hemostasis in adults. This difference can be problematic if the infant requires surgery to address a serious medical problem. During surgery, patients usually receive blood from an adult donor to replace blood lost during surgery.
However, when adult blood is given to an infant, the difference between adult and infant hemostasis can cause excessive clotting, leading to blood clots forming in the lungs and elsewhere, increasing the chance of thrombosis, which puts the infant at risk.
Ashley Brown, co-corresponding author on a paper related to this study
“My research team has done a lot of research on bleeding associated with neonatal surgery, and we wanted to develop therapeutic interventions that would reduce bleeding and, in turn, reduce the need for infants to receive adult blood transfusions during surgery,” says Professor Brown, Lampe Distinguished Professor of Biomedical Engineering in the Lampe Joint Department of Biomedical Engineering at North Carolina State University and the University of North Carolina at Chapel Hill.
To achieve this goal, the researchers developed a material called B-knob-triggered microgel (BK-TriG).
“Fibrin is the major clotting protein in human blood,” Brown explains. “There are short amino acid sequences called ‘B-peptides’ that bind fibrin molecules and create blood clots where they are needed, and these B-peptides play a particularly important role in hemostasis in infants. BK-TriG is an engineered particle studded with these B-peptides.”
The particles absorb water and become a squishy hydrogel, mimicking the mechanical properties of natural platelets in a way that maximizes the B-peptide’s ability to form a fibrin network and stop bleeding.
The researchers first tested BK-TriG using a microfluidic device that allows them to conduct in vitro tests to see how the microgel affects clotting in the plasma of adults and infants.
“We found that BK-TriG was more effective at improving blood clotting in infant plasma than in adult plasma, which was what we expected,” says Brown.
To further test the effectiveness of BK-TriG, the researchers studied laboratory mice that were genetically engineered to not make fibrinogen, the precursor of fibrin. This allowed the researchers to first introduce infant fibrinogen into laboratory mice, allowing them to exhibit a similar pattern of hemostasis as infants.
“We found that BK-TriG was superior to any other option tested in reducing blood loss,” Brown says. “Specifically, BK-TriG reduced blood loss by 50-60% compared to the control group.”
The next step in the study is to see how BK-TriG, when used alone or in combination with BK-TriG, compares to other hemostatic treatments on the market.
“The results we’re reporting here are interesting, but we’re still a long way from clinical use,” Brown says. “We need to make sure there are no unexpected risks related to blood clotting.
“However, we are optimistic that if BK-TriG proves to be safe and effective, this could be a cost-effective way to make surgery safer for infants. Manufacturing BK-TriG particles will be relatively inexpensive, certainly when compared to blood products.”
The paper, “Hemostasis B-knob-triggered microgels (BK-TriGs) to address neonatal hemorrhage,” is scheduled to be published on April 3 in the journal scientific progress. Co-corresponding author of the paper is Michael Daniele, professor of electrical engineering, computer engineering and biomedical engineering at North Carolina State University. The paper’s first author is Nooshin Zandi, a postdoctoral researcher in the Lampe Collaborative Department of Biomedical Engineering. Co-authors include Kimberly Nellenbach, a former postdoctoral fellow in the joint department; Connor Moore, undergraduate student in integrated studies; Julia Storch, former undergraduate student at North Carolina State University; Sarah Abrahams and Matthew Frick of the UNC Blood Research Center;
This research was supported by the American Heart Association under grant 22TPA969368. National Science Foundation (grant 2211404) and the North Carolina Institute of Comparative Medicine.
Brown is a co-founder of Celsim Biotech, which develops an injectable drug designed to stop bleeding.
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north carolina state university
Reference magazines:
Zandi, N. Others. (2026). Hemostasis B Knob Trigger Microgel (BK-TriG) to address neonatal bleeding. Science progresses. DOI: 10.1126/sciadv.ady7698. https://www.science.org/doi/10.1126/sciadv.ady7698
