Toxicologic evaluation of bacterial synthesized cellulose in endothelial cells and animals

Bacterial Cellulose Membrane Experimentally Implanted in the Peritoneum of Wistar Rats-Inflammatory Immunoreactivity and Oxidative Stress

Bacterial cellulose (BC) has been used for various applications; however, studies investigating the immunohistochemical characteristics of the inflammatory and scarring component in BC implanted in the peritoneum in vivo have not yet been fully described. This study aimed to evaluate the systemic and organic safety of BC through oxidative stress, blood, and serum biochemical markers, as well as the late inflammatory response in rats, using histopathology and immunohistochemistry. Forty-three rats (26 males; 17 females) received BC in the peritoneal cavity (implanted group-IG), while twenty-seven rats (12 males; 15 females) served as the control (sham group-SG). Sixty days after surgery, oxidative stress in tissues, blood biochemical markers, and histopathological and immunohistochemical analyses for lymphocytes, macrophages, collagen, and vascular response around the BC were assessed. Only one oxidative stress marker, glutathione peroxidase, was elevated in the liver of IG rats. Creatine kinase MB and lactate dehydrogenase levels were significantly lower in IG animals. Histopathological analysis showed granulomatous inflammation in 93% of IG rats, with 74% of mild intensity. Immunohistochemistry revealed a significant macrophage presence (F4/80), with CD3, CD20, and F4/80 markers indicating differences favoring macrophages. In conclusion, BC implantation in the peritoneum induces a foreign body granulomatous response with prominent macrophage presence (F4/80). Type I and III collagen were observed around the membrane, and vascularization was intense 60 days post-implantation. From a biochemical and oxidative stress perspective, BC seems to be a safe material to be used in the peritoneal cavity.

Recent advances in nanomaterial-stabilized pickering foam: Mechanism, classification, properties, and applications

Pickering foam is a type of foam stabilized by solid particles known as Pickering stabilizers. These solid stabilizers adsorb at the liquid-gas interface, providing superior stability to the foam. Because of its high stability, controllability, versatility, and minimal environmental impact, nanomaterial-stabilized Pickering foam has opened up new possibilities and development prospects for foam applications. This review provides an overview of the current state of development of Pickering foam stabilized by a wide range of nanomaterials, including cellulose nanomaterials, chitin nanomaterials, silica nanoparticles, protein nanoparticles, clay mineral, carbon nanotubes, calcium carbonate nanoparticles, MXene, and graphene oxide nanosheets. Particularly, the preparation and surface modification methods of various nanoparticles, the fundamental properties of nanomaterial-stabilized Pickering foam, and the synergistic effects between nanoparticles and surfactants, functional polymers, and other additives are systematically introduced. In addition, the latest progress in the application of nanomaterial-stabilized Pickering foam in the oil industry, food industry, porous functional material, and foam flotation field is highlighted. Finally, the future prospects of nanomaterial-stabilized Pickering foam in different fields, along with directions for further research and development directions, are outlined.

Cubosome-carrying bacterial cellulose membrane as a versatile drug delivery platform

Using advanced nanotechnology membranes has opened up new possibilities in the field of biomedicine, particularly for controlled drug delivery and especially for topical use. Bacterial cellulose membranes (BCM), particularly, have gained prominence owing to their distinctive attributes, including remarkable water retention, safety, biodegradability, and tunable gas exchange. However, they are aqueous matrices and, for this reason, of limited capacity for incorporation of apolar compounds. Cubosomes are lipid nanoparticles composed of a surfactant bicontinuous reverse cubic phase, which, owing to their bicontinuous structure, can incorporate both polar and apolar compounds. Therefore, these particles present a promising avenue for encapsulating and releasing drugs and biomolecules due to their superior entrapment efficiency. In this study, we aim to extend earlier investigations using polymeric hydrogels for cubosome immobilization, now using BCMs, a more resilient biocompatible matrix. Phytantriol cubosome-loaded BCMs were prepared by three distinct protocols: ex situ incorporation into wet BCMs, ex situ incorporation by swelling of dry BCMs, and an in situ process with the growth of BCMs in a sterile medium already containing cubosomes. Our investigation revealed that these methodologies ensured that cubosomes remained integral, uniformly distributed, and thoroughly dispersed within the membrane, as confirmed using Small-Angle X-ray Scattering (SAXS) and high-resolution confocal microscopy. The effective incorporation and sustained release of diclofenac were validated across the different BCMs and compared with hyaluronic acid (HA) hydrogel in our previous studies. Furthermore, the resistance against cubosome leaching from the three BCM and HA hydrogel samples was quantitatively evaluated and contrasted. We hope that the outcomes from this research will pave the way for innovative use of this platform in the incorporation and controlled release of varied active agents, amplifying the already multifaceted applicability of BCMs.

Marine versus Non-Marine Bacterial Exopolysaccharides and Their Skincare Applications

Bacteria are well-known to synthesize high molecular weight polysaccharides excreted in extracellular domain, which constitute their protective microenvironment. Several bacterial exopolysaccharides (EPS) are commercially available for skincare applications in cosmetic products due to their unique structural features, conferring valuable biological and/or textural properties. This review aims to give an overview of bacterial EPS, an important group of macromolecules used in cosmetics as actives and functional ingredients. For this purpose, the main chemical characteristics of EPS are firstly described, followed by the basics of the development of cosmetic ingredients. Then, a focus on EPS production, including upstream and downstream processes, is provided. The diversity of EPS used in the cosmetic industry, and more specifically of marine-derived EPS is highlighted. Marine bacteria isolated from extreme environments are known to produce EPS. However, their production processes are highly challenging due to high or low temperatures; yield must be improved to reach economically viable ingredients. The biological properties of marine-derived EPS are then reviewed, resulting in the highlight of the challenges in this field.

Bacterial Nanocellulose Hydrogel: A Promising Alternative Material for the Fabrication of Engineered Vascular Grafts

Blood vessels are crucial in the human body, providing essential nutrients to all tissues while facilitating waste removal. As the incidence of cardiovascular disease rises, the demand for efficient treatments increases concurrently. Currently, the predominant interventions for cardiovascular disease are autografts and allografts. Although effective, they present limitations including high costs and inconsistent success rates. Recently, synthetic vascular grafts, made from artificial materials, have emerged as promising alternatives to traditional methods. Among these materials, bacterial cellulose hydrogel exhibits significant potential for tissue engineering applications, particularly in developing nanoscale platforms that regulate cell behavior and promote tissue regeneration, attributed to its notable physicochemical and biocompatible properties. This study reviews recent progress in fabricating engineered vascular grafts using bacterial nanocellulose, demonstrating the efficacy of bacterial cellulose hydrogel as a biomaterial for synthetic vascular grafts, specifically for stimulating angiogenesis and neovascularization.

Insight into the Latest Medical Applications of Nanocellulose

Nanocelluloses (NCs) are appealing nanomaterials that have experienced rapid development in recent years, with great potential in the biomedical field. This trend aligns with the increasing demand for sustainable materials, which will contribute both to an improvement in wellbeing and an extension of human life, and with the demand to keep up with advances in medical technology. In recent years, due to the diversity of their physical and biological properties and the possibility of tuning them according to the desired goal, these nanomaterials represent a point of maximum interest in the medical field. Applications such as tissue engineering, drug delivery, wound dressing, medical implants or those in cardiovascular health are some of the applications in which NCs have been successfully used. This review presents insight into the latest medical applications of NCs, in the forms of cellulose nanocrystals (CNCs), cellulose nanofibers (CNFs) and bacterial nanocellulose (BNC), with an emphasis on the domains that have recently experienced remarkable growth, namely wound dressing, tissue engineering and drug delivery. In order to highlight only the most recent achievements, the presented information is focused on studies from the last 3 years. Approaches to the preparation of NCs are discussed either by top-down (chemical or mechanical degradation) or by bottom-up (biosynthesis) techniques, along with their morphological characterization and unique properties, such as mechanical and biological properties. Finally, the main challenges, limitations and future research directions of NCs are identified in a sustained effort to identify their effective use in biomedical fields.

Development and Characterization of a 96-Well Exposure System for Safety Assessment of Nanomaterials

In this study, a 96-well exposure system for safety assessment of nanomaterials is developed and characterized using an air-liquid interface lung epithelial model. This system is designed for sequential nebulization. Distribution studies verify the reproducible distribution over all 96 wells, with lower insert-to-insert variability compared to non-sequential application. With a first set of chemicals (TritonX), drugs (Bortezomib), and nanomaterials (silver nanoparticles and (non-)fluorescent crystalline nanocellulose), sequential exposure studies are performed with human lung epithelial cells followed by quantification of the deposited mass and of cell viability. The developed exposure system offers for the first time the possibility of exposing an air-liquid interface model in a 96-well format, resulting in high-throughput rates, combined with the feature for sequential dosing. This exposure system allows the possibility of creating dose-response curves resulting in the generation of more reliable cell-based assay data for many types of applications, such as safety analysis. In addition to chemicals and drugs, nanomaterials with spherical shapes, but also morphologically more complex nanostructures can be exposed sequentially with high efficiency. This allows new perspectives on in vivo-like and animal-free approaches for chemical and pharmaceutical safety assessment, in line with the 3R principle of replacing and reducing animal experiments.

Opportunities for bacterial nanocellulose in biomedical applications: Review on biosynthesis, modification and challenges

Bacterial nanocellulose (BNC) is a natural polysaccharide produced as extracellular material by bacterial strains and has favorable intrinsic properties for primary use in biomedical applications. In this review, an update on state-of-the art and challenges in BNC production, surface modification and biomedical application is given. Recent insights in biosynthesis allowed for better understanding of governing parameters improving production efficiency. In particular, introduction of different carbon/nitrogen sources from alternative feedstock and industrial upscaling of various production methods is challenging. It is important to have control on the morphology, porosity and forms of BNC depending on biosynthesis conditions, depending on selection of bacterial strains, reactor design, additives and culture conditions. The BNC is intrinsically characterized by high water absorption capacity, good thermal and mechanical stability, biocompatibility and biodegradability to certain extent. However, additional chemical and/or physical surface modifications are required to improve cell compatibility, protein interaction and antimicrobial properties. The novel trends in synthesis include the in-situ culturing of hybrid BNC nanocomposites in combination with organic material, inorganic material or extracellular components. In parallel with toxicity studies, the applications of BNC in wound care, tissue engineering, medical implants, drug delivery systems or carriers for bioactive compounds, and platforms for biosensors are highlighted.

Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (P(3HB-co-3HV))/Bacterial Cellulose (BC) Biocomposites for Potential Use in Biomedical Applications

The aim of this study was to obtain biocomposites consisting of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV), bacterial cellulose (BC) and α-tocopherol by a melt processing technique for potential use in biomedical applications. The melt processing and roughness of biocomposites were evaluated and compared to sample without BC. The degradation rate of PHBV/BC biocomposites was measured in phosphate buffer saline (PBS) by determining the mass variation and evidencing of thermal and structural changes by differential scanning calorimetry (DSC) and attenuated total reflectance-Fourier transformed infrared spectrometry (ATR-FTIR). The cell viability, cell morphology, cell cycle distribution and total collagen content were investigated on murine NCTC fibroblasts. Overall, the adding of BC to polyester matrix led to an adequate melt processing of biocomposites and increased surface roughness and cytocompatibility, allowing the cells to secrete the extracellular matrix (collagen) and stimulate cell proliferation. Results showed that the PHBV/BC biocomposites were favorable for long-term degradation and could be used for the design of medical devices with controlled degradability.

Bacterial Cellulose as a Versatile Biomaterial for Wound Dressing Application

Chronic ulcers are among the main causes of morbidity and mortality due to the high probability of infection and sepsis and therefore exert a significant impact on public health resources. Numerous types of dressings are used for the treatment of skin ulcers-each with different advantages and disadvantages. Bacterial cellulose (BC) has received enormous interest in the cosmetic, pharmaceutical, and medical fields due to its biological, physical, and mechanical characteristics, which enable the creation of polymer composites and blends with broad applications. In the medical field, BC was at first used in wound dressings, tissue regeneration, and artificial blood vessels. This material is suitable for treating various skin diseases due its considerable fluid retention and medication loading properties. BC membranes are used as a temporary dressing for skin treatments due to their excellent fit to the body, reduction in pain, and acceleration of epithelial regeneration. BC-based composites and blends have been evaluated and synthesized both in vitro and in vivo to create an ideal microenvironment for wound healing. This review describes different methods of producing and handling BC for use in the medical field and highlights the qualities of BC in detail with emphasis on biomedical reports that demonstrate its utility. Moreover, it gives an account of biomedical applications, especially for tissue engineering and wound dressing materials reported until date. This review also includes patents of BC applied as a wound dressing material.

Technological limitations in obtaining and using cellulose biocomposites

Among the many possible types of polymer composite materials, the most important are nanocomposites and biocomposites, which have received tremendous attention in recent years due to their unique properties. The fundamental benefits of using biocomposites as alternative materials to “petroleum-based” products are certainly shaping current development trends and setting directions for future research and applications of polymer composites. A dynamic growth of the production and sale of biocomposites is observed in the global market, which results not only from the growing interest and demand for this type of materials, but also due to the fact that for the developed and modified, thus improved materials, the area of their application is constantly expanding. Already today, polymer composites with plant raw materials are used in various sectors of the economy. In particular, this concerns the automotive and construction industries, as well as widely understood packaging. Bacterial cellulose, for example, also known as bionanocellulose, as a natural polymer with specific and unique properties, has been used extensively,primarily in numerous medical applications. Intensive research is also being carried out into composites with natural fibres composed mainly of organic compounds such as cellulose, hemicellulose and lignin. However, three aspects seem to be associated with the popularisation of biopolymers: performance, processing and cost. This article provides a brief overview of the topic under discussion. What can be the technological limitations considering the methods of obtaining polymer composites with the use of plant filler and the influence on their properties? What properties of cellulose constitute an important issue from the point of view of its applicability in polymers, in the context of compatibility with the polymer matrix and processability? What can be the ways of changing these properties through modifications, which may be crucial from the point of view of the development directions of biopolymers and bioplastics, whose further new applications will be related, among others, to the enhancement of properties? There still seems to be considerable potential to improve the cellulose material composites being produced, as well as to improve the efficiency of their manufacturing. Nevertheless, the material still needs to be well optimized before it can replace conventional materials at the industrial level in the near future. Typically, various studies discuss their comparison in terms of production, properties and highly demanding applications of plant or bacterial nanocellulose. Usually, aspects of each are described separately in the literature. In the present review, several important data are gathered in one place, providing a basis for comparing the types of cellulose described. On the one hand, this comparison aims to demonstrate the advantage of bacterial cellulose over plant cellulose, due to environmental protection and its unique properties. On the other hand, it aims to prepare a more comprehensive point of view that can objectively help in deciding which cellulosic raw material may be more suitable for a particular purpose, bacterial cellulose or plant cellulose.

Cellulose-Based Nanomaterials Advance Biomedicine: A Review

There are various biomaterials, but none fulfills all requirements. Cellulose biopolymers have advanced biomedicine to satisfy high market demand and circumvent many ecological concerns. This review aims to present an overview of cellulose knowledge and technical biomedical applications such as antibacterial agents, antifouling, wound healing, drug delivery, tissue engineering, and bone regeneration. It includes an extensive bibliography of recent research findings from fundamental and applied investigations. Cellulose-based materials are tailorable to obtain suitable chemical, mechanical, and physical properties required for biomedical applications. The chemical structure of cellulose allows modifications and simple conjugation with several materials, including nanoparticles, without tedious efforts. They render the applications cheap, biocompatible, biodegradable, and easy to shape and process.

In Vitro Cytotoxicity, Colonisation by Fibroblasts and Antimicrobial Properties of Surgical Meshes Coated with Bacterial Cellulose

Hernia repairs are the most common abdominal wall elective procedures performed by general surgeons. Hernia-related postoperative infective complications occur with 10% frequency. To counteract the risk of infection emergence, the development of effective, biocompatible and antimicrobial mesh adjuvants is required. Therefore, the aim of our in vitro investigation was to evaluate the suitability of bacterial cellulose (BC) polymer coupled with gentamicin (GM) antibiotic as an absorbent layer of surgical mesh. Our research included the assessment of GM-BC-modified meshes’ cytotoxicity against fibroblasts ATCC CCL-1 and a 60-day duration cell colonisation measurement. The obtained results showed no cytotoxic effect of modified meshes. The quantified fibroblast cells levels resembled a bimodal distribution depending on the time of culturing and the type of mesh applied. The measured GM minimal inhibitory concentration was 0.47 µg/mL. Results obtained in the modified disc-diffusion method showed that GM-BC-modified meshes inhibited bacterial growth more effectively than non-coated meshes. The results of our study indicate that BC-modified hernia meshes, fortified with appropriate antimicrobial, may be applied as effective implants in hernia surgery, preventing risk of infection occurrence and providing a high level of biocompatibility with regard to fibroblast cells.

Bacterial cellulose as a potential biopolymer in biomedical applications: a state-of-the-art review

Throughout history, natural biomaterials have benefited society. Nevertheless, in recent years, tailoring natural materials for diverse biomedical applications accompanied with sustainability has become the focus. With the progress in the field of materials science, novel approaches for the production, processing, and functionalization of biomaterials to obtain specific architectures have become achievable. This review highlights an immensely adaptable natural biomaterial, bacterial cellulose (BC). BC is an emerging sustainable biopolymer with immense potential in the biomedical field due to its unique physical properties such as flexibility, high porosity, good water holding capacity, and small size; chemical properties such as high crystallinity, foldability, high purity, high polymerization degree, and easy modification; and biological characteristics such as biodegradability, biocompatibility, excellent biological affinity, and non-biotoxicity. The structure of BC consists of glucose monomer units polymerized via cellulose synthase in β-1-4 glucan chains, creating BC nano fibrillar bundles with a uniaxial orientation. BC-based composites have been extensively investigated for diverse biomedical applications due to their similarity to the extracellular matrix structure. The recent progress in nanotechnology allows the further modification of BC, producing novel BC-based biomaterials for various applications. In this review, we strengthen the existing knowledge on the production of BC and BC composites and their unique properties, and highlight the most recent advances, focusing mainly on the delivery of active pharmaceutical compounds, tissue engineering, and wound healing. Further, we endeavor to present the challenges and prospects for BC-associated composites for their application in the biomedical field.

Nanocellulose-Based Biomedical Scaffolds in Future Bioeconomy: A Techno-Legal Assessment of the State-of-the-Art

Nanocellulose is a broader term used for nano-scaled cellulosic crystal and/or fibrils of plant or animal origin. Where bacterial nanocellulose was immediately accepted in biomedicine due to its “cleaner” nature, the plant-based nanocellulose has seen several roadblocks. This manuscript assesses the technological aspects (chemistry of cellulose, nanocellulose producing methods, its purity, and biological properties including toxicity and suggested applications in final drug formulation) along with legal aspects in REACH (Registration, Evaluation, Authorization, and Restriction of Chemicals) regulation by the European Union, EMA (European Medicine Agency). The botanical biomass processing methods leading to the nanoscale impurity (lignin and others) on nanocellulose surface, along with surface modification with harsh acid treatments are found to be two major sources of “impurity” in botanical biomass derived nanocellulose. The status of nanocellulose under the light of REACH regulation along with EMA has been covered. The provided information can be directly used by material and biomedical scientists while developing new nanocellulose production strategies as well as formulation design for European markets.

Bacterial Cellulose: Functional Modification and Wound Healing Applications

Significance: Wound dressings are frequently used for wound covering and healing. Ideal wound dressings should provide a moist environment for wounds and actively promote wound healing and skin recovery. The materials used as ideal wound dressings should possess specific properties, thus accelerating skin tissue regeneration process. Recent Advances: Bacterial cellulose (BC) is a natural polymer synthesized by some bacteria. As a kind of natural biopolymer, BC shows good biological activity, biodegradability, and biological adaptability. It has many unique physical, chemical, and biological properties, such as ultrafine nanofiber network, high crystallinity, high water absorption and retention capacity, and high tensile strength and elastic modulus. These excellent properties of BC have laid the foundation for its application as dressing in wound healing. Critical Issues: To optimize the biocompatibility and antimicrobial activity of BC, different methods including microbial fermentation, physical modification, chemical modification, and compound modification have been adopted to modify BC to ensure a better application in wound healing. BC-based wound dressings have been applied in infected wounds, acute traumatic injuries, burns, and diabetic wounds, showing remarkable therapeutic effects on promoting wound healing. Furthermore, there have been some commercial BC-based dressings and they have been utilized in clinical practice. Future Directions: Because of its excellent physicochemical characteristics and biological properties, BC shows high clinical value to be used as a wound dressing for skin tissue regeneration.

Bacterial cellulose and its potential for biomedical applications

Bacterial cellulose (BC) is an important polysaccharide synthesized by some bacterial species under specific culture conditions, which presents several remarkable features such as microporosity, high water holding capacity, good mechanical properties and good biocompatibility, making it a potential biomaterial for medical applications. Since its discovery, BC has been used for wound dressing, drug delivery, artificial blood vessels, bone tissue engineering, and so forth. Additionally, BC can be simply manipulated to form its derivatives or composites with enhanced physicochemical and functional properties. Several polymers, carbon-based nanomaterials, and metal nanoparticles (NPs) have been introduced into BC by ex situ and in situ methods to design hybrid materials with enhanced functional properties. This review provides comprehensive knowledge and highlights recent advances in BC production strategies, its structural features, various in situ and ex situ modification techniques, and its potential for biomedical applications.

Recent advancements in cellulose-based biomaterials for management of infected wounds

INTRODUCTION

Chronic wounds are a substantial burden on the healthcare system. Their treatment requires advanced dressings, which can provide a moist wound environment, prevent bacterial infiltration, and act as a drug carrier. Cellulose is biocompatible, biodegradable, and can be functionalized according to specific requirements, which makes it a highly versatile biomaterial. Antimicrobial cellulose dressings are proving to be highly effective against infected wounds.

AREAS COVERED

This review briefly addresses the mechanism of wound healing and its pathophysiology. It also discusses wound infections, biofilm formation, and progressive emergence of drug-resistant bacteria in chronic wounds and the treatment strategies for such types of infected wounds. It also summarizes the general properties, method of production, and types of cellulose wound dressings. It explores recent studies and advancements regarding the use of cellulose and its derivatives in wound management.

EXPERT OPINION

Cellulose and its various functionalized derivatives represent a promising choice of wound dressing material. Cellulose-based dressings loaded with antimicrobials are very useful in controlling infection in a chronic wound. Recent studies showing its efficacy against drug-resistant bacteria make it a favorable choice for chronic wound infections. Further research and large-scale clinical trials are required for better clinical evidence of its efficiency.

Bacterial Cellulose as a Potential Bio-Scaffold for Effective Re-Epithelialization Therapy

Currently, there are several therapeutic approaches available for wound injury management. However, a better understanding of the underlying mechanisms of how biomaterials affect cell behavior is needed to develop potential repair strategies. Bacterial cellulose (BC) is a bacteria-produced biopolymer with several advantageous qualities for skin tissue engineering. The aim here was to investigate BC-based scaffold on epithelial regeneration and wound healing by examining its effects on the expression of scavenger receptor-A (SR-A) and underlying macrophage behavior. Full-thickness skin wounds were generated on Sprague-Dawley rats and the healing of these wounds, with and without BC scaffolds, was examined over 14 days using Masson’s trichome staining. BC scaffolds displayed excellent in vitro biocompatibility, maintained the stemness function of cells and promoted keratinocyte differentiation of cells, which are vital in maintaining and restoring the injured epidermis. BC scaffolds also exhibited positive in vivo effects on the wound microenvironment, including improved skin extracellular matrix deposition and controlled excessive inflammation by reduction of SR-A expression. Furthermore, BC scaffold significantly enhanced epithelialization by stimulating the balance of M1/M2 macrophage re-programming for beneficial tissue repair relative to that of collagen material. These findings suggest that BC-based materials are promising products for skin injury repair.

Advanced Functional Materials Based on Nanocellulose for Pharmaceutical/Medical Applications

Nanocelluloses (NCs), with their remarkable characteristics, have proven to be one of the most promising "green" materials of our times and have received special attention from researchers in nanomaterials. A diversity of new functional materials with a wide range of biomedical applications has been designed based on the most desirable properties of NCs, such as biocompatibility, biodegradability, and their special physicochemical properties. In this context and under the pressure of rapid development of this field, it is imperative to synthesize the successes and the new requirements in a comprehensive review. The first part of this work provides a brief review of the characteristics of the NCs (cellulose nanocrystals-CNC, cellulose nanofibrils-CNF, and bacterial nanocellulose-BNC), as well as of the main functional materials based on NCs (hydrogels, nanogels, and nanocomposites). The second part presents an extensive review of research over the past five years on promising pharmaceutical and medical applications of nanocellulose-based materials, which have been discussed in three important areas: drug-delivery systems, materials for wound-healing applications, as well as tissue engineering. Finally, an in-depth assessment of the in vitro and in vivo cytotoxicity of NCs-based materials, as well as the challenges related to their biodegradability, is performed.

Recent Advances in the Synthesis of Nanocellulose Functionalized–Hybrid Membranes and Application in Water Quality Improvement

The increasing discharge of voluminous non or partially treated wastewaters characterized by complex contaminants poses significant ecological and health risks. Particularly, this practice impacts negatively on socio-economic, technological, industrial, and agricultural development. Therefore, effective control of water pollution is imperative. Over the past decade, membrane filtration has been established as an effective and commercially attractive technology for the separation and purification of water. The performance of membrane-based technologies relies on the intrinsic properties of the membrane barrier itself. As a result, the development of innovative techniques for the preparation of highly efficient membranes has received remarkable attention. Moreover, growing concerns related to cost-effective and greener technologies have induced the need for eco-friendly, renewable, biodegradable, and sustainable source materials for membrane fabrication. Recently, advances in nanotechnology have led to the development of new high-tech nanomaterials from natural polymers (e.g., cellulose) for the preparation of environmentally benign nanocomposite membranes. The synthesis of nanocomposite membranes using nanocelluloses (NCs) has become a prominent research field. This is attributed to the exceptional characteristics of these nanomaterials (NMs) namely; excellent and tuneable surface chemistry, high mechanical strength, low-cost, biodegradability, biocompatibility, and renewability. For this purpose, the current paper opens with a comprehensive yet concise description of the various types of NCs and their most broadly utilized production techniques. This is closely followed by a critical review of how NC substrates and their surface-modified versions affect the performance of the fabricated NC-based membranes in various filtration processes. Finally, the most recent processing technologies for the preparation of functionalized NCs-based composite membranes are discussed in detail and their hybrid characteristics relevant to membrane filtration processes are highlighted.

A review of functionalised bacterial cellulose for targeted biomedical fields

Bacterial cellulose (BC), which can be produced by microorganisms, is an ideal biomaterial especially for tissue engineering and drug delivery systems thanks to its properties of high purity, biocompatibility, high mechanical strength, high crystallinity, 3 D nanofiber structure, porosity and high-water holding capacity. Therefore, wide ranges of researches have been done on the BC production process and its structural and physical modifications to make it more suitable for certain targeted biomedical applications thoroughly. BC's properties such as mechanical strength, pore diameter and porosity can be tuned in situ or ex situ processes by using various polymer and compounds. Besides, different organic or inorganic compounds that support cell attachment, proliferation and differentiation or provide functions such as antimicrobial effectiveness can be gained to its structure for targeted application. These processes not only increase the usage options of BC but also provide success for mimicking the natural tissue microenvironment, especially in tissue engineering applications. In this review article, the studies on optimisation of BC production in the last decade and the BC modification and functionalisation studies conducted for the three main perspectives as tissue engineering, drug delivery and wound dressing with diverse approaches are summarized.

Limbal Stem Cells on Bacterial Nanocellulose Carriers for Ocular Surface Regeneration

Limbal stem cells (LSCs) are already used in cell-based treatments for ocular surface disorders. Clinical translation of LSCs-based therapies critically depends on the successful delivery, survival, and retention of these therapeutic cells to the desired region. Such a major bottleneck could be overcome by using an appropriate carrier to provide anchoring sites and structural support to LSC culture and transplantation. Bacterial nanocellulose (BNC) is an appealing, yet unexplored, candidate for this application because of its biocompatibility, animal-free origin and mechanical stability. Here, BNC as a vehicle for human embryonic stem cells-derived LSC (hESC-LSC) are investigated. To enhance cell-biomaterial interactions, a plasma activation followed by a Collagen IV and Laminin coating of the BNC substrates is implemented. This surface functionalization with human extracellular matrix proteins greatly improved the attachment and survival of hESC-LSC without compromising the flexible, robust and semi-transparent nature of the BNC. The surface characteristics of the BNC substrates are described and a preliminary ex vivo test in simulated transplantation scenarios is provided. Importantly, it is shown that hESC-LSC retain their self-renewal and stemness characteristics up to 21 days on BNC substrates. These results open the door for future research on hESC-LSC/BNC constructs to treat severe ocular surface pathologies.

Gelatin-Based Nanocomposite Film with Bacterial Cellulose–MgO Nanoparticles and Its Application in Packaging of Preserved Eggs

Preserved eggs are prone to lose water during storage, which causes the preserved eggs to shrink and have poor taste, bad flavor, and reduced quality. By studying a degradable coating agent and applying it to preserved eggs, we explored its effect on the quality of preserved eggs during storage. In this paper, the structure and performance of gelatin film (GF), gelatin–bacterial cellulose film (GBF), and gelatin–bacterial cellulose–MgO nanocomposite film (GBMF) were explored by adding bacterial cellulose (BC) and MgO nanoparticles to gelatin. The results showed that the BC solution increased the particle size and absolute value of the zeta potential. The cross-sectional microstructure of the film showed fewer and smaller pores. The water vapor permeability (WVP) decreased, and the elongation at break (EB) increased significantly. The addition of MgO nanoparticles increased the particle size and reduced the absolute value of the zeta potential. The cross section of the film became denser and more uniform by adding MgO nanoparticles, and the surface hydrophobicity of the film increased, and the EB decreased. After coating the preserved eggs with these films, the weight loss rate, the content of total volatile base nitrogen (TVB-N), and the hardness were lower than that of uncoated preserved eggs. The pH of the uncoated preserved eggs also dropped faster than the coated preserved eggs. Moreover, the preserved egg coated with GBMF had the lowest weight loss rate and the highest sensory score. It can be seen that these three films had a certain preservation effect on preserved eggs, and the GBMF had the best preservation effect.

Eco-friendly nanocellulose and its biomedical applications: current status and future prospect

Cellulose is the earth's leading natural polymer. It is known for its properties like biocompatibility, high mechanical strength, cost-effectiveness and lightweight. Nanocellulose displays better properties as compared to the native cellulose fibre. The nanocellulose is very remunerative in the arenas of routine application especially in health care, food industry, sanitary products and many more. In the biomedical area, cellulose-based products are utilized in applications like wound healing, dental applications, drug delivery, antimicrobial material, etc. Nanocellulose biomaterials have been commercialised, representing the material of new generation. With the objective to comprehend the contribution of nanocellulose in the current status and future development in biomedical utilisations, the review is focused on cellulose, nanocellulose, types and sources of nanocellulose, its preparation, characteristics, constraints related to its composites through the analysis of certain scientific reports.

Immunological aspects of nanocellulose

Cellulose is the most abundant natural polymer in the world. Nanoscale forms of cellulose, including cellulose nanofibers (CNF), cellulose nanocrystals (CNC) and bacterial nanocellulose (BC), are very attractive in industry, medicine and pharmacy. Biomedical applications of nanocellulose in tissue engineering, regenerative medicine, and controlled drug delivery are the most promising. Nanocellulose is considered a biocompatible nanomaterial and relatively safe for biomedical applications. However, more studies are needed to prove this hypothesis, especially those related to chronic exposure to nanocellulose. Besides toxicity, the response of the immune system is of particular importance in this sense. This paper provides a comprehensive and critical review of the current-state knowledge of the impact of nanocellulose on the immune system, especially on macrophages and dendritic cells (DC), as the central immunoregulatory cells, which has not been addressed in the literature sufficiently. Nanocellulose, especially CNC, can induce the inflammatory response upon the internalization by macrophages, but this reaction may be significantly modulated by introducing different functional groups on their surface. Our original results showed that nanocellulose has a potent immunotolerogenic potential. Native CNF potentiated the capacity of DC to induce conventional Tregs. When carboxyl groups were introduced on the CNF surface, the tolerogenic potential of DC was shifted towards the induction of regulatory CD8⁺ T cells, whereas the introduction of phosphonates on CNF surface potentiated DCs' capacity to induce both regulatory CD8⁺ T cells and Type 1 regulatory (Tr-1) cells. These results are extremely important when considering the application of nanocellulose in vivo, especially for tissue regeneration and wound healing.

Cellulose Nanofibers and Other Biopolymers for Biomedical Applications. A Review

Biopolymers are materials synthesised or derived from natural sources, such as plants, animals, microorganisms or any other living organism. The use of these polymers has grown significantly in recent years as industry shifts away from unsustainable fossil fuel resources and looks towards a softer and more sustainable environmental approach. This review article covers the main classes of biopolymers: Polysaccharides, proteins, microbial-derived and lignin. In addition, an overview of the leading biomedical applications of biopolymers is also provided, which includes tissue engineering, medical implants, wound dressings, and the delivery of bioactive molecules. The future clinical applications of biopolymers are vast, due to their inherent biocompatibility, biodegradability and low immunogenicity. All properties which their synthetic counterparts do not share.

Natural Polysaccharide Nanomaterials: An Overview of Their Immunological Properties

Natural occurring polymers, or biopolymers, represent a huge part of our planet biomass. They are formed by long chains of monomers of the same type or a combination of different ones. Polysaccharides are biopolymers characterized by complex secondary structures performing several roles in plants, animals, and microorganisms. Because of their versatility and biodegradability, some of them are extensively used for packaging, food, pharmaceutical, and biomedical industries as sustainable and renewable materials. In the recent years, their manipulation at the nanometric scale enormously increased the range of potential applications, boosting an interdisciplinary research attempt to exploit all the potential advantages of nanostructured polysaccharides. Biomedical investigation mainly focused on nano-objects aimed at drug delivery, tissue repair, and vaccine adjuvants. The achievement of all these applications requires the deep knowledge of polysaccharide nanomaterials' interactions with the immune system, which orchestrates the biological response to any foreign substance entering the body. In the present manuscript we focused on natural polysaccharides of high commercial importance, namely, starch, cellulose, chitin, and its deacetylated form chitosan, as well as the seaweed-derived carrageenan and alginate. We reviewed the available information on their biocompatibility, highlighting the importance of their physicochemical feature at the nanoscale for the modulation of the immune system.

Antimicrobial and wound healing properties of a bacterial cellulose based material containing B. subtilis cells

A biocomposite composed of bacterial cellulose (BC) gel-film and Bacillus subtilis (BS) cells was obtained and characterized with a view to future biomedical applications. The inclusion of functional ingredient (1010/g viable BS cells) in the composite was carried out by their joint aggregation with the BC gel-film. Immobilized BS cells displayed high antagonistic activity towards causative agents of wound infections such as Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa. Application of the BC/BS-biocomposite for the treatment of excision wounds, performed on laboratory animals, stimulated reparative processes and shortened the healing time. Possible mechanisms of the wound-healing effect of BC/BS gel films are discussed. In this work we claim that the developed BC/BS-material can be positioned as a universal wound coating and sanitary-hygienic product.

Bacterial Cellulose and Pullulan from Simple and Low Cost Production Media

In this study, the production rate of both water-insoluble EPS, bacterial cellulose, and water-soluble EPS, P, was improved through сultivation of their producers on a nutrient media containing industrial wastes, and their material properties were analyzed. The growth rate and productivity of Gluconoacetobacter xylinus C3 strain on media with industrial wastes was investigated. An optimal nutrient medium based on molasses was selected for the bacterial cellulose producer. The nutrient medium contains 2% molasses, 1% yeast extract and peptone in a 1: 1 ratio, 0.3% sodium hydrogen phosphate, 0.1% citric acid and 1% ethanol. Cultivation of Gluconoacetobacter xylinus C3 strain on this medium for 7 days at 25–30 °С ensures its high productivity – 8.21 g/L. The composition of the optimized medium with molasses provides high mechanical properties (tensile strength – 37.12 MPa and relative elongation at break – 3.28%) of bacterial cellulose and does not affect the polymer microfibrillar structure. A modified Czapek-Dox medium with 10% molasses and 1% peptone is preferable for the exopolysaccharide accumulation by A. pullulans C8 strain. The optimized media has an advantage over the traditionally used media in terms of the efficiency of exopolysaccharide accumulation and cost reduction. The pullulan yield in media was 10.08 g/l, that is 1.5 times higher than in a standard Czapek-Dox medium. The surface morphology and microstructure of the pullulan samples obtained on different media showed minor changes. Therefore, the replacement of carbon source for molasses in a Czapek-Dox media for pullulan production did not alter the polymer content and viscosity.

Printability of pulp derived crystal, fibril and blend nanocellulose-alginate bioinks for extrusion 3D bioprinting

BACKGROUND

One of the main challenges for extrusion 3D bioprinting is the identification of non-synthetic bioinks with suitable rheological properties and biocompatibility. Our aim was to optimize and compare the printability of crystal, fibril and blend formulations of novel pulp derived nanocellulose bioinks and assess biocompatibility with human nasoseptal chondrocytes.

METHODS

The printability of crystalline, fibrillated and blend formulations of nanocellulose was determined by assessing resolution (grid-line assay), post-printing shape fidelity and rheology (elasticity, viscosity and shear thinning characteristics) and compared these to pure alginate bioinks. The optimized nanocellulose-alginate bioink was bioprinted with human nasoseptal chondrocytes to determine cytotoxicity, metabolic activity and bioprinted construct topography.

RESULTS

All nanocellulose-alginate bioink combinations demonstrated a high degree of shear thinning with reversible stress softening behavior which contributed to post-printing shape fidelity. The unique blend of crystal and fibril nanocellulose bioink exhibited nano- as well as micro-roughness for cellular survival and differentiation, as well as maintaining the most stable construct volume in culture. Human nasoseptal chondrocytes demonstrated high metabolic activity post printing and adopted a rounded chondrogenic phenotype after prolonged culture.

CONCLUSIONS

This study highlights the favorable rheological, swelling and biocompatibility properties of nanocellulose-alginate bioinks for extrusion-based bioprinting.

Generation of Cost-Effective Paper-Based Tissue Models through Matrix-Assisted Sacrificial 3D Printing

Due to the combined advantages of cellulose and nanoscale (diameter 20-60 nm), bacterial cellulose possesses a series of attractive features including its natural origin, moderate biosynthesis process, good biocompatibility, and cost-effectiveness. Moreover, bacterial cellulose nanofibers can be conveniently processed into three-dimensional (3D) intertwined structures and form stable paper devices after simple drying. These advantages make it suitable as the material for construction of organ-on-a-chip devices using matrix-assisted sacrificial 3D printing. We successfully fabricated various microchannel structures embedded in the bulk bacterial cellulose hydrogels and retained their integrity after the drying process. Interestingly, these paper-based devices containing hollow microchannels could be rehydrated and populated with relevant cells to form vascularized tissue models. As a proof-of-concept demonstration, we seeded human umbilical vein endothelial cells (HUVECs) into the microchannels to obtain the vasculature and inoculated the MCF-7 cells onto the surrounding matrix of the paper device to build a 3D paper-based vascularized breast tumor model. The results showed that the microchannels were perfusable, and both HUVECs and MCF-7 cells exhibited favorable proliferation behaviors. This study may provide a new strategy for constructing simple and low-cost in vitro tissue models, which may find potential applications in drug screening and personalized medicine.

Anti-inflammatory and antioxidant nanostructured cellulose membranes loaded with phenolic-based ionic liquids for cutaneous application

The utilization of natural compounds, such as phenolic acids and biopolymers, in the healthcare domain is gaining increasing attention. In this study, bacterial nanocellulose (BC) membranes were loaded with ionic liquids (ILs) based on phenolic acids. These ionic compounds, with improved solubility and bioavailability, were prepared by combining the cholinium cation with anions derived from caffeic, ellagic and gallic acids. The obtained BC-ILs membranes were homogeneous, conformable and their swelling ability agreed with the solubility of each IL. These membranes revealed a controlled ILs dissolution rate in the wet state and high antioxidant activity. In vitro assays performed with Raw 264.7 macrophages and HaCaT keratinocytes revealed that these novel BC-ILs membranes are non-cytotoxic and present relevant anti-inflammatory properties. Diffusion studies with Hanson vertical diffusion cells showed a prolonged release profile of the ILs from the BC membranes. Thus, this work, successfully demonstrates the potential of BC-ILs membranes for skin treatment.

Recent advances in nanoengineering cellulose for cargo delivery

The recent decade has witnessed a growing demand to substitute synthetic materials with naturally-derived platforms for minimizing their undesirable footprints in biomedicine, environment, and ecosystems. Among the natural materials, cellulose, the most abundant biopolymer in the world with key properties, such as biocompatibility, biorenewability, and sustainability has drawn significant attention. The hierarchical structure of cellulose fibers, one of the main constituents of plant cell walls, has been nanoengineered and broken down to nanoscale building blocks, providing an infrastructure for nanomedicine. Microorganisms, such as certain types of bacteria, are another source of nanocelluloses known as bacterial nanocellulose (BNC), which benefit from high purity and crystallinity. Chemical and mechanical treatments of cellulose fibrils made up of alternating crystalline and amorphous regions have yielded cellulose nanocrystals (CNC), hairy CNC (HCNC), and cellulose nanofibrils (CNF) with dimensions spanning from a few nanometers up to several microns. Cellulose nanocrystals and nanofibrils may readily bind drugs, proteins, and nanoparticles through physical interactions or be chemically modified to covalently accommodate cargos. Engineering surface properties, such as chemical functionality, charge, area, crystallinity, and hydrophilicity, plays a pivotal role in controlling the cargo loading/releasing capacity and rate, stability, toxicity, immunogenicity, and biodegradation of nanocellulose-based delivery platforms. This review provides insights into the recent advances in nanoengineering cellulose crystals and fibrils to develop vehicles, encompassing colloidal nanoparticles, hydrogels, aerogels, films, coatings, capsules, and membranes, for the delivery of a broad range of bioactive cargos, such as chemotherapeutic drugs, anti-inflammatory agents, antibacterial compounds, and probiotics. SYNOPSIS: Engineering certain types of microorganisms as well as the hierarchical structure of cellulose fibers, one of the main building blocks of plant cell walls, has yielded unique families of cellulose-based nanomaterials, which have leveraged the effective delivery of bioactive molecules.

Inhalation of Bacterial Cellulose Nanofibrils Triggers an Inflammatory Response and Changes Lung Tissue Morphology of Mice

In view of the growing industrial use of Bacterial cellulose (BC), and taking into account that it might become airborne and be inhaled after industrial processing, assessing its potential pulmonary toxic effects assumes high relevance. In this work, the murine model was used to assess the effects of exposure to respirable BC nanofibrils (nBC), obtained by disintegration of BC produced by Komagataeibacter hansenii. Murine bone marrow-derived macrophages (BMMΦ) were treated with different doses of nBC (0.02 and 0.2 mg/mL, respectively 1 and 10 μg of fibrils) in absence or presence of 0.2% Carboxymethyl Cellulose (nBCMC). Furthermore, mice were instilled intratracheally with nBC or nBCMC at different concentrations and at different time-points and analyzed up to 6 months after treatments. Microcrystaline Avicel-plus® CM 2159, a plant-derived cellulose, was used for comparison. Markers of cellular damage (lactate dehydrogenase release and total protein) and oxidative stress (hydrogen peroxidase, reduced glutathione, lipid peroxidation and glutathione peroxidase activity) as well presence of inflammatory cells were evaluated in brochoalveolar lavage (BAL) fluids. Histological analysis of lungs, heart and liver tissues was also performed. BAL analysis showed that exposure to nBCMC or CMC did not induce major alterations in the assessed markers of cell damage, oxidative stress or inflammatory cell numbers in BAL fluid over time, even following cumulative treatments. Avicel-plus® CM 2159 significantly increased LDH release, detected 3 months after 4 weekly administrations. However, histological results revealed a chronic inflammatory response and tissue alterations, being hypertrophy of pulmonary arteries (observed 3 months after nBCMC treatment) of particular concern. These histological alterations remained after 6 months in animals treated with nBC, possibly due to foreign body reaction and the organism's inability to remove the fibers. Overall, despite being a safe and biocompatible biomaterial, BC-derived nanofibrils inhalation may lead to lung pathology and pose significant health risks.

The use of bacterial cellulose as a basement membrane improves the plausibility of the static in vitro blood-brain barrier model

There are several blood-brain barrier (BBB) models available for pharmaceutical research, but none of those are able to properly imitate the permeability of this special barrier. In this study, it is aimed to produce different BBB models with different cellular combinations and different basement membrane polymers, such as polyethylene terephthalate (PET) and bacterial cellulose (BC), which has not been used for BBB models before, to compare their barrier properties. Primary human brain microvascular endothelial cells were seeded on the luminal side and primary human astrocytes and/or primary human brain microvascular pericytes were seeded on the abluminal side of the membranes. Immunofluorescence (IF) staining results indicate that the expression of tight and adherence junction proteins increases on the 5th day of the cultivation. In accordance with Live-Dead staining results, IF images show that cells in the model lose their viability before the 10th day. Transendothelial electrical resistance (TEER) measurements indicate that BC membrane leads to statistically higher (p < 0.05) TEER values than the standard Transwell PET insert membrane. Sucrose and caffeine permeability values of all models are close to in vivo values. BC shows potential to be used as a more reliable basement membrane for BBB models for pharmaceutical research.

Bacterial nanocellulose: the future of controlled drug delivery?

Although bacterial nanocellulose (BNC), a natural nanostructured biopolymer network, offers unique material characteristics, the number of drug-loaded BNC-based carriers in clinical trials or on the market is still low. This report provides an overview of aspects still limiting the broad application of BNC as drug-delivery system and the challenges for its future applications. Continuous large-scale production, storability, the loading and controlled release of critical drugs, for example, with high molar mass or highly lipophilic character as well as the formulation of long-term release systems will be highlighted. Recent achievements toward promoting the application of BNC as drug-delivery system and overcoming these obstacles will be discussed. [Formula: see text].

Nanocellulose as a sustainable biomass material: structure, properties, present status and future prospects in biomedical applications

Nanocellulose, extracted from the most abundant biomass material cellulose, has proved to be an environmentally friendly material with excellent mechanical performance owing to its unique nano-scaled structure, and has been used in a variety of applications as engineering and functional materials. The great biocompatibility and biodegradability, in particular, render nanocellulose promising in biomedical applications. In this review, the structure, treatment technology and properties of three different nanocellulose categories, i.e., nanofibrillated cellulose (NFC), nanocrystalline cellulose (NCC) and bacterial nanocellulose (BNC), are introduced and compared. The cytotoxicity, biocompatibility and frontier applications in biomedicine of the three nanocellulose categories were the focus and are detailed in each section. Future prospects concerning the cytotoxicity, applications and industrial production of nanocellulose are also discussed in the last section.

DETC-based bacterial cellulose bio-curatives for topical treatment of cutaneous leishmaniasis

The treatment of leishmaniasis still relies on drugs with potentially serious adverse effects. Herein, we tested a topical formulation of bacterial cellulose (BC) membranes containing Diethyldithiocarbamate (DETC), a superoxide dismutase 1 inhibitor. Leishmania-infected macrophages exposed to BC-DETC resulted in parasite killing, without pronounced toxic effects to host cells. This outcome was associated with lower SOD1 activity and higher production of superoxide and cytokine mediators. Topical application of BC-DETC significantly decreased lesion size, parasite load and the inflammatory response at the infection site, as well as the production of both IFN-γ and TNF. Combination of topical BC-DETC plus intraperitoneal Sb^v also significantly reduced disease development and parasite load. The leishmanicidal effect of BC-DETC was extended to human macrophages infected with L. braziliensis, highlighting the feasibility of BC-DETC as a topical formulation for chemotherapy of cutaneous leishmaniasis caused by L. braziliensis.

A critical review of the current knowledge regarding the biological impact of nanocellulose

Several forms of nanocellulose, notably cellulose nanocrystals and nanofibrillated cellulose, exhibit attractive property matrices and are potentially useful for a large number of industrial applications. These include the paper and cardboard industry, use as reinforcing filler in polymer composites, basis for low-density foams, additive in adhesives and paints, as well as a wide variety of food, hygiene, cosmetic, and medical products. Although the commercial exploitation of nanocellulose has already commenced, little is known as to the potential biological impact of nanocellulose, particularly in its raw form. This review provides a comprehensive and critical review of the current state of knowledge of nanocellulose in this format. Overall, the data seems to suggest that when investigated under realistic doses and exposure scenarios, nanocellulose has a limited associated toxic potential, albeit certain forms of nanocellulose can be associated with more hazardous biological behavior due to their specific physical characteristics.

Advances in biomedical and pharmaceutical applications of functional bacterial cellulose-based nanocomposites

Bacterial cellulose (BC) synthesized by certain species of bacteria, is a fascinating biopolymer with unique physical and mechanical properties. BC's applications range from traditional dessert, gelling, stabilizing and thickening agent in the food industry to advanced high-tech applications, such as immobilization of enzymes, bacteria and fungi, tissue engineering, heart valve prosthesis, artificial blood vessels, bone, cartilage, cornea and skin, and dental root treatment. Various BC-composites have been designed and investigated in order to enhance its biological applicability. This review focuses on the application of BC-based composites for microbial control, wound dressing, cardiovascular, ophthalmic, skeletal, and endodontics systems. Moreover, applications in controlled drug delivery, biosensors/bioanalysis, immobilization of enzymes and cells, stem cell therapy and skin tissue repair are also highlighted. This review will provide new insights for academia and industry to further assess the BC-based composites in terms of practical applications and future commercialization for biomedical and pharmaceutical purposes.