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Yang XC, Wang XX, Wang CY, Zheng HL, Yin M, Chen KZ, Qiao SL. Silk-based intelligent fibers and textiles: structures, properties, and applications. Chem Commun (Camb) 2024; 60:7801-7823. [PMID: 38966911 DOI: 10.1039/d4cc02276a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
Multifunctional fibers represent a cornerstone of human civilization, playing a pivotal role in numerous aspects of societal development. Natural biomaterials, in contrast to synthetic alternatives, offer environmental sustainability, biocompatibility, and biodegradability. Among these biomaterials, natural silk is favored in biomedical applications and smart fiber technology due to its accessibility, superior mechanical properties, diverse functional groups, controllable structure, and exceptional biocompatibility. This review delves into the intricate structure and properties of natural silk fibers and their extensive applications in biomedicine and smart fiber technology. It highlights the critical significance of silk fibers in the development of multifunctional materials, emphasizing their mechanical strength, biocompatibility, and biodegradability. A detailed analysis of the hierarchical structure of silk fibers elucidates how these structural features contribute to their unique properties. The review also encompasses the biomedical applications of silk fibers, including surgical sutures, tissue engineering, and drug delivery systems, along with recent advancements in smart fiber applications such as sensing, optical technologies, and energy storage. The enhancement of functional properties of silk fibers through chemical or physical modifications is discussed, suggesting broader high-end applications. Additionally, the review addresses current challenges and future directions in the application of silk fibers in biomedicine and smart fiber technologies, underscoring silk's potential in driving contemporary technological innovations. The versatility and sustainability of silk fibers position them as pivotal elements in contemporary materials science and technology, fostering the development of next-generation smart materials.
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Affiliation(s)
- Xiao-Chun Yang
- Lab of Functional and Biomedical Nanomaterials, College of Materials Science and Engineering, Qingdao University of Science and Technology (QUST), Qingdao, 266042, P. R. China.
| | - Xiao-Xue Wang
- Lab of Functional and Biomedical Nanomaterials, College of Materials Science and Engineering, Qingdao University of Science and Technology (QUST), Qingdao, 266042, P. R. China.
| | - Chen-Yu Wang
- Lab of Functional and Biomedical Nanomaterials, College of Materials Science and Engineering, Qingdao University of Science and Technology (QUST), Qingdao, 266042, P. R. China.
| | - Hong-Long Zheng
- Lab of Functional and Biomedical Nanomaterials, College of Materials Science and Engineering, Qingdao University of Science and Technology (QUST), Qingdao, 266042, P. R. China.
| | - Meng Yin
- Lab of Functional and Biomedical Nanomaterials, College of Materials Science and Engineering, Qingdao University of Science and Technology (QUST), Qingdao, 266042, P. R. China.
| | - Ke-Zheng Chen
- Lab of Functional and Biomedical Nanomaterials, College of Materials Science and Engineering, Qingdao University of Science and Technology (QUST), Qingdao, 266042, P. R. China.
| | - Sheng-Lin Qiao
- Lab of Functional and Biomedical Nanomaterials, College of Materials Science and Engineering, Qingdao University of Science and Technology (QUST), Qingdao, 266042, P. R. China.
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2
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Song Y, Hu C, Wang Z, Wang L. Silk-based wearable devices for health monitoring and medical treatment. iScience 2024; 27:109604. [PMID: 38628962 PMCID: PMC11019284 DOI: 10.1016/j.isci.2024.109604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Previous works have focused on enhancing the tensile properties, mechanical flexibility, biocompatibility, and biodegradability of wearable devices for real-time and continuous health management. Silk proteins, including silk fibroin (SF) and sericin, show great advantages in wearable devices due to their natural biodegradability, excellent biocompatibility, and low fabrication cost. Moreover, these silk proteins possess great potential for functionalization and are being explored as promising candidates for multifunctional wearable devices with sensory capabilities and therapeutic purposes. This review introduces current advancements in silk-based constituents used in the assembly of wearable sensors and adhesives for detecting essential physiological indicators, including metabolites in body fluids, body temperature, electrocardiogram (ECG), electromyogram (EMG), pulse, and respiration. SF and sericin play vital roles in addressing issues related to discomfort reduction, signal fidelity improvement, as well as facilitating medical treatment. These developments signify a transition from hospital-centered healthcare toward individual-centered health monitoring and on-demand therapeutic interventions.
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Affiliation(s)
- Yu Song
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Key Laboratory of Regenerative Medicine and Multi-disciplinary Translational Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart Equipment, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Chuting Hu
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Key Laboratory of Regenerative Medicine and Multi-disciplinary Translational Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart Equipment, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zheng Wang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Key Laboratory of Regenerative Medicine and Multi-disciplinary Translational Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart Equipment, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lin Wang
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Key Laboratory of Regenerative Medicine and Multi-disciplinary Translational Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Provincial Engineering Research Center of Clinical Laboratory and Active Health Smart Equipment, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Phan VHG, Thai NKL, Tran THH, Nguyen TKN, Thambi T, Murgia X, Ho DK, Elmaleh DR. Triple-Hybrid BioScaffold Based on Silk Fibroin, Chitosan, and nano-Biphasic Calcium Phosphates: Preparation, Characterization of Physiochemical and Biopharmaceutical Properties. J Pharm Sci 2024:S0022-3549(24)00099-6. [PMID: 38527617 DOI: 10.1016/j.xphs.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
Bioscaffolds, which promote cell regeneration and restore tissues' functions, have emerged as significant need in clinic. The hybrid of several biomaterials in a bioscaffold renders clinically advanced and relevant properties for applications yet add challenges in cost efficiency, production, and clinical investigation. This study proposes a facile and sustainable method to formulate a triple-hybrid bioscaffold based on Vietnamese cocoon origin Silk Fibroin, Chitosan, and nano-Biphasic Calcium Phosphates (nano-BCP) that can be easily molded, has high porosity (55-80%), and swelling capacity that facilitates cell proliferation and nutrient diffusion. Notably, their mechanical properties, in particular compressive strength, can easily be tuned in a range from 50 - 200 kPa by changing the amount of nano-BCP addition, which is comparable to the successful precedents for productive cell regeneration. The latter parts investigate the biopharmaceutical properties of a representative bioscaffold, including drug loading and release studies with two kinds of active compounds, salmon calcitonin and methylprednisolone. Furthermore, the bioscaffold is highly biocompatible as the results of hemocompatibility and hemostasis tests, as well as ovo chick chorioallantoic membrane investigation. The findings of the study suggest the triple-hybrid scaffold as a promising platform for multi-functional drug delivery and bone defect repair.
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Affiliation(s)
- V H Giang Phan
- Biomaterials and Nanotechnology Research Group, Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
| | - Nguyen-Kim-Luong Thai
- Biomaterials and Nanotechnology Research Group, Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Thanh-Han Hoang Tran
- Biomaterials and Nanotechnology Research Group, Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Thien-Kim Ngoc Nguyen
- Biomaterials and Nanotechnology Research Group, Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Thavasyappan Thambi
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin si, Gyeonggi do 17104, Republic of Korea.
| | | | - Duy-Khiet Ho
- Department of Bioengineering, School of Medicine, University of Washington, Seattle, Washington 98195, United States
| | - David R Elmaleh
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02129, USA
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Promsuk J, Manissorn J, Laomeephol C, Luckanagul JA, Methachittipan A, Tonsomboon K, Jenjob R, Yang SG, Thongnuek P, Wangkanont K. Optimizing protein delivery rate from silk fibroin hydrogel using silk fibroin-mimetic peptides conjugation. Sci Rep 2024; 14:4428. [PMID: 38395958 PMCID: PMC10891107 DOI: 10.1038/s41598-024-53689-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Controlled release of proteins, such as growth factors, from biocompatible silk fibroin (SF) hydrogel is valuable for its use in tissue engineering, drug delivery, and other biological systems. To achieve this, we introduced silk fibroin-mimetic peptides (SFMPs) with the repeating unit (GAGAGS)n. Using green fluorescent protein (GFP) as a model protein, our results showed that SFMPs did not affect the GFP function when conjugated to it. The SFMP-GFP conjugates incorporated into SF hydrogel did not change the gelation time and allowed for controlled release of the GFP. By varying the length of SFMPs, we were able to modulate the release rate, with longer SFMPs resulting in a slower release, both in water at room temperature and PBS at 37 °C. Furthermore, the SF hydrogel with the SFMPs showed greater strength and stiffness. The increased β-sheet fraction of the SF hydrogel, as revealed by FTIR analysis, explained the gel properties and protein release behavior. Our results suggest that the SFMPs effectively control protein release from SF hydrogel, with the potential to enhance its mechanical stability. The ability to modulate release rates by varying the SFMP length will benefit personalized and controlled protein delivery in various systems.
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Affiliation(s)
- Jaturong Promsuk
- Department of Biochemistry, Center of Excellence for Molecular Biology and Genomics of Shrimp, Faculty of Science, Chulalongkorn University, Bangkok, 10330, Thailand
- Department of Biochemistry, Center of Excellence in Molecular Crop, Faculty of Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Juthatip Manissorn
- Biomedical Materials and Devices for Revolutionary Integrative Systems Engineering Research Unit (BMD-RISE), Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand.
| | - Chavee Laomeephol
- Biomedical Materials and Devices for Revolutionary Integrative Systems Engineering Research Unit (BMD-RISE), Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Jittima Amie Luckanagul
- Biomedical Materials and Devices for Revolutionary Integrative Systems Engineering Research Unit (BMD-RISE), Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Apipon Methachittipan
- Nano Engineering Program, International School of Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Khaow Tonsomboon
- National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency (NSTDA), Khlong Luang, 12120, Pathum Thani, Thailand
| | - Ratchapol Jenjob
- Department of Biomedical Science, BK21 FOUR Program in Biomedical Science and Engineering, Inha University College of Medicine, Incheon, 22332, Republic of Korea
| | - Su-Geun Yang
- Department of Biomedical Science, BK21 FOUR Program in Biomedical Science and Engineering, Inha University College of Medicine, Incheon, 22332, Republic of Korea
| | - Peerapat Thongnuek
- Biomedical Materials and Devices for Revolutionary Integrative Systems Engineering Research Unit (BMD-RISE), Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand.
- Biomedical Engineering Program, Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand.
- Biomedical Engineering Research Center, Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand.
| | - Kittikhun Wangkanont
- Department of Biochemistry, Center of Excellence for Molecular Biology and Genomics of Shrimp, Faculty of Science, Chulalongkorn University, Bangkok, 10330, Thailand.
- Department of Biochemistry, Center of Excellence in Molecular Crop, Faculty of Science, Chulalongkorn University, Bangkok, 10330, Thailand.
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5
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Manohar SS, Das C, Kakati V. Bone Tissue Engineering Scaffolds: Materials and Methods. 3D PRINTING AND ADDITIVE MANUFACTURING 2024; 11:347-362. [PMID: 38389691 PMCID: PMC10880649 DOI: 10.1089/3dp.2022.0216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
The wide development in biomedical, regenerative medicine, and surgical techniques has ensured that new technologies are developed to improve patient-specific treatment and care. Tissue engineering is a special field in biomedical engineering that works toward cell development using scaffolds. Bone tissue engineering is a separate branch of tissue engineering, in which the construction of bone, functionalities of bone, and bone tissue regeneration are studied in detail to repair or regenerate new functional bone tissues. In India alone, people suffering from bone diseases are extensive in numbers. Almost 15% to 20% of the population suffers from osteoporosis. Bone scaffolds are proving to be an excellent solution for osseous abnormalities or defect treatment. Scaffolds are three dimensional (3D) and mostly porous structures created to enhance new tissue growth. Bone scaffolds are specially designed to promote osteoinductive cell growth, expansion, and migration on their surface. This review article aims to provide an overview of possible bone scaffolding materials in practice, different 3D techniques to fabricate these scaffolds, and effective bone scaffold characteristics targeted by researchers to fabricate tissue-engineered bone scaffolds.
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Affiliation(s)
- Shreeprasad S. Manohar
- Mechanical Engineering Department, Assam Don Bosco University, Guwahati, India
- Mechanical Department, DBIT, Mumbai, India
| | - Chinmoy Das
- Department of Orthopaedics, Tezpur Medical College and Hospital, Tezpur, India
| | - Vikramjit Kakati
- Mechanical Engineering Department, Assam Don Bosco University, Guwahati, India
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6
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Saberian M, Abak N. Hydrogel-mediated delivery of platelet-derived exosomes: Innovations in tissue engineering. Heliyon 2024; 10:e24584. [PMID: 38312628 PMCID: PMC10835177 DOI: 10.1016/j.heliyon.2024.e24584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 02/06/2024] Open
Abstract
In this scholarly review, we conduct a thorough examination of the significant role played by platelet-derived exosomes (Plt-Exos) and hydrogels in the fields of tissue engineering and regenerative medicine. Our detailed investigation highlights the central involvement of Plt-Exos in various physiological and pathological processes, underscoring their potential contributions to diverse areas such as wound healing, neural rejuvenation, and cancer progression. Despite the promising therapeutic aspects, the notable variability in the isolation and characterization of pEVs underscores the need for a more rigorous and standardized methodology. Shifting our focus to hydrogels, they have emerged as promising biomaterials relevant to tissue engineering and regenerative medicine. Their unique characteristics, especially their chemical and physical adaptability, along with the modifiability of their biochemical properties, make hydrogels a captivating subject. These exceptional features open avenues for numerous tissue engineering applications, facilitating the delivery of essential growth factors, cytokines, and microRNAs. This analysis explores the innovative integration of Plt-Exos with hydrogels, presenting a novel paradigm in tissue engineering. Through the incorporation of Plt-Exos into hydrogels, there exists an opportunity to enhance tissue regeneration endeavors by combining the bioactive features of Plt-Exos with the restorative capabilities of hydrogel frameworks. In conclusion, the cooperative interaction between platelet-derived exosomes and hydrogels indicates a promising path in tissue engineering and regenerative medicine. Nevertheless, the successful execution of this approach requires a deep understanding of molecular dynamics, coupled with a dedication to refining isolation techniques.
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Affiliation(s)
- Mostafa Saberian
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Abak
- Hematology and Transfusion Science Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Ghosh S, Ghosh S, Sharma H, Bhaskar R, Han SS, Sinha JK. Harnessing the power of biological macromolecules in hydrogels for controlled drug release in the central nervous system: A review. Int J Biol Macromol 2024; 254:127708. [PMID: 37923043 DOI: 10.1016/j.ijbiomac.2023.127708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023]
Abstract
Hydrogels have immense potential in revolutionizing central nervous system (CNS) drug delivery, improving outcomes for neurological disorders. They serve as promising tools for controlled drug delivery to the CNS. Available hydrogel types include natural macromolecules (e.g., chitosan, hyaluronic acid, alginate), as well as hybrid hydrogels combining natural and synthetic polymers. Each type offers distinct advantages in terms of biocompatibility, mechanical properties, and drug release kinetics. Design and engineering considerations encompass hydrogel composition, crosslinking density, porosity, and strategies for targeted drug delivery. The review emphasizes factors affecting drug release profiles, such as hydrogel properties and formulation parameters. CNS drug delivery applications of hydrogels span a wide range of therapeutics, including small molecules, proteins and peptides, and nucleic acids. However, challenges like limited biodegradability, clearance, and effective CNS delivery persist. Incorporating 3D bioprinting technology with hydrogel-based CNS drug delivery holds the promise of highly personalized and precisely controlled therapeutic interventions for neurological disorders. The review explores emerging technologies like 3D bioprinting and nanotechnology as opportunities for enhanced precision and effectiveness in hydrogel-based CNS drug delivery. Continued research, collaboration, and technological advancements are vital for translating hydrogel-based therapies into clinical practice, benefiting patients with CNS disorders. This comprehensive review article delves into hydrogels for CNS drug delivery, addressing their types, design principles, applications, challenges, and opportunities for clinical translation.
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Affiliation(s)
- Shampa Ghosh
- GloNeuro, Sector 107, Vishwakarma Road, Noida, Uttar Pradesh 201301, India; ICMR - National Institute of Nutrition, Tarnaka, Hyderabad, Telangana 500007, India
| | - Soumya Ghosh
- GloNeuro, Sector 107, Vishwakarma Road, Noida, Uttar Pradesh 201301, India
| | - Hitaishi Sharma
- GloNeuro, Sector 107, Vishwakarma Road, Noida, Uttar Pradesh 201301, India
| | - Rakesh Bhaskar
- School of Chemical Engineering, Yeungnam University, Gyeonsang 38541, Republic of Korea; Research Institute of Cell Culture, Yeungnam University, Gyeonsang 38541, Republic of Korea.
| | - Sung Soo Han
- School of Chemical Engineering, Yeungnam University, Gyeonsang 38541, Republic of Korea; Research Institute of Cell Culture, Yeungnam University, Gyeonsang 38541, Republic of Korea.
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Altundag Ö, Öteyaka MÖ, Çelebi-Saltik B. Co- and Triaxial Electrospinning for Stem Cell-based Bone Regeneration. Curr Stem Cell Res Ther 2024; 19:865-878. [PMID: 37594104 DOI: 10.2174/1574888x18666230818094216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/06/2023] [Accepted: 07/19/2023] [Indexed: 08/19/2023]
Abstract
Bone tissue is composed of organic minerals and cells. It has the capacity to heal for certain minor damages, but when the bone defects surpass the critical threshold, they need fixing. Bone regeneration through natural and synthetic biodegradable materials requires various steps, such as manufacturing methods and materials selection. A successful biodegradable bone graft should have a high surface area/ volume ratio, strength, and a biocompatible, porous structure capable of promoting cell adhesion, proliferation, and differentiation. Considering these requirements, the electrospinning technique is promising for creating functional nano-sized scaffolds. The multi-axial methods, such as coaxial and triaxial electrospinning, are the most popular techniques to produce double or tri-layered scaffolds, respectively. Recently, stem cell culture on scaffolds and the application of osteogenic differentiation protocols on these scaffolds have opened new possibilities in the field of biomaterials research. This review discusses an overview of the progress in coaxial and triaxial technology through biodegradable composite bone materials. The review also carefully elaborates the osteogenic differentiation using stem cells and their performance with nano-sized scaffolds.
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Affiliation(s)
- Özlem Altundag
- Department of Stem Cell Sciences, Graduate School of Health Sciences, Hacettepe University, Ankara, Turkey
- Center for Stem Cell Research and Development, Hacettepe University, Ankara, Turkey
| | - Mustafa Özgür Öteyaka
- Department of Electronic and Automation, Mechatronic Program, Eskisehir Vocational School, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Betül Çelebi-Saltik
- Department of Stem Cell Sciences, Graduate School of Health Sciences, Hacettepe University, Ankara, Turkey
- Center for Stem Cell Research and Development, Hacettepe University, Ankara, Turkey
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Koczoń P, Dąbrowska A, Laskowska E, Łabuz M, Maj K, Masztakowski J, Bartyzel BJ, Bryś A, Bryś J, Gruczyńska-Sękowska E. Applications of Silk Fibroin in Human and Veterinary Medicine. MATERIALS (BASEL, SWITZERLAND) 2023; 16:7128. [PMID: 38005058 PMCID: PMC10672237 DOI: 10.3390/ma16227128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/03/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023]
Abstract
The properties of silk make it a promising material for medical applications, both in human and veterinary medicine. Its predominant amino acids, glycine and alanine, exhibit low chemical reactivity, reducing the risk of graft rejection, a notable advantage over most synthetic polymers. Hence, silk is increasingly used as a material for 3D printing in biomedicine. It can be used to build cell scaffolding with the desired cytocompatibility and biodegradability. In combination with gelatine, silk can be used in the treatment of arthritis, and as a hydrogel, to regenerate chondrocytes and mesenchymal cells. When combined with gelatine and collagen, it can also make skin grafts and regenerate the integumentary system. In the treatment of bone tissue, it can be used in combination with polylactic acid and hydroxyapatite to produce bone clips having good mechanical properties and high immunological tolerance. Furthermore, silk can provide a good microenvironment for the proliferation of bone marrow stem cells. Moreover, research is underway to produce artificial blood vessels using silk in combination with glycidyl methacrylate. Silk vascular grafts have demonstrated a high degree of patency and a satisfactory degree of endothelial cells coverage.
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Affiliation(s)
- Piotr Koczoń
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, 159C, Nowoursynowska St., 02-776 Warsaw, Poland; (P.K.); (J.B.)
| | - Alicja Dąbrowska
- The Scientific Society of Veterinary Medicine Students, Warsaw University of Life Sciences, 159, Nowoursynowska St., 02-776 Warsaw, Poland; (A.D.); (E.L.); (M.Ł.); (K.M.); (J.M.)
| | - Ewa Laskowska
- The Scientific Society of Veterinary Medicine Students, Warsaw University of Life Sciences, 159, Nowoursynowska St., 02-776 Warsaw, Poland; (A.D.); (E.L.); (M.Ł.); (K.M.); (J.M.)
| | - Małgorzata Łabuz
- The Scientific Society of Veterinary Medicine Students, Warsaw University of Life Sciences, 159, Nowoursynowska St., 02-776 Warsaw, Poland; (A.D.); (E.L.); (M.Ł.); (K.M.); (J.M.)
| | - Katarzyna Maj
- The Scientific Society of Veterinary Medicine Students, Warsaw University of Life Sciences, 159, Nowoursynowska St., 02-776 Warsaw, Poland; (A.D.); (E.L.); (M.Ł.); (K.M.); (J.M.)
| | - Jakub Masztakowski
- The Scientific Society of Veterinary Medicine Students, Warsaw University of Life Sciences, 159, Nowoursynowska St., 02-776 Warsaw, Poland; (A.D.); (E.L.); (M.Ł.); (K.M.); (J.M.)
| | - Bartłomiej J. Bartyzel
- Department of Morphological Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 159, Nowoursynowska St., 02-776 Warsaw, Poland;
| | - Andrzej Bryś
- Department of Fundamental Engineering and Energetics, Institute of Mechanical Engineering, Warsaw University of Life Sciences, 164, Nowoursynowska St., 02-787 Warsaw, Poland;
| | - Joanna Bryś
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, 159C, Nowoursynowska St., 02-776 Warsaw, Poland; (P.K.); (J.B.)
| | - Eliza Gruczyńska-Sękowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, 159C, Nowoursynowska St., 02-776 Warsaw, Poland; (P.K.); (J.B.)
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10
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Gómez-Álvarez M, Agustina-Hernández M, Francés-Herrero E, Rodríguez-Eguren A, Bueno-Fernandez C, Cervelló I. Addressing Key Questions in Organoid Models: Who, Where, How, and Why? Int J Mol Sci 2023; 24:16014. [PMID: 37958996 PMCID: PMC10650475 DOI: 10.3390/ijms242116014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/26/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
Organoids are three-dimensional cellular structures designed to recreate the biological characteristics of the body's native tissues and organs in vitro. There has been a recent surge in studies utilizing organoids due to their distinct advantages over traditional two-dimensional in vitro approaches. However, there is no consensus on how to define organoids. This literature review aims to clarify the concept of organoids and address the four fundamental questions pertaining to organoid models: (i) What constitutes organoids?-The cellular material. (ii) Where do organoids grow?-The extracellular scaffold. (iii) How are organoids maintained in vitro?-Via the culture media. (iv) Why are organoids suitable in vitro models?-They represent reproducible, stable, and scalable models for biological applications. Finally, this review provides an update on the organoid models employed within the female reproductive tract, underscoring their relevance in both basic biology and clinical applications.
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Affiliation(s)
- María Gómez-Álvarez
- Instituto de Investigación Sanitaria La Fe (IIS La Fe), IVI Foundation, IVIRMA Global Research Alliance, 46026 Valencia, Spain; (M.G.-Á.); (M.A.-H.); (E.F.-H.); (A.R.-E.); (C.B.-F.)
| | - Marcos Agustina-Hernández
- Instituto de Investigación Sanitaria La Fe (IIS La Fe), IVI Foundation, IVIRMA Global Research Alliance, 46026 Valencia, Spain; (M.G.-Á.); (M.A.-H.); (E.F.-H.); (A.R.-E.); (C.B.-F.)
| | - Emilio Francés-Herrero
- Instituto de Investigación Sanitaria La Fe (IIS La Fe), IVI Foundation, IVIRMA Global Research Alliance, 46026 Valencia, Spain; (M.G.-Á.); (M.A.-H.); (E.F.-H.); (A.R.-E.); (C.B.-F.)
- Department of Pediatrics, Obstetrics and Gynecology, Universitat de València, 46010 Valencia, Spain
| | - Adolfo Rodríguez-Eguren
- Instituto de Investigación Sanitaria La Fe (IIS La Fe), IVI Foundation, IVIRMA Global Research Alliance, 46026 Valencia, Spain; (M.G.-Á.); (M.A.-H.); (E.F.-H.); (A.R.-E.); (C.B.-F.)
| | - Clara Bueno-Fernandez
- Instituto de Investigación Sanitaria La Fe (IIS La Fe), IVI Foundation, IVIRMA Global Research Alliance, 46026 Valencia, Spain; (M.G.-Á.); (M.A.-H.); (E.F.-H.); (A.R.-E.); (C.B.-F.)
- Department of Pediatrics, Obstetrics and Gynecology, Universitat de València, 46010 Valencia, Spain
| | - Irene Cervelló
- Instituto de Investigación Sanitaria La Fe (IIS La Fe), IVI Foundation, IVIRMA Global Research Alliance, 46026 Valencia, Spain; (M.G.-Á.); (M.A.-H.); (E.F.-H.); (A.R.-E.); (C.B.-F.)
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11
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Tripathi AS, Zaki MEA, Al-Hussain SA, Dubey BK, Singh P, Rind L, Yadav RK. Material matters: exploring the interplay between natural biomaterials and host immune system. Front Immunol 2023; 14:1269960. [PMID: 37936689 PMCID: PMC10627157 DOI: 10.3389/fimmu.2023.1269960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/02/2023] [Indexed: 11/09/2023] Open
Abstract
Biomaterials are widely used for various medical purposes, for instance, implants, tissue engineering, medical devices, and drug delivery systems. Natural biomaterials can be obtained from proteins, carbohydrates, and cell-specific sources. However, when these biomaterials are introduced into the body, they trigger an immune response which may lead to rejection and failure of the implanted device or tissue. The immune system recognizes natural biomaterials as foreign substances and triggers the activation of several immune cells, for instance, macrophages, dendritic cells, and T cells. These cells release pro-inflammatory cytokines and chemokines, which recruit other immune cells to the implantation site. The activation of the immune system can lead to an inflammatory response, which can be beneficial or detrimental, depending on the type of natural biomaterial and the extent of the immune response. These biomaterials can also influence the immune response by modulating the behavior of immune cells. For example, biomaterials with specific surface properties, such as charge and hydrophobicity, can affect the activation and differentiation of immune cells. Additionally, biomaterials can be engineered to release immunomodulatory factors, such as anti-inflammatory cytokines, to promote a tolerogenic immune response. In conclusion, the interaction between biomaterials and the body's immune system is an intricate procedure with potential consequences for the effectiveness of therapeutics and medical devices. A better understanding of this interplay can help to design biomaterials that promote favorable immune responses and minimize adverse reactions.
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Affiliation(s)
| | - Magdi E A Zaki
- Department of Chemistry, Faculty of Science, Imam Mohammad lbn Saud Islamic University, Riyadh, Saudi Arabia
| | - Sami A Al-Hussain
- Department of Chemistry, Faculty of Science, Imam Mohammad lbn Saud Islamic University, Riyadh, Saudi Arabia
| | - Bidhyut Kumar Dubey
- Department of Pharmaceutical Chemistry, Era College of Pharmacy, Era University, Lucknow, India
| | - Prabhjot Singh
- Department of Pharmacology, Era College of Pharmacy, Era University, Lucknow, India
| | - Laiba Rind
- Department of Pharmacology, Era College of Pharmacy, Era University, Lucknow, India
| | - Rajnish Kumar Yadav
- Department of Pharmacology, Era College of Pharmacy, Era University, Lucknow, India
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12
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Păun AG, Dumitriu C, Ungureanu C, Popescu S. Silk Fibroin/ZnO Coated TiO 2 Nanotubes for Improved Antimicrobial Effect of Ti Dental Implants. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5855. [PMID: 37687548 PMCID: PMC10488414 DOI: 10.3390/ma16175855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/20/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023]
Abstract
The aim of the present research is to develop a novel hybrid coating for a Ti dental implant that combines nature-inspired biomimetic polymers and TiO2 nanostructures with an entrapped ZnO antimicrobial agent. ZnO was used in other studies to cover the surface of Ti or Ti-Zr to reduce the need of clinical antibiotics, prevent the onset of peri-implantitis, and increase the success rate of oral clinical implantation. We developed an original coating that represents a promising approach in clinical dentistry. The titanium surface was first anodized to obtain TiO2 nanotubes (NT). Subsequently, on the NT surface, silk fibroin isolated from Bombyx mori cocoons was deposited as nanofibers using the electrospun technique. For an improved antibacterial effect, ZnO nanoparticles were incorporated in this biopolymer using three different methods. The surface properties of the newly created coatings were assessed to establish how they are influenced by the most important features: morphology, wettability, topography. The evaluation of stability by electrochemical methods in simulated physiological solutions was discussed more in detail, considering that it could bring necessary information related to the behavior of the implant material. All samples had improved roughness and hydrophilicity, as well as corrosion stability (with protection efficiency over 80%). The antibacterial test shows that the functional hybrid coating has good antibacterial activity because it can inhibit the proliferation of Staphylococcus aureus up to 53% and Enterococcus faecalis up to 55%. All Ti samples with the modified surface have proven superior properties compared with unmodified TiNT, which proved that they have the potential to be used as implant material in dentistry.
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Affiliation(s)
| | | | | | - Simona Popescu
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica Bucharest, Gheorghe Polizu 1-7 Street, 011061 Bucharest, Romania; (A.G.P.); (C.D.); (C.U.)
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13
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彭 雨, 兰 梁, 穆 君, 侯 沙, 程 丽. [Research progress on biocomposites based on bioactive glass]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2023; 40:805-811. [PMID: 37666773 PMCID: PMC10477385 DOI: 10.7507/1001-5515.202202016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/25/2023] [Indexed: 09/06/2023]
Abstract
Bioactive glass (BG) has been widely used in the preparation of artificial bone scaffolds due to its excellent biological properties and non-cytotoxicity, which can promote bone and soft tissue regeneration. However, due to the brittleness, poor mechanical strength, easy agglomeration and uncontrollable structure of glass material, its application in various fields is limited. In this regard, most current researches mainly focus on mixing BG with organic or inorganic materials by freeze-drying method, sol-gel method, etc., to improve its mechanical properties and brittleness, so as to increase its clinical application and expand its application field. This review introduces the combination of BG with natural organic materials, metallic materials and non-metallic materials, and demonstrates the latest technology and future prospects of BG composite materials through the development of scaffolds, injectable fillers, membranes, hydrogels and coatings. The previous studies show that the addition of BG improves the mechanical properties, biological activity and regeneration potential of the composites, and broadens the application of BG in the field of bone tissue engineering. By reviewing the recent BG researches on bone regeneration, the research potential of new materials is demonstrated, in order to provide a reference for future related research.
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Affiliation(s)
- 雨 彭
- 成都大学 基础医学院(成都 610106)Basic Medical School, Chengdu University, Chengdu 610106, P. R. China
| | - 梁 兰
- 成都大学 基础医学院(成都 610106)Basic Medical School, Chengdu University, Chengdu 610106, P. R. China
| | - 君宇 穆
- 成都大学 基础医学院(成都 610106)Basic Medical School, Chengdu University, Chengdu 610106, P. R. China
| | - 沙 侯
- 成都大学 基础医学院(成都 610106)Basic Medical School, Chengdu University, Chengdu 610106, P. R. China
| | - 丽佳 程
- 成都大学 基础医学院(成都 610106)Basic Medical School, Chengdu University, Chengdu 610106, P. R. China
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14
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Duan L, Wang Z, Fan S, Wang C, Zhang Y. Research progress of biomaterials and innovative technologies in urinary tissue engineering. Front Bioeng Biotechnol 2023; 11:1258666. [PMID: 37645598 PMCID: PMC10461011 DOI: 10.3389/fbioe.2023.1258666] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/02/2023] [Indexed: 08/31/2023] Open
Abstract
Substantial interests have been attracted to multiple bioactive and biomimetic biomaterials in recent decades because of their ability in presenting a structural and functional reconstruction of urinary tissues. Some innovative technologies have also been surging in urinary tissue engineering and urological regeneration by providing insights into the physiological behavior of the urinary system. As such, the hierarchical structure and tissue function of the bladder, urethra, and ureter can be reproduced similarly to the native urinary tissues. This review aims to summarize recent advances in functional biomaterials and biomimetic technologies toward urological reconstruction. Various nanofirous biomaterials derived from decellularized natural tissues, synthetic biopolymers, and hybrid scaffolds were developed with desired microstructure, surface chemistry, and mechanical properties. Some growth factors, drugs, as well as inorganic nanomaterials were also utilized to enhance the biological activity and functionality of scaffolds. Notably, it is emphasized that advanced approaches, such as 3D (bio) printing and organoids, have also been developed to facilitate structural and functional regeneration of the urological system. So in this review, we discussed the fabrication strategies, physiochemical properties, and biofunctional modification of regenerative biomaterials and their potential clinical application of fast-evolving technologies. In addition, future prospective and commercial products are further proposed and discussed.
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Affiliation(s)
- Liwei Duan
- The Second Hospital, Jilin University, Changchun, China
| | - Zongliang Wang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, China
| | - Shuang Fan
- The Second Hospital, Jilin University, Changchun, China
| | - Chen Wang
- The Second Hospital, Jilin University, Changchun, China
| | - Yi Zhang
- The Second Hospital, Jilin University, Changchun, China
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15
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Su X, Wei L, Xu Z, Qin L, Yang J, Zou Y, Zhao C, Chen L, Hu N. Evaluation and Application of Silk Fibroin Based Biomaterials to Promote Cartilage Regeneration in Osteoarthritis Therapy. Biomedicines 2023; 11:2244. [PMID: 37626740 PMCID: PMC10452428 DOI: 10.3390/biomedicines11082244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/27/2023] Open
Abstract
Osteoarthritis (OA) is a common joint disease characterized by cartilage damage and degeneration. Traditional treatments such as NSAIDs and joint replacement surgery only relieve pain and do not achieve complete cartilage regeneration. Silk fibroin (SF) biomaterials are novel materials that have been widely studied and applied to cartilage regeneration. By mimicking the fibrous structure and biological activity of collagen, SF biomaterials can promote the proliferation and differentiation of chondrocytes and contribute to the formation of new cartilage tissue. In addition, SF biomaterials have good biocompatibility and biodegradability and can be gradually absorbed and metabolized by the human body. Studies in recent years have shown that SF biomaterials have great potential in treating OA and show good clinical efficacy. Therefore, SF biomaterials are expected to be an effective treatment option for promoting cartilage regeneration and repair in patients with OA. This article provides an overview of the biological characteristics of SF, its role in bone and cartilage injuries, and its prospects in clinical applications to provide new perspectives and references for the field of bone and cartilage repair.
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Affiliation(s)
- Xudong Su
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Laboratory of Orthopedics, Chongqing Medical University, Chongqing 400016, China
| | - Li Wei
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Laboratory of Orthopedics, Chongqing Medical University, Chongqing 400016, China
| | - Zhenghao Xu
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Laboratory of Orthopedics, Chongqing Medical University, Chongqing 400016, China
| | - Leilei Qin
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Laboratory of Orthopedics, Chongqing Medical University, Chongqing 400016, China
| | - Jianye Yang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Laboratory of Orthopedics, Chongqing Medical University, Chongqing 400016, China
| | - Yinshuang Zou
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Laboratory of Orthopedics, Chongqing Medical University, Chongqing 400016, China
| | - Chen Zhao
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Laboratory of Orthopedics, Chongqing Medical University, Chongqing 400016, China
| | - Li Chen
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Laboratory of Orthopedics, Chongqing Medical University, Chongqing 400016, China
| | - Ning Hu
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Laboratory of Orthopedics, Chongqing Medical University, Chongqing 400016, China
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16
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Bercea M. Rheology as a Tool for Fine-Tuning the Properties of Printable Bioinspired Gels. Molecules 2023; 28:molecules28062766. [PMID: 36985738 PMCID: PMC10058016 DOI: 10.3390/molecules28062766] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Over the last decade, efforts have been oriented toward the development of suitable gels for 3D printing, with controlled morphology and shear-thinning behavior in well-defined conditions. As a multidisciplinary approach to the fabrication of complex biomaterials, 3D bioprinting combines cells and biocompatible materials, which are subsequently printed in specific shapes to generate 3D structures for regenerative medicine or tissue engineering. A major interest is devoted to the printing of biomimetic materials with structural fidelity after their fabrication. Among some requirements imposed for bioinks, such as biocompatibility, nontoxicity, and the possibility to be sterilized, the nondamaging processability represents a critical issue for the stability and functioning of the 3D constructs. The major challenges in the field of printable gels are to mimic at different length scales the structures existing in nature and to reproduce the functions of the biological systems. Thus, a careful investigation of the rheological characteristics allows a fine-tuning of the material properties that are manufactured for targeted applications. The fluid-like or solid-like behavior of materials in conditions similar to those encountered in additive manufacturing can be monitored through the viscoelastic parameters determined in different shear conditions. The network strength, shear-thinning, yield point, and thixotropy govern bioprintability. An assessment of these rheological features provides significant insights for the design and characterization of printable gels. This review focuses on the rheological properties of printable bioinspired gels as a survey of cutting-edge research toward developing printed materials for additive manufacturing.
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Affiliation(s)
- Maria Bercea
- "Petru Poni" Institute of Macromolecular Chemistry, 41-A Grigore Ghica Voda Alley, 700487 Iasi, Romania
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17
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Vibrational Study on the Structure, Bioactivity, and Silver Adsorption of Silk Fibroin Fibers Grafted with Methacrylonitrile. Molecules 2023; 28:molecules28062551. [PMID: 36985523 PMCID: PMC10051891 DOI: 10.3390/molecules28062551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/16/2023] Open
Abstract
Natural fibers have received increasing attention as starting materials for innovative applications in many research fields, from biomedicine to engineering. Bombyx mori silk fibroin has become a material of choice in the development of many biomedical devices. Grafting represents a good strategy to improve the material properties according to the desired function. In the present study, Bombyx mori silk fibroin fibers were grafted with methacrylonitrile (MAN) with different weight gains. The potential interest in biomedical applications of MAN functionalization relies on the presence of the nitrile group, which is an acceptor of H bonds and can bind metals. IR and Raman spectroscopy were used to characterize the grafted samples and the possible structural changes induced by grafting. Afterward, the same techniques were used to study the bioactivity (i.e., the calcium phosphate nucleation ability) of MAN-grafted silk fibroins after ageing in simulated body fluid (SBF) for possible application in bone tissue engineering, and their interaction with Ag+ ions, for the development of biomaterials with enhanced anti-microbial properties. MAN was found to efficiently polymerize on silk fibroin through polar amino acids (i.e., serine and tryptophan), inducing an enrichment in silk fibroin-ordered domains. IR spectroscopy allowed us to detect the nucleation of a thin calcium phosphate layer and the uptake of Ag+ ions through the nitrile group, which may foster the application of these grafted materials in biomedical applications.
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18
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Sericultural By-Products: The Potential for Alternative Therapy in Cancer Drug Design. MOLECULES (BASEL, SWITZERLAND) 2023; 28:molecules28020850. [PMID: 36677907 PMCID: PMC9861160 DOI: 10.3390/molecules28020850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
Major progress has been made in cancer research; however, cancer remains one of the most important health-related burdens. Sericulture importance is no longer limited to the textile industry, but its by-products, such as silk fibroin or mulberry, exhibit great impact in the cancer research area. Fibroin, the pivotal compound that is found in silk, owns superior biocompatibility and biodegradability, representing one of the most important biomaterials. Numerous studies have reported its successful use as a drug delivery system, and it is currently used to develop three-dimensional tumor models that lead to a better understanding of cancer biology and play a great role in the development of novel antitumoral strategies. Moreover, sericin's cytotoxic effect on various tumoral cell lines has been reported, but also, it has been used as a nanocarrier for target therapeutic agents. On the other hand, mulberry compounds include various bioactive elements that are well known for their antitumoral activities, such as polyphenols or anthocyanins. In this review, the latest progress of using sericultural by-products in cancer therapy is discussed by highlighting their notable impact in developing novel effective drug strategies.
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19
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Cui J, Yu X, Shen Y, Sun B, Guo W, Liu M, Chen Y, Wang L, Zhou X, Shafiq M, Mo X. Electrospinning Inorganic Nanomaterials to Fabricate Bionanocomposites for Soft and Hard Tissue Repair. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:204. [PMID: 36616113 PMCID: PMC9823959 DOI: 10.3390/nano13010204] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
Tissue engineering (TE) has attracted the widespread attention of the research community as a method of producing patient-specific tissue constructs for the repair and replacement of injured tissues. To date, different types of scaffold materials have been developed for various tissues and organs. The choice of scaffold material should take into consideration whether the mechanical properties, biodegradability, biocompatibility, and bioresorbability meet the physiological properties of the tissues. Owing to their broad range of physico-chemical properties, inorganic materials can induce a series of biological responses as scaffold fillers, which render them a good alternative to scaffold materials for tissue engineering (TE). While it is of worth to further explore mechanistic insight into the use of inorganic nanomaterials for tissue repair, in this review, we mainly focused on the utilization forms and strategies for fabricating electrospun membranes containing inorganic components based on electrospinning technology. A particular emphasis has been placed on the biological advantages of incorporating inorganic materials along with organic materials as scaffold constituents for tissue repair. As well as widely exploited natural and synthetic polymers, inorganic nanomaterials offer an enticing platform to further modulate the properties of composite scaffolds, which may help further broaden the application prospect of scaffolds for TE.
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Affiliation(s)
- Jie Cui
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China
| | - Xiao Yu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China
| | - Yihong Shen
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China
| | - Binbin Sun
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China
| | - Wanxin Guo
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China
| | - Mingyue Liu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China
| | - Yujie Chen
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China
| | - Li Wang
- College of Science, Donghua University, Shanghai 201620, China
| | - Xingping Zhou
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China
| | - Muhammad Shafiq
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China
- Department of Chemical Engineering, Faculty of Engineering, Graduate School, Kyushu University, 744 Motooka, Nishi-Ku, Fukuoka 819-0395, Japan
- Department of Biotechnology, Faculty of Science and Technology (FOST), University of Central Punjab (UCP), Lahore 54000, Pakistan
| | - Xiumei Mo
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China
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20
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Designing Silk-Based Cryogels for Biomedical Applications. Biomimetics (Basel) 2022; 8:biomimetics8010005. [PMID: 36648791 PMCID: PMC9844337 DOI: 10.3390/biomimetics8010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
There is a need to develop the next generation of medical products that require biomaterials with improved properties. The versatility of various gels has pushed them to the forefront of biomaterials research. Cryogels, a type of gel scaffold made by controlled crosslinking under subzero or freezing temperatures, have great potential to address many current challenges. Unlike their hydrogel counterparts, which are also able to hold large amounts of biologically relevant fluids such as water, cryogels are often characterized by highly dense and crosslinked polymer walls, macroporous structures, and often improved properties. Recently, one biomaterial that has garnered a lot of interest for cryogel fabrication is silk and its derivatives. In this review, we provide a brief overview of silk-based biomaterials and how cryogelation can be used for novel scaffold design. We discuss how various parameters and fabrication strategies can be used to tune the properties of silk-based biomaterials. Finally, we discuss specific biomedical applications of silk-based biomaterials. Ultimately, we aim to demonstrate how the latest advances in silk-based cryogel scaffolds can be used to address challenges in numerous bioengineering disciplines.
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21
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Melrose J. High Performance Marine and Terrestrial Bioadhesives and the Biomedical Applications They Have Inspired. Molecules 2022; 27:molecules27248982. [PMID: 36558114 PMCID: PMC9783952 DOI: 10.3390/molecules27248982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
This study has reviewed the naturally occurring bioadhesives produced in marine and freshwater aqueous environments and in the mucinous exudates of some terrestrial animals which have remarkable properties providing adhesion under difficult environmental conditions. These bioadhesives have inspired the development of medical bioadhesives with impressive properties that provide an effective alternative to suturing surgical wounds improving closure and healing of wounds in technically demanding tissues such as the heart, lung and soft tissues like the brain and intestinal mucosa. The Gecko has developed a dry-adhesive system of exceptional performance and has inspired the development of new generation re-usable tapes applicable to many medical procedures. The silk of spider webs has been equally inspiring to structural engineers and materials scientists and has revealed innovative properties which have led to new generation technologies in photonics, phononics and micro-electronics in the development of wearable biosensors. Man made products designed to emulate the performance of these natural bioadhesive molecules are improving wound closure and healing of problematic lesions such as diabetic foot ulcers which are notoriously painful and have also found application in many other areas in biomedicine. Armed with information on the mechanistic properties of these impressive biomolecules major advances are expected in biomedicine, micro-electronics, photonics, materials science, artificial intelligence and robotics technology.
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Affiliation(s)
- James Melrose
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Faculty of Medicine and Health, University of Sydney at Royal North Shore Hospital, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia;
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2052, Australia
- Sydney Medical School, Northern Campus, The University of Sydney, St. Leonards, NSW 2065, Australia
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22
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Wu H, Lin K, Zhao C, Wang X. Silk fibroin scaffolds: A promising candidate for bone regeneration. Front Bioeng Biotechnol 2022; 10:1054379. [PMID: 36507269 PMCID: PMC9732393 DOI: 10.3389/fbioe.2022.1054379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/17/2022] [Indexed: 11/27/2022] Open
Abstract
It remains a big challenge in clinical practice to repair large-sized bone defects and many factors limit the application of autografts and allografts, The application of exogenous scaffolds is an alternate strategy for bone regeneration, among which the silk fibroin (SF) scaffold is a promising candidate. Due to the advantages of excellent biocompatibility, satisfying mechanical property, controllable biodegradability and structural adjustability, SF scaffolds exhibit great potential in bone regeneration with the help of well-designed structures, bioactive components and functional surface modification. This review will summarize the cell and tissue interaction with SF scaffolds, techniques to fabricate SF-based scaffolds and modifications of SF scaffolds to enhance osteogenesis, which will provide a deep and comprehensive insight into SF scaffolds and inspire the design and fabrication of novel SF scaffolds for superior osteogenic performance. However, there still needs more comprehensive efforts to promote better clinical translation of SF scaffolds, including more experiments in big animal models and clinical trials. Furthermore, deeper investigations are also in demand to reveal the degradation and clearing mechanisms of SF scaffolds and evaluate the influence of degradation products.
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Affiliation(s)
- Hao Wu
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China,Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Kaili Lin
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China,Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Cancan Zhao
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China,Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China,*Correspondence: Cancan Zhao, ; Xudong Wang,
| | - Xudong Wang
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China,Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China,*Correspondence: Cancan Zhao, ; Xudong Wang,
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Al Maruf DSA, Ghosh YA, Xin H, Cheng K, Mukherjee P, Crook JM, Wallace GG, Klein TJ, Clark JR. Hydrogel: A Potential Material for Bone Tissue Engineering Repairing the Segmental Mandibular Defect. Polymers (Basel) 2022; 14:polym14194186. [PMID: 36236133 PMCID: PMC9571534 DOI: 10.3390/polym14194186] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Free flap surgery is currently the only successful method used by surgeons to reconstruct critical-sized defects of the jaw, and is commonly used in patients who have had bony lesions excised due to oral cancer, trauma, infection or necrosis. However, donor site morbidity remains a significant flaw of this strategy. Various biomaterials have been under investigation in search of a suitable alternative for segmental mandibular defect reconstruction. Hydrogels are group of biomaterials that have shown their potential in various tissue engineering applications, including bone regeneration, both through in vitro and in vivo pre-clinical animal trials. This review discusses different types of hydrogels, their fabrication techniques, 3D printing, their potential for bone regeneration, outcomes, and the limitations of various hydrogels in preclinical models for bone tissue engineering. This review also proposes a modified technique utilizing the potential of hydrogels combined with scaffolds and cells for efficient reconstruction of mandibular segmental defects.
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Affiliation(s)
- D S Abdullah Al Maruf
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
- Correspondence:
| | - Yohaann Ali Ghosh
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
| | - Hai Xin
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
| | - Kai Cheng
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local, Camperdown 2050, Australia
| | - Payal Mukherjee
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local, Camperdown 2050, Australia
| | - Jeremy Micah Crook
- Biomedical Innovation, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- ARC Centre of Excellence for Electromaterials Science, The University of Wollongong, Wollongong 2522, Australia
- Intelligent Polymer Research Institute, AIIM Facility, The University of Wollongong, Wollongong 2522, Australia
- Illawarra Health and Medical Research Institute, The University of Wollongong, Wollongong 2522, Australia
| | - Gordon George Wallace
- ARC Centre of Excellence for Electromaterials Science, The University of Wollongong, Wollongong 2522, Australia
- Intelligent Polymer Research Institute, AIIM Facility, The University of Wollongong, Wollongong 2522, Australia
| | - Travis Jacob Klein
- Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove 4059, Australia
| | - Jonathan Robert Clark
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local, Camperdown 2050, Australia
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Jiang Y, Lin H, Shao Z, Chen X, Li W, Ni Y. Reconstruction of an orbital defect in rabbits using a silk fibroin-bone microparticle complex. Int J Artif Organs 2022; 45:849-856. [PMID: 35876430 DOI: 10.1177/03913988221113354] [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] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To construct a silk fibroin-bone microparticle composite based on a porous silk fibroin membrane and to study its feasibility as a material to reconstruct an orbital bone defect. METHODS A 3D porous silk fibroin membrane scaffold was constructed with a defined pore size and incorporated with bone microparticles from a New Zealand rabbit orbital bone defect. The silk fibroin-bone microparticle composite was then implanted into the orbital bone defect to promote osteogenesis along the surface of the porous silk fibroin membrane. The feasibility of constructing an ideal orbital defect repair material and the silk fibroin-bone micronucleus complex was evaluated by animal experiments, molecular biology, histomorphology, imaging, raw molecular mechanisms, and the biological behavior of the material in vivo. RESULTS The silk fibroin-bone microparticle composite promotes angiogenesis and osteogenesis to repair bone defects in vivo. Moreover, SF (silk fibroin)/BD (bone dust) complex promotes osteogenesis and angiogenesis by activating FGF2 (Fibroblast Growth Factor 2) and SF scaffolds can bind and restore FGF2. CONCLUSION Silk fibroin is biocompatible and the silk fibroin-bone microparticle complex successfully repaired orbital bone defects. Additionally, fibroblast growth factor expression around or within the remaining incompletely degraded silk fibroin materials was observed in vivo.
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Affiliation(s)
- Yi Jiang
- Department of Ophthalmology, Shanghai Xin Shi Jie Eye Hospital, Shanghai, China
| | - Hailiang Lin
- Department of Otology and Skull Base Surgery, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China
| | - Zhengzhong Shao
- The Key Laboratory of Molecular Engineering of Polymer of MOE and Department of Macromolecular Science, Fudan University, Shanghai, China
| | - Xin Chen
- The Key Laboratory of Molecular Engineering of Polymer of MOE and Department of Macromolecular Science, Fudan University, Shanghai, China
| | - Wen Li
- Central Laboratory, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China
| | - Yusu Ni
- Department of Otology and Skull Base Surgery, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China.,Key Laboratory of Hearing Medicine of National Health and Family Planning Commission, Shanghai, China.,Otorhinolaryngology Department of Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
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Self-Assembled Peptide Nanostructures for ECM Biomimicry. NANOMATERIALS 2022; 12:nano12132147. [PMID: 35807982 PMCID: PMC9268130 DOI: 10.3390/nano12132147] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 02/04/2023]
Abstract
Proteins are functional building blocks of living organisms that exert a wide variety of functions, but their synthesis and industrial production can be cumbersome and expensive. By contrast, short peptides are very convenient to prepare at a low cost on a large scale, and their self-assembly into nanostructures and gels is a popular avenue for protein biomimicry. In this Review, we will analyze the last 5-year progress on the incorporation of bioactive motifs into self-assembling peptides to mimic functional proteins of the extracellular matrix (ECM) and guide cell fate inside hydrogel scaffolds.
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Preparation and Characterization of Natural Silk Fibroin Hydrogel for Protein Drug Delivery. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27113418. [PMID: 35684356 PMCID: PMC9181960 DOI: 10.3390/molecules27113418] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 12/30/2022]
Abstract
In recent years, hydrogels have been widely used as drug carriers, especially in the area of protein delivery. The natural silk fibroin produced from cocoons of the Bombyx mori silkworm possesses excellent biocompatibility, significant bioactivity, and biodegradability. Therefore, silk fibroin-based hydrogels are arousing widespread interest in biomedical research. In this study, a process for extracting natural silk fibroin from raw silk textile yarns was established, and three aqueous solutions of silk fibroin with different molecular weight distributions were successfully prepared by controlling the degumming time. Silk fibroin was dispersed in the aqueous solution as “spherical” aggregate particles, and the smaller particles continuously accumulated into large particles. Finally, a silk fibroin hydrogel network was formed. A rheological analysis showed that as the concentration of the silk fibroin hydrogel increased its storage modulus increased significantly. The degradation behavior of silk fibroin hydrogel in different media verified its excellent stability, and the prepared silk fibroin hydrogel had good biocompatibility and an excellent drug-loading capacity. After the protein model drug BSA was loaded, the cumulative drug release within 12 h reached 80%. We hope that these investigations will promote the potential utilities of silk fibroin hydrogels in clinical medicine.
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