Switchable Dual-Function and Bioresponsive Materials to Control Bacterial Infections

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.

Zwitterionic hydrogel for preserving stability and activity of oxidase enzyme for electrochemical biosensor

Enzymatic electrochemical biosensor is the most common analytical platform for medical diagnosis. To mimic the biological environment of the enzyme for maintaining the function of biosensor, zwitterionic hydrogels have been recognized as effective matrices for enzymatic immobilization. Herein, a zwitterionic hydrogel derived from a copolymer, poly[2-methacryloyloxyethyl phosphorylcholine (MPC)-co-N-methacryloyloxyethyl tyrosine methylester (MAT)] (PMM) was firstly applied as versatile coating to preserve stability and activity of oxidase enzymes, glucose oxidase (GOx) and lactate oxidase (LOx) for enzymatic electrochemical sensor. A screen-printed carbon electrode (SPCE) was sequentially coated with nitrogen-doped graphene (NDG), oxidase enzyme, and PMM mixed with Ru(II)bpy32+ and (NH4)2S2O8 followed by visible light irradiation for 3 min to induce PMM gelation. Electrochemical detection of glucose and lactate using the modified SPCE was performed via amperometry in the presence of hydrogen peroxide. The activity of both GOx and LOx immobilized on the modified SPCE was well maintained for 49 days at 87 and 80 %, respectively. Additionally, two different electrodes, a screen-printed graphene electrode (SPGE), and a screen-printed silver electrode (SPAgE), similarly modified gave the same satisfactory detection of spiked glucose and lactate in human plasma and sweat with 93-118 % recovery. This indicates the potential of the PMM hydrogel as a universal platform for preservation of enzymes which can be easily fabricated without the need for specific chemical modification of the electrode.

Poly(dehydroalanine)-Based Hydrogels as Efficient Soft Matter Matrices for Light-Driven Catalysis

Soft matter integration of photosensitizers and catalysts provides promising solutions to developing sustainable materials for energy conversion. Particularly, hydrogels bring unique benefits, such as spatial control and 3D-accessibility of molecular units, as well as recyclability. Herein, the preparation of polyampholyte hydrogels based on poly(dehydroalanine) (PDha) is reported. Chemically crosslinked PDha with bis-epoxy poly(ethylene glycol) leads to a transparent, self-supporting hydrogel. Due to the ionizable groups on PDha, this 3D polymeric matrix can be anionic, cationic, or zwitterionic depending on the pH value, and its high density of dynamic charges has a potential for electrostatic attachment of charged molecules. The integration of the cationic molecular photosensitizer [Ru(bpy)3 ]2+ (bpy = 2,2'-bipyridine) is realized, which is a reversible process controlled by pH, leading to light harvesting hydrogels. They are further combined with either a thiomolybdate catalyst ([Mo3 S13 ]2- ) for hydrogen evolution reaction (HER) or a cobalt polyoxometalate catalyst (Co4 POM = [Co4 (H2 O)2 (PW9 O34 )2 ]10- ) for oxygen evolution reaction (OER). Under the optimized condition, the resulting hydrogels show catalytic activity in both cases upon visible light irradiation. In the case of OER, higher photosensitizer stability is observed compared to homogeneous systems, as the polymer environment seems to influence decomposition pathways.

Recent Advances in Dual-Function Superhydrophobic Antibacterial Surfaces

Bacterial adhesion and subsequent biofilm formation on the surfaces of synthetic materials imposes a significant burden in various fields, which can lead to infections in patients or reduce the service life of industrial devices. Therefore, there is increasing interest in imbuing surfaces with antibacterial properties. Bioinspired superhydrophobic surfaces with high water contact angles (>150°) exhibit excellent surface repellency against contaminations, thereby preventing initial bacterial adhesion and inhibiting biofilm formation. However, conventional superhydrophobic surfaces typically lack long-term durability and are incapable of achieving persistent efficacy against bacterial adhesion. To overcome these limitations, in recent decades, dual-function superhydrophobic antibacterial surfaces with both bacteria-repelling and bacteria-killing properties have been developed by introducing bactericidal components. These surfaces have demonstrated improved long-term antibacterial performance in addressing the issues associated with surface-attached bacteria. This review summarizes the recent advancements of these dual-function superhydrophobic antibacterial surfaces. First, a brief overview of the fabrication strategies and bacteria-repelling mechanism of superhydrophobic surfaces is provided and then the dual-function superhydrophobic antibacterial surfaces are classified into three types based on the bacteria-killing mechanism: i) mechanotherapy, ii) chemotherapy, and iii) phototherapy. Finally, the limitations and challenges of current research are discussed and future perspectives in this promising area are proposed.

Ag-lignin hybrid nanoparticles for high-performance solar absorption in photothermal antibacterial chitosan films

There is an urgent need for antimicrobial films based on sustainable resources and production methods. In this study, we present a bio-based nanocomposite film composed of chitosan (∼60 wt %), lignin nanoparticles (LNPs, ∼40 wt %), a small amount of glutaraldehyde (1.5 wt %), and a trace level of silver nanoparticles (AgNPs, 0.072 wt %). The uniform dispersion with LNPs prevented aggregation of metallic silver, resulting in small (diameter 3.3 nm) AgNPs. The nanocomposite film absorbs 89% of radiation across the entire solar spectrum and exhibits a remarkable photothermally triggered antibacterial effect, which is further enhanced by the dark color of lignin. Under simulated solar light illumination, the nanocomposite films demonstrated a significant reduction in viable Escherichia coli count compared to control scenarios. The potential applications of these nanocomposites extend to sunlight-activated antimicrobial films and coatings, addressing the growing demand for sustainable and effective antimicrobial materials.

Dynamic surface adapts to multiple service stages by orchestrating responsive polymers and functional peptides

Control over the implant surface functions is highly desirable to enhance tissue healing outcomes but has remained unexplored to adapt to the different service stages. In the present study, we develop a smart titanium surface by orchestrating thermoresponsive polymer and antimicrobial peptide to enable dynamic adaptation to the implantation stage, normal physiological stage and bacterial infection stage. The optimized surface inhibited bacterial adhesion and biofilm formation during surgical implantation, while promoted osteogenesis in the physiological stage. The further temperature increase driven by bacterial infection induced polymer chain collapse to expose antimicrobial peptides by rupturing bacterial membranes, as well as protect the adhered cells from the hostile environment of infection and abnormal temperature. The engineered surface could inhibit infection and promote tissue healing in rabbit subcutaneous and bone defect infection models. This strategy enables the possibility to create a versatile surface platform to balance bacteria/cell-biomaterial interactions at different service stages of implants that has not been achieved before.

Brush Polymer Coatings with Hydrophilic Main-Chains for Improving Surface Antibacterial Properties

Polymer coatings with improved surface antibacterial properties are of great importance for the application and development of implantable medical devices. Herein, we report the design, preparation, and antibacterial properties of a series of brush polymers (Dex-KEs) with hydrophilic dextran main-chains and mixed-charge polypeptide (KE) side-chains. Dex-KEs showed higher bactericidal activity and antifouling and antibiofilm properties than maleic acid modified dextran (Dex-Ma), KE, Dex-Ma/KE blend coatings, and brush polymer coatings with hydrophobic main-chains (AcDex-KEs). They also showed negligible in vitro cytotoxicity toward different mammalian cells and good in vivo biocompatibility. Dex-KE-coated implants exhibited potent in vivo resistance to bacterial infection before or after implantation.

Flat Silk Cocoon-Based Dressing: Daylight-Driven Rechargeable Antibacterial Membranes Accelerate Infected Wound Healing

One of the leading causes of death globally, especially in underdeveloped countries, is bacterial infection. Recently, the prevalence of infections from antibiotic-resistant bacteria has been increasing, which makes the need for innovative antibacterial wound dressings urgent. It is reported that g-C₃ N₄ -based flat silk cocoons (FSCs) with rechargeable antibacterial activity can efficiently generate reactive oxygen species (ROS) under daylight irradiation. The photoactive FSCs store the ROS and then release them in the dark. The engineered FSCs exhibit integrated properties of good biocompatibility, strong mechanical characteristics, robust photoactivity with photostorability, and excellent bactericidal efficiency (99.9% contact killing). In a rat model of infected wounds, the photoactive FSCs induce faster healing and reduce bacterial infections. The successful application of these FSC materials as wound dressings may provide a versatile platform for exploring the use of green photoactive antibacterial materials for accelerated wound healing and prevention of infections.

Recent Developments in Multifunctional Antimicrobial Surfaces and Applications toward Advanced Nitric Oxide-Based Biomaterials

Implant-associated infections arising from biofilm development are known to have detrimental effects with compromised quality of life for the patients, implying a progressing issue in healthcare. It has been a struggle for more than 50 years for the biomaterials field to achieve long-term success of medical implants by discouraging bacterial and protein adhesion without adversely affecting the surrounding tissue and cell functions. However, the rate of infections associated with medical devices is continuously escalating because of the intricate nature of bacterial biofilms, antibiotic resistance, and the lack of ability of monofunctional antibacterial materials to prevent the colonization of bacteria on the device surface. For this reason, many current strategies are focused on the development of novel antibacterial surfaces with dual antimicrobial functionality. These surfaces are based on the combination of two components into one system that can eradicate attached bacteria (antibiotics, peptides, nitric oxide, ammonium salts, light, etc.) and also resist or release adhesion of bacteria (hydrophilic polymers, zwitterionic, antiadhesive, topography, bioinspired surfaces, etc.). This review aims to outline the progress made in the field of biomedical engineering and biomaterials for the development of multifunctional antibacterial biomedical devices. Additionally, principles for material design and fabrication are highlighted using characteristic examples, with a special focus on combinational nitric oxide-releasing biomedical interfaces. A brief perspective on future research directions for engineering of dual-function antibacterial surfaces is also presented.

Bactericidal Anti-Adhesion Potential Integrated Polyoxazoline/Silver Nanoparticle Composite Multilayer Film with pH Responsiveness

Bacterial infections occur frequently during the implantation of medical devices, and functional coating is one of the effective means to prevent and remove biofilms. In this study, three different hydrophilic polyoxazolines with carboxyl groups (aPOx: PT1, PT2 and PT3) and bactericidal silver nanoparticles (AgNPs) were synthesized successfully, and an aPOx-AgNP multilayer film was prepared by electrostatic layer-by-layer self-assembly. The effect of charge density and assembly solution concentration was explored, and the optimal self-assembly parameters were established (PT2 1 mg/mL and AgNPs 3 mg/mL). The hydrophilicity of the surface can be enhanced to resist protein adhesion if the outermost layer is aPOx, and AgNPs can be loaded to kill bacteria, thereby realizing the bactericidal anti-adhesion potential integration of the aPOx-AgNP multilayer film. In addition, the aPOx-AgNP multilayer film was found to have the characteristic of intelligent and efficient pH-responsive silver release, which is expected to be used as a targeted anti-biofilm surface of implantable medical devices.

Zn-Mn-Doped Mesoporous Bioactive Glass Nanoparticle-Loaded Zein Coatings for Bioactive and Antibacterial Orthopedic Implants

In recent years, natural polymers have replaced synthetic polymers for antibacterial orthopedic applications owing to their excellent biocompatibility and biodegradability. Zein is a biopolymer found in corn. The lacking mechanical stability of zein is overcome by incorporating bioceramics, e.g., mesoporous bioactive glass nanoparticles (MBGNs). In the present study, pure zein and zein/Zn–Mn MBGN composite coatings were deposited via electrophoretic deposition (EPD) on 316L stainless steel (SS). Zn and Mn were co-doped in MBGNs in order to make use of their antibacterial and osteogenic potential, respectively. A Taguchi design of experiment (DoE) study was established to evaluate the effect of various working parameters on the morphology of the coatings. It was observed that coatings deposited at 20 V for 5 min with 4 g/L concentration (conc.) of Zn–Mn MBGNs showed the highest deposition yield. Uniform coatings with highly dispersed MBGNs were obtained adopting these optimized parameters. Scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR) were employed to investigate the morphology and elemental composition of zein/Zn–Mn MBGN composite coatings. Surface properties, i.e., coating roughness and wettability analysis, concluded that composite coatings were appropriate for cell attachment and proliferation. For adhesion strength, various techniques, including a tape test, bend test, pencil hardness test, and tensile test, were performed. Wear and corrosion analysis highlighted the mechanical and chemical stability of the coatings. The colony forming unit (CFU) test showed that the zein/Zn–Mn MBGN composite coating was highly effective against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) due to the presence of Zn. The formation of a hydroxyapatite (HA)-like structure upon immersion in the simulated body fluid (SBF) validated the in vitro bioactivity of the coating. Moreover, a WST-8 assay depicted that the MG-63 cells proliferate on the composite coating. It was concluded that the zein/Zn–Mn MBGN coating synthesized in this work can be used for bioactive and antibacterial orthopedic applications.

Recent Trends in Composite Nanozymes and Their Pro-Oxidative Role in Therapeutics

Nanozymes are inorganic nanostructures whose enzyme mimic activities are increasingly explored in disease treatment, taking inspiration from natural enzymes. The catalytic ability of nanozymes to generate reactive oxygen species can be used for designing effective antimicrobials and antitumor therapeutics. In this context, composite nanozymes are advantageous, particularly because they integrate the properties of various nanomaterials to offer a single multifunctional platform combining photodynamic therapy (PDT), photothermal therapy (PTT), and chemodynamic therapy (CDT). Hence, recent years have witnessed great progress in engineering composite nanozymes for enhanced pro-oxidative activity that can be utilized in therapeutics. Therefore, the present review traverses over the newer strategies to design composite nanozymes as pro-oxidative therapeutics. It provides recent trends in the use of composite nanozymes as antibacterial, antibiofilm, and antitumor agents. This review also analyzes various challenges yet to be overcome by pro-oxidative composite nanozymes before being used in the field.

Antibacterial and hemostatic capacities of cellulose nanocrystalline-reinforced poly(vinyl alcohol) electrospun mats doped with Tiger 17 and pexiganan peptides for prospective wound healing applications

Infection is a major issue in chronic wound care. Different dressings have been developed to prevent microbial propagation, but an effective, all-in-one (cytocompatible, antimicrobial and promoter of healing) solution is still to be uncovered. In this research, polyvinyl alcohol (PVA) nanofibrous mats reinforced with cellulose nanocrystal (CNC), at 10 and 20% v/v ratios, were produced by electrospinning, crosslinked with glutaraldehyde vapor and doped with specialized peptides. Crosslinking increased the mats' fiber diameters but maintained their bead-free morphology. Miscibility between polymers was confirmed by Fourier-transform infrared spectroscopy and thermal evaluations. Despite the incorporation of CNC having reduced the mats' mechanical performance, it improved the mats' surface energy and its structural stability over time. Pexiganan with an extra cysteine group was functionalized onto the mats via hydroxyl- polyethylene glycol 2-maleimide, while Tiger 17 was physisorbed to preserve its cyclic conformation. Antimicrobial assessments demonstrated the peptide-doped mat's effectiveness against Staphylococcus aureus and Pseudomonas aeruginosa; pexiganan contributed mostly for such outcome. Tiger 17 showed excellent capacity in accelerating clotting. Cytocompatibility evaluations attested to these mats' safety. C90/10 PVA/CNC mats were deemed the most effective from the tested group and, thus, a potentially effective option for chronic wound treatments.

Rational design of dual-functional surfaces on polypropylene with antifouling and antibacterial performances via a micropatterning strategy

The hydrophobicity and inertness of the polypropylene (PP) material surface usually lead to serious biofouling and bacterial infections, which hamper its potential application as a biomedical polymer. Many strategies have been developed to improve its antifouling or antibacterial properties, yet designing a surface to achieve both antifouling and antibacterial performances simultaneously remains a challenge. Herein, we construct a dual-function micropatterned PP surface with antifouling and antibacterial properties through plasma activation, photomask technology and ultraviolet light-induced graft polymerization. Based on the antifouling agent poly(2-methacryloyloxyethyl phosphate choline) (PMPC) and the antibacterial agent quaternized poly(N,N-dimethylamino)ethyl methacrylate (QPDMAEMA), two different micropatterning structures have been successfully prepared: PP-PMPC-QPDMAEMA in which QPDMAEMA is the micropattern and PMPC is the coating polymer, and PP-QPDMAEMA-PMPC in which PMPC is the micropattern and QPDMAEMA is the coating polymer. The composition, elemental distribution and surface morphology of PP-PMPC-QPDMAEMA and PP-QPDMAEMA-PMPC have been thoroughly characterized by Fourier transform infrared (FT-IR) spectroscopy, X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM), respectively. Compared with pristine PP, the two types of micropatterned PP films exhibit good surface hydrophilicity as characterized by water contact angle measurements. The results of anti-protein adsorption, platelet adhesion and antibacterial evaluation showed that PP-PMPC-QPDMAEMA and PP-QPDMAEMA-PMPC had good anti-protein adsorption properties, especially for lysozyme (Lyz). They can effectively prevent platelet adhesion, and the anti-platelet adhesion performance of PP-QPDMAEMA-PMPC is slightly better than that of the PP-PMPC-QPDMAEMA sample. The sterilization rate of S. aureus and E. coli is as high as 95% for the two types of micropatterned PP films. Due to the rational design of micropatterns on the PP surface, the two classes of dual-functional PP materials realize both the resistance of protein and platelet adhesion, and the killing of bacteria at the same time. We anticipate that this work could provide a design strategy for the construction of multifunctional biomedical polymer materials.

Naked-eye sensing and target-guiding treatment of bacterial infection using pH-tunable multicolor luminescent lanthanide-based hydrogel

In this work, a pH-tunable multicolor luminescent lanthanide-based hydrogel (CS/DEX/CP) was prepared based on lanthanide coordination polymer (CP), dextran aldehyde (DEX) and chitosan (CS). The CP was obtained by the self-assembly of guanosine acid (GMP), ciprofloxacin (CIP), Eu³⁺, and Tb³⁺. As-prepared CS/DEX/CP hydrogel could emit blue, green, and red luminescence of CIP, Tb³⁺, and Eu³⁺, respectively. It was also found that the luminescence of CS/DEX/CP hydrogel exhibited visual color change in the pH range of 5.5 to 8. Such pH-sensitive hydrogel was multicolor-responsive to protons produced by bacterial growth, therefore, it could provide early warning of bacterial infection by naked-eye. In addition, the increased acidity resulted in not only the degradation of acid-labile Schiff base linkages between DEX and CS, but also the fracture of coordination between CIP and lanthanide ions. As a result, the released CIP and CS showed significantly antibacterial activity against both S. aureus and E. coli.

Unraveling the Structured Solvation Shell of Zwitterion Nanoparticles for Controlled Release of Nitric Oxide

Zwitterions have been attracting emerging attention as an anti-fouling polymer. However, the relationship between structured solvation shells and controlled drug release induced by deceleration of water molecule's translational and vibrational motions of zwitterions is an uncharted territory. Herein, sulfobetaine zwitterion nanoparticles (ZWNPs) were designed as a stable nitric oxide (NO)-delivering carrier. The condensed water structure of the solvation shell at its isoelectric point (PI) and the loose structure of water under different pH conditions were investigated through rheological and thermodynamical analyses. The ZWNPs showed a sustained-release profile at the PI, which presented a structured solvation barrier. On the other hand, NO-loaded ZWNPs showed different release profiles with the burst release at pH 5.5. Notably, an increased cell proliferation rate and a decreased antibacterial effect were observed at the same concentration depending on solvation shell's characteristics.

Surface Design for Antibacterial Materials: From Fundamentals to Advanced Strategies

Healthcare-acquired infections as well as increasing antimicrobial resistance have become an urgent global challenge, thus smart alternative solutions are needed to tackle bacterial infections. Antibacterial materials in biomedical applications and hospital hygiene have attracted great interest, in particular, the emergence of surface design strategies offer an effective alternative to antibiotics, thereby preventing the possible development of bacterial resistance. In this review, recent progress on advanced surface modifications to prevent bacterial infections are addressed comprehensively, starting with the key factors against bacterial adhesion, followed by varying strategies that can inhibit biofilm formation effectively. Furthermore, "super antibacterial systems" through pre-treatment defense and targeted bactericidal system, are proposed with increasing evidence of clinical potential. Finally, the advantages and future challenges of surface strategies to resist healthcare-associated infections are discussed, with promising prospects of developing novel antimicrobial materials.

Dual-Functional Surfaces Based on an Antifouling Polymer and a Natural Antibiofilm Molecule: Prevention of Biofilm Formation without Using Biocides

Pathogenic biofilms formed on the surfaces of implantable medical devices and materials pose an urgent global healthcare problem. Although conventional antibacterial surfaces based on bacteria-repelling or bacteria-killing strategies can delay biofilm formation to some extent, they usually fail in long-term applications, and it remains challenging to eradicate recalcitrant biofilms once they are established and mature. From the viewpoint of microbiology, a promising strategy may be to target the middle stage of biofilm formation including the main biological processes involved in biofilm development. In this work, a dual-functional antibiofilm surface is developed based on copolymer brushes of 2-hydroxyethyl methacrylate (HEMA) and 3-(acrylamido)phenylboronic acid (APBA), with quercetin (Qe, a natural antibiofilm molecule) incorporated via acid-responsive boronate ester bonds. Due to the antifouling properties of the hydrophilic poly(HEMA) component, the resulting surface is able to suppress bacterial adhesion and aggregation in the early stages of contact. A few bacteria are eventually able to break through the protection of the anti-adhesion layer leading to bacterial colonization. In response to the resulting decrease in the pH of the microenvironment, the surface could then release Qe to interfere with the microbiological processes related to biofilm formation. Compared to bactericidal and anti-adhesive surfaces, this dual-functional surface showed significantly improved antibiofilm performance to prevent biofilm formation involving both Gram-negative Pseudomonas aeruginosa and Gram-positive Staphylococcus aureus for up to 3 days. In addition, both the copolymer and Qe are negligibly cytotoxic, thereby avoiding possible harmful effects on adjacent normal cells and the risk of bacterial resistance. This dual-functional design approach addresses the different stages of biofilm formation, and (in accordance with the growth process of the biofilm) allows sequential activation of the functions without compromising the viability of adjacent normal cells. A simple and reliable solution may thus be provided to the problems associated with biofilms on surfaces in various biomedical applications.

A sulfonate-based polypeptide toward infection-resistant coatings

Multifunctional coatings have gained significant attention for their promising potential to address the issue of medical device-related infections. However, they usually have multiple components in one layer which decreases the density of functional groups on surfaces and hence reduces the biological properties. Herein, we report a mono-component and sulfonate-based anionic polypeptide coating with on-demand antibacterial activity, antifouling property, and biocompatibility. The anionic polypeptide was prepared by ring-opening polymerization of L-cysteine-based N-carboxyanhydride (NCA) with allyl groups and a subsequent thiol-ene reaction to incorporate the sulfonate pendants. It adopted a 17.1-19.5% β-sheet conformation and self-assembled into a spherical nanoparticle. The polypeptide coating showed excellent in vitro antibacterial activity against both Gram-positive (i.e., S. aureus) and Gram-negative bacteria (i.e., E. coli) with >99% killing efficacy after acidic solution treatment and prominent antifouling property and biocompatibility after weak base treatment. An in vivo study revealed that the sulfonate-based polypeptide-coated polydimethylsiloxane (PDMS) exhibited good anti-infection property and histocompatibility.

Dressing Blood-Contacting Materials by a Stable Hydrogel Coating with Embedded Antimicrobial Peptides for Robust Antibacterial and Antithrombus Properties

Although dressing blood-contacting devices with robust and synergistic antibacterial and antithrombus properties has been explored for several decades, it still remains a great challenge. In order to endow materials with remarkable antibacterial and antithrombus abilities, a stable and antifouling hydrogel coating was developed via surface-initiated polymerization of sulfobetaine methacrylate and acrylic acid on a polymeric substrate followed by embedding of antimicrobial peptides (AMPs), including WR (sequence: WRWRWR-NH₂) or Bac2A (sequence: RLARIVVIRVAR-NH₂) AMPs. The chemical composition of the AMP-embedded hydrogel coating was determined through XPS, zeta potential, and SEM-EDS measurements. The AMP-embedded antifouling hydrogel coating showed not only good hemocompatibility but also excellent bactericidal and antiadhesion properties against Gram-positive and Gram-negative bacteria. Moreover, the hydrogel coating could protect the AMPs with long-term bioactivity and cover the positive charge of the dotted distributed AMPs, which in turn well retained the hemocompatibility and antifouling capacity of the bulk hydrogels. Furthermore, the microbiological results of animal experiments also verified the anti-infection performance in vivo. Histological and immunological data further indicated that the hydrogel coating had an excellent anti-inflammatory function. Therefore, the present study might provide a promising approach to prevent bacterial infections and thrombosis in clinical applications of blood-contacting devices and related implants.

Novel Multifunctional Silver Nanocomposite Serves as a Resistance-Reversal Agent to Synergistically Combat Carbapenem-Resistant Acinetobacter baumannii

In the face of the abundant production of various types of carbapenemases, the antibacterial efficiency of imipenem, seen as "the last line of defense", is weakening. Following, the incidence of carbapenem-resistant Acinetobacter baumannii (CRAB), which can generate antibiotic-resistant biofilms, is increasing. Based on the superior antimicrobial activity of silver nanoparticles against multifarious bacterial strains compared with common antibiotics, we constructed the IPM@AgNPs-PEG-NOTA nanocomposite (silver nanoparticles were coated with SH-PEG-NOTA as well as loaded by imipenem) whose core was a silver nanoparticle to address the current challenge, and IPM@AgNPs-PEG-NOTA was able to function as a novel smart pH-sensitive nanodrug system. Synergistic bactericidal effects of silver nanoparticles and imipenem as well as drug-resistance reversal via protection of the β-ring of carbapenem due to AgNPs-PEG-NOTA were observed; thus, this nanocomposite confers multiple advantages for efficient antibacterial activity. Additionally, IPM@AgNPs-PEG-NOTA not only offers immune regulation and accelerates tissue repair to improve therapeutic efficacy in vivo but also can prevent the interaction of pathogens and hosts. Compared with free imipenem or silver nanoparticles, this platform significantly enhanced antibacterial efficiency while increasing reactive oxygen species (ROS) production and membrane damage, as well as affecting cell wall formation and metabolic pathways. According to the results of crystal violet staining, LIVE/DEAD backlight bacterial viability staining, and real-time quantitative polymerase chain reaction (RT-qPCR), this silver nanocomposite downregulated the levels of ompA expression to prevent formation of biofilms. In summary, this research demonstrated that the IPM@AgNPs-PEG-NOTA nanocomposite is a promising antibacterial agent of security, pH sensitivity, and high efficiency in reversing resistance and synergistically combatting carbapenem-resistant A. baumannii. In the future, various embellishments and selected loads for silver nanoparticles will be the focus of research in the domains of medicine and nanotechnology.

Smart gating porous particles as new carriers for drug delivery

The design of smart drug delivery carriers has recently attracted great attention in the biomedical field. Smart carriers can specifically respond to physical and chemical changes in their environment, such as temperature, photoirradiation, ultrasound, magnetic field, pH, redox species, and biomolecules. This review summarizes recent advances in the integration of porous particles and stimuli-responsive gatekeepers for effective drug delivery. Their unique structural properties play an important role in facilitating the diffusion of drug molecules and cell attachment. Various techniques for fabricating porous materials, with their major advantages and limitations, are summarized. Smart gatekeepers provide advanced functions such as "open-close" switching by functionalized stimuli-responsive polymers on a particle's pores. These controlled delivery systems enable drugs to be targeted at specific rates, time programs, and sites of the human body. The gate structures, gating mechanisms, and controlled release mechanisms of each trigger are detailed. Current ongoing research and future trends in targeted drug delivery, tissue engineering, and regenerative medicine applications are highlighted.

Synthesis and characterization of lysozyme-conjugated Ag.ZnO@HA nanocomposite: A redox and pH-responsive antimicrobial agent with photocatalytic activity

Hydroxyapatite (HA) is extensively used for implantable device coating; however, it lacks antibacterial property, leading to potential bacterial infection during orthopedic implantation surgery. Herein, to enhance the antibacterial activity of HA, a redox- and pH-responsive HA nanocomposite with photocatalytic activity was designed. A photosensitive heterostructure, zinc oxide/hydroxyapatite (ZnO.HA), was coated with Ag nanoparticles (AgNPs) with assisted gallic acid using the UV-irradiation method. An antibacterial enzyme, lysozyme, was then conjugated on the surface of the nanocomposite by a cleavable disulfide linker, resulting in a redox-sensitive nanoplatform. In comparison with bare HA, the designed nanocomposites as Lyso.CAGZ@HA displayed much higher antibacterial activity (> 5-fold) toward Escherichia coli (E. coli) owing to the synergistic antibacterial effects of ZnONPs, AgNPs, gallic acid, and lysozyme on the surface of the nanocomposite. However, antibacterial and antifouling effects are much more enhanced in Lyso.CAGZ@HA-treated bacteria as they were subjected to UVA irradiation. Moreover, the cellular uptake of nanocomposite and intracellular glutathione depletion enhanced in the presence of UVA light, resulting in reactive oxygen specious generation enhancement. Further, in vitro cytotoxicity experiments on mammalian cells (human foreskin fibroblast) revealed that nanocomposite has no cytotoxic effects. Hence, this study demonstrated that Lyso.CAGZ@HA could be considered as a potential therapeutic approach against bacterial infectious diseases.

Corrosion resistance, nano-mechanical properties, and biocompatibility of Mg-plasma-implanted and plasma-etched Ta/TaN hierarchical multilayered coatings on the nitrided AZ91 Mg alloy

A tantalum/tantalum nitride (Ta/TaN) multilayered coating is deposited on plasma-nitridedAZ91 Mg alloy. The top TaN layer undergoes O₂+ Ar plasma etching to improve the antibacterial properties and Mg plasma immersion ion implantation (MgPIII) is performed to enhance the biocompatibility and wound healing capability. A uniform, compact, homogeneous, and columnar nanostructured MgPIII and plasma-etched TaN layer with a cluster size of about 17 nm, surface roughness of 0.28 nm, and needle morphology is observed. Although, plasma etching increases the corrosion current density (i_corr) from 0.02 to 0.19 µA cm^-2due to larger surface roughness and different potentials between sharp points and smooth points, MgPIII decreasesi_corrfrom 0.19 to 0.02 µA cm^-2besides a more positive corrosion potential. The amounts of Mg⁺²released to the simulated body fluid (SBF) diminishes from 89.63 ± 0.54 to 60.30 ± 0.47 mg l^-1cm^-2indicating improved corrosion resistance. Under fever conditions (40 °C),i_corrdecreases by 63%, but the open circuit potential does not change due to the constant chemical composition of the surface as well as thicker double layer and less defects, as confirmed by the larger amount of Mg⁺²of 71.49 ± 0.22 mg l^-1cm^-2leached to the SBF. In the self-healing process which occurs via the reactions between the tantalum intermediate layer and electrolytes and penetrating ions through the defects as well as formation of oxide compounds, creation and propagation of defects are deterred as shown the 24 h destructive polarization test in SBF. The combination of plasma etching and MgPIII enhance not only the bacterial resistance and biocompatibility of the super-hard TaN layer by providing the rougher surface on TaN-P-Mg, but also the nano-mechanical properties and anticorrosion properties. As a result, the hardness increases by 7%, elastic modulus decreases by 19%, and the stiffness increases by 21%.

In vitro and in vivo antibacterial performance of Zr & O PIII magnesium alloys with high concentration of oxygen vacancies

The effects of dual Zr and O plasma immersion ion implantation (Zr & O PIII) on antibacterial properties of ZK60 Mg alloys are systematically investigated. The results show that a hydrophobic, smooth, and ZrO₂-containing graded film is formed. Electrochemical assessment shows that the corrosion rate of the plasma-treated Mg alloy decreases and the decreased degradation rate is attributed to the protection rendered by the surface oxide. In vitro and in vivo antibacterial tests reveal Zr & O PIII ZK60 presents higher antibacterial rate compared to Zr PIII ZK60 and untreated control. The hydrophobic and smooth surface suppresses bacterial adhesion. High concentration of oxygen vacancies in the surface films are determined by X-ray photoelectron spectroscopy (XPS), UV–vis diffuse reflectance spectra (UV–vis DRS) and electron paramagnetic resonance (EPR) and involved in the production of reactive oxygen species (ROS). The higher level of ROS expression inhibits biofilm formation by down-regulating the expression of icaADBC genes but up-regulating the expression of icaR gene. In addition, Zr & O PIII improves cell viability and initial cell adhesion confirming good cytocompatibility. Dual Zr & O PIII is a simple and practical means to expedite clinical acceptance of biodegradable magnesium alloys.

•

A ZrO₂-containing graded film with high concentration of oxygen vacancies was formed via PIII.

•

S. aureus adhesion was suppressed due to enhanced hydrophobicity and decreased roughness.

•

High concentration of oxygen vacancies lead to the upregulation of ROS expression.

•

ROS mediates biofilm-associated genes expression to inhibit biofilm formation in vitro and in vivo.

Solvent-Free Fabrication of Self-Regenerating Antibacterial Surfaces Resisting Biofilm Formation

Biofilm formation on indwelling medical devices is a major cause of hospital-acquired infections. Monofunctional antibacterial surfaces have been developed to resist the formation of biofilms by killing bacteria on contact, but the adsorption of killed bacterial cells and debris gradually undermines the function of these surfaces. Here, we report a facile approach to produce an antibacterial surface that can regenerate its function after contamination. The self-regenerating surface was achieved by sequential deposition of alternating antibacterial and biodegradable layers of coating using a solvent-free initiated chemical vapor deposition method. As the top antibacterial layer gradually loses its killing ability due to the accumulation of debris, the underlying biodegradable layer degrades, shedding off the top surface layers and exposing another fresh antibacterial surface. Urinary catheters coated with monofunctional and self-regenerating antibacterial coatings both showed more than 99% bacterial killing ability at the initial antibacterial test, but the monofunctional surface lost its killing ability after continued exposure to concentrated bacterial solution, whereas the self-regenerating surfaces regained strong bacterial killing ability after prolonged exposure. Employing poly(methacrylic anhydride) and its copolymers with varied composition as the degrading layer, the degradation kinetics can be well-tailored and the self-regeneration duration spanned from minutes to days. The designed self-regenerating antibacterial surfaces could provide an effective approach to resist biofilm formation and extend the service life of indwelling medical devices.

Exploration of Bioengineered Scaffolds Composed of Thermo-Responsive Polymers for Drug Delivery in Wound Healing

Innate and adaptive immune responses lead to wound healing by regulating a complex series of events promoting cellular cross-talk. An inflammatory response is presented with its characteristic clinical symptoms: heat, pain, redness, and swelling. Some smart thermo-responsive polymers like chitosan, polyvinylpyrrolidone, alginate, and poly(ε-caprolactone) can be used to create biocompatible and biodegradable scaffolds. These processed thermo-responsive biomaterials possess 3D architectures similar to human structures, providing physical support for cell growth and tissue regeneration. Furthermore, these structures are used as novel drug delivery systems. Locally heated tumors above the polymer lower the critical solution temperature and can induce its conversion into a hydrophobic form by an entropy-driven process, enhancing drug release. When the thermal stimulus is gone, drug release is reduced due to the swelling of the material. As a result, these systems can contribute to the wound healing process in accelerating tissue healing, avoiding large scar tissue, regulating the inflammatory response, and protecting from bacterial infections. This paper integrates the relevant reported contributions of bioengineered scaffolds composed of smart thermo-responsive polymers for drug delivery applications in wound healing. Therefore, we present a comprehensive review that aims to demonstrate these systems' capacity to provide spatially and temporally controlled release strategies for one or more drugs used in wound healing. In this sense, the novel manufacturing techniques of 3D printing and electrospinning are explored for the tuning of their physicochemical properties to adjust therapies according to patient convenience and reduce drug toxicity and side effects.

Photothermal bactericidal surfaces: killing bacteria using light instead of biocides

Recent developments of photothermal bactericidal surfaces based on immobilized photothermal agents to kill bacteria through hyperthermia effects are reviewed.

A facile and universal strategy to endow implant materials with antibacterial ability via alkalinity disturbing bacterial respiration

Multifarious strategies have been proposed to enhance the antibacterial ability of implant surfaces for preventing bacterial infection, however, developing facile and universal modification methods still remains extremely elusive. Herein, inspired by the fact that the electron transfer respiratory chain of bacteria is embedded in the membrane, we proposed a novel strategy of local alkalinity disturbing bacterial respiration to endow implant materials with antibacterial ability. As a demonstration, MgO was deposited on biomedical titanium via magnetron sputtering to regulate surface alkalinity. With the thickness of MgO films increasing, they exhibited an excellent antibacterial rate against both Gram-negative and positive bacteria. The antibacterial mechanism confirmed that the alkaline surface can disturb the bacterial respiration action via weakening the transmembrane proton concentration gradient, resulting in the blockage of energy metabolism and the increase of oxidative stress of bacteria. Cell experiments indicated that MgO films not only have no obvious cytotoxicity to osteoblast cells, but can also selectively kill bacteria and promote cell proliferation in the presence of both bacteria and cells. More importantly, the by-product of MgO was only the biocompatible Mg2+, reducing any concerns about potential toxic effects. Furthermore, sputtering alkaline MgO films was confirmed to work well on polyetheretherketone polymer and zirconia ceramic implants, which indicates that this strategy has broad prospects of clinical application for preventing implant-associated bacterial infection.

pH responsive zwitterionic-to-cationic transition for safe self-defensive antibacterial application

Bacteria-induced infections have always been associated with various medical devices. The construction of an intelligent antimicrobial surface is an important challenge. In this study, we report the construction of a zwitterionic surface with good biocompatibility under physiological conditions and which shows an anti-adhesion effect on the original bacteria. Once the bacteria multiply, the acidic environment initiated by the bacteria will cause the amide bond on the surface to break, and the zwitterionic surface can be rapidly converted to a cationic bactericidal surface. Confocal laser scanning (CLSM) and scanning electron microscopy (SEM) show that the zwitterionic surface has efficient antibacterial activity with an anti-adhesion property while the pH-responsive transition to quaternary ammonium compounds with a germicidal surface in the acidic environment of bacterial metabolism aids the activity. Thus, the pH-responsive zwitterionic-to-cationic transition antibacterial design opens up new ideas for the efficient and safe application of cationic bactericides in clinical medical antibacterial materials.

Smart, Photothermally Activated, Antibacterial Surfaces with Thermally Triggered Bacteria-Releasing Properties

The development of effective antibacterial surfaces to prevent the attachment of pathogenic bacteria and subsequent bacterial colonization and biofilm formation is critically important for medical devices and public hygiene products. In the work reported herein, a smart antibacterial hybrid film based on tannic acid/Fe³⁺ ion (TA/Fe) complex and poly(N-isopropylacrylamide) (PNIPAAm) is deposited on diverse substrates. This surface is shown to have bacteria-killing and bacteria-releasing properties based on, respectively, near-infrared photothermal activation and subsequent cooling. The TA/Fe complex has three roles in this system: (i) as a universal adhesive "anchor" for surface modification, (ii) as a high-efficiency photothermal agent for ablation of attached bacteria (including multidrug resistant bacteria), and (iii) as a robust linker for immobilization of NH₂-terminated PNIPAAm via either Michael addition or Schiff base formation. Moreover, because of the thermoresponsive properties of the immobilized PNIPAAm, almost all of the killed bacteria and other debris can be removed from the surface simply by lowering the temperature. It is shown that this hybrid film can maintain good antibacterial performance after being used for multiple "kill-and-release" cycles and can be applied to various substrates regardless of surface chemistry or topography, thus providing a broadly applicable, simple, and reliable solution to the problems associated with surface-attached bacteria in various healthcare applications.

Multistimulus Responsive Biointerfaces with Switchable Bioadhesion and Surface Functions

Stimuli-responsive biointerfaces can serve as dynamic tools for modulation of biointerfacial interactions. Considering the complexity of biological environments, surfaces with multistimulus responsive switchable bioactivity are of great interest. In the work reported herein, a multistimulus responsive biointerface with on-off switchable bioadhesion (protein adsorption, bacterial adhesion, and cell adhesion) and surface functions in response to change in temperature, pH, or sugar content is developed. This surface is based on a silicon modified with a copolymer containing a thermoresponsive component (poly(N-isopropylacrylamide)) and a component, phenylboronic acid, that can form pH-responsive and sugar-responsive dynamic boronate ester bonds with diol-containing molecules. It is shown that biointeractions including protein adsorption and release, bacteria and cell attachment and detachment on this surface can be regulated by changing temperature, pH, and sugar content of the medium, either individually or all three simultaneously. Furthermore, this surface can switch between two different functions, namely between killing and releasing bacteria, by introduction of a diol-containing biocidal compound. Compared to switchable surfaces that are responsive to only one stimulus, our multistimulus responsive surface is better adapted to respond to the multifunctional complexities of the biological environment and thus has potential for use in numerous biomedical and biotechnology applications.

The synergistic effect of hierarchical structure and alkyl chain length on the antifouling and bactericidal properties of cationic/zwitterionic block polymer brushes

A well-organized hierarchical structure and appropriate alkyl chain length facilitate the synergistic anti-biofilm effect.

Antibacterial and Cytocompatible Nanoengineered Silk-Based Materials for Orthopedic Implants and Tissue Engineering

Many postsurgical complications stem from bacteria colony formation on the surface of implants, but the usage of antibiotic agents may cause antimicrobial resistance. Therefore, there is a strong demand for biocompatible materials with an intrinsic antibacterial resistance not requiring extraneous chemical agents. In this study, homogeneous nanocones were fabricated by oxygen plasma etching on the surface of natural, biocompatible Bombyx mori silk films. The new hydroxyl bonds formed on the surface of the nanopatterned film by plasma etching increased the surface energy by around 176%. This hydrophilic nanostructure reduced the bacterial attachment by more than 90% for both Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus) bacteria and at the same time improved the proliferation of osteoblast cells by 30%. The nanoengineered substrate and pristine silk were cultured for 6 h with three different bacteria concentrations of 10⁷, 10⁵, and 10³ CFU mL^-1 and the cell proliferation on the nanopatterned samples was significantly higher due to limited bacteria attachment and prevention of biofilm formation. The concept and materials described here reveal a promising alternative to produce biomaterials with an inherent biocompatibility and bacterial resistance simultaneously to mitigate postsurgical infections and minimize the use of antibiotics.