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Huang J, Fan Q, Shi L, Shen J, Wang H. A novel chlorin derivative Shengtaibufen (STBF) mediated photodynamic therapy combined with iodophor for the treatment of chronic superficial leg wounds infected with methicillin-resistant Staphylococcus aureus: A retrospective clinical study. Photodiagnosis Photodyn Ther 2024; 48:104300. [PMID: 39097252 DOI: 10.1016/j.pdpdt.2024.104300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 07/27/2024] [Accepted: 07/31/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVE Chronic wounds are costly and difficult to treat, resulting in morbidity and even mortality in some cases due to a high methicillin-resistant Staphylococcus aureus (MRSA) burden contributing to chronicity. We aimed to observe the antimicrobial activity and healing-promoting effect of a novel photosensitizer Shengtaibufen (STBF)-mediated antibacterial photodynamic therapy (PDT) on MRSA-infected chronic leg ulcers. PATIENTS AND METHODS This was a retrospective, comparative, single-center clinical study. A total of 32 patients with chronic lower limb wounds infected with MRSA from January 2022 to December 2023 were finally included in this study by searching the electronic medical records of the dermatology department of Huadong Hospital, including a group of red light combined with iodophor (control+iodophor, n=16, receiving red light once a week for 8 weeks and routine dressing change with iodophor once a day) and a group of STBF-mediated PDT (STBF-PDT) combined with iodophor (STBF-PDT+iodophor, n=16, receiving STBF-PDT and routine dressing change with iodophor once a day). STBF-PDT was performed once a week (1 mg/ml STBF, 1 h incubation, 630 nm red light, 80 J/cm2) for 8 weeks. The primary endpoints included wound clinical signs, wound size, wound-related pain, re-epithelialization score, MRSA load and wound-related quality of life (wound-QoL). Any adverse events were also recorded. RESULTS We found that STBF-PDT+iodophor could effectively alleviate clinical infection symptoms, accelerate wound closure, reduce average biological burden and improve wound-QoL without severe adverse events in comparison to the control+iodophor group. The STBF-PDT+iodophor group obtained a mean percentage reduction of 65.22% in wound size (from 18.96±11.18 cm2 to 6.59±7.94 cm2) and excellent re-epithelialization scores, as compared with a decrease of 30.17% (from 19.23±9.80 cm2 to 13.43±9.32 cm2) for the control+iodophor group. Significant differences in wound area were observed at week 6 (p=0.028*) and week 8 (p=0.002**). The bacterial load decreased by 99.86% (from 6.45 × 107±2.69 × 107 to 8.94 × 104±1.92 × 105 CFU/cm2, p<0.0001) in the STBF-PDT+iodophor group and 1.82% (from 6.61 × 107±2.13 × 107 to 6.49 × 107±2.01 × 107 CFU/cm2, p=0.029) in the control+iodophor group. The wound-QoL in STBF-PDT+iodophor group had a 51.62% decrease in overall score (from 29.65±9.33 at the initial to 14.34±5.17 at week 8, p<0.0001) compared to those receiving red light and routine wound care (from 30.73±17.16 to 29.32±15.89 at week 8, p=0.003). Moreover, patients undergoing STBF-PDT+iodophor exhibited great improvements in all domains of wound-QoL (physical, psychological and everyday-life), whereas the control+iodophor group ameliorated in only one field (everyday-life). CONCLUSION Our data confirmed that a novel photosensitizer, STBF-mediated PDT, when combined with iodophor, served as a potential modality for MRSA infection and a possible therapy for other drug-resistant microorganisms, and as a promising alternative for chronic cutaneous infectious diseases.
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Affiliation(s)
- Jianhua Huang
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai 200040, PR China
| | - Qing Fan
- Department of Dermatology, Shanghai Fengxian District Hospital, Shanghai 201499, PR China
| | - Lei Shi
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai 200040, PR China
| | - Jie Shen
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai 200040, PR China
| | - Hongwei Wang
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai 200040, PR China.
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Champagne PT, Tzen YT, Wang J, Bennett B, Van Beest D, Tan WH. Predictors of one year pressure injury outcomes in hospitalized spinal cord injured veterans with one stage 3 or 4 pressure injury. J Spinal Cord Med 2024; 47:605-611. [PMID: 36745095 PMCID: PMC11218571 DOI: 10.1080/10790268.2022.2158290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The purpose of this study is to investigate predictors of pressure injury (PrI) outcomes at one year after discharge for Veterans with spinal cord injury (SCI) hospitalized with a Stage 3 or 4 PrI. DESIGN/SETTING/PARTICIPANTS This is a retrospective medical record review from one VA Health Care System SCI unit. Participants were Veterans with traumatic or non-traumatic SCI admitted with one Stage 3 or 4 pelvic PrI treated medically (e.g. without flap surgery). Logistic models were used to select the significant predictors of PrI healing outcomes. OUTCOME MEASURE One year after discharge wound outcomes (healed vs non-healed) for Veterans with SCI hospitalized with a Stage 3 or 4 PrI. RESULTS A total of 62 hospitalizations were included for analyses resulting in 33 healed and 29 non-healed PrIs. Three significant predictors of non-healed PrI outcomes included use of pressure mapping during hospitalization, greater PrI depth, and usage of alginate dressings. Two significant predictors of healed PrI outcomes included the use of animal-based tissue and hydrocolloid dressings. Area under curve of this logistic regression model was 79.98%. CONCLUSION The clinical decision of having a patient pressure mapped predicts that the PrI may not heal at one year of discharge. Pressure mapping protocol correlated with another variable that could not serve as a predictor by itself, including using powered pressure relief techniques. The three PrI treatment predictors may represent characteristics of the PrI itself, rather than the efficacy of the product. Further investigation on these clinical decision-making factors is warranted to ensure efficient and cost-effective treatment strategies for individuals with SCI hospitalized with PrIs.
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Affiliation(s)
| | - Yi-Ting Tzen
- Applied Clinical Research, UT Southwestern Medical Center, Dallas, Texas, USA
- Physical Medicine & Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, USA
- Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jijia Wang
- Applied Clinical Research, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Bridget Bennett
- Physical Medicine & Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, USA
- Spinal Cord Injury, VA North Texas Health Care System, Dallas, Texas, USA
| | - Dominique Van Beest
- Physical Medicine & Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, USA
- Spinal Cord Injury, VA North Texas Health Care System, Dallas, Texas, USA
| | - Wei-Han Tan
- Physical Medicine & Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, USA
- Spinal Cord Injury, VA North Texas Health Care System, Dallas, Texas, USA
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Fares MM, Radaydeh SK, Jabani ZH. IPN based hydrogels for in-vivo wound dressings; catalytic wound healing dynamics and isothermal adsorption models. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 254:112901. [PMID: 38552571 DOI: 10.1016/j.jphotobiol.2024.112901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/08/2024] [Accepted: 03/22/2024] [Indexed: 04/22/2024]
Abstract
Interpenetrating network (IPN) methacrylated chitosan or methacrylated flaxseed gum based hydrogels have been utilized to make outstanding in-vivo wound dressings. The photopolymerization process was accomplished in presence of Eosin-Y photoinitiator with average exposure time of 13-14 s for gelation. Spectroscopic structural investigations of 1H NMR. ATR-FTIR, TGA, and AFM techniques were used. In-vitro hemolysis test provided evidence of no cytotoxicity in both hydrogels observed. The in-vivo wound dressings were monitored for five mice coated with each hydrogel and another uncoated five mice for control (self-healing). All measurements were performed in quintuplicate (n = 5) and expressed as mean ± SD values. In wound healing dynamics, our data confirmed that wound healing pass through two stages; hemostasis and inflammation for stage 1, and proliferation and remodeling for stage 2. It also provided evidence of 1st order kinetics with descending rate of healing. Consequently, catalytic role of hydrogels in wound healing was checked via half-life (δ) and negative change of activation energy values (ΔEa). Various isothermal adsorption models demonstrated spontaneous and high binding affinities of hydrogels. It also confirmed the two-stage healing process in presence of hydrogels. Conclusively, the outstanding properties of the two hydrogels suggest their potential applications in treating venous ulcers and diabetic wound healing dressings.
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Affiliation(s)
- Mohammad M Fares
- Department of Chemistry, Faculty of Science & Arts, Jordan University of Science & Technology, P.O. Box 3030, 22110 Irbid, Jordan.
| | - Samah K Radaydeh
- Department of Chemistry, Faculty of Science & Arts, Jordan University of Science & Technology, P.O. Box 3030, 22110 Irbid, Jordan
| | - Zaid H Jabani
- Department of Chemistry, Faculty of Science & Arts, Jordan University of Science & Technology, P.O. Box 3030, 22110 Irbid, Jordan
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Mabate B, Pletschke BI. Sequential and enzyme-assisted extraction of algal bioproducts from Ecklonia maxima. Enzyme Microb Technol 2024; 173:110364. [PMID: 38039714 DOI: 10.1016/j.enzmictec.2023.110364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 12/03/2023]
Abstract
Brown algae are gaining recognition as sources of bio-compounds with diverse properties and potential applications in the food, nutraceutical, and pharmaceutical industries. Compounds such as polyphenols, alginates and fucoidan possess multiple bioactivities, including antidiabetic, antioxidant, anticancer, anti-inflammatory, and antibacterial properties. Conventional extraction methods provide low yields, posing challenges for the industrial applications of biocompounds. However, innovations are rapidly emerging to address these challenges, and one such approach is enzyme-assisted extraction. Furthermore, extracting single compounds undervalues algal biomass as valuable compounds may remain in the waste. Therefore, the aim of our study was to develop a framework for the sequential and enzyme-assisted extraction of various bio-compounds using the same biomass in a biorefinery process. The Ecklonia maxima algal biomass was defatted, and polyphenols were extracted using solid-liquid extraction with aqueous ethanol. The remaining residue was treated with an enzyme combination (Cellic® Ctec 2 and Viscozyme L) to liberate carbohydrates into solution, where an alginate and fucoidan fraction were isolated. A second alginate fraction was harvested from the residue. The phenolic fraction yielded about 11% (dry weight of extract/dry weight of seaweed biomass), the alginate fraction 35% and the fucoidan fraction 18%. These were analysed using a variety of biochemical methods. Structural analyses, including FTIR, NMR and TGA, were performed to confirm the integrity of these compounds. This study demonstrated that a sequential extraction method for various algal bioproducts is possible, which can pave the way for a biorefinery approach. Furthermore, our study primarily employed environmentally and eco-friendly extraction technologies promoting an environmentally sustainable industrial approach. This approach enhances the feasibility and flexibility of biorefinery operations, contributing to the development of a circular bio-economy.
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Affiliation(s)
- Blessing Mabate
- Enzyme Science Programme (ESP), Department of Biochemistry and Microbiology, Rhodes University, Makhanda 6140, South Africa
| | - Brett Ivan Pletschke
- Enzyme Science Programme (ESP), Department of Biochemistry and Microbiology, Rhodes University, Makhanda 6140, South Africa.
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Nasra S, Patel M, Shukla H, Bhatt M, Kumar A. Functional hydrogel-based wound dressings: A review on biocompatibility and therapeutic efficacy. Life Sci 2023; 334:122232. [PMID: 37918626 DOI: 10.1016/j.lfs.2023.122232] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
Chronic wounds, burns, and surgical incisions represent critical healthcare challenges that significantly impact patient quality of life and strain healthcare resources. In response to these pressing needs, the field of wound healing has witnessed a radical advancement with the emergence of functional hydrogel-based dressings. This review article underscores the severity and importance of this transformative study in the domain of wound healing. The hydrogel matrix offers a moist and supportive environment that facilitates cellular migration, proliferation, and tissue regeneration, vital for efficient wound closure. Their conformable nature ensures patient comfort, reducing pain and uneasiness during dressing changes, particularly in chronic wounds where frequent interventions are required. Beyond their structural merits, functional hydrogel dressings possess the capability of incorporating bioactive molecules such as growth factors and antimicrobial agents. This facilitates targeted and sustained delivery of therapeutics directly to the wound site, addressing the multifactorial nature of chronic wounds and enhancing the healing trajectory. The integration of advanced nanotechnology has propelled the design of hydrogel dressings with enhanced mechanical strength and controlled drug release profiles, amplifying their therapeutic potential. In conclusion, the significance of this study lies in its ability to revolutionize wound healing practices and positively impact the lives of countless individuals suffering from chronic wounds and burns. As this transformative technology gains momentum, it holds the promise of addressing a major healthcare burden worldwide, thus heralding a new era in wound care management.
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Affiliation(s)
- Simran Nasra
- Biological and Life Sciences, School of Arts & Sciences, Ahmedabad University, Central Campus, Navrangpura, Ahmedabad 380009, Gujarat, India
| | - Milonee Patel
- Biological and Life Sciences, School of Arts & Sciences, Ahmedabad University, Central Campus, Navrangpura, Ahmedabad 380009, Gujarat, India
| | - Haly Shukla
- Biological and Life Sciences, School of Arts & Sciences, Ahmedabad University, Central Campus, Navrangpura, Ahmedabad 380009, Gujarat, India
| | - Mahek Bhatt
- Biological and Life Sciences, School of Arts & Sciences, Ahmedabad University, Central Campus, Navrangpura, Ahmedabad 380009, Gujarat, India
| | - Ashutosh Kumar
- Biological and Life Sciences, School of Arts & Sciences, Ahmedabad University, Central Campus, Navrangpura, Ahmedabad 380009, Gujarat, India.
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Soares GC, Alves APNN, de Sousa AM, Dantas TF, de Barros Silva PG, Júnior EML, de Moraes Filho MO, Paier CRK, Rodrigues FAR, Mota MRL. Evaluation of the healing potential of Nile tilapia skin collagen in traumatic oral ulcers in male rats. Arch Oral Biol 2023; 155:105793. [PMID: 37633029 DOI: 10.1016/j.archoralbio.2023.105793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/06/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE To evaluate the healing potential of Nile tilapia skin collagen using a rat model with experimentally induced traumatic oral ulcers. DESIGN Male Wistar rats were segregated into three experimental groups (n = 8/group/euthanasia day). Ulcers were induced using a dermatological punch on the left buccal mucosa. The rats were then euthanized on days 1, 5, 10, 15, and 20 (ntotal=120 rats). Each group received topical treatment, 2x/day, with 1 % Nile tilapia skin collagen orabase (experimental group), only orabase (negative control), or Oncilom-A® orabase (positive control). Ulcer area, closure percentage, and body mass variation were measured. Slides were prepared for histological analysis, which included Picrosirius red staining (collagen analysis), and immunohistochemistry (platelet endothelial cell adhesion molecule, alpha-smooth muscle actin, and transforming growth factor-beta). RESULTS On day 15, the experimental and positive control groups displayed smaller ulcer areas, a higher percentage of closure, complete re-epithelialization, superior histological repair scores, and a reduced count of polymorphonuclear cells in comparison to the negative control group (p < 0.05). Additionally, the experimental group exhibited an increased number of blood vessels, total collagen (types I and III) and expression of platelet endothelial cell adhesion molecule, alpha-smooth muscle actin, and transforming growth factor-beta relative to the negative and positive control groups (p < 0.05). By day 20, the experimental group showed a more significant weight gain compared to the other groups (p < 0.0001). CONCLUSIONS Nile tilapia skin collagen orabase optimizes the healing of traumatic ulcers by stimulating re-epithelialization, angiogenesis, and collagenesis. Transforming growth factor-beta plays a significant role in this process.
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Affiliation(s)
- Guilherme Costa Soares
- Department of Dental Clinic, Stomatology and Oral Pathology Sector, Federal University of Ceara, Fortaleza, Brazil
| | | | - Alceu Machado de Sousa
- Department of Dental Clinic, Stomatology and Oral Pathology Sector, Federal University of Ceara, Fortaleza, Brazil
| | - Tales Freitas Dantas
- Department of Dental Clinic, Stomatology and Oral Pathology Sector, Federal University of Ceara, Fortaleza, Brazil
| | - Paulo Goberlânio de Barros Silva
- Department of Dental Clinic, Stomatology and Oral Pathology Sector, Federal University of Ceara, Fortaleza, Brazil; Ceara Cancer Institute, Hospital Haroldo Juaçaba, Fortaleza, Brazil
| | | | - Manoel Odorico de Moraes Filho
- Drug Research and Development Center, Federal University of Ceara, Fortaleza, Brazil; Translational Medicine Postgraduate Program, Federal University of Ceara, Fortaleza, Brazil
| | - Carlos Roberto Koscky Paier
- Drug Research and Development Center, Federal University of Ceara, Fortaleza, Brazil; Translational Medicine Postgraduate Program, Federal University of Ceara, Fortaleza, Brazil
| | - Felipe Augusto Rocha Rodrigues
- Drug Research and Development Center, Federal University of Ceara, Fortaleza, Brazil; Translational Medicine Postgraduate Program, Federal University of Ceara, Fortaleza, Brazil
| | - Mário Rogério Lima Mota
- Department of Dental Clinic, Stomatology and Oral Pathology Sector, Federal University of Ceara, Fortaleza, Brazil.
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Cao X, Lin X, Li N, Zhao X, Zhou M, Zhao Y. Animal tissue-derived biomaterials for promoting wound healing. MATERIALS HORIZONS 2023; 10:3237-3256. [PMID: 37278612 DOI: 10.1039/d3mh00411b] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The skin serves as the primary barrier between the human body and external environment, and is therefore susceptible to damage from various factors. In response to this challenge, animal tissue-derived biomaterials have emerged as promising candidates for wound healing due to their abundant sources, low side-effect profiles, exceptional bioactivity, biocompatibility, and unique extracellular matrix (ECM) mimicry. The evolution of modern engineering technology and therapies has allowed these animal tissue-derived biomaterials to be transformed into various forms and modified to possess the necessary properties for wound repair. This review provides an overview of the wound healing process and the factors that influence it. We then describe the extraction methods, important properties, and recent practical applications of various animal tissue-derived biomaterials. Our focus then shifts to the critical properties of these biomaterials in skin wound healing and their latest research developments. Finally, we critically examine the limitations and future prospects of biomaterials generated from animal tissues in this field.
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Affiliation(s)
- Xinyue Cao
- Department of Vascular Surgery, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China.
| | - Xiang Lin
- Department of Vascular Surgery, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China.
| | - Ning Li
- Department of Vascular Surgery, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China.
| | - Xiaozhi Zhao
- Department of Andrology, Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing 210008, China.
| | - Min Zhou
- Department of Vascular Surgery, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China.
| | - Yuanjin Zhao
- Department of Vascular Surgery, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China.
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Garbuio DC, Leite MN, Figueiredo SA, de Freitas LAP, de Carvalho EC, Frade MAC. Topical formulation containing chitosan-chamomile microparticles in cutaneous wound healing in rats. J Wound Care 2023; 32:xxii-xxx. [PMID: 36930193 DOI: 10.12968/jowc.2023.32.3.xxii] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Objective: The aim of this research was to evaluate the efficacy of a topical formulation containing chitosan-chamomile microparticles in cutaneous healing in rats. Method: Male Wistar rats (n=57) were randomly distributed into three groups: treatment; vehicle; and control. Evaluations were performed on days 2, 7 and 14 after the surgical procedure using skin lesion photography, and histological and biochemical analyses. Results: The results showed that there was no difference in the healing index and in the histological analysis of the inflammatory infiltrate among groups. Fibrogenesis was more significant in the group treated with the test formulation at day 7, and angiogenesis was greater in the vehicle and chamomile groups at day 2. The quantification of hydroxyproline showed a higher amount of collagen in the group treated with chamomile, mainly at day 14, although the histological quantification of collagen showed no difference between the groups. Conclusion: From the results of this study, it can be concluded that the formulation, although it had no effect on the healing time, improved the quality of the cicatricial tissue formed with a greater quantity of fibroblasts and collagen.
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Affiliation(s)
| | - Marcel Nani Leite
- Ribeirão Preto Medical School at São Paulo University (FMRP/USP), Ribeirão Preto, SP, Brazil
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Garbuio DC, Leite MN, Figueiredo SA, de Freitas LAP, de Carvalho EC, Frade MAC. Topical formulation containing chitosan-chamomile microparticles in cutaneous wound healing in rats. J Wound Care 2023; 32:xxii-xxx. [PMID: 36930537 DOI: 10.12968/jowc.2023.32.sup3a.xxii] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Objective: The aim of this research was to evaluate the efficacy of a topical formulation containing chitosan-chamomile microparticles in cutaneous healing in rats. Method: Male Wistar rats (n=57) were randomly distributed into three groups: treatment; vehicle; and control. Evaluations were performed on days 2, 7 and 14 after the surgical procedure using skin lesion photography, and histological and biochemical analyses. Results: The results showed that there was no difference in the healing index and in the histological analysis of the inflammatory infiltrate among groups. Fibrogenesis was more significant in the group treated with the test formulation at day 7, and angiogenesis was greater in the vehicle and chamomile groups at day 2. The quantification of hydroxyproline showed a higher amount of collagen in the group treated with chamomile, mainly at day 14, although the histological quantification of collagen showed no difference between the groups. Conclusion: From the results of this study, it can be concluded that the formulation, although it had no effect on the healing time, improved the quality of the cicatricial tissue formed with a greater quantity of fibroblasts and collagen.
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Affiliation(s)
| | - Marcel Nani Leite
- Ribeirão Preto Medical School at São Paulo University (FMRP/USP), Ribeirão Preto, SP, Brazil
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10
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The Use of Proteins, Lipids, and Carbohydrates in the Management of Wounds. Molecules 2023; 28:molecules28041580. [PMID: 36838568 PMCID: PMC9959646 DOI: 10.3390/molecules28041580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/13/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Despite the fact that skin has a stronger potential to regenerate than other tissues, wounds have become a serious healthcare issue. Much effort has been focused on developing efficient therapeutical approaches, especially biological ones. This paper presents a comprehensive review on the wound healing process, the classification of wounds, and the particular characteristics of each phase of the repair process. We also highlight characteristics of the normal process and those involved in impaired wound healing, specifically in the case of infected wounds. The treatments discussed here include proteins, lipids, and carbohydrates. Proteins are important actors mediating interactions between cells and between them and the extracellular matrix, which are essential interactions for the healing process. Different strategies involving biopolymers, blends, nanotools, and immobilizing systems have been studied against infected wounds. Lipids of animal, mineral, and mainly vegetable origin have been used in the development of topical biocompatible formulations, since their healing, antimicrobial, and anti-inflammatory properties are interesting for wound healing. Vegetable oils, polymeric films, lipid nanoparticles, and lipid-based drug delivery systems have been reported as promising approaches in managing skin wounds. Carbohydrate-based formulations as blends, hydrogels, and nanocomposites, have also been reported as promising healing, antimicrobial, and modulatory agents for wound management.
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Ciprandi G, Crucianelli S, Grussu F, Spuntarelli G, Marino SFM, Urbani U, Bernaschi P, Sisto A, Rizzo MI, Zama M. Meeting the Challenges in Pediatric Wound Care: Our 15-Year Experience with Dialkylcarbamoyl Chloride-Coated Dressing Technology in Acute and Chronic Wounds. CHRONIC WOUND CARE MANAGEMENT AND RESEARCH 2022. [DOI: 10.2147/cwcmr.s376889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Jiang T, Li Q, Qiu J, Chen J, Du S, Xu X, Wu Z, Yang X, Chen Z, Chen T. Nanobiotechnology: Applications in Chronic Wound Healing. Int J Nanomedicine 2022; 17:3125-3145. [PMID: 35898438 PMCID: PMC9309282 DOI: 10.2147/ijn.s372211] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/06/2022] [Indexed: 12/15/2022] Open
Abstract
Wounds occur when skin integrity is broken and the skin is damaged. With progressive changes in the disease spectrum, the acute wounds caused by mechanical trauma have been become less common, while chronic wounds triggered with aging, diabetes and infection have become more frequent. Chronic wounds now affect more than 6 million people in the United States, amounting to 10 billion dollars in annual expenditure. However, the treatment of chronic wounds is associated with numerous challenges. Traditional remedies for chronic wounds include skin grafting, flap transplantation, negative-pressure wound therapy, and gauze dressing, all of which can cause tissue damage or activity limitations. Nanobiotechnology — which comprises a diverse array of technologies derived from engineering, chemistry, and biology — is now being applied in biomedical practice. Here, we review the design, application, and clinical trials for nanotechnology-based therapies for chronic wound healing, highlighting the clinical potential of nanobiotechnology in such treatments. By summarizing previous nanobiotechnology studies, we lay the foundation for future wound care via a nanotech-based multifunctional smart system.
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Affiliation(s)
- Tao Jiang
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Qianyun Li
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Jinmei Qiu
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Jing Chen
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Shuang Du
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Xiang Xu
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Zihan Wu
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xiaofan Yang
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Zhenbing Chen
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Tongkai Chen
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
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Liu E, Gao H, Zhao Y, Pang Y, Yao Y, Yang Z, Zhang X, Wang Y, Yang S, Ma X, Zeng J, Guo J. The potential application of natural products in cutaneous wound healing: A review of preclinical evidence. Front Pharmacol 2022; 13:900439. [PMID: 35935866 PMCID: PMC9354992 DOI: 10.3389/fphar.2022.900439] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/28/2022] [Indexed: 11/22/2022] Open
Abstract
Under normal circumstances, wound healing can be summarized as three processes. These include inflammation, proliferation, and remodeling. The vast majority of wounds heal rapidly; however, a large percentage of nonhealing wounds have still not been studied significantly. The factors affecting wound nonhealing are complex and diverse, and identifying an effective solution from nature becomes a key goal of research. This study aimed to highlight and review the mechanisms and targets of natural products (NPs) for treating nonhealing wounds. The results of relevant studies have shown that the effects of NPs are associated with PI3K-AKT, P38MAPK, fibroblast growth factor, MAPK, and ERK signaling pathways and involve tumor growth factor (TNF), vascular endothelial growth factor, TNF-α, interleukin-1β, and expression of other cytokines and proteins. The 25 NPs that contribute to wound healing were systematically summarized by an inductive collation of the six major classes of compounds, including saponins, polyphenols, flavonoids, anthraquinones, polysaccharides, and others, which will further direct the attention to the active components of NPs and provide research ideas for further development of new products for wound healing.
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Affiliation(s)
- E Liu
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongjin Gao
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - YiJia Zhao
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yaobing Pang
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yejing Yao
- Neijiang Hospital of Traditional Chinese Medicine, Neijiang, China
| | - Zhengru Yang
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xueer Zhang
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - YanJin Wang
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siming Yang
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiao Ma
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Xiao Ma, ; Jinhao Zeng, ; Jing Guo,
| | - Jinhao Zeng
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Xiao Ma, ; Jinhao Zeng, ; Jing Guo,
| | - Jing Guo
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Xiao Ma, ; Jinhao Zeng, ; Jing Guo,
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14
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Ongarora BG. Recent technological advances in the management of chronic wounds: A literature review. Health Sci Rep 2022; 5:e641. [PMID: 35601031 PMCID: PMC9117969 DOI: 10.1002/hsr2.641] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Wound treatment comprises a substantial portion of the healthcare budgets in developed countries. Studies suggest that about 50% of patients admitted to hospitals have wounds, while 1%−2% of the general population in the developed world suffers from chronic wounds. Chronic wounds fail to repair themselves within the expected period of 30 days. Technologies have been developed to address challenges encountered during wound care with the aim of alleviating pain, promoting healing, or controlling wound infections. Objective The objective of this study was to explore the technological improvements that have been made in this field over time. Methods To gain insight into the future of wound management, a systematic review of literature on the subject was conducted in scientific databases (PubMed, Scopus, Web of Science, Medline, and Clinical Trials). Results and Discussion Results indicate that wound dressings have evolved from the traditional cotton gauze to composite materials embedded with appropriate ingredients such as metal‐based nanoparticles. Studies on biodegradable dressing materials are also underway to explore their applicability in dressing large and irregular wounds. On the other hand, conventional drugs and traditional formulations for the management of pain, inflammation, infections, and accelerating healing have been developed. However, more research needs to be carried out to address the issue of microbial resistance to drugs. Drugs for managing other ailments also need to be designed in such a way that they can augment wound healing. In addition, it has been demonstrated that a coordinated integration of conventional and traditional medicine can produce laudable results in chronic wound management. Conclusion Accordingly, collaborative efforts and ingenuity of all players in the field can accelerate technological advances in the wound care market to the benefit of the patients. Wounds affect about 50% of patients admitted to hospitals.
Technologies have been developed including biodegradable dressing materials to address underlying challenges.
Technological advancement, rising incidences of chronic wounds, growing government support, and a rising elderly population will drive wound market growth.
A careful combination of recent research outputs can greatly change wound care technologies.
This review highlights the recent research advances and opportunities in the wound care field.
The future lies in biodegradable dressing materials, probably embedded with selected nanoparticles and which shall be combined in predetermined ratios.
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Affiliation(s)
- Benson G. Ongarora
- Department of Chemistry Dedan Kimathi University of Technology Nyeri Kenya
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15
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Gao Y, Qiu Z, Liu L, Li M, Xu B, Yu D, Qi D, Wu J. Multifunctional fibrous wound dressings for refractory wound healing. JOURNAL OF POLYMER SCIENCE 2022. [DOI: 10.1002/pol.20220008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Yujie Gao
- MOE Key Laboratory of Advanced Textile Materials & Manufacturing Technology Zhejiang Sci‐Tech University Hangzhou China
| | - Zhiye Qiu
- MOE Key Laboratory of Advanced Textile Materials & Manufacturing Technology Zhejiang Sci‐Tech University Hangzhou China
| | - Lei Liu
- MOE Key Laboratory of Advanced Textile Materials & Manufacturing Technology Zhejiang Sci‐Tech University Hangzhou China
| | - Mengmeng Li
- MOE Key Laboratory of Advanced Textile Materials & Manufacturing Technology Zhejiang Sci‐Tech University Hangzhou China
| | - Bingjie Xu
- MOE Key Laboratory of Advanced Textile Materials & Manufacturing Technology Zhejiang Sci‐Tech University Hangzhou China
| | - Dan Yu
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China
| | - Dongming Qi
- MOE Key Laboratory of Advanced Textile Materials & Manufacturing Technology Zhejiang Sci‐Tech University Hangzhou China
- Zhejiang Provincial Engineering Research Center for Green and Low‐carbon Dyeing & Finishing Zhejiang Sci‐Tech University Hangzhou China
| | - Jindan Wu
- MOE Key Laboratory of Advanced Textile Materials & Manufacturing Technology Zhejiang Sci‐Tech University Hangzhou China
- Zhejiang Provincial Engineering Research Center for Green and Low‐carbon Dyeing & Finishing Zhejiang Sci‐Tech University Hangzhou China
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16
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Flores AI, Pipino C, Jerman UD, Liarte S, Gindraux F, Kreft ME, Nicolas FJ, Pandolfi A, Tratnjek L, Giebel B, Pozzobon M, Silini AR, Parolini O, Eissner G, Lang-Olip I. Perinatal derivatives: How to best characterize their multimodal functions in vitro. Part C: Inflammation, angiogenesis, and wound healing. Front Bioeng Biotechnol 2022; 10:965006. [PMID: 35992360 PMCID: PMC9386263 DOI: 10.3389/fbioe.2022.965006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
Perinatal derivatives (PnD) are birth-associated tissues, such as placenta, umbilical cord, amniotic and chorionic membrane, and thereof-derived cells as well as secretomes. PnD play an increasing therapeutic role with beneficial effects on the treatment of various diseases. The aim of this review is to elucidate the modes of action of non-hematopoietic PnD on inflammation, angiogenesis and wound healing. We describe the source and type of PnD with a special focus on their effects on inflammation and immune response, on vascular function as well as on cutaneous and oral wound healing, which is a complex process that comprises hemostasis, inflammation, proliferation (including epithelialization, angiogenesis), and remodeling. We further evaluate the different in vitro assays currently used for assessing selected functional and therapeutic PnD properties. This review is a joint effort from the COST SPRINT Action (CA17116) with the intention to promote PnD into the clinics. It is part of a quadrinomial series on functional assays for validation of PnD, spanning biological functions, such as immunomodulation, anti-microbial/anti-cancer activities, anti-inflammation, wound healing, angiogenesis, and regeneration.
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Affiliation(s)
- Ana I. Flores
- Regenerative Medicine Group, Research Institute Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Caterina Pipino
- Center for Advanced Studies and Technology (CAST), Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio Chieti-Pescara, StemTech Group, Chieti, Italy
| | - Urška Dragin Jerman
- University of Ljubljana, Faculty of Medicine, Institute of Cell Biology, Ljubljana, Slovenia
| | - Sergio Liarte
- Laboratorio de Regeneración, Oncología Molecular y TGF-β, IMIB-Arrixaca, Murcia, Spain
- *Correspondence: Günther Eissner, ; Sergio Liarte,
| | - Florelle Gindraux
- Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 466, Université Bourgogne Franche-Comté, Besançon, France
| | - Mateja Erdani Kreft
- University of Ljubljana, Faculty of Medicine, Institute of Cell Biology, Ljubljana, Slovenia
| | - Francisco J. Nicolas
- Laboratorio de Regeneración, Oncología Molecular y TGF-β, IMIB-Arrixaca, Murcia, Spain
| | - Assunta Pandolfi
- Center for Advanced Studies and Technology (CAST), Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio Chieti-Pescara, StemTech Group, Chieti, Italy
| | - Larisa Tratnjek
- University of Ljubljana, Faculty of Medicine, Institute of Cell Biology, Ljubljana, Slovenia
| | - Bernd Giebel
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Michela Pozzobon
- Department of Women’s and Children’s Health, University of Padova, Padova, Italy and Foundation Institute of Pediatric Research Fondazione Città Della Speranza, Padova, Italy
| | | | - Ornella Parolini
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Günther Eissner
- Systems Biology Ireland, School of Medicine, Conway Institute, University College Dublin, Dublin, Ireland
- *Correspondence: Günther Eissner, ; Sergio Liarte,
| | - Ingrid Lang-Olip
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
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17
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Ding Y, Wang ZY, Ren ZW, Zhang XW, Wei D. Advances in Modified Hyaluronic Acid-Based Hydrogels for Skin Wound Healing. Biomater Sci 2022; 10:3393-3409. [DOI: 10.1039/d2bm00397j] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Hyaluronic acid (HA) is a natural linear anionic polysaccharide with many unique characteristics such as excellent biocompatibility and biodegradability, native biofunctionality, hydrophilicity, and non-immunoreactivity. HA plays crucial roles in numerous...
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18
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Pichlsberger M, Jerman UD, Obradović H, Tratnjek L, Macedo AS, Mendes F, Fonte P, Hoegler A, Sundl M, Fuchs J, Schoeberlein A, Kreft ME, Mojsilović S, Lang-Olip I. Systematic Review of the Application of Perinatal Derivatives in Animal Models on Cutaneous Wound Healing. Front Bioeng Biotechnol 2021; 9:742858. [PMID: 34631683 PMCID: PMC8498585 DOI: 10.3389/fbioe.2021.742858] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/06/2021] [Indexed: 12/21/2022] Open
Abstract
Knowledge of the beneficial effects of perinatal derivatives (PnD) in wound healing goes back to the early 1900s when the human fetal amniotic membrane served as a biological dressing to treat burns and skin ulcerations. Since the twenty-first century, isolated cells from perinatal tissues and their secretomes have gained increasing scientific interest, as they can be obtained non-invasively, have anti-inflammatory, anti-cancer, and anti-fibrotic characteristics, and are immunologically tolerated in vivo. Many studies that apply PnD in pre-clinical cutaneous wound healing models show large variations in the choice of the animal species (e.g., large animals, rodents), the choice of diabetic or non-diabetic animals, the type of injury (full-thickness wounds, burns, radiation-induced wounds, skin flaps), the source and type of PnD (placenta, umbilical cord, fetal membranes, cells, secretomes, tissue extracts), the method of administration (topical application, intradermal/subcutaneous injection, intravenous or intraperitoneal injection, subcutaneous implantation), and the type of delivery systems (e.g., hydrogels, synthetic or natural biomaterials as carriers for transplanted cells, extracts or secretomes). This review provides a comprehensive and integrative overview of the application of PnD in wound healing to assess its efficacy in preclinical animal models. We highlight the advantages and limitations of the most commonly used animal models and evaluate the impact of the type of PnD, the route of administration, and the dose of cells/secretome application in correlation with the wound healing outcome. This review is a collaborative effort from the COST SPRINT Action (CA17116), which broadly aims at approaching consensus for different aspects of PnD research, such as providing inputs for future standards for the preclinical application of PnD in wound healing.
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Affiliation(s)
- Melanie Pichlsberger
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Urška Dragin Jerman
- Institute of Cell Biology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Hristina Obradović
- Group for Hematology and Stem Cells, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Larisa Tratnjek
- Institute of Cell Biology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ana Sofia Macedo
- LAQV, REQUIMTE, Department of Chemical Sciences-Applied Chemistry Lab, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Francisca Mendes
- iBB-Institute for Bioengineering and Biosciences, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal.,Associate Laboratory i4HB-Institute for Health and Bioeconomy at Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - Pedro Fonte
- iBB-Institute for Bioengineering and Biosciences, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal.,Associate Laboratory i4HB-Institute for Health and Bioeconomy at Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal.,Center for Marine Sciences (CCMar), Faculty of Sciences and Technology, University of Algarve, Faro, Portugal.,Department of Chemistry and Pharmacy, Faculty of Sciences and Technology, University of Algarve, Faro, Portugal
| | - Anja Hoegler
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Monika Sundl
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Julia Fuchs
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Andreina Schoeberlein
- Department of Obstetrics and Feto-maternal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Mateja Erdani Kreft
- Institute of Cell Biology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Slavko Mojsilović
- Group for Hematology and Stem Cells, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Ingrid Lang-Olip
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
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19
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Extracellular matrix and cellular senescence in venous leg ulcers. Sci Rep 2021; 11:20168. [PMID: 34635751 PMCID: PMC8505655 DOI: 10.1038/s41598-021-99643-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
High prevalence of non-healing chronic wounds contributes to a huge healthcare burden across the world. Early treatment interventions for non-healing wounds are vital. It was previously shown that accumulation of 15% or more of senescent cells in a chronic wound edge is an indicator that the wound is unlikely to heal. However, determining the presence of senescent cells would require invasive procedures such as tissue biopsies to be taken. In this study, we found a strong correlation between decreased collagen area and presence of senescent cells in human chronic wounds i.e. venous leg ulcer (VLU), diabetic foot ulcer (DFU) and pressure ulcer (PRU). We also report that the lowest collagen levels were found in VLU patients less than 60 years of age, with a persistent wound of > 24 months. Elevated levels of senescent cells were also found in VLU of males. Second harmonic imaging of collagen at the edge of chronic wounds with a handheld multiphoton device could be used to predict the number of senescent cells, indicating if the wound is on a healing trajectory or not. Our data support the use of collagen imaging in cutaneous wound assessment for a faster and non-invasive method to predict cellular senescence and determining wound trajectory of healing.
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20
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Zeng QL, Liu DW. Mesenchymal stem cell-derived exosomes: An emerging therapeutic strategy for normal and chronic wound healing. World J Clin Cases 2021; 9:6218-6233. [PMID: 34434989 PMCID: PMC8362559 DOI: 10.12998/wjcc.v9.i22.6218] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/08/2021] [Accepted: 06/22/2021] [Indexed: 02/06/2023] Open
Abstract
Skin wound healing is a complex biological process. Mesenchymal stem cells (MSCs) play an important role in skin wound repair due to their multidirectional differentiation potential, hematopoietic support, promotion of stem cell implantation, self-replication, and immune regulation. Exosomes are vesicles with diameters of 40-100 nm that contain nucleic acids, proteins, and lipids and often act as mediators of cell-to-cell communication. Currently, many clinical scientists have carried out cell-free therapy for skin wounds, especially chronic wounds, using exosomes derived from MSCs. This review focuses on the latest research progress on the mechanisms of action associated with the treatment of wound healing with exosomes derived from different MSCs, the latest research progress on the combination of exosomes and other biological or nonbiological factors for the treatment of chronic skin wounds, and the new prospects and development goals of cell-free therapy.
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Affiliation(s)
- Qin-Lu Zeng
- Burns Institute, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
- First Clinical Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - De-Wu Liu
- Burns Institute, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
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21
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Panda DS, Eid HM, Elkomy MH, Khames A, Hassan RM, Abo El-Ela FI, Yassin HA. Berberine Encapsulated Lecithin-Chitosan Nanoparticles as Innovative Wound Healing Agent in Type II Diabetes. Pharmaceutics 2021; 13:pharmaceutics13081197. [PMID: 34452159 PMCID: PMC8401853 DOI: 10.3390/pharmaceutics13081197] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/27/2021] [Accepted: 07/30/2021] [Indexed: 01/29/2023] Open
Abstract
The aim of this research is to formulate a lecithin–chitosan based nanoparticulate system loaded with berberine (BER-LC-CTS-NPs) that could be integrated into a topically applied formulation and assessed for healing wounds in a diabetic animal model. In order to formulate BER-LC-CTS-NPs, soybean lecithin, isopropyl myristate, and berberine dispersed in ethanolic solution were added into an aqueous solution of chitosan dropwise with sonication. We assessed the influence of lecithin amount, chitosan amount, and isopropyl myristate concentration on particle diameter, zeta potential, and entrapment and employed a Box–Behnken statistical design. The resulting optimized BER-LC-CTS-NPs had a mean size of 168.4 nm, a surface charge of 33.1 mV, and entrapment of 82.3%. The optimized BER-LC-CTS-NPs showed a sustained in vitro release profile. Furthermore, the potential of the optimized BER-LC-CTS-NPs integrated into a topical gel formulation for wound healing in streptozocin-induced diabetic rats was assessed. Our findings show that combining chitosan and berberine in the nanoparticles produces a synergistic effect when it comes to wound healing. The optimized nanoparticulate system works by reducing inflammation, inducing blood vessels and fibroblast proliferation, and promoting mature collagen fibers deposition. Based on the experimental results, lecithin–chitosan nanoparticles loaded with berberine have evolved as a promising strategy for accelerating wound the healing process in diabetic patients. However, the clinical merits of the developed system need to be investigated in diabetic patients.
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Affiliation(s)
- Dibya Sundar Panda
- Department of Pharmaceutics, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Hussein M. Eid
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62511, Egypt;
| | - Mohammed H. Elkomy
- Department of Pharmaceutics, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia;
- Correspondence: ; Tel.: +966-560967705
| | - Ahmed Khames
- Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Randa M. Hassan
- Department of Cytology and Histology, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef 62511, Egypt;
| | - Fatma I. Abo El-Ela
- Department of Pharmacology, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef 62511, Egypt;
| | - Heba A. Yassin
- Pharmaceutics Department, Faculty of Pharmacy, AlSalam University, Tanta 31527, Egypt;
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22
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Tombulturk FK, Kanigur-Sultuybek G. A molecular approach to maggot debridement therapy with Lucilia sericata and its excretions/secretions in wound healing. Wound Repair Regen 2021; 29:1051-1061. [PMID: 34343386 DOI: 10.1111/wrr.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 06/15/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
Chronic wounds caused by underlying physiological causes such as diabetic wounds, pressure ulcers, venous leg ulcers and infected wounds affect a significant portion of the population. In order to treat chronic wounds, a strong debridement, removal of necrotic tissue, elimination of infection and stimulation of granulation tissue are required. Maggot debridement therapy (MDT), which is an alternative treatment method based on history, has been used quite widely. MDT is an efficient, simple, cost-effective and reliable biosurgery method using mostly larvae of Lucilia sericata fly species. Larvae can both physically remove necrotic tissue from the wound site and stimulate wound healing by activating molecular processes in the wound area through the enzymes they secrete. The larvae can stimulate wound healing by activating molecular processes in the wound area through enzymes in their excretions/secretions (ES). Studies have shown that ES has antibacterial, antifungal, anti-inflammatory, angiogenic, proliferative, hemostatic and tissue-regenerating effects both in vivo and in vitro. It is suggested that these effects stimulate wound healing and accelerate wound healing by initiating a direct signal cascade with cells in the wound area. However, the enzymes and peptides in ES are mostly still undefined. Examining the molecular content of ES and the biological effects of these ingredients is quite important to illuminate the molecular mechanism underlying MDT. More importantly, ES has the potential to have positive effects on wound healing and to be used more as a therapeutic agent in the future, so it can be applied as an alternative to MDT in wound healing.
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Affiliation(s)
- Fatma Kubra Tombulturk
- Medical Laboratory Techniques, Vocational School of Health Services, Istinye University, Istanbul, Turkey
| | - Gonul Kanigur-Sultuybek
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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23
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Banerjee K, Chatterjee M, Sandur V R, Nachimuthu R, Madhyastha H, Thiagarajan P. Azadirachta indica A. Juss (Neem) oil topical formulation with liquid crystals ensconcing depot water for anti-inflammatory, wound healing and anti-methicillin resistant Staphylococcus aureus activities. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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24
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Yang L, Yang Y, Chen H, Mei L, Zeng X. Polymeric microneedle‐mediated sustained release systems: Design strategies and promising applications for drug delivery. Asian J Pharm Sci 2021; 17:70-86. [PMID: 35261645 PMCID: PMC8888142 DOI: 10.1016/j.ajps.2021.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 04/24/2021] [Accepted: 07/03/2021] [Indexed: 12/24/2022] Open
Abstract
Parenteral sustained release drug formulations, acting as preferable platforms for long-term exposure therapy, have been wildly used in clinical practice. However, most of these delivery systems must be given by hypodermic injection. Therefore, issues including needle-phobic, needle-stick injuries and inappropriate reuse of needles would hamper the further applications of these delivery platforms. Microneedles (MNs) as a potential alternative system for hypodermic needles can benefit from minimally invasive and self-administration. Recently, polymeric microneedle-mediated sustained release systems (MN@SRS) have opened up a new way for treatment of many diseases. Here, we reviewed the recent researches in MN@SRS for transdermal delivery, and summed up its typical design strategies and applications in various diseases therapy, particularly focusing on the applications in contraception, infection, cancer, diabetes, and subcutaneous disease. An overview of the present clinical translation difficulties and future outlook of MN@SRS was also provided.
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Villalba-Rodríguez AM, Martínez-González S, Sosa-Hernández JE, Parra-Saldívar R, Bilal M, Iqbal HMN. Nanoclay/Polymer-Based Hydrogels and Enzyme-Loaded Nanostructures for Wound Healing Applications. Gels 2021; 7:59. [PMID: 34068868 PMCID: PMC8162325 DOI: 10.3390/gels7020059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 02/05/2023] Open
Abstract
Multi-polymeric nanocomposite hydrogels with multi-functional characteristics have been engineered with high interest around the globe. The ease in fine tunability with maintained compliance makes an array of nanocomposite biomaterials outstanding candidates for the biomedical sector of the modern world. In this context, the present work intends to tackle the necessity of alternatives for the treatment of diabetic foot ulcers through the formulation of nanoclay and/or polymer-based nanocomposite hydrogels. Laponite RD, a synthetic 2-D nanoclay that becomes inert when in a physiological environment, while mixed with water, becomes a clear gel with interesting shear-thinning properties. Adding Laponite RD to chitosan or gelatin allows for the modification of the mechanical properties of such materials. The setup explored in this research allows for a promising polymeric matrix that can potentially be loaded with active compounds for antibacterial support in foot ulcers, as well as enzymes for wound debridement.
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Affiliation(s)
- Angel M. Villalba-Rodríguez
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (A.M.V.-R.); (S.M.-G.); (J.E.S.-H.); (R.P.-S.)
| | - Sara Martínez-González
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (A.M.V.-R.); (S.M.-G.); (J.E.S.-H.); (R.P.-S.)
| | - Juan Eduardo Sosa-Hernández
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (A.M.V.-R.); (S.M.-G.); (J.E.S.-H.); (R.P.-S.)
| | - Roberto Parra-Saldívar
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (A.M.V.-R.); (S.M.-G.); (J.E.S.-H.); (R.P.-S.)
| | - Muhammad Bilal
- School of Life Science and Food Engineering, Huaiyin Institute of Technology, Huaian 223003, China
| | - Hafiz M. N. Iqbal
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (A.M.V.-R.); (S.M.-G.); (J.E.S.-H.); (R.P.-S.)
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Ferreira CAM, Félix R, Félix C, Januário AP, Alves N, Novais SC, Dias JR, Lemos MFL. A Biorefinery Approach to the Biomass of the Seaweed Undaria pinnatifida (Harvey Suringar, 1873): Obtaining Phlorotannins-Enriched Extracts for Wound Healing. Biomolecules 2021; 11:461. [PMID: 33808694 PMCID: PMC8003497 DOI: 10.3390/biom11030461] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 12/27/2022] Open
Abstract
Brown seaweeds are recognized sources of compounds with a wide range of properties and applications. Within these compounds, phlorotannins are known to possess several bioactivities (e.g., antioxidant, anti-inflammatory, and antimicrobial) with potential to improve wound healing. To obtain phlorotannins enriched extracts from Undaria pinnatifida, a biorefinery was set using low-cost industry-friendly methodologies, such as sequential solid-liquid extraction and liquid-liquid extraction. The obtained extracts were screened for their antioxidant and antimicrobial activity against five common wound pathogens and for their anti-inflammatory potential. The ethanolic wash fraction (wE100) had the highest antioxidant activity (114.61 ± 10.04 mmol·mg-1 extract by Diphenyl-1-picrylhydrazyl (DPPH) and 6.56 ± 1.13 mM eq. Fe II·mg-1 extract by and Ferric Reducing Antioxidant Power (FRAP)), acting efficiently against Gram-negative (Pseudomonas aeruginosa) and Gram-positive (Staphylococcus aureus) bacteria, and showing a nitric oxide production inhibition over 47% when used at 0.01 µg·mL-1. NMR and FTIR chemical characterization suggested that phlorotannins are present. Obtained fraction wE100 proved to be a promising candidate for further inclusion as wound healing agents, while the remaining fractions analyzed are potential sources for other biotechnological applications, giving emphasis to a biorefinery and circular economy framework to add value to this seaweed and the industry.
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Affiliation(s)
- Carolina A. M. Ferreira
- MARE—Marine and Environmental Sciences Centre, ESTM, Politécnico de Leiria, 2050-641 Peniche, Portugal; (C.A.M.F.); (R.F.); (C.F.); (A.P.J.); (S.C.N.)
- CDRSP—Centre for Rapid and Sustainable Product Development, Politécnico de Leiria, 2030-028 Marinha Grande, Portugal; (N.A.); (J.R.D.)
| | - Rafael Félix
- MARE—Marine and Environmental Sciences Centre, ESTM, Politécnico de Leiria, 2050-641 Peniche, Portugal; (C.A.M.F.); (R.F.); (C.F.); (A.P.J.); (S.C.N.)
| | - Carina Félix
- MARE—Marine and Environmental Sciences Centre, ESTM, Politécnico de Leiria, 2050-641 Peniche, Portugal; (C.A.M.F.); (R.F.); (C.F.); (A.P.J.); (S.C.N.)
| | - Adriana P. Januário
- MARE—Marine and Environmental Sciences Centre, ESTM, Politécnico de Leiria, 2050-641 Peniche, Portugal; (C.A.M.F.); (R.F.); (C.F.); (A.P.J.); (S.C.N.)
| | - Nuno Alves
- CDRSP—Centre for Rapid and Sustainable Product Development, Politécnico de Leiria, 2030-028 Marinha Grande, Portugal; (N.A.); (J.R.D.)
| | - Sara C. Novais
- MARE—Marine and Environmental Sciences Centre, ESTM, Politécnico de Leiria, 2050-641 Peniche, Portugal; (C.A.M.F.); (R.F.); (C.F.); (A.P.J.); (S.C.N.)
| | - Juliana R. Dias
- CDRSP—Centre for Rapid and Sustainable Product Development, Politécnico de Leiria, 2030-028 Marinha Grande, Portugal; (N.A.); (J.R.D.)
| | - Marco F. L. Lemos
- MARE—Marine and Environmental Sciences Centre, ESTM, Politécnico de Leiria, 2050-641 Peniche, Portugal; (C.A.M.F.); (R.F.); (C.F.); (A.P.J.); (S.C.N.)
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Guan H, Dong W, Lu Y, Jiang M, Zhang D, Aobuliaximu Y, Dong J, Niu Y, Liu Y, Guan B, Tang J, Lu S. Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in China. Front Med (Lausanne) 2021; 8:609584. [PMID: 33816517 PMCID: PMC8010674 DOI: 10.3389/fmed.2021.609584] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/22/2021] [Indexed: 12/17/2022] Open
Abstract
Background: To determine the distribution and antimicrobial susceptibility pattern of pathogenic bacteria in patients with chronic cutaneous wounds on a national scale. Methods: A retrospective study was conducted using the data recorded between January 1, 2018 and January1, 2020 in 195 hospitals across China. After screening the data, 815 patients with chronic wounds were finally analyzed. The data collected included information about the patients' general condition and local cutaneous wound assessments, especially microbial culture and antibiotic susceptibility tests. The analyses were performed using SPSS Version 26. Results: The study included 815 patients (290 [35.6%] females; 63 [50-74] years). The most common causes of chronic cutaneous wounds were diabetes (183, 22.5%), infection (178, 21.8%), and pressure (140, 17.2%). Among these, 521(63.9%) samples tested yielded microbial growth, including 70 (13.4%) polymicrobial infection and 451 (86.6%) monomicrobial infection. The positive rate of microbial culture was highest in wound tissue of ulcers caused by infection (87.6%), followed by pressure (77.1%), diabetes (68.3%), and venous diseases (67.7%). Bates-Jensen wound assessment tool (BWAT) scores >25 and wounds that lasted for more than 3 months had a higher positive rate of microbial culture. BWAT scores >25 and wounds in the rump, perineum, and feet were more likely to exhibit polymicrobial infection. A total of 600 strains were isolated, of which 46.2% (277 strains) were Gram-positive bacteria, 51.3% (308 strains) were Gram-negative bacteria, and 2.5% (15 strains) were fungi. The most common bacterial isolates were Staphylococcus aureus (29.2%), Escherichia coli (11.5%), Pseudomonas aeruginosa (11.0%), Proteus mirabilis (8.0%), and Klebsiella pneumoniae (5.8%). The susceptibility tests showed that 116 cultured bacteria were Multidrug resistant (MDR) strains. The resistance rates of S. aureus were 92.0% (161/175) to penicillin, 58.3% (102/175) to erythromycin, and 50.9% (89/175) to clindamycin. Vancomycin was the most effective antibiotic (0% resistance rate) against all Gram-positive bacteria. Besides, the resistance rates of E. coli were 68.1% (47/69) to ampicillin, 68.1% (47/69) to ciprofloxacin, 60.9% (42/69) to levofloxacin. However, all the isolated Gram-negative bacteria showed low resistance rates to tigecycline (3.9%) and amikacin (3.6%). Conclusions: The distribution of bacteria isolated from chronic cutaneous wounds varies with the BWAT scores, causes, duration, and the location of wounds. Multidrug resistance is a serious health issue, and therefore antibiotics used in chronic wounds must be under strict regulation. Our findings may help clinicians in making informed decisions regarding antibiotic therapy.
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Affiliation(s)
- Haonan Guan
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Wei Dong
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yechen Lu
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Minfei Jiang
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Di Zhang
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yakupu Aobuliaximu
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jiaoyun Dong
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yiwen Niu
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yingkai Liu
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Bingjie Guan
- Department of General Surgery, School of Medicine, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jiajun Tang
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Shuliang Lu
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
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Wu BC, Haney EF, Akhoundsadegh N, Pletzer D, Trimble MJ, Adriaans AE, Nibbering PH, Hancock REW. Human organoid biofilm model for assessing antibiofilm activity of novel agents. NPJ Biofilms Microbiomes 2021; 7:8. [PMID: 33495449 PMCID: PMC7835231 DOI: 10.1038/s41522-020-00182-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/11/2020] [Indexed: 02/08/2023] Open
Abstract
Bacterial biofilms cause 65% of all human infections and are highly resistant to antibiotic therapy but lack specific treatments. To provide a human organoid model for studying host-microbe interplay and enabling screening for novel antibiofilm agents, a human epidermis organoid model with robust methicillin-resistant Staphylococcus aureus (MRSA) USA300 and Pseudomonas aeruginosa PAO1 biofilm was developed. Treatment of 1-day and 3-day MRSA and PAO1 biofilms with antibiofilm peptide DJK-5 significantly and substantially reduced the bacterial burden. This model enabled the screening of synthetic host defense peptides, revealing their superior antibiofilm activity against MRSA compared to the antibiotic mupirocin. The model was extended to evaluate thermally wounded skin infected with MRSA biofilms resulting in increased bacterial load, cytotoxicity, and pro-inflammatory cytokine levels that were all reduced upon treatment with DJK-5. Combination treatment of DJK-5 with an anti-inflammatory peptide, 1002, further reduced cytotoxicity and skin inflammation.
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Affiliation(s)
- Bing Catherine Wu
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Evan F Haney
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Noushin Akhoundsadegh
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Daniel Pletzer
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
- Department of Microbiology and Immunology, University of Otago, Dunedin, Otago, New Zealand
| | - Michael J Trimble
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Alwin E Adriaans
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter H Nibbering
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert E W Hancock
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada.
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Barnum L, Samandari M, Schmidt TA, Tamayol A. Microneedle arrays for the treatment of chronic wounds. Expert Opin Drug Deliv 2020; 17:1767-1780. [PMID: 32882162 PMCID: PMC7722049 DOI: 10.1080/17425247.2020.1819787] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/02/2020] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Chronic wounds are seen frequently in diabetic and bedbound patients. Such skin injuries, which do not heal in a timely fashion, can lead to life-threatening conditions. In an effort to resolve the burdens of chronic wounds, numerous investigations have explored the efficacy of various therapeutics on wound healing. Therapeutics can be topically delivered to cutaneous wounds to reduce the complications associated with systemic drug delivery because the compromised skin barrier is not expected to negatively affect drug distribution. However, researchers have recently demonstrated that the complex environment of chronic wounds could lower the localized availability of the applied therapeutics. Microneedle arrays (MNAs) can be exploited to enhance delivery efficiency and consequently improved healing. AREAS COVERED In this review, we briefly describe the pathophysiology of chronic wounds and current treatment strategies. We further introduce methods and materials commonly used for the fabrication of MNAs. Subsequently, the studies demonstrating the benefits of MNAs in wound care are highlighted. EXPERT OPINION Microneedles have great potential to treat the complicated pathophysiology of chronic wounds. Challenges that will need to be addressed include development of a robust chronic wound model and MNAs that combine complex functionality with simplicity of use.
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Affiliation(s)
- Lindsay Barnum
- Department of Biomedical Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
| | - Mohamadmahdi Samandari
- Department of Biomedical Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
| | - Tannin A. Schmidt
- Department of Biomedical Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
| | - Ali Tamayol
- Department of Biomedical Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Mechanical and Materials Engineering, University of Nebraska, Lincoln, NE, 68588, USA
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Las Heras K, Igartua M, Santos-Vizcaino E, Hernandez RM. Chronic wounds: Current status, available strategies and emerging therapeutic solutions. J Control Release 2020; 328:532-550. [DOI: 10.1016/j.jconrel.2020.09.039] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 02/07/2023]
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Peck CT, Strauß S, Stahl GL, Vogt PM, Busche MN. Mannose-binding lectin (MBL) and the lectin complement pathway play a role in cutaneous ischemia and reperfusion injury. Innov Surg Sci 2020; 5:43-51. [PMID: 33506093 PMCID: PMC7798300 DOI: 10.1515/iss-2020-0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/08/2020] [Indexed: 11/15/2022] Open
Abstract
Objectives Cutaneous ischemia/reperfusion (CI/R) injury has shown to play a significant role in chronic wounds such as decubitus ulcers, diabetic foot ulcers, atherosclerotic lesions, and venous stasis wounds. CI/R also plays a role in free tissue transfer in reconstructive microsurgery and has been linked to clinical burn-depth progression after thermal injury. While the role of the complement system has been elucidated in multiple organ systems, evidence is lacking with respect to its role in the skin. Therefore, we evaluated the role of the complement system in CI/R injury. Methods Using a single pedicle skin flap mouse model of acute CI/R, we performed CI/R in wild-type (WT) mice and complement knock out (KO) mice, deficient in either C1q (C1q KO; classical pathway inhibition), mannose-binding lectin (MBL null; lectin pathway inhibition) or factor B (H2Bf KO; alternative pathway inhibition). Following 10 h ischemia and 7 days reperfusion, mice were sacrificed, flaps harvested and flap viability assessed via Image J software. The flap necrotic area was expressed as % total flap area. In another group, mice were sacrificed following CI/R with 10 h ischemia and 48 h reperfusion. Two cranial skin flap samples were taken for gene expression analysis of IL1b, IL6, TNFα, ICAM1, VCAM1, IL10, IL13 using real-time polymerase chain reaction (RT-PCR). Results Following CI/R, MBL null mice had a statistically significant smaller %necrotic flap area compared to WT mice (10.6 vs. 43.1%; p<0.05) suggesting protection from CI/R. A significantly reduced mean %necrotic flap area was not seen in either C1q KO or H2Bf KO mice relative to WT (22.9 and 31.3 vs. 43.1%; p=0.08 and p=0.244, respectively). There were no statistically significant differences between groups for markers of inflammation (TNFα, ICAM1, VCAM1, IL1b, IL6). In contrast, mRNA levels of IL10, a regulator of inflammation, were significantly increased in the MBL null group (p=0.047). Conclusions We demonstrated for the first time a significant role of MBL and the lectin complement pathway in ischemia/reperfusion injury of the skin and a potential role for IL10 in attenuating CI/R injury, as IL10 levels were significantly increased in the tissue from the CI/R-protected MBL null group.
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Affiliation(s)
- Claas-Tido Peck
- Hannover Medical School, Department of Plastic, Aesthetic, Hand, and Reconstructive Surgery, Hannover, Germany
| | - Sarah Strauß
- Hannover Medical School, Department of Plastic, Aesthetic, Hand, and Reconstructive Surgery, Hannover, Germany
| | - Gregory L Stahl
- Harvard Medical School, Center for Experimental Therapeutics and Reperfusion Injury, Brigham and Women's Hospital, Boston, MA, USA
| | - Peter-Maria Vogt
- Hannover Medical School, Department of Plastic, Aesthetic, Hand, and Reconstructive Surgery, Hannover, Germany
| | - Marc N Busche
- Hannover Medical School, Department of Plastic, Aesthetic, Hand, and Reconstructive Surgery, Hannover, Germany.,Leverkusen Hospital gGmbH, Department of Plastic and Aesthetic Surgery, Burn Surgery, Leverkusen, Germany
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Skin Wound Healing Process and New Emerging Technologies for Skin Wound Care and Regeneration. Pharmaceutics 2020; 12:pharmaceutics12080735. [PMID: 32764269 PMCID: PMC7463929 DOI: 10.3390/pharmaceutics12080735] [Citation(s) in RCA: 463] [Impact Index Per Article: 115.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/23/2020] [Accepted: 07/31/2020] [Indexed: 12/14/2022] Open
Abstract
Skin wound healing shows an extraordinary cellular function mechanism, unique in nature and involving the interaction of several cells, growth factors and cytokines. Physiological wound healing restores tissue integrity, but in many cases the process is limited to wound repair. Ongoing studies aim to obtain more effective wound therapies with the intention of reducing inpatient costs, providing long-term relief and effective scar healing. The main goal of this comprehensive review is to focus on the progress in wound medication and how it has evolved over the years. The main complications related to the healing process and the clinical management of chronic wounds are described in the review. Moreover, advanced treatment strategies for skin regeneration and experimental techniques for cellular engineering and skin tissue engineering are addressed. Emerging skin regeneration techniques involving scaffolds activated with growth factors, bioactive molecules and genetically modified cells are exploited to overcome wound healing technology limitations and to implement personalized therapy design.
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Mirzadegan E, Golshahi H, Kazemnejad S. Current evidence on immunological and regenerative effects of menstrual blood stem cells seeded on scaffold consisting of amniotic membrane and silk fibroin in chronic wound. Int Immunopharmacol 2020; 85:106595. [DOI: 10.1016/j.intimp.2020.106595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/03/2020] [Accepted: 05/08/2020] [Indexed: 12/13/2022]
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Miller C, Gilmore J. Detection of Quorum-Sensing Molecules for Pathogenic Molecules Using Cell-Based and Cell-Free Biosensors. Antibiotics (Basel) 2020; 9:antibiotics9050259. [PMID: 32429345 PMCID: PMC7277912 DOI: 10.3390/antibiotics9050259] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/18/2022] Open
Abstract
Since the discovery and subsequent use of penicillin, antibiotics have been used to treat most bacterial infections in the U.S. Over time, the repeated prescription of many antibiotics has given rise to many antibiotic-resistant microbes. A bacterial strain becomes resistant by horizontal gene transfer, where surviving microbes acquire genetic material or DNA fragments from adjacent bacteria that encode for resistance. In order to avoid significant bacterial resistance, novel and target therapeutics are needed. Further advancement of diagnostic technologies could be used to develop novel treatment strategies. The use of biosensors to detect quorum-sensing signaling molecules has the potential to provide timely diagnostic information toward mitigating the multidrug-resistant bacteria epidemic. Resistance and pathogenesis are controlled by quorum-sensing (QS) circuits. QS systems secrete or passively release signaling molecules when the bacterial concentration reaches a certain threshold. Signaling molecules give an early indication of virulence. Detection of these compounds in vitro or in vivo can be used to identify the onset of infection. Whole-cell and cell-free biosensors have been developed to detect quorum-sensing signaling molecules. This review will give an overview of quorum networks in the most common pathogens found in chronic and acute infections. Additionally, the current state of research surrounding the detection of quorum-sensing molecules will be reviewed. Followed by a discussion of future works toward the advancement of technologies to quantify quorum signaling molecules in chronic and acute infections.
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Sh. Ahmed A, Taher M, Mandal UK, Jaffri JM, Susanti D, Mahmood S, Zakaria ZA. Pharmacological properties of Centella asiatica hydrogel in accelerating wound healing in rabbits. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:213. [PMID: 31412845 PMCID: PMC6693193 DOI: 10.1186/s12906-019-2625-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/31/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Various extracts of Centella asiatica (Apiaceae) and its active constituent, asiaticoside, have been reported to possess wound healing property when assessed using various in vivo and in vitro models. In an attempt to develop a formulation with accelerated wound healing effect, the present study was performed to examine in vivo efficacy of asiaticoside-rich hydrogel formulation in rabbits. METHODS Asiaticoside-rich fraction was prepared from C. asiatica aerial part and then incorporated into polyvinyl alcohol/polyethylene glycol (PVA/PEG) hydrogel. The hydrogel was subjected to wound healing investigation using the in vivo incision model. RESULTS The results obtained demonstrated that: i) the hydrogel formulation did not cause any signs of irritation on the rabbits' skin and; ii) enhanced wound healing 15% faster than the commercial cream and > 40% faster than the untreated wounds. The skin healing process was seen in all wounds marked by formation of a thick epithelial layer, keratin, and moderate formation of granulation tissues, fibroblasts and collagen with no fibrinoid necrosis detected. CONCLUSION The asiaticoside-rich hydrogel developed using the freeze-thaw method was effective in accelerating wound healing in rabbits.
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Affiliation(s)
- Afnan Sh. Ahmed
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, Faculty of Pharmacy, International Islamic University Malaysia Bandar Indera Mahkota, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Muhammad Taher
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, Faculty of Pharmacy, International Islamic University Malaysia Bandar Indera Mahkota, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | | | - Juliana Md Jaffri
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, Faculty of Pharmacy, International Islamic University Malaysia Bandar Indera Mahkota, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Deny Susanti
- Department of Chemistry, Kulliyyah of Science,International Islamic University Malaysia, Bandar Indera Mahkota, 25200 Kuantan, Pahang Malaysia
| | - Syed Mahmood
- Department of Pharmaceutical Engineering, Faculty of Engineering Technology, University Malaysia Pahang, Pahang, Malaysia
| | - Zainul Amiruddin Zakaria
- Laboratory of Halal Science Research, Halal Products Research Institute, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor Malaysia
- Integrative Pharmacogenomics Institute (iPROMISE), Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, Bandar Puncak Alam, Selangor Malaysia
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Es-Haghi A, Mashreghi M, Rezazade Bazaz M, Homayouni-Tabrizi M, Darroudi M. Fabrication of biopolymer based nanocomposite wound dressing: evaluation of wound healing properties and wound microbial load. IET Nanobiotechnol 2019; 11:517-522. [PMID: 28745283 DOI: 10.1049/iet-nbt.2016.0160] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The aim of this study is to introduce natural-based polymers, chitosan and starch, to design a remedial nanocomposite, comprising of cerium oxide nanoparticles and silver nanoparticles, to investigate their effects in accelerating wound healing and in wound microbial load. Cerium oxide nanoparticles synthesized in starch solution added to the colloidal dispersion of synthesized silver nanoparticles in chitosan to make a three-component nanomaterial. Mice were anaesthetized and two parallel full-thickness round wounds were excised under aseptic conditions with the help of sterile dermal biopsy punch. Furthermore, effects of silver-chitosan and silver-cerium-chitosan nanocomposite had evaluated on rate of wound closure and collagen density and on microbial load of wound in full-thickness model. Results showed that both silver chitosan and silver-cerium-chitosan had significant impact on acceleration of wound closure and collagen content and on reduction of wound microbial load in comparison with control group, which was, received no treatments. However, the silver-cerium-chitosan nanocomposite is more potent than silver-chitosan group and control group in wound closure. The wound healing effects of silver-cerium-chitosan nanocomposite are due to unique features of its three components and this nanocomposite promises impressive remedies for clinical application.
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Affiliation(s)
- Ali Es-Haghi
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
| | - Mohammad Mashreghi
- Nanotechnology Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahere Rezazade Bazaz
- Division of Biotechnology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Masoud Homayouni-Tabrizi
- Department of Biochemistry and Biophysics, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Majid Darroudi
- Nuclear Medicine Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Jiang H, Ochoa M, Waimin JF, Rahimi R, Ziaie B. A pH-regulated drug delivery dermal patch for targeting infected regions in chronic wounds. LAB ON A CHIP 2019; 19:2265-2274. [PMID: 31179468 DOI: 10.1039/c9lc00206e] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This work presents a low-cost, passive, flexible, polymeric pump for topical drug delivery which uses wound pH as a trigger for localized drug release. Its operation relies on a pH-responsive hydrogel actuator which swells when exposed to the alkaline pH of an infected wound. The pump enables slow release (<0.1 μL min-1) of aqueous anti-bacterial solution for up to 4 hours and sustains against up to 8 kPa of backpressure. Featuring a scalable layer-by-layer fabrication technique to expand the pump into a 2 × 2 array, the device can dispense 50 μl onto a 160 mm2 dermal coverage within 4 hours. Robustness tests show that when integrated within a medical adhesive, the device can be worn around the forearm and can withstand various daily activities (non-intensive) for up to 12 hours. In vitro experiments demonstrate a 58 times decrease of live P. aeruginosa after 24 hours of the pump assisted antibiotics treatment.
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Affiliation(s)
- Hongjie Jiang
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA.
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Wang W, Junior JRP, Nalesso PRL, Musson D, Cornish J, Mendonça F, Caetano GF, Bártolo P. Engineered 3D printed poly(ɛ-caprolactone)/graphene scaffolds for bone tissue engineering. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 100:759-770. [PMID: 30948113 DOI: 10.1016/j.msec.2019.03.047] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/06/2019] [Accepted: 03/13/2019] [Indexed: 12/11/2022]
Abstract
Scaffolds are important physical substrates for cell attachment, proliferation and differentiation. Multiple factors could influence the optimal design of scaffolds for a specific tissue, such as the geometry, the materials used to modulate cell proliferation and differentiation, its biodegradability and biocompatibility. The optimal design of a scaffold for a specific tissue strongly depends on both materials and manufacturing processes. Previous studies of human adipose-derived stem cells (hADSCs) seeded on poly(ε-caprolactone) (PCL)/graphene scaffolds have proved that the addition of small concentrations of graphene to PCL scaffolds improves cell proliferation. Based on such results, this paper further investigates, for the first time, both in vitro and in vivo characteristics of 3D printed PCL/graphene scaffolds. Scaffolds were evaluated from morphological, biological and short term immune response points of view. Results show that the produced scaffolds induce an acceptable level of immune response, suggesting high potential for in vivo applications. Finally, the scaffolds were used to treat a rat calvaria critical size defect with and without applying micro electrical stimulation (10 μA). Quantification of connective and new bone tissue formation and the levels of ALP, RANK, RANKL, OPG were considered. Results show that the use of scaffolds containing graphene and electrical stimulation seems to increase cell migration and cell influx, leading to new tissue formation, well-organized tissue deposition and bone remodelling.
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Affiliation(s)
- Weiguang Wang
- School of Mechanical, Aerospace and Civil Engineering, The University of Manchester, Manchester M13 9PL, UK
| | | | - Paulo Roberto Lopes Nalesso
- Graduate Program in Biomedical Sciences, Hermínio Ometto University Centre, Araras 13607339, Sao Paulo, Brazil
| | - David Musson
- Bone and Joint Research Group, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Jillian Cornish
- Bone and Joint Research Group, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Fernanda Mendonça
- Graduate Program in Biomedical Sciences, Hermínio Ometto University Centre, Araras 13607339, Sao Paulo, Brazil
| | - Guilherme Ferreira Caetano
- Graduate Program in Biomedical Sciences, Hermínio Ometto University Centre, Araras 13607339, Sao Paulo, Brazil
| | - Paulo Bártolo
- School of Mechanical, Aerospace and Civil Engineering, The University of Manchester, Manchester M13 9PL, UK.
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Silver nanoparticle impregnated chitosan-PEG hydrogel enhances wound healing in diabetes induced rabbits. Int J Pharm 2019; 559:23-36. [DOI: 10.1016/j.ijpharm.2019.01.019] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 11/21/2022]
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Larouche J, Sheoran S, Maruyama K, Martino MM. Immune Regulation of Skin Wound Healing: Mechanisms and Novel Therapeutic Targets. Adv Wound Care (New Rochelle) 2018; 7:209-231. [PMID: 29984112 PMCID: PMC6032665 DOI: 10.1089/wound.2017.0761] [Citation(s) in RCA: 301] [Impact Index Per Article: 50.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/12/2017] [Indexed: 12/17/2022] Open
Abstract
Significance: The immune system plays a central role in orchestrating the tissue healing process. Hence, controlling the immune system to promote tissue repair and regeneration is an attractive approach when designing regenerative strategies. This review discusses the pathophysiology of both acute and chronic wounds and possible strategies to control the immune system to accelerate chronic wound closure and promote skin regeneration (scar-less healing) of acute wounds. Recent Advances: Recent studies have revealed the key roles of various immune cells and immune mediators in skin repair. Thus, immune components have been targeted to promote chronic wound repair or skin regeneration and several growth factors, cytokines, and biomaterials have shown promising results in animal models. However, these novel strategies are often struggling to meet efficacy standards in clinical trials, partly due to inadequate drug delivery systems and safety concerns. Critical Issues: Excess inflammation is a major culprit in the dysregulation of normal wound healing, and further limiting inflammation effectively reduces scarring. However, current knowledge is insufficient to efficiently control inflammation and specific immune cells. This is further complicated by inadequate drug delivery methods. Future Directions: Improving our understanding of the molecular pathways through which the immune system controls the wound healing process could facilitate the design of novel regenerative therapies. Additionally, better delivery systems may make current and future therapies more effective. To promote the entry of current regenerative strategies into clinical trials, more evidence on their safety, efficacy, and cost-effectiveness is also needed.
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Affiliation(s)
- Jacqueline Larouche
- European Molecular Biology Laboratory Australia, Australian Regenerative Medicine Institute, Monash University, Victoria, Australia
| | - Sumit Sheoran
- European Molecular Biology Laboratory Australia, Australian Regenerative Medicine Institute, Monash University, Victoria, Australia
| | - Kenta Maruyama
- WPI Immunology Frontier Research Center, Osaka University, Osaka, Japan
| | - Mikaël M. Martino
- European Molecular Biology Laboratory Australia, Australian Regenerative Medicine Institute, Monash University, Victoria, Australia
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Tolouei AE, Dülger N, Ghatee R, Kennedy S. A Magnetically Responsive Biomaterial System for Flexibly Regulating the Duration between Pro- and Anti-Inflammatory Cytokine Deliveries. Adv Healthc Mater 2018; 7:e1800227. [PMID: 29663695 PMCID: PMC7256859 DOI: 10.1002/adhm.201800227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 03/16/2018] [Indexed: 01/22/2023]
Abstract
While inflammation can be problematic, it is nonetheless necessary for proper tissue regeneration. However, it remains unclear how the magnitude and duration of the inflammatory response impacts regenerative outcome. This is partially due to the difficulty in temporally regulating macrophage phenotype at wound sites. Here, a magnetically responsive biomaterial system potentially capable of temporally regulating macrophage phenotypes through sequential, on-demand cytokine deliveries is presented. This material system is designed to (i) rapidly recruit proinflammatory macrophages (M1) through initial cytokine deliveries and (ii) subsequently transition macrophages toward anti-inflammatory phenotypes (M2s) through delayed, magnetically triggered cytokine release. Here, the ability of this system to initially deliver proinflammatory cytokines (i.e., monocyte chemoattractant protein-1 and interferon gamma), recruit, and harbor an expanding macrophage population, and delay deliveries of anti-inflammatory cytokines (i.e., IL-4 and IL-10) until the application of magnetic fields from simple hand-held magnets is demonstrated. Critically, the timing and rate of these delayed deliveries can be remotely/magnetically controlled. This biomaterial system can provide a powerful tool in (i) understanding the relationship between inflammation and regenerative outcome, (ii) developing optimized cytokine delivery strategies, and (iii) clinically implementing those optimized delivery strategies with the on-demand versatility needed to alter the course of therapies in real time.
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Affiliation(s)
- Anita E Tolouei
- Department of Chemical Engineering, University of Rhode Island, Kingston, RI, 02881, USA
| | - Nihan Dülger
- Department of Chemical Engineering, University of Rhode Island, Kingston, RI, 02881, USA
| | - Rosa Ghatee
- Department of Chemical Engineering, University of Rhode Island, Kingston, RI, 02881, USA
| | - Stephen Kennedy
- Department of Chemical Engineering, University of Rhode Island, Kingston, RI, 02881, USA
- Department of Electrical, Computer and Biomedical Engineering, University of Rhode Island, Kingston, RI, 02881, USA
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Raveendran RL, Devaki SJ. Design and Development of Biogel Through Hierarchical Self-Organisation of Biomolecule for Sustainable Antibacterial Applications. ChemistrySelect 2018. [DOI: 10.1002/slct.201702674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Reshma L. Raveendran
- Chemical Sciences and Technology Division; CSIR-National Institute for Interdisciplinary Science and Technology (CSIR-NIIST); Thiruvananthapuram 695019 India
| | - Sudha J. Devaki
- Chemical Sciences and Technology Division; CSIR-National Institute for Interdisciplinary Science and Technology (CSIR-NIIST); Thiruvananthapuram 695019 India
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Xue M, Zhao R, Lin H, Jackson C. Delivery systems of current biologicals for the treatment of chronic cutaneous wounds and severe burns. Adv Drug Deliv Rev 2018; 129:219-241. [PMID: 29567398 DOI: 10.1016/j.addr.2018.03.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 02/08/2018] [Accepted: 03/13/2018] [Indexed: 12/15/2022]
Abstract
While wound therapy remains a clinical challenge in current medical practice, much effort has focused on developing biological therapeutic approaches. This paper presents a comprehensive review of delivery systems for current biologicals for the treatment of chronic wounds and severe burns. The biologicals discussed here include proteins such as growth factors and gene modifying molecules, which may be delivered to wounds free, encapsulated, or released from living systems (cells, skin grafts or skin equivalents) or biomaterials. Advances in biomaterial science and technologies have enabled the synthesis of delivery systems such as scaffolds, hydrogels and nanoparticles, designed to not only allow spatially and temporally controlled release of biologicals, but to also emulate the natural extracellular matrix microenvironment. These technologies represent an attractive field for regenerative wound therapy, by offering more personalised and effective treatments.
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Boybeyi-Turer O, Kacmaz B, Arat E, Atasoy P, Kisa U, Gunal YD, Aslan MK, Soyer T. Does penile tourniquet application alter bacterial adhesion to rat urethral cells: an in vitro study. J Pediatr Surg 2018; 53:818-824. [PMID: 28693848 DOI: 10.1016/j.jpedsurg.2017.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/18/2017] [Accepted: 06/11/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the effects of penile tourniquet (PT) application on bacterial adhesion to urothelium. METHODS Fifty-six rats were allocated into control group (CG), sham group (SG), PT group (PTG). No intervention was applied in CG. A 5mm-length urethral repair was performed in SG and PTG. In PTG, a 10-min duration of PT was applied during the procedure and the tissue oxygenation monitor was used to adjust the same degree of ischemia in all subjects. Samples were examined for wound healing parameters and tissue levels of inflammatory markers, eNOS, e-selectin, and ICAM-1antibodies. The adhesion of Escherichia coli to urothelium was investigated with in vitro adhesion assay. RESULTS Inflammation was higher and wound healing was worse in SG than CG and in PTG in comparison to CG and SG (p<0.05). The endothelial damage, as shown by eNOS expression, was significantly higher in PTG compared to CG and SG (p<0.05). The staining with ICAM-1 and e-selectin antibodies, showing increased inflammatory response to bacterial adhesion, was significantly higher in PTG compared to CG and SG (p<0.05). In vitro urethral cell proliferation was achieved only in CG and SG revealing significantly increased adhesion in SG compared to CG (p<0.05). The PT application caused endothelial corruption and prevented cell proliferation in cell culture. CONCLUSION The PT application does not improve wound healing and increases bacterial adhesion molecules in penile tissue. The in vitro assays showed that PT causes severe endothelial damage and inhibits endothelial cell proliferation.
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Affiliation(s)
- Ozlem Boybeyi-Turer
- Hacettepe University, Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey.
| | - Birgul Kacmaz
- Kirikkale University, Faculty of Medicine, Department of Clinical Microbiology and Infectious Diseases, Kirikkale, Turkey
| | - Esra Arat
- Kirikkale University, Faculty of Science, Department of Biology, Kirikkale, Turkey
| | - Pınar Atasoy
- Kirikkale University, Faculty of Medicine, Department of Pathology, Kirikkale, Turkey
| | - Ucler Kisa
- Kirikkale University, Faculty of Medicine, Department of Biochemistry, Kirikkale, Turkey
| | - Yasemin Dere Gunal
- Kirikkale University, Faculty of Medicine, Department of Pediatric Surgery, Kirikkale, Turkey
| | - Mustafa Kemal Aslan
- Kirikkale University, Faculty of Medicine, Department of Pediatric Surgery, Kirikkale, Turkey
| | - Tutku Soyer
- Hacettepe University, Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey
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Tarusha L, Paoletti S, Travan A, Marsich E. Alginate membranes loaded with hyaluronic acid and silver nanoparticles to foster tissue healing and to control bacterial contamination of non-healing wounds. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:22. [PMID: 29396683 DOI: 10.1007/s10856-018-6027-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/10/2018] [Indexed: 06/07/2023]
Abstract
Chronic non-healing wounds are a clinically important problem in terms of number of patients and costs. Wound dressings such as hydrogels, hydrocolloids, polyurethane films and foams are commonly used to manage these wounds since they tend to maintain a moist environment which is shown to accelerate re-epithelialization. The use of antibacterial compounds is important in the management of wound infections. A novel wound-dressing material based on a blended matrix of the polysaccharides alginate, hyaluronic acid and Chitlac-silver nanoparticles is here proposed and its application for wound healing is examined. The manufacturing approach to obtain membranes is based on gelling, foaming and freeze-casting of alginate, hyaluronic acid and Chitlac-silver nanoparticles mixtures using calcium ions as the cross-linking agent. Comprehensive evaluations of the morphology, swelling kinetics, permeability, mechanical characteristics, cytotoxicity, capability to inhibit metalloproteinases and of antibacterial property were conducted. Biological in vitro studies demonstrated that hyaluronic acid released by the membrane is able to stimulate the wound healing meanwhile the metal silver exploits an efficient antibacterial activity against both planktonic bacteria and biofilms. Overall, the experimental data evidence that the studied material could be used as antibacterial wound dressing for wound healing promotion.
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Affiliation(s)
- Lorena Tarusha
- Department of Life Sciences, University of Trieste, Via Licio Giorgieri 5, I-34127, Trieste, Italy
| | - Sergio Paoletti
- Department of Life Sciences, University of Trieste, Via Licio Giorgieri 5, I-34127, Trieste, Italy
| | - Andrea Travan
- Department of Life Sciences, University of Trieste, Via Licio Giorgieri 5, I-34127, Trieste, Italy
| | - Eleonora Marsich
- Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, I-34129, Trieste, Italy.
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Li Z, Wang Q, Mi W, Han M, Gao F, Niu G, Ma Y. Effects of negative-pressure wound therapy combinedwith microplasma on treating wounds of ulcer and the expression of heat shock protein 90. Exp Ther Med 2017; 13:2211-2216. [PMID: 28565829 PMCID: PMC5443267 DOI: 10.3892/etm.2017.4266] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 01/20/2017] [Indexed: 12/25/2022] Open
Abstract
The effects of negative pressure wound therapy (NPWT) combined with microplasma on treating wounds of ulcer, and blood perfusion of wound-healing of interface, angiogenesis and the expressions of heat shock protein 90 (HSP90) were explored. We selected continuously 64 patients with wounds of ulcer. The patients were divided into the conventional treatment group (just medical foam dressing and 1% silver sulfadiazine cream for dressing changes) (n=20 cases), the NPWT group (n=22 cases) and the combination group (NPWT combined with microplasma) (n=22 cases), and compared the effects. It was found that in the 7 and 14 day combination group, maturity of granulation tissues and growth degree of epithelium were significantly higher than those in other two groups, and the areas of ulcer reduced significantly, the healing rate increased significantly (P<0.05). In the 7 and 14 day combination group, blood perfusion of wounds and density of new vessels were significantly higher than the other two groups (P<0.05). In the 7 and 14 day combination group, the expression of HSP90 was significantly higher than the other two groups (P<0.05). In conclusion, NPWT combined with microplasma can improve the healing of woulds of ulcers, and it is related to the upregulated expression of HSP90.
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Affiliation(s)
- Zhihong Li
- Department of Burns Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
| | - Qihong Wang
- Department of Burns Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
| | - Wenxin Mi
- Department of Burns Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
| | - Mei Han
- Department of Burns Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
| | - Fei Gao
- Department of Burns Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
| | - Guangyan Niu
- Department of Burns Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
| | - Yindong Ma
- Department of Burns Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
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Napavichayanun S, Aramwit P. Effect of animal products and extracts on wound healing promotion in topical applications: a review. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2017; 28:703-729. [DOI: 10.1080/09205063.2017.1301772] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Supamas Napavichayanun
- Bioactive Resources for Innovative Clinical Applications Research Unit, Chulalongkorn University, Bangkok, Thailand
- Faculty of Pharmaceutical Sciences, Department of Pharmacy Practice, Chulalongkorn University, Bangkok, Thailand
| | - Pornanong Aramwit
- Bioactive Resources for Innovative Clinical Applications Research Unit, Chulalongkorn University, Bangkok, Thailand
- Faculty of Pharmaceutical Sciences, Department of Pharmacy Practice, Chulalongkorn University, Bangkok, Thailand
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48
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Langasco R, Cadeddu B, Formato M, Lepedda AJ, Cossu M, Giunchedi P, Pronzato R, Rassu G, Manconi R, Gavini E. Natural collagenic skeleton of marine sponges in pharmaceutics: Innovative biomaterial for topical drug delivery. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 70:710-720. [DOI: 10.1016/j.msec.2016.09.041] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/05/2016] [Accepted: 09/21/2016] [Indexed: 10/21/2022]
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49
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Zhao R, Liang H, Clarke E, Jackson C, Xue M. Inflammation in Chronic Wounds. Int J Mol Sci 2016; 17:ijms17122085. [PMID: 27973441 PMCID: PMC5187885 DOI: 10.3390/ijms17122085] [Citation(s) in RCA: 530] [Impact Index Per Article: 66.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/30/2016] [Accepted: 12/05/2016] [Indexed: 12/26/2022] Open
Abstract
Non-healing chronic wounds present a major biological, psychological, social, and financial burden on both individual patients and the broader health system. Pathologically extensive inflammation plays a major role in the disruption of the normal healing cascade. The causes of chronic wounds (venous, arterial, pressure, and diabetic ulcers) can be examined through a juxtaposition of normal healing and the rogue inflammatory response created by the common components within chronic wounds (ageing, hypoxia, ischaemia-reperfusion injury, and bacterial colonisation). Wound bed care through debridement, dressings, and antibiotics currently form the basic mode of treatment. Despite recent setbacks, pharmaceutical adjuncts form an interesting area of research.
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Affiliation(s)
- Ruilong Zhao
- Sutton Arthritis Research Laboratory, Kolling Institute of Medical Research, University of Sydney, NSW 2065, Australia.
| | - Helena Liang
- Sutton Arthritis Research Laboratory, Kolling Institute of Medical Research, University of Sydney, NSW 2065, Australia.
| | - Elizabeth Clarke
- Murray Maxwell Biomechanics Laboratory, Kolling Institute of Medical Research, University of Sydney, NSW 2065, Australia.
| | - Christopher Jackson
- Sutton Arthritis Research Laboratory, Kolling Institute of Medical Research, University of Sydney, NSW 2065, Australia.
| | - Meilang Xue
- Sutton Arthritis Research Laboratory, Kolling Institute of Medical Research, University of Sydney, NSW 2065, Australia.
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Synthesis of silver nanoparticles using aqueous extracts of Heterotheca inuloides as reducing agent and natural fibers as templates: Agave lechuguilla and silk. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 69:429-36. [DOI: 10.1016/j.msec.2016.06.066] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/24/2016] [Accepted: 06/22/2016] [Indexed: 11/19/2022]
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