Unravelling host-pathogen interactions by biofilm infected human wound models

Approximately 80 % of persistent wound infections are affected by the presence of bacterial biofilms, resulting in a severe clinical challenge associated with prolonged healing periods, increased morbidity, and high healthcare costs. Unfortunately, in vitro models for wound infection research almost exclusively focus on early infection stages with planktonic bacteria. In this study, we present a new approach to emulate biofilm-infected human wounds by three-dimensional human in vitro systems. For this purpose, a matured biofilm consisting of the clinical key wound pathogen Pseudomonas aeruginosa was pre-cultivated on electrospun scaffolds allowing for non-destructive transfer of the matured biofilm to human in vitro wound models. We infected tissue-engineered human in vitro skin models as well as ex vivo human skin explants with the biofilm and analyzed structural tissue characteristics, biofilm growth behavior, and biofilm-tissue interactions. The structural development of biofilms in close proximity to the tissue, resulting in high bacterial burden and in vivo-like morphology, confirmed a manifest wound infection on all tested wound models, validating their applicability for general investigations of biofilm growth and structure. The extent of bacterial colonization of the wound bed, as well as the subsequent changes in molecular composition of skin tissue, were inherently linked to the characteristics of the underlying wound models including their viability and origin. Notably, the immune response observed in viable ex vivo and in vitro models was consistent with previous in vivo reports. While ex vivo models offered greater complexity and closer similarity to the in vivo conditions, in vitro models consistently demonstrated higher reproducibility. As a consequence, when focusing on direct biofilm-skin interactions, the viability of the wound models as well as their advantages and limitations should be aligned to the particular research question of future studies. Altogether, the novel model allows for a systematic investigation of host-pathogen interactions of bacterial biofilms and human wound tissue, also paving the way for development and predictive testing of novel therapeutics to combat biofilm-infected wounds.

Influence of drug molecular weight on self-assembly and intestinal permeation of polymer-based nanocarriers

For oral delivery, the physicochemical properties of nanocarriers are decisive factors for permeation through the intestinal epithelium. These properties are determined by the composition of the nanocarriers as well as by the process parameters during their self-assembly. For macromolecular drugs, there is still little understanding of the drug-polymer interactions during nanocarrier self-assembly and the effects on carrier properties. In this study, the effect of drug molecular weight on nanocarrier self-assembly, physicochemical properties of nanocarriers as well as their permeation across the intestinal epithelium was investigated. Our results show that the drug molecular weight impacts the physicochemical properties of nanocarriers. Further, the physicochemical properties of the nanocarriers, governed by the molecular weight of the drug, determine their permeation properties across the intestinal epithelium. Comparative in vitro and ex vivo studies revealed that intestinal absorption is dependent on both, the properties of the tissue as well as properties of the carrier system. In conclusion, the molecular weight of drug payload is a key factor determining the physiochemical properties of polymeric nanocarriers and is closely linked to their oral absorption. Using different preclinical models to evaluate intestinal permeation of nanocarriers allows for novel insights into key formulation properties governing oral bioavailability.

Imitating the microenvironment of native biofilms using nanofibrous scaffolds to emulate chronic wound infections

Three-dimensional scaffolds of electrospun fibers are widely investigated for in vitro human tissue engineering, but to date, their application in the cultivation of bacterial biofilms has been neglected. In contrast, in a clinical setting, biofilms have received increasing recognition as major determinants of severe and chronic tissue infections, illustrating their immense threat to global public health. Their complex three-dimensional structure enables their persistence in harsh infection environments, tight attachment to human tissue and reduced susceptibility to antimicrobials. For the investigation of biofilm formation and persistence and for the development of novel infection therapies, mimicking the complex biofilm architecture with adequate in vitro models is essential. In this study, electrospun nanofibers were designed to simulate the matrix of native biofilms to serve as scaffolds for a novel biofilm model, which provides an in vivo-like growth environment and comprises biofilm-tissue interfaces. The three-dimensional scaffolds closely imitate the composition and structure of the matrix, while providing high mechanical support. The specific material properties of the developed scaffolds promote bacterial adhesion, infiltration, and homogenous distribution throughout the fiber network. Furthermore, matrix production and increased tolerance against antibiotics were proven, verifying adequate biofilm formation and maturation. In combination with human ex vivo wound models, the chronic state of infected wounds could be emulated allowing for investigation of biofilm-tissue interfaces and biofilm-host interactions. The here-described biofilm model based on nanofibers represents a valuable tool for simulating biofilm-associated infections in a pathophysiologically relevant manner paving new grounds for a multitude of possible applications beyond infection research.

SEDDS-loaded mucoadhesive fiber patches for advanced oromucosal delivery of poorly soluble drugs

To date, buccal administration of lipophilic drugs is still a major challenge due to their poor solubility in saliva and limited penetration into mucosal tissues. To overcome these limitations, we developed electrospun patches combining the benefits of mucoadhesive fibers and self-emulsifying drug delivery systems (SEDDS). The fiber system comprises a combination of mucoadhesive thiolated polyacrylic acid fibers and SEDDS-loaded fibers fabricated by parallel electrospinning. The resulting mucoadhesive electrospun SEDDS patches were systemically investigated for fiber characteristics, self-emulsification, mucoadhesion, drug penetration into porcine buccal tissue and biocompatibility. The patches showed high encapsulation efficiency for SEDDS without causing fiber defects or leakage. SEDDS incorporation enhanced the spinning process and reduced the fiber diameter and fiber size distribution. Hydration-dependent self-emulsification provided a controlled release of curcumin being encapsulated in nano-scaled o/w emulsion for over 3 h. Due to the thiolated polyacrylic acid fibers, the buccal residence time of patches was 200-fold prolonged. Further, they promoted a significantly increased drug penetration into buccal tissue compared to fiber patches without SEDDS. Finally, biocompatibility and improved therapeutic effects of curcumin-loaded patches on human keratinocytes and fibroblasts were confirmed. Mucoadhesive electrospun SEDDS patches represent a promising approach to overcome current challenges in the oromucosal delivery of lipophilic drugs to unlock their full therapeutic potential.

In-situ tear fluid dissolving nanofibers enable prolonged viscosity-enhanced dual drug delivery to the eye

Liquid and semi-solid formulations are the most commonly used drug delivery systems for ophthalmic diseases. Upon application into the conjunctival sac, these systems introduce a variable and unphysiologically high liquid volume to the eye, resulting in overflow and extensive nasolacrimal drainage, accounting for dosing inaccuracy and short ocular residence time. In this study, we present nanofibrous electrospun scaffolds composed of biocompatible polymers, overcoming these challenges by immediate drug release. The fibers incorporate gentamicin and dexamethasone, intended for the treatment of bacterial conjunctivitis. Upon contact with the ocular surface, the nanofibers immediately dissolve in the tear fluid, quantitatively releasing the two actives, yielding over92% drug recovery, determined with fluorimetric and chromatographic quantifications methods. Simultaneously, the viscosity of the tear fluid increases, shown by complex viscometry measurements. A newly developed ex vivo microfluidic porcine cornea model was used to evaluated ocular residence time. In contrast to fluid eye drops, the contact time was significantly prolonged and 20min after application, an increase in drug availability on the ocular surface of 342% was observed. Biocompatibility of the polymer system was demonstrated in an OECD approved in vitro cornea model. The antibacterial activity after processing was evaluated according to EUCAST guidelines, and storage stability of the system was confirmed over a 12-week period. This innovative drug delivery system poses a highly promising platform technology, overcoming challenges associated with conventional dosage forms for drug delivery to the anterior eye and thus significantly advancing therapeutic approaches.

[Occurrence of vascular canals in alveolar bone]

The authors present the results from the investigation of 414 full-mouth X-rays from periodontally diseased individuals for the occurrence of visible bone canals. The frequency, the form the most frequent location and the age-distribution of the vascular canals as well as the possibility of classifying them according to type and severity of the periodontal disease are discussed. Follow-up examinations in 18 patients, on an average 15 years after the first examination, permit the conclusion that the bone canals cannot be influenced by periodontal treatment, and that they are not associated with the periodontal disease.

[The witness in German criminal case (a contribution from the legal, psychological and psychiatrical view) (author's transl)]

The judgement of adult witnesses in particular cases, as sufficiently made clear by the described special case, is at least as necessary as a specialist's opinion of child testimony. Furthermore, it should be noted that the present modus of criminal proceedings does not allow for adequate objectivation possibilities of testimony of witnesses. Thirdly, it should be pointed out that at least for the so-called key witnesses a specialist's examination, i.e. by a psychiater and a psychologist is of great importance; it seems at least necessary that in problematic cases the specialist or the court should have the possibility to interrogate the witness to the exclusion of the public. It also seems of utmost importance to extend the judge's knowledge in the field relevant to the subject during his university education and also during his further professional instruction in order to enable him to identify problematical cases in time and decide on calling upon an adequate specialist.