Angiogenesis and Full-Thickness Wound Healing Efficiency of a Copper-Doped Borate Bioactive Glass/Poly(lactic- co-glycolic acid) Dressing Loaded with Vitamin E in Vivo and in Vitro

A comparative in vitro and in vivo analysis of the impact of copper substitution on the cytocompatibility, osteogenic, and angiogenic properties of a borosilicate bioactive glass

The 0106-B1-bioactive glass (BG) composition (in wt %: 37.5 SiO2, 22.6 CaO, 5.9 Na2O, 4.0 P2O5, 12.0 K2O, 5.5 MgO, and 12.5 B2O3) has demonstrated favorable processing properties and promising bone regeneration potential. The present study aimed to evaluate the biological effects of the incorporation of highly pro-angiogenic copper (Cu) in 0106-B1-BG in vitro using human bone marrow-derived mesenchymal stromal cells (BMSCs) as well as its in vivo potential for bone regeneration. CuO was added to 0106-B1-BG in exchange for CaO, resulting in Cu-doped BG compositions containing 1.0, 2.5 and 5.0 wt % CuO (composition in wt %: 37.5 SiO2, 21.6/ 20.1/17.6 CaO, 5.9 Na2O, 4.0 P2O5, 12.0 K2O, 5.5 MgO, 12.5 B2O3, and 1.0/ 2.5/ 5.0 CuO). In vitro, the BGs' impact on the viability, proliferation, and growth patterns of BMSCs was evaluated. Analyses of protein secretion, matrix formation, and gene expression were used for the assessment of the BGs' influence on BMSCs regarding osteogenic differentiation and angiogenic stimulation. The presence of Cu improved cytocompatibility, osteogenic differentiation, and angiogenic response when compared with unmodified 0106-B1-BG in vitro. In vivo, a critical-size femoral defect in rats was filled with scaffolds made from BGs. Bone regeneration was evaluated by micro-computed tomography. Histological analysis was performed to assess bone maturation and angiogenesis. In vivo effects regarding defect closure, presence of osteoclastic cells or vascular structures in the defect were not significantly changed by the addition of Cu compared with undoped 0106-B1-BG scaffolds. Hence, while the in vitro properties of the 0106-B1-BG were significantly improved by the incorporation of Cu, further evaluation of the BG composition is necessary to transfer these effects to an in vivo setting.

Bioglass and nano bioglass: A next-generation biomaterial for therapeutic and regenerative medicine applications

Biomaterials are an indispensable component in tissue engineering that primarily functions to resemble the extracellular matrix of any tissue targeted for regeneration. In the last five decades, bioglass has been extensively used in the field of therapeutic and tissue engineering. The doping of metal components into bioglass and the synthesizing of nano bioglass particles have found remarkable implications, both in vivo and in vitro. These include various medical and biological applications such as rejuvenating tissues, facilitating regeneration, and delivering biomolecules into cells and therapy, etc. Therefore, the current review discusses the various techniques used in synthesizing bioglass particles, trends of various ion-doped nano bioglass, and their applications in therapy as well as in regenerative medicine, specifically in the fields of dentistry, cardiovascular, skin, nervous, and respiratory systems. Apart from these, this review also emphasizes the bioglass combined with diverse natural polymers (like collagen, chitosan, etc.) and their applications. Furthermore, we discuss the effectiveness of bioglass properties such as antibacterial effects, biomolecular delivery systems, tissue compatibility, and regenerative material. Finally, the prospects and limitations are elaborated.

Tailoring of bioactive glass and glass-ceramics properties for in vitro and in vivo response optimization: a review

Bioactive glasses are inorganic biocompatible materials that can find applications in many biomedical fields. The main application is bone and dental tissue engineering. However, some applications in contact with soft tissues are emerging. It is well known that both bulk (such as composition) and surface properties (such as morphology and wettability) of an implanted material influence the response of cells in contact with the implant. This review aims to elucidate and compare the main strategies that are employed to modulate cell behavior in contact with bioactive glasses. The first part of this review is focused on the doping of bioactive glasses with ions and drugs, which can be incorporated into the bioceramic to impart several therapeutic properties, such as osteogenic, proangiogenic, or/and antibacterial ones. The second part of this review is devoted to the chemical functionalization of bioactive glasses using drugs, extra-cellular matrix proteins, vitamins, and polyphenols. In the third and final part, the physical modifications of the surfaces of bioactive glasses are reviewed. Both top-down (removing materials from the surface, for example using laser treatment and etching strategies) and bottom-up (depositing materials on the surface, for example through the deposition of coatings) strategies are discussed.

The Effect of Intra-socket Vitamin E Application on the Reduction in Postoperative Pain and Reduction in Incidence of Dry Socket in Female Patients: A Randomized Controlled Trial

Introduction

Blum defined dry socket as the presence of postoperative pain in and around the extraction site that worsens 1-3 days after the extraction.

Methods

90 female patients seeking extraction of a single tooth in the lower posterior region were divided randomly into 45 patients who received vitamin E inside the socket after extraction (study group) and 45 patients who did not receive vitamin E after extraction (control group).

Results

After 3 days, there was a decrease in pain levels in the study group compared to the control group. Only 7 patients out of 45 (16%) suffered from pain compared to 17 patients out of 45 (38%) in the control group. So, the improvement in pain was statistically significant P = 0.02. After 7 days, there was a decrease in wound healing levels in the study group compared to the control group. Only 8 patients out of 45 (17%) had poor wound healing compared to 7 patients out of 45 (16%) in the control group. However, the improvement in wound healing was not statistically significant P = 0.8.

Conclusion

Based on the current results, we recommend the use of vitamin E as topical intra-socket medication in reducing the early postoperative pain.

Healing with precision: A multi-functional hydrogel-bioactive glass dressing boosts infected wound recovery and enhances neurogenesis in the wound bed

Chronic skin wounds, especially infected ones, pose a significant clinical challenge due to their increasing incidence and poor outcomes. The deteriorative microenvironment in such wounds, characterized by reduced extracellular matrix, impaired angiogenesis, insufficient neurogenesis, and persistent bacterial infection, has prompted the exploration of novel therapeutic strategies. In this study, we developed an injectable multifunctional hydrogel (GEL/BG@Cu + Mg) incorporating Gelatin-Tannic acid/ N-hydroxysuccinimide functionalized polyethylene glycol and Bioactive glass doped with copper and magnesium ions to accelerate the healing of infected wounds. The GEL/BG@Cu + Mg hydrogel composite demonstrates good biocompatibility, degradability, and rapid formation of a protective barrier to stop bleeding. Synergistic bactericidal effects are achieved through the photothermal properties of BG@Cu + Mg and sustained copper ions release, with the latter further promoting angiogenesis. Furthermore, the hydrogel enhances neurogenesis by stimulating axons and Schwann cells in the wound bed through the beneficial effects of magnesium ions. Our results demonstrate that the designed novel multifunctional hydrogel holds tremendous promise for treating infected wounds and allowing regenerative neurogenesis at the wound site, which provides a viable alternative for further improving clinical outcomes.

AESIS-1, a Rheumatoid Arthritis Therapeutic Peptide, Accelerates Wound Healing by Promoting Fibroblast Migration in a CXCR2-Dependent Manner

In patients with autoimmune disorders such as rheumatoid arthritis (RA), delayed wound healing is often observed. Timely and effective wound healing is a crucial determinant of a patient's quality of life, and novel materials for skin wound repair, such as bioactive peptides, are continuously being studied and developed. One such bioactive peptide, AESIS-1, has been studied for its well-established anti-rheumatoid arthritis properties. In this study, we attempted to use the anti-RA material AESIS-1 as a therapeutic wound-healing agent based on disease-modifying antirheumatic drugs (DMARDs), which can help restore prompt wound healing. The efficacy of AESIS-1 in wound healing was assessed using a full-thickness excision model in diabetic mice; this is a well-established model for studying chronic wound repair. Initial observations revealed that mice treated with AESIS-1 exhibited significantly advanced wound repair compared with the control group. In vitro studies revealed that AESIS-1 increased the migration activity of human dermal fibroblasts (HDFs) without affecting proliferative activity. Moreover, increased HDF cell migration is mediated by upregulating chemokine receptor expression, such as that of CXC chemokine receptor 2 (CXCR2). The upregulation of CXCR2 through AESIS-1 treatment enhanced the chemotactic reactivity to CXCR2 ligands, including CXC motif ligand 8 (CXCL8). AESIS-1 directly activates the ERK and p38 mitogen-activated protein kinase (MAPK) signaling cascades, which regulate the migration and expression of CXCR2 in fibroblasts. Our results suggest that the AESIS-1 peptide is a strong wound-healing substance that increases the movement of fibroblasts and the expression of CXCR2 by turning on the ERK and p38 MAPK signaling cascades.

Fabrication of a Nanoscale Magnesium/Copper Metal-Organic Framework on Zn-Based Guided Bone Generation Membranes for Enhancing Osteogenesis, Angiogenesis, and Bacteriostasis Properties

Recently, zinc (Zn) and its alloys have demonstrated great potential as guided bone regeneration (GBR) membranes to treat the problems of insufficient alveolar bone volume and long-term osseointegration instability during dental implantology. However, bone regeneration is a complex process consisting of osteogenesis, angiogenesis, and antibacterial function. For now, the in vivo osteogenic performance and antibacterial activity of pure Zn are inadequate, and thus fabricating a platform to endow Zn membranes with multifunctions may be essential to address these issues. In this study, various bimetallic magnesium/copper metal-organic framework (Mg/Cu-MOF) coatings were fabricated and immobilized on pure Zn. The results indicated that the degradation rate and water stability of Mg/Cu-MOF coatings could be regulated by controlling the feeding ratio of Cu2+. As the coating and Zn substrate degraded, an alkaline microenvironment enriched with Zn2+, Mg2+, and Cu2+ was generated. It significantly improved calcium phosphate deposition, differentiation of osteoblasts, and vascularization of endothelial cells in the extracts. Among them, Mg/Cu1 showed the best comprehensive performance. The superior antibacterial activity of Mg/Cu1 was demonstrated in vitro and in vivo, which indicated significantly enhanced bacteriostatic activity against Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli as compared to that of the bare sample. Bimetallic Mg/Cu-MOF coating could properly coordinate the multifunction on a Zn membrane and could be a promising platform for promoting its bone regeneration, which could pave the way for Zn-based materials to be used as barrier membranes in oral clinical trials.

3D bioprinting bioglass to construct vascularized full-thickness skin substitutes for wound healing

Constructing three-dimensional (3D) bioprinted skin tissues that accurately replicate the mechanical properties of native skin and provide adequate oxygen and nutrient support remains a formidable challenge. In this study, we incorporated phosphosilicate calcium bioglasses (PSCs), a type of bioactive glass (BG), into the bioinks used for 3D bioprinting. The resulting bioink exhibited mechanical properties and biocompatibility that closely resembled those of natural skin. Utilizing 3D bioprinting technology, we successfully fabricated full-thickness skin substitutes, which underwent comprehensive evaluation to assess their regenerative potential in treating full-thickness skin injuries in rats. Remarkably, the skin substitutes loaded with PSCs exhibited exceptional angiogenic activity, as evidenced by the upregulation of angiogenesis-related genes in vitro and the observation of enhanced vascularization in wound tissue sections in vivo. These findings conclusively demonstrated the outstanding efficacy of PSCs in promoting angiogenesis and facilitating the repair of full-thickness skin wounds. The insights garnered from this study provide a valuable reference strategy for the development of skin tissue grafts with potent angiogenesis-inducing capabilities.

NIR-triggered bacterial cellulose-based wound dressings for multiple synergistic therapy of infected wound

Skin wounds are repaired by a complex series of events and overlapping phases in which bacterial infection and insufficient angiogenesis at the wound site delay the healing process. Thus, functional wound dressings with enhanced antibacterial activity and angiogenic capacity have attracted attention. Herein, bacterial cellulose (BC)-based dressings were successfully fabricated by functionalization with a polydopamine (PDA) coating and copper sulfide nanoparticles (CuS NPs). Under 808 nm laser illumination, the BC/PDA/CuS composite membranes exhibited outstanding adjustable photothermal and photodynamic activities as well as controlled Cu2+ release, endowing the composite membranes with synergetic antibacterial activity. Specially, a bactericidal efficiency of 99.7 % and 88.0 % for Staphylococcus aureus and Escherichia coli was achieved after treatment with BC/PDA/CuS5 sample under NIR irradiation (0.8 W/cm2, 10 min), respectively. Moreover, the BC/PDA/CuS5 composite membrane could enhance the angiogenesis due to the released Cu2+. In vivo experiments revealed that the BC/PDA/CuS5 composite membrane dressing could accelerate the wound closure process of the full-thickness skin defects with S. aureus by synergistically reducing inflammation, enhancing collagen deposition, and promoting vascularization under NIR irradiation. Additionally, the BC/PDA/CuS5 composite membrane exhibited high biocompatibility and biosafety. This work offers a new strategy to prepare multifunctional BC-based dressing for clinical wound healing.

Opportunities for Bioactive Glass in Gastrointestinal Conditions: A Review of Production Methodologies, Morphology, Composition, and Performance

Bioactive glasses (BGs) are widely used in orthopedic and dental applications for their ability to stimulate endogenous bone formation and regeneration. BG applications more recently broadened to include soft tissue conditions, based on their ability to stimulate angiogenesis, soft tissue regeneration, and wound healing. Sol-gel synthesis has helped facilitate this expansion, allowing formulators to tailor the morphological characteristics of the BG matrix. The effectiveness of BGs in skin wound healing is viewed as a gateway for their use as both a therapeutic and drug delivery platform in other soft tissue applications, notably gastrointestinal (GI) applications, which form the focus of this review. Recent changes in international guidelines for GI conditions shifted clinical objectives from symptom management to mucosal wound healing. The additional scrutiny of proton pump inhibitor (PPI) safety, increasing burden of disease, and financial costs associated with gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and inflammatory bowel disease (IBD) open new clinical possibilities for BG. This narrative literature review intersects materials engineering, formulation science, and clinical practice, setting it apart from prior literature. Broadly, current evidence for BG applications in GI conditions is sparse and under-developed, which this review directly addresses. It explores and synthesizes evidence that supports the potential use of sol-gel-derived BG for the efficacious treatment of soft tissue applications, with specific reference to GI conditions. An overview with comparative analysis of current BG synthesis techniques and associated challenges is presented, and influences of composition, biologically active ions, and morphological characteristics in soft tissue applications are explored. To contextualize this, sol-gel-derived BGs are proposed as a dual, tailorable therapeutic and drug delivery platform for upper and lower GI conditions. Future directions for this largely untapped area of translational research are also proposed, based on extant literature.

The effect of red fruit oil (Pandanus conoideus Lamk.) emulgel on angiogenesis and collagen density in incisive wound healing in mice (Mus musculus)

Pandanus conoideus Lamk. or commonly known as red fruit oil (RFO) can be used to accelerate wound healing because it contains tocopherols, carotenoids, oleic acid, linoleic acid, and linolenic acid. The RFO in this study was formulated in the form of an emulgel because it has the most convenient and effective drug delivery system. The aims of this study were to determine the activity of RFO emulgel on increasing the amount of angiogenesis and collagen density in incised wound healing and to determine the optimal dose of RFO emulgel to increase the amount of angiogenesis and collagen density in incised wound healing. This was a true experimental study with a posttest only control group design that included five treatment groups: a positive control group (10% povidone-iodine), a negative control (gel base), and three groups that varied the concentration of RFO emulgel used at 5%, 10%, and 15%. Parameters observed were the amount of angiogenesis using Image Raster software and the percentage of areas of collagen density using ImageJ software. The data were analyzed using a one-way ANOVA test and continued with the least significant difference test. The results of this study showed that RFO emulgel was able to increase the amount of angiogenesis and collagen density in the wound healing process with P = 0.000. An increase in the amount of angiogenesis and collagen density occurred in mice treated with RFO compared to the positive and negative control groups. It can be concluded that RFO emulgel has activity toward increasing the amount of angiogenesis and collagen density in the wound healing of mice incisions. The optimal dose concentration of RFO emulgel for increasing the amount of angiogenesis and collagen density in incision wound healing was shown in RFO emulgel with a concentration of 15%.

Waste to Wealth: Near-Infrared/pH Dual-Responsive Copper-Humic Acid Hydrogel Films for Bacteria-Infected Cutaneous Wound Healing

The clinical applications of currently used photosensitizers are limited by high costs, inconvenient preparation, suboptimal biodegradability, and a lack of biological activity. Humic acids (HAs) show photothermal activity and can be used as a photosensitizer for photothermal therapy. In the presence of various functional groups, HAs are endowed with anti-inflammatory and antioxidant activities. The solubility of HAs is dependent on the pH value, which is soluble in neutral to alkaline conditions and undergoes a conformational change to a coiled and compact structure in acidic conditions. Additionally, Cu2+ is an emerging therapeutic agent for cutaneous wounds and can be chelated by HAs to form complexes. In this study, we explore the ability of HAs to modulate the inflammatory response, particularly macrophage polarization, and the potential underlying mechanism. We fabricate a near-infrared (NIR)/pH dual-responsive Cu-HAs nanoparticle (NP)-based poly(vinyl alcohol) (PVA) hydrogel film loaded with SEW2871 (SEW), a macrophage recruitment agent, to treat bacteria-infected cutaneous wounds. The results show that HAs could promote M2 macrophage polarization in a dose-dependent manner. The Cu-HAs NPs successfully eradicated bacterial infection through NIR-induced local hyperthermia. This PVA@Cu-HAs NPs@SEW hydrogel film improves tissue regeneration by promoting M2 macrophage polarization, alleviating oxidative stress, enhancing angiogenesis, and facilitating collagen deposition. These findings highlight the therapeutic potential of PVA@Cu-HAs NPs@SEW hydrogel film for the treatment of bacterially infected cutaneous wound healing.

Recent Advances in Biodegradable and Biocompatible Synthetic Polymers Used in Skin Wound Healing

The treatment of skin wounds caused by trauma and pathophysiological disorders has been a growing healthcare challenge, posing a great economic burden worldwide. The use of appropriate wound dressings can help to facilitate the repair and healing rate of defective skin. Natural polymer biomaterials such as collagen and hyaluronic acid with excellent biocompatibility have been shown to promote wound healing and the restoration of skin. However, the low mechanical properties and fast degradation rate have limited their applications. Skin wound dressings based on biodegradable and biocompatible synthetic polymers can not only overcome the shortcomings of natural polymer biomaterials but also possess favorable properties for applications in the treatment of skin wounds. Herein, we listed several biodegradable and biocompatible synthetic polymers used as wound dressing materials, such as PVA, PCL, PLA, PLGA, PU, and PEO/PEG, focusing on their composition, fabrication techniques, and functions promoting wound healing. Additionally, the future development prospects of synthetic biodegradable polymer-based wound dressings are put forward. Our review aims to provide new insights for the further development of wound dressings using synthetic biodegradable polymers.

Tannic acid-functionalized 3D porous nanofiber sponge for antibiotic-free wound healing with enhanced hemostasis, antibacterial, and antioxidant properties

Developing an antibiotic-free wound dressing with effective hemostasis and antibacterial and antioxidant capacity is highly desirable. In this work, a three-dimensional (3D) chitosan/polyvinyl alcohol-tannic acid porous nanofiber sponge (3D-TA) was prepared via electrospinning. Compared with two-dimensional (2D) fiber membrane, the unique fluffy 3D-TA nanofiber sponge had high porosity, water absorption and retention ability, hemostatic capacity. Furthermore, the 3D sponge functionalized by tannic acid (TA) endow the sponge with high antibacterial and antioxidant capacity without loading antibiotics. In addition, 3D-TA composite sponges have shown highly biocompatibility against L929 cells. The in vivo experiment shows the 3D-TA is enable to accelerate wound healing. This newly 3D-TA sponges hold great potential as wound dressings for future clinical application.

Tissue-engineered small-diameter vascular grafts containing novel copper-doped bioactive glass biomaterials to promote angiogenic activity and endothelial regeneration

Small-diameter vascular grafts frequently fail because of obstruction and infection. Despite the wide range of commercially available vascular grafts, the anatomical uniqueness of defect sites demands patient-specific designs. This study aims to increase the success rate of implantation by fabricating bilayer vascular grafts containing bioactive glasses (BGs) and modifying their composition by removing hemostatic ions to make them blood-compatible and to enhance their antibacterial and angiogenesis properties. The porous vascular graft tubes were 3D printed using polycaprolactone, polyglycerol sebacate, and the modified BGs. The polycaprolactone sheath was then wrapped around the 3D-printed layer using the electrospinning technique to prevent blood leakage. The results demonstrated that the incorporation of modified BGs into the polymeric matrix not only improved the mechanical properties of the vascular graft but also significantly enhanced its antibacterial activity against both gram-negative and gram-positive strains. In addition, no hemolysis or platelet activity was detected after incorporating modified BGs into the vascular grafts. Copper-releasing vascular grafts significantly enhanced endothelial cell proliferation, motility, and VEGF secretion. Additionally, In vivo angiogenesis (CD31 immunofluorescent staining) and gene expression experiments showed that copper-releasing vascular grafts considerably promoted the formation of new blood vessels, low-grade inflammation (decreased expression of IL-1β and TNF-α), and high-level angiogenesis (increased expression of angiogenic growth factors including VEGF, PDGF-BB, and HEBGF). These observations indicate that the use of BGs with suitable compositional modifications in vascular grafts may promote the clinical success of patient-specific vascular prostheses by accelerating tissue regeneration without any coagulation problems.

A copper-metal organic framework enhances the photothermal and chemodynamic properties of polydopamine for melanoma therapy

The combination of photothermal treatment and chemodynamic therapy has attracted extensive attention for improving therapeutic effects and compensating the insufficiency of monotherapy. In this work, a copper-metal organic framework (Cu-BTC) was used to augment the photothermal effect of polydopamine (PDA) and endow it with a chemodynamic ability by constructing a Cu-BTC@PDA nanocomposite. Density functional theory calculations revealed that the plasmonic vibrations formed by the d-d transition of Cu at the Fermi level in Cu-BTC@PDA could enhance the photothermal performance of PDA. In addition, more Cu²⁺ released from Cu-BTC@PDA in the acidic microenvironment of the tumor was then reduced to Cu⁺ by glutathione (GSH) and further catalyzed H₂O₂ to generate more toxic hydroxyl radical (•OH), which synergized with photothermal treatment for melanoma therapy. Furthermore, Cu-BTC@PDA could quickly and effectively kill bacteria under the action of PTT, and the sustained release of Cu ions could contribute to the long-term and stable bacteriostatic ability of the material. This sustained release of Cu ions could also promote the cell migration and angiogenesis, and upregulate the expression of COL-, TGF-, and VEGF-related genes to accelerate wound healing. This multifunctional nanomaterial has potential application in the treatment of melanoma and repair of wounds. STATEMENT OF SIGNIFICANCE: We constructed a multifunctional nanoplatform (Cu-BTC@PDA) by two steps. This nanoplatform can not only perform cascade catalysis in the tumor microenvironment to generate more toxic hydroxyl radical (•OH), but also synergize with photothermal treatment for melanoma therapy. Additionally, Cu-BTC@PDA possesses enhanced photothermal performance through the plasmonic vibrations formed by the d-d transition of Cu at the Fermi level in Cu-BTC@PDA, which is revealed by DFT calculations. And Cu-BTC@PDA shows good antitumor, antibacterial, and wound healing properties in vivo and in vitro. Such a multifunctional nanomaterial has potential application in the treatment of melanoma and repair of wounds.

A review on borate bioactive glasses (BBG): effect of doping elements, degradation, and applications

Because of their excellent biologically active qualities, bioactive glasses (BGs) have been extensively used in the biomedical domain, leading to better tissue-implant interactions and promoting bone regeneration and wound healing. Aside from having attractive characteristics, BGs are appealing as a porous scaffold material. On the other hand, such porous scaffolds should enable tissue proliferation and integration with the natural bone and neighboring soft tissues and degrade at a rate that allows for new bone development while preventing bacterial colonization. Therefore, researchers have recently become interested in a different BG composition based on borate (B₂O₃) rather than silicate (SiO₂). Furthermore, apatite synthesis in the borate-based bioactive glass (BBG) is faster than in the silicate-based bioactive glass, which slowly transforms to hydroxyapatite. This low chemical durability of BBG indicates a fast degradation process, which has become a concern for their utilization in biological and biomedical applications. To address these shortcomings, glass network modifiers, active ions, and other materials can be combined with BBG to improve the bioactivity, mechanical, and regenerative properties, including its degradation potential. To this end, this review article will highlight the details of BBGs, including their structure, properties, and medical applications, such as bone regeneration, wound care, and dental/bone implant coatings. Furthermore, the mechanism of BBG surface reaction kinetics and the role of doping ions in controlling the low chemical durability of BBG and its effects on osteogenesis and angiogenesis will be outlined.

Preparation and evaluation of chitosan- and hyaluronic acid-grafted pullulan succinate films for skin wound healing

A novel wound dressing that possesses antibacterial properties and accelerates skin wound repair was developed by physically blending hyaluronic acid-grafted pullulan succinate (HA-st-Pu) with chitosan (CS). The HA-st-Pu polymer was synthesized and characterized, and then CS/HA-st-Pu film dressings were prepared by a freeze-drying method. The novel film wound dressings exhibited a three-dimensional cavity structure under scanning electron microscopy (SEM) and a better swelling ratio than CS, HA and Pu alone, absorbing a large amount of liquid and effectively maintaining the moist environment of the wound. CS/HA-st-Pu materials had no cytotoxicity and increased cell proliferation when coincubated with L929 cells. Moreover, CS/HA-st-Pu wound dressings exhibited a certain antibacterial capability against E. coli and S. aureus. In rat skin wound healing, CS/HA-st-Pu film dressings outperformed both the control and market band-aid groups with respect to the reduction of inflammation and acceleration of wound closure.

Nanoparticles for Topical Application in the Treatment of Skin Dysfunctions-An Overview of Dermo-Cosmetic and Dermatological Products

Nanomaterials (NM) arouse interest in various fields of science and industry due to their composition-tunable properties and the ease of modification. They appear currently as components of many consumer products such as sunscreen, dressings, sports clothes, surface-cleaning agents, computer devices, paints, as well as pharmaceutical and cosmetics formulations. The use of NPs in products for topical applications improves the permeation/penetration of the bioactive compounds into deeper layers of the skin, providing a depot effect with sustained drug release and specific cellular and subcellular targeting. Nanocarriers provide advances in dermatology and systemic treatments. Examples are a non-invasive method of vaccination, advanced diagnostic techniques, and transdermal drug delivery. The mechanism of action of NPs, efficiency of skin penetration, and potential threat to human health are still open and not fully explained. This review gives a brief outline of the latest nanotechnology achievements in products used in topical applications to prevent and treat skin diseases. We highlighted aspects such as the penetration of NPs through the skin (influence of physical-chemical properties of NPs, the experimental models for skin penetration, methods applied to improve the penetration of NPs through the skin, and methods applied to investigate the skin penetration by NPs). The review summarizes various therapies using NPs to diagnose and treat skin diseases (melanoma, acne, alopecia, vitiligo, psoriasis) and anti-aging and UV-protectant nano-cosmetics.

Design of Volumetric Nanolayers via Rapid Proteolysis of Silk Fibroin for Tissue Engineering

Various methods have been studied to make a regenerated silk fibroin solution. However, most of them take too much time and effort to liquefy. Here, we report that a regenerated silk fibroin solution could be prepared within seconds through acid proteolysis for the first time. The solubilized fibroin could be applied to advanced tissue engineering. Our method shortened the production time to one day (more than 10 times) compared to the general fibroin solution preparation method. It was confirmed that the initial protein affinity nearly doubled from 0.028 to 0.076 μg·mm^-2 in FF(ac) compared to FF(aq). A fibroin nanofiber layer having a volumetric hierarchical structure was prepared by electrospinning an acid-proteolyzed fibroin solution, followed by gas foaming. In vitro results of cell adhesion and proliferation capacity of the gas-foamed scaffold were not significantly different compared to the two-dimensional (2D) fibroin nanofiber membrane, overcoming the limitations of volumetric nanofiber scaffolds. We are confident that our research will greatly contribute to the development of regenerative engineering using other proteins.

Niobium carbide–mediated photothermal therapy for infected wound treatment

Bacterial infections of the wounds on the skin surface significantly reduce the rate of wound healing, potentially leading to serious systemic infections. Antibiotics are the first-line drugs for the treatment of these infections. However, the misuse and overuse of antibiotics have led to the emergence of bacterial resistance. Therefore, a new antimicrobial strategy is urgently needed. Photothermal therapy (PTT) is a novel efficient therapeutic technique that can produce irreversible cell damage to induce death of bacteria, possessing a great potential in infected wound healing. This work describes the use of a new photothermal agent (PTA) such as niobium carbide (NbC) nanoparticles with outstanding near-infrared (NIR) absorption property. NbC nanoparticles converted NIR laser irradiation energy into localized heat for photothermal treatment. In vitro antimicrobial experiments have revealed that NbC nanoparticles exert excellent antimicrobial effects against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). Moreover, NbC nanoparticles accelerated E. coli–infected wound healing process, reduced inflammatory response, and showed good biosafety in vivo. Altogether, NbC nanoparticles represent an efficient PTA for antimicrobial treatment and are a bio-safe material with low toxicity in vivo.

Invigorating chronic wound healing by nanocomposites composed with bioactive materials: a comprehensive review

Wound healing research has revealed a plethora of data regarding various techniques for treating diverse types of wounds. It is well known that chronic wounds heal slowly and are vulnerable to infection. Also, there are numerous factors like destitute blood passage, undetermined inflammation, angiogenesis, neuropathy, and cell multiplication which overhang chronic wound healing. To eliminate the speculative features of chronic wounds, we made a consecutive survey on specific categories of biomaterials like bioglass, bioactive glass, bioceramics, biopolymers, and biocompatible metal oxide nanoparticles. In particular, the bioglass or bioactive glass which is a silica matrix composed of sodium, calcium, phosphorous, etc., is used for bone-bonding ability and easily dissolved in vivo conditions to repair damaged and wounded tissues with their peculiar physiochemical (surface area, porous nature, structural formation, mechanical stability) and biological properties (biocompatible, cytocompatible, osteoinductive, angiogenesis, hemostatic, antibacterial, and anti-inflammation). Furthermore, based on the existing literature studies, we summarized the healing of diabetes wound tendency by bioactive composite materials and offer detailed information on the method, techniques, and future technologies for wound healing.

Bioactive inorganic particles-based biomaterials for skin tissue engineering

The challenge for treatment of severe cutaneous wound poses an urgent clinical need for the development of biomaterials to promote skin regeneration. In the past few decades, introduction of inorganic components into material system has become a promising strategy for improving performances of biomaterials in the process of tissue repair. In this review, we provide a current overview of the development of bioactive inorganic particles-based biomaterials used for skin tissue engineering. We highlight the three stages in the evolution of the bioactive inorganic biomaterials applied to wound management, including single inorganic materials, inorganic/organic composite materials, and inorganic particles-based cell-encapsulated living systems. At every stage, the primary types of bioactive inorganic biomaterials are described, followed by citation of the related representative studies completed in recent years. Then we offer a brief exposition of typical approaches to construct the composite material systems with incorporation of inorganic components for wound healing. Finally, the conclusions and future directions are suggested for the development of novel bioactive inorganic particles-based biomaterials in the field of skin regeneration.

In-situ forming hydrogel based on thiolated chitosan/carboxymethyl cellulose (CMC) containing borate bioactive glass for wound healing

Suitable wound dressings for accelerating wound healing are actively being designed and synthesised. In this study, thiolated chitosan (tCh)/oxidized carboxymethyl cellulose (OCMC) hydrogel containing Cu-doped borate bioglass (BG) was developed as a wound dressing to improve wound healing in a full-thickness skin defect of mouse animal model. Thiolation was used to incorporate thiol groups into chitosan (Ch) to enhance its water solubility and mucoadhesion characteristics. Here, the in situ forming hydrogel was successfully developed using the Schiff-based reaction, and its physio-chemical and antibacterial characteristics were examined. Borate BG was also incorporated in the generated hydrogel to promote angiogenesis and tissue regeneration at the wound site. Investigations of in vitro cytotoxicity assays demonstrated that the synthesised hydrogels showed good biocompatibility and promoted cell growth. These results inspired us to investigate the effectiveness of skin wound healing in a mouse model. On the backs of animals, two full-thickness wounds were created and treated utilising two different treatment conditions: (1) OCMC/tCh hydrogel, (2) OCMC/tCh/borate BG, and (3) control defect. The wound closure ratio, collagen deposition, and angiogenesis activity were measured after 14 days to determine the healing efficacy of the in situ hydrogels used as wound dressings. Overall, the hydrogel containing borate BG was maintained in the defect site, healing efficiency was replicable, and wound healing was apparent. In conclusion, we found consistent angiogenesis, remodelling, and accelerated wound healing, which we propose may have beneficial effects on the repair of skin defects.

Modified Sol–Gel Synthesis of Mesoporous Borate Bioactive Glasses for Potential Use in Wound Healing

In this study, we successfully utilized nitrate precursors for the synthesis of silver (Ag)-doped borate-based mesoporous bioactive glass (MBGs) based on the 1393B3 glass formulation in the presence of a polymeric substrate (polyvinyl alcohol (PVA)) as a stabilizer of boric acid. The X-ray diffraction (XRD) analysis confirmed the glassy state of all the MBGs. The incorporation of 7.5 mol% Ag into the glass composition led to a decrease in the glass transition temperature (T_g). Improvements in the particle size, zeta potential, surface roughness, and surface area values were observed in the Ag-doped MBGs. The MBGs (1 mg/mL) had no adverse effect on the viability of fibroblasts. In addition, Ag-doped MBGs exhibited potent antibacterial activity against gram-positive and gram-negative species. In summary, a modified sol–gel method was confirmed for producing the Ag-doped 1393B3 glasses, and the primary in vitro outcomes hold promise for conducting in vivo studies for managing burns.

Borate Bioactive Glasses (BBG): Bone Regeneration, Wound Healing Applications, and Future Directions

Since the early 2000s, borate bioactive glasses (BBGs) have been extensively investigated for biomedical applications. The research so far indicates that BBGs frequently exhibit superior bioactivity and bone healing capacity compared to silicate glasses. They are also suitable candidates as drug delivery devices for infection or disease treatment such as osteoporosis. Additionally, BBGs are also an excellent option for wound healing applications, which includes the availability of commercial (FDA approved) microfibrous BBG dressings to treat chronic wounds. By addition of modifying ions, the bone or wound healing capacity of BBGs can be enhanced. For instance, addition of copper ions into BBGs was shown to drastically increase blood vessel formation for wound healing applications. Moreover, addition of ions such as magnesium, strontium, and cobalt improves bone healing. Other recent research interest related to BBGs is focused on nerve and muscle regeneration applications, while cartilage regeneration is also suggested as a potential application field for BBGs. BBGs are commonly produced by melt-quenching; however, sol-gel processing of BBGs is emerging and appears to be a promising alternative. In this review paper, the physical and biological characteristics of BBGs are analyzed based on the available literature, the applications of BBGs are discussed, and future research directions are suggested.

Osteogenic and anti-tumor Cu and Mn-doped borosilicate nanoparticles for syncretic bone repair and chemodynamic therapy in bone tumor treatment

Critical bone defects caused by extensive excision of malignant bone tumor and the probability of tumor recurrence due to residual tumor cells make malignant bone tumor treatment a major clinical challenge. The present therapeutic strategy concentrates on implanting bone substitutes for defect filling but suffers from failures in both enhancing bone regeneration and inhibiting the growth of tumor cells. Herein, Cu and Mn-doped borosilicate nanoparticles (BSNs) were developed for syncretic bone repairing and anti-tumor treatment, which can enhance bone regeneration through the osteogenic effects of Cu²⁺ and Mn³⁺ ions and meanwhile induce tumor cells apoptosis through the hydroxyl radicals produced by the Fenton-like reactions of Cu²⁺ and Mn³⁺ ions. In vitro study showed that both osteogenic differentiation of BMSCs and angiogenesis of endothelial cells were promoted by BSNs, and consistently the critical bone defects of rats were efficiently repaired by BSNs through in vivo evaluation. Meanwhile, BSNs could generate hydroxyl radicals through Fenton-like reactions in the simulated tumor microenvironment, promote the generation of intracellular reactive oxygen species, and eventually induce tumor cell apoptosis. Besides, subcutaneous tumors of mice were effectively inhibited by BSNs without causing toxic side effects to normal tissues and organs. Altogether, Cu and Mn-doped BSNs developed in this work performed dual functions of enhancing osteogenesis and angiogenesis for bone regeneration, and inhibiting tumor growth for chemodynamic therapy, thus holding a great potential for syncretic bone repairing and anti-tumor therapy.

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Dual-functional bioactive borosilicate nanoparticles were successfully synthesized.

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Incorporation of Cu and Mn to the nanoparticles enhanced osteogenesis and angiogenesis.

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Cu and Mn doped borosilicate nanoparticles inhibited tumor by producing ·OH.

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Potential syncretic bone repair and chemodynamic therapy developed for bone tumor treatment.

Chronic Inflammation in Non-Healing Skin Wounds and Promising Natural Bioactive Compounds Treatment

Chronic inflammation is one of the hallmarks of chronic wounds and is tightly coupled to immune regulation. The dysregulation of the immune system leads to continuing inflammation and impaired wound healing and, subsequently, to chronic skin wounds. In this review, we discuss the role of the immune system, the involvement of inflammatory mediators and reactive oxygen species, the complication of bacterial infections in chronic wound healing, and the still-underexplored potential of natural bioactive compounds in wound treatment. We focus on natural compounds with antioxidant, anti-inflammatory, and antibacterial activities and their mechanisms of action, as well as on recent wound treatments and therapeutic advancements capitalizing on nanotechnology or new biomaterial platforms.

Nanomaterials-based drug delivery approaches for wound healing

Abstract:

Wound healing is a complex and dynamic process that requires intricate synchronization between multiple cell types within appropriate extracellular microenvironment. Wound healing process involves four overlapping phases in a precisely regulated manner, consisting of hemostasis, inflammation, proliferation, and maturation. For an effective wound healing all four phases must follow in a sequential pattern within a time frame. Several factors might interfere with one or more of these phases in healing process, thus causing improper or impaired wound healing resulting in non-healing chronic wounds. The complications associated with chronic non-healing wounds, along with the limitations of existing wound therapies, have led to the development and emergence of novel and innovative therapeutic interventions. Nanotechnology presents unique and alternative approaches to accelerate the healing of chronic wounds by the interaction of nanomaterials during different phases of wound healing. This review focuses on recent innovative nanotechnology-based strategies for wound healing and tissue regeneration based on nanomaterials, including nanoparticles, nanocomposites and scaffolds. The efficacy of the intrinsic therapeutic potential of nanomaterials (including silver, gold, zinc oxide, copper, cerium oxide, etc.) and the ability of nanomaterials as carriers (liposomes, hydrogels, polymeric nanomaterials, nanofibers) as therapeutic agents associated with wound-healing applications have also been addressed. The significance of these nanomaterial-based therapeutic interventions for wound healing needs to be highlighted to engage researchers and clinicians towards this new and exciting area of bio-nanoscience. We believe that these recent developments will offer researchers an updated source on the use of nanomaterials as an advanced approach to improve wound healing.

Bioactive glass-based fibrous wound dressings

Since the discovery of silicate bioactive glass (BG) by Larry Hench in 1969, different classes of BGs have been researched over decades mainly for bone regeneration. More recently, validating the beneficial influence of BGs with tailored compositions on angiogenesis, immunogenicity and bacterial infection, the applicability of BGs has been extended to soft tissue repair and wound healing. Particularly, fibrous wound dressings comprising BG particle reinforced polymer nanofibers and cotton-candy-like BG fibers have been proven to be successful for wound healing applications. Such fibrous dressing materials imitate the physical structure of skin’s extracellular matrix and release biologically active ions e.g. regenerative, pro-angiogenic and antibacterial ions, e.g. borate, copper, zinc, etc., that can provoke cellular activities to regenerate the lost skin tissue and to induce new vessels formation, while keeping an anti-infection environment. In the current review, we discuss different BG fibrous materials meant for wound healing applications and cover the relevant literature in the past decade. The production methods for BG-containing fibers are explained and as fibrous wound dressing materials, their wound healing and bactericidal mechanisms, depending on the ions they release, are discussed. The present gaps in this research area are highlighted and new strategies to address them are suggested.

Bioabsorbable poly(4-hydroxybutyrate) (P4HB) fibrous membranes as a potential dermal substitute

Dermal substitutes are indispensable for repairing large full-thickness skin defects. Only a few biomaterials for dermal substitution have been put into clinical practice. Therefore, novel artificial dermal substitutes that can meet clinical requirements are in urgent need. Biodegradable poly(4-hydroxybutyrate) (P4HB), which has been approved by the U.S. FDA, can be considered as a possible alternative biomaterial to construct dermal substitutes. In this work, three-dimensional P4HB fibrous membranes were constructed by an electrospinning technique. These P4HB fibrous membranes showed excellent air-permeability, and better water uptake capacity compared to P4HB strip and polycaprolactone (PCL) fibrous membrane controls. The in vitro hemocompatibility and cytotoxicity of P4HB fibrous membranes were investigated. In vivo Sprague-Dawley (SD) rat model studies revealed that P4HB fibrous membranes can be used as artificial dermis to improve wound healing for full-thickness skin defects.

Facile Polyphenol-Europium Assembly Enabled Functional Poly(l-Lactic Acid) Nanofiber Mats with Enhanced Antioxidation and Angiogenesis for Accelerated Wound Healing

Burns, trauma, surgery and chronic diabetic ulcers are the most common reasons causing skin wounds in clinic. Thus, developing a functional wound dressing has been an imperative issue. Herein, functional wound dressing (poly(l-lactic acid) PLLA-((tanic acid (TA)/europium (Eu))_n ) is fabricated through a facile polyphenol-europium ion assembly to ameliorate wound microenvironment via scavenging excessive reactive oxygen species (ROS) and promoting angiogenesis. The physicochemical characterization indicates that the multicycle assembled TA/Eu is uniformly deposited on PLLA-(TA/Eu)_n nanofiber mats surface. In vitro 2,2-diphenyl-1-picrylhydrazyl (DPPH) antioxidant tests display good antioxidant ability by scavenging more than 75% ROS, and significantly increasing the antioxidant enzyme levels in vivo. Cytocompatibility experiments illustrate that PLLA-(TA/Eu)_n nanofiber mats can promote the adhesion and proliferation of human umbilical vein endothelial cells (HUVECs) and L929 cells. Meanwhile, real-time quantitative polymerase chain reaction (PCR) (RT-qPCR) and western blot assays illustrate that it can stimulate proangiogenesis by elevating the expression of angiogenesis-related genes and proteins. In vivo Sprague-Dawley (SD) rats experiments indicate that PLLA-(TA/Eu)_n nanofiber mats can significantly promote wound healing by improving both angiogenesis and antioxidant activity. Taken together, the functional PLLA-(TA/Eu)_n nanofiber mats can offer significant promise as wound dressing for accelerated wound healing.

Donut-like MOFs of copper/nicotinic acid and composite hydrogels with superior bioactivity for rh-bFGF delivering and skin wound healing

Background

Skin injury and the resultant defects are common clinical problems, and usually lead to chronic skin ulcers and even life-threatening diseases. Copper, an essential trace element of human body, has been reported to promote the regeneration of skin by stimulating proliferation of endothelial cell and enhance angiogenesis.

Results

Herein, we have prepared a new donut-like metal–organic frameworks (MOF) of copper-nicotinic acid (CuNA) by a simple solvothermal reaction. The rough surface of CuNA is beneficial for loading/release basic fibroblast growth factor (bFGF). The CuNAs with/without bFGF are easily processed into a light-responsive composite hydrogel with GelMA, which not only show excellent mechanical properties, but also display superior biocompatibility, antibacterial ability and bioactivity. Moreover, in the in vivo full-thickness defect model of skin wound, the resultant CuNA-bFGF@GelMA hydrogels significantly accelerate the wound healing, by simultaneously inhibiting the inflammatory response, promoting the new blood vessels formation and the deposition of collagen and elastic fibers.

Conclusions

Considering the superior biocompatibility, antibacterial ability and bioactivity, the CuNA and its composite light-responsive hydrogel system will be promising in the applications of skin and even other tissue regeneration.

Graphic abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s12951-021-01014-z.

Research progress on polysaccharide/protein hydrogels: Preparation method, functional property and application as delivery systems for bioactive ingredients

Some bioactive ingredients in foods are unstable and easily degraded during processing, storage, transportation and digestion. To enhance the stability and bioavailability, some food hydrogels have been developed to encapsulate these unstable compounds. In this paper, the preparation methods, formation mechanisms, physicochemical and functional properties of some protein hydrogels, polysaccharide hydrogels and protein-polysaccharide composite hydrogels were comprehensively summarized. Since the hydrogels have the ability to control the release and enhance the bioavailability of bioactive ingredients, the encapsulation and release mechanisms of polyphenols, flavonoids, carotenoids, vitamins and probiotics by hydrogels were further discussed. This review will provide a comprehensive reference for the deep application of polysaccharide/protein hydrogels in food industry.

A novel therapeutic phosphate-based glass improves full-thickness wound healing in a rat model

Wound healing is a highly dynamic process and innovative therapeutic approaches are currently developed to address challenges of providing optimal wound care. In this study, phosphate-based glasses in the (CuO)_x ·(KPO₃ )_79.5-x ·(ZnO)₂₀ ·(Ag₂ O)_0.5 system (CuKPO₃ ZnAg), with different CuO/ KPO₃ ratios were prepared by melt-quenching technique. Constant Cu concentrations were released from the samples during immersion in Simulated Body Fluid (SBF), while Zn concentrations were slightly decreased over time. Glass surface phosphatation leading to formation of Zn crystalline salts was revealed through spectroscopic techniques. This finding was supported by SEM images that illustrated new compound formation. Subsequent cytotoxicity evaluation on HaCaT Keratinocytes using the indirect MTT cell viability assay revealed a CuO concentration-dependent cytotoxicity profile and excellent biocompatibility at low CuO concentrations, in all CuKPO₃ ZnAg glasses. Furthermore, the (CuO)₅ ·(KPO₃ )_74.5 ·(ZnO)₂₀ ·(Ag₂ O)_0.5 sample (5CuKPO₃ ZnAg)_, demonstrated superior antibacterial potency against S. aureus (ATCC 25923) strain compared to amoxicillin and ciprofloxacin. In vivo full-thickness wound healing evaluation showed a significantly higher regenerative effect of the 5CuKPO₃ ZnAg sample, in terms of angiogenesis, collagen synthesis and re-epithelialization compared to non-treated wounds. These findings advance our understanding of the therapeutic perspectives of phosphate-based glasses, showing promising potential for wound-healing applications.

Mesoporous Silica Nanoparticles and Mesoporous Bioactive Glasses for Wound Management: From Skin Regeneration to Cancer Therapy

Exploring new therapies for managing skin wounds is under progress and, in this regard, mesoporous silica nanoparticles (MSNs) and mesoporous bioactive glasses (MBGs) offer great opportunities in treating acute, chronic, and malignant wounds. In general, therapeutic effectiveness of both MSNs and MBGs in different formulations (fine powder, fibers, composites etc.) has been proved over all the four stages of normal wound healing including hemostasis, inflammation, proliferation, and remodeling. The main merits of these porous substances can be summarized as their excellent biocompatibility and the ability of loading and delivering a wide range of both hydrophobic and hydrophilic bioactive molecules and chemicals. In addition, doping with inorganic elements (e.g., Cu, Ga, and Ta) into MSNs and MBGs structure is a feasible and practical approach to prepare customized materials for improved skin regeneration. Nowadays, MSNs and MBGs could be utilized in the concept of targeted therapy of skin malignancies (e.g., melanoma) by grafting of specific ligands. Since potential effects of various parameters including the chemical composition, particle size/morphology, textural properties, and surface chemistry should be comprehensively determined via cellular in vitro and in vivo assays, it seems still too early to draw a conclusion on ultimate efficacy of MSNs and MBGs in skin regeneration. In this regard, there are some concerns over the final fate of MSNs and MBGs in the wound site plus optimal dosages for achieving the best outcomes that deserve careful investigation in the future.

A multifunctional substance P-conjugated chitosan hydrochloride hydrogel accelerates full-thickness wound healing by enhancing synchronized vascularization, extracellular matrix deposition, and nerve regeneration

Due to the native skin limitations and the complexity of reconstructive microsurgery, advanced biomaterials are urgently required to promote wound healing for severe skin defects caused by accidents and disasters. Accumulating evidence has supported that substance P (SP) has a potential effect on skin regeneration. However, SP application is seriously impeded by its poor stability and oxidative reactions occurring during production, transportation, and storage. An SP-conjugated chitosan hydrochloride hydrogel (CSCl-SP) fabricated in this study demonstrated an enhanced capacity to repair full-thickness skin defects. CSCl-SP provided a stable in vitro delivery system for SP. The dissolution of CSCl-SP promoted the proliferation, migration, and tube formation, as well as angiogenesis-related gene and protein expression in human umbilical vein endothelial cells. CSCI-SP also stimulated the proliferation, migration, and production of anabolic growth factor in human fibroblasts. Moreover, CSCl-SP significantly promoted the neurite outgrowth in Neuro-2A cells. In vivo, CSCl-SP dramatically strengthened the vascularization, extracellular matrix deposition and remodeling, and nerve regeneration, thereby promoting efficient recovery of the full-thickness skin defect. Thus, synchronized multifunction of the CSCl-SP hydrogel makes it a promising and smart material for intractable skin defects.

Bioactive glass: A multifunctional delivery system

Bioactive glasses (BAGs) were invented five decades ago and have been widely used clinically in orthopedic and stomatology. However, in the past two decades, BAGs have been explored immensely by several researchers worldwide as a multifunctional delivery system for a multitude of therapeutics ranging from metal ions to small molecules (e.g., drugs) and macromolecules (e.g., DNA). The impetus for devising a BAG-based delivery system in the 21st century is based upon the facilitative properties it offers for entrapment of a wide range of therapeutic molecules and the tailorable controlled release kinetics to the target tissue site along with the biological activity of the ionic dissolution products in several pathological conditions such as osteoporosis, cancer, infection, and inflammation. This review comprises two parts: the first part discusses the need for a new delivery system and how the journey from melt quench progressed towards template-based sol-gel mesoporous. In the second part, we have comprehended the scientific advancements made so far, emphasizing BAGs as a delivery system ranging from therapeutic ions to phytopharmaceuticals. We have also highlighted a few loopholes that have prevented bench-to-bedside clinical translation of a plethora of elucidative researches done so far.

Multifunctional modified polylactic acid nanofibrous scaffold incorporating sodium alginate microspheres decorated with strontium and black phosphorus for bone tissue engineering

Polylactic acid (PLA) nanofibrous scaffolds have received extensive attention in the field of tissue engineering due to their excellent degradability, biocompatibility and the biomimetic extracellular matrix (ECM) topographies. However, the cell affinity and osteogenic activity of PLA scaffolds is not satisfactory because of their intrinsic hydrophobicity, the absence of cell recognition sites and the nucleation sites of the in vivo biomineralization. Furthermore, effective anti-inflammatory activity for the in vivo scaffold could not be ignored, so a strategy to develop a multifunctional PLLA (poly-L-lactic acid) nanofibrous scaffold with improved hydrophilicity, osteoinductivity, excellent near-infrared photothermal-responsive drug release capacity and anti-inflammatory activity via incorporating sodium alginate microspheres decorated with strontium and ibuprofen-loaded black phosphorus (BP + IBU@SA microspheres) into aminated modified PLLA nanofiber network is proposed in this study. Scanning electron microscopy (SEM) observation showed that the BP + IBU@SA microspheres were homogeneously dispersed into the modified PLLA matrix with uniform nanofiber structure and the chemical composition of the as-prepared scaffolds was confirmed by X-ray diffraction analysis (XRD) and elemental mapping. The photothermal property of the scaffolds was assessed under near-infrared (NIR) light irradiation, the results manifested that the entrapment of BP nanosheets endowed PLLA nanofibrous scaffold with significantly high photothermal conversion efficiency and optical cycle stability. Meanwhile, the scaffold also displayed an excellent photothermal-responsive intelligent drug release performance toward Sr²⁺ and ibuprofen. Moreover, the in vitro studies revealed that the as-developed scaffolds possessed a good biocompatibility for cell adhesion and proliferation and an improved bioactivity to induce apatite formation. All these results indicated the potential of the fabricated scaffolds in tissue engineering applications.

Injectable Desferrioxamine-Laden Silk Nanofiber Hydrogels for Accelerating Diabetic Wound Healing

Dysangiogenesis and chronic inflammation are two critical reasons for diabetic foot ulcers. Desferrioxamine (DFO) was used clinically in the treatment of diabetic foot ulcers by repeated injections because of its capacity to induce vascularization. Biocompatible carriers that release DFO slowly and facilitate healing simultaneously are preferable options to accelerate the healing of diabetic wounds. Here, DFO-laden silk nanofiber hydrogels that provided a sustained release of DFO for more than 40 days were used to treat diabetic wounds. The DFO-laden hydrogels stimulated the healing of diabetic wounds. In vitro cell studies revealed that the DFO-laden hydrogels modulated the migration and gene expression of endothelial cells, and they also tuned the inflammation behavior of macrophages. These results were confirmed in an in vivo diabetic wound model. The DFO-laden hydrogels alleviated dysangiogenesis and chronic inflammation in the diabetic wounds, resulting in a more rapid wound healing and increased collagen deposition. Both in vitro and in vivo studies suggested potential clinical applications of these DFO-laden hydrogels in the treatment of diabetic ulcers.

Nanotherapeutics for regeneration of degenerated tissue infected by bacteria through the multiple delivery of bioactive ions and growth factor with antibacterial/angiogenic and osteogenic/odontogenic capacity

Therapeutic options are quite limited in clinics for the successful repair of infected/degenerated tissues. Although the prevalent treatment is the complete removal of the whole infected tissue, this leads to a loss of tissue function and serious complications. Herein the dental pulp infection, as one of the most common dental problems, was selected as a clinically relevant case to regenerate using a multifunctional nanotherapeutic approach. For this, a mesoporous bioactive glass nano-delivery system incorporating silicate, calcium, and copper as well as loading epidermal growth factor (EGF) was designed to provide antibacterial/pro-angiogenic and osteo/odontogenic multiple therapeutic effects. Amine-functionalized Cu-doped bioactive glass nanospheres (Cu-BGn) were prepared to be 50-60 nm in size, mesoporous, positive-charged and bone-bioactive. The Cu-BGn could release bioactive ions (copper, calcium and silicate ions) with therapeutically-effective doses. The Cu-BGn treatment to human umbilical vein endothelial cells (HUVEC) led to significant enhancement of the migration, tubule formation and expression of angiogenic gene (e.g. vascular endothelial growth factor, VEGF). Furthermore, the EGF-loaded Cu-BGn (EGF@Cu-BGn) showed pro-angiogenic effects with antibacterial activity against E. faecalis, a pathogen commonly involved in the pulp infection. Of note, under the co-culture condition of HUVEC with E. faecalis, the secretion of VEGF was up-regulated. In addition, the osteo/odontogenic stimulation of the EGF@Cu-BGn was evidenced with human dental pulp stem cells. The local administration of the EGF@Cu-BGn in a rat molar tooth defect infected with E. faecalis revealed significant in vivo regenerative capacity, highlighting the nanotherapeutic uses of the multifunctional nanoparticles for regenerating infected/damaged hard tissues.

Cryogenically printed flexible chitosan/bioglass scaffolds with stable and hierarchical porous structures for wound healing

Wound healing is a dynamic and well-orchestrated process that can be promoted by creating an optimal environment with wound dressing. An ideal wound dressing material should possess a suitable matrix, structure and bioactive components, functioning synergistically to accelerate wound healing. Wound dressings that allow reproducibility and customizability are highly desirable in clinical practice. In this study, using chitosan (CS) as the matrix and bioglass (BG) as the biological component, a spatially designed dressing scaffold was fabricated from a home-made cryogenic printing system. The micro- and macro-structures of the scaffold were highly controllable and reproducible. The printed scaffold exhibited interconnected and hierarchical pore structures, as well as good flexibility and water absorption capacity, and these properties were not affected by the content of BG. Nevertheless, when the content of BGs exceeded 20% that of CS, the tension strength and elongation rate reduced, but in vitro antibacterial, cell proliferation and migration performance were enhanced. In vivo examinations revealed that the composite scaffold significantly promoted wound healing process, with the group having 30% bioglass showing better wound closure, neovascularization and collagen deposition than other groups. These results indicate that the 3D printed CS/BG composite scaffold is a promising dressing material that accelerates wound healing.

Copper-containing bioactive glasses and glass-ceramics: From tissue regeneration to cancer therapeutic strategies

Copper is one of the most used therapeutic metallic elements in biomedicine, ranging from antibacterial approaches to cancer theranostics. This element could be easily incorporated into different types of biomaterials; specifically, copper-doped bioactive glasses (BGs) provide great opportunities for biomedical engineers and clinicians as regards their excellent biocompatibility and regenerative potential. Although copper-incorporated BGs are mostly used in bone tissue engineering, accelerated soft tissue healing is achievable, too, with interesting potentials in wound treatment and skin repair. Copper can modulate the physico-chemical properties of BGs (e.g., reactivity with bio-fluids) and improve their therapeutic potential. Improving cell proliferation, promoting angiogenesis, reducing or even prohibiting bacterial growth are counted as prominent biological features of copper-doped BGs. Recent studies have also suggested the suitability of copper-doped BGs in cancer photothermal therapy (PTT). However, more research is needed to determine the extent to which copper-doped BGs are actually applicable for tissue engineering and regenerative medicine strategies in the clinic. Moreover, copper-doped BGs in combination with polymers may be considered in the future to produce relatively soft, pliable composites and printable inks for use in biofabrication.

Enhanced angiogenic effects of RGD, GHK peptides and copper (II) compositions in synthetic cryogel ECM model

Synthetic oligopeptides are a promising alternative to natural full-length growth factors and extracellular matrix (ECM) proteins in tissue regeneration and therapeutic angiogenesis applications. In this work, angiogenic properties of dual and triple compositions containing RGD, GHK peptides and copper (II) ions (Cu²⁺) were for the first time studied. To reveal specific in vitro effects of these compositions in three-dimensional scaffold, adamantyl group bearing peptides, namely Ada-Ahx-GGRGD (1) and Ada-Ahx-GGGHK (2), were effectively immobilized in bioinert pHEMA macroporous cryogel via host-guest β-cyclodextrin-adamantane interaction. The cryogels were additionally functionalized with Cu²⁺ via the formation of GHK-Cu complex. Angiogenic responses of HUVECs grown within the cryogel ECM model were analyzed. The results demonstrate that the combination of RGD with GHK and further with Cu²⁺ dramatically increases cell proliferation, differentiation, and production of a series of angiogenesis related cytokines and growth factors. Furthermore, the level of glutathione, a key cellular antioxidant and redox regulator, was altered in relation to the angiogenic effects. These results are of particular interest for establishing the role of multiple peptide signals on regeneration related processes and for developing improved tissue engineering materials.

"Hard" ceramics for "Soft" tissue engineering: Paradox or opportunity?

Tissue engineering provides great possibilities to manage tissue damages and injuries in modern medicine. The involvement of hard biocompatible materials in tissue engineering-based therapies for the healing of soft tissue defects has impressively increased over the last few years: in this regard, different types of bioceramics were developed, examined and applied either alone or in combination with polymers to produce composites. Bioactive glasses, carbon nanostructures, and hydroxyapatite nanoparticles are among the most widely-proposed hard materials for treating a broad range of soft tissue damages, from acute and chronic skin wounds to complex injuries of nervous and cardiopulmonary systems. Although being originally developed for use in contact with bone, these substances were also shown to offer excellent key features for repair and regeneration of wounds and "delicate" structures of the body, including improved cell proliferation and differentiation, enhanced angiogenesis, and antibacterial/anti-inflammatory activities. Furthermore, when embedded in a soft matrix, these hard materials can improve the mechanical properties of the implant. They could be applied in various forms and formulations such as fine powders, granules, and micro- or nanofibers. There are some pre-clinical trials in which bioceramics are being utilized for skin wounds; however, some crucial questions should still be addressed before the extensive and safe use of bioceramics in soft tissue healing. For example, defining optimal formulations, dosages, and administration routes remain to be fixed and summarized as standard guidelines in the clinic. This review paper aims at providing a comprehensive picture of the use and potential of bioceramics in treatment, reconstruction, and preservation of soft tissues (skin, cardiovascular and pulmonary systems, peripheral nervous system, gastrointestinal tract, skeletal muscles, and ophthalmic tissues) and critically discusses their pros and cons (e.g., the risk of calcification and ectopic bone formation as well as the local and systemic toxicity) in this regard. STATEMENT OF SIGNIFICANCE: Soft tissues form a big part of the human body and play vital roles in maintaining both structure and function of various organs; however, optimal repair and regeneration of injured soft tissues (e.g., skin, peripheral nerve) still remain a grand challenge in biomedicine. Although polymers were extensively applied to restore the lost or injured soft tissues, the use of bioceramics has the potential to provides new opportunities which are still partially unexplored or at the very beginning. This reviews summarizes the state of the art of bioceramics in this field, highlighting the latest evolutions and the new horizons that can be opened by their use in the context of soft tissue engineering. Existing results and future challenges are discussed in order to provide an up-to-date contribution that is useful to both experienced scientists and early-stage researchers of the biomaterials community.