Department of Biomedical Engineering, Rutgers University, Piscataway, New Jersey, USA.
Department of Surgery (Plastic), Yale School of Medicine, New Haven, Connecticut, USA.
Adv Wound Care (New Rochelle). 2021 May;10(5):221-233. doi: 10.1089/wound.2019.1077. Epub 2020 Jun 2.
Chronic wounds are one of the major burdens of the U.S. health care system with an annual cost of $31.7 billion and affecting an estimated 2.4-4.5 million people. Several underlying molecular and cellular pathophysiological mechanisms, including poor vascularization, excessive extracellular matrix (ECM) degradation by proteases, decreased growth factor activity, and bacterial infection can lead to chronic wounds. More effective wound therapies need to address one or more of these mechanisms to significantly advance wound care. Self-assembled nanomaterials may provide new therapeutic options for chronic wound healing applications as those materials generally exhibit excellent biocompatibility and can bear multiple functionalities, such as ECM-mimicking properties, drug delivery capabilities, and tunable mechanics. Furthermore, self-assembled nanomaterials can be produced at low cost, and owing to their ability to self-organize, generate complex multifunctional structures that can be tailored to the varying sizes and shapes of chronic wounds. Self-assembled nanomaterials have been engineered to serve as wound dressings, growth factor delivery systems, and antimicrobials. As there are many different types of self-assembled nanomaterials, which in turn have different mechanisms of self-assembly and physiochemical properties, one type of self-assembled nanomaterials may not be sufficient to address all underlying mechanisms of chronic wounds. However, self-assembled nanomaterials can be easily tailored, and developing multifunctional self-assembled nanomaterials that can address various targets in chronic wounds will be needed. Future studies should investigate combinations of various self-assembled nanomaterials to take full advantage of their multifunctional properties.
慢性创面是美国医疗保健系统的主要负担之一,每年的治疗费用高达 317 亿美元,影响约 240 万至 450 万人。几种潜在的分子和细胞病理生理学机制,包括血管生成不良、蛋白酶过度降解细胞外基质 (ECM)、生长因子活性降低和细菌感染,可导致慢性创面。更有效的创面治疗方法需要针对这些机制中的一种或多种,才能显著推进创面护理。自组装纳米材料可为慢性创面愈合应用提供新的治疗选择,因为这些材料通常具有优异的生物相容性,并能承载多种功能,如 ECM 模拟特性、药物传递能力和可调力学性能。此外,自组装纳米材料的生产成本低,而且由于其自组织能力,可以生成复杂的多功能结构,这些结构可以根据慢性创面的不同大小和形状进行定制。自组装纳米材料已被设计用作创面敷料、生长因子传递系统和抗菌剂。由于有许多不同类型的自组装纳米材料,它们各自具有不同的自组装机制和物理化学性质,因此一种类型的自组装纳米材料可能不足以解决慢性创面的所有潜在机制。然而,自组装纳米材料可以很容易地进行定制,因此需要开发能够针对慢性创面各种靶点的多功能自组装纳米材料。未来的研究应探讨各种自组装纳米材料的组合,以充分利用它们的多功能特性。