Evidence map›Paper›PMID 42804497›Full record

ArticlePloS one2026

Riboflavin-sensitized UVA collagen crosslinking produced a controllable, dose-dependent increase in the nanomechanical strength of ex vivo bovine dura mater.

Ioannis Vasilikos, Sukesh Mysore Swamy, Ulrich G Hofmann, Ulrich Hubbe, Roland Rölz, Angeliki Stathi, Katerina Wolk, Daniel Strahnen, Amir El Rahal, Mukesch J Shah and 7 more

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Ioannis VasilikosDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0001-5820-1110
Sukesh Mysore SwamyNeuroelectronic Systems, Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Ulrich G HofmannFaculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0002-6264-3701
Ulrich HubbeDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Roland RölzDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Angeliki StathiDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Katerina WolkDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Daniel StrahnenDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0009-0001-1903-2729
Amir El RahalDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Mukesch J ShahDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0002-7224-9185
Jürgen GrauvogelDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Florian VolzDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0001-7274-519X
Boris MizaikoffCAST, Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Lorena DiazCAST, Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Vidhya M RaviDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Kevin JosephDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Jürgen BeckDepartment of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0002-7687-6098

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDural defects, either from trauma, tumor resection, surgical approaches, genetics, or spontaneously represent a significant clinical challenge in neurosurgery. Given the established efficacy of riboflavin-sensitized ultraviolet-A (UVA) photo-crosslinking in ophthalmology, this study investigated its feasibility and dose-response characteristics as a novel strategy to biochemically augment the mechanical integrity and strength of ex-vivo bovine dura mater.

methodsForty bovine dura mater specimens were treated ex vivo using riboflavin concentrations of 2, 4, or 8 mM combined with UVA irradiation at 0.3 or 3 mW/cm2. PBS-treated specimens exposed to UVA served as controls. Atomic force microscopy nanoindentation was used to measure the local elastic modulus in matched regions before and after treatment, enabling paired assessment of treatment-induced mechanical changes while minimizing inter-sample variability. Post-treatment stiffness, fold-change from baseline, and riboflavin dose-response relationships were analyzed statistically.

resultsBaseline elastic moduli were equivalent across all groups (mean approximately 52 kPa, p = 0.92). While UVA alone caused a modest approximately 2- to 3-fold stiffness increase, riboflavin-UVA treatment produced a dramatic, concentration-dependent effect. The highest treatment (8 mM RF, 3 mW/cm2 UVA) increased the elastic modulus 150-fold, from approximately 53 kPa to approximately 8,000 kPa. Post-UV stiffness exhibited a strong linear relationship with riboflavin concentration (R2 = 0.994), indicating a precisely titratable crosslinking effect. All treatment conditions were statistically distinguishable (p < 0.001).

conclusionRiboflavin-sensitized UVA crosslinking substantially increases the nanomechanical strength of ex vivo bovine dura mater in a controllable, dose-dependent manner. These findings establish a proof of concept for biochemical reinforcement of dural tissue that might be used clinically. As a next step evaluation using human dura, macroscopic biomechanical testing, penetration-depth analysis, and safety assessment is warranted.

Indexed as

CollagenCross-Linking ReagentsDura MaterRiboflavinUltraviolet RaysAnimalsBiomechanical PhenomenaCattleElastic ModulusMicroscopy, Atomic ForceCollagenCross-Linking ReagentsRiboflavin

Identifiers

PMID42804497
PMCPMC13618906

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.