Delivery systems of current biologicals for the treatment of chronic cutaneous wounds and severe burns

• Published in: Advanced drug delivery reviews Vol. 129; pp. 219 - 241
• Main Authors: Xue, Meilang, Zhao, Ruilong, Lin, Haiyan, Jackson, Christopher
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.04.2018
• Subjects: Biologic; Chronic wounds; Cytokine; Extracellular matrix; Growth factor; Hydrogel; mRNA; Nanoparticle; Scaffold; Stem cells; Wound healing; CLI; PU; Nanoparticle; TNF; CTGF; DFU; SDF; cDNA; LSE; IL; Wound healing; FGF; HGF; AMS; iPSC; Cytokine; bFGF; MMP; Chronic wounds; TGF; AAV; Stem cells; Ang; NPWT; Hydrogel; Growth factor; FDA; NP; HTS; mRNA; BM; Scaffold; IFN; SC; ESC; miRNA; Extracellular matrix; MSC; PGE2; iMSC; EGF; VEGF; IGF; siRNA; KGF; ECM; antimiRs; PLGA; APC; CRISPR-Cas9; PDGF; EPC; EPCR; miRNA mimic; Biologic
• ISSN: 0169-409X; 1872-8294
• DOI: 10.1016/j.addr.2018.03.002

While wound therapy remains a clinical challenge in current medical practice, much effort has focused on developing biological therapeutic approaches. This paper presents a comprehensive review of delivery systems for current biologicals for the treatment of chronic wounds and severe burns. The biologicals discussed here include proteins such as growth factors and gene modifying molecules, which may be delivered to wounds free, encapsulated, or released from living systems (cells, skin grafts or skin equivalents) or biomaterials. Advances in biomaterial science and technologies have enabled the synthesis of delivery systems such as scaffolds, hydrogels and nanoparticles, designed to not only allow spatially and temporally controlled release of biologicals, but to also emulate the natural extracellular matrix microenvironment. These technologies represent an attractive field for regenerative wound therapy, by offering more personalised and effective treatments. To promote wound repair, strategies consisting of the administration of purified biologicals such as cytokines, growth factors and DNA/RNA; the delivery of biologicals from living systems, such as cells (cultured keratinocytes, stem cells), skin grafts or skin equivalents; or the combined delivery of purified biologicals and biologicals from living systems have been used. Purified biologicals can be applied systemically or locally by topical application or injections, which result in an uncontrolled burst release; they can also be encapsulated into predesigned biomaterial-based delivery systems such as scaffolds or hydrogels that better mimic the native ECM, then delivered to the wound area, which results in a gradient spatial release. In the future, use of biomimetic scaffolds/hydrogels incorporated with critical stem cell populations and growth factors or DNA/RNA released in a programmed spatiotemporal manner, taking into account genetic variability, wound type, and the patient's clinical and metabolic features, will offer more personalised and thus more effective therapies. Perhaps this will ultimately allow us to achieve foetal wound healing properties in adult wound healing, with complete regeneration of hair follicles and sweat glands, without chronicity or scarring. [Display omitted]