Synchronizing nonfouling and antimicrobial properties in a zwitterionic hydrogel

Antimicrobial Biomaterials Based on Physical and Physicochemical Action

Developing effective antimicrobial biomaterials is a relevant and fast-growing field in advanced healthcare materials. Several well-known (e.g., traditional antibiotics, silver, copper etc.) and newer (e.g., nanostructured, chemical, biomimetic etc.) approaches have been researched and developed in recent years and valuable knowledge has been gained. However, biomaterials associated infections (BAIs) remain a largely unsolved problem and breakthroughs in this area are sparse. Hence, novel high risk and potential high gain approaches are needed to address the important challenge of BAIs. Antibiotic free antimicrobial biomaterials that are largely based on physical action are promising, since they reduce the risk of antibiotic resistance and tolerance. Here, selected examples are reviewed such antimicrobial biomaterials, namely switchable, protein-based, carbon-based and bioactive glass, considering microbiological aspects of BAIs. The review shows that antimicrobial biomaterials mainly based on physical action are powerful tools to control microbial growth at biomaterials interfaces. These biomaterials have major clinical and application potential for future antimicrobial healthcare materials without promoting microbial tolerance. It also shows that the antimicrobial action of these materials is based on different complex processes and mechanisms, often on the nanoscale. The review concludes with an outlook and highlights current important research questions in antimicrobial biomaterials.

Fighting against biofilm: The antifouling and antimicrobial material

Biofilms are groups of microorganisms protected by self-secreted extracellular substances. Biofilm formation on the surface of biomaterial or engineering materials becomes a severe challenge. It has caused significant health, environmental, and societal concerns. It is believed that biofilms lead to life-threatening infection, medical implant failure, foodborne disease, and marine biofouling. To address these issues, tremendous effort has been made to inhibit biofilm formation on materials. Biofilms are extremely difficult to treat once formed, so designing material and coating bearing functional groups that are capable of resisting biofilm formation has attracted increasing attention for the last two decades. Many types of antibiofilm strategies have been designed to target different stages of biofilm formation. Development of the antibiofilm material can be classified into antifouling material, antimicrobial material, fouling release material, and integrated antifouling/antimicrobial material. This review summarizes relevant research utilizing these four approaches and comments on their antibiofilm properties. The feature of each method was compared to reveal the research trend. Antibiofilm strategies in fundamental research and industrial applications were summarized.

Functional Zwitterionic Polyurethanes: State-of-the-Art Review

Recent advancements in bioengineering and medical devices have been greatly influenced and dominated by synthetic polymers, particularly polyurethanes (PUs). PUs offer customizable mechanical properties and long-term stability, but their inherent hydrophobic nature poses challenges in practically biological application processes, such as interface high friction, strong protein adsorption, and thrombosis. To address these issues, surface modifications of PUs for generating functionally hydrophilic layers have received widespread attention, but the durability of generated surface functionality is poor due to irreversible mechanical wear or biodegradation. As a result, numerous researchers have investigated bulk modification techniques to incorporate zwitterionic polymers or groups onto the main or side chains of PUs, thereby improving their hydrophilicity and biocompatibility. This comprehensive review presents an extensive overview of notable zwitterionic PUs (ZPUs), including those based on phosphorylcholine, sulfobetaine, and carboxybetaine. The review explores their wide range of biomedical applications, from blood-contacting devices to antibacterial coatings, fouling-resistant marine coatings, separation membranes, lubricated surfaces, and shape memory and self-healing materials. Lastly, the review summarizes the challenges and future prospects of ZPUs in biological applications.

Zwitterionic Injectable Hydrogel-Combined Chemo- and Immunotherapy Medicated by Monomolecular Micelles to Effectively Prevent the Recurrence of Tumor Post Operation

Surgical resection remains the most common method of tumor treatment; however, the high recurrence and metastasis after surgery need to be solved urgently. Herein, we report an injectable zwitterionic hydrogel based on "thiol-ene" click chemistry containing doxorubicin (DOX) and a macrophage membrane (MM)-coated 1-methyl-tryptophan (1-MT)-loaded polyamide-amine dendrimer (P-DOX/1MT) for preventing the postoperative recurrence of tumors. The results indicated that P-DOX/1MT@MM exhibited enhanced recognition and uptake of the dendrimer by tumor cells and induced the immunogenic cell death. In the mice tumor model, the P-DOX/1MT@MM-Gel exhibited high therapeutic efficiency, which could significantly reduce the recurrence of the tumor, including suppressing tumor growth, promoting dendritic cell maturation, and increasing tumor-infiltrating cytotoxic T lymphocytes. The mechanism analysis revealed that the hydrogel greatly reduces the side effects to normal tissues and significantly improves its therapeutic effect. 1MT in the hydrogel is released more rapidly, improving the tumor suppressor microenvironment and increasing the tumor cell sensitivity to DOX. Then, the DOX in the P-DOX/1MT@MM effectively eliminatedo the residual tumor cells and exerted enhanced toxicity. In conclusion, this novel injectable hydrogel that combines chemotherapy and immunotherapy has the property of sequential drug release and is a promising strategy for preventing the postoperative recurrence of tumors.

Nanobiotics and the One Health Approach: Boosting the Fight against Antimicrobial Resistance at the Nanoscale

Antimicrobial resistance (AMR) is a growing public health concern worldwide, and it poses a significant threat to human, animal, and environmental health. The overuse and misuse of antibiotics have contributed significantly and others factors including gene mutation, bacteria living in biofilms, and enzymatic degradation/hydrolyses help in the emergence and spread of AMR, which may lead to significant economic consequences such as reduced productivity and increased health care costs. Nanotechnology offers a promising platform for addressing this challenge. Nanoparticles have unique properties that make them highly effective in combating bacterial infections by inhibiting the growth and survival of multi-drug-resistant bacteria in three areas of health: human, animal, and environmental. To conduct an economic evaluation of surveillance in this context, it is crucial to obtain an understanding of the connections to be addressed by several nations by implementing national action policies based on the One Health strategy. This review provides an overview of the progress made thus far and presents potential future directions to optimize the impact of nanobiotics on AMR.

A Novel Zwitterionic Hydrogel Incorporated with Graphene Oxide for Bone Tissue Engineering: Synthesis, Characterization, and Promotion of Osteogenic Differentiation of Bone Mesenchymal Stem Cells

Zwitterionic materials are widely applied in the biomedical field due to their excellent antimicrobial, non-cytotoxicity, and antifouling properties but have never been applied in bone tissue engineering. In this study, we synthesized a novel zwitterionic hydrogel incorporated with graphene oxide (GO) using maleic anhydride (MA) as a cross-linking agent by grafted L-cysteine (L-Cys) as the zwitterionic material on maleilated chitosan via click chemistry. The composition and each reaction procedure of the novel zwitterionic hydrogel were characterized via X-ray diffraction (XRD) and Fourier transformed infrared spectroscopy (FT-IR), while the morphology was imaged by scanning electron microscope (SEM). In vitro cell studies, CCK-8 and live/dead assay, alkaline phosphatase activity, W-B, and qRT-CR tests showed zwitterionic hydrogel incorporated with GO remarkably enhanced the osteogenic differentiation of bone mesenchymal stem cells (BMSCs); it is dose-dependent, and 2 mg/mL GO is the optimum concentration. In vivo tests also indicated the same results. Hence, these results suggested the novel zwitterionic hydrogel exhibited porous characteristics similar to natural bone tissue. In conclusion, the zwitterionic scaffold has highly biocompatible and mechanical properties. When GO was incorporated in this zwitterionic scaffold, the zwitterionic scaffold slows down the release rate and reduces the cytotoxicity of GO. Zwitterions and GO synergistically promote the proliferation and osteogenic differentiation of rBMSCs in vivo and in vitro. The optimal concentration is 2 mg/mL GO.

Zwitterionic Biomaterials

The term "zwitterionic polymers" refers to polymers that bear a pair of oppositely charged groups in their repeating units. When these oppositely charged groups are equally distributed at the molecular level, the molecules exhibit an overall neutral charge with a strong hydration effect via ionic solvation. The strong hydration effect constitutes the foundation of a series of exceptional properties of zwitterionic materials, including resistance to protein adsorption, lubrication at interfaces, promotion of protein stabilities, antifreezing in solutions, etc. As a result, zwitterionic materials have drawn great attention in biomedical and engineering applications in recent years. In this review, we give a comprehensive and panoramic overview of zwitterionic materials, covering the fundamentals of hydration and nonfouling behaviors, different types of zwitterionic surfaces and polymers, and their biomedical applications.

Porous Crosslinked Zwitterionic Microparticles Based on Glycidyl Methacrylate and N-Vinylimidazole as Possible Drug Delivery Systems

Crosslinked porous microparticles have received great attention as drug delivery systems lately due to their unique set of properties: the capability to form various polymer-drug combinations, low immunogenicity, patient compliance and ability to release drugs in a delayed or controlled manner. Moreover, polymers with betaine groups have shown some unique features such as antifouling, antimicrobial activity, biocompatibility and strong hydration properties. Herein, novel porous zwitterionic microparticles were prepared in two stages. The first step involves the synthesis of porous microparticles based on glycidyl methacrylate, N-vinylimidazole and triethyleneglycol dimethacrylate using the suspension polymerization technique, the second step being the synthesis of zwitterionic porous microparticles by polymer-analogous reaction in presence of sodium monochloroacetate as betainization agent. Both types of microparticles were characterized structurally and morphologically by FT-IR spectroscopy, energy dispersive X-ray analysis, scanning electron microscopy, dynamic vapors sorption and mercury porosimetry. The tetracycline loading into crosslinked and zwitterionic microparticles was also performed, the maximum tetracycline loading capacities being 87 mg/g and 135 mg/g, respectively. The drug release mechanism, elucidated by various mathematical models, is controlled by both diffusion and swelling processes as a function of the zwitterionic and/or porous microparticle structure. Both types of microparticles presented antibacterial activity against the two reference strains used in this study: Escherichia coli and Staphylococcus aureus.

Nonfouling and Antibacterial Zwitterionic Contact Lenses Loaded with Heme-Mimetic Gallium Porphyrin for Treating Keratitis

Antifouling and antibacterial are two critical challenges in the development of contact lenses (CLs). Herein, we presented nonfouling and antibacterial bifunctionalized CLs by encapsulating cationic heme-mimetic gallium porphyrin (Ga-CHP) into zwitterionic-elastomeric-networked (ZEN) hydrogel. Results proved that the ZEN hydrogel showed excellent abilities to resist non-specific protein adsorption, bacterial adhesion, and biofilm formation. Moreover, Ga-CHP could be sustainably released and kill >99.9% planktonic bacteria and >99.9% mature biofilms. In vivo, the symptoms of bacterial keratitis in mice were significantly alleviated after wearing the CLs for 7 days via iron-blocking and photodynamic synergistic antibacterial therapy with the help of natural sunlight. This study highlights the nonfouling and antibacterial superiority of the Ga-CHP-functional zwitterionic CLs and proposes a portable yet efficient non-antibiotic keratitis treatment strategy.

Zwitterionic keratin coating on silk-Laponite fibrous membranes for guided bone regeneration

Implant-related infection is one of the main challenges in periodontal diseases. According to the zwitterionic properties of keratin, we aim to develop guided bone regeneration (GBR) membrane with antibacterial and bioactivity properties using a keratin coating. In this study, electrospun silk fibroin (SF)-Laponite (LAP) fibrous membranes were developed as GBR membranes, and keratin extracted from sheep wool was electrosprayed on them. Here, the role of electrospraying time (2, 3, and 4h) on the properties of the GBR membranes was investigated. After physicochemical characterization of the keratin-modified membranes, in vitro bioactivity and degradation rate of the membranes were studied in simulated body fluid and phosphate buffer saline, respectively. Moreover, proliferation and differentiation of mesenchymal stem cells were evaluated in contact with the keratin-modified SF-LAP membrane. Finally, the antibacterial activity of membranes against gram-positive bacteria (Staphylococcus aureus) was investigated. Results demonstrated the successful formation of homogeneous wool keratin coating on SF-LAP fibrous membranes using a simple electrospray process. While wool keratin coating significantly enhanced the elongation and hydrophilicity of the SF-LAP membrane, the mechanical strength was not changed. In addition, keratin coating significantly improved the bioactivity and degradation rate of SF-LAP membranes, owing to the carboxyl groups of amino acids in keratin coating. In addition, the synergic role of LAP nanoparticles and keratin coating drastically improved osteoblast proliferation and differentiation. Finally, the zwitterionic property of wool keratin coating originating from their equal positive (NH₃ ⁺ ) and negative (COO^- ) charges considerably improved the antibacterial activity of the SF-LAP membrane. Overall, keratin-coated SF-LAP fibrous membranes with significant mechanical and biological properties could have the potential for GBR membranes.

Stimuli-Responsive Antibacterial Materials: Molecular Structures, Design Principles, and Biomedical Applications

Infections are regarded as the most severe complication associated with human health, which are urgent to be solved. Stimuli-responsive materials are appealing therapeutic platforms for antibacterial treatments, which provide great potential for accurate theranostics. In this review, the advantages, the response mechanisms, and the key design principles of stimuli-responsive antibacterial materials are highlighted. The biomedical applications, the current challenges, and future directions of stimuli-responsive antibacterial materials are also discussed. First, the categories of stimuli-responsive antibacterial materials are comprehensively itemized based on different sources of stimuli, including external physical environmental stimuli (e.g., temperature, light, electricity, salt, etc.) and bacterial metabolites stimuli (e.g., acid, enzyme, redox, etc.). Second, structural characteristics, design principles, and biomedical applications of the responsive materials are discussed, and the underlying interrelationships are revealed. The molecular structures and design principles are closely related to the sources of stimuli. Finally, the challenging issues of stimuli-responsive materials are proposed. This review will provide scientific guidance to promote the clinical applications of stimuli-responsive antibacterial materials.

Inherent and Composite Hydrogels as Promising Materials to Limit Antimicrobial Resistance

Antibiotic resistance has increased significantly in the recent years, and has become a global problem for human health and the environment. As a result, several technologies for the controlling of health-care associated infections have been developed over the years. Thus, the most recent findings in hydrogel fabrication, particularly antimicrobial hydrogels, could offer valuable solutions for these biomedical challenges. In this review, we discuss the most promising strategies in the development of antimicrobial hydrogels and the application of hydrogels in the treatment of microbial infections. The latest advances in the development of inherently and composite antimicrobial hydrogels will be discussed, as well as hydrogels as carriers of antimicrobials, with a focus on antibiotics, metal nanoparticles, antimicrobial peptides, and biological extracts. The emergence of CRISR-Cas9 technology for removing the antimicrobial resistance has led the necessity of new and performant carriers for delivery of the CRISPR-Cas9 system. Different delivery systems, such as composite hydrogels and many types of nanoparticles, attracted a great deal of attention and will be also discussed in this review.

Bacteria-Triggered Multifunctional Hydrogel for Localized Chemodynamic and Low-Temperature Photothermal Sterilization

Pathogenic infections seriously threaten public health and have been considered as one of the most critical challenges in clinical therapy. Construction of a safe and efficient photothermal antibacterial platform is a promising strategy for treatment of bacterial infections. Considering that high temperature does harm to the normal tissues and cells, herein, a bacteria-triggered multifunctional hydrogel is constructed for low-temperature photothermal sterilization with high efficiency by integrating localized chemodynamic therapy (L-CDT). The hydrogel is constructed by incorporating copper sulfide nanoparticles (CuS_NPs ) with photothermal profile into the network of hyaluronic acid (HA) and Fe³⁺ -EDTA complexes, named as CHFH (CuS_NPs -HA-Fe³⁺ -EDTA hydrogel). Bacteria can be accumulated on the surface of CHFH, which secretes hyaluronidase to decompose the HA and release Fe³⁺ . The Fe³⁺ is reduced into Fe²⁺ in microenvironment of bacteria to trigger Fenton reaction. The generated hydroxyl radicals result in sterilization based on L-CDT within short range. By integrating with photothermal property of CuS_NPs , low-temperature photothermal therapy (LT-PTT) for sterilization is realized, which improves the antibacterial efficiency while minimizes damage to normal tissues. The CHFH is further used to prepare Band aid which effectively promotes the Staphylococcus aureus-infected wound healing process in vivo, confirming the great potential for clinical application.

An in situ-forming polyzwitterion hydrogel: Towards vitreous substitute application

Development of a biostable and biosafe vitreous substitute is highly desirable, but remains a grand challenge. Herein, we propose a novel strategy for constructing a readily administered vitreous substitute based on a thiol-acrylate clickable polyzwitterion macromonomer. A biocompatible multivinyl polycarboxybetaine (PCB-OAA) macromonomer is designed and synthesized, and mixed with dithiothreitol (DTT) via a Michael addition reaction to form a hydrogel in vitreous cavity. This resultant PCB-OAA hydrogel exhibits controllable gelation time, super anti-fouling ability against proteins and cells, excellent biocompatibility, and approximate key parameters to human vitreous body including equilibrium water content, density, optical properties, modulus. Remarkably, outperforming clinically used silicone oil in biocompatibility, this rapidly formed hydrogel in the vitreous cavity of rabbit eyes remains stable in vitreous cavity, showing an appealing ability to prevent significantly inflammatory response, fibrosis and complications such as raised intraocular pressure (IOP), and cataract formation. This zwitterionic polymer hydrogel holds great potential as a vitreous substitute.

Polybetaines in Biomedical Applications

Polybetaines, that have moieties bearing both cationic (quaternary ammonium group) and anionic groups (carboxylate, sulfonate, phosphate/phosphinate/phosphonate groups) situated in the same structural unit represent an important class of smart polymers with unique and specific properties, belonging to the family of zwitterionic materials. According to the anionic groups, polybetaines can be divided into three major classes: poly(carboxybetaines), poly(sulfobetaines) and poly(phosphobetaines). The structural diversity of polybetaines and their special properties such as, antifouling, antimicrobial, strong hydration properties and good biocompatibility lead to their use in nanotechnology, biological and medical fields, water remediation, hydrometallurgy and the oil industry. In this review we aimed to highlight the recent developments achieved in the field of biomedical applications of polybetaines such as: antifouling, antimicrobial and implant coatings, wound healing and drug delivery systems.

Antifouling Antioxidant Zwitterionic Dextran Hydrogels as Wound Dressing Materials with Excellent Healing Activities

Hydrogels as wound dressings have received great attention in recent years. It is highly important yet challenging to develop hydrogel dressings that are biocompatible and that can promote wound healing by lowering the risk of inflammatory responses. In this work, we designed and prepared zwitterionic dextran-based hydrogels using carboxybetaine dextran (CB-Dex) and sulfobetaine dextran (SB-Dex) as raw materials, respectively. The efficacy of CB-Dex and SB-Dex hydrogels in promoting wound recovery was evaluated using a mouse skin wound model. Results suggested that the zwitterionic dextran wound dressings showed a faster healing rate than natural dextran hydrogel and a commercial wound dressing (Duoderm film) due to their excellent protein resistance and capacity to scavenge free hydroxyl radicals. In addition, both CB-Dex and SB-Dex hydrogel wound dressings showed excellent cytocompatibility with NIH3T3 and L929 cells, as well as antibacterial adhesion against Staphylococcus aureus and Escherichia coli. Furthermore, both zwitterionic hydrogels demonstrated self-healing properties and can be stretched to adapt to irregular full-thickness wound beds. More importantly, they can be removed from the wound site painlessly by washing with normal saline. Overall, this work provided a new pathway to fabricate multifunctional polysaccharide hydrogels for wound treatment and pain relief when changing wound dressings.

Imminent antimicrobial bioink deploying cellulose, alginate, EPS and synthetic polymers for 3D bioprinting of tissue constructs

3D printing, one of its kinds has been a recent technological trend to fabricate complex and patterned biomaterial with controlled precision. With the conventional kick-start of printing metals and plastics, advancements in printing viable cells, polysaccharides or microbes themselves have been achieved. The additive antimicrobial properties in bioinks sourced from organic and inorganic materials have profound implications in tissue engineering. Cellulose, alginate, exopolysaccharides, ceramics and synthetic polymers are integrated as a viable component in inks and used for bio-printing. To date, bacterial infection and immunogenicity pose a potential health risk during a tissue implant or bone substitution. In order to mitigate microbial infection, antimicrobial bioinks with significant antimicrobial potential have been the much sought after strategies. This approach could be an effective frontline defense against microbial interference in tissue engineering and biomedical applications. An overview on the antimicrobial potential of polysaccharides as bioinks for 3D bioprinting has been critically reviewed.

Injectable zwitterionic thermosensitive hydrogels with low-protein adsorption and combined effect of photothermal-chemotherapy

Injectable hydrogels have been developed as biomedical materials in various fields but the biofouling on their surface limits applications in vivo. In this work, a zwitterionic structure was introduced into an injectable hydrogel based on thermosensitive nanogels to overcome the foreign body reaction. The hydrodynamic diameter of the resultant poly(N-isopropylacrylamide-co-sulfobetaine methacrylate) (PNS) nanogels was ca. 105 nm. The aqueous dispersion with a high content of PNS nanogels showed a flowable sol state at room temperature, and turned into a hydrogel in situ at ∼36 °C due to the thermosensitivity of the PNS nanogels. In particular, the resulting hydrogel exhibited lower biofouling both in vitro and in vivo in comparison with similar hydrogels without a zwitterionic structure. Polydopamine nanoparticles (PDA NPs) as a photothermal agent and an anti-tumour drug could be easily co-loaded in the injectable hydrogel. Under near-infrared (NIR) irradiation for 10 min, the temperature of the PNS system containing PDA NPs could reach ca. 38 °C. The drug release from the in situ-forming hydrogel could be accelerated by NIR laser irradiation, and showed a sustainable release behavior and adjustability. The results of intratumoral injection of the as-prepared injectable hydrogel containing PDA NPs and an anti-tumour drug showed significant anticancer effects combining photothermal therapy and local chemotherapy. This constructed injectable zwitterionic thermosensitive hydrogel is easy to use with the advantage of low-fouling and may become a promising platform for various biomedical applications.

Functional macroporous amphoteric polyelectrolyte monoliths with tunable structures and properties through emulsion-templated synthesis

HYPOTHESIS

Macroporous polyampholyte hydrogels, simultaneously bearing both the anionic and cationic groups, demonstrate immense promise over the one-sign charged polyelectrolytes, owing to a unique phenomenon known as the ˝anti-polyelectrolyte˝ effect. Thus, they are extremely promising materials, since they remain solvated and functional even in harsh conditions. Furthermore, macroporous morphology significantly enhances polyampholyte response to external stimuli, since it accelerates the solvent transport through the hydrogel.

EXPERIMENTS

A new templated-synthesis through "HIPE mixtures" is reported, where the two pre-formed high internal phase emulsions (HIPE) containing the oppositely charged monomers (2-acrylamido-2-methyl-1-propanesulfonic acid and (3-acrylamidopropyl)trimethylammonium chloride) were combined in the same mould, which after polymerization result in the formation of macroporous monoliths of different structures. The resulting frameworks were either copolymer or dual homopolymers in the form of bilayered or mixed porous structures.

FINDINGS

The co- and mixed-amphoteric polyelectrolytes exhibit 'anti-polyelectrolyte' behaviour typical of polyampholytes, while the bilayered-structure behaves like a typical polyelectrolyte. Complete and simultaneous removal of both dyes from a dye mixture was observed for the bilayered- and mixed-amphoteric polyelectrolyte, while copoly-ampholyte showed only partial dye adsorption. These results clearly reveal the benefits of a mutual combination of the HIPE-templated structure and the oppositely charged amphoteric nature in one-piece material as a promising avenue toward advanced materials.

Stimulus-Responsive Polyzwitterionic Surfaces Made from Itaconic Acid: Self-Triggered Antimicrobial Activity, Protein Repellency, and Cell Compatibility

A functional monomer carrying a carboxylate and a protected primary ammonium group is synthesized from itaconic acid. When copolymerized with dimethyl acrylamide and 4-methacryloyloxybenzophenone, cross-linkable polyzwitterions are obtained. These are converted to surface-attached polyzwitterion networks by simultaneous UV-triggered C,H insertion reactions. The resulting polyzwitterion-coated substrates were studied by surface plasmon resonance spectroscopy measurements, ζ potential and various biological assays. They were (expectedly) protein repellent, yet at the same time (and unexpectedly) cell-adhesive and antimicrobially active. This was attributed to stimulus-responsiveness of the polyzwitterion (confirmed by the ζ potential measurements), which enables charge adjustment at different pH values. When protonated, the polyzwitterions become amphiphilic polycations and, in this state, kill bacteria upon contact like their parent structures (polymer-based synthetic mimics of antimicrobial peptides, SMAMPs).

Probing Surface Hydration and Molecular Structure of Zwitterionic and Polyacrylamide Hydrogels

A hydrogel is a hydrophilic cross-linked polymer network which can contain a large amount of water. Hydrogels with distinguished interfacial physical toughness were analyzed for their potential application as antifouling coating materials, utilizing sum frequency generation (SFG) spectroscopy as the interfacial analytical technique. The surface structures of one sulfobetaine (SBMA) zwitterionic hydrogel (ZWHG) and two polysaccharide hydrogels (PHGs) were probed in air; their interfacial structures with silica were examined using SFG in water and protein solutions, respectively. Both ZWHG and PHGs interfaces in water were dominated by strongly hydrogen-bonded water molecules, but the bonding strength associated with ZWHG was much stronger. Although all hydrogels experienced interfacial change in the presence of protein solutions, after cleaning, the zwitterionic hydrogel interface recovered almost completely while the other two hydrogels were subject to irreversible protein adsorption. Additionally, orientational analysis of ZWHG methyl groups in water was conducted and related to the superior hydrogen-bonding strength of water molecules at the ZWHG interface. The interfacial structures of hydrogel materials probed by SFG can be correlated to their antifouling properties. This research highlighted the critical role that hydrogen-bonding strength of interfacial water molecules play for antifouling applications.

Bifunctional Bioactive Polymer Surfaces with Micrometer and Submicrometer-sized Structure: The Effects of Structure Spacing and Elastic Modulus on Bioactivity

This study presents a comparison of two types of bifunctional structured surface that were made from the same polymer -- an antimicrobial polycation (a synthetic mimic of an antimicrobial peptide, SMAMP) and a protein-repellent polyzwitterion (poly(sulfobetaines), PSB). The first type of bifunctional surface was fabricated by a colloidal lithography (CL) based process where the two polymers were immobilized sequentially onto pre-structured surfaces with a chemical contrast (gold on silicon). This enabled site-selective covalent attachment. The CL materials had a spacing ranging from 200 nm to 2 µm. The second type of structured surface (spacing: 1 - 8.5 µm) was fabricated using a microcontact printing (µCP) process where SMAMP patches were printed onto a PSB network, so that 3D surface features were obtained. The thus obtained materials were studied by quantitative nanomechanical measurements using atomic force microscopy (QNM-AFM). The different architectures led to different local elastic moduli at the polymer-air interface, where the CL surfaces were much stiffer (Derjaguin-Muller-Toporov (DMT) modulus = 20 ± 0.8 GPa) compared to the structured 3D networks obtained by µCP (DMT modulus = 42 ± 1.1 MPa). The effects of the surface topology and stiffness on the antimicrobial activity against Escherichia coli, the protein repellency (using fibrinogen), and the compatibility with human gingival mucosal keratinocytes were investigated. The softer 3D µCP surfaces had simultaneous antimicrobial activity, protein repellency, and cell compatibility at all spacings. For the stiffer CL surfaces, quantitative simultaneous antimicrobial activity and protein repellency was not obtained. However, the cell compatibility could be maintained at all spacings. The optimum spacing for the CL materials was in the range of 500 nm-1 µm, with significantly reduced antimicrobial activity at 2 µm spacing. Thus, the soft polymer network obtained by µCP could be more easily optimized than the stiff CL surface, and had a broader topology range of optimal or near-optimal bioactivity.

Rapid and Superior Bacteria Killing of Carbon Quantum Dots/ZnO Decorated Injectable Folic Acid-Conjugated PDA Hydrogel through Dual-Light Triggered ROS and Membrane Permeability

One of the most difficult challenges in the biomedical field is bacterial infection, which causes tremendous harm to human health. In this work, an injectable hydrogel is synthesized through rapid assembly of dopamine (DA) and folic acid (FA) cross-linked by transition metal ions (TMIs, i.e., Zn²⁺ ), which was named as DFT-hydrogel. Both the two carboxyl groups in the FA molecule and catechol in polydopamine (PDA) easily chelates Zn²⁺ to form metal-ligand coordination, thereby allowing this injectable hydrogel to match the shapes of wounds. In addition, PDA in the hydrogel coated around carbon quantum dot-decorated ZnO (C/ZnO) nanoparticles (NPs) to rapidly generate reactive oxygen species (ROS) and heat under illumination with 660 and 808 nm light, endows this hybrid hydrogel with great antibacterial efficacy against Staphylococcus aureus (S. aureus, typical Gram-positive bacteria) and Escherichia coli (E. coli, typical Gram-negative bacteria). The antibacterial efficacy of the prepared DFT-C/ZnO-hydrogel against S. aureus and E. coli under dual-light irradiation is 99.9%. Importantly, the hydrogels release zinc ions over 12 days, resulting in a sustained antimicrobial effect and promoted fibroblast growth. Thus, this hybrid hydrogel exhibits great potential for the reconstruction of bacteria-infected tissues, especially exposed wounds.

Interaction Mechanisms of Zwitterions with Opposite Dipoles in Aqueous Solutions

Zwitterionic groups have been widely used in antibiofouling surfaces to resist nonspecific adsorption of proteins and other biomolecules. The interactions among zwitterionic groups have attracted considerable attention in bioengineering, whereas the understanding of their nanomechanical mechanism still remains limited. In this work, the interaction mechanisms between two zwitterionic groups with opposite dipoles, i.e., phosphorylcholine (PC) and sulfobetaine (SB), have been investigated via direct force measurements using an atomic force microscope (AFM) and dynamic adsorption tests using the quartz crystal microbalance with dissipation monitoring technique (QCM-D) in aqueous solutions. The AFM force measurements show that the adhesive forces between contacted zwitterionic surfaces during separation in both symmetric and asymmetric configurations were close, mainly due to the enforced alignment of opposing dipole pairs via complementary orientations under confinement. The solution salinity and pH had almost negligible influence on the adhesion measured during surface separation. The QCM-D adsorption tests of PC-headed lipid on PC and SB surfaces showed some degree of adsorption of lipid molecules on the SB surface, whereas not on the PC surface. The different adsorption behaviors indicate that because the outermost negatively charged sulfonic group on the SB faced the aqueous solution, this configuration could facilitate it to form an attractive electrostatic interaction with the PC head of lipid molecules in the solution. This work shows that in addition to hydration and steric interactions, the zwitterionic dipole-induced interactions play an important role in the adhesion and antifouling behaviors of the zwitterionic molecules and surfaces. The improved fundamental understanding provides useful insights into the development of new functional materials and coatings with antifouling applications.

Anti-biofouling and functionalizable bioinspired chitosan-based hydrogel coating via surface photo-immobilization

Zwitterionic polymer is a new generation of anti-fouling materials with its good resistance to protein and bacterial adhesion. Constructing the anti-fouling surfaces with zwitterionic polymer has been regarded as an effective approach for improving the biocompatibility and biofunctionality of clinic devices. Herein, we reported a facile approach to construct a biodegradable anti-biofouling and functionalizable hydrogel coating via photo-immobilization using commercial polyethylene terephthalate (PET) films as the substrate, based on zwitterionic glycidyl methacrylate-phosphorylcholine-chitosan (PCCs-GMA). The surface structure and physicochemical properties of zwitterionic PCCs-GMA hydrogel coating were investigated by X-ray photoelectron spectroscopy (XPS), atomic force microscope (AFM) and static water contact angle measurement, and its functionalizable sites were detected by fluorescence labeling. Compared with the pristine PET and cationic chitosan - GMA and hydroxypropyltrimethyl ammonium chloride chitosan (HTCC) - GMA hydrogel coatings, zwitterionic PCCs-GMA hydrogel coating exhibited excellent biocompatibility, and significantly reduced protein adsorption for three model proteins of fibrinogen, immunoglobulin and lysozyme, repelled platelet adhesion, as well as showed a high resistance to bacterial attachment of Escherichia coli and Staphylococcus aureus and superior anti-fouling properties to MRC-5 cells. The results indicated that photo-immobilized zwitterionic PCCs-GMA hydrogel coating has perspective as a dual functional platform with integrated antifouling and further biofunctional properties for various biomedical applications.

Three-Dimensional, Bifunctional Microstructured Polymer Hydrogels Made from Polyzwitterions and Antimicrobial Polymers

Biofilm-associated infections of medical devices are a global problem. For the prevention of such infections, biomaterial surfaces are chemically or topographically modified to slow down the initial stages of biofilm formation. In the bifunctional material here presented, chemical and topographical cues are combined, so that protein and bacterial adhesion as well as bacterial proliferation are effectively inhibited. Upon changes in the surface topography parameters and investigation of the effect of these changes on bioactivity, structure-property relationships are obtained. The target material is obtained by microcontact printing (μCP), a soft lithography method. The antimicrobial component, poly(oxanorbornene)-based synthetic mimics of an antimicrobial peptide (SMAMP), was printed onto a protein-repellent polysulfobetaine hydrogel, so that bifunctional 3D structured polymer surfaces with 1, 2, and 8.5 μm spacing are obtained. These surfaces are characterized with fluorescence microscopy, surface plasmon resonance spectroscopy, atomic force microscopy, and contact angle measurements. Biological studies show that the bifunctional surfaces with 1 and 2 μm spacing are 100% antimicrobially active against Escherichia coli and Staphylococcus aureus, 100% fibrinogen-repellent, and nontoxic to human gingival mucosal keratinocytes. At 8.5 μm spacing, the broad-band antimicrobial activity and the protein repellency are compromised, which indicates that this spacing is above the upper limit for effective simultaneous antimicrobial activity and protein repellency of polyzwitterionic-polycationic materials.

Ionic-Strength Responsive Zwitterionic Copolymer Hydrogels with Tunable Swelling and Adsorption Behaviors

In this work, we studied the swelling behavior and adsorption behavior of zwitterionic copolymer hydrogels, which were prepared via the free radical copolymerization of sulfobetaine methacrylate (SBMA) and other monomers including sodium p-styrenesulfonate (NaSS), acrylic acid, N-isopropylacrylamide, and 2-(dimethylamino) ethyl methacrylate. The PSBMA hydrogel showed increased swelling ratio with the increase of ionic strength at the same temperature, and the swelling process reflected endothermicity. Interestingly, the PSBMA-NaSS hydrogels collapsed when the ionic strength increased because the ions can weaken the repulsive interaction of the anionic groups of PNaSS. In addition, the PSBMA-NaSS showed high adsorption of methylene blue (760 mg/g). The zwitterionic hydrogels have potential to be used as an adsorbent in the field of wastewater treatment.

Simple Thermal Pretreatment Strategy to Tune Mechanical and Antifouling Properties of Zwitterionic Hydrogels

Zwitterionic hydrogels are promising biomaterials because of their high water content, three-dimensional network structure, and antifouling property. However, it still remains unclear about how mechanical properties of zwitterionic hydrogels affect their antifouling property. In this work, we propose a simple, thermal-pretreatment method to fabricate poly(sulfobetaine methacrylate) (pSBMA) hydrogels with varied mechanical properties that can be readily tuned by thermal pretreatment time and cross-linker density, as well as to correlate their mechanical property with antifouling property. The resulting thermal-treated pSBMA hydrogels show significantly enhanced mechanical properties with tunable compressive modulus and elastic modulus as compared to the untreated hydrogels. A combination of ELISA investigations and short-term cell adhesion assays also confirm that pSBMA hydrogels exhibit superior antifouling properties to resist protein adsorption and cell adhesion. Further analysis shows a linear inversion correlation between elastic modulus and protein adsorption of pSBMA hydrogels, i.e., the hydrogel with the higher elastic modulus exhibits the lower protein adsorption (the better antifouling property). This work not only provides a simple thermal-pretreatment strategy for fabricating pSBMA hydrogels, but also demonstrates multifunctional properties of the pSBMA hydrogels, which possess a great potential to fulfill some biomedical applications.

Self-healing zwitterionic sulfobetaine nanocomposite hydrogels with good mechanical properties

The development of zwitterionic hydrogels possessing both excellent self-healing and mechanical properties is of great significance. Herein, a class of zwitterionic sulfobetaine nanocomposite hydrogels was prepared by UV-initiated copolymerisation of zwitterionic sulfobetaine monomer N,N-dimethyl-N-(3-methacrylamidopropyl)-N-(3-sulfopropyl) ammonium betaine (DMAPMAPS) and 2-hydroxyethyl methacrylate (HEMA) in the presence of exfoliated clay platelets uniformly dispersed in an aqueous medium. The effects of the hydrogel compositions, including the DMAPMAPS/HEMA mass ratio and the amount of clay, on the self-healing behaviors and mechanical properties of the nanocomposite hydrogels were investigated. The results indicate that the fabricated zwitterionic sulfobetaine nanocomposite hydrogels can autonomously repair incisions or cracks at ambient temperature without the need for any stimulus and possess excellent mechanical properties.

The prepared zwitterionic sulfobetaine nanocomposite hydrogels can autonomously repair incisions or cracks at ambient temperature without the need for any stimulus and possess excellent mechanical properties.

Fabrication of Self-Healing Hydrogels with On-Demand Antimicrobial Activity and Sustained Biomolecule Release for Infected Skin Regeneration

Microbial infection has been considered as one of the most critical challenges in bioengineering applications especially in tissue regeneration, which engenders severe threat to public health. Herein, a hydrogel performing properties of rapid self-healing, on-demand antibiosis and controlled cargo release was fabricated by a simple assembly of Fe complex as the cross-linker and hyaluronic acid as the gel network. This hydrogel is able to locally degrade and release Fe³⁺ to kill bacteria as needed because of hyaluronidase excreted by surrounding bacteria, resulting in efficient antibacterial activity against different types of bacteria. The sustained release property of certain types of growth factors was also observed from this hydrogel owing to its dense network. Moreover, this hydrogel could repeatedly heal itself in minutes because of the coordination interaction between Fe³⁺ and COOH, exhibiting good potential in bioengineering applications on the exposed tissue, where the materials are easily damaged during daily life. When topically applied onto damaged mouse skin with infection of Staphylococcus aureus, the hydrogel is able to inhibit microbial infections, meanwhile promoting cutaneous regeneration, which formed new skin with no inflammation within a 10 day treatment. These results demonstrate the potential application of this self-healing hydrogel for the integrated therapy of antibiosis and tissue regeneration.

Recent Progress in Polymer Research to Tackle Infections and Antimicrobial Resistance

Global health is increasingly being threatened by the rapid emergence of drug-resistant microbes. The ability of these microbes to form biofilms has further exacerbated the scenario leading to notorious infections that are almost impossible to treat. For addressing this clinical threat, various antimicrobial polymers, polymer-based antimicrobial hydrogels and polymer-coated antimicrobial surfaces have been developed in the recent past. This review aims to discuss such polymer-based antimicrobial strategies with a focus on their current advancement in the field. Antimicrobial polymers, whose designs are inspired from antimicrobial peptides (AMPs), are described with an emphasis on structure-activity analysis. Additionally, antibiofilm activity and in vivo efficacy are delineated to elucidate the real potential of these antimicrobial polymers as possible therapeutics. Antimicrobial hydrogels, prepared from either inherently antimicrobial polymers or biocide-loaded into polymer-derived hydrogel matrix, are elaborated followed by various strategies to engineer polymer-coated antimicrobial surfaces. In the end, the current challenges are accentuated along with future directions for further expansion of the field toward tackling infections and antimicrobial resistance.

Antibacterial Hydrogels

Antibacterial materials are recognized as important biomaterials due to their effective inhibition of bacterial infections. Hydrogels are 3D polymer networks crosslinked by either physical interactions or covalent bonds. Currently, hydrogels with an antibacterial function are a main focus in biomedical research. Many advanced antibacterial hydrogels are developed, each possessing unique qualities, namely high water swellability, high oxygen permeability, improved biocompatibility, ease of loading and releasing drugs, and structural diversity. Here, an overview of the structures, performances, mechanisms of action, loading and release behaviors, and applications of various antibacterial hydrogel formulations is provided. Furthermore, the prospects in biomedical research and clinical applications are predicted.

Antimicrobial hydrogels: promising materials for medical application

The rapid emergence of antibiotic resistance in pathogenic microbes is becoming an imminent global public health problem. Local application of antibiotics might be a solution. In local application, materials need to act as the drug delivery system. The drug delivery system should be biodegradable and prolonged antibacterial effect should be provided to satisfy clinical demand. Hydrogel is a promising material for local antibacterial application. Hydrogel refers to a kind of biomaterial synthesized by a water-soluble natural polymer or a synthesized polymer, which turns into gel according to the change in different signals such as temperature, ionic strength, pH, ultraviolet exposure etc. Because of its high hydrophilicity, unique three-dimensional network, fine biocompatibility and cell adhesion, hydrogel is one of the suitable biomaterials for drug delivery in antimicrobial areas. In this review, studies from the past 5 years were reviewed, and several types of antimicrobial hydrogels according to different ingredients, different preparations, different antimicrobial mechanisms, different antimicrobial agents they contained and different applications, were summarized. The hydrogels loaded with metal nanoparticles as a potential method to solve antibiotic resistance were highlighted. Finally, future prospects of development and application of antimicrobial hydrogels are suggested.

Polydopamine/cysteine surface modified hemocompatible poly(vinylidene fluoride) hollow fiber membranes for hemodialysis

Membrane surface design is significant for the development and application of synthetic polymer hemodialysis membranes. In this study, the influence of zwitterionic cysteine on poly(vinylidene fluoride) (PVDF) hollow fiber membrane was investigated. The polydopamine layer was formed through dopamine self-polymerization on PVDF membrane surface, and then cysteine was covalent grafted onto the layer to improve the anti-biofouling property and hemocompatibility. The elementary composition of membrane surfaces was characterized by X-ray photoelectron spectroscopy. The influence of polydopamine and cysteine on modified membrane surface morphologies was studied by field emission scanning electron microscopy. The modified PVDF membranes were confirmed to have excellent hydrophilicity, stable mechanical properties and good hemocompatibility (dynamic and static anti-protein adsorption, hemolysis ratio, plasma coagulation). And these properties were increased with the incorporation of polydopamine and cysteine. The optimized modified membranes exhibited high pure water flux (∼ 195.5 L/m² h at 0.1 MPa) and selectivity (clearance ratio of urea and lysozyme was 75.1 and 55.4%, and rejection rate of bovine serum albumin was 98.8%). This work provides a surface modification method of PVDF hollow fiber membranes and suggests a potential application of PVDF membranes in hemodialysis field. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2869-2877, 2018.

Programming Ionic Pore Accessibility in Zwitterionic Polymer Modified Nanopores

Creating switchable and gradually tunable pores or channels that display transport control similar to biological pores remains a major challenge in nanotechnology. It requires the generation and manipulation of complex charge situations at the nanoscale and the understanding of how confinement influences chemistry and transport. Here, two different pore sizes, ∼100 nm and less than 10 nm, functionalized with varying amounts of responsive zwitterionic polycarboxybetaine methyl acrylate (PCBMA) give fascinating insight into the confinement controlled ionic transport of pores functionalized with pH-dependent zwitterionic polymers. Under basic conditions, the zwitterionic state offers complex, strongly pore-size-dependent ionic permselectivity characteristics. For mesoporous films with pore sizes smaller than 10 nm, complete ion exclusion is observed after reaching a critical zwitterionic polymer amount, clearly indicating an electrostatic behavior of "bipolar charged" pores. This ion exclusion is not observed for pore diameters of ∼100 nm. In addition, the solution pH of equal pore accessibility for oppositely charged ions and pore sizes smaller than 10 nm shifts with increasing polymer amount from a pH of 2.5 to 8.2, and the quantity of ions accessing the pores depends on the pore size. These observations clearly show the potential of controlling pore accessibility based on controlled functional composition at the nanoscale without changing the components themselves as well as the influence of spatial confinement on pore accessibility in the presence of complex (zwitterionic) charged states.

The effects of polymer topology and chain length on the antimicrobial activity and hemocompatibility of amphiphilic ternary copolymers

Hyperbranched random copolymers that consist of ethylhexyl hydrophobic groups have the best selectivity compared to linear random and block copolymers.

Temperature-Responsive Hierarchical Polymer Brushes Switching from Bactericidal to Cell Repellency

Unlike conventional poly(N-isopropylacrylamide) (PNIPAM)-based surfaces switching from bactericidal activity to bacterial repellency upon decreasing temperature, we developed a hierarchical polymer architecture, which could maintain bactericidal activities at room temperature while presenting bacterial repellency at physiological temperature. In this architecture, a thermoresponsive bactericidal upper layer consisting of PNIPAM-based copolymer and vancomycin (Van) moieties was built on an antifouling poly(sulfobetaine methacrylate) (PSBMA) bottom layer via sequential surface-initiated photoiniferter-mediated polymerization. At room temperature below the lower critical solution temperature (LCST), the PNIPAM-based upper layer was stretchable, facilitating contact killing of bacteria by Van. At physiological temperature (above the LCST), the PNIPAM-based layer collapsed, thus leading to the burial of Van and exposure of bottom PSBMA brushes, finally displaying notable performances in bacterial inhibition, dead bacteria detachment, and biocompatibility, simultaneously. Our strategy provides a novel pathway in the rational design of temperature-sensitive switchable surfaces, which shows great advantages in the real-world infection-resistant applications.

Polymer-Based Surfaces Designed to Reduce Biofilm Formation: From Antimicrobial Polymers to Strategies for Long-Term Applications

Contact-active antimicrobial polymer surfaces bear cationic charges and kill or deactivate bacteria by interaction with the negatively charged parts of their cell envelope (lipopolysaccharides, peptidoglycan, and membrane lipids). The exact mechanism of this interaction is still under debate. While cationic antimicrobial polymer surfaces can be very useful for short-term applications, they lose their activity once they are contaminated by a sufficiently thick layer of adhering biomolecules or bacterial cell debris. This layer shields incoming bacteria from the antimicrobially active cationic surface moieties. Besides discussing antimicrobial surfaces, this feature article focuses on recent strategies that were developed to overcome the contamination problem. This includes bifunctional materials with simultaneously presented antimicrobial and protein-repellent moieties; polymer surfaces that can be switched from an antimicrobial, cell-attractive to a cell-repellent state; polymer surfaces that can be regenerated by enzyme action; degradable antimicrobial polymers; and antimicrobial polymer surfaces with removable top layers.

Design of Antibacterial Poly(ether sulfone) Membranes via Covalently Attaching Hydrogel Thin Layers Loaded with Ag Nanoparticles

To inhibit bacteria attachment and the subsequent formation of biofilms on poly(ether sulfone) (PES) membranes, poly(sulfobetaine methacrylate)/poly(sodium acrylate) antibacterial hydrogel thin layers were covalently attached onto the membranes, followed by loading with Ag nanoparticles. In our strategy, double bonds were firstly introduced onto the PES membrane surfaces to provide anchoring sites, and then the hydrogel layers were synthesized on the membrane surfaces via UV light-initiated crosslinking copolymerization. Then, Ag ions were adsorbed into the hydrogel layers and reduced to Ag nanoparticles by sodium borohydride. The amounts of the adsorbed Ag ions were controlled by the mole ratios of carboxylate groups in the hydrogel layers. After attaching the hydrogel layers, a typical 3D porous structure was observed by scanning electron microscopy, and the surface chemical composition variations were characterized by attenuated total reflection-Fourier transform infrared spectroscopy. The live/dead staining, inhibition zone, and the optical degree of co-culture solution demonstrated that the designed surfaces could not only effectively resist bacteria attachment but also kill the surrounding bacteria Escherichia coli and Staphylococcus aureus. It was noteworthy that the strong antibacterial ability could be maintained for more than 5 weeks. Additionally, the excellent hemocompatibility of the modified membranes was confirmed by undetectable plasma protein adsorption, suppressed platelet adhesion, prolonged clotting time, low hemolysis ratio, and suppressed blood-related complement activation. Cell culture tests indicated that the membranes showed no cytotoxicity, but strong anti-cell adhesion properties. The proposed method to fabricate antibacterial hydrogel thin layers has great potential to be widely used to inhibit the formation of biofilms on various biomedical devices.

Injectable Self-Healing Hydrogel with Antimicrobial and Antifouling Properties

Microbial adhesion, biofilm formation and associated microbial infection are common challenges faced by implanted biomaterials (e.g., hydrogels) in bioengineering applications. In this work, an injectable self-healing hydrogel with antimicrobial and antifouling properties was prepared through self-assembly of an ABA triblock copolymer employing catechol functionalized polyethylene glycol (PEG) as A block and poly{[2-(methacryloyloxy)-ethyl] trimethylammonium iodide}(PMETA) as B block. This hydrogel exhibits excellent thermosensitivity, and can effectively inhibit the growth of E. coli (>99.8% killing efficiency) and prevent cell attachment. It can also heal autonomously from repeated damage, through mussel-inspired catechol-mediated hydrogen bonding and aromatic interactions, exhibiting great potential in bioengineering applications.