Spontaneous formation of MXene-oxidized sono/chemo-dynamic sonosensitizer/nanocatalyst for antibacteria and bone-tissue regeneration

Ultrasound-activated inorganic nanomaterials to generate ROS for antibacterial applications

Given the global overuse and misuse of antibiotics, the problem of antibiotic resistance has become increasingly severe, necessitating the urgent development of innovative therapeutic strategies to address bacterial infections. In recent years, nanomaterial-mediated sonodynamic therapy (SDT) has emerged as a promising alternative treatment. This strategy works by generating reactive oxygen species (ROS) to inhibit or kill bacteria, thereby avoiding the risk of antibiotic resistance. This review explores the various mechanisms by which ROS exert antibacterial effects and examines the different methods of generating ROS. It provides an overview of the diverse nanomaterials applied in SDT in recent years, including two-dimensional materials, metal-organic frameworks (MOFs), heterojunctions, and surface-modified bulk materials. Additionally, it discusses other types of nanomaterials such as metal oxides and piezoelectric materials, while also highlighting their specific therapeutic applications in treating infections like skin infections and osteomyelitis. At the conclusion of the review, the development of nanomaterial-mediated SDT is discussed in terms of both its potential and challenges. The article offers valuable theoretical insights and practical references for the preparation of the nanomaterials required for this antibiotic-free therapeutic approach, and proposes new directions for future research aimed at addressing the growing issue of antibiotic resistance.

A comprehensive review of pathology and treatment of staphylococcus aureus osteomyelitis

Osteomyelitis (OM) is an inflammation of the bone and bone marrow triggered by infectious pathogens which may induce progressive bone destruction. The majority of OM cases, especially the chronic OM cases, are induced by the most prevalent and devastating pathogen Staphylococcus aureus (S. aureus), partially due to its resistance mechanisms against the immune system and antibiotic therapies. Regarding the high rate of morbidity and recurrence in patients, it is pivotal to elucidate underlying mechanisms that how S. aureus enter and survive in hosts. The accumulated discoveries have identified multiple distinct strategies associated with chronicity and recurrence include biofilm development, small colony variants (SCVs), staphylococcus abscess communities (SACs), the osteocyte lacuno-canalicular network invasion (OLCN) of cortical bones, and S. aureus protein A (SpA). Unfortunately, little clinical progress has been achieved for the diagnosis and therapeutic treatment for OM patients, indicating that numerous questions remain to be solved. Therefore, we still have a long way to obtain the clear elucidation of the host-pathogen interactions which could be applied for clinical treatment of OM. In this review, we provide insights of current knowledge about how S. aureus evades immune eradication and remains persistent in hosts with recent discoveries. The common and novel treatment strategies for OM are also described. The purpose of this review is to have in-dept understanding of S. aureus OM and bring new perspectives to therapeutic fields which may be translated to the clinic.

MXenes in healthcare: synthesis, fundamentals and applications

Since their discovery over a decade ago, MXenes have transformed the field of "materials for healthcare", stimulating growing interest in their healthcare-related applications. These developments have also driven significant advancements in MXenes' synthesis. This review systematically examines the synthesis of MXenes and their applications in sensing and biomedical fields, underscoring their pivotal role in addressing critical challenges in modern healthcare. We describe the experimental synthesis of MXenes by combining appropriate laboratory modules with the mechanistic principles underlying each synthesis step. In addition, we provide extensive details on the experimental parameters, critical considerations, and essential instructions for successful laboratory synthesis. Various healthcare applications including sensing, biomedical imaging, synergistic therapies, regenerative medicine, and wearable devices have been explored. We further highlight the emerging trends of MXenes, viz., their role as nanovehicles for drug delivery, vectors for gene therapy, and tools for immune profiling. By identifying the important parameters that define the utility of MXenes in biomedical applications, this review outlines strategies to regulate their biomedical profile, thereby serving as a valuable guide to design MXenes with application-specific properties. The final section integrates experimental research with theoretical studies to provide a comprehensive understanding of the field. It examines the role of emerging technologies, such as artificial intelligence (AI) and machine learning (ML), in accelerating material discovery, structure-property optimization, and automation. Complemented by detailed supplementary information on synthesis, stability, biocompatibility, environmental impact, and theoretical insights, this review offers a profound knowledge base for understanding this diverse family of 2D materials. Finally, we compared the potential of MXenes with that of other 2D materials to underscore the existing challenges and prioritize interdisciplinary collaboration. By synthesizing key studies from its discovery to current trends (especially from 2018 onward), this review provides a cohesive assessment of MXene synthesis with theoretical foundations and their prospects in the healthcare sector.

Engineered MXene Biomaterials for Regenerative Medicine

MXene-based materials have attracted significant interest due to their distinct physical and chemical properties, which are relevant to fields such as energy storage, environmental science, and biomedicine. MXene has shown potential in the area of tissue regenerative medicine. However, research on its applications in tissue regeneration is still in its early stages, with a notable absence of comprehensive reviews. This review begins with a detailed description of the intrinsic properties of MXene, followed by a discussion of the various nanostructures that MXene can form, spanning from 0 to 3 dimensions. The focus then shifts to the applications of MXene-based biomaterials in tissue engineering, particularly in immunomodulation, wound healing, bone regeneration, and nerve regeneration. MXene's physicochemical properties, including conductivity, photothermal characteristics, and antibacterial properties, facilitate interactions with different cell types, influencing biological processes. These interactions highlight its potential in modulating cellular functions essential for tissue regeneration. Although the research on MXene in tissue regeneration is still developing, its versatile structural and physicochemical attributes suggest its potential role in advancing regenerative medicine.

Antimicrobial and antibiotic-potentiating effect of calcium peroxide nanoparticles on oral bacterial biofilms

Bacterial biofilms represent a prominent biological barrier against physical and chemical attacks. Disturbing the anaerobic microenvironment within biofilms by co-delivery of oxygen appears as a promising strategy to enhance the activity of an antibiotic. Here, we report the effect of oxygen-producing calcium peroxide nanoparticles (CaO2 NP) in combination with tobramycin sulfate (Tob). On Pseudomonas aeruginosa PAO1 biofilms in vitro, the additive effect of CaO2 NP towards Tob activity enhanced biofilm eradication by 2 log compared to Tob alone. For natural biofilms grown in the oral cavity of human volunteers in situ, treatment by CaO2 NP alone slightly increased the fraction of dead bacteria from 44% in various controls, including Tob alone, to 57%. However, the combination of CaO2 NP with Tob further increased the fraction of dead bacteria to 69%. These data confirm the intrinsic antimicrobial and antibiotic-potentiating effect of CaO2 NP also in a clinically relevant setting.

Endogenous electric field coupling Mxene sponge for diabetic wound management: haemostatic, antibacterial, and healing

Improper management of diabetic wound effusion and disruption of the endogenous electric field can lead to passive healing of damaged tissue, affecting the process of tissue cascade repair. This study developed an extracellular matrix sponge scaffold (K1P6@Mxene) by incorporating Mxene into an acellular dermal stroma-hydroxypropyl chitosan interpenetrating network structure. This scaffold is designed to couple with the endogenous electric field and promote precise tissue remodelling in diabetic wounds. The fibrous structure of the sponge closely resembles that of a natural extracellular matrix, providing a conducive microenvironment for cells to adhere grow, and exchange oxygen. Additionally, the inclusion of Mxene enhances antibacterial activity(98.89%) and electrical conductivity within the scaffold. Simultaneously, K1P6@Mxene exhibits excellent water absorption (39 times) and porosity (91%). It actively interacts with the endogenous electric field to guide cell migration and growth on the wound surface upon absorbing wound exudate. In in vivo experiments, the K1P6@Mxene sponge reduced the inflammatory response in diabetic wounds, increased collagen deposition and arrangement, promoted microvascular regeneration, Facilitate expedited re-epithelialization of wounds, minimize scar formation, and accelerate the healing process of diabetic wounds by 7 days. Therefore, this extracellular matrix sponge scaffold, combined with an endogenous electric field, presents an appealing approach for the comprehensive repair of diabetic wounds.

Research Progress on Ti3C2Tx-Based Composite Materials in Antibacterial Field

The integration of two-dimensional Ti3C2Tx nanosheets and other materials offers broader application options in the antibacterial field. Ti3C2Tx-based composites demonstrate synergistic physical, chemical, and photodynamic antibacterial activity. In this review, we aim to explore the potential of Ti3C2Tx-based composites in the fabrication of an antibiotic-free antibacterial agent with a focus on their systematic classification, manufacturing technology, and application potential. We investigate various components of Ti3C2Tx-based composites, such as metals, metal oxides, metal sulfides, organic frameworks, photosensitizers, etc. We also summarize the fabrication techniques used for preparing Ti3C2Tx-based composites, including solution mixing, chemical synthesis, layer-by-layer self-assembly, electrostatic assembly, and three-dimensional (3D) printing. The most recent developments in antibacterial application are also thoroughly discussed, with special attention to the medical, water treatment, food preservation, flexible textile, and industrial sectors. Ultimately, the future directions and opportunities are delineated, underscoring the focus of further research, such as elucidating microscopic mechanisms, achieving a balance between biocompatibility and antibacterial efficiency, and investigating effective, eco-friendly synthesis techniques combined with intelligent technology. A survey of the literature provides a comprehensive overview of the state-of-the-art developments in Ti3C2Tx-based composites and their potential applications in various fields. This comprehensive review covers the variety, preparation methods, and applications of Ti3C2Tx-based composites, drawing upon a total of 171 English-language references. Notably, 155 of these references are from the past five years, indicating significant recent progress and interest in this research area.

MXene-Mediated Catalytic Redox Reactions for Biomedical Applications

Reactive oxygen species (ROS) play a crucial role in orchestrating a myriad of physiological processes within living systems. With the advent of materdicine, an array of nanomaterials has been intricately engineered to influence the redox equilibrium in biological milieus, thereby pioneering a distinctive therapeutic paradigm predicated on ROS-centric biochemistry. Among these, two-dimensional carbides, nitrides, and carbonitrides, collectively known as MXenes, stand out due to their multi-valent and multi-elemental compositions, large surface area, high conductivity, and pronounced local surface plasmon resonance effects, positioning them as prominent contributors in ROS modulation. This review aims to provide an overview of the advancements in harnessing MXenes for catalytic redox reactions in various biological applications, including tumor, anti-infective, and anti-inflammatory therapies. The emphasis lies on elucidating the therapeutic mechanism of MXenes, involving both pro-oxidation and anti-oxidation processes, underscoring the redox-related therapeutic applications facilitated by self-catalysis, photo-excitation, and sono-excitation properties of MXenes. Furthermore, this review highlights the existing challenges and outlines future development trends in leveraging MXenes for ROS-involving disease treatments, marking a significant step towards the integration of these nanomaterials into clinical practice.

Single-Atom Cu Nanozyme-Loaded Bone Scaffolds for Ferroptosis-Synergized Mild Photothermal Therapy in Osteosarcoma Treatment

The rapid multiplication of residual tumor cells and poor reconstruction quality of new bone are considered the major challenges in the postoperative treatment of osteosarcoma. It is a promising candidate for composite bone scaffold which combines photothermal therapy (PTT) and bone regeneration induction for the local treatment of osteosarcoma. However, it is inevitable to damage the normal tissues around the tumor due to the hyperthermia of PTT, while mild heat therapy shows a limited effect on antitumor treatment as the damage can be easily repaired by stress-induced heat shock proteins (HSP). This study reports a new type of single-atom Cu nanozyme-loaded bone scaffolds, which exhibit exceptional photothermal conversion properties as well as peroxidase and glutathione oxidase mimicking activities in vitro experiments. This leads to lipid peroxidation (LPO) and reactive oxygen species (ROS) upregulation, ultimately causing ferroptosis. The accumulation of LPO and ROS also contributes to HSP70 inactivation, maximizing PTT efficiency against tumors at an appropriate therapeutic temperature and minimizing the damage to surrounding normal tissues. Further, the bone scaffold promotes bone regeneration via a continuous release of bioactive ions (Ca2+, P5+, Si4+, and Cu2+). The results of in vivo experiments reveal that scaffolds inhibit tumor growth and promote bone repair.

Remodeling Microenvironment for Implant-Associated Osteomyelitis by Dual Metal Peroxide

Implant-associated osteomyelitis (IAOM) is characterized by bone infection and destruction; current therapy of antibiotic treatment and surgical debridement often results in drug resistance and bone defect. It is challenging to develop an antibiotic-free bactericidal and osteogenic-enhanced strategy for IAOM. Herein, an IAOM-tailored antibacterial and osteoinductive composite of copper (Cu)-strontium (Sr) peroxide nanoparticles (CSp NPs), encapsulated in polyethylene glycol diacrylate (PEGDA) (CSp@PEGDA), is designed. The dual functional CSp NPs display hydrogen peroxide (H2O2) self-supplying and Fenton catalytic Cu2+ ions' release, generating plenty of hydroxyl radical (•OH) in a pH-responsive manner for bacterial killing, while the released Sr2+ promotes the in vitro osteogenicity regarding cell proliferation, alkaline phosphatase activity, extracellular matrix calcification, and osteo-associated genes expression. The integration of Cu2+ and Sr2+ in CSp NPs together with the coated PEGDA hydrogel ensures the stable and sustainable ion release during short- and long-term periods. Benefitted from the injectablity and photo-crosslink ability, CSp@PEGDA is able to thoroughly fill the infectious site and gelate in situ for bacterial elimination and bone regeneration, which is verified through in vivo evaluation using a clinical-simulating IAOM mouse model. These favorable abilities of CSp@PEGDA precisely meet the multiple therapeutic needs and pave a promising way for implant-associated osteomyelitis treatment.

Multifunctional MXene-Based Platforms for Soft and Bone Tissue Regeneration and Engineering

MXenes and their composites hold great promise in the field of soft and bone tissue regeneration and engineering (TRE). However, there are challenges that need to be overcome, such as ensuring biocompatibility and controlling the morphologies of MXene-based scaffolds. The future prospects of MXenes in TRE include enhancing biocompatibility through surface modifications, developing multifunctional constructs, and conducting in vivo studies for clinical translation. The purpose of this perspective about MXenes and their composites in soft and bone TRE is to critically evaluate their potential applications and contributions in this field. This perspective aims to provide a comprehensive analysis of the challenges, advantages, limitations, and future prospects associated with the use of MXenes and their composites for soft and bone TRE. By examining the existing literature and research, the review seeks to consolidate the current knowledge and highlight the key findings and advancements in MXene-based TRE. It aims to contribute to the understanding of MXenes' role in promoting soft and bone TRE, addressing the challenges faced in terms of biocompatibility, morphology control, and tissue interactions.

Advancing piezoelectric 2D nanomaterials for applications in drug delivery systems and therapeutic approaches

Precision drug delivery and multimodal synergistic therapy are crucial in treating diverse ailments, such as cancer, tissue damage, and degenerative diseases. Electrodes that emit electric pulses have proven effective in enhancing molecule release and permeability in drug delivery systems. Moreover, the physiological electrical microenvironment plays a vital role in regulating biological functions and triggering action potentials in neural and muscular tissues. Due to their unique noncentrosymmetric structures, many 2D materials exhibit outstanding piezoelectric performance, generating positive and negative charges under mechanical forces. This ability facilitates precise drug targeting and ensures high stimulus responsiveness, thereby controlling cellular destinies. Additionally, the abundant active sites within piezoelectric 2D materials facilitate efficient catalysis through piezochemical coupling, offering multimodal synergistic therapeutic strategies. However, the full potential of piezoelectric 2D nanomaterials in drug delivery system design remains underexplored due to research gaps. In this context, the current applications of piezoelectric 2D materials in disease management are summarized in this review, and the development of drug delivery systems influenced by these materials is forecast.

Metal-organic framework-based advanced therapeutic tools for antimicrobial applications

The escalating concern over conventional antibiotic resistance has emphasized the urgency in developing innovative antimicrobial agents. In recent times, metal-organic frameworks (MOFs) have garnered significant attention within the realm of antimicrobial research due to their multifaceted antimicrobial attributes, including the sustained release of intrinsic or exogenous antimicrobial components, chemodynamically catalyzed generation of reactive oxygen species (ROS), and formation of photogenerated ROS. This comprehensive review provides a thorough overview of the synthetic approaches employed in the production of MOF-based materials, elucidating their underlying antimicrobial mechanisms in depth. The focal point lies in elucidating the research advancements across various antimicrobial modalities, encompassing intrinsic component release system, extraneous component release system, auto-catalytical system, and energy conversion system. Additionally, the progress of MOF-based antimicrobial materials in addressing wound infections, osteomyelitis, and periodontitis is meticulously elucidated, culminating in a summary of the challenges and potential opportunities inherent within the realm of antimicrobial applications for MOF-based materials. STATEMENT OF SIGNIFICANCE: Growing concerns about conventional antibiotic resistance emphasized the need for alternative antimicrobial solutions. Metal-organic frameworks (MOFs) have gained significant attention in antimicrobial research due to their diverse attributes like sustained antimicrobial components release, catalytic generation of reactive oxygen species (ROS), and photogenerated ROS. This review covers MOF synthesis and their antimicrobial mechanisms. It explores advancements in intrinsic and extraneous component release, auto-catalysis, and energy conversion systems. The paper also discusses MOF-based materials' progress in addressing wound infections, osteomyelitis, and periodontitis, along with existing challenges and opportunities. Given the lack of related reviews, our findings hold promise for future MOF applications in antibacterial research, making it relevant to your journal's readership.

MXene: A wonderful nanomaterial in antibacterial

Increasing bacterial infections and growing resistance to available drugs pose a serious threat to human health and the environment. Although antibiotics are crucial in fighting bacterial infections, their excessive use not only weakens our immune system but also contributes to bacterial resistance. These negative effects have caused doctors to be troubled by the clinical application of antibiotics. Facing this challenge, it is urgent to explore a new antibacterial strategy. MXene has been extensively reported in tumor therapy and biosensors due to its wonderful performance. Due to its large specific surface area, remarkable chemical stability, hydrophilicity, wide interlayer spacing, and excellent adsorption and reduction ability, it has shown wonderful potential for biopharmaceutical applications. However, there are few antimicrobial evaluations on MXene. The current antimicrobial mechanisms of MXene mainly include physical damage, induced oxidative stress, and photothermal and photodynamic therapy. In this paper, we reviewed MXene-based antimicrobial composites and discussed the application of MXene in bacterial infections to guide further research in the antimicrobial field.

Highly Aligned Ternary Nanofiber Matrices Loaded with MXene Expedite Regeneration of Volumetric Muscle Loss

Current therapeutic approaches for volumetric muscle loss (VML) face challenges due to limited graft availability and insufficient bioactivities. To overcome these limitations, tissue-engineered scaffolds have emerged as a promising alternative. In this study, we developed aligned ternary nanofibrous matrices comprised of poly(lactide-co-ε-caprolactone) integrated with collagen and Ti3C2Tx MXene nanoparticles (NPs) (PCM matrices), and explored their myogenic potential for skeletal muscle tissue regeneration. The PCM matrices demonstrated favorable physicochemical properties, including structural uniformity, alignment, microporosity, and hydrophilicity. In vitro assays revealed that the PCM matrices promoted cellular behaviors and myogenic differentiation of C2C12 myoblasts. Moreover, in vivo experiments demonstrated enhanced muscle remodeling and recovery in mice treated with PCM matrices following VML injury. Mechanistic insights from next-generation sequencing revealed that MXene NPs facilitated protein and ion availability within PCM matrices, leading to elevated intracellular Ca2+ levels in myoblasts through the activation of inducible nitric oxide synthase (iNOS) and serum/glucocorticoid regulated kinase 1 (SGK1), ultimately promoting myogenic differentiation via the mTOR-AKT pathway. Additionally, upregulated iNOS and increased NO- contributed to myoblast proliferation and fiber fusion, thereby facilitating overall myoblast maturation. These findings underscore the potential of MXene NPs loaded within highly aligned matrices as therapeutic agents to promote skeletal muscle tissue recovery.

Acoustic platforms meet MXenes - a new paradigm shift in the palette of biomedical applications

The wide applicability of acoustics in the life of mankind spread over health, energy, environment, and others. These acoustic technologies rely on the properties of the materials with which they are made of. However, traditional devices have failed to develop into low-cost, portable devices and need to overcome issues like sensitivity, tunability, and applicability in biological in vivo studies. Nanomaterials, especially 2D materials, have already been proven to produce high optical contrast in photoacoustic applications. One such wonder kid in the materials family is MXenes, which are transition metal carbides, that are nowadays flourishing in the materials world. Recently, it has been demonstrated that MXene nanosheets and quantum dots can be synthesized by acoustic excitations. In addition, MXene can be used as a mechanical sensing material for building piezoresistive sensors to realize sound detection as it produces a sensitive response to pressure and vibration. It has also been demonstrated that MXene nanosheets show high photothermal conversion capability, which can be utilized in cancer treatment and photoacoustic imaging (PAI). In this review, we have rendered the role of acoustics in the palette of MXene, including acoustic synthetic strategies of MXenes, applications such as acoustic sensors, PAI, thermoacoustic devices, sonodynamic therapy, artificial ear drum, and others. The review also discusses the challenges and future prospects of using MXene in acoustic platforms in detail. To the best of our knowledge, this is the first review combining acoustic science in MXene research.

Sonodynamic therapy-based nanoplatforms for combating bacterial infections

The rapid spread and uncontrollable evolution of antibiotic-resistant bacteria have already become urgent global to treat bacterial infections. Sonodynamic therapy (SDT), a noninvasive and effective therapeutic strategy, has broadened the way toward dealing with antibiotic-resistant bacteria and biofilms, which base on ultrasound (US) with sonosensitizer. Sonosensitizer, based on small organic molecules or inorganic nanoparticles, is essential to the SDT process. Thus, it is meaningful to design a sonosensitizer-loaded nanoplatform and synthesize the nanoplatform with an efficient SDT effect. In this review, we initially summarize the probable SDT-based antibacterial mechanisms and systematically discuss the current advancement in different SDT-based nanoplatform (including nanoplatform for organic small-molecule sonosensitizer delivery and nanoplatform as sonosensitizer) for bacterial infection therapy. In addition, the biomedical applications of SDT-involved multifunctional nanoplatforms are also discussed. We believe the innovative SDT-based nanoplatforms would become a highly efficient next-generation noninvasive therapeutic tool for combating bacterial infection.

Advances in the two-dimensional layer materials for cancer diagnosis and treatment: unique advantages beyond the microsphere

In recent years, two-dimensional (2D) layer materials have shown great potential in the field of cancer diagnosis and treatment due to their unique structural, electronic, and chemical properties. These non-spherical materials have attracted increasing attention around the world because of its widely used biological characteristics. The application of 2D layer materials like lamellar graphene, transition metal dichalcogenides (TMDs), and black phosphorus (BPs) and so on have been developed for CT/MRI imaging, serum biosensing, drug targeting delivery, photothermal therapy, and photodynamic therapy. These unique applications for tumor are due to the multi-variable synthesis of 2D materials and the structural characteristics of good ductility different from microsphere. Based on the above considerations, the application of 2D materials in cancer is mainly carried out in the following three aspects: 1) In terms of accurate and rapid screening of tumor patients, we will focus on the enrichment of serum markers and sensitive signal transformation of 2D materials; 2) The progress of 2D nanomaterials in tumor MRI and CT imaging was described by comparing the performance of traditional contrast agents; 3) In the most important aspect, we will focus on the progress of 2D materials in the field of precision drug delivery and collaborative therapy, such as photothermal ablation, sonodynamic therapy, chemokinetic therapy, etc. In summary, this review provides a comprehensive overview of the advances in the application of 2D layer materials for tumor diagnosis and treatment, and emphasizes the performance difference between 2D materials and other types of nanoparticles (mainly spherical). With further research and development, these multifunctional layer materials hold great promise in the prospects, and challenges of 2D materials development are discussed.