Abstract

The extracellular matrix (ECM), comprising of hundreds of proteins, mainly collagen, provides physical, mechanical support for various cells and guides cell behavior as an interactive scaffold. However, deposition of ECM, especially collagen content, is seriously impaired in diabetic wounds, which cause inferior mechanical properties of the wound and further delay chronic wound healing. Thus, it is critical to develop ECM/collagen alternatives to remodel the mechanical properties of diabetic wounds and thus accelerate diabetic wound healing. Here, we firstly prepared mechanic-driven biodegradable PGA/SF nanofibrous scaffolds containing DFO for diabetic wound healing. In our study, the results in vitro showed that the PGA/SF-DFO scaffolds had porous three-dimensional nanofibrous structures, excellent mechanical properties, biodegradability, and biocompatibility, which would provide beneficial microenvironments for cell adhesion, growth, and migration as an ECM/collagen alternative. Furthermore, the data in vivo showed PGA/SF-DFO scaffolds can adhere well to the wound and have excellent biodegradability, which is helpful to avoid secondary damage by omitting the removal process of scaffolds. The finite element analysis results showed that the application of silk fibroin-based scaffolds could significantly reduce the maximum stress around the wound. Besides, PGA/SF-DFO scaffolds induced collagen deposition, re-vascularization, recovered impaired mechanical properties up to about 70%, and ultimately accelerated diabetic wound healing within 14 days. Thus, our work provides a promising therapeutic strategy for clinically chronic wound healing.

Highlights

  • IntroductionAbout 25% of diabetic patients will eventually develop a diabetic foot ulcer (DFU) [1,2]

  • Publisher’s Note: MDPI stays neutralDiabetes mellitus (DM) affects approximately 422 million patients worldwide [1].About 25% of diabetic patients will eventually develop a diabetic foot ulcer (DFU) [1,2].DFU, which leads to limb loss, disability, and even death, has caused serious medical, economic, and social burdens worldwide [3]

  • DFO was incorporated into Polyglycolic acid (PGA)/Silk fibroin (SF) nanofibrous scaffolds to obtain PGA/SF-DFO scaffolds by the amido bond (CO-NH) formation under EDC/NHS

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Summary

Introduction

About 25% of diabetic patients will eventually develop a diabetic foot ulcer (DFU) [1,2]. DFU, which leads to limb loss, disability, and even death, has caused serious medical, economic, and social burdens worldwide [3]. Normal skin wound healing is an intrinsic fundamental physiological process for ensuring the integrity of the skin and contains several overlapping stages: hemostasis, inflammation, proliferation, and remodeling [4]. ECM remodeling, involving a balance between formation, degradation, and maturation, is vital for optimum wound healing [8,9]. Accumulating evidence has proved that the highly orchestrated processes in diabetic wound healing are badly impaired [10], which leads to a reduction in ECM deposition, especially collagen content, inferior mechanical properties of the diabetic wound, and with regard to jurisdictional claims in published maps and institutional affiliations

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