Copper boron–imidazolate framework incorporated chitosan membranes for bacterial-infected wound healing dressing

In-situ forming carboxymethyl chitosan hydrogel containing Paeonia suffruticosa Andr. leaf extract for mixed infectious vaginitis treatment by reshaping the micro-biota

Mixed infectious vaginitis poses a serious threat to female reproductive health due to complex pathogenic factors, a long course and easy recurrence. Currently, antibiotic-based treatment methods are facing a crisis of drug resistance and secondary dysbiosis. Exploring effective drugs for the treatment of mixed vaginitis from Paeonia suffruticosa Andr., a natural traditional Chinese medicine with a long history of medicinal use, is a feasible treatment strategy. P. suffruticosa Andr. leaf extract (PLE) has significant anti-bacterial effects due to its rich content of polyphenols and flavonoids. The polyphenols in peony leaves have the potential to make carboxymethyl chitosan form in situ gel. In the current study, PLE and carboxymethyl chitosan were combined to develop another type of natural anti-bacterial anti-oxidant hydrogel for the treatment of mixed infectious vaginitis. Through a series of characterisations, CP had a three-dimensional network porous structure with good mechanical properties, high water absorption, long retention and a slow-release drug effect. The mixed infectious vaginitis mouse model induced by a mixture of pathogenic bacteria was used to investigate the therapeutic effects of CP in vivo. The appearance of the vagina, H&E colouring of the tissue and inflammatory factors (TNF-α, IL-6) confirm the good anti-vaginal effect of CP. Therefore, CP was expected to become an ideal effective strategy to improve mixed infection vaginitis due to its excellent hydrogel performance and remarkable ability to regulate flora.

Borate bonds-containing pH-responsive chitosan hydrogel for postoperative tumor recurrence and wound infection prevention

Chitosan has been widely used in biomedical fields due to its good antibacterial properties, excellent biocompatibility, and biodegradability. In this study, a pH-responsive and self-healing hydrogel was synthesized from 3-carboxyphenylboronic acid grafted with chitosan (CS-BA) and polyvinyl alcohol (PVA). The dynamic boronic ester bonds and intermolecular hydrogen bonds are responsible for the hydrogel formation. By changing the mass ratio of CS-BA and PVA, the tensile stress and compressive stress of hydrogel can controlled in the range of 0.61 kPa - 0.74 kPa and 295.28 kPa - 1108.1 kPa, respectively. After doping with tannic acid (TA)/iron nanocomplex (TAFe), the hydrogel successful killed tumor cells through the near infrared laser-induced photothermal conversion and the TAFe-triggered reactive oxygen species generation. Moreover, the photothermal conversion of the hydrogel and the antibacterial effect of CS and TA give the hydrogel a good antibacterial effect. The CS-BA/PVA/TAFe hydrogel exhibit good in vivo and in vitro anti-tumor recurrence and antibacterial ability, and therefore has the potential to be used as a powerful tool for the prevention of local tumor recurrence and bacterial infection after surgery.

Nanoclay Hydrogel Microspheres with a Sandwich-Like Structure for Complex Tissue Infection Treatment

Addressing complex tissue infections remains a challenging task because of the lack of effective means, and the limitations of traditional bioantimicrobial materials in single-application scenarios hinder their utility for complex infection sites. Hence, the development of a bioantimicrobial material with broad applicability and potent bactericidal activity is necessary to treat such infections. In this study, a layered lithium magnesium silicate nanoclay (LMS) is used to construct a nanobactericidal platform. This platform exhibits a sandwich-like structure, which is achieved through copper ion modification using a dopamine-mediated metallophenolic network. Moreover, the nanoclay is encapsulated within gelatin methacryloyl (GelMA) hydrogel microspheres for the treatment of complex tissue infections. The results demonstrate that the sandwich-like micro- and nanobactericidal hydrogel microspheres effectively eradicated Staphylococcus aureus (S. aureus) while exhibiting excellent biocompatibility with bone marrow-derived mesenchymal stem cells (BMSCs) and human umbilical vein endothelial cells (HUVECs). Furthermore, the hydrogel microspheres upregulated the expression levels of osteogenic differentiation and angiogenesis-related genes in these cells. In vivo experiments validated the efficacy of sandwich-like micro- and nanobactericidal hydrogel microspheres when injected into deep infected tissues, effectively eliminating bacteria and promoting robust vascular regeneration and tissue repair. Therefore, these innovative sandwich-like micro- and nanobacteriostatic hydrogel microspheres show great potential for treating complex tissue infections.

A Double Network Composite Hydrogel with Self-Regulating Cu2+/Luteolin Release and Mechanical Modulation for Enhanced Wound Healing

Designing adaptive and smart hydrogel wound dressings to meet specific needs across different stages of wound healing is crucial. Here, we present a composite hydrogel, GSC/PBE@Lut, that offers self-regulating release of cupric ions and luteolin and modulates mechanical properties to promote chronic wound healing. The double network hydrogel, GSC, is fabricated through photo-cross-linking of gelatin methacrylate, followed by Cu2+-alginate coordination cross-linking. On one hand, GSC allows for rapid Cu2+ release to eliminate bacteria in the acidic pH environment during inflammation and reduces the hydrogel's mechanical strength to minimize tissue trauma during early dressing changes. On the other hand, GSC enables slow Cu2+ release during the proliferation stage, promoting angiogenesis and biocompatibility. Furthermore, the inclusion of pH- and reactive oxygen species (ROS)-responsive luteolin nanoparticles (PBE@Lut) in the hydrogel matrix allows for controlled release of luteolin, offering antioxidant and anti-inflammatory effects and promoting anti-inflammatory macrophage polarization. In a murine model of Staphylococcus aureus infected wounds, GSC/PBE@Lut demonstrates exceptional therapeutic benefits in antibacterial, anti-inflammatory, angiogenic, and tissue regeneration. Overall, our results suggest that smart hydrogels with controlled bioactive agent release and mechanical modulation present a promising solution for treating chronic wounds.

Nanotechnology-driven strategies to enhance the treatment of drug-resistant bacterial infections

The misuse of antibiotics has led to increased bacterial resistance, posing a global public health crisis and seriously endangering lives. Currently, antibiotic therapy remains the most common approach for treating bacterial infections, but its effectiveness against multidrug-resistant bacteria is diminishing due to the slow development of new antibiotics and the increase of bacterial drug resistance. Consequently, developing new a\ntimicrobial strategies and improving antibiotic efficacy to combat bacterial infection has become an urgent priority. The emergence of nanotechnology has revolutionized the traditional antibiotic treatment, presenting new opportunities for refractory bacterial infection. Here we comprehensively review the research progress in nanotechnology-based antimicrobial drug delivery and highlight diverse platforms designed to target different bacterial resistance mechanisms. We also outline the use of nanotechnology in combining antibiotic therapy with other therapeutic modalities to enhance the therapeutic effectiveness of drug-resistant bacterial infections. These innovative therapeutic strategies have the potential to enhance bacterial susceptibility and overcome bacterial resistance. Finally, the challenges and prospects for the application of nanomaterial-based antimicrobial strategies in combating bacterial resistance are discussed. This article is categorized under: Biology-Inspired Nanomaterials > Nucleic Acid-Based Structures Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease.

Stimuli-Responsive 3D Printable Conductive Hydrogel: A Step toward Regulating Macrophage Polarization and Wound Healing

Conductive hydrogels (CHs) are promising alternatives for electrical stimulation of cells and tissues in biomedical engineering. Wound healing and immunomodulation are complex processes that involve multiple cell types and signaling pathways. 3D printable conductive hydrogels have emerged as an innovative approach to promote wound healing and modulate immune responses. CHs can facilitate electrical and mechanical stimuli, which can be beneficial for altering cellular metabolism and enhancing the efficiency of the delivery of therapeutic molecules. This review summarizes the recent advances in 3D printable conductive hydrogels for wound healing and their effect on macrophage polarization. This report also discusses the properties of various conductive materials that can be used to fabricate hydrogels to stimulate immune responses. Furthermore, this review highlights the challenges and limitations of using 3D printable CHs for future material discovery. Overall, 3D printable conductive hydrogels hold excellent potential for accelerating wound healing and immune responses, which can lead to the development of new therapeutic strategies for skin and immune-related diseases.

Photothermal antibacterial MoS2 composited chitosan hydrogel for infectious wound healing

Pathological bacterial infection poses a serious threat to public health security. The excessive use of antibiotics has resulted in a serious decline in treatment effect and bacterial resistance. For the treatment of infected wounds, we compounded dopamine-assisted exfoliated molybdenum disulfide (MoS2@PDA) into lipoic acid modified chitosan (LAMC) to obtain a composite hydrogel dressing (LAMC-MoS2@PDA). LAMC-MoS2@PDA hydrogels exhibited excellent photothermal conversion ability and the LAMC-MoS2@PDA2 group (0.3 wt%) has a photothermal conversion efficiency of 26.29 %. Meanwhile, they showed good biocompatibility and ROS scavenging activity in vitro. Photothermal therapy usually utilizes photothermal agents to convert near-infrared light into heat energy for bacterial cell membrane destruction and bacterial protein inactivation. Under the near-infrared light irradiation, the antibacterial ratio of LAMC-MoS2@PDA hydrogels against Staphylococcus aureus and Escherichia coli reached nearly 100 %, and the morphology of the bacteria showed obvious contraction and cleavage. The hydrogels also showed an excellent antibacterial effect and wound healing promotion in the infected wound of rats. In particular, the LAMC-MoS2@PDA2 (+) group (with NIR) showed almost complete wound closure after 14 days, indicating that the LAMC-MoS2@PDA hydrogels have great potential in clinical anti-infected treatment.

Polarity-dominated chitosan biguanide hydrochloride-based nanofibrous membrane with antibacterial activity for long-lasting air filtration

Facemasks play a significant role as personal protective equipment during the COVID-19 pandemic, but their longevity is limited by the easy dissipation of electrostatic charge and the accumulation of bacteria. In this study, nanofibrous membranes composed of polyacrylonitrile and chitosan biguanide hydrochloride (PAN@CGH) with remarkable antibacterial characteristics were prepared through the coaxial electrospinning process. Particulate matter could be efficiently captured by the fibrous membrane, up to 98 % or more, via polarity-dominated forces derived from cyano and amino groups. As compared commercial N95 masks, the PAN@CGH was more resistant to a wider variety of disinfection protocols. Additionally, the nanofibrous membrane could kill >99.99 % of both Escherichia coli and Staphylococcus aureus. Based on these characteristics, PAN@CGH nanofibrous membrane was applied to facial mask, which possessed an excellent and long-lasting effect on the capture of airborne particles. This work may be one of the most promising strategies on designing high-performance face masks for public health protection.

PMN-incorporated multifunctional chitosan hydrogel for postoperative synergistic photothermal melanoma therapy and skin regeneration

Melanoma excision surgery is usually accompanied by neoplasm residual, tissue defect, and bacterial infection, resulting in high tumor recurrence and chronic wound. Nanocomposite hydrogels can satisfy the twin requirements of avoiding tumor recurrence and skin wound healing following skin melanoma surgery due to their photothermal anti-tumor and anti-bacterial activities. In this study, carboxymethyl chitosan, oxidized fucoidan and polyphenol-metal nanoparticle (PMN) of tannic acid capped gold nanoparticles were used to fabricate multifunctional nanocomposite hydrogels through Schiff base reaction. The prepared hydrogel demonstrated outstanding photothermal effect, and the controlled high temperature will rapidly kill melanoma cells as well as bacteria within 10 min. Good injectability, self-healing and adhesion combined with high reactive oxygen species (ROS) scavenging capacity, hemostasis and biocompatibility made this hydrogel platform perfect for the postoperative treatment of melanoma and promoting wound healing. With the assistance of NIR irradiance, hydrogel can inhibit tumor tissue proliferation and promote tumor cell apoptosis, thereby helping to prevent melanoma recurrence after surgical removal of tumors. Simultaneously, the irradiance heat and polyphenol component kill bacteria on the wound surface, eliminate ROS, inhibit inflammatory responses, and promote angiogenesis, collagen deposition, and skin regeneration, all of which help to speed up wound healing.

Combining Chitosan, Stearic Acid, and (Cu-, Zn-) MOFs to Prepare Robust Superhydrophobic Coatings with Biomedical Multifunctionalities

There is an urgent need to develop a series of multifunctional materials with good biocompatibility, high mechanical strength, hemostatic properties, antiadhesion, and anti-infection for applications in wound care. However, successfully developing multifunctional materials is challenging. In this study, two superhydrophobic composite coatings with good biocompatibility, high mechanical strength, strong antifouling and blood repellency, fast hemostasis, and good antibacterial activity are prepared on cotton fabric surface by simple, green, and low-cost one-step dip-coating technology. The results discussed in the manuscript reveals that the two superhydrophobic composite coatings can maintain good mechanical stability, strong water repellency, and durability under various types of mechanical damage, high-temperature treatment, and long-term strong light irradiation. The coatings also exhibit good repellency to various solid pollutants, highly viscous liquid pollutants, and blood. In vitro and in vivo hemostatic experiments show that both composite coatings have good hemostatic and anticlot adhesion properties. More importantly, this superhydrophobic coating prevents bacterial adhesion and growth and released Cu2+ and Zn2+ ions and chitosan to achieve bactericidal properties, thereby protecting injured skin from bacterial infection. The two superhydrophobic coatings enhance the antifouling, antiadhesion, hemostatic, and antibacterial functions of blood-repellent dressings and therefore have broad application prospects in medical and textile fields.

Animal tissue-derived biomaterials for promoting wound healing

The skin serves as the primary barrier between the human body and external environment, and is therefore susceptible to damage from various factors. In response to this challenge, animal tissue-derived biomaterials have emerged as promising candidates for wound healing due to their abundant sources, low side-effect profiles, exceptional bioactivity, biocompatibility, and unique extracellular matrix (ECM) mimicry. The evolution of modern engineering technology and therapies has allowed these animal tissue-derived biomaterials to be transformed into various forms and modified to possess the necessary properties for wound repair. This review provides an overview of the wound healing process and the factors that influence it. We then describe the extraction methods, important properties, and recent practical applications of various animal tissue-derived biomaterials. Our focus then shifts to the critical properties of these biomaterials in skin wound healing and their latest research developments. Finally, we critically examine the limitations and future prospects of biomaterials generated from animal tissues in this field.

Antibacterial Chemodynamic Therapy: Materials and Strategies

The wide and frequent use of antibiotics in the treatment of bacterial infection can cause the occurrence of multidrug-resistant bacteria, which becomes a serious health threat. Therefore, it is necessary to develop antibiotic-independent treatment modalities. Chemodynamic therapy (CDT) is defined as the approach employing Fenton and/or Fenton-like reactions for generating hydroxyl radical (•OH) that can kill target cells. Recently, CDT has been successfully employed for antibacterial applications. Apart from the common Fe-mediated CDT strategy, antibacterial CDT strategies mediated by other metal elements such as copper, manganese, cobalt, molybdenum, platinum, tungsten, nickel, silver, ruthenium, and zinc have also been proposed. Furthermore, different types of materials like nanomaterials and hydrogels can be adopted for constructing CDT-involved antibacterial platforms. Besides, CDT can introduce some toxic metal elements and then achieve synergistic antibacterial effects together with reactive oxygen species. Finally, CDT can be combined with other therapies such as starvation therapy, phototherapy, and sonodynamic therapy for achieving improved antibacterial performance. This review first summarizes the advancements in antibacterial CDT and then discusses the present limitations and future research directions in this field, hoping to promote the development of more effective materials and strategies for achieving potentiated CDT.

New N-Methylimidazole-Functionalized Chitosan Derivatives: Hemocompatibility and Antibacterial Properties

Novel imidazole derivatives of the low molecular weight chitosan N-(2-hydroxypropyl)-1H-1,2,3-triazol-4-yl)methyl)-1-methyl-1H-imidazol-3-ium chitosan chloride (NMIC) were synthesized using copper-catalyzed azide-alkyne cycloaddition (CuAAC). The degrees of substitution (DSs) for the new derivatives were 18-76%. All chitosan derivatives (2000 µg/mL) were completely soluble in water. The antimicrobial activity of the new compounds against E. coli and S. epidermidis was studied. The effect of chitosan derivatives on blood and its components was studied. NMIC samples (DS 34-76%) at a concentration <10 μg/mL had no effect on blood and plasma coagulation. Chitosan derivatives (DS 18-76%) at concentrations of ≥83 μg/mL in blood and ≥116.3 μg/mL in plasma resulted in a prolongation of the clotting time of blood and plasma, positively related to the DS. At concentrations up to 9.1 μg/mL, NMIC did not independently provoke platelet aggregation. The degree of erythrocyte hemolysis upon contact with NMIC samples (2.5-2500 μg/mL) was below 4%. The inhibition of blood/plasma coagulation indicates the promising use of the studied samples to modify the surface of medical materials in order to achieve thromboresistance.

Bimetallic (Ag and MgO) nanoparticles, Aloe vera extracts loaded xanthan gum nanocomposite for enhanced antibacterial and in-vitro wound healing activity

We prepared nanocomposite (XG-AVE-Ag/MgO NCs) using the bimetallic Ag/MgO NPs, Aloe vera extract (AVE), and biopolymer (Xanthan gum (XG)) to archive a synergetic antibacterial and wound healing activity. The changes in XRD peaks at 20° of XG-AVE-Ag/MgO NCs indicated the XG encapsulation. The XG-AVE-Ag/MgO NCs showed the zeta potential and zeta size of 151.3 ± 3.14 d·nm and -15.2 ± 1.08 mV with a PDI of 0.265 while TEM showed an average size of 61.19 ± 3.89. The EDS confirmed the co-existence of Ag, Mg, carbon, oxygen, and nitrogen in NCs. XG-AVE-Ag/MgO NCs displayed higher antibacterial activity in terms of zone of inhibition, at 15.00 ± 0.12 mm for B. cereus and 14.50 ± 0.85 mm for E. coli. Moreover, NCs exhibited MICs of 2.5 μg/mL for E. coli, and 0.62 μg/mL for B. cereus. The in vitro cytotoxicity and hemolysis assays indicated the non-toxic properties of XG-AVE-Ag/MgO NCs. The higher wound closure activity was observed with the treatment of XG-AVE-Ag/MgO NCs (91.19 ± 1.87 %) compared to the control, untreated group (68.68 ± 3.54 %) at 48 h of incubation. These findings revealed that XG-AVE-Ag/MgO NCs was promising non-toxic, antibacterial, and wound-healing agent that deserved further in-vivo studies.

Chitosan-collagen-fibrinogen uncrosslinked scaffolds possessing skin regeneration and vascularization potential

Clinical success of regenerative medicine for treating deep-tissue skin injuries depends on the availability of skin grafts. Though bioengineered constructs are tested clinically, lack of neovascularization provide only superficial healing. Thus constructs, which promotes wound healing and supports vascularization has gained priority in tissue engineering. In this study, chitosan-collagen-fibrinogen (CCF) scaffold was fabricated using freeze-drying method without using any chemical crosslinkers. CCF scaffolds proved cytocompatibility and faster healing in in vitro scratch assay of primary human adult dermal fibroblasts cells with progressively increasing vascular endothelial growth factor-A and reducing vascular endothelial growth factor receptor 1 expressions. Skin regeneration evaluated on in vivo full thickness wound model confirmed faster remodeling with angiogenic signatures in CCF scaffold-implanted mice. Histopathological observations corroborated with stereo-zoom and SS-optical coherence tomography images of wound sites to prove the maturation of healing-bed, after 12 days of CCF implantation. Therefore, it is concluded that CCF scaffolds are promising for skin tissue regeneration and demonstrates pro-angiogenic potential.

Multifunctional Bletilla striata polysaccharide/copper/peony leaf sponge for the full-stage wound healing

Conventional wound dressings fail to satisfy the requirements and needs of wounds in various stages. It is challenging to develop a multifunctional dressing that is hemostatic, antibacterial, anti-inflammatory, and promotes wound healing. Therefore, this study aimed to develop a multifunctional sponge dressing for the full-stage wound healing based on copper and two natural products, Bletilla striata polysaccharide (BSP) and peony leaf extract (PLE). The developed BSP-Cu-PLE sponges were characterized by SEM, XRD, FTIR, and XPS to assess micromorphology and elemental composition. Their properties and bioactivities were also verified by the further experiments, whereby the findings revealed that the BSP-Cu-PLE sponges had improved water absorption and porosity while exhibiting excellent antioxidative, biocompatible, and biodegradable properties. Moreover, the antibacterial test revealed that BSP-Cu-PLE sponges had superior antibacterial activity against S. aureus and E. coli. Furthermore, the hemostatic activity of BSP-Cu-PLE sponges was significantly enhanced in a rat liver trauma model. Most notably, further studies have demonstrated that the BSP-Cu-PLE sponges could significantly (p < 0.05) accelerate the healing process of skin wounds by stimulating collagen deposition, promoting angiogenesis, and decreasing inflammatory cells. In summary, the BSP-Cu-PLE sponges could provide a new strategy for application in clinical setting for full-stage wound healing.

Pentoxifylline/Chitosan Films on Wound Healing: In Vitro/In Vivo Evaluation

This study aimed to develop films of chitosan (CSF) associated with pentoxifylline (PTX) for healing cutaneous wounds. These films were prepared at two concentrations, F1 (2.0 mg/mL) and F2 (4.0 mg/mL), and the interactions between the materials, structural characteristics, in vitro release, and morphometric aspects of skin wounds in vivo were evaluated. The formation of the CSF film with acetic acid modifies the polymeric structure, and the PTX demonstrates interaction with the CSF, in a semi-crystalline structure, for all concentrations. The release for all films was proportional to the concentration, with two phases: a fast one of ≤2 h and a slow one of >2 h, releasing 82.72 and 88.46% of the drug after 72 h, being governed by the Fickian diffusion mechanism. The wounds of the mice demonstrate a reduction of up to 60% in the area on day 2 for F2 when compared to CSF, F1, and positive control, and this characteristic of faster healing speed for F2 continues until the ninth day with wound reduction of 85%, 82%, and 90% for CSF, F1, and F2, respectively. Therefore, the combination of CSF and PTX is effective in their formation and incorporation, demonstrating that a higher concentration of PTX accelerates skin-wound reduction.

Studies on the Impact of the Photoinitiator Amount Used during the PVP-Based Hydrogels' Synthesis on Their Physicochemical Properties

In recent times, a great interest is directed to developing biomaterials incorporated with various therapeutical substances which may enhance them with new properties and thus increase their application potential. In this work, polyvinylpyrrolidone (PVP)-based hydrogels modified with Aloe vera juice and vitamin C and differing in the amount of the photoinitiator used during their synthesis were developed. Analysis of hydrogels included characterization of their chemical structure via FT-IR spectroscopy, sorption properties, wettability, surface morphology, behavior in simulated physiological liquids and mechanical properties. Finally, hydrogels' cytotoxicity towards L929 murine fibroblasts using MTT reduction assay was additionally verified. It was demonstrated that as the amount of the photoinitiator used during the synthesis of hydrogels increased, the smoother their surface and the higher their hydrophilicity. Next, the greater the amount of the photoinitiator, the lower is the percentage elongation of the hydrogel and the greater the hardness. In turn, the swelling ability of hydrogels depended strongly on the type of the absorbed liquid-swelling ratios of samples in distilled water were 24% higher than in SBF, 18% higher than in Ringer liquid, and 32% higher than in hemoglobin wherein the amount of the photoinitiator did not affect this property. Additionally, hydrogels were stable and did not degrade in simulated physiological liquids. The only changes in pH of the incubation media were probably caused by the active substances release from hydrogels which was also confirmed via a lesser intensity of the absorption band on FT-IR spectra corresponding to the functional group occurring in compounds included in Aloe vera juice. Importantly, the viability of fibroblasts incubated with developed materials was at least 86%. Thus the hydrogels, due to their properties, seem to show application potential to be used for biomedical purposes, e.g., as innovative dressing materials.

A Review on the Recent Advancements on Therapeutic Effects of Ions in the Physiological Environments

This review focuses on the therapeutic effects of ions when released in physiological environments. Recent studies have shown that metallic ions like Ag+, Sr2+, Mg2+, Mn2+, Cu2+, Ca2+, P+5, etc., have shown promising results in drug delivery systems and regenerative medicine. These metallic ions can be loaded in nanoparticles, mesoporous bioactive glass nanoparticles (MBGNs), hydroxyapatite (HA), calcium phosphates, polymeric coatings, and salt solutions. The metallic ions can exhibit different functions in the physiological environment such as antibacterial, antiviral, anticancer, bioactive, biocompatible, and angiogenic effects. Furthermore, the metals/metalloid ions can be loaded into scaffolds to improve osteoblast proliferation, differentiation, bone development, fibroblast growth, and improved wound healing efficacy. Moreover, different ions possess different therapeutic limits. Therefore, further mechanisms need to be developed for the highly controlled and sustained release of these ions. This review paper summarizes the recent progress in the use of metallic/metalloid ions in regenerative medicine and encourages further study of ions as a solution to cure diseases.