硼酸/硼硅酸盐生物活性玻璃促创面愈合进展

Progress on Promoting Wound Healing with Boric Acid/Borosilicate Bioactive Glass

随着社会老龄化的加剧,慢性创伤患者的发病率和死亡率激增。高复发率慢性创面难以得到简单有效和低成本的治疗,加重了医疗系统的负担,致使临床对高疗效、新疗法和创新产品的需求持续增长。近年来研究表明,生物活性玻璃可以通过调节免疫相关巨噬细胞、内皮细胞、真皮成纤维细胞和表皮细胞等,促进伤口愈合,成为一种具有临床应用前景的伤口敷料。特别是硼酸盐和硼硅酸盐组成的生物活性玻璃显示出可控的降解速率,可针对伤口愈合不同病理阶段,持续性释放功能离子并调控伤口微环境,以此诱导血管新生和加速病理伤口组织稳态恢复。本文简要概述了硼酸/硼硅酸盐生物活性玻璃结构与性能关系,重点介绍了其临床应用研究进展,并对未来生物活性玻璃创面敷料的发展进行了展望。

The morbidity and mortality of patients with chronic wounds increase with the aggravation of social aging.The sharp rise in the burden of the medical system leads to an increased demand for high clinical efficacy,developed therapies,and innovative products.Bioactive glass(BGs)is well considered as a promising clinical material in biomedical fields,especially in wound healing.BGs stimulate the production of growth factors due to its unique controlled dynamic ion release properties,enhancing cell proliferation and regulating the gene expression of related cells.Particularly,the bioglass composed of borate and borosilicate exhibits a controllable degradation rate,which can continuously release functional ions and regulate the wound microenvironment for various pathological stages of wound healing to induce angiogenesis and accelerate the steady recovery of pathological wound tissue.In over 50 years of clinical and fundamental research,the efficacy of bone grafts in repairing bone tissue has been conclusively demonstrated,and biomaterial scientists have analyzed in depth the molecular biological mechanisms underlying the interaction between BGs and bone.Emerging applications of BGs for soft tissue repair still require a further research.This review represented a relationship between the structure and properties of boric acid/borosilicate bioactive glass,focusing on the clinical application research progress and future prospects for the development of bioglass wound dressings.Complicated factors make chronic wounds difficult to manage.The excessive inflammation is a key factor in wound pathogenesis.To treat chronic wounds,it is essential to comprehend how to prevent the development of microorganisms at the wound site,reduce ROS production and tissue inflammation,induce cells to release more growth factors,alter the cell vitality,chemotaxis and mobility,and initiate new blood vessel growth.The development of BGs reveals its positive role in the treatment,restoration,and regeneration of hard and soft tissues in the human body.Compared to conventional inactive biomaterials,its clinical application significance and potential are substantial.Borosilicate bioactive glass(BBGs)with a unique glass network structure has a faster degradation rate,compared to silicate bioactive glass,making it suitable for soft tissue repair.BBGs with specific functional properties can be produced via adjusting the proportion of biologically active elements(i.e.,Na,K,Ag,Au,B,Ca,Cu,Co,Ga,Mg,Sr and Zn)doped into the glass network structure according to the therapeutic needs of target tissues or organs.BBGs with different ion compositions can continuously release functional ions and regulate the wound microenvironment for different pathological stages of wound healing,thereby inducing angiogenesis and accelerating the steady-state recovery of pathological wound tissue.In addition to the superior clinical therapeutic effect by using fiber as clinical application dressing,BBGs can also combine with polymer to form functional hydrogel dressing,and can prepare multi-functional composite materials by electrospinning technology or 3D tissue engineering printing technology to meet the personalized needs of different stages of wound repair.The majority of chronic wound patients are affected with the intensification of global aging.Boric acid/borosilicate bioactive glass wound repair materials are low-cost,easy to store,and have significant social and economic benefits.Summary and prospects Although clinical and basic application studies have confirmed the potential of BBGs in wound healing applications,the structural composition of BBGs,especially the types and concentrations of therapeutic ions released,as well as the regularity and molecular biological mechanisms of pathological wound healing,still need a further exploration.The risk of soft tissue and organ toxicity,and even systemic toxicity caused by BBGs,is needed to be evaluated.Also,it is necessary to effectively evaluate and ensure the biosafety of BBGs dissolved ions,and to construct a more advanced in-vitro simulated wound dynamic microenvironment.In addition,combining BBGs as additives with other treatment strategies(such as stem cell therapy or growth factors or drugs)or technologies(such as negative pressure drainage)could be a possible synergistic strategy for promoting wound healing and repair.In summary,the existing researches indicate that the full potential of BGs in medicine is not fully developed,and the related market is expected to further grow in the future.