Biocompatibility of Nanocellulose-Reinforced PVA Hydrogel with Human Corneal Epithelial Cells for Ophthalmic Applications

Injectable hydrogels based on biopolymers for the treatment of ocular diseases

Injectable hydrogels based on biopolymers, fabricated utilizing diverse chemical and physical methodologies, exhibit exceptional physical, chemical, and biological properties. They have multifaceted applications encompassing wound healing, tissue regeneration, and across diverse scientific realms. This review critically evaluates their largely uncharted potential in ophthalmology, elucidating their diverse applications across an array of ocular diseases. These conditions include glaucoma, cataracts, corneal disorders (spanning from age-related degeneration to trauma, infections, and underlying chronic illnesses), retina-associated ailments (such as diabetic retinopathy, retinitis pigmentosa, and age-related macular degeneration (AMD)), eyelid abnormalities, and uveal melanoma (UM). This study provides a thorough analysis of applications of injectable hydrogels based on biopolymers across these ocular disorders. Injectable hydrogels based on biopolymers can be customized to have specific physical, chemical, and biological properties that make them suitable as drug delivery vehicles, tissue scaffolds, and sealants in the eye. For example, they can be engineered to have optimum viscosity to be injected intravitreally and sustain drug release to treat retinal diseases. Their porous structure and biocompatibility promote cellular infiltration to regenerate diseased corneal tissue. By accentuating their indispensable role in ocular disease treatment, this review strives to present innovative and targeted approaches in this domain, thereby advancing ocular therapeutics.

A double-crosslinked nanocellulose-reinforced dexamethasone-loaded collagen hydrogel for corneal application and sustained anti-inflammatory activity

In cases of blinding disease or trauma, hydrogels have been proposed as scaffolds for corneal regeneration and vehicles for ocular drug delivery. Restoration of corneal transparency, augmenting a thin cornea and postoperative drug delivery are particularly challenging in resource-limited regions where drug availability and patient compliance may be suboptimal. Here, we report a bioengineered hydrogel based on porcine skin collagen as an alternative to human donor corneal tissue for applications where long-term stability of the hydrogel is required. The hydrogel is reinforced with cellulose nanofibers extracted from the Ciona intestinalis sea invertebrate followed by double chemical and photochemical crosslinking. The hydrogel is additionally loaded with dexamethasone to provide sustained anti-inflammatory activity. The reinforced double-crosslinked hydrogel after drug loading maintained high optical transparency with significantly improved mechanical characteristics compared to non-reinforced hydrogels, while supporting a gradual sustained drug release for 60 days in vitro. Dexamethasone, after exposure to crosslinking and sterilization procedures used in hydrogel production, inhibited tube formation and cell migration of TNFα-stimulated vascular endothelial cells. The drug-loaded hydrogels suppressed key pro-inflammatory cytokines CCL2 and CXCL5 in TNFα-stimulated human corneal epithelial cells. Eight weeks after intra-stromal implantation in the cornea of 12 New-Zealand white rabbits subjected to an inflammatory suture stimulus, the dexamethasone-releasing hydrogels suppressed TNFα, MMP-9, and leukocyte and fibroblast cell invasion, resulting in reduced corneal haze, sustained corneal thickness and stromal morphology, and reduced overall vessel invasion. This collagen-nanocellulose double-crosslinked hydrogel can be implanted to treat corneal stromal disease while suppressing inflammation and maintaining transparency after corneal transplantation. STATEMENT OF SIGNIFICANCE: To treat blinding diseases, hydrogel scaffolds have been proposed to facilitate corneal restoration and ocular drug delivery. Here, we improve on a clinically tested collagen-based scaffold to improve mechanical robustness and enzymatic resistance by incorporating sustainably sourced nanocellulose and dual chemical-photochemical crosslinking to reinforce the scaffold, while simultaneously achieving sustained release of an incorporated anti-inflammatory drug, dexamethasone. Evaluated in the context of a corneal disease model with inflammation, the drug-releasing nanocellulose-reinforced collagen scaffold maintained the cornea's transparency and resisted degradation while suppressing inflammation postoperatively. This biomaterial could therefore potentially be applied in a wider range of sight-threatening diseases, overcoming suboptimal administration of postoperative medications to maintain hydrogel integrity and good vision.

Development of corneal contact lens materials and current clinical application of contact lenses: A review

Unlike conventional glasses, corneal contact lenses (CLs) can directly contact the surface of the tear film through the application of biopolymer materials, to achieve therapeutic and cosmetic purposes. Since the advent of polymethylmethacrylate, a material that has gained widespread use and attention, statistically, there are now more than 150 × 106 people around the world who wear corneal contact lenses. However, the associated complications caused by the interaction of contact lenses with the ocular surface, tear film, endogenous and environmental microorganisms, and components of the solution affect nearly one-third of the wearer population. The application of corneal contact lenses in correcting vision and myopia control has been widely recognized. With the development of related materials, corneal contact lenses are applied to the treatment of ocular surface diseases, including corneal bandage lenses, drug-loaded corneal contact lenses, biosensors, and other new products, while minimizing the side effects associated with CL wear. This paper summarized the development history and material properties of CLs, focused on the current main clinical applications and mechanisms, as well as clarified the possible complications in wearing therapeutic contact lenses and the direction for improvement in the future.

Insight into the Latest Medical Applications of Nanocellulose

Nanocelluloses (NCs) are appealing nanomaterials that have experienced rapid development in recent years, with great potential in the biomedical field. This trend aligns with the increasing demand for sustainable materials, which will contribute both to an improvement in wellbeing and an extension of human life, and with the demand to keep up with advances in medical technology. In recent years, due to the diversity of their physical and biological properties and the possibility of tuning them according to the desired goal, these nanomaterials represent a point of maximum interest in the medical field. Applications such as tissue engineering, drug delivery, wound dressing, medical implants or those in cardiovascular health are some of the applications in which NCs have been successfully used. This review presents insight into the latest medical applications of NCs, in the forms of cellulose nanocrystals (CNCs), cellulose nanofibers (CNFs) and bacterial nanocellulose (BNC), with an emphasis on the domains that have recently experienced remarkable growth, namely wound dressing, tissue engineering and drug delivery. In order to highlight only the most recent achievements, the presented information is focused on studies from the last 3 years. Approaches to the preparation of NCs are discussed either by top-down (chemical or mechanical degradation) or by bottom-up (biosynthesis) techniques, along with their morphological characterization and unique properties, such as mechanical and biological properties. Finally, the main challenges, limitations and future research directions of NCs are identified in a sustained effort to identify their effective use in biomedical fields.

Unidirectional Nanopore Dehydration Induces an Anisotropic Polyvinyl Alcohol Hydrogel Membrane with Enhanced Mechanical Properties

As a biocompatible, degradable polymer material, polyvinyl alcohol (PVA) can have a wide range of applications in the biomedical field. PVA aqueous solutions at room temperature can be cast into very thin films with poor mechanical strength via water evaporation. Here, we describe a novel dehydration method, unidirectional nanopore dehydration (UND). The UND method was used to directly dehydrate a PVA aqueous solution to form a water-stable, anisotropic, and mechanically robust PVA hydrogel membrane (PVAHM), whose tensile strength, elongation at break, and swelling ratio reached values of up to ~2.95 MPa, ~350%, and ~350%, respectively. The film itself exhibited an oriented arrangement of porous network structures with an average pore size of ~1.0 μm. At 70 °C, the PVAHMs formed were even more mechanically robust, with a tensile strength and elongation at break of 10.5 MPa and 891%, almost 3.5 times and 2 times greater than the PVAHM prepared at 25 °C, respectively. The processing temperature affects the velocity at which the water molecules flow unidirectionally through the nanopores, and could, thus, alter the overall transformation of the PVA chains into a physically crosslinked 3D network. Therefore, the temperature setting during UND can control the mechanical properties of the hydrogel membrane to meet the requirements of various biomaterial applications. These results show that the UND can induce the ordered rearrangement of PVA molecular chains, forming a PVAHM with superior mechanical properties and exhibiting a greater number of stronger hydrogen bonds. Therefore, the novel dehydration mode not only induces the formation of a mechanically robust and anisotropic PVA hydrogel membrane with a porous network structure and an average pore size of ~1.0 μm, but also greatly enhances the mechanical properties by increasing the temperature. It may be applied for the processing of water-soluble polymers, including proteins, as novel functional materials.

Novel Trends in Hydrogel Development for Biomedical Applications: A Review

Nowadays, there are still numerous challenges for well-known biomedical applications, such as tissue engineering (TE), wound healing and controlled drug delivery, which must be faced and solved. Hydrogels have been proposed as excellent candidates for these applications, as they have promising properties for the mentioned applications, including biocompatibility, biodegradability, great absorption capacity and tunable mechanical properties. However, depending on the material or the manufacturing method, the resulting hydrogel may not be up to the specific task for which it is designed, thus there are different approaches proposed to enhance hydrogel performance for the requirements of the application in question. The main purpose of this review article was to summarize the most recent trends of hydrogel technology, going through the most used polymeric materials and the most popular hydrogel synthesis methods in recent years, including different strategies of enhancing hydrogels’ properties, such as cross-linking and the manufacture of composite hydrogels. In addition, the secondary objective of this review was to briefly discuss other novel applications of hydrogels that have been proposed in the past few years which have drawn a lot of attention.

Hydrogels as Corneal Stroma Substitutes for In Vitro Evaluation of Drug Ocular Permeation

Hydrogels are complex hydrophilic structures, consisting of crosslinked homopolymers or copolymers insoluble in water. Due to their controllable bio-physicochemical properties mimicking the morphology of the native extracellular matrix, they are a key part of a lot of research fields, including medicine, pharmaceutics, and tissue engineering. This paper was focused on the preparation and characterization of hydrogels from different blends of polyvinyl alcohol (PVA) with microcrystalline cellulose (MCC) and gelatin (GEL) at various ratios, and from gelatin and chitosan alone to understand their feasibility of utilizing as corneal stroma substitutes in permeability tests for drug candidate molecules in early stages of their development. The characterization was carried out by differential scanning calorimetry, electron microscopy (SEM), water content, mass loss, water permeability, wettability, and tensile stress–strain tests. After the physicochemical characterization, PVA/MCC blend and chitosan proved to be the most promising constructs, showing negligible mass loss after immersion in aqueous medium for two weeks and low hydrodynamic permeability. They were then employed in drug molecules permeation studies and these data were compared to that obtained through excised tissues. The results obtained showed that PVA/MCC hydrogels have similar mechanical and permeability properties to corneal stroma.

A solid ultrasonic coupling membrane for superficial vascular ultrasonography

Superficial thrombophlebitis is one of the most significant complications of superficial vein thrombosis. Rapid imaging and mapping with high resolution is particularly important for accurate diagnosis so as to carry out treatment as soon as possible. Ultrasound imaging technology has been used extensively because of the low-cost, minimal invasiveness, and convenient application in clinical practice. And the ultrasonic couplant is an essential component in ultrasound examination. However, when imaging superficial structures, traditional liquid ultrasonic couplants often produce inadequate results. In this study, we investigate whether a hydrogel membrane can be used to improve the imaging of superficial vessels. To this end, we generated a polyacrylamide-bacterial nanocellulose hydrogel membrane (PAM-BC) that efficiently forms at 60 °C in only 10 min by redox polymerization. With PAM-BC-2.5, it was possible to acquire high resolution intravascular ultrasound images to assess superficial vessels in humans and the superficial vasculature in rats and miniature pigs using various brands of ultrasound instruments. The PAM-BCs represent a new, solid ultrasonic membrane which is suitable for diagnosing disease in superficial vessels.

Bacterial Cellulose-A Remarkable Polymer as a Source for Biomaterials Tailoring

Nowadays, the development of new eco-friendly and biocompatible materials using ‘green’ technologies represents a significant challenge for the biomedical and pharmaceutical fields to reduce the destructive actions of scientific research on the human body and the environment. Thus, bacterial cellulose (BC) has a central place among these novel tailored biomaterials. BC is a non-pathogenic bacteria-produced polysaccharide with a 3D nanofibrous structure, chemically identical to plant cellulose, but exhibiting greater purity and crystallinity. Bacterial cellulose possesses excellent physicochemical and mechanical properties, adequate capacity to absorb a large quantity of water, non-toxicity, chemical inertness, biocompatibility, biodegradability, proper capacity to form films and to stabilize emulsions, high porosity, and a large surface area. Due to its suitable characteristics, this ecological material can combine with multiple polymers and diverse bioactive agents to develop new materials and composites. Bacterial cellulose alone, and with its mixtures, exhibits numerous applications, including in the food and electronic industries and in the biotechnological and biomedical areas (such as in wound dressing, tissue engineering, dental implants, drug delivery systems, and cell culture). This review presents an overview of the main properties and uses of bacterial cellulose and the latest promising future applications, such as in biological diagnosis, biosensors, personalized regenerative medicine, and nerve and ocular tissue engineering.

Applying Box-Behnken Design for Formulation and Optimization of PLGA-Coffee Nanoparticles and Detecting Enhanced Antioxidant and Anticancer Activities

In an attempt to prove biological activity enhancement upon particle size reduction to the nanoscale, coffee (Cf) was chosen to be formulated into poly(lactic-co-glycolic) acid (PLGA) nanoparticles (NPs) using the single emulsion-solvent evaporation (SE-SE) method via Box-Behnken Design (BBD) to study the impact of certain process and formulation parameters on the particle size and size homogeneity, surface stability and encapsulation efficiency (EE%). The coffee-loaded PLGA (PLGA-Cf) NPs were characterized by different methods to aid in selecting the optimum formulation conditions. The desirable physicochemical characteristics involved small particle sizes with an average of 318.60 ± 5.65 nm, uniformly distributed within a narrow range (PDI of 0.074 ± 0.015), with considerable stability (Zeta Potential of -20.50 ± 0.52 mV) and the highest EE% (85.92 ± 4.01%). The antioxidant and anticancer activities of plain PLGA NPs, pure Cf and the optimum PLGA-Cf NPs, were evaluated using 2,2-Diphenyl-1-picryl-hydrazyl (DPPH) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays, respectively. As a result of nano-encapsulation, antioxidant activity was enhanced by 26.5%. Encapsulated Cf showed higher anticancer potency than pure Cf against different cancerous cell lines with an increase of 86.78%, 78.17%, 85.84% and 84.84% against MCF-7, A-549, HeLa and HepG-2, respectively. The in vitro release followed the Weibull release model with slow and biphasic release profile in both tested pH media, 7.4 and 5.5.

The Application Status of Nanoscale Cellulose-Based Hydrogels in Tissue Engineering and Regenerative Biomedicine

As a renewable, biodegradable, and non-toxic material with moderate mechanical and thermal properties, nanocellulose-based hydrogels are receiving immense consideration for various biomedical applications. With the unique properties of excellent skeletal structure (hydrophilic functional groups) and micro-nano size (small size effect), nanocellulose can maintain the three-dimensional structure of the hydrogel to a large extent, providing mechanical strength while ensuring the moisture content. Owing to its unique features, nanocellulose-based hydrogels have made excellent progress in research and development on tissue engineering, drug carriers, wound dressings, development of synthetic organs, 3D printing, and biosensing. This review provides an overview of the synthesis of different types of nanocellulose, including cellulose nanocrystals, cellulose nanofibers, and bacterial nanocellulose, and describes their unique features. It further provides an updated knowledge of the development of nanocellulose-based functional biomaterials for various biomedical applications. Finally, it discusses the future perspective of nanocellulose-based research for its advanced biomedical applications.

Examining the Transmission of Visible Light through Electrospun Nanofibrous PCL Scaffolds for Corneal Tissue Engineering

The transparency of nanofibrous scaffolds is of highest interest for potential applications like corneal wound dressings in corneal tissue engineering. In this study, we provide a detailed analysis of light transmission through electrospun polycaprolactone (PCL) scaffolds. PCL scaffolds were produced via electrospinning, with fiber diameters in the range from (35 ± 13) nm to (167 ± 35) nm. Light transmission measurements were conducted using UV-vis spectroscopy in the range of visible light and analyzed with respect to the influence of scaffold thickness, fiber diameter, and surrounding medium. Contour plots were compiled for a straightforward access to light transmission values for arbitrary scaffold thicknesses. Depending on the fiber diameter, transmission values between 15% and 75% were observed for scaffold thicknesses of 10 µm. With a decreasing fiber diameter, light transmission could be improved, as well as with matching refractive indices of fiber material and medium. For corneal tissue engineering, scaffolds should be designed as thin as possible and fabricated from polymers with a matching refractive index to that of the human cornea. Concerning fiber diameter, smaller fiber diameters should be favored for maximizing graft transparency. Finally, a novel, semi-empirical formulation of light transmission through nanofibrous scaffolds is presented.

Optimization of polycaprolactone - based nanofiber matrices for the cultivation of corneal endothelial cells

Posterior lamellar transplantation of the eye’ s cornea (DSAEK, DMEK) currently is the gold standard for treating patients with corneal endothelial cell and back surface pathologies resulting in functional impairment. An artificial biomimetic graft carrying human corneal endothelium could minimize the dependency on human donor corneas giving access to this vision-restoring surgery to large numbers of patients, thus reducing current long waiting lists. In this study, four groups of electrospun nanofibrous scaffolds were compared: polycaprolactone (PCL), PCL/collagen, PCL/gelatin and PCL/chitosan. Each of the scaffolds were tissue-engineered with human corneal endothelial cells (HCEC-B4G12) and analyzed with regard to their potential application as artificial posterior lamellar grafts. Staining with ZO-1 and Na⁺/K⁺-ATPase antibodies revealed intact cell functionalities. It could be shown, that blending leads to decreasing contact angle, whereby a heterogeneous blend morphology could be revealed. Scaffold cytocompatibility could be confirmed for all groups via live/dead staining, whereby a significant higher cell viability could be observed for the collagen and gelatine blended matrices with 97 ± 3% and 98 ± 2% living cells respectively. TEM images show the superficial anchoring of the HCECs onto the scaffolds. This work emphasizes the benefit of blended PCL nanofibrous scaffolds for corneal endothelial keratoplasty.

Advanced Functional Materials Based on Nanocellulose for Pharmaceutical/Medical Applications

Nanocelluloses (NCs), with their remarkable characteristics, have proven to be one of the most promising "green" materials of our times and have received special attention from researchers in nanomaterials. A diversity of new functional materials with a wide range of biomedical applications has been designed based on the most desirable properties of NCs, such as biocompatibility, biodegradability, and their special physicochemical properties. In this context and under the pressure of rapid development of this field, it is imperative to synthesize the successes and the new requirements in a comprehensive review. The first part of this work provides a brief review of the characteristics of the NCs (cellulose nanocrystals-CNC, cellulose nanofibrils-CNF, and bacterial nanocellulose-BNC), as well as of the main functional materials based on NCs (hydrogels, nanogels, and nanocomposites). The second part presents an extensive review of research over the past five years on promising pharmaceutical and medical applications of nanocellulose-based materials, which have been discussed in three important areas: drug-delivery systems, materials for wound-healing applications, as well as tissue engineering. Finally, an in-depth assessment of the in vitro and in vivo cytotoxicity of NCs-based materials, as well as the challenges related to their biodegradability, is performed.

Preparation of Nanoparticle-Containing Ring-Implanted Poly(Vinyl Alcohol) Contact Lens for Sustained Release of Hyaluronic Acid

Here, a novel ring-implanted poly vinyl alcohol (PVA) contact lens (CL) is fabricated and evaluated as a therapeutic CL with potential of sustained release of hyaluronic acid (HA). HA is loaded on chitosan (CS) nanoparticles (NPs) and then the HA-loaded NPs are dispersed in a ring shape PVA hydrogel which is implanted in the final PVA CL. Results show that HA is successfully loaded on NPs (520 ± 18 nm) with loading efficacy of 87% and loading capacity of 50%. The CL hydrogel has a 275% swelling ratio, no degradation during 14 days, 97% light transmittance, and desirable rheological stability under physiological shear force. The release data show a sustained release for HA from the ring implanted CL up to 14 days. The cellular study reveals no corneal epithelial cell cytotoxicity and cell attachment on the CL. The study demonstrates the successful application of the ring-implanted CL to sustain the delivery of HA for treating the dry eye syndrome.

Topical Administration of SLN-Based Gene Therapy for the Treatment of Corneal Inflammation by De Novo IL-10 Production

One of the main challenges in gene therapy is the issue of delivery, and it is especially relevant for the success of gene therapy in the cornea. In the present work, eye drops containing biocompatible non-viral vectors based on solid lipid nanoparticles (SLNs) as gene delivery systems to induce the expression of interleukin 10 (IL-10) were designed to address the treatment of corneal inflammation. Two kinds of SLNs combined with different ligands (protamine, dextran, or hyaluronic acid (HA)) and formulated with polyvinyl alcohol (PVA) were prepared. SLN-based vectors were characterized in terms of size, adhesiveness, viscosity, and pH, before topical administration to wild type and IL-10 knock out (KO) mice. The formulations showed a homogenous particle size below 400 nm and a positive surface charge to favor bioadhesion; the incorporation of PVA improved the corneal penetration. After three days of treatment by topical instillation, SLN-based vectors mainly transfected corneal epithelial cells, HA-formulations being the most effective ones. IL-10 was capable of reaching even the endothelial layer. Corneal sections showed no histological change and formulations seemed to be well tolerated after repeated topical administration. These promising results highlight the possible contribution of non-viral gene augmentation therapy to the future clinical approach of corneal gene therapy.

Swelling characteristics and biocompatibility of ionic liquid based hydrogels for biomedical applications

Polymers are commonly used in medical device manufacturing, e.g. for drug delivery systems, bone substitutes and stent coatings. Especially hydrogels exhibit very promising properties in this field. Hence, the development of new hydrogel systems for customized application is of great interest, especially regarding the swelling behavior and mechanical properties as well as the biocompatibility. The aim of this work was the preparation and investigation of various polyelectrolyte and poly-ionic liquid based hydrogels accessible by radical polymerization. The obtained polymers were covalently crosslinked with N,Nʼ-methylenebisacrylamide (MBAA) or different lengths of poly(ethyleneglycol)diacrylate (PEGDA). The effect of different crosslinker-to-monomer ratios has been examined. In addition to the compression curves and the maximum degree of swelling, the biocompatibility with L929 mouse fibroblasts of these materials was determined in direct cell seeding experiments and the outcome for the different hydrogels was compared.