Search Results (1,734)

Excessive reactive oxygen species (ROS) and bacterial infection were the important obstacles to impaired wound healing. Herein, by the use of innate bioactivities of natural polysaccharides and flavonoid glycosides, a multifunctional hydrogel was engineered through the Schiff base reaction between oxidized fucoidan (oFu) and lysine-modified chitosan (CS-Ly) for wound dressing. Rutin and silver nanoparticle (AgNP)-modified polydopamine (PDA) nanoparticles were incorporated into the hydrogel matrix, thereby exhibiting favorable ROS scavenging ability and adhesive property. Moreover, the hydrogel demonstrated strong antibacterial activity against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), with antibacterial rates of 81.8% and 78.2%, respectively. Moreover, the dynamic crosslinking endowed the hydrogel with adjustable degradation behavior and self-healing ability. When cocultured with NIH-3T3 cells, the hydrogel exhibited good biocompatibility. Based on the above results, these multifunctional hydrogels with excellent performance have great appealing potential in clinical materials for wound healing. Full article

Conformability of advanced dressings is a key parameter to evaluate their ability to adapt to the complex shape of the wound, which promotes its healing and prevents the formation of gaps at the wound interface, which, in turn, may favour microbial proliferation. However, conformability is normally measured by evaluating the mechanical properties of dressings and frequently under dry conditions, failing to evaluate the behaviour in clinical conditions, where the wound is normally characterized by large volumes of exudate. New methods are under study for its evaluation, but they generally require complex experimental procedures or specialized equipment. Here, we validate a simple and inexpensive method proposed for conformability characterization by testing its application to a variety of dressings, differing in composition and type of absorbing layer. We test the impact of different volumes of exudate-simulating solution and the impact of dressing size on the results. In addition, we implement the test by simultaneously evaluating other parameters (time of absorption, lateral spreading of the solution) that impact wound healing. Finally, we validate the test by demonstrating its capability to predict adaptability of complex wound shapes in specifically developed wound-mimicking models. Our results show that the test can be applied to all tested dressings, successfully highlighting differences in conformability and demonstrating high reproducibility. We demonstrate that conformability can largely vary between different dressings but is not affected by either dressing size or exudate volume, whereas lateral spreading and time of absorption can be significantly affected by both parameters. Finally, we demonstrate that the tests succeed in predicting adaptability to wounds of complex shape in tissue models; hence it is suitable for a simple and cost-effective measure of conformability. Full article

Background/Objectives: Mucosal healing (MH) is a key therapeutic target in inflammatory bowel disease (IBD) associated with sustained remission, reduced hospitalisation, and improved outcomes. Its assessment relies on endoscopic evaluation, which is invasive, costly, and not always feasible. Therapeutic drug monitoring (TDM) of infliximab (IFX) and evaluation of available biomarkers may provide non-invasive tools for predicting treatment response. This study investigated the association between IFX pharmacokinetics, routinely available blood biomarkers and MH to identify potential surrogates for predicting treatment outcomes. Methods: A monocentric, retrospective, real-world study was conducted, and pharmacokinetic analysis was performed in NONMEM version 7.5, applying a model with priors to estimate individual pharmacokinetic parameters. Endoscopic findings were collected, and patients were categorised according to achievement of MH. Univariate and multivariable logistic regression analyses were performed to evaluate the predictive value of tested variables, and receiver operating characteristic (ROC) curve analysis was performed to assess discriminative performance. Results: All evaluated variables demonstrated statistically significant associations with MH (p < 0.05). IFX clearance showed a strong inverse relationship with the probability of achieving MH. Leukocyte count exhibited particularly good discriminative ability, with an area under the ROC curve of 74.04% and an odds ratio of 0.78, highlighting its potential clinical utility. Multivariable logistic regression identified a model including IFX clearance and platelet count (PLT) as the most promising predictors of MH. Significant differences between patient subgroups indicated the association of higher PLT and modestly increased IFX clearance with a lower probability of MH. Conclusions: IFX clearance represents a promising surrogate marker for MH. TDM-derived parameters coupled with routinely available biomarkers may improve treatment response assessment. Combining pharmacokinetic and biomarker-based approaches could reduce reliance on repeated endoscopies while facilitating more effective IBD monitoring in clinical practice. Full article

Root perforations represent a pathological communication between the root canal system and the external root surface and are among the most serious complications in endodontics. Their occurrence leads to bacterial contamination and inflammatory tissue destruction, resulting in resorption of dentin, cementum, and alveolar bone, thereby compromising the tooth’s long-term prognosis. Objective: The aim of this review is to summarize current data regarding the etiology, diagnosis, treatment strategies, and contemporary materials used in the management of root perforations, with particular emphasis on recent advances in non-surgical treatment. Methods: A narrative literature review was conducted using sources from PubMed, Scopus, Web of Science, Embase, CINAHL, and the Cochrane Library. After applying a predefined search strategy of inclusion and exclusion criteria, 60 scientific sources published between 2003 and 2026 were included. Results: Current evidence indicates that the treatment outcome depends primarily on the location and size, prompt perforation sealing, bacterial contamination, and selection of restorative material. Cone-beam computed tomography has improved diagnostic accuracy, while a non-surgical approach remains the preferred approach in most clinical situations. Mineral trioxide aggregate (MTA) continues to be the reference standard material due to its biocompatibility, bioactivity and sealing ability. New-generation calcium-silicate bioceramics offer improved physicochemical properties, while maintaining favorable biological properties. Regenerative materials have shown promising potential to enhance healing processes, but available evidence remains limited. Conclusions: Successful treatment of root perforations requires early diagnosis, timely repair of the defect, effective bacterial control, and use of bioactive materials with reliable sealing and regenerative properties. Modern calcium-silicate bioceramics have improved non-surgical treatment predictability, whereas regenerative approaches appear to be a promising alternative that requires further clinical studies to develop standardized therapeutic protocols. Full article

This study reports the development of an intelligent dual-layer wound dressing engineered to achieve active wound repair. The self-standing dressing integrates a polyvinylidene fluoride (PVDF) piezoelectric electrospun membrane with a multifunctional hydrogel based on interfacial fusion. The PVDF layer converted mechanical energy derived from human body movement into electrical stimulation, which dramatically motivated the controlled release of diclofenac sodium (DFs) encapsulated in the hydrogel. The relatively small diameter fibers and network caused strong connection with the hydrogel and smooth transfer of electricity. When a positive potential of 1.5 V was applied, up to a 55 μg mL⁻¹ cumulative amount of DFs was released, about five times higher than that only based on drug diffusion. This enhanced release rate resulted from the cooperation of accelerated drug migration under electrically driven and dynamic changes of the gel’s microstructure, which was the result of reversible behavior of borate bonds within the hydrogel. Consequently, the hydrogel exhibited self-healing properties and a tensile strain of up to 600%, much higher than that of conventional hydrogels. Under mechanical motivation, the dressing exhibited enhanced DFs release ability, confirming the piezoelectric transition and controlled drug release abilities. Therefore, the present work offers an innovative solution for the intelligent management of chronic wounds. Full article

The management of chronic wounds represents one of the major challenges in regenerative medicine, as the healing process can be compromised by infections, oxidative stress, and persistent inflammation. In this context, wound pH serves as an important biomarker of tissue status, highlighting the need for smart dressings capable of promoting regeneration while simultaneously monitoring the wound microenvironment. In this study, biomimetic silk fibroin films functionalized with curcuminoids extracted from Curcuma longa were developed and characterized through spectroscopic, swelling/degradation, antioxidant, colorimetric, and biological assays, with the aim of obtaining a multifunctional dressing with regenerative properties and pH responsiveness. The results showed that curcuminoids were physically incorporated into the protein matrix without altering its chemical structure. The films exhibited a high absorption ability and antioxidant activity in the initial stages, and a clear and reversible color change in response to pH. Biological assays on 3T3 fibroblasts further confirmed the high cytocompatibility of the materials and their ability to support cell migration and wound closure in vitro. The developed films represent a promising biomimetic platform for advanced wound dressings, capable of combining support for tissue regeneration, antioxidant protection, and visual monitoring of wound status through the detection of pH changes. Full article

Agarose is a promising biopolymer for wound healing due to its biocompatibility and ability to form stable macroporous cryogels. However, its bioinert nature limits its antibacterial functionality, while conventional chemical modification can disrupt its macroporous architecture and mechanical integrity. Here, we present a versatile post-synthetic heterogeneous surface quaternization strategy to transform prefabricated agarose cryogels into surface-modified agarose cryogels (SMACs) with contact-active antibacterial functionality while preserving their interconnected supermacroporous architecture. Using 3-chloro-2-hydroxypropyltrimethylammonium chloride (CHPTAC) in an alkaline environment, quaternary ammonium moieties were covalently immobilized onto the agarose surface. A multivariable optimization approach examining reaction time, temperature, and scaffold concentration yielded surface quaternization values (DS_EA) of 0.05 and 0.11 for SMAC-4 and SMAC-24, respectively, with successful modification confirmed via SEM-EDX and FT-IR analyses. Quaternization altered the physicochemical and mechanical properties of the scaffolds; notably, the average porosity increased from 66.7% in AC-0 to 78.7% in SMAC-24 while maintaining the integrity of the porous structure. Biological evaluation against Escherichia coli and Staphylococcus aureus identified SMAC-24 as the most favorable formulation, exhibiting the strongest antibacterial activity and maintaining 88.1 ± 1.6% human umbilical vein endothelial cell (HUVEC) viability after 24 h of exposure to scaffold extracts. These findings demonstrate that post-synthetic surface quaternization provides agarose cryogels with contact-active antibacterial functionality and favorable cytocompatibility, highlighting their potential as non-leaching antibacterial agarose scaffolds for chronic wound care. Full article

Gingival recession from traumatic occlusal contact commonly affects feline mandibular premolars and molars. Although crown reduction is routinely performed to eliminate traumatic occlusal forces, its ability to restore established periodontal defects remains unclear. This study evaluated whether adjunctive periodontal surgery provides additional clinical benefits following crown reduction. This retrospective study included 17 cats (34 teeth) with malocclusion-associated gingival recession. Treatment grouping was performed at the tooth level, with one cat contributing teeth to both the Control and Group A. Teeth were classified into three groups: no treatment (Control), crown reduction alone (Group A), and crown reduction with adjunctive periodontal surgery (Group B). Gingival recession, clinical attachment level (CAL), root coverage, and the vertical bone defect ratio (VBDR) were evaluated before and after treatment. Between-group differences were analyzed using linear mixed-effects models. Control showed no significant changes. Both treatment groups showed significant improvements in gingival recession, CAL, and VBDR. Compared with crown reduction alone, adjunctive surgery yielded significantly greater CAL improvement, radiographic bone healing, and overall clinical success rate (91.7% in Group B vs. 25.0% in Group A), though root coverage did not differ significantly. Traumatic occlusion elimination is foundational for managing feline malocclusion-associated gingival recession. However, adjunctive periodontal surgery enhances periodontal recovery and overall success, offering a valuable tooth-preserving option when complete reconstruction is required. Full article

Natural compounds in topical gel formulations are recognized for their ability to enhance wound healing, particularly in the context of postoperative care, including that of cesarean sections. Background: Cesarean sections are among the most common surgical procedures globally, highlighting the importance of their successful healing. Complementary medicine aimed at pain relief and wound healing after a cesarean section has been investigated worldwide, and natural compounds are considered safe for topical use during pregnancy and breastfeeding. The aim of our study is to demonstrate the efficacy of the use of natural compounds in post-cesarean scar treatment. Materials and Methods: We compared Reparis, a topical gel entirely composed of natural compounds such as Centella asiatica and Aloe vera, with Cicatridine, a topical gel containing synthetic and natural compounds, such as almond oil, in post-cesarean wound treatment. We conducted an observational retrospective study in County Hospital Hunedoara between 26 February and 31 May 2026, evaluating specific measures that relate to the cosmetic results of scars after surgical procedures in our unit, with 50 patients using Reparis twice a day compared to the control group, which itself consisted of 50 patients using Cicatridine twice a day for 30 days. We employed the POSAS, an internationally validated questionnaire for evaluating patient and surgeon opinions regarding the appearance of a scar. Results: The most important difference favoring Reparis was observed after 6 months (p = 0.0001). In addition, Cicatridine exhibits a positive correlation with BMI; Reparis can be used in cases of higher BMI with good healing results. Conclusions: Natural compounds alone, such as Reparis, pose promising potential for wound healing, based on the findings of our observational study. The therapeutic properties of traditional medical plants have been verified but not always in controlled clinical trials. Our findings still require external validation. Full article

Hydrogel bio-adhesives have gained great attention in wound healing and tissue regeneration applications because conventional wound closures are often hindered by insufficient adhesion and poor biocompatibility. Considering that dynamic covalent interactions facilitate robust wet adhesion in hydrogels, we fabricated a Schiff base hydrogel bio-adhesive based on oxidized chondroitin sulfate (OCS) and polyethylenimine (PEI), and employed different degrees of OCS oxidation to regulate the physicochemical properties of the bio-adhesives. In this system, aldehyde groups of OCS react with amino groups of PEI to form covalent imine crosslinks, while physical hydrogen bonds also contribute as supplementary interactions. The fabricated hydrogel bio-adhesives demonstrated a three-dimensional interconnected microstructure and regulated equilibrium swelling ratios. The rheological tests also confirmed the typical viscoelasticity of the hydrogels and their shear-thinning behavior. The obtained hydrogel bio-adhesives demonstrated rapid and autonomous self-healing ability and strong adhesion to the surfaces of various matrices and wet organs, including wood, glass, metal, plastic, rubber, and heart, liver, spleen, stomach, and lung tissue. Furthermore, an ABTS radical scavenging assay confirmed their potent antioxidant activity. The hydrogels possessed effective antibacterial activities against Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. The hydrogels exhibited good hemocompatibility, effective intracellular reactive oxygen species (ROS) scavenging activity, favorable cytocompatibility, and promoted cell proliferation. These results confirmed the fabricated hydrogels via Schiff base connections for biomedical applications and provided a facile design for biomedical hydrogel bio-adhesives. Full article

Antiretroviral therapy (ART) is essential for controlling human immunodeficiency virus (HIV) infection, requiring strict daily adherence for lifelong viral suppression. However, this continuous oral dosing results in persistent exposure of the gastrointestinal tract (GIT), raising the need to investigate the effects of TC-ART (Tri-combinationL: Abacavir, Dolutegravir, Lamivudine–ART) on epithelial integrity, barrier recovery mechanisms, and surface barrier architecture. TC-ART exposure (125 µM to 4000 µM) showed marked alterations in transepithelial resistance, permeability, and wound-healing abilities even at sub-cytotoxic doses. The dose exposure range at the mid-dose level showed the highest transcriptional activity, characterized by a downregulation of junctional genes [claudins (CLDNs), desmogleins (DSGs), and junctional plakoglobin (JUP)] and signaling mediators [the signal transducer and activator of transcription 3 (STAT3), mitogen-activated protein kinase 1 and 3 (MAPK1/3), and catenin beta 1 (CTNNB1)], along with reduced IL-9 expression that is linked to mucin loss. These transcriptional changes were consistent with structural findings, including partial transepithelial electrical resistance (TEER) recovery followed by a decline, delayed wound closure, and waning of the apical mucin layer in a dose-dependent manner. However, several cytokines, like IL-2 and IL-6, showed increased secretion despite lower transcriptional levels, suggesting alternative regulatory control during early stress responses. Together, these results support that TC-ART exposure alters epithelial responses in a way that may transition from early adaptation to signs of impaired recovery, leading to a gradual decline in mucosal barrier function. Such concentration- and time-dependent epithelial stress may contribute to gastrointestinal disturbances observed in treated HIV populations, emphasizing the need for incorporating intestinal epithelial health endpoints in drug safety evaluations. Full article

Thermosensitive polyurethane (PU) hydrogels were prepared and loaded with meloxicam (MX), a nonsteroidal anti-inflammatory drug (NSAID). The role of different excipients, i.e., eucalyptus essential oil as well as poly(vinylpyrrolidone), poly(ethylene glycol) and their mixture, was highlighted. The sol–gel transition induced by temperature increase was evidenced by rheological measurements in oscillatory shear conditions. The viscoelastic behavior was investigated at 37 °C in various shear conditions, evidencing the network strength and stability of formulations. The structural recovery was monitored after applying high strain values, and the self-healing ability was revealed. Depending on the excipient, the gel samples loaded with MX release between 60% and 90% of the active substance. It was shown that the Fickian and chain relaxation contributions compete during MX release from PU-based hydrogels. In vitro anti-inflammatory activity was evaluated and discussed. Full article

Wound healing is a dynamic and highly coordinated process that involves inflammation, cell proliferation, angiogenesis, re-epithelialization, extracellular matrix remodeling, and tissue maturation. The altered expression of important signaling pathways, such as transforming growth factor-β (TGF-β)/Smad, nuclear factor-κB (NF-κB), phosphoinositide 3-kinase/protein kinase B (PI3K/Akt), mitogen-activated protein kinase (MAPK), and Wnt/β-catenin, may be responsible for slower wound healing, chronic inflammation, excessive fibrosis, and impaired tissue regeneration. Multifunctional nanomaterials are a promising strategy for tuning these highly coordinated processes due to their tunable physicochemical properties, high surface area, and the ability to deliver cargo, as well as the integration of antimicrobial, antioxidant, anti-inflammatory, and pro-angiogenic properties. The aim of current review is to summarize the potential of multifunctional nanomaterials to promote wound healing, with a focus on mechanisms of action and modulation of key cellular signaling pathways. A systematic review of the literature was conducted using PubMed, Scopus, Web of Science, and Google Scholar, searching for publications from 1996 to June 2026, and representative experimental, mechanistic, preclinical, and translational studies were critically evaluated. In this review, the authors discuss the role of nanomaterial properties, therapeutic payload, molecular targets, modulation of cellular signaling pathways, and regenerative effects. These platforms have been shown in in vitro and animal studies to influence inflammatory signaling, oxidative stress, angiogenesis, collagen remodeling, re-epithelialization, cellular proliferation, and migration. However, the modulation of these pathways are dose-responsive, time-dependent, and cell- and wound-stage-specific. Despite the promising therapeutic potential of nanomaterial-based wound care strategies, the available evidence remains predominantly preclinical, with relatively limited clinical data supporting their use in humans. Concerns regarding long-term toxicity, biodistribution, batch-to-batch reproducibility, sterilization, scalable manufacturing, regulatory approval, and commercial feasibility further challenge translation into clinical practice. Multifunctional nanomaterials may offer a promising approach for pathway-specific and multimodal wound management; however, comprehensive mechanistic studies, long-term safety and biodistribution assessments, and well-designed clinically relevant investigations are required to establish their efficacy, safety, and true translational potential. Full article

Hyaluronic acid (HA)-based hydrogels are widely used as wound-healing materials and topical delivery systems because of their excellent biocompatibility, water retention capacity, and ability to promote cell migration. However, HA is prone to oxidative chain scission, which reduces molecular weight and compromises formulation stability and functional performance. This study evaluated the feasibility of ergothioneine (EGT) as a candidate antioxidant stabilizing excipient in a model HA-based wound-healing material. CCK-8 assays assessed the biocompatibility of EGT in L929 mouse fibroblasts after 24 h of exposure, and a stress-screening framework including Fenton oxidation, high-temperature/high-humidity treatment, light exposure, and quiescent storage at 4 °C was established. The results showed that Fenton oxidation markedly induced HA degradation, whereas EGT incorporation effectively protected HA structural integrity under oxidative stress. Cell scratch assays further demonstrated that EGT did not interfere with the ability of HA to promote cell migration. EGT may serve as a candidate antioxidant stabilizing excipient for HA-based wound-healing materials, improving HA structural and material stability under oxidative challenge while preserving HA-associated cell-migration function. Full article

Mesoporous silica nanoparticles (MSNs) have emerged as versatile nanocarriers for biomedical applications because of their unique physicochemical properties, including high surface area, large pore volume, excellent drug-loading capacity, controllable biodegradation, and facile surface functionalization. These characteristics have enabled the development of advanced drug delivery systems with enhanced therapeutic efficacy, targeted delivery, improved bioavailability, and reduced systemic toxicity. Recent advances in MSN synthesis, physicochemical properties, surface engineering, and functionalization strategies have significantly improved their biological performance and therapeutic potential. In particular, integrating polymers, lipids, and liposomes with MSN platforms has enhanced colloidal stability, circulation time, cellular uptake, and target specificity, thereby facilitating efficient, stimuli-responsive drug delivery. This review highlights MSN-based drug delivery systems in cancer therapy, where multifunctional nanocarriers enable site-specific delivery, controlled drug release, enhanced tumor accumulation, and reduced off-target effects. The review discusses the expanding roles of MSNs in antimicrobial therapy, wound healing, tissue engineering, and regenerative medicine, emphasizing their ability to promote localized therapeutic delivery, immunomodulation, angiogenesis, and tissue regeneration. The review discusses the diagnostic and theragnostic capabilities of MSNs for disease imaging and monitoring. It also critically evaluates current challenges related to biocompatibility, biodegradation, toxicity, biological barriers, large-scale manufacturing, clinical translation, and regulatory considerations. This review provides a comprehensive overview of recent progress, current limitations, and future opportunities for MSN-based platforms in targeted drug delivery and advanced biomedical applications, supporting their continued advancement toward clinical translation and precision medicine. Full article