Reactive Oxygen Species‐Scavenging Nanosystems in the Treatment of Diabetic Wounds

Abstract

Diabetic wounds are characterized by drug‐resistant bacterial infections, biofilm formation, impaired angiogenesis and perfusion, and oxidative damage to the microenvironment. Given their complex nature, diabetic wounds remain a major challenge in clinical practice. Reactive oxygen species (ROS), which have been shown to trigger hyperinflammation and excessive cellular apoptosis, play a pivotal role in the pathogenesis of diabetic wounds. ROS‐scavenging nanosystems have recently emerged as smart and multifunctional nanomedicines with broad synergistic applicability. The documented anti‐inflammatory and pro‐angiogenic ability of ROS‐scavenging treatments predestines these nanosystems as promising options for the treatment of diabetic wounds. Yet, in this context, the therapeutic applicability and efficacy of ROS‐scavenging nanosystems remain to be elucidated. Herein, the role of ROS in diabetic wounds is deciphered, and the properties and strengths of nanosystems with ROS‐scavenging capacity for the treatment of diabetic wounds are summarized. In addition, the current challenges of such nanosystems and their potential future directions are discussed through a clinical‐translational lens.

Adipose Mesenchymal Stem Cell Derived Exosomes Promote Keratinocytes and Fibroblasts Embedded in Collagen/Platelet‐Rich Plasma Scaffold and Accelerate Wound Healing

“…In multifunctional wound dressings, continuous release of exosomes can improve ROS damage, induce angiogenesis, enhance proliferation, granulation tissue formation, and collagen accumulation in diabetic wounds. [ 53 ] Here, in vitro experiments confirmed the promoting effect of ADSC‐exos on cell proliferation and migration. In vivo experiments showed that the scaffold based on ADSC‐exos could increase the number of blood vessels during wound repair, promote the proliferation of wound repair cells, and accelerate the healing process, which confirmed the considerable advantages of ADSC‐exos in vascularization and healing.…”

Wound microenvironment self-adaptive all-in-one hydrogel for rapid healing of the diabetic wound

“…The accumulated ROS in diabetic wounds surpasses the tissue's antioxidant capacity, which remarkably retards the self-healing of wounds. 28,29 L(+)-ascorbic acid, widely recognized for its antioxidant properties and excellent biocompatibility, has been extensively applied in clinical practice, including wound healing. 22,30 To validate whether hydrogel@lipo could promote diabetic wound healing, the ROS-scavenging efficacy was tested using 2 0 ,7 0 -dichlorodihydrofluorescein diacetate (DCFH-DA) and DPPH assays.…”

Novel Injectable, Self-Healing, Long-Effective Bacteriostatic, and Healed-Promoting Hydrogel Wound Dressing and Controlled Drug Delivery Mechanisms

“…The surface of healthy skin is generally weakly acidic, pH = 4.2–5.9. After skin being injured, the skin will first become briefly acidic due to the production of organic acids and increased local partial pressure of carbon dioxide, and then the value of pH will increase to 7.14–8.9 owing to the leakage from the microvessels. , With the recovery of the wound, the pH value will slowly return to the normal skin level, while the chronic wound will remain alkaline because of the continuous abnormal inflammation. − According to the acid–alkaline characteristics of wounds, wound dressings with different release characteristics at different wound healing stages can be designed.…”