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A review of diabetic wound models-Novel insights into diabetic foot ulcer

Phang SJ, Arumugam B, Kuppusamy UR, Fauzi MB, Looi ML

J Tissue Eng Regen Med, 2021 12;15(12):1051-1068.
PMID: 34551455 DOI: 10.1002/term.3246

Diabetic foot ulcer (DFU) is a major debilitating complication of diabetes. Many research investigations have been conducted with the aims to uncover the diabetic wound healing mechanisms, develop novel therapeutics, and screen bioactive wound dressings in order to improve the current management of DFU. These would have not been possible without the utilization of an appropriate wound model, especially in a diabetic wound context. This review focuses on the different in vitro research models used in DFU investigations such as the 2D scratch wound assay, 3D skin model, and 3D angiogenesis model as well as their limitations. The current efforts and challenges to apply the 2D and 3D in vitro models in a hyperglycemic context to provide insights into DFU modeling will be reviewed. Perspectives of utilizing 3D bioprinting and skin-on-the-chip model as a diabetic wound model in the future will also be highlighted. By leveraging knowledge from past experiences and current research, an improved experimental model for DFU is anticipated to be established in near future.
Metal-free n/n-junctioned graphitic carbon nitride (g-C3N4): a study to elucidate its charge transfer mechanism and application for environmental remediation

Phang SJ, Goh JM, Tan LL, Lee WPC, Ong WJ, Chai SP

Environ Sci Pollut Res Int, 2021 Jan;28(4):4388-4403.
PMID: 32940840 DOI: 10.1007/s11356-020-10814-z

Graphitic carbon nitride (g-C3N4) has been regarded as a promising visible light-driven photocatalyst ascribable to its tailorable structures, thermal stability and chemical inertness. Enhanced photocatalytic activity is achievable by the construction of homojunction nanocomposites to reduce the undesired recombination of photogenerated charge carriers. In the present work, a novel g-C3N4/g-C3N4 metal-free homojunction photocatalyst was synthesized via hydrothermal polymerization. The g-C3N4/g-C3N4 derived from urea and thiourea demonstrated admirable photocatalytic activity towards rhodamine B (RhB) degradation upon irradiation of an 18 W LED light. The viability of the photoreaction with a low-powered excitation source highlighted the economic and environmental benefits of the process. The optimal g-C3N4/g-C3N4 homojunction photocatalyst exhibited a 2- and 1.8-fold increase in efficiency in relative to pristine g-C3N4 derived from urea and thiourea respectively. The enhanced photocatalytic performance is credited to the improved interfacial transfer and separation of electron-hole pairs across the homojunction interface. Furthermore, an excellent photochemical stability and durability is displayed by g-C3N4/g-C3N4 after three consecutive cycles. In addition, a plausible photocatalytic mechanism was proposed based on various scavenging tests. Overall, experimental results generated from this study is expected to intrigue novel research inspirations in developing metal-free homojunction photocatalysts to be feasible for large-scale wastewater treatment without compromising economically. Graphical abstract.
Synergistic effects of the hybridization between boron-doped carbon quantum dots and n/n-type g-C3N4 homojunction for boosted visible-light photocatalytic activity

Phang SJ, Lee J, Wong VL, Tan LL, Chai SP

Environ Sci Pollut Res Int, 2022 Jan 28.
PMID: 35088270 DOI: 10.1007/s11356-021-18253-0

Dye wastewater has raised a prevalent environmental concern due to its ability to prevent the penetration of sunlight through water, thereby causing a disruption to the aquatic ecosystem. Carbon quantum dots (CQDs) are particularly sought after for their highly tailorable photoelectrochemical and optical properties. Simultaneously, graphitic carbon nitride (g-C3N4) has gained widespread attention due to its suitable band gap energy as well as excellent chemical and thermal stabilities. Herein, a novel boron-doped CQD (BCQD)-hybridized g-C3N4 homojunction (CN) nanocomposite was fabricated via a facile hydrothermal route. The optimal photocatalyst sample, 1-BCQD/CN (with a 1:3 mass ratio of boron to CQD) accomplished a Rhodamine B (RhB, 10 mg/L) degradation efficiency of 96.8% within 4 h under an 18 W LED light irradiation. The kinetic rate constant of 1.39 × 10-2 min-1 achieved by the optimum sample was found to be 3.6- and 2.8-folds higher than that of pristine CN and un-doped CQD/CN, respectively. The surface morphology, crystalline structure, chemical composition and optical properties of photocatalyst samples were characterized via TEM, FESEM-EDX, XRD, FTIR, UV-Vis DRS and FL spectrometer. Based on the scavenging tests, it was revealed that the photogenerated holes (h+), superoxide anions (∙O2-) and hydroxyl radicals (∙OH) were the primary reactive species responsible for the photodegradation process. Overall, the highly efficient 1-BCQD/CN composite with excellent photocatalytic activity could provide a cost-effective and robust means to address the increasing concerns over global environmental pollution.
Fulltext In vitro evaluation of genipin-crosslinked gelatin hydrogels for vocal fold injection

Ng WC, Lokanathan Y, Fauzi MB, Baki MM, Zainuddin AA, Phang SJ, et al.

Sci Rep, 2023 Mar 29;13(1):5128.
PMID: 36991038 DOI: 10.1038/s41598-023-32080-y

Glottic insufficiency is one of the voice disorders affecting all demographics. Due to the incomplete closure of the vocal fold, there is a risk of aspiration and ineffective phonation. Current treatments for glottic insufficiency include nerve repair, reinnervation, implantation and injection laryngoplasty. Injection laryngoplasty is favored among these techniques due to its cost-effectiveness and efficiency. However, research into developing an effective injectable for the treatment of glottic insufficiency is currently lacking. Therefore, this study aims to develop an injectable gelatin (G) hydrogel crosslinked with either 1-ethyl-3-(3-dimethylaminpropyl)carbodiimide hydrochloride) (EDC) or genipin (gn). The gelation time, biodegradability and swelling ratio of hydrogels with varying concentrations of gelatin (6-10% G) and genipin (0.1-0.5% gn) were investigated. Some selected formulations were proceeded with rheology, pore size, chemical analysis and in vitro cellular activity of Wharton's Jelly Mesenchymal Stem Cells (WJMSCs), to determine the safety application of the selected hydrogels, for future cell delivery prospect. 6G 0.4gn and 8G 0.4gn were the only hydrogel groups capable of achieving complete gelation within 20 min, exhibiting an elastic modulus between 2 and 10 kPa and a pore size between 100 and 400 μm. Moreover, these hydrogels were biodegradable and biocompatible with WJMSCs, as > 70% viability were observed after 7 days of in vitro culture. Our results suggested 6G 0.4gn and 8G 0.4gn hydrogels as potential cell encapsulation injectates. In light of these findings, future research should focus on characterizing their encapsulation efficiency and exploring the possibility of using these hydrogels as a drug delivery system for vocal fold treatment.
Fulltext Antioxidant Biomaterials in Cutaneous Wound Healing and Tissue Regeneration: A Critical Review

Fadilah NIM, Phang SJ, Kamaruzaman N, Salleh A, Zawani M, Sanyal A, et al.

Antioxidants (Basel), 2023 Mar 23;12(4).
PMID: 37107164 DOI: 10.3390/antiox12040787

Natural-based biomaterials play an important role in developing new products for medical applications, primarily in cutaneous injuries. A large panel of biomaterials with antioxidant properties has revealed an advancement in supporting and expediting tissue regeneration. However, their low bioavailability in preventing cellular oxidative stress through the delivery system limits their therapeutic activity at the injury site. The integration of antioxidant compounds in the implanted biomaterial should be able to maintain their antioxidant activity while facilitating skin tissue recovery. This review summarises the recent literature that reported the role of natural antioxidant-incorporated biomaterials in promoting skin wound healing and tissue regeneration, which is supported by evidence from in vitro, in vivo, and clinical studies. Antioxidant-based therapies for wound healing have shown promising evidence in numerous animal studies, even though clinical studies remain very limited. We also described the underlying mechanism of reactive oxygen species (ROS) generation and provided a comprehensive review of ROS-scavenging biomaterials found in the literature in the last six years.
Molecular pathways of NF-ĸB and NLRP3 inflammasome as potential targets in the treatment of inflammation in diabetic wounds: A review

Teh HX, Phang SJ, Looi ML, Kuppusamy UR, Arumugam B

Life Sci, 2023 Dec 01;334:122228.
PMID: 37922981 DOI: 10.1016/j.lfs.2023.122228

Diabetic wounds are slow healing wounds characterized by disordered healing processes and frequently take longer than three months to heal. One of the defining characteristics of impaired diabetic wound healing is an abnormal and unresolved inflammatory response, which is primarily brought on by abnormal macrophage innate immune signaling activation. The persistent inflammatory state in a diabetic wound may be attributed to inflammatory pathways such as nuclear factor kappa B (NF-ĸB) and nod-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, which have long been associated with inflammatory diseases. Despite the available treatments for diabetic foot ulcers (DFUs) that include debridement, growth factor therapy, and topical anti-bacterial agents, successful wound healing is still hampered. Further understanding of the molecular mechanism of these pathways could be useful in designing potential therapeutic targets for diabetic wound healing. This review provides an update and novel insights into the roles of NF-ĸB and NLRP3 pathways in the molecular mechanism of diabetic wound inflammation and their potential as therapeutic targets in diabetic wound healing.
PVA/PVP Nanofibres Incorporated with Ecklonia cava Phlorotannins Exhibit Excellent Cytocompatibility and Accelerate Hyperglycaemic Wound Healing

Phang SJ, Teh HX, Looi ML, Fauzi MB, Neo YP, Arumugam B, et al.

Tissue Eng Regen Med, 2024 Feb;21(2):243-260.
PMID: 37865625 DOI: 10.1007/s13770-023-00590-5

BACKGROUND: Diabetic foot ulcer (DFU) is a major debilitating complication of diabetes. The lack of effective diabetic wound dressings has been a significant problem in DFU management. In this study, we aim to establish a phlorotannin-incorporated nanofibre system and determine its potential in accelerating hyperglycaemic wound healing.
METHODS: The effective dose of Ecklonia cava phlorotannins (ECP) for hyperglycaemic wound healing was determined prior to phlorotannin nanofibre fabrication using polyvinyl-alcohol (PVA), polyvinylpyrrolidone (PVP), and ECP. Vapour glutaraldehyde was used for crosslinking of the PVA/PVP nanofibres. The phlorotannin nanofibres were characterised, and their safety and cytocompatibility were validated. Next, the wound healing effect of phlorotannin nanofibres was determined with 2D wound scratch assay, whereas immunofluorescence staining of Collagen-I (Col-I) and Cytokeratin-14 (CK-14) was performed in human dermal fibroblasts (HDF) and human epidermal keratinocytes (HEK), respectively.
RESULTS: Our results demonstrated that 0.01 μg/mL ECP significantly improved hyperglycaemic wound healing without compromising cell viability and proliferation. Among all nanofibres, PVA/PVP/0.01 wt% ECP nanofibres exhibited the best hyperglycaemic wound healing effect. They displayed a diameter of 334.7 ± 10.1 nm, a porosity of 40.7 ± 3.3%, and a WVTR of 1718.1 ± 32.3 g/m2/day. Besides, the FTIR spectra and phlorotannin release profile validated the successful vapour glutaraldehyde crosslinking and ECP incorporation. We also demonstrated the potential of phlorotannin nanofibres as a non-cytotoxic wound dressing as they support the viability and proliferation of both HDF and HEK. Furthermore, phlorotannin nanofibres significantly ameliorated the impaired hyperglycaemic wound healing and restored the hyperglycaemic-induced Col-I reduction in HDF.
CONCLUSION: Taken together, our findings show that phlorotannin nanofibres have the potential to be used as a diabetic wound dressing.