Vancomycin-loaded HPMC microparticles embedded within injectable thermosensitive chitosan hydrogels

Influence of Choline-Based Ionogel on Transdermal Delivery of Vancomycin Hydrochloride

Ionic liquids (ILs) have attracted considerable interest as new drug delivery solvents because of their superior transdermal absorption of large molecular weight drugs across the biological barrier and their capacity to solubilize hydrophobic compounds. It is difficult to administer hydrophilic peptide treatments with large molecular weights through the skin. Vancomycin hydrochloride (VH) is a glycopeptide antibiotic that cures bacterial infections. With a molecular weight of 1449 Da and a high water solubility of 50 mg/mL, VH is an impressive compound. This study aimed to quantify the amount of VH transdermal penetration by analyzing the influence of choline-based ILs. Choline geranate was used as an IL in this investigation, whereas oleic acid (OA) (unsaturated) and palmitic acid (PA) (saturated) were chosen as the two types of fatty acids. The molar ratio of choline bicarbonate (CB) to either OA (CO) or PA (CP) was 2:1. In an additional series of trials, choline geranate (CAGE) ILs were prepared by mixing CB and geranic acid in a 1:2 molar ratio. For NMR spectroscopy, powder X-ray diffraction, differential scanning calorimetry, and Fourier transform infrared investigations, these formulations were characterized. Zeta potential indicated that all of the formulations had negative charges. The decreased irritation potential of CAGE, as shown by conductivity studies, makes it appropriate for skin application. To determine which formulation enhancers worked best, ex vivo skin permeation studies were carried out on both intact and tape-stripped skin. After 48 h, skin transport investigations showed that neat VH did not penetrate the excised porcine skin. Nevertheless, the CO and CP-based formulations greatly improved the skin penetration (6729 ± 437 μg/cm2) and retention (3892 ± 215 μg/g) of VH across the tape-stripped skin, whereas CAGE exhibited the most significant improvement (p < 0.05). Ionogel (CAGE-P) was finally fabricated by combining CAGE with 22.7% w/v Pluronic F-127 and 45.0% w/v PEG-400. The physical and rheological properties of VH-loaded CAGE-P gel were examined. The amount of VH permeated across the CAGE-P gel cotreated intact skin was 369 ± 41 μg/cm2, but that penetrated tape-stripped skin was 7543 ± 585 μg/cm2. The skin's barrier property underwent notable modifications (p < 0.05) following incubation with CAGE and CAGE-P gel formulations, as seen in the biophysical investigations conducted at various time intervals. Taken together, CAGE-Pluronic F-127 ionogel is promising and efficient as a topical formulation for the administration of VH in a localized and systemic manner.

Therapeutic Potential of Injectable Supramolecular Hydrogels With Neural Stem Cell Exosomes and Hydroxypropyl Methylcellulose for Post-Stroke Neurological Recovery

Background

Stroke has significantly contributed to the global mortality rate over the years, emphasizing the urgency of finding effective treatment strategies. Neural stem cell (NSC)-derived exosomes have the potential to improve neurological recovery after stroke; however, their therapeutic efficacy is hindered by their rapid clearance and limited duration of action. This study presents an innovative drug delivery method: a hydrogel based on NSC exosomes and hydroxypropyl methylcellulose (HPMC), which is intended to offer a continuous release, thereby enhancing and prolonging neurological improvement.

Results

We developed a nanohydrogel (Exo-HPMC) by integrating Buyang Huanwu Decoction (BHD) -preconditioned NSC-derived exosomes with HPMC. This study thoroughly investigated the controlled-release capabilities and rheological properties of Exo-HPMC. Our findings show that Exo-HPMC enables effective sustained exosome release, significantly extending their retention in mice. When administered to mice with middle cerebral artery occlusion (MCAO), Exo-HPMC facilitated notable post-stroke neurorepair. Behavioral assessments and immunofluorescence staining demonstrated that exosomes significantly promoted angiogenesis and nerve regeneration in stroke-affected areas, thereby reversing programmed cell death.

Conclusion

The Exo-HPMC nanohydrogel presents a groundbreaking approach for stroke therapy. Ensuring a controlled and prolonged release of NSC-derived exosomes over two weeks, significantly enhances the therapeutic potential of exosomes for ischemic stroke treatment.

Hydrogel Applications in the Diagnosis and Treatment of Glioblastoma

Glioblastoma multiforme (GBM), a common malignant neurological tumor, has boundaries indistinguishable from those of normal tissue, making complete surgical removal ineffective. The blood-brain barrier (BBB) further impedes the efficacy of radiotherapy and chemotherapy, leading to suboptimal treatment outcomes and a heightened probability of recurrence. Hydrogels offer multiple advantages for GBM diagnosis and treatment, including overcoming the BBB for improved drug delivery, controlled drug release for long-term efficacy, and enhanced relaxation properties of magnetic resonance imaging (MRI) contrast agents. Hydrogels, with their excellent biocompatibility and customizability, can mimic the in vivo microenvironment, support tumor cell culture, enable drug screening, and facilitate the study of tumor invasion and metastasis. This paper reviews the classification of hydrogels and recent research for the diagnosis and treatment of GBM, including their applications as cell culture platforms and drugs including imaging contrast agents carriers. The mechanisms of drug release from hydrogels and methods to monitor the activity of hydrogel-loaded drugs are also discussed. This review is intended to facilitate a more comprehensive understanding of the current state of GBM research. It offers insights into the design of integrated hydrogel-based GBM diagnosis and treatment with the objective of achieving the desired therapeutic effect and improving the prognosis of GBM.

Nano-scaffold-based delivery systems of antimicrobial agents in the treatment of osteomyelitis ; a narrative review

Osteomyelitis caused by drug-resistant pathogens is one of the most important medical challenges due to high rates of mortality and morbidity, and limited therapeutical options. The application of novel nano-scaffolds loaded with antibiotics has widely been studied and extensively evaluated for in vitro and in vivo inhibition of pathogens, regenerating damaged bone tissue, and increasing bone cell proliferation. The treatment of bone infections using the local osteogenic scaffolds loaded with antimicrobial agents may efficiently overcome the problems of the systemic use of antimicrobial agents and provide a controlled release and sufficient local levels of antibiotics in the infected sites. The present study reviewed various nano-scaffolds delivery systems of antimicrobial drugs evaluated to treat osteomyelitis. Nano-scaffolds offer promising approaches because they simulate natural tissue regeneration in terms of their mechanical, structural, and sometimes chemical properties. The potential of several nano-scaffolds prepared by natural polymers such as silk, collagen, gelatin, fibrinogen, chitosan, cellulose, hyaluronic, alginate, and synthetic compounds such as polylactic acid, polyglycolic acid, poly (lactic acid-co-glycolic acid), poly-ɛ-caprolactone have been studied for usage as drug delivery systems of antimicrobial agents to treat osteomyelitis. In addition to incorporated antimicrobial agents and the content of scaffolds, the physical and chemical characteristics of the prepared delivery systems are a determining factor in their effectiveness in treating osteomyelitis.

Sequential release of vancomycin and BMP-2 from chitosan/nano-hydroxyapatite thermosensitive hydrogel for the treatment of chronic osteomyelitis

In this study, we developed scaffolds materials with microspheres to form a double sustained release system.Chitosan/nano-hydroxyapatite (CS-HA) was used as a drug carrier to construct a sustained-release system for Bone morphogenetic protein-2(BMP-2) and Vancomycin (VAN). Furthermore, VAN and BMP-2 loaded microspheres (Ms) were prepared by the emulsion ultrasonic method.The resultant composites were characterized by Scanning electron microscope (SEM), compressive strength, porosity, and biodegradation. The characterization results showed uniform porous and rough surface, enhanced thermal stability, and highest compressive strength ((1.912 ± 0.012) Kpa, the surface of the two microspheres was slightly folded and showed a regular spherical shape.The loading rate of BMP-2 was (59.611 × 10-4 ± 0.023 × 10-4)% and the encapsulation rate was (6.022 ± 0.005)%. The release rate of vancomycin and BMP-2 was 57.194% and 12.968% respectively. Osteogenic differentiation of Bone marrow mesenchymal stem cells (BMSCs) was confirmed by alkaline phosphatase quantification. The deposition of late osteogenic markers (calcium phosphates) detected by Alizarin red, which indicated extracellular matrix mineralization. The results showed that BMP-2/VAN in CS-HA hydrogel successfully achieved the sequential release of the double drugs, which could benefit bone regeneration.

A Thermoresponsive injectable drug delivery system of chitosan/β-glycerophosphate with gellan gum/alginate microparticles

The development of new Drug Delivery Systems (DDS) by incorporating microparticles within hydrogels can prolong the release rate of drugs and/or other bioactive agents. In this study, we combined gellan gum/alginate microparticles within a thermoresponsive chitosan (Ch) hydrogel with β-Glycerophosphate (β-GP), designing the system to be in the sol state at 21 °C and in the gel state at 37 °C to enable the injectability of the system. The system was in the sol state between 10 °C and 21 °C. Higher concentrations of β-GP (0, 2, 3, 4, 5 w/v%) and microparticles (0, 2 and 5 w/v%) allowed a faster sol-gel transition with higher mechanical strength at 37 °C. However, the sol-gel transition was not instantaneous. The release profile of methylene blue (MB) from the microparticles was significantly affected by their incorporation in Ch/β-GP hydrogels, only allowing the release of 60-70 % of MB for 6 days, while the microparticles alone released all the MB in 48 h. The proposed system did not present cytotoxicity to VERO cell lines as a preliminary assay, with the Ch/β-GP/GG:Alg having >90 % of cellular viability. The proposed Ch/β-GP system proved to have a delaying effect on drug release and biocompatible properties, being a promising future DDS.

Evolution of Hybrid Hydrogels: Next-Generation Biomaterials for Drug Delivery and Tissue Engineering

Hydrogels, being hydrophilic polymer networks capable of absorbing and retaining aqueous fluids, hold significant promise in biomedical applications owing to their high water content, permeability, and structural similarity to the extracellular matrix. Recent chemical advancements have bolstered their versatility, facilitating the integration of the molecules guiding cellular activities and enabling their controlled activation under time constraints. However, conventional synthetic hydrogels suffer from inherent weaknesses such as heterogeneity and network imperfections, which adversely affect their mechanical properties, diffusion rates, and biological activity. In response to these challenges, hybrid hydrogels have emerged, aiming to enhance their strength, drug release efficiency, and therapeutic effectiveness. These hybrid hydrogels, featuring improved formulations, are tailored for controlled drug release and tissue regeneration across both soft and hard tissues. The scientific community has increasingly recognized the versatile characteristics of hybrid hydrogels, particularly in the biomedical sector. This comprehensive review delves into recent advancements in hybrid hydrogel systems, covering the diverse types, modification strategies, and the integration of nano/microstructures. The discussion includes innovative fabrication techniques such as click reactions, 3D printing, and photopatterning alongside the elucidation of the release mechanisms of bioactive molecules. By addressing challenges, the review underscores diverse biomedical applications and envisages a promising future for hybrid hydrogels across various domains in the biomedical field.

Injectable systems of chitosan in situ forming composite gel incorporating linezolid-loaded biodegradable nanoparticles for long-term treatment of bone infections

The objective of the current study was to create an efficient, minimally invasive combined system comprising in situ forming hydrogel loaded with both spray-dried polymeric nanoparticles encapsulating linezolid and nanohydroxyapatite for local injection to bones or their close vicinity. The developed system was designed for a dual function namely releasing the drug in a sustained manner for long-term treatment of bone infections and supporting bone proliferation and new tissues generation. To achieve these objectives, two release sustainment systems for linezolid were optimized namely a composite in situ forming chitosan hydrogel and spray-dried PLGA/PLA solid nanoparticles. The composite, in situ forming hydrogel of chitosan was prepared using two different gelling agents namely glycerophosphate (GP) and sodium bicarbonate (NaHCO3) at 3 different concentrations each. The spray-dried linezolid-loaded PLGA/PLA nanoparticles were developed using a water-soluble carrier (PVP K30) and a lipid soluble one (cetyl alcohol) along with 3 types of DL-lactide and/or DL-lactide-co-glycolide copolymer using nano-spray-drying technique. Finally, the optimized spray-dried linezolid nanoparticles were incorporated into the optimized composite hydrogel containing nanohydroxy apatite (nHA). The combined hydrogel/nanoparticle systems displayed reasonable injectability with excellent gelation time at 37 °C. The optimum formulae sustained the release of linezolid for 7-10 days, which reveals its ability to reduce the frequency of injection during the course of treatment of bones infections and increase the patients' compliance. They succeeded to alleviate the bone infections and the associated clinical, biochemical, radiological, and histopathological changes within 2-4 weeks of injection. As to the state of art in this study and to the best of our knowledge, no such complete and systematic study on this type of combined in situ forming hydrogel loaded with spray-dried nanoparticles of linezolid is available yet in literatures.

Carboxymethyl Chitosan Microgels for Sustained Delivery of Vancomycin and Long-Lasting Antibacterial Effects

Carboxymethyl chitosan (CMCh) is a unique polysaccharide with functional groups that can develop positive and negative charges due to the abundant numbers of amine and carboxylic acid groups. CMCh is widely used in different areas due to its excellent biocompatibility, biodegradability, water solubility, and chelating ability. CMCh microgels were synthesized in a microemulsion environment using divinyl sulfone (DVS) as a crosslinking agent. CMCh microgel with tailored size and zeta potential values were obtained in a single stem by crosslinking CMCh in a water-in-oil environment. The spherical microgel structure is confirmed by SEM analysis. The sizes of CMCh microgels varied from one micrometer to tens of micrometers. The isoelectric point of CMCh microgels was determined as pH 4.4. Biocompatibility of CMCh microgels was verified on L929 fibroblasts with 96.5 ± 1.5% cell viability at 1 mg/mL concentration. The drug-carrying abilities of CMCh microgels were evaluated by loading Vancomycin (Van) antibiotic as a model drug. Furthermore, the antibacterial activity efficiency of Van-loaded CMCh microgels (Van@CMCh) was investigated. The MIC values of the released drug from Van@CMCh microgels were found to be 68.6 and 7.95 µg/mL against E. coli and S. aureus, respectively, at 24 h contact time. Disk diffusion tests confirmed that Van@CMCh microgels, especially for Gram-positive (S. aureus) bacteria, revealed long-lasting inhibitory effects on bacteria growth up to 72 h.

The Impact of Hypromellose on Pharmaceutical Properties of Alginate Microparticles as Novel Drug Carriers for Posaconazole

Fungal infections are a group of diseases which are challenging to treat because of drug-resistant fungi species, drug toxicity, and often severe patient conditions. Hence, research into new treatments, including new therapeutic substances and novel drug delivery systems, is being performed. Mucoadhesive dosage forms are beneficial to improving drug bioavailability by prolonging the residence time at the site of application. Sodium alginate is a natural polymer with favorable mucoadhesive and gelling properties, although its precipitation in acidic pH significantly disrupts the process of drug release in gastric conditions. Hypromellose is a hydrophilic, semi-synthetic cellulose derivative with mucoadhesive properties, which is widely used as a control release agent in pharmaceutical technology. The aim of this study was to evaluate the impact of hypromellose on alginate microparticles with posaconazole, designed to modify drug release and to improve their mucoadhesive properties for both oral or vaginal application.

Formulation development and evaluation of therapeutic contact lens loaded with ganciclovir

PURPOSE

In the present investigation ganciclovir (GAN) loaded microparticles dispersed in hydrogel-based contact lenses were fabricated, characterized and evaluated for eye irritation.

METHODS

GAN-Hydroxy Propyl Methyl Cellulose (HPMC) microparticles were prepared by solvent evaporation method and evaluated for entrapment efficiency, drug content and drug release. The Polyhydroxyethylmethacrylate (pHEMA) contact lenses were synthesized by free radical polymerization reaction using crosslinkers like ethylene glycoldimethacrylate and photoinitiator such as IRGACURE 1173^®, in UVB light, λ 365 nm. The GAN-HPMC microparticles when incorporated into the premonomer mixture and polymerized together give rise to a particle dispersion system in the hydrogel contact lenses. The contact lenses were studied for surface morphology, transmittance, swelling, drug release, Na⁺ion permeability and hens egg test chorioallantoic membrane assay (HETCAM).

RESULTS

Hydrogel contact lens exhibited satisfactory surface morphology, transmittance, swelling, Na⁺ion permeability (3.72 × 106 mm²/min) and a release of 48 h suggesting a potential for prolonged ocular drug delivery. Furthermore, HETCAM exhibited no signs of ocular irritation.

CONCLUSION

The developed delivery platform is a promising alternative to conventional dosage forms like eye drops, suspensions and ointments due to its increase in the residence time attributed to its prolonged release profile.

Fabrication and characterization of the H/J-type aggregates astaxanthin/bovine serum albumin/chitosan nanoparticles

Astaxanthin is a natural liposoluble ketocarotenoid with various biological activities. Hydrophobic astaxanthin with C_2h symmetry can self-assembly form H-type aggregates and J-type aggregates in hydrated polar solvents. However, astaxanthin and its aggregates are limited by its water insolubility and chemical instability. Here, the biological macromolecules bovine serum albumin (BSA) and chitosan were chosen as protein-polysaccharides based delivery systems for astaxanthin aggregates by molecular self-assembly method. The precise prepared H-ABC-NPs and J-ABC-NPs suspensions were both near spheres with hydrodynamic size around 281 ± 9 nm and 368 ± 5 nm and zeta potentials around +26 mV and +30 mV, respectively. Two types of astaxanthin aggregates were distinguished, water-dispersible, and stable in nanocarriers through UV-vis spectra observation. The encapsulation efficiency of the astaxanthin in ABC-NPs was above 90 %. Fourier transform infrared spectroscopy (FTIR) and circular dichroism (CD) analyses indicated that the dominant driving forces of ABC-NPs formation mainly included electrostatic, hydrophobic interactions and hydrogen bonding. These results offer an elegant opportunity for the protein-polysaccharides delivery systems, and provide an important perspective for applying novel water-dispersed astaxanthin aggregates products in nutrition and medicine industry.

Recent advances in the local antibiotics delivery systems for management of osteomyelitis

Chronic osteomyelitis is a challenging disease due to its serious rates of mortality and morbidity while the currently available treatment strategies are suboptimal. In contrast to the adopted systemic treatment approaches after surgical debridement in chronic osteomyelitis, local drug delivery systems are receiving great attention in the recent decades. Local drug delivery systems using special carriers have the pros of enhancing the feasibility of penetration of antimicrobial agents to bone tissues, providing sustained release and localized concentrations of the antimicrobial agents in the infected area while avoiding the systemic side effects and toxicity. Most important, the incorporation of osteoinductive and osteoconductive materials in these systems assists bones proliferation and differentiation, hence the generation of new bone materials is enhanced. Some of these systems can also provide mechanical support for the long bones during the healing process. Most important, if the local systems are designed to be injectable to the affected site and biodegradable, they will reduce the level of invasion required for implantation and can win the patients’ compliance and reduce the healing period. They will also allow multiple injections during the course of therapy to guard against the side effect of the long-term systemic therapy. The current review presents different available approaches for delivering antimicrobial agents for the treatment of osteomyelitis focusing on the recent advances in researches for local delivery of antibiotics.

HIGHLIGHTS

Chronic osteomyelitis is a challenging disease due to its serious mortality and morbidity rates and limited effective treatment options.

Local drug delivery systems are receiving great attention in the recent decades.

Osteoinductive and osteoconductive materials in the local systems assists bones proliferation and differentiation

Local systems can be designed to provide mechanical support for the long bones during the healing process.

Designing the local system to be injectable to the affected site and biodegradable will reduces the level of invasion and win the patients’ compliance.

Vancomycin conjugated iron oxide nanoparticles for magnetic targeting and efficient capture of Gram-positive and Gram-negative bacteria

Drug conjugated iron oxide magnetite (Fe3O4) nanoparticles are of great interest in the field of biomedicine. In this study, vancomycin (Van) conjugated magnetite (Fe3O4) nanoparticles were envisioned to capture and inhibit the growth of bacteria. Hydrophobic Fe3O4 nanoparticles were synthesized by using co-precipitation of ferrous (Fe2+) and ferric (Fe3+) ions following a surface modification step with oleic acid as stabilizers. Thereafter, a ligand exchange technique was employed to displace oleic acid with hydrophilic dopamine (DOPA) molecules which have a catechol group for anchoring to the iron oxide surface to prepare water dispersible nanoparticles. The surface of the resulting Fe3O4/DOPA nanoparticles contains amino (-NH2) groups that are conjugated with vancomycin via a coupling reaction between the -NH2 group of dopamine and the -COOH group of vancomycin. The prepared vancomycin conjugated Fe3O4/DOPA nanoparticles were named Fe3O4/DOPA/Van and exhibited a magnetic response to an external magnetic field due to the presence of magnetite Fe3O4 in the core. The Fe3O4/DOPA/Van nanoparticles showed bactericidal activity against both Gram positive Bacillus subtilis (B. subtilis) and Streptococcus and Gram-negative bacteria Escherichia coli (E. coli). Maximum inhibition zones of 22 mm, 19 mm and 18 mm were found against B. subtilis, Streptococcus and E. coli respectively. Most importantly, the vancomycin conjugated nanoparticles were effectively bound to the cell wall of the bacteria, promoting bacterial separation and growth inhibition. Therefore, the prepared Fe3O4/DOPA/Van nanoparticles can be promising for effective bacterial separation and killing in the dispersion media.

Design and Development of Hybrid Hydrogels for Biomedical Applications: Recent Trends in Anticancer Drug Delivery and Tissue Engineering

The applications of hydrogels in biomedical field has been since multiple decades. Discoveries in biology and chemistry render this platform endowed with much engineering potentials and growing continuously. Novel approaches in constructing these materials have led to the production of complex hybrid hydrogels systems that can incorporate both natural and synthetic polymers and other functional moieties for mediated cell response, tunable release kinetic profiles, thus they are used and research for diverse biomedical applications. Recent advancement in this field has established promising techniques for the development of biorelevant materials for construction of hybrid hydrogels with potential applications in the delivery of cancer therapeutics, drug discovery, and re-generative medicines. In this review, recent trends in advanced hybrid hydrogels systems incorporating nano/microstructures, their synthesis, and their potential applications in tissue engineering and anticancer drug delivery has been discussed. Examples of some new approaches including click reactions implementation, 3D printing, and photopatterning for the development of these materials has been briefly discussed. In addition, the application of biomolecules and motifs for desired outcomes, and tailoring of their transport and kinetic behavior for achieving desired outcomes in hybrid nanogels has also been reviewed.

Application of a novel thermo-sensitive injectable hydrogel in therapy in situ for drug accurate controlled release

Local drug injection therapy for tumor site, as a neoadjuvant chemotherapy method, shows important significance in clinical application; however, it obtains unsatisfying therapeutic effect due to the serious toxic and side effect in normal tissues caused by drug diffusion or complexity of the preparation. In this article, the influence factors of the gelling time of traditional Chitosan (CTS) thermo-sensitive hydrogels were analyzed, and the gelling properties were improved significantly, and a thermo-sensitive hydrogel with precisely regulated gelling time was obtained through a green and simple preparation method, and the shortest gelling time (gelling time = 27 ± 2 s) of this hydrogel was 5% of that of the common CTS thermo-sensitive hydrogels. After loaded with different chemotherapy drugs with different pH values (gemctiabin hydrochloride, levofloxacin, and 5-foluorouracil), the hydrogels' gelling performance was not affected, while the gelling time could be shortened by 5-foluorouracil, effectively hindering the drug loss at the early stage of sustained release. in vitro and in vivo experiments proved that precise encapsulation toward tumors with different volumes was achieved by the hydrogels, with minimal damage to surrounding normal tissues and higher utilization of drugs in tumor sites, ultimately achieving better tumor therapeutic effect. In conclusion, the new thermo-sensitive hydrogels with precisely regulated gelling time showed great significance and potential for drug delivery and neoadjuvant chemotherapy.

An Antibiotic-Releasing Bone Void Filling (ABVF) Putty for the Treatment of Osteomyelitis

The number of total joint replacements (TJR) is on the rise with a corresponding increase in the number of infected TJR, which necessitates revision surgeries. Current treatments with either non-biodegradable, antibiotic-releasing polymethylmethacrylate (PMMA) based bone cement, or systemic antibiotic after surgical debridement do not provide effective treatment due to fluctuating antibiotic levels at the site of infection. Here, we report a biodegradable, easy-to-use "press-fitting" antibiotic-releasing bone void filling (ABVF) putty that not only provides efficient antibiotic release kinetics at the site of infection but also allows efficient osseointegration. The ABVF formulation was prepared using poly (D,L-lactide-co-glycolide) (PLGA), polyethylene glycol (PEG), and polycaprolactone (PCL) as the polymer matrix, antibiotic vancomycin, and osseointegrating synthetic bone PRO OSTEON for bone-growth support. ABVF was homogenous, had a porous structure, was moldable, and showed putty-like mechanical properties. The ABVF putty released vancomycin for 6 weeks at therapeutic level. Furthermore, the released vancomycin showed in vitro antibacterial activity against Staphylococcus aureus for 6 weeks. Vancomycin was not toxic to osteoblasts. Finally, ABVF was biodegradable in vivo and showed an effective infection control with the treatment group showing significantly higher bone growth (p < 0.001) compared to the control group. The potential of infection treatment and osseointegration makes the ABVF putty a promising treatment option for osteomyelitis after TJR.

Therapeutics and delivery vehicles for local treatment of osteomyelitis

Osteomyelitis, or the infection of the bone, presents a major complication in orthopedics and may lead to prolonged hospital visits, implant failure, and in more extreme cases, amputation of affected limbs. Typical treatment for this disease involves surgical debridement followed by long-term, systemic antibiotic administration, which contributes to the development of antibiotic-resistant bacteria and has limited ability to eradicate challenging biofilm-forming pathogens including Staphylococcus aureus-the most common cause of osteomyelitis. Local delivery of high doses of antibiotics via traditional bone cement can reduce systemic side effects of an antibiotic. Nonetheless, growing concerns over burst release (then subtherapeutic dose) of antibiotics, along with microbial colonization of the nondegradable cement biomaterial, further exacerbate antibiotic resistance and highlight the need to engineer alternative antimicrobial therapeutics and local delivery vehicles with increased efficacy against, in particular, biofilm-forming, antibiotic-resistant bacteria. Furthermore, limited guidance exists regarding both standardized formulation protocols and validated assays to predict efficacy of a therapeutic against multiple strains of bacteria. Ideally, antimicrobial strategies would be highly specific while exhibiting a broad spectrum of bactericidal activity. With a focus on S. aureus infection, this review addresses the efficacy of novel therapeutics and local delivery vehicles, as alternatives to the traditional antibiotic regimens. The aim of this review is to discuss these components with regards to long bone osteomyelitis and to encourage positive directions for future research efforts.

Chitosan-based drug delivery systems: From synthesis strategy to osteomyelitis treatment - A review

Osteomyelitis is a complex disease in orthopedics mainly caused by bacterial pathogens invading bone or bone marrow. The treatment of osteomyelitis is highly difficult and it is a major challenge in orthopedic surgery. The long-term systemic use of antibiotics may lead to antibiotic resistance and has limited effects on eradicating local biofilms. Localized antibiotic delivery after surgical debridement can overcome the problem of antibiotic resistance and reduce systemic toxicity. Chitosan, a special cationic polysaccharide, is a product extracted from the deacetylation of chitin. It has numerous advantages, such as nontoxicity, biocompatibility, and biodegradability. Recently, chitosan has attracted significant attention in bacterial inhibition and drug delivery. Because chitosan contains many functional bioactive groups conducive to chemical reaction and modification, some chitosan-based biomaterials have been applied as the local antibiotic delivery systems in the treatment of osteomyelitis. This review aims to introduce recent advances in the biomedical applications of chitosan-based drug delivery systems in osteomyelitis treatment and to highlight the perspectives for further studies.

Vancomycin-loaded oxidized hyaluronic acid and adipic acid dihydrazide hydrogel: Bio-compatibility, drug release, antimicrobial activity, and biofilm model

BACKGROUND

Prosthesis infection is a difficult-to-treat situation. Hydrogel is a novel biomaterial, which can be applied by simply spraying or by coating on implants before surgery and can be easily mixed with antibiotics.

METHODS

In order to evaluate the potential use of antibiotic-loaded hydrogel, we incorporated vancomycin into oxidized hyaluronic acid (HA) and adipic acid dihydrazide and evaluated the drug release and antimicrobial activity against methicillin-resistant Staphylococcus aureus (ATCC 29213).

RESULTS

The average release percentage of vancomycin on day 3 was about 86%. The antibiotic-loaded gel was biocompatible with mesenchymal stem cell, MC3T3, and L929 cell lines. The in vitro inhibition zones of vancomycin-loaded hydrogel [500X minimal inhibition concentration (MIC), 50X MIC, 10X MIC, and blank hydrogel] were 21, 13, 9, and 5 mm, respectively. In the Ti6Al4V implant biofilm model, 0.01-1% vancomycin-loaded gel exhibited significant anti-biofilm activity, measured by the MTT assay.

CONCLUSIONS

Vancomycin could be loaded onto oxidized HA and adipic acid dihydrazide, which exhibited excellent drug release and in vitro antimicrobial activity with minimal cell toxicity.

Hybrid hydrogels for biomedical applications

The use of hydrogels in biomedical applications dates back multiple decades, and the engineering potential of these materials continues to grow with discoveries in chemistry and biology. The approaches have led to increasing complex hydrogels that incorporate both synthetic and natural polymers and functional domains for tunable release kinetics, mediated cell response, and ultimately use in clinical and research applications in biomedical practice. This review focuses on recent advances in hybrid hydrogels that incorporate nano/microstructures, their synthesis, and applications in biomedical research. Examples discussed include the implementation of click reactions, photopatterning, and 3D printing for the facile production of these hybrid hydrogels, the use of biological molecules and motifs to promote a desired cellular outcome, and the tailoring of kinetic and transport behavior through hybrid-hydrogel engineering to achieve desired biomedical outcomes. Recent progress in the field has established promising approaches for the development of biologically relevant hybrid hydrogel materials with potential applications in drug discovery, drug/gene delivery, and regenerative medicine.

Antimicrobial and anti-inflammatory drug-delivery systems at endodontic reparative material: Synthesis and characterization

OBJECTIVE

The aim of this study was to synthesize and characterize an experimental endodontic paste.

METHODS

An experimental endodontic paste (EX) was characterized by its particle size, zeta potential, drug content and morphology. The powder of EX is composed of amoxicillin microspheres, calcium tungstate and α-tricalcium phosphate, mixed with an indomethacin nanocapsules suspension. Ultracal^® (Ultradent), an iodoform-based paste (GP) and the EX were evaluated by its physical properties (flow, film thickness and radiopacity). The cytocompatibility was performed by MTT and SRB-colorimetric assays; the cell-migration was tested with scratch assay and cell-ability to remineralization with ALP and Alizarin Red S, with fibroblastic cell line. The antibacterial activity was assessed by the formation of inhibition zones and against planktonic bacteria.

RESULTS

The EX and UL flow achieved ISO6876 standard, and GP was lower than 17mm. All pastes achieved the film thickness required. Radiopacity was equivalent to 1.81±0.25mmAl for EX, which did not differ from GP group 1.39±0.33mmAl (p>0.05). The UL presented 3.04±0.33mmAl. The values for SRB showed better citocompatibility in comparison with MTT for all materials. The ALP activity and formation of mineralized nodules demonstrated the remineralization potential for UL and EX. Cell migration showed continuous wound closure until complete cell healing, however, the EX accelerated the process (p<0.05). The EX showed the greatest inhibition zone (p<0.05) and was the only group with antibacterial activity against planktonic bacteria.

SIGNIFICANCE

The synthesized endodontic paste demonstrated reliable physical and biological properties and could be a promising material for periapical tissue repair.

A Novel Biodegradable and Thermosensitive Poly(Ester-Amide) Hydrogel for Cartilage Tissue Engineering

Thermosensitive hydrogels are attractive alternative scaffolding materials for minimally invasive surgery through a simple injection and in situ gelling. In this study, a novel poly(ester-amide) polymer, methoxy poly(ethylene glycol)-poly(pyrrolidone-co-lactide) (mPDLA, P3L7) diblock copolymer, was synthesized and characterized for cartilage tissue engineering. A series of amphiphilic diblock copolymers was synthesized by ring-opening polymerization of mPEG 550, D,L-lactide, and 2-pyrrolidone. By dynamic light scattering analysis and tube-flipped-upside-down method, viscoelastic properties of the mPDLA diblock copolymer solution exhibited sol-gel transition behavior as a function of temperature. An in vitro degradation assay showed that degradation acidity was effectively reduced by introducing the 2-pyrrolidone monomer into the polyester hydrogel. Besides, mPDLA exhibited great biocompatibility in vitro for cell encapsulation due to a high swelling ratio. Moreover, cell viability and biochemical analysis proved that the mPDLA hydrogel presented a great chondrogenic response. Taken together, these results demonstrate that mPDLA hydrogels are promising injectable scaffolds potentially applicable to cartilage tissue engineering.

Composite Microparticles Based on Natural Mucoadhesive Polymers with Promising Structural Properties to Protect and Improve the Antifungal Activity of Miconazole Nitrate

Oropharyngeal candidiasis is a recurrent oral infection caused by Candida species. Gel formulation containing miconazole nitrate is the most common approach for treating oral candidiasis. However, traditional oral topical antifungal therapies have many limitations, including short contact time with the oral mucosa and the necessity to administrate various doses per day. Thus, the aim of this work was to formulate composited microparticulated systems based on combinations of mucoadhesive cationic, anionic, and nonionic polymers that could protect and modify the drug release rate and therefore avoid a fast dilution of the drug by saliva. Microparticulated systems were prepared by the spray drying method employing chitosan, gelatin, and hydroxypropyl methylcellulose. The morphology of the systems was investigated by scanning electron microscopy; drug crystallinity was studied by X-ray, while interactions between polymers were analyzed by infrared spectroscopy. Drug release and halo zone test were employed to analyze the release and activity of the systems loaded with miconazole against Candida albicans cultures. The most appropriate microparticulated system was the one based on chitosan and gelatin which showed homogeneous morphology (mean size of 1.7 ± 0.5 μm), a protective effect of the drug, and better antifungal effect against Candida culture than miconazole nitrate and the other assayed systems. Taking into account these results, this approach should be seriously considered for further evaluation of its safety and in vivo efficacy to be considered as an alternative therapeutic system for the treatment of oral candidiasis.

Cellulose-based hydrogel materials: chemistry, properties and their prospective applications

Hydrogels based on cellulose comprising many organic biopolymers including cellulose, chitin, and chitosan are the hydrophilic material, which can absorb and retain a huge proportion of water in the interstitial sites of their structures. These polymers feature many amazing properties such as responsiveness to pH, time, temperature, chemical species and biological conditions besides a very high-water absorption capacity. Biopolymer hydrogels can be manipulated and crafted for numerous applications leading to a tremendous boom in research during recent times in scientific communities. With the growing environmental concerns and an emergent demand, researchers throughout the globe are concentrating particularly on naturally derived hydrogels due to their biocompatibility, biodegradability and abundance. Cellulose-based hydrogels are considered as useful biocompatible materials to be used in medical devices to treat, augment or replace any tissue, organ, or help function of the body. These hydrogels also hold a great promise for applications in agricultural activity, as smart materials and some other useful industrial purposes. This review offers an overview of the recent and contemporary research regarding physiochemical properties of cellulose-based hydrogels along with their applications in multidisciplinary areas including biomedical fields such as drug delivery, tissue engineering and wound healing, healthcare and hygienic products as well as in agriculture, textiles and industrial applications as smart materials.

Microfluidic fabrication of biocompatible poly(N-vinylcaprolactam)-based microcarriers for modulated thermo-responsive drug release

Various thermo-responsive polymers have been developed for controlled drug delivery upon the local application of external heat. The development of thermo-responsive polymers with high biocompatibility and tunable thermo-sensitivity is crucial for safe and efficient therapeutic application. In this study, thermo-responsive drug carriers featuring tunable thermo-sensitivities were synthesized using biocompatible poly(N-vinyl caprolactam) (PVCL) and stop-flow lithography. The PVCL-based particles showed selective drug release depending on temperature, illustrating their feasibility for on-demand controlled drug delivery. The volume phase transition temperature (VPTT) of the PVCL-based particles can be adjusted to vary from room temperature to body temperature by controlling their monomer compositions. In addition, modulated drug release was achieved by constructing multicompartments of different thermo-sensitivities within the PVCL particles. To accomplish thermo-responsive anticancer therapy, doxorubicin (DOX) was encapsulated into the PVCL particles as an anticancer drug. The DOX-loaded PVCL particles exhibited both thermo-responsive drug release and anticancer activity. This study demonstrates that thermo-responsive PVCL particles are highly promising carriers for safe and targeted anticancer therapy.

Chitosan/hydroxyapatite (HA)/hydroxypropylmethyl cellulose (HPMC) spongy scaffolds-synthesis and evaluation as potential alveolar bone substitutes

Alveolar bone loss is associated with infections and its augmentation is a pre-requisite for the success of dental implants. In present study, we aim to develop and evaluate novel freeze dried doxycycline loaded chitosan (CS)/hydroxyapatite (HA) spongy scaffolds where hydroxypropylmethyl cellulose (HPMC) was added as a crosslinker. Scaffolds displayed compressive strength of 14MPa/cm³ and 0.34 as elastic response. The interconnected pore diameter was 41-273μm, favorably provided the template supporting cells and transport. An overall 10% degradation was seen after 14day's studies at pH 7.4 in PBS. Doxycycline hyclate, a frequently used drug to counter oral infections, demonstrated an initial burst release (6-8h), followed by a sustain release profile for the remaining 64h. CS/HA/HPMC scaffolds were nontoxic and promoted pre-osteoblast cell viability as seen with live/dead calcein staining after 24h where scaffolds with 10% and 25% HPMC by weight of scaffold had more viable cells. Scaffolds with 10%, 20% and 25% HPMC by weight of scaffold showed efficient cellular adhesion as seen in scanning electron microscopy images (day 8) indicating that pre-osteoblast cells were able to adhere well on the surface and into the porous structure via cytoplasmic extensions. Hoechst 33258 nuclear staining at day 2 and 8 indicated cell proliferation which was further supported byMTT assay at day 2, 4 and 8. Although all scaffolds supported pre-osteoblast cell viability, alkaline phosphatase (ALP) staining demonstrated that upon induction, differentiation was pronounced in case of scaffolds with 10% HMPC scaffolds. Conclusively, these materials having all the required mechanical and biological properties are potential candidates for alveolar bone regeneration.