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Uberoi A, McCready-Vangi A, Grice EA. The wound microbiota: microbial mechanisms of impaired wound healing and infection. Nat Rev Microbiol 2024; 22:507-521. [PMID: 38575708 DOI: 10.1038/s41579-024-01035-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 04/06/2024]
Abstract
The skin barrier protects the human body from invasion by exogenous and pathogenic microorganisms. A breach in this barrier exposes the underlying tissue to microbial contamination, which can lead to infection, delayed healing, and further loss of tissue and organ integrity. Delayed wound healing and chronic wounds are associated with comorbidities, including diabetes, advanced age, immunosuppression and autoimmune disease. The wound microbiota can influence each stage of the multi-factorial repair process and influence the likelihood of an infection. Pathogens that commonly infect wounds, such as Staphylococcus aureus and Pseudomonas aeruginosa, express specialized virulence factors that facilitate adherence and invasion. Biofilm formation and other polymicrobial interactions contribute to host immunity evasion and resistance to antimicrobial therapies. Anaerobic organisms, fungal and viral pathogens, and emerging drug-resistant microorganisms present unique challenges for diagnosis and therapy. In this Review, we explore the current understanding of how microorganisms present in wounds impact the process of skin repair and lead to infection through their actions on the host and the other microbial wound inhabitants.
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Affiliation(s)
- Aayushi Uberoi
- Departments of Dermatology and Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amelia McCready-Vangi
- Departments of Dermatology and Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth A Grice
- Departments of Dermatology and Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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2
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Gandini M, Cerullo A, Giusto G. Pectin-honey hydrogel to prevent laparotomy surgical site infection in horses: A pilot study. J Equine Vet Sci 2024; 139:105128. [PMID: 38852926 DOI: 10.1016/j.jevs.2024.105128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 05/23/2024] [Accepted: 06/07/2024] [Indexed: 06/11/2024]
Abstract
Surgical site infection (SSI) is a common complication after celiotomy in horses, leading to increased morbidity and costs. Increased concern about antibiotic resistance justifies evaluation of alternative preventive approaches, such a Manuka honey which has displayed antimicrobial properties. Pectin-Honey Hydrogels (PHH), composed by Manuka honey and pectin provide a moist wound environment and microbial growth inhibition. The aim of the study was to evaluate the effectiveness of PHHs in preventing SSI in horses subjected to emergency laparotomy. Horses undergoing laparotomy were evaluated. Horses were randomly divided into two groups: Group 1 received PHH application onto the sutured linea alba before skin closure, while Group 2 received no treatment. Horses with postoperative antimicrobial administration or survival of less than 5 days were excluded. The incidence of SSIs was reported as percentages and compared between groups. Out of 44 horses enrolled in the study, only thirty-six were ultimately included. Exclusions occurred either due to death before 5 days postoperatively (2 horses) or the administration of postoperative antimicrobials (6 horses). The median length of hospitalization was 9 days (range 8-14 days). The overall occurrence of SSI was 19.4 %. One out of eighteen horses (5.5 %) in Group 1 and 6 out of 18 (33.3 %) horses in Group 2 developed SSI. Group 2 had an 8.5-fold increased risk of SSI (p = 0.035, OR = 8.5, 95 % CI. 0.9-80.07). No macroscopically visible adverse reactions were associated with PHH. PHH placed at the abdominal incision during surgery was safe and reduced the prevalence of SSI in horses.
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Affiliation(s)
- Marco Gandini
- Veterinary Teaching Hospital, Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, 10095, Italy
| | - Anna Cerullo
- Veterinary Teaching Hospital, Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, 10095, Italy
| | - Gessica Giusto
- Veterinary Teaching Hospital, Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, 10095, Italy.
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3
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Onyango LA, Liang J. Manuka honey as a non-antibiotic alternative against Staphylococcus spp. and their small colony variant (SCVs) phenotypes. Front Cell Infect Microbiol 2024; 14:1380289. [PMID: 38868298 PMCID: PMC11168119 DOI: 10.3389/fcimb.2024.1380289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/21/2024] [Indexed: 06/14/2024] Open
Abstract
The antibiotic resistance (ABR) crisis is an urgent global health priority. Staphylococci are among the problematic bacteria contributing to this emergency owing to their recalcitrance to many clinically important antibiotics. Staphylococcal pathogenesis is further complicated by the presence of small colony variants (SCVs), a bacterial subpopulation displaying atypical characteristics including retarded growth, prolific biofilm formation, heightened antibiotic tolerance, and enhanced intracellular persistence. These capabilities severely impede current chemotherapeutics, resulting in chronic infections, poor patient outcomes, and significant economic burden. Tackling ABR requires alternative measures beyond the conventional options that have dominated treatment regimens over the past 8 decades. Non-antibiotic therapies are gaining interest in this arena, including the use of honey, which despite having ancient therapeutic roots has now been reimagined as an alternative treatment beyond just traditional topical use, to include the treatment of an array of difficult-to-treat staphylococcal infections. This literature review focused on Manuka honey (MH) and its efficacy as an anti-staphylococcal treatment. We summarized the studies that have used this product and the technologies employed to study the antibacterial mechanisms that render MH a suitable agent for the management of problematic staphylococcal infections, including those involving staphylococcal SCVs. We also discussed the status of staphylococcal resistance development to MH and other factors that may impact its efficacy as an alternative therapy to help combat ABR.
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Affiliation(s)
- Laura A. Onyango
- Department of Biology, Trinity Western University, Langley, BC, Canada
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4
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Wang S, Qiu Y, Zhu F. An updated review of functional ingredients of Manuka honey and their value-added innovations. Food Chem 2024; 440:138060. [PMID: 38211407 DOI: 10.1016/j.foodchem.2023.138060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 01/13/2024]
Abstract
Manuka honey (MH) is a highly prized natural product from the nectar of Leptospermum scoparium flowers. Increased competition on the global market drives MH product innovations. This review updates comparative and non-comparative studies to highlight nutritional, therapeutic, bioengineering, and cosmetic values of MH. MH is a good source of phenolics and unique chemical compounds, such as methylglyoxal, dihydroxyacetone, leptosperin glyoxal, methylsyringate and leptosin. Based on the evidence from in vitro, in vivo and clinical studies, multifunctional bioactive compounds of MH have exhibited anti-oxidative, anti-inflammatory, immunomodulatory, anti-microbial, and anti-cancer activities. There are controversial topics related to MH, such as MH grading, safety/efficacy, implied benefits, and maximum levels of contaminants concerned. Artificial intelligence can optimize MH studies related to chemical analysis, toxicity prediction, multi-functional mechanism exploration and product innovation.
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Affiliation(s)
- Sunan Wang
- Canadian Food and Wine Institute, Niagara College, 135 Taylor Road, Niagara-on-the-Lake, Ontario L0S 1J0, Canada; School of Chemical Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Yi Qiu
- Division of Engineering Science, Faculty of Applied Science and Engineering, University of Toronto, 35 St. George Street, Toronto, Ontario M5S 1A4, Canada
| | - Fan Zhu
- School of Chemical Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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5
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Zhuang ZM, Wang Y, Feng ZX, Lin XY, Wang ZC, Zhong XC, Guo K, Zhong YF, Fang QQ, Wu XJ, Chen J, Tan WQ. Targeting Diverse Wounds and Scars: Recent Innovative Bio-design of Microneedle Patch for Comprehensive Management. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2306565. [PMID: 38037685 DOI: 10.1002/smll.202306565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/16/2023] [Indexed: 12/02/2023]
Abstract
Wounds and the subsequent formation of scars constitute a unified and complex phased process. Effective treatment is crucial; however, the diverse therapeutic approaches for different wounds and scars, as well as varying treatment needs at different stages, present significant challenges in selecting appropriate interventions. Microneedle patch (MNP), as a novel minimally invasive transdermal drug delivery system, has the potential for integrated and programmed treatment of various diseases and has shown promising applications in different types of wounds and scars. In this comprehensive review, the latest applications and biotechnological innovations of MNPs in these fields are thoroughly explored, summarizing their powerful abilities to accelerate healing, inhibit scar formation, and manage related symptoms. Moreover, potential applications in various scenarios are discussed. Additionally, the side effects, manufacturing processes, and material selection to explore the clinical translational potential are investigated. This groundwork can provide a theoretical basis and serve as a catalyst for future innovations in the pursuit of favorable therapeutic options for skin tissue regeneration.
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Affiliation(s)
- Ze-Ming Zhuang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, P. R. China
| | - Yong Wang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, P. R. China
| | - Zi-Xuan Feng
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, P. R. China
| | - Xiao-Ying Lin
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, P. R. China
| | - Zheng-Cai Wang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, P. R. China
| | - Xin-Cao Zhong
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, P. R. China
| | - Kai Guo
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, P. R. China
| | - Yu-Fan Zhong
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, P. R. China
| | - Qing-Qing Fang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, P. R. China
| | - Xiao-Jin Wu
- Department of Ultrasound in Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, P. R. China
| | - Jian Chen
- Department of Ultrasound in Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, P. R. China
| | - Wei-Qiang Tan
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, P. R. China
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6
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V M A, Suresh S, Kumar A, K P, N M R, Rangappa S, Murthy SN, H N S. Overcoming challenges in dermal and transdermal delivery of herbal therapeutics with polymeric microneedles. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2024; 35:364-396. [PMID: 37982815 DOI: 10.1080/09205063.2023.2286033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023]
Abstract
Natural products are generally preferred medications owing to their low toxicity and irritancy potential. However, a good number of herbal therapeutics (HT) exhibit solubility, permeability and stability issues that eventually affect oral bioavailability. Transdermal administration has been successful in resolving some of these issues which has lead in commercialization of a few herbal transdermal products. Polymeric Microneedles (MNs) has emerged as a promising platform in transdermal delivery of HT that face problems in permeating the skin. Several biocompatible and biodegradable polymers used in the fabrication of MNs have been discussed. MNs have been exploited for cutaneous delivery of HT in management of skin ailments like skin cancer, acne, chronic wounds and hypertrophic scar. Considering the clinical need, MNs are explored for systemic delivery of potent HT for management of diverse disorders like asthma, disorders of central nervous system and nicotine replacement as it obviates first pass metabolism and elicits a quicker onset of therapeutic response. MNs of HT have found good number of aesthetic applications in topical delivery of HT to the skin. Interestingly, MNs have emerged as an attractive option as a minimally invasive diagnostic aid in sampling biomarkers from plants, skin and ocular interstitial fluid. The review updates the progress made by MN technology of HT for multiple therapeutic interventions along with the future challenges. An attempt is made to illustrate the challenging formulation strategies employed in the fabrication of polymeric MNs of HT. Efforts are on to extend the potential applications of polymeric MNs to HT for diverse therapeutic applications.
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Affiliation(s)
- Anusha V M
- Institute for Drug Delivery and Biomedical Research, Bengaluru, India
| | - Sarasija Suresh
- Institute for Drug Delivery and Biomedical Research, Bengaluru, India
| | - Avichal Kumar
- Department of Pharmaceutics, KLE College of Pharmacy, Bengaluru, India
| | - Paranjyothy K
- Institute for Drug Delivery and Biomedical Research, Bengaluru, India
| | - Reena N M
- Topical Products Testing LLC, Oxford, Mississippi, USA
| | | | - S Narasimha Murthy
- Institute for Drug Delivery and Biomedical Research, Bengaluru, India
- Topical Products Testing LLC, Oxford, Mississippi, USA
| | - Shivakumar H N
- Institute for Drug Delivery and Biomedical Research, Bengaluru, India
- Department of Pharmaceutics, KLE College of Pharmacy, Bengaluru, India
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7
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Yang X, Cao W, Gu X, Zheng L, Wang Q, Li Y, Wei F, Ma T, Zhang L, Wang Q. Simvastatin nanocrystals-based dissolving microneedles for wound healing. Int J Pharm 2023; 647:123543. [PMID: 37879572 DOI: 10.1016/j.ijpharm.2023.123543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/06/2023] [Accepted: 10/20/2023] [Indexed: 10/27/2023]
Abstract
Currently, one of the main problems encountered in wound healing therapy is related to inefficient drug delivery. However, dissolving microneedles (DMNs) can be administered percutaneously to effectively deliver a drug to a deep wound area. Simvastatin (SIM) can promote wound healing, albeit its insolubility in water limits its application. Here, we designed a DMNs (SIM-NC@DMNs) drug delivery system loaded with SIM nanocrystals (SIM-NC) and evaluated its efficacy in wound healing. Based on our observations, the dissolution performance of insoluble SIM is significantly improved after the preparation of SIM-NC. For example, the saturation solubility of SIM-NC in deionized water and PBS increased by 150.57 times and 320.14 times, respectively. After the SIM-NC@DMNs are deeply inserted into the wound, the needle portion, which is composed of hyaluronic acid (HA), dissolves rapidly, and the SIM-NC loaded on the needle portion is efficiently released into the deep wound area for optimal therapeutic efficacy. The combination of NC and DMNs makes this system further effective for wound healing. Our cumulative work suggests that the newly developed SIM-NC@DMNs possess great potential in accelerating wound healing. By day 12 after treatment, the residual wound area in the Control group was 21.34 %, while the residual wound area in the SIM-NC@DMNs group was only 2.36 %. This result as well as provides certain evidence of its efficacy for wound healing therapy. The SIM-NC@DMNs drug delivery system may become an efficient treatment modality that promotes wound healing, with a promising potential in the field of wound healing research.
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Affiliation(s)
- Xuejing Yang
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Wenyu Cao
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Xun Gu
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Lijie Zheng
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Qiuyue Wang
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Yingying Li
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Fang Wei
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Tao Ma
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, China; Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, Anhui 233030, China
| | - Lu Zhang
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, China; Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, Anhui 233030, China
| | - Qingqing Wang
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui 233030, China; Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, Anhui 233030, China.
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8
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Wang Y, Zong Q, Wu H, Ding Y, Pan X, Fu B, Sun W, Zhai Y. Functional Microneedle Patch for Wound Healing and Biological Diagnosis and Treatment. Macromol Biosci 2023; 23:e2300332. [PMID: 37633658 DOI: 10.1002/mabi.202300332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/17/2023] [Indexed: 08/28/2023]
Abstract
Wound healing, especially chronic wounds, has been one of the major challenges in the field of biomedicine. Drug therapy alone is not effective, so a variety of functional wound healing dressings have been developed. Microneedles have attracted more and more attentions in the field of wound healing dressings due to their penetration and high drug delivery efficiency. In this review, all the studies on the application of microneedles in wound healing in recent years are summarized, classify different microneedles according to their functions in the process of wound healing, discuss the current challenges in the transformation of microneedle technology toward clinical applications, and finally look forward to the future design and development directions of microneedles in this field.
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Affiliation(s)
- Ye Wang
- Department of Pharmaceutics, Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Qida Zong
- Department of Pharmaceutics, Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Huiying Wu
- Department of Pharmaceutics, Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Yan Ding
- Department of Pharmaceutics, Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Xi Pan
- Department of Pharmaceutics, Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Bo Fu
- Department of Pharmaceutics, Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Wei Sun
- Department of Biomedical Engineering, School of Pharmaceutical University, Shenyang, 110016, China
| | - Yinglei Zhai
- Department of Biomedical Engineering, School of Pharmaceutical University, Shenyang, 110016, China
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9
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Liang J, Adeleye M, Onyango LA. Combinatorial efficacy of Manuka honey and antibiotics in the in vitro control of staphylococci and their small colony variants. Front Cell Infect Microbiol 2023; 13:1219984. [PMID: 37928190 PMCID: PMC10622673 DOI: 10.3389/fcimb.2023.1219984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/04/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Staphylococci are among the list of problematic bacteria contributing to the global antibiotic resistance (ABR) crisis. Their ability to adopt the small colony variant (SCV) phenotype, induced by prolonged antibiotic chemotherapy, complicates staphylococcal infection control options. Novel and alternative approaches are needed to tackle staphylococcal infections and curb ABR. Manuka honey (MH), a non-antibiotic alternative is recognized for its unique antibacterial activity based on its methylglyoxal (MGO) component. Methods In this study, MH (MGO 830+) was tested in combination with gentamicin (GEN), rifampicin (RIF), or vancomycin (VA) against staphylococcal wildtype (WT) and SCVs. To our knowledge, there are no current studies in the literature documenting the effects of MH on staphylococcal SCVs. While Staphylococcus aureus is well-studied for its international ABR burden, limited data exists demonstrating the effects of MH on S. epidermidis and S. lugdunensis whose pathogenic relevance and contribution to ABR is also rising. Results & discussion The three staphylococci were most susceptible to RIF (0.06-0.24 μg/ml), then GEN (0.12-0.49 μg/ml), and lastly VA (0.49-0.96 μg/ml). The MICs of MH were 7%, 7-8%, and 6-7% (w/v), respectively. Fractional inhibitory concentration (FIC) evaluations showed that the combined MH + antibiotic effect was either additive (FICI 1-2), or partially synergistic (FICI >0.5-1). While all three antibiotics induced SCVs in vitro, stable SCVs were observed in GEN treatments only. The addition of MH to these GEN-SCV-induction analyses resulted in complete suppression of SCVs (p<0.001) in all three staphylococci, suggesting that MH's antibacterial properties interfered with GEN's SCV induction mechanisms. Moreover, the addition of MH to growth cultures of recovered stable SCVs resulted in the inhibition of SCV growth by at least 99%, indicating MH's ability to prevent subsequent SCV growth. These in vitro analyses demonstrated MH's broad-spectrum capabilities not only in improving WT staphylococci susceptibility to the three antibiotics, but also mitigated the development and subsequent growth of their SCV phenotypes. MH in combination with antibiotics has the potential to not only resensitize staphylococci to antibiotics and consequently require less antibiotic usage, but in instances where prolonged chemotherapy is employed, the development and growth of SCVs would be hampered, providing a better clinical outcome, all of which mitigate ABR.
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Dul M, Alali M, Ameri M, Burke MD, Craig CM, Creelman BP, Dick L, Donnelly RF, Eakins MN, Frivold C, Forster AH, Gilbert PA, Henke S, Henry S, Hunt D, Lewis H, Maibach HI, Mistilis JJ, Park JH, Prausnitz MR, Robinson DK, Hernandez CAR, Ross C, Shin J, Speaker TJ, Taylor KM, Zehrung D, Birchall JC, Jarrahian C, Coulman SA. Assessing the risk of a clinically significant infection from a Microneedle Array Patch (MAP) product. J Control Release 2023; 361:236-245. [PMID: 37437849 DOI: 10.1016/j.jconrel.2023.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/28/2023] [Accepted: 07/01/2023] [Indexed: 07/14/2023]
Abstract
Microneedle Array Patches (MAPs) are an emerging dosage form that creates transient micron-sized disruptions in the outermost physical skin barrier, the stratum corneum, to facilitate delivery of active pharmaceutical ingredients to the underlying tissue. Numerous MAP products are proposed and there is significant clinical potential in priority areas such as vaccination. However, since their inception scientists have hypothesized about the risk of a clinically significant MAP-induced infection. Safety data from two major Phase 3 clinical trials involving hundreds of participants, who in total received tens of thousands of MAP applications, does not identify any clinically significant infections. However, the incumbent data set is not extensive enough to make definitive generalizable conclusions. A comprehensive assessment of the infection risk is therefore advised for MAP products, and this should be informed by clinical and pre-clinical data, theoretical analysis and informed opinions. In this article, a group of key stakeholders identify some of the key product- and patient-specific factors that may contribute to the risk of infection from a MAP product and provide expert opinions in the context of guidance from regulatory authorities. Considerations that are particularly pertinent to the MAP dosage form include the specifications of the finished product (e.g. microbial specification), it's design features, the setting for administration, the skill of the administrator, the anatomical application site, the target population and the clinical context. These factors, and others discussed in this article, provide a platform for the development of MAP risk assessments and a stimulus for early and open dialogue between developers, regulatory authorities and other key stakeholders, to expedite and promote development of safe and effective MAP products.
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Affiliation(s)
- Maria Dul
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | | | - Jung-Hwan Park
- Department of Bionano Technology, Gachon University, Seongnam, Republic of Korea
| | - Mark R Prausnitz
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | | | | | | | | | | | - Kevin Michael Taylor
- University College London School of Pharmacy, British Pharmacopoeia Commission, UK
| | | | - James C Birchall
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | | | - Sion A Coulman
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.
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11
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Hajmohammadi K, Mohammadpour Y, Parizad N. Fighting postsurgical infection after myelomeningocele repair with medical honey (Medihoney): a case report. Childs Nerv Syst 2023; 39:1969-1976. [PMID: 36959360 DOI: 10.1007/s00381-023-05929-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/17/2023] [Indexed: 03/25/2023]
Abstract
Surgical site infection (SSI) prolongs the treatment period, delays wound healing, increases antibiotic consumption, and leads to patient death in complicated cases. This case was a 10-day female infant born at 37-week- and 6-day of gestational age with a birth weight of 3700 g and Apgar 5/8 by emergency cesarean section due to spina bifida cystica with myelomeningocele (MMC). She was admitted to the neonatal intensive care unit (NICU) because of respiratory distress and hypotonic lower extremities on June 2, 2022. A cardiovascular and neurosurgery consult was okay for reconstructive surgery, and she had MMC repair surgery by a plastic surgeon on June 5, 2022. The surgical site was infected, and SSI had no improvement, despite regularly receiving wet and Vaseline gauze dressing and intravenous antibiotic therapy. We started the treatment using Medihoney™, honey antibacterial wound dressing, on SSI once a day for 2 weeks, then once every other day for the next 6 weeks. Her SSI was cured entirely after 2 months, and she was discharged from our wound treatment team in satisfactory general condition. Clinicians and wound care management teams could use honey antibacterial wound gel to treat SSI, particularly in newborns with weakened immune systems after spinal birth defects repair.
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Affiliation(s)
| | - Yousef Mohammadpour
- Department of Medical Education, School of Medicine, Urmia University of Medical Sciences, Urmia, IR, Iran
| | - Naser Parizad
- Patient Safety Research Center, Clinical Research Institute, Faculty of Nursing and Midwifery, Department of Critical Care Nursing, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, Urmia, 575611-5111, West Azerbaijan, IR, Iran.
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12
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Pinthong T, Yooyod M, Daengmankhong J, Tuancharoensri N, Mahasaranon S, Viyoch J, Jongjitwimol J, Ross S, Ross GM. Development of Natural Active Agent-Containing Porous Hydrogel Sheets with High Water Content for Wound Dressings. Gels 2023; 9:459. [PMID: 37367130 DOI: 10.3390/gels9060459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/25/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023] Open
Abstract
This work was concerned with the fabrication of a porous hydrogel system suitable for medium to heavy-exudating wounds where traditional hydrogels cannot be used. The hydrogels were based on 2-acrylamido-2-methyl-1-propane sulfonic acid (AMPs). In order to produce the porous structure, additional components were added (acid, blowing agent, foam stabilizer). Manuka honey (MH) was also incorporated at concentrations of 1 and 10% w/w. The hydrogel samples were characterized for morphology via scanning electron microscopy, mechanical rheology, swelling using a gravimetric method, surface absorption, and cell cytotoxicity. The results confirmed the formation of porous hydrogels (PH) with pore sizes ranging from ~50-110 µm. The swelling performance showed that the non-porous hydrogel (NPH) swelled to ~2000%, while PH weight increased ~5000%. Additionally, the use of a surface absorption technique showed that the PH absorbed 10 μL in <3000 ms, and NPH absorbed <1 μL over the same time. Incorporating MH the enhanced gel appearance and mechanical properties, including smaller pores and linear swelling. In summary, the PH produced in this study had excellent swelling performance with rapid absorption of surface liquid. Therefore, these materials have the potential to expand the applicability of hydrogels to a range of wound types, as they can both donate and absorb fluid.
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Affiliation(s)
- Thanyaporn Pinthong
- Biopolymer Group, Department of Chemistry, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Maytinee Yooyod
- Biopolymer Group, Department of Chemistry, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Jinjutha Daengmankhong
- Biopolymer Group, Department of Chemistry, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Nantaprapa Tuancharoensri
- Biopolymer Group, Department of Chemistry, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Sararat Mahasaranon
- Biopolymer Group, Department of Chemistry, Center of Excellence in Biomaterials, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Jarupa Viyoch
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University, Phitsanulok 65000, Thailand
| | - Jirapas Jongjitwimol
- Department of Medical Technology, Faculty of Allied Health Sciences and Center of Excellence in Biomaterials, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Sukunya Ross
- Biopolymer Group, Department of Chemistry, Center of Excellence in Biomaterials, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Gareth M Ross
- Biopolymer Group, Department of Chemistry, Center of Excellence in Biomaterials, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
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Mo R, Zhang H, Xu Y, Wu X, Wang S, Dong Z, Xia Y, Zheng D, Tan Q. Transdermal drug delivery via microneedles to mediate wound microenvironment. Adv Drug Deliv Rev 2023; 195:114753. [PMID: 36828300 DOI: 10.1016/j.addr.2023.114753] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/16/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
Cutaneous wound healing is a complex process, while modulating the wound microenvironment has become an essential therapeutic goal. In clinics, advanced dressings or dermal templates can promote wound healing but their ability in mediating wound microenvironment is limited. In the last decade, microneedle (MN) array patches have emerged as a new class of wound dressings. These dressings enable non-invasive transdermal and precise medication delivery. Combined with smart materials, MN additionally allows real-time monitoring of wound site markers such as inflammatory factors, oxygen levels, vascularization, pH and temperature, etc., while releasing therapeutic molecules responsively to the wound site. In this review, the MN-based strategies were reviewed for modulating wound microenvironment via introducing the main characteristics of the wound microenvironment and various types of MN-based delivery systems. Additionally, the progress and future trends in the application of MNs in mediating wound microenvironments are also discussed.
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Affiliation(s)
- Ran Mo
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing, Jiangsu 210008, China
| | - Hao Zhang
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing, Jiangsu 210008, China
| | - Ye Xu
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing, Jiangsu 210008, China
| | - Xiangyi Wu
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing, Jiangsu 210008, China
| | - Shuqin Wang
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing, Jiangsu 210008, China
| | - Zheng Dong
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing, Jiangsu 210008, China
| | - Yangmin Xia
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing, Jiangsu 210008, China
| | - Dongfeng Zheng
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing, Jiangsu 210008, China.
| | - Qian Tan
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing, Jiangsu 210008, China; Department of Burns and Plastic Surgery, Anqing Shihua Hospital, Nanjing Drum Tower Hospital Group, Anqing 246002, China.
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14
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Badr LK, El Asmar R, Hakim S, Saad R, Merhi R, Zahreddine A, Muwakkit S. The efficacy of honey or olive oil on the severity of oral mucositis and pain compared to placebo (standard care) in children with leukemia receiving intensive chemotherapy: A randomized controlled trial (RCT). J Pediatr Nurs 2023; 70:e48-e53. [PMID: 36792398 DOI: 10.1016/j.pedn.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/28/2022] [Accepted: 12/07/2022] [Indexed: 02/17/2023]
Abstract
BACKGROUND Oral mucositis (OM) is a significant complication occurring in approximately 40 to 80% of patients receiving chemotherapy regimens. Although a wide variety of agents have been tested to prevent OM or reduce its severity, none have provided conclusive evidence. OBJECTIVES To determine the efficacy of honey or olive oil on the severity and OM pain in children with leukemia and suffering from OM compared to placebo (standard care) and, to assess which of the two interventions is more beneficial. METHODS A single blind randomized controlled study (RCT) was used to evaluate the effect of Manuka honey or olive oil, in the treatment of chemotherapy-related OM in 42 children with leukemia. The primary outcome was the severity of mucositis, using the World Health Organization (WHO) scale and the secondary outcome was the pain assessed using the Visual analogue scale (VAS). RESULTS Children who received the honey had less severe OM (assessed on the (WHO) scale), p = 0.00 and less pain (assessed on the VAS scale), p = 0.00, compared to the control group. Children who received the olive oil had less pain than the control group, p = 0.00), although not lower than the honey group. CONCLUSION Manuka honey or olive oil can be used as alternative therapies by nurses to children with leukemia and suffering from OM, especially in low and middle-income countries where more expensive therapies may not be available or economical. PRACTICE IMPLICATIONS Pediatric nurses may recommend Manuka honey to treat OM in children with leukemia as it is safe and inexpensive compared to other treatment modalities.
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Affiliation(s)
- Lina Kurdahi Badr
- Professor, American University of Beirut, Riad El Solh, PO Box: 11 0236, Beirut 1107 2020, Lebanon.
| | - Rebecca El Asmar
- Clinical Nurse Specialist, Oncology, American University of Beirut Medical center Riad El Solh, PO Box: 11 0236, Beirut 1107 2020, Lebanon.
| | - Sarah Hakim
- Clinical Educator-Clinical and Professional development Center, American University of Beirut Medical Center, Riad El Solh, PO Box: 11 0236, Beirut 1107 2020, Lebanon
| | - Rima Saad
- Clinical nurse specialist, American University of Beirut, Hariri School of Nursing, Riad El Solh, PO Box: 11 0236, Beirut 1107 2020, Lebanon
| | - Roni Merhi
- American University of Beirut Medical center, Riad El Solh, PO Box: 11 0236, Beirut, 1107 2020, Lebanon
| | - Ammar Zahreddine
- Case Manager, Hematology, American University of Beirut Medical center Riad El Solh, PO Box: 11 0236, Beirut 1107 2020, Lebanon.
| | - Samar Muwakkit
- Professor of Clinical Specialty, American University Of Beirut Medical center, Riad El Solh, PO Box: 11 0236, Beirut 1107 2020, Lebanon.
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15
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Tomić SL, Vuković JS, Babić Radić MM, Filipović VV, Živanović DP, Nikolić MM, Nikodinovic-Runic J. Manuka Honey/2-Hydroxyethyl Methacrylate/Gelatin Hybrid Hydrogel Scaffolds for Potential Tissue Regeneration. Polymers (Basel) 2023; 15:polym15030589. [PMID: 36771889 PMCID: PMC9920545 DOI: 10.3390/polym15030589] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/12/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
Scaffolding biomaterials are gaining great importance due to their beneficial properties for medical purposes. Targeted biomaterial engineering strategies through the synergy of different material types can be applied to design hybrid scaffolding biomaterials with advantageous properties for biomedical applications. In our research, a novel combination of the bioactive agent Manuka honey (MHo) with 2-hydroxyethyl methacrylate/gelatin (HG) hydrogel scaffolds was created as an efficient bioactive platform for biomedical applications. The effects of Manuka honey content on structural characteristics, porosity, swelling performance, in vitro degradation, and in vitro biocompatibility (fibroblast and keratinocyte cell lines) of hybrid hydrogel scaffolds were studied using Fourier transform infrared spectroscopy, the gravimetric method, and in vitro MTT biocompatibility assays. The engineered hybrid hydrogel scaffolds show advantageous properties, including porosity in the range of 71.25% to 90.09%, specific pH- and temperature-dependent swelling performance, and convenient absorption capacity. In vitro degradation studies showed scaffold degradability ranging from 6.27% to 27.18% for four weeks. In vitro biocompatibility assays on healthy human fibroblast (MRC5 cells) and keratinocyte (HaCaT cells) cell lines by MTT tests showed that cell viability depends on the Manuka honey content loaded in the HG hydrogel scaffolds. A sample containing the highest Manuka honey content (30%) exhibited the best biocompatible properties. The obtained results reveal that the synergy of the bioactive agent, Manuka honey, with 2-hydroxyethyl methacrylate/gelatin as hybrid hydrogel scaffolds has potential for biomedical purposes. By tuning the Manuka honey content in HG hydrogel scaffolds advantageous properties of hybrid scaffolds can be achieved for biomedical applications.
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Affiliation(s)
- Simonida Lj. Tomić
- University of Belgrade, Faculty of Technology and Metallurgy, Karnegijeva 4, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-11-3303-630
| | - Jovana S. Vuković
- University of Belgrade, Faculty of Technology and Metallurgy, Karnegijeva 4, 11000 Belgrade, Serbia
| | - Marija M. Babić Radić
- University of Belgrade, Faculty of Technology and Metallurgy, Karnegijeva 4, 11000 Belgrade, Serbia
| | - Vuk. V. Filipović
- University of Belgrade, Institute of Molecular Genetics and Genetic Engineering, Vojvode Stepe 444a, 11000 Belgrade, Serbia
| | - Dubravka P. Živanović
- University of Belgrade, Faculty of Medicine, Department of Dermatology and Venereology, Pasterova 2, 11000 Belgrade, Serbia
- University of Belgrade, University Clinical Center of Serbia, Clinic of Dermatology and Venereology, Pasterova 2, 11000 Belgrade, Serbia
| | - Miloš M. Nikolić
- University of Belgrade, Faculty of Medicine, Department of Dermatology and Venereology, Pasterova 2, 11000 Belgrade, Serbia
- University of Belgrade, University Clinical Center of Serbia, Clinic of Dermatology and Venereology, Pasterova 2, 11000 Belgrade, Serbia
| | - Jasmina Nikodinovic-Runic
- University of Belgrade, Institute of Molecular Genetics and Genetic Engineering, Vojvode Stepe 444a, 11000 Belgrade, Serbia
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16
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Fan D, Liu X, Ren Y, Bai S, Li Y, Luo Z, Dong J, Chen F, Zeng W. Functional insights to the development of bioactive material for combating bacterial infections. Front Bioeng Biotechnol 2023; 11:1186637. [PMID: 37152653 PMCID: PMC10160456 DOI: 10.3389/fbioe.2023.1186637] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/13/2023] [Indexed: 05/09/2023] Open
Abstract
The emergence of antibiotic-resistant "superbugs" poses a serious threat to human health. Nanomaterials and cationic polymers have shown unprecedented advantages as effective antimicrobial therapies due to their flexibility and ability to interact with biological macromolecules. They can incorporate a variety of antimicrobial substances, achieving multifunctional effects without easily developing drug resistance. Herein, this article discusses recent advances in cationic polymers and nano-antibacterial materials, including material options, fabrication techniques, structural characteristics, and activity performance, with a focus on their fundamental active elements.
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Affiliation(s)
- Duoyang Fan
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Diagnostic and Therapeutic Drug Research for Chronic Diseases, Changsha, China
| | - Xiaohui Liu
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Diagnostic and Therapeutic Drug Research for Chronic Diseases, Changsha, China
| | - Yueming Ren
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Diagnostic and Therapeutic Drug Research for Chronic Diseases, Changsha, China
| | - Shuaige Bai
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Diagnostic and Therapeutic Drug Research for Chronic Diseases, Changsha, China
| | - Yanbing Li
- Xiangya Hospital, Central South University, Changsha, China
| | - Ziheng Luo
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Diagnostic and Therapeutic Drug Research for Chronic Diseases, Changsha, China
| | - Jie Dong
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Diagnostic and Therapeutic Drug Research for Chronic Diseases, Changsha, China
| | - Fei Chen
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Diagnostic and Therapeutic Drug Research for Chronic Diseases, Changsha, China
- *Correspondence: Fei Chen, ; Wenbin Zeng,
| | - Wenbin Zeng
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Diagnostic and Therapeutic Drug Research for Chronic Diseases, Changsha, China
- *Correspondence: Fei Chen, ; Wenbin Zeng,
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17
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A Comprehensive Review of Natural Compounds for Wound Healing: Targeting Bioactivity Perspective. Int J Mol Sci 2022; 23:ijms23179573. [PMID: 36076971 PMCID: PMC9455684 DOI: 10.3390/ijms23179573] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/20/2022] [Accepted: 08/20/2022] [Indexed: 11/17/2022] Open
Abstract
Wound healing is a recovering process of damaged tissues by replacing dysfunctional injured cellular structures. Natural compounds for wound treatment have been widely used for centuries. Numerous published works provided reviews of natural compounds for wound healing applications, which separated the approaches based on different categories such as characteristics, bioactivities, and modes of action. However, current studies provide reviews of natural compounds that originated from only plants or animals. In this work, we provide a comprehensive review of natural compounds sourced from both plants and animals that target the different bioactivities of healing to promote wound resolution. The compounds were classified into four main groups (i.e., anti-inflammation, anti-oxidant, anti-bacterial, and collagen promotion), mostly studied in current literature from 1992 to 2022. Those compounds are listed in tables for readers to search for their origin, bioactivity, and targeting phases in wound healing. We also reviewed the trend in using natural compounds for wound healing.
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18
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Recent advances in microneedle designs and their applications in drug and cosmeceutical delivery. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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19
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Gope A, Mukhopadhyay A, Mukhopadhyay O, Chatterjee J. Regenerative repair of full thickness skin wound assisted by dual crosslinking percolative gel casting maneuvered alginate hydrogel embedded with honey ghee blend resembles standard cutaneous properties. J Tissue Viability 2022; 31:657-672. [PMID: 35870995 DOI: 10.1016/j.jtv.2022.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 04/12/2022] [Accepted: 07/15/2022] [Indexed: 10/17/2022]
Abstract
We report synergism in scarless cutaneous wound repair by alginate hydrogel (HGSAG) embedded with an optimized blend of characterized Jamun honey and characterized indigenously prepared ghee. Thorough screening and characterization of honey and ghee are carried out followed by obtaining a novel dual crosslinking percolative gel casting fabrication method to come up with HGSAG showing superior chemical stability, and mechanical strength (Nanoindentation study; lowest stiffness: 0.71 ± 0.19 μN/nm), and surface morphology (SEM; highest roughness: 0.13 ± 0.04 μm) to other variants. In vitro swelling study and degradation behavior study show intermediate swelling (swelling index: 0.59 ± 0.008 in 98 h) and required restricted degradation (PBS: 73.38 ± 0.55%, DMEM: 83.48 ± 0.69% in 10 days) for HGSAG which is necessary for providing nutrients to cells and in vivo therapeutic efficacy. We observe the remarkable antibacterial efficacy of HGSAG against Staphylococcus mutans and Escherichia coli. This particular substrate also shows decent 3T3 fibroblasts viability, cell-cell communication followed by cell-matrix interaction, and proliferation compared to other variants. Molecular gene expression studies by quantitative RT-PCR technique reveal strong upregulation of collagen I, CD26, and TGF-β3 while downregulation in the case of TGF-β1 which eventually substantiates scarless wound healing potential of HGSAG. Wound closure kinetics is most rapidly and successfully underpinned by HGSAG while compared to other alternatives including marketed healing patches. Regular close monitoring using histopathological studies and real-time imaging by Swept-Source Optical Coherence Tomography of in vivo wound model treated with HGSAG come up with the fascinating result of scarless healing (HGSAG treated epithelial thickness: 62.96 ± 0.67 μm, unwounded akin epithelial thickness: 62.56 ± 0.34 μm) within 12 days of wounding. Thus, the work highlights modified and stabilized alginate hydrogel embedded with honey and ghee blend as a potential scarless full-thickness cutaneous wound healing bio-scaffold.
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Affiliation(s)
- Ayan Gope
- Multimodal Imaging and Theranostics Laboratory, School of Medical Science and Technology, Indian Institute of Technology Kharagpur, West Bengal, 721302, India.
| | - Anurup Mukhopadhyay
- Multimodal Imaging and Theranostics Laboratory, School of Medical Science and Technology, Indian Institute of Technology Kharagpur, West Bengal, 721302, India.
| | - Oindrila Mukhopadhyay
- Multimodal Imaging and Theranostics Laboratory, School of Medical Science and Technology, Indian Institute of Technology Kharagpur, West Bengal, 721302, India
| | - Jyotirmoy Chatterjee
- Multimodal Imaging and Theranostics Laboratory, School of Medical Science and Technology, Indian Institute of Technology Kharagpur, West Bengal, 721302, India
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20
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Al-Rawi NN, Rawas-Qalaji M. Dissolving microneedles with antibacterial functionalities: A systematic review of laboratory studies. Eur J Pharm Sci 2022; 174:106202. [PMID: 35526676 DOI: 10.1016/j.ejps.2022.106202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/18/2022] [Accepted: 05/03/2022] [Indexed: 02/05/2023]
Affiliation(s)
| | - Mutasem Rawas-Qalaji
- College of Pharmacy, University of Sharjah, Sharjah, UAE; Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE; Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.
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21
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Treating extravasation injury by honey antibacterial wound dressing in a neonate: A case report. Int J Surg Case Rep 2022. [PMCID: PMC9184857 DOI: 10.1016/j.ijscr.2022.107279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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22
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Advancements in Skin Delivery of Natural Bioactive Products for Wound Management: A Brief Review of Two Decades. Pharmaceutics 2022; 14:pharmaceutics14051072. [PMID: 35631658 PMCID: PMC9143175 DOI: 10.3390/pharmaceutics14051072] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/25/2022] [Accepted: 05/13/2022] [Indexed: 02/06/2023] Open
Abstract
Application of modern delivery techniques to natural bioactive products improves their permeability, bioavailability, and therapeutic efficacy. Many natural products have desirable biological properties applicable to wound healing but are limited by their inability to cross the stratum corneum to access the wound. Over the past two decades, modern systems such as microneedles, lipid-based vesicles, hydrogels, composite dressings, and responsive formulations have been applied to natural products such as curcumin or aloe vera to improve their delivery and efficacy. This article reviews which natural products and techniques have been formulated together in the past two decades and the success of these applications for wound healing. Many cultures prefer natural-product-based traditional therapies which are often cheaper and more available than their synthetic counterparts. Improving natural products’ effect can provide novel wound-healing therapies for those who trust traditional compounds over synthetic drugs to reduce medical inequalities.
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23
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Deng X, Gould M, Ali MA. A review of current advancements for wound healing: Biomaterial applications and medical devices. J Biomed Mater Res B Appl Biomater 2022; 110:2542-2573. [PMID: 35579269 PMCID: PMC9544096 DOI: 10.1002/jbm.b.35086] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/28/2022] [Accepted: 04/30/2022] [Indexed: 12/12/2022]
Abstract
Wound healing is a complex process that is critical in restoring the skin's barrier function. This process can be interrupted by numerous diseases resulting in chronic wounds that represent a major medical burden. Such wounds fail to follow the stages of healing and are often complicated by a pro‐inflammatory milieu attributed to increased proteinases, hypoxia, and bacterial accumulation. The comprehensive treatment of chronic wounds is still regarded as a significant unmet medical need due to the complex symptoms caused by the metabolic disorder of the wound microenvironment. As a result, several advanced medical devices, such as wound dressings, wearable wound monitors, negative pressure wound therapy devices, and surgical sutures, have been developed to correct the chronic wound environment and achieve skin tissue regeneration. Most medical devices encompass a wide range of products containing natural (e.g., chitosan, keratin, casein, collagen, hyaluronic acid, alginate, and silk fibroin) and synthetic (e.g., polyvinyl alcohol, polyethylene glycol, poly[lactic‐co‐glycolic acid], polycaprolactone, polylactic acid) polymers, as well as bioactive molecules (e.g., chemical drugs, silver, growth factors, stem cells, and plant compounds). This review addresses these medical devices with a focus on biomaterials and applications, aiming to deliver a critical theoretical reference for further research on chronic wound healing.
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Affiliation(s)
- Xiaoxuan Deng
- Centre for Bioengineering & Nanomedicine (Dunedin), Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Maree Gould
- Centre for Bioengineering & Nanomedicine (Dunedin), Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - M Azam Ali
- Centre for Bioengineering & Nanomedicine (Dunedin), Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Potential of Microneedle Systems for COVID-19 Vaccination: Current Trends and Challenges. Pharmaceutics 2022; 14:pharmaceutics14051066. [PMID: 35631652 PMCID: PMC9144974 DOI: 10.3390/pharmaceutics14051066] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/27/2022] [Accepted: 05/09/2022] [Indexed: 12/12/2022] Open
Abstract
To prevent the coronavirus disease 2019 (COVID-19) pandemic and aid restoration to prepandemic normality, global mass vaccination is urgently needed. Inducing herd immunity through mass vaccination has proven to be a highly effective strategy for preventing the spread of many infectious diseases, which protects the most vulnerable population groups that are unable to develop immunity, such as people with immunodeficiencies or weakened immune systems due to underlying medical or debilitating conditions. In achieving global outreach, the maintenance of the vaccine potency, transportation, and needle waste generation become major issues. Moreover, needle phobia and vaccine hesitancy act as hurdles to successful mass vaccination. The use of dissolvable microneedles for COVID-19 vaccination could act as a major paradigm shift in attaining the desired goal to vaccinate billions in the shortest time possible. In addressing these points, we discuss the potential of the use of dissolvable microneedles for COVID-19 vaccination based on the current literature.
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25
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Yao S, Luo Y, Wang Y. Engineered Microneedles Arrays for Wound Healing. ENGINEERED REGENERATION 2022. [DOI: 10.1016/j.engreg.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Chen V, Burgess JL, Verpile R, Tomic-Canic M, Pastar I. Novel Diagnostic Technologies and Therapeutic Approaches Targeting Chronic Wound Biofilms and Microbiota. CURRENT DERMATOLOGY REPORTS 2022; 11:60-72. [PMID: 37007641 PMCID: PMC10065746 DOI: 10.1007/s13671-022-00354-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose of Review To provide an up-to-date overview of recent developments in diagnostic methods and therapeutic approaches for chronic wound biofilms and pathogenic microbiota. Recent Findings Biofilm infections are one of the major contributors to impaired wound healing in chronic wounds, including diabetic foot ulcers, venous leg ulcers, pressure ulcers, and nonhealing surgical wounds. As an organized microenvironment commonly including multiple microbial species, biofilms develop and persist through methods that allow evasion from host immune response and antimicrobial treatments. Suppression and reduction of biofilm infection have been demonstrated to improve wound healing outcomes. However, chronic wound biofilms are a challenge to treat due to limited methods for accurate, accessible clinical identification and the biofilm's protective properties against therapeutic agents. Here we review recent approaches towards visual markers for less invasive, enhanced biofilm detection in the clinical setting. We outline progress in wound care treatments including investigation of their antibiofilm effects, such as with hydrosurgical and ultrasound debridement, negative pressure wound therapy with instillation, antimicrobial peptides, nanoparticles and nanocarriers, electroceutical dressings, and phage therapy. Summary Current evidence for biofilm-targeted treatments has been primarily conducted in preclinical studies, with limited clinical investigation for many therapies. Improved identification, monitoring, and treatment of biofilms require expansion of point-of-care visualization methods and increased evaluation of antibiofilm therapies in robust clinical trials.
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Stavropoulou E, Voidarou C(C, Rozos G, Vaou N, Bardanis M, Konstantinidis T, Vrioni G, Tsakris A. Antimicrobial Evaluation of Various Honey Types against Carbapenemase-Producing Gram-Negative Clinical Isolates. Antibiotics (Basel) 2022; 11:antibiotics11030422. [PMID: 35326885 PMCID: PMC8944737 DOI: 10.3390/antibiotics11030422] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 12/21/2022] Open
Abstract
The development of antibiotic resistance is a major public health issue, as infections are increasingly unresponsive to antibiotics. Emerging antimicrobial resistance has raised researchers’ interest in the development of alternative strategies using natural compounds with antibacterial activity, like honey, which has emerged as an agent to treat several infections and wound injuries. Nevertheless, the antibacterial effect of honey was mostly evaluated against Gram-positive bacteria. Hence, the objective of our study was to evaluate the antibacterial activity, as well as the physicochemical parameters, of genuine Greek honeys against multidrug-resistant Gram-negative pathogenic bacteria. In this vein, we aimed to study the in vitro antibacterial potential of rare Greek honeys against Verona integron-encoded metallo-β-lactamase (VIM)- or Klebsiella pneumoniae carbapenemase-producing multidrug-resistant Gram-negative pathogens. Physicochemical parameters such as pH, hydrogen peroxide, free acidity, lactonic acid, total phenols total flavonoids, free radical scavenging activities, tyrosinase enzyme inhibitory activity and kojic acid were examined. Moreover, the antimicrobial activity of 10 different honey types was evaluated in five consecutive dilutions (75%, 50%, 25%, 12.5% and 6.25%) against the clinical isolates by the well diffusion method, as well as by the determination of the minimum inhibition concentration after the addition of catalase and protease. Almost all the physicochemical parameters varied significantly among the different honeys. Fir and manuka honey showed the highest values in pH and H2O2, while the free acidity and lactonic acid levels were higher in chestnut honey. Total phenols, total flavonoids and free radical scavenging activities were found higher in cotton, arbutus and manuka honey, and finally, manuka and oregano honeys showed higher tyrosinase inhibition activity and kojic acid levels. The antimicrobial susceptibility depended on the type of honey, on its dilution, on the treatment methodology and on the microorganism. Arbutus honey was the most potent against VIM-producing Enterobacter cloacae subsp. dissolvens in 75% concentration, while fir honey was more lethal for the same microorganism in the 25% concentration. Many honeys outperformed manuka honey in their antibacterial potency. It is of interest that, for any given concentration in the well diffusion method and for any given type of honey, significant differences were not detected among the four multidrug-resistant pathogens, which explains that the damaging effect to the bacterial cells was the same regardless of the bacterial species or strain. Although the antimicrobial potency of different honey varieties dependents on their geographical origin and on their compositional differences, the exact underlying mechanism remains yet unclear.
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Affiliation(s)
- Elisavet Stavropoulou
- Department of Microbiology, Medical School, National Kapodistrian University of Athens, 11527 Athens, Greece; (G.V.); (A.T.)
- Centre Hospitalier Universitaire Vaudois (CHUV), 1101 Lausanne, Switzerland
- Correspondence: or
| | - Chrysoula (Chrysa) Voidarou
- Department of Agriculture, School of Agriculture, University of Ioannina, 47100 Arta, Greece; (C.V.); (G.R.)
| | - Georgios Rozos
- Department of Agriculture, School of Agriculture, University of Ioannina, 47100 Arta, Greece; (C.V.); (G.R.)
| | - Natalia Vaou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (N.V.); (M.B.); (T.K.)
| | - Michael Bardanis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (N.V.); (M.B.); (T.K.)
- Gourmeli., 73100 Chania, Crete, Greece
| | - Theodoros Konstantinidis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (N.V.); (M.B.); (T.K.)
| | - Georgia Vrioni
- Department of Microbiology, Medical School, National Kapodistrian University of Athens, 11527 Athens, Greece; (G.V.); (A.T.)
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National Kapodistrian University of Athens, 11527 Athens, Greece; (G.V.); (A.T.)
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Parizad N, Hajimohammadi K, Hassanpour A, Goli R. Treating surgical site infection by honey antibacterial wound dressing in a neonate: a case report. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S8-S14. [PMID: 35220733 DOI: 10.12968/bjon.2022.31.4.s8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Surgical site infection (SSI) increases length of treatment, delays wound healing, increases antibiotic use and causes patient death in severe cases. This case was a boy aged 38 weeks and 4 days with a birthweight of 2100 g, a height of 42 cm and a head circumference of 32 cm. Twelve days after birth, he was admitted to hospital where a surgeon removed a sacrococcygeal teratoma. The surgical site became infected, and the infection failed to improve despite him receiving routine normal saline dressings twice a day and intravenous antibiotic therapy. The authors started treatment using an antibacterial wound dressing containing honey (Medihoney) on the SSI twice a day for a month. The infant's SSI was wholly healed after 3 months, and he was discharged from the wound treatment team in good general condition. This case shows that SSIs can be treated with honey-containing antibacterial wound gel, especially in infants who have weaker immune systems.
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Affiliation(s)
- Naser Parizad
- Assistant Professor, Patient Safety Research Center, Clinical Research Institute, Nursing & Midwifery School, Urmia University of Medical Sciences, Urmia, Iran
| | - Kazem Hajimohammadi
- Wound Manager, Imam Khomeini Teaching Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Amireh Hassanpour
- Registered Nurse, Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Registered Nurse, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
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Pena Júnior DS, Almeida CA, Santos MCF, Fonseca PHV, Menezes EV, de Melo Junior AF, Brandão MM, de Oliveira DA, de Souza LF, Silva JC, Royo VDA. Antioxidant activities of some monofloral honey types produced across Minas Gerais (Brazil). PLoS One 2022; 17:e0262038. [PMID: 35045085 PMCID: PMC8769325 DOI: 10.1371/journal.pone.0262038] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/15/2021] [Indexed: 12/16/2022] Open
Abstract
This study was carried out with the objective of determining the antioxidant properties and quantification of total phenolics and flavonoids in relation to quercetin and rutin in some of the monofloral honeys produced in Minas Gerais (Brazil). In this study, 15 monofloral honey samples were obtained from different geographic regions of Minas Gerias, Brazil. The honeys were obtained from Cooperative of Beekeepers and Family Farmers of Northern Minas. To determine the antioxidant properties of honey samples, the test methods of total phenolic content, flavonoids (rutin and quercetin) and DPPH were used. As a result of the analysis of phenolic and flavonoid contents, the samples with the best results were A1-Aroeira and A4-Assa peixe. In antioxidant activity, the honey with the best EC50 results was A6-Aroeira. Differences between the antioxidant activities of the honey samples were found significantly (p< 0.01).
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Affiliation(s)
- Deosvaldo S. Pena Júnior
- Department of General Biology, Laboratory of Natural Products, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
| | - Clarice A. Almeida
- Department of General Biology, Laboratory of Natural Products, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
| | - Maria Clara F. Santos
- Department of General Biology, Laboratory of Natural Products, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
| | - Pedro Henrique V. Fonseca
- Department of General Biology, Laboratory of Natural Products, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
| | - Elytania V. Menezes
- Department of General Biology, Laboratory of Bioprospecting and Genetic Resources, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
| | - Afranio F. de Melo Junior
- Department of General Biology, Laboratory of Bioprospecting and Genetic Resources, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
| | - Murilo M. Brandão
- Department of General Biology, Laboratory of Bioprospecting and Genetic Resources, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
| | - Dario A. de Oliveira
- Department of General Biology, Laboratory of Bioprospecting and Genetic Resources, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
| | - Luciano F. de Souza
- Cooperative of Beekeepers and Family Farmers of Northern Minas, Fazenda Bahia s/n, Bocaiuva, MG, Brazil
| | - Junio C. Silva
- Institute of Agricultural Sciences, Universidade Federal de Minas Gerais, Montes Claros, MG, Brazil
| | - Vanessa de A. Royo
- Department of General Biology, Laboratory of Natural Products, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
- Institute of Agricultural Sciences, Universidade Federal de Minas Gerais, Montes Claros, MG, Brazil
- * E-mail:
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Systematically Assessing Natural Compounds’ Wound Healing Potential with Spheroid and Scratch Assays. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1401:227-241. [DOI: 10.1007/5584_2022_727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Gomes A, Aguiar L, Ferraz R, Teixeira C, Gomes P. The Emerging Role of Ionic Liquid-Based Approaches for Enhanced Skin Permeation of Bioactive Molecules: A Snapshot of the Past Couple of Years. Int J Mol Sci 2021; 22:11991. [PMID: 34769430 PMCID: PMC8584570 DOI: 10.3390/ijms222111991] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/03/2021] [Indexed: 12/12/2022] Open
Abstract
Topical and transdermal delivery systems are of undeniable significance and ubiquity in healthcare, to facilitate the delivery of active pharmaceutical ingredients, respectively, onto or across the skin to enter systemic circulation. From ancient ointments and potions to modern micro/nanotechnological devices, a variety of approaches has been explored over the ages to improve the skin permeation of diverse medicines and cosmetics. Amongst the latest investigational dermal permeation enhancers, ionic liquids have been gaining momentum, and recent years have been prolific in this regard. As such, this review offers an outline of current methods for enhancing percutaneous permeation, highlighting selected reports where ionic liquid-based approaches have been investigated for this purpose. Future perspectives on use of ionic liquids for topical delivery of bioactive peptides are also presented.
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Affiliation(s)
- Ana Gomes
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre 687, P-4169-007 Porto, Portugal; (A.G.); (L.A.); (R.F.); (C.T.)
| | - Luísa Aguiar
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre 687, P-4169-007 Porto, Portugal; (A.G.); (L.A.); (R.F.); (C.T.)
| | - Ricardo Ferraz
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre 687, P-4169-007 Porto, Portugal; (A.G.); (L.A.); (R.F.); (C.T.)
- Ciências Químicas e das Biomoléculas, CISA, Escola Superior de Saúde, Politécnico do Porto, R. Dr. António Bernardino de Almeida 400, P-4200-072 Porto, Portugal
| | - Cátia Teixeira
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre 687, P-4169-007 Porto, Portugal; (A.G.); (L.A.); (R.F.); (C.T.)
| | - Paula Gomes
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre 687, P-4169-007 Porto, Portugal; (A.G.); (L.A.); (R.F.); (C.T.)
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Kharaziha M, Baidya A, Annabi N. Rational Design of Immunomodulatory Hydrogels for Chronic Wound Healing. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2100176. [PMID: 34251690 PMCID: PMC8489436 DOI: 10.1002/adma.202100176] [Citation(s) in RCA: 235] [Impact Index Per Article: 78.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/03/2021] [Indexed: 05/03/2023]
Abstract
With all the advances in tissue engineering for construction of fully functional skin tissue, complete regeneration of chronic wounds is still challenging. Since immune reaction to the tissue damage is critical in regulating both the quality and duration of chronic wound healing cascade, strategies to modulate the immune system are of importance. Generally, in response to an injury, macrophages switch from pro-inflammatory to an anti-inflammatory phenotype. Therefore, controlling macrophages' polarization has become an appealing approach in regenerative medicine. Recently, hydrogels-based constructs, incorporated with various cellular and molecular signals, have been developed and utilized to adjust immune cell functions in various stages of wound healing. Here, the current state of knowledge on immune cell functions during skin tissue regeneration is first discussed. Recent advanced technologies used to design immunomodulatory hydrogels for controlling macrophages' polarization are then summarized. Rational design of hydrogels for providing controlled immune stimulation via hydrogel chemistry and surface modification, as well as incorporation of cell and molecules, are also dicussed. In addition, the effects of hydrogels' properties on immunogenic features and the wound healing process are summarized. Finally, future directions and upcoming research strategies to control immune responses during chronic wound healing are highlighted.
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Affiliation(s)
- Mahshid Kharaziha
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, 84156-83111, Iran
| | - Avijit Baidya
- Chemical and Biomolecular Engineering, University of California - Los Angeles, Los Angeles, CA, 90095, USA
| | - Nasim Annabi
- Chemical and Biomolecular Engineering, University of California - Los Angeles, Los Angeles, CA, 90095, USA
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Abstract
The application of microneedles (MNs) for minimally invasive biological fluid sampling is rapidly emerging, offering a user-friendly approach with decreased insertion pain and less harm to the tissues compared to conventional needles. Here, a finger-powered microneedle array (MNA) integrated with a microfluidic chip was conceptualized to extract body fluid samples. Actuated by finger pressure, the microfluidic device enables an efficient approach for the user to collect their own body fluids in a simple and fast manner without the requirement for a healthcare worker. The processes for extracting human blood and interstitial fluid (ISF) from the body and the flow across the device, estimating the amount of the extracted fluid, were simulated. The design in this work can be utilized for the minimally invasive personalized medical equipment offering a simple usage procedure.
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Al Refaey HR, Newairy ASA, Wahby MM, Albanese C, Elkewedi M, Choudhry MU, Sultan AS. Manuka honey enhanced sensitivity of HepG2, hepatocellular carcinoma cells, for Doxorubicin and induced apoptosis through inhibition of Wnt/β-catenin and ERK1/2. Biol Res 2021; 54:16. [PMID: 34049576 PMCID: PMC8161992 DOI: 10.1186/s40659-021-00339-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 05/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Recently, there is increasing awareness focused on the identification of naturally occurring anticancer agents derived from natural products. Manuka honey (MH) has been recognized for its biological properties as antimicrobial, antioxidant, and anticancer properties. However, its antiproliferative mechanism in hepatocellular carcinoma is not investigated. The current study focused mainly on investigating the molecular mechanism and synergistic effect of anticancer properties of MH on Doxorubicin (DOX)-mediated apoptotic cell death, using two different p53 statuses (HepG2 and Hep3B) and one non-tumorigenic immortalized liver cell line. Results MH treatment showed a proliferative inhibitory effect on tested cells in a dose-dependent manner with IC50 concentration of (6.92 ± 0.005%) and (18.62 ± 0.07%) for HepG2 and Hep3B cells, respectively, and induced dramatic morphological changes of Hep-G2 cells, which considered as characteristics feature of apoptosis induction after 48 h of treatment. Our results showed that MH or combined treatments induced higher cytotoxicity in p53-wild type, HepG2, than in p53-null, Hep3B, cells. Cytotoxicity was not observed in normal liver cells. Furthermore, the synergistic effect of MH and Dox on apoptosis was evidenced by increased annexin-V-positive cells and Sub-G1 cells in both tested cell lines with a significant increase in the percentage of Hep-G2 cells at late apoptosis as confirmed by the flow cytometric analysis. Consistently, the proteolytic activities of caspase-3 and the degradation of poly (ADP-ribose) polymerase were also higher in the combined treatment which in turn accompanied by significant inhibitory effects of pERK1/2, mTOR, S6K, oncogenic β-catenin, and cyclin D1 after 48 h. In contrast, the MH or combined treatment-induced apoptosis was accompanied by significantly upregulated expression of proapoptotic Bax protein and downregulated expression of anti-apoptotic Bcl-2 protein after 48 h. Conclusions Our data showed a synergistic inhibitory effect of MH on DOX-mediated apoptotic cell death in HCC cells. To our knowledge, the present study provides the first report on the anticancer activity of MH and its combined treatment with DOX on HCC cell lines, introducing MH as a promising natural and nontoxic anticancer compound.
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Affiliation(s)
- Heba R Al Refaey
- Biochemistry Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Al-Sayeda A Newairy
- Biochemistry Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Mayssaa M Wahby
- Biochemistry Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Chris Albanese
- Oncology and Radiology Departments, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Mohamed Elkewedi
- Department of Medical Laboratory Technology, Faculty of Applied Health Sciences Technology, Pharos University, Alexandria, Egypt
| | - Muhammad Umer Choudhry
- Oncology Department, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Ahmed S Sultan
- Biochemistry Department, Faculty of Science, Alexandria University, Alexandria, Egypt. .,Oncology Department, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
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Dewey MJ, Harley BAC. Biomaterial design strategies to address obstacles in craniomaxillofacial bone repair. RSC Adv 2021; 11:17809-17827. [PMID: 34540206 PMCID: PMC8443006 DOI: 10.1039/d1ra02557k] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022] Open
Abstract
Biomaterial design to repair craniomaxillofacial defects has largely focused on promoting bone regeneration, while there are many additional factors that influence this process. The bone microenvironment is complex, with various mechanical property differences between cortical and cancellous bone, a unique porous architecture, and multiple cell types that must maintain homeostasis. This complex environment includes a vascular architecture to deliver cells and nutrients, osteoblasts which form new bone, osteoclasts which resorb excess bone, and upon injury, inflammatory cells and bacteria which can lead to failure to repair. To create biomaterials able to regenerate these large missing portions of bone on par with autograft materials, design of these materials must include methods to overcome multiple obstacles to effective, efficient bone regeneration. These obstacles include infection and biofilm formation on the biomaterial surface, fibrous tissue formation resulting from ill-fitting implants or persistent inflammation, non-bone tissue formation such as cartilage from improper biomaterial signals to cells, and voids in bone infill or lengthy implant degradation times. Novel biomaterial designs may provide approaches to effectively induce osteogenesis and new bone formation, include design motifs that facilitate surgical handling, intraoperative modification and promote conformal fitting within complex defect geometries, induce a pro-healing immune response, and prevent bacterial infection. In this review, we discuss the bone injury microenvironment and methods of biomaterial design to overcome these obstacles, which if unaddressed, may result in failure of the implant to regenerate host bone.
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Affiliation(s)
- Marley J. Dewey
- Dept of Materials Science and Engineering, University of Illinois at Urbana-ChampaignUrbanaIL 61801USA
| | - Brendan A. C. Harley
- Dept of Materials Science and Engineering, University of Illinois at Urbana-ChampaignUrbanaIL 61801USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-ChampaignUrbanaIL 61801USA
- Dept of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, 110 Roger Adams Laboratory600 S. Mathews AveUrbanaIL 61801USA+1-217-333-5052+1-217-244-7112
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Přidal A, Trávníček P, Kudělka J, Nedomová Š, Ondrušíková S, Trost D, Kumbár V. A Rheological Analysis of Biomaterial Behaviour as a Tool to Detect the Dilution of Heather Honey. MATERIALS 2021; 14:ma14102472. [PMID: 34064636 PMCID: PMC8150820 DOI: 10.3390/ma14102472] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/21/2022]
Abstract
Heather honey is a valuable and rheologically special type of honey. Its above-average selling price may motivate its intentional violation with a mixture of honey from another botanical origin, the price of which is lower on the market. This work deals with the rheological properties of such devalued heather honey in order to determine the changes in the individual rheological parameters depending on the degree of dilution of the heather honey. For this purpose, a differently diluted heather honey sample series was created and the following rheological parameters were determined: hysteresis area, n-value, yield stress (τ0), parameter B (Weltman model), parameter ϕ, or parameter C (model describing the logarithmic dependence of the complex viscosity on the angular frequency). Part of the work was research into whether the set parameters can be used as comparative parameters. It was found that the hysteresis area does not appear to be a suitable relative comparison parameter due to the high variability. The parameters that appear to be suitable are the relative parameters n-value and the parameter ϕ, which showed the greatest stability. The change in the determined rheological parameters is, depending on the degree of dilution, non-linear with a step change between the samples containing 40% (w/w) and 60% (w/w) of a heather honey.
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Affiliation(s)
- Antonín Přidal
- Department of Zoology, Fisheries, Hydrobiology and Apidology, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, 613 00 Brno, Czech Republic;
| | - Petr Trávníček
- Department of Agricultural, Food and Environmental Engineering, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, 613 00 Brno, Czech Republic; (P.T.); (J.K.)
| | - Jan Kudělka
- Department of Agricultural, Food and Environmental Engineering, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, 613 00 Brno, Czech Republic; (P.T.); (J.K.)
| | - Šárka Nedomová
- Department of Food Technology, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, 613 00 Brno, Czech Republic; (Š.N.); (S.O.)
| | - Sylvie Ondrušíková
- Department of Food Technology, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, 613 00 Brno, Czech Republic; (Š.N.); (S.O.)
| | - Daniel Trost
- Department of Technology and Automobile Transport (Section Physics), Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, 613 00 Brno, Czech Republic;
| | - Vojtěch Kumbár
- Department of Technology and Automobile Transport (Section Physics), Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, 613 00 Brno, Czech Republic;
- Correspondence: ; Tel.: +420-545132128
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Martinez-Armenta C, Camacho-Rea MC, Martínez-Nava GA, Espinosa-Velázquez R, Pineda C, Gomez-Quiroz LE, López-Reyes A. Therapeutic Potential of Bioactive Compounds in Honey for Treating Osteoarthritis. Front Pharmacol 2021; 12:642836. [PMID: 33967778 PMCID: PMC8097136 DOI: 10.3389/fphar.2021.642836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/06/2021] [Indexed: 12/16/2022] Open
Abstract
Dysregulation of joint tissue homeostasis induces articular degenerative changes and musculoskeletal diseases such as osteoarthritis. This pathology represents the first cause of motor disability in individuals over 60 years of age, impacting their quality of life and the costs of health systems. Nowadays, pharmacological treatments for cartilage disease have failed to achieve full tissue regeneration, resulting in a functional loss of the joint; therefore, joint arthroplasty is the gold standard procedure to cure this pathology in severe cases of Osteoarthritis. A different treatment is the use of anti-inflammatory drugs which mitigate pain and inflammation in some degree, but without significant inhibition of disease progression. In this sense, new therapeutic alternatives based on natural compounds have been proposed to delay osteoarthritis progression, particularly those agents that regulate articular homeostasis. Preclinical studies have shown a therapeutic application of honey and its bioactive compounds, ranging from treating wounds, coughs, skin infections, and are also used as a biological stimulant by exerting antioxidant and anti-inflammatory properties. In this article, we reviewed the current medicinal applications of honey with particular emphasis on its use regulating articular homeostasis by inhibiting inflammation and oxidative stress.
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Affiliation(s)
- Carlos Martinez-Armenta
- Posgrado en Biología Experimental, Dirección de Ciencias Biológicas y de La Salud (DCBS), Universidad Autónoma Metropolitana Iztapalapa, Ciudad de México, Mexico
| | - María Carmen Camacho-Rea
- Departamento de Nutrición Animal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - Gabriela Angélica Martínez-Nava
- Laboratorio de Líquido Sinovial, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
| | | | - Carlos Pineda
- División de Enfermedades Musculo-esqueléticas y Reumáticas, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
| | - Luis Enrique Gomez-Quiroz
- Área de Medicina Experimental y Traslacional, Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, Mexico
| | - Alberto López-Reyes
- Facultad de Ciencias de La Salud, Universidad Anáhuac México Sur, Ciudad de México, Mexico.,Laboratorio de Gerociencias, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
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Therapy of infected wounds: overcoming clinical challenges by advanced drug delivery systems. Drug Deliv Transl Res 2021; 11:1545-1567. [PMID: 33611768 PMCID: PMC8236057 DOI: 10.1007/s13346-021-00932-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 12/12/2022]
Abstract
In recent years, the incidence of infected wounds is steadily increasing, and so is the clinical as well as economic interest in effective therapies. These combine reduction of pathogen load in the wound with general wound management to facilitate the healing process. The success of current therapies is challenged by harsh conditions in the wound microenvironment, chronicity, and biofilm formation, thus impeding adequate concentrations of active antimicrobials at the site of infection. Inadequate dosing accuracy of systemically and topically applied antibiotics is prone to promote development of antibiotic resistance, while in the case of antiseptics, cytotoxicity is a major problem. Advanced drug delivery systems have the potential to enable the tailor-made application of antimicrobials to the side of action, resulting in an effective treatment with negligible side effects. This review provides a comprehensive overview of the current state of treatment options for the therapy of infected wounds. In this context, a special focus is set on delivery systems for antimicrobials ranging from semi-solid and liquid formulations over wound dressings to more advanced carriers such as nano-sized particulate systems, vesicular systems, electrospun fibers, and microneedles, which are discussed regarding their potential for effective therapy of wound infections. Further, established and novel models and analytical techniques for preclinical testing are introduced and a future perspective is provided. ![]()
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Su Y, Mainardi VL, Wang H, Zhang YS, Chen S, John JV, Wong SL, Hollins RR, Wang G, Xie J. Dissolvable Microneedles Coupled with Nanofiber Dressings Eradicate Biofilms via Effectively Delivering a Database-Designed Antimicrobial Peptide. ACS NANO 2020; 14:11775-11786. [PMID: 32840361 PMCID: PMC7673654 DOI: 10.1021/acsnano.0c04527] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Biofilms in chronic wounds, including diabetic foot ulcers, pressure ulcers, and venous leg ulcers, pose a major challenge to wound management. Herein, we report a Janus-type antimicrobial dressing for eradication of biofilms in chronic wounds. The dressing consists of electrospun nanofiber membranes coupled with dissolvable microneedle arrays to enable effective delivery of a database-designed antimicrobial peptide to both inside and outside biofilms. This antimicrobial dressing exhibited high efficacy against a broad spectrum of resistant pathogens in vitro. Importantly, such a dressing was able to eradicate methicillin-resistant Staphylococcus aureus (MRSA) biofilms in both an ex vivo human skin wound infection model and a type II diabetic mouse wound infection model after daily treatment without applying surgical debridement. Most importantly, the dressing can also completely remove the Pseudomonas aeruginosa and MRSA, dual-species biofilm in an ex vivo human skin infection model. In addition, our computational simulations also suggested that microneedles were more effective in the delivery of peptides to the biofilms than free drugs. Our results indicate that the Janus-type antimicrobial dressings may provide an effective treatment and management of chronic wound polymicrobial infections.
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Affiliation(s)
- Yajuan Su
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska 68130, United States
| | - Valerio Luca Mainardi
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, United States
| | - Hongjun Wang
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska 68130, United States
| | - Yu Shrike Zhang
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, United States
| | - Shixuan Chen
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska 68130, United States
| | - Johnson V. John
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska 68130, United States
| | - Shannon L. Wong
- Department of Surgery-Plastic Surgery, University of Nebraska Medical Center, Omaha, Nebraska 68130, United States
| | - Ronald R. Hollins
- Department of Surgery-Plastic Surgery, University of Nebraska Medical Center, Omaha, Nebraska 68130, United States
| | - Guangshun Wang
- Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States
- Corresponding Authors: To whom correspondence should be addressed. (J. Xie) and (G. Wang), Phone: +1 (402) 5599442, Fax: +1(402) 5597521
| | - Jingwei Xie
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska 68130, United States
- Corresponding Authors: To whom correspondence should be addressed. (J. Xie) and (G. Wang), Phone: +1 (402) 5599442, Fax: +1(402) 5597521
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