Short Walker D, Olutoye Oluyinka O, Padon Benjamin W, Parikh Umang M, Colchado Daniel, Vangapandu Hima, Shams Shayan, Chi Taiyun, Jung Jangwook P, Balaji Swathi
Laboratory for Regenerative Tissue Repair, Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, United States.
Department of Applied Data Science, San Jose State University, San Jose, CA, United States.
Front Bioeng Biotechnol. 2022 Sep 23;10:952198. doi: 10.3389/fbioe.2022.952198. eCollection 2022.
Impaired wound healing is a significant financial and medical burden. The synthesis and deposition of extracellular matrix (ECM) in a new wound is a dynamic process that is constantly changing and adapting to the biochemical and biomechanical signaling from the extracellular microenvironments of the wound. This drives either a regenerative or fibrotic and scar-forming healing outcome. Disruptions in ECM deposition, structure, and composition lead to impaired healing in diseased states, such as in diabetes. Valid measures of the principal determinants of successful ECM deposition and wound healing include lack of bacterial contamination, good tissue perfusion, and reduced mechanical injury and strain. These measures are used by wound-care providers to intervene upon the healing wound to steer healing toward a more functional phenotype with improved structural integrity and healing outcomes and to prevent adverse wound developments. In this review, we discuss bioengineering advances in 1) non-invasive detection of biologic and physiologic factors of the healing wound, 2) visualizing and modeling the ECM, and 3) computational tools that efficiently evaluate the complex data acquired from the wounds based on basic science, preclinical, translational and clinical studies, that would allow us to prognosticate healing outcomes and intervene effectively. We focus on bioelectronics and biologic interfaces of the sensors and actuators for real time biosensing and actuation of the tissues. We also discuss high-resolution, advanced imaging techniques, which go beyond traditional confocal and fluorescence microscopy to visualize microscopic details of the composition of the wound matrix, linearity of collagen, and live tracking of components within the wound microenvironment. Computational modeling of the wound matrix, including partial differential equation datasets as well as machine learning models that can serve as powerful tools for physicians to guide their decision-making process are discussed.
伤口愈合受损是一项重大的经济和医疗负担。新伤口中细胞外基质(ECM)的合成与沉积是一个动态过程,不断变化并适应伤口细胞外微环境的生化和生物力学信号。这会驱动再生性或纤维化及瘢痕形成的愈合结果。ECM沉积、结构和组成的破坏会导致疾病状态下的愈合受损,如糖尿病。成功进行ECM沉积和伤口愈合的主要决定因素的有效衡量标准包括无细菌污染、良好的组织灌注以及减少机械损伤和应变。伤口护理人员利用这些措施对正在愈合的伤口进行干预,以使愈合朝着具有更好结构完整性和愈合结果的更具功能性的表型发展,并防止伤口出现不良情况。在本综述中,我们讨论了生物工程在以下方面的进展:1)对愈合伤口的生物学和生理因素进行非侵入性检测;2)对ECM进行可视化和建模;3)基于基础科学、临床前、转化和临床研究有效评估从伤口获取的复杂数据的计算工具,这些工具将使我们能够预测愈合结果并进行有效干预。我们重点关注传感器和致动器的生物电子学和生物界面,以实现对组织的实时生物传感和致动。我们还讨论了高分辨率的先进成像技术,这些技术超越了传统的共聚焦和荧光显微镜,能够可视化伤口基质组成的微观细节、胶原蛋白的线性以及伤口微环境中成分的实时追踪。我们还讨论了伤口基质的计算建模,包括偏微分方程数据集以及机器学习模型,这些模型可作为强大工具帮助医生指导其决策过程。