Chitosan Derivatives in Macromolecular Co-assembly Nanogels with Potential for Biomedical Applications

Therapeutic Management of Malignant Wounds: An Update

OPINION STATEMENT

Malignant fungating wounds (MFW) are severe skin conditions generating tremendous distress in oncological patients with advanced cancer stages because of pain, malodor, exudation, pruritus, inflammation, edema, and bleeding. The classical therapeutic approaches such as surgery, opioids, antimicrobials, and application of different wound dressings are failing in handling pain, odor, and infection control, thus urgently requiring the development of alternative strategies. The aim of this review was to provide an update on the current therapeutic strategies and the perspectives on developing novel alternatives for better malignant wound management. The last decade screened literature evidenced an increasing interest in developing natural treatment alternatives based on beehive, plant extracts, pure vegetal compounds, and bacteriocins. Promising therapeutics can also be envisaged by involving nanotechnology due to either intrinsic biological activities or drug delivery properties of nanomaterials. Despite recent progress in the field of malignant wound care, the literature is still mainly based on in vitro and in vivo studies on small animal models, while the case reports and clinical trials (less than 10 and only one providing public results) remain scarce. Some innovative treatment approaches are used in clinical practice without prior extensive testing in fungating wound patients. Extensive research is urgently needed to fill this knowledge gap and translate the identified promising therapeutic approaches to more advanced testing stages toward creating multidimensional wound care strategies.

Chitosan Soft Matter Vesicles Loaded with Acetaminophen as Promising Systems for Modified Drug Release

Our study was designed to acquire, characterize and evaluate the biocompatibility of novel lipid vesicles loaded with acetaminophen (APAP) and coated with chitosan (CS). We investigated the in vitro and in vivo drug release kinetics from these systems, and we conducted assessments for both in vitro hemocompatibility and in vivo biocompatibility. For the in vivo biocompatibility evaluation, the mice were randomly divided into four groups of six animals and were treated orally as follows: control group: 0.1 mL/10 g body weight of double-distilled water; CS group: 0.1 mL/10 g body weight 1% CS solution; APAP group: 150 mg/kg body weight APAP; APAP-v group: 150 mg/kg body weight APAP-loaded lipid vesicles. The impact of APAP-v on various hematological, biochemical, and immune parameters in mice were assessed, and the harvested tissues were subjected to histopathological examination. The innovative formulations effectively encapsulating APAP within soft vesicles exhibited reasonable stability in solution and prolonged drug release in both in vitro and in vivo studies. The in vitro hemolysis test involving APAP-loaded vesicles revealed no signs of damage to red blood cells. The mice treated with APAP-v showed neither significant variances in hematological, biochemical, and immune parameters, nor structural changes in the examined organ samples, compared to the control group. APAP-v administration led to prolonged drug release. We can conclude that the APAP-v are innovative carrier systems for modifying drug release, making them promising candidates for biomedical applications.

Recent advances in chitosan-based materials; The synthesis, modifications and biomedical applications

The attention to polymer-based biomaterials, for instance, chitosan and its derivatives, as well as the techniques for using them in numerous scientific domains, is continuously rising. Chitosan is a decomposable naturally occurring polymeric material that is mostly obtained from seafood waste. Because of its special ecofriendly, biocompatible, non- toxic nature as well as antimicrobial properties, chitosan-based materials have received a lot of interest in the field of biomedical applications. The reactivity of chitosan is mainly because of the amino and hydroxyl groups in its composition, which makes it further fascinating for various uses, including biosensing, textile finishing, antimicrobial wound dressing, tissue engineering, bioimaging, gene, DNA and drug delivery and as a coating material for medical implants. This study is an overview of the different types of chitosan-based materials which now a days have been fabricated by applying different techniques and modifications that include etherification, esterification, crosslinking, graft copolymerization and o-acetylation etc. for hydroxyl groups' processes and acetylation, quaternization, Schiff's base reaction, and grafting for amino groups' reactions. Furthermore, this overview summarizes the literature from recent years related to the important applications of chitosan-based materials (i.e., thin films, nanocomposites or nanoparticles, sponges and hydrogels) in different biomedical applications.

Modern Approaches in Wounds Management

Wound management represents a well-known continuous challenge and concern of the global healthcare systems worldwide. The challenge is on the one hand related to the accurate diagnosis, and on the other hand to establishing an effective treatment plan and choosing appropriate wound care products in order to maximize the healing outcome and minimize the financial cost. The market of wound dressings is a dynamic field which grows and evolves continuously as a result of extensive research on developing versatile formulations with innovative properties. Hydrogels are one of the most attractive wound care products which, in many aspects, are considered ideal for wound treatment and are widely exploited for extension of their advantages in healing process. Smart hydrogels (SHs) offer the opportunities of the modulation physico-chemical properties of hydrogels in response to external stimuli (light, pressure, pH variations, magnetic/electric field, etc.) in order to achieve innovative behavior of their three-dimensional matrix (gel-sol transitions, self-healing and self-adapting abilities, controlled release of drugs). The SHs response to different triggers depends on their composition, cross-linking method, and manufacturing process approach. Both native or functionalized natural and synthetic polymers may be used to develop stimuli-responsive matrices, while the mandatory characteristics of hydrogels (biocompatibility, water permeability, bioadhesion) are preserved. In this review, we briefly present the physiopathology and healing mechanisms of chronic wounds, as well as current therapeutic approaches. The rational of using traditional hydrogels and SHs in wound healing, as well as the current research directions for developing SHs with innovative features, are addressed and discussed along with their limitations and perspectives in industrial-scale manufacturing.

Enzymatically-Crosslinked Gelatin Hydrogels with Nanostructured Architecture and Self-Healing Performance for Potential Use as Wound Dressings

Development of natural protein-based hydrogels with self-healing performance and tunable physical properties has attracted increased attention owing to their wide potential not only in the pharmaceutical field, but also in wounds management. This work reports the development of a versatile hydrogel based on enzymatically-crosslinked gelatin and nanogels loaded with amoxicillin (Amox), an antibiotic used in wound infections. The transglutaminase (TGase)-crosslinked hydrogels and encapsulating nanogels were formed rapidly through enzymatic crosslinking and self-assembly interactions in mild conditions. The nanogels formed through the self-assemble of maleoyl-chitosan (MAC5) and polyaspartic acid (PAS) may have positive influence on the self-healing capacity and drug distribution within the hydrogel network through the interactions established between gelatin and gel-like nanocarriers. The physicochemical properties of the enzymatically-crosslinked hydrogels, such as internal structure, swelling and degradation behavior, were studied. In addition, the Amox release studies indicated a rapid release when the pH of the medium decreased, which represents a favorable characteristic for use in the healing of infected wounds. It was further observed through the in vitro and in vivo biocompatibility assays that the optimized scaffolds have great potential to be used as wound dressings.

Self-Healing Chitosan Hydrogels: Preparation and Rheological Characterization

The paper aims at the preparation of chitosan self-healing hydrogels, designed as carriers for local drug delivery by parenteral administration. To this aim, 30 hydrogels were prepared using chitosan and pyridoxal 5-phosphate (P5P), the active form of vitamin B6 as precursors, by varying the ratio of glucosamine units and aldehyde on the one hand and the water content on the other hand. The driving forces of hydrogelation were investigated by nuclear magnetic resonance (NMR), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction, and polarized light microscopy (POM) measurements. NMR technique was also used to investigate the stability of hydrogels over time, and their morphological particularities were assessed by scanning electron microscopy (SEM). Degradability of the hydrogels was studied in media of four different pH, and preliminary self-healing ability was visually established by injection through a syringe needle. In-depth rheological investigation was conducted in order to monitor the storage and loss moduli, linear viscoelastic regime, and structural recovery capacity. It was concluded that chitosan crosslinking with pyridoxal 5-phosphate is a suitable route to reach self-healing hydrogels with a good balance of mechanical properties/structural recovery, good stability over time, and degradability controlled by pH.

Current trends in chitosan based nanopharmaceuticals for topical vaginal therapies

Large surface area, rich vascularisation, well defined mucous membrane, balanced pH and relatively low enzymatic activity makes vagina a suitable site for drugs associated with women's health issues like Urinary tract infection (UTI) and vaginal infections. Therapeutic performance of intravaginal dosage forms largely depends on the properties of polymers and drugs. Chitosan (CS) because of its unique physical, chemical, pharmaceutical and biopharmaceutical properties have received a great deal of attention as an essential component in vaginal drug delivery systems. Further the presence of free amino and hydroxyl groups on the chitosan skeleton allows easy derivatization under mild conditions to meet specific application requirements. Moreover, CS-based nanopharmaceuticals like nanoparticles, nanofiber, nanogel, nanofilm, liposomes and micelles are widely studied to improve therapeutic performance of vaginal formulations. However, susceptibility of CS to the acidic pH of vagina, poor loading of hydrophobic drugs, rapid mucosal turn over are the key issues need to be addressed for successful outcomes. In this review, we have discussed the application of CS and CS derivatives in vaginal drug delivery and also highlight the recent progress in chitosan based nanocarrier platforms in terms of their limitations and potentials.

Advancements in release-active antimicrobial biomaterials: A journey from release to relief

Escalating medical expenses due to infectious diseases are causing huge socioeconomic pressure on mankind globally. The emergence of antibiotic resistance has further aggravated this problem. Drug-resistant pathogens are also capable of forming thick biofilms on biotic and abiotic surfaces to thrive in a harsh environment. To address these clinical problems, various strategies including antibacterial agent delivering matrices and bactericidal coatings strategies have been developed. In this review, we have discussed various types of polymeric vehicles such as hydrogels, sponges/cryogels, microgels, nanogels, and meshes, which are commonly used to deliver antibiotics, metal nanoparticles, and biocides. Compositions of these polymeric matrices have been elaborately depicted by elucidating their chemical interactions and potential activity have been discussed. On the other hand, various implant/device-surface coating strategies which exploit the release-active mechanism of bacterial killing are discussed in elaboration. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease.

Research Progress of Chitosan-Based Biomimetic Materials

Chitosan is a linear polysaccharide produced by deacetylation of natural biopolymer chitin. Owing to its good biocompatibility and biodegradability, non-toxicity, and easy processing, it has been widely used in many fields. After billions of years of survival of the fittest, many organisms have already evolved a nearly perfect structure. This paper reviews the research status of biomimetic functional materials that use chitosan as a matrix material to mimic the biological characteristics of bivalves, biological cell matrices, desert beetles, and honeycomb structure of bees. In addition, the application of biomimetic materials in wound healing, hemostasis, drug delivery, and smart materials is briefly overviewed according to their characteristics of adhesion, hemostasis, release, and adsorption. It also discusses prospects for their application and provides a reference for further research and development.

A series of carboxymethyl cellulose-based antimicrobial peptide mimics were synthesized for antimicrobial applications

Inspired by antimicrobial peptides (AMP) which could alleviate drug resistance pressure, antimicrobial peptide mimics (AMPMs) were designed timely. Here, carboxymethyl cellulose (CMC) -based AMPMs were constructed by introducing different diamines on CMC effectively. Firstly, CMC was degraded to be oligomers with different molecular weights, followed by amination reactions with different diamines respectively. After protonation, a series of AMPMs with different structures were synthesized successfully. Their antibacterial effect has been evaluated by dynamic growth curves and microdilution method. The images snapped by the confocal laser scanning microscope and transmission electron microscope have fully proved its great lethality. And the antibacterial mechanism measured by flow cytometry analysis and zeta potential detection demonstrated that the destruction of membrane potential leads to bacteria death. The excellent blood compatibility and negligible drug resistance has also been confirmed. In addition, the synthesis method is simple and environmental-friendly.

Exploration of Bioengineered Scaffolds Composed of Thermo-Responsive Polymers for Drug Delivery in Wound Healing

Innate and adaptive immune responses lead to wound healing by regulating a complex series of events promoting cellular cross-talk. An inflammatory response is presented with its characteristic clinical symptoms: heat, pain, redness, and swelling. Some smart thermo-responsive polymers like chitosan, polyvinylpyrrolidone, alginate, and poly(ε-caprolactone) can be used to create biocompatible and biodegradable scaffolds. These processed thermo-responsive biomaterials possess 3D architectures similar to human structures, providing physical support for cell growth and tissue regeneration. Furthermore, these structures are used as novel drug delivery systems. Locally heated tumors above the polymer lower the critical solution temperature and can induce its conversion into a hydrophobic form by an entropy-driven process, enhancing drug release. When the thermal stimulus is gone, drug release is reduced due to the swelling of the material. As a result, these systems can contribute to the wound healing process in accelerating tissue healing, avoiding large scar tissue, regulating the inflammatory response, and protecting from bacterial infections. This paper integrates the relevant reported contributions of bioengineered scaffolds composed of smart thermo-responsive polymers for drug delivery applications in wound healing. Therefore, we present a comprehensive review that aims to demonstrate these systems' capacity to provide spatially and temporally controlled release strategies for one or more drugs used in wound healing. In this sense, the novel manufacturing techniques of 3D printing and electrospinning are explored for the tuning of their physicochemical properties to adjust therapies according to patient convenience and reduce drug toxicity and side effects.

Intra-articular injection of anti-inflammatory peptide-loaded glycol chitosan/fucoidan nanogels to inhibit inflammation and attenuate osteoarthritis progression

Glycol chitosan/fucoidan nanogels loaded with anti-inflammatory peptide KAFAK (GC/Fu@KAFAK NGs) were fabricated based on the electrostatic interaction and genipin cross-linking methods. The prepared NGs had an average size of 286.3 ± 5.0 nm and positive surface charge of 14.0 ± 0.2 mV. The anti-inflammatory and chondro-protective effects of GC/Fu@KAFAK NGs were evaluated on interlecukin-1β (IL-1β)-stimulated rat chondrocytes. We found that GC/Fu@KAFAK NGs not only inhibited the expression of inflammatory factors interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), but also enhanced the expression of chondrogenic markers type II collagen, aggrecan, and Sox9. More importantly, in rat osteoarthritis (OA) model, the intra-articular (IA) injection of GC/Fu@KAFAK NGs reduced glycosaminoglycan loss and diminished inflammatory cytokine release. In addition, GC/Fu@KAFAK NGs showed good biocompatibility both in vitro and in vivo. In conclusion, IA inject-able GC/Fu@KAFAK NGs might have great potential in OA treatment.

Self-Assembled Nanocarriers Based on Modified Chitosan for Biomedical Applications: Preparation and Characterization

Protein-polysaccharide systems are of increasing interest as their combined attributes allow for fulfilling a broad range of applications in biomedical and pharmaceutical fields. In this study, the preparation of nanogels based on maleic anhydride chitosan derivatives (MAC) and bovine serum albumin (BSA) was achieved through a self-assembly process performed in aqueous phase. A series of experiments performed by varying the concentrations of MAC and BSA were conducted to find an appropriate mixing ratio for the polymer solutions leading to thermodynamically stable nanogels with the ability to encapsulate active compounds. The influence of temperature on the formation of nanogels was also studied. The consequent conformational changes were monitored using ultraviolet-visible (UV-VIS) spectrophotometry. The spectrophotometric investigations combined with diffraction light scattering (DLS) technique and zeta potential measurement results were correlated to determine the interaction mechanism and assess the self-assembling processes during nanogel formation. It was found that the hydrodynamic diameter (D_h) of the nanoparticles increased slightly at acidic pH, and the protonation of ionizable amino groups with the pH was confirmed by the zeta potential measurements. MAC/BSA nanogels also exhibited antimicrobial properties after being loaded with amoxicillin (Amox), which is an antibiotic used for the treatment of various infections. The experimental data resulting from this study provide theoretical guidance for the design and development of attractive nanocarriers for a large variety of biomedical applications.