Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, 361102, Fujian, China.
Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100090, China.
Mil Med Res. 2023 Aug 23;10(1):37. doi: 10.1186/s40779-023-00473-9.
The treatment of chronic and non-healing wounds in diabetic patients remains a major medical problem. Recent reports have shown that hydrogel wound dressings might be an effective strategy for treating diabetic wounds due to their excellent hydrophilicity, good drug-loading ability and sustained drug release properties. As a typical example, hyaluronic acid dressing (Healoderm) has been demonstrated in clinical trials to improve wound-healing efficiency and healing rates for diabetic foot ulcers. However, the drug release and degradation behavior of clinically-used hydrogel wound dressings cannot be adjusted according to the wound microenvironment. Due to the intricacy of diabetic wounds, antibiotics and other medications are frequently combined with hydrogel dressings in clinical practice, although these medications are easily hindered by the hostile environment. In this case, scientists have created responsive-hydrogel dressings based on the microenvironment features of diabetic wounds (such as high glucose and low pH) or combined with external stimuli (such as light or magnetic field) to achieve controllable drug release, gel degradation, and microenvironment improvements in order to overcome these clinical issues. These responsive-hydrogel dressings are anticipated to play a significant role in diabetic therapeutic wound dressings. Here, we review recent advances on responsive-hydrogel dressings towards diabetic wound healing, with focus on hydrogel structure design, the principle of responsiveness, and the behavior of degradation. Last but not least, the advantages and limitations of these responsive-hydrogels in clinical applications will also be discussed. We hope that this review will contribute to furthering progress on hydrogels as an improved dressing for diabetic wound healing and practical clinical application.
治疗糖尿病患者的慢性和非愈合性伤口仍然是一个主要的医学问题。最近的报告表明,水凝胶伤口敷料由于其出色的亲水性、良好的药物负载能力和持续的药物释放特性,可能是治疗糖尿病伤口的有效策略。作为一个典型的例子,透明质酸敷料(Healoderm)已在临床试验中证明可以提高糖尿病足溃疡的伤口愈合效率和愈合率。然而,临床使用的水凝胶伤口敷料的药物释放和降解行为不能根据伤口微环境进行调整。由于糖尿病伤口的复杂性,抗生素和其他药物经常与水凝胶敷料联合使用于临床实践中,尽管这些药物很容易受到恶劣环境的阻碍。在这种情况下,科学家们根据糖尿病伤口的微环境特征(如高葡萄糖和低 pH 值)或结合外部刺激(如光或磁场)创造了响应性水凝胶敷料,以实现可控的药物释放、凝胶降解和微环境改善,从而克服这些临床问题。这些响应性水凝胶敷料有望在糖尿病治疗性伤口敷料中发挥重要作用。在这里,我们综述了近年来在糖尿病伤口愈合方面响应性水凝胶敷料的最新进展,重点介绍了水凝胶结构设计、响应原理和降解行为。最后但同样重要的是,我们还讨论了这些响应性水凝胶在临床应用中的优缺点。我们希望这篇综述将有助于推动水凝胶作为改善糖尿病伤口愈合的敷料的进一步发展和实际的临床应用。
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