Newswise — The global population of patients with diabetic wounds is expected to rise to between 9.1 million to 26.1 million by 2030. Diabetic wounds severely impact patients’ quality of life, both physically and mentally while also imposing a substantial economic burden on healthcare systems.

Current treatment methods for diabetic wounds include surgical debridement, negative pressure wound therapy, vascularized flaps and different types of local dressings. Among these dressings, commonly used options include gauze, metal ion dressings, hydrogel dressings and platelet-rich plasma dressings. However, traditional dressings have limited drug loading capacity and permeability, and are unable to deliver active medications to the deep wound bed.

In recent years, microneedles have become a research focus in wound management due to their advantages of high drug load/delivery capabilities, minimal invasiveness, convenience and strong adhesion. These attributes significantly reduce patient discomfort and improve compliance. Microneedles enhance the efficiency and permeability of transdermal drug delivery by penetrating the skin barrier and incorporating drugs, proteins, nanoparticles and other therapeutic agents, effectively transporting them to the wound bed.

At present, there is a lack of summary articles on the application of microneedles of different structures and materials to diabetic wounds. This also hampers the development of microneedle dressings related to diabetic wounds.

To that end, in a review (https://doi.org/10.1016/j.cjprs.2023.12.004) published in the KeAi journal Chinese Journal of Plastic and Reconstructive Surgery, a group of researchers from the China summarizes the materials of microneedles, techniques, structure, design, release mechanism, classification of delivered substances and their effects on different stages of wound healing.

“The structural composition and material selection of microneedles influence their efficacy in treating diabetic wounds,” explains corresponding author of the study, Youbai Chen, a professor in plastic and reconstructive surgery at the First Medical Center of Chinese PLA General Hospital in Beijing. "Microneedles can promote diabetic wound healing through several mechanisms, such as antibacterial, anti-inflammatory, antioxidant, hypoglycemic and angiogenic activities at different stages of the healing process.”

“In conclusion, microneedles are promising drug delivery systems for the treatment of diabetic wounds,” adds first author Chun Liang. “We hope that our summary will be enlightening and instructive for further research on microneedle dressings."

Reference:
(1)Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005 Jan 12;293(2):217-28. doi: 10.1001/jama.293.2.217. PMID: 15644549.
(2)Armstrong DG, Boulton AJM, Bus SA. Diabetic Foot Ulcers and Their Recurrence. N Engl J Med. 2017 Jun 15;376(24):2367-2375. doi: 10.1056/NEJMra1615439. PMID: 28614678.
(3)Xiao J, Zhu Y, Huddleston S, Li P, Xiao B, Farha OK, Ameer GA. Copper Metal-Organic Framework Nanoparticles Stabilized with Folic Acid Improve Wound Healing in Diabetes. ACS Nano. 2018 Feb 27;12(2):1023-1032. doi: 10.1021/acsnano.7b01850. Epub 2018 Feb 12. PMID: 29406741.
(4)Jiang P, Li Q, Luo Y, Luo F, Che Q, Lu Z, Yang S, Yang Y, Chen X, Cai Y. Current status and progress in research on dressing management for diabetic foot ulcer. Front Endocrinol (Lausanne). 2023 Aug 17;14:1221705. doi: 10.3389/fendo.2023.1221705. PMID: 37664860; PMCID: PMC10470649.
(5)Wang Y, Lu H, Guo M, Chu J, Gao B, He B. Personalized and Programmable Microneedle Dressing for Promoting Wound Healing. Adv Healthc Mater. 2022 Jan;11(2):e2101659. doi: 10.1002/adhm.202101659. Epub 2021 Nov 1. PMID: 34699675.
(6)Roberts MS, Cheruvu HS, Mangion SE, Alinaghi A, Benson HAE, Mohammed Y, Holmes A, van der Hoek J, Pastore M, Grice JE. Topical drug delivery: History, percutaneous absorption, and product development. Adv Drug Deliv Rev. 2021 Oct;177:113929. doi: 10.1016/j.addr.2021.113929. Epub 2021 Aug 14. PMID: 34403750.
(7)Guo Z, Liu H, Shi Z, Lin L, Li Y, Wang M, Pan G, Lei Y, Xue L. Responsive hydrogel-based microneedle dressing for diabetic wound healing. J Mater Chem B. 2022 May 11;10(18):3501-3511. doi: 10.1039/d2tb00126h. PMID: 35416225.
(8)Carthew RW. Gene Regulation and Cellular Metabolism: An Essential Partnership. Trends Genet. 2021 Apr;37(4):389-400. doi: 10.1016/j.tig.2020.09.018. Epub 2020 Oct 19. PMID: 33092903; PMCID: PMC7969386.
(9)Xu J, Danehy R, Cai H, Ao Z, Pu M, Nusawardhana A, Rowe-Magnus D, Guo F. Microneedle Patch-Mediated Treatment of Bacterial Biofilms. ACS Appl Mater Interfaces. 2019 Apr 24;11(16):14640-14646. doi: 10.1021/acsami.9b02578. Epub 2019 Apr 12. PMID: 30933463.
(10)Wang Z, Wang J, Li H, Yu J, Chen G, Kahkoska AR, Wu V, Zeng Y, Wen D, Miedema JR, Buse JB, Gu Z. Dual self-regulated delivery of insulin and glucagon by a hybrid patch. Proc Natl Acad Sci U S A. 2020 Nov 24;117(47):29512-29517. doi: 10.1073/pnas.2011099117. Epub 2020 Nov 11. PMID: 33177238; PMCID: PMC7703584.
(11)Yao S, Wang Y, Chi J, Yu Y, Zhao Y, Luo Y, Wang Y. Porous MOF Microneedle Array Patch with Photothermal Responsive Nitric Oxide Delivery for Wound Healing. Adv Sci (Weinh). 2022 Jan;9(3):e2103449. doi: 10.1002/advs.202103449. Epub 2021 Nov 16. PMID: 34783460; PMCID: PMC8787387.
(12)Guillot AJ, Cordeiro AS, Donnelly RF, Montesinos MC, Garrigues TM, Melero A. Microneedle-Based Delivery: An Overview of Current Applications and Trends. Pharmaceutics. 2020 Jun 19;12(6):569. doi: 10.3390/pharmaceutics12060569. PMID: 32575392; PMCID: PMC7355570.

###

References

DOI

10.1016/j.cjprs.2023.12.004

Original Source URL

https://doi.org/10.1016/j.cjprs.2023.12.004

Funding information

This research was funded under Joint Logistic Support Force Grant for Outstanding Young Top Scholars (2022-22).

Journal

Chinese Journal of Plastic and Reconstructive Surgery

Journal Link: Chinese Journal of Plastic and Reconstructive Surgery