Electrospun polymeric micro/nanofibrous scaffolds for long-term drug release and their biomedical applications

Bioelectronics for electrical stimulation: materials, devices and biomedical applications

Bioelectronics is a hot research topic, yet an important tool, as it facilitates the creation of advanced medical devices that interact with biological systems to effectively diagnose, monitor and treat a broad spectrum of health conditions. Electrical stimulation (ES) is a pivotal technique in bioelectronics, offering a precise, non-pharmacological means to modulate and control biological processes across molecular, cellular, tissue, and organ levels. This method holds the potential to restore or enhance physiological functions compromised by diseases or injuries by integrating sophisticated electrical signals, device interfaces, and designs tailored to specific biological mechanisms. This review explains the mechanisms by which ES influences cellular behaviors, introduces the essential stimulation principles, discusses the performance requirements for optimal ES systems, and highlights the representative applications. From this review, we can realize the potential of ES based bioelectronics in therapy, regenerative medicine and rehabilitation engineering technologies, ranging from tissue engineering to neurological technologies, and the modulation of cardiovascular and cognitive functions. This review underscores the versatility of ES in various biomedical contexts and emphasizes the need to adapt to complex biological and clinical landscapes it addresses.

A novel transdermal drug delivery system: drug-loaded ROS-responsive ferrocene fibers for effective photoprotective and wound healing activity

The present study proposes an innovative transdermal drug delivery system using ferrocene-incorporated fibers to enhance the bioavailability and therapeutic efficacy of ascorbyl tetraisopalmitate. Using electrospinning technology, the authors created ferrocene polymer fibers capable of highly efficient drug encapsulation and controlled release in response to reactive oxygen species commonly found in wound sites. The approach improves upon previous methods significantly by offering higher drug loading capacities and sustained release, directly targeting diseased cells. The results confirm the potential of ferrocene fibers for localized drug delivery, potentially reducing side effects and increasing patient convenience. The method could facilitate the application of bioactive compounds in medical textiles and targeted therapy.

Electrospun nanofibers: building blocks for the repair of bone tissue

Bone, one of the hardest structures of the body, is the basic constituent of the skeletal system, which gives the shape to the body, provides mechanical support for muscles and soft tissues, and provides movement. Even if there is no damage, bone remodeling is a permanent process to preserve and renew the structural, biochemical, and biomechanical integrity of bone tissue. Apart from the remodeling, bone healing is the highly complicated process of repairing deficiencies of bone tissue by the harmonious operation of osteoblasts, osteocytes, osteoclasts, and bone lining cells. Various materials can be used to both trigger the bone healing process and to provide mechanical support to damaged bone. Nanofiber scaffolds are at the forefront of these types of systems because of their extremely large surface area-to-volume ratio, small pore size, and high porosity. Nanofibers are known to be highly functional systems with the ability to mimic the structure and function of the natural bone matrix, facilitating osteogenesis for cell proliferation and bone regeneration. Electrospinning is an easy and fast method to produce non-woven structures consisting of continuous ultrafine fibers with diameters ranging from micrometers down to nanometers. The simplicity and cost-effectiveness of the electrospinning technique, its ability to use a wide variety of synthetic, natural, and mixed polymers, and the formation of highly porous and continuous fibers are the remarkable features of this method. The importance of nanofiber-based scaffolds in bone tissue regeneration is increasing because of suitable pore size, high porosity, osteoinduction, induction of bone growth with osteoconduction, adaptability to the target area, biodegradation, and appropriate mechanical properties, which are among the main parameters that are important in the design of polymeric bone grafts. The aim of this review is to cast light on the increasing use of nanofiber-based scaffolds in bone tissue regeneration and give an insight about bone regeneration, production techniques of the electrospun nanofibers, and varying formulation parameters in order to reach different drug delivery goals. This review also provides an extensive market research of electrospun nanofibers and an overview on scientific research and patents in the field.

Silver nanoparticles loaded triple-layered cellulose-acetate based multifunctional dressing for wound healing

Chronic wounds present considerable challenges which delay their effective healing. Currently, there are several biomaterial-based wound dressings available for healing diverse wound types. However, most of commercial wound dressings are too expensive to be affordable to the patients belonging to the middle and lower socioeconomic strata of the society. Thus, in this investigation affordable triple layered nanofibrous bandages were fabricated using the layer-by-layer approach. Here, the topmost layer comprised of a hydrophilic poly vinyl alcohol layer, cross-linked with citric acid. The middle layer comprising of cellulose acetate was loaded with silver nanoparticles as an antibacterial agent, while the lowermost layer was fabricated using hydrophobic polycaprolactone. The triple-layered nanofibrous bandages having a nano-topography, exhibited a smooth, uniform and bead-free morphology, with the nanofiber diameter ranging between 200 and 300 nm. The nanofibers demonstrated excellent wettability, slow in vitro degradation, controlled release of nano‑silver and potent antibacterial activity against Gram-negative (E.coli) and Gram-positive (S. aureus) bacteria. The fabricated bandages had excellent mechanical strength upto 12.72 ± 0.790 M. Pa, which was suitable for biomedical and tissue engineering applications. The bandage demonstrated excellent in vitro hemocompatibility and biocompatibility. In vivo excisional wound contraction, along with H and E and Masson's Trichrome staining further confirmed the potential of the nanofibrous bandage for full-thickness wound healing. Pre-clinical investigations thus indicated the possibility of further evaluating the triple-layered nanofibrous dressing in clinical settings.

The Impacts of the Sterilization Method and the Electrospinning Conditions of Nanofibrous Biodegradable Layers on Their Degradation and Hemocompatibility Behavior

The use of electrospun polymeric biodegradable materials for medical applications is becoming increasingly widespread. One of the most important parameters regarding the functionality of nanofiber scaffolds during implantation and the subsequent regeneration of damaged tissues concerns their stability and degradation behavior, both of which are influenced by a wide range of factors (the properties of the polymer and the polymer solution, the technological processing approach, the sterilization method, etc.). This study monitored the degradation of nanofibrous materials fabricated from degradable polyesters as a result of the sterilization method applied (ethylene oxide and gamma irradiation) and the solvent system used to prepare the spun polymer solution. Aliphatic polyesters PCL and PLCL were chosen for this study and selected with respect to the applicability and handling in the surgical setting of these nanofibrous materials for vascular bandaging. The results revealed that the choice of solvent system exerts a significant impact on degradation during sterilization, especially at higher gamma irradiation values. The subsequent enzyme-catalyzed degradation of the materials following sterilization indicated that the choice of the sterilization method influenced the degradation behavior of the materials. Whereas wave-like degradation was evident concerning ethylene oxide sterilization, no such behavior was observed following gamma-irradiation sterilization. With concern for some of the tested materials, the results also indicated the potential for influencing the development of degradation within the bulk versus degradation from the surface of the material. Both the sterilization method and the choice of the spinning solvent system were found to impact degradation, which was observed to be most accelerated in the case of PLCL (L-lactide-co-caprolactone copolymer) electrospun from organic acids and subsequently sterilized using gamma irradiation. Since we planned to use these materials in cardiovascular applications, it was decided that their hemocompatibility would also be tested. The results of these tests revealed that changes in the structures of the materials initiated by sterilization may exert thrombogenic and anticoagulant impacts. Moreover, the microscopic analysis suggested that the solvent system used in the preparation of the materials potentially affects the behavior of erythrocytes; however, no indication of the occurrence of hemolysis was detected.

Advanced postoperative tissue antiadhesive membranes enabled with electrospun nanofibers

Tissue adhesion is one of the most common postoperative complications, which is frequently accompanied by inflammation, pain, and even dyskinesia, significantly reducing the quality of life of patients. Thus, to prevent the formation of tissue adhesions, various strategies have been explored. Among these methods, placing anti-adhesion membranes over the injured site to separate the wound from surrounding tissues is a simple and prominently favored method. Recently, electrospun nanofibers have been the most frequently investigated antiadhesive membranes due to their tunable porous structure and high porosities. They not only can act as an essential barrier and functional carrier system but also allow for high permeability and nutrient transport, showing great potential for preventing tissue adhesion. Herein, we provide a short review of the most recent applications of electrospun nanofibrous antiadhesive membranes in tendons, the abdominal cavity, dural sac, pericardium, and meninges. Firstly, each section highlights the most representative examples and they are sorted based on the latest progress of related research. Moreover, the design principles, preparation strategies, overall performances, and existing problems are highlighted and evaluated. Finally, the current challenges and several future ways to develop electrospun nanofibrous antiadhesive membranes are proposed. The systematic discussion and proposed directions can shed light on ideas and guide the reasonable design of electrospun nanofibrous membranes, contributing to the development of exceptional tissue anti-adhesive materials in the foreseeable future.

A novel bifunctional multilayered nanofibrous membrane combining polycaprolactone and poly (vinyl alcohol) enriched with platelet lysate for skin wound healing

Skin wound healing is a complex physiological process that involves various cell types, growth factors, cytokines, and other bioactive compounds. In this study, a novel dual-function multilayered nanofibrous membrane is developed for chronic wound application. The membrane is composed of five alternating layers of polycaprolactone (PCL) and poly (vinyl alcohol) (PVA) nanofibers (PCL-PVA) with a dual function: the PCL nanofibrous layers allow cell adhesion and growth, and the PVA layers enriched with incorporated platelet lysate (PCL-PVA + PL) serve as a drug delivery system for continuous release of bioactive compounds from PL into an aqueous environment. The material is produced using a needleless multi-jet electrospinning approach which can lead to homogeneous large-scale production. The bioactive PCL-PVA + PL membranes are cytocompatible and hemocompatible. A spatially compartmented co-culture of three cell types involved in wound healing - keratinocytes, fibroblasts and endothelial cells - is used for cytocompatibility studies. PCL-PVA + PL membranes enhance the proliferation of all cell types and increase the migration of both fibroblasts and endothelial cells. The membranes are also hemocompatible without any deleterious effect for thrombogenicity, hemolysis and coagulation. Thus, the beneficial effect of the PCL-PVA + PL membrane is demonstrated in vitro, making it a promising scaffold for the treatment of chronic wounds.

Co- and Triaxial Electrospinning for Stem Cell-based Bone Regeneration

Bone tissue is composed of organic minerals and cells. It has the capacity to heal for certain minor damages, but when the bone defects surpass the critical threshold, they need fixing. Bone regeneration through natural and synthetic biodegradable materials requires various steps, such as manufacturing methods and materials selection. A successful biodegradable bone graft should have a high surface area/ volume ratio, strength, and a biocompatible, porous structure capable of promoting cell adhesion, proliferation, and differentiation. Considering these requirements, the electrospinning technique is promising for creating functional nano-sized scaffolds. The multi-axial methods, such as coaxial and triaxial electrospinning, are the most popular techniques to produce double or tri-layered scaffolds, respectively. Recently, stem cell culture on scaffolds and the application of osteogenic differentiation protocols on these scaffolds have opened new possibilities in the field of biomaterials research. This review discusses an overview of the progress in coaxial and triaxial technology through biodegradable composite bone materials. The review also carefully elaborates the osteogenic differentiation using stem cells and their performance with nano-sized scaffolds.

Psoralea corylifolia formula extract-loaded silk fibroin/polycaprolactone fibrous membrane for the treatment of colorectal cancer

Intestinal obstructions caused by intestinal tumors pose life-threatening risks to patients. Adjuvant treatment using intestinal stents carrying drug loaded membranes has the advantages of timely relief of intestinal obstruction, as well as effective inhibition of tumor progression. The present work is to develop an intestinal stent loaded with a combination of traditional Chinese medicines capable of good biocompatibility, degradability, sustained drug release and anti-tumor properties. The drug combination extract was obtained from Psoralea corylifolia formula (PCF) and then was loaded into silk fibroin (SF)/polycaprolactone (PCL) fibrous membranes using emulsion electrospinning technology. Results showed that the membrane prepared by emulsion electrospinning technology has apparent core-shell structure, and the mechanical property and hydrophilicity of the membrane are gradually improved with the addition of PCF. Drug sustained release results demonstrated that there were no bursting phenomena, and showed a gradual sustained release up to 400 h. The antitumor efficacy was assessed in vitro using a human colorectal cancer cell line HCT-116 and an epithelial cell line NCM-460. Results showed that this drug-loaded membrane sustained antitumor cell growth performance, indicating its great potential for clinical treatment for intestinal cancer in the near future.

A Biomimetic Adhesive and Robust Janus Patch with Anti-Oxidative, Anti-Inflammatory, and Anti-Bacterial Activities for Tendon Repair

Early stage oxidative stress, inflammatory response, and infection after tendon surgery are highly associated with the subsequent peritendinous adhesion formation, which may diminish the quality and function of the repaired tendon. Although various anti-inflammatory and/or antibacterial grafts have been proposed to turn the scale, most of them suffer from the uncertainty of drug-induced adverse effects, low mechanical strength, and tissue adhesiveness. Here, inspired by the tendon anatomy and pathophysiology of adhesion development, an adhesive and robust dual-layer Janus patch is developed, whose inner layer facing the operated tendon is a multifunctional electrospun hydrogel patch (MEHP), encircled further by a poly-l-lactic acid (PLLA) fibrous outer layer facing the surrounding tissue. Specifically, MEHP is prepared by gelatin methacryloyl (GelMA) and zinc oxide (ZnO) nanoparticles, which are co-electrospun first and then treated by tannic acid (TA). The inner MEHP exhibits superior mechanical performance, adhesion strength, and outstanding antioxidation, anti-inflammation, and antibacterial properties, and it can adhere to the injury site offering a favorable microenvironment for tendon regeneration. Meanwhile, the outer PLLA acts as a physical barrier that prevents extrinsic cells and tissues from invading the defect site, reducing peritendinous adhesion formation. This work presents a proof-of-concept of a drug-free graft with anisotropic adhesive and biological functions to concert the healing phases of injured tendon by alleviating incipient inflammation and oxidative damage but supporting tissue regeneration and reducing tendon adhesion in the later phase of repair and remodeling. It is envisioned that this Janus patch could offer a promising strategy for safe and efficient tendon therapy.

Effective BMP-2 Release and Mineralization on a Graphene Oxide/Polyvinylpyrrolidone Hydrogel Forming Poly (ε-Caprolactone) Nanofibrous Scaffolds

PCL nanofibrous scaffolds are widely used as bone scaffolds, and they can increase the efficiency of bone regeneration by loading drugs and/or growth factors onto them. However, to obtain a more effective bone regeneration effect, it is necessary to increase drug loading and release efficiency. In this study, conductive hydrogel forming nanofibrous scaffolds were prepared to increase drug efficiency. GO has an excellent conductivity and biocompatibility, making it an efficient conductive polymer for bone differentiation. Electrospun PCL was immersed in a mixed solution of GO and PVP and then crosslinked using gamma-ray irradiation. It was confirmed that GO/PVP-PCL was successfully prepared through its characterization (morphology, thermal, chemical, electrical, and biological properties). In addition, drug-release efficiency was confirmed by electrical stimulation after loading the sample with BMP-2, a bone-regeneration growth factor. Compared to PCL, it was confirmed that GO/PVP-PCL has an approximately 20% improved drug-release efficiency and an excellent mineralization of the scaffolds using SBF. After culturing MG63 cells on GO/PVP-PCL, a high effect on osteodifferentiation was confirmed by ALP activity. Therefore, GO/PVP-PCL prepared by a gamma-ray-induced crosslinking reaction is expected to be used as biomaterial for bone-tissue engineering.

Stretchable, conductive, breathable and moisture-sensitive e-skin based on CNTs/graphene/GelMA mat for wound monitoring

Deep skin wound needs a long wound healing process, in which external force on skin around wound can result in a sharp pain, wound re-damage and interstitial fluid flowing out, increasing the risk of deterioration and even amputation. While the conventional wound dressings cannot provide timely feedback of abnormal wound status and lose best time for wound treatment, real-time monitoring wound status is thus urgently needed for wound management. In this work, a breathable and stretchable electronic skin (i.e., e-skin) named CNTs/graphene/GelMA mat has been developed through electrospinning, ice-templating and in-situ loading method for evaluating wound status. The obtained porosity, swelling ratio and vapor transmission rate of the CNTs/graphene/GelMA mat are 55 %, 180 % and 3378.2 h^-1 day^-1, respectively. And owing to the good porous, nanofibrous architecture and excellent breathability of the mat, L929 cells grow and well spread on the CNTs/graphene/GelMA mat. In addition, the gauge factors of the prepared conductive CNTs/graphene/GelMA mat as a strain sensor are 15.4 and 72.9 in the strain ranges of 0-70 % and 70-85 %, respectively, matching the mechanical performance of human skin. The sensitivity coefficient of the mat for moisture sensing is 12.05, indicating its high efficiency for monitoring and warning interstitial fluid outflow from wound. Furthermore, the integration of CNTs/graphene/GelMA mat with a portable device is feasible to monitor strain and moisture on a rat model with abdominal wound. The healing process of the wounds treated with CNTs/graphene/GelMA mat is similar to that of GelMA mat, indicating that the dosage of CNTs and graphene in the CNTs/graphene/GelMA mat has negligible effect on the mat histocompatibility. The CNTs/graphene/GelMA mat demonstrates the application potential in wound management, home medical diagnosis and human-machine interactions.

Aligned electrospun fiber film loaded with multi-enzyme mimetic iridium nanozymes for wound healing

A film with elaborate microstructures that offers biomimetic properties and multi functionalities is highly desired in wound healing. Here, we develop an aligned hydrogel fiber film integrated with multi-active constituents to promote wound healing. Such fiber films are designed and constructed by photo-crosslinking the methacrylate gelatin (GelMA) doped with silver nanoparticles (Ag NPs) and iridium nanoparticles coated with polyvinylpyrrolidone (PVP-Ir NPs) in the precursor solution using electrospinning. The nature of GelMA hydrogel and the aligned arrangement of nanofibers endow the film with high-water content, self-degradability, improved bionic characteristics, oriented cell growth, and improved cell proliferation and migration. Moreover, the encapsulated nanozymes and Ag NPs offer the fiber film with superior reactive oxygen species (ROS) scavenging and antibacterial capability. The infected wound model shows that the multi-active hydrogel fiber film can reduce inflammation by killing bacteria and decomposing ROS, which accelerates the growth of new blood vessels and granulation tissue. Benefitting from these features, the versatile aligned GelMA fiber film demonstrates the clinically translational potential for wound healing.

Enzyme-Enhanced Codelivery of Doxorubicin and Bcl-2 Inhibitor by Electrospun Nanofibers for Synergistic Inhibition of Prostate Cancer Recurrence

One of the great challenges of postoperative prostate cancer management is tumor recurrence. Although postoperative chemotherapy presents benefits to inhibit unexpected recurrence, it is still limited due to the drug resistance or intolerable complications of some patients. Electrospun nanofiber, as a promising drug carrier, demonstrating sustained drug release behavior, can be implanted into the tumor resection site during surgery and is conductive to tumor inhibition. Herein, we fabricated electrospun nanofibers loaded with doxorubicin (DOX) and ABT199 to synergistically prevent postoperative tumor recurrence. Enzymatic degradation of the biodegradable electrospun nanofibers facilitated the release of the two drugs. The primarily released DOX from the electrospun nanofibers effectively inhibited tumor recurrence. However, the sustained release of DOX led to drug resistance of the tumor cells, yielding unsatisfactory eradication of the residual tumor. Remarkably, the combined administration of DOX and ABT199, simultaneously released from the nanofibers, not only prolonged the chemotherapy by DOX but also overcame the drug resistance via inhibiting the Bcl-2 activation and thereby enhancing the apoptosis of tumor cells by ABT199. This dual-drug-loaded implant system, combining efficient chemotherapy and anti-drug resistance, offers a prospective strategy for the potent inhibition of postoperative tumor recurrence.

Lodoxamide-Loaded Nanofibrous Wound Dressings Promote Wound Healing via Downregulation of IL-1β, NFK-β, and GPx Genes

Diabetic wounds are major clinical challenges which need immediate care to prevent complications such as limb amputation. There are a variety of treatment strategies available for the treatment of diabetic wounds among which wound dressings are the most effective and provide better therapeutic outcome. Lodoxamide was loaded into gelatin scaffolds in order to develop a potential wound dressing material for diabetic wound healing. Electrospinning method was used for the fabrication of wound dressings containing three different concentrations of 1 w/w%, 3 w/w%, and 6 w/w% of Lodoxamide. The developed scaffolds were studied regarding their various physicochemical and biological properties. In vitro study showed that the dressings containing 3% drug had significantly higher cell viability and cytoprotection under oxidative stress. Therefore, this formulation was chosen for treating diabetic wounds in a rat model of excisional diabetic wound. In vivo study showed that gelatin/3% Lodoxamide group had higher wound healing compared with other experimental groups. Gene expression studies showed that the wounds treated with drug-delivering wound dressings showed significantly lower tissue expression level of glutathione peroxidase gene, IL-1β gene, and NFK-β gene.

Phosphorylated Poly(vinyl alcohol) Electrospun Mats for Protective Equipment Applications

The development of intelligent materials for protective equipment applications is still growing, with enormous potential to improve the safety of personnel functioning in specialized professions, such as firefighters. The design and production of such materials by the chemical modification of biodegradable semisynthetic polymers, accompanied by modern manufacturing techniques such as electrospinning, which may increase specific properties of the targeted material, continue to attract the interest of researchers. Phosphorus-modified poly(vinyl alcohol)s have been, thus, synthesized and utilized to prepare environmentally friendly electrospun mats. Poly(vinyl alcohol)s of three different molecular weights and degrees of hydrolysis were phosphorylated by polycondensation reaction in solution in the presence of phenyl dichlorophosphate in order to enhance their flame resistance and thermal stability. The thermal behavior and the flame resistance of the resulting phosphorus-modified poly(vinyl alcohol) products were investigated by thermogravimetric analysis and by cone calorimetry at a micro scale. Based on the as-synthesized phosphorus-modified poly(vinyl alcohol)s, electrospun mats were successfully fabricated by the electrospinning process. Rheology studies were performed to establish the optimal conditions of the electrospinning process, and scanning electron microscopy investigations were undertaken to observe the morphology of the phosphorus-modified poly(vinyl alcohol) electrospun mats.

An anti-bacterial and anti-cancer fibrous membrane with multiple therapeutic effects for prevention of pancreatic cancer recurrence

Adjuvant systemic chemotherapy with gemcitabine (GEM) is recognized as the standard of care to improve the prognosis of patients with resected pancreatic cancer (PC); however, it is greatly limited by poor absorption of chemotherapy agents. Moreover, surgical site infection and Gammaproteobacteria-induced GEM resistance further decrease the chemotherapy efficacy and increase the risk of recurrence and even mortality. Here, we develop an implantable anti-bacterial and anti-cancer fibrous membrane (AAFM) to inhibit PC recurrence in a well-coordinated manner. Our AAFM can be readily prepared via simple co-electrospinning of GEM and poly-L-lactic acid (PLLA) and subsequent tannic acid (TA)-mediated in-situ generation of silver nanoparticles (AgNPs). The resultant membrane presents highly porous fibrous morphology and appropriate mechanical performance. Most importantly, we find the surface-deposited TA/AgNP complexes can exert multiple therapeutic effects: (1) they can act as a fence to extend GEM diffusion route, achieving a sustained drug release; (2) they can fight the pathogenic microorganisms in the local microenvironment and prevent infectious complications and alleviate Gammaproteobacteria-induced chemotherapy resistance; (3) they can combat residual cancer cells to synchronously strengthen the effectiveness of GEM-based chemotherapy. Altogether, our AAFM provides a proof-of-concept demonstration of the integrated anti-cancer and anti-bacterial strategy for enhanced therapeutic efficacy and will inspire the design of other high-performance implants for prevention of tumor relapse.

Intestinal stents: Structure, functionalization and advanced engineering innovation

Intestinal stents are a palliative treatment option that solves many shortcomings of traditional surgeries for cancer-induced intestinal obstructions. The present review provides an overview of the incidence, clinical manifestations and limitations in the treatment of intestinal cancers. The paper also discusses material property requirements, indications, complications and the future of stent-assisted therapy. The advantages and disadvantages of different materials and processing techniques for intestinal stents are reviewed along with new stent treatment combinations for colorectal cancer. Challenges that require further cooperative studies are also detailed. The future development of intestinal stents will depend on innovation in material designs as well as the utilization of multi-functional strategies and innovative engineering solutions.

ELECTROSPUN SODIUM ALGINATE/POLY(ETHYLENE OXIDE) NANOFIBERS FOR WOUND HEALING APPLICATIONS: CHALLENGES AND FUTURE DIRECTIONS

Alginate is an interesting natural biopolymer to be considered for biomedical applications due to its advantages and good biological properties. These biological properties make electrospun alginate nanofibers suitable for various uses in the biomedical field, such as wound healing dressings, drug delivery systems, or both. Unfortunately, the fabrication of alginate nanofibers by electrospinning is very challenging because of the high viscosity of the solution, high surface tension and rigidity in water due to hydrogen bonding, and also their diaxial linkages. This review presents an overview of the factors affecting the electrospinning process of sodium alginate/poly(ethylene oxide) (SA/PEO), the application of SA/PEO in drug delivery systems for wound healing applications, and the degradation and swelling properties of SA/PEO. The challenges and future directions of SA/PEO in the medical field are also discussed.

Regulated Exogenous/Endogenous Inflammation via "Inner-Outer" Medicated Electrospun Fibers for Promoting Tissue Reconstruction

Regenerative medicine aims to provide solutions for structural and functional recovery in conditions where organs suffer from varying degrees of diseases or injuries. However, the exogenous inflammation triggered by implanted biomaterials and endogenous inflammation caused by some disease or tissue destruction has not been solved properly yet. Herein, a functional "inner-outer" medicated core-shell electrospun fibrous membrane is fabricated with RGD surface modification for exogenous inflammation suppression and puerarin loading in the core for long-term endogenous inflammation inhibition through microsol electrospinning technique. The "outer" RGD significantly increases biocompatibility of fibrous membrane through promoting cell viability, adhesion, and proliferation while the "inner" puerarin suppresses inflammatory gene expression via sustained drug release in vitro. Moreover, in a rat abdominal wall hernia model, the functional fibrous membrane successfully reduces exogenous and endogenous inflammation response and promotes wound healing through collagen deposition, smooth muscle formation, and vascularization. In summary, the functional "inner-outer" medicated fibrous membrane holds a great potential for clinical treatment of diseases that needs tissue reconstruction structurally and functionally accompanied by immunoregulation.

Asymmetric resorbable-based dental barrier membrane for periodontal guided tissue regeneration and guided bone regeneration: A review

Guided tissue regeneration (GTR) and guided bone regeneration (GBR) are two common dental regenerative treatments targeted at reconstructing damaged periodontal tissue and bone caused by periodontitis. During GTR/GBR treatment, a barrier membrane is placed in the interface between the soft tissue and the periodontal defect to inhibit soft tissue ingrowth and creating a space for the infiltration of slow-growing bone cells into the defect site. Recently, asymmetric resorbable-based barrier membrane has received a considerable attention as a new generation of GTR/GBR membrane. Despite numerous literatures about asymmetric-based membrane that had been published, there is lacks comprehensive review on asymmetric barrier membrane that particularly highlight the importance of membrane structure for periodontal regeneration. In this review, we systematically cover the latest development and advancement of various kinds of asymmetric barrier membranes used in periodontal GTR/GBR application. Herein, the ideal requirements for constructing a barrier membrane as well as the rationale behind the asymmetric design, are firstly presented. Various innovative methods used in fabricating asymmetric barrier membrane are being further discussed. Subsequently, the application and evaluation of various types of asymmetric barrier membrane used for GTR/GBR are compiled and extensively reviewed based on the recent literatures reported. Based on the existing gap in this field, the future research directions of asymmetric resorbable-based barrier membrane such as its combination potential with bone grafts, are also presented.

Drug Delivery Systems for Photodynamic Therapy: The Potentiality and Versatility of Electrospun Nanofibers

Recently, photodynamic therapy (PDT) has become a promising approach for the treatment of a broad range of diseases, including oncological and infectious diseases. This minimally invasive and localized therapy is based on the production of reactive oxygen species (ROS) able to destroy cancer cells and inactivate pathogens by combining the use of photosensitizers (PSs), light and molecular oxygen. To overcome the drawbacks of drug systemic administration, drug delivery systems (DDS) can be used to carrier the PSs, allowing higher therapeutic efficacy and minimal toxicological effects. Polymeric nanofibers produced by electrospinning emerged as powerful platforms for drug delivery applications. Electrospun nanofibers exhibit outstanding characteristics, such as large surface area to volume ratio associated with high drug loading, high porosity, flexibility, ability to incorporate and release a wide variety of therapeutic agents, biocompatibility and biodegradability. Due to the versatility of this technique, fibers with different morphologies and functionalities, including drug release profile can be produced. The possibility of scalability makes electrospinning even more attractive for the development of DDS. This review aims to explore and show an up to date of the huge potential of electrospun nanofibers as DDS for different PDT applications and discuss the opportunities and challenges in this field. This article is protected by copyright. All rights reserved.

Conductive Nerve Guidance Conduits Based on Morpho Butterfly Wings for Peripheral Nerve Repair

Peripheral nerve injury (PNI), causing loss of sensory and motor function, is a complex and challenging disease in the clinic due to the restricted regeneration capacity. Nerve guidance conduits (NGCs) have become a promising substitute for peripheral nerve regeneration, but their efficacy is often limited. Here, inspired by the physiological structures of peripheral nerves, we present a conductive topological scaffold for nerve repair by modifying Morpho butterfly wing with reduced graphene oxide (rGO) nanosheets and methacrylated gelatin (GelMA) hydrogel encapsulated brain-derived neurotrophic factor (BDNF). Benefiting from the biocompatibility of GelMA hydrogel, the conductivity of rGO and parallel nanoridge structures of wing scales, PC12 cells, and neural stem cells grown on the modified wing have an increased neurite length with guided cellular orientation. In addition, the NGCs are successfully obtained by manually rolling up the scaffolds and exhibited great performance in repairing 10 mm sciatic nerve defects in rats, and we believe that the NGCs can be applied in reparing longer nerve defects in the future by further optimization. We also demonstrate the feasibility of electrically conductive NGCs based on the rGO/BDNF/GelMA-integrated Morpho butterfly wing as functional nerve regeneration conduits, which may have potential value for application in repairing peripheral nerve injuries.

Effects of drug concentration and PLGA addition on the properties of electrospun ampicillin trihydrate-loaded PLA nanofibers

The aim of this study was to produce ampicillin trihydrate-loaded poly(lactic acid) (PLA) and PLA/poly(lactic-co-glycolic acid) (PLA/PLGA) polymeric nanofibers via electrospinning using 1,1,1,3,3,3-hexafluoro-2-propanol (HFIP) as the solvent for local application in tissue engineering. The effects of ampicillin trihydrate concentration (4-12%) and addition of PLGA (20-80%) on the spinnability of the solutions, morphology, average nanofiber diameter, encapsulation efficiency, drug release, and mechanical properties of PLA and PLA/PLGA nanofibers were examined. All nanofibers were bead-free and uniform. They had favorable encapsulation efficiency (approx. 90%) and mechanical properties. The increase in the amount of ampicillin trihydrate caused an increase in the diameter and burst effect of the nanofibers. The drug release ended on the 7th and 3rd day with nanofibers containing 4% and 12% of drug, respectively. The prolonged and controlled drug release for ten days was obtained with nanofibers containing 8% of drug. Thus, the ideal drug concentration was determined to be 8%. Nanofibers containing PLA/PLGA had a larger diameter than those including PLA. In addition, both the strength and elongation of nanofibers decreased depending on the increase in nanofiber size with the addition of PLGA, increased amount of drug, and ratios of PLGA. Drug release studies showed that PLA/PLGA nanofibers exhibited a lower burst effect and a decrease in drug release when compared to PLA nanofibers. Finally, PLA/PLGA nanofibers can be produced with enhanced encapsulation efficiency and mechanical properties, resulting in controlled and tailored release of ampicillin trihydrate for at least ten days. In conclusion, it was demonstrated that the addition of PLGA in different ratios and the amount of drug can be manipulated to obtain the desired properties (average nanofiber diameter, morphology, in vitro drug release, and mechanical properties) of PLA nanofibers.

Comparing Antibiotic Pastes with Electrospun Nanofibers as Modern Drug Delivery Systems for Regenerative Endodontics

Nanomaterials have various features that make these types of materials able to be applied in different biomedical applications like, diagnosis, treatment, and drug delivery. Using such materials in endodontic filed both to face the challenges that occur during treatment processes and to make these materials have an antibacterial effect without showing any harm on the host cells. The approach of nanofibers loaded with various antibacterial drugs offers a potential treatment method to enhance the elimination procedure of intracanal biofilms. Clinically, many models of bacterial biofilms have been prepared under in vitro conditions for different aims. The process of drug delivery from polymeric nanofibers is based on the principle that the releasing ratio of drug molecules increases due to the increase in the surface area of the hosted structure. In our review, we discuss diverse approaches of loading/releasing drugs on/from nanofibers and we summarized many studies about electrospun nanofibers loaded various drugs applied in the endodontic field. Moreover, we argued both the advantages and the limitations of these modern endodontic treatment materials comparing them with the traditional ones.

Novel lipophosphonoxin-loaded polycaprolactone electrospun nanofiber dressing reduces Staphylococcus aureus induced wound infection in mice

Active wound dressings are attracting extensive attention in soft tissue repair and regeneration, including bacteria-infected skin wound healing. As the wide use of antibiotics leads to drug resistance we present here a new concept of wound dressings based on the polycaprolactone nanofiber scaffold (NANO) releasing second generation lipophosphonoxin (LPPO) as antibacterial agent. Firstly, we demonstrated in vitro that LPPO released from NANO exerted antibacterial activity while not impairing proliferation/differentiation of fibroblasts and keratinocytes. Secondly, using a mouse model we showed that NANO loaded with LPPO significantly reduced the Staphylococcus aureus counts in infected wounds as evaluated 7 days post-surgery. Furthermore, the rate of degradation and subsequent LPPO release in infected wounds was also facilitated by lytic enzymes secreted by inoculated bacteria. Finally, LPPO displayed negligible to no systemic absorption. In conclusion, the composite antibacterial NANO-LPPO-based dressing reduces the bacterial load and promotes skin repair, with the potential to treat wounds in clinical settings.

Antimicrobial nanofibrous mats with controllable drug release produced from hydrophobized hyaluronan

Due to their large active surface, high loading efficiency, and tunable dissolution profiles, nanofibrous mats are often cited as promising drug carriers or antimicrobial membranes. Hyaluronic acid has outstanding biocompatibility, but it is hydrophilic. Nanofibrous structures made from hyaluronan dissolve immediately, making them unsuitable for controlled drug release and longer applications. We aimed to prepare a hyaluronan-based antimicrobial nanofibrous material, which would retain its integrity in aqueous environments. Self-supporting nanofibrous mats containing octenidine dihydrochloride or triclosan were produced by electrospinning from hydrophobized hyaluronan modified with a symmetric lauric acid anhydride. The nanofibrous mats required no cross-linking to be stable in PBS for 7 days. The encapsulation efficiency of antiseptics was nearly 100%. Minimal release of octenidine was observed, while up to 30% of triclosan was gradually released in 72 h. The nanofibrous materials exhibited antimicrobial activity, the fibroblast viability was directly dependent on the antiseptic content and its release.

Combining Biocompatible and Biodegradable Scaffolds and Cold Atmospheric Plasma for Chronic Wound Regeneration

Skin regeneration is a quite complex process. Epidermal differentiation alone takes about 30 days and is highly regulated. Wounds, especially chronic wounds, affect 2% to 3% of the elderly population and comprise a heterogeneous group of diseases. The prevailing reasons to develop skin wounds include venous and/or arterial circulatory disorders, diabetes, or constant pressure to the skin (decubitus). The hallmarks of modern wound treatment include debridement of dead tissue, disinfection, wound dressings that keep the wound moist but still allow air exchange, and compression bandages. Despite all these efforts there is still a huge treatment resistance and wounds will not heal. This calls for new and more efficient treatment options in combination with novel biocompatible skin scaffolds. Cold atmospheric pressure plasma (CAP) is such an innovative addition to the treatment armamentarium. In one CAP application, antimicrobial effects, wound acidification, enhanced microcirculations and cell stimulation can be achieved. It is evident that CAP treatment, in combination with novel bioengineered, biocompatible and biodegradable electrospun scaffolds, has the potential of fostering wound healing by promoting remodeling and epithelialization along such temporarily applied skin replacement scaffolds.

Advanced technology-driven therapeutic interventions for prevention of tendon adhesion: Design, intrinsic and extrinsic factor considerations

Tendon adhesion formation describes the development of fibrotic tissue between the tendon and its surrounding tissues, which commonly occurs as a reaction to injury or surgery. Its impact on function and quality of life varies from negligible to severely disabling, depending on the affected area and extent of adhesion formed. Thus far, treatment options remain limited with prophylactic anti-inflammatory medications and revision surgeries constituting the only tools within the doctors' armamentarium - neither of which provides reliable outcomes. In this review, the authors aim to collate the current understanding of the pathophysiological mechanisms underlying tendon adhesion formation, highlighting the significant role ascribed to the inflammatory cascade in accelerating adhesion formation. The bulk of this article will then be dedicated to critically appraising different therapeutic structures like nanoparticles, hydrogels and fibrous membranes fabricated by various cutting-edge technologies for adhesion formation prophylaxis. Emphasis will be placed on the role of the fibrous membranes, their ability to act as drug delivery vehicles as well as the combination with other therapeutic structures (e.g., hydrogel or nanoparticles) or fabrication technologies (e.g., weaving or braiding). Finally, the authors will provide an opinion as to the future direction of the prevention of tendon adhesion formation in view of scaffold structure and function designs.

Role of Zinc-Doped Bioactive Glass Encapsulated with Microspherical Gelatin in Localized Supplementation for Tissue Regeneration: A Contemporary Review

Gelatin, a natural polymer, provides excellent tissue compatibility for use in tissue rehabilitation. Bioactive glasses (BAG) offer superior capacity in stimulating a bioactive response but show high variability in uptake and solubility. To tackle these drawbacks, a combination of gelatin with BAG is proposed to form composites, which then offer a synergistic response. The cross-linked gelatin structure's mechanical properties are enhanced by the incorporation of the inorganic BAG, and the rate of BAG ionic supplementation responsible for bioactivity and regenerative potential is better controlled by a protective gelatin layer. Several studies have demonstrated the cellular benefits of these composites in different forms of functional modification such as doping with zinc or incorporation of zinc such as ions directly into the BAG matrix. This review presents a comprehensive perspective on the individual characteristics of BAG and gelatin, including the synthesis and mechanism of action. Further, adaptation of the composite into various applications for bone tissue engineering is discussed and future challenges are highlighted.

Multidrug-loaded electrospun micro/nanofibrous membranes: Fabrication strategies, release behaviors and applications in regenerative medicine

Electrospun micro/nanofibrous membranes (EFMs) have been widely investigated as local drug delivery systems. Multiple drugs can be simultaneously incorporated into one EFM to create synergistic effects, reduce side effects, and play their respective roles in the complex physiological processes of tissue regeneration and postoperative adhesion prevention. Due to the versatile electrospinning techniques, sustained and programmed release behaviors of multiple drugs could be achieved by modulating the structure of the EFMs and the location of the drugs. In this review, various multidrug incorporation approaches based on electrospinning are overviewed. In particular, the advantages and limitations of each drug incorporation technique, the methods to control drug release and the effect of one drug release on another are discussed. Then the applications of multidrug-loaded EFMs in regenerative medicine, including wound healing, bone regeneration, vascular tissue engineering, nerve regeneration, periodontal regeneration and adhesion prevention are comprehensively reviewed. Finally, the future perspectives and challenges in the research of multidrug-loaded EFMs are discussed.

Electrospun Asymmetric Membranes as Promising Wound Dressings: A Review

Despite all the efforts that have been done up to now, the currently available wound dressings are still unable to fully re-establish all the structural and functional properties of the native skin. To overcome this situation, researchers from the tissue engineering area have been developing new wound dressings (hydrogels, films, sponges, membranes) aiming to mimic all the features of native skin. Among them, asymmetric membranes emerged as a promising solution since they reproduce both epidermal and dermal skin layers. Wet or dry/wet phase inversion, scCO2-assisted phase inversion, and electrospinning have been the most used techniques to produce such a type of membranes. Among them, the electrospinning technique, due to its versatility, allows the development of multifunctional dressings, using natural and/or synthetic polymers, which resemble the extracellular matrix of native skin as well as address the specific requirements of each skin layer. Moreover, various therapeutic or antimicrobial agents have been loaded within nanofibers to further improve the wound healing performance of these membranes. This review article provides an overview of the application of asymmetric electrospun membranes as wound dressings displaying antibacterial activity and as delivery systems of biomolecules that act as wound healing enhancers.

Petite miracles: insight into the nano-management of scarless wound healing

Scars affect millions of patients worldwide, yet their treatment efficacy and options clinically remain limited. In recent years, increased understanding of scar formation pathways leading to developments in nanotechnology have opened many opportunities for scar detection, prevention, and treatment due to the nanoscale features and therapeutic delivery capabilities of such technologies. Led by nanoparticles (NPs) and nanofibers, these novel strategies can aid in reducing scar contracture, improving wound-healing efficacy, and advancing progress towards scarless wound healing.

Bacterial Biofilms on Polyamide Nanofibers: Factors Influencing Biofilm Formation and Evaluation

Electrospun polyamide (PA) nanofibers have great potential for medical applications (in dermatology as antimicrobial compound carriers or surgical sutures). However, little is known about microbial colonization on these materials. Suitable methods need to be chosen and optimized for the analysis of biofilms formed on nanofibers and the influence of their morphology on biofilm formation. We analyzed 11 PA nanomaterials, both nonfunctionalized and functionalized with AgNO₃, and tested the formation of a biofilm by clinically relevant bacteria (Escherichia coli CCM 4517, Staphylococcus aureus CCM 3953, and Staphylococcus epidermidis CCM 4418). By four different methods, it was confirmed that all of these bacteria attached to the PAs and formed biofilms; however, it was found that the selected method can influence the outcomes. For studying biofilms formed by the selected bacteria, scanning electron microscopy, resazurin staining, and colony-forming unit enumeration provided appropriate and comparable results. The values obtained by crystal violet (CV) staining were misleading due to the binding of the CV dye to the PA structure. In addition, the effect of nanofiber morphology parameters (fiber diameter and air permeability) and AgNO₃ functionalization significantly influenced biofilm maturation. Furthermore, the correlations between air permeability and surface density and fiber diameter were revealed. Based on the statistical analysis, fiber diameter was confirmed as a crucial factor influencing biofilm formation (p ≤ 0.01). The functionalization of PAs with AgNO₃ (from 0.1 wt %) effectively suppressed biofilm formation. The PA functionalized with a concentration of 0.1 wt % AgNO₃ influenced the biofilm equally as nonfunctionalized PA 8% 2 g/m². Therefore, biofilm formation could be affected by the above-mentioned morphology parameters, and ultimately, the risk of infections from contaminated medical devices could be reduced.

Antibacterial nanosystems for cancer therapy

Bacteria and cancer cells share a unique symbiotic relationship in the process of cancer development and treatment. It has been shown that certain bacteria can mediate cancer and thrive inside cancerous tissues. Moreover, during cancer treatment, microbial infections have been shown to impair the therapeutic efficacy and lead to serious complications. In the past decades, the application of antibiotics has achieved great success in fighting numerous bacteria but the administration route, low localization effects and related drug resistance limit the further utilization of antibiotics. Recently, advances in nanotechnology have made a significant impact in the medical field, which enhance the drug solubility and can target lesion sites, and some nanomaterials can even be applied as the therapeutic agent itself. In this review, we introduce anti-bacterial nanosystems for cancer therapy in the aspects of spontaneous and triggered anti-bacterial action, and our notions, as well as proposed research directions for the further development of this field, are discussed.

Delivery of Therapeutics from Layer-by-Layer Electrospun Nanofiber Matrix for Wound Healing: An Update

Increasing incidences of chronic wounds urge the development of effective therapeutic wound treatment. As the conventional wound dressings are found not to comply with all the requirements of an ideal wound dressing, the development of alternative and effective dressings is demanded. Over the past few years, electrospun nanofiber has been recognized as a better system for wound dressing and hence has been studied extensively. Most of the electrospun nanofiber dressings were fabricated as single-layer structure mats. However, this design is less favorable for the effective healing of wounds mainly due to its burst release effect. To address this problem and to simulate the organized skin layer's structure and function, a multilayer structure of wound dressing had been proposed. This design enables a sustained release of the therapeutic agent(s), and more resembles the natural skin extracellular matrix. Multilayer structure is also referred to layer-by-layer (LbL), which has been established as an innovative method of drug incorporation and delivery, combines a high surface area of electrospun nanofibers with the multilayer structure mat. This review focuses on LbL multilayer electrospun nanofiber as a superior strategy in designing an optimal wound dressing.

WITHDRAWN: Petite miracles: insight into the nano-management of scarless wound healing

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Spatiotemporally Controlled Photoresponsive Hydrogels: Design and Predictive Modeling from Processing through Application

Photoresponsive hydrogels (PRHs) are soft materials whose mechanical and chemical properties can be tuned spatially and temporally with relative ease. Both photo-crosslinkable and photodegradable hydrogels find utility in a range of biomedical applications that require tissue-like properties or programmable responses. Progress in engineering with PRHs is facilitated by the development of theoretical tools that enable optimization of their photochemistry, polymer matrices, nanofillers, and architecture. This review brings together models and design principles that enable key applications of PRHs in tissue engineering, drug delivery, and soft robotics, and highlights ongoing challenges in both modeling and application.

Electrospun Nanofibrous Membranes for Preventing Tendon Adhesion

Tendon injuries are frequent, and surgical interventions toward their treatment might result in significant clinical complications. Pretendinous adhesion results in the disruption of the normal gliding mechanism of a damaged tendon, painful movements, and an increased chance of rerupture in the future. To alleviate postsurgical tendon-sheath adhesions, many investigations have been directed toward the development of repair approaches using electrospun nanofiber scaffolds. Such methods mainly take advantage of nanofibrous membranes (NFMs) as physical barriers to prevent or minimize adhesion of a repaired tendon to its surrounding sheath. In addition, these nanofibers can also locally deliver antiadhesion and anti-inflammatory agents to reduce the risk of tendon adhesion. This article reviews recent advances in the design, fabrication, and characterization of nanofibrous membranes developed to serve as (i) biomimetic tendon sheaths and (ii) physical barriers. Various features of the membranes are discussed to present insights for further development of repair methods suitable for clinical practice.

Multifunctional Chitosan/Polycaprolactone Nanofiber Scaffolds with Varied Dual-Drug Release for Wound-Healing Applications

Electrospinning-based wound dressings with multifunctional properties, including hemostasis-promoting, antibacterial, drug release, and therapeutic effects, are of great interest in military and civilian trauma healthcare. Herein, we designed lidocaine hydrochloride (LID) and mupirocin-loaded chitosan/polycaprolactone (CSLD-PCLM) scaffolds with multiple functions as wound dressings. Through the dual spinneret electrospinning technique, the scaffolds achieved a nanofiber structure, which enhanced the interfacial interaction between the scaffold and blood cells and showed excellent blood coagulation capacity. In particular, the scaffolds loaded with LID and mupirocin exhibited rapid release of LID and sustained release of mupirocin. The CSLD-PCLM scaffold containing mupirocin exhibited outstanding antibacterial activity. Moreover, the scaffold significantly enhanced the wound healing process with complete re-epithelialization as well as collagen deposition in a full-thickness skin defect model. Thus, CSLD-PCLM nanofibrous scaffolds may ideally meet the various requirements of the wound healing process and are promising candidates for wound dressings in future clinical applications.