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Xiao X, Zhao F, DuBois DB, Liu Q, Zhang YL, Yao Q, Zhang GJ, Chen S. Nanozymes for the Therapeutic Treatment of Diabetic Foot Ulcers. ACS Biomater Sci Eng 2024; 10:4195-4226. [PMID: 38752382 DOI: 10.1021/acsbiomaterials.4c00470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Diabetic foot ulcers (DFU) are chronic, refractory wounds caused by diabetic neuropathy, vascular disease, and bacterial infection, and have become one of the most serious and persistent complications of diabetes mellitus because of their high incidence and difficulty in healing. Its malignancy results from a complex microenvironment that includes a series of unfriendly physiological states secondary to hyperglycemia, such as recurrent infections, excessive oxidative stress, persistent inflammation, and ischemia and hypoxia. However, current common clinical treatments, such as antibiotic therapy, insulin therapy, surgical debridement, and conventional wound dressings all have drawbacks, and suboptimal outcomes exacerbate the financial and physical burdens of diabetic patients. Therefore, development of new, effective and affordable treatments for DFU represents a top priority to improve the quality of life of diabetic patients. In recent years, nanozymes-based diabetic wound therapy systems have been attracting extensive interest by integrating the unique advantages of nanomaterials and natural enzymes. Compared with natural enzymes, nanozymes possess more stable catalytic activity, lower production cost and greater maneuverability. Remarkably, many nanozymes possess multienzyme activities that can cascade multiple enzyme-catalyzed reactions simultaneously throughout the recovery process of DFU. Additionally, their favorable photothermal-acoustic properties can be exploited for further enhancement of the therapeutic effects. In this review we first describe the characteristic pathological microenvironment of DFU, then discuss the therapeutic mechanisms and applications of nanozymes in DFU healing, and finally, highlight the challenges and perspectives of nanozyme development for DFU treatment.
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Affiliation(s)
- Xueqian Xiao
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei 430065, China
| | - Fei Zhao
- Institute of Hematology, Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei 430065, China
| | - Davida Briana DuBois
- Department of Chemistry and Biochemistry, University of California, 1156 High Street, Santa Cruz, California 95064, United States
| | - Qiming Liu
- Department of Chemistry and Biochemistry, University of California, 1156 High Street, Santa Cruz, California 95064, United States
| | - Yu Lin Zhang
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei 430065, China
- Hubei Shizhen Laboratory, Wuhan, Hubei 430065, China
| | - Qunfeng Yao
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei 430065, China
- Hubei Shizhen Laboratory, Wuhan, Hubei 430065, China
| | - Guo-Jun Zhang
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei 430065, China
- Hubei Shizhen Laboratory, Wuhan, Hubei 430065, China
| | - Shaowei Chen
- Department of Chemistry and Biochemistry, University of California, 1156 High Street, Santa Cruz, California 95064, United States
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Hou C, Zhang L, Wang L, Zhao S, Nie J, Lv M, Zhang W, Su X, Tian S, Li Y. A meta-analysis and systematic review of photodynamic therapy for diabetic foot ulcers. Photodiagnosis Photodyn Ther 2024; 48:104228. [PMID: 38866070 DOI: 10.1016/j.pdpdt.2024.104228] [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: 03/25/2024] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Diabetic foot ulcer (DFU) is a chronic and challenging condition, addressed through various treatments including photodynamic therapy (PDT) and standard of care (SOC), yet lacking consensus on the optimal approach. This study presents a comprehensive meta-analysis of randomized controlled trials to evaluate the efficacy and safety of PDT versus SOC in managing DFU. METHODS An extensive literature search was conducted across PubMed, Embase, and the Cochrane Library databases to identify RCTs that compared the effectiveness of PDT with SOC in treating DFU. The primary metrics evaluated included changes in ulcer area, wound healing indices, and pain levels experienced by the patients. RESULTS This meta-analysis incorporated data from 6 RCTs, encompassing 458 patients with 467 DFUs. The analysis indicated that while PDT led to a faster reduction in ulcer size compared to SOC, the difference was not statistically significant [mean difference (MD): 2.73cm², 95 % Confidence Interval (CI) -2.98 to 8.44; p > 0.05]. However, a notable improvement was observed in the wound healing rate in the PDT group [MD: 29.26 %, 95 % CI 7.24 to 51.28; p = 0.01]. Based on the Visual Analog Scale (VAS), pain assessment revealed no significant difference between the two treatment groups [MD: 2.35, 95 % CI -2.36 to 7.06; p = 0.33]. CONCLUSION The study suggests that PDT might offer an enhanced healing rate for DFUs compared to SOC alone, potentially leading to improved patient outcomes. Importantly, our findings highlight the superiority of photodynamic therapy in accelerating ulcer healing without an associated increase in complications. PROSPERO 2023 CRD42023493930.
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Affiliation(s)
- Chunliu Hou
- Shanxi Medical University, No. 56, Xinjian south Road, Yingze District, Shanxi 030000, PR China
| | - Lei Zhang
- Novo Nordisk (Shanghai) Pharma Trading Co. Ltd, Beijing, PR China
| | - Lifeng Wang
- Tianjin Jizhou District People's Hospital, No. 18, Nanhuan road, Jizhou District, Tianjin 301900, PR China
| | - Sai Zhao
- Systematic Review Solutions. Ltd, Shanghai, PR China
| | - Jing Nie
- Tianjin Jizhou District People's Hospital, No. 18, Nanhuan road, Jizhou District, Tianjin 301900, PR China
| | - Mo Lv
- Tianjin Jizhou District People's Hospital, No. 18, Nanhuan road, Jizhou District, Tianjin 301900, PR China
| | - Wenjie Zhang
- Shanxi Medical University, No. 56, Xinjian south Road, Yingze District, Shanxi 030000, PR China
| | - Xuesen Su
- Shanxi Medical University, No. 56, Xinjian south Road, Yingze District, Shanxi 030000, PR China
| | - Shouyuan Tian
- Shanxi Medical University, No. 56, Xinjian south Road, Yingze District, Shanxi 030000, PR China
| | - Yan Li
- Tianjin Jizhou District People's Hospital, No. 18, Nanhuan road, Jizhou District, Tianjin 301900, PR China; Shanxi Medical University, No. 56, Xinjian south Road, Yingze District, Shanxi 030000, PR China.
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Barba-Rosado LV, Carrascal-Hernández DC, Insuasty D, Grande-Tovar CD. Graphene Oxide (GO) for the Treatment of Bone Cancer: A Systematic Review and Bibliometric Analysis. NANOMATERIALS (BASEL, SWITZERLAND) 2024; 14:186. [PMID: 38251150 PMCID: PMC10820493 DOI: 10.3390/nano14020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Abstract
Cancer is a severe disease that, in 2022, caused more than 9.89 million deaths worldwide. One worrisome type of cancer is bone cancer, such as osteosarcoma and Ewing tumors, which occur more frequently in infants. This study shows an active interest in the use of graphene oxide and its derivatives in therapy against bone cancer. We present a systematic review analyzing the current state of the art related to the use of GO in treating osteosarcoma, through evaluating the existing literature. In this sense, studies focused on GO-based nanomaterials for potential applications against osteosarcoma were reviewed, which has revealed that there is an excellent trend toward the use of GO-based nanomaterials, based on their thermal and anti-cancer activities, for the treatment of osteosarcoma through various therapeutic approaches. However, more research is needed to develop highly efficient localized therapies. It is suggested, therefore, that photodynamic therapy, photothermal therapy, and the use of nanocarriers should be considered as non-invasive, more specific, and efficient alternatives in the treatment of osteosarcoma. These options present promising approaches to enhance the effectiveness of therapy while also seeking to reduce side effects and minimize the damage to surrounding healthy tissues. The bibliometric analysis of photothermal and photochemical treatments of graphene oxide and reduced graphene oxide from January 2004 to December 2022 extracted 948 documents with its search strategy, mainly related to research papers, review papers, and conference papers, demonstrating a high-impact field supported by the need for more selective and efficient bone cancer therapies. The central countries leading the research are the United States, Iran, Italy, Germany, China, South Korea, and Australia, with strong collaborations worldwide. At the same time, the most-cited papers were published in journals with impact factors of more than 6.0 (2021), with more than 290 citations. Additionally, the journals that published the most on the topic are high impact factor journals, according to the analysis performed, demonstrating the high impact of the research field.
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Affiliation(s)
- Lemy Vanessa Barba-Rosado
- Grupo de Investigación en Fotoquímica y Fotobiología, Programa de Química, Facultad de Ciencias Básicas, Universidad del Atlántico, Puerto Colombia 081008, Colombia; (L.V.B.-R.); (D.C.C.-H.)
| | - Domingo César Carrascal-Hernández
- Grupo de Investigación en Fotoquímica y Fotobiología, Programa de Química, Facultad de Ciencias Básicas, Universidad del Atlántico, Puerto Colombia 081008, Colombia; (L.V.B.-R.); (D.C.C.-H.)
- Departamento de Química y Biología, División de Ciencias Básicas, Universidad del Norte, Km 5 Vía Puerto Colombia, Barranquilla 081007, Colombia;
| | - Daniel Insuasty
- Departamento de Química y Biología, División de Ciencias Básicas, Universidad del Norte, Km 5 Vía Puerto Colombia, Barranquilla 081007, Colombia;
| | - Carlos David Grande-Tovar
- Grupo de Investigación en Fotoquímica y Fotobiología, Programa de Química, Facultad de Ciencias Básicas, Universidad del Atlántico, Puerto Colombia 081008, Colombia; (L.V.B.-R.); (D.C.C.-H.)
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Sammarro Silva KJ, Lima AR, Dias LD, de Souza M, Nunes Lima TH, Bagnato VS. Hydrogen peroxide preoxidation as a strategy for enhanced antimicrobial photodynamic action against methicillin-resistant Staphylococcus aureus. JOURNAL OF WATER AND HEALTH 2023; 21:1922-1932. [PMID: 38153721 PMCID: wh_2023_245 DOI: 10.2166/wh.2023.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Antimicrobial photodynamic treatment (aPDT) is a photooxidative process based on the excitation of a photosensitizer (PS) in the presence of molecular oxygen, under specific wavelengths of light. It is a promising method for advanced treatment of water and wastewater, particularly targeting disinfection challenges, such as antibiotic-resistant bacteria (ARB). Research in improved aPDT has been exploring new PS materials, and additives in general. Hydrogen peroxide (H2O2) a widely applied disinfectant, mostly in the food industry and clinical settings, present environmentally negligible residuals at the usually applied concentrations, making it friendly for the water and wastewater sectors. Here, we explored the effects of preoxidation with H2O2 followed by blue light-mediated (450 nm) aPDT using curcumin (a natural-based PS) against methicillin-resistant Staphylococcus aureus (MRSA). Results of the sequential treatment pointed to a slight hampering in aPDT efficiency at very low H2O2 concentrations, followed by an increasing cooperative effect up to a deleterious point (≥7 log10 inactivation in CFU mL-1), suggesting a synergistic interaction of preoxidation and aPDT. The increased performance in H2O2-pretreated aPDT encourages studies of optimal operational conditions for the assisted technology and describes potentials for using the described strategy to tackle the issue of ARB spread.
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Affiliation(s)
- Kamila Jessie Sammarro Silva
- Environmental Biophotonics Laboratory, São Carlos Institute of Physics (IFSC), University of São Paulo (USP), 13563-120 São Carlos/SP, Brazil E-mail:
| | - Alessandra Ramos Lima
- Environmental Biophotonics Laboratory, São Carlos Institute of Physics (IFSC), University of São Paulo (USP), 13563-120 São Carlos/SP, Brazil
| | - Lucas Danilo Dias
- Laboratório de Novos Materiais, Universidade Evangélica de Goiás, Anápolis 75083-515, GO, Brazil
| | - Mariana de Souza
- Environmental Biophotonics Laboratory, São Carlos Institute of Physics (IFSC), University of São Paulo (USP), 13563-120 São Carlos/SP, Brazil
| | - Thalita Hellen Nunes Lima
- Environmental Biophotonics Laboratory, São Carlos Institute of Physics (IFSC), University of São Paulo (USP), 13563-120 São Carlos/SP, Brazil
| | - Vanderlei Salvador Bagnato
- Environmental Biophotonics Laboratory, São Carlos Institute of Physics (IFSC), University of São Paulo (USP), 13563-120 São Carlos/SP, Brazil; Biomedical Engineering, Texas A&M University College of Engineering, 3127 TAMU, College Station, TX 77843-3127, USA
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