Silver sulfadiazine loaded core-shell airbrushed nanofibers for burn wound healing application

Resveratrol-Ampicillin Dual-Drug Loaded Polyvinylpyrrolidone/Polyvinyl Alcohol Biomimic Electrospun Nanofiber Enriched with Collagen for Efficient Burn Wound Repair

Background

The healing of burn wounds is a complicated physiological process that involves several stages, including haemostasis, inflammation, proliferation, and remodelling to rebuild the skin and subcutaneous tissue integrity. Recent advancements in nanomaterials, especially nanofibers, have opened a new way for efficient healing of wounds due to burning or other injuries.

Methods

This study aims to develop and characterize collagen-decorated, bilayered electrospun nanofibrous mats composed of PVP and PVA loaded with Resveratrol (RSV) and Ampicillin (AMP) to accelerate burn wound healing and tissue repair.

Results

Nanofibers with smooth surfaces and web-like structures with diameters ranging from 200 to 400 nm were successfully produced by electrospinning. These fibres exhibited excellent in vitro properties, including the ability to absorb wound exudates and undergo biodegradation over a two-week period. Additionally, these nanofibers demonstrated sustained and controlled release of encapsulated Resveratrol (RSV) and Ampicillin (AMP) through in vitro release studies. The zone of inhibition (ZOI) of PVP-PVA-RSV-AMP nanofibers against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) was found 31±0.09 mm and 12±0.03, respectively, which was significantly higher as compared to positive control. Similarly, the biofilm study confirmed the significant reduction in the formation of biofilms in nanofiber-treated group against both S. aureus and E. coli. X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) analysis proved the encapsulation of RSV and AMP successfully into nanofibers and their compatibility. Haemolysis assay (%) showed no significant haemolysis (less than 5%) in nanofiber-treated groups, confirmed their cytocompatibility with red blood cells (RBCs). Cell viability assay and cell adhesion on HaCaT cells showed increased cell proliferation, indicating its biocompatibility as well as non-toxic properties. Results of the in-vivo experiments on a burn wound model demonstrated potential burn wound healing in rats confirmed by H&E-stained images and also improved the collagen synthesis in nanofibers-treated groups evidenced by Masson-trichrome staining. The ELISA assay clearly indicated the efficient downregulation of TNF-alpha and IL-6 inflammatory biomarkers after treatment with nanofibers on day 10.

Conclusion

The RSV and AMP-loaded nanofiber mats, developed in this study, expedite burn wound healing through their multifaceted approach.

Recent progress of electrospun nanofibers as burning dressings

Burns are a global public health problem, which brings great challenges to public health and the economy. Severe burns often lead to systemic infection, shock, multiple organ failure, and even death. With the increasing demand for the therapeutic effect of burn wounds, traditional dressings have been unable to meet people's needs due to their single function and many side effects. In this context, electrospinning shows a great prospect on the way to open up advanced wound dressings that promote wound repairing and prevent infection. With its large specific surface area, high porosity, and similar to natural extracellular matrix (ECM), electrospun nanofibers can load drugs and accelerate wound healing. It provides a promising solution for the treatment and management of burn wounds. This review article introduces the concept of burn and the types of electrospun nanofibers, then summarizes the polymers used in electrospun nanofiber dressings. Finally, the drugs (plant extracts, small molecule drugs and nanoparticles) loaded with electrospun burn dressings are summarized. Some promising aspects for developing commercial electrospun burn dressings are proposed.

Levofloxacin loaded poly (ethylene oxide)-chitosan/quercetin loaded poly (D,L-lactide-co-glycolide) core-shell electrospun nanofibers for burn wound healing

This study developed a new burn wound dressing based on core-shell nanofibers that co-deliver antibiotic and antioxidant drugs. For this purpose, poly(ethylene oxide) (PEO)-chitosan (CS)/poly(D,L-lactide-co-glycolide) (PLGA) core-shell nanofibers were fabricated through co-axial electrospinning technique. Antibiotic levofloxacin (LEV) and antioxidant quercetin (QS) were incorporated into the core and shell parts of PEO-CS/PLGA nanofibers, respectively. The drugs could bond to the polymer chains through hydrogen bonding, leading to their steady release for 168 h. An in vitro drug release study showed a burst effect followed by sustained release of LEV and QS from the nanofibers due to the Fickian diffusion. The NIH 3T3 fibroblast cell viability of the drug loaded core-shell nanofibers was comparable to that in the control (tissue culture polystyrene) implying biocompatibility of the nanofibers and their cell supportive role. However, there was no significant difference in cell viability between the drug loaded and drug free core-shell nanofibers. According to in vivo experiments, PEO-CS-LEV/PLGA-QS core-shell nanofibers could accelerate the healing process of a burn wound compared to a sterile gauze. Thanks to the synergistic therapeutic effect of LEV and QS, a significantly higher wound closure rate was recorded for the drug loaded core-shell nanofibrous dressing than the drug free nanofibers and control. Conclusively, PEO-CS-LEV/PLGA-QS core-shell nanofibers were shown to be a promising wound healing material that could drive the healing cascade through local co-delivery of LEV and QS to burn wounds.

Advanced 3D Electrospinning "Xspin" System: Fabrication of Bifiber Floating Oral Pharmaceutical Scaffolds for Controlled Drug Delivery

Electrospinning has become a widely used and efficient method for manufacturing nanofibers from diverse polymers. This study introduces an advanced electrospinning technique, Xspin - a multi-functional 3D printing platform coupled with electrospinning system, integrating a customised 3D printhead, MaGIC - Multi-channeled and Guided Inner Controlling printheads. The Xspin system represents a cutting-edge fusion of electrospinning and 3D printing technologies within the realm of pharmaceutical sciences and biomaterials. This innovative platform excels in the production of novel fiber with various materials and allows for the creation of highly customized fiber structures, a capability hitherto unattainable through conventional electrospinning methodologies. By integrating the benefits of electrospinning with the precision of 3D printing, the Xspin system offers enhanced control over the scaffold morphology and drug release kinetics. Herein, we fabricated a model floating pharmaceutical dosage for the dual delivery of curcumin and ritonavir and thoroughly characterized the product. Fourier transform infrared (FTIR) spectroscopy demonstrated that curcumin chemically reacted with the polymer during the Xspin process. Thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) confirmed the solid-state properties of the active pharmaceutical ingredient after Xspin processing. Scanning electron microscopy (SEM) revealed the surface morphology of the Xspin-produced fibers, confirming the presence of the bifiber structure. To optimize the quality and diameter control of the electrospun fibers, a design of experiment (DoE) approach based on quality by design (QbD) principles was utilized. The bifibers expanded to approximately 10-11 times their original size after freeze-drying and effectively entrapped 87% curcumin and 84% ritonavir. In vitro release studies demonstrated that the Xspin system released 35% more ritonavir than traditional pharmaceutical pills in 2 h, with curcumin showing complete release in pH 1.2 in 5 min, simulating stomach media. Furthermore, the absorption rate of curcumin was controlled by the characteristics of the linked polymer, which enables both drugs to be absorbed at the desired time. Additionally, multivariate statistical analyses (ANOVA, pareto chart, etc.) were conducted to gain better insights and understanding of the results such as discern statistical differences among the studied groups. Overall, the Xspin system shows significant potential for manufacturing nanofiber pharmaceutical dosages with precise drug release capabilities, offering new opportunities for controlled drug delivery applications.

Airbrushed nanofibers with bioactive core and antibacterial shell for wound healing application

Acute and chronic wounds are vulnerable to infection and delayed healing and require critical care and advanced wound protection. To overcome the challenges, dual therapy of antibacterial and growth factors will be a novel wound care strategy. The present study explores airbrushed core-shell nanofiber for dual delivery of epidermal growth factor (EGF) and amoxicillin (AMOX) in a sustained manner. A blend of polycaprolactone (PCL)-polyethylene oxide (PEO) was used to prepare the shell compartment for amoxicillin loading and poly-DL-lactide (PDLLA) core for EGF loading by using a customized airbrush setup. Characterization result shows a uniform distribution of nanofibers ranging between 200 and 500 nm in diameter. Amoxicillin loading in the shell compartment offers an initial burst release followed by a sustained release for up to 14 days. Whereas EGF in the core part shows a continuous sustained release throughout the release study.In-vitrostudy indicates the biocompatibility of EGF-AMOX loaded core-shell nanofibers with human dermal fibroblast cell (HDF) cells and a higher cellular proliferation compared to control samples. Gene expression data show an increase in fold change of collagen I and tropoelastin expression, indicating the regenerative properties of EGF-AMOX encapsulated nanofiber. The combination of bioactive core (EGF) and antibiotic shell (amoxicillin) in an airbrushed nanofibrous scaffold is a novel approach, which is the first time explored to deliver sustainable therapy to treat skin wounds. Our results demonstrate that PCL-PEO-Amoxicillin/PDLLA-EGF-loaded core-shell nanofibers are promising dual therapy scaffolds to deliver effective skin wound care, with the possibility of direct deposition on the wound.

Distribution characteristics of pathogens in different stages of pressure ulcers and the therapeutic effect of linear polarized polychromatic light combined with silver sulfadiazine cream

To investigate the distribution characteristics of pathogens in different stages of pressure ulcers and observe the application of linear polarized polychromatic light (LPPL) combined with silver sulfadiazine cream in treating varying stages of pressure ulcers. This study comprised 88 patients with pressure ulcers who were enrolled in the department of burn and plastic surgery of our hospital from April 2019 to April 2022. The wound exudates from patients were collected, followed by analyzing the distribution of pathogens in different stages of pressure ulcers. Patients were randomly divided into 2 groups. The first group (n = 44) received LPPL combined with silver sulfadiazine. The other group was intervened with LPPL group only for 2 weeks. The clinical efficacy, condition, and pain in the 2 groups, as well as the healing timeframes for patients were measured at different stages. The findings showed that among 88 patients with pressure ulcers, 62 were infected, and the infection rate was 70.45%. The pathogens that were observed in stage II and III to IV pressure ulcers were mainly Gram-negative bacteria. The total effective rate in the combined group was 90.91%, which was much higher than that of LPPL group (70.45%). Compared with LPPL group, the pressure ulcer scale for healing and visual analogue scale scores in the combined group were markedly lower (P < .05). It is important to note that in LPPL group, the healing time of patients in stage II and stage III to IV in the combined arm were 9.76 ± 2.38 days and 13.19 ± 2.54 days, respectively. The corresponding time in the LPPL group was prolonged to 13.20 ± 3.76 and 18.82 ± 4.17 days, respectively. The main pathogens associated with wound infection in patients with pressure ulcers are Gram-negative bacteria. The curative effects of LPPL combined with sulfadiazine silver cream on patients with pressure ulcer is obviously improved, and the recovery and pain relief are faster while the healing time of pressure ulcer is shorter.

PCL/gelatin nanofibers embedded with doxorubicin-loaded mesoporous silica nanoparticles/silver nanoparticles as an antibacterial and anti-melanoma cancer

Melanoma cancer wound healing is critical and complex and poses a significant challenge to researchers. Drug resistance, adverse side effects, and inefficient localization of chemotherapeutic drugs limit common treatment strategies in melanoma cancer. Using drug delivery nanostructures with low side effects and high efficiency, besides having antibacterial and antiseptic properties, can effectively repair the damage caused by the disease. To this end, this study aimed to develop a drug delivery nanosystem based on doxorubicin (DOX)-loaded amine-functionalized mesoporous silica nanoparticles (MSNs), linked with green synthesized silver nanoparticles (AgNPs). Characterization methods including microscopic methods and X-ray diffraction (XRD) confirmed the synthesis and functionalization of the well-dispersed nanoparticles with nanosized and uniform structures. The poly(ε-caprolactone) (PCL) nanofibers as a strong scaffold were produced by the blow spinning method and DOX-loaded nanoparticles were blow spun on PCL nanofibers along with gelatin solution. The resulting nanosystem including nanofibers and nanoparticles (NFs/NPS) showed a fine loading percent with a proper release profile of DOX and AgNPs and low hemolysis activity. Moreover, besides preventing infection by AgNPs, the DOX-loaded NFs/NPs could effectively destroy melanoma cancer cells. The attachment of normal cells to the nanoparticles-loaded nanofibers scaffold revealed the possibility of healing wounds caused by melanoma cancer.

3D Printed Chitosan/Alginate Hydrogels for the Controlled Release of Silver Sulfadiazine in Wound Healing Applications: Design, Characterization and Antimicrobial Activity

The growing demand for personalized medicine requires innovation in drug manufacturing to combine versatility with automation. Here, three-dimensional (3D) printing was explored for the production of chitosan (CH)/alginate (ALG)-based hydrogels intended as active dressings for wound healing. ALG hydrogels were loaded with 0.75% w/v silver sulfadiazine (SSD), selected as a drug model commonly used for the therapeutic treatment of infected burn wounds, and four different 3D CH/ALG architectures were designed to modulate the release of this active compound. CH/ALG constructs were characterized by their water content, elasticity and porosity. ALG hydrogels (Young's modulus 0.582 ± 0.019 Mpa) were statistically different in terms of elasticity compared to CH (Young's modulus 0.365 ± 0.015 Mpa) but very similar in terms of swelling properties (water content in ALG: 93.18 ± 0.88% and in CH: 92.76 ± 1.17%). In vitro SSD release tests were performed by using vertical diffusion Franz cells, and statistically significant different behaviors in terms of the amount and kinetics of drugs released were observed as a function of the construct. Moreover, strong antimicrobial potency (100% of growth inhibition) against Staphylococcus aureus and Pseudomonas aeruginosa was demonstrated depending on the type of construct, offering a proof of concept that 3D printing techniques could be efficiently applied to the production of hydrogels for controlled drug delivery.

Histopathological Evaluation of the Healing Process of Standardized Skin Burns in Rabbits: Assessment of a Natural Product with Honey and Essential Oils

Skin burns are one of the most difficult medical problems. Recently, studies have been directed towards development of natural products in order to identify effective and safe remedies. In the present study, we evaluated the efficacy of a natural composite (formulated from honey and essential oils) compared with MEBO® (0.25% β-sitosterol) and DERMAZIN® creams (1% silver-sulfadiazine) in the treatment of thermally induced skin burns. For this purpose, four burn-wounds were created on the back of male New Zealand rabbits (n = 10) using a thermal stamp under the effect of general anesthesia. Each wound represents one of the following groups: non-treated, natural composite-cream, MEBO®-cream, and silver-sulfadiazine treated groups, respectively. Treatments were applied once a day topically until one of these wounds appeared to be healed grossly. The non-treated group received no treatment. Grossly, skin burns have been healed after 28 days of the treatment in all groups except of the non-treated group. The healing efficacy of the natural composite, MEBO® and silver-sulfadiazine creams was quite similar macroscopically. However, microscopically, the epidermal layer of the composite-cream treated group was more mature than those of both MEBO® and silver-sulfadiazine creams treated groups. In conclusion, the tested composite may be a promising effective and inexpensive treatment of skin burns.

Development and Characterization of an In Vitro Round Window Membrane Model for Drug Permeability Evaluations

Hearing loss and balance disorders are highly common disorders, and the development of effective oto-therapeutics remains an area of intense research. Drug development and screening in the hearing research field heavily rely on the use of preclinical models with often ambiguous translational relevance. This often leads to failed advancement in the market of effective therapeutics. In this context, especially for inner ear-specific pathologies, the availability of an in vitro, physiologically relevant, round window membrane (RWM) model could enable rapid, high-throughput screening of potential topical drugs for inner ear and cochlear dysfunctions and could help accelerate the advancement to clinic and market of more viable drug candidates. In this study, we report the development and evaluation of an in vitro model that mimics the native RWM tissue morphology and microenvironment as shown via immunostaining and histological analyses. The developed three-dimensional (3D) in vitro model was additionally assessed for barrier integrity by transepithelial electrical resistance, and the permeability of lipophilic and hydrophilic drugs was determined. Our collective findings suggest that this in vitro model could serve as a tool for rapid development and screening of topically deliverable oto-therapeutics.