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Latif A, Fisher LE, Dundas AA, Cuzzucoli Crucitti V, Imir Z, Lawler K, Pappalardo F, Muir BW, Wildman R, Irvine DJ, Alexander MR, Ghaemmaghami AM. Microparticles Decorated with Cell-Instructive Surface Chemistries Actively Promote Wound Healing. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022:e2208364. [PMID: 36440539 DOI: 10.1002/adma.202208364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Wound healing is a complex biological process involving close crosstalk between various cell types. Dysregulation in any of these processes, such as in diabetic wounds, results in chronic nonhealing wounds. Fibroblasts are a critical cell type involved in the formation of granulation tissue, essential for effective wound healing. 315 different polymer surfaces are screened to identify candidates which actively drive fibroblasts toward either pro- or antiproliferative functional phenotypes. Fibroblast-instructive chemistries are identified, which are synthesized into surfactants to fabricate easy to administer microparticles for direct application to diabetic wounds. The pro-proliferative microfluidic derived particles are able to successfully promote neovascularization, granulation tissue formation, and wound closure after a single application to the wound bed. These active novel bio-instructive microparticles show great potential as a route to reducing the burden of chronic wounds.
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Affiliation(s)
- Arsalan Latif
- School of Life Sciences, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Leanne E Fisher
- School of Life Sciences, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Adam A Dundas
- Faculty of Engineering, University of Nottingham, Nottingham, NG7 2RD, UK
| | | | - Zeynep Imir
- School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Karen Lawler
- School of Life Sciences, University of Nottingham, Nottingham, NG7 2RD, UK
| | | | - Benjamin W Muir
- Commonwealth Scientific & Industrial Research Organization, Canberra ACT 2601, Australia
| | - Ricky Wildman
- Faculty of Engineering, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Derek J Irvine
- Faculty of Engineering, University of Nottingham, Nottingham, NG7 2RD, UK
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Collantes M, Vairo C, Erhard Á, Navas C, Villullas S, Ecay M, Pareja F, Quincoces G, Gainza G, Peñuelas I. Preclinical safety of negatively charged microspheres (NCMs): optimization of radiolabeling for in vivo and ex vivo biodistribution studies after topical administration on full-thickness wounds in a rat model. Eur J Pharm Biopharm 2022; 177:61-67. [PMID: 35697288 DOI: 10.1016/j.ejpb.2022.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 11/15/2022]
Abstract
Negatively charged microspheres (NCMs) are postulated as a new form of treatment for chronic wounds. Despite the efficacy shown at clinical level, more studies are required to demonstrate their safety and local effect. The objective of the work was to confirm the lack of NCM systemic absorption performing a biodistribution study of the NCMs in an open wound rat animal model. To this end, radiolabeling of NCMs with technetium-99m was optimized and biodistribution studies were performed by in vivo SPEC/CT imaging and ex vivo counting during 24 h after topical administration. The studies were performed on animals treated with a single or repeated dose to study the effect of macrophages during a prolonged treatment. NCM radiolabeling was achieved in a simple, efficient and stable manner with high yield. SPECT/CT images showed that almost all NCMs (about 85 %) remained on the wound for 24 h either after single or multiple administrations. Ex vivo biodistribution studies confirmed that there was no accumulation of NCMs in any organ or tissue except in the wound area, suggesting a lack of absorption. In conclusion, NCMs can be considered safe as local wound treatment since they remain at the administration area.
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Affiliation(s)
- María Collantes
- Translational Molecular Imaging Unit (UNIMTRA), Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; RADIOMIN Research Group, Radiopharmacy Unit, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; Nuclear Medicine Department, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain
| | - Claudia Vairo
- BioKeralty Research Institute AIE, Albert Einstein, 25-E3, 01510, Miñano, Spain
| | - Álvaro Erhard
- Translational Molecular Imaging Unit (UNIMTRA), Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; RADIOMIN Research Group, Radiopharmacy Unit, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; Nuclear Medicine Department, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain
| | - Cristina Navas
- Translational Molecular Imaging Unit (UNIMTRA), Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain
| | - Silvia Villullas
- BioKeralty Research Institute AIE, Albert Einstein, 25-E3, 01510, Miñano, Spain
| | - Margarita Ecay
- Translational Molecular Imaging Unit (UNIMTRA), Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; RADIOMIN Research Group, Radiopharmacy Unit, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; Nuclear Medicine Department, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain
| | - Félix Pareja
- Nuclear Medicine Department, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain
| | - Gemma Quincoces
- RADIOMIN Research Group, Radiopharmacy Unit, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; Nuclear Medicine Department, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain
| | - Garazi Gainza
- BioKeralty Research Institute AIE, Albert Einstein, 25-E3, 01510, Miñano, Spain.
| | - Iván Peñuelas
- Translational Molecular Imaging Unit (UNIMTRA), Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; RADIOMIN Research Group, Radiopharmacy Unit, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; Nuclear Medicine Department, Clínica Universidad de Navarra, Avenida Pío XII, 31080, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain
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Lázaro-Martínez JL, García-Madrid M, López-Moral M, Tardáguila-García A, Álvaro-Afonso FJ, García-Álvarez Y. Clinical and Histological Outcomes of Negatively Charged Polystyrene Microspheres Applied Daily Versus Three Times per Week in Hard-to-Heal Diabetic Foot Ulcers: A Randomized Blinded Controlled Trial. INT J LOW EXTR WOUND 2022:15347346221104946. [PMID: 35635201 DOI: 10.1177/15347346221104946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Negatively charged polystyrene microspheres (NCMs) have been demonstrated as a novel and effective therapy for managing hard-to-heal diabetic foot ulcers (DFUs). However, one limitation of this therapy is that the protocol is based on daily application, which sometimes does not fit local protocols of wound care. Thus, we aimed to analyze the safety and efficacy of a new dose regimen. We conducted a randomized blinded controlled trial in a specialized diabetic foot unit between May 2019 and February 2021 with a total of 30 patients who had neuropathic or neuroischemic DFUs that had not responded after four weeks of standard treatment. Patients were randomized consecutively into a group that received daily application (control) or one that received applications three times per week (experimental). The clinical outcomes were evaluated using the Wollina score and wound-area reduction (WAR) weekly during a treatment period of 28 days. The histological outcomes were assessed using a soft-tissue punch biopsy (3 mm) at 0, 14, and 28 days to evaluate cellular proliferation. The Wollina scores were higher at the end of treatment by week 4 in both groups, but the differences were not significant between groups. The averages were 6 (5, 7) points in Experimental group (EG) and 6 (6,7) points in Control group (CG) (p = 0.848). Wound area reduction at day 28 was 53.57 [37.43, 79.16] % in the CG and 79.37 [42.74, 93.57] % in the EG, without differences among groups (p = 0.305). Cellular proliferation was similar in both groups at day 28. Application three times per week showed similar clinical and histological outcomes to those of daily application, both dose regimens demonstrated significant improvement of granulation tissue formation and WAR during the treatment.
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Affiliation(s)
- José Luis Lázaro-Martínez
- Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, 16734Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Marta García-Madrid
- Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, 16734Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Mateo López-Moral
- Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, 16734Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Aroa Tardáguila-García
- Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, 16734Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Francisco Javier Álvaro-Afonso
- Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, 16734Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Yolanda García-Álvarez
- Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, 16734Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Xiong X, Xiao W, Zhou S, Cui R, Xu HHK, Qu S. Enhanced proliferation and angiogenic phenotype of endothelial cells via negatively-charged alginate and chondroitin sulfate microsphere hydrogels. Biomed Mater 2021; 16:025012. [PMID: 33412523 DOI: 10.1088/1748-605x/abd994] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Sodium alginate-based hydrogel was the one of the most used polymers for cell delivery. However, the adsorption of extracellular matrix and proteins was inhibited due to the formation of a hydrated surface layer of these hydrogels. In this study, a novel cell delivery system, negatively-charged alginate and chondroitin sulfate microsphere hydrogel (nCACSMH), was fabricated with excellent permeability and biocompatibility in the action of a high voltage direct-current electric field. Negative charge was introduced to the surface of nCACSMH to obtain the expanded network and enhanced permeability. Additionally, the increasing content of chondroitin sulfate in nCACSMH could give rise to the charge density and its asymmetric structure, thus the uneven, plicate and expanded surface of nCACSMH which was favorable to cell proliferation was developed. Moreover, chondroitin sulfate was released with the degradation of nCACSMH, which played a crucial role in maintaining the normal physiological functions of cells. Thus the proliferation of human umbilical vein endothelial cells (HUVECs) was further accelerated and the angiogenesis related genes expression in endothelial cells was continuously and dramatically up-regulated. After 4 d, the proliferation and viability of HUVECs were significantly improved, the cells were distributed evenly in nCACSMH. The novel nCACSMH has the potential to be used as cell delivery, three-dimensional (3D) cell cultures for cell therapy, 3D bioprinting, high-throughput screening for drugs, and disease model for regeneration and constructing of tissue engineering.
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Affiliation(s)
- Xiong Xiong
- Key Lab of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, People's Republic of China. School of Life Science and Engineering, Southwest Jiaotong University, Chengdu 610031, People's Republic of China. Department of Endodontics, Periodontics and Prosthodontics, University of Maryland School of Dentistry, Baltimore, MD 21201, United States of America. These authors contributed to this work equally
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Álvaro-Afonso FJ, Sanz-Corbalán I, Lázaro-Martínez JL, Kakagia D, Papanas N. Adipose-Derived Mesenchymal Stem Cells in the Treatment of Diabetic Foot Ulcers: A Review of Preclinical and Clinical Studies. Angiology 2020; 71:853-863. [PMID: 32723090 DOI: 10.1177/0003319720939467] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This review provides an outline of the use of adipose-derived mesenchymal stem cells (AMSCs) in the treatment of diabetic foot ulcers (DFUs). A systematic search of PubMed and the Cochrane database was performed on October 2, 2019. Eighteen studies were identified (14 preclinical and 4 clinical). Studies in animal models have demonstrated that AMSCs enhance diabetic wound healing, accelerate granulation tissue formation, and increase reepithelialization and neovascularization. Only 1 randomized control trial has been published so far. Patients (n = 25) with DFUs were treated using an allogeneic AMSC directly on the wound bed as a primary dressing, and improvements were found in complete wound closure in the treatment group (n = 16). Three clinical studies showed that autologous AMSC might be a safe alternative to achieve therapeutic angiogenesis in patients with diabetes and peripheral arterial disease. Based on the available evidence, AMSCs hold promise in the treatment of DFUs. However, this evidence requires confirmation by well-designed trials. Additional studies are also required to understand some issues regarding this treatment for DFUs. For example, the potential application of autologous or allogeneic AMSCs in different types of DFUs, optimal dose/infusion schedules, safety evaluations, and cost-effectiveness.
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Affiliation(s)
- Francisco Javier Álvaro-Afonso
- Diabetic Foot Unit, University Podiatric Clinic, Edificio Facultad de Medicina, 16734Complutense University of Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Irene Sanz-Corbalán
- Diabetic Foot Unit, University Podiatric Clinic, Edificio Facultad de Medicina, 16734Complutense University of Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - José Luis Lázaro-Martínez
- Diabetic Foot Unit, University Podiatric Clinic, Edificio Facultad de Medicina, 16734Complutense University of Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Despoina Kakagia
- Department of Plastic Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - Nikolaos Papanas
- Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
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Overcoming the Inflammatory Stage of Non-Healing Wounds: In Vitro Mechanism of Action of Negatively Charged Microspheres (NCMs). NANOMATERIALS 2020; 10:nano10061108. [PMID: 32503283 PMCID: PMC7353184 DOI: 10.3390/nano10061108] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 05/23/2020] [Accepted: 06/01/2020] [Indexed: 01/20/2023]
Abstract
Negatively charged microspheres (NCMs) represent a new therapeutic approach for wound healing since recent clinical trials have shown NCM efficacy in the recovery of hard-to-heal wounds that tend to stay in the inflammatory phase, unlocking the healing process. The aim of this study was to elucidate the NCM mechanism of action. NCMs were extracted from a commercial microsphere formulation (PolyHeal® Micro) and cytotoxicity, attachment, proliferation and viability assays were performed in keratinocytes and dermal fibroblasts, while macrophages were used for the phagocytosis and polarization assays. We demonstrated that cells tend to attach to the microsphere surface, and that NCMs are biocompatible and promote cell proliferation at specific concentrations (50 and 10 NCM/cell) by a minimum of 3 fold compared to the control group. Furthermore, NCM internalization by macrophages seemed to drive these cells to a noninflammatory condition, as demonstrated by the over-expression of CD206 and the under-expression of CD64, M2 and M1 markers, respectively. NCMs are an effective approach for reverting the chronic inflammatory state of stagnant wounds (such as diabetic wounds) and thus for improving wound healing.
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