Post-myocardial infarction (MI), the rapid decrease in pH triggers myocardial cell acidosis, which compromises the therapeutic efficacy of exosomes in MI. The groundbreaking research in the human cardiac organoid MI model suggests that exosomes, when paired with pH adjustment, dramatically reduce cardiomyocyte mortality while maintaining their proliferative potential, underscoring the importance of pH regulation in myocardial preservation. Micro-robot mounted micro-needle (MN) patch is thus proposed, targeting MI-acidic microenvironmet, to deliver exosomes into deep injured tissue. Upon injection, the patch base releases VEGF-laden nanoparticles adhering to the infarcted myocardium. The smart patch is found not only 3D reconstructs the vascular network in MI regions but also effectively saves cardiomyocytes in rats. Furthermore, the minimally invasive delivery of MN patches are also verified to hearts of rabbits and pigs via thoracoscopic surgery underscores. These findings suggest that precise regulation of the microenvironment is a key to improving treatment outcomes.
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