Abstract

The rapidly increasing resistance of bacteria to currently approved antibiotic drugs makes surgical interventions and the treatment of bacterial infections increasingly difficult. In recent years, complementary strategies to classical antibiotic therapy have, therefore, gained importance. One of these strategies is the use of medicinal honey in the treatment of bacterially colonized wounds. One of the several bactericidal effects of honey is based on the in situ generation of hydrogen peroxide through the activity of the enzyme glucose oxidase. The strategy underlying this work is to mimic this antibacterial redox effect of honey in an injectable, biocompatible, and rapidly forming hydrogel. The hydrogel was obtained by thiol–ene click reaction between hyperbranched polyethylene glycol diacrylate (HB PEGDA), synthesized using reversible addition-fragmentation chain transfer (RAFT) polymerization, and thiolated hyaluronic acid (HA-SH). After mixing 500 µL HB PEGDA (10%, w/w) and 500 µL HA-SH (1%, w/w) solutions, hydrogels formed in ∼60 s (HB PEGDA/HA-SH 10.0–1.0), as assessed by the tube inverting test. The HB PEGDA/HA-SH 10.0–1.0 hydrogel (200 µL) was resistant to in vitro dissolution in water for at least 64 days, absorbing up to 130 wt% of water. Varying glucose oxidase (GO) amounts (0–500 U/L) and constant glucose content (2.5 wt%) were loaded into HB PEGDA and HA-SH solutions, respectively, before hydrogel formation. Then, the release of H2O2 was evaluated through a colorimetric pertitanic acid assay. The GO content of 250 U/L was selected, allowing the formation of 10.8 ± 1.4 mmol H2O2/L hydrogel in 24 h, under static conditions. The cytocompatibility of HB PEGDA/HA-SH 10.0–1.0 hydrogels loaded with different GO activities (≤ 500 U/L) at a constant glucose amount (2.5 wt%) was investigated by in vitro assays at 24 h with L929 and HaCaT cell lines, according to DIN EN ISO 10993-5. The tests showed cytocompatibility for GO enzyme activity up to 250 U/L for both cell lines. The antibacterial activity of HB PEGDA/HA-SH 10.0–1.0 hydrogels loaded with increasing amounts of GO was demonstrated against various gram-positive bacteria (S. aureus and S. epidermidis), antibiotic-resistant gram-positive bacteria (MRSA and MRSE), gram-negative bacteria (P. aeruginosa, E. coli, and A. baumanii), and antibiotic-resistant gram-negative strains (P. aeruginosa and E. coli) using agar diffusion tests. For all gram-positive bacterial strains, increasing efficacy was measured with increasing GO activity. For the two P. aeruginosa strains, efficacy was shown only from an enzyme activity of 125 U/L and for E. coli and A. baumanii, efficacy was shown only from 250 U/L enzyme activity. HB PEGDA/HA-SH 10.0–1.0 hydrogels loaded with ≤250 U/L GO and 2.5 wt% glucose are promising formulations due to their fast-forming properties, cytocompatibility, and ability to produce antibacterial H2O2, warranting future investigations for bacterial infection treatment, such as wound care.

Highlights

  • IntroductionThe huge problem of antibacterial resistance to antibiotics has increased the demand for drug-free antimicrobial strategies, and this has led to reevaluation of ancient antibacterial remedies, such as those derived from natural products, including honey (Mandal and Mandal, 2011).Research has been conducted on manuka (L. scoparium) honey, which has been demonstrated to be effective against several human pathogens, including Escherichia coli (E. coli), Enterobacter aerogenes, Salmonella typhimurium, Staphylococcus aureus (S. aureus), β-haemolytic streptococci, vancomycinresistant enterococci (VRE), and Pseudomonas aeruginosa (P. aeruginosa) (Mandal and Mandal, 2011; Shenoy et al, 2012).Honey has been widely studied for its bactericidal effects (Shenoy et al, 2012; Albaridi, 2019)

  • Research has been conducted on manuka (L. scoparium) honey, which has been demonstrated to be effective against several human pathogens, including Escherichia coli (E. coli), Enterobacter aerogenes, Salmonella typhimurium, Staphylococcus aureus (S. aureus), β-haemolytic streptococci, vancomycinresistant enterococci (VRE), and Pseudomonas aeruginosa (P. aeruginosa) (Mandal and Mandal, 2011; Shenoy et al, 2012)

  • An in situ producing H2O2-polyethylene glycol diacrylate (PEGDA)/HA-SH 10–1.0 hydrogel was developed that can be used as a drug-free antibacterial injectable hydrogel for the treatment of infected wounds

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Summary

Introduction

The huge problem of antibacterial resistance to antibiotics has increased the demand for drug-free antimicrobial strategies, and this has led to reevaluation of ancient antibacterial remedies, such as those derived from natural products, including honey (Mandal and Mandal, 2011).Research has been conducted on manuka (L. scoparium) honey, which has been demonstrated to be effective against several human pathogens, including Escherichia coli (E. coli), Enterobacter aerogenes, Salmonella typhimurium, Staphylococcus aureus (S. aureus), β-haemolytic streptococci, vancomycinresistant enterococci (VRE), and Pseudomonas aeruginosa (P. aeruginosa) (Mandal and Mandal, 2011; Shenoy et al, 2012).Honey has been widely studied for its bactericidal effects (Shenoy et al, 2012; Albaridi, 2019). Among them is SurgihoneyRO , a commercially available antibacterial product based on a bioengineered honey gel, which enzymatically produces H2O2 from glucose oxidase and glucose after application to a wound (Cooke et al, 2015). Another ROS-based commercially available wound dressing is Oxyzyme (Moffatt et al, 2014). The in situ formed hydrogen peroxide from Oxyzyme allows the oxidation of loaded iodide ions into iodine, exerting antimicrobial activity, and the formation of oxygen, favoring wound healing (Brimson and Nigam, 2013)

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