Photoactivated Release of Nitric Oxide and Antimicrobial Peptide Derivatives for Synergistic Therapy of Bacterial Skin Abscesses

Applications of nitric oxide-releasing nanomaterials in dermatology: Skin infections and wound healing

Nitric oxide (NO) is produced in most cells in the skin and is an important regulator of essential cutaneous functions, including responses to UV irradiation, microbial defense, wound healing, melanogenesis and epidermal permeability barrier homeostasis. Harnessing the physiological activities of NO for therapeutic use is difficult because the molecule is highly reactive and unstable. A variety of exogenous NO delivery platforms have been developed and evaluated; however, they have limited clinical applications in dermatology due to instability and poor cutaneous penetration. NO-releasing nanomaterials overcome these limitations, providing targeted tissue delivery, and sustained and controlled NO release. This review provides a comprehensive and up-to-date evaluation of the use of NO-releasing nanomaterials in dermatology for the treatment of skin and soft tissue infections and wound healing.

Near-infrared laser-assisted Ag@Chi-PB nanocompounds for synergistically eradicating multidrug-resistant bacteria and promoting diabetic abscess healing

Chronic wound infections, particularly multidrug-resistant microbe-caused infections, have imposed severe challenges in clinical administration. The therapeutic effectiveness of the current strategy using conventional antibiotics is extremely unsatisfactory. The development of novel treatment strategies to inhibit the infections caused by multidrug-resistant bacteria is highly desired. In this work, based on the combination of nanocompounds with the assistance of NIR laser, an antibacterial strategy was designed for MRSA-infected abscesses in diabetic mice. The nanocompounds named Ag@Chi-PB were prepared by using chitosan-coated Prussian blue (PB) as a nanocarrier for silver nanoparticles anchoring. Combined with near-infrared (NIR) laser, the nanocompounds were more efficient at killing Escherichia coli (E. coli) and Methicillin-resistant staphyllococcus aureus (MRSA) in vitro. Notably, MRSA was significantly removed in vivo and promoted diabetic abscess healing by the combined therapy of this nanocompound and NIR laser, owing to the synergistic antibacterial effect of photothermal therapy and release of Ag+. Meanwhile, the nanocompound showed satisfactory biocompatibility and superior biosafety. Collectively, the combination therapy of this nanocompound with the assistance of NIR laser may represent a promising strategy for clinical anti-infection.

Immunomodulatory hydrogels for skin wound healing: cellular targets and design strategy

Skin wounds significantly impact the global health care system and represent a significant burden on the economy and society due to their complicated dynamic healing processes, wherein a series of immune events are required to coordinate normal and sequential healing phases, involving multiple immunoregulatory cells such as neutrophils, macrophages, keratinocytes, and fibroblasts, since dysfunction of these cells may impede skin wound healing presenting persisting inflammation, impaired vascularization, and excessive collagen deposition. Therefore, cellular target-based immunomodulation is promising to promote wound healing as cells are the smallest unit of life in immune response. Recently, immunomodulatory hydrogels have become an attractive avenue to promote skin wound healing. However, a detailed and comprehensive review of cellular targets and related hydrogel design strategies remains lacking. In this review, the roles of the main immunoregulatory cells participating in skin wound healing are first discussed, and then we highlight the cellular targets and state-of-the-art design strategies for immunomodulatory hydrogels based on immunoregulatory cells that cover defect, infected, diabetic, burn and tumor wounds and related scar healing. Finally, we discuss the barriers that need to be addressed and future prospects to boost the development and prosperity of immunomodulatory hydrogels.

Near-infrared-guided NO generator for combined NO/photothermal/chemodynamic therapy of bacterial infections

Nitric oxide (NO)-based gas therapy approaches are promising in the treatment of infections; however, these strategies are hindered by poor delivery to the target site, which leads to unsatisfactory effects. In this study, we developed a NO-controlled platform (SCM@HA) via NO-generating mesoporous silica nanoparticles co-doped with sodium nitroprusside and copper sulphide to control NO production under near-infrared (NIR)-laser irradiation. Irradiation with an 808 nm NIR laser rapidly triggered the release of NO from the particles to actualise gas therapy. Photothermal therapy (PTT) also increased the local microenvironment temperature, and the close relationship between chemodynamic therapy (CDT) and temperature suggests that the increasing temperature facilitates in its working. The hydroxyl radicals generated by CDT can destroy the structure of bacteria in acidic environments. The germicidal activity of the nanoparticles was determined by the combined action of PTT, CDT, and NO-based gas therapy. The nanoparticles showed bactericidal activity in vitro against bacterial strains Staphylococcus aureus (S. aureus) and Salmonella typhimurium (S. typhimurium). Finally, the anti-infective efficacy in vivo in S. aureus-infected mouse model was demonstrated. Thus, the synergistic antimicrobial effects of NO-generating silica nanoparticles have good potential for the non-antibiotic treatment of bacterial infections in wounds. STATEMENT OF SIGNIFICANCE: Bacterial infections and resistance are challenging health threats. Therefore, the development of an antibiotic-independent method is essential for the treatment of wound bacterial infections. In this study, NO-generating nanoparticles loaded with sodium nitroprusside in copper sulphide-doped mesoporous silica were prepared to control the long-term release of NO using near-infrared laser, which has good efficacy of PTT and CDT. The bactericidal effects of as-prepared nanoparticles against S. aureus and S. typhimurium have been well elucidated. This study proposes a feasible method in the field of NO-based therapy, thus paving the way that will benefit for the treatment of bacterial infections in wounds.

Black Phosphorus - A Rising Star in the Antibacterial Materials

Antibiotics are the most commonly used means to treat bacterial infection at present, but the unreasonable use of antibiotics induces the generation of drug-resistant bacteria, which causes great problems for their clinical application. In recent years, researchers have found that nanomaterials with high specific surface area, special structure, photocatalytic activity and other properties show great potential in bacterial infection control. Among them, black phosphorus (BP), a two-dimensional (2D) nanomaterial, has been widely reported in the treatment of tumor and bone defect due to its excellent biocompatibility and degradability. However, the current theory about the antibacterial properties of BP is still insufficient, and the relevant mechanism of action needs to be further studied. In this paper, we introduced the structure and properties of BP, elaborated the mechanism of BP in bacterial infection, and systematically reviewed the application of BP composite materials in the field of antibacterial. At the same time, we also discussed the challenges faced by the current research and application of BP, which laid a solid theoretical foundation for the further study of BP in the future.

Overview of the effects and mechanisms of NO and its donors on biofilms

Microbial biofilm is undoubtedly a challenging problem in the food industry. It is closely associated with human health and life, being difficult to remove and antibiotic resistance. Therefore, an alternate method to solve these problems is needed. Nitric oxide (NO) as an antimicrobial agent, has shown great potential to disrupt biofilms. However, the extremely short half-life of NO in vivo (2 s) has facilitated the development of relatively more stable NO donors. Recent studies reported that NO could permeate biofilms, causing damage to cellular biomacromolecules, inducing biofilm dispersion by quorum sensing (QS) pathway and reducing intracellular bis-(3'-5')-cyclic dimeric guanosine monophosphate (c-di-GMP) levels, and significantly improving the bactericidal effect without drug resistance. In this review, biofilm hazards and formation processes are presented, and the characteristics and inhibitory effects of NO donors are carefully discussed, with an emphasis on the possible mechanisms of NO resistance to biofilms and some advanced approaches concerning the remediation of NO donor deficiencies. Moreover, the future perspectives, challenges, and limitations of NO donors were summarized comprehensively. On the whole, this review aims to provide the application prospects of NO and its donors in the food industry and to make reliable choices based on these available research results.

Theranostics applications of quantum dots in regenerative medicine, cancer medicine, and infectious diseases

Quantum dots (QDs) have attracted attention for their application and commercialization in all industrial fields, including communications, displays, and solar cells, due to their excellent optical properties based on the quantum size effect. In recent years, the development of QDs that do not contain cadmium which is toxic to cells and living organisms, has progressed, and they have attracted considerable attention in the bio-imaging field for targeting molecules and cells. Furthermore, recently, the need for diagnostics and treatment at the single molecule and single cell level in the medical field has been increasing, and the application of QDs in the medical field is also accelerating. Therefore, this paper outlines the frontiers of diagnostic and therapeutic applications (theranostics) of QDs, especially in advanced medical fields such as regenerative medicine, oncology, and infectious diseases.

Fire Needle Combined Topical Mupirocin for the Treatment of Simple Skin Abscesses in Pediatric Patients: A Case Series

Background

Skin abscesses are a common skin condition usually caused by bacterial infections and their incidence is increasing in children. Its current management strategy is still mainly incision and drainage, sometimes with antibiotics. In pediatric patients, surgical incision and drainage of skin abscesses is challenging compared to in adults because of their specific age and psychological characteristics and high aesthetic requirements. Therefore, it is important to seek better treatment options.

Patients and methods

We reported 17 cases of skin abscesses in pediatric patients aged 1 to 9 years. Ten cases had lesions on the face and neck and 7 cases on the trunk and limbs. They all received treatment based on fire needle combined with topical mupirocin.

Results

The lesions of all 17 pediatric patients healed within 4 to 14 days, with a median time of 6 days, and all achieved satisfactory results with no scarring left behind. No adverse events were observed in all patients, and no recurrence occurred within 4 weeks.

Conclusion

For skin abscesses in pediatric patients, early application of a combination therapy based on fire needle is convenient, aesthetic, economical, safe and clinically important as an alternative to incision and drainage, and deserves further clinical promotion.

A Magneto-Heated Silk Fibroin Scaffold for Anti-Biofouling Solar Steam Generation

Macroscopic 3D porous materials are ideal solar evaporators for water purification. However, the limited sunlight intensity and penetrating depth during solar-driven evaporation cannot prevent the biofouling formation by photothermal effect, thus leading to the deterioration of evaporation rate. Herein, a magnetic heating strategy is reported for anti-biofouling solar steam generation based on a magnetic silk fibroin (SF) scaffold with bi-heating property. Under one sun, the solar-heated top surface of magnetic SF scaffolds accelerates water evaporation at 2.03 kg m^-2 h^-1 , while the unheated inner channels suffer from the formation of biofilm. When exposed to alternating magnetic field (AMF), the magnetic SF scaffold can be integrally heated, leading to an efficient inner temperature to prevent biofouling in channels for water transportation. Accordingly, magneto-heated scaffolds show steady water evaporation rates after exposure to S. aureus and E. coli, which maintained 93.6-94.6% of original performance. In contrast, the evaporation rates of the scaffolds without AMF treatment are reduced to 1.31 (S. aureus) and 1.32 (E. coli) kg m^-2 h^-1 , decreased by 35.5% and 35.0%, respectively. In addition, the magneto-heated scaffold inhibits biofouling formation in natural lake water, maintaining 99.5% original performance.

Nitric oxide-releasing poly(ionic liquid)-based microneedle for subcutaneous fungal infection treatment

Poor permeation of therapeutic agents and similar eukaryotic cell metabolic and physiological properties of fungi and human cells are two major challenges that lead to the failure of current therapy for fungi-induced skin and soft tissue infections. Herein, a nitric oxide (NO)-releasing poly(ionic liquid)-based microneedle (PILMN-NO) with the capacity of deep persistent NO toward subcutaneous fungal bed is presented as a synergistic antifungal treatment strategy to treat subcutaneous fungal infection. Upon the insertion of PILMN-NO into skin, the contact fungicidal activities induced by electrostatic and hydrophobic effects of poly(ionic liquid) and the released NO sterilization resulting from the peroxidation and nitrification effect of NO achieved enhanced antifungal efficacy against fungi (Candida albicans) both in vitro and in vivo. Simultaneously, PILMN-NO showed biofilm ablation ability and efficiently eliminated mature biofilms. In vivo fungal-induced subcutaneous abscess studies revealed that PILMN-NO could effectively sterilize fungi while suppressing the inflammatory reaction, facilitating collagen deposition and angiogenesis, and promoting wound healing. This work provides a new strategy to overcome the difficulties in deep skin fungal infection treatment and has potential for further exploitation of NO-releasing microbicidal therapy.

Antibacterial Collagen-Based Nanocomposite Dressings for Promoting Infected Wound Healing

Pathogenic bacterial infection is the most frequent wound complication, which has become a major clinical and healthcare challenge in wound management worldwide, leading to impaired healing processes, the risk of amputation, and even death. Here, collagen-based nanocomposite dressings (APZC) with broad-spectrum antibacterial activity are developed to promote the infected full-thickness wound healing. Short rod-like shaped ZnO NPs are synthesized and then coated with polydopamine (PDA) to obtain PDA coated ZnO NPs (PDA@ZnO NPs). Afterward, PDA@ZnO NPs are conjugated on the backbone of a collagen chain, and the obtained collagen-PDA@ZnO NPs conjugate is crosslinked by dialdehyde sodium alginate to fabricate APZC dressings. PDA@ZnO NPs show well dispersibility and are uniformly incorporated into the collagen matrix. APZC dressings have interconnected microporous structure and great physicochemical properties, besides good blood coagulation performance and well cytocompatibility. APZC dressings demonstrate long-lasting and excellently broad-spectrum antimicrobial activity, which can relieve the inflammatory reaction by killing pathogenic bacteria and induce the generation of blood vessels and the orderly deposition of collagen in the wound site, thus promoting infected full-thickness wound healing without obvious scar formation. Overall, the functionalized collagen-based nanocomposite dressings have great potential in the clinical treatment against bacteria-associated wound infection.

Thermodynamics, Conformation, and Biocatalytic Performance of Glucose Oxidase Combined with Black Phosphorus Quantum Dots

Glucose oxidase (GOD) has a wide range of applications in biosensing and cancer treatment as a result of its unique biocatalytic properties. More importantly, GOD could synergistically enhance the cancer therapeutic effect when combined with other cancer therapeutic strategies. However, the interaction of GOD with a cancer therapeutic agent has not been well-studied. Herein, the thermodynamic properties of the interaction between black phosphorus quantum dots (BPQDs) and GOD were systematically elucidated, and the dose-dependent conformational and enzymatic activity changes of BPQDs on GOD were quantitatively and qualitatively analyzed. The results indicated that the stoichiometric ratio of BPQDs to GOD was approximately 1:1. In particular, fluorescence spectroscopy, circular dichroism spectra, and Fourier transform infrared spectra have synergistically studied the changes in secondary and tertiary conformations of GOD induced by BPQDs. Higher doses of BPQDs resulted in a loose structure of GOD but still maintained the native conformation and preserved effective enzymatic activity, effectively catalyzing the production of H₂O₂ from glucose in a cell. The interaction mechanism between BPQDs and GOD provides a theoretical basis for the design of GOD-based multimodal synergistic cancer therapy and its clinical translation analysis.

On-Demand Changeable Theranostic Hydrogels and Visual Imaging-Guided Antibacterial Photodynamic Therapy to Promote Wound Healing

Antibacterial wound dressings are confronted with the challenges in real-time imaging of infected wounds and effective removal of bacterial debris after sterilization to promote the healing process. Herein, injectable theranostic hydrogels were constructed from antimicrobial peptide ε-polylysine (ePL) and polydopamine (PDA) nanoparticles for real-time diagnosis of infected wounds, imaging-guided antibacterial photodynamic therapy (PDT), and on-demand removal of bacterial debris. Ureido-pyrimidinone was conjugated on ePL to produce PLU hydrogels through quadruple hydrogen bonding, and the inoculation of tetrakis(4-carboxyphenyl)porphyrin (TCPP)-loaded PDA (PTc) nanoparticles introduced Schiff base linkages in PLU@PTc hydrogels. The double-cross-linked networks enhance mechanical performance, adhesion strength, and self-healing properties of hydrogels, and the dynamic cross-linking enables their photothermal removal. The injection of PLU precursors and PTc NPs generates in situ sol-gel transformation, and the acid-triggered release of TCPP restores fluorescence emissions for real-time imaging of infected wounds under 410 nm illumination. Then, the released TCPP in the infected wounds is illuminated at 660 nm to launch a precise antibacterial PDT, which is strengthened by the bacterial capture on hydrogels. Hydrogels with wrapped bacterial debris are removed under illumination at 808 nm, and the hydrogel dressing change accelerates healing of infected wounds through simultaneous relief of oxidative stress, regulation of inflammatory factors, acceleration of collagen deposition, and promotion of angiogenesis. Thus, this study demonstrates a feasible strategy for wound infection theranostics through bacterial infection-triggered visual imaging, efficient nonantibiotic sterilization, and on-demand dressing change and bacterial debris removal.