Hemostatic performance and biocompatibility of chitosan-based agents in experimental parenchymal bleeding

Revolutionizing Cancer Treatment: Biopolymer-Based Aerogels as Smart Platforms for Targeted Drug Delivery

Cancer stands as a leading cause of global mortality, with chemotherapy being a pivotal treatment approach, either alone or in conjunction with other therapies. The primary goal of these therapies is to inhibit the growth of cancer cells specifically, while minimizing harm to healthy dividing cells. Conventional treatments, often causing patient discomfort due to side effects, have led researchers to explore innovative, targeted cancer cell therapies. Thus, biopolymer-based aerogels emerge as innovative platforms, showcasing unique properties that respond intelligently to diverse stimuli. This responsiveness enables precise control over the release of anticancer drugs, enhancing therapeutic outcomes. The significance of these aerogels lies in their ability to offer targeted drug delivery with increased efficacy, biocompatibility, and a high drug payload. In this comprehensive review, the author discuss the role of biopolymer-based aerogels as an emerging functionalized platforms in anticancer drug delivery. The review addresses the unique properties of biopolymer-based aerogels showing their smart behavior in responding to different stimuli including temperature, pH, magnetic and redox potential to control anticancer drug release. Finally, the review discusses the application of different biopolymer-based aerogel in delivering different anticancer drugs and also discusses the potential of these platforms in gene delivery applications.

Strongly Adhesive, Self-Healing, Hemostatic Hydrogel for the Repair of Traumatic Brain Injury

With wide clinical demands, therapies for traumatic brain injury (TBI) are a major problem in surgical procedures and after major trauma. Due to the difficulty in regeneration of neurons or axons after injury, as well as the inhibition of blood vessel growth by the formation of neural scars, existing treatment measures have limited effectiveness in repairing brain tissue. Herein, the biomultifunctional hydrogels are developed for TBI treatment based on the Schiff base reaction of calcium ion (Ca2+)-cross-linked oxidized sodium alginate (OSA) and carboxymethyl chitosan (CMCS). The obtained COCS hydrogel exhibits excellent adhesion to wet tissues, self-repair capability, and antimicrobial properties. What's particularly interesting is that the addition of Ca2+ increases the hydrogel's extensibility, enhancing its hemostatic capabilities. Biological assessments indicate that the COCS hydrogel demonstrates excellent biocompatibility, hemostatic properties, and the ability to promote arterial vessel repair. Importantly, the COCS hydrogel promotes the growth of cerebral microvessels by upregulating CD31, accelerates the proliferation of astrocytes, enhances the expression of GFAP, and stimulates the expression of neuron-specific markers such as NEUN and β-tubulin. All of these findings highlight that the strongly adhesive, self-healing, hemostatic hydrogel shows great potential for the repair of traumatic brain injury and other tissue repair therapy.

Pelvic Organ Prolapse Reconstruction with the Chitosan-Based Novel Haemostatic Agent in Ovine Model-Preliminary Report

This prospective study aimed to assess the feasibility of chitosan biomaterial and subcutaneous gel implantation in an ovine model, with implications for women with genital prolapse. Twenty-four ewes were divided into four groups (n = 6 per group): chitosan type B, chitosan type C, chitosan unmodified injections, and polypropylene mesh. Ovine models were chosen due to their morphological resemblance to human reproductive organs. Animals were sacrificed after 90 days for macroscopic, pathomorphological, and immunohistochemical analysis. In the chitosan type B group, IL-6 and IL-10 levels decreased after 28 days, while chitosan type C and injection groups exhibited higher IL-6 than IL-10 levels. The polypropylene group displayed the highest IL-6 and lowest IL-10 levels. Histological examination of the polypropylene group revealed no degenerative changes or inflammation, whereas chitosan injection induced local inflammation. Other groups exhibited no degenerative changes. Ewes implanted with chitosan displayed reduced inflammation compared to polypropylene-implanted ewes. Chitosan implantation facilitated vaginal tissue healing, in contrast to polypropylene mesh, which led to extrusion. While chitosan holds promise as an alternative to polypropylene mesh, further research is imperative for comprehensive evaluation. This study suggests the potential of a chitosan biomaterial in pelvic organ prolapse treatment, warranting additional investigation.

Electrospinning Silk-Fibroin-Based Fibrous Membranes with AgNPs for Antimicrobial Application

Silk fibroin (SF) has excellent biocompatibility and is one of the most commonly used polymer materials. However, SF fibers have serious drawbacks as antibacterial materials due to their lack of stability and bacterial resistance. Therefore, it is of paramount significance to enhance the stability and bolster the bacterial resistance of SF fibers. In this study, SF fibers were fabricated and loaded with Ag nanoparticles (AgNPs) to improve the antimicrobial properties of the fibers. The impact of reduction conditions on the size of AgNPs was also investigated. In an antibacterial test, the fibers that were prepared exhibited over 98% bacterial resistance against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). Therefore, as an efficient antibacterial material, these fibers are expected to become a candidate material in medical and textile fields. This study offers a novel approach for the utilization of SF fibers in the realm of antibacterial applications.

Functional electrospun nanofibers: fabrication, properties, and applications in wound-healing process

Electrostatic spinning as a technique for producing nanoscale fibers has recently attracted increasing attention due to its simplicity, versatility, and loadability. Nanofibers prepared by electrostatic spinning have been widely studied, especially in biomedical applications, because of their high specific surface area, high porosity, easy size control, and easy surface functionalization. Wound healing is a highly complex and dynamic process that is a crucial step in the body's healing process to recover from tissue injury or other forms of damage. Single-component nanofibers are more or less limited in terms of structural properties and do not fully satisfy various needs of the materials. This review aims to provide an in-depth analysis of the literature on the use of electrostatically spun nanofibers to promote wound healing, to overview the infinite possibilities for researchers to tap into their biomedical applications through functional composite modification of nanofibers for advanced and multifunctional materials, and to propose directions and perspectives for future research.

Multiple Natural Polymers in Drug and Gene Delivery Systems

Natural polymers are organic compounds produced by living organisms. In nature, they exist in three main forms, including proteins, polysaccharides, and nucleic acids. In recent years, with the continuous research on drug and gene delivery systems, scholars have found that natural polymers have promising applications in drug and gene delivery systems due to their excellent properties such as biocompatibility, biodegradability, low immunogenicity, and easy modification. However, since the structure, physicochemical properties, pharmacological properties and biological characteristics of biopolymer molecules have not yet been entirely understood, further studies are required before large-scale clinical application. This review focuses on recent advances in the representative natural polymers such as proteins (albumin, collagen, elastin), polysaccharides (chitosan, alginate, cellulose) and nucleic acids. We introduce the characteristics of various types of natural polymers, and further outline the characterization methods and delivery forms of these natural polymers. Finally, we discuss possible challenges for natural polymers in subsequent experimental studies and clinical applications. It provides an important strategy for the clinical application of natural polymers in drug and gene delivery systems.

Antibacterial chitosan-based composite sponge with synergistic hemostatic effect for massive haemorrhage

Uncontrollable acute bleeding and wound infection pose significant challenges in emergency treatment and surgical operations. Therefore, the research and development of highly efficient antibacterial hemostatic agents are of great importance in reducing the mortality rate among patients with massive hemorrhage. In this study, we utilized hydrophobically modified chitosan (HM-CS) and gallic acid chitosan (GA-CS) to create a composite sponge (HM/GA-CS) that exhibits complementary advantages. The composite sponge combines the alkyl chain and polyphenol structure, allowing it to adsorb blood cells and plasma proteins simultaneously. This synergistic effect was confirmed through various tests, including blood cell adhesion, plasma protein barrier behavior, and in vitro hemostatic testing. Furthermore, experiments conducted on a rat liver injury model demonstrated that the composite sponge achieved rapid coagulation within 52 s, resulting in significantly lower bleeding volume compared with traditional gauze. In addition, the incorporation of GA-CS into HM-CS enhanced the antibacterial properties of the composite sponge. The antibacterial rate of the composite sponge against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) reached 100 % and 98.2 %, respectively. To evaluate its biocompatibility, the composite sponge underwent blood compatibility and cell activity tests, confirming its suitability. The HM/GA-CS sponge holds promising applications in managing cases of massive hemorrhage.

A multi-crosslinking strategy of organic and inorganic compound bio-adhesive polysaccharide-based hydrogel for wound hemostasis

Polysaccharides are naturally occurring polymers with exceptional biodegradable and biocompatible qualities that are used as hemostatic agents. In this study, photoinduced CC bond network and dynamic bond network binding was used to give polysaccharide-based hydrogels the requisite mechanical strength and tissue adhesion. The designed hydrogel was composed of modified carboxymethyl chitosan (CMCS-MA) and oxidized dextran (OD), and introduced hydrogen bond network through tannic acid (TA) doping. Halloysite nanotubes (HNTs) were also added, and the effects of various doping amount on the performance of the hydrogel were examined, in order to enhance the hemostatic property of hydrogel. Experiments on vitro degradation and swelling demonstrated the strong structural stability of hydrogels. The hydrogel has improved tissue adhesion strength, with a maximum adhesion strength of 157.9 kPa, and demonstrated improved compressive strength, with a maximum compressive strength of 80.9 kPa. Meanwhile, the hydrogel had a low hemolysis rate and had no inhibition on cell proliferation. The created hydrogel exhibited a significant aggregation effect on platelets and a reduced blood clotting index (BCI). Importantly, the hydrogel can quickly adhere to seal the wound and has good hemostatic effect in vivo. Our work successfully prepared a polysaccharide-based bio-adhesive hydrogel dressing with stable structure, appropriate mechanical strength, and good hemostatic properties.

Surface configuration of microarc oxidized Ti with regionally loaded chitosan hydrogel containing ciprofloxacin for improving biological performance

The bacterial colonization and poor osseointegration of Ti implants significantly compromise their applications in load-bearing bone repair and replacement. To endorse the Ti with both excellent bioactivity and antibacterial ability, we developed a microarc oxidation coating that was modified uniformly by hydroxyapatite (HA) nanodots arrays and loaded regionally with chitosan hydrogel containing ciprofloxacin. The bonding between the HA nanodots covered coating and the chitosan hydrogel is further enhanced via silanization and chemical grafting of glutaraldehyde. Benefiting from the regionally loaded structure of the chitosan hydrogel, the chitosan hydrogel unloaded area can promote the cell adhesion and proliferation with excellent bioactivity, though relatively low OD value of cck8 has been observed at the beginning of the cell culturing. Whereas, the OD value of cck8 rises with the prolongation of the cell culturing time due to the degradation of the regionally loaded chitosan hydrogel. With the help of the laden ciprofloxacin in chitosan hydrogels, the sample effectively sterilizes the bacterial with a bacteriostatic ring. Therefore, regional loading of chitosan hydrogel containing ciprofloxacin on the modified microarc oxidation coating is a good approach to endorse Ti with both excellent bioactivity and antibacterial ability.

Effect of naturally derived surgical hemostatic materials on the proliferation of A549 human lung adenocarcinoma cells

Hemostatic materials are generally applied in surgical operations for cancer, but their effects on the growth and recurrence of tumors are unclear. Herein, three commonly used naturally derived hemostatic materials, gelatin sponge, Surgicel (oxidized regenerated cellulose), and biopaper (mixture of sodium hyaluronate and carboxymethyl chitosan), were cocultured with A549 human lung adenocarcinoma cells in vitro. Furthermore, the performance of hemostatic materials and the tumorigenicity of the materials with A549 ​cells were observed after subcutaneous implantation into BALB/c mice. The in vitro results showed that biopaper was dissolved quickly, with the highest cell numbers at 2 and 4 days of culture. Gelatin sponges retained their structure and elicited the least cell infiltration during the 2- to 10-day culture. Surgicel partially dissolved and supported cell growth over time. The in vivo results showed that biopaper degraded rapidly and elicited an acute Th1 lymphocyte reaction at 3 days after implantation, which was decreased at 7 days after implantation. The gelatin sponge resisted degradation and evoked a hybrid M1/M2 macrophage reaction at 7–21 days after implantation, and a protumor M2d subset was confirmed. Surgicel resisted early degradation and caused obvious antitumor M2a macrophage reactions. Mice subjected to subcutaneous implantation of A549 ​cells and hemostatic materials in the gelatin sponge group had the largest tumor volumes and the shortest overall survival (OS), while the Surgicel and the biopaper group had the smallest volumes and the longest OS. Therefore, although gelatin sponges exhibited cytotoxicity to A549 ​cells in vitro, they promoted the growth of A549 ​cells in vivo, which was related to chronic M2d macrophage reaction. Surgicel and biopaper inhibited A549 ​cell growth in vivo, which is associated with chronic M2a macrophage reaction or acute Th1 lymphocyte reaction.

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The gelatin sponge, Surgicel and biopaper had different effects on A549 ​cell growth and proliferation.

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Biopaper degraded rapidly in vivo and elicited an antitumor Th1 lymphocyte reaction at acute inflammatory phase.

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The gelatin sponge resisted degradation and evoked a protumor M2d macrophage reactions.

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Surgicel resisted early degradation and caused obvious antitumor M2a macrophage reactions.

Safety and efficacy assessment of aerogels for biomedical applications

The unique physicochemical properties of aerogels have made them an attractive class of materials for biomedical applications such as drug delivery, regenerative medicine, and wound healing. Their low density, high porosity, and ability to regulate the pore structure makes aerogels ideal nano/micro-structures for loading of drugs and active biomolecules. As a result of this, the number of in vitro and in vivo studies on the therapeutic efficacy of these porous materials has increased substantially in recent years and continues to be an area of great interest. However, data about their in vivo performance and safety is limited. Studies have shown that polymer-based, silica-based and some hybrid aerogels are generally regarded as safe but given that studies on the acute, subacute, and chronic toxicity for the majority of aerogel types is missing, more work is still needed. This review presents a comprehensive summary of different biomedical applications of aerogels proposed to date as well as new and innovative applications of aerogels in other areas such as decontamination. We have also reviewed their biological effect on cells and living organisms with a focus on therapeutic efficacy and overall safety (in vivo and in vitro).

What affects the biocompatibility of polymers?

In recent decades synthetic polymers have gained increasing popularity, and nowadays they are an integral part of people's daily lives. In addition, owing to their competitive advantage and being susceptible to modification, polymers have stimulated the fast development of innovative technologies in many areas of science. Biopolymers are of particular interest in various branches of medicine, such as implantology of bones, cartilage and skin tissues as well as blood vessels. Biomaterials with such specific applications must have appropriate mechanical and strength characteristics and above all they must be compatible with the surrounding tissues, human blood and its components, i.e. exhibit high hemo- and biocompatibility, low or no thrombo- and carcinogenicity, foreign body response (host response), appropriate osteoconduction, osteoinduction and mineralization. For biocompatibility improvement many surface treatment techniques have been utilized leading to fabricate the polymer biomaterials of required properties, also at nanoscale. This review paper discusses the most important physicochemical and biological factors that affect the biocompatibility, thus the reaction of the living organism after insertion of the polymer-based biomaterials, i.e. surface modification and/or degradation, surface composition (functional groups and charge), size and shapes, hydrophilic-hydrophobic character, wettability and surface free energy, topography (roughness, stiffness), crystalline and amorphous structure, nanostructure, cell adhesion and proliferation, cellular uptake. Particularly, the application of polysaccharides (chitosan, cellulose, starch) in the tissue engineering is emphasized.

Application and outlook of topical hemostatic materials: a narrative review

Bleeding complications can cause significant morbidities and mortalities in both civilian and military conditions. The formation of stable blood clots or hemostasis is essential to prevent major blood loss and death from excessive bleeding. However, the body's self-coagulation process cannot accomplish timely hemostasis without the assistance of hemostatic agents under some conditions. In the past two decades, topical hemostatic materials and devices containing platelets, fibrin, and polysaccharides have been gradually developed and introduced to induce faster or more stable blood clot formation, updating or iterating traditional hemostatic materials. Despite the various forms and functions of topical hemostatic materials that have been developed for different clinical conditions, uncontrolled hemorrhage still causes over 30% of trauma deaths across the world. Therefore, it is important to fabricate fast, efficient, safe, and ready-to-use novel hemostatic materials. It is necessary to understand the coagulation process and the hemostatic mechanism of different materials to develop novel topical hemostatic agents, such as tissue adhesives and sealants from various natural and synthetic materials. This review discusses the structural features of topical hemostatic materials related to the stimulation of hemostasis, summarizes the commercially available products and their applications, and reviews the ongoing clinical trials and recent studies concerning the development of different hemostatic materials.