A Single Smart Nanomaterial for Near-Infrared-Switchable Theranostics of Hemorrhage and Thrombosis via Photoacoustic Imaging.

Abstract

The clinical management of hemorrhagic patients remains a significant challenge, as current therapeutic approaches lack real-time diagnostic capability and spatiotemporal precision. Conventional materials (e.g., hydrogels) require surgical intervention, while molecular targeting strategies are limited by slow kinetics and uncontrollable thrombotic risks. To address these limitations, we developed a smart nanomaterial based on a NiFe-layered double hydroxide decorated with both Ag single atoms and nanoparticles (AgSA + NP/NiFe-LDH). This platform can bind plasminogen activators, achieving rapid hemostasis with approximately 30% reduced fibrinolysis in vitro and approximately 50% reduced blood loss in vivo in models of intracranial and abdominal hemorrhage. Under pulsed near-infrared (NIR) irradiation, the dominant photoelectric effect enhances hemostatic efficacy, reducing blood loss by about 50% compared to the unexposed part; under sustained NIR exposure, strong photothermal effects inactivate clot-enriched thrombin and alter fibrin structure, thereby promoting controlled thrombolysis. This dual functionality is consistently demonstrated in arterial models and in cryopreserved human blood samples from healthy individuals and hemorrhagic patients. Moreover, the material enables real-time visualization of active bleeding (as low as 3 μL) via photoacoustic imaging, as validated in an intracranial hemorrhage model. Our work demonstrates a proof-of-concept NIR-based strategy for externally modulated management with potential applications in dynamic vascular emergencies.

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