Biocatalytic nitric oxide generating hydrogels with enhanced anti-inflammatory, cell migration, and angiogenic capabilities for wound healing applications

Although wound healing is a normal physiological process in the human body, it is often impaired by bacterial infections, ischemia, hypoxia, and excess inflammation, which can lead to chronic and non-healing wounds. Recently, injectable hydrogels with controlled nitric oxide (NO) release behaviour have become potential wound healing therapeutic agents due to their excellent biochemical, mechanical, and biological properties. Here, we proposed novel multifunctional NO-releasing hydrogels that could regulate various wound healing processes, including hemostasis, inflammation, cell proliferation and angiogenesis. By incorporating the copper nanoparticles (NPs) in the network of dual enzymatically crosslinked gelatin hydrogels (GH/Cu), NO was in situ produced via the Cu-catalyzed decomposition of endogenous RSNOs available in the blood, thus resolving the intrinsic shortcomings of NO therapies, such as the short storage and release time, as well as the burst and uncontrollable release modes. We demonstrated that the NO-releasing gelatin hydrogels enhanced the proliferation and migration of endothelial cells, while promoting the M2 (anti-inflammatory) polarization of the macrophage. Furthermore, the effects of NO release on angiogenesis were evaluated using an in vitro tube formation assay and in ovo chicken chorioallantoic membrane (CAM) assay, which revealed that GH/Cu hydrogels could significantly facilitate neovascularization, consistent with the in vivo results. Therefore, we suggested that these hydrogel systems would significantly enhance the wound healing process through the synergistic effects of the hydrogels and NO, and hence could be used as advanced wound dressing materials.

A comparative study on essential oils from the leaves and stems of Vietnamese Mikania micrantha Kunth

Mikania micrantha Kunth is widely known as potential herbal medicine, although it is an invasive alien species in Southeast Asia. In this study, the essential oils from leaves and stems of M. micrantha were extracted by hydrodistillation method, and the chemical profiles of essential oils were then analysed by gas chromatography (GC) and gas chromatography coupled with mass spectrometry (GC/MS). It was found that there were similarities and differences in chemical compositions and their percentage between the essential oils obtained from these two parts. The dominant components of leaves essential oil are β-Cubebene, Germacrene D, and α-Zingiberene, accounting for 11.34%, 10.96%, and 10.76%, respectively. Additionally, the major components of stems essential oils are D-Limonene (16.99%), β-Pinene (7.91%), and α-Zingiberene (7.26%). The research sheds fresh light on the chemical makeup of M. micrantha essential oils, emphasising their potential for the future.

Potential from synergistic effect of quercetin and paclitaxel co-encapsulated in the targeted folic-gelatin-pluronic P123 nanogels for chemotherapy

Dual-drug delivery systems for anticancer therapy have recently attracted substantial attention due to their potency to overcome limitations of conventional anti-cancer drugs, tackle drug resistance problems, as well as improve the therapeutic efficacy. In this study, we introduced a novel nanogel based on folic acid-gelatin-pluronic P123 (FA-GP-P123) conjugate to simultaneously deliver quercetin (QU) and paclitaxel (PTX) to the targeted tumor. The results indicated that the drug loading capacity of FA-GP-P123 nanogels was significantly higher than that of P123 micelles. The kinetic release profiles of QU and PTX from the nanocarriers were governed by Fickian diffusion and swelling behavior, respectively. Notably, FA-GP-P123/QU/PTX dual-drug delivery system induced higher toxicity to MCF-7 and Hela cancer cells than either QU or PTX individual delivery system, and the non-targeted dug delivery system (GP-P123/QU/PTX), indicating the synergistic combination of dual drugs and FA positive targeting effect. Furthermore, FA-GP-P123 could effectively deliver QU and PTX to tumors in vivo after administration into MCF-7 tumor-bearing mice, which resulted in 94.20 ± 5.90 % of tumor volume reduced at day 14. Moreover, the side effects of the dual-drug delivery system were significantly reduced. Overall, we suggest FA-GP-P123 as potential nanocarrier for dual-drug delivery for targeted chemotherapy.

Feasibility of combining short tandem repeats (STRs) haplotyping with preimplantation genetic diagnosis (PGD) in screening for beta thalassemia

β-thalassemia is an autosomal recessive disease with the reduction or absence in the production of β-globin chain in the hemoglobin, which is caused by mutations in the Hemoglobin subunit beta (HBB) gene. In Vietnam, the number of β-thalassemia carriers range from 1.5 to 25.0%, depending on ethnic and geographical areas, which is much higher than WHO's data worldwide (1.5%). Hence, preimplantation genetic diagnosis (PGD) plays a crucial role in reducing the rate of β-thalassemia affected patients/carriers. In this research, we report the feasibility and reliability of conducting PGD in combination with the use of short tandem repeat (STR) markers in facilitating the birth of healthy children. Six STRs, which were reported to closely linked with the HBB gene, were used on 15 couples of β-thalassemia carriers. With 231 embryos, 168 blastocysts were formed (formation rate of 72.73%), and 88 were biopsied and examined with STRs haplotyping and pedigree analysis. Thus, the results were verified by Sanger sequencing, as a definitive diagnosis. Consequently, 11 over 15 couples have achieved pregnancy of healthy or at least asymptomatic offspring. Only three couples failed to detect any signs of pregnancy such as increased Human Chorionic Gonadotropin (HCG) level, foetal sac, or heart; and one couple has not reached embryo transfer as they were proposed to continue with HLA-matching to screen for a potential umbilical cord blood donor sibling. Thus, these results have indicated that the combination of PGD with STRs analysis confirmed by Sanger sequencing has demonstrated to be a well-grounded and practical clinical strategy to improve the detection of β-thalassemia in the pregnancies of couples at-risk before embryo transfer, thus reducing β-thalassemia rate in the population.

Injectable Reactive Oxygen and Nitrogen Species-Controlling Hydrogels for Tissue Regeneration: Current Status and Future Perspectives

The dual role of reactive oxygen and nitrogen species (RONS) in physiological and pathological processes in biological systems has been widely reported. It has been recently suggested that the regulation of RONS levels under physiological and pathological conditions is a potential therapy to promote health and treat diseases, respectively. Injectable hydrogels have been emerging as promising biomaterials for RONS-related biomedical applications owing to their excellent biocompatibility, 3-dimensional (3D) and extracellular matrix-mimicking structures, tunable properties, and easy functionalization. These hydrogels have been developed as advanced injectable platforms for locally generating or scavenging RONS, depending on the specific conditions of the target disease. In this review article, the design principles and mechanism by which RONS are generated/scavenged from hydrogels are outlined alongside a discussion of their in vitro and in vivo evaluations. Additionally, we highlight the advantages and recent developments of these injectable RONS-controlling hydrogels for regenerative medicines and tissue engineering applications.

In situ forming gelatin: Cyclodextrin hydrogels prepared by “click chemistry” to improve the sustained release of hydrophobic drugs

Injectable hydrogels offer a wide range of attractive benefits in drug delivery applications, such as non-invasive administration, easy drug incorporation and locally controlled release at the target sites. Herein, we designed a simple and efficient method to prepare injectable hydrogels composed of gelatin and cyclodextrin (CD) for high loading capacity of hydrophobic drugs. The hydrogels were formed by thiol-functionalized gelatin (GSH) and βCD-vinyl sulfone (βCD-VS) as cross-linker, via thiol-ene “click” chemistry. Hydrogels comprising of different cross-linker feed amount were investigated in terms of their physico-chemical properties, such as gelation time, mechanical strength, swelling ratio, porosity and degradation rates. For the use as a drug delivery vehicle, dexamethasone (DEX), a commonly anti-inflammatory, immunosuppressive but poorly water soluble drug was chosen to show the high drug loading capacity and prolonged drug release of hydrogels. The drug release was found to be depended on the concentration of βCD-VS due to the drug-CD interaction. In vitro cytotoxicity experiment also showed the cell compatibility of these hydrogels against human dermal fibroblasts. In summary, we expect this gelatin-CD “click” hydrogel will be a promising candidate for localized and long-term delivery of hydrophobic drugs.

Photocatalytic disinfection of Coliforms and degradation of natural organic matters in river water using titanate nanotubes

In this study, we synthesized and modified titanate nanotubes (TNTs) under different conditions of acid rinsing and calcination. The produced materials were then characterized by transmission electron microscopy, X-ray diffraction, ultraviolet-visible spectroscopy, temperature programmed desorption, inductively coupled plasma atomic emission spectroscopy, and Brunauer-Emmett-Teller analysis. The activity of material was evaluated via its application for disinfection of Coliforms and removal of natural organic matters (NOMs) in river water. Results showed that TNTs rinsed at pH 1.6 and calcined at 500°C had the highest removal efficiency for the treatment of Coliforms and NOMs in Sai Gon river water, possibly due to its high surface area, crystallinity, and surface acidity. The application of this TNTs material for the treatment of waters from Dong Nai River and Mekong River also show high removal efficiency, which could meet the quality standard for supply water, suggesting the potential of TNTs for practical drinking water treatment.

Supramolecular Gels Incorporating Cordyline terminalis Leaf Extract as a Polyphenol Release Scaffold for Biomedical Applications

Cordyline terminalis leaf extract (aqCT) possesses abundant polyphenols and other bioactive compounds, which are encapsulated in gelatin-polyethylene glycol-tyramine (GPT)/alpha-cyclodextrin (α-CD) gels to form the additional functional materials for biomedical applications. In this study, the gel compositions are optimized, and the GPT/α-CD ratios equal to or less than one half for solidification are found. The gelation time varies from 40.7 min to 5.0 h depending on the increase in GPT/α-CD ratios and aqCT amount. The aqCT extract disturbs the hydrogen bonding and host-guest inclusion of GPT/α-CD gel networks, postponing the gelation. Scanning electron microscope observation shows that all gels with or without aqCT possess a microarchitecture and porosity. GPT/α-CD/aqCT gels could release polyphenols from 110 to 350 nmol/mL at the first hour and sustainably from 5.5 to 20.2 nmol/mL for the following hours, which is controlled by feeding the aqCT amount and gel properties. GPT/α-CD/aqCT gels achieved significant antioxidant activity through a 100% scavenging DPPH radical. In addition, all gels are non-cytotoxic with a cell viability more than 85%. Especially, the GPT3.75α-CD10.5aqCT gels with aqCT amount of 3.1-12.5 mg/mL immensely enhanced the cell proliferation of GPT3.75α-CD10.5 gel without extract. These results suggest that the inherent bioactivities of aqCT endowed the resulting GPT/α-CD/aqCT gels with effective antioxidant and high biocompatibility, and natural polyphenols sustainably release a unique platform for a drug delivery system or other biomedical applications.

Tunable and high tissue adhesive properties of injectable chitosan based hydrogels through polymer architecture modulation

Chitosan-based hydrogels have been widely used for various biomedical applications due to their versatile properties such as biocompatibility, biodegradability, muco-adhesiveness, hemostatic effect and so on. However, the inherent rigidity and brittleness of pure chitosan hydrogels are still unmanageable, which has limited their potential use in biomaterial research. In this study, we developed in situ forming chitosan/PEG hydrogels with improved mechanical properties, using the enzymatic crosslinking reaction of horseradish peroxidase (HRP). The effect of PEG on physico-chemical properties of hybrid hydrogels was thoroughly elucidated by varying the content (0-100 %), molecular weight (4, 10 and 20 kDa) and geometry (linear, 4-arm) of the PEG derivatives. The resulting hydrogels demonstrated excellent hemostatic ability and are highly biocompatible in vivo, comparable to commercially available fibrin glue. We suggest these chitosan/PEG hybrid hydrogels with tunable physicochemical and tissue adhesive properties have great potential for a wide range of biomedical applications in the near future.

Three-Dimensional Printable Gelatin Hydrogels Incorporating Graphene Oxide to Enable Spontaneous Myogenic Differentiation

Three-dimensional (3D) bioprinting has attracted considerable attention for producing 3D engineered cellular microenvironments that replicate complex and sophisticated native extracellular matrices (ECM) as well as the spatiotemporal gradients of numerous physicochemical and biological cues. Although various hydrogel-based bioinks have been reported, the development of advanced bioink materials that can reproduce the complexity of ECM accurately and mimic the intrinsic property of laden cells is still a challenge. This paper reports 3D printable bioinks composed of phenol-rich gelatin (GHPA) and graphene oxide (GO) as a component for a myogenesis-inducing material, which can form a hydrogel network in situ by a dual enzyme-mediated cross-linking reaction. The in situ curable GO/GHPA hydrogel can be utilized successfully as 3D-printable bioinks to provide suitable cellular microenvironments with facilitated myogenic differentiation of C2C12 skeletal myoblasts. Overall, we suggest that functional bioinks may be useful in muscle tissue engineering and regenerative medicine.

Multifunctional surfaces through synergistic effects of heparin and nitric oxide release for a highly efficient treatment of blood-contacting devices

Thrombosis and inflammation after implantation remain unsolved problems associated with various medical devices with blood-contacting applications. In this study, we develop a multifunctional biomaterial with enhanced hemocompatibility and anti-inflammatory effects by combining the anticoagulant activity of heparin with the vasodilatory and anti-inflammatory properties of nitric oxide (NO). The co-immobilization of these two key molecules with distinct therapeutic effects is achieved by simultaneous conjugation of heparin (HT) and copper nanoparticles (Cu NPs), an NO-generating catalyst, via a simple tyrosinase (Tyr)-mediated reaction. The resulting immobilized surface showed long-term, stable and adjustable NO release for 14 days. Importantly, the makeup of the material endows the surface with the ability to promote endothelialization and to inhibit coagulation, platelet activation and smooth muscle cell proliferation. In addition, the HT/Cu NP co-immobilized surface enhanced macrophage polarization towards the M2 phenotype in vitro, which can reduce the inflammatory response and improve the adaptation of implants in vivo. This study demonstrated a simple but efficient method of developing a multifunctional surface for blood-contacting devices.

Calcium peroxide-mediated in situ formation of multifunctional hydrogels with enhanced mesenchymal stem cell behaviors and antibacterial properties

CaO₂ catalyzes the formation of in situ hydrogels with multifunctional properties through its decomposition into H₂O₂, O₂, and Ca²⁺ ions.

Graphene oxide immobilized surfaces facilitate the sustained release of doxycycline for the prevention of implant related infection

Preventing implant-associated infection, which can lead to implant failure and increased medical costs, is one of the biggest challenges in the orthopaedic surgeons. Therefore, the development of stable and highly effective surface modifications to increase the antimicrobial properties of implants is required. In this study, graphene oxide (GO-)-immobilized titanium dioxide (TiO₂) was developed to efficiently carry and release antimicrobial drugs. Firstly, tyramine-conjugated GO (GOTA) was synthesized and immobilized onto the surfaces of TiO₂ through tyrosinase (Tyr)-catalyzed oxidative reaction (GOTA/TiO₂). Doxycycline hyclate (Dox) was then loaded onto GOTA/TiO₂ via non-covalent interactions between GO and Dox (Dox/GOTA/TiO₂), including electrostatic interaction, π-π stacking, hydrophobic interaction, and hydrogen bonds. The amount of loaded drug was able to be controlled, reaching a maximum of 36 μg/cm². in vitro experiments revealed that the sustained release of Dox from the TiO₂ surfaces continued for over 30 days. Compared with bare TiO₂ and GOTA/TiO₂, Dox/GOTA/TiO₂ exhibited superior antibacterial activity against both gram-negative Escherichia coli and gram-positive Staphylococcus aureus bacteria, without affecting the viability of human dermal fibroblasts. The obtained results indicated that GO-immobilized TiO₂ is an effective carrier for antimicrobial drug delivery to reduce implant-associated infection through the synergistic antimicrobial effect of GO and the prescribed drugs.

Catechol-rich gelatin hydrogels in situ hybridizations with silver nanoparticle for enhanced antibacterial activity

Recently, the interest in antimicrobial hydrogels with impregnated antibacterial agents has significantly increased because of their ability to combat infection in biomedical applications, including wound management, tissue engineering, and biomaterial surface coating. Among these antibacterial reagents, silver nanoparticles (AgNP) show good antibacterial activity against both gram-negative and gram-positive bacteria, including highly multi-resistant strains. However, the entrapment of AgNP within a hydrogel matrix is often associated with toxicity issues because of the use of chemical reductants (e.g., commonly sodium borohydride), burst leaching, or unwanted agglomeration of AgNP in the absence of surfactants or stabilizers. In this study, we present catechol-rich gelatin hydrogels with in situ hybridization of AgNP for enhanced antimicrobial activities. AgNP were formed through a redox reaction between silver ions and the catechol moieties of a gelatin derivative polymer, without the addition of any chemical reductants. The AgNP with an average size of 20 nm were entrapped within hydrogel matrices and showed sustained release from the hydrogel matrix (8.7% for 14 days). The resulting hydrogels could kill both gram-negative and gram-positive bacteria, depending on the amount of AgNP released from the hydrogels and did not have a significant influence on mammalian cell viability. We believe that our catechol-rich hydrogels in situ hybridizations with AgNP have great potential for biomedical applications, such as wound management and surface coating, because of their excellent antibacterial activities and biocompatibility.

Sulfobetaine methacrylate hydrogel-coated anti-fouling surfaces for implantable biomedical devices

BACKGROUND

Zwitterionic molecules have been widely studied as coating materials for preparing anti-fouling surfaces because they possess strong hydration properties that can resist non-specific protein adsorption. Numerous studies on surface modification using zwitterionic molecules have been investigated, such as electrochemically mediated and photoinitiated radical polymerization. However, these methods have some limitations, including multi-step process, difficulties in producing thick and dense layers as well as the requirement of extra facilities. In this study, we report a novel zwitterionic hydrogel-coating method via Fenton reaction for the preparation of anti-fouling surfaces.

METHODS

Sulfobetaine methacrylate (SBMA) hydrogel was coated on polyurethane (PU) by polymerization of SBMA molecules via the Fenton reaction. The coated surfaces were characterized by the measurements of water contact angle, SEM and XPS. The anti-fouling properties of the modified surfaces were evaluated by reductions of fibrinogen absorption and cell (human dermal fibroblasts, hDFBs) adhesion.

RESULTS

SBMA hydrogel layers were coated on the PU substrates and these layers have a high affinity for water. The hydrogel coatings were highly stable for 7 days, without a significant change in surface wettability. Importantly, the hydrogel-coated PU substrates decrease 80% of surface-adsorbed fibrinogen and surface-attached hDFBs (compared with uncoated PU substrates), indicating the excellent anti-fouling activities of modified surfaces.

CONCLUSIONS

The hydrogel-coated PU surfaces prepared by Fenton reaction with anti-fouling properties could have potential uses for implantable biomedical devices.

Nitric oxide-releasing injectable hydrogels with high antibacterial activity through in situ formation of peroxynitrite

Nitric oxide (NO) is an endogenous molecule with many critical biological functions that depend on its concentration. At high levels, NO provides broad-spectrum antibacterial effects through both its pathogen inhibition and killing abilities. However, its short half-life has been a great challenge to its clinical application in pharmaceutical forms. In this study, we incorporated the NO donor S-nitrosothiolated gelatin (GelSNO) into injectable gelatin-based hydrogels (GHs) to controllably release NO. Under catalysis by horseradish peroxidase, H₂O₂ oxidizes phenol moieties functionalized on gelatin to quickly form phenol-phenol crosslinks that encapsulate GelSNO. Through thermal, visible light, and oxidizing agent-driven mechanisms, NO is released from the GH/GelSNO hydrogels. By varying the GelSNO concentration, the release of NO was controllable in a wide range, 0.054-2.050 μmol/mL, for up to 14 days. In addition, NO release was fine-tunable as a function of H₂O₂ concentration. Notably, the in situ formation of peroxynitrite (ONOO^-) that produces potent antibacterial effects originated from H₂O₂ residues and nitrous acid formed by NO and oxygen in aqueous solution. The Kirby-Bauer method indicated that there was an inhibition zone against both Escherichia coli and Staphylococcus aureus incubated with GH/GelSNO hydrogels. The AlarmaBlue assay showed that E. coli and S. aureus were completely killed at NO concentrations of 0.39 and 0.58 μmol/mL. Cytotoxicity tests of GH/GelSNO hydrogels on human dermal fibroblasts at the indicated bactericidal NO concentrations induced no cell toxicity. In summary, GH/GelSNO hydrogels may provide a new platform for topical delivery of NO in treating wound infections and for various biomedical applications.

STATEMENT OF SIGNIFICANCE

NO is an effective antibacterial agent even in cases of antibiotic-resistant bacteria. Moreover, its intermediate, peroxynitrite, has been reported to have a much higher ability to kill bacteria. In this study, we utilized injectable GH/GelSNO hydrogels formed by HRP/H₂O₂ reaction not only to control NO release but also to generate peroxynitrite in situ from released NO and H₂O₂ residues. The GH/GelSNO hydrogels showed significant antibacterial ability on both gram-positive and negative bacteria, while no cytotoxicity was induced on human dermal fibroblasts. In addition, their tunable chemico-physical properties and controllable NO release within a wide range but narrow scale will make the hydrogels useful in various biomedical applications.

Heparin-functionalized polymer graft surface eluting MK2 inhibitory peptide to improve hemocompatibility and anti-neointimal activity

The leading cause of synthetic graft failure includes thrombotic occlusion and intimal hyperplasia at the site of vascular anastomosis. Herein, we report a co-immobilization strategy of heparin and potent anti-neointimal drug (Mitogen Activated Protein Kinase II inhibitory peptide; MK2i) by using a tyrosinase-catalyzed oxidative reaction for preventing thrombotic occlusion and neointimal formation of synthetic vascular grafts. The binding of heparin-tyramine polymer (HT) onto the polycarprolactone (PCL) surface enhanced blood compatibility with significantly reduced protein absorption (64.7% decrease) and platelet adhesion (85.6% decrease) compared to bare PCL surface. When loading MK2i, 1) the HT depot surface gained high MK2i-loading efficiency through charge-charge interaction, and 2) this depot platform enabled long-term, controlled release over 4weeks (92-272μg/mL of MK2i). The released MK2i showed significant inhibitory effects on VSMC migration through down-regulated phosphorylation of target proteins (HSP27 and CREB) associated with intimal hyperplasia. In addition, it was found that the released MK2i infiltrated into the tissue with a cumulative manner in ex vivo human saphenous vein (HSV) model. This present study demonstrates that enzymatically HT-coated surface modification is an effective strategy to induce long-term MK2i release as well as hemocompatibility, thereby improving anti-neointimal activity of synthetic vascular grafts.

Tyrosinase-Mediated Surface Coimmobilization of Heparin and Silver Nanoparticles for Antithrombotic and Antimicrobial Activities

Thrombus and infections are the most common causes for the failure of medical devices, leading to higher hospitalization costs and, in some cases, patient morbidity. It is, therefore, necessary to develop novel strategies to prevent thrombosis and infection caused by medical devices. Herein, we report a simple and a highly efficient strategy to impart antithrombotic and antimicrobial properties to substrates, by simultaneously immobilizing heparin and in situ-synthesized silver nanoparticles (Ag NPs) via a tyrosinase-catalyzed reaction. This consists of tyrosinase-oxidized phenolic groups of a heparin derivative (heparin-grafted tyramine, HT) to catechol groups, followed by immobilizing heparin and inducing the in situ Ag NP formation onto poly(urethane) (PU) substrates. The successful immobilization of both heparin and in situ Ag NPs on the substrates was confirmed by analyses of water contact angles, XPS, SEM, and AFM. The sustained silver release and the surface stability were observed for 30 days. Importantly, the antithrombotic potential of the immobilized surfaces was demonstrated by a reduction in fibrinogen absorption, platelet adhesion, and prolonged blood clotting time. Additionally, the modified PU substrates also exhibited remarkable antibacterial properties against both Gram-positive and Gram-negative bacteria. The results of this work suggest a useful, effective, and time-saving method to improve simultaneous antithrombotic and antibacterial performances of a variety of substrate materials for medical devices.

In situ forming gelatin hydrogels by dual-enzymatic cross-linking for enhanced tissue adhesiveness

In situ forming hydrogels show promise as therapeutic implants and carriers in a wide range of biomedical applications. They can easily seal or fill damaged tissue, thereby functioning as cell/drug delivery vehicles or hemostats. In this regard, strong and stable adhesion to the surrounding tissue is considered an important parameter to improve the in vivo performance of in situ forming hydrogels. In this study, tissue-adhesive gelatin-based hydrogels were prepared by dual-enzymatic cross-linking, where horseradish peroxidase (HRP) and tyrosinase (Tyr) were used. Tyr was employed to convert phenol groups of gelatin derivatives into o-quinone, which can readily react with nucleophiles (e.g., amines or thiols) on tissue surfaces, thereby resulting in strong tissue adhesion. Incorporating Tyr (0.25 kU mL^-1) did not affect the gelation rate or mechanical strength of HRP-cross-linked hydrogels. Importantly, the dual-enzymatically cross-linked hydrogels (GH/HRP/Tyr) exhibited significantly improved adhesive strength (34 kPa), which was superior to single HRP-cross-linked hydrogels (GH/HRP; 19 kPa) and commercially available fibrin glues (7 kPa). These dual-enzymatically cross-linked gelatin-based hydrogels with strong adhesiveness could act as promising bio-adhesives for tissue-regeneration applications.

In situ forming gelatin hydrogels by dual-enzymatic cross-linking for enhanced tissue adhesiveness

In situ forming hydrogels show promise as therapeutic implants and carriers in a wide range of biomedical applications.

Aetiologies of central nervous system infection in Viet Nam: a prospective provincial hospital-based descriptive surveillance study

Background

Infectious diseases of the central nervous system (CNS) remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen.

Methods

We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007– April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology.

Results

We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52%) of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24%) and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%). Mycobacterium tuberculosis was confirmed in 34/617 (6%) adult patients and 11/624 (2%) paediatric patients. The acute case fatality rate (CFR) during hospital admission was 73/617 (12%) in adults and to 42/624 (7%) in children.

Conclusions

Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.