Modulating the immune system towards a functional chronic wound healing: A biomaterials and Nanomedicine perspective

IF 15.2 1区医学 Q1 PHARMACOLOGY & PHARMACY Advanced drug delivery reviews Pub Date : 2024-05-24 DOI:10.1016/j.addr.2024.115342

Kevin Las Heras , Itxaso Garcia-Orue , Fiorenza Rancan , Manoli Igartua , Edorta Santos-Vizcaino , Rosa Maria Hernandez

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Abstract

Chronic non-healing wounds persist as a substantial burden for healthcare systems, influenced by factors such as aging, diabetes, and obesity. In contrast to the traditionally pro-regenerative emphasis of therapies, the recognition of the immune system integral role in wound healing has significantly grown, instigating an approach shift towards immunological processes. Thus, this review explores the wound healing process, highlighting the engagement of the immune system, and delving into the behaviors of innate and adaptive immune cells in chronic wound scenarios. Moreover, the article investigates biomaterial-based strategies for the modulation of the immune system, elucidating how the adjustment of their physicochemical properties or their synergistic combination with other agents such as drugs, proteins or mesenchymal stromal cells can effectively modulate the behaviors of different immune cells. Finally this review explores various strategies based on synthetic and biological nanostructures, including extracellular vesicles, to finely tune the immune system as natural immunomodulators or therapeutic nanocarriers with promising biophysical properties.

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调节免疫系统，实现功能性慢性伤口愈合：生物材料与纳米医学的视角

受老龄化、糖尿病和肥胖等因素的影响，慢性伤口不愈合一直是医疗系统的沉重负担。与传统的促进再生疗法不同，人们越来越认识到免疫系统在伤口愈合中不可或缺的作用，并开始将研究方向转向免疫过程。因此，这篇综述探讨了伤口愈合过程，强调了免疫系统的参与，并深入研究了先天性和适应性免疫细胞在慢性伤口情况下的行为。此外，文章还探讨了基于生物材料的免疫系统调控策略，阐明了调整生物材料的理化特性或将其与药物、蛋白质或间充质基质细胞等其他制剂协同组合，可如何有效调控不同免疫细胞的行为。最后，本综述探讨了基于合成和生物纳米结构（包括细胞外囊泡）的各种策略，以精细调节免疫系统，使其成为具有良好生物物理特性的天然免疫调节剂或治疗性纳米载体。

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来源期刊

Advanced drug delivery reviews 医学-药学

CiteScore

28.10

自引率

5.00%

发文量

294

审稿时长

15.1 weeks

期刊介绍： The aim of the Journal is to provide a forum for the critical analysis of advanced drug and gene delivery systems and their applications in human and veterinary medicine. The Journal has a broad scope, covering the key issues for effective drug and gene delivery, from administration to site-specific delivery. In general, the Journal publishes review articles in a Theme Issue format. Each Theme Issue provides a comprehensive and critical examination of current and emerging research on the design and development of advanced drug and gene delivery systems and their application to experimental and clinical therapeutics. The goal is to illustrate the pivotal role of a multidisciplinary approach to modern drug delivery, encompassing the application of sound biological and physicochemical principles to the engineering of drug delivery systems to meet the therapeutic need at hand. Importantly the Editorial Team of ADDR asks that the authors effectively window the extensive volume of literature, pick the important contributions and explain their importance, produce a forward looking identification of the challenges facing the field and produce a Conclusions section with expert recommendations to address the issues.