Cellulose-Based Fibrous Materials From Bacteria to Repair Tympanic Membrane Perforations.

Bahareh Azimi,Mario Milazzo,Serena Danti

doi:10.3389/fbioe.2021.669863

Abstract

Perforation is the most common illness of the tympanic membrane (TM), which is commonly treated with surgical procedures. The success rate of the treatment could be improved by novel bioengineering approaches. In fact, a successful restoration of a damaged TM needs a supporting biomaterial or scaffold able to meet mechano-acoustic properties similar to those of the native TM, along with optimal biocompatibility. Traditionally, a large number of biological-based materials, including paper, silk, Gelfoam®, hyaluronic acid, collagen, and chitosan, have been used for TM repair. A novel biopolymer with promising features for tissue engineering applications is cellulose. It is a highly biocompatible, mechanically and chemically strong polysaccharide, abundant in the environment, with the ability to promote cellular growth and differentiation. Bacterial cellulose (BC), in particular, is produced by microorganisms as a nanofibrous three-dimensional structure of highly pure cellulose, which has thus become a popular graft material for wound healing due to a number of remarkable properties, such as water retention, elasticity, mechanical strength, thermal stability, and transparency. This review paper provides a comprehensive overview of the current experimental studies of BC, focusing on the application of BC patches in the treatment of TM perforations. In addition, computational approaches to model cellulose and TM are summarized, with the aim to synergize the available tools toward the best design and exploitation of BC patches and scaffolds for TM repair and regeneration.

Highlights

Bacterial cellulose (BC) is an extracellular polymer biosynthesized by bacteria from glucose and can be considered as the next-generation material due to its special properties, including high chemical purity, excellent water uptake, degree of polymerization up to 8000, high tensile strength and thermal stability due to the crystalline nanofibrillar structure coupled with the physico-chemical nature of BC
One remarkable field of application for BC is otology, and in particular the treatment of perforations of the Tympanic membrane (TM). Different factors, such as physical external trauma, purulent secretion or infections of the ear can result in eardrum perforation, which may bring to conductive hearing loss (CHL) and, possibly, long-term hearing damage (Mehta et al, 2006)
Chronic otitis media (COM) is a recurrent disease of the middle ear sustained by an ongoing inflammatory process typically associated with unresolved and resistant bacterial infections, and is a leading risk factor for TM perforations

Summary

Introduction

Bacterial cellulose (BC) is an extracellular polymer biosynthesized by bacteria from glucose and can be considered as the next-generation material due to its special properties, including high chemical purity (e.g., without any lignin and hemicellulose), excellent water uptake, degree of polymerization up to 8000, high tensile strength and thermal stability due to the crystalline nanofibrillar structure coupled with the physico-chemical nature of BC (de Olyveira et al, 2011; Annabi et al, 2013; Singhsa et al, 2018). One remarkable field of application for BC is otology, and in particular the treatment of perforations of the Tympanic membrane (TM) Different factors, such as physical external trauma, purulent secretion or infections of the ear can result in eardrum perforation, which may bring to conductive hearing loss (CHL) and, possibly, long-term hearing damage (Mehta et al, 2006). Anand et al (2020) produced poly(ethylene oxide terephthalate)/poly(butylene terephthalate) (PEOT/PBT)-based TM scaffolds using a hybrid fabrication strategy combining electrospinning and additive manufacturing. They evaluated their efficiency as functional biomimetic TM replacements. Kakehata et al (2008) have demonstrated that the application of chitin membrane in autologous serum eardrops therapy is a promising, safe, and feasible strategy for closing the TM perforations

Objectives

Conclusion