Cao Yuqi, Sun Jiagui, Qin Shengao, Zhou Zhengshu, Xu Yanan, Liu Chenggang
School Basic Medical Sciences, Heilongjiang University of Chinese Medicine, 24 Heping Road, Harbin 150040, China.
Beijing Laboratory of Oral Health, Capital Medical University, 10 Xitoutiao, Beijing 100054, China.
Pharmaceutics. 2024 Jul 26;16(8):990. doi: 10.3390/pharmaceutics16080990.
Wound healing progresses through three distinct stages: inflammation, proliferation, and remodeling. Immune regulation is a central component throughout, crucial for orchestrating inflammatory responses, facilitating tissue repair, and restraining scar tissue formation. Elements such as mitochondria, reactive oxygen species (ROS), macrophages, autophagy, ferroptosis, and cytokines collaboratively shape immune regulation in this healing process. Skin wound dressings, recognized for their ability to augment biomaterials' immunomodulatory characteristics via antimicrobial, antioxidative, pro- or anti-inflammatory, and tissue-regenerative capacities, have garnered heightened attention. Notwithstanding, a lack of comprehensive research addressing how these dressings attain immunomodulatory properties and the mechanisms thereof persists. Hence, this paper pioneers a systematic review of biomaterials, emphasizing immune regulation and their underlying immunological mechanisms. It begins by highlighting the importance of immune regulation in wound healing and the peculiarities and obstacles faced in skin injury recovery. This segment explores the impact of wound metabolism, infections, systemic illnesses, and local immobilization on the immune response during healing. Subsequently, the review examines a spectrum of biomaterials utilized in skin wound therapy, including hydrogels, aerogels, electrospun nanofiber membranes, collagen scaffolds, microneedles, sponges, and 3D-printed constructs. It elaborates on the immunomodulatory approaches employed by these materials, focusing on mitochondrial and ROS modulation, autophagic processes, ferroptosis, macrophage modulation, and the influence of cytokines on wound healing. Acknowledging the challenge of antibiotic resistance, the paper also summarizes promising plant-based alternatives for biomaterial integration, including curcumin. In its concluding sections, the review charts recent advancements and prospects in biomaterials that accelerate skin wound healing via immune modulation. This includes exploring mitochondrial transplantation materials, biomaterial morphology optimization, metal ion incorporation, electrostimulation-enabled immune response control, and the benefits of composite materials in immune-regulatory wound dressings. The ultimate objective is to establish a theoretical foundation and guide future investigations in the realm of skin wound healing and related materials science disciplines.
炎症期、增殖期和重塑期。免疫调节贯穿始终，是核心组成部分，对于协调炎症反应、促进组织修复以及抑制瘢痕组织形成至关重要。线粒体、活性氧（ROS）、巨噬细胞、自噬、铁死亡和细胞因子等因素在这个愈合过程中共同塑造免疫调节。皮肤伤口敷料因其能够通过抗菌、抗氧化、促炎或抗炎以及组织再生能力增强生物材料的免疫调节特性而受到越来越多的关注。尽管如此，关于这些敷料如何获得免疫调节特性及其机制的全面研究仍然缺乏。因此，本文率先对生物材料进行系统综述，强调免疫调节及其潜在的免疫机制。文章首先强调免疫调节在伤口愈合中的重要性以及皮肤损伤恢复过程中面临的特殊性和障碍。这部分探讨了伤口代谢、感染、全身性疾病和局部固定对愈合过程中免疫反应的影响。随后，综述考察了用于皮肤伤口治疗的一系列生物材料，包括水凝胶、气凝胶、电纺纳米纤维膜、胶原支架、微针、海绵和3D打印结构。详细阐述了这些材料所采用的免疫调节方法，重点关注线粒体和ROS调节、自噬过程、铁死亡、巨噬细胞调节以及细胞因子对伤口愈合的影响。认识到抗生素耐药性的挑战，本文还总结了有前景的基于植物的生物材料替代物，包括姜黄素。在结论部分，综述梳理了通过免疫调节加速皮肤伤口愈合的生物材料的最新进展和前景。这包括探索线粒体移植材料、生物材料形态优化、金属离子掺入、电刺激介导的免疫反应控制以及复合材料在免疫调节伤口敷料中的优势。最终目标是为皮肤伤口愈合及相关材料科学领域的未来研究建立理论基础并提供指导。
