Cold atmospheric plasma physically reinforced substances of platelets-laden photothermal-responsive methylcellulose complex restores burn wounds

Physicochemical properties of bacterial cellulose/phototherapeutic polypyrrole/antibacterial chitosan composite membranes and their evaluation as chronic wound dressings

Bacterial cellulose (BC) is a natural fiber membrane and has been applied in many biomedical applications. Herein, it was used as the main scaffold to prepare wound dressings for treating diabetic skin wounds. Polypyrrole (PPy) was first synthesized by in situ oxidative polymerization within BC membrane and applied as a photothermal agent, followed by coating with chitosan (CS) to improve the biocompatibility and antibacterial properties. SEM pictures revealed sub-micron PPy particles ranging from 100 to 200 nm were formed and attached to the BC fibrils, whereas CS formed a thin, porous layer on the surface. FTIR analysis showed that there was hydrogen bonding between BC, PPy and CS components. The crystalline structure of BC was maintained yet with decreased crystallinity by addition of PPy and CS. The water absorption capability and water vapor transmission rate decreased by PPy incorporation owing to its hydrophobic nature, but they were regained by addition of hydrophilic CS. The prepared BC/PPy/CS membrane was biocompatible toward L929 cells and maintained hemocompatibility. Additionally, both PPy and CS contributed to the antibacterial activity against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli, while they demonstrated a potential for synergistic antibacterial effects when combined. Finally, the near-infrared (NIR)-driven photothermal-hyperthermic effects by PPy on lesions upregulated heat-shock protein (HSP) expression and anti-inflammatory properties by CS boosted restoration of diabetic wounds in vivo without the addition of any antibiotics or anti-inflammatory drugs. The results thus support using the BC/PPy/CS membrane for diabetic wound regeneration.

Integration of Photodiagnosis and Therapy Guided by Micro/Nanorobots

Micro/Nanorobots(MNRs)integrated with phototherapy represent an emerging approach to cancer treatment and hold significant potential for addressing bacterial infections, neurological disorders, cardiovascular diseases, and related conditions. By leveraging micro/nanoscale motor systems in conjunction with phototherapy, these robots enable real-time guidance and monitoring of therapeutic processes, improving drug delivery precision and efficiency. This integration not only enhances the effectiveness of phototherapy but also minimizes damage to surrounding healthy tissues. Nevertheless, clinical translation of MNRs-assisted phototherapy still faces numerous challenges. In this review, recent key developments in the field are comprehensively summarized, the critical roles of MNRs-assisted phototherapy in clinical applications are highlighted, and insights into future directions and the pathway toward large-scale clinical implementation are provided.

RSL3-loaded nanoparticles amplify the therapeutic potential of cold atmospheric plasma

Cold atmospheric plasma (CAP) has exhibited exciting potential for cancer treatment. Reactive oxygen and nitrogen species (RONS), the primary constituents in CAP, contribute to cancer cell death by elevating oxidative stress in cells. However, several intrinsic cellular antioxidant defense systems exist, such as the glutathione peroxidase 4 (GPX4) enzyme, which dampens the cell-killing efficacy of CAP. RAS-selective lethal 3 (RSL3), also known as a ferroptosis inducer, is a synthetic GPX4 inhibitor. Therefore, we hypothesized that RSL3 can amplify CAP-induced cell death by inhibition of GPX4. In this study, we showed that RSL3 loaded in poly (ethylene glycol)-block-poly(lactide-co-glycolide) (PLGA-PEG) nanoparticles can enhance CAP-induced cell deaths in 4T1 tumor cells. Furthermore, the combination of CAP and RSL3 also promoted cancer immunogenic cell death (ICD), induced dendritic cell (DC) maturation, and macrophage polarization, initiating tumor-specific T-cell mediated immune responses against tumors. For in vivo application, RSL3@NP was co-delivered with CAP via injectable Pluronic hydrogel. In 4T1-bearing mice, hydrogel-mediated delivery of CAP and RSL3-loaded nanoparticles can effectively elicit potent anti-tumor immune responses and inhibit tumor growth.

Alleviating rheumatoid arthritis with a photo-pharmacotherapeutic glycan-integrated nanogel complex for advanced percutaneous delivery

The prospective of percutaneous drug delivery (PDD) mechanisms to address the limitations of oral and injectable treatment for rheumatoid arthritis (RA) is increasing. These limitations encompass inadequate compliance among patients and acute gastrointestinal side effects. However, the skin's intrinsic layer can frequently hinder the percutaneous dispersion of RA medications, thus mitigating the efficiency of drug delivery. To circumvent this constraint, we developed a strontium ranelate (SrR)-loaded alginate (ALG) phototherapeutic hydrogel to assess its effectiveness in combating RA. Our studies revealed that this SrR-loaded ALG hydrogel incorporating photoelectrically responsive molybdenum disulfide nanoflowers (MoS2 NFs) and photothermally responsive polypyrrole nanoparticles (Ppy NPs) to form ALG@SrR-MoS2 NFs-Ppy NPs demonstrated substantial mechanical strength, potentially enabling delivery of hydrophilic therapeutic agents into the skin and significantly impeding the progression of RA. Comprehensive biochemical, histological, behavioral, and radiographic analyses in an animal model of zymosan-induced RA demonstrated that the application of these phototherapeutic ALG@SrR-MoS2 NFs-Ppy NPs effectively reduced inflammation, increased the presence of heat shock proteins, regulatory cluster of differentiation M2 macrophages, and alleviated joint degeneration associated with RA. As demonstrated by our findings, treating RA and possibly other autoimmune disorders with this phototherapeutic hydrogel system offers a distinctive, highly compliant, and therapeutically efficient method.

Trehalose enhanced cold atmospheric plasma-mediated cancer treatment

Cold atmospheric plasma (CAP) is a unique form of physical plasma that has shown great potential for cancer therapy. CAP uses ionized gas to induce lethal oxidative stress on cancer cells; however, the efficacy of CAP therapy continues to be improved. Here, we report an injectable hydrogel-mediated approach to enhance the anti-tumor efficacy of CAP by regulating the phosphorylation of eIF2α. We discovered that reactive oxygen and nitrogen species (ROS/RNS), two main anti-tumor components in CAP, can lead to lethal oxidative stress on tumor cells. Elevated oxidative stress subsequently induces eIF2α phosphorylation, a pathognomonic marker of immunogenic cell death (ICD). Trehalose, a natural disaccharide sugar, can further enhance CAP-induced ICD by elevating the phosphorylation of eIF2α. Moreover, injectable hydrogel-mediated delivery of CAP/trehalose treatment promoted dendritic cell (DC) maturation, initiating tumor-specific T-cell mediated anti-tumor immune responses. The combination therapy also supported the polarization of tumor-associated macrophages to an M1-like phenotype, reversing the immunosuppressive tumor microenvironment and promoting tumor antigen presentation to T cells. In combination with immune checkpoint inhibitors (i.e., anti-programmed cell death protein 1 antibody, aPD1), CAP/trehalose therapy further inhibited tumor growth. Importantly, our findings also indicated that this hydrogel-mediated local combination therapy engaged the host systemic innate and adaptive immune systems to impair the growth of distant tumors.

Mussel-inspired tissue adhesive composite hydrogel with photothermal and antioxidant properties prepared from pectin for burn wound healing

Biodegradable self-healing hydrogels with antibacterial property attracted growing attentions in biomedication as wound dressings since they can prevent bacterial infection and promote wound healing process. In this research, a biodegradable self-healing hydrogel with ROS scavenging performance and enhanced tissue adhesion was fabricated from dopamine grafted oxidized pectin (OPD) and naphthoate hydrazide terminated PEO (PEO NH). At the same time, Fe3+ ions were incorporated to endow the hydrogel with near-infrared (NIR) triggered photothermal property to obtain antibacterial activity. The composite hydrogel showed good hemostasis performance based on mussel inspired tissue adhesion with biocompatibility well preserved. As expected, the composition of FeCl3 improved conductivity and endowed photothermal property to the hydrogel. The in vivo wound repairing experiment revealed the 808 nm NIR light triggered photothermal behavior of the hydrogel reduced the inflammation response and promoted wound repairing rate. As a result, this composite FeCl3/hydrogel shows great potential to be an excellent wound dressing for the treatment of infection prong wounds with NIR triggers.

Fabrication of Low-Temperature Fast Gelation β-Cyclodextrin-Based Hydrogel-Loaded Medicine for Wound Dressings

β-Cyclodextrin (β-CD) is often used as a drug carrier for biomedical materials due to its unique cavity structure. Herein, β-CD was modified by acryloyl chloride and further copolymerized with N-isopropylacrylamide (NIPAM) and acrylic acid (AA) to obtain PNIPAM-co-β-CD-AC. The results showed that the critical phase transition temperature of PNIPAM/β-CD-AC could be controlled at 19 °C, and the fast sol-gel phase transition was realized in 2-10 s. The hydrophobic drug carried in this hydrogel can constantly be released for more than 6 days at pH values (pH 5.5-8), and the duration may match the recovery of the wound. As a dressing hydrogel, its rapid gel formation and inversion as well as shear-thinning behavior prevent secondary wound damage. The β-CD-based hydrogel also has good biocompatibility and antioxidant properties, which provide a good potential choice for wound dressings, especially for exposed wounds in winter.

Gold-hyaluranic acid micromotors and cold atmospheric plasma for enhanced drug delivery and therapeutic applications

Micro/nanomotors have emerged as promising platforms for various applications, including drug delivery and controlled release. These tiny machines, built from nanoscale materials such as carbon nanotubes, graphene, metal nanoparticles, or nanowires, can convert different forms of energy into mechanical motion. In the field of medicine, nanomotors offer potential for targeted drug delivery and diagnostic applications, revolutionizing areas such as cancer treatment and lab-on-a-chip devices. One prominent material used in drug delivery is hyaluronic acid (HA), known for its biocompatibility and non-immunogenicity. HA-based drug delivery systems have shown promise in improving the efficacy and reducing the toxicity of chemotherapeutic agents like doxorubicin (DOX). Additionally, micro/nanomotors controlled by external stimuli enable precise drug delivery to specific areas of the body. Cold atmospheric plasma (CAP) has also emerged as a promising technology for drug delivery, utilizing low-temperature plasma to enhance drug release and bioavailability. CAP offers advantages such as localized delivery and compatibility with various drug types. However, further research is needed to optimize CAP drug delivery systems and understand their mechanisms. In this study, gold-hyaluronic acid (Au-HA) micromotors were synthesized for the first time, utilizing acoustic force for self-motion. The release profile of DOX, a widely used anticancer drug, was investigated in pH-dependent conditions, and the effect of CAP on drug release from the micromotors was examined. Following exposure to the CAP jet for 1 min, the micromotors released approximately 29 μg mL-1 of DOX into the PBS (pH 5), which is significantly higher than the 17 μg mL-1 released without CAP. The research aims to minimize side effects, increase drug loading and release efficiency, and highlight the potential of HA-based micromotors in cancer therapy. This study contributes to the advancement of micro-motor technology and provides insights into the utilization of pH and cold plasma technology for enhancing drug delivery systems.

Cold atmospheric plasma-enabled platelet vesicle incorporated iron oxide nano-propellers for thrombolysis

A new approach to treating vascular blockages has been developed to overcome the limitations of current thrombolytic therapies. This approach involves biosafety and multimodal plasma-derived theranostic platelet vesicle incorporating iron oxide constructed nano-propellers platformed technology that possesses fluorescent and magnetic features and manifold thrombus targeting modes. The platform is capable of being guided and visualized remotely to specifically target thrombi, and it can be activated using near-infrared phototherapy along with an actuated magnet for magnetotherapy. In a murine model of thrombus lesion, this proposed multimodal approach showed an approximately 80 % reduction in thrombus residues. Moreover, the new strategy not only improves thrombolysis but also boosts the rate of lysis, making it a promising candidate for time-sensitive thrombolytic therapy.

Plasma-Derived Nanoclusters for Site-Specific Multimodality Photo/Magnetic Thrombus Theranostics

Traditional thrombolytic therapeutics for vascular blockage are affected by their limited penetration into thrombi, associated off-target side effects, and low bioavailability, leading to insufficient thrombolytic efficacy. It is hypothesized that these limitations can be overcome by the precisely controlled and targeted delivery of thrombolytic therapeutics. A theranostic platform is developed that is biocompatible, fluorescent, magnetic, and well-characterized, with multiple targeting modes. This multimodal theranostic system can be remotely visualized and magnetically guided toward thrombi, noninvasively irradiated by near-infrared (NIR) phototherapies, and remotely activated by actuated magnets for additional mechanical therapy. Magnetic guidance can also improve the penetration of nanomedicines into thrombi. In a mouse model of thrombosis, the thrombosis residues are reduced by ≈80% and with no risk of side effects or of secondary embolization. This strategy not only enables the progression of thrombolysis but also accelerates the lysis rate, thereby facilitating its prospective use in time-critical thrombolytic treatment.

Bioinspired and self-restorable alginate-tyramine hydrogels with plasma reinforcement for arthritis treatment

Long-standing administration of disease-modifying antirheumatic drugs confirms their clinical value for managing rheumatoid arthritis (RA). Nevertheless, there are emergent worries over unwanted adverse risks of systemic drug administration. Hence, a novel strategy that can be used in a drug-free manner while diminishing side effects is immediately needed, but challenges persist in the therapy for RA. To this end, herein we conjugated tyramine (TYR) with alginate (ALG) to form ALG-TYR and then treated it for 5 min with oxygen plasma (ALG-TYR + P/5 min). It was shown that the ALG-TYR + P/5 min hydrogel exhibited favorable viscoelastic, morphological, mechanical, biocompatible, and cellular heat-shock protein amplification behaviors. A thorough physical and structural analysis was conducted on the ALG-TYR + P/5 min hydrogel, revealing favorable physical characteristics and uniform porous structural features within the hydrogel. Moreover, ALG-TYR + P/5 min not only effectively inhibited inflammation of RA but also potentially regulated lesion immunity. Once ALG-TYR + P/5 min was intra-articularly administered to joints of rats with zymosan-induced arthritis, we observed that ALG-TYR + P/5 min could ameliorate syndromes of RA joint. This bioinspired and self-restorable ALG-TYR + P/5 min hydrogel can thus serve as a promising system to provide prospective outcomes to potentiate RA therapy.

Tissue engineered skin substitutes: A comprehensive review of basic design, fabrication using 3D printing, recent advances and challenges

The multi-layered skin structure includes the epidermis, dermis and hypodermis, which forms a sophisticated tissue composed of extracellular matrix (ECM). The wound repair is a well-orchestrated process when the skin is injured. However, this natural wound repair will be ineffective for large surface area wounds. Autografts-based treatment is efficient but, additional pain and secondary healing of the patient limits its successful application. Therefore, there is a substantial need for fabricating tissue-engineered skin constructs. The development of a successful skin graft requires a fundamental understanding of the natural skin and its healing process, as well as design criteria for selecting a biopolymer and an appropriate fabrication technique. Further, the fabrication of an appropriate skin graft needs to meet physicochemical, mechanical, and biological properties equivalent to the natural skin. Advanced 3D bioprinting provides spatial control of the placement of functional components, such as biopolymers with living cells, which can satisfy the prerequisites for the preparation of an ideal skin graft. In this view, here we elaborate on the basic design requirements, constraints involved in the fabrication of skin graft and choice of ink, the probable solution by 3D bioprinting technique, as well as their latest advancements, challenges, and prospects.

Basic research and clinical exploration of cold atmospheric plasma for skin wounds

Skin wounds, such as burns, diabetic foot ulcers, pressure sores, and wounds formed after laser or surgical treatment, comprise a very high proportion of dermatological disorders. Wounds are treated in a variety of ways; however, some wounds are greatly resistant, resulting in delayed healing and an urgent need to introduce new alternatives. Our previous studies have shown that cold atmospheric plasma (CAP) has antibacterial activity and promotes cell proliferation, differentiation, and migration in vitro. To further advance the role of CAP in wound healing, we evaluated the safety and efficacy of CAP in vitro by irradiation of common refractory bacteria on the skin, irradiation of normal skin of rats and observing reactions, treatment of scald wounds in rats, and treating clinically common acute wounds. Our findings revealed that CAP can eliminate refractory skin bacteria in vitro; CAP positively affected wound healing in a rat scalding wound model; and direct CAP irradiation of low intensity and short duration did not lead to skin erythema or edema. CAP promises to be a new, economical, and safe means of wound treatment.

Biomimetic Platelet Nanomotors for Site-Specific Thrombolysis and Ischemic Injury Alleviation

Due to the mortality associated with thrombosis and its high recurrence rate, there is a need to investigate antithrombotic approaches. Noninvasive site-specific thrombolysis is a current approach being used; however, its usage is characterized by the following limitations: low targeting efficiency, poor ability to penetrate clots, rapid half-life, lack of vascular restoration mechanisms, and risk of thrombus recurrence that is comparable to that of traditional pharmacological thrombolysis agents. Therefore, it is vital to develop an alternative technique that can overcome the aforementioned limitations. To this end, a cotton-ball-shaped platelet (PLT)-mimetic self-assembly framework engineered with a phototherapeutic poly(3,4-ethylenedioxythiophene) (PEDOT) platform has been developed. This platform is capable of delivering a synthetic peptide derived from hirudin P6 (P6) to thrombus lesions, forming P6@PEDOT@PLT nanomotors for noninvasive site-specific thrombolysis, effective anticoagulation, and vascular restoration. Regulated by P-selectin mediation, the P6@PEDOT@PLT nanomotors target the thrombus site and subsequently rupture under near-infrared (NIR) irradiation, achieving desirable sequential drug delivery. Furthermore, the movement ability of the P6@PEDOT@PLT nanomotors under NIR irradiation enables effective penetration deep into thrombus lesions, enhancing bioavailability. Biodistribution analyses have shown that the administered P6@PEDOT@PLT nanomotors exhibit extended circulation time and metabolic capabilities. In addition, the photothermal therapy/photoelectric therapy combination can significantly augment the effectiveness (ca. 72%) of thrombolysis. Consequently, the precisely delivered drug and the resultant phototherapeutic-driven heat-shock protein, immunomodulatory, anti-inflammatory, and inhibitory plasminogen activator inhibitor-1 (PAI-1) activities can restore vessels and effectively prevent rethrombosis. The described biomimetic P6@PEDOT@PLT nanomotors represent a promising option for improving the efficacy of antithrombotic therapy in thrombus-related illnesses.

Ablation of Gap Junction Protein Improves the Efficiency of Nanozyme-Mediated Catalytic/Starvation/Mild-Temperature Photothermal Therapy

Reactive oxygen species (ROS)-mediated tumor catalytic therapy is typically hindered by gap junction proteins that form cell-to-cell channels to remove cytotoxic ROS, thereby protecting tumor cells from oxidative damage. In this work, a multifunctional nanozyme, FePGOGA, is designed and prepared by Fe(III)-mediated oxidative polymerization (FeP), followed by glucose oxidase (GOx) and GAP19 peptides co-loading through electrostatic and π-π interactions. The FePGOGA nanozyme exhibits excellent cascade peroxidase- and glutathione-oxidase-like activities that efficiently catalyze hydrogen peroxide conversion to hydroxyl radicals and convert reduced glutathione to oxidized glutathione disulfide. The loaded GOx starves the tumors and aggravates tumor oxidative stress through glucose decomposition, while GAP19 peptides block the hemichannels by inducing degradation of Cx43, thus increasing the accumulation of intracellular ROS, and decreasing the transport of intracellular glucose. Furthermore, the ROS reacts with primary amines of heat shock proteins to destroy their structure and function, enabling tumor photothermal therapy at the widely sought-after mild temperature (mildPTT, ≤45 °C). In vivo experiments demonstrate the significant antitumor effectof FePGOGA on cal27 xenograft tumors under near-infrared light irradiation. This study demonstrates the successful ablation of gap junction proteins to overcome resistance to ROS-mediated therapy, providing a regulator to suppress tumor self-preservation during tumor starvation, catalytic therapy, and mildPTT.

Impact of Non-Invasive Physical Plasma on Heat Shock Protein Functionality in Eukaryotic Cells

Recently, biomedical research has increasingly investigated physical plasma as an innovative therapeutic approach with a number of therapeutic biomedical effects. It is known from radiation and chemotherapy that these applications can lead to the induction and activation of primarily cytoprotective heat shock proteins (HSP). HSP protect cells and tissues from physical, (bio)chemical, and physiological stress and, ultimately, along with other mechanisms, govern resistance and treatment failure. These mechanisms are well known and comparatively well studied in drug therapy. For therapies in the field of physical plasma medicine, however, extremely little data are available to date. In this review article, we provide an overview of the current studies on the interaction of physical plasma with the cellular HSP system.

Small-size Ti3C2Tx MXene nanosheets coated with metal-polyphenol nanodots for enhanced cancer photothermal therapy and anti-inflammation

As a controllable, simple method with few side effects, near-infrared (NIR) light-based photothermal therapy (PTT) has been proven an effective cancer therapeutic approach. However, PTT-induced inflammation is a potential negative factor. And the overexpressed heat shock proteins (HSPs) by cancer cells can protect them from hyperthermia during PTT. In this work, small-size Ti₃C₂T_x MXene nanosheets with high photothermal conversion efficiency in the region of NIR, high cargo loading capability and good free radical scavenging capability were chosen for cancer PTT and anti-inflammation. And (-)-epigallocatechin gallate (EGCG) was applied to form EGCG/Fe metal-polyphenol nanodots on the nanosheets. EGCG being released in acid cancer cells could reduce the expression of HSPs and could be used for anti-inflammation. As a result, the complex nanosheets named MXene@EGCG could achieve enhanced cancer PTT and be anti-inflammatory. Both in vitro and in vivo studies proved the good photothermal ability of MXene@EGCG and demonstrated that it could inhibit the expression of HSPs in tumor cells and relieve PTT-induced inflammation. Therefore, the nanosheets show good results in tumor ablation with a low level of inflammation, which provides another possibility for cancer therapy. STATEMENT OF SIGNIFICANCE: Photothermal therapy (PTT)-induced inflammation plays an essential role in some important stages of tumor development and is unfavorable for cancer treatment. And hyperthermia leads to the overexpression of heat shock proteins (HSPs) in cancer cells, which limits the therapeutic effect of PTT. Therefore, we coated small-size Ti₃C₂T_x MXene nanosheets with (-)-epigallocatechin gallate (EGCG)/Fe metal-polyphenol nanodots and named them as MXene@EGCG. This system shows a good photothermal conversion efficiency at 808 nm. And it can release EGCG in cancer cells to inhibit the expression of HSPs, thus achieving an enhanced cancer PTT. Both MXene and EGCG can also diminish the PTT-trigged inflammation. Both in vitro and in vivo studies prove the good anti-cancer PTT effect and anti-inflammation capability of MXene@EGCG.

Polysaccharide-based hydrogel with photothermal effect for accelerating wound healing

Polysaccharide-based hydrogel has excellent biochemical function, abundant sources, good biocompatibility and other advantages, and has a broad application prospect in biomedical fields, especially in the field of wound healing. With its inherent high specificity and low invasive burden, photothermal therapy has shown great application prospect in preventing wound infection and promoting wound healing. Combining polysaccharide-based hydrogel with photothermal therapy (PTT), multifunctional hydrogel with photothermal, bactericidal, anti-inflammatory and tissue regeneration functions can be designed, so as to achieve better therapeutic effect. This review first focuses on the basic principles of hydrogel and PTT, and the types of polysaccharides that can be used to design hydrogels. In addition, according to the different materials that produce photothermal effects, the design considerations of several representative polysaccharide-based hydrogels are emphatically introduced. Finally, the challenges faced by polysaccharide-based hydrogels with photothermal properties are discussed, and the future prospects of this field are put forward.