Recent advances in the development of chitosan/hyaluronic acid-based hybrid materials for skin protection, regeneration, and healing: A review

Biomaterials play vital roles in regenerative medicine, specifically in tissue engineering applications. They promote angiogenesis and facilitate tissue creation and repair. The most difficult aspect of this field is acquiring smart biomaterials that possess qualities and functions that either surpass or are on par with those of synthetic products. The biocompatibility, biodegradability, film-forming capacity, and hydrophilic nature of the non-sulfated glycosaminoglycans (GAGs) (hyaluronic acid (HA) and chitosan (CS)) have attracted significant attention. In addition, CS and HA possess remarkable inherent biological capabilities, such as antimicrobial, antioxidant, and anti-inflammatory properties. This review provides a comprehensive overview of the recent progress made in designing and fabricating CS/HA-based hybrid materials for dermatology applications. Various formulations utilizing CS/HA have been developed, including hydrogels, microspheres, films, foams, membranes, and nanoparticles, based on the fabrication protocol (physical or chemical). Each formulation aims to enhance the materials' remarkable biological properties while also addressing their limited stability in water and mechanical strength. Additionally, this review gave a thorough outline of future suggestions for enhancing the mechanical strength of CS/HA wound dressings, along with methods to include biomolecules to make them more useful in skin biomedicine applications.

Chemical modification of hyaluronic acid as a strategy for the development of advanced drug delivery systems

Hyaluronic acid (HA) has emerged as a promising biopolymer for various biomedical applications due to its biocompatibility, biodegradability, and intrinsic ability to interact with cell surface receptors, making it an attractive candidate for drug delivery systems and tissue engineering. Chemical modification of HA has opened up versatile possibilities to tailor its properties, enabling the development of advanced drug delivery systems and biomaterials with enhanced functionalities and targeted applications. This review analyzes the strategies and applications of chemically modified HA in the field of drug delivery and biomaterial development. The first part of the review focuses on the different methods and functional groups used for the chemical modification of HA, highlighting the impact of these modifications on its physicochemical properties, degradation behavior and interactions with drugs. The second part of the review evaluates the use of chemically modified HA in the development of advanced biomedical materials including nano- and microparticles, hydrogels and mucoadhesive materials with tailored drug release profiles, site-specific targeting and stimuli-responsive behavior. Thus, the review consolidates the current advances and future perspectives in the field of chemical modification of HA, underscoring its immense potential to drive the development of advanced drug delivery systems and biomaterials with diverse biomedical applications.

Investigation of construction and characterization of carboxymethyl chitosan - sodium alginate nanoparticles to stabilize Pickering emulsion hydrogels for curcumin encapsulation and accelerating wound healing

Limitations in compatibility and effectiveness in delivering bioactive compounds often make it prohibitively difficult to apply Pickering emulsions in wound dressing. In this research, we prepared Pickering emulsion composite hydrogels based on carboxymethyl chitosan - sodium alginate (CMCS-SA) nanoparticles (NPs) stabilized Pickering emulsions, poloxamer 407 (PLX), and curcumin (CUR). CMCS-SA NPs were prepared and used to stabilize Pickering emulsion. The stability of Pickering emulsion improved with the increase of the concentration of NPs, and was highly sensitive to ionic strength change. This Pickering emulsion remained stable at various temperatures. After curcumin were introduced into the emulsion, 0.6% CMCS-SA NPs Pickering emulsion showed controlled release of curcumin in vitro. The CMCS-SA-PLX-CUR hydrogels also exhibited smooth surface and dense structure. This composite hydrogels has antibacterial properties against Escherichia coli and Staphylococcus aureus. Moreover, the CMCS-SA-PLX-CUR hydrogels improved wound healing and increased expression of Ki67 and CD31. RT-qPCR results indicated that the mRNA levels of α-SMA and TGF-β1 in the CMCS-SA-PLX-CUR group were downregulated, while the mRNA levels of TGF-β3 increased. The present study suggests that the potentials of CMCS-SA-PLX-CUR hydrogels are promising in protecting bioactive components and wound care management.

Therapeutic neovascularization promoted by injectable hydrogels

The aim of therapeutic neovascularization is to repair ischemic tissues via formation of new blood vessels by delivery of angiogenic growth factors, stem cells or expansion of pre-existing cells. For efficient neovascularization, controlled release of growth factors is particularly necessary since bolus injection of molecules generally lead to a poor outcome due to inadequate retention within the injured site. In this regard, injectable hydrogels, made of natural, synthetic or hybrid biomaterials, have become a promising solution for efficient delivery of angiogenic factors or stem and progenitor cells for in situ tissue repair, regeneration and neovascularization. This review article will broadly discuss the state-of-the-art in the development of injectable hydrogels from natural and synthetic precursors, and their applications in ischemic tissue repair and wound healing. We will cover a wide range of in vitro and in vivo studies in testing the functionalities of the engineered injectable hydrogels in promoting tissue repair and neovascularization. We will also discuss some of the injectable hydrogels that exhibit self-healing properties by promoting neovascularization without the presence of angiogenic factors.

Electrospinning of in situ crosslinked recombinant human collagen peptide/chitosan nanofibers for wound healing

Electrospun collagen nanofibers are effective for wound healing; however, many problems, such as the tedious preparation process, weak strength and poor structure integration, limit further applications. In this study, recombinant human collagen (RHC) peptides and a simple one-step crosslinking strategy were used to prepare RHC/chitosan nanofibers. With the nonpathogenic, water-soluble RHC and a mild electrospinning solvent, in situ crosslinked nanofibers (S-CN) not only simplified the preparation procedure but also maintained a more integrated morphology. Compared with the immersed crosslinked nanofibers (I-CN), S-CN showed better performance in moisture retention, degradation and mechanical strength tests. In vitro cell proliferation, morphology and RT-PCR studies confirmed that fibroblasts presented better activities on nanofibers crosslinked in situ. Importantly, after treating with the nanofibers, rapid epidermidalization and angiogenesis were observed in an SD rat scalding model. All these data suggest that electrospun RHC/chitosan nanofibers crosslinked in situ are an ideal candidate that can be used for wound healing applications.

Hydrogel scaffolds for differentiation of adipose-derived stem cells

Natural extracellular matrices (ECMs) have been widely used as a support for the adhesion, migration, differentiation, and proliferation of adipose-derived stem cells (ADSCs). However, poor mechanical behavior and unpredictable biodegradation properties of natural ECMs considerably limit their potential for bioapplications and raise the need for different, synthetic scaffolds. Hydrogels are regarded as the most promising alternative materials as a consequence of their excellent swelling properties and their resemblance to soft tissues. A variety of strategies have been applied to create synthetic biomimetic hydrogels, and their biophysical and biochemical properties have been modulated to be suitable for cell differentiation. In this review, we first give an overview of common methods for hydrogel preparation with a focus on those strategies that provide potential advantages for ADSC encapsulation, before summarizing the physical properties of hydrogel scaffolds that can act as biological cues. Finally, the challenges in the preparation and application of hydrogels with ADSCs are explored and the perspectives are proposed for the next generation of scaffolds.

A functional chitosan-based hydrogel as a wound dressing and drug delivery system in the treatment of wound healing

Functional active wound dressings are expected to provide a moist wound environment, offer protection from secondary infections, remove wound exudate and accelerate tissue regeneration, as well as to improve the efficiency of wound healing. Chitosan-based hydrogels are considered as ideal materials for enhancing wound healing owing to their biodegradable, biocompatible, non-toxic, antimicrobial, biologically adhesive, biological activity and hemostatic effects. Chitosan-based hydrogels have been demonstrated to promote wound healing at different wound healing stages, and also can alleviate the factors against wound healing (such as excessive inflammatory and chronic wound infection). The unique biological properties of a chitosan-based hydrogel enable it to serve as both a wound dressing and as a drug delivery system (DDS) to deliver antibacterial agents, growth factors, stem cells and so on, which could further accelerate wound healing. For various kinds of wounds, chitosan-based hydrogels are able to promote the effectiveness of wound healing by modifying or combining with other polymers, and carrying different types of active substances. In this review, we will take a close look at the application of chitosan-based hydrogels in wound dressings and DDS to enhance wound healing.

Injectable Mussel-Inspired Immobilization of Platelet-Rich Plasma on Microspheres Bridging Adipose Micro-Tissues to Improve Autologous Fat Transplantation by Controlling Release of PDGF and VEGF, Angiogenesis, Stem Cell Migration

Platelets-rich plasma (PRP) can produce growth factors (GFs) to improve angiogenesis. However, direct injection of PRP does not lead to highly localized GFs. The current study employs a mussel-inspired polydopamine to immobilize PRP on gelatin microspheres (GMs) with the purpose of bridging adipose micro-tissues to help implanted fat survive (GM-pDA-PRP). Enhanced PRP adhesion leads to a prolonged and localized production of GFs, which is verified by platelet counting and by ELISA of vascular endothelial growth factors (VEGFs) and of platelet derived growth factors (PDGFs). The GM-pDA-PRP "hatches" a microenvironment for the proliferation of adipose-derived stem cells. After the adipose micro-tissue has bridged with GM-pDA-PRP after 16 weeks, triple-fluorescence staining reveals that the mature adipocytes, blood vessels, and capillaries are arranged like in normal adipose tissue. The survival fat increases significantly compared to that in control, PRP, and GM-PRP groups (84.8 ± 11.4% versus 47.8 ± 8.9%, 56.9 ± 9.7%, and 60.2 ± 10.5%, respectively). Both histological assessments and CD31 immunofluorescence indicate that the improvement of angiogenesis in GM-pDA-PRP is higher than in the fat graft group (6.4-fold in quantitative CD31 positive cells). The CD34 positive cells in the GM-pDA-PRP group are around 3.5-fold the amount in the fat graft group, which suggests that more stem cells migrate to the implant area. Cell proliferation staining shows that the number of Ki67 positive cells is around five times as high as that in the fat graft group.

Flexible and highly interconnected, multi-scale patterned chitosan porous membrane produced in situ from mussel shell to accelerate wound healing

Mussel shell-derived dressing for full-thickness wound healing. The mussel shell-derived, in situ formed flexible membrane dressing promotes wound healing processes.

Nanostructured injectable cell microcarriers for tissue regeneration

Biodegradable polymer microspheres have emerged as cell carriers for the regeneration and repair of irregularly shaped tissue defects due to their injectability, controllable biodegradability and capacity for drug incorporation and release. Notably, recent advances in nanotechnology allowed the manipulation of the physical and chemical properties of the microspheres at the nanoscale, creating nanostructured microspheres mimicking the composition and/or structure of natural extracellular matrix. These nanostructured microspheres, including nanocomposite microspheres and nanofibrous microspheres, have been employed as cell carriers for tissue regeneration. They enhance cell attachment and proliferation, promote positive cell-carrier interactions and facilitate stem cell differentiation for target tissue regeneration. This review highlights the recent advances in nanostructured microspheres that are employed as injectable, biomimetic and cell-instructive cell carriers.

Recent advances in hyaluronic acid hydrogels for biomedical applications

Hyaluronic acid (HA) is widely used in the design of engineered hydrogels, due to its biofunctionality, as well as numerous sites for modification with reactive groups. There are now widespread examples of modified HA macromers that form either covalent or physical hydrogels through crosslinking reactions such as with click chemistry or supramolecular assemblies of guest-host pairs. HA hydrogels range from relatively static matrices to those that exhibit spatiotemporally dynamic properties through external triggers like light. Such hydrogels are being explored for the culture of cells in vitro, as carriers for cells in vivo, or to deliver therapeutics, including in an environmentally responsive manner. The future will bring new examples of HA hydrogels due to the synthetic diversity of HA.

Fabrication of Hyaluronan-Poly(vinylphosphonic acid)-Chitosan Hydrogel for Wound Healing Application

A new hydrogel made of hyaluronan, poly(vinylphosphonic acid), and chitosan (HA/PVPA/CS hydrogel) was fabricated and characterized to be used for skin wound healing application. Firstly, the component ratio of hydrogel was studied to optimize the reaction effectiveness. Next, its microstructure was observed by light microscope. The chemical interaction in hydrogel was evaluated by nuclear magnetic resonance spectroscopy and Fourier transform-infrared spectroscopy. Then, a study on its degradation rate was performed. After that, antibacterial activity of the hydrogel was examined by agar diffusion method. Finally,in vivostudy was performed to evaluate hydrogel’s biocompatibility. The results showed that the optimized hydrogel had a three-dimensional highly porous structure with the pore size ranging from about 25 µm to less than 125 µm. Besides, with a degradation time of two weeks, it could give enough time for the formation of extracellular matrix framework during remodeling stages. Furthermore, the antibacterial test showed that hydrogel has antimicrobial activity againstE. coli.Finally,in vivostudy indicated that the hydrogel was not rejected by the immune system and could enhance wound healing process. Overall, HA/PVPA/CS hydrogel was successfully fabricated and results implied its potential for wound healing applications.

Study of stiffness effects of poly(amidoamine)-poly(n-isopropyl acrylamide) hydrogel on wound healing

The mechanical miss-match between the host and an implanted foreign body is one of the primary causes for implantation failure. To enhance the efficacy in wound repair, we developed stiffness-tunable temperature-sensitive hydrogels composed of poly(amidoamine) (PAA)-based poly(n-isopropyl acrylamide) (PNIPAM). PNIPAM-PAA hydrogels with three different stiffness fabricated by varying the concentrations of poly(amidoamine) were chosen for morphology and rheology tests. The degradation rate and cell compatibility of gels were also characterized. The PAA-PNIPAM hydrogels were then tested in a wound healing model of mice with full-thickness skin loss. We found that the stiffness of hydrogels has an impact on the wound healing process mainly by regulating the cell activities in the proliferation phase. PNIPAM-PAA hydrogels with appropriate stiffness reduce scar formation and improve wound healing by promoting myofibroblast transformation, keratinocytes proliferation, extracellular matrix synthesis and remodeling. Moreover, the stiffness of hydrogels impact on the secretion of TGF-β1 and bFGF, which play an important role in skin wound healing. These results suggest that the therapeutic effects of hydrogels in skin wound healing can by regulated by hydrogels' stiffness.

Adipose stem cell-laden injectable thermosensitive hydrogel reconstructing depressed defects in rats: filler and scaffold

Facial depressed defects are a common cosmetic problem. Temporary fillers need to be re-injected frequently to maintain the desired outcomes. Here, the feasibility of a novel type of injectable hydrogel for persistent effect is demonstrated. We first useed agmatine to synthesize a poly(amidoamine) (PAA) to form a cell-attachable crosslinker and then the crosslinker was co-polymerized with N-isopropylacrylamide to obtain an injectable and temperature sensitive hydrogel. ¹H NMR showed the successful synthesis of the crosslinker. In vitro tests, CCK-8 assay and live/dead viability test showed that the hydrogel was non-toxic to adipose-derived stem cells (ASCs). SEM images also confirmed that ASCs could adhere to the hydrogel. Then we constructed a novel depressed defect model in rats and injected four different fillers in the depressed defects: (1) the hydrogel with ASCs, (2) the hydrogel only, (3) hyaluronic acid, and (4) PBS. After 4 weeks, gross and histological analyses showed the defects in hydrogel, hydrogel + ASCs, and HA groups improved significantly and there were no significant differences among them. Significant differences in thickness from skin to muscle in the defect was found between the hydrogel + ASCs group and the other groups after 6 months. The hydrogels degraded completely in defects in both the hydrogel group and the hydrogel + ASCs group, and were filled with adipocytes and multilocular immature adipocytes. Immunohistochemical study using s-100 and perilipin staining revealed adipocyte differentiation in the defect sites. We also used green fluorescent protein (GFP)-ASCs for tracing and found that exogenous added ASCs were involved in adipogenesis. In conclusion, such a cell attachable thermosensitive hydrogel has definite potential not only as a filler but also as a scaffold, and has a persistent effect for small depressed defects. It might ultimately become a new material in plastic and reconstructive surgery.

A laminin mimetic peptide SIKVAV-conjugated chitosan hydrogel promoting wound healing by enhancing angiogenesis, re-epithelialization and collagen deposition

Angiogenesis and re-epithelialization are critical factors in skin wound healing.