{
  "abstract": "Background: Dural 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. Methods: Forty 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. Results: Baseline 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). Conclusion: Riboflavin-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.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany",
    "Faculty of Medicine, University of Freiburg, Freiburg, Germany",
    "CAST, Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany",
    "Laboratory of Experimental Brain & Spine Surgery (LENS), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany",
    "Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Freiburg, Germany",
    "Berta-Ottenstein-Program for Clinician Scientists, Faculty of Medicine, University of Freiburg, Freiburg, Germany",
    "Neuroelectronic Systems, Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany",
    "Institute of Analytical and Bioanalytical Chemistry, Ulm University, Ulm, Germany"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ioannis Vasilikos"
    },
    {
      "affs": [
        1
      ],
      "name": "Sukesh Mysore Swamy"
    },
    {
      "affs": [
        2
      ],
      "name": "Ulrich G. Hofmann"
    },
    {
      "affs": [
        3
      ],
      "name": "Ulrich Hubbe"
    },
    {
      "affs": [
        4
      ],
      "name": "Roland Rölz"
    },
    {
      "affs": [
        5
      ],
      "name": "Angeliki Stathi"
    },
    {
      "affs": [
        6
      ],
      "name": "Katerina Wolk"
    },
    {
      "affs": [
        7
      ],
      "name": "Daniel Strahnen"
    },
    {
      "name": "Amir El Rahal"
    },
    {
      "name": "Mukesch J. Shah"
    },
    {
      "name": "Jürgen Grauvogel"
    },
    {
      "name": "Florian Volz"
    },
    {
      "name": "Boris Mizaikoff"
    },
    {
      "name": "Lorena Diaz"
    },
    {
      "name": "Vidhya M. Ravi"
    },
    {
      "name": "Kevin Joseph"
    },
    {
      "name": "Jürgen Beck"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/570sd9kh2gqp7.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0351819",
  "fulltext_url": null,
  "id": "570sd9kh2gqp7",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0351819",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2502|Collagen: Extraction and Characterization"
    ],
    [
      "plos",
      "/Biology and life sciences/Anatomy/Ocular system/Ocular anatomy/Cornea"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Proteins/Collagens"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Ocular system/Ocular anatomy/Cornea"
    ],
    [
      "plos",
      "/Physical sciences/Chemistry/Chemical compounds/Organic compounds/Vitamins/B vitamins/Riboflavin"
    ],
    [
      "plos",
      "/Physical sciences/Chemistry/Organic chemistry/Organic compounds/Vitamins/B vitamins/Riboflavin"
    ],
    [
      "plos",
      "/Physical sciences/Chemistry/Physical chemistry/Chemical bonding/Cross-linking"
    ],
    [
      "plos",
      "/Physical sciences/Chemistry/Physical chemistry/Photochemistry"
    ],
    [
      "plos",
      "/Physical sciences/Materials science/Material properties/Mechanical properties/Stiffness"
    ],
    [
      "plos",
      "/Physical sciences/Physics/Electromagnetic radiation/Light/Ultraviolet radiation/Ultraviolet A"
    ],
    [
      "plos",
      "/Research and analysis methods/Microscopy/Scanning probe microscopy/Atomic force microscopy"
    ]
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  "openalex": "W7214670788",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0351819&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-28",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/570sd9kh2gqp7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:37Z",
      "native_id": "10.1371/journal.pone.0351819",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0351819"
    }
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  "subjects": [
    {
      "field": "chemistry",
      "origin": "plos:organic chemistry",
      "subfield": "organic"
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    {
      "field": "chemistry",
      "origin": "plos:physical chemistry",
      "subfield": "physical"
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    {
      "field": "medicine",
      "origin": "plos:anatomy",
      "subfield": "physiology"
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  ],
  "title": "Riboflavin-sensitized UVA collagen crosslinking produced a controllable, dose-dependent increase in the nanomechanical strength of ex vivo bovine dura mater",
  "title_text": "Riboflavin-sensitized UVA collagen crosslinking produced a controllable, dose-dependent increase in the nanomechanical strength of ex vivo bovine dura mater",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:37Z",
  "url": "https://research.draconitic.com/paper/570sd9kh2gqp7",
  "venue": "PLOS One",
  "versions": []
}