Bacteria-Activated Dual pH- and Temperature-Responsive Hydrogel for Targeted Elimination of Infection and Improved Wound Healing

"Monitor-and-treat" that integrates bacterio-therapeutics and bio-optics for infected wound management

Wound infections are one of the major threats to human health, accounting for millions of deaths annually. Real-time monitoring, accurate diagnosis, and on-demand therapy are crucial to minimizing complications and saving lives. Herein, we propose a "monitor-and-treat" strategy for infected wound management by integrating the emerging development of bacterio-therapeutics and bio-optics. The upper layer consists of gelatin methacryloyl (GelMA)-collagen III methacryloyl (Col3MA) (GC), Reuterin (Reu) isolated from the probiotic Lactobacillus reuteri (L. reuteri) and microfluidic safflower polysaccharide (SPS)@GelMA microspheres using 3D printing technology. The lower layer is made of acryloylated glycine (ACG) hydrogel with tissue adhesion capability, which enables the hydrogel to adapt to the movement and stretching of the skin. By integrating temperature-sensitive polydimethylsiloxane (PDMS) optical fibers, the ACG-GC/Reu/SPS-PDMS hydrogel could accurately and steadily sense and send wound temperature information to intelligent devices for real-time monitoring of the healing status ("monitor"). The double-layered hydrogel not only inhibited bacterial survival and colonization (97.4 % against E. coli and 99 % against S. aureus), but also exhibited remarkable hemostatic properties. Furthermore, it was conducive to L929 cell proliferation and pro-angiogenesis, and promoted the polarization of pro-inflammatory M1 macrophages to the anti-inflammatory M2-phenotype, therefore creating a favorable immune microenvironment at the wound site. Animal experiments using SD rats and Bama minipigs demonstrated that this hydrogel promoted wound closure, directed polarization to M2 macrophages, alleviated inflammation, enhanced neovascularization, therefore accelerating infected wound healing ("treat"). In addition, RNA-Seq analysis revealed the mechanism of action of ACG-GC/Reu/SPS-PDMS hydrogel in modulating key signaling pathways, including down-regulation of AMPK, IL-17, and NF-κB signaling pathways, activation of NLRP3 inflammatory vesicles, and enrichment of MAPK, TGF-β, PI3K-Akt, TNF, and VEGF signaling pathways. The modulation of these signaling pathways suggests that hydrogels play an important role in the molecular mechanisms that promote wound healing and tissue regeneration. Therefore, the design of this study provides an innovative and multifunctional bandage strategy that can significantly improve pathologic diagnosis and wound treatment.

Dual functional antibacterial nanofiber membranes: Polyhexamethylene biguanide-integrated alginate-chitosan-dye modified polyamide 56 for single-use biomedical applications

Polyamide 56 (PA56) nanofiber membranes were functionalized with alginate (AG), chitosan (CS), reactive dyes (RG19, RR141), and poly(hexamethylene biguanide) (PHMB) to develop multifunctional antimicrobial membranes for single-use applications. The resulting membranes, PA56-AG-CS-RG19-PHMB and PA56-AG-CS-RR141-PHMB, achieved high antibacterial efficiencies of 97.12 % and 90.65 %, respectively, against Escherichia coli, demonstrating potent bacterial inhibition. The antimicrobial performance results from a synergistic dual mechanism. Chitosan disrupts bacterial adhesion and biofilm formation through electrostatic interactions, while PHMB compromises membrane integrity and interferes with intracellular processes. This combined action enhances bactericidal efficacy. The functionalization strategy also maintained excellent biocompatibility, with minimal cytotoxicity observed in L929 fibroblasts. Optimized concentrations of AG and CS were systematically evaluated to ensure balanced antibacterial performance and mechanical stability. These membranes, designed for single-use, exhibited significantly reduced antibacterial activity upon reuse, supporting their intended application. Overall, the integration of chemical and physical antimicrobial strategies within a nanofiber matrix presents a novel and effective approach. This strategy enables the development of next-generation materials suitable for real-world single-use biomedical applications, including wound dressings, food packaging, and protective textiles.

Advancements and Prospects of pH-Responsive Hydrogels in Biomedicine

As an intelligent polymer material, pH-sensitive hydrogels exhibit the capability to dynamically sense alterations in ambient pH levels and subsequently initiate corresponding physical or chemical responses, including swelling, contraction, degradation, or ion exchange. Given the significant pH variations inherent in human pathophysiological microenvironments, particularly in tumor tissues, inflammatory lesions, and the gastrointestinal system, these smart materials demonstrate remarkable application potential across diverse domains such as targeted drug delivery systems, regenerative medicine engineering, biosensing, and disease diagnostics. Recent breakthroughs in nanotechnology and precision medicine have substantially propelled advancements in the design and application of pH-responsive hydrogels. This review systematically elaborates on the current research progress and future challenges regarding pH-responsive hydrogels in biomedical applications, with particular emphasis on their stimulus-response mechanisms, fabrication methodologies, multifunctional integration strategies, and application scenarios.

γ-polyglutamic acid-encapsulated metformin-loaded Ga-Car-MOF and hydrocaffeic acid-modified chitosan double-layer microneedle patch for accelerated bacterial-infected wound healing

Bacteria deep in the wound can cause prolonged inflammation and dysfunctional angiogenesis, impeding healing and potentially leading to chronic conditions, disability, or even death. To address this, we developed a double-layer metal-organic framework (MOF) microneedle (MN) patch system (GCM-MN-CSH), designed to accelerate the healing of infected wounds through programmed therapy. The GCM-MN-CSH system consists of a hydrocaffeic acid-modified chitosan (CSH) hydrogel patch and a metformin (Met)-loaded Ga-Car-MOF (GCM)-based γ-polyglutamic acid matrix MN array (GCM-MN). The GCM nanoparticles were incorporated in the MN tips. The deep, localized penetration of GCM-MN, combined with the multifunctional activity of GCM, enables effective delivery of GCM nanoparticles into the dermis. These nanoparticles acid-response release Ga3+ ions and benzylpenicillin carboxylate, which possess antimicrobial activity, as well as Met, which promotes tissue regeneration. The adhesive CSH patch not only helps create a controlled, moist environment at the wound site but also provides antimicrobial properties on the surface. Together, the components of the GCM-MN-CSH system work synergistically to control infection, reduce inflammation, stimulate tissue proliferation, support tissue remodeling, and ultimately enable programmed wound healing. This advanced system offers a promising therapeutic platform for the management of infected wounds.

Chlorella-encapsulated living hydrogel based on gelatin and carrageenan with oxygen production, hemostatic and antibacterial capacity for promoting wound healing

Hypoxia can prolong the healing time of wounds and oxygen delivery to the hypoxic tissue has been reported an effective strategy for promoting wound regeneration. Bacterial infections can interfere with the wound healing process, leading to poor skin regeneration and even more serious complications, which is also an urgent issue to be solved during the process of wound healing. To address the problem of delayed wound healing caused by hypoxia and bacterial infections, we fabricated a series of Chlorella-loaded hydrogels (CK) using gelatin, κ-carrageenan and I-carrageenan as matrixes, which introduced Chlorella and ampicillin conferred oxygen-producing and antimicrobial capacity to the hydrogel. The CK hydrogels possessed good mechanical and adhesive properties, as well as the capability of efficient and sustained oxygen release. The hydrogels possessed outstanding hemostatic ability, excellent blood and cell compatibility, which also owned excellent antibacterial capacity against E. coli and S. aureus. More notably, the in vivo evaluation revealed that the hydrogel can accelerate wound healing by promoting collagen deposition, which may as a promising potential wound dressing for hypoxic wound healing.

Advances in Wearable Biosensors for Wound Healing and Infection Monitoring

Wound healing is a complicated biological process that is important for restoring tissue integrity and function after injury. Infection, usually due to bacterial colonization, significantly complicates this process by hindering the course of healing and enhancing the chances of systemic complications. Recent advances in wearable biosensors have transformed wound care by making real-time monitoring of biomarkers such as pH, temperature, moisture, and infection-related metabolites like trimethylamine and uric acid. This review focuses on recent advances in biosensor technologies designed for wound management. Novel sensor architectures, such as flexible and stretchable electronics, colorimetric patches, and electrochemical platforms, enable the non-invasive detection of changes associated with wounds with high specificity and sensitivity. These are increasingly combined with AI and analytics based on smartphones that can enable timely and personalized interventions. Examples are the PETAL patch sensor that applies multiple sensing mechanisms for wide-ranging views on wound status and closed-loop systems that connect biosensors to therapeutic devices to automate infection control. Additionally, self-powered biosensors that tap into body heat or energy from the biofluids themselves avoid any external batteries and are thus more effective in field use or with limited resources. Internet of Things connectivity allows further support for remote sharing and monitoring of data, thus supporting telemedicine applications. Although wearable biosensors have developed relatively rapidly and their prospects continue to expand, regular clinical application is stalled by significant challenges such as regulatory, cost, patient compliance, and technical problems related to sensor accuracy, biofouling, and power, among others, that need to be addressed by innovative solutions. The goal of this review is to synthesize current trends, challenges, and future directions in wound healing and infection monitoring, with emphasis on the potential for wearable biosensors to improve patient outcomes and reduce healthcare burdens. These innovations are leading the way toward next-generation wound care by bridging advanced materials science, biotechnology, and digital health.

Hyperglycemia-responsive nitric oxide-releasing biohybrid cryogels with cascade enzyme catalysis for enhanced healing of infected diabetic wounds

Diabetic wound infections are a frequent complication for diabetic patients, and conventional treatment for combating diabetic wound infections relies on antibiotics. However, the misuse and overuse of antibiotics have led to the emergence of drug-resistant bacteria, making these infections challenging to treat. Thus, there is an urgent need for alternative strategies to effectively manage diabetic wound infections. Herein, we have developed a hyperglycemia-responsive antibacterial cryogel system that can generate and release hydrogen peroxide (H2O2) and nitric oxide (NO). This system involves incorporating glucose oxidase (GO) and L-Arginine (L-Arg: A) into hyaluronic acid aldehyde methacryloyl (HAAMA: H) and gelatin methacryloyl (GelMA: G) hybrid cryogels (GOA@HG). HAAMA facilitated higher loading and longer stability of L-Arg and GO via a Schiff base reaction. In vitro studies demonstrate that GOA@HG cryogels exhibited outstanding breathability, effective exudate management, and excellent hemostasis capabilities. Moreover, this system could consume excess glucose in diabetic wounds and efficiently eliminate bacteria through the cascaded release of H2O2 and NO without causing antibiotic resistance. In vivo studies further reveal that GOA@HG cryogels significantly enhanced the healing of infected diabetic wounds by inhibiting bacterial growth, accelerating blood vessel formation, and promoting collagen deposition. Overall, GOA@HG cryogels displayed remarkable wound dressing properties and synergistic antimicrobial effects owing to glucose-responsive H2O2 and NO release, which could serve as a highly efficient therapeutic strategy for treating infected diabetic wounds.

Construction of chitosan/carboxylated polyvinyl alcohol/poly(N-isopropylacrylamide) composite antibacterial hydrogel for rapid wound healing

In the realm of skin injury management, the expedited closure of wounds, prevention of scar formation, and enhancement of the healing process are of critical significance. The creation of economical dressings that effectively facilitate swift wound sealing in the initial phase of skin trauma while curbing scar development represents a promising avenue for clinical utility. Within the context of this investigation, we synthesized a novel hydrogel composed of chitosan (CS), carboxylated poly(vinyl alcohol) (PVA-COOH) via a Schiff base reaction between carboxylated PVA and chitosan, yielding networks abundant in amide bonds. Following this, a chitosan/carboxylated PVA/poly(N-isopropylacrylamide) hydrogel (CNP) was engineered by incorporating poly-N-isopropylacrylamide chains for interpenetration at ambient temperature. Our findings indicate that the CNP hydrogel exhibits favorable degradability and swelling characteristics. Moreover, it possesses favorable antimicrobial efficacy and biocompatibility. In a murine full-thickness skin injury model, the hydrogel was found to expedite wound healing by augmenting granulation tissue formation, mitigating wound inflammation, and promoting angiogenesis.

Unlocking the Potential of Hybrid Nanocomposite Hydrogels: Design, Mechanical Properties and Biomedical Performances

Hybrid nanocomposite hydrogels consist of the homogeneous incorporation of nano‐objects in a hydrogel matrix. The latter, whether made of natural or synthetic materials, possesses a microporous, soft structure that makes it an ideal host for a variety of polymer and lipid‐based nano‐objects as well as metal‐ and silica‐based ones. By carefully choosing the composition and the proportions of the different constituents, hybrid hydrogels can display a wide array of properties, from simple enhancement of mechanical characteristics to specific bioactivity. This review aims to provide an overview of the state of the art in hybrid hydrogels highlighting key aspects that make them a promising choice for a variety of biomedical applications. Strategies for the preparation of hybrid hydrogels are discussed by covering the selection of individual components. The review will also explore the physico‐chemical and rheological characterization of these materials, which is essential for understanding their structure and function, ultimately satisfying specifications for the intended use. Successful examples of biomedical applications will also be presented, and the main challenges to be met will be discussed, with the aim of stimulating the research community to exploit the full potential of these materials.

Clinically relevant evaluation of the antimicrobial and anti-inflammatory properties of nanocrystalline and nanomolecular silver

Burns and chronic wounds present significant challenges in wound management due to risks of infection, excessive inflammation, and prolonged healing. Silver-based treatments have long been central to burn care, but limitations have prompted the exploration of nanocrystalline silver as an alternative, with its nanoscale properties offering distinct benefits. This paper reviews the structure, properties, mechanisms of action, and clinical applications of nanocrystalline silver in burn and general wound management, with particular emphasis on how wound healing processes inform the application of these dressings. Nanocrystalline silver's high surface area-to-volume ratio and crystal structure enhance its antimicrobial and anti-inflammatory efficacy. Nanocrystalline silver's mechanisms of action are disrupting cellular functions, inducing DNA damage, and inhibiting biofilms. Clinical studies demonstrate accelerated healing and reduced inflammation compared to traditional treatments. Whilst nanocrystalline silver dressings are costly, their effectiveness in lowering drug-resistant infections and minimising complications supports a financial case for their use, potentially reducing overall wound care expenses. Considerations of cytotoxicity, allergic reactions, and accessibility underscore the importance of individualised treatment selection based on wound and patient factors. In conclusion, nanocrystalline silver holds substantial promise in burn wound management, and further research is warranted to optimise its therapeutic potential and economic benefits in clinical practice.

The Acid-Buffered Engineered Gel Promotes In Vitro Cutaneous Healing and Fights Resistant Bacteria in Wounds

Background: Treatment of cutaneous wound infections is becoming a major clinical challenge due to the growing problem of antimicrobial resistance associated with existing wound treatments. Two prevalent pathogens in wound infections, Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa), continue to present a serious challenge, underscoring the critical need for new therapeutic alternatives. Methods: Novel alginate acid-buffered gels (ABF-1, ABF-2, and ABF-3) were developed using a combination of organic acids in various concentrations and buffered at a pH of 4.5. The acid-buffering capacity of the gels was evaluated against sodium hydroxide solution and simulated wound fluid (SWF) at different wound pHs, mimicking infected and non-infected wound environments. The in vitro antibacterial activity was assessed against resistant bacterial strains (Gram-positive and Gram-negative) using a microdilution method and wound biofilm assay. The rheological properties and cell viability of the gels were evaluated and the gel showing positive cell viability was further investigated for healing ability using an in vitro wound scratch assay. Results: The gels showed promising in vitro antibacterial activity against Staphylococcus epidermidis, S. aureus, and P. aeruginosa. Gels with higher acid concentrations (ABF-1 and ABF-2) were highly effective in reducing the bacterial load in chronic biofilms of S. aureus and P. aeruginosa, while the gel with a lower acid concentration (ABF-3) showed positive effects on the viability of skin cells (over 80% cells viable) and for promoting wound closure. All three gels demonstrated excellent acid-buffering capabilities. Conclusions: The acid-buffered gels demonstrate promising in vitro antibacterial effects, indicating their potential for enhancing wound healing.

Endogenous/exogenous stimuli‐responsive smart hydrogels for diabetic wound healing

Diabetes significantly impairs the body's wound‐healing capabilities, leading to chronic, infection‐prone wounds. These wounds are characterized by hyperglycemia, inflammation, hypoxia, variable pH levels, increased matrix metalloproteinase activity, oxidative stress, and bacterial colonization. These complex conditions complicate effective wound management, prompting the development of advanced diabetic wound care strategies that exploit specific wound characteristics such as acidic pH, high glucose levels, and oxidative stress to trigger controlled drug release, thereby enhancing the therapeutic effects of the dressings. Among the solutions, hydrogels emerge as promising due to their stimuli‐responsive nature, making them highly effective for managing these wounds. The latest advancements in mono/multi‐stimuli‐responsive smart hydrogels showcase their superiority and potential as healthcare materials, as highlighted by relevant case studies. However, traditional wound dressings fall short of meeting the nuanced needs of these wounds, such as adjustable adhesion, easy removal, real‐time wound status monitoring, and dynamic drug release adjustment according to the wound's specific conditions. Responsive hydrogels represent a significant leap forward as advanced dressings proficient in sensing and responding to the wound environment, offering a more targeted approach to diabetic wound treatment. This review highlights recent advancements in smart hydrogels for wound dressing, monitoring, and drug delivery, emphasizing their role in improving diabetic wound healing. It addresses ongoing challenges and future directions, aiming to guide their clinical adoption.

Integration of Hydrogels and 3D Bioprinting Technologies for Chronic Wound Healing Management

The integration of hydrogel-based bioinks with 3D bioprinting technologies presents an innovative approach to chronic wound management, which is particularly challenging to treat because of its multifactorial nature and high risk of complications. Using precise deposition techniques, 3D bioprinting significantly alters traditional wound care paradigms by enabling the fabrication of patient-specific wound dressings that imitate natural tissue properties. Hydrogels are notably beneficial for these applications because of their abundant water content and mechanical properties, which promote cell viability and pathophysiological processes of wound healing, such as re-epithelialization and angiogenesis. This article reviews key 3D printing technologies and their significance in enhancing the structural and functional outcomes of wound-care solutions. Challenges in bioink viscosity, cell viability, and printability are addressed, along with discussions on the cross-linking and mechanical stability of the constructs. The potential of 3D bioprinting to revolutionize chronic wound management rests on its capacity to generate remedies that expedite healing and minimize infection risks. Nevertheless, further studies and clinical trials are necessary to advance these therapies from laboratory to clinical use.

Enhanced Mechanical Strength and Sustained Drug Release in Carrier-Free Silver-Coordinated Anthraquinone Natural Antibacterial Anti-Inflammatory Hydrogel for Infectious Wound Healing

The persistent challenge of healing infectious wounds and the rise of bacterial resistance represent significant hurdles in contemporary medicine. In this study, based on the natural small molecule drug Rhein self-assembly to form hydrogels and coordinate assembly with silver ions (Ag+), a sustained-release carrier-free hydrogel with compact structure is constructed to promote the repair of bacterial-infected wounds. As a broad-spectrum antimicrobial agent, Ag+ can avoid the problem of bacterial resistance caused by the abuse of traditional antibiotics. In addition, due to the slow-release properties of Rhein hydrogel, continuous effective concentration of Ag+ at the wound site can be ensured. The assembly of Ag+ and Rhein makes the hydrogel system with enhanced mechanical stability. More importantly, it is found that Rhein effectively promotes skin tissue regeneration and wound healing by reprogramming M1 macrophages into M2 macrophages. Further mechanism studies show that Rhein realizes its powerful anti-inflammatory activity through NRF2/HO-1 activation and NF-κB inhibition. Thus, the hydrogel system combines the excellent antibacterial properties of Ag+ with the excellent anti-inflammatory and tissue regeneration ability of Rhein, providing a new strategy for wound management with dual roles.

Novel theranostic wounds dressing based on pH responsive alginate hydrogel/graphene oxide/levofloxacin modified silk

Integrating pH sensor with controlled antibiotic release is fabricated on silk to create a theranostic wound dressing. Alginate (ALG) hydrogel and graphene oxide (GO) loaded with levofloxacin (LVX) and a pH indicator are applied to fabricate a pH-responsive theranostic wound dressing. The modified silk color changes from yellow to green in response to elevated skin pH, indicating the skin infection. The semi-quantitative analysis was conducted using ImageJ, revealing significant color changes across the wide range. At elevated pH levels, the ionization of the COOH bonds within ALG induces repulsion among the COO- groups, thereby accelerating the release of the incorporated drug compared to release under lower pH. At an infected pH of 8, ALG hydrogel triggers LVX releasing up to 135.86 ± 0.3 µg, while at a normal pH of 7, theranostic silk releases 123.13 ± 0.26 µg. Incorporating GO onto silk fibers enhances LVX loading and sustains LVX release. Furthermore, these modified silks possess antimicrobial abilities without causing irritation or allergies on the human skin. This theranostic silks represents a major step forward in smart wound care, introducing a versatile platform of smart wound care.

An antioxidant hydrogel dressing with wound pH indication function prepared based on silanized bacterial nanocellulose crosslinked with beet red pigment extract

Maintaining wound moisture and monitoring of infection are crucial aspects of chronic wound treatment. The development of a pH-sensitive functional hydrogel dressing is an effective approach to monitor, protect, and facilitate wound healing. In this study, beet red pigment extract (BRPE) served as a native and efficient pH indicator by being grafted into silane-modified bacterial nanocellulose (BNC) to prepare a pH-sensitive wound hydrogel dressing (S-g-BNC/BRPE). FTIR confirmed the successful grafting of BRPE into the BNC matrix. The S-g-BNC/BRPE showed superior mechanical properties (0.25 MPa), swelling rate (1251 % on average), and hydrophilic properties (contact angle 21.83°). The composite exhibited a notable color change as the pH changed between 4.0 and 9.0. It appeared purple-red when the pH ranged from 4.0 to 6.0, and appeared light pink at pH 7.0 and 7.4, and appeared ginger-yellow at pH 8.0 and 9.0. Subsequently, the antioxidant activity and cytotoxicity of the composite was evaluated, its DPPH·, ABTS+, ·OH scavenging rates were 32.33 %, 19.31 %, and 30.06 %, respectively, and the cytotoxicity test clearly demonstrated the safety of the dressing. The antioxidant hydrogel dressing, fabricated with a cost-effective and easy method, not only showed excellent biocompatibility and dressing performance but could also indicated the wound state based on pH changes.

Multifunctional fucoidan-loaded Zn-MOF-encapsulated microneedles for MRSA-infected wound healing

Infected wound healing remains a challenging task in clinical practice due to several factors: (I) drug-resistant infections caused by various pathogens, (II) persistent inflammation that hinders tissue regeneration and (III) the ability of pathogens to persist intracellularly and evade antibiotic treatment. Microneedle patches (MNs), recognized for their effecacious and painless subcutaneous drug delivery, could greatly enhance wound healing if integrated with antibacterial functionality and tissue regenerative potential. A multifunctional agent with subcellular targeting capability and contained novel antibacterial components, upon loading onto MNs, could yield excellent therapeutic effects on wound infections. In this study, we sythesised a zeolitic imidazolate framework-8 nanoparticles (ZIF-8 NPs) loaded with low molecular weight fucoidan (Fu) and further coating by hyaluronic acid (HA), obtained a multifunctional HAZ@Fu NPs, which could hinders Methicillin-resistant Staphylococcus aureus (MRSA) growth and promotes M2 polarization in macrophages. We mixed HAZ@Fu NPs with photocrosslinked gelatin methacryloyl (GelMA) and loaded it into the tips of the MNs (HAZ@Fu MNs), administered to mice model with MRSA-infected full-thickness cutaneous wounds. MNs are able to penetrate the skin barrier, delivering HAZ@Fu NPs into the dermal layer. Since cells within infected tissues extensively express the HA receptor CD44, we also confirmed the HA endows the nanoparticles with the ability to target MRSA in subcellular level. In vitro and in vivo murine studies have demonstrated that MNs are capable of delivering HAZ@Fu NPs deep into the dermal layers. And facilitated by the HA coating, HAZ@Fu NPs could target MRSA surviving at the subcellular level. The effective components, such as zinc ions, Fu, and hyaluronic acid could sustainably released, which contributes to antibacterial activity, mitigates inflammation, promotes epithelial regeneration and fosters neovascularization. Through the RNA sequencing of macrophages post co-culture with HAZ@Fu, the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis reveals that the biological functionalities associated with wound healing could potentially be facilitated through the PI3K-Akt pathway. The results indicate that the synergistic application of HAZ@Fu NPs with biodegradable MNs may serve as a significant adjunct in the treatment of infected wounds. The intricate mechanisms driving its biological effects merit further investigation.

Enhanced antibacterial activity of porous chitosan-based hydrogels crosslinked with gelatin and metal ions

Addressing the increasing drug resistance in pathogenic microbes, a significant threat to public health, calls for the development of innovative antibacterial agents with versatile capabilities. To enhance the antimicrobial activity of non-toxic biomaterials in this regard, this study focuses on novel, cost-effective chitosan (CS)-based hydrogels, crosslinked using gelatin (GEL), formaldehyde, and metallic salts (Ag+, Cu2+, and Zn2+). These hydrogels are formed by mixing CS and GEL with formaldehyde, creating iminium ion crosslinks with metallic salts without hazardous crosslinkers. Characterization techniques like FTIR, XRD, FESEM, EDX, and rheological tests were employed. FTIR analysis showed metal ions binding to amino and hydroxyl groups on CS, enhancing hydrogelation. FESEM revealed that freeze-dried hydrogels possess a crosslinked, porous structure influenced by various metal ions. Antibacterial testing against gram-negative and gram-positive bacteria demonstrated significant bacterial growth inhibition. CS-based hydrogels containing metal ions showed reduced MIC and MBC values against Staphylococcus aureus (0.5, 8, 16 µg/mL) and Escherichia coli (1, 16, 8 µg/mL) for CS-g-GEL-Ag+, CS-g-GEL-Cu2+, and CS-g-GEL-Zn2+. MTT assay results confirmed high biocompatibility (84.27%, 85.24%, 84.96% viability at 10 µg/mL) for CS-based hydrogels towards HFF-1 cells over 48 h. Therefore, due to their non-toxic nature, these CS hydrogels are promising for antibacterial applications.

Progress of stimulus responsive nanosystems for targeting treatment of bacterial infectious diseases

In recent decades, due to insufficient concentration at the lesion site, low bioavailability and increasingly serious resistance, antibiotics have become less and less dominant in the treatment of bacterial infectious diseases. It promotes the development of efficient drug delivery systems, and is expected to achieve high absorption, targeted drug release and satisfactory therapy effects. A variety of endogenous stimulation-responsive nanosystems have been constructed by using special infection microenvironments (pH, enzymes, temperature, etc.). In this review, we firstly provide an extensive review of the current research progress in antibiotic treatment dilemmas and drug delivery systems. Then, the mechanism of microenvironment characteristics of bacterial infected lesions was elucidated to provide a strong theoretical basis for bacteria-targeting nanosystems design. In particular, the discussion focuses on the design principles of single-stimulus and dual-stimulus responsive nanosystems, as well as the use of endogenous stimulus-responsive nanosystems to deliver antimicrobial agents to target locations for combating bacterial infectious diseases. Finally, the challenges and prospects of endogenous stimulus-responsive nanosystems were summarized.

Designing Composite Stimuli-Responsive Hydrogels for Wound Healing Applications: The State-of-the-Art and Recent Discoveries

Effective wound treatment has become one of the most important challenges for healthcare as it continues to be one of the leading causes of death worldwide. Therefore, wound care technologies significantly evolved in order to provide a holistic approach based on various designs of functional wound dressings. Among them, hydrogels have been widely used for wound treatment due to their biocompatibility and similarity to the extracellular matrix. The hydrogel formula offers the control of an optimal wound moisture level due to its ability to absorb excess fluid from the wound or release moisture as needed. Additionally, hydrogels can be successfully integrated with a plethora of biologically active components (e.g., nanoparticles, pharmaceuticals, natural extracts, peptides), thus enhancing the performance of resulting composite hydrogels in wound healing applications. In this review, the-state-of-the-art discoveries related to stimuli-responsive hydrogel-based dressings have been summarized, taking into account their antimicrobial, anti-inflammatory, antioxidant, and hemostatic properties, as well as other effects (e.g., re-epithelialization, vascularization, and restoration of the tissue) resulting from their use.

A dual pH- and temperature-responsive hydrogel produced in situ crosslinking of cyclodextrin-cellulose for wound healing

Cellulose hydrogels have gained attention in the field of wound healing due to their biodegradability, biocompatibility, and the capacity to sustain a humid environment that promotes healing. Conventional cellulose hydrogels were usually lacked responsiveness to changing wound conditions, and limited capacity for controlled release of active substances. The composite hydrogels with Berberine (BBR) loading were prepared from bamboo parenchymal cellulose and in situ crosslinking carboxylated-β-cyclodextrin (BPCH-B) via dissolution. The inclusion of BBR enhanced the antibacterial properties of cellulose hydrogel while maintaining biocompatibility and drug delivery capabilities. The dual-responsive dressing was demonstrated to modulate drug release kinetics in accordance with the pH and temperature conditions prevailing within the wound site. Specifically, study exhibited a significant increase in drug release (over 70 %) under alkaline pH (7.6) and temperature (40 °C) conditions. Full-thickness wound healing experiments indicated that BPCH-B had better healing ability, and the wound healing area of BPCH-B treated was 80 % within 12 days, while the control group was only 50 %. This strategy for generating functional wound healing can be further control release of drug compounds for treatment of wounds, enabling development of practical wound care materials.

Smart Responsive and Controlled-Release Hydrogels for Chronic Wound Treatment

Chronic wounds are a major health challenge that require new treatment strategies. Hydrogels are promising drug delivery systems for chronic wound healing because of their biocompatibility, hydration, and flexibility. However, conventional hydrogels cannot adapt to the dynamic and complex wound environment, which involves low pH, high levels of reactive oxygen species, and specific enzyme expression. Therefore, smart responsive hydrogels that can sense and respond to these stimuli are needed. Crucially, smart responsive hydrogels can modulate drug release and eliminate pathological factors by changing their properties or structures in response to internal or external stimuli, such as pH, enzymes, light, and electricity. These stimuli can also be used to trigger antibacterial responses, angiogenesis, and cell proliferation to enhance wound healing. In this review, we introduce the synthesis and principles of smart responsive hydrogels, describe their design and applications for chronic wound healing, and discuss their future development directions. We hope that this review will inspire the development of smart responsive hydrogels for chronic wound healing.

A Temperature and pH Dual-Sensitive Multifunctional Polyurethane with Bacteria-Triggered Antibacterial Activity

An effective and practical antibacterial strategy is to design multifunctional and stimuli-responsive materials that exhibit antibacterial activity in response to bacterial triggers. In this study, because the metabolism of Staphylococcus aureus (S. aureus) can acidify the surrounding environment and pH level can affect the lower critical solution temperature of temperature/pH dual-sensitive polymers, a monomer containing a temperature-sensitive N-isopropyl amide derivative and pH-sensitive tertiary amine groups is first synthesized. Then, the monomer is copolymerized with a polyurethane chain, and partial tertiary amine groups are quaternized to obtain bactericidal activity. The modified polyurethane exhibits temperature/pH sensitivity, antibacterial adhesion activity, bactericidal activity, and good cytocompatibility. An in situ investigation of bacterial behavior and pH changes in the bacterial suspension during the process confirms that the temperature/pH dual-sensitive polyurethane successfully achieves antibacterial activity though the metabolic activity of S. aureus without external intervention. This design concept provides a new perspective for antibacterial material design.

Multifunctional and theranostic hydrogels for wound healing acceleration: An emphasis on diabetic-related chronic wounds

Hydrogels represent intricate three-dimensional polymeric structures, renowned for their compatibility with living systems and their ability to naturally degrade. These networks stand as promising and viable foundations for a range of biomedical uses. The practical feasibility of employing hydrogels in clinical trials has been well-demonstrated. Among the prevalent biomedical uses of hydrogels, a significant application arises in the context of wound healing. This intricate progression involves distinct phases of inflammation, proliferation, and remodeling, often triggered by trauma, skin injuries, and various diseases. Metabolic conditions like diabetes have the potential to give rise to persistent wounds, leading to delayed healing processes. This current review consolidates a collection of experiments focused on the utilization of hydrogels to expedite the recovery of wounds. Hydrogels have the capacity to improve the inflammatory conditions at the wound site, and they achieve this by diminishing levels of reactive oxygen species (ROS), thereby exhibiting antioxidant effects. Hydrogels have the potential to enhance the growth of fibroblasts and keratinocytes at the wound site. They also possess the capability to inhibit both Gram-positive and Gram-negative bacteria, effectively managing wounds infected by drug-resistant bacteria. Hydrogels can trigger angiogenesis and neovascularization processes, while also promoting the M2 polarization of macrophages, which in turn mitigates inflammation at the wound site. Intelligent and versatile hydrogels, encompassing features such as pH sensitivity, reactivity to reactive oxygen species (ROS), and responsiveness to light and temperature, have proven advantageous in expediting wound healing. Furthermore, hydrogels synthesized using environmentally friendly methods, characterized by high levels of biocompatibility and biodegradability, hold the potential for enhancing the wound healing process. Hydrogels can facilitate the controlled discharge of bioactive substances. More recently, there has been progress in the creation of conductive hydrogels, which, when subjected to electrical stimulation, contribute to the enhancement of wound healing. Diabetes mellitus, a metabolic disorder, leads to a slowdown in the wound healing process, often resulting in the formation of persistent wounds. Hydrogels have the capability to expedite the healing of diabetic wounds, facilitating the transition from the inflammatory phase to the proliferative stage. The current review sheds light on the biological functionalities of hydrogels, encompassing their role in modulating diverse mechanisms and cell types, including inflammation, oxidative stress, macrophages, and bacteriology. Additionally, this review emphasizes the significance of smart hydrogels with responsiveness to external stimuli, as well as conductive hydrogels for promoting wound healing. Lastly, the discussion delves into the advancement of environmentally friendly hydrogels with high biocompatibility, aimed at accelerating the wound healing process.

Culture-Delivery Live Probiotics Dressing for Accelerated Infected Wound Healing

Probiotic therapy in infected wound healing is hindered by its low viability and colonization efficiency during treatments. Developing dressings that maintain metabolic activity and prevent the potential leakage of probiotics is imperative. Herein, a culture-delivery live probiotics hydrogel dressing is designed and synthesized, formed by gelatin modified with norbornene (GelNB) and sulfhydryl (GelSH), distributing Lactobacillus reuteri (L. reuteri)-laden alginate microspheres (AlgMPs). GelNB-GelSH hydrogel (GelNBSH) incorporating AlgMPs embedding L. reuteri (GelNBSH-L) possesses bioprintability and efficient polymerization that can maintain the activity of L. reuteri in situ, promote its proliferation, and limit its leakage. Thereby, GelNBSH-L achieved a sustainable antimicrobial effect against both S. aureus and E. coli (>90%). Above all, the results show that GelNBSH-L could ensure propitious viability and efficient antibacterial properties of probiotics, effectively inhibit the further development of bacterial infectious wounds and shorten the repair cycle, aiding in ameliorating future clinical probiotic biotherapy.

Layered Black Phosphorus Nanoflakes Reduce Bacterial Burden and Enhance Healing of Murine Infected Wounds

Current treatment modalities of cutaneous wound infections are largely ineffective, attributed to the increasing burden of antimicrobial resistance. S. aureus, a commonly wound‐associated pathogen continues to pose a clinical challenge, suggesting that new alternative therapeutic materials are urgently required to provide optimal treatment. A layered allotrope of phosphorus termed Black Phosphorus nanoflakes (BPNFs) has emerged as a potential alternative antibacterial material. However, wider deployment of this material requires extensive biological validation using the latest pre‐clinical models to understand its role in wound management. Here, the antibacterial potential of BPNFs against wound pathogens demonstrates over 99% killing efficiency at ambient conditions, while remaining non‐toxic to mammalian skin cells. In addition, in vivo validation of BPNFs using a preclinical model of S. aureus acute wound infection demonstrates that daily topical application significantly reduces infection (3‐log reduction) comparable to ciprofloxacin antibiotic control. Furthermore, the application of BPNFs also accelerates wound closure, increases wound re‐epithelization, and reduces tissue inflammation compared to controls, suggesting a potential role in alleviating the current challenges of infected cutaneous wounds. For the first time, this study demonstrates the potential role of BPNFs in ambient light conditions for clearing a clinically relevant wound infection with favorable wound healing properties.

Novel Antibacterial Materials and Coatings-A Perspective by the Editors

The fight between humans and bacteria has escalated to a new level.

pH-responsive scaffolds for tissue regeneration: In vivo performance

A myriad of pH-sensitive scaffolds has been reported in recent decades. Information on their behaviour in vitro under conditions that mimic the pH changes that occur during tissue regeneration is abundant. Differently, the in vivo demonstration of the advantages of pH-responsive systems in comparison with non-responders is more limited. The in vivo scenario is very complex and the intricate relationship between the host response, the overall pathological conditions of the patient, and the risk of colonization by microorganisms is very difficult to imitate in in vitro tests. This review aims to shed light on how the changes in pH between healthy and damaged states and also during the healing process have been exploited so far to develop polymer-based scaffolds that actively contribute in vivo to the healing process avoiding chronification. The main strategies so far tested to prepare pH-responsive scaffolds rely on (i) changes in ionization of natural polymers, ionizable monomers and clays, (ii) reversible cross-linkers, (iii) coatings, and (iv) production of CO2 gas. These strategies are analysed in detail in this review with the description of relevant examples of their performance on specific animal models. The versatility of the techniques used to prepare biocompatible and environment-friendly pH-responsive scaffolds that have been implemented in the last decade may pave the way for a successful translation to the clinic. STATEMENT OF SIGNIFICANCE: We report here on the most recent advances in pH-responsive polymer-based scaffolds that have been demonstrated in vivo to be suitable for wound and bone healing. pH is a critical variable in the tissue regeneration process, and small changes can speed up or completely stop the process. Although there is still a paucity of information on the performance in the complex in vivo environment, recently reported achievements using scaffolds endowed with pH-responsiveness through ionic natural polymers, ionizable monomers and clays, reversible cross-linkers, coatings, or formation of CO2 ensure a promising future towards clinical translation.

Research advances in smart responsive-hydrogel dressings with potential clinical diabetic wound healing properties

The treatment of chronic and non-healing wounds in diabetic patients remains a major medical problem. Recent reports have shown that hydrogel wound dressings might be an effective strategy for treating diabetic wounds due to their excellent hydrophilicity, good drug-loading ability and sustained drug release properties. As a typical example, hyaluronic acid dressing (Healoderm) has been demonstrated in clinical trials to improve wound-healing efficiency and healing rates for diabetic foot ulcers. However, the drug release and degradation behavior of clinically-used hydrogel wound dressings cannot be adjusted according to the wound microenvironment. Due to the intricacy of diabetic wounds, antibiotics and other medications are frequently combined with hydrogel dressings in clinical practice, although these medications are easily hindered by the hostile environment. In this case, scientists have created responsive-hydrogel dressings based on the microenvironment features of diabetic wounds (such as high glucose and low pH) or combined with external stimuli (such as light or magnetic field) to achieve controllable drug release, gel degradation, and microenvironment improvements in order to overcome these clinical issues. These responsive-hydrogel dressings are anticipated to play a significant role in diabetic therapeutic wound dressings. Here, we review recent advances on responsive-hydrogel dressings towards diabetic wound healing, with focus on hydrogel structure design, the principle of responsiveness, and the behavior of degradation. Last but not least, the advantages and limitations of these responsive-hydrogels in clinical applications will also be discussed. We hope that this review will contribute to furthering progress on hydrogels as an improved dressing for diabetic wound healing and practical clinical application.

Advances in the Research and Application of Smart-Responsive Hydrogels in Disease Treatment

Smart-responsive hydrogels have been widely used in various fields, particularly in the biomedical field. Compared with traditional hydrogels, smart-responsive hydrogels not only facilitate the encapsulation and controlled release of drugs, active substances, and even cells but, more importantly, they enable the on-demand and controllable release of drugs and active substances at the disease site, significantly enhancing the efficacy of disease treatment. With the rapid advancement of biomaterials, smart-responsive hydrogels have received widespread attention, and a wide variety of smart-responsive hydrogels have been developed for the treatment of different diseases, thus presenting tremendous research prospects. This review summarizes the latest advancements in various smart-responsive hydrogels used for disease treatment. Additionally, some of the current shortcomings of smart-responsive hydrogels and the strategies to address them are discussed, as well as the future development directions and prospects of smart-responsive hydrogels.

pH-Responsive Biomaterials for the Treatment of Dental Caries-A Focussed and Critical Review

Dental caries is a common and costly multifactorial biofilm disease caused by cariogenic bacteria that ferment carbohydrates to lactic acid, demineralizing the inorganic component of teeth. Therefore, low pH (pH 4.5) is a characteristic signal of the localised carious environment, compared to a healthy oral pH range (6.8 to 7.4). The development of pH-responsive delivery systems that release antibacterial agents in response to low pH has gained attention as a targeted therapy for dental caries. Release is triggered by high levels of acidogenic species and their reduction may select for the establishment of health-associated biofilm communities. Moreover, drug efficacy can be amplified by the modification of the delivery system to target adhesion to the plaque biofilm to extend the retention time of antimicrobial agents in the oral cavity. In this review, recent developments of different pH-responsive nanocarriers and their biofilm targeting mechanisms are discussed. This review critically discusses the current state of the art and innovations in the development and use of smart delivery materials for dental caries treatment. The authors' views for the future of the field are also presented.

Super-Rapid In Situ Formation of a Silver Ion-Induced Supramolecular Hydrogel with Efficient Antibacterial Activity for Root Canal Disinfection

Supramolecular hydrogels prepared using low-molecular-weight gelators have attracted considerable attention for biomedical applications. However, in situ supramolecular hydrogels are limited in terms of their prolonged gelation time and/or unstable nature at high temperatures. In this study, we constructed a stable supramolecular Ag-isoG hydrogel through super-rapid in situ formation, wherein hydrogelation process occurred instantaneously upon mixing isoG and Ag⁺ within 1 s under ambient conditions. Interestingly, unlike most nucleoside-based supramolecular hydrogels, this Ag-isoG hydrogel remains stable even at a high temperature (100 °C). Moreover, the as-designed hydrogel demonstrated significant antibacterial activity against Staphylococcus aureus and the oral bacterium Streptococcus mutans owing to the strong chelating ability of Ag ions, and the hydrogel exhibited relatively low cytotoxicity in root canal and an easy removal feature by saline. The hydrogel was then applied to a root canal infection model, which demonstrated strong antibacterial activity against Enterococcus faecalis, with performance even better than that of the regular calcium hydroxide paste. This feature makes the Ag-isoG hydrogel a prospective alternative material as intracanal medicaments for root canal treatment.

Optimal Concentration and Duration of Endotracheal Tube Coating to Achieve Optimal Antimicrobial Efficacy and Safety Balance: An In Vitro Study

BACKGROUND

Ventilator-associated pneumonia (VAP) is a common and genuine complication in fundamentally sick patients accepting mechanical ventilation. Silver nitrate sol-gel (SN) has been proposed as a potential preventative measure against VAP. Be that as it may, the arrangement of SN with distinctive concentrations and pH values remains a basic factor influencing its effectiveness.

METHODS

Silver nitrate sol-gel was arranged with distinctive concentrations (0.1852%, 0.03496%, 0.1852%, and 0.01968%) and pH values (8.5, 7.0, 8.0, and 5.0) separately. The antimicrobial action of the silver nitrate and NaOH arrangements were assessed against Escherichia coli as a reference strain. The thickness and pH of the arrangements were measured, and biocompatibility tests were performed on the coating tube. The auxiliary changes in the endotracheal tube (ETT) tests after treatment were analyzed utilizing electron microscopy (SEM) and transmission electron microscopy (TEM).

RESULTS

The pH estimations of the diverse arrangements showed that the pH values shifted depending on the test conditions, with pH values extending from 5.0 to 8.5. The consistency estimations of the arrangements showed that the thickness values expanded as the pH values drew closer to 7.5 and diminished when the pH values went over 7.5. The antimicrobial action of the silver nitrate and NaOH arrangements were successful against Escherichia coli, with microbial checks decreasing in concentration (0.03496%, 0.1852% (pH: 8), and 0.01968%). The biocompatibility tests revealed tall cell reasonability rates, demonstrating that the coating tube was secure for therapeutic utilization and did not hurt typical cells. The SEM and TEM investigation gave visual proof of the antibacterial impacts of the silver nitrate and NaOH arrangements on the bacterial surface or interior of the bacterial cells. Moreover, the investigation revealed that a concentration of 0.03496% was the foremost successful in hindering the development of ETT bacterial colonization at the nanoscale level.

CONCLUSIONS

We propose that cautious control and alteration of the pH and thickness of the arrangements are essential to guaranteeing the reproducibility and quality of the sol-gel materials. The silver nitrate and NaOH arrangements may serve as a potential preventative degree against VAP in sick patients, with a concentration of 0.03496% appearing to show the most elevated viability. The coating tube may serve as a secure and viable preventative measure against VAP in sick patients. Further investigation is required to optimize the concentration and introduction time of the arrangements to maximize their adequacy in avoiding VAP in real-world clinical settings.

Biomimicry in nanotechnology: a comprehensive review

Biomimicry has been utilized in many branches of science and engineering to develop devices for enhanced and better performance. The application of nanotechnology has made life easier in modern times. It has offered a way to manipulate matter and systems at the atomic level. As a result, the miniaturization of numerous devices has been possible. Of late, the integration of biomimicry with nanotechnology has shown promising results in the fields of medicine, robotics, sensors, photonics, etc. Biomimicry in nanotechnology has provided eco-friendly and green solutions to the energy problem and in textiles. This is a new research area that needs to be explored more thoroughly. This review illustrates the progress and innovations made in the field of nanotechnology with the integration of biomimicry.