Astaneh Mohammad Ebrahim, Fereydouni Narges
Department of Anatomical Sciences, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran; Department of Tissue Engineering, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran; Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran.
Department of Anatomical Sciences, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran; Department of Tissue Engineering, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran; Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran; Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran.
Int J Biol Macromol. 2023 Dec 31;253(Pt 8):127607. doi: 10.1016/j.ijbiomac.2023.127607. Epub 2023 Oct 21.
The significant clinical challenge presented by diabetic wounds is due to their impaired healing process and increased risk of complications. It is estimated that a foot ulcer will develop at some point in the lives of 15-25 % of diabetic patients. Serious complications, including infection and amputation, are often led to by these wounds. In the field of tissue engineering and regenerative medicine, nanofiber-based wound dressings have emerged in recent years as promising therapeutic strategies for diabetic wound healing. Hyaluronic acid (HA), among various nanofiber materials, has gained considerable attention due to its unique properties, including biocompatibility, biodegradability, and excellent moisture retention capacity. By promoting skin hydration and controlling inflammation, a crucial role in wound healing is played by HA. Wounds are also helped to heal faster by HA through the regulation of inflammation levels and signaling the body to build more blood vessels in the damaged area. Great potential in various applications, including wound healing, has been shown by the development and use of nanofiber formulations in medicine. However, challenges and limitations associated with nanofibers in medicine exist, such as reproducibility, proper characterization, and biological evaluation. By providing a biomimetic environment that enhances re-epithelialization and facilitates the delivery of active substances, nanofibers promote wound healing. In accelerating wound healing, promising results have been shown by HA-contained nanofiber formulations in diabetic wounds. Key strategies employed by these formulations include revascularization, modulation of the inflammation microenvironment, delivery of active substances, photothermal nanofibers, and nanoparticle-loaded fabrics. Particularly crucial is revascularization as it restores blood flow to the wound area, promoting healing. Wound healing can also be enhanced by modulating the inflammation microenvironment through controlling inflammation levels. Future perspectives in this field involve addressing the current challenges and limitations of nanofiber technology and further optimizing HA-contained nanofiber formulations for improved efficacy in diabetic wound healing. This includes exploring new fabrication techniques, enhancing the biocompatibility and biodegradability of nanofibers, and developing multifunctional nanofibers for targeted drug delivery. Not only does writing a review in the field of nanofiber-based wound dressings, particularly those containing hyaluronic acid, allow us to consolidate our current knowledge and understanding but also broadens our horizons. An opportunity is provided to delve deeper into the intricacies of this innovative therapeutic strategy, explore its potential and limitations, and envision future directions. By doing so, a contribution can be made to the ongoing advancements in tissue engineering and regenerative medicine, ultimately improving the quality of life for patients with diabetic wounds.
糖尿病伤口带来的重大临床挑战源于其愈合过程受损以及并发症风险增加。据估计,15%至25%的糖尿病患者在其一生中的某个阶段会发生足部溃疡。这些伤口常常导致严重的并发症,包括感染和截肢。在组织工程和再生医学领域,近年来基于纳米纤维的伤口敷料已成为糖尿病伤口愈合的有前景的治疗策略。在各种纳米纤维材料中,透明质酸(HA)因其独特的性质,包括生物相容性、生物可降解性和出色的保湿能力而备受关注。通过促进皮肤水合作用和控制炎症,HA在伤口愈合中发挥着关键作用。HA还通过调节炎症水平并促使身体在受损区域生成更多血管,帮助伤口更快愈合。纳米纤维制剂在医学中的开发和应用在包括伤口愈合在内的各种应用中显示出巨大潜力。然而,医学中与纳米纤维相关的挑战和局限性依然存在,如可重复性、恰当表征和生物学评估。通过提供一种增强再上皮化并促进活性物质递送的仿生环境,纳米纤维可促进伤口愈合。含HA的纳米纤维制剂在加速糖尿病伤口愈合方面已显示出有前景的结果。这些制剂采用的关键策略包括血管再生、炎症微环境调节、活性物质递送、光热纳米纤维和载纳米颗粒织物。血管再生尤为关键,因为它可恢复伤口区域的血流,促进愈合。通过控制炎症水平来调节炎症微环境也可增强伤口愈合。该领域的未来前景包括应对纳米纤维技术当前的挑战和局限性,并进一步优化含HA的纳米纤维制剂以提高糖尿病伤口愈合的疗效。这包括探索新的制造技术、增强纳米纤维的生物相容性和生物可降解性,以及开发用于靶向药物递送的多功能纳米纤维。撰写一篇关于基于纳米纤维的伤口敷料,特别是含透明质酸的伤口敷料领域的综述,不仅能让我们巩固当前的知识和理解,还能拓宽我们的视野。这为我们深入探究这种创新治疗策略的复杂性、探索其潜力和局限性以及设想未来方向提供了契机。通过这样做,可为组织工程和再生医学的持续进步做出贡献,最终改善糖尿病伤口患者的生活质量。