1
|
Olteanu G, Neacșu SM, Joița FA, Musuc AM, Lupu EC, Ioniță-Mîndrican CB, Lupuliasa D, Mititelu M. Advancements in Regenerative Hydrogels in Skin Wound Treatment: A Comprehensive Review. Int J Mol Sci 2024; 25:3849. [PMID: 38612660 PMCID: PMC11012090 DOI: 10.3390/ijms25073849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/19/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
This state-of-the-art review explores the emerging field of regenerative hydrogels and their profound impact on the treatment of skin wounds. Regenerative hydrogels, composed mainly of water-absorbing polymers, have garnered attention in wound healing, particularly for skin wounds. Their unique properties make them well suited for tissue regeneration. Notable benefits include excellent water retention, creating a crucially moist wound environment for optimal healing, and facilitating cell migration, and proliferation. Biocompatibility is a key feature, minimizing adverse reactions and promoting the natural healing process. Acting as a supportive scaffold for cell growth, hydrogels mimic the extracellular matrix, aiding the attachment and proliferation of cells like fibroblasts and keratinocytes. Engineered for controlled drug release, hydrogels enhance wound healing by promoting angiogenesis, reducing inflammation, and preventing infection. The demonstrated acceleration of the wound healing process, particularly beneficial for chronic or impaired healing wounds, adds to their appeal. Easy application and conformity to various wound shapes make hydrogels practical, including in irregular or challenging areas. Scar minimization through tissue regeneration is crucial, especially in cosmetic and functional regions. Hydrogels contribute to pain management by creating a protective barrier, reducing friction, and fostering a soothing environment. Some hydrogels, with inherent antimicrobial properties, aid in infection prevention, which is a crucial aspect of successful wound healing. Their flexibility and ability to conform to wound contours ensure optimal tissue contact, enhancing overall treatment effectiveness. In summary, regenerative hydrogels present a promising approach for improving skin wound healing outcomes across diverse clinical scenarios. This review provides a comprehensive analysis of the benefits, mechanisms, and challenges associated with the use of regenerative hydrogels in the treatment of skin wounds. In this review, the authors likely delve into the application of rational design principles to enhance the efficacy and performance of hydrogels in promoting wound healing. Through an exploration of various methodologies and approaches, this paper is poised to highlight how these principles have been instrumental in refining the design of hydrogels, potentially revolutionizing their therapeutic potential in addressing skin wounds. By synthesizing current knowledge and highlighting potential avenues for future research, this review aims to contribute to the advancement of regenerative medicine and ultimately improve clinical outcomes for patients with skin wounds.
Collapse
Affiliation(s)
- Gabriel Olteanu
- Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania; (G.O.); (M.M.)
| | - Sorinel Marius Neacșu
- Department of Pharmaceutical Technology and Bio-Pharmacy, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020945 Bucharest, Romania; (S.M.N.); (D.L.)
| | - Florin Alexandru Joița
- Department of Pharmaceutical Technology and Bio-Pharmacy, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020945 Bucharest, Romania; (S.M.N.); (D.L.)
| | | | - Elena Carmen Lupu
- Department of Mathematics and Informatics, Faculty of Pharmacy, “Ovidius” University of Constanta, 900001 Constanta, Romania;
| | - Corina-Bianca Ioniță-Mîndrican
- Department of Toxicology, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020945 Bucharest, Romania;
| | - Dumitru Lupuliasa
- Department of Pharmaceutical Technology and Bio-Pharmacy, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020945 Bucharest, Romania; (S.M.N.); (D.L.)
| | - Magdalena Mititelu
- Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania; (G.O.); (M.M.)
| |
Collapse
|
2
|
Verdú-Soriano J, Casado-Díaz A, de Cristino-Espinar M, Luna-Morales S, Dios-Guerra C, Moreno-Moreno P, Dorado G, Quesada-Gómez JM, Rodríguez-Mañas L, Lázaro-Martínez JL. Hard-to-Heal Wound Healing: Superiority of Hydrogel EHO-85 (Containing Olea europaea Leaf Extract) vs. a Standard Hydrogel. A Randomized Controlled Trial. Gels 2023; 9:962. [PMID: 38131948 PMCID: PMC10742797 DOI: 10.3390/gels9120962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Chronic wounds, especially those that are hard-to-heal, constitute a serious public-health problem. Although progress has been made in the development of wound dressings for healing, there is little high-quality evidence of their efficacy, with no evidence of superiority in the use of one hydrogel over another. To evaluate the superiority of a hydrogel (EHO-85), containing Olea europaea leaf extract (OELE), over a standard hydrogel (SH), the promotion and/or improvement of healing of difficult-to-heal wounds was compared in a prospective, parallel-group multicenter, randomized, observer-blinded, controlled trial ("MACAON"). Non-hospitalized patients with pressure, venous or diabetic foot-ulcers difficult-to-heal were recruited and treated with standard care, and EHO-85 (n = 35) or VariHesive (n = 34) as SH. Wound-area reduction (WAR; percentage) and healing rate (HR; mm2/day) were measured. EHO-85 showed a statistically significant superior effect over VariHesive. At the end of the follow-up period, the relative WAR decreased by 51.6% vs. 18.9% (p < 0.001), with a HR mean of 10.5 ± 5.7 vs. 1.0 ± 7.5 mm2/day (p = 0.036). EHO-85 superiority is probably based on its optimal ability to balance the ulcer bed, by modulating pH and oxidative stress. That complements the wetting and barrier functions, characteristics of conventional hydrogels. These results support the use of EHO-85 dressing, for treatment of hard-to-heal ulcers. Trial Registration AEMPS:PS/CR623/17/CE.
Collapse
Affiliation(s)
- José Verdú-Soriano
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain
| | - Antonio Casado-Díaz
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Córdoba, Spain; (M.d.C.-E.); (S.L.-M.); (C.D.-G.); (P.M.-M.); (J.M.Q.-G.)
- Endocrinology and Nutrition Unit, Reina Sofia University Hospital, 14004 Córdoba, Spain
- Consortium for Biomedical Research in Frailty & Healthy Ageing (CIBERFES), Institute of Health Carlos III, 28029 Madrid, Spain; (G.D.); (L.R.-M.)
| | - Marisol de Cristino-Espinar
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Córdoba, Spain; (M.d.C.-E.); (S.L.-M.); (C.D.-G.); (P.M.-M.); (J.M.Q.-G.)
- Pharmacy Department, Reina Sofia University Hospital, 14004 Córdoba, Spain
| | - Silvia Luna-Morales
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Córdoba, Spain; (M.d.C.-E.); (S.L.-M.); (C.D.-G.); (P.M.-M.); (J.M.Q.-G.)
- Occidente Health Center, Córdoba and Guadalquivir Health Management Area, 14005 Córdoba, Spain
| | - Caridad Dios-Guerra
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Córdoba, Spain; (M.d.C.-E.); (S.L.-M.); (C.D.-G.); (P.M.-M.); (J.M.Q.-G.)
- Occidente Health Center, Córdoba and Guadalquivir Health Management Area, 14005 Córdoba, Spain
- Department of Nursing, Faculty of Medicine and Nursing, University of Cordoba, 14004 Córdoba, Spain
| | - Paloma Moreno-Moreno
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Córdoba, Spain; (M.d.C.-E.); (S.L.-M.); (C.D.-G.); (P.M.-M.); (J.M.Q.-G.)
- Endocrinology and Nutrition Unit, Reina Sofia University Hospital, 14004 Córdoba, Spain
| | - Gabriel Dorado
- Consortium for Biomedical Research in Frailty & Healthy Ageing (CIBERFES), Institute of Health Carlos III, 28029 Madrid, Spain; (G.D.); (L.R.-M.)
- Department Bioquímica y Biología Molecular, Campus Rabanales C6-1-E17, Campus de Excelencia Internacional Agroalimentario (ceiA3), Universidad de Córdoba, 14071 Córdoba, Spain
| | - José Manuel Quesada-Gómez
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Córdoba, Spain; (M.d.C.-E.); (S.L.-M.); (C.D.-G.); (P.M.-M.); (J.M.Q.-G.)
- Consortium for Biomedical Research in Frailty & Healthy Ageing (CIBERFES), Institute of Health Carlos III, 28029 Madrid, Spain; (G.D.); (L.R.-M.)
| | - Leocadio Rodríguez-Mañas
- Consortium for Biomedical Research in Frailty & Healthy Ageing (CIBERFES), Institute of Health Carlos III, 28029 Madrid, Spain; (G.D.); (L.R.-M.)
- Department of Geriatrics, University Hospital of Getafe, 28905 Getafe, Spain
| | - José Luis Lázaro-Martínez
- Diabetic Foot Unit, University Podiatry Clinic, Complutense University of Madrid, 28040 Madrid, Spain;
| |
Collapse
|
3
|
Torrecillas-Baena B, Camacho-Cardenosa M, Carmona-Luque MD, Dorado G, Berenguer-Pérez M, Quesada-Gómez JM, Gálvez-Moreno MÁ, Casado-Díaz A. Comparative Study of the Efficacy of EHO-85, a Hydrogel Containing Olive Tree ( Olea europaea) Leaf Extract, in Skin Wound Healing. Int J Mol Sci 2023; 24:13328. [PMID: 37686133 PMCID: PMC10487427 DOI: 10.3390/ijms241713328] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Olive tree (Olea europaea) leaf extract (OELE) has important antioxidant and anti-inflammatory properties, supporting its use in human clinical practice. We recently designed an amorphous hydrogel called EHO-85 (EHO indicates olive leaf extract in Spanish) containing OELE for skin ulcer treatments. Yet, its effectiveness has not been previously compared with other products used in routine clinical practice. This is necessary to evaluate its potential translation to the human clinic. Thus, in this study, the effect of EHO-85 on healing was evaluated in comparison with treatments containing Indian/Asiatic pennywort (Centella asiatica), hyaluronic acid, or dexpanthenol in a rat model. The speed of wound closure and histological parameters after seven and 14 days were analyzed. All treatments accelerated wound closure, but there were differences between them. Dexpanthenol after seven days produced the highest epithelialization and the lowest inflammation and vascularization. EHO-85 also promoted epithelialization and reduced vascularization. After 14 days, wounds treated with EHO-85 showed less inflammation and higher levels of collagen in the extracellular matrix. This indicates a higher degree of maturity in the regenerated tissue. In conclusion, the effect of EHO-85 on healing was equal to or superior to that of other treatments routinely used in human clinical practice. Therefore, these results, together with previous data on the effects of this hydrogel on ulcer healing in humans, indicate that EHO-85 is a suitable, low-cost, and efficient therapeutic option for wound healing.
Collapse
Affiliation(s)
- Bárbara Torrecillas-Baena
- Maimonides Institute of Biomedical Research in Cordoba (IMIBIC), 14004 Cordoba, Spain; (B.T.-B.); (M.C.-C.); (M.D.C.-L.); (J.M.Q.-G.)
- Endocrinology and Nutrition Unit, Reina Sofia University Hospital, 14004 Cordoba, Spain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Marta Camacho-Cardenosa
- Maimonides Institute of Biomedical Research in Cordoba (IMIBIC), 14004 Cordoba, Spain; (B.T.-B.); (M.C.-C.); (M.D.C.-L.); (J.M.Q.-G.)
- Endocrinology and Nutrition Unit, Reina Sofia University Hospital, 14004 Cordoba, Spain
| | - María Dolores Carmona-Luque
- Maimonides Institute of Biomedical Research in Cordoba (IMIBIC), 14004 Cordoba, Spain; (B.T.-B.); (M.C.-C.); (M.D.C.-L.); (J.M.Q.-G.)
- Cellular Therapy Unit, Reina Sofia University Hospital, 14004 Cordoba, Spain
| | - Gabriel Dorado
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Department Bioquímica y Biología Molecular, Campus Rabanales C6-1-E17, Campus de Excelencia Internacional Agroalimentario (ceiA3), Universidad de Córdoba, 14071 Córdoba, Spain
| | - Miriam Berenguer-Pérez
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
| | - José Manuel Quesada-Gómez
- Maimonides Institute of Biomedical Research in Cordoba (IMIBIC), 14004 Cordoba, Spain; (B.T.-B.); (M.C.-C.); (M.D.C.-L.); (J.M.Q.-G.)
| | - María Ángeles Gálvez-Moreno
- Maimonides Institute of Biomedical Research in Cordoba (IMIBIC), 14004 Cordoba, Spain; (B.T.-B.); (M.C.-C.); (M.D.C.-L.); (J.M.Q.-G.)
- Endocrinology and Nutrition Unit, Reina Sofia University Hospital, 14004 Cordoba, Spain
| | - Antonio Casado-Díaz
- Maimonides Institute of Biomedical Research in Cordoba (IMIBIC), 14004 Cordoba, Spain; (B.T.-B.); (M.C.-C.); (M.D.C.-L.); (J.M.Q.-G.)
- Endocrinology and Nutrition Unit, Reina Sofia University Hospital, 14004 Cordoba, Spain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| |
Collapse
|