Insights into Host-Pathogen Interactions in Biofilm-Infected Wounds Reveal Possibilities for New Treatment Strategies

Rational Design and Testing of Antibacterial Aloe Vera Hemostatic Hydrogel

Bleeding resulting from surgical procedures or trauma, including gunshot wounds, represents a life-threatening health issue. Therefore, the development of safe, effective, and convenient hemostatic agents is critical in securing the "golden time" to save patients' lives. Plant-derived compounds and plant extracts have been regarded as promising sources of hemostatic agents in previous studies, regulating hemostatic function with low toxicity and minimal side effects within the human body. Aloe vera-based hydrogels, which are characterized by flexible strength and high functionality, have emerged as a promising platform for wound applications due to their unique biocompatibility features. This study provides a comprehensive exploration of the utilization of thickening agents and natural agents such as xanthan gum, carrageenan, Carbomer, and alginate in applying aloe vera-based hydrogels as a hemostatic. Furthermore, it also tests the use of aloe vera-based hydrogels for therapeutic delivery at wound sites through the incorporation of various antimicrobial agents to extend the utility of the hydrogels beyond hemostasis. Our novel applied research utilizes aloe vera-based hydrogel as an antimicrobial hemostatic agent, providing valuable insights for a wide range of applications and highlighting its potential to enhance hemorrhage control in various emergency scenarios.

Insights on Pseudomonas aeruginosa Carbohydrate Binding from Profiles of Cystic Fibrosis Isolates Using Multivalent Fluorescent Glycopolymers Bearing Pendant Monosaccharides

Pseudomonas aeruginosa contributes to frequent, persistent, and, often, polymicrobial respiratory tract infections for individuals with cystic fibrosis (CF). Chronic CF infections lead to bronchiectasis and a shortened lifespan. P. aeruginosa expresses numerous adhesins, including lectins known to bind the epithelial cell and mucin glycoconjugates. Blocking carbohydrate-mediated host-pathogen and intra-biofilm interactions critical to the initiation and perpetuation of colonization offer promise as anti-infective treatment strategies. To inform anti-adhesion therapies, we profiled the monosaccharide binding of P. aeruginosa from CF and non-CF sources, and assessed whether specific bacterial phenotypic characteristics affected carbohydrate-binding patterns. Focusing at the cellular level, microscopic and spectrofluorometric tools permitted the solution-phase analysis of P. aeruginosa binding to a panel of fluorescent glycopolymers possessing distinct pendant monosaccharides. All P. aeruginosa demonstrated significant binding to glycopolymers specific for α-D-galactose, β-D-N-acetylgalactosamine, and β-D-galactose-3-sulfate. In each culture, a small subpopulation accounted for the binding. The carbohydrate anomeric configuration and sulfate ester presence markedly influenced binding. While this opportunistic pathogen from CF hosts presented with various colony morphologies and physiological activities, no phenotypic, physiological, or structural feature predicted enhanced or diminished monosaccharide binding. Important to anti-adhesive therapeutic strategies, these findings suggest that, regardless of phenotype or clinical source, P. aeruginosa maintain a small subpopulation that may readily associate with specific configurations of specific monosaccharides. This report provides insights into whole-cell P. aeruginosa carbohydrate-binding profiles and into the context within which successful anti-adhesive and/or anti-virulence anti-infective agents for CF must contend.

Copper Nanodots-Based Hybrid Hydrogels with Multiple Enzyme Activities for Acute and Infected Wound Repair

Effectively controlling bacterial infection, reducing the inflammation and promoting vascular regeneration are all essential strategies for wound repair. Nanozyme technology has potential applications in the treatment of infections because its non-antibiotic dependent, topical and noninvasive nature. In wound management, copper-based nanozymes have emerged as viable alternatives to antibiotics. In this study, an ultrasmall cupric enzyme with high enzymatic activity is synthesized and added to a nontoxic, self-healing, injectable cationic guar gum (CG) hydrogel network. The nanozyme exhibits remarkable antioxidant properties under neutral conditions, effectively scavenging reactive nitrogen and oxygen species (RNOS). Under acidic conditions, Cu NDs have peroxide (POD) enzyme-like activity, which allows them to eliminate hydrogen peroxides and produce free radicals locally. Antibacterial experiments show that they can kill bacteria and remove biofilms. It reveals that low concentrations of Cu ND/CG decrease the expression of the inflammatory factors in cells and tissues, effectively controlling inflammatory responses. Cu ND/CG hydrogels also inhibit HIF-1α and promote VEGF expression in the wound with the ability to promote vascular regeneration. In vivo safety assessments reveal a favorable biosafety profile. Cu ND/CG hydrogels offer a promising solution for treating acute and infected wounds, highlighting the potential of innovative nanomaterials in wound healing.

Green synthetized Cu-Oxide Nanoparticles: Properties and applications for enhancing healing of wounds infected with Staphylococcus aureus

Treating wound infections is a challenging concern in various clinical settings in Egypt, especially in the increasing global problem of resistance to antimicrobials. Here, we aimed to fabricate CuO NPs via green synthesis using aqueous Yucca gigantea extract. Then, the effect of green synthesized CuO NPs on Staphylococcus aureus clinical isolates has been studied in vivo and in vitro. The aqueous extract of Yucca gigantea has been employed in our study as a scale-up approach to safely, affordably, sustainably, and practically fabricate copper oxide nanoparticles (CuO NPs). Fourier transforms infrared (FT-IR), X-ray Diffraction (XRD), and UV-vis spectroscopy were utilized in vitro to describe the bonding features of CuO NPs.Scanning Electron microscopy (SEM), Transmission electron microscopy (TEM), Energy dispersive X-ray (EDX), and dynamic light scattering (DLS) were used to detect the morphological and elemental composition of the resulting CuO NPs. The fabrication of CuO NPs was confirmed by the IR spectral band at 515 cm-1, ensuring the metal-oxygen bondCu-O with two strong bands at 229 and 305 nm. SEM and TEM show CuO NPs with a size range from 30 to 50 nm. Cu and O comprised most of the particles produced through green synthesis, with weight percentages of 57.82 and 42.18 %, respectively. CuO NPs were observed to have a Zeta-potential value of -15.7 mV, demonstrating their great stability. CuO NPs revealed antibacterial potential toward the tested isolates with minimum inhibitory concentration values of 128 to 512 µg/mL. CuO NPs had antibiofilm potential by crystal violet assay, downregulating the expression of icaA and icaD genes in 23.07 % and 19.32 of the S. aureus isolates. The wound-healing potential of CuO NPs was investigated in vivo. It significantly decreased the bacterial burden and increased wound healing percentage compared to the positive control group. Moreover, CuO NPs caused an upregulation of the genes encoding platelet-derived growth factor (PDGF) and fibronectin in tissue repair. Thus, we can use CuO NPs as a future source for wound healing materials, especially in infected wounds.

A Novel and Versatile Microfluidic Device for Cell Assays under Radio Frequency Exposure

Wound healing is a complex process composed of different stages, which involves extensive communication between the different cellular factors of the extracellular matrix (ECM). The radio frequency electromagnetic field (RF-EMF) has been used to accelerate the wound-healing process and it has been found to enhance cell alignment and mobility. The conventional methods for cell mobility analysis in an electromagnetic field generated by a radiation source are not advisable due to the low-precision, nonuniform distribution of the field, low efficiency of the analysis in batch and the lack of system integration for autonomous on-body operation. Here, a novel and versatile electromagnetic exposure system integrated with a microfluidic chip was fabricated to explore the EMF-induced response. A gradient electromagnetic field in a two-dimensional plane has been successfully established in the microchambers placed along the field line. In this work, by deploying our radiation experiments in vitro, we validated the on-chip monitoring of cell response to exposure. This electromagnetic field was simulated and human amniotic epithelial cells (HAECs) were cultured in different microchambers for continuous exposure to the electromagnetic field excited by a monopole RF antenna (1.8 GHz). New protrusions were generated and an obvious increase in filopodia with the increased field intensity was investigated. Meanwhile, the variation in intracellular Ca2+ concentration under the electromagnetic field was examined. The inhibitory effect of the Ca2+ circulation was further inspected to reveal the potential downstream signaling pathway in the RF-EMF-related bioassay, suggesting that cytoskeletal dynamics of cells under exposure are highly associated with the EGF receptor (EGFR)-cytoskeleton downstream signaling pathway. Finally, the field-induced cell elongation and alignment parallel to the field direction were observed. Additionally, the subsequent recovery (field withdrawal) and re-establishment (field re-exposure) were explored. These results indicated that this reliable and versatile exposure system for bioassay could achieve precise and high-throughput detection of the RF-EMF-induced cytoskeletal reorganization in vitro and evaluate the possible health risk from RF-EMF exposure.

A Designed Host Defense Peptide for the Topical Treatment of MRSA-Infected Diabetic Wounds

Diabetes mellitus is a chronic disease characterized by metabolic dysregulation which is frequently associated with diabetic foot ulcers that result from a severely compromised innate immune system. The high levels of blood glucose characteristic of diabetes cause an increase in circulating inflammatory mediators, which accelerate cellular senescence and dampen antimicrobial activity within dermal tissue. In diabetic wounds, bacteria and fungi proliferate in a protective biofilm forming a structure that a compromised host defense system cannot easily penetrate, often resulting in chronic infections that require antimicrobial intervention to promote the healing process. The designed host defense peptide (dHDP) RP557 is a synthesized peptide whose sequence has been derived from naturally occurring antimicrobial peptides (AMPs) that provide the first line of defense against invading pathogens. AMPs possess an amphipathic α-helix or β-sheet structure and a net positive charge that enables them to incorporate into pathogen membranes and perturb the barrier function of Gram-positive and Gram-negative bacteria along with fungi. The capacity of skin to resist infections is largely dependent upon the activity of endogenous AMPs that provided the basis for the design and testing of RP557 for the resolution of wound infections. In the current study, the topical application of RP557 stopped bacterial growth in the biofilm of methicillin-resistant Staphylococcus aureus (MRSA) USA300 infected wounds on the flanks of clinically relevant diabetic TALLYHO mice. Topical application of RP557 reduced bacterial load and accelerated wound closure, while wound size in control diabetic mice continued to expand. These studies demonstrate that RP557 reduces or eliminates an infection in its biofilm and restores wound-healing capacity.

Effect of Moringa oleifera Leaf Extract on Excision Wound Infections in Rats: Antioxidant, Antimicrobial, and Gene Expression Analysis

The present study investigated the wound healing activity of Moringa oleifera leaf extract on an infected excision wound model in rats. Infection was induced using methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa. An investigation was also done to study the effect of Moringa extract on the vascular endothelial growth factor (VEGF) and transforming growth factor-beta 1 (TGF-β1) gene expression in vitro using human keratinocytes (HaCaT). The methanol extract of M. oleifera leaves was analyzed for the presence of phytochemicals by LCMS. The antimicrobial activity of the extract was also determined. Wound contraction, days for epithelization, antioxidant enzyme activities, epidermal height, angiogenesis, and collagen deposition were studied. M. oleifera showed an antimicrobial effect and significantly improved wound contraction, reduced epithelization period, increased antioxidant enzymes activity, and reduced capillary density. Effect of the extract was less in wounds infected with P. aeruginosa when compared to MRSA. The VEGF and TGF-β1 gene expression was increased by M. oleifera.

Development of pH-responsive nanocomposites with remarkably synergistic antibiofilm activities based on ultrasmall silver nanoparticles in combination with aminoglycoside antibiotics

Bacterial biofilms are responsible for many chronic infections because antibacterial agents exhibit poor penetration into the dense matrix barrier and cannot easily reach the internal bacteria. Herein, we reported pH-responsive nanocomposites (PDA@Kana-AgNPs) that could penetrate and disperse biofilms, which were synthesized by the combination of ultrasmall silver nanoparticles (AgNPs) and kanamycin, and then coating with polydopamine. Confocal fluorescence imaging indicated that PDA@Kana-AgNPs could respond to the acidic microenvironment of biofilms, leading to biofilm-triggered on- demand drug release in situ. The zone of inhibition test and Resazurin assay showed that the combination of kanamycin and AgNPs had greater antimicrobial activity against test strains (Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Escherichia coli BL21) than when applied separately. The crystal violet staining test demonstrated that biofilms were effectively dispersed by the proposed nanocomposites. Biocompatibility was also evaluated, which showed that PDA@Kana-AgNPs were non-toxic to mammalian cells. Therefore, the proposed pH-responsive nanocomposites held great potential for efficient antibiotics delivery and showed synergistic antibacterial and antibiofilm activities. This strategy could also be used to encapsulate a variety of antibiotics in combination with other drugs or materials, thereby showing therapeutic potential in preventing biofilm-related infections and realizing fluorescence imaging in situ.

New Insights on Biofilm Antimicrobial Strategies

Over the last few decades, the study of microbial biofilms has been gaining interest among the scientific community [...].

Biofilm-Innate Immune Interface: Contribution to Chronic Wound Formation

Delayed wound healing can cause significant issues for immobile and ageing individuals as well as those living with co-morbid conditions such as diabetes, cardiovascular disease, and cancer. These delays increase a patient’s risk for infection and, in severe cases, can result in the formation of chronic, non-healing ulcers (e.g., diabetic foot ulcers, surgical site infections, pressure ulcers and venous leg ulcers). Chronic wounds are very difficult and expensive to treat and there is an urgent need to develop more effective therapeutics that restore healing processes. Sustained innate immune activation and inflammation are common features observed across most chronic wound types. However, the factors driving this activation remain incompletely understood. Emerging evidence suggests that the composition and structure of the wound microbiome may play a central role in driving this dysregulated activation but the cellular and molecular mechanisms underlying these processes require further investigation. In this review, we will discuss the current literature on: 1) how bacterial populations and biofilms contribute to chronic wound formation, 2) the role of bacteria and biofilms in driving dysfunctional innate immune responses in chronic wounds, and 3) therapeutics currently available (or underdevelopment) that target bacteria-innate immune interactions to improve healing. We will also discuss potential issues in studying the complexity of immune-biofilm interactions in chronic wounds and explore future areas of investigation for the field.