1
|
Hosty L, Heatherington T, Quondamatteo F, Browne S. Extracellular matrix-inspired biomaterials for wound healing. Mol Biol Rep 2024; 51:830. [PMID: 39037470 PMCID: PMC11263448 DOI: 10.1007/s11033-024-09750-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 06/21/2024] [Indexed: 07/23/2024]
Abstract
Diabetic foot ulcers (DFU) are a debilitating and life-threatening complication of Diabetes Mellitus. Ulceration develops from a combination of associated diabetic complications, including neuropathy, circulatory dysfunction, and repetitive trauma, and they affect approximately 19-34% of patients as a result. The severity and chronic nature of diabetic foot ulcers stems from the disruption to normal wound healing, as a result of the molecular mechanisms which underly diabetic pathophysiology. The current standard-of-care is clinically insufficient to promote healing for many DFU patients, resulting in a high frequency of recurrence and limb amputations. Biomaterial dressings, and in particular those derived from the extracellular matrix (ECM), have emerged as a promising approach for the treatment of DFU. By providing a template for cell infiltration and skin regeneration, ECM-derived biomaterials offer great hope as a treatment for DFU. A range of approaches exist for the development of ECM-derived biomaterials, including the use of purified ECM components, decellularisation and processing of donor/ animal tissues, or the use of in vitro-deposited ECM. This review discusses the development and assessment of ECM-derived biomaterials for the treatment of chronic wounds, as well as the mechanisms of action through which ECM-derived biomaterials stimulate wound healing.
Collapse
Affiliation(s)
- Louise Hosty
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, 123, St Stephen's Green, Dublin 2, Ireland
| | - Thomas Heatherington
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, 123, St Stephen's Green, Dublin 2, Ireland
| | - Fabio Quondamatteo
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, 123, St Stephen's Green, Dublin 2, Ireland.
| | - Shane Browne
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, 123, St Stephen's Green, Dublin 2, Ireland.
- CÙRAM, Centre for Research in Medical Devices, University of Galway, Galway, H91 W2TY, Ireland.
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland.
| |
Collapse
|
2
|
Zhang H, Lin X, Cao X, Wang Y, Wang J, Zhao Y. Developing natural polymers for skin wound healing. Bioact Mater 2024; 33:355-376. [PMID: 38282639 PMCID: PMC10818118 DOI: 10.1016/j.bioactmat.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/02/2023] [Accepted: 11/16/2023] [Indexed: 01/30/2024] Open
Abstract
Natural polymers are complex organic molecules that occur in the natural environment and have not been subjected to artificial synthesis. They are frequently encountered in various creatures, including mammals, plants, and microbes. The aforementioned polymers are commonly derived from renewable sources, possess a notable level of compatibility with living organisms, and have a limited adverse effect on the environment. As a result, they hold considerable significance in the development of sustainable and environmentally friendly goods. In recent times, there has been notable advancement in the investigation of the potential uses of natural polymers in the field of biomedicine, specifically in relation to natural biomaterials that exhibit antibacterial and antioxidant characteristics. This review provides a comprehensive overview of prevalent natural polymers utilized in the biomedical domain throughout the preceding two decades. In this paper, we present a comprehensive examination of the components and typical methods for the preparation of biomaterials based on natural polymers. Furthermore, we summarize the application of natural polymer materials in each stage of skin wound repair. Finally, we present key findings and insights into the limitations of current natural polymers and elucidate the prospects for their future development in this field.
Collapse
Affiliation(s)
- Han Zhang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Xiang Lin
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Xinyue Cao
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Yu Wang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Jinglin Wang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Yuanjin Zhao
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325001, China
- Shenzhen Research Institute, Southeast University, Shenzhen, 518038, China
| |
Collapse
|
3
|
Mirshekar M, Afkhami H, Razavi S, Masjedian Jazi F, Darban-Sarokhalil D, Ohadi E, Nezhad MM, Karimi R. Potential antibacterial activity and healing effect of topical administration of bone marrow and adipose mesenchymal stem cells encapsulated in collagen-fibrin hydrogel scaffold on full-thickness burn wound infection caused by Pseudomonas aeruginosa. Burns 2023; 49:1944-1957. [PMID: 38042618 DOI: 10.1016/j.burns.2023.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
Burns injuries are prone to hospital-acquired infections, and Pseudomonas aeruginosa is one of the most common causes of mortality and morbidity in patients with burn injuries. Thus, this study aimed to analyze the effects of topical treatment with bone marrow (BM-MSC) and adipose mesenchymal stem cells (AD-MSC) encapsulated in collagen and fibrin scaffolds in a Balb/c model of burn wound infection. Extraction of stem cells from adipose and bone marrow tissue of rats was performed and cells were characterized using standard methods. Then, collagen, fibrin and collagen-fibrin scaffolds were constructed and the extracted cells were encapsulated in all three scaffolds. Then, 3rd degree burn was induced in mice and 1.5 × 108 (CFU/ml) of P. aeruginosa was introduced to the burn wound. Subsequently, after 24 h of inducing wound infection, encapsulated MSCs were introduced as dressings to burn wound infection and microbial load as well as rate of wound infection healing was measured. The results of this study showed that the use of BM-MSC and AD-MSC encapsulated in collagen-fibrin scaffold reduced the bacteria load down to 54 and 21 CFU/gr, respectively (P < 0.05). Moreover, BM-MSC and AD-MSC encapsulated in collagen-fibrin showed 80% and 75% wound healing, respectively (P < 0.05). Also, we found no significant between cell origin and healing. Encapsulation of MSCs into collagen-fibrin scaffolds could be effective not only against P. aeruginosa infection, but also healing and regeneration of burn wound.
Collapse
Affiliation(s)
- Maryam Mirshekar
- Microbiology Department, School of Medicine, Iran University Of Medical Science, Iran
| | - Hamed Afkhami
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Shabnam Razavi
- Microbiology Department, School of Medicine, Iran University Of Medical Science, Iran; Microbial Biotechnology Research Centre, Iran University of Medical Sciences, Tehran, Iran.
| | | | | | - Elnaz Ohadi
- Microbiology Department, School of Medicine, Iran University Of Medical Science, Iran
| | - Majid Mottaghi Nezhad
- Chronic Respiratory Disease Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Karimi
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
4
|
Zhang G, Zhang Z, Cao G, Jin Q, Xu L, Li J, Liu Z, Xu C, Le Y, Fu Y, Ju J, Li B, Hou R. Engineered dermis loaded with confining forces promotes full-thickness wound healing by enhancing vascularisation and epithelialisation. Acta Biomater 2023; 170:464-478. [PMID: 37657662 DOI: 10.1016/j.actbio.2023.08.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/03/2023]
Abstract
Tissue-engineered skin is ideal for clinical wound repair. Restoration of skin tissue defects using tissue-engineered skin remains a challenge owing to insufficient vascularisation. In our previous study, we developed a 3D bioprinted model with confined force loading and demonstrated that the confined force can affect vascular branching, which is regulated by the YAP signalling pathway. The mechanical properties of the model must be optimised to suture the wound edges. In this study, we explored the ability of a GelMA-HAMA-fibrin scaffold to support the confined forces created by 3D bioprinting and promote vascularisation and wound healing. The shape of the GelMA-HAMA-fibrin scaffold containing 3% GelMA was affected by the confined forces produced by the embedded cells. The GelMA-HAMA-fibrin scaffold was easy to print, had optimal mechanical properties, and was biocompatible. The constructs were successfully sutured together after 14 d of culture. Scaffolds seeded with cells were transplanted into skin tissue defects in nude mice, demonstrating that the cell-seeded GelMA-HAMA-fibrin scaffold, under confined force loading, promoted neovascularisation and wound restoration by enhancing blood vessel connections, creating a patterned surface, growth factors, and collagen deposition. These results provide further insights into the production of hydrogel composite materials as tissue-engineered scaffolds under an internal mechanical load that can enhance vascularisation and offer new treatment methods for wound healing. STATEMENT OF SIGNIFICANCE: Tissue-engineered skin is ideal for use in clinical wound repair. However, treatment of tissue defects using synthetic scaffolds remains challenging, mainly due to slow and insufficient vascularization. Our previous study developed a 3D bioprinted model with confined force loading, and demonstrated that confined force can affect vascular branching regulated by the YAP signal pathway. The mechanical properties of the construct need to be optimized for suturing to the edges of wounds. Here, we investigated the ability of a GelMA-HAMA-fibrin scaffold to support the confined forces created by 3D bioprinting and promote vascularization in vitro and wound healing in vivo. Our findings provide new insight into the development of degradable macroporous composite materials with mechanical stimulation as tissue-engineered scaffolds with enhanced vascularization, and also provide new treatment options for wound healing.
Collapse
Affiliation(s)
- Guangliang Zhang
- Department of Orthopaedics, Suzhou Ruihua Orthopaedic Hospital, Suzhou Medical College, Soochow University, 5 Tayun Road, Suzhou, Jiangsu 215104, China.
| | - Zhiqiang Zhang
- Department of Orthopaedics, Suzhou Ruihua Orthopaedic Hospital, Suzhou Medical College, Soochow University, 5 Tayun Road, Suzhou, Jiangsu 215104, China; Department of Orthopedic Surgery, Medical 3D Printing Center, Orthopedic Institute, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medicine College of Soochow University, Soochow University, 199 Renai Road, Suzhou, Jiangsu 215000, China
| | - Gaobiao Cao
- Department of Orthopaedics, Suzhou Ruihua Orthopaedic Hospital, Suzhou Medical College, Soochow University, 5 Tayun Road, Suzhou, Jiangsu 215104, China
| | - Qianheng Jin
- Department of Orthopaedics, Suzhou Ruihua Orthopaedic Hospital, Suzhou Medical College, Soochow University, 5 Tayun Road, Suzhou, Jiangsu 215104, China; Department of Orthopedic Surgery, Medical 3D Printing Center, Orthopedic Institute, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medicine College of Soochow University, Soochow University, 199 Renai Road, Suzhou, Jiangsu 215000, China
| | - Lei Xu
- Department of Orthopaedics, Suzhou Ruihua Orthopaedic Hospital, Suzhou Medical College, Soochow University, 5 Tayun Road, Suzhou, Jiangsu 215104, China; Department of Orthopedic Surgery, Medical 3D Printing Center, Orthopedic Institute, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medicine College of Soochow University, Soochow University, 199 Renai Road, Suzhou, Jiangsu 215000, China
| | - Jiaying Li
- Department of Orthopedic Surgery, Medical 3D Printing Center, Orthopedic Institute, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medicine College of Soochow University, Soochow University, 199 Renai Road, Suzhou, Jiangsu 215000, China
| | - Zhe Liu
- Department of Orthopaedics, Suzhou Ruihua Orthopaedic Hospital, Suzhou Medical College, Soochow University, 5 Tayun Road, Suzhou, Jiangsu 215104, China; Department of Orthopedic Surgery, Medical 3D Printing Center, Orthopedic Institute, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medicine College of Soochow University, Soochow University, 199 Renai Road, Suzhou, Jiangsu 215000, China
| | - Chi Xu
- Department of Orthopaedics, Suzhou Ruihua Orthopaedic Hospital, Suzhou Medical College, Soochow University, 5 Tayun Road, Suzhou, Jiangsu 215104, China; Department of Orthopedic Surgery, Medical 3D Printing Center, Orthopedic Institute, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medicine College of Soochow University, Soochow University, 199 Renai Road, Suzhou, Jiangsu 215000, China
| | - Yingying Le
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yi Fu
- Department of Human Anatomy, Histology and Embryology, School of Biology and Basic Medical Sciences, Soochow University, 199 Renai Road, Suzhou, Jiangsu 215000, China
| | - Jihui Ju
- Department of Orthopaedics, Suzhou Ruihua Orthopaedic Hospital, Suzhou Medical College, Soochow University, 5 Tayun Road, Suzhou, Jiangsu 215104, China; Department of Orthopedic Surgery, Medical 3D Printing Center, Orthopedic Institute, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medicine College of Soochow University, Soochow University, 199 Renai Road, Suzhou, Jiangsu 215000, China; Teaching Hospital of Medical College of Yangzhou University, Yangzhou, Jiangsu 225009, China.
| | - Bin Li
- Department of Orthopedic Surgery, Medical 3D Printing Center, Orthopedic Institute, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medicine College of Soochow University, Soochow University, 199 Renai Road, Suzhou, Jiangsu 215000, China.
| | - Ruixing Hou
- Department of Orthopaedics, Suzhou Ruihua Orthopaedic Hospital, Suzhou Medical College, Soochow University, 5 Tayun Road, Suzhou, Jiangsu 215104, China; Department of Orthopedic Surgery, Medical 3D Printing Center, Orthopedic Institute, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medicine College of Soochow University, Soochow University, 199 Renai Road, Suzhou, Jiangsu 215000, China; Teaching Hospital of Medical College of Yangzhou University, Yangzhou, Jiangsu 225009, China.
| |
Collapse
|
5
|
Fuchs B, Birt A, Moellhoff N, Kuhlmann C, Giunta RE, Wiggenhauser PS. Adipose-Derived Stem Cells Improve Angiogenesis and Lymphangiogenesis in a Hypoxic Dermal Regeneration Model In Vitro. Medicina (B Aires) 2023; 59:medicina59040706. [PMID: 37109664 PMCID: PMC10142758 DOI: 10.3390/medicina59040706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 04/07/2023] Open
Abstract
Background and Objectives: Impaired wound healing represents an unsolved medical issue with a high impact on patients’ quality of life and global health care. Even though hypoxia is a significant limiting factor for wound healing, it reveals stimulating effects in gene and protein expression at cellular levels. In particular, hypoxically treated human adipose tissue-derived stem cells (ASCs) have previously been used to stimulate tissue regeneration. Therefore, we hypothesized that they could promote lymphangiogenesis or angiogenesis. Materials and Methods: Dermal regeneration matrices were seeded with human umbilical vein endothelial cells (HUVECs) or human dermal lymphatic endothelial cells (LECs) that were merged with ASCs. Cultures were maintained for 24 h and 7 days under normoxic or hypoxic conditions. Finally, gene and protein expression were measured regarding subtypes of VEGF, corresponding receptors, and intracellular signaling pathways, especially hypoxia-inducible factor-mediated pathways using multiplex-RT-qPCR and ELISA assays. Results: All cell types reacted to hypoxia with an alteration of gene expression. In particular, vascular endothelial growth factor A (VEGFA), vascular endothelial growth factor B (VEGFB), vascular endothelial growth factor C (VEGFC), vascular endothelial growth factor receptor 1 (VEGFR1/FLT1), vascular endothelial growth factor receptor 2 (VEGFR2/KDR), vascular endothelial growth factor receptor 3 (VEGFR3/FLT4), and prospero homeobox 1 (PROX1) were overexpressed significantly depending on upregulation of hypoxia-inducible factor 1 alpha (HIF-1a). Moreover, co-cultures with ASCs showed a more intense change in gene and protein expression profiles and gained enhanced angiogenic and lymphangiogenic potential. In particular, long-term hypoxia led to continuous stimulation of HUVECs by ASCs. Conclusions: Our findings demonstrated the benefit of hypoxic conditioned ASCs in dermal regeneration concerning angiogenesis and lymphangiogenesis. Even a short hypoxic treatment of 24 h led to the stimulation of LECs and HUVECs in an ASC-co-culture. Long-term hypoxia showed a continuous influence on gene expressions. Therefore, this work emphasizes the supporting effects of hypoxia-conditioned-ASC-loaded collagen scaffolds on wound healing in dermal regeneration.
Collapse
Affiliation(s)
- Benedikt Fuchs
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital Ludwig-Maximilians-Universität, Ziemssenstraße 5, 80336 Munich, Germany
| | - Alexandra Birt
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital Ludwig-Maximilians-Universität, Ziemssenstraße 5, 80336 Munich, Germany
| | - Nicholas Moellhoff
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital Ludwig-Maximilians-Universität, Ziemssenstraße 5, 80336 Munich, Germany
| | - Constanze Kuhlmann
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital Ludwig-Maximilians-Universität, Ziemssenstraße 5, 80336 Munich, Germany
| | - Riccardo E. Giunta
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital Ludwig-Maximilians-Universität, Ziemssenstraße 5, 80336 Munich, Germany
| | - Paul Severin Wiggenhauser
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital Ludwig-Maximilians-Universität, Ziemssenstraße 5, 80336 Munich, Germany
| |
Collapse
|
6
|
Chen Z, Cheng Q, Wang L, Mo Y, Li K, Mo J. Optical coherence tomography for in vivo longitudinal monitoring of artificial dermal scaffold. Lasers Surg Med 2023; 55:316-326. [PMID: 36806261 DOI: 10.1002/lsm.23645] [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: 08/08/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVES Artificial dermal scaffold (ADS) has undergone rapid development and been increasingly used for treating skin wound in clinics due to its good biocompatibility, controllable degradation, and low risk of disease infection. To obtain good treatment efficacy, ADS needs to be monitored longitudinally during the treatment process. For example, scaffold-tissue fit, cell in-growth, vascular regeneration, and scaffold degradation are the key properties to be inspected. However, to date, there are no effective, real-time, and noninvasive techniques to meet the requirement of the scaffold monitoring above. MATERIALS AND METHODS In this study, we propose to use optical coherence tomography (OCT) to monitor ADS in vivo through three-dimensional imaging. A swept source OCT system with a handheld probe was developed for in vivo skin imaging. Moreover, a cell in-growth, vascular regeneration, and scaffold degradation rate (IRDR) was defined with the volume reduction rate of the scaffold's collagen sponge layer. To measure the IRDR, a semiautomatic image segmentation algorithm was designed based on U-Net to segment the collagen sponge layer of the scaffold from OCT images. RESULTS The results show that the scaffold-tissue fit can be clearly visualized under OCT imaging. The IRDR can be computed based on the volume of the segmented collagen sponge layer. It is observed that the IRDR appeared to a linear function of the time and in addition, the IRDR varied among different skin parts. CONCLUSION Overall, it can be concluded that OCT has a good potential to monitor ADS in vivo. This can help guide the clinicians to control the treatment with ADS to improve the therapy.
Collapse
Affiliation(s)
- Ziye Chen
- Department of Electronic Information, Engineering School of Electronics and Information Engineering, Soochow University, Suzhou, China
| | - Qiong Cheng
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lingyun Wang
- Department of Electronic Information, Engineering School of Electronics and Information Engineering, Soochow University, Suzhou, China
| | - Yunfeng Mo
- Department of Electronic Information, Engineering School of Electronics and Information Engineering, Soochow University, Suzhou, China
| | - Ke Li
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jianhua Mo
- Department of Electronic Information, Engineering School of Electronics and Information Engineering, Soochow University, Suzhou, China
| |
Collapse
|