Epidural Thin Film Implants of Polymerized Curcumin Downregulate Inflammatory Markers and Improve Functional Recovery After Spinal Cord Injury in Mice
Spinal cord injury (SCI) is a notoriously intractable medical problem for which there is no neuroprotective pharmacotherapy, despite four decades of clinical trials on systemically administered small molecules that target plausible injury mechanisms. The shared failure mode of those trials is delivery: oxidative and inflammatory injury evolves locally at the lesion site over days to weeks, a timescale that far exceeds the half-life of systemically administered drugs. Furthermore, systemically administered drugs often cannot be dosed at high enough levels to achieve efficacious concentrations locally at the lesion site, without off-target effects. In this study, we show the first example of a locally implantable drug depot that exerts long-lasting activity at the lesion site. We demonstrate in vivo efficacy of a poly(pro-drug) thin film deployed locally, to address delivery problem in SCI. The films are composed of a copolyester in which curcumin, a potent natural antioxidant, is incorporated as a backbone repeat unit alongside poly(ethylene glycol) sebacate segments. The soft, thin film ([~]100 {micro}m) is employed as an epidural implant that quenches reactive oxygen species on-contact and can sustain activity for over two months, which is orders of magnitude longer than free curcumin (half-life of [~]10 min in buffer). A single epidural P50 film, placed on the exposed dura immediately after a moderate-to-severe T9 contusion in mice, produced a statistically significant improvement in Basso Mouse Scale locomotor recovery at 14 days post-injury, relative to a non-antioxidant control polymer of same architecture. The film preserved myelinated white matter, attenuated reactive gliosis (GFAP, Iba1), and produced coherent downregulation of neuroinflammatory gene-expression programs. These effects were spatially restricted to tissue rostral to the lesion, consistent with on-contact, locally confined polymer activity. Because curcumin is covalently enchained within the polymer itself, rather than blended as a payload in a carrier matrix, release is governed by backbone hydrolysis and the architecture can generalize to other phenolic bioactives, potentially establishing epidural poly(pro-drug) thin films as a mechanistically grounded, surgical platform for sustained local pharmacotherapy of CNS injury.